Feasibility of Live Video Feed Transmission from Unmanned Aerial Vehicles for Medical Surveillance During the 2022 Montreal Marathon.

INTRODUCTION: In recent years, unmanned aerial vehicles (UAVs) have been increasingly used for medical surveillance purposes in mass-gathering events. No studies have investigated the reliability of live video transmission from UAVs for accurate identification of distressed race participants in need of medical attention. The aim of this study was to determine the proportion of time during which live medical surveillance UAV video feed was successfully transmitted and considered of sufficient quality to identify acute illness in runners participating in the 2022 Montreal Marathon (Canada). METHODS: Four UAVs equipped with high-resolution cameras were deployed at two pre-defined high-risk areas for medical incidents located within the last 500 meters of the race. The video footage was transmitted in real-time during four consecutive hours to a remote viewing station where four research assistants monitored it on large screens. Interruptions in live feed transmission and moments with inadequate field of view (FOV) on runners were documented. RESULTS: On September 25, 2022, a total of 6,916 athletes ran during the Montreal Marathon and Half Marathon. Out of the eight hours of video footage analyzed (four hours per high-risk area), 91.7% represented uninterrupted live video feed with an adequate view of the runners passing through the high-risk areas. There was a total of 18 live feed interruptions leading to a total interruption time of 22 minutes and 19 seconds (median interruption time of 32 seconds) and eight distinct moments with inadequate FOV on runners which accounted for 17 minutes and 33 seconds (median of 1 minute 47 seconds per moments with inadequate FOV). Active surveillance of drone-captured footage allowed early identification of two race participants in need of medical attention. Appropriate resources were dispatched, and UAV repositioning allowed for real-time viewing of the medical response. CONCLUSION: Live video transmission from UAVs for medical surveillance of runners passing through higher risk segments of a marathon for four consecutive hours is feasible. Live feed interruptions and moments with inadequate FOV could be minimized through practice and additional equipment redundancy.

Clinical characteristics of patients from Quebec, Canada, with Morquio A syndrome: a longitudinal observational study.

BACKGROUND: Morquio A syndrome is a rare, autosomal recessive, progressively debilitating disorder, with multi-system impairments and high medical burden. Quebec, Canada has a large Morquio A population, which is considered unique due to the presence of founder pathogenic variants. The objectives of this study were to document the genetic and clinical heterogeneity of patients with Morquio A in Quebec, to better characterize the phenotype of those with the French Canadian founder pathogenic variant (NM_000512.5: c.1171A>G, p.Met391Val), and to describe the natural history of the patients treated with elosulfase alfa enzyme replacement therapy. Patients with Morquio A were genotyped for pathogenic variants in the lysosomal enzyme N-acetylgalactosamine-6-sulfatase. Clinical data were retrospectively collected from medical charts of patients and included medical history, height, physical examination, respiratory function tests, electrocardiogram, echocardiogram, endurance in the 6-min walk test (6MWT), and activities of daily living (ADL) as assessed by the Mucopolysaccharidosis Health Assessment Questionnaire (MPS-HAQ). Longitudinal data were collected retrospectively and prospectively for patients treated with elosulfase alfa. RESULTS: A total of 33 patients, aged 5-63 years, were included in the analysis. Patients with the founder pathogenic variant (n = 17) generally exhibited a non-classical form of Morquio A. As compared with patients with a non-founder pathogenic variant (n = 16), these patients were generally taller, had greater endurance and were better able to perform ADL. However, they still had significant musculoskeletal disease. Most of the 26 patients treated with elosulfase alfa, regardless of pathogenic variant, showed improvements in endurance and ADL. After 5 to 12 months of treatment, the mean improvement from baseline in the 6MWT was 23% and 10 of 14 patients improved in at least one MPS-HAQ domain. Endurance and ADL generally continued to improve or maintained stable in the long term (up to 7 years). Four out of 19 treated patients with echocardiogram data at follow-up showed progression of cardiac disease. CONCLUSIONS: In Quebec, Canada, Morquio A frequently manifests as a non-classical form of the syndrome due to a founder effect. Patients treated with elosulfase alfa generally show long-term improvement or stability in endurance and function, regardless of pathogenic variant.

Specification of an integrated information architecture for a mobile teleoperated robot for home telecare.

OBJECTIVE: The objective of this study was to design effectively integrated information architecture for a mobile teleoperated robot in remote assistance to the delivery of home health care. METHODS: Three role classes were identified related to the deployment of a telerobot, namely, engineer, technology integrator, and health professional. Patients and natural caregivers were indirectly considered, this being a component of future field studies. Interviewing representatives of each class provided the functions, and information content and flows for each function. Interview transcripts enabled the formulation of UML (Universal Modeling Language) diagrams for feedback from participants. The proposed information architecture was validated with a use-case scenario. RESULTS: The integrated information architecture incorporates progressive design, ergonomic integration, and the home care needs from medical specialist, nursing, physiotherapy, occupational therapy, and social worker care perspectives. The integrated architecture iterative process promoted insight among participants. The use-case scenario evaluation showed the design's robustness. CONCLUSIONS: Complex innovation such as a telerobot must coherently mesh with health-care service delivery needs. The deployment of integrated information architecture bridging development, with specialist and home care applications, is necessary for home care technology innovation. It enables continuing evolution of robot and novel health information design in the same integrated architecture, while accounting for patient ecological need.

Function and health status in surgically treated bone metastases.

UNLABELLED: In a prospective study, we evaluated if surgery substantially improved functional and quality of life outcomes in patients with nonspinal bone metastases. Sixty-seven patients were followed up prospectively. The Short Form-36, the Musculoskeletal Tumor Society 1987 form, the Musculoskeletal Tumor Society 1993 form, and the Toronto Extremity Salvage Score were administered preoperatively and 6 weeks and 3 months postoperatively. Fifty percent of the patients had pathologic fractures. Intramedullary nailing was done in 36 patients, prosthetic replacement was done in 24 patients, and plating was done in five patients. The average postoperative survival was 8 months. At 6 weeks, 13 patients had died and seven were lost to followup. Twenty-one percent of patients had complications, although only 4.5% needed additional surgery. The patients' Musculoskeletal Tumor Society 1987 form, Musculoskeletal Tumor Society 1993 form, and Toronto Extremity Salvage Score scores improved at 6 weeks and 3 months postoperatively. There were no improvements in the Short Form-36 mental and physical summary scales of the patients. The number of patients using pain medication did not decrease. Patients had functional improvements after surgical treatment of bone metastases, even patients with a limited life expectancy. Future prospective studies should anticipate a high rate of attrition with this population from death and loss to followup. LEVEL OF EVIDENCE: Prognostic study, Level I (high quality prospective study-all patients were enrolled at the same point in their disease with > or = 80% followup of enrolled patients). See the Guidelines for Authors for a complete description of levels of evidence.