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Importance: Incident atrial fibrillation (AF) is associated with an increased risk of dementia. However, data on the association between smoking cessation after AF diagnosis and dementia risk are limited.Objective: To evaluate the association between changes in smoking status after AF diagnosis and dementia risk.Design, Setting, and Participants: This nationwide cohort study with 126 252 patients used data from the Korean National Health Insurance Service database, including patients who had a national health checkup examination within 2 years before and after AF diagnosis between January 1, 2010, and December 31, 2016. Based on their smoking status, participants were classified as never smokers, ex-smokers, quit smokers, and current smokers. Ex-smokers were defined as those who had quit smoking before the first examination and remained quit until the second examination. Patients who were current smokers at the first health examination but had quit smoking before the second examination were classed as quit smokers. The index date was the second health examination. Patients were followed up until dementia, death, or the study period ended (December 31, 2017), whichever occurred first. Data were analyzed from January 13, 2020, to March 29, 2022.Exposures: Smoking cessation after newly diagnosed AF.Main Outcomes and Measures: Dementia, including Alzheimer disease and vascular dementia, was the primary outcome. Cox proportional hazards regression model was used to estimate hazard ratios.Results: A total of 126 252 patients (mean [SD] age, 62.6 [12.0] years; 61.9% men) were included in the analysis. The mean (SD) CHA2DS2-VASc score, which measures the risk of ischemic stroke, was 2.7 (1.7). Smoking status of the total study population was as follows: 65 579 never smokers (51.9%), 34 670 ex-smokers (27.5%), 8919 quit smokers (7.1%), and 17 084 current smokers (13.5%). During a median of 3 years of follow-up, dementia occurred in 5925 patients (1.11 per 1000 person-years). After multivariable adjustment, the risk of quit smokers was significantly lower than that of current smokers (hazard ratio, 0.83 [95% CI, 0.72-0.95]).Conclusions and Relevance: The findings of this cohort study suggest that all types of smoking were associated with a significantly higher risk of dementia in patients with new-onset AF. Smoking cessation after AF diagnosis was associated with a lower risk of dementia than among current smokers. These findings may support promoting smoking cessation to reduce dementia risk in patients with new-onset AF.

Graphical Abstract

Business schools and Engineering colleges are seeking to work with Design schools to forge new interdisciplinary programs (Lockwood, 2010). Multidisciplinary Design Education plays an essential role in such programs. Seoul National University’s Design department, Engineering College, and Business school began its Integrated Creative Design Education Program in 2009. Two years of education management has revealed the necessity of developing implementable multidisciplinary design education. This paper studies multidisciplinary design education cases to identify its factors and conditions, and to analyze the causes of such behavior. The final aim is to find blueprint for multidisciplinary design education model. As an outcome, four main categories have been drawn out: project theme and attribution, composition of project team members, project development process, and knowledge resource management. Then causal relation between these categories are identified. The next step is to explore more education cases and refining study outcome for an actual application.

In various contexts of interaction, users should creatively adjust their product/system use for fully attaining their goals and ensuring satisfactory experiences. To do so, users need to learn how to apply their problem-solving knowledge in the task domain (i.e. domain knowledge). This research aims to develop a methodology for designing interactive products/systems that can help users actively develop their domain knowledge through interaction. This new approach to interactive product/system design is named Learning-Based Approach (LBA). In order to develop the LBA methodology, this paper first proposes a model of users' knowledge development cycles in interaction. Then, some principles for enhancing the learning cycles are introduced, consisting of principles for motivation, knowledge acquisition, and meta-knowledge acquisition. In final, this paper describes the processes of the development and evaluation of the LBA-based prototype as a case product (a digital camera).

Additional file 1. Supplementary table and figure.