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

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Intelligent Platform for Smart Port - IPaSPort’2017

International audienc

Intelligent Platform for Smart Port - IPaSPort’2017

International audienc

Détecteur et capteur de présence d'un liquide sur une feuille

L'invention concerne un détecteur (1) de présence d'un liquide sur une feuille (2) comportant deux électrodes (4, 5) destinées à être reliées à un circuit électronique (3) de mise en forme d'un signal électrique. BR/ Selon l'invention, le détecteur (1) comprend: BR/ - un support (6) pourvu d'un évidement (7), BR/ - une pluralité de fils conducteurs (8a, 8b, , 9a, 9b) fixés au support (6) de manière à s'étendre en travers de l'évidement (7) et reliés entre eux de manière à constituer deux électrodes (4, 5), et BR/ - une plaque (10) reliée au support (6) par un ressort (12), la plaque (10) et le support (6) formant une pince. BR/ L'invention concerne également un capteur comportant un détecteur tel que défini plus haut et un circuit électronique soumettant le détecteur à une différence de tension alternative

Wetness sensors for detecting condensation on leaves and exudates from leaf pruning wounds

International audienc

A comparative study of geometric transformation models for the historical ‘map of france’ registration

International audienceIt is widely recognized that present-day biological diversity may reflect past land use and landscape features. Understanding the historical background is essential to explain the ecosystem functioning of landscapes today. Numerous historical spatial data have been used to reconstruct these pathways but resulted in problems of sources, formats and supports. One major problem is how to incorporate historical data in current coordinate systems to enable them to be compared with each other and with current sources. Previous works on the registration of historical maps already demonstrated the superiority of local methods (e.g. a Delaunay-based method) over global methods (like polynomial mapping models) because of the existence of local geometric distortions. The same studies also highlighted the importance of selecting ground control points with a homogeneous spatial distribution to improve the accuracy of registration. Furthermore, while kernel-based methods have already proved their efficiency for many other applications, they have rarely been used for map registration even though they provide an interesting alternative to conventional methods. In this paper, we present a comparative study of various geometric transformation methods to register an excerpt of the historical ‘Map of France’ (an Ordnance Survey map) dating from the 19th century. We compare the performance of several global and local methods with kernel-based methods (Gaussian and polynomials) and analyze the impact of the number of control points, their nature and their spatial distribution on the quality of registration. A protocol was developed to apply the transformation models in various situations and to identify the best strategy for the georeferencing of historical maps

Pilotage d'une enceinte climatique régulée en température et humidité

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Development of a controlled-environment chamber for studying the epidemiology of fungal pathogens

International audienceThe requirements for studying the epidemiology of fungal pathogens are analysed and a controlled environment chamber is described which was developed to meet these requirements. It allows accurate reproduction of a wide range of combinations of the most relevant climatic factors influencing the development of fungal diseases on plants, namely, air temperature, air humidity and dew formation. Dew can be simulated by means of a transparent radiative panel placed in the ceiling of the chamber. Data on condensation of natural dew on the leaves of tomato plants are presented and the elements of the energy balance during the dew formation are analysed. Finally, the performance of the system is discussed and improvements are proposed