Multimodal integrated intervention for children with attentiondeficit/hyperactivity disorder

BACKGROUND Attention-deficit/hyperactivity disorder(ADHD)is one of the most common disorders in child and adolescent psychiatry,with a prevalence of more than 5%.Despite extensive research on ADHD in the last 10 to 20 years,effective treatments are still lacking.Instead,the concept of ADHD seems to have become broader and more heterogeneous.Therefore,the diagnosis and treatment of ADHD remains challenging for clinicians.AIM To investigate the effects of a multimodal integrated intervention for children with ADHD.METHODS Between March 2019 and September 2020,a total of 100 children with ADHD who were diagnosed and treated at our hospital were assessed for eligibility,two of whom revoked their consent.A case-control study was conducted in which the children were equally assigned,using a randomized number table,to either a medication group(methylphenidate hydrochloride extended-release tablets and atomoxetine hydrochloride tablets)or a multimodal integrated intervention group(medication+parent training+behavior modification+sensory integration therapy+sand tray therapy),with 49 patients in each group.The clinical endpoint was the efficacy of the different intervention modalities.RESULTS The two groups of children with ADHD had comparable patient characteristics(P>0.05).Multimodal integrated intervention resulted in a significantly higher treatment efficacy(91.84%)than medication alone(75.51%)(P<0.05).Children who received the multimodal integrated intervention showed lower scores in the Conners Parent Symptom Questionnaire and the Weiss Functional Impairment Rating Scale than those treated with medication alone(P<0.05).The Sensory Integration Scale scores of children in the multimodal integrated intervention group were higher than those of children in the medication group(P<0.05).Children who received the multimodal integrated intervention had higher compliance and family satisfaction and a lower incidence of adverse events than those treated with medication alone(P<0.05).CONCLUSION Multimodal integrated intervention effectively alleviated symptoms associated with ADHD in children.It enhanced their memory and attention with high safety and parental satisfaction,demonstrating good potential for clinical promotion.

Application of Texture Measures to Study Effect of B Chromosomes on the 3D Architecture of Plant Chromatin

Background: Supernumerary chromosomes (B) comprise optional complement to basic (A) chromosome set. The presence of B-chromosomes may significantly reduce plant vigor and fertility. Potentially active genes constitute only small fraction of DNA of these chromosomes indicating that these effects are mediated by epigenetic mechanisms. One example is down-regulation of rDNA genes and condensation of their respective chromatin regions (demonstrated in squashed preparations using 2D microscopy). It may be postulated that the presence of B chromosomes leads to more extensive changes of local chromatin structure. Verification of hypothesis requires studying 3D spatial architecture of intact nuclei in tissue. Results: An image processing algorithm was developed and applied for isolation (from the confocal datasets) of regions corresponding to single nuclei. The nuclei were segmented using iterative global thresholding followed by growing and merging of regions belonging to different nuclei. The result of segmentation was verified by a human observer. Chromatin architecture was characterized quantitatively using global fluorescence intensity distribution measures (mean, variance) and local intensity distribution parameters (haraclick features, wavelet energy, run- length features). The sets of parameters corresponding to populations of nuclei with different number of B-chromo- somes were subjected to discriminate analysis. The distinct parameters were then correlated with depth in tissue at which a given nucleus was positioned. Conclusions: Combination of light microscopy with dedicated image processing and analysis framework made it possible to study chromatin architecture in nuclei containing various number of B chromosomes. These data indicate that alterations of 3D chromatin distribution occur globally in the interphase nuclei in the presence of Bs. The changes occur at the spatial scale comparable with the resolution limit of light microscopy and at larger distances.