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Using the no-core fiber (NCF)–seven-core fiber (SCF) interference structure, two curvature sensors of Michelson interference type and Mach–Zehnder interference (MZI) type are proposed, respectively. The curvature sensor based on Michelson interference shows wavelength-modulation characteristics, the sensitivity is about −22.76 nm/m−1with a linearity of 0.9823, the temperature sensitivity is only 0.054 nm/°C, and the effect of temperature on curvature can be negligible. The MZI sensor based on an enlarged taper-embedded cascaded structure is an intensity-modulated sensor. The sensitivities are −63.6271 dB m/m−1and 93.3293 dBm/m−1for the forward and reverse curvature, respectively, and the linearities are 0.9987 and 0.9930, respectively. But the strain sensitivity (8.357 × 10−4dBm/με) of the MZI sensor is so tiny, which can avoid the strain cross effect. The two sensors can be used in the detection of the curvature at different (temperature/strain) conditions.

Pharmacotherapy provides an option for adults with overweight and obesity to reduce their bodyweight if lifestyle modifications fail. We summarised the latest evidence for the benefits and harms of weight-lowering drugs.

Pharmacotherapy provides an option for adults with overweight and obesity to reduce their bodyweight if lifestyle modifications fail. We summarised the latest evidence for the benefits and harms of weight-lowering drugs.

ABSTRACTObjectivesTo evaluate the performance and cost-effectiveness of existing diabetes risk scores (DRSs) to screen for undiagnosed diabetes mellitus (UDM) and prediabetes (PD) in a community-based southwestern Chinese population.MethodsParticipants in TIDE-Chengdu survey with requisite data and without known diabetes were included. Five Chinese-derived DRSs and six non-Chinese-derived DRSs were included for evaluation. Their performance in detecting UDM and UMD or PD (UDM/PD) was assessed using the C-statistic. The cost-effectiveness of the optimal DRS was compared with that of capillary fasting blood glucose (CFBG).ResultsOf the 1,692 TIDE-Chengdu survey participants included, 177 (10.5%) had UDM and 339 (20.0%) had PD. The rural participants (N = 737) were more likely to have UDM (13.4% vs. 8.2%) and PD (24.8% vs. 16.3%) than their urban counterparts (N = 955) (P < 0.0001). In the full population, the included DRSs all showed good discrimination in detecting UDM (C-statistic: 0.699 to 0.762) and UDM/PD (C-statistic: 0.717 to 0.769), but the New Chinese DRS (NCDRS) performed best for both UDM and UDM/PD. The DRSs evaluated all showed better performance in urban participants than rural participants for both UDM (C-statistic: 0.718 to 0.795 vs. 0.642 to 0.720) and UDM/PD (C-statistic: 0.729 to 0.793 vs. 0.682 to 0.726) (all P < 0.05). The mean cost per UDM/PD case identified was lower with NCDRS at score 25 (¥503.3($71.9)) and 27 (¥490.5 ($70.1)) than CFBG at 5.0, 5.1, 5.2, or 5.3 mmol/L (¥631.7 ($90.2), ¥611.8 ($87.4), ¥579.2 ($82.7) and ¥551.9 ($78.8)), whereas the mean costs per UDM case identified was higher with NCDRS at score 25 (¥1379.3 ($197.0)) and 27 (¥1315.1 ($187.9)) than CFBG at 5.3, 5.4, or 5.5 mmol/L (¥1301.7 ($186.0), ¥1247.7 ($178.2) and ¥1173.3 ($167.6)).ConclusionThe NCDRS represents a valid and cost-effective tool for use in southwestern China to identify high-risk patients with UDM or PD who need a diagnostic test.

ABSTRACTObjectives: We aim to conduct a meta-analysis, by stratifying diabetic patients with or without clinical cardiovascular diseases (CVD), to explore whether there are different cardiovascular effects of dipeptidyl peptidase-4 inhibitors (DPP-4is) on these two different classes of diabetic patients.Methods: We searchedMedline,Embase, theCochrane Libraryand ClinicalTrials.gov for relevant randomized controlled trials (RCTs). The included trials are divided into CVD (+) trials (subjects with established CVD), and CVD (-) trials (subjects with no CVD). We use all-cause mortality and cardiovascular outcomes as primary endpoints.Results: (1) Three CVD (+) trials were included and 36,895 subjects were enrolled with a mean follow-up duration of 127.1 weeks. The pooled results showed that DPP-4is treatment, compared with the placebo, did not significantly affect all-cause mortality (RR, 1.03; 95% CI, 0.95 to 1.11), cardiovascular death (1.01, 0.91 to 1.12), myocardial infarction (0.98, 0.88 to 1.08) or stroke (1.02, 0.88 to 1.18) in diabetic patients with coexisting CVD history; however, it significantly increased the risk of heart failure (1.14, 1.01 to 1.27) in this population. 2) Thirty-five CVD (-) trials were included, and 29,600 patients were enrolled with a mean follow-up duration of 77.8 weeks. The analysis comparing DPP-4is with the placebo control showed that DPP-4is treatment did not significantly affect the risk of all-cause mortality or cardiovascular outcomes in diabetic patients free of CVD history. However, when compared with the active control, the pooling data showed that DPP-4is had a significant reduction on the risk of stroke (0.58, 0.34 to 0.99) but did not significantly affect the risk of all-cause mortality and other cardiovascular outcomes.Conclusion: DPP-4is may have no cardiovascular protective effects in diabetic patients with coexisting CVD, while there is a lack of definitive evidence supporting the cardiovascular benefits of DPP-4is treatment among diabetic patients free of CVD history.

Preventing type 2 diabetes is a major challenge in China, which has the world's largest population with impaired glucose tolerance (IGT). Given that no validated diabetes risk-prediction tools exist for Chinese people with IGT to inform decision making when considering primary diabetes prevention measures, we evaluated the performance of published Asian-derived type 2 diabetes risk-prediction models in Chinese people with IGT.