Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

AIM: The psychological impact of the coronavirus disease 2019 (COVID-19) pandemic on hospital workers has been reported, but most previous studies focused on the first year of the pandemic, and long-term monitoring remains scarce. This study aimed to evaluate the psychological status of hospital workers as of March 2023, and identify associated factors. METHODS: A cross-sectional survey was conducted in March 2023 among all workers at two university hospitals in Yokohama, Japan. Similar surveys were conducted in March-April 2020 and March 2021. The prevalence of general psychological stress, event-related stress, and suicidal ideation was assessed using the 12-item General Health Questionnaire (GHQ-12), the Impact of Event Scale-Revised (IES-R), and Item 9 of the Patient Health Questionnaire (PHQ-9), respectively. Multivariable logistic regression analysis was performed to identify associated factors. RESULTS: A total of 4244 questionnaires were distributed and 2635 responses (62.1%) were analyzed. Severe general stress, event-related stress, and suicidal ideation were observed in 38.0%, 18.1%, and 10.0% of participants, respectively. Regression analysis identified isolation, exhaustion, and being office workers or support staff as significant factors for general stress; living with a partner and feeling protected were inversely associated. Event-related stress was associated with clerical work, isolation, and exhaustion. Suicidal ideation was associated with younger age, isolation, and coexisting general and event-related stress, while the anxiety factor showed a negative association. CONCLUSION: This study highlights the sustained psychological burden experienced by hospital workers in 2023. The findings underscore the importance of strategies to reduce isolation and enhance mental health support in healthcare settings.

DOI： 10.1002/pcn5.70157

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Time toxicity in breast cancer refers to the time burden patients face from treatments, hospital visits, and managing side effects. As survival improves, attention has shifted to the impact of time spent on care. For those receiving long-term endocrine therapy, visiting hospital and waiting time for clinic affect their daily life. Thus, reducing time toxicity is essential to improve quality of life alongside survival outcomes. METHODS: This study surveyed postoperative breast cancer patients requiring hormonal therapy, who attended Yokohama City University Hospital from August 2023 to July 2024, using a digital self-administered survey to assess prescription refills. The Hospital Anxiety and Depression Scale and the original questionnaire were used to compare changes in status of patients before and after the introduction of prescription refills. RESULTS: A comparison of outpatient visits before and after prescription refills revealed a decreasing trend in visit frequency. Patient satisfaction showed a significant improvement, with patients giving higher ratings after prescription refills were introduced. The proportion of patients experiencing shorter waits increased, with 49% reporting a reduction in waiting times. Anxiety about extended visit intervals decreased, with only 1% of patients reporting increased anxiety. Notably, patient satisfaction with prescription refills remained high across various postoperative durations and age groups. Approximately 70% of patients expressed a desire to continue using prescription refills, indicating overall positive reception regardless of age or postoperative period. CONCLUSION: The introduction of prescription refills led to a reduction in outpatient visits and improvements in patient satisfaction and perceived waiting times. Prescription refills, recently introduced in Japan, are not yet widely recognized but may become a valuable tool for breast cancer patients and healthcare providers. Further research is required to assess the impact of the prescription refills on patient outcomes.

DOI： 10.1007/s12282-025-01761-z

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

BackgroundThe prevalence of Alzheimer's disease is increasing in Japan, highlighting the need to establish evidence-based strategies for its prevention.ObjectiveWe aimed to evaluate the effectiveness of a multimodal community-based intervention for Japanese older people with lifestyle-related diseases and to identify challenges in implementing such interventions to prevent dementia in local communities.MethodsAn 18-month randomized controlled trial was conducted among individuals aged 65-85 years with lifestyle-related diseases (hypertension, hyperlipidemia, diabetes, overweight/underweight, smoking), residing in a single apartment complex. Participants were randomly assigned to a multimodal intervention group (group-based physical exercise, nutritional guidance, management of lifestyle-related diseases, and cognitive training) or a control group. The primary outcome was the change in the composite score derived from seven neuropsychological tests. The trial was registered (UMIN000041887: September 24, 2020).ResultsOf 224 screened individuals, 198 were randomized (99 in each group), and 175 (88.4%) completed the 18-month assessment. There was no significant difference between the intervention and control groups in the primary outcome (change in composite test score: 0.25; 95% confidence interval 0.16 to 0.33 versus 0.29; 95% confidence interval 0.20 to 0.38, respectively; p = 0.463). However, a subgroup analysis of participants with mild cognitive impairment showed a significant intervention effect on changes in logical memory, for both immediate (p = 0.041) and delayed recall tasks (p = 0.043).ConclusionsThis multimodal intervention program demonstrated no effectiveness in mitigating cognitive decline. Further research is needed to develop more effective strategies and to better define target populations.

DOI： 10.1177/13872877251344222

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Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Given emerging evidence of immune involvement in Alzheimer's disease (AD), we aimed to clarify whether peripheral lymphocyte counts are associated with regional cerebral blood flow (rCBF) as measured by brain single-photon emission computed tomography (SPECT). Identifying such a relationship may help to establish early, accessible biomarkers of disease progression. METHODS: Participants were 111 patients diagnosed with AD at the Yokohama City University Hospital Medical Center for Dementia Diseases between January 2021 and December 2023 and who underwent blood tests and brain SPECT. Sex, age, cognitive function tests, peripheral blood values, and rCBF on brain SPECT were investigated retrospectively. Neutrophil and lymphocyte counts were extracted from blood values. In addition, the rCBF in each region (frontal, parietal, temporal, occipital, and limbic system) was calculated from brain SPECT, and correlation analysis between lymphocytes and rCBF was performed. RESULTS: Significant positive correlations between lymphocyte counts in peripheral blood and rCBF were found in all regions except the left frontal lobe. In particular, the correlation coefficient between rCBF and lymphocyte count was highest in the right temporal lobe (ρ = 0.311, P = 0.001). CONCLUSIONS: Peripheral blood lymphocyte counts are positively related to rCBF on brain SPECT, and lymphocytes can be an early biomarker that can be tested inexpensively and easily. Limitations include the retrospective cross-sectional design and single-center setting, which preclude analysis of causality and changes over time.

DOI： 10.1016/j.brainres.2025.149657

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Language：English   Publishing type：Research paper (scientific journal)  

The impact of Coronavirus Disease 2019 (COVID-19) is not limited to acute symptoms; it also extends to post-infection sequelae, such as long COVID and post-COVID conditions. These conditions are characterized by various symptoms, such as malaise, fatigue, and cognitive dysfunction, and are considered to reflect different underlying pathologies. Using a cluster analysis, we hypothesized that long COVID may have different psychosocial outcomes depending on the phenotype. This study is based on the COVID-19 RECOVERY STUDY II (CORES II) conducted in 20 centers in Japan. CORES II included patients aged 20 years and older who were hospitalized and discharged alive between April and September 2021. In CORES II, information collected at hospitalization was followed by an investigation one year after diagnosis into post-infection symptoms, physical and mental health, and patients' social circumstances. Long COVID symptoms, based on symptoms one month after infection, and psychosocial well-being, including anxiety, depression, post-traumatic stress disorder, and quality of life (QOL), one year after onset were assessed via questionnaires provided one year after diagnosis. We performed a cluster analysis based on long COVID symptoms. We also compared the psychosocial status between clusters. We identified five clusters of symptoms in 746 patients. These clusters were characterized by severe multi-organ dysfunction, olfactory and gustatory disturbances, shortness of breath, muscle weakness, and hair loss. The severe multi-organ dysfunction cluster included a large number of patients with malaise and who were more likely to have a poor psychosocial status one year after onset. In addition, the olfactory and gustatory disturbance cluster appeared to have the second highest depression and anxiety scores after the multi-organ dysfunction cluster. The results obtained on the five-symptom clusters suggest that the multi-organ dysfunction phenotype with malaise and olfactory and gustatory disturbances has psychosocial consequences. Patients with these phenotypes require more extensive follow-ups and interventions.

DOI： 10.1080/13548506.2025.2465654

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Language：Japanese   Publisher：(一社)日本認知症学会  

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Language：Japanese   Publisher：(公社)日本精神神経学会  

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Language：Japanese   Publisher：(一社)日本認知症学会  

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Language：Japanese   Publisher：(株)ワールドプランニング  

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