Search Results (5,170)

Semaglutide represents a unique therapeutic option for patients with type 2 diabetes mellitus (T2DM), being the first and currently only glucagon-like peptide-1 receptor agonist (GLP-1RA) available in both subcutaneous and oral formulations. This study aimed to compare the effectiveness of oral versus subcutaneous (sc) semaglutide on metabolic parameters and cardiovascular risk factors in T2DM patients. This is a retrospective real-world study including adult patients with T2DM taking oral or sc semaglutide followed at the ASUGI Diabetes Center. We analyzed data from 434 patients (median age 70 years, diabetes duration 13 years), treated with oral (n = 232) or sc (n = 202) semaglutide. The oral formulation had a higher discontinuation rate. Among these patients, 130 patients in the oral group and 145 in the sc group had an 18-month follow-up. When comparing these groups, patients taking sc semaglutide had a significantly higher baseline BMI. However, multivariate linear regression models suggested that both formulations were comparably effective in reducing HbA1c and BMI, with baseline values being the primary predictors of response. To address BMI imbalances, propensity score matching was performed, identifying 55 matched pairs. Both oral and sc semaglutide reduced HbA1c and BMI and there were no significant differences in the median change in HbA1c and BMI between groups. Interestingly, oral semaglutide was associated with a significantly greater reduction in diastolic blood pressure compared to the sc formulation. Furthermore, concomitant therapy with SGLT2 inhibitors significantly enhanced the reduction in total and LDL cholesterol. Oral and subcutaneous semaglutide show comparable effectiveness in lowering HbA1c and BMI in a real-world setting. Full article

With the high penetration of distributed photovoltaic and storage systems, active distribution grids are prone to experiencing “active power surplus and reactive power shortage” during the evening peak, leading to voltage sags at the network end. Although electric vehicle (EV) grid-connected inverters possess four-quadrant reactive power regulation capabilities without causing the additional chemical cyclic aging of the battery cells, existing dispatch systems often treat them as unconditional response resources, overlooking users’ actual willingness to cede control and the associated strategic interactions. To address this, this paper proposes a “grid-load” coordinated reactive power optimization strategy that accounts for EV users’ willingness to respond: a Logit model incorporating price incentives, initial energy consumption, and parking duration is constructed based on discrete choice theory. By combining a truncated normal distribution with the Monte Carlo method to eliminate micro-sampling errors, a model of the expected reactive power capacity of charging stations under dynamic incentives is established; considering the physical constraints of SVCs and EVs, a scalarized single-objective optimization model is constructed with grid loss-equivalent costs, ancillary service costs, and voltage deviation as objectives, and solved using an improved particle swarm optimization algorithm with linearly decreasing weights. Simulations on a modified 33-node IEEE system incorporating storage indicate that this strategy can assign optimal compensation prices to each node based on the spatial value of reactive power. Compared to traditional single-voltage regulation and fixed subsidies, it not only stabilizes the grid-wide voltage within a safe range but also avoids overcompensation, achieving global optimization of both power quality and economic efficiency. Full article

Field-service operations for utility companies require routing technicians across multiple depots while guaranteeing same-day response to critical infrastructure customers, a constraint that standard multi-depot routing methods cannot structurally enforce. We introduce the MDVRP with Priority Requests (MDVRP-PR), formalised as a lexicographic optimisation problem that guarantees service to priority customers before maximising coverage and minimising route duration. A three-stage pipeline is proposed: hybrid DBSCAN-Hierarchical clustering for topology-aware depot assignment, an Enhanced Max-Min Ant System (MMAS) with priority-driven construction, lexicographic solution selection, and repair, and a Boundary Relocate post-optimisation stage with global cross-depot recovery. The approach is evaluated on a real-world applied case study from Algérie Télécom (Guelma, Algeria), comprising a single four-depot field-service instance scaled to three sizes (55, 90, and 150 customers) and assessed over 2135 controlled runs. On this case study, the proposed clustering method outperforms the MDVRP-adapted Sweep baseline by $22.9$ percentage points on the largest instance (n = 150; Friedman p < 0.001). The priority mechanisms sustain $100\%$ feasibility across all configurations, compared to complete collapse without them ($0/10$ seeds at $\ge 40\%$ priority), at a route-time overhead below $5\%$. Relative to the company’s current manual practice, the framework improves customer coverage by $16.1$ percentage points within 28 s, confirming its practical utility for daily deployment in this capacity-constrained, priority-sensitive routing context. Full article

Sarcopenia is an age-related syndrome characterized by the progressive loss of skeletal muscle mass, strength, and function, significantly impairing older adults’ independence and quality of life. Given their anti-inflammatory, antioxidant, and metabolic regulatory properties, n-3 polyunsaturated fatty acids (n-3 PUFAs) have emerged as a promising nutritional strategy to mitigate this muscle degeneration. This review systematically synthesizes existing evidence regarding the association between n-3 PUFAs and sarcopenia. To capture the relevant literature, we searched PubMed, Web of Science, CNKI, and Wanfang Data using a combination of subject headings and free-text terms. We supplemented primary search terms—such as “n-3 polyunsaturated fatty acids,” “omega-3 fatty acids,” “sarcopenia,” and “muscle mass”—with mechanism-related keywords like “inflammation,” “muscle satellite cells,” and “oxidative stress.” We also manually screened the reference lists of the included literature. Our inclusion criteria encompassed interventional studies, observational studies, and high-quality reviews, while excluding conference abstracts, duplicate publications, and studies with incomplete data. This review first outlines the established biological mechanisms linking n-3 PUFAs to the pathological progression of sarcopenia, specifically detailing how these fatty acids improve muscle satellite cell function, suppress inflammation and oxidative stress, and ameliorate metabolic disorders. Next, we critically evaluate recent clinical studies and reviews, analyzing sources of study heterogeneity such as variations in sample size, intervention dose and duration, outcome measures, and baseline participant characteristics. We also highlight current research hotspots—including specialized pro-resolving mediators (SPMs), the gut–organ axis, combined interventions, and precision nutrition strategies—while emphasizing the functional differences between EPA and DHA to guide future intervention designs. Current evidence indicates that while n-3 PUFA supplementation can improve muscle strength and physical performance in older adults, its effects on muscle mass remain inconsistent. Addressing key research gaps, particularly the lack of standardized core outcome measures and unclear dose–response relationships, is critical. Ultimately, future research must prioritize developing high-bioavailability formulations, conducting personalized trials based on baseline n-3 PUFA status, and deepening investigations into inter-organ networks to translate these nutritional insights into effective sarcopenia prevention and management strategies. Full article

Degraded network conditions and intermittent disconnections can impair solar greenhouse Internet of Things (IoT) systems by delaying cloud-to-field control, generating burst traffic after reconnection, and disrupting alarm feedback loops. This paper proposes a resilient end–edge–cloud collaborative framework for maintaining control continuity and closed-loop alarm reliability under unstable edge–cloud communication. The framework evaluates network quality using round-trip time, packet loss rate, and consecutive no-response duration, and combines hysteresis-based state switching, control leases, edge takeover, differential backfill, and locally persistent alarm-state synchronization. During disconnection, the edge gateway uses the latest valid configuration to execute fallback local control; after reconnection, high-priority events are uploaded first through a hierarchically rate-limited recovery strategy. In the scripted simulation experiments, the proposed method reduced peak backfill throughput from 2.16 ± 0.06 MB/s to 0.69 ± 0.01 MB/s, shortened high-priority event completion time from 17.3 ± 2.7 s to 2.0 ± 0.7 s, and increased the acknowledgment success rate at 20% packet loss from 76.5 ± 2.2% to 98.4 ± 0.8%. It also reduced the maximum temperature deviation during disconnection from 7.20 °C to 3.50 °C. These results suggest that the proposed framework can improve control continuity and alarm-loop completeness under the specified simulation settings. A supplementary trace-driven recovery evaluation using public 5G testbed measurements showed a similar qualitative trend. Broader validation with field-deployed greenhouse IoT platforms or hardware-in-the-loop testbeds is still needed. Full article

Background: Prolonged exposure to moderate and loud noise is known to impair hearing; however, the safety of long-duration exposure to low-level sound, such as that encountered during everyday conversation, remains unclear. This study aimed to determine the effect of continuous exposure to sound at a 65 dB sound pressure level (SPL) on auditory processing. Methods: Auditory brainstem responses (ABRs) were recorded in C57BL/6 mice before and after a 1 h exposure to a continuous pure tone at 65 dB SPL. Changes in ABR thresholds, wave amplitudes, and latencies were analyzed across frequencies and time points. Correlations between amplitude and latency changes across ABR waves were also assessed. Results: Tone exposure induced a significant, frequency-specific increase in ABR thresholds, with a mean elevation of approximately 6 dB and a maximum shift of 15 dB. Significant reductions in amplitudes and prolongations of latencies were observed in Waves I–III, while Wave V amplitude remained relatively stable. A strong negative correlation between amplitude reduction and latency increase was found in Wave I, which progressively weakened from Wave II to Wave V. These functional changes persisted for up to three hours following exposure before gradually returning to baseline. Conclusions: Prolonged exposure to low-level sound at intensities typical of conversational speech can transiently impair auditory function and alter early neural processing in the auditory pathway. These findings suggest that sound levels commonly considered safe may still pose a risk when exposure is sustained, with implications for understanding hidden hearing loss and improving early diagnostic approaches. Full article

Background and Objectives: Conditioning activities (CAs) are commonly used to induce post-activation performance enhancement (PAPE); however, it remains unclear whether load-dependent responses established in bilateral, predominantly isotonic models extend to unilateral split squat conditions. In particular, evidence regarding holding isometric muscle action (HIMA) is limited, and it is unknown how external load and holding duration interact to influence both performance outcomes and phase-specific muscle activation. Therefore, this study examined the acute effects of HIMA duration and external load during unilateral split squat CA on jump performance and phase-specific electromyographic (EMG) activity. Materials and Methods: Twenty recreationally active men completed a randomized, counterbalanced crossover design involving four split squat CA conditions, unloaded 3 s, unloaded 5 s, 3 s loaded (60% 1RM), and 5 s loaded (60% 1RM), each performed as three sets of three repetitions. To minimize fatigue effects, standardized rest intervals and familiarization sessions were implemented prior to testing. Single-leg jump (SLJ) and countermovement jump (CMJ) were assessed before and after CA, with post-activation measurements conducted at 3 min (SLJ) and 4 min (CMJ), consistent with established PAPE time windows. Surface EMG was time-normalized across the split squat cycle and analyzed using phase-specific area under the curve. Results: CMJ significantly increased following both loaded conditions (p < 0.05; moderate to large effect sizes), whereas no differences were observed between unloaded durations. External load consistently elevated EMG amplitude across all measured muscles (moderate to large effects). Extending duration under load further increased activation in the hamstrings, stabilizers, vastus medialis, and gastrocnemius medialis (p < 0.05; small to moderate effects), whereas unloaded conditions showed minimal neuromuscular differences. Conclusions: External load, rather than isometric holding duration, appears to be a key factor influencing acute PAPE responses in unilateral split squat HIMA, whereas prolonged holding duration may primarily modulate muscle recruitment patterns without additional performance gains. However, given the acute experimental design and a recreationally active sample, these findings should be interpreted with caution and considered exploratory. Further studies are warranted to confirm these effects across different populations and longer-term training conditions. Full article

Generative artificial intelligence (GenAI) is reshaping learning in higher education, with particularly pronounced implications for the humanities and social sciences (HSS), where learning outcomes are commonly expressed through written and interpretive forms that align closely with GenAI’s capabilities. Yet, systematic evidence on the educational impacts of GenAI on HSS students remains limited. Addressing this gap, this study draws on a large-scale survey of HSS students in China to examine its role in academic development. Guided by relevant learning theories, this study focuses on four dimensions: patterns of use, effects on learning processes and academic performance, challenges associated with GenAI use, and preferred approaches to curricular integration. We found that more than half perceived enhanced learning motivation, independent thinking and creativity, although a substantial minority reported little change or even decline. Comparatively, a notably larger majority reported academic performance gains, although these gains may partly reflect limitations in conventional assessment practices. The study identifies variations in perceived learning and performance improvements among students with differing durations of GenAI experience, along with observable disciplinary differences and modest gender differences. While an overwhelming majority valued the importance of ethical considerations, only slightly more than half were satisfied with privacy protection. Limited accuracy and overreliance emerged as the most pressing concerns reported by students. Students favored partial or optional curricular integration supported by practice-oriented training, and widely recognized GenAI’s significance for their future professional development. Grounded in student perspectives, this study offers evidence-based recommendations for the responsible and pedagogically meaningful integration of GenAI. Full article

Aristotelia chilensis (maqui berry) is a Chilean native fruit rich in anthocyanins with potential antioxidant, glycemic, cardiometabolic, and ocular benefits, but its clinical efficacy remains unclear. This systematic review synthesized and critically appraised human trials evaluating oral maqui supplementation in adults. Following PRISMA 2020 and a PROSPERO-registered protocol, five databases were searched, and risk of bias and certainty of evidence were assessed using RoB 2/ROBINS-I and GRADE. Twelve clinical trials published between 2014 and 2023 were included. Acute studies consistently showed reduced postprandial glucose and modulation of insulin response, whereas chronic interventions showed modest and inconsistent effects on HbA1c, lipid profile, and other cardiometabolic markers. Favorable changes were also reported for oxidative stress biomarkers and autonomic parameters, although these findings were mainly based on surrogate endpoints. The most consistent evidence was observed in the ocular domain, where maqui supplementation improved tear production, dry eye symptoms, and tear inflammatory markers. The overall certainty of evidence ranged from moderate to very low because of methodological heterogeneity, small sample sizes, and short intervention duration. Maqui berry supplementation shows promise, particularly for acute glycemic control and ocular surface health, but larger long-term randomized trials using standardized formulations are needed before definitive clinical recommendations can be made. Full article

Background/Objectives: Regular physical exercise is strongly recommended for individuals with type 1 diabetes mellitus (T1DM) because of its beneficial effects on cardiovascular fitness, insulin sensitivity, metabolic control, and overall health. Nevertheless, participation in physical activity remains limited, largely due to the fear of exercise-induced hypoglycemia and glycemic instability. Glycemic responses to exercise in T1DM are influenced by the interaction between exercise modality, circulating insulin levels, nutritional status, and diabetes technologies. Continuous aerobic exercise, resistance training, high-intensity interval exercise, and mixed intermittent activities elicit distinct metabolic and hormonal responses, resulting in heterogeneous glycemic trajectories. This narrative review aimed to provide a clinically oriented synthesis of the physiological mechanisms underlying exercise-related glycemic fluctuations in T1DM and to discuss integrated insulin- and carbohydrate-based strategies to support safer participation in physical activity in the context of modern diabetes technologies. Methods: A structured narrative review was conducted using PubMed/MEDLINE, Scopus, and complementary searches in Google Scholar to identify experimental studies, observational studies, systematic reviews, consensus statements, and clinical guidelines focused on exercise-related glycemic responses in individuals with T1DM. Only articles published in English were considered. Evidence was selected and synthesized according to relevance to exercise modality, insulin therapy strategies, carbohydrate management, and diabetes technologies, including continuous glucose monitoring, continuous subcutaneous insulin infusion, and automated insulin delivery systems. The final narrative synthesis was based on 44 selected studies, reviews, consensus statements, and guidance documents considered most relevant to the objectives of this narrative review. Results: Available evidence indicates that continuous moderate-intensity aerobic exercise is most consistently associated with progressive glucose declines and increased risk of hypoglycemia, particularly when performed in the presence of elevated insulin on board. In contrast, resistance exercise and short-duration high-intensity or anaerobic exercise more frequently induce stable glycemia or transient hyperglycemia through adrenergic stimulation and increased hepatic glucose output. Mixed and intermittent exercise modalities often produce more variable responses depending on exercise sequencing, nutritional status, and insulin exposure. Across studies, integrated adjustment of basal and prandial insulin doses together with individualized carbohydrate supplementation emerged as the most effective strategy to reduce exercise-related glycemic instability. Continuous glucose monitoring and insulin pump technologies improved glucose trend awareness and management flexibility; however, physical exercise remains a challenging condition for current automated insulin delivery algorithms and still requires active user-driven decision-making. Conclusions: Exercise management in T1DM should be based on an individualized interpretation of exercise modality, glucose trends, insulin exposure, and nutritional context rather than on fixed glucose thresholds alone. Combining anticipatory insulin adjustments, tailored carbohydrate strategies, and appropriate use of diabetes technologies may substantially reduce glycemic variability and improve confidence toward physical activity participation. Structured education and individualized clinical guidance remain essential to translate physiological knowledge into effective real-world exercise management. Full article

Background/Objectives: Trigeminal neuralgia (TN) is a debilitating neurological condition characterized by recurrent, severe pain linked to peripheral and central sensitization within trigeminal pathways. Current pharmacologic treatments are limited by inadequate efficacy or dose-limiting side effects, and botulinum neurotoxin type A (BoNT/A) has emerged as a viable option. However, its potential use in the management of TN is hampered by methodological limitations in existing studies and a lack of pivotal clinical trials. This study investigated the efficacy, optimal treatment site, preventive utility, and duration of effect of incobotulinumtoxinA (Inco/A), a BoNT/A, in a model of TN. Methods: An infraorbital nerve chronic constriction injury model was used to induce mechanical allodynia in male Sprague–Dawley rats, reproducing the trigeminal sensitization seen in TN. The effects of subcutaneous Inco/A (1, 2, and 4 U) were measured using the mechanical sensitivity (von Frey) test to evaluate the dose response, effect of injection location, potential preventive nature of treatment, and duration of benefit. Results: Inco/A produced a robust, dose-dependent reduction in mechanical allodynia, predominantly via a local mechanism of action. Both preventive and therapeutic administration of Inco/A was efficacious, with significant reduction in allodynia even when administered up to 28 days before nerve injury. The anti-allodynic effect persisted up to 56 days post-injection. Conclusions: Inco/A is highly effective in alleviating mechanical allodynia in a validated rat model of TN. The findings highlight Inco/A as a promising candidate for clinical translation in TN and related neuropathic pain syndromes and support systematic investigation in well-controlled human trials. Full article

Toxic metals from industrialization and urbanization pose major human health risks, and mixture-based exposure requires broader toxicity assessment. This study investigated the effects of a mixture of arsenic, lead, mercury, cadmium, chromium (VI), and nickel on pancreatic function in rats (45 male/45 female; n = 5 per group), focusing on sex- and duration-specific differences after 28 and 90 days of exposure. The metals were administered as a single mixture dissolved in deionised water via oral gavage. Evaluated parameters included pancreatic metal levels, histopathology, serum glucose, amylase, malate dehydrogenase 1 (MDH-1) activity, redox status, and bioelements. Dose levels were based on human exposure data to reflect realistic scenarios. Metals accumulated in pancreatic tissue, causing dose- and time-dependent histopathological changes, including acinar cell vacuolization, vascular congestion, and Langerhans islet alterations. Males showed more pronounced vascular and islet changes, while females had greater acinar alterations. In males, higher doses decreased glucose and amylase and increased MDH-1 activity, while females showed more variable responses. Males demonstrated adaptive responses to oxidative stress over time, while females experienced more persistent stress. These findings reveal sex-, dose-, and duration-dependent effects of toxic metal(oid) mixtures on pancreatic function, indicating that individually safe doses may be harmful when combined. Full article

Japanese flounder (Paralichthys olivaceus) is an economically important species in China’s marine fishery industry. However, due to long-term intensive fishing, its wild population has declined sharply. Artificial stock enhancement has become a core measure for restoring its resources. This study aimed to investigate the effects of different immersion durations and concentrations of SrCl₂ solution (10, 20, 40, 80 mg/L) on strontium (Sr) deposition in the otoliths of P. olivaceus, and to systematically evaluate the impacts of Sr marking on the fish’s antioxidant capacity and digestive enzyme activity. The results showed that the otolith Sr/Ca ratio was positively correlated with marking concentration and duration; the optimal parameters were 40 mg/L for 4 days, with the Sr/Ca ratio returning to baseline after 30 days post-marking, and a 100% marking success rate. There were no significant differences in body length, body weight, or condition factor between the experimental groups and the control group (p > 0.05), but mortality was significantly increased in the 80 mg/L group. Digestive enzymes exhibited a dose-dependent response to Sr exposure, characterized by activation at low concentrations and inhibition at high concentrations; lipase was the most sensitive, with an inhibition threshold of 10 mg/L. Sr marking within the range of 20–40 mg/L for 4–8 days significantly activated the activity of T-AOC, CAT, GPx, and SOD (p < 0.05) and reduced MDA content, indicating that the antioxidant system was activated without causing persistent oxidative damage. In conclusion, Sr marking is a safe and efficient method for otolith marking in Paralichthys olivaceus. The recommended protocol is immersion in a 40 mg/L SrCl₂ solution for 4 days, followed by a 30-day recovery period in clean seawater before being used for stock enhancement evaluation. This study provides a scientific basis and technical support for assessing the effectiveness of stock enhancement in P. olivaceus. Full article

Rock masses in short-term freeze–thaw zones tend to fail under long-term loading. Therefore, investigating the creep damage characteristics of rocks under short-term freeze–thaw cycles is of great significance for the stability evaluation of rock engineering. In this study, white sandstone was used as the research material. Multi-gradient short-term freeze–thaw cycle tests and graded loading creep acoustic emission (AE) tests were performed to investigate the creep behavior and AE response characteristics of sandstone after short-term freeze–thaw action, and a creep damage constitutive model was established. The results show the following: (1) The mass loss rate, P-wave velocity reduction rate, and porosity growth rate of sandstone increase with increasing freeze–thaw cycles and duration. (2) The instantaneous axial strain of specimens increases with the stress level under different freeze–thaw durations and cycle numbers. (3) The cumulative AE event rate decreases significantly with increasing freeze–thaw cycles and duration. (4) Based on the seven-element viscoelastic model, a creep damage constitutive model was developed by introducing the freeze–thaw damage factor (D), with an average goodness-of-fit of 0.964. The findings can provide a theoretical reference for the long-term stability assessment and disaster early warning of geotechnical engineering in short-term freeze–thaw regions. Full article

History museum exhibition spaces convey historical and cultural information through static artifacts, graphic–text narratives, and spatial atmosphere. The light environment affects not only exhibit visibility but also visitors’ visual comfort and perceptual preference. However, existing studies mainly focus on single lighting parameters, and perceptual differences across multiple lighting conditions remain insufficiently understood. This study investigated static exhibition spaces in history museums through a comparison of 12 virtual lighting conditions generated from different combinations of ambient illuminance, exhibit illuminance, and correlated color temperature. Visitors’ visual behavior and subjective perception were evaluated through eye-tracking experiments, heatmap analysis, and Likert-scale ratings. Different lighting combinations significantly affected visual attention allocation and subjective evaluation. Total duration of fixation, number of fixations, and average pupil diameter showed significant differences across conditions, whereas average fixation time did not. Overall, moderate ambient illuminance and higher exhibit illuminance were associated with more stable visual responses and more positive perceptual evaluations, while correlated color temperature showed a regulatory effect within the tested range of 3000–4000 K. These findings provide preliminary evidence for understanding perceptual responses to lighting combinations in static exhibition spaces and may inform future field-based validation of museum lighting design. Full article