Semaglutide (SUSTAIN and PIONEER) reduces cardiovascular events in type 2 diabetes across varying cardiovascular risk

The inside front cover image is based on the Original Article Semaglutide (SUSTAIN and PIONEER) reduces cardiovascular events in type 2 diabetes across varying cardiovascular risk by Mansoor Husain, ILDIKO LINGVAY, Marianne Treppendahl et al., https://doi.org/10.1111/dom.13955 .

     

Long-term risk of colorectal cancer after screen-detected adenoma: Experiences from a Danish gFOBT-positive screening cohort

Fecal occult blood test (FOBT) screening for colorectal cancer (CRC) is implemented in several countries. Approximately half of all FOBT-positive persons have screen-detected adenomas. Despite removal of these, patients with large/multiple adenomas have increased risk of later developing new advanced adenomas and CRC. International guidelines exist for colonoscopic surveillance following adenoma removal. These divide patients into low-, intermediate- and high-risk groups. We followed 711 FOBT-positive patients with screening adenoma identified during population-based CRC screening in two Danish counties in 2005–2006. As reference population, we included 1,240,348 persons in the same age group from the rest of Denmark not included in the screening. We estimated the long-term CRC risk stratified by adenoma findings during screening and compared to the reference group. After 12 years follow-up, the CRC incidence among all adenoma patients was 322 cases per 100,000 person-years (95% confidence interval [CI]: 212–489) ranging from 251 (95% CI: 94–671) to 542 (95% CI: 300–978) cases per 100,000 person-years in the low- and high-risk groups, respectively. In the reference population, the CRC incidence was 244 (95% CI: 242–247) per 100,000. Patients with screen-detected high-risk adenomas after a positive FOBT had an almost doubled risk of CRC compared to the reference population (adjusted hazard ratio [aHR] 1.95, 95% CI: 1.08–3.51), and the incidence in those with no follow-up visits was over 3.6 (aHR 3.64, 95% CI: 1.82–7.29) times the incidence in the reference population. The increased CRC risk could be controlled if high-risk patients underwent follow-up colonoscopy (aHR 0.87, 95% CI: 0.28–2.69).     

Intravascular iliac artery lithotripsy to enable transfemoral thoracic endovascular aortic repair

Thoracic endovascular aortic repair (TEVAR) is performed with large‐bore delivery systems. Small‐size access vessels may be a contraindication for TEVAR, particularly in case of severe calcifications. In this case report, we describe the first‐in‐man use of intravascular lithotripsy to enable transfemoral delivery of TEVAR stent grafts in a patient with severely calcified iliac arteries. A 69‐year‐old female with multiple sclerosis and thoracic aortic aneurysm (TAA) was referred for percutaneous TEVAR. Both common iliac arteries were severely calcified with circumferential calcifications and a minimum diameter below 5.5 mm. In order to enable percutaneous delivery of 20 French Valiant Navion stent grafts (Medtronic), the circumferential calcified plaques were treated by use of a Shockwave? Peripheral Intravascular Lithotripsy Balloon (Shockwave Medical Inc.). Subsequently, the aortic stent grafts were safely and successfully passed through the iliofemoral artery and the TAA was excluded by TEVAR. Final angiography showed normal flow in the iliofemoral artery without any signs of perforation or overt dissection. This case report demonstrates successful application of intravascular lithotripsy in calcified iliofemoral arteries enabling percutaneous transfemoral TEVAR. If confirmed in future cases and trials, indications for transfemoral TEVAR may further expand toward patients with severely calcified peripheral arterial disease.     

Rapid invisible frequency tagging reveals nonlinear integration of auditory and visual information

During communication in real‐life settings, the brain integrates information from auditory and visual modalities to form a unified percept of our environment. In the current magnetoencephalography (MEG) study, we used rapid invisible frequency tagging (RIFT) to generate steady‐state evoked fields and investigated the integration of audiovisual information in a semantic context. We presented participants with videos of an actress uttering action verbs (auditory; tagged at 61 Hz) accompanied by a gesture (visual; tagged at 68 Hz, using a projector with a 1,440 Hz refresh rate). Integration difficulty was manipulated by lower‐order auditory factors (clear/degraded speech) and higher‐order visual factors (congruent/incongruent gesture). We identified MEG spectral peaks at the individual (61/68 Hz) tagging frequencies. We furthermore observed a peak at the intermodulation frequency of the auditory and visually tagged signals (f_visual − f_auditory = 7 Hz), specifically when lower‐order integration was easiest because signal quality was optimal. This intermodulation peak is a signature of nonlinear audiovisual integration, and was strongest in left inferior frontal gyrus and left temporal regions; areas known to be involved in speech‐gesture integration. The enhanced power at the intermodulation frequency thus reflects the ease of lower‐order audiovisual integration and demonstrates that speech‐gesture information interacts in higher‐order language areas. Furthermore, we provide a proof‐of‐principle of the use of RIFT to study the integration of audiovisual stimuli, in relation to, for instance, semantic context.     

Mandibular premolar differentiation

The authors present a method for differentiating between human mandibular premolars: P1 inf and P2 inf. The material with which the method was developed consisted of 260 stone casts. On these, both premolars were present and were intact on at least one side. The study models represented 131 girls and 129 boys, mean age 14.6 yr. In a comprehensive pilot project, a whole range of macromorphologic criteria was tested that, in various combinations, could be expected to be usable for differentiation between P1 inf and P2 inf. On the basis of the pilot study, the total variation was reduced to four criteria-combinations, called types, which, in summary, can be characterized as the following: type 1: flattening of the mesiolingual part of the crown, no lingual lobe; type 2: at least one lingual lobe; type 3: lingual part of the crown symmetrically curved, no lingual lobe; type 4: other characteristics. After definition of the types, their occurrence on P1 inf and P2 inf was definitively registered. Observations were made with a stereomicroscope; 131 premolar pairs from the right side and 129 from the left were registered. Statistical tests showed that there was no significant difference in the distribution of types between variants from the right and left sides, or between girls and boys. These data were therefore pooled for P1 inf and P2 inf, respectively. A subsequent test revealed, as expected, a highly significant difference in the distribution of the four types among 1. and 2. premolar. For estimation of the degree of certainty when the types concerned were used for differentiation, 95% confidence limits were set up from the observed frequencies. Results of these statistical analyses can be described as follows: the probability that a mandibular premolar of type 1 was a 1. premolar was 0.96 (0.93–0.98), that a type 2 variant was a 2. premolar was 0.99 (0.96–1.00), that a type 3 variant was a 2. premolar was 0.79 (0.58–0.93), and that a type 4 variant was a 2. premolar was 0.92 (0.74–0.99). The target groups of this publication are clinical dentists, forensic odontologists, dental anthropologists, and dental morphologists.     

Levels of environmental pollutants in flounder (Platichthys flesus L.) and cod (Gadus morhua L.) caught in the waterway of Glomma,Norway. II. Mercury and arsenic

The present study is a survey on mercury and arsenic pollution in two sedentary fish species stationed in or close to the Glomma estuary in the Hvaler archipelago, Norway. Mercury and arsenic were determined individually in 80 flounder (Platichthys flesus L.) and 100 cod (Gadus morhua L.). The fish were caught at five different localities near or in the relatively polluted Glomma estuary. There were significantly higher mercury and arsenic concentrations in fillets of flounder than in fillets of cod (wet weight), 0.15 vs. 0.08 mg/kg and 5.2 vs. 4.1 mg/kg, respectively. Seasonal variation in mercury concentration was only found in flounder, with a significantly higher level in spring than in autumn. A significant increase in mercury content with increasing age was found for both species. For cod, a significantly higher arsenic level was found on the outer stations as compared to the inner stations, while arsenic levels in flounder was less dependent on sampling site.