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Introduction Material and Methods Results Conclusions Evidence suggests that gestational diabetes mellitus (GDM) is associated with subsequent cardiovascular disease; however, it is unclear what impact changes in screening and diagnostic criteria have had on the association of GDM with long‐term outcomes such as cardiovascular disease. The purpose of this study was to determine the association between GDM and subsequent cardiovascular disease during a period of rising gestational diabetes diagnosis in England. Specifically, associations were compared before and after 2008, when national guidelines supporting risk factor‐based screening were introduced.We conducted a cohort study using routinely collected data from the Clinical Practice Research Datalink linked to the Hospital Episode Statistics and Office for National Statistics databases. The study consisted of persons aged 15–45 years with a livebirth or stillbirth between 1998 and 2017 and without a history of cardiovascular disease or pre‐pregnancy diabetes mellitus. Cox proportional hazards models, with propensity score weighting using matching weights, were used to estimate adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) for the association of GDM diagnosis in the first recorded pregnancy with subsequent cardiovascular disease.Among 232 315 individuals, the incidence of cardiovascular disease was 6.6 per 1000 person‐years among those with GDM and 2.2 per 1000 person‐years among those without GDM over a mean follow‐up duration of 5.8 years. The overall aHR, 95% CI was 1.91 (1.41, 2.60). Diagnosis of GDM increased over the study period, from 0.7% in 1998–99 to 5.3% in 2017. The effect size was not markedly different in the years before (1998–2007: adjusted HR 2.05, 95% CI 2.05 1.35, 3.12) and after 2008 (2008–2017: adjusted HR 1.79, 95% CI 1.15, 2.80).There was a strong association of GDM with cardiovascular disease after accounting for social and demographic factors and multiple comorbidities, and this association was present both before and after 2008, when national gestational diabetes screening criteria were established. [ABSTRACT FROM AUTHOR]

Aims: Metformin is increasingly used off‐label as the treatment of gestational diabetes (GDM). Our objective was to determine if metformin versus insulin initiation is associated with the adverse pregnancy outcomes. Materials and Methods: We conducted a retrospective cohort study using data from the Clinical Practice Research Datalink, its pregnancy register, and Hospital Episode Statistics from 1998 to 2018. We included pregnancies of women who initiated metformin or insulin between 20 weeks gestation and pregnancy end. The primary outcome was a composite outcome of large for gestational age (LGA) and macrosomia. The secondary outcomes included small for gestational age (SGA), preterm birth, caesarean delivery, and hypertensive disorders during pregnancy (HDP). Inverse probability weighted‐Cox proportional hazards models were to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CI), comparing those who initiated metformin versus insulin at cohort entry, accounting for baseline covariates. Results: Our cohort included pregnancies of 1297 women initiating metformin and of 895 women initiating insulin. Compared to insulin initiation, metformin initiation was associated with a decreased risk of LGA or macrosomia (HR 0.64, 95% CI 0.49, 0.78), Caesarean delivery (HR 0.83, 95% CI 0.69, 0.98), and preterm birth (HR 0.83, 95% CI 0.58, 1.08). The HRs for HDP and SGA were 0.92 (95% CI 0.57, 1.27) and 1.33 (95% CI 0.67, 2.00), respectively. Conclusions: Our study suggests that, compared to initiating insulin, initiating metformin is associated with decreased risks of adverse pregnancy outcomes among women with GDM. These findings provide important real‐world evidence regarding the use of metformin for GDM. [ABSTRACT FROM AUTHOR]

Background: While the benefits of levothyroxine are well‐established for overt hypothyroidism, they are unclear for subclinical hypothyroidism (SCH) among pregnant women. Objective: To estimate the effect of initiation of levothyroxine on pregnancy loss among women with SCH with an emulated target trial using observational data. Methods: We emulated a target trial using the United Kingdom's Clinical Practice Research Datalink to account for the staggered timing of diagnosis and treatment of SCH and the time of entry of women into prenatal care. We emulated multiple nested trials (at each gestational week) and used an intention‐to‐treat approach to define levothyroxine use (≥1 prescription in the 7 days prior to trial entry), with eligible users matched to non‐users (1:4) on time of diagnosis, gestational week of the first eligible trial and high‐dimensional propensity score. Pregnancy losses included spontaneous abortion and stillbirth. A pooled logistic regression model with bootstrap resampling was used to estimate the hazard ratios (HR) and 95% confidence intervals (CI). Results: Based on 159,177 eligible person‐trials (5781 women), the matched cohort included 181 initiators and 640 non‐initiators of levothyroxine, with 57 pregnancy losses occurring during follow‐up. Overall, the mean age of women was 32.2 years (SD 5.4), 25% were obese, 8% had type 2 diabetes and about 50% were nulliparous. After matching, women who initiated levothyroxine versus not had higher thyroid‐stimulating levels during pregnancy and were more likely to have a history of hypothyroidism. The cumulative incidence of pregnancy loss was lower in initiators versus non‐initiators of levothyroxine. The adjusted HR for pregnancy loss was 0.87 (95% CI 0.22, 1.56). Conclusions: Although our assessment of the effect of initiation of levothyroxine for SCH in pregnancy precludes any definitive conclusions due to wide confidence intervals, this study illustrates the feasibility of using the target trial emulation framework to examine the effectiveness of medication use in pregnancy. [ABSTRACT FROM AUTHOR]

BACKGROUND This article reviewed the research progress of pretreatment techniques for the analysis of precious metal elements in geological samples in recent years. The fire assay, alkali fusion, acid decomposition and adsorption methods used in the separation and enrichment of samples and absorption, tellurium co-precipitation, ion exchange, solvent extraction, distillation, and biosorption methods commonly used for sample decomposition were reviewed. The characteristics and deficiencies of each method were investigated, and the future development direction of the method is prospected. OBJECTIVES In order to make the analysis results accurate and reliable, it is necessary to select the appropriate means of sample decomposition and separation and enrichment to ensure complete sample decomposition, effectively eliminate the interference of co-existing ions and matrix effect, enhance the precious metal element test signal, and improve the signal-to-noise ratio. METHODS The fire assay method used for sample decomposition has been continuously explored and improved by analysts, and has become the best method to decompose precious metals. However, it still has the disadvantages of large reagent consumption, high cost, and long procedure. Although the alkali fusion method can decompose almost all geological samples, the resulted solution contained a large amount of sodium salt, which needed to be further purified. The acid decomposition method was mainly based on the high-pressure sealed Carius tube digestion, but it was limited by the nature of the sample. Different separation and enrichment methods were highly targeted. For example, the adsorption method was mostly used for the enrichment of Au, Pt, and Pd. The distillation method was only suitable for the analysis of Os and Ru. RESULTS Precious metal elements had features such as strong particle effects, complex and diverse forms, and ultra-trace amounts, so it was necessary to choose a suitable pretreatment method according to the type of samples. CONCLUSIONS Based on the existing precious metal decomposition methods, in combination with the current new experimental equipment and conditions, more efficient and rapid decomposition technologies should be sought and the background of the procedure and pollution problems in each step strictly controlled, realizing multi-technology and multi-method integration and meeting the requirements of precious metal analysis.

Black rock as an important carrier of platinum group elements was discovered in recent years. Due to the multiple origins and complex mineralization, the distribution and occurrence of platinum group elements in black rock are not clear, which is also the major reason why the analytical results of platinum group elements are unstable. According to the mineral properties and composition of black rock, the occurrences of Pt, Pd and Au in black rock could be divided into exchangeable phase, organic binding phase, sulfide bounding phase, and residue phase. The adsorption of Pt, Pd and Au from the organic carbon in black rocks was inhibited by adding potassium thiocyanate and sodium cyanide as desorbents. The distribution of Pt, Pd and Au in each phase was identified by Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). The results show that: (1) The ratios of the total extraction of each phase to the total amount of the element are 94.4%-101.0% for Pt, 95.8%-101.0% for Pd, and 96.7%-102.0% for Au, indicating good accuracy and reproducibility. (2) The enrichment of Pt, Pd and Au in black rock minerals not only shows the chalcophile affinity, but also shows obvious correlation with the geological conditions and geological setting of organic carbon formation. The results provide important information for studying the geochemical environment and the metallogenic regularity of the platinum group elements in black rocks.

Treatment with a magnetic induced electric field (MIEF) under acidic conditions has proven to be an effective method for modifying pectin, enhancing its functional attributes. In this study, the effects of varying excitation voltages of MIEF under acidic conditions on the physicochemical, structural, and functional properties of citrus pectin (CP) were explored. The results demonstrated that compared to CP without MIEF treatment, MIEF-treated CP exhibited enhanced thermal stability, rheological behavior, emulsifying and gel-forming abilities, and antioxidant capacity. These improvements were attributed to higher degrees of esterification, reduced molecular weights, and increased levels of galacturonic acid and homogalacturonan in the structural backbone of the treated CP. Additionally, MIEF treatment under acidic conditions altered the surface morphology and crystalline structure of CP. Therefore, our findings suggest that applying moderate excitation voltages (150–200 V) during MIEF treatment can enhance the functional properties of CP, leading to the production of high-quality modified pectin. [Display omitted] • MIEF treatment under an acidic condition was used to modify citrus pectin (CP). • MIEF-assisted acid treatment CPs had higher GalA content and DE value, and lower M w. • MIEF-assisted acid treatment improved functional properties of CP. • Increasing excitation voltage resulted in the enhancement of the hydrolysis of CP. [ABSTRACT FROM AUTHOR]

[Display omitted] • PFP-T and PFP-UM were slightly degraded after in vitro gastrointestinal digestion. • PFP-T and PFP-UM were obviously degraded and utilized by intestinal microorganisms. • PFP-T and PFP-UM effectively stimulated the proliferation of beneficial bacteria. • PFP-T yielded higher SCFAs content and had better prebiotic potential than PFP-UM. In this study, two pectic polysaccharides (PFP-T and PFP-UM) were extracted from fresh passion fruit peels using three-phase partitioning (TPP) and sequential ultrasound-microwave-assisted TPP methods, respectively, and their effects on the in vitro gastrointestinal digestion and fecal fermentation characteristics were examined. The results indicate that gastrointestinal digestion has a minimal effect on the physicochemical and structural characteristics of PFP-T and PFP-UM. However, during in vitro fecal fermentation, both undigested PFP-T and PFP-UM are significantly degraded and utilized by intestinal microorganisms, showing increased the total relative abundance of Firmicutes and Bacteroidota in the intestinal flora. Notably, compared with PFP-UM, PFP-T better promoted the reproduction of beneficial bacteria such as Prevotella , Megasphaera and Dialister , while suppressed the growth of harmful genera including Escherichia-Shigella , producing higher content of short-chain fatty acids. Therefore, our findings suggest that PFP-T derived from passion fruit peel has potential as a dietary supplement for promoting intestinal health. [ABSTRACT FROM AUTHOR]

The prevalent new-user design includes a broader study population than the traditional new-user approach that is frequently used in pharmacoepidemiologic research. In an article appearing in this issue (Am J Epidemiol. 2021;190(7):1341–1348) , Webster-Clark et al. describe the treatment initiator types included in the prevalent new-user design and contrast the causal questions assessed using a prevalent new-user design versus a new-user design. They further applied a series of simulation studies showing the importance of accounting for treatment history in addition to time since initiation of the comparator in the prevalent new-user design. In this commentary, we put their findings in the broader context with a discussion of the strengths and limitations of the prevalent new-user design and settings where it would be most useful. The prevalent new-user design and new-user design both address unique questions of clinical and public health importance. Real-world evidence generated by pharmacoepidemiologic research is increasingly being used by regulators and other knowledge users to inform their decision-making. Understanding the causal questions addressed by different designs is crucial in this process; the study by Webster-Clark et al. represents an important step in addressing this issue. [ABSTRACT FROM AUTHOR]