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BACKGROUND: The insufficient number of general practitioners (GPs) is a major challenge facing China's healthcare system. The purpose of the GP transfer training programme was to provide training for experienced doctors to transition to general practice. However, research on the competencies of GP transfer training trainers in teaching skills in China is limited. This cross-sectional study aimed to examine the baseline familiarity with teaching skills among Chinese GP transfer training trainers. METHODS: An online survey was conducted among trainers who participated in the 2021 Sichuan Province General Practice Training Trainer Program. The survey collected data on participants' characteristics and familiarity with 20 skills in three essential teaching knowledge areas: the core functions of primary care (five questions), preparation for lesson plan (four questions), and teaching methods (11 questions). RESULTS: In total, 305 participants completed the survey. Familiarity rates were generally low across all three essential teaching knowledge areas. No significant differences were observed in familiarity rates between the tertiary and secondary hospitals. CONCLUSION: This study revealed gaps in the teaching skills of GP transfer training trainers in China. These results suggest the necessity for targeted training programs to enhance the teaching skills and competencies of trainers.
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Medicina Geral , Clínicos Gerais , Humanos , Estudos Transversais , Medicina Geral/educação , Medicina de Família e Comunidade/educação , China , EnsinoRESUMO
2D heterostructures provide a competitive platform to tailor electrical property through control of layer structure and constituents. However, despite the diverse integration of 2D materials and their application flexibility, tailoring synergistic interlayer interactions between 2D materials that form electronically coupled heterostructures remains a grand challenge. Here, the rational design and optimized synthesis of electronically coupled N-doped mesoporous defective carbon and nitrogen modified titanium carbide (Ti3 C2 ) in a 2D sandwiched heterostructure, is reported. First, a F127-polydopamine single-micelle-directed interfacial assembly strategy guarantees the construction of two surrounding mesoporous N-doped carbon monolayers assembled on both sides of Ti3 C2 nanosheets. Second, the followed ammonia post-treatment successfully introduces N elements into Ti3 C2 structure and more defective sites in N-doped mesoporous carbon. Finally, the oxygen reduction reaction (ORR) and theoretical calculation prove the synergistic coupled electronic effect between N-Ti3 C2 and defective N-doped carbon active sites in the 2D sandwiched heterostructure. Compared with the control 2D samples (0.87-0.88 V, 4.90-5.15 mA cm-2 ), the coupled 2D heterostructure possesses the best onset potential of 0.90 V and limited density current of 5.50 mA cm-2 . Meanwhile, this catalyst exhibits superior methanol tolerance and cyclic durability. This design philosophy opens up a new thought for tailoring synergistic interlayer interactions between 2D materials.
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Background: Comorbidity is a common phenomenon in the older population; it causes a heavy burden on societies and individuals. However, the relevant evidence, especially in the southwestern region of China, is insufficient. Objectives: We aimed to examine current comorbidity characteristics as well as correlations among diseases in individuals aged >60 years. Design: Retrospective study. Methods: We included records of 2,995 inpatients treated at the Gerontological Department of Sichuan Geriatric Hospital from January 2018 to February 2022. The patients were divided into groups according to sex and age. Diseases were categorised based on the International Classification of Diseases and their Chinese names. We calculated the age-adjusted Charlson Comorbidity Index (ACCI), categorised diseases using the China Health and Retirement Longitudinal Study questionnaire, and visualised comorbidity using web graphs and the Apriori algorithm. Results: The ACCI was generally high, and it increased with age. There were significant differences in the frequency of all diseases across age groups, especially in individuals aged ≥90 years. The most common comorbid diseases were liver diseases, stomach or other digestive diseases, and hypertension. Strong correlations between the most common digestive diseases and hypertension were observed. Conclusion: Our findings provide insights into the current situation regarding comorbidity and the correlations among diseases in the older population. We expect our findings to inform future research directions as well as policies regarding general clinical practice and public health, especially for medical consortiums.
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Hipertensão , Pacientes Internados , Humanos , Idoso , Estudos Retrospectivos , Estudos Longitudinais , Comorbidade , Hipertensão/epidemiologiaRESUMO
Metal-free carbon-based catalysts are crucial for the electrocatalytic chlorine evolution reaction (CER) to reduce the usage of noble metals and industrial cost. However, the corresponding catalytic activity of high overpotential and low durability hinders their wide application. Here, a hollow porous carbon (HPC) nanocage with a controlled oxygen electronic state around designed carbon defects for CER activity is reported. Alkali etching can bring defects in zeolite with a hollow structure. In a hard template strategy, the type of carbon defects is directly related to etching degree of the zeolite template. More importantly, the oxygen atoms can be "borrowed" from the zeolite framework by the defective carbon. The electron density around unsaturated O atoms can be decreased on the minor defects in carbon compared with that on large defects which is favorable for the adsorption of Cl- . Consequently, the as-synthesized HPC nanocages with minor defects show excellent electrocatalytic performance for CER with a low overpotential of 94 mV at current density of 10 mA cm-2 with good stability, which is superior to the commercial precious metal catalyst of dimensionally stable anode (DSA), and the best in the reported carbon materials. The designed carbon materials provide an option for metal-free industrial catalysts with significant CER activities.
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Cloro , Zeolitas , Porosidade , Carbono , Cloretos , OxigênioRESUMO
A highly efficient catalyst for Li-O2 batteries based on Ru and MnFe phosphides nanoparticles entrapped in a MnFe Prussian blue analogue (PBA) substrate (Ru-MnFeP/PBA) was explored. Synergy between homogeneous Ru and MnFe phosphides nanoparticles improved the catalytic activity and alleviated side reactions. The Li-O2 battery based on Ru-MnFeP/PBA exhibited excellent performance.
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Fontes de Energia Elétrica , Ferrocianetos , Eletrodos , Íons , LítioRESUMO
Cotton maps (10 m) of Xinjiang (XJ_COTTON10), which is the largest cotton production region of China, were produced from 2018 to 2021 through supervised classification. A two-step mapping strategy, i.e., cropland mapping followed by cotton extraction, was employed to improve the accuracy and efficiency of cotton mapping for a large region of about 1.66 million km2 with high heterogeneity. Additionally, the time-series satellite data related to spectral, textural, structural, and phenological features were combined and used in a supervised random forest classifier. The cotton/non-cotton classification model achieved overall accuracies of about 95% and 90% on the test samples of the same and adjacent years, respectively. The proposed two-step cotton mapping strategy proved promising and effective in producing multi-year and consistent cotton maps. XJ_COTTON10 agreed well with the statistical areas of cotton at the county level (R2 = 0.84-0.94). This is the first cotton mapping for the entire Xinjiang at 10-meter resolution, which can provide a basis for high-precision cotton monitoring and policymaking in China.
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Low-cost non-noble metal nanoparticles are promising electrocatalysts that can catalyze oxygen evolution reaction (OER). Various factors such as poor activity and stability hinder the practical applications of these materials. The electroactivity and durability of the electrocatalysts can be improved by optimizing the morphology and composition of the materials. Herein, we report the successful synthesis of hollow porous carbon (HPC) catalysts loaded with ternary alloy (FeCoNi) nanoparticles (HPC-FeCoNi) for efficient OER. HPC is firstly synthesized by a facile carbon deposition method using the hierarchical porous zeolite ZSM-5 as the hard template. Numerous defects are generated on the carbon shell during the removal of zeolite template. Subsequently, FeCoNi alloy nanoparticles are supported on HPC by a sequence of impregnation and H2 reduction processes. The synergistic effect between carbon defects and FeCoNi alloy nanoparticles endows the catalyst with an excellent OER performance (low overpotential of 219 mV; Tafel slope of 60.1 mV dec-1) in a solution of KOH (1 M). A stable potential is maintained during the continuous operation over 72 h. The designed HPC-FeCoNi presents a platform for the development of electrocatalysts that can be potentially applied for industrial OER.
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Yield monitoring is an important parameter to evaluate cotton productivity during cotton harvest. Nondestructive and accurate yield monitoring is of great significance to cotton production. Unmanned aerial vehicle (UAV) remote sensing has fast and repetitive acquisition ability. The visible vegetation indices has the advantages of low cost, small amount of calculation and high resolution. The combination of the UAV and visible vegetation indices has been more and more applied to crop yield monitoring. However, there are some shortcomings in estimating cotton yield based on visible vegetation indices only as the similarity between cotton and mulch film makes it difficult to differentiate them and yields may be saturated based on vegetation index estimates near harvest. Texture feature is another important remote sensing information that can provide geometric information of ground objects and enlarge the spatial information identification based on original image brightness. In this study, RGB images of cotton canopy were acquired by UAV carrying RGB sensors before cotton harvest. The visible vegetation indices and texture features were extracted from RGB images for cotton yield monitoring. Feature parameters were selected in different methods after extracting the information. Linear and nonlinear methods were used to build cotton yield monitoring models based on visible vegetation indices, texture features and their combinations. The results show that (1) vegetation indices and texture features extracted from the ultra-high-resolution RGB images obtained by UAVs were significantly correlated with the cotton yield; (2) The best model was that combined with vegetation indices and texture characteristics RF_ELM model, verification set R 2 was 0.9109, and RMSE was 0.91277 t.ha-1. rRMSE was 29.34%. In conclusion, the research results prove that UAV carrying RGB sensor has a certain potential in cotton yield monitoring, which can provide theoretical basis and technical support for field cotton production evaluation.
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Background: Uneven distribution of health resources is higher in Tibet than in other regions. The development of core professional capability for general practitioners (GPs) is the main goal of continuing medical education (CME) training programs. Aim: This study aimed to explore the needs of CME for GPs and provide advice for the development of policy, practice, and CME curriculums. Methods: We conducted a cross-sectional online survey among GPs in Tibet Autonomous Region, China. We designed an online questionnaire including the demographic section, training contents, and training formats about CME. Results: A total of 108 questionnaires were included in this study. Notably, 79 (73.15%) were women and 56 participants (51.85%) were working in primary care settings. We developed a curriculum priority: first-choice, major alternatives, and secondary considerations. The topics identified as first-choice for CME were related to "cardiovascular disease" (85.19%), "respiratory disease" (81.48%), and "digestive disease" (80.56%). Major alternatives included two essential knowledge and eight clinical skill items. We rated 10 items as secondary considerations. Only 39.81% ranked mental health as an essential priority; bedside teaching (51.85%) was the first choice. Conclusion: We presented priority areas identified in this study to focus on CME for GPs in Tibet. The 23 topics may reflect the features of general practice, which increasingly require common disease management skills, while a demand-oriented curriculum and staged training plans should be adopted. CME programs should be adapted dynamically to respond to evolving needs.
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Clínicos Gerais , Feminino , Humanos , Masculino , Clínicos Gerais/educação , Educação Médica Continuada , Estudos Transversais , Tibet , Currículo , ChinaRESUMO
NC@Co-HPNC is synthesized, which exhibits a superior ORR/OER performance in acid/base solution. Hence, acid-base dual-electrolyte-based Zn-air batteries using NC@Co-HPNC reveal a long cycling life and a super-high voltage (2.1 V).
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Tuning the structural features that furnish electrochemically active sites with improved kinetic diffusion can provide an alternative way to achieve high performance of electrocatalysis. Here, we report a nano-structure of Ni2P/C(NPC) nano-sheets supported on nickel foam (NF) that is prepared by sequenced nitrogen pyrolysis and gas phosphatization of Ni-MOF nanosheets. Initially, the passivated surface of nickel foam facilitates the oriented growth of Ni-MOF nanosheets, which is crucial for the maintenance of structure stability during the subsequent pyrolysis and phosphatization treatment. As a result, more catalytic active sites are exposed than the non-oriented NPC catalysts and diffusion kinetics is favorable. Consequently, the obtained composite can exhibit excellent hydrogen evolution catalytic activity in an alkaline electrolyte. For hydrogen evolution reaction, a current density of 10 mA cm-2 is provided at an overpotential of 97 mV and its onset overpotential is only 29 mV. Meanwhile, good morphology and catalytic activity can be maintained after 12 h of stability testing. This excellent performance is believed to be the result of NPC nanosheet structure on NF derived from the facet-oriented control of pristine Ni-MOF, enabling excellent reaction kinetics.
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Li-based reduced (r)GO-Ni (Li/rGO-Ni) was prepared by a thermal-infusion method. Li/rGO-Ni based symmetric cells have high cycling stability and small voltage hysteresis at various current densities. Furthermore, the Li/rGO-Ni based Li-O2 batteries exhibit good performances.