黒瀨 聖司

Abstract Background Cancer-related weight loss is associated with poor prognosis, reduced treatment tolerance, and impaired quality of life. Recent studies have highlighted the importance of oral health in maintaining nutritional status among older adults. Oral frailty, a reversible stage of oral function decline, has been linked to reduced food intake and systemic frailty. However, the relationship between oral frailty and weight loss in patients with lung cancer undergoing chemotherapy remains unclear. This study aimed to identify factors associated with weight loss, with a particular focus on oral frailty, in this population. Methods This single-center retrospective study included 67 patients with lung cancer who received outpatient chemotherapy at Kansai Medical University Hospital between October and December 2024. Oral frailty was evaluated using the 5-item Oral Frailty Checklist (OF-5) by non-dental clinicians on the day of chemotherapy. Weight loss was defined as an unintentional loss of > 5% within 6 months. Logistic regression models were constructed to examine associations between oral frailty, dysgeusia, and weight loss, adjusting stepwise for performance status, C-reactive protein, sex, and cancer stage. Model robustness was confirmed using bootstrap resampling (1,000 replications). Results Nineteen patients (28.4%) experienced significant weight loss. In multivariate analyses, oral frailty (odds ratio [OR]: 28.79, 95% confidence interval [CI]: 1.81–36.05, p  = 0.006) and dysgeusia (OR: 39.84, 95% CI: 1.76–40.62, p  = 0.001) were independently associated with weight loss after adjustment for confounders. These associations remained robust in bootstrap analyses. No multicollinearity was detected among variables. Conclusions Oral frailty and dysgeusia were significantly associated with weight loss in patients with lung cancer receiving chemotherapy. Screening for oral frailty using the simple OF-5 checklist, even when performed by non-dental clinicians, may facilitate early identification of patients at risk for nutritional decline. Multidisciplinary supportive care, including oral and taste function management, should be integrated into oncology practice to help mitigate cancer-related weight loss.

Abstract Aim This prospective non‐randomized controlled study examined the Autonomy‐Supportive Circuit Training Program (ASCTP), a structured physical activity intervention. The primary objective was to assess and compare changes in internalizing (emotional symptoms) and externalizing (behavioral difficulties) traits between children with autism spectrum disorder (ASD) and those with subthreshold ASD following ASCTP participation. Methods A total of 28 boys (aged 4–10 years) were divided into an ASD (n = 14) and a non‐ASD group (n = 14). The ASCTP intervention was developed and implemented in an exercise‐focused daycare center for children with disabilities in Japan. The intervention consisted of a structured 45‐min exercise program conducted once a week for 6 months. It emphasized an autonomy‐supportive and standardized session structure, implemented by trained facilitators, and was specifically designed to support children's self‐regulation and individualized activity selection. Emotional and behavioral traits were assessed pre‐ and post‐intervention using the Strengths and Difficulties Questionnaire, completed by the parents. Additionally, the children's lifestyle habits (sleep, screen time, and breakfast consumption) were recorded pre‐ and post‐intervention through parental reports. Results The ASD group showed a significant reduction in behavioral difficulties, whereas the non‐ASD group exhibited an increase in behavioral difficulties (−1 [−2 to 0] vs. 1 [−1 to 1], adjusted p = 0.034, r = 0.45). Although no significant changes in emotional symptoms were present in either group, a decreasing trend was observed. Conclusion Participation in the ASCTP was associated with a reduction in behavioral difficulties in children with ASD, which may reflect the potential benefits of the structured framework of the program. Conversely, the increased behavioral difficulties observed in the non‐ASD group may indicate the need for more flexible intervention approaches.

ABSTRACT Background The long‐term prognosis of patients with heart failure (HF) remains poor. Most patients with HF are older, and multiple factors involved in geriatric syndromes are associated with worse long‐term prognosis. Sarcopenia is a major component of geriatric syndrome. Early diagnosis and therapeutic intervention for sarcopenia are clinically important in patients with HF; however, the prevalence and long‐term prognostic impact of sarcopenia in patients with stage B HF remain unclear. This study aimed to determine the prevalence of sarcopenia in older patients with stage B HF and its impact on the long‐term prognosis. Methods The PAPRIKA‐HF study was a multicenter, prospective study that enrolled outpatients ≥ 65 years who were diagnosed with stage B HF. Sarcopenia was assessed based on the Asian Working Group for Sarcopenia 2019 diagnostic criteria. The primary endpoint was a composite endpoint (all‐cause mortality, incident myocardial infarction, or hospitalization for heart failure) of > 2 years. Results Among 312 patients (mean age: 78.2 ± 6.5 years, 45% female), 17.7% (56 of 312 patients) had sarcopenia. The rate of the composite endpoint over 2 years was significantly higher in patients with sarcopenia than in those without (25.0% vs. 2.7%, log‐rank test, p < 0.0001). Multivariate analysis using the Cox proportional hazards model showed that sarcopenia was an independent predictor of long‐term prognosis (hazard ratio: 5.78, 95% confidence interval: 2.16–15.43, p < 0.001). Conclusions Sarcopenia was associated with a worse long‐term prognosis in older patients with stage B HF, highlighting the importance of early diagnosis of sarcopenia.