The relationship between air pollutants and gestational diabetes: an updated systematic review and meta-analysis.

PURPOSE: Air pollution is an environmental stimulus that may predispose pregnant women to gestational diabetes mellitus (GDM). This systematic review and meta-analysis were conducted to investigate the relationship between air pollutants and GDM. METHODS: PubMed, Web of Science, and Scopus were systematically searched for retrieving English articles published from January 2020 to September 2021, investigating the relationship of exposure to ambient air pollution or levels of air pollutants with GDM and related parameters, including fasting plasma glucose (FPG), insulin resistance, and impaired glucose tolerance. Heterogeneity and publication bias were evaluated using I-squared (I2), and Begg's statistics, respectively. We also performed the subgroup analysis for particulate matters (PM2.5, PM10), Ozone (O3), and sulfur dioxide (SO2) in the different exposure periods. RESULTS: A total of 13 studies examining 2,826,544 patients were included in this meta-analysis. Compared to non-exposed women, exposure to PM2.5 increases the odds (likelihood of occurrence outcome) of GDM by 1.09 times (95% CI 1.06, 1.12), whereas exposure to PM10 has more effect by OR of 1.17 (95% CI 1.04, 1.32). Exposure to O3 and SO2 increases the odds of GDM by 1.10 times (95% CI 1.03, 1.18) and 1.10 times (95% CI 1.01, 1.19), respectively. CONCLUSIONS: The results of the study show a relationship between air pollutants PM2.5, PM10, O3, and SO2 and the risk of GDM. Although evidence from various studies can provide insights into the linkage between maternal exposure to air pollution and GDM, more well-designed longitudinal studies are recommended for precise interpretation of the association between GDM and air pollution by adjusting all potential confounders.

The targeted high-risk case-finding approach versus universal screening for thyroid dysfunction during pregnancy: thyroid-stimulating hormone (TSH) and/or thyroid peroxidase antibody (TPOAb) test?

PURPOSE: To compare the effects of different thyroid screening scenarios, using the universal and targeted high-risk case-finding approaches with different diagnostic tests on the prevalence of subclinical hypothyroidism (SCH), thyroid autoimmunity, and pregnancy outcomes after adjustments for the intervention. METHODS: During a secondary analysis of data collected in Tehran Thyroid and Pregnancy Study, a total of 2277 women from the total population, including 1303 high-risk individuals for thyroid dysfunction. The Cochran-Mantel-Haenszel method, adjusted for the intervention, was also used to evaluate the relationships between different screening scenarios [i.e., universal approach using thyroid-stimulating hormone (TSH) and/or thyroid peroxidase antibody (TPOAb) tests and targeted high-risk case-finding approach using TSH and/or TPOAb tests] and pregnancy outcomes (i.e., preterm delivery and NICU admission). The universal approach using both TSH and TPOAb measurements was considered as the reference scenario. We analyzed outcomes of different screening methods in individuals treated with LT4, compared to those individuals who were not treated. RESULTS: Compared to the universal screening approach with both TSH and TPOAb measurements, the targeted high-risk case-finding approach overlooked approximately 42%, 62%, and 74% of women with elevated TSH (> 4 µlU/mL) when using both TSH and TPOAb tests, TSH alone, and TPO alone, respectively. After adjusting for the missed cases, 2.86% of women with preterm delivery and 2.76% of women with NICU admission were missed when they were screened using the targeted high-risk case-finding approach by measuring both TSH and TPOAb. The percentage of missed cases increased when applying the targeted approach with the TSH test alone, without measuring TPOAb. Overall, 4.16% and 4.02% of women with preterm delivery and NICU admission were overlooked in this scenario, respectively. After adjustments for the intervention, the probability of NICU admission in neonates of mothers, who were screened using the targeted high-risk case-finding approach with TPOAb measurement, was 2.31 folds higher than those screened by the reference scenario. CONCLUSION: This study suggests that although the targeted high-risk case-finding approach including both TSH and TPOAb tests, may overlook some women with SCH, it is a reasonable option since it is not associated with a higher risk of adverse pregnancy outcomes.

The impact of a sexual enhancement program on the sexual function of postmenopausal women.

OBJECTIVES: To examine the effects of sex education on sexual function in postmenopausal women. METHODS: A randomized clinical trial was carried on 104 postmenopausal women, aged 40-60 years, residing in the cities of Chalus and Nowshahr, Iran. Their sexual function was assessed using the Female Sexual Function Index (FSFI) questionnaire. The participants were randomly assigned to two groups: (1) intervention, in which the subjects received a sexual enhancement program with weekly follow-ups; and (2) controls, who received general educational material on postmenopause. Both groups were re-assessed after 12 weeks using the FSFI questionnaire. RESULTS: There were no significant differences between the two groups in terms of demographic and socioeconomic characteristics, or their total scores of FSFI, in the initial stage of the study. After implementation of the sexual enhancement program, however, the total scores of sexual function, as well as the scores in the arousal and pain domains, were significantly higher in the intervention group, compared to the control group (24.41 vs. 22.70, 3.35 vs. 2.73, and 4.50 vs. 3.98, respectively). CONCLUSION: Sexual function of postmenopausal women can be improved by a sexual enhancement program.

Thyroid autoantibodies and the effect on pregnancy outcomes.

Thyroid antibody positivity is relatively common in women. While many epidemiological studies have investigated the links between thyroid antibodies and pregnancy complications, evidence regarding the effect of Levothyroxine treatment of euthyroid pregnant women with autoimmune thyroid disease on pregnancy outcome is limited. The objective of this paper is to provide a review on the impact of treatment of euthyroid thyroid antibody-positive pregnant women on adverse pregnancy outcome. This systematic review was conducted with a prospective protocol. PubMed, Science direct, Google scholar, Embase and the Cochrane Library databases were searched through January 2014 to identify studies that met pre-stated inclusion criteria. The search was limited to English manuscripts. We found that there is inadequate data regarding both the adverse effect of thyroid antibody positivity in euthyroid women on pregnancy outcomes and the effects Levothyroxine on these women. It seems that the results of most studies indicate adverse effects of thyroid antibody positivity in euthyroid women on pregnancy outcomes. Further randomised clinical trials are needed to investigate the effects of treating pregnant euthyroid women with positive thyroid antibodies on the maternal and early/late neonatal outcomes.

Residual Stress Relaxation Induced by Mass Transport Through Interface of the Pd/SrTiO3.

Metal interconnections having a small cross-section and short length can be subjected to very large mass transport due to the passing of high current densities. As a result, nonlinear diffusion and electromigration effects which may result in device failure and electrical instabilities may be manifested. Various thicknesses of Pd were deposited over SrTiO3 substrate. Residual stress of the deposited film was evaluated by measuring the variation of d-spacing versus sin2ψ through conventional X-ray diffraction method. It has been found that the lattice misfit within film and substrate might be relaxed because of mass transport. Besides, the relation between residual intrinsic stress and oxygen diffusion through deposited film has been expressed. Consequently, appearance of oxide intermediate layer may adjust interfacial characteristics and suppress electrical conductivity by increasing electron scattering through metallic films.