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

Classification of objects consisting of multiple segments with application to crater detection

Pages: 81-8

Efficient 2-D Grayscale Morphological Transformations With Arbitrary Flat Structuring Elements

An efficient algorithm is presented for the computation of grayscale morphological operations with arbitrary 2-D flat structuring elements (S.E.). The required computing time is independent of the image content and of the number of gray levels used. It always outperforms the only existing comparable method, which was proposed in earlier work, by a factor between 3.5 and 35.1, depending on the image type and shape of S.E. So far, filtering using multiple S.E.s is always done by performing the operator for each size and shape of the S.E. separately. With our method, filtering with multiple S.E.s can be performed by a single operator for a slightly reduced computational cost per size or shape, which makes this method more suitable for use in granulometries, dilation-erosion scale spaces, and template matching using the hit-or-miss transform. The discussion focuses on erosions and dilations, from which other transformations can be derived.