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In July 2005, the United Nations special rapporteur on discrimination and racism, Doudou Diene, went on a nine-day tour of Japan and talked to minority groups, antidiscrimination campaigners and government and police officials around the country. After releasing his preliminary findings to the press last year, Diene handed the completed 23-page report based on his research to the UN Commission on Human Rights in January. [Doudou Diene Report]
From the centre of empire, the map of the rest of the world is largely blank, assumed either to be “just like us” and hence boring, or alternatively “not like us” and hence of marginal interest. Either way, the rest of the world is of little concern to those at the centre, at least until ugly blotches of “trouble spots” crack the surface glaze of imperial narcissism.
On July 1, 1946, less than a year after the bombing of Hiroshima and Nagasaki, the United States resumed nuclear testing in the Pacific. In March, 1954 the US forced the 166 inhabitants of Bikini Atoll in the Marshall Islands, part of the United Nations Trust Territory that was among the spoils of victory in world War II, to leave their home island. On July 1, 1954 it conducted the first full-scale test of a Hydrogen Bomb at Bikini. The blast is estimated at 15 megatons, that is the equivalent of 15 million tons of TNT, one thousand times as powerful as the bomb exploded at Hiroshima. The Japanese fishing boat Lucky Dragon No. 5, sailing well beyond the zone demarcated by US authorities for the test, was covered with white ashes, later recognized as radioactive coral dust. The next day all 23 crew members suffered from headache, nausea, diarrhea and other symptoms from exposure to radioactivity. The symptoms were more acute among inhabitants of Longelap Atoll, 180 kilometers East of Bikini and other atolls. On September 23, the Lucky Dragon's chief radio operator died of jaundice, diagnosed as having been complicated by radioactivity. In Japan, the incident sparked a national petition campaign to ban nuclear weapons led by a women's group in Suginami Ward, Tokyo. The twenty million signatures that it collected within months provided a springboard for a national and international anti-nuclear movement. In August 1955 the World Conference Against Atomic and Hydrogen Bombs convened in Hiroshima, the first in a series of annual meetings that became the center of the antinuclear movement. This series of articles, on the fiftieth anniversary of the Bikini test, records the fate of the crew members, the fishing communities that were their homes, and their impact on the subsequent treatment of atomic victims in Japan.
[Japan Focus introduction: Prime Minister Abe Shinzo recently added another entry to the long, sorry chapter of official Japanese war-crime denials when he said that there was no coercion of the so-called comfort-women by the imperial military “in the narrow sense of the word.” On March 1, an historic day in the history of Korean resistance to Japanese colonial rule, he said: “The fact is, there is no evidence to prove there was coercion.”
In the course of a forty-five year career, Honda Katsuichi has established himself as one of Japan's, and the world's, premier investigative journalists and authors. Hailing from a mountain village in Shinshu (Nagano) and an avid mountain climber throughout his life, Honda's interests extended from nature and the environment to the politics of colonialism and war, with the Vietnam War as a critical moment in his development. In writing for the Asahi Shimbun and in a series of best-selling books, Honda has addressed the most controversial contemporary and historical issues confronting Japan as well as the United States and others. Most famously, he “broke” the Nanjing Massacre story in Japan thirty-four years after the event with first-hand interview reportage from China. His reportage and his book, Nankin Daigyakusatsu, published in English as The Nanjing Massacre: A Japanese Journalist Confronts Japan's National Shame inspired a generation of Japanese, Chinese and international researchers who have excavated the Nanjing Massacre. It also touched off fierce polemics in the form of a Nanjing Massacre denial literature.
The Diene Report of 2005 represents an instance in which an international organization investigated Japanese official treatment of minority communities in Japan in relation to international standards, and their findings strongly supported the Ainu activists. The United Nations sent Doudou Diene, their Special Rapporteur, to Japan to look into discrimination and racism. Diene's report harshly criticized the racism that exists in Japan and suggested that improved measures are necessary to protect the Ainu and other minorities there. This article is a response to his report by five Japanese individuals who have long been committed to countering discrimination and racism in the country. Four of the five contributors agree with the overall content of the Diene report and provide further information. They see the report as a small but positive impetus that will help the 21st century activism that further counters discrimination and racism in Japan. On the other hand, William Wetherall criticizes the report as seriously flawed, because he thinks it misunderstands the main aspects of the issue.
Cases of hospital-onset bacteremia and fungemia (HOBF) are on the rise in Japanese hospitals, but little is known about their incidence in hospitals and how it relates to the availability of services provided by infectious diseases departments.
Methods:
We herein investigated the monthly incidence density of HOBF per 1,000 patient days from 2013 through 2023 at a tertiary care hospital in Japan. The incidence of overall HOBF and pathogen-specific HOBF, including those caused by Enterobacterales, Staphylococcus aureus, coagulase-negative staphylococci (CNS), and Candida species, was tracked. Changes in the HOBF trend before and after the establishment of an infectious diseases department at the hospital were evaluated.
Results:
In total, 4,315 HOBF-related events were identified. The overall incidence density of HOBF increased by 2.4-fold from 0.58 per 1,000 PD in 2013 to 1.42 per 1,000 PD in 2023. Both the level and trend changes in the incidence density of overall HOBF (+0.3142 for change in level [P < .001]; +0.0085 for change in trend [P < .001]), HOBF caused by S. aureus (+0.0983 for change in level [P < .001]; +0.0016 for change in trend [P = 0.016]), and Candida spp. (+0.0466 for change in level [P = 0.030]; +0.0019 for change in trend [P = 0.002]) significantly increased after the establishment of the infectious diseases department.
Conclusion:
The incidence density of overall HOBF and clinically important pathogen-specific HOBF increased over the last decade. The availability of services through the infectious diseases department was significantly associated with an increase in the HOBF incidence, likely suggesting improvement in the diagnosis of HOBF.
Twins lag behind singletons in their early psychomotor development, but little is known about how chorionicity affects this difference. We compared early psychomotor development in singletons, monochorionic (MC) twins and dichorionic (DC) twins. Our longitudinal data from the Japan Environment and Children’s Study (JECS; see Appendix) included 98,042 singletons, 577 MC twins and 1051 DC twins representing the general Japanese population. Chorionicity was evaluated by ultrasound images and complemented by postnatal pathological examinations. Five domains of psychomotor development were evaluated at 6 time points from 6 months to 3 years of age using the Ages and Stages Questionnaires (ASQ-3). The data were analyzed using linear regression models. Twins lagged behind singletons in all areas of psychomotor development during infancy. This gap decreased over time but was still noticeable at 3 years of age. More than half of this difference was attributed to twins having lower birth weight and being born earlier in gestation. MC twins showed slightly delayed development compared to DC twins, but this difference was minor compared to the overall gap between twins and singletons. Twins delay singletons in their early psychomotor development, and this delay is not specific to MC twinning.
Improved food availability and a growing economy in Tanzania may insufficiently decrease pre-existing nutritional deficiencies and simultaneously increase overweight within the same individual, household or population, causing a double burden of malnutrition (DBM). We investigated economic inequalities in DBM at the household level, expressed as a stunted child with a mother with overweight/obesity, and the moderating role of dietary diversity in these inequalities.
Design:
We used cross-sectional data from the 2015–2016 Tanzania Demographic and Health Survey.
Setting:
A nationally representative survey.
Participants:
Totally, 2867 children (aged 6–23 months) and their mothers (aged 15–49 years). The mother–child pairs were categorised into two groups based on dietary diversity score: achieving and not achieving minimum dietary diversity.
Results:
The prevalence of DBM was 5·6 % (sd = 0·6) and significantly varied by region (ranging from 0·6 % to 12·2 %). Significant interaction was observed between dietary diversity and household wealth index (Pfor interaction < 0·001). The prevalence of DBM monotonically increased with greater household wealth among mother–child pairs who did not achieve minimum dietary diversity (Pfor trend < 0·001; however, this association was attenuated in those who achieved minimum dietary diversity (Pfor trend = 0·16), particularly for the richest households (P = 0·44). Analysing household wealth index score as a continuous variable yielded similar results (OR (95 % CI): 2·10 (1·36, 3·25) for non-achievers of minimum dietary diversity, 1·38 (0·76, 2·54) for achievers).
Conclusions:
Greater household wealth was associated with higher odds of DBM in Tanzania; however, the negative impact of household economic status on DBM was mitigated by minimum dietary diversity.
We evaluated the secondary COVID-19 incidence among uninfected hospitalized patients after nosocomial COVID-19 exposure. An exposure source of SARS-CoV-2 was hospitalized patients or healthcare personnel (HCP) newly diagnosed as having COVID-19. Patients exposed to a COVID-19-infected patient in a shared room more frequently developed COVID-19 than those exposed to an infected HCP.
Inspired by a result in T. H. Colding. (16). Acta. Math.209(2) (2012), 229-263 [16] of Colding, the present paper studies the Green function $G$ on a non-parabolic $\operatorname {RCD}(0,\,N)$ space $(X,\, \mathsf {d},\, \mathfrak {m})$ for some finite $N>2$. Defining $\mathsf {b}_x=G(x,\, \cdot )^{\frac {1}{2-N}}$ for a point $x \in X$, which plays a role of a smoothed distance function from $x$, we prove that the gradient $|\nabla \mathsf {b}_x|$ has the canonical pointwise representative with the sharp upper bound in terms of the $N$-volume density $\nu _x=\lim _{r\to 0^+}\frac {\mathfrak {m} (B_r(x))}{r^N}$ of $\mathfrak {m}$ at $x$;
\[ |\nabla \mathsf{b}_x|(y) \le \left(N(N-2)\nu_x\right)^{\frac{1}{N-2}}, \quad \text{for any }y \in X \setminus \{x\}. \]
Moreover the rigidity is obtained, namely, the upper bound is attained at a point $y \in X \setminus \{x\}$ if and only if the space is isomorphic to the $N$-metric measure cone over an $\operatorname {RCD}(N-2,\, N-1)$ space. In the case when $x$ is an $N$-regular point, the rigidity states an isomorphism to the $N$-dimensional Euclidean space $\mathbb {R}^N$, thus, this extends the result of Colding to $\operatorname {RCD}(0,\,N)$ spaces. It is emphasized that the almost rigidities are also proved, which are new even in the smooth framework.
The reactivity and stability of the edge faces of swelling clay minerals can be altered by layer charge and the stacking structure; however, these effects are poorly understood due to experimental limitations. The structure and stability of the montmorillonite {110}, {010}, {100}, and {130} edge faces with a layer charge of either y = 0.50 or y = 0.33 (e−/Si4O10) were investigated using first-principles calculations based on density functional theory. Stacked- and single-layer models were tested and compared to understand the effect of stacking on the stability of montmorillonite edge faces. Most stacked layers stabilize the edge faces by creating hydrogen bonds between the layers; therefore, the surface energy of the layers in the stacked-layer model is lower than in the single-layer model. This indicates that the estimates of edge face surface energy should consider the swelling conditions. Negative surface energies were calculated for these edge faces in the presence of chemisorbed water molecules. A high layer charge of 0.50 reduced the surface energy relative to that of the low layer charge of 0.33. The isomorphic substitution of Mg for Al increased the stability of interlayer Na ion positions, which were stable in the trigonal ring next to the Mg ions. The lowest surface energies of the {010} and {130} edge faces were characterized by the presence of Mg ions on edge faces, which had a strong cation adsorption site due to the local negative charge of the edges. The coordination numbers of O atoms around cations adsorbed to these edge faces were small in comparison to interlayers without water.
The days of therapy (DOT) metric, used to estimate antimicrobial consumption, has some limitations. Days of antibiotic spectrum coverage (DASC), a novel metric, overcomes these limitations. We examined the difference between these 2 metrics of inpatient intravenous antimicrobial consumption in assessing antimicrobial stewardship efficacy and antimicrobial resistance using vector autoregressive (VAR) models with time-series analysis.
Methods:
Differences between DOT and DASC were investigated at a tertiary-care center over 8 years using VAR models with 3 variables in the following order: (1) the monthly proportion of prospective audit and feedback (PAF) acceptance as an index of antimicrobial stewardship efficacy; (2) monthly DOT and DASC adjusted by 1,000 days present as indices of antimicrobial consumption; and (3) the monthly incidence of 5 organisms as an index of antimicrobial resistance.
Results:
The Granger causality test, which evaluates whether incorporating lagged variables can help predict other variables, showed that PAF activity contributed to DOT and DASC, which, in turn, contributed to the incidence of drug-resistant P. aeruginosa. Notably, only DASC helped predict the incidence of drug-resistant Enterobacterales. Another VAR analysis demonstrated that a high proportion of PAF acceptance was accompanied by decreased DASC in a given month, whereas increased DASC was accompanied by an increased incidence of drug-resistant Enterobacterales, unlike with DOT.
Conclusions:
The VAR models of PAF activity, antimicrobial consumption, and antimicrobial resistance suggested that DASC may more accurately reflect the impact of PAF on antimicrobial consumption and be superior to DOT for predicting the incidence of drug-resistant Enterobacterales.
We evaluated the impact of carbapenem shortage on antimicrobial practice and patient outcome at a tertiary care center. During the shortage, hospital antimicrobial practice could be safely managed through additional antimicrobial stewardship measures including treatment guidance and mandatory preauthorization. Antimicrobial shortage may present a unique opportunity for promoting antimicrobial stewardship.
Phenotypic variation is the result of gene expression based on complex interaction between genetic and environmental factors. It is well known that genetic and environmental factors influence gene expression, but our understanding of their relative importance remains limited. To obtain a hint for the understanding of their contributions, we took advantage of monozygotic twins, as they share genetic and shared environmental factors but differ in nonshared factors, such as environmental differences and stochastic factors. In this study, we performed cap analysis of gene expression on three pairs of twins and clustered each individual based on their expression profiles of annotated genes. The dendrogram of annotated gene transcripts showed a monophyletic clade for each twin pair. We also analyzed the expression of retrotransposons, such as human endogenous retroviruses (HERVs) and long interspersed nuclear elements (LINEs), given their abundance in the genome. Clustering analyses demonstrated that HERV and LINE expression diverged even within monozygotic twin pairs. Thus, HERVs and LINEs are more susceptible to nonshared factors than annotated genes. Motif analysis of differentially expressed annotated genes suggests that specificity protein/Krüppel-like factor family transcription factors are involved in the expression divergence of annotated gene influenced by nonshared factors. Collectively, our findings suggest that expressions of annotated genes and retrotransposons are differently regulated, and that the expression of retrotransposons is more susceptible to nonshared factors than annotated genes.
The persistence of seed-dispersing animals in degraded habitats could be critical for ensuring the long-term conservation value and restoration of forests. This is particularly important in Southeast Asia, where > 70% of the remaining forest areas are within 1 km of a forest edge, and many are degraded (e.g. logged). We synthesized information on the habitat associations of the binturong Arctictis binturong, a large, semi-arboreal, frugivorous civet and one of the most important seed dispersers in the region, especially for figs (Ficus spp). We adopted a multiscale approach by employing ensemble species distribution modelling from presence-only records, assessing landscape-scale variation in detection rates in published camera-trap studies and using hierarchical occupancy modelling to assess local (i.e. within-landscape) patterns observed from 20 new camera-trap surveys. Contrary to prior reports that binturongs are strongly associated with intact forests, the species was equally present in degraded forests and near forest edges where sufficient forest cover was maintained (> 40% forest cover within a 20-km radius). The species also tolerates moderate incursions of oil palm plantations (< 20% of the area within a 20-km radius covered by oil palm plantations). The relative resilience of binturongs to habitat degradation could be in part because of behavioural adaptations towards increased nocturnal activity. These results support the notion that key seed dispersers can persist and maintain their ecological function in degraded forests.
To evaluate antibiotic prescribing behavior (APB) among physicians with various specialties in five Asian countries.
Design:
Survey of antibiotics prescribing behavior in three stages (initial, on-treatment, and de-escalation stages).
Methods:
Participants included internists, infectious diseases (ID) specialists, hematologists, intensivists, and surgeons. Participants’ characteristics, patterns of APB, and perceptions of antimicrobial stewardship were collected. A multivariate analysis was conducted to evaluate factors associated with appropriate APB.
Results:
There were 367 participants. The survey response rate was 82.5% (367/445). For the initial stage, different specialties had different choices for empiric treatment. For the on-treatment stage, if the patient does not respond to empiric treatment, most respondents will step up to broader-spectrum antibiotics (273/367: 74.39%). For the de-escalation stage, the rate of de-escalation was 10%–60% depending on the specialty. Most respondents would de-escalate antibiotics based on guidelines (250/367: 68.12%). De-escalation was mostly reported by ID specialists (66/106: 62.26%). Respondents who reported that they performed laboratory investigations prior to empirical antibiotic prescriptions (aOR = 2.83) were associated with appropriate use, while respondents who reported ID consultation were associated with appropriate antibiotic management for infections not responding to empiric treatment (aOR = 40.87); adherence with national guidelines (aOR = 2.57) was associated with reported successful carbapenem de-escalation.
Conclusion:
This study highlights the variation in practices and gaps in appropriate APB on three stages of antibiotic prescription among different specialties. Education on appropriate investigation, partnership with ID specialist, and availability and adherence with national guidelines are critical to help guide appropriate APB among different specialties.