Objective: The aim of this study was to describe the epidemiological, clinical and Para clinical characteristics in patients hospitalized for pulmonary embolism in the cardiology department of Gabriel Toure University...Objective: The aim of this study was to describe the epidemiological, clinical and Para clinical characteristics in patients hospitalized for pulmonary embolism in the cardiology department of Gabriel Toure University Hospital. Methodology: It was a retrospective and descriptive study from January 2011 to December 2014 and involved all patients hospitalized during the study period. Results: The study included 21 patients out of 1738 hospitalized patients, with a prevalence of 1.21%. The mean age was 38.57 years with extreme ages of 18 and 64 years. The sex ratio was 0.40. Risk factors found in the study were oral contraception (19.05%), overweight (19.05%), smoking (14.28%), HIV (4.76%) and heart failure (4, 76%). 61.90% (n = 13) had isolated pulmonary embolism, 38.09% (n = 8) had venous thrombosis and pulmonary embolism association. Through the chest angio-CT, 28.57% of obstructions were located at the left branch of the pulmonary artery, 9.52% at the right branch and 61.90% were bilateral obstructions. Four deaths were recorded, all in a context of massive pulmonary embolism, with a fatality rate of 19.05%. Conclusion: Pulmonary embolism is a serious and common disease, often difficult to diagnose. It is a cardiovascular emergency and requires immediate and adequate care.展开更多
Traumatic diaphragmatic injury (TDI) is rare and is most often the result of a traffic road accident (TRA) or an assault. We initiated this study with the aims of determining the epidemiological, clinical and therapeu...Traumatic diaphragmatic injury (TDI) is rare and is most often the result of a traffic road accident (TRA) or an assault. We initiated this study with the aims of determining the epidemiological, clinical and therapeutic aspects of TDI at Gabriel Toure University Hospital. This was a retrospective study from January 1999 to June 2021 that included all patients who presented a diaphragmatic injury consecutive to abdominal and/or thoracic trauma. In 22 years and 6 months, 46 cases of TDI were collected. They represented 0.17% of hospitalizations, 0.26% of surgical emergencies and 5.5% of thoraco-abdominal traumas. The average age was 31.69 years with a sex ratio of 3.2. Criminal stabbings accounted for 56.5% and TRA for 19.6%. Penetrating injuries accounted for 78.3% of cases. The parietal lesion was thoracic in 21 cases (45.7%), abdominal in 19 cases (41.3%) and thoraco-abdominal in 6 cases (13%). The chest X-ray, performed in 15 patients, showed an intrathoracic gas bubble (4 cases) and hemothorax (6 cases). Diagnosis of diaphragmatic lesion was preoperative in 21.7% (10 cases). The diaphragmatic breach was on the left side in 65.2% (30 cases) and the average size was 3.17 cm. Laparotomy was performed in 89.1%, thoracotomy in 4.4% and thoraco-laparotomy in 6.5% of cases. The surgical procedure consisted of reduction of the herniated viscera in 15.2% (7 cases) and closure of the diaphragmatic breach with non-absorbable sutures in 82.6% (36 cases). Chest tube drainage was performed in 73.9%. The average length of hospital stay was 9.8 days. Mortality was 13.04%. Conclusion: Traumatic diaphragmatic injury is rare but its frequency is increasing in our country. It most often affects the young man victim of assault or TRA. This type of trauma is rarely isolated;you have to think about it in case of any thoraco-abdominal trauma. The treatment is surgical. The prognosis depends on the severity of the associated lesions.展开更多
Introduction: Voluntary assault and injuries are acts that damage the physical and psychological integrity of a human being. WHO in its global report on violence and health estimates that in 2000, 1.6 million people w...Introduction: Voluntary assault and injuries are acts that damage the physical and psychological integrity of a human being. WHO in its global report on violence and health estimates that in 2000, 1.6 million people worldwide died as a result of self-harm, interpersonal or collective violence, resulting in an overall rate adjusted by age of 28.8 per 100,000 population. Because of the seriousness of this phenomenon and the heavy socio-economic and health consequences that they generate, it seemed important to us to undertake this study, which aimed to study the deliberate injuries in the emergency unite of the Gabriel Touré Teaching Hospital in Bamako. Material and methods: This was a descriptive and cross-sectional study with a prospective study from September 1st, 2016 to August 31st, 12 months, covering 295 patients, including any patient received for voluntary injury consultation with a workable medical record and/or a full investigation record with or without requisition. Our data were collected on individual survey cards and subsequently analyzed with Word, Excel, IBM SPSS Statistics 22 software. Results: The majority of victims of assault and bodily injury were male with 83.1%;with a sex ratio of 4.9, the 18 to 28 age group was the most concerned with 163 cases of the 295 cases in our study, 55.2%. The extremes were 6 and 100 years old with an ectype at 11.08. The most affected ethnic group was Bambara with 38.6% (n = 114) followed by Fulani with 15.6% (n = 46). Students were the most affected at 24.7% (n = 73), followed by traders at 10%. The victims coming from outside Bamako are the most predominant with 22.4% (n = 66) followed by those of commune IV of Bamako 15.6% (n = 46). In 92.2% of the cases the mechanism was direct with n = 272. Of the lesions recorded in our study, wounds came first with 53.2% of cases. Radiography was the most used imaging at 44.7% (n = 89) followed by computed tomography at 34.7% (n = 69). The hemoperitoneum objectified by abdominal ultrasound represented 29.3% (n = 12). Fractures embarrure associated with bruising-hemorrhagic bruises were the most predominant with 13.4% (n = 10) objectified by brain scan. Conclusion: We note that the phenomenon of violence has reached worrying proportions, especially among young adults, particularly among students and is observed in all so-cio-professional layers. The polymorphism of these injuries caused by the predominant use of knives must draw the attention of our authorities to take measures to reduce these aggressions.展开更多
Digestive hemorrhage by rupture of esophageal Varices is common and has a pejorative prognosis in our context. <strong>Purpose:</strong> The main purpose of this work was to study the digestive bleeding by...Digestive hemorrhage by rupture of esophageal Varices is common and has a pejorative prognosis in our context. <strong>Purpose:</strong> The main purpose of this work was to study the digestive bleeding by esophageal varices and prognosis value of blood transfusion in the Hospital of Gabriel Touré. <strong>Methodology:</strong> It was a prospective study that took place in the service of Hepato-gastroenterology of Gabriel Touré Hospital from June 2016 to May 2017 and from November 2017 to August 2018. <strong>Results:</strong> At the end of the study, 77 patients met the inclusion criteria out of 1396 patients hospitalized during the same period. Varices bleeding represented a prevalence of 5.5% among hospitalized patients during the same period. The average age of our patients was 46.58 ± 15.09 years. The male sex was more reported in our study with a prevalence of 67.5%. At admission, 63.2% had clinical anemia, 58.4% low arterial pressure and 50.6% hemoglobin rate less than 7 g/dL. Blood transfusion was indicated in 47 patients (61%). The mortality rate was 23.4% and was comparable in both groups (p = 0.0990). Early rebleeding was significantly observed in the case of transfusion (p = 0.0452). Hepatic encephalopathy was the leading cause of death of our patients with 72.2%. <strong>Conclusion:</strong> Digestive bleeding by esophageal varices is a worsen complication in cirrhosis in hospital setting. Transfusion has not significantly improved the prognosis of our patients.展开更多
Summary:Deep vein thrombosis(DVT)and pulmonary embolism(PE)are two entities of venous thromboembolism(VTE)whose incidence is difficult to assess.Objective:This paper aims to evaluate the prevalence of venous thromboem...Summary:Deep vein thrombosis(DVT)and pulmonary embolism(PE)are two entities of venous thromboembolism(VTE)whose incidence is difficult to assess.Objective:This paper aims to evaluate the prevalence of venous thromboembolism.Patients and Methods:This was a descriptive cross-sectional study with prospective collection,over 12 months from May 1,2023 to April 30,2024.Results:We admitted 627 patients including 6 cases of VTE,with a prevalence of 096%.The average age was 49.67±17.58 years with extremes of 30 to 71 years,the sex ratio 0.2,and housewives represented 33.3%.The transient risk factors(FDR)were prolonged immobilization≥05 days(05 cases)83.3%,major surgery(01 case)16.7%,spinal cord trauma(01 case)16.7%,central venous catheter(04 cases)66.6%;the permanent risk factors(FDR)were obesity(04 cases)66.6%,age(3 cases)50%,high blood pressure(hypertension)(3 cases)50%,cancer(01 case)16.7%.The main clinical signs were dyspnea(100%),tachycardia(33.3%),chest pain(33.3%),and Homans sign with increased local heat(01 cases)16.7%.The diagnoses retained were PE(04 cases)83.3%,PE+DVT(01 case)16.7% and DVT(01 case)16.7%.All patients were placed on oxygen therapy,(02 cases)intubated and ventilated,(02 cases)High Flow Oxygenation,(02 cases)on amines such as dobutamine+norepinephrine and norepinephrine alone(83.3%)of patients were placed on direct oral anticoagulants(DOACs)and 16.7%on low molecular weight heparin(LMWH).The average length of stay was 7.3±3.33 days with extremes of 4 to 13 days and the lethality of(03 cases)50% of which(02 cases)had sPESI≥2.Conclusion:The diagnosis and management of VTE remains difficult and responsible for significant morbidity and mortality.展开更多
Semantic segmentation is a core task in computer vision that allows AI models to interact and understand their surrounding environment. Similarly to how humans subconsciously segment scenes, this ability is crucial fo...Semantic segmentation is a core task in computer vision that allows AI models to interact and understand their surrounding environment. Similarly to how humans subconsciously segment scenes, this ability is crucial for scene understanding. However, a challenge many semantic learning models face is the lack of data. Existing video datasets are limited to short, low-resolution videos that are not representative of real-world examples. Thus, one of our key contributions is a customized semantic segmentation version of the Walking Tours Dataset that features hour-long, high-resolution, real-world data from tours of different cities. Additionally, we evaluate the performance of open-vocabulary, semantic model OpenSeeD on our own custom dataset and discuss future implications.展开更多
Tour Overview.“Yangtze River Fantasy Tour-Charm of the Yangtze”is a carefully crafted 6-night,7-day journey for you to fully experience the endless charm of China's Yangtze River.On this trip,tourists will embar...Tour Overview.“Yangtze River Fantasy Tour-Charm of the Yangtze”is a carefully crafted 6-night,7-day journey for you to fully experience the endless charm of China's Yangtze River.On this trip,tourists will embark on a top luxury cruise ship on China,s inland rivers,sailing through the Yangtze River,enjoying comfort and luxury.The modern design and complete facilities of the cruise ship not only provide first-class accommodation but also offer a variety of onboard entertainment activities,filling your journey with laughter and joy.展开更多
On May 26,40 teachers and students from the graduating class of the Buddhist Academy of Xizang in Lhasa embarked on a teaching practice and national condition study tour in Zhejiang and Shanghai.
Twenty years ago,during an inspection tour of the pollutionbesieged village Yucun in Anji County,east China’s Zhejiang Province,then provincial Party Secretary Xi Jinping proposed that“lucid waters and lush mountain...Twenty years ago,during an inspection tour of the pollutionbesieged village Yucun in Anji County,east China’s Zhejiang Province,then provincial Party Secretary Xi Jinping proposed that“lucid waters and lush mountains are invaluable assets”–a seminal insight now known as the“Two Mountains”Theory.展开更多
Artificial intelligence(AI)is transforming the tourism industry and affecting on natural ecology,making it more environmentally friendly,efficient and personalized.In 2025,AI technologies are being actively implemente...Artificial intelligence(AI)is transforming the tourism industry and affecting on natural ecology,making it more environmentally friendly,efficient and personalized.In 2025,AI technologies are being actively implemented to reduce the carbon footprint,optimize resources,and improve the travel experience.Here are the key applications of AI in environmentally sustainable smart tourism:AI in smart tourism is not just a technological trend,but a necessity for the sustainable development of the industry.Paper analyses personalized and green travel experience and smart tourism.AI-based applications(Google ARCore)allow tourists to get information about attractions without paper booklets.Virtual tours reduce the need for physical travel by reducing the carbon footprint.Platforms offer routes with minimal impact on nature(for example,hiking trails instead of car tours).Tourists can offset their carbon footprint through AI tools by financing tree planting.The introduction of AI solutions allows combining economic benefits with environmental responsibility,creating a future where travel becomes safer for the planet.Paper confirms idea about sustainable tourism development in developing countries and focus on premium ecotourism.Instead of mass tourism,AI helps promote unique destinations(safaris,diving,ethnographic tours),which increases income with less environmental damage.Smart cities with AI-driven transport and energy-saving solutions make tourism more sustainable.展开更多
A“smart course”denotes a learner-centered curriculum model that deeply integrates advanced technologies,including generative artificial intelligence(AI)and big data analytics,with ongoing optimization and iterative ...A“smart course”denotes a learner-centered curriculum model that deeply integrates advanced technologies,including generative artificial intelligence(AI)and big data analytics,with ongoing optimization and iterative refinement.This paper examines the pathways of smart course development in higher vocational education by using the Study Tour Course Design course as a practical case study.The analysis is conducted from four perspectives:innovation in educational concepts,innovation in teaching models,transformation in learning paradigms,and enhancement in evaluation systems.By developing a threedimensional framework encompassing“knowledge,skills,and problems”,the focus of education shifts from“knowledge imparting”to“competency development”.This approach fosters a transformation in teaching interactions,moving beyond the traditional“teacher and student interaction”to a more integrated trinity collaboration of“teachers,students,and machines”,and promotes the transformation of students’learning from“passive receptive learning”to“autonomous inquiry-based learning”.Simultaneously,it facilitates the transition of evaluation methods from“outcome-based evaluation”to“multi-dimensional evaluation”.展开更多
Summary: Hepatomegaly is one of the clinical signs commonly encountered in chronic liver disease. The aim of our study was to study the epidemiological, clinical and etiological aspects of hepatomegaly in the hepato-g...Summary: Hepatomegaly is one of the clinical signs commonly encountered in chronic liver disease. The aim of our study was to study the epidemiological, clinical and etiological aspects of hepatomegaly in the hepato-gastroenterology department (HGE) of the Gabriel Touré university hospital. This was a cross-sectional study that took place from September 2021 to October 2022 in the department. All patients aged 18 years and older with hepatomegaly, hospitalized or examined by physicians were included. We collected 100 cases of hepatomegaly, representing 3.7% of 2661 patients examined or hospitalized in the HGE department during the study period. These patients had a mean age was 46.7 ± 16.10 years with extremes of 18 and 76 years. The sex ratio was 2.7. Jaundice was the most commonly reported history with a frequency of 26%. Pertaining to patients’ lifestyle, alcohol consumption was the most common feature with 6%. The most common associated clinical signs were jaundice, ascites, and edema of the lower limbs. Painful hepatomegaly (86%), with a sharp lower edge (74%), a firm consistency (69%), and an irregular surface (52%) was frequently observed. Cytolysis (75.5%), increased alphafetoprotein levels (70%), microcytic anemia (37%), hyperleukocytosis (54.3%), and biological hepatocellular insufficiency syndrome (low albumin with 30.4%, high bilirubinemia with 61.2% and low platelets with 33.9%) were the most common observed laboratory abnormalities. Hepatitis B virus markers (61%) were the most frequently found in the study patients. At ultrasound examination, heterogeneous hepatomegaly was observed in 87.3% of the patients. Esophageal varices (43.1%) were more commonly seen than other varices during upper gastrointestinal endoscopy. The dominant etiology was hepatocellular carcinoma on cirrhosis with 66% followed by cirrhosis. Conclusion: Painful hepatomegaly was quite frequently in our urban setting hospital with several etiologies. HCC was the most common etiology, therefore measures to prevent it in the community need to be established by the concerned stakeholders to improve adult population health in Bamako.展开更多
The studypresents theHalfMax InsertionHeuristic (HMIH) as a novel approach to solving theTravelling SalesmanProblem (TSP). The goal is to outperform existing techniques such as the Farthest Insertion Heuristic (FIH) a...The studypresents theHalfMax InsertionHeuristic (HMIH) as a novel approach to solving theTravelling SalesmanProblem (TSP). The goal is to outperform existing techniques such as the Farthest Insertion Heuristic (FIH) andNearest Neighbour Heuristic (NNH). The paper discusses the limitations of current construction tour heuristics,focusing particularly on the significant margin of error in FIH. It then proposes HMIH as an alternative thatminimizes the increase in tour distance and includes more nodes. HMIH improves tour quality by starting withan initial tour consisting of a ‘minimum’ polygon and iteratively adding nodes using our novel Half Max routine.The paper thoroughly examines and compares HMIH with FIH and NNH via rigorous testing on standard TSPbenchmarks. The results indicate that HMIH consistently delivers superior performance, particularly with respectto tour cost and computational efficiency. HMIH’s tours were sometimes 16% shorter than those generated by FIHand NNH, showcasing its potential and value as a novel benchmark for TSP solutions. The study used statisticalmethods, including Friedman’s Non-parametric Test, to validate the performance of HMIH over FIH and NNH.This guarantees that the identified advantages are statistically significant and consistent in various situations. Thiscomprehensive analysis emphasizes the reliability and efficiency of the heuristic, making a compelling case for itsuse in solving TSP issues. The research shows that, in general, HMIH fared better than FIH in all cases studied,except for a few instances (pr439, eil51, and eil101) where FIH either performed equally or slightly better thanHMIH. HMIH’s efficiency is shown by its improvements in error percentage (δ) and goodness values (g) comparedto FIH and NNH. In the att48 instance, HMIH had an error rate of 6.3%, whereas FIH had 14.6% and NNH had20.9%, indicating that HMIH was closer to the optimal solution. HMIH consistently showed superior performanceacross many benchmarks, with lower percentage error and higher goodness values, suggesting a closer match tothe optimal tour costs. This study substantially contributes to combinatorial optimization by enhancing currentinsertion algorithms and presenting a more efficient solution for the Travelling Salesman Problem. It also createsnew possibilities for progress in heuristic design and optimization methodologies.展开更多
In recent years,with the support and promotion of relevant policies such as the Opinions on Promoting Study Tour for Primary and Secondary School Students jointly issued by the Ministry of Education and 11 other depar...In recent years,with the support and promotion of relevant policies such as the Opinions on Promoting Study Tour for Primary and Secondary School Students jointly issued by the Ministry of Education and 11 other departments,a wave of study tour has been sparked nationwide from individual pilot projects to gradual promotion.In this paper,students and teachers from grades 4 to 6 of L Primary School in Nanchang City,Jiangxi Province were selected as the survey objects.Combining the survey questionnaire,the current situation of conducting study tour in the primary school was sorted out and analyzed in depth from several aspects such as study tour cognition,study tour participation,study tour implementation,etc.Based on the survey results and relevant research,the current problems in conducting study tours in primary schools were summarized,and targeted improvement measures were proposed,in order to promote the healthy development of study tours in primary schools.展开更多
Curriculum ideology and politics are critical for colleges and universities to fulfill theirfundamental mission of fostering moral and intellectual development. Within this framework, professionalcourses serve as the ...Curriculum ideology and politics are critical for colleges and universities to fulfill theirfundamental mission of fostering moral and intellectual development. Within this framework, professionalcourses serve as the primary vehicles for integrating ideological and political education. Specifically, inthe field of study tours, the Study Tour Course Design emerges as a pivotal component for actualizingthe educational objectives of such programs. To construct a robust ideological and political curriculum,it is essential to devise a comprehensive system that aligns with professional teaching standards, industrybenchmarks, and vocational skill requirements. This involves a thorough exploration of ideologicaland political elements within the curriculum, ensuring their seamless integration throughout the coursedevelopment process.展开更多
Urban night tourism is a new form of urban tourism development and an important driving force for the prosperity of urban night economy.As the most prestigious business card among many night tour projects in Guangzhou...Urban night tourism is a new form of urban tourism development and an important driving force for the prosperity of urban night economy.As the most prestigious business card among many night tour projects in Guangzhou,the Pearl River water night tour has contributed to the development of Guangzhou s night economy,which cannot be underestimated.However,in the process of rapid development,there are also problems such as diversified operators,insufficient integration of intangible cultural elements,excessive commercial attributes,issues of tourism facilities and service facilities.Under the new stage of integrated development of culture and tourism,how to use mutual promotion of culture and tourism in the Pearl River night tour to seek innovative paths for high-quality development in the future is the main problem expected to be solved in this paper.Therefore,based on the perspective of culture and tourism integration,this paper analyzes the general situation and development status of the Pearl River night tour,and proposes five development strategies:the overall planning of culture and tourism integration,the deep integration of intangible cultural elements,the balance of commercial attributes and tourism attributes,the high integration of culture,business,tourism and education,and the creation of tourism atmosphere,in order to provide inspiration for the healthy,orderly and high-quality development of the Pearl River night tour.展开更多
During some tours to the high mountain region of southern Sinai, that I did in different occasions between 1979-1984, I received from different Bedouin guides some information, about geographical sites in that region....During some tours to the high mountain region of southern Sinai, that I did in different occasions between 1979-1984, I received from different Bedouin guides some information, about geographical sites in that region. Part of that information does not appear in the updated maps of southern Sinai. Therefore, I would like to bring here that geographical information. The areas to which that geographical information refers are: the mountain massif of Santa Katarina, and also the mountain massif of Jebel Bab, which is located about 8 km - 10 km WSW of the Santa Katarina village or town.展开更多
With the sharp increase in life pressures,holiday travel has become a popular choice for many.As an indispensable role in tourism,tour guides can significantly enhance the tourist experience and showcase the allure of...With the sharp increase in life pressures,holiday travel has become a popular choice for many.As an indispensable role in tourism,tour guides can significantly enhance the tourist experience and showcase the allure of various scenic spots.In the new era,to achieve sustainable development and positive transformation,tour guides face significant challenges.This paper explores these challenges and proposes potential transformation paths for the tour guide profession in Nanchang,a city with a rich history,as it strives to build a strong city brand.展开更多
Classical Chinese gardens,with their intricate interplay of architectural landscapes featuring narrow corridors and expansive courtyards,are designed to surprise and captivate visitors at every turn.Unraveling the con...Classical Chinese gardens,with their intricate interplay of architectural landscapes featuring narrow corridors and expansive courtyards,are designed to surprise and captivate visitors at every turn.Unraveling the connection between visual perception,walking behaviors,and the spatial elements of these garden compounds is essential to grasping the essence of traditional Chinese garden design.This study employs Virtual Reality(VR)and eye-tracking technologies to evaluate the touring patterns within Chinese classical gardens,with a case study focusing on the Canglang Pavilion Garden in Suzhou.A total of 68 participants were enlisted to engage in a VR experiment simulating a visit to a courtyard space within this garden.The study analyzed route choices between 2 distinct spatial types:corridor-architecture and courtyard-wall.Eye movement indicators within the Areas of Interest(AOIs)for frame-of-view and depth-of-view spatial elements were monitored,and visitors’spatial-temporal trajectory maps were documented.This research offers valuable insights into the intricate dynamics between visual attention,spatial elements,and visitor behavior within garden environments.The methodology applied in this study has broad implications for environmental psychology,landscape architecture,and the study of cultural heritage sites,providing a deeper understanding of the interactions and perceptions of visitors within garden spaces.展开更多
文摘Objective: The aim of this study was to describe the epidemiological, clinical and Para clinical characteristics in patients hospitalized for pulmonary embolism in the cardiology department of Gabriel Toure University Hospital. Methodology: It was a retrospective and descriptive study from January 2011 to December 2014 and involved all patients hospitalized during the study period. Results: The study included 21 patients out of 1738 hospitalized patients, with a prevalence of 1.21%. The mean age was 38.57 years with extreme ages of 18 and 64 years. The sex ratio was 0.40. Risk factors found in the study were oral contraception (19.05%), overweight (19.05%), smoking (14.28%), HIV (4.76%) and heart failure (4, 76%). 61.90% (n = 13) had isolated pulmonary embolism, 38.09% (n = 8) had venous thrombosis and pulmonary embolism association. Through the chest angio-CT, 28.57% of obstructions were located at the left branch of the pulmonary artery, 9.52% at the right branch and 61.90% were bilateral obstructions. Four deaths were recorded, all in a context of massive pulmonary embolism, with a fatality rate of 19.05%. Conclusion: Pulmonary embolism is a serious and common disease, often difficult to diagnose. It is a cardiovascular emergency and requires immediate and adequate care.
文摘Traumatic diaphragmatic injury (TDI) is rare and is most often the result of a traffic road accident (TRA) or an assault. We initiated this study with the aims of determining the epidemiological, clinical and therapeutic aspects of TDI at Gabriel Toure University Hospital. This was a retrospective study from January 1999 to June 2021 that included all patients who presented a diaphragmatic injury consecutive to abdominal and/or thoracic trauma. In 22 years and 6 months, 46 cases of TDI were collected. They represented 0.17% of hospitalizations, 0.26% of surgical emergencies and 5.5% of thoraco-abdominal traumas. The average age was 31.69 years with a sex ratio of 3.2. Criminal stabbings accounted for 56.5% and TRA for 19.6%. Penetrating injuries accounted for 78.3% of cases. The parietal lesion was thoracic in 21 cases (45.7%), abdominal in 19 cases (41.3%) and thoraco-abdominal in 6 cases (13%). The chest X-ray, performed in 15 patients, showed an intrathoracic gas bubble (4 cases) and hemothorax (6 cases). Diagnosis of diaphragmatic lesion was preoperative in 21.7% (10 cases). The diaphragmatic breach was on the left side in 65.2% (30 cases) and the average size was 3.17 cm. Laparotomy was performed in 89.1%, thoracotomy in 4.4% and thoraco-laparotomy in 6.5% of cases. The surgical procedure consisted of reduction of the herniated viscera in 15.2% (7 cases) and closure of the diaphragmatic breach with non-absorbable sutures in 82.6% (36 cases). Chest tube drainage was performed in 73.9%. The average length of hospital stay was 9.8 days. Mortality was 13.04%. Conclusion: Traumatic diaphragmatic injury is rare but its frequency is increasing in our country. It most often affects the young man victim of assault or TRA. This type of trauma is rarely isolated;you have to think about it in case of any thoraco-abdominal trauma. The treatment is surgical. The prognosis depends on the severity of the associated lesions.
文摘Introduction: Voluntary assault and injuries are acts that damage the physical and psychological integrity of a human being. WHO in its global report on violence and health estimates that in 2000, 1.6 million people worldwide died as a result of self-harm, interpersonal or collective violence, resulting in an overall rate adjusted by age of 28.8 per 100,000 population. Because of the seriousness of this phenomenon and the heavy socio-economic and health consequences that they generate, it seemed important to us to undertake this study, which aimed to study the deliberate injuries in the emergency unite of the Gabriel Touré Teaching Hospital in Bamako. Material and methods: This was a descriptive and cross-sectional study with a prospective study from September 1st, 2016 to August 31st, 12 months, covering 295 patients, including any patient received for voluntary injury consultation with a workable medical record and/or a full investigation record with or without requisition. Our data were collected on individual survey cards and subsequently analyzed with Word, Excel, IBM SPSS Statistics 22 software. Results: The majority of victims of assault and bodily injury were male with 83.1%;with a sex ratio of 4.9, the 18 to 28 age group was the most concerned with 163 cases of the 295 cases in our study, 55.2%. The extremes were 6 and 100 years old with an ectype at 11.08. The most affected ethnic group was Bambara with 38.6% (n = 114) followed by Fulani with 15.6% (n = 46). Students were the most affected at 24.7% (n = 73), followed by traders at 10%. The victims coming from outside Bamako are the most predominant with 22.4% (n = 66) followed by those of commune IV of Bamako 15.6% (n = 46). In 92.2% of the cases the mechanism was direct with n = 272. Of the lesions recorded in our study, wounds came first with 53.2% of cases. Radiography was the most used imaging at 44.7% (n = 89) followed by computed tomography at 34.7% (n = 69). The hemoperitoneum objectified by abdominal ultrasound represented 29.3% (n = 12). Fractures embarrure associated with bruising-hemorrhagic bruises were the most predominant with 13.4% (n = 10) objectified by brain scan. Conclusion: We note that the phenomenon of violence has reached worrying proportions, especially among young adults, particularly among students and is observed in all so-cio-professional layers. The polymorphism of these injuries caused by the predominant use of knives must draw the attention of our authorities to take measures to reduce these aggressions.
文摘Digestive hemorrhage by rupture of esophageal Varices is common and has a pejorative prognosis in our context. <strong>Purpose:</strong> The main purpose of this work was to study the digestive bleeding by esophageal varices and prognosis value of blood transfusion in the Hospital of Gabriel Touré. <strong>Methodology:</strong> It was a prospective study that took place in the service of Hepato-gastroenterology of Gabriel Touré Hospital from June 2016 to May 2017 and from November 2017 to August 2018. <strong>Results:</strong> At the end of the study, 77 patients met the inclusion criteria out of 1396 patients hospitalized during the same period. Varices bleeding represented a prevalence of 5.5% among hospitalized patients during the same period. The average age of our patients was 46.58 ± 15.09 years. The male sex was more reported in our study with a prevalence of 67.5%. At admission, 63.2% had clinical anemia, 58.4% low arterial pressure and 50.6% hemoglobin rate less than 7 g/dL. Blood transfusion was indicated in 47 patients (61%). The mortality rate was 23.4% and was comparable in both groups (p = 0.0990). Early rebleeding was significantly observed in the case of transfusion (p = 0.0452). Hepatic encephalopathy was the leading cause of death of our patients with 72.2%. <strong>Conclusion:</strong> Digestive bleeding by esophageal varices is a worsen complication in cirrhosis in hospital setting. Transfusion has not significantly improved the prognosis of our patients.
文摘Summary:Deep vein thrombosis(DVT)and pulmonary embolism(PE)are two entities of venous thromboembolism(VTE)whose incidence is difficult to assess.Objective:This paper aims to evaluate the prevalence of venous thromboembolism.Patients and Methods:This was a descriptive cross-sectional study with prospective collection,over 12 months from May 1,2023 to April 30,2024.Results:We admitted 627 patients including 6 cases of VTE,with a prevalence of 096%.The average age was 49.67±17.58 years with extremes of 30 to 71 years,the sex ratio 0.2,and housewives represented 33.3%.The transient risk factors(FDR)were prolonged immobilization≥05 days(05 cases)83.3%,major surgery(01 case)16.7%,spinal cord trauma(01 case)16.7%,central venous catheter(04 cases)66.6%;the permanent risk factors(FDR)were obesity(04 cases)66.6%,age(3 cases)50%,high blood pressure(hypertension)(3 cases)50%,cancer(01 case)16.7%.The main clinical signs were dyspnea(100%),tachycardia(33.3%),chest pain(33.3%),and Homans sign with increased local heat(01 cases)16.7%.The diagnoses retained were PE(04 cases)83.3%,PE+DVT(01 case)16.7% and DVT(01 case)16.7%.All patients were placed on oxygen therapy,(02 cases)intubated and ventilated,(02 cases)High Flow Oxygenation,(02 cases)on amines such as dobutamine+norepinephrine and norepinephrine alone(83.3%)of patients were placed on direct oral anticoagulants(DOACs)and 16.7%on low molecular weight heparin(LMWH).The average length of stay was 7.3±3.33 days with extremes of 4 to 13 days and the lethality of(03 cases)50% of which(02 cases)had sPESI≥2.Conclusion:The diagnosis and management of VTE remains difficult and responsible for significant morbidity and mortality.
文摘Semantic segmentation is a core task in computer vision that allows AI models to interact and understand their surrounding environment. Similarly to how humans subconsciously segment scenes, this ability is crucial for scene understanding. However, a challenge many semantic learning models face is the lack of data. Existing video datasets are limited to short, low-resolution videos that are not representative of real-world examples. Thus, one of our key contributions is a customized semantic segmentation version of the Walking Tours Dataset that features hour-long, high-resolution, real-world data from tours of different cities. Additionally, we evaluate the performance of open-vocabulary, semantic model OpenSeeD on our own custom dataset and discuss future implications.
文摘Tour Overview.“Yangtze River Fantasy Tour-Charm of the Yangtze”is a carefully crafted 6-night,7-day journey for you to fully experience the endless charm of China's Yangtze River.On this trip,tourists will embark on a top luxury cruise ship on China,s inland rivers,sailing through the Yangtze River,enjoying comfort and luxury.The modern design and complete facilities of the cruise ship not only provide first-class accommodation but also offer a variety of onboard entertainment activities,filling your journey with laughter and joy.
文摘On May 26,40 teachers and students from the graduating class of the Buddhist Academy of Xizang in Lhasa embarked on a teaching practice and national condition study tour in Zhejiang and Shanghai.
文摘Twenty years ago,during an inspection tour of the pollutionbesieged village Yucun in Anji County,east China’s Zhejiang Province,then provincial Party Secretary Xi Jinping proposed that“lucid waters and lush mountains are invaluable assets”–a seminal insight now known as the“Two Mountains”Theory.
基金financed as part of the project“Development of a methodology for instrumental base formation for analysis and modeling of the spatial socio-economic development of systems based on internal reserves in the context of digitalization”(FSEG-2023-0008).
文摘Artificial intelligence(AI)is transforming the tourism industry and affecting on natural ecology,making it more environmentally friendly,efficient and personalized.In 2025,AI technologies are being actively implemented to reduce the carbon footprint,optimize resources,and improve the travel experience.Here are the key applications of AI in environmentally sustainable smart tourism:AI in smart tourism is not just a technological trend,but a necessity for the sustainable development of the industry.Paper analyses personalized and green travel experience and smart tourism.AI-based applications(Google ARCore)allow tourists to get information about attractions without paper booklets.Virtual tours reduce the need for physical travel by reducing the carbon footprint.Platforms offer routes with minimal impact on nature(for example,hiking trails instead of car tours).Tourists can offset their carbon footprint through AI tools by financing tree planting.The introduction of AI solutions allows combining economic benefits with environmental responsibility,creating a future where travel becomes safer for the planet.Paper confirms idea about sustainable tourism development in developing countries and focus on premium ecotourism.Instead of mass tourism,AI helps promote unique destinations(safaris,diving,ethnographic tours),which increases income with less environmental damage.Smart cities with AI-driven transport and energy-saving solutions make tourism more sustainable.
基金Sponsored by Vocational Education Teaching Reform Research Project of Shandong Province“Research on Digital New-Form Curriculum Development Based on AI Knowledge Maps in the Context of Industry-Education Integration”(2023352)Vocational Education Teaching Reform Research Project of Shandong Province“Innovation and Practice in the Development Model of Vocational College Master Craftsman Studios under the Perspective of Industry-Education Integration”(2024375).
文摘A“smart course”denotes a learner-centered curriculum model that deeply integrates advanced technologies,including generative artificial intelligence(AI)and big data analytics,with ongoing optimization and iterative refinement.This paper examines the pathways of smart course development in higher vocational education by using the Study Tour Course Design course as a practical case study.The analysis is conducted from four perspectives:innovation in educational concepts,innovation in teaching models,transformation in learning paradigms,and enhancement in evaluation systems.By developing a threedimensional framework encompassing“knowledge,skills,and problems”,the focus of education shifts from“knowledge imparting”to“competency development”.This approach fosters a transformation in teaching interactions,moving beyond the traditional“teacher and student interaction”to a more integrated trinity collaboration of“teachers,students,and machines”,and promotes the transformation of students’learning from“passive receptive learning”to“autonomous inquiry-based learning”.Simultaneously,it facilitates the transition of evaluation methods from“outcome-based evaluation”to“multi-dimensional evaluation”.
文摘Summary: Hepatomegaly is one of the clinical signs commonly encountered in chronic liver disease. The aim of our study was to study the epidemiological, clinical and etiological aspects of hepatomegaly in the hepato-gastroenterology department (HGE) of the Gabriel Touré university hospital. This was a cross-sectional study that took place from September 2021 to October 2022 in the department. All patients aged 18 years and older with hepatomegaly, hospitalized or examined by physicians were included. We collected 100 cases of hepatomegaly, representing 3.7% of 2661 patients examined or hospitalized in the HGE department during the study period. These patients had a mean age was 46.7 ± 16.10 years with extremes of 18 and 76 years. The sex ratio was 2.7. Jaundice was the most commonly reported history with a frequency of 26%. Pertaining to patients’ lifestyle, alcohol consumption was the most common feature with 6%. The most common associated clinical signs were jaundice, ascites, and edema of the lower limbs. Painful hepatomegaly (86%), with a sharp lower edge (74%), a firm consistency (69%), and an irregular surface (52%) was frequently observed. Cytolysis (75.5%), increased alphafetoprotein levels (70%), microcytic anemia (37%), hyperleukocytosis (54.3%), and biological hepatocellular insufficiency syndrome (low albumin with 30.4%, high bilirubinemia with 61.2% and low platelets with 33.9%) were the most common observed laboratory abnormalities. Hepatitis B virus markers (61%) were the most frequently found in the study patients. At ultrasound examination, heterogeneous hepatomegaly was observed in 87.3% of the patients. Esophageal varices (43.1%) were more commonly seen than other varices during upper gastrointestinal endoscopy. The dominant etiology was hepatocellular carcinoma on cirrhosis with 66% followed by cirrhosis. Conclusion: Painful hepatomegaly was quite frequently in our urban setting hospital with several etiologies. HCC was the most common etiology, therefore measures to prevent it in the community need to be established by the concerned stakeholders to improve adult population health in Bamako.
基金the Centre of Excellence in Mobile and e-Services,the University of Zululand,Kwadlangezwa,South Africa.
文摘The studypresents theHalfMax InsertionHeuristic (HMIH) as a novel approach to solving theTravelling SalesmanProblem (TSP). The goal is to outperform existing techniques such as the Farthest Insertion Heuristic (FIH) andNearest Neighbour Heuristic (NNH). The paper discusses the limitations of current construction tour heuristics,focusing particularly on the significant margin of error in FIH. It then proposes HMIH as an alternative thatminimizes the increase in tour distance and includes more nodes. HMIH improves tour quality by starting withan initial tour consisting of a ‘minimum’ polygon and iteratively adding nodes using our novel Half Max routine.The paper thoroughly examines and compares HMIH with FIH and NNH via rigorous testing on standard TSPbenchmarks. The results indicate that HMIH consistently delivers superior performance, particularly with respectto tour cost and computational efficiency. HMIH’s tours were sometimes 16% shorter than those generated by FIHand NNH, showcasing its potential and value as a novel benchmark for TSP solutions. The study used statisticalmethods, including Friedman’s Non-parametric Test, to validate the performance of HMIH over FIH and NNH.This guarantees that the identified advantages are statistically significant and consistent in various situations. Thiscomprehensive analysis emphasizes the reliability and efficiency of the heuristic, making a compelling case for itsuse in solving TSP issues. The research shows that, in general, HMIH fared better than FIH in all cases studied,except for a few instances (pr439, eil51, and eil101) where FIH either performed equally or slightly better thanHMIH. HMIH’s efficiency is shown by its improvements in error percentage (δ) and goodness values (g) comparedto FIH and NNH. In the att48 instance, HMIH had an error rate of 6.3%, whereas FIH had 14.6% and NNH had20.9%, indicating that HMIH was closer to the optimal solution. HMIH consistently showed superior performanceacross many benchmarks, with lower percentage error and higher goodness values, suggesting a closer match tothe optimal tour costs. This study substantially contributes to combinatorial optimization by enhancing currentinsertion algorithms and presenting a more efficient solution for the Travelling Salesman Problem. It also createsnew possibilities for progress in heuristic design and optimization methodologies.
基金Supported by Research Project on Basic Education in Jiangxi Province(SZUNDZH2021-1136,SZUNDZH2020-1138).
文摘In recent years,with the support and promotion of relevant policies such as the Opinions on Promoting Study Tour for Primary and Secondary School Students jointly issued by the Ministry of Education and 11 other departments,a wave of study tour has been sparked nationwide from individual pilot projects to gradual promotion.In this paper,students and teachers from grades 4 to 6 of L Primary School in Nanchang City,Jiangxi Province were selected as the survey objects.Combining the survey questionnaire,the current situation of conducting study tour in the primary school was sorted out and analyzed in depth from several aspects such as study tour cognition,study tour participation,study tour implementation,etc.Based on the survey results and relevant research,the current problems in conducting study tours in primary schools were summarized,and targeted improvement measures were proposed,in order to promote the healthy development of study tours in primary schools.
基金Vocational Education Teaching Reform Research Project of Shandong Province(2022273)2023 General Project of Shandong Higher Education AssociationSchool-level Key Research Project of Qingdao Preschool Education College(kyzd2023-01).
文摘Curriculum ideology and politics are critical for colleges and universities to fulfill theirfundamental mission of fostering moral and intellectual development. Within this framework, professionalcourses serve as the primary vehicles for integrating ideological and political education. Specifically, inthe field of study tours, the Study Tour Course Design emerges as a pivotal component for actualizingthe educational objectives of such programs. To construct a robust ideological and political curriculum,it is essential to devise a comprehensive system that aligns with professional teaching standards, industrybenchmarks, and vocational skill requirements. This involves a thorough exploration of ideologicaland political elements within the curriculum, ensuring their seamless integration throughout the coursedevelopment process.
基金the"14 th Five-year"Plan Project for the Development of Philosophy and Social Sciences of Guangzhou(2023GZGJ83)the Guangdong Ploytechnic of Industry and Commerce Project(2023-SKJ-20).
文摘Urban night tourism is a new form of urban tourism development and an important driving force for the prosperity of urban night economy.As the most prestigious business card among many night tour projects in Guangzhou,the Pearl River water night tour has contributed to the development of Guangzhou s night economy,which cannot be underestimated.However,in the process of rapid development,there are also problems such as diversified operators,insufficient integration of intangible cultural elements,excessive commercial attributes,issues of tourism facilities and service facilities.Under the new stage of integrated development of culture and tourism,how to use mutual promotion of culture and tourism in the Pearl River night tour to seek innovative paths for high-quality development in the future is the main problem expected to be solved in this paper.Therefore,based on the perspective of culture and tourism integration,this paper analyzes the general situation and development status of the Pearl River night tour,and proposes five development strategies:the overall planning of culture and tourism integration,the deep integration of intangible cultural elements,the balance of commercial attributes and tourism attributes,the high integration of culture,business,tourism and education,and the creation of tourism atmosphere,in order to provide inspiration for the healthy,orderly and high-quality development of the Pearl River night tour.
文摘During some tours to the high mountain region of southern Sinai, that I did in different occasions between 1979-1984, I received from different Bedouin guides some information, about geographical sites in that region. Part of that information does not appear in the updated maps of southern Sinai. Therefore, I would like to bring here that geographical information. The areas to which that geographical information refers are: the mountain massif of Santa Katarina, and also the mountain massif of Jebel Bab, which is located about 8 km - 10 km WSW of the Santa Katarina village or town.
文摘With the sharp increase in life pressures,holiday travel has become a popular choice for many.As an indispensable role in tourism,tour guides can significantly enhance the tourist experience and showcase the allure of various scenic spots.In the new era,to achieve sustainable development and positive transformation,tour guides face significant challenges.This paper explores these challenges and proposes potential transformation paths for the tour guide profession in Nanchang,a city with a rich history,as it strives to build a strong city brand.
基金Supported by the College Students’Innovative and Entrepreneurial Training Plan ProgramYuxiu Innovation Project of North China University of Technology(2024NCUTYXCX214).
文摘Classical Chinese gardens,with their intricate interplay of architectural landscapes featuring narrow corridors and expansive courtyards,are designed to surprise and captivate visitors at every turn.Unraveling the connection between visual perception,walking behaviors,and the spatial elements of these garden compounds is essential to grasping the essence of traditional Chinese garden design.This study employs Virtual Reality(VR)and eye-tracking technologies to evaluate the touring patterns within Chinese classical gardens,with a case study focusing on the Canglang Pavilion Garden in Suzhou.A total of 68 participants were enlisted to engage in a VR experiment simulating a visit to a courtyard space within this garden.The study analyzed route choices between 2 distinct spatial types:corridor-architecture and courtyard-wall.Eye movement indicators within the Areas of Interest(AOIs)for frame-of-view and depth-of-view spatial elements were monitored,and visitors’spatial-temporal trajectory maps were documented.This research offers valuable insights into the intricate dynamics between visual attention,spatial elements,and visitor behavior within garden environments.The methodology applied in this study has broad implications for environmental psychology,landscape architecture,and the study of cultural heritage sites,providing a deeper understanding of the interactions and perceptions of visitors within garden spaces.
