SGLT2-Inhibition in patients with Alport syndrome

Introduction Large-scale trials showed positive outcomes of sodium–glucose cotransporter-2 inhibitors (SGLT2i) in adults with chronic kidney disease (CKD). Whether the use of SGLT2i is safe and effective in patients with the common hereditary CKD Alport syndrome has not yet been investigated specifically in larger cohorts. Methods This observational, multi-center, international study (NCT02378805) assessed 112 patients with Alport syndrome after start of SGLT2i. The study’s primary endpoint was change of albuminuria in albumin/gram creatinine from start of therapy. Results Compared to randomized trials investigating the effect of SGLT2i in CKD, the adult patients in this study were younger (38±14 years) and had a better estimated glomerular filtration rate, eGFR, (63±35 ml/min/1.73m2; n=98). Maximum follow up was 32 months. Compared to baseline, at the first three follow-up visits (months 1 to 3, 4 to 8 and 9 to 15) after initiation of SGLT2i-therapy, a significant reduction of albuminuria in milligrams albumin/gram creatinine (>30%) was observed. Mean loss of eGFR was 9±12 ml/min/1.73 m2 almost one year after initiation of SGLT2i-therapy (n=35). At a total of 71 patient-years at risk, 0.24 adverse events per patient year on SGLT2i were reported. Conclusion This study indicates that, additive to RAS-inhibition, SGLT2i have the potential to reduce the amount of albuminuria in patients with Alport syndrome. Future studies are needed to investigate the long-term effects of SGLT2i on CKD progression in patients with Alport syndrome to assess whether the observed reduction in albuminuria translates to a delay in kidney failure

Crowdsourcing hypothesis tests: Making transparent how design choices shape research results

To what extent are research results influenced by subjective decisions that scientists make as they design studies? Fifteen research teams independently designed studies to answer fiveoriginal research questions related to moral judgments, negotiations, and implicit cognition. Participants from two separate large samples (total N > 15,000) were then randomly assigned to complete one version of each study. Effect sizes varied dramatically across different sets of materials designed to test the same hypothesis: materials from different teams renderedstatistically significant effects in opposite directions for four out of five hypotheses, with the narrowest range in estimates being d = -0.37 to +0.26. Meta-analysis and a Bayesian perspective on the results revealed overall support for two hypotheses, and a lack of support for three hypotheses. Overall, practically none of the variability in effect sizes was attributable to the skill of the research team in designing materials, while considerable variability was attributable to the hypothesis being tested. In a forecasting survey, predictions of other scientists were significantly correlated with study results, both across and within hypotheses. Crowdsourced testing of research hypotheses helps reveal the true consistency of empirical support for a scientific claim.</div

Quiet sustainability: Fertile lessons from Europe’s productive gardeners

This paper investigates notable examples of sustainable lifestyles in relation to food systems. It explores the surprisingly neglected case of widely practised and environmentally sustainable food self-provisioning in post-socialist Central and Eastern Europe. Our argument is rooted in qualitative and quantitative data gathered over a seven-year period (2005-2011). The research considers the extent of and motivations for these practices in Poland and Czechia. The very high rates compared to Western Europe and North America have generally been explained in terms of an ‘urban peasantry’ meeting essential needs. After reviewing and rejecting those accounts we present evidence for these as socially and environmentally beneficial practices, and explore how the motivations derive from a range of feelings about food, quality, capability and family and / or friendship. Rather than relate these practices to temporal signals of quality and sustainability in food (‘slow’ and ‘fast’), or presenting them as ‘alternative food networks’ we suggest that they represent ‘quiet sustainability’. This novel concept summarises widespread practices that result in beneficial environmental or social outcomes and that do not relate directly or indirectly to market transactions, but are not represented by their practitioners as relating directly to environmental or sustainability goals. These practices represent exuberant, appealing and socially inclusive, but also unforced, forms of sustainability. This case further demonstrates the severe limitations of decision makers’ focus on economics and behaviour change, and their neglect of other dimensions of social life and change in developing environmental policies

Exploring the Synergistic Effects of Dual‐Layer Electrodes for High Power Li‐Ion Batteries

Abstract Invited for this issue's Front Cover are the group of Prof. Janine Mauzeroll and Prof. Steen B. Schougaard. The front cover picture shows Li‐metal cells which contain two active materials (red and blue). The cell on the left has both materials intermixed (blended electrode), while the cell on the right has them segregated (dual‐layer electrode). The brightness emitted by the bulbs, the position on the scale, and the distribution of Li+ in the liquid phase (green orbs) reflects the high‐power capabilities of the dual‐layer architecture. Cover design by Jeremy I. G. Dawkins, Janine Mauzeroll and Steen B. Schougaard. Read the full text of the Research Article at 10.1002/celc.202300279