Search Results (407)

Background: Type 2 diabetes mellitus (T2DM) is a global epidemic in which gut microbiota dysbiosis contributes to impaired glucose homeostasis and chronic inflammation. Intermittent fasting (IF) and probiotic supplementation have independently demonstrated glycemic benefits in T2DM, largely through microbiota remodeling. This narrative review synthesizes evidence up to October 2025 to clarify the microbiota-dependent mechanisms of IF and probiotics, and to evaluate the biological plausibility and preliminary clinical data for their combined application in T2DM management. Methods: We conducted a comprehensive literature review of preclinical and clinical studies (PubMed, Embase, Web of Science, and Cochrane Library) examining IF regimens (primarily time-restricted feeding and 5:2 protocols) and multi-strain probiotics containing Lactobacillus and Bifidobacterium species in T2DM or relevant models. Mechanistic pathways, microbial compositional shifts, and metabolic outcomes were qualitatively synthesized, with emphasis on overlapping signaling (short-chain fatty acids, bile acids, GLP-1, and barrier function). Results: IF consistently increases Akkermansia muciniphila and, variably, Faecalibacterium prausnitzii abundance, restores microbial circadian rhythmicity, and enhances SCFA and secondary bile acid production. Multi-strain probiotics modestly reduce HbA1c (–0.3% to –0.6%) and fasting glucose, outperforming single-strain preparations. Both interventions converge on reduced endotoxaemia and improved intestinal integrity. Preclinical models indicate potential synergy, whereas the only direct human trial to date showed neutral results. Conclusions: IF and probiotics engage overlapping microbiota-mediated pathways, supporting their combined use as an adjunctive strategy in T2DM. Adequately powered randomized trials incorporating deep metagenomics, metabolomics, and hard clinical endpoints are now required to confirm additive or synergistic efficacy. Full article

Background/Objectives: Prolonged fasting—defined as voluntary abstinence from caloric intake for periods exceeding 24 h—is increasingly recognized not only as a metabolic intervention but also as a psycho-behavioral modulator. According to the 2024 international consensus, intermittent fasting encompasses diverse temporal patterns including time-restricted feeding, alternate-day fasting, and periodic fasting of multi-day duration. While metabolic benefits are well documented, the psychoneurobiological and psychiatric consequences remain incompletely characterized. This review critically appraises current evidence on the psychological and psychiatric effects of prolonged and intermittent fasting, including both secular and religious practices. Methods: A narrative synthesis was conducted on clinical trials, observational studies, and translational research published between January 2010 and June 2025 in PubMed, Scopus, and PsycINFO. Search terms included combinations of “prolonged fasting,” “intermittent fasting,” “psychological,” “psychiatric,” “religious fasting,” “Ramadan,” and “Orthodox Church.” Eligible studies required explicit evaluation of mood, cognition, stress physiology, or psychiatric symptoms. Data were analyzed qualitatively, with particular attention to study quality, fasting regimen characteristics, and participant vulnerability. This is a non-registered narrative synthesis drawing on clinical trials, observational studies, and preclinical evidence published between January 2010 and June 2025. Results: Eighty-seven studies met inclusion criteria (39 human; 48 preclinical). In metabolically healthy adults, short-term time-restricted eating and supervised prolonged fasting were associated with modest reductions in depressive symptoms and perceived stress, with small improvements in executive functioning—typically observed in small samples and with limited follow-up. Religious fasting during Ramadan and the Orthodox Christian fasting periods demonstrated similar neuropsychological effects, including greater perceived spiritual meaning and affective modulation, though cultural context played a moderating role. Potential adverse mental-health impacts included mood destabilization, anxiety exacerbation, and rare psychotic or manic decompensations in vulnerable individuals. Randomized trials reported few adverse events and no signal for severe psychiatric harm, whereas observational studies more often noted symptom exacerbations in at-risk groups. Patients with eating disorder phenotypes exhibited increased cognitive preoccupation with food and a heightened risk of behavioral relapse. Methodological heterogeneity across studies—including variation in fasting protocols, psychological assessments, and follow-up duration—limited cross-study comparability. Conclusions: Evidence indicates a bidirectional relationship wherein fasting may foster psychological resilience in select populations while posing significant psychiatric risks in others. Inclusion of religious fasting traditions enriches understanding of culturally mediated outcomes. To enhance rigor and safety, future studies should incorporate clinician-rated outcomes (e.g., HDRS-17, CGI-S/CGI-I), standardized adverse-event tracking using validated psychiatric terminology, and prospective safety monitoring protocols, with ≥6–12-month follow-up. Full article

Optimizing energy conversion in photovoltaic (PV) systems is crucial for maximizing energy conversion efficiency and ensuring reliable operation. Achieving this requires that the PV array consistently operates at the Global Maximum Power Point (GMPP). Conventional Maximum Power Point Tracking (MPPT) algorithms, such as Perturb and Observe (P&O) and Incremental Conductance (INC), perform effectively under uniform irradiance but fail to track the GMPP under partial shading conditions (PSCs), resulting in energy losses and degraded system efficiency. To overcome this limitation, this paper proposes a hybrid MPPT method that integrates the Crayfish Optimization Algorithm (COA), a bio-inspired metaheuristic, with the P&O technique. The proposed approach combines the global exploration ability of COA with the fast convergence of P&O to ensure accurate and stable GMPP identification. The algorithm is validated under multiple irradiance patterns and benchmarked against established MPPT methods, including voltage-source and current-source region detection, Improved Variable Step Perturb and Observe and Global Scanning (VSPO&GS), and a hybrid Particle Swarm Optimization (PSO)-P&O method. Simulation studies performed in MATLAB/Simulink demonstrate that the proposed technique achieves higher accuracy, faster convergence, and enhanced robustness under PSCs. Results show that the proposed method reliably identifies the global peak, limits steady-state oscillations to below 1%, restricts maximum overshoot to 0.5%, and achieves the fastest settling time, stabilizing at the new power point significantly faster following major step changes, thereby enhancing overall PV system performance. Full article

Cancer remains a leading global cause of morbidity and mortality. Modifiable lifestyle factors, including avoidance of tobacco use and excessive ultraviolet radiation, healthy dietary patterns, regular physical activity, and weight management, play key roles in prevention and care. This narrative review synthesizes evidence on lifestyle-based interventions influencing cancer risk, treatment tolerance, and survivorship. A literature search was conducted in PubMed and Scopus, supplemented by manual screening via Google Scholar. The time frame (2001–2025) was selected to reflect evidence produced within the modern era of molecular oncology and contemporary lifestyle medicine research. Eligible publications addressed carcinogen exposure (tobacco, alcohol, ultraviolet radiation), diet and nutritional strategies, physical activity, sedentary behavior, obesity, metabolic health, complementary therapies, and cancer outcomes. Evidence indicates that reducing exposure to tobacco and ultraviolet radiation remains central to cancer prevention. Adherence to predominantly plant-based diets, regular physical activity, and maintenance of healthy body weight are consistently associated with lower incidence of several cancers, including breast, colorectal, and liver cancer. Nutritional strategies such as caloric restriction, ketogenic diets, and fasting-mimicking diets show promise in improving treatment efficacy and quality of life. Complementary and mind–body therapies may alleviate treatment-related symptoms, although high-quality evidence on long-term safety and effectiveness is limited. Integrating lifestyle medicine into oncology offers a cost-effective, sustainable strategy to reduce cancer burden and enhance survivorship. Comprehensive programs combining carcinogen avoidance, dietary regulation, structured exercise, and effective radiation risk mitigation may extend healthspan, improve treatment tolerance, and help prevent recurrence. Full article

Background: Advancements in low-cost additive manufacturing and artificial intelligence have enabled new avenues for developing accessible myoelectric prostheses. However, achieving reliable real-time control and ensuring mechanical durability remain significant challenges, particularly for affordable systems designed for resource-constrained settings. Objective: This study aimed to design and validate a low-cost, 3D-printed prosthetic arm that integrates single-channel electromyography (EMG) sensing with machine learning for real-time gesture classification. The device incorporates an anatomically inspired structure with 14 passive mechanical degrees of freedom (DOF) and 5 actively actuated tendon-driven DOF. The objective was to evaluate the system’s ability to recognize open, close, and power-grip gestures and to assess its functional grasping performance. Method: A Fast Fourier Transform (FFT)-based feature extraction pipeline was implemented on single-channel EMG data collected from able-bodied participants. A Support Vector Machine (SVM) classifier was trained on 5000 EMG samples to distinguish three gesture classes and benchmarked against alternative models. Mechanical performance was assessed through power-grip evaluation, while material feasibility was examined using PLA-based 3D-printed components. No amputee trials or long-term durability tests were conducted in this phase. Results: The SVM classifier achieved 92.7% accuracy, outperforming K-Nearest Neighbors and Artificial Neural Networks. The prosthetic hand demonstrated a 96.4% power-grip success rate, confirming stable grasping performance despite its simplified tendon-driven actuation. Limitations include the reliance on single-channel EMG, testing restricted to able-bodied subjects, and the absence of dynamic loading or long-term mechanical reliability assessments, which collectively limit clinical generalizability. Overall, the findings confirm the technical feasibility of integrating low-cost EMG sensing, machine learning, and 3D printing for real-time prosthetic control while emphasizing the need for expanded biomechanical testing and amputee-specific validation prior to clinical application. Full article

Obesity remains a major global health challenge, with glucagon-like peptide-1 receptor agonists (GLP-1RAs) providing substantial yet sensitive benefits in weight reduction, glycemic control, and cardiovascular protection. Despite robust trial data, real-world persistence is limited by cost, tolerability, and hedonic adaptation. Intermittent fasting and time-restricted eating offer physiologically complementary, low-cost strategies that enhance fat oxidation, insulin sensitivity, and metabolic flexibility while engaging behavioral mechanisms of self-control and dietary regularity. This narrative review synthesizes current evidence and proposes a pragmatic, phased framework integrating GLP-1RA therapy with structured intermittent fasting and protein-optimized nutrition. The model emphasizes sequential initiation, transition, and maintenance phases designed to align pharmacologic appetite suppression with lifestyle-driven metabolic remodeling. Mechanistically, GLP-1RAs target vascular and neuroendocrine pathways, whereas fasting activates nutrient-sensing networks (AMPK, mTOR, sirtuins) associated with autophagy and longevity. Combined application may preserve lean mass, improve psychological autonomy, and reduce healthcare costs. Future research should validate this hybrid strategy in randomized trials assessing long-term weight durability, functional outcomes, and cost-effectiveness. By uniting pharmacologic potency with behavioral sustainability, phased GLP-1–fasting integration may represent an effective, affordable, and longevity-oriented paradigm for metabolic health. Full article

Time-qualified dietary interventions, including time-restricted eating (TRE), intermittent fasting (IF), and periodic fasting-mimicking diets (FMDs), have emerged as strategies to improve metabolic health. While preclinical studies consistently demonstrate robust effects on energy metabolism, cardiometabolic function, and longevity, translation to humans remains heterogeneous. In free-living settings, most metabolic improvements observed with TRE and IF appear primarily driven by spontaneous caloric restriction rather than meal timing per se, and isocaloric randomized controlled trials generally show no additional benefits compared to standard calorie restriction. Evidence supporting circadian-specific advantages, particularly for early TRE, is promising but inconsistent and often context-dependent. Important uncertainties also persist regarding long-term efficacy, lean mass preservation, safety in specific populations, and the physiological impact of extended fasting windows. Despite these controversies, time-qualified diets represent a paradigm shift in nutritional science by integrating chronobiology with dietary patterns. Future directions include tailoring eating windows to individual chronotypes, combining fasting regimens with high-quality dietary patterns and structured physical activity, and clarifying the molecular mechanisms that may mediate calorie-independent benefits. Large, long-term, mechanistically informed human trials are essential to determine whether aligning eating behaviors with circadian biology can produce durable clinical improvements. Such work will ultimately shape the role of personalized chrononutrition in preventive and therapeutic nutrition. Full article

Background: Obesity is a metabolic condition that may impair insulin sensitivity and disrupt glucose homeostasis. Since insulin and glucose affect insulin-like growth factor-1 (IGF-1), disruptions in this axis may elevate the risk of chronic diseases. Intermittent fasting (IF) modulates metabolic parameters, but the impacts on glucose regulation and IGF-1 remain underexplored. This study aimed to assess the short-term effects of two IF types, time-restricted feeding (TRF) and alternate-day modified fasting (ADMF), on fasting blood glucose (FBG) and IGF-1 in obese young women. Methods: A quasi-experimental pretest–posttest control group design was conducted over 20 days. The 31 subjects were allocated into ADMF (n = 10), TRF (n = 11), and Control (n = 10). After excluding dropouts and outliers, the final sample consisted of 22 subjects (ADMF = 7, TRF = 8, Control = 7). FBG and IGF-1 serum were measured pre- and post-intervention. Results: The FBG post-intervention significantly increased in TRF (p = 0.001) and ADMF (p = 0.036) groups, but not in Controls. Only the TRF group showed a significant reduction in IGF-1 levels (p < 0.001). Nevertheless, the ADMF group exhibited substantial decreases in body weight (p = 0.047) and visceral fat (p = 0.017). Conclusions: A 20-day IF in obese young women induced distinct metabolic effects: TRF lowered IGF-1, ADMF reduced adiposity, and both regimens increased FBG. These findings suggest that early changes in glucose regulation are highly dependent on the specific dietary regimen used. Specifically, TRF predominantly influences endocrine regulation (IGF-1 axis), while ADMF favours adiposity reduction. The concurrent rise in FBG may reflect a transient shift in glucose homeostasis during the early stages of fasting. Full article

Direct current fast charging is a necessary element of the transition to electric vehicles (EVs). Regulatory complexity, capital requirements, and challenging business models hinder charging infrastructure deployment, so focusing on the efficient use of such infrastructure is of paramount importance. A tool to improve this efficiency is an incentive to terminate charging events when charging power drops, the vehicle state of charge rises above some value, or time plugged in exceeds a threshold. A timeseries charging demand model was built based on observed EV population and charging behavior. This was used to explore these three incentive trigger metrics across a range of plausible values, to find their relative impacts on the vehicles charging, those waiting in line to access a cordset, and charging site operators. Results indicate that basing such a trigger on charging power would have little impact if the threshold power is low enough to accommodate older, slower-charging vehicles, but that more restrictive limits based on state of charge or charging duration can decrease wait times, increase vehicle throughput, and increase total energy sales for cordsets serving more than 1000 EVs per year. Full article

The variation in in-cylinder pressure of diesel engine directly determines its working performance; therefore, the real-time monitoring technology for in-cylinder pressure of diesel engine is of great significance for monitoring the operation status of diesel engine. However, restricted by factors such as technology and cost, it is often impossible to monitor the in-cylinder pressure data of diesel engine during actual operation. To solve the above problem, this paper proposes an in-cylinder pressure curve monitoring model for diesel engine based on GRU (Gated Recurrent Unit), using easily collectible data signals such as crankshaft torque, crankshaft angle, and displacement of each cylinder as the basis. The correctness and accuracy of the above monitoring model are trained and verified using data obtained from bench tests, and a comparison is made with the commonly used in-cylinder pressure monitoring method based on simulation model. The results show that the diesel engine in-cylinder pressure monitoring model proposed in this paper has advantages such as high monitoring accuracy and fast calculation speed. Full article

Objectives: The present study was conducted to examine the effects of a one-year multicomponent exercise training (MCET) program on the physical function and cardiovascular risk factors of community-dwelling older adults at risk of sarcopenic obesity. Methods: Data of 78 Brazilian community-dwelling older adults at risk of sarcopenic obesity, identified as the simultaneous presence of probable sarcopenia and overweight, were examined. The MCET program was performed twice a week over one year. Physical performance evaluations included (i) a timed “up-and-go” (TUG), (ii) one-leg stand, (iii) walking speed (WS) at normal pace and fast pace, (iv) a 5-time sit-to-stand (5STS) test, and (v) isometric handgrip strength (IHG). Cardiovascular risk factors involved blood pressure (BP) values and waist-to-hip ratio. Results: Significant improvements in balance and WS at a normal pace were observed following the MCET program, while no changes were noted in other physical performance markers. Additionally, a significant reduction in diastolic BP was recorded. Conclusions: Findings indicated significant improvements in mobility and balance, as well as a notable reduction in diastolic BP, among community-dwelling older adults at risk of sarcopenic obesity following a one-year MCET program. These improvements may play a critical role in reducing the risk of adverse outcomes such as falls, disability, cardiovascular events, hospitalization, and mortality. However, the quasi-experimental design of the present study, the absence of a control group, and other methodological limitations restrict the generalizability of the results. Future research using more rigorous study designs is necessary to confirm and expand upon these findings. Full article

Gestational diabetes mellitus (GDM) is a heterogeneous disorder that compromises maternal and offspring health. Conventional medical nutrition therapy focuses on nutrient composition and caloric targets but largely omits timing and individualized biology. This narrative review synthesizes mechanistic, epidemiologic and interventional evidence linking circadian biology and meal timing (chrononutrition) to maternal glycemic control. Observational cohorts associate late eating and breakfast skipping with worse glycemia, while pilot interventions and CGM-based studies indicate that front-loading carbohydrates, restricting evening carbohydrate, extending overnight fasting (≈10–12 h), and simple within-meal sequencing can reduce postprandial excursions and increase time-in-range. We propose a pragmatic, tiered clinical pathway in which routine second-trimester triage (50 g glucose challenge test and ultrasound abdominal subcutaneous fat thickness) identifies higher-risk women for short-term CGM phenotyping and prioritized chrononutrition counseling. Integrating phenotype-matched timing interventions with dietetic support and digital decision tools allows rapid, individualized adjustments informed by real-time glucose patterns and patient chronotype. In principle, this tiered strategy could improve daily glycemic profiles, reduce the need for pharmacotherapy, and translate into better neonatal outcomes if supported by larger randomized trials. Chrononutrition therefore offers a promising extension of standard care: simple, low-cost adjustments to “when” food is eaten, supported by digital tools, could allow nutrition therapy for GDM to become more precise, more responsive, and ultimately more effective for both mother and child. Key priorities include validating bedside and chrono-omic stratifiers, testing scalable delivery platforms, and ensuring equitable access to personalized chrononutrition in pregnancy. Full article

Background: Vitamin D supplementation may influence oxidative stress, but evidence in populations following specific dietary patterns is limited. Methods: In this non-randomized, two-group exploratory study, 50 Orthodox nuns received vitamin D supplementation (2000 IU/day orally) for 16 weeks, whereas 50 age-matched women following time-restricted eating (TRE) served as controls receiving no supplementation. Anthropometric parameters, serum 25-hydroxyvitamin D [25(OH)D], and oxidative stress markers—total antioxidant capacity (TAC), glutathione (GSH), and thiobarbituric acid reactive substances—were measured at baseline and post-intervention. Results: At baseline, both groups were comparable in anthropometric and oxidative stress markers, except for serum 25-hydroxyvitamin D [25(OH)D], which was lower in the intervention group. Following supplementation, serum 25(OH)D increased from 15.77 ± 5.21 to 31.24 ± 7.87 ng/mL (p = 0.031) in Orthodox nuns. No significant changes were observed for TAC (0.93 ± 0.11 to 0.97 ± 0.09, p = 0.081) and GSH (6.01 ± 1.55 to 5.81 ± 1.41, p = 0.069), whereas TBARS decreased significantly (7.32 ± 1.31 to 6.94 ± 1.21, p = 0.041). No significant changes were observed in controls under TRE. Changes (Δ) in all variables represented the post–pre difference over the 16-week period. Pearson correlations showed no significant associations between Δ25(OH)D and ΔTAC (r = −0.244, p = 0.346), ΔGSH (r = 0.110, p = 0.675), or ΔTBARS (r = −0.116, p = 0.657). In multivariable regression adjusted for age, weight, body fat percentage, and baseline 25(OH)D, Δ25(OH)D was not an independent predictor of oxidative stress marker changes; however, weight (β = 0.08, p = 0.011) and body fat percentage (β = −0.13, p = 0.014) were associated with reductions in TBARS. Conclusions: In conclusion, sixteen weeks of vitamin D supplementation in women adhering to Orthodox fasting produced no consistent improvements in oxidative stress markers. While a small reduction in TBARS was observed, this effect was modest and appeared indirect, being more closely associated with decreases in body weight and fat mass than with vitamin D status itself. Taken together, our findings indicate an overall neutral impact of vitamin D on redox balance, suggesting that any antioxidant benefit is likely secondary to metabolic or adiposity-related changes. Full article

Background: Bone metastasis of breast cancer (BC) is a key reason for poor prognosis. Recently, natural ingredients derived from plants have been found to exert a broad anti-tumor effect and are considered to be promising candidates for adjuvant therapy. Astragalin (AS) was found to inhibit the progression of several types of tumors; however, the role of AS in regulating the bone metastasis of BC is still unclear. Methods: The effects of AS on the progression of bone metastasis of BC were detected in vivo through safranin O and fast green staining, in vivo living imaging and microCT. The BrdU assay and Annexin V-PI analysis were used to detect the effects of AS on the growth of BC cells. Furthermore, TRAP staining was performed to examine the formation of osteoclasts regulated by AS. A transcriptome was performed to explore the downstream effects of AS on regulating the growth of BC cells, and the mechanism was further confirmed by Western blot and real-time PCR. Results: Administration of AS could effectively attenuate the bone destruction and the progression of bone metastasis of BC. The growth of BC cells can be inhibited by AS by inducing ER stress-mediated upregulation of Ddit3. In addition, AS can also prevent osteoclastogenesis through inhibiting the activation of the AKT pathway. Conclusions: Our studies suggest that AS could be an ideal adjuvant therapy for attenuating the progression of bone metastasis of BC, since it can directly restrict the growth of tumor, as well as attenuate osteolysis. Full article

Atherosclerotic cardiovascular disease treatment is being reevaluated, since a residual cardiovascular risk (RCR) persists even in patients who achieve optimal LDL-C values. Underlying causes are metabolic dysfunction, lipoprotein(a), inflammation, and triglyceride-rich lipoproteins and their remnants. Dietary treatment options like time-restricted eating (TRE) are becoming more widely acknowledged for their potential advantages in metabolic health and weight control, as a treatment of atherosclerosis expanding beyond LDL-C medication. Beyond weight loss, TRE (which restricts meals to a window of 6 to 8 h) appears as the most accessible treatment, and has been shown to improve blood pressure, lipid profiles, and glucose regulation through mechanisms like metabolic switching and circadian synchronization. We hypothesize, and will present our arguments, that a key mechanism underlying the cardiovascular and weight-related benefits of TRE is its impact on the circadian regulation of angiopoietin-like protein 4 (ANGPTL4) activity within adipose tissue. Additionally, lipolysis is accelerated by ANGPTL4 activation. TRE, via its actions on ANGPTL4, therefore not only inhibits adipose fatty acid uptake but stimulates their release as well. Additionally, TRE may increase intravascular very low-density lipoprotein (VLDL) catabolism by muscle due to the reduced exposure of lipoprotein lipase (LPL) to competing chylomicrons, known to slow the rate of VLDL catabolism. During the prolonged fasting, VLDL residence time is thus shortened, limiting the exposure to endothelium and hepatic lipases and thus reducing the amount of atherogenic remnant particles. Larger, longer-term randomized controlled studies in a variety of groups are required to further clarify TRE’s function in RCR prevention and therapy. As knowledge of triglyceride lipoprotein (TRL) metabolism expands, a comprehensive strategy for the management of RCR emerges, and a broader spectrum of LPL regulator-based therapeutics is created. Consequently, it is advisable to prioritize further research into the influence of TRE on LPL modulation via ANGPTL4 and ANGPTL8, which provides a natural, accessible, and low-cost alternative. Full article