Evidence of sexual reproduction in the hermatypic corals Pocillopora damicornis, Porites panamensis, and Pavona gigantea in Banderas Bay, Mexican Pacific [Evidencia de reproducción sexual en los corales hermatópicos Pocillopora damicornis, Porites panamensis y Pavona gigantea en Bahía de Banderas, Pacífico mexicano]

The reproductive capacity of coral communities in the Mexican Pacific is still poorly documented. One of the most abundant coral communities in this region is found in Banderas Bay, yet the reproductive patterns of the coral species have not been analyzed. In order to document the annual reproductive cycle of the three most common species of corals in the bay, samples of Pocillopora damicornis, Porites panamensis, and Pavona gigantea were collected monthly from Redonda Island from December 2001 to November 2002. Colony fragments were processed by histological techniques and analyzed under a microscope. The three species showed the presence of gametes, which was associated with an increase in sea surface temperature. Gametogenesis was first observed in P. damicornis, classified as hermaphrodite. In P. panamensis, reproductive cells were observed in May 2002, and embryos and planulae in September 2002; this species was classified as gonochoric, showing internal fertilization and a distinct reproductive behavior compared with that reported for other areas of the eastern tropical Pacific. In P. gigantea, gametogenesis started later and occurred over a short period of time; this species was classified as gonochoric and no mature gametes were evident. All three species showed reproductive potential during the summer, confirming the reproductive capacity documented for these species in adjoining areas of the Mexican Pacific. The intensity and duration of the reproductive cycle in Banderas Bay are likely regulated by periodic events like El Niño and microscale climate oscillations that modulate temperature and light patterns in the area

Evidence of sexual reproduction in the hermatypic corals Pocillopora damicornis, Porites panamensis, and Pavona gigantea in Banderas Bay, Mexican Pacific [Evidencia de reproducción sexual en los corales hermatípicos Pocillopora damicornis, Porites panamensis y Pavona gigantea en Bahía de Banderas, Pacífico mexicano]

The reproductive capacity of coral communities in the Mexican Pacific is still poorly documented. One of the most abundant coral communities in this region is found in Banderas Bay, yet the reproductive patterns of the coral species have not been analyzed. In order to document the annual reproductive cycle of the three most common species of corals in the bay, samples of Pocillopora damicornis, Porites panamensis, and Pavona gigantea were collected monthly from Redonda Island from December 2001 to November 2002. Colony fragments were processed by histological techniques and analyzed under a microscope. The three species showed the presence of gametes, which was associated with an increase in sea surface temperature. Gametogenesis was first observed in P. damicornis, classified as hermaphrodite. In P. panamensis, reproductive cells were observed in May 2002, and embryos and planulae in September 2002; this species was classified as gonochoric, showing internal fertilization and a distinct reproductive behavior compared with that reported for other areas of the eastern tropical Pacific. In P. gigantea, gametogenesis started later and occurred over a short period of time; this species was classified as gonochoric and no mature gametes were evident. All three species showed reproductive potential during the summer, confirming the reproductive capacity documented for these species in adjoining areas of the Mexican Pacific. The intensity and duration of the reproductive cycle in Banderas Bay are likely regulated by periodic events like El Niño and microscale climate oscillations that modulate temperature and light patterns in the area

Sparsentan in patients with IgA nephropathy: a prespecified interim analysis from a randomised, double-blind, active-controlled clinical trial

Background: Sparsentan is a novel, non-immunosuppressive, single-molecule, dual endothelin and angiotensin receptor antagonist being examined in an ongoing phase 3 trial in adults with IgA nephropathy. We report the prespecified interim analysis of the primary proteinuria efficacy endpoint, and safety. Methods: PROTECT is an international, randomised, double-blind, active-controlled study, being conducted in 134 clinical practice sites in 18 countries. The study examines sparsentan versus irbesartan in adults (aged ≥18 years) with biopsy-proven IgA nephropathy and proteinuria of 1·0 g/day or higher despite maximised renin-angiotensin system inhibitor treatment for at least 12 weeks. Participants were randomly assigned in a 1:1 ratio to receive sparsentan 400 mg once daily or irbesartan 300 mg once daily, stratified by estimated glomerular filtration rate at screening (30 to <60 mL/min per 1·73 m2 and ≥60 mL/min per 1·73 m2) and urine protein excretion at screening (≤1·75 g/day and >1·75 g/day). The primary efficacy endpoint was change from baseline to week 36 in urine protein–creatinine ratio based on a 24-h urine sample, assessed using mixed model repeated measures. Treatment-emergent adverse events (TEAEs) were safety endpoints. All endpoints were examined in all participants who received at least one dose of randomised treatment. The study is ongoing and is registered with ClinicalTrials.gov, NCT03762850. Findings: Between Dec 20, 2018, and May 26, 2021, 404 participants were randomly assigned to sparsentan (n=202) or irbesartan (n=202) and received treatment. At week 36, the geometric least squares mean percent change from baseline in urine protein–creatinine ratio was statistically significantly greater in the sparsentan group (–49·8%) than the irbesartan group (–15·1%), resulting in a between-group relative reduction of 41% (least squares mean ratio=0·59; 95% CI 0·51–0·69; p<0·0001). TEAEs with sparsentan were similar to irbesartan. There were no cases of severe oedema, heart failure, hepatotoxicity, or oedema-related discontinuations. Bodyweight changes from baseline were not different between the sparsentan and irbesartan groups. Interpretation: Once-daily treatment with sparsentan produced meaningful reduction in proteinuria compared with irbesartan in adults with IgA nephropathy. Safety of sparsentan was similar to irbesartan. Future analyses after completion of the 2-year double-blind period will show whether these beneficial effects translate into a long-term nephroprotective potential of sparsentan. Funding: Travere Therapeutics

Colombian surgical outcomes study insights on perioperative mortality rate, a main indicator of the lancet commission on global surgery – a prospective cohort studyResearch in context

Summary: Background: Surgical care holds significant importance in healthcare, especially in low and middle-income countries, as at least 50% of the 4.2 million deaths within the initial 30 days following surgery take place in these countries. The Lancet Commission on Global Surgery proposed six indicators to enhance surgical care. In Colombia, studies have been made using secondary data. However, strategies to reduce perioperative mortality have not been implemented. This study aims to describe the fourth indicator, perioperative mortality rate (POMR), with primary data in Colombia. Methods: A multicentre prospective cohort study was conducted across 54 centres (hospitals) in Colombia. Each centre selected a 7-day recruitment period between 05/2022 and 01/2023. Inclusion criteria involved patients over 18 years of age undergoing surgical procedures in operating rooms. Data quality was ensured through a verification guideline and statistical analysis using mixed-effects multilevel modelling with a case mix analysis of mortality by procedure-related, patient-related, and hospital-related conditions. Findings: 3807 patients were included with a median age of 48 (IQR 32–64), 80.3% were classified as ASA I or II, and 27% of the procedures had a low-surgical complexity. Leading procedures were Orthopedics (19.2%) and Gynaecology/Obstetrics (17.7%). According to the Clavien–Dindo scale, postoperative complications were distributed in major complications (11.7%, 10.68–12.76) and any complication (31.6%, 30.09–33.07). POMR stood at 1.9% (1.48–2.37), with elective and emergency surgery mortalities at 0.7% (0.40–1.23) and 3% (2.3–3.89) respectively. Interpretation: The POMR was higher than the ratio reported in previous national studies, even when patients had a low–risk profile and low-complexity procedures. The present research represents significant public health progress with valuable insights for national decision-makers to improve the quality of surgical care. Funding: This work was supported by Universidad del Rosario and Fundación Cardioinfantil-Instituto de Cardiología grant number CTO-057-2021, project-ID IV-FGV017