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The 2017 clinical guidelines for obstetrical practice by the Japan Society of Obstetrics and Gynecology and the Japan Association of Obstetricians and Gynecologists were revised and published as the 2020 edition (in Japanese). The aim of these guidelines is to present appropriate standard obstetric diagnosis and management procedures that have reached consensus among Japanese obstetricians. The 2020 guidelines include 113 clinical questions and an appendix, followed by answers (CQA; originally 112 in the 2017 edition), a discussion, list of references, and some tables and figures presenting common problems and questions encountered in obstetrical practice. Each answer comes with a recommendation level of A, B, or C and has been prepared based principally on evidence or a consensus among Japanese obstetricians in situations where "evidence" is weak or lacking. Answers with a recommendation level of A or B represent current standard care practices in Japan. All 113 CQAs and the appendix are presented here to promote a better understanding of the current standard care practices for pregnant and lactating women in Japan.

Contributed talk in "Exploring the Hot and Energetic Universe: the 3rd scientific conference dedicated to the Athena X-ray Observatory". This presentation is based on the published paper "Chemical enrichment in the cool core of the Centaurus cluster of galaxies" (Fukushima et al., 2022, MNRAS, 514, 4222)., This work is financially supported by the Japanese Society for the Promotion of Science (JSPS) through the Grant-in-Aid for JSPS Fellows grant No. 21J21541 (KF).

Despite their importance, a detailed understanding of Type Ia supernovae (SNe Ia) remains elusive. X-ray measurements of the element distributions in supernova remnants (SNRs) offer important clues for understanding the explosion and nucleosynthesis mechanisms for SNe Ia. However, it is challenging to observe the entire ejecta mass in X-rays for young SNRs, because the central ejecta may not have been heated by the reverse shock yet. Here we present over 200 kilosecond Chandra observations of the Type Ia SNR G344.7-0.1, whose age is old enough for the reverse shock to have reached the SNR center, providing an opportunity to investigate the distribution of the entire ejecta mass. We reveal a clear stratification of heavy elements with a centrally peaked distribution of the Fe ejecta surrounded by intermediate-mass elements (IMEs: Si, S, Ar Ca) with an arc-like structure. The centroid energy of the Fe K emission is marginally lower in the central Fe-rich region than in the outer IME-rich regions, suggesting that the Fe ejecta were shock-heated more recently. These results are consistent with the prediction for standard SN Ia models, where the heavier elements are synthesized in the interior of an exploding white dwarf. We find, however, that the peak location of the Fe K emission is slightly offset to the west with respect to the geometric center of the SNR. This apparent asymmetry is likely due to the inhomogeneous density distribution of the ambient medium, consistent with our radio observations of the ambient molecular and neutral gas., 16 pages, 10 figures, Accepted for publication in Astrophysical Journal

Seismic performance of an existing building frame can be improved using various devices such as shear walls, shear dampers, buckling restrained brace, base isolator, etc. If we construct shear walls using latticed blocks, we can have much ventilation and transparency compared with the solid walls. In our previous study, we presented a nonlinear programming approach to optimize the topology of latticed blocks to maximize the horizontal stiffness, and also to minimize the increase of shear force in the existing beam. However, it has been found that very thin members exist in the optimal solutions, if the thicknesses of members are considered as continuous variables. In this study, a combinatorial optimization approach is presented for topology design of a latticed shear wall. The existing beams and columns, as well as the lattice members in blocks, are modeled using beam elements. The connections between the latticed blocks as well as those between the blocks and existing members are modeled using the zero-length bi-linear elastic elements. The response against forced shear deformation is evaluated through an incremental geometrically and materially nonlinear analysis. The types of unit blocks that can be selected are given in view of the results of optimization using the nonlinear programming approach. A heuristic approach called simulated annealing is used for optimizing combination of unit blocks. The following three problems are solved: 1. Minimization of structural volume under constraints on horizontal stiffness and stress. 2. Maximization of horizontal stiffness under constraints on structural volume and stress. 3. Minimization of shear force of the upper beam under constraints on horizontal stiffness, structural volume, and maximum stress of lattice members. It is confirmed through numerical examples that various optimal combinations of latticed blocks can be generated using the proposed approach. A latticed shear wall with small structural volume can be found through combinatorial optimization while maintaining the horizontal stiffness and limiting the additional force in the existing frame members. Appropriate choice of types of units that can be selected is important to obtain mechanically efficient latticed shear walls.

FRP blocks are effectively used for reduction of cost and period of time for seismic retrofit of building frames, because they can be manufactured in plants and attached to the existing frame easily. However, in the current process of retrofit, the effect of installing blocks on the forces in the existing frame is not appropriately considered. In this study, a shape optimization approach is presented for improving mechanical property and reducing the section forces of existing frame members. The existing beams, columns, and the members in latticed blocks are modeled using beam elements, and the contact between members are evaluated using the penalty approach. It is shown that various shapes can be generated by solving nonlinear programming problems considering structural weight of latticed blocks, horizontal stiffness of the frame, and the shear forces of the existing beam.

Klippel-Trenaunay syndrome (KTS) is a rare congenital disease, and extensive cutaneous hemangiomas and abnormal venous vessels are characteristic. In our case, to manage her pregnancy with KTS, whole-body MRA was performed before delivery. A 29-year-old woman was referred at 28 weeks because of prominent vulvovaginal varicosities due to KTS. At 35 weeks, hypertrophy and multiple venous varicosities of her leg as well as massive vulvovaginal varicosities became prominent with a normal coagulation profile. Systematic MRAs revealed hemangiomas and varicosities in the right leg, the lower abdomen, and the pubic region, while no obvious AVM was detected around the bronchial tube and spine. We decided to deliver her baby by cesarean section at 37 weeks under general anesthesia, and a healthy baby was delivered. No blood transfusion was required. Prophylaxis against thrombosis was performed after the operation. She was discharged with her baby. Her vulvovaginal varicosities shrunk considerably one month later.