PBL和LBL结合实际病例教学方法对临床麻醉教学效果影响评价

探讨结合PBL模式、LBL模式进行临床麻醉的实际病例教学的效果。方法 由麻醉科择取50名实习学生进行分组,采取PBL模式、LBL模式进行临床麻醉的实际病例教学(研究组)、常规教学模式(对照组)。结果 教学效果指标以及教学后自主学习能力分值的对比上,研究组更高,P<0.05;而教学前自主学习能力分值的两组数据对比结果是P>0.05。结论 结合PBL模式、LBL模式进行临床麻醉的实际病例教学,有助于实习学生教学效果获得大幅度增加。

在临床输血实习带教中应用PBL、LBL教学模式的效果分析

探究临床输血实习带教期间运用PBL、LBL教学模式的效果。方法 于2021年1月-2022年1月抽取200名临床输血实习生按照随机数字表法分为参考组及实验组,每组100名,其中前者行LBL,后者行PBL。对两组教学效果进行评价。结果 实验组理论、操作考试成绩显高于参考组(P<0.05)。实验组实践反馈情况显优于参考组(P<0.05)。实验组教学满意度显高于参考组(P<0.05)。结论 将PBL教学法应用在临床输血实习中能够较好地提高实习生理论和操作考试的成绩,增强实习的实际操作能力,从而使实习生对教学工作的满意程度得到提高。

LBL/CBL/PBL交叉教学法用于我院临床药师培训的探索

目的探索临床药师培训的新方法,为提高临床药学带教水平提供参考。方法在理论学习和临床实践中,将传统教学法(LBL)与病例导向(CBL)、问题导向(PBL)教学方法交叉结合应用于临床药师培训基地学员的培养。将临床药师分为参照组和研究组。参照组全程以LBL理论为主。研究组为LBL/CBL/PBL交叉教学组,该组分阶段培训:理论知识第一阶段灌输以LBL法为主;第二和第三阶段的培训以CBL/PBL法为主。临床实践阶段:第一阶段的药学问诊、药学监护、患者用药教育的教学以LBL法为主,交叉CBL/PBL法为辅;第二阶段,对患者治疗方案的制定以CBL/PBL法为主,在遇到新病例等特殊情况时辅以LBL法。结果研究组在理论考核、问诊考核和案例考核三个分数均高于参照组,分数提高率分别为2.8%、9.82%和7.79%(P<0.05)。在带教老师打分和学员单位主任评分中,研究组得分也同样高于参照组,提高率分别为6.16%和10.97%(P<0.05)。结论LBL/CBL/PBL交叉教学法与单纯地使用其中一种教学方法相比,具有更好的教学效果,可以使临床药师学员成长为一名具备独立工作能力的专科临床药师,避免出现理论知识扎实而解决问题能力不足的情况。

Layered Structural PBAT Composite Foams for Efficient Electromagnetic Interference Shielding

The utilization of eco-friendly,lightweight,high-efficiency and high-absorbing electromagnetic interference(EMI)shielding composites is imperative in light of the worldwide promotion of sustainable manufacturing.In this work,magnetic poly(butyleneadipate-coterephthalate)(PBAT)microspheres were firstly synthesized via phase separation method,then PBAT composite foams with layered structure was constructed through the supercritical carbon dioxide foaming and scraping techniques.The merits of integrating ferroferric oxideloaded multi-walled carbon nanotubes(Fe3O4@MWCNTs)nanoparticles,a microcellular framework,and a highly conductive silver layer have been judiciously orchestrated within this distinctive layered configuration.Microwaves are consumed throughout the process of“absorption-reflection-reabsorption”as much as possible,which greatly declines the secondary radiation pollution.The biodegradable PBAT composite foams achieved an EMI shielding effectiveness of up to 68 dB and an absorptivity of 77%,and authenticated favorable stabilization after the tape adhesion experiment.

Pile foundation in alternate layered liquefiable and non-liquefiable soil deposits subjected to earthquake loading

Pile foundations are still the preferred foundation system for high-rise structures in earthquake-prone regions.Pile foundations have experienced failures in past earthquakes due to liquefaction.Research on pile foundations in liquefiable soils has primarily focused on the pile foundation behavior in two or three-layered soil profiles.However,in natural occurrence,it may occur in alternative layers of liquefiable and non-liquefiable soil.However,the experimental and/or numerical studies on the layered effect on pile foundations have not been widely addressed in the literature.Most of the design codes across the world do not explicitly mention the effect of sandwiched non-liquefiable soil layers on the pile response.In the present study,the behavior of an end-bearing pile in layered liquefiable and non-liquefiable soil deposit is studied numerically.This study found that the kinematic bending moment is higher and governs the design when the effect of the sandwiched non-liquefied layer is considered in the analysis as opposed to when its effect is ignored.Therefore,ignoring the effect of the sandwiched non-liquefied layer in a liquefiable soil deposit might be a nonconservative design approach.

PACS联合LBL与CBL教学法在医学影像学教学中的应用

目的:分析PACS联合LBL与CBL教学法在医学影像学教学中的应用价值。方法:以100名2019年12月至2021年3月于我院影像科实习的医学影像学专业本科生为研究对象,对照组接受传统教学法,试验组接受PACS联合LBL与CBL教学法,观察两组实习结束后的考试成绩、教学效果及满意率。结果:实习结束后,试验组自学及独立思考能力、对理论知识的理解能力、读片能力评分以及实践技能、报告书写、综合阅片成绩高于对照组,差异有统计学意义(P<0.05)。试验组满意率高于对照组,差异有统计学意义(P<0.05)。结论:相较于传统教学法,PACS联合LBL与CBL教学法可提高医学影像学专业本科生考试成绩及教学效果,学生满意率更高。

微信结合LBL、CBL教学法在医学影像临床教学中的应用价值探讨

目的:探讨微信结合LBL、CBL教学法在医学影像临床教学中的应用价值。方法:以笔者所在医院放射科本科实习生、住院医师规范化学员、进修生为研究对象,对学生随机分组,对照组(n=60)采用LBL、CBL教学法,试验组(n=60)采用微信结合LBL、CBL教学法,对两种教学方法进行比较分析。结果:试验组出科考试成绩中病例分析得分高于对照组(P<0.05);问卷调查中试验组学习兴趣满意度、教学互动满意度、教学效果满意度评分均高于对照组(P<0.05)。结论:微信结合LBL、CBL教学法不仅可以提高学生的医学影像临床思维能力,而且可以提高学生自主学习能力。

LBL+PBL+CBL三轨教学法用于传统康复方法学的探讨

三轨教学法“LBL+PBL+CBL”是一种具有授课导向、问题导向、案例导向的融合式教学法。在传统康复方法学的教学中,应用三轨教学法,将理论与实践相结合,提出问题,模拟情景,激发学生思考,并且通过授课、问题和案例驱动,引导学生独立学习以及对案例进行分析讨论,主动回答临床问题,最终构建课程体系。文章采用三轨教学法,在传统康复方法学课程中进行创新教学,并对这种教学模式的效果进行了调查和分析。实践证明,三轨融合式教学方法在提高学生的信息收集和应用能力、任务组团队合作的有效性、独立思考能力等方面具有显著优势,在康复方法学本科教学中具有较好的可行性。

Interception of Layered LP-N and HLP-N at Ambient Conditions by Confined Template

We propose a feasible strategy of intercepting the layered polymeric nitrogen(LP-N)and hexagonal layered polymeric nitrogen(HLP-N)at ambient conditions by using the confinement templates.The stable mechanism of confined LP-N and HLP-N at ambient conditions is revealed.

Impact of Dietary Lactobacillus plantarum Postbiotics on the Performance of Layer Hens under Heat Stress Conditions

This experiment was conducted to determine the performance of heat-stressed layers fed a diet containing the probiotic Lactobacillus plantarum RS5 or its products of fermentation (postbiotics). Twenty-week-old Isa White layers, were subdivided into six treatments of 32 individually caged birds. Half of the birds were reared under regular temperature conditions, while the other half was subjected to cyclic daily heat stress. Layers were offered one of three diets: 1) Control;2) Control + Lactobacillus plantarum RS5 probiotic;3) Control + Lactobacillus plantarum RS5 postbiotics. Birds were tested for performance and visceral organ development for 5 months. Heat stress negatively affected the birds’ feed intake, egg weight, shell weight percentage, Haugh unit, shell thickness, yolk color, body weight and spleen weight percentage. Postbiotics significantly increased egg production (p < 0.05) in comparison to the control and the probiotic fed group (94.8% vs 92.6% vs 93.1%, respectively). Birds under probiotic or postbiotic diet showed a significantly higher (p < 0.05) feed intake and egg weight, although the probiotic had a more pronounced and gradual effect. Specific gravity, yolk weight percentage and shell thickness didn’t show differences among dietary groups. The Haugh Unit was significantly higher (p < 0.05) in probiotic group which also showed a significantly lower yolk color index (p < 0.05). The different feed treatments did not impact the bird’s viscera weight percentage, except for the ileum that was significantly lower (p < 0.05) under postbiotic supplementation. Both probiotics and postbiotics could be used as a potential growth promoters and might alleviate heat stress impact in poultry industry.

Values of macular ganglion cell-inner plexiform layer and 10-2 visual field measurements in detecting and evaluating glaucoma

AIM:To assess the performance of macular ganglion cell-inner plexiform layer thickness(mGCIPLT)and 10-2 visual field(VF)parameters in detecting early glaucoma and evaluating the severity of advanced glaucoma.METHODS:Totally 127 eyes from 89 participants(36 eyes of 19 healthy participants,45 eyes of 31 early glaucoma patients and 46 eyes of 39 advanced glaucoma patients)were included.The relationships between the optical coherence tomography(OCT)-derived parameters and VF sensitivity were determined.Patients with early glaucoma were divided into eyes with or without central 10°of the VF damages(CVFDs),and the diagnostic performances of OCT-derived parameters were assessed.RESULTS:In early glaucoma,the mGCIPLT was significantly correlated with 10-2 VF pattern standard deviation(PSD;with average mGCIPLT:β=-0.046,95%CI,-0.067 to-0.024,P<0.001).In advanced glaucoma,the mGCIPLT was related to the 24-2 VF mean deviation(MD;with average mGCIPLT:β=0.397,95%CI,0.199 to 0.595,P<0.001),10-2 VF MD(with average mGCIPLT:β=0.762,95%CI,0.485 to 1.038,P<0.001)and 24-2 VF PSD(with average mGCIPLT:β=0.244,95%CI,0.124 to 0.364,P<0.001).Except for the minimum and superotemporal mGCIPLT,the decrease of mGCIPLT in early glaucomatous eyes with CVFDs was more severe than that of early glaucomatous eyes without CVFDs.The area under the curve(AUC)of the average mGCIPLT(AUC=0.949,95%CI,0.868 to 0.982)was greater than that of the average circumpapillary retinal nerve fiber layer thickness(cpRNFLT;AUC=0.827,95%CI,0.674 to 0.918)and rim area(AUC=0.799,95%CI,0.610 to 0.907)in early glaucomatous eyes with CVFDs versus normal eyes.CONCLUSION:The 10-2 VF and mGCIPLT parameters are complementary to 24-2 VF,cpRNFLT and ONH parameters,especially in detecting early glaucoma with CVFDs and evaluating the severity of advanced glaucoma in group level.

Anode surface engineering of zinc-ion batteries using tellurium nanobelt as a protective layer for enhancing energy storage performance

Over the years,zinc-ion batteries(ZIBs)have attracted attention as a promising next-generation energy storage technology because of their excellent safety,long cycling performance,eco-friendliness,and high-power density.However,issues,such as the corrosion and dissolution of the Zn anode,limited wet-tability,and lack of sufficient nucleation sites for Zn plating,have limited their practical application.The introduction of a protective layer comprising of tellurium(Te)nanobelts onto the surface of Zn anode has emerged as a promising approach to overcome these limitations and improve the electrochemical behav-ior by enhancing the safety and wettability of ZIBs,as well as providing numerous nucleation sites for Zn plating.In the presence of a Te-based protective layer,the energy power density of the surface-engineered Zn anode improved significantly(ranging from 310 to 144 W h kg^(-1),over a power density range of 270 to 1,800 W kg^(-1)),and the lifespan capability was extended.These results demonstrate that the proposed strategy of employing Te nanobelts as a protective layer holds great promise for enhancing the energy storage performance of zIBs,making them even more attractive as a viable energy storage solution forthefuture.

探讨LBL联合CBL教学法在神经外科住培教学中的作用

讨论在神经外科住培教学中,向学员实施LBL与CBL联合的教学方式,对提升教学成绩所产生的积极影响。方法 研究抽取参与神经外科住培的学员50名设置为本次教学对象,按照教学内容的差异性设置为观察组和对照组,分别对学员实施不同的教学内容。观察组内应用LBL联合CBL教学法,对照组内实施传统教学方式。对比两组学员的考试分值及教学满意度评分。结果 观察组学员的考试成绩分数高,学员对教学的满意度评分高,各项数据在对比后形成对比,P<0.05。结论 在神经外科住培的教学中,建议将LBL与CBL两种教学方式联合实施,保证临床带教质量,激发学员的自主学习兴趣,为今后的医学工作奠定良好的基础,值得推广。

Layered metastructure containing freely-designed local resonators for wave attenuation

Combining periodic layered structure with three-dimensional cylindrical local resonators,a hybrid metastructure with improved wave isolation ability was designed and investigated through theoretical and numerical approaches.The metastructure is composed of periodic rubber layers and concrete layers embedded with three-dimensional resonators,which can be freely designed with multi local resonant frequencies to attenuate vibrations at required frequencies and widen the attenuation bandgap.The metastructure can also effectively attenuate seismic responses.Compared with layered rubber-based structures,the metastructure has more excellent wave attenuation effects with greater attenuation and wider bandgap.

Phase engineering of Ni-Mn binary layered oxide cathodes for sodiumion batteries

Nickel-manganese binary layered oxides with high working potential and low cost are potential candidates for sodium-ion batteries,but their electrochemical properties are highly related to compositional diversity.Diverse composite materials with various phase structures of P3,P2/P3,P2,P2/O3,and P2/P3/O3 were synthesized by manipulating the sodium content and calcination conditions,leading to the construction of a synthetic phase diagram for Na_(x)Ni_(0.25)Mn_(0.75)O_(2)(0.45≤x≤1.1).Then,we compared the electrochemical characteristics and structural evolution during the desodiation/sodiation process of P2,P2/P3,P2/03,and P2/P3/O3-Na_(x)Ni_(0.25)Mn_(0.75)O_(2).Among them,P2/P3-Na0.75Ni0.25Mn0.75O2exhibits the best rate capability of 90.9 mA h g^(-1)at 5 C,with an initial discharge capacity of 142.62 mA h g^(-1)at 0.1 C and a capacity retention rate of 78.25%after 100 cycles at 1 C in the voltage range of 2-4.3 V.The observed superior sodium storage performance of P2/P3 hybrids compared to other composite phases can be attributed to the enhanced Na^(+)transfer dynamic,reduction of the Jahn-teller effect,and improved reaction reversibility induced by the synergistic effect of P2 and P3 phases.The systematic research and exploration of phases in Na_(x)Ni_(0.25)Mn_(0.75)O_(2)provide new sights into high-performance nickel-manganese binary layered oxide for sodium-ion batteries.

Sedimentary Environment and Mineralization of the Black Shale Polymetallic Layer in the Early Cambrian,SW China:Constraints from in situ LA-ICP-MS Analysis of Pyrite

A polymetallic layer is usually developed at the bottom of the early Cambrian black shale in Guizhou Province.The mineral that makes up the polymetallic layer is related to the sedimentary facies.To analyze the differentiation mechanism between polymetallic deposits(Ni-Mo and V),the Zhijin Gezhongwu profile located in the outer shelf and the Sansui Haishan V deposit located in the lower slope are selected to study the in situ sulfur isotopes and trace elements of pyrite.The results show that δ^(34)S values of pyrite vary widely from−7.8‰to 28‰in the Gezhongwu profile,while the δ^(34)S values are relatively uniform(from 27.8‰to 38.4‰)in the Haishan profile.The isotopic S composition is consistent with the transition that occurs in the sedimentary phase from the shelf to the deep sea on the transgressive Yangtze platform;this indicates that the δ^(34)SO_(4)^(2−)values in seawater must be differently distributed in depositional environments.The sulfur in the Ni-Mo layer is produced after the mixing of seawater and hydrothermal fluid,while the V layer mainly originates from seawater.Overall,the Ni-Mo and V deposits have been differentiated primarily on the basis of the combined effect of continental weathering and hydrothermal fluid.

Reversible Mn^(2+)/Mn^(4+)double-electron redox in P3-type layer-structured sodium-ion cathode

The balance between cationic redox and oxygen redox in layer-structured cathode materials is an important issue for sodium batteries to obtain high energy density and considerable cycle stability.Oxygen redox can contribute extra capacity to increase energy density,but results in lattice instability and capacity fading caused by lattice oxygen gliding and oxygen release.In this work,reversible Mn^(2+)/Mn^(4+)redox is realized in a P3-Na_(0.65)Li_(0.2)Co_(0.05)Mn_(0.75)O_(2)cathode material with high specific capacity and structure stability via Co substitution.The contribution of oxygen redox is suppressed significantly by reversible Mn^(2+)/Mn^(4+)redox without sacrificing capacity,thus reducing lattice oxygen release and improving the structure stability.Synchrotron X-ray techniques reveal that P3 phase is well maintained in a wide voltage window of 1.5-4.5 V vs.Na^(+)/Na even at 10 C and after long-term cycling.It is disclosed that charge compensation from Co/Mn-ions contributes to the voltage region below 4.2 V and O-ions contribute to the whole voltage range.The synergistic contributions of Mn^(2+)/Mn^(4+),Co^(2+)/Co^(3+),and O^(2-)/(O_n)^(2-)redox in P3-Na_(0.65)Li_(0.2)Co_(0.05)Mn_(0.75)O_(2)lead to a high reversible capacity of 215.0 m A h g^(-1)at 0.1 C with considerable cycle stability.The strategy opens up new opportunities for the design of high capacity cathode materials for rechargeable batteries.

Constructing Al@C-Sn pellet anode without passivation layer for lithium-ion battery

Al is considered as a promising lithium-ion battery(LIBs)anode materials owing to its high theoretical capacity and appropri-ate lithation/de-lithation potential.Unfortunately,its inevitable volume expansion causes the electrode structure instability,leading to poor cyclic stability.What’s worse,the natural Al2O3 layer on commercial Al pellets is always existed as a robust insulating barrier for elec-trons,which brings the voltage dip and results in low reversible capacity.Herein,this work synthesized core-shell Al@C-Sn pellets for LIBs by a plus-minus strategy.In this proposal,the natural Al2O3 passivation layer is eliminated when annealing the pre-introduced SnCl2,meanwhile,polydopamine-derived carbon is introduced as dual functional shell to liberate the fresh Al core from re-oxidization and alle-viate the volume swellings.Benefiting from the addition of C-Sn shell and the elimination of the Al2O3 passivation layer,the as-prepared Al@C-Sn pellet electrode exhibits little voltage dip and delivers a reversible capacity of 1018.7 mAh·g^(-1) at 0.1 A·g^(-1) and 295.0 mAh·g^(-1) at 2.0 A·g^(-1)(after 1000 cycles),respectively.Moreover,its diffusion-controlled capacity is muchly improved compared to those of its counterparts,confirming the well-designed nanostructure contributes to the rapid Li-ion diffusion and further enhances the lithium storage activity.

Investigation of anisotropic strength criteria for layered rock mass

Layered rock mass is a type of engineering rock mass with sound mechanical anisotropy,which is generally unfavorable to the stability of underground works.To investigate the strength anisotropy of layered rock,the Mohr-Coulomb and Hoek-Brown criteria are introduced to establish the two transverse isotropic strength criteria based on Jaeger's single weak plane theory and maximum axial strain theory,and parameter determination methods.Furthermore,the sensitivity of strength parameters(K 1,K 2,and K 3)that are used to characterize the anisotropy strength of non-sliding failure involved in the strength criteria and confining pressure are investigated.The results demonstrate that strength parameters K 1 and K 2 affect the strength of layered rock samples at all bedding angles except for the bedding angle of 90°and the angle range that can cause the shear sliding failure along the bedding plane.The strength of samples at any bedding angle decreases with increasing K 1,whereas the opposite is for K 2.Except for bedding angles of 0°and 90°and the bedding angle range that can cause the shear sliding along the bedding plane,K 3 has an impact on the strength of rock samples with other bedding angles that the specimens'strength increases with increase of K 3.In addition,the strength of the rock sample increases as confining pressure rises.Furthermore,the uniaxial and triaxial tests of chlorite schist samples were carried out to verify and evaluate the strength criteria proposed in the paper.It shows that the predicted strength is in good agreement with the experimental results.To test the applicability of the strength criterion,the strength data of several types of rock in the literature are compared.Finally,a comparison is made between the fitting effects of the two strength criteria and other available criteria for layered rocks.

Cationic ordering transition in oxygen-redox layered oxide cathodes

Understanding the structural origin of the competition between oxygen 2p and transition-metal 3d orbitals in oxygen-redox(OR)layered oxides is eminently desirable for exploring reversible and high-energy-density Li/Na-ion cathodes.Here,we reveal the correlation between cationic ordering transition and OR degradation in ribbon-ordered P3-Na_(0.6)Li_(0.2)Mn_(0.8)O_(2) via in situ structural analysis.Comparing two different voltage windows,the OR capacity can be improved approximately twofold when suppressing the in-plane cationic ordering transition.We find that the intralayer cationic migration is promoted by electrochemical reduction from Mn^(4+)to Jahn–Teller Mn^(3+)and the concomitant NaO_(6) stacking transformation from triangular prisms to octahedra,resulting in the loss of ribbon ordering and electrochemical decay.First-principles calculations reveal that Mn^(4+)/Mn^(3+)charge ordering and alignment of the degenerate eg orbital induce lattice-level collective Jahn–Teller distortion,which favors intralayer Mn-ion migration and thereby accelerates OR degradation.These findings unravel the relationship between in-plane cationic ordering and OR reversibility and highlight the importance of superstructure protection for the rational design of reversible OR-active layered oxide cathodes.