Dr. Adrian Owen: Revolutionizing the Diagnosis of Comatose Patients| OKWAVE

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和訳お願いします Owen and his collaborators repeated their fMRI experiment on 54 patients who had previously been classified as either vegetative or minimally conscious(a consistently respond to commands, but cannot communicate interactively). They found that five of these 54 patients responded to commands to imagine playing tennis or navigating thought a familiar house. Four of those five patients had classified as vegetative, but when clinicians repeated their assessment following the fMRI study, they found evidence that two of those four should instead have been classified as minimally conscious. One of the responsive patients, a 22-year-old man who had been diagnosed as vegetative for five years after a traffic accident left him with a traumatic brain injury, was selected for further study. Because it is difficult-if not impossible-to determine whether someone is thinking yes or no, the reseachers instead asked the patient to imagine playing tennis when the answer to imagine playing tennis when the answer to a question was yes, and to imagine walking through a house when the answer was no. Visualizing these two activities stimulates different parts of the brain that are easily distinguished using fMRI. They asked the patient a series of simple yes-or-no question pertaining to his personal history, such as Is your father's name Alexander? He answered five out of six question correctly. No brain activity was observed in response to the sixth question. The results suggest that fMRI could be useful in diagnosing unresponsive patients, says Owen. There are things that are just not going to manifest themselves in outward behavior , says Owen. This method can tell us which patients are aware, and it can tell us what they are capable of. For Naccache, it is the patient's ability to respond using the code suggested by Owen and his team that indicates he is truly conscious. When you are conscious, you have the ability to use an arbitrary code to communicate with somebody, he says. Parashkev Nachev, a neuroscientist at University College London who was not affiliated with the work, cautions that it is important not to over-interpret the results. The patient only answered a series of very basic questions, he notes, and the results in his view do not necessarily suggest that the patient is fully conscious or has the potential for recovery. There is no doubt that it does merit further research, he says, but I could not see using it as a clinical tool at this stage. As a next step, Owen and his colleagues intend to ask the patient a series of questions with unverifiable answers. For example, the technique could be used to ask whether they are experiencing any pain-a question that frequently troubles family members and hospital staff. But should a vegetative patient be asked whether they want to live or die? I think there's an enormous problem with that, says Owen. Just because a patient is able to respond with yes or no doesn't tell you if they have the necessary level of competence to answer difficult, ethically challenging questions about their destiny.

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和訳お願いします Owen and his collaborators repeated their fMRI experiments on 54 patients who had previously been classified as either vegetative or minimally conscious(a condition in which a patient may inconsistently respond to commands, but cannot communicate interactively). They found that five of these 54 patients responded to commands to imagine playing tennis or navigating though a familiar house. Four of those five patients had classified as vegetative, but when clinicians repeated their assessment following the fMRI study, they found evidence that two of those four should instead have been classified as minimally conscious. One of the responsive patients, a 22-year-old man who had been diagnosed as vegetative for five years after a traffic accident left him with a traumatic brain injury, was selected for further study. Because it is difficult-if not impossible-to determine whether someone is thinking yes or no, the reseachers instead asked the patient to imagine playing tennis when the answer to imagine playing tennis when the answer to a question was yes, and to imagine walking through a house when the answer was no. Visualizing these two activities stimulates different parts of the brain that are easily distinguished using fMRI. They asked the patient a series of simple yes-or-no question pertaining to his personal history, such as Is your father's name Alexander? He answered five out of six question correctly. No brain activity was observed in response to the sixth question. The results suggest that fMRI could be useful in diagnosing unresponsive patients, says Owen. There are things that are just not going to manifest themselves in outward behavior , says Owen. This method can tell us which patients are aware, and it can tell us what they are capable of. For Naccache, it is the patient's ability to respond using the code suggested by Owen and his team that indicates he is truly conscious. When you are conscious, you have the ability to use an arbitrary code to communicate with somebody, he says. Parashkev Nachev, a neuroscientist at University College London who was not affiliated with the work, cautions that it is important not to over-interpret the results. The patient only answered a series of very basic questions, he notes, and the results in his view do not necessarily suggest that the patient is fully conscious or has the potential for recovery. There is no doubt that it does merit further research, he says, but I could not see using it as a clinical tool at this stage. As a next step, Owen and his colleagues intend to ask the patient a series of questions with unverifiable answers. For example, the technique could be used to ask whether they are experiencing any pain-a question that frequently troubles family members and hospital staff. But should a vegetative patient be asked whether they want to live or die? I think there's an enormous problem with that, says Owen. Just because a patient is able to respond with yes or no doesn't tell you if they have the necessary level of competence to answer difficult, ethically challenging questions about their destiny.

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和訳お願いします Brain imaging has allowed a man who was previously considered unconscious to answer a series of yes-or-no question. The study, published this week in New England Journal of Medicine, challenges clinicians' definition of consciousness and provides an unprecedented opportunity to communicate with those who show no outward signs of awareness. Patients are classified as unconscious, or being in a vegetative state, if they are unable to respond in any fashion to an extensive series of questions and requests. But if the patient is completely unable to move, an aware or communicative mind could go unrecognized by this method of assessment. The conundrum with the vegetative state is that it's a diagnosis made on lack of evidence, says neuroscientist Adrian Owen of the Medical Research Council's Cognition and Brian Sciences Unit in Cambridge, UK. Owen and his colleagues made headlines three years ago when they used a brain-scanning technique called functional magnetic resonance imaging(fMRI) to demonstrate that a woman in a vegetative state could respond to verbal commands. When researchers directed her to imagine playing a game of tennis or walking through her house, the fMRI scan revealed that she activated the same areas of her brain as healthy subjects who were asked to do the same. The findings sparked a debate over whether or not the woman was actually conscious(see Thoughts of woman in waking coma revealed).Some argued that Owen and his collaborators saw was nothing more than an automatic activation of those brain regions on hearing certain words. One such critic was Lionel Naccache, a neuroscientist at the Pitie-Salpetriere hospital in Paris, who urged caution before concluding that the woman was indeed conscious. This latest evidence of communication with a vegetative patients, however, has Naccache convinced. This is clear-cut evidence of consciousness he says.

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It is hard to imagine how customers who rush after trends, or the stores that serve them, will respond to the report’s suggestions: that people lease clothes and return them at the end of a month or a season, so the garments can be lent again to someone else — like library books — and that they buy more expensive and durable clothing that can be worn for years. Perhups surprisingly , the report highlights the benefits of synthetic fabrics they require less hot water to wash and less ironing. It suggests that consumers air-dry clothes and throw away their tumble dryers, which require huge amounts of energy.

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Hugh Miller will be admitted by many as a competent witness to the untenability of the theory of Chalmers and Buckland on mere geological grounds. He had, indeed, a theory of his own to propose, which we shall presently consider; but we may take his word that it was not without the compulsion of what he considered irresistible evidence that he relinquished a view which would have saved him infinite time and labour, could he have adhered to it.

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The early speculator was harassed by no such scruples, and asserted as facts what he knew in reality only as probabilities. But we are not on that account to doubt his perfect good faith, nor need we attribute to him wilful misrepresentation, or consciousness of asserting that which he knew not to be true. He had seized one great truth, in which, indeed, he anticipated the highest revelation of modern enquiry -- namely, the unity of the design of the world, and its subordination to one sole Maker and Lawgiver. With regard to details, observation failed him. He knew little of the earth's surface, or of its shape and place in the universe; the infinite varieties of organized existences which people it, the distinct floras and faunas of its different continents, were unknown to him. But he saw that all which lay within his observation bad been formed for the benefit and service of man, and the goodness of the Creator to his creatures was the thought predominant in his mind. Man's closer relations to his Maker is indicated by the representation that he was formed last of all creatures, and in the visible likeness of God. For ages, this simple view of creation satisfied the wants of man, and formed a sufficient basis of theological teaching, and if modern research now shows it to be physically untenable, our respect for the narrative which has played so important a part in the culture of our race need be in nowise diminished. No one contends that it can be used as a basis of astronomical or geological teaching, and those who profess to see in it an accordance with facts, only do this sub modo, and by processes which despoil it of its consistency and grandeur, both which may be preserved if we recognise in it, not an authentic utterance of Divine knowledge, but a human utterance, which it has pleased Providence to use Providence a special way for the education of mankind.

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The point is that, notwithstanding special difficulties in assigning this or that being to one or the other class, the psychological classification which I advocate resembles the zoological classification which I have cited ; it is a valid classification, inasmuch as it recognizes a distinction where there is certainly something to distinguish. For even if we take the most mechanical view of mental processes that is possible, and suppose that conscious intelligence plays no part whatever in determining action, there still remains the fact that such conscious intelligence exists, and that prior to certain actions it is always affected in certain ways. Therefore, even if we suppose that the state of things is, so to speak, accidental, and that the actions in question would always he performed in precisely the same way whether or not they were thus connected with consciousness, it would still remain desirable, for scientific purposes, that a marked distinction should be drawn between cases of activity that proceed without, and those that proceed with this remarkable association with consciousness. As the phenomena of subjectivity are facts at any rate no less real than those of objectivity, if it is found that some of the latter are invariably and faithfully mirrored in those of the former, such pheno mena, for this reason alone, deserve to be placed in a distinct scientific category, even though it were proved that the mirror of subjectivity might be removed without affecting any of the phenomena of objectivity.

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The $1 trillion global textile industry must become eco-conscious, the report concludes. It explores how to develop more “sustainable clothing” — a seeming oxymoron in a world where fashions change every few months. “Hmmm,” said Sally Neild, 44, dressed in casual chic, ー jeans and boots, as she pondered the idea , shopping bags in hand. “People now think a lot about green travel and green food. But I think we are a long way from there in terms of clothes. People are mad about those stores.” It is hard to imagine how customers who rush after trends, or the stores that serve them, will respond to the report’s suggestions: that people lease clothes and return them at the end of a month or a season, so the garments can be lent again to someone else — like library books — and that they buy more expensive and durable clothing that can be worn for years.

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Now in this necessarily ejective method of enquiry, what is the kind of activities that we are entitled to regard as indicative of mind ? I certainly do not so regard the flowing of a river or the blowing of a wind. Why ? First, because the subjects are too remote in kind from my own organism to admit of my drawing any reasonable analogy between them and it; and, secondly, because the activities which they present are invariably of the same kind under the same circumstances : they therefore offer no evidence of that which I deem the distinctive character of my own mind as such — Consciousness. In other words, two conditions require to he satisfied before we even begin to imagine that observable activities are indicative of mind ; the activities must be dis played by a living organism, and they must be of a kind to suggest the presence of consciousness. What then is to be taken as the criterion of consciousness ? Subjectively, no criterion is either needful or possible ; for to me, individually, nothing can be more ultimate than my own consciousness, and, therefore, my consciousness cannot admit of any criterion having a claim to a higher certainty. But, ejectively, some such criterion is required, and as my consciousness cannot come within the territory of a foreign consciousness, I can only appreciate the latter through the agency of ambassadors — these ambassadors being, as I have now so frequently said, the observable activities of an organism. The next question, therefore, is, What activities of an organism are to be taken as indicative of consciousness ? The answer that comes most readily is, — All activities that are indicative of Choice; wherever wo see a living organism apparently exerting inten tional choice, we may infer that it is conscious choice, and, therefore, that the organism has a mind. But physiology shows that this answer will not do ; for, while not disputing whether there is any mind without the power of conscious choice, physiology, as we shall see in the next chapter, is very firm in denying that all apparent choice is due to mind.

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和訳をお願いします！ I think that he’s an incredible dreamer, incredibly naïve, he’s incredibly smart in what he wants to be smart at he’s one of those guys that knows ten thousand little things but doesn’t know much about one big thing and it was really fun, it was really fun to read and... Again there was something inspiring about it, there was something child like about it. There was something oddly brave about it and the thing that was very cool about the part to me was that he’s a simple guy and in his simplicity he doesn’t over think the world. And so he just lets the world happen to him and I think that that’s a blessing a lot of the time. ある俳優のインタビューです。自分の役柄について聞かれ答えているのですが、どうしても意味が理解できないんです。。。長文ですが宜しくお願いしますm(_ _)m

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Dr. Nicholas Day is a professor of global health at Oxford University, and he coordinates research on infectious diseases such as malaria and dengue fever in rural Southeast Asia. There is hope that malaria can someday be eradicated, but the disease is still very common. Unfortunately, it seems that malaria parasites in Cambodia are becoming resistant to the drug that was once thought to be the best chance of eradicating the disease. Two groups of malaria patients were used in a study directed by Dr. Day. One group was from Cambodia, and the other was located in Thailand. Each group was divided into two subgroups. One subgroup took artesunate; the other took an artesunate-mefloquine combination. The Cambodian subjects took longer to clear the parasite. In other words, the parasite found in the Cambodian subjects was able to resist both treatments better than the parasite that was present in the Thai subjects. Furthermore, six of the Cambodian subjects in the artesunate sub-group contracted the disease again, while only two of the Thai artesunate sub-group subjects fell ill with malaria after the first clearance of the parasite. The combined therapy was much more effective, with only one case of re-infection in each group. The largest lesson from the study is that eradication efforts ― developing improved drugs, controlling mosquito populations, and protecting people by using mosquito nets, among other actions ― must be accelerated, or the malaria parasites will become too strong to eliminate. よろしくお願いします＾＾；

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The Hebrew race, their works, and their books, are great facts in the history of man; the influence of the mind of this people upon the rest of mankind has been immense and peculiar, and there can be no difficulty in recognising therein the hand of a directing Providence. But we may not make ourselves wiser than God, nor attribute to Him methods of procedure which are not His. If, then, it is plain that He has not thought it needful to communicate to the writer of the Cosmogony that knowledge which modern researches have revealed, why do we not acknowledge this, except that it conflicts with a human theory which presumes to point out how God ought to have instructed man? The treatment to which the Mosaic narrative is subjected by the theological geologists is anything but respectful. The writers of this school, as we have seen, agree in representing it as a series of elaborate equivocations -- a story which palters with us in a double sense.' But if we regard it as the speculation of some Hebrew Descartes or Newton, promulgated in all good faith as the best and most probable account that could be then given of God's universe, it resumes the dignity and value of which the writers in question have done their utmost to deprive it. It has been sometimes felt as a difficulty to taking this view of the case, that the writer asserts so solemnly and unhesitatingly that for which he must have known that he had no authority. But this arises only from our modern habits of thought, and from the modesty of assertion which the spirit of true science has taught us. Mankind has learnt caution through repeated slips in the process of tracing out the truth.

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The principal reason why he was always being asked to umpire a game―aside from the fact that he never expected to be paid for his services, saying that he liked to umpire for the good of the game―was that he never failed to try to please both teams. If one side did not like one of his decisions, he would stop the game then and there and let the players on both sides swear at him as much as they pleased and call him the worst names they would think of until they were tired of arguing aand wanted to get back to playing ball. 構文分析よろしくお願い致しますできるだけ丁寧に解説してくださると嬉しいです。

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We may fairly ask,' he argues, of those persons who consider physical science a fit subject for revelation, what point they can imagine short of a communication of Omniscience at which such a revelation might have stopped without imperfections of omission, less in degree, but similar in kind, to that which they impute to the existing narrative of Moses? A revelation of so much only of astronomy as was known to Copernicus would have seemed imperfect after the discoveries of Newton; and a revelation of the science of Newton would have appeared defective to La Place: a revelation of all the chemical knowledge of the eighteenth century would have been as deficient in comparison with the information of the present day, as what is now known in this science will probably appear before the termination of another age; in the whole circle of sciences there is not one to which this argument may not be extended, until we should require from revelation a full development of all the mysterious agencies that uphold the mechanism of the material world.' Buckland's question is quite inapplicable to the real difficulty, which is, not that circumstantial details are omitted -- that might reasonably be expected -- but that what is told, is told so as to convey to ordinary apprehensions an impression at variance with facts. We are indeed told that certain writers of antiquity had already anticipated the hypothesis of the geologist, and two of the Christian fathers, Augustine and Episcopius, are referred to as having actually held that a wide interval elapsed between the first act of creation, mentioned in the Mosaic account, and the commencement of the six days' work. If, however, they arrived at such a conclusion, it was simply because, like the modern geologist, they had theories of their own to support, which led them to make somewhat similar hypotheses.

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I have traced them upwards from the raised beaches and old coast lines of the human period, to the brick clays, Clyde beds, and drift and boulder deposits of the Pleistocene era; and again from them, with the help of museums and collections, up through the mammaliferous crag of England to its red and coral crags; and the conclusion at which I have been compelled to arrive is, that for many long ages ere man was ushered into being, not a few of his humbler contemporaries of the fields and woods enjoyed life in their present haunts, and that for thousands of years anterior to even their appearance, many of the existing molluscs lived in our seas. That day during which the present creation came into being, and in which God, when he had made the beast of the earth after his kind, and the cattle after their kind,' at length terminated the work by moulding a creature in His own image, to whom He gave dominion over them all, was not a brief period of a few hours' duration, but extended over, mayhap, millenniums of centuries. No blank chaotic gap of death and darkness separated the creation to which man belongs from that of the old extinct elephant, hippopotamus, and hyæna; for familiar animals, such as the red deer, the roe, the fox, the wild cat, and the badger, lived throughout the period which connected their time with our own; and so I have been compelled to hold that the days of creation were not natural but prophetic days, and stretched far back into the bygone eternity.'

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Maxim didn't run to New York and give his opinion to a newspaper,but went to his laboratory and began trying to make a lamp after Edison's ideas.He had no success,however,and after a few weeks sent to Menlo Park an emissary who got in touch with Boehm.It was also said that the agent approached another of our men.The deportment of Boehm changed perceptibly and soon begame suspicious. Hw was changing his allegiance to that of Maxim.In fact,he soon departed Menlo Park and entered that electrician's employ.This as far I am aware was the only defection that ever occured at our laboratory in those early days.In a few months Boehm managed to place the Maxim laboratory incondition so that it was able to produce some incandescent lamps that had their light-giving element made of paper.While at Menlo Park Boehm had had the oppotunity of watching all the various processes by which Edison made a practical lamp,and that acquired knowledge he imparted to Maxim.With the compensation he received,he was enabled to return to Germany and study.After receiving the degree of Ph.D. from the University of Freiburg in 1886,he returned to America.

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The hypothesis adopted by Dr Buckland was first promulgated at a time when the gradual and regular formation of the earth's strata wasn't seen or admitted so clearly as it is now. Geologists were more disposed to believe in great catastrophes and sudden breaks. Buckland's theory supposes that, previous to the appearance of the present races of animals and vegetables,there was a great gap in the globe's history—that the earth was completely depopulated as well of marine as land animals; and that the creation of all existing plants and animals was coeval with that of man. This theory is by no means supported by geological phenomena, and is we suppose, now rejected by all geologists whose authority is valuable . Thus writes Hugh Miller in 1857, 'I certainly did once believe with Chalmers and with Buckland that the six days were simply natural days of twenty-four hours each, that they had comprised the entire work of existing creation, and that the latest of the ages was separated by a great chaotic gap from our own. My labours at the time as a practical geologist had been very much restricted to the palaeozoic and secoundary rocks, more especially to the old red and Carboniferous systems of the one division and the oolitic system of the other ;and the long-extinct organisms which I found in them certainly didn't conflict with the view of Chalmers. All I found necessary at the time to the work of reconciliation was some scheme that would permit me to assign to the earth a high antiquity and to regard it SSS scene of many succeeding creation. During the last nine years, however, I have spent a few weeks every autumn in exploring the late formations, and acquainting myself with their particular organisms.

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There he was on the ground,in no condition to go on, and all of a sudden he was no longer in Poland.instead,he found himself imaging himself standing on a stage on postwar Vienna giving a lecture on The Psychology of Death Camps. Audience of two hundred listened to his every word. The lecture was one that he had been working out the whole time he had been in the death camp. He spoke about how some people seem to survive the experience better than others, psychologically and emotionally. It was a brilliant lecture, all taking place　in his mind's eye and ear. He was no longer half dead on the field but living in the lecture. During the lecture, Frankl told the imaginary audience about the day he was in that field being beaten and was certain he didn't have the strength to get up and keep walking. 　　Then, wonder of wonders, he told his imagined audience, he was able to stand up. The guard stopped beating him and get began to walk slowly. As he was imagining describing this to his audience, his body got up and began to walk. He continued to imagine this lecture all the while he was doing the work and through the cold march back to the death comp. He collapsed into his narrow bed, imagining ending this brilliantly clear speech and receiving a standing ovation.

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The Romish Church,it is presumed,adheres to the old views to the present day. Protestant instincts,however,in the 17th century were strongly in sympathy with the augmentation of science[science=scientific knowledge],and consequently Reformed Churches more easily allowed themselves to be helped over the difficultly,which, according to the views of inspiration then held and which have survived to the present day,was in reality quite as formidable for them as for those of the old faith. The solution of the difficultly offered by Galileo and others was that the object of a rebelation or divine unveiling of mysteries must be to teach man things which he is unable and must ever remain unable to find out for himself:but not physical truths,for the discovery of which he has faculties specially proved by his Creater.Hence it was not unreasonable that,in regard to matters of fact marely,the Sacred Writings should use the common language and assume the common belief of mankind,without purporting to correct errors upon points morally indifficult.So in regard to such a text as 'The world is established it cannot be moved'[Psalms93.1],though it might imply the sacred penman's ignorance of the fact that the earth does move,yet it does not put forth this opinion as an indispensable point of faith.And this remark is applicable to anumber of texts which presents a similar difficalty.

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His North node was in yours second house, this mean both of you, can draw on karmic resources and skills from other life's and put them to use to earn money in this life. In the past life he developed various skills or talent but did not profit from them because of a fear that if he worked for himself, or struck out in those skills in a different kind of work place. you and he would loose the security you had. He found it difficult to anchor himself in the material and practical world, he felt too much emotionally, dreamed too much. He had the potential to be self supporting, and support you, but you may have somehow made him feel he did not Afraid of financial insecurity. In the present incarnation you must encourage him and also your self towards being self supporting in a mutual interest or talent and regaining the success you can enjoyed. In then present life the karma is to correct this mistake. He needs in this life to be independent in the kind of work and money life you will have together. He needs to earn the money but need to use his talents to do so. Your role is to help him, rather than discourage him, to make it easier and help him belief in himself.

Dr. Adrian Owen: Revolutionizing the Diagnosis of Comatose Patients

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Dr. Adrian Owen: Revolutionizing the Diagnosis of Comatose Patients

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構文分析、よろしくお願い致しますm(_ _)m

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