Navigating the pathways:TAR-DNA-binding-protein-43 aggregation,axonal transport,and local synthesis in amyotrophic lateral sclerosis pathology

Neurons are highly polarized cells with axons reaching over a meter long in adult humans.To survive and maintain their proper function,neurons depend on specific mechanisms that regulate spatiotemporal signaling and metabolic events,which need to be carried out at the right place,time,and intensity.Such mechanisms include axonal transport,local synthesis,and liquid-liquid phase separations.Alterations and malfunctions in these processes are correlated to neurodegenerative diseases such as amyotrophic lateral sclerosis(ALS).

Reducing Extended Hospital Lengths of Stay

In the United States, the costs of health care have become a major burden for the health care system. In order to address this problem, the hospitals of Syracuse, New York, developed programs to provide subacute and complex care. The Subacute programs provided patient transportation services for dialysis and other types of care outside hospitals. They also developed programs for services such as intravenous therapy in nursing homes. The Complex Care Programs, such as intravenous therapy and mental health services, have provided alternatives to extended care in hospitals. During the past five years, utilization of these programs has varied, declining between 2019 and 2022, and then increasing between 2022 and 2024. The programs have avoided the need for 1530 - 2974 patient days in hospitals. The programs saved the Syracuse hospitals approximately $600 per inpatient day. This amounted to savings of $918,000 - $1,784,400 per year. These programs demonstrated how relatively small mechanisms can save large amounts of health care resources.

The Peripheral Hospital as Focal Point for Pacemaker Activity: Review of the Last 300 Implantations Carried out at the Haute Correze Hospital Center

Background: Pacemaker implantation is a very old activity which has revolutionized the cardiology practice throughout the world. This activity is effective at the Haute Correze Hospital Center since more than 20 years. Due to progress in this area, and the increasing request within this center located at the outskirts of town, we set out to evaluate our pacemaker activity in general and more specifically to assess the post-procedural complications in our series patients. Methodology: This was a retrospective longitudinal study. Data were recorded for period of 90 months from 27/05/2016 to 19/11/2023. This data collection was possible via a specific register completed by computerized patient data from the SillageTM software. All files of patients implanted with single or dual chamber pacemakers were included, generator replacements, upgrading procedures and addition of leads were excluded. The sampling was non-probabilistic, consecutive and non-exhaustive. Statistical analysis was carried out using the Excel 2019 spreadsheet and SPSS version 23 software. The quantitative variables were presented as mean ± standard deviation, the qualitative data as proportions. Results: A total of 303 first-time pacemaker’s implantations were carried out during the study period (rate of 40 per year). The average age in the population was 79.7 ± 9.4 years (44 - 99 years) with a male predominance of 63.7% (n = 193). Atrioventricular block (2nd and 3rd degree) was the main indication for pacemaker implantation in 42.9% of cases (n = 130). Patients were most often implanted with a dual-chamber pacemaker (57.7%, n = 175). The approach was most often cephalic in 72.6% of cases (n = 220), followed by the subclavian access in 27.4% of cases (n = 84). The average fluoroscopy time was 7.9 min ± 2.4 (1 - 43). The average irradiation dose in gray/cm2 was 12.4 ± 9.3 (0.22 - 117.5). The average length of hospitalization was 7 ± 4 (2 - 26) days. The overall complication rate at one year was 12.9% (n = 39). These complications are distributed as follows: Leads dislodgement in 8.2% (n = 25), hematoma 3.6% (n = 11) all without clinical consequences, pneumothorax 0.7% (n = 2), both cases of pneumothorax did not require specific care, infection (superficial) in 0.3% (n = 1). Leads dislodgement occurred after a median time of 18 days (IQR: 3 - 36). The earliest dislodgement was observed on D0 and the latest on D207. No serious complications were recorded. The average atrial threshold at implantation/first control/last follow-up was 0.7/1.3/0.8 V, respectively. The average ventricular threshold at implantation/first control/last follow-up was 0.5/1.08/0.87 V, respectively. The average atrial detection at implantation/first control/last follow-up was 3.2/2.3/ 2.05 mv, respectively. The average ventricular detection at implantation/first control/last follow-up was 10.3/11.03/10.8 mv. The average atrial impedance at implantation/first control/last follow-up was 610/457/457 ohms. The average ventricular impedance at implantation/first control/last follow-up was 754/547/563 ohms. Conclusion: Pacemaker implantation is safe at the Haute Correze Hospital Center with a relatively low rate of complications, in this case an almost zero major infection and no serious hematoma. The peripheral hospital should remain a focal point of this activity in order to respond more quickly to the needs of the populations.

Efficient electrocatalytic urea synthesis from CO_(2)and nitrate over the scale-up produced FeNi alloy-decorated nanoporous carbon

Electrocatalytic urea synthesis provides a favorable strategy for conventional energy-consuming urea synthesis,but achieving large-scale catalyst synthesis with high catalytic efficiency remains challenging.Herein,we developed a simple method for the preparation of a series of FeNi-alloy-based catalysts,named FeNi@nC-T(n represents the content of nanoporous carbon as 1,3,5,7 or 9 g and T=900,950,1000 or 1100°C),for highly performed urea synthesis via NO_(3)−and CO_(2)co-reduction.The FeNi@7C-1000 achieved a high urea yield of 1041.33 mmol h^(−1)gFeNi^(−1)with a Faradaic efficiency of 15.56%at–1.2 V vs.RHE.Moreover,the scale-up synthesized FeNi@7C-950-S(over 140 g per batch)was achieved with its high catalytic performance and high stability maintained.Mechanism investigation illuminated that the Ni and Fe sites catalyze and stabilize the key*CO and*N intermediates and minimize the C–N coupling reaction barriers for highly efficient urea synthesis.

Changes in Inpatient Hospital Utilization at the Community Level

This study demonstrated that numbers of hospital inpatient discharges have declined in the metropolitan area of Syracuse, New York. The largest impact has been in adult medicine and adult surgery, the hospital services with the highest utilization rates. Reductions in inpatient care have also affected services with lower utilization, such as pediatrics, obstetrics, and mental health. The study indicated that, between January - June 2019 and 2024, adult medicine discharges declined by 11.9 percent and adult surgery discharges declined by 24.6 percent. A large proportion of the reductions involved orthopedic surgery. They indicated that more than 50 percent of the joint replacements in the Syracuse hospitals have been moved to outpatient services. These patients included those with low severity of illness. The study suggested that reductions in hospital discharges could contribute to the efficiency of care. Fewer inpatient admissions could reduce the need for staffing and other resources. Information from the Syracuse hospitals has suggested that these reductions may continue.

Monitoring Changes in Hospital Utilization

This study focused on recent issues concerning health care utilization at the community level. The study focused on developments in hospital inpatient lengths of stay and discharges. The analysis in the study demonstrated that hospital lengths of stay in the metropolitan area of Syracuse, New York increased by 25.0 percent between 2019 and 2023. This has been a notable increase in the movement of patients with this indicator. The analysis also demonstrated that numbers of inpatient discharges for these hospital services declined substantially during the same periods. Review of the data suggested that this information has been related. The increase in hospital lengths of stay has been related to a rise in numbers of patients at high severity of illness. They have also been associated with a decline in numbers of patients at low severity.

Analysis of Hospital Budget Management Control Based on Smart Hospital

Hospitals are crucial healthcare facilities where patients seek treatment,and effective budget management within hospitals significantly impacts their operational efficiency and financial performance.In the age of information technology and advanced healthcare solutions,the emergence of smart hospitals represents a new trend in the medical industry’s evolution.Leveraging modern information technology can enhance the development of hospital IT systems and drive budget management toward greater intelligence.This paper begins by analyzing the influence of smart hospitals on hospital budget control.It then examines the current state of budget management control within smart hospitals.Finally,it proposes several strategies for budget management control in smart hospitals,aiming to provide guidance for relevant stakeholders.

Research Progress on Synthesis of Superoxide Dismutase Mimics

Research on the synthesis of superoxide dismutase mimics by chemical and biologi-cal synthetic methods were reviewed.The advantages and limitations were analyzed.A prospect for the future development of superoxide dismutase mimics is proposed.

Templated synthesis of transition metal phosphide electrocatalysts for oxygen and hydrogen evolution reactions

Transition metal phosphides(TMPs)have been regarded as alternative hydrogen evolution reaction(HER)and oxygen evolution reaction(OER)catalysts owing to their comparable activity to those of noble metal-based catalysts.TMPs have been produced in various morphologies,including hollow and porous nanostructures,which are features deemed desirable for electrocatalytic materials.Templated synthesis routes are often responsible for such morphologies.This paper reviews the latest advances and existing challenges in the synthesis of TMP-based OER and HER catalysts through templated methods.A comprehensive review of the structure-property-performance of TMP-based HER and OER catalysts prepared using different templates is presented.The discussion proceeds according to application,first by HER and further divided among the types of templates used-from hard templates,sacrificial templates,and soft templates to the emerging dynamic hydrogen bubble template.OER catalysts are then reviewed and grouped according to their morphology.Finally,prospective research directions for the synthesis of hollow and porous TMP-based catalysts,such as improvements on both activity and stability of TMPs,design of environmentally benign templates and processes,and analysis of the reaction mechanism through advanced material characterization techniques and theoretical calculations,are suggested.

Facile synthesis of hierarchical NaX zeolite from natural kaolinite for efficient Knoevenagel condensation

Zeolite catalysts have found extensive applications in the synthesis of various fine chemicals.However,the micropores of zeolites impose diffusion limitations on bulky molecules,greatly reducing the catalytic efficiency.Herein,we explore an economic and environmentally friendly method for synthesizing hierarchical NaX zeolite that exhibits improved catalytic performance in the Knoevenagel condensation reaction for producing the useful fine chemical 2-cyano-3-phenylacrylate.The synthesis was achieved via a low-temperature activation of kaolinite and subsequent in-situ transformation strategy without any template or seed.Systematic characterizations reveal that the synthesized NaX zeolite has both intercrystalline and intra-crystalline mesopores,smaller crystal size,and larger external specific surface area compared to commercial NaX zeolite.Detailed mechanism investigations show that the inter-crystalline mesopores are generated by stacking smaller crystals formed from in-situ crystallization of the depolymerized kaolinite,and the intra-crystalline mesopores are inherited from the pores in the depolymerized kaolinite.This synthesis strategy provides an energy-saving and effective way to construct hierarchical zeolites,which may gain wide applications in fine chemical manufacturing.

Optimal synthesis of heat-integrated distillation configurations using the two-column superstructure

In the realm of the synthesis of heat-integrated distillation configurations,the conventional approach for exploring more heat integration possibilities typically entails the splitting of a single column into a twocolumn configuration.However,this approach frequently necessitates tedious enumeration procedures,resulting in a considerable computational burden.To surmount this formidable challenge,the present study introduces an innovative remedy:The proposition of a superstructure that encompasses both single-column and multiple two-column configurations.Additionally,a simultaneous optimization algorithm is applied to optimize both the process parameters and heat integration structures of the twocolumn configurations.The effectiveness of this approach is demonstrated through a case study focusing on industrial organosilicon separation.The results underscore that the superstructure methodology not only substantially mitigates computational time compared to exhaustive enumeration but also furnishes solutions that exhibit comparable performance.

Microfluidic-oriented synthesis of enriched iridium nanodots/carbon architecture for robust electrocatalytic nitrogen fixation

Electrocatalytic nitrogen reduction reaction(NRR)is considered as a promising candidate to achieve ammonia synthesis because of clean electric energy,moderate reaction condition,safe operating process and harmless by-products.However,the chemical inertness of nitrogen and poor activated capacity on catalyst surface usually produce low ammonia yield and faradic efficiency.Herein,the microfluidic technology is proposed to efficiently fabricate enriched iridium nanodots/carbon architecture.Owing to in-situ co-precipitation reaction and microfluidic manipulation,the iridium nanodots/carbon nanomaterials possess small average size,uniform dispersion,high conductivity and abundant active sites,producing good proton activation and rapid electrons transmission and moderate adsorption/desorption capacity.As a result,the as-prepared iridium nanodots/carbon nanomaterials realize large ammonia yield of 28.73 μg h^(-1) cm^(-2) and faradic efficiency of 9.14%in KOH solution.Moreover,the high ammonia yield of 11.21 μg h^(-1) cm^(-2) and faradic efficiency of 24.30%are also achieved in H_(2)SO_(4) solution.The microfluidic method provides a reference for large-scale fabrication of nano-sized catalyst materials,which may accelerate the progress of electrocatalytic NRR in industrialization field.

Boosting Fischer-Tropsch Synthesis via Tuning of N Dopants in TiO_(2)@CN-Supported Ru Catalysts

Nitrogen(N)-doped carbon materials as metal catalyst supports have attracted signifi cant attention,but the eff ect of N dopants on catalytic performance remains unclear,especially for complex reaction processes such as Fischer-Tropsch synthesis(FTS).Herein,we engineered ruthenium(Ru)FTS catalysts supported on N-doped carbon overlayers on TiO_(2)nanoparticles.By regulating the carbonization temperatures,we successfully controlled the types and contents of N dopants to identify their impacts on metal-support interactions(MSI).Our fi ndings revealed that N dopants establish a favorable surface environment for electron transfer from the support to the Ru species.Moreover,pyridinic N demonstrates the highest electron-donating ability,followed by pyrrolic N and graphitic N.In addition to realizing excellent catalytic stability,strengthening the interaction between Ru sites and N dopants increases the Ru^(0)/Ru^(δ+)ratios to enlarge the active site numbers and surface electron density of Ru species to enhance the strength of adsorbed CO.Consequently,it improves the catalyst’s overall performance,encompassing intrinsic and apparent activities,as well as its ability for carbon chain growth.Accordingly,the as-synthesized Ru/TiO_(2)@CN-700 catalyst with abundant pyridine N dopants exhibits a superhigh C_(5+)time yield of 219.4 mol CO/(mol Ru·h)and C_(5+)selectivity of 85.5%.

Correlation of neutrophil to lymphocyte ratio to severity of coronary artery disease and in-hospital clinical outcomes in patients with acute coronary syndrome: A prospective observational study

Objective:To explore correlation of neutrophil-to-lymphocyte ratio(NLR)to severity of coronary artery disease(CAD)and in-hospital clinical outcomes in patients with acute coronary syndrome(ACS).Methods:In this prospective and observational study,we recruited 500 patients with ACS.For all the eligible patients,demographic details were collected,and laboratory parameters were evaluated.The CAD severity was evaluated in terms of the number of involved vessels.The NLR was calculated based on neutrophils and lymphocytes and the correlation of various risk factors and severity and outcome of CAD was performed.Results:77.2%of Patients was male,and 52%of the patients aged between 55-70 years.Based on the type of ACS,396 out of 500 patients had ST-elevation myocardial infarction.An ascending trend in the white blood cell levels and NLR value was noted as the severity of the ACS increased and the highest white blood cell levels and NLR was noted among classⅣpatients.The mean NLR value among the non-survivors were higher compared to the survivors(9.52±5.72 vs.4.76±2.36;P<0.01).Receiver operating curve showed that the cut-off NLR value was 5.76 with a sensitivity of 75.0%and a specificity of 77.3%.Conclusions:The NLR can be used as an independent prognostic marker in ACS.An elevated NLR value serves as a reliable predictor for short-term complications,notably in-hospital mortality.

Room Temperature Synthesis of Vertically Aligned Amorphous Ultrathin NiCo-LDH Nanosheets Bifunctional Flexible Supercapacitor Electrodes

Developing a simple scalable method to fabricate electrodes with high capacity and wide voltage range is desired for the real use of electrochemical supercapacitors.Herein,we synthesized amorphous NiCo-LDH nanosheets vertically aligned on activated carbon cloth substrate,which was in situ transformed from Co-metal-organic framework materials nano-columns by a simple ion exchange process at room temperature.Due to the amorphous and vertically aligned ultrathin structure of NiCo-LDH,the NiCo-LDH/activated carbon cloth composites present high areal capacities of 3770 and 1480 mF cm^(-2)as cathode and anode at 2 mA cm^(-2),and 79.5%and 80%capacity have been preserved at 50 mA cm^(-2).In the meantime,they all showed excellent cycling performance with negligible change after>10000 cycles.By fabricating them into an asymmetric supercapacitor,the device achieves high energy densities(5.61 mWh cm^(-2)and 0.352 mW cm^(-3)).This work provides an innovative strategy for simplifying the design of supercapacitors as well as providing a new understanding of improving the rate capabilities/cycling stability of NiCo-LDH materials.

Bowel preparation protocol for hospitalized patients ages 50 years or older:A randomized controlled trial

BACKGROUND The incidence and mortality rate of colorectal cancer progressively increase with age and become particularly prominent after the age of 50 years.Therefore,the population that is≥50 years in age requires long-term and regular colonoscopies.Uncomfortable bowel preparation is the main reason preventing patients from undergoing regular colonoscopies.The standard bowel preparation regimen of 4-L polyethylene glycol(PEG)is effective but poorly tolerated.AIM To investigate an effective and comfortable bowel preparation regimen for hospitalized patients≥50 years in age.METHODS Patients were randomly assigned to group 1(2-L PEG+30-mL lactulose+a lowresidue diet)or group 2(4-L PEG).Adequate bowel preparation was defined as a Boston bowel preparation scale(BBPS)score of≥6,with a score of≥2 for each segment.Non-inferiority was prespecified with a margin of 10%.Additionally,the degree of comfort was assessed based on the comfort questionnaire.RESULTS The proportion of patients with a BBPS score of≥6 in group 1 was not significantly different from that in group 2,as demonstrated by intention-to-treat(91.2%vs 91.0%,P=0.953)and per-protocol(91.8%vs 91.0%,P=0.802)analyses.Furthermore,in patients≥75 years in age,the proportion of BBPS scores of≥6 in group 1 was not significantly different from that in group 2(90.9%vs 97.0%,P=0.716).Group 1 had higher comfort scores(8.85±1.162 vs 7.59±1.735,P<0.001),longer sleep duration(6.86±1.204 h vs 5.80±1.730 h,P<0.001),and fewer awakenings(1.42±1.183 vs 2.04±1.835,P=0.026)than group 2.CONCLUSION For hospitalized patients≥50 years in age,the bowel preparation regimen comprising 2-L PEG+30-mL lactulose+a low-residue diet produced a cleanse that was as effective as the 4-L PEG regimen and even provided better comfort.

Echocardiographic Aspects of Type 2 Diabetics Patients Hospitalized in the Medicine and Endocrinology Department of the Mali Hospital

Introduction: Cardiovascular disease is the leading cause of death in diabetics. The objective of our study was to investigate the echocardiographic aspects of type 2 diabetics. Patients and Method: Descriptive and cross-sectional study of 12 months from June 2020 to June 2021. We included hospitalized type 2 diabetics who underwent transthoracic cardiac ultrasound in the Department of Medicine and Endocrinology at the Mali Hospital. Results: We collected 128 type 2 diabetics. The predominance was male with a sex ratio of 1.2. The mean age of patients was 60.06 ± 11.54 years with extremes of 28 and 84 years. Echocardiographic abnormalities were dominated by abnormal relaxation of left ventricle in 62.5%, increased of left ventricle mass in 54.7% and left atrium dilation in 28.1%. Patients with type 2 diabetes mellitus and hypertension had more left atrium dilation with a p of 0.02. Disorders of global kinetics and systolic dysfunction were more prevalent in smoking patients with statistically significant associations, respectively, p = 0.02;p = 0.03. Dyslipidemia had a statistically significant association with segmental kinetic disorders with a p of 0.008. Duration of diabetes greater than 5 years was associated with left atrium dilation and p-value was 0.04. Conclusion: Diabetes is responsible for cardiovascular manifestations that can be identified with transthoracic echocardiography. Its performance in diabetic patients makes it possible to refine the patient’s management.

Epidemiological, Clinical, Therapeutic, and Evolutionary Aspects of Heart Failure in the Medical Department at Gao Regional Hospital

Introduction: Heart failure is a major public health pandemic, particularly in Africa, where its prevalence continues to increase. In northern Mali, few data exist, hence the interest of this study with the objective of studying the epidemiological, clinical and therapeutic and evolutionary aspects of Heart failure at the regional hospital of Gao. Patients and Methods: This was a cross-sectional, descriptive study that took place from July 2022 to June 2023 in the medical department at Gao Hospital. Results: The hospital prevalence of heart failure was 44.1%. The mean age was 47.30 ± 20 years (range: 16-88). Hypertension was the most common with 46.1%, followed by a sedentary lifestyle, and diabetes with 18.2% and 8.3% respectively;NYHA stage III-IV dyspnea was found in 83.9%. Reduced EF heart failure was present in 110 patients (76.9%), seventeen cases with moderately reduced EF (11.9%) and sixteen patients had preserved EF (11.2%). Global heart failure was the dominant (91.6%). The main etiologies of heart failure were dominated by hypertensive heart disease in 46 patients (32.2%), followed by postpartum cardiomyopathy with 43 cases (30.1%), primary dilated cardiomyopathy in 18 patients (12.6%), ischemic heart disease in 16 patients with 11.2%. Seven cases of valvular heart disease, or 4.9%. The evolution was favorable under treatment in 104 patients or 72.7%. In-hospital mortality was 14.7%. Conclusion: Heart failure is a common condition in sub-Saharan Africa, particularly in our country.

Profile of Anemia in Cirrhotic Patients at the National Hospital of Niamey

Objective: To study the profile of anemia in cirrhotic patients diagnosed in the Hepato-Gastroenterology (HGE) department of the National Hospital of Niamey. Patients and Method: This was a prospective and descriptive study carried out from August 1, 2023 to February 29, 2024, including cirrhotic patients, with anemia on the blood count, outside of any recent blood transfusion and/or treatment. History of anemia. Results: The diagnosis of anemia was made in 91 patients out of the 100 cirrhotics recorded, 91%. Men were more common, with a sex ratio of 2.79. The average age was 50 ± 14.22 years old. Anemia was moderate in 52.75% of cases (n = 48). It was non-microcytic in 50.55% (n = 46) and iron deficient in 55.56% of cases (n = 20). There was a statistically significant correlation between the severity of anemia and upper gastrointestinal bleeding with a p-value = 0.000. Conclusion: Cirrhotic anemia is multifactorial, which makes its etiological diagnosis complex.

Pericarditis in Cardiology at a Regional Hospital

Introduction: Pericarditis is an inflammation of the pericardium with or without pericardial fluid effusion. Its prevalence is difficult to determine given the many forms that are not symptomatic. In Africa, its prevalence was 6.3% in Gabon in 2020 and 7.2% in Mali in 2022. In Europe, an Italian study estimates the incidence of acute pericarditis at 27.7 cases per 100,000 people per year. In another study conducted in Finland over a period of 9 years, the incidence of pericarditis requiring hospitalisation was 3.32 cases per 100,000 people per year. The aim of our study was to describe the clinical and paraclinical characteristics of pericarditis observed in the cardiology department of the regional hospital in Mali. Methodology: This was a single centre cross-sectional study from 30 January 2018 to 30 June 2020 in the cardiology department of the Ségou regional hospital. All consenting patients, regardless of age or sex hospitalised in the department for pericarditis confirmed on cardiac ultrasound were included. Data were collected using an individual patient follow-up form recording sociodemographic, clinical, biological, electrocardiographic and echocardiographic data, as well as the course of the disease. Results: Out of 879 patients hospitalized, the hospital frequency was 7.28%. Females predominated, with a sex ratio of 0.42. More than half the patients were aged 45 or younger (59.4%). The mean age of patients was 41.8 ± 18.1 years. Cardiovascular risk factors were dominated by hypertension and smoking (46.9% and 12.5% respectively). The reasons for consultation were dyspnoea (84.3%), chest pain (54.7%), cough (71.9%) and fever (34.4%). Physical signs included muffled heart sounds (76.6%), tachycardia (70.3%), pericardial friction (17.2%) and signs of peripheral stasis in 53.1% of cases. We observed elevated C-reactive protein (CRP) in 57.8% of cases, hypercreatininaemia in 37.5% and positive HIV serology in 3.1%. The major radiographic signs were cardiomegaly in 82.8% and pleural effusion in 37.5%. On electrocardiogram (ECG), 51.6% of patients had a repolarisation disorder and sinus tachycardia;34.4% had QRS microvoltage. Echocardiography revealed tamponade in 1.6% and pericardial effusion in 100%. The effusion was very large in 17.3% of cases. The pericardial fluid was citrine yellow in 18.8%, serosanguineous in 9.4% and haemorrhagic in 7.8%. The aetiology of the pericarditis was idiopathic in 42.1% and secondary to HIV in 3.1%. Transudative fluid was observed in 16.5% of cases. The outcome was generally favourable, with 92.2% of cases cured, but 1.6% with persistent effusion, 3.1% with recurrence, and 3.1% with mortality.