The effect of deliberative process on the self-sacrificial decisions of utilitarian healthcare students.

BACKGROUND: The COVID-19 pandemic has highlighted prosocial behavior as a professional healthcare core competency. Although medical students are expected to work in the best interests of their patients, in the pandemic context, there is a greater need for ethical attention to be paid to the way medical students deal with moral dilemmas that may conflict with their obligations. METHODS: This study was conducted in the spring semester of 2019 on 271 students majoring in health professions: medicine, dentistry, and veterinary medicine. All participants provided informed consent and completed measures that assessed utilitarian moral views, cognitive reflections, cognitive reappraisal, and moral judgment. RESULTS: The healthcare-affiliated students who scored higher on the instrumental harm subscale in the measurement of utilitarian moral views were more likely to endorse not only other-sacrificial actions but also self-sacrificial ones for the greater good in moral dilemma scenarios. In particular, those engaged in deliberative processes tended to make more self-sacrificial judgments. The mediation analysis also revealed that the effect of deliberative processes on self-sacrificial judgments was mediated by cognitive reappraisal. CONCLUSIONS: These findings suggested that cognitive reappraisal through deliberative processes is involved when the students with utilitarian inclination make prosocial decisions, that it is necessary to consider both moral views and emotional regulation when admitting candidates, and that moral education programs are needed in the healthcare field.

Biocompatible Electronic Skins for Cardiovascular Health Monitoring.

Cardiovascular diseases represent a significant threat to the overall well-being of the global population. Continuous monitoring of vital signs related to cardiovascular health is essential for improving daily health management. Currently, there has been remarkable proliferation of technology focused on collecting data related to cardiovascular diseases through daily electronic skin monitoring. However, concerns have arisen regarding potential skin irritation and inflammation due to the necessity for prolonged wear of wearable devices. To ensure comfortable and uninterrupted cardiovascular health monitoring, the concept of biocompatible electronic skin has gained substantial attention. In this review, biocompatible electronic skins for cardiovascular health monitoring are comprehensively summarized and discussed. The recent achievements of biocompatible electronic skin in cardiovascular health monitoring are introduced. Their working principles, fabrication processes, and performances in sensing technologies, materials, and integration systems are highlighted, and comparisons are made with other electronic skins used for cardiovascular monitoring. In addition, the significance of integrating sensing systems and the updating wireless communication for the development of the smart medical field is explored. Finally, the opportunities and challenges for wearable electronic skin are also examined.

Implantable Multi-Cross-Linked Membrane-Ionogel Assembly for Reversible Non-Faradaic Neurostimulation.

Neural interfaces play a major role in modulating neural signals for therapeutic purposes. To meet the demand of conformable neural interfaces for developing bioelectronic medicine, recent studies have focused on the performance of electrical neurostimulators employing soft conductors such as conducting polymers and electronic or ionic conductive hydrogels. However, faradaic charge injection at the interface of the electrode and nerve tissue causes irreversible gas evolution, oxidation of electrodes, and reduction of biological ions, thus causing undesired tissue damage and electrode degradation. Here we report a conformable neural interface engineering based on multicross-linked membrane-ionogel assembly (termed McMiA), which enables nonfaradaic neurostimulation without irreversible charge transfer reaction. The McMiA consists of a genipin-cross-linked biopolymeric ionogel coupled with a dopamine-cross-linked graphene oxide membrane to prevent ion exchange between biological and synthetic McMiA ions and to function as a bioadhesive forming covalent bonds with the target tissues. In addition, the demonstration of bioelectronic medicine via the McMiA-based neurostimulation of sciatic nerves shows the enhanced clinical utility in treating the overactive bladder syndrome. As the McMiA-based neural interface is soft, robust for bioadhesion, and stable in a physiological environment, it can offer significant advancement in biocompatibility and long-term operability for neural interface engineering.

Ultrafast, autonomous self-healable iontronic skin exhibiting piezo-ionic dynamics.

The self-healing properties and ionic sensing capabilities of the human skin offer inspiring groundwork for the designs of stretchable iontronic skins. However, from electronic to ionic mechanosensitive skins, simultaneously achieving autonomously superior self-healing properties, superior elasticity, and effective control of ion dynamics in a homogeneous system is rarely feasible. Here, we report a Cl-functionalized iontronic pressure sensitive material (CLiPS), designed via the introduction of Cl-functionalized groups into a polyurethane matrix, which realizes an ultrafast, autonomous self-healing speed (4.3 µm/min), high self-healing efficiency (91% within 60 min), and mechanosensitive piezo-ionic dynamics. This strategy promotes both an excellent elastic recovery (100%) and effective control of ion dynamics because the Cl groups trap the ions in the system via ion-dipole interactions, resulting in excellent pressure sensitivity (7.36 kPa-1) for tactile sensors. The skin-like sensor responds to pressure variations, demonstrating its potential for touch modulation in future wearable electronics and human-machine interfaces.

Liquid-crystalline semiconducting copolymers with intramolecular donor-acceptor building blocks for high-stability polymer transistors.

The ability to control the molecular organization of electronically active liquid-crystalline polymer semiconductors on surfaces provides opportunities to develop easy-to-process yet highly ordered supramolecular systems and, in particular, to optimize their electrical and environmental reliability in applications in the field of large-area printed electronics and photovoltaics. Understanding the relationship between liquid-crystalline nanostructure and electrical stability on appropriate molecular surfaces is the key to enhancing the performance of organic field-effect transistors (OFETs) to a degree comparable to that of amorphous silicon (a-Si). Here, we report a novel donor-acceptor type liquid-crystalline semiconducting copolymer, poly(didodecylquaterthiophene-alt-didodecylbithiazole), which contains both electron-donating quaterthiophene and electron-accepting 5,5'-bithiazole units. This copolymer exhibits excellent electrical characteristics such as field-effect mobilities as high as 0.33 cm(2)/V.s and good bias-stress stability comparable to that of amorphous silicon (a-Si). Liquid-crystalline thin films with structural anisotropy form spontaneously through self-organization of individual polymer chains as a result of intermolecular interactions in the liquid-crystalline mesophase. These thin films adopt preferential well-ordered intermolecular pi-pi stacking parallel to the substrate surface. This bottom-up assembly of the liquid-crystalline semiconducting copolymer enables facile fabrication of highly ordered channel layers with remarkable electrical stability.

Deformable Ionic Polymer Artificial Mechanotransducer with an Interpenetrating Nanofibrillar Network.

We demonstrate an ionic polymer artificial mechanotransducer (i-PAM) capable of simultaneously yielding an efficient wide bandwidth and a blocking force to maximize human tactile recognition in soft tactile feedback. The unique methodology in the i-PAM relies on an ionic interpenetrating nanofibrillar network that is formed at the interface of (i) an ionic thermoplastic polyurethane nanofibrillar matrix with an ionic liquid of 1-ethyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide ([EMIM]+[TFSI]-) and (ii) ionic poly(3,4-ethylenedioxythiophene):poly(styrenesulfonic acid) (PEDOT:PSS) conducting polymer electrodes with dimethyl sulfoxide and [EMIM]+[TFSI]- as additives. The i-PAM-based actuator with the ionic PEDOT:PSS exhibits a stable operation up to 200 Hz at low voltage as well as a blocking force of 0.4 mN, which can be potentially adapted to soft tactile feedback. Furthermore, on the basis of this fast i-PAM, we realized alphabet tactile rendering by using a 3 × 3 i-PAM array stimulated by a dc input of 2 V. We believe that our proposed approach can provide a rational guide to the human-machine soft haptic interface.

A bioinspired hydrogen bond-triggered ultrasensitive ionic mechanoreceptor skin.

Biological cellular structures have inspired many scientific disciplines to design synthetic structures that can mimic their functions. Here, we closely emulate biological cellular structures in a rationally designed synthetic multicellular hybrid ion pump, composed of hydrogen-bonded [EMIM+][TFSI-] ion pairs on the surface of silica microstructures (artificial mechanoreceptor cells) embedded into thermoplastic polyurethane elastomeric matrix (artificial extracellular matrix), to fabricate ionic mechanoreceptor skins. Ionic mechanoreceptors engage in hydrogen bond-triggered reversible pumping of ions under external stimulus. Our ionic mechanoreceptor skin is ultrasensitive (48.1-5.77 kPa-1) over a wide spectrum of pressures (0-135 kPa) at an ultra-low voltage (1 mV) and demonstrates the ability to surpass pressure-sensing capabilities of various natural skin mechanoreceptors (i.e., Merkel cells, Meissner's corpuscles, Pacinian corpuscles). We demonstrate a wearable drone microcontroller by integrating our ionic skin sensor array and flexible printed circuit board, which can control directions and speed simultaneously and selectively in aerial drone flight.

An Ultrasensitive, Visco-Poroelastic Artificial Mechanotransducer Skin Inspired by Piezo2 Protein in Mammalian Merkel Cells.

An artificial ionic mechanotransducer skin with an unprecedented sensitivity over a wide spectrum of pressure by fabricating visco-poroelastic nanochannels and microstructured features, directly mimicking the physiological tactile sensing mechanism of Piezo2 protein is demonstrated. This capability enables voice identification, health monitoring, daily pressure measurements, and even measurements of a heavy weight beyond capabilities of human skin.

Two modes of transformation of amorphous calcium carbonate films in air.

Large-area amorphous calcium carbonate (ACC) films in air are shown to be transformed into crystalline calcium carbonate (CaCO(3)) films via two modes-dissolution-recrystallization and solid-solid phase transition-depending on the relative humidity of the air and the temperature. Moisture in the air promotes the transformation of ACC into crystalline forms via a dissolution-recrystallization process. Increasing the humidity increases the rate of ACC crystallization and gives rise to films with numerous large pores. As the temperature is increased, the effect of moisture in the air is reduced and solid-solid transition by thermal activation becomes the dominant transformation mechanism. At 100 and 120 degrees C, ACC films are transformed into predominantly (110) oriented crystalline films. Collectively, the results show that calcium carbonate films with different morphologies, crystal phases, and structures can be obtained by controlling the humidity and temperature. This ability to control the transformation of ACC should assist in clarifying the role of ACC in the biomineralization of CaCO(3) and should open new avenues for preparing CaCO(3) films with oriented and fine structure.

Controlled one-dimensional nanostructures in poly(3-hexylthiophene) thin film for high-performance organic field-effect transistors.

With the aim of improving the field-effect mobilities in poly(3-hexylthiophene) (P3HT) thin film transistors, we controlled the nanostructures of P3HT thin film by changing the solvent vapor pressure in a spin-coating chamber during solidification. The transistors with P3HT thin films spin-coated under a high solvent vapor pressure (56.5 KPa), showing the one-dimensional nanowire morphologies, resulted in the relatively high field-effect mobilities (0.02 cm2/(V.s)) that are typically more than 1 order of magnitude higher than those prepared under ambient conditions, showing the featureless morphologies. This can be attributed to the higher solvent vapor pressure during film formation, providing the solvent is allowed to evaporate slowly and the degree of ordering within the P3HT crystalline domains is dramatically improved.

Stretchable and Multimodal All Graphene Electronic Skin.

A transparent and stretchable all-graphene multifunctional electronic-skin sensor matrix is developed. Three different functional sensors are included in this matrix: humidity, thermal, and pressure sensors. These are judiciously integrated into a layer-by-layer geometry through a simple lamination process.

Flexible polymer transistors with high pressure sensitivity for application in electronic skin and health monitoring.

Flexible pressure sensors are essential parts of an electronic skin to allow future biomedical prostheses and robots to naturally interact with humans and the environment. Mobile biomonitoring in long-term medical diagnostics is another attractive application for these sensors. Here we report the fabrication of flexible pressure-sensitive organic thin film transistors with a maximum sensitivity of 8.4 kPa(-1), a fast response time of <10 ms, high stability over >15,000 cycles and a low power consumption of <1 mW. The combination of a microstructured polydimethylsiloxane dielectric and the high-mobility semiconducting polyisoindigobithiophene-siloxane in a monolithic transistor design enabled us to operate the devices in the subthreshold regime, where the capacitance change upon compression of the dielectric is strongly amplified. We demonstrate that our sensors can be used for non-invasive, high fidelity, continuous radial artery pulse wave monitoring, which may lead to the use of flexible pressure sensors in mobile health monitoring and remote diagnostics in cardiovascular medicine.

Design of a polymer-carbon nanohybrid junction by interface modeling for efficient printed transistors.

Molecularly hybridized materials composed of polymer semiconductors (PSCs) and single-walled carbon nanotubes (SWNTs) may provide a new way to exploit an advantageous combination of semiconductors, which yields electrical properties that are not available in a single-component system. We demonstrate for the first time high-performance inkjet-printed hybrid thin film transistors with an electrically engineered heterostructure by using specially designed PSCs and semiconducting SWNTs (sc-SWNTs) whose system achieved a high mobility of 0.23 cm(2) V(-1) s(-1), no V(on) shift, and a low off-current. PSCs were designed by calculation of the density of states of the backbone structure, which was related to charge transfer. The sc-SWNTs were prepared by a single cascade of the density-induced separation method. We also revealed that the binding energy between PSCs and sc-SWNTs was strongly affected by the side-chain length of PSCs, leading to the formation of a homogeneous nanohybrid film. The understanding of electrostatic interactions in the heterostructure and experimental results suggests criteria for the design of nanohybrid heterostructures.