Semaglutide and cardiovascular outcomes in patients with obesity and prevalent heart failure: a prespecified analysis of the SELECT trial

Background: Semaglutide, a GLP-1 receptor agonist, reduces the risk of major adverse cardiovascular events (MACE) in people with overweight or obesity, but the effects of this drug on outcomes in patients with atherosclerotic cardiovascular disease and heart failure are unknown. We report a prespecified analysis of the effect of once-weekly subcutaneous semaglutide 2·4 mg on ischaemic and heart failure cardiovascular outcomes. We aimed to investigate if semaglutide was beneficial in patients with atherosclerotic cardiovascular disease with a history of heart failure compared with placebo; if there was a difference in outcome in patients designated as having heart failure with preserved ejection fraction compared with heart failure with reduced ejection fraction; and if the efficacy and safety of semaglutide in patients with heart failure was related to baseline characteristics or subtype of heart failure. Methods: The SELECT trial was a randomised, double-blind, multicentre, placebo-controlled, event-driven phase 3 trial in 41 countries. Adults aged 45 years and older, with a BMI of 27 kg/m2 or greater and established cardiovascular disease were eligible for the study. Patients were randomly assigned (1:1) with a block size of four using an interactive web response system in a double-blind manner to escalating doses of once-weekly subcutaneous semaglutide over 16 weeks to a target dose of 2·4 mg, or placebo. In a prespecified analysis, we examined the effect of semaglutide compared with placebo in patients with and without a history of heart failure at enrolment, subclassified as heart failure with preserved ejection fraction, heart failure with reduced ejection fraction, or unclassified heart failure. Endpoints comprised MACE (a composite of non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death); a composite heart failure outcome (cardiovascular death or hospitalisation or urgent hospital visit for heart failure); cardiovascular death; and all-cause death. The study is registered with ClinicalTrials.gov, NCT03574597. Findings: Between Oct 31, 2018, and March 31, 2021, 17 604 patients with a mean age of 61·6 years (SD 8·9) and a mean BMI of 33·4 kg/m2 (5·0) were randomly assigned to receive semaglutide (8803 [50·0%] patients) or placebo (8801 [50·0%] patients). 4286 (24·3%) of 17 604 patients had a history of investigator-defined heart failure at enrolment: 2273 (53·0%) of 4286 patients had heart failure with preserved ejection fraction, 1347 (31·4%) had heart failure with reduced ejection fraction, and 666 (15·5%) had unclassified heart failure. Baseline characteristics were similar between patients with and without heart failure. Patients with heart failure had a higher incidence of clinical events. Semaglutide improved all outcome measures in patients with heart failure at random assignment compared with those without heart failure (hazard ratio [HR] 0·72, 95% CI 0·60-0·87 for MACE; 0·79, 0·64-0·98 for the heart failure composite endpoint; 0·76, 0·59-0·97 for cardiovascular death; and 0·81, 0·66-1·00 for all-cause death; all pinteraction>0·19). Treatment with semaglutide resulted in improved outcomes in both the heart failure with reduced ejection fraction (HR 0·65, 95% CI 0·49-0·87 for MACE; 0·79, 0·58-1·08 for the composite heart failure endpoint) and heart failure with preserved ejection fraction groups (0·69, 0·51-0·91 for MACE; 0·75, 0·52-1·07 for the composite heart failure endpoint), although patients with heart failure with reduced ejection fraction had higher absolute event rates than those with heart failure with preserved ejection fraction. For MACE and the heart failure composite, there were no significant differences in benefits across baseline age, sex, BMI, New York Heart Association status, and diuretic use. Serious adverse events were less frequent with semaglutide versus placebo, regardless of heart failure subtype. Interpretation: In patients with atherosclerotic cardiovascular diease and overweight or obesity, treatment with semaglutide 2·4 mg reduced MACE and composite heart failure endpoints compared with placebo in those with and without clinical heart failure, regardless of heart failure subtype. Our findings could facilitate prescribing and result in improved clinical outcomes for this patient group. Funding: Novo Nordisk

Planck early results XIV : ERCSC validation and extreme radio sources

Peer reviewe

Planck early results XV : Spectral energy distributions and radio continuum spectra of northern extragalactic radio sources

Peer reviewe

Planck early results III : First assessment of the Low Frequency Instrument in-flight performance

Peer reviewe

Ordered magnetic fields around the 3C 84 central black hole

Context. 3C 84 is a nearby radio source with a complex total intensity structure, showing linear polarisation and spectral patterns. A detailed investigation of the central engine region necessitates the use of very-long-baseline interferometry (VLBI) above the hitherto available maximum frequency of 86 GHz.Aims. Using ultrahigh resolution VLBI observations at the currently highest available frequency of 228 GHz, we aim to perform a direct detection of compact structures and understand the physical conditions in the compact region of 3C 84.Methods. We used Event Horizon Telescope (EHT) 228 GHz observations and, given the limited (u; v)-coverage, applied geometric model fitting to the data. Furthermore, we employed quasi-simultaneously observed, ancillary multi-frequency VLBI data for the source in order to carry out a comprehensive analysis of the core structure.Results. We report the detection of a highly ordered, strong magnetic field around the central, supermassive black hole of 3C 84. The brightness temperature analysis suggests that the system is in equipartition. We also determined a turnover frequency of gamma(m) = (113 +/- 4) GHz, a corresponding synchrotron self-absorbed magnetic field of B-SSA = (2.9 +/- 1.6) G, and an equipartition magnetic field of B-eq = (5.2 +/- 0.6) G. Three components are resolved with the highest fractional polarisation detected for this object (m(net) = (17.0 +/- 3.9)%). The positions of the components are compatible with those seen in low-frequency VLBI observations since 2017-2018. We report a steeply negative slope of the spectrum at 228 GHz. We used these findings to test existing models of jet formation, propagation, and Faraday rotation in 3C 84.Conclusions. The findings of our investigation into di fferent flow geometries and black hole spins support an advection-dominated accretion flow in a magnetically arrested state around a rapidly rotating supermassive black hole as a model of the jet-launching system in the core of 3C 84. However, systematic uncertainties due to the limited (u, v)-coverage, however, cannot be ignored. Our upcoming work using new EHT data, which offer full imaging capabilities, will shed more light on the compact region of 3C 84

Elliptic and triangular flow of (anti)deuterons in Pb-Pb collisions at sNN =5.02 TeV

The measurements of the (anti)deuteron elliptic flow (v2) and the first measurements of triangular flow (v3) in Pb-Pb collisions at a center-of-mass energy per nucleon-nucleon collision √sNN = 5.02 TeV are presented. A mass ordering at low transverse momentum (pT) is observed when comparing these measurements with those of other identified hadrons, as expected from relativistic hydrodynamics. The measured (anti)deuteron v2 lies between the predictions from the simple coalescence and blast-wave models, which provide a good description of the data only for more peripheral and for more central collisions, respectively. The mass number scaling, which is violated for v2, is approximately valid for the (anti)deuterons v3. The measured v2 and v3 are also compared with the predictions from a coalescence approach with phase-space distributions of nucleons generated by IEBEVISHNU with AMPT initial conditions coupled with URQMD, and from a dynamical model based on relativistic hydrodynamics coupled to the hadronic afterburner SMASH. The model predictions are consistent with the data within the uncertainties in midcentral collisions, while a deviation is observed in the most central collisions

Coherent psi (2S) photo-production in ultra-peripheral Pb-Pb collisions at root s(NN)=2.76TeV

We have performed the first measurement of the coherent psi(2S) photo-production cross section in ultraperipheral Pb-Pb collisions at the LHC. This charmonium excited state is reconstructed via the psi(2S) -> l(+)l(-) and ->(2S) -> J/psi pi(+)pi(-) decays, where the J/psi decays into two leptons. The analysis is based on an event sample corresponding to an integrated luminosity of about 22 mu b(-1). The cross section for coherent psi(2S) production in the rapidity interval -0.9 <y <0.9is d sigma(coh)(psi(2S))/dy = 0.83 +/- 0.19 (stat+syst) mb. The psi(2S) to J/psi coherent cross section ratio is 0.34(-0.07)(+0.08)(stat+syst). The obtained results are compared to predictions from theoretical models. (C) 2015 CERN for the benefit of the ALICE Collaboration. Published by Elsevier B.V.Peer reviewe

Production of omega mesons in pp collisions at s=7 TeV

The invariant differential cross section of inclusive omega (782) meson production at midrapidity (|y| pi+pi-pi 0 decay channel. The measured omega production cross section is compared to various calculations: PYTHIA 8.2 Monash 2013 describes the data, while PYTHIA 8.2 Tune 4C overestimates the data by about 50%. A recent NLO calculation, which includes a model describing the fragmentation of the whole vector-meson nonet, describes the data within uncertainties below 6 GeV/c, while it overestimates the data by up to 50% for higher pT. The omega/pi 0 ratio is in agreement with previous measurements at lower collision energies and the PYTHIA calculations. In addition, the measurement is compatible with transverse mass scaling within the measured pT range and the ratio is constant with C omega/pi 0=0.67 +/- 0.03(stat) +/- 0.04(sys) above a transverse momentum of 2.5 GeV/c.Peer reviewe

Search for chargino-neutralino production in events with Higgs and W bosons using 137 fb−1 of proton-proton collisions at √s = 13 TeV

A search for electroweak production of supersymmetric (SUSY) particles in final states with one lepton, a Higgs boson decaying to a pair of bottom quarks, and large missing transverse momentum is presented. The search uses data from proton-proton collisions at a center-of-mass energy of 13 TeV collected using the CMS detector at the LHC, corresponding to an integrated luminosity of 137 fb−1. The observed yields are consistent with backgrounds expected from the standard model. The results are interpreted in the context of a simplified SUSY model of chargino-neutralino production, with the chargino decaying to a W boson and the lightest SUSY particle (LSP) and the neutralino decaying to a Higgs boson and the LSP. Charginos and neutralinos with masses up to 820 GeV are excluded at 95% confidence level when the LSP mass is small, and LSPs with mass up to 350 GeV are excluded when the masses of the chargino and neutralino are approximately 700 GeV. [Figure not available: see fulltext.]. © 2021, The Author(s)

Measurements of Higgs boson production cross sections and couplings in the diphoton decay channel at √s = 13 TeV

Measurements of Higgs boson production cross sections and couplings in events where the Higgs boson decays into a pair of photons are reported. Events are selected from a sample of proton-proton collisions at s = 13 TeV collected by the CMS detector at the LHC from 2016 to 2018, corresponding to an integrated luminosity of 137 fb−1. Analysis categories enriched in Higgs boson events produced via gluon fusion, vector boson fusion, vector boson associated production, and production associated with top quarks are constructed. The total Higgs boson signal strength, relative to the standard model (SM) prediction, is measured to be 1.12±0.09. Other properties of the Higgs boson are measured, including SM signal strength modifiers, production cross sections, and its couplings to other particles. These include the most precise measurements of gluon fusion and vector boson fusion Higgs boson production in several different kinematic regions, the first measurement of Higgs boson production in association with a top quark pair in five regions of the Higgs boson transverse momentum, and an upper limit on the rate of Higgs boson production in association with a single top quark. All results are found to be in agreement with the SM expectations. [Figure not available: see fulltext.] © 2021, The Author(s)