In recognition of the morbidity and mortality associated with human immunodeficiency virus (HIV), the Joint United Nations Programme on HIV/acquired immunodeficiency syndrome (AIDS) (UNAIDS) aims to end the epidemic by setting and striving to achieve the ambitious 95-95-95 targets. However, Singapore is still not performing well in the first UNAIDS target. The National HIV Programme (NHIVP) developed this set of recommendations based on an adaptation of major international guidelines from the World Health Organization and the US Centers for Disease Control and Prevention. The goals of this recommendation are: (1) to increase the uptake of HIV testing; (2) to allow earlier detection and identification of individuals with unrecognised HIV infection; (3) to facilitate linkage to clinical services; and (4) reduce further transmission of HIV infection in Singapore.
Humans ; Singapore/epidemiology* ; HIV Infections/epidemiology* ; United States ; HIV Testing ; Mass Screening ; World Health Organization ; Practice Guidelines as Topic ; Centers for Disease Control and Prevention, U.S. ; National Health Programs

Signal detection is a critical task in drug safety regulation. However, it inevitably generates irrelevant or false signals, posing challenges for resource allocation by marketing authorization holders. To reasonably assess these signals, different countries have established various principles for prioritizing the evaluation of risk signals. This study systematically compares these principles and finds that the U.S. Food and Drug Administration(FDA) focuses on practical issues, such as identifying drug confusion or drug interactions. However, China's Good Pharmacovigilance Practices and the European Medicines Agency(EMA) emphasize a comprehensive evaluation framework. The Council for International Organizations of Medical Sciences(CIOMS) emphasizes the consistency of multiple data sources, highlighting the reliability of signal evaluation. China practices a multidisciplinary approach combining traditional Chinese and western medicine, and the risk signals related to traditional Chinese medicine(TCM) have unique characteristics, including complex components, cumulative toxicity, specific theoretical foundations, and drug interactions. The different priorities in risk signal evaluation principles across countries suggest that China should strengthen clinical trial research, emphasize corroboration with evidence of multiple sources, and pay particular attention to the risks of drug interactions in the TCM regulatory science. Establishing the risk signal prioritization principles that align with the characteristics of TCM enables more precise and efficient scientific regulation of TCM.
Humans ; Medicine, Chinese Traditional/standards* ; China ; Drugs, Chinese Herbal/adverse effects* ; United States ; United States Food and Drug Administration

The objective of this study is to map the global scientific competitive landscape in the field of artificial intelligence (AI) medical devices using scientific data. A bibliometric analysis was conducted using the Web of Science Core Collection to examine global research trends in AI-based medical devices. As of the end of 2023, a total of 55 147 relevant publications were identified worldwide, with 76.6% published between 2018 and 2024. Research in this field has primarily focused on AI-assisted medical image and physiological signal analysis. At the national level, China (17 991 publications) and the United States (14 032 publications) lead in output. China has shown a rapid increase in publication volume, with its 2023 output exceeding twice that of the U.S.; however, the U.S. maintains a higher average citation per paper (China: 16.29; U.S.: 35.99). At the institutional level, seven Chinese institutions and three U.S. institutions rank among the global top ten in terms of publication volume. At the researcher level, prominent contributors include Acharya U Rajendra, Rueckert Daniel and Tian Jie, who have extensively explored AI-assisted medical imaging. Some researchers have specialized in specific imaging applications, such as Yang Xiaofeng (AI-assisted precision radiotherapy for tumors) and Shen Dinggang (brain imaging analysis). Others, including Gao Xiaorong and Ming Dong, focus on AI-assisted physiological signal analysis. The results confirm the rapid global development of AI in the medical device field, with "AI + imaging" emerging as the most mature direction. China and the U.S. maintain absolute leadership in this area-China slightly leads in publication volume, while the U.S., having started earlier, demonstrates higher research quality. Both countries host a large number of active research teams in this domain.
Artificial Intelligence ; Bibliometrics ; Humans ; China ; Equipment and Supplies ; United States ; Biomedical Research

The rapid development of artificial intelligence technology is driving profound changes in medical practice, particularly in the field of medical device application. Based on data from the U.S. clinical trials registry, this study analyzes the global registration landscape of clinical trials involving artificial intelligence-based medical devices, aiming to provide a reference for their clinical research and application. A total of 2 494 clinical trials related to artificial intelligence medical devices have been registered worldwide, with participation from 66 countries or regions. The United States leads with 908 trials, while for other countries or regions, including China, each has fewer than 300 trials. Germany, the United States, and Belgium serve as central hubs for international collaboration. Among the sponsors, 63.96% are universities or hospitals, 22.36% are enterprises, and the remainder includes individuals, government agencies and others. Of all trials, 79.99% are interventional studies, 94.67% place no restrictions on participant gender, and 69.69% exclude children. The targeted diseases are primarily neurological and mental disorders. This study systematically reveals the global distribution characteristics and research trends of artificial intelligence medical device clinical trials, offering valuable data support and practical insights for advancing international collaboration, resource allocation, and policy development in this field.
Artificial Intelligence ; Humans ; Clinical Trials as Topic/statistics & numerical data* ; Equipment and Supplies ; Registries ; United States

OBJECTIVE: To analyze the current status and temporal trends of the disease burden of spinal fractures in China from 1990 to 2021 based on data from the Global Burden of Disease Study 2021 (GBD 2021), aiming to provide evidence for developing prevention and treatment strategies. METHODS: Epidemiological data on spinal fractures in China, the United States of America (USA), and globally were extracted from the GBD 2021 database. Joinpoint regression models were applied to analyze temporal trends. Age-standardized incidence, prevalence, and disability-adjusted life years (DALYs) rates were calculated, with comparisons of gender- and age-group disparities. RESULTS: In 2021, the number of incident cases, prevalent cases, and DALYs of spinal fractures in China increased by 52.28%, 113.68%, and 106.98%, respectively, compared to 1990. The age-standardized incidence, prevalence, and DALYs rates rose by 11.80%, 16.11%, and 14.79%, respectively. The disease burden escalated significantly with age, peaking in individuals aged ≥75 years. Males exhibited higher age-standardized incidence and DALYs rates than females. Comparative analysis revealed that the age-standardized DALYs rate in China (4.19/100 000) was lower than that in globally (6.62/100 000) and USA (15.92/100 000). However, China showed an upward trend [annual average percentage change (AAPC)=0.19%], contrasting with a declining trend in the USA (AAPC=-0.08%). CONCLUSION The escalating disease burden of spinal fractures in China is closely linked to population aging, gender disparities, and insufficient targeted prevention policies. Future strategies should integrate age- and gender-specific interventions, including strengthened osteoporosis prevention, trauma risk control, and big data-driven precision measures, to mitigate this burden.
Humans ; China/epidemiology* ; Global Burden of Disease/trends* ; Male ; Female ; Spinal Fractures/epidemiology* ; Middle Aged ; Aged ; Disability-Adjusted Life Years ; Prevalence ; Incidence ; Adult ; Young Adult ; Adolescent ; Aged, 80 and over ; United States/epidemiology* ; Cost of Illness ; Quality-Adjusted Life Years ; Child

Hallux rigidus is the most common type of foot degenerative arthritis. With the aging of the population and the increasing demand for exercise, its incidence rate continues to rise. In October 2024, the American College of Foot and Ankle Surgeon (ACFAS) published 24 clinical consensus statements in the Journal of Foot & Ankle Surgery. The latest expert opinions are formed around hallux rigidus assessment, classification, conservative treatment, surgical indications, surgical method selection. Combined with the characteristics of Chinese patients and the current clinical situation, this article interprets and analyzes the key points of the consensus, and proposes individualized surgical plans for joint preservation, with the aim of providing evidence-based basis and decision-making reference for colleagues in domestic foot and ankle surgery.
Humans ; Hallux Rigidus/diagnosis* ; Consensus ; United States ; Foot/surgery* ; Ankle/surgery* ; Societies, Medical

Hip osteoarthritis (OA) is a significant disease worldwide that causes functional impairment and reduced quality of life. With the aging of the population and the increasing prevalence of obesity, its disease burden is becoming increasingly heavy. In December 2023, the American Academy of Orthopaedic Surgeons (AAOS) released the updated Clinical Practice Guideline for the Management of Osteoarthritis of the Hip (summary). Based on evidence-based medicine, this guideline provides systematic recommendations for the diagnosis and treatment of hip OA. This article will comprehensively interpret the guideline, compare it with relevant domestic expert consensus in China, analyze the consistency and differences in disease management strategies between the two, and provide references for clinical practice.
Humans ; Academies and Institutes ; Arthroplasty, Replacement, Hip ; China ; Evidence-Based Medicine ; Orthopedic Surgeons ; Orthopedics ; Osteoarthritis, Hip/surgery* ; Quality of Life ; United States

Objective To explore the effect of the knockdown of transmembrane 9 superfamily protein member 2 (TM9SF2) on the replication of vesicular stomatitis virus (VSV), and investigate its role in the mechanism of antiviral innate immunity. Methods Small interfering RNA (siRNA) was used to knock down the TM9SF2 gene in human non-small cell lung cancer A549 cells. The CCK-8 method was used to assess cell proliferation. A VSV-green fluorescent protein (VSV-GFP) infected cell model was established. The plaque assay was used to measure the viral titer in the supernatant. RT-qPCR and Western blotting were employed to quantify the mRNA and protein levels of VSV genome replication in A549 cells following VSV infection, as well as the expression of interferon β (IFN-β) mRNA and interferon regulatory factor 3 (IRF3) protein phosphorylation following polyinosinic-polycytidylic acid (poly(I:C)) stimulation. Results Compared to the negative control, the knockdown of TM9SF2 exhibited a significant effect, with no observed impact on A549 cell proliferation. The VSV-GFP infected A549 cell model was successfully established. After viral stimulation, fluorescence intensity was reduced following TM9SF2 knockdown, and the mRNA and protein levels of VSV were significantly downregulated. The viral titer of VSV was decreased. After poly(I:C) stimulation, TM9SF2 knockdown significantly upregulated the mRNA level of IFN-β and the phosphorylation level of IRF3 protein. Conclusion The knockdown of TM9SF2 inhibits the replication of vesicular stomatitis virus, and positively regulates the type I interferon signaling pathway, thus enhancing the host's antiviral innate immune response.
Humans ; Virus Replication/genetics* ; Signal Transduction ; Membrane Proteins/metabolism* ; A549 Cells ; Vesiculovirus/physiology* ; Interferon-beta/metabolism* ; Interferon Regulatory Factor-3/genetics* ; Interferon Type I/metabolism* ; Vesicular Stomatitis/immunology* ; Gene Knockdown Techniques ; Vesicular stomatitis Indiana virus/physiology* ; RNA, Small Interfering/genetics*

PURPOSE: Although there are significant differences between China and the United States (US) in trauma medical services, there has been no direct comparative research on the epidemiological data of trauma centers between the 2 countries. This study aims to fill this research gap by directly comparing trauma centers in China and the US, providing valuable data and insights for the development of trauma centers in both countries, promoting academic exchange and cooperation internationally, and enhancing the level of global trauma medical care. METHODS: This is a multicenter retrospective descriptive study. Data were collected for trauma patients with an injury severity score ≥16 treated from September 2013 to September 2019 at 2 hospital trauma centers in these 2 countries. Detailed clinical data (including injury mechanism, age, injury site, injury severity score, pre-hospital transport time, whether blood transfusion was performed, whether resuscitative thoracotomy was conducted, hospital and intensive care unit stay duration, the number of organ donor patients, mortality rates, and costs) were meticulously compiled and retrospectively analyzed to identify differences between the 2 trauma centers. The comparison was conducted using SPSS 23 software. Continuous variables are reported as median (Q₁, Q₃), and Mann Whitney U test is used to compare the median of continuous variables. Use clinically relevant critical points to classify continuous variables, with categorical variables represented as n (%), and comparisons were made between the 2 groups using the χ² test or Fisher's exact test. Statistical significance was defined as a 2-sided p < 0.05. RESULTS: These results point to significant differences in trauma center capacity, pre-hospital transport times, treatment procedures, hospital stay duration, mortality rates, and costs between the 2 centers. The volume of patients in trauma centers is less in China (2465 vs. 5288). Pre-hospital transport time was notably longer in China (180 min vs. 14 min), and the rate of emergency blood transfusions was lower in China (18.4% vs. 50.6%), Emergency thoracotomy was not performed in China but was conducted in 9.8% of cases in the US. Hospitalization costs were significantly lower in China than in the US ($5847 vs. $75,671). CONCLUSION There are clear differences in trauma center capacity (number of patients treated), pre-hospital transport time, age distribution of injured patients, injury mechanisms, injury sites, whether emergency thoracotomy is performed, hospital costs, and length of stay between the 2 trauma centers in China and America. Understanding these differences can help us further recognize the characteristics of Eastern and Western trauma patients.
Humans ; China/epidemiology* ; Trauma Centers/statistics & numerical data* ; Retrospective Studies ; United States/epidemiology* ; Male ; Female ; Wounds and Injuries/therapy* ; Middle Aged ; Adult ; Injury Severity Score ; Length of Stay/statistics & numerical data* ; Treatment Outcome

This study was to survey the relationship between semen values and demographics, comorbidities, and recreational substance use in a large cohort of adult men at the University of Chicago Medical Center Department of Urology (Chicago, IL, USA). We performed an analysis from January 2013 to December 2023 of semen samples obtained from adult patients at our institution and collected their demographics, comorbid medical conditions, and recreational substance use information. Patients were divided into categories of normozoospermia, oligozoospermia, and azoospermia on the basis of the 5 th version of the World Health Organization (WHO) guidelines. Data were analyzed by univariate linear and logistic regression models, after which statistically significant variables were placed into multivariable models. Azoospermia and oligozoospermia were both associated with Caucasian or Black, Indigenous, and People of Color (BIPOC) race (both P < 0.001), increasing age ( P = 0.005 and P < 0.001, respectively), anemia ( P < 0.001 and P = 0.02, respectively), lifetime tobacco use (both P < 0.001), lifetime alcohol use ( P = 0.02 and P < 0.001, respectively), and lifetime use of at least two recreational substances ( P < 0.001 and P = 0.003, respectively) in multivariable models. Oligospermia was additionally associated with benign prostatic hyperplasia (BPH; P = 0.003) in multivariable models. This study suggests that at-risk populations may benefit from additional early screening and workup for infertility.
Humans ; Male ; Adult ; Longitudinal Studies ; Middle Aged ; Semen Analysis ; Life Style ; Oligospermia/epidemiology* ; Azoospermia/epidemiology* ; Comorbidity ; Midwestern United States/epidemiology* ; Young Adult