Toyama Prefectural University

Abstract Background Poor self-management in older patients with diabetes undergoing hemodialysis contributes to adverse outcomes, including malnutrition. However, practical tools to identify patients who require targeted support are lacking. This study aimed to establish and validate a clinical cutoff value for a Diet-Related Life Skills Scale (DRLSS) to predict poor self-care and nutritional risk in this population. Methods This multicenter, cross-sectional study included 140 patients with diabetes undergoing hemodialysis aged 65 years or older. We assessed diet-related life skills, self-care behavior, nutritional status (using the Geriatric Nutritional Risk Index [GNRI]), and functional/psychosocial status. Receiver operating characteristic (ROC) curve analysis was performed to determine a cutoff value for predicting poor self-care. The validity of this cutoff was tested against GNRI-defined nutritional risk, including a sensitivity analysis using an alternative GNRI threshold (< 91.2). Additionally, age-stratified ROC analyses were conducted to examine performance differences between early old (65–74 years) and late-old (≥ 75 years) groups. A multiple linear regression analysis was conducted to identify predictors of self-care. Results The DRLSS demonstrated fair discriminatory power for predicting poor self-care (area under the curve (AUC) 0.760). A clinical cutoff of 116 was established, yielding a sensitivity of 0.726 and a specificity of 0.723. Stratified analysis revealed superior discriminatory performance in the early old group (AUC 0.815). Validation against nutritional risk identified a nearly identical cutoff (116; AUC 0.660), and the sensitivity analysis using GNRI < 91.2 produced a similar pattern. The high life skills group (> 116) demonstrated significantly better self-care ( p < 0.001) but paradoxically had a higher prevalence of moderate or higher nutritional risk ( p = 0.009). Multiple regression analysis identified the total life skills score ( β = 0.53, p < 0.001) and depression ( β = −0.198, p = 0.007) as significant independent predictors of self-care behavior. Conclusions The DRLSS is a valuable tool for assessing self-management capabilities in older patients with diabetes undergoing hemodialysis, particularly in the early old population. A clinical cutoff of 116 may help identify individuals with complex needs, including poor self-care or hidden nutritional risk, and support the design of targeted, multidisciplinary interventions. The paradoxical association between higher life skills and poorer nutritional status warrants further investigation into potential over-restriction.

The prevalence and mortality rates of type 2 diabetes mellitus (T2DM) are increasing, making it a significant public health concern. Effective self-management of T2DM requires external factors, such as medical interventions and social support, and internal factors, including self-efficacy. However, during humanitarian emergencies, such as the COVID-19 pandemic, healthcare system disruptions limit external factors, making internal factors even more critical. Nonetheless, existing reviews have primarily focused on external factors and clinical outcomes during the pandemic, with no comprehensive review examining internal factors. Therefore, this review aims to systematically synthesize evidence on the internal factors supporting T2DM self-management during the COVID-19 pandemic and identify research gaps. This scoping review follows the Joanna Briggs Institute guidelines and is conducted according to the PRISMA-P framework. A comprehensive search strategy will be employed to systematically explore multiple databases, including PubMed (MEDLINE), CINAHL, Web of Science, Scopus, ERIC, PsycINFO, and the Cochrane Library, as well as gray literature platforms, such as Google, Google Scholar, and Semantic Scholar. The search will include both published and gray literature without language restrictions. Studies that utilize quantitative and qualitative methodologies will also be included. Two independent reviewers will screen titles, abstracts, and full texts for eligibility, and discrepancies will be resolved through discussion or consultation with a third reviewer. The outcomes related to the internal factors contributing to the improvement of self-management among T2DM patients will be extracted and summarized. The findings will be presented descriptively and in tabular form, emphasizing key insights and identifying research gaps in the literature. The findings will be actively disseminated through academic conferences and peer-reviewed journals to provide valuable insights into the internal factors that contribute to the improvement of self-management in T2DM patients. These results are expected to contribute to the development of innovative strategies for sustaining and improving self-management in T2DM patients during future humanitarian emergencies and major public health challenges.

This paper presents a fully onboard control and planning system for indoor quadrotor navigation, leveraging modular control and lightweight motion planning. Autonomous operation of unmanned aerial vehicles (UAVs) in indoor environments, such as inspection, monitoring, and mapping, faces challenges due to the absence of global navigation satellite system (GNSS) and limited onboard computational resources. Existing methods often rely on external localization systems or high-specification CPUs, restricting deployment on compact, low-power UAVs. To address this, we develop a hierarchical control architecture comprising motor, attitude, velocity, and position controllers, all implemented with full-state feedback. Paired with a custom lightweight motion planning algorithm, the system operates efficiently on resource-constrained CPUs such as the Raspberry Pi. This approach enables affordable, low-power UAVs to achieve autonomous indoor navigation without external infrastructure. The results show stable flight performance and computational efficiency, validating suitability for GNSS-denied environments.

In this study, we performed a hazard assessment of actual and potential impurities involved in the synthesis of a newly developed LpxC inhibitor T-1228 in accordance with the ICH M7(R2) guideline. We identified eight mutagenic/carcinogenic impurities in need of control: benzyl chloride, 1-(3-(dimethylamino)propyl)-3-ethylcarbodiimide hydrochloride, O-(tetrahydro-2H-pyran-2-yl)hydroxylamine, 2-(4-iodophenyl)-2-oxoethyl acetate, (S)-1-(4-ethynylphenyl)ethane-1,2-diol, isopropyl methanesulfonate, hydroxylamine, and (S)-4-((4-(1,2-dihydroxyethyl)phenyl)ethynyl)-N-hydroxybenzamide. We then conducted risk assessments of the first six impurities using purge factors, and determined that Option 4 control of ICH M7(R2) guideline was the optimal approach for controlling these impurities. Furthermore, as (S)-1-(4-ethynylphenyl)ethane-1,2-diol and isopropyl methanesulfonate are impurities introduced during the later stages of active pharmaceutical ingredient (API) synthesis, we obtained additional experimental data (verification of reactivity, solubility, spike experiments, and analytical experiments) to verify the validity of the purge-based risk assessment. Regarding the final two impurities, hydroxylamine may be produced as a byproduct in the final intermediate and final processes; therefore, we determined that Option 1 control of ICH M7(R2) guideline was the optimal control strategy and set appropriate API criteria. Although (S)-4-((4-(1,2-dihydroxyethyl)phenyl)ethynyl)-N-hydroxybenzamide is a degradation product of API, in vivo mutagenicity assay conducted according to the ICH M7(R2) guideline showed negative results. Therefore, we determined that (S)-4-((4-(1,2-dihydroxyethyl)phenyl)ethynyl)-N-hydroxybenzamide can be managed as a nonmutagenic impurity according to the ICH Q3A(R2) guideline. The risk assessment of mutagenic impurities related to the T-1228 API manufacturing method, performed in accordance with ICH M7(R2) guideline, can guarantee the quality of this manufacturing method for initial clinical trials.

This workshop aims to support early-career researchers in the field of Human-Agent Interaction (HAI), especially those from non-native English-speaking backgrounds. Despite increasing global engagement, many talented researchers face challenges in presenting their work internationally due to language barriers and limited opportunities. By providing a platform to present research in English in a supportive and peer-driven environment, this workshop will foster accessibility, visibility, and confidence among participants. Presentations will be followed by extended and moderated Q&A sessions to encourage inclusive discussion. The workshop also invites guest talks from early-career researchers who exemplify innovative HAI research, promoting role models for the next generation. Overall, the workshop seeks to lower entry barriers and empower underrepresented voices in the global HAI community.

Type 2 diabetes mellitus (T2DM) and metabolic dysfunction-associated steatohepatitis (MASH) frequently coexist and are mechanistically linked via insulin resistance, lipotoxicity, and chronic inflammation. Cholic acid (CA), a primary bile acid (BA), modulates metabolic and immune pathways by influencing BA composition and the gut microbiota. In this study, we examined the role of dietary CA in the modulation of T2DM and MASH in Tsumura Suzuki obese diabetes (TSOD) mice, a model of spontaneous obesity and diabetes. Mice were fed a high-fat, high-cholesterol diet with or without CA (iHFC and CA(-) iHFC diets, respectively). CA supplementation significantly improved hyperglycemia and hyperinsulinemia, independent of adipose tissue inflammation. These metabolic benefits were associated with an increased intestinal abundance of Akkermansia muciniphila and elevated ileal expression of fibroblast growth factor 15 (FGF-15), suggesting activation of the FXR-FGF-15 axis. However, CA also exacerbated MASH, accompanied by increased hepatic inflammation, fibrosis, and accumulation of hepatotoxic BAs, including deoxycholic acid and taurodeoxycholic acid. The removal of CA mitigated these hepatic changes while abolishing glycemic improvement. Accordingly, CA can exert opposing effects in TSOD mice-ameliorating T2DM while worsening MASH-highlighting the need for caution when targeting BA pathways in metabolic diseases.