Physicians are an indispensable part of the healthcare system, crucial for maintaining public health. Since the issues in market-oriented healthcare reform emerged in 2003, China has implemented a series of healthcare system reforms to improve the equitable distribution of medical resources. The impact of these reform measures on the physician workforce has yet to be systematically assessed. Data were sourced from the China Health Statistics Yearbook from 2003 to 2021. We conducted a detailed descriptive statistical analysis of physicians' quantity, quality, and structure. The Gini coefficient was calculated to evaluate national physician distribution equity, and the Theil index was further used to analyze interprovincial and intraprovincial inequality trends in the physician workforce. Global Moran's I and hotspot analysis were employed to examine the spatial heterogeneity and clustering of physician labor. The number of physicians increased from 1.87 million in 2003 to 4.29 million in 2021, with an average annual growth rate of 4.72%. The male-to-female ratio changed from 1:0.69 to 1:0.92. The main educational level of physicians elevated to a bachelor's degree (45.9%). However, the proportion of young doctors (< 35 years) declined from 41.1 to 26.0%. The Gini coefficient decreased from 0.140 in 2003 to 0.071 in 2021, and the Theil index dropped from 0.091 to 0.057. Decomposition of the Theil index revealed that overall differences in physician distribution primarily stemmed from intraprovincial inequality rather than interprovincial inequality. Global Moran's I decreased from 0.304 in 2003 to 0.109 in 2015 and then increased to 0.444 in 2021. Hotspot analysis showed uneven physician distribution, with high-value clusters in northern regions and low-value clusters in southern regions. Over the past 19 years, despite improvements in the quantity and quality of physicians, the decline in young physicians and worsening regional disparities pose challenges.

The global burden of inflammatory bowel disease (IBD) is increasing, but detailed data on older adults remain scarce. This study describes trends in incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of IBD among individuals aged 60–89 years from 1992 to 2021 at global, regional, and national levels, and forecasts the epidemiological status for 2030. We used the Global Burden of Disease (GBD) database, covering 204 countries and territories. Temporal trends were analyzed using Joinpoint regression models. Decomposition analysis assessed the impacts of population growth, aging, and epidemiological changes. The Nordpred model forecasted 2030 incidence, prevalence, mortality, and DALYs of IBD among older adults. From 1992 to 2021, the global age-standardized incidence rate (ASIR) of IBD among older adults increased (AAPC 0.34). Conversely, the prevalence rate (ASPR) slightly decreased (AAPC − 0.04). Both mortality (ASMR) and DALYs significantly declined (AAPC − 0.60 and − 0.49, respectively). High SDI regions had the highest ASIR and ASPR, with Middle SDI regions experiencing the fastest ASIR growth. Population growth accounted for 117.77% of the overall increase in the IBD burden. By 2030, the incidence rate is expected to rise, but prevalence, mortality, and DALYs rates are predicted to decrease. The incidence rate of IBD among older adults is rising, while prevalence, mortality, and DALYs rates are declining. Significant regional variations underscore the need for targeted public health policies.

Sexual harassment (SH) is a particularly harmful type of harassment that can inflict lasting psychological harm on victims. Within the healthcare sector, it negatively impacts teamwork, communication, and potentially compromises patient care. While concerns about workplace SH, including in healthcare, are long-standing, the #MeToo movement has brought renewed scrutiny to this issue since late 2017. Despite increased awareness, evidence suggests that SH remains prevalent in healthcare settings and shows no signs of decline over time. Therefore, there is an urgent need for effective training and intervention measures to enhance the identification of potential sexually offensive behaviors, thus fostering a work environment characterized by respect and inclusivity.

Soil respiration is one of the most important components in the carbon (C) cycle in terrestrial ecosystems. To investigate the contribution of each component of C cycle to the total soil C efflux, we quantified the rates of litter, root, and other mineral soil respiration from 2012 to 2014 in the primary and secondary tropical mountain rain forests in Hainan Island, China. The seasonal dynamics of soil (R_s), non-litter (R_NL) and non-root (R_NR) respiration rates were measured using an automatic chamber system (Li-8100). Litter removal and root removal treatments were used to assess the contribution of litter and roots to belowground C production. We estimated the annual C efflux of each component of soil respiration in primary and secondary forests using a temperature-based exponential model and analyzed the impact of each component in each forest type. The annual total soil C efflux was significantly higher in the primary rain forest (1567±205g C m⁻² yr⁻¹) than that in the secondary forest (1300±70g C m⁻² yr⁻¹, P < 0.05). The litter, root, and mineral soils contributed 22% (349±185g C m⁻² yr⁻¹), 38% (589±100g C m⁻² yr⁻¹), and 40% (628±128g C m⁻² yr⁻¹) to the total soil C efflux in primary rain forest, respectively. In secondary forest, these three components contributed 11% (148±35g C m⁻² yr⁻¹), 45% (572±259g C m⁻² yr⁻¹), and 44% (580±226g C m⁻² yr⁻¹), respectively. The temperature sensitivity (Q₁₀) of R_s (2.70±0.14) in the primary forest was significantly higher than that in the secondary forest (2.34±0.12), with the Q₁₀ values for respiration decreasing in the order of R_NR > R_s > R_NL. These results show that the difference in litter respiration between primary and secondary forest caused the major difference in annual soil respiration efflux between these two forest types. In addition, the litter respiration is more sensitive to the soil temperature than the other soil respiration components.

Alcohol-Related Cirrhosis (AC) has become a growing global health issue, particularly affecting women. This study provides a comprehensive analysis of the global, regional, and national burden of AC in women from 1992 to 2021, addressing a research gap by focusing on long-term trends specific to women. Using data from the Global Burden of Disease (GBD) 2021 database, we assessed trends in age-standardized incidence rates (ASIR), mortality rates (ASMR), and disability-adjusted life years (DALYs) for AC in women across 204 countries. Temporal trends were examined using the estimated annual percentage change (EAPC) method, and future projections to 2030 were generated using the Nordpred model. Between 1992 and 2021, the global ASIR of AC in women showed a slight decrease, from 3.10 to 2.42 per 100,000, with an EAPC of -1.02. A significant variation was observed across Socio-Demographic Index (SDI) regions, with the highest ASIR (3.77 per 100,000) reported in low-SDI regions in 2021. Mortality and DALYs also declined globally but remained disproportionately high in lower-SDI regions. The age distribution analysis revealed distinct gender-specific trends, with women experiencing a marked increase in AC burden in older age groups. Predictions indicate a further decline in AC burden by 2030, although the disease remains a significant public health concern. The findings highlight both global progress and persistent regional disparities in the burden of AC among women. Targeted public health interventions, particularly in lower-SDI regions, are essential to address the ongoing burden of this preventable disease.

Background: Inflammatory bowel disease (IBD) substantially affects women of reproductive age, yet global trends and burdens within this group remain inadequately explored. This study evaluates the global, regional, and national burdens of IBD among women aged 15– 49 from 1992 to 2021, with projections to 2030. Methods: Data were obtained from the Global Burden of Disease (GBD) 2021 study. We analyzed incidence, mortality, and disability-adjusted life years (DALYs) of IBD across age groups. Trends over time were assessed using estimated annual percentage change (EAPC), and socio-demographic index (SDI) levels were applied to examine disparities related to development status. Results: In 2021, the global IBD cases among women aged 15– 49 reached 98,974.56, representing a 55.04% increase since 1992. Mortality remained relatively stable, with 2,586.76 deaths in 2021, while DALYs rose by 38.53% to 281,580.36. High SDI regions exhibited higher incidence and DALYs rates but lower mortality rates. Conversely, low and middle SDI regions faced greater challenges, with higher mortality and DALYs rates despite lower incidence rates. By 2030, projections suggest a slight decline in global incidence rates, reducing total cases to approximately 94,773. Mortality rates are anticipated to remain stable, though deaths may slightly increase to 2781. DALYs are projected to rise marginally to 284,508 by 2030. Conclusion: The global burden of IBD among women of reproductive age has markedly increased, displaying considerable regional and socio-demographic variations. Targeted public health strategies are crucial, particularly in regions with lower development levels.