Present Situation and the Future Development of Web-Based Prenatal Education in China: Cross-sectional Web-Based Survey.

BACKGROUND: Pregnancy serves as an important chapter in the life of women since more attention needs to be paid to both their physical and psychological health during this period. Adequate prenatal knowledge plays a key role in ensuring the health and safety of not only the pregnant women but also their fetuses and the entire family. With the development of information technology, web-based prenatal education has been brought into focus owing to its accessibility to comprehensive information, with high-quality information available to improve the quality of the overall gestation period, labor process, perinatal outcomes, and fetal outcomes. OBJECTIVE: This study aims to investigate the present situation of web-based prenatal education and to predict the future research direction of web-based prenatal education in China, thereby providing insights into improving the quality of health care of pregnant women. METHODS: A national cross-sectional study was conducted on 590,912 pregnant women in 31 provincial administrations of mainland China between August 2018 and August 2019. These pregnant women were initially recruited from local hospitals across the nation during antenatal and postnatal periods via a web-based education school. Demographic information and course completion status (including the categories and the number of courses they completed) of all the participants were collected. RESULTS: A total of 590,912 pregnant women participated in the web-based prenatal education in 2018. Among them, 188,508 (31.90%) participants were excluded because they did not complete any course, while 17,807 (3.01%) actively participated in web-based prenatal education and completed more than 100 courses. There were 5 categories of web-based courses; almost half of the pregnant women attended the courses on first and second trimesters (293,262/590,912, 49.63% and 298,168/590,912, 50.46%, respectively). We found that pregnant women were more concerned about the gestational diet, fetal-related knowledge, and other precautions before the labor. CONCLUSIONS: In the era of digitalization where information is rapidly disseminated, web-based prenatal education could become a more convenient, productive, and effective pathway for pregnant women since it could help them obtain adequate and optimal pregnancy-related information and gain more intellectual awareness about their pregnancy or preparation for pregnancy.

Online Antenatal Care During the COVID-19 Pandemic: Opportunities and Challenges.

People across the world have been greatly affected by the ongoing coronavirus disease (COVID-19) pandemic. The high infection risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in hospitals is particularly problematic for recently delivered mothers and currently pregnant women who require professional antenatal care. Online antenatal care would be a preferable alternative for these women since it can provide pregnancy-related information and remote clinic consultations. In addition, online antenatal care may help to provide relatively economical medical services and diminish health care inequality due to its convenience and cost-effectiveness, especially in developing countries or regions. However, some pregnant women will doubt the reliability of such online information. Therefore, it is important to ensure the quality and safety of online services and establish a stable, mutual trust between the pregnant women, the obstetric care providers and the technology vis-a-vis the online programs. Here, we report how the COVID-19 pandemic brings not only opportunities for the development and popularization of online antenatal care programs but also challenges.

Comparison of clinical and radiological outcomes of full-endoscopic versus microscopic lumbar decompression laminectomy for the treatment of lumbar spinal stenosis: a systematic review and meta-analysis.

BACKGROUND: To determine the clinical and radiological outcomes of full-endoscopic (FE) versus microscopic (MI) lumbar decompression laminectomy in the treatment of lumbar spinal stenosis (LSS), we performed a meta-analysis to explore the best choice for patients with LSS requiring surgical relief. METHODS: Literature searches of the PubMed, the Cochrane Library, Embase, Medline, Embase, and Web of Science databases were performed. The searches covered all indexed studies published between 2008 and 2020, using keywords identifying the patient group (lumbar spine stenosis) and the interventions (full-endoscopic lumbar decompression laminectomy and microscopic lumbar decompression laminectomy). A total of 1,727 patients were included in 10 studies. The primary outcomes of the analysis were visual analogue scale (VAS) scores for leg and back pain, and Oswestry Disability Index (ODI) score. RESULTS: The meta-analysis of the VAS score for low back pain showed that in the first 24 hours postoperatively, participants who underwent FE had better pain control than those who underwent MI [FE: mean difference (MD) =-0.78, 95% confidence interval (CI): -1.11, -0.45; MI: MD =-1.53, 95% CI: -1.94, -1.12]. In all subgroup analyses, the VAS score for back pain was lower in the FE group than in the MI group (MD =-0.71, 95% CI: -0.96, -0.47). Regarding the VAS score for leg pain, the FE group had a significantly lower score than the MI group in the first 24 hours (Total: MD =-1.02, 95% CI: -1.31, -0.73). The meta-analysis demonstrated that the FE group had a significantly lower ODI score than the MI group (MD =-1.03, 9% CI: -1.54, -0.51). At 6 months, the MI group had a significantly lower score than the FE group (MD =1.09, 95% CI: 0.53, 1.64), but at 12 months, the FE group had a significantly lower score than the MI group (MD =-2.40, 95% CI: -3.12, -1.67). DISCUSSION: Compared to MI decompression, the FE decompression method resulted in better pain control in the early postoperative period, both in the lower back and legs, as well as shorter operative and shorter hospitalization times.

The Influence of Average Temperature and Relative Humidity on New Cases of COVID-19: Time-Series Analysis.

BACKGROUND: The influence of meteorological factors on the transmission and spread of COVID-19 is of interest and has not been investigated. OBJECTIVE: This study aimed to investigate the associations between meteorological factors and the daily number of new cases of COVID-19 in 9 Asian cities. METHODS: Pearson correlation and generalized additive modeling (GAM) were performed to assess the relationships between daily new COVID-19 cases and meteorological factors (daily average temperature and relative humidity) with the most updated data currently available. RESULTS: The Pearson correlation showed that daily new confirmed cases of COVID-19 were more correlated with the average temperature than with relative humidity. Daily new confirmed cases were negatively correlated with the average temperature in Beijing (r=-0.565, P<.001), Shanghai (r=-0.47, P<.001), and Guangzhou (r=-0.53, P<.001). In Japan, however, a positive correlation was observed (r=0.416, P<.001). In most of the cities (Shanghai, Guangzhou, Hong Kong, Seoul, Tokyo, and Kuala Lumpur), GAM analysis showed the number of daily new confirmed cases to be positively associated with both average temperature and relative humidity, especially using lagged 3D modeling where the positive influence of temperature on daily new confirmed cases was discerned in 5 cities (exceptions: Beijing, Wuhan, Korea, and Malaysia). Moreover, the sensitivity analysis showed, by incorporating the city grade and public health measures into the model, that higher temperatures can increase daily new case numbers (beta=0.073, Z=11.594, P<.001) in the lagged 3-day model. CONCLUSIONS: The findings suggest that increased temperature yield increases in daily new cases of COVID-19. Hence, large-scale public health measures and expanded regional research are still required until a vaccine becomes widely available and herd immunity is established.