Evaluation of Hemodialysis Arteriovenous Bruit by Deep Learning.

Physical findings of auscultation cannot be quantified at the arteriovenous fistula examination site during daily dialysis treatment. Consequently, minute changes over time cannot be recorded based only on subjective observations. In this study, we sought to supplement the daily arteriovenous fistula consultation for hemodialysis patients by recording the sounds made by the arteriovenous fistula and evaluating the sounds using deep learning methods to provide an objective index. We sampled arteriovenous fistula auscultation sounds (192 kHz, 24 bits) recorded over 1 min from 20 patients. We also extracted arteriovenous fistula sounds for each heartbeat without environmental sound by using a convolutional neural network (CNN) model, which was made by comparing these sound patterns with 5000 environmental sounds. The extracted single-heartbeat arteriovenous fistula sounds were sent to a spectrogram and scored using a CNN learning model with bidirectional long short-term memory, in which the degree of arteriovenous fistula stenosis was assigned to one of five sound types (i.e., normal, hard, high, intermittent, and whistling). After 100 training epochs, the method exhibited an accuracy rate of 70-93%. According to the receiver operating characteristic (ROC) curve, the area under the ROC curves (AUC) was 0.75-0.92. The analysis of arteriovenous fistula sound using deep learning has the potential to be used as an objective index in daily medical care.

NFkappaB-p65 dependent transcriptional regulation of glycosyltransferases in human colon adenocarcinoma HT-29 by stimulation with tumor necrosis factor alpha.

Regulation of fucosyltransferases (FUTs) and sialyltransferases (STs) in a human colon adenocarcinoma cell line HT-29 and nuclear factor kappaB (NFkappaB)-p65 knockdown HT-29 cells was investigated after stimulation with tumor necrosis factor alpha (TNFalpha) using real time PCR. TNFalpha stimulation induced the biphasic increases in expression of NFkappaB-p65, ST3Gal I, FUT IV, ST3Gal IV and ST6GalNAc III mRNAs and the transient increase in expression of ST6Gal I mRNA and the decrease in ST3GalNAc IV mRNA. In NFkappaB-p65 knockdown HT-29 cells, the biphasic and transient increases in all of these mRNA expression induced with TNFalpha were diminished. On the other hand, NFkappaB-p65 siRNA enhanced the constitutive expression levels of ST3GalNAc IV mRNA which was suppressed by TNFalpha. Transcription activities of ST3Gal I reporter gene from nt -1050 5'-flanking region to translation initiation site which has consensus NFkappaB binding sites were up-regulated by stimulation with TNFalpha in HT-29 cells. The promoter activities for deletion constructs of each NFkappaB binding sites were determined using dual luciferase assay. The results indicated that constitutive promoter activities were detected at nt -120 5'-flanking translation initiation site and TNFalpha enhanced ST3Gal I gene expression through NFkappaB binding sites in HT-29 cells. Combination of stimulation with TNFalpha and NFkappaB knockdown with siRNA is useful for determination of NFkappaB dependent transcriptional regulation.