Randomized multicentre pilot study of sacubitril/valsartan versus irbesartan in patients with chronic kidney disease: United Kingdom Heart and Renal Protection (HARP)- III—rationale, trial design and baseline data

BACKGROUND: Patients with chronic kidney disease (CKD) are at risk of progression to end-stage renal disease and cardiovascular disease. Data from other populations and animal experiments suggest that neprilysin inhibition (which augments the natriuretic peptide system) may reduce these risks, but clinical trials among patients with CKD are required to test this hypothesis. METHODS: UK Heart and Renal Protection III (HARP-III) is a multicentre, double-blind, randomized controlled trial comparing sacubitril/valsartan 97/103 mg two times daily (an angiotensin receptor-neprilysin inhibitor) with irbesartan 300 mg one time daily among 414 patients with CKD. Patients ≥18 years of age with an estimated glomerular filtration rate (eGFR) of ≥45 but <60 mL/min/1.73 m2 and urine albumin:creatinine ratio (uACR) >20 mg/mmol or eGFR ≥20 but <45 mL/min/1.73 m2 (regardless of uACR) were invited to be screened. Following a 4- to 7-week pre-randomization single-blind placebo run-in phase (during which any current renin-angiotensin system inhibitors were stopped), willing and eligible participants were randomly assigned either sacubitril/valsartan or irbesartan and followed-up for 12 months. The primary aim was to compare the effects of sacubitril/valsartan and irbesartan on measured GFR after 12 months of therapy. Important secondary outcomes include effects on albuminuria, change in eGFR over time and the safety and tolerability of sacubitril/valsartan in CKD. RESULTS: Between November 2014 and January 2016, 620 patients attended a screening visit and 566 (91%) entered the pre-randomization run-in phase. Of these, 414 (73%) participants were randomized (mean age 63 years; 72% male). The mean eGFR was 34.0 mL/min/1.73 m2 and the median uACR was 58.5 mg/mmol. CONCLUSIONS: UK HARP-III will provide important information on the short-term effects of sacubitril/valsartan on renal function, tolerability and safety among patients with CKD

Enabling relationship building in tabletop-supported advisory settings

Recent research has shown that financial advisory encounters can successfully be supported with IT-artifacts. Tabletop scenarios, for example, can increase the transparency of the advisory process for customers. However, we have also had the experience that the relationship quality as experienced by customers can suffer severely when IT-artifacts are introduced

P6257 Blood pressure and death from vascular and metabolic diseases in Mexico City: 12-year follow-up of 150,000 adults

Blood pressure is a major cause of premature death, but few large studies of Hispanic populations exist. Between 1998 and 2004, a prospective study in Mexico City recruited 100,000 women and 50,000 men, and has followed cause-specific mortality electronically

Entrepreneurial education’s and entrepreneurial role models’ influence on career choice

Orientation: Little research has been done into the impact of entrepreneurial education and entrepreneurial role models on entrepreneurship as a career choice, especially in developing countries. Research purpose: The purpose of the study is to firstly explore the differences in entrepreneurial intentions between entrepreneurship students and non-entrepreneurship students, and secondly to investigate the relationship between entrepreneurial education and entrepreneurial intentions as well as between role models and entrepreneurial intentions. Motivation for the study: There is a need for stakeholders, such as training authorities and training providers, to understand the influence of entrepreneurship education and role models on entrepreneurial career choice. Knowing this could assist in developing and implementing more effective entrepreneurial education programmes. Research design, approach and method: The study was conducted amongst a convenience sample of 269 final-year students, of which 162 (60.2%) were entrepreneurship and 107 (39.8%) non-entrepreneurship students from a higher education institution in Johannesburg. The entrepreneurial intentions of entrepreneurship students were compared with those of non-entrepreneurship students. The findings of the study suggest that entrepreneurship students have stronger entrepreneurial intentions than non-entrepreneurship students, and that there is a positive relationship between entrepreneurship education and entrepreneurial intentions and between role models and entrepreneurial intentions respectively. Practical/managerial implications: Entrepreneurship stakeholders can use the findings of the study to improve curriculum design, delivery methods and assessment strategies in their efforts to advance entrepreneurship. Contribution/value-add: The findings of the study suggest that entrepreneurship education and role models can influence students’ entrepreneurial intentions in a developing country

Classifying chalk microtextures: Sedimentary versus diagenetic origin (Cenomanian-Santonian, Paris Basin, France)

International audienceMicrotexture describes the type of particles and their arrangement in matrix samples at scanning electron microscopy scale. Although a microtexture classification exists for micritic limestone, it cannot be directly applied to chalk. This study therefore proposes a classification of chalk microtextures and discusses the origin of microtexture variability. Chalk was sampled at thirteen spatio-temporal locations along the coastline of northern France (Cenomanian-Santonian). Four criteria are defined to describe, characterize and determine chalk matrix microtexture: (i) mineralogical content; (ii) biogenic fraction; (iii) micritic fraction; and (iv) cement fraction. From these criteria, two major groups are defined: Pure Chalk Microtexture Group, with seven classes, and Impure Chalk Microtexture Group, divided into two subgroups: Argillaceous Microtexture with four classes and Siliceous Microtexture with two classes. Microtexture variability is related both to initial sedimentation and to diagenesis. Sedimentological conditions (for example, climate and distance from shore) affect chalk composition (carbonate content and type of insoluble particles), thus influencing microtexture. Changes in Pure Chalk Microtexture are the result of increasing diagenetic intensity. This classification can also be used to characterize the microtexture of subsurface chalk reservoirs. Reservoir quality depends on the petrophysical and mechanical properties of reservoir rocks, which can be better understood by exploring their sedimentary and diagenetic history, revealed by the study of chalk microtexture variability