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Since reform and opening, our country's sports and cultural industries have grown from nothing. Due to the complexity of the evaluation factors and methods used to determine the competitiveness of the sports cultural industry, this paper establishes a seven-dimensional sports cultural industry competition based on the integration and development of the sports tourism industry and national culture, drawing on the theory and methods used to determine the tourism industry's competitiveness. Based on a fuzzy analysis algorithm, we developed a system for evaluating strength and a model for evaluating the competitiveness of the sports culture industry. According to the results of the evaluation of the competitiveness of the sports culture industry in numerous regions of China, the evaluation method proposed in this paper is superior to the traditional evaluation method and has contributed to the development of China's sports culture industry. [ABSTRACT FROM AUTHOR]

Background The association between iron supplementation and gestational diabetes mellitus (GDM) is still inconclusive, and this association has not been extensively studied in relation to plasma ferritin in the early second trimester. Objectives We aimed to prospectively examine the independent and combined associations of plasma ferritin concentrations and iron supplement use with GDM. Methods We studied 2117 women from the Tongji Maternal and Child Health Cohort in Wuhan, China. Plasma ferritin around 16 weeks' gestation was measured by ELISA kits and information on iron supplement use was collected by questionnaires. GDM was diagnosed by a 75-g oral-glucose-tolerance test (OGTT) at 24–28 weeks' gestation. A log-Poisson regression model was used to estimate the RR of GDM associated with plasma ferritin and iron supplementation. Results The median and IQR of plasma ferritin was 52.1 (29.6–89.9) ng/mL, and 863 (40.8%) participants reported use of iron supplements during the second trimester. A total of 219 (10.3%) participants developed GDM. Adjusted RRs (95% CIs) for GDM across increasing quartiles of plasma ferritin were 1.00 (reference), 2.14 (1.37, 3.34), 2.03 (1.30, 3.19), and 2.72 (1.76, 4.21), respectively. After adjustment, supplemental iron ≥60 mg/d during the second trimester was associated with an increased risk of GDM compared with nonusers (RR: 1.37; 95% CI: 1.02, 1.84). Conclusions Both elevated plasma ferritin concentrations in the early second trimester and use of ≥60 mg/d of supplemental iron during pregnancy are independently associated with increased risk of GDM. Further clinical trials with precision nutrition approaches considering both baseline iron status and supplement use are needed to evaluate the benefits and risks of iron supplementation during pregnancy. [ABSTRACT FROM AUTHOR]

Investigators in previous studies have drawn inconsistent conclusions regarding the relationship between relatively low exposure to fine particulate matter (particulate matter with an aerodynamic diameter ≤2.5 μm (PM2.5)) and risk of gestational diabetes mellitus (GDM), while the association between high PM2.5 exposure and GDM risk has not been well studied. We investigated the association of high PM2.5 exposure during pregnancy with blood glucose levels and GDM risk in Chinese women. The present study was conducted from August 2013 to May 2016 among 3,967 pregnant women in the Tongji Maternal and Child Health Cohort in Wuhan, China. PM2.5 exposure during pregnancy for each participant was estimated by means of land-use regression models. An interquartile-range increase in PM2.5 exposure (33.84 μg/m3 for trimester 1 and 33.23 μg/m3 for trimester 2) was associated with 36% (95% confidence interval (CI): 1.15, 1.61) and 23% (95% CI: 1.01, 1.50) increased odds of GDM during trimester 1 and trimester 2, respectively. An interquartile-range increment of PM2.5 exposure during trimester 1 increased 1-hour and 2-hour blood glucose levels by 1.40% (95% CI: 0.42, 2.37) and 1.82% (95% CI: 0.98, 2.66), respectively. The same increment of PM2.5 exposure during trimester 2 increased fasting glucose level by 0.85% (95% CI: 0.41, 1.29). Our findings suggest that high PM2.5 exposure during pregnancy increases blood glucose levels and GDM risk in Chinese women. [ABSTRACT FROM AUTHOR]

This paper presents detrital modes, clay and carbonate cements and major and trace element contents of the sandstones from the lower Xiaganchaigou formation deposited during the Eocene/Oligocene transition in the Lenghu tectonic belt on the northern margin of the Qaidam Basin, NW Qinghai–Tibetan plateau. Our results show that the sandstones are mainly lithic feldspathic, with clay content varying from 4.1 to 42.5 vol. % (average 13.7 vol. %). These sandstones have low contents of Na2O, MgO, Al2O3, K2O, CaO and TiO2, with the average contents of 2.14 wt%, 0.78 wt%, 7.96 wt%, 2.11 wt%, 6.14 wt% and 0.15 wt%, respectively. The total content of major elements is < 30 wt%, indicating that the pore water was in an alkaline environment with high pressure, so that the decarboxylation reaction of the organic matter took place to generate a large amount of carbon dioxide with a loss of 13C. Consequently, the δ13C of the carbonate cement is negatively biased to − 6.4‰; the deep high temperature environment and the external fresh water leaching make the δ18O value of the carbonate cement gradually lose, reaching − 13.19‰, according to its precipitation temperature (78–108 °C) and pore water salinity (104–110), it is judged that carbonate cement is mainly formed in the middle diagenetic stage and early diagenetic stage. The rare earth elements are mainly authigenic by the results of ∑REE and Y/Ho, and the deposition characteristics of trace elements such as Zn, Th, U, Ni, Co, Cr, Sr/Cu, Ceanom, Ce/La, ∑REE, Eu/Eu*, La/Yb, V/(V + Ni) and the transformation of later diagenesis, combining the characteristic of the global climate and the influence of uplifting of the Qinghai–Tibetan Plateau, indicate that the lower Xiaganchaigou formation was in a dry, cold and anoxic reducing environment. [ABSTRACT FROM AUTHOR]

Based on petrography and geochemistry, formation phases of carbonate cements and their sedimentary–diagenetic environments in Jurassic clastic rocks from the Lenghu V tectonic belt are determined. The results demonstrate that studied successions are mainly dark gray or black mudstone with interbedded thin gray siltstone and a few greywacke layers. Sandstones are lithic and feldspathic lithic greywacke with high kaolinite content. Calcite and ferrocalcite are the main carbonate cements. The carbon isotope values(δ13C) of the carbonate cements range from − 15.6 to 9.2‰ (average − 3.2‰) with a bimodal distribution. One peak is 4‰, which includes samples from the upper Xiaomeigou Formation (Fm) and the other one is − 12‰, which mainly represents the lower section. The oxygen isotope values(δ18O) have a wide range from − 18.5 to − 8.3‰ (average − 13.31‰). Combined with microscopic observations, two phases of carbonate cements are distinguished according to their isotopic characteristics. The earlier carbonate cements are mainly calcite and ferrocalcite, and they were precipitated in eodiagenesis stage. The carbon source of calcite was inorganic, and ferrocalcite was mixed with carbon from methanogenesis. This mixture led to a positive bias in the δ13C curve, which artificially inflated the paleosalinity. The later carbonate cements, formed in mesodiagenesis stage, were ferrocalcite. Decarboxylation of organic matters led to lower δ13C values. The major and trace elements data show that Sr, Ba, Fe and Mn have weak correlation with Al, Ti. So, they are effective to interpret the sedimentary environment. The Sr/Ba ratio < 1 indicates fresh water environment, Sr/Ca, Sr/Cu and Fe/Mn ratios suggest humid climate, and V/(V + Ni) ratio shows suboxic–anoxic environment. The carbon and oxygen isotopes, together with elemental geochemistry, show that the climate during the Early Jurassic was warm and wet and the studied successions were deposited in fresh water. The variations in elemental ratio curves indicate that climate became wetter and warmer later in the Early Jurassic. [ABSTRACT FROM AUTHOR]

This study aimed to determine whether increased carotenoids intake was associated with reduced risk of gestational diabetes mellitus (GDM). We performed a cross-sectional analysis using data from Tongji Maternal and Child Health Cohort study. The dietary carotenoids intake of 1978 pregnant women was assessed using a researcher-administered FFQ before undertaking an oral glucose tolerance test at 24–28 weeks. Multivariate logistic and linear regression analyses were used to obtain the effect estimates. Participants in the highest quartile of lycopene intake showed a lower risk of GDM (OR 0·50; 95 % CI 0·29, 0·86; P for trend = 0·007) compared with those in the lowest quartile; each 1 mg increase in lycopene consumption was associated with a 5 % (95 % CI 0·91, 0·99; P for trend = 0·020) decrease in GDM risk. No significant association was found between α-carotene, β-carotene, β-cryptoxanthin, lutein/zeaxanthin intake and GDM risk. Multiple linear regression analysis suggested an inverse association between lycopene intake and fasting blood glucose (FBG) (P for trend < 0·001); each 1 mg increase in lycopene intake was associated with 0·005 (95 % CI 0·002, 0·007; P for trend < 0·001) mmol/l decrease in FBG. Interaction analysis indicated consistent effect on each age or pre-BMI subgroup; however, a stronger protective effect of lycopene intake against GDM was observed among primigravid women (OR 0·20; 95 % CI 0·07, 0·55 in the highest v. the lowest quartile of intake; P for interaction = 0·036). In conclusion, dietary lycopene intake was mainly assumed via reducing FBG to decrease GDM risk, and the protection was relatively increased among primigravid women. [ABSTRACT FROM AUTHOR]

Background: Maternal iodine status has been suggested to affect birth outcomes. Few studies have focused on its effects on fetal growth during pregnancy.Objective: This study aimed to assess maternal iodine status during early pregnancy and further examine the relation between maternal iodine status and fetal growth.Methods: A total of 2087 singleton-pregnant women participating in the Tongji Maternal and Child Health Cohort study were involved. Urinary iodine concentration (UIC) and creatinine concentration were measured in spot urine samples collected in early pregnancy (<20 wk of gestation). Fetal head circumference (HC), femur length (FL), and estimated fetal weight (EFW) were evaluated by ultrasonography in each trimester. A multiple linear regression model was used to examine the association of iodine status with fetal growth characteristics, and a mixed-effects model was used to assess longitudinal effect.Results: The median UIC and iodine-to-creatinine (I/Cr) ratio were 178 μg/L and 234 μg/g, respectively. The prevalence of insufficient iodine status (I/Cr ratio <150 μg/g) was 19.8%(n = 414), of adequate iodine status (150-249 μg/g) was 34.8% (n = 726), of iodine status above the requirements (250-499 μg/g) was 32.1% (n = 669), and of excessive iodine status (≥500 μg/g) was 13.3% (n = 278). Maternal iodine insufficiency was inversely associated with fetal FL in the second and third trimesters. In stratified analysis, significant interactions were found between maternal iodine status and age as well as parity (all P < 0.05). The longitudinal analyses showed negative associations of maternal insufficient, more than adequate, or excessive iodine status with fetal growth during pregnancy (all P < 0.05).Conclusions: In central China, maternal iodine insufficiency and excess coexisted during early pregnancy and they both adversely affected fetal growth. There is an urgent need for ongoing monitoring of iodine status among vulnerable pregnant women in order to optimize iodine nutrition during pregnancy. [ABSTRACT FROM AUTHOR]

Background: "Doing the month", or "sitting month", is a traditional practice for postpartum women in China and other Asian countries, which includes some taboos against well-accepted healthy diet and lifestyles in general population. Previous studies have shown this practice may be associated with higher prevalence of postpartum problems. The current multicenter randomized controlled trial (RCT) aims to evaluate outcomes of diet and lifestyle interventions in Chinese postpartum women.Methods/design: The current multicenter RCT will be conducted in three representative areas in China, Shandong province, Hubei province and Guangdong province, which locate in northern, central and southern parts of China, respectively. Women who attend routine pregnancy diagnosis in hospitals or maternal healthcare centers will be invited to take part in this study. At least 800 women who meet our eligibility criteria will be recruited and randomly assigned to the intervention group (n > = 400) and the control group (n > = 400). A three-dimension comprehensive intervention strategy, which incorporates intervention measures simultaneously to individual postpartum woman, their family members and community environment, will be utilized to maximize the effectiveness of intervention. Regular visiting and follow-up will be done in both group; nutrition and health-related measurements will be assessed both before and after the intervention.Discussion: To our knowledge, this current study is the first and largest multicenter RCT which focus on the effectiveness of diet and lifestyle intervention on reducing the incidence rate of postpartum diseases and improving health status in postpartum women. We hypothesize that the intervention will reduce the incidence rates of postpartum diseases and improve nutrition and health status due to a balanced diet and reasonable lifestyle in comparison with the control condition. If so, the results of our study will provide especially important evidence for changes in both the concept and action of traditional postpartum practice in China.Trial Registration: ClinicalTrials.gov ID NCT01039051. [ABSTRACT FROM AUTHOR]

Background: Few studies have focused on cesarean delivery (CD) trends among primipara under the one-child and the two-child policies. This study aimed to explore the trends in CD rates among primipara during 1995-2019 and the associated factors with CD risk.Methods: This study obtained clinical data on primiparous mothers and newborns from 1995 to 2019 at a large tertiary hospital in Wuhan, China. Trends in CD rates were calculated using the joinpoint regression analysis. The Chi-square tests and log-binomial regression analyses were used to evaluate the associations between primary variables and CD risk.Results: CD rates showed a significant upward trend with an average annual percentage change (APC) of 2.2% (95% CI: 0.6, 3.8%) during the study period. In 1995-2006, the CD rates continued to increase with an APC of 7.8% (95% CI: 4.8, 10.9%). After 2006, the CD rates started to decline by an APC of - 4.1% (95% CI: - 5.5, - 2.6%). The CD rates non-significantly increased from 36.2% in 2016 to 43.2% in 2019. Moreover, the highest CD rate during 2015-2019 was observed on August 30 (59.2%) and the lowest on September 1 (29.7%). Primipara of older age and those with >3pregnancies had higher risks of CD. Furthermore, primipara who gave birth to newborns with low birth weight and macrosomia had higher risks of CD.Conclusions: Maternal and fetal as well as social and cultural factors may contribute to the rising trend of CD rates. Effective measures should be taken to control CD under the two-child policy, especially for primipara. [ABSTRACT FROM AUTHOR]

The average thickness of Paleogene sandstones reaches about 3000–4000 m at the northern margin of the Qaidam Basin. However, the provenance and sedimentary environment of these sandstones are uncertain; thus, more comprehensive research is needed. Integrated research is conducted on the provenance and weathering process based on petrographic characteristics, clay minerals, and geochemical compositions of sandstones in the center of the northern Qaidam Basin. The results of lithofacies analysis show that the Paleogene sandstones were mainly derived from an active continental magmatic arc, subduction accretion, or a fold-thrust belt. The average illite content in the Paleogene clay minerals is more than 50%, followed by chlorite and smectite, which reflect climatic and environmental characteristics that were arid to semi-arid, whereas the characteristics of carbon–oxygen isotopes reveal a mainly freshwater sedimentary environment. The corrected chemical index of alteration (CIAcorr) is between 56.3 and 75.7, with an average value of 66.5. These results indicate that the provenance of the Paleogene sandstones in the center of the northern Qaidam Basin mainly formed under cold and dry climatic conditions and experienced limited chemical weathering with a small amount that underwent intermediate chemical weathering under warm and humid conditions. [ABSTRACT FROM AUTHOR]

• The thermal aging of high viscosity modified asphalt consists of three processes: polymer degradation, phase structure damage and asphalt oxidation. • In short-term aging, the degradation of polymer has a more pronounced effect on the property of high viscosity modified asphalt. • In long-term aging, the oxidation of asphalt is dominated for the property change of high viscosity modified asphalt. • High viscosity modified asphalt has a better aging resistance than PEN70 asphalt and SBS modified asphalt. Currently, the high viscosity modified asphalt (HVMA) is widely used in the porous asphalt pavement (PA) in China. HVMA provides good raveling resistance and rutting resistance for PA due to the excellent rheological property of it. However, the high construction temperature and the well-developed void structure of PA lead to a severe aging of HVMA. In order to understand the thermal aging behavior and mechanism of HVMA, the changes of rheological property, chemical composition, and phase morphology of HVMA, SBS modified asphalt (SBSMA) and PEN70 asphalt (70#A) during thermal aging process were investigated in this study. Rotational viscosity (RV) test, frequency sweep test, and multiple stress creep recovery (MSCR) test were used to evaluate the rheological property of HVMA. Then, Fourier transform infrared spectroscopy (FTIR) test and Gel permeation chromatography (GPC) test were used to determine the effect of thermal aging on the chemical composition of HVMA. Moreover, the phase morphology of HVMA, and SBSMA were observed by Fluorescence microscopic (FM) test. Test results indicate that the rotational viscosity, softening point, and strain recovery of HVMA show a decreasing trend initially and then increase with the process of thermal aging. The polymer phase structure of HVMA degrades obviously in short-term aging process, which leads to a deteriorated rheological property of HVMA. After long-term aging, the oxidation of base asphalt is the main reason for the changes in rheological property of HVMA. The aging resistance of HVMA is better than 70#A and SBSMA. As the amount of polymers increases, the aging resistance of HVMA is further improved. During thermal aging process, the polymer phase structure of HVMA is more abundant than SBSMA, which contributes to the superior anti-aging property of HVMA. [ABSTRACT FROM AUTHOR]

We performed mineralogical and geochemical analyses of core samples from the Lenghuqi area in the northern marginal tectonic belt of the Qaidam Basin. The clay mineralogy of the Xiaganchaigou Formation sandstone is dominated by I + I/S + C types and characterized by high illite, a higher mixed-layer illite/smectite and chlorite, lesser smectite, and an absence of kaolinite. The clay minerals reflect that the Oligocene sedimentary basin formed in an arid-semi-arid climate with weak leaching and chemical weathering, and that diagenesis occurred in a K+- and Mg2+-rich alkaline environment. Measured major oxide concentrations show clear correlations. The lower Xiaganchaigou Formation is representative of a dry and cold freshwater sedimentary environment, whereas the upper Xiaganchaigou Formation is warmer and more humid. Trace element and rare earth element variations indicate that the paleoclimate conditions of the lower Xiaganchaigou Formation sedimentary period were relatively cold and dry, while the upper Xiaganchaigou Formation formed under warmer and more humid climate conditions. These findings reflect a global climate of a cold and dry period from the late Eocene to early Oligocene, and a short warming period in the late Oligocene. [ABSTRACT FROM AUTHOR]

Power dispatching systems currently receive massive, complicated, and irregular monitoring alarms during their operation, which prevents the controllers from making accurate judgments on the alarm events that occur within a short period of time. In view of the current situation with the low efficiency of monitoring alarm information, this paper proposes a method based on natural language processing (NLP) and a hybrid model that combines long short-term memory (LSTM) and convolutional neural network (CNN) for the identification of grid monitoring alarm events. Firstly, the characteristics of the alarm information text were analyzed and induced and then preprocessed. Then, the monitoring alarm information was vectorized based on the Word2vec model. Finally, a monitoring alarm event identification model based on a combination of LSTM and CNN was established for the characteristics of the alarm information. The feasibility and effectiveness of the method in this paper were verified by comparison with multiple identification models. [ABSTRACT FROM AUTHOR]

Objective: To explore the interactions between cervical length (CL) and placenta accreta spectrum (PAS) on severe postpartum hemorrhage (SPPH) in patients with placenta previa. Methods: A retrospective case–control study was conducted at four medical centers in China, and 588 patients with placenta previa were included. The logistic regression analysis and restricted cubic splines (RCS) were used to evaluate the association between CL and SPPH. Furthermore, the joint effect of CL and PAS on SPPH was assessed, and the additive and multiplicative interactions were calculated. Results: After adjusting for potential confounders, the negative linear dose–response relationship was confirmed by RCS, and the change of odds ratio (OR) was more significant when CL was 2.5 cm or less. The risk of SPPH was significantly higher when CL of 2.5 cm or less co‐existed with placenta increta/percreta than when CL of 2.5 cm less, or placenta increta/percreta existed alone (adjusted OR [aOR]CL ≤2.5cm&placenta accreta/non‐PAS 3.40, 95% confidence interval [CI] 1.37–8.45; aORplacenta increta/percreta&CL >2.5cm 4.75, 95% CI 3.03–7.47; aORCL ≤2.5cm&placenta increta/percreta 14.51, 95% CI 6.08–34.64), and there might be additive interaction between CL and placenta increta/percreta on SPPH (attributable proportion due to interaction 50.7%, 95% CI 6.1%–95.3%). Conclusion: If CL was routinely performed during PAS evaluation, the increased OR of short CL and PAS could allow better patient preparation through counseling. Synopsis: Risk of severe postpartum hemorrhage in patients with placenta previa tends to increase with shortening of cervical length, especially in patients with placenta increta/percreta. [ABSTRACT FROM AUTHOR]

Solar energy has received considerable attention worldwide because of its clean, safe and easily accessible characteristics. Accurate global solar radiation estimation is crucial for local energy potential assessments and deployment of photovoltaic power generation systems. However, the distribution of metrological data varies considerably between regions, and its quality considerably affects the accuracy of the estimation model. Motivated by these concerns, a metrological data estimation framework based on the time-series generative adversarial network (TimeGAN) and deep belief network (DBN) was proposed. First, the metrological data collected from 30 urban meteorological stations in China were analyzed through time-series aggregation. Next, a novel metrological data simulation model based on TimeGAN was proposed to enrich the quality of training samples. Furthermore, a generalized estimation model of daily solar radiation based on DBN was constructed. In the case study in China, TimeGAN outperforms other conventional generative adversarial networks in terms of data generation performance. The simulation results reveal that the TimeGAN-based simulation model can capture the inherent temporal characteristics of the original data, generate high-quality simulation data to reasonably improve the distribution of training data in various cities. In addition, the estimation results indicate that the proposed hybrid framework improve the accuracy of daily solar radiation estimation. [Display omitted] • A metrological data simulation model based on TimeGAN is firstly proposed. • Large-scale metrological data is analyzed by a novel time series aggregation. • A novel generalized daily solar radiation estimation framework is established. • The proposed estimation framework ensures high stability and generalization. [ABSTRACT FROM AUTHOR]

Objectives: To examine the relationship between poor sleep quality during pregnancy and the risk of gestational diabetes mellitus (GDM).Methods: A total of 4066 singleton pregnant women from the Tongji Maternal and Child Health Cohort (TMCHC) without overt diabetes before pregnancy were analyzed. Sleep quality and duration during early pregnancy were self-reported by enrolled women at their first antenatal care visit before 16 weeks of gestation. Gestational diabetes mellitus (GDM) was assessed with a 75-g, 2-h oral glucose tolerance test at 24-28 weeks of gestation. Information about self-reported sleep quality and duration in mid-pregnancy were also collected at this time. Odds ratios (OR) and 95% CIs were calculated by multivariable logistic regression models, and adjusted for potential confounders to estimate the effect of poor sleep quality and the interaction between sleep quality and duration on the development of GDM. Stratified analyses were performed according to age, parity, family history of diabetes and napping.Results: A total of 335 (8.2%) participants were diagnosed with GDM. Poor sleep quality was reported in 259 (6.4%) women during early pregnancy and 248 (6.1%) in mid-pregnancy. The risk of GDM was increased in women with poor sleep quality during early pregnancy (OR 1.77, 95% CI 1.20-2.61). No association was found between poor sleep quality during mid-pregnancy and the risk of GDM. The risk of GDM was highest in women with poor sleep and longer nighttime sleep duration during early pregnancy (OR 2.27, 95% CI 1.20-4.29) when compared with those who reported good sleep and 7.0-8.5 h of sleep duration per night. Stratified analysis found that the association between poor sleep quality in early pregnancy and the risk of GDM was stronger among women aged ≥30 years (OR 2.35, 95% CI 1.35-4.09) and those with a family history of diabetes (OR 4.02, 95% CI 1.54-10.48).Conclusions: Poor sleep quality during early pregnancy was associated with an increased risk of GDM. Screening for and treating sleep problems in early pregnancy could potentially reduce the risk of GDM. [ABSTRACT FROM AUTHOR]

[Display omitted] • Aromatic oil cannot solve the storage stability and compatibility issues of high-viscosity particle modified asphalt (HVPMA). • Stabilizers (PPA or sulfur) can significantly improve the storage stability and compatibility of HVPMA. • Rheological-based segregation index is more accurate for evaluating storage stability than softening point difference. • Cole-Cole plot analysis do not provide sufficient information predict the compatibility of HVPMA. High-viscosity particle modified asphalt (HVPMA) is one of the most popular asphalt binders for permeable pavement in China. This commercial high-viscosity particle modifier is usually rich in styrene–butadienestyrene (SBS) polymers, which brings marked storage stability and compatibility issues to HVPMA. Hence, this study aims to investigate the roles of aromatic oils (AO), polyphosphoric acid (PPA) and sulfur on the storage stability and compatibility of HVPMA. The effects of AO, PPA and sulfur on the overall performance of HVPMA are firstly investigated by physical, rheological tests and morphological observations. Through the cigar tube test, the effects of various additives on the storage stability of HVPMA are then analyzed. Lastly, the effects of various additives on the compatibility of HVPMA are determined by the Cole-Cole plot method via frequency scan test. Morphological observations indicate that the polymer phases become swelled and smoother after adding AO, and adding the chemical stabilizers can boost the formation of the network structures. The physical and rheological results show that the combination of PPA and sulfur makes the greatest contribution to the high-temperature performance improvement of HVPMA, followed by PPA and sulfur. Separation test results reflect that adding AO has little improvement on the storage stability of HVPMA, while the storage stability of HVPMA can be significantly improved by the addition of chemical stabilizers (i.e., PPA, sulfur, or a combination of both). The accuracy of the segregation index (SI) based on rheological properties is higher than that of the traditional softening point difference (SPD) index, and the SI value based on ZSV is easier to determine the segregation status. However, it is difficult to determine the correspondence between Cole-Cole curve symmetry and compatibility due to the influence of temperature, and the Cole-Cole curve method cannot provide sufficient information to determine the compatibility of HVPMA. [ABSTRACT FROM AUTHOR]

Abstract: Matsumoto and Ekman’s Japanese and Caucasian facial expressions of emotion (JACFEE) have been tried in many countries including China. Consistent results from these nominal (or categorical) studies have been shown that the perception accuracies of Anger, Disgust, Happiness and Sadness are high, and that of Contempt is low, and those of Fear and Surprise are mixed. We have hypothesized that a principal component analysis (PCA) on the perceived intensity alone might offer a scalar (dimensional) classification of emotion. We therefore invited 200 Chinese university students who were blind to the JACFEE nominal classification, to rate the emotion intensities displayed by each poser. Happiness received the highest intensity score, and Contempt the lowest. PCA results produced seven scalar factors of emotion which corresponded well to the nominal ones. Picture loadings on the target emotions demonstrated that Contempt emerged as an independent factor, similarly to Anger, Disgust, Happiness and Sadness. However, picture loadings in regard to Fear and Surprise were mixed up, which still leaves the question open how to separate the two emotions efficiently. Nevertheless, our study has been demonstrated the validity of JACFEE in Chinese culture, and suggests a modification of the picture clusters, especially those of Fear and Surprise. [Copyright &y& Elsevier]

Solar energy plays an essential role in environment governance and resource protection, as it is totally pollution-free and extensively accessed. An accurate knowledge of solar radiation is beneficial to the deployments of solar energy constructions, photovoltaic and thermal solar systems. In this study, a deep learning method is proposed for estimating daily global solar radiation, which is constituted by embedding clustering (EC) and functional deep belief network (DBN). Based on the curve shapes of daily solar radiation, EC divides the overall dataset into different subsets, which can be modeled separately. Knowledge from empirical radiation models is also merged as the input of functional DBN. The model can be directly applied to solar estimation in various stations due to its strong nonlinear representation. The case study in China is adopted that involves radiation data from a total of 30 stations to validate the practicability and accuracy of the proposed method. From the results, the method obtains better estimation precision with empirical knowledge, achieving 1.706 MJ/m2 of mean absolute error (MAE), 2.352 MJ/m2 of root mean square error (RMSE) and 13.71% of mean absolute percentage error (MAPE) according to the average values at the 30 stations. • One sole deep model can be applied at multiple sites to estimate solar radiation. • The pre-training of RBM reduces the optimization difficulty of deep networks. • The knowledge from empirical equations is involved by means of functional neurons. • The embedding clustering method provides initial cluster centers for k-means. • The proposed method is feasible for both daily and hourly estimation. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the clinical characteristics and pregnancy outcomes of acute pancreatitis during pregnancy (APIP)., Methods: A retrospective analysis was conducted on 20 cases of APIP admitted to Hubei Maternal and Child Health Hospital from January 2017 to September 2021. The etiology, clinical manifestations, and perinatal outcomes of APIP were analyzed using descriptive statistical analysis of the collected data., Results: The incidence of APIP in our hospital was 20 (0.02%) cases, all of which occurred in the late stage of pregnancy. Hypertriglyceridemic acute pancreatitis (HTG-AP) was the primary cause of APIP in 10 (50.0%) patients. A total of 11 (55.0%), seven (35.0%) and two (10.0%) patients had mild acute pancreatitis (MAP), moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP), respectively. Pregnant women with HTG-AP had significantly elevated serum triglyceride levels, had higher prepregnancy body mass indices, were more prone to developing diabetes and were more likely to progress to SAP. With a multidisciplinary approach and individualized treatment plans, there were no maternal deaths, and fetal death only occurred in one (5.0%) case., Conclusion: HTG-AP is prone to advancing to more severe states, and it is becoming more common every year. Therefore, blood lipid management during pregnancy should be emphasized. Pregnant women with digestive symptoms or severe hyperlipidaemia should be screened for APIP in a timely manner and receive clinical intervention to improve maternal and fetal outcomes during the perinatal period., (© 2024 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.)

This study aimed to explore key quality control factors that affected the prognosis of intensive care unit (ICU) patients in Chinese mainland over six years (2015-2020). The data for this study were from 31 provincial and municipal hospitals (3425 hospital ICUs) and included 2 110 685 ICU patients, for a total of 27 607 376 ICU hospitalization days. We found that 15 initially established quality control indicators were good predictors of patient prognosis, including percentage of ICU patients out of all inpatients (%), percentage of ICU bed occupancy of total inpatient bed occupancy (%), percentage of all ICU inpatients with an APACHE II score ⩾15 (%), three-hour (surviving sepsis campaign) SSC bundle compliance (%), six-hour SSC bundle compliance (%), rate of microbe detection before antibiotics (%), percentage of drug deep venous thrombosis (DVT) prophylaxis (%), percentage of unplanned endotracheal extubations (%), percentage of patients reintubated within 48 hours (%), unplanned transfers to the ICU (%), 48-h ICU readmission rate (%), ventilator associated pneumonia (VAP) (per 1000 ventilator days), catheter related blood stream infection (CRBSI) (per 1000 catheter days), catheter-associated urinary tract infections (CAUTI) (per 1000 catheter days), in-hospital mortality (%). When exploratory factor analysis was applied, the 15 indicators were divided into 6 core elements that varied in weight regarding quality evaluation: nosocomial infection management (21.35%), compliance with the Surviving Sepsis Campaign guidelines (17.97%), ICU resources (17.46%), airway management (15.53%), prevention of deep-vein thrombosis (14.07%), and severity of patient condition (13.61%). Based on the different weights of the core elements associated with the 15 indicators, we developed an integrated quality scoring system defined as F score=21.35%xnosocomial infection management + 17.97%xcompliance with SSC guidelines + 17.46%×ICU resources + 15.53%×airway management + 14.07%×DVT prevention + 13.61%×severity of patient condition. This evidence-based quality scoring system will help in assessing the key elements of quality management and establish a foundation for further optimization of the quality control indicator system., (© 2022. Higher Education Press.)

Objectives: As current studies on the relationships between air pollutants exposure during the first trimester and birth defects were not fully elucidated, this study aimed to assess the association between selected air pollutants and birth defects., Design: An observational study., Participants: We obtained 70 854 singletons with gestational age <20 weeks who were delivered at a large maternal and child healthcare centre in Wuhan, China., Outcome Measures: Birth defects data and daily average concentration of ambient particulate matter ≤10 µm diameter (PM 10 ), PM ≤2.5 µm diameter (PM 2.5 ), sulfur dioxide (SO 2 ) and nitrogen dioxide (NO 2 ) were obtained. Logistic regression analysis was applied to assess the association between maternal air pollutants exposure during first trimester and total birth defects, congenital heart defects (CHDs), limb defects and orofacial clefts with adjustments of potential covariates., Results: There were a total of 1352 birth defect cases included in this study, with a prevalence of 19.08‰. Maternal exposed to high concentrations of PM 10 , PM 2.5 , NO 2 and SO 2 in the first trimester were significantly associated with elevated ORs of birth defects (ORs ranged from 1.13 to 1.23). Additionally, for male fetuses, maternal exposed to high PM 2.5 concentration was associated with an elevated odd of CHDs (OR 1.27, 95% CI 1.06 to 1.52). In the cold season, the ORs of birth defects were significantly increased among women exposed to PM 2.5 (OR 1.64, 95% CI 1.41 to 1.91), NO 2 (OR 1.22, 95% CI 1.08 to 1.38) and SO 2 (OR 1.26, 95% CI 1.07 to 1.47)., Conclusions: This study showed unfavourable effects of air pollutants exposure during the first trimester on birth defects. Especially, the association between maternal PM 2.5 exposure and CHDs was only observed among male fetuses, and stronger effects of PM 2.5 , NO 2 and SO 2 exposure on birth defects were observed in the cold season., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Human activities have significantly increased the release of thallium (Tl) to the environment. However, the study of the relationship between maternal Tl exposure during pregnancy and the risk of preterm birth (PTB) is scarce so far. We aimed to investigate the association between Tl exposure in early pregnancy and the risk of PTB. A total of 2104 pregnant women from the Tongji Maternal and Child Health Cohort (TMCHC) in Wuhan, China were enrolled in the analysis. We collected the urine samples in early pregnancy (< 20 weeks) and inductively coupled plasma mass spectrometry (ICP-MS) was used to detect urinary Tl levels. The association between Tl levels and the risk of PTB was evaluated by an unconditional logistic regression. The median and geometric mean values of Tl levels were 0.35 μg/L (0.47 μg/g creatinine) and 0.33 μg/L (0.47 μg/g creatinine), respectively. Compared with the lowest tertile of Tl levels (≤ 0.37 μg/g creatinine), the highest tertile (> 0.57 μg/g creatinine) was associated with an increased risk of PTB with an adjusted odds ratio (OR) of 2.11 (95% confidence interval (CI): 1.08, 4.12). Stratified analyses showed an elevated risk of PTB related to the highest tertile of Tl levels for male newborns. After excluding women with miss covariate information, gestational diabetes mellitus, pregnancy-induced hypertension, reporting fish intake, or exposed to smoke, the association remained stable. Our results suggested that maternal Tl exposure during early pregnancy was positively associated with the risk of PTB, and Tl exposure may have a sex-specific effect on PTB., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Abstract: There is no information concerning the prevalence of thalassemia among pregnant women in Hubei Province currently. This study is aimed to explore the prevalence of α- and β-thalassemia genotypes among pregnant women in Hubei Province, and to explore the clinically applicable screening approach, as well as to investigate the pregnancy outcomes of α- and β-thalassemia carriers.Pregnant participants were recruited from 4 hospitals for the screening of α- and β-thalassemia mutations in Hubei Province. Polymerase Chain Reaction and flow cytometry methods were used to examine α- and β-thalassemia mutations. The hematological parameters and pregnancy outcomes of α- and β-thalassemia carriers were obtained from the hospital information system. The chi-square tests were used to evaluate the difference in hematological parameters between pregnant thalassemia carriers and the control group.Among 11,875 participants, 414 (3.49%) were confirmed with α-thalassemia carriers, 228 (1.92%) were confirmed with β-thalassemia carriers, and 3 (0.03%) were confirmed with both α- and β-thalassemia carriers. The frequency of -α3.7 accounted for 2.05% and it was the most frequent genotype of α-thalassemia; the proportion of IVS-II-654 was 0.85% and it was the most frequent genotype of β-thalassemia in Hubei Province. Furthermore, the proportion of patients with low mean corpuscular volume (MCV) or mean cell hemoglobin (MCH) values was accounted for 36.64% and 93.97% among α-thalassemia and β-thalassemia carriers, respectively. And participants with normal MCV and MCH values were accounted for 95.07% among non-thalassemia participants. High prevalence of pregnancy-induced diabetes (16.97%), preterm birth (9.96%), pregnancy-induced hypertension (8.12%), and low birth weight (5.90%) were observed among pregnant thalassemia carriers.MCV and MCH values were suggested to apply on the preliminary screening of pregnant β-thalassemia; however, it's unpractical on that of α-thalassemia. Furthermore, thalassemia carriers might have a high risk of negative pregnancy outcomes. These findings could be useful for the preliminary screening of thalassemia and perinatal care for the pregnant thalassemia carriers., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Fetal growth velocity standards have yet to be established for the Chinese population. This study aimed to establish such standards suitable for the Chinese population., Methods: We performed a multicenter, population-based longitudinal cohort study including 9075 low-risk singleton pregnant women. Data were collected from the clinical records of 24 hospitals in 18 provinces of China. Demographic characteristics, reproductive history, fetal ultrasound measurements, and perinatal outcome data were collected. The fetal ultrasound measurements included biparietal diameter (BPD), abdominal circumference (AC), head circumference (HC), and femur diaphysis length (FDL). We used linear mixed models with cubic splines to model the trajectory of four ultrasound parameters and estimate fetal weight. Fetal growth velocity was determined by calculating the first derivative of fetal size curves. We also used logistic regression to estimate the association between fetal growth velocities in the bottom 10th percentile and adverse perinatal outcomes., Results: Fetal growth velocity was not consistent over time or among individuals. The estimated fetal weight (EFW) steadily increased beginning at 12 gestational weeks and peaked at 35 gestational weeks. The maximum velocity was 211.71 g/week, and there was a steady decrease in velocity from 35 to 40 gestational weeks. The four ultrasound measurements increased in the early second trimester; BPD and HC peaked at 13 gestational weeks, AC at 14 gestational weeks, and FDL at 15 gestational weeks. BPD and HC also increased from 19 to 24 and 19 to 21 gestational weeks, respectively. EFW velocity in the bottom 10th percentile indicated higher risks of neonatal complications (odds ratio [OR] = 2.23, 95% confidence interval [CI]: 1.79-2.78) and preterm birth < 37 weeks (OR = 3.68, 95% CI: 2.64-5.14). Sensitivity analyses showed that EFW velocity in the bottom 10th percentile was significantly associated with more adverse pregnancy outcomes for appropriate-for-gestational age neonates., Conclusions: We established fetal growth velocity curves for the Chinese population based on real-world clinical data. Our findings demonstrated that Chinese fetal growth patterns are somewhat different from those of other populations. Fetal growth velocity could provide more information to understand the risk of adverse perinatal outcomes, especially for appropriate-for-gestational age neonates., (© 2021. The Author(s).)

Aims: Iron supplementation has been recommended for healthy pregnancy, but concerns have been raised regarding the potential adverse effects. We sought to examine the impact of periconceptional iron supplement use on subsequent gestational diabetes mellitus (GDM) risk., Methods: Participants (N = 5101) with information on periconceptional micronutrient supplementation and diagnosis of GDM were involved. Information on iron supplementation and general characteristics were collected at enrollment and follow-up visits. GDM was diagnosed by oral glucose tolerance tests (OGTT) conducted at 24-28 weeks of gestation. Robust Poisson regression model was used to estimate the relative risks (RRs) and 95% confidence intervals (CI) for the effect of iron supplement use on GDM., Results: 10.5% of the participants were diagnosed with GDM and the incidence was significantly higher in users with iron >30 mg/d for more than 3 months (Iron >30-L) than in nonusers. Adjusted RRs (95% CI) were 1.53 (1.21, 1.93) in Iron >30-L group, 1.14 (0.80, 1.61) in users with iron >30 mg/d for<3 months (Iron > 30-S) and 1.15 (0.86, 1.54) in users with iron ≤30 mg/d for any duration (Iron ≤30) respectively, compared to nonusers. This link in Iron >30-L group was even stronger (adjusted RR: 1.70, 95% CI: 1.25, 2.31) when restricting the analysis among primiparous and iron-replete participants without family history of diabetes. There were no significant differences in birth outcomes among groups., Conclusions: Periconceptional iron supplementation >30 mg/d for long-term was associated with increased GDM risk. The need and safety of prophylactic iron supplement in iron-replete pregnant women should be reconsidered., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Associations between environmental tobacco smoke (ETS) and the risk of adverse birth outcomes may be confounded. We aimed to clarify the associations of ETS before and during pregnancy with the risk of adverse birth outcomes and determine whether the associations were modified by key potential confounders. A total of 7147 non-smoking mothers from the Tongji Maternal and Child Health Cohort (TMCHC) in Wuhan, China, were included in the final analyses. ETS status was self-reported by pregnant women at their first antenatal care visit before 16 gestational weeks. Information on birth outcomes was extracted from delivery records. Poisson regression was used to identify the association between ETS before and during pregnancy and the risk of adverse birth outcomes. Exposures to ETS before and during pregnancy were reported by 645 (9.0%) and 464 (6.5%) mothers, respectively. Compared with no ETS, continued ETS during pregnancy was associated with an increased risk of preterm birth (PTB) (RR: 1.55, 95% CI: 1.07, 2.25) after adjustment for potential confounders. The association remained consistent in medically indicated PTB and late PTB. The risk of PTB associated with continued ETS during pregnancy was significantly increased in mothers more educated (P for interaction < 0.05). However, the increased risk of low birth weight (LBW) or small for gestational age (SGA) births by ETS during pregnancy was not observed. Exposure to ETS during pregnancy was associated with a higher risk of PTB, but not LBW or SGA births in a Chinese birth cohort.

Background: No Pain Labor &Delivery (NPLD) is a nongovernmental project to increase access to safe neuraxial analgesia through specialized training. This study explores the change in overall cesarean delivery (CD) rate and maternal request CD(MRCD) rate in our hospital after the initiation of neuraxial analgesia service (NA)., Methods: NA was initiated in May 1st 2015 by the help of NPLD. Since then, the application of NA became a routine operation in our hospital, and every parturient can choose to use NA or not. The monthly rates of NA, CD, MRCD, multiparous women, intrapartum CD, episiotomy, postpartum hemorrhage (PPH), operative vaginal delivery and neonatal asphyxia were analyzed from January 2015 to April 2016., Results: The rate of NA in our hospital was getting increasingly higher from 26.1% in May 2015 to 44.6% in April 2016 (p < 0.001); the rate of CD was 48.1% (3577/7360) and stable from January to May 2015 (p>0.05), then decreased from 50.4% in May 2015 to 36.3% in April 2016 (p < 0.001); the rate of MRCD was 11.4% (406/3577) and also stable from January to May 2015 (p>0.05), then decreased from 10.8% in May 2015 to 5.7% in April 2016 (p < 0.001). At the same time, the rate of multiparous women remained unchanged during the 16 month of observation (p>0.05). There was a negative correlation between the rate of NA and rate of overall CD, r = - 0.782 (95%CI [- 0.948, - 0.534], p<0.001), and between the utilization rate of NA and rate of MRCD, r = - 0.914 (95%CI [- 0.989, - 0.766], p<0.001). The rates of episiotomy, PPH, operative vaginal delivery and neonatal asphyxia in women who underwent vaginal delivery as well as the rates of intrapartum CD, neonatal asphyxia, and PPH in women who underwent CD remained unchanged, and there was no correlation between the rate of NA and anyone of those rates from January 1st 2015 to April 30th 2016 (p>0.05)., Conclusions: Our study shows that the rates of CD and MRCD in our department were significantly decreased from May 1st 2015 to April 30th 2016, which may be due to the increasing use of NA during vaginal delivery with the help of NPLD.

Rationale: Acute fatty liver of pregnancy (AFLP) is extremely hazardous to pregnant woman in the 3rd trimester of pregnancy. AFLP has an insidious onset and nonspecific experimental indicators, which therefore is difficult to be diagnosed., Patient Concerns: Case 1 was transferred to our hospital for hypertensive disorders complicating pregnancy at gestation of 38 weeks + 3 days. Case 2 was transferred to our hospital for suspicious fetal heart monitoring response at gestation of 36 weeks + 4 days. Case 3 was transferred to our hospital for prelabor rupture of membranes at gestation of 37 weeks + 1 days., Diagnosis: The diagnosis of AFLP was based on the Swansea criteria., Interventions: All 3 cases were delivered by cesarean section, and they were all transferred to intensive care unit for further treatment. Cases 2 and 3 were subjected to plasma exchange and continuous renal replacement therapy., Outcomes: In this study, all 3 patients were initially diagnosed as gastritis. In addition, case 1 was diagnosed as preeclampsia and her AFLP was misdiagnosed with postpartum hemorrhage after cesarean delivery. Case 2 was admitted to the hospital for intrahepatic cholestasis of pregnancy and fetal distress, but we considered it as AFLP before delivery. Case 3 was treated according to severe intrahepatic cholestasis of pregnancy, but we rediagnosed it as postpartum hemorrhage and disseminated intravascular coagulation after cesarean delivery. Neonatal asphyxia and complications were not found. All of the 3 cases were fully recovered and discharged from our hospital., Lessons: If there are multiple risk factors including vomiting, abdominal pain, and fetal distress, AFLP should be highly suspected. Early diagnosis, especially before termination of pregnancy, is the key to successful treatment of AFLP.

Background: 2019 novel coronavirus disease (COVID-19) has become a worldwide pandemic. Under such circumstance pregnant women are also affected significantly., Objective: This study aims to observe the clinical features and outcomes of pregnant women who have been confirmed with COVID-19., Methods: The research objects were 55 cases of suspected COVID-19 pregnant women who gave a birth from Jan 20th 2020 to Mar 5th 2020 in our hospital-a big birth center delivering about 30,000 babies in the last 3 years. These cases were subjected to pulmonary CT scan and routine blood test, manifested symptoms of fever, cough, chest tightness or gastrointestinal symptoms. They were admitted to an isolated suite, with clinical features and newborn babies being carefully observed. Among the 55 cases, 13 patients were assigned into the confirmed COVID-19 group for being tested positive sever acute respiratory syndrome coronavirus 2(SARS-CoV-2) via maternal throat swab test, and the other 42 patients were assigned into the control group for being ruled out COVID-19 pneumonia based on new coronavirus pneumonia prevention and control program(the 7th edition)., Results: There were 2 fever patients during the prenatal period and 8 fever patients during the postpartum period in the confirmed COVID-19 group. In contrast, there were 11 prenatal fever patients and 20 postpartum fever patients in the control group (p>0.05). Among 55 cases, only 2 case had cough in the confirmed group. The imaging of pulmonary CT scan showed ground- glass opacity (46.2%, 6/13), patch-like shadows(38.5%, 5/13), fiber shadow(23.1%, 3/13), pleural effusion (38.5%, 5/13)and pleural thickening(7.7%, 1/13), and there was no statistical difference between the confirmed COVID-19 group and the control group (p>0.05). During the prenatal and postpartum period, there was no difference in the count of WBC, Neutrophils and Lymphocyte, the radio of Neutrophils and Lymphocyte and the level of CRP between the confirmed COVID-19 group and the control group(p<0.05). 20 babies (from confirmed mother and from normal mother) were subjected to SARS-CoV-2 examination by throat swab samples in 24 h after birth and no case was tested positive., Conclusion: The clinical symptoms and laboratory indicators are not obvious for asymptomatic and mild COVID-19 pregnant women. Pulmonary CT scan plus blood routine examination are more suitable for finding pregnancy women with asymptomatic or mild COVID-19 infection, and can be used screening COVID-19 pregnant women in the outbreak area of COVID-19 infection., Competing Interests: Declaration of Competing Interest We declare no competing interests., (Copyright © 2020. Published by Elsevier Ltd.)

Background & Aims: Delayed onset of lactogenesis II (OL) negatively affects breastfeeding and consequently, the health of the newborn. Few studies have examined the association between gestational weight gain (GWG) throughout pregnancy and risk of delayed OL., Methods: We used data from a prospective cohort study in Wuhan of China, which enrolled pregnant women at 8-16 weeks of gestation and followed-up regularly. GWG was assessed by the last available weight measurement (LAWM) during pregnancy and the self-reported pre-pregnancy weight at enrollment. The outcome was delayed OL self-reported after 4 days postpartum. Odds ratios (ORs) and 95% confidence intervals (CIs) were derived from multivariate logistic regression., Results: Delayed OL was reported by 18.4% of the 3282 participants. After adjustment for the demographic, clinical and breastfeeding characteristics, compared to the lowest quartile 1 of GWG, ORs (95% CIs) were 1.20 (0.91, 1.57) for quartile 2, 1.47 (1.13, 1.92) for quartile 3, and 1.42 (1.08, 1.86) for quartile 4 (P for trend = 0.006). When GWG was classified by the 2009 Institute of Medicine (IOM) guidelines, compared with women with adequate GWG, the adjusted ORs (95% CIs) were 0.82 (0.61, 1.10) for inadequate GWG, and 1.13 (0.93, 1.38) for excessive GWG., Conclusions: Women with higher GWG throughout pregnancy are more likely to suffer from delayed OL in Chinese population., (Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Purpose: Emerging clinical evidence has implied that alkaline phosphatase (ALP) may contribute to gestational diabetes mellitus (GDM). However, there were no studies to reveal the independent and prospective associations between ALP and GDM. Our aim was to explore the independent and prospective associations between early maternal ALP level and GDM risk and glucose regulation., Methods: In a prospective cohort study with 2073 singleton mothers at four maternity units in China, maternal serum ALP levels were measured before 20 gestational weeks. Using logistic regression, we analyzed the relationship between maternal ALP level and risk of GDM. We further explored the relationships of ALP level to fasting blood glucose (FBG), 1-h and 2-h post-load blood glucose (1-h, 2-h PBG) with multiple linear regression. Finally, we analyzed the association between maternal ALP level and isolated impaired fasting glucose (i-IFG) and isolated impaired glucose tolerance (i-IGT) risk., Results: The maximum value of maternal ALP level was 90 U/L, within the normal range. After adjustment for confounding factors, the odds ratio (ORs) of GDM increased linearly with ALP level (p for overall association = 0.002, p for nonlinear association = 0.799), with the OR comparing the highest versus lowest quartile of 2.47 (95% CI 1.47, 4.15). Moreover, each additional of 10 U/L ALP level was associated with a 2% higher FBG (p = 0.043) and a 12% higher 1-h PBG (p = 0.004). Higher ALP level also increased the risk of i-IFG (OR 3.73, 95% CI 1.17-11.86) and i-IGT (OR 2.03, 95% CI 1.07-3.84)., Conclusions: Even within the upper limit of normal, higher early maternal ALP level could increase the risk of GDM. Moreover, both FBG and PBG were increased with early maternal ALP.

Objective: This study aimed to investigate the potential factors that affect the induction to delivery time interval in women undergoing induction of labor with a controlled-release dinoprostone vaginal insert., Methods: Pregnant women who presented for delivery at Hubei Maternal and Child Health Hospital from January 2016 to August 2016 were recruited. Finally, 1265 women who underwent labor induction with a vaginal dinoprostone (PGE2) insert were analyzed. Univariate and multivariate linear regression analyses were used to estimate the relevant risks for delivery time., Results: Among the1265 subjects, the mean delivery time was 18.92 ± 12.50 hours. Univariate and multivariate analyses showed that fetal weight, an obstetric complication (premature rupture of the membranes), and the delivery history were significantly associated with the induction to delivery time. Biparietal diameter was related to the vaginal delivery time in univariate analysis, but there was no significant difference after adjustment in multivariate analysis., Conclusions: Vaginal dinoprostone is an effective method for successful induction of labor. Gestational age, parity, and fetal weight are major factors that predict the induction to delivery time interval.

Objective: To examine optimal gestational weight gain(GWG) for Chinese pregnant women., Methods: A total of 6998 women with singleton and term pregnancy recruited to the Tongji Maternal and Child Health Cohort during January 2013 to May 2016 in Wuhan, Hubei were included. Information on sociodemographic, medical and family history of disease was obtained by questionnaire, body weight and height were measured at the first antenatal care during 8-16 weeks of gestation. Prenatal weight of mothers were measured, and gestational week, mode of delivery, pregnancy complications, gender of newborn, birth weight and length were collected from medical records after delivery. Restricted cubic spline was used to model nonlinear relationships between GWG and the occurrence of small for gestational age(SGA), large for gestational age(LGA), low birth weight(LBW), macrosomia, cesarean, gestational hypertension(GH)and gestational diabetes mellitus(GDM), respectively. The GWG of the lowest risks for adverse pregnant outcomes was regarded as optimal GWG recommended by Tongji(TJ) for pregnant women. The P25-P75 of GWG was defined as the optimal GWG recommended by percentile method. Logistic regression was used to analyze the effect of excessive or insufficient GWG on adverse pregnancy outcomes, while the recommendations of TJ and percentile method were used as references, respectively., Results: (1) The GWG with lower risk of adverse pregnant outcomes based on pre-gravid body mass index(BMI) are 12. 0-17. 0 kg for underweight, 9. 0-14. 0 kg for normal weight and 7. 0-11. 0 kg for overweight, respectively, which are defined as TJ recommendations. The recommended GWG by percentile method are 14. 0-19. 0 kg for underweight, 13. 0-19. 0 kg for normal weight, 10. 8-18. 0 kg for overweight and 9. 0-15. 8 kg for obesity, respectively. (2) Compared to women gain within the TJ recommendations, OR of LGA is 2. 94(95%CI 2. 31-3. 73), macrosomia is 3. 13(95%CI 2. 38-4. 13), cesarean is 1. 53(95%CI 1. 38-1. 71) and GH is 2. 18(95%CI 1. 50-3. 17) for those with excessive GWG, OR of SGA is 1. 82(95%CI 1. 32-2. 53) for those who gain less. The corresponding ORs according to percentile method are 2. 11(95%CI 1. 76-2. 54) for LGA, 2. 16(95%CI 1. 76-2. 65) for macrosomia, 1. 53(95%CI 1. 36-1. 72) for cesarean, 1. 39(95%CI 1. 02-1. 90) for GH and 1. 60(95%CI 1. 29-1. 99) for SGA, respectively., Conclusion: The optimal GWG of Chinese pregnant women recommended by the study are 12. 0-17. 0 kg for pre-gravid underweight women, 9. 0-14. 0 kg for normal weight women and 7. 0-11. 0 kg for overweight, respectively.

Background: Antimony (Sb) has been associated with type 2 diabetes in previous studies. However, the role of Sb in the incidence of Gestational diabetes mellitus (GDM) remains unclear., Objectives: We investigated the association between Sb exposure during early pregnancy and the risk of GDM., Methods: We performed a prospective study of 2093 pregnant women from the Tongji Maternal and Child Health Cohort (TMCHC). Sb concentrations were measured in urine samples during early pregnancy by ICP-MS. The association between urinary Sb concentration and GDM incidence was assessed using robust Poisson regression model after adjustment for confounders., Results: The 95th percentile value of creatinine-corrected Sb (CC-Sb) concentration in the urine of all pregnant women was 1.33 μg/g. The CC-Sb concentrations were significantly higher in women with GDM than those without GDM (median value: 0.49 μg/g vs. 0.38 μg/g, p = 0.001). After adjustment for potential confounders, for each one natural logarithmic unit increase in Sb concentration, there was 29% [adjusted relative risk (RR) = 1.29; 95% confidence interval (CI): 1.06, 1.57] increase in the risk of GDM. Women in the highest tertile for CC-Sb had a 1.92-fold (95% CI: 1.42, 2.60) higher risk of GDM compared with women in the lowest tertile (p-value for trend <0.001)., Conclusion: To our knowledge, this is the first research of an association between urinary Sb levels during pregnancy and GDM. Our study suggests that pregnant women with higher Sb exposure levels may have a higher risk of GDM and this association remains consistent even after stratification., (Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Aim: To compare perinatal outcomes of dinoprostone for induced labor in pregnancies with a borderline versus normal amniotic fluid index (AFI) at term, and to investigate the related factors affecting outcomes of cesarean section., Methods: The retrospective study was carried out in Hubei Maternal and Child Health Hospital with singleton pregnancies of 37-42 weeks' gestation from January to August 2016. A total of 992 subjects were divided into two groups: borderline AFI group (n =125) with 5 < AFI ≤ 8 and normal AFI group (n = 867) with 8 < AFI ≤ 24., Results: Time to delivery (P =0.004) and use of oxytocin augmentation (P = 0.011) were significantly lower in pregnancies with borderline AFI. There were no significant differences between the two groups in terms of delivery mode, time to onset of labor, fetal distress, Apgar scores, meconium-stained amniotic fluid, birth weight, or incidences of admission to neonatal intensive care unit (NICU). Gestational hypertension and birth weight were the major factors affecting outcomes of cesarean section in the borderline group (odds ratio [OR] = 13.61, 95% confidence interval [CI] 1.96-94.49, P =0.008 and OR = 1.003, 95% CI 1.001-1.005, P =0.001, respectively). Maternal age (OR = 1.12, 95% CI 1.06-1.19, P < 0.001), parity (OR = 7.57, 95% CI 3.05-18.76, P < 0.001), biparietal diameter (OR = 0.55, 95% CI 0.33-0.91, P = 0.021), and meconium-stained amniotic fluid (OR = 1.56, 95% CI 1.12-2.17, P = 0.009) were related factors in the normal group., Conclusion: The perinatal outcomes of dinoprostone for induced labor are comparable between the two groups. Gestational hypertension and birth weight are factors related to outcomes of cesarean section in the borderline group., (© 2018 Japan Society of Obstetrics and Gynecology.)

Background: "Doing the month", or "sitting month", is a traditional practice for postpartum women in China and other Asian countries, which includes some taboos against well-accepted healthy diet and lifestyles in general population. Previous studies have shown this practice may be associated with higher prevalence of postpartum problems. The current multicenter randomized controlled trial (RCT) aims to evaluate outcomes of diet and lifestyle interventions in Chinese postpartum women., Methods/design: The current multicenter RCT will be conducted in three representative areas in China, Shandong province, Hubei province and Guangdong province, which locate in northern, central and southern parts of China, respectively. Women who attend routine pregnancy diagnosis in hospitals or maternal healthcare centers will be invited to take part in this study. At least 800 women who meet our eligibility criteria will be recruited and randomly assigned to the intervention group (n > = 400) and the control group (n > = 400). A three-dimension comprehensive intervention strategy, which incorporates intervention measures simultaneously to individual postpartum woman, their family members and community environment, will be utilized to maximize the effectiveness of intervention. Regular visiting and follow-up will be done in both group; nutrition and health-related measurements will be assessed both before and after the intervention., Discussion: To our knowledge, this current study is the first and largest multicenter RCT which focus on the effectiveness of diet and lifestyle intervention on reducing the incidence rate of postpartum diseases and improving health status in postpartum women. We hypothesize that the intervention will reduce the incidence rates of postpartum diseases and improve nutrition and health status due to a balanced diet and reasonable lifestyle in comparison with the control condition. If so, the results of our study will provide especially important evidence for changes in both the concept and action of traditional postpartum practice in China., Trial Registration: ClinicalTrials.gov ID NCT01039051.