Ken Yamaguchi

Aim: To describe interfacility variation in threatened preterm labor (TPL) management in a perinatal care network in western Japan and the association between the neonatal intensive care unit (NICU) admission threshold and the long‐term tocolysis policy. Methods: A cross‐sectional, facility‐level questionnaire survey was conducted for all 43 perinatal maternal and child health centers in the Chugoku–Shikoku region of western Japan in 2024. Centers reported diagnostic criteria for TPL, use of objective scoring systems, first‐line intravenous tocolytic drugs, NICU admission gestational age threshold, and institutional policies regarding planned duration of intravenous tocolysis (short‐term, ≤ 48 h; long‐term, > 48 h). Factors related to the adoption of long‐term tocolysis were evaluated using logistic regression. Results: Valid responses were obtained from 32 centers (74.4%). A long‐term‐only tocolysis policy was reported by 65.6% (21/32) of centers. Diagnostic criteria and thresholds for intervention varied widely, and only three centers (9.4%) used an objective severity score, such as the preterm labor index or tocolysis index. Ritodrine hydrochloride was used as the first‐line intravenous tocolytic drug in 93.8% (30/32) of centers. The NICU admission threshold differed among centers. In multivariable analysis, centers with a higher NICU admission threshold were more likely to report a long‐term‐only policy (adjusted odds ratio, 1.38 per 1‐week increase; 95% confidence interval, 1.04–1.83; p = 0.028). Conclusions: Management of TPL showed marked interfacility variation in the regional perinatal care network. The NICU admission threshold was associated with the institutional tocolysis‐duration policy, suggesting that regional perinatal system structure should be considered when discussing optimal tocolysis duration.

Background: Dietary and nutritional interventions have gained popularity among patients with cancer undergoing treatment due to the high cost of medical treatment and increased health awareness. Diet, nutrition, psychological stress, and adverse events during treatment have a significant impact on the quality of life of patients with cancer. This study aimed to review published studies and guidelines on diet and exercise for cancer survivors. Recent Findings: Although several academic associations have published guidelines on the impact of diet and nutrition on cancer treatment, physicians typically do not consider this impact. Conclusion: This study summarizes recent findings on the effects of diet and nutrition, particularly fasting‐mimicking diet, on the prognosis and adverse events of chemotherapy. Furthermore, this study outlines future perspectives on cancer treatment based on “Precision Nutrition” and “Molecular Precision Medicine”.

Purpose: Appetite loss is common during chemotherapy. However, its association with dietary intake and quality of life (QOL) in patients with gynecologic cancer remains unclear. This study aimed to clarify the dietary changes associated with appetite loss and investigate their association with QOL and adverse events. Methods: Patients with gynecologic cancer receiving chemotherapy were enrolled in this single-center longitudinal observational study. Dietary intake was assessed at baseline and before the third chemotherapy cycle using a diet history questionnaire. Appetite loss, QOL, and adverse events were evaluated using the EORTC QLQ-C30 and PRO-CTCAE. Sensitivity analyses addressed pre-existing appetite loss and postoperative effects. A complementary analysis of a separate cohort examined the association between appetite loss and longitudinal QOL changes. Results: Among 105 patients, 41 (39.0%) reported appetite loss before the third chemotherapy cycle. The appetite loss group showed greater reductions in energy and macronutrient intake, whereas macronutrient composition did not differ between the groups. Absolute micronutrient intake broadly decreased, but no difference remained significant after energy adjustment. Among adverse events, taste changes were most closely associated with appetite loss. Appetite loss was also associated with QOL decline, and dietary findings were directionally consistent in sensitivity analyses. The complementary analysis showed appetite loss was consistently associated with QOL fluctuations. Conclusion: Appetite loss during chemotherapy was associated with reduced dietary intake and lower QOL. Taste alterations were closely associated with appetite loss. These findings support appetite loss as a clinically relevant target for the supportive care of patients with gynecologic cancers.

Supplementary Figure S3 shows the generation and characterization of CDK12 knockdown cell lines using short hairpin RNA (shRNA) in human uterine serous carcinoma and mouse endometrial carcinoma models, including validation of CDK12 protein reduction and effects on cell proliferation.

Supplementary Figure S5 shows that short-term CDK12/13 inhibition by CTX-439 induces DNA damage and enhances cisplatin sensitivity without affecting short-term cell viability in uterine serous carcinoma cell lines.

Supplementary Figure S6 shows dose–response analyses of CTX-439 and olaparib, alone or in combination at different molar ratios, demonstrating enhanced cytotoxic effects of combination treatment in uterine serous carcinoma cell lines.

Supplementary Figure S4 shows suppression of HR-related gene expression and associated protein changes following CTX-439 treatment in uterine serous carcinoma cell lines, as assessed by RT–qPCR and Western blotting.

Supplementary Figure S1 shows RNA-seq–based analyses of transcriptional changes induced by CTX-439 treatment, including pathway enrichment analyses across multiple USC xenograft models and volcano plots highlighting representative cell cycle–related genes.

Supplementary Figure S2 shows HRD status, CDK12 copy number alterations, and related genomic features in uterine serous carcinoma, including correlations with HRD scores and survival analyses in the TCGA and Kyoto University cohorts.

Supplementary Figure S7 shows longitudinal body weight monitoring in mice bearing ARK2 xenografts treated with vehicle, CTX-439, olaparib, or their combination, demonstrating no significant treatment-related weight loss during the dosing period.