No abstract

Background Gestational diabetes mellitus (GDM) is a common pregnancy complication that negatively impacts the health of both the mother and child. Early prediction of the risk of GDM may permit prompt and effective interventions. This systematic review and meta-analysis aimed to summarize the study characteristics, methodological quality, and model performance of first-trimester prediction model studies for GDM. Methods Five electronic databases, one clinical trial register, and gray literature were searched from the inception date to March 19, 2022. Studies developing or validating a first-trimester prediction model for GDM were included. Two reviewers independently extracted data according to an established checklist and assessed the risk of bias by the Prediction Model Risk of Bias Assessment Tool (PROBAST). We used a random-effects model to perform a quantitative meta-analysis of the predictive power of models that were externally validated at least three times. Results We identified 43 model development studies, six model development and external validation studies, and five external validation-only studies. Body mass index, maternal age, and fasting plasma glucose were the most commonly included predictors across all models. Multiple estimates of performance measures were available for eight of the models. Summary estimates range from 0.68 to 0.78 (I2 ranged from 0% to 97%). Conclusion Most studies were assessed as having a high overall risk of bias. Only eight prediction models for GDM have been externally validated at least three times. Future research needs to focus on updating and externally validating existing models.

Flip-chip package has great potential for use in millimeter-wave applications. However, the coefficient of thermal expansion mismatch between the chip and the substrate usually generates thermal stresses that fracture the flip-chip structure. The use of underfills with low dielectric loss is essential to improve the mechanical strength and reliability of the flip-chip package. Benzocyclobutene (BCB) was used in this study as the underfill material for the flip-chip structure using the no-flow process. The flip-chip structure with BCB injection provides good RF performance with a return loss of better than 18 dB and an insertion loss of 0.6 dB up to 100 GHz, in addition to a lower dielectric loss. Furthermore, thermal cycle and shear force tests show that the underfill injection can significantly improve the reliability of a flip-chip package.

No abstract