Association between genetic variants of the cholinergic system and postoperative delirium and cognitive dysfunction in elderly patients.

BACKGROUND: Postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) are frequent and serious complications after surgery. We aim to investigate the association between genetic variants in cholinergic candidate genes according to the Kyoto encyclopedia of genes and genomes - pathway: cholinergic neurotransmission with the development of POD or POCD in elderly patients. METHODS: This analysis is part of the European BioCog project ( www.biocog.eu ), a prospective multicenter observational study with elderly surgical patients. Patients with a Mini-Mental-State-Examination score ≤ 23 points were excluded. POD was assessed up to seven days after surgery using the Nursing Delirium Screening Scale, Confusion Assessment Method and a patient chart review. POCD was assessed three months after surgery with a neuropsychological test battery. Genotyping was performed on the Illumina Infinium Global Screening Array. Associations with POD and POCD were analyzed using logistic regression analysis, adjusted for age, comorbidities and duration of anesthesia (for POCD analysis additionally for education). Odds ratios (OR) refer to minor allele counts (0, 1, 2). RESULTS: 745 patients could be included in the POD analysis, and 452 in the POCD analysis. The rate of POD within this group was 20.8% (155 patients), and the rate of POCD was 10.2% (46 patients). In a candidate gene approach three genetic variants of the cholinergic genes CHRM2 and CHRM4 were associated with POD (OR [95% confidence interval], rs8191992: 0.61[0.46; 0.80]; rs8191992: 1.60[1.22; 2.09]; rs2067482: 1.64[1.10; 2.44]). No associations were found for POCD. CONCLUSIONS: We found an association between genetic variants of CHRM2 and CHRM4 and POD. Further studies are needed to investigate whether disturbances in acetylcholine release and synaptic plasticity are involved in the development of POD. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02265263.

Generalized tonic-clonic seizures are accompanied by changes of interrelations within the autonomic nervous system.

PURPOSE: A seizure is a strong central stimulus that affects multiple subsystems of the autonomic nervous system (ANS), and results in different interactions across ANS modalities. Here, we aimed to evaluate whether multimodal peripheral ANS measures demonstrate interactions before and after seizures as compared to controls to provide the basis for seizure detection and forecasting based on peripheral ANS signals. METHODS: Continuous electrodermal activity (EDA), heart rate (HR), peripheral body temperature (TEMP), and respiratory rate (RR) calculated based on blood volume pulse were acquired by a wireless multi-sensor device. We selected 45 min of preictal and 60 min of postictal data and time-matched segments for controls. Data were analyzed over 15-min windows. For unimodal analysis, mean values over each time window were calculated for all modalities and analyzed by Friedman's two-way analysis of variance. RESULTS: Twenty-one children with recorded generalized tonic-clonic seizures (GTCS), and 21 age- and gender-matched controls were included. Unimodal results revealed no significant effect for RR and TEMP, but EDA (p = 0.002) and HR (p < 0.001) were elevated 0-15 min after seizures. The averaged bimodal correlation across all pairs of modalities changed for 15-min windows in patients with seizures. The highest correlations were observed immediately before (0.85) and the lowest correlation immediately after seizures. Overall, average correlations for controls were higher. SIGNIFICANCE: Multimodal ANS changes related to GTCS occur within and across autonomic nervous system modalities. While unimodal changes were most prominent during postictal segments, bimodal correlations increased before seizures and decreased postictally. This offers a promising avenue for further research on seizure detection, and potentially risk assessment for seizure recurrence and sudden unexplained death in epilepsy.

Multimodal approach towards understanding the changes in the autonomic nervous system induced by an ultramarathon.

Purpose: Running an ultramarathon can be considered as a multifaceted, intense stressor inducing changes within the autonomic nervous system (ANS). The aim of this study was to examine changes within and across ANS modalities in response to an ultramarathon.Methods: Thirteen runners (44.3 ± 5.9 years) completed a 65 km run. Electrodermal activity (EDA), heart rate (HR), and skin temperature measured at wrist (Temp), were recorded before and after running. Three-minute intervals were analysed. Mean values were compared by t-tests for dependent samples. Joint principal component analysis-canonical correlation analysis (PCA-CCA) and multiset CCA techniques were employed to measure the interactions between either any two or among all modalities.Results: HR (p < 0.01) and EDA (p < 0.01) increased, while Temp decreased (p < 0.01). PCA-CCA revealed one significant component (p < 0.05) for each modality pair in pre and post measures. Component strength increased from pre (mean = 0.73) to post (mean = 0.92) test. Multiset CCA supported the assumption of increasing strength of correlations across modalities.Conclusion: Ultramarathon, an intense physical stressor, increases correlations across modalities pointing towards a reorganization of central ANS control to restore dynamic balance after physical load. This characterization of ANS-states might offer new avenues for training control.

Exercise-Induced Changes of Multimodal Interactions Within the Autonomic Nervous Network.

Physical exercise has been shown to modulate activity within the autonomic nervous system (ANS). Considering physical exercise as a holistic stimulus on the nervous system and specifically the ANS, uni- and multimodal analysis tools were applied to characterize centrally driven interactions and control of ANS functions. Nineteen young and physically active participants performed treadmill tests at individually determined moderate and high intensities. Continuous electrodermal activity (EDA), heart rate (HR), and skin temperature at wrist (Temp) were recorded by wireless multisensor devices (Empatica® E4, Milan, Italy) before and 30 min after exercise. Artifact-free continuous 3 min intervals were analyzed. For unimodal analysis, mean values were calculated, for bimodal and multimodal analysis canonical correlation analysis (CCA) was performed. Unimodal results indicate that physical exercise affects ANS activity. More specifically, Temp increased due to physical activity (moderate intensity: from 34.15°C to 35.34°C and high intensity: from 34.11°C to 35.09°C). HR increased more for the high (from 60.76 bpm to 79.89 bpm) than for the moderate (from 64.81 bpm to 70.83 bpm) intensity. EDA was higher for the high (pre: 8.06 µS and post: 9.37 µS) than for the moderate (pre: 4.31 µS and post: 3.91 µS) intensity. Bimodal analyses revealed high variations in correlations before exercise. The overall correlation coefficient showed varying correlations in pretest measures for all modality pairs (EDA-HR, HR-Temp, Temp-EDA at moderate: 0.831, 0.998, 0.921 and high: 0.706, 0, 0.578). After exercising at moderate intensity coefficients changed little (0.828, 0.744, 0.994), but increased substantially for all modality pairs after exercising at high intensity (0.976, 0.898, 0.926). Multimodal analysis confirmed bimodal results. Exercise-induced changes in ANS activity can be found in multiple ANS modalities as well as in their interactions. Those changes are intensity-specific: with higher intensity the interactions increase. Canonical correlations between different ANS modalities may therefore offer a feasible approach to determine exercise induced modulations of ANS activity.

Information-Theoretic Analysis of a Family of Improper Discrete Constellations.

Non-circular or improper Gaussian signaling has proven beneficial in several interference-limited wireless networks. However, all implementable coding schemes are based on finite discrete constellations rather than Gaussian signals. In this paper, we propose a new family of improper constellations generated by widely linear processing of a square M-QAM (quadrature amplitude modulation) signal. This family of discrete constellations is parameterized by κ , the circularity coefficient and a phase ϕ . For uncoded communication systems, this phase should be optimized as ϕ * ( κ ) to maximize the minimum Euclidean distance between points of the improper constellation, therefore minimizing the bit error rate (BER). For the more relevant case of coded communications, where the coded symbols are constrained to be in this family of improper constellations using ϕ * ( κ ) , it is shown theoretically and further corroborated by simulations that, except for a shaping loss of 1.53 dB encountered at a high signal-to-noise ratio (snr), there is no rate loss with respect to the improper Gaussian capacity. In this sense, the proposed family of constellations can be viewed as the improper counterpart of the standard proper M-QAM constellations widely used in coded communication systems.

Author Correction: Volatiles Emitted by Calling Males of Burying Beetles and Ptomascopus morio (Coleoptera: Silphidae: Nicrophorinae) Are Biogenetically Related.

The original version of this article unfortunately contained a mistake. The name of the main component released by Nicrophorus defodiens in Fig. 1a should read "Fuscumyl acetate", not "Fuscumol".

Volatiles Emitted by Calling Males of Burying Beetles and Ptomascopus morio (Coleoptera: Silphidae: Nicrophorinae) Are Biogenetically Related.

In burying beetles, Nicrophorus spp. (Coleoptera: Silphidae: Nicrophorinae) mate finding is mediated by male produced volatile compounds. To date, pheromone components of only two species have been identified. In an attempt to better understand the evolution of male pheromone signaling in burying beetles, we investigated the male released volatiles of ten Nicrophorus species and one closely related nicrophorine species, Ptomascopus mori. Volatiles emitted by calling males were collected in the laboratory by means of solid phase micro extraction and analyzed using gas chromatography coupled with mass spectrometry. Identified volatiles included short chain esters of 4-methylcarboxylic acids, terpenoids, and some other aliphatic compounds. The long-range volatile signals of the burying beetle species included in this study are blends of two to seven components. We found that methyl or ethyl esters of 4-methylheptanoic acid and 4-methyloctanoic acid are produced by eight of the ten investigated Nicrophorus species. These esters may play a key role in chemical communication. Their widespread occurrence suggests that these compounds did not evolve recently, but appeared relatively early in the phylogeny of the genus. Although Ptomascopus is considered the sister genus of Nicrophorus, P. morio males do not produce any of the Nicrophorus compounds, but release 3-methylalkan-2-ones, which are absent in Nicrophorus. A better understanding of the evolution of burying beetle pheromones, however, will only be possible once more species have been studied.

Sample-poor estimation of order and common signal subspace with application to fusion of medical imaging data.

Due to their data-driven nature, multivariate methods such as canonical correlation analysis (CCA) have proven very useful for fusion of multimodal neurological data. However, being able to determine the degree of similarity between datasets and appropriate order selection are crucial to the success of such techniques. The standard methods for calculating the order of multimodal data focus only on sources with the greatest individual energy and ignore relations across datasets. Additionally, these techniques as well as the most widely-used methods for determining the degree of similarity between datasets assume sufficient sample support and are not effective in the sample-poor regime. In this paper, we propose to jointly estimate the degree of similarity between datasets and their order when few samples are present using principal component analysis and canonical correlation analysis (PCA-CCA). By considering these two problems simultaneously, we are able to minimize the assumptions placed on the data and achieve superior performance in the sample-poor regime compared to traditional techniques. We apply PCA-CCA to the pairwise combinations of functional magnetic resonance imaging (fMRI), structural magnetic resonance imaging (sMRI), and electroencephalogram (EEG) data drawn from patients with schizophrenia and healthy controls while performing an auditory oddball task. The PCA-CCA results indicate that the fMRI and sMRI datasets are the most similar, whereas the sMRI and EEG datasets share the least similarity. We also demonstrate that the degree of similarity obtained by PCA-CCA is highly predictive of the degree of significance found for components generated using CCA.

Finding brain oscillations with power dependencies in neuroimaging data.

Phase synchronization among neuronal oscillations within the same frequency band has been hypothesized to be a major mechanism for communication between different brain areas. On the other hand, cross-frequency communications are more flexible allowing interactions between oscillations with different frequencies. Among such cross-frequency interactions amplitude-to-amplitude interactions are of a special interest as they show how the strength of spatial synchronization in different neuronal populations relates to each other during a given task. While, previously, amplitude-to-amplitude correlations were studied primarily on the sensor level, we present a source separation approach using spatial filters which maximize the correlation between the envelopes of brain oscillations recorded with electro-/magnetoencephalography (EEG/MEG) or intracranial multichannel recordings. Our approach, which is called canonical source power correlation analysis (cSPoC), is thereby capable of extracting genuine brain oscillations solely based on their assumed coupling behavior even when the signal-to-noise ratio of the signals is low. In addition to using cSPoC for the analysis of cross-frequency interactions in the same subject, we show that it can also be utilized for studying amplitude dynamics of neuronal oscillations across subjects. We assess the performance of cSPoC in simulations as well as in three distinctively different analysis scenarios of real EEG data, each involving several subjects. In the simulations, cSPoC outperforms unsupervised state-of-the-art approaches. In the analysis of real EEG recordings, we demonstrate excellent unsupervised discovery of meaningful power-to-power couplings, within as well as across subjects and frequency bands.

Apple procyanidins affect several members of the ErbB receptor tyrosine kinase family in vitro.

Complex polyphenol-rich extracts from apples are known to inhibit the activity of the epidermal growth factor receptor (EGFR) in vitro. The aim of the present study was to identify the bioactive constituents of the apple juice extract which contribute substantially to this potentially chemopreventive effect and to address the question whether the effect is specific to the EGFR or whether other members of the ErbB-receptor family might also be affected. Apple-derived dihydrochalcones and their respective glycosides were found to decrease EGFR activity under cell-free conditions with IC50-values ranging from 0.4 ± 0.1 to 267.0 ± 50.0 µM but showed no activity on human cancer cells. The concentration of quercetin or its glycosides in the extract was too low to contribute substantially to the EGFR-inhibitory properties. In contrast, fractions derived from the apple juice extract comprising ≥86% oligomeric procyanidins (OPCs) suppressed the activity of the EGFR in cell culture with an IC50 ∼ 100 µg mL(-1). In addition, the activity of further members of the ErbB-receptor family was potently inhibited, with ErbB3 receptor activity being most potently decreased (IC50 ∼ 10 µg mL(-1)). From the apple polyphenols identified so far OPCs were found to add the highest contribution to the inhibitory effects towards members of the ErbB-receptor family. Considering the crucial role of the ErbB-receptors in carcinogenesis, these results support the hypothesis that apple-derived OPCs as well as OPC-rich apple preparations might be of interest with respect to chemoprevention.

Targeting GSK3 from Ustilago maydis: type-II kinase inhibitors as potential antifungals.

Protein kinases are key enzymes in the complex regulation of cellular processes in almost all living organisms. For this reason, protein kinases represent attractive targets to stop the growth of eukaryotic pathogens such as protozoa and fungi. However, using kinase inhibitors to fight against these organisms bears several challenges since most of them are unselective and will also affect crucial host kinases. Here we present the X-ray structure of glycogen synthase kinase 3 from the fungal plant pathogen Ustilago maydis (UmGSK3) and its inhibition by type-II kinase inhibitors. Despite the high sequence homology between the human and the fungal variant of this vital kinase, we found substantial differences in the conformational plasticity of their active sites. Compounds that induced such conformational changes could be used to selectively inhibit the fungal kinase. This study serves as an example of how species-specific selectivity of inhibitors can be achieved by identifying and addressing the inactive state of a protein kinase. In addition to this, our study gives interesting insights into the molecular plasticity of UmGSK3 by revealing a previously unknown inactive conformation of this important kinase family.

Bilberries and their anthocyanins ameliorate experimental colitis.

Bilberries have positive effects in acute and chronic diarrhea. Patients with inflammatory bowel disease (IBD) report on improved symptoms upon ingestion. Bilberries contain approximately 10% of anthocyanins (ACs), which have anti-oxidative, anti-carcinogenic, and anti-inflammatory properties. We investigated whether experimental colitis can be ameliorated by dried bilberries or ACs. Acute and chronic dextrane sodium sulphate (DSS) colitis were induced in Balb/c mice by 2.5% DSS in the drinking water. Mice were fed with dried bilberries or ACs, respectively. Cytokines were determined in supernatants from mesenteric lymph nodes (MLNs) by ELISA and apoptosis was investigated by terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling assays. Oral administration of bilberries during acute DSS-induced colitis ameliorated disease severity and reduced secretion of IFN-γ and tumor necrosis factor from mesenteric lymph node cells. Dried bilberries also improved chronic DSS-colitis. Ingestion of ACs reduced intestinal inflammation in acute and chronic DSS-colitis with decreased histological scores and cytokine secretion. Both bilberries and ACs prevented inflammation-induced apoptosis in colonic epithelial cells. Taken together, ingestion of dried bilberries had positive effects on various parameters especially in acute DSS-colitis. Oral administration of ACs resulted in an amelioration of acute colitis as well as chronic colitis. These promising results justify a clinical study on their therapeutic effect in inflammatory bowel disease patients.

Identification of Ustilago maydis Aurora kinase as a novel antifungal target.

Infestation of crops by pathogenic fungi has continued to have a major impact by reducing yield and quality, emphasizing the need to identify new targets and develop new agents to improve methods of crop protection. Here we present Aurora kinase from the phytopathogenic fungus Ustilago maydis as a novel target for N-substituted diaminopyrimidines, a class of small-molecule kinase inhibitors. We show that Aurora kinase is essential in U. maydis and that diaminopyrimidines inhibit its activity in vitro. Furthermore, we observed an overall good correlation between in vitro inhibition of Aurora kinase and growth inhibition of diverse fungi in vivo. In vitro inhibition assays with Ustilago and human Aurora kinases indicate that some compounds of the N-substituted diaminopyrimidine class show specificity for the Ustilago enzyme, thus revealing their potential as selective fungicides.

Preparation and characterization of shellac-coated anthocyanin pectin beads as dietary colonic delivery system.

SCOPE: Anthocyanins are connected with various biological activities. A promising way to enhance the availability of anthocyanins for in situ effects in the lower intestine is colon-specific delivery. METHODS AND RESULTS: Shellac and shellac/hydroxypropyl methylcellulose (HPMC) coated anthocyanin amidated pectin beads as dietary colonic delivery systems were successfully prepared by ionotropic gelation and fluid bed Wurster coating with aqueous shellac solution. Release characteristics, studied in vitro and ex vivo using simulated gastric fluid (SGF), ileostomy fluid and colostomy fluid (CF) revealed a retardation of anthocyanins during simulated passage of stomach and ileum as well as the desired release of pigments in the colon. Coating level was identified as an important parameter. By addition of 5 or 15% of the water-soluble polysaccharide HPMC to the shellac film, resistance in SGF was increased due to the plasticizer properties of the polymer. Incorporation of 15% HPMC (w/w based on shellac) into the shellac film additionally led to increased anthocyanin diffusivity and complete release as well as degradation of the formulation in CF. CONCLUSION: In the used in vitro and ex vivo model system mimicking the human intestinal transit, the potential of shellac and shellac/HPMC coated anthocyanin amidated pectin beads as dietary colon targeting systems was demonstrated.

Intestinal transit and systemic metabolism of apple polyphenols.

BACKGROUND: Apples are the most widely consumed fruits in Germany and various other countries. Positive health effects of apple-derived polyphenols in vivo depend on their absorption, metabolism, distribution, and elimination from the body after consumption. Data on the metabolism of these polyphenols in humans are scarce. In order to study the intestinal transit and metabolism of apple polyphenols in humans, a variety of experiments were carried out. METHODS: Polyphenols were incubated with saliva (for 5 min), simulated gastric or duodenal juice (4 or 10 h, respectively), or rat hepatocytes (4 h) under aerobic conditions, and with ileostomy fluid under aerobic conditions for 10 h. The polyphenol profile in human serum (8 h later) and renal elimination in urine (24 h later) were also investigated after consumption of 1 L apple juice. Polyphenols and their metabolites were identified and quantified by high-performance liquid chromatography with diode array detection (HPLC-DAD), HPLC-electrospray ionization-tandem mass spectrometry (ESI-MS/MS), and gas chromatography (GC)-MS. RESULTS: In the presence of native saliva or ileostomy fluid, ß-glycosides of phloretin and quercetin were hydrolyzed, to varying degrees depending on the sugar moiety, and to much lesser degrees in the presence of antibiotics. In the gastric milieu, almost complete degradation of procyanidin B(2) to (-)-epicatechin was observed. In the presence of artificial duodenal juice flavan-3-ol epimerization occurred. Quercetin was completely converted to phloroglucinol, 3,4-dihydroxybenzoic acid, and 2,4,6-trihydroxybenzoic acid. Formation of isomeric products of hydroxycinnamic acid esters and their corresponding methyl esters was also observed, and similar results were obtained after incubation with rat hepatocytes. Products of phase II metabolism, two phloretin O-glucuronides and eight (methyl) quercetin O-glucuronides, were identified in the hepatocyte samples. Following enzymatic hydrolysis, 5-caffeoylquinic acid, 4-p-coumaroylquinic acid, caffeic acid, (-)-epicatechin, phloretin, and quercetin were recovered in both serum and urine (5.3% and 3.5% of the amounts consumed, respectively). In addition, 19.5% of the polyphenols consumed were identified in the urine in the form of hydroxylated phenolic and hippuric acids. CONCLUSION: The findings relating to the absorption, metabolism, and systemic availability of polyphenols in vivo should contribute to our understanding of their biological effects, and the characterization of newly formed metabolites should facilitate further studies.

Flavan-3-ol C-glycosides--preparation and model experiments mimicking their human intestinal transit.

In order to study the human intestinal transit of flavan-3-ol C-glycosides, several C-glycosyl derivatives were prepared by non-enzymatic reaction of (+)-catechin with α-D-glucose, α-D-galactose and α-D-rhamnose, respectively. In contrast to literature data, we propose that the reaction mechanism proceeds in analogy to the rearrangement of flavan-3-ols during epimerization under alkaline conditions. Four of the 12 synthesized flavan-3-ol C-glycosides were incubated under aerobic conditions at 37°C using saliva (2 min) and simulated gastric juice (3 h). To simulate human intestine, the C-glycosides were also incubated under anaerobic conditions at 37°C both in human ileostomy fluid (10 h) and colostomy fluid (24 h), respectively. The flavan-3-ol C-glycosides under study, i.e. (+)-epicatechin 8-C-ß-D-glucopyranoside (1a), (+)-epicatechin 6-C-ß-D-glucopyranoside (1d), (+)-catechin 6-C-ß-D-galactopyranoside (2b), (+)-catechin 6-C-ß-D-rhamnopyranoside (3b) were analyzed in the incubation samples by HPLC-DAD and HPLC-DAD-MS/MS. They were found to be stable in the course of incubation in saliva, simulated gastric juice and ileostomy fluid and underwent degradation in colostomy fluid. While the 6-C-ß-D-glucopyranoside 1d was completely metabolized between 2 and 4 h, decomposition of the 6-C-ß-D-galactopyranoside 2b reached only 16 ± 2% within 4 h of incubation. Linear degradation rates of 1d and 2b in colostomy fluid differed significantly. As microbial metabolism of flavan-3-ols is known not to be influenced by the stereochemistry of the aglycon, varying degradation rates are ascribed to the effect of the sugar moiety. Based on these results we assume that flavan-3-ol C-glycosides pass through the upper gastrointestinal tract (oral cavity, stomach and small intestine) unmodified and are then metabolized by the colonic microflora.

Pyrrolizidine alkaloids in pollen and pollen products.

Recently, 1,2-dehydropyrrolizidine alkaloid (PA) ester alkaloids, found predominantly as their N-oxides (PANOs, pyrrolizidine N-oxides), have been reported in both honey and in pollen obtained directly from PA plants and pollen loads collected by bees, raising the possibility of health risks for consumers of these products. We confirm these findings in regard to floral pollen, using pollen collected directly from flowers of the known PA plants Senecio jacobaea, S. vernalis, Echium vulgare and pollinia of Phalaenopsis hybrids, and we extend analyses of 1,2-unsaturated PAs and 1,2-unsaturated PANOs to include bee-pollen products currently being sold in supermarkets and on the Internet as food supplements. PA content of floral pollen ranged from 0.5 to 5 mg/g. The highest values were observed in pollen obtained from Senecio species. Up to 95% of the PAs are found as PANOs. Detailed studies with S. vernalis revealed unique PA patterns in pollen and flowers. While seneciphylline was the most prominent PA in S. vernalis pollen, the flowers were dominated by senecionine. To analyze trace amounts of 1,2-unsaturated PAs in pollen products, our previously elaborated method consisting of strong cation exchange-SPE, two reduction steps followed by silylation and subsequent capillary high-resolution GC-MS using SIM mode was applied. In total, 55 commercially available pollen products were analyzed. Seventeen (31%) samples contained 1,2-unsaturated PAs in the range from 1.08 to 16.35 microg/g, calculated as retronecine equivalents. The 1,2-unsaturated PA content of pollen products is expressed in terms of a single sum parameter and no background information such as foraged plants, pollen analysis, etc. was needed to analyze the samples. The detection limit of overall procedure and the reliable quantitation limit were 0.003 and 0.01 microg/g, respectively.