No abstract

Bullous pemphigoid (BP) is a chronic debilitating autoimmune blistering disease that frequently occurs in the elderly population. Previous studies have suggested a high morbidity and mortality associated with BP. However, relatively few studies have investigated prognostic factors of BP mortality, and they showed considerably various results. This meta-analysis aimed to quantitatively assess the association between several potential prognostic factors and risk of mortality in bullous pemphigoid. A comprehensive search was performed using Pubmed, Embase, and Cochrane Library. Cohort studies that assessed prognostic factors of BP mortality were included. Random-effects model was utilized to calculate the pooled hazard ratio (HR). Publication bias was evaluated qualitatively by constructing a funnel plot and quantitatively by conducting Egger’s test. 14 studies were included comprising 2499 patients. Combined HRs suggested that advanced age (HR 1.63, 95% CI 1.34–1.97), presence of circulating antibodies (HR 1.77, 95% CI 1.20–2.62), concomitant dementia (HR 2.01, 95% CI 1.22–3.33), and concomitant stroke (HR 1.86, 95% CI 1.29–2.67) have an unfavorable impact on patient survival. Gender, disease extent, mucosal involvement, and indirect immunofluorescence result were not shown to be linked to mortality by our analysis. This study indicated that BP patients with older age, circulating antibodies, dementia, and stroke are at greater risk of mortality. Clinicians should be aware of this association and utilize this information in patient education and treatment process.Electronic supplementary materialThe online version of this article (doi:10.1007/s00403-017-1736-1) contains supplementary material, which is available to authorized users.

Covalent organic frameworks (COFs) are an emerging type of porous crystalline material for efficient catalysis of the oxygen evolution reaction (OER). However, it remains a grand challenge to address the best candidates from thousands of possible COFs. Here, we report a methodology for the design of the best candidate screened from 100 virtual M–N x O y (M = 3d transition metal)-based model catalysts via density functional theory (DFT) and machine learning (ML). The intrinsic descriptors of OER activity of M–N x O y were addressed by the machine learning and used for predicting the best structure with OER performances. One of the predicted structures with a Ni–N 2 O 2 unit is subsequently employed to synthesize the corresponding Ni–COF. X-ray absorption spectra characterizations, including XANES and EXAFS, validate the successful synthesis of the Ni–N 2 O 2 coordination environment. The studies of electrocatalytic activities confirm that Ni–COF is comparable with the best reported COF-based OER catalysts. The current density reaches 10 mA cm –2 at a low overpotential of 335 mV. Furthermore, Ni–COF is stable for over 65 h during electrochemical testing. This work provides an accelerating strategy for the design of new porous crystalline-material-based electrocatalysts.