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Background The competency in primary performance positions of rural order-oriented medical graduates of standardized general residency training program (abbreviate for oriented general practitioners) has attracted wide attention. Strengthening continuing medical education is an important measure to enhance the competency of oriented general practitioners. Objective To understand the current situation, problems and needs of continuing medical education for oriented general practitioners in Guizhou Province, and to provide a basis for improving continuing medical education for oriented general practitioners. Methods From November to December 2021, 42 oriented general practitioners from 39 township hospitals in 9 cities in Guizhou Province were selected as the research subjects for semi-structured interviews by the purposive sampling and snowball sampling methods. The interview results were coded and analyzed by the research method of procedural grounded theory to extract and summarize the current situation, problems and needs of their continuing medical education. Results After three-level coding, 145 concepts, 23 categories and 5 domains related to the continuing medical education of oriented general practitioners were finally sorted out, and a story line was consequenty formed: the continuing medical education of oriented general practitioners is influenced by several factors, among which actual situation is the obstacle, competency requirement is the extrinsic driver, policy system is important guarantee, self-demand is the intrinsic motivation, and the improvement of the training process management is the key process. Conclusion The training intention of oriented general practitioners remains to be strengthened in Guizhou Province. The quality of continuing medical education, integration degree of training content and demand, and attention of primary care institutions need to be improved. The support for continuing medical education and the construction of information platform should be strengthened, and the content and form of continuing medical education suitable for oriented general practitioners should be improved, in order to improve the quality and effect of training in continuing medical education.

Monodentate organophosphorus ligands have been used for the extraction of the uranyl ion (UO22+) for over half a century and have exhibited exceptional extractability and selectivity toward the uranyl ion due to the presence of the phosphoryl group (O═P). Tributyl phosphate (TBP) is the extractant of the world-renowned PUREX process, which selectively recovers uranium from spent nuclear fuel. Trialkyl phosphine oxide (TRPO) shows extractability toward the uranyl ion that far exceeds that for other metal ions, and it has been used in the TRPO process. To date, however, the mechanism of the high affinity of the phosphoryl group for UO22+ remains elusive. We herein investigate the bonding covalency in a series of complexes of UO22+ with TRPO by oxygen K-edge X-ray absorption spectroscopy (XAS) in combination with density functional theory (DFT) calculations. Four TRPO ligands with different R substituents are examined in this work, for which both the ligands and their uranyl complexes are crystallized and investigated. The study of the electronic structure of the TRPO ligands reveals that the two TRPO molecules, irrespective of their substituents, can engage in σ- and π-type interactions with U 5f and 6d orbitals in the UO2Cl2(TRPO)2 complexes. Although both the axial (Oyl) and equatorial (Oeq) oxygen atoms in the UO2Cl2(TRPO)2 complexes contribute to the X-ray absorption, the first pre-edge feature in the O K-edge XAS with a small intensity is exclusively contributed by Oeq and is assigned to the transition from Oeq 1s orbitals to the unoccupied molecular orbitals of 1b1u + 1b2u + 1b3u symmetries resulting from the σ- and π-type mixing between U 5f and Oeq 2p orbitals. The small intensity in the experimental spectra is consistent with the small amount of Oeq 2p character in these orbitals for the four UO2Cl2(TRPO)2 complexes as obtained by Mulliken population analysis. The DFT calculations demonstrate that the U 6d orbitals are also involved in the U-TRPO bonding interactions in the UO2Cl2(TRPO)2 complexes. The covalent bonding interactions between TRPO and UO22+, especially the contributions from U 5f orbitals, while appearing to be small, are sufficiently responsible for the exceptional extractability and selectivity of monodentate organophosphorus ligands for the uranyl ion. Our results provide valuable insight into the fundamental actinide chemistry and are expected to directly guide actinide separation schemes needed for the development of advanced nuclear fuel cycle technologies.

We have used angle-dependent soft x-ray absorption spectroscopy (XAS) at the O K edge and first-principles calculations to investigate the electronic structures of iridate-based superlattices (SrIrO3)m/(SrTiO3) (m=1, 2, 3, and ∞). We focus on the pre-edge Ir 5d t2g-O 2p orbital hybridization feature in the XAS spectra. By varying the measurement geometry relative to the incident photon polarization, we are able to extract the dichroic contrast and observe the systematic increase in the anisotropy of Ir 5d orbitals as m decreases. First-principles calculations elucidate the orbital anisotropy coming mainly from the enhanced out-of-plane compression of IrO6 octahedra in the SrIrO3 layers that are adjacent to the inserted SrTiO3 layers. As m decreases, the increased volume fraction of these interfacial SrIrO3 layers and their contact with the SrTiO3 layers within the (SrIrO3)m/(SrTiO3) supercell lead to enhanced orbital anisotropy. Furthermore, the tilt and rotation of IrO6 octahedra are shown to be essential to understand the subtle orbital anisotropy in these superlattices, and constraining these degrees of freedom will give an incorrect trend. Our results demonstrate that the structural constraint from the inserted SrTiO3 layers, in addition to other electronic means such as polar interface and charge transfer, can serve as a knob to control the orbital degree of freedom in these iridate-based superlattices.

Background The training of targeted admission medical students (TAMS) is an important measure to alleviate the shortage of primary care physicians and to improve the overall quality and level of primary care workforce in rural China. Objective To explore the recent hot topics, present and future trends in the research on TAMS in China, so that a solid theoretical foundation can be laid for future studies. Methods All articles about the training of TAMS published from January 1, 2010 to December 31, 2021 in three databases (i.e., CNKI, WanFang Data and CQVIP) were searched on February 15, 2022. The number of the articles was counted for analysis. CiteSpace was used to conduct a visualization analysis of authors, research institutions and keywords extracted from the identified articles. Results A total of 598 articles were finally included. The annual number of publications demonstrated an increasing trend generally during the period, with a peak in 2018 (n=81) . Five major groups of authors were identified. The top three prolific institutions were Gannan Medical University〔113 articles (18.9%) 〕, Guangxi Medical University〔40 articles (6.7%) 〕 and Xinxiang Medical University〔28 articles (4.7%) 〕. The top three high-frequency keywords were "order-oriented" (70 times) , "targeted admission students" (57 times) and "talent cultivation" (44 times) . Eight topic clusters were derived from keyword cluster mapping, namely "#0 learning motivation" "#1 teaching model" "#2 order-oriented cultivation" "#3 influencing factors" "#4 general medicine" "#5 primary care" "#6 medical college" and "#7 medical students". Knowledge map of keywords with the strongest citation bursts showed that the top three were "career identity" "major identity" and "rural primary care". The time-dependent graph indicated that the evolution of research on the training of TAMS could be roughly divided into three stages: education and training for TAMS at school, post-graduation training and education of TAMS, and current work status of TAMS in primary care. Conclusion The research on the training of TAMS in China is increasingly flourishing. Relevant policies are the major facilitators for the training of TAMS. The research is also featured by lack of inter-regional and inter-institutional coordination among related research institutions and authors. Moreover, the hotspots are constantly changing with the times, and the major topics about which can be summarized as follows: training models for TAMS, learning motivation of TAMS, and intention to work at primary care and associated factors in TAMS. The future research directions may be the evaluation of current work status and intention to work at primary care in a long-term period in TAMS, effectiveness of the implementation of policies related to the training of TAMS, and the innovative development of training models for TAMS.