Chronomics: circadian and circaseptan timing of radiotherapy, drugs, calories, perhaps nutriceuticals and beyond

We suggest a putative benefit from timing nutriceuticals (substances that are both nutrients and pharmaceuticals) such as antioxidants for preventive or curative health care, based on the proven merits of timing nutrients, drugs, and other treatments, as documented, i.a., in India. The necessity of timing melatonin, a major antioxidant, is noted. A protocol to extend the scope of chronoradiotherapy awaits testing. Imaging in time by mapping rhythms and broader time structures, chronomes, for earliest diagnoses, for example detection of vascular disease risk, is recommended. The study of rhythms and broader chronomes leads to a dynamic functional genomics, guided by imaging in time of free radicals and antioxidants, amongst many other variables.

100 or 30 years after Janeway or Bartter, Healthwatch helps avoid 'flying blind'

Longitudinal records of blood pressure (BP) and heart rate (HR) around the clock for days, weeks, months, years, and even decades obtained by manual self-measurements (during waking) and/or automatically by ambulatory monitoring reveal, in addition to well-known large within-day variation, also considerable day-to-day variability in most people, whether normotensive or hypertensive. As a first step, the circadian rhythm is considered along with gender differences and changes as a function of age to derive time-specified reference values (chronodesms), while reference values accumulate to also account for the circaseptan variation. Chronodesms serve for the interpretation of single measurements and of circadian and other rhythm parameters. Refined diagnoses can thus be obtained, namely MESOR-hypertension when the chronome-adjusted mean value (MESOR) of BP is above the upper limit of acceptability, excessive pulse pressure (EPP) when the difference in MESOR between the systolic (S) and diastolic (D) BP is too large, CHAT (circadian hyper-amplitude tension) when the circadian BP amplitude is excessive, DHRV (decreased heart rate variability) when the standard deviation (SD) of HR is below the acceptable range, and/or ecphasia when the overall high values recurring each day occur at an odd time (a condition also contributing to the risk associated with 'non-dipping'). A non-parametric approach consisting of a computer comparison of the subject's profile with the time-varying limits of acceptability further serves as a guide to optimize the efficacy of any needed treatment by timing its administration (chronotherapy) and selecting a treatment schedule best suited to normalize abnormal patterns in BP and/or HR. The merit of the proposed chronobiological approach to BP screening, diagnosis and therapy (chronotheranostics) is assessed in the light of outcome studies. Elevated risk associated with abnormal patterns of BP and/or HR variability, even when most if not all measurements lie within the range of acceptable values, becomes amenable to treatment as a critical step toward prevention (prehabilitation) to reduce the need for rehabilitation (the latter often after costly surgical intervention).

Chronomics of tree rings for chronoastrobiology and beyond

Gliding spectral windows illustrate the changes as a function of time in the relative prominence of signals in a given frequency range, viewed in 3D or as surface charts. As an example, the method is applied to a 2,189-year series of averages of ring measurements on 11 sequoia trees published by Douglass. Analyses of the original data and after filtering reveal, among others, components with periods of about 10.5 and 21 years similar to the Schwabe and Hale solar activity cycles. An alignment of gliding spectra with a global spectrum serves to define, by minima, the ranges of variability around the anticipated Schwabe and Hale cycles. This procedure may have more general applicability when dealing with ranges of only transiently synchronized, wobbly, and perhaps sometimes free-running periodicities. Solar activity is known to affect climate and changes in climate are reflected to some extent in tree growth. The spectral structure in tree rings could serve not only to check any relations of climate with sunspots, auroras and more modern measures of solar activity, but also to check any purely mathematical extrapolations from the much shorter available actual data on solar activity. With such extrapolated series and the data analyzed herein, the task remains to align physical and physiological variables to further study the influence of natural environmental factors near and far on biota, including international battles, which cover an even longer span of 2,556 years.

Rewards in practice from chrono-meta-analyses 'recycling' heart rate, ectopy, ischemia and blood pressure information

Previously published average curves of heart rate and duration of ischemia in patients with coronary artery disease, studied while on placebo or on treatment with either atenolol or diltiazem, are re-analysed for the assessment of about-daily (circadian) and about-weekly (circaseptan) changes in these variables and of any treatment effect on rhythm characteristics. In addition to circadians, a circaseptan pattern characterizes the duration of ischemia in all three aforementioned study stages. Both drugs decrease the duration of ischemia, atenolol, but not diltiazem, also affects the circadian amplitude and acrophase of this variable. A circaseptan pattern is also found for heart rate on placebo and on treatment with atenolol, but not with diltiazem. Both drugs lower heart rate and the circadian amplitude and 24-h standard deviation of heart rate, atenolol much more markedly than diltiazem. Circadian and circaseptan rhythm characteristics and their alterations with treatment serve to optimize treatment by timing its administration. Chronobiologic surveillance of variables that are being readily monitored as-one-goes by modern implantable devices can also serve for the validation of the effectiveness of drug and electrical therapy. Rhythm alterations, in turn, can provide the earliest warnings of an elevated disease risk and lead to an improved diagnosis.

System times and time horizons for biospheric near-matches of primarily non-photic environmental cycles

System time is defined as the duration (T) and sampling density (deltat) of a given study. A time horizon is obtained by combining analytical results on endpoints of time structures (chronomes), usually on control groups, from accumulating diverse studies carried out with drastically different values of T and deltat. These two design considerations depend upon and are limited by resources. The desideratum of a small At e.g., for studies of chaotic endpoints, limits T, e.g., has thus far precluded a continuous mapping of decadal cycles in endpoints such as the approximate entropy or the correlation dimension. Time horizons are being documented for an increasing number of variables that undergo cycles with infra-annual frequencies - with one cycle in about one, two and/or five decades - in the biosphere as in the environment. These infra-annuals, in and around us, modulate ultra-annuals, including circadians, as well as about 7-day (circaseptan) and about half-yearly (circasemiannual) cycles, all prominent, e.g., in geophysical and biospheric specta. Neglect of infra-annual chronomics can lead to blunders. A statistically highly significant decrease in the excretion of steroidal metabolites (or in heart rate variability) may be misinterpreted as premature aging if it lasts for several years, and may be unnecessarily acted upon, e.g., by drugs. The decrease, however, may only be transient, occurring only during a given stage of a circadecadal cycle, and it may be followed for the next several years by an also spurious "rejuvenation", possibly misinterpreted as a drug effect. When recognized as the alternating stages of decadal cycles and assessed with an affordable deltat, infra-annuals of variables involved in major problems of our day, including homicides and wars, may lead us to manipulable internal or external mechanisms, and thus, eventually, possibly to countermeasures to crime and terror as well as to the optimization of aims such as spirituality.

Transient circadian hyper-amplitude-tension (CHAT) may be intermittent: case reports illustrating gliding spectral windows

Taking the heart rate (HR) for one cycle, whether to examine behavior in the region of periods of 1 s, 1 day, 1 week, 1.3 or 10.5 years, etc., is hazardous. Replications, when possible are mandatory for examining altered variability, whatever the period(s) involved may be. This replication in the individual, and across individuals when the periods are long, measured in decades, may serve for diagnosis and treatment. This rule applies in particular to a seemingly transient circadian hyper-amplitude-tension (CHAT), an over peer-threshold variability in blood pressure (BP), based on the fit of a 24-h cosine curve to time series of appropriate length, rather than to a mere snapshot covering just a single day or week. Transient CHAT may turn into intermittent CHAT, as determined in two cases presented herein. One case of transient CHAT could be so named after a successful treatment (Rx) change eliminated CHAT as an effect validated by monitoring at 30-min intervals for a 7-day span on a new treatment. CHAT disappeared for over 300 consecutive half-hourly measurements, but thereafter it reappeared. During the ensuing nearly continuously monitored 5 years, CHAT continued to appear and disappear sometimes without a treatment change. In another case, which was responsive to a change in the timing of medication, CHAT also disappeared and thereafter reappeared. In a short-term perspective of weeks or months of monitoring, CHAT seemed to be transient, but further monitoring again revealed it to be intermittent. Cases of intermittent CHAT require follow-up for outcomes by comparison with the population at large. Miniaturized instrumentation for their detection should be a high priority, but it must be realized that the automatic ambulatorily functioning monitors, available at 10% of the regular price through a BIOCOS project (corne001@umn.edu), already signify great progress, as compared to previously used manual measurements made around the clock by hypertensive opinion leaders in medicine from diagnosis to death. On automatically collected time series of BP and HR, gliding pergressive spectral windows as such, or such pergressive windows aligned further with global spectral windows, visualize the changing dynamics involved in health and disease, in the steps of Werner Menzel and Paolo Scarpelli.

Geographic and extraterrestrial aspects of morbidity and/or mortality patterns from myocardial infarction and stroke

Two authors (M.K. and M.M.) provided insight into a manuscript submitted by them elsewhere for publication and kindly offered for meta-analysis data on the monthly incidence from January 1989 up to December 2004, of 6094 cerebral infarctions, 414 intracerebral and 277 subarachnoid hemorrhages, cases admitted at the Neurological Clinic in Nové Zamky, Slovakia. Spectral components with a period exceeding (beyond = trans) the length of the calendar year--transyears--reported originally by M.K. and M.M. are here also documented linearly on original data without and after detrending by the fit of first- or second-order polynomials. For intracerebral and subarachnoidal hemorrhage, the zero-amplitude (no-rhythm) assumption is rejected (P < 0.05, not corrected for multiple testing) for the transyear but not for a precise 1.0-year trial period. As reported earlier by M.K. and M.M., the transyear's amplitude is larger than the calendar year's amplitude for all three series of stroke incidence in Slovakia. The putative importance of the new findings stems from earlier and new analyses revealing other spectral components that are presumed signatures of magnetoperiodisms, e.g. about 50- and 7-year components in about five decades of diagnostically unqualified, pooled data on stroke in Minnesota. There is, however, the danger of relatively small numbers providing artifacts for loosely defined transyears. The original cosinor approach by M.K. and M.M., testing anticipated periods, had its strength. The observation of a quindecadal component in mortality from strokes in Minnesota supports the presence of signatures of effects from extraterrestrial space in acute human pathology such as strokes, myocardial infarctions and sudden cardiac death. Magnetoperiodic mechanisms remain to be investigated further as added strokes accumulate in Nové Zamky and greater Slovakia as well as for sudden cardiac death where transyears have been documented in the Czech Republic, in Arkansas and particularly in Minnesota, but not elsewhere (as yet?). This study is also a plea for worldwide access to morbidity, mortality and natality data that constitute a largely unexploited treasure, brought to the fore mainly for relatively short-term comparisons of the effect of interventions against the fiction of imaginary baselines.

A Comparison between Two Sonic Measuring Systems for Demersal Fish

Two sonic methods for estimation of abundance of fish stocks, the echo integrator and the digital counter methods, were compared on single and schooling fish in the Lofoten area of Norway during March 1969. Good correlation was obtained between the two systems for both situations, but the slopes of the regressions of integrated values on the digital counter differed significantly between low and high density fish concentrations. This suggests that the two systems treated the echo information differently, but nevertheless maintained a linear relation between themselves over a wide range of counts.

Chronobiologic perspective of international health care reform for the future of children

The realization of the implications of splitting the atom ended a tragic war. The nuclear age ensued. Likewise, a devastating escalation of health care costs could be ended by realizing the implications of splitting the normal range. Our currently disease-cure-oriented health care system does too little too late. Chronobiology could change this status quo into a system that recognizes risk early; it would gain new information from the resolution of predictable variations that take place within the physiologic range. Investment into vaccinations leads to returns in the form of savings in suffering and cost. A relatively modest investment into a 'Blood Pressure Health Start', pursued while chronobiology is being taught as an integral part in primary, secondary, higher and continued education, may not only drastically and in some respects promptly reduce the health care bill, but it would help the economy of the country that invests into the development of instrumentation for a chronobiologic systems approach. On the one hand, reducing the number of cases of catastrophic diseases, via improved diagnosis (to start with) of the blood pressure status, is likely to substantially reduce the budget deficit by reducing the legitimate and essential costs of care (to start with, of strokes and heart attacks, that kill more people than all other diseases combined and that have blood pressure disorders as their major risk factor). On the other hand, by implementing a novel health care system which also involves new technology that can become in demand worldwide, any trade balance will be improved.(ABSTRACT TRUNCATED AT 250 WORDS)

[Promoting physical activity in overweight and obese patients: counseling in primary care from Italy (Cesena, 2002--2003)]

Lack of physical activity and obesity represent important public health problems. The objectives of the current study is to evaluate the effects of a counseling intervention (the PACE protocol) conducted by general practitioners and designed to motivate persons who are overweight or obese to increase their levels of physical activity. The counseling was offered 145 patients with a BMI > or =27 who were seen between May 2002 and April 2003 in the offices of 10 general practioners. The intervention, which lasted 3-5 minutes, was conducted during routine visits, based on the Prochaska-DiClemente model of behavioral change. Changes in the motivation of the patients to engage in physical activity and actual changes in levels of activity were measured, as were BMI and abdominal circumference. The median followup was 9 months. Among the 145 eligible patients, 103 (71%) agreed to particpate. Six months following the counselling, there was a significant change in both the motivational status and physical activity of the group, and they experienced significant decreases in BMI and abdominal circumference. Counseling using the PACE model appears to positively influence levels motivation and of physical activity in those patients who agreed to participate. Further studies should be conducted to evaluate the effectiveness of this strategy in other settings and the public health benefits of such counseling.