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All sources NASA NTRS DOE OSTI

DOE OSTI2023

High Sensitivity of Mobile Phone Microscopy Screening for Schistosoma haematobium in Azaguié, Côte d’Ivoire

Schistosomiasis infections continue to impact African settings disproportionately, and there is an urgent need for novel tools to evaluate infection control and elimination strategies at the community level. Mobile phone microscopes are portable and semiautomated devices with multiple applications for screening neglected tropical diseases. In a community-based schistosomiasis screening program in Azaguié, Côte d’Ivoire, mobile phone microscopy demonstrated a sensitivity of 85.7% (95% CI: 69.7–95.2%) and specificity of 93.3% (95% CI: 87.7–96.9%) for Schistosoma haematobium identification compared with conventional light microscopy, and 95% sensitivity (95% CI: 74.1–99.8%) with egg concentrations of five or more per 10 mL of urine. Mobile phone microscopy is a promising tool for schistosomiasis control and elimination efforts.

59 BASIC BIOLOGICAL SCIENCES↗

DOE OSTI2023

Interaction between clay minerals and organics in asteroid Ryugu

The Hayabusa 2 spacecraft brought back to Earth grains of the carbonaceous asteroid Ryugu. Such grains represent the pristine state of CI chondritic materials and have been preserved from exposure to Earth’s atmosphere. Here, we show evidence of the presence of organics trapped within the interlayer space of smectite layers in Ryugu grains. No such organics are found in the Orgueil CI meteorite. We put forward that the organics within the interlayer space of smectite in Orgueil CI meteorite were lost during their oxidation on Earth. Also, we propose that the presence of organics within the interlayers space of smectite might be responsible for the possible NH infrared signature observed in Ryugu particles and potentially to a few large C-type asteroids including Ceres

58 GEOSCIENCES↗

DOE OSTI2020

Life cycle Management of 324 Project High-Activity, Mixed/Low-Level Radioactive Waste - 20506

U.S. DOE contractor CH2M Hill Plateau Remediation Company (CHPRC) manages the 324 Building and is preparing to remotely excavate and disposition the radioactive soil beneath the building to allow further deactivation of the building. The 324 Building is a non-reactor Category 2 Nuclear Facility located in the 300 Area of the Hanford Site. Records indicate that in October 1986, approximately 516 liters of a concentrated liquid waste stream containing cesium-137 ({sup 137}Cs) and strontium-90 ({sup 90}Sr) spilled onto the floor of a hot cell, B-Cell, in the 324 Building. The spill contained an estimated 1.3 million curies (Ci) of radioactivity. A breach in the sump of B-Cell was discovered in November 2009 during characterization of the soil under the building. Exposure rates in excess of 10,000 R/hr were detected through a system of access pipes installed under the hot cell, and an estimated 1.557 E+05 Ci of {sup 137}Cs and 6.842 E+04 Ci of {sup 90}Sr are in the soil beneath B-Cell. The magnitude of the soil contamination below B-Cell represents one of the most challenging remediation activities in the DOE complex. The objective of CHPRC's 324 Project is to remotely excavate and disposition the highly contaminated soil under the hot cell so building deactivation and stabilization activities can resume. Depending on the volume and radioactivity of contaminated soil under B-Cell, the material will be dispositioned either at the Hanford Site's Environmental Restoration Disposal Facility (ERDF) or in grout monoliths that will be created in the hot cells (A, C and D) next to B-Cell during future building demolition activities. The current project scope includes installing structural supports under the walls of B-Cell and using remotely operated equipment to remove debris from the hot cell, remove debris mixed with grout on the floor, saw through and remove the cell floor and liner, and excavate contaminated soil under B-Cell to a depth of up to 3.66 meters (12 feet). Addition or removal of debris in A-Cell may be required to support B-Cell cleanout and excavation activities. The base approach is to disposition debris and soil bins in the Radiochemical Engineering Cell (REC) monoliths, and subsequently disposition the monoliths during building demolition. (authors)

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

DOE OSTI2024

Software stewardship and advancement of a high-performance computing scientific application: QMCPACK

Here, we provide an overview of the software engineering efforts and their impact in QMCPACK, a production-level ab-initio Quantum Monte Carlo open-source code targeting high-performance computing (HPC) systems. Aspects included are: (i) strategic expansion of continuous integration (CI) targeting CPUs, using GitHub Actions own runners, and NVIDIA and AMD GPUs used in pre-exascale systems, (ii) incremental reduction of memory leaks using sanitizers, (iii) incorporation of Docker containers for CI and reproducibility, and (iv) refactoring efforts to improve maintainability, testing coverage, and memory lifetime management. We quantify the value of these improvements by providing metrics to illustrate the shift towards a predictive, rather than reactive, maintenance approach. Our goal, in documenting the impact of these efforts on QMCPACK, is to contribute to the body of knowledge on the importance of research software engineering (RSE) for the stewardship and advancement of community HPC codes to enable scientific discovery at scale.

97 MATHEMATICS AND COMPUTING↗

DOE OSTI2022

Port Impedance Measurement and Current Injection Response Analysis for PLCs

Programmable Logic Controllers (PLCs) are used to control devices throughout the power system since they have fast control capabilities and can utilize multiple types of communication interfaces. Therefore, studying and mitigating their vulnerabilities to electromagnetic pulse is important for the reliability of PLC operations. Here, in this paper, an effective impedance measurement scheme is proposed and demonstrated for three PLCs to estimate their susceptibility to an electromagnetic pulse. The equivalent non-uniform transmission line model is established to eliminate the impact of the fixture in the de-embedding process. Then different parameters of the impedance measurement setup are explored. Based on the measured impedance, the equivalent circuit is established to calculate the response of the device when subjected to the electromagnetic pulse. The voltage and current responses of different interfaces are compared utilizing the developed pulsed Current Injection (CI) method. Finally, the impedance measurement scheme is verified through testing using three measuring instruments. And the CI simulation experiments reveal the characteristics and susceptibilities of different PLCs interfaces, indicating that some protection measures are required for the reliable operation of the PLC.

42 ENGINEERING↗

DOE OSTI2022

Intra-canopy leaf trait variation facilitates high LAI and compensatory growth in a clonal woody encroaching shrub in the tallgrass prairie

This data package contains the data for Tooley et al. (2022) Intra-canopy leaf trait variation facilitates high leaf area index and compensatory growth in a clonal woody encroaching shrub. The purpose of this project was to evaluate the leaf ecophysiological traits of Cornus drummondii C.A. Mey to better understand how C. drummondii maximizes photosynthetic rates across large gradients of light availability in its short, dense canopies. We also evaluate how C. drummondii modifies its allocation of leaf traits in response to grassland disturbance. High LAI canopies and a compensatory growth response to disturbance are two key factors contributing to the success of C. drummondii and other woody species responsible for the encroachment of grasslands.The data package contains ecophysiological measurements, including leaf morphological, physiological, and chemical traits; photosynthetic measurements, leaf carbon and nitrogen stable isotopes, leaf area index, and photosynthetically active radiation. All measurements were taken vertically across canopies of the clonal woody-encroaching shrub Cornus drummondii under browsed, grazed, and control (unbrowsed and ungrazed) conditions.Files:SeasonalMeasurements_Archive.csv - Data for all seasonal measurements used in the study.LeafPhotoSeasonalRaw_Archive.zip - zip file containing raw data from an li-6400 for each sampling period in the study.LAI_Archive.xlsx - Data for LAI Measurements.ACiandLightCurveResults_Archive.xlsx - Contains parameters extracted from A-ci and Light Response curves along with the morphological and chemical traits for each leaf.ACiRaw Archive.xlsx - Raw data from Li-6400 for A-ci response curvesLightCurves_Raw.zip - zip file containing raw data for Li-6400 light response curves. Excel file format: "IslandID"-"Depth"-lc.xlsx (or .csv)DataCollectionMethods.docx - file containing the methods of data collection, processing, and QA/QC for all data files. File also contains a list of excel file headers, abbreviations, and their units.

54 ENVIRONMENTAL SCIENCES↗

DOE OSTI2021

Relativistic Configuration-Interaction and Perturbation Theory Calculations for Heavy Atoms

Heavy atoms present challenges to atomic theory calculations due to the large number of electrons and their complicated interactions. Conventional approaches such as calculations based on Cowan’s code are limited and require a large number of parameters for energy agreement. One promising approach is relativistic configuration-interaction and many-body perturbation theory (CI-MBPT) methods. We present CI-MBPT results for various atomic systems where this approach can lead to reasonable agreement: La I, La II, Th I, Th II, U I, Pu II. Among atomic properties, energies, g-factors, electric dipole moments, lifetimes, hyperfine structure constants, and isotopic shifts are discussed. While in La I and La II accuracy for transitions is better than that obtained with other methods, more work is needed for actinides.

74 ATOMIC AND MOLECULAR PHYSICS↗

DOE OSTI2020

Association Between Changes in Timing of Spring Onset and Asthma Hospitalization in Maryland

The proposed association between climate change and increased burden of allergic diseases are based on three different thematic observational studies that have linked (i) increased CO 2 concentration with higher pollen production, (ii) warmer air/surface temperatures with early spring onset and longer pollen season, and (iii) higher pollen exposure with increased risk of asthma hospitalizations. Yet empirical evidence collectively linking climate change with pollen season and asthma exacerbation is still lacking. Using satellite observations, in situ pollen monitoring data, and hospitalization records (2001-2012), here we show that changes in the timing of spring onset resulting from ongoing climate variability and change is directly related to a longer tree pollen season and increased risk of asthma hospitalization. More specifically, we observed that very early start of season (SOS) to be associated with 10% increase in risk of asthma hospitalization (Incident Rate Ratio (IRR): 1.10, 95% Confidence Interval (CI): 1.02- 1.20) while late onset of SOS to be associated with 3% increase in risk of asthma hospitalization in Maryland (IRR: 1.03, 95% CI: 0.97-1.11), however the risk in the latter case was not statistically significant. Our results serve as a wake-up call to public health and medical communities regarding the need to anticipate and adapt to the ongoing changes in the timing and severity of the spring allergy season.

54 ENVIRONMENTAL SCIENCES↗

DOE OSTI2023

Evaluation of Plasma Phosphorylated Tau217 for Differentiation Between Alzheimer Disease and Frontotemporal Lobar Degeneration Subtypes Among Patients With Corticobasal Syndrome

Plasma phosphorylated tau217 (p-tau217), a biomarker of Alzheimer disease (AD), is of special interest in corticobasal syndrome (CBS) because autopsy studies have revealed AD is the driving neuropathology in up to 40% of cases. This differentiates CBS from other 4-repeat tauopathy (4RT)–associated syndromes, such as progressive supranuclear palsy Richardson syndrome (PSP-RS) and nonfluent primary progressive aphasia (nfvPPA), where underlying frontotemporal lobar degeneration (FTLD) is typically the primary neuropathology. To validate plasma p-tau217 against positron emission tomography (PET) in 4RT-associated syndromes, especially CBS. This multicohort study with 6, 12, and 24-month follow-up recruited adult participants between January 2011 and September 2020 from 8 tertiary care centers in the 4RT Neuroimaging Initiative (4RTNI). All participants with CBS (n = 113), PSP-RS (n = 121), and nfvPPA (n = 39) were included; other diagnoses were excluded due to rarity (n = 29). Individuals with PET-confirmed AD (n = 54) and PET-negative cognitively normal control individuals (n = 59) were evaluated at University of California San Francisco. Operators were blinded to the cohort. Plasma p-tau217, measured by Meso Scale Discovery electrochemiluminescence, was validated against amyloid-β (Aβ) and flortaucipir (FTP) PET. Imaging analyses used voxel-based morphometry and bayesian linear mixed-effects modeling. Clinical biomarker associations were evaluated using longitudinal mixed-effect modeling. Of 386 participants, 199 (52%) were female, and the mean (SD) age was 68 (8) years. Plasma p-tau217 was elevated in patients with CBS with positive Aβ PET results (mean [SD], 0.57 [0.43] pg/mL) or FTP PET (mean [SD], 0.75 [0.30] pg/mL) to concentrations comparable to control individuals with AD (mean [SD], 0.72 [0.37]), whereas PSP-RS and nfvPPA showed no increase relative to control. Within CBS, p-tau217 had excellent diagnostic performance with area under the receiver operating characteristic curve (AUC) for Aβ PET of 0.87 (95% CI, 0.76-0.98; P < .001) and FTP PET of 0.93 (95% CI, 0.83-1.00; P < .001). At baseline, individuals with CBS-AD (n = 12), defined by a PET-validated plasma p-tau217 cutoff 0.25 pg/mL or greater, had increased temporoparietal atrophy at baseline compared to individuals with CBS-FTLD (n = 39), whereas longitudinally, individuals with CBS-FTLD had faster brainstem atrophy rates. Individuals with CBS-FTLD also progressed more rapidly on a modified version of the PSP Rating Scale than those with CBS-AD (mean [SD], 3.5 [0.5] vs 0.8 [0.8] points/year; P = .005). In this cohort study, plasma p-tau217 had excellent diagnostic performance for identifying Aβ or FTP PET positivity within CBS with likely underlying AD pathology. Plasma P-tau217 may be a useful and inexpensive biomarker to select patients for CBS clinical trials.

59 BASIC BIOLOGICAL SCIENCES↗

DOE OSTI2025

Shear–Mediated Stabilization of Spin Spiral Order in Multiferroic NiI 2

Type-II multiferroicity from non-collinear spin order is recently explored in the van der Waals material NiI 2 . Despite the importance for improper ferroelectricity, the microscopic mechanism of the helimagnetic order remains poorly understood. Here, the magneto-structural phases of NiI 2 are investigated using resonant magnetic X-ray scattering (RXS) and X-ray diffraction. Two competing magnetic phases are identified. Below 60 K, an incommensurate magnetic reflection (q ≈ [0.143,0,1.49] reciprocal lattice units) is observed which exhibits finite circular dichroism in RXS, signaling the inversion symmetry-breaking helimagnetic ground state. At elevated temperature, in the non-polar phase (60 K < T < 75 K), a distinct q ≈ [0.087,0.087,1.5] magnetic order is observed, attributed to a collinear incommensurate (CI) state. The first-order CI-helix transition is concomitant with a structural transition characterized by a significant interlayer shear, which drives the helimagnetic ground state as evidenced by a mean-field Heisenberg model including interlayer exchange and its coupling to the structural distortion. Furthermore, these findings identify interlayer magneto-structural coupling as the key driver behind multiferroicity in NiI 2 .

36 MATERIALS SCIENCE↗

DOE OSTI2020

Naphthalene‐Diimide‐Based Ionenes as Universal Interlayers for Efficient Organic Solar Cells

Abstract Self‐doping ionene polymers were efficiently synthesized by reacting functional naphthalene diimide (NDI) with 1,3‐dibromopropane ( NDI‐NI ) or trans ‐1,4‐dibromo‐2‐butene ( NDI‐CI ) via quaternization polymerization. These NDI‐based ionene polymers are universal interlayers with random molecular orientation, boosting the efficiencies of fullerene‐based, non‐fullerene‐based, and ternary organic solar cells (OSCs) over a wide range of interlayer thicknesses, with a maximum efficiency of 16.9 %. NDI‐NI showed a higher interfacial dipole (Δ), conductivity, and electron mobility than NDI‐CI , affording solar cells with higher efficiencies. These polymers proved to efficiently lower the work function ( WF ) of air‐stable metals and optimize the contact between metal electrode and organic semiconductor, highlighting their power to overcome energy barriers of electron injection and extraction processes for efficient organic electronics.

Liu, Ming↗

DOE OSTI2020

Naphthalene‐Diimide‐Based Ionenes as Universal Interlayers for Efficient Organic Solar Cells

Liu, Ming↗

DOE OSTI2020

Using waste CO 2 from corn ethanol biorefineries for additional ethanol production: life‐cycle analysis

Abstract Corn ethanol plants generate high‐purity carbon dioxide (CO 2 ) while producing ethanol. If that CO 2 could be converted into ethanol by carbon capture and utilization technologies it would be possible to increase ethanol production more than 37% without additional corn grain inputs. Gas fermentation processes use microbes to convert carbon‐containing gases into ethanol and so have the potential to be used with the CO 2 from biorefineries for this purpose. However, as CO 2 utilization technologies for converting thermodynamically stable CO 2 are typically energy intensive, it is necessary to evaluate the related life‐cycle greenhouse gas (GHG) emissions (carbon intensities or CIs) to see whether there are actual emission reduction benefits. In this study, we evaluate the CIs of ethanol produced from high‐purity CO 2 in corn ethanol plants by gas fermentation plus electrochemical reduction. Our analysis shows that the sources of electricity and hydrogen are key drivers of CO 2 ‐based ethanol's GHG emissions. With wind electricity, the design cases show the potential of near‐zero CI ethanol (1.1 g CO 2 e/MJ), but that can increase to up to 331–531 g CO 2 e/MJ when today's U.S. Midwest electricity mix is used. To avoid the renewable electricity intermittency issue, we considered a power purchase agreement option using wind electricity 40% of the time and using the regional mix for the rest, which provides a 42% GHG emission reduction from the CI of gasoline. © 2020 The Authors and UChicago Argonne, LLC, Operator of Argonne National Laboratory. Biofuels, Bioproducts and Biorefining published by Society of Chemical Industry and John Wiley & Sons, Ltd.

09 BIOMASS FUELS↗

DOE OSTI2024

Pan‐Cancer Survival Impact of Immune Checkpoint Inhibitors in a National Healthcare System

ABSTRACT Background The cumulative, health system‐wide survival benefit of immune checkpoint inhibitors (ICIs) is unclear, particularly among real‐world patients with limited life expectancies and among subgroups poorly represented on clinical trials. We sought to determine the health system‐wide survival impact of ICIs. Methods We identified all patients receiving PD‐1/PD‐L1 or CTLA‐4 inhibitors from 2010 to 2023 in the national Veterans Health Administration (VHA) system (ICI cohort) and all patients who received non‐ICI systemic therapy in the years before ICI approval (historical control). ICI and historical control cohorts were matched on multiple cancer‐related prognostic factors, comorbidities, and demographics. The effect of ICI on overall survival was quantified with Cox regression incorporating matching weights. Cumulative life‐years gained system‐wide were calculated from the difference in adjusted 5‐year restricted mean survival times. Results There were 27,322 patients in the ICI cohort and 69,801 patients in the historical control cohort. Among ICI patients, the most common cancer types were NSCLC (46%) and melanoma (10%). ICI demonstrated a large OS benefit in most cancer types with heterogeneity across cancer types (NSCLC: adjusted HR [aHR] 0.56, 95% confidence interval [CI] 0.54–0.58,p < 0.001; urothelial: aHR 0.91, 95% CI 0.83–1.01,p = 0.066). The relative benefit of ICI was stable across patient age, comorbidity, and self‐reported race subgroups. Across VHA, 15,859 life‐years gained were attributable to ICI within 5‐years of treatment, with NSCLC contributing the most life‐years gained. Conclusion We demonstrated substantial increase in survival due to ICIs across a national health system, including in patient subgroups poorly represented on clinical trials.

Oncology↗

DOE OSTI2022

Risk and incidence of head and neck cancers in veterans living with HIV and matched HIV‐negative veterans

Background Persons living with HIV/AIDS have a higher incidence of virus‐related and tobacco/alcohol‐related cancers. This study is the first to estimate the effect of HIV versus HIV‐negative veterans on the risk of head and neck squamous cell carcinoma incidence in a large retrospective cohort study. Methods The authors constructed a retrospective cohort study using patient data from 1999 to 2016 from the National Veterans Administration Corporate Data Warehouse and the VA Central Cancer Registry. This cohort study included 45,052 veterans living with HIV/AIDS and 162,486 HIV‐negative patients matched by age, sex, and index visit (i.e., HIV diagnosis date or clinic visit date). The age‐standardized incidence rates and estimated adjusted hazard ratios were calculated with a Cox proportional hazards regression for oropharyngeal and nonoropharyngeal head and neck cancer squamous cell carcinoma (HNSCC). The authors also abstracted human papillomavirus (HPV) status from oropharyngeal HNSCC diagnosed after 2010. Results Veterans living with HIV/AIDS (VLWH) have 1.71 (95% confidence interval [CI], 1.36, 2.14) times the risk of oropharyngeal cancer and 2.06 (95% CI, 1.76, 2.42) times the hazard of nonoropharyngeal cancer compared with HIV‐negative veterans. VLWH with oropharyngeal squamous cell carcinoma (OPSCC) were more likely to be HPV‐positive ( N = 30 [81.1%]) than the HIV‐negative veterans with OPSCC ( N = 50 [67.6%]), although this difference was not significant ( p = .135). For nonoropharyngeal cancer, the increased risk of oral cavity cancer among VLWH drove the increased risk. Conclusions The study results suggest that HIV may play a role in virally mediated and nonvirally mediated HNSCC. As the HIV prevalence rises in the United States due to better survival and the incidence of HPV‐positive oropharyngeal HNSCC increases, the interaction between HPV and HIV becomes increasingly relevant.

Mazul, Angela L.↗

DOE OSTI2020

Validation of Stage N3 of the Eighth Edition AJCC Staging System for Nasopharyngeal Carcinoma

Objectives To validate stage nodal (N)3 of the 8th edition American Joint Committee on Cancer (AJCC) staging system for nasopharyngeal carcinoma (NPC). Methods This retrospective cohort study extracted NPC patients from the Surveillance, Epidemiology, and End Results database between 2004 and 2016. Pathologically confirmed patients with complete data of level IV, N3a, and N3b lymph node metastasis were investigated. The included patients were divided into level IV, N3a, and N3b groups. Five‐year overall survival (OS) and cancer‐specific survival (CSS) were compared among the three groups. Results A total of 693 patients were included: 285 (41.13%) patients in the level IV group, 124 (17.89%) patients in the N3a group, and 284 (40.98%) patients in the N3b group. The 5‐year OS (57.1%, 55.0%, and 55.2%) and CSS (64.4%, 63.5%, and 64.4%) were not different among the level IV, N3a, and N3b groups. Multivariate regression analysis revealed that N stage was not an independent prognostic factor for OS (hazard ratio [HR] = 1.03, 95% confidence interval [CI]: 0.91–1.17; P = .65) or CSS (HR = 1.03, 95% CI: 0.89–1.19; P = .70). Conclusion Stage N3 of the 8th edition AJCC staging system for NPC is reasonable. Level of Evidence III Laryngoscope , 131:535–540, 2021

Pan, Xin‐Bin↗

DOE OSTI2021

A bespoke health risk assessment methodology for the radiation protection of astronauts

An alternative approach that is particularly suitable for the radiation health risk assessment (HRA) of astronauts is presented. The quantity, Radiation Attributed Decrease of Survival (RADS), representing the cumulative decrease in the unknown survival curve at a certain attained age, due to the radiation exposure at an earlier age, forms the basis for this alternative approach. Results are provided for all solid cancer plus leukemia incidence RADS from estimated doses from theoretical radiation exposures accumulated during long-term missions to the Moon or Mars. For example, it is shown that a 1000-day Mars exploration mission with a hypothetical mission effective dose of 1.07 Sv at typical astronaut ages around 40 years old, will result in the probability of surviving free of all types of solid cancer and leukemia until retirement age (65 years) being reduced by 4.2% (95% CI 3.2; 5.3) for males and 5.8% (95% CI 4.8; 7.0) for females. RADS dose–responses are given, for the outcomes for incidence of all solid cancer, leukemia, lung and female breast cancer. Results showing how RADS varies with age at exposure, attained age and other factors are also presented. The advantages of this alternative approach, over currently applied methodologies for the long-term radiation protection of astronauts after mission exposures, are presented with example calculations applicable to European astronaut occupational HRA. Some tentative suggestions for new types of occupational risk limits for space missions are given while acknowledging that the setting of astronaut radiation-related risk limits will ultimately be decided by the Space Agencies. Suggestions are provided for further work which builds on and extends this new HRA approach, e.g., by eventually including non-cancer effects and detailed space dosimetry.

61 RADIATION PROTECTION AND DOSIMETRY↗

DOE OSTI2021

Mortality among individuals exposed to atomic bomb radiation in utero: 1950–2012

We examined the mortality risks among 2463 individuals who were exposed in utero to atomic bomb radiation in Hiroshima or Nagasaki in August 1945 and were followed from October 1950 through 2012. Individual estimates of mother’s weighted absorbed uterine dose (DS02R1) were used. Poisson regression method was used to estimate the radiation-associated excess relative risk per Gy (ERR/Gy) and 95% confidence intervals (CI) for cause-specific mortality. Head size, birth weight, and parents’ survival status were evaluated as potential mediators of radiation effect. There were 339 deaths (216 males and 123 females) including deaths from solid cancer (n = 137), lymphohematopoietic cancer (n = 8), noncancer disease (n = 134), external cause (n = 56), and unknown cause (n = 4). Among males, the unadjusted ERR/Gy (95% CI) was increased for noncancer disease mortality (1.22, 0.10–3.14), but not for solid cancer mortality (-0.18,< -0.77–0.95); the unadjusted ERR/Gy for external cause mortality was not statistically significant (0.28, < -0.60–2.36). Among females, the unadjusted ERRs/Gy were increased for solid cancer (2.24, 0.44–5.58), noncancer (2.86, 0.56–7.64), and external cause mortality (2.57, 0.20–9.19). The ERRs/Gy adjusted for potential mediators did not change appreciably for solid cancer mortality, but decreased notably for noncancer mortality (0.39, < -0.43–1.91 for males; 1.48, - 0.046–4.55 for females) and external cause mortality (0.10, < -0.57–1.96 for males; 1.38, < -0.46–5.95 for females). In conclusion, antenatal radiation exposure is a consistent risk factor for increased solid cancer mortality among females, but not among males. The effect of exposure to atomic bomb radiation on noncancer disease and external cause mortality among individuals exposed in utero was mediated through small head size, low birth weight, and parental loss.

Public, Environmental & Occupational Health↗