ObjectivesTo investigate the patient safety culture in an outpatient setting in Beijing and explore the meaning and implications of the safety culture from the perspective of health workers and patients.MethodsA mixed methods approach involving a questionnaire survey and in-depth interviews was adopted. Among the 410 invited staff members, 318 completed the Hospital Survey of Patient Safety Culture (HSOPC). Patient safety culture was described using 12 subscale scores. Inter-subscale correlation analysis, ANOVA and stepwise multivariate regression analyses were performed to identify the determinants of the patient safety culture scores. Interviewees included 22 patients selected through opportunity sampling and 27 staff members selected through purposive sampling. The interview data were analysed thematically.ResultsThe survey respondents perceived high levels of unsafe care but had personally reported few events. Lack of ‘communication openness’ was identified as a major safety culture problem, and a perception of ‘penalty’ was the greatest barrier to the encouragement of error reporting. Cohesive ‘teamwork within units’, while found to be an area of strength, conversely served as a protective and defensive mechanism for medical practice. Low levels of trust between providers and consumers and lack of management support constituted an obstacle to building a positive patient safety culture.ConclusionsThis study in China demonstrates that a punitive approach to error is still widespread despite increasing awareness of unsafe care, and managers have been slow in acknowledging the importance of building a positive patient safety culture. Strong ‘teamwork within units’, a common area of strength, could fuel the concealment of errors.

Contaminant transport is a common process for a waste disposal site, which is a practical concern in geo-environmental field. It is essential to study the contaminant transport behavior in impermeable clay liner. Considering the anisotropy of a clay barrier in permeability, a three-dimensional model coupled mechanical consolidation and contaminant transport is developed for simulation of contaminant transport through a deforming porous medium. This is based on the combination of Biot's theory and the theory of contaminant transport. Meanwhile, porosity is viewed as a coupling parameter. The influence of soil consolidation deformation and permeability anisotropy on contaminant transport can thus be determined reasonably. Transport equations are solved by using the finite-element software COMSOL Multiphysics. A parametric study has moreover been conducted to understand the influence of contaminant source types and adsorption modes, including constant contaminated source, attenuation contaminated source, linear adsorption, Freundlich adsorption, Langmuir adsorption. The simulation results indicate that the permeability anisotropy has a negligible effect on contaminant transport, adsorption modes have a significant impact on transport depth and range, and the concentration distribution of contaminant with different contaminated source types have showed a marked difference.

Study Design. A scanning electron microscopic study performed on three cadaveric specimens focused on the human suboccipital region, specifically, myodural bridge (MDB). Objective. This study showed the connection form of the MDB among the suboccipital muscles, the posterior atlanto-occipital membrane (PAOM) and the spinal dura mater (SDM), and provided an ultrastructural morphological basis for the functional studies of the MDB. Summary of Background Data. Since the myodural bridge was first discovered by Hack, researches on its morphology and functions had been progressing continuously. However, at present, research results about MDB were still limited to the gross anatomical and histological level. There was no research report showing the MDB's ultrastructural morphology and its ultrastructural connection forms between PAOM and SDM. Methods. A scanning electron microscope (SEM) was used to observe the connection of myodural bridge fibers with PAOM and SDM in atlanto-occipital and atlanto-axial interspaces, and the connection forms were analyzed. Results. Under the SEM, it was observed that there were clear direct connections between the suboccipital muscles and the PAOM and SDM in the atlanto-occipital and atlanto-axial spaces. These connections were myodural bridge. The fibers of the myodural bridge merged into the spinal dura mater and gradually became a superficial layer of the spinal dura mater. Conclusion. MDB fibers merged into the SDM and became part of the SDM in the atlanto-occipital and atlanto-axial space. MDB could transfer tension and pulling force to the SDM effectively, during the contraction or relaxation of the suboccipital muscles. Level of Evidence: N/A

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With the rise of 2D materials, copper (Cu) is revealed as good surface catalyst, especially in the self‐limited growth of graphene. In the regime of surface catalyst, the catalytic activities and functionalities of Cu should be highly dependent on its surface type. Traditional methods to determine the surface index are mainly high‐vacuum based surface science techniques and are typically of low throughput and in small scale. A method to fast detect the surface index of Cu in large scale is still lacking. Here, the authors report an effective optical contrast method to identify the Cu surface index in large area. This method is based on the Cu2O‐thickness dependent color of Cu surface after a mild oxidation in hot air. It is revealed that different Cu surfaces (Cu(111), Cu(100), and Cu(110) as examples) have various oxidation barriers and would exhibit distinct color evolution with heating time. It is also showed that graphene grown on Cu surfaces with varied orientations has totally different growth behaviors. The results would greatly facilitate the high‐throughput determination of Cu surface index and accelerate the large‐scale facet‐dependent catalytic research of Cu, such as in single‐crystal graphene growth.