El cultivo del caqui

En este libro se escribe del caqui en toda su amplitud, los mejores investigadores en las diferentes especialidades nos explican los resultados de la investigación y experiencias en fertirrigación, pies y variedades, sanidad vegetal, poda y postcosecha; acompañado y documentado de una amplia bibliografía de los investigadores de los principales países productores del mundo: China, Japón e Israel, e Italia, más que por su producción, por su continua y avanzada investigación. Este libro, fruto del trabajo de las diferentes líneas de investigación del producto, coordinada por el magnífico equipo de investigadores del IVIA, pone a disposición de la producción, postcosecha y comercialización todos los avances conocidos a nivel nacional e internacional

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

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

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

El cultivo del caqui

En los climas semi-áridos de las zonas productoras de caqui en España (Valencia y Andalucía, fundamentalmente) la pluviometría es frecuentemente inferior a 500 mm (500 L/m2 de superficie de suelo). Bajo estas condiciones climáticas, el manejo del riego es sin duda alguna la práctica de cultivo que más puede influir sobre la producción total y el tamaño y calidad de los frutos en recolección. El riego es además una práctica compleja dado que, además de aspectos agronómicos, influyen factores relacionados con las estructuras de las redes de riego y con la tecnología empleada para suministrar el agua al cultivo. Hoy en día, con la extensión del riego localizado por goteo, es posible aplicar con bastante exactitud la cantidad de agua que un cultivo necesita en cada momento, la clave en este punto es disponer de información de cuáles deben ser las dosis de riego adecuadas

Acta Horticulturae

Persimmon (Diospyros kaki) culture is gaining importance as a temperate fruit crop in the Mediterranean area. The main persimmon cultivar grown in Spain is 'Rojo Brillante', which produces an astringent fruit. This implies the need of a deastringency post-harvest treatment prior commercialization. Persimmon culture in Spain is concentrated in an area of water scarcity, but there is no information about tree water needs nor responses to deficit irrigation. With this in mind, an experiment was conducted over three consecutive seasons in order to determine yield responses to water restrictions applied during different stages of fruit growth. Moreover, the effects of timing of deficit irrigation on fruit quality at harvest and on the effectiveness of a postharvest deastringency treatment were evaluated. Four irrigation treatments were applied including watering at 100% of the estimated tree evapotranspiration (ETc) during the entire season, and other three treatments where irrigation inputs were reduced at 50% ETc only during certain periods (spring, summer or fall). In all three seasons, water deficit, when applied during spring, reduced June fruit drop. This effect could be either positive or negative depending on the tree crop level and the grower´s final fruit size target. However, water restrictions regardless of the period when they were applied, significantly affected (up to 22% reduction) fruit weight at harvest suggesting high sensitivity of Kaki trees to water stress. Fruit ripening was accelerated when water restriction were applied during fall; this is reflected in a higher external color and lower firmness of the fruit at harvest maintaining high quality. None of the deficit irrigation treatments affected the effectiveness of deastringency treatment with high CO2 concentration. It is concluded that, despite Diospyros kaki being a crop sensitive to water stress, deficit irrigation can still be used as a measure for increasing tree crop level and accelerating fruit ripening

Acta Horticulturae

Persimmon trees (Diospyros kaki) belongs to the so-called group of minor fruit tree species. The main persimmon cultivar grown in Spain is ‘Rojo Brillante’, which produces an astringent fruit. This implies the need of deastringency post-harvest treatments prior commercialization. Persimmon growing in Spain is concentrated in an area of water scarcity, but there is no information about tree water needs or responses to deficit irrigation. With this in mind, an experiment was started with the objective to determine tree water needs and yield responses to water restrictions applied during different stages of fruit growth. Moreover the effect of the deficit irrigation period on the level of astringency at harvest and after a deastringency treatment with elevated CO2 were determined. Four irrigation treatments where applied including watering at 100% the estimated tree evapotranspiration during the entire season, and other three treatments where irrigation inputs were severely reduced but only during certain periods (spring, summer or fall). Water deficit, particularly if applied during spring or summer, reduced yield, mainly due to reduced fruit weight. However, water restrictions, particularly when applied late in the season lead to lower fruit firmness than the control. Therefore, this treatment accelerated fruit ripening. None of the deficit irrigation treatments affected the astringency level of the fruit at harvest or after the deastringency treatment