Strong Agreement of Nationally Recommended Retention Measures from the Institute of Medicine and Department of Health and Human Services

Objective

We sought to quantify agreement between Institute of Medicine (IOM) and Department of Health and Human Services (DHHS) retention indicators, which have not been compared in the same population, and assess clinical retention within the largest HIV cohort collaboration in the U.S.

Design

Observational study from 2008–2010, using clinical cohort data in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD).

Methods

Retention definitions used HIV primary care visits. The IOM retention indicator was: ≥2 visits, ≥90 days apart, each calendar year. This was extended to a 2-year period; retention required meeting the definition in both years. The DHHS retention indicator was: ≥1 visit each semester over 2 years, each ≥60 days apart. Kappa statistics detected agreement between indicators and C statistics (areas under Receiver-Operating Characteristic curves) from logistic regression analyses summarized discrimination of the IOM indicator by the DHHS indicator.

Results

Among 36,769 patients in 2008–2009 and 34,017 in 2009–2010, there were higher percentages of participants retained in care under the IOM indicator than the DHHS indicator (80% vs. 75% in 2008–2009; 78% vs. 72% in 2009–2010, respectively) (p<0.01), persisting across all demographic and clinical characteristics (p<0.01). There was high agreement between indicators overall (κ = 0.83 in 2008–2009; κ = 0.79 in 2009–2010, p<0.001), and C statistics revealed a very strong ability to predict retention according to the IOM indicator based on DHHS indicator status, even within characteristic strata.

Conclusions

Although the IOM indicator consistently reported higher retention in care compared with the DHHS indicator, there was strong agreement between IOM and DHHS retention indicators in a cohort demographically similar to persons living with HIV/AIDS in the U.S. Persons with poorer retention represent subgroups of interest for retention improvement programs nationally, particularly in light of the White House Executive Order on the HIV Care Continuum.     

大豆油脂生产的污染源分析及污染防治

分析了大豆预处理、油脂浸出和油脂精炼等生产过程中,废水、废气、粉尘、异味和废渣等主要污染物的来源。结合大豆油脂加工的行业特性,相应地提出了源头控制和末端治理的废水污染防治措施,冷凝和吸附的溶剂尾气治理方式,以及油脂回收的废渣处理和利用措施。提出了低污染、低能耗的清洁生产方式是大豆油脂生产过程中污染防治的最有效的办法。     

青海省北祁连中三叠统孢粉组合及其沉积相意义

青海省祁连县俄博乡大擦汗沟、土圈沟、柯柯里等三叠系剖面的粉砂岩、砂质页岩、泥质页岩中首次发现较丰富的孢粉和疑源类化石,计57属98种。孢粉中的蕨类植物孢子占总组合的44.6%,裸子植物花粉占33.9%;疑源类有8属13种,占21.5%,称Verrucosisporites-Triadispora-Trematosp haeridium孢粉组合。该组合面貌与国内外中三叠世不同相区的孢粉组合特征基本相似并可对比。北祁连山南坡本组合及上下其它组合中海相疑源类的存在,表明该区在三叠纪受到海水影响,海水完全退出是在三叠纪之后。文章还初步探讨其沉积相意义。     

SO2熏气对油桐叶片细胞膜脂组成和叶绿体超微结构的影响

经SO2熏气处理的油桐叶片电导率增加,叶片中脂质过氧化作用增强,总类脂、极性脂、非极性脂、糖脂含量下降,磷脂含量稍有增加;极性脂和非极性脂中不饱和脂肪酸C18:3含量、C18:3/IUFA、不饱和指标UFA和IUFA值下降,叶绿体结构受到破坏,片层结构模糊不清;随着熏气时间的延长叶绿体中的淀粉颗粒增大,脂滴变小.     

水杉的保护历程和存在的问题

水杉(Metasequoia glyptostroboides)的保护过程在某种程度上可以说是新中国成立50年来中国珍稀植物保护过程的一个缩影。2003年,以保护水杉为主要目的而建设的湖北省国家级星斗山自然保护区是我国水杉保护和发展中的里程碑,对于这一过程的了解有助于今后正确地制订就地和迁地保护计划和采取有效的行动。本文对水杉保护历程进行了全面回顾,针对水杉原产地的保护现状和存在的问题,提出四条具体的保护措施：(1)加强以水杉保护为主要目的的国家级自然保护区建设,建设重点应放在对水杉原生母树及其生境的保护。保护水杉原生母树及其生境要有长远的规划,机构的设置和功能以及人员的素质和经费要能支持水杉原生母树及其生境保护和发展的需要;(2)要把有关水杉保护的法规和措施落到实处;(3)建立基因保存林,对现有水杉原生母树基因进行全面保存;(4)积极协调环保、林业、科学院以及其他教育科研单位的关系,加强在这一领域的分工协作,开展科学研究,加强学术交流,共同促进水杉的保护和利用。     

BioTRIZ Suggests Radiative Cooling of Buildings Can Be Done Passively by Changing the Structure of Roof Insulation to Let Longwave Infrared Pass

This paper demonstrates the application of a design tool called BioTRIZ. Its developers claim that it can be used to access biological strategies for solving engineering problems. Our aim is to design a roof for hot climates that gets free cooling through radiant coupling with the sky. The insulation in a standard roof stops the sun and convection from warming the thermal mass. But it also restricts the mass＇s longwave view of the cool sky. Different solutions to this conflict are offered by BioTRIZ. The chosen solution is to replace the standard insulation component with an open cell honeycomb. The vertical cells would allow longwave radiation to pass, while arresting convection. The solutions offered by BioTRIZ＇s technological counterpart include no such changes in structure. It is estimated that the thermal mass in the biomimetic roof would remain on average 4.5℃ cooler than in a standard roof over a year in Riyadh, Saudi Arabia.     

桉树人工林冠层、凋落物及土壤水文生态效应

水文功能是森林生态功能的重要方面,为了解桉树人工林的水文生态效应,采用定位研究并结合室内测定的实验方法,研究了广东肇庆桉树人工林冠层降雨再分配、凋落物持水能力、土壤水分物理及蓄水能力。结果表明,研究期间(2006-05-2007-05)的大气降雨量为2016.7mm,通过林冠层后降雨被重新分配,穿透降雨量、树干茎流量和林冠截留量分别占总降雨量的85.70%、3.62%和10.68%。产生树干茎流的临界降雨量为3.93mm,穿透雨量、树干茎流量与林外降雨量均呈极显著正相关(P0.01);林冠截留率与降雨量呈显著的负相关(P0.05),降雨量超过20mm后,林冠截留率基本保持稳定。本研究桉树人工林的凋落物最大持水量为4.27mm,凋落物中树叶的最大持水量最大,为2.54mm。0-100cm土层的最大蓄水量为470.06mm,其中非毛管蓄水量为98.22mm,土壤总孔隙度和非毛管孔隙度随土壤深度增加呈递减趋势;0-10cm土壤层的初渗速率和稳渗速率分别为25.03mm.min-1和8.83mm.min-1,且随土壤深度增加而逐渐减小。