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CARS (Cardiac Amyloidosis Registry Study) is a multicenter registry established in 2019 that includes patients with transthyretin (ATTR, wild-type and variant) and light chain (AL) cardiac amyloidosis (CA) evaluated at major amyloidosis centers between 1997 and 2025. CARS aims to describe the natural history of CA with attention to clinical and diagnostic variables at the time of diagnosis, real-world treatment patterns, and associated outcomes of patients in a diverse cohort that is more representative of the at-risk population than that described in CA clinical trials. This article describes the design and methodology of CARS, including procedures for data collection and preliminary results. As of February 2023, 20 centers in the United States enrolled 1415 patients, including 1155 (82%) with ATTR and 260 (18%) with AL CA. Among those with ATTR, wild-type is the most common ATTR (71%), and most of the 305 patients with variant ATTR have the p.V142I mutation (68%). A quarter of the total population identifies as Black. More individuals with AL are female (39%) compared to those with ATTR (13%). CARS will answer crucial clinical questions about CA natural history and permit comparison of different therapeutics not possible through current clinical trials. Future international collaboration will further strengthen the validity of observations of this increasingly recognized condition. [ABSTRACT FROM AUTHOR]

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An 11-factor random forest model has been developed among ambulatory heart failure (HF) patients for identifying potential wild-type amyloidogenic TTR cardiomyopathy (wtATTR-CM). The model has not been evaluated in a large sample of patients hospitalized for HF. This study included Medicare beneficiaries aged ≥65 years hospitalized for HF in the Get With The Guidelines-HF® Registry from 2008-2019. Patients with and without a diagnosis of ATTR-CM were compared, as defined by inpatient and outpatient claims data within 6 months pre- or post-index hospitalization. Within a cohort matched 1:1 by age and sex, univariable logistic regression was used to evaluate relationships between ATTR-CM and each of the 11 factors of the established model. Discrimination and calibration of the 11-factor model were assessed. Among 205,545 patients (median age 81 years) hospitalized for HF across 608 hospitals, 627 patients (0.31%) had a diagnosis code for ATTR-CM. Univariable analysis within the 1:1 matched cohort of each of the 11-factors in the ATTR-CM model found pericardial effusion, carpal tunnel syndrome, lumbar spinal stenosis, and elevated serum enzymes (e.g., troponin elevation) to be strongly associated with ATTR-CM. The 11-factor model showed modest discrimination (c-statistic 0.65) and good calibration within the matched cohort. Among US patients hospitalized for HF, the number of patients with ATTR-CM defined by diagnosis codes on an inpatient/outpatient claim within 6 months of admission was low. Most factors within the prior 11-factor model were associated with greater odds of ATTR-CM diagnosis. In this population, the ATTR-CM model demonstrated modest discrimination. [ABSTRACT FROM AUTHOR]

Cogan's syndrome is a rare form of vasculitis mainly affecting young subjects of whatever gender, associating cochleovestibular and ophthalmological damage. Despite medical treatment, auditory prognosis is uncertain, with 50–60% of patients showing irreversible severe to profound hearing loss, thus being candidates for cochlear implantation. Following CARE guidelines, we report 10 cases of cochlear implantation in Cogan's syndrome, with assessment of speech reception threshold and maximum intelligibility after a minimum 1 year's experience with the implant. Ten patients from 4 centers received cochlear implants (14 implants) for Cogan's syndrome between 2005 and 2020. After 1 year's experience, there was significant improvement in speech reception threshold (P = 0.0002) and maximum intelligibility (P = 0.0002). Audiovestibular signs associated with ophthalmological manifestations should suggest Cogan's syndrome. Hearing impairment is usually irreversible. Cochlear implantation may be necessary and improves hearing performance. [ABSTRACT FROM AUTHOR]

Objective: To identify tools that predict the risk of complications in patients presenting to outpatient clinics or emergency departments (ED) with acute infectious diarrhea.Methods: Medline, Embase, Cochrane Library, Web of Science and CINAHL were searched from inception to July 2021. Articles reporting on the derivation or validation of a score to stratify the risk of intravenous rehydration or hospitalization among patients with acute infectious diarrhea in the ED or outpatient clinic were retained for analysis.Results: Five articles reporting on two different tools were identified. Developed to assess the risk of hospitalization of children, the EsVida scale has not been externally validated. Developed originally to assess the level of dehydration in children, the Clinical Dehydration Scale (CDS) was evaluated as a risk stratification tool. For predicting intravenous rehydration, a CDS score ≥ 1 showed a sensitivity between 0.73 and 0.88 and specificity between 0.38 and 0.69, whereas a CDS score ≥ 5 showed a sensitivity between 0.06 and 0.32 and specificity between 0.94 and 0.99. For predicting hospitalization, a CDS score ≥ 1 showed a sensitivity between 0.74 and 1.00 and specificity between 0.34 and 0.38, whereas a CDS score ≥ 5 showed a sensitivity between 0.26 and 0.62 and specificity between 0.66 and 0.96. High heterogeneity among studies and unclear risk of bias precluded meta-analysis.Conclusion: As a risk-stratification tool, the CDS has been validated only for children. Further research is needed to develop and validate a tool suitable for adults in the ED. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the impact of cochlear reimplantation (CR) on hearing performance in children and adults with severe to profound hearing loss. Retrospective observational study. The main objective of this study was to determine whether there was a difference in hearing performance before and after CR. Secondary objectives were to analyze reasons for CR; to assess correlations between auditory performance and complete electrode reinsertion during CR, age, gender, explantation-to-CR interval, and interval between first implantation and CR; and to assess difference in APCEI score and the French evaluation protocol for implanted patients before and after CR. Comparison of speech perception scores before and after explantation-reimplantation showed no significant difference (P > 0.005) at 1 year or at 2 years after CR. In 80% of cases, reimplantation was due to hard implant failure. In other cases, it was undertaken for soft failure (diminished performance but no abnormalities on integrity testing) (8%), medical reasons (6%), or undetermined reasons (6%). There was no significant correlation between auditory performance at 1 or 2 years and complete or incomplete reinsertion of electrodes, age, gender, explantation-to-CR interval, or interval between first implantation and CR (P > 0.005). For the adult subgroup, the French evaluation protocol scores did not differ after reimplantation (P = 0.62). Likewise, for the child sub-group, APCEI and CAP results did not deteriorate after reimplantation. Reimplantation had no negative impact on hearing and speech perception, but provided performance equivalent to or better than after initial implantation. [ABSTRACT FROM AUTHOR]

• La dysphagie est la manifestation ORL la plus courante de la maladie de Forestier. • Le traitement chirurgical primaire des patients par ailleurs en bonne santé reste encore discutable. • L'atteinte des voies respiratoires peut être due à une obstruction mécanique directe, une inflammation chronique ou une paralysie en adduction des cordes vocales. • Une approche multidisciplinaire faisant appel à un ORL est le fondement de la prise en charge des complications de la maladie de Forestier. La maladie de Forestier ou l'hyperostose squelettique idiopathique diffuse (DISH) est une maladie fréquente de la population âgée mais peu rapportée dans la littérature. D'un point de vue oto-rhino-laryngologique (ORL) cette maladie peut se manifester par une dysphagie, une dysphonie et même une dyspnée. Le but de cette étude a été d'identifier toutes les publications portant sur les manifestations ORL de la maladie de Forestier durant la dernière décennie afin d'établir un algorithme de prise en charge. Une revue exhaustive de la littérature a été menée en mai 2020 sur les bases de données Medline et Embase suivant les lignes directrices PRISMA pour l'écriture et la lecture des revues systématiques et des méta-analyses. Soixante-trois articles, dont 50 rapports de cas et 13 séries de cas, ont répondu aux critères d'inclusion. Un total de 236 cas de DISH a été recensé de 2010 à ce jour. Une évaluation nasofibroscopique anatomique de la filière pharyngolaryngée et dynamique de la déglutition est fréquemment rapportée. Le traitement chirurgical est la modalité thérapeutique la plus adoptée pour la dysphagie (58,9 % des patients), alors que 41,1 % des patients sont traités de façon conservatrice. Une trachéotomie a été réalisée chez 6 % des patients présentant une obstruction des voies aéro-digestives supérieures. Aucune corrélation significative n'a pu être identifiée entre la modalité thérapeutique et l'amélioration de la dysphagie. La maladie de Forestier est actuellement une source croissante de complications chez les personnes âgées, essentiellement en raison de la dysphagie et moins souvent en raison de l'obstruction des voies respiratoires. La prise en charge de ces complications nécessite une approche multidisciplinaire, où l'ORL joue un rôle fondamental. [ABSTRACT FROM AUTHOR]

Sutureless microvascular anastomoses could simplify the microvascular field, shortening operative time and improving the final outcome. The use of thermosensitive poloxamers (TP407) together with the application of cyanoacrylate as an alternative method for conventional sutures was well-documented for arteries, but not for veins. The purpose of our study was to prove the feasibility of this technique for venous anastomoses and compare it with the traditional hand-sewn technique on a rat model. Twenty male Sprague-Dawley rats that weighed between 265 and 310 g were used. In the sutureless group (SG), 20 left external jugular veins (LEJV) end-to-end anastomoses were performed using a T704 and cyanoacrylate glue. They were compared to 20 right external jugular veins (REJV) anastomoses sutured with conventional 10–0 stitches (control group - CG). Diameters of veins, anastomosis time, and patency rate at 15 days were reported. Foreign body reaction was assessed histologically. The mean diameter of the LEJV was 0.94 ± 0.1 mm and 0.95 ± 0.09 mm for the REJV. The mean anastomosis time was 11.9 ± 1.37 min for the SG and 27.75 ± 3.31 min for the CG. In the latter group, the immediate patency rate was 95% and 90% at 15 days. For the SG group, 90% of the anastomoses were patent immediately and 85% at 15 days. TP407 and cyanoacrylate could offer a fast and reliable technique for sutureless venous anastomoses. Before human application, effectiveness of this method remains to be confirmed in larger animals in a long-term follow-up. [ABSTRACT FROM AUTHOR]

Background: Ventricular arrhythmias (VAs) and electrical storm (ES) are recognized complications following left ventricular assist device (LVAD) implantation; however, their association with long term-outcomes remains poorly understood.Objective: The purpose of this study was to describe the clinical impact of ES in a population of patients undergoing LVAD implantation at a quaternary care center in the United States.Methods: This was an observational retrospective study of patients undergoing LVAD implantation from 2009 to 2020 at Duke University Hospital. The incidence of ES (≥3 sustained VA episodes over a 24-hour period without an identifiable reversible cause) was determined from patient records. Risk factors for ES were identified using multivariable Cox proportional hazards modeling.Results: Among 730 patients undergoing LVAD implant, 78 (10.7%) developed ES at a median of 269 (interquartile range [IQR] 7-766) days following surgery. Twenty-seven patients (34.6%) developed ES within 30 days, while 51 (65.4%) presented with ES at a median 639 (IQR 281-1017) days after implant. Following ES, 41% of patients died within 1 year. Patients who developed ES were more likely to have a history of VAs, ventricular tachycardia ablation, antiarrhythmic drug use, and perioperative mechanical circulatory support around the time of LVAD implant than patients without ES.Conclusion: ES occurs in 1 in 10 patients after LVAD and is associated with higher mortality. Risk factors for ES include a history of VAs, VT ablation, antiarrhythmic drug use, and perioperative mechanical circulatory support. Optimal management of ES surrounding LVAD implant, including escalation of medical therapy, catheter ablation, or adjunctive sympatholytic therapies, remains uncertain. [ABSTRACT FROM AUTHOR]

Previous mental health trajectory studies were mostly limited to the months before access to vaccination. They are not informing on whether public mental health has adapted to the pandemic. The aim of this analysis was to 1) investigate trajectories of monthly reported depressive symptoms from July 2020 to December 2021 in Switzerland, 2) compare average growth trajectories across regions with different stringency phases, and 3) explore the relative impact of self-reported worries related to health, economic and social domains as well as socio-economic indicators on growth trajectories. As part of the population-based Corona Immunitas program of regional, but harmonized, adult cohorts studying the pandemic course and impact, participants repeatedly reported online to the DASS-21 instrument on depressive symptomatology. Trajectories of depressive symptoms were estimated using a latent growth model, specified as a generalised linear mixed model. The time effect was modelled parametrically through a polynomial allowing to estimate trajectories for participants' missing time points. In all regions level and shape of the trajectories mirrored those of the KOF Stringency-Plus Index, which quantifies regional Covid-19 policy stringency. The higher level of average depression in trajectories of those expressing specific worries was most noticeable for the social domain. Younger age, female gender, and low household income went along with higher mean depression score trajectories throughout follow-up. Interventions to promote long-term resilience are an important part of pandemic preparedness, given the observed lack of an adaptation in mental health response to the pandemic even after the availability of vaccines in this high-income context. • Depression trajectories in Swiss adults mirrored the temporal course of the region-specific stringency of COVID-19 policies. • No mental health adaptation to the stringency measures was observed after the broad vaccine availability. • Social worries more so than health or economic worries went along with higher average depression levels in trajectories • Average depression symptom scores remained mostly in the normal range during follow-up. [ABSTRACT FROM AUTHOR]

Myocardial infarction (MI, heart attack) is the deterioration of heart tissue due to the cessation of blood supply which may result from a blood clot obstructing one of the coronary arteries, the major vessels supplying blood to the heart. Thrombolytic agents, such as tissue plasminogen activator (t-PA), which break down blood clots may be useful in the treatment of MI. Thrombolysis in Myocardial Infarction (TIMI) phase II is a multicenter study of 228 patients with MI who were treated with t-PA within four hours after the onset of symptoms. Within 18 to 48 hours after thrombolytic therapy, these patients underwent percutaneous transluminal coronary angioplasty, a procedure in which a balloon attached to a catheter, or flexible tube, is inserted into the narrowed portion of a coronary vessel and inflated to enlarge the vessel. The estimated six-week, six-month, and one-year rates of death or MI were 9, 13, and 14 percent, respectively. Most of the cardiac events, such as recurrent MI, occurred early during the follow-up period. Continuing chest pain after t-PA treatment, a history of congestive heart failure, low blood pressure at initial evaluation, and hypertension, or abnormally high blood pressure, increased the risks of death or recurrent MI. Patient age and history of chest discomfort influenced future hospitalization or the frequency of procedures to revascularize, or restore blood flow to the heart. (Consumer Summary produced by Reliance Medical Information, Inc.)

Atrial arrhythmias commonly occur in patients with cardiac amyloidosis (CA), but there is limited data on safety or efficacy of cardioversion (DCCV) for management of these rhythms in CA. We identified 25 patients with CA (20 with transthyretin (TTR) and 5 with light-chain (AL) amyloidosis) at Duke University who underwent DCCV for atrial arrhythmias and documented procedural success, complications, and long-term morbidity and mortality. While DCCV successfully restored sinus rhythm in 96% of patients, 36% of patients experienced immediate procedural complications (primarily bradycardia and hypotension), 80% had recurrence of atrial arrhythmias at 1 year, and 52% died at 3 years, highlighting short-term safety concerns, long-term inefficacy, and poor prognosis associated with symptomatic atrial arrhythmias requiring DCCV in CA. [ABSTRACT FROM AUTHOR]

Peripheral neck nerve tumors are rare and mostly benign neoplasms. The exceptional malignant forms are very aggressive, and diagnosis is difficult. The objective of this study was to evaluate diagnostic and therapeutic management and identify possible predictive factors. A retrospective study was conducted of 73 patients treated for peripheral neck nerve tumor between 1995 and 2015. Mean age was 44 years. The main presenting symptom was a cervical mass, isolated or associated with signs related to the affected nerve structure. Diagnosis was suspected by slow progression of a firm mass, featuring T1 hyposignal and T2 hypersignal on magnetic resonance imaging. Surgery was performed in 99% of cases, completed by adjuvant chemotherapy in case of malignant neuroblastic tumor. Type 1 neurofibromatosis and sudden increase in mass with or without associated pain suggested malignant transformation. Age below 10 years suggested neuroblastic tumor. Neck nerve tumors are very often benign with low degenerative potential. Surgery is the treatment of choice after risk/benefit analysis. However, there is no clearly defined consensus regarding the timing of surgery for these lesions. [ABSTRACT FROM AUTHOR]

The impact of Staphylococcus aureus on onset of nasal polyposis has been the focus of numerous studies, but there have been few studies of other germs found in the ethmoid of operated patients or of their impact on post-operative results. All patients undergoing endoscopic radical ethmoidectomy for nasal polyposis in the teaching hospital of Nantes (France) between 2006 and 2016 had intraoperative ethmoid cavity bacterial sampling. Phenotypic characteristics, pre- and post-operative symptoms and endoscopic findings were analyzed. Mann–Whitney tests and Kruskal–Wallis correlation analysis were used to assess clinical/bacteriological correlations. The main objective was to describe bacterial colonization of patients undergoing surgery for nasal polyposis, and to assess correlations with phenotypic features, functional results and postoperative clinical course. One hundred and seven patients were included. A total of 26% were not infected, 55% mono-infected and 19% multi-infected. In 27.3%, staphylococci were isolated; in 30.5%, isolates were gram-negative bacilli. There were no significant correlations between presence or type of pathogen and symptom profile. This study confirmed the high rate of pathogenic bacteria in nasal cavities in case of polyposis, with high frequencies of S. aureus but also of gram-negative bacilli, raising the question of their involvement in the inflammatory reactions underlying the nasal polyposis. [ABSTRACT FROM AUTHOR]

Abstract In this article, numerical results from a highly resolved large eddy simulations (LES) of an air-helium buoyant jet developing in a two vented cavity are presented. The simulated configuration mimics the helium-release experiment carried out at CEA Saclay in the framework of security assessment of indoor used hydrogen-based systems. The height of the enclosure was chosen so that a laminar-turbulent transition occurs approximately at the middle of the upstream direction. An exterior region, of different spatial dimensions, has been modeled in the computational domain in order to move the boundary conditions away from the vent surface and to approach the natural inlet/outlet conditions. A sensitivity analysis regarding the size of the exterior region is presented to define the minimum horizontal extension so that the flow inside the cavity is not furthermore influenced by bigger computational domains. We observe mainly that applying an ambient equilibrium-hydrostatic pressure outlet condition directly on the surface of the vent reduces the volume of the air inflow, and thus predicts larger helium mass inside the cavity, in contrary with the cases where an exterior region is considered. A qualification analysis shows that the sub-grid scale model plays a small role in the calculations and thus implies that the LES predictions approach the direct numerical simulation (DNS) solution. Analysis carried out on the time-averaged helium field depicts a concentration regime that is not classical in such configurations and thus the theoretical model used in safety pre-calculations can not be served. Highlights • Modelling an exterior region in the computational domain influences significantly the flow. • Global quantities, like volumetric flow rates and fluid mass, are mainly influenced by the computational domain. • A sensitive study of the size of the exterior domain is required to provide numerical reference solutions. • A concentration regime not situated in the framework of the theoretical model of Linden et al. 1990 is predicted. [ABSTRACT FROM AUTHOR]

Abstract This work takes place in the context of potential hazards in the use of hydrogen in fuel cells. The present article describes comparisons between PIV measurements performed on a two vented cavity with an helium injection and Large Eddy Simulation of the same configuration. A two vented cavity is chosen because a quasi state is reached rapidly and it facilitates both CFD calculations by reducing the CPU costs and also enables statistical treatment of the data, the temporal averaging being possible at steady state. At the same time, this configuration is close to fuel cell designs, except for the set-up reduced size. We also describe the experimental set-up and the care which has to be taken to produce Particle Image Velocimetry velocity fields. The final goal of the paper is to validate a L.E.S approach as a good replacement to experiments, since access to both velocity and concentration fields is required to improve existing simplified models. Indeed, most of the 2 vents models rely on simplified assumptions such as a constant entrainment coefficient, a bi-layer formation which is not always the case in real situations. Highlights • L.E.S concentrations are conservative which is well suited for safety applications. • L.E.S results and experimental measurements exhibit strong similarities. • L.E.S and experimental results differences are mostly within a 20% range. • In the plume L.E.S fluctuations are much lower than in experiments. • DNS should be preferred to L.E.S calculations as a replacement for experiments. [ABSTRACT FROM AUTHOR]

Abstract Purpose Binge eating disorder (BED) is associated with higher psychopathology, including emotional and personality disorders, in the adult population, whether or not they are obese; although few data are available on adolescents, particularly among obese adolescents. Objective To explore the association of both emotional disorders and personality dimensions with BED in obese adolescents. Methods The sample consisted of 115 French adolescents enrolled at a clinical unit for the multidisciplinary care of their overweight or obesity. BED was defined using the Binge Eating Scale (BES). Emotional disorders and personality dimensions were assessed using the following tools: Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Junior Temperament and Character Inventory (JTCI); impulsivity was determined by the Barratt Impulsiveness Scale (BIS) and the Toronto Alexithymia Scale (TAS). Associations between emotional disorders (BDI/BAI) and personality dimensions (TAS/BIS/JTCI), considered first separately and then jointly with BED were determined with multivariate analysis. Results More severe depression (β=0.27, CI [0.06; 0.48], P = 0.011), a higher level of excess weight (β=1.91, CI [0.22; 3.59], P = 0.027), older age (β=1.28, CI [0.43; 2.14], P = 0.003), and greater cooperativeness (β=0.36, CI [0.07; 0.66], P = 0.017) were independently significantly associated with the presence of BED. Conclusions This cross-sectional study underlines the co-occurrence of emotional and personality disorders with BED. This points out the importance of a multidisciplinary approach and the relevance of a joint diagnosis of binge eating, emotional disorders, and personality dimensions in obese adolescents, for better prevention and treatment of pediatric obesity. [ABSTRACT FROM AUTHOR]

Abstract The present review lays out the main principles governing outpatient management in the French health system in 2018, and more specifically in plastic and reconstructive head and neck surgery. The historical regulatory aspects and the changes of the last few years are explained, along with the trends and health authorities' expectations for the years to come. The main limitations to implementing outpatient procedures are the common to all surgical specialities, plastic and reconstructive head and neck surgery being no exception. Apart from purely technical aspects concerning surgical procedure and anesthesia, there are issues concerning institutional approval, the organization and continuity of health care, and the patient's environment. The French General Inspectorate of Social Affairs (IGAS), in its 2012 report on the assessment and pricing of hospital care and medical acts, stated that outpatient surgery was becoming standard practice and conventional admission a fall-back, with the aim of meeting the requirement to provide more care without more expenditure. Outpatient plastic and reconstructive head and neck surgery may be available for most patients, but still presupposes certain conditions. [ABSTRACT FROM AUTHOR]

Résumé Les conduites à risques chez les enfants et les adolescents sont un réel problème de santé publique tant leurs conséquences en termes de morbidité que de mortalité sur le court terme et le long terme sont désastreuses. Dans cet article, nous définirons dans un premier temps les conduites à risques (CAR) puis nous soulignerons l’importance du trouble déficit de l’attention avec hyperactivité (TDA/H) dans les conduites de mise en danger. Nous présenterons les principaux résultats soulignant l’implication du TDA/H dans l’usage des toxiques ainsi que dans les comportements sexuels à risques (CSR). Puis nous examinerons plus spécifiquement les liens entre TDA/H et les accidents et les blessures non intentionnelles. Dans la discussion, nous mènerons une réflexion sur les actions à mener en termes de prévention. Risk behaviors in children and adolescents are a real public health problem with disastrous short-term and long-term consequences in terms of morbidity and mortality. In this article, first we define the concept of risk behaviors and highlight their diversity and co-occurrence. According to the Center for Disease Control (CDC), risk behaviors include unintentional injuries and violence, tobacco and alcohol consumption, illicit drug use, unsafe sexual behavior, unhealthy dietary habits, and inadequate physical activity. Although these risk behaviors are distinct, they are often inter-connected to one another. Second, we define the attention deficit and hyperactivity disorder (ADHD) and review the evidence showing its association with risky behaviors such as substance use (e.g., tobacco, alcohol, and cannabis), risky sexual practices, and suicidal behaviors. Next, we illustrate the risk behaviors via specific cases of accidents and unintentional injuries (e.g., sport, car accidents) whereby the negative consequences of these behaviors are most explicit in terms of morbidity and mortality in both children and adolescents. For instance, several datasets collected from hospitalized children have indicated the significant relationship between facial trauma and ADHD. The review of these findings on risk behaviors and particularly on accidents casts light on the extent to which excess mortality is associated with ADHD. Furthermore, we point out the ambiguities that exist in the study of the links between ADHD and risky behaviors, including the importance of comorbidity (e.g., conduct disorder, oppositional defiant disorder) as well as the effect of specific symptoms such as inattention in accidents and unintentional injuries. We argue for the advantages of considering ADHD as a kind of “accident proneness”, that is, individuals with ADHD demonstrate signs of a predisposition to accidents. There are several scholars who insist on the necessity to detect the symptoms of ADHD in injured children and adolescents (e.g., during consultation or hospitalization for various trauma and injuries) and include the treatment of those symptoms in their recovery process. Finally, we reflect on the practical implication of this and review the practical implications such as the taking some preventative measures in schools, particularly the implementation of longitudinal programs based on the acquisition of skills to reduce the risks for health. [ABSTRACT FROM AUTHOR]

The nucleolus is the site of ribosome biogenesis and forms around the actively transcribed ribosomal RNA (rRNA) genes. However, the nucleolus is also implicated in cell cycle regulation, tumour suppression and chromosome segregation and nucleolar disfunction is linked to a wide range of human diseases. Interestingly, the nucleolus is also required for genome reprogramming and the establishment of heterochromatin in the mammalian embryo. Mammalian oocytes contain a subnuclear structure that is believed to be the precursor of the functional nucleolus, the Nucleolar Precursor Body (NPB). But the NPB is also required for the organisation of the zygotic heterochromatin and the establishment of pluripotency. We found that disruption of the mouse Upstream Binding Factor (UBF (UBTF)) gene caused disassembly of somatic nucleoli and the accumulation of the key rRNA gene transcription factors into dense subnuclear foci resembling NPBs. Here we show that UBF deletion causes the rRNA genes to collapse onto their centromere-proximal chromosomal sites spatially distinct from NPB-like structures, and that these structures contain rRNA gene transcription factors but not all nucleolar proteins. We further find that embryonic NPBs and their surrounding heterochromatin are both disrupted in UBF-null mouse embryos. These embryos also display subnuclear foci containing the rRNA gene transcription factors and arrest development before completing the forth cleavage division. The data suggest that the rRNA gene transcription factors have an intrinsic ability to interact and form a discrete nuclear compartment even in the absence of any rRNA gene activity and that the formation or maintenance of the zygotic NPB and surrounding heterochromatin requires UBF. [ABSTRACT FROM AUTHOR]