China is experiencing rapid population aging and a growing burden of disability, creating urgent demand for sustainable long-term care systems. In response, China has progressively developed a long-term care insurance system since the launch of national pilot programs in 2016. China's long-term care insurance has evolved through three major stages: Pilot launch phase (2016–2019), Expansion phase (2020–2025), and Comprehensive implementation phase (2026–present). The system has significantly expanded coverage, improved access to long-term care for severely disabled older adults, reduced the family caregiving burden, and promoted the transformation of elder care from a family-based responsibility to a shared social responsibility. However, substantial structural challenges remain. These include heavy dependence on medical insurance funds, lack of a sustainable financing mechanism, regional disparities in disability assessment standards, a dearth of professional caregivers, fragmented governance structures, and inadequate digital supervision systems. Looking forward, China's long-term care insurance is expected to transition from a supplementary medical insurance arrangement toward an integrated social care security system. Future reforms should focus on establishing diversified financing mechanisms, unified disability assessment standards, delivery of community-centered care, integrated health and social care governance, and digitalized regulatory systems. China's experience may provide an important policy reference for other rapidly aging middle-income countries facing growing long-term care demands.

Recent advances in computerized technologies, neuroscience, and materials and engineering have transformed brain‑computer interfaces (BCIs) from conventional unidirectional signal recording systems (brain-to-device) to bidirectional closed-loop neuromodulation systems (brain-device-brain). BCI-based devices enable direct information exchange between the human central nervous system and external electronic devices, and they are widely used in scenarios such as rehabilitation of patients with dyskinesia or enhancement of the self-care ability of disabled individuals. This editorial discusses the rapidly evolving field of BCIs, highlighting both their transformative potential to restore neurological function and the emerging ethical concerns associated with neural data access, cognitive enhancement, and human autonomy. The academic consensus and future translational prospects are also discussed. This article attempts to provide insightful, balanced, and critical viewpoints to help BCI-related research. Indeed, the future of BCIs will depend not only on technological innovation but also on society’s ability to establish robust ethical and regulatory frameworks. Whether BCIs become a lifeline for millions of patients or a source of new societal risks will be determined by the choices made today.

Long-term care insurance (LTCI) is commonly understood as a social insurance mechanism that compensates care-related costs after disability has occurred. This compensation function remains essential, but it is insufficient in the context of rapid population aging, multimorbidity, cognitive impairment, and long-term family caregiving burden. In older adults, disability often emerges from the cumulative interaction of geriatric syndromes, including frailty, recurrent falls, cognitive decline, malnutrition, depressive symptoms, pressure injuries, together with multimorbidity, environmental vulnerability, and caregiver burden. This article argues that the next stage of LTCI reform should not simply expand coverage or reimbursement, but should incorporate earlier identification of functional risk, comprehensive geriatric assessment, continuous care, caregiver support, and functional outcome evaluation. Existing quasi-experimental studies from China suggest that current LTCI pilots are associated with partial benefits in cognitive and psychological outcomes, changes in healthcare utilization including reduced hospitalization in some studies, modest improvements in health-related quality of life, and favorable frailty-related outcomes. However, these studies do not establish the effectiveness or added value of a geriatric-syndrome-oriented LTCI model. We therefore distinguish between the current evidence base and a proposed reform model, outline potential pathways linking LTCI to healthy aging, and propose operational priorities for future evaluation.

Rapid population aging is increasing demand for long-term care (LTC), prompting many countries to institutionalize financing and service provision through long-term care insurance (LTCI). Digital health technologies are increasingly embedded into LTCI, and yet the pathways in which they are embedded and their governance effects differ across institutional contexts. This comparative review synthesizes evidence from Japan, South Korea, and China across five operational domains—institutional foundations, eligibility determination, service management, fund oversight, and policy steering—and uses a sociotechnical systems lens to analyze how technology and institutions co-evolve. We propose a three-layer model of institutional embedding linking welfare-boundary constraints, governance mechanisms shaping data-driven operations, and path dependence in policy and implementation. In the three countries, digital health technologies have not fundamentally expanded the welfare boundary of LTCI, but they have reshaped how LTCI is administered, shifting i) needs assessment from experience-led judgment toward data-driven decision-making support, ii) service management from flexible discretion toward rules and platform-based coordination, and iii) oversight from ex post auditing toward process-oriented monitoring. Distinct national pathways have emerged: a supplementary-technology pathway in Japan, a state-led integration pathway in South Korea, and an exploratory co-evolutionary pathway in China. These benefits are accompanied by practical risks, including algorithmic bias, inconsistent data quality, privacy and security concerns, and potential erosion of institutional flexibility. The proposed model helps explain cross-national divergence and provides a governance-oriented basis for selecting embedding strategies and safeguards in different LTCI contexts.

Brain-computer interface (BCI) technology establishes a direct communication pathway between neural activity and external devices. Driven by advances in neuroscience, artificial intelligence (AI), neural signal acquisition, decoding algorithms, and implantable system design, BCIs have progressed rapidly from experimental prototypes toward clinically relevant neurotechnologies. However, the translation of these technical advances into routine clinical practice and equitable real-world access remains substantially slower than technological innovation. This review summarizes the major technological pathways of BCIs and their clinical applications, and it then examines BCI development from the perspective of clinical translation and accessibility. We focus on key barriers across the translational chain, including long-term technical stability, quality of clinical evidence, evaluation standards, reimbursement mechanisms, health-economic evidence, and the feasibility of implementation in real-world healthcare settings. We argue that the central challenge in BCI development has shifted from improving technical performance alone to building the translational infrastructure required for safe, effective, affordable, and sustainable clinical integration.

Liver cirrhosis (LC) represents a substantial and growing global health burden, driving high mortality through liver failure and hepatocellular carcinoma (HCC), for which liver transplantation (LT) remains the only definitive and life-saving therapy. Despite continuous technical and perioperative advances, a critical unmet need persists due to the imbalance between organ demand and availability. In Japan, the practice of LT is uniquely shaped by the predominance of living donor transplantation and a marked epidemiological transition: the burden of viral hepatitis-related cirrhosis has declined with antiviral therapies, while metabolic dysfunction–associated steatohepatitis (MASH) and alcohol-associated liver disease (ALD) are emerging as leading indications. This paradigm shift necessitates refinement of transplant strategies, including improved candidate selection for HCC through integration of tumor biology and novel biomarkers and careful consideration of immunotherapy-related risks. Moreover, MASH introduces complex challenges related to obesity, disease recurrence, and the role and timing of metabolic interventions, whereas ALD raises ongoing clinical and ethical questions regarding early transplantation and relapse prevention. Future progress will depend on expanding the donor pool through innovations such as machine perfusion and xenotransplantation as well as expanding indications to selected non-HCC malignancies and adopting advanced surgical technologies. Collectively, LT is transitioning toward a precision-based, multidisciplinary, and innovation-driven paradigm.

Confocal laser endomicroscopy (CLE) is a critical modality for the early, minimally invasive diagnosis of intraluminal diseases. However, its clinical translation is constrained by the inherent optical-mechanical trade-offs between numerical aperture (NA), probe diameter, and clinical maneuverability. Achieving high-performance imaging within the strict dimensional limits of standard biopsy channels remains a significant technical bottleneck. To address these challenges, we propose a clinically constrained optical design strategy. This integrated design approach incorporates anatomical boundary constraints directly into the optical optimization process. Based on this method, the developed miniature immersion objective achieved a 0.78 μm lateral resolution across a 300 μm field of view, while the integrated pCLE probe maintained a 1.1 μm lateral resolution. This system realizes stable cellular-level imaging under constrained geometry. It is bending-compatible and clinically deployable. Animal experiments and representative histology-correlated clinical gastric images demonstrated the feasibility of resolving tissue microstructures and clinically relevant mucosal abnormalities, supporting the translational potential of the integrated pCLE probe.

Patients with end-stage liver disease often exhibit impaired neutrophil function and have an elevated risk for perioperative infections. Liver transplantation (LT) restores hepatic function; however, perioperative neutrophil dynamics and their association with graft size remain unclear. We retrospectively analyzed 71 adult patients who underwent LT between January 2019 and June 2021. Leukocyte, neutrophil, and lymphocyte counts and the neutrophil-to-lymphocyte ratio were assessed at three intraoperative time points: beginning of surgery (BS), anhepatic phase (AP), and abdominal closure (AC), as well as on postoperative days (PODs) 1–3. The patients were stratified by graft-to-recipient weight ratio (GRWR < 1.0 vs. ≥ 1.0), and the correlations between GRWR and leukocyte parameters were evaluated. Neutrophil and leukocyte counts remained unchanged from the BS to AP and increased significantly after graft reperfusion (AC vs. BS: p < 0.01). Lymphocyte counts declined significantly during surgery. On POD 1, both neutrophil counts and their increases from BS correlated significantly with GRWR in the GRWR < 1.0 group (r_s = 0.424 and 0.442, respectively; both p < 0.01), although not in the GRWR ≥ 1.0 group. No postoperative infections were observed within 7 days. Graft reperfusion was associated with a robust increase in peripheral neutrophil counts, particularly in the recipients of smaller grafts. These findings suggest an association between graft size and early postoperative neutrophil dynamics, which may help interpret early immune responses after LT.

In May 2026, an outbreak of Ebola virus disease caused by Bundibugyo ebolavirus emerged in the Democratic Republic of the Congo and spread to Uganda, prompting a WHO Public Health Emergency of International Concern. With no approved vaccine or specific antiviral treatment, Bundibugyo virus poses an acute importation risk in an era of dense global air travel. This perspective frames imported Ebola as a hospital resilience stress test and proposes the Hospital Resilience 4P Framework, organizing preparedness around Prediction, Preparedness, Protection, and Partnership. We critically analyze the drivers of nosocomial amplification, including diagnostic delay, healthcare worker undertraining, and insufficient infection prevention and control. For China, whose aviation hubs in Guangzhou and Shenzhen sustain dense air links with Africa under the Belt and Road Initiative, this risk is particularly urgent. We further examine the vulnerabilities of East Asian healthcare systems - aging workforces, emergency department overcrowding, and skewed PPE stockpiles - and evaluate emerging technologies (deep-ultraviolet laser disinfection, AI-driven surveillance, differential serology) with explicit evidence grading. A full-chain, multi-layered system from the aircraft cabin to isolation ward, guided by the 4P Framework, can ensure imported cases remain contained clinical events rather than triggers of hospital-based outbreaks.

Liver transplantation has long been the definitive treatment for end-stage liver diseases, and yet its clinical use remains constrained by donor shortages, surgical risks, and the burden of lifelong immunosuppression. Emerging regenerative strategies, and particularly chemically induced liver progenitors (CLiPs), are reshaping this paradigm by enabling functional restoration rather than organ replacement. CLiP technology utilizes small-molecule-mediated partial reprogramming of mature hepatocytes into proliferative progenitor-like cells, which can be expanded and re-differentiated into functional hepatic lineages. This commentary discusses the conceptual shift from replacement to regeneration, it evaluates the clinical positioning of CLiP-based therapies, and it highlights key translational challenges. Rather than serving as a complete substitute for liver transplantation, such approaches may significantly reduce transplant demand by restoring critical hepatic function in selected patients.