Evidence of a nonlinear human magnetic sense.

Human subjects respond to low-intensity electric and magnetic fields. If the ability to do so were a form of sensory transduction, one would expect that fields could trigger evoked potentials, as do other sensory stimuli. We tested this hypothesis by examining electroencephalograms from 17 subjects for the presence of evoked potentials caused by the onset and by the offset of 2 G, 60 Hz (a field strength comparable to that in the general environment). Both linear (time averaging) and nonlinear (recurrence analysis) methods of data analysis were employed to permit an assessment of the dynamical nature of the stimulus/response relationship. Using the method of recurrence analysis, magnetosensory evoked potentials (MEPs) in the signals from occipital derivations were found in 16 of the subjects (P<0.05 for each subject). The potentials occurred 109-454 ms after stimulus application, depending on the subject, and were triggered by onset of the field, offset of the field, or both. Using the method of time averaging, no MEPs were detected. MEPs in the signals from the central and parietal electrodes were found in most subjects using recurrence analysis, but no MEPs were detected using time averaging. The occurrence of MEPs in response to a weak magnetic field suggested the existence of a human magnetic sense. In distinction to the evoked potentials ordinarily studied, MEPs were nonlinearly related to the stimulus as evidenced by the need to employ a nonlinear method to detect the responses.

Plant cell wall fractionation and structural analysis.

The structure of the major plant polysaccharides contributing to dietary fiber, their organization within the plant cell wall, and the problems associated with their analysis are briefly reviewed. Alkaline, acidic, and detergent fractionation methods are described and considered in relation to their specificity. The analysis of pectin, often ignored as a component of dietary fiber, is examined in detail. The solubility of pectins from a number of common plant foods was determined, indicating that a considerable portion of pectin polyuronide is lost to many of the commonly used analytical procedures.

Postictal elevation of serum creatine kinase level.

Serial serum creatine kinase (CK) level determinations were performed on selected patients for six days following tonic-clonic or focal motor seizures in a prospective study. The time course and magnitude of serum CK elevation was correlated with seizure CK level was observed in all patients. Isoenzyme determinations revealed that CK was derived from skeletal muscle. Our data demonstrate that profound elevations of serum CK level may occur postictally and appear to be related to the intensity of muscular activity. patients with seizures associated with alcohol abuse had the greatest postictal serum CK level increases.

Biphasic periodic paralysis.

A young man with episodes characteristic of familial normokalemic periodic paralysis was restudied after a change in the nature of his attacks. He now has spontaneously occurring and provokable episodes of both hyperkalemic and hypokalemic periodic paralyses that are superimposed on a persistent myopathy. Hypokalemia seems to be associated with facilitated entry of glucose and potassium into muscles, whereas resistance to glucose and potassium entry accompanies hyperkalemia. The possibility that episodes of both hypokalemic and hyperkalemic weaknesses can occur in one person should be considered in pathogenic postulates regarding periodic paralysis.

Assessment of the role of diet in cancer prevention.

Population studies have demonstrated a clear relationship between the incidence of various cancers and consumption of different classes of foods, indicating that diet can have a protective effect. Diets, however, contain many hundreds of nutrient and non-nutrient compounds. Moving beyond the generalities provided by population studies requires short-term studies in which diets can be adjusted to test the effects of specific ingredients or compounds. The cost of this approach is the loss of direct outcome measures. Biomarkers related to early events in the cancer process which can show significant change within the duration of a trial, have to substitute. The choice of marker and the ability to validate its use are crucial both to the refining of dietary advice and to the search for the active principles of diet.

Neuroendocrine evaluation in Kleine-Levin syndrome: evidence of reduced dopaminergic tone during periods of hypersomnolence.

A patient with Kleine-Levin syndrome had polysomnography and neuroendocrinological assays performed during asymptomatic (ASMP) and symptomatic (SMP) 24-hr periods. During the SMP, sleep data revealed poor nocturnal sleep efficiency, increased sleep fragmentation and reduced stages 3, 4 and rapid eye movement (REM). No sleep onset REM episodes were seen. Sleep staging in the ASMP was normal. Blood samples were obtained every 20 min and assayed for thyroid-stimulating hormone (TSH), cortisol (CORT), prolactin (PRL) and growth hormone (GH). Patterns of secretion, 24-hr mean and total integrated concentrations, and mean sleep period time values during the ASMP and SMP were compared. The mean 24-hr level of TSH was increased and GH decreased in the SMP. Comparing sleep period time in the SMP to the ASMP, values for TSH and PRL were increased and GH and CORT were reduced in the SMP. These hormone changes support the hypothesis that reduced hypothalamic dopaminergic tone is present in the SMP compared to the ASMP in Kleine-Levin patients.

Presentation and reading level of sleep brochures: are they appropriate for sleep disorders patients?

OBJECTIVE: Sleep-disorders patients must be given information and health education they understand. The purpose of this study was twofold: (1) to assess suitability of American Sleep Disorders Association and National Sleep Foundation patient education brochures; and (2) to assess one widely used brochure, using patient input and patient literacy level, as a model for development of future materials. DESIGN: Twelve American Sleep Disorders Association and National Sleep Foundation brochures were assessed for reading level using Grammatik, and for design, presentation, and motivating qualities using the Suitability Assessment of Materials (SAM). Patient literacy level was assessed using the Rapid Estimate Of Adult Literacy in Medicine (REALM). SETTING: The Louisiana State University Medical Center sleep clinic, faculty private sleep clinic, and in the sleep center laboratory. PATIENTS OR PARTICIPANTS: During the months of February-May 1997, 170 sleep disorders patients, 39% African American, 59% white participated in the study. Participants ranged in age from 18-73 years, with a mean age of 46. MEASUREMENTS AND RESULTS: Suitability scores for the 12 brochures indicate that none scored in the superior range, 83% scored adequate, and 17% scored not suitable. Ninety-four percent of the brochures were written on a 12th grade level or higher, yet 37% of the sleep patients tested were reading at less than a 9th grade level. Low-level readers were significantly more likely than their higher-reading-level counterparts to report that a brochure was too long (22% vs 12%; p < .05), and that they would need help reading it (44% vs 3%; p < .001). CONCLUSIONS: Patients need sleep information given to them on a level they understand. When developing and selecting appropriate materials, reading level, length, and suitability of written material should be considered.

Practice parameters for the nonpharmacologic treatment of chronic insomnia. An American Academy of Sleep Medicine report. Standards of Practice Committee of the American Academy of Sleep Medicine.

Insomnia is the most common sleep complaint reported to physicians. Treatment has traditionally involved medication. Behavioral approaches have been available for decades, but lack of physician awareness and training, difficulty in obtaining reimbursements, and questions about efficacy have limited their use. These practice parameters review the current evidence with regards to a variety of nonpharmacologic treatments for insomnia. Using a companion paper which provides a background review, the available literature was analyzed. The evidence was graded by previously reported criteria of the American Academy of Sleep Medicine with references to American Psychological Association criteria. Treatments considered include: stimulus control, progressive muscle relaxation, paradoxical intention, biofeedback, sleep restriction, multicomponent cognitive behavioral therapy, sleep hygiene education, imagery training, and cognitive therapy. Improved experimental design has significantly advanced the process of evaluation of nonpharmacologic treatments for insomnia using guidelines outlined by the American Psychological Association (APA). Recommendations for individual therapies using the American Academy of Sleep Medicine recommendation levels for each are: Stimulus Control (Standard); Progressive Muscle Relaxation, Paradoxical Intention, and Biofeedback (Guidelines); Sleep Restriction, and Multicomponent Cognitive Behavioral Therapy (Options); Sleep Hygiene Education, Imagery Training, and Cognitive Therapy had insufficient evidence to be recommended as a single therapy. Optimal duration of therapy, who should perform the treatments, long term outcomes and safety concerns, and the effect of treatment on quality of life are questions in need of future research.

The Taskforce 2000 survey on medical education in sleep and sleep disorders.

Previous research has shown evidence of a widening gap between scientific research and clinical teaching in sleep and sleep disorders. To address the deficiencies in current medical education in sleep, the Taskforce 2000 was established by the American Sleep Disorders Association. The present study was undertaken to assess the teaching activities, needs and interests of the membership of the two largest professional sleep societies (American Sleep Disorders Association and Sleep Research Society). Survey instruments included a brief, 5-item postcard survey, which was mailed to all members, followed by an in-depth, 34-item questionnaire, which was completed by 158 respondents from the intitial postcard survey (N = 808). Results indicated that the majority of respondents (65.2%) are currently involved in teaching sleep to medical students or postgraduate trainees, although the average amount of teaching time was only 2.1 hours for undergraduate and 4.8 hours for graduate education in sleep. Teaching of sleep laboratory procedures and clinical evaluation of sleep-disordered patients is limited at either an undergraduate or postgraduate level. The major deficiencies noted were the lack of time in the medical curriculum and the need for better resources and teaching facilities. A large majority of respondents indicated their willingness to be involved in sleep education for physicians, and rated this a high priority for the professional organization.

Practice parameters for the use of light therapy in the treatment of sleep disorders. Standards of Practice Committee, American Academy of Sleep Medicine.

These clinical guidelines were developed by the Standards of Practice Committee and reviewed and approved by the Board of Directors of the American Academy of Sleep Medicine. The guidelines provide recommendations for the practice of sleep medicine in North America regarding the use of light therapy for treatment of various sleep disorders. This paper is based on a series of articles in the Journal of Biological Rhythms and also includes evidence tables from an updated Medline review covering the period January 1994 to December 1997. Evidence is presented by grade and level. Recommendations are identified as standards, guidelines, or options. Recommendations are provided for delayed sleep phase syndrome (DSPS), advanced sleep phase syndrome (ASPS), non-24-hour sleep-wake syndrome, jet lag, shift work, dementia, and sleep complaints in the healthy elderly. Light therapy appears generally safe if used within recommended intensity and time limits. Light therapy can be useful in treatment of DSPS and ASPS. Benefits of light therapy are less clear and treatment is an option in jet lag, shift work, and non-24-hour sleep-wake syndrome in some blind patients.

Practice parameters for the treatment of restless legs syndrome and periodic limb movement disorder. An American Academy of Sleep Medicine Report. Standards of Practice Committee of the American Academy of Sleep Medicine.

These are the first clinical guidelines published for the treatment of Restless Legs Syndrome (RLS) and Periodic Limb Movement Disorder (PLMD) providing evidence-based practice parameters. They were developed by the Standards of Practice Committee and reviewed and approved by the Board of Directors of the American Academy of Sleep Medicine. The guidelines provide recommendations for the practice of sleep medicine in North America regarding the treatment of RLS and PLMD. Recommendations are based on the accompanying comprehensive review of the medical literature regarding treatment of RLS and PLMD which was developed by a task force commissioned by the American Academy of Sleep Medicine. Recommendations are identified as standards, guidelines, or options, based on the strength of evidence from published studies that meet criteria for inclusion. Dopaminergic agents are the best studied and most successful agents for treatment of RLS and PLMD. Specific recommendations are also given for the use of opioid, benzodiazepine, anticonvulsant, and adrenergic medications, and for iron supplementation. In general, pharmacological treatment should be limited to individuals who meet diagnostic criteria and especially who experience insomnia and/or excessive sleepiness that is thought to occur secondary to RLS or PLMD. Individuals treated with medication should be followed by a physician and monitored for clinical response and adverse effects. It would be desirable for future investigations to employ multicenter clinical trials, with expanded numbers of subjects using double-blind, placebo-controlled designs, and an assessment of long-term response, side effects, and impact of treatment on quality of life. Evaluation of special groups such as children, pregnant women, and the elderly is warranted.

Practice parameters for the evaluation of chronic insomnia. An American Academy of Sleep Medicine report. Standards of Practice Committee of the American Academy of Sleep Medicine.

Chronic insomnia is the most common sleep complaint which health care practitioners must confront. Most insomnia patients are not, however, seen by sleep physicians but rather by a variety of primary care physicians. There is little agreement concerning methods for effective assessment and subsequent differential diagnosis of this pervasive problem. The most common basis for diagnosis and subsequent treatment has been the practitioner's clinical impression from an unstructured interview. No systematic, evidence-based guidelines for diagnosis exist for chronic insomnia. This practice parameter paper presents recommendations for the evaluation of chronic insomnia based on the evidence in the accompanying review paper. We recommend use of these parameters by the sleep community, but even more importantly, hope the large number of primary care physicians providing this care can benefit from their use. Conclusions reached in these practice parameters include the following recommendations for the evaluation of chronic insomnia. Since the complaint of insomnia is so widespread and since patients may overlook the impact of poor sleep quality on daily functioning, the health care practitioner should screen for a history of sleep difficulty. This evaluation should include a sleep history focused on common sleep disorders to identify primary and secondary insomnias. Polysomnography, and the Multiple Sleep Latency Test (MSLT) should not be routinely used to screen or diagnose patients with insomnia complaints. However, the complaint of insomnia does not preclude the appropriate use of these tests for diagnosis of specific sleep disorders such as obstructive sleep apnea, periodic limb movement disorder, and narcolepsy that may be present in patients with insomnia. There is insufficient evidence to suggest whether portable sleep studies, actigraphy, or other alternative assessment measures including static charge beds are effective in the evaluation of insomnia complaints. Instruments such as sleep logs, self-administered questionnaires, symptom checklist, or psychological screening tests may be of benefit to discriminate insomnia patients from normals, but these instruments have not been shown to differentiate subtypes of insomnia complaints.

The indications for polysomnography and related procedures.

This paper is a review of the literature on the use of polysomnography in the diagnosis of sleep disorders in the adult. It is based on a search of MEDLINE from January 1966 through April 1996. It has been reviewed and approved by the Board of Directors of the American Sleep Disorders Association and provides the background for the accompanying ASDA Standards of Practice Committee's Parameters for the Practice of Sleep Medicine in North America. The diagnostic categories reviewed are: sleep-related breathing disorders; other respiratory disorders; narcolepsy; parasomnias and sleep-related epilepsy; restless legs syndrome and periodic limb movement disorders: insomnia; and circadian rhythm sleep disorders. Where appropriate, previously published practice parameters papers are cited and discussed. The relevant published peer-reviewed literature used as the basis for critical decisions was compiled into accompanying evidence tables and is analyzed in the text. In the section on the assessment of sleep apnea syndrome, options for estimating pretest probability to select high risk patients are also reviewed. Sleep-testing procedures other than standard polysomnography are also addressed (daytime polysomnography, split-night studies, oximetry, limited full respiratory recordings, and less-than-full respiratory recording) and treatment-related follow-up studies are discussed.

Frequency-specific blocking in the human brain caused by electromagnetic fields.

Based on preliminary observations that continuous exposure to electromagnetic fields (EMFs) produced an after-effect on human brain electrical activity, the effect of 10 Hz, 1 gauss, on the intrinsic activity of the brain at that frequency was studied. Ten subjects were exposed for 10 min and the 10 Hz spectral power was measured during the 1 min interval following stimulation and compared with control values obtained from the same subjects. Significantly reduced brain electrical activity from the occipital electrodes following termination of the EMF exposure was observed, thereby confirming the preliminary results.

Electrical states in the rabbit brain can be altered by light and electromagnetic fields.

The effect of low-frequency magnetic fields on the rabbit electroencephalograph (EEG) was studied using a quantitative procedure that permitted statistical evaluation of the response of individual animals. The field conditions used were those predicted by various theories to result in field-animal interactions; light and sham exposure were employed as positive and negative controls, respectively. Sixty-seven percent of the rabbits exhibited changes in the EEG power spectra when light was presented in 2-s epochs; none of the animals responded to sham exposure. When 1 Gauss, 5 Hz, was presented in 2-s epochs, 100% of the animals tested responded to the presence of the field. The rabbits did not respond when the magnetic-field frequency was higher than the physiological range (1-20 Hz) or when it was tuned for resonance of K+. The results showed that an electrical state function may be operationally defined for the rabbit brain, and used to assess the occurrence of an interaction between an animal and external magnetic fields.

Extent of incorporation of hydroxycinnamaldehydes into lignin in cinnamyl alcohol dehydrogenase-downregulated plants.

Down-regulation of cinnamyl alcohol dehydrogenase leads to an accumulation of cinnamaldehydes available for incorporation into the developing lignin polymer. Using electron spin resonance spectroscopy we have demonstrated that the parent radical of 4-hydroxy-3-methoxycinnamaldehyde is generated by peroxidase catalysed oxidation. The extent of radical generation is similar to that of 4-hydroxy-3-methoxycinnamyl alcohol and is increased by further aromatic methoxylation. From the distribution of the electron-spin density, it was predicted that the regiochemistry of 4-hydroxy-3-methoxycinnamaldehyde coupling would be similar to that of the corresponding alcohol, with the possibility of a higher degree of 8-O-4 linkages occurring. These predictions were confirmed by polymerisation studies, which also showed that after radical coupling the alpha,beta-enone structure was regenerated. This suggests that, although the cross-linking and physical properties of cinnamaldeyde rich lignins differ from that of normal lignins, cinnamaldehydes are incorporated into the lignin polymer under the same controlling factors as the cinnamyl alcohols.

Low-level EMFs are transduced like other stimuli.

The aims of this study were to test the theory that transduction of low-level electromagnetic fields (EMFs) is mediated like other stimuli, and to determine the false-negative rate of the method used to assess the occurrence of transduction (intra-subject comparison of stimulus and non-stimulus states (ICOS)). A light stimulus was chosen as a basis of comparison because light could be applied and removed at precise time points, similar to the manner in which EMFs were controlled. Subjects exposed to a weak light stimulus during 2-second epochs exhibited alterations in brain electrical activity that were similar to those previously observed in subjects exposed to EMFs. The false-negative rate of the ICOS method was 61%, since it registered an effect in only 39% of the subjects (11/28) whereas all subjects were actually aware of the light. In a second group of subjects that were exposed to 0.8 G (1.5 or 10 Hz), 58% (11/19) exhibited similar alterations in brain activity, as determined using ICOS. Previous measurements in the same subjects using a different method showed that the EMFs actually affected brain electrical activity in all subjects; consequently, the false-negative rate was 42% when an EMF was used as the stimulus. The results suggested that the post-transduction brain electrical processes in human subjects were similar in the cases of EMF and light stimuli, as hypothesized, and that the high negative rate of the ICOS method (here and in previous studies) was composed partly or entirely of false-negative results.

Frequency-specific responses in the human brain caused by electromagnetic fields.

The effects of 1.5- and 10-Hz electromagnetic fields (EMFs), 0.2-0.4 gauss, on the intrinsic electrical activity of the human brain at these frequencies was studied. Each of 19 subjects exposed for 2-sec epochs exhibited altered brain electrical activity at the frequency of the EMF during the time of stimulation, as determined by spectral analysis of the electroencephalogram. Since brain activity at specific frequencies could be altered by applied EMFs, the results suggest that it may be possible to use EMFs to determine whether particular intrinsic frequencies subserve specific physiological or behavioral responses.

Effect of phenolic structures on the degradability of cell walls isolated from newly extended apical internode of tall fescue (Festuca arundinacea Schreb.).

Apical internodes of tall fescue (Festuca arundinacea Schreb. var. Clarine) harvested at flowering were sectioned into 5 or 10 equal parts to study in situ degradability and cell wall composition, respectively. The basal (youngest) section had the greatest primary wall content. Cell walls in the upper (older) sections had the highest xylose/arabinose ratio and lignin content and a lignin rich in syringyl units, all typical of extensive secondary wall development. Almost all of the p-coumaric (p-CA) and about half of the ferulic acid (FA) were released by 1 M NaOH and presumed to be ester-linked. The total FA content was approximately double that of p-CA in all sections other than the youngest with a distribution similar to that of total p-CA. However, the ratio of esterified to ether and ether plus ester linked (Et & Et+Es) FA differed with age. Whereas the esterified form remained essentially constant ( approximately 4.5 g/kg of cell wall), Et & Et+Es ferulate increased with increasing age of the tissue and was significantly related to lignin deposition (r = 0.79, P < 0.01). The extent of cell wall degradation after 48 h of incubation in the rumen was inversely related to maturity, falling from 835 g/kg of dry matter in the youngest section to 396 g/kg in the oldest. Both the rate and extent of cell wall degradation were significantly negatively related to the ratio of xylose to arabinose, lignin content, proportion of syringyl units present in lignin, and concentration of Et & Et+Es FA present. A positive relationship between Et & Et+Es FA was also found, with the rate (P < 0.01) being better correlated than the extent (P < 0.05) of cell wall degradation. Application of the newly extended internode model to fescue produced results consistent with the view that both the lignin content and the extent to which lignin was covalently bound to the other wall polymers crucially influenced the rate and extent of degradation.

Unintended effects and their detection in genetically modified crops.

The commercialisation of GM crops in Europe is practically non-existent at the present time. The European Commission has instigated changes to the regulatory process to address the concerns of consumers and member states and to pave the way for removing the current moratorium. With regard to the safety of GM crops and products, the current risk assessment process pays particular attention to potential adverse effects on human and animal health and the environment. This document deals with the concept of unintended effects in GM crops and products, i.e. effects that go beyond that of the original modification and that might impact primarily on health. The document first deals with the potential for unintended effects caused by the processes of transgene insertion (DNA rearrangements) and makes comparisons with genetic recombination events and DNA rearrangements in traditional breeding. The document then focuses on the potential value of evolving "profiling" or "omics" technologies as non-targeted, unbiased approaches, to detect unintended effects. These technologies include metabolomics (parallel analysis of a range of primary and secondary metabolites), proteomics (analysis of polypeptide complement) and transcriptomics (parallel analysis of gene expression). The technologies are described, together with their current limitations. Importantly, the significance of unintended effects on consumer health are discussed and conclusions and recommendations presented on the various approaches outlined.