Epidemiological, Clinical and Etiological Aspects of Adult Hepatomegaly at the Gabriel Touré University Hospital of Bamako in 2023

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.

Implementation Status and Development Strategies of Study Tour in Primary Schools in Nanchang City : A Case Study of L Primary School

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.

Curriculum Ideological and Political Teaching and Practice of Study Tour Course Design in Higher Vocational Colleges: A Case Study of Qingdao Preschool Education College

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.

High-quality Development of the Pearl River Night Tour in the Context of Deep Integration of Culture and Tourism

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.

Research on the Challenges and Transformation Path of Tour Guide Profession in the New Era

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.

A Branch and Cut Algorithm for Two-Echelon Inventory Routing Problem with End-of-Tour Replenishment Policy

This study presents a two-echelon inventory routing problem (2E-IRP) with an end-of-tour replenishment (ETR) policy whose distribution network consists of a supplier, several distribution centers (DCs) and several retailers on a multi-period planning horizon. A formulation of the problem based on vehicle indices is proposed in the form of a mixed integer linear program (MILP). The mathematical model of the problem is solved using a branch and cut (B&C) algorithm. The results of the tests are compared to the results of a branch and price (B&P) algorithm from the literature on 2E-IRP with a classical distribution policy. The results of the tests show that the B&C algorithm solves 197 out of 200 instances (98.5%). The comparison of the B&C and B&P results shows that 185 best solutions are obtained with the B&C algorithm on 197 instances (93.9%). Overall, the B&C algorithm achieves cost reductions ranging from 0.26% to 41.44% compared to the classic 2E-IRP results solved with the B&P algorithm, with an overall average reduction of 18.08%.

红色研学融入高校爱国主义教育的价值与创新路径

红色研学是依托红色文化遗迹和革命故事开展的实践学习之旅,它引领参与者走出课堂,踏入历史发生地,让红色过往变得可亲可感。从斑驳的旧居墙壁到珍贵的历史文物,每一处都承载着先辈的热血与牺牲,鲜活地勾勒出爱国奋斗的壮丽画卷。高校爱国主义教育作为高校思政体系的关键组成部分,通过课程、讲座等形式,系统地向大学生传授爱国理念、民族精神,塑造大学生正确的世界观、人生观、价值观,为人才培育奠定坚实的精神基础。红色研学与高校爱国主义教育契合紧密。红色研学的体验式特性为高校稍显理论化的爱国主义教育注入了新的活力,把抽象知识具象化,增强了学习的感染力和实效性。而高校丰富的知识资源和深厚的师资储备,为红色研学活动的行程规划、深度解读提供了有力支持,共同强化青年学子的爱国情感和向心力。

文化养老视域下老年游学课程产品开发与设计

文化养老是当代老年人适应时代发展的新型养老方式。老年游学作为集休闲、旅游、教育于一体的创新型老年教育方式,能有效满足老年大众的精神文化需求,受到老年群体的普遍青睐。结合老年人的身心特征和游学偏好进行游学课程产品的开发,具有重要意义。老年游学课程产品主要包括怀旧型、观光型、增知型、疗养型等四种类型。老年游学课程产品开发可以从以下四个方面加以改进:一是明确产品目标定位,做好游学课程顶层设计;二是评估顾客游学需求,合理开发老年游学课程;三是丰富游学课程产品供给,创新课程实施形式;四是多方收集产品反馈意见,注重游学课程成效。

TOUR及其改进模型在路径搜索中的应用研究

定性空间推理是近几年来空间关系推理的一个热点,TOUR模型就是一个很好的定性空间推理模型,它基于认知图,对空间信息进行合理描述,能够吸收新的信息和解决路径搜索问题,但TOUR模型本身也存在一些不足之处。文中介绍了基于空间关系路径搜索的TOUR模型,用TOUR模型解决了一个具体的路径搜索问题,根据具体的应用指出了TOUR模型的不足,对TOUR模型进行了改进,并提出了改进后的算法,最后分析了对TOUR模型改进后的主要优势。

Construction of Ecological Tourist Destinations for Health Preservation

The approaches of constructing ecological tourist destinations for health preservation are introduced from 8 aspects,that is,resources,environment,cultures,services,facilities,management,marketing and education.Meanwhile,this study states that the key of building such tourist destinations is the health-preservation environment system,including ecological environment,cultural environment and social environment.

Discussion on Semantic and Communicative Translation and Its Application to English Translation of Tour Guide Manuals

Semantic translation and communicative translation are two strategies in Newmark's translation theory.This article begins with a discussion on Newmark's two translation methods,and aims at providing a theoretical basis for the combined application of both methods in translation of tour guide manuals.

指向核心素养培育的红色研学旅行课程建构研究——以来宾市红色资源为例

指向核心素养培育的红色研学旅行课程的建构要坚持以学生发展为主线、真实问题情境的课程体系、跨学科的知识整合的原则,从素养化的课程目标、项目化的课程内容、实践化的课程实施、多元化的课程评价四个方面来进行。

E-Card电子名片交互系统

该文设计并实现了基于UML电子名片E-Card系统,并对系统中的一些难点及解决办法进行了介绍,这种方法经实践验证安全性和移植性都比较好。

“红文农旅”研学实践活动的设计与实施——以通道侗族自治县为例

红色文化蕴含丰富的育人价值,是开展思想政治的重要资源。随着社会经济的发展,人们对于旅游业和教育业的要求逐渐提高,研学旅行作为一种新型的教育方式受到越来越多人的关注。在这种背景下,“红文农旅”研学实践活动应运而生,通过导向鲜明、形式活泼的实践活动促进学生知行合一能力提升,在潜移默化中感悟革命历史,传承红色基因。该文以通道侗族自治县为例,探讨“红文农旅”研学实践活动的设计与实施,旨在为类似活动的开展提供借鉴。

浅析由“半tour废”引起的中英文混搭

从“洋泾浜”英语、字母词到“汉形英语”等,中英文混搭在我们日常交往的使用中已屡见不鲜,这由英语的普及、网络的兴起与大众的猎奇心理等众多因素引起。2016年末至2017年初,网红papi酱的“半tour废”引起了新一轮的中英文网络语言混搭。本文分析、归纳此轮中英文混搭网络语言的表现形式,并将其与过往中英文混搭网络语言进行比较。

Efficient Tour Planning for Tourist Sites Visitation in Lokoja, Nigeria: A Multi-Scenario Analysis Using GIS

This study used GIS to analyse various visitation sequence and routes for tourist sites in Lokoja considering multiple scenarios. This was done with a view to determining the most efficient visitation sequence vis-à-vis the routes for optimizing the overall visiting time and distance for the various scenarios considered. The main datasets used were the transportation network and the geographic coordinates of the tourist sites. These were collected through a comprehensive field survey of the study area. The ArcGIS 10.1 Network Analyst Extension was the main software used for this analysis. Five scenarios were considered comprising open and closed tours as well as Sequential Ordering Problems (SOP) and non-SOPs. In addition, for the first and second scenarios, an auxiliary scenario was considered that featured a hypothetical road block on an important arterial route. The fifth scenario considered the implication of a hypothetical flooding of some road sections along the bank of the River Niger. Furthermore, for each scenario, there were two optimization solutions: One that optimized the distance covered in visiting all the tourist sites and the other that optimized the time duration required to complete the site visitations. Optimal visitation sequences were determined by the network analyst as part of the solution of the respective scenarios. Sensitivity analysis was also performed to compare the consequences of time savings vis-à-vis distance savings across the various scenarios. In addition to the detailed navigation map produced for each scenario, a comprehensive navigation description guide was derived. The study reveals that scenarios where the site visitation sequence were optimized saved both time and distance markedly compared to scenarios with a predefined site visitation sequence. In all cases, shorter visitation durations were associated with time-optimized scenarios compared to distance-optimized ones while shorter visitation distances were associated with distance-optimized scenarios as compared to time-optimized scenarios. However, the disparities between distance-optimized and time-optimized scenarios were negligible in some cases. Furthermore, the blockage of an important arterial route (including the flooding of a vulnerable road segment) resulted in a striking increase in the optimal distance and time required to visit all the tourist sites in Lokoja. Overall, the shortest cumulative travel time (of approximately 17.69 minutes) and distance (of 15,897.20 meters) were derived from the second scenario.

Pulmonary Embolism in Hospitalization in the Department of Cardiology of Gabriel Toure University Hospital

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.

Tour Planning Design for Mobile Robots Using Pruned Adaptive Resonance Theory Networks

The development of intelligent algorithms for controlling autonomous mobile robots in real-time activities has increased dramatically in recent years.However,conventional intelligent algorithms currently fail to accurately predict unexpected obstacles involved in tour paths and thereby suffer from inefficient tour trajectories.The present study addresses these issues by proposing a potential field integrated pruned adaptive resonance theory(PPART)neural network for effectively managing the touring process of autonomous mobile robots in real-time.The proposed system is implemented using the AlphaBot platform,and the performance of the system is evaluated according to the obstacle prediction accuracy,path detection accuracy,time-lapse,tour length,and the overall accuracy of the system.The proposed system provide a very high obstacle prediction accuracy of 99.61%.Accordingly,the proposed tour planning design effectively predicts unexpected obstacles in the environment and thereby increases the overall efficiency of tour navigation.

Context-Aware Tour Planning System Based on Satisfaction Model

With the development of communication and ubiquitous computing technologies, context-aware services, which acquire contextual information of users and environment, have become critical applications providing customization in mobile commerce. Meanwhile, tourism has attracted increasing attention as a high value-added service and a hot academic topic. However, the research on how to provide tour services based on context-aware services is in fact still at an early stage, limited to concept elaboration, service framework discussion, prototype system development etc. In this paper, we summarized the previous researches on context-aware services to establish the research foundation, put forward a way of analyzing a tour planning problem with a modified model of Traveling Salesman Problem （TSP） and Vehicle Routing Problem （VRP）, and we applied an innovated Resource Constrain Project Scheduling Problem （RCPSP） mathematical model to solve the tour planning problem based on context information. The simulation under branch and bound algoritban evaluated the validity of our solution.

Bacteriology of Healthcare-Associated Infections in the Gynecology and Obstetrics Department of CHU Gabriel Touré

Introduction: Healthcare-associated infections (HAIs) are a public health issue. An infection is said to be associated with the care if it occurs during or after the care of a patient, and if it was neither present nor incubation at the beginning of the care. Objective: The purpose of this work was to study the bacteriology of infections associated with obstetric care in the gynecology-obstetrics department of CHU Gabriel Touré. Patients and Methods: This is an epidemiological, descriptive, analytical study conducted in the gynecology-obstetrics department of the CHU Gabriel Touré, from April 11th, 2016 to August 29th, 2016 (5 months). Data collection focused on the clinical and laboratory characteristics of healthcare-associated infections in patients during their hospitalization. Included in the study were any patients hospitalized in the Gynecology and Obstetrics Department who agreed to participate in the study. The criteria used to diagnose the associated infection were those of the Atlanta CDC. Operative wound monitoring was done up to the 30th postoperative day. Results: We have recorded 200 patients, out of whom 138 were operated on and 23 cases of bacterial infection associated with care (11.50%). The average age of the patients was 32.52 years ± 13.36 years against 29.36 years ± 10.28 years for the patients who did not present the infection. Seven point five percent of the evacuated patients had an infection associated with care. The most common types of infection were surgical site infection (60.86%), urinary tract infection (26.08%), endometritis and sepsis with 13.04% each. The isolated organisms were all resistant to Amoxicillin, to Amoxicillin + Clavulanic acid (88.88%) and to Ciprofloxacin (77.77%). The average duration of hospitalization for patients who developed the infection was 14.70 days. The lethality was 1.50%. The average cost of management of patients who developed the surgical site infection was 119,837 FCFA. Conclusion: The bacterial infections associated with the care remain frequent in our service and dominated by the infections of the operating site. Isolated organisms were all resistant to amoxicillin in 88.88% case ciprofloxacin.