Respect for patient autonomy is paramount in resolving ethical tensions in end-of-life care. The concept of relational autonomy has contributed to this debate; however, scholars often use this concept in a fragmented manner. This leads to partial answers on ascertaining patients' true wishes, meaningfully engaging patients' significant others, balancing interests among patients and significant others, and determining clinicians' obligations to change patients' unconventional convictions to enhance patient autonomy. A satisfactory solution based on relational autonomy must incorporate patients' competence (apart from decisional capacity), authenticity (their true desires or beliefs) and the involvement level of their significant others. To that end, we argue that John Christman's procedural approach to relational autonomy provides critical insights, such as the diachronic or socio-historical personhood, sustained critical reflection and his recent explication of the nature of asymmetrical relationships and helpful interlocutors. This study reviews Christman's account, proposes minor modifications and advocates for an integrated three-dimensional model for medical decision-making. Clarifying the relationship among the three elements promotes an ethical framework with a coherent understanding of relational autonomy. This model not only provides a descriptive and normative framework for end-of-life care practice but also reconsiders the nature of the clinician-patient relationship and its normative implications. We further present a case study to illustrate the merits of our proposed model. Altogether, our proposal will help navigate complex medical decision-making, foster trust and negotiate shared values between patients and their significant others, particularly in end-of-life care.
The tutorial covers the recent progresses and future perspectives on optical-wireless-communication (OWC) technology, from devices, systems to applications. Shorter-reach OWC systems, including visible-light-communication (VLC), optical-camera-communication (OCC) and visible-light-communication (VLP) will be discussed. Then, transmission in issues in longer-reach Infrared-based-communication (IRC) systems will be presented. These issues include atmospheric attenuation, optical beam divergence, pointing error, and atmospheric turbulence. Active alignment is used to mitigate the pointing error issues. These include mechanical-based systems, e.g. fast steering mirror (FSM); solid-state-based systems; and liquid-crystal (LC) based systems, e.g. spatial light modulator (SLM). Solid-state-based systems can be further classified into optical-phased-array (OPA), focal-plane-array (FPA) and dispersive grating approaches. LC-based system using SLM can be used for optical beam steering and beam division. Different integrated devices will be discussed for OWC applications, e.g. optical beam steering and atmospheric turbulence mitigation.
Generative Artificial Intelligence (GenAI) functions not merely as a tool but an active collaborator in human knowledge construction; however, the Human-GenAI interaction dynamics is still underexplored. This study investigates Human-GenAI interaction profiles, the network interactivity and profile differences within a statistics learning community, as well as the underlying mechanisms linking Human-GenAI interaction to learning performance. We designed the Human-GenAI Inquiry and Problem-Solving Scaffold to foster shared agency between twentyeight graduate students and GenAI across seven homework assignments in a sixteen-week advanced statistics course. Analytical approaches included k-modes clustering, social network analysis, and Partial Least Squares Structural Equation Modeling, complemented by case studies of interaction profiles. Three distinct Human-GenAI interaction profiles were identified: HumanGenAI collaborators, Peer collaborators with GenAI assistance, and Individual learners with late GenAI adoption. The network interactivity becomes cohesive with GenAI occupying the central hub role within the learning community. The models then demonstrate unique pathways through which Human-GenAI interaction influences learning performance, via degree centrality (number of direct connections) and peer nomination as helpers. The case studies highlight GenAI's capability to augment human roles, encouraging deeper inquiry, expanding the depth of peer discussion, or promoting the exploration of diverse problem-solving strategies. These findings add value to theory and practice by providing empirical evidence for the framework of a scaffolded Human-GenAI shared agency, offering pedagogical implications to foster active student participation and cultivate learner agency within the symbiotic Human-GenAI partnership.
Using commercial materials for colorimetric detection of toxic cyanide (CN-) anions can greatly improve safety and benefit society. This work discusses the colorimetric sensing properties of commercially available trans-(3-nitrostyrene analogues, including trans-(3-nitrostyrene (P1), trans-4-methoxy-(3-nitrostyrene (P2), trans-4-methyl-(3-nitrostyrene (P3), trans-4-fluoro-(3-nitrostyrene (P4), trans-4-bromo-(3-nitrostyrene (P5), trans-4-chloro-(3-nitrostyrene (P6), and trans-(3-methyl-(3-nitrostyrene (P7), in dimethyl sulfoxide (DMSO) and acetonitrile (ACN). P1-P4 show strong reddish-pink and yellowish-orange colors while detecting CN-ions in DMSO and ACN, with new UV-visible peaks appearing at 515 nm/510 nm and at 490 nm/485 nm, respectively. Conversely, P5 and P6 exhibit mild color responses to CN-in DMSO and ACN, with absorbance peaks at 505 nm/510 nm and at 490 nm/430 nm, respectively. P7 shows no selectivity for CN-ions due to steric and electronic structural effects. The high selectivity of P1-P4 for CN-is confirmed through interference studies. pH values of 6 and 7 are ideal for sensory testing. The sensor response of P1-P6 to CN-is linear across a range of 0.1 to 1000 mu M (mu M = 10-6 M), with estimated detection limits (LODs) at 10-9-10-6 M. Nuclear Magnetic Resonance (NMR), mass spectra, and density functional theory (DFT) analyses validate the Michael addition as the sensing mechanism. The test strip method demonstrates the solid-state colorimetric sensing ability of P1-P3 for CN-ions. Spiked CN-ions in water samples show the real-time sensing capability of P1-P4. These results open the door for future designs using different fluorophores with nitro (-NO2) Michael acceptor.
Ammonia synthesis from renewable energies on protonic ceramic electrochemical cells (PCECs) shows great potential. The primary challenges in ammonia synthesis on PCECs include sluggish catalytic activity, competition from the hydrogen evolution reaction, and unsatisfactory durability of the cathode, which is the active site of ammonia generation. Here, we report an elaborate design of the cathode with an intended formula of Pr4Ni1.79Co1.2Ru0.01O10-delta, where NiCo alloy nanoparticles are exsolved from Ruddlesden-Popper perovskite substrates after the reduction in 5 % H2/Ar at 400 degrees C for 1 h, for electrocatalysis of the nitrogen reduction reaction to ammonia. The host material Pr4Ni1.8Co1.2O10-delta with embeddable layered structure and stability was deliberately chosen to fix the Ru cation and maximize the catalytic activity of NiCo. Also, density functional theory calculations suggest that Ru doping provides an optimal balance between structural stability and redox activity, facilitating the controlled exsolution of NiCo nanoparticles and enhancing catalytic performance. As a result, the composite electrode with exsolved NiCo alloy and abundant oxygen vacancies on fuel-electrodesupported PCECs achieves a superior electrochemical activity towards ammonia synthesis: a peak ammonia formation rate of 27.84 mu g h-1 cm- 2 and excellent Faradaic efficiencies of 62.6 % at 350 degrees C.
