Regional Medical System Research Articles

Activities of a Pharmacist in Community Medicine in Nagasaki, Japan

With the increasing separation of dispensing and prescribing, Japanese pharmacists have changed over the past 50 years. Changes affecting pharmacists include the bashing of the separation of dispensing and prescribing, the formulation of the "Vision for Patient-centered Pharmacies" and the implementation of the Action Plan to realize this vision, and the amendment of the "Pharmaceuticals and Medical Devices Act." By 2025, when many baby boomers will be 75 years of age and older, the construction of the "Integrated Community Care System" is being promoted in various regions, and pharmacists are expected to be involved in community healthcare as members of community support networks based on multidisciplinary cooperation. In Nagasaki City, Japan, a regional medical cooperation system centered on the "Nagasaki Home Doctor Net" has been established, and a multidisciplinary network supports the region. In 2007, volunteers, mainly pharmacy managers, established the "Nagasaki Pharmaceutical Care Net (P-net)" to provide home medical care. To date, these volunteers have been involved in community healthcare while continuing their studies through the group. At the symposium, I introduced my active involvement in community healthcare as a pharmacist and as a member of P-net. I hope this symposium will help pharmacists' involvement and collaboration in community healthcare.

Developing a simple field triage scheme compatible with regional trauma situations and medical systems using machine learning: A nationwide trauma database study

Developing a simple field triage scheme compatible with regional trauma situations and medical systems using machine learning: A nationwide trauma database study

The role of microbiological monitoring in the prevention and control of antibiotic resistance

The article deals with the problem of antibiotic resistance of opportunistic microorganisms. The aim of the study is to determine the predominant microflora of a medical organization and to develop protocols for empirical antibacterial therapy in infectious and inflammatory processes. The main groups of infectious agents in the departments for the treatment of patients with new coronavirus infection of the Oryol region «Botkin City Hospital» for 2020–2022 are analyzed. Isolation, identification and determination of antibiotic sensitivity were carried out using standard methods. The results of the study made it possible to identify priority microorganisms and assess their antibiotic resistance. The growth of resistance to carbapenems of microorganisms isolated from patients in 2020–2021 was revealed. The effect obtained from the correction of antibiotic therapy has been shown, which has significantly reduced the resistance of isolated strains to carbapenems. To ensure effective epidemiological surveillance of clinically significant microorganisms and curb the growth of antimicrobial resistance in medical organizations of the Orel region, it is important to consider the possibility of maintaining a regional medical information system in order to monitor the prevalence of potential pathogens of infectious diseases, including those related to the provision of medical care resistant to antimicrobial drugs.

An end-to-end screen shooting resilient blind watermarking scheme for medical images

The rapid progress in artificial intelligence and network communication has led to the development of advanced regional medical systems, revolutionizing the way hospitals and patients connect. However, the security of these systems is threatened by the potential breach of medical data, especially sensitive medical images. Existing watermarking schemes have focused on optimizing either imperceptibility or robustness, creating a fundamental trade-off between these two aspects that poses a significant challenge in the field. To address this challenge and ensure the confidentiality and integrity of medical data, this paper proposes an end-to-end screen shooting resistant blind watermarking scheme for medical images. The proposed method offers a robust and reliable solution for the secure transmission and storage of medical images, particularly in the face of screen shooting attacks. To enhance both security and imperceptibility, the scheme employs a novel encryption technique based on BCH codes, resulting in a trinary sequence for watermark images. These watermarks are then embedded in the spatial domain, effectively protecting against unauthorized access while preserving the integrity of the original image. To further enhance robustness, the method introduces a neural network structure specifically designed to resilient screen shooting attacks. By simulating the screen shooting process and incorporating various distortions, this network combines the strengths of residual networks and generative adversarial networks. Moreover, the proposed method introduces a novel loss function that exploits the unique characteristics of the image transformation domain, optimizing both imperceptibility and robustness. In the subsequent experiment, the watermarked images achieved satisfactory results with the highest PSNR and SSIM values reaching 62.563 dB and 0.9999, respectively. The proposed scheme provides an effective solution to protect the privacy and copyright of medical images, effectively addressing a critical security concern prevalent in regional healthcare systems.

Cloud-Based Integrated Cross-Platform Regional Medical Image Cooperative Storage System

With the increasing volume of medical image data, efficient storage and retrieval of these images have become critical in the healthcare industry. This paper proposes an integrated cross-platform regional medical image cooperative storage system based on cloud computing. The system comprises a storage layer, a basic management layer, an application interface layer, and an access layer. The storage layer consists of medical image storage devices and a storage device management system. The basic management layer facilitates the collaborative operation of multiple storage devices within the medical image cloud storage. The application interface layer assigns permissions to users based on their needs. The access layer allows users to access the medical image cloud storage system. This system aims to provide a cost-effective, high-availability solution for storing and accessing a large volume of medical images. The research objective is to realize rapid storage and retrieval of medical images, satisfying the needs of healthcare professionals. The findings demonstrate the practical significance of the system and its potential to enhance medical image management.

MP40-04 LONG-TERM TUMOR NECROSIS FACTOR-ALPHA INHIBITOR USE DECREASES THE RISK OF PROSTATE CANCER

You have accessJournal of UrologyCME1 Apr 2023MP40-04 LONG-TERM TUMOR NECROSIS FACTOR-ALPHA INHIBITOR USE DECREASES THE RISK OF PROSTATE CANCER Conor Driscoll, Jordan Rich, Dylan Isaacson, Joseph Nicolas, Yu Jiang, Xinlei Mi, Christopher Yang, Victoria Kocsuta, Regine Goh, Niti Patel, Eric Li, Rashid Siddiqui, Travis Meyers, John Witte, Linda Kachuri, Hui Zhang, Molly Beestrum, Edward Schaeffer, and Shilajit Kundu Conor DriscollConor Driscoll More articles by this author , Jordan RichJordan Rich More articles by this author , Dylan IsaacsonDylan Isaacson More articles by this author , Joseph NicolasJoseph Nicolas More articles by this author , Yu JiangYu Jiang More articles by this author , Xinlei MiXinlei Mi More articles by this author , Christopher YangChristopher Yang More articles by this author , Victoria KocsutaVictoria Kocsuta More articles by this author , Regine GohRegine Goh More articles by this author , Niti PatelNiti Patel More articles by this author , Eric LiEric Li More articles by this author , Rashid SiddiquiRashid Siddiqui More articles by this author , Travis MeyersTravis Meyers More articles by this author , John WitteJohn Witte More articles by this author , Linda KachuriLinda Kachuri More articles by this author , Hui ZhangHui Zhang More articles by this author , Molly BeestrumMolly Beestrum More articles by this author , Edward SchaefferEdward Schaeffer More articles by this author , and Shilajit KunduShilajit Kundu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003278.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: It is estimated that inflammation accounts for 20% of all cancers. Tumor necrosis factor-alpha inhibitors (TNF-I) are widely prescribed for chronic inflammatory conditions yet modulatory effect on prostate cancer risk is not known. We hypothesize that affecting systemic TNF-alpha modifies risk of prostate cancer and performed a contemporary study in a large regional medical system. METHODS: This was a retrospective, unmatched-cohort study involving a regional hospital system between 1998 and 2022. 4,209 men with TNF-I exposure for inflammatory conditions and 10,981 men with inflammatory conditions without TNF-I exposure were identified. Cox proportional hazards regression analysis, adjusting for age, race, gender, smoking status and underlying inflammatory disease type, was performed. TNF-I exposure was considered a time-varying factor, as TNF-I induction date was not fixed for patients in the TNF-I-exposed group. Models were fit incorporating all patients who developed any malignancy during the study period and individually for each type of cancer. Results of regression models were presented as forest plots with hazard ratios and 95% confidence intervals. RESULTS: While TNF-I exposure was associated with increased risk of any malignancy (HR=1.19, 95% CI 1.09-1.29, p<0.001), exposure to TNF-I had a strongly protective effect against a diagnosis of prostate cancer (HR=0.58, 95% CI 0.42-0.80, p=0.001). CONCLUSIONS: Decreased risk of prostate cancer in men exposed to TNF-I suggests that the inflammatory milieu of prostate cancer development is potentially modulated by the anti-inflammatory effects of TNF-I and should be studied further. Source of Funding: Polsky Urologic Cancer Institute, Northwestern University Feinberg School of Medicine © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e546 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Conor Driscoll More articles by this author Jordan Rich More articles by this author Dylan Isaacson More articles by this author Joseph Nicolas More articles by this author Yu Jiang More articles by this author Xinlei Mi More articles by this author Christopher Yang More articles by this author Victoria Kocsuta More articles by this author Regine Goh More articles by this author Niti Patel More articles by this author Eric Li More articles by this author Rashid Siddiqui More articles by this author Travis Meyers More articles by this author John Witte More articles by this author Linda Kachuri More articles by this author Hui Zhang More articles by this author Molly Beestrum More articles by this author Edward Schaeffer More articles by this author Shilajit Kundu More articles by this author Expand All Advertisement PDF downloadLoading ...

Particulate matter in the ambient air as a risk factor of bronchial asthma in adults

AIM: to study the role of fine suspended particles in the atmospheric air in the formation of allergic, non-allergic and mixed phenotypes of bronchial asthma in adults.&#x0D; METHODS: The analysis of atmospheric air pollution by fine particles in Kazan was carried out according to the database of social and hygienic monitoring of the Center for Hygiene and Epidemiology in the Republic of Tatarstan for 20142020. To study the relationship between the level of atmospheric air pollution with fine particles and bronchial asthma in adults (1865 years old), a retrospective analysis of the incidence of bronchial asthma (ICD-10 codes J45.0, J45.1, J45.8) was carried out during the same period among the population of Kazan. The regional medical information system "Electronic Health of the Republic of Tatarstan" was used. Statistical modeling was carried out using the method of mixed models based on the Poisson distribution or the negative binomial distribution.&#x0D; RESULTS: The average annual absolute risk of bronchial asthma in the adult population of Kazan was 0.51 per 100 people aged 1865 years, an increase of 0.09 per 100 people (17.6%) per year (p=0.039). An increase in the annual maximum concentrations of PM2,5 by 10 g increased the absolute risk of non-allergic bronchial asthma by 0.066 per 100 people aged 1865 years (p=0.043). Similar dependences, but without statistical significance at the level of p 0.05, were found for such exposure parameters as the mass concentration of РМ10 and the mass of particles deposited in the tracheobronchial and alveolar sections of the lungs. For allergic and mixed asthma, no statistically significant relationships with mass concentrations and deposited doses of suspended particles were found.&#x0D; CONCLUSION: Air pollution with fine suspended particles increases the risk of developing a non-allergic phenotype of adult bronchial asthma, which may be associated with specific pathogenetic mechanisms, including the reaction of the epithelium to the deposition of fine particles.

P691 Disparate care: rates of treat to target among patients with inflammatory bowel disease

Abstract Background Inflammatory bowel diseases (IBD) therapies are limited by low response rates and risks of loss of response. Treat to target (T2T) algorithms aim to maximize the benefit of therapies by establishing a framework for assessing patient reported outcomes, biochemical evaluation (C-reactive protein (CRP) or fecal calprotectin (FC)), and structural assessment via endoscopy or enterography. There are limited data on adoption rates of T2T in real-world clinical practice. We aimed to describe rates of T2T utilization in a large regional medical system in the United States. Methods A retrospective cohort study was conducted from 2015-2021. Individuals with IBD starting a new biologic therapy were identified. Collected data included demographics, laboratory data, current medications, and procedure and imaging data. Patients were categorized based on whether they completed T2T, defined as CRP or FC testing at 2-4 months after starting a new therapy, and structural assessment, defined as colonoscopy, sigmoidoscopy, capsule endoscopy, or enterography within 6-12 months after starting a new therapy. Complete adherence was defined as both of these criteria being met. Social deprivation index (SDI), with higher values associated with higher rates of social deprivation, was derived using mail codes. T-tests, Pearson chi-square tests, ANOVA and multivariable logistic regression were used for comparisons. Results 7,962 patients were identified (Table 1). Rates of T2T were low; only 7.81% of patients completed biochemical monitoring at 2-4 months (0.83% FC, 8.65% CRP, 1.76% both), 9.80% completed structural assessment, and 3.43% completed both. In univariable logistic regression, higher age (OR 0.98, p&amp;lt;0.01), IBD type (UC OR: 0.69, p&amp;lt;0.01), having no insurance (OR 0.84, p=0.02) and low social deprivation index (SDI) (OR 1.004, p&amp;lt;0.01) were associated with lower T2T completion rates. In multivariable logistic regression, ulcerative colitis (UC), younger age, and lower SDI score were significantly associated with likelihood of completing any T2T (Table 2). When considering biochemical monitoring at 2-4 months, Asian race, UC diagnosis, age, SDI score and year were significantly associated with completion (Table 3). UC diagnosis, year and age were significantly associated with completion of structural assessment (Table 4). Conclusion Treat to target completion rates among patients with IBD starting biologic therapies were low in this large cohort. Age and UC diagnosis were negatively associated with completing T2T. Social deprivation score was positively associated with biochemical monitoring. Further research is required to understand barriers to T2T monitoring.

A SURVEY ON MEDICAL CARE FOR ALLERGIC DISEASES IN MIYAGI

In Miyagi, the number of allergy specialists per population is higher at Sendai city compared to the other areas (non-Sendai areas). Therefore, the healthcare delivery for allergic diseases are unevenly distributed. In the current study, we investigated differences of medical care for allergic diseases between Sendai city and non-Sendai areas. We conducted a web-based questionnaire survey to all of hospitals and clinics in the prefecture. The questionnaire responses were analyzed and compared between the Sendai city and non-Sendai areas. Responses to the questionnaire were obtained from 175 hospitals and clinics, including 72 internal physicians, 34 pediatricians, 17 dermatologists, 15 otorhinolaryngologists, 12 ophthalmologists and 25 others. More clinicians in non-Sendai areas felt the difficulty in treating asthma and chronic urticaria than those in Sendai city. Fewer institutions prescribed biologics for severe allergic diseases in non-Sendai areas than in Sendai city, which might be due to the lack of knowledge on the biologic agents. On the other hand, referring patients with anaphylaxis to specialized hospitals tended to be more difficult in Sendai city compared to in non-Sendai areas. Additionally, the regional medical liaison system is needed to refer patients with severe allergic diseases to advanced medical institutions. There are unique problems about allergy care in Miyagi.

THE HISTORY OF THE ONE LABORATORY

The article provides information about the history, state and prospects of development of the laboratory service of the Kostroma region. The laboratory service of Kostroma originates from a laboratory organized in the Provincial Zemstvo Hospital of Kostroma in the early twentieth century. Over the years, the laboratory staff has constantly improved the range of research and put modern tests into practice. The author gives a list of specialists in charge of the laboratory from the beginning of the twentieth century to the present time. Since 2016, the process of centralization of the laboratory service of the city of Kostroma, the Kostroma region and partially the Kostroma region has begun. By 2018, the laboratory began to serve 35 medical organizations in Kostroma and the Kostroma region. The laboratory has a Laboratory information System integrated into the regional medical information system, which allows specialist doctors to see the results of laboratory tests at the workplace within a few hours after the biomaterial arrives at the laboratory and the entire research archive. Patients have the opportunity to receive research results by e-mail. The range of laboratory research is increasing every year. The laboratory conducts more than 450 different types of research, performs more than 6,000,000 laboratory studies per year - this is more than half of the research of laboratories in the entire region.

Comparison of Population Mortality Rates in Ukraine and Poland: A Spatial Aspect

The main task of the article is to analyze the dynamics of mortality in Poland and Ukraine and to establish similar regional types of mortality structure by the leading causes. The novelty of this research is to analyze the objects of study from the standpoint of typical regional medical and demographic systems, along with the subsequent typification of administrative units. This approach is due to several factors: the growing rate of migration of Ukrainians to Poland and the similarity of the problems of industrial regions and coastal and mountainous regions. The article presents the results of a comparative geographical study on mortality rates in Poland and Ukraine. The study establishes that the level of mortality is radically different in the two countries. For example, the mortality rate in Poland is 1.4 times lower than in Ukraine. However, Poland is affected by typical problems of European countries, such as an increase in mortality rate from neoplasm and diseases of the digestive and endocrine systems. The leading cause of mortality in Ukraine is cardiovascular diseases, the share of which continues to grow. The highest mortality rates in spatial aspects are recorded in the central and coastal territories of both states, which, together with the analysis of the structure of the leading causes of death according to regions, allow us to remark on similar types of mortality in both states. In accordance, cluster analysis made it possible to identify the high, medium, and low types of mortality structure in both states.

A Cross-Domain Authentication Scheme Based on Cooperative Blockchains Functioning With Revocation for Medical Consortiums

Regional medical consortium systems facilitates medical information sharing. However, many security issues exposed by the dominant centralized architectures, such as single points of failure, unauthorized operations and illegal access, are increasingly apparent constraints on the security and efficiency of data sharing across domains. Even more, any malicious operation detected, effective measures should be executed promptly for identity tracing. In this paper, we propose a secure and efficient cross-domain authentication scheme based on two cooperative blockchains (BCs) for medical consortium systems. Specifically, an intra-domain BC records any legal users’ registration and authentication information while an inter-domain BC is responsible for writing users’ cross-domain authentication information. In each domain, the general hospital acts as a trusted third service provider to achieve cross-chain interactions. For the entire cross-domain authentication procedure, anonymity mechanism is utilized to enhance security, and to trace malicious users, the improved chameleon hash is used in the intra-domain BC to redact the state of the user, and blacklist merkle tree is extended in the inter-domain BC to protect different domains’ services from illegal accessing. In addition, security analysis and performance evaluation are completely given to prove the superior security features and performance compared with other schemes.

Comparison of Outcomes at Trauma Centers versus Non-Trauma Centers for Severe Traumatic Brain Injury.

Traumatic brain injury (TBI) is one of the most common injuries in patients with multiple trauma, and it associates with high post-traumatic mortality and morbidity. A trauma center was established to provide optimal treatment for patients with severe trauma. This study aimed to compare the treatment outcomes of patients with severe TBI between non-trauma and trauma centers based on data from the Korean Neuro-Trauma Data Bank System (KNTDBS). From January 2018 to June 2021, 1122 patients were enrolled in the KNTDBS study. Among them, 253 patients from non-traumatic centers and 253 from trauma centers were matched using propensity score analysis. We evaluated baseline characteristics, the time required from injury to hospital arrival, surgery-related factors, neuromonitoring, and outcomes. The time from injury to hospital arrival was shorter in the non-trauma centers (110.2 vs. 176.1 minutes, p=0.012). The operation time was shorter in the trauma centers (156.7 vs. 128.1 minutes, p0.003). Neuromonitoring was performed in nine patients (3.6%) in the non-trauma centers and 67 patients (26.5%) in the trauma centers (p<0.001). Mortality rates were lower in trauma centers than in non-trauma centers (58.5% vs. 47.0%, p=0.014). The average Glasgow coma scale (GCS) at discharge was higher in the trauma centers (4.3 vs. 5.7, p=0.011). For the Glasgow outcome scale-extended (GOSE) at discharge, the favorable outcome (GOSE 5-8) was 17.4% in the non-trauma centers and 27.3% in the trauma centers (p=0.014). This study showed lower mortality rates, higher GCS scores at discharge, and higher rates of favorable outcomes in trauma centers than in non-trauma centers. The regional trauma medical system seems to have a positive impact in treating patients with severe TBI.

Medical School Without Walls: 50 Years of Regional Campuses at Indiana University School of Medicine.

The history of Indiana University School of Medicine (IUSM) dates to 1871, when Indiana Medical College entered into an affiliation with Indiana University in Bloomington to offer medical education. In 1971, the Indiana General Assembly passed a bill to create and fund a distributed model for medical education for which IUSM was responsible, an innovative approach to implementing a statewide medical education program. IUSM became one of the first U.S. medical schools to implement what is today known as a regional medical campus model. This regional medical campus system has permitted IUSM to expand enrollment based on national and local concerns about physician shortages, increase access to care locally, support expansion of graduate medical education, and provide opportunities for research and scholarship by faculty and students statewide. This effort was made possible by partnerships with other universities and health care systems across the state and the support of local community and state leaders. The model is a forward-thinking and cost-effective way to educate physicians for service in the state of Indiana and is applicable to others. This article highlights milestones in IUSM's 50-year history of regional medical education, describes the development of the regional medical campus model, recognizes significant achievements over the years, shares lessons learned, and discusses considerations for the future of medical education.

The experience of reforming primary health care in conditions of demographic trends of average population age increasing

The article presents experience of reforming of primary health care in the Belgorod Oblast in 2016-2019. In the course of reforming the original organizational model of interaction between doctors and patients developed and implemented. The measures were applied to strengthen the material-technical base and personnel potential of primary medical care. The offices of General Practitioners were arranged within step accessibility for patients. The continuous training of family physicians was organized at the workplace. The unified regional medical information system was developed and implemented enabling corporate conference communication, remote consultations, population feedback and remote arrangement of making appointment with physician. The differentiated approach to medical personnel remuneration of labor was brought on the basis of key performance indices that permitted to increase their salary and quality of work. As a result of the reforms, the percentage of people covered by family physicians dispensary observation increased by 13%, number of emergency calls decreased by 3.3% and number of calls because of illness reduced by 17%. The mortality rate of people older than able-bodied age began to decrease and population life expectancy reached prognosticated numbers of 74 years in 2019.

Approaches to management and assessment of the health of military services using information technologies

Introduction. At the present stage of developing domestic health care, active processes of informatization of the clinical diagnostic process are taking place. In most regions of the Russian Federation, various medical information systems are actively exploited in medical organizations, digital medical devices and devices are being introduced, which determines the relevance of the formation of a methodology for the use of information technologies in the health care system of military personnel. Materials and methods. The materials of literary sources, bibliographic databases, regulatory documents, research and development work data, materials of military-scientific support of military-medical information systems have been studied. The historical, literary and structural-logical approach, system analysis methods, comparison, composition, and decomposition were used. Results. This study proposes approaches to managing the health of servicemen and a system of its assessment using information technologies. Within the framework of the entire system of medical support for troops at the sectoral level, the ultimate goal of informatization is to construct a single information space for the medical service of the RF Armed Forces. It should be based on the use of unified personal electronic cards of military personnel, a single protected intradepartmental telecommunication network, and medical information systems for various purposes, depending on the level of a medical organization, unit or subdivision. In the informatization of the medical service, it is necessary to distinguish three primary levels, each of which develops its technologies and means of automation: personal (the level of an individual soldier); the level of medical organizations; the systemic level that determines the activities of the entire medical service. A personal electronic card of a serviceman should be used as an individual carrier of passport and medical information in military medical information systems. To decide on the medical and evacuation purpose of a particular patient at the admission and triage department of a medical company, it is necessary to ensure the formation of a protocol of medical and evacuation measures, which includes information from the electronic medical archive, vital activity sensors and medical care accounting systems. Conclusion. The capabilities of information technologies, vital activity sensors, electronic medical archives and communication channels should ensure the collection of relevant information about an individual patient for the needs of the treatment and diagnostic process, even when military medical organizations are deployed at the stages of medical evacuation. The integration of all information systems in the health care system of servicemen into a single information space must be carried out, taking into account the requirements of regional medical information systems and a unified state information system in the field of health.

Cancer care for people with mental disorders: A qualitative survey among cancer care and psychiatric care professionals in Japan.

It is widely assumed that there are multiple levels (from individual to policy level) of problems involving disparities in cancer care for people with mental disorders. However, few studies have comprehensively investigated issues as perceived by medical professionals. The purpose of the present study was to identify a wide range of issues in cancer care for people with mental disorders and offer corresponding solutions for both cancer care professionals and psychiatric care professionals. We distributed open-ended questionnaires to 754 healthcare professionals in various medical facilities, including designated cancer hospitals, psychiatric hospitals, and other local healthcare/welfare facilities. Participants were asked to describe issues in cancer care for people with mental disorders. Of the 754 recruited professionals, 439 (58.2%) responded to the questionnaire. Sixty-one issues were extracted and categorized into 10 categories: patient factors; isolation and lack of support; obstacles to transport; socioeconomic factors; attitudes of psychiatric professionals; medical system of psychiatric hospitals; attitudes of cancer care professionals; medical system of designated cancer hospitals; regional cancer medical systems; and lack of coordination among multidisciplinary healthcare professionals. Forty-eight specific solutions were summarized into 12 goals. The present study widely identified issues causing disparities in cancer care for patients with mental disorders. We found that the issues extended from the patient level to the public-policy level. Our findings suggest the need for a multidisciplinary approach that includes both cancer and psychiatric care professionals to address the gap in cancer care for people with mental disorders.

Survey on children with cerebral palsy in Tochigi Prefecture, Japan.

The incidence of cerebral palsy (CP) is influenced by perinatal medicine and regional medical systems. We investigated the recent incidence of CP and the current problems of children with CP in living at home under an advanced perinatal medical system in Tochigi Prefecture, Japan. A clinical datasheet survey was performed among 13 hospitals and six rehabilitation facilities treating children with CP born in Tochigi Prefecture to estimate the incidence of CP among children born between 2009 and 2013. The severity of motor and intellectual impairment, presumed causal factors, complications, and provided medical interventions were investigated and compared between preterm and term-born children with CP. The incidence of CP was 1.6 per 1000 live births. Shorter gestation period and lower birthweight were associated with a higher incidence of CP. Fifty-one percent of children with CP were non-ambulatory and 55% had severe to profound intellectual impairment. Episodes of neonatal asphyxia and periventricular leukomalacia were the most frequent causal factors; both were significantly more frequent in preterm than in term-born children. Approximately 30% of children with CP had respiratory disorders, dysphagia, or epilepsy; 62% received medical interventions, including medication, mechanical ventilation, oxygen therapy, tube feeding, and intraoral/intranasal suction. We found the incidence of CP to be lower in comparison to previous Japanese studies. However, the motor and intellectual impairments were severe, and many children with CP and their families were burdened by daily medical care. Public support systems should be developed, as well as the perinatal medical system.

Intelligent Prediction and Optimization Algorithm for Chronic Disease Rehabilitation in Sports Using Big Data.

This paper investigates chronic diseases in the older population in the Chinese province of Henan and analyzes the rehabilitation needs and the current supply of related services in different levels of medical and elderly care institutions. We explore the fundamental causes for the diversified needs and insufficient supply of chronic disease patients in professional medical services and daily care. Using big data and deep learning (DL) in the sports domain, we propose a novel and intelligent prediction system for chronic diseases. Our model explores effective sinking methods of high-quality medical resources, training and guidance practices, assistance and guidance measures, and the ability to improve the grassroots services so that more chronically ill populations can stay in the community family as long as possible. In such an environment, they can receive cheap, safe, and suitable services. It can also lead to further improvement in constructing the government's regional medical rehabilitation care service system and can formulate long-term care relevant compensation policies.

Modern content and improvement of high cardiovascular risk strategy in reducing mortality from cardiovascular diseases

The article describes the modern content of the high-risk strategy, which, along with the population strategy, forms the basis of a set of measures to reduce mortality from cardiovascular diseases. The high cardiovascular risk strategy is carried out at the individual level in outpatient structures as a part of primary and secondary prevention of cardiovascular diseases, and is also implemented in hospitals when performing elective surgical procedures, including high-tech interventions. Improving this strategy within the framework of primary health care involves the development of a system of high-risk offices, telemedicine consulting, remote monitoring of physiological parameters on the basis of a regional medical information system, and in the future, on the basis of a uniform vertically integrated medical information system. The development of the high-risk strategy as a part of inpatient practice occurs through the further replication of high technologies and the implementation of new types of them.