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

Habitat Fragmentation in Arid Zones: A Case Study of Linaria nigricans Under Land Use Changes (SE Spain)

Habitat fragmentation due to human activities is one of the most important causes of biodiversity loss. In Mediterranean areas the species have co-evolved with traditional farming, which has recently been replaced for more severe and aggressive practices. We use a methodological approach that enables the evaluation of the impact that agriculture and land use changes have for the conservation of sensitive species. As model species, we selected Linaria nigricans, a critically endangered plant from arid and semiarid ecosystems in south-eastern Spain. A chronosequence of the evolution of the suitable habitat for the species over more than 50 years has been reconstructed and several geometrical fragmentation indices have been calculated. A new index called fragmentation cadence (FC) is proposed to quantify the historical evolution of habitat fragmentation regardless of the habitat size. The application of this index has provided objective forecasting of the changes of each remnant population of L. nigricans. The results indicate that greenhouses and construction activities (mainly for tourist purposes) exert a strong impact on the populations of this endangered species. The habitat depletion showed peaks that constitute the destruction of 85% of the initial area in only 20 years for some populations of L. nigricans. According to the forecast established by the model, a rapid extinction could take place and some populations may disappear as early as the year 2030. Fragmentation-cadence analysis can help identify population units of primary concern for its conservation, by means of the adoption of improved management and regulatory measures

Vegetation recovery of gypsum quarries: short-term sowing response to different soil treatments

Question: How does the sowing of native species under different soil treatments contribute to the recovery of gypsum habitats affected by quarrying in Mediterranean environments? Location: Mediterranean gypsum outcrops in Granada (SE Spain; 37 degrees 2' N, 3 degrees 45' W). Methods: We conducted an experimental sowing of native perennial species from gypsum habitats (both gypsophiles and gypsovags) considering two factors: bedding materials and surface treatments. For bedding material we used: gypsum spoil, topsoil addition on gypsum spoil, raw gypsum and topsoil removal. The surface treatments were: control, sowing, sowing plus organic matter and sowing plus an organic blanket. There were five replicates per combination treatment (80 plots in total, of 25 m (2) each). The sowing was performed in Nov 2009. All subplots were monitored to estimate density, richness, survival, growth of seedlings and herbaceous biomass, in two monitoring periods (Jul and Oct). Results: No gypsophiles or gypsovags were found in the control plots (no sowing or surface treatment), and therefore natural succession proved ineffective in the first year. In contrast, sowing was very satisfactory, especially on gypsum spoil, where mean density was of more than 15 individuals m(-2). This result is noteworthy as this material remains after the end of gypsum mining activity. Spreading topsoil over gypsum spoil proved to be no more positive, since it provided not only seeds of target species but also of competitor species. Also, with regard to herbaceous species, this treatment produced a highly significant increase of biomass. The organic blanket increased plant density, whereas the addition of organicmatter had significant positive effects on survival and growth of the seedlings. The global high survival rate is remarkable, especially for the gypsum spoil treatment. Conclusions: We highlight the importance of implementing recovery measures in gypsum habitats. An appropriate selection of seed mixture and density, as well as the use of gypsum spoil (the most favourable bedding material, according the results), is sufficient to ensure presence of the key species. Both technical solutions tested, organic blanket installation and organic matter addition, improved the results in terms of density, survival and growth of the seedlings