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In the framework of the OECD/NEA/CSNI/WGAMA, an activity on the “Status report on thermal–hydraulic passive systems design and safety assessment” has been conducted. Within this activity, a benchmark exercise, based on the experimental data developed in the full scale PERSEO (in-Pool Energy Removal System for Emergency Operation) component separate effect test facility, built at SIET (Piacenza, Italy), has been proposed and carried out. An “OPEN” benchmark exercise, hosted by ENEA, has been conducted. Twelve results from eleven Organizations were submitted. PERSEO is a full-scale separate effect test facility designed to study a new passive decay heat removal system operating in natural circulation. Test 7 is a full pressure test (7 MPa) and investigates the system stability and the system operation. The accuracy of the calculated results has been evaluated both qualitatively and quantitatively. The latter has been conducted adopting the Fast Fourier Transform Based Method. The present paper summarizes the main features of the PERSEO facility and Test 7 and discusses the main results and outcome of the benchmark exercise.

Introduction The impact on clinical practice of the international guidelines including the Sendai Guidelines (SG06) and Fukuoka Guidelines (FG12) on the management of cystic lesions of the pancreas (CLP) has not been well-studied. The primary aim was to examine the changing trends and outcomes in the surgical management of CLP in our institution over time and to determine the impact of these guidelines on our institution practice. Methods 462 patients with surgically-treated CLP were retrospectively reviewed and classified under the 2 guidelines. The cohort was divided into 3 time periods: 1998–2006, 2007–2012 and 2013 to 2018. Results Comparison across the 3 time periods demonstrated significantly increasing frequency of older patients, asymptomatic CLP, male gender, smaller tumor size, elevated Ca 19-9, use of magnetic resonance imaging (MRI) and use of endoscopic ultrasound (EUS) prior to surgery. There was also significantly increasing frequency of adherence to the international guidelines as evidenced by the increasing proportion of HRSG06 and HRFG12 CLP with a corresponding lower proportion of LRSG06 and LRFG12 being resected. This resulted in a significantly higher proportion of resected CLP whereby the final pathology confirmed that a surgery was actually indicated. Conclusions Over time, there was increasing adherence to the international guidelines for the selection of patients for surgical resection as evidenced by the significantly increasing proportion of HRSG06 and HRFG06 CLPs undergoing surgery. This was associated with a significantly higher proportion of patients with a definitive indication for surgery. These suggested that over time, there was a continuous improvement in our selection of appropriate CLP for surgical treatment.

Introduction Over the years, several guidelines have been introduced to guide management of mucinous pancreatic cystic neoplasms (mPCN). In this study, we aimed to evaluate and compare the clinically utility of the Sendai-06, Fukuoka-12, Fukuoka-17 and European-18 guidelines in predicting malignancy of mPCN. Methods One hundred and eighty-eight patients with mucinous cystic neoplasms (MCN) or intraductal papillary mucinous neoplasm (IPMN) who underwent surgery were retrospectively reviewed and classified under the 4 guidelines. Malignancy was defined as high grade dysplasia and invasive carcinoma. Results Raised CA19-9>37U/ml, enhancing mural nodule≥5 mm and main pancreatic duct≥10 mm were significantly associated with malignancy on multivariate analysis. Increasing number of high risk features, absolute indications (European-18), worrisome risk or relative indications (European-18) were significantly associated with an increased likelihood of malignancy. The positive predictive values (PPV) of high risk features for Sendai-06, Fukuoka-12, Fukuoka-17 and absolute indications (European-18) for malignancy were 53%, 76%, 78% and 78% respectively. The negative predictive values (NPV) of the Sendai-06, Fukuoka-12 and Fukuoka-17 were 100%, while that of the European-18 was 92%. Risk of malignancy for patients with ≥4 worrisome features (Fukuoka-17) and ≥3 relative indications (European-18) was 66.7% and 75.0% respectively. Conclusions All 4 guidelines studied were useful in the initial triage of mPCN for the risk stratification of malignancy. The Fukuoka-17 had the highest PPV and NPV.

The COSINE-100 experiment is designed to test the DAMA experiment which claimed an observation of a dark matter signal from an annual modulation in their residual event rate. To measure the 1 %-level signal amplitude, it is crucial to control and monitor nearly all environmental quantities that might systematically mimic the signal. The environmental monitoring also helps ensure a stable operation of the experiment. Here, we describe the design and performance of the centralized environmental monitoring system for the COSINE-100 experiment., 13 pages, 11 figures

Background There is no clear consensus on the recommended second-line treatment for patients with metastatic pancreatic cancer who have disease progression following gemcitabine-based therapy. We retrospectively evaluated the clinical outcomes of liposomal irinotecan (nal-IRI) plus fluorouracil/leucovorin (FL) and FOLFIRINOX (fluorouracil, leucovorin, irinotecan, and oxaliplatin) in patients who had failed on the first-line gemcitabine-based therapy. Patients and methods From January 2015 to August 2019, 378 patients with MPC who had received nal-IRI/FL (n = 104) or FOLFIRINOX (n = 274) as second-line treatment across 11 institutions were included in this retrospective study. Results There were no significant differences in baseline characteristics between groups, except age and first-line regimens. With a median follow-up of 6 months, the median progression-free survival (PFS) was 3.7 months with nal-IRI/FL versus 4.6 months with FOLFIRINOX (P = 0.44). Median overall survival (OS) was 7.7 months with nal-IRI/FL versus 9.7 months with FOLFRINOX (P = 0.13). There was no significant difference in PFS and OS between the two regimens in the univariate and multivariate analyses. The subgroup analysis revealed that younger age (, Highlights • This multicenter retrospective study investigated nal-IRI/FL and FOLFIRINOX outcomes after gemcitabine-based therapy. • We found no significant differences in outcome between nal-IRI/FL and FOLFIRINOX treatment. • Both regimens were well tolerated; however, neutropenia and peripheral neuropathy were more frequent with FOLFIRINOX. • Age (cut-off, 70 years) showed differential efficacy between chemotherapy regimens.

Background Administrative processing by the police may affect the process involved in organ donation in the event of an accidental brain injury. The purpose of this study was to evaluate the knowledge and attitude of police toward brain-dead donors and organ donation. Methods This was a descriptive research study using a 41-item questionnaire. As of July 19, 2017, 11 police stations in Seoul had collected questionnaires completed by 115 police officers. Data were analyzed using SAS (version 9.4) software. Results There were statistically significant differences in the scores on knowledge about brain death/donation according to religion (P = .022). Attitude was significantly positively correlated with the knowledge about brain-death organ donation (P = .029). Conclusion It is necessary to understand and cooperate with the police when processing brain death organs from accidents. Education about organ donation can enhance the information and knowledge of the police and can also help to establish a positive attitude about organ donation.

An ultra-compact pulse compressor for generating ultrawideband short pulses is proposed and tested. The proposed pulse compressor consists of a thin copper-coated dielectric laminate to form an ‘ultra-compact’ reverberant cavity, where a time-reversal-based input pulse is compressed into an ultrawideband short pulse. The proposed pulse compressor is validated via numerical simulation and measurement, and results show that a short pulse is generated with a peak gain of >10 dB.

Background Current guideline recommends potent antiplatelet agents and transradial intervention. However, it is uncertain whether routine use of IVUS, thrombus aspiration and glycoprotein IIB-IIIA inhibitor is beneficial for improving clinical outcome in patients with ST-segment elevation myocardial infarction (STEMI). Purpose The aim of this study was to investigate optimal procedural strategy to improve clinical outcome. Methods A total of 6,046 patients who underwent primary percutaneous coronary intervention (PCI) for STEMI were analyzed from the Korean Acute Myocardial Infarction Registry (KAMIR) – National Institute of Health (NIH) database. MACCEs were defined as a composition of all cause death, non-fatal MI, repeat revascularizations including repeated percutaneous coronary intervention and coronary bypass grafting, cerebrovascular accident and rehospitalizations. This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention. Results During the primary PCI, potent antiplatelet agents such as prasugrel and ticagrelor were used in 2342 (38.4%). PCI was performed through transradial approach in 1490 (25.2%). Thrombus aspiration and intravascular ultrasound (IVUS) examination was done in 2204 (36.1%) and 1079 (18.1%), respectively. Glycoprotein IIB-IIIA inhibitor was administered in 1295 (21.7%). Among them, potent antiplatelet agents, transradial intervention, IVUS, and thrombus aspiration significantly reduced MACCEs at 1 year. Glycoprotein IIB-IIIA inhibitor was not effective to improved clinical outcome. In Cox-proportional hazards model, potent antiplatelet agents (hazard ratio 0.82, 95% confidence interval 0.67–0.99; p=0.045) and transradial intervention (hazard ratio 0.61, 95% confidence interval 0.47–0.78; p Conclusion Among evidence based procedures during the primary PCI, combined use of potent antiplatelet agents and transradial intervention was optimal procedural strategy to improve clinical outcome.

As decommissioning of a research reactor and a nuclear installation requires a long period of time from the decommissioning preparation work to the site remediation, the management of the data generated during the entire period of decommissioning is one of the most important tasks. In particular, the data obtained from research reactor decontamination and decommissioning activities can be important resources securing the safety and economic feasibility for other research reactor decommissioning. The owner of the research reactor and nuclear power plant need to submit decommissioning plan to the regulatory body at the starting stage of the research reactor and nuclear installation decommissioning project. The cost plan for decommissioning and the method for assessing the amount of exposure to protect workers must be stated in the decommissioning plan. This paper introduces the DES (Decommissioning Engineering System) that can be able to manage the data generated in the process of decommissioning of the TRIGA research reactor, to calculate an amount of waste, to evaluate decommissioning cost after deriving unit work productivity factor, and to predict the decommissioning process in advance. To verify the usability of this system and data integrity through connections among the unit systems, it describes the process to calculate the decommissioning cost using the data generated in dismantling an activated bio-shielding concrete in the TRIGA research reactor. As a result of the experiment to calculate the decommissioning cost with the TRIGA research reactor structure, it was found that the calculations were done precisely without flaw as the purpose of the experiment. Therefore, the DES can not only be used for other research reactors decommissioning, but also it is expected to be applied to other research reactors in the future. As a decommissioning cost between an activated concrete and a non-activated concrete according to the method of the dismantling procedure was significantly different, a study regarding the dismantling procedure needs more research.

COL6A1 and BMP-2 genes have been implicated in ossification of the posterior longitudinal ligament (OPLL) susceptibility in Japanese and Chinese Han populations. However, no study has yet investigated the DNA of unaffected family members of patients with OPLL. This study investigated differences in genetic polymorphisms of BMP-2 and COL6A1 between Korean patients with OPLL and their family members (with and without OPLL). A total of 321 subjects (110 patients with OPLL and 211 family members) were enrolled in the study. Associations between two single nucleotide polymorphisms (SNPs) of the BMP-2 gene (Ser37Ala and Ser87Ser) and two SNPs of COL6A1 [promoter (-572) and intron 33 (+20)] with susceptibility to OPLL of the cervical spine were investigated between the two groups (OPLL+ and OPLL-). Of the 321 subjects, 162 had cervical OPLL (50.4%; 110 patients, 52 family members). There was a familial tendency of OPLL in 34 of the 110 families (30.9%). Allele and haplotype frequencies of the four SNPs in the BMP-2 and COL6A1 genes did not differ significantly between the OPLL+ and OPLL- groups, even when excluding participants over 50 years of age. This is the first report identifying SNPs of COL6A1 and BMP-2 in Korean patients and family members with OPLL. Although allele and haplotype frequencies were similar with those of a previous study in Japanese and Chinese patients, unaffected family members also showed similar rates of these SNPs in the present study. These results suggest that these SNPs may not directly influence the expression of OPLL.

Background Incorporating HER2-blockade into neoadjuvant drug regimens have led to a higher pathologic response in HER-positive breast cancer. In a view point of surgeon, a higher response to neoadjuvant treatment may offer a chance for de-escalating axillary surgery in patients with node-positive breast cancer at initial presentation. We investigated the rates of axillary lymph node dissection (ALND) and pathologic nodal response according to the types of neoadjuvant treatments including single or dual HER2 blockade in patients with clinically node-positive, HER2-postive breast cancer. Methods We retrospectively reviewed medical records from two institutions. From 2007 to 2018, patients with clinically node-positive, HER2-positive breast cancer treated with neoadjuvant chemotherapy were included. Primary outcome was the ALND rates after SLNB according to regimens. Secondary outcome was incidence of nodal pathologic complete response after axillary surgery. Results In a total, 512 patients were included for analysis. Two hundred and eighty-five patients (55.7%) were treated with chemotherapy alone, 135 (26.4%) with chemotherapy and trastuzumab, and 92 (18.0%) with chemotherapy, trastuzumab and pertuzumab. Nodal pCR rates were 45.6%, 77.8%, and 78.4% in each group (p-value Conclusions For patients with node-positive, HER2-positive breast cancer, incorporating trastuzumab into neoadjuvant treatment had led to higher nodal pCR and reduced ALND. However, dual HER2-blockade with pertuzumab did not lead to increase nodal pCR and might not offer a chance of de-escalating axillary surgery compared to single HER2-blockade. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.

Ossification of the posterior longitudinal ligaments (OPLL) has been considered to be associated with abnormalities of bone metabolism, and transforming growth factor-β1 (TGF-β1) has been demonstrated to affect the bone remodeling process. We investigated two SNPs of the TGF-β1 promoter (-509C>T; rs1800469) and exon 1 (869T>C; rs1982073) in 298 Koreans (98 patients with OPLL and 200 control subjects). The promoter SNP -509C>T was determined by PCR and RFLP, and the TaqMan probe assay was used to determine 869T>C polymorphism genotypes. The subjects were divided into OPLL continuous group (continuous type plus mixed type) and OPLL segmental group (segmental and localized type). We also separately analyzed this association according to gender difference. There was no significant difference in genotype distributions of -509C>T and 869T>C polymorphisms of the TGF-β1 gene between OPLL patients and controls. A combined analysis of TGF-β1 -509C>T and 869T>C polymorphisms showed no significant association with OPLL, and a subgroup analysis did not show any significant correlation between the SNP -509C>T or SNP 869T>C and OPLL subgroups. Stratification by gender demonstrated no significant effect. We conclude that promoter region (-509C>T) and exon 1 (869T>C) polymorphisms are not associated with OPLL in the Korean population.

Chrysanthemums are well known for their esthetic and medicinal values. Characterization of chrysanthemums is vital for their conservation and management as well as for understanding their genetic relationships. We found 12 simple sequence repeat markers (SSRs) of 100 designed primers to be polymorphic. These novel SSR markers were used to evaluate 95 accessions of chrysanthemums (3 indigenous and 92 cultivated accessions). Two hundred alleles were identified, with an average of 16.7 alleles per locus. KNUCRY-77 gave the highest polymorphic information content value (0.879), while KNUCRY-10 gave the lowest (0.218). Similar patterns of grouping were observed with a distance-based dendrogram developed using PowerMarker and model-based clustering with Structure. Three clusters with some admixtures were identified by model-based clustering. These newly developed SSR markers will be useful for further studies of chrysanthemums, such as taxonomy and marker-assisted selection breeding.

We investigated the molecular response of degenerated human cervical and lumbar nucleus pulposus (NP) cells following cytokine treatment. Degenerated cervical and lumbar discs (8 each) were obtained from patients who underwent discectomy for degenerative disc disease; NP cells were isolated and cultured. The mRNA expressions of aggrecan, alkaline phosphatase, type I collagen, type II collagen, osteocalcin, and Sox9 in the 2 groups were compared by real-time PCR, before and following treatment with rhBMP-2 and TGF-β1. Immunoreactivity was analyzed to check protein activity. Type I collagen expression was significantly higher in cervical compared with that in lumbar disc cells. The mRNA expression was significantly increased after rhBMP-2 and TGF-β1 treatment. After rhBMP-2 treatment, mRNA expression of type I and II collagens increased significantly more in cervical than in lumbar NP cells. Following TGF-β1 treatment, the increase in mRNA expression was not significantly different between cervical and lumbar disc cells. Protein immunoreactivity, before and after cytokine treatment was similar to mRNA expression data. The matrix-related gene expression of cervical and lumbar NP after rhBMP-2 and TGF-β1 treatment increased similarly, with the exception of collagen expression.