The integration of the Internet of Things (IoT) into health care is transforming the industry by enhancing disease care and management, as well as supporting self-health management. The COVID-19 pandemic has accelerated the adoption of IoT devices, particularly wearable medical devices, which enable real-time health monitoring and advanced remote health management. Globally, the increased adoption of IoT in health care has improved efficiency, enhanced patient care, and generated substantial economic value.

This review aims to conduct a comprehensive meta- and weight analysis of quantitative studies to identify the most influential predictors and theoretical frameworks explaining the adoption of IoT in health care.

We searched databases, including Web of Science and PubMed, for quantitative studies on IoT health care adoption, with the last search conducted in early July 2025. Inclusion criteria comprised peer-reviewed articles written in English that employed a quantitative approach to IoT health care technology adoption. Studies were excluded if they did not report the significance of relationships, involved technologies without IoT features or were outside the scope, or examined target variables irrelevant to the analysis. The weight analysis identified the pathways with the most significant effects. A meta-analysis using a random-effects model was conducted to estimate combined effect sizes and their statistical significance. The results from both methods were then integrated to visualize the most frequently used theoretical frameworks. Risk of bias and heterogeneity were assessed using a funnel plot, Egger regression test, the I2 statistic, and subgroup analysis, which indicated no strong evidence of publication bias but revealed a high level of heterogeneity.

Analysis of 115 datasets from 109 papers identified the Technology Acceptance Model and the Unified Theory of Acceptance and Use of Technology (UTAUT) as the primary frameworks for explaining IoT adoption in health care. Incorporating context-specific variables-such as health consciousness, innovativeness, and trust-into these traditional technology acceptance frameworks enhances the understanding of IoT adoption. Although high heterogeneity suggests a need to refine theoretical models to account for regional contexts, universal adoption drivers such as performance expectancy and effort expectancy remain consistent.

Behavioral intention is the most frequently studied variable in IoT health care adoption, whereas attitude, performance expectancy, effort expectancy, and task-technology fit remain underexplored. While adoption theories from the information systems field, such as the TAM, are predominantly used, integrating context-specific constructs and theories-such as trust and innovativeness-can provide deeper insights into IoT adoption in health care. The strongest and most consistent predictors of behavioral intention were attitude, performance expectancy, habit, self-efficacy, functional congruence, and benefits. Additionally, social influence, facilitating conditions, trust, and aesthetic appeal demonstrated promising or strong effects. By contrast, variables such as privacy and security, barriers, vulnerability, severity, compatibility, financial cost, health, and technology anxiety were generally inconsistent or not statistically significant.

Respiratory syncytial virus (RSV) bronchiolitis during infancy has the potential to progress to recurrent wheezing and asthma. However, studies evaluating lung function using tidal breath analysis in this age group are limited.

This study aimed to assess lung function in infants hospitalized during their first episode of acute RSV bronchiolitis using tidal breath analysis, to compare tidal breathing parameters between the acute phase and 2 months after clinical recovery, and to evaluate the impact of bronchiolitis severity on lung function.

A total of 78 infants aged 1-12 months were enrolled in this prospective study; 39 diagnosed with RSV bronchiolitis and 39 age-and sex-matched healthy controls. Lung function was measured using tidal breath analysis during hospitalization for the acute episode and re-evaluated 2 months after recovery.

The ratio of time to peak tidal expiratory flow to expiratory time (tPTEF/tE) was significantly lower in the RSV bronchiolitis group than in healthy controls, and remained significantly reduced at the 2-month follow-up [19.2% (14.9-24.2) vs. 31.4% (28.7-35.3), p < 0.01]. No significant changes in tidal breath analysis parameters were observed between the acute phase and two- months after recovery. In the severe subgroup, both tPTEF and tPTEF/tE values were lower than in the mild and moderate subgroups.

Our findings suggest that expiratory airway obstruction may persist despite clinical recovery in infants following RSV bronchiolitis. The lack of improvement in tidal breathing parameters, particularly tPTEF and tPTEF/tE, highlights the need for long-term follow-up. Moreover, greater disease severity was associated with more sustained impairment in lung function. These findings emphasize the importance of early detection, long-term monitoring, and preventive strategies to reduce the long-term respiratory consequences of RSV infection.

Optimal management of allergic bronchopulmonary aspergillosis (ABPA) remains debated, particularly regarding glucocorticoid (GC) dosage, duration, antifungal selection, and combination therapy. This study evaluated the impact of different regimens on ABPA prognosis.

A total of 76 ABPA patients at Zhongshan Hospital, Fudan University from March 2009 to June 2018 were enrolled and stratified by one-year relapse status. Demographics, treatment details (GC dosage, GC duration, antifungal type), and outcomes (GC dependence, acute exacerbations, lesion resolution, recurrence) were analyzed. Multivariate logistic regression analysis was utilized.

No significant difference were observed between the relapse group (n = 20) and non-relapse group (n = 56) in baseline demographics, clinical characteristics, or use of GC duration/dosage or antifungals. The mean follow-up time for the relapse and non-relapse groups were 23.95 vs 24.91 months. The former had higher long-term GC use (>3 months) than the non-relapse group (80% vs. 30.36%, p < 0.001). Long-term GC was an independent risk factor for relapse (OR 6.85, 95%CI 1.51-31.51), GC dependence (OR 5.92, 95%CI 1.29-27.11), and acute exacerbations (OR 9.41, 95%CI 2.76-32.06). Conversely, low-dose GC (<7.5 mg/day) reduced relapse risk (OR 0.06, 95%CI 0.01-0.36), GC dependence (OR 0.07, 95%CI 0.01-0.41), and exacerbations (OR 0.16, 95%CI 0.03-0.91). Voriconazole offered superior initial efficacy vs itraconazole (OR 4.42, 95%CI 1.18-16.52) but poorer long-term lesion resolution (OR 0.24, 95%CI 0.06-0.97). Nevertheless, a higher proportion of non-relapse patients had received combination therapy compared to relapse patients (67.9% vs. 50%, p = 0.322).

Long-term GC increases risks of adverse outcomes in ABPA, while low-dose GC demonstrates protective effects. Voriconazole provides better initial response but inferior long-term lesion resolution compared to itraconazole. More non-relapse patients on combination therapy may related to possible benefit of combination therapy. Prospective studies are warranted to confirm these findings.

The modified Erasmus GBS Respiratory Insufficiency Score (mEGRIS) has been proposed to be a useful tool for predicting the risk of mechanical ventilation (MV) in Guillain-Barré syndrome (GBS), whereas most of the patients included in previous studies had classical demyelinating GBS. This study validated the utility of the mEGRIS in axonal, as well as demyelinating GBS, defined by electrophysiologic criteria in Japan.

Data from 214 consecutive patients diagnosed with GBS at our institution within 28 days from disease onset between 1998 and 2023 were reviewed and 200 patients with adequate data were analyzed. Acute motor axonal neuropathy (AMAN) and acute inflammatory demyelinating polyneuropathy (AIDP) were diagnosed by sequential nerve conduction studies and mEGRIS was applied to each group.

A total of 200 GBS patients were classified as AMAN (n = 73 [37%]), AIDP (n = 72 [36%]), or unclassified (n = 55 [28%]) and 27 (14%) patients required MV (18% of AMAN, 15% of AIDP). Patients with MV had a significantly higher mEGRIS than those without MV (17 [median range: 5-29] vs. 6 [0-22]). Approximately 81% of the patients in the moderate- or high-risk group (mEGRIS ≧ 18) required MV. Area under the curves (AUCs) of the mEGRIS prediction formulas was 0.89 (95% CI, 0.82-0.96) for total GBS group and 0.92 (95% CI, 0.85-1.00) for the AMAN group.

The mEGRIS is useful for predicting MV risk in patients with AMAN, as well as AIDP. Close monitoring was required for patients who were classified as moderate or high-risk by mEGRIS, irrespective of GBS subtypes.

Point-of-care testing (POCT) helps accelerate and streamline many processes in primary care. However, there is little information on the characteristics of their users.

Data were provided by the largest Czech health insurance company, covering 60% of the population. A proprietary spatial categorization model based on OECD typology, adapted to Czech primary care conditions, was used for localization.

In all monitored groups, we observed continuous growth in the number of general practices using POCT methods, unaffected by Covid-19. Absolute numbers of POCT-INR and POCT-CRP examinations decreased during the pandemic years. The number of POCT-INR tests is more affected by practice location, while the number of POCT-CRP tests is influenced by the age of GPs.

Although POCT methods are a voluntary part of general practitioners' office equipment in Czechia, their more frequent use indicates that system-level conditions are appropriately set. The interest of GPs aged 60+ is surprising. Despite using POCT examinations the least, they show similar growth to other groups.

Disease stability is an achievable goal in chronic obstructive pulmonary disease (COPD) management. However, the clinical implications of disease stability in patients with COPD remain unclear.

We conducted a single-center retrospective cohort study using the electronic medical records of treated patients with symptomatic COPD. Patients who had newly initiated inhaler therapy with long-acting β2-agonist/long-acting muscarinic antagonist (LABA/LAMA) or inhaled corticosteroid/LABA/LAMA combinations were included. Disease stability was defined over a one-year assessment period as meeting all of the following criteria: (1) symptom stability; (2) no moderate or severe exacerbations; and (3) no rapid decline in lung function. The outcomes included acute exacerbations and all-cause mortality.

Of the 725 screened patients, 405 were eligible for inclusion in the study. Among them, 158 (39.0%) achieved disease stability. The proportions of patients who met each criterion were 70.4% for symptom stability, 63.7% for no exacerbations, and 71.4% for a non-rapid lung function decline. Only 5.9% met none of these criteria. During the follow up duration of median 62 (interquartile ranges, 30-90) months, disease stability was significantly associated with a reduced risk of moderate-to-severe (adjusted hazard ratio [aHR] 0.521, 95% confidence interval [CI] 0.392-0.692) and severe (aHR 0.393, 95% CI 0.279-0.553) exacerbations after adjusting for confounders. It was also associated with a decreased mortality risk (aHR 0.345, 95% CI 0.135-0.883).

Disease stability was associated with a lower risk of exacerbation and mortality, suggesting its potential role as a treatment target and outcome measure for COPD.

Impairment of voice and swallowing after thyroidectomy can negatively affect communication, eating and overall quality of life. The Thyroidectomy-Related Voice and Symptom Questionnaire was developed to facilitate the early identification and monitoring of voice and swallowing outcomes in patients who have undergone thyroidectomy. While it has been translated and culturally adapted to Brazilian Portuguese, there is currently no evidence supporting its construct validity.

To examine the construct validity of the Brazilian Portuguese version of the Thyroidectomy-Related Voice and Symptom Questionnaire (BR-PT-TVSQ).

This cross-sectional study included 395 Brazilian individuals undergoing thyroidectomy, mainly female (95.2%), with a mean age of 41.38 ± 11.12 years. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to test the structural validity of the 20-item BR-PT-TVSQ. Internal consistency was assessed using Cronbach's alpha. Convergent and discriminant validity were analysed through internal correlations.

The EFA suggested a three-factor model with a Cronbach's alpha of 0.947. The CFA confirmed the three-factor model with acceptable goodness-of-fit indices: Factor 1 = voice symptoms; Factor 2 = oropharyngolaryngeal symptoms and Factor 3 = cervical and thoracic discomfort. All three factors presented significant convergent validity. The discriminatory power between Factors 2 and 3 was smaller than in other comparisons.

The BR-PT-TVSQ provided evidence of construct validity for a three-factor model with acceptable structure, convergent and discriminant validity. These sources of validity evidence are crucial to clinically ensure that the TVSQ-PT-BR structure accurately represents the investigated outcomes.

What is already known on this subject The Thyroidectomy-Related Voice and Symptom Questionnaire (TVSQ) was developed to identify and monitor symptoms related to voice, swallowing and neck discomfort in patients undergoing thyroidectomy. The TVSQ has already been translated and culturally adapted into Brazilian Portuguese (BR-PT-TVSQ). However, the BR-PT-TVSQ still lacks validation for other measurement properties, including construct validity. What this paper adds to existing knowledge This study demonstrates that the BR-PT-TVSQ has construct validity, featuring three dimensions and acceptable levels of internal consistency, convergent validity and discriminant validity. These forms of validity evidence ensure that the structure of the instrument accurately represents the outcomes and dimensions being investigated, making it suitable for clinical use. What are the potential or actual clinical implications of this work? The BR-PT-TVSQ is the only tool available in Brazilian Portuguese that has verified construct validity for the early assessment of symptoms related to voice, swallowing and neck discomfort in patients undergoing thyroidectomy. This questionnaire aids in decision-making and the rehabilitation process.

Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) are prevalent conditions with overlapping pathophysiological mechanisms. Their coexistence, termed overlap syndrome, is thought to amplify cardiometabolic risk. This study examined the 10-year risk of major adverse cardiovascular events (MACE) and all-cause mortality in individuals with COPD and OSA symptoms in a community-based cohort.

Baseline data (1998-1999) from the Hordaland Health Study were linked to national registries on mortality and cardiovascular events. Of 7,456 eligible adults born 1925-1927 and 1950-1951, a random sample of 5,100 was invited, and 3,305 with valid spirometry were included. OSA symptoms were assessed by questionnaire, and chronic airway obstruction (CAO) was defined as post-bronchodilator FEV₁/FVC < 0.70. Cox regression estimated hazard ratios (HR) for MACE and all-cause mortality.

CAO independently predicted both MACE (HR 1.48, 95% CI 1.12-1.97, p < 0.006) and all-cause mortality (HR 1.78, 95% CI 1.44-2.22, p < 0.001). Excessive daytime sleepiness (EDS) was associated with increased mortality (HR 1.37, 95% CI 1.01-1.85, p = 0.045). A significant interaction was found between CAO and habitual snoring, with participants displaying both having more than a twofold increased risk of mortality (HR 2.22, 95% CI 1.31-3.76, p = 0.003).

CAO and EDS emerged as independent predictors of mortality, while the coexistence of CAO and snoring conferred synergistic risk. These findings highlight the need to recognize OSA symptoms in patients with obstructive lung disease, as they may identify a vulnerable subgroup at heightened risk. Future studies using objective sleep assessments are warranted to clarify mechanisms and guide preventive strategies.

Long COVID (LC) is associated with significantly more days of work missed due to illness. Given this impact on the workforce, we estimated the lost labor costs associated with these additional missed workdays among individuals with LC in the US in 2022.

104,889,622 (weighted) adult full-time workers in the 2022 Medical Expenditure Panel Survey were categorized as: never had COVID-19, had COVID-19 without LC, and had LC. The estimated cost of lost labor from days of work missed due to illness/injury in 2022 was calculated as: (hours worked per week ÷ 5) × (hourly wage) × (days of work missed). Differences in mean costs were assessed using one-way ANOVA. The population-level lost labor cost associated with LC was estimated as (mean lost labor cost for LC - mean lost labor cost for never had COVID-19) × (number of full-time workers ≥18 years in the US in 2022 × prevalence of LC in the study population).

The total estimated lost labor cost from days of work missed due to illness/injury for individuals with LC was $15,863,994,281 (SE, $1,748,160,632). The mean lost labor cost for individuals with LC was more than twice that of individuals who never had COVID-19 and significantly higher than those who had COVID-19 without LC. The population-level lost labor cost associated with LC was estimated to be $12,784,168,675.20 (SE, $1,946,074,821.60).

These findings highlight the substantial economic impact of LC, totaling more than $12 billion in lost labor costs in 2022, emphasizing the need for targeted prevention and treatment strategies.

Since many years, immunoglobulin G (IgG) substitution has been used to treat patients with primary immunodeficiencies (PID) to reduce the number of infections and the burden of disease. Nevertheless, many patients continue to suffer from persisting infections. In this SINUS study, a patient questionnaire consisting of 21 questions was used to assess the current situation in patients with PID. Of the 160 patients included, most showed a persistent tendency to infections (N=140, 87.5%). During the last 12 month, most of the patients suffered from upper and lower respiratory tract infections such as sinusitis (N=85, 60.7%), bronchitis (N=88, 62.9%), and pneumonia (N=10, 7.1%). Yet the presence of persistent infections was not inversely correlated with patient satisfaction. Therefore, the treating physicians need to carefully evaluate the infection history and additional therapeutic approaches are required for satisfying improvement in the patient's infection control. Patients are open to explore new ways to achieve this goal.