Previous studies investigating HIV-infected patients suggested a direct link between underweight and the mortality rate of AIDS. However, there was a lack of evidence showing the optimal range of ...initial body mass index (BMI) patients maintain during antiretroviral therapy (ART). We aimed to evaluate associations of the BMI values pre-ART and during the entire ART duration with mortality among HIV-positive individuals. In total, 5101 HIV/AIDS patients, including 1439 (28.2%) underweight, 3047 (59.7%) normal-weight, 548 (10.7%) overweight and 67 (1.3%) obese patients, were included in this cohort. The cumulative mortality of underweight, normal-weight, and overweight were 2.4/100 person-years (95% CI 1.9-2.9), 1.1/100 person-years (95% CI 0.9-1.3), and 0.5/100 person-years (95% CI 0.1-0.9), respectively. Cumulative mortality was lower in both the normal-weight and overweight populations than in the underweight population, with an adjusted hazard ratio (AHR) of 0.5 (95% CI 0.4-0.7, p < 0.001) and 0.3 (95% CI 0.1-0.6, p = 0.002), respectively. Additionally, in the 1176 patients with available viral load data, there was significant difference between the underweight and normal-weight groups after adjustment for all factors, including viral load (p = 0.031). This result suggests that HIV-infected patients in Guangxi maintaining a BMI of 19-28 kg/m
, especially 24-28 kg/m
, have a reduced risk of death.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
On the premise of security, it is necessary to ensure good operational performance and technical indicators for nonlethal weapons such as flash detonation bombs. To make the weight of a flash ...detonation grenade more convenient for hand throwing and material costs save, the outer dimensions of the grenade body are fixed, and the optimal parameters of outer shell thickness of the vertigo grenade are explored. Based on the maximum deformation energy theorem, the strength of the shell with the obtained maximum thickness of 8 mm is checked, and then the optimal shell thickness under the ideal air explosion condition is obtained by reducing the thickness; Then check the thread strength to obtain the inner casing fracture, shock wave, and sound pressure level. The fragmentation performance test, detonation test, and sound pressure level test were carried out for the projectiles involving the shell thickness of 4 and 5 mm, and the simulation results were verified from three aspects of sound intensity, shell strength, and fragments. The results show that the maximum equivalent stress is 232.6 MPa and the maximum deformation is 1.07 × 10−4 mm when the outer shell thickness of the vertigo grenade is 5 mm, which is less than the material failure strength standard and no plastic deformation could occur. The structural connection strength of the missile body meets the standard. Most of the fragments are trapped in the cavity. The average sound pressure level at 1.5 m can reach 159.7 dB. The relative error between the sound pressure level at 3 m and the live ammunition test results is 4.8%, which meets the expected operational technical indicators and has good safety performance. The results of the numerical simulation can provide a reference for the design optimization and performance evaluation of similar vertigo grenades.
In this article, a security stun grenade with a double‐layer structure with parallel side openings is designed. Taking into account the impact mechanical strength and the overall weight characteristics of the shell, the law of the stress concentration characteristics at the openings changing with the thickness during the explosion process was explored, and the optimal thickness was obtained. At the same time, the reliability of the simulation and the practical safety are verified by experiments.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
To explore the response law of non-lethal large-size kinetic energy projectiles to blunt attack on skin tissue, and to evaluate the skin injury characteristics of the attacked personnel and the use ...safety of kinetic energy projectiles. Based on the LS-DYNA simulation software, a three-layer skin simulation model and a Flash-Ball rubber bullet model are established, and the force-time and deformation-time biomechanical corridors of the Flash-Ball rubber bullet impacting human skin tissue are obtained. The corridor curve and the energy transfer and diffusion are analyzed and compared. The safety evaluation of the damage caused by the rubber bullet shooting a human body at different distances is carried out using the empirical formula of the penetration limit. Finally, the safe shooting distance is obtained. The results show that the model used in the simulation has a good correlation with the experimental data, its biomechanical corridor characteristics are different from those of conventional vehicle impact and small-size projectile response characteristics. The energy transfer and action time of medium and low-speed impact may cause greater damage. The fat layer is the largest energy absorption unit. The minimum safe shooting distance to ensure skin tissue from penetrating damage is 15.8 m, and the limit specific kinetic energy of skin damage is 7.88 J/cm2. This study can be extended to the study of biomechanical response law and safety evaluation under the impact of the same type of large kinetic energy projectile, which provides an important theoretical reference for the police to use large kinetic energy projectiles to conduct safe shooting in peacekeeping operations.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The thermal response of energetic materials involves processes of thermochemical mechanical coupling, which can lead to thermal damage in such materials both before and after ignition, thereby ...increasing ignition sensitivity and the level of danger. Many studies to date have either neglected or oversimplified the effects of thermal coupling, leading to significant discrepancies between simulated and experimental outcomes. This paper aims to examine the complex processes of ammunition ignition, combustion, and detonation. Employing finite element simulations in conjunction with Arrhenius dynamics and the ignition growth model theory under thermodynamic coupling analysis, it simulates the entire process from the thermal expansion of B explosive prior to ignition, through to combustion and detonation. It establishes the relationship between the damage and fracture state of the shell and the thermal response of the energetic material at varying heating rates. Findings indicate that the severity of the thermal response is determined by the balance between pressure accumulation and the loss of confinement leading to pressure release. Specifically, at heating rates below 0.25 K/min, the shell fractures before combustion of the energetic material; whereas, at rates exceeding 0.375 K/min, the shell fractures after combustion, significantly increasing the risk. The simulation outcomes of this study show strong correlation with experimental results reported in the literature, offering a valuable reference for simulating the ignition and combustion responses of ammunition with similar structural characteristics.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The HIV/AIDS prevalence in female sex workers (FSWs) and elderly male clients is increasing in Guangxi, China, but the transmission relationship between them remains unclear. This study aims to ...illuminate the transmission network between FSWs and elderly male clients using molecular epidemiological analyses. Phylogenetic analysis indicated that CRF01_AE was the dominant strain, followed by CRF07_BC and CRF08_BC in both groups. Multivariate logistic regression analysis indicated that viral loads of 50 to 1000 copies/mL, immunological treatment failure and CRF07_BC were risk factors for entering the transmission network. Transmission network analysis showed that CRF07_BC tended to form large clusters, whereas CRF01_AE tended to form multiple but small clusters. Two groups of 11 FSWs and 169 clients were intricately intertwined. Spatial analysis demonstrated the formation of hotspots and clusters of transmission sharing regional differences. In conclusion, our study provides direct genetic evidence of transmission linkages between FSWs and elderly male clients. Although the CRF01_AE subtype was still the predominant subtype in the region, the higher degree and larger clusters found in CRF07_BC illustrate a rapid and intensive uptrend, which is expected to increase its prevalence in the region in the future.
Female sex workers (FSW) are a population that are at high risk for HIV infection, and their HIV/AIDS knowledge levels and sexual behaviors are of concern. This study describes changes in HIV ...prevalence and factors associated among female sex workers in Guigang City, Guangxi, one of the highest HIV prevalence areas in China.
Data were derived from an annual cross-sectional venue-based survey, 2008 to 2015, in the form of sentinel surveillance. The participants were recruited using cluster sampling. FSW aged 16 years and above who completed a questionnaire and HIV testing. Both descriptive and multi-level analyses were used to explore factors associated with changes in HIV prevalence.
Seven thousand four hundred ninety-six FSW were recruited in this study. HIV prevalence among FSW in Guigang City fell into two periods, one with an increasing trend (2008-2011) and one with a decline (2012-2015). Differences between these time periods included age, relationship status, HIV knowledge, consistent condom use, lifetime illicit drug use, history of sexually transmitted infection in the past year, HIV testing, receipt of a condom distribution and education program or HIV counseling and testing, and peer education services.
Since 2012, a reduction in HIV prevalence among FSW in Guigang City has been observed. The decline of HIV prevalence was associated with coinciding changes in demographic characteristics of FSW, improvement of HIV knowledge and safer sexual behaviors, and a program that promotes condom use, HIV counseling & testing, and peer education.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Objective To evaluate the impact of AIDS-defining events (ADE) on long-term mortality of HIV positive individuals on antiretroviral therapy (ART), a retrospective HIV/AIDS treatment cohort study ...performed in Southwestern China. Methods The retrospective cohort was conducted among 6757 HIV/AIDS patients on ART (2NRTIs + 1NNRTI, 2NRTIs + 1PI and Single or two drugs) recruited in Guigang city, Guangxi, China, from January 2004 to December 2018. Participants were divided into ADE and non-ADE groups, and were followed-up every six months to observe treatment outcomes. Comparison of mortality between groups was performed using the log-rank test and Kaplan-Meier analysis. Cox proportional hazard regression was used to explore the risk factors of mortality. 1:1 propensity score matching (PSM) was used to balance confounding factors and adjust the mortality risk. Results Of 6757 participants with 29,096.06 person-years of follow-up, 16.86% (1139/6757) belonged to ADE group while the others (83.14%) belonged to the non-ADE group. The most common cause of death by ADE was disseminated mycosis (31.65%), followed by recurrent severe bacterial pneumonia (28.48%), herpes zoster (17.72%), and extra-pulmonary tuberculosis (8.86%). The mortality of the ADE group was significantly higher than that of the non-ADE group 3.45/100 person-years (95% CI 2.92-3.97) vs. 2.34/100 person-years (95% CI 2.15-2.52), P<0.001. The death risk of the ADE group was also higher than that of the non- ADE group adjusted hazard ratio (aHR) = 1.291, 95% CI 1.061-1.571, P = 0.011, which was confirmed by PSM analysis (aHR = 1.581, 95% CI 1.192-2.099, P = 0.002). Cox analysis indicated that ADE, older age, male gender, previous non-use of cotrimoxazole, advanced WHO clinical stage, and low baseline CD4.sup.+ cell count were the risk factors for death. Conclusions Even on ART, the mortality risk of HIV positive individuals with ADE was higher than those without ADE. Active testing, earlier diagnosis, and timely therapy with ART may reduce the death risk of ADE. Keywords: HIV, AIDS, Antiretroviral therapy, AIDS-defining events, Mortality
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
旨在为广西贵港市预防食源性疾病提供科学依据，采用GB ...5009.22—2016中的高效液相色谱-柱后衍生法测定2018—2022年从贵港市不同地点采集的625件食用植物油样品的黄曲霉毒素B1（AFB1）含量，并应用人群肝癌发病风险法和暴露限值(MOE)法对AFB1的暴露风险进行评估。结果表明：在625件食用植物油样品中，AFB1的检出率为96.80%，超标率为20.00%，其中定型包装油均合格，散装油超标率为31.97%；花生油中AFB1的检出率为97.04%，超标率为2470%，其他食用植物油均合格；采集自油坊、杂货店和街头摊点的样品的AFB1超标率较高；食用植物油中AFB1的日膳食暴露量为5.26 ng/kg，AFB1致肝癌发病风险为0.236例/（年·10万人），其中散装油为0.581例/(年·10万人)，花生油为0.416例/(年·10万人)；食用植物油的MOE值为76，其中散装油为31，定型包装油为625，花生油为43，其他油为930。综上，贵港市食用植物油中以散装花生油中AFB1的污染及暴露风险最高，存在一定的食品安全潜在风险，须加强监管并采取相应措施以提高食品安全性。In order to provide a scientific basis for the prevention of foodborne diseases in Guigang, Guangxi, a total of 625 edible vegetable oil samples were collected from different locations in Guigang from 2018 to 2022, and aflatoxin B1 (AFB1) was detected by post-column derivatization high performance liquid chromatography method in GB 5009.22-2016. The exposure risk of AFB1 was assessed using margin of exposure (MOE) method and population risk of liver cancer method. The results showed that in 625 samples, the detection rate of AFB1 was 96.80%, and the exceeded rate was 20.00%, among which all the packaged samples were qualified, and the exceeded rate of bulk samples was 31.97%. The detection rate of AFB1 in peanut oil was 97.04%, and the exceeded rate was 24.70%, while the other edible vegetable oils were qualified. The exceeded rate of AFB1 in samples collected from oil mills, grocery stores and street stalls was higher. The daily dietary exposure of AFB1 in edible vegetable oil was 5.26 ng/kg, and the incidence risk of liver cancer caused by AFB1 was 0.236 cases/100 000 people per year, of which bulk oil was 0.581 cases/100 000 people per year and peanut oil was 0.416 cases/100 000 people per year. The MOE value of edible vegetable oil was 76, of which bulk oil was 31, packaged samples were 625, peanut oil was 43, and other oils were 930. In conclusion, the risk of AFB1 contamination and exposure of bulk peanut oil in edible vegetable oils in Guigang is high, and there are certain potential risks of food safety. Supervision should be strengthened and corresponding measures should be taken to improve food safety.
This paper explores the impact of changes in charge quantity and diameter on the thermal response of DNAN-based explosives. To achieve this, we established a method for simulating thermal, chemical, ...and mechanical coupling. The study focuses on three fixed charge quantities of explosives, each with varying length-to-diameter ratios, examining alterations in ignition position, timing, and temperature changes under different heating rates, as well as the safe thermal response size in various heating environments. The findings show that the maximum discrepancy between the simulation results and experimental data is under 5 %. It was observed that larger charges are less sensitive to variations in external heating rates and aspect ratios. Specifically, at a heating rate of 1 K/min, projectiles with a diameter exceeding their length by the same factor exhibit greater thermal safety than those with a length exceeding their diameter. This research not only enhances the accuracy of simulation experiments but also offers a comprehensive safety analysis for the combustion of ammunition. The findings provide valuable insights for designing low-vulnerability ammunition structures that are subject to significant thermal stress in various environments, and they are useful for guiding ammunition storage and destruction experiments.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
ObjectiveTo characterise the association between duration of exposure to antiretroviral treatment (ART) and liver damage in HIV patients with an initially normal baseline liver function and without ...hepatitis B virus (HBV)/hepatitis C virus (HCV) infection.MethodsA retrospective cohort study was conducted in HIV-infected individuals with normal liver function parameters at ART initiation and without HBV/HCV infection, from 14 April 2004 to 13 April 2015 in Guigang city, Guangxi, China. The association between duration of ART and liver damage (grade II–IV liver enzyme elevation LEE and/or total bilirubin elevation TBE), was analysed. Cox regression was used to examine the factors related to liver damage.ResultsOf 2119 eligible patients, 12.41% (263/2119) developed liver damage (grade II–IV LEE/TBE) and contributed 4.11/100 person-years crude incidence rate. The highest liver damage incidence was observed in patients with 6–12 months’ ART (15.16/100 person-years). The incidence decreased to 5.56/100 person-years in patients with 12–18 months’ ART and 3.13/100 person years in patients with 18–24 months’ ART, and then maintained at a relatively low and stable level in patients with 2 years’ ART or longer (average of 3.65/100 person-years). Cox regression analysis revealed that current WHO disease stage II, III or IV (compared with stage I) were the risk factors for liver damage, while baseline disease stage II, III (compared with stage I) and current regimen 3TC+AZT+NVP were the protective factors for liver damage.ConclusionsLiver damage always exists among HIV-infected patients on ART with normal baseline liver function and without HBV/HCV infection. Nevertheless, cumulative ART duration does not increase the risk of liver damage. ART could tend to be long-term, however, monitoring and management of liver damage among patients on ART are also important in clinical therapy.
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