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Patients with CTCL are at increased risk for bacteremia which is a leading cause of morbidity and mortality. We assessed risk factors for and the impact of bacteremia on survival in a retrospective cohort of 188 CTCL patients at a single US academic institution treated between 1990 and 2018. With a median follow up of 6.2 years, 20% of patients (n = 36) developed 79 bacteremia events. Risk factors for bacteremia included advanced stage, female gender, African American (AA) race, invasive lines, and chemotherapy. Bacteremia was associated with an increased risk of death on univariate and multivariable models. Bacteremia is associated with an increased risk of death in patients with CTCL. The greatest avoidable risk factors included chemotherapy treatment and presence of an invasive line.

Aim To study the effect of regular drug therapy for cardiovascular and other diseases preceding the COVID-19 infection on severity and outcome of COVID-19 based on data of the ACTIVE (Analysis of dynamics of Comorbidities in paTIents who surVived SARS-CoV-2 infEction) registry.Material and methods The ACTIVE registry was created at the initiative of the Eurasian Association of Therapists. The registry includes 5 808 male and female patients diagnosed with COVID-19 treated in a hospital or at home with a due protection of patients’ privacy (data of nasal and throat smears; antibody titer; typical CT imaging features). The register territory included 7 countries: the Russian Federation, the Republic of Armenia, the Republic of Belarus, the Republic of Kazakhstan, the Kyrgyz Republic, the Republic of Moldova, and the Republic of Uzbekistan. The registry design: a closed, multicenter registry with two nonoverlapping arms (outpatient arm and in-patient arm). The registry scheduled 6 visits, 3 in-person visits during the acute period and 3 virtual visits (telephone calls) at 3, 6, and 12 mos. Patient enrollment started on June 29, 2020 and was completed on October 29, 2020. The registry completion is scheduled for October 29, 2022. The registry ID: ClinicalTrials.gov: NCT04492384. In this fragment of the study of registry data, the work group analyzed the effect of therapy for comorbidities at baseline on severity and outcomes of the novel coronavirus infection. The study population included only the patients who took their medicines on a regular basis while the comparison population consisted of noncompliant patients (irregular drug intake or not taking drugs at all despite indications for the treatment).ResultsThe analysis of the ACTIVE registry database included 5808 patients. The vast majority of patients with COVID-19 had comorbidities with prevalence of cardiovascular diseases. Medicines used for the treatment of COVID-19 comorbidities influenced the course of the infectious disease in different ways. A lower risk of fatal outcome was associated with the statin treatment in patients with ischemic heart disease (IHD); with angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor antagonists and with beta-blockers in patients with IHD, arterial hypertension, chronic heart failure (CHF), and atrial fibrillation; with oral anticoagulants (OAC), primarily direct OAC, clopidogrel/prasugrel/ticagrelor in patients with IHD; with oral antihyperglycemic therapy in patients with type 2 diabetes mellitus (DM); and with long-acting insulins in patients with type 1 DM. A higher risk of fatal outcome was associated with the spironolactone treatment in patients with CHF and with inhaled corticosteroids (iCS) in patients with chronic obstructive pulmonary disease (COPD).Conclusion In the epoch of COVID-19 pandemic, a lower risk of severe course of the coronavirus infection was observed for patients with chronic noninfectious comorbidities highly compliant with the base treatment of the comorbidity.

The organizer of the registers “Dynamics analysis of comorbidities in SARSCoV-2 survivors” (AKTIV) and “Analysis of hospitalizations of comorbid patients infected during the second wave of SARS-CoV-2 outbreak” (AKTIV 2) is the Eurasian Association of Therapists (EAT). Currently, there are no clinical registries in the Eurasian region designed to collect and analyze information on long-term outcomes of COVID-19 survivors with comorbid conditions. The aim of the register is to assess the impact of a novel coronavirus infection on long-term course of chronic non-communicable diseases 3, 6, 12 months after recovery, as well as to obtain information on the effect of comorbidity on the severity of COVID-19. Analysis of hospitalized patients of a possible second wave is planned for register “AKTIV 2”. To achieve this goal, the register will include men and women over 18 years of age diagnosed with COVID-19 who are treated in a hospital or in outpatient basis. The register includes 25 centers in 5 federal districts of the Russian Federation, centers in the Republic of Armenia, the Republic of Kazakhstan, the Republic of Kyrgyzstan, the Republic of Belarus, the Republic of Moldova, and the Republic of Uzbekistan. The estimated capacity of the register is 5400 patients.

One of the most serious complications of modern anesthesia is malignant hyperthermia, which is a pharmacogenetic disease phenotype manifested by skeletal muscle hypermetabolism and rhabdomyolysis during or after general anesthe- sia with the use of inhaled anesthetics and succinylcholine. In Russia, the problem of malignant hyperthermia remains unresolved. This is mainly due to the fact that the only specific drug dantrolene created for the effective treatment of malignant hyperthermia is still not legalized and thus formally prohibited to import, disseminate and apply on the domestic pharmaceutical market. This article deals with the regulatory framework of specific treatment of malignant hyperthermia in Russia, allowing the possibility to legally import to the territory of the Russian Federation dantrolene as an unregistered drug, if it is a question of rendering medical assistance on vital indications to a particular patient, or its unauthorized use for vital indications in a situation of extreme necessity. The article presents the recommendations of domestic experts on the treatment of malignant hyperthermia. In this case, as a possible alternative to dantrolene, magnesium preparations are considered, whose role in the treatment of the crisis of malignant hyperthermia continues to be specified. Thus, given the increasing use of inhalation anesthesia by Russian anesthetists, to ensure the safety of patients with regard to the development of malignant hyperthermia, it is possible only in the case of official registration in the do- mestic dantrolene market. Also, in the territory of Russia, a network of relevant consultative and diagnostic centers should be established. These measures will undoubtedly increase the effectiveness of treatment and prevention of severe consequences of this disease in our country.

Background We aimed to compare trough infliximab levels and the development of anti-drug antibody (ADA) for 1 year between Crohn’s disease (CD) and ulcerative colitis (UC) patients who were biologic-naïve and to evaluate their impact on clinical outcomes. Methods This was a prospective, multi-center, observational study. Biologic-naïve patients with moderate to severe CD and UC who started CT-P13 therapy were eligible for the study. The trough drug and ADA levels were measured serially for 1-year after CT-P13 initiation. Clinical outcomes were assessed with intention-to-treat purpose. Results 267 patients who received CT-P13 treatment were enrolled in the study (CD 168, UC 99). The rates of clinical remission (72% vs. 32.3%, p Conclusion CD shows favorable pharmacokinetics of infliximab including high trough drug and low ADA level compared with UC which might be related with better clinical outcomes for 1-year of infliximab.

Aim.To study the clinical course specifics of coronavirus disease 2019 (COVID-19) and comorbid conditions in COVID-19 survivors 3, 6, 12 months after recovery in the Eurasian region according to the AKTIV register.Material and methods.The AKTIV register was created at the initiative of the Eurasian Association of Therapists. The AKTIV register is divided into 2 parts: AKTIV 1 and AKTIV 2. The AKTIV 1 register currently includes 6300 patients, while in AKTIV 2 — 2770. Patients diagnosed with COVID-19 receiving in- and outpatient treatment have been anonymously included on the registry. The following 7 countries participated in the register: Russian Federation, Republic of Armenia, Republic of Belarus, Republic of Kazakhstan, Kyrgyz Republic, Republic of Moldova, Republic of Uzbekistan. This closed multicenter register with two nonoverlapping branches (in- and outpatient branch) provides 6 visits: 3 in-person visits during the acute period and 3 telephone calls after 3, 6, 12 months. Subject recruitment lasted from June 29, 2020 to October 29, 2020. Register will end on October 29, 2022. A total of 9 fragmentary analyzes of the registry data are planned. This fragment of the study presents the results of the post-hospitalization period in COVID-19 survivors after 3 and 6 months.Results.According to the AKTIV register, patients after COVID-19 are characterized by long-term persistent symptoms and frequent seeking for unscheduled medical care, including rehospitalizations. The most common causes of unplanned medical care are uncontrolled hypertension (HTN) and chronic coronary artery disease (CAD) and/or decompensated type 2 diabetes (T2D). During 3- and 6-month follow-up after hospitalization, 5,6% and 6,4% of patients were diagnosed with other diseases, which were more often presented by HTN, T2D, and CAD. The mortality rate of patients in the post-hospitalization period was 1,9% in the first 3 months and 0,2% for 4-6 months. The highest mortality rate was observed in the first 3 months in the group of patients with class II-IV heart failure, as well as in patients with cardiovascular diseases and cancer. In the pattern of death causes in the post-hospitalization period, following cardiovascular causes prevailed (31,8%): acute coronary syndrome, stroke, acute heart failure.Conclusion.According to the AKTIV register, the health status of patients after COVID-19 in a serious challenge for healthcare system, which requires planning adequate health system capacity to provide care to patients with COVID-19 in both acute and post-hospitalization period.

Background Thiopurine-related myelosuppression (most frequently leukopenia) interferes with thiopurine therapy for patients with inflammatory bowel diseases (IBD). We investigated whether pre-treatment analyses genetic variants associated with thiopurine-induced leukopenia could be used to effectively identify patients who required dose adjustments. Methods We performed a multicentre, prospective study of patients with IBD at 5 tertiary medical centres in Korea, from January 2016 through September 2018. Seventy-two patients were randomly assigned to a group that underwent genotype analysis for the NUDT15 variant (rs116855232) and FTO variant (rs79206939) and 3 common TPMT variants (rs1800460, rs1800462, rs1142345) associated with myelosuppression and 92 patients were assigned to a group that did not undergo genotype analysis (non-genotyping group). Patients heterozygous for any variant received 50 mg azathioprine equivalents, whereas those who were homozygous for any variant received alternative drugs. Patients who did not carry any of the genetic variants and patients in the non-genotyping group received 50 mg azathioprine equivalents followed by dose escalation up to 2–2.5 mg/kg. Myelosuppression was defined as white blood cell counts below 3000/μL, levels of haemoglobin 10 g/dl, or platelet counts below 100 K/μl. Results Twelve patients (16.7%) in the genotype analysis group and 33 patients (35.9%) in the non-genotyping group developed myelosuppression (p = .005). A multivariate analysis revealed that body mass indices above 21 kg/m2 (hazard ratio [HR], 0.43; 95% CI, 0.22–0.81; p = 0.009), pre-treatment genotype analysis (HR, 0.37; 95% CI, 0.18–0.77; p = 0.008), and the maximum dose of thiopurines (HR, 0.34; 95% CI, 0.19–0.59; p < 0.001) independently decreased risk of myelosuppression. Pre-treatment genotype analysis reduced numbers of outpatient clinic visit and numbers of patients with drug discontinuation or dose reductions. Conclusion In a randomised controlled study of patients undergoing thiopurine therapy for IBD, we found that selection of therapy based on genetic variants associated with thiopurine-induced leucopoenia significantly reduced the proportion of patients with myelosuppression during treatment.

The international AKTIV register presents a detailed description of out- and inpatients with COVID-19 in the Eurasian region. It was found that hospitalized patients had more comorbidities. In addition, these patients were older and there were more men than among outpatients. Among the traditional risk factors, obesity and hypertension had a significant negative effect on prognosis, which was more significant for patients 60 years of age and older. Among comorbidities, CVDs had the maximum negative effect on prognosis, and this effect was more significant for patients 60 years of age and older. Among other comorbidities, type 2 and 1 diabetes, chronic kidney disease, chronic obstructive pulmonary disease, cancer and anemia had a negative impact on the prognosis. This effect was also more significant (with the exception of type 1 diabetes) for patients 60 years and older. The death risk in patients with COVID-19 depended on the severity and type of multimorbidity. Clusters of diseases typical for deceased patients were identified and their impact on prognosis was determined. The most unfavorable was a cluster of 4 diseases, including hypertension, coronary artery disease, heart failure, and diabetes mellitus. The data obtained should be taken into account when planning measures for prevention (vaccination priority groups), treatment and rehabilitation of COVID-19 survivors.

COVID-19 is a severe infection with high mortality. The concept of the disease has been shaped to a greater extent on the basis of large registers from the USA, Spain, Italy, and China. However, there is no information on the disease characteristics in Caucasian patients.Therefore, we created an international register with the estimated capacity of 5,000 patients — Dynamics Analysis of Comorbidities in SARS-CoV-2 Survivors (AKTIV SARS-CoV-2), which brought together professionals from the Russian Federation, Republic of Armenia, Republic of Kazakhstan, and Kyrgyz Republic. The article presents the first analysis of the register involving 1,003 patients. It was shown that the most significant difference of the Caucasian population was the higher effect of multimorbidity on the mortality risk vs other registers. More pronounced effect on mortality of such diseases as diabetes, obesity, hypertension, chronic kidney disease, and age over 60 years was also revealed.

Background Despite its increasing incidence, large-scale data regarding the demographics and characteristics of paediatric inflammatory bowel disease (IBD) at diagnosis in Korea is scarce. We aimed to compare the differences of paediatric Crohn’s disease (CD) and ulcerative colitis (UC) at diagnosis in Korea. Methods This analysis was conducted using data from a multicentre, registry-based, retrospective cohort study conducted at five centres in Korea between 2013 and 2018. Baseline demographics, clinical characteristics, results from laboratory, endoscopic, radiologic examinations were compared between paediatric CD and UC patients who were Results A total 307 patients were included in this analysis. Among them 227 patients were diagnosed with CD (73.9%), and 80 patients (26.1%) with UC. The male to female ratio was 2.49:1 for CD, and 1.29:1 for UC (p = 0.019). Median age at diagnosis was 14.4 years (IQR 12.4–16.2) for CD, and 14.4 (11.7–16.5) for UC (p = 0.962). Symptoms at presentation that were dominant in CD patients compared with UC patients were abdominal pain (76.2% vs. 51.2%, p < 0.001), weight loss (51.5% vs. 22.5%, p < 0.001), perianal fistulas (18.9% vs. 0%, p < 0.001), perianal skin tags (15.9% vs. 1.2%, p < 0.001), fever (20.3% vs. 6.2%, p = 0.007), and oral ulcers (13.7% vs. 3.8%, p = 0.026), while hematochezia was the only dominant symptom in UC patients compared with CD patients (86.2% vs. 30.8%, p < 0.001). White blood cell counts, platelet counts, ESR, CRP were significantly higher, and serum albumin level was significantly lower in CD patients. ASCA was positive in 44.5% and 16.2% of CD and UC patients, respectively (p < 0.001), and ANCA was positive in 15.0% and 58.8% of CD and UC patients, respectively (p < 0.001). Terminal ileal involvement on endoscopy was prominent in CD (62.1% vs. 16.2%, p < 0.001), while rectal involvement was more prominent in UC (52.4% vs. 83.8%, p < 0.001). Small bowel involvement and perianal perforating diseases on radiologic exams were also more prominent in CD. Conclusion Clinical symptoms, laboratory test results, radiologic findings, endoscopic findings were significantly different between paediatric Crohn’s disease and ulcerative colitis at diagnosis in Korea. A large-scale study on a nationwide basis is expected to better clarify this difference in the future.

Background Recent researches reported that inflammatory bowel disease (IBD) in Asia has become more prevalent. Since IBD is chronic inflammation disorder and its relapse is frequent, obtaining and maintaining remission is important. As our knowledge on the pathogenesis of IBD deepened, many immunosuppressants and biological agents were introduced and confirmed to be both safe and effective. However, biologics known as anti-tumour necrosis factor (anti-TNF) agents was reported to lose response over time in 23–46% of patients. Therefore, combination therapy adding immunomodulator drug such as azathioprine was introduced and showed better outcome by optimising biologic pharmacokinetics and minimising immunogenicity. Adversely, rates of tuberculosis are increased, but there is no large population data estimating and comparing these risk in combination therapy. Methods We used 2008–2016 data of the South Korean Health Insurance and Review Agency (HIRA), and odd ratio (OR) for tuberculosis in IBD patients who underwent anti-tumour necrosis factor (TNF) agent, azathioprine, or combination therapy. Results Between 2008 and 2016, 47,760 patients were newly diagnosed as IBD, 29,440 as UC and 15,320 as CD. We compared the risk of tuberculosis according to the medication divided into 5 groups; infliximab only, azathioprine only, combination of azathioprine and infliximab, azathioprine monotherapy and infliximab monotherapy, and azathioprine and infliximab whether simultaneously or separately. We also compared the risk between male and female. Hazard ratio of tuberculosis in infliximab monotherapy, azathioprine, and combination therapy in IBD patients were 1.132, 1.256, and 2.118, respectively. Conclusion Our study shows that Korean IBD patients are at risk for tuberculosis, and this results may highlight the importance of screening for tuberculosis in IBD patients.

Background The aim of this study to assess the efficacy and safety of adalimumab (ADA), a monoclonal antibody against tumour necrosis factor α (TNF-α), and to explore predictors of response in Korean patients with ulcerative colitis (UC). Methods We conducted a prospective observational multicenter study over 56 weeks in adult patients with moderately to severely active UC. Clinical response and remission were assessed by Mayo score. Mucosal healing was defined as Mayo subscore 0 or 1. Faecal calprotectin (FC) were assessed at baseline, week 8 and 56. Adalimumab drug levels were checked at week 8 and at loss of response. Missing or incomplete data were handled using the nonresponder imputation method. Results A total of 146 patients were enrolled and included in the analysis. Clinical response rates were 52.1% (76/146) and 37.7% (55/146) at week 8 and 56, respectively. Clinical remission was achieved in 24.0% (35/146) and 21.9% (32/146) of patients at week 8 and 56. Steroid-free remission rates were 21.2% (31/146) at week 56. Mucosal healing rates were 39.0% (57/146) and 30.1% (44/146) at week 8 and 56. Prior use of anti-TNF-α did not affect the clinical and endoscopic responses. Treatment persistence was achieved in 57.5% (84/146) of patients at week 56. Adalimumab drug level was significantly higher in patients with clinical response (10.8 vs. 8.0, p = 0.004), clinical remission (11.7 vs. 8.8, p = 0.007) and mucosal healing (11.0 vs. 8.5, p = 0.010) at week 8. Adalimumab dose was escalated to 40 mg weekly in 25 (17.1%) patients, and clinical response and remission were achieved in 40% and 20% of patients at week 56, respectively. Mean faecal calprotectin levels were significantly more decreased in clinical responders compared with non-responders at week 8 (336.3 mg/kg vs. 628.8 mg/kg, p < 0.001). The Fecal calprotectin levels are well correlated with endoscopic severity, and the best cut-off value to predict mucosal healing was 274 mg/kg. The lower endoscopic severity, higher body mass index and higher serum albumin level at baseline were associated with a clinical response at week 8. The lower Mayo score, lower C-reactive protein level, clinical response (74.5% vs. 38.5%, p < 0.001) and mucosal healing (52.7% vs. 30.8%, p = 0.008) at week 8 were associated with clinical response at week 56. Serious adverse drug reactions were identified in 2.7% (4/146) of patients including 1 case of pulmonary tuberculosis. Conclusion Adalimumab is safe and effective for induction and maintenance in Korean patients with UC, regardless of prior anti-TNF therapy. Adalimumab drug level is associated with the efficacy of induction therapy. A better response to induction therapy can predict a better long-term response.

A beam position monitor (BPM) with the nanometer-scale position resolution and the decay time of approximately 20 ns is developed as an interaction point BPM, to verify the nanometer stabilization of the International Linear Collider beam trains at the Accelerator Test Facility (ATF), High Energy Accelerator Research Organization (KEK). The developed low- $Q$ cavity BPM consists of a one-cell sensor cavity and a one-cell reference cavity. An electronic system is developed, based on the beam test results, to process the signals from the BPM. The beam position resolution of the low- $Q$ cavity BPM with the electronics system is measured at the ATF2 beam line of KEK, and the results of the beam tests conducted on the developed low- $Q$ cavity-type BPM are described.

Lactic acid bacteria (LAB) are major components of the microbial flora of packaged and cured meats and can contribute to spoilage. Bacteriological analyses of the pork meat and pork meat product samples were carried out to know the diversity of LAB across the samples. Thirty-one samples of raw pork meat, semi-processed pork meat and pork meat products were collected from four meat factories in Korea. A total of 216 LAB were isolated and identified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and 16S rRNA gene sequencing followed by confirmation of results using matrix-assisted laser desorption ionization-time of flight mass spectrometry. Lactobacillus (Lb.) sakei was the most dominant LAB associated with all samples, regardless of the origin or packaging. The next predominant LAB were Lactococcus (Lc.) lactis and Pediococcus pentosaceus in raw samples, Lb. plantarum and Lb. brevis in semi-processed samples, and Weissella viridescens and Lc. lactis in product samples. Lb. plantarum, Lc. lactis and Lb. brevis were LAB found in all sample groups. Practical Applications Identification of lactic acid bacteria (LAB) in pork meat and pork meat products is fundamental to understanding the onset of spoilage. The results will reveal the prevalence of different species in different processing conditions and be helpful in order to analyze spoilage by LAB rapidly and accurately. The high LAB loads detected on pork meat indicated that strategies to reduce microbial load and improve food safety are needed.

Introduction: Patients (pts) with CTCL have disruption in their skin barrier and are at increased risk for cutaneous infections. In particular, staphylococcal infections are common in pts with CTCL and are associated with pathogenesis of the lymphoma. Previous studies have identified extra-cutaneous involvement of lymphoma as the most important independent risk factor for recurrent skin infection, bacteremia, and death from infection. However, the risk of mortality with bacteremia and risk factors for developing bacteremia in CTCL have not been fully elucidated. We aimed to explore risk factors for bacteremia and subsequent mortality in pts with CTCL at Emory University. Methods: We conducted a single center retrospective analysis at the Winship Cancer Institute of Emory University analyzing CTCL pts from 01/01/1990 - 06/01/2019. We selected pts from an existing cutaneous lymphoma database and separated them by presence or absence of bacteremia at any point following diagnosis. Bacteremia was defined as identification of at least one microbe in the bloodstream on culture. The primary objective was to assess 90-day mortality among pts with CTCL with bacteremia. Secondary objectives included assessing patterns of care in bacteremic pts, identifying risk factors for bacteremia incidence and for poor outcomes following bacteremia (defined as a composite outcome of intensive care unit stay, mortality at 90 days, or re-current hospitalization within 90 days). Additionally, we explored patterns of oral antibiotic use in the outpatient setting and their association with bacteremia incidence and outcomes. Prophylactic skin antibiotics were defined in the notes as "prophylactic" i.e. not being used to treat active cellulitis or other infections. Categorical variables were analyzed with chi-squared tests. Results: 184 of 549 pts identified from our cutaneous lymphoma database were included in our analysis. Patients were excluded for lack of follow up or missing data. The median age was 57. Most pts had mycosis fungoides (n=137), followed by Sézary syndrome (n=20), CTCL, NOS (n=12), and CD30+ variants (n=6). 85 pts were early stage, and 87 were advanced stage (stage 2B n=41; 3 n=16; 4 n= 30) at diagnosis. 37 of 184 pts (20.1%) developed bacteremia. 95 pts used intermittent skin prophylactic antibiotics in the outpatient setting, 84 did not, and 5 were unknown. A total of 101 bacteremic episodes were noted (range of 1-10 per pt). The most common organisms were Staphylococcus species (sp) (MRSA n=21, MSSA n=10, other staph n=10). Other organisms included Corynebacterium sp., Enterococcus sp., Acinetobacter sp., Pseudomonas sp., and Escherichia-coli. Polymicrobial bacteremias were noted in 23 pts (28.8%). 42 (40%) had concurrent positive skin/wound . 69 pts (86.3%) were taking oral at the time of bacteremia. 71 pts were hospitalized for bacteremia (88.8%), and 41 pts (51.3%) had a recurrent admission within 90 days of discharge. 45 pts (56.3%) had invasive lines prior to bacteremia, and 44 of these had them removed following bacteremia. 71 (88.8%) cases were treated with appropriate antibiotic coverage. 56 pts were receiving active disease therapy at the time of bacteremia (70%), including 33 who were receiving systemic therapy. Intermittent prophylactic antibiotic use was highly associated with development of bacteremia (p < 0.001, table 1), as was advanced stage (12.8% early stage patients developed bacteremia compared to 29.9% of advanced stage, p=0.005). Prior systemic therapy, and in particular chemotherapy was associated with increased incidence of bacteremia (31 of 106 (29.2%) patients treated with chemotherapy developed bacteremia, p=0.0003) Extra-cutaneous disease was not associated with bacteremia in our analysis. The 90-day mortality among CTCL pts developing bacteremia was 11.25%. Conclusions This is the largest study assessing outcomes and risk factors for bacteremia in CTCL in the modern era. We confirmed that bacteremia is associated with high rates of re-admission, recurrent infection, and 90-day mortality, and identified advanced stage and use of chemotherapy as risk factors associated with bacteremia. The positive association of prophylactic antibiotics with bacteremia likely represents increased prescribing of skin prophylaxis among those at higher risk for bacteremia. Uni-variate, multivariate, and survival analyses will be updated at the time of the presentation. Disclosures Lechowicz: Kyowa: Consultancy.

4-1BB, a member of the TNF receptor superfamily, has a role in various inflammatory pathologies through its interaction with 4-1BB ligand. We previously demonstrated that it participates in initiating and promoting obesity-induced adipose inflammation in a rodent model. In this study, we examined whether 4-1BB is related to obesity-induced adipose inflammation and metabolic parameters in humans. A total of 50 subjects, 25 obese (body mass index (BMI)⩾25 kg m−2) and 25 lean (BMI

The purpose of this study was to determine the changing pattern of Salmonella serotypes causing acute diarrhoea in humans in Gwangju area, Korea, during 2000-2009. A total of 596 Salmonella isolated from culture of 29,896 faecal samples of patients with acute diarrhoea were included in this study. Faecal samples were collected from local hospitals and clinics in Gwangju area during January 2000-December 2009. The mean annual frequency of isolates for the 10 years was 2.0% (range, 0.9-6.0). The isolates were serologically classified into 43 different serotypes. The 10 most common serotypes were Salmonella Enteritidis (47.9%), S. Typhimurium (20.4%), S. Braenderup (3.2%), S. Montevideo (2.9%), S. Paratyphi B (2.9%), S. London (2.3%), S. Bardo (1.7%), S. Virchow (1.7%), S. Infantis (1.5%) and S. Typhi (1.5%), accounting for 86% of all the isolates. Temporal variations were observed in the distribution of different Salmonella serotypes over the years, and only S. Enteritidis and S. Typhimurium were persistent throughout the study period. Although age specificity varied with serotypes, Salmonella was isolated most frequently from children below 5 years of age (179/596, 30.0%). A seasonal trend was apparent, and the highest rates were found in the summer months. This is the first report of the annual frequency of isolation of Salmonella serotypes, and seasonal and age-specific patterns of salmonellosis in humans in Gwangju area, Korea, over a decade-long period.

The use of tower cranes can cause critical accidents during large building construction projects. Failure of the tower crane results in critical injuries to crane operators and other workers at the construction site. Issues that often cause the fatal collapse of tower cranes include the damage and fracture of the mast (or tower) and turntable parts, and the tower crane slewing-unit-support fleeing. Without systematic investigations and proper prevention procedures in place, this type of crane accident, which often leads to worker fatalities, will continue to occur. Therefore, more proactive, specialized and systematic research needs to be performed in terms of forensic engineering to minimize the occurrence of similar disasters. In this research, the tower crane collapse accidents are thoroughly investigated and the exact cause of the damaged crane parts is also identified using fractography and mechanical/chemical characterizations techniques, including visual inspections, field research, scanning electron microscopes and optical microscopes. Specifically, instrumented indentation technique is employed to evaluate the material properties, and energy spectrum analysis is used to determine the chemical characteristics. Based on thorough investigations, it has been identified that the connecting bolts of the tower crane are very vulnerable. It is recommended to improve the reliability of the bolts and to implement additional regulations to check their maintenance and safety. This research clearly provides guidance for investigating crane collapse accidents and contributes to the prevention of similar types of accidents. Several corrective actions and recommendations are suggested to reduce the risk of the tower crane failures.

Aliment Pharmacol Ther 2012; 35: 56–65 Summary Background The eradication rates following standard triple therapy for Helicobacter pylori infection are declining worldwide. Recent studies have shown that sequential therapy for H. pylori infection yields high cure rates. Aim To compare the efficacy and tolerability of a sequential regimen as first-line treatment of H. pylori infection with a standard triple regimen. Methods A total of 348 naive H. pylori-infected patients from six hospitals in Korea were assigned randomly to standard triple or sequential therapy groups. Standard triple therapy consisted of 20 mg of rabeprazole, 1 g of amoxicillin and 500 mg of clarithromycin, twice daily for 7 days. Sequential therapy consisted of a 5-day dual therapy (20 mg of rabeprazole and 1 g of amoxicillin, twice daily) followed by a 5-day triple therapy (20 mg of rabeprazole, 500 mg of clarithromycin, and 500 mg of metronidazole, twice daily). Results The intention-to-treat (ITT) and per-protocol (PP) eradication rates were 62.2% (95% CI 54.8–69.6%) and 76.0% (95% CI 68.5–83.5%) in the standard triple group, and 77.8% (95% CI 71.4–84.2%) and 87.9% (95% CI 82.3–93.5%) in the sequential group, respectively. The eradication rate was significantly higher in the sequential group compared with the standard triple group in both the ITT and PP populations (P = 0.002 and P = 0.013 respectively), whereas the incidence of adverse events was similar. Conclusions Ten-day sequential therapy is more effective and equally tolerated for eradication of H. pylori infection compared with standard triple therapy. Sequential therapy may have a role as first-line treatment for H. pylori infection.

Neck fracture is a major cause of death in traffic accidents. This pattern of injury normally occurs in a frontal collision or overturn of a vehicle. This study investigates the case of a neck fracture from a low-speed collision. In the examined case, the passenger in the front seat of the car fractured his neck and died. He did not have his seatbelt on when the vehicle slipped on a frozen road surface on a downward slope of a hill and impacted into the shoulder of the road at low speed. In this type of collision, an occupant’s body will be impacted by the windshield or other interior trim of the car. However, in this case, rather unusually, neither body tissue nor fiber remained although the collision involved a broken windshield. Thus, the reason for the passenger death was unidentified. This study applied the computer simulation package Madymo for analyzing the accident. The result of the simulation was that the passenger, who did not wear a seatbelt, moved forward due to inertia. The upper part of the passenger then rotated and lifted when the knee contacted with the dashboard. By evaluating the structural deformation of the vehicle at the front, we deduced that the collision velocity was 30 km/h. Through a computational experiment that was undertaken using Madymo 7.0, NIC was estimated to be 240 m2/s2. This result far exceeded the threshold for neck injuries. In particular, in comparison with whiplash injuries, when the passenger’s head directly impacts the roof following a rear-end collision, the bending moment through hyperextension of the neck is greatly increased. In this study, we concluded that the manner of death was the hyperextension of the neck, as the passenger’s head contacted the roof from underneath.

To determine the transscleral permeability of chemotherapeutic drugs vinblastine and doxorubicin for treatment of intraocular tumors, and to compare the use of doxorubicin encapsulated in PLGA and liposome nanoparticles.Human sclera was isolated and mounted in a Lucite chamber. Fluorescently tagged vinblastine (VIN), innately fluorescent free doxorubicin (DOX), PLGA doxorubicin (PLGA-DOX), or Doxil (Tibotec Therapeutics) were added to the episcleral donor chamber. The choroidal side was perfused with Balanced Salt Solution. Perfusate fractions were collected over 24 h and measured for fluorescence. Following the experiment, tissue sections were imaged, underwent a drug wash out procedure, and tissue drug content was analyzed using an LC-MS/MS method.Within 24 h, a total of 68%, 74%, 29%, and 1.9% of the drug dose from VIN, DOX, PLGA-DOX, and Doxil, respectively, diffused across the sclera. VIN and DOX scleral tissue showed strong fluorescence after 24 h. PLGA-DOX displayed scattered fluorescence, and Doxil indicated minimal fluorescence. LC-MS/MS revealed strong tissue binding of DOX.This study suggests both vinblastine and doxorubicin are able to diffuse across human sclera. In addition, PLGA nanoparticles delivered doxorubicin at a slower rate across the sclera, and the liposome preparation resulted in the slowest delivery of drug.

Background: Asthma is a chronic inflammatory disease, characterized by airway inflammation, bronchial hyper-responsiveness, and airway obstruction. Although asthma induces partially reversible airway obstruction, obstruction can sometimes become irreversible. This may be a consequence of airway remodeling, which includes a number of structural changes, such as epithelial detachment, basement membrane (BM) thickening, smooth muscle hypertrophy, and new vessel formation. This study evaluated children with asthma for the presence of BM thickening. Methods: Eighteen children with asthma and 24 control subjects underwent flexible bronchoscopy with endobronchial biopsy. Light microscopy was used to measure BM thickness in paraffin-embedded biopsy sections. The association between BM thickening and age, sex, duration of asthma, asthma severity, FEV1, FEV1/FVC, FEF25–75%, methacholine PC20, eosinophil count, and presence of atopy was examined. Results: Basement membrane thickness was greater in subjects with asthma (8.3 ± 1.4 μM) than in control subjects (6.8 ± 1.3 μM, P = 0.0008). Multiple regression analysis revealed that sex, FEV1/FVC, total IgE, and atopy (IgE for Dermatophagoides pteronyssinus >0.34 kUA/l) were significant predictive factors for BM thickness. There was no significant association between BM thickness and age, duration of asthma, FEV1, FEF25–75%, methacholine PC20, eosinophil count, or asthma severity. Conclusions: Basement membrane thickening has been known to be present in children with asthma. In addition, we report an association between BM thickness and sex, FEV1/FVC, total IgE, and the presence of IgE specific to D. pteronyssinus.

Epidermal growth factor receptor inhibitors (EGFRIs) have demonstrated improved overall survival in patients with non-small cell lung cancer, pancreatic cancer, and colorectal cancer; however, their use is associated with dermatologic reactions of varying severity. The similar spectrum of events observed with monoclonal antibodies and tyrosine kinase inhibitors suggests such toxicities are a class effect. While such reactions do not necessarily require any alteration in EGFRI treatment, being best addressed through symptomatic treatment, there is limited evidence on which to base such therapies. In October 2006, at an international and interdisciplinary EGFRI dermatologic toxicity forum, the underlying mechanisms of these toxicities were discussed and commonly used therapeutic interventions were evaluated. Our aim was to reach a current consensus on management strategies. A three-tiered, EGFRI-focused toxicity grading system is suggested for the purposes of therapeutic decision making, and as a framework on which to build a stepwise approach to intervention. This approach to successful management is specifically tailored to accurately categorize dermatologic toxicity associated with EGFRIs, and can be easily applied by all health care professionals. The goal is to maximize quality of life in patients who are being treated with these agents—many of whom will be on these drugs for several months or even years.

Most upland in Korea have irregular field shapes. Boom sprayers working alone winding row will show considerable differences of spraying amount per unit area between left and right booms. If flow rates of both booms are equal. This phenomenon becomes significant as steering radius of sprayer decreases. This study was performed to seek a method which reduce the difference of the spray amount between left, right and center booms while spraying along curvy rows. A flow rate control method for keeping application rate of each boom section constant was proposed and experimentally proved using a boom sprayer attached to a cultivating tractor. The flow rate control device was composed of 3 ball valves and a rotary angle sensor. The rotary angle sensor showed a symmetric voltage output with respect to steering radius. The spray overlapping was happened in a boom nearby the steering center when steering radius of the sprayer was less than 5.2 m. Flow rates for left, right and center booms were regulated using ball valves based on the steering radius and spraying areas ration of right/left boom. The Maximum spraying area ratio () of left to right boom section was 1:3.6 at the steering radius of 5.2 m. However, The Maximum achieved right and left spraying flow ratio was 1:2.7.

Delayed post-hypoxic leucoencephalopathy is a demyelinating syndrome characterized by acute onset of neuropsychiatric symptoms including parkinsonism or akinetic mutism that occurs days to weeks after recovery from cerebral hypo-oxygenation. We encountered a patient who presented with an akinetic mute state late after cervical cord injury without a definite hypoxic event.

Electro-optic switching of refraction is experimentally demonstrated in a phase-discontinuity complementary metasurface twisted nematic cell. The phase-discontinuity complementary metasurface is fabricated by focused-ion-beam milling, and a twisted nematic cell is constructed with complementary V-shape slot antenna metasurface. By application of an external voltage, switching is achieved between ordinary refraction and extraordinary refraction satisfying the generalized Snell's law. It has a strong implication for applications in spatial light modulation and wavelength division multiplexer/demultiplexer in a near-IR spectral range. (C) 2014 Optical Society of America

Background. To identify variable prognostic factors and analyze failure patterns in uterine cervix cancer after radical operation and adjuvant radiotherapy, a retrospective analysis was undertaken.

An investigation of the shear behaviour of reinforced concrete beams containing steel fibres is presented. The major test variables were the amount of steel fibres and the volume of shear stirrups. The fibre content was varied from 0% to 2% by volume, and the amount of stirrups from zero to full reinforcement using code-required values. The test results show that the cracking shear strength increases significantly as the fibre content increases, and that improvement in ultimate shear strength is also achieved. It is seen that the steel fibres play an important role in reinforced concrete beams by curbing crack occurrence and reducing the crack width. This effect greatly enhances the serviceability and durability of reinforced concrete structures. The mode of failure changed from shear to flexure when the volume fraction of fibres exceeded 1%. This means that fibre reinforcement greatly increases the shear capacity. The ductility is also enhanced remarkably by the addition of fibres. The present study indicates that fibre reinforcement can reduce the amount of shear stirrups required, and that a combination of fibres and stirrups may be used to achieve both strength and ductility requirements. An analytical method for predicting the shear strength of reinforced concrete beams containing steel fibres is proposed. Good correlation was obtained between calculated and test data. The proposed method allows a more realistic shear analysis of reinforced concrete structural members containing steel fibres.

The three-vessel view is a transverse view of the fetal upper mediastinum is as simple to obtain as the four-chamber view. It demonstrates the main pulmonary artery, ascending aorta and superior vena cava in cross- or oblique sections. The purposes of this study were to describe the normal anatomy of the three-vessel view and to analyze what anatomical changes would occur in this view when there are lesions of the ventricular outflow tracts and/or great arteries. Sonograms of 29 fetuses with lesions involving the ventricular outflow tracts and/or great arteries were reviewed. Three-vessel views were evaluated in terms of vessel size, number, arrangement and alignment. Twenty-eight of 29 fetuses showed an abnormal three-vessel view that included abnormal vessel size (n = 12), abnormal alignment (n = 8), abnormal arrangement (n = 7) and abnormal vessel number (n = 3). The vessel size was abnormal in obstructive lesions of the right (n = 4) or the left (n = 8) side of the heart. An abnormal alignment was seen in tetralogy of Fallot (n = 6) and double-outlet right ventricle (n = 2) that showed anterior displacement of the aorta. An abnormal arrangement was seen in complete (n = 4) and corrected (n = 1) transposition, double-outlet right ventricle (n = 1) and pulmonary atresia with ventricular septal defect (n = 1). Only two vessels were seen in truncus arteriosus (n = 1). Four vessels were seen in persistent left superior vena cava (n = 2). A fetus with pulmonary atresia and intact ventricular septum showed a normal three-vessel view. In conclusion, most of the lesions involving the ventricular outflow tracts and/or great arteries showed an abnormal three-vessel view.

A series of THz metamaterials were fabricated, which have different pattern line widths of Au and different doping carrier densities of p-type silicon substrate. Transmission spectra of the metamaterials were obtained by a terahertz time domain spectroscopic measurement. Upon increasing the doping carrier density and narrowing the pattern line width, the transmission spectra showed a blue shift in resonance frequency and a broadening of resonance spectral shape, i.e., a decrease in quality factor.

Electric switching of reflection resonances at near-IR spectral range is experimentally demonstrated in a reflective metamaterial twisted nematic liquid crystal cell. Reflective metamaterial composed of nano-sized double-split ring resonator aperture is fabricated by a focused ion beam milling. Two-fold rotational symmetry of double-split ring resonators allows for two orthogonal polarization-dependent reflection resonances in the reflective metamaterial. With an external voltage of 10V across 12 mu m cell gap, a full switching is achieved between two reflection resonances. Dynamic measurements show the time constants of switch-on and switch-off are in the order of 100ms and 10ms, respectively. (C) 2013 Optical Society of America

We fabricated an electrically tunable metamaterial based on twisted nematics liquid crystal cell, where polarization dependent reflectance of the metamaterial can be controlled via applied voltage. When the metamaterial-twisted nematics liquid crystal cell is driven with a voltage above the threshold, optical reflection of the cell has changed. Our result provides the possibility of tuning the frequency selective properties of metamaterials by applied voltage.

Recently, jaw size was changed from 4 mm aper- ture (J4) to 1 mm (J1) in TomoTherapy Hi-Art II® (TomoThe- rapy Inc., Madison, WI) to improve the longitudinal (IEC-Y) resolution of megavoltage computed tomography (MVCT) images. This study attempted to conduct a comparative analy- sis on the effect of jaw aperture size of MVCT on image quali- ty and dose. Also, this study investigated the clinical effect of jaw aperture size on highly radiosensitive lens dose. MVCT image quality test (image noise, uniformity, contrast linearity, and spatial resolution) and multiple scan average dose (MSAD) were measured to examine the effect of change in jaw aperture size. A head phantom and photoluminescence glass dosimeters (PLDs) were used to measure exposed lens dose (cGy). For image quality, the change in jaw aperture size did not have a significant effect on image noise, uniformity, con- trast linearity, and spatial resolution although showing slight improvement of image quality. FHWM was 6.7 mm and 4.1 mm in J4 and J1, respectively, which represents enhancement in the longitudinal resolution of MVCT image. MSAD of cen- ter point was approximately 0.69-2.32 cGy (peripheral: 0.83- 2.48 cGy) in J4, and 0.85-2.81 cGy (peripheral: 1.05-2.86 cGy) in J1. The measured lens dose using PLDs ranged 0.92-3.36 cGy and 1.06-3.91 cGy in J4 and J1, respectively, indicating dose increase for the narrower jaw aperture size. An addition- al dose of 3.86 cGy, 1.92 cGy, and 1.22 cGy was delivered for a pitch of 1, 2, and 3, respectively during MVCT scan per frac- tion in head and neck treatment plans. Therefore, 15% in- crease in imaging dose with 1 mm aperture jaw should be allowed for compared to that with previous 4 mm aperture jaw.

Nano-scaled metamaterials are fabricated by a focused ion beam milling under the fine control of process factors. The meta-resonances are studied in NTR regime and they show the polarization-angle dependence coming from their meta-structures.

Doping level of dopant carrier density of substrates is varied to control the meta-resonances in terahertz metamaterials. Resonance peak position and quality factor exhibit a red shift and broadening when doping level is lowered.

THz metamaterials are employed to examine changes in the meta-resonances when two anisotropic organic materials, liquid crystal and carbon nanotubes, are placed on top of metamaterials. In both anisotropic double split-ring resonators and isotropic four-fold symmetric split-ring resonators, anisotropic interactions between the electric field and organic materials are enhanced in the vicinity of meta-resonances. In liquid crystal, meta-resonance frequency shift is observed with the magneto-optical coupling giving rise to the largest anisotropic shift. In carbon nanotube, meta-resonance absorptions, parallel and perpendicular to nanotube direction, experience different amount of broadening of Lorentzian oscillator of meta-resonance. Investigation reported here opens the application of metamaterials as a sensor for anisotropic materials. (C) 2012 Optical Society of America

A symmetric metamaterial superlattice is introduced accommodating a high Q-factor trapped mode. THz time-domain spectroscopy is employed to measure the transmission spectra, identifying the excitation of trapped and open-modes in the meta-resonances. A finite-difference-time- domain calculation showed that the trapped mode excitation is from the cancelation of current densities among the nearest-neighboring meta-particles. A cryogenic temperature THz measurement is carried out to examine the temperature dependence of resonance characteristics of meta-resonances. At low temperatures, the temperature-independent radiative damping is dominant for the open-mode, while the Q-factor of the trapped mode is determined by the temperature-dependent phonon scattering and temperature-independent defect scattering with the radiative damping significantly suppressed. When compared with the room temperature measurement, a 16% increase in Q-factor is observed for the trapped mode, while a 7% increase for the open-mode at the cryogenic temperature.

The hydrophilic bile acids ursodeoxycholic acid and tauroursodeoxycholic acid are approved by regulatory bodies of many countries for treatment of gallstones and cirrhosis. Delivery is by oral administration and side effects are minimal. This chapter reviews evidence demonstrating that systemic treatment with the two compounds is protective in models of neuronal and retinal degeneration and injury. Variability in the regulation of circulating bile acids suggests a need to explore local delivery as a treatment modality. Our initial experiments testing in vivo intraocular injections and in vitro transscleral permeability indicate that this is feasible and efficacious.

Healthcare personnel (HCP) can acquire influenza and transmit it to patients and other hospital staff. The aim of this study was to evaluate the attack rate of HCP by the 2009 H1N1 influenza virus during the 2009 pandemic influenza season in Korea. HCP infected with H1N1 virus were asked to fill out a questionnaire, which included job type, method of diagnosis, facility type, history of contact with patients infected by H1N1 virus, vaccination status, and use of personal protective equipment. A total of 328 HCP (female 68.6%, 225/328) were infected with H1N1 virus at the nine study centers. The highest attack rate was in physicians, followed by nurses and nurses’ aides. Transmission occurred primarily after contact with outpatients (27.8%), followed by contact with inpatients (21.6%). Most (77.3%) of the infected HCP never used an N95 mask during contact with patients. Surgical masks were always used by 29.4% of the subjects and usually or intermittent used by 46.9%. The peak incidence of the H1N1 infection among HCP preceded that among the general population. Among HCPs, physicians, nurses, and nurses’ aides were at the greatest risk of H1N1 infection. HCP should be more vigilant and protect themselves with appropriate personal protective equipment during the influenza season.

Linear dichroism in metamaterial-twisted nematics structure of nano meta surface is controlled via photoisomerization process. Azo twisted nematic cell structure enables the switching on-off of meta-induced resonance by trans-cis-trans isomerization when irradiated by UV light.

Terahertz metamaterial superlattice is fabricated with double-split ring resonators oriented alternately. By cooling down to cryogenic temperature 4K, changes in Q-factor of closed mode resonance originating from coherent coupling in metamaterial superlattice is investigated.

The integrated system of a Very High Temperature Gas-Cooled Reactor (VHTR) and a High Temperature Steam Electrolysis (HTSE) process is one of systems being investigated by the U.S. Department of Energy and Idaho National Laboratory. This system will produce hydrogen by utilizing a highly efficient VHTR with an outlet temperature of 900 °C and supplying necessary energy and electricity to the HTSE process for electrolysis of high temperature steam. This report includes a description of five configurations including an indirect parallel cycle, an indirect serial cycle, a direct serial cycle, a steam combined cycle, and a reheat cycle. HYSYS simulations were performed for each of these configurations coupled to a HTSE process. Final results are presented along with parametric studies and process optimization.

The status of the large grain niobium cavity R&D in Asia and the future scope are presented. Recently KEK has received CBMM and NingXia large grain niobium sheets through collaborations. KEK has fabricated 1.3 GHz single cell cavities using these materials and measured the cavity performance. Those results are presented in this paper.