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Search Results (267)

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12 pages, 471 KB  
Article
Impact of CPAP Therapy Adherence on Time to First Recurrence of Paroxysmal Atrial Fibrillation in Patients with Severe Obstructive Sleep Apnea
by Petar Kalaydzhiev, Radostina Ilieva, Natalia Spasova, Slavi Yakov, Dimitar Markov, Neli Georgieva, Elena Kinova and Assen Goudev
Life 2026, 16(3), 389; https://doi.org/10.3390/life16030389 - 28 Feb 2026
Viewed by 195
Abstract
Background: Obstructive sleep apnea (OSA) is a major modifiable risk factor for atrial fibrillation (AF), promoting arrhythmogenesis through intermittent hypoxia, autonomic activation, and atrial remodeling. Although continuous positive airway pressure (CPAP) effectively treats OSA, real-world evidence linking objectively measured CPAP exposure to [...] Read more.
Background: Obstructive sleep apnea (OSA) is a major modifiable risk factor for atrial fibrillation (AF), promoting arrhythmogenesis through intermittent hypoxia, autonomic activation, and atrial remodeling. Although continuous positive airway pressure (CPAP) effectively treats OSA, real-world evidence linking objectively measured CPAP exposure to clinically relevant AF recurrence remains limited. Aims: We aimed to evaluate the association between CPAP adherence and risk of recurrent paroxysmal AF, and to compare time to first recurrence between patients with mean nightly CPAP use ≥4 h/night versus <4 h/night. Materials and Methods: In this prospective observational cohort (2017–2024), consecutive hospitalized and outpatient adults with severe obstructive sleep apnea (OSA; apnea–hypopnea index > 30 events/h) and documented paroxysmal atrial fibrillation (AF) were enrolled. Persistent and long-standing persistent AF were excluded to ensure a homogeneous population with respect to atrial substrate. OSA was assessed using home sleep apnea testing (ResMed ApneaLink), and all patients initiated continuous positive airway pressure (CPAP) therapy (ResMed AirSense 10). Objective adherence data were obtained via the ResMed AirView telemonitoring platform. Exclusion criteria included permanent AF, prior pulmonary vein isolation, central sleep apnea, left ventricular ejection fraction < 50%, end-stage chronic kidney disease (eGFR < 15 mL/min/1.73 m2 or dialysis), or inability to initiate or maintain CPAP therapy. Patients were followed for 12 months. The primary endpoint was time to first documented recurrence of paroxysmal AF (≥30 s on 12-lead electrocardiography or 24-h Holter monitoring). Progression to permanent AF, defined after unsuccessful rhythm control attempts and subsequent transition to a rate control strategy, was assessed as a secondary endpoint. Time-to-event analyses used Kaplan–Meier estimates with log-rank testing, and Cox proportional hazards regression adjusted for age, body mass index, apnea–hypopnea index, heart failure, left atrial volume index, and antiarrhythmic drug therapy. Results: The final analysis included 91 patients (mean age 62.15 ± 8.29 years; 68.13% men). Mean nightly CPAP use was ≥4 h/night in 49 patients and <4 h/night in 42 patients. During follow-up, paroxysmal AF recurrence occurred in 12/49 (24.5%) patients in the ≥4 h/night group and 16/42 (38.1%) in the <4 h/night group. Mean arrhythmia-free survival at 12 months was numerically higher in the ≥4 h/night group (11.25 vs. 10.51 months), without a statistically significant difference in Kaplan–Meier curves (log-rank p = 0.11). In multivariable Cox regression, binary adherence (≥4 h/night) was not independently associated with recurrence (HR 0.52, p = 0.13), whereas mean nightly CPAP use analyzed as a continuous variable remained independently associated with delayed recurrence (per 1-h increase: HR 0.66, 95% CI 0.48–0.91, p = 0.01). Progression to permanent AF occurred in 4/49 (10.0%) versus 9/42 (17.6%) patients, respectively (p = 0.29). Conclusions: In this real-world cohort of patients with severe OSA and paroxysmal AF, higher objectively measured CPAP exposure was independently associated with delayed AF recurrence when analyzed as a continuous variable, suggesting a graded association between objectively measured CPAP exposure and AF recurrence. Larger studies with extended follow-up and continuous rhythm monitoring are warranted to confirm long-term rhythm benefits and effects on AF progression. Full article
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9 pages, 610 KB  
Article
Monitoring Vital Parameters Enhanced by Wireless Devices Related to Bariatric Surgery (MOVIES-Trial)
by Jai Scheerhoorn, Max Herman Funnekotter, Friso Schonck, R. Arthur Bouwman and Simon W. Nienhuijs
Surg. Tech. Dev. 2026, 15(1), 2; https://doi.org/10.3390/std15010002 - 3 Jan 2026
Viewed by 460
Abstract
Background: Obesity and its accompanying complications have an influence on diurnal rhythm, potentially causing cardiometabolic disease. This study explores how weight loss due to bariatric surgery affects circadian rhythm disruptions measurable through wearable heart rate monitors. Methods: A single-center observational study was performed, [...] Read more.
Background: Obesity and its accompanying complications have an influence on diurnal rhythm, potentially causing cardiometabolic disease. This study explores how weight loss due to bariatric surgery affects circadian rhythm disruptions measurable through wearable heart rate monitors. Methods: A single-center observational study was performed, in which patients who had undergone primary bariatric surgery 3 years ago with telemonitoring of vital parameters using a wireless accelerometer were eligible to participate. A Wilcoxon signed-rank test was conducted to evaluate the delta of, or amount of change in, circadian patterns between the baseline (before) and post-weight-loss peak, nadir, and peak–nadir heart rates. Results: In this cohort of 69 patients, 70% were female, with a median total weight loss of 31.4% towards a median BMI of 28.4 kg/m2. Analysis revealed significant changes in peak–nadir excursions post-weight loss. Peak, nadir, and peak–nadir differences showed a significant reduction in values in the post-weight-loss group. No significant correlations between other clinical endpoints and change in peak–nadir excursion were found in the multivariable regression models. Conclusions: In conclusion, this study reveals significant changes in circadian heart rate patterns before and after weight loss due to metabolic surgery. The results could add to the health benefits of bariatric surgery, as it could lower the incidence of diseases associated with changes in diurnal rhythm due to obesity. However, a clear clinical explanation is lacking, as no correlation with total weight loss nor other variables was substantiated. Full article
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27 pages, 1331 KB  
Study Protocol
Application of Telemedicine and Artificial Intelligence in Outpatient Cardiology Care: TeleAI-CVD Study (Design)
by Stefan Toth, Marianna Barbierik Vachalcova, Kamil Barbierik, Adriana Jarolimkova, Pavol Fulop, Mariana Dvoroznakova, Dominik Pella and Tibor Poruban
Diagnostics 2026, 16(1), 145; https://doi.org/10.3390/diagnostics16010145 - 1 Jan 2026
Viewed by 844
Abstract
Background/Objectives: Cardiovascular (CV) diseases remain the leading cause of morbidity and mortality across Europe. Despite substantial progress in prevention, diagnostics, and therapeutics, outpatient cardiology care continues to face systemic challenges, including limited consultation time, workforce constraints, and incomplete clinical information at the point [...] Read more.
Background/Objectives: Cardiovascular (CV) diseases remain the leading cause of morbidity and mortality across Europe. Despite substantial progress in prevention, diagnostics, and therapeutics, outpatient cardiology care continues to face systemic challenges, including limited consultation time, workforce constraints, and incomplete clinical information at the point of care. The primary objective of this study is threefold. First, to evaluate whether AI-enhanced telemedicine improves clinical control of hypertension, dyslipidemia, and heart failure compared to standard ambulatory care. Second, to assess the impact on physician workflow efficiency and documentation burden through AI-assisted clinical documentation. Third, to determine patient satisfaction and safety profiles of integrated telemedicine–AI systems. Clinical control will be measured by a composite endpoint of disease-specific targets assessed at the 12-month follow-up visit. Methods: The TeleAI-CVD Concept Study aims to evaluate the integration of telemedicine and artificial intelligence (AI) to enhance the efficiency, quality, and individualization of cardiovascular disease management in the ambulatory setting. Within this framework, AI-driven tools will be employed to collect structured clinical histories and current symptomatology from patients prior to outpatient visits using digital questionnaires and conversational interfaces. Results: Obtained data, combined with telemonitoring metrics, laboratory parameters, and existing clinical records, will be synthesized to support clinical decision-making. Conclusions: This approach is expected to streamline consultations, increase diagnostic accuracy, and enable personalized, data-driven care through continuous evaluation of patient trajectories. The anticipated outcomes of the TeleAI-CVD study include the development of optimized, AI-assisted management protocols for cardiology patients, a reduction in unnecessary in-person visits through effective telemedicine-based follow-up, and accelerated attainment of therapeutic targets. Ultimately, this concept seeks to redefine the paradigm of outpatient cardiovascular care by embedding advanced digital technologies within routine clinical workflows. Full article
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15 pages, 4105 KB  
Article
Six-Month Home-Based Telemedicine Program for Heart Failure and Type 2 Diabetes Patients: Applicability, Usability of Telemonitoring Devices and Apps, and Patient Satisfaction
by Palmira Bernocchi, Gloria Fiorini Aloisi, Marilisa Serlini, Elisa Pasotti, Laura Comini and Simonetta Scalvini
Healthcare 2026, 14(1), 90; https://doi.org/10.3390/healthcare14010090 - 30 Dec 2025
Viewed by 425
Abstract
Background: Telemedicine can improve early symptom detection using medical devices and applications. It can also help identify barriers to patient adherence and enhance communication with healthcare professionals. This study aimed to evaluate the applicability, usability, and patient satisfaction with telemonitoring devices and apps [...] Read more.
Background: Telemedicine can improve early symptom detection using medical devices and applications. It can also help identify barriers to patient adherence and enhance communication with healthcare professionals. This study aimed to evaluate the applicability, usability, and patient satisfaction with telemonitoring devices and apps for individuals with heart failure and type 2 diabetes. Methods: In a randomized study, patients in the Intervention Group received six months of nursing teleassistance and telemonitoring using a wearable electrocardiograph, a step tracker, and an App for recording clinical information and conducting video calls. Usability was measured using the System Usability Scale (SUS) and satisfaction with a six-item questionnaire. Results: A total of 43 patients (71 ± 8 years) were enrolled in the intervention group. A total of 41 (95%) of patients utilized the App daily, entering 13,048 information, 53 ± 59 per patient. The nurses performed 896 video-calls, 22 ± 21 per patient. The mean number of walking sessions recorded was 6.1 ± 0.9 per week (159 ± 24 per patient). Thirty-five patients (81%) used a 3-lead ECG and recorded 942 traces, 27 ± 14 per patient. At the end, 40 SUS were collected from patients: 15 (38%, 71 ± 7 years) considered the system excellent or good, 20 (50%, 71 ± 8 years) thought it fair, and 5 (13%, 74 ± 7 years) considered the system offered poor. The overall assessment of patient satisfaction with the service was 22 ± 3.3. Conclusions: This study provides evidence that, although technology can be complex for older adults, it is broadly accepted by most patients, especially when the benefits are understood. The support offered by nurses is essential for significantly enhancing the overall patient experience. Full article
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19 pages, 2870 KB  
Article
The Impact of the Accelerometer Sampling Rate on the Performance of Machine and Deep Learning Models in Wearable Fall-Detection Systems
by Manny Villa and Eduardo Casilari
Sensors 2026, 26(1), 162; https://doi.org/10.3390/s26010162 - 26 Dec 2025
Viewed by 720
Abstract
Population aging has intensified the prevalence of falls among older adults, making automatic Fall Detection Systems (FDS) a key component of telemonitoring and remote care. Among wearable-based approaches, inertial sensors, particularly accelerometers, offer an effective and low-cost alternative for continuous monitoring. However, the [...] Read more.
Population aging has intensified the prevalence of falls among older adults, making automatic Fall Detection Systems (FDS) a key component of telemonitoring and remote care. Among wearable-based approaches, inertial sensors, particularly accelerometers, offer an effective and low-cost alternative for continuous monitoring. However, the impact of the selection of the sampling frequency on model performance remains insufficiently explored. This work seeks to determine the sampling rate that best balances accuracy, stability, and computational efficiency in wearable FDS. Five representative algorithms (CNN-LSTM, CNN, LSTM-BN, k-NN, and SVM) were trained and evaluated using the SisFall dataset at 10, 20, 50, and 100 Hz, followed by a multi-stage validation including the real-fall repositories FARSEEING and Free From Falls, as well as a seven-day continuous monitoring test under real-life conditions. The results show that deep learning architectures consistently outperform traditional classifiers, with the CNN-LSTM model at 20 Hz achieving the best balance of accuracy (98.9%), sensitivity (96.7%), and specificity (99.6%), while maintaining stable performance across all validations. The observed consistency indicates that intermediate frequencies, around 20 Hz and down to 10 Hz, provide sufficient temporal resolution to capture fall dynamics while reducing data volume, which translates into more efficient energy usage compared to higher sampling rates. Overall, these findings establish a solid empirical foundation for designing next-generation wearable fall-detection systems that are more autonomous, robust, and sustainable in long-term IoT-based monitoring environments. Full article
(This article belongs to the Special Issue Wearable Sensors for Human Posture and Motion Recognition)
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16 pages, 839 KB  
Article
Association Between Physical Activity and Fitness in Patients with Heart Failure and Type 2 Diabetes Mellitus: Influence of a Telemedicine Program
by Mara Paneroni, Palmira Bernocchi, Beatrice Salvi, Carla Simonelli, Gloria Fiorini Aloisi, Luigina Viscardi, Salvatore D’Isa and Simonetta Scalvini
Healthcare 2025, 13(24), 3250; https://doi.org/10.3390/healthcare13243250 - 11 Dec 2025
Viewed by 391
Abstract
Background. Few studies have evaluated physical fitness (PF) and physical activity (PA) in individuals with heart failure and type 2 diabetes mellitus and the possibility that some telemedicine programs (TMPs) may impact them. This post hoc subgroup analysis of an RCT study aimed [...] Read more.
Background. Few studies have evaluated physical fitness (PF) and physical activity (PA) in individuals with heart failure and type 2 diabetes mellitus and the possibility that some telemedicine programs (TMPs) may impact them. This post hoc subgroup analysis of an RCT study aimed to describe PF and PA in this population before and after a TMP. Methods. We evaluated (a) PF as distance, assessed via the 6-Minute Walking Test (6MWT), and PA as daily step count in this population before and after a TMP; (b) their relationship; and (c) the patient characteristics that influence PF and PA. Results. Fifty-eight patients (aged 71.31 ± 7.92 years old, 84% male, BMI 28.01 ± 4.70 Kg/m2, ejection fraction 48.64 ± 10.64%) were enrolled between August 2022 and September 2024. All patients received a six-month TMP (nurse teleassistance, telemonitoring, a dedicated app, and PA evaluation using a tracker bracelet and step count goals). The 6MWT improved (from 418 ± 113 to 439 ± 120 m, p < 0.001), while PA remained unchanged after the TMP (from 7181 ± 4149 to 7229 ± 4947 steps/day, p = 0.92). The PA and PF association ranged from moderate at baseline (rho = 0.4958, p < 0.001) to strong at the end of the study (rho = 0.6807, p < 0.001). The regression model shows that following the TMP, PA(y) was associated with baseline 6MWT [β= 8.5, 95%IC −0.31; 17.24], age (β = −144.0, 95%IC −262.14; −25.90)), baseline daily steps (β = 0.5967, 95%IC 0.37; 0.82), and HDL cholesterol (β = 119.7, 95%IC 39.07; 200.31) (R2= 0.6580, F(4.53) = 25.49, p < 0.001), while PF(y) was associated with BMI (β= −2.04, 95%IC −4.30; 0.22)), age (β= 0.90, 95%IC −4.4; 1.32), and baseline 6MWT (β = 0.90, 95%IC 0.79; 1.00) (R2 = 0.9007, F(3.54) = 163.29, p < 0.001). Conclusions. Our TMP led to a statistically significant but clinically modest improvement in PF but did not impact PA despite there being variability among patients. PA and PF appear to be interdependent. PF, age, HDL cholesterol, and baseline PA were key predictors of PA, while BMI, age, and baseline 6MWT impacted PF at the end of the TMP. Full article
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20 pages, 1313 KB  
Article
Healthcare Professionals’ Perceptions and Acceptance of Telemonitoring During Pregnancy and Early Labor: A Single-Center Survey
by Julia Jockusch, Sophie Schneider, Andrea Hochuli, Marianne Simone Joerger-Messerli, Daniel Surbek and Anda-Petronela Radan
Int. J. Environ. Res. Public Health 2025, 22(11), 1753; https://doi.org/10.3390/ijerph22111753 - 19 Nov 2025
Viewed by 869
Abstract
The use of health monitoring software applications (apps) and devices is gaining popularity in obstetrics. The attitude and acceptance of different healthcare professionals regarding telemonitoring during pregnancy and the early phase of labor have not been sufficiently investigated. This study aims to assess [...] Read more.
The use of health monitoring software applications (apps) and devices is gaining popularity in obstetrics. The attitude and acceptance of different healthcare professionals regarding telemonitoring during pregnancy and the early phase of labor have not been sufficiently investigated. This study aims to assess healthcare professionals’ views on telemonitoring during pregnancy and childbirth, as well as data processing in the telemonitoring process. The study is part of an international project called `Newlife`, funded by the European Council and nationally funded by the Swiss State Secretariat for Education, Research and Innovation and Innosuisse. Eleven physicians from the fields of obstetrics and neonatology and five prenatal care nurses and five midwives were interviewed. First, participants were asked to fill out a written questionnaire with open and closed-ended answers, containing questions with a 5-point Likert scale. In a second step, a personal oral interview was conducted with all respondents. The study had an exploratory, qualitative focus. Questionnaire responses were summarized using descriptive statistics, while interview recordings were transcribed verbatim and systematically coded to identify recurring themes. Of the respondents (n = 20), five (25.0%) reported previous experience with telemonitoring in their professional practice, and all of them considered it useful. Regarding attitudes and acceptance, 57.1% (n = 12) of respondents would welcome telemonitoring during pregnancy and 52.4% (n = 11) during the early phase of labor, while 33.3% expressed no clear opinion. Rejection of telemonitoring was indicated by 9.6% (n = 2) during pregnancy, and 19.0% (n = 4) during early labor. In terms of perceived benefits, respondents highlighted early detection of problems (n = 13, 61.9%), improved prenatal care (n = 11, 52.4%), and better opportunities for data analysis and research (n = 12, 47.1%). Perceived risks included technical challenges and susceptibility to errors (n = 14, 66.7%), the lack of human contact and personal support (n = 14, 66.7%), and potentially inaccurate measurements (n = 12, 57.1%). This study offers insights into healthcare professionals’ attitudes and acceptance of telemonitoring in healthcare during pregnancy and the early stages of labor. There is a generally positive outlook but concerns and preferences exist. Addressing these considerations is essential for developing effective and user-friendly telemonitoring systems that benefit both healthcare professionals and pregnant women. Full article
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27 pages, 1422 KB  
Article
Stress, Anxiety, and Self-Efficacy in Hypertension: Evidence from a Romanian Case—Control Study
by Lucia Bubulac, Mirela Zivari, Irina Anca Eremia, Constantin Erena, Consuela-Mădălina Gheorghe, Iuliana-Raluca Gheorghe, Viorica Tudor, Claudia Florina Bogdan-Andreescu, Emin Cadar and Cristina-Crenguța Albu
Diseases 2025, 13(11), 373; https://doi.org/10.3390/diseases13110373 - 13 Nov 2025
Viewed by 1943
Abstract
Background: Hypertension and psychological distress often coexist, though evidence from Eastern Europe is still limited. Stress, anxiety, and self-efficacy influence blood pressure control and treatment adherence. Their effect on hypertension prevention and treatment has not been systematically evaluated in Romania. Aim: This study [...] Read more.
Background: Hypertension and psychological distress often coexist, though evidence from Eastern Europe is still limited. Stress, anxiety, and self-efficacy influence blood pressure control and treatment adherence. Their effect on hypertension prevention and treatment has not been systematically evaluated in Romania. Aim: This study evaluated the associations between stress, anxiety, and self-efficacy in Romanian adults with and without hypertension to identify modifiable psychological factors relevant for integrated cardiovascular management. Methods: A retrospective case–control study was conducted among 215 adults, including individuals with hypertension and normotensive controls. Participants completed validated questionnaires assessing stress vulnerability, perceived stress, state and trait anxiety, self-efficacy, and Type A behavior, together with demographic and occupational data. Results: Hypertensive participants reported higher stress vulnerability, perceived stress, and anxiety, as well as lower self-efficacy, compared with controls. Type A behavior showed no association with hypertension. These differences remained consistent after accounting for demographic characteristics. Conclusions: Hypertension in Romanian adults is associated with a distinct psycho-emotional profile characterized by elevated stress and anxiety and reduced self-efficacy. Type A personality showed no association. The results emphasize the importance of recognizing and addressing modifiable psychological determinants in hypertension care. Integrating psychosocial assessment with personalized interventions, including mindfulness-based approaches, digital health support, and nurse-led telemonitoring, could improve treatment adherence, reduce emotional burden, and contribute to overall cardiovascular health. This region-specific evidence supports expanding hypertension management to include psychological care alongside standard medical approaches. Full article
(This article belongs to the Special Issue Insights into the Management of Cardiovascular Disease Risk Factors)
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21 pages, 1029 KB  
Review
Remote Hemodynamic Monitoring in Heart Failure Management: A Comprehensive Review of Recent Advances and Clinical Challenges
by Carmen M. Galvez-Sánchez, Julio A. Camacho-Ruiz, Lorys Castelli and Rosa M. Limiñana-Gras
Biomedicines 2025, 13(11), 2731; https://doi.org/10.3390/biomedicines13112731 - 7 Nov 2025
Viewed by 1415
Abstract
Background/Objectives: Heart Failure (HF) remains a leading cause of hospitalization and mortality worldwide, representing a significant burden on patients and healthcare systems. Despite advances in pharmacological and device-based therapies, readmission rates remain high and traditional monitoring approaches often fail to detect early physiological [...] Read more.
Background/Objectives: Heart Failure (HF) remains a leading cause of hospitalization and mortality worldwide, representing a significant burden on patients and healthcare systems. Despite advances in pharmacological and device-based therapies, readmission rates remain high and traditional monitoring approaches often fail to detect early physiological deterioration. This review examines the clinical utility and implementation challenges of remote hemodynamic monitoring in HF, highlighting its role in improving patient outcomes and guiding precision care. Method: A comprehensive narrative review was conducted using PubMed, Scopus, and Web of Science databases to identify peer-reviewed English-language studies published in the past ten years. Results: Monitoring hemodynamic status is essential for preventing HF readmissions, as elevated filling pressures often precede symptoms. Previous studies suggest that traditional methods may be less effective in detecting early changes, which could contribute to delays in initiating treatment. Remote monitoring offers continuous, individualized assessment and has shown potential to reduce hospitalizations, though its effectiveness varies across populations and settings. Telemonitoring primarily targets patients at higher risk of hospitalization, such as those classified as New York Heart Association(NYHA) class III and individuals with comorbidities that exacerbate HF. Remote hemodynamic monitoring presents notable clinical advantages, although its widespread adoption faces several challenges (i.e., the invasiveness of some monitoring systems; limited patient adherence due to technical complexity or cognitive and physical barriers; difficulties associated with comorbidities; variability in the efficacy of monitoring strategies across populations; difficulties faced by healthcare teams in managing and interpreting large volumes of real-time data; cost-effectiveness issues related to devices and infrastructure costs). Addressing these limitations will be essential to fully understanding the potential of remote monitoring in HF care. Conclusions: Remote hemodynamic monitoring enables early detection of physiological deterioration in HF, allowing timely interventions that reduce hospitalizations and improve outcomes. Emerging evidence suggests that, in contrast to traditional approaches, this method has the potential to support more personalized, data-driven care. Integrating biopsychosocial, gender, and intersectional perspectives further aligns this strategy with precision medicine, enhancing its effectiveness and equity in clinical practice. Despite promising recent advances, further research is essential to broaden the scientific evidence base and to enhance support for clinical decision-making. Full article
(This article belongs to the Special Issue Advanced Research in Cardiovascular and Hemodynamic Monitoring)
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16 pages, 805 KB  
Article
Reimagining Arterial Hypertension and Dyslipidemia Care: Telemedicine’s Promise and Pitfalls from the Slovak Patient Viewpoint
by Stefan Toth, Adriana Jarolimkova, Patrik Bucek, Martin Sevcik, Pavol Fulop and Tibor Poruban
Clin. Pract. 2025, 15(11), 197; https://doi.org/10.3390/clinpract15110197 - 27 Oct 2025
Viewed by 706
Abstract
Background and objectives: Numerous studies and meta-analyses have established the efficacy of telemonitoring for blood pressure and other components of metabolic syndrome in improving disease management. Nevertheless, the adoption of telemonitoring technologies is often hindered by personal, technological, and systemic barriers. In [...] Read more.
Background and objectives: Numerous studies and meta-analyses have established the efficacy of telemonitoring for blood pressure and other components of metabolic syndrome in improving disease management. Nevertheless, the adoption of telemonitoring technologies is often hindered by personal, technological, and systemic barriers. In Slovakia, where patient–physician contact rates are high, there is limited research on patients’ perspectives regarding telemedicine adoption for cardiovascular risk management. The objective of this study was to examine patients’ perspectives on and perceived obstacles to the use of telemonitoring for arterial hypertension and dyslipidemia in Slovakia. Methods: This cross-sectional, questionnaire-based survey targeted a cohort of 18,053 patients. The survey instrument was designed to gather data on several key areas: patient demographic characteristics, blood pressure measurement habits, the utilization of smart technologies, perceived benefits and barriers to telemonitoring, and patients’ knowledge of their lipid profiles and cardiovascular risk factors. Statistical analysis included chi-square tests, ANOVA, and effect size calculations with 95% confidence intervals (CI). Results: A total of 1787 patient responses (9.9%) were collected. Among the respondents, 67.4% (n = 1204) had arterial hypertension, while 7.9% (n = 95) were on non-pharmacological therapy. Only 21.2% (n = 255) of hypertensive patients measured their blood pressure daily, with a significantly higher proportion of men than women (28.6% vs. 12.7%, p = 0.011, Cohen’s d = 0.42). The most frequent users of blood pressure monitoring were in the 31–45 age group (p = 0.001, η2 = 0.08). A total of 19.4% (n = 347) of respondents used wearable devices, and 6.3% (n = 113) used blood pressure monitors connected to an application. Smart technology use was significantly more common in the 31–45 age group (p = 0.01, Cramer’s V = 0.15). Moderate interest in telemedicine was expressed by 69.8% (n = 1247) of respondents, though only 27.4% (n = 490) showed strong interest. The majority of patients (73.8%, n = 1319) did not know their LDL-C levels, and 45.7% (n = 817) of those who did had elevated levels. Conclusions: The findings suggest that while interest in telemedicine methods for the management of arterial hypertension and dyslipidemia exists among Slovak patients, it is more moderate than initially assumed. Importantly, expressed willingness to participate in a study should not be directly equated with readiness to adopt new technologies in daily practice. Successful integration of telemonitoring into the Slovak healthcare system will therefore require not only patient engagement but also active support from healthcare providers to overcome practical and motivational barriers. These findings highlight the need for targeted implementation strategies that address the specific barriers identified in the Central and Eastern European healthcare context. Full article
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18 pages, 1562 KB  
Article
NS-Assist: Nephrotic Syndrome Assistance System for Pediatric Decision-Making in Pandemic Situations
by Nada Zendaoui, Nardjes Bouchemal, Naila Bouchemal, Imane Boussebough and Galina Ivanova
Appl. Sci. 2025, 15(21), 11433; https://doi.org/10.3390/app152111433 - 26 Oct 2025
Viewed by 920
Abstract
The COVID-19 pandemic has underscored the need for telemedicine to ensure continuity of pediatric care during health emergencies. This paper presents NS-Assist, a hybrid web–mobile decision support system for managing Idiopathic Nephrotic Syndrome (INS) in children. The system combines rule-based reasoning and fuzzy [...] Read more.
The COVID-19 pandemic has underscored the need for telemedicine to ensure continuity of pediatric care during health emergencies. This paper presents NS-Assist, a hybrid web–mobile decision support system for managing Idiopathic Nephrotic Syndrome (INS) in children. The system combines rule-based reasoning and fuzzy inference to assist clinicians in diagnosis, treatment adjustment, and relapse monitoring, while enabling caregivers to record and track daily health data. Implemented using Spring Boot, ReactJS, and Flutter with a secure MySQL database, NS-Assist integrates medical expertise with computational intelligence to support remote decision-making. A pilot evaluation involving 40 participants, including clinicians and caregivers, showed improved communication, reduced consultation time, and enhanced follow-up continuity. These results highlight the system’s potential as a reliable and adaptable framework for pediatric telemedicine in resource-constrained and emergency settings. Full article
(This article belongs to the Special Issue Applications in Neural and Symbolic Artificial Intelligence)
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41 pages, 4151 KB  
Systematic Review
AI Video Analysis in Parkinson’s Disease: A Systematic Review of the Most Accurate Computer Vision Tools for Diagnosis, Symptom Monitoring, and Therapy Management
by Lazzaro di Biase, Pasquale Maria Pecoraro and Francesco Bugamelli
Sensors 2025, 25(20), 6373; https://doi.org/10.3390/s25206373 - 15 Oct 2025
Cited by 5 | Viewed by 2991
Abstract
Background. Clinical assessment of Parkinson’s disease (PD) is limited by high subjectivity and inter-rater variability. Markerless video analysis, namely Computer Vision (CV), offers objective and scalable characterization of motor signs. We systematically reviewed CV technologies suited for PD diagnosis, symptom monitoring, and treatment [...] Read more.
Background. Clinical assessment of Parkinson’s disease (PD) is limited by high subjectivity and inter-rater variability. Markerless video analysis, namely Computer Vision (CV), offers objective and scalable characterization of motor signs. We systematically reviewed CV technologies suited for PD diagnosis, symptom monitoring, and treatment management. Methods. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched PubMed for articles published between 1 January 1984 and 9 May 2025. We used the following search strategy: (“Parkinson Disease” [MeSH Terms] OR “parkinson’s disease” OR “parkinson disease”) AND (“computer vision” OR “video analysis” OR “pose estimation” OR “OpenPose” OR “DeepLabCut” OR “OpenFace” OR “YOLO” OR “MediaPipe” OR “markerless motion capture” OR “skeleton tracking”). Results. Out of 154 identified studies, 45 met eligibility criteria and were synthesized. Gait was assessed in 42% of studies, followed by bradykinesia items (17.7%). OpenPose and custom CV solutions were each used in 36% of studies, followed by MediaPipe (16%), DeepLabCut (9%), YOLO (4%). Across aims, CV pipelines consistently showed diagnostic discrimination and severity tracking aligned with expert ratings. Conclusions. CV non-invasively quantifies PD motor impairment, holding potential for objective diagnosis, longitudinal monitoring, and therapy response. Guidelines for standardized video-recording protocols and software usage are needed for real-world applications. Full article
(This article belongs to the Collection Sensors for Gait, Human Movement Analysis, and Health Monitoring)
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14 pages, 544 KB  
Article
Extended Telemonitored Follow-Up After Acute Coronary Syndrome: A Healthcare Pathway That Improves Cardiovascular Prevention and Patient Experience, and Reduces Outpatient Visits
by Ernesto Dalli-Peydró, Alicia Serrano-Romero, Rocío Serrats-López, Alvaro Salvador Minaya-Zaballos, Alan Herrera-Vásquez, Sofía Ramírez-Candela, Angela Arias-Fresneda, Alejandra Llanos-Gabaroa, Nuria Muñoz-Ramos, Amparo Fresneda-Fresneda and Juan Cosín-Sales
J. Clin. Med. 2025, 14(20), 7283; https://doi.org/10.3390/jcm14207283 - 15 Oct 2025
Viewed by 831
Abstract
Background: Extended telemonitored follow-up after acute coronary syndrome (ACS) has been shown to optimize secondary prevention outcomes. However, its impact on patient experience and outpatient visits remains unclear. Methods: This observational, retrospective, longitudinal study included 75 consecutive patients who underwent 10-month [...] Read more.
Background: Extended telemonitored follow-up after acute coronary syndrome (ACS) has been shown to optimize secondary prevention outcomes. However, its impact on patient experience and outpatient visits remains unclear. Methods: This observational, retrospective, longitudinal study included 75 consecutive patients who underwent 10-month telemonitored follow-up after ACS and 50 consecutive patients who received standard care. Lipid parameters at hospital admission and 12 months post-discharge, patient experience (measured using the IEXPAC scale), and outpatient visits were evaluated. Results: The mean patient age was 58.0 years in the telemonitored group and 60.8 years in the control group, with males comprising 87% and 92%, respectively. The telemonitored group showed significant decreases in triglyceride levels (p < 0.011), VLDL cholesterol (p = 0.003), triglyceride/HDL ratio (p = 0.007), and remnant cholesterol levels (p = 0.018). The IEXPAC score was significantly higher in the telemonitored group (7.9 ± 1.5) compared to the standard care group (6.0 ± 1.9, p < 0.001). Higher ratings were observed across all domains: patient-professional productive interaction, the new patient-healthcare system relational model, and self-care. The telemonitored group also had fewer visits to Cardiology (1.0 ± 1.2 vs. 1.7 ± 1.0; p < 0.001) and Primary Care (7.1 ± 4.6 vs. 9.4 ± 5.2; p = 0.014). Conclusions: Extended telemonitored follow-up after ACS significantly enhances patient experience, improves lipid-related cardiovascular risk, and reduces outpatient visits to Primary Care and Cardiology compared to standard follow-up. These findings support the broader implementation of this healthcare pathway. Full article
(This article belongs to the Section Cardiology)
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26 pages, 1429 KB  
Review
Healthcare Management in Cardio-Oncology, Clinical Strategies and Future Perspectives: A Narrative Review
by Vincenzo Quagliariello, Massimiliano Berretta, Fabrizio Maurea, Matteo Barbato, Andrea Paccone, Martina Iovine, Alfredo Mauriello, Celeste Fonderico, Domenico Gabrielli, Andrea Camerini, Carmine Riccio, Marino Scherillo, Stefano Oliva, Maria Laura Canale and Nicola Maurea
Healthcare 2025, 13(20), 2599; https://doi.org/10.3390/healthcare13202599 - 15 Oct 2025
Cited by 1 | Viewed by 1766
Abstract
The growing overlap between cardiovascular disease and cancer has made cardio-oncology a key subspecialty in modern oncology care. Improved cancer survival has increased the burden of therapy-related cardiovascular complications, including heart failure, arrhythmias, ischemic events, and vascular toxicity, driven by oxidative stress, endothelial [...] Read more.
The growing overlap between cardiovascular disease and cancer has made cardio-oncology a key subspecialty in modern oncology care. Improved cancer survival has increased the burden of therapy-related cardiovascular complications, including heart failure, arrhythmias, ischemic events, and vascular toxicity, driven by oxidative stress, endothelial dysfunction, immune-mediated injury, and metabolic vulnerability. Effective management requires a continuum-of-care approach, integrating baseline risk assessment, biomarker- and imaging-guided surveillance, and timely cardioprotective therapy without compromising cancer treatment. Key strategies include validated risk scores (HFA/ICOS, Mayo), early detection of subclinical dysfunction via troponin, natriuretic peptides, and strain imaging, and proactive cardioprotective agents such as ACE inhibitors, beta-blockers, SGLT2 inhibitors, and statins in high-risk patients. This narrative review summarizes risk-stratification models, structured care pathways, and multidisciplinary hub-and-spoke networks linking specialized centers with community oncology services. It emphasizes modifiable cardiometabolic factors, obesity, insulin resistance, NAFLD, sarcopenia, and chronic inflammation, which heighten cardiotoxicity risk and should guide precision prevention and survivorship care. We also address emerging challenges, including the integration of digital health, tele-monitoring, and AI-based decision support, and the shift toward value-based reimbursement models, highlighting persistent barriers such as data privacy, infrastructure gaps, and inequitable access to specialized care. Full article
(This article belongs to the Special Issue Advances in Public Health and Healthcare Management for Chronic Care)
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11 pages, 305 KB  
Article
Appetite Assessment Using the Arabic CNAQ Following a Telenutrition Weight-Loss Intervention with Health Coaching and Telemonitoring: A Cross-Sectional Analysis
by Sarah N. Alsharif, Noura M. S. Eid, Noor A. Hakim, Najlaa M. M. Jawad and Soaad F. Alsulami
Obesities 2025, 5(4), 73; https://doi.org/10.3390/obesities5040073 - 9 Oct 2025
Cited by 2 | Viewed by 1219
Abstract
Obesity is closely associated with appetite dysregulation, influenced by behavioral, hormonal, and neurological factors. The Council on Nutrition Appetite Questionnaire (CNAQ) is a validated tool, translated into Arabic, but its application in weight-loss interventions remains underexplored. This secondary cross-sectional analysis evaluated whether the [...] Read more.
Obesity is closely associated with appetite dysregulation, influenced by behavioral, hormonal, and neurological factors. The Council on Nutrition Appetite Questionnaire (CNAQ) is a validated tool, translated into Arabic, but its application in weight-loss interventions remains underexplored. This secondary cross-sectional analysis evaluated whether the Arabic CNAQ can differentiate appetite levels after a 6-month telenutrition weight-loss intervention supported by telemonitoring and health coaching, and whether appetite is associated with weight-loss outcomes. A total of 36 participants were assessed: the intervention group (n = 21), who completed the program, and the control group (n = 15), who received no continuous support. Appetite was measured using the CNAQ after 6 months. Independent-samples t-tests and Mann–Whitney U tests were applied to compare appetite scores, while Chi-square tests were used for appetite categories. Results showed mean CNAQ scores of 27.87 (SD = 2.64) for the control group and 26.86 (SD = 4.46) for the intervention group (p = 0.402). Most participants reported moderate appetite (93.3% control; 76.2% intervention), with no significant between-group differences (p = 0.367). Although differences were not statistically significant, the findings demonstrate the feasibility of using the Arabic CNAQ in telehealth weight management. Larger studies with repeated measures are needed to confirm its utility in clinical and dietetic practice. Full article
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