The Italian Fight Against the COVID-19 Pandemic in the Second Phase: The Renewed Opportunity of Telemedicine.

Recent studies published in the Telemedicine and e-Health journal stated the reality in Italy of the importance of telemedicine promotion during the coronavirus 2019 (COVID-19) pandemic. In Italy, we gradually approached the second phase of the COVID-19 pandemic. During this phase, the activities restarted according to a temporal plan. During the second phase, "social distancing" will continue and telemedicine will continue to play a pivotal role. Now, during the second phase of the fight against the pandemic, we need: (1) to maintain social distancing; (2) to face new imminent criticalities highlighted in recent studies published in Telemedicine and e-Health; (3) to protect fragile subjects and to support disabled subjects; and (4) to still care/rehabilitate critical patients (still present even if in a decreased number). Telemedicine is still important and must also be rethought. The study, starting from the needs of chronic patients, highlighted in the recent studies published in this journal, expanded the possibilities of multiple opportunities for telemedicine integration during the second phase. An emerged categorization takes into consideration (1) the subjects with fragility, including those with rare diseases; (2) the experience gained during the emergency; (3) the new opportunities emerged for telemedicine boundaries; and (4) the new needs for telemedicine-based pulmonary rehabilitation at home.

Toward the Integration of Devices for Pulmonary Respiratory Rehabilitation in Telemedicine and e-Health.

Respiratory rehabilitation is a therapeutic path based on performing regular physical exercise. It aims to modify the impact that the respiratory disease has on the patients' quality of life, reducing the severity of the symptoms, and improving their ability to adhere to the activities of daily life. After an initial assessment, they are prescribed (1) different forms and modes of physical exercise and (2) exercise of pulmonary musculature to improve individual performance and the consequences of the symptoms of the emotional sphere related to the pathological condition. At the moment, the devices for pulmonary exercitation/incentivization, even if gamified, give out qualitative information and are not provided with electronics and/or are not connected to the network. The objective of this opinion article is to introduce new models of rehabilitation in this field of Telemedicine and e-Health at a first stage of research. In particular, a new environment for home rehabilitation is proposed, which is based to gamified devices for pulmonary incentivization integrated to the e-Healthcare system integratable also with automatic systems for the 6-min walk tests proposed by the same authors. A first device has been designed and tested. The next steps will be dedicated to the widening of the environment with the design of other devices and to complete the integration with the healthcare system.

Integration of tablet technologies in the e-laboratory of cytology: a health technology assessment.

INTRODUCTION: Although tablet systems are becoming a powerful technology, particularly useful in every application of medical imaging, to date no one has investigated the acceptance and performance of this technology in digital cytology. The specific aims of the work were (1) to design a health technology assessment (HTA) tool to assess, in terms of performance and acceptance, the introduction of tablet technologies (wearable, portable, and non portable) in the e-laboratories of cytology and (2) to test the tool in a first significant application of digital cytology. MATERIALS AND METHODS: An HTA tool was proposed operating on a domain of five dimensions of investigation comprising the basic information of the product of digital cytology, the perceived subjective quality of images, the assessment of the virtual navigation on the e-slide, the assessment of the information and communication technologies features, and the diagnostic power. Six e-slides regarding studies of cervicovaginal cytology digitalized by means of an Aperio ( www.aperio.com ) scanner and uploaded onto the www.digitalslide.it Web site were used for testing the methodology on three different network connections. RESULTS: Three experts of cytology successfully tested the methodology on seven tablets found suitable for the study in their own standard configuration. Specific indexes furnished by the tool indicated both a high degree of performance and subjective acceptance of the investigated technology. CONCLUSIONS: The HTA tool thus could be useful to investigate new tablet technologies in digital cytology and furnish stakeholders with useful information that may help them make decisions involving the healthcare system. From a global point of view the study demonstrates the feasibility of using the tablet technology in digital cytology.

Joint Expedition: Exploring Telehealth and the Digital Healthcare Landscape as a Team Integration.

The TeleHealth and digital healthcare domains have witnessed remarkable advancements in recent years (Contribution 1), propelled by the evolution of digitization processes, both in mobile [...].

Joint Expedition: Exploring the Intersection of Digital Health and AI in Precision Medicine with Team Integration.

Precision medicine stands as a transformative force in the orbit of healthcare, fundamentally reshaping traditional approaches by customizing therapeutic interventions to align with the distinctive attributes of individual patients [...].

Joint Expedition: Exploring Clinical Medical Imaging and Artificial Intelligence as a Team Integration.

The field of clinical medical imaging has seen remarkable advancements in recent years, particularly with the introduction of artificial intelligence (AI) techniques [...].

Smart Tattoo Sensors 2.0: A Ten-Year Progress Report through a Narrative Review.

The increased interest in sensing tattoos reflects a shift in wearable technology, emphasizing their flexible, skin-adherent nature. These devices, driven by advancements in nanotechnology and materials science, offer highly sensitive and customizable sensors. The growing body of research in this area indicates a rising curiosity in their design and applications, with potential uses ranging from vital sign monitoring to biomarker detection. Sensing tattoos present a promising avenue in wearable healthcare technology, attracting attention from researchers, clinicians, and technology enthusiasts. The objective of this study is to analyze the development, application, and integration of the sensing tattoos in the health domain. A review was conducted on PubMed and Scopus, applying a standard checklist and a qualification process. The outcome reported 37 studies. Sensing tattoos hold transformative potential in health monitoring and physiological sensing, driven by their focus on affordability, user-friendly design, and versatile sensorization solutions. Despite their promise, ongoing refinement is essential, addressing limitations in adhesion, signal quality, biocompatibility, and regulatory complexities. Identified opportunities, including non-invasive health monitoring, multiplexed detection, and cost-effective fabrication methods, open avenues for personalized healthcare applications. However, bridging gaps in medical device standards, cybersecurity, and regulatory compliance is imperative for seamless integration. A key theme calls for a holistic, user-centric approach, emphasizing interdisciplinary collaboration. Balancing innovation with practicality, prioritizing ethics, and fostering collaboration are crucial for the evolution of these technologies. The dynamic state of the field is evident, with active exploration of new frontiers. This overview also provides a roadmap, urging scholars, industry players, and regulators to collectively contribute to the responsible integration of sensing tattoos into daily life.

Beyond the Clinic Walls: Examining Radiology Technicians' Experiences in Home-Based Radiography.

In recent years, the landscape of diagnostic imaging has undergone a significant transformation with the emergence of home radiology, challenging the traditional paradigm. This shift, bringing diagnostic imaging directly to patients, has gained momentum and has been further accelerated by the global COVID-19 pandemic, highlighting the increasing importance and convenience of decentralized healthcare services. This study aims to offer a nuanced understanding of the attitudes and experiences influencing the integration of in-home radiography into contemporary healthcare practices. The research methodology involves a survey administered through Computer-Aided Web Interviewing (CAWI) tools, enabling real-time engagement with a diverse cohort of medical radiology technicians in the health domain. A second CAWI tool is submitted to experts to assess their feedback on the methodology. The survey explores key themes, including perceived advantages and challenges associated with domiciliary imaging, its impact on patient care, and the technological intricacies specific to conducting radiologic procedures outside the conventional clinical environment. Findings from a sample of 26 medical radiology technicians (drawn from a larger pool of 186 respondents) highlight a spectrum of opinions and constructive feedback. Enthusiasm is evident for the potential of domiciliary imaging to enhance patient convenience and provide a more patient-centric approach to healthcare. Simultaneously, this study suggests areas of intervention to improve the diffusion of home-based radiology. The methodology based on CAWI tools proves instrumental in the efficiency and depth of data collection, as evaluated by 16 experts from diverse professional backgrounds. The dynamic and responsive nature of this approach allows for a more allocated exploration of technicians' opinions, contributing to a comprehensive understanding of the evolving landscape of medical imaging services. Emphasis is placed on the need for national and international initiatives in the field, supported by scientific societies, to further explore the evolving landscape of teleradiology and the integration of artificial intelligence in radiology. This study encourages expansion involving other key figures in this practice, including, naturally, medical radiologists, general practitioners, medical physicists, and other stakeholders.

Reimagining Radiology: A Comprehensive Overview of Reviews at the Intersection of Mobile and Domiciliary Radiology over the Last Five Years.

(Background) Domiciliary radiology, which originated in pioneering studies in 1958, has transformed healthcare, particularly during the COVID-19 pandemic, through advancements such as miniaturization and digitization. This evolution, driven by the synergy of advanced technologies and robust data networks, reshapes the intersection of domiciliary radiology and mobile technology in healthcare delivery. (Objective) The objective of this study is to overview the reviews in this field with reference to the last five years to face the state of development and integration of this practice in the health domain. (Methods) A review was conducted on PubMed and Scopus, applying a standard checklist and a qualification process. The outcome detected 21 studies. (Key Content and Findings) The exploration of mobile and domiciliary radiology unveils a compelling and optimistic perspective. Notable strides in this dynamic field include the integration of Artificial Intelligence (AI), revolutionary applications in telemedicine, and the educational potential of mobile devices. Post-COVID-19, telemedicine advances and the influential role of AI in pediatric radiology signify significant progress. Mobile mammography units emerge as a solution for underserved women, highlighting the crucial importance of early breast cancer detection. The investigation into domiciliary radiology, especially with mobile X-ray equipment, points toward a promising frontier, prompting in-depth research for comprehensive insights into its potential benefits for diverse populations. The study also identifies limitations and suggests future exploration in various domains of mobile and domiciliary radiology. A key recommendation stresses the strategic prioritization of multi-domain technology assessment initiatives, with scientific societies' endorsement, emphasizing regulatory considerations for responsible and ethical technology integration in healthcare practices. The broader landscape of technology assessment should aim to be innovative, ethical, and aligned with societal needs and regulatory standards. (Conclusions) The dynamic state of the field is evident, with active exploration of new frontiers. This overview also provides a roadmap, urging scholars, industry players, and regulators to collectively contribute to the further integration of this technology in the health domain.

Under the Tech Umbrella: Assessing the Landscape of Telemedicine Innovations (Telemechron Study).

The expanding role of technology assessment in telemedicine is the focus of this study. An umbrella review has been proposed to delve into emerging themes within telemedicine technology assessment by scrutinizing systematic reviews gathered from PubMed and Scopus. The proposed approach was based on a standard narrative checklist and a qualification process. The selection process identified 20 systematic reviews. The main findings underscore the transformative potential of telemedicine, emphasizing technology assessments focused on systematic evaluations, stakeholder engagement, societal impact recognition, targeted interventions, and structured frameworks. While offering valuable insights, the current studies highlight certain limitations that require attention. There is a need for the following: (I) First of all, a more focused approach, primarily centered on a process-centric, multidomain, and generalizable technology assessment (TA). (II) A deeper analysis in specific healthcare areas, including a comprehensive examination of the cost-benefit ratio, peer-to-peer interactions, and a broader inclusion of diagnostic technologies. (III) Greater emphasis on the involved stakeholders, ranging from patients to stakeholders. In conclusion, this study contributes to a comprehensive and nuanced understanding of the continually evolving landscape in telemedicine technology assessment, offering valuable insights for practitioners, researchers, and policymakers alike. Researchers are encouraged to further explore both the established and emerging themes identified in this study.

The Integration of Deep Learning in Radiotherapy: Exploring Challenges, Opportunities, and Future Directions through an Umbrella Review.

This study investigates, through a narrative review, the transformative impact of deep learning (DL) in the field of radiotherapy, particularly in light of the accelerated developments prompted by the COVID-19 pandemic. The proposed approach was based on an umbrella review following a standard narrative checklist and a qualification process. The selection process identified 19 systematic review studies. Through an analysis of current research, the study highlights the revolutionary potential of DL algorithms in optimizing treatment planning, image analysis, and patient outcome prediction in radiotherapy. It underscores the necessity of further exploration into specific research areas to unlock the full capabilities of DL technology. Moreover, the study emphasizes the intricate interplay between digital radiology and radiotherapy, revealing how advancements in one field can significantly influence the other. This interdependence is crucial for addressing complex challenges and advancing the integration of cutting-edge technologies into clinical practice. Collaborative efforts among researchers, clinicians, and regulatory bodies are deemed essential to effectively navigate the evolving landscape of DL in radiotherapy. By fostering interdisciplinary collaborations and conducting thorough investigations, stakeholders can fully leverage the transformative power of DL to enhance patient care and refine therapeutic strategies. Ultimately, this promises to usher in a new era of personalized and optimized radiotherapy treatment for improved patient outcomes.

Portable kit for the assessment of gait parameters in daily telerehabilitation.

BACKGROUND: When designing a complete process of daily telerehabilitation, it should be borne in mind that patients should be furnished with properly designed methodologies for executing specific motion tasks and the assessment of the relevant parameters. In general, such a process should comprehend three basic elements in both the hospital and the home: (a) instrumented walkways, (b) walking aids or supports, and (c) equipment for the assessment of parameters. The objective, with gait being the focus, of this study was thus to design a simple, portable kit-as an alternative to the complex and expensive instruments currently used-to be easily interfaced or integrated with the instrumented walkways and aids/supports both for self-monitoring while patients are exercising with their own aids and for clinical reporting. MATERIALS AND METHODS: The proposed system is a portable kit that furnishes useful parameters with feedback to both the patient and the trainer/therapist. Capable of being integrated with the most common mechanical tools used in motion rehabilitation (handrail, scales, walkways, etc.), it constantly monitors and quantitatively assesses progress in rehabilitation care. It is composed of one step counter, photo-emitter detectors, one central unit for collecting and processing the telemetrically transmitted data, and a software interface. RESULTS AND DISCUSSION: The system has been successfully validated on 16 subjects at the second level of the Tinetti test in a clinical application for both home and the hospital. The portable kit can be used with different rehabilitation tools and on varying ground rugosity. Advantages include (a) very low cost, when compared with optoelectronic solutions or other portable devices, (b) very high accuracy, also for subjects with imbalance problems, compared with other commercial solutions, and (c) integration (compatibility) with any rehabilitative tool.

Precision Medicine 2.0: How Digital Health and AI Are Changing the Game.

In the era of rapid IT developments, the health domain is undergoing a considerable transformation [...].

Advancing Dermatological Care: A Comprehensive Narrative Review of Tele-Dermatology and mHealth for Bridging Gaps and Expanding Opportunities beyond the COVID-19 Pandemic.

Mobile health (mHealth) has recently had significant advances in tele-dermatology (TD) thanks to the developments following the COVID-19 pandemic. This topic is very important, as telemedicine and mHealth, when applied to dermatology, could improve both the quality of healthcare for citizens and the workflow in the health domain. The proposed study was centered on the last three years. We conducted an overview on the opportunities, the perspectives, and the problems involved in TD integration with mHealth. The methodology of the narrative review was based on: (I) a search of PubMed and Scopus and (II) an eligibility assessment, using properly proposed parameters. The outcome of the study showed that during the COVID-19 pandemic, TD integration with mHealth advanced rapidly. This integration enabled the monitoring of dermatological problems and facilitated remote specialist visits, reducing face-to-face interactions. AI and mobile apps have empowered citizens to take an active role in their healthcare. This differs from other imaging sectors where information exchange is limited to professionals. The opportunities for TD in mHealth include improving service quality, streamlining healthcare processes, reducing costs, and providing more accessible care. It can be applied to various conditions, such as (but not limited to) acne, vitiligo, psoriasis, and skin cancers. Integration with AI and augmented reality (AR), as well as the use of wearable sensors, are anticipated as future developments. However, integrating TD with mHealth also brings about problems and challenges related to regulations, ethics, cybersecurity, data privacy, and device management. Scholars and policymakers need to address these issues while involving citizens in the process.

The Artificial Intelligence in Teledermatology: A Narrative Review on Opportunities, Perspectives, and Bottlenecks.

Artificial intelligence (AI) is recently seeing significant advances in teledermatology (TD), also thanks to the developments that have taken place during the COVID-19 pandemic. In the last two years, there was an important development of studies that focused on opportunities, perspectives, and problems in this field. The topic is very important because the telemedicine and AI applied to dermatology have the opportunity to improve both the quality of healthcare for citizens and the workflow of healthcare professionals. This study conducted an overview on the opportunities, the perspectives, and the problems related to the integration of TD with AI. The methodology of this review, following a standardized checklist, was based on: (I) a search of PubMed and Scopus and (II) an eligibility assessment, using parameters with five levels of score. The outcome highlighted that applications of this integration have been identified in various skin pathologies and in quality control, both in eHealth and mHealth. Many of these applications are based on Apps used by citizens in mHealth for self-care with new opportunities but also open questions. A generalized enthusiasm has been registered regarding the opportunities and general perspectives on improving the quality of care, optimizing the healthcare processes, minimizing costs, reducing the stress in the healthcare facilities, and in making citizens, now at the center, more satisfied. However, critical issues have emerged related to: (a) the need to improve the process of diffusion of the Apps in the hands of citizens, with better design, validation, standardization, and cybersecurity; (b) the need for better attention paid to medico-legal and ethical issues; and (c) the need for the stabilization of international and national regulations. Targeted agreement initiatives, such as position statements, guidelines, and/or consensus initiatives, are needed to ensure a better result for all, along with the design of both specific plans and shared workflows.

The Chatbots Are Invading Us: A Map Point on the Evolution, Applications, Opportunities, and Emerging Problems in the Health Domain.

The inclusion of chatbots is potentially disruptive in society, introducing opportunities, but also important implications that need to be addressed on different domains. The aim of this study is to examine chatbots in-depth, by mapping out their technological evolution, current usage, and potential applications, opportunities, and emerging problems within the health domain. The study examined three points of view. The first point of view traces the technological evolution of chatbots. The second point of view reports the fields of application of the chatbots, giving space to the expectations of use and the expected benefits from a cross-domain point of view, also affecting the health domain. The third and main point of view is that of the analysis of the state of use of chatbots in the health domain based on the scientific literature represented by systematic reviews. The overview identified the topics of greatest interest with the opportunities. The analysis revealed the need for initiatives that simultaneously evaluate multiple domains all together in a synergistic way. Concerted efforts to achieve this are recommended. It is also believed to monitor both the process of osmosis between other sectors and the health domain, as well as the chatbots that can create psychological and behavioural problems with an impact on the health domain.

A Deep Dive into the Nexus between Digital Health and Life Sciences Amidst the COVID-19 Pandemic: An Editorial Expedition.

I am proposing this editorial to briefly trace the evidences that emerged from the Special Issue (SI)-The Digital Health in the Pandemic Era- [...].

Synergizing Intelligence and Building a Smarter Future: Artificial Intelligence Meets Bioengineering.

Smart Engineering (SE) describes the methods, processes, and IT tools for the interdisciplinary, system-oriented development of innovative, intelligent, networked products, production plants, and infrastructures [...].

The Neural Odyssey: Unveiling the Potential of Neuroscience-ICT Convergence.

The integration of neuroscience and information and communication technology (ICT) has ignited a profound transformation in the understanding of the complex biology of the brain and neural system [...].