Targeted lung cancer screening selects individuals at high risk of cardiovascular disease.

BACKGROUND: Cardiovascular disease (CVD) is a major cause of morbidity and mortality in populations eligible for lung cancer screening. The aim of this study was to determine whether a brief CV risk assessment, delivered as part of a targeted community-based lung cancer screening programme, was effective in identifying individuals at high risk who might benefit from primary prevention. METHODS: The Manchester Lung Screening Pilot consisted of annual low dose CT (LDCT) over 2 screening rounds, targeted at individuals in deprived areas at high risk of lung cancer (age 55-74 and 6-year risk ≥1.51%, using PLCOM2012 risk model). All participants of the second screening round were eligible to take part in the study. Ten-year CV risk was estimated using QRISK2 in participants without CVD and compared to age (±5 years) and sex matched Health Survey for England (HSE) controls; high risk was defined as QRISK2 score ≥10%. Coronary artery calcification (CAC) was assessed on LDCT scans and compared to QRISK2 score. RESULTS: Seventy-seven percent (n=920/1,194) of screening attendees were included in the analysis; mean age 65.6 ± 5.4 and 50.4% female. QRISK2 and lung cancer risk (PLCOM2012) scores were correlated (r = 0.26, p < 0.001). Median QRISK2 score was 21.1% (IQR 14.9-29.6) in those without established CVD (77.6%, n = 714/920), double that of HSE controls (10.3%, IQR 6.6-16.2; n = 714) (p < 0.001). QRISK2 score was significantly higher in those with CAC (p < 0.001). Screening attendees were 10-fold more likely to be classified high risk (OR 10.2 [95% CI 7.3-14.0]). One third (33.7%, n = 310/920) of all study participants were high risk but not receiving statin therapy for primary CVD prevention. DISCUSSION: Opportunistic CVD risk assessment within a targeted lung cancer screening programme is feasible and is likely to identify a very large number of individuals suitable for primary prevention.

Reconciling conductance fluctuations and the scaling theory of localization.

We reconcile the phenomenon of mesoscopic conductance fluctuations with the single parameter scaling theory of the Anderson transition. We calculate three averages of the conductance distribution, exp(), , and 1/, where g is the conductance in units of e(2)/h and R = 1/g is the resistance, and demonstrate that these quantities obey single parameter scaling laws. We obtain consistent estimates of the critical exponent from the scaling of all these quantities.

Topology dependent quantities at the anderson transition

The boundary condition dependence of the critical behavior for the three dimensional Anderson transition is investigated. A strong dependence of the scaling function and the critical conductance distribution on the boundary conditions is found, while the critical disorder and critical exponent are found to be independent of the boundary conditions.

A model for the measurement of whole-body protein turnover incorporating a protein pool with lifetime kinetics.

The hypothesis is proposed that the body contains a pool of protein turning over by lifetime rather than traditional first-order kinetics. The basis of the hypothesis is the observation of a step in the labelling curve or urinary ammonia during constant infusion of [15N]glycine. A four pool model has been constructed with different values for the rate of uptake of tracer into the lifetime pool; the calculated curves of tracer concentration show a step quite similar to that observed experimentally. It is concluded that it is possible, from an experimental curve, to derive an approximate estimate of the relative flux to the lifetime protein pool. Some suggestions are proposed for the physiological nature of this pool.