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21.
Child sex trafficking (CST) has become a global public health crisis and is a $150 billion criminal enterprise. Nurse practitioners are key in the recognition and prevention of CST in health care settings. Evidence demonstrates that up to 80% of CST victims have had a recent health care encounter. It is the role of the NP in practice to understand risk factors, screen for CST, and educate parents and caregivers on signs of victimization and prevention.  相似文献   
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We propose a high order finite difference linear scheme combined with a high order bound preserving maximum-principle-preserving (MPP) flux limiter to solve the incompressible flow system. For such problem with highly oscillatory structure but not strong shocks, our approach seems to be less dissipative and much less costly than a WENO type scheme, and has high resolution due to a Hermite reconstruction. Spurious numerical oscillations can be controlled by the weak MPP flux limiter. Numerical tests are performed for the Vlasov-Poisson system, the 2D guiding-center model and the incompressible Euler system. The comparison between the linear and WENO type schemes, with and without the MPP flux limiter, will demonstrate the good performance of our proposed approach.  相似文献   
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儿童哮喘与慢性阻塞性肺疾病(COPD)是儿童期与成人期常见的存在气流受限的慢性气道疾病。研究发现,儿童哮喘会增加成年期罹患COPD的风险,而肺功能变化是预测COPD患病风险的重要指标。针对哮喘患儿建立长期肺功能监测管理,对于评估其成年后存在不可逆气道阻塞的风险有重要意义。文章综述儿童哮喘与COPD相关的研究进展。  相似文献   
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The emerging field of global oral and maxillofacial surgery (OMS) aims to improve worldwide access to safe, timely, and affordable OMS care. However, there exists a dearth of literature thoroughly detailing the scope of academic global OMS collaborations between high-income countries (HICs) and low- and/or lower middle-income countries (LICs/LMICs). This scoping review was performed to characterize the landscape of global academic OMS collaborations between HICs and LICs/LMICs. A five-stage methodological framework was used. Academic global OMS collaborations from 1996 to 2020 were identified via an electronic database and grey literature review. A total 1318 articles were identified on December 17, 2020. Following the application of inclusion and exclusion criteria, 71 articles describing 81 unique global OMS academic collaborations were included in the final analysis. The most common HIC was the United States (44.4%); the majority of LIC/LMICs were within Africa (45.8%). Of the total interventions, 89.6% improved LIC/LMIC capacity development, and surgical (43.8%) interventions were the most common. By serving as a central report on current and past academic collaborations in global OMS, this review helps identify areas in need of surgical capacity building, lays the foundation for future research efforts on the topic, and serves as a resource for individuals aiming to become involved in global OMS.  相似文献   
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[摘要] 目的 探讨ICU患者发生产超广谱β-内酰胺酶(extended spectrum beta-lactamases, ESBLs)革兰阴性杆菌感染的危险因素,并构建相关预测模型。方法 选取2017年5月—2021年4月我院ICU发生大肠埃希菌或肺炎克雷伯菌感染的189例患者作为研究对象,收集患者的临床资料,使用单因素分析、LASSO回归和多因素Logistic回归分析ICU患者30 d内发生产ESBLs革兰阴性杆菌感染的危险因素,并据此建立列线图预测模型。结果 急性生理与慢性健康评分≥16分、留置尿管时长≥7 d、抑酸剂使用时长≥3 d、第三代头孢菌素使用时长≥3 d、抗菌药物联用时长≥3 d和ICU住院时间≥15 d是ICU患者30 d内发生产ESBLs革兰阴性杆菌感染的危险因素(P均<0.05)。依此建立预测ICU患者30 d内发生产ESBLs革兰阴性杆菌感染的列线图风险模型,模型验证结果显示C-index为0.795,校正曲线趋近于理想曲线,AUC为0.807(95%CI:0.775~0.839),在2%~81%预测范围内,列线图净获益。结论 ICU患者30 d内发生产ESBLs革兰阴性杆菌感染的危险因素包括APACHEⅡ评分≥16分、留置尿管时长≥7 d、抑酸剂使用时长≥3 d、第三代头孢菌素使用时长≥3 d、抗菌药物联用时长≥3 d和ICU住院时间≥15 d,据此构建的列线图模型能有效预测ICU患者30 d内发生产ESBLs革兰阴性杆菌感染的风险概率,具有一定的临床价值。  相似文献   
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目的 分析南京市某国际高中学生艾滋病知识知晓率及其影响因素,为制定高中生艾滋病健康教育策略提供依据。方法 对南京市某国际高中所有学生开展纸质问卷调查,统计分析艾滋病知识知晓率及其影响因素。 共纳入171名高中生为调查对象,艾滋病和梅毒的知识知晓率分别为56.1%和46.8%;有过性行为的占14.6%,其艾滋病知识知晓率最高为32.0%,(χ2=10.799,P=0.005);有吸毒史的学生占9.3%,其艾滋病知识知晓率最高为31.2%,(χ2=21.062,P<0.001);梅毒知识知晓者与不知晓者的艾滋病知识知晓率差异具有统计学意义(χ2=21.716,P<0.001)。 该国际高中学生性病和艾滋病知识知晓率较低,对高中生开展毒品危害教育和性病艾滋病防治应作为健康教育工作重点。  相似文献   
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ObjectiveTo investigate the feasibility of transnasal heated humidified high flow nasal cannula oxygen therapy (HFNC) in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with respiratory failure in elderly patients. MethodsA total of 176 elderly patients with AECOPD complicated with respiratory failure who were hospitalized at Peking University Shougang Hospital from December 2016 to January 2022 were enrolled, including 82 patients in an HFNC group and 94 patients in an NPPV group. After treatment, pulse oxygen saturation (SPO2), arterial partial pressure of carbon dioxide (PaCO2), oxygenation index (OI), respiratory rate (RR), heart rate (HR), mean arterial pressure (MAP), comfort score, discharge rate, rate of endotracheal intubation, rate of transfer to intensive care unit (ICU), and mortality were compared between the two groups. The independent sample t-test was used for comparison between the two groups. Statistical data are expressed in percentage or number of cases and the χ2 test was used for their comparisons. ResultsThe SPO2 values at 30 min, 1 h, and 6 h were significantly higher in the HFNC group than in the NPPV group (t=-2.049,-2.618, and -3.314, P=0.043, 0.010, and 0.001, respectively). SPO2 before discharge was significantly lower than that of the NPPV group (t=2.162, P=0.033), but OI at each time point and before discharge had no statistical significance (P>0.05). MAP at 6 h was significantly higher in the HFNC group than in the NPPV group (t=-2.209, P=0.029), but within the normal range. HRs at 2 h and 3 h in the HFNC group were significantly higher than those of the NPPV group (t=-2.199 and -2.336, P=0.030 and 0.021, respectively). There were no significant differences in RR, HR, or MAP between the two groups at other time points and before discharge (P>0.05). There was no significant difference in PaCO2 between the two groups (P>0.05). Comfort score in the HFNC group was significantly higher than that of the NPPV group (t=-46.807, P<0.001). There were no significant differences in discharge rate, ICU transfer rate, endotracheal intubation rate, and mortality between the two groups (P>0.05). ConclusionHFNC is as effective as NPPV in treating elderly patients with AECOPD complicated with type Ⅰ or mild type Ⅱ respiratory failure, and HFNC is more comfortable than NPPV.  相似文献   
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