Although advance care planning can lead to more patient-centered care, the communication around it can be challenging in acute care hospitals, where saving a life or shortening hospitalization is important priorities. Our qualitative study in an acute care hospital in Japan revealed when specifically physicians and nurses start communication to facilitate ACP. Seven physicians and 19 nurses responded to an interview request, explaining when ACP communication was initiated with 32 patients aged 65 or older. Our qualitative approach employed descriptive analysis (...) to identify major themes, which included “initiation by patients” and “initiation by healthcare professionals.” In the latter case, seven specific triggers were identified: when the patients’ medical condition changed in terms of symptom relief, when the patients’ medical condition changed in terms of prognostic prediction, when serious events occurred, when a choice of treatment was presented, when the location for end-of-life care was chosen, when the patients’ cognitive function deteriorated, and when serious events settled down. Within this group of healthcare professionals, physicians were more focused on changes in their patients’ medical condition, whereas nurses focused more on their patients’ desire for a long-term perspective. Nurses encouraged patients to consider ACP themselves, which developed into an approach to respect patients’ autonomy. In acute care hospitals, it appeared to be desirable to have an early discussion where patients could understand the significance ACP, which would matter even after their discharge from the hospital. (shrink)

Comprehenders generate expectations about upcoming lexical items in language processing using various types of contextual information. However, a number of studies have shown that argument roles do not impact neural and behavioral prediction measures. Despite these robust findings, some prior studies have suggested that lexical prediction might be sensitive to argument roles in production tasks such as the cloze task or in comprehension tasks when additional time is available for prediction. This study demonstrates that both the task and additional time (...) for prediction independently influence lexical prediction using argument roles, via evidence from closely matched electroencephalogram (EEG) and speeded cloze experiments. In order to investigate the timing effect, our EEG experiment used maximally simple Japanese stimuli such as Bee-nom/acc sting, and it manipulated the time for prediction by changing the temporal interval between the context noun and the target verb without adding any further linguistic content. In order to investigate the task effect, we conducted a speeded cloze study that was matched with our EEG study both in terms of stimuli and the time available for prediction. We found that both the EEG study with additional time for prediction and the speeded cloze study with matched timing showed clear sensitivity to argument roles, while the EEG conditions with less time for prediction replicated the standard pattern of argument role insensitivity. Based on these findings, we propose that lexical prediction is initially insensitive to argument roles but a monitoring mechanism serially inhibits role-inappropriate candidates. This monitoring process operates quickly in production tasks, where it is important to quickly select a single candidate to produce, whereas it may operate more slowly in comprehension tasks, where multiple candidates can be maintained until a continuation is perceived. Computational simulations demonstrate that this mechanism can successfully explain the task and timing effects observed in our experiments. (shrink)

Transport of macromolecules from the nucleus to the cytoplasm is essential for nearly all cellular and developmental events, and when mis‐regulated, is associated with diseases, tumor formation/growth, and cancer progression. Nuclear Envelope (NE)‐budding is a newly appreciated nuclear export pathway for large macromolecular machineries, including those assembled to allow co‐regulation of functionally related components, that bypasses canonical nuclear export through nuclear pores. In this pathway, large macromolecular complexes are enveloped by the inner nuclear membrane, transverse the perinuclear space, and then (...) exit through the outer nuclear membrane to release its contents into the cytoplasm. NE‐budding is a conserved process and shares many features with nuclear egress mechanisms used by herpesviruses. Despite its biological importance and clinical relevance, little is yet known about the regulatory and structural machineries that allow NE‐budding to occur in any system. Here we summarize what is currently known or proposed for this intriguing nuclear export process. (shrink)

Is the state we experienced meditating a religious, philosophical, mystical experience? Or is it just a change in brain physiology? Is it possible to achieve a state "beyond the mind" (meditative state) through a technique that uses the mind (meditative technique)? This article explores these aspects by the perspective of neurobiology.

The neuromodulatory effects of brain stimulation therapies notably involving repetitive transcranial magnetic stimulation on nocturnal sleep, which is critically disturbed in major depression and other neuropsychiatric disorders, remain largely undetermined. We have previously reported in major depression patients that prefrontal rTMS sessions enhanced their slow wave activity power, but not their sigma power which is related to sleep spindle activity, for electrodes located nearby the stimulation site. In the present study, we focused on measuring the spindle density to investigate cumulative (...) effects of prefrontal rTMS sessions on the sleep spindle activity. Fourteen male inpatients diagnosed with medication-resistant unipolar or bipolar depression were recruited and subjected to 10 daily rTMS sessions targeting the left dorsolateral prefrontal cortex. All-night polysomnography data was acquired at four time points: Adaptation, Baseline, Post-1, and Post-2. Clinical and cognitive evaluations were longitudinally performed at Baseline, Post-1, and Post-2 time points to explore associations with the spindle density changes. The PSG data from 12 of 14 patients was analyzed to identify sleep spindles across the sleep stages II–IV at four electrode sites: F3, F4, P3, and P4. Statistical analysis by two-way ANOVA revealed that spindle density at F3 increased at Post-1 but decreased at Post-2 time points. Moreover, the local and transient increase of spindle density at F3 was associated with the previously reported SWA power increase at F3, possibly reflecting a shared mechanism of thalamocortical synchronization locally enhanced by diurnal prefrontal rTMS sessions. Clinical and cognitive correlations were not observed in this dataset. These findings suggest that diurnal rTMS sessions transiently modulate nocturnal sleep spindle activity at the stimulation site, although clinical and cognitive effects of the local changes warrant further investigation. (shrink)

Clique sizes for chimpanzee (Pan troglodytes) grooming and for human conversation are compared in order to test Robin Dunbar’s hypothesis that human language is almost three times as efficient a bonding mechanism as primate grooming. Recalculation of the data provided by Dunbar et al. (1995) reveals that the average clique size for human conversation is 2.72 whereas that of chimpanzee grooming is shown to be 2.18. The efficiency of human conversation and actual chimpanzee grooming over Dunbar’s primate grooming model (always (...) one-to-one and a one-way interaction) is 1.27 and 1.25, respectively, when we take role alternation into account. Chimpanzees can obtain about the same efficiency as humans in terms of quantity of social interactions because their grooming is often mutual and polyadic. (shrink)

中国古代(おもに戦国期~漢代初期)の新出土文献を検討により、古代思想史の空白を埋め、その変遷過程を明らかにする。.