Effects of combined treatment of probiotics and metformin in management of type 2 diabetes:A systematic review and meta-analysis

Background: Lifestyle changes and dietary intervention, including the use of probiotics, can modulate dysbiosis of gut microbiome and contribute to the management of type 2 diabetes mellitus (T2DM). This systematic review and meta-analysis aim to assess the efficacy of metformin plus probiotics versus metformin alone on outcomes in patients with T2DM. Methods: We searched MEDLINE and EMBASE from inception to February 2023 to identify all randomized controlled trials (RCTs), which compared the use of metformin plus probiotics versus metformin alone in adult patients with T2DM. Data were summarized as mean differences (MD) with 95 % confidence interval (CI) and pooled under the random effects model. Findings: Fourteen RCTs (17 comparisons, 1009 patients) were included in this systematic review. Pooled results show a significant decrease in fasting glucose (FG) (MD = −0.64, 95 % CI = −1.06, −0.22) and HbA1c (MD = −0.29, 95 % CI = −0.47, −0.10) levels in patients with T2DM treated with metformin plus probiotics versus metformin alone. The addition of probiotics to metformin resulted in lower odds of gastrointestinal adverse events (Odds ratio = 0.18, 95 % CI = 0.09, 0.3.8; I2 = 0 %). Conclusions: The addition of probiotics to metformin therapy is associated with improvement in T2DM outcomes. However, high-quality and adequately reported RCTs are needed in the future to confirm our findings.</p

PPAR agonists as add-on treatment with metformin in management of type 2 diabetes:a systematic review and meta-analysis

The combination of metformin and the peroxisome proliferator-activated receptors (PPAR) agonists offers a promising avenue for managing type 2 diabetes (T2D) through their potential complementary mechanisms of action. The results from randomized controlled trials (RCT) assessing the efficacy of PPAR agonists plus metformin versus metformin alone in T2D are inconsistent, which prompted the conduct of the systematic review and meta-analysis. We searched MEDLINE and EMBASE from inception (1966) to March 2023 to identify all RCTs comparing any PPAR agonists plus metformin versus metformin alone in T2D. Categorical variables were summarized as relative risk along with 95% confidence interval (CI). Twenty RCTs enrolling a total of 6058 patients met the inclusion criteria. The certainty of evidence ranged from moderate to very low. Pooled results show that using PPAR agonist plus metformin, as compared to metformin alone, results in lower concentrations of fasting glucose [MD = - 22.07 mg/dl (95% CI - 27.17, - 16.97), HbA1c [MD = - 0.53% (95% CI - 0.67, - 0.38)], HOMA-IR [MD = - 1.26 (95% CI - 2.16, - 0.37)], and fasting insulin [MD = - 19.83 pmol/L (95% CI - 29.54, - 10.13)] without significant increase in any adverse events. Thus, synthesized evidence from RCTs demonstrates the beneficial effects of PPAR agonist add-on treatment versus metformin alone in T2D patients. In particular, novel dual PPARα/γ agonist (tesaglitazar) demonstrate efficacy in improving glycaemic and lipid concentrations, so further RCTs should be performed to elucidate the long-term outcomes and safety profile of these novel combined and personalized therapeutic strategies in the management of T2D.PROSPERO registration no. CRD42023412603.</p

Neural network based corrosion modeling of Stainless Steel 316L elbow using electric field mapping data

Abstract Stainless steel (SS) is widely employed in industrial applications that demand superior corrosion resistance. Modeling its corrosion behavior in common structural and various operational scenarios is beneficial to provide wall-thickness (WT) information, thus leading to a predictive asset integrity regime. In this spirit, an approach to model the corrosion behavior of SS 316L using artificial neural networks (ANNs) is developed, whereby saline water at different concentrations is flown through an elbow structure at different flow rates and salt concentrations. Voltage, current, and temperature data are recorded hourly using electric field mapping (EFM) pins installed on the elbow surface, which serve as training data for the ANNs. The performance of corrosion modeling is verified by comparing the predicted WT with actual measurements obtained from experimental tests. The results show the exceptional performance of the proposed single ANN model to predict WT. The error is calculated by comparing the estimated WT and actual measurement recorded, where the maximum error for each setting is range from 0.5363 to $$0.7535\%$$ 0.7535 % . RMSE and MAE values of each pin in every setting are also computed such that the maximum values of RMSE and MAE are 0.0271 and 0.0266, respectively. Moreover, a concise account of the observed scale formation is also reported. This comprehensive study contributes to a better understanding of SS 316L corrosion and offers valuable insights for developing efficient strategies to prevent corrosion in industrial environments. By accurately predicting WT loss using ANNs, this approach enables proactive maintenance planning, minimizing the risk of structural failures and ensuring the extended sustainability of industrial assets

Experimental study on efficient propulsion system for multicopter UAV design applications

The usage of multicopter unmanned aerial vehicles (UAVs) has increased for various military and civilian purposes. The choice of propulsion system of such a vehicle is crucial to fulfill the intended mission requirements. The present study focuses on evaluating the efficiency of propulsion system by experimenting with different motor, propeller and battery combinations. The connection between the electronic speed controller (ESC) signal, current, power, thrust and torque in relation to propeller size is determined. It is observed that regardless of battery capacity or motor type, the thrust and torque produced for a given motor speed (RPM) for a specified propeller are similar. The higher capacity battery with 6000 mAh, denoted as B2 battery, consumes less current and can attain higher motor speed to produce the required thrust force than a lower capacity battery with 3300 mAh, denoted as B1 battery. The most efficient propeller, 12 inches in diameter (P4 propeller), is observed to achieve efficiency levels of 12.9 % for the B1 battery and 11.4 % for the B2 battery. Similarly, the most efficient motor, 700 KV motor (M1), is determined to exhibit efficiency of 64.29 % when coupled with the B1 battery and 62.01 % when coupled with the B2 battery. It is identified that using the B2 battery results in an increased payload capacity of 5.82 N, compared to 2.02 N with the B1 battery. Furthermore, when considering both scenarios with and without payload, greater endurance is observed when B2 battery is used as opposed to the B1 battery

Extended Discrete-Time Quasi-Sliding Mode Control for VTOL UAV in the Presence of Uncertain Disturbances

The discrete control problem of vertical take-off and landing unmanned aerial vehicle (VTOL UAV) in the presence of time-varying uncertain disturbances is developed in this paper. The complexity of control problem is managed by dividing the dynamical model into two subsystems i.e. translational dynamics and rotational dynamics, where each subsystem is composed of three states. A discrete-time quasi-sliding mode control (DTQSMC) is extended to maintain the trajectory tracking control by proposing a new-reaching law for VTOL UAV. A robust controller is designed to handle unknown time-varying disturbances acting upon the translational and rotational dynamics. Moreover, the proposed controller is designed to reduce the chattering issue that commonly appears in conventional sliding mode control (SMC). Rigorous mathematical proof is presented to analyze the stability of the entire closed-loop system. The performance of this design is demonstrated with numerous numerical analyses and simulations

PPAR agonists as add-on treatment with metformin in management of type 2 diabetes:a systematic review and meta-analysis

The combination of metformin and the peroxisome proliferator-activated receptors (PPAR) agonists offers a promising avenue for managing type 2 diabetes (T2D) through their potential complementary mechanisms of action. The results from randomized controlled trials (RCT) assessing the efficacy of PPAR agonists plus metformin versus metformin alone in T2D are inconsistent, which prompted the conduct of the systematic review and meta-analysis. We searched MEDLINE and EMBASE from inception (1966) to March 2023 to identify all RCTs comparing any PPAR agonists plus metformin versus metformin alone in T2D. Categorical variables were summarized as relative risk along with 95% confidence interval (CI). Twenty RCTs enrolling a total of 6058 patients met the inclusion criteria. The certainty of evidence ranged from moderate to very low. Pooled results show that using PPAR agonist plus metformin, as compared to metformin alone, results in lower concentrations of fasting glucose [MD = - 22.07 mg/dl (95% CI - 27.17, - 16.97), HbA1c [MD = - 0.53% (95% CI - 0.67, - 0.38)], HOMA-IR [MD = - 1.26 (95% CI - 2.16, - 0.37)], and fasting insulin [MD = - 19.83 pmol/L (95% CI - 29.54, - 10.13)] without significant increase in any adverse events. Thus, synthesized evidence from RCTs demonstrates the beneficial effects of PPAR agonist add-on treatment versus metformin alone in T2D patients. In particular, novel dual PPARα/γ agonist (tesaglitazar) demonstrate efficacy in improving glycaemic and lipid concentrations, so further RCTs should be performed to elucidate the long-term outcomes and safety profile of these novel combined and personalized therapeutic strategies in the management of T2D.PROSPERO registration no. CRD42023412603.</p