Job satisfaction and turnover of the first group of rural-oriented tuition-waived medical students in Guangxi, China: a mixed-method study.

BACKGROUND: In 2010, China launched a rural-oriented tuition-waived medical education (RTME) programme to train more general practitioners (GPs) to meet the needs of the rural health workforce. Motivating and maintaining GPs is an important consideration for the shortage in the rural health workforce. This study aimed to investigate job satisfaction and turnover among the first group of rural-oriented tuition-waived medical students (RTMSs) who had completed a three-year compulsory service in Guangxi, as well as the factors affecting RTMSs turnover. METHODS: This study adopted a mixed-method approach. A quantitative survey of 129 RTMSs was analysed (81.6% response rate), and qualitative interviews were conducted with 30 stakeholders, including 18 RTMSs, six administrators of the County Health Bureau, and six administrators of township health centers (THCs). A t-test, chi-square test, Fisher's exact test, and logistic regression analysis were used to examine the quantitative data, and thematic analysis was used to analyse the qualitative data. RESULTS: Among the 129 participants, the turnover rate was high, with 103 RTMSs reporting turnover (79.84%). Interpersonal relationships scored the highest in job satisfaction (3.63 ± 0.64) among RTMSs, while working conditions were rated the lowest (2.61 ± 0.85). Marital status (odds ratio [OR] = 0.236, 95% confidence interval [95%CI] = 0.059-0.953, P = 0.043), only child status (OR = 8.660, 95%CI = 1.714-43.762, P = 0.009), and job return satisfaction (OR = 0.290, 95%CI = 0.090-0.942, P = 0.039) were significantly associated with turnover. Univariate analyses showed that income had a significant influence on turnover, but the relationship gone by multivariable; however it was deemed important in the qualitative study. Qualitative analysis revealed that turnover was influenced by the working atmosphere, effort-reward imbalance, professional competence, and opportunities for training and promotion. CONCLUSIONS: This study provides insights for the policymakers about the priority areas for retaining GPs in rural locations and provides reference values for the retention of GPs in other regions with a shortage of rural health workers. For RTMSs to continue providing services to rural areas, the government should improve their salaries, balance their income and workload, provide more opportunities for training and career promotion, and managers should recognise their efforts and create an optimistic working atmosphere.

Effect of Hollow 304 Stainless Steel Fiber on Corrosion Resistance and Mechanical Properties of Ultra-High Performance Concrete (UHPC).

This study investigated the effect of hollow 304 stainless-steel fiber on the corrosion resistance and mechanical properties of ultra-high-performance concrete (UHPC), and prepared copper-coated-fiber-reinforced UHPC as the control group. The electrochemical performance of the prepared UHPC was compared with the results of X-ray computed tomography (X-CT). The results reveal that cavitation can improve the distribution of steel fibers in the UHPC. Compared with solid steel fibers, the compressive strength of UHPC with hollow stainless-steel fibers did not exhibit significant change, but the maximum flexural strength increased by 45.2% (2 vol% content, length-diameter ratio of 60). Hollow stainless-steel fiber could better improve the durability of UHPC compared with copper-plated steel fiber, and the gap between the two continued to increase as the durability test progressed. After the dry-wet cycle test, the flexural strength of the copper-coated-fiber-reinforced UHPC was 26 MPa, marking a decrease of 21.9%, while the flexural strength of the UHPC mixed with hollow stainless-steel fibers was 40.1 MPa, marking a decrease of only 5.6%. When the salt spray test had run for seven days, the difference in the flexural strength between the two was 18.4%, but when the test ended (180 days), the difference increased to 34%. The electrochemical performance of the hollow stainless-steel fiber improved, owing to the small carrying capacity of the hollow structure, and more uniform distribution in the UHPC and lower interconnection probability were achieved. According to the AC impedance test results, the charge transfer impedance of the UHPC doped with solid steel fiber is 5.8 KΩ, while that of the UHPC doped with hollow stainless-steel fiber is 8.8 KΩ.

Structural Electromagnetic Absorber Based on MoS2 /PyC-Al2 O3 Ceramic Metamaterials.

Limited by the types of suitable absorbents as well as the challenges in engineering the nanostructures (e.g., defects, dipoles, and hetero-interface) using state-of-the-art additive manufacturing (AM) techniques, the electromagnetic (EM) wave absorption performance of the current ceramic-based materials is still not satisfying. Moreover, because of the high residual porosity and the possible formation of cracks during sintering or pyrolysis, AM-formed ceramic components may in many cases exhibit low mechanical strength. In this work, semiconductive MoS2 and conductive PyC modified Al2 O3 (MoS2 /PyC-Al2 O3 ) ceramic-based structural EM metamaterials are developed by innovatively harnessing AM, precursor infiltration and pyrolysis (PIP), and hydrothermal methods. Three different meta-structures are successfully created, and the ceramic-based nanocomposite benefit from its optimization of EM parameters. Ultra-broad effective absorption bandwidth (EAB) of 35 GHz is achieved by establishment of multi-loss mechanism via nanostructure engineering and fabrication of meta-structures via AM. Due to the strengthening by the PyC phase, the bending strength of the resulting ceramics can reach ≈327 MPa, which is the highest value measured on 3D-printed ceramics of this type that has been reported so far. For the first time, the positive effect deriving from the engineering of the microscopic nano/microstructure and of the macroscopic meta-structure of the absorber on the permittivity and EM absorption performance is proposed. Integration of outstanding mechanical strength and ultra-broad EAB is innovatively realized through a multi-scale design route. This work provides new insights for the design of advanced ceramic-based metamaterials with outstanding performance under extreme environment.

Polymer-derived SiOC reinforced with core-shell nanophase structure of ZrB2/ZrO2 for excellent and stable high-temperature microwave absorption (up to 900 °C).

Microwave absorbing materials for high-temperature harsh environments are highly desirable for aerodynamically heated parts and engine combustion induced hot spots of aircrafts. This study reports ceramic composites with excellent and stable high-temperature microwave absorption in air, which are made of polymer-derived SiOC reinforced with core-shell nanophase structure of ZrB2/ZrO2. The fabricated ceramic composites have a crystallized t-ZrO2 interface between ZrB2 and SiOC domains. The ceramic composites exhibit stable dielectric properties, which are relatively insensitive to temperature change from room temperature to 900 °C. The return loss exceeds - 10 dB, especially between 28 and 40 GHz, at the elevated temperatures. The stable high-temperature electromagnetic (EM) absorption properties are attributed to the stable dielectric and electrical properties induced by the core-shell nanophase structure of ZrB2/ZrO2. Crystallized t-ZrO2 serve as nanoscale dielectric interfaces between ZrB2 and SiOC, which are favorable for EM wave introduction for enhancing polarization loss and absorption. Existence of t-ZrO2 interface also changes the temperature-dependent DC conductivity of ZrB2/SiOC ceramic composites when compared to that of ZrB2 and SiOC alone. Experimental results from thermomechanical, jet flow, thermal shock, and water vapor tests demonstrate that the developed ceramic composites have high stability in harsh environments, and can be used as high-temperature wide-band microwave absorbing structural materials.

Highly electromagnetic transparent ceramic composite made of boron nitride nanotubes and silicon oxynitride via perhydropolysilazane infiltration method.

With the rapid development of electromagnetic (EM) wave circuit devices, high-performance wave-transparent materials with various functions have attracted great attention. Ceramic material is a promising candidate to be applied in harsh environments because of its chemical and corrosion resistance. In this work, a polymer-derived route was adopted to synthesize ceramic composite at room temperature. The composite is made of perhydropolysilazane-derived SiON ceramic and reinforced with boron nitride nanotubes (BNNTs) sheets. With the addition of SiON ceramic materials, the resultant sample showed an excellent hydrophobicity with a contact angle of 135-146.9°. More importantly, superior thermal stability at 1600 °C in the oxygen-containing atmosphere was observed for the fabricated SiON/BNNTs sample, without any shape change. The electromagnetic transparency of the SiON/BNNTs was studied through the waveguide method. The prepared SiON/BNNTs sample has an average real permittivity between 1.52 and 1.55 and an average loss tangent value in the range of 0.0074-0.0266, at the frequency range of 26.5-40 GHz. The effect of thickness on the wave transparency of SiON/BNNTs samples is also discussed. To summarize the aforementioned superior characterization and measurement results, the presented SiON/BNNTs material system has a great potential to be used as EM transparent materials in harsh conditions.

Does Public Health Influence Economic Performance? Investigating the Role of Governance and Greener Energies for the Case of China.

In the last few decades, the world has faced some natural issues, due to which economic growth faces a severe threat. Natural disasters like pandemic outbreaks and man-made disasters like pollution emissions are very frequent in the current times, which also influenced the economic growth, where the institutes could play a primary role in economic growth stimulation. This study aims to analyze the association of public health expenditures, institutional quality, renewable energy, and economic performance in China. This study uses quarterly data covering the period from 1996Q1 to 2020Q4 and employs various time-series estimating approaches. The Augmented Dickey-Fuller estimates asserted that all the variables are stationary at first difference. Also, the Bayer-Hanck combined cointegration validates that all the variables are cointegrated. Employing the three long-run estimators, i.e., Fully Modified Ordinary Least Square, Dynamic Ordinary Least Square, and canonical cointegrating regression, the results asserted public health expenditures and institutional quality (including government efficiency and political stability) significantly enhances economic performance in China. Whereas two indicators of corruption control and regulatory quality do not play any significant role in promoting the economic performance of China. On the contrary, renewable energy is found negatively associated with economic performance. Also, the Pair-wise Granger causality validates mixed causal associations between the study variables. As a developing and fossil energy-dependent economy, this study provides relevant policy implications for maintaining economic growth and rebalancing economic performance in China.

Temperature and Pressure Wireless Ceramic Sensor (Distance = 0.5 Meter) for Extreme Environment Applications.

This paper presents a design for temperature and pressure wireless sensors made of polymer-derived ceramics for extreme environment applications. The wireless sensors were designed and fabricated with conductive carbon paste on an 18.24 mm diameter with 2.4 mm thickness polymer-derived ceramic silicon carbon nitride (PDC-SiCN) disk substrate for the temperature sensor and an 18 × 18 × 2.6 mm silicon carbide ceramic substrate for the pressure sensor. In the experiment, a horn antenna interrogated the patch antenna sensor on a standard muffle furnace and a Shimadzu AGS-J universal test machine (UTM) at a wireless sensing distance of 0.5 m. The monotonic relationship between the dielectric constant of the ceramic substrate and ambient temperature is the fundamental principle for wireless temperature sensing. The temperature measurement has been demonstrated from 600 °C to 900 °C. The result closely matches the thermocouple measurement with a mean absolute difference of 2.63 °C. For the pressure sensor, the patch antenna was designed to resonate at 4.7 GHz at the no-loading case. The sensing mechanism is based on the piezo-dielectric property of the silicon carbon nitride. The developed temperature/pressure sensing system provides a feasible solution for wireless measurement for extreme environment applications.

Multifunctional Ceramic Composite System for Simultaneous Thermal Protection and Electromagnetic Interference Shielding for Carbon Fiber-Reinforced Polymer Composites.

Achieving a high electrical conductivity while maintaining a good thermal insulation is often contradictory in the material design for the goal of simultaneous thermal protection and electromagnetic interference shielding. The reason is that materials with a high electrical conductivity often pertain a high thermal conductivity. To address this challenge, this study reports a multifunctional ceramic composite system for carbon fiber-reinforced polymer composites. The fabricated multifunctional ceramic composite system has a multilayer structure. The polymer-derived SiCN ceramic reinforced with yttria-stabilized zirconia fibers serves as the thermal protection and impedance-matching layer, while the yttria-stabilized zirconia fiber-reinforced SiCN ceramic with carbon nanotubes provides the electromagnetic interference shielding. The thermal conductance of the multilayered ceramic composite is about 22.5% lower compared to that of the carbon fiber-reinforced polymer composites. The thermal insulation test during the steady-state condition shows that the hybrid composite can be used up to 300 °C while keeping the temperature reaching the surface of carbon fiber-reinforced polymer composites at around 167.8 °C. The flame test was used to characterize the thermal protection capability under transient conditions. The hybrid composite showed temperature differences of 72.9 and 280.7 °C during the low- and high-temperature settings, respectively. The average total shielding efficiency per thickness of the fabricated four-layered ceramic composite system was 21.45 dB/mm, which showed a high reflection-dominant electromagnetic interference shielding. The average total shielding efficiency per thickness of the eight-layered composite system was 16.57 dB/mm, revealing a high absorption-dominant electromagnetic interference shielding. Typical carbon fiber-reinforced polymer composites reveal a reflection-dominant electromagnetic interference shielding. The electrons can freely move in the percolated carbon nanotubes within the inner layers of the composite material, which provide the improved electromagnetic interference shielding ability. The movement of electrons was impeded by the top and bottom layers whose thermal conduction relies on the lattice vibrations, resulting in a satisfactory thermal insulation of the composite materials and impedance matching with the free space. Results of this study showed that materials with a good thermal insulation and electromagnetic interference shielding can be obtained simultaneously by confining the electron movement inside the materials and refraining their movement at the skin surface.

Ultrahigh-Temperature Ceramic-Polymer-Derived SiOC Ceramic Composites for High-Performance Electromagnetic Interference Shielding.

High-performance electromagnetic interference (EMI) shielding materials for a high-temperature harsh environment are highly required for electronics and aerospace applications. Here, a composite made of ultrahigh-temperature ceramic- and polymer-derived SiOC ceramic (PDC-SiOC) with high EMI shielding was reported for such applications. A total EMI shielding efficiency (SET) of 26.67 dB with a thickness of 0.6 mm at the Ka-band (26.5-40 GHz) was reported for ZrB2 fabricated by spark plasma sintering, which showed reflection-dominant shielding. A unique interface of t-ZrO2 was formed after the introduction of PDC-SiOC into ZrB2. This interface has better electrical conductivity than SiOC. The composites also displayed reflection-dominant shielding. Accordingly, the composite with a normalized ZrB2 fraction of 50% pyrolyzed at 1000 °C exhibited a significant SET of 72 dB (over 99.99999% shielded) with a thickness of 3 mm at the entire Ka-band. A maximum SET of 90.8 dB (over 99.9999999% shielded) was achieved with a thickness of 3 mm at around 39.7 GHz.

Wide-Band Tunable Microwave-Absorbing Ceramic Composites Made of Polymer-Derived SiOC Ceramic and in Situ Partially Surface-Oxidized Ultra-High-Temperature Ceramics.

Microwave-absorbing materials in a high-temperature harsh environment are highly desired for electronics and aerospace applications. This study reports a novel high-temperature microwave-absorbing ceramic composites made of polymer-derived SiOC ceramic and in situ partially surface-oxidized ultra-high-temperature ceramic (UHTC) ZrB2 nanoparticles. The fabricated composites with a normalized weight fraction of ZrB2 nanoparticles at 40% has a significantly wide microwave absorption bandwidth of 13.5 GHz (26.5-40 GHz) covering the entire Ka-band. This is attributed to the extensive nanointerfaces introduced in the composites, attenuation induced by the interference of electromagnetic wave, attenuation from the formed current loops, and the electronic conduction loss provided by the partially surface-oxidized ZrB2 nanoparticles. The minimum reflection coefficient (RC) was -29.30 dB at 29.47 GHz for a thickness of 1.26 mm for the composites with a normalized weight fraction of ZrB2 nanoparticles at 32.5%. The direct current (dc) conductivity of the nanocomposites showed a clear percolation phenomenon as the normalized weight fraction of ZrB2 nanoparticles increases to 30.49%. The results provide new insights in designing microwave-absorbing materials with a wide absorption frequency range and strong absorption loss for high-temperature harsh environment applications.

Fully Printed Halide Perovskite Light-Emitting Diodes with Silver Nanowire Electrodes.

Printed organometal halide perovskite light-emitting diodes (LEDs) are reported that have indium tin oxide (ITO) or carbon nanotubes (CNTs) as the transparent anode, a printed composite film consisting of methylammonium lead tribromide (Br-Pero) and poly(ethylene oxide) (PEO) as the emissive layer, and printed silver nanowires as the cathode. The fabrication can be carried out in ambient air without humidity control. The devices on ITO/glass have a low turn-on voltage of 2.6 V, a maximum luminance intensity of 21014 cd m(-2), and a maximum external quantum efficiency (EQE) of 1.1%, surpassing previous reported perovskite LEDs. The devices on CNTs/polymer were able to be strained to 5 mm radius of curvature without affecting device properties.

Polymer-derived ceramic composite fibers with aligned pristine multiwalled carbon nanotubes.

Polymer-derived ceramic fibers with aligned multiwalled carbon nanotubes (MWCNTs) are fabricated through the electrospinning of polyaluminasilazane solutions with well-dispersed MWCNTs followed by pyrolysis. Poly(3-hexylthiophene)-b-poly (poly (ethylene glycol) methyl ether acrylate) (P3HT-b-PPEGA), a conjugated block copolymer compatible with polyaluminasilazane, is used to functionalize MWCNT surfaces with PPEGA, providing a noninvasive approach to disperse carbon nanotubes in polyaluminasilazane chloroform solutions. The electrospinning of the MWCNT/polyaluminasilazane solutions generates polymer fibers with aligned MWCNTs where MWCNTs are oriented along the electrospun jet by a sink flow. The subsequent pyrolysis of the obtained composite fibers produces ceramic fibers with aligned MWCNTs. The study of the effect of polymer and CNT concentration on the fiber structures shows that the fiber size increases with the increment of polymer concentration, whereas higher CNT content in the polymer solutions leads to thinner fibers attributable to the increased conductivity. Both the SEM and TEM characterization of the polymer and ceramic fibers demonstrates the uniform orientation of CNTs along the fibers, suggesting excellent dispersion of CNTs and efficient CNT alignment via the electrospinning. The electrical conductivity of a ceramic fibers with 1.2% aligned MWCNTs is measured to be 1.58 x 10(-6) S/cm, which is more than 500 times higher than that of bulk ceramic (3.43 x 10(-9) S/cm). Such an approach provides a versatile method to disperse CNTs in preceramic polymer solutions and offers a new approach to integrate aligned CNTs in ceramics.