Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

The Influence of Problem Construction on Undergraduates&rsquo; Success with Stoichiometry Problems

Although there are numerous studies that aim to reveal the source of student failure in problem solving in STEM fields, there is a lack of attention on testing different methods to identify what works best in improving students&rsquo; problem-solving performance. In this study, the authors examined the influence of the type of problem construction intervention and compared it to the effect of traditional practice on 38 general chemistry students&rsquo; comprehension of problem-solving process as well as overall success with given stoichiometric problems. To determine students&rsquo; success with each subtopic involved in stoichiometric problems and to better understand the source of difficulty at a finer level rather than focusing on the end product as practiced in most studies, students&rsquo; solutions were examined using the COSINE (Coding System for Investigating Sub-problems and Network) method. The findings revealed that students who practiced the problem-construction method outperformed their counterparts in the control group who followed a traditional approach during their study session. An in-depth analysis also showed that the experimental group improved their success with seven out of nine subtopics while three topics observed an increase in the control group. The practical implication of the problem-construction method was discussed for a wider adoption by textbook publishers and educators across different disciplines