Gestational diabetes mellitus:The optimal time of delivery

Gestational diabetes mellitus(GDM)is a common pregnancy complication strongly associated with poor maternal-fetal outcomes.Its incidence and prevalence have been increasing in recent years.Women with GDM typically give birth through either vaginal delivery or cesarean section,and the maternal-fetal outcomes are related to several factors such as cervical level,fetal lung maturity,the level of glycemic control still present,and the mode of treatment for the condition.We categorized women with GDM based on the latter two factors.GDM that is managed without medication when it is responsive to nutrition-and exercise-based therapy is considered diet-and exercise-controlled GDM,or class A1 GDM,and GDM managed with medication to achieve adequate glycemic control is considered class A2 GDM.The remaining cases in which neither medical nor nutritional treatment can control glucose levels or patients who do not control their blood sugar are categorized as class A3 GDM.We investigated the optimal time of delivery for women with GDM according to the classification of the condition.This review aimed to address the benefits and harms of giving birth at different weeks of gestation for women with different classes of GDM and attempted to provide an analytical framework and clearer advice on the optimal time for labor.

Cationic engineered nanodiamonds for efficient antibacterial surface with strong wear resistance

The spread of diseases caused by bacterial adhesion and immobilization in public places constitutes a serious threat to public health.Prevention of bacteria spread by the construction of an antibacterial surface takes precedence over post-infection treatment.Herein,we demonstrate an effective antibacterial surface with strong wear resistance by constructing cationic engineered nanodiamonds(C-NDs).The C-NDs with positive surface potentials interact effectively with bacteria through electrostatic interactions,where the C-NDs act on the phospholipid bilayer and lead to bacterial membrane collapse and rupture through hydrogen bonding and residual surface oxygen-containing reactive groups.In this case,bactericidal rate of 99.99%and bacterial biofilm inhibition rate of more than 80%can be achieved with the C-NDs concentration of 1 mg/mL.In addition,the C-NDs show outstanding antibacterial stability,retaining over 87%of the antibacterial effect after stimulation by adverse environments of heat,acid,and external abrasion.Therefore,an antibacterial surface with high wear resistance obtained by integrating C-NDs with commercial plastics has been demonstrated.The antibacterial surface with a mass fraction of 1 wt.%C-NDs improved abrasion resistance by 3981 times,with 99%killing of adherent bacteria.This work provides an effective strategy for highly efficient antibacterial wear-resistant surface,showing great practical applications in public health environments.