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)

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)

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)

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)

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

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)

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)

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)

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 paper examines how Japanese leading politicians cope with the communication problems posed during televised political interviews. Based on data gathered during the year 2012 equivocation, thereby to also assess the significance of these talk shows in the broader context of political communication in Japan.

This study examined why intensive care unit (ICU) nurses experience difficulties in respecting the wishes of patients in end-of-life care in Japan. A questionnaire survey was conducted with ICU nurses working in Japanese university hospitals. The content of their narratives was analyzed concerning the reasons why the nurses believed that patients' wishes were not respected. The most commonly stated reason was that patients' wishes were impossible to realize, followed by the fact that decision making was performed by others, regardless of (...) whether the patients' wishes were known, if the death was sudden, and time constraints. Many nurses wanted to respect the wishes of dying patients, but they questioned how patients die in ICUs and were therefore faced with ethical dilemmas. However, at the same time, many of the nurses realized that respecting patients' wishes about end-of-life care in an ICU would be difficult and that being unable to respect these wishes would often be unavoidable. The results thus suggest that there has been insufficient discussion about respecting the wishes of patients undergoing intensive care. (shrink)

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)

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.

My title question as it stands is ambiguous, and is in want of some initial clarification. Does the question ask how the explanandum is logically related to the explanans? Or does it ask about the details of the dynamics of the explanation speech-act? Or does it ask how the linguistic ambiguities of explanation questions and answers should properly be unpacked? Or does it ask yet some other question? The ways of studying explanation, like the ways of understanding the world, are (...) many and varied. By this, I mean more than that the phenomenon of explanation can be studied as it arises in the different disciplines of biology, physics, the social sciences, and the like. Rather, I mean that there are varied disciplines of explanation-study itself. For example, the Hempelian tradition has largely focused on the logic of explanation, and others have focused on the linguistic, psychological, social, and epistemological angles of explanation. Thus, it is not appropriate for me to begin by arguing that explanation is a set of logically related statements or a speech-act , but appropriate instead to begin by specifying the explanatory discipline within which I ask my title question. (shrink)

ABSTRACT This paper explores how specific Mahāyāna ethics, namely the interpretation of the Lotus Sūtra by Zhiyi (536–597), Nichiren (1222–1282) and Sōka Gakkai (1930–), can relate to core principles of international humanitarian law (IHL). In particular, it also assesses and discusses how Sōka Gakkai’s three key doctrines (the dignity of life, the variability of life and the interconnectedness of life) are congruent with some IHL principles. The paper then analyses how Buddhist organisations today can be advocates of IHL and specifically (...) looks at how Sōka Gakkai agrees with – and commits to – IHL in terms of the humanitarian impact of the use of nuclear weapons. (shrink)

As most work on flower foraging focuses on bees, studying Lepidoptera can offer fresh perspectives on how sensory capabilities shape the interaction between flowers and insects. Through a combination of innate preferences and learning, many Lepidoptera persistently visit particular flower species. Butterflies tend to rely on their highly developed sense of colour to locate rewarding flowers, while moths have evolved sophisticated olfactory systems towards the same end. However, these modalities can interact in complex ways; for instance, butterflies’ colour preference can (...) shift depending on olfactory context. The mechanisms by which such cross‐modal interaction occurs are poorly understood, but the mushroom bodies appear to play a central role. Because of the diversity seen within Lepidoptera in terms of their sensory capabilities and the nature of their relationships with flowers, they represent a fruitful avenue for comparative studies to shed light on the co‐evolution of flowers and flower‐visiting insects. (shrink)

Dienes & Perner's analysis provides a clear theoretical justification for using a demonstration of volitional control as a criterion for conscious awareness. However, in memory tasks, the converse does not hold: A phenomenological awareness of a memory episode can arise involuntarily, even when the task does not require retrieval of the episode. The varying amounts of volitional retrieval required by different memory tasks need to be recognized.

In recent decades, much work has been directed toward clarifying the logical relations among various sciences. Because of an emphasis on the logical aspects of interfield relations, the issue of scientific unity often wore a distinctly logical mantle.1 For example, Robert Causey, a prominent philosopher of this tradition, has linked scientific unity and progress to a project of successive microreductions. He states, “Other things being equal, we tend to feel that our understanding of a class of phenomena increases as we (...) develop increasingly general and intuitively unified theories of that class of phenomena. It is therefore natural to consider the possibility of one very general, unified theory which, at least in principle, governs all known phenomena.” (1977, p. 1)Kinds of unity separable from reductive logical unity have, of course, been proposed; these include reductive and nonreductive unities of method, translation, and ontology. For example, J.A. Fodor (1974) has argued for a broad kind of ontological unity of token physicalism, and against type reduction. (shrink)

朱子がめざした新たな学問とはどのような歴史的背景を踏まえ、何を追究したのか?歴史の現場に降り立ち、侵略や飢餓などに苦しむ人々の日常に直面した民政官たち、母権としての「母皇」が国政の中枢において「国権」 を簒奪しようとする深刻な危機感、これらの現実に向き合って営まれた苦心と創意が、政治を本源とする経学の形成過程にいかに織り込まれていったか。民政官、母権、馴致、現実をキータームにして、著者は思想の誕生す る姿を広範な文献を駆使して生き生きと描出し、中国思想研究に新しい地平を切り開いた。皇帝専制、家父長制的支配、家産官僚という学術用語は「皇帝―吏」関係を絶対的な命令者と服従者として捉え、そこには独自の内 面性を有する皇帝や吏は存在しえない。自己の馴致を核心にし、物事についての知の精度を磨き、民生の現場の安寧に取り組むことを通して学へと高まっていく中国思想の本質に迫る。.