Academic journals,consulting firms,and mainstream media have often published“predictions”about the future develop-ment of medical and health care.These publications often emphasize the potential of cutting-edge scie...Academic journals,consulting firms,and mainstream media have often published“predictions”about the future develop-ment of medical and health care.These publications often emphasize the potential of cutting-edge scientific or technical breakthroughs.Health Care Science looks at the problem from another perspective.We focus on how these changes enter the health system,how they operate in the real world,and how they reshape the organization and governance of medical services.At the beginning of 2026,we envision the following three major shifts that will reshape healthcare.展开更多
Background:Studies have shown that heart rate variability(HRV)is a predictor of the prognosis of cardiovascular diseases.Contact heartbeat monitoring equipment is widely used,especially in hospitals,and benefits from ...Background:Studies have shown that heart rate variability(HRV)is a predictor of the prognosis of cardiovascular diseases.Contact heartbeat monitoring equipment is widely used,especially in hospitals,and benefits from the rapidity and accuracy of the detection of physiological health indicators.However,long-term contact with equipment has many adverse effects.The purpose of this study was to improve the accuracy of HRV detection via noncontact equipment,thus enabling HRV to be assessed in various scenarios.Methods:A novel deep learning approach was proposed for measuring heartbeats through camera videos.First,we performed facial segmentation and divided the face into 16 grid cells with different light balance scores.After the trend is filtered by the Hamming window,a transformer-based neural network is used to further filter the signal.Finally,heart rate(HR)and HRV are estimated.Results:We used 1 million synthetic data points for pretraining and a public dataset in combination with a dataset that we constructed for task training.The final results were obtained on a test dataset that we constructed.The accuracy for HR with a low light balance score(0.867-0.983)was greater than that with a high score(0.667-0.750).Our method had higher accuracy in estimating HR than traditional filtering methods(0.167-0.417)and state-of-the-art neural network filtering methods(0.783-0.917)did.The root mean square error of the HRV from the time domain was the lowest,and the correlation index score was the highest for the HRV from the frequency domain estimated by our method compared with those estimated by two neural networks.Conclusions:Light balance,large sample training,and two-stage training can improve the accuracy of HRV estimation.展开更多
Background:Assess ChatGPT and Bard's effectiveness in the initial identification of articles for Otolaryngology—Head and Neck Surgery systematic literature reviews.Methods:Three PRISMA-based systematic reviews(Ja...Background:Assess ChatGPT and Bard's effectiveness in the initial identification of articles for Otolaryngology—Head and Neck Surgery systematic literature reviews.Methods:Three PRISMA-based systematic reviews(Jabbour et al.2017,Wong et al.2018,and Wu et al.2021)were replicated using ChatGPTv3.5 and Bard.Outputs(author,title,publication year,and journal)were compared to the original references and cross-referenced with medical databases for authenticity and recall.Results:Several themes emerged when comparing Bard and ChatGPT across the three reviews.Bard generated more outputs and had greater recall in Wong et al.'s review,with a broader date range in Jabbour et al.'s review.In Wu et al.'s review,ChatGPT-2 had higher recall and identified more authentic outputs than Bard-2.Conclusion:Large language models(LLMs)failed to fully replicate peer-reviewed methodologies,producing outputs with inaccuracies but identifying relevant,especially recent,articles missed by the references.While human-led PRISMA-based reviews remain the gold standard,refining LLMs for literature reviews shows potential.展开更多
Background:Artificial intelligence(AI)is transforming healthcare,demanding reevaluation of medical education.China's“New Medical Education”initiative urgently requires a standardized AI literacy framework for me...Background:Artificial intelligence(AI)is transforming healthcare,demanding reevaluation of medical education.China's“New Medical Education”initiative urgently requires a standardized AI literacy framework for medical students to address fragmented standards,rapid technological evolution,and insufficient localized ethical norms.Objective:To establish a Chinese expert consensus defining core AI competencies and a multi-modal assessment framework for medical students.Methods:A multidisciplinary(including medical education,clinical medicine,medical AI,public health,and medical ethics)expert group(n=32)developed an initial competency list based on the“Knowledge-Skills-Attitude”Medical Competency Model.Two Delphi rounds(100%response rate;consensus threshold:mean≥4.0,CV≤0.25)refined the framework.Core competencies were prioritized via Analytic Hierarchy Process(AHP).The final consensus document was established after multiple expert group meetings.Results:The consensus defines AI literacy for medical students as a comprehensive attribute for integrating AI into profes-sional knowledge,clinical practice,research,and health management.It comprises a 21-item Competencies of AI Proficiency(CAIP)list across knowledge(eight indicators),skills(seven indicators),and attitude(six indicators)dimensions.Key com-petencies prioritized include understanding AI's role in multidisciplinary knowledge integration(CAIP3),identifying AI output biases(CAIP4),understanding health data governance(CAIP2),maintaining physician-led AI-assisted diagnosis(CAIP16),and identifying AI diagnostic biases(CAIP12).A multi-modal assessment framework is recommended,including paper-based/computerized tests for knowledge,situational judgment tests(SJTs)for attitudes,and objective structured clinical examinations(OSCEs)with a specific“AI Clinical Decision Conflict Scoring Scale”for skills.A multi-stage dynamic assessment system(“Pre-enrollment-Pre-clinical-Post-clinical”)is proposed for longitudinal tracking.Educational integration pathways emphasize embedding AI literacy modularly from early undergraduate years,constructing an integrated curriculum covering fundamental principles,advanced large model applications(e.g.,prompt engineering,agent development),and ethical considerations,supported by a"digital twin hospital platform."Conclusion:This consensus provides authoritative,China-specific guidance for defining and assessing medical students'AI literacy,adhering to national policies and regulations.It offers a core action framework for optimizing AI integration into medical education,fostering future healthcare professionals proficient in both AI technology and medical humanism,with a commitment to dynamic updating to adapt to evolving AI advancements.展开更多
Background:The World Health Organization Disability Assessment Schedule 2.0(WHODAS 2.0)is a popular tool for eval-uating functioning and disability in a range of population demographics and medical situations.However,...Background:The World Health Organization Disability Assessment Schedule 2.0(WHODAS 2.0)is a popular tool for eval-uating functioning and disability in a range of population demographics and medical situations.However,very little is known about the WHODAS 2.0's validity and reliability,particularly when dealing with potentially life-threatening maternal condi-tions(PLTCs).The aim of this study was to evaluate the validity of the WHODAS 2.0 Tigrigna version.Methods:This cross-sectional study was conducted in Tigray,northern Ethiopia,from December 15 to 20,2023.Following translation and back translation,women who had experienced PLTCs during a recent pregnancy,childbirth,or postpartum period were administered the 36-item WHODAS 2.0 in Tigrigna version 6 months after the childbirth.In total,121 women with a history of PLTCs participated.Cronbach′sαwas used to evaluate internal consistency in all six WHODAS 2.0 domains,while Spearman′s correlation coefficient was used to evaluate convergent validity.With confirmatory factor analysis,construct validity was also examined.Results:All domain scores of the Tigrigna version of the WHODAS 2.0 indicated excellent internal consistency(α=0.917-0.978 for 36 items andα=0.874-0.940 for 12 items),while the Cronbach′sαcoefficients for the summary score were 0.981 and 0.952 for 36 and 12 items,respectively.The convergent validity between the 36-item and 12-item WHODAS 2.0 showed a strong correlation between similar constructs(r=0.909-0.981).Conclusion:Despite the small sample limitation,the WHODAS 2.0 tool adapted to the Tigrigna version indicated an acceptable reliability and validity and therefore could be applied to women with a history of PLTCs at 6 months postpartum.展开更多
Introduction:Chemotherapy-induced gastrointestinal symptom clusters in breast cancer impair quality of life and treatment adherence,yet lack effective interventions.While acupuncture mitigates isolated chemotherapy-in...Introduction:Chemotherapy-induced gastrointestinal symptom clusters in breast cancer impair quality of life and treatment adherence,yet lack effective interventions.While acupuncture mitigates isolated chemotherapy-induced symptoms,its mechanisms for multi-symptom clusters remain unclear.This study evaluates electroacupuncture's efficacy and explores its biological mechanisms in managing these clusters.Methods:This prospective,multicenter,block-randomized,double-blind,sham-controlled trial will enroll 388 patients with breast cancer undergoing neoadjuvant/adjuvant chemotherapy,to be randomly assigned(1:1)to electroacupuncture or sham electro-acupuncture groups.Both groups will receive the standard quadruple antiemetic regimen combined with electroacupuncture or sham intervention.The primary endpoint is the incidence of chemotherapy-induced gastrointestinal symptom clusters within 120 h after chemotherapy.Secondary endpoints include improvement in gastrointestinal symptom clusters post-first chemotherapy cycle,nausea-free rates during acute and delayed phases,vomiting-free rates during overall,acute,and delayed phases,complete response rate,complete protection rate,and quality of life.Adverse events will be documented throughout the study.Discussion:This study will assess the efficacy and safety of electroacupuncture in alleviating chemotherapy-induced gastro-intestinal symptom clusters in patients with breast cancer.By integrating multi-omics analyses,we aim to elucidate the biological mechanisms underlying its therapeutic effects.The findings may offer a robust clinical foundation for optimizing symptom cluster management in cancer care.Trial Registration:Clinical Trials ID:NCT06952920.Date of registration:April 16,2025.Prospectively registered.URL of Trial Registry Record:https://clinicaltrials.gov/study/NCT06952920cond=NCT06952920&rank=1.展开更多
Background:The effective delivery of nursing care is crucial in hospital settings because it directly affects patient outcomes.However,nursing care can be missed because of various factors,including inadequate teamwor...Background:The effective delivery of nursing care is crucial in hospital settings because it directly affects patient outcomes.However,nursing care can be missed because of various factors,including inadequate teamwork among nursing staff.Understanding the interplay between missed nursing care and nursing teamwork is essential for enhancing care quality in inpatient settings.This study therefore explored the relationship between missed nursing care and nursing teamwork among registered nurses in hospital inpatient units.Methods:A descriptive,correlational,cross-sectional study was conducted,involving 375 registered nurses from four hospitals in three healthcare sectors in Jordan.Missed nursing care and nursing teamwork were measured using the Missed Nursing Care Survey and the Nursing Teamwork Survey.Data collection occurred between September and October 2024,with con-venience sampling used for participant recruitment.Descriptive and inferential statistics,including mean,standard deviation,percentage,frequency,and Pearson's r correlation coefficient,were used to analyze the data.Results:The overall average missed nursing care score was 2.35 out of 5,suggesting that nursing care is rarely missed.The most frequently missed care activities reported by registered nurses included attending interdisciplinary care conferences,providing mouth care,and ambulating patients three times daily or as ordered.Activities least often missed included medi-cation administration within 30 min of the scheduled time,assessing vital signs as ordered,and performing patient assessments each shift.The overall mean score for nursing teamwork was 3.5 out of 5(standard deviation=1.06).There was a moderate but significant negative correlation between missed nursing care and nursing teamwork(r=−0.310,p<0.001).Conclusions:The results underscore the urgent need for targeted interventions to enhance resource allocation and teamwork,ultimately reducing missed nursing care and improving patient outcomes.Addressing these areas will foster a more effective healthcare system and enable nursing professionals to consistently deliver high-quality care.展开更多
Background:Large language models(LLMs)have shown considerable promise in supporting clinical decision-making.However,their adoption and evaluation in dermatology remains limited.This study aimed to explore the prefere...Background:Large language models(LLMs)have shown considerable promise in supporting clinical decision-making.However,their adoption and evaluation in dermatology remains limited.This study aimed to explore the preferences of Chinese dermatologists regarding LLM-generated responses in clinical psoriasis scenarios and to assess how they prioritize key quality dimensions,including accuracy,traceability,and logicality.Methods:A cross-sectional,web-based survey was conducted between December 25,2024,and January 22,2025,following the Checklist for Reporting Results of Internet E-Surveys guidelines.A total of 1247 valid responses were collected from practicing dermatologists across 33 of China's provincial-level administrative divisions.Participants evaluated responses to five categories of clinical questions(etiology,clinical presentation,differential diagnosis,treatment,and case study)generated by five LLMs:ChatGPT-4o,Kimi.ai,Doubao,ZuoYiGPT,and Lingyi-agent.Statistical associations between participant characteristics and model preferences were examined using chi-square tests.Results:ChatGPT-4o(Model 1)emerged as the most preferred model across all clinical tasks,consistently receiving the highest number of votes in case study(n=740),clinical presentation(n=666),differential diagnosis(n=707),etiology(n=602),and treatment(n=656).Significant variation in model preference by professional title was observed only for the differential diagnosis task(χ^(2)=21.13,df=12,p=0.0485),while no significant differences were found across hospital tiers(p>0.05).In terms of evaluation dimensions,accuracy was most frequently rated as“very important”(n=635).A significant association existed between hospital tier and the most valued dimension(χ^(2)=27.667,df=9,p=0.0011),with dermatologists in primary hospitals prioritizing traceability more than their peers in higher-tier hospitals.No significant associations were found across professional titles(p=0.127).Conclusions:Chinese dermatologists suggest a strong preference for ChatGPT-4o over domestic LLMs in psoriasis-related clinical tasks.While accuracy remains the primary criterion,traceability and logicality are also critical,particularly for clinicians in lower-tier hospitals.These findings suggest that future clinical LLMs should prioritize not only content accuracy but also source transparency and structural clarity to meet the diverse needs of different clinical settings.展开更多
Large language models(LLMs)show considerable potential to revolutionize healthcare through their performance across diverse clinical applications.Given the inherent constraints of LLMs and the critical nature of medic...Large language models(LLMs)show considerable potential to revolutionize healthcare through their performance across diverse clinical applications.Given the inherent constraints of LLMs and the critical nature of medical practice,a rigorous and systematic evaluation of their medical competence is imperative.This study presents a comprehensive review of the established methodologies and benchmarks for evaluating the medical competence of LLMs,encompassing a thorough analysis of current assessment practices across medical knowledge,clinical practice competence,and ethical-safety considerations.By integrating clinician competency assessment frameworks into LLMs evaluation,we propose a structured tri-dimensional framework that systematically organizes existing evaluation approaches according to medical theoretical knowledge,clinical practice ability,and ethical-safety considerations.Furthermore,this research provides critical insights into future developmental trajectories while establishing foundational frameworks and standardization protocols for the integration of LLMs into medical practice.展开更多
As we bring 2024 to a close and step into the promise of 2025,it is a moment to celebrate our accomplishments,revisit our commitments,and chart the course ahead for Health Care Science.1|A Year of Progress This year m...As we bring 2024 to a close and step into the promise of 2025,it is a moment to celebrate our accomplishments,revisit our commitments,and chart the course ahead for Health Care Science.1|A Year of Progress This year marked extraordinary growth for Health Care Science.We received a total of 225 manuscript submissions—a remarkable 55.8%increase from the previous year.Thanks to the dedication and expertize of our reviewers and editorial team,we maintained an average review time of just 35 days,ensuring a swift and rigorous editorial process.展开更多
Background:The risk of internal fixation failure remains relatively high in stable femoral neck fracture(FNF)(Garden I or II).Preoperative sagittal displacement of the femoral head has been proposed as a potential inf...Background:The risk of internal fixation failure remains relatively high in stable femoral neck fracture(FNF)(Garden I or II).Preoperative sagittal displacement of the femoral head has been proposed as a potential influencing factor.This study aimed to evaluate the impact of sagittal displacement on the outcomes of cannulated screw internal fixation(CSIF)in patients with stable FNF(Garden I or II)by reconstructing the axial sagittal oblique plane of the fracture using preoperative computed tomography(CT)imaging.Methods:This study included 167 patients with FNF who underwent CSIF.The sagittal tilt angle of the femoral head(STAFH)was evaluated using three-dimensional CT(3D-CT).The distribution of preoperative STAFH was analyzed,and its independent association with treatment failure was assessed.Treatment failure was defined as the need for revision surgery within 2 years postoperatively due to avascular necrosis,nonunion,or internal fixation failure.Results:Among the 167 patients,9(5.4%)exhibited anterior tilt(AT)of the femoral head,158(94.60%)presented with posterior tilt(PT).A total of 50 patients(29.9%)demonstrated excessive sagittal displacement(AT≥10°or PT≥20°).In the failure group,80.0%of patients had excessive sagittal displacement compared to 28.1%in the healed group.Excessive sagittal displacement was significantly associated with an increased risk of surgical failure(odds ratio:11.953,95%CI:3.656-39.083,p<0.05).Conclusions:In patients with Garden I or II FNF,greater preoperative sagittal displacement of the femoral head was correlated with a higher likelihood of CSIF failure.AT≥10°or PT≥20°were identified as independent predictors of CSIF failure in FNF patients.Nevertheless,these findings still require confirmation through prospective,multi-center clinical trials with large sample sizes.展开更多
As a new type of production factor in healthcare,healthcare data elements have been rapidly integrated into various health production processes,such as clinical assistance,health management,biological testing,and oper...As a new type of production factor in healthcare,healthcare data elements have been rapidly integrated into various health production processes,such as clinical assistance,health management,biological testing,and operation and supervision[1,2].Healthcare data elements include biolog.ical and clinical data that are related to disease,environ-mental health data that are associated with life,and operational and healthcare management data that are related to healthcare activities(Figure 1).Activities such as the construction of a data value assessment system,the devel-opment of a data circulation and sharing platform,and the authorization of data compliance and operation products support the strong growth momentum of the market for health care data elements in China[3].展开更多
Background:Telehealth has emerged as a powerful tool for managing chronic diseases and mental health conditions,offering increased access to care and improved patient outcomes.However,inequities in digital connectivit...Background:Telehealth has emerged as a powerful tool for managing chronic diseases and mental health conditions,offering increased access to care and improved patient outcomes.However,inequities in digital connectivity and technological resources have created significant disparities in access to these potentially life-changing services,disproportionately impacting marginalized and minoritized communities across the globe.Methods:Data on 473,716 telehealth encounters occurring between January 1,2022,and June 30,2023 were retrieved from the electronic health records(EHR)system used by University Hospitals.These encounters were classified into three groups:attended,canceled,and no-show.Relative risk was calculated based on age,sex,and race,and a multivariate linear regression was performed with age,sex,and race as inputs,to determine their effect on the encounter outcome.Results:Our analysis identified significant differences in relative risk between demographic groups.Patients 20-39 years of age had a high relative risk of cancellation and no-show,and Black patients demonstrated the highest relative risk for cancellation and no-show.The regression analysis illustrated a statistically significant link between no-shows and patients with a cellular plan with no other internet subscription(p<0.001),smartphone ownership(p<0.001),and not having a computer(p<0.05).Conclusions:This study highlights the clinical repercussions of the digital divide,as patients relying on a mobile phone and data plan to attend telehealth visits were more likely to no-show.Current disparities in digital connectivity for historically marginalized populations heightens the risk of creating a digital underclass.There is evidence this study may be applicable in multiple countries across the world.Further research on the causes of the observed no-shows is necessary to ensure equitable delivery of digital healthcare services.展开更多
Background:Precision medicine(PM)has taken center stage in healthcare since the completion of the genomic project.Developed countries have gradually integrated PM into mainstream patient management.However,Nigeria sti...Background:Precision medicine(PM)has taken center stage in healthcare since the completion of the genomic project.Developed countries have gradually integrated PM into mainstream patient management.However,Nigeria still grapples with wide acceptance,key translational research and implementation of PM.This study sought to explore the knowledge and attitude of PM among pharmacists as key stakeholders in the healthcare team.Methods:A cross‐sectional study was conducted in selected tertiary hospitals across the country.A 21‐item semi‐structured questionnaire was administered by hybrid online and physical methods and the results analyzed with Statistical Package for the Social Sciences Version 25.Descriptive statistics were used to summarize the data.A chi‐square test was employed to determine the association of knowledge of PM and the sociodemographic characteristics of the study population.Results:A total of 167 hospital pharmacists participated in the study.A high proportion of the participants are familiar with artificial intelligence(91.75%),Pharmacogenomics(84.5%),and precision medicine(61%).Overall,38.9%of the pharmacists had a good knowledge while 13.2%had a poor knowledge of PM and associated terms.The level of knowledge did not correlate significantly with gender(X^(2)=3.21,p=0.201),age(X^(2)=5,p=0.27),marital status(X^(2)=3.21,p=0.201),and professional level(X^(2)=6.85,p=0.144).The most important value of precision medicine to hospital pharmacists is the ability to minimize the impact of disease through preventive medicine(49%)while a large portion are pursuing and or actively planning to pursue additional education in precision medicine.Conclusions:There is a highly positive attitude toward the prospect of PM among hospital pharmacists in Nigeria.Education modules in this field are highly recommended as most do not have a holistic knowledge of terms used in PM.Also,more research aimed at translating PM knowledge into clinical practice is recommended.展开更多
Background:Oral health issues persistently affect the overall health and well-being of rural populations.Village health volunteers(VHVs)play a crucial role in advancing oral health literacy in their community.This stu...Background:Oral health issues persistently affect the overall health and well-being of rural populations.Village health volunteers(VHVs)play a crucial role in advancing oral health literacy in their community.This study aimed to examine the factors related to nutritional literacy for oral health among VHVs.Methods:This was a mixed-methods study employing an explanatory sequential design.The quantitative data were gathered through questionnaires distributed to a cohort of 10,514 VHVs registered in Health Region 1.A stratified random sampling technique was used to ensure adequate representation of various subgroups within the VHV population,considering factors such as age,education level,and geographical distribution across the region.This approach allowed for a more representative sample that accurately reflects the diversity of the VHV population.Qualitative data were obtained through semi-structured interviews with a purposive sampling of 20 participants based on specific criteria.Quantitative data were analyzed using descriptive statistics and biserial correlation techniques,while qualitative data were analyzed using content analysis.Results:The study found that the sample group possessed a moderate level of knowledge of health literacy principles and nutrition for oral health.However,their self-assessed skills in nutritional literacy for oral health were rated as high.A statistically significant negative correlation was found between knowledge of nutrition for oral health and skills in nutritional literacy for oral health.VHVs equated health literacy with knowledge because their public health training had focused more on imparting knowledge rather than developing skills based on health literacy principles.Conclusion:There is a need to emphasize skill-based health literacy training and to use effective skill development techniques that are tailored to the specific roles and responsibilities of health volunteers.It is also recommended to continuously monitor and evaluate the outcomes of these efforts.展开更多
On November 3,2025,United Therapeutics Corporation(Nasdaq:UTHR)announced the first clinical xenotransplantation within its EXPAND study,involving transplantation of the UKidney into a patient with end‐stage renal dis...On November 3,2025,United Therapeutics Corporation(Nasdaq:UTHR)announced the first clinical xenotransplantation within its EXPAND study,involving transplantation of the UKidney into a patient with end‐stage renal disease(ESRD)at New York University(NYU)Langone Health.The UKidney is a genetically engineered porcine kidney incorporating 10 gene modifications-6 human gene insertions to enhance immunologic compatibility and 4 porcine gene knockouts to minimize rejection risk and control graft growth[1].In the context of the first xenotransplantation studies,“EXPAND”refers to the US Food and Drug Administration(FDA)“expanded access”program,often colloquially known as compassionate use.展开更多
Objective:The scarcity of healthcare resources and inadequate access to medical services in rural and remote areas are pervasive challenges many countries face,particularly in the developing world.Telemedicine,with it...Objective:The scarcity of healthcare resources and inadequate access to medical services in rural and remote areas are pervasive challenges many countries face,particularly in the developing world.Telemedicine,with its capacity to overcome geographical barriers and provide patients with real‐time medical services,has shown considerable potential in addressing these issues,attracting wide-spread attention.Compact medical communities and family doctor systems play important roles in improving healthcare accessibility.However,despite the critical nature of patients'perceptions of healthcare accessibility,research in this domain is sparse.This study aimed to explore the impact of telemedicine on rural residents'perceived healthcare accessibility in China,analyze the mechanisms underpinning this relationship,and elucidate the roles of compact medical communities and the family doctor system.Methods:Survey data from 3311 rural residents were analyzed using a probit model,instrumental variables,and subgroup regression analyses to ascertain causal effects,perform heterogeneity analysis,examine mechanisms,and ascertain the robustness of the findings.Results:Telemedicine significantly enhanced rural residents'perceived healthcare accessibility,with particularly notable benefits for those in sparsely populated areas,regions with high‐speed internet access,within the purview of compact healthcare consortiums,and those with access to family doctor services.Furthermore,telemedicine improved rural residents'perceived healthcare accessibility by encouraging the use of primary care services.Conclusion:Telemedicine in China has played a significant role in improving the perceived healthcare accessibility among rural residents and aiding in the reduction of disparities in accessibility across different demographic groups.This is consistent with the broader objective of achieving universal health coverage.However,the efficacy of telemedicine in enhancing healthcare accessibility is contingent upon certain preconditions.Policymakers must confront local infrastructure challenges,particularly regarding internet connectivity,when expanding telemedicine services to ensure their effective operation.The synergistic interaction observed between telemedicine,the family doctor system,and compact medical communities highlights the importance of integrating telemedicine into existing healthcare systems.Such integration could enhance collaboration with current healthcare frameworks,ensuring the provision of safe,accessible,and affordable healthcare services,and promoting the health and well‐being of local populations.展开更多
Background:To evaluate sex‐related differences in the risk factors associated with nonhealing or recurrence of hyper-thyroidism(NHRH)in patients with Graves'disease(GD)treated with radioactive iodine.Methods:In t...Background:To evaluate sex‐related differences in the risk factors associated with nonhealing or recurrence of hyper-thyroidism(NHRH)in patients with Graves'disease(GD)treated with radioactive iodine.Methods:In total,285 patients were enrolled.Data on radioactive iodine(RAI)dosage,ultrasound indexes of the thyroid,and other clinical factors were collected.Patients were divided into NHRH and non‐NHRH(hypothyroidism or euthyroidism)groups based on treatment outcomes.Univariate and multivariate weighted logistic regression analyses were used to identify factors associated with NHRH.Sex‐specific analyses of these risk factors were also conducted.Results:There were no significant differences between the two groups in terms of sex,thyroid shear wave elastography velocity values,or pretreatment serum free thyroxine(FT4)levels.Thyroid volume and age were independently associated with NHRH,with the odds of NHRH gradually decreasing as age increased.In subgroup analyses,both age and thyroid volume were independent risk factors for NHRH in female patients(p<0.05),while in male patients,only FT4 was independently associated with NHRH(p<0.05).Conclusions:In patients of different sexes,the influence of thyroid volume,age,and FT4 on treatment outcomes exhibits distinct patterns.展开更多
The milestone reported by He et al.—demonstrating pig‐tohuman lung xenotransplantation in a brain‐dead recipient—is a seminal moment in organ xenografting.It extends the horizons of xenotransplantation beyond the ...The milestone reported by He et al.—demonstrating pig‐tohuman lung xenotransplantation in a brain‐dead recipient—is a seminal moment in organ xenografting.It extends the horizons of xenotransplantation beyond the breakthroughs achieved in porcine heart and kidney grafts and aligns with the emergent clinical data on porcine liver applications[1].展开更多
文摘Academic journals,consulting firms,and mainstream media have often published“predictions”about the future develop-ment of medical and health care.These publications often emphasize the potential of cutting-edge scientific or technical breakthroughs.Health Care Science looks at the problem from another perspective.We focus on how these changes enter the health system,how they operate in the real world,and how they reshape the organization and governance of medical services.At the beginning of 2026,we envision the following three major shifts that will reshape healthcare.
基金National Natural Science Foundation of China,Grant/Award Number:72204169Department of Science and Technology of Sichuan Province,Grant/Award Number:2021YFS0393。
文摘Background:Studies have shown that heart rate variability(HRV)is a predictor of the prognosis of cardiovascular diseases.Contact heartbeat monitoring equipment is widely used,especially in hospitals,and benefits from the rapidity and accuracy of the detection of physiological health indicators.However,long-term contact with equipment has many adverse effects.The purpose of this study was to improve the accuracy of HRV detection via noncontact equipment,thus enabling HRV to be assessed in various scenarios.Methods:A novel deep learning approach was proposed for measuring heartbeats through camera videos.First,we performed facial segmentation and divided the face into 16 grid cells with different light balance scores.After the trend is filtered by the Hamming window,a transformer-based neural network is used to further filter the signal.Finally,heart rate(HR)and HRV are estimated.Results:We used 1 million synthetic data points for pretraining and a public dataset in combination with a dataset that we constructed for task training.The final results were obtained on a test dataset that we constructed.The accuracy for HR with a low light balance score(0.867-0.983)was greater than that with a high score(0.667-0.750).Our method had higher accuracy in estimating HR than traditional filtering methods(0.167-0.417)and state-of-the-art neural network filtering methods(0.783-0.917)did.The root mean square error of the HRV from the time domain was the lowest,and the correlation index score was the highest for the HRV from the frequency domain estimated by our method compared with those estimated by two neural networks.Conclusions:Light balance,large sample training,and two-stage training can improve the accuracy of HRV estimation.
文摘Background:Assess ChatGPT and Bard's effectiveness in the initial identification of articles for Otolaryngology—Head and Neck Surgery systematic literature reviews.Methods:Three PRISMA-based systematic reviews(Jabbour et al.2017,Wong et al.2018,and Wu et al.2021)were replicated using ChatGPTv3.5 and Bard.Outputs(author,title,publication year,and journal)were compared to the original references and cross-referenced with medical databases for authenticity and recall.Results:Several themes emerged when comparing Bard and ChatGPT across the three reviews.Bard generated more outputs and had greater recall in Wong et al.'s review,with a broader date range in Jabbour et al.'s review.In Wu et al.'s review,ChatGPT-2 had higher recall and identified more authentic outputs than Bard-2.Conclusion:Large language models(LLMs)failed to fully replicate peer-reviewed methodologies,producing outputs with inaccuracies but identifying relevant,especially recent,articles missed by the references.While human-led PRISMA-based reviews remain the gold standard,refining LLMs for literature reviews shows potential.
基金Science and Technology Innovation 2030 Major Project,Grant/Award Number:2023ZD0508506。
文摘Background:Artificial intelligence(AI)is transforming healthcare,demanding reevaluation of medical education.China's“New Medical Education”initiative urgently requires a standardized AI literacy framework for medical students to address fragmented standards,rapid technological evolution,and insufficient localized ethical norms.Objective:To establish a Chinese expert consensus defining core AI competencies and a multi-modal assessment framework for medical students.Methods:A multidisciplinary(including medical education,clinical medicine,medical AI,public health,and medical ethics)expert group(n=32)developed an initial competency list based on the“Knowledge-Skills-Attitude”Medical Competency Model.Two Delphi rounds(100%response rate;consensus threshold:mean≥4.0,CV≤0.25)refined the framework.Core competencies were prioritized via Analytic Hierarchy Process(AHP).The final consensus document was established after multiple expert group meetings.Results:The consensus defines AI literacy for medical students as a comprehensive attribute for integrating AI into profes-sional knowledge,clinical practice,research,and health management.It comprises a 21-item Competencies of AI Proficiency(CAIP)list across knowledge(eight indicators),skills(seven indicators),and attitude(six indicators)dimensions.Key com-petencies prioritized include understanding AI's role in multidisciplinary knowledge integration(CAIP3),identifying AI output biases(CAIP4),understanding health data governance(CAIP2),maintaining physician-led AI-assisted diagnosis(CAIP16),and identifying AI diagnostic biases(CAIP12).A multi-modal assessment framework is recommended,including paper-based/computerized tests for knowledge,situational judgment tests(SJTs)for attitudes,and objective structured clinical examinations(OSCEs)with a specific“AI Clinical Decision Conflict Scoring Scale”for skills.A multi-stage dynamic assessment system(“Pre-enrollment-Pre-clinical-Post-clinical”)is proposed for longitudinal tracking.Educational integration pathways emphasize embedding AI literacy modularly from early undergraduate years,constructing an integrated curriculum covering fundamental principles,advanced large model applications(e.g.,prompt engineering,agent development),and ethical considerations,supported by a"digital twin hospital platform."Conclusion:This consensus provides authoritative,China-specific guidance for defining and assessing medical students'AI literacy,adhering to national policies and regulations.It offers a core action framework for optimizing AI integration into medical education,fostering future healthcare professionals proficient in both AI technology and medical humanism,with a commitment to dynamic updating to adapt to evolving AI advancements.
文摘Background:The World Health Organization Disability Assessment Schedule 2.0(WHODAS 2.0)is a popular tool for eval-uating functioning and disability in a range of population demographics and medical situations.However,very little is known about the WHODAS 2.0's validity and reliability,particularly when dealing with potentially life-threatening maternal condi-tions(PLTCs).The aim of this study was to evaluate the validity of the WHODAS 2.0 Tigrigna version.Methods:This cross-sectional study was conducted in Tigray,northern Ethiopia,from December 15 to 20,2023.Following translation and back translation,women who had experienced PLTCs during a recent pregnancy,childbirth,or postpartum period were administered the 36-item WHODAS 2.0 in Tigrigna version 6 months after the childbirth.In total,121 women with a history of PLTCs participated.Cronbach′sαwas used to evaluate internal consistency in all six WHODAS 2.0 domains,while Spearman′s correlation coefficient was used to evaluate convergent validity.With confirmatory factor analysis,construct validity was also examined.Results:All domain scores of the Tigrigna version of the WHODAS 2.0 indicated excellent internal consistency(α=0.917-0.978 for 36 items andα=0.874-0.940 for 12 items),while the Cronbach′sαcoefficients for the summary score were 0.981 and 0.952 for 36 and 12 items,respectively.The convergent validity between the 36-item and 12-item WHODAS 2.0 showed a strong correlation between similar constructs(r=0.909-0.981).Conclusion:Despite the small sample limitation,the WHODAS 2.0 tool adapted to the Tigrigna version indicated an acceptable reliability and validity and therefore could be applied to women with a history of PLTCs at 6 months postpartum.
基金Noncommunicable Chronic Diseases-National Science and Technology Major Project,Grant/Award Numbers:2024ZD0521400,2024ZD0521404Affiliated Hospital of Qinghai University。
文摘Introduction:Chemotherapy-induced gastrointestinal symptom clusters in breast cancer impair quality of life and treatment adherence,yet lack effective interventions.While acupuncture mitigates isolated chemotherapy-induced symptoms,its mechanisms for multi-symptom clusters remain unclear.This study evaluates electroacupuncture's efficacy and explores its biological mechanisms in managing these clusters.Methods:This prospective,multicenter,block-randomized,double-blind,sham-controlled trial will enroll 388 patients with breast cancer undergoing neoadjuvant/adjuvant chemotherapy,to be randomly assigned(1:1)to electroacupuncture or sham electro-acupuncture groups.Both groups will receive the standard quadruple antiemetic regimen combined with electroacupuncture or sham intervention.The primary endpoint is the incidence of chemotherapy-induced gastrointestinal symptom clusters within 120 h after chemotherapy.Secondary endpoints include improvement in gastrointestinal symptom clusters post-first chemotherapy cycle,nausea-free rates during acute and delayed phases,vomiting-free rates during overall,acute,and delayed phases,complete response rate,complete protection rate,and quality of life.Adverse events will be documented throughout the study.Discussion:This study will assess the efficacy and safety of electroacupuncture in alleviating chemotherapy-induced gastro-intestinal symptom clusters in patients with breast cancer.By integrating multi-omics analyses,we aim to elucidate the biological mechanisms underlying its therapeutic effects.The findings may offer a robust clinical foundation for optimizing symptom cluster management in cancer care.Trial Registration:Clinical Trials ID:NCT06952920.Date of registration:April 16,2025.Prospectively registered.URL of Trial Registry Record:https://clinicaltrials.gov/study/NCT06952920cond=NCT06952920&rank=1.
文摘Background:The effective delivery of nursing care is crucial in hospital settings because it directly affects patient outcomes.However,nursing care can be missed because of various factors,including inadequate teamwork among nursing staff.Understanding the interplay between missed nursing care and nursing teamwork is essential for enhancing care quality in inpatient settings.This study therefore explored the relationship between missed nursing care and nursing teamwork among registered nurses in hospital inpatient units.Methods:A descriptive,correlational,cross-sectional study was conducted,involving 375 registered nurses from four hospitals in three healthcare sectors in Jordan.Missed nursing care and nursing teamwork were measured using the Missed Nursing Care Survey and the Nursing Teamwork Survey.Data collection occurred between September and October 2024,with con-venience sampling used for participant recruitment.Descriptive and inferential statistics,including mean,standard deviation,percentage,frequency,and Pearson's r correlation coefficient,were used to analyze the data.Results:The overall average missed nursing care score was 2.35 out of 5,suggesting that nursing care is rarely missed.The most frequently missed care activities reported by registered nurses included attending interdisciplinary care conferences,providing mouth care,and ambulating patients three times daily or as ordered.Activities least often missed included medi-cation administration within 30 min of the scheduled time,assessing vital signs as ordered,and performing patient assessments each shift.The overall mean score for nursing teamwork was 3.5 out of 5(standard deviation=1.06).There was a moderate but significant negative correlation between missed nursing care and nursing teamwork(r=−0.310,p<0.001).Conclusions:The results underscore the urgent need for targeted interventions to enhance resource allocation and teamwork,ultimately reducing missed nursing care and improving patient outcomes.Addressing these areas will foster a more effective healthcare system and enable nursing professionals to consistently deliver high-quality care.
基金National Key Research and Development Program of China,Grant/Award Number:2024YFF0507404Special Clinical Business Fund for High-Level Hospitals of China-Japan Friendship Hospital,Grant/Award Number:2024-NHLHCRF-TS-01。
文摘Background:Large language models(LLMs)have shown considerable promise in supporting clinical decision-making.However,their adoption and evaluation in dermatology remains limited.This study aimed to explore the preferences of Chinese dermatologists regarding LLM-generated responses in clinical psoriasis scenarios and to assess how they prioritize key quality dimensions,including accuracy,traceability,and logicality.Methods:A cross-sectional,web-based survey was conducted between December 25,2024,and January 22,2025,following the Checklist for Reporting Results of Internet E-Surveys guidelines.A total of 1247 valid responses were collected from practicing dermatologists across 33 of China's provincial-level administrative divisions.Participants evaluated responses to five categories of clinical questions(etiology,clinical presentation,differential diagnosis,treatment,and case study)generated by five LLMs:ChatGPT-4o,Kimi.ai,Doubao,ZuoYiGPT,and Lingyi-agent.Statistical associations between participant characteristics and model preferences were examined using chi-square tests.Results:ChatGPT-4o(Model 1)emerged as the most preferred model across all clinical tasks,consistently receiving the highest number of votes in case study(n=740),clinical presentation(n=666),differential diagnosis(n=707),etiology(n=602),and treatment(n=656).Significant variation in model preference by professional title was observed only for the differential diagnosis task(χ^(2)=21.13,df=12,p=0.0485),while no significant differences were found across hospital tiers(p>0.05).In terms of evaluation dimensions,accuracy was most frequently rated as“very important”(n=635).A significant association existed between hospital tier and the most valued dimension(χ^(2)=27.667,df=9,p=0.0011),with dermatologists in primary hospitals prioritizing traceability more than their peers in higher-tier hospitals.No significant associations were found across professional titles(p=0.127).Conclusions:Chinese dermatologists suggest a strong preference for ChatGPT-4o over domestic LLMs in psoriasis-related clinical tasks.While accuracy remains the primary criterion,traceability and logicality are also critical,particularly for clinicians in lower-tier hospitals.These findings suggest that future clinical LLMs should prioritize not only content accuracy but also source transparency and structural clarity to meet the diverse needs of different clinical settings.
基金Guangzhou Science and Technology Program,Grant/Award Numbers:2025B03J0110,2024A03J1074,2024A03J0927。
文摘Large language models(LLMs)show considerable potential to revolutionize healthcare through their performance across diverse clinical applications.Given the inherent constraints of LLMs and the critical nature of medical practice,a rigorous and systematic evaluation of their medical competence is imperative.This study presents a comprehensive review of the established methodologies and benchmarks for evaluating the medical competence of LLMs,encompassing a thorough analysis of current assessment practices across medical knowledge,clinical practice competence,and ethical-safety considerations.By integrating clinician competency assessment frameworks into LLMs evaluation,we propose a structured tri-dimensional framework that systematically organizes existing evaluation approaches according to medical theoretical knowledge,clinical practice ability,and ethical-safety considerations.Furthermore,this research provides critical insights into future developmental trajectories while establishing foundational frameworks and standardization protocols for the integration of LLMs into medical practice.
文摘As we bring 2024 to a close and step into the promise of 2025,it is a moment to celebrate our accomplishments,revisit our commitments,and chart the course ahead for Health Care Science.1|A Year of Progress This year marked extraordinary growth for Health Care Science.We received a total of 225 manuscript submissions—a remarkable 55.8%increase from the previous year.Thanks to the dedication and expertize of our reviewers and editorial team,we maintained an average review time of just 35 days,ensuring a swift and rigorous editorial process.
基金supported by the National Natural Science Foundation of China(82422045).
文摘Background:The risk of internal fixation failure remains relatively high in stable femoral neck fracture(FNF)(Garden I or II).Preoperative sagittal displacement of the femoral head has been proposed as a potential influencing factor.This study aimed to evaluate the impact of sagittal displacement on the outcomes of cannulated screw internal fixation(CSIF)in patients with stable FNF(Garden I or II)by reconstructing the axial sagittal oblique plane of the fracture using preoperative computed tomography(CT)imaging.Methods:This study included 167 patients with FNF who underwent CSIF.The sagittal tilt angle of the femoral head(STAFH)was evaluated using three-dimensional CT(3D-CT).The distribution of preoperative STAFH was analyzed,and its independent association with treatment failure was assessed.Treatment failure was defined as the need for revision surgery within 2 years postoperatively due to avascular necrosis,nonunion,or internal fixation failure.Results:Among the 167 patients,9(5.4%)exhibited anterior tilt(AT)of the femoral head,158(94.60%)presented with posterior tilt(PT).A total of 50 patients(29.9%)demonstrated excessive sagittal displacement(AT≥10°or PT≥20°).In the failure group,80.0%of patients had excessive sagittal displacement compared to 28.1%in the healed group.Excessive sagittal displacement was significantly associated with an increased risk of surgical failure(odds ratio:11.953,95%CI:3.656-39.083,p<0.05).Conclusions:In patients with Garden I or II FNF,greater preoperative sagittal displacement of the femoral head was correlated with a higher likelihood of CSIF failure.AT≥10°or PT≥20°were identified as independent predictors of CSIF failure in FNF patients.Nevertheless,these findings still require confirmation through prospective,multi-center clinical trials with large sample sizes.
基金supported by National Natural Science Foundation of China(Grants 72474022,71974011,72174022,71972012,71874009)"BIT think tank"Promotion Plan of Science and Technology Innovation Program of Beijing Institute of Technology(Grants 2024CX14017,2023CX13029).
文摘As a new type of production factor in healthcare,healthcare data elements have been rapidly integrated into various health production processes,such as clinical assistance,health management,biological testing,and operation and supervision[1,2].Healthcare data elements include biolog.ical and clinical data that are related to disease,environ-mental health data that are associated with life,and operational and healthcare management data that are related to healthcare activities(Figure 1).Activities such as the construction of a data value assessment system,the devel-opment of a data circulation and sharing platform,and the authorization of data compliance and operation products support the strong growth momentum of the market for health care data elements in China[3].
文摘Background:Telehealth has emerged as a powerful tool for managing chronic diseases and mental health conditions,offering increased access to care and improved patient outcomes.However,inequities in digital connectivity and technological resources have created significant disparities in access to these potentially life-changing services,disproportionately impacting marginalized and minoritized communities across the globe.Methods:Data on 473,716 telehealth encounters occurring between January 1,2022,and June 30,2023 were retrieved from the electronic health records(EHR)system used by University Hospitals.These encounters were classified into three groups:attended,canceled,and no-show.Relative risk was calculated based on age,sex,and race,and a multivariate linear regression was performed with age,sex,and race as inputs,to determine their effect on the encounter outcome.Results:Our analysis identified significant differences in relative risk between demographic groups.Patients 20-39 years of age had a high relative risk of cancellation and no-show,and Black patients demonstrated the highest relative risk for cancellation and no-show.The regression analysis illustrated a statistically significant link between no-shows and patients with a cellular plan with no other internet subscription(p<0.001),smartphone ownership(p<0.001),and not having a computer(p<0.05).Conclusions:This study highlights the clinical repercussions of the digital divide,as patients relying on a mobile phone and data plan to attend telehealth visits were more likely to no-show.Current disparities in digital connectivity for historically marginalized populations heightens the risk of creating a digital underclass.There is evidence this study may be applicable in multiple countries across the world.Further research on the causes of the observed no-shows is necessary to ensure equitable delivery of digital healthcare services.
文摘Background:Precision medicine(PM)has taken center stage in healthcare since the completion of the genomic project.Developed countries have gradually integrated PM into mainstream patient management.However,Nigeria still grapples with wide acceptance,key translational research and implementation of PM.This study sought to explore the knowledge and attitude of PM among pharmacists as key stakeholders in the healthcare team.Methods:A cross‐sectional study was conducted in selected tertiary hospitals across the country.A 21‐item semi‐structured questionnaire was administered by hybrid online and physical methods and the results analyzed with Statistical Package for the Social Sciences Version 25.Descriptive statistics were used to summarize the data.A chi‐square test was employed to determine the association of knowledge of PM and the sociodemographic characteristics of the study population.Results:A total of 167 hospital pharmacists participated in the study.A high proportion of the participants are familiar with artificial intelligence(91.75%),Pharmacogenomics(84.5%),and precision medicine(61%).Overall,38.9%of the pharmacists had a good knowledge while 13.2%had a poor knowledge of PM and associated terms.The level of knowledge did not correlate significantly with gender(X^(2)=3.21,p=0.201),age(X^(2)=5,p=0.27),marital status(X^(2)=3.21,p=0.201),and professional level(X^(2)=6.85,p=0.144).The most important value of precision medicine to hospital pharmacists is the ability to minimize the impact of disease through preventive medicine(49%)while a large portion are pursuing and or actively planning to pursue additional education in precision medicine.Conclusions:There is a highly positive attitude toward the prospect of PM among hospital pharmacists in Nigeria.Education modules in this field are highly recommended as most do not have a holistic knowledge of terms used in PM.Also,more research aimed at translating PM knowledge into clinical practice is recommended.
文摘Background:Oral health issues persistently affect the overall health and well-being of rural populations.Village health volunteers(VHVs)play a crucial role in advancing oral health literacy in their community.This study aimed to examine the factors related to nutritional literacy for oral health among VHVs.Methods:This was a mixed-methods study employing an explanatory sequential design.The quantitative data were gathered through questionnaires distributed to a cohort of 10,514 VHVs registered in Health Region 1.A stratified random sampling technique was used to ensure adequate representation of various subgroups within the VHV population,considering factors such as age,education level,and geographical distribution across the region.This approach allowed for a more representative sample that accurately reflects the diversity of the VHV population.Qualitative data were obtained through semi-structured interviews with a purposive sampling of 20 participants based on specific criteria.Quantitative data were analyzed using descriptive statistics and biserial correlation techniques,while qualitative data were analyzed using content analysis.Results:The study found that the sample group possessed a moderate level of knowledge of health literacy principles and nutrition for oral health.However,their self-assessed skills in nutritional literacy for oral health were rated as high.A statistically significant negative correlation was found between knowledge of nutrition for oral health and skills in nutritional literacy for oral health.VHVs equated health literacy with knowledge because their public health training had focused more on imparting knowledge rather than developing skills based on health literacy principles.Conclusion:There is a need to emphasize skill-based health literacy training and to use effective skill development techniques that are tailored to the specific roles and responsibilities of health volunteers.It is also recommended to continuously monitor and evaluate the outcomes of these efforts.
文摘On November 3,2025,United Therapeutics Corporation(Nasdaq:UTHR)announced the first clinical xenotransplantation within its EXPAND study,involving transplantation of the UKidney into a patient with end‐stage renal disease(ESRD)at New York University(NYU)Langone Health.The UKidney is a genetically engineered porcine kidney incorporating 10 gene modifications-6 human gene insertions to enhance immunologic compatibility and 4 porcine gene knockouts to minimize rejection risk and control graft growth[1].In the context of the first xenotransplantation studies,“EXPAND”refers to the US Food and Drug Administration(FDA)“expanded access”program,often colloquially known as compassionate use.
基金supported by the China National Health Development Rescarch Center Study on Total Health Insurance Package Payment and National Office for Philosophy and Social Sciences,National Social Science Fund of China(17ZDA121)Tsinghua University Dushi Program(2024Z11DSZ001).
文摘Objective:The scarcity of healthcare resources and inadequate access to medical services in rural and remote areas are pervasive challenges many countries face,particularly in the developing world.Telemedicine,with its capacity to overcome geographical barriers and provide patients with real‐time medical services,has shown considerable potential in addressing these issues,attracting wide-spread attention.Compact medical communities and family doctor systems play important roles in improving healthcare accessibility.However,despite the critical nature of patients'perceptions of healthcare accessibility,research in this domain is sparse.This study aimed to explore the impact of telemedicine on rural residents'perceived healthcare accessibility in China,analyze the mechanisms underpinning this relationship,and elucidate the roles of compact medical communities and the family doctor system.Methods:Survey data from 3311 rural residents were analyzed using a probit model,instrumental variables,and subgroup regression analyses to ascertain causal effects,perform heterogeneity analysis,examine mechanisms,and ascertain the robustness of the findings.Results:Telemedicine significantly enhanced rural residents'perceived healthcare accessibility,with particularly notable benefits for those in sparsely populated areas,regions with high‐speed internet access,within the purview of compact healthcare consortiums,and those with access to family doctor services.Furthermore,telemedicine improved rural residents'perceived healthcare accessibility by encouraging the use of primary care services.Conclusion:Telemedicine in China has played a significant role in improving the perceived healthcare accessibility among rural residents and aiding in the reduction of disparities in accessibility across different demographic groups.This is consistent with the broader objective of achieving universal health coverage.However,the efficacy of telemedicine in enhancing healthcare accessibility is contingent upon certain preconditions.Policymakers must confront local infrastructure challenges,particularly regarding internet connectivity,when expanding telemedicine services to ensure their effective operation.The synergistic interaction observed between telemedicine,the family doctor system,and compact medical communities highlights the importance of integrating telemedicine into existing healthcare systems.Such integration could enhance collaboration with current healthcare frameworks,ensuring the provision of safe,accessible,and affordable healthcare services,and promoting the health and well‐being of local populations.
基金suported by the National High Level Hospital Clinical Research Funding(2022-NHLHCRF-LX-02-03,2023-NHLHCRF-YXHZ-ZRZD-06)Ministry ofScience and Technology of the People's Republic ofChina,and National Natural Science Foundation ofChina(82071943,82273523).
文摘Background:To evaluate sex‐related differences in the risk factors associated with nonhealing or recurrence of hyper-thyroidism(NHRH)in patients with Graves'disease(GD)treated with radioactive iodine.Methods:In total,285 patients were enrolled.Data on radioactive iodine(RAI)dosage,ultrasound indexes of the thyroid,and other clinical factors were collected.Patients were divided into NHRH and non‐NHRH(hypothyroidism or euthyroidism)groups based on treatment outcomes.Univariate and multivariate weighted logistic regression analyses were used to identify factors associated with NHRH.Sex‐specific analyses of these risk factors were also conducted.Results:There were no significant differences between the two groups in terms of sex,thyroid shear wave elastography velocity values,or pretreatment serum free thyroxine(FT4)levels.Thyroid volume and age were independently associated with NHRH,with the odds of NHRH gradually decreasing as age increased.In subgroup analyses,both age and thyroid volume were independent risk factors for NHRH in female patients(p<0.05),while in male patients,only FT4 was independently associated with NHRH(p<0.05).Conclusions:In patients of different sexes,the influence of thyroid volume,age,and FT4 on treatment outcomes exhibits distinct patterns.
文摘The milestone reported by He et al.—demonstrating pig‐tohuman lung xenotransplantation in a brain‐dead recipient—is a seminal moment in organ xenografting.It extends the horizons of xenotransplantation beyond the breakthroughs achieved in porcine heart and kidney grafts and aligns with the emergent clinical data on porcine liver applications[1].
