Development of the China's list of ambulatory care sensitive conditions (ACSCs): a study protocol

BACKGROUND

The hospitalization rate of ambulatory care sensitive conditions (ACSCs) has been recognized as an essential indicator reflective of the overall performance of healthcare system. At present, ACSCs has been widely used in practice and research to evaluate health service quality and efficiency worldwide. The definition of ACSCs varies across countries due to different challenges posed on healthcare systems. However, China does not have its own list of ACSCs. The study aims to develop a list to meet health system monitoring, reporting and evaluation needs in China.

METHODS

To develop the list, we will combine the best methodological evidence available with real-world evidence, adopt a systematic and rigorous process and absorb multidisciplinary expertise. Specific steps include: (1) establishment of working groups; (2) generations of the initial list (review of already published lists, semi-structured interviews, calculations of hospitalization rate); (3) optimization of the list (evidence evaluation, Delphi consensus survey); and (4) approval of a final version of China's ACSCs list. Within each step of the process, we will calculate frequencies and proportions, use descriptive analysis to summarize and draw conclusions, discuss the results, draft a report, and refine the list.

DISCUSSION

Once completed, China's list of ACSCs can be used to comprehensively evaluate the current situation and performance of health services, identify flaws and deficiencies embedded in the healthcare system to provide evidence-based implications to inform decision-makings towards the optimization of China's healthcare system. The experiences might be broadly applicable and serve the purpose of being a prime example for nations with similar conditions.

In Situ Chiral Template Approach to Synthesize Homochiral Lead Iodides for Second-Harmonic Generation

Homochiral halide perovskites have gained increasing attention because of their fascinating optoelectronic properties and prospective applications in laser technologies. However, the limited choice of chiral organic templates severely restricts their structural diversity and second-harmonic generation (SHG) effects. Here, we present an in situ chiral template approach for the synthesis of one-dimensional (1D) homochiral lead iodides. A chiral imine (L-ipp) template was generated in situ by reacting L-proline (L-pro) and acetone under ambient conditions. Notably, L-ipp can cooperate with L-pro to direct the formation of a homochiral lead iodide with dual chiral templates, which is unprecedented in crystalline metal halides. The homochiral lead iodide containing both L-ipp and L-pro shows a strong SHG response of 8.0 times that of KH2 PO4 (8.0×KDP). The SHG efficiency is one of the largest values reported to date for any homochiral lead halides under 1064 nm laser irradiation. A comparative study shows that homochiral 1D lead iodides containing either L-ipp or L-pro exhibit relatively weak SHG responses (≤1.0×KDP). This work demonstrates the advantage of using two different chiral templates over a single chiral template in enhancing the SHG responses of halide materials.

Fully recyclable multifunctional adhesive with high durability, transparency, flame retardancy, and harsh-environment resistance

Recyclable/reversible adhesives have attracted growing attention for sustainability and intelligence but suffer from low adhesion strength and poor durability in complex conditions. Here, we demonstrate an aromatic siloxane adhesive that exploits stimuli-responsive reversible assembly driven by π-π stacking, allowing for elimination and activation of interfacial interactions via infiltration-volatilization of ethanol. The robust cohesive energy from water-insensitive siloxane assembly enables durable strong adhesion (3.5 MPa shear strength on glasses) on diverse surfaces. Long-term adhesion performances are realized in underwater, salt, and acid/alkali solutions (pH 1-14) and at low/high temperatures (-10-90°C). With reversible assembly/disassembly, the adhesive is closed-loop recycled (~100%) and reused over 100 times without adhesion loss. Furthermore, the adhesive has unique combinations of high transparency (~98% in the visible light region of 400-800 nm) and flame retardancy. The experiments and theoretical calculations reveal the corresponding mechanism at the molecular level. This π-π stacking-driven siloxane assembly strategy opens up an avenue for high-performance adhesives with circular life and multifunctional integration.