Suchergebnisse

On August 10, 2019, the Multidisciplinary Expert Seminar on Healthcare Security for Rare Diseases in China was held in Beijing. The seminar was organized by the Shanghai Foundation for Rare Disease and Shanghai Health Development Research Center and advised by the China Alliance of Rare Diseases. Participants in this seminar included government officials, experts in clinical medicine, pharmacy, epidemiology, health economics, and law as well as representatives from rare disease patient organizations. The participating experts cited three key elements of healthcare security, including its concept, data, and mechanism, to solve the problem of health care security for patients with rare diseases at the national level. Collection of basic data and creation of a model of healthcare security for rare diseases were discussed. Data collection should be actively promoted. Creation of a special zone to ensure medical care for patients with rare diseases should be considered. Healthcare security should be classified, which means that basic medical insurance provides better care for rare diseases that respond to treatment, and channels should be established for rare diseases that respond poorly to treatment.

AbstractThe Northern Sea Route (NSR) makes travel between Europe and Asia shorter and quicker than a southern transit via the Strait of Malacca and Suez Canal. It provides greater access to Arctic resources such as oil and gas. As global warming accelerates, melting Arctic ice caps are likely to increase traffic in the NSR and enhance its commercial viability. Due to the harsh Arctic environment imposing threats to the safety of ship navigation, it is necessary to assess Arctic navigation risk to maintain shipping safety. Currently, most studies are focused on the conventional assessment of the risk, which lacks the validation based on actual data. In this study, actual data about Arctic navigation environment and related expert judgments were used to generate a structured data set. Based on the structured data set, extreme gradient boosting (XGBoost) and alternative methods were used to establish models for the assessment of Arctic navigation risk, which were validated using cross‐validation. The results show that compared with alternative models, XGBoost models have the best performance in terms of mean absolute errors and root mean squared errors. The XGBoost models can learn and reproduce expert judgments and knowledge for the assessment of Arctic navigation risk. Feature importance (FI) and shapley additive explanations (SHAP) are used to further interpret the relationship between input data and predictions. The application of XGBoost, FI, and SHAP is aimed to improve the safety of Arctic shipping using advanced artificial intelligence techniques. The validated assessment enhances the quality and robustness of assessment.

Pengfei Cao,1,2,* Jun Xing,1,* Yin Cao,3 Qi Cheng,1 Xiaojing Sun,1 Qi Kang,1 Libin Dai,1 Xianju Zhou,3 Zixiang Song1 1Psychological Centre for Adolescents and Children, The Affiliated 102nd Hospital of The Second Military Medical University of People's Liberation Army of China, Shanghai, China; 2Department of Political Affairs, College of Politics, National Defense University of People's Liberation Army of China, Beijing, China; 3Laboratory of Neurological Diseases, Department of Neurology, The Affiliated Changzhou No 2 People's Hospital of Nanjing Medical University, Changzhou, China *These authors contributed equally to this work Objective: To explore the effect of repetitive transcranial magnetic stimulation (rTMS) combined with atomoxetine (ATX) in the treatment of attention-deficit hyperactivity disorder (ADHD). Methods: Sixty-four patients with newly diagnosed ADHD were enrolled from January 2016 to October 2017 from Psychological Centre for Adolescents and Children at 102th Hospital of People's Liberation Army of China. These patients were randomly assigned to three groups according to treatment method: the rTMS group, the ATX group, and the rTMS+ ATX group. Before treatment and 6 weeks after treatment, clinical symptoms and executive functions of ADHD patients were evaluated with the Swanson, Nolan, and Pelham, Version IV (SNAP-IV) Questionnaire, continuous performance test, three subtests (arithmetic, digit span, and coding) of Wechsler Intelligence Scale for Children, as well as Iowa Gambling Tasks (IGT). The effects of treatment were compared among three groups. Results: After 6 weeks of treatment, the scores of all factors in the SNAP-IV questionnaire were lower than those before treatment in the three groups; the scores of three subtests of Wechsler Intelligence Scale for Children, continuous performance test, and IGT were also significantly higher than those before treatment. The rTMS+ ATX group had a better improvement in attention deficits and hyperactivity impulse on the SNAP-IV questionnaire compared with the other groups, and also had a higher efficacy on cold and hot executive functions such as arithmetic, forward numbers, coding, and IGT. In addition, the ATX group performed better than the rTMS group in coding and IGT. Conclusion: rTMS, ATX, and the combination therapy are effective in improving core symptoms and executive function in patients with ADHD. The combined treatment has significant therapeutic advantages over the single treatment groups. Compared with rTMS, the drug therapy has a better improvement in coding and IGT. Keywords: attention-deficit hyperactivity disorder, repetitive transcranial magnetic stimulation, atomoxetine, executive function