We herein report a case of a 76-year-old male patient with chronic obstructive pulmonary disease whose advance care planning (ACP) was facilited by rehabilitation staff by utilizing dialogue in rehabilitation settings, mainly in the context of conditioning and self-management during pulmonary rehabilitation. When a rehabilitation professional is involved in ACP, it is easy to be involved in the so-called ACP in the broad sense. Compared to other professions, rehabilitation professionals have more time being with a patient for dialogue and can discuss the patient's values and future concerns from a life-centered perspective. To promote ACP in the practical settings, rehabilitation professionals, who have the advantage of having more time for dialogue than other professions, need to be involved in ACP by taking advantage of repeated opportunities for dialogue.

Gene expression analyses suggest that more than 1000-2000 genes are expressed predominantly in mouse and human testes. Although functional analyses of hundreds of these genes have been performed, there are still many testis-enriched genes whose functions remain unexplored. Analyzing gene function using knockout (KO) mice is a powerful tool to discern if the gene of interest is essential for sperm formation, function, and male fertility in vivo. In this study, we generated KO mice for 12 testis-enriched genes, 1700057G04Rik, 4921539E11Rik, 4930558C23Rik, Cby2, Ldhal6b, Rasef, Slc25a2, Slc25a41, Smim8, Smim9, Tmem210, and Tomm20l, using the clustered regularly interspaced short palindromic repeats /CRISPR-associated protein 9 (CRISPR/Cas9) system. We designed two gRNAs for each gene to excise almost all the protein-coding regions to ensure that the deletions in these genes result in a null mutation. Mating tests of KO mice reveal that these 12 genes are not essential for male fertility, at least when individually ablated, and not together with other potentially compensatory paralogous genes. Our results could prevent other laboratories from expending duplicative effort generating KO mice, for which no apparent phenotype exists.
Animals ; CRISPR-Cas Systems/genetics* ; Fertility/genetics* ; Gene Editing ; Humans ; Male ; Mice ; Mice, Knockout ; Testis/metabolism*