Remote screening of athletes' condition dynamics based on the analysis of cardiointervalograms using the Dirichlet distribution

Health of people involved in sports is an important social problem and requires modern methods of control, including directly during training and competitions. The article discusses the possibilities of a diagnostic method based on the assessment of heart rate variability. Unlike most of the methods used, the analysis is based on the fact that complex multi-level hierarchically organized systems can be described in the framework of non-equilibrium thermodynamics, in particular, the statistical Dirichlet distribution model. The authors propose a system of indicators that allow remote monitoring of the current state of the body, describe hardware and software solutions, and consider the prospects for using the proposed method in sports medicine.

Telemedicine technologies for organizing the work of mental health services to prevent disorders of the depressive spectrum during the COVID-19 pandemic

Introduction. The problems of telepsychiatry are analyzed from the point of view of the method of information modeling of complex conflict systems. Materials and methods. Methodological approaches to the use of information technologies for monitoring mental health and prevention of depressive spectrum disorders during the COVID-19 pandemic, including in the young generation of representatives of the indigenous peoples of the North and the Amur region, are considered. Results. The proposed telepsychiatric method of providing medical and psychiatric services is most effective in preventing depression in remote areas of the Khabarovsk territory where distance is a critical factor, during the COVID-19 pandemic. Discussion. Remote recording of cases of depression due to depression in patients with coronavirus, adequate teleconsultation and prevention of panic attacks and phobias will reduce the severity of the chronic course of depression and the risk of suicide. Conclusions. An actual solution to psychiatric problems associated with the COVID-19 pandemic is proposed for remote regions where, in addition to the existing problems of social and medical infrastructure, there is also a significantly increased risk of concomitant socially significant mental illness. It will be useful for specialists in early diagnosis and prevention of mental disorders, tele-medicine, mathematical modeling, system analysis in medical psychology, as well as for psychiatrists and psychotherapists.

The use of inventive activity results in the work of Department of Orthopedic Denticity: digital and additive technologies

Introduction. We examined the results of scientific activity of the department of orthopedic denticity of Donetsk National Medical University on invention and digital technologies for 2020, as well as the possibility of their implementation in the educational process and industrial practice. All developments relate to the field of orthopedic dentistry and are intended for dental prosthetics. Aim. To analyze the possibility of using the inventive activity results in the work of the department of orthopedic dentistry in teaching the discipline «Clinical orthopedic dentistry». Materials and methods. We proposed several developments, the main purpose of which was the use of digital technologies in dental prosthetics with removable dentures. Results. Scientific developments were introduced into the educational process of the department in field of teaching the discipline «Clinical orthopedic dentistry». Certain techniques are also tested in dental facilities of various forms of ownership. Conclusion. We noted that the consideration and analysis of new developments in the relevant classes, the comparison of their effectiveness with existing analogues arouses interest among students, and in result, stimulates students to rationalization and inventive activity. The results of such work can be realized both during the educational process and during practical training.

Automation of COVID-19 detection in pregnant womens

Introduction. In the article we discuss the use of information technology in obstetric care during the COVID-19 pandemic. The aim was reached by continuous monitoring of all cases of upper respiratory infection in pregnant women, women in labor and postpartum women in each specific medical organization and in the whole Sverdlovsk region with subsequent information digiti- zation and automated analysis of different COVID – 19 forms: suspicious, probable and confirmed. Materials and methods. «Regional obstetric monitoring (AIST «ROM») digital system was used for automated COVID-19 diagnosis in pregnant women, women in labor and postpartum women, as well as for detection of suspicious cases. AIST «RAM» allows to analyze patient’s epidemiological data and objective indicators of their physical status and automatically generate signal information. Results. The automatic analysis of the data on the COVID-19 situation in the region is implemented. A register of pregnant patients with COVID-19 is being formed, taking into account the severity of the disease and gestation time. A situational awareness is main- tained using the algorithms of AIST «ROM»: each participant of the process receives information about patient’s condition and his passage through the routing stages. Conclusions. A database, containing information about pregnant and postpartum women, who have COVID-19, is created. This data could be used in further large-scale studies.

Matrix for direct-to-consumer telemedicine quality assessing

Introduction. The growing demand for online medical services, the active inclusion of telemedicine consultations in state health insurance programs, and the general intensive development of telemedicine require a methodology for quality assurance and control. Objective is to develop a methodological basis for a comprehensive assessment of the quality and effectiveness of direct-to-consumer telemedicine consultations. Material and methods. There are sources of primary data: systematizing scientific publications (descriptions of models and methodologies for telemedicine quality assessing); own theoretical researches, accumulated practical experience with of directto-consumer telemedicine. Methods of analysis and synthesis have been use. Results and discussion. The matrix for for direct-to-consumer telemedicine quality assessing has formed. It includes four domains «Accessibility», «Efficiency», «Safety» and «Responsibility» from the standpoint of all participants of the distant interaction processes: patient and/or legal representative; medical consultant; operator of a telemedicine information system; medical organization; health care system (society). The matrix takes into account the aspects of goal-setting and the interests of each participant. There are structured metrics in frame of each domain. Conclusions. The matrix can be used as a basis for scientific research and as a methodology for internal and departmental quality control of medical care provided via telemedicine technologies.

Regional caesarean section register «C-Register» – experience of digitalization of operative obstetrics on the example of the Sverdlovsk region

Introduction. Caesarean section is one of the most common surgical procedures in the world and its frequency continues to increase, especially in developing and developed countries. While caesarean section can save lives, it is often performed without medical indications, putting women and their children at risk of high morbidity in the short or long term. Aim. To create a single digital regional database of all caesarean section procedures. To automatize the analysis of medical organizations in online format. To conduct a continuous online monitoring of surgical interventions in obstetrics. Materials and methods. It was decided to develop and introduce the regional register of cesarean sections «CesRegister» in the Sverdlovsk region as a structural and functional module of the automated information system «Regional Obstetric Monitoring» (AIST «RAM»). The goal of the system is to improve the quality of medical care for pregnant women and improve the systems for supporting medical decision-making in the operational obstetrics as well as to automatize the analytics of obstetric care institutions activities, including the Robson classification. Results. AIST «RAM» allowed to collect the data on caesarian sections performed from the electronic medical records. This information, collected before the introduction of the register, provided the possibility of automated analytics and implementation of the systems for supporting medical decision-making in the operational obstetrics. Conclusions. «CesRegister» can help to reduce the percentage of repeated cesarean sections by providing information about previous births online and enabling doctors to quickly make the right and safe decision on the management of pregnancy and childbirth.

Remote health monitoring: motivating patients

Introduction. There is currently a great number of mobile apps and devices for remote monitoring of biometric indicators used by patents and healthy people. Aim. The purpose of the paper is to review principles and methods of patient motivation for active using of mobile apps and devices for health state estimation. Matireals and methods. We conducted the analysis of 66 scientific sources for the last 5 years, 32 sources related to this theme were selected. We also used our experience of 250 000 remote consultations of urological patients. Results. Physicians should actively involve patients in care of their health – explain advantages of using mobile apps which allow to monitor health state and its changings in real time. Thus it will allow to react to emerging disfunctions, to correct them and to prevent complications or fatal outcome. In spite of evident prospectivity of remote health monitoring we can highlight several difficulties and risks, connected with it, such as low physicians’ motivation, increasing of their labor costs, safe personal and medical data storage, inaccurate and excessive data, difficulties of systematization, slow decrease of patients adherence to using mobile apps. Conclusions. The application of devices and apps for remote monitoring of health indicators is greatly promising as a source of secondary diagnostic information. Further research for clarification of remote technologies influence on clinical outcome is required. Long work for enlightenment and promoting patients’ and physicians’ interest is to be done before telemonitoring devices will occupy a niche in the healthcare system.

Application of telemedical technologies in neurology – a historical aspect

Introduction. In the middle of the twentieth century, biotelemetry technologies were actively used in neurology, in the form of remote transmission and interpretation of an electroencephalogram (tele-EEG) for solving scientific and practical problems. Previously, this aspect of the development of clinical neurology has not been studied sufficiently. Materials and methods. The period of 1940-1980 was chosen for study. The relevant papers were identified thought electronic database (eLibrary ru, Pubmed). There are 28 papers are included in review. Results. In a global prospect, tele-EEG concepts, methods and technologies have evolved in parallel. The main contribution of the USSR is the development of methodology and technological solutions for tele-EEG, also as its application for solving scientific problems of sports and occupational medicine. The most significant are the works of the Sverdlovsk biotelemetric group. The main contribution of the USA is the development of computational tele-EEG and applications for scientific solutions in clinical neurology and psychiatry. Also, in the United States, tele-EEG was first limitedly used to solve personnel problems. The main contribution of European countries is in the formation of in-hospital and outpatient tele-EEG systems, their application for solving scientific problems of clinical neurology. Conclusion. In the middle of the twentieth century, the intensive development of telemetric electroencephalography (tele-EEG) led to the formation of a new direction in clinical telemedicine – teleneurology. Distant fixation of the brain electrical activity carried out both for the purpose of neurophysiology study and for solving clinical problems. General methodological issues and neurophysiological results of the tele-EEG highlighted in papers published in 1974-1977 by scientists from the USSR, USA, Hungary, Germany, Canada, the Netherlands, France. From the clinical point of view, the main contribution of tele-EEG is the study of the pathophysiology and innovative diagnosis of seizure syndrome and epilepsy.

Remote cognitive behavioral psychotherapy for stress disorder associated with the COVID-19 pandemic

This article presents for the first time the symptoms of pandemic-related stress disorder. The article describes the general specifics of remote cognitive behavioral psychotherapy in the context of the COVID-19 pandemic, highlights its advantages and disadvantages. The components of remote examination of the mental state of a patient with a pandemic stress disorder are described. The modules and effectiveness of the short-term protocol of cognitive behavioral psychotherapy Anderson's approach is aimed at influencing the patient's viral anxiety by minimizing dysfunctional strategies for regulating emotions (anxiety rumination, catastrophization, health anxiety) and replacing them with more flexible ones (acceptance and responsibility, a sense of optimal awareness, a positive time perspective for the future, decatastrophization). The Protocol of remote trauma-oriented cognitive behavioral psychotherapy and its effectiveness.

Regional oncological service informatization: work support system of the oncological service

Requirements to the modern information systems become more complicated. Nowadays it is not enough just to collect data and to ascertain the result. Work support system of the oncological service (WSSO) allows to prevent defects in patient diagnostic and treatment management in real time mode. Regional oncological information system ONCOR performs this role in Sverdlovsk region. ONCOR is a part of State information system. It aggregates data from different sources: medical organizations, primary oncology offices, healthcare department, compulsory health insurance fund, insurance companies etc. The results of WSSO introduction in Sverdlovsk region are presented in this issue. First it led to the shortening the term of routing the patients with malignant tumors from the first visit to the medical organization at the place of residence to the specialized organization. Mean time from the first visit of doctor till the referral to the regional oncology dispensary grew from 20 to 32 days as the electronic entry throughout ViPNet was introduced. It was reduced from 32 to 18 days thanks to WSSO. The time from referral till actual doctor’s appointment is under the responsibility of regional oncology center. WSSO allows to control this index, to reveal the problem key points and to affect them. This time was reduced from 14 to 5 days. The second part of the issue is devoted to the veracity of WSSO data which are controlled throughout the integration and coordination with different information systems. As an example, the dynamic of early detection of malignant tumors is presented. The share of I-II stages has changed from 53% to 57%.