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Maki Nagaoka,1,2 Akihiro Koreki,1– 3 Teppei Kosugi,4 Akira Ninomiya,1,2 Masaru Mimura,2,5 Mitsuhiro Sado1,2,6 1Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Japan; 2Mindfulness & Stress Research Center, Keio University, Shinjuku-ku, Japan; 3Department of Psychiatry, National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba, Japan; 4Department of Psychiatry, Gunma Hospital, Takasaki, Japan; 5Keio University Centre for Preventive Medicine, Keio University, Shinjuku-ku, Japan; 6Keio University Health Center, Keio University, Yokohama City, JapanCorrespondence: Mitsuhiro Sado, Keio University Health Center, Keio University, 4-1-1 Hiyoshi, Kouhoku-ku, Yokohama City, Kanagawa, 223-8521, Japan, Tel +81-045-566-1055, Fax +81-045-566-1059, Email mitsusado@keio.jpPurpose: This study aimed to conduct an economic evaluation of mindfulness-based cognitive therapy (MBCT) in healthy participants by performing cost-utility analysis (CUA) and cost-benefit analysis (CBA).Patients and Methods: CUA was carried out from a healthcare sector perspective and CBA was from the employer’s perspective in parallel with a randomized controlled trial. Of the 90 healthy participants, 50 met the inclusion criteria and were randomized to the MBCT group (n = 25) or wait-list control group (n = 25). In the CUA, intervention costs and healthcare costs were included, while the mean difference in the change in quality-adjusted life years (QALYs) between the baseline and 16-week follow-up was used as an indicator of effect. Incremental cost-effectiveness ratio (ICER) was produced, and uncertainty was addressed using non-parametric bootstrapping with 5000 replications. In the CBA, the change in productivity losses was reflected as a benefit, while the costs included intervention and healthcare costs. The net monetary benefit was calculated, and uncertainty was handled with 5000 bootstrapping. Healthcare costs were measured with the self-report Health Service Use Inventory. The purchasing power parity in 2019 was used for currency conversion.Results: In the CUA, incremental costs and QALYs were estimated at JPY 19,700 (USD 189) and 0.011, respectively. The ICER then became JPY 1,799,435 (USD 17,252). The probability of MBCT being cost-effective was 92.2% at the threshold of 30,000 UK pounds per QALY. The CBA revealed that MBCT resulted in increased costs (JPY 24,180) and improved work productivity (JPY 130,640), with a net monetary benefit of JPY 106,460 (USD 1021). The probability of the net monetary benefit being positive was 69.6%.Conclusion: The results suggested that MBCT may be more cost-effective from a healthcare sector perspective and may be cost-beneficial from the employer’s perspective.Keywords: mindfulness, healthy individuals, cost-effectiveness, MBCT

Akihiro Koreki,1– 3 Maki Nagaoka,1,3 Akira Ninomiya,1,3 Masaru Mimura,1,3 Mitsuhiro Sado1,3,4 1Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; 2Department of Psychiatry, National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba, Japan; 3Center for Stress Research, Keio University, Tokyo, Japan; 4Health Center, Keio University, Tokyo, JapanCorrespondence: Mitsuhiro Sado, Department of Neuropsychiatry, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582, Japan, Tel +81-3-3353-1211 Ext. 62454, Fax +81-3-5379-0187, Email mitsusado@keio.jpPurpose: Cost-effective analysis is one of the most useful analyses for political decision-making in medicine under a limited budget. Although the data of the ICEpop CAPability measure for Adults (ICECAP-A) is sometimes essential for the measurement of cost effectiveness, such data are often lacking in most clinical trials. Therefore, a conversion formula (ie mapping) derived from the values of clinical assessment scales into utility is required.Patients and Methods: We used an internet survey where 500 general residents were asked to fill in four kinds of self-reported questionnaires [ICECAP-A, the Satisfaction with Life Scale (SWLS), Flourishing Scale (FS), and the Scale of Positive and Negative Experience (SPANE)]. A beta regression was conducted with the utility assessed by ICECAP-A as a dependent variable.Results: We developed several mapping formulae depending on available questionnaires. These mapping formulae were well-validated in our validation sample. The models using a greater number of questionnaires tended to show better mapping.Conclusion: The mapping function of our formula was within the range of other reported mapping studies. We believe this formula is useful for cost effective analyses of several trials where utility data are lacking.Keywords: mapping, well-being, ICECAP, SWLS, FS, SPANE

Mitsuhiro Sado,1,2 Teppei Kosugi,1 Akira Ninomiya,1,2 Sunre Park,3,4 Daisuke Fujisawa,1,4,5 Maki Nagaoka,1 Masaru Mimura1,2 1Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku, Tokyo, Japan; 2Center for Stress Research, Keio University, Shinjuku, Tokyo, Japan; 3Faculty of Nursing and Medicine Care, Keio University, Shinjuku, Tokyo, Japan; 4Palliative Care Center, Keio University Hospital, Shinjuku, Tokyo, Japan; 5Division of Patient Safety, Keio University Hospital, Shinjuku, Tokyo, JapanCorrespondence: Mitsuhiro SadoDepartment of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, JapanTel +81-03-3353-1211Fax +81-03-5379-0187Email mitsusado@keio.jpPurpose: Mindfulness-based cognitive therapy (MBCT) could be an intervention for improving subjective well-being among healthy individuals (HIs). However, MBCT studies for HIs to improve their subjective well-being are rare. The aim of this study was to report the feasibility, safety and effectiveness of MBCT for HIs in comparison with clinical samples.Patients and Methods: We conducted a single-arm, pre-post comparison pilot study offering MBCT to both HIs and people with common mental disorders. Twenty-four participants in total were included in the study. Eight weekly two-hour sessions with six monthly boosters were offered to all participants. Assessment was carried out at baseline, week 4, 8, and during follow-up. The 5-item World Health Organization Well-Being Index (WHO-5) was the primary clinical outcome measure.Results: The results showed the MBCT is sufficiently safe and would be more feasible in HIs compared to in clinical samples (attendance rate: 81.5% vs 61.3%, p=0.06). Although Satisfaction with Life Scale, the other scale of subjective well-being used, improved significantly at week 20 (p=0.01), no significant improvement was seen in WHO-5. The results of the sub-group analysis revealed WHO-5 improved significantly at week 8 and 32 among the subjects whose baseline scores began in the lower half.Conclusion: MBCT is sufficiently safe and would be more feasible with HIs compared to the clinical samples. In designing randomized controlled trials, selecting HIs with lower subjective well-being would be reasonable to minimize the “ceiling effect” on outcomes.Keywords: subjective well-being, mindfulness-based cognitive therapy, feasibility, common mental disorders

Ryosuke Kitahata,1 Shinichiro Nakajima,1–4 Hiroyuki Uchida,1,3 Tetsu Hayashida,5 Maiko Takahashi,5 Shintaro Nio,1 Jinichi Hirano,1 Maki Nagaoka,1 Takefumi Suzuki,1 Hiromitsu Jinno,6 Yuko Kitagawa,5 Masaru Mimura1 1Psychopharmacology Research Program, Department of Neuropsychiatry, School of Medicine, Keio University, Tokyo, Japan; 2Multimodal Imaging Group – Research Imaging Centre, 3Geriatric Mental Health Division, Centre for Addiction and Mental Health, 4Department of Psychiatry, University of Toronto, Toronto, Canada; 5Department of Surgery, School of Medicine, Keio University, 6Department of Surgery, School of Medicine, Teikyo University, Tokyo, Japan Purpose: The purpose of the study was to evaluate subjective (self-rated), family-rated, and objective (researcher-rated) cognitive functions in patients with breast cancer after chemotherapy.Method: We conducted a prospective study to trace self-rated cognitive functions in 30 patients with breast cancer at the completion of chemotherapy (T0) and 6 months later (T1). Subjective cognitive functions were assessed with Cognitive Failures Questionnaire (CFQ), Dysexecutive Questionnaire (DEX-S), and Everyday Memory Checklist (EMC-S) for attention, executive function, and episodic memory, respectively. Their family members also completed DEX-I and EMC-I for executive function and episodic memory, respectively. We also examined objective cognitive functions. Self-rated cognitive functions were compared with the normative data. They were compared between T0 and T1. We calculated correlation coefficients between self-rated and other cognitive functions.Results: At T0, 6 (20.0%) and 2 (6.7%) participants showed higher DEX-S and EMC-S scores than the normative data, respectively, while no participant had abnormal CFQ scores. At T1, DEX-S and EMC-S scores were normalized in 3 (50.0%) and 2 (100.0%) participants, respectively. No participant showed increases in CFQ scores. No changes were found in objective cognitive functions from T0 to T1. DEX-S and DEX-I or EMC-S and EMC-I scores were correlated at both T0 and T1, which did not survive multiple corrections. There was no association between subjective and objective cognitive functions.Conclusion: Impairments in subjective cognition may be transient after chemotherapy in patients with breast cancer. Furthermore, patients and their families appear to share similar prospects on their cognitive functions. Keywords: breast cancer, chemotherapy, subjective cognitive functions

Jinichi Hirano,1,2 Koichiro Watanabe,3 Takefumi Suzuki,1,4 Hiroyuki Uchida,1 Ryosuke Den,5 Taishiro Kishimoto,1 Takashi Nagasawa,5 Yusuke Tomita,4 Koichiro Hara,6 Hiromi Ochi,7 Yoshimi Kobayashi,1 Mutsuko Ishii,1 Akane Fujita,1 Yoshihiko Kanai,1 Megumi Goto,1 Hiromi Hayashi,1 Kanako Inamura,1 Fumiko Ooshima,1 Mariko Sumida,1 Tomoko Ozawa,1 Kayoko Sekigawa,1 Maki Nagaoka,1 Kae Yoshimura,1 Mika Konishi,1 Ataru Inagaki,1 Takuya Saito,8 Nobutaka Motohashi,9 Masaru Mimura,1 Yoshiro Okubo,8 Motoichiro Kato,11Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan; 2Ohizumi Hospital, Tokyo, Japan; 3Department of Psychiatry School of Medicine, Kyorin University, Tokyo, Japan; 4Inokashira Hospital, Tokyo, Japan; 5Komagino Hospital, Tokyo, Japan; 6Asai Hospital, Chiba, Japan; 7Kurumegaoka Hospital, Tokyo, Japan; 8Department of Psychiatry School of Medicine, Nippon Medical School, Tokyo, Japan; 9Department of Psychiatry, School of Medicine, University of Yamanashi, Yamanashi, JapanObjective: The use of an algorithm may facilitate measurement-based treatment and result in more rational therapy. We conducted a 1-year, open-label study to compare various outcomes of algorithm-based treatment (ALGO) for schizophrenia versus treatment-as-usual (TAU), for which evidence has been very scarce.Methods: In ALGO, patients with schizophrenia (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) were treated with an algorithm consisting of a series of antipsychotic monotherapies that was guided by the total scores in the positive and negative syndrome scale (PANSS). When posttreatment PANSS total scores were above 70% of those at baseline in the first and second stages, or above 80% in the 3rd stage, patients proceeded to the next treatment stage with different antipsychotics. In contrast, TAU represented the best clinical judgment by treating psychiatrists.Results: Forty-two patients (21 females, 39.0 ± 10.9 years-old) participated in this study. The baseline PANSS total score indicated the presence of severe psychopathology and was significantly higher in the ALGO group (n = 25; 106.9 ± 20.0) than in the TAU group (n = 17; 92.2 ± 18.3) (P = 0.021). As a result of treatment, there were no significant differences in the PANSS reduction rates, premature attrition rates, as well as in a variety of other clinical measures between the groups. Despite an effort to make each group unique in pharmacologic treatment, it was found that pharmacotherapy in the TAU group eventually became similar in quality to that of the ALGO group.Conclusion: While the results need to be carefully interpreted in light of a hard-to-distinguish treatment manner between the two groups and more studies are necessary, algorithm-based antipsychotic treatments for schizophrenia compared well to treatment-as-usual in this study.Keywords: algorithm, open-label clinical trial, measurement-based treatment, schizophrenia, treatment-as-usual

A study is conducted to report the development of surface-functional nanocomposites of calcium phosphate (CaP) with the help of collagen and fibronectin and the success in enabling the DNA carrying composite particles to be internalized by specific cell surface integrin receptors. The rapid cellular endocytosis resulted in significantly high DNA delivery in cytoplasm and eventual drastic enhancement in transgene expression.

Examines the general form of the slippage to be applied to the initial conditions of the Redfield master equation for a slow open quantum subsystem. Non-Markovian dynamics of the subsystem; Preservation of possitivity by the Redfield equation after the slippage superoperator has been applied to the initial density matrix of the subsystem; Reduction of the Redfield equation to the Lindblad equation.

Studies a non-Markovian stochastic Schrodinger equation corresponding to the Redfield master equation. Description of the dynamics of a slow subsystem coupled to a thermal bath; Simulation of the time evolution of the quantum wave functions.

Higher order version of the generalized diffusion hypothesis (HOGGDH) for turbulent heat flux is applied to predict heat transfer in a square sectioned U-bend duct. It is important to take account of streamwise heat flux for predicting complex three dimensional heat flows since the HOGGDH has better performance for predicting the streamwise heat flux.