Lead‐free dielectric ceramics have been the spotlight in the search for environmentally benign materials for electrostatic energy storage because of the ever‐increasing environmental concerns. ...However, the inverse correlation between the polarization and dielectric breakdown strength is the major barrier hindering the provision of sufficient energy densities in lead‐free dielectric ceramics and practical applications thereof. Herein, a rational structure design inspired by nature is demonstrated as an effective strategy to overcome these challenges. Bioinspired raspberry‐like hierarchically structured all‐inorganic nanocomposites have been prepared by enclosing microsized BaTiO3‐Bi(Mg0.5Zr0.5)O3 (BT‐BMZ) relaxor ferroelectrics using core‐shell BT‐BMZ@SiO2 nanoparticles. The synergistic effects of the bioinspired hierarchical structure and insulating SiO2 nano‐coating result in significantly improved dielectric breakdown strength and sustained large polarization in the nanocomposites, as corroborated by experimental characterizations and theoretical simulations. As a result, an ultrahigh energy density of 3.41 J cm−3 and a high efficiency of 85.1%, together with outstanding thermal stability within a broad temperature range, have been simultaneously achieved in the hierarchically structured nanocomposites. This contribution provides a feasible and paradigmatic approach to develop high‐performance dielectrics for electrostatic energy storage applications using bioinspired structure design.
A conceptual material paradigm of structure design strategy inspired by nature is developed to break the inverse correlation between polarization and breakdown strength inherently existing in dielectrics, and thus to boost their energy storage performance, as successfully validated by the bioinspired hierarchical structured all‐inorganic BaTiO3‐Bi(Mg0.5Zr0.5)O3‐based nanocomposites with a high energy density of 3.41 J cm−3, and efficiency of 85.1% simultaneously.
Advance care planning in Asian culture Cheng, Shao-Yi; Lin, Cheng-Pei; Chan, Helen Yue-lai ...
Japanese journal of clinical oncology,
09/2020, Letnik:
50, Številka:
9
Journal Article
Recenzirano
Odprti dostop
Abstract
Ageing has been recognized as one of the most critically important health-care issues worldwide. It is relevant to Asia, where the increasing number of older populations has drawn attention ...to the paramount need for health-care investment, particularly in end-of-life care. The advocacy of advance care planning is a mean to honor patient autonomy. Since most East Asian countries are influenced by Confucianism and the concept of ‘filial piety,’ patient autonomy is consequently subordinate to family values and physician authority. The dominance from family members and physicians during a patient’s end-of-life decision-making is recognized as a cultural feature in Asia. Physicians often disclose the patient’s poor prognosis and corresponding treatment options to the male, family member rather to the patient him/herself. In order to address this ethical and practical dilemma, the concept of ‘relational autonomy’ and the collectivism paradigm might be ideally used to assist Asian people, especially older adults, to share their preferences on future care and decision-making on certain clinical situations with their families and important others. In this review article, we invited experts in end-of-life care from Hong Kong, Indonesia, Japan, South Korea, Singapore and Taiwan to briefly report the current status of advance care planning in each country from policy, legal and clinical perspectives. According to the Asian experiences, we have seen different models of advance care planning implementation. The Asian Delphi Taskforce for advance care planning is currently undertaken by six Asian countries and a more detailed, culturally sensitive whitepaper will be published in the near future.
Alcohol addiction is a leading risk factor for personal death and disability. In 2016, alcohol use caused 2.2% of female deaths and 6.8% of male deaths, and disability-adjusted life years (DALYs) ...were 2.3% in female and 8.9% in male. Individuals with alcohol use disorder are at high risk of anxiety, depression, impaired cognition performance, and illicit drug use and are comorbid with liver disease, such as alcoholic hepatitis and liver cirrhosis, which is a major cause of personal death and disability worldwide. Psychological interventions, such as cognitive behavior therapy and motivational interviewing, as well as medical treatments, such as disulfiram, naltrexone, acamprosate, and nalmefene, are used for the treatment of alcohol addiction in Europe and the United States. However, the effect of current interventions is limited, and the need for additional interventions is substantial. Alcohol use impairs the intestinal barrier and causes changes to the intestinal permeability as well as the gut microbiota composition. Emerging studies have tried to reveal the role of the gut-brain axis among individuals with alcohol use disorder with or without alcohol liver disease. Bacterial products penetrate the impaired intestinal barrier and cause central inflammation; changes to the gut microbiota impair enterohepatic circulation of bile acids; alcohol abuse causes shortage of vital nutrients such as thiamine. Several studies have suggested that probiotics, through either oral administration or fecal microbiota transplantation, increased intestinal levels of potentially beneficial bacteria such as bifidobacteria and lactobacilli, improving the levels of liver-associated enzymes in patients with mild alcoholic hepatitis, and demonstrating beneficial psychotropic effects on anxiety and depression. In addition to medications for alcohol addiction, gene editing therapy such as clustered regularly interspaced short palindromic repeats (CRISPRs) may be another potential research target. Alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH), which are associated with ADH and ALDH genes, are major enzymes involved in alcohol metabolism, and gene editing approaches may have the potential to directly modify specific genes to treat alcoholism caused by genetic defects. Further research is needed to study the effect of the combined treatment for alcohol addiction.
Opioid addiction is a chronic and complex disease characterized by relapse and remission. In the past decade, the opioid epidemic or opioid crisis in the United States has raised public awareness. ...Methadone, buprenorphine, and naloxone have proven their effectiveness in treating addicted individuals, and each of them has different effects on different opioid receptors. Classic and molecular genetic research has provided valuable information and revealed the possible mechanism of individual differences in vulnerability for opioid addiction. The polygenic risk score based on the results of a genome-wide association study (GWAS) may be a promising tool to evaluate the association between phenotypes and genetic markers across the entire genome. A novel gene editing approach, clustered, regularly-interspaced short palindromic repeats (CRISPR), has been widely used in basic research and potentially applied to human therapeutics such as mental illness; many applications against addiction based on CRISPR are currently under research, and some are successful in animal studies. In this article, we summarized the biological mechanisms of opioid addiction and medical treatments, and we reviewed articles about the genetics of opioid addiction, the promising approach to predict the risk of opioid addiction, and a novel gene editing approach. Further research on medical treatments based on individual vulnerability is needed.
Reopening colleges and universities during the coronavirus disease 2019 (COVID-19) pandemic poses a special challenge worldwide. Taiwan is one of the few countries where schools are functioning ...normally. To secure the safety of students and staff, the Ministry of Education in Taiwan established general guidelines for college campuses. The guidelines delineated creation of a task force at each university; school-based risk screening based on travel history, occupation, contacts, and clusters; measures on self-management of health and quarantine; general hygiene measures (including wearing masks indoors); principles on ventilation and sanitization; regulations on school assemblies; a process for reporting suspected cases; and policies on school closing and make-up classes. It also announced that a class should be suspended if 1 student or staff member in it tested positive and that a school should be closed for 14 days if it had 2 or more confirmed cases. As of 18 June 2020, there have been 7 confirmed cases in 6 Taiwanese universities since the start of the pandemic. One university was temporarily closed, adopted virtual classes, and quickly reopened after 14 days of contact tracing and quarantine of possible contacts. Taiwan's experience suggests that, under certain circumstances, safely reopening colleges and universities this fall may be feasible with a combination of strategies that include containment (access control with contact tracing and quarantine) and mitigation (hygiene, sanitation, ventilation, and social distancing) practices.
DSM-V-defined substance use disorder comprises four groups of symptoms: impaired control, social impairment, risky use, and pharmacological reactions. Behavioral patterns of impaired control, ...including impulsivity and risk taking, are associated with HIV risk behaviors. Substance users with stronger craving symptoms are more likely to use drugs via intravenous injection than other routes because of the faster drug effect and the higher bioavailability; thus, they are at high risk of HIV infection. HIV risk behaviors such as unprotected sex and intravenous injection facilitate HIV disease spread. Public health policies such as Needle and Syringe Exchange Programs and medication-assisted treatment are proven to reduce HIV risk behaviors such as the frequency of intravenous injection and even the incidence of HIV infection, but both of them have limitations. While intravenous injection is a frequently discussed issue in public policies and the HIV-related literature, it is a much less frequent topic in the addiction literature. We believed that understanding the mental substrate behind impulsivity/risk taking and the possible biological mechanism of intravenous injection may help in creating more effective strategies to slow down HIV infection.
Immunotherapy is a novel anti-cancer method which employs a different mechanism to conventional treatment. It has become a significant strategy because it provides a better or an alternative option ...for cancer patients. Recently, immunotherapy has been increasingly approved for the treatment of cancer; however, it has various limitations; for instance, it is only suitable for specific patients, the response rate is still low in most cases, etc. Colorectal cancer, lung cancer and pancreatic cancer are known as three major death-causing cancers in most countries. In this review, we discuss immunotherapeutic treatment for these three cancers, and consider the option, prospects and limitations of immunotherapy. The development of immunotherapy should focus on the discovery of biomarkers to screen suitable patients, new targets on tumors, neoadjuvant immunotherapy and the combination of immunotherapy with conventional therapeutic methods. We can expect that immunotherapy potentially will develop as one of the best therapies for patients with advanced cancer or poor responses to traditional methods.
Metal-doped zeolitic imidazolate framework-8 (ZIF-8)-derived carbon materials are attractive for the electrocatalytic reduction of CO2 into CO. In such carbon materials, due to the fusion and ...aggregation of ZIF-8 precursors during the high-temperature pyrolysis process, it is desirable yet still challenging to create a high specific surface area with more active sites available for reacting with reactants. Using SiO2 as a protective coating on the ZIF-8 surface, we synthesize Fe, N-co-doped porous carbon nanoparticles (Fe-CNPs) which possess a hierarchical pore structure with a specific surface area as high as 1156.6 m2 g–1, much higher than the counterparts without a SiO2 coating (360.1 m2 g–1). Over these highly porous Fe-CNPs, the total current densities are more than 3 times higher than those of the lowly porous ones for the electrochemical CO2 reduction. More importantly, the maximum CO Faradaic efficiency for Fe-CNPs increases from ca. 75.0 to 98.8% in a concentrated KHCO3 solution (1 mol L–1). The porosity-induced high selectivity for CO production is also revealed on Ni-doped and Co-doped ZIF-derived CNPs, suggesting a new pathway for designing high-performance carbon catalysts through engineering the porosity for the electrochemical CO2 reduction.
In this paper, an adaptive fuzzy output feedback control approach is proposed for single-input-single-output nonlinear systems without the measurements of the states. The nonlinear systems addressed ...in this paper are assumed to possess unmodeled dynamics in the presence of unstructured uncertainties and dynamic disturbances, where the unstructured uncertainties are not linearly parameterized, and no prior knowledge of their bounds are available. Fuzzy logic systems are used to approximate the unstructured uncertainties, and a state observer is developed to estimate the unmeasured states. By combining the backstepping technique with the small-gain approach, a stable adaptive fuzzy output feedback control method is proposed. It is shown that by applying the proposed adaptive fuzzy control approach, the closed-loop systems are semiglobally uniformly ultimately bounded. The effectiveness of the proposed approach is illustrated from simulation results.
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