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Deep learning-based classification algorithms have been used for automatic modulation recognition (AMR). However, most methods only focus on end-to-end mapping and neglect the classic key features. In this paper, signals are enforced with key classification features to propose a novel deep learning model for AMR by learning the shared latent space of the aligned signals and key features (LLAF); this is done to increase the generalizability of the model and to ensure the physical plausibility of the results. To obtain adequate signal representations, an encoder-decoder architecture is proposed to learn the shared latent space, and the architecture is trained to approximate prior label distributions for precise signal classification. Simulation results verify the high recognition accuracy of the proposed LLAF model under different signal-to-noise ratios (SNRs).

It is well known that hypercholesterolemia in the body has pro-inflammatory effects through the formation of inflammasomes and augmentation of TLR (Toll-like receptor) signaling, which gives rise to cardiovascular disease and neurodegenerative diseases. However, the interaction between cholesterol-related lipids and acute pancreatitis (AP) has not yet been summarized before. This hinders the consensus on the existence and clinical importance of cholesterol-associated AP. This review focuses on the possible interaction between AP and cholesterol-related lipids, which include total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and apolipoprotein (Apo) A1, from the bench to the bedside. With a higher serum level of total cholesterol, LDL-C is associated with the severity of AP, while the persistent inflammation of AP is allied with a decrease in serum levels of cholesterol-related lipids. Therefore, an interaction between cholesterol-related lipids and AP is postulated. Cholesterol-related lipids should be recommended as risk factors and early predictors for measuring the severity of AP. Cholesterol-lowering drugs may play a role in the treatment and prevention of AP with hypercholesterolemia.

Background and AimsThe aim of this study was to apply machine learning models and a nomogram to differentiate critically ill from non-critically ill COVID-19 pneumonia patients.MethodsClinical symptoms and signs, laboratory parameters, cytokine profile, and immune cellular data of 63 COVID-19 pneumonia patients were retrospectively reviewed. Outcomes were followed up until Mar 12, 2020. A logistic regression function (LR model), Random Forest, and XGBoost models were developed. The performance of these models was measured by area under receiver operating characteristic curve (AUC) analysis.ResultsUnivariate analysis revealed that there was a difference between critically and non-critically ill patients with respect to levels of interleukin-6, interleukin-10, T cells, CD4+ T, and CD8+ T cells. Interleukin-10 with an AUC of 0.86 was most useful predictor of critically ill patients with COVID-19 pneumonia. Ten variables (respiratory rate, neutrophil counts, aspartate transaminase, albumin, serum procalcitonin, D-dimer and B-type natriuretic peptide, CD4+ T cells, interleukin-6 and interleukin-10) were used as candidate predictors for LR model, Random Forest (RF) and XGBoost model application. The coefficients from LR model were utilized to build a nomogram. RF and XGBoost methods suggested that Interleukin-10 and interleukin-6 were the most important variables for severity of illness prediction. The mean AUC for LR, RF, and XGBoost model were 0.91, 0.89, and 0.93 respectively (in two-fold cross-validation). Individualized prediction by XGBoost model was explained by local interpretable model-agnostic explanations (LIME) plot.ConclusionsXGBoost exhibited the highest discriminatory performance for prediction of critically ill patients with COVID-19 pneumonia. It is inferred that the nomogram and visualized interpretation with LIME plot could be useful in the clinical setting. Additionally, interleukin-10 could serve as a useful predictor of critically ill patients with COVID-19 pneumonia.

Summary: Gut mesenchyme provides key stem cell niche signals such as Wnt ligands, but how these signals are regulated is unclear. Because Hedgehog (Hh) signaling is critical for gut mesenchymal development and tumorigenesis, we investigated Hh-mediated mechanisms by analyzing mice deleted for key negative regulators of Hh signaling, Sufu and/or Spop, in the gut mesenchyme, and demonstrated their dosage-dependent roles. Although these mutants exhibit abnormal mesenchymal cell growth and functionally defective muscle layers, villification is completed with proper mesenchymal clustering, implying a permissive role for Hh signaling. These mesenchymal defects are partially rescued by Gli2 reduction. Consistent with increased epithelial proliferation caused by abnormal Hh activation in development, Sufu reduction promotes intestinal tumorigenesis, whereas Gli2 heterozygosity suppresses it. Our analyses of chromatin and GLI2 binding genomic regions reveal its transcriptional regulation of stem cell niche signals through enhancers, providing mechanistic insight into the intestinal stem cell niche in development and tumorigenesis. : Coquenlorge et al. utilize various mouse models to investigate the mechanisms of gut stromal stem cell niche signals in development and cancer. This work demonstrates that Hh signaling in the gut stroma directly activates Wnt niche signals, and its dysregulation promotes epithelial proliferation and intestinal tumorigenesis. Keywords: Sufu, Spop, GLI2, villus formation, mesenchymal proliferation, WNT, intestinal tumorigenesis

BACKGROUND Oral intake is dependent on the gastric ability to accommodate the food bolus. Comparatively, neonates have a smaller gastric capacity than adults and this may limit the volume of their milk intake. Yet, we previously reported that the newborn rat gastric milk volume is greatest after birth and, when normalized to body weight, decreases with postnatal age. Such age-dependent changes are not the result of intake differences, but greater gastric accommodation and reduced emptying rate. AIM Hypothesizing that breastmilk-derived adiponectin is the factor regulating gastric accommodation in neonates, we comparatively evaluated its effects on the rat fundic muscle tone at different postnatal ages. METHODS In freshly dispersed smooth muscle cells (SMC), we measured the adiponectin effect on the carbachol-induced length changes. RESULTS Adiponectin significantly reduced the carbachol-stimulated SMC shortening independently of age. In the presence of the inhibitor iberiotoxin, the adiponectin effect on SMC shortening was suppressed, suggesting that it is mediated via large-conductance Ca2+ sensitive K+ channel activation. Lastly, we comparatively measured the newborn rat gastric milk curd adiponectin content in one- and two-week-old rats and found a 50% lower value in the latter. CONCLUSION Adiponectin, a major component of breastmilk, downregulates fundic smooth muscle contraction potential, thus facilitating gastric volume accommodation. This rodent's adaptive response maximizes breastmilk intake volume after birth.

Retinopathy of prematurity (ROP) is one of the leading causes of blindness in preterm Infants. Anti-vascular endothelial growth factor (VEGF) is emerging as a promising treatment, but there is insufficient evidence on their safety. We investigate the effect of systemic anti-VEGF in rat pups with equivalent maturity to a 32 week neonate. A single dose of either anti-VEGF antibody (n = 7) or saline (control group; n = 6) was administered to newborn rats intra-peritoneally on the first day of life. 14 days' post treatment, the serum concentration of anti-VEGF was measured and the brain, lung, heart, kidney and liver were harvested and weighed. The heart was processed to measure the Fulton index (a surrogate for pulmonary hypertension). All other organs were processed for mRNA expression of VEGF and VEGF-receptors (R1R2). No group differences in body and organ weights were noted. The anti-VEGF was still detected in serum 14 days post Injection and resulted in increase in lung (p 0.002) and kidney (p 0.01) VEGF mRNA expressions and the lung (p 0.02) VEGF-R1 and kidney (P 0.001) VEGF-R2 mRNA expressions. The treated pups exhibited increased total heart weight (p 0.01) and Fulton Index (p 0.05). No changes were seen in the liver and brain. Anti-VEGF antibody did not affect mortality, total body and organ weights, but was associated with pulmonary hypertension. Expression of lung and kidney VEGF and its receptors was increased, whilst the brain and liver did not show changes. Dosing experiments can now be targeted to assess safety threshold and at anti-VEGF dose used in human ROP treatment.

BackgroundHuman milk has a high content of the antimicrobial compound hydrogen peroxide (H2O2). As opposed to healthy full-term infants, preterm neonates are fed previously expressed and stored maternal milk. These practices may favor H2O2 decomposition, thus limiting its potential benefit to preterm infants. The goal of this study was to evaluate the factors responsible for H2O2 generation and degradation in breastmilk.MethodsHuman donors' and rats' milk, along with rat mammary tissue were evaluated. The role of oxytocin and xanthine oxidase on H2O2 generation, its pH-dependent stability, as well as its degradation via lactoperoxidase and catalase was measured in milk.ResultsBreast tissue xanthine oxidase is responsible for the H2O2 generation and its milk content is dependent on oxytocin stimulation. Stability of the human milk H2O2 content is pH-dependent and greatest in the acidic range. Complete H2O2 degradation occurs when human milk is maintained, longer than 10 min, at room temperature and this process is suppressed by lactoperoxidase and catalase inhibition.ConclusionFresh breastmilk H2O2 content is labile and quickly degrades at room temperature. Further investigation on breastmilk handling techniques to preserve its H2O2 content, when gavage-fed to preterm infants is warranted.

Hypothesis This paper investigates the self-assembly behavior of a new amphiphilic block copolymer, PPEGMA-PPC-PPEGMA, in dilute aqueous solution and at the air–water interface. In PPEGMA-PPC-PPEGMA, the hydrophilic PEG moieties exist as side chains attached to the PMA backbone. Because of this unique non-linear architecture, the morphological and conformational properties of self-assembled PPEGMA-PPC-PPEGMA polymers are expected to be different from those of conventional linear PEG-based polymer surfactants. Experiments For this study, three PPE G MA-PP C -PPE G MA samples having an identical PPC molecular weight ( 5.6 kDa) and different PPEGMA molecular weights ( 7.2 , 2.8 and 2.1 kDa on either side) (named “ G7C6G7 ”, “ G3C5G3 ”, and “ G2C6G2 ”, respectively) were synthesized. The micellar self-assembly behaviors of these materials were investigated by cryo-TEM, rheology, DLS, and visual observation. Langmuir monolayers of these materials were characterized by surface mechanical testing. Findings PPEGMA-PPC-PPEGMA micelles were found to have a spherical geometry, irrespective of copolymer composition. Interestingly, G2C6G2 and G3C6G3 micelles formed weakly-bound clusters, whereas G7C6G7 micelles predominantly existed as isolated micelles. Detailed analysis suggests that this unexpected trend in micelle morphology originates from the fact that the PPEGMA blocks are only partially hydrated at aqueous interfaces. Detailed features of the surface pressure-area isotherms obtained from Langmuir PPEG-PPC-PPEGMA monolayers further supported this notion.

Acetaminophen is widely prescribed to both neonates and young children for a variety of reasons. In adults, therapeutic usage of acetaminophen induces systemic arterial pressure changes and exposure to high doses promotes tissue toxicity. The pulmonary vascular effects of acetaminophen at any age are unknown. Hypothesizing that, early in life, it promotes vasomotor tone changes via oxidative stress, we tested the in vitro acetaminophen effects on intrapulmonary and carotid arteries from newborn and adult rats.We measured the acetaminophen dose-response in isometrically mounted arteries and pharmacologically evaluated the factors accounting for its vasomotor effects.Acetaminophen induced concentration- and age-dependent vasomotor tone changes. Whereas a progressive increase in vasomotor tone was observed in the newborn, the adult arteries showed mostly vasorelaxation. Inhibition of endogenous nitric oxide generation with L-NAME and the use of the peroxynitrite decomposition catalyst FeTPPS (Fe(III)5,10,15,20-tetrakis(4-sulfonatophenyl)porphyrinato chloride) mostly abolished the drug-induced increase in newborn pulmonary vasomotor tone CONCLUSIONS: In newborn rats, acetaminophen increases pulmonary vasomotor tone via peroxynitrite generation. Given its therapeutic usage, further clinical studies are warranted to assess the acetaminophen effects on the newborn pulmonary and systemic vascular resistance.

When compared with infant formula, human milk enhances gastric emptying in preterm infants. Hydrogen peroxide (H2O2) is present in large quantities in human milk that has an antimicrobial role for the mother and infant. In vitro adult rat studies suggest that H2O2 facilitates gastric motor contraction. Hypothesizing that H2O2 enhances gastric motility, we investigated its effects on the newborn rat stomach tissue. Rat newborn and adult gastric fundic segments, or their smooth muscle cells, were used to evaluate the muscle response to H2O2 exposure. Tissue expression of Rho kinase 2 (ROCK-2; Western blot), its catalase activity, and H2O2 content (Amplex Red) were measured. H2O2 gastric mucosal diffusion was evaluated with Ussing chambers. In both newborn and adult rats, H2O2 induced gastric muscle contraction and this response was attenuated by pre-incubation with the antioxidant melatonin. H2O2 passively diffused across the gastric mucosa. Its effect on the muscle was modulated via ROCK-2 activation and inhibited by melatonin. H2O2, at a concentration similar to that of human milk, promotes gastric motility in the rat. To the extent that the present findings can be clinically extrapolated, the human milk H2O2 content may enhance gastric emptying in neonates.

The factors accounting for the pathological maintenance of a high pulmonary vascular (PV) resistance postnatally remain elusive, but neonatal stressors may play a role in this process. Cross-fostering in the immediate neonatal period is associated with adult-onset vascular and behavioral changes, likely triggered by early-in-life stressors. In hypothesizing that fostering newborn rats induces long-lasting PV changes, we evaluated them at 14 days of age during adulthood and compared the findings with animals raised by their biological mothers. Fostering resulted in reduced maternal-pup contact time when compared with control newborns. At 2 wk of age, fostered rats exhibited reduced pulmonary arterial endothelium-dependent relaxation secondary to downregulation of tissue endothelial nitric oxide synthase expression and tetrahydrobiopterin deficiency-induced uncoupling. These changes were associated with neonatal onset-increased ANG II receptor type 1 expression, PV remodeling, and right ventricular hypertrophy that persisted into adulthood. The pulmonary arteries of adult-fostered rats exhibited a higher contraction dose response to ANG II and thromboxane A2, the latter of which was abrogated by the oxidant scavenger Tempol. In conclusion, fostering-induced neonatal stress induces long-standing PV changes modulated via the renin-angiotensin system.

BackgroundHuman milk has a high content of the antimicrobial compound hydrogen peroxide (H

Background Gastric residuals are a common finding in enterally fed preterm neonates and traditionally thought to reflect immaturity-related delayed gastric emptying. Adult human data suggest that the meal volume regulate the gastric emptying rate, but early in life, this has not been adequately evaluated. The goal of this study was to study the rat postnatal changes in gastric emptying rate and the strain-induced effect on muscle contraction. We hypothesized that the stomach content volume and not developmental factors determines the newborn gastric emptying rate, via the Rho-kinase 2 (ROCK-2) pathway. Methods Gastric volume and emptying rate measurements were obtained by ultrasound at different postprandial times and the wall strain-dependent changes in muscle contraction were evaluated ex vivo. Key results The newborn rat gastric emptying rate was unrelated to postnatal age, maximal 30 min postprandial, and directly proportional to content volume. In vitro measurements showed that the agonist-induced gastric muscle contraction was directly proportional to the stomach wall strain. These changes were mediated via upregulation of ROCK-2 activity. Conclusions & inferences The newborn rat gastric emptying rate is not developmentally regulated, but dependent on the content volume via wall strain-induced ROCK-2 activation. Further clinical studies addressing the content volume effect on the rate of gastric emptying are warranted, to enhance feeding tolerance in preterm neonates.

Tetrahydrobiopterin (BH4) is a cofactor of a number of regulatory enzymes. Although there are no known BH4 exogenous sources, the tissue content of this biopterin increases with age in GTP cyclohydrolase 1-deficient hyperphenylalaninemia-1 (hph-1) mice. Since certain bacteria are known to generate BH4, we hypothesize that generation of this biopterin by the intestinal microbiota contributes to its tissue increase in hph-1 adult mice. The goal of this study was to comparatively evaluate hph-1 mice and wild-type C57Bl/6 controls for the presence of intestinal BH4-producing bacteria. Newborn and adult mice fecal material was screened for 6-pyruvoyltetrahydropterin synthase (PTPS-2) an enzyme only present in BH4-generating bacteria. Adult, but not newborn, wild-type control and hph-1 mouse fecal material contained PTPS-2 mRNA indicative of the presence of BH4-generating bacteria. Utilizing chemostat-cultured human fecal bacteria, we identified the PTPS-2-producing bacteria as belonging to the Actinobacteria phylum. We further confirmed that at least two PTPS-2-producing species, Aldercreutzia equolifaciens and Microbacterium schleiferi, generate BH4 and are present in hph-1 fecal material. In conclusion, intestinal Actinobacteria generate BH4. This finding has important translational significance, since manipulation of the intestinal flora in individuals with congenital biopterin deficiency may allow for an increase in total body BH4 content.

Scientific Reports 7: Article number: 39854; published online: 12 January 2017; updated: 11 April 2017 In the original version of this Article, all instances of “Adlercreutzia equolifaciens” were incorrectly given as “Aldercreutzia equolifaciens”. This error has now been corrected in the PDF and HTML versions of the Article.

Background Tetrahydrobiopterin (BH4) is an essential cofactor in multiple metabolic processes and plays an essential role in maintaining the inflammatory and neurovascular homeostasis. In this study, we have investigated the deleterious effects of BH4 deficiency on retinal vasculature during development. Methods hph-1 mice, which display deficiency in BH4 synthesis, were used to characterize the inflammatory effects and the integrity of retinal microvasculature. BH4 levels in retinas from hph-1 and wild type (WT) mice were measured by LC-MS/MS. Retinal microvascular area and microglial cells number were quantified in hph-1 and WT mice at different ages. Retinal expression of pro-inflammatory, anti-angiogenic, and neuronal-derived factors was analyzed by qPCR. BH4 supplementation was evaluated in vitro, ex-vivo, and in vivo models. Results Our findings demonstrated that BH4 levels in the retina from hph-1 mice were significantly lower by ~ 90% at all ages analyzed compared to WT mice. Juvenile hph-1 mice showed iris atrophy, persistent fetal vasculature, significant increase in the number of microglial cells (p

Tetrahydrobiopterin (BH4) is a cofactor of a number of regulatory enzymes. Although there are no known BH4 exogenous sources, the tissue content of this biopterin increases with age in GTP cyclohydrolase 1-deficient hyperphenylalaninemia-1 (hph-1) mice. Since certain bacteria are known to generate BH4, we hypothesize that generation of this biopterin by the intestinal microbiota contributes to its tissue increase in hph-1 adult mice. The goal of this study was to comparatively evaluate hph-1 mice and wild-type C57Bl/6 controls for the presence of intestinal BH4-producing bacteria. Newborn and adult mice fecal material was screened for 6-pyruvoyltetrahydropterin synthase (PTPS-2) an enzyme only present in BH4-generating bacteria. Adult, but not newborn, wild-type control and hph-1 mouse fecal material contained PTPS-2 mRNA indicative of the presence of BH4-generating bacteria. Utilizing chemostat-cultured human fecal bacteria, we identified the PTPS-2-producing bacteria as belonging to the Actinobacteria phylum. We further confirmed that at least two PTPS-2-producing species, Adlercreutzia equolifaciens and Microbacterium schleiferi, generate BH4 and are present in hph-1 fecal material. In conclusion, intestinal Actinobacteria generate BH4. This finding has important translational significance, since manipulation of the intestinal flora in individuals with congenital biopterin deficiency may allow for an increase in total body BH4 content.

Tetrahydrobiopterin (BH4) deficiency is associated with upregulated expression of pro-inflammatory mediators at P14. Quantitative real-time PCR analysis was performed on whole retinas at P7 and P14 from control (WT) and hph-1 animals; control values were set at 1. A significant increase in retinal mRNA expression of IL-1β (p

Intraocular supplementation of tetrahydrobiopterin (BH4) prevents retinal vasoobliteration in mice exposed to oxygen-induced retinopathy (OIR). Representative images of flat-mounted retinas labeled with fluorescein-labeled Griffonia Simplicifolia Lectin 1 (GSL 1), isolectin B4 to examine vasoobliteration in animals exposed to 75% oxygen from P7 until P9. Animals were intravitreally injected at P7 with 100 μM of BH4 or vehicle (PBS steril 1×) and retinas analyzed at P9. Significant differences (p value) in the vasoobliterated area between vehicle and BH4 treatment after 48 h of hyperoxia are shown in the graphs; ***p

Morphology of the eyes from hph-1 and WT mice. (A) Representative images of the eyeballs from wild type (WT) and hph-1 mice analyzed by H&E staining at postnatal day 1, 7, and 14. The pictures show a reduction in the size, as well as, appearance of hypertrophy in the iris and persistence of fetal hyaloid vasculature in the eyes of hph-1 mice. (PDF 297Â kb)

Tetrahydrobiopterin (BH4) content in hph-1 mice at early ages. BH4 content (ng/mg of tissue) in retinas from control (WT) and hph-1 mice at postnatal day 7 and 14 (P7 and P14) was measured by using liquid chromatography tandem mass spectrometry (LC-MS/MS). The levels of BH4 were significantly decreased by ~ 90% in the retinas of hph-1 at P7 and P14 compared with WT mice. Results showed in the histograms are expressed as means ± SEM of n = 5 mice for each group. **p

Retinal flat-mounts from hph-1 and WT mice at different ages. Representative images of whole-mounted retinas labeled with TRITC-conjugated lectin endothelial cell marker Bandeiraea simplicifolia showing retinal vasculature from controls (WT) and hph-1 mice at different postnatal ages (P1, P7, P14, and P22). Note that at P1, the vessels in the retina are mainly represented by the hyaloid vasculature. (PDF 263Â kb)

Interleukin-1β (IL-1β) is localized on microglial cells and Semaphorin 3A (Sema3A) is decreased in the retinas from BH4 deficient mice. (A) Representative confocal images showing immunoreactivity for IL-1β (green) and Iba-1 (red) merged with DAPI (blue and yellow) in retinal cryosections from control (WT) and hph-1 mice at 22-day-old (n = 3 per group). Co-staining of IL-1β with Iba-1 was detected on microglial cells localized in the ganglion cell layer (GCL) and deep plexiform layer (IPL) in retinas from hph-1 mice but not in WT mice. Scale bar = 50 μm. (B) Quantitative real-time PCR analysis was performed on whole retinas at P22 from control (WT) and hph-1 animals; control values were set at 1. A significant decrease in retinal mRNA expression of Sema3A (***p

Vascular density in hph-1 and WT mice at early ages. The quantification of the vascular density in both superficial and deep retinal vascular complexes was not significant in hph-1 mice compared to the WT control at P1, P7, and P14. Results showed in the histograms are expressed as means ± SEM of n = 3–4 retinas for each group. ns = not significant compared to the control. (PDF 193 kb)

Inhaled nitric oxide (NO) and other cGMP- or cAMP-dependent pulmonary vasodilators are often used in combination for the treatment of the persistent pulmonary hypertension of the newborn syndrome. There is in vitro evidence to indicate that NO downregulate the pulmonary vascular response to cGMP-dependent agonists raising concern as to whether a synergistic effect is observed when employing a combined strategy in newborns. Hypothesizing that a synergistic effect is absent, we evaluated newborn and juvenile rat pulmonary arteries to determine the individual and combined vasodilatory effect of cGMP- and cAMP-dependent agonists. In precontracted near-resistance pulmonary arteries, the addition of sildenafil reduced vasorelaxation response to NO donor S-nitroso- N-acetyl penicillamine (SNAP). A similar decrease in SNAP-induced vasodilation was observed in arteries pretreated with BAY 41–2272 (10−9M), a soluble guanylate cyclase stimulator cGMP, and its downstream protein kinase activator. cGMP also reduced the vasorelaxant response to the cAMP-dependent forskolin. Inhibition of endogenous vascular NO generation enhanced SNAP-induced relaxation. The present data suggest that the mechanism involved in the cGMP desensitization to other relaxant agonists involves downregulation of the small heat shock protein HSP20 and is evident in rat pulmonary and systemic vascular smooth muscle cells. In newborn rats with chronic hypoxia-induced pulmonary hypertension, the combination of sildenafil and inhaled NO resulted in a lesser reduction in pulmonary vascular resistance compared with their individual effect. These data suggest that clinical exposure to one cGMP-dependent pulmonary vasodilator may affect the response to other cGMP- or cAMP-mediated agonists.