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.Meanwh...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.展开更多
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-...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.展开更多
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
通过分析欧拉所给出Knight’s Tour Problem的解法,结合哈密尔顿路和哈密尔顿圈的相关知识,得出其解法对应着二部图中的一条哈密尔顿圈.由此再充分利用8×8棋盘所对应的8×8表格的对称性及同格图的特性,对欧拉所给出的Knight’s...通过分析欧拉所给出Knight’s Tour Problem的解法,结合哈密尔顿路和哈密尔顿圈的相关知识,得出其解法对应着二部图中的一条哈密尔顿圈.由此再充分利用8×8棋盘所对应的8×8表格的对称性及同格图的特性,对欧拉所给出的Knight’s Tour Problem的解法作了进一步的探讨,得出了以欧拉的解法为基础的以任一棋格为骑士周游起点的另外一系列解法.最后,把Knight’sTour Problem推广到m×n棋盘上,考虑到移动规则的特殊性,利用图论的相关知识,得到3×4,8×16和16×16棋盘上的Knight’s Tour Problem的解法,同时给出8m×8n(m>2,n>2)棋盘上Knight’s Tour Problem的猜想.展开更多
To meet the tourists' need,more and more tourist materials,including guide commentary,have been translated into English.This paper analyses the text type and criteria of tour guide commentary.It also analyses the ...To meet the tourists' need,more and more tourist materials,including guide commentary,have been translated into English.This paper analyses the text type and criteria of tour guide commentary.It also analyses the possible problems that may exist in the translation of guide commentary and suggests some feasible techniques.展开更多
Interpersonal metafunction is one of the most important functions of language, through which people express their view-points, establish and maintain relations with other people. This paper analyzes the interpersonal ...Interpersonal metafunction is one of the most important functions of language, through which people express their view-points, establish and maintain relations with other people. This paper analyzes the interpersonal metafunction in tour advertise-ments from mood, modality and person system. Through the analysis, this paper reveals how tour advertisements achieve its pur-pose of persuading the potential consumers.展开更多
This paper is a corpus-based study which aims at analyzing lexical features of English tour commentary and creating a keyword list as teaching material.
[Objective] The study aimed to assess tourism environment in oases of Xinjiang. [Method] Based on basic theory of tourism environ- ment assessment and related standards at home and abroad, the evaluation indicator sys...[Objective] The study aimed to assess tourism environment in oases of Xinjiang. [Method] Based on basic theory of tourism environ- ment assessment and related standards at home and abroad, the evaluation indicator system and standards for tourism environment in oases of Xin- jiang were constructed according to the actual situation of the tourism environment, and then the comprehensive evaluation model was constructed to assess tourism environment in Urumqi using linear weighted sum. [Result] The comprehensive score of tourism environment in Urumqi is 6.807 68, and the tourism environment is in a good state. Resource and landscape environment is the best, followed by social service and economic environ- ment, while the other environments are bad. [ Conclusion] The comprehensive evaluation indicator system for tourism environment in oases of Xin- jiang is rational.展开更多
The following theorem is proved: A knight’s tour exists on all 3 x n chessboards with one square removed unless: n is even, the removed square is (i, j) with i + j odd, n = 3 when any square other than the center squ...The following theorem is proved: A knight’s tour exists on all 3 x n chessboards with one square removed unless: n is even, the removed square is (i, j) with i + j odd, n = 3 when any square other than the center square is removed, n = 5, n = 7 when any square other than square (2, 2) or (2, 6) is removed, n = 9 when square (1, 3), (3, 3), (1, 7), (3, 7), (2, 4), (2, 6), (2, 2), or (2, 8) is removed, or when square (1, 3), (2, 4), (3, 3), (1, n – 2), (2, n – 3), or (3, n – 2) is removed.展开更多
Taking overall planning of tour routes as the guiding concept of regional tourism development,one core,three subjects,three sections and three levels in the overall planning of tour routes were explored. Range,plannin...Taking overall planning of tour routes as the guiding concept of regional tourism development,one core,three subjects,three sections and three levels in the overall planning of tour routes were explored. Range,planning principle,optimized layout of travel channels,construction of tourist towns,construction of scenic areas,construction of highway landscapes along travel channels,construction of tourist distribution centers in the overall planning of tourist routes for Panzhihua City,Sichuan Province were elaborated. Signifi cance of the overall planning of tour routes was summarized.展开更多
A cerebrole is a patient with a neurological deficit of central origin;these patients very often present disorders of the ion concentration, hence the need for hospitalization in intensive care. The aim of our study w...A cerebrole is a patient with a neurological deficit of central origin;these patients very often present disorders of the ion concentration, hence the need for hospitalization in intensive care. The aim of our study was to study hydro-electrolyte disorders in brain-damaged patients, to describe the clinical aspects, to identify the contributing factors and to determine the prognosis of these patients in the intensive care unit of gabriel touré teaching hospital. <strong>Material and Methods:</strong> It was a prospective cross-sectional study, descriptive of a period of 11 months going from June 2015 to April 2016 in the intensive care unit of CHU Gabriel TOURE we included all the cerebral patients admitted in intensive care in which hydro-ionic disorders have detected on arrival or during hospitalization. Data were collected through transfer sheets, a survey sheet and medical records. Data entry and analysis were done respectively on SPSS software (version 19) and Microsoft Word Starter 2010 software. <strong>Results:</strong> During our study, out of 450 hospitalization patients, we identified 110 brain-damaged patients and 75 patients were retained in our study, i.e. a prevalence of 16.6%. Male was predominant with 72% with a sex ratio of 2.5 the age group 20 - 50 years was majority with 45.3%, the average age was 38.49 years. The majority of patients (58.7%) were admitted from the emergency department. The most common reason for admission was impairment of consciousness in 94.7% (Table 1) of cases and the Glasgow admission score was less than or equal to 8 in 58.7% (Table 1) of patients. Hydro-electrolyte disturbances were present in 93.3% of patients on admission. Hyponatremia was the most common disorder with 56% (42 cases). Followed by hyperkalaemia 10.7% (8 cases), hypernatremia 9.3% (7 cases), at hypocalcemia 9.3% (7 cases), associated disorders 8% (6 cases). Brain CT was performed in 52% of the patients. In our study, malaria was the most common etiology of ionic disorders with 36%. Of the patients who died, 80% had developed hyponatremia after 5 days in hospital, and the overall lethality was 73.3%. <strong>Conclusion:</strong> Hydro-electrolyte disorders are frequent in the intensive care setting and their management must be rapid in order to reduce morbidity and mortality.展开更多
Objective: The aim of our work was to access the epidemiological and clinical aspects of congenital hydrocephalus in the pediatrics department of Gabriel Touré teaching Hospital Bamako. Methods: We conducted a re...Objective: The aim of our work was to access the epidemiological and clinical aspects of congenital hydrocephalus in the pediatrics department of Gabriel Touré teaching Hospital Bamako. Methods: We conducted a retro and prospective study that ran from January, 1st 2018 to July, 30, 2019. All newborns of 72 hours of life or less with hydrocephalus confirmed by sonography or CT scan were enrolled in this study. Results: During the study period, 5416 patients were hospitalized in the neonatology department. Among them, 39 patients (0.72%) presented congenital hydrocephalus and congenital infectious causes accounted for 25.6%. The sex ratio (M/F) was 1.78. Mothers were housewives and not educated in 79.5% and 64.1% respectively. The parents resided outside Bamako in 61.5% of cases. Prenatal consultations were conducted in 32 patients (82%). Consanguinity between the 2 parents was present in 38.5%. The antenatal diagnosis was made in 8 patients (20.5%). Vaginal delivery was the main mode of birth (67%). The average birth weight was 2930 g (1000 to 5400 g) and the average head circumference was 37.82 cm (26 - 55 cm). In 87.2% of cases, newborns were eutrophic. The main clinical signs were bulging anterior fontanel (46.2%), sunset gaze (20.5%), prominent forehead (48.7%), reduced face (20.5%), enlarged cranial sutures (43.6%), macrocrania (25.6%). Transfontanellar ultrasound and CT scan were performed in 51.3% and 48.7% of cases respectively. Associated malformations were spina bifida in 30.8% of cases followed by Dandy Walker malformation (5.1%), and omphalocele (2.5%). The neurological signs were diminished neonatal reflexes (51.3%), hypotonia (30.8%), motor deficit (38.4%), intracranial hypertension (25.6%), seizures 10.25% and psychomotor delay (43.6%). Surgery was performed in 8 neonates (20.5%). Ventriculo-peritoneal shunt (VPB) was the main treatment. Postoperative complications were infectious (37.5%) and mechanical complications (12.5%). The postoperative mortality rate was 12.5%.The overall mortality was 13 cases (33.3%). Conclusion: The hospital frequency of congenital hydrocephalus in our environment seems low but does not reflect reality.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
This paper proposes a new personal tour planning problem with time-dependent satisfactions, traveling and activity duration times for sightseeing. It is difficult to represent the time-dependent model using general st...This paper proposes a new personal tour planning problem with time-dependent satisfactions, traveling and activity duration times for sightseeing. It is difficult to represent the time-dependent model using general static network models, and hence, Time-Expanded Network (TEN) is introduced. The TEN contains a copy to the set of nodes in the underlying static network for each discrete time step, and it turns the problem of determining an optimal flow over time into a classical static network flow problem. Using the proposed TEN-based model, it is possible not only to construct various variations with time of costs and satisfactions flexibly in a single network, but also to select optimal departure places and accommodations according to the tour route with tourist’s favorite places and to obtain the time scheduling of tour route, simultaneously. The proposed model is formulated as a 0 - 1 integer programming problem which can be applied by existing useful combinatorial optimization and soft computing algorithms. It’s also equivalently transformed into several existing tour planning problems using some natural assumptions. Furthermore, comparing the proposed model with some previous models using a numerical example with time-dependent parameters, both the similarity of these models in the static network and the advantage of the proposed TEN-based model are obtained.展开更多
Stop frequency models, as one of the elements of activity based models, represent an important part of travel behavior. Unobserved heterogeneity across the travelers should be taken into consideration to prevent biase...Stop frequency models, as one of the elements of activity based models, represent an important part of travel behavior. Unobserved heterogeneity across the travelers should be taken into consideration to prevent biasedness and inconsistency in the estimated parameters in the stop frequency models. Additionally, previous studies on the stop frequency have mostly been done in larger metropolitan areas and less attention has been paid to the areas with less population. This study addresses these gaps by using 2012 travel data from a medium sized U.S. urban area using the work tour for the case study. Stop in the work tour were classified into three groups of outbound leg, work based subtour, and inbound leg of the commutes. Latent Class Poisson Regression Models were used to analyze the data. The results indicate the presence of heterogeneity across the commuters. Using latent class models significantly improves the predictive power of the models compared to regular one class Poisson regression models. In contrast to one class Poisson models, gender becomes insignificant in predicting the number of tours when unobserved heterogeneity is accounted for. The commuters are associated with increased stops on their work based subtour when the employment density of service-related occupations increases in their work zone, but employment density of retail employment does not significantly contribute to the stop making likelihood of the commuters. Additionally, an increase in the number of work tours was associated with fewer stops on the inbound leg of the commute. The results of this study suggest the consideration of unobserved heterogeneity in the stop frequency models and help transportation agencies and policy makers make better inferences from such models.展开更多
This research study explores the use of an innovative freight tour-based approach to model truck trips as an alternative to the conventional trip-based approach. The tour-based approach is more realistic as it capture...This research study explores the use of an innovative freight tour-based approach to model truck trips as an alternative to the conventional trip-based approach. The tour-based approach is more realistic as it captures the intermediate stops of each truck and reflects the implications of those stops on vehicle miles traveled (VMT). The paper describes the truck tour-based model concept, and presents the framework of a truck tour-based travel demand forecasting approach. As a case study, Global Positioning System (GPS) truck data are used to determine origin, destination, and truck stops for trucks moving within the Birmingham, Alabama region. Such information is then utilized to model truck movements within the study region as individual truck tours. The tour-based model is ran, and the resulting performance measures are contrasted to those obtained from the conventional trip-based planning model used by the Regional Planning Commission of Greater Birmingham (RPCGB). This case study demonstrates the feasibility of using a tour-based freight demand forecasting model as an alternative to the conventional 4-step process currently used to estimate truck trips in the Birmingham region. The results and lessons learned from the Birmingham case study are expected to improve truck movement modeling practices in the region and advance the accuracy of truck travel demand forecasting models at other locations in the future.展开更多
基金Sponsored by Scientific Research Project of Sanjiang University (K10004)~~
文摘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.
文摘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.
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.
文摘通过分析欧拉所给出Knight’s Tour Problem的解法,结合哈密尔顿路和哈密尔顿圈的相关知识,得出其解法对应着二部图中的一条哈密尔顿圈.由此再充分利用8×8棋盘所对应的8×8表格的对称性及同格图的特性,对欧拉所给出的Knight’s Tour Problem的解法作了进一步的探讨,得出了以欧拉的解法为基础的以任一棋格为骑士周游起点的另外一系列解法.最后,把Knight’sTour Problem推广到m×n棋盘上,考虑到移动规则的特殊性,利用图论的相关知识,得到3×4,8×16和16×16棋盘上的Knight’s Tour Problem的解法,同时给出8m×8n(m>2,n>2)棋盘上Knight’s Tour Problem的猜想.
文摘To meet the tourists' need,more and more tourist materials,including guide commentary,have been translated into English.This paper analyses the text type and criteria of tour guide commentary.It also analyses the possible problems that may exist in the translation of guide commentary and suggests some feasible techniques.
文摘Interpersonal metafunction is one of the most important functions of language, through which people express their view-points, establish and maintain relations with other people. This paper analyzes the interpersonal metafunction in tour advertise-ments from mood, modality and person system. Through the analysis, this paper reveals how tour advertisements achieve its pur-pose of persuading the potential consumers.
文摘This paper is a corpus-based study which aims at analyzing lexical features of English tour commentary and creating a keyword list as teaching material.
文摘[Objective] The study aimed to assess tourism environment in oases of Xinjiang. [Method] Based on basic theory of tourism environ- ment assessment and related standards at home and abroad, the evaluation indicator system and standards for tourism environment in oases of Xin- jiang were constructed according to the actual situation of the tourism environment, and then the comprehensive evaluation model was constructed to assess tourism environment in Urumqi using linear weighted sum. [Result] The comprehensive score of tourism environment in Urumqi is 6.807 68, and the tourism environment is in a good state. Resource and landscape environment is the best, followed by social service and economic environ- ment, while the other environments are bad. [ Conclusion] The comprehensive evaluation indicator system for tourism environment in oases of Xin- jiang is rational.
文摘The following theorem is proved: A knight’s tour exists on all 3 x n chessboards with one square removed unless: n is even, the removed square is (i, j) with i + j odd, n = 3 when any square other than the center square is removed, n = 5, n = 7 when any square other than square (2, 2) or (2, 6) is removed, n = 9 when square (1, 3), (3, 3), (1, 7), (3, 7), (2, 4), (2, 6), (2, 2), or (2, 8) is removed, or when square (1, 3), (2, 4), (3, 3), (1, n – 2), (2, n – 3), or (3, n – 2) is removed.
文摘Taking overall planning of tour routes as the guiding concept of regional tourism development,one core,three subjects,three sections and three levels in the overall planning of tour routes were explored. Range,planning principle,optimized layout of travel channels,construction of tourist towns,construction of scenic areas,construction of highway landscapes along travel channels,construction of tourist distribution centers in the overall planning of tourist routes for Panzhihua City,Sichuan Province were elaborated. Signifi cance of the overall planning of tour routes was summarized.
文摘A cerebrole is a patient with a neurological deficit of central origin;these patients very often present disorders of the ion concentration, hence the need for hospitalization in intensive care. The aim of our study was to study hydro-electrolyte disorders in brain-damaged patients, to describe the clinical aspects, to identify the contributing factors and to determine the prognosis of these patients in the intensive care unit of gabriel touré teaching hospital. <strong>Material and Methods:</strong> It was a prospective cross-sectional study, descriptive of a period of 11 months going from June 2015 to April 2016 in the intensive care unit of CHU Gabriel TOURE we included all the cerebral patients admitted in intensive care in which hydro-ionic disorders have detected on arrival or during hospitalization. Data were collected through transfer sheets, a survey sheet and medical records. Data entry and analysis were done respectively on SPSS software (version 19) and Microsoft Word Starter 2010 software. <strong>Results:</strong> During our study, out of 450 hospitalization patients, we identified 110 brain-damaged patients and 75 patients were retained in our study, i.e. a prevalence of 16.6%. Male was predominant with 72% with a sex ratio of 2.5 the age group 20 - 50 years was majority with 45.3%, the average age was 38.49 years. The majority of patients (58.7%) were admitted from the emergency department. The most common reason for admission was impairment of consciousness in 94.7% (Table 1) of cases and the Glasgow admission score was less than or equal to 8 in 58.7% (Table 1) of patients. Hydro-electrolyte disturbances were present in 93.3% of patients on admission. Hyponatremia was the most common disorder with 56% (42 cases). Followed by hyperkalaemia 10.7% (8 cases), hypernatremia 9.3% (7 cases), at hypocalcemia 9.3% (7 cases), associated disorders 8% (6 cases). Brain CT was performed in 52% of the patients. In our study, malaria was the most common etiology of ionic disorders with 36%. Of the patients who died, 80% had developed hyponatremia after 5 days in hospital, and the overall lethality was 73.3%. <strong>Conclusion:</strong> Hydro-electrolyte disorders are frequent in the intensive care setting and their management must be rapid in order to reduce morbidity and mortality.
文摘Objective: The aim of our work was to access the epidemiological and clinical aspects of congenital hydrocephalus in the pediatrics department of Gabriel Touré teaching Hospital Bamako. Methods: We conducted a retro and prospective study that ran from January, 1st 2018 to July, 30, 2019. All newborns of 72 hours of life or less with hydrocephalus confirmed by sonography or CT scan were enrolled in this study. Results: During the study period, 5416 patients were hospitalized in the neonatology department. Among them, 39 patients (0.72%) presented congenital hydrocephalus and congenital infectious causes accounted for 25.6%. The sex ratio (M/F) was 1.78. Mothers were housewives and not educated in 79.5% and 64.1% respectively. The parents resided outside Bamako in 61.5% of cases. Prenatal consultations were conducted in 32 patients (82%). Consanguinity between the 2 parents was present in 38.5%. The antenatal diagnosis was made in 8 patients (20.5%). Vaginal delivery was the main mode of birth (67%). The average birth weight was 2930 g (1000 to 5400 g) and the average head circumference was 37.82 cm (26 - 55 cm). In 87.2% of cases, newborns were eutrophic. The main clinical signs were bulging anterior fontanel (46.2%), sunset gaze (20.5%), prominent forehead (48.7%), reduced face (20.5%), enlarged cranial sutures (43.6%), macrocrania (25.6%). Transfontanellar ultrasound and CT scan were performed in 51.3% and 48.7% of cases respectively. Associated malformations were spina bifida in 30.8% of cases followed by Dandy Walker malformation (5.1%), and omphalocele (2.5%). The neurological signs were diminished neonatal reflexes (51.3%), hypotonia (30.8%), motor deficit (38.4%), intracranial hypertension (25.6%), seizures 10.25% and psychomotor delay (43.6%). Surgery was performed in 8 neonates (20.5%). Ventriculo-peritoneal shunt (VPB) was the main treatment. Postoperative complications were infectious (37.5%) and mechanical complications (12.5%). The postoperative mortality rate was 12.5%.The overall mortality was 13 cases (33.3%). Conclusion: The hospital frequency of congenital hydrocephalus in our environment seems low but does not reflect reality.
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This paper proposes a new personal tour planning problem with time-dependent satisfactions, traveling and activity duration times for sightseeing. It is difficult to represent the time-dependent model using general static network models, and hence, Time-Expanded Network (TEN) is introduced. The TEN contains a copy to the set of nodes in the underlying static network for each discrete time step, and it turns the problem of determining an optimal flow over time into a classical static network flow problem. Using the proposed TEN-based model, it is possible not only to construct various variations with time of costs and satisfactions flexibly in a single network, but also to select optimal departure places and accommodations according to the tour route with tourist’s favorite places and to obtain the time scheduling of tour route, simultaneously. The proposed model is formulated as a 0 - 1 integer programming problem which can be applied by existing useful combinatorial optimization and soft computing algorithms. It’s also equivalently transformed into several existing tour planning problems using some natural assumptions. Furthermore, comparing the proposed model with some previous models using a numerical example with time-dependent parameters, both the similarity of these models in the static network and the advantage of the proposed TEN-based model are obtained.
文摘Stop frequency models, as one of the elements of activity based models, represent an important part of travel behavior. Unobserved heterogeneity across the travelers should be taken into consideration to prevent biasedness and inconsistency in the estimated parameters in the stop frequency models. Additionally, previous studies on the stop frequency have mostly been done in larger metropolitan areas and less attention has been paid to the areas with less population. This study addresses these gaps by using 2012 travel data from a medium sized U.S. urban area using the work tour for the case study. Stop in the work tour were classified into three groups of outbound leg, work based subtour, and inbound leg of the commutes. Latent Class Poisson Regression Models were used to analyze the data. The results indicate the presence of heterogeneity across the commuters. Using latent class models significantly improves the predictive power of the models compared to regular one class Poisson regression models. In contrast to one class Poisson models, gender becomes insignificant in predicting the number of tours when unobserved heterogeneity is accounted for. The commuters are associated with increased stops on their work based subtour when the employment density of service-related occupations increases in their work zone, but employment density of retail employment does not significantly contribute to the stop making likelihood of the commuters. Additionally, an increase in the number of work tours was associated with fewer stops on the inbound leg of the commute. The results of this study suggest the consideration of unobserved heterogeneity in the stop frequency models and help transportation agencies and policy makers make better inferences from such models.
文摘This research study explores the use of an innovative freight tour-based approach to model truck trips as an alternative to the conventional trip-based approach. The tour-based approach is more realistic as it captures the intermediate stops of each truck and reflects the implications of those stops on vehicle miles traveled (VMT). The paper describes the truck tour-based model concept, and presents the framework of a truck tour-based travel demand forecasting approach. As a case study, Global Positioning System (GPS) truck data are used to determine origin, destination, and truck stops for trucks moving within the Birmingham, Alabama region. Such information is then utilized to model truck movements within the study region as individual truck tours. The tour-based model is ran, and the resulting performance measures are contrasted to those obtained from the conventional trip-based planning model used by the Regional Planning Commission of Greater Birmingham (RPCGB). This case study demonstrates the feasibility of using a tour-based freight demand forecasting model as an alternative to the conventional 4-step process currently used to estimate truck trips in the Birmingham region. The results and lessons learned from the Birmingham case study are expected to improve truck movement modeling practices in the region and advance the accuracy of truck travel demand forecasting models at other locations in the future.