Effect of aliskiren on post-discharge outcomes among diabetic and non-diabetic patients hospitalized for heart failure: insights from the ASTRONAUT trial

Aims The objective of the Aliskiren Trial on Acute Heart Failure Outcomes (ASTRONAUT) was to determine whether aliskiren, a direct renin inhibitor, would improve post-discharge outcomes in patients with hospitalization for heart failure (HHF) with reduced ejection fraction. Pre-specified subgroup analyses suggested potential heterogeneity in post-discharge outcomes with aliskiren in patients with and without baseline diabetes mellitus (DM). Methods and results ASTRONAUT included 953 patients without DM (aliskiren 489; placebo 464) and 662 patients with DM (aliskiren 319; placebo 343) (as reported by study investigators). Study endpoints included the first occurrence of cardiovascular death or HHF within 6 and 12 months, all-cause death within 6 and 12 months, and change from baseline in N-terminal pro-B-type natriuretic peptide (NT-proBNP) at 1, 6, and 12 months. Data regarding risk of hyperkalaemia, renal impairment, and hypotension, and changes in additional serum biomarkers were collected. The effect of aliskiren on cardiovascular death or HHF within 6 months (primary endpoint) did not significantly differ by baseline DM status (P = 0.08 for interaction), but reached statistical significance at 12 months (non-DM: HR: 0.80, 95% CI: 0.64-0.99; DM: HR: 1.16, 95% CI: 0.91-1.47; P = 0.03 for interaction). Risk of 12-month all-cause death with aliskiren significantly differed by the presence of baseline DM (non-DM: HR: 0.69, 95% CI: 0.50-0.94; DM: HR: 1.64, 95% CI: 1.15-2.33; P < 0.01 for interaction). Among non-diabetics, aliskiren significantly reduced NT-proBNP through 6 months and plasma troponin I and aldosterone through 12 months, as compared to placebo. Among diabetic patients, aliskiren reduced plasma troponin I and aldosterone relative to placebo through 1 month only. There was a trend towards differing risk of post-baseline potassium ≥6 mmol/L with aliskiren by underlying DM status (non-DM: HR: 1.17, 95% CI: 0.71-1.93; DM: HR: 2.39, 95% CI: 1.30-4.42; P = 0.07 for interaction). Conclusion This pre-specified subgroup analysis from the ASTRONAUT trial generates the hypothesis that the addition of aliskiren to standard HHF therapy in non-diabetic patients is generally well-tolerated and improves post-discharge outcomes and biomarker profiles. In contrast, diabetic patients receiving aliskiren appear to have worse post-discharge outcomes. Future prospective investigations are needed to confirm potential benefits of renin inhibition in a large cohort of HHF patients without D

Priorities for mitigating greenhouse gas and ammonia emissions to meet UK policy targets

Agriculture is essential for providing food and maintaining food security while concurrently delivering multiple other ecosystem services. However, agricultural systems are generally a net source of greenhouse gases and ammonia. They, therefore, need to substantively contribute to climate change mitigation and net zero ambitions. It is widely acknowledged that there is a need to further reduce and mitigate emissions across sectors, including agriculture to address the climate emergency and emissions gap. This discussion paper outlines a collation of opinions from a range of experts within agricultural research and advisory roles following a greenhouse gas and ammonia emission mitigation workshop held in the UK in March 2022. The meeting identified the top mitigation priorities within the UK’s agricultural sector to achieve reductions in greenhouse gases and ammonia that are compatible with policy targets. In addition, experts provided an overview of what they believe are the key knowledge gaps, future opportunities and co-benefits to mitigation practices as well as indicating the potential barriers to uptake for mitigation scenarios discussed

Using high spatial resolution remote sensing for risk mapping of malaria occurrence in the Nouna district, Burkina Faso

Introduction: Malaria control measures such as early diagnosis and treatment, intermittent treatment of pregnant women, impregnated bed nets, indoor spraying and larval control measures are difficult to target specifically because of imprecise estimates of risk at a small-scale level. Ways of estimating local risks for malaria are therefore important.Methods: A high-resolution satellite view from the SPOT 5 satellite during 2008 was used to generate a land cover classification in the malaria endemic lowland of North-Western Burkina Faso. For the area of a complete satellite view of 60 x 60 km, a supervised land cover classification was carried out. Ten classes were built and correlated to land cover types known for acting as Anopheles mosquito breeding sites.Results: According to known correlations of Anopheles larvae presence and surface water-related land cover, cultivated areas in the riverine vicinity of Kossi River were shown to be one of the most favourable sites for Anopheles production. Similar conditions prevail in the South of the study region, where clayey soils and higher precipitations benefit the occurrence of surface water. Besides pools, which are often directly detectable, rice fields and occasionally flooded crops represent most appropriate habitats. On the other hand, forests, elevated regions on porous soils, grasslands and the dryer, sandy soils in the north-western part turned out to deliver fewer mosquito breeding opportunities.Conclusions: Potential high and low risks for malaria at the village level can be differentiated from satellite data. While much remains to be done in terms of establishing correlations between remotely sensed risks and malaria disease patterns, this is a potentially useful approach which could lead to more focused disease control programmes.</p

Track A Basic Science

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138319/1/jia218438.pd

Characterization of the chemical composition of the essential oils from Annona emarginata (Schltdl.) H. Rainer 'terra-fria' and Annona squamosa L.

O objetivo do presente estudo foi caracterizar a composição química do óleo essencial das folhas de Annona emarginata (Schltdl.) H. Rainer 'terra-fria' e Annona squamosa L. As espécies foram cultivadas em casa de vegetação, com aplicação semanal de solução nutritiva até completar 18 meses, quando se realizaram a colheita e a secagem das folhas para a extração do óleo essencial, analisado por cromatografia gasosa acoplada à espectrometria de massas, para estudo dos perfis químicos. Onze substâncias majoritárias foram encontradas no óleo essencial de A. emarginata: (E)-cariofileno-29,29%; (Z)-cariofileno-16,86%; γ-muroleno-7,54%; α-pineno-13,86%; tricicleno-10,04%. No óleo de A. squamosa, 10 substâncias foram detectadas, entre elas: (E)-cariofileno-28.71%; (Z)-cariofileno-14,46%; α-humuleno-4,41%; canfeno-18,10%; α-pineno-7,37%, e β-pineno-8,71%; longifoleno-5,64%; majoritárias. (E)-cariofileno; (Z)-cariofileno; α-humuleno; canfeno; α-pineno, e β-pineno foram as seis substâncias comuns às duas espécies.The objective of this study was to characterize the chemical composition of the essential oil from the leaves of Annona emarginata (Schltdl.) H. Rainer 'terra-fria' and Annona squamosa L. The species were grown in a greenhouse for 18 months, which nutrient solution was applied weekly; the plants were then harvested and the leaves dried to extract the essential oil. The essential oil was analyzed by gas chromatography and mass spectrometry to study its chemical profiles. Eleven substances were found in the essential oil of A. emarginata, primarily (E)-caryophyllene (29.29%), (Z)-caryophyllene (16.86%), γ-muurolene (7.54%), α-pinene (13.86%), and tricyclene (10.04%). Ten substances were detected in the oil from A. squamosa, primarily (E)-caryophyllene (28.71%), (Z)-caryophyllene (14.46%), α-humulene (4.41%), camphene (18.10%), α-pinene (7.37%), β-pinene (8.71%), and longifolene (5.64%). Six substances were common to both species: (E)-caryophyllene, (Z)-caryophyllene, α-humulene, camphene, α-pinene, and β-pinene.Universidade Estadual Paulista Júlio de Mesquita Filho Agronomy Sciences CollegeUNESP Biosciences InstituteAgronomy Institute P & D Center of Vegetable Genetic ResourcesUNESP Biosciences Institute Botany DepartmentUniversidade Estadual Paulista Júlio de Mesquita Filho Agronomy Sciences CollegeUNESP Biosciences InstituteUNESP Biosciences Institute Botany Departmen

Comparing production-biomass ratios of benthos and suprabenthos in macrofaunal marine crustaceans

Using available data from the literature, we compared the productionbiomass ratios (P/B) between the suprabenthic (= hyperbenthic) and the benthic (infaunaepifauna) species within the group of the macrofaunal marine crustaceans. This data set consists of 91 P/B estimates (26 for suprabenthos and 65 for infaunaepifauna) for 49 different species. Suprabenthic crustacean P/B was significantly higher than P/B of benthic crustacean (post-hoc Scheffé test; one-way analysis of covariance, ANCOVA; p < 103) and also of other (noncrustacean) benthic invertebrate (p < 104). Predictive multilinear regression (MLR) analysis for macrofaunal marine crustaceans showed P/B to depend significantly on mean annual temperature (T) and mean individual weight (W) (R2 = 0.367). Adding the variable swimming capacity increased goodness-of-fit to R2 = 0.528. The higher P/B of suprabenthic (= swimming) macrofauna in comparison with that of the benthic compartment seems to be related to the most apparent feature of the suprabenthos, its swimming capacity. The high P/Bs reported for suprabenthic species indicate how a nontrivial part of benthic production can be ignored if suprabenthos is not well sampled, therefore biasing the models of energy flow generated for trophic webs