An Exploratory Investigation of Difficulties in Applying Functional Behavior Assessment and Implementing Behavioral Intervention Plans in ADHD Programs in Saudi Arabia

Functional behavior assessment(FBA)and behavioral intervention plans(BIPs)can be effective for students with attention deficit hyperactivity disorder(ADHD);however,teachers may face difficulties when implementing FBA procedures and,in turn,BIPs because of lack of time,insufficient training,and multiplicity of beliefs.Thus,it is important to identify the difficulties teachers may face and the obstacles that can deter them from implementing intervention plans.This is a worthwhile endeavor because nearly all classrooms will have students with behavioral problems who will benefit from specifically designed educational interventions.This study aimed to identify the difficulties in applying FBA and the barriers in implementing BIPs among Saudi teachers in specialized ADHD programs.Using the descriptive-analytical approach,a questionnaire targeting difficulties and barriers was admi-nistered to 209 public school teachers from specialized ADHD programs in Saudi Arabia.The results revealed that the difficulty level of applying FBA in ADHD programs was high.The level of barriers in implementing BIPs was moderate.Finally,the study indicated that barriers in implementing BIPs could be predicted by the difficulties of applying FBA.The results suggest the importance offinding better practices,restructuring the provision of ADHD programs,training teachers,improving assessment tool availability,and ensuring cooperation between school administrators and teachers.

Assessment of hindlimb motor recovery affer severe thoracic spinal cord injury in rats: classification of CatWalk XT■ gait analysis parameters

Assessment of locomotion recovery in preclinical studies of experimental spinal cord injury remains challenging. We studied the CatWalk XT■gait analysis for evaluating hindlimb functional recovery in a widely used and clinically relevant thoracic contusion/compression spinal cord injury model in rats. Rats were randomly assigned to either a T9 spinal cord injury or sham laminectomy. Locomotion recovery was assessed using the Basso, Beattie, and Bresnahan open field rating scale and the CatWalk XT■gait analysis. To determine the potential bias from weight changes, corrected hindlimb(H) values(divided by the unaffected forelimb(F) values) were calculated. Six weeks after injury, cyst formation, astrogliosis, and the deposition of chondroitin sulfate glycosaminoglycans were assessed by immunohistochemistry staining. Compared with the baseline, a significant spontaneous recovery could be observed in the CatWalk XT■parameters max intensity, mean intensity, max intensity at%, and max contact mean intensity from 4 weeks after injury onwards. Of note, corrected values(H/F) of CatWalk XT■parameters showed a significantly less vulnerability to the weight changes than absolute values, specifically in static parameters. The corrected CatWalk XT■parameters were positively correlated with the Basso, Beattie, and Bresnahan rating scale scores, cyst formation, the immunointensity of astrogliosis and chondroitin sulfate glycosaminoglycan deposition. The CatWalk XT■gait analysis and especially its static parameters, therefore, seem to be highly useful in assessing spontaneous recovery of hindlimb function after severe thoracic spinal cord injury. Because many CatWalk XT■parameters of the hindlimbs seem to be affected by body weight changes, using their corrected values might be a valuable option to improve this dependency.

Efficacy of Children Neuropsychological and Behavioral Scale in Screening for Autism Spectrum Disorders through a Combination of Developmental Surveillance

Objective This study aimed to explore the clinical value of Children Neuropsychological and Behavioral Scale-Revision 2016(CNBS-R2016)for Autism Spectrum Disorder(ASD)screening in the presence of developmental surveillance.Methods All participants were evaluated by the CNBS-R2016 and Gesell Developmental Schedules(GDS).Spearman’s correlation coefficients and Kappa values were obtained.Taking GDS as a reference assessment,the performance of the CNBS-R2016 for detecting the developmental delays of children with ASD was analyzed with receiver operating characteristic(ROC)curves.The efficacy of the CNBS-R2016 to screen for ASD was explored by comparing Communication Warning Behavior with Autism Diagnostic Observation Schedule,Second Edition(ADOS-2).Results In total,150 children aged 12–42 months with ASD were enrolled.The developmental quotients of the CNBS-R2016 were correlated with those of the GDS(r=0.62–0.94).The CNBS-R2016 and GDS had good diagnostic agreement for developmental delays(Kappa=0.73–0.89),except for Fine Motor.There was a significant difference between the proportions of Fine Motor,delays detected by the CNBS-R2016 and GDS(86.0%vs.77.3%).With GDS as a standard,the areas under the ROC curves of the CNBS-R2016 were above 0.95 for all the domains except Fine Motor,which was 0.70.In addition,the positive rate of ASD was 100.0%and 93.5%when the cut-off points of 7 and 12 in the Communication Warning Behavior subscale were used,respectively.Conclusion The CNBS-R2016 performed well in developmental assessment and screening for children with ASD,especially by Communication Warning Behaviors subscale.Therefore,the CNBS-R2016 is worthy of clinical application in children with ASD in China.

Enhancement of motor functional recovery in thoracic spinal cord injury: voluntary wheel running versus forced treadmill exercise

Spinal cord injury necessitates effective rehabilitation strategies, with exercise therapies showing promise in promoting recovery. This study investigated the impact of rehabilitation exercise on functional recovery and morphological changes following thoracic contusive spinal cord injury. After a 7-day recovery period after spinal cord injury, mice were assigned to either a trained group(10 weeks of voluntary running wheel or forced treadmill exercise) or an untrained group. Bi-weekly assessments revealed that the exercise-trained group, particularly the voluntary wheel exercise subgroup, displayed significantly improved locomotor recovery, more plasticity of dopaminergic and serotonin modulation compared with the untrained group. Additionally, exercise interventions led to gait pattern restoration and enhanced transcranial magnetic motor-evoked potentials. Despite consistent injury areas across groups, exercise training promoted terminal innervation of descending axons. In summary, voluntary wheel exercise shows promise for enhancing outcomes after thoracic contusive spinal cord injury, emphasizing the role of exercise modality in promoting recovery and morphological changes in spinal cord injuries. Our findings will influence future strategies for rehabilitation exercises, restoring functional movement after spinal cord injury.

Estimation of the behavior factor of existing RC-MRF buildings

In recent years, several research groups have studied a new generation of analysis methods for seismic response assessment of existing buildings. Nevertheless, many important developments are still needed in order to define more reliable and effective assessment procedures. Moreover, regarding existing buildings, it should be highlighted that due to the low knowledge level, the linear elastic analysis is the only analysis method allowed. The same codes（such as NTC2008, EC8） consider the linear dynamic analysis with behavior factor as the reference method for the evaluation of seismic demand. This type of analysis is based on a linear-elastic structural model subject to a design spectrum, obtained by reducing the elastic spectrum through a behavior factor. The behavior factor（reduction factor or q factor in some codes） is used to reduce the elastic spectrum ordinate or the forces obtained from a linear analysis in order to take into account the non-linear structural capacities. The behavior factors should be defined based on several parameters that influence the seismic nonlinear capacity, such as mechanical materials characteristics, structural system, irregularity and design procedures. In practical applications, there is still an evident lack of detailed rules and accurate behavior factor values adequate for existing buildings. In this work, some investigations of the seismic capacity of the main existing RC-MRF building types have been carried out. In order to make a correct evaluation of the seismic force demand, actual behavior factor values coherent with force based seismic safety assessment procedure have been proposed and compared with the values reported in the Italian seismic code, NTC08.

Changes in synapse quantity and growth associated protein 43 expression in the motor cortex of focal cerebral ischemic rats following catalpol treatment

The present study investigated the effects of catalpol, the main constituent of the Chinese herb Rehmannia root, on neurons following brain ischemia, A rat model of focal permanent brain ischemia was established using electrocoagulation, The rats were intrapedtoneally injected with catalpol, at a dose of 5 mg/kg, daily for 1 week, Results showed that the number of neuronal synapses in the motor cortex and growth associated protein 43 expression were increased following catalpol treatment, indicating that catalpol might contribute to neuroplasticity and ameliorate functional neurological deficits induced by cerebral ischemia.

The mechanism of Naringin-enhanced remyelination after spinal cord injury

Our previous study revealed that intragastric administration of naringin improved remyelination in rats with spinal cord injury and promoted the recovery of neurological function of the injured spinal cord.This study sought to reveal the mechanisms by which naringin improves oligodendrocyte precursor cell differentiation and maturation,and promotes remyelination.Spinal cord injury was induced in rats by the weight-drop method.Naringin was intragastrically administered daily（20,40 mg/kg） for 4 weeks after spinal cord injury induction.Behavioral assessment,histopathological staining,immunofluorescence spectroscopy,ultrastructural analysis and biochemical assays were employed.Naringin treatment remarkably mitigated demyelination in the white matter,increased the quality of myelinated nerve fibers and myelin sheath thickness,promoted oligodendrocyte precursor cell differentiation by upregulating the expression of NKx2.2 and 2′3′-cyclic nucleotide 3′-phosphodiesterase,and inhibited β-catenin expression and glycogen synthase kinase-3β（GSK-3β） phosphorylation.These findings indicate that naringin treatment regulates oligodendrocyte precursor cell differentiation and promotes remyelination after spinal cord injury through the β-catenin/GSK-3β signaling pathway.

Recovery from prolonged disorders of consciousness:A dual-center prospective cohort study in China

BACKGROUND Recent innovations in intensive care have improved the prognosis of patients with severe brain injuries and brought more patients with disorders of consciousness(DoC).Data are lacking regarding the long-term outcomes of those patients in China.It is necessary to study the long-term outcomes of patients with prolonged DoC in light of many factors likely to influence crucial decisions about their care and their life.AIM To present the preliminary results of a DoC cohort.METHODS This was a two-center prospective cohort study of inpatients with vegetative state(VS)/unresponsive wakefulness syndrome(UWS).The study outcomes were the recovery from VS/UWS to minimally conscious state(MCS)and the long-term status of patients with prolonged DoC considered in VS/UWS or MCS for up to 6 years.The patients were evaluated using the Glasgow coma scale,coma recovery scale-revised,and Glasgow outcome scale.The endpoint of follow-up was recovery of full consciousness or death.The changes in the primary clinical outcome improvement in clinical diagnosis were evaluated at 12 mo compared with baseline.RESULTS The study population included 93 patients(62 VS/UWS and 31 MCS).The postinjury interval range was 28-634 d.Median follow-up was 20 mo(interquartile range,12-37 mo).At the endpoint,33 transitioned to an emergence from MCS or full consciousness,eight had a locked-in syndrome,and there were 35 patients remaining in a VS/UWS and 11 in an MCS.Seven(including one locked-in syndrome)patients(7.5%)died within 12 mo of injury.Compared with the unresponsive group(n=52)at 12 mo,the responsive group(n=41)had a higher proportion of males(87.8%vs 63.5%,P=0.008),shorter time from injury(median,40.0 d vs 65.5 d,P=0.006),higher frequency of vascular etiology(68.3%vs 38.5%,P=0.007),higher Glasgow coma scale score at admission(median,9 vs 6,P<0.001),higher coma recovery scale-revised score at admission(median,9 vs 2.5,P<0.001),at 1 mo(median,14 vs 5,P<0.001),and at 3 mo(median,20 vs 6,P<0.001),lower frequency of VS/UWS(36.6%vs 90.0%,P<0.001),and more favorable Glasgow outcome scale outcome(P<0.001).CONCLUSION Patients with severe DoC,despite having strong predictors of poor prognosis,might recover consciousness after a prolonged time of rehabilitation.An accurate initial diagnosis of patients with DoC is critical for predicting outcome and a long-term regular follow-up is also important.

Epidural oscillating field stimulation increases axonal regenerative capacity and myelination after spinal cord trauma

Oscillating field stimulation(OFS)with regular alterations in the polarity of electric current is a unique,experimental approach to stimulate,support,and potentially guide the outgrowth of both sensory and motor nerve fibers after spinal cord injury(SCI).In previous experiments,we demonstrated the beneficial effects of OFS in a 4-week survival period after SCI.In this study,we observed the major behavioral,morphological,and protein changes in rats after 15 minutes of T9 spinal compression with a 40 g force,followed by long-lasting OFS(50μA),over a 8-week survival period.Three groups of rats were analyzed:rats after T9 spinal compression(SCI group);SCI rats subjected to implantation of active oscillating field stimulator(OFS+SCI group);and SCI rats subjected to nonfunctional OFS(nOFS+SCI group).Histopathological analysis of spinal tissue indicated a strong impact of epidural OFS on the reduction of tissue and myelin loss after SCI in the segments adjacent to the lesion site.Quantitative fluorescent analysis of the most affected areas of spinal cord tissue revealed a higher number of spared axons and oligodendrocytes of rats in the OFS+SCI group,compared with rats in the SCI and nOFS+SCI groups.The protein levels of neurofilaments(NF-l),growth-associated protein-43(marker for newly sprouted axons),and myelin basic protein in rats were signifiantly increased in the OFS+SCI group than in the nOFS+SCI and SCI groups.This suggests a supporting role of the OFS in axonal and myelin regeneration after SCI.Moreover,rats in the OFS+SCI group showed great improvements in sensory and motor functions than did rats in the nOFS+SCI and SCI groups.All these findings suggest that long-lasting OFS applied immediately after SCI can provide a good microenviroment for recovery of damaged spinal tissue by triggering regenreative processes in the acute phase of injury.

Assessment of leaching behavior and human bioaccessibility of rare earth elements in typical hospital waste incineration ash in China

Leaching behavior and gastrointestinal bioaccessibility of rare earth elements （REEs） from hospital waste incineration （HWI） fly and bottom ash samples collected from Beijing and Nanjing Cities were assessed. In the same ash sample, the leaching concentrations of individual REEs determined by the Toxicity Characteristic Leaching Procedure （TCLP） were higher than those detected by the European standard protocol （EN-type test）, thereby suggesting that the low pH value of leaching solution was an important factor influencing the leacha（bility-of REE. The REE bioaccessibility results, which were evaluated using the physiologically based extraction test （PBET）, indicated that REEs were highly absorbed during fgastric phase by dissolution; and subsequently precipitated and/or re-adsorbed in small intestinal phase. The relative amounts of the total REEs extracted by the TCLP method, EN-type test and PBET test were compared. In addition to the pH value of extraction solutions, the chelating role of REEs witllt organic ligands used in the PBET method was also an important parameter affecting REE adsorption in human body. Additionally, this study showed that REEs were extracted by these methods as concomitants of heavy metals and anions （NO3^-, F^-, SO4^2- , and Cl^-） from HWI ash, which probably caused the remarkably complex toxicity on human body by the exposure pathway.

Numerical modeling and performance evaluation of passive convergence-permeable reactive barrier(PC-PRB)

The passive convergence-permeable reactive barrier(PC-PRB)was proposed to address the limitations of traditional PRB configurations.To evaluate the hydraulic and pollutant removal performance of the PC-PRB system,we developed a simulation code named PRB-Trans.This code uses the two-dimensional(2D)finite element method to simulate groundwater flow and solute transport.Case studies demonstrate that PC-PRB technology is more efficient and cost-effective than continuous permeable reactive barrier(C-PRB)in treating the same contaminated plume.Implementation of PC-PRB technology results in a 33.3%and 72.7%reduction in PRB length(L_(PRB))and height(H_(PRB)),respectively,while increasing 2D horizontal and 2D vertical pollutant treatment efficiencies of PRB by 87.8%and 266.8%,respectively.In addition,the PC-PRB technology has the ability to homogenize the pollutant concentration and pollutant flux through the PRB system,which can mitigate the problems arising from uneven distribution of pollutants in the C-PRB to some extent.The L_(PRB)required for PC-PRB decreases as the water pipe length(L_(p))increases,while the H_(PRB)required initially decreases and then increases with increasing L_(p).The effect of passive well height(Hw)on H_(PRB)is not as significant as that of L_(p)on H_(PRB).Overall,PC-PRB presents a promising and advantageous PRB configuration in the effective treatment of various types of contaminated plumes.