Multivoxel neurofeedback selectively modulates confidence without changing perceptual performance

© 2016 The Author(s). A central controversy in metacognition studies concerns whether subjective confidence directly reflects the reliability of perceptual or cognitive processes, as suggested by normative models based on the assumption that neural computations are generally optimal. This view enjoys popularity in the computational and animal literatures, but it has also been suggested that confidence may depend on a late-stage estimation dissociable from perceptual processes. Yet, at least in humans, experimental tools have lacked the power to resolve these issues convincingly. Here, we overcome this difficulty by using the recently developed method of decoded neurofeedback (DecNef) to systematically manipulate multivoxel correlates of confidence in a frontoparietal network. Here we report that bi-directional changes in confidence do not affect perceptual accuracy. Further psychophysical analyses rule out accounts based on simple shifts in reporting strategy. Our results provide clear neuroscientific evidence for the systematic dissociation between confidence and perceptual performance, and thereby challenge current theoretical thinking.Link_to_subscribed_fulltex

Decoded fMRI neurofeedback can induce bidirectional confidence changes within single participants

© 2017 The Authors Neurofeedback studies using real-time functional magnetic resonance imaging (rt-fMRI) have recently incorporated the multi-voxel pattern decoding approach, allowing for fMRI to serve as a tool to manipulate fine-grained neural activity embedded in voxel patterns. Because of its tremendous potential for clinical applications, certain questions regarding decoded neurofeedback (DecNef) must be addressed. Specifically, can the same participants learn to induce neural patterns in opposite directions in different sessions? If so, how does previous learning affect subsequent induction effectiveness? These questions are critical because neurofeedback effects can last for months, but the short- to mid-term dynamics of such effects are unknown. Here we employed a within-subjects design, where participants underwent two DecNef training sessions to induce behavioural changes of opposing directionality (up or down regulation of perceptual confidence in a visual discrimination task), with the order of training counterbalanced across participants. Behavioral results indicated that the manipulation was strongly influenced by the order and the directionality of neurofeedback training. We applied nonlinear mathematical modeling to parametrize four main consequences of DecNef: main effect of change in confidence, strength of down-regulation of confidence relative to up-regulation, maintenance of learning effects, and anterograde learning interference. Modeling results revealed that DecNef successfully induced bidirectional confidence changes in different sessions within single participants. Furthermore, the effect of up- compared to down-regulation was more prominent, and confidence changes (regardless of the direction) were largely preserved even after a week-long interval. Lastly, the effect of the second session was markedly diminished as compared to the effect of the first session, indicating strong anterograde learning interference. These results are interpreted in the framework of reinforcement learning and provide important implications for its application to basic neuroscience, to occupational and sports training, and to therapy.Link_to_subscribed_fulltex

Fragmentation of Protein Kinase N (PKN) in the Hydrocephalic Rat Brain

PKN (protein kinase N; also called protein kinase C-related kinase (PRK-1)), is a serine/threonine protein kinase that is ubiquitously expressed in several organs, including the brain. PKN has a molecular mass of 120 kDa and has two domains, a regulatory and a catalytic domain, in its amino-terminals and carboxyl-terminus, respectively. Although the role of PKN has not been fully elucidated, previous studies have revealed that PKN is cleaved to a constitutively active catalytic fragment of 55 kDa in response to apoptotic signals. Hydrocephalus is a pathological condition caused by insufficient cerebrospinal fluid (CSF) circulation and subsequent excess of CSF in the brain. In this study, in order to elucidate the role of PKN in the pathophysiology of hydrocephalus, we examined PKN fragmentation in hydrocephalic model rats

Atypical spatial frequency dependence of visual metacognition among schizophrenia patients

Although altered early stages of visual processing have been reported among schizophrenia patients, how such atypical visual processing may affect higher-level cognition remains largely unknown. Here we tested the hypothesis that metacognitive performance may be atypically modulated by spatial frequency (SF) of visual stimuli among individuals with schizophrenia, given their altered magnocellular function. To study the effect of SF on metacognitive performance, we asked patients and controls to perform a visual detection task on gratings with different SFs and report confidence, and analyzed the data using the signal detection theoretic measure meta-d′. Control subjects showed better metacognitive performance after yes- (stimulus presence) than after no- (stimulus absence) responses (‘yes-response advantage’) for high SF (HSF) stimuli but not for low SF (LSF) stimuli. The patients, to the contrary, showed a ‘yes-response advantage’ not only for HSF but also for LSF stimuli, indicating atypical SF dependency of metacognition. An fMRI experiment using the same task revealed that the dorsolateral prefrontal cortex (DLPFC), known to be crucial for metacognition, shows activity mirroring the behavioral results: decoding accuracy of perceptual confidence in DLPFC was significantly higher for HSF than for LSF stimuli in controls, whereas this decoding accuracy was independent of SF in patients. Additionally, the functional connectivity of DLPFC with parietal and visual areas was modulated by SF and response type (yes/no) in a different manner between controls and patients. While individuals without schizophrenia may flexibly adapt metacognitive computations across SF ranges, patients may employ a different mechanism that is independent of SF. Because visual stimuli of low SF have been linked to predictive top-down processing, this may reflect atypical functioning in these processes in schizophrenia

A 大学看護学生に対する慢性看護学実習における患者のセルフマネジメント支援のための対話学修の取り組みと課題

報告Reports　慢性疾患は、患者自身が疾患の急性増悪を起こさないようにコントロールすることが重要であるため、看護師が行うセルフマネジメント支援の重要性は大きい。しかし、看護学生にとって、患者のセルフマネジメント力向上の支援をするために、患者と向き合い患者の体験を知るための対話を行うことは難しい。そこで、Ａ大学慢性看護学領域では、慢性疾患を有する人のセルフマネジメント力向上の支援をするために、シナリオを用いた対話学修を学内実習として導入した。　学生は、本学内実習での患者役体験から、看護師の問いかけ方で患者に生じる感情が異なることに気づき、自身のコミュニケーションが患者の体験を知るための対話となっていたか考察を深めることができていた。学生からは、ディスカッション時間の延長を希望する意見があった。今後の課題は、学生の思考がより深まるようにディスカッションの時間配分をはじめ本学内実習全体の構成を検討することである

Characteristics of Training Center for Nurses Pertaining to Specified Medical Practice at Seirei Christopher University

P(論文)本学は2018 年に看護師特定行為研修指定研修機関に指定され、2019 年から研修を開始した。開講区分は「栄養及び水分管理に係る薬剤投与関連」の1 区分で、4 年間で16 名の修了者（見込み含む） を輩出した。2023 年度からは「在宅・慢性期領域パッケージ」が追加となる。本報告では、本学における特定行為研修の実際と特色についてまとめ、高度実践看護師育成に向けた今後の課題、方向性について述べる。紀要委員会企画Special Articlesdepartmental bulletin pape

Nursing Practicum Based on the Philosophy of Seirei Held at Seirei-related Welfare Facilities in the Spring Semester of the First Year at Seirei Christopher University

P(論文)聖隷看護基盤実習は、入学直後の1 年次生春セメスターに聖隷ゆかりの福祉施設などに赴き、看護を学ぶ上で基盤となる対人援助職としてのあり方を、建学の精神や聖隷の理念を礎に、学生自身の体験を振り返りながら学ぶ実習である。聖隷ゆかりの施設における臨地実習では、創設期からの歴史的な変遷や活動を知り、キリスト教精神を基盤とした建学の精神や聖隷の理念について考え、施設での出会いや語りから、対人援助職としてのあり方を、聖隷の理念と関連させて意味づけていく。 　本報告では、聖隷クリストファー大学看護基礎教育における2022 年度の聖隷看護基盤実習の創設について、①聖隷看護基盤実習の構築（看護学部学位授与方針、カリキュラムポリシー）、②単位、セメスター履修者数、③科目概要、④実習目標、⑤実習展開、⑥学内委員会・授業との連携、⑦実習記録の構成をふまえ報告する。紀要委員会企画Special Articlesdepartmental bulletin pape

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation