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Taiki Kato,1 Kentaro Mizuno,2 Hidenori Nishio,2 Yoshinobu Moritoki,1 Akihiro Nakane,1 Satoshi Kurokawa,1 Hideyuki Kamisawa,1 Tetsuji Maruyama,3 Takahiro Yasui,1 Yutaro Hayashi2 1Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan; 2Department of Pediatric Urology, Nagoya City University Graduate School of Medical Sciences, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Japan; 3Department of Urology, Nagoya City East Medical Center, Wakamizu, Chikusa-ku, Nagoya, Japan Introduction: Lichen sclerosus (LS), or balanitis xerotica obliterans, is a chronic, inflammatory disease accompanied by cicatrizing skin conditions resulting in pathologic phimosis. LS can be detected clinically by the whitish appearance of the glans or the foreskin, thickened, nonretractable foreskin, dysuria, and spraying. However, diagnosis is confirmed histopathologically. Purpose: The aim of this study was to investigate whether LS can be diagnosed on the basis of clinical manifestation and symptoms. Patients and methods: A retrospective analysis was performed, which included boys referred to our institutions for phimosis evaluation between May 2001 and December 2016. Pediatric urologists clinically diagnosed LS preoperatively. Boys with voiding problems, recurrent balanoposthitis, or who were unresponsive to topical steroid treatment underwent surgical treatment. Patients who underwent religious circumcisions were not included. Results: Three-hundred twenty boys diagnosed with phimosis were identified, and 71 (22%) boys underwent surgery. Fifty-eight boys underwent complete or partial circumcision, and 13 boys underwent a dorsal slit or preputioplasty. Thirty foreskin samples were sent for histopathologic examination. Histopathologic evaluation showed evidence of LS in 13 of 30 (43%) circumcised boys, chronic inflammation in ten (33%), no abnormality in four (13%), dysplasia in two (7%), and acute inflammation in one (3%). In the 22 boys who were clinically diagnosed with LS, 13 patients had histopathologic evidence of LS (59%). Visually, eleven cases had whitish foreskins and 21 cases had thickened nonretractable foreskins, of which there were seven (64%) (P>0.05) and 12 (57%) (P0.2). Conclusion: It is difficult to reliably distinguish whether a patient has histopathological LS by clinical findings alone. Keywords: balanitis xerotica obliterans, lichen sclerosus, circumcision, histology, child

Takuya Samukawa,1,* Koichiro Matsumoto,2,* Go Tsukuya,1 Chihaya Koriyama,3 Satoru Fukuyama,2 Akifumi Uchida,1 Keiko Mizuno,1 Hironori Miyahara,4 Yutaka Kiyohara,5 Toshiharu Ninomiya,6 Hiromasa Inoue1 1Department of Pulmonary Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, 2Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 3Department of Epidemiology and Preventive Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, 4Kagoshima Kouseiren Medical Health Care Center, Kagoshima, 5Hisayama Research Institute for Lifestyle Diseases, 6Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan *These authors contributed equally to this work Background: The use of a simple screening questionnaire to detect persistent airflow obstruction (AO) in COPD may facilitate the early, accurate diagnosis of COPD in general practice settings. Objective: This study developed an original persistent AO questionnaire for screening individuals with COPD in a general Japanese population. Methods: A working group was established to generate initial draft questionnaire items about COPD. Eligible subjects aged 40 and older living in Japan were solicited to participate in a health checkup from 2014 to 2015. In study I, 2,338 subjects who fully completed the initial draft questionnaire and who had valid spirometry measurements were statistically analyzed to determine the final questionnaire items as a COPD screening questionnaire (COPD-Q). Persistent AO was defined as a post-bronchodilator FEV1/FVC

BACKGROUND AND OBJECTIVES: The spread of Coronavirus disease limited the activities of humans in the globe in 2020 with Jakarta reported to have also struggled with the virus. The pandemic stopped humans from visiting public amenities such as urban green spaces which are one of the key components of sustainable and livable cities and have the ability to reduce the negative impact on mental health. However, there are limited studies on the behaviors and perceptions of humans toward the usage of urban green spaces during the pandemic. Therefore, this study was conducted to determine the changes in the behaviors, perceptions, and visitation of residents towards the urban green space during the pandemic based on the socioeconomic aspects as well as the access and proximity to the parks and urban forests. METHODS: A questionnaire was distributed through an online survey on social media for approximately two months, from March to April 2021, and the last data recorded showed there were 1,660 respondents. The attention was on their perceptions and visitation to the urban green spaces spread across administrative cities in Jakarta, representing 42 districts and 239 sub-districts. Data obtained were analyzed empirically using the partial least square structural equation approach and SmartPLS 3.0 software to determine the relationship between the respondents' characteristics and proximity to urban green space visitation. FINDINGS: The results showed that almost half of the respondents perceived changes in the urban green spaces and the majority believed the spaces were more useful during the pandemic. It was also discovered that the socioeconomic characteristics of the respondents including age, education level, occupational status, and average monthly income differed statistically significantly from the criteria associated with the visitation to urban green spaces during the pandemic. The findings indicated that education was substantially associated with the decision to exercise and engage in outdoor recreation in urban green spaces. Meanwhile, not all houses close to the parks and urban forests have a statistically significant impact on their usage and this is the explanation for the noncorrelation and non-causation. CONCLUSION: This study showed that the perception of urban green space by the people changed during the pandemic but its usage was reduced due to the closures and restriction policies implemented. It was also discovered that socioeconomic characteristics have a significant influence on visitation but not all accessibility factors were significantly affected and this is different from the findings of previous studies. Moreover, this study discussed and shared empirical evidence that depicts urban green space as a resilient urban infrastructure during the pandemic. This means it is necessary to promote sustainable urban planning through the development of urban green spaces to manage the medium and long-term crises. [ABSTRACT FROM AUTHOR]