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BackgroundThe narratives of hierarchical medical sytem are generally classified into two patterns, one is the policy narrative, which is used to persuade the target audience to gain their support in practice, and the other is the academic narrative, which describes the thinking process of researchers to explore problems and enhance perceptions using words. The narratives of the hierarchical medical system are rich and diverse, but have been rarely systematically reviewed and summarized.ObjectiveWe explored the evolution process, focuses and characteristics of academic narratives of 10-year development of hierarchical medical system in China using social network analysis, aiming to provide a reference for improving the implementation of hierarchical medical system.MethodsOn March 21, 2021, we searched the database of CNKI for studies regarding hierarchical medical system in China published in academic journals in Chinese during January 1, 2009 to March 21, 2021 using "hierarchical medical system" "seeking healthcare in an orderly way" "seeking diagnosis and treatment services in an orderly way" "division of healthcare" "division of diagnosis and treatment" "first contact in primary care" "treating acute and chronic diseases separately" "cooperation between tertiary and secondary/primary hospitals" "bi-directional referrals" as keywords. Bibliometric methods, SATI 3.0 and UCINET 6.0 were used to explore the process, focuses and characteristics of academic narratives of hierarchical medical system through time series analysis, high-frequency keywords analysis, centrality analysis and small group analysis, and to generate visualized co-occurrence network diagrams of high-frequency keywords.ResultsA total of 4 882 studies were included for analysis. According to the results of time series analysis, the development of the hierarchical medical system could be roughly divided into three stages: embryonic stage (2009—2013) , acceleration stage (2014—2017) and standardization stage (2018 to present) . In terms of the use of frequency, the top five high-frequency keywords were "hierarchical medical system" "medical consortium" "primary healthcare institutions" "bi-directional referrals" and "public hospitals". In terms of closeness centrality, the top five high-frequency keywords were "hierarchical medical system" "medical consortium" "primary healthcare institutions" "bi-directional referrals" and "general practitioners". Small-group analysis yielded three groups of word clusters: core word clusters (including "medical consortium" "reform of public hospitals" "bi-directional referrals" "general practitioners" and "first contact in primary care") , secondary word clusters (including "the internet" "internet-based healthcare" "internet-based hospital" and "telemedicine") , and marginal word clusters (including "diabetes" "chronic disease" "cognition" and "influencing factors") . Health policy rhetoric was an important part of the core word clusters. And secondary and marginal word clusters were constantly evolving and generating.ConclusionThe academic narratives of hierarchical medical system have gradually derived from the mutually-promoted development of policies and real implementation regarding the hierarchical medical system, generally demonstrated various structures and relatively homogeneous research direction. Available academic and policy narratives of the hierarchical medical system are still limited to the scope of guiding principles, and the implementation of the concept and system still relies on the top-down push from the policy-making level, while the self-motivated micro-practices of hierarchical medical system in primary care have not yet emerged.

BackgroundThe analysis of the influencing factors of local government innovation has always been an important topic in the research of local government innovation.ObjectiveTo analyze the influencing factors and various combination types of local government's practice innovation toward county medical community.MethodsIn March 2021, the preliminary results of the 2nd "Searching for Value Cases of County Medical Community Practice" held by the County Medical Community Branch of the China Hospital Association was used as the source of cases; The "type of policy innovation" was used as the outcome variable ("central dominative innovation"/"local responsive innovation"=0; "local autonomous innovation"=1) ; The level of economic development, administrative level, geographical location, problem attributes, and platform were used as condition variables; The crisp set qualitative comparative analysis (csQCA) was used to explore the factors influencing the county medical community innovation by local government, in order to constructthe path models of innovation practice through necessary condition analysis and conditional combination analysis.ResultsThe consistency of all five conditional variables was

Porous liquids (PLs), an emerging porous material with permanent cavities, have attracted extensive attention in recent years. However, the current construction methods are complicated and resulting PLs possess high viscosity values, which cannot meet the requirements of practical industrial applications. Herein, we demonstrate a generalizable and simple strategy to prepare type III PLs with low viscosity based on the rule of "like dissolves like". Specifically, the monoglycidyl ether terminated polydimethylsiloxane (denoted by E-PDMS) is attached to the surface of Universitetet i Oslo (UiO)-66-NH2 via covalent linkage, constructing the pore generator (UiO-66-NH2-E-PDMS, denoted by P-UiO-66). Then, P-UiO-66 is dispersed into different types and amounts of sterically hindered solvents (PDMS400 or PDMS6000), obtaining a series of type III PLs (denoted by P-UiO-66-PLs) with permanent cavities and low viscosities. The gas sorption-desorption test shows that P-UiO-66-PLs have an enormous potential for CO2/N2 selective separation. Besides, the porosity of P-UiO-66-PLs and the CO2 sorption mechanism are demonstrated by molecular simulation. Furthermore, the generality of the synthesis strategy is confirmed by the successful construction of PLs using two other amino-metal-organic frameworks (MOFs) (MIL-53(Al)-NH2 and MIL-88B(Fe)-NH2). Importantly, it's worth noting that the strategy based on the rule of "like dissolves like" sheds light on the preparation of other types of PLs for task-specific applications. [ABSTRACT FROM AUTHOR]

Composite materials are susceptible to environmental threats correlated to moisture absorption, which affects the bonding performance of the joints. Therefore, drying should be taken into account during actual manufacturing operations. In this work, the influence of moisture absorption‐drying of composite materials on the bonding performance of the joints is investigated to provide a theoretical direction for the co‐bonding process. Firstly, the surfaces of composite materials are treated with three methods: sanding, dry peel ply, and wet peel ply. Secondly, the composite materials are subjected to moisture absorption‐drying treatment at 26 °C/65% relative humidity (RH) and 70 °C/85% RH. Finally, the above materials are bonded to evaluate the bonding performance. These results show that the bonding performance of the joints treated with two peel plies decreases significantly after moisture absorption. After moisture absorption‐drying at 26 °C/65% RH, the bonding performance of the joints treated with dry peel ply cannot fully recover, while wet peel ply can be fully recoverable. However, the bonding performance of all joints cannot fully recover after absorbing moisture‐drying at 70 °C/85% RH, whose recovery has relations with surface treatment. [ABSTRACT FROM AUTHOR]

The introduction of ionic liquids crystals (ILCs) into porous liquids (PLs) might be an effective way to overcome the problems associated with their processability, such as leakage, packaging, transportation, and long-term stability. Herein, a generalizable strategy to construct stimuli-responsive porous ionic liquids (SRPILs) based on the self-assembly of responsive ILCs and metal–organic frameworks (MOFs) has been demonstrated. The unique rapid reversible transition behaviors of the SRPILs induced by shearing and heating stimuli are verified. Furthermore, the SRPILs exhibited an approximately 3-fold increase in adsorption capacity for CO2 and C2H4 compared with that of the neat ILC solvent, confirming that the accessible porosity was retained in the SRPILs. Remarkably, the stimuli-responsiveness of the SRPILs can be demonstrated through changes in their phase, porosity, gas adsorption, and separation. Benefiting from their stimuli-responsive nature, SRPILs can be regarded as "smart porous liquids", undoubtedly providing enormous inspiration for the development of new applications, including but not limited to gas capture/separation, sensing, catalysis, and electrochemical applications. [ABSTRACT FROM AUTHOR]

Despite many important industrial applications, epoxy resin (EP) suffers from high flammability. To solve the problem, functionalized graphene oxide with Co‐MOF and phytic acid (ZIF‐67@GO‐PA) was successfully prepared. Subsequently, 2 wt% of ZIF‐67@GO‐PA nano‐hybrids were added into EP. Base on the fire test results, the limiting oxygen index value of EP/ZIF‐67@GO‐PA enhances to 29.4% and its UL‐94 achieves V‐0 rating. Moreover, compared with pure EP, the peak heat release rate and total release rate are dramatically decreased by 57.4% and 25.7%, respectively. In addition, the fire growth index was reduced by 64.0%. These superior fire safety properties are due to the catalytic effect of metal oxide and phosphorous compounds produced during the combustion of ZIF‐67@GO‐PA, and the barrier effect of the graphene oxide. Because the denser char blocks the diffusion of heat during combustion, the fire hazard of EP composites is reduced. [ABSTRACT FROM AUTHOR]