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The Asian corn borer, Ostrinia furnacalis (Guenée), emerges as a significant threat to maize cultivation, inflicting substantial damage upon the crops. Particularly, its larval stage represents a critical point characterised by significant economic consequences on maize yield. To manage the infestation of this pest effectively, timely and precise identification of its larval stages is required. Currently, the absence of techniques capable of addressing this urgent need poses a formidable challenge to agricultural practitioners. To mitigate this issue, the current study aims to establish models conducive to the identification of larval stages. Furthermore, this study aims to devise predictive models for estimating larval weights, thereby enhancing the precision and efficacy of pest management strategies. For this, 9 classification and 11 regression models were established using four feature datasets based on the following features geometry, colour, and texture. Effectiveness of the models was determined by comparing metrics such as accuracy, precision, recall, F1-score, coefficient of determination, root mean squared error, mean absolute error, and mean absolute percentage error. Furthermore, Shapley Additive exPlanations analysis was employed to analyse the importance of features. Our results revealed that for instar identification, the DecisionTreeClassifier model exhibited the best performance with an accuracy of 84%. For larval weight, the SupportVectorRegressor model performed best with R2 of 0.9742. Overall, these findings present a novel and accurate approach to identify instar and predict the weight of O. furnacalis larvae, offering valuable insights for the implementation of management strategies against this key pest.
Knowledge is growing on the essential role of neural circuits involved in aberrant cognitive control and reward sensitivity for the onset and maintenance of binge eating.
Aims
To investigate how the brain's reward (bottom-up) and inhibition control (top-down) systems potentially and dynamically interact to contribute to subclinical binge eating.
Method
Functional magnetic resonance imaging data were acquired from 30 binge eaters and 29 controls while participants performed a food reward Go/NoGo task. Dynamic causal modelling with the parametric empirical Bayes framework, a novel brain connectivity technique, was used to examine between-group differences in the directional influence between reward and executive control regions. We explored the proximal risk factors for binge eating and its neural basis, and assessed the predictive ability of neural indices on future disordered eating and body weight.
Results
The binge eating group relative to controls displayed fewer reward-inhibition undirectional and directional synchronisations (i.e. medial orbitofrontal cortex [mOFC]–superior parietal gyrus [SPG] connectivity, mOFC → SPG excitatory connectivity) during food reward_nogo condition. Trait impulsivity is a key proximal factor that could weaken the mOFC–SPG connectivity and exacerbate binge eating. Crucially, this core mOFC–SPG connectivity successfully predicted binge eating frequency 6 months later.
Conclusions
These findings point to a particularly important role of the bottom-up interactions between cortical reward and frontoparietal control circuits in subclinical binge eating, which offers novel insights into the neural hierarchical mechanisms underlying problematic eating, and may have implications for the early identification of individuals suffering from strong binge eating-associated symptomatology in the general population.
The large number of patients with ankle injuries and the high incidence make ankle rehabilitation an urgent health problem. However, there is a certain degree of difference between the motion of most ankle rehabilitation robots and the actual axis of the human ankle. To achieve more precise ankle joint rehabilitation training, this paper proposes a novel 3-PUU/R parallel ankle rehabilitation mechanism that integrates with the human ankle joint axis. Moreover, it provides comprehensive ankle joint motion necessary for effective rehabilitation. The mechanism has four degrees of freedom (DOFs), enabling plantarflexion/dorsiflexion, eversion/inversion, internal rotation/external rotation, and dorsal extension of the ankle joint. First, based on the DOFs of the human ankle joint and the variation pattern of the joint axes, a 3-PUU/R parallel ankle joint rehabilitation mechanism is designed. Based on the screw theory, the inverse kinematics inverse, complete Jacobian matrix, singular characteristics, and workspace analysis of the mechanism are conducted. Subsequently, the motion performance of the mechanism is analyzed based on the motion/force transmission indices and the constraint indices. Then, the performance of the mechanism is optimized according to human physiological characteristics, with the motion/force transmission ratio and workspace range as optimization objectives. Finally, a physical prototype of the proposed robot was developed, and experimental tests were performed to evaluate the above performance of the proposed robot. This study provides a good prospect for improving the comfort and safety of ankle joint rehabilitation from the perspective of human-machine axis matching.
This study aims to evaluate the impact of low-carbohydrate diet, balanced dietary guidance and pharmacotherapy on weight loss among individuals with overweight or obesity over a period of 3 months. The study involves 339 individuals with overweight or obesity and received weight loss treatment at the Department of Clinical Nutrition at the Second Affiliated Hospital of Zhejiang University, School of Medicine, between 1 January 2020 and 31 December 2023. The primary outcome is the percentage weight loss. Among the studied patients, the majority chose low-carbohydrate diet as their primary treatment (168 (49·56 %)), followed by balanced dietary guidance (139 (41·00 %)) and pharmacotherapy (32 (9·44 %)). The total percentage weight loss for patients who were followed up for 1 month, 2 months and 3 months was 4·98 (3·04, 6·29) %, 7·93 (5·42, 7·93) % and 10·71 (7·74, 13·83) %, respectively. Multivariable logistic regression analysis identified low-carbohydrate diet as an independent factor associated with percentage weight loss of ≥ 3 % and ≥ 5 % at 1 month (OR = 0·461, P < 0·05; OR = 0·349, P < 0·001). The results showed that a low-carbohydrate diet was an effective weight loss strategy in the short term. However, its long-term effects were comparable to those observed with balanced dietary guidance and pharmacotherapy.
Purple nutsedge (Cyperus rotundus L.) is one of the world’s resilient upland weeds, primarily spreading through its tubers. Its emergence in rice (Oryza sativa L.) fields has been increasing, likely due to changing paddy-farming practices. This study aimed to investigate how C. rotundus, an upland weed, can withstand soil flooding and become a problematic weed in rice fields. The first comparative analysis focused on the survival and recovery characteristics of growing and mature tubers of C. rotundus exposed to soil-flooding conditions. Notably, mature tubers exhibited significant survival and recovery abilities in these environments. Based on this observation, further investigation was carried out to explore the morphological structure, nonstructural carbohydrates, and respiratory mechanisms of mature tubers in response to prolonged soil flooding. Over time, the mature tubers did not form aerenchyma but instead gradually accumulated lignified sclerenchymal fibers, with lignin content also increasing. After 90 d, the lignified sclerenchymal fibers and lignin contents were 4.0 and 1.1 times higher than those in the no soil-flooding treatment. Concurrently, soluble sugar content decreased while starch content increased, providing energy storage, and alcohol dehydrogenase activity rose to support anaerobic respiration via alcohol fermentation. These results indicated that mature tubers survived in soil-flooding conditions by adopting a low-oxygen quiescence strategy, which involves morphological adaptations through the development of lignified sclerenchymal fibers, increased starch reserves for energy storage, and enhanced anaerobic respiration. This mechanism likely underpins the flooding tolerance of mature C. rotundus tubers, allowing them to endure unfavorable conditions and subsequently germinate and grow once flooding subsides. This study provides a preliminary explanation of the mechanism by which mature tubers of C. rotundus from the upland areas confer flooding tolerance, shedding light on the reasons behind this weed’s increasing presence in rice fields.
Early-season rice often faces limited market competition due to its lower quality, which diminishes farmers' incentives to cultivate it. Developing specific early-season rice varieties tailored for rice noodle production represents a practical solution to this challenge. However, limited information exists on the varietal differences regarding the yield and quality of noodles produced from early-season rice and their determinants. To address this gap, this study conducted field experiments with 15 early-season rice varieties during 2022 and 2023. The results revealed significant varietal differences in rice noodle yield per unit of land area and cooking and eating (texture) qualities of the noodles, with the variety Zhuliangyou 4024 standing out for its ability to produce rice noodles that are both high yielding and of superior cooking and eating qualities. Correlation analysis showed the yield of rice noodles per unit of land area was significantly related to grain yield per unit of land, which in turn was linked to grain weight. Additionally, the analysis showed the cooking loss rate of rice noodles and their chewiness were significantly correlated with both amylose and amylopectin content, whereas the hardness, springiness, and resilience of cooked rice noodles were significantly correlated only with amylose content. However, partial correlation analysis indicated that all these quality traits were significantly correlated solely with amylose content when controlling the influence of other chemical properties. These findings indicate that selecting early-season rice varieties with high grain weight and high amylose content can lead to the production of high-yield and high-quality rice noodles.
Understanding the yield attributes of rice crops grown at super high-yielding sites is useful for identifying how to achieve super high yield in rice. In this study, field experiments were conducted in 2021 and 2022 to compare grain yield and yield attributes of ten high-yielding hybrid rice varieties between Xingyi (a super high-yielding site) and Hengyang (a site with typical yields). Results showed that Xingyi produced an average grain yield of 13.4 t ha−1 in 2021 and 14.0 t ha−1 in 2022, which were, respectively, 20% and 44% higher than those at Hengyang. Higher panicles per m2 and higher grain weight were responsible for the higher grain yield at Xingyi compared to Hengyang. The higher values of panicles per m2 and grain weight at Xingyi compared to Hengyang were due to greater source capacity resulting from improved pre-heading biomass production. This study suggests that simultaneously increasing panicle number and grain weight through improving pre-heading biomass production is a potential way to achieve super high yield in rice.
Previous studies have revealed an association between dietary factors and atopic dermatitis (AD). To explore whether there was a causal relationship between diet and AD, we performed Mendelian randomisation (MR) analysis. The dataset of twenty-one dietary factors was obtained from UK Biobank. The dataset for AD was obtained from the publicly available FinnGen consortium. The main research method was the inverse-variance weighting method, which was supplemented by MR‒Egger, weighted median and weighted mode. In addition, sensitivity analysis was performed to ensure the accuracy of the results. The study revealed that beef intake (OR = 0·351; 95 % CI 0·145, 0·847; P = 0·020) and white bread intake (OR = 0·141; 95 % CI 0·030, 0·656; P = 0·012) may be protective factors against AD. There were no causal relationships between AD and any other dietary intake factors. Sensitivity analysis showed that our results were reliable, and no heterogeneity or pleiotropy was found. Therefore, we believe that beef intake may be associated with a reduced risk of AD. Although white bread was significant in the IVW analysis, there was large uncertainty in the results given the wide 95 % CI. Other factors were not associated with AD in this study.
Treatment with atezolizumab plus standard chemotherapy can prolong the overall survival of patients with metastatic non-squamous non-small cell lung cancer (NSCLC). However, the economic value of this treatment regimen is unknown. This study aimed to estimate the cost effectiveness of atezolizumab plus chemotherapy in the first-line treatment of metastatic non-squamous NSCLC from a healthcare system perspective in China.
Methods
A partitioned survival model consisting of three discrete health states was developed to estimate the cost and effectiveness of atezolizumab plus carboplatin or cisplatin plus pemetrexed (APP) versus carboplatin or cisplatin plus pemetrexed (PP) in the first-line treatment of metastatic non-squamous NSCLC over a 12-year lifetime horizon. Key clinical data were generated from the IMpower132 trial. Local direct medical and non-medical costs were used and health preference data were collected from patients with NSCLC in 13 tertiary hospitals across five provinces in China. Costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs) were measured. One-way and probabilistic sensitivity analyses were performed to assess the robustness of the model.
Results
Compared with the PP regimen, APP therapy yielded a gain of 0.21 QALYs at an increased cost of CNY145,602 (USD22,574), resulting in an ICER of CNY684,894 (USD106,185) per QALY gained. The ICER was significantly higher than three times the gross domestic product per capita for China in 2021 (USD37,663). One-way sensitivity analyses revealed that one of the most influential factors in this model was the cost of atezolizumab. Probabilistic sensitivity analysis showed that there was 14.7% probability that atezolizumab plus chemotherapy was cost effective at a willingness-to-pay value of CNY242,928 (USD37,663) per QALY gained.
Conclusions
The APP regimen could prolong survival and improve health benefits over standard chemotherapy in the first-line treatment of patients with metastatic non-squamous NSCLC, but it is unlikely to be a cost-effective treatment option in China.
This study assesses the difference in professional attitudes among medical students, both before and after coronavirus disease 2019 (COVID-19), and identifies the determinants closely associated with it, while providing precise and scientific evidence for implementing precision education on such professional attitudes.
Methods:
A pre-post-like study was conducted among medical students in 31 provinces in mainland China, from March 23, to April 19, 2021.
Results:
The proportion of medical students whose professional attitudes were disturbed after the COVID-19 pandemic, was significantly lower than before the COVID-19 pandemic (χ2 = 15.6216; P < 0.0001). Compared with the “undisturbed -undisturbed” group, the “undisturbed-disturbed” group showed that there was a 1.664-fold risk of professional attitudes disturbed as grade increased, 3.269-fold risk when others suggested they choose a medical career rather than their own desire, and 7.557-fold risk for students with COVID-19 in their family, relatives, or friends; while the “disturbed-undisturbed” group showed that students with internship experience for professional attitudes strengthened was 2.933-fold than those without internship experience.
Conclusions:
The professional attitudes of medical students have been strengthened during the COVID-19 pandemic. The results provide evidence of the importance of education on professional attitudes among medical students during public health emergencies.
Purple nutsedge (Cyperus rotundus L.) is a globally distributed noxious weed that poses a significant challenge for control due to its fast and efficient propagation through the tuber, which is the primary reproductive organ. Gibberellic acid (GA3) has proven to be crucial for tuberization in tuberous plants. Therefore, understanding the relationship between GA3 and tuber development and propagation of C. rotundus will provide valuable information for controlling this weed. This study shows that the GA3 content decreases with tuber development, which corresponds to lower expression of bioactive GA3 synthesis genes (CrGA20ox, two CrGA3ox genes) and two upregulated GA3 catabolism genes (CrGA2ox genes), indicating that GA3 is involved in tuber development. Simultaneously, the expression of two CrDELLA genes and CrGID1 declines with tuber growth and decreased GA3, and yeast two-hybrid assays confirm that the GA3 signaling is DELLA-dependent. Furthermore, exogenous application of GA3 markedly reduces the number and the width of tubers and represses the growth of the tuber chain, further confirming the negative impact that GA3 has on tuber development and propagation. Taken together, these results demonstrate that GA3 is involved in tuber development and regulated by the DELLA-dependent pathway in C. rotundus and plays a negative role in tuber development and propagation.
Straightplasma channels are widely used to guide relativistic intense laser pulses over several Rayleigh lengths for laser wakefield acceleration. Recently, a curved plasma channel with gradually varied curvature was suggested to guide a fresh intense laser pulse and merge it into a straight channel for staged wakefield acceleration [Phys. Rev. Lett. 120, 154801 (2018)]. In this work, we report the generation of such a curved plasma channel from a discharged capillary. Both longitudinal and transverse density distributions of the plasma inside the channel were diagnosed by analyzing the discharging spectroscopy. Effects of the gas-filling mode, back pressure and discharging voltage on the plasma density distribution inside the specially designed capillary are studied. Experiments show that a longitudinally uniform and transversely parabolic plasma channel with a maximum channel depth of 47.5 μm and length of 3 cm can be produced, which is temporally stable enough for laser guiding. Using such a plasma channel, a laser pulse with duration of 30 fs has been successfully guided along the channel with the propagation direction bent by 10.4°.
The objective was to evaluate the association between serum carotenoid levels and respiratory morbidity and mortality in a nationally representative sample of US adults. We assessed the association of serum carotenoid levels with respiratory morbidity and mortality using logistic regression and proportional hazards regression models. Meanwhile, a series of confounders were controlled in regression models and restricted cubic spline, which included age, sex, race, marriage, education, income, drinking, smoking, regular exercise, BMI, daily energy intake, vitamin E, vitamin C, fruit intake, vegetable intake, diabetes, hypertension, asthma, emphysema and chronic bronchitis. Compared with participants in the lowest tertiles, participants in the highest tertiles of serum total carotenoids, β-cryptoxanthin and lutein/zeaxanthin levels had a significantly lower prevalence of emphysema (ORtotal carotenoids = 0·61, 95% CI: 0·41–0·89, ORβ-cryptoxanthin = 0·67, 95% CI: 0·49–0·92), chronic bronchitis (ORβ-cryptoxanthin = 0·66, 95% CI: 0·50–0·87) and asthma (Q2: ORlutein/zeaxanthin = 0·78, 95% CI: 0·62–0·97); participants in the highest tertiles of total carotenoids, α-carotene, lutein/zeaxanthin and lycopene had a lower risk of respiratory mortality (hazard ratio (HR)total carotenoids = 0·62, 95% CI: 0·42–0·90, HRα-carotene = 0·54, 95% CI: 0·36–0·82, HRlutein/zeaxanthin = 0·48, 95% CI: 0·33–0·71, HRlycopene = 0·66, 95% CI: 0·45–0·96) than those in the lowest tertiles. Higher serum total carotenoids and β-cryptoxanthin levels is associated with decreased prevalence of emphysema and chronic bronchitis, and higher serum total carotenoids, α-carotene, lutein/zeaxanthin and lycopene levels had a lower mortality of respiratory disease.
Evidence on the long-term comparative effectiveness of posttraumatic stress disorder (PTSD) psychotherapies in adults remains unknown. Therefore, we performed an extensive network meta-analysis of randomised controlled trials (RCTs) to determine the comparative effectiveness of psychotherapies for people diagnosed with PTSD.
Methods
A comprehensive search was conducted in Cochrane library, Embase, Medline-OVID, PubMed, Scopus, and Psych-Info until March 2021. Studies on the effectiveness of cognitive processing therapy (CPT), cognitive therapy (CT), eye movement desensitisation reprocessing (EMDR), narrative exposure therapy (NET), prolonged exposure (PE), cognitive behavioural therapy (CBT), present-centred therapy (PCT), brief eclectic psychotherapies (BEP), psychodynamic therapy (PDT) or combination therapies compared to no treatment (NT) or treatment as usual (TAU) in adults with PTSD were included. Frequentist and Bayesian approaches were used for analysis in R-software.
Results
We included 98 RCTs with 5567 participants from 18 897 studies. CPT, EMDR, CT, NET, PE, CBT, and PCT were significant to reduce PTSD symptoms (SMD range: −1.53 to −0.75; Certainty: very low to high) at immediate post-treatment and ranked accordingly. Longitudinal analysis found EMDR (1.02) and CPT (0.85) as the significant therapies with large effect size in short-term and long-term follow-up, respectively. NET and CPT showed higher proportion of loss of PTSD diagnosis (RR range: 5.51–3.45) while there were no significant psychotherapies for retention rate compared to NT.
Conclusions:
Our findings provide evidence for improving current guidelines and informing clinical decision-making for PTSD management. However, the best PTSD treatment plan should be tailored to patients' needs, characteristics, and clinician expertise.
This work elucidated the performance and mechanisms of Pb2+ adsorption by kaolinite, montmorillonite, goethite and ferrihydrite using batch experiments. The contributions of various adsorption mechanisms were quantified using a stepwise extraction method. Several characterizations (scanning electron microscopy, X-ray diffraction, Fourier-transform infrared spectroscopy, point of zero charge analysis and X-ray fluorescence) were utilized to analyse the physicochemical properties and the potential adsorption mechanisms. The results indicated that the adsorption processes of montmorillonite and goethite approached equilibrium within 20 min, while 60 min were required for the adsorption processes of kaolinite and ferrihydrite. The adsorption processes of Pb2+ by the four minerals best fit the pseudo-second order model. The adsorption capacities of the four minerals for Pb2+ followed the order: montmorillonite > goethite > ferrihydrite > kaolinite, and the maximum adsorption capacities were 69.20, 46.95, 34.32 and 18.62 mg g–1, respectively. The stepwise extraction test showed that the adsorption mechanism of Pb2+ was dominated by ion exchange for montmorillonite, precipitation and complexation for goethite and complexation for kaolinite and ferrihydrite.
Caregiver-mediated intervention (CMI), based on parent skills training, is a family-mediated intervention model for children with neurodevelopmental disorders, in particular autism spectrum disorder. This study aimed to evaluate the effectiveness of CMI.
Methods:
Thirty-three children (aged 22–69 months from our department) and their caregivers participated in a two-week training course of ten 90-minute lessons. Caregivers were encouraged to try their best to apply intervention skills in both home routines and play routines to encourage the development of cognition, motion, social adaptability, and behavior of children. Demographic information, video-recorded data, and diagnostic scales were collected at two key time points: baseline and post-training (PT – within six months).
Results:
Three aspects were assessed – primary variables, secondary variables, and correlation analyses. Results showed an improvement in PT in (1) Adult/Child Interaction Fidelity Rating (P < 0.01) and (2) adaptability of Gesell Developmental Scale and stereotyped behaviors and limited interests of Autism Diagnostic Observation Schedule (P < 0.05, P < 0.01). Moreover, a negative correlation occurred between caregiver skill improvement and parent education (P < 0.05), but without correlations with other demographics.
Conclusions:
As an efficacious family intervention for both children and their caregivers, CMI is worth being generalized widely.
Despite increasing knowledge on the neuroimaging patterns of eating disorder (ED) symptoms in non-clinical populations, studies using whole-brain machine learning to identify connectome-based neuromarkers of ED symptomatology are absent. This study examined the association of connectivity within and between large-scale functional networks with specific symptomatic behaviors and cognitions using connectome-based predictive modeling (CPM).
Methods
CPM with ten-fold cross-validation was carried out to probe functional networks that were predictive of ED-associated symptomatology, including body image concerns, binge eating, and compensatory behaviors, within the discovery sample of 660 participants. The predictive ability of the identified networks was validated using an independent sample of 821 participants.
Results
The connectivity predictive of body image concerns was identified within and between networks implicated in cognitive control (frontoparietal and medial frontal), reward sensitivity (subcortical), and visual perception (visual). Crucially, the set of connections in the positive network related to body image concerns identified in one sample was generalized to predict body image concerns in an independent sample, suggesting the replicability of this effect.
Conclusions
These findings point to the feasibility of using the functional connectome to predict ED symptomatology in the general population and provide the first evidence that functional interplay among distributed networks predicts body shape/weight concerns.
The relationship of a diet low in fibre with mortality has not been evaluated. This study aims to assess the burden of non-communicable chronic diseases (NCD) attributable to a diet low in fibre globally from 1990 to 2019.
Design:
All data were from the Global Burden of Disease (GBD) Study 2019, in which the mortality, disability-adjusted life-years (DALY) and years lived with disability (YLD) were estimated with Bayesian geospatial regression using data at global, regional and country level acquired from an extensively systematic review.
Setting:
All data sourced from the GBD Study 2019.
Participants:
All age groups for both sexes.
Results:
The age-standardised mortality rates (ASMR) declined in most GBD regions; however, in Southern sub-Saharan Africa, the ASMR increased from 4·07 (95 % uncertainty interval (UI) (2·08, 6·34)) to 4·60 (95 % UI (2·59, 6·90)), and in Central sub-Saharan Africa, the ASMR increased from 7·46 (95 % UI (3·64, 11·90)) to 9·34 (95 % UI (4·69, 15·25)). Uptrends were observed in the age-standardised YLD rates attributable to a diet low in fibre in a number of GBD regions. The burden caused by diabetes mellitus increased in Central Asia, Southern sub-Saharan Africa and Eastern Europe.
Conclusions:
The burdens of disease attributable to a diet low in fibre in Southern sub-Saharan Africa and Central sub-Saharan Africa and the age-standardised YLD rates in a number of GBD regions increased from 1990 to 2019. Therefore, greater efforts are needed to reduce the disease burden caused by a diet low in fibre.
To investigate the association between folate levels and the risk of gestational diabetes mellitus (GDM) risk during the whole pregnancy.
Design:
In this retrospective cohort study of pregnant women, serum folate levels were measured before 24 gestational weeks (GW). GDM was diagnosed between 24th and 28th GW based on the criteria of the International Association of Diabetes and Pregnancy Study Groups. General linear models were performed to examine the association of serum folate with plasma glucose (i.e. linear regressions) and risk of GDM (i.e. log-binomial regressions) after controlling for confounders. Restricted cubic spline regression was conducted to test the dosage–response relationship between serum folate and the risk of GDM.
Setting:
A sigle, urban hospital in Shanghai, China.
Participants:
A total of 42 478 women who received antenatal care from April 2013 to March 2017 were included.
Results:
Consistent positive associations were observed between serum folate and plasma glucose levels (fasting, 1-h, 2-h). The adjusted relative risks (RR) and 95 % CI of GDM across serum folate quartiles were 1·00 (reference), 1·15 (95 % CI (1·04, 1·26)), 1·40 (95 % CI (1·27, 1·54)) and 1·54 (95 % CI (1·40, 1·69)), respectively (P-for-trend < 0·001). The positive association between serum folate and GDM remained when stratified by vitamin B12 (adequate v. deficient groups) and the GW of serum folate measurement (≤13 GW v. >13 GWs)
Conclusions:
The findings of this study may provide important evidence for the public health and clinical guidelines of pregnancy folate supplementation in terms of GDM prevention.