Subočius, Andrėjus

The common ACTN3 R577X polymorphism leads to α-actinin-3 deficiency in ~20% of the human population and may be detrimental to their muscle power. However, the impact of ACTN3R577X on metabolic health and exercise capacity in the general population remains unclear. The objective of the current study was to compare metabolic health markers, musculoskeletal traits, and cardiorespiratory capacity between untrained overweight α-actinin-3-deficient (XX; 20 men and 19 women) and α-actinin-3 expressing (RR; 20 men and 21 women) individuals. The participants were aged 43 ± 7 years and had a BMI of 28.6 ± 3.2 kg·m-2. Various metabolic health and exercise capacity aspects encompassing segmental body composition, bone density, systemic low-grade inflammation, blood lipid profile, whole-body glucose tolerance and insulin sensitivity, resting and exercise metabolism, and exercise capacity were evaluated. While XX groups had lower fat-free mass than RR groups, other anthropometrical and body composition features, including bone mineral content, did not differ between the genotype groups in either women or men. We found no significant differences between XX and RR individuals for blood lipid profile, markers of systemic inflammation, glucose tolerance, resting metabolism, and leg strength. Moreover, no clear genotype-related differences were observed in markers of insulin resistance and sensitivity, although XX women exhibited a slightly smaller increase in insulin concentration than RR women during an oral glucose tolerance test. An incremental cardiopulmonary cycling test revealed no differences in metabolic and heart rate responses, maximal fat oxidation, or exercise capacity. In conclusion, we observed no associations between α-actinin-3 deficiency and metabolic health, body composition, muscle function, or cardiorespiratory capacity in untrained overweight men and women.

Technological advancements have profoundly reshaped healthcare systems, transforming workflows, communication, and education. This paper explores the integration of digital health innovations, including electronic health records (EHRs), artificial intelligence (AI), and virtual reality (VR), within Lithuanian healthcare institutions, educational settings and research initiatives. It emphasizes the pivotal role of health care professionals and nursing informatics in adapting to digital transformation, while also addressing key challenges such as digital competence, system usability, and implementation costs.

At Lithuania’s largest hospital, Kaunas Clinics, digital systems such as Hospital Information Systems (HIS, AREST), and automated monitoring tools are enhancing care coordination and clinical decision-making. A case study from Kėdainiai District Hospital highlights disparities in digital competence between nurses and nursing assistants, underscoring the need for systematic and personalized training programs.

In healthcare education, the Lithuanian University of Health Sciences (LSMU) incorporates simulation technologies, VR, and AI to strengthen students’ clinical reasoning and technical skills in safe, immersive environments. The paper also presents a collaborative initiative with Kaunas University of Technology (KTU) to develop an AI-and XR (extended reality)-based educational model focused on critical clinical scenarios, such as the management of anaphylactic shock. Despite technical and linguistic barriers, innovations like GPU-accelerated speech recognition and AI-driven virtual patients offer promising solutions to enhance health care students’ critical thinking and decision-making in acute care settings.

The authors conclude that the integration of advanced digital technologies and interdisciplinary innovations in both healthcare practice and education not only improves clinical workflows and patient outcomes but also transforms medical training. This ensures future professionals are equipped with the skills and tools essential for delivering high-quality care in modern clinical environments. The paper further highlights the importance of interdisciplinary collaboration in research as a driving force shaping the future of digital health.

Introduction Bilateral partial hand amputations severely reduce function. Losing multiple fingers, especially thumbs, which provide about 40 % of hand function [1] limits grasp and independence. Crush injuries often cannot be fully reconstructed [2]. Partial hand prostheses fill a gap when reconstructive surgery is not possible [3]. Modern 3D scanning and printing allow rapid individualised prostheses. Case Presentation A 62 y music performer’s hands were crushed by a press, causing traumatic amputations of all fingers except the right thumb and index, part of the left thumb. Emergency surgery involved debridement, osteosynthesis of the remaining digits, attempted replantation. Nonviable fingers were amputated. Over the next year the right index developed chronic osteomyelitis with a comminuted fracture. After failed conservative care, sequestrectomy and Masquelet technique with a polymethylmethacrylate (PMMA) spacer reinforced the bone. Prostheses were considered only when no other treatments remained. Once the wounds healed, palms were laser scanned with a HandySCAN 700 to capture residual anatomy. Anonymised 3D scans were transferred into Fuse CAD to create digital models of a mechanical left hand prosthesis with custom sockets, finger segments. Discussion Digital fabrication provided precise, patient specific prosthesis. Reports show that custom 3D printed devices improve grasp and fit [4]. A mechanical design was chosen because body powered prostheses are lighter and more durable than myoelectric prostheses [5]. The HandySCAN 700 captures up to 480000 measurements s⁻¹ using laser triangulation enabling accurate custom prosthetic design [6]. Although many body powered partial hand devices can be coupled to preserved joints, digits this case used a self contained mechanical prosthesis without residual finger actuation. Masquelet technique reinforced the index finger. Its PMMA spacer fills bone cavities and provides structural support [7]. Conclusions Digital 3D scanning and CAD based fabrication produced a custom mechanical partial hand prosthesis that should restore functional grasp and improve the patient’s independence. Precisely matched to the residual palm this printed lightweight body powered device provided a stable, comfortable interface and may offer a feasible option when multiple digits are amputated and not reconstructable.

Surgical services were poorly prepared for the COVID-19 pandemic, leading to widescale disruption to elective activity. This study aimed to identify actionable priorities to strengthen pandemic preparedness of surgical and hospital systems.

Restoration of surgical capacity is essential to post-COVID-19 recovery. This study explored the use and safety of anaesthesia options for inguinal hernia surgery, a common tracer condition, to describe current global practice and highlight opportunities to build the capacity of health systems.

The growing complexity of healthcare systems and the imperative for collaborative practice underscore the pressing need to innovate interprofessional education. This paper presents a multidimensional pedagogical framework that integrates blended classroom-based learning, high-fidelity simulation (HFS), and AI-enhanced extended reality (XR) technologies to develop interprofessional competences and improve preparedness for emergency care. Grounded in socio-constructivist and student-centred educational theories, the approach combines theoretical knowledge acquisition with immersive and experiential learning environments that reflect the realities of clinical practice. HFS provides a controlled setting to cultivate critical thinking, decision-making, and collaborative skills. In parallel, AI-enhanced XR introduces adaptive, gamified scenarios that foster digital competence, emotional resilience, and situated cognition. Together, these elements form a cohesive educational strategy that prepares nursing, midwifery, and medical students for high-stakes clinical situations such as anaphylaxis and trauma care. The framework contributes to enhanced patient safety, learner engagement, and the cultivation of future-ready professionals. It also responds to international calls for digital transformation and innovation in healthcare education. By harmonising traditional teaching methods with emerging technologies, this framework offers a globally relevant, scalable solution for advancing interprofessional learning across diverse healthcare contexts.

Traditional surgical training faces challenges related to sustainability, cost, and ethical considerations. Limited access to resources, ethical concerns about cadaver-based learning, limited availability of surgical cases, and the high costs associated with hands-on training impede the effectiveness and accessibility of surgical education. Despite these challenges, the need for direct tactile experience remains critical, as it fosters the development of essential motor skills and tactile abilities vital for surgical practice. However, advancements in immersive technologies such as virtual reality (VR), augmented reality (AR), and haptics offer a promising solution to address these challenges. VR and AR technologies offer realistic, controlled environments where learners can visualise anatomical structures and practice surgical procedures without risks. The integration of haptic feedback in these immersive simulations further enriches the learning process by adding the sense of touch and physical interaction, aiding in mastering critical surgical skills. The incorporation of immersive technologies in surgical training presents an opportunity to address the constraints of conventional methods. These technologies offer the possibility of creating platforms that replicate real-life surgical scenarios, allowing learners to hone their skills and build confidence in a safe and controlled environment. Moreover, immersive learning offers an ethical alternative to cadaver-based training and extends access to training materials irrespective of geographical limitations. Such an approach allows for step-based training, where students may begin acquiring skills through immersive learning, then move to special surgical simulators, and finally to patients. This article deals with the impact of immersive technologies such as VR, AR, and haptics on reshaping conventional surgical training, by focusing specifically on basic surgical skills. Targeting educators, medical experts, and involved parties, the article aims to stimulate additional exploration and adoption of immersive technologies to elevate surgical competencies and patient care standards.

Introduction Learning surgical skills is crucial in surgeons’ training, as it affects patients’ survival and the risk of complications. Traditional apprenticeship model, while of the highest fidelity, offers limited hands-on practice due to safety concerns, time constraints, and resource shortage, therefore there is a need to explore innovative simulation technologies [1-4]. Evidence shows that virtual simulators play a significant role in surgical training. LSMU has implicated the novel platform for mannequin-type simulation and peer-to-peer learning based education and training of surgical skills [5,6]. Evaluating the efficacy of these simulations requires considering both mentor feedback and trainees’ satisfaction, self-confidence, and motivation [7]. Aim Aim of this study is to evaluate how medical students assess the design features of surgical skills simulations developed for their training. Methods The study included 82 third-year medical students enrolled in a practical surgical skills simulation course who provided informed consent. Conducted in 2024, the study had no exclusion criteria. Hybrid simulation training is unique for its real-life algorithm designs (surgical instrument etc.) and simulators. The Simulation Design ScaleStudent Version (SDS) was utilized, consisting of five subscales: objectives and information, support, problemsolving, feedback/guided reflection, and fidelity. Students rated items on a five-point scale from 1 (strongly disagree) to 5 (strongly agree), with higher scores indicating greater recognition of simulation design features. The Lithuanian University of Health Sciences Bioethics Centre approved the study protocol (No. 2024-BEC2-1273). Data analysis was performed using IBM SPSS for Windows 29.0, calculating average SDS scores and employing numerical characteristics such as mean, standard deviation, and Spearman correlation coefficients. P values less than 0.05 were considered statistically significant. Results Students identified key simulation design features as follows: scenarios resembling real-life situations (4.55, SD 0.78), incorporation of real-life factors (4.54, SD 0.81), clear information for problem-solving (4.48, SD 0.89), opportunities for guidance and feedback post-simulation (4.46, SD 0.87), and sufficient initial direction (4.39, SD 0.88). Additionally, personal interest in surgical skills correlated positively with all SDS subscales: objectives and information (r=0.478, p<0.001), support (r=0.441, p<0.001), problem-solving (r=0.316, p=0.005), feedback (r=0.460, p<0.001), and guided reflection (r=0.316, p=0.029). Conclusions Medical students provided positive evaluations of surgical skills simulation design features. The findings suggest that the educational practices and characteristics of simulation design are vital for ensuring a high-quality learning experience for medical students.

Sveikatos priežiūros skaitmenizavimas sudaro sąlygas geresnei prieigai prie pacientų duomenų, didina sveikatos priežiūros specialistų produktyvumą, taupo laiką, užtikrina didesnį pacientų saugumą ir mažina klaidų riziką, taip pat gerina pacientų pasitenkinimą teikiamomis paslaugomis. Skaitmeninė darbuotojo kompetencija apima patikimą, kritinį ir atsakingą skaitmeninių technologijų naudojimą bei nuolatinį mokymą(si) naudotis šiomis technologijomis darbe ir visuomeniniame gyvenime. Siekiant užtikrinti, kad būsimi sveikatos priežiūros specialistai būtų pasirengę dirbti elektroninės sveikatos priežiūros srityje, būtina integruoti skaitmenines technologijas į studijų programas.

Background. Pulmonary complications are the most common cause of death after surgery. This study aimed to derive and externally validate a novel prognostic model that can be used before elective surgery to estimate the risk of postoperative pulmonary complications and to support resource allocation and prioritisation during pandemic recovery.