Environmental Impact Assessment Follow-Up of Seismic Survey Offshore Activities in Brazil

Follow-up of environmental impacts is an integral part of the Environmental Impact Assessment (EIA) process, closely related to the effectiveness of the instrument. EIA follow-up has been receiving a lot of interest from scientists and practitioners, though it is recognized as one of the weakest points of EIA systems globally. Also, EIA follow-up is influenced by the context, mainly in terms of the types of projects or activities and their related impacts on the environment. Therefore, the present paper is focused on the investigation of the follow-up stage applied to the activity of seismic survey coupled with offshore oil & gas exploitation in Brazil. Research was based on a qualitative approach that included document analysis and semi-structured interviews with analysts involved in EIA processes, and sought to generate evidence of effectiveness of the EIA follow-up as conducted by the Federal Environment Agency (Ibama) in order to situate the practice of follow-up in the broader context of international best practice principles. Based on the findings, it was concluded that, due to the peculiarities of offshore seismic survey, it is necessary to promote adaptations in the procedures for monitoring impacts in order to ensure proper alignment with the principles and conceptual foundations that guide EIA practice. Specifically, the timing of the execution of the activity imposes challenges for its integration into the “conventional” cycle that has guided the monitoring of the impacts in the EIA of projects.

Follow-Up Care of HIV-Positive Pregnant Women in North Central Nigerian: A 15-Year Review

Background: Pregnant women bear the greatest burden of people living with HIV in the West Africa sub-region, and the country requires continuous optimal follow-up care for their disease after delivery. Documentation of such very important services is rarely done in this high-burden environment, and hence the present study. Method: A 15-year retrospective review of medical records of HIV-positive pregnant women who attended antenatal care services from January 2006 to December 2020 at the prevention of the mothers-to-child transmission unit of the health facility was carried out to document the HIV service provided at the unit, and the follow-up care at the adult HIV special treatment clinic for the continuation of their HIV treatment. Results: Of the 1245 HIV-positive pregnant mothers reviewed during the period, 702 (56.4%) were between the ages of 26 - 35 years, 1043 (83.8%) were on HIV treatment before their index pregnancy, 202 (16.2%) were diagnosed of HIV infection during their last trimester and labor, while 878 (70.5%) continued their HIV services at adult HIV special treatment clinic after delivery. The predictors of continuous care include: maternal parity with [OR] 0.51 (0.35 - 0.73), p = 0.02, time of presentation in trimester with [OR] 1.54 (1.15 - 2.06), p = 0.003, duration on antiretroviral therapy [OR] 2.14 (1.57 - 2.9) p Conclusion: The high rate of optimal follow-up care of HIV-positive mothers after delivery in the adult special treatment clinic in this study speaks of the preparedness and good supportive services provided to these mothers in the health facility. However, the high rate of loss to follow-up among this cohort of women requires a more focused intervention during their postpartum period for a better outcome.

Determinants of the Ophthalmological Follow-Up of Sickle Cell Patients at the National Center of Research and Care for Sickle Cell Patients in Lome-Togo

Objectives: To assess the factors influencing the ophthalmological follow-up of sickle cell patients in Togo. Materials and Methods: The national center of research and care for sickle cell patients (CNRSD) served as study setting. It was a descriptive and analytical study by interview over a three-month period from December 01, 2020 to March 02, 2021. Was included in the study, any patient with sickle cell disease genotype SS or SC, age ≥ 17 years, regularly followed at the CNRSD and having accepted the interview by a survey sheet. Excluded were patients with sickle cell trait genotype AS or AC or with a disability that prevented them from being interviewed. Results: Two hundred and fifty (250) patients with sickle cell disease were interviewed. The mean age was 29.1 years ± 11.12 years [17 years;67 years] and the sex ratio = 0.52. Nine patients over ten (9/10) attended at least secondary school. The jobless represented 25.60% of the total population followed respectively by students and laborers in 20.40% and 16% of cases. Twenty-four percent (24%) of patients were followed up in ophthalmology department. Statistically, there was no significant relationship between level of education (p = 0.4083), occupation (p = 0.6441) and knowledge of the ocular complications of sickle cell disease. Statistically, there was a significant relationship between knowledge of the ocular complications of sickle cell disease and compliance with ophthalmological follow-up (p = 0.0009). Conclusion: The knowledge of eye disorders related to sickle cell disease by patients with sickle cell disease improves their ophthalmological follow-up. Greater awareness on eye disorders related to sickle cell disease by medical staff towards patients with sickle cell disease would improve ophthalmological follow-up. .

Postpartum Intrauterine Device: Use and Follow-Up of Users in the Maternity Ward of the Ratoma Communal Medical Center in Conakry, Guinea

Objective: The aim of this study was to describe the use of the postpartum intrauterine device in the maternity ward of the Ratoma communal medical center in Conakry. Methods: This was a descriptive cross-sectional study carried out between July 1st 2015 and June 30 2016, i.e. a duration of one year. Results: A total of 551 patients received advice on various contraceptive methods. Most of this advice was given in the post-partum period (40.2%) and during antenatal care (39.1%). Of the patients advised, 87 (15.8%) used the intrauterine device. The majority of users (93%) were married and uneducated (63.2%), and 39.1% were poor. The majority (56.3%) of intra-uterine devices were inserted in the immediate post-partum period. The majority of women had no adverse events either during the first six weeks (n = 57;65.5%) or at 3rd months (n = 75;86.2%) or 6th months (n = 76;87.4%) after IUD insertion. Most users remained complication-free throughout the follow-up period (n = 76;87.4% at 6th weeks and 3rd months, and n = 77;88.5% at 6th months). The continuation rate was 89.7% at 6 weeks and 3rd months, and 87.4% at 6th months after insertion. The majority of users (87.0%) were satisfied with the care they received. Conclusion: This study showed very few complications among intrauterine device users, and high continuation and satisfaction rates. The intrauterine device is a long-acting, effective, reversible and safe contraceptive that can be used by most women for birth spacing in Guinea, where women do not regularly visit health facilities.

Evolution of HBV Viral Load during Clinical and Biological Follow-Up of Chronic Hepatitis B Patients at the Saint Camille Hospital in Ouagadougou

Hepatitis B virus (HBV) infection is a major public health problem worldwide. The aim of this study was to document the dynamics of HBV viral load during the follow-up of chronic hepatitis B patients at the Saint Camille Hospital in Ouagadougou (HOSCO) from 2017 to 2021. This descriptive retrospective study was carried out in the Hepato-Gastro-Enterology Department of HOSCO and focused on patients who were undergoing treatment for chronic viral hepatitis B. A total of 260 cases of chronic hepatitis B were included in the study. The most affected age group was 21 to 30 years, accounting for 48.08% of the cases. Lifestyle factors included alcohol consumption (3.08%) and tobacco use (2.69%). Major risk factors for transmission included lack of vaccination (98.46%), family history of HBV infection (68.00%) and engagement in high-risk activities (28.00%). Patients requiring treatment were prescribed Tenofovir 300 mg tablets. FibroScan® showed the presence of stage F3-F4 fibrosis (2.14%) and S3 steatosis (13.33%). After one year of follow-up, 6.92% of patients achieved an undetectable viral load with normalized transaminase levels. The majority of other patients had a detectable viral load but below 20,000 IU/mL. The prevalence of viral hepatitis B remains significant worldwide. Although effective and well-monitored treatment can lead to undetectable viremia, prevention remains the most effective strategy for successful management of this disease.

Adult Congenital Lumbar Kyphosis Requiring Anteroposterior Correction and Fusion: A Case Report with 32-Year Follow-Up

Congenital pure kyphosis due to failure of vertebral body segmentation is a relatively rare entity, and surgical intervention is infrequent compared to that for failure of vertebral body formation [1] [2]. There are very few reports of long-term follow-up of surgical treatment in patients with congenital pure kyphosis, and all the reported cases were diagnosed as failure of formation and had an age at the time of surgery of less than 18 years. It is important for orthopedic surgeons to follow the postoperative course of rare cases over 30 years. Here, we present a surgically treated case with ultra-long term follow-up of a 50-year-old patient with congenital pure kyphosis of the lumbar spine. Imaging of the lumbar spine showed six vertebrae and an unsegmented bar at L3-4 causing a pure kyphosis of 54°. The wedge-shaped block vertebra had 4 pedicles with the neural foramen between the pedicles without concomitant disc space, with compensatory thoracic hypokyphosis and lower lumbar hyperlordosis. One-stage correction and fusion surgery using anterior opening and posterior closing osteotomy was successfully performed. Both clinical and radiographic results were excellent and have been maintained for over 30 years postoperatively. The basic principle in the surgical treatment of adult spinal deformity is to achieve and maintain a good global sagittal balance over time. This case reaffirms the importance of spinopelvic harmony.

MRI术前定量评估距骨骨软骨损伤范围对术式选择及中长期随访结果的影响

背景:距骨骨软骨损伤是一种常见的运动系统疾病,该损伤类型会影响患者的日常生活和工作能力,如不及时治疗可能加重病情。手术治疗是常用的治疗方法,但术式选择和中长期随访结果的评估一直是临床上的难题。目的:探究术前T1ρ技术定量评估距骨骨软骨损伤范围对术式选择及中长期随访结果的影响。方法:回顾性选择2019年1月至2022年8月唐山市第二医院收治的距骨骨软骨损伤患者154例作为研究对象。术前MRI检查距骨骨软骨损伤部位,比较不同分型患者的T1ρ值及T2值;再根据T1ρ值选择不同的手术方式,将T1ρ值<45 ms采用微骨折手术治疗设为A组(n=73),T1ρ值≥45 ms采用自体骨软骨移植治疗设为B组(n=81)。比较不同术式下患者的一般临床特征及疗效,多因素Logistic回归分析患者术后复发的重要因素,限制性立方样条图分析T1ρ值与患者术后复发的关系,y=1-1/(1+e-z)回归方程建立预测模型,十字交叉验证法验证模型稳定性。结果与结论:①154例患者中距骨骨软骨损伤分型Ⅰ型36例,Ⅱ型37例,Ⅲ型40例,Ⅳ型41例,4个分型患者的T1ρ值及T2值相比差异均有显著性意义(P<0.05),两两比较差异亦有显著性意义(P均<0.05);②154例患者治疗后局部肿胀7例(4.6%),疼痛加重3例(2.0%),创口感染5例(3.3%),软骨愈合不良2例(1.3%);③A、B组治疗后美国骨科足踝协会评分、目测类比评分、跖屈活动度、背伸活动度、软骨下骨骨髓水肿体积、白细胞介素6、白细胞介素8、C-反应蛋白、降钙素原、血小板衍生生长因子、转化生长因子β1水平、疗效方面比较差异均有显著性意义(P<0.05),其中B组的疗效总有效率为90%,比A组总有效率(85%)高(P<0.05);④年龄(OR=1.589,95%CI:0.305-1.252,P=0.036)、白细胞介素6(OR=1.737,95%CI:0.974-5.254,P=0.049)、白细胞介素8(OR=1.385,95%CI:1.066-4.355,P=0.034)、C-反应蛋白(OR=1.957,95%CI:1.323-2.178,P=0.035)、转化生长因子β1(OR=1.459,95%CI:0.897-2.455,P=0.038)、T1ρ值(OR=1.687,95%CI:0.854-3.321,P=0.026)、T2值(OR=1.843,95%CI:0.657-2.454,P=0.036)、并发症(OR=1.719,95%CI:0.654-3.464,P=0.019)、距骨骨软骨损伤分型(OR=3.789,95%CI:1.023-5.897,P=0.028)均是影响患者术后复发的独立危险因素;而微骨折手术(OR=0.751,95%CI:0.321-1.264,P=0.012)、自体骨软骨移植(OR=0.649,95%CI:0.246-1.356,P=0.023)、是中长期随访术后复发的独立保护因素;⑤当T1ρ值≤35 ms时,术后复发的风险迅速降低;当T1ρ值>35 ms时,术后复发风险迅速升高;⑥进一步逐步回归分析显示上述9个危险因素与术后复发的关联最紧密,得出术后复发的公式,利用回归方程计算术后复发的可能性;P=0.75时,约登指数值最大,为77.728,提示模型预测效果较好;⑦提示术前T1ρ技术定量评估可有效指导术式的选择,提高手术成功率和患者生活质量。

Cancer Occurrence and Associated Factors to Malignancy in BIRADS-3 Lesions in Yaoundé: The Need to Be More Proactive for Patients above 40, Non-Compliant with Imaging Follow-Up and Presenting with Nipple Discharge

Background and objectives: Breast Imaging Reporting and Data System in Category 3 (BIRADS-3) includes probably benign lesions which need a short-term imaging follow-up. However, in our context, the lesions graded BIRADS-3 remain insufficiently evaluated. We therefore conducted this study to assess the cancer occurrence and associated factors in BIRADS-3 lesions during the follow-up in order to propose an adaptation of the management for lesions in this category in our setting. Patients and methods: A retrospective longitudinal study of patients with lesions initially classified as BIRADS-3 and who realised each at least one additional imaging check-up between January 2014 and December 2022 in five Yaoundé hospitals. All clinical and imaging data were analysed using SPSS® 21.0 software with a significant p-value Results: Patients were aged 13 to 73 (33.0 ± 13.4) years, with a history of breast mass (315 cases;79.7%), breast pain (25 patients;6.3%), nipple discharge (20 patients;5.1%) or past family history of breast cancer (25 cases;6.3%). The most common baseline abnormalities were mammogram opacities (64.8%) and microcalcifications (48.6%), whereas initial breast ultrasound showed solid masses (77.0%) and cystic lesions (11.1%). Compliance with imaging appointment periods was low with only 23.9% of all patients performing an imaging control at the scheduled moment. During the follow-up, 115 patients (29.1%) were upgraded to BIRADS-4 and histology performed revealed 43 cancers (10.9% of overall initial BIRADS-3 sample). The presence of malignancies was associated to age above 40 years (p = 0.0001) and to the presence of nipple discharge (p = 0.0375). Conclusion: The frequency of malignancies among initial BIRADS-3 lesions in our series is higher than that described in the guidelines. This study highlights the need to be more proactive in the management of BIRADS-3 lesions in our setting as the compliance with follow-up is low. So, biopsy should be considered as an alternative to long-term follow-up for patients above 40, non-compliant with imaging check-ups and presenting with nipple discharge.

良性阵发性位置性眩晕患者七年大数据回顾分析

目的良性阵发性位置性眩晕(BPPV)是最常见的外周性前庭疾病,但目前我国尚缺乏对BPPV大样本数据的回顾性分析,本研究旨在为BPPV患者家庭疾病预警和防范提供相应的理论依据。方法回顾性选取2014年6月—2021年6月中国人民解放军总医院眩晕诊疗中心数据库中眩晕患者45807例的临床资料,其中符合BPPV诊断患者5883例,根据其类型分类,统计患者年龄、性别、就诊时间、首诊BPPV类型、复诊BPPV类型等信息。使用Python 3.7进行数据可视化。结果BPPV患者中,女性3909例,男性1974例,50~59岁人群BPPV患者最多,且各BPPV类型中,女性患者比例均高于男性患者。所有眩晕患者位置性试验(+)阳性率为12.8%。不同类型BPPV比例中后管BPPV比例为64.5%,水平管BPPV比例为30.9%。有1092例BPPV复诊记录,首次诊断BPPV至复诊阴性有411例,234例患者BPPV类型在2~6次的就诊过程中有改变,BPPV类型转换比较常见的是左右耳PC-BPPV之间变化(71例)。结论本研究大数据显示,BPPV患者主要分布在50岁左右人群,女性患者约为男性的2倍。LC-BPPV患者比例远高于前期研究数据,约占所有BPPV患者的30.9%。在长期随访中,除大部分患者的BPPV类型没有发生变化外,主要的耳石变化存在后管侧别之间、后管与水平管之间进行转换的趋势。

基于医院登记的78046例恶性肿瘤患者生存报告

目的基于医院登记的恶性肿瘤患者随访资料,以真实世界数据侧面反映地区恶性肿瘤的治疗效果。方法纳入2011年1月1日至2020年12月31日于广西医科大学附属肿瘤医院确诊的恶性肿瘤住院患者,共78046例包括17种恶性肿瘤的随访数据质量符合要求纳入研究。通过医院疾病管理系统及电话随访等方式收集生存随访信息,随访统计时间截至2023年6月30日。应用寿命表法估计各瘤别的1年、3年和5年总生存(overall survival,OS)率,分别对不同性别、年龄组、民族、临床分期及首次治疗时间患者的生存情况进行分析。结果收治的前5位恶性肿瘤依次为肝癌(14672例)、肺癌(10878例)、女性乳腺癌(9430例)、结直肠癌(6895例)、宫颈癌(6250例)。17种恶性肿瘤患者的1、3、5年OS率分别为76.3%、58.6%和51.4%,其中男性患者5年OS率低于女性(39.9%vs 63.1%)。各癌种OS的总体趋势均随着年龄增加而下降,其中≤44岁、45~54岁、55~64岁、65~74岁和≥75岁年龄组患者的5年OS率分别为64.0%、59.6%、52.7%、44.9%和35.7%。相比2011—2015年,2016—2020年肝癌、肺癌、女性乳腺癌、结直肠癌、鼻咽癌、淋巴瘤患者的5年OS率均明显升高(均P<0.05)。不同临床分期恶性肿瘤患者的生存状况差异有统计学意义(均P<0.01),其中Ⅰ~Ⅱ期患者的5年OS率高于Ⅲ~Ⅳ期患者(82.2%vs 43.4%)。肝癌、肺癌、女性乳腺癌、鼻咽癌、结直肠癌、宫颈癌中壮族患者的5年OS率较汉族患者明显降低(均P<0.05)。结论肝癌、肺癌是主要的收治癌种,恶性肿瘤患者中总体50%以上可以获得超过5年的生存期,不同癌种、年龄、性别、民族的恶性肿瘤患者生存状况存在明显差异,应持续实施规范、创新、多学科联合及精准的肿瘤临床治疗和早诊早治手段,以进一步改善患者的生存情况。

调Q激光与手术切除治疗口腔黏膜黑斑后的复发率比较:一项回顾性队列研究

目的比较755 nm调Q激光与手术切除治疗口腔黏膜黑斑后的复发率。方法本研究已通过单位伦理委员会审查批准,并获得患者知情同意。采用回顾性队列研究设计,纳入2019年1月—2021年8月在上海交通大学医学院附属第九人民医院口腔黏膜病科门诊接受调Q激光或手术切除治疗的口腔黏膜黑斑患者,收集患者的一般资料、临床特征和随访病史。将治疗后1年复发率作为主要结局指标,长期不良反应发生率作为安全性评价指标,采用Kaplan⁃Meier法分析两组间的1年无复发率。结果本研究共纳入了57例患者,其中16例患者接受了手术切除治疗,41例患者接受了调Q激光治疗,两组人口统计学和临床特征基线无显著差异。手术切除组所有患者均未观察到口腔黏膜黑斑的复发(0%),而调Q激光组有12例(29.27%)患者出现复发,平均复发时间为治疗后6.08个月,复发与吸烟(P=1.000)、胃肠道息肉(P=1.000)、纵型黑甲(P=0.187)、家族史(P=0.552)、治疗次数(P=0.567)或是否多发(P=0.497)均无相关性。与手术切除相比,调Q激光治疗口腔黏膜黑斑1年复发的比值比为4.41,95%置信区间为1.27⁃15.24(P=0.020)。手术切除组中有3例患者(18.75%)报告损害切除处出现凹陷和疤痕,而调Q激光组没有患者报告长期不良反应(0%)(P=0.019)。结论与手术切除相比,调Q激光治疗口腔黏膜黑斑的优势在于长期不良反应率较低,但复发率相对较高,在治疗前需与患者沟通两种方法的优劣,以助临床决策。

单中心瓣膜外科手术数据库和随访系统20年建设成果分析

目的探讨心外科专业数据库发展的困境及突破方向,希望为心外科专业数据库的建设带来有益的参考。方法通过对首都医科大学附属北京安贞医院瓣膜外科中心的手术数据库和随访系统信息提取与对比分析,回顾总结数据库的运行情况及存在的问题。结果手术信息数据库2001年起已持续运行20余年,收录瓣膜手术患者15420例,并已成为临床工作的一部分。我们发现20余年来瓣膜手术患者在年龄、病变瓣膜、手术方式等多方面发生改变,提示了瓣膜疾病的变迁及外科手术技术的进步,治疗患者年龄由最初2001年的(46±15)岁上升至2023年的(58±13)岁。随访系统自2013年运行2年内,注册患者962例,参与随访691例,随访率71.8%。但后续出现持续发展的瓶颈。相比于手术数据库,随访系统在服务主体定位、信息采集方式、数据库工作模式等多方面存在差异。结论大数据时代的心外科数据库建设需要国家顶层设计与实践探索相结合,建立以患者为核心、国家层面的纵向数据库,配合以病种为核心、专业层面的横向数据库。涵盖完善的基础及专业信息,应该是未来专业数据库发展的方向。

综合心理行为护理对后续精神分裂症患者负性情绪和认知功能的影响

目的:探讨综合心理行为护理对精神分裂症后续情绪行为反应和功能情况的影响。方法:选择2022年10月1日~2023年11月30日收治的248例精神分裂症患者,根据随机数字表法分为对照组和研究组各124例,两组均按照医嘱服用药物治疗,对照组采用常规护理,研究组采用综合心理行为护理;比较两组护理前后认知功能[采用MATRICS共识认知成套测验(MCCB)]、负性情绪[采用焦虑自评量表(SAS)、抑郁自评量表(SDS)],患者对护理的满意度。结果:护理后,研究组MCCB中语言流畅性、连线、数字序列、空间广度、语言记忆、持续操作管理、情绪管理维度均高于护理前(P<0.01,P<0.05),对照组语言流畅性、连线、数字序列、空间广度、持续操作管理、情绪管理维度评分均高于护理前(P<0.01,P<0.05),研究组语言流畅性、连线、数字序列、空间广度、语言记忆、视觉记忆、持续操作管理、情绪管理维度评分均高于对照组(P<0.01,P<0.05);护理后,两组SDS、SAS评分均低于护理前(P<0.01),且研究组低于对照组(P<0.01);研究组患者对护理的满意度高于对照组(P<0.01)。结论:综合心理行为护理对后续神经分裂症患者负性情绪、认知功能均具有改善作用,提高患者对护理的满意度。

新疆某健康体检机构重要异常结果分析与随访结果研究

目的研究新疆某健康体检机构重要异常结果人群分布特征及随访结果。方法选取2022年在新疆医科大学健康管理中心参加健康体检的受检者65045例,检出4665例有重要异常结果的受检者,制定重要异常结果A类B类随访规则,进行电话通知及1月、6月随访,使用随访信息系统进行提醒及表单记录。结果4665例重要异常结果受检者中A类重要异常结果447例(9.58%),B类4218例(90.42%);男性2815例(60.34%)、女性1850例(39.66%),男性高于女性(P<0.05);年龄与重要异常结果存在相关性(P<0.05);41~50岁(1114例)、51~60岁(1211例)这两个年龄段重要段异常结果人数占比高。有效通知4457例(95.54%),通知后有效随访4397例(98.65%),失访60例(1.35%);电话随访后就诊2118例(48.17%),未就诊2279例(51.83%);未就诊男性1562(58.57%)高于女性717(41.45%),性别与是否就诊有统计学意义(P<0.05)。就诊后非肿瘤性疾病1194例(56.40%),恶性肿瘤性疾病97例(4.5%),未明确827例(39.1%)。结论重要异常结果男性高于女性,随年龄增长重要异常结果发生率增高。随访路径实施中通知及随访成功率还应提高。受检者对重要异常结果指标理解不够及重视程度不高(60.44%),未按随访建议进行及时就诊,需加强健康宣教提高其健康意识,督促其重视及时治疗,对提高疾病“早筛查,早评估,早干预”有重要意义。

基于数据驱动的快速路合流区加速车道长度的研究

设计长度合理的加速车道能有效地缓解快速路合流区频繁出现的交通瓶颈问题,因此采用数据驱动方法对快速路合流区的加速车道长度进行研究。利用无人机设备测取了快速路合流区的交通数据,从交通流特性及车辆汇入行为这两个角度对实测数据进行分析,得到了合流区车辆的驾驶行为;根据合流区交通流特点,对数据集进行聚类分析,使用生成对抗式网络训练不同合流区汇入行为车辆的跟驰换道模型,并与实测数据和SUMO仿真软件中内置模型进行对比分析;应用生成对抗式网络模型进行交通环境仿真,选取速度、交通密度、交通冲突率指标建立奖励评价函数,得出了加速车道长度设计的推荐值。研究结果表明:采用主线车辆提前减速和向内侧车道换道这两种手段,可实现协同换道避让匝道汇入的车辆;相比SUMO软件内置模型,生成对抗式网络模型更加贴近实际情况;仿真得出的单车道平行式加速车道长度分别在100、80、60 km/h情况下的推荐值为280、240、200 m。

流动儿童社会排斥、自尊、亲子依恋与抑郁的关系:一项追踪研究

目的:为探讨流动儿童社会排斥、自尊、亲子依恋与抑郁的动态关系。方法:以班级为单位对385名流动儿童进行为期一年的纵向追踪调查。采用协方差结构方程模型对前、后两次4个研究变量间的动态关系进行检验。结果:控制年龄和性别作用后显示:①流动儿童前测社会排斥可以预测其后测抑郁水平(β=0.12,P<0.01);②流动儿童前测自尊在社会排斥对抑郁的即时和延时预测中均起部分中介作用,中介效应值分别是0.11和0.03;③流动儿童前测亲子依恋在其前测社会排斥影响后测抑郁的中介路径前半段中起延时调节作用,调节效应值为-0.12。结论:①社会排斥可以预测流动儿童的抑郁水平;②自尊在社会排斥和流动儿童抑郁中起即时和延时中介作用;③亲子依恋能够延时调节流动儿童社会排斥与自尊的关系。

随动辊压型低应力精密断料教学实验平台开发

为了增强学生对先进成形装备及低应力精密断料技术的理解,开发了随动辊压型低应力精密断料教学实验平台。该实验平台综合利用机械设计、传感器技术及计算机控制技术,将应力集中效应和随动辊压技术引入管料的精密分离断料工序中,设计了管料断面质量评价方法,对带有V型槽的45#钢及304不锈钢管料进行了裂纹可控式低应力精密下料实验,验证了断料效果。该实验平台不仅使低应力断料过程更加直观,还提升了学生对低应力精密成形技术的认识,增强了学生对“机械制造工程基础”“切削原理与刀具”及“先进制造技术”等课程的学习兴趣。

《广州管圆线虫病诊断标准》(WS/T 321—2010)在福建省和云南省实施情况的跟踪评价

目的了解《广州管圆线虫病诊断标准》(WS/T 321—2010)(简称《标准》)的实施情况,为《标准》的推广和进一步修订、完善提供科学依据。方法通过分层抽样的方式抽取福建省和云南省的省、市、县和乡镇4级的疾病预防控制机构(简称疾控机构)和医疗机构的专业技术人员作为调查对象,采用调查对象自填问卷的方式开展《标准》实施情况调查。结果共调查工作人员308人,回收有效问卷308份。《标准》知晓率为71.10%(219/308),不同特征调查对象中,≥50岁(81.40%,35/43)、市级单位(79.76%,67/84)、疾控机构(88.24%,105/119)、从事寄生虫病防治工作(85.71%,114/133)、高级职称(82.86%,58/70)、本科文化程度(77.09%,138/179)、公共卫生专业(86.21%,75/87)等人群的《标准》知晓率较高,且随着年龄增加和职称升高,《标准》知晓率呈上升趋势(χ^(2)_(趋势)=8.272、8.258,P均<0.01);知晓途径主要是业务培训(65.30%,143/219)和自主查阅(60.73%,133/219)。在《标准》的使用情况方面,知晓《标准》的调查对象中,有75.34%(165/219)会在工作中使用,15.98%(35/219)会经常使用。不同宣贯方式中,宣传资料的普及率最高(58.77%,181/308);75.32%(232/308)的调查对象认为专题讲座的宣贯效果好。能正确且完整掌握诊断原则、感染方式、临床表现、实验室检查方法和诊断类型等知识的调查对象人数分别为292人(占94.81%)、102人(占33.12%)、130人(占42.21%)、117人(占37.99%)和152人(占49.35%)。绝大多数调查对象(占89.61%,276/308)认为标准的可操作性好或较好。宣贯力度对标准实施的影响最大(占80.84%,249/308)。91.88%(283/308)的调查对象认为现行标准不需要修订。结论《标准》仍适用于当前阶段的诊断需求,应继续加大对专业人员的宣贯力度,提高其认知和应用水平。

胎儿蛛网膜囊肿磁共振随访研究

目的 探讨胎儿蛛网膜囊肿随胎龄及年龄增长而发生的形态改变及预后评估。方法 选取磁共振诊断蛛网膜囊肿18例胎儿的MRI资料及其相应产后随诊资料,通过随访对比蛛网膜囊肿部位、大小变化及周围组织关系等方面数据进行总结。结果 位于幕下蛛网膜囊肿10例,其中右侧小脑延髓池1例,四叠体池右侧1例,右侧小脑半球后方2例,小脑蚓下方偏左1例,后颅窝中线处5例。位于幕上8例,其中中间帆腔区域1例,小脑幕右上方1例,左右侧颞极各3例。18例胎儿中15例随访至生后;另3例胎儿期随访2次,产后未遵嘱随访。蛛网膜囊肿逐渐增大11例,其中后颅窝中线处仅1例增大。生后进行性脑积水4例,3例发生于偏中线处,1例位于中间帆腔区域。结论 胎儿蛛网膜囊肿因部位不同,其结局具有一定差异。部分蛛网膜囊肿有随胎龄及年龄增大趋势,偏中线处蛛网膜囊肿更容易进行性增大,胎儿期其增长速度及对邻近脑组织的受压、脑室梗阻变化相对产后变化要慢。

基于随访系统的延续性护理干预在酒精依赖患者中的应用

目的探讨基于随访系统的延续性护理干预在酒精依赖患者中的应用效果。方法采用方便抽样法,选取2021年3月-2022年8月在我院成瘾医学科住院治疗的酒精依赖患者120例,采用随机数字表法分为对照组和干预组,各60例。对照组出院后接受常规药物治疗,干预组在对照组基础上接受为期6个月的基于随访系统的延续性护理干预。比较2组患者干预前后对酒精的渴求程度和生活质量,以及干预后1个月、3个月和6个月对酒精的依赖状态和复饮率。结果干预前,2组患者对酒精的渴求程度和生活质量比较,差异无统计学意义(P>0.05);干预后,干预组对酒精的渴求程度和生活质量显著优于对照组(P<0.05)。干预后1个月、3个月、6个月,干预组对酒精的依赖状态和复饮率均显著优于对照组(P<0.05)。结论基于随访系统的延续性护理干预能降低酒精依赖患者对酒精的渴求和依赖程度,降低复饮率,改善患者生活质量,为酒精依赖患者院外康复管理提供了新的护理理念及干预方法。