Chun-Yin Yeh

Background: Wearable technology has evolved in managing COVID-19, offering early monitoring of key physiological parameters. However, the role of wearables in tracking and managing long COVID is less understood and requires further exploration of their potential. Objective: This review assessed the application and effectiveness of wearable devices in managing long COVID symptoms, focusing on commonly used sensors and their potential for improving long-term patient care. Methods: A literature search was conducted across databases including PubMed, Embase, Web of Science, and Cochrane Central, adhering to PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) reporting guidelines. The search was updated regularly throughout 2024. Abstract and full-text screening and selection were facilitated using Rayyan software developed by Qatar Computing Research Institute. Quality appraisal was conducted using the Joanna Briggs Institute (JBI) critical appraisal tool to ensure the methodological rigor of the included studies. Data were extracted on study characteristics, wearable devices, sensors used, and monitored physiological parameters, and the results were synthesized in a narrative format. Results: A total of 1186 articles were identified, and after duplicate removal and screening, 15 studies were initially included, with 11 studies meeting the criteria for final data synthesis. The included studies varied in design, ranging from observational to interventional trials, and involved sample sizes from 3 to 17,667 participants across different countries. In total, 10 different wearable devices were used to monitor long COVID symptoms, capturing key metrics such as heart rate variability, body temperature, sleep, and physical activity. Smartwatches were the most used wearable devices and fitness trackers with electrocardiography and photoplethysmography sensors were used to monitor heart rate, oxygen saturation, and respiratory rate. Of the 10 devices, 4 were Food and Drug Administration–approved, emphasizing the reliability and validation of the physiological data collected. Studies were primarily conducted in the United States and Europe, reflecting significant regional research interest in wearable technology for long COVID management. Conclusions: This review highlights the potential of wearable technology in providing continuous and personalized monitoring for long COVID patients. Although wearables show promise in tracking persistent symptoms, further research is needed to improve usability, validate long-term efficacy, and enhance patient engagement.

BACKGROUND Wearable technology has evolved in managing COVID-19, offering early monitoring of key physiological parameters. However, the role of wearables in tracking and managing long COVID is less understood and requires further exploration of their potential. OBJECTIVE This review assessed the application and effectiveness of wearable devices in managing long COVID symptoms, focusing on commonly used sensors and their potential for improving long-term patient care. METHODS A literature search was conducted across databases including PubMed, Embase, Web of Science, and Cochrane Central, adhering to PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) reporting guidelines. The search was updated regularly throughout 2024. Abstract and full-text screening and selection were facilitated using Rayyan software developed by Qatar Computing Research Institute. Quality appraisal was conducted using the Joanna Briggs Institute (JBI) critical appraisal tool to ensure the methodological rigor of the included studies. Data were extracted on study characteristics, wearable devices, sensors used, and monitored physiological parameters, and the results were synthesized in a narrative format. RESULTS A total of 1186 articles were identified, and after duplicate removal and screening, 15 studies were initially included, with 11 studies meeting the criteria for final data synthesis. The included studies varied in design, ranging from observational to interventional trials, and involved sample sizes from 3 to 17,667 participants across different countries. In total, 10 different wearable devices were used to monitor long COVID symptoms, capturing key metrics such as heart rate variability, body temperature, sleep, and physical activity. Smartwatches were the most used wearable devices and fitness trackers with electrocardiography and photoplethysmography sensors were used to monitor heart rate, oxygen saturation, and respiratory rate. Of the 10 devices, 4 were Food and Drug Administration–approved, emphasizing the reliability and validation of the physiological data collected. Studies were primarily conducted in the United States and Europe, reflecting significant regional research interest in wearable technology for long COVID management. CONCLUSIONS This review highlights the potential of wearable technology in providing continuous and personalized monitoring for long COVID patients. Although wearables show promise in tracking persistent symptoms, further research is needed to improve usability, validate long-term efficacy, and enhance patient engagement.

Objective: To assess the healthcare utilization, economic burden, and long-term neurological complications and mortality of an adult population with Japanese encephalitis (JE). Methods: This study utilized two nationwide datasets in Taiwan: the Notifiable Disease Dataset of confirmed cases from the Centers for Disease Control to identify JE patients, and the National Health Insurance Research Database to obtain patients’ healthcare utilization. Survival analyses were performed to identify prognostic factors associated with the all-cause mortality of patients. Results: This study included 352 adult cases with JE (aged≥20 years). The mean age of JE patients was 45 years. Stroke (event rate: 3.49/100 person-years) was the most common neurological complication, followed by epilepsy/convulsions (3.13/100 person-years), encephalopathy/delirium (2.20/100 person-years), and parkinsonism (1.97/100 person-years). Among the 336 hospitalized patients at JE diagnosis, 58.33% required intensive care. Among 79 patients who died following JE diagnosis, 48.84% of death events occurred within the year of diagnosis. The medical costs increased considerably at JE diagnosis and subsequent-year costs remained significantly higher than the costs before diagnosis (pp<0.05). Conclusion: A considerable medical burden associated with JE was observed in affected adults, even in the years following JE diagnosis. Vaccination should be considered to prevent this sporadic, but lethal, viral infection.

Background: Variations in body temperature are highly informative during an illness. To date, there are not many adequate studies that have investigated the feasibility of a wearable wrist device for the continuous monitoring of body surface temperatures in humans. Objective: The objective of this study was to validate the performance of HEARThermo, an innovative wearable device, which was developed to continuously monitor the body surface temperature in humans. Methods: We implemented a multi-method research design in this study, which included 2 validation studies—one in the laboratory and one with human subjects. In validation study I, we evaluated the test-retest reliability of HEARThermo in the laboratory to measure the temperature and to correct the values recorded by each HEARThermo by using linear regression models. We conducted validation study II on human subjects who wore HEARThermo for the measurement of their body surface temperatures. Additionally, we compared the HEARThermo temperature recordings with those recorded by the infrared skin thermometer simultaneously. We used intraclass correlation coefficients (ICCs) and Bland-Altman plots to analyze the criterion validity and agreement between the 2 measurement tools. Results: A total of 66 participants (age range, 10-77 years) were recruited, and 152,881 completed data were analyzed in this study. The 2 validation studies in the laboratory and on human skin indicated that HEARThermo showed a good test-retest reliability (ICC 0.96-0.98) and adequate criterion validity with the infrared skin thermometer at room temperatures of 20°C-27.9°C (ICC 0.72, P<.001). The corrected measurement bias averaged –0.02°C, which was calibrated using a water bath ranging in temperature from 16°C to 40°C. The values of each HEARThermo improved by the regression models were not significantly different from the temperature of the water bath (P=.19). Bland-Altman plots showed no visualized systematic bias. HEARThermo had a bias of 1.51°C with a 95% limit of agreement between –1.34°C and 4.35°C. Conclusions: The findings of our study show the validation of HEARThermo for the continuous monitoring of body surface temperatures in humans.

Individual attitudes toward aging have been regarded as a modifiable risk for physical disability. However, longitudinal cohort studies have not been carried out in countries in Asia. In the present study, we aimed to explore the association between individual attitudes toward aging and subsequent physical disabilities using a nationwide representative cohort, the Taiwan Longitudinal Study on Aging (TLSA), over a 4-year follow-up period. In 2003, a baseline survey for 10-item attitudes toward aging scale consisting of widely different domains across financial relationships with children, grandparenting, living arrangements, and remarriage was conducted. Later, physical disabilities, including mobility and activities of daily living (ADL) limitations, were evaluated in 2007. A total of 1635 participants aged 57 and over were analyzed. Older age, self-rated poor health, and those suffering from pain were found to be more likely to have higher risk of physical disabilities. The older adults who expressed a willingness to receive financial support from their adult children were reported to have a lower risk of mobility limitations (adjusted odds ratio (aOR): 0.67, 95% confidence interval (CI): 0.50–0.90), while those who did not want to assist with child care as grandparents had a higher risk of ADL difficulties (aOR: 2.46, 95% CI: 1.31–4.60). Our work shed light on the importance of individual attitudes toward aging in predicting long-term physical disabilities and illuminated the intimate role of grandparents, both financial and participatory, in Chinese families. In the future, culturally adapted attitudes toward aging scale should be developed to identify older Chinese adults at risk of physical disabilities.

BACKGROUND Healthcare workers (HCWs) are recommended to measure their body temperature every 8 hours to reduce the risk of cross infections during the COVID-19 pandemic in Taiwan. However, temperature reporting accuracy among HCWs is difficult to attain due to busy working schedules and high chances of human errors. OBJECTIVE This study describes the application of a continuous temperature monitoring system (HEARThermo Care AI.) based on the Internet of Things (IoT) among HCWs in hospitals during the COVID-19 outbreak. METHODS A prospective cohort study was conducted among HCWs in a major tertiary hospital in southern Taiwan. HCWs participated in this study wore HEARThermo, an innovative wearable device used to measure body surface temperature and heart rate every 10s, to continue monitoring their body surface temperature and heart rate during working hours. The HEARThermo Care AI. system combined with the routine body temperature measurement flow were used to automatedly notify the manager about the HCWs with fever risks. The completion rate of body temperature measurements was calculated as the number of HCWs using the continuous temperature monitoring system divided by the number of HCWs on duty. RESULTS A total of 52 HCWs (medical doctors, nurses, and interns) working in the medical ward between April 22 and June 30, 2020, voluntarily participated. The completion rate of body temperature measurements increased from 77.7% to 85% among HCWs in hospitals using HEARThermo Care AI. system. All the HCWs who received warning messages were reconfirmed by their managers and found they had discomforts at that time. CONCLUSIONS The application of the continuous temperature monitoring system serves as a solution to early identify HCWs suspected of having discomforts during the COVID-19 pandemic.

People living with HIV (PLWH) had a higher prevalence and incidence rate of bone fracture compared to general population. Although several studies have explored this phenomenon, the prevalence and incidence rate of fracture were varied. The aim of the study is to determine and analyze the pooled prevalence, incidence rate of fracture and fracture risk factors among people living with HIV (PLWH). PubMed, Cochrane Library, CINAHL with full Text, and Medline databases for studies published up to August 2019 were searched. Studies reporting the prevalence or incidence of fracture among PLWH were included. Study quality was assessed using the Joanna Briggs Institute (JBI) appraisal tool. A meta-analysis with random-effects model was performed to determine pooled estimates of prevalence and incidence rates of fracture. A meta-regression was performed to determine the source of heterogeneity. The pooled estimated prevalence of fracture among PLWH was 6.6% (95% CI: 3.8–11.1) with pooled odds ratio of 1.9 (95%CI: 1.1–3.2) compared to the general population. The pooled estimates of fracture incidence were 11.3 per 1000 person-years (95% CI: 7.9–14.5) with incidence rate ratio (IRR) of 1.5 (95% CI: 1.3–1.8) compared to the general population. Risk factors for fracture incidence were older age (aHR 1.4, 95% CI: 1.3–1.6), smoking (aHR 1.3, 95% CI: 1.1–1.5), HIV/HCV co-infection (aHR 1.6, 95% CI: 1.3–1.9), and osteoporosis (aHR 3.3, 95% CI: 2.2–5.1). Our finding highlights a higher risk of fracture among PLWH compared to the general population. Osteoporosis, smoking and HIV/HCV coinfection as the significant modifiable risk factors should be prioritized by the HIV health providers when care for PLWH.