A People to People Citizen Ambassador GI Delegationʼs Visit to China
Bibliographic record
Abstract
Purpose: The People To People Citizen Ambassador Program, founded by President Eisenhower in 1956, aims to promote professional exchanges with various countries. Methods: 17 gastroenterologists from the USA, 1 gastroenterologist and 3 surgeons from Canada, visited China in 2008. Meetings were arranged with local staff and faculty in 6 hospitals; 2 each in Beijing, Xi'an and Shanghai, including a rural primary public health hospital, secondary county hospitals, a hospital of integrated traditional Chinese and Western medicine, and 2 tertiary care university hospitals. Results: Patterns and Management of Gastrointestinal (GI) Diseases in China - GI infectious diseases used to predominate; now there is an increased incidence of cancers and chronic idiopathic disorders. Esophageal (squamous cell) and gastric are the most common cancers in China, followed by liver cancer. There are esophageal cancer screening programs in Hunan, northern China and Shanghai. Colorectal cancer is less common but the prevalence is increasing (15/100,000). There is no countrywide screening. Etiologies cited include chronic constipation which is common in China; subtotal colectomy for chronic constipation is not rare. Colonic diverticulosis is uncommon; small bowel diverticuli occurs frequently. Although the incidence of Crohn's Disease is increasing, ulcerative colitis is still more common. Herbal drugs are used to improve circulation and mucosal repair in ischemic colitis. Traditional Chinese Medicine is used to treat “maldigestion,” functional dyspepsia, IBS and obesity. At one university hospital, the GI Division has 110 beds, 25 gastroenterologists and 10 endoscopy suites where 80 procedures are performed daily (upper:colon - 3:1). Only topical anesthetic spray is used for esophagogastroduodenoscopy while colonoscopy is frequently performed without sedation. Research funding is abundant and focuses on stem cell transplants, H. pylori, and probiotics. 80 liver transplants were performed in 2007. China accounts for 1/3 of cases of viral hepatitis worldwide; neonatal immunization for HBV is compulsory. Antiviral drugs are unavailable or too costly. Complications of cirrhosis are the most common indications for admission in one top hospital. Conclusion: 1. The Chinese Health Care System (CHS) has evolved since “market economy” was introduced in the 1980s; 2. There is a continuing focus to improve health care delivery to rural workers, farmers and soldiers; 3. CHS is entirely dependent on government financial resources; medical insurance is virtually non-existent; 4. Health care delivery cannot meet the demand for costly services, including drugs; 5. Suboptimal patient compliance for cancer screening remains a challenge.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.007 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.034 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".