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Kiselev AR, Mureeva EN, Skazkina VV, Panina OS, Karavaev AS, Chernenkov YV. Full-Term and Preterm Newborns Differ More Significantly in Photoplethysmographic Waveform Variability than Heart Rate Variability. Life (Basel) 2024; 14:675. [PMID: 38929659 PMCID: PMC11204696 DOI: 10.3390/life14060675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/16/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Features of cardiovascular autonomic regulation in infants are poorly studied compared with adults. However, the clinical significance of autonomic dysfunction in infants is very high. The goal of our research was to study the temporal and frequency-dependent features, as well as low-frequency synchronization in cardiovascular autonomic regulation in full-term vs. preterm newborns, based on the analysis of their heart rate variability (HRV) and photoplethysmographic waveform variability (PPGV). METHODS The study included three groups of newborns: 64 full-term newborns (with a gestational age at birth of 37-40 weeks) with a physiological course of the neonatal adaptation; 23 full-term newborns (with a gestational age at birth of 37-40 weeks) with a pathological course of the neonatal adaptation; and 17 preterm newborns (with a postconceptional age of 34 weeks or more). We conducted spectral analysis of HRV and PPGV, along with an assessment of the synchronization strength between low-frequency oscillations in HRV and in PPGV (synchronization index). We employed several options for the boundaries of the high-frequency (HF) band: 0.15-0.40 Hz, 0.2-2 Hz, 0.15-0.8 Hz, and 0.24-1.04 Hz. RESULTS Preterm newborns had higher heart rate, RMSSD, and PNN50 values relative to both groups of full-term newborns. Values of SDNN index and synchronization index (S index) were similar in all groups of newborns. Differences in frequency domain indices of HRV between groups of newborns depended on the considered options of HF band boundaries. Values of frequency domain indices of PPGV demonstrated similar differences between groups, regardless of the boundaries of considered options of HF bands and the location of PPG signal recording (forehead or leg). An increase in sympathetic influences on peripheral blood flow and a decrease in respiratory influences were observed along the following gradient: healthy full-term newborns → preterm newborns → full-term newborns with pathology. CONCLUSIONS Differences in frequency domain indices of autonomic regulation between the studied groups of newborns depended on the boundaries of the considered options of the HF band. Frequency domain indices of PPGV revealed significantly more pronounced differences between groups of newborns than analogous HRV indicators. An increase in sympathetic influences on peripheral blood flow and a decrease in respiratory influences were observed along the following gradient: healthy full-term newborns → preterm newborns → full-term newborns with pathology.
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Affiliation(s)
- Anton R. Kiselev
- Coordinating Center for Fundamental Research, National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia
| | - Elena N. Mureeva
- Department of Pediatrics and Neonatology, Saratov State Medical University, 410012 Saratov, Russia
| | - Viktoria V. Skazkina
- Department of Dynamic Modeling and Biomedical Engineering, Saratov State University, 410012 Saratov, Russia
| | - Olga S. Panina
- Department of Pediatrics and Neonatology, Saratov State Medical University, 410012 Saratov, Russia
| | - Anatoly S. Karavaev
- Department of Dynamic Modeling and Biomedical Engineering, Saratov State University, 410012 Saratov, Russia
| | - Yuri V. Chernenkov
- Department of Pediatrics and Neonatology, Saratov State Medical University, 410012 Saratov, Russia
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Zhao X, Hu F. Developing a predictive equation of cardiovascular age to evaluate cardiovascular health in Chinese community-dwelling women. Health Care Women Int 2023; 44:1239-1251. [PMID: 35766491 DOI: 10.1080/07399332.2022.2091138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 03/13/2022] [Accepted: 06/14/2022] [Indexed: 10/17/2022]
Abstract
Cardiovascular health plays a dominant role in shaping the overall health of individuals. Our aim was to develop a predictive equation of cardiovascular age (CVA) and determine its validity. In this study, we developed an equation of CVA based on 101 healthy women by using multiple linear regression analysis. Based on cross-sectional validity tests, we discovered that the mean CVA is remarkably younger than the mean chronological age in the active group, while there was no statistical age difference in the non-active group. We conclude that CVA is a valid assessment to evaluate cardiovascular health in Chinese community-dwelling women. Healthcare practitioners should consider CVA as a motivational tool for increasing physical activity or modifying diet to improve cardiovascular health in community-dwelling women.
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Affiliation(s)
- Xiaoguang Zhao
- Department of Research Academy of Grand Health, Ningbo University, Zhejiang, China
- Faculty of Sport Science, Ningbo University, Zhejiang, China
| | - Fei Hu
- Faculty of Sport Science, Ningbo University, Zhejiang, China
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3
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Adams JA, Lopez JR, Banderas V, Sackner MA. A Nonrandomized Trial of the Effects of Passive Simulated Jogging on Short-Term Heart Rate Variability in Type 2 Diabetic Subjects. J Diabetes Res 2023; 2023:4454396. [PMID: 37082380 PMCID: PMC10113059 DOI: 10.1155/2023/4454396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/27/2022] [Accepted: 03/18/2023] [Indexed: 04/22/2023] Open
Abstract
Background Diabetes mellitus has reached global epidemic proportions, with type 2 diabetes (T2DM) comprising more than 90% of all subjects with diabetes. Cardiovascular autonomic neuropathy (CAN) frequently occurs in T2DM. Heart rate variability (HRV) reflects a neural balance between the sympathetic and parasympathetic autonomic nervous systems (ANS) and a marker of CAN. Reduced HRV has been shown in T2DM and improved by physical activity and exercise. External addition of pulses to the circulation, as accomplished by a passive simulated jogging device (JD), restores HRV in nondiseased sedentary subjects after a single session. We hypothesized that application of JD for a longer period (7 days) might improve HRV in T2DM participants. Methods We performed a nonrandomized study on ten T2DM subjects (age range 44-73 yrs) who were recruited and asked to use a physical activity intervention, a passive simulated jogging device (JD) for 7 days. JD moves the feet in a repetitive and alternating manner; the upward movement of the pedal is followed by a downward movement of the forefoot tapping against a semirigid bumper to simulate the tapping of feet against the ground during jogging. Heart rate variability (HRV) analysis was performed using an electrocardiogram in each subject in seated posture on day 1 (baseline, BL), after seven days of JD (JD7), and seven days after discontinuation of JD (Post-JD). Time domain variables were computed, viz., standard deviation of all normal RR intervals (SDNN), standard deviation of the delta of all RR intervals (SDΔNN), and the square root of the mean of the sum of the squares of differences between adjacent RR intervals (RMSSD). Frequency domain measures were determined using a standard Fast Fourier spectral analysis, as well as the parameters of the Poincaré plots (SD1 and SD2). Results Seven days of JD significantly increased SDNN, SDΔNN, RMSSD, and both SD1 and SD2 from baseline values. The latter parameters remained increased Post-JD. JD did not modify the frequency domain measures of HRV. Conclusion A passive simulated jogging device increased the time domain and Poincaré variables of HRV in T2DM. This intervention provided effortless physical activity as a novel method to harness the beneficial effects of passive physical activity for improving HRV in T2DM subjects.
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Affiliation(s)
- Jose A. Adams
- Division Neonatology, Mount Sinai Medical Center of Greater Miami, Miami Beach, Florida, USA
| | - Jose R. Lopez
- Mount Sinai Medical Center of Greater Miami, Miami Beach, Florida, USA
| | | | - Marvin A. Sackner
- Mount Sinai Medical Center of Greater Miami, Miami Beach, Florida, USA
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4
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Karavaev AS, Skazkina VV, Borovkova EI, Prokhorov MD, Hramkov AN, Ponomarenko VI, Runnova AE, Gridnev VI, Kiselev AR, Kuznetsov NV, Chechurin LS, Penzel T. Synchronization of the Processes of Autonomic Control of Blood Circulation in Humans Is Different in the Awake State and in Sleep Stages. Front Neurosci 2022; 15:791510. [PMID: 35095399 PMCID: PMC8789746 DOI: 10.3389/fnins.2021.791510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 12/09/2021] [Indexed: 01/09/2023] Open
Abstract
The influence of higher nervous activity on the processes of autonomic control of the cardiovascular system and baroreflex regulation is of considerable interest, both for understanding the fundamental laws of the functioning of the human body and for developing methods for diagnostics and treatment of pathologies. The complexity of the analyzed systems limits the possibilities of research in this area and requires the development of new tools. Earlier we propose a method for studying the collective dynamics of the processes of autonomic control of blood circulation in the awake state and in different stages of sleep. The method is based on estimating a quantitative measure representing the total percentage of phase synchronization between the low-frequency oscillations in heart rate and blood pressure. Analysis of electrocardiogram and invasive blood pressure signals in apnea patients in the awake state and in different sleep stages showed a high sensitivity of the proposed measure. It is shown that in slow-wave sleep the degree of synchronization of the studied rhythms is higher than in the awake state and lower than in sleep with rapid eye movement. The results reflect the modulation of the processes of autonomic control of blood circulation by higher nervous activity and can be used for the quantitative assessment of this modulation.
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Affiliation(s)
- Anatoly S. Karavaev
- Department of Basic Research in Neurocardiology, Institute of Cardiological Research, Saratov State Medical University, Saratov, Russia
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
- Laboratory of Nonlinear Dynamics Modeling, Saratov Branch of the Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia
| | - Viktoriia V. Skazkina
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
- LUT School of Engineering Science, LUT University, Lappeenranta, Finland
| | - Ekaterina I. Borovkova
- Department of Basic Research in Neurocardiology, Institute of Cardiological Research, Saratov State Medical University, Saratov, Russia
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
- Laboratory of Nonlinear Dynamics Modeling, Saratov Branch of the Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia
| | - Mikhail D. Prokhorov
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
- Laboratory of Nonlinear Dynamics Modeling, Saratov Branch of the Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia
| | | | - Vladimir I. Ponomarenko
- Laboratory of Nonlinear Dynamics Modeling, Saratov Branch of the Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia
| | - Anastasiya E. Runnova
- Department of Basic Research in Neurocardiology, Institute of Cardiological Research, Saratov State Medical University, Saratov, Russia
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
| | - Vladimir I. Gridnev
- Department of Basic Research in Neurocardiology, Institute of Cardiological Research, Saratov State Medical University, Saratov, Russia
| | - Anton R. Kiselev
- Department of Basic Research in Neurocardiology, Institute of Cardiological Research, Saratov State Medical University, Saratov, Russia
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
- Coordinating Center for Fundamental Research, National Medical Research Center for Therapy and Preventive Medicine, Moscow, Russia
| | - Nikolay V. Kuznetsov
- LUT School of Engineering Science, LUT University, Lappeenranta, Finland
- Faculty of Mathematics and Mechanics, St. Petersburg State University, St. Petersburg, Russia
- Institute for Problems in Mechanical Engineering RAS, St. Petersburg, Russia
| | - Leonid S. Chechurin
- LUT School of Engineering Science, LUT University, Lappeenranta, Finland
- Faculty of Mathematics and Mechanics, St. Petersburg State University, St. Petersburg, Russia
| | - Thomas Penzel
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
- Interdisciplinary Sleep Medicine Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Xing X, Ma Z, Xu S, Zhang M, Zhao W, Song M, Dong WF. Blood pressure assessment with in-ear photoplethysmography. Physiol Meas 2021; 42. [PMID: 34571491 DOI: 10.1088/1361-6579/ac2a71] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/27/2021] [Indexed: 11/11/2022]
Abstract
Objective. In this study, we aimed to estimate blood pressure (BP) from in-ear photoplethysmography (PPG). This novel implementation provided an unobtrusive and steady way of recording PPG, whereas previous PPG measurements were mostly performed at the wrist, finger, or earlobe.Methods. The time between forward and reflected PPG waves was very short at the ear site. To minimize errors introduced by feature extraction, a multi-Gaussian decomposition of in-ear PPG was performed. Both hand-crafted and whole-based features were extracted and the best combination of features was selected using a backward-search wrapper method and evaluated by the Akaike information criteria. Hemodynamic parameters such as compliance and inertance were estimated from a four-element Windkessel (WK4) model, which was used to pre-classify PPG signals and generate different BP estimation algorithms. Calibration was done by using previous measurements from the same class. To validate this novel approach, 53 subjects were recruited for a one-month follow-up study, and 17 subjects were recruited for a two-month follow-up study. Calibrated systolic BP estimation accuracy was significantly improved with inertance-based pre-classification, while diastolic BP showed less improvement.Results. With proper feature selection, pre-classification and calibration, we have achieved a mean absolute error of 5.35 mmHg for SBP estimation, compared to 6.16 mmHg if no pre-classification was carried out. The performance did not deteriorate in two months, showing a decent BP trend-tracking ability.Conclusion. The study demonstrated the feasibility of in-ear PPG to reliably measure BP, which represents an important technological advancement in terms of unobtrusiveness and steadiness.
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Affiliation(s)
- Xiaoman Xing
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Sciences and Technology of China, Suzhou, Jiangsu, People's Republic of China.,Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, People's Republic of China
| | - Zhimin Ma
- The Affiliated Suzhou Science &Technology Town Hospital of Nanjing Medical University, Suzhou, Jiangsu, People's Republic of China
| | - Shengkai Xu
- The Affiliated Suzhou Science &Technology Town Hospital of Nanjing Medical University, Suzhou, Jiangsu, People's Republic of China
| | - Mingyou Zhang
- The First Hospital of Jilin University, Changchun, Jilin, People's Republic of China
| | - Wei Zhao
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Mingxuan Song
- Jinan Guoke Medical Technology Development Co., Ltd, Shandong, People's Republic of China
| | - Wen-Fei Dong
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, People's Republic of China
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Borovkova EI, Hramkov AN, Karavaev AS, Ponomarenko VI, Prokhorov MD, Ishbulatov YM, Penzel T. Directional Couplings Between Electroencephalogram and Interbeat Intervals Signals in Awake State and Different Stages of Sleep. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:5398-5402. [PMID: 34892347 DOI: 10.1109/embc46164.2021.9630385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Purpose of the work is to identify the directional coupling between the structures of the brain and the autonomic control of the heart rate variability, to analyze the changes in these coupling in sleep and in wakefulness. Infra-slow oscillations of the electroencephalograms potential and low-frequency components (0.04-0.15 Hz) of the interbeat intervals signal where analyzed using a sensitive method for identifying the directional coupling. The technique, based on modeling the dynamics of instantaneous phases of oscillations, made it possible to reveal the presence and quantify the directional couplings between the structures of the brain and the autonomic control of the heart rate variability. It was shown that the coupling coefficients in the frequency band of 0.04-0.15 Hz (associated mainly with sympathetic control of blood circulation), on average, decrease with falling asleep. We have also shown the asymmetry of coupling. At the same time, stronger connections were revealed in the direction from the autonomic control of the heart rate variability to the brain structures than in the opposite direction. It has been shown that the strength of such couplings decreases with increasing of sleep depth.
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7
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Skazkina VV, Krasikova NS, Borovkova EI, Ishbulatov YM, Gorshkov AY, Korolev AI, Dadaeva VA, Fedorovich AA, Kuligin AV, Drapkina OM, Karavaev AS, Kiselev AR. Synchronization Of Autonomic Control Loops Of Blood Circulation In Patients With COVID-19. RUSSIAN OPEN MEDICAL JOURNAL 2021. [DOI: 10.15275/rusomj.2021.0307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
This study aims to investigate the strength of synchronization between the autonomic control loops of the cardiovascular system (CVS) in patients with COronaVIrus Disease 2019 (COVID-19). Methods — We calculated the total percent of phase synchronization index (S index) between the loops of autonomic control of heart rate and vascular tone in two sample groups: healthy individuals and COVID-19 patients. Results — The group-average value of the S index in COVID-19 patients is lower comparing to healthy individuals, the Mann-Whitney U-test confirmed that the differences are statistically significant. Conclusion — Obtained results suggest that the decreased value of the S index reflects the presence of a viral disease, and the S index is a promising basis for non-invasive screening diagnostics of viral diseases, particularly of COVID-19.
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Affiliation(s)
- Viktoriia V. Skazkina
- Saratov State University, Saratov, Russia; Lappeenranta University of Technology, Finland
| | | | - Ekaterina I. Borovkova
- Saratov Branch of the Institute of RadioEngineering and Electronics of Russian Academy of Sciences, Saratov, Russia; Saratov State Medical University, Saratov, Russia; Saratov State University, Saratov, Russia
| | - Yurii M. Ishbulatov
- Saratov State Medical University, Saratov, Russia; Saratov State University, Saratov, Russia
| | | | - Andrei I. Korolev
- National Medical Research Center for Therapy and Preventive Medicine, Moscow, Russia
| | - Valida A. Dadaeva
- National Medical Research Center for Therapy and Preventive Medicine, Moscow, Russia
| | - Andrei A. Fedorovich
- National Medical Research Center for Therapy and Preventive Medicine, Moscow, Russia; Research Center – Institute of Biomedical Problems of the Russian Academy of Sciences (IBMP), Moscow, Russia
| | | | - Oxana M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine, Moscow, Russia
| | - Anatoly S. Karavaev
- Saratov State University, Saratov, Russia; Saratov State Medical University, Saratov, Russia; Saratov Branch of the Institute of RadioEngineering and Electronics of Russian Academy of Sciences, Saratov, Russia
| | - Anton R. Kiselev
- National Medical Research Center for Therapy and Preventive Medicine, Moscow, Russia; Saratov State Medical University, Saratov, Russia; Saratov State University, Saratov, Russia
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8
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Karavaev AS, Borovik AS, Borovkova EI, Orlova EA, Simonyan MA, Ponomarenko VI, Skazkina VV, Gridnev VI, Bezruchko BP, Prokhorov MD, Kiselev AR. Low-frequency component of photoplethysmogram reflects the autonomic control of blood pressure. Biophys J 2021; 120:2657-2664. [PMID: 34087217 PMCID: PMC8390904 DOI: 10.1016/j.bpj.2021.05.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 04/18/2021] [Accepted: 05/17/2021] [Indexed: 11/30/2022] Open
Abstract
The question of how much information the photoplethysmogram (PPG) signal contains on the autonomic regulation of blood pressure (BP) remains unsolved. This study aims to compare the low-frequency (LF) and high-frequency components of PPG and BP and assess their correlation with oscillations in interbeat (RR) intervals at similar frequencies. The PPG signal from the distal phalanx of the right index finger recorded using a reflective PPG sensor at green light, the BP signal from the left hand recorded using a Finometer, and RR intervals were analyzed. These signals were simultaneously recorded within 15 min in a supine resting condition in 17 healthy subjects (12 males and 5 females) aged 33 ± 9 years (mean ± SD). The study revealed the high coherence of LF components of PPG and BP with the LF component of RR intervals. The high-frequency components of these signals had low coherence. The analysis of the signal instantaneous phases revealed the presence of high-phase coherence between the LF components of PPG and BP. It is shown that the LF component of PPG is determined not only by local myogenic activity but also reflects the processes of autonomic control of BP.
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Affiliation(s)
- Anatoly S Karavaev
- Saratov State Medical University, Saratov, Russia; Saratov Branch of the Institute of Radio-Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia; Saratov State University, Saratov, Russia
| | - Anatoly S Borovik
- Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | - Ekaterina I Borovkova
- Saratov State Medical University, Saratov, Russia; Saratov State University, Saratov, Russia
| | - Eugeniya A Orlova
- Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | | | - Vladimir I Ponomarenko
- Saratov Branch of the Institute of Radio-Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia; Saratov State University, Saratov, Russia
| | | | - Vladimir I Gridnev
- Saratov State Medical University, Saratov, Russia; Saratov State University, Saratov, Russia
| | - Boris P Bezruchko
- Saratov Branch of the Institute of Radio-Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia; Saratov State University, Saratov, Russia
| | - Mikhail D Prokhorov
- Saratov Branch of the Institute of Radio-Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia
| | - Anton R Kiselev
- Saratov State Medical University, Saratov, Russia; National Medical Research Center for Therapy and Preventive Medicine, Moscow, Russia.
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Karavaev AS, Ishbulatov YM, Prokhorov MD, Ponomarenko VI, Kiselev AR, Runnova AE, Hramkov AN, Semyachkina-Glushkovskaya OV, Kurths J, Penzel T. Simulating Dynamics of Circulation in the Awake State and Different Stages of Sleep Using Non-autonomous Mathematical Model With Time Delay. Front Physiol 2021; 11:612787. [PMID: 33519518 PMCID: PMC7838681 DOI: 10.3389/fphys.2020.612787] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/25/2020] [Indexed: 11/13/2022] Open
Abstract
We propose a mathematical model of the human cardiovascular system. The model allows one to simulate the main heart rate, its variability under the influence of the autonomic nervous system, breathing process, and oscillations of blood pressure. For the first time, the model takes into account the activity of the cerebral cortex structures that modulate the autonomic control loops of blood circulation in the awake state and in various stages of sleep. The adequacy of the model is demonstrated by comparing its time series with experimental records of healthy subjects in the SIESTA database. The proposed model can become a useful tool for studying the characteristics of the cardiovascular system dynamics during sleep.
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Affiliation(s)
- Anatoly S. Karavaev
- Saratov Branch of the Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
- Department of Innovative Cardiological Information Technology, Saratov State Medical University, Saratov, Russia
| | - Yurii M. Ishbulatov
- Saratov Branch of the Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
- Department of Innovative Cardiological Information Technology, Saratov State Medical University, Saratov, Russia
| | - Mikhail D. Prokhorov
- Saratov Branch of the Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
| | - Vladimir I. Ponomarenko
- Saratov Branch of the Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia
| | - Anton R. Kiselev
- Department of Innovative Cardiological Information Technology, Saratov State Medical University, Saratov, Russia
| | - Anastasiia E. Runnova
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
- Department of Innovative Cardiological Information Technology, Saratov State Medical University, Saratov, Russia
| | | | | | - Jürgen Kurths
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
- Physics Department, Humboldt University of Berlin, Berlin, Germany
- Research Department Complexity Science, Potsdam Institute for Climate Impact Research (PIK), Potsdam, Germany
| | - Thomas Penzel
- Smart Sleep Laboratory, Saratov State University, Saratov, Russia
- Interdisciplinary Sleep Medicine Center, Charité – Universitätsmedizin Berlin, Berlin, Germany
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10
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Skazkina VV, Karavaev AS, Borovkova EI, Simonyan MA, Prokhorov MD, Ponomarenko VI, Dubinkina ES, Bezruchko BP, Gridnev VI, Kiselev AR. Uncovering Interaction Between The Loops Of Autonomic Regulation Of Blood Circulation From Long Time Series. RUSSIAN OPEN MEDICAL JOURNAL 2020. [DOI: 10.15275/rusomj.2020.0403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The purpose of this work is to study the interaction between the autonomic regulatory loops of blood circulation from long time series. Methods ― We simultaneously recorded four-hour signals of electrocardiogram and photoplethysmogram from the ear and finger of ten healthy adults. We determined the intervals of phase synchronization of the studied regulatory loops and analyzed the dependence of their length on the recording time. The deviations of the total percentage of phase synchronization (index S) from its mean value were estimated in moving non-overlapping windows. Results ― For studied signals we found no significant correlation between the length of synchronization epoch and the time of its beginning. A sharp increase in the deviation of the index S from its mean was shown at the end of the experiment. Conclusion ― The increase in the deviation from the mean at the end of our records is most likely associated more with psychosomatic influences than with hormonal regulation or immobilization stress.
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Affiliation(s)
| | | | | | | | - Mikhail D. Prokhorov
- Saratov Branch of the Institute of RadioEngineering and Electronics of Russian Academy of Sciences
| | - Vladimir I. Ponomarenko
- Saratov Branch of the Institute of RadioEngineering and Electronics of Russian Academy of Sciences
| | | | - Boris P. Bezruchko
- Saratov Branch of the Institute of RadioEngineering and Electronics of Russian Academy of Sciences
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11
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Ishbulatov YM, Karavaev AS, Kiselev AR, Simonyan MA, Prokhorov MD, Ponomarenko VI, Mironov SA, Gridnev VI, Bezruchko BP, Shvartz VA. Mathematical modeling of the cardiovascular autonomic control in healthy subjects during a passive head-up tilt test. Sci Rep 2020; 10:16525. [PMID: 33020530 PMCID: PMC7536219 DOI: 10.1038/s41598-020-71532-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/18/2020] [Indexed: 01/10/2023] Open
Abstract
A mathematical model is proposed for the autonomic control of cardiovascular system, which takes into account two separated self-exciting sympathetic control loops of heart rate and peripheral vascular tone. The control loops are represented by self-exciting time-delay systems and their tone depends on activity of the aortic, carotid, and lower-body baroreceptors. The model is used to study the dynamics of the adaptive processes that manifest in a healthy cardiovascular system during the passive head-up tilt test. Computer simulation provides continuous observation of the dynamics of the indexes and variables that cannot be measured in the direct experiment, including the noradrenaline concentration in vessel wall and heart muscle, tone of the sympathetic and parasympathetic control, peripheral vascular resistance, and blood pressure. In the supine and upright positions, we estimated the spectral characteristics of the model variables, especially in the low-frequency band, and the original index of total percent of phase synchronization between the low-frequency oscillations in heart rate and blood pressure signals. The model demonstrates good quantitative agreement with the dynamics of the experimentally observed indexes of cardiovascular system that were averaged for 50 healthy subjects.
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Affiliation(s)
- Yurii M Ishbulatov
- Department of Innovative Cardiological Information Technology, Institute of Cardiological Research, Saratov State Medical University, Saratov, Russia.,Department of Surgical Treatment for Interactive Pathology, Bakulev Scientific Center for Cardiovascular Surgery, Moscow, Russia
| | - Anatoly S Karavaev
- Department of Innovative Cardiological Information Technology, Institute of Cardiological Research, Saratov State Medical University, Saratov, Russia.,Laboratory of Nonlinear Dynamics Modeling, Saratov Branch of the Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia.,Department of Dynamic Modeling and Biomedical Engineering, Saratov State University, Saratov, Russia
| | - Anton R Kiselev
- Department of Innovative Cardiological Information Technology, Institute of Cardiological Research, Saratov State Medical University, Saratov, Russia. .,Department of Surgical Treatment for Interactive Pathology, Bakulev Scientific Center for Cardiovascular Surgery, Moscow, Russia. .,Department of Dynamic Modeling and Biomedical Engineering, Saratov State University, Saratov, Russia.
| | - Margarita A Simonyan
- Department of Atherocslerosis and Chronic Ischemic Heart Disease, Institute of Cardiological Research, Saratov, Russia
| | - Mikhail D Prokhorov
- Laboratory of Nonlinear Dynamics Modeling, Saratov Branch of the Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia
| | - Vladimir I Ponomarenko
- Laboratory of Nonlinear Dynamics Modeling, Saratov Branch of the Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia.,Department of Dynamic Modeling and Biomedical Engineering, Saratov State University, Saratov, Russia
| | - Sergey A Mironov
- Department of Innovative Cardiological Information Technology, Institute of Cardiological Research, Saratov State Medical University, Saratov, Russia
| | - Vladimir I Gridnev
- Department of Innovative Cardiological Information Technology, Institute of Cardiological Research, Saratov State Medical University, Saratov, Russia.,Department of Dynamic Modeling and Biomedical Engineering, Saratov State University, Saratov, Russia
| | - Boris P Bezruchko
- Laboratory of Nonlinear Dynamics Modeling, Saratov Branch of the Institute of Radio Engineering and Electronics of Russian Academy of Sciences, Saratov, Russia.,Department of Dynamic Modeling and Biomedical Engineering, Saratov State University, Saratov, Russia
| | - Vladimir A Shvartz
- Department of Surgical Treatment for Interactive Pathology, Bakulev Scientific Center for Cardiovascular Surgery, Moscow, Russia
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12
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Ishbulatov YM, Kiselev AR, Mureeva EN, Popova YV, Kurbako AV, Gridnev VI, Bezruchko BP, Simonyan MA, Borovkova EI, Posnenkova OM, Panina OS, Chernenkov YV, Karavaev AS. Diagnostics of coupling between low-frequency loops in cardiovascular autonomic control in adults, newborns and mathematical model using cross-recurrence analysis. RUSSIAN OPEN MEDICAL JOURNAL 2019. [DOI: 10.15275/rusomj.2019.0405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The aim of study is to investigate effectiveness of cross-recurrence analysis for the detection of coupling between the loops of heart rate and vessel tone sympathetic control. The cross-recurrence analysis is applied to the interbeat intervals and photopletysmographic signals from the mathematical model of cardiovascular system and from adults and newborn children. The model is examined under the conditions of the four experiments: with fully operational autonomic control, autonomic control weakened by 40%, autonomic control weakened by 70% and autonomic blockade. The coupling is most pronounced in adult subjects and the model with fully operational autonomic control, while it is absent under the autonomic blockade. Autonomic control is also not fully developed in newborn children. As the result, smaller coupling strength is expected. The results of cross-recurrence analysis of the model and experimental data are compared with the results of coupling detection based on the analysos of phase synchronization. Synchronization index demonstrates good correlation with the coupling strength in the model and weak coupling in newborn children in relation to adult subjects. In both cases, no correlation is observed between the synchronization index and the results of cross-recurrence analysis.
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Affiliation(s)
- Yurii M. Ishbulatov
- Saratov Branch of Kotelnikov Institute of Radio Engineering and Electronics of Russian Academy of Sciences
| | | | | | - Yulia V. Popova
- Saratov Branch of Kotelnikov Institute of Radio Engineering and Electronics of Russian Academy of Sciences
| | | | | | - Boris P. Bezruchko
- Saratov Branch of Kotelnikov Institute of Radio Engineering and Electronics of Russian Academy of Sciences
| | | | | | - Olga M. Posnenkova
- Saratov Branch of Kotelnikov Institute of Radio Engineering and Electronics of Russian Academy of Sciences
| | | | | | - Anatoly S. Karavaev
- Saratov Branch of Kotelnikov Institute of Radio Engineering and Electronics of Russian Academy of Sciences
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13
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Kiselev AR, Karavaev AS. The intensity of oscillations of the photoplethysmographic waveform variability at frequencies 0.04-0.4 Hz is effective marker of hypertension and coronary artery disease in males. Blood Press 2019; 29:55-62. [PMID: 31402715 DOI: 10.1080/08037051.2019.1645586] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: It is believed that the intensity of oscillations in the photoplethysmographic waveform variability reflects the activity of vascular regulatory mechanisms. However, the relationship of such fluctuations with the state of health is poorly understood.Purpose: The aim of our study was to assess the possibility of using spectral indices that reflect the intensity of oscillations of the photoplethysmographic waveform variability at frequencies 0.04-0.4 Hz as markers of hypertension and coronary artery disease. We did not study women to exclude the influence of menopause and sex hormones on the results.Materials and Methods: We compared synchronous 10-minute records of finger photoplethysmogram and respiration at rest in 30 healthy males (48.8 ± 4.5 years; data presented as Mean ± SD) versus 30 patients with hypertension (aged 49.0 ± 4.3 years) versus 30 patients with stable coronary artery disease (49.2 ± 4.8 years). Percentages of high-frequency and low-frequency ranges in the total power of photoplethysmographic waveform variability spectrum (HF% and LF%), and LF/HF ratio were assessed.Results: HF% are subject to by 2- to 5-fold increase in hypertensive patients (p < .001) and up to an 8-fold increase in patients with coronary artery disease (p < .001) when compared with healthy persons. On the contrary, LF% is reduced by 1.5-5 times in all patients when compared with healthy people (p < .001). We identified cut-off points for each photoplethysmographic index to distinguish patients with coronary artery disease or hypertension from healthy subjects. Multiple logistic regression models based on photoplethysmographic waveform variability indices had sufficient sensitivity and specificity for patients with hypertension or coronary artery disease.Conclusion: Frequency-domain indices of photoplethysmographic waveform variability (in particular, HF%, LF%, and LF/HF) are sufficiently sensitive and specific markers of hypertension and coronary artery disease in adult males.
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Affiliation(s)
- Anton R Kiselev
- Department of Innovative Cardiological Information Technology, Institute of Cardiological Research, Saratov State Medical University, Saratov, Russia.,Department of Dynamic Modeling and Biomedical Engineering, Saratov State University, Saratov, Russia
| | - Anatoly S Karavaev
- Department of Dynamic Modeling and Biomedical Engineering, Saratov State University, Saratov, Russia.,Saratov Branch of the Institute of RadioEngineering and Electronics, Russian Academy of Sciences, Saratov, Russia
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14
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Melinosky C, Yang S, Hu P, Li H, Miller CHT, Khan I, Mackenzie C, Chang WT, Parikh G, Stein D, Badjatia N. Continuous Vital Sign Analysis to Predict Secondary Neurological Decline After Traumatic Brain Injury. Front Neurol 2018; 9:761. [PMID: 30319521 PMCID: PMC6167472 DOI: 10.3389/fneur.2018.00761] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 08/22/2018] [Indexed: 01/01/2023] Open
Abstract
Background: In the acute resuscitation period after traumatic brain injury (TBI), one of the goals is to identify those at risk for secondary neurological decline (ND), represented by a constellation of clinical signs that can be identified as objective events related to secondary brain injury and independently impact outcome. We investigated whether continuous vital sign variability and waveform analysis of the electrocardiogram (ECG) or photoplethysmogram (PPG) within the first hour of resuscitation may enhance the ability to predict ND in the initial 48 hours after traumatic brain injury (TBI). Methods: Retrospective analysis of ND in TBI patients enrolled in the prospective Oximetry and Noninvasive Predictors Of Intervention Need after Trauma (ONPOINT) study. ND was defined as any of the following occurring in the first 48 h: new asymmetric pupillary dilatation (>2 mm), 2 point GCS decline, interval worsening of CT scan as assessed by the Marshall score, or intervention for cerebral edema. Beat-to-beat variation of ECG or PPG, as well as waveform features during the first 15 and 60 min after arrival in the TRU were analyzed to determine physiologic parameters associated with future ND. Physiologic and admission clinical variables were combined in multivariable logistic regression models predicting ND and inpatient mortality. Results: There were 33 (17%) patients with ND among 191 patients (mean age 43 years old, GCS 13, ISS 12, 69% men) who met study criteria. ND was associated with ICU admission (P < 0.001) and inpatient mortality (P < 0.001). Both ECG (AUROC: 0.84, 95% CI: 0.76,0.93) and PPG (AUROC: 0.87, 95% CI: 0.80, 0.93) analyses during the first 15 min of resuscitation demonstrated a greater ability to predict ND then clinical characteristics alone (AUROC: 0.69, 95% CI: 0.59, 0.8). Age (P = 0.02), Marshall score (P = 0.001), penetrating injury (P = 0.02), and predictive probability for ND by PPG analysis at 15 min (P = 0.03) were independently associated with inpatient mortality. Conclusions: Analysis of variability and ECG or PPG waveform in the first minutes of resuscitation may represent a non-invasive early marker of future ND.
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Affiliation(s)
- Christopher Melinosky
- Program in Trauma, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Shiming Yang
- Program in Trauma, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Peter Hu
- Program in Trauma, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - HsiaoChi Li
- Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Catriona H T Miller
- Enroute care Division, Department of Aeromedical Research, U.S. Air Force School of Aerospace Medicine, Wright Patterson AFB, Dayton, OH, United States
| | - Imad Khan
- Program in Trauma, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Colin Mackenzie
- Program in Trauma, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Wan-Tsu Chang
- Program in Trauma, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Gunjan Parikh
- Program in Trauma, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Deborah Stein
- Program in Trauma, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Neeraj Badjatia
- Program in Trauma, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States
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15
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John RT, Henricson J, Junker J, Jonson CO, Nilsson GE, Wilhelms D, Anderson CD. A cool response-The influence of ambient temperature on capillary refill time. JOURNAL OF BIOPHOTONICS 2018; 11:e201700371. [PMID: 29384267 DOI: 10.1002/jbio.201700371] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 01/21/2018] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To describe the effect of low ambient temperature on skin temperature and capillary refill (CR) time in forehead, sternum and finger pulp. METHODS An observational, nonrandomized experimental study on 15 healthy subjects (6 females) in a cold room (8°C). Outcome measures were skin temperature and quantified CR test after application of a standardized blanching pressure (9 N/cm2 ) using digital photographic polarization spectroscopy to generate CR times. RESULTS The finger pulp showed marked temperature fall and prolonged CR times (>10 seconds). The CR registrations of the forehead and sternum were more comparable to curves observed in a control material at room temperature, and skin temperature falls were less marked. CR times were not prolonged in forehead measurements. At the sternum, some individuals showed CR times beyond guideline recommendations despite only a marginal reduction in skin temperature. CONCLUSIONS Low ambient temperature is a strong independent factor for CR time at peripheral sites. Reservation about sternum as a site of measurement is warranted since cold provocation produced prolonged CR times in some individuals. We found that the forehead is the most thermostable of the 3 sites and thus the preferred site to avoid ambient temperature artifact in measuring CR time.
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Affiliation(s)
- Rani Toll John
- Division of Neuro and Inflammation Sciences, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
- Department of Emergency Medicine, Local Health Care Services in Central Östergötland, Linköping, Östergötland, Sweden
| | - Joakim Henricson
- Department of Emergency Medicine, Local Health Care Services in Central Östergötland, Linköping, Östergötland, Sweden
- Division of Drug Research, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - Johan Junker
- Center for Disaster Medicine and Traumatology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Carl-Oscar Jonson
- Center for Disaster Medicine and Traumatology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | | | - Daniel Wilhelms
- Department of Emergency Medicine, Local Health Care Services in Central Östergötland, Linköping, Östergötland, Sweden
- Division of Drug Research, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - Chris D Anderson
- Division of Cell Biology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
- Department of Dermatology and Venereology, Heart and Medicine Center, Linköping, Sweden
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