Pipeline embolization device dynamics: prediction of incomplete occlusion by elongation from nominal length.

OBJECTIVE: According to benchtop studies, the oversizing of a Pipeline embolization device (PED) relative to the parent artery leads to a significant increase in porosity and potentially compromises aneurysm occlusion as well as transitional zone (TZ) formation around the neck of aneurysms. However, no clinical assessment has been reported. Here this potential was studied by measuring the dynamic changes of PEDs in the clinical time course. METHODS: The authors retrospectively examined 124 anterior circulation unruptured aneurysms in 114 consecutive patients treated with a PED between July 2015 and December 2020 at their institution. The authors excluded 77 cases of 68 patients with adjunctive coil embolization or multiple stents that could affect the PED dynamics and measurements, and 47 aneurysms in 46 patients were included. Measurements were performed before, immediately after, and 6 months after treatment, and then at intervals of 6 months to 1 year after that for nonocclusion cases. RESULTS: Complete occlusion was achieved in 79.0% and incomplete occlusion in 21.0% at last follow-up. The PED length immediately after deployment was 136% nominal length. A multivariable regression analysis revealed that age (OR 1.11/year; p = 0.02) and PED elongation from nominal length (OR 1.31/mm; p = 0.012) were independently associated with a higher rate of incomplete occlusion at the last follow-up. TZ formation did not affect the occlusion rate. CONCLUSIONS: PED elongation from the nominal length is a new predictor of incomplete aneurysm occlusion. The PED showed vascular remodeling by changing its diameter and length in the clinical course. TZ formation was remodeled and did not affect the occlusion rate.

Fetal heart rate patterns related to neonatal brain damage and neonatal death in placental abruption.

AIM: The aim of this study was to determine the correlation between non-reassuring fetal heart rate (NRFHR) patterns and poor neonatal outcome in placental abruption. MATERIAL AND METHODS: A retrospective study was performed involving 83 placental abruptions with a live fetus at one tertiary and one secondary hospital in Miyazaki prefecture, Japan. We examined the correlation among NRFHR, umbilical arterial blood gas status, and neonatal poor outcomes, including neonatal death (ND) and cerebral palsy (CP). RESULTS: A total of 83 cases were divided into bradycardia (n=27), recurrent late deceleration (rLD, n=29), severe variable deceleration or prolonged deceleration (sVD/PD, n=8), and other cases (n=19). In the bradycardia group, the incidence of low umbilical artery (UA) pH (<7.0) was 59% and the average UA pH was 6.96±0.22. Among these cases, 10 showed severe bradycardia (less than 80 b.p.m.) and an average UA pH of 6.85±0.24, and four cases resulted in poor outcome (three CP and one ND). In the rLD group, the incidence of low UA pH (<7.0) was 7% and the average UA pH was 7.24±0.12. In this group, a 40-week-old fetus with umbilical phlebitis had a lower UA pH (6.92) and developed CP. In the sVD/PD group, there were no cases of a low UA pH (<7.0) and the average UA pH was 7.30±0.04. In this group, a 31-week-old boy with a UA pH of 7.36 developed CP (PVL). The remaining 19 cases had no CP. CONCLUSION: Poor neonatal outcome of placental abruption is closely related to NRFHR, especially the degree of bradycardia. In the rLD and sVD/PD groups, risk factors, such as prematurity and fetal inflammation, co-existed.

A Privacy-Preserving Distributed Medical Data Integration Security System for Accuracy Assessment of Cancer Screening: Development Study of Novel Data Integration System.

BACKGROUND: Big data useful for epidemiological research can be obtained by integrating data corresponding to individuals between databases managed by different institutions. Privacy information must be protected while performing efficient, high-level data matching. OBJECTIVE: Privacy-preserving distributed data integration (PDDI) enables data matching between multiple databases without moving privacy information; however, its actual implementation requires matching security, accuracy, and performance. Moreover, identifying the optimal data item in the absence of a unique matching key is necessary. We aimed to conduct a basic matching experiment using a model to assess the accuracy of cancer screening. METHODS: To experiment with actual data, we created a data set mimicking the cancer screening and registration data in Japan and conducted a matching experiment using a PDDI system between geographically distant institutions. Errors similar to those found empirically in data sets recorded in Japanese were artificially introduced into the data set. The matching-key error rate of the data common to both data sets was set sufficiently higher than expected in the actual database: 85.0% and 59.0% for the data simulating colorectal and breast cancers, respectively. Various combinations of name, gender, date of birth, and address were used for the matching key. To evaluate the matching accuracy, the matching sensitivity and specificity were calculated based on the number of cancer-screening data points, and the effect of matching accuracy on the sensitivity and specificity of cancer screening was estimated based on the obtained values. To evaluate the performance, we measured central processing unit use, memory use, and network traffic. RESULTS: For combinations with a specificity ≥99% and high sensitivity, the date of birth and first name were used in the data simulating colorectal cancer, and the matching sensitivity and specificity were 55.00% and 99.85%, respectively. In the data simulating breast cancer, the date of birth and family name were used, and the matching sensitivity and specificity were 88.71% and 99.98%, respectively. Assuming the sensitivity and specificity of cancer screening at 90%, the apparent values decreased to 74.90% and 89.93%, respectively. A trial calculation was performed using a combination with the same data set and 100% specificity. When the matching sensitivity was 82.26%, the apparent screening sensitivity was maintained at 90%, and the screening specificity decreased to 89.89%. For 214 data points, the execution time was 82 minutes and 26 seconds without parallelization and 11 minutes and 38 seconds with parallelization; 19.33% of the calculation time was for the data-holding institutions. Memory use was 3.4 GB for the PDDI server and 2.7 GB for the data-holding institutions. CONCLUSIONS: We demonstrated the rudimentary feasibility of introducing a PDDI system for cancer-screening accuracy assessment. We plan to conduct matching experiments based on actual data and compare them with the existing methods.

Study on suitability of KOD DNA polymerase for enzymatic production of artificial nucleic acids using base/sugar modified nucleoside triphosphates.

Recently, KOD and its related DNA polymerases have been used for preparing various modified nucleic acids, including not only base-modified nucleic acids, but also sugar-modified ones, such as bridged/locked nucleic acid (BNA/LNA) which would be promising candidates for nucleic acid drugs. However, thus far, reasons for the effectiveness of KOD DNA polymerase for such purposes have not been clearly elucidated. Therefore, using mutated KOD DNA polymerases, we studied here their catalytic properties upon enzymatic incorporation of nucleotide analogues with base/sugar modifications. Experimental data indicate that their characteristic kinetic properties enabled incorporation of various modified nucleotides. Among those KOD mutants, one achieved efficient successive incorporation of bridged nucleotides with a 2'-ONHCH2CH2-4' linkage. In this study, the characteristic kinetic properties of KOD DNA polymerase for modified nucleoside triphosphates were shown, and the effectiveness of genetic engineering in improvement of the enzyme for modified nucleotide polymerization has been demonstrated.

Validation of the sperm quality analyzer and the hypo-osmotic swelling test for frozen-thawed ram and minke whale (Balaenoptera bonarensis) spermatozoa.

The object of the present study was to investigate the validation of the sperm quality analyzer (SQA) and the hypo-osmotic swelling (HOS) test with standard sperm analysis methods in frozen-thawed ram and minke whale spermatozoa. In rams, highly significant correlations were observed in the percentage of motile spermatozoa (P<0.01) and sperm concentration (P<0.01) between the standard and SQA methods. But, the percentage of morphologically normal spermatozoa did not significantly correlate between the standard and SQA methods. The percentages of swollen spermatozoa at 15 minutes by the HOS test were significantly correlated with the motility by the standard (P<0.05) and by the SQA (P<0.05) methods. For minke whale spermatozoa, the SVI (sperm viability index) values by the standard method were significantly (P<0.001) correlated with the sperm motility index (SMI) values by SQA. The percentage of motile spermatozoa was also significantly correlated (P<0.01) with the motility measured by SQA. Using different hypo-osmotic solutions and incubation times, the HOS test with 25, 100 and 150 mOsM did not show significant variations. Motility observed by the standard method and the percentage of swollen spermatozoa were significantly correlated (P<0.05). These results indicate that the SQA and HOS test can be utilized to assess the post-thawing motility of ram and minke whale spermatozoa, and that the SQA and HOS test values are significantly correlated in ram spermatozoa. However, sperm concentration and morphologically normal spermatozoa are not assessed accurately by SQA in minke whales.