Evaluating the impact of sugar-sweetened beverages tax on overweight, obesity, and type 2 diabetes in an affluent Asian setting: A willingness-to-pay survey and simulation analysis.

BACKGROUND: The potential health effects of taxing sugar-sweetened beverages (SSBs) has been insufficiently examined in Asian contexts. This study aimed to assess the impact of SSB taxation on the prevalence of obesity/overweight and type 2 diabetes mellitus (T2DM) in Hong Kong using a willingness-to-pay (WTP) survey and simulation analysis. METHODS: A random telephone survey was conducted with 1000 adults from May to June 2020. We used a contingent valuation approach to assess individuals' WTP for SSBs under four tax payment scenarios (5%, 10%, 40%, and 50% of the current market price). Based on the WTP, a simulation analysis was conducted to project changes in SSB purchase and associated reductions in the prevalence of obesity/overweight and T2DM over a 10-year simulation period. FINDINGS: When 5% and 10% taxation rates were introduced, approximately one-third of the population were unwilling to maintain their SSB purchase. Our simulation demonstrated a gradual decline in the prevalence of obesity/overweight and diabetes with a more pronounced decrease when higher taxation rates were introduced. 10% taxation resulted in a mean reduction of 1532.7 cases of overweight/obesity per 100 thousand population at the sixth year, while T2DM prevalence decreased by 267.1 (0.3%). CONCLUSIONS: This study underscores the effects of an SSB tax on purchase behaviors and health outcomes in an affluent Asia setting, with a more pronounced influence on adult population. These findings are expected to inform policymakers in making decisions regarding an effective and equitable tax rate on SSBs.

Evaluation of racial and ethnic heterogeneity in the associations of sleep quality and sleep apnea risk with cognitive function and cognitive decline.

INTRODUCTION: The prevalence of poor sleep quality and sleep apnea differs by race and ethnicity and may contribute to racial disparities in cognitive aging. We investigated whether sleep quality and sleep apnea risk were associated with cognitive function and decline and whether the associations differed by race/ethnicity. METHODS: Participants from the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE; N = 1690; mean age: 75.7 years) study, a cohort of Asian, Black, Latino, and White participants, completed a modified Pittsburgh Sleep Quality Index assessing subjective sleep quality, latency, duration, disturbances, sleep medication use, and daytime dysfunction. Sleep apnea risk was measured by questions about snoring, tiredness, and whether apnea was observed. Executive function and verbal episodic memory were assessed at three time points over an average of 2.7 years with the Spanish and English Neuropsychological Assessment Scale. We fit linear mixed-effect models and stratified analyses by race/ethnicity. RESULTS: Higher sleep apnea risk was associated with faster declines in verbal episodic memory (ß^ sleep apnea = -0.02, 95% confidence interval [CI], -0.04, -0.001) but not in executive function. Poorer sleep quality was associated with lower levels of and faster decline in executive function but not in verbal episodic memory. Race/ethnicity modified these associations: compared to estimated effects among White participants, poorer global sleep quality (ß^ sleep*time = -0.02, 95% CI, -0.02, -0.01) was associated with larger effects on decline in executive function among Black participants. Estimated effects of some individual sleep quality components were also modified by race/ethnicity; for example, sleep medication use was associated with faster declines in executive function (ß^ sleep*time = -0.05, 95% CI, -0.07, -0.03) and verbal episodic memory ß^ sleep*time = -0.04, 95% CI, -0.07, -0.02) among Black participants compared to White participants. DISCUSSION: Observational evidence indicates sleep quality is a promising target for addressing racial/ethnic disparities in cognitive aging, especially among Black older adults. Highlights: Sleep apnea risk was associated with faster declines in verbal episodic memory but not executive function among all participants.Global sleep quality was associated with lower levels of and faster decline in executive function but not verbal episodic memory among all participants.Black older adults were particularly susceptible to the estimated adverse cognitive impacts of global sleep quality, particularly the use of sleep medication.

Comparative assessment of formation pathways and adsorption behavior reveals the role of NaOH of MgO-modified diatomite on phosphate recovery.

The phosphate adsorption behavior on MgO-modified diatomite has been routinely investigated. Batch experiments tend to show that the addition of NaOH during preparation largely promoted adsorption performance, but comparative studies of MgO-modified diatomite with and without NaOH (MODH and MOD) based on morphology, composition, functional groups, isoelectric points and adsorption behavior have not been reported. We demonstrated that NaOH can etch the structure of MODH and promote the migration of phosphate to active sites, which allowed MODH to have a faster adsorption rate, superior environmental adaptability, adsorption selectivity and regeneration performance. The phosphate adsorption ability was enhanced from 96.73 (MOD) to 197.4 mg P/g (MODH) under optimum conditions. Furthermore, the partially hydrolyzed Si-OH group reacted with Mg-OH via a hydrolytic condensation reaction to form a new Si-O-Mg bond. Intraparticle diffusion, electrostatic attraction and surface complexation may be the main modes of phosphate adsorption by MOD, while the MODH surface mainly relied on the synergy of chemical precipitation and electrostatic attraction due to the abundant MgO adsorptive sites. Indeed, the present study provides a new understanding of the microscopic analysis of sample differences.

Does education finance reduce the inequality of educational results? The mediation effect of shadow education.

Public education finance in China plays an important role in education equality. This study investigated two mediation effects with a generalized structural equation model that comprised the mediation effect of shadow education at the school, family, and individual levels and the moderating role of education finance. There was a strong association among heterogeneity factors, shadow education, and educational results, with shadow education playing a mediating role in math and English courses. Individual heterogeneity differences had a negative impact on equality in educational results through access to additional shadow education opportunities, while heterogeneous factors were mediated through shadow education, causing financial moderation effects, in turn affecting inequality in educational results. Finally, the moderation degree and direction of education finance varied significantly, with a greater moderation effect on household-level factors that lead to unequal educational results. Targeted efforts are required to regulate shadow education, which is key to the development of the education system.