Journal of | | Open Access Pub

Karabayev M. ¹

M. Gasanova N. ¹ T. Botirov M. ¹ Kosimova G.S. ¹

1 Fergana Medical Institute of Public Health, Uzbekistan.

Abstract

Author Contributions

Received Nov 23, 2021 Accepted Jan 17, 2022 Published Jan 25, 2022

Copyright© 2022 Karabayev M., et al.
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The authors have declared that no competing interests exist.

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Citation:

Karabayev M., M. Gasanova N., T. Botirov M., Kosimova G.S. et al. (2022) Principles And Constants Of The Golden Proportion As A Criterion In Donosological Diagnostics Of The Functional States Of The Body And In The Assessment Of The Probability Of Their Changes International Physiology Journal. - 2(3):10-21

DOI 10.14302/issn.2578-8590.ipj-21-4026

Results

Results of Investigations and their Discussions

When developing methods for quantitative assessment of the level of health, the correct assessment of the functional states of the body and systems that ensure the vital activity of the body as a whole is an important task. Since medicine deals with physiological processes, it operates, as necessary, with different numerical indicators, and connections between different characteristics. Currently, in medicine, many scales and criteria for assessments and classifications are used, for various conditions 910. Back in the 10th century, Avicenna gave a comprehensive classification of health levels 11, considering six classes of the functional state of the body. This classification is consistent with the modern one, which is based on the degree of tension of regulatory mechanisms (normal, moderate, pronounced, pronounced and overstrain) 112. If we take into account that the assessment of the prenosological status is aimed at objectifying the adaptive activity of the organism in the process of maintaining health and the formation of prenosological states, then the position of the theory of adaptation can be used as the basis for predicting the development of health. Adaptation as a functional property of biological objects, along with homeostasis, is one of the basic concepts of biology. RM Baevsky and AP Bersenova proposed a classification of the FS of the body, according to the index of functional changes, based on ideas about homeostasis and adaptation 12, providing for the allocation of four levels of health and criteria for their assessment - the higher the conditional IFСh (index of functional changes) score, the higher the likelihood of developing pathological abnormalities. On their basis, they were the first to create a scale for prenosological assessment of functional states and the degree of tension of regulatory systems.

Note that measurement in its broadest sense can be defined as assigning numbers to objects or events according to some rules. These rules should establish a correspondence between the properties of the objects in question and the numbers. In the theory of measurements, it is customary to distinguish four main types of scales: names, order, interval and relations. In this case, measurements carried out using the first two scales are considered qualitative and nonparametric criteria are used for their processing, and measurements made on the last two scales are quantitative in this case, parametric criteria are applied. In each scale, the properties of numbers assigned to objects or phenomena are strictly defined. In this regard, we have chosen the interval scale as a model of the scale for assessing FS.

In mathematical statistics, interval estimation is the result of using a sample to calculate the interval of possible values of an unknown parameter, the estimate of which must be constructed. An interval scale is a scale that classifies according to the principle "more by a certain number of units - less by a certain number of units." The use of an interval scale is also possible in the case when, using a certain criterion (measurement standard), it is possible to determine the magnitude of the difference in features not only by the type of more or less, but also by how many units one object or phenomenon differs from another. A unit of measurement is set for this measurement. The scale of intervals is a fully ordered series with calibrated intervals between ranks, with the counting starting from an arbitrary value from the chosen value (there is no absolute zero). As a result, a conclusion on the state of health is formed.

Below is one of the options for the scale, such a simplified interpretation of prenosological diagnoses.

Standard rating scale	Simplified rating scale
Physiological state:	Physiological state:
1. Norms	High level of health;
2. Optimum	Optimum level of health;
3. Prenosological Good health with some condition - 1	Deviations that can be easily corrected;
4. Prenosological The level of health is mediocre,Yet condition - 2	Complete recovery of health is possible;
5. Premorbid Poor health with signs	Condition of diseases that are still compensated due to high voltage regulation systems
6. Pathological condition	The probable presence of pathology

As you can see, medical rating and prognostic scales have their own characteristics, principles and approaches to construction. From the existing scales of functional states, we have adopted an interval scale and built its following model, which follows from modern concepts and corresponds to the views of Avicenna:

Intervals of functional state	1	2	3	4	5	6
ModernOption 12	Physiologicalnorm	Physiologicaloptimum	1-prenosology Conditionstress	2-prenosology ConditionOvervoltage	Premorbidfortunes	Pathology
Avicenna's version 11	body is healthy to the limit	body is healthy, but not to the limit	the body is not healthy, but not sick	body easily accepting health	the body is sick but not to the limit	the body is sick to the limit

Thus, the scale we recommend has 6 physiological states - “corridors” and 5 possible qualitative transitions.

The next task is to determine the indicators characterizing these intervals, i.e. translate this verbal scale into a numerical one. It should be taken into account that the construction of a scale for assessing the functional state should be based on indicators acting on the principle of optimization and harmonization of the state of the body. Therefore, as an indicator of the scale of verification of the functional state of the organism, we have chosen the adaptive potential of its cardiovascular system that meets these requirements.

Since the functional state of the organism is subject to the hierarchical principle, i.e. Since a qualitative transition from one state to another is continuous, the upper boundary of each interval of the corridor is simultaneously the lower boundary of the next. Therefore, the scale proposed by us, with 6 intervals of states, is characterized by 12 boundaries, of which 5 are combined values. In accordance with the objectives of the study and taking into account the conclusions of 8, the numerical characteristics - the boundary indicators of the intervals of the proposed scale, we have determined based on the principles and constants of the golden ratio. In this case, we were guided by the fact that the n-step Fibonacci plan (Fn) is the optimal plan for finding the local minimum of the free energy consumption of the system in n-steps. Using this plan, biological systems receive the smallest errors in their work (in the search for and adaptation to the changed conditions of existence). This position explains the fact of the extraordinary frequency of finding in the structures and functions of biological systems of the "golden ratio" and the corresponding "golden" numbers. The number system for various structures and functions of a living organism cannot be determined by any one proportion, but it can use many different options, which are based on the golden ratio. Based on these provisions, in order to establish the values of the minimum and maximum boundaries of the functional corridors of the projected scale, on the basis of the constants of the golden ratio, we built two harmonic series of variability numbers, namely:

F⁰, F¹, F², F³, F⁴, F⁵ (1)

F²/2 , F³/2, F⁴/2 , F⁵/2 (2)

Taking into account the above principles of constructing the proposed scale, from the numbers of series (1) and (2), we have compiled the following boundaries of the projected 6 intervals of functional states:

(F⁰÷ F²/2); (F²/2 ÷ F¹); (F1÷ F³/2); (F³/2 ÷ F²); (F²÷ F⁴/2); (F⁴/2 ÷ F³ ).

Taking into account the values of the constant of the golden ratio F = 1.6180033, the following numerical indicators An of the boundaries of 6 intervals of the scale are established:

А₁ А₂- (1÷1,309);

А₂ А₃ - (1,309÷1,618);

А₃ А₄ - (1,618÷2,118);

А₄ А₅ - (2,118÷2,618);

А₅ А₆- (2,618÷3,427);

А₆А₇ - (3,427÷4,236)

Thus, the scale we propose has the following criteria for the indicators of assessing states (table 1.):

Table 1. </caption> <table rules="all" frame="box"> <tbody> <tr> <td>function.intervals</td> <td>1 interval</td> <td> 2 interval</td> <td>3 interval</td> <td>4 interval</td> <td>5 interval</td> <td>6 interval</td> </tr> <tr> <td>Adaptation levels<xref ref-type="bibr" rid="ridm1843171852">13</xref></td> <td>excellent</td> <td>Good</td> <td>Satisfactory</td> <td>Tense</td> <td>Unsatisfactory</td> <td>breakdownadaptations</td> </tr> <tr> <td>indicatorsthe proposed scalesin conditional units</td> <td> А<sub>1 </sub> А<sub>2</sub>1,0÷1,309</td> <td> А<sub>2</sub> А<sub>3</sub> 1,309÷1,618</td> <td> А<sub>3</sub> А<sub>4</sub> 1,618÷2,118</td> <td> А<sub>4</sub> А<sub>5</sub> 2,118÷2,618</td> <td> А<sub>5</sub> А<sub>6</sub> 2,618÷3,427</td> <td> А<sub>6</sub> А<sub>7</sub> 3,427÷4,236</td> </tr> <tr> <td>functionalcorridor,in conditional units</td> <td> 0,309</td> <td> 0,309</td> <td> 0,500</td> <td> 0,500</td> <td> 0,809</td> <td> 0,809</td> </tr> </tbody> </table> </table-wrap> <p>The values of the boundary indicators of the scale presented in <xref ref-type="table" rid="idm1843086316">Table 1</xref>, as well as the intervals of functional states generally correspond to the principles and constants of the golden ratio and the golden wurf <xref ref-type="bibr" rid="ridm1843215476">6</xref><xref ref-type="bibr" rid="ridm1843205460">7</xref><xref ref-type="bibr" rid="ridm1843203156">8</xref>, namely:</p> <p>1. There is a constancy of the ratios of the values of the boundary indicators of each state of the scale, equal to the constant of the golden ratio - Аn / An-2 = 1.618 = F,</p> <p>where n is 3,4,5,6,7;</p> <p>2. The ratio of the values of the maximum and minimum boundaries of odd intervals correspond to the numbers of the golden wurf-1.309; and even intervals are 1.236, i.e. the ratio of the constant of the golden ratio to the golden wurf.</p> <p>3. The width of the functional corridors of the scale also has its "golden" features, namely, the ratio of the width of the subsequent, even interval to the previous even interval and, similarly, the ratios of odd intervals correspond to the constant of the golden ratio - F = 1.618.</p> <p>The most important characteristics of rating scales are their discriminatory ability and calibration, the first of which characterizes the ability of the scale to divide the subjects into groups, depending on any factor, and the second, the degree to which its indications correspond to the actual results, i.e. the reliability of the assessment. For these purposes, in accordance with the criteria of the developed scale, the individual indicators of the examined persons were analyzed - their adaptive potential, health levels according to Apanasenko and the state of the cardiovascular system (CVS) according to the Robinson index, assessed using the following methods. </p> <p>The individual indicators of the surveyed, obtained by us, in terms of their adaptive potential, health levels and CVS state, were analyzed and verified based on the criteria of the proposed FS scale. The results of this analysis are presented in <xref ref-type="table" rid="idm1843023948">Table 2</xref>.</p> <table-wrap id="idm1843023948"> <label>Table 2.</label> <caption> <title/> </caption> <table rules="all" frame="box"> <tbody> <tr> <td colspan="2">Functional corridor boundaries</td> <td>Classification FunctionalCorridor</td> <td>LevelsAdaptivePotential</td> <td colspan="3">Quantitiessurveyedwith indicatorsgivencorridor</td> <td colspan="10">Of them </td> </tr> <tr> <td colspan="2"/> <td/> <td/> <td colspan="3"/> <td colspan="5">Health levels according to Apanasenko</td> <td colspan="5">The state of the cardiovascular system according to Robinson</td> </tr> <tr> <td colspan="2"/> <td/> <td/> <td colspan="3"/> <td>Low</td> <td>below the average.</td> <td>average</td> <td>above the average</td> <td>high</td> <td>Very bad</td> <td>bad</td> <td>average</td> <td>good</td> <td>Exellent</td> </tr> <tr> <td colspan="2"/> <td/> <td/> <td>Всего</td> <td>Of them</td> <td> </td> <td/> <td/> <td/> <td/> <td/> <td/> <td/> <td/> <td/> <td/> </tr> <tr> <td colspan="2"/> <td/> <td/> <td/> <td>Boys</td> <td>Girls</td> <td/> <td/> <td/> <td/> <td/> <td/> <td/> <td/> <td/> <td/> </tr> <tr> <td> Min</td> <td> max</td> <td/> <td/> <td/> <td/> <td/> <td/> <td/> <td/> <td/> <td/> <td/> <td/> <td/> <td/> <td/> </tr> <tr> <td>1,0</td> <td> 1,309</td> <td>FN</td> <td>optimal</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> </tr> <tr> <td>1,309</td> <td> 1,618</td> <td>FN</td> <td>good</td> <td>6</td> <td>1</td> <td>5</td> <td>-</td> <td>-</td> <td>6</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>1</td> <td>5</td> </tr> <tr> <td>1,618</td> <td> 2,118</td> <td>DS</td> <td>Satisfactory</td> <td>27</td> <td>11</td> <td>16</td> <td>7</td> <td>8</td> <td>12</td> <td>-</td> <td>-</td> <td>-</td> <td>2</td> <td>6</td> <td>18</td> <td>1</td> </tr> <tr> <td>2,118</td> <td> 2,618</td> <td>DS</td> <td>tense</td> <td>10</td> <td>7</td> <td>3</td> <td> 10</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>2</td> <td>4</td> <td>1</td> <td>3</td> <td>-</td> </tr> <tr> <td>2,618</td> <td> 3,427</td> <td>premorbital state</td> <td>unsatisfactory</td> <td>No</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> </tr> <tr> <td>3,427</td> <td> 4,236</td> <td>Pathological condition</td> <td>Breakdown</td> <td>No</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> </tr> <tr> <td>Total</td> <td> </td> <td> </td> <td> </td> <td>43</td> <td>19</td> <td>24</td> <td>117</td> <td>8</td> <td>18</td> <td>-</td> <td>-</td> <td>2</td> <td>6</td> <td>7</td> <td>22</td> <td>6</td> </tr> </tbody> </table> </table-wrap> <p>Personalized analysis of these data, in the light of existing ideas about the functional state and adaptation mechanisms, allow us to state the following:</p> <p>1. Of the 43 examined, only 6 (13.9%) individuals, the FS of the body corresponds, according to our scales, to the physiological norm with good adaptation and a normal level of regulatory mechanisms. At the same time, they all have an average level of physical health according to Apanasenko and high CVS reserves according to the Robinson index. Among the girls surveyed, 20.8% are in this state, and 5.3% of the boys.. </p> <p>2. Of the surveyed, 27 (girls-16, boys-11) are in a prenosological state, with sufficient functional capabilities and satisfactory adaptation. However, the levels of their physical health have certain variations with the prevalence of the average level. Corresponding variations are observed in the states of CVS, where 67% of these individuals have normal values;</p> <p>3. Of the surveyed 10 persons (girls-3, boys-7), have a prenosological level of functional state, but with a tense adaptation mechanism and significant mobilization of functional reserves to maintain homeostasis of the body. All of them have low levels of physical health and variations in the Robinson index, with the prevalence of the level of bad and very bad. </p> <p>At the same time, for the criterion of such an analysis, we propose the functional state stability index (<bold>FSSI</bold>), and inversely proportional to it, the probability of a qualitative change in the functional state, the probability of a qualitative change in the functional state (<bold>PQFS</bold>), the value of which, in% can be calculated by the formulas:</p> <p><bold>FSSI={(A</bold><sub><bold>max,i </bold></sub><bold>– </bold><bold>АР</bold><sub><bold>k,o </bold></sub><bold>)/ (A</bold><sub><bold>max,i </bold></sub><bold>- A</bold><sub><bold>min,i </bold></sub><bold>)</bold><bold>}x 100 </bold>(3)<bold> ; </bold></p> <p><bold>PQFS=( 100- FSSI) </bold>(4), </p> <p><bold>A</bold><sub><bold>max,i</bold></sub><sub> ,</sub><bold>A</bold><sub><bold>min,i</bold></sub> values of the maximum and minimum boundaries of the <bold>i</bold>-th functional interval, where the adaptive potential of the <bold>AP</bold><sub><bold>k,0</bold></sub> is fixed, about <bold>k</bold>-examined. Note that quite often, when conducting expert assessments, it becomes necessary to use a special type of ordinal scales - <italic>verbal-numerical scales</italic>. Such scales include a verbal description of the selected gradations and the corresponding numerical values. The most famous and widely used in practice is the Harrington scale <xref ref-type="bibr" rid="ridm1843179772">15</xref>, which has universal application. So for example, adapted by us for any, separately taken, one functional interval, for the assessment of <bold>FSSI</bold> and <bold>PQFS</bold>, it has the following form.</p> <table-wrap id="idm1842808372"> <table rules="all" frame="box"> <tbody> <tr> <td>No</td> <td>value of FSSI (in%)</td> <td>indicators FSSI</td> <td>value PQFS</td> <td>indicators PQFS</td> </tr> <tr> <td>1</td> <td>80–100</td> <td>Very high</td> <td>20-0</td> <td>Very low</td> </tr> <tr> <td>2</td> <td>64–80</td> <td>High</td> <td>37-20</td> <td>Low</td> </tr> <tr> <td>3</td> <td>37-64</td> <td>The average</td> <td>64-37</td> <td>The average</td> </tr> <tr> <td>4</td> <td>20-37</td> <td>Low</td> <td>80-64</td> <td>High</td> </tr> <tr> <td>5</td> <td>0-20</td> <td>Very low</td> <td>100-80</td> <td>Very high</td> </tr> </tbody> </table> </table-wrap> <p>In accordance with these approaches, first of all, the individual indicators of the FSSI were assessed, which showed that 8 persons (girls-4 and boys-4), out of all surveyed, have very high; 1 (girl) - tall; 22 (girls-15 and boys-7) -medium; 1-low and 11 (girls-4, boys-8) - very low levels of functional stability of the body. Using the individual FSSI values obtained for each subject according to formula 3, the PQFS were estimated, which are presented in <xref ref-type="table" rid="idm1842735764">table 3</xref>.</p> <p>Note that the integral indicators of the FS, such as the levels of its reserve, stability and the probability of change are interrelated, namely - the more the reserve of the FS, the higher the levels of its stability and the less the probability of change (deterioration); and vice versa.</p> <p>Based on these provisions, we analyzed the results of prenosological assessment of the FS of the surveyed presented in <xref ref-type="table" rid="idm1842735764">Table 3</xref> and found that 12 (27.9%) of the surveyed individuals have high levels of probability of qualitative changes in functional states, namely: 2 of them transition from physiological norm in the D-1 state; 8- from D-1 to D-2 state; and in 2 surveyed there is a risk of developing pre-morbid conditions, that is, a transition to a premorbid state. At the same time, 31 (72.1%) persons from the surveyed contingent, having below the threshold levels of the probability of a change in FS, do not have a risk of deteriorating their health.</p> <table-wrap id="idm1842735764"> <label>Table 3.</label> <caption> <title/> </caption> <table rules="all" frame="box"> <tbody> <tr> <td>meaningVIFS onformula 4 v, %</td> <td> IndicatorsVIFS onHarrington</td> <td> Total ofsurveyed withdataVIFS</td> <td colspan="4">Of these, the likelihood of quality transition have:</td> </tr> <tr> <td/> <td/> <td/> <td>from FN in D-1</td> <td>from D-1 in D-2</td> <td>from D-2 to premorbid.condition</td> <td>From premorbid to pathology</td> </tr> <tr> <td>80-100</td> <td>Very high</td> <td>11</td> <td>2</td> <td>8</td> <td>1</td> <td>-</td> </tr> <tr> <td>64-80</td> <td> High</td> <td>1</td> <td>-</td> <td>-</td> <td>1</td> <td>-</td> </tr> <tr> <td>37-64</td> <td> The average</td> <td>22</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> </tr> <tr> <td>20-37</td> <td> Low</td> <td>1</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> </tr> <tr> <td>0-20</td> <td> Very low</td> <td>8</td> <td>-</td> <td>-</td> <td>-</td> <td>-</td> </tr> </tbody> </table> </table-wrap> </sec></p></div> </div> <div class="tab-pane fade show active" id="v-pills-discussion" role="tabpanel" aria-labelledby="v-pills-discussion-tab"> </div> <div class="tab-pane fade show active" id="v-pills-reference" role="tabpanel" aria-labelledby="v-pills-reference-tab"> </div> <div class="tab-pane fade" id="v-pills-ethics" role="tabpanel" aria-labelledby="v-pills-ethics-tab"> </div> <div class="tab-pane fade" id="v-pills-conclusion" role="tabpanel" aria-labelledby="v-pills-conclusion-tab"> <h2 class="article_heading" id="results" >Conclusion</h2> <div class="article_text"><sec id="idm1850620980-1" sec-type="results"><p><sec id="idm1849305812" sec-type="conclusions"> <title>Conclusions

Thus, the developed scale and its criteria, and algorithms for assessing the indicators of the adaptive potential of the CVS, allow us to classify practically healthy individuals, according to the levels of the functional state. Its sufficient sensitivity and discriminatory properties are confirmed by the presence of a correlation between the scaling results and the indicators of those examined by the level of health and functional reserve of CVS.

The proposed scale, its criteria and methods of analysis, also make it possible to assess the levels of FS stability, within certain functional intervals and the likelihood of their qualitative changes in the direction of deterioration. As a result, it becomes possible to quantitatively assess functional states, their reserves and predict the occurrence of premorbid conditions, that is, to carry out prenosological monitoring of the health of healthy people and to determine the contingent of persons at risk of deteriorating health.

International Physiology Journal