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Background South Korea has been providing 10-valent pneumococcal conjugate vaccine/(PCV10)/13-valent pneumococcal conjugate vaccine (PCV13) to children and 23-valent pneumococcal polysaccharide vaccine (PPSV23) to older adults as part of a national immunization program. Methods From September 2015 to August 2017, a prospective cohort study was conducted for adults aged ≥19 years with community-acquired pneumonia (CAP) at four university hospitals. All-cause and pneumococcal CAP incidence and mortality rates were evaluated on the basis of hospital catchment population. Serotype distribution of pneumococcal CAP was also evaluated. Results Among 2669 patients with CAP, 252 cases (9.4%) were pneumococcal CAP cases. The annual incidences of all-cause and pneumococcal CAP were 194.3 cases and 18.3 cases respectively, per 100,000 persons. Serotyped Streptococcus pneumoniae was identified in 107 cases (42.5%) through culture or a serotype-specific urinary antigen detection assay. Pneumococcal CAP caused by the PCV13 and PPSV23 serotypes were 50 cases (46.7% of serotyped pneumococcal CAP and 19.8% of pneumococcal CAP), and 83 cases (77.6% of serotyped pneumococcal CAP and 32.9% of pneumococcal CAP), respectively. The most prevalent serotype was 3 (n = 21, 19.6% of serotyped pneumococcal CAP), followed by 19A (n = 10, 9.3% of serotyped pneumococcal CAP) and 11A (n = 10, 9.3% of serotyped pneumococcal CAP). Compared with non-pneumococcal CAP patients, pneumococcal CAP patients were more likely to have a higher CURB-65 scores (P = 0.002). The overall 30-day mortality rate of pneumococcal CAP was higher than that of non-pneumococcal CAP (6.3% versus 5.6%; odds ratio [OR], 1.15; 95% confidence interval [CI], 0.67–1.96), but this trend was reversed in patients aged 65–74 years (4.2% versus 8.6%; OR, 0.47; 95% CI, 0.14–1.54). Conclusions The disease burden of PCV13-serotype pneumococcal CAP remains significantly high in Korean adults, particularly among elderly people, even after a high uptake of pediatric PCVs.

Background Hemorrhagic fever with renal syndrome is a serious health problem in Eurasian countries. This study aimed to evaluate the immunogenicity and safety of formalin-inactivated Hantaan virus vaccine (Hantavax®) with a 3 + 1 vaccination schedule. Methods A phase III, multi-center clinical trial was conducted to evaluate the immunogenicity and safety of Hantavax® (three primary doses and a booster dose schedule at 0, 1, 2 and 13 months) among healthy adults. Immune responses were assessed using the plaque reduction neutralizing antibody test (PRNT) and immunofluorescent antibody assay (IFA). Systemic and local adverse events were assessed. Results A total of 320 healthy subjects aged ≥19 years were enrolled. Following three primary doses of Hantavax®, the seroconversion rate was 80.97% and 92.81% by PRNT and IFA, respectively. With booster administration, seropositive rates were 67.47% and 95.68% at one-month post-vaccination according to PRNT and IFA, respectively. Solicited local and systemic adverse events were reported in 30.50–42.81% and 16.67–33.75% during the three primary dose vaccination, while those were reported 36.57% and 21.36% after the booster doses. Both local and systemic adverse events did not increase with repeated vaccinations. Conclusion Hantavax® showed a high seroconversion rate after the three-dose priming, and additional dose administration with 11-month interval induced good booster effects. (ClinicalTrials.gov Identifier: NCT02553837).

Background Annually, about 80% of the Korean elderly aged ≥65 years receive influenza vaccination. Repeated annual vaccination has been suggested as an important factor of poor influenza vaccine effectiveness (VE), though reported conflicting results. Methods During the consecutive A/H3N2-dominant influenza seasons between 2012 and 2015, we comparatively evaluated the VE (repeated vs. current season only) against laboratory-confirmed influenza, pneumonia and hospitalization in the elderly aged ≥65 years with influenza-like illness (ILI). Clinical and demographic data were collected prospectively, and vaccination status of prior and current seasons was verified using the immunization registry data of Korean Centers for Disease Control and Prevention. Results During the first A/H3N2-dominant season in 2012–2013, influenza vaccine showed statistically significant effectiveness against influenza A infection only and when vaccinated in the current season only (VE 53%, 95% CI 15–77). In the latter two seasons (2013–2015 years), the adjusted VE for influenza A was indistinguishable between repeated vaccination and vaccination in the current season only. Conclusion During consecutive influenza A/H3N2 epidemics, poor influenza vaccine effectiveness may be more pronounced among the elderly population with a high annual vaccine uptake rate.

We aimed to determine if the severity of computed tomographic coronary angiography (CTCA)-diagnosed coronary artery disease (CAD) is associated with postliver transplantation (LT) myocardial infarction (MI) within 30 days and early mortality. We retrospectively evaluated 2118 consecutive patients who underwent CAD screening using CTCA. Post-LT type-2 MI, elicited by oxygen supply-and-demand mismatch within a month after LT, was assessed according to the severity of CTCA-diagnosed CAD. Obstructive CAD (>50% narrowing, 9.2% prevalence) was identified in 21.7% of patients with 3 or more known CAD risk factors of the American Heart Association. Post-LT MI occurred in 60 (2.8%) of total patients in whom 90-day mortality rate was 16.7%. Rates of post-LT MI were 2.1%, 3.1%, 3.4%, 4.3%, and 21.4% for normal, nonobstructive CAD, and 1-, 2-, and 3-vessel obstructive CAD, respectively. Two-vessel or 3-vessel obstructive CAD showed a 4.9-fold higher post-LT MI risk compared to normal coronary vessels. The sensitivity and negative predictive value of obstructive CAD in detecting post-LT MI were, respectively, 20% and 97.5%. In conclusion, negative CTCA finding in suspected patients can successfully exclude post-LT MI, whereas proceeding with invasive angiography is needed to further risk-stratify in patients with significant CTCA-diagnosed CAD. Prognostic role of CTCA in predicting post-LT MI needs further research.

Background While herd effects and serotype replacement by childhood pneumococcal protein conjugated vaccines (PCVs) continues to accumulate worldwide, direct effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPV23) against pneumococcal diseases in the elderly has been challenged. We estimated the direct effectiveness of PPV23 in the elderly population. Methods For a hospital-based case-control study, cases of invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NBPP) (adults ≥ 65 years) were identified in 14 hospitals participated in the pneumococcal surveillance program from March 2013 to October 2015, following implementation of PPV23 national immunization program (NIP) for the elderly in the Republic of Korea. Controls matched by age, sex, and hospital were selected at ratios of 1:2 (IPD) or 1:1 (NBPP). Clinical data and vaccination records were collected. Vaccine effectiveness was calculated as (1-adjusted odds ratio) × 100. Results We enrolled 148 IPD and 557 NBPP cases, and 295 IPD and 557 NBPP controls for analyses. Overall effectiveness of PPV23 against IPD was 28.5% [95% confidence interval (CI) −5.8%–51.6%] and against NBPP was 10.2% (-15.1-30.6) in all patients ≥ 65 years. However, in subgroup analysis of patients aged 65–74 years, PPV23 was protective against IPD [effectiveness 57.4% (19.4–77.5)] and against NBPP [effectiveness 35.0% (2.3–56.7)]. Furthermore, serotype-specific effectiveness of PPV23 against IPD was 90.6% (27.6–98.8) for PPV23-unique serotypes and 81.3% (38.6–94.3) for PPV23 serotypes excluding serotype 3. Conclusions This study indicates that PPV23 with broad serotype coverage might be beneficial in preventing IPD and NBPP due to non-PCV13 serotypes in the young-elderly, with potentially increasing effectiveness in the setting of childhood PCV NIP.

Omicron has become the globally dominant severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant, creating additional challenges due to its ability to evade neutralization. Here, we report that neutralizing antibodies against Omicron variants are undetected following COVID-19 infection with ancestral or past SARS-CoV-2 variant viruses or after two-dose mRNA vaccination. Compared with two-dose vaccination, a three-dose vaccination course induces broad neutralizing antibody responses with improved durability against different SARS-CoV-2 variants, although neutralizing antibody titers against Omicron remain low. Intriguingly, among individuals with three-dose vaccination, Omicron breakthrough infection substantially augments serum neutralizing activity against a broad spectrum of SARS-CoV-2 variants, including Omicron variants BA.1, BA.2, and BA.5. Additionally, after Omicron breakthrough infection, memory T cells respond to the spike proteins of both ancestral and Omicron SARS-CoV-2 by producing cytokines with polyfunctionality. These results suggest that Omicron breakthrough infection following three-dose mRNA vaccination induces pan-SARS-CoV-2 immunity that may protect against emerging SARS-CoV-2 variants of concern.

We assessed humoral responses and reactogenicity following the heterologous vaccination compared to the homologous vaccination groups.We enrolled healthcare workers (HCWs) who were either vaccinated with ChAdOx1 followed by BNT162b2 (heterologous group) or 2 doses of ChAdOx1 (ChAdOx1 group) or BNT162b2 (BNT162b2 group). Immunogenicity was assessed by measuring antibody titers against receptor-binding domain (RBD) of SARS-CoV-2 spike protein in all participants and neutralizing antibody titer in 100 participants per group. Reactogenicity was evaluated by a questionnaire-based survey.We enrolled 499 HCWs (ChAdOx1, n = 199; BNT162b2, n = 200; heterologous ChAdOx1/BNT162b2, n = 100). The geometric mean titer of anti-receptor-binding domain antibody at 14 days after the booster dose was significantly higher in the heterologous group (11 780.55 binding antibody unit (BAU)/mL [95% CI, 10 891.52-12 742.14]) than in the ChAdOx1 (1561.51 [95% CI, 1415.03-1723.15]) or BNT162b2 (2895.90 [95% CI, 2664.01-3147.98]) groups (both p 0.001). The neutralizing antibody titer of the heterologous group (geometric mean NDHeterologous ChAdOx1 followed by BNT162b2 vaccination with a 12-week interval induced a robust humoral immune response against SARS-CoV-2, including the Delta variant, that was comparable to the homologous BNT162b2 vaccination and stronger than the homologous ChAdOx1 vaccination, with a tolerable reactogenicity profile.

Objectives The aim was to determine whether various clinical specimens obtained from COVID-19 patients contain the infectious virus. Methods To demonstrate whether various clinical specimens contain the viable virus, we collected naso/oropharyngeal swabs and saliva, urine and stool samples from five COVID-19 patients and performed a quantitative polymerase chain reaction (qPCR) to assess viral load. Specimens positive with qPCR were subjected to virus isolation in Vero cells. We also used urine and stool samples to intranasally inoculate ferrets and evaluated the virus titres in nasal washes on 2, 4, 6 and 8 days post infection. Results SARS-CoV-2 RNA was detected in all naso/oropharyngeal swabs and saliva, urine and stool samples collected between days 8 and 30 of the clinical course. Notably, viral loads in urine, saliva and stool samples were almost equal to or higher than those in naso/oropharyngeal swabs (urine 1.08 ± 0.16–2.09 ± 0.85 log10 copies/mL, saliva 1.07 ± 0.34–1.65 ± 0.46 log10 copies/mL, stool 1.17 ± 0.32 log10 copies/mL, naso/oropharyngeal swabs 1.18 ± 0.12–1.34 ± 0.30 log10 copies/mL). Further, viable SARS-CoV-2 was isolated from naso/oropharyngeal swabs and saliva of COVID-19 patients, as well as nasal washes of ferrets inoculated with patient urine or stool. Discussion Viable SARS-CoV-2 was demonstrated in saliva, urine and stool samples from COVID-19 patients up to days 11–15 of the clinical course. This result suggests that viable SARS-CoV-2 can be secreted in various clinical samples and respiratory specimens.

Highlights • To counteract COVID-19 pandemics, more airborne-infection isolation rooms are needed • Negative air machines can generate negative pressure in patient rooms. • Every effort should be made to equip anterooms in airborne-infection isolation rooms. • When selecting isolation rooms, oxygen and medical air supply should be checked., More airborne-infection isolation rooms are needed in centers that treat severely affected coronavirus 2019 patients. Wards and rooms must be carefully checked to ensure an ample supply of medical air and oxygen. Anterooms adjacent to airborne-infection isolation rooms are required to maintain pressure differentials and provide an area for donning/doffing or disinfecting medical equipment.

Objectives: This study aimed to characterize the risk factors for mortality in adult patients with invasive pneumococcal disease (IPD) stratified by age groups, after implementation of the national immunization program of 23-valent polysaccharide vaccine (PPSV23) for those aged ≥65 years in the Republic of Korea (ROK). Methods: Clinical data and pneumococcal isolates from adult patients with IPD (≥18 years of age) were collected prospectively from 20 hospitals through the nationwide surveillance program from March 2013 to October 2015. Results: A total of 319 patients with IPD were enrolled. Median age was 69 years. Overall in-hospital mortality was 34.2%: 17.1% in those aged 18–49 years, 23.7% in those aged 50–64 years, 33.0% in those aged 65–74 years, and 51.0% in those aged ≥75 years (p

We aimed to characterize the lineages of influenza B viruses obtained from clinical specimens during the 2007-2014 seasons in South Korea. RT-PCR for the partial hemagglutinin gene of influenza B virus was performed on laboratory-confirmed influenza B samples from the 2007-2008 season to 2013-2014 season. A phylogenetic tree was generated, and current influenza vaccine strains for the Northern Hemisphere were used as representative strains of Victoria and Yamagata lineages. A total of 571 influenza B virus sequences were analyzed. During the 2009-2010 season, most of the circulating influenza B viruses matched the vaccine strain; 91.0% (91/100) of viruses belonged to the Victoria lineage. In the 2007-2008, 2011-2012, and 2013-2014 seasons, co-circulation of each influenza B lineage was found with a match ratio to the vaccine strain of 53.2% (42/79), 40.9% (63/154), and 58.3% (134/230), respectively. Overall, 41.7% (238/571) of the circulating influenza B viruses belonged to the lineage mismatching the vaccine strain. During the seven influenza seasons, influenza B epidemics were substantial in four seasons in South Korea. Significant mismatches of the vaccine and lineage of the circulating influenza B viruses were found. The current trivalent influenza vaccine may not be fully suitable for effective protection against influenza B.

Free-standing, one-dimensional TiO2 nanotube arrays (TNAs) with a disordered surface structure are synthesized on transparent conducting substrates, and their opto-physicochemical properties and photoelectrocatalytic (PEC) performances are examined in detail. A two-step anodization process is used to transplant TNAs grown on titanium foils onto fluorine-doped SnO2 substrates (denoted as W-TNAs), after which they are electrochemically reduced for 20 and 90 s (denoted as B-TNAs-20 and 90, respectively). The as-transplanted W-TNAs exhibit low PEC activities in terms of their photocurrent, oxygen evolution reaction (OER), and oxidations of inorganic and organic substrates (iodide and urea, respectively) under simulated sunlight (AM 1.5; 100 mW cm−2), primarily because of the sluggish charge transfer through the poor electrically conductive TNA framework. The quick electrochemical reduction of the W-TNAs leads to an 8-fold larger photocurrent, while significantly accelerating the OER (by three times) and iodide and urea oxidation reactions (by 2 and ∼20 times, respectively). These enhanced PEC activities of the B-TNAs are attributed to the creation of Ti3+ and associated oxygen vacancies which strengthen their n-type characteristics and thereby increase their electrical conductivity. The time-resolved photoluminescence spectra further reveal that the lifetime (τ) of the photogenerated charge carriers in the B-TNAs (τ = 0.33 ns) is an order of magnitude shorter than that of the W-TNAs (τ = 3.63 ns). The disordered surface exhibits a lower Faradaic efficiency for multi-electron transfer oxidation reactions and a higher Faradaic efficiency for single-electron transfer oxidation reactions compared to the W-TNAs. The detailed surface characterization and PEC mechanism are discussed.

This study investigated the effect of TiO 2 morphology-driven intrinsic oxygen defects on photocatalytic activities for removal of Cr(VI). To do so, two different-shaped TiO 2 particles, nano-granular TiO 2 particles (TiNP) and TiO 2 nanotube particles (TiNT), were prepared and applied. The surface analyses indicated that TiNP was found to have a greater photocatalytic activity than TiNT because of its more crystallinity and lower bandgap energy, more oxygen vacancies closer to the conduction band (CB), and its resulting more amounts of photogenerated electrons. Accordingly, these photocatalytic properties of TiO 2 particles were more evident in experimental result for photocatalytic reduction of Cr(VI) that was tested as a model target compound. The batch system showed that TiNP completely reduced Cr(VI) to Cr(III) at acidic and neutral pH, whereas TiNT were less effective even at low pH.

Memory T-cell responses have been demonstrated after recovery from SARS-CoV-2 infection, but the phenotypes of SARS-CoV-2-specific T cells have not been comprehensively investigated ex vivo. We detected SARS-CoV-2-specific CD8+ T cells by MHC-I multimer staining and examined their phenotypes in relation to their functional capacity in acute and convalescent COVID-19. In the convalescent phase, multimer+ cells exhibited early differentiated effector-memory phenotypes. The frequency of CD127+KLRG1- memory precursor effector cells among multimer+ cells was significantly lower in convalescent individuals with severe disease than those with mild disease. Cytokine-secretion assays combined with MHC-I multimer staining revealed that the proportion of IFN-γ-producing cells was significantly lower among SARS-CoV-2-specific CD8+ T cells than those specific to other viruses. Importantly, the proportion of IFN-γ-producing cells was significantly higher in PD-1+ cells than PD-1- cells among multimer+ cells in both the acute and convalescence phases, indicating that PD-1-expressing, SARS-CoV-2-specific CD8+ T cells are not exhausted, but functional. Our findings provide insights for effective vaccine development.

Background: With high pneumococcal vaccine uptake rates in South Korea, the burden of community-acquired pneumonia (CAP) and serotype distribution of pneumococcal CAP may change. Methods: From September 2015 to August 2017, a prospective cohort study was conducted for Korean adults aged ≥ 19 years who were hospitalized with CAP at four university hospitals. All-cause and pneumococcal CAP incidence and mortality rates were evaluated based on the hospital catchment population. Pneumococcal CAP was identified by culture and BinaxNOW urinary antigen test. A newly developed 24 serotype-specific urinary antigen detection (UAD) assay was also used. Findings: Among 2,669 patients with medically attended CAP, 252 cases (9.4%) were pneumococcal CAP. Pneumococcal serotypes were determined in 107 cases. Annual incidence of all-cause and pneumococcal CAP were 194.3 cases and 18.3 cases per 100,000 persons, respectively. Pneumococcal CAP caused by PCV13 and PPSV23 serotypes comprised 46.7% and 77.6% of all serotypable S. pneumonia, respectively. The most prevalent serotype was 3 (19.6%), followed by 19A (9.3%) and 11A (9.3%). The overall 30-day mortality rate of pneumococcal CAP was higher than that of all-cause CAP (6.3% versus 5.7%), but the opposite was found in patients aged 65–74 years (4.2% versus 8.1%) Interpretation: Indirect herd effect from pediatric vaccination might be insufficient. To better control adult CAP, age- and risk-targeted individual PCV13 vaccination should be considered. PPSV23 might decrease the severity of pneumococcal pneumonia, thereby lowering the mortality rate in elderly patients aged 65–74 years. Funding Statement: This work was supported by a Korea University Guro Hospital grant (no. K1719481) that was underwritten by Pfizer. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The study was conducted after approval by Institutional Review Boards at each participating study hospital.

A photoelectrochemical (PEC) cell composed of a WO 3 /dye-sensitized solar cell (WO 3 /DSSC) and copper oxide (Cu x O, where x =1 and 2) wire arrays as a dual-absorber photoanode and cathode, respectively, is demonstrated as a stand-alone, durable device for CO 2 photoconversion. The Cu x O wire arrays, which have high surface-to-volume ratios, exhibit promising electrocatalytic activity for CO 2 conversion to CO at Faradaic efficiencies of ~80% and ~60% at E=−0.2 and −0.4 V vs . RHE, respectively, and H 2 production is minimized at a Faradaic efficiency vs . RHE. The single-absorber cell of a WO 3 photoanode and Cu x O wire array cathode couple (WO 3 -Cu x O) requires a minimum overpotential of ~0.7 V to drive CO 2 conversion. For stand-alone CO 2 conversion, a DSSC is coupled to the WO 3 -Cu x O system. In the dual-absorber cell (WO 3 /DSSC-Cu x O), the long-wave band (λ > ca . 450 nm) passed through the semitransparent WO 3 film is absorbed by the dye-sensitized TiO 2 electrode of the DSSC. The WO 3 /DSSC-Cu x O shows a potential gain of ~0.7 V and is able to successfully drive CO 2 conversion on Cu x O and simultaneously oxidize water on WO 3 without an external power supply. In this stand-alone system, the primary CO 2 conversion product is CO, with a solar-to-chemical energy efficiency of ~2.5%; H 2 and formate are obtained with energy efficiencies of 0.7% and 0.25%, respectively, in 5 h (overall efficiency ~3.45%). Neither CO 2 conversion product nor H 2 is found using the single-absorber system.

Metal oxide anode electrocatalysts are important for an effective removal of contaminants and the enhancement of electrode durability in the electrochemical oxidation process. Herein, we report the enhanced lifetime of RuOx−TiO2 composite anodes that was achieved by optimizing the fabrication conditions (e.g., the Ru mole fraction, total metal content, and calcination time). The electrode durability was assessed through accelerated service lifetime tests conducted under harsh environmental conditions, by using 3.4% NaCl and 1.0 A/cm2. The electrochemical characteristics of the anodes prepared with metal oxides having different compositions were evaluated using cyclic voltammetry, electrochemical impedance spectroscopy, and X-ray analyses. We noticed that, the larger the Ru mole fraction, the more durable were the electrodes. The RuOx−TiO2 electrodes were found to be highly stable when the Ru mole fraction was >0.7. The 0.8RuOx−0.2TiO2 electrode was selected as the one with the most appropriate composition, considering both its stability and contaminant treatability. The electrodes that underwent a 7-h calcination (between 1 and 10 h) showed the longest lifetime under the tested conditions, because of the formation of a stable Ru oxide structure (i.e., RuO3) and a lower resistance to charge transfer. The electrode deactivation mechanism that occurred due to the dissolution of active catalysts over time was evidenced by an impedance analysis of the electrode itself and surface elemental mapping.

Memory T cell responses have been demonstrated in COVID-19 convalescents, but ex vivo phenotypes of SARS-CoV-2-specific T cells have been unclear. We detected SARS-CoV-2-specific CD8+ T cells by MHC class I multimer staining and examined their phenotypes and functions in acute and convalescent COVID-19. Multimer+ cells exhibited early differentiated effector-memory phenotypes in the early convalescent phase. The frequency of stem-like memory cells was increased among multimer+ cells in the late convalescent phase. Cytokine secretion assays combined with MHC class I multimer staining revealed that the proportion of interferon-I³ (IFN-I³)-producing cells was significantly lower among SARS-CoV-2-specific CD8+ T cells than those specific to influenza A virus. Importantly, the proportion of IFN-I³-producing cells was higher in PD-1+ cells than PD-1- cells among multimer+ cells, indicating that PD-1-expressing, SARS-CoV-2-specific CD8+ T cells are not exhausted, but functional. Our current findings provide information for understanding of SARS-CoV-2-specific CD8+ T cells elicited by infection or vaccination.

This study examines the electrocatalytic activity of disordered titania nanotube arrays modified with Co2+ for the oxidation of (in)organic substrates and inactivation of E. coli in a flow-through electrochemical device. As-anodized TiO2 nanotubes (TNTs) on perforated Ti foils are electrochemically reduced to create Ti3+ states and oxygen vacancies. The electrochemically reduced TNTs (r-TNTs) are capable of adsorbing Co2+ in ~7 times larger amounts than the bare TNTs. Among the bare and modified TNT samples (TNTs, r-TNTs, Co-TNTs, and Co-r-TNTs), Co-r-TNTs exhibit the lowest interfacial charge-transfer resistance and fastest internal charge-transfer kinetics. The electron spin resonance analysis further reveals an enhanced production of OOH radicals in Co-r-TNTs. The combined effect of the excellent charge-transfer behavior and the radical production of Co-r-TNTs leads to faster decomposition of N,N-dimethyl-p-nitrosoaniline, higher current efficiency in the oxidation of iodide to triiodide, and greater inactivation of E. coli as compared to r-TNTs. Details on the surface characterization of the bare and modified TNTs samples are presented and the role of the adsorbed Co2+ is discussed.

The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in China and rapidly spread worldwide. To prevent SARS-CoV-2 dissemination, understanding the in vivo characteristics of SARS-CoV-2 is a high priority. We report a ferret model of SARS-CoV-2 infection and transmission that recapitulates aspects of human disease. SARS-CoV-2-infected ferrets exhibit elevated body temperatures and virus replication. Although fatalities were not observed, SARS-CoV-2-infected ferrets shed virus in nasal washes, saliva, urine, and feces up to 8 days post-infection. At 2 days post-contact, SARS-CoV-2 was detected in all naive direct contact ferrets. Furthermore, a few naive indirect contact ferrets were positive for viral RNA, suggesting airborne transmission. Viral antigens were detected in nasal turbinate, trachea, lungs, and intestine with acute bronchiolitis present in infected lungs. Thus, ferrets represent an infection and transmission animal model of COVID-19 that may facilitate development of SARS-CoV-2 therapeutics and vaccines.

Background Previous reports mostly from Europe suggested an association between an occurrence of narcolepsy and an influenza A(H1N1)pdm09 vaccine adjuvanted with AS03 (Pandemrix ® ). During the 2009 H1N1 pandemic vaccination campaign, the Korean military performed a vaccination campaign with one type of influenza vaccine containing MF59-adjuvants. This study was conducted to investigate the background incidence rate of narcolepsy in South Korean soldiers and the association of the MF59-adjuvanted vaccine with the occurrence of narcolepsy in a young adult group. Methods To assess the incidence of narcolepsy, we retrospectively reviewed medical records of suspicious cases of narcolepsy in 2007–2013 in the whole 20 military hospitals of the Korean military. The screened cases were classified according to the Brighton Collaboration case definition of narcolepsy. After obtaining the number of confirmed cases of narcolepsy per 3 months in 2007–2013, we compared the crude incidence rate of narcolepsy before and after the vaccination campaign. Results We included 218 narcolepsy suspicious cases in the initial review, which were screened by the diagnostic code on the computerized disease registry in 2007–2013. Forty-one cases were finally diagnosed with narcolepsy in 2007–2013 (male sex, 95%; median age, 21 years). The average background incidence rate of narcolepsy in Korean soldiers was 0.91 cases per 100,000 persons per year. During the 9 months before vaccination implementation (April to December 2009), 6 narcolepsy cases occurred, whereas during the next 9 months (January to September 2010) including the 3-month vaccination campaign, 5 cases occurred. Conclusions The incidence of narcolepsy in South Korean soldiers was not increased after the pandemic vaccination campaign using the MF59-adjuvanted vaccine. Our results suggest that the MF59-adjuvanted H1N1 vaccine did not contribute to the occurrence of narcolepsy in this young adult group.

The catalytic effects of four different carbon materials (graphite, multi-walled carbon nanotubes, carbon fibers, and activated carbon) on dye-sensitized solar hydrogen production were investigated under a simulated solar light (AM 1.5G, 100 mW/cm2). Eosin-Y (EY) and triethanolamine (TEOA) were employed as a sensitizer and electron donor, respectively. All the tested carbon materials enhanced the sensitized H2 production, while multi-walled carbon nanotubes (CNT) exhibited the highest catalytic activity with 9- and 4-fold enhanced H2 production and photocurrent generation, respectively. This suggests that CNT is highly effective in catalyzing charge injection and thus sensitized H2 production. With Pt loading onto the carbon materials, the H2 production was further improved by a maximum of 10 times. With the bare carbon materials, EY underwent simultaneous spectral shifts and decreases in absorbance presumably due to stepwise de-bromination and cleavage of chromophoric groups. With CNT/Pt, however, only the former was observed despite far higher H2 production. This indicates that the regeneration of EY is significantly enhanced with CNT/Pt. A detailed comparison of carbon materials and the sensitized mechanism was discussed.

Influenza is an acute respiratory illness, which can be accompanied by complications such as pneumonia. This study was conducted to survey the clinical courses and outcomes of hospitalized adult patients with laboratory-confirmed seasonal influenza. A prospective case–control study was performed in adult influenza patients who were admitted to hospitals participating in the Hospital-based Influenza Morbidity and Mortality (HIMM) surveillance system in Korea from October 2011 to May 2012. Cases with complicated influenza were compared to those without complications. A total of 123 (5.6%) patients among 2184 laboratory-confirmed adult influenza patients were hospitalized during the 2011–2012 influenza epidemic season. Forty (32.5%) experienced 50 complication episodes. Age older than 60 years (P < 0.01), male sex (P = 0.04), diabetes (P < 0.01), chronic cardiovascular disease (P < 0.01) and neuromuscular disease (P = 0.02) were significantly related to development of complications in univariate analysis. Multivariate logistic regression analysis revealed that diabetes (odds ratio [OR] 3.63, 95% confidence interval [CI] 1.15–11.51, P = 0.02) was an independent risk factor for complicated seasonal influenza. C-reactive protein (CRP) was discriminative between complicated and uncomplicated influenza (cutoff value 13 mg/L, sensitivity 70%, specificity 74%). Complicated patients received antibiotics more frequently (P < 0.01) with longer hospital stays (P = 0.01). In conclusion, diabetic patients are at great risk for complicated influenza, and CRP would be useful to predicting complication. Therefore, early interventions such as antiviral therapy should be considered for high risk patients with diabetes, especially those with increased serum CRP level.