Smoking Cessation After Lung Cancer Diagnosis and the Risk of Second Primary Lung Cancer: The Multiethnic Cohort Study

Background

Smoking cessation reduces lung cancer mortality. However, little is known about whether diagnosis of lung cancer impacts changes in smoking behaviors. Furthermore, the effects of smoking cessation on the risk of second primary lung cancer (SPLC) have not been established yet. This study aims to examine smoking behavior changes after initial primary lung cancer (IPLC) diagnosis and estimate the effect of smoking cessation on SPLC risk following IPLC diagnosis.

Methods

The study cohort consisted of 986 participants in the Multiethnic Cohort Study who were free of lung cancer and active smokers at baseline (1993-1996), provided 10-year follow-up smoking data (2003-2008), and were diagnosed with IPLC in 1993-2017. The primary outcome was a change in smoking status from “current” at baseline to “former” at 10-year follow-up (ie, smoking cessation), analyzed using logistic regression. The second outcome was SPLC incidence after smoking cessation, estimated using cause-specific Cox regression. All statistical tests were 2-sided.

Results

Among 986 current smokers at baseline, 51.1% reported smoking cessation at 10-year follow-up. The smoking cessation rate was statistically significantly higher (80.6%) for those diagnosed with IPLC between baseline and 10-year follow-up vs those without IPLC diagnosis (45.4%) during the 10-year period (adjusted odds ratio = 5.12, 95% confidence interval [CI] = 3.38 to 7.98; P < .001). Incidence of SPLC was statistically significantly lower among the 504 participants who reported smoking cessation at follow-up compared with those without smoking cessation (adjusted hazard ratio = 0.31, 95% CI = 0.14 to 0.67; P = .003).

Conclusion

Lung cancer diagnosis has a statistically significant impact on smoking cessation. Quitting smoking after IPLC diagnosis may reduce the risk of developing a subsequent malignancy in the lungs.

Trends in the Performance of the Korean National Cancer Screening Program for Gastric Cancer from 2007 to 2016

Purpose

The Korean National Cancer Screening Program (KNCSP) has implemented two screening methods for gastric cancer— upper gastrointestinal series (UGIS) and endoscopy—for Koreans aged ≥ 40 years. We aimed to assess performance trends for both screening methods.

Materials and Methods

The KNCSP database was used to evaluate individuals who underwent screening from 2007 to 2016. The final gastric cancer diagnosis was ascertained by linking with the Korean Central Cancer Registry. We conducted a prospective, cross-sectional analysis to estimate performance indicators of gastric cancer screening by UGIS and endoscopy, stratified by sociodemographic factors.

Results

We found that screening rates for gastric cancer increased from 28% to 51.7% between 2007 and 2016, and that the rate of endoscopy use for gastric cancer screening increased sharply. Cancer detection rates (CDR) of UGIS and endoscopy were 0.41 and 2.25 per 1,000 screens in 2007–2008 and 0.26 and 1.99 in 2015–2016, respectively. Interval cancer rates (ICR) per 1,000 negative screenings were 1.33 (2007–2008) and 1.21 (2015–2016) for UGIS and 1.14 (2007–2008) and 0.88 (2015–2016) for endoscopy. The sensitivity of UGIS decreased from 23.6% (2007–2008) to 17.6% (2015–2016), whereas that of endoscopy increased from 66.4% (2007–2008) to 69.3% (2015–2016). Specificity was maintained at > 99% for both methods over the study period.

Conclusion

The use of endoscopy for gastric cancer screening within the KNCSP has increased. Endoscopy has higher CDR, sensitivity, and specificity, and lower ICR estimates than does UGIS.

Ultrafast H2-selective nanoporous multilayer graphene membrane prepared by confined thermal annealing

H₂ selective dense pores are generated in a graphene oxide (GO) layer by thermal-decomposition of oxygen-functional groups under high pressure. The nanoporous GO membrane shows H₂/CO₂ selectivity of 12.1 and H₂ permeability of 10360 Barrer.

Development and Validation of a Risk Prediction Tool for Second Primary Lung Cancer

Background

With advancing therapeutics, lung cancer (LC) survivors are rapidly increasing in number. Although mounting evidence suggests LC survivors have high risk of second primary lung cancer (SPLC), there is no validated prediction model available for clinical use to identify high-risk LC survivors for SPLC.

Methods

Using data from 6325 ever-smokers in the Multiethnic Cohort (MEC) study diagnosed with initial primary lung cancer (IPLC) in 1993-2017, we developed a prediction model for 10-year SPLC risk after IPLC diagnosis using cause-specific Cox regression. We evaluated the model’s clinical utility using decision curve analysis and externally validated it using 2 population-based data—Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) and National Lung Screening Trial (NLST)—that included 2963 and 2844 IPLC (101 and 93 SPLC cases), respectively.

Results

Over 14 063 person-years, 145 (2.3%) ever-smoking IPLC patients developed SPLC in MEC. Our prediction model demonstrated a high predictive accuracy (Brier score = 2.9, 95% confidence interval [CI] = 2.4 to 3.3) and discrimination (area under the receiver operating characteristics [AUC] = 81.9%, 95% CI = 78.2% to 85.5%) based on bootstrap validation in MEC. Stratification by the estimated risk quartiles showed that the observed SPLC incidence was statistically significantly higher in the 4th vs 1st quartile (9.5% vs 0.2%; P < .001). Decision curve analysis indicated that in a wide range of 10-year risk thresholds from 1% to 20%, the model yielded a larger net-benefit vs hypothetical all-screening or no-screening scenarios. External validation using PLCO and NLST showed an AUC of 78.8% (95% CI = 74.6% to 82.9%) and 72.7% (95% CI = 67.7% to 77.7%), respectively.

Conclusions

We developed and validated a SPLC prediction model based on large population-based cohorts. The proposed prediction model can help identify high-risk LC patients for SPLC and can be incorporated into clinical decision making for SPLC surveillance and screening.

Effectiveness of the Korean National Cancer Screening Program in reducing breast cancer mortality

High incidences of breast cancer (BC) are reported in Asian women in their forties, and it is not clear whether mammographic screening reduces mortality among them. This study evaluated the effect of BC screening on mortality in Korea. We conducted a nationwide prospective cohort study of women invited to the Korean National Cancer Screening Program (KNCSP) between 2002 and 2003 (N = 8,300,682), with data linkage to the Korea Central Cancer Registry and death certificates through 2014 and 2015, respectively. Exposure to mammographic screening was defined using a modified never/ever approach. The primary study outcome was adjusted mortality rate ratio (MRR) for BC among screened and non-screened women estimated by Poisson regression. An adjusted MRR for all cause-death other than BC was examined to account for selection bias in the cohort. BC incidence rates for screened and non-screened women were 84.41 and 82.88 per 100,000 women-years, respectively. BC mortality rates for screened and non-screened women were 5.81 and 13.43 per 100,000 women-years, respectively, with an adjusted MRR for BC of 0.43 (95% CI, 0.41-0.44). The adjusted MRR for all-cause death excluding BC was 0.52 (95% CI, 0.52-0.52). The greatest reduction in BC mortality was noted for women aged 45-54 years, and there was no observable reduction in mortality after the age of 70 years. In conclusion, the KNCSP has been effective in reducing BC mortality among Korean women aged 40-69 years.

Tobacco Smoking and Risk of Second Primary Lung Cancer

INTRODUCTION

Lung cancer survivors are at high risk of developing a second primary lung cancer (SPLC). However, SPLC risk factors have not been established and the impact of tobacco smoking remains controversial. We examined the risk factors for SPLC across multiple epidemiologic cohorts and evaluated the impact of smoking cessation on reducing SPLC risk.

METHODS

We analyzed data from 7059 participants in the Multiethnic Cohort (MEC) diagnosed with an initial primary lung cancer (IPLC) between 1993 and 2017. Cause-specific proportional hazards models estimated SPLC risk. We conducted validation studies using the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (N = 3423 IPLC cases) and European Prospective Investigation into Cancer and Nutrition (N = 4731 IPLC cases) cohorts and pooled the SPLC risk estimates using random effects meta-analysis.

RESULTS

Overall, 163 MEC cases (2.3%) developed SPLC. Smoking pack-years (hazard ratio [HR] = 1.18 per 10 pack-years, p < 0.001) and smoking intensity (HR = 1.30 per 10 cigarettes per day, p < 0.001) were significantly associated with increased SPLC risk. Individuals who met the 2013 U.S. Preventive Services Task Force's screening criteria at IPLC diagnosis also had an increased SPLC risk (HR = 1.92; p < 0.001). Validation studies with the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial and European Prospective Investigation into Cancer and Nutrition revealed consistent results. Meta-analysis yielded pooled HRs of 1.16 per 10 pack-years (pmeta < 0.001), 1.25 per 10 cigarettes per day (pmeta < 0.001), and 1.99 (pmeta < 0.001) for meeting the U.S. Preventive Services Task Force's criteria. In MEC, smoking cessation after IPLC diagnosis was associated with an 83% reduction in SPLC risk (HR = 0.17; p < 0.001).

CONCLUSIONS

Tobacco smoking is a risk factor for SPLC. Smoking cessation may reduce the risk of SPLC. Additional strategies for SPLC surveillance and screening are warranted.

Large-Area Ti3C2Tx-MXene Coating: Toward Industrial-Scale Fabrication and Molecular Separation

Large-scale fabrication of MXene films is in high demand for various applications, but it remains difficult to meet industrial requirements. In this study, we develop a slot-die coating method for the preparation of large-area MXene membranes. The technique allows the fabrication of continuous and scalable coatings with a rapid coating speed of 6 mm s^-1. The thickness can be readily controlled from the nanometer scale to the micrometer scale, and the alignment of the nanosheet is enhanced by the shear force of the slot-die head. Molecular separation experiments employing a film with a thickness of approximately 100 nm are performed. A nanofiltration performance with water permeance of 190 LMH/bar and molecular weight cutoff of 269 Da is achieved, surpassing previously reported results obtained using MXene-based nanofiltration membranes. The stability of the membrane is highlighted by its nanofiltration performance of 30 days under harsh oxidizing conditions, which is the longest operation ever achieved for a 2D material-based membrane. The extraordinary stability of the film suggests its high potential for industrial and practical applications. The antioxidizing phenomena can be attributed to self-protection of the MXene surface by adsorbed organic molecules, which are particularly stabilized with positively charged molecules via chemisorption.

Diamine vapor treatment of viscoelastic graphene oxide liquid crystal for gas barrier coating

A layered graphene oxide/ethylenediamine (GO/EDA) composite film was developed by exposing aqueous GO liquid crystal (GOLC) coating to EDA vapor and its effects on the gas barrier performance of GO film were systematically investigated. When a GO/EDA coating with a thickness of approximately 1 μm was applied to a neat polyethylene terephthalate (PET) film, the resultant film was highly impermeable to gas molecules, particularly reducing the gas permeance up to 99.6% for He and 98.5% for H₂ in comparison to the neat PET film. The gas barrier properties can be attributed to the long diffusion length through stacked GO nanosheets. The EDA can crosslink oxygen-containing groups of GO, enhancing the mechanical properties of the GO/EDA coating with hardness and elastic modulus values up to 1.14 and 28.7 GPa, respectively. By the synergistic effect of the viscoelastic properties of GOLC and the volatility of EDA, this coating method can be applied to complex geometries and EDA intercalation can be spontaneously achieved through the scaffold of the GOLC.

Older Korean Americans' concern about Alzheimer's disease: the role of immigration-related factors and objective and subjective cognitive status

Objectives: The present study examined the associations between immigration-related factors and objective and subjective cognitive status with older Korean Americans' concern about developing Alzheimer's Disease (AD). It was hypothesized that (1) AD concern would be associated with immigration-related factors and (2) self-rated cognitive status would mediate the relationship between cognitive performance (Mini Mental State Examination (MMSE) scores) and concern about AD.Method: Using data from the Study of Older Korean Americans (n = 2061, mean age = 73.2; 66.8% female), the direct and indirect effect models were tested.Results: Korean American immigrants with a higher level of acculturation had better cognitive performance, more positive self-ratings of cognitive status, and a lower level of concern about AD. Both poor cognitive performance and negative self-ratings of cognitive status were associated with increased concern about AD. Supporting the mediation hypothesis, the indirect effect of cognitive performance on AD concern through self-rated cognitive status was significant (bias corrected 95% confidence interval for the indirect effect = -.012, -.003).Conclusion: The mediation model not only helps us better understand the psychological mechanisms that underlie the link between cognitive status and AD concern but also highlights the potential importance of subjective perceptions about cognitive status as an avenue for interventions.

Genome wide CRISPR screening reveals a role for sialylation in the tumorigenesis and chemoresistance of acute myeloid leukemia cells

Aberrant activation of cytokine and growth factor signal transduction pathways confers enhanced survival and proliferation properties to acute myeloid leukemia (AML) cells. However, the mechanisms underlying the deregulation of signaling pathways in leukemia cells are unclear. To identify genes capable of independently supporting cytokine-independent growth, we employed a genome-wide CRISPR/Cas9-mediated loss-of-function screen in GM-CSF-dependent human AML TF-1 cells. More than 182 genes (p < 0.01) were found to suppress the cytokine-independent growth of TF-1 cells. Among the top hits, genes encoding key factors involved in sialylation biosynthesis were identified; these included CMAS, SLC35A1, NANS, and GNE. Knockout of either CMAS or SLC35A1 enabled cytokine-independent proliferation and survival of AML cells. Furthermore, NSG (NOD/SCID/IL2Rγ^-/-) mice injected with CMAS or SLC35A1-knockout TF-1 cells exhibited a shorter survival than mice injected with wild-type cells. Mechanistically, abrogation of sialylation biosynthesis in TF-1 cells induced a strong activation of ERK signaling, which sensitized cells to MEK inhibitors but conferred resistance to JAK inhibitors. Further, the surface level of α2,3-linked sialic acids was negatively correlated with the sensitivity of AML cell lines to MEK/ERK inhibitors. We also found that sialylation modulated the expression and stability of the CSF2 receptor. Together, these results demonstrate a novel role of sialylation in regulating oncogenic transformation and drug resistance development in leukemia. We propose that altered sialylation could serve as a biomarker for targeted anti-leukemic therapy.

Aorto-left atrial fistula secondary to infective aortic endocarditis and endarteritis in a cat with valvular aortic stenosis

A cat previously diagnosed with valvular aortic stenosis developed acute respiratory distress. A new continuous heart murmur was noted on physical exam. Echocardiographic examination revealed vegetative lesions on the aortic valve and continuously shunting blood flow from the aorta into the left atrium. Despite initial treatment for left-sided congestive heart failure, the cat died suddenly. In addition to confirming aortic valve endocarditis and an acquired aorto-left atrial shunt, pathological examination identified vegetative lesions on the luminal surface of the ascending aorta. Although antemortem aerobic blood culture, 16s bacterial ribosomal DNA PCR, and Bartonella PCR failed to identify causative organisms, Escherichia coli was identified on postmortem tissue culture of the aortic lesion. This represented a unique case of primary valvular aortic stenosis with secondary infective aortic endocarditis, infective aortic endarteritis, and aorto-left atrial fistula in a cat. It highlighted potential adverse outcomes of aortic stenosis that are more commonly recognized in humans and dogs.

Sleep Quality and Associated Factors in Premenopausal, Perimenopausal, and Postmenopausal Women in Korea: Findings from the K-Stori 2016

PURPOSE

Poor sleep quality is a common problem among middle-aged women. Few studies, however, have assessed differences in sleep quality among premenopausal, perimenopausal, and postmenopausal women and related risk factors in Korea women. The aim of this study was to assess sleep quality and factors associated therewith according to menopausal status in Korean women.

PATIENTS AND METHODS

This study was based on the 2016 Korean Study of Women's Health Related Issues (K-Stori), a cross-sectional survey employing nationally representative random sampling. In total, 3000 Korean women aged 45 to 64 years completed the Pittsburgh Sleep Quality Index (PSQI). Comparison of demographic characteristics and sleep quality among pre-, peri-, and postmenopausal women was conducted.

RESULTS

Among the participants, 26% suffered from poor sleep quality based on the PSQI. The prevalence of poor sleep quality increased with later menopausal stage (from 18.8% in the premenopausal stage to 29.5% in the postmenopausal stage P <0.001). Multivariate logistic regression analysis showed that peri- and postmenopausal women were 1.50 and 1.73 times more likely to have poor sleep quality in comparison to premenopausal women, respectively. Chronic disease, depression, at-risk drinking, taking dietary supplements, and single women were associated with a higher likelihood of having poor sleep quality. Health status, at-risk drinking, chronic illness, dietary supplementation, and depression were significantly associated with poor sleep quality.

CONCLUSION

Poor sleep quality appears to be prevalent in peri- and postmenopausal women in Korea. The management of sleep quality during menopause transition is important, and further research on how sleep disturbances influence the health status of women in menopausal transition is required.

TXNIP Regulates Natural Killer Cell-Mediated Innate Immunity by Inhibiting IFN-γ Production during Bacterial Infection

The function of natural killer (NK) cell-derived interferon-γ (IFN-γ) expands to remove pathogens by increasing the ability of innate immune cells. Here, we identified the critical role of thioredoxin-interacting protein (TXNIP) in the production of IFN-γ in NK cells during bacterial infection. TXNIP inhibited the production of IFN-γ and the activation of transforming growth factor β-activated kinase 1 (TAK1) activity in primary mouse and human NK cells. TXNIP directly interacted with TAK1 and inhibited TAK1 activity by interfering with the complex formation between TAK1 and TAK1 binding protein 1 (TAB1). Txnip^−/− (KO) NK cells enhanced the activation of macrophages by inducing IFN-γ production during Pam3CSK4 stimulation or Staphylococcus aureus (S. aureus) infection and contributed to expedite the bacterial clearance. Our findings suggest that NK cell-derived IFN-γ is critical for host defense and that TXNIP plays an important role as an inhibitor of NK cell-mediated macrophage activation by inhibiting the production of IFN-γ during bacterial infection.

Trend analysis of process quality indicators for the Korean National Cervical Cancer Screening Program from 2005 to 2013

Objective

This study sought to examine changes in trends for quality indicators of the population-based Korean National Cancer Screening Program (KNCSP) for cervical cancer from years 2005 to 2013.

Methods

Our study data were derived from the KNCSP database. Cervical cancer diagnosis information was ascertained through linkage with the Korean National Cancer Registry and the KNCSP database. Performance measures for cervical cancer screening were estimated, including participation rate, positive rate, crude detection rate (CDR), interval cancer rate (ICR), positive predictive value (PPV), sensitivity, and specificity. Joinpoint analysis was applied to calculate annual percentage changes (APCs) in all indicators according to socio-demographic factors.

Results

A significant increasing trend was noted in participation rates (APC=13.4%; 95% confidence interval [CI]=10.5, 16.4). PPV and specificity increased from years 2005 to 2009 and remained stable till 2013. An increasing trend was discovered in CDRs for cervical cancer in situ (APC=3.9%; 95% CI=1.0, 6.9), whereas a decreasing trend was observed in ICRs for invasive cervical cancer (APC=−2.5%; 95% CI=−4.5, −0.5). Medical Aid recipients and women older than 70 years showed the lowest participation rates, but higher CDRs and ICRs, compared to other groups. In general, most of the quality indicators for cervical cancer screening improved from 2005 to 2009 and remained stable to 2013.

Conclusion

The KNCSP for cervical cancer in Korea has improved in terms of participation rate and accuracy of the screening test. These results may be attributed to the National Quality Improvement Program for KNCSP.

Association of a dysbiotic oral microbiota with the development of focal lymphocytic sialadenitis in IκB-ζ-deficient mice

Mice lacking IκB-ζ, a protein encoded by the Nfkbiz gene, spontaneously develop a Sjögren’s syndrome-like disease involving the lachrymal glands, but no salivary gland symptoms have been reported. We found that Nfkbiz^−/− female mice presented a significantly reduced salivary flow rate, focal lymphocytic sialadenitis (FLS), and a dysbiotic oral microbiota at week 24. To dissect the contributions of genetic and environmental factors to the salivary gland phenotype, Nfkbiz^+/+ and Nfkbiz^−/− mice were cohoused after weaning and evaluated at week 20. Cohousing alleviated the salivary gland phenotype of Nfkbiz^−/− mice but did not induce any disease phenotype in Nfkbiz^+/+ mice. Additionally, the oral microbiota in the cohoused mice was synchronized toward that in Nfkbiz^+/+ mice. In conclusion, IκB-ζ-deficient mice developed hyposalivation and FLS, in which a dysbiotic oral microbiota played an important role. This finding suggests that the dysbiotic oral microbiota could be a therapeutic target.

Graphene Oxide Nanoribbon Hydrogel: Viscoelastic Behavior and Use as a Molecular Separation Membrane

The preparation of carbon materials based hydrogels and their viscoelastic properties are essential for their broad application and scale-up. However, existing studies are mainly focused on graphene derivatives and carbon nanotubes, and the behavior of graphene nanoribbon (GNR), a narrow strip of graphene, remains elusive. Herein, we demonstrate the concentration-driven gelation of oxidized GNR (graphene oxide nanoribbon, GONR) in aqueous solvents. Exfoliated individual GONRs sequentially assemble into strings (∼1 mg/mL), nanoplates (∼20 mg/mL), and a macroporous scaffold (50 mg/mL) with increasing concentration. The GONR hydrogels exhibit viscoelastic shear-thinning behavior and can be shear-coated to form large-area GONR films on substrates. The entangled and stacked structure of the GONR film contributed to outstanding nanofiltration performance under high pressure, cross-flow, and long-term filtration, while the precise molecular separation with 100% rejection rate was maintained for sub-nanometer molecules.

Impact of Awareness of Breast Density on Perceived Risk, Worry, and Intentions for Future Breast Cancer Screening among Korean Women

PURPOSE

This study sought to examine perceived risk and concerns for breast cancer according to awareness of breast density and states thereof among Korea women and to identify the impact of such awareness on screening intentions.

Materials and Methods

This study was based on the 2017 Korean National Cancer Screening Survey of a nationally representative and randomly selected sample of Koreans. Ordinal logistic regression was conducted to examine associations for awareness of and knowledge on breast density in relation to psychological factors. Multivariate logistic regression analyses were conducted to investigate significant factors associated with intentions to undergo breast cancer screening.

RESULTS

Among a total of 1,609 women aged 40-69 years, 62.0% were unaware of their breast density, and only 29.7% had good breast density knowledge. Awareness of one's breast density and knowledge about breast density were positively associated with perceptions of absolute and comparative risk and cancer worry. Women aware of their breast density (adjusted odds ratio [aOR], 1.35 for women aware of having a non-dense breast; aOR, 4.17 for women aware of having a dense breast) and women with a good level of breast density knowledge (aOR, 1.65) were more likely to undergo future breast cancer screening.

CONCLUSION

Breast density awareness and knowledge showed positive associations with psychological factors and breast cancer screening intentions. However, the majority of Korean women were not aware of their breast density status and demonstrated poor knowledge about breast density. These results demonstrate a need for better health communication concerning breast density.

"Male Hair Cannot Extend Below Plane of the Shoulder" and "No Cross Dressing": Critical Queer Analysis of High School Dress Codes in the United States

In this study, we questioned how high school dress codes outlined in official handbooks were written or presented in regard to the gender binary, either/or perspective. We critically analyzed how or if they allowed for flexibility in expression of gender and sexual identity and if they supported, encouraged, or affirmed a variety of expressions, in particular transgender and gender non-conforming expressions, throughout the text or images. The content analysis method was used to analyze 735 handbooks from the 2016 to 2017 school year. Three themes emerged from the data: (1) support of fluid gender expression, yet not overt support; (2) passive marginalization of gender non-conforming or transgender identities or expressions; and (3) active marginalization of gender non-conforming or transgender identities or expressions. The "LGBTQ+ Dress Code Analysis Tool" was developed for policy makers to use to analyze their dress codes.

Magnetic Reconnection Inside a Flux Rope Induced by Kelvin-Helmholtz Vortices

On 5 May 2017, MMS observed a crater-type flux rope on the dawnside tailward magnetopause with fluctuations. The boundary-normal analysis shows that the fluctuations can be attributed to nonlinear Kelvin-Helmholtz (KH) waves. Reconnection signatures such as flow reversals and Joule dissipation were identified at the leading and trailing edges of the flux rope. In particular, strong northward electron jets observed at the trailing edge indicated midlatitude reconnection associated with the 3-D structure of the KH vortex. The scale size of the flux rope, together with reconnection signatures, strongly supports the interpretation that the flux rope was generated locally by KH vortex-induced reconnection. The center of the flux rope also displayed signatures of guide-field reconnection (out-of-plane electron jets, parallel electron heating, and Joule dissipation). These signatures indicate that an interface between two interlinked flux tubes was undergoing interaction, causing a local magnetic depression, resulting in an M-shaped crater flux rope, as supported by reconstruction.

Superconductivity in a uranium containing high entropy alloy

High entropy alloys (HEA) are an unusual class of materials where mixtures of elements are stochastically arrayed on a simple crystalline lattice. These systems exhibit remarkable functionality, often along several distinct axes: e.g., the examples [TaNb]1-x(TiZrHf)x are high strength and damage resistant refractory metals that also exhibit superconductivity with large upper critical fields. Here we report the discovery of an f-electron containing HEA, [TaNb]0.31(TiUHf)0.69, which is the first to include an actinide ion. Similar to the Zr-analogue, this material crystallizes in a body-centered cubic lattice with the lattice constant a = 3.41(1) Å and exhibits phonon mediated superconductivity with a transition temperatures Tc ≈ 3.2 K and upper critical fields Hc2 ≈ 6.4 T. These results expand this class of materials to include actinide elements, shows that superconductivity is robust in this sub-group, and opens the path towards leveraging HEAs as functional waste forms for a variety of radioisotopes.

P3762The impact of type and burden of atrial fibrillation on stroke occurrence in patients with atrial fibrillation: from a prospective cohort of atrial fibrillation patients (CODE-AF Registry)

Background and purpose

Although several studies reported that stroke risk in patients with paroxysmal atrial fibrillation (AF) is similar to those with persistent or permanent AF, there is still controversy on the relationship of AF type and stroke occurrence. We investigated the effect of AF type on AF burden and stroke risk in patients with non-valvular AF.

Methods

Within the CODE-AF prospective, outpatient registry (COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation), we identified 8,883 patients ≥18 years of age with non-valvular AF and eligible follow-up visits. We compared AF burden and stroke risk among patients with 3 types of AF: paroxysmal (n=5,808) or persistent (n=2,806) or permanent (n=269).

Results

The median age of the overall population was 68.0 (interquartile range, 60.0–75.0); 36.0% were female. Patients with persistent and permanent AF were older and had higher CHA2DS2-VASc scores and anticoagulation rate than those with paroxysmal AF. Compared with permanent AF (5.2±16.4%), the arrhythmic burden of AF on 24hrs Holter monitoring was significantly lower in paroxysmal AF (2.1±7.2%, p<0.001) and persistent AF (2.0±7.5%, p<0.001). During median follow-up period of 1.38 years (interquartile range: 0.96–1.67), total 82 (0.92%) patients experienced ischemic stroke with incidence rates of 0.51, 1.04 and 1.69 events per 100 person-years for paroxysmal, persistent and permanent AF, respectively. Compared with paroxysmal AF, the risk of ischemic stroke was increased in persistent AF with clinical variable adjusted hazard ratio (aHR) of 1.94 (95% confidence intervals [CI], 1.23–3.07; P=0.005) and permanent AF with aHR of 2.64 (95% CI, 1.09–6.41; P=0.03).

AF type and HR of stroke occurrence Paroxysmal (n=5,808) Persistent (n=2,806) Permanent (n=269) Stoke events 39 37 6 Person years (PYs) 7673 3544 356 /100 PYs 0.51 1.04 1.69 HR (95% CI), p-value HR (95% CI), p-value HR (95% CI), p-value Unadjusted HR 1 (Reference) 2.05 (1.27–3.31), 0.003 3.32 (1.15–7.90), 0.02 Clinical variables adjusted HR 1 (Reference) 1.94 (1.23–3.07), 0.005 2.64 (1.09–6.41), 0.03 PYs: Person years; HR: Hazard ratio.

Conclusion

Persistent and permanent AF was associated with the increased risk of stroke than paroxysmal AF, after adjustment of clinical variables including age, sex, comorbidities and anticoagulation rate. These results suggest that AF type and burden might be related with the risk of ischemic stroke and should be considered in the stroke prevention of AF.

A-23 Mental Illness and Emotional Functioning as Moderated by Executive Functioning: Incarcerated Population

Objective

The purpose of this study is to investigate whether executive functioning will moderate the relationship of a history of mental illness on aggression in a male forensic population.

Method

Using an archival database from a larger study, 232 male inmates (ages 21 and 49 years old) from three medium/maximum Maryland Correctional facilities were recruited using a pseudo-random selection process during intake. Participants were administered three EF tasks (Cambridge Decision Making Task, Logan Stop-Signal Task, and Stroop Interference Task), history of mental illness was obtained using the Symptom Checklist-90, and aggression was assessed with the Novaco Reaction to Provocation Questionnaire.

Results

Hierarchical multiple regressions were conducted. For overall aggression reactivity, inhibition moderated depression (IR2 = .025, F(3, 224) = 9.977, p < .001, β = -.246, p = .015) and psychoticism (IR2 = .019, F(3, 224) = 8.216, p < .001, β = -.136, p = .031). For reactive aggression subtype, inhibition moderated depression (IR2 = .025, F(3, 224) = 2.679, p = .048, β = .071, p = .017). For proactive aggression subtype, cognitive flexibility moderated anxiety (IR2 = .018, F(3, 224) = 4.731, p = .003, β = -.014, p = .039); and depression (IR2 = .022, F(3, 224) = 3.888, p = .010, β = -.017, p = .025).

Conclusions

Overall, there was mixed findings for inhibition. On Cambridge Decision Making task, inhibition moderated the predictive relationship of depression on reactive aggression and psychoticism and overall aggression but not for other measures of inhibition. For another inhibition task (Stroop), inhibition did not significantly moderate any mental illness on severity of aggression. Cognitive flexibility moderated the predictive relationships of anxiety and depression on proactive aggression. Findings suggest targeting cognitive flexibility for inmates diagnosed with anxiety depression, and psychosis when treating aggression in a male forensic population.

Electron Vorticity Indicative of the Electron Diffusion Region of Magnetic Reconnection

While vorticity defined as the curl of the velocity has been broadly used in fluid and plasma physics, this quantity has been underutilized in space physics due to low time resolution observations. We report Magnetospheric Multiscale (MMS) observations of enhanced electron vorticity in the vicinity of the electron diffusion region of magnetic reconnection. On 11 July 2017 MMS traversed the magnetotail current sheet, observing tailward-to-earthward outflow reversal, current-carrying electron jets in the direction along the electron meandering motion or out-of-plane direction, agyrotropic electron distribution functions, and dissipative signatures. At the edge of the electron jets, the electron vorticity increased with magnitudes greater than the electron gyrofrequency. The out-of-plane velocity shear along distance from the current sheet leads to the enhanced vorticity. This, in turn, contributes to the magnetic field perturbations observed by MMS. These observations indicate that electron vorticity can act as a proxy for delineating the electron diffusion region of magnetic reconnection.

Weight control behaviors according to body weight status and accuracy of weight perceptions among Korean women: a nationwide population-based survey

This study aimed to identify associations among self-perceived weight status, accuracy of weight perceptions, and weight control behaviors, including both healthy and unhealthy behaviors, in a large, nationally representative sample from an East Asian country. Data were collected from the 2016 Korean Study of Women's Health Related Issues, a population-based, nationwide survey. Accurate weight perceptions were investigated by comparing body mass index (BMI) categories, based on self-reported height and weight, and weight perceptions. Weight control behaviors over the previous 12 months were additionally surveyed. Odds ratios (ORs) and 95% confidence intervals (CIs) are presented as an index of associations. Among normal weight, overweight, and obese women, 12.8%, 44.3%, and 17.4% under-assessed their weight; 17.9% of normal weight women over-assessed their weight. Both weight status according to BMI category and weight perceptions were strongly associated with having tried to lose weight. Exercise and diet (ate less) were the most commonly applied weight control behaviors. Misperception of weight was related to more unhealthy weight control behaviors and less healthy behaviors: Women who under-assessed their weight showed a lower tendency to engage in dieting (OR = 0.57, 95% CI = 0.43-0.75) and a greater tendency to fast/skip meals (OR = 1.47, 95% CI = 1.07-1.99). Meanwhile, normal weight or overweight women who over-assessed their weight were more likely to have engaged in fasting/skipping meals or using diet pills (OR = 5.72, 95% CI = 2.45-13.56 for fasting/skipping meal in overweight women; OR = 1.62, 95% CI = 1.15-2.29 and OR = 3.16, 95% CI = 1.15-8.23 for using diet pills in normal and overweight women). Inaccuracy of weight perceptions in any direction (over/under) were related to more unhealthy weight control behaviors and less healthy weight control behaviors, especially in normal and overweight women.

Determinants of undergoing thyroid cancer screening in Korean women: a cross-sectional analysis from the K-Stori 2016

OBJECTIVES

Thyroid cancer is the most common cancer among Korean women. Studies suggest that the incidence of thyroid cancer might be associated with overdiagnosis resulting from thyroid cancer screening. The objective of this study was to identify the determinants of participation in thyroid cancer screening in Korean women.

METHODS

Data were obtained from the 2016 Korean Study of Women's Health-Related Issues, a nationwide cross-sectional survey of women according to the reproductive life cycle. A total of 8697 cancer-free women of ages between 20 and 79 years were included for analysis. Multivariable logistic regression analysis was applied to analyse factors associated with adherence to thyroid cancer screening based on Andersen's health behavioural model.

RESULTS

Over the last 2 years, the rate of thyroid cancer screening was 39.2%. In multivariable models, older age, higher household income, high school education level and higher perceived risk of cancer were positively associated with thyroid cancer screening participation. Moreover, women who underwent cervical cancer screening (adjusted OR [aOR] 3.67; 95% CI 2.90 to 4.64) and breast cancer screening (aOR 10.91; 95% CI 8.41 to 14.14) had higher odds of attending thyroid cancer screening than women who did not attend cancer screening.

CONCLUSIONS

These findings highlight the need to increase awareness of different recommendations on screening for various cancers to improve cost-effectiveness and to prevent unnecessary treatments.

Socioeconomic inequalities in obesity among Korean women aged 19-79 years: the 2016 Korean Study of Women's Health-Related Issues

OBJECTIVES

While the prevalence of obesity in Asian women has remained stagnant, studies of socioeconomic inequalities in obesity among Asian women are scarce. This study aimed to examine the recent prevalence of obesity in Korean women aged between 19 years and 79 years and to analyze socioeconomic inequalities in obesity.

METHODS

Data were derived from the 2016 Korean Study of Women’s Health-Related Issues. The chi-square test and logistic regression analysis were used to analyze the associations between socioeconomic factors and obesity using Asian standard body mass index (BMI) categories: low (<18.5 kg/m² ), normal (18.5-22.9 kg/m² ), overweight (23.0-24.9 kg/m² ), and obese (≥25.0 kg/ m² ). As inequality-specific indicators, the slope index of inequality (SII) and relative index of inequality (RII) were calculated, with adjustment for age and self-reported health status.

RESULTS

Korean women were classified into the following BMI categories: underweight (5.3%), normal weight (59.1%), overweight (21.2%), and obese (14.4%). The SII and RII revealed substantial inequalities in obesity in favor of more urbanized women (SII, 4.5; RII, 1.4) and against of women who were highly educated (SII, -16.7; RII, 0.3). Subgroup analysis revealed inequalities in obesity according to household income among younger women and according to urbanization among women aged 65-79 years.

CONCLUSIONS

Clear educational inequalities in obesity existed in Korean women. Reverse inequalities in urbanization were also apparent in older women. Developing strategies to address the multiple observed inequalities in obesity among Korean women may prove essential for effectively reducing the burden of this disease.

Self-perceptions of body weight status according to age-groups among Korean women: A nationwide population-based survey

While numerous studies have investigated body image, including body weight perception, most of which have focused on adolescents or young women, few studies have attempted to evaluate body weight perceptions in adult women according to age groups. This study was conducted to investigate the accuracy of self-perceived weight and actual body mass index (BMI) values among adult Korean women according to age. We used data from the 2016 Korean Study of Women's Health Related Issues, a population-based, nationwide, cross-sectional survey. BMI was calculated from self-reported weight and height. Participants were asked to describe their body image by choosing one of the following descriptions: very underweight, underweight, about right, overweight, or obese. The proportions of women aged 20-29, 30-39, 40-49, 50-59, 60-69, and 70-79 years who underestimated their body weight relative to their actual BMI category were 12.6%, 15.1%, 22.2%, 34.0%, 45.6%, and 50.7%, respectively; those who overestimated their body weight comprised 18.7%, 17.8%, 14.3%, 10.8%, and 7.4%. In all BMI categories, the proportion of those who overestimated their weight status increased as age decreased, while those who underestimated their weight status increased as age increased. After adjusting for possible covariates, age was strongly associated with both underestimation and overestimation. The odds ratio for underestimating one's weight status among women aged 70-79 yeas was 2.96 (95% CI: 2.10-4.18), and that for overestimation was 0.52 (95% CI: 0.35-0.79), compared to women aged 20-29 years. Age is the most important factor associated with weight perceptions among Korean women, affecting both underestimation and overestimation of weight status.