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Background: Pharmacotherapy provides an option for overweight and obese adults to reduce their body weight if lifestyle modification fails. This systematic review summarises latest and likely practice-changing evidence for the benefits and harms of weight-lowering drugs. Methods: The network meta-analysis included searches of PubMed, Embase, and Cochrane Library (CENTRAL) for randomised controlled trials of weight-lowering drugs in overweight and obese adults. We performed a frequentist random-effect network meta-analysis to summarise the evidence and applied GRADE frameworks to rate the certainty of the evidence, calculate the absolute effects, categorise interventions and present the findings. Findings: The 143 eligible trials enrolled 49 810 participants. Except for levocarnitine, all drugs lowered body weight compared with lifestyle modification alone; all subsequent numbers refer to comparisons with lifestyle modification alone. High to moderate certainty evidence established phentermine/topiramate (odds ratio [OR] of ≥5% weight reduction: 8·00, 95% confidence interval [CI]: 5·19 to 12·34; mean difference [MD] of percent body weight change: −7·97%, 95%CI: −9·28 to −6·66%) and glucagon-like peptide-1 (GLP-1) receptor agonists (OR: 6·20, 95% CI: 4·88 to 7·89; MD: −5·75%, 95%CI: −6·30 to −5·20%) were among the most effective in lowering weight. Naltrexone/bupropion (OR: 2·68, 95% CI: 2·06 to 3·49), phentermine/topiramate (OR, 2·36, 95% CI: 1·60 to 3·46), GLP-1 receptor agonists (OR: 2·16, 95% CI: 1·68 to 2·78), and orlistat (OR: 1·68, 95% CI: 1·38 to 2·05) increase any adverse event leading to drug discontinuation. In a post hoc analysis, semaglutide, one of the GLP-1 receptor agonists, demonstrated for both likelihood of ≥5% weight loss (OR: 9·81, 95% CI: 7·06 to 13·63) and percent body weight change (MD: −11.41%, 95%CI: −12.54 to −10.27%) and substantially larger than any other drugs with an increased risk of adverse events leading to discontinuation (OR: 1·98; 95% CI: 1·33 to 2·96). Interpretation: In overweight and obese adults, phentermine/topiramate and GLP-1 receptor agonists proved the best drugs in reducing weight; of the GLP-1 agonists, semaglutide may be the most effective. Funding: 1.3.5 Project for Disciplines of Excellence, West China Hospital, Sichuan University (grant numbers ZYGD18022 and 2020HXF011). Declaration of Interest: We declare no competing interests.

A highly potential visible light active g-C3N4/Bi4NbO8X (Cl, Br) heterojunction photocatalysts were constructed at the interface of the coupling between Bi4NbO8X (Cl, Br) and g-C3N4. The band gap value of heterojunctions g-C3N4/Bi4NbO8Br-20% (CNBNB-3) and g-C3N4/Bi4NbO8Cl-20% (CNBNC-3), and pristine materials g-C3N4 (CN), Bi4NbO8Cl and Bi4NbO8Br materials were analyzed to be 2.68 eV, 2.69 eV and 2.74 eV, 2.46 eV and 2.48 eV, respectively. The degradation performance of optimized CNBNC-3 and CNBNB-3 photocatalysts revealed much superior removal efficiency of 97% and 84% than the pristine material for rhodamine B. The synthesized photocatalysts maintained good recyclable stability after five consecutive cycles and potentially capable of pollutant degradation. The electrochemical impedance and photoluminescence spectroscopy revealed that the migration and separation efficiency of photogenerated charge carriers of photocatalyst were boosted, while reduced recombination rate was observed. The photocatalytic reaction mechanism also revealed the superoxide ·O 2 − and •OH radicals are the main active species responsible for the pollutant degradation.

Based on the Mach-Zehnder interference principle, a optic-fiber curvature and temperature sensor consisting of a lateral-offset spliced single-mode fiber-four-core fiber-single-mode fiber (SMF-FCF-SMF) interference structure has been proposed and demonstrated. The curvature and temperature characteristics of the sensor with different offset distances are studied in detail. Within the curvature range of 0.042–0.163 m−1, the maximum curvature sensitivity can reach −18.75 nm/m−1. Besides, the temperature sensitivity of the sensor is as high as 74 pm/°C in the range of 30–80 °C. The sensor has good linearity in measuring curvature and temperature with a simple structure, expected to be applied in industrial production, building monitoring, etc.

Background 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. Methods To identify Asian-derived type 2 diabetes risk-prediction models we did a systematic MEDLINE and Embase literature search for publications from inception until July 13, 2019. The publications identified were divided into basic (clinical variables only) and extended (plus laboratory variables) models. Validation was done in two prospective Chinese IGT cohorts: the Acarbose Cardiovascular Evaluation (ACE) trial of participants with IGT and coronary heart disease treated with placebo (n=3241), and the Luzhou survey cohort with IGT in which 96% did not have coronary heart disease (n=1155). Model performance was assessed in terms of discrimination (C-statistic) and calibration (Hosmer-Lemeshow test and calibration plot). Findings We identified 36 Asian-derived models (13 basic and 23 extended). In the ACE trial type 2 diabetes developed over a median of 5 years (IQR 3·4–6·0) with a follow-up for 15·7% of participants and in the Luzhou cohorts the disease developed over 3 years (3·0–3·0) with a follow-up for 20·7%. Basic models showed poor discrimination in these populations (C-statistic 0·53–0·59 for the ACE trial participants and 0·52–0·58 for the Luzhou cohorts). Extended models showed poor-to-acceptable discrimination (C-statistic 0·56–0·73 for the ACE trial participants and 0·51–0·66 for the Luzhou cohorts). Most extended models overestimated diabetes risk in the ACE cohort and underestimated risk in the Luzhou cohort, whereas all basic models underestimated diabetes risk in both populations. Basic and extended models showed poor calibration, although performance was improved by recalibration. The navigator model showed the best discrimination in both populations but had poor calibration. Interpretation In Chinese people with IGT (with or without coronary heart disease), Asian-derived basic models to predict type 2 diabetes did not exhibit good discrimination or calibration. Several extended models performed better, but a robust Chinese diabetes risk-prediction tool remains a major unmet need. Funding None.

A novel multi-parameter (refractive index, temperature and curvature) sensor based on the splicing-point tapered FBG-SMF-FCF-SMF (FBG, fiber Bragg grating; SMF, single-mode fiber; FCF, four-core fiber) Mach-Zehnder interferometer (MZI) is proposed and fabricated. Two waist-enlarged tapers formed at the fusion points between SMFs and FCF play the roles of the beam splitter and coupler, respectively. FBG is used to monitor temperature change and to compensate for temperature shift in the measurements of refractive index and curvature. The results show that the extinction ratio of transmission spectrum can reach at 27.22 dB. The sensitivities of the sensor to the external refractive index and curvature are 116.396 nm/RIU and 15.57 pm/m−1, respectively. The temperature sensitivities of MZI and FBG are respectively 67.31 pm/℃ and 8.73 pm/℃ in the range of 0-80℃. All the three-parameter measurements present good linear relationship. The sensor has the advantages of simple structure, easy process and low cost, which can be used in multi-parameter detection.