Factors impacting the demonstration of relational autonomy in medical decision-making: A meta-synthesis.

BACKGROUND: Relational autonomy is an alternative concept of autonomy in which an individual is recognized as embedded into society and influenced by relational factors. Social context, including social location, political structure, and social forces, significantly influence an agent to develop and exercise autonomy skills. The relational approach has been applied in clinical practice to identify relational factors impacting patient autonomy and decision-making, yet there is a knowledge gap in how these factors influence the demonstration of relational autonomy in the context of medical decisions of adults. OBJECTIVE: The present study targeted the existing knowledge of what and how relational factors impact individuals making medical decisions using the theoretical framework of relational autonomy. METHODS: A meta-synthesis study was utilized. Four electronic databases, including Embase, OVID Medline, CINAHL, and PubMed, were searched, along with gray literature and reference lists, to identify relevant studies. RESULTS: 23 studies reporting 21 qualitative and two mixed-method studies were reviewed. Four themes emerged from the qualitative findings: (1) supportive relationships facilitate an individual's relational autonomy; (2) obtaining comprehensive information from broader sources helps individuals exercise relational autonomy; (3) undue family pressure impedes the exercising of patient relational autonomy; and (4) healthcare providers' dominant voice hampers the demonstration of relational autonomy. CONCLUSIONS: Applying relational autonomy to assist adults in making well-considered decisions is essential. The meta-synthesis suggests establishing a supportive relationship between individuals, healthcare providers, and family. A supportive relationship will allow healthcare providers to make judgments in line with an individual's values and wishes with the aim of promoting relational autonomy. Advance care planning was proposed as the effective solution to obtain a consensus between individuals and their families while respecting an individual's values and preferences. Furthermore, it is considered crucial for healthcare providers to appreciate an individual's values and incorporate their preferences into recommendations.

The first maternal genetic study of hunter-gatherers from Vietnam.

The current limitation of ancient DNA data from Vietnam led to the controversy surrounding the prehistory of people in this region. The combination of high heat and humidity damaged ancient bones that challenged the study of human evolution, especially when using DNA as study materials. So far, only 4 k years of history have been recorded despite the 65 k years of history of anatomically modern human occupations in Vietnam. Here we report, to our knowledge, the oldest mitogenomes of two hunter-gatherers from Vietnam. We extracted DNA from the femurs of two individuals aged 6.2 k cal BP from the Con Co Ngua (CCN) site in Thanh Hoa, Vietnam. This archeological site is the largest cemetery of the hunter-gatherer population in Southeast Asia (SEA) that was discovered, but their genetics have not been explored until the present. We indicated that the CCN haplotype belongs to a rare haplogroup that was not detected in any present-day Vietnamese individuals. Further matrilineal analysis on CCN mitogenomes showed a close relationship with ancient farmers and present-day populations in SEA. The mitogenomes of hunter-gatherers from Vietnam debate the "two layers" model of peopling history in SEA and provide an alternative solution for studying challenging ancient human samples from Vietnam.

The Complete Chloroplast Genome of An Ophiorrhiza baviensis Drake Species Reveals Its Molecular Structure, Comparative, and Phylogenetic Relationships.

Ophiorrhiza baviensis Drake, a flowering medical plant in the Rubiaceae, exists uncertainly within the Ophiorrhiza genus' evolutionary relationships. For the first time, the whole chloroplast (cp) genome of an O. baviensis Drake species was sequenced and annotated. Our findings demonstrate that the complete cp genome of O. baviensis is 154,770 bp in size, encoding a total of 128 genes, including 87 protein-coding genes, 8 rRNAs, and 33 tRNAs. A total of 59 SSRs were screened in the studied cp genome, along with six highly variable loci, which can be applied to generate significant molecular markers for the Ophiorrhiza genus. The comparative analysis of the O. baviensis cp genome with two published others of the Ophiorrhiza genus revealed a high similarity; however, there were some notable gene rearrangements in the O. densa plastome. The maximum likelihood phylogenetic trees were constructed based on the concatenation of the rps16 gene and the trnL-trnF intergenic spacer sequence, indicating a close relationship between the studied O. baviensis and other Ophiorrhiza. This study will provide a theoretical molecular basis for identifying O. baviensis Drake, as well as species of the Ophiorrhiza genus, and contribute to shedding light on the chloroplast genome evolution of Rubiaceae.

Adsorptive removal of dichlorophenoxyacetic acid (2,4-D) using novel nanoparticles based on cationic surfactant-coated titania nanoparticles.

A novel nanomaterial based on cationic surfactant-coated TiO2 nanoparticle (CCTN) was systematically fabricated in this work. Synthesized titania nanoparticles were thoroughly characterized by XRD, FT-IR, HR-TEM, TEM-EDX, SEM with EDX mapping, BET, and ζ potential measurements. The adsorption of cationic surfactant, cetyltrimethylammonium bromide (CTAB), on TiO2 was studied under various pH and ionic strength conditions. Adsorption of CTAB on TiO2 increased with ionic strength increment in the presence of hemimicelle monolayer structure, indicating that nonelectrostatic and electrostatic forces control CTAB uptake. CTAB adsorption isotherms on TiO2 were according to a two-step model. Potential application in pesticide removal of 2,4-dichorophenoxy acetic acid (2,4-D) using CCTN was also studied. Optimum parameters for 2,4-D treatment through adsorption technique were pH 5, adsorption time of 120 min, and CCTN dosage of 10 mg·mL-1. Very low 2,4-D removal efficiency using TiO2 without CTAB coating was found to be approximately 28.5% whereas the removal efficiency was up to about 90% by using CCTN under optimum conditions, and the maximum adsorption capacity of 12.79 mg·g-1 was found. Adsorption isotherms of 2,4-D on CCTN were more suitable with the Langmuir model than Freundlich. Adsorption mechanisms of 2,4-D on CCTN were mainly governed by Columbic attraction based on isotherms and surface charge changes.

Synthesis and Characterization of Novel Core-Shell ZnO@SiO2 Nanoparticles and Application in Antibiotic and Bacteria Removal.

A novel core-shell nanomaterial, ZnO@SiO2, based on rice husk for antibiotic and bacteria removal, was successfully fabricated. The ZnO@SiO2 nanoparticles were characterized by X-ray diffraction (XRD), energy-dispersive X-ray spectroscopy (EDX), Fourier transform infrared (FTIR) spectroscopy, transmission electron microscopy (TEM), photoluminescence spectroscopy (PL), Brunauer-Emmett-Teller (BET) method, diffuse reflectance ultraviolet-vis (DR-UV-vis) spectroscopy, X-ray photoelectron spectroscopy (XPS), Raman spectroscopy, and ζ-potential measurements. ß-Lactam antibiotic amoxicillin (AMX) was removed using ZnO@SiO2 nanoparticles with an efficiency greater than 90%, while Escherichia coli removal was higher than 91%. The optimum effective conditions for AMX removal using ZnO@SiO2, including solution pH, adsorption time, and ZnO@SiO2 dosage, were 8, 90 min, and 25 mg/mL, respectively. The maximum adsorption capacity reached 52.1 mg/g, much higher than those for other adsorbents. Adsorption isotherms of AMX on ZnO@SiO2 were more in accordance with the Freundlich model than the Langmuir model. The electrostatic attraction between negative species of AMX and the positively charged ZnO@SiO2 surface induced adsorption, while the removal of E. coli was governed by both electrostatic and hydrophobic interactions. Our study demonstrates that ZnO@SiO2 based on rice husk is a useful core-shell nanomaterial for antibiotic and bacteria removal from water.

Adsorptive Removal of Azo Dye New Coccine Using High-Performance Adsorbent-Based Polycation-Modified Nano-Alpha Alumina Particles.

The azo dyes new coccine (NCC) were successfully removed through the adsorption onto PVBTAC-modified α-Al2O3 particles. The optimal conditions of both the surface modification by PVBTAC adsorption and the NCC adsorption were thoroughly investigated. Formerly, polycations PVBTAC were adsorbed onto the nanosized α-Al2O3 particles at pH 8, NaCl 100 mM, with a contact time of 2 h, and initial concentration of 1000 ppm to modify the α-Al2O3 surface. Latterly, the NCC adsorptive removal was conducted at pH 8, NaCl 10 mM, α-Al2O3 adsorbent dosage of 3 mg mL-1, and a contact time of 45 min. Interestingly, the optimal pH of 8 potentially applies to treat real wastewater as the environmental pH range is often about 7-8. High removal efficiency and adsorption capacity of the NCC azo dyes were, respectively, found to be approximately 95% and 3.17 mg g-1 with an initial NCC concentration of 10 ppm. The NCC adsorption on the modified α-Al2O3 particles was well fitted with a Freundlich model isotherm. A pseudo-second kinetic was more suitable for the NCC adsorption on the PVBTAC-modified α-Al2O3 surface than a pseudo-first kinetic. The NCC adsorptive removal kinetic was also affirmed by the FT-IR spectra, based especially on the changes of functional group stretch vibrations of -SO3 - group in the NCC molecules and -N+(CH3)3 group in the PVBTAC molecules. The high reusability of the α-Al2O3 particles was proved to be higher than 50% after four generation times.

Association between BoLA-DRB3 polymorphism and bovine leukemia virus proviral load in Vietnamese Holstein Friesian cattle.

Bovine leukemia virus (BLV) is the causative agent of enzootic bovine leukosis. Polymorphism in bovine leukocyte antigen (BoLA)-DRB3 allele can influence the host immune response to pathogens, including BLV. However, association between specific BoLA-DRB3 alleles and BLV proviral load (PVL), which is a useful index for estimating disease progression and transmission risk, in Vietnamese cattle are unknown. Here, association study of BoLA-DRB3 allele frequency between cattle with high or low PVL demonstrated BoLA-DRB3*12:01 associates with high PVL in Vietnamese Holstein Friesian (HF) crossbred cattle. This is the first study to demonstrate that BoLA-DRB3 polymorphism confers susceptibility to BLV high PVL in HF crossbred kept in Vietnam. Our results may be useful in disease control and eradiation for BLV through genetic selection.