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Although there is strong evidence that SARS-CoV-2 infection is associated with adverse outcomes in certain ethnic groups, the association of disease severity and risk factors such as comorbidities and biomarkers with racial disparities remains undefined. This retrospective study between March 2020 and February 2021 explores COVID-19 risk factors as predictors for patients' disease progression through country comparison. Disease severity predictors in Germany and Japan were cardiovascular-associated comorbidities, dementia, and age. We adjusted age, sex, body mass index, and history of cardiovascular disease comorbidity in the country cohorts using a propensity score matching (PSM) technique to reduce the influence of differences in sample size and the surprisingly young, lean Japanese cohort. Analysis of the 170 PSM pairs confirmed that 65.29% of German and 85.29% of Japanese patients were in the uncomplicated phase. More German than Japanese patients were admitted in the complicated and critical phase. Ethnic differences were identified in patients without cardiovascular comorbidities. Japanese patients in the uncomplicated phase presented a suppressed inflammatory response and coagulopathy with hypocoagulation. In contrast, German patients exhibited a hyperactive inflammatory response and coagulopathy with hypercoagulation. These differences were less pronounced in patients in the complicated phase or with cardiovascular diseases. Coagulation/fibrinolysis-associated biomarkers rather than inflammatory-related biomarkers predicted disease severity in patients with cardiovascular comorbidities: platelet counts were associated with severe illness in German patients. In contrast, high D-dimer and fibrinogen levels predicted disease severity in Japanese patients. Our comparative study indicates that ethnicity influences COVID-19-associated biomarker expression linked to the inflammatory and coagulation (thrombo-inflammatory) response. Future studies will be necessary to determine whether these differences contributed to the less severe disease progression observed in Japanese COVID-19 patients compared with those in Germany. [ABSTRACT FROM AUTHOR]

Abstract: The high voltage/high power DC-cathode power supply for the Gyrotron Test Facility at the Forschungszentrum in Karlsruhe consists of a 12-pulse thyristor star-point-controller, a 130kV capacitor-bank followed by a tetrode regulator. Originally designed for 80kV/30A CW (continous-wave) operation, its operating regime has been extended in line with gyrotron development to pulses of 65kV/45A/3min and more recently to 65kV/80A/10s without any changes to the main load bearing components (thyristors, transformers or power tetrode). This allows testing of gyrotrons in the 0.5MW (CW), 1MW (3min) and 2MW (10s) output power range. The paper describes the system, its operation and some critical aspects of the last upgrade, such as the issue of harmonics in the 20kV distribution mains-grid, the dynamic response of the thyristor-controller and the avoidance of microwave parasitic oscillations in the high power tetrode (a CQK-200-4, developed by ABB, Switzerland and now produced by Thales Electron Devices, France). Finally, an outlook is given on the extension-plans of the FZK Gyrotron Test Facility, namely to procure a Pulse-Step-Modulator (PSM) cathode power supply for 100kV/100A capable of CW operation for the development and testing of gyrotrons for fusion reactors (i.e. DEMO), with up to 4MW CW output power. Some of the advantages and disadvantages of a PSM versus an analogue regulator system are being discussed. [Copyright &y& Elsevier]

Background: Positive surgical margins (PSMs) represent a poor prognostic factor at radical prostatectomy (RP). To investigate the impact of PSM, its length, the focality, and the PSM Gleason, on biochemical recurrence (BCR) in organ-confined RP patients., Methods: Within a high-volume center database, we identified patients who harbored organ-confined (pathologic stage T2 disease) prostate cancer (PCa) at RP (2010-2016). Kaplan-Meier analyses and multivariable Cox regression models were used to test the effect of the PSM on the BCR risk., Results: Overall, 8770 patients were identified. Of those, 6.6% (n = 579) harbored PSM. BCR-free survival at 72 months after RP was 77.7% vs 89.0% for patients with vs without PSM (P < .001). BCR-free survival rates at 72 months were 77.4% vs 73.6% (P = .1) for unifocal vs multifocal PSM, 77.2% vs 71.8% (P = .03) for Gleason pattern 3 vs ≥4 at the margin and 88.4% vs 66.3% (P < .001) for <3 vs ≥3 mm length of margin. In multivariable Cox models PSM was an independent predictor for BCR (hazard ratio [HR] = 2.40, P < .001). However, in subgroups with PSM, only ≥3 mm PSM represented an independent predictor (HR = 1.93, P = .04), while focality and Gleason at the margin were no significant predictors., Conclusion: PSM represents an independent predictor for BCR in organ-confined PCa at RP. Moreover, Gleason ≥4 at the margin and ≥3 mm PSM length were associated with worse BCR-free survival. Closer surveillance of patients with organ-confined PCa at RP and PSM can help to identify those who qualify for early salvage radiotherapy., (© 2019 Wiley Periodicals, Inc.)