Effects of the COVID-19 pandemic on the rates of adverse birth outcomes and fetal mortality in Japan: an analysis of national data from 2010 to 2022.

BACKGROUND: Although the coronavirus disease 2019 (COVID-19) pandemic affected trends of multiple health outcomes in Japan, there is a paucity of studies investigating the effect of the pandemic on adverse birth outcomes and fetal mortality. This study aimed to investigate the effect of the onset of the pandemic on the trends in adverse birth outcomes and fetal mortality using national data in Japan. METHODS: We used the 2010-2022 birth and fetal mortality data from the Vital Statistics in Japan. We defined the starting time of the effect of the pandemic as April 2020, and the period from January 2010 to March 2020 and that from April 2020 to December 2022 were defined as the pre- and post- pandemic period, respectively. The rates of preterm birth, term low birth weight (TLBW), small-for-gestational-age (SGA), large-for-gestational-age (LGA), spontaneous fetal mortality, and artificial fetal mortality were used as outcomes. An interrupted time series analysis was conducted using monthly time series data of the outcomes to evaluate the effects of the pandemic. In addition, a modified Poisson regression model was used to evaluate the effects of the pandemic on these outcomes using individual-level data, and the adjusted risk ratio of the effect was calculated. RESULTS: The adverse birth and fetal mortality outcomes showed a decreasing trend over the years, except for preterm birth and LGA birth rates, and SGA birth rates tended to reach their lowest values after the onset of the pandemic. The interrupted time series analysis revealed that the pandemic decreased preterm birth, TLBW, and SGA birth rates. In addition, the regression analysis revealed that the pandemic decreased the TLBW, SGA, and artificial fetal mortality rates. CONCLUSIONS: Analyses performed using national data suggested that the pandemic decreased the TLBW and SGA rates in Japan.

Analysis of Differences in Preterm Birth Rates According to Household Occupation in Japan From 2007 to 2019 / 예방의학회지

Objectives@#No studies have examined the association between preterm birth rates and socioeconomic factors in Japan using nationwide statistical data. We analyzed the association between preterm birth rates and household occupation using Vital Statistics data. @*Methods@#Aggregated Vital Statistics data from Japan from 2007 to 2019 were obtained from the Ministry of Health, Labour and Welfare. From the data, the number of births according to year, age group, gestational period, number of pregnancies, and household occupation were used in this study. Crude preterm birth rates and preterm birth rates adjusted by maternal age according to household occupation were calculated for each year. Poisson regression analysis was conducted to evaluate the association between household occupation and preterm births. @*Results@#Unemployed households had the highest preterm birth rate, and households with an occupation classification of “full-time worker 2” (an employee at a large company, civil servant, or board member) had the lowest preterm birth rate throughout each period. Poisson regression analysis revealed that unemployed households were statistically significantly associated with a high preterm birth risk. In contrast, the preterm birth rate adjusted by maternal age remained stable throughout each period regardless of household occupation, and preterm birth rates were found not to have increased in recent years in Japan. @*Conclusions@#Unemployed households had higher preterm birth rates than other household occupations. Further studies investigating the characteristics of unemployed households are needed to identify the reasons for this disparity.

Emerging Technologies for Telemedicine

This paper focuses on new technologies that are practically useful for telemedicine. Three representative systems are introduced: a Digital Video Transport System (DVTS), an H.323 compatible videoconferencing system, and Vidyo. Based on some of our experiences, we highlight the advantages and disadvantages of each technology, and point out technologies that are especially targeted at doctors and technicians, so that those interested in using similar technologies can make appropriate choices and achieve their own goals depending on their specific conditions.

A remote educational system in medicine using digital video.

BACKGROUND/AIMS: Telemedicine has opened the door to a wide range of learning experience and simultaneous feedback to doctors and students at various remote locations. However, there are limitations such as lack of approved international standards of ethics. The aim of our study was to establish a telemedical education system through the development of high quality images, using the digital transfer system on a high-speed network. METHODOLOGY: Using telemedicine, surgical images can be sent not only to domestic areas but also abroad, and opinions regarding surgical procedures can be exchanged between the operation room and a remote place. The Asia Pacific Information Infrastrucuture (APII) link, a submarine cable between Busan and Fukuoka, was used to connect Korea with Japan, and Korea Advanced Research Network (KOREN) was used to connect Busan with Seoul. Teleconference and video streaming between Hanyang University Hospital in Seoul and Kyushu University Hospital in Japan were realized using Digital Video Transfer System (DVTS) over Ipv4 network. RESULTS: Four endoscopic surgeries were successfully transmitted between Seoul and Kyushu, while concomitant teleconferences took place between the two throughout the operations. Enough bandwidth of 60 Mbps could be kept for two-line transmissions. The quality of transmitted video image had no frame loss with a rate of 30 images per second. The sound was also clear, and time delay was less than 0.3 sec. CONCLUSIONS: Our experience has demonstrated the feasibility of domestic and international telemedicine. We have established an international medical network with high-quality video transmission over Internet protocol, which is easy to perform, reliable, and economical. Our network system may become a promising tool for worldwide telemedical communication in the future.

A Remote Educational System in Medicine Using Digital Video Transfer System / 대한소화기내시경학회지

BACKGROUND/AIMS: Telemedicine has opened the door to a wide range of learning experience to the doctors and students working and studying at various remote locations. However, there are limitations to this technology, such as the lack of any approved international standards of ethics. The aim of our study was to establish a telemedical education system using the Digital Video Transfer System (DVTS) on the high-speed network. METHODS: The Asia Pacific Information Infrastructure (APII) link was used to connect Korea with Japan, and the Korea Advanced Research Network (KOREN) was used to connect Busan with Seoul. Teleconferencing and video streaming between Hanyang University Hospital in Seoul and Kyushu University Hospital in Japan were realized using DVTS over the Ipv4 network. RESULTS: Four endoscopic surgeries and two endoscopic procedures were successfully transmitted between Seoul and Kyushu, while concomitant teleconferences were taking place between the two cities throughout the operations. An adequate bandwidth of 60 Mbps was kept for two-line transmissions. The quality of transmitted video image showed no frame loss with a rate of 30 images per second. The sound was also clear, and the time delay was less than 0.3 sec. CONCLUSIONS: We have established an international medical network with high-quality video transmission over Internet medium and this was easy to perform, reliable and economical.

Telemedicine with Digital Video Transport System / 대한소화기학회지

BACKGROUND/AIMS: The growth of technology based on internet protocol has affected on the informatics and automatic controls of medical fields. The aim of this study was to establish the telemedical educational system by developing the high quality image transfer using the DVTS (digital video transmission system) on the high-speed internet network. METHODS: Using telemedicine, we were able to send surgical images not only to domestic areas but also to international area. Moreover, we could discuss the condition of surgical procedures in the operation room and seminar room. The Korean-Japan cable network (KJCN) was structured in the submarine between Busan and Fukuoka. On the other hand, the Korea advanced research network (KOREN) was used to connect between Busan and Seoul. To link the image between the Hanyang University Hospital in Seoul and Kyushu University Hospital in Japan, we started teleconference system and recorded image-streaming system with DVTS on the circumstance with IPv4 network. RESULTS: Two operative cases were transmitted successfully. We could keep enough bandwidth of 60 Mbps for two-line transmission. The quality of transmitted moving image had no frame loss with the rate 30 per second. The sound was also clear and the time delay was less than 0.3 sec. CONCLUSIONS: Our study has demonstrated the feasibility of domestic and international telemedicine. We have established an international medical network with high-quality video transmission over internet protocol. It is easy to perform, reliable, and also economical. Thus, it will be a promising tool in remote medicine for worldwide telemedical communication in the future.

Development of International Medical Teleconference System Using Advanced Research Network and Digital Video Transport System(DVTS) / 대한의료정보학회지

OBJECTIVE: The purpose of this study is to develop telesurgical conference system by establishing a gigabit broad-banded network between hospitals in Korea and Japan using Digital Video Transport System(DVTS) on internet protocol, and to audit performance of this system through questionnaire study. METHODS: The Korea Advanced Research Network(Korean side), the Fukuoka Gigabit Highway(Japanese side), and the Korea-Japan Cable Network(international line)were used for assuring a high speed network connectivity. DVTS streaming was propagated with 30 M bps bandwidth for two channels on IPv4 network. Network security was built with virtual private network solution to guarantee protecting patient's privacy. Technological performance and satisfaction of users were evaluated following the events. RESULTS: The teleconference sessions and live surgery transmission with DVTS on internet protocol using advanced research network were performed successfully. Bandwidth of 60 Mbps for two-line transmission was maintained throughout the conference. The quality of the transmitted pictures had no frame loss with the rate of 30 frames per second. The sound was also clear and the time delay was less than 0.3 sec. Effectiveness of telesurgical conference using advanced network was felt beneficial for 94% of the attendants in questionnaire study. CONCLUSION: Establishing an international telesurgical conference system with high quality digital video transmission over internet protocol using international gigabit network was performed successfully. With the improvement of network engineering, this system is expected to contribute penetration of medical skills and knowledge through network infrastructure.