around the first online publication date, especially within the first week, which is the most active period of viewership for most articles, 6 the direct effect of one-time-only tweeting on journal readership has not been fully elucidated.The Japanese Circulation Society (JCS) manages 2 official journals: Circulation Journal and Circulation Reports. The Information and Communication Committee (ICC) of the JCS launched an official Twitter account in M any medical journals have implemented social media strategies, including Twitter, to disseminate their new publications, which can be easily shared by authors and readers. 1 Several randomized control trials have evaluated the effects of social media on journal readership through page views, Altmetric scores, and even article citations. 2-5 However, because many social network interventions include comprehensive interventions involving multiple tweets and have been