Medical Support Research Articles

Adaptive Movement Analysis And Enhanced Self-Monitoring Hypercube For Parkinson’s Disease

Parkinson’s Disease (PD) is a chronic neurodegenerative disorder characterized by motor impairments, including tremors, rigidity, bradykinesia, and postural instability, which progressively diminish patients’ ability to perform daily activities independently. Current rehabilitation practices, primarily focused on physical therapy, medication, and traditional support devices, provide essential symptom management but often lack customization to individual patient needs, leading to inconsistent adherence and limited long-term benefits. This paper introduces the Adaptive Movement Analysis and Enhanced Self-Monitoring Hypercube, a novel rehabilitation framework aimed at improving PD management through a comprehensive, adaptive approach.The system leverages cutting-edge sensors, including the MPU6050 Inertial Measurement Unit (IMU) and infrared proximity sensors, integrated with a Teensy microcontroller to deliver real-time movement analysis and tailored exercise feedback. Through Bluetooth-enabled connectivity, patient data is transmitted to a digital platform where it can be analyzed and adjusted based on performance metrics. Additionally, gamification techniques, task-specific training modules, and customizable feedback mechanisms are embedded to increase patient engagement and adherence to exercise routines. This adaptive solution provides a structured, motivating environment that addresses the fluctuating capabilities of PD patients, promoting functional recovery and enhanced self-monitoring.

BEHAVIOURAL PATTERNS OF CHILDREN IN KADUNA STATE ORPHANAGES: A COMPARATIVE ANALYSIS

Background The plight of orphans, exacerbated by conflict, disease, and socioeconomic factors, remains a pressing global issue, particularly in sub-Saharan Africa. Nigeria, notably impacted by the HIV/AIDS epidemic, terrorism, and natural disasters, has witnessed a substantial increase in orphan populations. These children face severe challenges, including child abuse, malnutrition, limited access to education, stigmatization, and a range of psychological and behavioural disorders. Despite some interventions, orphanages primarily address material needs, often neglecting comprehensive medical, social, and psychosocial support. This study explores the behavioural patterns of orphans in Kaduna, Nigeria, and examines how their medical and social challenges compare across various orphanages. Methodology A cross-sectional, comparative analysis was conducted among 100 orphans from selected orphanages in Kaduna. Data were collected through interviewer-administered questionnaires assessing socio-demographics, medical conditions, behavioural patterns, stigma, psychosocial status, and coping strategies. Results The mean age of respondents was 10 years, with 68% being male. Nutritional issues were prevalent, with 53.7% classified as underweight despite 54.9% reportedly consuming balanced diets. Medical concerns were significant, with 33.7% showing clinical signs of illness and 46.7% not fully immunized. Behavioural issues were prominent, including hyperactivity symptoms (27.0%), enuresis (22.3%), and depressive symptoms (1.8%). Socially, most respondents (83.3%) reported positive peer relationships, though bullying (11.4%) and stigmatization (9%) were also observed. Educational access was generally high, with only 2.2% not attending school. However, social support systems varied, with 35.2% reporting strong support and 46.8% adapting their goals as a coping mechanism. Conclusion The findings highlight the complex medical and behavioural challenges faced by orphans in Kaduna's orphanages, underscoring the need for integrated interventions that provide medical, psychosocial, and educational support. A holistic approach is crucial to improving their overall well-being and future prospects.

Experience in using artificial intelligence services for diagnosing compression fracture of vertebral body based on computed tomography – from testing to trials

Backgraund:Osteoporosis (OP) is often diagnosed at the stage of complications. Compression fractures (CF) of the vertebral bodies, complications of OP, and predictors of subsequent fractures are often asymptomatic. CF can be detected on CT scan performed for other indications. We have analyzed approaches to using artificial intelligence services (AI services) generated for diagnosing CF of the vertebral bodies. Aims:Testing AI services to identify CF based on chest CT and to assess the possibility of their implementation into the practice of medical facilities of the Moscow Healthcare Department. Materials and methods:For setting a clinical task for AI services, basic diagnostic requirements in the direction of “Osteoporosis” are formed. AI services go through the following stages: self-testing, functional and calibration testing, trial and trial operation. The first three stages of testing are carried out on previously generated datasets. At the stages of trial and trial operation, AI services analyze CT examinations performed in medical facilities. An expert group of radiologists evaluates the diagnostic accuracy and functional capacity of AI services at all stages. The obtained quantitative metrics of the accuracy of AI services are compared with the target values ​​specified in the requirements. Results:From June 2021 to June 2022, two AI services (AI service №1 and AI service №2) which used different methods for identifying a presence of CF were tested. AI services successfully passed the self-testing stage (6), functional (5) and calibration (100) testing. The ROC AUC for AI service №1 was 0.99 and for AI service №2–0.91. The AI service №1 passed the trial stage without any significant remarks, while AI service №2 was sent for revision. After the trial operation stage, the following accuracy metrics were obtained: the ROC AUC for AI service №1 was 0.93; for AI service №2–0.92. At all stages, both AI services showed sufficient metrics for clinical validation. Conclusions:A testing of the performance of AI services in the direction of “Osteoporosis” was carried out. A high quality of diagnosis was demonstrated. AI services can act as an auxiliary tool in the medical decision support system.

Secondary Bacterial Infections in Critically Ill COVID-19 Patients Admitted in the Intensive Care Unit of a Tertiary Hospital in Romania.

Background: The outbreak of the COVID-19 pandemic caught healthcare systems in many countries unprepared. Shortages of personnel, medicines, disinfectants, and intensive care unit (ICU) capacities, combined with inadvertent use of antibiotics and emergence of drug-resistant secondary infections, led to a surge in COVID-19-related mortality. Objective: We aimed to evaluate the prevalence of secondary bacterial infections and the associated antibiotic resistance in a temporary established ICU dedicated to COVID-19 patients. We also assessed the utility of clinical and routine laboratory data as predictors of secondary infections and mortality in these patients. Methods: We examined the medical records of 243 patients admitted to the COVID-19 Medical Support Unit of Târgu Mures, Romania, between 1 August 2020 and 31 January 2021. Results: Among the 243 patients admitted to the COVID-19 Medical Support Unit of Târgu Mures between 1 August 2020 and 31 January 2021, 59 (24.3%) presented secondary infections. Acinetobacter baumannii and Klebsiella pneumoniae were the most frequent isolates (31.1% and 18.9%, respectively), most of them multidrug resistant. Chronic obstructive pulmonary disease had a higher prevalence in patients who developed secondary infections (p = 0.012). Secondary infections were associated with longer stay in the ICU and with higher mortality (p = 0.006 and p = 0.038, respectively). Conclusions: Early identification of secondary infections and proper use of antibiotics are necessary to limit the spread of multidrug-resistant microorganisms in COVID-19 patients admitted in the ICU.

Highlights From the 2023 Revision of Pediatric Tactical Emergency Casualty Care Guidelines.

In 2023 the Committee for Tactical Emergency Casualty Care (C-TECC) issued updated Pediatric Tactical Emergency Casualty Care (TECC) Guidelines (Guidelines) that focus on the delivery of stabilizing care of children who are the victims of high-threat incidents such as an active shooter event. The Guidelines provide evidence-based and best practice recommendations to those individuals and departments that specifically provide operational medical support to law enforcement agencies caring for children in this uniquely dangerous environment where traditional resources may not be available. This article highlights key takeaway points from the Guidelines, including several updates since the first version was released in 2013.The evidence base for the care of children in this environment is lacking, and medical care delivered in the high-threat environment is inconsistent and often not optimized for the care of infants and children. The Guidelines are supported from the existing literature base where possible, and where it is not, by consensus as to the current best practices as determined by iterative deliberations among the diverse and experienced group of stakeholders who are members of C-TECC. The Guidelines provide patient assessment and management information specific to the care of children in the following 3 dynamic phases of the high-threat environment: Direct Threat, Indirect Threat, and Evacuation. The phases represent a continuum of risk to the patient and the responder ranging from extreme (such as ongoing gunfire) to minimal (during movement toward definitive medical care).The high-threat environment is dynamic and there is competing safety, tactical/operational, and patient care priorities for responders when infants and children are injured. The Guidelines provide recommendations on the type of medical and psychological care that should be considered under each phase of threat and establishes the context for how and why to deliver (or potentially defer) certain interventions under some circumstances in order the maximize the opportunity for a good outcome for an injured pediatric patient. The Guidelines also emphasize the importance of synergizing hospital-based pediatric trauma care with those law enforcement and fire/emergency medical services that may provide field care to children under high-threat circumstances.

Roadmap for rebuilding the health system and scenarios of crisis path in Gaza.

The horrific attacks on Gaza have had a profound impact on Gaza's health system, culminating in a multidimensional crisis. The deliberate destruction of vital infrastructure, such as hospitals, schools, housing, and public facilities, coupled with the deaths and injuries of medical personnel and support workers has only exacerbated the situation and further highlighted the existing gaps. This unprecedented catastrophe proves the criticality of adopting a new national inclusive integrated approach to meeting the immediate and long-term needs of the population. In this perspective, we explore the recovery roadmap features for rebuilding the health system in Gaza, specifically focusing on determining the primary challenges that might emerge, the trajectory of recovery, and the expected crisis scenarios. The existing evidence and perspectives of key stakeholders, including state and non-state health authorities in Palestine were synthesised. Despite some local and international initiatives undertaken to generate a concrete road to recovery, there remains a need for realistic, innovative, and comprehensive Marshall plans to rebuild Gaza's health system. The article draws on insights and gaps in current efforts and underscores the urgent need to address the challenges of rebuilding the health system. The authors strive to offer an inclusive and realistic path with the potential scenarios toward recovery and resilience considering the mass levels of loss and damage, and ways to move forward for building back a resilient health system in Gaza.

The MapMe Body Scales: Validity and Reliability of a Biometrically Accurate, Photorealistic Set of Child Body Size Scales.

It is vital to identify children whose weight status means that they may benefit from medical or behavioural support, but adult visual judgements of child weight status are inaccurate, and children are seldom routinely weighed and measured. Consequently, there is a need for validated visual tools for use in training, communication, and interventions relating to child weight. This paper presents validation data for a set of innovative photo-realistic colour body size scales depicting boys and girls aged 4-5 and 10-11. Each age- and gender-specific scale consists of 7 figures based on three-dimensional (3D) scans of 388 children to accurately represent the change in body size caused by changing adiposity. To assess scale validity, 238 adult participants (105 men, 132 women, 1 non-binary individual) undertook two tasks: rating figure adiposity using a visual analogue scale and ranking figures in ascending order of adiposity (OSF Reference: gdp9j). Participants accurately estimated the relative adiposity of each figure, i.e., they were able to tell the difference between figures and correctly rank them by size. This demonstrates scale validity for use in body size tasks. One hundred and fifty-one participants also provided 3-day test-retest data, which demonstrates excellent short-term reliability. Overall, the MapMe child body size scales provide an anthropometrically accurate, valid, reliable, and usable tool for size-related tasks and communication with adults regarding child weight.

Screening of Pre-Diabetes and Type-II Diabetes Mellitus Among the Personnel of Bangladesh Air Force

Background: Medical Squadron (Med Sqn) of Bangladesh Air Force (BAF) Base Bashar (BSR) has been providing medical support for BAF Base BSR, Air Headquarters, most of the retired officers and their families. It has been observed that the number of Diabetes Mellitus (DM) patient is increasing day by day, and now it becomes a major health problem among the members of BAF, even among the young age group. In view of above, a study was conducted among the BAF uniform members who reported for laboratory investigation to Med Sqn BAF Base BSR. Assessing prevalence of DM among BAF personnel will also help for overall assessment of health problem of BAF personnel to make a preventive guideline. Methods: A descriptive type of cross-sectional study was conducted with available data in the pathological laboratory of Med Sqn BAF Base BSR during the period from 01 July 2021 to 30 Jun 2022. Within this period a total 9269 Air Force uniform members reported for routine as well as diagnostic purpose of checking blood sugar. Associated risk factor like overweight or obesity was also assessed by latest data from personal documents. Age and job pattern wise data were also analyzed. Statistical Package for Social Sciences (SPSS) version 29.0 was used to analyze data. Results: Out of 9269 BAF members a total 683 persons (7.36%) had high (above normal) plasma glucose. Of these 413(60.46%) were diabetic and 270(39.53%) were pre-diabetic (IFG/IGT). Among the 413 diabetic patients 292(42.75%) had fasting plasma glucose (FPG) ≥7 mmol/L as well as post prandial plasma glucose (PPPG) level ≥11.1 mmol/L. Among the 270 pre-diabetic patients 205(30.01%) had FPG level between 6.1-6.9 mmol/L with PPPG level <7.8 mmol/L (Impaired Fasting Glucose/IFG) and 65(9.51%) had FPG level <7 mmol/L with PPPG level between 7.8-11 mmol/L (Impaired Glucose Tolerance/IGT). Conclusion: DM has become a major health concern all over the world. This study attempted to identify the prevalence of age-related factors for DM among BAF uniform members between the ages 30 to 60 years. It has been observed that the prevalence of pre-diabetes is more among the 41 to 45 years age group and Type-II DM among the 46-50 years age group. Bangladesh Armed Forces Med J Vol 57 No (1) June 2024, pp 22-27

Virtual medical astronaut avatars for future deep space missions

This paper explores the telemedicine possibilities available to astronauts during spaceflight, focusing on the possible utilization of medical avatars for continuous health monitoring. Various types and sources of telemedicine are examined, along with their applications in deep space travel to address the challenges faced by astronauts and facilitate timely intervention in case of injuries and illnesses. The use of medical avatars presents a promising solution to mitigate risks and ensure effective healthcare delivery in the absence of immediate physical medical support. Furthermore, potential terrestrial applications of telemedicine and virtual medical avatars are discussed, highlighting the wider implications and benefits beyond space exploration. By leveraging advanced technologies and innovative approaches, telemedicine in conjunction with medical avatars offers a compelling avenue for enhancing healthcare practices both in space and on Earth.

Developing a Comprehensive Inventory to Define Harm Reduction Housing.

Background The City of Boston has faced unprecedented challenges with substance use amidst changes to the illicit drug supply and increased visibility of homelessness. Among its responses, Boston developed six low threshold harm reduction housing (HRH) sites geared towards supporting the housing needs of people who use drugs (PWUD) and addressing health and safety concerns around geographically concentrated tent encampments. HRH sites are transitional supportive housing that adhere to a "housing first" approach where abstinence is not required and harm reduction services and supports are co-located. Despite the importance of HRH, the specific characteristics and operations of these sites are not well understood. This study sought to address this gap by cataloging the common features of Boston's HRH sites to generate a comprehensive inventory tool for evaluating implementation of harm reduction strategies at transitional housing locations. Methods We collected data between June and September 2023 and included semi-structured qualitative interviews with HRH staff (n = 19), ethnographic observations and photos at six HRH sites. Candidate inventory components were derived through triangulation of the data. Two expert medical staff unaffiliated with data collection reviewed a draft inventory measuring awareness and utility of HRH inventory components. We then pilot tested the inventory with 3 HRH residents across two sites for readability and reliability. Inventory performance was further tested in a survey of 106 residents. Results HRH staff identified best practices, resources, and policies in HRH sites that were further contextualized with ethnographic field notes. Common to all were overdose prevention protocols, behavioral policies, security measures, and harm reduction supplies distribution. The initial 44-item inventory of services, policies and site best practices was further refined with expert and participant feedback and application, then finalized to generate a 32-item inventory. Residents identified and valued harm reduction services; medical supports were highly valued but less utilized. Conclusion The HRH inventory comprehensively assesses harm reduction provision and residents' awareness and perceived helpfulness of HRH operational components. Characterizing the critical components of HRH through this tool will aid in standardizing the concept and practice of HRH for PWUD and may assist other cities in planning and implementing HRH.

Microplastics in different nasal irrigation options.

We aimed to assess the presence of microplastics in nasal irrigation methods commonly used in the treatment of sinusitis and rhinitis, and to evaluate human exposure. A total of 150 samples were included in the study, consisting of nasal wash bottles containing nasal irrigation solution, seawater spray, syringes for nasal irrigation with isotonic solution. The amount of microplastics per millilitre in the samples and patient exposure during single use were assessed separately for each method and product. All samples were filtered using a stainless steel vacuum filter on filter paper with a pore size of 1.2μm, washed at least three times with distilled water and incubated at 45°C for 24h to prevent mould growth. Identification and counting of microplastics was performed using a Leica Flexacam C1 camera connected to an M80 stereomicroscope. The presence of microplastics was confirmed by the hot needle method and Nile red staining. An average of 6.49 ± 13.08 microplastics/product was detected in all filtered samples. The lowest microplastic count was 0 microplastics/product in syringes and the highest was 92 microplastics/product in nasal wash bottles. Significant differences in the amount of microplastics individuals were exposed to during a single use were found between nasal wash bottles and seawater brands, while no significant differences were found between syringe brands. When nasal wash kits, seawater sprays and isotonic nasal rinses were evaluated separately, significant differences were found in the number of microplastics, the microplastics/ml ratio and the number of microplastics exposed during a single use. The highest microplastic exposure was found in nasal irrigation bottles. The exposure of individuals to microplastics increases with medical support treatments, regardless of intranasal or intravenous administration. Due to the inflammation, oxidative stress and proliferation caused by microplastics, new regulations and inspections of production conditions should be implemented worldwide to reduce exposure.

Work Experience of Medosmotr39 LLC in Organizing and Conducting Medical Support for the Floating Staff of the Fishing and Scientific Fleet in the Subject of the Russian Federation

There is a problem in the country of comprehensive and competent pre-voyage medical examination of seafarers. Since the implementation of Federal Law no. 326 dated 11/29/2010 On Compulsory medical insurance in the Russian Federation, the issues of compulsory medical insurance in the field of marine medicine have not been resolved. Crew members with chronic diseases are sent on the flight without prior medical examinations. There is no medical worker on the ships, a member of the crew is responsible for the medical part without a license to provide medical care, who does not have the right to provide it, which in turn led to an increase in morbidity and deaths on the voyage. There is no single standardized form of laying first-aid kits on ships, which also affects the health of the crew. This situation prompted the medical organization Medical Examinations 39 to open a Marine Medicine Department at its base, which significantly improved the situation in the region. We also propose to legislate the issue of a single form of packing first-aid kits on flights, the composition of which will depend on the time of year, natural and social conditions of the area to which the sailors will go.

Partnership and relationship happiness in endometriosis related chronic pelvic pain: a multicenter case-control study.

Partnership is an important resource in dealing with endometriosis related chronic pain. Hence, our objective was to assess partnership in the context of endometriosis and its symptoms, considering the perspectives of both individuals involved. The study was designed as a multi-center matched case-control study in Switzerland, Germany and Austria. Altogether 381 women with surgically/histologically confirmed endometriosis and 381 control women, 250 male partners of endometriosis-affected women and 229 of control women were evaluated. Partnership quality, partnership happiness, separation thoughts, and areas of conflict were evaluated through the Partnership Questionnaire and a validated list of conflict areas. Quality of partnership was rated as high by 60.1% of the women with endometriosis and 66.7% of the control women, as well as by 45.8 and 50.2% of their respective partners. Women with endometriosis mentioned separation thoughts, mostly related to sexual satisfaction, more often (34.9%/28.3%) and experienced more partnership-related conflicts than control women. Chronic pain, dyspareunia, dissatisfaction with sexuality, fatigue, and infertility were significantly associated with partnership conflicts. Fatigue and infertility but not pain experiences were related to lower partnership quality. Male partners in both groups reported separation thoughts equally often. In men, a high intensity of pain experienced by their partner was associated with reduced partnership happiness. Given the significance of partnership in dealing with chronic diseases and the connection between symptoms of endometriosis and a decrease in partnership quality, it is essential to incorporate strategies that alleviate the negative impacts on relationships for both partners into medical support. identifier NCT02511626.

Current Congenital Heart Surgery and Pediatric Perfusion Practices in Japan and Vietnam.

The declining birth rate and aging population are becoming increasingly serious social issues in Japan. In this report, we summarize the current congenital heart surgery and pediatric perfusion practices in Japan and Vietnam. In addition we report the rapid growth and development of congenital heart surgery in Vietnam made possible by medical education support provided by Japan over the past decade.

University student suicides in Türkiye: Insights from two decades of media reports

University student suicides have emerged as a significant societal concern, reflecting challenges inherent in the transition to adulthood and academic pressures. This study aims to analyze two decades of national media coverage on university student suicides in Türkiye, examining demographic trends, suicide methods, and social factors implicated in these tragic incidents. A comprehensive scan of Turkish national media archives from January 1, 2004, to December 31, 2023, identified 213 unique reports of university student suicides. Data extracted included age, sex, year of incident, prior suicide attempts, geographic distribution, housing status, academic major, psychiatric history, social background, suicide method, and presence of suicide notes or social media posts. Statistical analyses utilized Fisher's Exact Test and Pearson's Chi-square to examine categorical data. Male students accounted for 61.6% (n=125) of reported suicides, with a mean age of 22.2 years (SD=3.05). The most common suicide method was jumping from height, differing by sex, with hanging prevalent among males and jumping more frequent among females. Mobbing emerged as a predominant social stressor implicated in suicide incidents, surpassing other factors reported in the literature. The findings highlight an alarming increase in media-reported university student suicides, predominantly affecting males and characterized by distinct suicide methods. The pervasive impact of mobbing underscores the urgent need for targeted interventions addressing social stressors, alongside comprehensive medical, psychological, social, and economic support systems within academic settings. Efforts should prioritize proactive mental health initiatives, policy reforms, and community-based interventions to mitigate suicide risks among university students.

EVALUATION OF THE ROLE OF THE ACUTE MEDICAL REGISTRAR IN ORTHOPAEDICS

This project hoped to evaluate a new role, encompassing an in-hours registrar physician being based on the orthopaedic wards for advice, patient reviews, and patient journey optimisation. This service aimed to provide input for all patients who required them outwith the already established ortho-geriatric service.The success of this role was assessed through feedback questionnaires, as well as through the auditing of functional indicators such as the burden on the on-call orthopaedic registrar and other departments for advice from junior doctors, plus the number of medical emergencies.The survey received a total of 42 responses from various staff roles. All respondents thought the role had improved patient care or the functioning of the department. Respondents thought the role primarily enhanced patient care and safety and led to increased support for junior doctors and nursing staff. Data showed a 44% reduction in medical emergency calls since the role began. Total calls outwith the department for medical support reduced by 100% in hours and 50% out of hours when analysed over 22 days. Over a 14 day period, calls to the on-call orthopaedic registrar also reduced by 100% in hours, with no significant difference out of hours.This role has improved patient care and safety and allowed faster medical support with reduced impact on orthopaedic and general medical services. Feedback has been very positive from all staff. The major limitation is lack of 24 hour support. Next steps will include expanding the role, as well as introduction of framework for professional development.

Strengthening the role of primary care for the success of the community care system

Background: Globally, population aging is a widespread phenomenon. However, Korea is experiencing this demographic shift at the fastest rate globally. As the number of older adults increases, the local primary healthcare system has become increasingly important in supporting them to maintain their lives within the community.Current Concepts: The integrated medical support project is systematic and comprehensive, focusing on services provided by primary care providers. The project requires a tailored implementation plan specific to the community for long-term operations. Therefore, providers need to explore roles and collaborative measures to establish a sustainable system of primary care-centered supportive care for elderly patients.Discussion and Conclusion: Local governments must identify patients, establish a cooperative system, manage and entrust patient information and communications technology (ICT), educate ICT users, and secure a budget to integrate and provide medical care in the community effectively. The local medical association should establish and operate a medical and healthcare support center, coordinate a consultative body between medical institutions, and implement a 24-hour patient response system. The proposed medical and healthcare support center will facilitate cooperation and comprehensive evaluation during home visits by primary care doctors. This center can also connect patients needing care by collaborating with local care-related organizations. In addition to providing home-visit services, primary care institutions must establish a system for conducting comprehensive patient evaluations with medical care support teams. Additionally, the recommendation is to incorporate elements beyond home-visit treatment fees to facilitate the systematic and intensive management of patients.

Challenges Faced By Families of SMA Patients

SMA, a genetic neuromuscular disease that affects the control of muscle movement and results in severe motor disorders, is among the rare diseases. Due to the low prevalence of rare diseases and serious problems with correct diagnosis, there may be delays in diagnosis. When the studies on SMA are examined, it is known that the issues related to diagnosis are mostly emphasised, but a limited number of studies have been conducted on the current issues of patients with SMA or their caregivers. In addition to studies on treatment, it would be useful to consider the patient and his/her environment together in studies on the quality of life of patients and caregivers. Examining the concept of quality of life in SMA disease will form the basis for studies on quality of life, and at the same time, the continuity of studies on the subject will be ensured. In this sense, current issues the treatment of patients diagnosed with SMA was addressed in this study. The fact that these patients experience significant deficiencies such as respiratory impairment, malnutrition and skeletal deformity causes them to face difficulties in meeting their basic needs, especially in nutrition and toileting. These problems reduce the quality of life of patients and their relatives. Therefore, early diagnosis and providing medical, psychological, and social support to patients and their relatives will be effective in their quality of life. In this review, recommendations were made to address the current issues of SMA patients and their relatives.

Use of telemedicine for trauma care since the Russian invasion of Ukraine: A qualitative assessment.

Ukraine's health and trauma system has been detrimentally impacted since the start of the Russian invasion in February 2022. Use of telemedicine became critical to providing timely medical care. As such, the aim of this study was to describe telemedicine's use in the health and trauma system of Ukraine following the full-scale invasion. We conducted qualitative key informant interviews with military and civilian health care workers using an expanded version of the Global Trauma System Evaluation Tool which had components focusing on telemedicine use. Thematic content analysis was used to derive key telemedicine themes from interviews. We conducted 36 key informant interviews. Most respondents described using telemedicine through informal means of communication such as messaging apps to meet patient care needs. Concerns and challenges with use of telemedicine included weapons targeting, internet connections and safety of communications from Russian hackers. A unified system for telemedicine would greatly improve use in country both during and post conflict. Telemedicine use has rapidly increased in Ukraine during the current conflict particularly in the scope of providing trauma care when numerous specialties are needed. Development of a unified, secure telemedicine system with mechanisms for integrating multinational medical support would aid in providing swift medical care to persons injured in the conflict or unable to access a specialty provider in their proximity.

An electrocardiogram signal classification using a hybrid machine learning and deep learning approach

An electrocardiogram (ECG) is a diagnostic tool that captures the electrical activity of the heart. Any irregularity in the heart's electrical system is referred to as an arrhythmia, which can be identified through the analysis of ECG signals. Timely diagnosis of cardiac arrhythmias is crucial in order to mitigate their potentially harmful consequences. However, manual analysis of ECG signals is time-consuming and prone to inaccuracies. Therefore, researchers have developed medical decision support systems that utilize machine learning techniques to automate the analysis of ECG signals. In this study, we propose a novel method for classifying ECG signals into four distinct types of heartbeats: normal, supraventricular, ventricular, and fusion. Our method consists of two subsystems that integrate both machine learning and deep learning approaches. The first subsystem uses a residual network block to extract features from the input ECG signal, followed by an LSTM network for learning and classification of these features. The second subsystem uses several feature extraction methods and a random forest to classify the ECG signals. Furthermore, it employs a Synthetic Minority Over-Sampling Technique to improve dataset balance and overall performance. The ultimate result is achieved by merging the results of both subsystems together. An assessment of our approach was carried out on the MIT-BIH dataset, which acts as a recognized ECG signal classification benchmark. Our technique attained an impressive accuracy rate of 99.26%, ranking it as one of the most superior methods in the current literature. Our findings demonstrate the effectiveness and efficiency of our approach in accurately classifying ECG signals for arrhythmia detection.