Induced Superconducting Pairing in Integer Quantum Hall Edge States.

Indium arsenide (InAs) near surface quantum wells (QWs) are promising for the fabrication of semiconductor-superconductor heterostructures given that they allow for a strong hybridization between the two-dimensional states in the quantum well and the ones in the superconductor. In this work, we present results for InAs QWs in the quantum Hall regime placed in proximity of superconducting NbTiN. We observe a negative downstream resistance with a corresponding reduction of Hall (upstream) resistance, consistent with a very high Andreev conversion. We analyze the experimental data using the Landauer-Büttiker formalism, generalized to allow for Andreev reflection processes. We attribute the high efficiency of Andreev conversion in our devices to the large transparency of the InAs/NbTiN interface and the consequent strong hybridization of the QH edge modes with the states in the superconductor.

Psychological screening service for men newly admitted to an Italian prison: Preliminary clinical outcome analysis after 1 year of clinical activity.

BACKGROUND: Screening for mental disorders among prisoners is crucial for early detection and intervention of psychopathology and substance use disorders. In Italy, only a minority of prisons have implemented a structured screening process, and there is not yet a standard approach to this worldwide. AIMS: First, to describe a systematic psychological screening for early identification of mental disorder, including drug use disorders, and suicide risk among men on reception into one Italian prison, designed to inform management and, secondly, to describe mental health outcomes among those prisoners accepted into the in-reach mental health service as a result of the assessment. METHODS: All prisoners newly received in the Parma Penitentiary Institute at any time in 2020 were screened using the Jail Screening Assessment Tool. Those who screened positive for any mental disorder, including substance use disorders and suicide indicators, were asked to complete the Parma Scale for the treatment evaluation of offenders with psychiatric disorders (Pr-Scale), a locally developed tool that allows for the measurement of mental state change as well as changes in treatment and management. Scores on this scale soon after reception were compared with scores after 1 year of work with the in-reach team. RESULTS: Among 303 newly admitted male prisoners in 2020, 167 (55%) screened positive for substance use disorder and 30 (10%) for other primary mental disorders. Most of these (n = 151) were offered and accepted care by the mental health in-reach service. After 1 year, those who had been treated by this service showed significant improvement in all Pr-Scale clinical variables. CONCLUSIONS: Our findings support the extension of a psychological screening into a service for new receptions to Italian prisons. They add evidence for the utility of the Pr-Scale for detecting those newly admitted prisoners likely to benefit from early mental health interventions provided by in-reach services and for evidencing resultant change. Future studies are needed to replicate our results in other Italian prisons as a precursor to systems improvement, while other countries might also benefit from using similar evaluation and reevaluation routinely.

Vortex and Surface Phase Transitions in Superconducting Higher-order Topological Insulators.

Topological insulators, having intrinsic or proximity-coupled s-wave superconductivity, host Majorana zero modes (MZMs) at the ends of vortex lines. The MZMs survive up to a critical doping of the TI at which there is a vortex phase transition that eliminates the MZMs. In this work, we show that the phenomenology in higher-order topological insulators (HOTIs) can be qualitatively distinct. In particular, we find two distinct features. (i) We find that vortices placed on the gapped (side) surfaces of the HOTI, exhibit a pair of phase transitions as a function of doping. The first transition is a surface phase transition after which MZMs appear. The second transition is the well-known vortex phase transition. We find that the surface transition appears because of the competition between the superconducting gap and the local T-breaking gap on the surface. (ii) We present numerical evidence that shows strong variation of the critical doping for the vortex phase transition as the center of the vortex is moved toward or away from the hinges of the sample. We believe our work provides new phenomenology that can help identify HOTIs, as well as illustrating a promising platform for the realization of MZMs.

Electronic Structure-Dependent Surface Plasmon Resonance in Single Au-Fe Nanoalloys.

The relationship between composition and plasmonic properties in noble metal nanoalloys is still largely unexplored. Yet, nanoalloys of noble metals, such as gold, with transition elements, such as iron, have unique properties and a number of potential applications, ranging from nanomedicine to magneto-plasmonics and plasmon-enhanced catalysis. Here, we investigate the localized surface plasmon resonance at the level of the single Au-Fe nanoparticle by applying a strategy that combines experimental measurements using near field electron energy loss spectroscopy with theoretical studies via a full wave numerical analysis and density functional theory calculations of electronic structure. We show that, as the iron fraction increases, the plasmon resonance is blue-shifted and significantly damped, as a consequence of the changes in the electronic band structure of the alloy. This allows the identification of three relevant phenomena to be considered in the design and realization of any plasmonic nanoalloy, specifically: the appearance of new states around the Fermi level; the change in the free electron density of the metal; and the blue shift of interband transitions. Overall, this study provides new opportunities for the control of the optical response in Au-Fe and other plasmonic nanoalloys, which are useful for the realization of magneto-plasmonic devices for molecular sensing, thermo-plasmonics, bioimaging, photocatalysis, and the amplification of spectroscopic signals by local field enhancement.

Geometric and Conventional Contribution to the Superfluid Weight in Twisted Bilayer Graphene.

By tuning the angle between graphene layers to specific "magic angles" the lowest energy bands of twisted bilayer graphene (TBLG) can be made flat. The flat nature of the bands favors the formation of collective ground states and, in particular, TBLG has been shown to support superconductivity. When the energy bands participating in the superconductivity are well isolated, the superfluid weight scales inversely with the effective mass of such bands. For flat band systems one would therefore conclude that even if superconducting pairing is present, most of the signatures of the superconducting state should be absent. This conclusion is at odds with the experimental observations for TBLG. We calculate the superfluid weight for TBLG taking into account both the conventional contribution and the contribution arising from the quantum geometry of the bands. We find that both contributions are larger than one would expect treating the bands as well isolated, that at the magic angle the geometric contribution is larger than the conventional one, and that for small deviations away from the magic angle the conventional contribution is larger than the geometric one. Our results show that, despite the flatness of the bands the superfluid weight in TBLG is finite and consistent with experimental observations. We also show how the superfluid weight can be tuned by varying the chemical potential and the twist angle opening the possibility to tune the nature of the superconducting transition between the standard BCS transition and the Berezinskii-Kosterlitz-Thouless transition.

Local, global, and nonlinear screening in twisted double-layer graphene.

One-atom-thick crystalline layers and their vertical heterostructures carry the promise of designer electronic materials that are unattainable by standard growth techniques. To realize their potential it is necessary to isolate them from environmental disturbances, in particular those introduced by the substrate. However, finding and characterizing suitable substrates, and minimizing the random potential fluctuations they introduce, has been a persistent challenge in this emerging field. Here we show that Landau-level (LL) spectroscopy offers the unique capability to quantify both the reduction of the quasiparticles' lifetime and the long-range inhomogeneity due to random potential fluctuations. Harnessing this technique together with direct scanning tunneling microscopy and numerical simulations we demonstrate that the insertion of a graphene buffer layer with a large twist angle is a very effective method to shield a 2D system from substrate interference that has the additional desirable property of preserving the electronic structure of the system under study. We further show that owing to its remarkable nonlinear screening capability a single graphene buffer layer provides better shielding than either increasing the distance to the substrate or doubling the carrier density and reduces the amplitude of the potential fluctuations in graphene to values even lower than the ones in AB-stacked bilayer graphene.

Pseudoporphyria following self-medication with chlorophyll.

Two cases of pseudoporphyria are described in which the clinical features of porphyria cutanea tarda occurred in the absence of abnormalities in porphyrin metabolism. Both patients presented with skin fragility and bullae on the dorsal aspect of the hands. The patients consumed a commercial liquid chlorophyll drink in which we detected fluorescent compounds with characteristics typical of previously described chlorophyll derived photosensitisers.

Factors that affect serum levels of ferritin in Australian adults and implications for follow-up.

BACKGROUND & AIMS: Serum levels of ferritin are commonly measured to assess iron stores but are affected by factors such as obesity and chronic disease. Published reference ranges have not changed in decades, and the number of patients whose levels exceed the upper limits has been increasing. As a result, more patients are evaluated for iron overload. METHODS: We compared serum levels of ferritin in 1188 Australian adults who participated in the 2005 Busselton Population Survey with levels from the 1995 survey. Parametric regression was used to assess the effects of body weight and biochemical parameters on serum level of ferritin to derive contemporary population-appropriate reference ranges. RESULTS: In 2005, age-adjusted levels of ferritin were 21% higher in men (P < .0001) and 10% higher in women (P = .01) than in 1995; 31% of men exceeded levels of 300 µg/L, compared with 23% in 1995. Body mass index (BMI) ≥25 kg/m(2) was associated with higher levels of ferritin in men ≥35 years old and in postmenopausal women (P ≤ .002). Serum level of γ-glutamyltransferase (GGT) correlated with serum level of ferritin (P < .0001). In men, the estimated 95th percentiles ranged from 353 to 495 µg/L (<35 years), from 350 to 511 µg/L (≥35 years, BMI <25 kg/m(2)), and from 413 to 696 µg/L (≥35 years, BMI ≥25 kg/m(2)) when GGT levels were 10-75 IU/L. In women, the 95th percentiles ranged from 106 to 235 µg/L (premenopausal), from 222 to 323 µg/L (postmenopausal, BMI <25 kg/m(2)), and from 249 to 422 µg/L (postmenopausal, BMI ≥25 kg/m(2)) when GGT levels were 8-45 IU/L. CONCLUSION: Serum levels of ferritin increased significantly between 1995 and 2005. Reference ranges that accommodate demographic and biomedical variations will assist clinicians in identifying individuals who require further evaluation for iron overload.

Prediction of morbidity and mortality in patients with chronic hepatitis C by non-invasive liver fibrosis models.

BACKGROUND & AIMS: Liver fibrosis is prognostic of outcomes among patients with chronic hepatitis C (CHC). We evaluated the accuracy of non-invasive markers and liver biopsy in predicting morbidity and mortality in CHC patients. METHODS: Compensated CHC patients were evaluated over a 10-year period. Non-invasive markers including Hepascore, FIB-4, APRI and liver biopsy results were retrospectively collated. Follow-up morbidity and mortality data were obtained from the Western Australian Data Linkage System. The prognostic significance of baseline non-invasive markers and biopsy were assessed using Kaplan-Meier analysis. RESULTS: A total of 406 subjects (64% male, mean age 48 ± 11 years) were followed up for 2385 person-years, during which there were 22 (5.4%) deaths including 14 (3.4%) who died from liver disease or required liver transplantation. Sixteen (3.9%) subjects developed liver decompensation. Hepascore and liver biopsy (P < 0.005) but not APRI or FIB-4 were predictive of overall and liver-related mortality as well as liver decompensation. A Hepascore>0.5 was associated with increased overall mortality [Hazard Ratio (95%CI) 6.7 (2.6-17), P < 0.001], liver-related mortality [32.8 (4.3-250), P = 0.001] and risk of future decompensation [11.8 (3.3-41), P < 0.001], whereas a Hepascore ≤0.5 was associated with a 99% probability of not dying from liver-related causes over 10 years. Hepascore had comparable accuracy with liver biopsy in predicting liver-related mortality with AUROC of 0.86 (95%CI 0.80-0.90) and 0.87 (0.79-0.96), respectively. CONCLUSION: Hepascore is predictive of overall and liver-related mortality and morbidity in CHC patients with comparable accuracy to liver biopsy. Hepascore may be a useful prognostic marker in clinical practice.

Image analysis of liver collagen using sirius red is more accurate and correlates better with serum fibrosis markers than trichrome.

BACKGROUND: Collagen proportional area (CPA) determined by quantitative digital image analysis better quantifies liver fibrosis than histological stage; however, its clinical use has been limited by non-standardized methods. AIM: This study aimed to compare CPA obtained using different staining methods, magnifications and biopsy sizes. METHODS: Two hundred and forty-nine patients with chronic hepatitis C who had a liver biopsy and serum fibrosis markers performed were included. CPA was measured either using a sirius red (CPAs) or a trichrome (CPAt) stain. RESULTS: CPAs measured at 20× and 40× magnifications generated similar outcomes with interclass correlation (ICC) coefficient of 0.98. Compared with trichrome, sirius red staining had much less variation with an ICC coefficient of 0.99 for slides stained in the same batch and 0.92 in different batches. Mean CPAs was higher than mean CPAt by 3.53%, P < 0.001. Morphological analysis found that sirius red detected delicate fibrous septa and spurs better than trichrome. Both CPAs and CPAt correlated well with Metavir stage, whereas CPAs had better ability to detect cirrhosis with the area under ROC curve of 0.95. Overall CPA had superior correlation with serum markers of fibrosis in Metavir F2-F4 than that in F0-F1 and CPAs correlated better with serum fibrosis markers than CPAt in Metavir F0-F1. Multivairate analysis found that HA, α2-macroglobulin, platelet count and albumin were independently correlated with CPAs and only HA was independently correlated with CPAt. CONCLUSIONS: Sirius red staining for CPA determination was more accurate and reliable for quantifying hepatic collagen compared with trichrome staining.

High biological variation of serum hyaluronic acid and Hepascore, a biochemical marker model for the prediction of liver fibrosis.

BACKGROUND: Serum hyaluronic acid and biochemical models which require hyaluronic acid analysis are commonly used as predictors of liver fibrosis in patients with chronic liver disease, however biological variation data for hyaluronic acid are deficient. METHODS: Four serial serum samples were obtained at weekly intervals from healthy volunteers and patients with chronic hepatitis B, chronic hepatitis C and non- alcoholic fatty liver disease (NAFLD; 20 in each group). The within-individual week-to-week variation (CVI) and reference change values for hyaluronic acid, α2-macroglobulin and Hepascore were obtained. Hepascore is calculated from hyaluronic acid, α2-macroglobulin, bilirubin and γ-glutamyltransferase activity. RESULTS: Hyaluronic acid displayed large within-individual variation, the CVI values were 62% in healthy subjects, 38% in hepatitis C, 37% in hepatitis B and 36% in NAFLD patients. Hepascore CVIs were 43% in healthy subjects, 24% in hepatitis C, 28% in hepatitis B and 39% in NAFLD patients. α2-Macroglobulin was much less variable with CVIs ranging from 4.4% to 7.6%. Bland-Altman plots of week-to-week variations showed rates of significant disagreement for samples collected in any 2 successive weeks varied from 5% in NAFLD patients to 8.3% in healthy subjects. CONCLUSIONS: When using non-fasting serum samples, hyaluronic acid and to a lesser extent, the Hepascore model display large within-individual variations in both health and chronic liver disease. This information is critical for interpreting the significance of both single measurements and changes in serial measurements.

Leukocytoclastic vasculitis masking chronic vascular changes in previously undiagnosed erythropoietic protoporphyria.

A 31-year old man presented with swelling and purpura of the dorsum of the hands following sun exposure. There was a preceding lifelong history of photosensitivity, but this episode, which occurred after the recent commencement of oral iron therapy, and after recent alcohol ingestion, was much more severe than any preceding episode. Skin biopsy performed 48 h after the onset of symptoms showed features consistent with the early stages of leukocytoclastic vasculitis. Direct immunofluorescence showed homogeneous thick staining of the vessel walls with IgG, IgM and IgA, together with abundant perivascular fibrinogen. A subsequent periodic acid-Schiff (PAS) stain on the skin biopsy revealed thickening of the walls of dermal vessels, which was not discernible in routinely stained (hematoxylin/eosin) sections. The diagnosis of erythropoietic protoporphyria (EPP) was confirmed by significantly elevated erythrocyte protoporphyrin levels and positive plasma fluorimetry. The diagnosis of porphyria may have been missed by routine skin microscopy if not for the additional information provided by clinical history, direct immunofluorescence and PAS stain. The pathogenesis and histopathology of acute and chronic vascular changes in EPP are reviewed.

Evolution of 4π-Periodic Supercurrent in the Presence of an In-Plane Magnetic Field.

In the presence of a 4π-periodic contribution to the current phase relation, for example in topological Josephson junctions, odd Shapiro steps are expected to be missing. While missing odd Shapiro steps have been observed in several material systems and interpreted in the context of topological superconductivity, they have also been observed in topologically trivial junctions. Here, we study the evolution of such trivial missing odd Shapiro steps in Al-InAs junctions in the presence of an in-plane magnetic field Bθ. We find that the odd steps reappear at a crossover Bθ value, exhibiting an in-plane field angle anisotropy that depends on spin-orbit coupling effects. We interpret this behavior by theoretically analyzing the Andreev bound state spectrum and the transitions induced by the nonadiabatic dynamics of the junction and attribute the observed anisotropy to mode-to-mode coupling. Our results highlight the complex phenomenology of missing Shapiro steps and the underlying current phase relations in planar Josephson junctions designed to realize Majorana states.

Effects of Lavender Essential Oil Inhalation on the Welfare and Meat Quality of Fattening Heavy Pigs Intended for Parma Ham Production.

We assessed the effects of inhalation administration of lavender essential oil (LEO) either once (L1) or twice (L2) a day on animal welfare indicators, carcass and meat quality of Italian heavy pigs. Pigs (n = 108) were allotted to three experimental groups (control -C-, L1 and L2) and lavender was administered, via a vaporizer device, to the treated groups during the entire fattening-finishing period (79-160 kg BW). Tail lesion severity was reduced in L1 at the end of the trial compared to the other groups (p < 0.05). Body lesion counts, however, were higher in L2 than in C (p < 0.05), resulting in a more severe overall damage classification (p < 0.01). At slaughter, no differences were observed in carcass traits or blood stress indicators, only minor differences were observed in meat quality, and no LEO residual was found in fat or lean tissues, highlighting the preserved suitability of thighs for the dry curing process. While it was not possible to conclude on the ability to improve animal welfare of vaporized LEO in this production phase, the absence of adverse effects on meat quality and the discrepancies observed regarding the body lesions in L1 and L2 make further studies on behavioral aspects and the method of administration (route, frequency) of the product desirable.

A Remote Control System for Emergency Ventilators During SARS-CoV-2.

As COVID-19 began to grip healthcare systems worldwide, worst-case models predicted huge demands for ventilators. The global community sprang to action, producing a large number of emergency "makeshift" ventilator designs. This brought about another problem: a gap between the quantity of new mechanical ventilators and the number of skilled physicians to operate them. New physicians could not complete training at the pace of ventilator production, which threatened to leave patients sitting untreated, next to unusable ventilators. To address this challenge, we developed a universal remote control system for makeshift ventilators that uses low-cost hardware add-on modules to connect to different ventilators, and a three-tier control architecture to interface the ventilators with telemedicine software. We demonstrate system integration with two representative ventilator designs, adding a remote control option that allows caregivers to quickly and easily monitor and control these ventilators remotely.

Complex non-invasive fibrosis models are more accurate than simple models in non-alcoholic fatty liver disease.

BACKGROUND AND AIM: Significant hepatic fibrosis is prognostic of liver morbidity and mortality in non-alcoholic fatty liver disease (NAFLD); however, it remains unclear whether non-invasive fibrosis models can determine this end-point. We therefore compared the accuracy of simple bedside versus complex fibrosis models across a range of fibrosis in a multi-centre NAFLD cohort. METHODS: Simple (APRI, BARD) and complex (Hepascore, Fibrotest, FIB4) fibrosis models were calculated in 242 NAFLD subjects undergoing liver biopsy. Significant (F2-4) and advanced fibrosis (F3,4) were defined using Kleiner criteria. Models were compared using area under the receiver operator characteristic curves (AUC). Cut-offs were determined by Youden Index or 90% predictive values. RESULTS: For significant fibrosis, non-invasive fibrosis models had modest accuracy (AUC 0.707-0.743) with BARD being least accurate (AUC 0.609, P < 0.05 vs others). Using single cut-offs, sensitivities and predictive values were < 80%; using two cut-offs, > 75% of subjects fell within indeterminate ranges. Simple models had significantly more subjects within indeterminate ranges than complex models (99.1-100% vs 82.1-84.4% respectively, P < 0.05 for all). For advanced fibrosis, complex models were more accurate than BARD (AUC 0.802-0.858 vs 0.701, P < 0.05). Using two cut-offs, complex models had fewer individuals within indeterminate ranges than BARD (11.1-32.3% vs 70.7%, P < 0.01 for all). For cirrhosis, complex models had higher AUC values than simple models. CONCLUSIONS: In NAFLD subjects, non-invasive models have modest accuracy for determining significant fibrosis and have predictive values less than 90% in the majority of subjects. Complex models are more accurate than simple bedside models across a range of fibrosis.

Missing Shapiro steps in topologically trivial Josephson junction on InAs quantum well.

Josephson junctions hosting Majorana fermions have been predicted to exhibit a 4π periodic current phase relation. One experimental consequence of this periodicity is the disappearance of odd steps in Shapiro steps experiments. Experimentally, missing odd Shapiro steps have been observed in a number of materials systems with strong spin-orbit coupling and have been interpreted in the context of topological superconductivity. Here we report on missing odd steps in topologically trivial Josephson junctions fabricated on InAs quantum wells. We ascribe our observations to the high transparency of our junctions allowing Landau-Zener transitions. The probability of these processes is shown to be independent of the drive frequency. We analyze our results using a bi-modal transparency distribution which demonstrates that only few modes carrying 4π periodic current are sufficient to describe the disappearance of odd steps. Our findings highlight the elaborate circumstances that have to be considered in the investigation of the 4π Josephson junctions in relationship to topological superconductivity.

The Parma integrated model for intervention on pathological addictions in an Italian prison: process description and preliminary findings.

Background - Interventions for inmates with Pathological Addiction (PA) still remain a problematic issue in Italian prisons, despite a 1999 major government reform transferring PA care in prison to the National Health Service. Aim of this research was to describe the integrated intervention model implemented for prisoners with PA in the Parma Penitentiary Institutes from January 2020 to June 2020. This specific approach is based on "person-tailored" therapeutic-rehabilitation programs in line with local community PA services. Methods - All the procedures were first carefully illustrated, especially the service for newly admitted inmates and the specialized rehabilitation treatments provided. A process analysis on the first six months of clinical activity was then performed. Results - Since January 2020, 178 subjects entered the service for newly admitted inmates: 55 (30.9%) were taken in charge for a PA. Conclusions - Our results support the feasibility of an integrated intervention model for PA in Italian prisons, based on specialized psychiatric treatments planned and provided in collaboration with inmates and their community health and social services.

Mental health interventions in an Italian prison: the Parma integrated approach.

PURPOSE: Mental health interventions for Italian prisoners with mental disorders remain a problematic issue, despite radical changes in general psychiatric care and a 2008 major government reform transferring mental health care in prison to the National Health Service. The aim of this study is to describe the mental health intervention model implemented since January 2020 for prisoners allocated in the Parma Penitentiary Institutes (PPI). This approach is specifically based on specialized, "person-centered" and "person-tailored" therapeutic-rehabilitation plans in line with psychiatric treatments usually provided in community mental health-care centers of the Parma Department of Mental Health. DESIGN/METHODOLOGY/APPROACH: All the processes and procedures included in the PPI intervention model were first carefully illustrated, paying special attention to the service for newly admitted prisoners and each typology of specialized therapeutic-rehabilitation treatment potentially provided. Additionally, a preliminary descriptive process analysis of the first six months of clinical activity was also performed. FINDINGS: Since January 2020, 178 individuals entered the PPI service for newly admitted prisoners. In total, 83 (46.7%) of them were engaged in the services of the PPI mental health-care team (35 with pathological addiction and 48 with mental disorders): 56 prisoners were offered an integrated mental health intervention and 27 exclusively an individual psychological or psychiatric treatment. ORIGINALITY/VALUE: The results support the potential applicability of an integrated mental health intervention in prison, planning a person-tailored rehabilitation in close collaboration with the prisoners, their families and the local mental health/social services.

Comparison of cystatin C and creatinine as predictors of cardiovascular events in a community-based elderly population.

BACKGROUND: Reduced renal function is an established risk factor for cardiovascular events. We compared 3 measures of renal function--serum cystatin C, serum creatinine, and calculated creatinine clearance--as predictors of subsequent cardiovascular events in a community-based population of elderly individuals. METHODS: Comprehensive cardiovascular risk factor data were available for 1410 surviving participants of previous Busselton health surveys who were >or=60 years old. Hazard ratios for risk of incident coronary heart disease and cardiovascular disease over 10 years of follow-up were derived for each baseline measure of renal function by use of Cox regression. RESULTS: All measures of renal function were significantly related to risks of morbidity and mortality from coronary heart disease and cardiovascular disease. There were 453 incident cardiovascular disease events; and the age- and sex-adjusted hazard ratios (95% CIs) were 1.34 (1.23-1.46), 1.32 (1.20-1.45), and 1.22 (1.06-1.41) per 1-SD deterioration in cystatin C, creatinine, and creatinine clearance, respectively. All 3 measures gave approximately the same age-adjusted relative risk estimates. After further adjustment for established cardiovascular risk factors, the relative risk estimates were all reduced but remained statistically significant (P < 0.05). Cystatin C was not a significant predictor for cardiovascular disease after adjustment for creatinine clearance. CONCLUSIONS: In relation to predicting risk for coronary heart disease or cardiovascular disease over a 10-year follow-up in a community-based population of elderly subjects, there was no evidence that cystatin C was a better risk predictor than creatinine or creatinine clearance.