Innovative Medical Technologies Research Articles

Regulatory Issues Encountered in the Process of Medical Device Project Management

The medical device industry is subject to rigorous regulatory frameworks aimed at ensuring the safety, efficacy, and quality of medical devices. This paper explores the regulatory challenges encountered during the project management of medical device development and commercialization. These challenges include navigating complex and frequently changing regulatory standards, managing lengthy and intricate approval processes, and ensuring compliance with quality and safety requirements across different jurisdictions. The study also highlights the difficulties associated with intellectual property protection, ethical review processes for clinical trials, and the growing demands for environmental sustainability in device manufacturing and disposal. Through a comprehensive review of literature and analysis of case studies, this research identifies key obstacles in regulatory compliance and offers insights into strategies for effective project management in the medical device sector. The findings suggest that successful navigation of regulatory challenges requires a multifaceted approach, including the adoption of advanced management software, continuous professional development, and proactive engagement with regulatory bodies. The paper concludes with recommendations for medical device firms to enhance their project management practices, thereby facilitating smoother regulatory compliance and faster market access for innovative medical technologies.

Three-Dimensional Visualization of Shunt Valves with Photon Counting CT and Comparison to Traditional X-ray in a Simple Phantom Model.

This study introduces an application of innovative medical technology, Photon Counting Computer Tomography (PC CT) with novel detectors, for the assessment of shunt valves. PC CT technology offers enhanced visualization capabilities, especially for small structures, and opens up new possibilities for detailed three-dimensional imaging. Shunt valves are implanted under the skin and redirect excess cerebrospinal fluid, for example, to the abdominal cavity through a catheter. They play a vital role in regulating cerebrospinal fluid drainage in various pathologies, which can lead to hydrocephalus. Accurate imaging of shunt valves is essential to assess the rate of drainage, as their precise adjustment is a requirement for optimal patient care. This study focused on two adjustable shunt valves, the proGAV 2.0® and M. blue® (manufactured by Miethke, Potsdam, Germany). A comprehensive comparative analysis of PC CT and traditional X-ray techniques was conducted to explore this cutting-edge technology and it demonstrated that routine PC CT can efficiently assess shunt valves' adjustments. This technology shows promise in enhancing the accurate management of shunt valves used in settings where head scans are already frequently required, such as in the treatment of hydrocephalus.

Research and Application of Deep Learning in Medical Image Reconstruction and Enhancement

In recent years, deep learning technology has made remarkable progress in medical image reconstruction and enhancement, and has become one of the research hotspots in the field of medical image processing. This paper discusses the latest research progress and application of deep learning in medical image reconstruction and enhancement. Firstly, the importance of medical image reconstruction and enhancement and the limitations of traditional methods are introduced. Then, a detailed discussion was conducted on the application of deep learning models, including Convolutional Neural Networks (CNN), Generative Adversarial Networks (GAN), and Autoencoders, in medical image processing. Specifically, an analysis and comparison were conducted on the image reconstruction ability of CNN models, the image enhancement effect of GAN models, and the image denoising and reconstruction of Autoencoder models. Then, the advantages and challenges of deep learning model in medical image processing are discussed, and the future development direction is discussed. Finally, the research results of this paper are summarized and the prospect of future research is put forward. The research in this paper provides some enlightenment and reference for researchers and practitioners in the field of medical image processing, which is helpful to promote the continuous innovation and progress of medical image processing technology.

Artificial Intelligence-Based Diagnostic Support System for Patent Ductus Arteriosus in Premature Infants.

Background: Patent ductus arteriosus (PDA) is a prevalent congenital heart defect in premature infants, associated with significant morbidity and mortality. Accurate and timely diagnosis of PDA is crucial, given the vulnerability of this population. Methods: We introduce an artificial intelligence (AI)-based PDA diagnostic support system designed to assist medical professionals in diagnosing PDA in premature infants. This study utilized electronic health record (EHR) data from 409 premature infants spanning a decade at Severance Children's Hospital. Our system integrates a data viewer, data analyzer, and AI-based diagnosis supporter, facilitating comprehensive data presentation, analysis, and early symptom detection. Results: The system's performance was evaluated through diagnostic tests involving medical professionals. This early detection model achieved an accuracy rate of up to 84%, enabling detection up to 3.3 days in advance. In diagnostic tests, medical professionals using the system with the AI-based diagnosis supporter outperformed those using the system without the supporter. Conclusions: Our AI-based PDA diagnostic support system offers a comprehensive solution for medical professionals to accurately diagnose PDA in a timely manner in premature infants. The collaborative integration of medical expertise and technological innovation demonstrated in this study underscores the potential of AI-driven tools in advancing neonatal diagnosis and care.

A neural network approach to explore bioelectromagnetics aspects of blood circulation conveying tetra-hybrid nanoparticles and microbes in a ciliary artery with an endoscopy span

Bioelectromagnetics is gaining remarkableness due to its wide-ranging applications in medical and biochemical industries. Our proposed model delves into the bioelectromagnetics aspects of blood circulation in a scenario involving tetra-hybrid nanoparticles and gyrotactic microbes within a ciliated arterial annulus, particularly one mimicking an endoscopic environment. Our model takes into account influential factors, including cilia beating, buoyancy force, heat source, viscous and Joule warming, arterial wall properties, chemical reaction, and bioconvection. Different geometric shapes of suspended tetra-hybrid nanoparticles (spheres, bricks, cylinders, and platelets) are incorporated into the model formation. The close-form solution of the Poisson equation is found in terms of Bessel’s functions. The homotopy perturbation methodology (HPM) is implemented to track down the rapidly convergent series solutions of the highly non-linear coupled flow equations arising. The hemodynamical attributes of distinct evolving factors on the different dimensionless hemodynamic profiles and entities of interest are elucidated evocatively via a sort of graphs and charts. Our results prove that the factors related to electroosmosis have a dual effect on the blood flow pattern. The bloodstream rapidity is alleviated or boosted for the assisting or opposing electroosmosis process. Cooling of blood within the annulus is achieved with a larger cilia length. The Peclet number positively correlates with the gyrotactic microbes’ density. Blood infused with tetra-hybrid nanoparticles exhibits a superior heat transmission rate across the arterial wall compared to others. Additionally, an artificial neural network (ANN) model, developed using HPM-derived data, accurately predicts shearing stress (SS), achieving high accuracy rates of 99.98% in testing and 100% in validation for MB flow. The model’s new findings could be noteworthy for engineers and medical device designers to develop innovative medical devices and technologies based on bioelectromagnetic principles.

System for evaluating medical technologies in military healthcare

Modern challenges and threats, as well as unprecedented sanctions pressure on the Russian Federation, have contributed to the intensification of research both on the development of innovative medical technologies and on expanding the range of use of existing ones. At the same time, on the one hand, there is an increase in incoming proposals for the use of various medical technologies in military healthcare, and on the other hand, the need to ensure accessibility and improve the quality of medical care for military personnel and other cate- gories of assigned contingents is rapidly increasing. At the same time, in con- ditions of limited resources, the level of requirements for justifying the need to introduce one or another medical technology into the activities of military medical organizations and other medical units of the Armed Forces of the Rus- sian Federation naturally increases. All this predetermines the relevance of the development of a departmental system for assessing medical technologies for effective information support for making rational management decisions. The study examined the main directions of development of the medical tech- nology assessment system in military healthcare. In particular, goals and objectives are defined, the main aspects and possible forms of organizing a departmental system for assessing medical technologies are substantiated. The main elements of the basic model for assessing medical technologies in military healthcare are identified. In addition, the characteristics of the in- formation system for assessing medical technologies in military healthcare are given, its main components are given, as well as the expected effects of implementation. The implementation of the departmental concept for assessing medical tech- nologies in the main directions of development presented in the article on the basis of a specialized information system will not only help increase the availability of effective and safe medical technologies, but also the rational use of funds and other military healthcare resources. In addition, taking into ac- count the results of departmental assessment of medical technologies at the state level will serve as the basis for the formation of priority directions for the strategic development of the domestic medical and pharmaceutical industry in the interests of national defense and state security.

Research and solutions to cardiovascular disease in China

In China, cardiovascular disease (CVD) incidence and mortality rates are rising. CVD is the leading cause of illness mortality in both urban and rural China. Therefore, understanding the social and behavioral aspects of cardiovascular diseases is essential for addressing risk factors such as diet, physical activity, smoking and stress to prevent and manage these diseases. Finally, this article gives some solutions and research conclusions. China should take multi-faceted measures, including education and publicity, medical resource construction, community medical service system construction, scientific research and technological innovation, as well as policy support and financial investment, to comprehensively respond to the challenge of cardiovascular disease.

Innovative Deep Learning Methods for Precancerous Lesion Detection

With the continuous advancement of socio-economic levels and relentless innovation in modern medical technologies, there's been a significant increase in the importance people place on their physiological health, particularly in the context of colorectal cancer—a prevalent malignant tumor that has captivated widespread attention within the medical community for its prevention and treatment. Notably, colorectal polyps, identified as precursors to colorectal cancer, are crucial for early diagnosis and precise detection, serving as fundamental elements in averting the disease and diminishing both its incidence and mortality rates. The swift progression of deep neural network technology in recent years has revolutionized computer-assisted medical diagnosis, especially for the detection of colorectal polyps. Deep learning technology, with its robust capability for feature learning and representation, has emerged as an invaluable aid for physicians, markedly enhancing diagnostic accuracy and efficiency. This study centers on colorectal polyps, striving to develop a detection model with superior accuracy by meticulously analyzing contemporary leading target detection algorithms. By fully exploiting the potent capabilities of deep neural networks, the model aims to boost the precision of colorectal polyp detection significantly, aiding physicians in elevating detection efficiency and simplifying diagnostic processes. By undertaking this research, we aim to make a significant contribution toward more accurate and efficient technological support for the early diagnosis and prevention of colorectal polyps, thereby aiding in the reduction of both the incidence and mortality rates associated with colorectal cancer.

Dualistic Effects of PRKAR1A as a Potential Anticancer Target in Cancer Cells and Cancer-Derived Stem Cells.

The integration of innovative medical technologies and interdisciplinary collaboration could improve the treatment of cancer, a globally prevalent and often deadly disease. Despite recent advancements, current cancer therapies fail to specifically address recurrence and target cancer stem cells (CSCs), which contribute to relapse. In this study, we utilized three types of cancer cells, from which three types of CSCs were further derived, to conduct a proteomic analysis. Additionally, shared cell surface biomarkers were identified as potential targets for a comprehensive treatment strategy. The selected biomarkers were evaluated through short hairpin RNA treatment, which revealed contrasting functions in cancer cells and CSCs. Knockdown of the identified proteins revealed that they regulate the epithelial-mesenchymal transition (EMT) and stemness via the ERK signaling pathway. Resistance to anticancer agents was consequently reduced, ultimately enhancing the overall anticancer effects of the treatment. Additionally, the significance of these biomarkers in clinical patient outcomes was confirmed using bioinformatics. Our study suggests a novel cancer treatment strategy that addresses the limitations of current anticancer therapies.

Chronicling the Experiences of Life Sciences Teachers and Learners on the Usage of Enquiry-Based Learning in Enhancing Learners’ Academic Performance

Life sciences research provides critical insights into disease processes and allows for the development of novel treatments and innovative medical technologies, thereby directly improving human health and technology. Despite the widely acknowledged relevance of life sciences, there has been a long-term pattern of low performance. This is due to inefficient teaching methods, as how a lesson is delivered influences the learners' level of understanding, among other things. Hence, the present study examined the experiences of life sciences teachers and learners in using IBL to enhance the academic performance of life science learners. This study was underpinned by the interpretivism paradigm, a qualitative approach, and a participatory research approach. The study population consisted of all life sciences learners in a rural school in the Amathole West district, Eastern Cape province of South Africa, from which 2 life sciences teachers and 14 learners were conveniently sampled. Data were collected using interviews, observations, and document reviews, and they were analysed using thematic analysis. The research findings revealed that enquiry-based learning has the potential to foster the development of critical thinking, problem-solving, and communication skills among life sciences learners. However, several issues make it difficult to successfully implement enquiry-based learning in the context of teaching and learning life sciences, including a lack of resources, time constraints, misreading of instructions, a lack of support or supervision, and a lack of pedagogical topic expertise among teachers. The study concludes that enquiry-based learning, when done right, can help learners understand life sciences concepts deeper and remember what they have learnt for a longer period.

A Novel Design-Thinking, Hospital Innovation Core Certificate Curriculum for Radiologists and Trainees: Creation, Implementation, and Multiyear Results

Innovation is a crucial skill for physicians and researchers, yet traditional medical education does not provide instruction or experience to cultivate an innovative mindset. This study evaluates the effectiveness of a novel course implemented in an academic radiology department training program over a 5-year period designed to educate future radiologists on the fundamentals of medical innovation. A pre- and post-course survey and examination were administered to residents who participated in the innovation course (MESH Core) from 2018 to 2022. Respondents were first evaluated on their subjectivecomfort level, understanding, and beliefs on innovation-related topics using a 5-point Likert-scale survey. Respondents were also administered a 21-question multiple-choice exam to test their objective knowledge of innovation-related topics. Thirty-eight residents participated in the survey (response rate 95%). Resident understanding, comfort and belief regarding innovation-related topics improved significantly (P<.0001) on all nine Likert-scale questions after the course. After the course, a significant majority of residents either agreed or strongly agreed that technological innovation should be a core competency for the residency curriculum, and that a workshop to prototype their ideas would be beneficial. Performance on the course exam showed significant improvement (48% vs 86%, P<.0001). The overall course experience was rated 5 out of 5 by all participants. MESH Core demonstrates long-term success in educating future radiologists on the basic concepts of medical technological innovation. Years later, residents used the knowledge and experience gained from MESH Core to successfully pursue their own inventions and innovative projects. This innovation model may serve as an approach for other institutions to implement training in this domain.

Telemedicine in Service of Family Doctors in North Macedonia: Search for the New Frontier for Medical Professionals.

Introduction: Innovative medical technologies such as telemedicine, telehealth, and artificial intelligence have great potential in North Macedonia. Our nation was a leader in the region in advancing internet connections. A key barrier to wider adoption has been human resources. Material and Methods: Family doctors are skilled and trained enough to accept and use these technologies in everyday work. In our School of Family Medicine, we thought that additional training was necessary. This was the key objective of our task-if telemedicine and telehealth are presented to a critical mass of doctors as yet another tool that will make their day-to-day work easier, the "chain reaction" of adopting and applying telemedicine and telehealth would not be stopped. Discussion: To further study this objective, we started with a pilot project with a course in telemedicine and telehealth for future family medicine specialists. Telepsychiatry and teledermatology were the first modules to be taught. In addition, telehealth care equipment was also presented to participants. Conclusion: Participants' reactions were very positive.

Expert consensus on the clinical application of narrow-band intense pulsed light (2024 edition)

The continuous innovation of medical cosmetology technology promotes the rapid development of aesthetic medicine. Narrow-band intense pulsed light (NB-IPL), which is developed based on conventional intense pulsed light, is a more accurate, efficient, and safer technique on clinical application. In order to promote more professionalization and standardization of the clinical application of NB-IPL, a panel of clinical experts in plastic surgery, dermatology and other fields developed the consensus based on the evidence-based medicine, clinical practice, and authoritative guidelines of other disciplines. The consensus panel discussed the indications, treatment parameters, contraindications, and precautions for the clinical application of NB-IPL and would serve as a reference for clinicians, nurses, teaching and research personnels engaged in plastic and cosmetics related work.

Anticipating emerging medical technologies: The start of an international horizon scanning tool for medical devices

The governance of innovative medical technologies is fraught with uncertainties. Responsible governing bodies prepare for future advances by engaging in anticipatory practices aimed at knowing and acting earlier-on, but little is known about such work. We examine an anticipatory practice of a multinational, mostly European horizon scanning collaboration, drawing on the analytical framework of anticipatory governance and micro-regimes of anticipation. We distinguish four inter-related micro-regimes that emerge from participants’ expectations of a horizon scanning tool. We show how all micro-regimes relate to ideas about anticipatory governance that focus on prediction and reducing uncertainties. Moreover, participants’ expectations about the tool are vested on prior experiences with horizon scanning for pharmaceuticals. We argue that this may affect the governance of medical technologies that do not fit a linear approach, conventional for pharmaceuticals, but develop more iteratively. Finally, we highlight the importance as well as the complexity of engagement between different stakeholder groups. Overall, we conclude a need for anticipatory practices to become more reflexive about the consequences of future visions, the assumptions behind them, and the implications for the actions needed in the present. This would increase the relevance and value of policy tools developed for the governance of emerging medical technologies.

Doctor, let us not tell her about the porcine implant.

With the proliferation of pharmaceuticals and advances in innovative medical technologies, use of animal-derived products is widespread in the healthcare industry. The use of these products sometimes conflicts with the religious beliefs of patients. I was involved in an ethical dilemma during reoperative abdominal hernia surgery. I engaged with the patient's next-of-kin via an intraoperative phone discussion regarding the possible use of a porcine-derived biological mesh implant. Here, I reflect on the experience to help clinicians who seek ethical competence alongside clinical competence.

Criminal Responsibility for Errors Committed by Medical Robots: Legal and Ethical Challenges

Objective: This study aims to know Criminal Responsibility for Errors Committed by Medical Robots, where the use of robots in healthcare and medicine has been steadily growing in recent years. Robotic surgical systems, robotic prosthetics, and other assistive robots are being into patient care. However, these autonomous systems also carry risks of errors and adverse events resulting from mechanical failures, software bugs, or other technical issues. When such errors occur and lead to patient harm, it raises complex questions around legal and ethical responsibility Char. Method: A descriptive analytical method was followed. Results: Traditional principles of criminal law have not been designed to address the issue of liability for actions committed by artificial intelligence systems and robots. There are open questions around whether autonomous medical robots can or should be held criminally responsible for errors that result in patient injury or death. If criminal charges cannot be brought against the robot itself, legal responsibility could potentially be attributed to manufacturers, operators, hospitals, or software programmers connected to the robot. However, proving causation and intent in such cases can be very difficult. Conclusions: The prospect of bringing criminal charges against a non-human triggers ethical dilemma. Should autonomous machines have legal personhood? How to weigh patient safety versus promoting innovation in medical technology? This research will analyze the legal and ethical challenges associated with determining criminal responsibility when medical robots cause unintended harm. It has important implications for patient rights, healthcare regulation, technological ethics and the legal status of intelligent machines.

Stakeholder Insights into Czech Performance-Based Managed Entry Agreements: Potential for Transformative Change in Pharmaceutical Access?

Managed Entry Agreements (MEAs) play a pivotal role in addressing the challenges arising from escalating prices of innovative medical technologies, especially in areas like oncology, immunology, and rare diseases. Among MEAs, Performance-Based MEAs (PB MEAs) and Outcome-Based MEAs (OB MEAs) stand out as innovative strategies. This study examines the adoption of PB MEAs in the Czech Republic post a 2022 legislative change. Interviews with key stakeholders, including the Ministry of Health, pharmaceutical companies, insurers, and patient groups, were conducted to explore perceptions and challenges. Stakeholders expressed concerns about legislation completeness, data quality, transparency, and methodology. Interestingly, pharmaceutical companies were less concerned about transparency and methodology, likely due to their multinational experience. Despite legislative progress, challenges persist, especially in data infrastructure, risk-sharing perceptions, and stakeholder readiness. Addressing these issues requires collaboration between pharmaceutical companies and payers. Patient involvement, though mandated, remains limited, potentially due to a lack of awareness. This study emphasizes the need for a comprehensive transformation beyond legislation for a successful PB MEA implementation. Trust, technical infrastructure, and data availability are crucial, necessitating a holistic approach. It contributes to the global discourse on PB MEAs, stressing the adjustment of financial frameworks, embracing value-based healthcare principles, and ensuring high-quality health data metrics. A more holistic, value-based MEA approach could reshape pharmaceutical reimbursement in the future.

Understanding Medical Technology Innovation in Low- and Middle-Income Countries: Factors, Impact, and a Model Proposal

The existing conceptual model for medical technology innovation management is a poor fit for low- and middle-income countries as it overlooks their unique challenges and constraints. The purpose of this article is to investigate key governing factors and underlying challenges and barriers of medical technology innovation in low- and middle-income countries and how they impact firm-level activities of innovation management. A two-fold qualitative research methodology was adopted for data collection, comprised of a literature review and multiple case study analyses via semi-structured interviews. A thematic coding approach and multiple theoretical perspectives were used for data analysis and drawing conclusions. The study identified 23 challenges and barriers to medical technology innovation, then categorized these under six factors: healthcare context and system, organizational capabilities, innovation ecosystem, demographic burdens and characteristics, market forces, and science and technology. It was found that compared to high-income countries, in low- and middle-income countries, issues associated with country-specific healthcare context and system, innovation ecosystem, and demographic burdens and characteristics influence innovation management activities and make medical technology innovation more challenging. The study contributes to the technology innovation model research by demystifying new factors and proposing a comprehensive conceptual model for understanding the roadmap of medical technology innovation and the influence of various factors on innovation management activities.

Development and application of the Rapha® device for the treatment of diabetic foot ulcers.

Transforming medical research into real-world healthcare solutions is a complex endeavor that may benefit from the synergy between academic research, governmental support, and industry innovation. In this article we delve into the framework of Translational Medical Research (TMR) in Brazil, elucidating the possible interplay between public universities and other pivotal stakeholders in the translational journey. Our focal point is the Rapha® device, an innovative medical technology, as we explore its ethical and regulatory journey. We seek to understand the environment that shapes healthcare technology development through a mixed-methods research design, combining policy analysis with stakeholder interviews. The research begins by examining public policies, aiming to carve out a socially inclusive and advantageous ecosystem. We then highlight the pivotal components-steps, milestones, stakeholders, and policies that underpin the TMR process. Our findings reveal that while TMR frequently culminates in patents and technology transfer agreements, specific regulatory and production challenges exist, particularly during transitioning from the T3 (clinical trials) to T4 (public health practice) phase. We provide insights into its translational progression by tracing the developmental stages from foundational research (T0) to clinical trials (T3) for the Rapha® device. Ultimately, this study underscores TMR's vital role in advancing healthcare access and posits that academic institutions can significantly influence the creation of ethically robust, regulated, and impactful medical innovations, contributing meaningfully to global healthcare.

Global, regional, and national burden of HIV and other sexually transmitted infections in older adults aged 60–89 years from 1990 to 2019: results from the Global Burden of Disease Study 2019

Sexually active older adults are often more susceptible to HIV and other sexually transmitted infections (STIs) due to various health conditions (especially a weakened immune system) and low use of condoms. We aimed to assess the global, regional, and national burdens and trends of HIV and other STIs in older adults from 1990 to 2019. We retrieved data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 on the incidence and disability-adjusted life-years (DALYs) of HIV and other STIs (syphilis, chlamydia, gonorrhoea, trichomoniasis, and genital herpes) for older adults aged 60-89 years in 204 countries and territories from 1990 to 2019. Estimated annual percentage changes in the age-standardised incidence and DALY rates of HIV and other STIs, by age, sex, and Socio-demographic Index (SDI), were calculated to quantify the temporal trends. Spearman correlation analysis was used to examine the relationship between age-standardised rates and SDI. In 2019, among older adults globally, there were an estimated 77 327 (95% uncertainty interval 59 443 to 97 648) new cases of HIV (age-standardised incidence rate 7·6 [5·9 to 9·6] per 100 000 population) and 26 414 267 (19 777 666 to 34 860 678) new cases of other STIs (2607·1 [1952·1 to 3440·8] per 100 000). The age-standardised incidence rate decreased by an average of 2·02% per year (95% CI -2·38 to -1·66) for HIV and remained stable for other STIs (-0·02% [-0·06 to 0·01]) from 1990 to 2019. The number of DALYs globally in 2019 was 1 905 099 (95% UI 1 670 056 to 2 242 807) for HIV and 132 033 (95% UI 83 512 to 225 630) for the other STIs. The age-standardised DALY rate remained stable from 1990 to 2019, with an average change of 0·97% (95% CI -0·54 to 2·50) per year globally for HIV but decreased by an annual average of 1·55% (95% CI -1·66 to -1·43) for other STIs. Despite the global decrease in the age-standardised incidence rate of HIV in older people from 1990 to 2019, many regions showed increases, with the largest increases seen in eastern Europe (average annual change 17·84% [14·16 to 21·63], central Asia (14·26% [11·35 to 17·25]), and high-income Asia Pacific (7·52% [6·54 to 8·51]). Regionally, the age-standardised incidence and DALY rates of HIV and other STIs decreased with increases in the SDI. Although the incidence and DALY rates of HIV and STIs either declined or remained stable from 1990 to 2019, there were regional and demographic disparities. Health-care providers should be aware of the effects of ageing societies and other societal factors on the risk of HIV and other STIs in older adults, and develop age-appropriate interventions. The disparities in the allocation of health-care resources for older adults among regions of different SDIs should be addressed. Natural Science Foundation of China, Fujian Province's Third Batch of Flexible Introduction of High-Level Medical Talent Teams, Science and Technology Innovation Team (Tianshan Innovation Team) Project of Xinjiang Uighur Autonomous Region, Cure Alzheimer's Fund, Helse Sør-Øst, the Research Council of Norway, Molecule/VitaDAO, NordForsk Foundation, Akershus University Hospital, the Civitan Norges Forskningsfond for Alzheimers Sykdom, the Czech Republic-Norway KAPPA programme, and the Rosa Sløyfe/Norwegian Cancer Society & Norwegian Breast Cancer Society.