Health Care Science最新文献

{"title":"A Smartphone Is Not Enough: Telehealth Attendance and the Digital Divide","authors":"James Labadorf,&nbsp;Matthew Nichols,&nbsp;Tayana Williams,&nbsp;Celina Cunanan,&nbsp;Brian D'Anza","doi":"10.1002/hcs2.70033","DOIUrl":"https://doi.org/10.1002/hcs2.70033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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 (<i>p</i> &lt; 0.001), smartphone ownership (<i>p</i> &lt; 0.001), and not having a computer (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"4 4","pages":"259-268"},"PeriodicalIF":3.3,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144885109","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":"Harnessing Digital Health Technologies to Combat Climate Change-Related Health Impacts","authors":"Yuhang Li,&nbsp;Ge Wu,&nbsp;Puxi Gong,&nbsp;Chang Liu,&nbsp;Lizhong Liang,&nbsp;Mengchun Gong,&nbsp;Zhirong Zeng","doi":"10.1002/hcs2.70032","DOIUrl":"https://doi.org/10.1002/hcs2.70032","url":null,"abstract":"<p>Climate change poses a significant threat to global health. It exacerbates existing health challenges and generates new ones. Therefore, innovative solutions to mitigate and adapt to its adverse effects are urgently required. This article explores the potential of digital health technologies to address the challenge posed by climate change-related health issues. It discusses their dual functionality of diminishing the carbon footprint of healthcare services and increasing understanding and governance of climate-sensitive diseases. Notably, with advanced technologies such as Generative medical AI (GMAI) presenting environmental concerns like substantial energy consumption during data processing and the generation of electronic waste, it is essential to underscore the significance of their responsible development and implementation of these technologies. This will ensure that the benefits of digital health technologies can be maximized while minimizing their ecological drawbacks. This study, therefore propose, a framework for leveraging digital health technologies to support climate change adaptation, including disease surveillance, telemedicine, patient support systems, and public awareness campaigns.</p>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"4 4","pages":"235-242"},"PeriodicalIF":3.3,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144885107","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":"Exploring Regulatory Frameworks for Exosome Therapy: Insights and Perspectives","authors":"Qiushi Li,&nbsp;Yuxia Li,&nbsp;Jiaqing Shao,&nbsp;Jianhua Sun,&nbsp;Lan Hu,&nbsp;Xia Yun,&nbsp;Chen Liuqing,&nbsp;Likun Gong,&nbsp;Shuxia Wu","doi":"10.1002/hcs2.70028","DOIUrl":"https://doi.org/10.1002/hcs2.70028","url":null,"abstract":"<p>Extracellular vesicles (EVs) have emerged as a promising technology for diagnostic and therapeutic applications in clinical settings over the past decade. However, their advancement is hindered by complex technological and regulatory challenges. This review outlines key considerations in the manufacturing process, quality management, and nonclinical evaluation relevant to EV-based drug development. Furthermore, we summarize and compare technical regulatory requirements across major countries to help clarify the regulatory principles governing EV products. Our analysis reveals an ongoing international debate regarding the regulatory review of EVs. Nevertheless, adopting a risk-based classification framework that categorizes EV products as advanced therapeutic drugs is a rational approach. Critical challenges include the development of standardized production protocols, a clearer understanding of therapeutic mechanisms, and resolving complex regulatory issues.</p>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"4 4","pages":"299-309"},"PeriodicalIF":3.3,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144885078","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 Pattern of Garlic and Risk of Chronic Diseases: Evidence From Three Large-Scale Cohorts","authors":"Xiaoyu Tai,&nbsp;Tao Luo,&nbsp;Keying Song,&nbsp;Hui Zhao,&nbsp;Silu Chen,&nbsp;Huiqin Li,&nbsp;Min Liu,&nbsp;Jianghong Dai,&nbsp;Xu Qian,&nbsp;Mulong Du","doi":"10.1002/hcs2.70030","DOIUrl":"https://doi.org/10.1002/hcs2.70030","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Understanding the relationship between garlic and chronic diseases could help to improve prevention and reduce the burden of diseases. This study aimed to examine the association between garlic consumption and the risk of chronic diseases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included 26,524 participants from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) with data of the frequency of garlic consumption, 7658 participants from the Xinjiang multiethnic cohort (XMC) study with data of garlic intake, and 141,684 participants from the UK Biobank (UKBB) with data of the preference for garlic. The dietary pattern of garlic, including the frequency of consuming garlic, garlic intake, and garlic preference information, was collected using a food questionnaire for each cohort. Logistic regression and structural equation modeling were used to assess the effect of garlic consumption on five common chronic diseases, which comprised cancer, diabetes, hypertension, respiratory diseases, and cardiovascular disease (CVD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the CLHLS cohort, individuals who consumed garlic almost every day had a significantly lower risk of five of the most common chronic diseases (cancer: odds ratio [OR] = 0.51, 95% confidence interval [CI] = 0.30–0.81, <i>p</i> = 0.006; diabetes: OR = 0.58, 95% CI = 0.43–0.76, <i>p</i> &lt; 0.001; hypertension: OR = 0.68, 95% CI = 0.61–0.77, <i>p</i> &lt; 0.001; respiratory diseases: OR = 0.77, 95% CI = 0.67–0.87, <i>p</i> &lt; 0.001; and CVD: OR = 0.69, 95% CI = 0.59–0.80, <i>p</i> &lt; 0.001). Similarly, in the XMC, there was a consistent protective effect of high garlic intake on hypertension, respiratory diseases and CVD. Additionally, in the UKBB cohort, individuals who liked garlic had a decreased risk of diabetes and CVD. Notably, in three cohorts, structural equation modeling results showed that there was a significant protective total effect of garlic consumption on the five common chronic diseases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A high garlic consumption is associated with a reduced risk of chronic diseases. Our findings highlight the potential protective role of garlic in preventing chronic diseases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"4 4","pages":"269-280"},"PeriodicalIF":3.3,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888303","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":"Multilingual Virtual Healthcare Assistant","authors":"Geetika Munjal,&nbsp;Piyush Agarwal,&nbsp;Lakshay Goyal,&nbsp;Nandy Samiran","doi":"10.1002/hcs2.70031","DOIUrl":"https://doi.org/10.1002/hcs2.70031","url":null,"abstract":"<p>This study proposes a virtual healthcare assistant framework designed to provide support in multiple languages for efficient and accurate healthcare assistance. The system employs a transformer model to process sophisticated, multilingual user inputs and gain improved contextual understanding compared to conventional models, including long short-term memory (LSTM) models. In contrast to LSTMs, which sequence processes information and may experience challenges with long-range dependencies, transformers utilize self-attention to learn relationships among every aspect of the input in parallel. This enables them to execute more accurately in various languages and contexts, making them well-suited for applications such as translation, summarization, and conversational Comparative evaluations revealed the superiority of the transformer model (accuracy rate: 85%) compared with that of the LSTM model (accuracy rate: 65%). The experiments revealed several advantages of the transformer architecture over the LSTM model, such as more effective self-attention, the ability for models to work in parallel with each other, and contextual understanding for better multilingual compatibility. Additionally, our prediction model exhibited effectiveness for disease diagnosis, with accuracy of 85% or greater in identifying the relationship between symptoms and diseases among different demographics. The system provides translation support from English to other languages, with conversion to French (Bilingual Evaluation Understudy score: 0.7), followed by English to Hindi (0.6). The lowest Bilingual Evaluation Understudy score was found for English to Telugu (0.39). This virtual assistant can also perform symptom analysis and disease prediction, with output given in the preferred language of the user.</p>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"4 4","pages":"281-288"},"PeriodicalIF":3.3,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888502","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":"Redefining Medical Publishing in the Artificial Intelligence Era","authors":"You Wu,&nbsp;Haibo Wang","doi":"10.1002/hcs2.70026","DOIUrl":"https://doi.org/10.1002/hcs2.70026","url":null,"abstract":"&lt;p&gt;On April 26, 2025, the Second Tsinghua Medicine Journal Innovation Conference convened in Beijing. Centered on the theme “AI-driven Academic: Shaping the Next Frontier” the Conference brought together journal editors, medical researchers, and science policy experts to examine how data and artificial intelligence (AI) are reshaping scholarly publishing. Two keynote speeches set the stage: the first analyzed the opportunities for hospital-based research arising from new journal policies, data infrastructure, and enabling technologies; the second introduced the latest advances in general AI and their implications for academic publishing security and integrity.&lt;/p&gt;&lt;p&gt;The conference unfolded through four roundtable discussions, each addressing critical intersections of AI and medical publishing. The first session explored strategic approaches to hospital research planning and AI's catalytic role in medical innovation. The second examined how academic journals can leverage AI to enhance editorial workflows and amplify the global influence of Chinese research. The third delved into institutional strategies for building interdisciplinary research clusters, with journals serving as key dissemination platforms. The concluding discussion identified systemic bottlenecks in translational research while championing cross-sector collaboration to bridge the gap between laboratory discoveries and clinical applications. Together, these dialogues mapped the complex ecosystem of challenges and solutions reshaping medical knowledge dissemination.&lt;/p&gt;&lt;p&gt;AI's transformative impact manifests across healthcare's clinical and academic dimensions. Beijing Children's Hospital, Capital Medical University demonstrated their “Futang Baichuan” pediatric AI system—A state-of-the-art model trained on 38 million research publications, 40,000+ clinical guidelines, and 80 years of institutional case data [&lt;span&gt;1&lt;/span&gt;]. Beyond achieving 95% diagnostic concordance with senior specialists, its dedicated research module autonomously generates hypotheses by mining multimodal clinical data, creating a closed-loop system between bedside practice and bench research.&lt;/p&gt;&lt;p&gt;The publishing workflow is also being rapidly transformed by AI. Elsevier has launched its end-to-end Research Information Management System (RIMS) product, integrating literature management and data storage, boosting efficiency by 40% [&lt;span&gt;2&lt;/span&gt;]. As for the scientific editing process, Dr. Yong Hu introduced a pilot study where large language models could complete most of pre-screening and basic editing tasks, albeit with a very low rate of hallucinated errors. AgentReview, a novel LLM-based simulation framework to analyze peer review dynamics, revealed a 37.1% decision variance due to reviewer biases while addressing privacy concerns and latent factors in the process [&lt;span&gt;3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;As AI development accelerates exponentially, more people began to recognize the value of its true enabler—data. Medical d","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"4 4","pages":"314-315"},"PeriodicalIF":3.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888519","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":"Clinical Characteristics and Influencing Factors of Postoperative Pain in Patients Undergoing Gastric Endoscopic Submucosal Dissection","authors":"Fen Deng,&nbsp;Liru Pan,&nbsp;Lei Tao,&nbsp;Xiaoyu Qiu,&nbsp;Bing Li,&nbsp;Jing Hao,&nbsp;Huihui Li,&nbsp;Zhenzhen Zhang,&nbsp;Weiwei Ding,&nbsp;Yingying Wang,&nbsp;Bo Ning","doi":"10.1002/hcs2.70024","DOIUrl":"https://doi.org/10.1002/hcs2.70024","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;To comprehensively analyze the clinical characteristics of patients who underwent gastric endoscopic submucosal dissection (ESD) and explore the incidence and influencing factors of postoperative pain.&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;The clinical data of patients who underwent gastric ESD at our center from 2009 to 2024 were retrospectively analyzed. Pain severity was assessed using a visual analogue scale, with a score ≥ 4 defined as postoperative pain. Based on the presence or absence of postoperative pain, patients were divided into a pain group and a control group. Independent factors influencing postoperative pain were identified using multivariate logistic regression analysis. To control for confounding bias, patients in the case and control groups were matched by sex and lesion size, and the matched participants were further analyzed using a conditional logistic regression model.&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;In total, 993 patients were analyzed. The incidence of postoperative pain was 9.1% (95% confidence interval [CI], 7.3–11.1). In the univariate analysis, sex, operation duration, anesthesia method, intraoperative electrocoagulation, nasogastric tube placement, and postoperative vomiting were significantly associated with postoperative pain. Multivariate analysis identified eight independent factors: male sex (odds ratio [OR], 0.61; 95% CI, 0.37–0.97; &lt;i&gt;p&lt;/i&gt; = 0.04), operation duration (OR, 1.29; 95% CI, 1.03–1.63; &lt;i&gt;p&lt;/i&gt; = 0.02), protuberant lesions (OR, 0.43; 95% CI, 0.26–0.71; &lt;i&gt;p&lt;/i&gt; &lt; 0.01), antral lesions (OR, 1.84; 95% CI, 1.10–3.05; &lt;i&gt;p&lt;/i&gt; = 0.01), intubation general anesthesia (OR, 0.40; 95% CI, 0.22–0.72; &lt;i&gt;p&lt;/i&gt; = 0.002), intraoperative electrocoagulation (OR, 0.32; 95% CI, 0.19–0.55; &lt;i&gt;p&lt;/i&gt; &lt; 0.01), nasogastric tube placement (OR, 2.005; 95% CI, 1.12–3.57; &lt;i&gt;p&lt;/i&gt; = 0.01), and postoperative vomiting (OR, 3.24; 95% CI, 1.40–7.47; &lt;i&gt;p&lt;/i&gt; = 0.005). Conditional logistic regression analysis further identified diabetes mellitus (OR, 2.50; 95% CI, 1.03–6.06; &lt;i&gt;p&lt;/i&gt; = 0.04).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Female sex, diabetes mellitus, concave-type lesions, lesions in the gastric antrum, non-intubation general anesthesia, absence of intraoperative electrocoagulation, prolonged operation duration, nasogastric tube placement, and postoperative vomiting were independent factors associated with moderate to severe pain after gastric ESD. For patients at increased risk of postoperative pain, appropriate prophylactic and therapeutic m","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"4 4","pages":"289-298"},"PeriodicalIF":3.3,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888447","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":"Validation and Reliability Testing of the Yonsei Lifestyle Profile for Assessing Multifaceted Health Lifestyles","authors":"Young-Myoung Lim,&nbsp;Ah-Ram Kim,&nbsp;Seung-Ju Lim,&nbsp;Ji-Hyuk Park","doi":"10.1002/hcs2.70023","DOIUrl":"https://doi.org/10.1002/hcs2.70023","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In this study, we aimed to validate and test the reliability of the Yonsei lifestyle profile (YLP) in assessing multifaceted health lifestyle levels in a study population from the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The YLP-English version and health-promoting lifestyle profile II were administered to 100 individuals living in the United States. Concurrent validity was analyzed using Pearson's correlation coefficient, and discriminant validity was examined by comparing sex and age differences through <i>t</i>-tests and multiple variance analysis. Internal consistency was assessed using Cronbach's α for each sub-factor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The YLP-English Version demonstrated concurrent validity with the Health-Promoting Lifestyle Profile II, showing consistent correlations for the total score (0.3, <i>p</i> &lt; 0.01) and frequency sub-factors (0.25–0.69, <i>p</i> &lt; 0.01). Among the satisfaction sub-factors, only nutrition showed a weak negative correlation (−0.19, <i>p</i> &lt; 0.01); all others were nonsignificant. Discriminant validity revealed no significant sex differences, but physical activity frequency varied across age groups. Internal consistency was high (Cronbach's <i>α</i> = 0.80–0.86).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this study, we validated the YLP-English version as a reliable instrument for assessing health-related lifestyle behaviors. The YLP uniquely captures both lifestyle frequency and satisfaction, offering a comprehensive perspective on health behaviors. Although this tool is currently most applicable in population-level studies, future research should establish clinical thresholds to enhance its utility in individualized health assessments and interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"4 4","pages":"243-249"},"PeriodicalIF":3.3,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888493","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":"Noninvasive Breast Cancer Screening Strategies Supported by AI-Based Technologies in Resource-Limited Settings: Is It the Best Opportunity to Strengthen Women's Preferences, Values and Acceptability?","authors":"Wolmark Xiques-Molina,&nbsp;Ivan David Lozada-Martinez,&nbsp;Ornella Fiorillo-Moreno,&nbsp;Alexis Narvaez-Rojas","doi":"10.1002/hcs2.70025","DOIUrl":"https://doi.org/10.1002/hcs2.70025","url":null,"abstract":"&lt;p&gt;Breast cancer is the leading cause of cancer-related mortality in women globally, with its incidence continuing to rise, particularly in low- and middle-income countries, presenting a significant public health challenge worldwide [&lt;span&gt;1&lt;/span&gt;]. According to data from the Institute for Health Metrics and Evaluation (IHME) and the World Health Organization (WHO), the gap in access to healthcare services between high- and low-income countries contributes to delayed detection, increased incidence of advanced-stage disease, and, consequently, higher mortality rates (up to 50% higher compared to high-income countries) [&lt;span&gt;1, 2&lt;/span&gt;]. This translates into inequalities in access to screening and early diagnosis methods, which exacerbate the burden of this disease in low-resource settings where infrastructure, funding, and access to trained professionals are limited [&lt;span&gt;3&lt;/span&gt;]. These limitations hinder the implementation of resource-dependent strategies required to achieve evidence-based outcomes, such as clinical breast exams (which necessitate trained personnel) or screening mammography (which requires appropriate infrastructure and trained specialists with adequate operator concordance) [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The use of artificial intelligence (AI) and emerging health technologies, particularly in the field of breast cancer screening, has shown to significantly enhance diagnostic accuracy and reduce operational costs in delivering comprehensive breast health services [&lt;span&gt;5&lt;/span&gt;]. For instance, AI enables the development of low-cost imaging analysis systems, such as for mammograms and ultrasounds, that can be implemented in resource-limited settings [&lt;span&gt;5&lt;/span&gt;]. Recent evidence suggests that these technologies can match or even exceed the diagnostic accuracy of radiologists in detecting suspicious lesions, a critical advancement in regions facing a shortage of these professionals [&lt;span&gt;6&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;A common limitation in low- and middle-income countries is the presence of cultural and social barriers, often related to the preferences, values, and needs of women [&lt;span&gt;7&lt;/span&gt;]. In ancestral, conservative, and vulnerable communities, there is a notable level of mistrust and resistance toward certain interventions, primarily when these do not account for factors that benefit their communities [&lt;span&gt;7&lt;/span&gt;]. Integrating women's values and preferences is essential for the success of any public health program. Previous research has indicated that women in these communities prefer noninvasive methods that reduce pain and minimize the risk of unnecessary radiation exposure [&lt;span&gt;7&lt;/span&gt;]. AI-based technologies can personalize the screening experience, making it less invasive and more aligned with patient needs, thereby enhancing acceptability and adherence [&lt;span&gt;5&lt;/span&gt;]. This approach can help overcome barriers such as language, physical exposure, direct palpation, among others, which strengthens trust and demonstrates","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"4 4","pages":"310-313"},"PeriodicalIF":3.3,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888494","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":"The Failure Rate of Internal Fixation Increases With Sagittal Displacement of the Femoral Head: A Retrospective Study","authors":"Lei Shi,&nbsp;Chen Chen,&nbsp;Junsong Wang,&nbsp;Yuanhao Wu,&nbsp;Jia Li,&nbsp;Houchen Lyu,&nbsp;Quanyi Guo,&nbsp;Peifu Tang","doi":"10.1002/hcs2.70022","DOIUrl":"https://doi.org/10.1002/hcs2.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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, <i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"4 4","pages":"250-258"},"PeriodicalIF":3.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888520","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}