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Background: Rural patients experience a higher incidence of and mortality from colorectal cancer. Ensuring high-quality screening is essential to address these disparities., Objective: To investigate whether socioecological determinants of health are associated with colonoscopy quality in rural Alabama., Design: Retrospective review., Setting: Data across 3 rural hospitals in Alabama from August 2021 to July 2023., Patients: We included adults (aged 18 years or older) who underwent screening or diagnostic colonoscopy and completed a validated survey that measures socioecological determinants of health., Main Outcome Measures: Primary outcomes included bowel preparation quality, cecal intubation, and adenoma detection rate. We linked the survey responses to these quality metrics to identify factors associated with outcomes. Analyses included the χ 2 , Fisher exact, and Kruskal-Wallis rank-sum tests, with a p value of < 0.05 considered statistically significant., Results: The 84 patients surveyed were 66.7% men, 50.0% Black, and had a median age of 64 years. Optimal bowel preparation was present in 88.0%, successful cecal intubation was observed in 89.3%, and the overall adenoma detection rate was 45.8%. Patients with suboptimal bowel preparation described lower rates of internet access (60.0% vs 87.4%, p < 0.05), more difficulty in understanding written information (30.0% vs 1.4%, p < 0.05), and lacked a sense of responsibility for their health (30.0% vs 51.4%, p < 0.05) compared to those having optimal bowel preparation. Those with unsuccessful cecal intubations had lower physician trust (55.6% vs 73.3%, p < 0.05), whereas patients with successful cecal intubations were more confident in preventing health-related problems (53.3% vs 33.3%, p < 0.05) and had a more supportive social environment (72.0% vs 66.7%, p < 0.05)., Limitations: Retrospective design and small sample size limiting multivariable analyses., Conclusion: In rural Alabama, lower health literacy, internet access, and physician trust were associated with low-quality colonoscopy, whereas a higher patient sense of responsibility and a supportive social environment were associated with higher-quality metrics. These findings identify potential targets for improving colonoscopy quality in rural settings. See Video Abstract., Determinantes Socioecolgicos De La Salud Y La Calidad De La Colonoscopia En Las Zonas Rurales De Alabama: ANTECEDENTES:Los pacientes rurales sufren una mayor incidencia y mortalidad por cáncer colorrectal. Garantizar un cribado de alta calidad es esencial para abordar estas disparidades.OBJETIVO:Investigar si los determinantes socioecológicos de la salud están asociados con la calidad de la colonoscopia en las zonas rurales de Alabama.DISEÑO:Revisión retrospectiva.LUGAR:Datos a través de tres hospitales rurales en Alabama desde agosto de 2021 hasta julio de 2023.PACIENTES:Se incluyeron adultos (≥18 años) que se sometieron a colonoscopia de cribado o diagnóstica y completaron una encuesta validada que mide los determinantes socioecológicos de la salud.PRINCIPALES MEDIDAS DE RESULTADO:Los resultados primarios incluyeron la calidad de la preparación intestinal, la canulazion cecal y la tasa de detección de adenomas. Vinculamos las respuestas de la encuesta a estas métricas de calidad para identificar factores asociados con los resultados. Los análisis incluyeron las pruebas χ2 , exacta de Fisher y de suma de rangos de Kruskal-Wallis, considerándose estadísticamente significativa una p < 0,05.RESULTADOS:Los 84 pacientes encuestados eran un 66,7% varones, un 50,0% de raza negra y tenían una edad media de 64 años. La preparación intestinal óptima estuvo presente en el 88,0%, el 89,3% tuvo canulazion cecales exitosas, y la tasa general de detección de adenomas fue del 45,8%. Los pacientes con una preparación intestinal subóptima describieron tasas más bajas de acceso a Internet (60,0% frente a 87,4%, p < 0,05), más dificultades para comprender la información escrita (30,0% frente a 1,4%, p < 0,05) y carecían de sentido de la responsabilidad por su salud (30,0% frente a 51,4%, p < 0,05) en comparación con los que tenían una preparación intestinal óptima. Los pacientes con canulaziones cecales fallidas tenían menos confianza en el médico (55,6% frente a 73,3%, p < 0,05), mientras que los pacientes con canulaziones cecales satisfactorias tenían más confianza en la prevención de problemas relacionados con la salud (53,3% frente a 33,3%, p < 0,05) y contaban con un entorno social más favorable (72,0% frente a 66,7%, p < 0,05).LIMITACIONES:El diseño retrospectivo y el pequeño tamaño de la muestra limitan los análisis multivariables.CONCLUSIÓN:En las zonas rurales de Alabama, la alfabetización sanitaria, el acceso a Internet y la confianza en el médico se asociaron con una colonoscopia de baja calidad, mientras que un mayor sentido de la responsabilidad del paciente y un entorno social de apoyo se asociaron con métricas de mayor calidad. Estos hallazgos identifican objetivos potenciales para mejorar la calidad de la colonoscopia en entornos rurales. (Traducción-Dr Yolanda Colorado )., (Copyright © The ASCRS 2024.)

Introduction: In the past 3 decades, thyroid cancer research has surged, becoming the leading topic in clinical thyroidology. Despite this, there's a lack of data identifying key articles, authors, and journals. This study aims to provide insights for authors, physicians, and research labs by highlighting the most influential journals, authors, and research topics in thyroid cancer., Methods: A comprehensive search was conducted using the Scopus database, employing the medical subject heading (MeSH) terms "Thyroid" and "Cancer" in the titles, abstracts, or keywords of articles. The search was limited to English articles in academic medicine journals published between January 1993 and December 2021., Results: The search yielded 21 472 articles across 3076 journals, authored by 13 974 senior authors. The number of journals publishing on thyroid cancer expanded from 29 in 1993 to 733 in 2021, marking an average annual growth of 14%. Article output on the topic increased from 54 in the initial year to 1580 by 2021, with an annual growth rate of 16%. A thematic analysis revealed 369 articles mentioning "BRAF" since 2004, 479 articles on "ultrasound" techniques, 325 on "ablation" methods, and 453 articles focusing on "genetics" in thyroid cancer. The Journal of Clinical Endocrinology and Metabolism emerged as the most prolific, publishing 1017 articles over the 29-year period., Conclusion: This study guides resource allocation towards impactful journals for thyroid cancer researchers, helps identify key contributors for collaboration or mentorship, and provides a framework for similar analyses in other fields., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

A 2×2×1 superstructure of the P6 3 /mmc NiAs structure is reported in which kagome nets are stabilized in the octahedral transition metal layers of the compounds Ni 0.7 Pd 0.2 Bi, Ni 0.6 Pt 0.4 Bi, and Mn 0.99 Pd 0.01 Bi. The ordered vacancies that yield the true hexagonal kagome motif lead to filling of trigonal bipyramidal interstitial sites with the transition metal in this family of "kagome-NiAs" type materials. Further ordering of vacancies within these interstitial layers can be compositionally driven to simultaneously yield kagome-connected layers and a net polarization along the c axes in Ni 0.9 Bi and Ni 0.79 Pd 0.08 Bi, which adopt Fmm2 symmetry. The polar and non-polar materials exhibit different electronic transport behaviour, reflecting the tuneability of both structure and properties within the NiAs-type bismuthide materials family., (© 2024 The Authors. Angewandte Chemie International Edition published by Wiley-VCH GmbH.)

The mixed anion material Bi 4 O 4 SeCl 2 has an ultralow thermal conductivity of 0.1 W m -1 K -1 along its stacking axis ( c axis) at room temperature, which makes it an ideal candidate for electronic band structure optimization via doping to improve its thermoelectric performance. Here, we design and realize an optimal doping strategy for Bi 4 O 4 SeCl 2 from first principles and predict an enhancement in the density of states at the Fermi level of the material upon Sn and Ge doping. Experimental work realizes the as-predicted behavior in Bi 4- x Sn x O 4 SeCl 2 ( x = 0.01) through the precise control of composition. Careful consideration of multiple accessible dopant sites and charge states allows for the effective computational screening of dopants for thermoelectric properties in Bi 4 O 4 SeCl 2 and may be a suitable route for assessing other candidate materials., Competing Interests: The authors declare no competing financial interest., (© 2022 The Authors. Published by American Chemical Society.)

The thermal conductivity of crystalline materials cannot be arbitrarily low, as the intrinsic limit depends on the phonon dispersion. We used complementary strategies to suppress the contribution of the longitudinal and transverse phonons to heat transport in layered materials that contain different types of intrinsic chemical interfaces. BiOCl and Bi 2 O 2 Se encapsulate these design principles for longitudinal and transverse modes, respectively, and the bulk superlattice material Bi 4 O 4 SeCl 2 combines these effects by ordering both interface types within its unit cell to reach an extremely low thermal conductivity of 0.1 watts per kelvin per meter at room temperature along its stacking direction. This value comes within a factor of four of the thermal conductivity of air. We demonstrated that chemical control of the spatial arrangement of distinct interfaces can synergically modify vibrational modes to minimize thermal conductivity., (Copyright © 2021 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.)

The piezoelectric devices widespread in society use noncentrosymmetric Pb-based oxides because of their outstanding functional properties. The highest figures of merit reported are for perovskites based on the parent Pb(Mg 1/3 Nb 2/3 )O 3 (PMN), which is a relaxor: a centrosymmetric material with local symmetry breaking that enables functional properties, which resemble those of a noncentrosymmetric material. We present the Pb-free relaxor (K 1/2 Bi 1/2 )(Mg 1/3 Nb 2/3 )O 3 (KBMN), where the thermal and (di)electric behavior emerges from the discrete structural roles of the s 0 K + and s 2 Bi 3+ cations occupying the same A site in the perovskite structure, as revealed by diffraction methods. This opens a distinctive route to Pb-free piezoelectrics based on relaxor parents, which we demonstrate in a solid solution of KBMN with the Pb-free ferroelectric (K 1/2 Bi 1/2 )TiO 3 , where the structure and function evolve together, revealing a morphotropic phase boundary, as seen in PMN-derived systems. The detailed multiple-length-scale understanding of the functional behavior of KBMN suggests that precise chemical manipulation of the more diverse local displacements in the Pb-free relaxor will enhance performance.

Making new van der Waals materials with electronic or magnetic functionality is a chemical design challenge for the development of two-dimensional nanoelectronic and energy conversion devices. We present the synthesis and properties of the van der Waals material Bi 4 O 4 SeCl 2 , which is a 1:1 superlattice of the structural units present in the van der Waals insulator BiOCl and the three-dimensionally connected semiconductor Bi 2 O 2 Se. The presence of three anions gives the new structure both the bridging selenide anion sites that connect pairs of Bi 2 O 2 layers in Bi 2 O 2 Se and the terminal chloride sites that produce the van der Waals gap in BiOCl. This retains the electronic properties of Bi 2 O 2 Se while reducing the dimensionality of the bonding network connecting the Bi 2 O 2 Se units to allow exfoliation of Bi 4 O 4 SeCl 2 to 1.4 nm height. The superlattice structure is stabilized by the configurational entropy of anion disorder across the terminal and bridging sites. The reduction in connective dimensionality with retention of electronic functionality stems from the expanded anion compositional diversity.

The electrical Hall effect is the production, upon the application of an electric field, of a transverse voltage under an out-of-plane magnetic field. Studies of the Hall effect have led to important breakthroughs, including the discoveries of Berry curvature and topological Chern invariants 1,2 . The internal magnetization of magnets means that the electrical Hall effect can occur in the absence of an external magnetic field 2 ; this 'anomalous' Hall effect is important for the study of quantum magnets 2-7 . The electrical Hall effect has rarely been studied in non-magnetic materials without external magnetic fields, owing to the constraint of time-reversal symmetry. However, only in the linear response regime-when the Hall voltage is linearly proportional to the external electric field-does the Hall effect identically vanish as a result of time-reversal symmetry; the Hall effect in the nonlinear response regime is not subject to such symmetry constraints 8-10 . Here we report observations of the nonlinear Hall effect 10 in electrical transport in bilayers of the non-magnetic quantum material WTe 2 under time-reversal-symmetric conditions. We show that an electric current in bilayer WTe 2 leads to a nonlinear Hall voltage in the absence of a magnetic field. The properties of this nonlinear Hall effect are distinct from those of the anomalous Hall effect in metals: the nonlinear Hall effect results in a quadratic, rather than linear, current-voltage characteristic and, in contrast to the anomalous Hall effect, the nonlinear Hall effect results in a much larger transverse than longitudinal voltage response, leading to a nonlinear Hall angle (the angle between the total voltage response and the applied electric field) of nearly 90 degrees. We further show that the nonlinear Hall effect provides a direct measure of the dipole moment 10 of the Berry curvature, which arises from layer-polarized Dirac fermions in bilayer WTe 2 . Our results demonstrate a new type of Hall effect and provide a way of detecting Berry curvature in non-magnetic quantum materials.

Turning on superconductivity in a topologically nontrivial insulator may provide a route to search for non-Abelian topological states. However, existing demonstrations of superconductor-insulator switches have involved only topologically trivial systems. Here we report reversible, in situ electrostatic on-off switching of superconductivity in the recently established quantum spin Hall insulator monolayer tungsten ditelluride (WTe 2 ). Fabricated into a van der Waals field-effect transistor, the monolayer's ground state can be continuously gate-tuned from the topological insulating to the superconducting state, with critical temperatures T c up to ~1 kelvin. Our results establish monolayer WTe 2 as a material platform for engineering nanodevices that combine superconducting and topological phases of matter., (Copyright © 2018 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.)

Both layered multiple-anion compounds and homologous series are of interest for their electronic properties, including the ability to tune the properties by changing the nature or number of the layers. Here we expand, using both computational and experimental techniques, a recently reported three-anion material, Bi 4 O 4 Cu 1.7 Se 2.7 Cl 0.3 , to the homologous series Bi 2+2 n O 2+2 n Cu 2-δ Se 2+ n-δ X δ (X = Cl, Br), composed of parent blocks that are well-studied thermoelectric materials. All of the materials show exceptionally low thermal conductivity (0.2 W/mK and lower) parallel to the axis of pressing of the pellets, as well as narrow band gaps (as low as 0.28 eV). Changing the number of layers affects the band gap, thermal conductivity, carrier type, and presence of a phase transition. Furthermore, the way in which the different numbers of layers are accessed, by tuning the compensating Cu vacancy concentration and halide substitution, represents a novel route to homologous series. This homologous series shows tunable properties, and the route explored here could be used to build new homologous series out of known structural blocks.

A variety of monolayer crystals have been proposed to be two-dimensional topological insulators exhibiting the quantum spin Hall effect (QSHE), possibly even at high temperatures. Here we report the observation of the QSHE in monolayer tungsten ditelluride (WTe 2 ) at temperatures up to 100 kelvin. In the short-edge limit, the monolayer exhibits the hallmark transport conductance, ~ e 2 / h per edge, where e is the electron charge and h is Planck's constant. Moreover, a magnetic field suppresses the conductance, and the observed Zeeman-type gap indicates the existence of a Kramers degenerate point and the importance of time-reversal symmetry for protection from elastic backscattering. Our results establish the QSHE at temperatures much higher than in semiconductor heterostructures and allow for exploring topological phases in atomically thin crystals., (Copyright © 2018, American Association for the Advancement of Science.)

Layered two-anion compounds are of interest for their diverse electronic properties. The modular nature of their layered structures offers opportunities for the construction of complex stackings used to introduce or tune functionality, but the accessible layer combinations are limited by the crystal chemistries of the available anions. We present a layered three-anion material, Bi 4 O 4 Cu 1.7 Se 2.7 Cl 0.3 , which adopts a new structure type composed of alternately stacked BiOCuSe and Bi 2 O 2 Se-like units. This structure is accessed by inclusion of three chemically distinct anions, which are accommodated by aliovalently substituted Bi 2 O 2 Se 0.7 Cl 0.3 blocks coupled to Cu-deficient Bi 2 O 2 Cu 1.7 Se 2 blocks, producing a formal charge modulation along the stacking direction. The hypothetical parent phase Bi 4 O 4 Cu 2 Se 3 is unstable with respect to its charge-neutral stoichiometric building blocks. The complex layer stacking confers excellent thermal properties upon Bi 4 O 4 Cu 1.7 Se 2.7 Cl 0.3 : a room-temperature thermal conductivity (κ) of 0.4(1) W/mK was measured on a pellet with preferred crystallite orientation along the stacking axis, with perpendicular measurement indicating it is also highly anisotropic. This κ value lies in the ultralow regime and is smaller than those of both BiOCuSe and Bi 2 O 2 Se. Bi 4 O 4 Cu 1.7 Se 2.7 Cl 0.3 behaves like a charge-balanced semiconductor with a narrow band gap. The chemical diversity offered by the additional anion allows the integration of two common structural units in a single phase by the simultaneous and coupled creation of charge-balancing defects in each of the units.

We report on optical reflectivity experiments performed on Cd&#95;{3}As&#95;{2} over a broad range of photon energies and magnetic fields. The observed response clearly indicates the presence of 3D massless charge carriers. The specific cyclotron resonance absorption in the quantum limit implies that we are probing massless Kane electrons rather than symmetry-protected 3D Dirac particles. The latter may appear at a smaller energy scale and are not directly observed in our infrared experiments.

We report the crystal structures and elementary properties of the new aurobismuthides La3Au3Bi4, Ce3Au3Bi4, Pr3Au3Bi4, Nd3Au3Bi4, Sm3Au3Bi4, and Gd3Au3Bi4. These ternary compounds are found only for the large lanthanides and crystallize in the cubic Y3Au3Sb4 structure type, which is a stuffed Th3P4-type derivative. The compounds are electron-precise, leading to semiconducting behavior, and display magnetic properties arising from localized lanthanide f states. Resistivity data, Seebeck coefficient measurements, and electronic structure calculations suggest that these phases are heavily doped, p-type semiconductors. Nd3Au3Bi4 and Sm3Au3Bi4 have Seebeck coefficients of 105 and 190 μV/K at 350 K, respectively, making them worthy of further thermoelectric studies.

A three-dimensional strong-topological insulator or semimetal hosts topological surface states which are often said to be gapless so long as time-reversal symmetry is preserved. This narrative can be mistaken when surface state degeneracies occur away from time-reversal-invariant momenta. The mirror invariance of the system then becomes essential in protecting the existence of a surface Fermi surface. Here we show that such a case exists in the strong-topological-semimetal Bi(4)Se(3). Angle-resolved photoemission spectroscopy and ab initio calculations reveal partial gapping of surface bands on the Bi(2)Se(3) termination of Bi(4)Se(3)(111), where an 85 meV gap along Γ̅K̅ closes to zero toward the mirror-invariant Γ̅M̅ azimuth. The gap opening is attributed to an interband spin-orbit interaction that mixes states of opposite spin helicity.

We report a new family of ternary 111 hexagonal LnAuSb (Ln = La-Nd, Sm) compounds that, with a 19 valence electron count, has one extra electron compared to all other known LnAuZ compounds. LaAuSb, CeAuSb, PrAuSb, NdAuSb, and SmAuSb crystallize in the YPtAs-type structure, and have a doubled unit cell compared to other LnAuZ phases as a result of the buckling of the Au-Sb honeycomb layers to create interlayer Au-Au dimers. The dimers accommodate the one excess electron per Au and thus these new phases can be considered Ln2(3+)(Au-Au)(0)Sb2(3-). Band structure, density of states, and crystal orbital calculations confirm this picture, which results in a nearly complete band gap between full and empty electronic states and stable compounds; we can thus present a structural stability phase diagram for the LnAuZ (Z = Ge, As, Sn, Sb, Pb, Bi) family of phases. Those calculations also show that LaAuSb has a bulk Dirac cone below the Fermi level. The YPtAs-type LnAuSb family reported here is an example of the uniqueness of gold chemistry applied to a rigidly closed shell system in an unconventional way.

Magnetoresistance is the change in a material's electrical resistance in response to an applied magnetic field. Materials with large magnetoresistance have found use as magnetic sensors, in magnetic memory, and in hard drives at room temperature, and their rarity has motivated many fundamental studies in materials physics at low temperatures. Here we report the observation of an extremely large positive magnetoresistance at low temperatures in the non-magnetic layered transition-metal dichalcogenide WTe2: 452,700 per cent at 4.5 kelvins in a magnetic field of 14.7 teslas, and 13 million per cent at 0.53 kelvins in a magnetic field of 60 teslas. In contrast with other materials, there is no saturation of the magnetoresistance value even at very high applied fields. Determination of the origin and consequences of this effect, and the fabrication of thin films, nanostructures and devices based on the extremely large positive magnetoresistance of WTe2, will represent a significant new direction in the study of magnetoresistivity.

We present an ARPES study of the surface states of Ru2Sn3, a new type of a strong 3D topological insulator (TI). In contrast to currently known 3D TIs, which display two-dimensional Dirac cones with linear isotropic dispersions crossing through one point in the surface Brillouin Zone (SBZ), the surface states on Ru2Sn3 are highly anisotropic, displaying an almost flat dispersion along certain high-symmetry directions. This results in quasi-one dimensional (1D) Dirac electronic states throughout the SBZ that we argue are inherited from features in the bulk electronic structure of Ru2Sn3 where the bulk conduction bands are highly anisotropic. Unlike previous experimentally characterized TIs, the topological surface states of Ru2Sn3 are the result of a d-p band inversion rather than an s-p band inversion. The observed surface states are the topological equivalent to a single 2D Dirac cone at the surface Brillouin zone.

Resistivity, dc magnetization, and heat capacity measurements are reported for superconducting NaBi. T(c), the electronic contribution to the specific heat γ, the ΔC(p)/γT(c) ratio, and the Debye temperature are found to be 2.15 K, 3.4 mJ mol(-1) K(-2), 0.78, and 140 K respectively. The calculated electron-phonon coupling constant (λ(ep) = 0.62) implies that NaBi is a moderately coupled superconductor. The upper critical field and coherence length are found to be 250 Oe and 115 nm, respectively. Electronic structure calculations show NaBi to be a good metal, in agreement with the experiments; the p(x) and p(y) orbitals of Bi dominate the electronic states at the Fermi Energy.

Polycrystalline CuRhO2 is investigated as a photocathode for the splitting of water under visible irradiation. The band edge positions of this material straddle the water oxidation and reduction redox potentials. Thus, photogenerated conduction band electrons are sufficiently energetic to reduce water, while the associated valence band holes are energetically able to oxidize water to O2. Under visible illumination, H2 production is observed with ~0.2 V underpotential in an air-saturated solution. In contrast, H2 production in an Ar-saturated solution was found to be unstable. This instability is associated with the reduction of the semiconductor forming Cu(s). However, in the presence of air or O2, bulk Cu(s) was not detected, implying that CuRhO2 is self-healing when air is present. This property allows for the stable formation of H2 with ca. 80% Faradaic efficiency.

Anaemia is a chief determinant of global ill health, contributing to cognitive impairment, growth retardation and impaired physical capacity. To understand further the genetic factors influencing red blood cells, we carried out a genome-wide association study of haemoglobin concentration and related parameters in up to 135,367 individuals. Here we identify 75 independent genetic loci associated with one or more red blood cell phenotypes at P < 10(-8), which together explain 4-9% of the phenotypic variance per trait. Using expression quantitative trait loci and bioinformatic strategies, we identify 121 candidate genes enriched in functions relevant to red blood cell biology. The candidate genes are expressed preferentially in red blood cell precursors, and 43 have haematopoietic phenotypes in Mus musculus or Drosophila melanogaster. Through open-chromatin and coding-variant analyses we identify potential causal genetic variants at 41 loci. Our findings provide extensive new insights into genetic mechanisms and biological pathways controlling red blood cell formation and function.

Platelets are the second most abundant cell type in blood and are essential for maintaining haemostasis. Their count and volume are tightly controlled within narrow physiological ranges, but there is only limited understanding of the molecular processes controlling both traits. Here we carried out a high-powered meta-analysis of genome-wide association studies (GWAS) in up to 66,867 individuals of European ancestry, followed by extensive biological and functional assessment. We identified 68 genomic loci reliably associated with platelet count and volume mapping to established and putative novel regulators of megakaryopoiesis and platelet formation. These genes show megakaryocyte-specific gene expression patterns and extensive network connectivity. Using gene silencing in Danio rerio and Drosophila melanogaster, we identified 11 of the genes as novel regulators of blood cell formation. Taken together, our findings advance understanding of novel gene functions controlling fate-determining events during megakaryopoiesis and platelet formation, providing a new example of successful translation of GWAS to function.

Background: C-reactive protein (CRP) is a heritable marker of chronic inflammation that is strongly associated with cardiovascular disease. We sought to identify genetic variants that are associated with CRP levels., Methods and Results: We performed a genome-wide association analysis of CRP in 66 185 participants from 15 population-based studies. We sought replication for the genome-wide significant and suggestive loci in a replication panel comprising 16 540 individuals from 10 independent studies. We found 18 genome-wide significant loci, and we provided evidence of replication for 8 of them. Our results confirm 7 previously known loci and introduce 11 novel loci that are implicated in pathways related to the metabolic syndrome (APOC1, HNF1A, LEPR, GCKR, HNF4A, and PTPN2) or the immune system (CRP, IL6R, NLRP3, IL1F10, and IRF1) or that reside in regions previously not known to play a role in chronic inflammation (PPP1R3B, SALL1, PABPC4, ASCL1, RORA, and BCL7B). We found a significant interaction of body mass index with LEPR (P<2.9×10(-6)). A weighted genetic risk score that was developed to summarize the effect of risk alleles was strongly associated with CRP levels and explained ≈5% of the trait variance; however, there was no evidence for these genetic variants explaining the association of CRP with coronary heart disease., Conclusions: We identified 18 loci that were associated with CRP levels. Our study highlights immune response and metabolic regulatory pathways involved in the regulation of chronic inflammation.