Caring without Tolerance: Care Literacy as an Enabler of an Inclusive Society

Japanese society has been undergoing significant social changes in recent years, which has led to a greater variety of lived experiences in juxtaposition with pressures to conform from its group-oriented cultural context. Achieving inclusion in an increasingly heterogeneous society depends on how relatedness connects people, for example, in caring for others. The purpose of this study is to examine aspects of caring for others in Japanese society based on in-depth narrative interviews conducted in 2022 involving 18 informants. The fieldwork findings point to constraints on individual autonomy from relations stemming from care being intertwined with a broader relational context. Additionally, cultural conformity pressures lead to a propensity to assess social practices and, in turn, provide “excessive care”. Yet, such “excessive care”, as premised on cultural conformity, is at odds with increasingly heterogeneous choices. This leads to the emergence of intolerance, which supresses individuals’ autonomy and agency. Instead, to achieve an inclusive society, these findings point to the need for appropriate relations of understanding, tolerance and caring. This would be enabled by fostering “care literacy” across communities and stakeholders, thus supporting the transition towards a more inclusive society

Instruments to Assess People’s Attitude and Behaviours towards Tolerance: A Systematic Review of Literature

While tolerance is recognised as important, especially to diverse societies, understanding tolerance poses complexities, both theoretically and in practical application. Tolerance is relevant in different social contexts, yet these pose distinct challenges to measurement. Thus, understanding the measurement of tolerance is important. This study provides a systematic review of tolerance scales, with the procedure based on the PRISMA statement. The initial collection of over 1600 papers through the systematic review process yielded a set of 11 papers. These papers trace the development of tolerance scales to encompass distinct social contexts over time, including political, cultural, ethnic and racial, racial and religious, gender and sexual, and social. Correspondingly, the approaches reflect particular challenges relevant to these domains for understanding and measuring tolerance. In contrast, some recent contributions aim to develop broader, less context-specific means to assess tolerance. Notwithstanding the breadth of articles included, this systematic review yielded articles that covered only selected Western-centric geographies: this indicates the opportunity for further research to access and integrate non-English-language articles to broaden the geographical and cultural perspectives on tolerance

A Kinetic Pump Integrated Microfluidic Plate (KIM-Plate) with High Usability for Cell Culture-Based Multiorgan Microphysiological Systems

Microphysiological systems (MPSs), including organ-on-a-chip (OoC), have attracted attention as a novel method for estimating the effects and side effects of drugs in drug discovery. To reproduce the dynamic in vivo environment, previous MPSs were connected to pump systems to perfuse culture medium. Therefore, most MPSs are not user-friendly and have poor throughput. We aimed to develop a kinetic pump integrated microfluidic plate (KIM-Plate) by applying the stirrer-based micropump to an open access culture plate to improve the usability of MPSs. The KIM-Plate integrates six multiorgan MPS (MO-MPS) units and meets the ANSI/SBS microplate standards. We evaluated the perfusion function of the kinetic pump and found that the KIM-Plate had sufficient agitation effect. Coculture experiments with PXB cells and hiPS intestinal cells showed that the TEER of hiPS intestinal cells and gene expression levels related to the metabolism of PXB cells were increased. Hence, the KIM-Plate is an innovative tool for the easy coculture of highly conditioned cells that is expected to facilitate cell-based assays in the fields of drug discovery and biology because of its usability and high throughput nature

Efficacy of Endoscopic Resection and Selective Chemoradiotherapy for Stage I Esophageal Squamous Cell Carcinoma

Background & Aims: Esophagectomy is the standard treatment for stage I esophageal squamous cell carcinoma (ESCC). We conducted a single-arm prospective study to confirm the efficacy and safety of selective chemoradiotherapy (CRT) based on findings from endoscopic resection (ER). Methods: We performed a prospective study of patients with T1b (SM1-2) N0M0 thoracic ESCC from December 2006 through July 2012; 176 patients underwent ER. Based on the findings from ER, patients received the following: no additional treatment for patients with pT1a tumors with a negative resection margin and no lymphovascular invasion (group A); prophylactic CRT with 41.4 Gy delivered to locoregional lymph nodes for patients with pT1b tumors with a negative resection margin or pT1a tumors with lymphovascular invasion (group B); or definitive CRT (50.4 Gy) with a 9-Gy boost to the primary site for patients with a positive vertical resection margin (group C). Chemotherapy comprised 5-fluorouracil and cisplatin. The primary end point was 3-year overall survival in group B, and the key secondary end point was 3-year overall survival for all patients. If lower limits of 90% confidence intervals for the primary and key secondary end points exceeded the 80% threshold, the efficacy of combined ER and selective CRT was confirmed. Results: Based on the results from pathology analysis, 74, 87, and 15 patients were categorized into groups A, B, and C, respectively. The 3-year overall survival rates were 90.7% for group B (90% confidence interval, 84.0%-94.7%) and 92.6% in all patients (90% confidence interval, 88.5%-95.2%). Conclusions: In a prospective study of patients with T1b (SM1-2) N0M0 thoracic ESCC, we confirmed the efficacy of the combination of ER and selective CRT. Efficacy is comparable to that of surgery, and the combination of ER and selective CRT should be considered as a minimally invasive treatment option. UMIN-Clinical Trials Registry no.: UMIN000000553