Jue Wang

This paper is aimed at a critical assessment of the moral framework of the current Chinese health system from a Confucian perspective, by focusing on the debate between the individual directed approach and the family-oriented approach to a health care system. Concerned with the nature and status of the family in communal life, the paper deals with the following questions: to cope with the frailties of material life (including susceptibility to disease), what good is presupposed by human existence and flourishing; why it is the family that serves as the primary locus of bearing and realizing this unique good; and what kind of society might possess the structures necessary to achieve the good thus conceived. All these questions lead to a revision of the theory of justice required in health care, in favor of family health saving accounts as an important institutional guarantee

We present a study of the dynamics of optical contrast agents indocyanine green and methylene blue in an adenocarcinoma rat tumor model. Measurements are conducted with a combined frequency-domain and steady-state optical technique that facilitates rapid measurement of tissue absorption in the 650–1000-nm spectral region. Tumors were also imaged by use of contrast-enhanced magnetic resonance imaging and coregistered with the location of the optical probe. The absolute concentrations of contrast agent, oxyhemoglobin, deoxyhemoglobin, and water are measured simultaneously each second for approximately 10 min. The differing tissue uptake kinetics of ICG and MB in these late-stage tumors arise from differences in their effective molecular weights. ICG, because of its binding to plasma proteins, behaves as a macromolecular contrast agent with a low vascular permeability. A compartmental model describing ICG dynamics is used to quantify physiologic parameters related to capillary permeability. In contrast, MB behaves as a small-molecular-weight contrast agent that leaks rapidly from the vasculature into the extravascular, extracellular space, and is sensitive to blood flow and the arterial input function. © 2003 Optical Society of America.

Objective: The objectives of this study are to understand the current functions, structure and operation of hospital ethics committees (HECs) in Shanghai and to facilitate their improvement. Methods: (1) A questionnaire survey, (2) interviews with secretaries and (3) on-site document reviews of HECs in Shanghai were used in the study, which surveyed 33 hospitals. Results: In Shanghai, 57.56% of the surveyed hospitals established HECs from 1998 to 2005. Most HECs used bioethical review of research involving human subjects as well as bioethical review or consultation regarding medical care services and administrative decision- making. Of the surveyed HECs, 14.3% did not provide any formal bioethical training to the HECs’ members and many HECs had no standard operating procedures. Some HECs had no clear definition of what was “conflict of interest” that should be considered by the HECs, while 44.4% of the HECs did not perform continuing review. Discussion: After the issues of related national regulations, more and more hospitals established HECs in Shanghai, but the functions of HECs need to be further developed and formal training on bioethics should be provided to HEC members. To assure the independence and good performance of HECs, the conflict of interest procedure, the standard operating procedures and bioethical review should be improved. Conclusion: HECs in Shanghai had developed in the preceding 10 years and they played great roles in protecting the rights and welfare of human subjects and patients; some areas need improvement

Generative artificial intelligence (GenAI) tools like ChatGPT are reshaping higher education, raising concerns about academic integrity alongside potential benefits. The psychological tension accompanying the decision whether to use GenAI or not for a particular task may lead to “AI guilt”—students’ moral discomfort when using GenAI for traditionally human tasks. This study examines the impact of AI guilt on students’ use of ChatGPT for academic tasks, focusing on disciplinary differences between pure and applied fields. We conducted a survey at a Singaporean university, measuring AI guilt and ChatGPT usage. Using logistic regression analysis, we found that AI guilt significantly reduces ChatGPT use for creativity-based tasks but not for routine-based tasks. The relationship between AI guilt and ChatGPT use is linear in pure fields, while applied fields show a nonlinear pattern. Specifically, the perceived risk of being detected and potential academic penalties decreases ChatGPT use in creativity-based tasks for all samples, while rationalization tendencies increase it. Interestingly, the interaction between rationalization tendencies and perceived social norms reduces usage, reflecting the tension between internal justification and external pressures. Heterogeneous analysis shows that rationalization tendencies and perceived risk influence pure fields more, whereas social norms drive applied fields more. These results show how AI guilt varies across disciplines and affects task-level GenAI tool use, offering insights for developing tailored ethical guidelines and integration strategies in higher education.

This chapter contends that algorithmic morality can never supplant a human moral agent. Regardless of their sophistication, automated vehicles are unable to navigate moral dilemmas in a morally responsible manner. By delineating the distinct roles that machines and humans assume in moral decision-making for automated vehicles, we advocate for a pragmatic alternative moral framework rooted in Confucian machine ethics. Accordingly, it is suggested that driverless automated vehicles should only be used on closed-up roads built specifically for such vehicles, while on other roads, the autonomous machine must be held under the control of responsible human agents to deal with emergent situations.

Generative artificial intelligence (GenAI) tools like ChatGPT are reshaping higher education, raising concerns about academic integrity alongside potential benefits. The psychological tension accompanying the decision whether to use GenAI or not for a particular task may lead to “AI guilt”—students’ moral discomfort when using GenAI for traditionally human tasks. This study examines the impact of AI guilt on students’ use of ChatGPT for academic tasks, focusing on disciplinary differences between pure and applied fields. We conducted a survey at a Singaporean university, measuring AI guilt and ChatGPT usage. Using logistic regression analysis, we found that AI guilt significantly reduces ChatGPT use for creativity-based tasks but not for routine-based tasks. The relationship between AI guilt and ChatGPT use is linear in pure fields, while applied fields show a nonlinear pattern. Specifically, the perceived risk of being detected and potential academic penalties decreases ChatGPT use in creativity-based tasks for all samples, while rationalization tendencies increase it. Interestingly, the interaction between rationalization tendencies and perceived social norms reduces usage, reflecting the tension between internal justification and external pressures. Heterogeneous analysis shows that rationalization tendencies and perceived risk influence pure fields more, whereas social norms drive applied fields more. These results show how AI guilt varies across disciplines and affects task-level GenAI tool use, offering insights for developing tailored ethical guidelines and integration strategies in higher education.

Quantitative analysis of tissues and organs can reveal large-scale patterning as well as the impact of perturbations and aging on biological architecture. Here we develop tools for imaging of single cells in intact organs and computational approaches to assess spatial relationships in 3D. In the mouse ovary, we use nuclear volume of the oocyte to read out quiescence or growth of oocyte-somatic cell units known as follicles. This in-ovary quantification of non-growing follicle dynamics from neonate to adult fits a mathematical function, which corroborates the model of fixed oocyte reserve. Mapping approaches show that radial organization of folliculogenesis established in the newborn ovary is preserved through adulthood. By contrast, inter-follicle clustering increases during aging with different dynamics depending on size. These broadly applicable tools can reveal high dimensional phenotypes and age-related architectural changes in other organs. In the adult mouse pancreas, we find stochastic radial organization of the islets of Langerhans but evidence for localized interactions among the smallest islets.

The human cationic antimicrobial protein LL-37 is a multifunctional host defense peptide with a wide range of immunomodulatory activities. Previous work has shown that LL-37 exerts both pro- and anti-inflammatory effects. The role of mitochondria in the skin inflammatory effects of LL-37 has not been well studied. Therefore, our aim was to investigate the immunomodulatory effect of LL-37 in HaCaT cells and to delineate the underlying mechanisms related to mitochondrial function. Immunohistochemistry results from tissue microarrays showed strong cytoplasmic LL-37 staining in inflammatory cells in chronic dermatic inflammation. Using exogenous LL-37 stimulation and LL-37 knockdown and overexpression, LL-37 was demonstrated to dramatically reduce the mRNA levels and protein secretion of inflammatory cytokines including IL-6, IL-8, IL-1α and tumor necrosis factor-α, which are induced by lipopolysaccharides. The anti-inflammatory effects of LL-37 are dependent upon its ability to increase mitochondrial biogenesis and to maintain mitochondrial homeostasis. Furthermore, we observed that LL-37 enhances the LPS-induced phosphorylation of extracellular signal-regulated kinase and mammalian target of rapamycin. The mTOR inhibitor rapamycin can neutralize the protective effects of LL-37 on mitochondria. In conclusion, these results suggest that high LL-37 expression levels correlate with chronic skin inflammation; mitochondrial dysfunction occurs in HaCaT cells during inflammation; and LL-37 attenuates inflammatory impairment by stimulating mitochondrial biogenesis and protecting mitochondrial function, which are dependent upon mTOR signaling. These findings provide new insights into targeting mitochondria with LL-37 to prevent skin inflammatory reactions. © 2014 Elsevier Ltd.

© 2016 American Chemical Society.A tetravalent cerium macrocyclic complex was prepared with an octadentate terephthalamide ligand comprised of hard catecholate donors and characterized in the solution state by spectrophotometric titrations and electrochemistry and in the crystal by X-ray diffraction. The solution-state studies showed that L exhibits a remarkably high affinity toward Ce4+, with log β110 = 61 and ΔG = -348 kJ/mol, compared with log β110 = 32.02 for the analogous Pr3+ complex. In addition, L exhibits an unusual preference for forming CeL4- relative to formation of the analogous actinide complex, ThL4-, which has β110 = 53.7. The extreme stabilization of tetravalent cerium relative to its trivalent state is also evidenced by the shift of 1.91 V in the redox potential of the Ce3+/Ce4+ couple of the complex. The unprecedented behavior prompted an electronic structure analysis using L3- and M5,4-edge X-ray absorption near-edge structure spectroscopies and configuration interaction calculations, which showed that 4f-orbital bonding in CeLK4 has partial covalent character due to ligand-to-metal charge transfer in the ground state. The experimental results are presented in the context of earlier measurements on tetravalent cerium compounds, indicating that the amount of LMCT for CeLK4 is similar to that observed for [Et4N]2[CeCl6] and CeO2 and significantly less than that for the organometallic sandwich compound cerocene, 2Ce. A simple model to rationalize changes in 4f orbital bonding for tri- and tetravalent lanthanide and actinide compounds is also provided.

We report coregistration of near-infrared diffuse optical spectroscopy and magnetic resonance imaging for the study of animal model tumors. A combined broadband steady-state and frequency-domain apparatus was used to determine tissue oxyhemoglobin, deoxyhemoglobin, and water concentration locally in tumors. Simultaneous MRI coregistration provided structural and contrast-enhanced images of the tumor that were correlated with the optical measurements. By use of Monte Carlo simulations, the optically sampled volume was superimposed on the MR images, showing precisely which tissue structure was probed optically. DOS and MRI coregistration measurements were performed on seven rats over 20 days and were separated into three tumor tissue classifications: viable, edematous, and necrotic. A ratio of water concentration to total hemoglobin concentration, as measured optically, was performed for each tissue type and showed values for edematous tissue to be greater than viable tissue. Tissue hemoglobin oxygen saturation also showed a large variation between tissue types: viable tissue had an optically measured StO2 value of 61 ± 5%, whereas StO2 determined for necrotic tissue was 43 ± 6%. © 2003 Optical Society of America.

We present a combined near-infrared diffuse optical spectroscopy and Magnetic Resonance Imaging system for the study of animal model tumors. A combined broad-band steady-state and frequency domain optical spectroscopy apparatus was integrated with the MRI. The physiological properties of tissue rendered by MRI, including vascular volume fraction and water, were compared with chromophore concentrations as determined from the parameters obtained by optical measurements. DOS measurements provided oxyhemoglobin, deoxy-hemoglobin, and water concentration locally in tumors. A method for coregistration of the information obtained by both modalities was developed. Using Monte Carlo simulations, the optically sampled volume was superimposed on the MR images, illustrating which tissue structure was probed optically. Finally, two optical contrast agents, indocyanine green and methylene blue, were employed and their kinetics were measured by DOS system from different locations on the tumor and compared with Gd-DTPA enhancement maps obtained from MRI.

© 2015 Elsevier B.V.This article demonstrates an instrumented mouthguard capable of non-invasively monitoring salivary uric acid levels. The enzyme -modified screen printed electrode system has been integrated onto a mouthguard platform along with anatomically-miniaturized instrumentation electronics featuring a potentiostat, microcontroller, and a Bluetooth Low Energy transceiver. Unlike RFID-based biosensing systems, which require large proximal power sources, the developed platform enables real-time wireless transmission of the sensed information to standard smartphones, laptops, and other consumer electronics for on-demand processing, diagnostics, or storage. The mouthguard biosensor system offers high sensitivity, selectivity, and stability towards uric acid detection in human saliva, covering the concentration ranges for both healthy people and hyperuricemia patients. The new wireless mouthguard biosensor system is able to monitor SUA level in real-time and continuous fashion, and can be readily expanded to an array of sensors for different analytes to enable an attractive wearable monitoring system for diverse health and fitness applications.

© Hsiao et al.; licensee BioMed Central.Background: Identifying cellular signaling pathways that become corrupted in the presence of androgens that increase the metastatic potential of organ-confined tumor cells is critical to devising strategies capable of attenuating the metastatic progression of hormone-naïve, organ-confined tumors. In localized prostate cancers, gene fusions that place ETS-family transcription factors under the control of androgens drive gene expression programs that increase the invasiveness of organ-confined tumor cells. C-X-C chemokine receptor type 4 is a downstream target of ERG, whose upregulation in prostate-tumor cells contributes to their migration from the prostate gland. Recent evidence suggests that CXCR4-mediated proliferation and metastasis of tumor cells is regulated by CXCR7 through its scavenging of chemokine CXCL12. However, the role of androgens in regulating CXCR4-mediated motility with respect to CXCR7 function in prostate-cancer cells remains unclear. Methods: Immunocytochemistry, western blot, and affinity-purification analyses were used to study how androgens influenced the expression, subcellular localization, and function of CXCR7, CXCR4, and androgen receptor in LNCaP prostate-tumor cells. Moreover, luciferase assays and quantitative polymerase chain reaction were used to study how chemokines CXCL11 and CXCL12 regulate androgen-regulated genes in LNCaP prostate-tumor cells. Lastly, cell motility assays were carried out to determine how androgens influenced CXCR4-dependent motility through CXCL12. Results: Here we show that, in the LNCaP prostate-tumor cell line, androgens coordinate the expression of CXCR4 and CXCR7, thereby promoting CXCL12/CXCR4-mediated cell motility. RNA interference experiments revealed functional interactions between AR and CXCR7 in these cells. Co-localization and affinity-purification experiments support a physical interaction between AR and CXCR7 in LNCaP cells. Unexpectedly, CXCR7 resided in the nuclear compartment and modulated AR-mediated transcription. Moreover, androgen-mediated cell motility correlated positively with the co-localization of CXCR4 and CXCR7 receptors, suggesting that cell migration may be linked to functional CXCR4/CXCR7 heterodimers. Lastly, CXCL12-mediated cell motility was CXCR7-dependent, with CXCR7 expression required for optimal expression of CXCR4 protein. Conclusions: Overall, our results suggest that inhibition of CXCR7 function might decrease the metastatic potential of organ-confined prostate cancers.

© 2014 American Chemical Society.Attempts to apply artificial nano/micromotors for diverse biomedical applications have inspired a variety of strategies for designing motors with diverse propulsion mechanisms and functions. However, existing artificial motors are made exclusively of synthetic materials, which are subject to serious immune attack and clearance upon entering the bloodstream. Herein we report an elegant approach that turns natural red blood cells into functional micromotors with the aid of ultrasound propulsion and magnetic guidance. Iron oxide nanoparticles are loaded into the RBCs, where their asymmetric distribution within the cells results in a net magnetization, thus enabling magnetic alignment and guidance under acoustic propulsion. The RBC motors display efficient guided and prolonged propulsion in various biological fluids, including undiluted whole blood. The stability and functionality of the RBC motors, as well as the tolerability of regular RBCs to the ultrasound operation, are carefully examined. Since the RBC motors preserve the biological and structural features of regular RBCs, these motors possess a wide range of antigenic, transport, and mechanical properties that common synthetic motors cannot achieve and thus hold considerable promise for a number of practical biomedical uses.

IMPORTANCE: Most evaluations of pay-for-performance incentives have focused on large-group practices. Thus, the effect of P4P in small practices, where many US residents receive care, is largely unknown. Furthermore, whether electronic health records with chronic disease management capabilities support small-practice response to P4P has not been studied. OBJECTIVE: To assess the effect of P4P incentives on quality in EHR-enabled small practices in the context of an established quality improvement initiative. DESIGN, SETTING, AND PARTICIPANTS: A cluster-randomized trial of small primary care clinics in New York City from April 2009 through March 2010. A city program provided all participating clinics with the same EHR software with decision support and patient registry functionalities and quality improvement specialists offering technical assistance. INTERVENTIONS: Incentivized clinicswere paid for each patient whose care met the performance criteria, but they received higher payments for patients with comorbidities, who had Medicaid insurance, or who were uninsured. Quality reports were given quarterly to both the intervention and control groups. MAIN OUTCOMES AND MEASURES: Comparison of differences in performance improvement, from the beginning to the end of the study, between control and intervention clinics for aspirin or antithrombotic prescription, blood pressure control, cholesterol control, and smoking cessation interventions. Mixed-effects logistic regression was used to account for clustering of patients within clinics, with a treatment by time interaction term assessing the statistical significance of the effect of the intervention. RESULTS: Participating clinics had similar baseline characteristics, with a mean of 4592 patients at the intervention group clinics and 3042 at the control group clinics. Intervention clinics had greater adjusted absolute improvement in rates of appropriate antithrombotic prescription, blood pressure control, and in smoking cessation interventions. Intervention clinics performed better on all measures for Medicaid and uninsured patients except cholesterol control, but no differences were statistically significant. CONCLUSIONS AND RELEVANCE: Among small EHR-enabled clinics, a P4P incentive program compared with usual care resulted in modest improvements in cardiovascular care processes and outcomes. Because most proposed P4P programs are intended to remain in place more than a year, further research is needed to determine whether this effect increases or decreases over time. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00884013.

Industry groups engage in venue shifting when they seek to overturn or alter restrictive regulations imposed by one political venue through another. A critical step in this process is resolving uncertainties surrounding the preference of the targeted venue and the nature of the relevant policy proposal. While existing studies emphasize a long-term trial-and-error process of policy learning, we focus on nascent industries and argue that ventures seek other information sources to resolve these uncertainties quickly. In particular, nascent industry groups are likely to perceive that the targeted venue will support their policy proposal if the targeted venue is ideologically distant from the venue that has enacted the restrictive regulations, if the targeted venue has recently supported other nascent industry groups’ similar policy proposals, or if the industry groups themselves are more exposed to industry peers’ success in promoting the same policy proposal in other jurisdictions. Under these conditions, the industry groups invest more to influence the targeted venue in response to restrictive regulations enacted by other venues. We find support for our theory by examining how from 2013 to 2019 the small unmanned aircraft systems industry trade associations in the United States lobbied state governments to nullify local regulations.

A study of the structural perfection of icosahedral quasicrystalline grains of various alloys and Al-Cu-Fe), grown by different slow solidification techniques was performed using high-resolution diffraction, including recording rocking curves combined with X-ray topography and phase contrast radiography, at a third-generation synchrotron radiation source . For Al-Pd-Mn, additional coherent diffraction and diffuse scattering measurements were also carried out. After evaluating the potentialities of the techniques used, in the light of the criteria defined for crystals, it is shown that the structural perfection of icosahedral quasicrystals is quite comparable with that of metallic crystals but is considerably influenced by either uniform phason strains which can destroy the quasiperiodic long-range order, or by long-wavelength phason fluctuations leading to diffuse scattering. The structural perfection was also found to be extremely variable across the as-grown quasicrystalline grains and to be dependent on the presence and characteristics of inhomogeneities often included in the quasicrystalline matrix. Regarding the grains that we used, it has been impossible to distinguish a clear influence of either the type of alloy or the growth method. It has, however, been noticed that Al-Pd-Mn and Al-Cu-Fe grains appeared less defective than Zn-Mg-RE grains and that the microstructure of these latter grains looks like that of crystals grown by the same technique. Annealing and mechanical polishing effects have also been analysed in the case of Al-Pd-Mn grains. It appeared that annealing improves the quasicrystalline lattice perfection by lowering phason strains insofar as no precipitates are nucleated. Mechanical polishing can introduce defects, located at the external surfaces, having the shape of bands

Artificial intelligence technology and human-like robots raise key questions regarding appropriate relationships between humans and such social robots. These artificial, AI infused, creations are programmed to mimic and manipulate human emotions so as to provide affective companionship for humans. How should we treat them: as a mere machine, as a fellow human being, or as some third thing set in between the two? This chapter explores the ethical implications of affective, emphatic connections with robots. Is it possible to create a human-robot moral community? Section one provides methodological reflections on the empathy that humans often feel for robots. Empathy does not begin and end with human beings. Persons often have such feeling for pets, for example. Very probably in the future human empathy will extend to embrace highly intelligent, empathetic robots. Against this background, one urgent issue arises: Morally speaking, should we develop empathy for social robots? This paper critically explores different ways that humans might empathize with robot companions, examining the social and moral influence of various empathetic relationships on the human agents involved. I will argue from the Confucian point of view that given the dramatic difference between human emotions and programed robot emotions, we should be cautious of attempts to build love machines that will distract us from the more valuable pursuit of empathy and sympathy with our human fellows.

The advent of the intelligence age has injected new elements into the development of literature. The synergic modification of Anglo-American traumatic narrative literature by artificial intelligence technology and interactive design psychology will produce new possibilities in literary creation. First, by studying natural language processing technology, this study proposes a modification language model based on the double-layered recurrent neural network algorithm and constructs an intelligent language modification system based on the improved LM model. The results show that the performance of the proposed model is excellent; only about 30% of the respondents like AAL literature; the lack of common cultural background, appreciation difficulties, and language barriers have become the main reasons for the decline of reading willingness of AAL literature. Finally, AI technology and ID psychology are used to modify a famous TN work respectively and synergically, and the modified work is appreciated by respondents to collect their comments. The results corroborate that 62% of the respondents like original articles, but their likability scores have decreased for individually modified work by AI or ID psychology. In comparison, under the synergic modification efforts of AI and ID psychology, the popularity of the modified work has increased slightly, with 65% of the respondents showing a likability to read. Therefore, it is concluded that literary modification by single ID psychology or AI technology will reduce the reading threshold by trading off the literary value of the original work. The core of literary creation depends on human intelligence, and AI might still not be able to generate high-standard literary works independently because human minds and thoughts cannot be controlled and predicted by machines. The research results provide new ideas and improvement directions for the field of AI-assisted writing.