[Deepening the Action on Salt Reduction in China-suggestions on strategy and implementation plan]

Excessive sodium/salt intake is the leading dietary risk factor for the loss of healthy life in the Chinese population. The "Healthy China 2030" Action Plan set the goal of reducing salt intake by 20% by 2030. However, salt intake in China is still at a very high level in the world, with adults reaching 11 g/d, more than twice the recommended limit of 5 g/d. The current policies and action plans of China have targeted catering workers, children, adolescents, and home chefs in salt, oil, and sugar reduction actions. However, there are still obvious deficiencies in the coordinated promotion and implementation. This study, therefore, proposed a set of comprehensive strategies (named CHRPS that is composed of communication and education, salt reduction in home cooking, salt reduction in restaurants, reducing salt content in pre-packaged food, and surveillance and evaluation) and key implementation points for further deepening the salt reduction action in China. These strategies were developed based on the main sources of dietary sodium for Chinese residents, the status of"knowledge, attitude and practice"in salt reduction, evidence of effective intervention measures, existing policies and requirements, and the salt reduction strategies of the World Health Organization and experience from some other countries. As a scientific reference, the CHRPS strategies will help the government and relevant organizations quickly implement salt reduction work and facilitate the earlier realization of China's salt reduction goal.

Prevalence of Emergency Department Social Risk and Social Needs

Introduction

Social risks, or adverse social conditions associated with poor health, are prevalent in emergency department (ED) patients, but little is known about how the prevalence of social risk compares to a patient’s reported social need, which incorporates patient preference for intervention. The goal of this study was to describe the relationship between social risk and social need, and identify factors associated with differential responses to social risk and social need questions.

Methods

We conducted a cross-sectional study with 48 hours of time-shift sampling in a large urban ED. Consenting patients completed a demographic questionnaire and assessments of social risk and social need. We applied descriptive statistics to the prevalence of social risk and social need, and multivariable logistic regression to assess factors associated with social risk, social need, or both.

Results

Of the 269 participants, 100 (37%) reported social risk, 83 (31%) reported social need, and 169 (63%) reported neither social risk nor social need. Although social risk and social need were significantly associated (p < 0.01), they incompletely overlapped. Over 50% in each category screened positive in more than one domain (eg, housing instability, food insecurity). In multivariable models, those with higher education (adjusted odds ratio [aOR] 0.44 [95% confidence interval {CI}, 0.24–0.80]) and private insurance (aOR 0.50 [95% CI, 0.29–0.88]) were less likely to report social risk compared to those with lower education and state/public insurance, respectively. Spanish-speakers (aOR 4.07 [95% CI, 1.17–14.10]) and non-Hispanic Black patients (aOR 5.00 [95% CI, 1.91–13.12]) were more likely to report social need, while those with private insurance were less likely to report social need (private vs state/public: aOR 0.13 [95% CI, 0.07–0.26]).

Conclusion

Approximately one-third of patients in a large, urban ED screened positive for at least one social risk or social need, with over half in each category reporting risk/need across multiple domains. Different demographic variables were associated with social risk vs social need, suggesting that individuals with social risks differ from those with social needs, and that screening programs should consider including both assessments.

Extended theory of planned behaviour for promoting construction waste recycling in Hong Kong

Changing individual's recycling attitude and behaviour is of utmost importance in achieving sustainable construction and demolition (C&D) waste management, yet it has often been underachieved. To understand the motivations for recycling, this study identifies and prioritizes the key factors that affect C&D waste recycling behaviour of various stakeholders in Hong Kong (i.e., representatives from construction-waste-related organizations, environmental consultants and contractors, and government engineers) in a quantitative manner using statistical tools. Different from traditional C&D waste behavioural determinants studies, this paper utilizes an integrated analytical method through semi-structured interviews and survey questionnaire on the basis of Theory of Planned Behaviour (TPB). Qualitative thematic analysis and quantitative frequency analysis were performed to analyse responses from semi-structured interviews and questionnaires, followed by correlation analysis to quantify the relationships between factors. Results indicated that four key factors: (i) regulatory compliance, (ii) economic incentives, (iii) accreditation scheme, and (iv) logistics and management incentives directly influenced recycling behaviour of individuals. Regulatory compliance was the most determining factor for consultants, contractors, experts, and government officials, whereas economic incentives were of great concern to the public. Under the factor of economic incentives, strong positive relationships were identified between disposal costs and collection and sorting costs, thus increasing waste disposal charging fee may promote recycling behaviour. In comparison, accreditation scheme deserved better recognition to facilitate a closed-loop material flow in the construction industry. These findings help to devise more effective and stakeholder-oriented policy tools to raise awareness and encourage behavioural change towards C&D waste recycling, and assist policy makers to establish regulations and practices for sustainable resource management.

[Experience of Sun's procedure for chronic type B dissection with aortic arch involvement]

Objective: To study the surgical treatment of chronic type B dissection with aortic arch involvement using Sun's procedure. Methods: Between February 2009 and December 2015, 29 patients [20 males, 9 females, with a mean age of (41±12) years, range 24-64 years] with type B dissection with aortic arch involvement underwent Sun's procedure. Sixteen patient had a history of hypertension. Marfan syndrome was observed in 9 cases, coronary artery disease in 3 cases, mitral regurgitation in 3 patients, cerebrovascular disease in one patient. Twenty-two patients suffered proximal aortic arch disease, 4 cases experienced history of aortic root procedure and 2 subjects had history of pregnancy. Four patients had aortic arch malformation. Results: One case suffered from massive cerebral infarction after surgery and died in another hospital. Concomitant procedures included mitral valve replacement in 3 cases, coronary artery bypass grafting in 3 patients, reconstruction of the right aberrant subclavian artery in one patient. Ventilator support exceeding 24 hours obseved in 2 patients. One of them recieved continuous renal replacement therapy and recovered before discharge. Spinal cord injury was obseved in one case, brain infarction in one patient and pericardial drainage in one case. Two patients required tracheotomy. During 12-94 (43±23) months' follow-up, thoracoabdominal aortic replacment was performed in 4 patients, thoracic endovascular aortic repair (TEVAR) in 2 subjects and repair of perivalvular leakage in one patient. Conclusions: Sun's procedure obtained satisfactory results in patients with chronic type B dissection with aortic arch involvement. Concomitant repair of proximal aortic arch lesions and distal type B dissection can be adopted using Sun's procedure.

Quantum efficiency enhancement in selectively transparent silicon thin film solar cells by distributed Bragg reflectors

This work demonstrated a-Si:H thin-film solar cells with backside TiO(2) / SiO(2) distributed Bragg reflectors (DBRs) for applications involving building-integrated photovoltaics (BIPVs). Selectively transparent solar cells are formed by adjusting the positions of the DBR stop bands to allow the transmission of certain parts of light through the solar cells. Measurement and simulation results indicate that the transmission of blue light (430 ~500 nm) with the combination of three DBR mirrors has the highest increase in conversion efficiency.

Contrast and efficiency enhancement in organic light-emitting devices utilizing high absorption and high charge mobility organic layers

Organic light-emitting devices utilizing copper phthalocyanine (CuPc) and C(60) as the hole- and electron-injection layers were reported. Compared with a conventional device without CuPc and C(60) layers, the improvement of the contrast is more than 100% under 140-lx ambient lighting at a brightness of 300 cd/m(2). A maximum current efficiency of 3.93 cd/A, which is higher than 3.62 cd/A for a conventional device, was obtained at 9 V. The device has a maximum luminance of 17170 cd/m(2) at 15 V. The high contrast and high efficiency of the device are attributed to the high absorption and high charge mobility of CuPc and C(60) films.