Prenatal maternal stress, sleep quality, and neonatal birth weight: A prospective cohort study.

To assess if the impacts of prenatal maternal stress (PNMS) on neonatal physical development including birth weight and body length vary by trimesters, and to explore the mediating effect of sleep quality in the relationships. A total of 2778 pregnant women were included from the Shanghai Maternal-Child Pairs Cohort. PNMS and sleep quality were measured in the first trimester (12-16 gestational weeks) and third trimester (32-36 gestational weeks) using the Life Event Scale for Pregnant Women (LESPW) and Pittsburgh Sleep Quality Index, respectively. And total LESPW scores were classified into three groups: high stress (≥75th percentile), medium stress (≥25th and <75th percentile), and low stress (<25th percentile). Multiple linear and logistic regressions were employed to examine the associations between PNMS and birth weight, and bootstrap were utilized to explore the mediating effects of maternal sleep. Higher (adjusted odds ratio, aOR = 1.521; 95% confidence interval (CI), 1.104-2.096) and medium (aOR = 1.421; 95% CI, 1.071-1.885) PNMS and stress from subjective events (aOR = 1.334; 95% CI, 1.076-1.654) in the first trimester were significantly associated with elevated risk for large for gestational age. Maternal severe negative objective events stress (OE3) in the third trimester were negatively associated with birth weight (ß = -0.667; 95% CI, -1.047∼-0.287), and maternal sleep latency during this period acted as a mediator in the association (indirect effect: ß = -0.0144; 95% CI, -0.0427∼-0.0003). Besides, a significant negative correlation between total LESPW score (ß = -0.022; 95% CI, -0.038∼-0.006; per 100 score) and body length in the third trimester was also observed. The impact of PNMS on neonatal birth weight varies by stress types and exposure timing. Prolonged maternal sleep latency in the third trimester correlated with lower birth weight, and mediating the link of OE3 and birth weight, which might indicate a critical period of vulnerability to the effects of PNMS on neonatal physical development.

Pharmacologic Venous Thromboembolism Prophylaxis in Patients with Nontraumatic Subarachnoid Hemorrhage Requiring an External Ventricular Drain.

BACKGROUND: Optimal pharmacologic thromboprophylaxis dosing is not well described in patients with subarachnoid hemorrhage (SAH) with an external ventricular drain (EVD). Our patients with SAH with an EVD who receive prophylactic enoxaparin are routinely monitored using timed anti-Xa levels. Our primary study goal was to determine the frequency of venous thromboembolism (VTE) and secondary intracranial hemorrhage (ICH) for this population of patients who received pharmacologic prophylaxis with enoxaparin or unfractionated heparin (UFH). METHODS: A retrospective chart review was performed for all patients with SAH admitted to the neurocritical care unit at Emory University Hospital between 2012 and 2017. All patients with SAH who required an EVD were included. RESULTS: Of 1,351 patients screened, 868 required an EVD. Of these 868 patients, 627 received enoxaparin, 114 received UFH, and 127 did not receive pharmacologic prophylaxis. VTE occurred in 7.5% of patients in the enoxaparin group, 4.4% in the UFH group (p = 0.32), and 3.2% in the no VTE prophylaxis group (p = 0.08). Secondary ICH occurred in 3.83% of patients in the enoxaparin group, 3.51% in the UFH group (p = 1), and 3.94% in the no VTE prophylaxis group (p = 0.53). As steady-state anti-Xa levels increased from 0.1 units/mL to > 0.3 units/mL, there was a trend toward a lower incidence of VTE. However, no correlation was noted between rising anti-Xa levels and an increased incidence of secondary ICH. When compared, neither enoxaparin nor UFH use was associated with a significantly reduced incidence of VTE or an increased incidence of ICH. CONCLUSIONS: In this retrospective study of patients with nontraumatic SAH with an EVD who received enoxaparin or UFH VTE prophylaxis or no VTE prophylaxis, there was no statistically significant difference in the incidence of VTE or secondary ICH. For patients receiving prophylactic enoxaparin, achieving higher steady-state target anti-Xa levels may be associated with a lower incidence of VTE without increasing the risk of secondary ICH.

Linkage Effect Induced by Hierarchical Architecture in Magnetic MXene-based Microwave Absorber.

Hierarchical architecture engineering is desirable in integrating the physical-chemical behaviors and macroscopic properties of materials, which present great potential for developing multifunctional microwave absorption materials. However, the intrinsic mechanisms and correlation conditions among cellular units have not been revealed, which are insufficient to maximize the fusion of superior microwave absorption (MA) and derived multifunctionality. Herein, based on three models (disordered structure, porous structure, lamellar structure) of structural units, a range of MXene-aerogels with variable constructions are fabricated by a top-down ice template method. The aerogel with lamellar structure with a density of only 0.015 g cm-3 exhibits the best MA performance (minimum reflection loss: -53.87 dB, effective absorption bandwidth:6.84 GHz) at a 6 wt.% filling ratio, which is preferred over alternative aerogels with variable configurations. This work elucidates the relationship between the hierarchical architecture and the superior MA performance. Further, the MXene/CoNi Composite aerogel with lamellar structure exhibits >90% compression stretch after 1000 cycles, excellent compressive properties, and elasticity, as well as high hydrophobicity and thermal insulation properties, broadening the versatility of MXene-based aerogel applications. In short, through precise microstructure design, this work provides a conceptually novel strategy to realize the integration of electromagnetic stealth, thermal insulation, and load-bearing capability simultaneously.

Porifera-Inspired Lightweight, Thin, Wrinkle-Resistance, and Multifunctional MXene Foam.

Transition metal carbides/nitrides (MXenes) demonstrate a massive potential in constructing lightweight, multifunctional wearable electromagnetic interference (EMI) shields for application in various fields. Nevertheless, it remains challenging to develop a facile, scalable approach to prepare the MXene-based macrostructures characterized by low density, low thickness, high mechanical flexibility, and high EMI SE at the same time. Herein, the ultrathin MXene/reduced graphene oxide (rGO)/Ag foams with a porifera-inspired hierarchically porous microstructure are prepared by combining Zn2+ diffusion induction and hard template methods. The hierarchical porosity, which includes a mesoporous skeleton and a microporous MXene network within the skeleton, not only exerts a regulatory effect on stress distribution during compression, making the foams rubber-like resistant to wrinkling but also provides more channels for multiple reflections of electromagnetic waves. Due to the interaction between Ag nanosheets, MXene/rGO, and porous structure, it is possible to produce an outstanding EMI shielding performance with the specific surface shielding effectiveness reaching 109152.4 dB cm2 g-1. Furthermore, the foams exhibit multifunctionalities, such as transverse Joule heating, longitudinal heat insulation, self-cleaning, fire resistance, and motion detection. These discoveries open up a novel pathway for the development of lightweight MXene-based materials with considerable application potential in wearable electromagnetic anti-interference devices.

Examining the effectiveness of gamification as a tool promoting teaching and learning in educational settings: a meta-analysis.

The integration of gamification into educational settings has gained recognition for its potential to boost student motivation, engagement, interest, and learning outcomes. Despite its popularity, research on gamification has produced mixed results regarding student learning outcomes. This meta-analysis aims to synthesize the existing empirical evidence on the effectiveness of gamification as a tool for promoting teaching and learning in educational settings. Forty-one studies with 49 independent samples involving more than 5,071 participants were included in our analysis. Results from random effects models showed an overall significant large effect size (g = 0.822 [0.567 to 1.078]). The research performed the moderator analysis to scrutinize the effects of a number of factors on the relationship between gamification and student learning outcomes. The study uncovered significant moderating effects for user type, educational discipline, design principles for educational gamification, duration of "gameful" experience, and learning environment. However, measurement of student outcomes and publication type did not appear to have any significant moderating effect. Those findings hold important implications for improving and implementing gamification to promote teaching and learning in future research.

High-Pressure Synthesis of Single-Crystalline SnS Nanoribbons.

Two-dimensional tin monosulfide (SnS) is attractive for the development of electronic and optoelectronic devices with anisotropic characteristics. However, its shape-controlled synthesis with an atomic thickness and high quality remains challenging. Here, we show that highly crystalline SnS nanoribbons can be produced via high-pressure (0.5 GPa) and thermal treatment (400 °C). These SnS nanoribbons have a length of several tens of micrometers and a thickness down to 5.8 nm, giving an average aspect ratio of ∼30.6. The crystal orientation along the zigzag direction and the in-plane structural anisotropy of the SnS nanoribbons are identified by transmission electron microscopy and polarized Raman spectroscopy, respectively. An ionic liquid-gated field-effect transistor fabricated using the SnS nanoribbon exhibits an on/off current ratio of >103 and a field-effect mobility of ∼0.7 cm2 V-1 s-1. This work provides a unique way to achieve one-dimensional growth of SnS.

Ordered Heterostructured Aerogel with Broadband Electromagnetic Wave Absorption Based on Mesoscopic Magnetic Superposition Enhancement.

Demand for lightweight and efficient electromagnetic wave (EW) absorbers continues to increase with technological advances in highly integrated electronics and military applications. Although MXene-based EW absorbers have been extensively developed, more efficient electromagnetic coupling and thinner thickness are still essential. Recently, ordered heterogeneous materials have emerged as a novel design concept to address the bottleneck faced by current material development. Herein, an ordered heterostructured engineering to assemble Ti3 CNTx MXenes/Aramid nanofibers/FeCo@SiO2 nanobundles (FS) aerogel (AMFS-O) is proposed, where the commonly disordered magnetic composition is transformed to ordered FS arrays that provide more powerful magnetic loss capacity. Experiments and simulations reveal that the anisotropy magnetic networks enhance the response to the magnetic field vector of EW, which effectively improves the impedance matching and makes the reflection loss (RL) peaks shift to lower frequencies, leading to the thinner matching thickness. Furthermore, the temperature stability and excellent compressibility of AMFS-O expand functionalized applications. The synthesized AMFS-O achieves full-wave absorption in X and Ku-band (8.2-18.0 GHz) at 3.0 mm with a RLmin of -41 dB and a low density of 0.008 g cm-3 . These results suggest that ordered heterostructured engineering is an effective strategy for designing high-performance multifunctional EW absorbers.

Maternal affective and stress-related factors during pregnancy affect the occurrence of childhood allergic diseases: A Shanghai MCPC study.

OBJECTIVE: To investigate the association between exposures to maternal affective and stress-related factors during pregnancy and allergies in children from birth to 2 years of age. METHODS: We enrolled a total of 4178 children from the Shanghai Maternal-Child Pairs Cohort and measured maternal stress, anxiety, and depression during pregnancy by applying the Life Events Scale for Pregnant Women, Self-Rating Anxiety Scale, and the Center for Epidemiologic Studies-Depression Scale, respectively. Children's allergies were assessed by community physicians at 2, 6, 12, and 24 months, respectively; these included eczema, atopic dermatitis, food allergy, wheezing, asthma, and atopic rhinitis. We applied a latent class analysis (LCA) to these factors and analyzed the impacts of maternal affective and stress-related factors on childhood allergies by exploiting multivariate logistic regression. RESULTS: Three distinct classes of children were revealed by LCA: healthy (79.8%), transient allergy (15.2%), and persistent allergy (4.9%). High maternal stress in both early and late pregnancy was associated with an increased risk of infant eczema at 2 months (aOR = 1.30, 95% CI = 1.01-1.67; aOR = 1.64, 95% CI = 1.14-2.36). Moreover, high maternal stress in late pregnancy was also associated with food allergy at 6 months, rhinitis at 2 years of age, and persistent allergy (aOR = 3.22, 95% CI = 1.27-8.12; aOR = 1.78, 95% CI = 1.01-3.15; and aOR = 1.93, 95% CI = 1.10-3.40). CONCLUSIONS: The associations of maternal affective and stress-related factors during pregnancy with childhood allergies may vary by type and disease onset. We postulate that maternal stress in late pregnancy may exert a sustained negative effect on early childhood allergic diseases.

Surge Capacity in the COVID-19 Era: a Natural Experiment of Neurocritical Care in General Critical Care.

BACKGROUND: COVID-19 surges led to significant challenges in ensuring critical care capacity. In response, some centers leveraged neurocritical care (NCC) capacity as part of the surge response, with neurointensivists providing general critical care for patients with COVID-19 without neurologic illness. The relative outcomes of NCC critical care management of patients with COVID-19 remain unclear and may help guide further surge planning and provide broader insights into general critical care provided in NCC units. METHODS: We performed an observational cohort study of all patients requiring critical care for COVID-19 across four hospitals within the Emory Healthcare system during the first three surges. Patients were categorized on the basis of admission to intensive care units (ICUs) staffed by general intensivists or neurointensivists. Patients with primary neurological diagnoses were excluded. Baseline demographics, clinical complications, and outcomes were compared between groups using univariable and propensity score matching statistics. RESULTS: A total of 1141 patients with a primary diagnosis of COVID-19 required ICU admission. ICUs were staffed by general intensivists (n = 1071) or neurointensivists (n = 70). Baseline demographics and presentation characteristics were similar between groups, except for patients admitted to neurointensivist-staffed ICUs being younger (59 vs. 65, p = 0.027) and having a higher PaO2/FiO2 ratio (153 vs. 120, p = 0.002). After propensity score matching, there was no correlation between ICU staffing and the use of mechanical ventilation, renal replacement therapy, and vasopressors. The rates of in-hospital mortality and hospice disposition were similar in neurointensivist-staffed COVID-19 units (odds ratio 0.9, 95% confidence interval 0.31-2.64, p = 0.842). CONCLUSIONS: COVID-19 surges precipitated a natural experiment in which neurology-trained neurointensivists provided critical care in a comparable context to general intensivists treating the same disease. Neurology-trained neurointensivists delivered comparable outcomes to those of general ICUs during COVID-19 surges. These results further support the role of NCC in meeting general critical care needs of neurocritically ill patients and as a viable surge resource in general critical care.

Longitudinal association between maternal psychological stress during pregnancy and infant neurodevelopment: The moderating effects of responsive caregiving.

Background: Little is known regarding the role of responsive caregiving in the association between maternal psychological stress and child neurodevelopment. We, therefore, herein investigated the relationship between maternal psychological stress during pregnancy and children's neurodevelopment with modifications in responsive caregiving. Methods: A total of 3,603 mother-child pairs were recruited from the Shanghai Maternal-Child Pairs Cohort, and we assessed maternal psychological stress using the Life Events Scale for Pregnant Women (LESPW) during early and late pregnancy. Early neurodevelopment of infants at 6 and 12 months of age was also evaluated using the Age and Stage Questionnaire, Third Edition (ASQ-3). The 2-month-old infant nursing-care questionnaire was designed based on the Five Elements of Parenting Care Framework released by the World Health Organization (WHO) and used to evaluate the levels of early responsive caregiving for infants. Multivariate logistic regression analysis was then applied to determine the association between maternal psychological stress during pregnancy and child development. Results: The suspected developmental delay rate of infants aged 6 and 12 months ranged between 13.3% and 24.5%. After adjusting for confounders, we noted that high maternal subjective events stress during early pregnancy was associated with an increased risk of suspected developmental delay in problem-solving domains at 12 months of age [adjusted OR (aOR) = 1.51; 95% confidence interval (CI), 1.09-2.20]. High general negative objective events' stress during late pregnancy also constituted a risk factor for development in the personal-social domain at 12 months of age (aOR = 1.57; 95% CI, 1.13-2.19). Remarkably, we noted in infants with insufficient responsive caregiving that there were greater associations between the risk of general maternal negative objective events during late pregnancy and personal-social domain at 12 months of age (aOR = 2.06; 95% CI, 1.15-3.68). Similarly, there was a greater association between the risk for maternal subjective events during early pregnancy and problem-solving at 12 months of age (aOR = 1.55; 95% CI, 1.11-2.34). Conclusions: Maternal psychological stress during pregnancy was predominantly associated with suspected developmental delay in infants at 6 and 12 months of age, and these associations were modified by early responsive caregiving.

C-C Bond Activation of Cyclopropanes Enabled by Phosphine-Catalyzed In Situ Formation of High-Strain Methylenecycopropane Intermediate.

An effective strategy for the ring-opening/elaboration of cyclopropanes by phosphine catalyst is documented, providing the 2,4-pentadiene sulfonamides and isoindolines in moderate to good yields. The key to the success of this reaction is phosphine-catalyzed introduction of a trigonal center into cyclopropanes, which results in the formation of higher ring strain cyclopropylidenemethyl phosphonium salt. Moreover, this methodology is employed as the key step for the synthesis of bioactive molecules.

Effects of Gestational Sleep Patterns and Their Changes on Maternal Glycemia and Offspring Physical Growth in Early Life.

Maternal sleep patterns during pregnancy are drawing increased attention to examine its role in the regulation of maternal glycemia and physical growth of offspring within 24 months. Among 3329 eligible mother−child pairs included in the Shanghai Maternal−Child Pairs Cohort, sleep patterns of pregnant women were assessed by Pittsburgh Sleep Quality Index and objective measurement in early and late pregnancy. Offspring physical growth within 24 months was primarily indicated by the body mass index Z-score (BAZ), catch-up growth, and overweight/obesity. In total, 3329 and 382 pregnant women were included with subjectively assessed and objectively measured sleep pattern, respectively. The increased risk of GDM was associated with maternal night-time sleep duration ≥8.5 h in early pregnancy, or sleep quality change from poor to good during pregnancy (OR = 1.48; 95% CI, 1.06 to 2.07). In the GDM group, the effect of sleep duration in early pregnancy on overweight/obesity in offspring within 24 months showed a U-shaped curve, with a 1.73-fold and 1.43-fold increased risk of overweight/obesity of offspring in pregnant women with <7.5 or ≥8.5 h of sleep duration, respectively. A good gestational sleep pattern was required to reduce the risk of GDM and offspring overweight/obesity within 24 months.

Responsive Caregiving and Opportunities for Early Learning Associated With Infant Development: Results From a Prospective Birth Cohort in China.

Background: Infant development shapes children's health into adulthood. Although providing responsive caregiving and opportunities regarding early learning for infants have received increasing attention from the international community, few studies have been published on these topics thus far. The purpose of the present study, then, was to explore the influences of responsive caregiving and the opportunities for early learning on infant development. Methods: Mother-child dyads (3,714 pairs) were recruited from the Shanghai Maternal-Child Pairs Cohort (Shanghai MCPC) for the present study, and the development of infants, responsive caregiving and opportunities for early learning were collected from three waves of follow-up (2-, 6-, and 12-month old) We used the cross-lagged model to analyze the longitudinal correlation between responsive caregiving or opportunities for early learning and development of infants. We used the generalized estimation equation (GEE) to evaluate the effect of responsive caregiving and opportunities for early learning on suspected developmental delay; we also conducted a hierarchical analysis to investigate the interaction between responsive caregiving or opportunities for early learning and annual family income. Results: There was a mutual prediction between responsive caregiving or opportunities for early learning and some developmental domains of the Ages and Stages Questionnaires, third edition (ASQ-3). Sustained high-exposure to responsive caregiving or opportunities for early learning significantly decreased the risk of suspected developmental delay in most domains of the ASQ-3. And For infants whose annual family income was < ¥200,000, sustained high-exposure (Adjusted Odds Ratio = 0.456, 95% CI, 0.325-0.638) and fluctuating-exposure (Adjusted Odds Ratio = 0.510, 95% CI, 0.414-0.627) to responsive caregiving significantly reduced the risk for suspected developmental delay. Conclusion: Responsive caregiving or opportunities for early learning interacted with infant development. Infants' early access to adequate responsive caregiving and opportunities for early learning exerted a sustained and positive impact on infant development, and this effect is more pronounced in relative low-income families.

Macroscopic Electromagnetic Cooperative Network-Enhanced MXene/Ni Chains Aerogel-Based Microwave Absorber with Ultra-Low Matching Thickness.

Electromagnetic cooperative strategy has been presented as a mainstream approach that can effectively optimize the matching thickness of dielectric loss dominant system. However, it is still challenging for dielectric-magnetic loss coexisting-type absorber to develop electromagnetic wave (EMW) performance with ultra-low matching thickness (≤ 1 mm). Breaking the limitation of traditional electromagnetic response at microscopic/mesoscopic scale, a ficus microcarpa-like magnetic aerogel with macroscopical electromagnetic cooperative effect was fabricated through highly oriented self-assembly engineering. The highly oriented Ni chains with unique macroscopic morphology (~ 1 cm in length) were achieved via a special magnetic field-induced growth. Strong magnetic coupling was observed in the Ni chains confirmed by the micromagnetic simulation. The deductive calculation validates that maintaining high value of electromagnetic parameters at high frequencies is the prerequisites of ultrathin absorber. The electromagnetic cooperative networks with uninterrupted and dual pathways spread through the entire aerogel skeleton, resulting in the impressive permittivity even at high frequencies. Consequently, the aerogel exhibits a remarkable EMW performance at an ultrathin thickness of 1 mm. Thus, based on the modulation of electromagnetic parameters, this work proposed a macroscopic ordered structure with the electromagnetic cooperative effect useful to develop a suitable strategy for achieving ultrathin EMW absorbers.

Multi-interface Assembled N-Doped MXene/HCFG/AgNW Films for Wearable Electromagnetic Shielding Devices with Multimodal Energy Conversion and Healthcare Monitoring Performances.

With the progressive requirements of modern electronics, outstanding electromagnetic interference (EMI) shielding materials are extensively desirable to protect intelligent electronic equipment against EMI radiation under various conditions, while integrating functional applications. So far, it remains a great challenge to effectively construct thin films with diversiform frameworks as integrated shielding devices. To simultaneously promote electromagnetic waves (EMWs) attenuation and construct integrated multifunction, an alternating-layered deposition strategy is designed to fabricate polydimethylsiloxane packaged N-doped MXene (Ti3CNTx)/graphene oxide wrapped hollow carbon fiber/silver nanowire films (p-LMHA) followed by annealing and encapsulation approaches. Contributed by the synergistic effect of consecutively conductive networks and porous architectures, LMHA films exhibit satisfying EMI shielding effectiveness of 73.2 dB at a thickness of 11 µm, with a specific EMI shielding effectiveness of 31 150.1 dB·cm2·g-1. Benefiting from the encapsulation, p-LMHA films further impart hydrophobicity and reliability against harsh environments. Besides, p-LMHA devices integrate a rapid-response behavior of the electro/photothermal and, meanwhile, function as a healthcare monitoring sensor. Therefore, it is believed that the p-LMHA films assembled by independent conductive networks with reliability offer a facile solution for practical multimodular protection of devices with integration characteristics.

Longitudinal Associations Between Maternal Glucose Levels and Ultrasonographic Fetal Biometrics in a Shanghai Cohort.

Importance: Evidence on the timing of fetal growth alterations associated with gestational diabetes or on the association of the maternal glycemic trajectory with fetal growth during pregnancy remains lacking. Objective: To examine the associations between maternal glucose levels and offspring intrauterine growth. Design, Setting, and Participants: This cohort study used data from 4574 eligible pregnant women and their offspring in the Shanghai Maternal-Child Pairs Cohort collected from April 10, 2016, to April 30, 2018. Group-based trajectory modeling was used to classify fasting plasma glucose levels during pregnancy into 3 glycemic trajectories (trajectory 1, consistently normal glucose levels in all 3 trimesters; trajectory 2, hyperglycemia only in late pregnancy; and trajectory 3, hyperglycemia in all 3 trimesters [ie, consistently high glucose levels]). Statistical analysis was performed from April 25, 2020, to October 1, 2021. Exposures: Gestational diabetes, which was defined using the results of an oral glucose tolerance test. Main Outcomes and Measures: Longitudinal fetal biometrics during gestational weeks 11 to 40 and birth outcomes were obtained from medical records. Pregnancy was partitioned into 3 periods (<24, 24-34, and >34 weeks' gestational age). The differences in offspring growth (log-transformed) and maternal glucose levels were compared using generalized linear mixed models. Results: A total of 4121 pregnant women had oral glucose tolerance test results (mean [SD] age, 28.8 [4.1] years), 3746 of whom had glycemic trajectory data (mean [SD] age, 28.6 [4.1] years); 983 women (23.8%) had gestational diabetes. Throughout the pregnancy period and compared with the women without gestational diabetes or with women in the trajectory 1 group, the fetal biometrics for the women with gestational diabetes or for those in the trajectory 3 group were significantly higher (except for biparietal diameter), with an estimated increase in fetal weight in the group with gestational diabetes (ß = 1.82; 95% CI, 1.03-2.61) and in the trajectory 3 group (ß = 1.50; 95% CI, 0.54-2.47; P = .002). Fetal biometric alterations among women with gestational diabetes appeared before 24 weeks' gestational age, with neonatal birth weight significantly higher than in the group without gestational diabetes at 40.4 g (95% CI, 9.8-71.1 g) along with an increased risk of large size for gestational age (odds ratio, 1.36; 95% CI, 1.05-1.75) and macrosomia (odds ratio, 1.47; 95% CI, 1.12-1.94). However, pregnant women in the trajectory 2 group manifested significantly reduced fetal biometrics, and abdominal circumference was significantly augmented after 34 weeks' gestational age (increase, ß = 1.92; 95% CI, 0.87-2.99). Conclusions and Relevance: In this cohort study, pregnant women who received a diagnosis of gestational diabetes in midpregnancy or had hyperglycemia during all 3 trimesters showed an association with altered fetal growth patterns, including increased estimated fetal weight that appeared before 24 weeks' gestational age, increased birth weight, and the risk for large size for gestational age and macrosomia.

Heterointerface Engineering of ß-Chitin/Carbon Nano-Onions/Ni-P Composites with Boosted Maxwell-Wagner-Sillars Effect for Highly Efficient Electromagnetic Wave Response and Thermal Management.

The rational construction of microstructure and composition with enhanced Maxwell-Wagner-Sillars effect (MWSE) is still a challenging direction for reinforcing electromagnetic wave (EMW) absorption performance, and the related EMW attenuation mechanism has rarely been elucidated. Herein, MWSE boosted ß-chitin/carbon nano-onions/Ni-P composites is prepared according to the heterointerface engineering strategy via facile layer-by-layer electrostatic assembly and electroless plating techniques. The heterogeneous interface is reinforced from the aspect of porous skeleton, nanomaterials and multilayer construction. The composites exhibit competitive EMW response mechanism between the conductive loss and the polarization/magnetic loss, as describing like the story of "The Hare and the Tortoise". As a result, the composites not only achieve a minimum reflection loss (RLmin) of - 50.83 dB and an effective bandwidth of 6.8 GHz, but also present remarkable EMW interference shielding effectiveness of 66.66 dB. In addition, diverse functions such as good thermal insulation, infrared shielding and photothermal performance were also achieved in the hybrid composites as a result of intrinsic morphology and chemicophysics properties. Therefore, we believe that the boosted MWSE open up a novel orientation toward developing multifunctional composites with high-efficient EMW response and thermal management.

A Longitudinal Study of the Effects of Bed-Sharing Experience in Infancy on Sleep Outcomes at 2 Years Old.

OBJECTIVE: To assess the effects of bed-sharing experiences in infancy on sleep patterns and sleep problems at 2 years of age. STUDY DESIGN: A total of 1564 children from an ongoing Shanghai Maternal-Child Pairs Cohort were included. Bed-sharing experiences were collected when children were 2, 6, and 24 months old via caregiver-completed questionnaires (whether caregivers shared a bed with children during the night), and children's bed-sharing experiences were classified as follows: no bed-sharing, early-only bed-sharing, late-onset bed-sharing, and persistent bed-sharing. Sleep outcomes at month 24 were assessed using the Brief Infant Sleep Questionnaire. Sleep patterns and problems were compared among the 4 types of bed-sharing experiences. RESULTS: Of the 1564 infants, 10.10% had no bed-sharing, 18.35% had early-only, 27.94% had late-onset, and 43.61% had persistent bed-sharing. Compared with children with no bed-sharing, children with late-onset and persistent bed-sharing had shorter nighttime sleep durations and longer daytime sleep durations (P < .05) and were more likely to snore (aOR 1.87 [95% CI 1.25-2.79]; aOR 1.68 [95% CI 1.14-2.47]) and have sleep onset difficulty (aOR 2.06 [95% CI 1.37-3.09]; aOR 2.07 [95% CI 1.41-3.05]). However, caregivers of infants in the late-onset and persistent bed-sharing groups perceived less problematic sleep (aOR 0.38 [95% CI 0.26-0.56] and aOR 0.40 [95% CI 0.28-0.58]). CONCLUSIONS: Bed-sharing is a common experience among Chinese children. Although bed-sharing may reduce caregivers' perception of children's problematic sleep, late-onset or persistent bed-sharing in infancy is associated with sleep problems at 2 years of age.

Effect of magnetite on anaerobic digestion treating saline wastewater: Methane production, biomass aggregation and microbial community dynamics.

In this study, the effect of magnetite amendment on anaerobic digestion was investigated at three increasing salinity levels (0.5%, 1% and 2% NaCl). The amendment of magnetite enhanced the methane yield by 36.3%, 33.3% and 16.5% at low salinity (0.5% NaCl) and high salinity (1% and 2% NaCl), respectively. Meanwhile, a larger proportion of granules was obtained in the magnetite amended reactor (48.05% vs 33.16% at the end of operation). Microbial analysis suggested magnetite could induce more methanogenesis partnerships between hydrogenotrophic methanogens and syntrophic bacteria. Methanosaeta and Methanocorpusculum were the alternating dominant methanogens at low salinity and high salinity. While Streptococcus and Mesotoga were two prevalent bacteria that showed totally different transition tendency in two reactors. Additionally, the supplement of magnetite could relieve the suppression of methanogenesis-related gene expression caused by salinity, thus facilitated the higher methane production.