The Fist-Edge-Palm task, a manual hand task, has been used to detect frontal dysfunctions in clinical situations: its performance failures are observed in various prefrontal cortex -related disorders, including schizophrenia. However, previous imaging studies reported that the performance of the FEP task activated motor-related areas, but not the PFC. Here, we aimed to investigate the relationships between the performance of the FEP task and PFC functions. Hemodynamic activity in the PFC, including the dorsolateral PFC and frontal pole, was recorded. Healthy (...) young subjects performed the FEP task as well as a palm tapping task three times. The subjects also completed a Wisconsin Card Sorting Test and Schizotypal Personality Scale questionnaire. We found that hemodynamic activity in the PFC increased in the first trial of the FEP task but decreased considerably in the second and third trials compared to the PT task. The number of performance errors in the FEP task also decreased in the second and third trials. Error reduction in the FEP task between the first and second trials was negatively correlated with schizotypal trait and the number of perseveration errors in the WCST. Furthermore, changes in the PFC hemodynamic activity between the first and second trials were positively correlated with error reduction in the FEP task between the first and second trials, and negatively correlated with the number of perseveration errors in the WCST. These results suggest that learning in the FEP task requires PFC activation, which is negatively associated with perseveration errors in the WCST. The results further suggest that the FEP task, in conjunction with near-infrared spectroscopy, may be useful as a diagnostic method for various disorders with PFC dysfunction. (shrink)

This article presents a critique of the health promotion policy of Japan, which is based on an examination of the social importance of and justification for health promotion. This is done to suggest the proper direction that the future Japanese policy could take, and to question the adequacy of the term of ‘health promotion’. We find the ‘social progress’ characterization of the ‘Second Term of National Health Promotion Movement in the Twenty-First Century - Health Japan 21 ’ to be problematic. (...) While there are clear restraints found in terms of social costs related to the policy, the aims toward social justice provided by the policy are not clear. Considering the social importance and justification of health promotion, and the present conditions seen in Japan, we believe that it is necessary clearly to position health promotion as a form of social justice. Having said this, the term ‘health promotion’ is in itself misleading and can belie the range of activities required to action these policies. Therefore, we propose considering the selection of a different and more appropriate term for health promotion that concretely defines policies that actively work toward definitive health equity. (shrink)

In Japan, where a prominent gap exists in what is considered a patient’s best interest between the medical and patient sides, appropriate decision-making can be difficult to achieve. In Japanese clinical settings, decision-making is considered an act of choice-making from multiple potential options. With many ethical dilemmas still remaining, establishing an appropriate decision-making process is an urgent task in modern Japanese healthcare. This paper examines ethical issues related to shared decision-making (SDM) in clinical settings in modern Japan from the psychocultural-social (...) perspective and discusses the ideal decision-making process in present Japan. Specifically, we discuss how five psychocultural-social tendencies – “surmise (Sontaku),” “self-restraint (Jishuku),” “air (atmosphere or mood, Kuuki),” “peer pressure (or tuning pressure, Docho-Atsuryoku),” and “community (Seken)”—which have often been referred to as characteristics of present-day Japanese people, may affect the ideal practice of SDM in Japanese clinical settings. We conclude that health care professionals must be aware of the possible adverse effects of the above Japanese psychocultural-social tendencies on the implementation of SDM and attempt to promote autonomous decision-making, thereby allowing patients to make treatment choices that sufficiently reflect their individual and personal views of life, experiences, goals, preferences, and values. (shrink)

Progress in artificial intelligence technological innovation raises questions about the role of medical staff and the meaning of medical specialization. This study involved a qualitative survey of medical professionals and ordinary citizens to expand knowledge of this topic. A combination of Neo-Socratic Dialogue and Transfer Dialogue techniques, was used to acquire knowledge related to emerging forms of medical care and changing work demands after the implementation of AI, qualitatively analyzing the TD transcript only. Eleven subjects participated in two surveys. The (...) main points raised during TD were classified into five categories: i) Functions which AI could perform/would find difficult to perform, ii) Changes in medicine caused by AI, iii) Necessary preparations for the application of AI to medicine, iv) Concerns about AI, and v) Others. The survey findings suggest that initiatives to promote the acceptance of each individual in society and appropriate technological development are essential to the process of preparing for the changes in medicine following the implementation of AI. These preparatory conditions cannot be limited to medical professionals, and must extend to workers across all disciplines and to society as a whole. (shrink)

Some modal logics based on logics weaker than the classical logic have been studied by Fitch [4], Prior [7], Bull [1], [2], [3], Prawitz [6] etc. Here we treat modal logics based on the intuitionistic propositional logic, which call intuitionistic modal logics.

The use of single-use items is now ubiquitous in medical practice. Because of the high costs of these items, the practice of reusing them after sterilisation is also widespread especially in resource-poor economies. However, the ethics of reusing disposable items remain unclear. There are several analogous conditions, which could shed light on the ethics of reuse of disposables. These include the use of restored kidney transplantation and the use of generic drugs etc. The ethical issues include the question of patient (...) safety and the possibility of infection. It is also important to understand the role of informed consent before reuse of disposables. The widespread practice of reuse may bring down high healthcare costs and also reduce the huge amount of hospital waste that is generated. The reuse of disposables can be justified on various grounds including the safety and the cost effectiveness of this practice. (shrink)

A murder case that had some features in common with the Tarasoff case occurred in Sasebo City, Japan, in 2014. A 15-year-old high school girl was murdered and her 16-year-old classmate was arrested on suspicion of homicide. One and a half months before the murder, a psychiatrist who had been examining the girl called a prefectural child consultation centre to warn that she might commit murder, but he did not reveal her name, considering it his professional duty to keep it (...) confidential. Article 134 of the Japanese Criminal Law states that doctors should not disclose patient information obtained in clinical practice without a legitimate reason, but the Japanese Supreme Court has not specified what constitutes a legitimate reason. Mass media and commentators suggested that the murder could have been prevented if the psychiatrist had disclosed the girl's name to the authorities or had isolated her coercively in a psychiatric ward. However, the authors disagree with such claims. This article discusses obligations imposed on concerned individuals and third party members in cases involving ethical dilemmas regarding patient confidentiality and information disclosure. It is concluded that everyone should fulfill their obligations to prevent such tragedies and one should judge the appropriateness of others’ actions based not on the consequences of their actions, but on the processes used to decide on a course of action and their commitment. It is necessary for us to establish a society in which concerned parties can do what they think is ethically best without fearing ungrounded charges. (shrink)

Both Ambrose St. John (1815–1875) and John Henry Newman (1801–1890), who were received into the Roman Catholic Church in 1845, became members of the Birmingham Oratory. Newman’s closest companion for over three decades, St. John’s death was extremely painful for Newman, not only because it was unexpected, but because of his devotion to Newman as well as his dedication to his spiritual duties. Along with presenting Newman’s narrative of the last few weeks of St. John’s life, this essay raises the (...) question: why did Newman write this “account.”. (shrink)

John Henry Newman has rightly been hailed as a giant in the Catholic intellectual tradition. His contributions to theology, literature, and education have been studied at length; however, his contribution to philosophy has not received appropriate attention. This essay 1) explores Newman’s unique philosophical insights in terms of the phenomenological tradition of Edmund Husserl; 2) analyzes the transcendental approach of certain British scientists—notably Ronald Knox and Charles Darwin; and 3) discusses how Newman might be considered a phenomenologist.

Along the same line as that in Ono (Ann Pure Appl Logic 161:246–250, 2009), a proof-theoretic approach to Glivenko theorems is developed here for substructural predicate logics relative not only to classical predicate logic but also to arbitrary involutive substructural predicate logics over intuitionistic linear predicate logic without exponentials QFLe. It is shown that there exists the weakest logic over QFLe among substructural predicate logics for which the Glivenko theorem holds. Negative translations of substructural predicate logics are studied by using (...) the same approach. First, a negative translation, called extended Kuroda translation is introduced. Then a translation result of an arbitrary involutive substructural predicate logics over QFLe is shown, and the existence of the weakest logic is proved among such logics for which the extended Kuroda translation works. They are obtained by a slight modification of the proof of the Glivenko theorem. Relations of our extended Kuroda translation with other standard negative translations will be discussed. Lastly, algebraic aspects of these results will be mentioned briefly. In this way, a clear and comprehensive understanding of Glivenko theorems and negative translations will be obtained from a substructural viewpoint. (shrink)

To consider whether or not we should aim to create a perfect healthy utopia on Earth, we focus on the SF novel Harmony, written by Japanese writer Project Ito, and analyze various issues in the world established in the novel from a bioethical standpoint. In the world depicted in Harmony, preserving health and life is a top priority. Super-medicine is realized through highly advanced medical technologies. Citizens in Harmony are required to strictly control themselves to achieve perfect health and must (...) always disclose their health information to the public and continuously prove their health. From a bioethical standpoint, the world in Harmony is governed by a “healthy longevity supremacy” principle, with being healthy equated to being good and right. Privacy no longer exists, as it is perceived ethical for citizens to openly communicate health-related information to establish one’s credibility. Moreover, there is no room for self-determination concerning healthcare because medical interventions and care are completely routinized, automated, centralized, and instantly provided. This is a situation where the community exhibits extremely powerful and effective paternalism. One can argue that healthy longevity is highly preferred. But is it right to aim for a perfectly healthy society at all costs? Should we sacrifice freedom, privacy, vivid feelings, and personal dignity to achieve such a world? In our view, the answer is no, as this would require the loss of many essential values. We conclude by proposing an alternative governing principle for future healthcare, and refer to it as the “do-everything-in-moderation” principle. (shrink)

In many countries, prenatal testing for certain fetal abnormalities is offered via publicly funded screening programs. The concept of reproductive autonomy is regarded as providing a justificatory basis for many such programs. The purpose of this study is to re‐examine the normative basis of public prenatal screening for fetal abnormalities by changing our perspective from that of autonomy to obligation. After clarifying the understanding of autonomy adopted in the justification for public prenatal screening programs, we identify two problems concerning this (...) justification: first, the extent to which the government is obliged to meet this demand is not evident; and, second, it is not clear whether the provision of public screening is the most appropriate way to promote autonomy. Next, to tackle these problems, we focus on Onora O’Neill’s argument of rights and obligations. Drawing on this argument, we show that, in addressing the problems above, it is important to change our normative perspective from rights or autonomy to obligation. Our argument will show that since the government does not have an incontrovertibly fundamental obligation to promote autonomy, this obligation needs to be constrained in terms of compatibility with other fundamental obligations. In addition, even if a government is obliged to promote autonomy to some degree, there could be more appropriate means to achieve it than providing public prenatal screening; therefore, it is not necessary for government obligations to extend to the provision of public prenatal screening. (shrink)

Substructural logics have received a lot of attention in recent years from the communities of both logic and algebra. We discuss the algebraization of substructural logics over the full Lambek calculus and their connections to residuated lattices, and establish a weak form of the deduction theorem that is known as parametrized local deduction theorem. Finally, we study certain interpolation properties and explain how they imply the amalgamation property for certain varieties of residuated lattices.

We will give here a purely algebraic proof of the cut elimination theorem for various sequent systems. Our basic idea is to introduce mathematical structures, called Gentzen structures, for a given sequent system without cut, and then to show the completeness of the sequent system without cut with respect to the class of algebras for the sequent system with cut, by using the quasi-completion of these Gentzen structures. It is shown that the quasi-completion is a generalization of the MacNeille completion. (...) Moreover, the finite model property is obtained for many cases, by modifying our completeness proof. This is an algebraic presentation of the proof of the finite model property discussed by Lafont [12] and Okada-Terui [17]. (shrink)

Background: The introduction of healthcare AI to society as well as the clinical setting will improve individual health statuses and increase the possible medical choices. AI can be, however, regarded as a double-edged sword that might cause medically and socially undesirable situations. In this paper, we attempt to predict several negative situations that may be faced by healthcare professionals, patients and citizens in the healthcare setting, and our society as a whole. Discussion: We would argue that physicians abuse healthcare AI (...) through their excessive and dependent use of it, and they will focus only on the AI services in their office and patient medical data and information, and forget to observe the patient in their clinical encounters. In the era of AI introduction, data from the wearable terminal or AI advice will become the primary target of the physician’s interest, and could be regarded as a patient surrogate. Paternalism would be paradoxically resurrected by the introduction of state-of-the-art AI. A physician’s conflict of interest related to AI as a commercial product could strongly influence his or her actions in clinical settings. We also worry that the general public will become uneasy and hypersensitive slaves to information, compulsively and uninterruptedly requesting healthcare information concerning their own health and advice from AI. An AI system capable of expressing proper and timely empathy to suffering patients could deprive healthcare professionals of their roles in terms of hospitality and emotional exchange. Finally, entire societies would soon share and consolidate healthcare sensitive information from all in the general public as part of a totalitarian healthcontrolled society where individual privacy and personal secrets could be neglected. The advent of the healthcontrolled society could lead to the metamorphosis of the concept of privacy itself into something completely different. Conclusion: Although AI which surpasses human healthcare professionals may never appear, hoping for the best and preparing for the worst is the best approach to take. To this end, we present some potential countermeasures including conducting clinical research and social investigations concerning problems surrounding the introduction of AI and developing guidelines for its appropriate use. (shrink)

The global increase in patients with chronic conditions has led to increased interest in ethical issues regarding such conditions. A basic biomedical principle—respect for autonomy—is being reexamined more critically in its clinical implications. New accounts of this basic principle are being proposed. While new accounts of respect for autonomy do underpin the design of many public programs and policies worldwide, addressing both chronic disease management and health promotion, the risk of applying such new accounts to clinical setting remain understudied. However, (...) the application of new accounts of respect for autonomy to clinical settings could support disrespectful attitudes toward or undue interference with patients with chronic conditions. Reconsidering autonomy and respect using Kantian accounts, this paper proposes respect for persons as an alternative basic bioethical principle to respect for autonomy. Unlike the principle of respect for persons in the Belmont Report, our principle involves respecting any patient’s decisions, behaviors, emotions, or life-style regardless of his or her “autonomous” capabilities. Thus, attitudes toward patients should be no different irrespective of the assessment of their decisional or executive capabilities. (shrink)

BackgroundIn the coming years, surrogate decision-making is expected to become highly prevalent in Japanese clinical practice. Further, there has been a recent increase in activities promoting advance care planning, which potentially affects the manner in which judgements are made by surrogate decision-makers. This study aims to clarify the grounds on which surrogate decision-makers in Japan base their judgements.MethodsIn this qualitative study, semi-structured interviews were conducted to examine the judgement grounds in surrogate decision-making for critical life-sustaining treatment choices in acute care (...) hospitals.ResultsA total of 228 participants satisfied the inclusion criteria, and 15 were selected for interviews. We qualitatively analysed the content of 14 interview transcripts, excluding one that did not meet the inclusion criteria. Based on this analysis, we extracted 4 core categories, 17 categories, 35 subcategories, and 55 codes regarding judgement grounds in surrogate decision-making. The four core categories were as follows: patient preference-oriented factor (Type 1), patient interest-oriented factor (Type 2), family preference-oriented factor (Type 3), and balanced patient/family preference-oriented factor (Type 4). The Type 4 core category represented attempts to balance the preferences of the patient with those of the surrogate decision-maker.ConclusionsSurrogate decision-makers based their decisions on important aspects related to a patient’s life, and they considered not only the patient’s preferences and best interests but also their own preferences. As the need for surrogate decisions will increase in the future, decision-makers will need to consider judgement grounds from a more diverse perspective. (shrink)

We develop a general algebraic and proof-theoretic study of substructural logics that may lack associativity, along with other structural rules. Our study extends existing work on substructural logics over the full Lambek Calculus [34], Galatos and Ono [18], Galatos et al. [17]). We present a Gentzen-style sequent system that lacks the structural rules of contraction, weakening, exchange and associativity, and can be considered a non-associative formulation of . Moreover, we introduce an equivalent Hilbert-style system and show that the logic associated (...) with and is algebraizable, with the variety of residuated lattice-ordered groupoids with unit serving as its equivalent algebraic semantics. Overcoming technical complications arising from the lack of associativity, we introduce a generalized version of a logical matrix and apply the method of quasicompletions to obtain an algebra and a quasiembedding from the matrix to the algebra. By applying the general result to specific cases, we obtain important logical and algebraic properties, including the cut elimination of and various extensions, the strong separation of , and the finite generation of the variety of residuated lattice-ordered groupoids with unit. (shrink)

In medical ethics, an appropriate national healthcare system that meets the requirements of justice in healthcare resource allocation is a major concern. Japan is no exception to this trend, and the pros and cons of introducing a two-tier healthcare system, which permits insured medical care services to be provided along with services not covered by social health insurance, have been the subject of debate for many years. The Supreme Court ruled in 2011 that it was valid for the government to (...) ban mixing medical treatments and both the Ministry of Health, Labour and Welfare and Japanese Medical Association oppose the introduction of such a system. In this paper, we examine the main arguments against the introduction of a two-tier healthcare system and ideas that form their basis, which can be broadly divided into opinions based on the importance of equality and those derived from the logical conclusion that the outcomes would be detrimental. We point out issues and shortcomings of each standpoint and argue that the introduction of the system would not necessarily threaten equality and social solidarity in Japanese society, and that abuses of a self-pay tier would be controllable to a certain extent. Then, the authors—who do not actively promote the introduction of a two-tier healthcare system—conclude that the allegation that is completely devoted to one side and the theory that social healthcare is collapsing, which makes the public excessively nervous, cannot be accepted. (shrink)

Prevention and control of chronic conditions are global healthcare challenges. Patient self-management has been deemed essential for treating chronic conditions and improving the quality of patient life. However, the current Japanese system for supporting patient self-management of chronic conditions has received little ethical assessment. The first aim of this article is to provide an ethical analysis of current Japanese support for self-management of chronic conditions with reference to international discussions concerning self-management, developed mainly in western societies such as Europe, the (...) United States. The second aim is to clarify the challenges faced by Japanese biomedical ethics concerning selfmanagement support by focusing on the ethical concepts of quality of life and autonomy. This article identifies the following two challenges: [1] dispelling conceptual confusion concerning basic ethical concepts such as quality of life and autonomy, and [2] exploring the conceptual relationship between these ethical concepts, as they relate to providing support for chronically ill patients. By addressing these challenges and constructing a theoretical basis for radical change in support mechanisms, bioethics in Japan could contribute to efforts to construct a comprehensive support system for patients with chronic conditions, which organize variety kinds of supports, such as medical professional supports, supports from patient’s groups, local community supports, familial supports, support in patients’ workplace, and supports for patients’ family members as well. (shrink)

It is well known that classical propositional logic can be interpreted in intuitionistic propositional logic. In particular Glivenko's theorem states that a formula is provable in the former iff its double negation is provable in the latter. We extend Glivenko's theorem and show that for every involutive substructural logic there exists a minimum substructural logic that contains the first via a double negation interpretation. Our presentation is algebraic and is formulated in the context of residuated lattices. In the last part (...) of the paper, we also discuss some extended forms of the Kolmogorov translation and we compare it to the Glivenko translation. (shrink)

The present paper deals with the predicate version MTL of the logic MTL by Esteva and Godo. We introduce a Kripke semantics for it, along the lines of Ono''s Kripke semantics for the predicate version of FLew (cf. [O85]), and we prove a completeness theorem. Then we prove that every predicate logic between MTL and classical predicate logic is undecidable. Finally, we prove that MTL is complete with respect to the standard semantics, i.e., with respect to Kripke frames on the (...) real interval [0,1], or equivalently, with respect to MTL-algebras whose lattice reduct is [0,1] with the usual order. (shrink)

In this paper, we will develop an algebraic study of substructural propositional logics over FLew, i.e. the logic which is obtained from intuitionistic logics by eliminating the contraction rule. Our main technical tool is to use residuated lattices as the algebraic semantics for them. This enables us to study different kinds of nonclassical logics, including intermediate logics, BCK-logics, Lukasiewicz’s many-valued logics and fuzzy logics, within a uniform framework.

Glivenko-type theorems for substructural logics are comprehensively studied in the paper [N. Galatos, H. Ono, Glivenko theorems for substructural logics over FL, Journal of Symbolic Logic 71 1353–1384]. Arguments used there are fully algebraic, and based on the fact that all substructural logics are algebraizable 279–308] and also [N. Galatos, P. Jipsen, T. Kowalski, H. Ono, Residuated Lattices: An Algebraic Glimpse at Substructural Logics, in: Studies in Logic and the Foundations of Mathematics, vol. 151, Elsevier, 2007] for the details). As (...) a complementary work to the algebraic approach developed in [N. Galatos, H. Ono, Glivenko theorems for substructural logics over FL, Journal of Symbolic Logic 71 1353–1384], we present here a concise, proof-theoretic approach to Glivenko theorems for substructural logics. This will show different features of these two approaches. (shrink)

In everyday medical settings in Japan, physicians occasionally tell an elderly patient that their symptoms are “due to old age,” and there is some concern that patient care might be negatively impacted as a result. That said, as this phrase can have multiple connotations and meanings, there are certain instances in which the use of this phrase may not necessarily be indicative of ageism, or prejudice against the elderly. One of the goals in medical care is to address pain and (...) suffering that develops with age in elderly individuals, and whether or not aging is a disease is inconsequential. However, assuming that an individualized and thorough examination has been performed, there are some conditions that can be attributed only to age. Accordingly, physicians must acknowledge the merits and drawbacks of using the phrase “due to old age,” and exercise caution when using it. Both physicians and their elderly patients must share a common awareness of the incomplete and limited nature of modern medicine and its scope, and physicians must help their elderly patients accept and live with the aging phenomenon. (shrink)

In this paper, a theorem on the existence of complete embedding of partially ordered monoids into complete residuated lattices is shown. From this, many interesting results on residuated lattices and substructural logics follow, including various types of completeness theorems of substructural logics.

An intermediate predicate logicS + n (n>0) is introduced and investigated. First, a sequent calculusGS n is introduced, which is shown to be equivalent toS + n and for which the cut elimination theorem holds. In § 2, it will be shown thatS + n is characterized by the class of all linear Kripke frames of the heightn.

In this paper, a theorem on the existence of complete embedding of partially ordered monoids into complete residuated lattices is shown. From this, many interesting results on residuated lattices and substructural logics follow, including various types of completeness theorems of substructural logics.

LetL be any modal or tense logic with the finite model property. For eachm, definer L (m) to be the smallest numberr such that for any formulaA withm modal operators,A is provable inL if and only ifA is valid in everyL-model with at mostr worlds. Thus, the functionr L determines the size of refutation Kripke models forL. In this paper, we will give an estimation ofr L (m) for some linear modal and tense logicsL.

An emerging concept is that quiescent mature skeletal cells provide an important cellular source for bone regeneration. It has long been considered that a small number of resident skeletal stem cells are solely responsible for the remarkable regenerative capacity of adult bones. However, recent in vivo lineage‐tracing studies suggest that all stages of skeletal lineage cells, including dormant pre‐adipocyte‐like stromal cells in the marrow, osteoblast precursor cells on the bone surface and other stem and progenitor cells, are concomitantly recruited to (...) the injury site and collectively participate in regeneration of the damaged skeletal structure. Lineage plasticity appears to play an important role in this process, by which mature skeletal cells can transform their identities into skeletal stem cell‐like cells in response to injury. These highly malleable, long‐living mature skeletal cells, readily available throughout postnatal life, might represent an ideal cellular resource that can be exploited for regenerative medicine. (shrink)

We prove that certain natural sequent systems for bi-intuitionistic logic have the analytic cut property. In the process we show that the (global) subformula property implies the (local) analytic cut property, thereby demonstrating their equivalence. Applying a version of Maehara technique modified in several ways, we prove that bi-intuitionistic logic enjoys the classical Craig interpolation property and Maximova variable separation property; its Halldén completeness follows.

Previous studies have explored the effects of attention on spatial representation. Specifically, in the attentional repulsion effect, a transient visual cue that captures attention has been shown to alter the perceived position of a target stimulus to the direction away from the cue. The effect is also susceptible to retrospective influence, that attention appears to attract the target when the cue appears afterwards. This study examined the necessity of visual awareness of the cue in these phenomena. We found that when (...) the cues were rendered invisible by backward visual masks, both repulsion and attraction effects were weakened but still observed. The results suggest that the effects possibly depend on processes that are not necessarily associated with conscious visual awareness of the cues. We conjecture that attentional shift produced by the weak, invisible cues may play a role in spatial distortion; but other possible accounts including non-attentional ones are also discussed. (shrink)