Cardiovascular and kidney outcomes of uric acid-lowering therapy in patients with different kidney functions: study protocol for a systematic review, pairwise and network meta-analysis.

INTRODUCTION: Hyperuricaemia has been implicated in the development of kidney function in populations with chronic kidney disease; however, the benefits of urate-lowering therapy (ULT) remain uncertain in different clinical studies. The different kidney functions of enrolled populations and distinct pharmacokinetic characteristics of ULT might be of the essence for the contrasting results. In this study, we will synthesise all available data from randomised controlled trials (RCTs) and cohort studies, then evaluate the outcomes of ULT in patients stratified by different estimated glomerular filtration rate (eGFR) stratifications. Furthermore, we will attempt to explore a relatively optimal ULT regimen using a Bayesian network meta-analysis in different eGFRs. METHODS AND ANALYSIS: We searched published and unpublished data from MEDLINE, EMBASE, the Cochrane Central Register of Controlled trials and ClinicalTrials.gov website (before March 2022) for RCTs and cohort studies without language restriction. In the pairwise meta-analysis, all regimens of ULT will be pooled as a whole and compared with controls in different eGFRs. The random-effects model will be applied to generate the summary values using the software Stata V.12.0 (StataCorp). Network meta-analysis within a Bayesian framework will be conducted to explore the relative efficacy profiles of different ULTs and to find optimal ULT in different eGFRs. The software of WinBUGS V.1.4.3 and R2WinBUGS package of R V.3.1.1 will be used in the network meta-analysis. Primary outcomes will be the occurrence of major cardiovascular events and kidney failure events. Secondary outcomes will include the rate of change in eGFR per year, all-cause death, changes in serum uric acid level and major adverse events. Two authors will independently review study selection, data extraction and quality assessment. ETHICS AND DISSEMINATION: The meta-analysis does not require ethical certification. The results will be disseminated through publication in a peer-reviewed journal and through presentations at academic conferences. PROSPERO REGISTRATION NUMBER: CRD42021226163.

Outcomes and risk factors in patients with crescentic glomerulonephritis: a multicenter cohort study.

BACKGROUND: Patients with crescentic glomerulonephritis have a poor prognosis despite immunosuppressive therapy. This study investigated the clinicopathologic features, outcomes, and risk factors in Chinese patients with crescentic glomerulonephritis. METHODS: The multicenter cohort study included consecutive individuals with crescentic glomerulonephritis and a minimum follow-up of 1 year after biopsy, observed from January 2013 to December 2020. Primary outcome was the occurrence of death or end stage kidney disease (ESKD) for surviving patients. Multivariable adjusted Cox proportional hazards model was applied. RESULTS: Of 109 patients enrolled, 73 (67%) suffered primary outcomes, including 39 deaths, and 34 ESKDs among the 70 surviving patients, with a mean follow-up of 26 months. All 26 patients with over 90% glomeruli with crescents reached a primary outcome. Patients with type III crescentic glomerulonephritis had the worst prognosis for primary outcomes (HR, 95% CI for type I vs. type III: 0.29, 0.14-0.58; type II vs. type III: 0.44, 0.22-0.91) and a significantly faster rate of eGFR decline after adjusting for baseline variables. In patients with 75%-100% glomeruli with crescents, the risk of a primary outcome increased nearly fourfold (HR 3.96; 95% CI 2.17-7.23) compared with patients with 50-75% glomeruli with crescents after adjusting for baseline variables. Type of crescentic glomerulonephritis and percentage of cellular and total glomeruli with crescents were independent risk factors for early primary outcomes (within 6 months). CONCLUSIONS: This study provides new insights into crescentic glomerulonephritis, including a description of the worst outcomes occurring in patients with type III crescentic glomerulonephritis, and suggests that the quantification of the percentage of crescents may be of use for guiding therapeutic decisions, due to their role in identifying the risk of primary outcomes.

Photonic time crystals.

When space (time) translation symmetry is spontaneously broken, the space crystal (time crystal) forms; when permittivity and permeability periodically vary with space (time), the photonic crystal (photonic time crystal) forms. We proposed the concept of photonic time crystal and rewritten the Maxwell's equations. Utilizing Finite Difference Time Domain (FDTD) method, we simulated electromagnetic wave propagation in photonic time crystal and photonic space-time crystal, the simulation results show that more intensive scatter fields can obtained in photonic time crystal and photonic space-time crystal.

Quantized chiral anomaly materials cloak.

Chiral anomaly materials (CAM, e.g., axion insulator, topological insulator and some of Weyl semimetal) are new states of quantum matter. Anomalous Hall effect can occur in CAM, the anomalous Hall effect is closely related to the topological magneto-electric effect, i.e., when an electric field is applied to CAM, not only the electric field is induced, but also the magnetic field, vice versa. According to those properties, we design an electric cloak with quantized CAM and conductor, and a magnetic cloak with quantized CAM and superconductor. Simulation and calculation results show that the electric cloak can cloak applied electric field and induce magnetic field, and the magnetic cloak can cloak applied magnetic field and induce electric field. When applied electric field is generated by a point charge, the monopole can be obtained.

Controlling chloride ions diffusion in concrete.

The corrosion of steel in concrete is mainly due to the chemical reaction between the chloride ions and iron ions. Indeed, this is a serious threaten for reinforced concrete structure, especially for the reinforced concrete structure in the sea. So it is urgent and important to protect concrete against chloride ions corrosion. In this work, we report multilayer concrete can cloak chloride ions. We formulated five kinds of concrete A, B, C, D and E, which are made of different proportion of cement, sand and glue, and fabricated six-layer (ABACAD) cylinder diffusion cloak and background media E. The simulation results show that the six-layer mass diffusion cloak can protect concrete against chloride ions penetration, while the experiment results show that the concentration gradients are parallel and equal outside the outer circle in the diffusion flux lines, the iso-concentration lines are parallel outside the outer circle, and the concentration gradients in the inner circle are smaller than those outside the outer circle.