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Neuroscience and Biobehavioral Reviews Jun 2024Out-of-body experiences (OBEs) are characterized by the subjective experience of being located outside the physical body. Little is known about the neurophysiology of... (Review)
Review
Out-of-body experiences (OBEs) are characterized by the subjective experience of being located outside the physical body. Little is known about the neurophysiology of spontaneous OBEs, which are often reported by healthy individuals as occurring during states of reduced vigilance, particularly in proximity to or during sleep (sleep-related OBEs). In this paper, we review the current state of research on sleep-related OBEs and hypothesize that maintaining consciousness during transitions from wakefulness to REM sleep (sleep-onset REM periods) may facilitate sleep-related OBEs. Based on this hypothesis, we propose a new conceptual model that potentially describes the relationship between OBEs and sleep states. The model sheds light on the phenomenological differences between sleep-related OBEs and similar states of consciousness, such as lucid dreaming (the realization of being in a dream state) and sleep paralysis (feeling paralyzed while falling asleep or waking up), and explores the potential polysomnographic features underlying sleep-related OBEs. Additionally, we apply the predictive coding framework and suggest a connecting link between sleep-related OBEs and OBEs reported during wakefulness.
PubMed: 38880408
DOI: 10.1016/j.neubiorev.2024.105770 -
Journal of the American Psychoanalytic... Jun 2024In this essay the author describes some of the transformations that occur as one moves from preverbal functioning to verbally symbolic language. In preverbal experience,...
In this essay the author describes some of the transformations that occur as one moves from preverbal functioning to verbally symbolic language. In preverbal experience, there is a direct connection between the sign and what is signified. An infant or child signifies displeasure by throwing his food or other objects to the floor. Much of the emotional tie between mother and infant and patient and analyst is communicated in this way. When a transformation occurs from preverbal to verbally symbolic language, as occurs in early development and as one interprets a dream, meaning is not merely translated, meaning is created. On acquiring verbally symbolic language, a "space" mediated by an interpreting subject opens between the symbol (for instance, the word ) and the symbolized (the experience of guilt) and a new subjectivity is created. On entry into verbally symbolic language, one becomes able to experience oneself in a qualitatively different way; one becomes both subject and object, I and me; one becomes able to experience a far broader range of feelings and types of thinking. Helen Keller's account of her experience of acquiring verbally symbolic language is drawn upon.
PubMed: 38877745
DOI: 10.1177/00030651241257263 -
Nature Cell Biology Jun 2024Transcription factor (TF) proteins regulate gene activity by binding to regulatory regions, most importantly at gene promoters. Many genes have alternative promoters...
Transcription factor (TF) proteins regulate gene activity by binding to regulatory regions, most importantly at gene promoters. Many genes have alternative promoters (APs) bound by distinct TFs. The role of differential TF activity at APs during tumour development is poorly understood. Here we show, using deep RNA sequencing in 274 biopsies of benign prostate tissue, localized prostate tumours and metastatic castration-resistant prostate cancer, that AP usage increases as tumours progress and APs are responsible for a disproportionate amount of tumour transcriptional activity. Expression of the androgen receptor (AR), the key driver of prostate tumour activity, is correlated with elevated AP usage. We identified AR, FOXA1 and MYC as potential drivers of AP activation. DNA methylation is a likely mechanism for AP activation during tumour progression and lineage plasticity. Our data suggest that prostate tumours activate APs to magnify the transcriptional impact of tumour drivers, including AR and MYC.
PubMed: 38871824
DOI: 10.1038/s41556-024-01438-3 -
Advanced Materials (Deerfield Beach,... Jun 2024Producing green hydrogen in a cost-competitive manner via water electrolysis will make the long-held dream of hydrogen economy a reality. Although platinum (Pt)-based...
Producing green hydrogen in a cost-competitive manner via water electrolysis will make the long-held dream of hydrogen economy a reality. Although platinum (Pt)-based catalysts show good performance toward hydrogen evolution reaction (HER), the high cost and scarce abundance challenge their economic viability and sustainability. Here, a non-Pt, high-performance electrocatalyst for HER achieved by engineering high fractions of stacking fault (SF) defects for MoNi/MoO nanosheets (d-MoNi) through a combined chemical and thermal reduction strategy is shown. The d-MoNi catalyst offers ultralow overpotentials of 78 and 121 mV for HER at current densities of 500 and 1000 mA cm in 1 M KOH, respectively. The defect-rich d-MoNi exhibits four times higher turnover frequency than the benchmark 20% Pt/C, together with its excellent durability (> 100 h), making it one of the best-performing non-Pt catalysts for HER. The experimental and theoretical results reveal that the abundant SFs in d-MoNi induce a compressive strain, decreasing the proton adsorption energy and promoting the associated combination of *H into hydrogen and molecular hydrogen desorption, enhancing the HER performance. This work provides a new synthetic route to engineer defective metal and metal alloy electrocatalysts for emerging electrochemical energy conversion and storage applications.
PubMed: 38869191
DOI: 10.1002/adma.202402156 -
Journal of Sleep Research Jun 2024Several brainstem, subcortical and cortical areas are involved in the generation of rapid eye movement (REM) sleep. The alteration of these structures as a result of a... (Review)
Review
Several brainstem, subcortical and cortical areas are involved in the generation of rapid eye movement (REM) sleep. The alteration of these structures as a result of a neurodegenerative process may therefore lead to REM sleep anomalies. REM sleep behaviour disorder is associated with nightmares, dream-enacting behaviours and increased electromyographic activity in REM sleep. Its isolated form is a harbinger of synucleinopathies such as Parkinson's disease or dementia with Lewy bodies, and neuroprotective interventions are advocated. This link might also be present in patients taking antidepressants, with post-traumatic stress disorder, or with a history of repeated traumatic head injury. REM sleep likely contributes to normal memory processes. Its alteration has also been proposed to be part of the neuropathological changes occurring in Alzheimer's disease.
PubMed: 38867555
DOI: 10.1111/jsr.14263 -
Pediatric Blood & Cancer Jun 2024
PubMed: 38867370
DOI: 10.1002/pbc.31127 -
BMC Medicine Jun 2024Seeking and obtaining effective health care for Long COVID remains a challenge in the USA. Women have particularly been impacted, as they are both at higher risk of...
BACKGROUND
Seeking and obtaining effective health care for Long COVID remains a challenge in the USA. Women have particularly been impacted, as they are both at higher risk of developing Long COVID and of facing gendered barriers to having symptoms acknowledged. Long COVID clinics, which provide multidisciplinary and coordinated care, have emerged as a potential solution. To date, however, there has been little examination of U.S. patient experiences with Long COVID clinics and how patients may or may not have come to access care at a Long COVID clinic.
METHODS
We conducted semi-structured interviews with 30 U.S. women aged 18 or older who had experienced Long COVID symptoms for at least 3 months, who had not been hospitalized for acute COVID-19, and who had seen at least one medical provider about their symptoms. Participants were asked about experiences seeking medical care for Long COVID. Long COVID clinic-related responses were analyzed using qualitative framework analysis to identify key themes in experiences with Long COVID clinics.
RESULTS
Of the 30 women, 43.3% (n = 13) had been seen at a Long COVID clinic or by a provider affiliated with a Long COVID clinic and 30.0% (n = 9) had explored or attempted to see a Long COVID clinic but had not been seen at time of interview. Participants expressed five key themes concerning their experiences with seeking care from Long COVID clinics: (1) Access to clinics remains an issue, (2) Clinics are not a one stop shop, (3) Not all clinic providers have sufficient Long COVID knowledge, (4) Clinics can offer validation and care, and (5) Treatment options are critical and urgent.
CONCLUSIONS
While the potential for Long COVID clinics is significant, findings indicate that ongoing barriers to care and challenges related to quality and coordination of care hamper that potential and contribute to distress among women seeking Long COVID care. Since Long COVID clinics are uniquely positioned and framed as being the place to go to manage complex symptoms, it is critical to patient wellbeing that they be properly resourced to provide a level of care that complies with emerging best practices.
Topics: Humans; Female; COVID-19; Middle Aged; Adult; Qualitative Research; United States; Patient Acceptance of Health Care; Aged; Health Services Accessibility; SARS-CoV-2; Ambulatory Care Facilities; Post-Acute COVID-19 Syndrome; Interviews as Topic; Young Adult
PubMed: 38867247
DOI: 10.1186/s12916-024-03465-1 -
The Gerontologist Jun 2024Older adults experiencing neurocognitive disease (NCD) contend with complex care often characterized by high emotional strain. Mitigating complex care with decision...
BACKGROUND AND OBJECTIVES
Older adults experiencing neurocognitive disease (NCD) contend with complex care often characterized by high emotional strain. Mitigating complex care with decision support tools can clarify options. When used in conjunction with the practice of Shared Decision Making (SDM) these tools can improve satisfaction and confidence in treatment. Use of these tools for cognitive health has increased but more is needed to understand how these tools incorporate social needs into treatment plans.
RESEARCH DESIGN AND METHODS
We conducted an environmental scan using a MEDLINE informed search strategy and feedback from an expert steering committee to characterize current tools and approaches for engaging older adults experiencing NCD. We assessed their application and development, incorporation of social determinants, goals or preferences, and inclusion of caregivers in their design.
RESULTS
We identified eleven articles, seven of which show that SDM helps guide tool development and that all tools center on clinical decision making. Types of tools varied by clinical site and those differences reflected patient need. A collective value across tools was their use to forge meaningful conversations. No tool appeared designed with the explicit goal to elicit patient social needs or incorporate non-clinical strategies into treatment plans.
DISCUSSION AND IMPLICATIONS
Several challenges and opportunities that centered on strategies to engage patients in the design and testing of tools that support conversations with clinicians about cognitive health. Future work should focus on building and testing adaptable tools that support patient and family social care needs beyond clinical care settings.
PubMed: 38864593
DOI: 10.1093/geront/gnae071 -
Journal of the American Psychoanalytic... Jun 2024
PubMed: 38864185
DOI: 10.1177/00030651241256646 -
Acute and Critical Care May 2024
PubMed: 38863364
DOI: 10.4266/acc.2023.01074