Work and leisure in outdoor spaces influences people's physiological and psychological, while it can also lead to a reduction of energy consumed via air conditioning and lighting. In this study, the effects of solar radiation shading by trees in the open space around buildings on microclimatic development and pedestrian radiation environment are evaluated through a case study on the redevelopment buildings in front of Central Osaka Station, based on both observation and calculation. In both open space and green garden, direct solar radiation is shielded mainly by the buildings located behind the trees rather than by the trees themselves. Solar radiation shielding by trees is necessary in the range of more than 10 m from the south side of the buildings and more than 6 m from the west or east sides of the buildings.

We aimed to evaluate the changes in maternal and neonatal complications such as threatened preterm labor (TPL) and preterm birth before and during the coronavirus disease 2019 (COVID-19) pandemic using large-scale real-world data in Japan. We obtained data from the Japan Medical Data Center claims database and evaluated differences in maternal and neonatal complications, such as the prevalence of TPL and preterm birth before the COVID-19 pandemic (in the year 2018 or 2019) and during the COVID-19 pandemic (in 2020). We included 5533, 6257, and 5956 deliveries in the years 2018, 2019, and 2020, respectively. TPL prevalence and preterm birth had significantly decreased in 2020 (41.3%, 2.6%, respectively) compared with those reported in 2018 (45.3%, 3.9%, respectively) and 2019 (44.5%, 3.8%, respectively). Neonatal outcomes such as low-birth-weight infants and retinopathy of prematurity were also improved during the pandemic. There were no clear trends in the prevalence of maternal complications such as hypertensive disorders of pregnancy; hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome; and preeclampsia. Oral ritodrine hydrochloride usage in all participants had significantly decreased during the COVID-19 pandemic. In conclusion, our results suggest that the COVID-19 pandemic has ameliorated TPL and consequently reduced the number of preterm births.

We aimed to characterize the clinical features of premenopausal osteoporosis in Japan and evaluate medical interventions after fracture diagnosis. From a nationwide Japanese administrative claims database, we extracted 105,931 records of women regarding date of childbirth and divided them into two groups based on presence of a fragility fracture diagnostic code. From the records, we identified 231 women who had suffered a low-trauma fracture at reproductive age as the case group, and we randomly selected 1000 women as the control group. Age at childbirth was significantly higher (P = 0.00146) and estrogen-deficient conditions were significantly more frequent in the case than in the control group (odds ratio = 2.97, 95% confidence interval: 1.57–5.63). The most common fracture site was the vertebrae (35.2%), and fractures were also frequent in the 18 months around childbirth (32.9%). More than half of these fracture types overlapped, with significantly more opportunities for bone densitometry, an osteoporosis diagnosis, and antiosteoporosis pharmacotherapyfor these than for other fracture types, which were seldom treated as osteoporosis. Therefore, vertebral fractures and fracturesaround childbirth are a representative subtype of premenopausal osteoporosis. More medical attention isrecommended for all cases of premenopausal osteoporosis to reduce future fracture risk.

Endometriosis is a common condition that affects women of reproductive age. It mainly occurs in the pelvis and involvesthebowelin3-37%ofcases. We report a case of intestinal endometriosis accompanied by ileocecal obstruction. The patient was a 50-year-old woman,gravida0,para0whowasadmittedforileustothelocalhospital.Acystictumorwasidentifiedinherovary. Shewastransferredtothishospitalbecauseofsuspectedileusrelatedtotheovariancyst. Although an ileus tube was inserted, ileus did not improve, and a contrast study showed ileocecal obstruction. Ileocecalresectionandsalpingo-oophorectomywereperformedlaparoscopicallyforintestinalendometriosisandovarian endometrioticcyst. Pathologicalexaminationconfirmedthepresenceofendometrialtissueinthelaminapropriamucosaeandmuscularis propriaoftheileum.Seventeenmonthsaftersurgery,therearenosignsofintestinalendometriosisrecurrence.

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