Background: The coronavirus disease 2019 (COVID-19) pandemic is continuing unabated in Japan, as of October 2021. We aimed to compare first-year university students’ psychological distress before the pandemic in 2019, during the pandemic in 2020, and one year after the onset of the pandemic, in 2021. Methods: The study conducted online surveys over three years from April to May each year. Participants were 400 first-year students in 2019, 766 in 2020, and 738 in 2021. We examined differences in scores on the Counseling Center Assessment of Psychological Symptoms—Japanese version (CCAPS-Japanese) between the three years using a one-way analysis of variance, and differences in the CCAPS-Japanese critical items using chi-squared test and residual analysis. Results: The average scores on the Depression and Generalized Anxiety subscale in 2021 were significantly higher than those in 2020, but remained the same as in 2019. The Academic Distress subscale score in 2020 was the worst compared to 2019 and 2021. Meanwhile, the number of students who experienced severe suicidal ideation increased year by year from 2019 to 2021. Conclusion: The mean mental health of first-year university students worsened after the onset of the COVID-19 pandemic, and recovered to the pre-pandemic level over the next two years. However, the number of high-risk students with suicidal ideation continued to increase. A system is required for early detection and support for students at high risk of mental health issues.

This cross-sectional study examined the prevalence and characteristics of steatotic liver disease (SLD) based on a recently introduced nomenclature in the Japanese health checkup population. SLD was evaluated using liver ultrasonography, and participants were categorized into metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol associated steatotic liver disease (MetALD), alcohol-associated/related liver disease (ALD), and cryptogenic SLD groups. The prevalence and characteristics of the SLD subclasses were assessed, and subgroup analyses were conducted for the non-obese (body mass index [BMI] ≤ 25 kg/m²) and lean (BMI ≤ 23 kg/m²) populations. Among the 694 participants, with a median age of 47 years and comprising 54% males, the prevalence of MASLD, MetALD, ALD, and cryptogenic SLD was 26%, 2%, 1%, and 2%, respectively. A remarkable difference was observed in the prevalence of SLD subclasses according to age, sex, and BMI. Subgroup analyses revealed heterogeneous demographic, clinical, and biochemical parameters between the SLD categories. Individuals with MetALD had higher gamma-glutamyl transferase levels, lower platelet counts, and higher fibrosis-4 index than did those with MASLD. Furthermore, the prevalence of non-obese and lean MASLD was 13% and 6%, respectively. This study provides preliminary information on the prevalence of SLD based on a new nomenclature in the Japanese population.

Aims: The application of indices in the context of metabolic dysfunction‐associated steatotic liver disease (MASLD) remains unexplored. We aimed to validate the ability of alanine aminotransferase (ALT), fatty liver index (FLI), and hepatic steatosis index (HSI) to identify MASLD during health checkups.Methods: We recruited 627 participants and utilized their health checkup data and ultrasound to assess the potential of using ALT, FLI, and HSI as indices for MASLD; this was indicated by the area under the curve (AUC) and restricted cubic spline (RCS) model. The optimal, rule‐out (sensitivity ≥90%), and rule‐in (specificity ≥90%) cutoff values of each index for identifying MASLD were reported.Results: Among participants with a median age of 46 years, the prevalence of MASLD was 28% in total (38% in males and 18% in females). RCS models confirmed a linear association between indices and MASLD. ROC analyses indicated that the AUC of ALT in identifying MASLD was 0.79 for the total cohort, 0.81 for males, and 0.69 for females. The optimal, rule‐out, and rule‐in cutoff values for ALT were 21, 13, and 29, respectively. Similarly, the AUC of FLI/HSI in identifying MASLD was 0.90/0.88 for the total cohort, 0.86/0.85 for males, and 0.93/0.90 for females. Considering the reference cutoff values, distinct cutoff values were observed between the sexes for FLI, while HSI had similar cutoff values.Conclusion: This study demonstrated that ALT > 30 IU/L is a reasonable cutoff value to rule‐in MASLD. ALT, FLI, and HSI are reliable indices for identifying MASLD during health checkups.

This study aimed to investigate the differences in mental health during COVID-19, specifically among second-, third-, and fourth-year Japanese university students (n = 2,157; n = 2,000; and n = 2,284; respectively). A one-way MANOVA was conducted to assess the association between year of enrollment (academic years 2020, 2021, and 2022) and each of the eight subscales of the counseling Center Assessment Psychological Symptoms-Japanese. For second-year students, depression and generalized anxiety mean scores were higher in 2021 than those in 2020 and 2022. Alcohol use mean scores got smaller each year. For third-year students, depression, generalized anxiety, social anxiety, hostility, and alcohol use were significantly higher in 2021 than those in 2020 and 2022. Among fourth-year students, means for all eight subscale categories were significantly higher in 2021 than those in 2020 and 2022. The findings found worsened mental health profiles during 2021, which recovered to approximate pre-pandemic levels in 2022. This study demonstrates that university students' mental health has been negatively impacted by the COVID-19 pandemic, an effect which is more salient among fourth-year students. Further, it offers insights into mental health trends among Japanese university students and a possible foundation for learning about changes among university students worldwide.