The effect of age on the heart rate variability of healthy subjects

In this work we study the characteristics of heart rate variability (HRV) as a function of age and gender. Our analysis covers a wider age range than that studied so far. It includes results previously reported in the literature and reveals behaviours not reported before. We can establish basic scale relationships in different HRV measurements. The mean value of the RR intervals shows a power-law behaviour independent of gender. Magnitudes such as the standard deviation or pNN50 show abrupt changes at around the age of 12 years, and above that age they show gender dependence, which mainly affects short-time (or high frequency) scales. We present a unified analysis for the calculation of the non-linear α and β parameters. Both parameters depend on age; they increase in the extremes of life and reach a minimum at around one year of age. These gender-independent changes occur at low frequencies and in scale ranges that depend on age. The results obtained in this work are discussed in terms of the effects of basal metabolic rate, hormonal regulation, and neuronal activity on heart rate variability. This work finally discusses how these findings influence the interpretation of HRV measurements from records of different lengths.

Non-neoplastic morbidity, disability, mortality in adult population at radioactively contaminated territories of Ukraine. Epidemiological research 1988-2016

Objective: We presented a comprehensive description of the changes in the health status of the adult population of radioactively contaminated territories of Ukraine depending on gender and age at the date of the Chornobyl accident on the basis of cohort epidemiological studies after accident. Materials and methods: The epidemiological analysis of non-neoplastic morbidity, disability, mortality in the residents of radioactively contaminated territories (RCT) aged 18-60 years old at the date of the Chornobyl accident (65,189 people) was conducting during 1988-2016 for five-year observation periods and by eight classes of ICD-10. We applied the methods of mathematical and statistical analysis. Results: During 1988-2016, 90590 (100%) cases of non-neoplastic morbidity (34.94% in men and 65.06% in women), 11153 (100%) cases of disability (38.22% and61.78%, respectively), and 11586 (100%) cases of mortality(50,42% and 49,58%, respectively)were detected in the residents of the RCT for the first time as a result of epidemiological study. Most of the victims suffered from the nosological forms of the nosological forms of respiratory, circulatory and digestive systems, which made up 67.43% in the structure of non-neoplastic morbidity. Diseases of circulatory, endocrine and nervous systems (87.92%) were the main factors of disability and diseases of circulatory system (89.49%) - of mortality. The gender dependence of the development of the incidence of non-neoplastic diseases, disability and mortality due to them were established. The indices of mortality (116.08, ID/103 man-years of observation) and disability (13.57)in females significantly exceeded the males’ ones (86.57 and 11.65, respectively). But males had a higher mortality rate (16.01 vs. - 11.32). Changes in the incidence rates of non-neoplastic diseases, disability and mortality due to them throughout the observation period were characterized by a divergence of vectors: morbidity decreased, and disability and mortality increased simultaneously. The intersection of the dynamics of the mortality of non-neoplastic diseases with disability and mortality through those diseases was identified in 2008-2012. Conclusions 1. During epidemiological surveillance in 1988-2016, in the residents of RCT aged 18-60 years old on the date of the Chornobyl accident epidemiological surveillance, the non-neoplastic morbidity was formed mainly due to the significant development of diseases of the respiratory, circulatory and digestive systems, which together made up 67.43%. Non-neoplastic diseases of the circulatory, endocrine and nervous systems (87.92) were the main causes of disability, diseases of circulatory system (89.49%) - of mortality. 2. The gender dependence of the development of the morbidity of non-neoplastic diseases, disability and mortality in the residents of RCT over the thirty-year observation period was established. Diseases of the circulatory system were the main causes of disability and mortality. In males, disability and mortality were caused by the mental and behavioral disorders, diseases of respiratory and digestive systems, in females - by the diseases of nervous and urogenital systems. 3. In the residents of RCT, regardless of gender, over the years of observation, a feature of the development of morbidity, disability and mortality due to them was established, it was in the significant reduction of the incidence of diseases in 2008-2016, due to the increase of disability and mortality of the suffered, especially in 2008-2016, in comparison with the previous years, i.e. in 22-30 years after the Chornobyl accident. 4. Summarizing the obtained data, it is important to continue the epidemiological studies of the health status of the residents of RCT (non-neoplastic morbidity, disability, mortality) for the determination of the impact of radiation on the development of the main forms of non-neoplastic diseases.

Expanding the arsenal of diagnostic monitoring of patients with uveitis

Goal. To evaluate the structure of somatic and ophthalmological polymorbidity, etiology, and course of the disease in patients with uveitis on the basis of clinical, laboratory, and instrumental research methods based on the data of a 24-hour ophthalmological hospital. Materials and methods. We examined 655 patients diagnosed with uveitis who were treated in the adult ophthalmology department of the GBUZ TO OKB No. 2 for the period from 2017 to 2019. All patients underwent standard laboratory, clinical, and instrumental examinations. In addition, the leukocyte index, a marker of viral infections (MVI), was determined. Results. The average age of patients with uveitis was 51 years, with a significant (p < 0.05) prevalence of cases of anterior uveitis over posterior and panuveitis. Pathology of the cardiovascular system occupies a leading position in the structure of somatic polymorbidity, mainly in women. Gender dependence in patients with rheumatic diseases, pathology of the gastrointestinal tract and endocrine system, bronchopulmonary pathology, cancer, and HIV infection was not detected. A method of early diagnosis of the nature of the course of the inflammatory process of the vascular membrane (acute or chronic) by determining the age of the patient and the indicator of MVI is proposed. Conclusions. Modern monitoring of the diagnosis of this disease and adequate empirical treatment with antiviral drugs with an extended spectrum of activity until the results of ELISA are obtained, followed by treatment correction, will prevent early disability of the population and improve the quality of life.

Analysis of SARS-CoV-2 mutations in the United States suggests presence of four substrains and novel variants

SARS-CoV-2 has been mutating since it was first sequenced in early January 2020. Here, we analyze 45,494 complete SARS-CoV-2 geneome sequences in the world to understand their mutations. Among them, 12,754 sequences are from the United States. Our analysis suggests the presence of four substrains and eleven top mutations in the United States. These eleven top mutations belong to 3 disconnected groups. The first and second groups consisting of 5 and 8 concurrent mutations are prevailing, while the other group with three concurrent mutations gradually fades out. Moreover, we reveal that female immune systems are more active than those of males in responding to SARS-CoV-2 infections. One of the top mutations, 27964C > T-(S24L) on ORF8, has an unusually strong gender dependence. Based on the analysis of all mutations on the spike protein, we uncover that two of four SARS-CoV-2 substrains in the United States become potentially more infectious.

Normal reference intervals of prognostic nutritional index in healthy adults: A large multi-center observational study from Western China

Background It has been widely reported that the prognostic nutritional index (PNI) played a pivotal role in nutritional assessment of surgical patients and tumor prognosis. In order to improve the accuracy of evaluation in western China, we established reference intervals (RIs) of PNI in healthy controls. Methods A retrospective cohort study on healthy ethnic Han adults (18–79 years) was conducted to explore the influences of age, gender, study centers, and instruments on PNI and to establish RIs. The data came from a healthy routine examination center database and laboratory information system (LIS) of four centers in western China, and there were 200 persons selected randomly for verification of RIs. Results 5,839 healthy candidates were enrolled. PNI showed a marked gender dependence, and males had significantly higher PNI than females across all ages (P < 0.01). We found that PNI is significantly different between age groups (P < 0.01), the value of PNI tended to decrease with age increasing. There is also an obvious influence of centers and instruments on PNI (P < 0.01). Conclusions We established reference intervals of PNI in healthy Han Chinese population in Western China, and validated successfully. Further established RIs will lead to better standardizations of PNI for clinical applications.

Smoking Enigma in Coronavirus Disease 2019: A Tug of War between Predisposition and Possible Way Out

Background: The recent global inclination for smoking during the Coronavirus Disease 2019 (COVID-19) pandemic has drawn attention to the impact of smoking on COVID-19. While smoking increases susceptibility to common respiratory pathogens including the closely related coronaviruses, COVID-19 causing Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) being a respiratory pathogen intrigues the possible association between smoking and viral pathogenicity. Smoking and COVID-19: The gender dependence of COVID-19 infection rates and a higher prevalence of smokers among males made the scientific world assume smoking to be a confounding variable in sex predisposition to COVID-19. Conversely, the controversial findings of discrepant morbidity and mortality rates of COVID-19 among smokers questioned the credibility of this hypothesis. More importantly, nicotine in smoking has been hypothesized to downregulate Interleukin-6 (IL-6) which plays a role in COVID-19 severity and to interfere with the Angiotensin-Converting Enzyme 2 (ACE2), the receptor of SARS-CoV-2 led the scientists to experiment nicotine patch prophylactically against COVID-19. Besides, interaction between spike protein and nicotinic acetylcholine receptors (nAChRs) supports the nicotinic cholinergic system dysregulation hypothesis in COVID-19 pathophysiology leading to its therapeutic use. However, despite the contradictions in the direct impact of smoking, it surely acts as fomites for viral transmission. Conclusion: Irrespective of the role nicotine in COVID-management, compassionate use of smoking against SARS-CoV-2 cannot be recommended until the therapeutic value gets proved and therapeutic form becomes available.

Age and gender dependence of liver diffusion parameters and the evidence of intravoxel incoherent motion modelling of perfusion component is constrained by diffusion component

ObjectivesTo establish reference values for middle aged subjects and investigate age and gender dependence of liver diffusion MRI parameters.MethodsThe IVIM type of liver diffusion scan was based on a single-shot spin-echo type echo-planar sequence using a 1.5-T magnet with 16 b-values. DDVD (diffusion-derived vessel density) was the signal difference between b=0 and b=2 s/mm2 images after removing visible vessels. IVIM analysis was performed with full-fitting and segmented-fitting, and with threshold b-value of 60 or 200 s/mm2, and fitting started from b=2 s/mm2. 32 men (age range: 25-71 years) and 26 men (age: 22-69 years) had DDVD and IVIM analysis respectively, while 36 women (age: 20-71 years) had DDVD and IVIM analysis.ResultsDDVD had an age-related reduction noted for women. IVIM results of full fitting had good agreement with segmented fitting with threshold b of 60 s/mm2 results, but less so with results of threshold b of 200 s/mm2. As age increases, female subjects’ Dslow measure had significant reduction, and PF and Dfast measure had significant increase. For the age group of 40-55 years, DDVD, Dslow, PF, and Dfast were 12.27±3.90, 1.072±0.067 (10−3mm2/s), 0.141±0.025, 61.0±14.0 (10−3mm2/s), and 13.4±3.6, 1.069±0.074 mm2/s, 0.119±0.014, 57.1±13.2 mm2/s, for men and women, respectively.ConclusionDDVD measure suggest that aging may be associated with reduction in liver perfusion. Lower Dslow measurement can lead to artificial higher PF and Dfast measurement, providing the evidence of IVIM modeling of perfusion component is constrained by diffusion component.

Characterizing SARS-CoV-2 mutations in the United States

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been mutating since it was first sequenced in early January 2020. The genetic variants have developed into a few distinct clusters with different properties. Since the United States (US) has the highest number of viral infected patients globally, it is essential to understand the US SARS-CoV-2. Using genotyping, sequence-alignment, time-evolution, k-means clustering, protein-folding stability, algebraic topology, and network theory, we reveal that the US SARS-CoV-2 has four substrains and five top US SARS-CoV-2 mutations were first detected in China (2 cases), Singapore (2 cases), and the United Kingdom (1 case). The next three top US SARS-CoV-2 mutations were first detected in the US. These eight top mutations belong to two disconnected groups. The first group consisting of 5 concurrent mutations is prevailing, while the other group with three concurrent mutations gradually fades out. We identify that one of the top mutations, 27964C>T-(S24L) on ORF8, has an unusually strong gender dependence. Based on the analysis of all mutations on the spike protein, we further uncover that three of four US SASR-CoV-2 substrains become more infectious. Our study calls for effective viral control and containing strategies in the US.