177 research outputs found

    Low-dose CT for lung cancer screening in a high-risk population (SUMMIT): a prospective, longitudinal cohort study

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    Background: Low-dose CT screening reduces lung cancer mortality. In advance of planned national lung cancer screening programmes, research is needed to inform policies regarding implementation. We aimed to assess the implementation of low-dose CT for lung cancer screening in a high-risk population and to validate a multicancer early detection blood test.// Methods: In this prospective, longitudinal cohort study, individuals aged 55–77 years recorded as current smokers in their primary care records at any point within the past 20 years were identified from 329 primary care practices in London (UK) and invited for a lung health check via postal letter. Individuals meeting the 2013 United States Preventive Services Taskforce criteria (current or former smokers within the past 15 years with at least 30 pack-year smoking histories) or having a Prostate, Lung, Colorectal and Ovarian 2012 model 6-year risk of 1·3% or greater, and not currently receiving treatment for an active cancer (except adjuvant hormonal therapy), were eligible for the study. These individuals underwent lung cancer screening via non-contrast, thin collimation low-dose CT. In this analysis, we report the results of the baseline round of low-dose CT screening. Key primary endpoints were those associated with examining the performance of a lung cancer screening service. Outcome measures were analysed on a per-participant level using descriptive frequencies. The study was registered with ClinicalTrials.gov, NCT03934866.// Findings: Between April 8, 2019, and May 14, 2021, 12 773 participants were recruited and analysed. 7353 (57·6%) of 12 773 participants were male and 5420 (42·4%) were female, and 10 665 (83·5%) participants were White. 261 (2·0%) of 12 773 participants were diagnosed with lung cancer (including 163 [1·3%] participants with screen-detected lung cancer and 98 [0·8%] with delayed screen-detected lung cancer [ie, after a 3-month or 6-month nodule follow-up CT]) and 276 (2·2%) participants were diagnosed with any intrathoracic malignancy after a positive baseline screen. 207 (79·3%) of 261 individuals with prevalent screen-detected lung cancer were diagnosed at stage I or II and surgical resection was the primary treatment modality in 201 (77·0%) of 261 individuals. Including cases where multiple resections were done in the same participant (eg, for synchronous primaries), 28 (11·6%) of 241 surgical resections were benign, and there was one (0·4%) death within 90 days of surgery. At 12 months, the episode sensitivity of our low-dose CT screening protocol for detecting lung cancer was 97·0% (95% CI 95·0–99·1; 261 of 269 participants). The specificity was 95·2% (94·8–95·6; 11 905 of 12 504 participants), with a false-positive rate of 4·8% (4·4–5·2).// Interpretation: Large-scale lung cancer screening is effective and can be delivered efficiently to an ethnically and socioeconomically diverse population. Funding GRAIL

    Who stays proactive after entrepreneurship training? Need for cognition, personal initiative maintenance, and well-being

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    Personal initiative training is a promising way to increase entrepreneurial personal initiative, which is a key behavior for successful entrepreneurship. Although personal initiative training has been shown to promote personal initiative, little is known about how this proactive behavior can be maintained over time and what the consequences are. The training transfer literature suggests that training effects usually decline with time. It is not clear, however, which factors contribute to personal initiative maintenance and which benefits go along with it. In a randomized controlled field experiment with 912 microentrepreneurs in Lomé, Togo, we investigate the influence of need for cognition—a cognitive factor driving proactive behavior—on personal initiative maintenance after training. In addition, we examine the effect of need for cognition on the well‐being consequences of personal initiative maintenance. We show that people high in need for cognition tend to maintain posttraining personal initiative longer than those low in need for cognition. However, contrary to our predictions, need for cognition has no effect on the level of well‐being that results from personal initiative maintenance. Our findings contribute to a better understanding of personal initiative and its maintenance and could be used to increase training effectiveness

    Petrophysical, Geochemical, and Hydrological Evidence for Extensive Fracture-Mediated Fluid and Heat Transport in the Alpine Fault's Hanging-Wall Damage Zone

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    International audienceFault rock assemblages reflect interaction between deformation, stress, temperature, fluid, and chemical regimes on distinct spatial and temporal scales at various positions in the crust. Here we interpret measurements made in the hanging‐wall of the Alpine Fault during the second stage of the Deep Fault Drilling Project (DFDP‐2). We present observational evidence for extensive fracturing and high hanging‐wall hydraulic conductivity (∼10−9 to 10−7 m/s, corresponding to permeability of ∼10−16 to 10−14 m2) extending several hundred meters from the fault's principal slip zone. Mud losses, gas chemistry anomalies, and petrophysical data indicate that a subset of fractures intersected by the borehole are capable of transmitting fluid volumes of several cubic meters on time scales of hours. DFDP‐2 observations and other data suggest that this hydrogeologically active portion of the fault zone in the hanging‐wall is several kilometers wide in the uppermost crust. This finding is consistent with numerical models of earthquake rupture and off‐fault damage. We conclude that the mechanically and hydrogeologically active part of the Alpine Fault is a more dynamic and extensive feature than commonly described in models based on exhumed faults. We propose that the hydrogeologically active damage zone of the Alpine Fault and other large active faults in areas of high topographic relief can be subdivided into an inner zone in which damage is controlled principally by earthquake rupture processes and an outer zone in which damage reflects coseismic shaking, strain accumulation and release on interseismic timescales, and inherited fracturing related to exhumation

    The Manzanar “Riot”: An Ethnic Perspective

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    Connecting People and Place Prosperity: Workforce Development and Urban Planning in Scholarship and Practice

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    In recent years, the field of workforce development has emerged as a distinct area of policy and practice. While planning scholars have begun to engage with the workforce development field, its relevance and points of connection to planning scholarship remain underexplored. This article attempts to define the workforce development field by articulating its core concerns as well as its domains of practice and scholarship outside the planning field. The article locates workforce development within three stands of planning scholarship, concluding that workforce development represents an important bridge for planners between “place” and “people” prosperity within communities
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