Search

Background Graduate supervisors in general practice are responsible for the important task of training future general practice professionals, so their abilities to communicate with patients are essential for the development of general practice. Objective To examine the abilities to communicate with patients in supervisors of master's students in general practice during outpatient encounters. Methods Seventy-five supervisors of master's students in general practice from Capital Medical University were selected by use of cluster sampling to receive a survey using a self-developed demographic questionnaire conducted from April to June 2022. Then their doctor-patient communication skills during outpatient encounters were assessed by relevant professionals who participated in the whole encounter process as accompaniers using the SEGUE Framework. The total score and dimension scores of SEGUE Framework of these supervisors were compared with those of outpatient specialists in tertiary hospitals and general practitioners (GPs) in community health centers (CHCs) in our previous studies, and were compared across these supervisors by sex, employment method and level of medical institutions. Then the total score of SEGUE Framework was compared between the supervisors and US GPs. Results The total score of SEGUE Framework attained by the supervisors ranged from 12 to 24 points, and the average score was (17.8±2.6) . The average scores of five dimensions (set the stage, elicit information, give information, understand the patient's perspective, and end the encounter) obtained by them were (3.9±0.9) , (6.5±1.7) , (3.1±1.1) , (2.6±0.9) and (1.7±0.5) , respectively. These supervisors scored higher on dimensions of set the stage and end the encounter than GPs in CHCs and outpatient specialists in tertiary hospitals (P

Road cracks significantly affect the serviceability and safety of roadways, especially in mountainous terrain. Traditional inspection methods, such as manual detection, are excessively time-consuming, labor-intensive, and inefficient. Additionally, multi-function detection vehicles equipped with diverse sensors are costly and unsuitable for mountainous roads, primarily because of the challenging terrain conditions characterized by frequent bends in the road. To address these challenges, this study proposes a customized Unmanned Aerial Vehicle (UAV) inspection system designed for automatic crack detection. This system focuses on enhancing autonomous capabilities in mountainous terrains by incorporating embedded algorithms for route planning, autonomous navigation, and automatic crack detection. The slide window method (SWM) is proposed to enhance the autonomous navigation of UAV flights by generating path planning on mountainous roads. This method compensates for GPS/IMU positioning errors, particularly in GPS-denied or GPS-drift scenarios. Moreover, the improved MRC-YOLOv8 algorithm is presented to conduct autonomous crack detection from UAV imagery in an on/offboard module. To validate the performance of our UAV inspection system, we conducted multiple experiments to evaluate its accuracy, robustness, and efficiency. The results of the experiments on automatic navigation demonstrate that our fusion method, in conjunction with SWM, effectively enables real-time route planning in GPS-denied mountainous terrains. The proposed system displays an average localization drift of 2.75% and a per-point local scanning error of 0.33 m over a distance of 1.5 km. Moreover, the experimental results on the road crack detection reveal that the MRC-YOLOv8 algorithm achieves an F1-Score of 87.4% and a mAP of 92.3%, thus surpassing other state-of-the-art models like YOLOv5s, YOLOv8n, and YOLOv9 by 1.2%, 1.3%, and 3.0% in terms of mAP, respectively. Furthermore, the parameters of the MRC-YOLOv8 algorithm indicate a volume reduction of 0.19(×106) compared to the original YOLOv8 model, thus enhancing its lightweight nature. The UAV inspection system proposed in this study serves as a valuable tool and technological guidance for the routine inspection of mountainous roads. [ABSTRACT FROM AUTHOR]

Background and Aims Understanding patterns and mechanisms of nurse plant facilitation is important to predict the resilience of arid/semi-arid ecosystems to climate change. We investigate whether water availability and nurse species turnover interact to shape the facilitation pattern of widespread legume shrubs along a large elevation gradient. We also investigate whether leaf δ13C of nurse plants can track the facilitation pattern. Methods We measured the relative interaction index (RII) of the number of species within and outside the canopy of two widespread legume shrub species (Caragana gerardiana and Caragana versicolor) alternatively distributed along a large elevation gradient in the Trans-Himalayas. We also assessed the proportional increase of species richness (ISR) at the community level using the paired plot data. To determine site-specific water availability, we measured the leaf δ13C of nurse shrubs and calculated the Thornthwaite moisture index (MI) for each elevation site. Key Results Elevational variations in RII, ISR and δ13C were mainly explained by the MI when the effects of soil nitrogen and plant traits (leaf nitrogen and shrub size) were controlled. Variations in RII and ISR across the two nurse species were explained better by δ13C than by smoothly changing climatic factors along elevation. At the transition zone between the upper limit of C. gerardiana (4100 m) and the lower limit of C. versicolor (4200 m), RII and ISR were much higher in C. versicolor than in C. gerardiana under a similar MI. Such an abrupt increase in facilitation induced by nurse species replacement was well tracked by the variation of δ13C. Conclusions Water availability and nurse species replacement are crucial to shaping facilitation patterns by legume shrubs along a large elevation gradient in dry mountainous regions, such as the Trans-Himalayas. Turnover in nurse species under global change might significantly alter the pattern of nurse plant facilitation associated with water availability, which can be well tracked by leaf δ13C. [ABSTRACT FROM AUTHOR]

Alpine and northern treelines are primarily controlled by low temperatures. However, little is known about the impact of low soil temperature on tree transpiration at treelines. We aim to test the hypothesis that in cold-limited forests, the main limiting factors for tree transpiration switch from low soil temperature before summer solstice to atmospheric evaporative demand after summer solstice, which generally results in low transpiration in the early growing season. Sap flow, meteorological factors and predawn needle water potential were continuously monitored throughout one growing season across Smith fir (Abies georgei var. smithii) and juniper (Juniperus saltuaria) treelines in southeast Tibet. Sap flow started in early May and corresponded to a threshold mean air-temperature of 0 oC. Across tree species, transpiration was mainly limited by low soil temperature prior to the summer solstice but by vapor pressure deficit and solar radiation post-summer solstice, which was further confirmed on a daily scale. As a result, tree transpiration for both tree species was significantly reduced in the pre-summer solstice period as compared to post-summer solstice, resulting in a lower predawn needle water potential for Smith fir trees in the early growing season. Our data supported the hypothesis, suggesting that tree transpiration mainly responds to soil temperature variations in the early growing season. The results are important for understanding the hydrological response of cold-limited forest ecosystems to climate change.

As the roof of the world, the Mt. Qomolangma National Nature Reserve and adjacent regions have a fragile environment and are very sensitive to global climate change. Based on the MODIS and SPOT remote sensing data during 2000–2018, we aimed to explore the change trend and driving factors of grassland in this area under the dual influence of climate change and human activities. Here, temperature and precipitation data were enrolled as the main indicators of climate change, while the number of livestock at the end of the year was regarded as the key indicator of grazing. The results showed that: (1) during 2000–2018, the grassland NDVI reflected an overall increasing trend, and the impact of precipitation was more significant than those of temperature and grazing at both pixel and county levels; (2) probably due to the large population and high grazing intensity, the grassland NDVI in Tingri County was controlled by both precipitation and grazing. In general, precipitation exerts a greater impact on the NDVI changes since this region is characterized by arid and semiarid climates. In some areas, vegetation growth is simultaneously affected by both grazing and climate factors due to the relatively greater pressure of grazing. In the context of future warming, control of the number of tourists for Mt. Qomolangma, as well as that of livestock in Tingri County, will help improve sustainability development and to reduce the adverse effects of grassland degradation. [ABSTRACT FROM AUTHOR]