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AbstractObjectiveTo evaluate the comparative efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on glycaemic control, body weight, and lipid profile in adults with type 2 diabetes.DesignSystematic review and network meta-analysis.Data sourcesPubMed, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and Embase from database inception to 19 August 2023.Eligibility criteria for selecting studiesEligible randomised controlled trials enrolled adults with type 2 diabetes who received GLP-1RA treatments and compared effects with placebo or any GLP-1RA drug, with a follow-up duration of at least 12 weeks. Trials with a crossover design, non-inferiority studies comparing GLP-1RA and other drug classes without a placebo group, using withdrawn drugs, and non-English studies were deemed ineligible.Results76 eligible trials involving 15 GLP-1RA drugs and 39 246 participants were included in this network meta-analysis; all subsequent estimates refer to the comparison with placebo. All 15 GLP-1RAs effectively lowered haemoglobin A1c and fasting plasma glucose concentrations. Tirzepatide induced the largest reduction of haemoglobin A1c concentrations (mean difference −2.10% (95% confidence interval −2.47% to −1.74%), surface under the cumulative ranking curve 94.2%; high confidence of evidence), and fasting plasma glucose concentrations (−3.12 mmol/L (−3.59 to −2.66), 97.2%; high confidence), and proved the most effective GLP-1RA drug for glycaemic control. Furthermore, GLP-1RAs were shown to have strong benefits to weight management for patients with type 2 diabetes. CagriSema (semaglutide with cagrilintide) resulted in the highest weight loss (mean difference −14.03 kg (95% confidence interval −17.05 to −11.00); high confidence of evidence), followed by tirzepatide (−8.47 kg (−9.68 to −7.26); high confidence). Semaglutide was effective in lowering the concentration of low density lipoprotein (−0.16 mmol/L (−0.30 to −0.02)) and total cholesterol (−0.48 mmol/L (−0.84 to −0.11)). Moreover, this study also raises awareness of gastrointestinal adverse events induced by GLP-1RAs, and concerns about safety are especially warranted for high dose administration.ConclusionsGLP-1RAs are efficacious in treating adults with type 2 diabetes. Compared with the placebo, tirzepatide was the most effective GLP-1RA drug for glycaemic control by reducing haemoglobin A1c and fasting plasma glucose concentrations. GLP-1RAs also significantly improved weight management for type 2 diabetes, with CagriSema performing the best for weight loss. The results prompt safety concerns for GLP-1RAs, especially with high dose administration, regarding gastrointestinal adverse events.Systematic review registrationPROSPERO CRD42022342845.

El Niño–Southern Oscillation (ENSO) is a naturally occurring mode of tropical Pacific variability, with global impacts on society and natural ecosystems. While it has long been known that El Niño events display a diverse range of amplitudes, triggers, spatial patterns, and life cycles, the realization that ENSO’s impacts can be highly sensitive to this event-to-event diversity is driving a renewed interest in the subject. This paper surveys our current state of knowledge of ENSO diversity, identifies key gaps in understanding, and outlines some promising future research directions.

In around 1990, significant shifts occurred in the spatial pattern and temporal evolution of the El Niño‐Southern Oscillation (ENSO), with these shifts showing asymmetry between El Niño and La Niña phases. El Niño transitioned from the Eastern Pacific (EP) to the Central Pacific (CP) type, while La Niña's multi‐year (MY) events increased. These changes correlated with shifts in ENSO dynamics. Before 1990, El Niño was influenced by the Tropical Pacific (TP) ENSO dynamic, shifting to the Subtropical Pacific (SP) ENSO dynamic afterward, altering its spatial pattern. La Niña was influenced by the SP ENSO dynamic both before and after 1990 and has maintained the CP type. The strengthened SP ENSO dynamic since 1990, accompanied by enhanced precipitation efficiency during La Niña, make it easier for La Niña to transition into MY events. In contrast, there is no observed increase in precipitation efficiency during El Niño. Plain Language Summary In this study, we explored changes in the El Niño‐Southern Oscillation (ENSO) phenomenon from 1950 to 2022. We discovered significant shifts in ENSO complexity, particularly after 1990, affecting where ENSO events occur and how long they last. Notably, these changes differed between El Niño and La Niña phases. El Niño's location shifted from the Eastern Pacific to the Central Pacific, while La Niña extended its duration, leading to more multi‐year events. These complexities relate to shifts in El Niño and La Niña dynamics. El Niño changed from a Tropical Pacific dynamic to a Subtropical Pacific dynamic, influencing its shift to the central Pacific. La Niña dynamics remained constant, causing La Niña's central location to remain unchanged. After 1990, the tropical precipitation efficiency showed an asymmetric change between El Niño and La Niña phases. The intensified atmospheric response to La Niña cooling enabled more frequent activations of the SP ENSO dynamic, thus increasing the frequency of multi‐year La Niña. These findings advance our understanding of ENSO and can enhance ENSO prediction. Key Points El Niño‐Southern Oscillation complexity underwent significant asymmetric changes around 1990, especially in spatial pattern and temporal evolution El Niño's pattern shifted from Eastern Pacific to Central Pacific, while La Niña's timing transitioned from single‐year to multi‐year El Niño's primary dynamic shifted from Tropical Pacific to Subtropical Pacific (SP) whereas La Niña consistently remained in the SP

In this study, we evaluate the intensity of the Central‐Pacific (CP) and Eastern‐Pacific (EP) types of El Niño‐Southern Oscillation (ENSO) simulated in the pre‐industrial, historical, and the Representative Concentration Pathways (RCP) 4.5 experiments of the Coupled Model Intercomparison Project Phase 5 (CMIP5). Compared to the CMIP3 models, the pre‐industrial simulations of the CMIP5 models are found to (1) better simulate the observed spatial patterns of the two types of ENSO and (2) have a significantly smaller inter‐model diversity in ENSO intensities. The decrease in the CMIP5 model discrepancies is particularly obvious in the simulation of the EP ENSO intensity, although it is still more difficult for the models to reproduce the observed EP ENSO intensity than the observed CP ENSO intensity. Ensemble means of the CMIP5 models indicate that the intensity of the CP ENSO increases steadily from the pre‐industrial to the historical and the RCP4.5 simulations, but the intensity of the EP ENSO increases from the pre‐industrial to the historical simulations and then decreases in the RCP4.5 projections. The CP‐to‐EP ENSO intensity ratio, as a result, is almost the same in the pre‐industrial and historical simulations but increases in the RCP4.5 simulation. Key Points Smaller inter‐model diversity of ENSO intensities in CMIP5 than in CMIP3 Decrease in the diversity is particularly significant for the simulated EP ENSO Different response of EP and CP ENSO to global warming

The El Niño-Southern Oscillation (ENSO) and the variability in the Pacific subtropical highs (PSHs) have major impacts on social and ecological systems. Here we present an Atlantic capacitor effect mechanism to suggest that the Atlantic is a key pacemaker of the biennial variability in the Pacific including that in ENSO and the PSHs during recent decades. The ‘charging’ (that is, ENSO imprinting the North Tropical Atlantic (NTA) sea surface temperature (SST) via an atmospheric bridge mechanism) and ‘discharging’ (that is, the NTA SST triggering the following ENSO via a subtropical teleconnection mechanism) processes alternate, generating the biennial rhythmic changes in the Pacific. Since the early 1990s, a warmer Atlantic due to the positive phase of Atlantic multidecadal oscillation and global warming trend has provided more favourable background state for the Atlantic capacitor effect, giving rise to enhanced biennial variability in the Pacific that may increase the occurrence frequency of severe natural hazard events. Biennial variability has intensified in the Pacific in recent decades, but the cause of this increase is not fully understood. Here, with statistical analyses and numerical experiments, the authors show that an Atlantic capacitor effect has given rise to this enhanced biennial variability since the early 1990s.

A bstract We derive the three-body quantization condition in a finite volume using an effective field theory in the particle-dimer picture. Moreover, we consider the extraction of physical observables from the lattice spectrum using the quantization condition. To illustrate the general framework, we calculate the volume-dependent three-particle spectrum in a simple model both below and above the three-particle threshold. The relation to existing approaches is discussed in detail.

Metallic lithium affords the highest theoretical capacity and lowest electrochemical potential and is viewed as a leading contender as an anode for high-energy-density rechargeable batteries. However, the poor wettability of molten lithium does not allow it to spread across the surface of lithiophobic substrates, hindering the production and application of this anode. Here we report a general chemical strategy to overcome this dilemma by reacting molten lithium with functional organic coatings or elemental additives. The Gibbs formation energy and newly formed chemical bonds are found to be the governing factor for the wetting behavior. As a result of the improved wettability, a series of ultrathin lithium of 10–20 μm thick is obtained together with impressive electrochemical performance in lithium metal batteries. These findings provide an overall guide for tuning the wettability of molten lithium and offer an affordable strategy for the large-scale production of ultrathin lithium, and could be further extended to other alkali metals, such as sodium and potassium. Molten lithium cannot spread onto the lithiophobic substrate, hindering the production and application of lithium metal anodes. Here, the authors show a general chemical strategy to tune the wettability by forming new chemical bonds through the reactions with various organic coatings or elemental additives.

Surface Enhanced Raman Scattering (SERS) has been widely applied in many research fields such as biological detection and chemical analysis. However, for the common Au nanoparticles, it’s too hard to guarante the three aspects: the great enhanced effect, the controllable aggregation and the uniformity of nanoparticles, the environmental friendliness and biocompatibility of nanoparticles. In this paper, phytate acid (IP6)-coated Au nanoparticles (IP6@Au NPs) are more stable and have a higher enhancement factor than Au nanoparticles. In order to achieve the uniformity of the spherical IP6-coated@Au nanoparticles (IP6@Au NPs), IP6 was used as a soft template. In the presence of IP6, IP6@Ag nanoparticles were first synthesized by reducing AgNO 3 with trisodium citrate, then IP6@Au NPs were obtained by reducing HAuCl 4 with Ag nanoparticles. The IP6@Au NPs exhibit excellent Raman signal enhancement by using p-aminothiophenol (4-ATP) as the probe molecules. The effects of Fe 3+ on the performance of IP6@Au NPs SERS substrates were also studied. The results show that SERS has the best enhancement effect when adding proper amount of Fe 3+ (0.56 PPM), and the limit of detection was 10 −7  M 4-ATP.

A bstract Using non-relativistic effective Lagrangians in the particle-dimer picture, we rederive the expression for the energy shift of a loosely bound three-particle bound state of identical bosons in the unitary limit. The effective field theory formalism allows us to explicitly investigate the role of the three-particle force. Moreover, we discuss relaxing the unitary limit of infinite scattering length and demonstrate a smooth transition from the weakly bound three-particle state to a two-particle bound state of a particle and a deeply bound dimer.

Future changes in the position of the intertropical convergence zone (ITCZ; a narrow band of heavy precipitation in the tropics) with climate change could affect the livelihood and food security of billions of people. Although models predict a future narrowing of the ITCZ, uncertainties remain large regarding its future position, with most past work focusing on zonal-mean shifts. Here we use projections from 27 state-of-the-art climate models and document a robust zonally varying ITCZ response to the SSP3-7.0 scenario by 2100, with a northward shift over eastern Africa and the Indian Ocean and a southward shift in the eastern Pacific and Atlantic oceans. The zonally varying response is consistent with changes in the divergent atmospheric energy transport and sector-mean shifts of the energy flux equator. Our analysis provides insight about mechanisms influencing the future position of the tropical rain belt and may allow for more-robust projections of climate change impacts.The intertropical convergence zone is predicted to narrow under climate change with large uncertainties about its location. Analysis with CMIP6 models shows a zonally varying response, with northward shift over east Africa and the Indian Ocean and southward shift in east Pacific and Atlantic oceans.