The core aims of the Global Health Impact Project include incentivizing pharmaceutical companies for socially conscious production and promoting socially conscious consumption among consumers. Its backbone is a metric that computes the amount of illness burden alleviated by a pharmaceutical drug. This essay aims to assess the connection between values and numbers in the Global Health Impact Project. Specifically, I concentrate on two issues, the anonymity of illness burden and the distribution of health benefits. The former issue asks whether we (...) should treat the illness burden of every person the same. The latter issue asks among whom health benefits should be fairly distributed. Examination of these issues begs for clarification of some of the key concepts of the Global Health Impact Project, such as the definition of essential medicines and the significance of national borders. Although this essay focuses on the two particular metric issues in the Global Health Impact Project, its core argument is applicable to other metrics for ethically motivated initiatives—to construct a metric for an ethically motivated initiative, it is not only important to articulate underlying concepts and values, but it is also important to operationalize them, so they are consistently reflected in the metric. (shrink)

Lysosomal positioning is an important factor in regulating cellular responses, including autophagy. Because proteins encoded by disease‐responsible genes are involved in lysosomal trafficking, proper intracellular lysosomal trafficking is thought to be essential for cellular homeostasis. In the past few years, the mechanisms of lysosomal trafficking have been elucidated with a focus on adapter proteins linking motor proteins to lysosomes. Here, we outline recent findings on the mechanisms of lysosomal trafficking by focusing on adapter protein c‐Jun NH2‐terminal kinase‐interacting protein (JIP) 4, (...) which plays a central role in this process, and other JIP4 functions and JIP family proteins. Additionally, we discuss neuronal diseases associated with aberrance in the JIP family protein. Accumulating evidence suggests that chemical manipulation of lysosomal positioning may be a therapeutic approach for these neuronal diseases. (shrink)

In a dynamic environment, even if an agent makes a plan to obtain a goal, the environment might change while the agent is executing the plan. In that case, the plan, which was initially valid when it was made, might later become invalid. Furthermore, in the process of replanning, it is necessary to take into account the side effects of actions already executed. Nowadays, HTN planning is becoming popular among agent researchers because its task decomposition algorithm is efficient and suitable (...) for joint planning in multi-agent systems. However, the dynamic replanning algorithm of HTN planning has not yet been established. In order to solve this problem, we have previously presented an agent life cycle that integrates HTN planning, action execution, knowledge updates, and plan modification. In that agent life cycle, the plans are always kept valid according to the most recent knowledge and situation. However, when one plan does not work and the agent starts using an alternative plan, it sometimes undoes some actions that do not have to be undone. The source of this problem lies in the need to have total-order plans. In other words, all the actions have to be sequentially ordered even when the order is not important in some parts of the plan. This paper extends our previous agent life cycle and presents new ways to avoid unnecessary action cancellation. This enables the agent to handle partial-order plans and to make use of two kinds of undoing actions: sequential undoing actions and concurrent undoing actions. (shrink)

Proteins on the cell surface and secreted proteins are modified with sugar chains that generate and modulate biological complexity and diversity. Sugar chains not only contribute physically to the conformation and solubility of proteins, but also exert various functions via sugar-binding proteins that reside on the cell surface or in organelles of the secretory pathway. However, some glycosidases and lectins are found in the cytosol or nucleus. Recent studies of cytosolic sugar–related molecules have revealed that sugar chains on proteins in (...) the cytosol act as signals of adverse cellular conditions. In this review, we summarize recent reports that cytosolic sugar chains can trigger ubiquitination, followed by proteasomal and autophagic degradation to maintain cellular homeostasis. In addition, we discuss the functions of sugar-binding proteins revealed to date, along with possibilities not yet explored. The cytosolic N-glycans that normally reside on the cell surface or in organelles serves as a signal for the presence of unwanted proteins or organelles. Here, we review the monitoring system for cytosolic glycans including glycosidases and lectin in the cytosol. (shrink)

The history of the documentation of health inequality is long. The way in which health inequality has customarily been documented is by comparing differences in the average health across groups, for example, by sex or gender, income, education, occupation, or geographic region. In the controversial World Health Report 2000, researchers at the World Health Organization criticized this traditional practice and proposed to measure health inequality across individuals irrespective of individuals’ group affiliation. They defended its proposal on the moral grounds without (...) clear explanation. In this paper I ask: is health inequality across individuals of moral concern, and, if so, why? Clarification of these questions is crucial for meaningful interpretation of health inequality measured across individuals. Only if there was something morally problematic in health inequality across individuals, its reduction would be good news. Specifically, in this paper I provide three arguments for the moral significance of health inequality across individuals: (a) health is special, (b) health equity plays an important and unique role in the general pursuit of justice, and (c) health inequality is an indicator of general injustice in society. I then discuss three key questions to examine the validity of these arguments: (i) how special is health?, (ii) how good is health as an indicator?, and (iii) what do we mean by injustice? I conclude that health inequality across individuals is of moral interest with the arguments (b) and (c). (shrink)

ObjectivesThe purpose of the current study was to examine whether a self-report measure identifies prenatal substance use and predicts resulting adverse birth outcomes in a large cohort using electronic medical records.MethodsPregnant patients who were admitted between 2014 and 2015 at Christiana Care Health System and delivered singleton birth were included in the analyses. Participant demographic information, pregnancy comorbidities, self-reported substance use, and birth outcomes were retrieved from electronic medical records. Detailed descriptive analyses of prenatal substance use were conducted, and logistic (...) models were evaluated for the associations between substance use and each birth outcome.ResultsThe average maternal age was 30 years, 37% receiving Medicaid. Over 58% were White, 26% were Black, and 13% were Hispanic. Cigarette smoking only showed the highest prevalence among substance u... (shrink)

9th and 10th Nov. 2013 at Kyoto University. Organizers: Takeshi Sato and Shunsuke Sugimoto.

This paper provides a detailed comparison between discourse representation theory and dependent type semantics, two frameworks for discourse semantics. Although it is often stated that DRT and those frameworks based on dependent types are mutually exchangeable, we argue that they differ with respect to variable handling, more specifically, how substitution and other operations on variables are defined. This manifests itself in two recalcitrant problems posed for DRT; namely, the overwrite problem and the duplication problem. We will see that these problems (...) still pose a challenge for various extended compositional systems based on DRT, while they do not arise in a framework of DTS where substitution and other operations are defined in the standard type-theoretic manner without stipulating any additional constraints. We also compare the notions of contexts underlying these two kinds of frameworks, namely, contexts represented as assignment functions and contexts represented as proof terms, and see what different predictions they make for some linguistic examples. (shrink)

BackgroundTranscranial direct current stimulation is a non-invasive, non-convulsive technique for modulating brain function. In contrast to other non-invasive brain stimulation techniques, where costs, clinical applicability, and availability limit their large-scale use in clinical practices, the low-cost, portable, and easy-to-use tDCS devices may overcome these restrictions.ObjectiveDespite numerous clinical applications in large numbers of patients suffering from psychiatric disorders, it is not quite clear how tDCS influences the mentally affected human brain. In order to decipher potential neural mechanisms of action of tDCS (...) in patients with psychiatric conditions, we focused on the combination of tDCS with neuroimaging techniques.DesignWe propose a contemporary overview on the currently available neurophysiological and neuroimaging data where tDCS has been used as a research or treatment tool in patients with psychiatric disorders.ResultsOver a reasonably short period of time, tDCS has been b... (shrink)

Emerging parallel to long-standing, academic and policy inquiries on personal responsibility for health is the empirical assessment of lay persons’ views. Yet, previous studies rarely explored personal responsibility for health among lay persons as dynamic societal values. We sought to explore lay persons’ views on personal responsibility for health using the Fairness Dialogues, a method for lay persons to deliberate equity issues in health and health care through a small group dialogue using a hypothetical scenario. We conducted two 2-h Fairness (...) Dialogues sessions (n = 15 in total) in Nova Scotia, Canada. We analyzed data using thematic analysis. Our analysis showed that personal choice played an important role in participants’ thinking about health. Underlying the concept of personal choice was considerations of freedom and societal debt. In participants’ minds, personal and social responsibilities co-existed and they were unwilling to determine health care priority based on personal responsibility. The Fairness Dialogues is a promising deliberative method to explore lay persons’ views as dynamic values to be developed through group dialogues as opposed to static, already-formed values waiting to be elicited. (shrink)

Brain imaging studies have consistently shown subgenual Anterior Cingulate Cortical (sgACC) involvement in emotion processing. COMT Val158 and Met158 polymorphisms may influence such emotional brain processes in specific ways. Given that resting-state fMRI (rsfMRI) may increase our understanding on brain functioning, we integrated genetic and rsfMRI data and focused on sgACC functional connections. No studies have yet investigated the influence of the COMT Val158Met polymorphism (rs4680) on sgACC resting-state functional connectivity (rsFC) in healthy individuals. A homogeneous group of sixty-one Caucasian (...) right-handed healthy female university students, all within the same age range, underwent rsfMRI. Compared to Met158 homozygotes, Val158 allele carriers displayed significantly stronger rsFC between the sgACC and the left parahippocampal gyrus, ventromedial parts of the inferior frontal gyrus, and the nucleus accumbens (NAc). On the other hand, compared to Val158 homozygotes, we found in Met158 allele carriers stronger sgACC rsFC with the medial frontal gyrus, more in particular the anterior parts of the medial orbitofrontal cortex. Although we did not use emotional or cognitive tasks, our sgACC rsFC results point to possible distinct differences in emotional and cognitive processes between Val158 and Met158 allele carriers. However, the exact nature of these directions remains to be determined. (shrink)

Tracheostomy with invasive ventilation may be required for the survival of patients at advanced stages of amyotrophic lateral sclerosis. In Japan it has been shown that a proactive approach toward TIV may prolong the survival of ALS patients by over 10 years by preventing the lethal respiratory failure that generally occurs within 3-5 years of the onset of the disease. Measures to prolong life expectancy without foregoing quality of life have produced better results in Japan than in other developed countries. (...) This ‘Japanese bias’ has been attributed to socio-cultural and religious factors as well as to the availability of material resources in Japan. In this article, we use the concepts of onozukara in kadō and amae to illuminate features of patient care that may contribute to this ‘Japanese bias’. (shrink)

The promised open space of cyber-interaction has its dark side hidden behind its brilliant rhetoric. The danger emerges within the very center of developing this technology (cyber-evolution). That is a more fundamental danger than this dark side seems to have. The possible replacement of our primary reality with virtual reality might erode the significance of our existential reality. This means also that the virtual reality might lose its own ground to be constructed. In order to clarify this fundamental problem at (...) issue I show some results from a questionnaire done on younger generation. The results seem to suggest possible way of facing this problem. (shrink)

This meta-analysis synthesizes quantitative findings of the gender differences in moral sensitivity retrieved from 19 primary studies. We found the average effect size of 0.25, favoring women, with a standard deviation of 0.14. The variation in the observed effect sizes could not be attributed to differences in participants' educational level, the utilized measure of moral sensitivity, or the publication format in which the study was reported. This suggests that gender differences in moral sensitivity are consistent across different levels of participants' (...) education regardless of the instrument used to assess moral sensitivity or the format in which the research was reported. (shrink)

This article proposes a methodological schema for engaging in a productive discussion of ethical issues regarding human brain organoids, which are three-dimensional cortical neural tissues created using human pluripotent stem cells. Although moral consideration of HBOs significantly involves the possibility that they have consciousness, there is no widely accepted procedure to determine whether HBOs are conscious. Given that this is the case, it has been argued that we should adopt a precautionary principle about consciousness according to which, if we are (...) not certain whether HBOs have consciousness—and where treating HBOs as not having consciousness may cause harm to them—we should proceed as if they do have consciousness. This article emphasizes a methodological advantage of adopting the precautionary principle: it enables us to sidestep the question of whether HBOs have consciousness and, instead, directly address the question of what kinds of conscious experiences HBOs can have, where the what-kind-question is more tractable than the whether-question. By addressing the what-kind-question, we will be able to examine how much moral consideration HBOs deserve. With this in mind, this article confronts the what-kind-question with the assistance of experimental studies of consciousness and suggests an ethical framework which supports restricting the creation and use of HBOs in bioscience. (shrink)

In Western countries, the ideal professional and ethical attributes of healthcare providers and the ideal patient-doctor relationship have been analysed in detail. Other cultures, however, may have different norms, arising in response to diverse healthcare needs, cultural values and offering alternative perspectives. In this paper, drawing a case study, we introduce the concept of Shinmi, used in Japan to describe a desirable approach to medical care. Shinmi means kind or cordial in Japanese. In the medical context, it refers to doctors (...) treating patients with a degree of emotional closeness as if they were the doctors’ own family. We analyse the concept of Shinmi, drawing on virtue ethics. We distinguish two different elements to a Shinmi-na attitude. As illustrated in our example, excessive Shinmi can be problematic for patients and doctors. Furthermore, elements of Shinmi may conflict with existing Western values (for example, norms that encourage emotional detachment and discourage doctors’ treatment of family members). However, if pursued appropriately, we argue that a balanced Shinmi-na approach can be conducive to the goals of medicine. The concept of Shinmi may be valuable for medical students, in Japanese and potentially other health care systems, and help them to cultivate a virtuous approach to meeting the emotional needs of patients. (shrink)

In their target article, Peterson et al. discuss the intriguing prospect of using psychedelics as a treatment for patients with Alzheimer’s Disease and Related Dementias (AD/ADRD) (Peterson et al....

Located in a settler-Australian tertiary education institution we develop a worldly or mundane approach to working in and between institutions enacting two distinct world philosophies. We engage with the epistemics embedded and expressed in the functioning of modern institutions committed to a naturalistic scientific world. And albeit to a more limited extent we engage with epistemics embedded in and expressed by institutions framed and ordered by collectively enacting intentions of Eternal World-Making Beings of Yolngu Aboriginal Australian lands and peoples.

This paper focuses on a water management project in the remote Aboriginal community of Milingimbi, Northern Australia. Drawing on materials and experiences from two distinct stages of this project, we revisit a policy report and engage in ethnographic storytelling in order to highlight a series of sensing practices associated with water management. In the former, a working symmetry between Yolngu and Western water knowledges is actively sought through the practices of the project. However, in the latter, recurrent asymmetries in the (...) research work continue to appear: a bilingual diagram of water usage is displayed but produces confusion; measuring a water hole for salinity, a member of the scientific team throws in a water meter, while a Yolngu elder prefers the telling of an ancestral story; a collaborative 3-D mapping exercise invites participation from community members but struggles to develop an outcome that differs from existing maps used by scientists and government staff. Focusing on these moments as subtle points of rupture, we suggest that attending to “seeing,” “telling,” and “mapping” in both stages of this water management project offers a way to explore the political work of crafting climate futures and beginning to interrogate differing means for “doing difference” within them. (shrink)

ABSTRACTExperiences that contradict one's core concepts elicit intense emotions. Such schema incongruence can elicit awe, wherein experiences that are too vast...

We associate with any game G another game, which is a variant of it, and which we call . Winning strategies for have a lower recursive degree than winning strategies for G: if a player has a winning strategy of recursive degree 1 over G, then it has a recursive winning strategy over , and vice versa. Through we can express in algorithmic form, as a recursive winning strategy, many common proofs of non-constructive Mathematics, namely exactly the theorems of the (...) sub-classical logic Limit Computable Mathematics [6], Hayashi and Nakata [7]). (shrink)

Considerando as mudanças que ocorreram no contexto histórico-social e também na pesquisa em Educação no Brasil a partir da década de 1990, este estudo analisou a produção científica do PPGE-UFSCar, tendo como objeto 55 teses defendidas na Área de Fundamentos da Educação, entre 1993 e 2007, submetidas à análise bibliométrica e epistemológica, objetivando determinar qual o paradigma foi predominante no período. O resultado revelou que o Marxismo foi utilizado em mais de 60% das pesquisas; e também identificou a presença de (...) tendências pós-modernas fundamentando 17 teses e da Fenomenologia em 3 teses. (shrink)

The so-called Buddhist momentarists, such as Dharmakīrti and his followers, defend the momentariness of all things. However, with equal force they also defend the persistence of all things, not just within a single lifetime but over an indefinite cycle of rebirth. Naturally, they have an interesting theory of persistence, according to which things persist without being self-identical over time. The theory is best presented in the Lokāyatāparīkṣā chapter of Śāntarakṣita’s Tattvasaṃgraha and Kamalaśīla’s Paṅjikā, as they clearly articulate the criteria of (...) persistence without identity. The purpose of this paper is to formulate a Buddhist theory of persistence through the analysis of these texts. Here is the basic formula: Things persist as series, which is constituted by momentary entities that are causally related as upādāna and upādeya. Upādāna causal relation is demarcated from other causal relations by the principle of changeability with temporal restriction, and the principle adopts further qualifications to accommodate complex cases and personal persistence. I have addressed a problem that contemporary physicalism might pose a threat to the Buddhist account of personal persistence, and argued that the problem can be evaded by regarding persons as psycho-physical entities rather than strictly non-physical. In its general outlook, the Buddhist theory of persistence is close to Theodore Sider’s stage theory in that persistence is a matter of distinct individuals standing in a special causal relationship. As regards personal persistence, the Buddhist has a stricter condition than Parfit’s IDM thesis, which states that psychological connectedness with any cause is what matters for survival. The Buddhist would say it is moral connectedness with a special cause called upādāna. (shrink)

Health inequalities are of concern both becausestudying them may help one learn how to improvehealth and because health inequalities may beunjust. This paper argues that attending tothese reasons why health inequalities may beimportant undercuts the claims of researchersat the World Health Organization in favor offocusing on individual health variation ratherthan on social group health differences. Inequalities in individual health are of littleinterest unless one goes on to study how theyare related to other factors.

Previous research has associated social marginalization with the rejection of mainstream cultural values. Since cultural values reflect affect valuation, the present research investigates the relationships between social marginalization and ideal/actual affect in two different non-WEIRD cultures, Brazil and Japan. As a social marginalization index, we used the NEET-Hikikomori Risk Scale. We predicted that cultural differences would emerge in the valuation of affective states. Affect valuation theory suggests that in East Asia, individuals are encouraged to pursue and value low arousal positive (...) emotions over high arousal positive emotions as they can harm social relationships in these societies. In contrast, Latin American cultures value HAP over LAP, because social relationships are promoted through vibrant positive emotional expression in these cultures. Hence, we hypothesized that individuals’ ideal affect, actual affect, and the discrepancy between ideal and actual affect would be associated with higher risk of social marginalization. Participants from Japan and Brazil reported their ideal affect and actual affect and completed the NEET-Hikikomori Risk Scale. Regression analyses showed that actual HAP and the discrepancy between ideal and actual HAP were negatively associated with NHR in Brazil, but no association was found in the Japanese data. The other variables, including ideal affect, were only minorly or not significantly associated with NHR. Though the study has limitations regarding its small sample size, we can explore future perspectives and discuss the relationships between emotion and cultural marginalization. Socioecological factors that promote actual HAP in Brazilians may encourage other mainstream cultural ideals, which buffers against cultural marginalization. (shrink)

Persons infected with the Human Immunodeficiency Virus often experience intermittent life-threatening infections, a progressive decrease in cognitive abilities, and a loss of capacity to communicate their wishes to their family and medical care providers. Accordingly, AIDS patients are among those most likely to benefit from the increased availability of legally recognized forms of advance care planning. Although the three countries examined in this article differ greatly in the prevalence of HIV infection, the legal status of advance directives, and in the (...) attitudes toward their use, a collection of case studies is used to demonstrate that an ability to address the specific needs, values and goals of individual patients is promoted by the availability of a variety of options for implementing advance directives or health care proxies. The conclusion of the analysis is that the best option in a specific context will depend upon differences in individual values and medical objectives of the sort discussed in the case studies. Das mit der HIV-Infektion verbundene Krankheitsbild ist durch wechselnde lebensbedrohliche Infektionen und den fortschreitenden Verfall kognitiver Fähigkeiten gekennzeichnet. Es führt zudem häufig zum Verlust der Möglichkeit, Behandlungswünsche gegenüber Ärzten und Angehörigen zu äußern. Deshalb gehören besonders AIDS-Patienten zu denjenigen, die von rechtlich anerkannten vorsorglichen Patientenverfügungen profitieren werden.In diesem Artikel werden drei Länder betrachtet, die sich hinsichtlich der Häufigkeit des Auftretens der HIV-Infektion sowie des rechtlichen Status von und der Einstellung zu Patientenverfügungen erheblich unterscheiden. Fallstudien belegen allerdings, daß nicht allein die kulturellen und sozialen Bedingungen für die jeweils beste Form der Patientenverfügung ausschlaggebend sind. Voraussetzung für die Möglichkeit, den Bedingungen, Wert- und Zielvorstellungen des individuellen Patienten zu entsprechen, ist auf jeden Fall die Verfügbarkeit unterschiedlicher Formen von Patienten- und Betreuungsverfügungen. Auch innerhalb eines Kulturkreises müssen daher verschiedene Formen vorsorglicher Willensäußerungen des Patienten rechtlich anerkannt werden. Welche Art von Verfügung jeweils die beste Option darstellt, ist dabei abhängig von medizinischen Bedingungen und persönlichen Wertvorstellungen, wie sie in den Fallstudien diskutiert werden. (shrink)

The doctrine of radical impermanence expresses the temporal dimension of Buddhist metaphysics, especially in the philosophy of Dharmakīrti and his successors. Most straightforwardly, the doctrine says that everything that exists is momentary; we are not impermanent in the sense that we perish eventually, say when our brain ceases functioning, but rather we perish immediately upon conception. The person who begins to write this sentence and the person who completes it are, strictly speaking, different entities. However, there is a devastating problem (...) for the doctrine: How can any momentary entities be causally efficacious, and more particularly, given their extremely meager duration of existence, how might the momentarist explain the phenomena of cooperation among contemporaneous entities to occasion novel entities, such as seeds, soil, water and sunlight giving rise to sprouts? Even more difficult, can the momentarist offer such an explanation that does not undermine his negative claim that non-momentary things cannot exist? Śāntarakṣita and Ratnakīrti offer answers, but they both fail. By meticulously analyzing and evaluating their arguments, I identify the stumbling blocks of their arguments and show what needs to be done to save the doctrine of momentariness. (shrink)