Wood waste-derived dual-mode materials paving the way for year-round energy saving in buildings.

In the face of the challenges posed by global warming, traditional methods of building heating and cooling contribute significantly to electricity and coal consumption, thereby emitting considerable amounts of greenhouse gases. Here, a dual-mode thermal management structural material is created by processing sustainable cellulose and lignin derived from wood waste into gels, followed by lamination. The cellulose surface of the material exhibits the ability to scatter solar radiation backward while emitting strongly in the mid-infrared wavelengths, whereas the lignin surface absorbs visible and near-infrared light, primarily releasing energy through non-radiative transitions. Consequently, the material can achieve sub-ambient radiative cooling of 6 °C and solar heating of 27.5 °C during the daytime by simply flipping its orientation. This pioneering material showcases the potential to significantly reduce cooling energy consumption by an average of 18% and heating energy consumption by 42%. Moreover, the integration of a thermal-electric generator within the dual-layer structure optimally utilizes the temperature differential between the two layers, converting it into electrical power. Notably, the dual-mode thermal management structural material exhibits impressive mechanical strength, boasting a flexural strength of 102 MPa, surpassing that of natural wood by over 4.8 times. With its dual-mode functionality and embedded thermal-electric generator, this material represents a crucial step towards achieving both thermal comfort and energy autonomy in sustainable building practices, thereby contributing to a more environmentally friendly and efficient future.

Trend Analysis of the Mortality Rates of the Top Three Causes of Death Among Chinese Residents from 2003 to 2019.

Objective: To delineate the mortality trends of malignant tumors, heart disease and cerebrovascular disease in China. Methods: The crude mortality from 2003 to 2019 was derived from the China Health Statistical Yearbook, and the mortality rates were analyzed through joinpoint regression supplemented by descriptive statistics and χ2 tests. Results: The fitting model of age-standardized mortality due to malignant tumors showed three joinpoints. The APCs from 2003 to 2005, 2005-2008, 2008-2012 and 2012-2019 were -11.00%, 9.63%, -4.67% and -1.40%, respectively, and the AAPC was -1.54%. The mortality rate of cerebrovascular disease consistently decreased (APC = AAPC = -0.98%). In the subgroup analyses, significant differences were observed between sexes and regions. The mortality rate of heart disease among rural females exhibited an upward trend (APC = AAPC = 2.33%). Older adults aged over 75 years had the highest mortality rates and the most drastic change. Conclusion: The three diseases had variable change trends. The government should focus more on policies that promote the equalization of basic public health services. Continuous education on heart disease, which includes not only beneficial behaviors but also knowledge of first aid, should be strengthened for rural females.

Developing an Integrated Evaluation Model for Physician Comprehensive Workload Tethered to Outpatient Practice: An Empirical Study From China.

Background: Previous studies, often simply using either objective workload or mental workload as a measure of physician workload in various healthcare settings might have failed to comprehensively reflect the real workload among physicians. Despite this, there is little research that further explores a comprehensive workload evaluation framework with the integration of objective workload and mental workload to describe their comprehensive workload. Methods: A comprehensive evaluation framework for physician workload was proposed based on the combination of objective workload and task-level mental workload also with the consideration of quality of provided medical services and served patient complexity; and accordingly, an integrated evaluation model for physician comprehensive workload (PCW) tethered to outpatient practice was developed and further applied to perform a PCW analysis using cross-sectional data on outpatient workload of 1,934 physicians mainly from 24 hospitals in 6 provinces in Eastern, Central, and Western China. Multiple linear regression and multinomial logistic regression analyses were established to identify significant factors influencing the PCW. Results: Overall, the average score of PCW tethered to outpatient practice Chinese physicians experienced was 811.30 (SD=494.98) with concentrating on between 200 and 1,200. Physicians who were female, from Eastern or Western China, and those who worked >60 h per week and longer outpatient hours per week were more likely to experience a higher PCW. 11.2% of participating physicians were identified as very high PCW physicians, compared with 11.6% as low PCW physicians, 45.5% as medium PCW physicians and 30.7% as high PCW physicians. Those who were female, older, from Western China, those who had lower educational levels, lower professional titles and longer working years in the current institution, and those who worked in tertiary A hospitals and Internal or Surgical, and worked >60 h per week and longer outpatient hours per week were more likely to be very high PCW physicians. Conclusions: Our work has a potential application for comprehensively assessing physician workload tethered to outpatient practice and could provide a solid foundation for hospital managers to further accurately determine and identify physicians with high workload, who would otherwise be missed in either objective workload or mental workload.

Toward the Impact of English as a Foreign Language Teachers' Grit and Self-Efficacy on Their Burnout.

Due to the adverse effects of teachers' burnout on their professional performance, remarkable attention has been devoted to this mental state and its negative predictors. In this regard, multiple empirical research has been carried out to assess the effects of grit and self-efficacy as negative predictors of teacher burnout. Yet, no empirical or review study has delved into the impact of these variables at the same time. The current study attempts to fill this gap by delineating the impact of English as a Foreign Language (EFL) teachers' grit and self-efficacy on their burnout. The significant role of grit and self-efficacy in curbing EFL teachers' burnout was illustrated using theoretical and empirical evidence. The pedagogical implications are also offered.

A Latent Profile Analysis of Chinese Physicians' Workload Tethered to Paperwork During Outpatient Encounters.

Background: Physician dissatisfaction with more time spent on related paperwork but less time available for direct interaction with patients is increasing internationally. Increased physician workload resulting from paperwork might negatively affect their interaction with patients and increase the risk for burnout. This study aimed to investigate the level of physician workload tethered to paperwork during outpatient encounters and explore its latent workload subgroups among Chinese physicians. Methods: A cross-sectional survey was conducted via online questionnaire primarily in 24 hospitals in 6 provinces in Eastern, Central, and Western China from November 2020 to February 2021. The Chinese physician mental workload scale developed by our research team was used for assessment of physician workload tethered to paperwork. Physicians were categorized into different subgroups of workload via latent profile analysis. Multinomial logistic regression was subsequently performed to examine how demographic variables differ among physicians belonging to different subgroups. Results: A total of 1,934 valid questionnaires were received. Chinese physicians reported medium levels of workload while performing non-physician-patient communication work tasks characterized by paperwork during outpatient encounters. Four latent workload subgroups were identified: "low workload group" (8.8%), "medium workload group" (34.0%), "high workload group" (42.1%) and "very high workload group" (15.1%). Compared with the other latent workload subgroups, physicians belonging to the "very high workload group" were more likely to be younger, married, those who had worse health status, lower educational levels and lower average monthly incomes, those who worked more years in the current institution, more hours per week and longer outpatient hours per week, and those who worked in public general hospitals, tertiary B hospitals and Obstetrics and Gynecology, and saw more than 50 outpatients per day, with more time spent on per patient. Conclusions: There exit four latent workload subgroups among Chinese physicians tethered to paperwork during outpatient encounters along with great individual variations among these subgroups. The characteristics of the latent "very high workload group" can help permit more targeted guidance for developing interventions with optimized human resource allocation to, in turn, increase the time available for direct interaction with patients, thereby resulting in improved quality of physician-patient interactions and decreased risk for physician burnout.