Health Care Science最新文献

{"title":"Emerging Governance Principles for Health-System Transformation in the Digital Era: A Policy Discourse Analysis of an Official Side Event of the Seventy-Ninth World Health Assembly.","authors":"Hui Yin, Xiaobaiju Wu, Daping Song, Yunping Wang, Xiaoyun Liu, He Zhu, Xueqing Tian, Xiaodan Fan, Yingpeng Qiu, Minghui Ren","doi":"10.1002/hcs2.70110","DOIUrl":"10.1002/hcs2.70110","url":null,"abstract":"<p><strong>Background: </strong>Health-system transformation has become a major policy priority in response to demographic change, rising chronic disease burdens, workforce constraints, and fiscal pressures. Although digital technologies are widely promoted as enablers of transformation, less attention has been paid to the governance principles that guide their implementation and integration within health systems.</p><p><strong>Methods: </strong>This study employed a qualitative policy discourse analysis of an official side event held on May 18, 2026, during the Seventy-ninth World Health Assembly. The complete transcript of 16 speakers was analyzed using a structured coding framework comprising four dimensions: challenge framing, principle justification, transformation pathways, and envisioned health systems. Actor type and van Leeuwen-aligned legitimation strategies were also coded. A master governance principles matrix, theme frequency tables, actor-theme heatmaps, and discursive convergence assessments were generated to synthesize the findings.</p><p><strong>Results: </strong>Five interrelated, discourse-grounded analytical constructs emerged: equity-oriented transformation, people-centered digital health, governance-led system architecture, evidence-based and context-sensitive implementation, and national ownership with international cooperation. Digital tools were framed as supportive instruments rather than primary drivers. Actor-specific emphases varied, including less explicit people-centered language among World Health Organization headquarters speakers and more frequent financing and system-architecture language in that group. Broad discursive convergence, rather than formal policy consensus, was observed within the event.</p><p><strong>Conclusions: </strong>Official side events offer a useful but context-specific lens to examine how governance principles for health-system transformation are constructed, justified, and operationalized. Findings highlight the role of governance frameworks in enabling effective, equitable, and sustainable transformation, while recognizing that convergence in diplomatic discourse should not be interpreted as formal policy consensus or implementation commitment.</p>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13697015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149279533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-Term Outcomes of Two Interventions for Patients With Active Proliferative Diabetic Retinopathy in an Urban, Safety-Net Hospital.","authors":"Paul S Micevych, Abu Tahir Taha, Anika Kumar, Jay M Stewart","doi":"10.1002/hcs2.70109","DOIUrl":"https://doi.org/10.1002/hcs2.70109","url":null,"abstract":"<p><strong>Background: </strong>Proliferative diabetic retinopathy carries significant visual morbidity and loss to follow-up can lead to poorer visual outcomes. This study aims to evaluate the short-term impact of two systems-focused clinical initiatives directed toward reducing loss-to-follow-up and increasing pan-retinal photocoagulation (PRP) rates in patients with active proliferative diabetic retinopathy (PDR) in an urban, safety-net, teaching-hospital setting. The introduction of an additional weekly PRP clinic was followed by the creation of an active PDR patient registry with an appointment reminder system.</p><p><strong>Methods: </strong>This was a single-center, observational, retrospective cohort study between December 2022 and May 2024. We established three cohorts of encounters based on the number of eyes with active PDR in sequential order: historical controls (115 encounters) in the 8 months preceding the first intervention, increased provider PRP volume (74 encounters) over the next 4 months, and patient registry with an appointment reminder system in addition to increased provider PRP volume (65 encounters) for the following 4 months. We used linear and generalized linear mixed-effects models clustered at the patient level. Short-term process measures included the number of monthly PRP clinics, time to PRP after referral, rates of PRP and full PRP, PRP clinic adherence rate, 3-month ophthalmology clinic adherence rate, and 3-month loss-to-follow-up rate.</p><p><strong>Results: </strong>The introduction of an additional weekly PRP clinic was associated with a decrease in time from referral to PRP by 37 days (<i>p</i> < 0.001), increased odds of 3-month PRP (odds ratio [OR]: 6.53; 95% confidence interval [CI]: 3.03-14.10; <i>p</i> < 0.001) and 3-month full PRP (OR: 4.66; 95% CI: 2.22-9.78; <i>p</i> < 0.001). Subsequent introduction of a patient registry/appointment reminder system was associated with decreased odds of 3-month loss-to-follow-up (OR: 0.10; 95% CI: 0.01-0.79; <i>p</i> < 0.05) compared to historical cohort and improved odds of 3-month ophthalmology clinic adherence (OR: 2.96; 95% CI: 1.18-7.47; <i>p</i> < 0.05) compared to the increased PRP clinic cohort.</p><p><strong>Conclusions: </strong>Dedicating additional clinic time for PRP and introducing a high-risk registry and reminder system were associated with improved access to care, reduced loss-to-follow-up, and increased overall clinic adherence in an urban, safety-net hospital system. Long-term visual and functional outcomes of these initiatives are an essential area of future study.</p>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electronic Devices and Digital Therapeutics in Neuromuscular Diseases: Narrative Review on Current Applications in Patients' Management and Pharmacovigilance.","authors":"Ilaria Saltarella, Concetta Altamura, Paola Laghetti, Giuseppina Settanni, Nicola Savino, Angelo Galiano, Bodvaël Fraysse, Angelo Vacca, Jean-François Desaphy","doi":"10.1002/hcs2.70108","DOIUrl":"https://doi.org/10.1002/hcs2.70108","url":null,"abstract":"<p><p>Digital health technologies have revolutionized the management of neuromuscular diseases (NMDs), offering novel opportunities for disease monitoring, rehabilitation, telemedicine, pharmacological research, and pharmacovigilance. This narrative review aims to provide an integrated overview of the current applications of digital health technologies in NMDs, highlighting their role in diagnosis, disease monitoring, rehabilitation, telemedicine, pharmacological research, and pharmacovigilance. Relevant articles were identified by interrogating PubMed using combinations of keywords including \"neuromuscular diseases,\" \"digital health,\" \"digital therapeutics,\" \"telemedicine,\" \"wearable devices,\" \"remote monitoring,\" \"telerehabilitation,\" and \"pharmacovigilance.\" This review describes how wearable devices, digital biomarkers, telemedicine platforms, and digital therapeutics can facilitate continuous and real-time monitoring of clinically relevant parameters, including muscle strength, mobility, physical activity, and disease progression. In addition, digital technologies support remote patient management, rehabilitation programs, early detection of clinical changes, and the development of personalized therapeutic interventions. Emerging evidence also suggests that digital health tools may improve the design and conduct of clinical trials, enhance the collection and analysis of real-world data and patient-reported outcomes, and contribute to more effective pharmacovigilance strategies. Despite challenges on data privacy, digital literacy, integration into healthcare system and the need for large-scale or long-term clinical trials, the integration of digital therapeutics, digital biomarkers, and pharmacovigilance frameworks represents a promising and still underexplored area of research that may substantially contribute to the development of precision medicine approaches in NMDs.</p>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpretable Machine Learning Model for Fungal Infection Prediction: A Real-World Study","authors":"Jinru Yang,&nbsp;Shuqi Pan,&nbsp;Tao Luo,&nbsp;Bingzheng Zhang,&nbsp;Bilong Feng,&nbsp;Ying Wang","doi":"10.1002/hcs2.70099","DOIUrl":"10.1002/hcs2.70099","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Fungal infections (FIs) are common and severe complications in hospitalized patients, with early identification of high-risk patients being critical for improving clinical outcomes. Although previous studies have attempted to predict FI using traditional methods, the accuracy and clinical applicability of existing models still need improvement. The aim of this study is to develop and validate an interpretable machine learning (ML) model for predicting FI risk in hospitalized patients, enhancing the precision of clinical decision-making.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We utilized real-world inpatient data from Zhongnan Hospital of Wuhan University. Feature selection was performed using least absolute shrinkage and selection operator, random forest, and support vector machine recursive feature elimination methods. We then developed ML models, including logistic regression, random forest, decision tree, extreme gradient boosting, and light gradient boosting machine, K-nearest neighbors and histogram gradient boosting trees, which were validated on both the training set and an internal testing set. During the model development process, the Shapley additive explanations (SHAPs) method was employed to enhance the clinical interpretability of the models. Additionally, an online prediction tool based on Streamlit was developed, integrating the model into the clinical workflow.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The study cohort comprised 806,761 hospitalized patients after data cleaning. Baseline characteristics were well balanced between the two cohorts (&lt;i&gt;p&lt;/i&gt; &gt; 0.05), including demographics, disease types, and key clinical variables. The extreme gradient boosting model demonstrated excellent predictive performance, with an area under the curve of 0.952 (0.951–0.953) on the training cohort, and 0.952 (0.951–0.952) on the testing cohort, showing good internal validity. The model also exhibited favorable sensitivity, specificity, and accuracy (&lt;i&gt;F&lt;/i&gt;&lt;sub&gt;1&lt;/sub&gt; score: 0.605). SHAP analysis revealed key predictive features such as antimicrobial use, mechanical ventilation, and bacterial infections, which contributed significantly to the model's predictions. An interactive Streamlit-based web tool was developed, providing real-time risk assessment, SHAP-based interpretability, and risk-stratified clinical recommendations.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study successfully developed and validated a ML-based model for FI prediction, demonstrating good predictive ac","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"5 5","pages":"473-486"},"PeriodicalIF":6.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13559117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crosstalk Between Parkinson's Disease and Colorectal Cancer: Genetic Mechanisms, Gut Microbiota, and Therapeutic Insights","authors":"Jiacheng Ying,&nbsp;Zhengyuan Fang,&nbsp;Cheng Zhang,&nbsp;Xu Liu,&nbsp;Jianzhi Cui,&nbsp;Zezhi Li,&nbsp;Jiayin Tang","doi":"10.1002/hcs2.70087","DOIUrl":"10.1002/hcs2.70087","url":null,"abstract":"<p>This review summarizes the potential genes involved in both Parkinson's disease (PD) pathogenesis and colorectal cancer (CRC) carcinogenesis, focusing on the oncogenic mechanisms that may arise from PD gene dysfunctions. By investigating genes such as <i>PRKN</i>, <i>PINK1</i>, and <i>DJ-1</i>, which influence pathways primarily related to oxidative stress, mitophagy, cell cycle regulation, and inflammation, this review provides insight into how PD genes may contribute to CRC tumorigenesis through interactions with gut microbes such as <i>Bacillus subtilis</i> and <i>Clostridium butyricum</i>. This review highlights a mechanistic bridge between neurodegeneration and cancer centered on mitochondrial dysfunction, mitophagy, and inflammation. The convergence of molecular mechanisms and gut microbiota in PD and CRC highlights promising avenues for microbiome-targeted interventions alongside genetic and molecular approaches to advance novel diagnostic and therapeutic strategies for these two diseases. Importantly, therapeutic strategies should be considered in a holistic manner, as interventions for one disease may influence the course of another, and probiotics represent a unique modality with the potential to confer preventive and therapeutic benefits across both conditions.</p>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"5 5","pages":"495-513"},"PeriodicalIF":6.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital Healthy Aging in China: Current Landscape and the Way Forward","authors":"Yingpeng Qiu,&nbsp;Han Yao,&nbsp;Ping Ren,&nbsp;Xueqing Tian,&nbsp;Xuefei Gu","doi":"10.1002/hcs2.70097","DOIUrl":"10.1002/hcs2.70097","url":null,"abstract":"<p>China is experiencing rapid population aging, which poses increasing challenges for healthcare and social support systems. Digital health technologies, including artificial intelligence, big data, and telemedicine, offer innovative solutions to support healthy aging and integrated care. This paper reviews China's national strategies, digital innovations, and service models, with a focus on applications across different functional stages of older adults' daily living. Ethical considerations, policy challenges, and practical case studies are also discussed, providing insights for building inclusive, technology-enabled health systems in aging societies.</p>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"5 5","pages":"532-541"},"PeriodicalIF":6.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary Carotenoids and Cognitive Decline: A Longitudinal Study Among Chinese Middle-Aged and Older Adults","authors":"Liyan Huang,&nbsp;Ting Shen,&nbsp;Minyu Wu,&nbsp;Yiying Gong,&nbsp;Gulisiya Hailili,&nbsp;Ziping Wang,&nbsp;Caifeng Zhao,&nbsp;Wei Chen,&nbsp;Shuang Rong,&nbsp;Changzheng Yuan","doi":"10.1002/hcs2.70096","DOIUrl":"10.1002/hcs2.70096","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study examined the association between dietary intakes of total and specific carotenoids and cognitive decline among Chinese middle-aged and older adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included 4043 participants aged 55 years and older from the China Health and Nutrition Survey (1997–2006). Average daily dietary intakes of total carotenoids, α-carotene, β-carotene, β-cryptoxanthin, lycopene, and lutein + zeaxanthin were calculated from 3-day 24-h dietary recalls. Cognitive function was measured repeatedly using the Telephone Interview for Cognitive Status-Modified. Linear mixed-effects models were utilized to estimate beta coefficients (<i>β</i>) and the 95% confidence intervals (CIs) for the association of energy-adjusted carotenoid intake with changes in cognitive <i>z</i>-scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Higher intake of total dietary carotenoids was associated with slower cognitive decline. Comparing the top to bottom quintiles (median intake: 37.0 vs. 3.1 mg/day) of total carotenoids, the adjusted difference in annual decline rates (95% CI) was 0.018 (0.001–0.035, <i>p</i>-trend = 0.037). The strongest association was observed for moderate intake at the fourth quintile (median intake: 23.5 mg/day, <i>β</i> = 0.028, 95% CI: 0.011–0.046, <i>p</i>-quadratic = 0.030). Protective associations were also found for specific carotenoids, including α-carotene (<i>β</i>_{Q5 vs. Q1} = 0.037, 95% CI: 0.020–0.055), β-cryptoxanthin (<i>β</i> = 0.032, 95% CI: 0.014–0.049), lutein + zeaxanthin (<i>β</i> = 0.020, 95% CI: 0.002–0.037), lycopene (<i>β</i> = 0.018, 95% CI: 0.001–0.035) and β-carotene (<i>β</i> = 0.019, 95% CI: 0.001–0.036).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A potential nonlinear association between dietary carotenoids and cognitive decline was observed in Chinese middle-aged and older adults. Further research is warranted to confirm optimal intake level for dietary carotenoids and to investigate the underlying biological mechanisms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"5 5","pages":"415-423"},"PeriodicalIF":6.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning for Autism Spectrum Disorder Prediction: A Review of Data Augmentation and Feature Selection Techniques","authors":"Sahar Alkhaibari,&nbsp;Feng Dong","doi":"10.1002/hcs2.70098","DOIUrl":"10.1002/hcs2.70098","url":null,"abstract":"<p>Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by persistent difficulties in social communication, social interaction, and repetitive behaviors. Early and accurate diagnosis is essential but is often hindered by subjective clinical assessments, limited data availability, and inconsistencies in existing diagnostic tools. This review evaluates the role of machine learning and deep learning approaches in improving ASD prediction, with a particular focus on two important yet relatively underexplored methodological components: data augmentation and feature selection. A structured literature search was conducted across major scientific databases, including IEEE Xplore, PubMed, Scopus, and Google Scholar, to identify studies published between 2021 and 2024. The methodological quality and risk of bias of the included studies were assessed using the Prediction Model Risk of Bias Assessment Tool. A total of 26 peer-reviewed studies were included based on their relevance to machine learning/deep learning-based ASD prediction and their explicit application of data augmentation or feature selection techniques. Data augmentation methods were categorized into conventional approaches, such as geometric and color-space transformations, and advanced techniques, including generative adversarial network-based synthetic data generation. Although augmentation techniques may improve model robustness and help address dataset scarcity, relatively few studies conducted ablation analyses to isolate the contribution of individual augmentation strategies. Feature selection approaches were classified into filter, wrapper, and embedded methods. Commonly used techniques included information gain, chi-square tests, recursive feature elimination, and elastic net regularization. While these methods may improve predictive performance and model interpretability, they are frequently applied without sufficient empirical justification or biological interpretation. Overall, this review highlights important methodological limitations, including limited external validation, insufficient ablation analyses, and inadequate evaluation frameworks, which reduce confidence in reported performance improvements and model generalizability. Future research should emphasize methodological transparency, robust validation strategies, multimodal data integration, and clinically interpretable modeling approaches to improve the reliability and clinical applicability of ASD prediction systems.</p>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"5 5","pages":"514-531"},"PeriodicalIF":6.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Study on Post-Traumatic Stress Disorder, Anxiety, and Depression Among Medical Staff in China","authors":"Zongju Chen,&nbsp;Ruiting Cai,&nbsp;Yifang Liu,&nbsp;Na Tao,&nbsp;Yang Fei,&nbsp;Jing Wen,&nbsp;Pu Zhang,&nbsp;Yu Lu,&nbsp;Jun Zhang,&nbsp;Jing Wang,&nbsp;Li Zou,&nbsp;Wenning Fu","doi":"10.1002/hcs2.70101","DOIUrl":"10.1002/hcs2.70101","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Evidence of the longitudinal relationship between anxiety, depression, and post-traumatic stress disorder (PTSD) is not uniform. This study aimed to explore the dynamic changes, independent factors, and bidirectional predictive relationships of anxiety, depression, and PTSD among medical staff.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study conducted a longitudinal follow-up with two time points, 6 months apart, to collect medical staff's psychological data. Generalized linear mixed model and cross-lagged model were used to identify independent factors of anxiety, depression, and PTSD among medical staff and explore longitudinal predictive relationships in main variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 2650 medical staff completed both baseline and follow-up surveys, with a follow-up response rate of 96.3%. From the first phase of the survey (T1) to the second phase of the survey (T2), the prevalence of anxiety (28.9% at T1 and 34.5% at T2), depression (19.4% and 26.7%), and PTSD (6.1% and 13.1%) among medical staff showed an upward trend. Occupational exposure, sleep quality, and experiencing traumatic life events were identified as independent factors associated with psychological disorders among medical staff. In addition, from T1 to T2, PTSD predicted anxiety and depression, and depression predicted PTSD and anxiety. However, anxiety could not predict depression and PTSD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The prevalence of anxiety, depression, and PTSD among medical staff was higher and showed an upward trend. It is recommended to conduct early screening and intervention for medical staff's mental health problems, while paying close attention to the comprehensive management and intervention of these symptoms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"5 5","pages":"404-414"},"PeriodicalIF":6.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality Assessment and Management in Organ Transplantation: A Comparative Analysis of the United States, Germany, and Chinese Mainland","authors":"Björn Nashan,&nbsp;Miao Pu,&nbsp;Jie Zhao,&nbsp;Haibo Wang","doi":"10.1002/hcs2.70104","DOIUrl":"10.1002/hcs2.70104","url":null,"abstract":"<p>Organ transplantation is among the most complex domains of modern medicine, requiring the integration of advanced surgical techniques, individualized immunosuppressive therapy, structured professional training, and comprehensive quality assessment systems. As transplantation programs expand globally, ensuring consistency in clinical outcomes and patient safety has become increasingly dependent on the governance structures that regulate these domains. While Western systems emphasize decentralized, profession-led models of training and quality assurance, Chinese Mainland has developed a centrally coordinated framework integrating regulatory oversight, standardized education, and data-driven monitoring. This manuscript provides a comprehensive analysis of the interplay between immunosuppression, transplant surgeon training, and quality assessment systems, comparing Chinese Mainland with the United States and Germany. The findings highlight converging trends toward data-driven quality management and competency-based training, while underscoring persistent differences in regulatory philosophy. Chinese Mainland's integrated model offers advantages in standardization and scalability, whereas Western systems provide flexibility and innovation. These complementary approaches may inform future global harmonization of transplantation practice.</p>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"5 5","pages":"389-403"},"PeriodicalIF":6.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13586064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}