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

PORTABLE RAMP OF ACCESSIBILITY FOR WHEELCHAIR USERS

Inspirado no Acessibiliy Mat criado pela Ford Brasil, que transformou o tapete do porta-malas do carro EcoSport em uma rampa portátil de acessibilidade para cadeirantes. O trabalho visa contribuir para a acessibilidade e mobilidade dos usuários de cadeiras de rodas nas ruas da cidade de Florianópolis, Santa Catarina, Sul do Brasil, por meio do desenvolvimento da concepção final de um protótipo de uma rampa portátil de acesso. A rampa portátil facilitará a mobilidade dos usuários, atuando como ferramenta de acessibilidade. A metodologia utilizada teve por base o gerenciamento de projetos e a aplicação de pesquisas de mercado, realizadas com os usuários, onde ressaltaram que a maior barreira enfrentada diariamente, em razão da deficiência física, são as calçadas sem rampa. Como resultado, foi elaborada a concepção final do protótipo da rampa portátil. O apoio a projetos de inclusão social contribui para a qualidade de vida das pessoas com deficiência física.Inspired by the Accessibility Mat created by Ford Brasil, which transformed the EcoSport car trunk mat into a portable wheelchair accessibility ramp. The work aims to contribute to the accessibility and mobility of the wheelchair users on the streets of the city of Florianópolis, Santa Catarina, Southern Brazil, through the development of the final conception of a prototype of a portable access ramp. The portable ramp will facilitate the mobility of users, acting as an accessibility tool. The methodology used was based on project management and the application of market research, carried out with users, where they highlighted that the biggest barrier faced daily, due to physical disability, are the sidewalks without a ramp. As a result, the final conception of the portable ramp prototype was elaborated. Support for social inclusion projects contributes to the quality of life of people with physical disabilities

RAMPA PORTÁTIL DE ACESSIBILIDADE PARA CADEIRANTES

Inspired by the Accessibility Mat created by Ford Brasil, which transformed the EcoSport car trunk mat into a portable wheelchair accessibility ramp. The work aims to contribute to the accessibility and mobility of the wheelchair users on the streets of the city of Florianópolis, Santa Catarina, Southern Brazil, through the development of the final conception of a prototype of a portable access ramp. The portable ramp will facilitate the mobility of users, acting as an accessibility tool. The methodology used was based on project management and the application of market research, carried out with users, where they highlighted that the biggest barrier faced daily, due to physical disability, are the sidewalks without a ramp. As a result, the final conception of the portable ramp prototype was elaborated. Support for social inclusion projects contributes to the quality of life of people with physical disabilities.Inspirado en el Tapete de Accesibilidad creado por Ford Brasil, que transformó el tapete de la cajuela del auto EcoSport en una rampa portátil de accesibilidad para sillas de ruedas. El trabajo tiene como objetivo contribuir a la accesibilidad y movilidad de los usuarios de sillas de ruedas en las calles de la ciudad de Florianópolis, Santa Catarina, Sur de Brasil, a través del desarrollo del diseño final de un prototipo de rampa de acceso portátil. La rampa portátil facilitará la movilidad de los usuarios, actuando como herramienta de accesibilidad. La metodología utilizada se basó en la gestión de proyectos y la aplicación de estudios de mercado, realizados con los usuarios, donde destacaron que la mayor barrera que enfrentan a diario, por discapacidad física, son las aceras sin rampa. Como resultado se elaboró ??el diseño final del prototipo de rampa portátil. El apoyo a proyectos de inclusión social contribuye a la calidad de vida de las personas con discapacidad física.Inspirado no Acessibiliy Mat criado pela Ford Brasil, que transformou o tapete do porta-malas do carro EcoSport em uma rampa portátil de acessibilidade para cadeirantes. O trabalho visa contribuir para a acessibilidade e mobilidade dos usuários de cadeiras de rodas nas ruas da cidade de Florianópolis, Santa Catarina, Sul do Brasil, por meio do desenvolvimento da concepção final de um protótipo de uma rampa portátil de acesso. A rampa portátil facilitará a mobilidade dos usuários, atuando como ferramenta de acessibilidade. A metodologia utilizada teve por base o gerenciamento de projetos e a aplicação de pesquisas de mercado, realizadas com os usuários, onde ressaltaram que a maior barreira enfrentada diariamente, em razão da deficiência física, são as calçadas sem rampa. Como resultado, foi elaborada a concepção final do protótipo da rampa portátil. O apoio a projetos de inclusão social contribui para a qualidade de vida das pessoas com deficiência física

Relationships between microbial activity and soil physical and chemical properties in native and reforested Araucaria angustifolia forests in the state of São Paulo, Brazil

Araucaria angustifolia (Bert.) O. Kuntze is the main component of the Mixed Ombrophilous forest and, in the State of São Paulo, it is associated with a high diversity of soil organisms, essential for the maintenance of soil quality, making the conservation of this ecosystem a major and pressing challenge. The objective of this study was to identify the physical and chemical properties that are most closely correlated with dehydrogenase enzyme activity, basal respiration and microbial biomass under native (NF) and replanted (RF) Araucaria angustifolia forests in three regions of the state of São Paulo, in winter and summer. The main differentiating factors between the areas were also determined. Each forest was represented by three true replications; at each site, from around the araucaria trees, 15 soil samples (0-20 cm) were collected to evaluate the soil physical, chemical and microbiological properties. At the same points, forest litter was sampled to assess mass and chemical properties. The following microbiological properties were evaluated: microbial biomass carbon (MBC), basal respiration (CO2-C), metabolic quotient (Q: CO2), dehydrogenase enzyme activity (DHA) as well as the physical properties (moisture, bulk density, macroporosity and total porosity), soil chemical properties &#91;pH, organic carbon (org-C), P, Ca, K, Mg, Al, H+Al&#93;, litter dry mass, and C, N and S contents. The data were subjected to analysis of variance (TWO-WAY: ANOVA). A Canonical Discriminant Analysis (CDA) and a Canonical Correlation Analysis (CCA) were also performed. In the soil under NF, the values of K, P, soil macroporosity, and litter dry mass were higher and Q: CO2 and DHA lower, regardless of the sampling period, and DHA was lower in winter. In the RF areas, the levels of moisture, porosity and Q: CO2 were higher in both sampling periods, and DHA was higher in winter. The MBC was only higher under NF in the summer, while the litter contents of C, N and S were greater in winter. In winter, CCA showed a high correlation of DHA with CO2-C, pH and H+Al, while in the summer org-C, moisture, Mg, pH and litter C were more associated with DHA and CO2-C. The CDA indicated H+Al, available P, total porosity, litter S content, and soil moisture as the most discriminating variables between NF and RF, but moisture was the most relevant, in both seasons and CO2-C only in winter. The combined analysis of CCA and CDA showed that the contribution of the microbiological variables to a differentiation of the areas was small at both samplings, which may indicate that the period after reforestation was long enough to allow an almost complete recovery of the microbial activity