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ABSTRACT IMPACT: The knowledge acquired from my research can inform the development of early diagnostic methods for HIV-associated neurocognitive disorders. OBJECTIVES/GOALS: In the era of combination antiretroviral therapy (cART), the prevalence of HIV-associated neurocognitive disorders (HAND) remains high but the neural mechanisms are unclear. We examined whether older people with HIV (PWH) with minimal cognitive impairment have reduced functional connectivity in frontostriatal circuits compared to controls. METHODS/STUDY POPULATION: 99 PWH (mean age 56.6 years, 75% male, 62% Black, mean duration of HIV-infection 26.2 years ±9.3, 90% viral load <50 copies, 98% on stable cART) and 38 demographically-comparable controls (mean age 54.5 years, 71% male, 58% Black) participated in a cross-sectional study. A 7-domain neuropsychological battery and an Activities of Daily Living index were used to determine HAND diagnoses: 32 PWH met criteria for asymptomatic to mild HAND. Motor skill was assessed using the Grooved Pegboard Test by measuring performance speed. Structural MRI and resting-state functional MRI were collected. Seed-to-voxel analyses were conducted using 4 distinct regions in the striatum as seed regions. We used a voxel threshold of p<0.001 and cluster threshold of p<0.05 (FDR-corrected) after controlling for demographic variables. RESULTS/ANTICIPATED RESULTS: Compared to controls, PWH had lower resting state functional connectivity between the default mode region of the striatum (i.e., medial caudate) and bilateral superior frontal gyrus, supplementary motor cortex and paracingulate gyrus (p<0.05; cluster size: 567 voxels). Also, compared to controls, PWH had reduced resting state functional connectivity between the motor division of the striatum (i.e., posterior putamen) and anterior cingulate cortex and left supplementary motor cortex (p<0.05, cluster size: 405 voxels). Performance speed on the Grooved Pegboard motor test negatively correlated with functional connectivity between the motor region of the striatum and supplementary motor frontal regions in all participants (Spearman’s rho=-0.18, p=0.04). DISCUSSION/SIGNIFICANCE OF FINDINGS: Our results support the hypothesis that frontostriatal abnormalities are widely present in PWH and might play a key role in HAND development. Our data suggest that dysfunction within the frontostriatal circuits may be involved in motor impairment in PWH, and ongoing inflammation may contribute to motor impairment and frontostriatal injury.
Previous studies have reported inverse associations between certain healthy lifestyle factors and non-alcoholic fatty liver disease (NAFLD), but limited evidence showed the synergistic effect of those lifestyles. This study examined the relationship of a combination of lifestyles, expressed as Healthy Lifestyle Score (HLS), with NAFLD.
A community-based cross-sectional study. Questionnaires and body assessments were used to collect data on the six-item HLS (ranging from 0 to 6, where higher scores indicate better health). The HLS consists of non-smoking (no active or passive smoking), normal BMI (18·5–23·9 kg/m2), physical activity (moderate or vigorous physical activity ≥ 150 min/week), healthy diet pattern, good sleep (no insomnia or <6 months) and no anxiety (Self-rating Anxiety Scale < 50), one point each. NAFLD was diagnosed by ultrasonography.
Two thousand nine hundred and eighty-one participants aged 40–75 years.
The overall prevalence of NAFLD was 50·8 %. After adjusting for potential covariates, HLS was associated with lower presence of NAFLD. The OR of NAFLD for subjects with higher HLS (3, 4, 5–6 v. 0–1 points) were 0·68 (95 % CI 0·51, 0·91), 0·58 (95 % CI 0·43, 0·78) and 0·35 (95 % CI 0·25, 0·51), respectively (P-values < 0·05). Among the six items, BMI and physical activity were the strongest contributors. Sensitivity analyses showed that the association was more significant after weighting the HLS. The beneficial association remained after excluding any one of the six components or replacing BMI with waist circumference.
Higher HLS was associated with lower presence of NAFLD, suggesting that a healthy lifestyle pattern might be beneficial to liver health.
This study aimed to evaluate to what extent the different interval times between trophectoderm (TE) biopsy and vitrification influence the clinical outcomes in preimplantation genetic testing (PGT) cycles. Patients who underwent frozen embryo transfer (FET) after PGT between 2015 and 2019 were recruited. In total, 297 cycles with single day 5 euploid blastocyst transfer were included. These cycles were divided into three groups according to the interval times: <1 h group, 1–2 h group, and ≥2 h group. Blastocyst survival, clinical pregnancy, miscarriage, and ongoing pregnancy rates were compared. The results showed that, in PGT-SR cycles, survival rate in the ≥2 h group (96.72%) was significantly lower than in the <1 h group (100%, P = 0.047). The clinical pregnancy rate in the ≥2 h group was 55.93%, significantly lower than in the <1 h group (74.26%, P = 0.017). The ongoing pregnancy rates in the 1–2 h group and the ≥2 h group were 48.28% and 47.46%, respectively, significantly lower than that in the <1 h group (67.33%, P < 0.05). The miscarriage rate in the 1–2 h group was 18.42%, significantly higher than that in the <1 h group (5.33%, P = 0.027). In PGT-A cycles, the clinical pregnancy and ongoing pregnancy rates in the <1 h group were 67.44% and 53.49%, respectively, higher than that in the 1–2 h group (52.94%, 47.06%, P > 0.05) and the ≥2 h group (52.63%, 36.84%, P > 0.05). In conclusion, vitrification of blastocysts beyond 1 h after biopsy significantly influences embryo survival and clinical outcomes and is therefore not recommended.
As essential specifications of correlation domain for signal quality evaluation, distortions of the S-curve, including bias and slope distortions of the zero-crossing point, are usually selected as indicators of optimisation in the process of designing the channels of receivers or navigation satellites. Focusing on this issue, we present a detailed analysis of slope distortion in the presence of group delay and amplitude distortions. After validating the theoretical results, we present further discussions about the impacts of different group delay terms on slope distortions. The results indicate that both the odd-order and the even-order terms have impacts on the slope distortion, and higher odd-order terms have less slope distortion compared with the lower odd-order terms. These results are useful for evaluating the slope distortion from the group delay and guiding improvement in design of the channel.
In this paper, dual-band and tri-band bandpass filters (BPFs) with fully independent and controllable passbands based on multipath-embedded resonators are presented. The dual-band BPF consists of two double open-ended stub-loaded terminal-shorted resonators (DOESL-TSRs) with a common via-hole connected along the symmetric plane of the filter. Based on DOESL-TSRs, a triple open-ended stub-loaded terminal-shorted resonator (TOESL-TSR) is proposed in the design of tri-band BPFs. The resonant characteristics of DOESL-TSR/TOESL-TSR are analyzed by the numerical calculation method. The measured results of the dual-band BPF show that the center frequencies (CFs) are located at 2.595 and 5.75 GHz, respectively, with 3 dB fraction bandwidth (FBWs) of 15 and 12.8%. The measured CFs of the tri-band BPF are located at 2.545, 3.775, and 5.95 GHz, respectively, with 3 dB FBWs of 9.8, 9.3, and 5.5%. Both of the filters exhibit the merits of fully independent and controllable passbands, high selectivity, and compact size.
In this paper, the microstructure and the shear property of Cu/In–45Cu/Ni solder joints by transient liquid phase were studied, and the intermetallic compounds (IMCs) growth mechanism was investigated. The results showed that the IMCs volume ratio of solder joints was increased firstly and then decreased with increasing bonding time, and the IMCs volume ratio reached its maximum value of 95.8% at 60 min. The Cu interfacial IMC of the solder joint with dense microstructure was Cu2In phase at 60 min, and the Ni interfacial IMC was Ni3In7. The maximum shear strength of solder joints was obtained at 60 min, which is 15.21 MPa. The shear fracture appeared honeycomb structure, and the fracture occurred at the phase interface of Ni3In7/Cu11In9. The thickness of the interfacial IMCs and the white IMCs around the Cu particles (Cu@IMC) was increased continuously with increasing bonding time, and thus, the interconnection of Cu–Ni substrates was realized ultimately.
The aim of this study was to explore the application of the flipped classroom approach in the training of Mass Casualty Triage (MCT) to medical undergraduate students.
In this study, 103 fourth-year medical students were randomly divided into a Flipped Classroom (FC) group (n = 51) and a Traditional Lecture-based Classroom (TLC) group (n = 52). A post-class quiz, simulated field triage (SFT) and feedback questionnaires were performed to assess both groups of students for their learning of the course.
In the post-quiz, the median (IQR) scores achieved by students from the FC and TLC groups were 42(5) and 39(5.5), respectively. Significant differences were found between the two groups. In the SFT, overall triage accuracy was 67.06% for FC, and 64.23% for TLC students. Over-triage and under-triage errors occurred in 18.43% and 14.50% of the FC group, respectively. The TLC group had a similar pattern of 20.77% over-triage and 15.0% under-triage errors. No significant differences were found regarding overall triage accuracy or triage errors between the two groups.
The FC approach could enhance course grades reflected in the post-quiz and improve students’ satisfaction with the class. However, there was no significant difference of competency between the two groups demonstrated in the SFT exercise.
We develop a general method for constructing knotted flux tubes with finite thickness, arbitrary shape and tunable twist. The central axis of the knotted tube is specified by a smooth and non-degenerate parametric equation. The helicity of the corresponding solenoidal knotted field can be explicitly decomposed into writhe, normalized total torsion and intrinsic twist. We construct several knotted magnetic flux tubes with various twisting degrees, and investigate the effect of twist on their evolution in resistive magnetohydrodynamic flows using direct numerical simulation. For large twist, the magnetic knot gradually shrinks to a tight stable state, similar to the relaxation process in ideal magnetohydrodynamic flows. For small twist, the knotted flux tube splits at early times, accompanied by a rising magnetic dissipation rate. We elucidate the mechanism of the tube splitting using the phase portrait of the Lorentz force projected onto divergence-free space. For finite twist, the Hopf bifurcation from an unstable spiral point to a limit cycle occurs on the phase plane. In the evolution, field lines inside the limit cycle form invariant tori, whereas they become chaotic outside the limit cycle.
As electrode materials, metal-organic frameworks always have low electrical conductivity and poor structural stability, which limits its applications in electrochemical fields. Here, Ni-BPDC/GO composites are synthesized using graphene oxide (GO) as a substrate and 4,4′-biphenyldicarboxylic acid (BPDC) as an organic ligand via a hydrothermal approach. The growth mechanism of the Ni-BPDC and Ni-BPDC/GO composites is proposed. In the composites, highly dispersed Ni-BPDC macro-nanostrips are supported on the GO surface in parallel. The presence of GO does not affect the growth and crystalline structure of Ni-BPDC. Compared with the Ni-BPDC, Ni-BPDC/GO composites exhibit higher specific capacitance, rate capability, and operating current density through lowering intrinsic resistance, charge-transfer resistance, and ion diffusion impedance. Moreover, the assembled Ni-BPDC/GO-3//reduced graphene oxide (rGO) asymmetric supercapacitor has large specific capacitance, good cycling stability, and high energy density (16.5 W h/kg at 250 W/kg). Hence, Ni-BPDC/GO composites are a potential electrode material for supercapacitors.
The Gangdese magmatic belt across the southern Tibetan Plateau is juxtaposed with the Indus–Yurlung Zangbo suture zone (IYS), and many mafic microgranular enclaves (MMEs) are exposed in the belt, thus providing a window for observing deep crust–mantle processes related to the Indo-Asian collision. The Nyemo intrusion is located in the middle part of the Gangdese magmatic belt and comprises host diorites with abundant MMEs. Compared with other parts of the Gangdese magmatic belt, the host rock of the Nyemo intrusion has a mineral composition similar to that of the MME, although differences are observed in chemical contents. To explore the genetic type of the MMEs and the deep processes of the Gangdese magmatic belt, the Nyemo intrusion is selected as the research object for this paper. Here, we report zircon U–Pb geochronological and whole-rock geochemical data for host diorites and MMEs, and electron probe data for hornblendes in diorites and MMEs, and combine mineralogy, petrology, petrogeochemistry and isotope geochemistry analyses. Research has shown that diorites in the Nyemo intrusion belong to the medium-K, metaluminous series. The light rare earth elements (LREEs) and heavy rare earth elements (HREEs) are significantly fractionated, and the LREE/HREE values are 5.77–7.71. The (87Sr/86Sr)i values of the diorites range from 0.704260 to 0.704287, and the εNd(t) values are from 3.73 to 4.17. The MMEs in the Nyemo intrusion have a limited range of SiO2 contents, are calc-alkaline with metaluminous affinity, and have relatively high contents of MgO (4.34–5.00 wt %) with Mg# (Mg2+/Mg2+ + Fe2+) values of 42.36–43.53, which is close to that of evolved basic magma. The contents of REEs vary from 108.87 to 120.59 ppm and show obvious Eu anomalies. The (87Sr/86Sr)i values of the MMEs range from 0.704680 to 0.704704, and the εNd(t) values are 0.35–3.74. The crystallization temperature of the hornblende in the diorite is 820 °C, the formation depth is 5.39 km, the oxygen fugacity is ΔNNO + 0.88 and the water content is 5.95 %. The crystallization temperature of the hornblende in the MMEs is 880 °C, the formation depth is 12.18 km, the oxygen fugacity is ΔNNO + 0.38 and the water content is 8.27 %. The Nyemo MMEs are formed by magma mingling, and originate from the partial melting of the depleted mantle, while the host diorite originates from partial melting of the juvenile crust with the addition of mantle material. The formation of the Gangdese magmatic belt is related to the Indo-Asian continental collision. The break-off of the subducted Neo-Tethyan oceanic plate triggered partial melting of the asthenosphere, which resulted in accumulation of the basaltic magma and then caused the partial melting of the juvenile crust with the addition of mantle material, thus forming a variety of granitic rocks and the large Gangdese magmatic belt.
Organic light-emitting diodes (OLEDs) have aroused great attention due to the advantages of high luminescent efficiency, fast response time, wide viewing angle, and the compatibility with the flexible electronics. Nevertheless, the organic luminescent materials are vulnerable to environment moisture/oxygen. Thus, how to protect the OLEDs from the ambient moisture/oxygen erosion is of great importance to ensure the stability and reliability. Thin film encapsulation (TFE) via atomic layer deposition (ALD) has emerged as a potential method to meet the encapsulation requirements of OLEDs due to its unique assets. In this review, the challenges of TFE, including pinholes, crystallization, cracks, and overheated, are introduced first. The ALD-based monolayer, composite structures, and hybrid laminates were developed to improve the barrier property, flexibility, and thermal conductivity. Besides, the ALD reactors and processes for TFE are also reviewed. Finally, the challenges remained and future development in the stabilization of OLEDs via ALD are also discussed.
Small intestinal epithelium homeostasis involves four principal cell types: enterocytes, goblet, enteroendocrine and Paneth cells. Epidermal growth factor (EGF) has been shown to affect enterocyte differentiation. This study determined the effect of dietary EGF on goblet, enteroendocrine and Paneth cell differentiation in piglet small intestine and potential mechanisms. Forty-two weaned piglets were used in a 2 × 3 factorial design; the major factors were time post-weaning (days 7 and 14) and dietary treatment (0, 200 or 400 µg/kg EGF supplementation). The numbers of goblet and enteroendocrine cells were generally greater with the increase in time post-weaning. Moreover, the supplementation of 200 µg/kg EGF increased (P < 0.01) the number of goblet and enteroendocrine cells in villus and crypt of the piglet small intestine as compared with the control. Dietary supplementation with 200 µg/kg EGF enhanced (P < 0.05) abundances of differentiation-related genes atonal homologue 1, mucin 2 and intestinal trefoil factor 3 messenger RNA (mRNA) as compared with the control. Piglets fed 200 or 400 µg/kg EGF diet had increased (P < 0.05) abundances of growth factor-independent 1, SAM pointed domain containing ETS transcription factor and pancreatic and duodenal homeobox 1 mRNA, but decreased the abundance (P < 0.01) of E74 like ETS transcription factor 3 mRNA as compared with the control. Animals receiving 400 µg/kg EGF diets had enhanced (P < 0.05) abundances of neurogenin3 and SRY-box containing gene 9 mRNA as compared with the control. The mRNA abundance and protein expression of lysozyme, a marker of Paneth cell, were also increased (P < 0.05) in those animals. As compared with the control, dietary supplementation with 200 µg/kg EGF increased the abundance of EGF receptor mRNA and the ratio of non-phospho(p)-β-catenin/β-catenin (P < 0.05) in villus epithelial cells at days 7 and 14. This ratio in crypt epithelial cells was higher (P < 0.05) on the both 200 and 400 µg/kg EGF groups during the same period. Our results demonstrated that dietary EGF stimulated goblet, enteroendocrine and Paneth cell differentiation in piglets during the post-weaning period, partly through EGFR and Wnt/β-catenin signalling.
Hand, foot and mouth disease (HFMD) has spread widely and leads to high disease burden in many countries. However, relative transmissibility from male to female individuals remains unclear. HFMD surveillance database was built in Shenzhen City from 2013 to 2017. An intersex transmission susceptible–infectious–recovered model was developed to calculate the transmission relative rate among male individuals, among female individuals, from male to female and from female to male. Two indicators, ratio of transmission relative rate (Rβ) and relative transmissibility index (RTI), were developed to assess the relative transmissibility of male vs. female. During the study period, 270 347 HFMD cases were reported in the city, among which 16 were death cases with a fatality of 0.0059%. Reported incidence of total cases, male cases and female cases was 0.0057 (range: 0.0036–0.0058), 0.0052 (range: 0.0032–0.0053) and 0.0044 (range: 0.0026–0.0047), respectively. The difference was statistically significant between male and female (t = 3.046, P = 0.002). Rβ of male vs. female, female vs. female, from female to male vs. female and from male to female vs. female was 7.69, 1.00, 1.74 and 7.13, respectively. RTI of male vs. female, female vs. female, from female to male vs. female and from male to female vs. female was 3.08, 1.00, 1.88 and 1.43, respectively. Transmissibility of HFMD is different between male and female individuals. Male cases seem to be more transmissible than female.
We extend the vortex-surface field (VSF), whose isosurface is a vortex surface consisting of vortex lines, to identify vortex tubes and sheets in homogeneous isotropic turbulence. The VSF at a time instant is constructed by solving a pseudo-transport equation. This equation is convected by a given instantaneous vorticity obtained from direct numerical simulation. In each pseudo-time step, we develop a novel local optimization algorithm to minimize a hybrid VSF constraint, balancing the accuracy and smoothness of VSF solutions. This key improvement makes the numerical construction of VSFs feasible for arbitrarily complex flow fields, as a general flow diagnostic tool. In the visualization of VSF isosurfaces in decaying homogeneous isotropic turbulence, the initial curved vortex sheets first evolve into vortex tubes, and then the vortex tubes are stretched and tangled, constituting a complex network. Some vortex tubes exhibit helical geometry, which suggests the important role of vortex twisting in the generation of small-scale structures in energy cascade.
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; Pfor 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; Pfor 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) (Pfor trend < 0·001); each 1 mg increase in lycopene intake was associated with 0·005 (95 % CI 0·002, 0·007; Pfor 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; Pfor 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.
Image stitching is important for the perception and manipulation of undersea robots. In spite of a well-developed technique, it is still challenging for undersea images because of their inevitable appearance ambiguity caused by the limited light in the undersea environment, and local disturbance caused by moving objects, ocean current, etc. To get a clean and stable background panorama in the undersea environment, this paper proposes an undersea image-stitching method by introducing graph-based registration and blending procedures. Specifically, in the registration procedure, matching the features in each undersea image pair is formulated and solved by graph matching, to incorporate the structural information between features. In the blending procedure, an energy function on the indirect graph Markov random field is proposed, which takes both image consistency and neighboring consistency into consideration. Coincidentally, both graph matching and energy minimization can be mathematically formulated by integer quadratic programming problems with different constraints; the recently proposed graduated nonconvexity and concavity procedure is used to optimize both problems. Experiments on both synthetic images and real-world undersea images witness the effectiveness of the proposed method.
We present updated U–Pb ages and Hf isotopic compositions of detrital zircons and whole-rock geochemical data to investigate the provenance and tectonic setting of late Neoproterozoic and early Cambrian sandstones from the Cathaysia Block, in order to offer new constraints on its tectonic evolution and its palaeo-position within the supercontinent. The source rocks for the studied sandstones were dominated by felsic–intermediate materials with moderate weathering history. U–Pb dating results show major populations at c. 2500 Ma, 1000–900 Ma and 870–716 Ma with subordinate peaks at 655–532 Ma, consistent with the global Neoarchean continental crust growth, assembly and break-up of Rodinia, and Pan-African Event associated with the formation of Gondwana. Zircon U–Pb ages and Hf isotopic data suggest that most derived from exotic terranes once connected to the Cathaysia Block. Using whole-rock geochemical analysis, it was determined that the studied sedimentary rocks were deposited in a passive continental margin and the Cathaysia and Yangtze blocks were part of the same continent; no Cambrian ocean existed between them. Compiling a detrital zircon dataset from Qiangtang, northern India, the Lhasa Terrane and Western Australia, the Cathaysia Block seems to be more similar to the Qiangtang and western part of the northern India margin, instead of having a direct connection with the Lhasa Terrane and Western Australia in the Gondwana reconstruction during the late Neoproterozoic and Cambrian eons.
We demonstrate that, if a globally smooth virtual circulation-preserving velocity exists, Kelvin’s and Helmholtz’s theorems can be extended to some non-ideal flows which are viscous, baroclinic or with non-conservative body forces. Then we track vortex surfaces frozen in the virtual velocity in the non-ideal flows, based on the evolution of a vortex-surface field (VSF). For a flow with a viscous-like diffusion term normal to the vorticity, we obtain an explicit virtual velocity to accurately track vortex surfaces in time. This modified flow is dissipative but prohibits reconnection of vortex lines. If a globally smooth virtual velocity does not exist, an approximate virtual velocity can still facilitate the tracking of vortex surfaces in non-ideal flows. In a magnetohydrodynamic Taylor–Green flow, we find that the conservation of vorticity flux is significantly improved in the VSF evolution convected by the approximate virtual velocity instead of the physical velocity, and the spurious vortex deformation induced by the Lorentz force is eliminated.
Maternal dietary patterns and macronutrients intake have been shown to affect the development of gestational diabetes mellitus (GDM), but the findings are inconsistent. We aimed to identify maternal dietary patterns and examine their associations with GDM risk, and to evaluate the contributions of macronutrients intake to these associations. We included 2755 Chinese pregnant women from the Tongji Maternal and Child Health Cohort. Dietary intakes were assessed using a validated semi-quantitative FFQ 2 weeks before the diagnosis of GDM. GDM (n 248) was diagnosed based on the results of a 75-g, 2-h oral glucose tolerance test at 24–28 weeks gestation. We derived five different dietary patterns from a principal component analysis. The results showed that high fish–meat–eggs scores, which were positively related to protein intake and inversely related to carbohydrate intake, were associated with a higher risk of GDM (adjusted OR for quartile 4 v. quartile 1: 1·83; 95 % CI 1·21, 2·79; Ptrend=0·007) and higher plasma glucose levels. In contrast, high rice–wheat–fruits scores, which were positively related to carbohydrate intake and inversely related to protein intake, were associated with lower risk of GDM (adjusted OR for quartile 3 v. quartile 1: 0·54; 95 % CI 0·36, 0·83; Ptrend=0·010) and lower plasma glucose levels. In addition, dietary protein and carbohydrate intake significantly contributed to the associations between dietary patterns and GDM risk or glucose levels. These findings suggest that a dietary pattern characterised by high protein and low carbohydrate intake in pregnancy was associated with a higher risk of GDM, which may provide important clues for dietary guidance during pregnancy to prevent GDM.