Search

BackgroundClinical trials have demonstrated that immediate initiation of antiretroviral therapy (ART) reduces AIDS-related morbidity and mortality. We tested the hypothesis that initiating ART ≤30 days after human immunodeficiency virus (HIV) diagnosis would be associated with reduced mortality among people living with HIV (PLWH) with CD4 counts >500 cells/μL.MethodsPLWH enrolled in the Chinese National HIV Information System between January 2012 and June 2014 with CD4 counts >500 cells/μL were followed for 12 months. Cox proportional hazards model was used to determine hazard ratios (HRs) for PLWH who initiated ART after HIV diagnosis. ART initiation was treated as a time-dependent variable.ResultsWe enrolled 34581 PLWH with CD4 >500 cells/μL; 1838 (5.3%) initiated ART ≤30 days after diagnosis (immediate ART group), and 19 deaths were observed with a mortality rate of 1.04 per 100 person-years (PY). Fifty-eight deaths were documented among the 5640 PLWH in the delayed ART group with a mortality rate of 2.25 per 100 PY. There were 713 deaths among the 27103 PLWH in the no ART group with a mortality rate of 2.39 per 100 PY. After controlling for potential confounding factors, ART initiation at ≤30 days (adjusted HR, 0.37 [95% confidence interval, .23-.58]) was a statistically significant protective factor.ConclusionsWe found that immediate ART is associated with a 63% reduction in overall mortality among PLWH with CD4 counts >500 cells/μL in China, supporting the recommendation to initiate ART immediately following HIV diagnosis.

The impact of flooding on cities is becoming increasingly significant in the context of climate change and rapid urbanization. Based on the analysis of the land use changes and rainstorm waterlogging inundation scenarios of Jiangqiao Town from 1980 to 2020, a scenario analysis was conducted to simulate and assess the rainstorm waterlogging disaster risk in 2040 under three land use scenarios (a natural development scenario, Scenario ND; an economic growth scenario, Scenario EG; and an ecological development priority scenario, Scenario EP) and three rainstorm scenarios with return periods of 10, 50, and 100 years. The following results were found: (1) Land use change is a significant factor in the risk of urban rainstorm waterlogging disaster caused by surface runoff and inundation depth change. In particular, the resultant increase in impermeable surfaces such as residential land and industrial land and the decrease in farmland during urbanization would lead to an increase in urban rainstorm waterlogging disaster risk. (2) Under three rainstorm scenarios, the future land use exposure elements and losses are consistent in terms of spatial distribution; from 10-year to 100-year return periods, they manifest as an expansion from the south to the surroundings, especially to the central region of the study area. The locations at risk are mainly distributed in the central and southern regions of Jiangqiao Town. (3) The economic losses are different in different land use scenarios and rainstorm scenarios. In the context of rainstorm scenarios with return periods of 10, 50, and 100 years, the total losses in land use scenario ND are CNY 560 million, CNY 890 million, and CNY 1.07 billion; those in land use scenario EG are CNY 630 million, CNY 980 million, and CNY 1.19 billion; and those in land use scenario EP are CNY 480 million, CNY 750 million, and CNY 910 million. The total losses of land use EP are the lowest by comparison. So, the influence of land use change on the rainstorm waterlogging disaster risk shows obvious differences among different rainstorm scenarios. This study has important reference value for decision making on land use management and flood disaster risk management in rapidly urbanizing areas. [ABSTRACT FROM AUTHOR]

BackgroundLate diagnosis of HIV infection is common. We aim to assess the proportion of newly diagnosed HIV cases receiving timely baseline CD4 count testing and the associated factors in China.MethodsData were extracted from the Chinese HIV/AIDS Comprehensive Response Information Management System. Adult patients over 15 years old who had been newly diagnosed with HIV infection in China between 2006 and 2012 were identified. The study cohort comprised individuals who had a measured baseline CD4 count.ResultsAmong 388,496 newly identified HIV cases, the median baseline CD4 count was 294 cells/µl (IQR: 130-454), and over half (N = 130,442, 58.8%) were less than 350 cells/µl. The median baseline CD4 count increased from 221 (IQR: 63-410) in 2006 to 314 (IQR: 159-460) in 2012. A slight majority of patients (N = 221,980, 57.1%) received baseline CD4 count testing within 6 months of diagnosis. The proportion of individuals who received timely baseline CD4 count testing increased significantly from 20.0% in 2006 to 76.9% in 2012. Factors associated with failing to receiving timely CD4 count testing were: being male (OR: 1.17, 95% CI: 1.15-1.19), age 55 years or older (OR:1.03, 95% CI: 1.00-1.06), educational attainment of primary school education or below (OR: 1.30, 95% CI: 1.28-1.32), infection with HIV through injection drug use (OR: 2.07, 95% CI: 2.02-2.12) or sexual contact and injection drug use (OR: 1.87, 95% CI: 1.76-1.99), diagnosis in a hospital (OR: 1.91, 95% CI: 1.88-1.95) or in a detention center (OR: 1.75, 95% CI: 1.70-1.80), and employment as a migrant worker (OR:1.55, 95% CI:1.53-1.58).ConclusionThe proportion of newly identified HIV patients receiving timely baseline CD4 testing has increased significantly in China from 2006-2012. Continued effort is needed for further promotion of early HIV diagnosis and timely baseline CD4 cell count testing.

The integration of nature-based solutions into land use optimization has become a central focus of current research, primarily due to its effectiveness in mitigating flooding impacts and promoting sustainable development in both urban and rural areas. Taking Shanghai's Pujiang Country Park as a case study, this paper conducts a simulation analysis to assess the flood mitigation effectiveness of three distinct land use patterns (Natural scenario, Scenario N; Complete urbanization scenario, Scenario U; Country Park Planning scenario, Scenario P) under five stormwater scenarios with return periods of 2, 5, 10, 20, and 50 years. The findings reveal that Scenario P exhibits superior flood mitigation performance, particularly under stormwater scenarios with a return period of less than 50 years. Building upon these results, the paper proposes recommendations for optimizing land use to mitigate the impact of flooding. This study is crucial for understanding the mechanisms involved in urban stormwater logging mitigation through land use methods and holds significance for decision-making in land use and planning at the micro level. [ABSTRACT FROM AUTHOR]

Based on the survey data of Jiaozhou Bay waters in May, September and October 1993, this paper studies the surface horizontal distribution of PHC content in Jiaozhou Bay waters. According to the definition, model and classification of Yang Dongfang homogeneity theory of matter content in waters proposed by the author, the calculation results show that in May, in the waters of Jiaozhou Bay, the non-homogeneous column of PHC content was 46.86μg/L, and the homogeneity of PHC content was 8.15%. At this time, the PHC content had non-homogeneity; in September, the non-homogeneous column of PHC content was 6.53μg/L, and the homogeneous was 48.58%, on which the PHC content had a low degree of homogeneity; in October, the non-homogeneous column of PHC content was 0.40μg/L, and the homogeneity was 96.61%, on which the PHC content had a high degree of homogeneity. This shows that in May, in the entire waters of Jiaozhou Bay, there was the only source of marine oil spill transportation, and the PHC content transported was 51.00μg/L, which was relatively high, resulting that the PHC content was unevenly distributed in the entire water body in the bay. In September, in the entire waters of Jiaozhou Bay, there was only the source of marine oil spill transportation, and its PHC content was 12.70μg/L, which was relatively low. In this way, the distribution of PHC content in the entire water body was lowly homogeneous. In October, there was no source of PHC content in the bay, and the PHC content was relatively low. In this way, the distribution of PHC content in the entire water body was highly homogeneous. From May to September, the monthly decline rate of the PHC content from marine oil spill was 9.57μg/L, the monthly decline rate of the non-homogeneous column of PHC content was 10.08μg/L, and the monthly increase rate of the homogeneity of PHC content was 10.10%. From September to October, the monthly decline rate of the PHC content of marine oil spill was 12.70μg/L, the monthly decline rate of the non-homogeneous column of PHC content was 6.13μg/L, and the monthly increase rate of the homogeneity of PHC content was 48.03%. This fully reveals that the PHC content of marine oil spill is the driving force of its non-homogeneity in the water area, while the ocean tides and currents are the driving force of its homogeneity in the water area. Based on this, the author puts forward the theory of homogeneous distribution of material content: under the action of ocean tides and currents, the ocean has the characteristics of homogeneity, and the distribution of material content in the ocean water body shows homogeneity.