BackgroundSeveral Chinese cities have implemented dispatcher-assisted cardiopulmonary resuscitation (DA-CPR), although out-of-hospital cardiac arrest (OHCA) survival rates remain low. We aimed to assess the process compliance, barriers and outcomes of OHCA in one of the earliest implemented (DA-CPR) programmes in China.MethodsWe retrospectively reviewed OHCA emergency dispatch records of Suzhou emergency medical service from 2014 to 2015 and included adult OHCA victims (>18 years) with a bystander-witnessed atraumatic OHCA that was subsequently confirmed by on-site emergency physician. The circumstances and DA-CPR process related to the OHCA event were analysed. Dispatch audio records were reviewed to identify potential barriers to implementation during the DA-CPR process.ResultsOf the 151 OHCA victims, none survived. The median time from patient collapse to call for emergency services and that from call to provision of cardiopulmonary resuscitation instructions was 30 (IQR 20–60) min and 115 (IQR 90–153) s, respectively. Only 110 (80.3%) bystanders/rescuers followed the dispatcher instructions; of these, 51 (46.3%) undertook persistent chest compressions. Major barriers to following the DA-CPR instructions were present in 104 (68.9%) cases, including caller disconnection of the call, distraught mood or refusal to carry out either compressions or ventilations.ConclusionsThe OHCA survival rate and the DA-CPR process were far from optimal. The zero survival rate is disproportionally low compared with survival statistics in high-income countries. The prolonged delay in calling the emergency services negated and rendered futile any DA-CPR efforts. Thus, efforts targeted at developing public awareness of OHCA, calling for help and competency in DA-CPR should be increased.

An emerging and pressing issue in China’s economic reform is the intensified conflict between arable land protection and the encroachment of urban development into fertile farmlands that threaten food security and urban sustainability. New policies were issued to encourage rural land circulation as an attempt to ensure urban development and a sustainable food system, but farmers’ willingness to adopt the policies is largely unknown. A total of 4500 farmers within 9 cities’ boundaries in the Pearl River Delta were surveyed, and the theory of planned behavior and statistical tools were used to determine key factors affecting farmers’ attitudes towards the new sustainability policy. The results indicate that farmers’ cognition of the policies positively influenced farmers’ willingness to participate in land circulation. Attitude toward the Behavior (AB), Subjective Norm (SN), and Perceived Behavioral Control (PBC) were the dominant factors affecting the policies’ implementation. PBC had the most significant influence on sustainable policy participation, followed by SN and AB. AB alone could not determine the actual participation behavior because of external factors such as family, community, and other policy-related considerations. In conclusion, the successful implementation of the rural land-use policy will be primarily determined by the farmers’ cognition and behavior.

Spray-drying and freeze-drying are effective approaches to improve the long-term stability of nanosuspensions. This research explored the effect of spray-drying and freeze-drying techniques on PVP K30-stabilized silybin nanosuspensions. The morphology was observed by scanning electron microscopy (SEM): The spray-dried sample was spherical, and the freeze-dried samples were rodlike with smooth surfaces. The redispersibility was studied via dynamic light scattering (DLS): The size, PDI, and zeta of the spray-dried sample were 133.27 nm, 0.214, and 24.37 mV, respectively; the size, PDI, and zeta of the freeze-dried sample were 298.70 nm, 0.114, and 20.98 mV, respectively. The in vitro dissolution was studied, and the two dry powders showed a significant increase compared to silybin. The two dried powders had better long-term stability than the liquid starting material. Overall, spray-drying and freeze-drying are appropriate drying methods for the preparation of silybin nanosuspensions with better stability and dissolution velocity.

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