Multimodal treatment of hepatocellular carcinoma: an eastern European experience.

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Dima, Simona Olimpia; Iacob, Speranţa; Botea, Florin; Matei, Emil; Dorobanfu, Bogdan; Vasile, Serban; Alexandrescu, Sorin; Croitoru, Adina; Dumitrascu, Traian; Stroescu, Cezar; Herlea, Vlad; Popescu, Irinel

2009-01-01

The aim of the present study was to evaluate the outcomes of a multimodal treatment approach of hepatocellular carcinoma (HCC) in a tertiary hepatobiliary specialty center. A total of 294 consecutive patients treated for HCC were retrospectively analyzed. Two hundred sixteen patients (73.4%) were men and 78 (26.6%) were women. Liver resection (LR) was performed in 201 patients (68.4%), liver transplantation (LT) in 19 patients (6.5%), radiofrequency ablation (RFA) in 74 patients (25.1%), and 56 (19%) patients received adjuvant systemic chemotherapy. The median follow-up was 15.7 mo (range 0.1-90.3). Five-year overall survival and recurrence rates were 28% and 26.8%, respectively. Serum AFP > 43.8ng/ml (p = 0.005), BCLC C/D (p = 0.006) and JIS 3/4/5 classifications (p = 0.02) were independent negative prognostic factors for overall survival, while JIS 3/4/5 (p = 0.01) and BCLC C/D (p = 0.01) classifications, tumors larger than 6.5cm (p = 0.001) and RFA (p = 0.02) were independent predictors for recurrence. The current treatment of HCC should be multimodal, and therapeutic modalities and their combinations should be tailored to each patient. LT represents the best therapeutic option for patients with HCC in the setting of cirrhosis. Resection remains a good option in cirrhotic patients, while RFA is a safe and effective procedure for small tumors.

Treatment of children with attention-deficit/hyperactivity disorder (ADHD) and irritability: results from the multimodal treatment study of children with ADHD (MTA).

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Fernández de la Cruz, Lorena; Simonoff, Emily; McGough, James J; Halperin, Jeffrey M; Arnold, L Eugene; Stringaris, Argyris

2015-01-01

Clinically impairing irritability affects 25% to 45% of children with attention-deficit/hyperactivity disorder (ADHD); yet, we know little about what interventions are effective in treating children with ADHD and co-occurring irritability. We used data from the Multimodal Treatment Study of Children With ADHD (MTA) to address 3 aims: to establish whether irritability in children with ADHD can be distinguished from other symptoms of oppositional defiant disorder (ODD); to examine whether ADHD treatment is effective in treating irritability; and to examine how irritability influences ADHD treatment outcomes. Secondary analyses of data from the MTA included multivariate analyses, and intent-to-treat random-effects regression models were used. Irritability was separable from other ODD symptoms. For treating irritability, systematic stimulant treatment was superior to behavioral management but not to routine community care; a combination of stimulants and behavioral treatment was superior to community care and to behavioral treatment alone, but not to medication alone. Irritability did not moderate the impact of treatment on parent- and teacher-reported ADHD symptoms in any of the 4 treatment groups. Treatments targeting ADHD symptoms are helpful for improving irritability in children with ADHD. Moreover, irritability does not appear to influence the response to treatment of ADHD. Multimodal Treatment Study of Children With Attention Deficit and Hyperactivity Disorder (MTA); http://www.clinicaltrials.gov; NCT00000388. Copyright © 2015 American Academy of Child & Adolescent Psychaitry. Published by Elsevier Inc. All rights reserved.

Multimodal news framing effects

NARCIS (Netherlands)

Powell, T.E.

2017-01-01

Visuals in news media play a vital role in framing citizens’ political preferences. Yet, compared to the written word, visual images are undervalued in political communication research. Using framing theory, this thesis redresses the balance by studying the combined, or multimodal, effects of visual

Practical multimodal care for cancer cachexia.

Science.gov (United States)

Maddocks, Matthew; Hopkinson, Jane; Conibear, John; Reeves, Annie; Shaw, Clare; Fearon, Ken C H

2016-12-01

Cancer cachexia is common and reduces function, treatment tolerability and quality of life. Given its multifaceted pathophysiology a multimodal approach to cachexia management is advocated for, but can be difficult to realise in practice. We use a case-based approach to highlight practical approaches to the multimodal management of cachexia for patients across the cancer trajectory. Four cases with lung cancer spanning surgical resection, radical chemoradiotherapy, palliative chemotherapy and no anticancer treatment are presented. We propose multimodal care approaches that incorporate nutritional support, exercise, and anti-inflammatory agents, on a background of personalized oncology care and family-centred education. Collectively, the cases reveal that multimodal care is part of everyone's remit, often focuses on supported self-management, and demands buy-in from the patient and their family. Once operationalized, multimodal care approaches can be tested pragmatically, including alongside emerging pharmacological cachexia treatments. We demonstrate that multimodal care for cancer cachexia can be achieved using simple treatments and without a dedicated team of specialists. The sharing of advice between health professionals can help build collective confidence and expertise, moving towards a position in which every team member feels they can contribute towards multimodal care.

Multimodal non-surgical treatment of a feline tracheal adenocarcinoma

Directory of Open Access Journals (Sweden)

Carolina Azevedo

2017-02-01

Full Text Available Case summary A 10-year-old, castrated male domestic shorthair cat presented with a 2–3 month history of weight loss, lethargy and coughing. Thoracic radiographs revealed a soft tissue opacity overlying the dorsal trachea from the first rib to second rib and the ventral aspect of the trachea extending from the second rib to approximately the fourth rib. CT confirmed a mass involving the dorsal, right lateral and ventral aspects of the trachea narrowing the lumen and extending from vertebra C7 through T4. Bronchoscopy revealed a partially circumferential irregular and multilobulated tracheal mass, which was biopsied. The histopathological diagnosis was tracheal adenocarcinoma. The cat was treated with a definitive course of external beam radiation therapy (RT; 3 Gy × 18, cytotoxic chemotherapy, a tyrosine kinase inhibitor and palliative RT. The cat remained asymptomatic for 2 months and the mass remained stable radiographically for 11 months after RT. Relevance and novel information With multimodal treatment the cat had a survival time of 755 days. Initial treatment included definitive RT, carboplatin and piroxicam, followed by toceranib phosphate and palliative RT when the mass recurred. This case report describes the first documented use of non-surgical treatment and long-term outcome of tracheal adenocarcinoma in a cat. This case report is an indication that prolonged survival can be achieved with multimodal therapy.

A multi-modal treatment approach for the shoulder: A 4 patient case series

Directory of Open Access Journals (Sweden)

Pollard Henry

2005-09-01

Full Text Available Abstract Background This paper describes the clinical management of four cases of shoulder impingement syndrome using a conservative multimodal treatment approach. Clinical Features Four patients presented to a chiropractic clinic with chronic shoulder pain, tenderness in the shoulder region and a limited range of motion with pain and catching. After physical and orthopaedic examination a clinical diagnosis of shoulder impingement syndrome was reached. The four patients were admitted to a multi-modal treatment protocol including soft tissue therapy (ischaemic pressure and cross-friction massage, 7 minutes of phonophoresis (driving of medication into tissue with ultrasound with 1% cortisone cream, diversified spinal and peripheral joint manipulation and rotator cuff and shoulder girdle muscle exercises. The outcome measures for the study were subjective/objective visual analogue pain scales (VAS, range of motion (goniometer and return to normal daily, work and sporting activities. All four subjects at the end of the treatment protocol were symptom free with all outcome measures being normal. At 1 month follow up all patients continued to be symptom free with full range of motion and complete return to normal daily activities. Conclusion This case series demonstrates the potential benefit of a multimodal chiropractic protocol in resolving symptoms associated with a suspected clinical diagnosis of shoulder impingement syndrome.

Effectiveness of a multimodal inpatient treatment for adolescents with anorexia nervosa in comparison with adults: an analysis of a specialized inpatient setting : treatment of adolescent and adult anorexics.

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Naab, Silke; Schlegl, Sandra; Korte, Alexander; Heuser, Joerg; Fumi, Markus; Fichter, Manfred; Cuntz, Ulrich; Voderholzer, Ulrich

2013-06-01

There is evidence for an increased prevalence and an earlier onset of anorexia nervosa (AN) in adolescents. Early specialized treatment may improve prognosis and decrease the risk of a chronic course. The current study evaluates the effectiveness of a multimodal inpatient treatment for adolescent AN patients treated in a highly specialized eating disorder unit for adults. 177 adolescents and 1,064 adult patients were included. The evaluation focused on eating behavior, depressive symptoms and general psychopathology. All measured variables decreased significantly in both groups during inpatient treatment. No differences were found concerning weight gain, improvement of global eating disorder symptomatology as well as depressive symptoms. However, adults showed a higher psychological distress and in this regard also a greater improvement. Results indicate that treating adolescent AN patients in a highly specialized eating disorder unit for adults can be an effective treatment setting for these patients.

Multimodality treatment of locally advanced squamous cell carcinoma of the oesophagus: A comprehensive review and network meta-analysis.

Science.gov (United States)

Montagnani, Francesco; Fornaro, Lorenzo; Frumento, Paolo; Vivaldi, Caterina; Falcone, Alfredo; Fioretto, Luisa

2017-06-01

Surgery is the mainstay of treatment for oesophageal squamous-cell carcinoma (OSCC) but with poor results. Attempts to improve patient outcome have been made by introducing chemotherapy (CT), radiotherapy (RT), or both (CRT). However, randomized comparisons for all these strategies are not always available. We conducted an extensive literature search for studies comparing surgery with multimodality treatment (i.e. [neo-]adjuvant CT or RT or CRT or definitive CRT). Network meta-analysis was performed in a Bayesian framewor and node-split models were built to assess inconsistency. Twenty-five trials including a total of 3866 OSCC patients were included. Neoadjuvant CRT was associated with the most robust survival advantage across different multimodality treatment options (HR 0.73; 95% credible interval [CrI] 0.63-0.86). Definitive CRT was also significantly more effective than surgery but with greater uncertainties (HR 0.62; 95%CrI 0.41-0.96). Neoadjuvant CT (HR 0.90; 95%CrI 0.76-1.07) and adjuvant CRT (HR 1.00; 95%CrI 0.70-1.40) are associated with a non-significant benefit. To date, neoadjuvant CRT seems to represent the best approach to maximize the benefit of a multimodality approach. Copyright © 2017 Elsevier B.V. All rights reserved.

Long-Term Outcomes of a Multimodal Day-Clinic Treatment for Chronic Pain under the Conditions of Routine Care

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Mira A. Preis

2018-01-01

Full Text Available Chronic pain has high prevalence rates and is one of the top causes of years lived with disability. The aim of the present study was to evaluate the long-term effects of a multimodal day-clinic treatment for chronic pain. The sample included 183 chronic pain patients (114 females and 69 males; 53.3 ± 9.8 years who participated in a four-week multimodal day-clinic treatment for chronic pain. The patients’ average current pain intensity (NRS, sensory and affective pain (Pain Perception Scale, and depression and anxiety (HADS were assessed at pre- and posttreatment, as well as at three follow-ups (one month, six months, and twelve months after completion of the treatment. Multilevel models for discontinuous change were performed to evaluate the change of the outcome variables. Improvements from pretreatment to posttreatment and from pretreatment to all follow-ups emerged for pain intensity (NRS; 0.54 ≤ d ≤ 0.74, affective pain (Pain Perception Scale; 0.24 ≤ d ≤ 0.47, depression (HADS; 0.38 ≤ d ≤ 0.53, and anxiety (HADS; 0.26 ≤ d ≤ 0.43 (all p<0.05. Sensory pain as assessed with the Pain Perception Scale did not show any significant change. Patients suffering from chronic pain benefited from the multimodal pain treatment up to twelve months after completion of the treatment.

MINERVA: A multi-modality plug-in-based radiation therapy treatment planning system

International Nuclear Information System (INIS)

Wemple, C. A.; Wessol, D. E.; Nigg, D. W.; Cogliati, J. J.; Milvich, M.; Fredrickson, C. M.; Perkins, M.; Harkin, G. J.; Hartmann-Siantar, C. L.; Lehmann, J.; Flickinger, T.; Pletcher, D.; Yuan, A.; DeNardo, G. L.

2005-01-01

Researchers at the INEEL, MSU, LLNL and UCD have undertaken development of MINERVA, a patient-centric, multi-modal, radiation treatment planning system, which can be used for planning and analysing several radiotherapy modalities, either singly or combined, using common treatment planning tools. It employs an integrated, lightweight plug-in architecture to accommodate multi-modal treatment planning using standard interface components. The design also facilitates the future integration of improved planning technologies. The code is being developed with the Java programming language for inter-operability. The MINERVA design includes the image processing, model definition and data analysis modules with a central module to coordinate communication and data transfer. Dose calculation is performed by source and transport plug-in modules, which communicate either directly through the database or through MINERVA's openly published, extensible markup language (XML)-based application programmer's interface (API). All internal data are managed by a database management system and can be exported to other applications or new installations through the API data formats. A full computation path has been established for molecular-targeted radiotherapy treatment planning, with additional treatment modalities presently under development. (authors)

Congenital peripheral primitive neuroectodermal tumor: A case treated successfully with multimodality treatment

International Nuclear Information System (INIS)

Goyal, Sh.; Biswas, A.; Mohanti, B.K.; Gupta, R.

2014-01-01

Neonatal tumors comprise less than two percent of childhood malignancies. Most are solid tumors, most common histologies being teratoma and neuroblastoma. We encountered a child who was detected to have a right arm mass on antenatal sonogram, which was diagnosed to be a primitive neuroectodermal tumor involving the triceps on fine needle aspiration cytology performed in the post-natal period. The child was successfully treated with multimodality treatment consisting of surgery, chemotherapy and radiotherapy. We also discuss briefly the problems associated with therapy in neonatal period. A review of all cases reported to have congenital Ewing’s sarcoma family of tumors is presented. Novel therapies are needed to improve efficacy and decrease the devastating side effects of treatment in this age group.

[Chronic pain patients' readiness to change after multimodal treatment. Short- and long-term effects].

Science.gov (United States)

Küchler, A; Sabatowski, R; Kaiser, U

2012-12-01

Patients' readiness to behavioural changes according to the transtheoretical model (TTM) and criteria of treatment outcome are positively associated and have in part already been confirmed. For a stable effect of therapeutic treatment, patients' readiness to change seems indispensable for an independent and active pain management. Thus, in addition to an enhanced quality of life, increasing patients' motivation is a declared objective of the treatment at Dresden's Comprehensive Pain Center. In this study, it was examined how the readiness to change develops in the course of and during the 2 years following the multimodal treatment program. Furthermore, associations between outcome criteria of the treatment and patients' readiness to change were explored. The database constitutes 169 patients who took part in a 4-week interdisciplinary, partially residential pain treatment. Beside the Freiburg Pain Stages questionnaire ("Frieburger Fragebogen - Stadien der Bewältigung chronischer Schmerzen", FF-STABS), a comprehensive pain diagnostic inventory including the Pain Disability Index (PDI), the SF-36 questionnaire, and the Hospital Anxiety and Depression Scale (HADS) was completed at six different time points (beginning of treatment, end of treatment, booster session after 10 weeks, after 6, 12, and 24 months). The statistical analyses were performed with SPSS 16.0 including nonparametric analyses and variance analyses. Significant differences in the level of readiness to change between the beginning of treatment and all follow-up measures were observed. The average patients' readiness to change was still higher after 2 years than at the first measurement. However, a differentiated consideration revealed a small portion of patients who showed no change or even a reduction of motivation. After an additional week (booster session), the stages of readiness to change remained stable, irrespective of the direction of the previous change. Regarding therapeutic outcome

[Acute inpatient conservative multimodal treatment of complex and multifactorial orthopedic diseases in the ANOA concept].

Science.gov (United States)

Psczolla, M

2013-10-01

In Germany there is a clear deficit in the non-operative treatment of chronic and complex diseases and pain disorders in acute care hospitals. Only about 20 % of the treatments are carried out in orthopedic hospitals. Hospitals specialized in manual medicine have therefore formed a working group on non-operative orthopedic manual medicine acute care clinics (ANOA). The ANOA has developed a multimodal assessment procedure called the OPS 8-977 which describes the structure and process quality of multimodal and interdisciplinary diagnosis and treatment of the musculoskeletal system. Patients are treated according to clinical pathways oriented on the clinical findings. The increased duration of treatment in the German diagnosis-related groups (DRG) system is compensated for with a supplemental remuneration. Thus, complex and multifactorial orthopedic diseases and pain disorders are conservatively and appropriately treated as inpatient departments of acute care hospitals.

[Hypothyroidism incidence after multimodal treatment for laryngeal cancer].

Science.gov (United States)

Ortega-Gutiérrez, César; Luna-Ortiz, Kuauhyama; Villavicencio-Valencia, Verónica; Herrera Gómez, Angel; Téllez-Palacios, Daniela; Contreras-Buendía, Marlen

2012-01-01

Hypothyroidism following total laryngectomy or radiotherapy treatment for laryngeal cancer is not a rare event, especially in advanced stages. There are no reports on the incidence of hypothyroidism in patients who received chemotherapy and radiotherapy. The objective of this study is to determine the incidence of thyroid dysfunction in a group of patients with laryngeal cancer who underwent surgery as sole treatment, total laryngectomy or radiotherapy alone, and patients with combined treatment: surgery plus radiotherapy, concomitant chemoradiation therapy and chemoradiation therapy plus salvage surgery. A prospective study of patients diagnosed with laryngeal cancer whose serum TSH and T4 levels were evaluated in a serial fashion. 70 patients with laryngeal cancer were studied; the average age at diagnosis was 70.2 years. Male patients were more affected, with a men-women ratio of 3.6:1. Glottic localization was the most frequent (44%). 64% of tumors were locally advanced carcinomas and 51% received multimodal treatment. 45 patients (63%) were diagnosed with hypothyroidism; 49% of the patients with subclinical hypothyroidism, and 51% with clinical hypothyroidism. Hypothyroidism is a complication following treatment for laryngeal cancer. It is recommended to evaluate the thyroid function periodically for timely detection.

Multimodal scanning laser ophthalmoscopy for image guided treatment of age-related macular degeneration

Science.gov (United States)

Hammer, Daniel X.; Ferguson, R. D.; Patel, Ankit H.; Iftimia, Nicusor V.; Mujat, Mircea; Husain, Deeba

2009-02-01

Subretinal neovascular membranes (SRNM) are a deleterious complication of laser eye injury and retinal diseases such as age-related macular degeneration (AMD), choroiditis, and myopic retinopathy. Photodynamic therapy (PDT) and anti-vascular endothelial growth factor (VEGF) drugs are approved treatment methods. PDT acts by selective dye accumulation, activation by laser light, and disruption and clotting of the new leaky vessels. However, PDT surgery is currently not image-guided, nor does it proceed in an efficient or automated manner. This may contribute to the high rate of re-treatment. We have developed a multimodal scanning laser ophthalmoscope (SLO) for automated diagnosis and image-guided treatment of SRNMs associated with AMD. The system combines line scanning laser ophthalmoscopy (LSLO), fluorescein angiography (FA), indocyanine green angiography (ICGA), PDT laser delivery, and retinal tracking in a compact, efficient platform. This paper describes the system hardware and software design, performance characterization, and automated patient imaging and treatment session procedures and algorithms. Also, we present initial imaging and tracking measurements on normal subjects and automated lesion demarcation and sizing analysis of previously acquired angiograms. Future pre-clinical testing includes line scanning angiography and PDT treatment of AMD subjects. The automated acquisition procedure, enhanced and expedited data post-processing, and innovative image visualization and interpretation tools provided by the multimodal retinal imager may eventually aid in the diagnosis, treatment, and prognosis of AMD and other retinal diseases.

Novel magnetic heating probe for multimodal cancer treatment.

Science.gov (United States)

Kan-Dapaah, Kwabena; Rahbar, Nima; Soboyejo, Wole

2015-05-01

Multifunctional materials consisting of polymers and magnetic nanoparticles (MNPs) are highly sought after in the field of biomedical engineering. These materials offer new opportunities for the development of novel cancer treatment modalities that can increase the efficacy of cancer therapy. In this paper, a novel probe for multimodal cancer treatment is proposed and analyzed. The probe is essentially a cannula with two main parts: a distal heat generating tip made of a magnetic nanocomposite and a proximal insulated shaft. A description of the concept and functional operations of the probe is presented. In an effort to assess its feasibility, the authors evaluated the ability of probe tip (made of PMMA-Fe3O4 nanocomposite) to generate heat in biological tissue using alternating magnetic field (AMF) parameters (field strength and frequency) that are acceptable for human use. Heat generation by MNPs was determined using the linear response theory. The effects of Fe3O4 volume fraction on heat generation as well as treatment time on the thermal dose were studied. The finite element method model was tested for its validity using an analytical model. Lesions were revealed to have an ellipsoidal shape and their sizes were affected by treatment time. However, their shapes remained unchanged. The comparison with the analytical model showed reasonably a good agreement to within 2%. Furthermore, the authors' numerical predictions also showed reasonable agreement with the experimental results previously reported in the literature. The authors' predictions demonstrate the feasibility of their novel probe to achieve reasonable lesion sizes, during hyperthermic or ablative heating using AMF parameters (field strength and frequency) that are acceptable for human use.

[Diagnostics and multimodal treatment of depression in old age : New developments].

Science.gov (United States)

Eschweiler, Gerhard W

2017-02-01

Depressive disorders in elderly persons are frequent and can either first be manifested at a younger age and show a recurrent pattern during later life (ICD 10, F33.*) or have an onset beyond 60 years, which is termed late onset depression (LOD). This LOD has a higher tendency to chronification and implies an increased risk of progression, especially to vascular dementia. The multifactorial genesis of depression in old age includes psychosocial, vascular and metabolic factors and requires multimodal therapy modules at the biological and psychosocial level, which is now increasingly being empirically proven. Depressive disorders with executive and cognitive deficits have to be considered a defined entity with respect to prognosis and treatment. As a first step of treatment watchful waiting is appropriate, especially in depressive adjustment disorders triggered by acute psychosocial stressors (e.g. loss of relatives and conflicts). After 2-4 weeks pharmacological antidepressant therapy should be initiated, at least in a moderate depressive episode. Furthermore, the revised national guidelines for depressive disorders also explicitly recommend psychotherapy as an alternative or supplement to pharmacotherapy in the elderly. Several forms of psychotherapy are emphasized: cognitive behavioral therapy, interpersonal therapy and in particular problem solving, as this is a form of treatment that can also be carried out by other professional groups, thus alleviating the treatment gap caused by the lack of psychotherapists. In summary, a depressive disorder in old age should not induce therapeutic nihilism: after stepped diagnostic assessments, multimodal therapies are individually adapted to the physical, cognitive and social resources of the patients.

Effects on functional outcome after IORT-containing multimodality treatment for locally advanced primary and locally recurrent rectal cancer

International Nuclear Information System (INIS)

Mannaerts, Guido H.H.; Rutten, Harm J.T.; Martijn, Hendrik; Hanssens, Patrick E.J.; Wiggers, Theo

2002-01-01

Purpose: In the treatment of patients with locally advanced primary or locally recurrent rectal cancer, much attention is focused on the oncologic outcome. Little is known about the functional outcome. In this study, the functional outcome after a multimodality treatment for locally advanced primary and locally recurrent rectal cancer is analyzed. Methods and Materials: Between 1994 and 1999, 55 patients with locally advanced primary and 66 patients with locally recurrent rectal cancer were treated with high-dose preoperative external beam irradiation, followed by extended surgery and intraoperative radiotherapy. To assess long-term functional outcome, all patients still alive (n = 97) were asked to complete a questionnaire regarding ongoing morbidity, as well as functional and social impairment. Seventy-six of the 79 patients (96%) returned the questionnaire. The median follow-up was 14 months (range: 4-60 months). Results: The questionnaire revealed fatigue in 44%, perineal pain in 42%, radiating pain in the leg(s) in 21%, walking difficulties in 36%, and voiding dysfunction in 42% of the patients as symptoms of ongoing morbidity. Functional impairment consisted of requiring help with basic activities in 15% and sexual inactivity in 56% of the respondents. Social handicap was demonstrated by loss of former lifestyle in 44% and loss of professional occupation in 40% of patients. Conclusions: As a result of multimodality treatment, the majority of these patients have to deal with long-term physical morbidity, the need for help with daily care, and considerable social impairment. These consequences must be weighed against the chance of cure if the patient is treated and the disability eventually caused by uncontrolled tumor progression if the patient is not treated. These potential drawbacks should be discussed with the patient preoperatively and taken into account when designing a treatment strategy

Multimodality treatment including postoperative radiation and concurrent chemotherapy with weekly docetaxel is feasible and effective in patients with oral and oropharyngeal cancer

International Nuclear Information System (INIS)

Kovacs, A.F.; Bitter, K.; Mose, S.; Boettcher, H.D.

2005-01-01

Background: to examine the feasibility and efficacy of weekly docetaxel with concurrent radiation as postoperative treatment in a multimodality approach to oral and oropharyngeal cancer. Patients and methods: 94 patients (Table 1) with primary resectable squamous cell carcinoma of the oral cavity and oropharynx (UICC stage I 14%, II 15%, III 18%, IV 53%; Table 2) were treated with a multimodality therapy program consisting of neoadjuvant intra-arterial high-dose chemotherapy (cisplatin 150 mg/m 2 with parallel systemic sodium thiosulfate 9 g/m 2 for neutralization), followed by surgery of the primary and neck, and postoperative concurrent radiation and chemotherapy with weekly docetaxel (20-30 mg/m 2 ; Table 3). Chronic toxicities were followed over a period of 5 years. Results: at a median follow-up of 4 years, the 5-year survival rate for all 94 patients was 80%, and disease-free survival was 73% (Figures 1 and 2). Among patients with advanced disease (stage III and IV), survival was 83 and 59%, respectively (Figure 4). Grade 3 and 4 mucositis was the main acute toxicity necessitating supportive care. Long-term toxicity appears to be moderate (Table 4). The maximum tolerated dose of weekly docetaxel was 25 mg/m 2 . Conclusions: concurrent radiation and chemotherapy with weekly docetaxel is a feasible postoperative treatment in a multimodality approach to oral and oropharyngeal cancer, resulting in high overall and disease-free survival. This approach warrants further evaluation in prospective randomized trials. (orig.)

Multimodal pain management after arthroscopic surgery

DEFF Research Database (Denmark)

Rasmussen, Sten

Multimodal Pain Management after Arthroscopic Surgery By Sten Rasmussen, M.D. The thesis is based on four randomized controlled trials. The main hypothesis was that multimodal pain treatment provides faster recovery after arthroscopic surgery. NSAID was tested against placebo after knee arthroscopy...

Bulimia nervosa symptoms in the multimodal treatment study of children with ADHD.

Science.gov (United States)

Mikami, Amori Yee; Hinshaw, Stephen P; Arnold, L Eugene; Hoza, Betsy; Hechtman, Lily; Newcorn, Jeffrey H; Abikoff, Howard B

2010-04-01

We investigated body image dissatisfaction and bingeing/purging characteristics of bulimia nervosa (BN) in the ongoing prospective follow-up of the Multimodal Treatment Study of Children with attention-deficit/hyperactivity disorder (ADHD). Participants were 337 boys and 95 girls with ADHD and 211 boys and 53 girls forming a local normative comparison group (LNCG), reassessed in midadolescence (mean age, 16.4), 8 years after original recruitment. Youth with childhood ADHD showed more BN symptoms in midadolescence than did LNCG youth, and girls demonstrated more BN symptoms than did boys, with effect sizes between small and medium. Childhood impulsivity, as opposed to hyperactivity or inattention, best predicted adolescent BN symptoms, particularly for girls. Among youth with ADHD, treatment received during the follow-up period was not associated with BN pathology. Both boys and girls with ADHD may be at risk for BN symptoms in adolescence because of the impulsivity central to both disorders.

Effects of Multimodal Presentation and Stimulus Familiarity on Auditory and Visual Processing

Science.gov (United States)

Robinson, Christopher W.; Sloutsky, Vladimir M.

2010-01-01

Two experiments examined the effects of multimodal presentation and stimulus familiarity on auditory and visual processing. In Experiment 1, 10-month-olds were habituated to either an auditory stimulus, a visual stimulus, or an auditory-visual multimodal stimulus. Processing time was assessed during the habituation phase, and discrimination of…

Multimodality therapy approaches, local and systemic treatment, compared with chemotherapy alone in recurrent glioblastoma

International Nuclear Information System (INIS)

Scorsetti, Marta; Navarria, Pierina; Pessina, Federico; Ascolese, Anna Maria; D’Agostino, Giuseppe; Tomatis, Stefano; De Rose, Fiorenza; Villa, Elisa; Maggi, Giulia; Simonelli, Matteo; Clerici, Elena; Soffietti, Riccardo; Santoro, Armando; Cozzi, Luca; Bello, Lorenzo

2015-01-01

Long-term local control in Glioblastoma is rarely achieved and nearly all patients relapse. In this study we evaluated the clinical effect of different treatment approaches in recurrent patients. Forty-three patients, with median age of 51 years were evaluated for salvage treatment: re-resection and/or re-irradiation plus chemotherapy or chemotherapy alone. Response was recorded using the Response Assessment in Neuro-Oncology criteria. Hematologic and non-hematologic toxicities were graded according to Common Terminology Criteria for Adverse Events 4.0. Twenty-one patients underwent chemotherapy combined with local treatment, surgery and/or radiation therapy, and 22 underwent chemotherapy only. The median follow up was 7 months (range 3–28 months). The 1 and 2-years Progression Free Survival was 65 and 10 % for combined treatment and 22 and 0 % for chemotherapy alone (p < 0.01). The 1 and 2-years overall survival was 69 and 29 % for combined and 26 and 0 % for chemotherapy alone (p < 0.01). No toxicity greater than grade 2 was recorded. These data showed that in glioblastoma recurrence the combination of several approaches in a limited group of patients is more effective than a single treatment alone. This stress the importance of multimodality treatment whenever clinically feasible

Patterns of failure after multimodal treatments for high-grade glioma: effectiveness of MIB-1 labeling index

International Nuclear Information System (INIS)

Uehara, Kazuyuki; Fujii, Osamu; Soejima, Toshinori; Sugimura, Kazuro; Kohmura, Eiji; Sasaki, Ryohei; Sasayama, Takashi; Miyawaki, Daisuke; Nishimura, Hideki; Yoshida, Kenji; Okamoto, Yoshiaki; Mukumoto, Naritoshi; Akasaka, Hiroaki; Nishihara, Masamitsu

2012-01-01

The purpose of the present study was to analyze the recurrence pattern of high-grade glioma treated with a multimodal treatment approach and to evaluate whether the MIB-1 labeling index (LI) could be a useful marker for predicting the pattern of failure in glioblastoma (GB). We evaluated histologically confirmed 131 patients with either anaplastic astrocytoma (AA) or GB. A median dose was 60 Gy. Concomitant and adjuvant chemotherapy were administered to 111 patients. MIB-1 LI was assessed by immunohistochemistry. Recurrence patterns were categorized according to the areas of recurrence as follows: central failure (recurrence in the 95% of 60 Gy); in-field (recurrence in the high-dose volume of 50 Gy; marginal (recurrence outside the high-dose volume) and distant (recurrence outside the RT field). The median follow-up durations were 13 months for all patients and 19 months for those remaining alive. Among AA patients, the 2-year progression-free and overall survival rates were 23.1% and 39.2%, respectively, while in GB patients, the rates were 13.3% and 27.6%, respectively. The median survival time was 20 months for AA patients and 15 months for GB patients. Among AA patients, recurrences were central in 68.7% of patients; in-field, 18.8%; and distant, 12.5%, while among GB patients, 69.0% of recurrences were central, 15.5% were in-field, 12.1% were marginal, and 3.4% were distant. The MIB-1 LI medians were 18.2% in AA and 29.8% in GB. Interestingly, in patients with GB, the MIB-1 LI had a strong effect on the pattern of failure (P = 0.014), while the extent of surgical removal (P = 0.47) and regimens of chemotherapy (P = 0.57) did not. MIB-1 LI predominantly affected the pattern of failure in GB patients treated with a multimodal approach, and it might be a useful tool for the management of the disease

Gastric Adenocarcinoma: A Multimodal Approach

Directory of Open Access Journals (Sweden)

Humair S. Quadri

2017-08-01

Full Text Available Despite its declining incidence, gastric cancer (GC remains a leading cause of cancer-related deaths worldwide. A multimodal approach to GC is critical to ensure optimal patient outcomes. Pretherapy fine resolution contrast-enhanced cross-sectional imaging, endoscopic ultrasound and staging laparoscopy play an important role in patients with newly diagnosed ostensibly operable GC to avoid unnecessary non-therapeutic laparotomies. Currently, margin negative gastrectomy and adequate lymphadenectomy performed at high volume hospitals remain the backbone of GC treatment. Importantly, adequate GC surgery should be integrated in the setting of a multimodal treatment approach. Treatment for advanced GC continues to expand with the emergence of additional lines of systemic and targeted therapies.

Effects of Multimodal Analgesia on the Success of Mouse Embryo Transfer Surgery

Science.gov (United States)

Parker, John M.; Austin, Jamie; Wilkerson, James; Carbone, Larry

2011-01-01

Multimodal analgesia is promoted as the best practice pain management for invasive animal research procedures. Universal acceptance and incorporation of multimodal analgesia requires assessing potential effects on study outcome. The focus of this study was to assess effects on embryo survival after multimodal analgesia comprising an opioid and nonsteroidal antiinflammatory drug (NSAID) compared with opioid-only analgesia during embryo transfer procedures in transgenic mouse production. Mice were assigned to receive either carprofen (5 mg/kg) with buprenorphine (0.1 mg/kg; CB) or vehicle with buprenorphine (0.1 mg/kg; VB) in a prospective, double-blinded placebo controlled clinical trial. Data were analyzed in surgical sets of 1 to 3 female mice receiving embryos chimeric for a shared targeted embryonic stem-cell clone and host blastocyst cells. A total of 99 surgical sets were analyzed, comprising 199 Crl:CD1 female mice and their 996 offspring. Neither yield (pups weaned per embryo implanted in the surgical set) nor birth rate (average number of pups weaned per dam in the set) differed significantly between the CB and VB conditions. Multimodal opioid–NSAID analgesia appears to have no significant positive or negative effect on the success of producing novel lines of transgenic mice by blastocyst transfer. PMID:21838973

Severe Speech Sound Disorders: An Integrated Multimodal Intervention

Science.gov (United States)

King, Amie M.; Hengst, Julie A.; DeThorne, Laura S.

2013-01-01

Purpose: This study introduces an integrated multimodal intervention (IMI) and examines its effectiveness for the treatment of persistent and severe speech sound disorders (SSD) in young children. The IMI is an activity-based intervention that focuses simultaneously on increasing the "quantity" of a child's meaningful productions of target words…

Fractures after multimodality treatment of soft tissue sarcomas with isolated limb perfusion and radiation; likely to occur and hard to heal.

Science.gov (United States)

Seinen, J M; Jutte, P C; Been, L B; Pras, E; Hoekstra, H J

2018-04-24

Treatment associated fractures (TAFs) are known severe side effects after surgery and radiotherapy for soft tissue sarcoma (STS). There is no literature about TAF after multimodality treatment with isolated limb perfusion (ILP) for locally advanced STS. This study aimed to analyze predictive factors, treatment and outcome for TAF after multimodality treatment with ILP. Out of 126 consecutive patients undergoing ILP after 1991 till now, 25 patients were excluded due to no surgery or direct amputation at initial surgery. Therefore, 101 patients were at risk and 12 developed a TAF (12%). The majority of tumors was located at the upper leg and knee (N = 60), and 11 patients developed a TAF (18%) after median 28 (5-237) months. Twenty-five tumors were located at the lower leg, and 1 patient developed a TAF after 12 months (4%). No patients with a tumor at the upper extremities (N = 16) developed a TAF. Ten out of 12 patients with a fracture received adjuvant RT with a dose of 50 Gy, and a median boost dose of 18 (10-20) Gy. Predictive factors were periosteal stripping, age over 65 years at time of treatment and tumor size after ILP ≥10 cm. Multivariate analysis showed periosteal stripping and tumor size after ILP ≥10 cm as significant predictive factors. The majority of the fractures were treated with intramedullary nailing. Only one of 12 patients without radiotherapy reached bone union (8%). The median survival after developing TAF was 18 (1-195) months. The overall risk of TAF after multimodality treatment with ILP was relatively high with 15% at ten years. The incidence of TAF for patients with tumors located at the thigh and knee after resection with periosteal stripping and radiotherapy was even >50%. The treatment of these fractures is challenging due to the high non-union rate, requiring an extensive orthopedic oncological TAF experience. Copyright © 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical

Adolescent substance use in the multimodal treatment study of attention-deficit/hyperactivity disorder (ADHD) (MTA) as a function of childhood ADHD, random assignment to childhood treatments, and subsequent medication.

Science.gov (United States)

Molina, Brooke S G; Hinshaw, Stephen P; Eugene Arnold, L; Swanson, James M; Pelham, William E; Hechtman, Lily; Hoza, Betsy; Epstein, Jeffery N; Wigal, Timothy; Abikoff, Howard B; Greenhill, Laurence L; Jensen, Peter S; Wells, Karen C; Vitiello, Benedetto; Gibbons, Robert D; Howard, Andrea; Houck, Patricia R; Hur, Kwan; Lu, Bo; Marcus, Sue

2013-03-01

To determine long-term effects on substance use and substance use disorder (SUD), up to 8 years after childhood enrollment, of the randomly assigned 14-month treatments in the multisite Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (MTA; n = 436); to test whether medication at follow-up, cumulative psychostimulant treatment over time, or both relate to substance use/SUD; and to compare substance use/SUD in the ADHD sample to the non-ADHD childhood classmate comparison group (n = 261). Mixed-effects regression models with planned contrasts were used for all tests except the important cumulative stimulant treatment question, for which propensity score matching analysis was used. The originally randomized treatment groups did not differ significantly on substance use/SUD by the 8-year follow-up or earlier (mean age = 17 years). Neither medication at follow-up (mostly stimulants) nor cumulative stimulant treatment was associated with adolescent substance use/SUD. Substance use at all time points, including use of two or more substances and SUD, were each greater in the ADHD than in the non-ADHD samples, regardless of sex. Medication for ADHD did not protect from, or contribute to, visible risk of substance use or SUD by adolescence, whether analyzed as randomized treatment assignment in childhood, as medication at follow-up, or as cumulative stimulant treatment over an 8-year follow-up from childhood. These results suggest the need to identify alternative or adjunctive adolescent-focused approaches to substance abuse prevention and treatment for boys and girls with ADHD, especially given their increased risk for use and abuse of multiple substances that is not improved with stimulant medication. Clinical trial registration information-Multimodal Treatment Study of Children With Attention Deficit and Hyperactivity Disorder (MTA); http://clinical trials.gov/; NCT00000388. Copyright © 2013 American Academy of Child and Adolescent

Learning multimodal dictionaries.

Science.gov (United States)

Monaci, Gianluca; Jost, Philippe; Vandergheynst, Pierre; Mailhé, Boris; Lesage, Sylvain; Gribonval, Rémi

2007-09-01

Real-world phenomena involve complex interactions between multiple signal modalities. As a consequence, humans are used to integrate at each instant perceptions from all their senses in order to enrich their understanding of the surrounding world. This paradigm can be also extremely useful in many signal processing and computer vision problems involving mutually related signals. The simultaneous processing of multimodal data can, in fact, reveal information that is otherwise hidden when considering the signals independently. However, in natural multimodal signals, the statistical dependencies between modalities are in general not obvious. Learning fundamental multimodal patterns could offer deep insight into the structure of such signals. In this paper, we present a novel model of multimodal signals based on their sparse decomposition over a dictionary of multimodal structures. An algorithm for iteratively learning multimodal generating functions that can be shifted at all positions in the signal is proposed, as well. The learning is defined in such a way that it can be accomplished by iteratively solving a generalized eigenvector problem, which makes the algorithm fast, flexible, and free of user-defined parameters. The proposed algorithm is applied to audiovisual sequences and it is able to discover underlying structures in the data. The detection of such audio-video patterns in audiovisual clips allows to effectively localize the sound source on the video in presence of substantial acoustic and visual distractors, outperforming state-of-the-art audiovisual localization algorithms.

A multimodal communication program for aphasia during inpatient rehabilitation: A case study.

Science.gov (United States)

Wallace, Sarah E; Purdy, Mary; Skidmore, Elizabeth

2014-01-01

Communication is essential for successful rehabilitation, yet few aphasia treatments have been investigated during the acute stroke phase. Alternative modality use including gesturing, writing, or drawing has been shown to increase communicative effectiveness in people with chronic aphasia. Instruction in alternative modality use during acute stroke may increase patient communication and participation, therefore resulting in fewer adverse situations and improved rehabilitation outcomes. The study purpose was to explore a multimodal communication program for aphasia (MCPA) implemented during acute stroke rehabilitation. MCPA aims to improve communication modality production, and to facilitate switching among modalities to resolve communication breakdowns. Two adults with severe aphasia completed MCPA beginning at 2 and 3 weeks post onset a single left-hemisphere stroke. Probes completed during each session allowed for evaluation of modality production and modality switching accuracy. Participants completed MCPA (10 and 14 treatment sessions respectively) and their performance on probes suggested increased accuracy in the production of various alternate communication modalities. However, increased switching to an alternate modality was noted for only one participant. Further investigation of multimodal treatment during inpatient rehabilitation is warranted. In particular, comparisons between multimodal and standard treatments would help determine appropriate interventions for this setting.

Recent developments in multimodality fluorescence imaging probes

Directory of Open Access Journals (Sweden)

Jianhong Zhao

2018-05-01

Full Text Available Multimodality optical imaging probes have emerged as powerful tools that improve detection sensitivity and accuracy, important in disease diagnosis and treatment. In this review, we focus on recent developments of optical fluorescence imaging (OFI probe integration with other imaging modalities such as X-ray computed tomography (CT, magnetic resonance imaging (MRI, positron emission tomography (PET, single-photon emission computed tomography (SPECT, and photoacoustic imaging (PAI. The imaging technologies are briefly described in order to introduce the strengths and limitations of each techniques and the need for further multimodality optical imaging probe development. The emphasis of this account is placed on how design strategies are currently implemented to afford physicochemically and biologically compatible multimodality optical fluorescence imaging probes. We also present studies that overcame intrinsic disadvantages of each imaging technique by multimodality approach with improved detection sensitivity and accuracy. KEY WORDS: Optical imaging, Fluorescence, Multimodality, Near-infrared fluorescence, Nanoprobe, Computed tomography, Magnetic resonance imaging, Positron emission tomography, Single-photon emission computed tomography, Photoacoustic imaging

A comprehensive multimodal pain treatment reduces opioid consumption after multilevel spine surgery

DEFF Research Database (Denmark)

Mathiesen, Ole; Dahl, Benny; Thomsen, Berit A

2013-01-01

and postoperative nausea and vomiting (PONV) treatment protocol would improve pain treatment in this population. METHODS: A new regimen with acetaminophen, NSAIDs, gabapentin, S-ketamine, dexamethasone, ondansetron and epidural local anesthetic infusion or patient controlled analgesia with morphine, was introduced......PURPOSE: Major spine surgery with multilevel instrumentation is followed by large amount of opioid consumption, significant pain and difficult mobilization in a population of predominantly chronic pain patients. This case-control study investigated if a standardized comprehensive pain...... and dizziness on POD 1-6. CONCLUSIONS: In this study of patients scheduled for multilevel spine surgery, it was demonstrated that compared to a historic group of patients receiving usual care, a comprehensive and standardized multimodal pain and PONV protocol significantly reduced opioid consumption, improved...

When to Intervene in Selective Mutism: The Multimodal Treatment of a Case of Persistent Selective Mutism.

Science.gov (United States)

Powell, Shawn; Dalley, Mahlono

1995-01-01

An identification and treatment model differentiating transient mutism from persistent selective mutism is proposed. The case study of a six-year-old girl is presented, who was treated with a multimodal approach combining behavioral techniques with play therapy and family involvement. At posttreatment and follow-up, she was talking in a manner…

Reflection effects in multimode fiber systems utilizing laser transmitters

Science.gov (United States)

Bates, Harry E.

1991-11-01

A number of optical communication lines are now in use at NASA-Kennedy for the transmission of voice, computer data, and video signals. Now, all of these channels use a single carrier wavelength centered near 1300 or 1550 nm. Engineering tests in the past have given indications of the growth of systematic and random noise in the RF spectrum of a fiber network as the number of connector pairs is increased. This noise seems to occur when a laser transmitter is used instead of a LED. It has been suggested that the noise is caused by back reflections created at connector fiber interfaces. Experiments were performed to explore the effect of reflection on the transmitting laser under conditions of reflective feedback. This effort included computer integration of some of the instrumentation in the fiber optic lab using the Lab View software recently acquired by the lab group. The main goal was to interface the Anritsu Optical and RF spectrum analyzers to the MacIntosh II computer so that laser spectra and network RF spectra could be simultaneously and rapidly acquired in a form convenient for analysis. Both single and multimode fiber is installed at Kennedy. Since most are multimode, this effort concentrated on multimode systems.

Multimodal analgesic treatment in video-assisted thoracic surgery lobectomy using an intraoperative intercostal catheter

DEFF Research Database (Denmark)

Wildgaard, Kim; Petersen, Rene H; Hansen, Henrik J

2012-01-01

OBJECTIVES: No golden standard for analgesia in video-assisted thoracic surgery (VATS) lobectomy exists. A simple multimodal approach using an intercostal catheter (ICC) may be of benefit since acute post-operative pain following VATS lobectomy primarily originates from the chest drain area......) and inserted an ICC at the drain site level for continuous delivery of 6 ml of 0.25% bupivacaine h(-1). Pain scores at rest, mobilization and with the extended arms were followed until discharge or for 4 days. RESULTS: Forty-eight patients, mean age 64 years (CI: 61-68), were included. The mean time...... for the PVB and ICC placement was 5 min (CI: 4.7-5.9). The mean pain score at rest using a numerical rating scale (NRS, 0-10) was 85% of patients reporting satisfactory or very satisfactory pain treatment all days. CONCLUSIONS: Acute pain after VATS lobectomy may be adequately controlled using a multimodal...

Manual Therapy, Therapeutic Patient Education, and Therapeutic Exercise, an Effective Multimodal Treatment of Nonspecific Chronic Neck Pain: A Randomized Controlled Trial.

Science.gov (United States)

Beltran-Alacreu, Hector; López-de-Uralde-Villanueva, Ibai; Fernández-Carnero, Josué; La Touche, Roy

2015-10-01

The aim of this study was to determine the effectiveness of a multimodal treatment in the short and medium term for disability in nonspecific chronic neck pain. The design of this study is a single-blinded randomized controlled trial carried out in a university research laboratory. Forty-five patients between 18 and 65 yrs with nonspecific chronic neck pain were included in this study. Each patient was treated eight times over a 4-wk period. The sample was divided into three groups: control group, subjected to a protocol of manual therapy; experimental group 1, subjected to a protocol of manual therapy and therapeutic patient education; and experimental group 2, subjected to manual therapy, therapeutic patient education, and a therapeutic exercise protocol. Assessments were performed at baseline and at 4, 8, and 16 wks using the following measurements: the Neck Disability Index, the 11-item Tampa Scale of Kinesiophobia, the Fear Avoidance Beliefs Questionnaire, the Neck Flexor Muscle Endurance Test, and the Visual Analog Fatigue Scale. The nonparametric Kruskal-Wallis test for the Neck Disability Index showed statistically significant differences between baseline outcomes and all follow-up periods (P Kruskal-Wallis test, differences were found for the Visual Analog Fatigue Scale and the Neck Flexor Muscle Endurance Test in the follow-ups at 8 and 16 wks (P < 0.05). Analysis of variance for group × time interaction showed statistically significant changes (Tampa Scale of Kinesiophobia, F = 3.613, P = 0.005; Fear Avoidance Beliefs Questionnaire, F = 2.803, P = 0.022). Minimal detectable changes were obtained in both experimental groups for the 11-item Tampa Scale of Kinesiophobia but not in the control group. Differences between experimental groups and the control group were found in the short and medium term. A multimodal treatment is a good method for reducing disability in patients with nonspecific chronic neck pain in the short and medium term.

Effective dose for patient in multimode panoramic radiography

International Nuclear Information System (INIS)

Yasaki, Shiro; Daibo, Motoji

1999-01-01

In recent years, multimode panoramic radiography has had various functions, such as the auto exposure function, auto focus function (auto function), TMJ radiography and tomogram radiography functions. The purpose of this study was to estimate the effective dose for patients in each mode of the new multimode panoramic radiography (J. MORITA MFG. CORP. Dental Panorama X-ray Apparatus: Veraview Scope X 600). The absorbed doses in important organs involved in the causation of stochastic effects were measured by a thermoluminescent dosimeter using RANDO phantom. The effective doses were calculated using modified tissue weighting factors recommended by the International Commission on Radiological Protection (ICRP) in 1999. The mean field size over skin in typical panoramic and tomographic examinations was about 3% and 0.4% of the total body surface area of 15000 cm 2 . Assuming that the incidence of skin cancer is proportional to the area of skin exposed to ionizing radiation, the tissue weighting factor of skin can be estimated to be about 0.0003 and 0.00004. The estimate in effective dose was lower (5.3 μSv) in the panoramic auto function mode (an average exposure condition of 69 kV 7 mA) than that (6.5-13.8 μSv) in the linear tomogram modes. Since the linear tomogram mode requires a scout view, such as standard panoramic radiography, the dose in the linear tomogram mode becomes higher than other modes. A percentage of gonad doses in effective doses was negligible. (author)

Gadolinium oxysulfide nanoprobes with both persistent luminescent and magnetic properties for multimodal imaging

OpenAIRE

ROSTICHER , C.; Viana , Bruno; Fortin , M.-A.; Lagueux , J.; Faucher , L.; Chanéac , Corinne

2016-01-01

International audience; Persistent luminescence and magnetic properties of Gd2O2S: Eu 3+ , Ti 4+ , Mg 2+ nanoparticles have been studied to attest the relevance of such nanoparticles as nanoprobes for multimodal imaging. The development of new imaging tools is required to improve the quality of medical images and then to diagnose some disorders as quickly as possible in order to ensure more effective treatment. Multimodal imaging agents here developed combine the high resolution abilities of ...

Reading in the Australian Curriculum English: Describing the Effects of Structure and Organisation on Multimodal Texts

Science.gov (United States)

Exley, Beryl; Cottrell, Amber

2012-01-01

The recently introduced "Australian Curriculum: English" (Australian Curriculum, Assessment and Reporting Authority (ACARA), 2012) requires students to "read" multimodal text and describe the effects of structure and organisation. We begin this article by tracing the variable understandings of what reading multimodal text might…

A Multimodal Communication Program for Aphasia during Inpatient Rehabilitation: A Case Study

Science.gov (United States)

Wallace, Sarah E.; Purdy, Mary; Skidmore, Elizabeth

2014-01-01

BACKGROUND Communication is essential for successful rehabilitation, yet few aphasia treatments have been investigated during the acute stroke phase. Alternative modality use including gesturing, writing, or drawing has been shown to increase communicative effectiveness in people with chronic aphasia. Instruction in alternative modality use during acute stroke may increase patient communication and participation, therefore resulting in fewer adverse situations and improved rehabilitation outcomes. OBJECTIVE The study purpose was to explore a multimodal communication program for aphasia (MCPA) implemented during acute stroke rehabilitation. MCPA aims to improve communication modality production, and to facilitate switching among modalities to resolve communication breakdowns. METHODS Two adults with severe aphasia completed MCPA beginning at 2 and 3 weeks post onset a single left-hemisphere stroke. Probes completed during each session allowed for evaluation of modality production and modality switching accuracy. RESULTS Participants completed MCPA (10 and 14 treatment sessions respectively) and their performance on probes suggested increased accuracy in the production of various alternate communication modalities. However, increased switching to an alternate modality was noted for only one participant. CONCLUSIONS Further investigation of multimodal treatment during inpatient rehabilitation is warranted. In particular, comparisons between multimodal and standard treatments would help determine appropriate interventions for this setting. PMID:25227547

Effects of Multimodal Information on Learning Performance and Judgment of Learning

Science.gov (United States)

Chen, Gongxiang; Fu, Xiaolan

2003-01-01

Two experiments were conducted to investigate the effects of multimodal information on learning performance and judgment of learning (JOL). Experiment 1 examined the effects of representation type (word-only versus word-plus-picture) and presentation channel (visual-only versus visual-plus-auditory) on recall and immediate-JOL in fixed-rate…

Multimodality Registration without a Dedicated Multimodality Scanner

Directory of Open Access Journals (Sweden)

Bradley J. Beattie

2007-03-01

Full Text Available Multimodality scanners that allow the acquisition of both functional and structural image sets on a single system have recently become available for animal research use. Although the resultant registered functional/structural image sets can greatly enhance the interpretability of the functional data, the cost of multimodality systems can be prohibitive, and they are often limited to two modalities, which generally do not include magnetic resonance imaging. Using a thin plastic wrap to immobilize and fix a mouse or other small animal atop a removable bed, we are able to calculate registrations between all combinations of four different small animal imaging scanners (positron emission tomography, single-photon emission computed tomography, magnetic resonance, and computed tomography [CT] at our disposal, effectively equivalent to a quadruple-modality scanner. A comparison of serially acquired CT images, with intervening acquisitions on other scanners, demonstrates the ability of the proposed procedures to maintain the rigidity of an anesthetized mouse during transport between scanners. Movement of the bony structures of the mouse was estimated to be 0.62 mm. Soft tissue movement was predominantly the result of the filling (or emptying of the urinary bladder and thus largely constrained to this region. Phantom studies estimate the registration errors for all registration types to be less than 0.5 mm. Functional images using tracers targeted to known structures verify the accuracy of the functional to structural registrations. The procedures are easy to perform and produce robust and accurate results that rival those of dedicated multimodality scanners, but with more flexible registration combinations and while avoiding the expense and redundancy of multimodality systems.

A multimodal parallel architecture: A cognitive framework for multimodal interactions.

Science.gov (United States)

Cohn, Neil

2016-01-01

Human communication is naturally multimodal, and substantial focus has examined the semantic correspondences in speech-gesture and text-image relationships. However, visual narratives, like those in comics, provide an interesting challenge to multimodal communication because the words and/or images can guide the overall meaning, and both modalities can appear in complicated "grammatical" sequences: sentences use a syntactic structure and sequential images use a narrative structure. These dual structures create complexity beyond those typically addressed by theories of multimodality where only a single form uses combinatorial structure, and also poses challenges for models of the linguistic system that focus on single modalities. This paper outlines a broad theoretical framework for multimodal interactions by expanding on Jackendoff's (2002) parallel architecture for language. Multimodal interactions are characterized in terms of their component cognitive structures: whether a particular modality (verbal, bodily, visual) is present, whether it uses a grammatical structure (syntax, narrative), and whether it "dominates" the semantics of the overall expression. Altogether, this approach integrates multimodal interactions into an existing framework of language and cognition, and characterizes interactions between varying complexity in the verbal, bodily, and graphic domains. The resulting theoretical model presents an expanded consideration of the boundaries of the "linguistic" system and its involvement in multimodal interactions, with a framework that can benefit research on corpus analyses, experimentation, and the educational benefits of multimodality. Copyright © 2015.

Current state of the art, multimodality research and future visions for the treatment of patients with prostate cancer: consensus results from "Challenges and Chances in Prostate Cancer Research Meeting 2013".

Science.gov (United States)

Combs, Stephanie E; Debus, Jürgen; Feick, Günter; Hadaschik, Boris; Hohenfellner, Markus; Schüle, Roland; Zacharias, Jens-Peter; Schwardt, Malte

2014-11-04

A brainstorming and consensus meeting organized by the German Cancer Aid focused on modern treatment of prostate cancer and promising innovative techniques and research areas. Besides optimization of screening algorithms, molecular-based stratification and individually tailored treatment regimens will be the future of multimodal prostate cancer management. Effective interdisciplinary structures, including biobanking and data collection mechanisms are the basis for such developments.

Comparative Study of Multimodal and Pharmacological Therapy in Treating School Aged Children with ADHD

Directory of Open Access Journals (Sweden)

Susana Bogdana MILEA

2012-09-01

Full Text Available The attention deficit hyperactivity disorder (ADHD, one of the most commonly diagnosed psychiatric disorders among school aged children, continues to create disputes between specialists, upon the best treatment to be used. The herby study aims to bring forward some differences that may exist between the efficacy of the multimodal treatment compared to the drug treatment of ADHD. The novelty component of this study, unfolded February 2010-July 2012, is that the children, their parents and also their teachers were included in the multimodality treatment. The children included in this research (n=63, aged 6-14 and ADHD diagnosed, were randomly assigned in two groups. In the medication (Med group (n=32 the children only received the specific pharmacological treatment (Atomoxetine or Methylphenidate, and for the multimodality (MM group (n=31 the therapy included psychosocial interventions besides the drug therapy. All children were evaluated, both pre and post intervention, with the Achenbach System of Empirically Based Assessment – ASEBA, for the 6-18 aged category. We have compared the influence of therapy on the core symptoms, on the adaptive functionality and academic performance and on the competences and social functioning of the children in the two groups. The multimodal intervention proved to be more effective (p<0.05 than medication alone, firstly in ameliorating the child’s social behavior in both family and school environment, than in what concerns the main ADHD symptoms. The children’s academic performance was little impacted by either of the two therapies.

Multimodal surveillance sensors, algorithms, and systems

CERN Document Server

Zhu, Zhigang

2007-01-01

From front-end sensors to systems and environmental issues, this practical resource guides you through the many facets of multimodal surveillance. The book examines thermal, vibration, video, and audio sensors in a broad context of civilian and military applications. This cutting-edge volume provides an in-depth treatment of data fusion algorithms that takes you to the core of multimodal surveillance, biometrics, and sentient computing. The book discusses such people and activity topics as tracking people and vehicles and identifying individuals by their speech.Systems designers benefit from d

Outcome of multimodality treatment of Ewing′s sarcoma of the extremities

Directory of Open Access Journals (Sweden)

Tiwari Akshay

2010-01-01

Full Text Available Background: The management of Ewing′s sarcoma family of tumors (ESFT, Ewing′s sarcoma/primitive neuroectodermal tumor has been established as a multimodality treatment. Advances in imaging and diagnostics, chemotherapy, surgical techniques, radiotherapy and prosthetic technology have resulted in drastic changes in the outcome of this disease, with most of the recent studies having 5-year survival rates of more than 60%. The Indian patients present at a more advanced stage and the compliance of treatment is suboptimal. While there is plenty of data in the world literature on the outcome of Ewing′s sarcoma, there is paucity of data in Indian patients. Therefore, we conducted the present study to analyze the outcome of multimodality treatment of ESFT of the extremities at a tertiary nonprofit institute over a decade. Materials and Methods: 34 patients who had histopathologically proven diagnosis of Ewing′s sarcoma of the extremities and had received treatment at our institute from 1997 through 2007 were included for analysis. The majority of patients had involvement of the femur (35%, followed by tibia (17%, fibula and foot (15% each, humerus (12% and soft tissue of thigh (6%. Twenty-nine patients presented with localized disease (Enneking stage II B while five patients presented with metastases (Enneking stage III. All patients received Vincristine, Actinomycine D, Cyclofosfamide + Ifosfamide and Etoposide (VAC+IE-based chemotherapy and local treatment was offered to all but three patients having multicentric disease. The local treatment offered were, radiation (n= 15, surgery (n= 12 both surgery and radiation (n=4. All patients were analyzed for oncological outcome (event-free and overall survival, local and systemic relapses by clinical and imaging evaluation and functional outcome by using the musculoskeletal tumor society (MSTS score. These outcomes were correlated with age, sex, size of tumor, stage at presentation, modality of local

Multimodal treatment in difficult sialolithiasis: Role of extracorporeal shock-wave lithotripsy and intraductal pneumatic lithotripsy.

Science.gov (United States)

Koch, Michael; Schapher, Mirco; Mantsopoulos, Konstantinos; von Scotti, Felix; Goncalves, Miguel; Iro, Heinrich

2017-12-15

To assess results after treatment of difficult/complex sialolithiasis with extracorporeal shock-wave lithotripsy (ESWL) and intraductal pneumatic lithotripsy (IPL). Retrospective study in a tertiary referral center. Altogether, 63 stones were diagnosed in 38 patients with difficult/complex sialolithiasis. Forty-nine stones were treated with fragmentation using both ESWL and IPL. Stones accessible with the sialendoscope were treated primarily with IPL in multiple sialolithiasis. Seventy-one ESWL procedures and 57 IPL were performed in our patients. Forty-nine stones were treated by 67 ESWL procedures and 52 IPL. ESWL converted sialoliths from sialendoscopically untreatable into sialendoscopically treatable cases in 94.7%; the treatment then was completed by a total of 52 IPL procedures. ESWL was performed before IPL (81.6%), in combination with IPL (7.9%) and after (10.5%). Complete fragmentation was achieved in 97.9%. Four stones each were treated with ESWL and IPL alone in multiple sialolithiasis. Altogether, 53 stones were treated by 57 IPL procedures. Complete fragmentation was achieved in 98.1% of the 53 stones. ESWL and IPL were the dominant treatment modalities in 84.1% of all 63 stones treated. Of all 38 patients, 92.1% became stone-free and all became symptom-free. All the glands were preserved. Multiple stones were treated in 34.2% of the patients; of these, 92.3% became stone-free. These results show that patients with difficult and complex sialolithiasis can be treated with high success rates of > 90% using a multimodal, minimally invasive, and gland-preserving treatment approach. ESWL and IPL played a key role in this multimodal treatment regime in > 80% of stones. 4. Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Effectiveness of a multimodal hand hygiene improvement strategy in the emergency department.

Science.gov (United States)

Arntz, P R H; Hopman, J; Nillesen, M; Yalcin, E; Bleeker-Rovers, C P; Voss, A; Edwards, M; Wei, A

2016-11-01

Hand hygiene (HH) is essential in preventing nosocomial infection. The emergency department (ED) is an open portal of entry for pathogens into the hospital system, hence the important sentinel function of the ED personnel. The main objective of this study was to assess the effect of a multimodal improvement strategy on hand hygiene compliance in the ED. Our study was a prospective before-and-after study to determine the effect of a multimodal improvement strategy on the compliance of HH in the ED according to the My 5 Moments of Hand Hygiene defined by the World Health Organization. Interventions such as education, reminders, and regular feedback on HH performance and role models were planned during the 3 intervention weeks. In total, 57 ED nurses and ED physicians were observed in this study, and approximately 1,000 opportunities for handrubs were evaluated during the 3 intervention periods. HH compliance increased significantly from baseline from 18% (74/407) to 41% (77/190) after the first intervention and stabilized to 50% (99/200) and 46% (96/210) after the second and third interventions, respectively. Implementing a multimodal HH improvement program significantly improved the HH compliance of ED personnel. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

超激光疗法在骨科术后多模式镇痛的临床应用分析%Multimodal effect of ultra laser treatment on theperioperative analgesia in orthopaedic surgery

Institute of Scientific and Technical Information of China (English)

覃旭; 赵新

2013-01-01

Objective To investigate the ultra laser treatment ( physical therapy ) on orthopaedic postoperative pain suppression of synergies. Methods 60 cases of postoperative orthopedic patients were randomly divided into multimodal analgesia group ( experimental group) and group PCA (control group ) , the experimental group patients after the use of laser therapy, the ? control group patients not using other physical factors of analgesia. Using a visual analogue pain scale method ( VAS) were performed after 4 to 48 hours each time on patients with pain score, statistically analyses of variance. Results using the ultra laser treatment of multimodal analgesia in postoperative except 4h and 8h two time periods and epidural analgesia effect is better than that of control group. Conclusion Laser in postoperative analgesia after orthopedic surgery have obvious synergistic effect, with fast, efficient, spasmolytic analgesic effect. The therapeutic mechanism and mode of physical therapy of multimodal analgesia remains to be further investigated.%目的 探讨超激光疗法(物理因子疗法)时骨科术后疼痛抑制的协同作用.方法 选取60例骨科术后患者随机分为多模式镇痛组(实验组)和PCA组(对照组),对照组术后使用一次性静脉微量镇痛泵,实验组在对照组的基础上加用超激光治疗,采用视觉模拟疼痛标尺法(VAS)分别于术后分时点对患者做疼痛评分.结果 术后4h、8h两组评分差异无统计学意义,其余时点实验组评分低于对照组.结论 超激光在骨科术后镇痛有明显协同效应.

Acoustic multimode interference and self-imaging phenomena realized in multimodal phononic crystal waveguides

International Nuclear Information System (INIS)

Zou, Qiushun; Yu, Tianbao; Liu, Jiangtao; Wang, Tongbiao; Liao, Qinghua; Liu, Nianhua

2015-01-01

We report an acoustic multimode interference effect and self-imaging phenomena in an acoustic multimode waveguide system which consists of M parallel phononic crystal waveguides (M-PnCWs). Results show that the self-imaging principle remains applicable for acoustic waveguides just as it does for optical multimode waveguides. To achieve the dispersions and replicas of the input acoustic waves produced along the propagation direction, we performed the finite element method on M-PnCWs, which support M guided modes within the target frequency range. The simulation results show that single images (including direct and mirrored images) and N-fold images (N is an integer) are identified along the propagation direction with asymmetric and symmetric incidence discussed separately. The simulated positions of the replicas agree well with the calculated values that are theoretically decided by self-imaging conditions based on the guided mode propagation analysis. Moreover, the potential applications based on this self-imaging effect for acoustic wavelength de-multiplexing and beam splitting in the acoustic field are also presented. (paper)

On the effects of multimodal information integration in multitasking.

Science.gov (United States)

Stock, Ann-Kathrin; Gohil, Krutika; Huster, René J; Beste, Christian

2017-07-07

There have recently been considerable advances in our understanding of the neuronal mechanisms underlying multitasking, but the role of multimodal integration for this faculty has remained rather unclear. We examined this issue by comparing different modality combinations in a multitasking (stop-change) paradigm. In-depth neurophysiological analyses of event-related potentials (ERPs) were conducted to complement the obtained behavioral data. Specifically, we applied signal decomposition using second order blind identification (SOBI) to the multi-subject ERP data and source localization. We found that both general multimodal information integration and modality-specific aspects (potentially related to task difficulty) modulate behavioral performance and associated neurophysiological correlates. Simultaneous multimodal input generally increased early attentional processing of visual stimuli (i.e. P1 and N1 amplitudes) as well as measures of cognitive effort and conflict (i.e. central P3 amplitudes). Yet, tactile-visual input caused larger impairments in multitasking than audio-visual input. General aspects of multimodal information integration modulated the activity in the premotor cortex (BA 6) as well as different visual association areas concerned with the integration of visual information with input from other modalities (BA 19, BA 21, BA 37). On top of this, differences in the specific combination of modalities also affected performance and measures of conflict/effort originating in prefrontal regions (BA 6).

In vivo evaluation of adipose- and muscle-derived stem cells as a treatment for nonhealing diabetic wounds using multimodal microscopy

Science.gov (United States)

Li, Joanne; Pincu, Yair; Marjanovic, Marina; Bower, Andrew J.; Chaney, Eric J.; Jensen, Tor; Boppart, Marni D.; Boppart, Stephen A.

2016-08-01

Impaired skin wound healing is a significant comorbid condition of diabetes, which often results in nonhealing diabetic ulcers due to poor peripheral microcirculation, among other factors. The effectiveness of the regeneration of adipose-derived stem cells (ADSCs) and muscle-derived stem cells (MDSCs) was assessed using an integrated multimodal microscopy system equipped with two-photon fluorescence and second-harmonic generation imaging. These imaging modalities, integrated in a single platform for spatial and temporal coregistration, allowed us to monitor in vivo changes in the collagen network and cell dynamics in a skin wound. Fluorescently labeled ADSCs and MDSCs were applied topically to the wound bed of wild-type and diabetic (db/db) mice following punch biopsy. Longitudinal imaging demonstrated that ADSCs and MDSCs provided remarkable capacity for improved diabetic wound healing, and integrated microscopy revealed a more organized collagen remodeling in the wound bed of treated mice. The results from this study verify the regenerative capacity of stem cells toward healing and, with multimodal microscopy, provide insight regarding their impact on the skin microenvironment. The optical method outlined in this study, which has the potential for in vivo human use, may optimize the care and treatment of diabetic nonhealing wounds.

Duloxetine Contributing to a Successful Multimodal Treatment Program for Peripheral Femoral Neuropathy and Comorbid ‘Reactive Depression’ in an Adolescent

OpenAIRE

Kachko, Ludmyla; Ben Ami, Shiri; Liberman, Alon; Birk, Einat; Kronenberg, Sefi

2011-01-01

In the United States, duloxetine has been approved for the treatment of major depressive disorder, diabetic peripheral neuropathic pain and fibromyalgia in the adult population. Data regarding the use of duloxetine in the pediatric population, however, are very limited. Femoral nerve injury is a rare complication of cardiac catheterization. In the case described, duloxetine contributed to a successful multimodal treatment program for peripheral neuropathic pain due to femoral neuropathy in an...

The Impact of Multimodal Texts on Reading Achievement: A Study of Iranian Secondary School Learners

Directory of Open Access Journals (Sweden)

Bahareh Baharani

2015-07-01

Full Text Available This study was designed to investigate the impact of multimodal text on reading comprehension test performance of Iranian intermediate learners. A total of 80 students participated in this study. All of them were Iranian female EFL learners with the age ranging from 16 to 18. They were selected from a boarding high school in Nasr Abad, Torbat Jam in Khorasan e Razavi, Iran. The students were randomly settled in four groups, who received different instructional approaches through using linear texts, multimodal printed texts, non-printed multimodal texts, and both multimodal printed and non-printed texts.  A pre-test and post-test were used to find out the differences before and after the experimental treatment.  The results reflected that the printed and non-printed multimodal texts had significant impact on reading comprehension test performance. In contrast, applying linear texts or traditional texts did not exert significant influence on reading comprehension ability of the participants. The findings provide useful hints for language instructors to improve effectiveness of instructional reading curriculums and reading ability of language learners. The participants who learned reading comprehension through using multimodal printed and non-printed texts enjoy reading programs and develop their intrinsic and extrinsic motivation for improving reading ability.

Ethnicity as a Moderator of Treatment Effects on Parent-Child Interaction for Children with ADHD

Science.gov (United States)

Jones, Heather A.; Epstein, Jeffery N.; Hinshaw, Stephen P.; Owens, Elizabeth B.; Chi, Terry C.; Arnold, L. Eugene; Hoza, Betsy; Wells, Karen C.

2010-01-01

Objective: To examine ethnic differences in observed parenting and child behavior and the moderating effects of ethnicity on the relationship between treatment and parent and child behavior. Method: Observations of 508 children with ADHD (ages 7-9) and their caregivers, collected during the Multimodal Treatment Study of ADHD, were analyzed using…

A fully automatic approach for multimodal PET and MR image segmentation in gamma knife treatment planning.

Science.gov (United States)

Rundo, Leonardo; Stefano, Alessandro; Militello, Carmelo; Russo, Giorgio; Sabini, Maria Gabriella; D'Arrigo, Corrado; Marletta, Francesco; Ippolito, Massimo; Mauri, Giancarlo; Vitabile, Salvatore; Gilardi, Maria Carla

2017-06-01

Nowadays, clinical practice in Gamma Knife treatments is generally based on MRI anatomical information alone. However, the joint use of MRI and PET images can be useful for considering both anatomical and metabolic information about the lesion to be treated. In this paper we present a co-segmentation method to integrate the segmented Biological Target Volume (BTV), using [ 11 C]-Methionine-PET (MET-PET) images, and the segmented Gross Target Volume (GTV), on the respective co-registered MR images. The resulting volume gives enhanced brain tumor information to be used in stereotactic neuro-radiosurgery treatment planning. GTV often does not match entirely with BTV, which provides metabolic information about brain lesions. For this reason, PET imaging is valuable and it could be used to provide complementary information useful for treatment planning. In this way, BTV can be used to modify GTV, enhancing Clinical Target Volume (CTV) delineation. A novel fully automatic multimodal PET/MRI segmentation method for Leksell Gamma Knife ® treatments is proposed. This approach improves and combines two computer-assisted and operator-independent single modality methods, previously developed and validated, to segment BTV and GTV from PET and MR images, respectively. In addition, the GTV is utilized to combine the superior contrast of PET images with the higher spatial resolution of MRI, obtaining a new BTV, called BTV MRI . A total of 19 brain metastatic tumors, undergone stereotactic neuro-radiosurgery, were retrospectively analyzed. A framework for the evaluation of multimodal PET/MRI segmentation is also presented. Overlap-based and spatial distance-based metrics were considered to quantify similarity concerning PET and MRI segmentation approaches. Statistics was also included to measure correlation among the different segmentation processes. Since it is not possible to define a gold-standard CTV according to both MRI and PET images without treatment response assessment

Preparation and evaluation of a multimodal minoxidil microemulsion versus minoxidil alone in the treatment of androgenic alopecia of mixed etiology: a pilot study

Directory of Open Access Journals (Sweden)

Sakr FM

2013-05-01

< 0.001, mean hair weight (P < 0.001, and mean hair thickness (P < 0.05. A patient self-assessment questionnaire demonstrated that the multimodal minoxidil formulation significantly (P < 0.001 slowed hair loss, increased hair growth, and improved appearance, and showed no appreciable side effects, such as itching and/or inflammation of the scalp compared with the minoxidil alone and placebo formulations. These improvements were in agreement with the photographic assessments made by the investigators. Formula A was shown to be an o/w formulation with consistent pH, viscosity, specific gravity, and homogeneity, and was physically stable after 24 months of normal storage. Conclusion: A multimodal microemulsion comprising minoxidil, diclofenac, and tea tree oil was significantly superior to minoxidil alone and placebo in terms of stability, safety, and efficacy, and achieved an earlier response in the treatment of androgenic alopecia compared with minoxidil alone in this 32-week pilot study. Keywords: androgenic alopecia, diclofenac, microemulsion, minoxidil, nonsteroidal anti-inflammatory agents, tea tree oil

Multimodality and Ambient Intelligence

NARCIS (Netherlands)

Nijholt, Antinus; Verhaegh, W.; Aarts, E.; Korst, J.

2004-01-01

In this chapter we discuss multimodal interface technology. We present eexamples of multimodal interfaces and show problems and opportunities. Fusion of modalities is discussed and some roadmap discussions on research in multimodality are summarized. This chapter also discusses future developments

Multimodality imaging of the postoperative shoulder

Energy Technology Data Exchange (ETDEWEB)

Woertler, Klaus [Technische Universitaet Muenchen, Department of Radiology, Munich (Germany)

2007-12-15

Multimodality imaging of the postoperative shoulder includes radiography, magnetic resonance (MR) imaging, MR arthrography, computed tomography (CT), CT arthrography, and ultrasound. Target-oriented evaluation of the postoperative shoulder necessitates familiarity with surgical techniques, their typical complications and sources of failure, knowledge of normal and abnormal postoperative findings, awareness of the advantages and weaknesses with the different radiologic techniques, and clinical information on current symptoms and function. This article reviews the most commonly used surgical procedures for treatment of anterior glenohumeral instability, lesions of the labral-bicipital complex, subacromial impingement, and rotator cuff lesions and highlights the significance of imaging findings with a view to detection of recurrent lesions and postoperative complications in a multimodality approach. (orig.)

Multimode optical fibers: steady state mode exciter.

Science.gov (United States)

Ikeda, M; Sugimura, A; Ikegami, T

1976-09-01

The steady state mode power distribution of the multimode graded index fiber was measured. A simple and effective steady state mode exciter was fabricated by an etching technique. Its insertion loss was 0.5 dB for an injection laser. Deviation in transmission characteristics of multimode graded index fibers can be avoided by using the steady state mode exciter.

Towards an intelligent framework for multimodal affective data analysis.

Science.gov (United States)

Poria, Soujanya; Cambria, Erik; Hussain, Amir; Huang, Guang-Bin

2015-03-01

An increasingly large amount of multimodal content is posted on social media websites such as YouTube and Facebook everyday. In order to cope with the growth of such so much multimodal data, there is an urgent need to develop an intelligent multi-modal analysis framework that can effectively extract information from multiple modalities. In this paper, we propose a novel multimodal information extraction agent, which infers and aggregates the semantic and affective information associated with user-generated multimodal data in contexts such as e-learning, e-health, automatic video content tagging and human-computer interaction. In particular, the developed intelligent agent adopts an ensemble feature extraction approach by exploiting the joint use of tri-modal (text, audio and video) features to enhance the multimodal information extraction process. In preliminary experiments using the eNTERFACE dataset, our proposed multi-modal system is shown to achieve an accuracy of 87.95%, outperforming the best state-of-the-art system by more than 10%, or in relative terms, a 56% reduction in error rate. Copyright © 2014 Elsevier Ltd. All rights reserved.

Log-Gabor Energy Based Multimodal Medical Image Fusion in NSCT Domain

Directory of Open Access Journals (Sweden)

Yong Yang

2014-01-01

Full Text Available Multimodal medical image fusion is a powerful tool in clinical applications such as noninvasive diagnosis, image-guided radiotherapy, and treatment planning. In this paper, a novel nonsubsampled Contourlet transform (NSCT based method for multimodal medical image fusion is presented, which is approximately shift invariant and can effectively suppress the pseudo-Gibbs phenomena. The source medical images are initially transformed by NSCT followed by fusing low- and high-frequency components. The phase congruency that can provide a contrast and brightness-invariant representation is applied to fuse low-frequency coefficients, whereas the Log-Gabor energy that can efficiently determine the frequency coefficients from the clear and detail parts is employed to fuse the high-frequency coefficients. The proposed fusion method has been compared with the discrete wavelet transform (DWT, the fast discrete curvelet transform (FDCT, and the dual tree complex wavelet transform (DTCWT based image fusion methods and other NSCT-based methods. Visually and quantitatively experimental results indicate that the proposed fusion method can obtain more effective and accurate fusion results of multimodal medical images than other algorithms. Further, the applicability of the proposed method has been testified by carrying out a clinical example on a woman affected with recurrent tumor images.

Multimodal physiotherapy treatment based on a biobehavioral approach for patients with chronic cervico-craniofacial pain: a prospective case series.

Science.gov (United States)

Marcos-Martín, Fernando; González-Ferrero, Luis; Martín-Alcocer, Noelia; Paris-Alemany, Alba; La Touche, Roy

2018-01-17

The purpose of this prospective case series was to observe and describe changes in patients with chronic cervico-craniofacial pain of muscular origin treated with multimodal physiotherapy based on a biobehavioral approach. Nine patients diagnosed with chronic myofascial temporomandibular disorder and neck pain were treated with 6 sessions over the course of 2 weeks including: (1) orthopedic manual physiotherapy (joint mobilizations, neurodynamic mobilization, and dynamic soft tissue mobilizations); (2) therapeutic exercises (motor control and muscular endurance exercises); and (3) patient education. The outcome measures of craniofacial (CF-PDI) and neck disability (NDI), kinesiophobia (TSK-11) and catastrophizing (PCS), and range of cervical and mandibular motion (ROM) and posture were collected at baseline, and at 2 and 14 weeks post-baseline. Compared to baseline, statistically significant (p posture were observed following a multimodal physiotherapy treatment based on a biobehavioral approach.

New developments in multimodal clinical multiphoton tomography

Science.gov (United States)

König, Karsten

2011-03-01

80 years ago, the PhD student Maria Goeppert predicted in her thesis in Goettingen, Germany, two-photon effects. It took 30 years to prove her theory, and another three decades to realize the first two-photon microscope. With the beginning of this millennium, first clinical multiphoton tomographs started operation in research institutions, hospitals, and in the cosmetic industry. The multiphoton tomograph MPTflexTM with its miniaturized flexible scan head became the Prism-Award 2010 winner in the category Life Sciences. Multiphoton tomographs with its superior submicron spatial resolution can be upgraded to 5D imaging tools by adding spectral time-correlated single photon counting units. Furthermore, multimodal hybrid tomographs provide chemical fingerprinting and fast wide-field imaging. The world's first clinical CARS studies have been performed with a hybrid multimodal multiphoton tomograph in spring 2010. In particular, nonfluorescent lipids and water as well as mitochondrial fluorescent NAD(P)H, fluorescent elastin, keratin, and melanin as well as SHG-active collagen have been imaged in patients with dermatological disorders. Further multimodal approaches include the combination of multiphoton tomographs with low-resolution imaging tools such as ultrasound, optoacoustic, OCT, and dermoscopy systems. Multiphoton tomographs are currently employed in Australia, Japan, the US, and in several European countries for early diagnosis of skin cancer (malignant melanoma), optimization of treatment strategies (wound healing, dermatitis), and cosmetic research including long-term biosafety tests of ZnO sunscreen nanoparticles and the measurement of the stimulated biosynthesis of collagen by anti-ageing products.

A Study of Patients with Primary Mediastinal Germ Cell Tumors Treated Using Multimodal Therapy

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Yutaro Tanaka

2017-01-01

Full Text Available Objectives. Primary mediastinal germ cell tumors (PMGCTs are rare, which often makes them difficult to treat. Herein, we examined patients with PMGCTs who underwent multimodal treatment. Methods. We examined 6 patients (median age: 25 years, range: 19–27 years with PMGCTs who underwent multimodal treatment between April 2001 and March 2015. Three patients had seminomas, 2 patients had yolk sac tumors, and 1 patient had choriocarcinoma. The median observation period was 32.5 months (range: 8–84 months. Results. Three of the 6 patients received initial operation followed by 3-4 courses of chemotherapy (bleomycin, etoposide, and cisplatin (BEP or etoposide and cisplatin (EP. One patient developed multiple lung metastases 17 months after surgery; received salvage chemotherapy with vinblastine, ifosfamide, and cisplatin; and achieved complete remission. The remaining 3 patients received initial BEP and EP chemotherapy. Multiple lung metastases and supraclavicular lymph node metastases were detected in 2 of these patients at the initial diagnosis. The patients underwent resections to remove residual tumor after treatment, and no viable tumor cells were found. Conclusions. Reliable diagnosis and immediate multimodal treatments are necessary for patients with PMGCTs. The 6 patients treated in our hospital have never experienced recurrence after the multimodal treatment.

Conservative multimodal management of a primitive neuroectodermal tumor of the thyroid

Directory of Open Access Journals (Sweden)

Juliette Haudebourg

2013-04-01

Full Text Available Primitive neuroectodermal tumors (PNET represent 1% of sarcomas. Head and neck peripheral PNETs have an intermediate prognosis between abdominopelvic disease and extremities. We here report the case of a 40-year old male who presented with primitive neuroectodermal tumor of the thyroid and was treated by multimodal treatment, including surgery, chemotherapy and intermediate dose radiotherapy. The patient is alive and fit with a functional larynx at 27 months. Multimodal treatments yield five-year survival rates of about 60%. Major drug regimens use vincristine, doxorubicin, ifosfamide or cyclophosphamide, dactinomycin and/or etoposide. Complete surgical excision is undertaken whenever possible to improve long-term survival. However, the relative radiosensitivity of tumors of the Ewing family, suggest multimodal treatment including adjuvant conformal radiotherapy in case of positive margins or poor response to chemotherapy rather than resection with 2-3 cm margins, which would imply laryngeal sacrifice for thyroid tumors. The role of expert rare tumor networks is crucial for optimal decision-making and management of such rare tumors on a case by case basis.

Multimodality

DEFF Research Database (Denmark)

Buhl, Mie

2010-01-01

In this paper, I address an ongoing discussion in Danish E-learning research about how to take advantage of the fact that digital media facilitate other communication forms than text, so-called ‘multimodal' communication, which should not be confused with the term ‘multimedia'. While multimedia...... on their teaching and learning situations. The choices they make involve e-learning resources like videos, social platforms and mobile devices, not just as digital artefacts we interact with, but the entire practice of using digital media. In a life-long learning perspective, multimodality is potentially very...

[New aspects of complex chronic tinnitus. I: Assessment of a multi-modality behavioral medicine treatment concept].

Science.gov (United States)

Goebel, G; Keeser, W; Fichter, M; Rief, W

1991-01-01

"Complex tinnitus" is a diagnostic term denoting a disturbance pattern where the patient hears highly annoying and painful noises or sounds that do not originate from a recognisable external source and can be described only by the patient himself. It seems that the suffering mainly depends upon the extent to which the tinnitus is experienced as a phenomenon that is beyond control. Part I reports on an examination of the treatment success achieved with 28 consecutive patients who had been treated according to an integrative multimodal behavioural medicine concept. This resulted--despite continual loudness--in a decrease in the degree of unpleasantness of the tinnitus, by 17% (p less than 0.01) with corresponding normalisation of decisive symptom factors in Hopkins Symptom-Check-List (SCL-90-R) and Freiburg Personality-Inventary (FPI-R). On the whole, 19 out of the total of 28 patients showed essential to marked improvement of the disturbance pattern. Part II presents a multidimensional tinnitus model and the essential psychotherapeutic focal points of a multimodal psychotherapy concept in complex chronic tinnitus, as well as the parallel phenomena in the chronic pain syndrome.

Reading Multimodal Texts for Learning – a Model for Cultivating Multimodal Literacy

Directory of Open Access Journals (Sweden)

Kristina Danielsson

2016-08-01

Full Text Available The re-conceptualisation of texts over the last 20 years, as well as the development of a multimodal understanding of communication and representation of knowledge, has profound consequences for the reading and understanding of multimodal texts, not least in educational contexts. However, if teachers and students are given tools to “unwrap” multimodal texts, they can develop a deeper understanding of texts, information structures, and the textual organisation of knowledge. This article presents a model for working with multimodal texts in education with the intention to highlight mutual multimodal text analysis in relation to the subject content. Examples are taken from a Singaporean science textbook as well as a Chilean science textbook, in order to demonstrate that the framework is versatile and applicable across different cultural contexts. The model takes into account the following aspects of texts: the general structure, how different semiotic resources operate, the ways in which different resources are combined (including coherence, the use of figurative language, and explicit/implicit values. Since learning operates on different dimensions – such as social and affective dimensions besides the cognitive ones – our inclusion of figurative language and values as components for textual analysis is a contribution to multimodal text analysis for learning.

Evaluation and Socio-occupational Intervention in Bipolar and Schizophrenic Patients within a Multimodal Intervention Program- PRISMA.

Science.gov (United States)

Díaz Zuluaga, Ana M; Duica, Kelly; Ruiz Galeano, Carlos; Vargas, Cristian; Agudelo Berruecos, Yuli; Ospina, Sigifredo; López-Jaramillo, Carlos

Functional improvement in bipolar and schizophrenic patients is one of the main aims of treatment. Nevertheless, there is no evidence about the effect of socio-occupational intervention within a multimodal intervention (MI) programme. To describe the socio-occupational profile and to evaluate the functional effect of a MI in bipolar I and schizophrenic patients. A prospective, longitudinal, therapeutic-comparative study was performed including 302 subjects (104 schizophrenic and 198 Bipolar Disorder I [BDI] patients), who were randomised into two groups, multimodal (psychiatry, psychology, medicine, occupational therapy, neuropsychology, and family therapy), or traditional intervention (psychiatry and medicine only). Several scales were applied to assess assertiveness, free time management, social abilities, general anxiety, self-care and performance in home, work and community tasks. After performing the longitudinal analysis, it was shown that the multimodal intervention was more effective than traditional intervention in general anxiety scores (P=.026) and development in home tasks (P=.03) in schizophrenic patients. No statistical differences were found in bipolar patients. The other variables showed improvement, however, their effect was similar in both intervention groups. Our study identified functional improvement in home tasks in schizophrenic patients after receiving multimodal intervention. Other variables also showed improvement for both interventions groups. Future studies, applying longer rehabilitation programs and other ecological strategies should be performed to identify the most effective interventions. Copyright © 2017 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Is multimodal care effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration.

Science.gov (United States)

Sutton, Deborah A; Côté, Pierre; Wong, Jessica J; Varatharajan, Sharanya; Randhawa, Kristi A; Yu, Hainan; Southerst, Danielle; Shearer, Heather M; van der Velde, Gabrielle M; Nordin, Margareta C; Carroll, Linda J; Mior, Silvano A; Taylor-Vaisey, Anne L; Stupar, Maja

2016-12-01

Little is known about the effectiveness of multimodal care for individuals with whiplash-associated disorders (WAD) and neck pain and associated disorders (NAD). To update findings of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders and evaluate the effectiveness of multimodal care for the management of patients with WAD or NAD. Systematic review and best-evidence synthesis. We included randomized controlled trials (RCTs), cohort studies, and case-control studies. Self-rated recovery, functional recovery (eg, disability, return to activities, work, or school), pain intensity, health-related quality of life, psychological outcomes (eg, depression, fear), or adverse events. We systematically searched five electronic databases (MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane Central Register of Controlled Trials) from 2000 to 2013. RCTs, cohort, and case-control studies meeting our selection criteria were eligible for critical appraisal. Random pairs of independent reviewers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria. Scientifically admissible studies were summarized using evidence tables and synthesized following best-evidence synthesis principles. We retrieved 2,187 articles, and 23 articles were eligible for critical appraisal. Of those, 18 articles from 14 different RCTs were scientifically admissible. There were a total of 31 treatment arms, including 27 unique multimodal programs of care. Overall, the evidence suggests that multimodal care that includes manual therapy, education, and exercise may benefit patients with grades I and II WAD and NAD. General practitioner care that includes reassurance, advice to stay active, and resumption of regular activities may be an option for the early management of WAD grades I and II. Our synthesis suggests that patients receiving high-intensity health care tend to experience poorer outcomes than those who receive fewer

Is eccentric exercise an effective treatment for lateral epicondylitis? A systematic review.

Science.gov (United States)

Cullinane, Frances L; Boocock, Mark G; Trevelyan, Fiona C

2014-01-01

To establish the effectiveness of eccentric exercise as a treatment intervention for lateral epicondylitis. ProQuest, Medline via EBSCO, AMED, Scopus, Web of Science, CINAHL. A systematic review was undertaken to identify randomized and controlled clinical trials incorporating eccentric exercise as a treatment for patients diagnosed with lateral epicondylitis. Studies were included if: they incorporated eccentric exercise, either in isolation or as part of a multimodal treatment protocol; they assessed at least one functional or disability outcome measure; and the patients had undergone diagnostic testing. The methodological quality of each study was assessed using the Modified Cochrane Musculoskeletal Injuries Group score sheet. Twelve studies met the inclusion criteria. Three were deemed 'high' quality, seven were 'medium' quality, and two were 'low' quality. Eight of the studies were randomized trials investigating a total of 334 subjects. Following treatment, all groups inclusive of eccentric exercise reported decreased pain and improved function and grip strength from baseline. Seven studies reported improvements in pain, function, and/or grip strength for therapy treatments inclusive of eccentric exercise when compared with those excluding eccentric exercise. Only one low-quality study investigated the isolated effects of eccentric exercise for treating lateral epicondylitis and found no significant improvements in pain when compared with other treatments. The majority of consistent findings support the inclusion of eccentric exercise as part of a multimodal therapy programme for improved outcomes in patients with lateral epicondylitis.

Prospective, longitudinal, multi-modal functional imaging for radical chemo-IMRT treatment of locally advanced head and neck cancer: the INSIGHT study

International Nuclear Information System (INIS)

Welsh, Liam; Panek, Rafal; McQuaid, Dualta; Dunlop, Alex; Schmidt, Maria; Riddell, Angela; Koh, Dow-Mu; Doran, Simon; Murray, Iain; Du, Yong; Chua, Sue; Hansen, Vibeke; Wong, Kee H.; Dean, Jamie; Gulliford, Sarah; Bhide, Shreerang; Leach, Martin O.; Nutting, Christopher; Harrington, Kevin; Newbold, Kate

2015-01-01

Radical chemo-radiotherapy (CRT) is an effective organ-sparing treatment option for patients with locally advanced head and neck cancer (LAHNC). Despite advances in treatment for LAHNC, a significant minority of these patients continue to fail to achieve complete response with standard CRT. By constructing a multi-modality functional imaging (FI) predictive biomarker for CRT outcome for patients with LAHNC we hope to be able to reliably identify those patients at high risk of failing standard CRT. Such a biomarker would in future enable CRT to be tailored to the specific biological characteristics of each patients’ tumour, potentially leading to improved treatment outcomes. The INSIGHT study is a single-centre, prospective, longitudinal multi-modality imaging study using functional MRI and FDG-PET/CT for patients with LAHNC squamous cell carcinomas receiving radical CRT. Two cohorts of patients are being recruited: one treated with, and another treated without, induction chemotherapy. All patients receive radical intensity modulated radiotherapy with concurrent chemotherapy. Patients undergo functional imaging before, during and 3 months after completion of radiotherapy, as well as at the time of relapse, should that occur within the first two years after treatment. Serum samples are collected from patients at the same time points as the FI scans for analysis of a panel of serum markers of tumour hypoxia. The primary aim of the INSIGHT study is to acquire a prospective multi-parametric longitudinal data set comprising functional MRI, FDG PET/CT, and serum biomarker data from patients with LAHNC undergoing primary radical CRT. This data set will be used to construct a predictive imaging biomarker for outcome after CRT for LAHNC. This predictive imaging biomarker will be used in future studies of functional imaging based treatment stratification for patients with LAHNC. Additional objectives are: defining the reproducibility of FI parameters; determining robust

HPMA copolymer-conjugated pirarubicin in multimodal treatment of a patient with stage IV prostate cancer and extensive lung and bone metastases

Czech Academy of Sciences Publication Activity Database

Dozono, H.; Yanazume, S.; Nakamura, H.; Etrych, Tomáš; Chytil, Petr; Ulbrich, Karel; Fang, J.; Arimura, T.; Douchi, T.; Kobayashi, H.; Ikoma, M.; Maeda, H.

2016-01-01

Roč. 11, č. 1 (2016), s. 101-106 ISSN 1776-2596 R&D Projects: GA ČR(CZ) GCP207/12/J030; GA MŠk(CZ) EE2.3.30.0029 Institutional support: RVO:61389013 Keywords : HPMA copolymer * piraraubicin * multimodal treatment Subject RIV: CD - Macromolecular Chemistry Impact factor: 3.438, year: 2016

Virtual Chironomia: A Multimodal Study of Verbal and Non-Verbal Communication in a Virtual World

Science.gov (United States)

Verhulsdonck, Gustav

2010-01-01

This mixed methods study examined the various aspects of multimodal use of non-verbal communication in virtual worlds during dyadic negotiations. Quantitative analysis uncovered a treatment effect whereby people with more rhetorical certainty used more neutral non-verbal communication; whereas people that were rhetorically less certain used more…

The Effects of Using Multimodal Approaches in Meaning-Making of 21st Century Literacy Texts Among ESL Students in a Private School in Malaysia

Directory of Open Access Journals (Sweden)

Malini Ganapathy

2016-04-01

Full Text Available In today’s globalised digital era, students are inevitably engaged in various multimodal texts due to their active participation in social media and frequent usage of mobile devices on a daily basis. Such daily activities advocate the need for a transformation in the teaching and learning of ESL lessons in order to promote students’ capabilities in making meaning of different literacy texts which students come across in their ESL learning activities. This paper puts forth the framework of Multimodality in the restructuring of the teaching and learning of ESL with the aim of investigating its effects and students perspectives on the use of multimodal approaches underlying the Multiliteracies theory. Using focus group interviews, this qualitative case study examines the effectiveness of ESL teaching and learning using the Multimodal approaches on literacy in meaning-making among 15 students in a private school in Penang, Malaysia. The results confirm the need to reorientate the teaching and learning of ESL with the focus on multimodal pedagogical practices as it promotes positive learning outcomes among students. The implications of this study suggest that the multimodal approaches integrated in the teaching and learning of ESL have the capacity to promote students’ autonomy in learning, improve motivation to learn and facilitate various learning styles. Keywords: Multimodal Approaches; Multiliteracies; Monomodal; Flipped Classroom; Literacy; Multimodal texts; Ipad

Gold Nanoconstructs for Multimodal Diagnostic Imaging and Photothermal Cancer Therapy

Science.gov (United States)

Coughlin, Andrew James

Cancer accounts for nearly 1 out of every 4 deaths in the United States, and because conventional treatments are limited by morbidity and off-target toxicities, improvements in cancer management are needed. This thesis further develops nanoparticle-assisted photothermal therapy (NAPT) as a viable treatment option for cancer patients. NAPT enables localized ablation of disease because heat generation only occurs where tissue permissive near-infrared (NIR) light and absorbing nanoparticles are combined, leaving surrounding normal tissue unharmed. Two principle approaches were investigated to improve the specificity of this technique: multimodal imaging and molecular targeting. Multimodal imaging affords the ability to guide NIR laser application for site-specific NAPT and more holistic characterization of disease by combining the advantages of several diagnostic technologies. Towards the goal of image-guided NAPT, gadolinium-conjugated gold-silica nanoshells were engineered and demonstrated to enhance imaging contrast across a range of diagnostic modes, including T1-weighted magnetic resonance imaging, X-Ray, optical coherence tomography, reflective confocal microscopy, and two-photon luminescence in vitro as well as within an animal tumor model. Additionally, the nanoparticle conjugates were shown to effectively convert NIR light to heat for applications in photothermal therapy. Therefore, the broad utility of gadolinium-nanoshells for anatomic localization of tissue lesions, molecular characterization of malignancy, and mediators of ablation was established. Molecular targeting strategies may also improve NAPT by promoting nanoparticle uptake and retention within tumors and enhancing specificity when malignant and normal tissue interdigitate. Here, ephrinA1 protein ligands were conjugated to nanoshell surfaces for particle homing to overexpressed EphA2 receptors on prostate cancer cells. In vitro, successful targeting and subsequent photothermal ablation of

Critical Analysis of Multimodal Discourse

DEFF Research Database (Denmark)

van Leeuwen, Theo

2013-01-01

This is an encyclopaedia article which defines the fields of critical discourse analysis and multimodality studies, argues that within critical discourse analysis more attention should be paid to multimodality, and within multimodality to critical analysis, and ends reviewing a few examples of re...

Multimodal label-free microscopy

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Nicolas Pavillon

2014-09-01

Full Text Available This paper reviews the different multimodal applications based on a large extent of label-free imaging modalities, ranging from linear to nonlinear optics, while also including spectroscopic measurements. We put specific emphasis on multimodal measurements going across the usual boundaries between imaging modalities, whereas most multimodal platforms combine techniques based on similar light interactions or similar hardware implementations. In this review, we limit the scope to focus on applications for biology such as live cells or tissues, since by their nature of being alive or fragile, we are often not free to take liberties with the image acquisition times and are forced to gather the maximum amount of information possible at one time. For such samples, imaging by a given label-free method usually presents a challenge in obtaining sufficient optical signal or is limited in terms of the types of observable targets. Multimodal imaging is then particularly attractive for these samples in order to maximize the amount of measured information. While multimodal imaging is always useful in the sense of acquiring additional information from additional modes, at times it is possible to attain information that could not be discovered using any single mode alone, which is the essence of the progress that is possible using a multimodal approach.

Treatment for chronic low back pain: the focus should change to multimodal management that reflects the underlying pain mechanisms.

Science.gov (United States)

Müller-Schwefe, Gerhard; Morlion, Bart; Ahlbeck, Karsten; Alon, Eli; Coaccioli, Stefano; Coluzzi, Flaminia; Huygen, Frank; Jaksch, Wolfgang; Kalso, Eija; Kocot-Kępska, Magdalena; Kress, Hans-Georg; Mangas, Ana Cristina; Margarit Ferri, Cesar; Mavrocordatos, Philippe; Nicolaou, Andrew; Hernández, Concepción Pérez; Pergolizzi, Joseph; Schäfer, Michael; Sichère, Patrick

2017-07-01

Chronic low back pain: Chronic pain is the most common cause for people to utilize healthcare resources and has a considerable impact upon patients' lives. The most prevalent chronic pain condition is chronic low back pain (CLBP). CLBP may be nociceptive or neuropathic, or may incorporate both components. The presence of a neuropathic component is associated with more intense pain of longer duration, and a higher prevalence of co-morbidities. However, many physicians' knowledge of chronic pain mechanisms is currently limited and there are no universally accepted treatment guidelines, so the condition is not particularly well managed. Diagnosis should begin with a focused medical history and physical examination, to exclude serious spinal pathology that may require evaluation by an appropriate specialist. Most patients have non-specific CLBP, which cannot be attributed to a particular cause. It is important to try and establish whether a neuropathic component is present, by combining the findings of physical and neurological examinations with the patient's history. This may prove difficult, however, even when using screening instruments. Multimodal management: The multifactorial nature of CLBP indicates that the most logical treatment approach is multimodal: i.e. integrated multidisciplinary therapy with co-ordinated somatic and psychotherapeutic elements. As both nociceptive and neuropathic components may be present, combining analgesic agents with different mechanisms of action is a rational treatment modality. Individually tailored combination therapy can improve analgesia whilst reducing the doses of constituent agents, thereby lessening the incidence of side effects. This paper outlines the development of CLBP and the underlying mechanisms involved, as well as providing information on diagnosis and the use of a wide range of pharmaceutical agents in managing the condition (including NSAIDs, COX-2 inhibitors, tricyclic antidepressants, opioids and

Duloxetine contributing to a successful multimodal treatment program for peripheral femoral neuropathy and comorbid 'reactive depression' in an adolescent.

Science.gov (United States)

Kachko, Ludmyla; Ben Ami, Shiri; Liberman, Alon; Birk, Einat; Kronenberg, Sefi

2011-01-01

In the United States, duloxetine has been approved for the treatment of major depressive disorder, diabetic peripheral neuropathic pain and fibromyalgia in the adult population. Data regarding the use of duloxetine in the pediatric population, however, are very limited. Femoral nerve injury is a rare complication of cardiac catheterization. In the case described, duloxetine contributed to a successful multimodal treatment program for peripheral neuropathic pain due to femoral neuropathy in an adolescent with 'reactive depression' and conversion symptoms. To the best of the authors' knowledge, the present article is only the third such report on this dual use of duloxetine in children and adolescents, and the first report of such treatment following femoral neuropathy induced by cardiac catheterization.

The Multimodal Possibilities of Online Instructions

DEFF Research Database (Denmark)

Kampf, Constance

2006-01-01

The WWW simplifies the process of delivering online instructions through multimodal channels because of the ease of use for voice, video, pictures, and text modes of communication built into it.  Given that instructions are being produced in multimodal format for the WWW, how do multi-modal analy......The WWW simplifies the process of delivering online instructions through multimodal channels because of the ease of use for voice, video, pictures, and text modes of communication built into it.  Given that instructions are being produced in multimodal format for the WWW, how do multi...

Effect of Multimodal Pore Channels on Cargo Release from Mesoporous Silica Nanoparticles

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Sushilkumar A. Jadhav

2016-01-01

Full Text Available Mesoporous silica nanoparticles (MSNs with multimodal pore channels were fully characterized by TEM, nitrogen adsorption-desorption, and DLS analyses. MSNs with average diameter of 200 nm with dual pore channel zones with pore diameters of 1.3–2.6 and 4 nm were tested for their use in drug delivery application. Important role of the multimodal pore systems present on MSNs on the quantitative release of model drug ibuprofen was investigated. The results obtained revealed that the release profile for ibuprofen clearly shows distinct zones which can be attributed to the respective porous channel zones present on the particles. The fluctuations in the concentration of ibuprofen during the prolonged release from MSNs were caused by the multimodal pore channel systems.

Validation of a multimodal travel simulator with travel information provision

NARCIS (Netherlands)

Chorus, C.G.; Molin, E.J.E.; Arentze, T.A.; Hoogendoorn, S.P.; Timmermans, H.J.P.; Wee, van G.P.

2007-01-01

This paper presents a computer based travel simulator for collecting data concerning the use of next-generation ATIS and their effects on traveler decision making in a multimodal travel environment. The tool distinguishes itself by presenting a completely abstract multimodal transport network, where

Multimodality imaging techniques.

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Martí-Bonmatí, Luis; Sopena, Ramón; Bartumeus, Paula; Sopena, Pablo

2010-01-01

In multimodality imaging, the need to combine morphofunctional information can be approached by either acquiring images at different times (asynchronous), and fused them through digital image manipulation techniques or simultaneously acquiring images (synchronous) and merging them automatically. The asynchronous post-processing solution presents various constraints, mainly conditioned by the different positioning of the patient in the two scans acquired at different times in separated machines. The best solution to achieve consistency in time and space is obtained by the synchronous image acquisition. There are many multimodal technologies in molecular imaging. In this review we will focus on those multimodality image techniques more commonly used in the field of diagnostic imaging (SPECT-CT, PET-CT) and new developments (as PET-MR). The technological innovations and development of new tracers and smart probes are the main key points that will condition multimodality image and diagnostic imaging professionals' future. Although SPECT-CT and PET-CT are standard in most clinical scenarios, MR imaging has some advantages, providing excellent soft-tissue contrast and multidimensional functional, structural and morphological information. The next frontier is to develop efficient detectors and electronics systems capable of detecting two modality signals at the same time. Not only PET-MR but also MR-US or optic-PET will be introduced in clinical scenarios. Even more, MR diffusion-weighted, pharmacokinetic imaging, spectroscopy or functional BOLD imaging will merge with PET tracers to further increase molecular imaging as a relevant medical discipline. Multimodality imaging techniques will play a leading role in relevant clinical applications. The development of new diagnostic imaging research areas, mainly in the field of oncology, cardiology and neuropsychiatry, will impact the way medicine is performed today. Both clinical and experimental multimodality studies, in

Multimodality localization of epileptic foci

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Desco, Manuel; Pascau, Javier; Pozo, M. A.; Santos, Andres; Reig, Santiago; Gispert, Juan D.; Garcia-Barreno, Pedro

2001-05-01

This paper presents a multimodality approach for the localization of epileptic foci using PET, MRI and EEG combined without the need of external markers. Mutual Information algorithm is used for MRI-PET registration. Dipole coordinates (provided by BESA software) are projected onto the MRI using a specifically developed algorithm. The four anatomical references used for electrode positioning (nasion, inion and two preauricular points) are located on the MRI using a triplanar viewer combined with a surface-rendering tool. Geometric transformation using deformation of the ideal sphere used for dipole calculations is then applied to match the patient's brain size and shape. Eight treatment-refractory epileptic patients have been studied. The combination of the anatomical information from the MRI, hipoperfusion areas in PET and dipole position and orientation helped the physician in the diagnosis of epileptic focus location. Neurosurgery was not indicated for patients where PET and dipole results were inconsistent; in two cases it was clinically indicated despite the mismatch, showing a negative follow up. The multimodality approach presented does not require external markers for dipole projection onto the MRI, this being the main difference with previous methods. The proposed method may play an important role in the indication of surgery for treatment- refractory epileptic patients.

Multimodal treatment utilizing intraoperative radiotherapy for advanced cancer of the pancreas

International Nuclear Information System (INIS)

Onodera, Tokio

1982-01-01

A multimodal treatment was consisted of intraoperative radiation, external radiation, by-pass operation, chemotherapy and total parenteral nutrition if necessary to cover decreased oral-intake. Thirty-three cases were subjected to this therapy for 6 years. The stage of the tumors varied from a localized tumor in the pancreas to a huge tumor with multiple metastases, though the latter abandoned recently to be contraindication to this therapy. At laparotomy, a high energy electron beam was irradiated to the tumor with a dosage of 3,000 rad using a 20 MeV Betatron. The tumor was carefully prepared in order to avoid irradiating the duodenum and stomach. Choledochojejunostomy and gastrojejunostomy were performed in almost all of patients with cancer of head of pancreas. In some patients, external radiation was added with a dosage of 3,000 rad by linear X-ray. After radiotherapy, chemotherapy employing 5-FU or FT-207 was continued including. The survival time after this therapy was varied mainly according to the stages of the tumor. In patients with multiple metastasis to the liver or peritoneal dissemination, no remarkable effects were obtained by this therapy. On the otherhand, among 14 patients with localized tumor in the pancreas, 7 survived more than one year and the mean survival time of treated patients was nevershorter than that of patients who received resection of the tumor. Most of the treated patients could spend at home until their condition became critical, because by-pass operation could overcome jaundice or the duodenal stenosis and intraoperative radiation could palliate the pain of cancer of pancreas. Tumor effect of intraoperative radiation was confirmed by both of the second laporatomy for twice intraoperative radiation and laparatomy. (author)

The Management Of Homosexuality Using Multimodal Therapy: A ...

African Journals Online (AJOL)

Anxiety, depression, marital distress and low self-esteem were identified as correlates of the client's condition. Multimodal therapy was instituted thereafter. The result after three months of treatment showed reduction in sexual attraction for men, increased attraction to females, reduced frequency of masturbation, lowered ...

Multimodal Counseling of Childhood Encopresis: A Case Example.

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Gumaer, Jim

1990-01-01

Provides information regarding childhood disorder of encopresis and presents multimodal therapy techniques for school counselors who cannot successfully refer clients. Presents a case study of a teenage boy suffering from encopresis who was referred for counseling. Suggests specific treatment strategies including behavior modification, nutrition…

Preparation and evaluation of a multimodal minoxidil microemulsion versus minoxidil alone in the treatment of androgenic alopecia of mixed etiology: a pilot study.

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Sakr, Farouk M; Gado, Ali Mi; Mohammed, Haseebur R; Adam, Abdel Nasser Ismail

2013-01-01

The variable success of topical minoxidil in the treatment of androgenic alopecia has led to the hypothesis that other pathways could mediate this form of hair loss, including infection and/or microinflammation of the hair follicles. In this study, we prepared a multimodal microemulsion comprising minoxidil (a dihydrotestosterone antagonist), diclofenac (a nonsteroidal anti-inflammatory agent), and tea tree oil (an anti-infective agent). We investigated the stability and physicochemical properties of this formulation, and its therapeutic efficacy compared with a formulation containing minoxidil alone in the treatment of androgenic alopecia. We developed a multimodal oil/water (o/w) microemulsion, a formulation containing minoxidil alone, and another containing vehicle. A three-phase diagram was constructed to obtain the optimal concentrations of the selected oil, surfactant, and cosurfactant. Thirty-two men aged 18-30 years were randomized to apply 1 mL of microemulsion containing the multimodal formulation (formulation A, n = 11), minoxidil alone (formulation B, n = 11) or placebo (formulation C, n = 10) twice daily to the affected area for 32 weeks. Efficacy was evaluated by mean hair count, thickness, and weight on the targeted area of the scalp. Global photographs were taken, changes in the area of scalp coverage were assessed by patients and external investigators, and the benefits and safety of the study medications were evaluated. The physical stability of formula A was examined after a shelf storage period of 24 months. Formulation A achieved a significantly superior response than formulations B and C in terms of mean hair count (P minoxidil formulation significantly (P minoxidil alone and placebo formulations. These improvements were in agreement with the photographic assessments made by the investigators. Formula A was shown to be an o/w formulation with consistent pH, viscosity, specific gravity, and homogeneity, and was physically stable after 24 months

Active multimodal psychotherapy in children and adolescents with suicidality: description, evaluation and clinical profile.

Science.gov (United States)

Högberg, Goran; Hällström, Tore

2008-07-01

The aim of this study was to describe and evaluate the clinical pattern of 14 youths with presenting suicidality, to describe an integrative treatment approach, and to estimate therapy effectiveness. Fourteen patients aged 10 to 18 years from a child and adolescent outpatient clinic in Stockholm were followed in a case series. The patients were treated with active multimodal psychotherapy. This consisted of mood charting by mood-maps, psycho-education, wellbeing practice and trauma resolution. Active techniques were psychodrama and body-mind focused techniques including eye movement desensitization and reprocessing. The patients were assessed before treatment, immediately after treatment and at 22 months post treatment with the Global Assessment of Functioning Scale. The clinical pattern of the group was observed. After treatment there was a significant change towards normality in the Global Assessment of Functioning scale both immediately post-treatment and at 22 months. A clinical pattern, post trauma suicidal reaction, was observed with a combination of suicidality, insomnia, bodily symptoms and disturbed mood regulation. We conclude that in the post trauma reaction suicidality might be a presenting symptom in young people. Despite the shortcomings of a case series the results of this study suggest that a mood-map-based multimodal treatment approach with active techniques might be of value in the treatment of children and youth with suicidality.

Locoregional Treatment Outcomes After Multimodality Management of Inflammatory Breast Cancer

International Nuclear Information System (INIS)

Bristol, Ian J.; Woodward, Wendy A.; Strom, Eric A.; Cristofanilli, Massimo; Domain, Delora; Singletary, S. Eva; Perkins, George H.; Oh, Julia L.; Yu, T.-K.; Terrefe, Welela; Sahin, Aysegul A.; Hunt, Kelly K.; Hortobagyi, Gabriel N.; Buchholz, Thomas A.

2008-01-01

Purpose: The aims of this study were to determine outcomes for patients with inflammatory breast cancer (IBC) treated with multimodality therapy, to identify factors associated with locoregional recurrence, and to determine which patients may benefit from radiation dose escalation. Methods and Materials: We retrospectively reviewed 256 consecutive patients with nonmetastatic IBC treated at our institution between 1977 and 2004. Results: The 192 patients who were able to complete the planned course of chemotherapy, mastectomy, and postmastectomy radiation had significantly better outcomes than the 64 patients who did not. The respective 5-year outcome rates were: locoregional control (84% vs. 51%), distant metastasis-free survival (47% vs. 20%), and overall survival (51% vs. 24%) (p < 0.0001 for all comparisons). Univariate factors significantly associated with locoregional control in the patients who completed plan treatment were response to neoadjuvant chemotherapy, surgical margin status, number of involved lymph nodes, and use of taxanes. Increasing the total chest-wall dose of postmastectomy radiation from 60 Gy to 66 Gy significantly improved locoregional control for patients who experienced less than a partial response to chemotherapy, patients with positive, close, or unknown margins, and patients <45 years of age. Conclusions: Patients with IBC who are able to complete treatment with chemotherapy, mastectomy, and postmastectomy radiation have a high probability of locoregional control. Escalation of postmastectomy radiation dose to 66 Gy appears to benefit patients with disease that responds poorly to chemotherapy, those with positive, close, or unknown margin status, and those <45 years of age

Investigation of an angiogenesis-promoting topical treatment for diabetic wounds using multimodal microscopy (Conference Presentation)

Science.gov (United States)

Li, Joanne; Bower, Andrew J.; Arp, Zane A.; Olson, Eric; Holland, Claire; Chaney, Eric J.; Marjanovic, Marina; Boppart, Stephen A.

2016-02-01

Impaired skin wound healing is a significant co-morbid condition of diabetes that is caused by poor microcirculation among other factors. Hypoxia-inducible factors (HIFs) are transcription factors that mediate the effects of decreased levels of oxygen in biological environments. Inducing mild hypoxia in the tissue could promote angiogenesis, a critical step in the wound healing process in diabetic wounds. To investigate the relationship between hypoxia and diabetic wound healing, a topical treatment consisting of a HIF-activating prolyl-hydroxylase inhibitor was administered to the wounded skin of diabetic (db/db) mice. Studies were conducted in accordance with the GSK Policy on the Care, Welfare and Treatment of Laboratory Animals and were reviewed at GSK or by the ethical review process at the institution where the work was performed. The wounded area was tracked in vivo for 28 days utilizing a custom-built multimodal microscopy system. An increase in vascular density around the wounds of treated animals was observed using phase-variance optical coherence tomography (PV-OCT), in comparison to normal controls. In addition, second harmonic generation (SHG) and fluorescence lifetime imaging microscopy (FLIM) were utilized to examine the collagen regeneration and cellular metabolic activity, respectively, in the wounded skin. The utilization of these light based methods can follow metabolic and morphologic changes in the wound healing process in ways not possible with current evaluation processes. Insights demonstrated in these studies could lead to new endpoints for evaluation of the efficacy of drugs and lead to more direct ways of detecting patient response to treatment.

Thyroid Function in Women after Multimodal Treatment for Breast Cancer Stage II/III: Comparison With Controls From a Population Sample

International Nuclear Information System (INIS)

Reinertsen, Kristin Valborg; Cvancarova, Milada; Wist, Erik; Bjoro, Trine; Dahl, Alv A.; Danielsen, Turi; Fossa, Sophie D.

2009-01-01

Purpose: A possible association between thyroid diseases (TD) and breast cancer (BC) has been debated. We examined prevalence and development of TD in women after multimodal treatment for Stage II/III BC compared with women from a general population. Secondarily, we explored the impact of two different radiotherapy (RT) techniques (standardized field arrangements vs. computed tomography [CT]-based dose planning) on TD in BC patients examined 35-120 months after primary BC treatment. Methods and Materials: A total of 403 BC patients completed a questionnaire about TD and had blood samples taken for analyses of thyroid function. All had undergone postoperative RT with or without (2%) adjuvant systemic treatment. The results in the BC patients were compared with a cancer-free, age-matched control group from a general population (CGr). Results: There was higher prevalence of self-reported hypothyroidism in the BC patients as compared with the CGr (18% vs. 6%, p < 0.001). The raised prevalence was predominantly due to a substantial increase in the development of hypothyroidism after BC diagnosis, whereas the prevalence of hypothyroidism before BC diagnosis was similar to that observed in the CGr. Patients treated with CT-based RT showed a trend for increased post-BC development of hypothyroidism as compared with those treated with standardized field arrangements (p = 0.08). Conclusions: Hypothyroidism is significantly increased in women after multimodal treatment for Stage II/III BC. Radiation to the thyroid gland may be a contributing factor. BC patients should be routinely screened for hypothyroidism.

Multimode model for projective photon-counting measurements

International Nuclear Information System (INIS)

Tualle-Brouri, Rosa; Ourjoumtsev, Alexei; Dantan, Aurelien; Grangier, Philippe; Wubs, Martijn; Soerensen, Anders S.

2009-01-01

We present a general model to account for the multimode nature of the quantum electromagnetic field in projective photon-counting measurements. We focus on photon-subtraction experiments, where non-Gaussian states are produced conditionally. These are useful states for continuous-variable quantum-information processing. We present a general method called mode reduction that reduces the multimode model to an effective two-mode problem. We apply this method to a multimode model describing broadband parametric down-conversion, thereby improving the analysis of existing experimental results. The main improvement is that spatial and frequency filters before the photon detector are taken into account explicitly. We find excellent agreement with previously published experimental results, using fewer free parameters than before, and discuss the implications of our analysis for the optimized production of states with negative Wigner functions.

Multimodal hyperspectroscopy screening in women at risk of ...

African Journals Online (AJOL)

Background: Screening and treatment of pre‑cancerous lesions is important for prevention of cervical cancer. Currently, most available screening tests for cervical cancer are limited by low sensitivity, prohibitive costs, logistics and technical concerns. This study evaluates the role of multimodal hyperspectroscopy (MHS) as a ...

Effective Fusion of Multi-Modal Remote Sensing Data in a Fully Convolutional Network for Semantic Labeling

Directory of Open Access Journals (Sweden)

Wenkai Zhang

2017-12-01

Full Text Available In recent years, Fully Convolutional Networks (FCN have led to a great improvement of semantic labeling for various applications including multi-modal remote sensing data. Although different fusion strategies have been reported for multi-modal data, there is no in-depth study of the reasons of performance limits. For example, it is unclear, why an early fusion of multi-modal data in FCN does not lead to a satisfying result. In this paper, we investigate the contribution of individual layers inside FCN and propose an effective fusion strategy for the semantic labeling of color or infrared imagery together with elevation (e.g., Digital Surface Models. The sensitivity and contribution of layers concerning classes and multi-modal data are quantified by recall and descent rate of recall in a multi-resolution model. The contribution of different modalities to the pixel-wise prediction is analyzed explaining the reason of the poor performance caused by the plain concatenation of different modalities. Finally, based on the analysis an optimized scheme for the fusion of layers with image and elevation information into a single FCN model is derived. Experiments are performed on the ISPRS Vaihingen 2D Semantic Labeling dataset (infrared and RGB imagery as well as elevation and the Potsdam dataset (RGB imagery and elevation. Comprehensive evaluations demonstrate the potential of the proposed approach.

Multimodal fluorescence imaging spectroscopy

NARCIS (Netherlands)

Stopel, Martijn H W; Blum, Christian; Subramaniam, Vinod; Engelborghs, Yves; Visser, Anthonie J.W.G.

2014-01-01

Multimodal fluorescence imaging is a versatile method that has a wide application range from biological studies to materials science. Typical observables in multimodal fluorescence imaging are intensity, lifetime, excitation, and emission spectra which are recorded at chosen locations at the sample.

Intraoperative high-field magnetic resonance imaging, multimodal neuronavigation, and intraoperative electrophysiological monitoring-guided surgery for treating supratentorial cavernomas.

Science.gov (United States)

Li, Fang-Ye; Chen, Xiao-Lei; Xu, Bai-Nan

2016-09-01

To determine the beneficial effects of intraoperative high-field magnetic resonance imaging (MRI), multimodal neuronavigation, and intraoperative electrophysiological monitoring-guided surgery for treating supratentorial cavernomas. Twelve patients with 13 supratentorial cavernomas were prospectively enrolled and operated while using a 1.5 T intraoperative MRI, multimodal neuronavigation, and intraoperative electrophysiological monitoring. All cavernomas were deeply located in subcortical areas or involved critical areas. Intraoperative high-field MRIs were obtained for the intraoperative "visualization" of surrounding eloquent structures, "brain shift" corrections, and navigational plan updates. All cavernomas were successfully resected with guidance from intraoperative MRI, multimodal neuronavigation, and intraoperative electrophysiological monitoring. In 5 cases with supratentorial cavernomas, intraoperative "brain shift" severely deterred locating of the lesions; however, intraoperative MRI facilitated precise locating of these lesions. During long-term (>3 months) follow-up, some or all presenting signs and symptoms improved or resolved in 4 cases, but were unchanged in 7 patients. Intraoperative high-field MRI, multimodal neuronavigation, and intraoperative electrophysiological monitoring are helpful in surgeries for the treatment of small deeply seated subcortical cavernomas.

High-resolution multimodal clinical multiphoton tomography of skin

Science.gov (United States)

König, Karsten

2011-03-01

This review focuses on multimodal multiphoton tomography based on near infrared femtosecond lasers. Clinical multiphoton tomographs for 3D high-resolution in vivo imaging have been placed into the market several years ago. The second generation of this Prism-Award winning High-Tech skin imaging tool (MPTflex) was introduced in 2010. The same year, the world's first clinical CARS studies have been performed with a hybrid multimodal multiphoton tomograph. In particular, non-fluorescent lipids and water as well as mitochondrial fluorescent NAD(P)H, fluorescent elastin, keratin, and melanin as well as SHG-active collagen has been imaged with submicron resolution in patients suffering from psoriasis. Further multimodal approaches include the combination of multiphoton tomographs with low-resolution wide-field systems such as ultrasound, optoacoustical, OCT, and dermoscopy systems. Multiphoton tomographs are currently employed in Australia, Japan, the US, and in several European countries for early diagnosis of skin cancer, optimization of treatment strategies, and cosmetic research including long-term testing of sunscreen nanoparticles as well as anti-aging products.

Inorganic Nanoparticles for Multimodal Molecular Imaging

Directory of Open Access Journals (Sweden)

Magdalena Swierczewska

2011-01-01

Full Text Available Multimodal molecular imaging can offer a synergistic improvement of diagnostic ability over a single imaging modality. Recent development of hybrid imaging systems has profoundly impacted the pool of available multimodal imaging probes. In particular, much interest has been focused on biocompatible, inorganic nanoparticle-based multimodal probes. Inorganic nanoparticles offer exceptional advantages to the field of multimodal imaging owing to their unique characteristics, such as nanometer dimensions, tunable imaging properties, and multifunctionality. Nanoparticles mainly based on iron oxide, quantum dots, gold, and silica have been applied to various imaging modalities to characterize and image specific biologic processes on a molecular level. A combination of nanoparticles and other materials such as biomolecules, polymers, and radiometals continue to increase functionality for in vivo multimodal imaging and therapeutic agents. In this review, we discuss the unique concepts, characteristics, and applications of the various multimodal imaging probes based on inorganic nanoparticles.

Adaptive Multiview Nonnegative Matrix Factorization Algorithm for Integration of Multimodal Biomedical Data

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Bisakha Ray

2017-08-01

Full Text Available The amounts and types of available multimodal tumor data are rapidly increasing, and their integration is critical for fully understanding the underlying cancer biology and personalizing treatment. However, the development of methods for effectively integrating multimodal data in a principled manner is lagging behind our ability to generate the data. In this article, we introduce an extension to a multiview nonnegative matrix factorization algorithm (NNMF for dimensionality reduction and integration of heterogeneous data types and compare the predictive modeling performance of the method on unimodal and multimodal data. We also present a comparative evaluation of our novel multiview approach and current data integration methods. Our work provides an efficient method to extend an existing dimensionality reduction method. We report rigorous evaluation of the method on large-scale quantitative protein and phosphoprotein tumor data from the Clinical Proteomic Tumor Analysis Consortium (CPTAC acquired using state-of-the-art liquid chromatography mass spectrometry. Exome sequencing and RNA-Seq data were also available from The Cancer Genome Atlas for the same tumors. For unimodal data, in case of breast cancer, transcript levels were most predictive of estrogen and progesterone receptor status and copy number variation of human epidermal growth factor receptor 2 status. For ovarian and colon cancers, phosphoprotein and protein levels were most predictive of tumor grade and stage and residual tumor, respectively. When multiview NNMF was applied to multimodal data to predict outcomes, the improvement in performance is not overall statistically significant beyond unimodal data, suggesting that proteomics data may contain more predictive information regarding tumor phenotypes than transcript levels, probably due to the fact that proteins are the functional gene products and therefore a more direct measurement of the functional state of the tumor. Here, we

Multimodal Physiotherapy Based on a Biobehavioral Approach as a Treatment for Chronic Tension-Type Headache: A Case Report.

Science.gov (United States)

Beltran-Alacreu, Hector; Lopez-de-Uralde-Villanueva, Ibai; La Touche, Roy

2015-12-01

Tension-type headache (TTH) is the most common primary headache affecting the general population, which is characterized by bilateral headache and mild to moderate pain. This disorder causes high levels of disability and recent scientific evidence suggests that manual therapy (MT) and therapeutic exercise are effective in reducing medication intake and decreasing the frequency and intensity of headaches in patients with TTH. A 34-year-old woman was known to have chronic TTH. Initially, the patient presented moderate headaches 5 days per week, mechanical neck pain and no positive response to analgesics. A battery of self-reports was given to the patient to assess disability (using the Spanish versions of the Headache Impact Test-6 and the neck disability index), pain (visual analogue scale) and psychosocial issues (Spanish version of the pain catastrophizing scale) involved in the headaches. All measurements were taken four times during 161 days. Eleven sessions of treatment including MT, motor control therapeutic exercise (MCTE) and therapeutic patient education (TPE) were applied. This biobehavioral-based multimodal physical rehabilitation treatment combining MT, TPE and MCTE produced a substantial reduction in pain intensity, pain catastrophizing, disability and the impact of headaches on patient's life.

Multimodality in organization studies

DEFF Research Database (Denmark)

Van Leeuwen, Theo

2017-01-01

This afterword reviews the chapters in this volume and reflects on the synergies between organization and management studies and multimodality studies that emerge from the volume. These include the combination of strong sociological theorizing and detailed multimodal analysis, a focus on material...

Preparation and evaluation of a multimodal minoxidil microemulsion versus minoxidil alone in the treatment of androgenic alopecia of mixed etiology: a pilot study

Science.gov (United States)

Sakr, Farouk M; Gado, Ali MI; Mohammed, Haseebur R; Adam, Abdel Nasser Ismail

2013-01-01

Background: The variable success of topical minoxidil in the treatment of androgenic alopecia has led to the hypothesis that other pathways could mediate this form of hair loss, including infection and/or microinflammation of the hair follicles. In this study, we prepared a multimodal microemulsion comprising minoxidil (a dihydrotestosterone antagonist), diclofenac (a nonsteroidal anti-inflammatory agent), and tea tree oil (an anti-infective agent). We investigated the stability and physicochemical properties of this formulation, and its therapeutic efficacy compared with a formulation containing minoxidil alone in the treatment of androgenic alopecia. Methods: We developed a multimodal oil/water (o/w) microemulsion, a formulation containing minoxidil alone, and another containing vehicle. A three-phase diagram was constructed to obtain the optimal concentrations of the selected oil, surfactant, and cosurfactant. Thirty-two men aged 18–30 years were randomized to apply 1 mL of microemulsion containing the multimodal formulation (formulation A, n = 11), minoxidil alone (formulation B, n = 11) or placebo (formulation C, n = 10) twice daily to the affected area for 32 weeks. Efficacy was evaluated by mean hair count, thickness, and weight on the targeted area of the scalp. Global photographs were taken, changes in the area of scalp coverage were assessed by patients and external investigators, and the benefits and safety of the study medications were evaluated. The physical stability of formula A was examined after a shelf storage period of 24 months. Results: Formulation A achieved a significantly superior response than formulations B and C in terms of mean hair count (P microemulsion comprising minoxidil, diclofenac, and tea tree oil was significantly superior to minoxidil alone and placebo in terms of stability, safety, and efficacy, and achieved an earlier response in the treatment of androgenic alopecia compared with minoxidil alone in this 32-week pilot study

The Stability of Multi-modal Traffic Network

International Nuclear Information System (INIS)

Han Linghui; Sun Huijun; Zhu Chengjuan; Jia Bin; Wu Jianjun

2013-01-01

There is an explicit and implicit assumption in multimodal traffic equilibrium models, that is, if the equilibrium exists, then it will also occur. The assumption is very idealized; in fact, it may be shown that the quite contrary could happen, because in multimodal traffic network, especially in mixed traffic conditions the interaction among traffic modes is asymmetric and the asymmetric interaction may result in the instability of traffic system. In this paper, to study the stability of multimodal traffic system, we respectively present the travel cost function in mixed traffic conditions and in traffic network with dedicated bus lanes. Based on a day-to-day dynamical model, we study the evolution of daily route choice of travelers in multimodal traffic network using 10000 random initial values for different cases. From the results of simulation, it can be concluded that the asymmetric interaction between the cars and buses in mixed traffic conditions can lead the traffic system to instability when traffic demand is larger. We also study the effect of travelers' perception error on the stability of multimodal traffic network. Although the larger perception error can alleviate the effect of interaction between cars and buses and improve the stability of traffic system in mixed traffic conditions, the traffic system also become instable when the traffic demand is larger than a number. For all cases simulated in this study, with the same parameters, traffic system with dedicated bus lane has better stability for traffic demand than that in mixed traffic conditions. We also find that the network with dedicated bus lane has higher portion of travelers by bus than it of mixed traffic network. So it can be concluded that building dedicated bus lane can improve the stability of traffic system and attract more travelers to choose bus reducing the traffic congestion. (general)

Quantum teleportation of nonclassical wave packets: An effective multimode theory

Energy Technology Data Exchange (ETDEWEB)

Benichi, Hugo; Takeda, Shuntaro; Lee, Noriyuki; Furusawa, Akira [Department of Applied Physics, University of Tokyo, Tokyo (Japan)

2011-07-15

We develop a simple and efficient theoretical model to understand the quantum properties of broadband continuous variable quantum teleportation. We show that, if stated properly, the problem of multimode teleportation can be simplified to teleportation of a single effective mode that describes the input state temporal characteristic. Using that model, we show how the finite bandwidth of squeezing and external noise in the classical channel affect the output teleported quantum field. We choose an approach that is especially relevant for the case of non-Gaussian nonclassical quantum states and we finally back-test our model with recent experimental results.

Manifold regularized multi-task feature selection for multi-modality classification in Alzheimer's disease.

Science.gov (United States)

Jie, Biao; Zhang, Daoqiang; Cheng, Bo; Shen, Dinggang

2013-01-01

Accurate diagnosis of Alzheimer's disease (AD), as well as its prodromal stage (i.e., mild cognitive impairment, MCI), is very important for possible delay and early treatment of the disease. Recently, multi-modality methods have been used for fusing information from multiple different and complementary imaging and non-imaging modalities. Although there are a number of existing multi-modality methods, few of them have addressed the problem of joint identification of disease-related brain regions from multi-modality data for classification. In this paper, we proposed a manifold regularized multi-task learning framework to jointly select features from multi-modality data. Specifically, we formulate the multi-modality classification as a multi-task learning framework, where each task focuses on the classification based on each modality. In order to capture the intrinsic relatedness among multiple tasks (i.e., modalities), we adopted a group sparsity regularizer, which ensures only a small number of features to be selected jointly. In addition, we introduced a new manifold based Laplacian regularization term to preserve the geometric distribution of original data from each task, which can lead to the selection of more discriminative features. Furthermore, we extend our method to the semi-supervised setting, which is very important since the acquisition of a large set of labeled data (i.e., diagnosis of disease) is usually expensive and time-consuming, while the collection of unlabeled data is relatively much easier. To validate our method, we have performed extensive evaluations on the baseline Magnetic resonance imaging (MRI) and fluorodeoxyglucose positron emission tomography (FDG-PET) data of Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Our experimental results demonstrate the effectiveness of the proposed method.

[Radiofrequency ablation in the multimodal treatment of liver metastases--preliminary report].

Science.gov (United States)

Burcoveanu, C; Dogaru, C; Diaconu, C; Grecu, F; Dragomir, Cr; Pricop, Adriana; Balan, G; Drug, V L

2007-01-01

Although the "gold standard" in the multimodal treatment of liver primary and secondary tumors is the surgical ablation, the rate of resection, despite the last decades advances, remains still low (10 - 20%). In addition, the interest for non-surgical ablation therapies is increasing. Among them, regional or systemic chemotherapy, intra-arterial radiotherapy as well as locally targeted therapies--cryotherapy, alcohol instillation and radiofrequency (RF) are the most valuable options as alternative to the surgical approach. Between February 2005 - January 2007, 9 patients with liver metastases underwent open RF ablation of their secondaries in the III-rd Surgical Unit, "St. Spiridon" Hospital. An Elektrotom 106 HiTT Berchtold device with a 60W power generator and a 15 mm monopolar active electrode was used. Destruction of the tumors was certified with intraoperative ultrasound examination. Pre- and postoperative CarcinoEmbryonic Antigen (CEA) together with imaging follow-up was carried out, in order to determine local or systemic recurrencies. Six patients died between 6 month - 4 years after the RF ablation. Median survival is 29.2 months. RF ablation is a challenge alternative in non-resectable liver tumors.

Endovascular treatment of acute basilar artery occlusion: time to treatment is crucial

International Nuclear Information System (INIS)

Dorňák, T.; Herzig, R.; Kuliha, M.; Havlíček, R.; Školoudík, D.; Šaňák, D.; Köcher, M.; Procházka, V.; Lacman, J.; Charvát, F.; Krajina, A.

2015-01-01

Aim: To evaluate the safety and efficacy of multimodal endovascular treatment (EVT) of acute basilar artery occlusion (BAO), including bridging therapy [intravenous thrombolysis (IVT) with subsequent EVT], to compare particular EVT techniques and identify predictors of clinical outcome. Materials and methods: This retrospective, multi-centre study comprised 72 acute ischaemic stroke patients (51 males; mean age 59.1 ± 13.3 years) with radiologically confirmed BAO. The following data were collected: baseline characteristics, risk factors, pre-event antithrombotic treatment, neurological deficit at time of treatment, localization of occlusion, time to therapy, recanalization rate, post-treatment imaging findings. Thirty- and 90-day outcomes were evaluated using the modified Rankin scale with a good clinical outcome defined as 0–3 points. Results: Successful recanalization was achieved in 94.4% patients. Stepwise binary logistic regression analysis identified the presence of arterial hypertension (OR = 0.073 and OR = 0.067, respectively), National Institutes of Health Stroke Scale (NIHSS) at the time of treatment (OR = 0,829 and OR = 0.864, respectively), and time to treatment (OR = 0.556 and OR = 0.502, respectively) as significant independent predictors of 30- and 90-day clinical outcomes. Conclusion: Data from this multicentre study showed that multimodal EVT was an effective recanalization method in acute BAO. Bridging therapy shortens the time to treatment, which was identified as the only modifiable outcome predictor. - Highlights: • Various treatments are being used in recanalization of basilar artery occlusion. • Multimodal endovascular treatment is an effective recanalization method. • Time-to-treatment is the only modifiable outcome predictor. • Bridging therapy shortens time-to-treatment. • Arterial hypertension, neurologic deficit are associated with poor outcome

A Learning Algorithm for Multimodal Grammar Inference.

Science.gov (United States)

D'Ulizia, A; Ferri, F; Grifoni, P

2011-12-01

The high costs of development and maintenance of multimodal grammars in integrating and understanding input in multimodal interfaces lead to the investigation of novel algorithmic solutions in automating grammar generation and in updating processes. Many algorithms for context-free grammar inference have been developed in the natural language processing literature. An extension of these algorithms toward the inference of multimodal grammars is necessary for multimodal input processing. In this paper, we propose a novel grammar inference mechanism that allows us to learn a multimodal grammar from its positive samples of multimodal sentences. The algorithm first generates the multimodal grammar that is able to parse the positive samples of sentences and, afterward, makes use of two learning operators and the minimum description length metrics in improving the grammar description and in avoiding the over-generalization problem. The experimental results highlight the acceptable performances of the algorithm proposed in this paper since it has a very high probability of parsing valid sentences.

Duloxetine Contributing to a Successful Multimodal Treatment Program for Peripheral Femoral Neuropathy and Comorbid ‘Reactive Depression’ in an Adolescent

Directory of Open Access Journals (Sweden)

Ludmyla Kachko

2011-01-01

Full Text Available In the United States, duloxetine has been approved for the treatment of major depressive disorder, diabetic peripheral neuropathic pain and fibromyalgia in the adult population. Data regarding the use of duloxetine in the pediatric population, however, are very limited. Femoral nerve injury is a rare complication of cardiac catheterization. In the case described, duloxetine contributed to a successful multimodal treatment program for peripheral neuropathic pain due to femoral neuropathy in an adolescent with ‘reactive depression’ and conversion symptoms. To the best of the authors’ knowledge, the present article is only the third such report on this dual use of duloxetine in children and adolescents, and the first report of such treatment following femoral neuropathy induced by cardiac catheterization.

Hybrid PD and effective multi-mode positive position feedback control for slewing and vibration suppression of a smart flexible manipulator

International Nuclear Information System (INIS)

Lou, Jun-qiang; Wei, Yan-ding; Yang, Yi-ling; Xie, Feng-ran

2015-01-01

A hybrid control strategy for slewing and vibration suppression of a smart flexible manipulator is presented in this paper. It consists of a proportional derivative controller to realize motion control, and an effective multi-mode positive position feedback (EMPPF) controller to suppress the multi-mode vibration. Rather than treat each mode equally as the standard multi-mode PPF, the essence of the EMPPF is that control forces of different modes are applied according to the mode parameters of the respective modes, so the vibration modes with less vibration energy receive fewer control forces. Stability conditions for the close loop system are established through stability analysis. Optimal parameters of the EMPPF controller are obtained using the method of root locus analysis. The performance of the proposed strategy is demonstrated by simulation and experiments. Experimental results show that the first two vibration modes of the manipulator are effectively suppressed. The setting time of the setup descends approximately 55%, reaching 3.12 s from 5.67 s. (paper)

Hybrid PD and effective multi-mode positive position feedback control for slewing and vibration suppression of a smart flexible manipulator

Science.gov (United States)

Lou, Jun-qiang; Wei, Yan-ding; Yang, Yi-ling; Xie, Feng-ran

2015-03-01

A hybrid control strategy for slewing and vibration suppression of a smart flexible manipulator is presented in this paper. It consists of a proportional derivative controller to realize motion control, and an effective multi-mode positive position feedback (EMPPF) controller to suppress the multi-mode vibration. Rather than treat each mode equally as the standard multi-mode PPF, the essence of the EMPPF is that control forces of different modes are applied according to the mode parameters of the respective modes, so the vibration modes with less vibration energy receive fewer control forces. Stability conditions for the close loop system are established through stability analysis. Optimal parameters of the EMPPF controller are obtained using the method of root locus analysis. The performance of the proposed strategy is demonstrated by simulation and experiments. Experimental results show that the first two vibration modes of the manipulator are effectively suppressed. The setting time of the setup descends approximately 55%, reaching 3.12 s from 5.67 s.

An overview of neoadjuvant chemotherapy in the multimodality treatment of malignant pleural mesothelioma.

Science.gov (United States)

Pasello, G; Ceresoli, G L; Favaretto, A

2013-02-01

Malignant Pleural Mesothelioma (MPM) is an aggressive tumour with poor prognosis and increasing incidence in industrialized countries because of the previous widespread exposure to asbestos fibres and to the long lag period from time of exposure and the diagnosis of the disease. MPM shows high refractoriety to systemic treatment, single-modality treatment was generally ineffective and did not achieve higher results than supportive care. The incidence of local and distant recurrences after surgery remains high and that was the reason for many centres to perform combined treatments. In the attempt of reducing the incidence of local recurrences, a multimodality approach with surgery followed by adjuvant radiotherapy was explored. Extrapleural pneumonectomy (EPP) allows higher doses of radiotherapy to the whole hemithorax by avoiding pulmonary toxicity and the results of this approach is a significant reduction of loco-regional relapses; although, extrathoracic metastasis represent a major problem in the management of the disease because of the impact on overall survival. The success with surgical resection after neoadjuvant chemotherapy in stage IIIA lung cancer has been the impetus for several groups to apply this strategy in MPM aiming at reducing the incidence of distant relapse after surgery. Platinum-based chemotherapy plus gemcitabine or pemetrexed for 3-4 cycles followed by surgery and postoperative high-dose radiotherapy showed the best results in terms of overall and progression free survival. This review will focus on the main clinical studies and overview the results of different chemotherapy regimens in the neoadjuvant treatment of MPM. Copyright © 2012 Elsevier Ltd. All rights reserved.

Multimodality imaging of pulmonary infarction

International Nuclear Information System (INIS)

Bray, T.J.P.; Mortensen, K.H.; Gopalan, D.

2014-01-01

Highlights: • A plethora of pulmonary and systemic disorders, often associated with grave outcomes, may cause pulmonary infarction. • A stereotypical infarct is a peripheral wedge shaped pleurally based opacity but imaging findings can be highly variable. • Multimodality imaging is key to diagnosing the presence, aetiology and complications of pulmonary infarction. • Multimodality imaging of pulmonary infarction together with any ancillary features often guide to early targeted treatment. • CT remains the principal imaging modality with MRI increasingly used alongside nuclear medicine studies and ultrasound. - Abstract: The impact of absent pulmonary arterial and venous flow on the pulmonary parenchyma depends on a host of factors. These include location of the occlusive insult, the speed at which the occlusion develops and the ability of the normal dual arterial supply to compensate through increased bronchial arterial flow. Pulmonary infarction occurs when oxygenation is cut off secondary to sudden occlusion with lack of recruitment of the dual supply arterial system. Thromboembolic disease is the commonest cause of such an insult but a whole range of disease processes intrinsic and extrinsic to the pulmonary arterial and venous lumen may also result in infarcts. Recognition of the presence of infarction can be challenging as imaging manifestations often differ from the classically described wedge shaped defect and a number of weighty causes need consideration. This review highlights aetiologies and imaging appearances of pulmonary infarction, utilising cases to illustrate the essential role of a multimodality imaging approach in order to arrive at the appropriate diagnosis

Multimodality imaging of pulmonary infarction

Energy Technology Data Exchange (ETDEWEB)

Bray, T.J.P., E-mail: timothyjpbray@gmail.com [Department of Radiology, Papworth Hospital NHS Foundation Trust, Ermine Street, Papworth Everard, Cambridge CB23 3RE (United Kingdom); Mortensen, K.H., E-mail: mortensen@doctors.org.uk [Department of Radiology, Papworth Hospital NHS Foundation Trust, Ermine Street, Papworth Everard, Cambridge CB23 3RE (United Kingdom); University Department of Radiology, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Box 318, Cambridge CB2 0QQ (United Kingdom); Gopalan, D., E-mail: deepa.gopalan@btopenworld.com [Department of Radiology, Papworth Hospital NHS Foundation Trust, Ermine Street, Papworth Everard, Cambridge CB23 3RE (United Kingdom)

2014-12-15

Highlights: • A plethora of pulmonary and systemic disorders, often associated with grave outcomes, may cause pulmonary infarction. • A stereotypical infarct is a peripheral wedge shaped pleurally based opacity but imaging findings can be highly variable. • Multimodality imaging is key to diagnosing the presence, aetiology and complications of pulmonary infarction. • Multimodality imaging of pulmonary infarction together with any ancillary features often guide to early targeted treatment. • CT remains the principal imaging modality with MRI increasingly used alongside nuclear medicine studies and ultrasound. - Abstract: The impact of absent pulmonary arterial and venous flow on the pulmonary parenchyma depends on a host of factors. These include location of the occlusive insult, the speed at which the occlusion develops and the ability of the normal dual arterial supply to compensate through increased bronchial arterial flow. Pulmonary infarction occurs when oxygenation is cut off secondary to sudden occlusion with lack of recruitment of the dual supply arterial system. Thromboembolic disease is the commonest cause of such an insult but a whole range of disease processes intrinsic and extrinsic to the pulmonary arterial and venous lumen may also result in infarcts. Recognition of the presence of infarction can be challenging as imaging manifestations often differ from the classically described wedge shaped defect and a number of weighty causes need consideration. This review highlights aetiologies and imaging appearances of pulmonary infarction, utilising cases to illustrate the essential role of a multimodality imaging approach in order to arrive at the appropriate diagnosis.

Content-based TV sports video retrieval using multimodal analysis

Science.gov (United States)

Yu, Yiqing; Liu, Huayong; Wang, Hongbin; Zhou, Dongru

2003-09-01

In this paper, we propose content-based video retrieval, which is a kind of retrieval by its semantical contents. Because video data is composed of multimodal information streams such as video, auditory and textual streams, we describe a strategy of using multimodal analysis for automatic parsing sports video. The paper first defines the basic structure of sports video database system, and then introduces a new approach that integrates visual stream analysis, speech recognition, speech signal processing and text extraction to realize video retrieval. The experimental results for TV sports video of football games indicate that the multimodal analysis is effective for video retrieval by quickly browsing tree-like video clips or inputting keywords within predefined domain.

Cost-effectiveness of carbon ion radiation therapy for locally recurrent rectal cancer

International Nuclear Information System (INIS)

Mobaraki, A.; Ohno, Tatsuya; Sakurai, Hideyuki; Nakano, Takashi; Yamada Shigeru

2010-01-01

The aim of this study was to evaluate the cost-effectiveness of carbon ion radiotherapy compared with conventional multimodality therapy in the treatment of patients with locally recurrent rectal cancer. Direct costs for diagnosis, recurrent treatment, follow-up, visits, supportive therapy, complications, and admission were computed for each individual using a sample of 25 patients presenting with local recurrent rectal cancer at the National Institute of Radiological Science (NIRS) and Gunma University Hospital (GUH). Patients received only radical surgery for primary rectal adenocarcinoma and had isolated unresectable pelvic recurrence. Fourteen and 11 patients receiving treatment for the local recurrence between 2003 and 2005 were followed retrospectively at NIRS and GUH, respectively. Treatment was carried out with carbon ion radiotherapy (CIRT) alone at NIRS, while multimodality therapy including three-dimensional conformal radiotherapy, chemotherapy, and hyperthermia was performed at GUH. The 2-year overall survival rate was 85% and 55% for CIRT and multimodality treatment, respectively. The mean cost was 4803946 yen for the CIRT group and 4611100 yen for the multimodality treatment group. The incremental cost-effectiveness ratio for CIRT was 6428 yen per 1% increase in survival. The median duration of total hospitalization was 37 days for CIRT and 66 days for the multimodality treatment group. In conclusion, by calculating all direct costs, CIRT was found to be a potential cost effective treatment modality as compared to multimodality treatment for locally recurrent rectal cancer. (author)

Burnout: A Multimodal Approach to Assessment and Resolution.

Science.gov (United States)

Kesler, Kathryn D.

1990-01-01

Claims assessment and treatment of guidance counselor burnout is not simple. A variety of causes and symptoms leads to the need for multidimensional conceptualization and action plan. The multimodal behavior mode, BASIC I.D., with the adoption of a Setting modality, has been shown to be a comprehensive approach when applied to the understanding…

Novel multimodality segmentation using level sets and Jensen-Renyi divergence

NARCIS (Netherlands)

Markel, Daniel; Zaidi, Habib; El Naqa, Issam

2013-01-01

Purpose: Positron emission tomography (PET) is playing an increasing role in radiotherapy treatment planning. However, despite progress, robust algorithms for PET and multimodal image segmentation are still lacking, especially if the algorithm were extended to image-guided and adaptive radiotherapy

Multimodal Aspects of Corporate Social Responsibility Communication

Directory of Open Access Journals (Sweden)

Carmen Daniela Maier

2014-12-01

Full Text Available This article addresses how the multimodal persuasive strategies of corporate social responsibility communication can highlight a company’s commitment to gender empowerment and environmental protection while advertising simultaneously its products. Drawing on an interdisciplinary methodological framework related to CSR communication, multimodal discourse analysis and gender theory, the article proposes a multimodal analysis model through which it is possible to map and explain the multimodal persuasive strategies employed by Coca-Cola company in their community-related films. By examining the semiotic modes’ interconnectivity and functional differentiation, this analytical endeavour expands the existing research work as the usual textual focus is extended to a multimodal one.

Multimodal sequence learning.

Science.gov (United States)

Kemény, Ferenc; Meier, Beat

2016-02-01

While sequence learning research models complex phenomena, previous studies have mostly focused on unimodal sequences. The goal of the current experiment is to put implicit sequence learning into a multimodal context: to test whether it can operate across different modalities. We used the Task Sequence Learning paradigm to test whether sequence learning varies across modalities, and whether participants are able to learn multimodal sequences. Our results show that implicit sequence learning is very similar regardless of the source modality. However, the presence of correlated task and response sequences was required for learning to take place. The experiment provides new evidence for implicit sequence learning of abstract conceptual representations. In general, the results suggest that correlated sequences are necessary for implicit sequence learning to occur. Moreover, they show that elements from different modalities can be automatically integrated into one unitary multimodal sequence. Copyright © 2015 Elsevier B.V. All rights reserved.

Self-imaging effect of TM modes in photonic crystal multimode waveguides only exhibiting band gaps for TE modes

International Nuclear Information System (INIS)

Yu Tianbao; Jiang Xiaoqing; Yang Jianyi; Zhou Haifeng; Liao Qinghua; Wang Minghua

2007-01-01

This Letter presents the properties of transverse-magnetic (TM) modes in multimode photonic crystal waveguides (PCWs), which only exhibit photonic band gaps for transverse-electric (TE) modes. A good equivalent model is applied to analysis the designed structures on the basis of multimode interference effect and self-imaging principle. The performance shows that the TM modes can also be propagated with high efficiency, and resemble index-guided modes owing to the combination of total internal reflection (TIR) and distribution Bragg reflection. It provides a novel way to realize the components for both TM and TE polarizations by combining PBG and TIR effect in PCWs. As one of potential applications, polarization-insensitive power splitter based on the proposed structures can be designed

Manifold Regularized Multi-Task Feature Selection for Multi-Modality Classification in Alzheimer’s Disease

Science.gov (United States)

Jie, Biao; Cheng, Bo

2014-01-01

Accurate diagnosis of Alzheimer’s disease (AD), as well as its pro-dromal stage (i.e., mild cognitive impairment, MCI), is very important for possible delay and early treatment of the disease. Recently, multi-modality methods have been used for fusing information from multiple different and complementary imaging and non-imaging modalities. Although there are a number of existing multi-modality methods, few of them have addressed the problem of joint identification of disease-related brain regions from multi-modality data for classification. In this paper, we proposed a manifold regularized multi-task learning framework to jointly select features from multi-modality data. Specifically, we formulate the multi-modality classification as a multi-task learning framework, where each task focuses on the classification based on each modality. In order to capture the intrinsic relatedness among multiple tasks (i.e., modalities), we adopted a group sparsity regularizer, which ensures only a small number of features to be selected jointly. In addition, we introduced a new manifold based Laplacian regularization term to preserve the geometric distribution of original data from each task, which can lead to the selection of more discriminative features. Furthermore, we extend our method to the semi-supervised setting, which is very important since the acquisition of a large set of labeled data (i.e., diagnosis of disease) is usually expensive and time-consuming, while the collection of unlabeled data is relatively much easier. To validate our method, we have performed extensive evaluations on the baseline Magnetic resonance imaging (MRI) and fluorodeoxyglucose positron emission tomography (FDG-PET) data of Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. Our experimental results demonstrate the effectiveness of the proposed method. PMID:24505676

Apatia multimodal iatrogênica Multimodal apathy: a unique effect of antidepressant therapy at the neurological-psychiatric interface

Directory of Open Access Journals (Sweden)

Ricardo de Oliveira-Souza

1996-06-01

Full Text Available O presente trabalho documenta um efeito peculiar dos antidepressivos em 5 pacientes - a apatia -, definida pela incapacidade de experimentar emoções. O reconhecimento da apatia no curso de tratamento antidepressivo deve levantar a possibilidade de iatrogenia e suspensão do antidepressivo em uso. Frizamos que a apatia deve ser diferenciada da abulia e da avolição, com as quais é comumente contundida. Documentamos que a indiferença emocional pode se confinar a um domínio sensorial ("apatia unimodal" ou, como em nossos casos, a mais de uma modalidade ("apatia multimodal". Circuitos anterobasais, centrados na amígdala e no pólo temporal, são fortes candidatos para integrar a experiência emocional às imagens mentais e percepções multimodais do ambiente, uma vez que para eles convergem os principais sistemas de projeção do prosencéfalo, ao mesmo tempo em que se situam em pontos estratégicos para modular o córtex pré-frontal e parieto-têmporo-occipital. O fato de que a apatia foi produzida por classes quimicamente distintas, como ISRSs (inibidores seletivos de recaptação da serotonina, IMAOs (inibidores reversíveis da monoamino oxidase e tricíclicos, indica que a fisiopatologia em jogo se deve a alguma ação compartilhada por essas drogas no plano subneuronal. A intervenção em circuitos serotoninérgicos cerebrais parece o mecanismo mais adequado para explicar tal efeito.The present paper reports on five patients who developed apathy as a peculiar side effect of antidepressants. Their behavioral and psychopathological changes were primarily due to the near-absence of emotional experience, a key characteristic that distinguishes apathy from avolition and abulia. The emergence of apathy in the course of an antidepressant treatment should raise the suspicion of an adverse effect of the drug and lead to its prompt withdrawal. A sample of the relevant clinical evidence favoring the distinction of apathy confined to a single

Effects of Multimodal Mandala Yoga on Social and Emotional Skills for Youth with Autism Spectrum Disorder: An Exploratory Study.

Science.gov (United States)

Litchke, Lyn Gorbett; Liu, Ting; Castro, Stephanie

2018-01-01

Youth with autism spectrum disorder (ASD) demonstrates impairment in the ability to socially and emotionally relate to others that can limit participation in groups, interaction with peers, and building successful life relationships. The aim of this exploratory study was to examine the effects of a novel multimodal Mandala yoga program on social and emotional skills for youth with ASD. Five males with ASD attended 1 h yoga sessions, twice a week for 4 weeks. Multimodal Mandala yoga comprised 26 circular partner/group poses, color and tracing sheets, rhythmic chanting, yoga cards, and games. Treatment and Research Institute for ASD Social Skills Assessment (TSSA) scores were collected before and after the eight yoga sessions. The Modified Facial Mood Scale (MFMS) was used to observe mood changes before and after each yoga class. Paired sample t -tests were conducted on TSSA and MFMS scores to compare social and emotional differences post the 4-week camp. Narrative field notes were documented after each of the eight yoga sessions. A significant improvement from pre- to post-test was found in overall TSSA ( t (4) = -5.744, P = 0.005) and on respondent to initiation ( t (4) = -3.726, P = 0.020), initiating interaction ( t (4) = -8.5, P = 0.039), and affective understanding and perspective taking subscales ( t (4) = -5.171 P = 0.007). Youth's MFMS scores increased from 80% to 100% at the end of eight yoga sessions demonstrating a pleasant or positive mood. Thematic analysis of the narrative notes identified three key factors associated with the yoga experience: (a) enhanced mood and emotional expression, (b) increased empathy toward others, and (c) improved teamwork skills. This multimodal Mandala yoga training has implication for developing positive social and emotional skills for youth with ASD.

Effects of multimodal mandala yoga on social and emotional skills for youth with autism spectrum disorder: An exploratory study

Directory of Open Access Journals (Sweden)

Lyn Gorbett Litchke

2018-01-01

Full Text Available Context: Youth with autism spectrum disorder (ASD demonstrates impairment in the ability to socially and emotionally relate to others that can limit participation in groups, interaction with peers, and building successful life relationships. Aims: The aim of this exploratory study was to examine the effects of a novel multimodal Mandala yoga program on social and emotional skills for youth with ASD. Subjects and Methods: Five males with ASD attended 1 h yoga sessions, twice a week for 4 weeks. Multimodal Mandala yoga comprised 26 circular partner/group poses, color and tracing sheets, rhythmic chanting, yoga cards, and games. Treatment and Research Institute for ASD Social Skills Assessment (TSSA scores were collected before and after the eight yoga sessions. The Modified Facial Mood Scale (MFMS was used to observe mood changes before and after each yoga class. Paired sample t-tests were conducted on TSSA and MFMS scores to compare social and emotional differences post the 4-week camp. Narrative field notes were documented after each of the eight yoga sessions. Results: A significant improvement from pre- to post-test was found in overall TSSA (t(4 = −5.744, P = 0.005 and on respondent to initiation (t(4 = −3.726, P = 0.020, initiating interaction (t(4 = −8.5, P = 0.039, and affective understanding and perspective taking subscales (t(4 = −5.171 P = 0.007. Youth's MFMS scores increased from 80% to 100% at the end of eight yoga sessions demonstrating a pleasant or positive mood. Thematic analysis of the narrative notes identified three key factors associated with the yoga experience: (a enhanced mood and emotional expression, (b increased empathy toward others, and (c improved teamwork skills. Conclusion: This multimodal Mandala yoga training has implication for developing positive social and emotional skills for youth with ASD.

Multimodal Processes Rescheduling

DEFF Research Database (Denmark)

Bocewicz, Grzegorz; Banaszak, Zbigniew A.; Nielsen, Peter

2013-01-01

Cyclic scheduling problems concerning multimodal processes are usually observed in FMSs producing multi-type parts where the Automated Guided Vehicles System (AGVS) plays a role of a material handling system. Schedulability analysis of concurrently flowing cyclic processes (SCCP) exe-cuted in the......Cyclic scheduling problems concerning multimodal processes are usually observed in FMSs producing multi-type parts where the Automated Guided Vehicles System (AGVS) plays a role of a material handling system. Schedulability analysis of concurrently flowing cyclic processes (SCCP) exe...

Naturalistic follow-up of subjects affected with anorexia nervosa 8 years after multimodal treatment: Personality and psychopathology changes and predictors of outcome.

Science.gov (United States)

Amianto, F; Spalatro, A; Ottone, L; Abbate Daga, G; Fassino, S

2017-09-01

Eating disorders (EDs) are serious mental illnesses of growing clinical and social impact. Despite their severity, there is still no satisfactory evidence-based treatment. Follow-up investigations are the most reliable studies to enlighten long-term outcome predictors and modifiers. In total, 59 subjects affected with anorexia nervosa were assessed 8 years after their admission into an outpatient multimodal treatment program for eating disorders. The follow-up changes in diagnostic criteria were compared with Chi-square test. Improved and not-improved subjects were compared. Clinical, personality and psychopathology features between T0 and T1 were compared with t-test for repeated measures. Correlation between T0 features and changes at T1 in personality and psychopathology features were assessed. The rate of complete remission was 42%, an overall rate of 67.8% improved, a rate of 18.6% worsened. Concerning personality, a significant decrease of harm avoidance and increase in self-directedness were evidenced. Interoceptive awareness, drive for thinness, bulimia were significantly reduced at follow-up. Many T0 personality facets were related to personality and psychopathology improvement at follow-up. Multimodal treatment encompassing psychiatric, nutritional and psychological approaches is at the moment the most reliable approach for the treatment of moderate to severe anorexia nervosa with a discrete rate of improvement. Some personality and psychopathology characteristics may represent specific factors which favor resistance and impair improvement. Future approaches should consider the personalization of therapeutic approach according to these features. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Multimodal Resources in Transnational Adoption

DEFF Research Database (Denmark)

Raudaskoski, Pirkko Liisa

The paper discusses an empirical analysis which highlights the multimodal nature of identity construction. A documentary on transnational adoption provides real life incidents as research material. The incidents involve (or from them emerge) various kinds of multimodal resources and participants...

Recent Progress in Synthesis and Functionalization of Multimodal Fluorescent-Magnetic Nanoparticles for Biological Applications

Directory of Open Access Journals (Sweden)

Raquel Serrano García

2018-01-01

Full Text Available There is a great interest in the development of new nanomaterials for multimodal imaging applications in biology and medicine. Multimodal fluorescent-magnetic based nanomaterials deserve particular attention as they can be used as diagnostic and drug delivery tools, which could facilitate the diagnosis and treatment of cancer and many other diseases. This review focuses on the recent developments of magnetic-fluorescent nanocomposites and their biomedical applications. The recent advances in synthetic strategies and approaches for the preparation of fluorescent-magnetic nanocomposites are presented. The main biomedical uses of multimodal fluorescent-magnetic nanomaterials, including biological imaging, cancer therapy and drug delivery, are discussed, and prospects of this field are outlined.

Multimodal Diversity of Postmodernist Fiction Text

Directory of Open Access Journals (Sweden)

U. I. Tykha

2016-12-01

Full Text Available The article is devoted to the analysis of structural and functional manifestations of multimodal diversity in postmodernist fiction texts. Multimodality is defined as the coexistence of more than one semiotic mode within a certain context. Multimodal texts feature a diversity of semiotic modes in the communication and development of their narrative. Such experimental texts subvert conventional patterns by introducing various semiotic resources – verbal or non-verbal.

Experiments in Multimodal Information Presentation

NARCIS (Netherlands)

van Hooijdonk, Charlotte; Bosma, W.E.; Krahmer, Emiel; Maes, Alfons; Theune, Mariet; van den Bosch, Antal; Bouma, Gosse

In this chapter we describe three experiments investigating multimodal information presentation in the context of a medical QA system. In Experiment 1, we wanted to know how non-experts design (multimodal) answers to medical questions, distinguishing between what questions and how questions. In

Modeling multimodal human-computer interaction

NARCIS (Netherlands)

Obrenovic, Z.; Starcevic, D.

2004-01-01

Incorporating the well-known Unified Modeling Language into a generic modeling framework makes research on multimodal human-computer interaction accessible to a wide range off software engineers. Multimodal interaction is part of everyday human discourse: We speak, move, gesture, and shift our gaze

Multimodal Discourse Analysis of the Movie "Argo"

Science.gov (United States)

Bo, Xu

2018-01-01

Based on multimodal discourse theory, this paper makes a multimodal discourse analysis of some shots in the movie "Argo" from the perspective of context of culture, context of situation and meaning of image. Results show that this movie constructs multimodal discourse through particular context, language and image, and successfully…

Evaluation of the Effectiveness of a Multimodal Complementary Medicine Program for Improving the Quality of Life of Cancer Patients during Adjuvant Radiotherapy and/or Chemotherapy or Outpatient Aftercare.

Science.gov (United States)

Domnick, Martin; Domnick, Manju; Wiebelitz, Karl-Rüdiger; Beer, André-Michael

2017-01-01

Evidence for complementary therapies as important strategies to relieve cancer treatment-associated symptoms is increasing. Mostly, these complementary therapies start at the end of adjuvant treatments, resulting in a long delay until the well-being of patients is addressed. Further, long distances between the rehabilitation center and the patients' residence hinder patients' compliance. The multimodal outpatient LOTUS Care Cure Project (LCCP) was tested in a randomized controlled trial including patients of various cancer entities and stages while on adjuvant chemotherapy and/or radiotherapy or outpatient aftercare. The intervention group received the LCCP additionally to the conventional treatment (LCCP group, n = 50). The control group (CG) was split into 2 groups, with (CG1, n = 33) and without (CG2, n = 17) weekly talks. The primary endpoint was quality of life (QoL) after 3 months. In the LCCP group, QoL significantly improved after 3 months compared to CG2 (p = 0.022) but not compared to CG1. Other parameters showing a significant improvement were cognitive (p < 0.05, vs. CG1 and CG2) and social function (p < 0.05, vs. CG2). This pilot study describes a multimodal outpatient complementary therapy program conducted in parallel with conventional therapies and its potential to significantly improve QoL and reduce treatment-associated side effects. To substantiate these data, multicenter trials are needed. © 2017 S. Karger AG, Basel.

A randomized phase II feasibility trial of a multimodal intervention for the management of cachexia in lung and pancreatic cancer.

Science.gov (United States)

Solheim, Tora S; Laird, Barry J A; Balstad, Trude Rakel; Stene, Guro B; Bye, Asta; Johns, Neil; Pettersen, Caroline H; Fallon, Marie; Fayers, Peter; Fearon, Kenneth; Kaasa, Stein

2017-10-01

Cancer cachexia is a syndrome of weight loss (including muscle and fat), anorexia, and decreased physical function. It has been suggested that the optimal treatment for cachexia should be a multimodal intervention. The primary aim of this study was to examine the feasibility and safety of a multimodal intervention (n-3 polyunsaturated fatty acid nutritional supplements, exercise, and anti-inflammatory medication: celecoxib) for cancer cachexia in patients with incurable lung or pancreatic cancer, undergoing chemotherapy. Patients receiving two cycles of standard chemotherapy were randomized to either the multimodal cachexia intervention or standard care. Primary outcome measures were feasibility assessed by recruitment, attrition, and compliance with intervention (>50% of components in >50% of patients). Key secondary outcomes were change in weight, muscle mass, physical activity, safety, and survival. Three hundred and ninety-nine were screened resulting in 46 patients recruited (11.5%). Twenty five patients were randomized to the treatment and 21 as controls. Forty-one completed the study (attrition rate 11%). Compliance to the individual components of the intervention was 76% for celecoxib, 60% for exercise, and 48% for nutritional supplements. As expected from the sample size, there was no statistically significant effect on physical activity or muscle mass. There were no intervention-related Serious Adverse Events and survival was similar between the groups. A multimodal cachexia intervention is feasible and safe in patients with incurable lung or pancreatic cancer; however, compliance to nutritional supplements was suboptimal. A phase III study is now underway to assess fully the effect of the intervention. © 2017 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders.

Multimodal exemplification: The expansion of meaning in electronic ...

African Journals Online (AJOL)

Functional Multimodal Discourse Analysis (SF-MDA) and argues for improving their exemplifica-tion multimodally. Multimodal devices, if well coordinated, can help optimize e-dictionary exam-ples in informativity, diversity, dynamicity and ...

Preferential loss of dorsal-hippocampus synapses underlies memory impairments provoked by short, multimodal stress.

Science.gov (United States)

Maras, P M; Molet, J; Chen, Y; Rice, C; Ji, S G; Solodkin, A; Baram, T Z

2014-07-01

The cognitive effects of stress are profound, yet it is unknown if the consequences of concurrent multiple stresses on learning and memory differ from those of a single stress of equal intensity and duration. We compared the effects on hippocampus-dependent memory of concurrent, hours-long light, loud noise, jostling and restraint (multimodal stress) with those of restraint or of loud noise alone. We then examined if differences in memory impairment following these two stress types might derive from their differential impact on hippocampal synapses, distinguishing dorsal and ventral hippocampus. Mice exposed to hours-long restraint or loud noise were modestly or minimally impaired in novel object recognition, whereas similar-duration multimodal stress provoked severe deficits. Differences in memory were not explained by differences in plasma corticosterone levels or numbers of Fos-labeled neurons in stress-sensitive hypothalamic neurons. However, although synapses in hippocampal CA3 were impacted by both restraint and multimodal stress, multimodal stress alone reduced synapse numbers severely in dorsal CA1, a region crucial for hippocampus-dependent memory. Ventral CA1 synapses were not significantly affected by either stress modality. Probing the basis of the preferential loss of dorsal synapses after multimodal stress, we found differential patterns of neuronal activation by the two stress types. Cross-correlation matrices, reflecting functional connectivity among activated regions, demonstrated that multimodal stress reduced hippocampal correlations with septum and thalamus and increased correlations with amygdala and BST. Thus, despite similar effects on plasma corticosterone and on hypothalamic stress-sensitive cells, multimodal and restraint stress differ in their activation of brain networks and in their impact on hippocampal synapses. Both of these processes might contribute to amplified memory impairments following short, multimodal stress.

Preferential loss of dorsal-hippocampus synapses underlies memory impairments provoked by short, multimodal stress

Science.gov (United States)

Maras, P M; Molet, J; Chen, Y; Rice, C; Ji, S G; Solodkin, A; Baram, T Z

2014-01-01

The cognitive effects of stress are profound, yet it is unknown if the consequences of concurrent multiple stresses on learning and memory differ from those of a single stress of equal intensity and duration. We compared the effects on hippocampus-dependent memory of concurrent, hours-long light, loud noise, jostling and restraint (multimodal stress) with those of restraint or of loud noise alone. We then examined if differences in memory impairment following these two stress types might derive from their differential impact on hippocampal synapses, distinguishing dorsal and ventral hippocampus. Mice exposed to hours-long restraint or loud noise were modestly or minimally impaired in novel object recognition, whereas similar-duration multimodal stress provoked severe deficits. Differences in memory were not explained by differences in plasma corticosterone levels or numbers of Fos-labeled neurons in stress-sensitive hypothalamic neurons. However, although synapses in hippocampal CA3 were impacted by both restraint and multimodal stress, multimodal stress alone reduced synapse numbers severely in dorsal CA1, a region crucial for hippocampus-dependent memory. Ventral CA1 synapses were not significantly affected by either stress modality. Probing the basis of the preferential loss of dorsal synapses after multimodal stress, we found differential patterns of neuronal activation by the two stress types. Cross-correlation matrices, reflecting functional connectivity among activated regions, demonstrated that multimodal stress reduced hippocampal correlations with septum and thalamus and increased correlations with amygdala and BST. Thus, despite similar effects on plasma corticosterone and on hypothalamic stress-sensitive cells, multimodal and restraint stress differ in their activation of brain networks and in their impact on hippocampal synapses. Both of these processes might contribute to amplified memory impairments following short, multimodal stress. PMID:24589888

Residential Treatment for Sexually Abusive Youth: An Assessment of Treatment Outcomes

Science.gov (United States)

Jones, Christopher D.; Chancey, Roy; Lowe, Laura A.; Risler, Edwin A.

2010-01-01

Objective: This research study assesses the effectiveness of participation in a multimodal/holistic residential treatment program on changing deviant sexual interests and functional impairment among sexually abusive youth. Method: A one-group pretest posttest design was utilized to examine pretest (intake) and posttest (discharge) scores for 58…

MultiModality Surgical and Hyperbaric Management of Mandibular Osteoradionecrosis

International Nuclear Information System (INIS)

Freiberger, John J.; Yoo, David S.; Lisle Dear, Guy de; McGraw, Thomas A.; Blakey, George H.; Padilla Burgos, Rebecca; Kraft, Kevin; Nelson, John W.; Moon, Richard E.; Piantadosi, Claude A.

2009-01-01

Purpose: To elucidate long-term outcomes in 65 consecutive patients meeting a uniform definition of mandibular osteoradionecrosis (ORN) treated with multimodality therapy including hyperbaric oxygen (HBO). Methods and Materials: Pretreatment, post-treatment and long-term follow-up of mandibular lesions with exposed bone were ranked by a systematic review of medical records and patient telephone calls. The ranking system was based on lesion diameter and number plus disease progression. Changes from pretreatment to post-treatment and follow-up were analyzed by Wilcoxon signed-rank tests. Improved wound survival, measured by time to relapse, defined as any less favorable rank after HBO treatment, was assessed by Kaplan-Meier analysis. Results: In all, 57 cases (88%) resolved or improved by lesion grade or progression and evolution criteria after HBO (p < 0.001). Four patients healed before surgery after HBO alone. Of 57 patients who experienced improvement, 41 had failed previous nonmultimodality therapy for 3 months and 26 for 6 months or more. A total of 43 patients were eligible for time-to-relapse survival analysis. Healing or improvement lasted a mean duration of 86.1 months (95% confidence interval [95% CI], 64.0-108.2) in nonsmokers (n = 20) vs. 15.8 months (95% CI, 8.4-23.2) in smokers (n = 14) versus 24.2 months (95% CI, 15.2-33.2) in patients with recurrent cancer (n = 9) (p = 0.002 by the log-rank method). Conclusions: Multimodality therapy using HBO is effective for ORN when less intensive therapies have failed. Although the healing rate in similarly affected patients not treated with HBO is unknown, the improvements seen with peri-operative HBO were durable provided that the patients remained cancer free and abstained from smoking.

Reference resolution in multi-modal interaction: Preliminary observations

NARCIS (Netherlands)

González González, G.R.; Nijholt, Antinus

2002-01-01

In this paper we present our research on multimodal interaction in and with virtual environments. The aim of this presentation is to emphasize the necessity to spend more research on reference resolution in multimodal contexts. In multi-modal interaction the human conversational partner can apply

Reference Resolution in Multi-modal Interaction: Position paper

NARCIS (Netherlands)

Fernando, T.; Nijholt, Antinus

2002-01-01

In this position paper we present our research on multimodal interaction in and with virtual environments. The aim of this presentation is to emphasize the necessity to spend more research on reference resolution in multimodal contexts. In multi-modal interaction the human conversational partner can

Neurofeedback and multimodal treatment of ADHD

Directory of Open Access Journals (Sweden)

Artur Kołakowski

2012-03-01

Full Text Available The attention‑deficit/hyperactivity disorder belongs to the most frequently diagnosed psychological (psychiatric disorders in childhood. It is characterized by the presence of fixed behaviour patterns maintained for at least 6 months and forming a characteristic triad of symptoms, such as inattention, impulsivity and hyperactivity, increased to the extent incommensurable to the child’s age and development level. Most of the guidelines on han‑ dling the ADHD suggest using non‑pharmacological methods and only when these appear ineffective, considering inclusion of pharmacological treatment. On the other hand, the studies indicate that most effective in ADHD treat‑ ment is the pharmacological treatment. It is worth emphasizing, however, that none of the presently available treat‑ ment methods solves all problems of the child’s functioning, therefore there is a constant demand for searching new ways of help for the ADHD‑affected children. One of the investigated methods is neurobiofeedback (NF. In this method, teaching the patient to influence the brain activity through instructing her/him on how to change the type of waves in the EEG – is to improve her/his functioning. In the problem described in the article an improvement in the EEG (achieved during exercise is to reduce the ADHD symptoms. But a survey of the existing research does not give an explicit answer whether or not this method is effective in ADHD treatment to the extent which could improve the patient’s functioning in real life. It is worth noting that as for now none of the guidelines has pointed to neurobiofeedback as a method recommended in the treatment of ADHD. Concluding, up to date we have not had any evidence that NF may constitute an independent or leading therapy in ADHD; we need further studies to spec‑ ify whether or not this is a method which could be a part of a comprehensive therapeutic program of the child with ADHD. Presently, it is treated rather

Robust Multimodal Dictionary Learning

Science.gov (United States)

Cao, Tian; Jojic, Vladimir; Modla, Shannon; Powell, Debbie; Czymmek, Kirk; Niethammer, Marc

2014-01-01

We propose a robust multimodal dictionary learning method for multimodal images. Joint dictionary learning for both modalities may be impaired by lack of correspondence between image modalities in training data, for example due to areas of low quality in one of the modalities. Dictionaries learned with such non-corresponding data will induce uncertainty about image representation. In this paper, we propose a probabilistic model that accounts for image areas that are poorly corresponding between the image modalities. We cast the problem of learning a dictionary in presence of problematic image patches as a likelihood maximization problem and solve it with a variant of the EM algorithm. Our algorithm iterates identification of poorly corresponding patches and re-finements of the dictionary. We tested our method on synthetic and real data. We show improvements in image prediction quality and alignment accuracy when using the method for multimodal image registration. PMID:24505674

Multimodality image registration with software: state-of-the-art

International Nuclear Information System (INIS)

Slomka, Piotr J.; Baum, Richard P.

2009-01-01

Multimodality image integration of functional and anatomical data can be performed by means of dedicated hybrid imaging systems or by software image co-registration techniques. Hybrid positron emission tomography (PET)/computed tomography (CT) systems have found wide acceptance in oncological imaging, while software registration techniques have a significant role in patient-specific, cost-effective, and radiation dose-effective application of integrated imaging. Software techniques allow accurate (2-3 mm) rigid image registration of brain PET with CT and MRI. Nonlinear techniques are used in whole-body image registration, and recent developments allow for significantly accelerated computing times. Nonlinear software registration of PET with CT or MRI is required for multimodality radiation planning. Difficulties remain in the validation of nonlinear registration of soft tissue organs. The utilization of software-based multimodality image integration in a clinical environment is sometimes hindered by the lack of appropriate picture archiving and communication systems (PACS) infrastructure needed to efficiently and automatically integrate all available images into one common database. In cardiology applications, multimodality PET/single photon emission computed tomography and coronary CT angiography imaging is typically not required unless the results of one of the tests are equivocal. Software image registration is likely to be used in a complementary fashion with hybrid PET/CT or PET/magnetic resonance imaging systems. Software registration of stand-alone scans ''paved the way'' for the clinical application of hybrid scanners, demonstrating practical benefits of image integration before the hybrid dual-modality devices were available. (orig.)

Linear Narratives, Arbitrary Relationships: Arbitrary Relationships: Mimesis and Direct Communication for Effectively Representing Engineering Realities Multimodally

Science.gov (United States)

Jeyaraj, Joseph

2017-01-01

Engineers communicate multimodally using written and visual communication, but there is not much theorizing on why they do so and how. This essay, therefore, examines why engineers communicate multimodally, what, in the context of representing engineering realities, are the strengths and weaknesses of written and visual communication, and how,…

Multimode-singlemode-multimode fiber sensor for alcohol sensing application

Science.gov (United States)

Rofi'ah, Iftihatur; Hatta, A. M.; Sekartedjo, Sekartedjo

2016-11-01

Alcohol is volatile and flammable liquid which is soluble substances both on polar and non polar substances that has been used in some industrial sectors. Alcohol detection method now widely used one of them is the optical fiber sensor. In this paper used fiber optic sensor based on Multimode-Single-mode-Multimode (MSM) to detect alcohol solution at a concentration range of 0-3%. The working principle of sensor utilizes the modal interference between the core modes and the cladding modes, thus make the sensor sensitive to environmental changes. The result showed that characteristic of the sensor not affect the length of the single-mode fiber (SMF). We obtain that the sensor with a length of 5 mm of single-mode can sensing the alcohol with a sensitivity of 0.107 dB/v%.

Persistence of Diabetes and Hypertension After Multimodal Treatment of Acromegaly.

Science.gov (United States)

González, Baldomero; Vargas, Guadalupe; de Los Monteros, Ana Laura Espinosa; Mendoza, Victoria; Mercado, Moisés

2018-06-01

Diabetes and hypertension are frequent comorbidities of acromegaly. To analyze the course of diabetes and hypertension at diagnosis and after multimodal therapy in a large cohort of patients with acromegaly. Retrospective study at a tertiary care center. A total of 522 patients with acromegaly treated according to a preestablished protocol. Prevalence of diabetes and hypertension and its relationship with biochemical indices of acromegalic control. The cohort was stratified according to disease activity upon last visit to clinic: (1) surgical remission (n = 122), (2) pharmacologically controlled (n = 92), (3) active disease (n = 148), (4) insulinlike growth factor (IGF)-1 discordance (n = 64), and (5) growth hormone (GH) discordance (n = 96). The prevalence of diabetes and hypertension at diagnosis was 30% and 37%, respectively, and did not change upon the last visit (30.6% and 38%). Both comorbidities were more prevalent at diagnosis and on the last visit than in the general population. Diabetes was less prevalent on the last visit in patients who achieved surgical remission than in those who persisted with active disease (25% vs 40%, P = 0.01). Upon multivariate analysis, diabetes was associated with an IGF-1 at diagnosis >2× upper limit of normal, with the persistence of active acromegaly, the presence of hypertension upon the last visit, with the presence of a macroadenoma, and with female sex. Our findings underscore the importance of an integral approach when managing these patients, focusing not only on the control of GH and IGF-1 levels but also on the timely diagnosis and the specific treatment of each comorbidity.

[Multimodal medical image registration using cubic spline interpolation method].

Science.gov (United States)

He, Yuanlie; Tian, Lianfang; Chen, Ping; Wang, Lifei; Ye, Guangchun; Mao, Zongyuan

2007-12-01

Based on the characteristic of the PET-CT multimodal image series, a novel image registration and fusion method is proposed, in which the cubic spline interpolation method is applied to realize the interpolation of PET-CT image series, then registration is carried out by using mutual information algorithm and finally the improved principal component analysis method is used for the fusion of PET-CT multimodal images to enhance the visual effect of PET image, thus satisfied registration and fusion results are obtained. The cubic spline interpolation method is used for reconstruction to restore the missed information between image slices, which can compensate for the shortage of previous registration methods, improve the accuracy of the registration, and make the fused multimodal images more similar to the real image. Finally, the cubic spline interpolation method has been successfully applied in developing 3D-CRT (3D Conformal Radiation Therapy) system.

Advanced Multimodal Solutions for Information Presentation

Science.gov (United States)

Wenzel, Elizabeth M.; Godfroy-Cooper, Martine

2018-01-01

High-workload, fast-paced, and degraded sensory environments are the likeliest candidates to benefit from multimodal information presentation. For example, during EVA (Extra-Vehicular Activity) and telerobotic operations, the sensory restrictions associated with a space environment provide a major challenge to maintaining the situation awareness (SA) required for safe operations. Multimodal displays hold promise to enhance situation awareness and task performance by utilizing different sensory modalities and maximizing their effectiveness based on appropriate interaction between modalities. During EVA, the visual and auditory channels are likely to be the most utilized with tasks such as monitoring the visual environment, attending visual and auditory displays, and maintaining multichannel auditory communications. Previous studies have shown that compared to unimodal displays (spatial auditory or 2D visual), bimodal presentation of information can improve operator performance during simulated extravehicular activity on planetary surfaces for tasks as diverse as orientation, localization or docking, particularly when the visual environment is degraded or workload is increased. Tactile displays offer a third sensory channel that may both offload information processing effort and provide a means to capture attention when urgently required. For example, recent studies suggest that including tactile cues may result in increased orientation and alerting accuracy, improved task response time and decreased workload, as well as provide self-orientation cues in microgravity on the ISS (International Space Station). An important overall issue is that context-dependent factors like task complexity, sensory degradation, peripersonal vs. extrapersonal space operations, workload, experience level, and operator fatigue tend to vary greatly in complex real-world environments and it will be difficult to design a multimodal interface that performs well under all conditions. As a

Evaluating the efficacy of an integrated motivational interviewing and multi-modal exercise intervention for youth with major depression: Healthy Body, Healthy Mind randomised controlled trial protocol.

Science.gov (United States)

Nasstasia, Yasmina; Baker, Amanda L; Halpin, Sean A; Hides, Leanne; Lewin, Terry J; Kelly, Brian J; Callister, Robin

2018-03-01

Recent meta-analytic reviews suggest exercise can reduce depression severity among adults with major depressive disorder (MDD); however, efficacy studies with depressed youth are limited. Few studies have investigated the efficacy of multi-modal exercise interventions in this population, addressed treatment engagement, or explored the differential effects of exercise on depressive symptom profiles. This paper describes the study protocol and recruitment pattern for an assessor blinded, two-arm randomised controlled trial investigating the efficacy of an integrated motivational interviewing (MI) and multi-modal exercise intervention in youth diagnosed with MDD. Associations between depressive symptom profiles (cognitive, somatic and affective) and psychological, physiological (fitness), and biological (blood biomarker) outcomes will also be examined. Participants aged 15-25 years with current MDD were recruited. Eligible participants were randomised and stratified according to gender and depression severity to either an immediate or delayed (control) group. The immediate group received a brief MI intervention followed by a 12-week small group exercise intervention (3 times per week for 1 h), all delivered by personal trainers. The delayed control group received the same intervention 12-weeks later. Both groups were reassessed at mid-treatment or mid-control, post-treatment or post-control, and follow-up (12 weeks post-treatment). 68 participants were recruited and randomly allocated to an intervention group. This trial will increase our understanding of the efficacy of multi-modal exercise interventions for depression and the specific effects of exercise on depressive symptom profiles. It also offers a novel contribution by addressing treatment engagement in exercise efficacy trials in youth with MDD.

Chemotherapy in combined and multimodality treatment

International Nuclear Information System (INIS)

Anon.

1989-01-01

It is shown that chemotherapy of tumors of various localizations developes intensively in the last few years. It is connected with discovery and adoption of new active antitumoral preparations, such as alkylating preparations, antimetabolites, antitumoral antibiotics, hormonal preparations. To create the rational effective conditions of chemotherapy a study was made on kinetics of tumor gowth, molecular mechanisms of interaction of cytostatics and cells of malignant tumor. Main factors of chemotherapy combination with radiotherapy when treating numerous malignant tumors were considered. Effectiveness of using chemotherapy in combination with other methods of treatment was shown

Multimodality, creativity and children's meaning-making: Drawings ...

African Journals Online (AJOL)

Multimodality, creativity and children's meaning-making: Drawings, writings, imaginings. ... Framed by social semiotic theories of communication, multimodal ... to create imaginary worlds and express meanings according to their interests.

Multimode-singlemode-multimode optical fiber sensor coated with novolac resin for detecting liquid phase alcohol

Science.gov (United States)

Marfu'ah, Amalia, Niza Rosyda; Hatta, Agus Muhamad; Pratama, Detak Yan

2018-04-01

Alcohol sensor based on multimode-singlemode-multimode (MSM) optical fiber with novolac resin as the external medium is proposed and demonstrated experimentally. Novolac resin swells when it is exposed by the alcohol. This effect causes a change in the polymer density leading to the refractive index's variation. The transmission light of the sensor depends on the refractive index of external medium. Based on the results, alcohol sensor based on MSM optical fiber structure using novolac resin has a higher sensitivity compared to the sensor without using novolac resin in the mixture of alcohol and distilled water. Alcohol sensor based on MSM optical fiber structure using novolac resin in the mixture of alcohol and distilled water with a singlemode fiber length of 5 mm has a sensitivity of 0.028972 dBm per % V/V, and in the mixture of alcohol and sugar solution of 10% w/w has a sensitivity of 0.005005 dBm per % V/V.

Link Design Rules for Cost-Effective Short-Range Radio Over Multimode Fiber Systems

DEFF Research Database (Denmark)

Visani, Davide; Tartarini, Giovanni; Petersen, Martin Nordal

2010-01-01

Referring to short-range radio over multimode fiber links, we find out important guidelines for the realization of cost-effective intensity modulated directly detected systems. Since the quality of today's connectors is considerably higher than in the past, we demonstrate that two important...... parameters of the system are the finite detecting area of the photodiode and the laser frequency chirp. Furthemore, we show that the use of the central launch technique inherently determines a lower impact of modal noise fluctuations with respect to the offset launch one. This makes CL more convenient...

Multimodality image registration with software: state-of-the-art

Energy Technology Data Exchange (ETDEWEB)

Slomka, Piotr J. [Cedars-Sinai Medical Center, AIM Program/Department of Imaging, Los Angeles, CA (United States); University of California, David Geffen School of Medicine, Los Angeles, CA (United States); Baum, Richard P. [Center for PET, Department of Nuclear Medicine, Bad Berka (Germany)

2009-03-15

Multimodality image integration of functional and anatomical data can be performed by means of dedicated hybrid imaging systems or by software image co-registration techniques. Hybrid positron emission tomography (PET)/computed tomography (CT) systems have found wide acceptance in oncological imaging, while software registration techniques have a significant role in patient-specific, cost-effective, and radiation dose-effective application of integrated imaging. Software techniques allow accurate (2-3 mm) rigid image registration of brain PET with CT and MRI. Nonlinear techniques are used in whole-body image registration, and recent developments allow for significantly accelerated computing times. Nonlinear software registration of PET with CT or MRI is required for multimodality radiation planning. Difficulties remain in the validation of nonlinear registration of soft tissue organs. The utilization of software-based multimodality image integration in a clinical environment is sometimes hindered by the lack of appropriate picture archiving and communication systems (PACS) infrastructure needed to efficiently and automatically integrate all available images into one common database. In cardiology applications, multimodality PET/single photon emission computed tomography and coronary CT angiography imaging is typically not required unless the results of one of the tests are equivocal. Software image registration is likely to be used in a complementary fashion with hybrid PET/CT or PET/magnetic resonance imaging systems. Software registration of stand-alone scans ''paved the way'' for the clinical application of hybrid scanners, demonstrating practical benefits of image integration before the hybrid dual-modality devices were available. (orig.)

Immunotherapy in multimodality treatment

International Nuclear Information System (INIS)

Anon.

1989-01-01

Application of immunotherapy for treatment of oncologic patients is considered. Monoclonal antibodies (MCA) are used for immunotherapy both independently and as carriers of various toxins, chemopreparations and radioactive isotopes. It is shown that immunotherapy should be considered as one of additional methods of multimodulity treatment of patients with malignant tumors

(Re-)Examination of Multimodal Augmented Reality

NARCIS (Netherlands)

Rosa, N.E.; Werkhoven, P.J.; Hürst, W.O.

2016-01-01

The majority of augmented reality (AR) research has been concerned with visual perception, however the move towards multimodality is imminent. At the same time, there is no clear vision of what multimodal AR is. The purpose of this position paper is to consider possible ways of examining AR other

Multimodal integration of anatomy and physiology classes: How instructors utilize multimodal teaching in their classrooms

Science.gov (United States)

McGraw, Gerald M., Jr.

Multimodality is the theory of communication as it applies to social and educational semiotics (making meaning through the use of multiple signs and symbols). The term multimodality describes a communication methodology that includes multiple textual, aural, and visual applications (modes) that are woven together to create what is referred to as an artifact. Multimodal teaching methodology attempts to create a deeper meaning to course content by activating the higher cognitive areas of the student's brain, creating a more sustained retention of the information (Murray, 2009). The introduction of multimodality educational methodologies as a means to more optimally engage students has been documented within educational literature. However, studies analyzing the distribution and penetration into basic sciences, more specifically anatomy and physiology, have not been forthcoming. This study used a quantitative survey design to determine the degree to which instructors integrated multimodality teaching practices into their course curricula. The instrument used for the study was designed by the researcher based on evidence found in the literature and sent to members of three associations/societies for anatomy and physiology instructors: the Human Anatomy and Physiology Society; the iTeach Anatomy & Physiology Collaborate; and the American Physiology Society. Respondents totaled 182 instructor members of two- and four-year, private and public higher learning colleges collected from the three organizations collectively with over 13,500 members in over 925 higher learning institutions nationwide. The study concluded that the expansion of multimodal methodologies into anatomy and physiology classrooms is at the beginning of the process and that there is ample opportunity for expansion. Instructors continue to use lecture as their primary means of interaction with students. Email is still the major form of out-of-class communication for full-time instructors. Instructors with

Multi-Modality Registration And Fusion Of Medical Image Data

International Nuclear Information System (INIS)

Kassak, P.; Vencko, D.; Cerovsky, I.

2008-01-01

Digitalisation of health care providing facilities allows US to maximize the usage of digital data from one patient obtained by various modalities. Complex view on to the problem can be achieved from the site of morphology as well as functionality. Multi-modal registration and fusion of medical image data is one of the examples that provides improved insight and allows more precise approach and treatment. (author)

Experimental evaluation of user performance in a pursuit tracking task with multimodal feedback

Directory of Open Access Journals (Sweden)

Obrenović Željko

2004-01-01

Full Text Available In this paper we describe the results of experimental evaluation of user performance in a pursuit-tracking task with multimodal feedback. Our experimental results indicate that audio can significantly improve the accuracy of pursuit tracking. Experiments with 19 participants have shown that addition of acoustic modalities reduces the error during pursuit tracking for up to 19%. Moreover, experiments indicated the existence of perceptual boundaries of multimodal HCI for different scene complexity and target speeds. We have also shown that the most appealing paradigms are not the most effective ones, which necessitates a careful quantitative analysis of proposed multimodal HCI paradigms.

Multimodale trafiknet i GIS (Multimodal Traffic Network in GIS)

DEFF Research Database (Denmark)

Kronbak, Jacob; Brems, Camilla Riff

1996-01-01

The report introduces the use of multi-modal traffic networks within a geographical Information System (GIS). The necessary theory of modelling multi-modal traffic network is reviewed and applied to the ARC/INFO GIS by an explorative example.......The report introduces the use of multi-modal traffic networks within a geographical Information System (GIS). The necessary theory of modelling multi-modal traffic network is reviewed and applied to the ARC/INFO GIS by an explorative example....

Training of Perceptual Motor Skills in Multimodal Virtual Environments

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Gopher Daniel

2011-12-01

Full Text Available Multimodal, immersive, virtual reality (VR techniques open new perspectives for perceptualmotor skill trainers. They also introduce new risks and dangers. This paper describes the benefits and pitfalls of multimodal training and the cognitive building blocks of a multimodal, VR training simulators.

Multimodal processes scheduling in mesh-like network environment

Directory of Open Access Journals (Sweden)

Bocewicz Grzegorz

2015-06-01

Full Text Available Multimodal processes planning and scheduling play a pivotal role in many different domains including city networks, multimodal transportation systems, computer and telecommunication networks and so on. Multimodal process can be seen as a process partially processed by locally executed cyclic processes. In that context the concept of a Mesh-like Multimodal Transportation Network (MMTN in which several isomorphic subnetworks interact each other via distinguished subsets of common shared intermodal transport interchange facilities (such as a railway station, bus station or bus/tram stop as to provide a variety of demand-responsive passenger transportation services is examined. Consider a mesh-like layout of a passengers transport network equipped with different lines including buses, trams, metro, trains etc. where passenger flows are treated as multimodal processes. The goal is to provide a declarative model enabling to state a constraint satisfaction problem aimed at multimodal transportation processes scheduling encompassing passenger flow itineraries. Then, the main objective is to provide conditions guaranteeing solvability of particular transport lines scheduling, i.e. guaranteeing the right match-up of local cyclic acting bus, tram, metro and train schedules to a given passengers flow itineraries.

Influence of Blood Contamination During Multimode Adhesive ...

African Journals Online (AJOL)

Objectives: The present study evaluated the effects of blood contamination performed at different steps of bonding on the microtensile bond strength (μTBS) of multimode adhesives to dentin when using the self-etch approach. Materials and Methods: Seventy-five molars were randomly assigned to three adhesive groups ...

Effectiveness of a multimodal hand hygiene campaign and obstacles to success in Addis Ababa, Ethiopia

OpenAIRE

Schmitz, Karen; Kempker, Russell R; Tenna, Admasu; Stenehjem, Edward; Abebe, Engida; Tadesse, Lia; Jirru, Ermias Kacha; Blumberg, Henry M

2014-01-01

Background Hand hygiene is the cornerstone of infection control and reduces rates of healthcare associated infection. There are limited data evaluating hand hygiene adherence and hand hygiene campaign effect in resource-limited settings, especially in Sub-Saharan Africa. This study assessed the impact of implementing a World Health Organization (WHO)-recommended multimodal hand hygiene campaign at a hospital in Ethiopia. Methods This study included a before-and-after assessment of health care...

Randomized comparison of effectiveness of unimodal opioid analgesia with multimodal analgesia in post–cesarean section pain management

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Adeniji AO

2013-05-01

Full Text Available Adetunji Oladeni Adeniji,1 Oluseyi Olaboyede A Atanda21Department of Obstetrics and Gynaecology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria; 2Department of Obstetrics and Gynaecology, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, NigeriaBackground: Postoperative pain leads to patient discomfort, decreased level of satisfaction, prolonged recovery, and higher health costs. Acute pain control therefore improves the overall quality of life in patients undergoing cesarean section. Pain relief is a fundamental human right, but there is no gold standard for post–cesarean section pain management.Objective: To compare the efficacy of pentazocine and tramadol used in unimodal and multimodal (in combination with piroxicam approach, in the management of post–cesarean section pain.Materials and methods: This study employed a random allocation design to compare the effectiveness of intramuscular pentazocine (60 mg or tramadol (100 mg as single analgesic agent and in combination with daily intramuscular piroxicam 20 mg, for the management of post–cesarean section pain during the immediate 12 hours after surgery. The primary outcome measure was control of postoperative pain, while the secondary outcome measures were the analgesic agent onset of action, duration of action, patient satisfaction, and maternal and neonatal adverse outcomes. Data obtained were entered into a predesigned sheet and analyzed with the Statistical Package for Social Sciences version 17. Means ± standard deviation (SD were calculated for the quantitative variables, and the difference between two independent groups was compared using unpaired Student's t-test. The level of significance was set at 0.05.Results: A total of 120 patients were equally and randomly allocated to four study groups – two that received unimodal analgesia (the pentazocine group and the tramadol group and two that received multimodal analgesia (the pentazocine

Mediating multimodal environmental knowledge across animation techniques

DEFF Research Database (Denmark)

Maier, Carmen Daniela

2011-01-01

://www.sustainlane.com/. The multimodal discourse analysis is meant to reveal how selection and representation of environmental knowledge about social actors, social actions, resources, time and space are influenced by animation techniques. Furthermore, in the context of this multimodal discourse analysis, their influence upon......The growing awareness of and concern about present environmental problems generate a proliferation of new forms of environmental discourses that are mediated in various ways. This chapter explores issues related to the ways in which environmental knowledge is multimodally communicated...

Effects of arginine on multimodal anion exchange chromatography.

Science.gov (United States)

Hirano, Atsushi; Arakawa, Tsutomu; Kameda, Tomoshi

2015-12-01

The effects of arginine on binding and elution properties of a multimodal anion exchanger, Capto adhere, were examined using bovine serum albumin (BSA) and a monoclonal antibody against interleukin-8 (mAb-IL8). Negatively charged BSA was bound to the positively charged Capto adhere and was readily eluted from the column with a stepwise or gradient elution using 1M NaCl at pH 7.0. For heat-treated BSA, small oligomers and remaining monomers were also eluted using a NaCl gradient, whereas larger oligomers required arginine for effective elution. The positively charged mAb-IL8 was bound to Capto adhere at pH 7.0. Arginine was also more effective for elution of the bound mAb-IL8 than was NaCl. The results imply that arginine interacts with the positively charged Capto adhere. The mechanism underlying the interactions of arginine with Capto adhere was examined by calculating the binding free energy between an arginine molecule and a Capto adhere ligand in water through molecular dynamics simulations. The overall affinity of arginine for Capto adhere is attributed to the hydrophobic and π-π interactions between an arginine side chain and the aromatic moiety of the ligand as well as hydrogen bonding between arginine and the ligand hydroxyl group, which may account for the characteristics of protein elution using arginine. Copyright © 2015 Elsevier Inc. All rights reserved.

Nimh Treatment Study of ADHD Follow-Up

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J Gordon Millichap

2004-04-01

Full Text Available The effects of changes in medication use between 14 and 24 months follow-up on effectiveness (symptom ratings and growth (height and weight measures were analyzed, comparing 4 groups of patients, in the Multimodal Treatment Study of ADHD (MTA reported by the MTA Cooperative Group.

An 8-Week Knee Osteoarthritis Treatment Program of Hyaluronic Acid Injection, Deliberate Physical Rehabilitation, and Patient Education is Cost Effective at 2 Years Follow-up: The OsteoArthritis Centers of America Experience

Directory of Open Access Journals (Sweden)

Larry E. Miller

2014-01-01

Full Text Available Numerous nonsurgical interventions have been reported to improve symptoms of knee osteoarthritis (OA over the short term. However, longer follow-up is required to accurately characterize outcomes such as cost effectiveness and delayed arthroplasty. A total of 553 patients with symptomatic knee OA who previously underwent a single 8-week multimodal treatment program were contacted at 1 year ( n = 336 or 2 years ( n = 217 follow-up. The percentage of patients who underwent knee arthroplasty was 10% at 1 year and 18% at 2 years following program completion. The treatment program was highly cost effective at $12,800 per quality-adjusted life year at 2 years. Cost effectiveness was maintained under a variety of plausible assumptions and regardless of gender, age, body mass index, disease severity, or knee pain severity. In summary, a single 8-week multimodal knee OA treatment program is cost effective and may lower knee arthroplasty utilization through 2 years follow-up.

Deep Multimodal Distance Metric Learning Using Click Constraints for Image Ranking.

Science.gov (United States)

Yu, Jun; Yang, Xiaokang; Gao, Fei; Tao, Dacheng

2017-12-01

How do we retrieve images accurately? Also, how do we rank a group of images precisely and efficiently for specific queries? These problems are critical for researchers and engineers to generate a novel image searching engine. First, it is important to obtain an appropriate description that effectively represent the images. In this paper, multimodal features are considered for describing images. The images unique properties are reflected by visual features, which are correlated to each other. However, semantic gaps always exist between images visual features and semantics. Therefore, we utilize click feature to reduce the semantic gap. The second key issue is learning an appropriate distance metric to combine these multimodal features. This paper develops a novel deep multimodal distance metric learning (Deep-MDML) method. A structured ranking model is adopted to utilize both visual and click features in distance metric learning (DML). Specifically, images and their related ranking results are first collected to form the training set. Multimodal features, including click and visual features, are collected with these images. Next, a group of autoencoders is applied to obtain initially a distance metric in different visual spaces, and an MDML method is used to assign optimal weights for different modalities. Next, we conduct alternating optimization to train the ranking model, which is used for the ranking of new queries with click features. Compared with existing image ranking methods, the proposed method adopts a new ranking model to use multimodal features, including click features and visual features in DML. We operated experiments to analyze the proposed Deep-MDML in two benchmark data sets, and the results validate the effects of the method.

A community intervention trial of multimodal suicide prevention program in Japan: A Novel multimodal Community Intervention program to prevent suicide and suicide attempt in Japan, NOCOMIT-J

OpenAIRE

Ono, Yutaka; Awata, Shuichi; Iida, Hideharu; Ishida, Yasushi; Ishizuka, Naoki; Iwasa, Hiroto; Kamei, Yuichi; Motohashi, Yutaka; Nakagawa, Atsuo; Nakamura, Jun; Nishi, Nobuyuki; Otsuka, Kotaro; Oyama, Hirofumi; Sakai, Akio; Sakai, Hironori

2008-01-01

Abstract Background To respond to the rapid surge in the incidence of suicide in Japan, which appears to be an ongoing trend, the Japanese Multimodal Intervention Trials for Suicide Prevention (J-MISP) have launched a multimodal community-based suicide prevention program, NOCOMIT-J. The primary aim of this study is to examine whether NOCOMIT-J is effective in reducing suicidal behavior in the community. Methods/DesignThis study is a community intervention trial involving seven intervention re...

Highly Sensitive Liquid Core Temperature Sensor Based on Multimode Interference Effects

Directory of Open Access Journals (Sweden)

Miguel A. Fuentes-Fuentes

2015-10-01

Full Text Available A novel fiber optic temperature sensor based on a liquid-core multimode interference device is demonstrated. The advantage of such structure is that the thermo-optic coefficient (TOC of the liquid is at least one order of magnitude larger than that of silica and this, combined with the fact that the TOC of silica and the liquid have opposite signs, provides a liquid-core multimode fiber (MMF highly sensitive to temperature. Since the refractive index of the liquid can be easily modified, this allows us to control the modal properties of the liquid-core MMF at will and the sensor sensitivity can be easily tuned by selecting the refractive index of the liquid in the core of the device. The maximum sensitivity measured in our experiments is 20 nm/°C in the low-temperature regime up to 60 °C. To the best of our knowledge, to date, this is the largest sensitivity reported for fiber-based MMI temperature sensors.

A randomized controlled trial of multimodal music therapy for children with anxiety disorders.

Science.gov (United States)

Goldbeck, Lutz; Ellerkamp, Thomas

2012-01-01

Music therapy has been shown to be effective for children with psychopathology, providing an alternative nonverbal approach to the treatment of children with anxiety disorders. This pilot study investigates the efficacy of Multimodal Music Therapy (MMT), a combination of music therapy and cognitive-behavioral therapy, compared to treatment as usual (TAU). Thirty-six children aged 8-12 years with a primary diagnosis of an anxiety disorder were randomly assigned to 15 sessions of MMT or to TAU. Diagnostic status and dimensional outcome variables were assessed at the end of treatment and 4 months later. MMT was superior compared to TAU according to the remission rates after treatment (MMT 67%; TAU 33%; chi2 = 4.0; p = 0.046) and remissions persisted until four months post-treatment. Dimensional measures showed equivalent improvement after either MMT or TAU. The results regarding the efficacy of MMT are promising for children with anxiety disorders. Further evaluation with larger samples and comparisons to pure CBT are recommended.

Effectiveness of individualized, integrative outpatient treatment for females with anorexia nervosa and bulimia nervosa.

Science.gov (United States)

Freudenberg, Cara; Jones, Rebecca A; Livingston, Genvieve; Goetsch, Virginia; Schaffner, Angela; Buchanan, Linda

2016-01-01

The effectiveness of an individualized outpatient program was investigated in the treatment of bulimia nervosa (BN) and anorexia nervosa (AN). Participants included 151 females who received outpatient eating disorder treatment in the partial hospitalization program, the intensive outpatient program, or a combination of the two programs. Outcome measures included the Eating Disorder Inventory (EDI-2), Beck Depression Inventory (BDI-II), frequency of binge eating and purging, and mean body weight. Findings included significant increases in weight for the AN group, reductions in binge eating frequency for the BN group, and reductions in EDI-2 and BDI-II scores and purging frequency for both groups. This study provides preliminary support for the efficacy of a multimodal program for the treatment of both anorexia nervosa and bulimia nervosa.

Randomized Controlled Trial: Multimodal Anxiety and Social Skill Intervention for Adolescents with Autism Spectrum Disorder

Science.gov (United States)

White, Susan W.; Ollendick, Thomas; Albano, Anne Marie; Oswald, Donald; Johnson, Cynthia; Southam-Gerow, Michael A.; Kim, Inyoung; Scahill, Lawrence

2012-01-01

Anxiety is common among adolescents with autism spectrum disorders (ASD) and may amplify the core social disability, thus necessitating combined treatment approaches. This pilot, randomized controlled trial (RCT) evaluated the feasibility and preliminary outcomes of the Multimodal Anxiety and Social Skills Intervention (MASSI) program in a sample of 30 adolescents with ASD and anxiety symptoms of moderate or greater severity. The treatment was acceptable to families, subject adherence was high, and therapist fidelity was high. A 16% improvement in ASD social impairment (within-group effect size = 1.18) was observed on a parent-reported scale. Although anxiety symptoms declined by 26%, the change was not statistically significant. These findings suggest MASSI is a feasible treatment program and further evaluation is warranted. PMID:22735897

The treatment of late radiation effects with hyperbaric oxygenation (HBO)

International Nuclear Information System (INIS)

Plafki, C.; Carl, U.M.; Glag, M.; Hartmann, K.A.

1998-01-01

Background: Late radiation injuries may impose a negative influence on the quality of life in the affected patients. In several entities, standardized treatment protocols are lacking. Hyperbaric oxygenation (HBO) has been shown to have beneficial effects in the treatment of late radiation sequelae. Material and methods: The basic principles of HBO are reviewed as well as clinical issues. Current study protocols are presented. Results: During HBO-therapy the patient breathes pure oxygen at pressures above 100 kPa. The oxygen solubility within the fluid phase of the blood is largely increased. Biological effects include an increased oxygen diffusibility, improved collagen synthesis and neoangiogenesis as well as an enhancement of antimicrobial defenses. By decreasing the capillary filtration pressure a reduction of edema becomes possible. HBO has been shown to prevent complications following surgery in irradiated tissues. Its efficacy as an adjunct in the treatment of osteonecroses in radiation patients could be demonstrated. In addition, the loss of osseointegrated implants in the maxillofacial bones of these patients could be significantly reduced. Further indications include soft tissue necroses, hemorrhagic cystitis and proctitis in tumor patients that have been treated by radiotherapy as part of a multimodality approach. Conclusions: HBO in the treatment of late radiation effects is still subject of investigation, but remarkable results have been reported. Optimized treatment protocols need to be determined in various entities. The rate of side effects is acceptable low. (orig.) [de

Evaluating the efficacy of an integrated motivational interviewing and multi-modal exercise intervention for youth with major depression: Healthy Body, Healthy Mind randomised controlled trial protocol

Directory of Open Access Journals (Sweden)

Yasmina Nasstasia

2018-03-01

Conclusion: This trial will increase our understanding of the efficacy of multi-modal exercise interventions for depression and the specific effects of exercise on depressive symptom profiles. It also offers a novel contribution by addressing treatment engagement in exercise efficacy trials in youth with MDD.

Sex in the Curriculum: The Effect of a Multi-Modal Sexual History-Taking Module on Medical Student Skills

Science.gov (United States)

Lindau, Stacy Tessler; Goodrich, Katie G.; Leitsch, Sara A.; Cook, Sandy

2008-01-01

Purpose: The objective of this study was to determine the effect of a multi-modal curricular intervention designed to teach sexual history-taking skills to medical students. The Association of Professors of Gynecology and Obstetrics, the National Board of Medical Examiners, and others, have identified sexual history-taking as a learning objective…

Advanced driver assistance systems: Using multimodal redundant warnings to enhance road safety.

Science.gov (United States)

Biondi, Francesco; Strayer, David L; Rossi, Riccardo; Gastaldi, Massimiliano; Mulatti, Claudio

2017-01-01

This study investigated whether multimodal redundant warnings presented by advanced assistance systems reduce brake response times. Warnings presented by assistance systems are designed to assist drivers by informing them that evasive driving maneuvers are needed in order to avoid a potential accident. If these warnings are poorly designed, they may distract drivers, slow their responses, and reduce road safety. In two experiments, participants drove a simulated vehicle equipped with a forward collision avoidance system. Auditory, vibrotactile, and multimodal warnings were presented when the time to collision was shorter than five seconds. The effects of these warnings were investigated with participants performing a concurrent cell phone conversation (Exp. 1) or driving in high-density traffic (Exp. 2). Braking times and subjective workload were measured. Multimodal redundant warnings elicited faster braking reaction times. These warnings were found to be effective even when talking on a cell phone (Exp. 1) or driving in dense traffic (Exp. 2). Multimodal warnings produced higher ratings of urgency, but ratings of frustration did not increase compared to other warnings. Findings obtained in these two experiments are important given that faster braking responses may reduce the potential for a collision. Copyright © 2016 Elsevier Ltd. All rights reserved.

Multi-Modality Cascaded Convolutional Neural Networks for Alzheimer's Disease Diagnosis.

Science.gov (United States)

Liu, Manhua; Cheng, Danni; Wang, Kundong; Wang, Yaping

2018-03-23

Accurate and early diagnosis of Alzheimer's disease (AD) plays important role for patient care and development of future treatment. Structural and functional neuroimages, such as magnetic resonance images (MRI) and positron emission tomography (PET), are providing powerful imaging modalities to help understand the anatomical and functional neural changes related to AD. In recent years, machine learning methods have been widely studied on analysis of multi-modality neuroimages for quantitative evaluation and computer-aided-diagnosis (CAD) of AD. Most existing methods extract the hand-craft imaging features after image preprocessing such as registration and segmentation, and then train a classifier to distinguish AD subjects from other groups. This paper proposes to construct cascaded convolutional neural networks (CNNs) to learn the multi-level and multimodal features of MRI and PET brain images for AD classification. First, multiple deep 3D-CNNs are constructed on different local image patches to transform the local brain image into more compact high-level features. Then, an upper high-level 2D-CNN followed by softmax layer is cascaded to ensemble the high-level features learned from the multi-modality and generate the latent multimodal correlation features of the corresponding image patches for classification task. Finally, these learned features are combined by a fully connected layer followed by softmax layer for AD classification. The proposed method can automatically learn the generic multi-level and multimodal features from multiple imaging modalities for classification, which are robust to the scale and rotation variations to some extent. No image segmentation and rigid registration are required in pre-processing the brain images. Our method is evaluated on the baseline MRI and PET images of 397 subjects including 93 AD patients, 204 mild cognitive impairment (MCI, 76 pMCI +128 sMCI) and 100 normal controls (NC) from Alzheimer's Disease Neuroimaging

Understanding and treating vaginismus: a multimodal approach.

Science.gov (United States)

Pacik, Peter T

2014-12-01

This clinical opinion was written to bring attention to the understanding and treatment of vaginismus, a condition that is often under diagnosed and therefore inadequately treated, yet affects millions of women worldwide. Despite its description more than a century ago, vaginismus is rarely taught in medical school, residency training, and medical meetings. The DSM 5 classification stresses that vaginismus is a penetration disorder in that any form of vaginal penetration such as tampons, finger, vaginal dilators, gynecological examinations, and intercourse is often painful or impossible. Compared with other sexual pain disorders such as vulvodynia and vestibulodynia, the treatment of vaginismus has the potential for a high rate of success. Stratifying the severity of vaginismus allows the clinician to choose among numerous treatment options and to better understand what the patient is experiencing. Vaginismus is both a physical and an emotional disorder. In the more severe cases of vaginismus women (and men) complain that attempted intercourse is like "hitting a wall" suggestive of spasm at the level of the introitus. The emotional fallout resulting from this needs to be addressed in any form of treatment applied. This article is based on lessons learned in the treatment of more than 250 patients and evaluation of more than 400 inquiries, and was written to make vaginismus more widely understood, to aid in the differential diagnosis of sexual pain, suggest a variety of effective treatments, and explain how Botox can be used as part of a multimodal treatment program to treat vaginismus. With greater awareness among clinicians it is hoped that medical schools, residency programs, and medical meetings will begin teaching the understanding and treatment of vaginismus.

Polarization Characterization of a Multi-Moded Feed Structure

Data.gov (United States)

National Aeronautics and Space Administration — The Polarization Characterization of a Multi-Moded Feed Structure projects characterize the polarization response of a multi-moded feed horn as an innovative...

Adaptive multimodal interaction in mobile augmented reality: A conceptual framework

Science.gov (United States)

Abidin, Rimaniza Zainal; Arshad, Haslina; Shukri, Saidatul A'isyah Ahmad

2017-10-01

Recently, Augmented Reality (AR) is an emerging technology in many mobile applications. Mobile AR was defined as a medium for displaying information merged with the real world environment mapped with augmented reality surrounding in a single view. There are four main types of mobile augmented reality interfaces and one of them are multimodal interfaces. Multimodal interface processes two or more combined user input modes (such as speech, pen, touch, manual gesture, gaze, and head and body movements) in a coordinated manner with multimedia system output. In multimodal interface, many frameworks have been proposed to guide the designer to develop a multimodal applications including in augmented reality environment but there has been little work reviewing the framework of adaptive multimodal interface in mobile augmented reality. The main goal of this study is to propose a conceptual framework to illustrate the adaptive multimodal interface in mobile augmented reality. We reviewed several frameworks that have been proposed in the field of multimodal interfaces, adaptive interface and augmented reality. We analyzed the components in the previous frameworks and measure which can be applied in mobile devices. Our framework can be used as a guide for designers and developer to develop a mobile AR application with an adaptive multimodal interfaces.

Filter. Remix. Make.: Cultivating Adaptability through Multimodality

Science.gov (United States)

Dusenberry, Lisa; Hutter, Liz; Robinson, Joy

2015-01-01

This article establishes traits of adaptable communicators in the 21st century, explains why adaptability should be a goal of technical communication educators, and shows how multimodal pedagogy supports adaptability. Three examples of scalable, multimodal assignments (infographics, research interviews, and software demonstrations) that evidence…

Compact and broadband directional coupling and demultiplexing in dielectric-loaded surface plasmon polariton waveguides based on the multimode interference effect

DEFF Research Database (Denmark)

Zhu, Zhihong; García Ortíz, César Eduardo; Han, Zhanghua

2013-01-01

We theoretically, numerically, and experimentally demonstrate that a directional coupling function can be realized with a wide bandwidth (greater than 200 nm) in dielectric-loaded surface plasmon polariton waveguides based on the multimode interference effect. The functional size of the structure...

Impact of multimodality in reading comprehension of narrative texts in English as a foreign language (EFL in undergraduate students

Directory of Open Access Journals (Sweden)

Fernando Vera Millalén

2014-11-01

Full Text Available This research seeks to compare the effect that monomodal and multimodal tests have on the reading comprehension level of English-written narrative texts that EFL learners achieve at a private Chilean university. For this purpose, a quasi-experiment was performed, using a monomodal reading comprehension test and another multimodal one, with intact groups. The experimental group took the multimodal format test, while the control group took the monomodal format test. The interest of this research focused on the need to integrate multimodal texts in L2 reading comprehension. The results endorse the hypothesis that students reach higher comprehension levels in multimodal reading comprehension tests.

Hearing and Seeing Tone through Color: An Efficacy Study of Web-Based, Multimodal Chinese Tone Perception Training

Science.gov (United States)

Godfroid, Aline; Lin, Chin-Hsi; Ryu, Catherine

2017-01-01

Multimodal approaches have been shown to be effective for many learning tasks. In this study, we compared the effectiveness of five multimodal methods for second language (L2) Mandarin tone perception training: three single-cue methods (number, pitch contour, color) and two dual-cue methods (color and number, color and pitch contour). A total of…

Evaluation of selectivity in homologous multimodal chromatographic systems using in silico designed antibody fragment libraries.

Science.gov (United States)

Karkov, Hanne Sophie; Woo, James; Krogh, Berit Olsen; Ahmadian, Haleh; Cramer, Steven M

2015-12-24

This study describes the in silico design, surface property analyses, production and chromatographic evaluations of a diverse set of antibody Fab fragment variants. Based on previous findings, we hypothesized that the complementarity-determining regions (CDRs) constitute important binding sites for multimodal chromatographic ligands. Given that antibodies are highly diversified molecules and in particular the CDRs, we set out to examine the generality of this result. For this purpose, four different Fab fragments with different CDRs and/or framework regions of the variable domains were identified and related variants were designed in silico. The four Fab variant libraries were subsequently generated by site-directed mutagenesis and produced by recombinant expression and affinity purification to enable examination of their chromatographic retention behavior. The effects of geometric re-arrangement of the functional moieties on the multimodal resin ligands were also investigated with respect to Fab variant retention profiles by comparing two commercially available multimodal cation-exchange ligands, Capto MMC and Nuvia cPrime, and two novel multimodal ligand prototypes. Interestingly, the chromatographic data demonstrated distinct selectivity trends between the four Fab variant libraries. For three of the Fab libraries, the CDR regions appeared as major binding sites for all multimodal ligands. In contrast, the fourth Fab library displayed a distinctly different chromatographic behavior, where Nuvia cPrime and related multimodal ligand prototypes provided markedly improved selectivity over Capto MMC. Clearly, the results illustrate that the discriminating power of multimodal ligands differs between different Fab fragments. The results are promising indications that multimodal chromatography using the appropriate multimodal ligands can be employed in downstream bioprocessing for challenging selective separation of product related variants. Copyright © 2015 Elsevier B

Multimodal Pedagogies for Teacher Education in TESOL

Science.gov (United States)

Yi, Youngjoo; Angay-Crowder, Tuba

2016-01-01

As a growing number of English language learners (ELLs) engage in digital and multimodal literacy practices in their daily lives, teachers are starting to incorporate multimodal approaches into their instruction. However, anecdotal and empirical evidence shows that teachers often feel unprepared for integrating such practices into their curricula…

Multimodal Counseling Interventions: Effect on Human Papilloma Virus Vaccination Acceptance

OpenAIRE

Oroma Nwanodi; Helen Salisbury; Curtis Bay

2017-01-01

Human papilloma virus (HPV) vaccine was developed to reduce HPV-attributable cancers, external genital warts (EGW), and recurrent respiratory papillomatosis. Adolescent HPV vaccination series completion rates are less than 40% in the United States of America, but up to 80% in Australia and the United Kingdom. Population-based herd immunity requires 80% or greater vaccination series completion rates. Pro-vaccination counseling facilitates increased vaccination rates. Multimodal counseling inte...

Childhood Predictors of Adult Functional Outcomes in the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (MTA).

Science.gov (United States)

Roy, Arunima; Hechtman, Lily; Arnold, L Eugene; Swanson, James M; Molina, Brooke S G; Sibley, Margaret H; Howard, Andrea L

2017-08-01

Recent results from the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (ADHD; MTA) have demonstrated impairments in several functioning domains in adults with childhood ADHD. The childhood predictors of these adult functional outcomes are not adequately understood. The objective of the present study was to determine the effects of childhood demographic, clinical, and family factors on adult functional outcomes in individuals with and without childhood ADHD from the MTA cohort. Regressions were used to determine associations of childhood factors (age range 7-10 years) of family income, IQ, comorbidity (internalizing, externalizing, and total number of non-ADHD diagnoses), parenting styles, parental education, number of household members, parental marital problems, parent-child relationships, and ADHD symptom severity with adult outcomes (mean age 25 years) of occupational functioning, educational attainment, emotional functioning, sexual behavior, and justice involvement in participants with (n = 579) and without (n = 258) ADHD. Predictors of adult functional outcomes in ADHD included clinical factors such as baseline ADHD severity, IQ, and comorbidity; demographic factors such as family income, number of household members and parental education; and family factors such as parental monitoring and parental marital problems. Predictors of adult outcomes were generally comparable for children with and without ADHD. Childhood ADHD symptoms, IQ, and household income levels are important predictors of adult functional outcomes. Management of these areas early on, through timely treatments for ADHD symptoms, and providing additional support to children with lower IQ and from households with low incomes, could assist in improving adult functioning. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Implications of Multimodal Learning Models for foreign language teaching and learning

Directory of Open Access Journals (Sweden)

Miguel Farías

2011-04-01

Full Text Available This literature review article approaches the topic of information and communications technologies from the perspective of their impact on the language learning process, with particular emphasis on the most appropriate designs of multimodal texts as informed by models of multimodal learning. The first part contextualizes multimodality within the fields of discourse studies, the psychology of learning and CALL; the second, deals with multimodal conceptions of reading and writing by discussing hypertextuality and literacy. A final section outlines the possible implications of multimodal learning models for foreign language teaching and learning.

Registration of deformed multimodality medical images

International Nuclear Information System (INIS)

Moshfeghi, M.; Naidich, D.

1989-01-01

The registration and combination of images from different modalities have several potential applications, such as functional and anatomic studies, 3D radiation treatment planning, surgical planning, and retrospective studies. Image registration algorithms should correct for any local deformations caused by respiration, heart beat, imaging device distortions, and so forth. This paper reports on an elastic matching technique for registering deformed multimodality images. Correspondences between contours in the two images are used to stretch the deformed image toward its goal image. This process is repeated a number of times, with decreasing image stiffness. As the iterations continue, the stretched image better approximates its goal image

Performance Evaluation of Multimodal Multifeature Authentication System Using KNN Classification

Directory of Open Access Journals (Sweden)

Gayathri Rajagopal

2015-01-01

Full Text Available This research proposes a multimodal multifeature biometric system for human recognition using two traits, that is, palmprint and iris. The purpose of this research is to analyse integration of multimodal and multifeature biometric system using feature level fusion to achieve better performance. The main aim of the proposed system is to increase the recognition accuracy using feature level fusion. The features at the feature level fusion are raw biometric data which contains rich information when compared to decision and matching score level fusion. Hence information fused at the feature level is expected to obtain improved recognition accuracy. However, information fused at feature level has the problem of curse in dimensionality; here PCA (principal component analysis is used to diminish the dimensionality of the feature sets as they are high dimensional. The proposed multimodal results were compared with other multimodal and monomodal approaches. Out of these comparisons, the multimodal multifeature palmprint iris fusion offers significant improvements in the accuracy of the suggested multimodal biometric system. The proposed algorithm is tested using created virtual multimodal database using UPOL iris database and PolyU palmprint database.

Effects of a multimodal exercise program on balance, functional mobility and fall risk in older adults with cognitive impairment: a randomized controlled single-blind study.

Science.gov (United States)

Kovács, E; Sztruhár Jónásné, I; Karóczi, C K; Korpos, A; Gondos, T

2013-10-01

Exercise programs have important role in prevention of falls, but to date, there are conflicting findings about the effects of exercise programs on balance, functional performance and fall risk among cognitively impaired older adults. AIM. To investigate the effects of a multimodal exercise program on static and dynamic balance, and risk of falls in older adults with mild or moderate cognitive impairment. A randomized controlled study. A long-term care institute. Cognitively impaired individuals aged over 60 years. Eighty-six participants were randomized to an exercise group providing multimodal exercise program for 12 months or a control group which did not participate in any exercise program. The Performance Oriented Mobility Assessment scale, Timed Up and Go test, and incidence of falls were measured at baseline, at 6 months and at 12 months. There was a significant improvement in balance-related items of Performance Oriented Mobility Assessment scale in the exercise group both at 6 month and 12 month (Pfalls. Our results confirmed that a 12-month multimodal exercise program can improve the balance in cognitively impaired older adults. Based on our results, the multimodal exercise program may be a promising fall prevention exercise program for older adults with mild or moderate cognitive impairment improving static balance but it is supposed that more emphasis should be put on walking component of exercise program and environmental fall risk assessment.

Efficacy of a multimodal treatment for disruptive behavior disorders in children and adolescents: focus on internalizing problems.

Science.gov (United States)

Masi, Gabriele; Milone, Annarita; Paciello, Marinella; Lenzi, Francesca; Muratori, Pietro; Manfredi, Azzurra; Polidori, Lisa; Ruglioni, Laura; Lochman, John E; Muratori, Filippo

2014-11-30

Disruptive Behavior Disorders (DBDs) are among the most common reasons for youth referrals to mental health clinics. Aim of this study is to compare short and medium term efficacy of a multimodal treatment program (MTP), compared to community care (treatment-as-usual, TAU). The sample included 135 youths with DBDs (113 males, age range 9-15 years, mean age 12±2.5 years) were assigned either to a MTP (n=64), or addressed to community care for a TAU (n=71). Outcome measures were the Child Behaviour Checklist (CBCL) and the Children's Global Assessment Scale (C-GAS). All subjects were assessed at the baseline (T0), after 1-year treatment (T1) and after a 2-year follow-up (T2). Compared with patients receiving TAU, youths in the MTP showed, both at T1 and T2, significantly lower scores on CBCL Externalizing Scale, Internalizing Scale, Anxious/Depressed, Social Problems, and Aggressive Behavior, and higher scores at the C-GAS. Improvement in Internalizing Scales was particularly evident, with a shift from the clinical to the non-clinical range. Rate of use of mental health services and scholastic failure were reduced in the MTP. It is suggested that the improvement of the Internalizing symptoms is a crucial component of the therapeutic process in this MTP. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Multimodality treatment of large AVMs in eloquent areas

International Nuclear Information System (INIS)

Inoue, Hiroshi K.; Naitou, Isao

2004-01-01

Our treatment of arteriovenous malformations (AVMs) with Gamma Knife Radiosurgery (optimal dose treatment) showed 88.4% total obliteration in small AVMs less than 10 ml after the first treatment and very low morbidity (1.7%) in long-term follow-up (5 to 12 years). These results indicate that combined treatment is a good strategy for large AVMs in eloquent areas. Therefore, we evaluated larger AVMs treated with direct surgery including feeder clipping and/or intravascular embolization prior to radiosurgery for further development of radiosurgery of large AVMs. Fifty of 171 patients had combined treatment (embolization: 27, direct surgery: 19, both: 4) and were followed more than 4 years and 6 months. Mean volume at the time of radiosurgery was smallest in the surgery group. Total obliteration was obtained in 94.4% of small AVMs less than 10 ml (surgery: 100%, embolization: 88.9%), although larger AVMs still have a lower obliteration rate. No lethal hemorrhages appeared after combination treatment up to date. We concluded that radiosurgery combined with surgery and/or embolization is a safe and effective treatment for large AVMs in eloquent areas. (author)

Surgery and Multimodal treatments in pancreatic cancer. A review on the basis of future multimodal treatment concepts

International Nuclear Information System (INIS)

Link, K.H.; Leder, G; Formentini, A.; Fortnagel, G.; Kornmann, M.; Schatz, M.; Beger, H.G.

1999-01-01

The literature on the indications and results of adjuvant/neoadjuvant therapies in pancreatic cancer was reviewed to provide a solid base for current recommendations and future developments. A special view was concentrated on the biology of the disease in the spontaneous course, after surgery and during/after various palliative and adjuvant/neoadjuvant treatment modalities, to characterize the disease for an optimally targeted treatment in conjunction with surgical removal of the tumor. The results of systemic and regional chemotherapy and radiotherapy either alone or in combination, before, during, and after surgery, were critically analyzed with respect to the oncological possibilities and pitfalls of each treatment method. In two randomized trials, one testing postoperative radio chemotherapy (GITSG), and one postoperative chemotherapy (Bakkevold), the adjuvant treatment, achieved a significant prolongation of the median survival time. The 5- and 10-year survival rates were improved in the GITSG study. The EORTC-GITCCG trial could not confirm the benefit of adjuvant radiochemotherapy. This study had a different design than the GITSG trial. Several historical control studies supported the beneficial effect of postoperative radio chemotherapy. In three historical control trials using regional chemotherapy, one with intraoperative radiotherapy, the survival times were improved vs. surgery alone. Intraoperative or postoperative radiotherapy as single modalities might reduce local relapses, but a survival advantage is still debated. Preoperative neoadjuvant radio chemotherapy has several advantages, and does not seem to increase the postoperative morbidity. Several trials have confirmed the feasibility of this concept, but no survival advantage has yet been proven. Systemic and regional chemotherapy is able to down stage primarily nonresectable pancreatic cancers. (K.H.). 111 refs

Interaction between visual and chemical cues in a Liolaemus lizard: a multimodal approach.

Science.gov (United States)

Vicente, Natalin S; Halloy, Monique

2017-12-01

Multimodal communication involves the use of signals and cues across two or more sensory modalities. The genus Liolaemus (Iguania: Liolaemidae) offers a great potential for studies on the ecology and evolution of multimodal communication, including visual and chemical signals. In this study, we analyzed the response of male and female Liolaemus pacha to chemical, visual and combined (multimodal) stimuli. Using cue-isolation tests, we registered the number of tongue flicks and headbob displays from exposure to signals in each modality. Number of tongue flicks was greater when a chemical stimulus was presented alone than in the presence of visual or multimodal stimuli. In contrast, headbob displays were fewer in number with visual and chemical stimuli alone, but significantly higher in number when combined. Female signallers triggered significantly more tongue flicks than male signallers, suggesting that chemical cues are involved in sexual recognition. We did not find an inhibition between chemical and visual cues. On the contrary, we observed a dominance of the chemical modality, because when presented with visual stimuli, lizards also responded with more tongue flicks than headbob displays. The total response produced by multimodal stimuli was similar to that of the chemical stimuli alone, possibly suggesting non-redundancy. We discuss whether the visual component of a multimodal signal could attract attention at a distance, increasing the effectiveness of transmission and reception of the information in chemical cues. Copyright © 2017 Elsevier GmbH. All rights reserved.

Vaginismus Treatment: Clinical Trials Follow Up 241 Patients.

Science.gov (United States)

Pacik, Peter T; Geletta, Simon

2017-06-01

Vaginismus is mostly unknown among clinicians and women. Vaginismus causes women to have fear, anxiety, and pain with penetration attempts. To present a large cohort of patients based on prior published studies approved by an institutional review board and the Food and Drug Administration using a comprehensive multimodal vaginismus treatment program to treat the physical and psychologic manifestations of women with vaginismus and to record successes, failures, and untoward effects of this treatment approach. Assessment of vaginismus included a comprehensive pretreatment questionnaire, the Female Sexual Function Index (FSFI), and consultation. All patients signed a detailed informed consent. Treatment consisted of a multimodal approach including intravaginal injections of onabotulinumtoxinA (Botox) and bupivacaine, progressive dilation under conscious sedation, indwelling dilator, follow-up and support with office visits, phone calls, e-mails, dilation logs, and FSFI reports. Logs noting dilation progression, pain and anxiety scores, time to achieve intercourse, setbacks, and untoward effects. Post-treatment FSFI scores were compared with preprocedure scores. One hundred seventy-one patients (71%) reported having pain-free intercourse at a mean of 5.1 weeks (median = 2.5). Six patients (2.5%) were unable to achieve intercourse within a 1-year period after treatment and 64 patients (26.6%) were lost to follow-up. The change in the overall FSFI score measured at baseline, 3 months, 6 months, and 1 year was statistically significant at the 0.05 level. Three patients developed mild temporary stress incontinence, two patients developed a short period of temporary blurred vision, and one patient developed temporary excessive vaginal dryness. All adverse events resolved by approximately 4 months. One patient required retreatment followed by successful coitus. A multimodal program that treated the physical and psychologic aspects of vaginismus enabled women to achieve

Percorsi linguistici e semiotici: Critical Multimodal Analysis of Digital Discourse

Directory of Open Access Journals (Sweden)

edited by Ilaria Moschini

2014-12-01

Full Text Available The language section of LEA - edited by Ilaria Moschini - is dedicated to the Critical Multimodal Analysis of Digital Discourse, an approach that encompasses the linguistic and semiotic detailed investigation of texts within a socio-cultural perspective. It features an interview with Professor Theo van Leeuwen by Ilaria Moschini and four essays: “Retwitting, reposting, repinning; reshaping identities online: Towards a social semiotic multimodal analysis of digital remediation” by Elisabetta Adami; “Multimodal aspects of corporate social responsibility communication” by Carmen Daniela Maier; “Pervasive Technologies and the Paradoxes of Multimodal Digital Communication” by Sandra Petroni and “Can the powerless speak? Linguistic and multimodal corporate media manipulation in digital environments: the case of Malala Yousafzai” by Maria Grazia Sindoni. 

Linking variability in brain chemistry and circuit function through multimodal human neuroimaging

DEFF Research Database (Denmark)

Fisher, Patrick M; Hariri, A R

2012-01-01

and dopamine system and its effects on threat- and reward-related brain function, we review evidence for how such a multimodal neuroimaging strategy can be successfully implemented. Furthermore, we discuss how multimodal PET-fMRI can be integrated with techniques such as imaging genetics, pharmacological......Identifying neurobiological mechanisms mediating the emergence of individual differences in behavior is critical for advancing our understanding of relative risk for psychopathology. Neuroreceptor positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) can be used...

Effectiveness of a multimodal hand hygiene campaign and obstacles to success in Addis Ababa, Ethiopia

Science.gov (United States)

2014-01-01

Background Hand hygiene is the cornerstone of infection control and reduces rates of healthcare associated infection. There are limited data evaluating hand hygiene adherence and hand hygiene campaign effect in resource-limited settings, especially in Sub-Saharan Africa. This study assessed the impact of implementing a World Health Organization (WHO)-recommended multimodal hand hygiene campaign at a hospital in Ethiopia. Methods This study included a before-and-after assessment of health care worker (HCW) adherence with WHO hand hygiene guidelines. It was implemented in three phases: 1) baseline evaluation of hand hygiene adherence and hospital infrastructure; 2) intervention (distribution of commercial hand sanitizer and implementation of an abbreviated WHO-recommended multimodal hand hygiene campaign); and 3) post-intervention evaluation of HCW hand hygiene adherence. HCWs’ perceptions of the campaign and hand sanitizer tolerability were assessed through a survey performed in the post-intervention period. Results At baseline, hand washing materials were infrequently available, with only 20% of sinks having hand-washing materials. There was a significant increase in hand hygiene adherence among HCWs following implementation of a WHO multimodal hand hygiene program. Adherence increased from 2.1% at baseline (21 hand hygiene actions/1000 opportunities for hand hygiene) to 12.7% (127 hand hygiene actions /1000 opportunities for hand hygiene) after the implementation of the hand hygiene campaign (OR = 6.8, 95% CI 4.2-10.9). Hand hygiene rates significantly increased among all HCW types except attending physicians. Independent predictors of HCW hand hygiene compliance included performing hand hygiene in the post-intervention period (aOR = 5.7, 95% CI 3.5-9.3), in the emergency department (aOR = 4.9, 95% CI 2.8-8.6), during patient care that did not involve Attending Physician Rounds (aOR = 2.4, 95% CI 1.2-4.5), and after patient contact (aOR = 2

Effectiveness of a multimodal hand hygiene campaign and obstacles to success in Addis Ababa, Ethiopia.

Science.gov (United States)

Schmitz, Karen; Kempker, Russell R; Tenna, Admasu; Stenehjem, Edward; Abebe, Engida; Tadesse, Lia; Jirru, Ermias Kacha; Blumberg, Henry M

2014-03-17

Hand hygiene is the cornerstone of infection control and reduces rates of healthcare associated infection. There are limited data evaluating hand hygiene adherence and hand hygiene campaign effect in resource-limited settings, especially in Sub-Saharan Africa. This study assessed the impact of implementing a World Health Organization (WHO)-recommended multimodal hand hygiene campaign at a hospital in Ethiopia. This study included a before-and-after assessment of health care worker (HCW) adherence with WHO hand hygiene guidelines. It was implemented in three phases: 1) baseline evaluation of hand hygiene adherence and hospital infrastructure; 2) intervention (distribution of commercial hand sanitizer and implementation of an abbreviated WHO-recommended multimodal hand hygiene campaign); and 3) post-intervention evaluation of HCW hand hygiene adherence. HCWs' perceptions of the campaign and hand sanitizer tolerability were assessed through a survey performed in the post-intervention period. At baseline, hand washing materials were infrequently available, with only 20% of sinks having hand-washing materials. There was a significant increase in hand hygiene adherence among HCWs following implementation of a WHO multimodal hand hygiene program. Adherence increased from 2.1% at baseline (21 hand hygiene actions/1000 opportunities for hand hygiene) to 12.7% (127 hand hygiene actions /1000 opportunities for hand hygiene) after the implementation of the hand hygiene campaign (OR = 6.8, 95% CI 4.2-10.9). Hand hygiene rates significantly increased among all HCW types except attending physicians. Independent predictors of HCW hand hygiene compliance included performing hand hygiene in the post-intervention period (aOR = 5.7, 95% CI 3.5-9.3), in the emergency department (aOR = 4.9, 95% CI 2.8-8.6), during patient care that did not involve Attending Physician Rounds (aOR = 2.4, 95% CI 1.2-4.5), and after patient contact (aOR = 2.1, 95% CI 1.4-3.3). In the

Effective multimodality treatment for advanced epidermoid carcinoma of the female genital tract

International Nuclear Information System (INIS)

Kalra, J.; Cortes, E.; Chen, S.; Krumholz, B.; Rovinsky, J.J.; Molho, L.; Seltzer, V.; Papantoniou, P.; Lee, J.Y.

1985-01-01

Fifteen patients with advanced or recurrent squamous-cell carcinoma of the cervix, vulva, vagina, and urethra were treated with simultaneous combination chemotherapy (5-fluorouracil infusion and mitomycin C) and radiotherapy (3,000 rad for a period of three weeks). Three to four weeks after completion of radiotherapy, 13 of 15 patients achieved partial or complete tumor shrinkage. Nine of 15 patients are alive, eight of whom (at a median follow-up time of 24 months) have no evidence of disease. The longest survival time was 45 + months. There was minimal toxicity associated with this therapy. The results of this pilot study suggest that the simultaneous administration of radiation and chemotherapy is an effective method of treatment of advanced female genital tract carcinoma

Fiber-Optic Vibration Sensor Based on Multimode Fiber

Directory of Open Access Journals (Sweden)

I. Lujo

2008-06-01

Full Text Available The purpose of this paper is to present a fiberoptic vibration sensor based on the monitoring of the mode distribution in a multimode optical fiber. Detection of vibrations and their parameters is possible through observation of the output speckle pattern from the multimode optical fiber. A working experimental model has been built in which all used components are widely available and cheap: a CCD camera (a simple web-cam, a multimode laser in visible range as a light source, a length of multimode optical fiber, and a computer for signal processing. Measurements have shown good agreement with the actual frequency of vibrations, and promising results were achieved with the amplitude measurements although they require some adaptation of the experimental model. Proposed sensor is cheap and lightweight and therefore presents an interesting alternative for monitoring large smart structures.

An Efficient Quality-Related Fault Diagnosis Method for Real-Time Multimode Industrial Process

Directory of Open Access Journals (Sweden)

Kaixiang Peng

2017-01-01

Full Text Available Focusing on quality-related complex industrial process performance monitoring, a novel multimode process monitoring method is proposed in this paper. Firstly, principal component space clustering is implemented under the guidance of quality variables. Through extraction of model tags, clustering information of original training data can be acquired. Secondly, according to multimode characteristics of process data, the monitoring model integrated Gaussian mixture model with total projection to latent structures is effective after building the covariance description form. The multimode total projection to latent structures (MTPLS model is the foundation of problem solving about quality-related monitoring for multimode processes. Then, a comprehensive statistics index is defined which is based on the posterior probability of the monitored samples belonging to each Gaussian component in the Bayesian theory. After that, a combined index is constructed for process monitoring. Finally, motivated by the application of traditional contribution plot in fault diagnosis, a gradient contribution rate is applied for analyzing the variation of variable contribution rate along samples. Our method can ensure the implementation of online fault monitoring and diagnosis for multimode processes. Performances of the whole proposed scheme are verified in a real industrial, hot strip mill process (HSMP compared with some existing methods.

Drusen Characterization with Multimodal Imaging

Science.gov (United States)

Spaide, Richard F.; Curcio, Christine A.

2010-01-01

by multimodal imaging due to differences in location, morphology, and optical filtering effects by drusenoid material and the RPE. PMID:20924263

Analysis of the harmonic and intermodulation distortion in a multimode fiber optic link.

Science.gov (United States)

Gasulla, I; Capmany, J

2007-07-23

We present an analytical evaluation of the harmonic and the intermodulation distortion effects produced in the transmission of an analog signal composed of various RF tones through a multimode fiber link. It is based on the electric field propagation model previously published by the authors. Results show the possibility of implementing subcarrier multiplexing techniques (SCM) with Composite Second Order (CSO) values below -50 dBc over short and middle reach multimode fiber links.

Spontaneous generalization of abstract multimodal patterns in young domestic chicks.

Science.gov (United States)

Versace, Elisabetta; Spierings, Michelle J; Caffini, Matteo; Ten Cate, Carel; Vallortigara, Giorgio

2017-05-01

From the early stages of life, learning the regularities associated with specific objects is crucial for making sense of experiences. Through filial imprinting, young precocial birds quickly learn the features of their social partners by mere exposure. It is not clear though to what extent chicks can extract abstract patterns of the visual and acoustic stimuli present in the imprinting object, and how they combine them. To investigate this issue, we exposed chicks (Gallus gallus) to three days of visual and acoustic imprinting, using either patterns with two identical items or patterns with two different items, presented visually, acoustically or in both modalities. Next, chicks were given a choice between the familiar and the unfamiliar pattern, present in either the multimodal, visual or acoustic modality. The responses to the novel stimuli were affected by their imprinting experience, and the effect was stronger for chicks imprinted with multimodal patterns than for the other groups. Interestingly, males and females adopted a different strategy, with males more attracted by unfamiliar patterns and females more attracted by familiar patterns. Our data show that chicks can generalize abstract patterns by mere exposure through filial imprinting and that multimodal stimulation is more effective than unimodal stimulation for pattern learning.

Video genre classification using multimodal features

Science.gov (United States)

Jin, Sung Ho; Bae, Tae Meon; Choo, Jin Ho; Ro, Yong Man

2003-12-01

We propose a video genre classification method using multimodal features. The proposed method is applied for the preprocessing of automatic video summarization or the retrieval and classification of broadcasting video contents. Through a statistical analysis of low-level and middle-level audio-visual features in video, the proposed method can achieve good performance in classifying several broadcasting genres such as cartoon, drama, music video, news, and sports. In this paper, we adopt MPEG-7 audio-visual descriptors as multimodal features of video contents and evaluate the performance of the classification by feeding the features into a decision tree-based classifier which is trained by CART. The experimental results show that the proposed method can recognize several broadcasting video genres with a high accuracy and the classification performance with multimodal features is superior to the one with unimodal features in the genre classification.

MULTIMODAL ANALGESIC EFFECT ON PROINFLAMMATORY AND ANTI-INFLAMMATORY CYTOKINES SERUM

Directory of Open Access Journals (Sweden)

Muhammad Ramli Ahmad

2014-06-01

Full Text Available Objective: To investigate the effect of combination epidural bupivacaine and intravenous parecoxib analgesia on immune response in patients who underwent open reduction and internal fixation of the lower limb under epidural anesthesia. Methods: This research was conducted using the randomized, placebo-controlled double blind trial method on 52 patients who were randomly divided into 2 groups: the Parecoxib group which received 40 mg intravenous parecoxib for 30 minutes before incision and the control group which received an equal volume of 0.9% normal saline. Both groups received epidural anesthesia and postoperative epidural 0.125% bupivacaine analgesia continously. Venous blood samples were obtained before parecoxib administration, 2 and 24 hours after the surgery. The data were analyzed using Mann Whitney U and independent t tests (p<0.05. Results: There was a significant difference between the two groups (p<0.05 in IL-1β, IL-6, IL-10 levels and proinflammatory to anti-inflammatory ratio, 2 hours after surgery. Conclusions: Multimodal analgesic combination of 40 mg IV parecoxib and 0.125% bupivacaine epidural analgesia have the effect to alter and stabilize the systemic immune response.

Concepts for space nuclear multi-mode reactors

International Nuclear Information System (INIS)

Myrabo, L.; Botts, T.E.; Powell, J.R.

1983-01-01

A number of nuclear multi-mode reactor power plants are conceptualized for use with solid core, fixed particle bed and rotating particle bed reactors. Multi-mode systems generate high peak electrical power in the open cycle mode, with MHD generator or turbogenerator converters and cryogenically stored coolants. Low level stationkeeping power and auxiliary reactor cooling (i.e., for the removal of reactor afterheat) are provided in a closed cycle mode. Depending on reactor design, heat transfer to the low power converters can be accomplished by heat pipes, liquid metal coolants or high pressure gas coolants. Candidate low power conversion cycles include Brayton turbogenerator, Rankine turbogenerator, thermoelectric and thermionic approaches. A methodology is suggested for estimating the system mass of multi-mode nuclear power plants as a function of peak electric power level and required mission run time. The masses of closed cycle nuclear and open cycle chemical power systems are briefly examined to identify the regime of superiority for nuclear multi-mode systems. Key research and technology issues for such power plants are also identified

Is intensive multimodality therapy the best treatment for fournier gangrene? Evaluation of clinical outcome and survival rate of 41 patients.

Science.gov (United States)

Wagner, Sigrid; Greco, Francesco; Hoda, M Raschid; Kawan, Felix; Heynemann, Hans; Fornara, Paolo

2011-10-01

To evaluate the effect of surgical wound debridement, antibiotics, and hyperbaric oxygen (HBO) in the treatment of Fournier gangrene (FG). Forty-one patients with a mean age of 54.3±14.6 years were referred to our department with a diagnosis of FG. To calculate a Fourier Gangrene Severity Index (FGSI), nine factors were assessed (temperature; heart rate; ventilatory rate; serum sodium, potassium, creatinine, and bicarbonate concentrations; hematocrit; and leukocyte count). After clinical stabilization, extensive debridement of the necrotic tissue was performed, and a surgical vacuum-assisted closure (V.A.C.®) device was applied. Hyperbaric oxygen was administered; medical therapy consisted of intravenous antibiotics, electrolyte replacement, and parenteral nutrition. Intraoperative cultures revealed Escherichia coli in 27 patients (66%), Pseudomonas aeruginosa in 28 (68%), gram-positive cocci in 24 (59%), and mixed flora (aerobic and anaerobic bacteria) in 39 (95%). One month after primary debridement, wound granulation was sufficient for plastic surgical reconstruction in all patients. Because of the rapid worsening of FG, early diagnosis and immediate, aggressive multi-modality therapy with surgical debridement and broad-spectrum empiric antibiotics is crucial. The utility of HBO remains unproved.

Multimodal psychoanalytically informed aid work with children traumatized by the Chechen war.

Science.gov (United States)

Cerfolio, Nina E

2009-01-01

As demonstrated in three cases, this paper illustrates how psychoanalytically informed multimodal care was an essential element of effective medical treatment of children traumatized by the Chechen war. Multimodal psychoanalytically informed aid work involves holding a variety of psychoanalytic viewpoints, including but not restricted to those represented by the Freudian, Interpersonal, and Relational orientations; its purpose is to allow for greater clarity in conceptualizing the traumatized child's response to war in order to provide the necessary care during the therapeutic process. Among the issues addressed are how traumatic memory can initially be expressed nonverbally, and therefore the use of embodied life-metaphors and witnessing are central to the survivors' ability to remember and symbolize. In addition, the significance of cultural awareness and sensitivity are explored as key components to the children's care. In the first case, the author illustrates how a traumatic life-metaphor can be resolved at an embodied, rather than an exclusively verbal, level. In the second case, cultural tradition and relativism have a significant impact on addressing medical and quality of life issues for the child. The third case illustrates how the analyst functions as recognizing witness to a parent's trauma; the "being with" of the relationship becomes the agent of the parent's change.

Standard of Care Versus Metastases-directed Therapy for PET-detected Nodal Oligorecurrent Prostate Cancer Following Multimodality Treatment: A Multi-institutional Case-control Study.

Science.gov (United States)

Steuber, T; Jilg, C; Tennstedt, P; De Bruycker, A; Tilki, D; Decaestecker, K; Zilli, T; Jereczek-Fossa, B A; Wetterauer, U; Grosu, A L; Schultze-Seemann, W; Heinzer, H; Graefen, M; Morlacco, A; Karnes, R J; Ost, P

2018-03-10

Most prostate cancer (PCa) patients with a biochemical failure following primary multimodality treatment (surgery and postoperative radiotherapy) relapse in the nodes. To perform a matched-case analysis in men with lymph node recurrent PCa comparing standard of care (SOC) with metastasis-directed therapy (MDT). PCa patients with a prostate-specific antigen (PSA) progression following multimodality treatment were included in this retrospective multi-institutional analysis. The SOC cohort (n=1816) received immediate or delayed androgen deprivation therapy administered at PSA progression. The MDT cohort (n=263) received either salvage lymph node dissection (n=166) or stereotactic body radiotherapy (n=97) at PSA progression to a positron emission tomography-detected nodal recurrence. The primary endpoint, cancer-specific survival (CSS), was analyzed using the Kaplan-Meier method, log-rank test, Cox proportional hazards models, and propensity score-matched analyses. At a median follow-up of 70 (interquartile range: 48-98) mo, MDT was associated with an improved CSS on univariate (p=0.029) and multivariate analysis (hazard ratio: 0.33, 95% confidence interval [CI]: 0.17-0.64) adjusted for the year of radical prostatectomy (RP), age at RP, PSA at RP, time from RP to PSA progression, Gleason score, surgical margin status, pT- and pN-stage. In total, 659 men were matched (3:1 ratio). The 5-yr CSS was 98.6% (95% CI: 94.3-99.6) and 95.7% (95% CI: 93.2-97.3) for MDT and SOC, respectively (p=0.005, log-rank). The main limitations of our study are its retrospective design and lack of standardization of systemic treatment in the SOC cohort. MDT for nodal oligorecurrent PCa improves CSS as compared with SOC. These retrospective data from a multi-institutional pooled analysis should be considered as hypothesis-generating and inform future randomized trials in this setting. Prostate cancer patients experiencing a lymph node recurrence might benefit from local treatments directed at

Effects of a novel multimodal group intervention on myocardial perfusion in patients with coronary heart disease (CHD)

International Nuclear Information System (INIS)

Theissen, P.; Schicha, H.; Albus, C.; Koehle, K.; Griebenow, R.; Son, P.

2002-01-01

Full text: Recently, it could be shown that a multimodal intervention can promote health behavior in patients with CHD. Purpose of the actual study was to evaluate the effects on somatic endpoints, e.g. myocardial perfusion. We randomly assigned 77 patients (age 54 ± 6.9 y, male 87 %) with angiographically documented CHD to a multimodal group intervention plus standardized cardiological care (INT n=39) or standardized cardiological care only (CO n = 38). The intervention, for out-patients only, consisted of 77.5 hours of group-psychotherapy, relaxation and exercise training, and teaching lessons for one year. A Thallium myocardial perfusion scintigraphy (MyoSc) (after bicycle exercise test and at rest; 70 - 110 MBq Thallium-201, SPECT-technique, quantitative wash-out (w.-o.) analysis derived from polar maps) was performed at baseline, after 2 years, and 3 years, respectively: A w.-o. increase res. decrease by 5 % or more indicated an improved / a diminished myocardial perfusion within the affected coronary artery territory. Results were analyzed on an intention to treat basis. 70/77 patients (91 %) completed the study (drop-outs CO n=4, INT n=3). After 2 years (1st interval), there was no significant difference between groups. After 3 years (2nd interval) 36/39 patients (92.3 %) of INT showed a stable or improved myocardial perfusion, compared to 18/38 patients (47.4 %) of CO (p= 0.008). The recent data analysis demonstrates the extra benefit of a multimodal intervention, compared to standardized cardiological care alone, on myocardial perfusion in CHD patients. (author)

Multimodal system for the planning and guidance of bronchoscopy

Science.gov (United States)

Higgins, William E.; Cheirsilp, Ronnarit; Zang, Xiaonan; Byrnes, Patrick

2015-03-01

Many technical innovations in multimodal radiologic imaging and bronchoscopy have emerged recently in the effort against lung cancer. Modern X-ray computed-tomography (CT) scanners provide three-dimensional (3D) high-resolution chest images, positron emission tomography (PET) scanners give complementary molecular imaging data, and new integrated PET/CT scanners combine the strengths of both modalities. State-of-the-art bronchoscopes permit minimally invasive tissue sampling, with vivid endobronchial video enabling navigation deep into the airway-tree periphery, while complementary endobronchial ultrasound (EBUS) reveals local views of anatomical structures outside the airways. In addition, image-guided intervention (IGI) systems have proven their utility for CT-based planning and guidance of bronchoscopy. Unfortunately, no IGI system exists that integrates all sources effectively through the complete lung-cancer staging work flow. This paper presents a prototype of a computer-based multimodal IGI system that strives to fill this need. The system combines a wide range of automatic and semi-automatic image-processing tools for multimodal data fusion and procedure planning. It also provides a flexible graphical user interface for follow-on guidance of bronchoscopy/EBUS. Human-study results demonstrate the system's potential.

The integration of emotional and symbolic components in multimodal communication

Directory of Open Access Journals (Sweden)

Marc eMehu

2015-07-01

Full Text Available Human multimodal communication can be said to serve two main purposes: information transfer and social influence. In this paper, I argue that different components of multimodal signals play different roles in the processes of information transfer and social influence. Although the symbolic components of communication (e.g. verbal and denotative signals are well suited to transfer conceptual information, emotional components (e.g. nonverbal signals that are difficult to manipulate voluntarily likely take a function that is closer to social influence. I suggest that emotion should be considered a property of communicative signals, rather than an entity that is transferred as content by nonverbal signals. In this view, the effect of emotional processes on communication serve to change the quality of social signals to make them more efficient at producing responses in perceivers, whereas symbolic components increase the signals’ efficiency at interacting with the cognitive processes dedicated to the assessment of relevance. The interaction between symbolic and emotional components will be discussed in relation to the need for perceivers to evaluate the reliability of multimodal signals.

The integration of emotional and symbolic components in multimodal communication

Science.gov (United States)

Mehu, Marc

2015-01-01

Human multimodal communication can be said to serve two main purposes: information transfer and social influence. In this paper, I argue that different components of multimodal signals play different roles in the processes of information transfer and social influence. Although the symbolic components of communication (e.g., verbal and denotative signals) are well suited to transfer conceptual information, emotional components (e.g., non-verbal signals that are difficult to manipulate voluntarily) likely take a function that is closer to social influence. I suggest that emotion should be considered a property of communicative signals, rather than an entity that is transferred as content by non-verbal signals. In this view, the effect of emotional processes on communication serve to change the quality of social signals to make them more efficient at producing responses in perceivers, whereas symbolic components increase the signals’ efficiency at interacting with the cognitive processes dedicated to the assessment of relevance. The interaction between symbolic and emotional components will be discussed in relation to the need for perceivers to evaluate the reliability of multimodal signals. PMID:26217280

Multimodal Analgesia in Breast Surgical Procedures: Technical and Pharmacological Considerations for Liposomal Bupivacaine Use

Directory of Open Access Journals (Sweden)

Anoushka M. Afonso, MD

2017-09-01

Full Text Available Enhanced recovery after surgery is a multidisciplinary perioperative clinical pathway that uses evidence-based interventions to improve the patient experience as well as increase satisfaction, reduce costs, mitigate the surgical stress response, accelerate functional recovery, and decrease perioperative complications. One of the most important elements of enhanced recovery pathways is multimodal pain management. Herein, aspects relating to multimodal analgesia following breast surgical procedures are discussed with the understanding that treatment decisions should be individualized and guided by sound clinical judgment. A review of liposomal bupivacaine, a prolonged-release formulation of bupivacaine, in the management of postoperative pain following breast surgical procedures is presented, and technical guidance regarding optimal administration of liposomal bupivacaine is provided.

MO-DE-202-04: Multimodality Image-Guided Surgery and Intervention: For the Rest of Us

Energy Technology Data Exchange (ETDEWEB)

Shekhar, R. [Children’s National Health System (United States)

2016-06-15

At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guided neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504

MO-DE-202-04: Multimodality Image-Guided Surgery and Intervention: For the Rest of Us

International Nuclear Information System (INIS)

Shekhar, R.

2016-01-01

At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guided neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504

Deterministic multimode photonic device for quantum-information processing

DEFF Research Database (Denmark)

Nielsen, Anne E. B.; Mølmer, Klaus

2010-01-01

We propose the implementation of a light source that can deterministically generate a rich variety of multimode quantum states. The desired states are encoded in the collective population of different ground hyperfine states of an atomic ensemble and converted to multimode photonic states by exci...

Multimodal network design for sustainable household plastic recycling

NARCIS (Netherlands)

Bing Xiaoyun, Xiaoyun; Groot, J.J.; Bloemhof, J.M.; Vorst, van der J.G.A.J.

2013-01-01

Purpose – This research studies a plastic recycling system from a reverse logistics angle and investigates the potential benefits of a multimodality strategy to the network design of plastic recycling. This research aims to quantify the impact of multimodality on the network, to provide decision

Multimodal warnings to enhance risk communication and safety

NARCIS (Netherlands)

Haas, E.C.; Erp, J.B.F. van

2014-01-01

Multimodal warnings incorporate audio and/or skin-based (tactile) cues to supplement or replace visual cues in environments where the user’s visual perception is busy, impaired, or nonexistent. This paper describes characteristics of audio, tactile, and multimodal warning displays and their role in

Bridging the Gap Between Speech and Language: Using Multimodal Treatment in a Child With Apraxia.

Science.gov (United States)

Tierney, Cheryl D; Pitterle, Kathleen; Kurtz, Marie; Nakhla, Mark; Todorow, Carlyn

2016-09-01

Childhood apraxia of speech is a neurologic speech sound disorder in which children have difficulty constructing words and sounds due to poor motor planning and coordination of the articulators required for speech sound production. We report the case of a 3-year-old boy strongly suspected to have childhood apraxia of speech at 18 months of age who used multimodal communication to facilitate language development throughout his work with a speech language pathologist. In 18 months of an intensive structured program, he exhibited atypical rapid improvement, progressing from having no intelligible speech to achieving age-appropriate articulation. We suspect that early introduction of sign language by family proved to be a highly effective form of language development, that when coupled with intensive oro-motor and speech sound therapy, resulted in rapid resolution of symptoms. Copyright © 2016 by the American Academy of Pediatrics.

Multimodal genres in textbooks: are students being schooled for visual literacy?

Directory of Open Access Journals (Sweden)

Cláudia Graziano Paes de Barros

2012-11-01

Full Text Available In this paper, we discuss some issues involved in teaching and learning reading, especially schooling in visual literacy. We seek to observe the work developed with genres that combine verbal and visual languages, found in the reading activities of two high school textbook series for Portuguese language teaching. Our goal was to understand to what extent these activities contribute towards the development of reading skills needed to deal with the specificities of these genres. Therefore, we used the enunciative and discursive assumptions of the socio-historical approach of Bakhtin Circle, as well as the Social Semiotics perspective to understand multimodality. Data analysis revealed that the incidence of multimodal genres studied in the two textbook series is hardly representative. The didactic treatment these genres receive in reading activities does not favor the mobilization of specific reading skills and contributes little to students‟ visual literacy schooling.

Discovery of 1-[2-(2,4-dimethylphenylsulfanyl)phenyl]piperazine (Lu AA21004): a novel multimodal compound for the treatment of major depressive disorder.

Science.gov (United States)

Bang-Andersen, Benny; Ruhland, Thomas; Jørgensen, Morten; Smith, Garrick; Frederiksen, Kristen; Jensen, Klaus Gjervig; Zhong, Huailing; Nielsen, Søren Møller; Hogg, Sandra; Mørk, Arne; Stensbøl, Tine Bryan

2011-05-12

The synthesis and structure-activity relationship of a novel series of compounds with combined effects on 5-HT(3A) and 5-HT(1A) receptors and on the serotonin (5-HT) transporter (SERT) are described. Compound 5m (Lu AA21004) was the lead compound, displaying high affinity for recombinant human 5-HT(1A) (K(i) = 15 nM), 5-HT(1B) (K(i) = 33 nM), 5-HT(3A) (K(i) = 3.7 nM), 5-HT(7) (K(i) = 19 nM), and noradrenergic β(1) (K(i) = 46 nM) receptors, and SERT (K(i) = 1.6 nM). Compound 5m displayed antagonistic properties at 5-HT(3A) and 5-HT(7) receptors, partial agonist properties at 5-HT(1B) receptors, agonistic properties at 5-HT(1A) receptors, and potent inhibition of SERT. In conscious rats, 5m significantly increased extracellular 5-HT levels in the brain after acute and 3 days of treatment. Following the 3-day treatment (5 or 10 (mg/kg)/day) SERT occupancies were only 43% and 57%, respectively. These characteristics indicate that 5m is a novel multimodal serotonergic compound, and 5m is currently in clinical development for major depressive disorder.

Multimodal Speaker Diarization.

Science.gov (United States)

Noulas, A; Englebienne, G; Krose, B J A

2012-01-01

We present a novel probabilistic framework that fuses information coming from the audio and video modality to perform speaker diarization. The proposed framework is a Dynamic Bayesian Network (DBN) that is an extension of a factorial Hidden Markov Model (fHMM) and models the people appearing in an audiovisual recording as multimodal entities that generate observations in the audio stream, the video stream, and the joint audiovisual space. The framework is very robust to different contexts, makes no assumptions about the location of the recording equipment, and does not require labeled training data as it acquires the model parameters using the Expectation Maximization (EM) algorithm. We apply the proposed model to two meeting videos and a news broadcast video, all of which come from publicly available data sets. The results acquired in speaker diarization are in favor of the proposed multimodal framework, which outperforms the single modality analysis results and improves over the state-of-the-art audio-based speaker diarization.

Multi-modal locomotion: from animal to application

International Nuclear Information System (INIS)

Lock, R J; Burgess, S C; Vaidyanathan, R

2014-01-01

The majority of robotic vehicles that can be found today are bound to operations within a single media (i.e. land, air or water). This is very rarely the case when considering locomotive capabilities in natural systems. Utility for small robots often reflects the exact same problem domain as small animals, hence providing numerous avenues for biological inspiration. This paper begins to investigate the various modes of locomotion adopted by different genus groups in multiple media as an initial attempt to determine the compromise in ability adopted by the animals when achieving multi-modal locomotion. A review of current biologically inspired multi-modal robots is also presented. The primary aim of this research is to lay the foundation for a generation of vehicles capable of multi-modal locomotion, allowing ambulatory abilities in more than one media, surpassing current capabilities. By identifying and understanding when natural systems use specific locomotion mechanisms, when they opt for disparate mechanisms for each mode of locomotion rather than using a synergized singular mechanism, and how this affects their capability in each medium, similar combinations can be used as inspiration for future multi-modal biologically inspired robotic platforms. (topical review)

Sarcopenia: Prevalence, and Impact on Operative and Oncologic Outcomes in the Multimodal Management of Locally Advanced Esophageal Cancer.

Science.gov (United States)

Elliott, Jessie A; Doyle, Suzanne L; Murphy, Conor F; King, Sinead; Guinan, Emer M; Beddy, Peter; Ravi, Narayanasamy; Reynolds, John V

2017-11-01

The aim of this article was to study the prevalence and significance of sarcopenia in the multimodal management of locally advanced esophageal cancer (LAEC), and to assess its independent impact on operative and oncologic outcomes. Sarcopenia in cancer may confer negative outcomes, but its prevalence and impact on modern multimodal regimens for LAEC have not been systematically studied. Two hundred fifty-two consecutive patients were studied. Lean body mass (LBM), skeletal muscle index (SMI), and fat mass (FM) were determined pre-treatment, preoperatively, and 1 year postoperatively. Sarcopenia was defined by computed tomography (CT) at L3 as SMI Sarcopenia increased (P = 0.02) from 16% at diagnosis to 31% post-neoadjuvant therapy, with loss of LBM (-3.0 ± 5.4 kg, P sarcopenia was associated with CCI (P = 0.043), and CDC ≥IIIb (P = 0.003). PPCs occurred in 36% nonsarcopenic versus 55% sarcopenic patients (P = 0.01). Sarcopenia did not impact disease-specific (P = 0.14) or overall survival (P = 0.11) after resection. At 1 year, 35% had sarcopenia, significantly associated with pre-treatment BMI (P = 0.013) but not complications (P = 0.20). Sarcopenia increases through multimodal therapy, is associated with an increased risk of major postoperative complications, and is prevalent in survivorship. These data highlight a potentially modifiable marker of risk that should be assessed and targeted in modern multimodal care pathways.

Sustained Spatial Attention in Touch: Modality-Specific and Multimodal Mechanisms

Directory of Open Access Journals (Sweden)

Chiara F. Sambo

2011-01-01

Full Text Available Sustained attention to a body location results in enhanced processing of tactile stimuli presented at that location compared to another unattended location. In this paper, we review studies investigating the neural correlates of sustained spatial attention in touch. These studies consistently show that activity within modality-specific somatosensory areas (SI and SII is modulated by sustained tactile-spatial attention. Recent evidence suggests that these somatosensory areas may be recruited as part of a larger cortical network,also including higher-level multimodal regions involved in spatial selection across modalities. We discuss, in turn, the following multimodal effects in sustained tactile-spatial attention tasks. First, cross-modal attentional links between touch and vision, reflected in enhanced processing of task-irrelevant visual stimuli at tactuallyattended locations, are mediated by common (multimodal representations of external space. Second, vision of the body modulates activity underlying sustained tactile-spatial attention, facilitating attentional modulation of tactile processing in between-hand (when hands are sufficiently far apart and impairing attentional modulation in within-hand selection tasks. Finally, body posture influences mechanisms of sustained tactile-spatial attention, relying, at least partly, on remapping of tactile stimuli in external, visuallydefined, spatial coordinates. Taken together, the findings reviewed in this paper indicate that sustained spatial attention in touch is subserved by both modality-specific and multimodal mechanisms. The interplay between these mechanisms allows flexible and efficient spatial selection within and across sensory modalities.

Multimodal Scaffolding in the Secondary English Classroom Curriculum

Science.gov (United States)

Boche, Benjamin; Henning, Megan

2015-01-01

This article examines the topic of multimodal scaffolding in the secondary English classroom curriculum through the viewpoint of one teacher's experiences. With technology becoming more commonplace and readily available in the English classroom, we must pinpoint specific and tangible ways to help teachers use and teach multimodalities in their…

Multimodal impairment-based physical therapy for the treatment of patients with post-concussion syndrome: A retrospective analysis on safety and feasibility.

Science.gov (United States)

Grabowski, Patrick; Wilson, John; Walker, Alyssa; Enz, Dan; Wang, Sijian

2017-01-01

Demonstrate implementation, safety and feasibility of multimodal, impairment-based physical therapy (PT) combining vestibular/oculomotor and cervical rehabilitation with sub-symptom threshold exercise for the treatment of patients with post-concussion syndrome (PCS). University hospital outpatient sports medicine facility. Twenty-five patients (12-20 years old) meeting World Health Organization criteria for PCS following sport-related concussion referred for supervised PT consisting of sub-symptom cardiovascular exercise, vestibular/oculomotor and cervical spine rehabilitation. Retrospective cohort. Post-Concussion Symptom Scale (PCSS) total score, maximum symptom-free heart rate (SFHR) during graded exercise testing (GXT), GXT duration, balance error scoring system (BESS) score, and number of adverse events. Patients demonstrated a statistically significant decreasing trend (p feasibility for future clinical trials to determine viable treatment approaches to reduce symptoms and improve function while avoiding negative repercussions of physical inactivity and premature return to full activity. Copyright © 2016 Elsevier Ltd. All rights reserved.

Optimal Face-Iris Multimodal Fusion Scheme

Directory of Open Access Journals (Sweden)

Omid Sharifi

2016-06-01

Full Text Available Multimodal biometric systems are considered a way to minimize the limitations raised by single traits. This paper proposes new schemes based on score level, feature level and decision level fusion to efficiently fuse face and iris modalities. Log-Gabor transformation is applied as the feature extraction method on face and iris modalities. At each level of fusion, different schemes are proposed to improve the recognition performance and, finally, a combination of schemes at different fusion levels constructs an optimized and robust scheme. In this study, CASIA Iris Distance database is used to examine the robustness of all unimodal and multimodal schemes. In addition, Backtracking Search Algorithm (BSA, a novel population-based iterative evolutionary algorithm, is applied to improve the recognition accuracy of schemes by reducing the number of features and selecting the optimized weights for feature level and score level fusion, respectively. Experimental results on verification rates demonstrate a significant improvement of proposed fusion schemes over unimodal and multimodal fusion methods.

Multimodal coaching and its application to workplace, life and health coaching

OpenAIRE

Stephen Palmer

2012-01-01

This article highlights how the multimodal approach (Lazarus, 1989) has been adapted to the field of coachingand coaching psychology. It covers the basic theories underpinning the multimodal approach and illustratesthe link between the theory and practice. Key multimodal strategies are covered including modalityprofiles, structural profiles, tracking and bridging.

Investigating the Abscopal Effects of Radioablation on Shielded Bone Marrow in Rodent Models Using Multimodality Imaging.

Science.gov (United States)

Afshar, Solmaz F; Zawaski, Janice A; Inoue, Taeko; Rendon, David A; Zieske, Arthur W; Punia, Jyotinder N; Sabek, Omaima M; Gaber, M Waleed

2017-07-01

The abscopal effect is the response to radiation at sites that are distant from the irradiated site of an organism, and it is thought to play a role in bone marrow (BM) recovery by initiating responses in the unirradiated bone marrow. Understanding the mechanism of this effect has applications in treating BM failure (BMF) and BM transplantation (BMT), and improving survival of nuclear disaster victims. Here, we investigated the use of multimodality imaging as a translational tool to longitudinally assess bone marrow recovery. We used positron emission tomography/computed tomography (PET/CT), magnetic resonance imaging (MRI) and optical imaging to quantify bone marrow activity, vascular response and marrow repopulation in fully and partially irradiated rodent models. We further measured the effects of radiation on serum cytokine levels, hematopoietic cell counts and histology. PET/CT imaging revealed a radiation-induced increase in proliferation in the shielded bone marrow (SBM) compared to exposed bone marrow (EBM) and sham controls. T 2 -weighted MRI showed radiation-induced hemorrhaging in the EBM and unirradiated SBM. In the EBM and SBM groups, we found alterations in serum cytokine and hormone levels and in hematopoietic cell population proportions, and histological evidence of osteoblast activation at the bone marrow interface. Importantly, we generated a BMT mouse model using fluorescent-labeled bone marrow donor cells and performed fluorescent imaging to reveal the migration of bone marrow cells from shielded to radioablated sites. Our study validates the use of multimodality imaging to monitor bone marrow recovery and provides evidence for the abscopal response in promoting bone marrow recovery after irradiation.

Diffusion Maps for Multimodal Registration

Directory of Open Access Journals (Sweden)

Gemma Piella

2014-06-01

Full Text Available Multimodal image registration is a difficult task, due to the significant intensity variations between the images. A common approach is to use sophisticated similarity measures, such as mutual information, that are robust to those intensity variations. However, these similarity measures are computationally expensive and, moreover, often fail to capture the geometry and the associated dynamics linked with the images. Another approach is the transformation of the images into a common space where modalities can be directly compared. Within this approach, we propose to register multimodal images by using diffusion maps to describe the geometric and spectral properties of the data. Through diffusion maps, the multimodal data is transformed into a new set of canonical coordinates that reflect its geometry uniformly across modalities, so that meaningful correspondences can be established between them. Images in this new representation can then be registered using a simple Euclidean distance as a similarity measure. Registration accuracy was evaluated on both real and simulated brain images with known ground-truth for both rigid and non-rigid registration. Results showed that the proposed approach achieved higher accuracy than the conventional approach using mutual information.

FDTD simulation of microwave sintering of ceramics in multimode cavities

Energy Technology Data Exchange (ETDEWEB)

Iskander, M.F.; Smith, R.L.; Andrade, A.O.M.; Walsh, L.M. (Univ. of Utah, Salt Lake City, UT (United States). Dept. of Electrical Engineering); Kimrey, H. Jr. (Oak Ridge National Lab., TN (United States))

1994-05-01

At present, various aspects of the sintering process such as preparation of sample sizes and shapes, types of insulations, and the desirability of including a process stimulus such as SiC rods are considered forms of art and highly dependent on human expertise. The simulation of realistic sintering experiments in a multimode cavity may provide an improved understanding of critical parameters involved and allow for the development of guidelines towards the optimization of the sintering process. In this paper, the authors utilize the FDTD technique to model various geometrical arrangements and material compatibility aspects in multimode microwave cavities and to simulate realistic sintering experiments. The FDTD procedure starts with the simulation of a field distribution in multimode microwave cavities that resembles a set of measured data using liquid crystal sheets. Also included in the simulation is the waveguide feed as well as a ceramic loading plate placed at the base of the cavity. The FDTD simulation thus provides realistic representation of a typical sintering experiment. Aspects that have been successfully simulated include the effects of various types of insulation, the role of SiC rods on the uniformity of the resulting microwave fields, and the possible shielding effects that may result from excessive use of SiC. These results as well as others showing the electromagnetic fields and power-deposition patterns in multiple ceramic samples are presented.

Is the residential combined (psychotherapy plus medication) treatment of patients with severe personality disorder effective in terms of suicidality and impulsivity?

Science.gov (United States)

Vaslamatzis, Grigorios; Theodoropoulos, Panayiotis; Vondikaki, Stamatia; Karamanolaki, Hara; MiliaTsanira, Myrto; Gourounti, Kleanthi

2014-02-01

The aim of this study was to compare the effectiveness of combined treatment-medication plus psychodynamic psychotherapy-and psychodynamic psychotherapy alone on the outcome variables of suicidality and impulsivity in a population of adult inpatients with severe personality disorder (SPD). This is a naturalistic-empirical (observational) study under the conditions of clinical practice (an intensive specialized inpatient psychotherapeutic program [SIPP]). The sample consisted of 33 inpatients with SPD who were allocated to two subgroups (groups A and B). The patients in group A received psychodynamic psychotherapy and adjunctive pharmacotherapy, whereas the patients in group B received multimodal psychodynamic psychotherapy only. A statistically significant reduction in suicidality score was observed in the patients in group A, whereas a tendency for significant reduction in impulsivity score was observed in group B after the SIPP termination. Pharmacotherapy combined with multimodal psychodynamic psychotherapy, always within the SIPP, seems more effective in the case of suicidality rather than impulsivity.

Nanoparticle delivered vascular disrupting agents (VDAs): use of TNF-alpha conjugated gold nanoparticles for multimodal cancer therapy.

Science.gov (United States)

Shenoi, Mithun M; Iltis, Isabelle; Choi, Jeunghwan; Koonce, Nathan A; Metzger, Gregory J; Griffin, Robert J; Bischof, John C

2013-05-06

Surgery, radiation and chemotherapy remain the mainstay of current cancer therapy. However, treatment failure persists due to the inability to achieve complete local control of the tumor and curtail metastatic spread. Vascular disrupting agents (VDAs) are a class of promising systemic agents that are known to synergistically enhance radiation, chemotherapy or thermal treatments of solid tumors. Unfortunately, there is still an unmet need for VDAs with more favorable safety profiles and fewer side effects. Recent work has demonstrated that conjugating VDAs to other molecules (polyethylene glycol, CNGRCG peptide) or nanoparticles (liposomes, gold) can reduce toxicity of one prominent VDA (tumor necrosis factor alpha, TNF-α). In this report, we show the potential of a gold conjugated TNF-α nanoparticle (NP-TNF) to improve multimodal cancer therapies with VDAs. In a dorsal skin fold and hindlimb murine xenograft model of prostate cancer, we found that NP-TNF disrupts endothelial barrier function and induces a significant increase in vascular permeability within the first 1-2 h followed by a dramatic 80% drop in perfusion 2-6 h after systemic administration. We also demonstrate that the tumor response to the nanoparticle can be verified using dynamic contrast-enhanced magnetic resonance imaging (MRI), a technique in clinical use. Additionally, multimodal treatment with thermal therapies at the perfusion nadir in the sub- and supraphysiological temperature regimes increases tumor volumetric destruction by over 60% and leads to significant tumor growth delays compared to thermal therapy alone. Lastly, NP-TNF was found to enhance thermal therapy in the absence of neutrophil recruitment, suggesting that immune/inflammatory regulation is not central to its power as part of a multimodal approach. Our data demonstrate the potential of nanoparticle-conjugated VDAs to significantly improve cancer therapy by preconditioning tumor vasculature to a secondary insult in a targeted

Multimodal neuromonitoring in pediatric cardiac anesthesia

Directory of Open Access Journals (Sweden)

Alexander J. C. Mittnacht

2014-01-01

Full Text Available Despite significant improvements in overall outcome, neurological injury remains a feared complication following pediatric congenital heart surgery (CHS. Only if adverse events are detected early enough, can effective actions be initiated preventing potentially serious injury. The multifactorial etiology of neurological injury in CHS patients makes it unlikely that one single monitoring modality will be effective in capturing all possible threats. Improving current and developing new technologies and combining them according to the concept of multimodal monitoring may allow for early detection and possible intervention with the goal to further improve neurological outcome in children undergoing CHS.

Robustness of multimodal processes itineraries

DEFF Research Database (Denmark)

Bocewicz, G.; Banaszak, Z.; Nielsen, Izabela Ewa

2013-01-01

itineraries for assumed (O-D) trip. Since itinerary planning problem, constitutes a common routing and scheduling decision faced by travelers, hence the main question regards of itinerary replanning and particularly a method aimed at prototyping of mode sequences and paths selections. The declarative model......This paper concerns multimodal transport systems (MTS) represented by a supernetworks in which several unimodal networks are connected by transfer links and focuses on the scheduling problems encountered in these systems. Assuming unimodal networks are modeled as cyclic lines, i.e. the routes...... of multimodal processes driven itinerary planning problem is our main contribution. Illustrative examples providing alternative itineraries in some cases of MTS malfunction are presented....

Multimodal coaching and its application to workplace, life and health coaching

Directory of Open Access Journals (Sweden)

Stephen Palmer

2012-10-01

Full Text Available This article highlights how the multimodal approach (Lazarus, 1989 has been adapted to the field of coachingand coaching psychology. It covers the basic theories underpinning the multimodal approach and illustratesthe link between the theory and practice. Key multimodal strategies are covered including modalityprofiles, structural profiles, tracking and bridging.

Experiencia de enseñanza multimodal en una clase de idiomas [Experience of multimodal teaching in a language classroom

Directory of Open Access Journals (Sweden)

María Martínez Lirola

2013-12-01

Full Text Available Resumen: Nuestra sociedad es cada vez más tecnológica y multimodal por lo que es necesario que la enseñanza se adapte a los nuevos tiempos. Este artículo analiza el modo en que la asignatura Lengua Inglesa IV de la Licenciatura en Filología Inglesa en la Universidad de Alicante combina el desarrollo de las cinco destrezas (escucha, habla, lectura, escritura e interacción evaluadas por medio de un portafolio con la multimodalidad en las prácticas docentes y en cada una de las actividades que componen el portafolio. Los resultados de una encuesta preparada al final del curso académico 2011-2012 ponen de manifiesto las competencias principales que el alumnado universitario desarrolla gracias a la docencia multimodal y la importancia de las tutorías en este tipo de enseñanza. Abstract: Our society becomes more technological and multimodal and, consequently, teaching has to be adapted to the new time. This article analyses the way in which the subject English Language IV of the degree English Studies at the University of Alicante combines the development of the five skills (listening, speaking, reading, writing and interacting evaluated through a portfolio with multimodality in the teaching practices and in each of the activities that are part of the portfolio. The results of a survey prepared at the end of the academic year 2011-2012 point out the main competences that university students develop thanks to multimodal teaching and the importance of tutorials in this kind of teaching.

Multimodal vaginal toning for bladder symptoms and quality of life in stress urinary incontinence.

Science.gov (United States)

de la Torre, Sarah; Miller, Larry E

2017-08-01

Treatment options for women with stress urinary incontinence (SUI) have limitations. We hypothesized that multimodal vaginal toning therapy would improve bladder symptoms and quality of life in women with postpartum SUI and sexual function complaints. Patients self-administered 24 sessions of multimodal vaginal toning therapy lasting 10 min each over 50 days. Outcomes included 1-h pad weight test, Urogenital Distress Inventory Short Form (UDI-6), Incontinence Impact Questionnaire-Short Form (IIQ-7), Female Sexual Distress Scale-Revised 2005 (FSDS-R), Female Sexual Function Index (FSFI), pelvic floor muscle strength, patient satisfaction, and adverse events. Of the 55 patients enrolled (safety population), 48 completed the study per-protocol (PP population). A total of 38 (79%) patients had a positive 1-h pad weight test at baseline. In this group, urine leakage was moderate or severe in 82% of patients at baseline, but in only 18% after treatment. Treatment success was 84%, defined as >50% improvement in pad weight relative to baseline. In the PP population, mean UDI-6 score improved by 50% (p life improved by 54% for FSDS-R and 15% for FSFI (both p life in women with SUI.

Multimodality

DEFF Research Database (Denmark)

Buhl, Mie

In this paper, I address an ongoing discussion in Danish E-learning research about how to take advantage of the fact that digital media facilitate other communication forms than text, so-called ‘multimodal’ communication, which should not be confused with the term ‘multimedia’. While multimedia...... and learning situations. The choices they make involve E-learning resources like videos, social platforms and mobile devices, not just as digital artefacts we interact with, but the entire practice of using digital media. In a life-long learning perspective, multimodality is potentially very useful...

Multimodal freight investment criteria.

Science.gov (United States)

2010-07-01

Literature was reviewed on multi-modal investment criteria for freight projects, examining measures and techniques for quantifying project benefits and costs, as well as ways to describe the economic importance of freight transportation. : A limited ...

Demonstration of analyzers for multimode photonic time-bin qubits

Science.gov (United States)

Jin, Jeongwan; Agne, Sascha; Bourgoin, Jean-Philippe; Zhang, Yanbao; Lütkenhaus, Norbert; Jennewein, Thomas

2018-04-01

We demonstrate two approaches for unbalanced interferometers as time-bin qubit analyzers for quantum communication, robust against mode distortions and polarization effects as expected from free-space quantum communication systems including wavefront deformations, path fluctuations, pointing errors, and optical elements. Despite strong spatial and temporal distortions of the optical mode of a time-bin qubit, entangled with a separate polarization qubit, we verify entanglement using the Negative Partial Transpose, with the measured visibility of up to 0.85 ±0.01 . The robustness of the analyzers is further demonstrated for various angles of incidence up to 0 .2∘ . The output of the interferometers is coupled into multimode fiber yielding a high system throughput of 0.74. Therefore, these analyzers are suitable and efficient for quantum communication over multimode optical channels.

Multimodal follow-up questions to multimodal answers in a QA system

NARCIS (Netherlands)

van Schooten, B.W.; op den Akker, Hendrikus J.A.

2007-01-01

We are developing a dialogue manager (DM) for a multimodal interactive Question Answering (QA) system. Our QA system presents answers using text and pictures, and the user may pose follow-up questions using text or speech, while indicating screen elements with the mouse. We developed a corpus of

Reliability-Based Decision Fusion in Multimodal Biometric Verification Systems

Directory of Open Access Journals (Sweden)

Kryszczuk Krzysztof

2007-01-01

Full Text Available We present a methodology of reliability estimation in the multimodal biometric verification scenario. Reliability estimation has shown to be an efficient and accurate way of predicting and correcting erroneous classification decisions in both unimodal (speech, face, online signature and multimodal (speech and face systems. While the initial research results indicate the high potential of the proposed methodology, the performance of the reliability estimation in a multimodal setting has not been sufficiently studied or evaluated. In this paper, we demonstrate the advantages of using the unimodal reliability information in order to perform an efficient biometric fusion of two modalities. We further show the presented method to be superior to state-of-the-art multimodal decision-level fusion schemes. The experimental evaluation presented in this paper is based on the popular benchmarking bimodal BANCA database.

Context-Aware Multimodal FIDO Authenticator for Sustainable IT Services

Directory of Open Access Journals (Sweden)

Seung-Hyun Kim

2018-05-01

Full Text Available Existing sustainable IT services have several problems related to user authentication such as the inefficiency of managing the system security, low security, and low usability. In this paper, we propose a Fast IDentity Online (FIDO authenticator that performs continuous authentication with implicit authentication based on user context and multimodal authentication. The proposed FIDO authenticator, a context-aware multimodal FIDO authentication (CAMFA method, combines information such as the user context, state of the mobile device, and user biometrics, then applies implicit and explicit authentication methods to meet the level of authentication required by the service provider. This reduces the user’s explicit authentication burden and continually authenticates users at risk during the session. Moreover, it is able to respond to attacks such as the theft of the authentication method or session hijacking. To study the effectiveness of CAMFA, we ran a user study by collecting data from 22 participants over 42 days of activity on a practical Android platform. The result of the user study demonstrates that the number of explicit authentication requests could be reduced by half. Based on the results of this study, an advanced user authentication that provides multimodal and continuous authentication could be applied to sustainable IT services.

Teleportation of continuous variable multimode Greeberger-Horne-Zeilinger entangled states

International Nuclear Information System (INIS)

He Guangqiang; Zhang Jingtao; Zeng Guihua

2008-01-01

Quantum teleportation protocols of continuous variable (CV) Greeberger-Horne-Zeilinger (GHZ) and Einstein-Podolsky-Rosen (EPR) entangled states are proposed, and are generalized to teleportation of arbitrary multimode GHZ entangled states described by Van Loock and Braunstein (2000 Phys. Rev. Lett. 84 3482). Each mode of a multimode entangled state is teleported using a CV EPR entangled pair and classical communication. The analytical expression of fidelity for the multimode Gaussian states which evaluates the teleportation quality is presented. The analytical results show that the fidelity is a function of both the squeezing parameter r, which characterizes the multimode entangled state to be teleported, and the channel parameter p, which characterizes the EPR pairs shared by Alice and Bob. The fidelity increases with increasing p, but decreases with increasing r, i.e., it is more difficult to teleport the more perfect multimode entangled states. The entanglement degree of the teleported multimode entangled states increases with increasing both r and p. In addition, the fact is proved that our teleportation protocol of EPR entangled states using parallel EPR pairs as quantum channels is the best case of the protocol using four-mode entangled states (Adhikari et al 2008 Phys. Rev. A 77 012337).

Locally advanced oral cavity squamous cell carcinoma: Barriers related to effective treatment

Directory of Open Access Journals (Sweden)

K C Lakshmaiah

2015-01-01

Full Text Available Background: Oral cavity cancer is a significant health problem in India. Majority of patients present with locally advanced disease requiring multimodality treatment. Compliance to recommended treatment is an important factor affecting outcome. Aims: The aim was to evaluate the outcome of locally advanced oral cavity cancer patients with regards to treatment adherence and to assess reasons of noncompliance. Materials and Methods: This was a prospective observational study. We included patients referred to Department of Medical Oncology for induction chemotherapy in view of locally advanced oral cavity cancer. Results: Only 15 (26% patients completed planned treatment schedule. Their 1 year overall survival was 93%. The remaining 43 patients who received inadequate treatment had a dismal 21% 1 year overall survival. Illiteracy, poverty, long waiting list for surgery, prolonged delay for health scheme treatment plan approval and dissatisfaction with attitude of hospital staffs are major barriers related to effective treatment of these patients. Conclusions: A detailed discussion with patient and their relatives regarding recommended treatment, proper implementation of health schemes, increasing trained manpower to avoid long waiting list for surgery, provision of additional financial support for family member accompanying the patient and a sympathetic approach toward patients are needed to help these patients overcome the battle.

Multimode waveguide speckle patterns for compressive sensing.

Science.gov (United States)

Valley, George C; Sefler, George A; Justin Shaw, T

2016-06-01

Compressive sensing (CS) of sparse gigahertz-band RF signals using microwave photonics may achieve better performances with smaller size, weight, and power than electronic CS or conventional Nyquist rate sampling. The critical element in a CS system is the device that produces the CS measurement matrix (MM). We show that passive speckle patterns in multimode waveguides potentially provide excellent MMs for CS. We measure and calculate the MM for a multimode fiber and perform simulations using this MM in a CS system. We show that the speckle MM exhibits the sharp phase transition and coherence properties needed for CS and that these properties are similar to those of a sub-Gaussian MM with the same mean and standard deviation. We calculate the MM for a multimode planar waveguide and find dimensions of the planar guide that give a speckle MM with a performance similar to that of the multimode fiber. The CS simulations show that all measured and calculated speckle MMs exhibit a robust performance with equal amplitude signals that are sparse in time, in frequency, and in wavelets (Haar wavelet transform). The planar waveguide results indicate a path to a microwave photonic integrated circuit for measuring sparse gigahertz-band RF signals using CS.

Randomized Controlled Trial: Multimodal Anxiety and Social Skill Intervention for Adolescents with Autism Spectrum Disorder

OpenAIRE

White, Susan W.; Ollendick, Thomas; Albano, Anne Marie; Oswald, Donald; Johnson, Cynthia; Southam-Gerow, Michael A.; Kim, Inyoung; Scahill, Lawrence

2013-01-01

Anxiety is common among adolescents with autism spectrum disorders (ASD) and may amplify the core social disability, thus necessitating combined treatment approaches. This pilot, randomized controlled trial (RCT) evaluated the feasibility and preliminary outcomes of the Multimodal Anxiety and Social Skills Intervention (MASSI) program in a sample of 30 adolescents with ASD and anxiety symptoms of moderate or greater severity. The treatment was acceptable to families, subject adherence was hig...

Multimodal brain monitoring in fulminant hepatic failure

Science.gov (United States)

Paschoal Jr, Fernando Mendes; Nogueira, Ricardo Carvalho; Ronconi, Karla De Almeida Lins; de Lima Oliveira, Marcelo; Teixeira, Manoel Jacobsen; Bor-Seng-Shu, Edson

2016-01-01

Acute liver failure, also known as fulminant hepatic failure (FHF), embraces a spectrum of clinical entities characterized by acute liver injury, severe hepatocellular dysfunction, and hepatic encephalopathy. Cerebral edema and intracranial hypertension are common causes of mortality in patients with FHF. The management of patients who present acute liver failure starts with determining the cause and an initial evaluation of prognosis. Regardless of whether or not patients are listed for liver transplantation, they should still be monitored for recovery, death, or transplantation. In the past, neuromonitoring was restricted to serial clinical neurologic examination and, in some cases, intracranial pressure monitoring. Over the years, this monitoring has proven insufficient, as brain abnormalities were detected at late and irreversible stages. The need for real-time monitoring of brain functions to favor prompt treatment and avert irreversible brain injuries led to the concepts of multimodal monitoring and neurophysiological decision support. New monitoring techniques, such as brain tissue oxygen tension, continuous electroencephalogram, transcranial Doppler, and cerebral microdialysis, have been developed. These techniques enable early diagnosis of brain hemodynamic, electrical, and biochemical changes, allow brain anatomical and physiological monitoring-guided therapy, and have improved patient survival rates. The purpose of this review is to discuss the multimodality methods available for monitoring patients with FHF in the neurocritical care setting. PMID:27574545

Development of a Framework for Multimodal Research: Creation of a Bibliographic Database

National Research Council Canada - National Science Library

Coovert, Michael D; Gray, Ashley A; Elliott, Linda R; Redden, Elizabeth S

2007-01-01

.... The results of the overall effort, the multimodal framework and article tracking sheet, bibliographic database, and searchable multimodal database make substantial and valuable contributions to the accumulation and interpretation of multimodal research. References collected in this effort are listed in the appendix.

Multimodal aspects of CSR communication related to gender empowerment and environmental protection

DEFF Research Database (Denmark)

Maier, Carmen Daniela

Purpose – This paper explores how the multimodal persuasive strategies of CSR communication related to Coca-Cola’s “5 by 20” succeed to highlight the company’s continuous commitment to gender empowerment and environmental protection. Launched in 2010, “5 by 20” is a program designed to empower 5...... as the usual textual focus is extended to a multimodal one. Shedding light on how the multimodal interplay contributes to communicate corporate commitment to gender empowerment and environmental protection, this model can also be employed in order to explore multimodally other areas of CSR communication....... a multimodal analysis model through which it is possible to map and explain the multimodal persuasive strategies employed by the company in their CSR communication. The paper is focused on the analysis of the video series that can be accessed at: http://www.coca-colacompany.com/stories/5by20. Based on a social...

Mode-multiplexed transmission over conventional graded-index multimode fibers

NARCIS (Netherlands)

Ryf, R.; Fontaine, N.K.; Chen, H.; Guan, B.; Huang, B.; Esmaeelpour, M.; Gnauck, A.H.; Randel, S.; Yoo, S.J.B.; Koonen, A.M.J.; Shubochkin, R.; Sun, Yi; Lingle, R.

2015-01-01

We present experimental results for combined mode-multiplexed and wavelength multiplexed transmission over conventional graded-index multimode fibers. We use mode-selective photonic lanterns as mode couplers to precisely excite a subset of the modes of the multimode fiber and additionally to

A Multimodal Database for Affect Recognition and Implicit Tagging

NARCIS (Netherlands)

Soleymani, Mohammad; Lichtenauer, Jeroen; Pun, Thierry; Pantic, Maja

MAHNOB-HCI is a multimodal database recorded in response to affective stimuli with the goal of emotion recognition and implicit tagging research. A multimodal setup was arranged for synchronized recording of face videos, audio signals, eye gaze data, and peripheral/central nervous system

Quantifying Quality Aspects of Multimodal Interactive Systems

CERN Document Server

Kühnel, Christine

2012-01-01

This book systematically addresses the quantification of quality aspects of multimodal interactive systems. The conceptual structure is based on a schematic view on human-computer interaction where the user interacts with the system and perceives it via input and output interfaces. Thus, aspects of multimodal interaction are analyzed first, followed by a discussion of the evaluation of output and input and concluding with a view on the evaluation of a complete system.

The Effect of Multimodal Feedback on Perceived Exertion on a VR Exercise Setting

DEFF Research Database (Denmark)

Bruun-Pedersen, Jon Ram; Andersen, Morten G.; Clemmesen, Mathias M.

2018-01-01

This paper seeks to determine if multimodal feedback, from auditory and haptic stimuli, can affect a user’s perceived exertion in a virtual reality setting. A simple virtual environment was created in the style of a desert to minimize the amount of visual distractions; a head mounted display was ...

Saree cancer in Indian woman treated successfully with multimodality management

Directory of Open Access Journals (Sweden)

Unmesh Vidyadhar Takalkar

2014-05-01

Full Text Available Saree is a common, traditional garment of Indian women, wrapped around the waist tightened by a thick cord and with one end draped over the shoulder. Tight knot in the same place, sweat, soiling and continuous use can cause pigmentation, scaling of the waist and even transform to malignancy. We present here a case of saree cancer successfully managed with multimodality therapy. A 50-year-old woman was referred to our hospital (India for itching and non-healing ulcerative lesion on waistline. She was wearing saree continuously for 34 years with knot at the same place. Magnetic resonance images suggested ulcerative growth with lymph node metastasis. She then underwent wide local excision; histopathological examination confirmed it was a squamous cell carcinoma. She therefore received concomitant chemotherapy and radiotherapy. She is now (2 years after the completion of treatment in remission state. Awareness of saree cancer among Indian is important to avoid malignant lesions at waistline. Multimodality management with surgery, chemotherapy and radiotherapy is ideal mean for good outcome.

Randomized Controlled Trial: Multimodal Anxiety and Social Skill Intervention for Adolescents with Autism Spectrum Disorder

Science.gov (United States)

White, Susan W.; Ollendick, Thomas; Albano, Anne Marie; Oswald, Donald; Johnson, Cynthia; Southam-Gerow, Michael A.; Kim, Inyoung; Scahill, Lawrence

2013-01-01

Anxiety is common among adolescents with autism spectrum disorders (ASD) and may amplify the core social disability, thus necessitating combined treatment approaches. This pilot, randomized controlled trial evaluated the feasibility and preliminary outcomes of the Multimodal Anxiety and Social Skills Intervention (MASSI) program in a sample of 30…

Intratumoral Administration of Holmium-166 Acetylacetonate Microspheres : Antitumor Efficacy and Feasibility of Multimodality Imaging in Renal Cancer

NARCIS (Netherlands)

Bult, Wouter; Kroeze, Stephanie G. C.; Elschot, Mattijs; Seevinck, Peter R.; Beekman, Freek J.; de Jong, Hugo W. A. M.; Uges, Donald R. A.; Kosterink, Jos G. W.; Luijten, Peter R.; Hennink, Wim E.; Schip, Alfred D. van Het; Bosch, J. L. H. Ruud; Nijsen, J. Frank W.; Jans, Judith J. M.

2013-01-01

Purpose: The increasing incidence of small renal tumors in an aging population with comorbidities has stimulated the development of minimally invasive treatments. This study aimed to assess the efficacy and demonstrate feasibility of multimodality imaging of intratumoral administration of

Multimodal Estimation of Distribution Algorithms.

Science.gov (United States)

Yang, Qiang; Chen, Wei-Neng; Li, Yun; Chen, C L Philip; Xu, Xiang-Min; Zhang, Jun

2016-02-15

Taking the advantage of estimation of distribution algorithms (EDAs) in preserving high diversity, this paper proposes a multimodal EDA. Integrated with clustering strategies for crowding and speciation, two versions of this algorithm are developed, which operate at the niche level. Then these two algorithms are equipped with three distinctive techniques: 1) a dynamic cluster sizing strategy; 2) an alternative utilization of Gaussian and Cauchy distributions to generate offspring; and 3) an adaptive local search. The dynamic cluster sizing affords a potential balance between exploration and exploitation and reduces the sensitivity to the cluster size in the niching methods. Taking advantages of Gaussian and Cauchy distributions, we generate the offspring at the niche level through alternatively using these two distributions. Such utilization can also potentially offer a balance between exploration and exploitation. Further, solution accuracy is enhanced through a new local search scheme probabilistically conducted around seeds of niches with probabilities determined self-adaptively according to fitness values of these seeds. Extensive experiments conducted on 20 benchmark multimodal problems confirm that both algorithms can achieve competitive performance compared with several state-of-the-art multimodal algorithms, which is supported by nonparametric tests. Especially, the proposed algorithms are very promising for complex problems with many local optima.

Late effects of high-dose adjuvant chemotherapy on white and gray matter in breast cancer survivors: Converging results from multimodal magnetic resonance imaging

NARCIS (Netherlands)

de Ruiter, Michiel B.; Reneman, Liesbeth; Boogerd, Willem; Veltman, Dick J.; Caan, Matthan; Douaud, Gwenaëlle; Lavini, Cristina; Linn, Sabine C.; Boven, Epie; van Dam, Frits S. A. M.; Schagen, Sanne B.

2012-01-01

The neural substrate underlying cognitive impairments after chemotherapy is largely unknown. Here, we investigated very late (>9 years) effects of adjuvant high-dose chemotherapy on brain white and gray matter in primary breast cancer survivors (n = 17) with multimodal magnetic resonance imaging

Player/Avatar Body Relations in Multimodal Augmented Reality Games

NARCIS (Netherlands)

Rosa, N.E.

2016-01-01

Augmented reality research is finally moving towards multimodal experiences: more and more applications do not only include visuals, but also audio and even haptics. The purpose of multimodality in these applications can be to increase realism or to increase the amount or quality of communicated

Composition at Washington State University: Building a Multimodal Bricolage

Science.gov (United States)

Ericsson, Patricia; Hunter, Leeann Downing; Macklin, Tialitha Michelle; Edwards, Elizabeth Sue

2016-01-01

Multimodal pedagogy is increasingly accepted among composition scholars. However, putting such pedagogy into practice presents significant challenges. In this profile of Washington State University's first-year composition program, we suggest a multi-vocal and multi-theoretical approach to addressing the challenges of multimodal pedagogy. Patricia…

Multifuel multimodal network design; Projeto de redes multicombustiveis multimodal

Energy Technology Data Exchange (ETDEWEB)

Lage, Carolina; Dias, Gustavo; Bahiense, Laura; Ferreira Filho, Virgilio J.M. [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Coordenacao dos Programas de Pos-graduacao de Engenharia (COPPE). Programa de Engenharia de Producao

2008-07-01

The objective of the Multi commodity Multimodal Network Project is the development of modeling tools and methodologies for the optimal sizing of production networks and multimodal distribution of multiple fuel and its incomes, considering investments and transportation costs. Given the inherently non-linear combinatory nature of the problem, the resolution of real instances by the complete model, in an exact way, becomes computationally intractable. Thus, the strategy for resolution should contain a combination of exacts and heuristics methods, that must be applied to subdivisions of the original problem. This paper deals with one of these subdivisions, tackling the problem of modeling a network of pipelines in order to drain the production of ethanol away from the producing plants. The objective consists in defining the best network topology, minimizing investment and operational costs, and attending the total demand. In order to do that, the network was considered a tree, where the nodes are the center of producing regions and the edges are the pipelines, trough where the ethanol produced by plants must be drained away. The main objective also includes the decision over the optimal diameter of each pipeline and the optimal size of the bombs, in order to minimize the pumping costs. (author)

MULTIMODAL FEEDBACK PROVISION IN IMPROVING PRE-SERVICE TEACHERS’ COMPETENCE

Directory of Open Access Journals (Sweden)

Fazri Nur Yusuf

2017-09-01

Full Text Available Studies on potentials of feedback over English language teaching seem not to have not been well-revealed, including studies on the use of feedback to improve English pre-service teachers’ competence. The present study investigates to what extent a multimodal feedback can influence pre-service teachers’ teaching, and which teaching aspects are influenced. Twenty five pre-service teachers taking Microteaching Course served as respondents supervised by a course advisor. The data were collected by teacher observation in a rating-scale form, self-appraisal, and interviews. The data were analyzed by using correlated sample t-test and the eight teaching components proposed by Brown (2001. The results showed that after multimodal feedback provision, pre-service teachers indicated an improvement significantly in seven out of eight teaching aspects. The provision of multimodal feedback could improve their teaching competence on preparation, instructional objective elicitation, mastery of instructional materials, use of media, and classroom management, including classroom language. But, the results do not indicate that they perform well on reflection and follow-up due to some reasons. In addition, the results evince that multimodal feedback provision could improve pre-service teachers’ pedagogical competence when the multimodal feedback is integrated with content, interpersonal relationship, and management.

Multimode optical fiber

Science.gov (United States)

Bigot-Astruc, Marianne; Molin, Denis; Sillard, Pierre

2014-11-04

A depressed graded-index multimode optical fiber includes a central core, an inner depressed cladding, a depressed trench, an outer depressed cladding, and an outer cladding. The central core has an alpha-index profile. The depressed claddings limit the impact of leaky modes on optical-fiber performance characteristics (e.g., bandwidth, core size, and/or numerical aperture).

Multimodal versus Unimodal Instruction in a Complex Learning Context.

Science.gov (United States)

Gellevij, Mark; van der Meij, Hans; de Jong, Ton; Pieters, Jules

2002-01-01

Compared multimodal instruction with text and pictures with unimodal text-only instruction as 44 college students used a visual or textual manual to learn a complex software application. Results initially support dual coding theory and indicate that multimodal instruction led to better performance than unimodal instruction. (SLD)

The Big Five: Addressing Recurrent Multimodal Learning Data Challenges

NARCIS (Netherlands)

Di Mitri, Daniele; Schneider, Jan; Specht, Marcus; Drachsler, Hendrik

2018-01-01

The analysis of multimodal data in learning is a growing field of research, which has led to the development of different analytics solutions. However, there is no standardised approach to handle multimodal data. In this paper, we describe and outline a solution for five recurrent challenges in

Facilitating Multiple Intelligences Through Multimodal Learning Analytics

Directory of Open Access Journals (Sweden)

Ayesha PERVEEN

2018-01-01

Full Text Available This paper develops a theoretical framework for employing learning analytics in online education to trace multiple learning variations of online students by considering their potential of being multiple intelligences based on Howard Gardner’s 1983 theory of multiple intelligences. The study first emphasizes the need to facilitate students as multiple intelligences by online education systems and then suggests a framework of the advanced form of learning analytics i.e., multimodal learning analytics for tracing and facilitating multiple intelligences while they are engaged in online ubiquitous learning. As multimodal learning analytics is still an evolving area, it poses many challenges for technologists, educationists as well as organizational managers. Learning analytics make machines meet humans, therefore, the educationists with an expertise in learning theories can help technologists devise latest technological methods for multimodal learning analytics and organizational managers can implement them for the improvement of online education. Therefore, a careful instructional design based on a deep understanding of students’ learning abilities, is required to develop teaching plans and technological possibilities for monitoring students’ learning paths. This is how learning analytics can help design an adaptive instructional design based on a quick analysis of the data gathered. Based on that analysis, the academicians can critically reflect upon the quick or delayed implementation of the existing instructional design based on students’ cognitive abilities or even about the single or double loop learning design. The researcher concludes that the online education is multimodal in nature, has the capacity to endorse multiliteracies and, therefore, multiple intelligences can be tracked and facilitated through multimodal learning analytics in an online mode. However, online teachers’ training both in technological implementations and

Analyzing Multimode Wireless Sensor Networks Using the Network Calculus

Directory of Open Access Journals (Sweden)

Xi Jin

2015-01-01

Full Text Available The network calculus is a powerful tool to analyze the performance of wireless sensor networks. But the original network calculus can only model the single-mode wireless sensor network. In this paper, we combine the original network calculus with the multimode model to analyze the maximum delay bound of the flow of interest in the multimode wireless sensor network. There are two combined methods A-MM and N-MM. The method A-MM models the whole network as a multimode component, and the method N-MM models each node as a multimode component. We prove that the maximum delay bound computed by the method A-MM is tighter than or equal to that computed by the method N-MM. Experiments show that our proposed methods can significantly decrease the analytical delay bound comparing with the separate flow analysis method. For the large-scale wireless sensor network with 32 thousands of sensor nodes, our proposed methods can decrease about 70% of the analytical delay bound.

Photoacoustic-Based Multimodal Nanoprobes: from Constructing to Biological Applications.

Science.gov (United States)

Gao, Duyang; Yuan, Zhen

2017-01-01

Multimodal nanoprobes have attracted intensive attentions since they can integrate various imaging modalities to obtain complementary merits of single modality. Meanwhile, recent interest in laser-induced photoacoustic imaging is rapidly growing due to its unique advantages in visualizing tissue structure and function with high spatial resolution and satisfactory imaging depth. In this review, we summarize multimodal nanoprobes involving photoacoustic imaging. In particular, we focus on the method to construct multimodal nanoprobes. We have divided the synthetic methods into two types. First, we call it "one for all" concept, which involves intrinsic properties of the element in a single particle. Second, "all in one" concept, which means integrating different functional blocks in one particle. Then, we simply introduce the applications of the multifunctional nanoprobes for in vivo imaging and imaging-guided tumor therapy. At last, we discuss the advantages and disadvantages of the present methods to construct the multimodal nanoprobes and share our viewpoints in this area.

PET-MRI and multimodal cancer imaging

International Nuclear Information System (INIS)

Wang Taisong; Zhao Jinhua; Song Jianhua

2011-01-01

Multimodality imaging, specifically PET-CT, brought a new perspective into the fields of clinical imaging. Clinical cases have shown that PET-CT has great value in clinical diagnosis and experimental research. But PET-CT still bears some limitations. A major drawback is that CT provides only limited soft tissue contrast and exposes the patient to a significant radiation dose. MRI overcome these limitations, it has excellent soft tissue contrast, high temporal and spatial resolution and no radiation damage. Additionally, since MRI provides also functional information, PET-MRI will show a new direction of multimodality imaging in the future. (authors)

Multimodal training between agents

DEFF Research Database (Denmark)

Rehm, Matthias

2003-01-01

In the system Locator1, agents are treated as individual and autonomous subjects that are able to adapt to heterogenous user groups. Applying multimodal information from their surroundings (visual and linguistic), they acquire the necessary concepts for a successful interaction. This approach has...

Multimodality gynecomastia repair by cross-chest power-assisted superficial liposuction combined with endoscopic-assisted pull-through excision.

Science.gov (United States)

Ramon, Ytzhack; Fodor, Lucian; Peled, Isaac J; Eldor, Liron; Egozi, Dana; Ullmann, Yehuda

2005-12-01

Numerous methods of gynecomastia repair have been described to accomplish removal of breast tissue. Our multimodality surgical approach for the treatment of gynecomastia combines the use of power-assisted superficial cross-chest liposuction with direct pull-through excision of the breast parenchyma under endoscopic supervision. Seventeen patients, aging 17-39, underwent this multimodality approach. According to Simon's grading, 3 patients had grade 1, 5 had grade 2a, 6 had grade 2b, and 3 had grade 3 gynecomastia. Power-assisted liposuction was performed with a 3- or 4-mm triple-hole cannula inserted through the contralateral periareolar medial incision to suction the contralateral prepectoral fatty breast. At the end of the liposuction, the fibrous tissue was easily pulled through the ipsilateral stab wound and excised under endoscopic control. Follow-up time ranged from 6 to 34 months. The amount of fat removed by liposuction varied from 100-800 mL per breast, and the amount of breast parenchyma removed by excision varied from 20-110 g. All patients recovered remarkably well. No complications were recorded. All patients were satisfied with their results. This technique enables an effective treatment of both the fatty and fibrous tissue of the male breast and avoids skin redundancy due to skin contraction. A smooth masculine breast contour is consistently achieved without the stigma of this type of surgery.

Using multiple metaphors and multimodalities as a semiotic resource when teaching year 2 students computational strategies

Science.gov (United States)

Mildenhall, Paula; Sherriff, Barbara

2017-06-01

Recent research indicates that using multimodal learning experiences can be effective in teaching mathematics. Using a social semiotic lens within a participationist framework, this paper reports on a professional learning collaboration with a primary school teacher designed to explore the use of metaphors and modalities in mathematics instruction. This video case study was conducted in a year 2 classroom over two terms, with the focus on building children's understanding of computational strategies. The findings revealed that the teacher was able to successfully plan both multimodal and multiple metaphor learning experiences that acted as semiotic resources to support the children's understanding of abstract mathematics. The study also led to implications for teaching when using multiple metaphors and multimodalities.

A Multimodal Discourse Analysis of Tmall's Double Eleven Advertisement

Science.gov (United States)

Hu, Chunyu; Luo, Mengxi

2016-01-01

From the 1990s, the multimodal turn in discourse studies makes multimodal discourse analysis a popular topic in linguistics and communication studies. An important approach to applying Systemic Functional Linguistics to non-verbal modes is Visual Grammar initially proposed by Kress and van Leeuwen (1996). Considering that commercial advertisement…

Developing a ‘big picture’: Effects of collaborative construction of multimodal representations in history

NARCIS (Netherlands)

Prangsma, M.E.; van Boxtel, C.A.M.; Kanselaar, G.

2008-01-01

Many pupils have difficulties with the abstract verbal information in history lessons. In this study we assessed the value of active construction of multimodal representations of historical phenomena. In an experimental study we compared the learning outcomes of pupils who co-constructed textual

Locally advanced prostate cancer: a population-based study of treatment patterns.

Science.gov (United States)

Lowrance, William T; Elkin, Elena B; Yee, David S; Feifer, Andrew; Ehdaie, Behfar; Jacks, Lindsay M; Atoria, Coral L; Zelefsky, Michael J; Scher, Howard I; Scardino, Peter T; Eastham, James A

2012-05-01

Study Type--Therapy (practice patterns). Level of Evidence 2b. What's known on the subject? And what does the study add? The treatment of locally advanced prostate cancer varies widely even though there is level one evidence supporting the use of multimodality therapy as compared with monotherapy. This study defines treatment patterns of locally advanced prostate cancer within the United States and identifies predicators of who receives multimodality therapy rather than monotherapy. • To identify treatment patterns and predictors of receiving multimodality therapy in patients with locally advanced prostate cancer (LAPC). • The cohort comprised patients ≥66 years with clinical stage T3 or T4 non-metastatic prostate cancer diagnosed between 1998 and 2005 identified from the Surveillance, Epidemiology and End Results (SEER) cancer registry records linked with Medicare claims. • Treatments were classified as radical prostatectomy (RP), radiation therapy (RT) and androgen deprivation therapy (ADT) received within 6 and 24 months of diagnosis. • We assessed trends over time and used multivariable logistic regression to identify predictors of multimodality treatment. • Within the first 6 months of diagnosis, 1060 of 3095 patients (34%) were treated with a combination of RT and ADT, 1486 (48%) received monotherapy (RT alone, ADT alone or RP alone), and 461 (15%) received no active treatment. • The proportion of patients who received RP increased, exceeding 10% in 2005. • Use of combined RT and ADT and use of ADT alone fluctuated throughout the study period. • In all 6% of patients received RT alone in 2005. • Multimodality therapy was less common in patients who were older, African American, unmarried, who lived in the south, and who had co-morbidities or stage T4 disease. • Treatment of LAPC varies widely, and treatment patterns shifted during the study period. • The slightly increased use of multimodality therapy since 2003 is encouraging, but

Agrupador de imágenes multimodal no supervisado

OpenAIRE

Pérez Hernando, Jesús

2013-01-01

Trabajo Fin de Máster donde se implementa un método multimodal para la clasificación de imágenes sin etiquetar y sin intervención humana. Treball Fi de Màster on s'implementa un mètode multimodal per a la classificació d'imatges sense etiquetar i sense intervenció humana. Master thesis for the Computer Science Engineering program.

Family accommodation of anxiety symptoms in youth undergoing intensive multimodal treatment for anxiety disorders and obsessive-compulsive disorder: Nature, clinical correlates, and treatment response.

Science.gov (United States)

La Buissonnière-Ariza, Valérie; Schneider, Sophie C; Højgaard, Davíð; Kay, Brian C; Riemann, Bradley C; Eken, Stephanie C; Lake, Peter; Nadeau, Joshua M; Storch, Eric A

2018-01-01

Family accommodation is associated with a range of clinical features including symptom severity, functional impairment, and treatment response. However, most previous studies in children and adolescents investigated family accommodation in samples of youth with obsessive-compulsive disorder (OCD) or anxiety disorders receiving non-intensive outpatient services. In this study, we aimed to investigate family accommodation of anxiety symptoms in a sample of youth with clinical anxiety levels undergoing an intensive multimodal intervention for anxiety disorders or OCD. We first assessed the internal consistency of the Family Accommodation Scale - Anxiety (FASA). We next examined family accommodation presentation and correlates. The FASA showed high internal consistency for all subscales and total score, and good item and subscale correlations with the total score. All parents reported at least mild accommodation, and the mean levels of family accommodation were particularly high. Child age, anxiety severity, and comorbid depressive symptoms predicted baseline accommodation. However, the association between anxiety severity and family accommodation no longer remained significant after adding the other factors to the model. In addition, family accommodation partially mediated the relationship between anxiety severity and functional impairment. Finally, post-treatment changes in family accommodation predicted changes in symptom severity and functional impairment. These findings suggest the FASA is an appropriate tool to assess family accommodation in intensive treatment samples. Further, they underline the importance of addressing family accommodation in this population given the particularly high levels of accommodating behaviors and the evidence for adverse outcomes associated with this feature. Copyright © 2017 Elsevier Inc. All rights reserved.

Multimodal prevention of pain, nausea and vomiting after breast cancer surgery

DEFF Research Database (Denmark)

Gärtner, Rune; Kroman, N; Callesen, T

2010-01-01

Despite many one- or two-modal attempts to relieve postoperative nausea and vomiting (PONV) and pain, postoperative issues following breast cancer surgery remain a substantial problem. Therefore, the aim of this explorative, hypothesis-generating study was to evaluate the effect of a multimodal...

Object recognition through a multi-mode fiber

Science.gov (United States)

Takagi, Ryosuke; Horisaki, Ryoichi; Tanida, Jun

2017-04-01

We present a method of recognizing an object through a multi-mode fiber. A number of speckle patterns transmitted through a multi-mode fiber are provided to a classifier based on machine learning. We experimentally demonstrated binary classification of face and non-face targets based on the method. The measurement process of the experimental setup was random and nonlinear because a multi-mode fiber is a typical strongly scattering medium and any reference light was not used in our setup. Comparisons between three supervised learning methods, support vector machine, adaptive boosting, and neural network, are also provided. All of those learning methods achieved high accuracy rates at about 90% for the classification. The approach presented here can realize a compact and smart optical sensor. It is practically useful for medical applications, such as endoscopy. Also our study indicated a promising utilization of artificial intelligence, which has rapidly progressed, for reducing optical and computational costs in optical sensing systems.

The dynamics of multimodal integration: The averaging diffusion model.

Science.gov (United States)

Turner, Brandon M; Gao, Juan; Koenig, Scott; Palfy, Dylan; L McClelland, James

2017-12-01

We combine extant theories of evidence accumulation and multi-modal integration to develop an integrated framework for modeling multimodal integration as a process that unfolds in real time. Many studies have formulated sensory processing as a dynamic process where noisy samples of evidence are accumulated until a decision is made. However, these studies are often limited to a single sensory modality. Studies of multimodal stimulus integration have focused on how best to combine different sources of information to elicit a judgment. These studies are often limited to a single time point, typically after the integration process has occurred. We address these limitations by combining the two approaches. Experimentally, we present data that allow us to study the time course of evidence accumulation within each of the visual and auditory domains as well as in a bimodal condition. Theoretically, we develop a new Averaging Diffusion Model in which the decision variable is the mean rather than the sum of evidence samples and use it as a base for comparing three alternative models of multimodal integration, allowing us to assess the optimality of this integration. The outcome reveals rich individual differences in multimodal integration: while some subjects' data are consistent with adaptive optimal integration, reweighting sources of evidence as their relative reliability changes during evidence integration, others exhibit patterns inconsistent with optimality.

Operative and economic evaluation of a 'Laser Printer Multimodality' System

International Nuclear Information System (INIS)

Battaglia, G.; Moscatelli, G.; Maroldi, R.; Chiesa, A.

1991-01-01

The increasing application of digital techniques to diagnostic imaging is causing significant changes in several related activities, such as a reproduction of digital images on film. In the Department of Diagnostic Imaging of the University of Brescia, about 70% of the whole of images are produced by digital techniques; at present, most of these images are reproduced on film with a Multimodality System interfacing CT, MR, DSA, and DR units with a single laser printer. Our analysis evaluates the operative and economics aspects of image reproduction, by comparing the 'single cassette' multiformat Camera and the Laser Printer Multimodality SAystem. Our results point out the advantages obtained by reproducing images with a Laser Printer Multimodality System: outstanding quality, reproduction of multiple originals, and marked reduction in the time needed for both image archiving and film handling. The Laser Printer Multimodality System allows over 5 hours/day to be saved -that is to say the working day of an operator, who can be thus shifted to other functions. The important economic aspect of the reproduction of digital images on film proves the Laser Printer Multimodality System to have some advantage over Cameras

ALERT. Adverse late effects of cancer treatment. Vol. 1. General concepts and specific precepts

Energy Technology Data Exchange (ETDEWEB)

Rubin, Philip; Constine, Louis S. [Univ. Rochester Medical Center, NY (United States). Dept. of Radiation Oncology; Marks, Lawrence B. (ed.) [Univ. North Carolina and Lineberger, Comprehensive Cancer Center, Chapel Hill, NC (United States). Dept. of Radiation Oncology

2014-09-01

Considers in detail the general concepts and principles relevant to the adverse late effects of cancer treatment. Explains the molecular, cytologic and histopathologic events that lead to altered physiologic and metabolic functions and their clinical manifestations. Includes chapters on legal issues, economic aspects, nursing, psychological issues and quality of life. The literature on the late effects of cancer treatment is widely scattered in different journals since all major organ systems are affected and management is based on a variety of medical and surgical treatments. The aim of ALERT - Adverse Late Effects of Cancer Treatment is to offer a coherent multidisciplinary approach to the care of cancer survivors. The central paradigm is that cytotoxic multimodal therapy results in a perpetual cascade of events that affects each major organ system differently and is expressed continually over time. Essentially, radiation and chemotherapy are intense biologic modifiers that allow for cancer cure and cancer survivorship but accelerate senescence of normal tissues and increase the incidence of age-related diseases and second malignant tumors. Volume 1 of this two-volume work focuses on the general concepts and principles relevant to late effects and on the dynamic interplay of molecular, cytologic and histopathologic events that lead to altered physiologic and metabolic functions and their clinical manifestations. Chapters are also included on legal issues, economic aspects, nursing, psychological issues and quality of life.

ALERT. Adverse late effects of cancer treatment. Vol. 1. General concepts and specific precepts

International Nuclear Information System (INIS)

Rubin, Philip; Constine, Louis S.; Marks, Lawrence B.

2014-01-01

Considers in detail the general concepts and principles relevant to the adverse late effects of cancer treatment. Explains the molecular, cytologic and histopathologic events that lead to altered physiologic and metabolic functions and their clinical manifestations. Includes chapters on legal issues, economic aspects, nursing, psychological issues and quality of life. The literature on the late effects of cancer treatment is widely scattered in different journals since all major organ systems are affected and management is based on a variety of medical and surgical treatments. The aim of ALERT - Adverse Late Effects of Cancer Treatment is to offer a coherent multidisciplinary approach to the care of cancer survivors. The central paradigm is that cytotoxic multimodal therapy results in a perpetual cascade of events that affects each major organ system differently and is expressed continually over time. Essentially, radiation and chemotherapy are intense biologic modifiers that allow for cancer cure and cancer survivorship but accelerate senescence of normal tissues and increase the incidence of age-related diseases and second malignant tumors. Volume 1 of this two-volume work focuses on the general concepts and principles relevant to late effects and on the dynamic interplay of molecular, cytologic and histopathologic events that lead to altered physiologic and metabolic functions and their clinical manifestations. Chapters are also included on legal issues, economic aspects, nursing, psychological issues and quality of life.

Changes in brain activity of somatoform disorder patients during emotional empathy after multimodal psychodynamic psychotherapy

Science.gov (United States)

de Greck, Moritz; Bölter, Annette F.; Lehmann, Lisa; Ulrich, Cornelia; Stockum, Eva; Enzi, Björn; Hoffmann, Thilo; Tempelmann, Claus; Beutel, Manfred; Frommer, Jörg; Northoff, Georg

2013-01-01

Somatoform disorder patients show a variety of emotional disturbances including impaired emotion recognition and increased empathic distress. In a previous paper, our group showed that several brain regions involved in emotional processing, such as the parahippocampal gyrus and other regions, were less activated in pre-treatment somatoform disorder patients (compared to healthy controls) during an empathy task. Since the parahippocampal gyrus is involved in emotional memory, its decreased activation might reflect the repression of emotional memories (which—according to psychoanalytical concepts—plays an important role in somatoform disorder). Psychodynamic psychotherapy aims at increasing the understanding of emotional conflicts as well as uncovering repressed emotions. We were interested, whether brain activity in the parahippocampal gyrus normalized after (inpatient) multimodal psychodynamic psychotherapy. Using fMRI, subjects were scanned while they shared the emotional states of presented facial stimuli expressing anger, disgust, joy, and a neutral expression; distorted stimuli with unrecognizable content served as control condition. 15 somatoform disorder patients were scanned twice, pre and post multimodal psychodynamic psychotherapy; in addition, 15 age-matched healthy control subjects were investigated. Effects of psychotherapy on hemodynamic responses were analyzed implementing two approaches: (1) an a priori region of interest approach and (2) a voxelwise whole brain analysis. Both analyses revealed increased hemodynamic responses in the left and right parahippocampal gyrus (and other regions) after multimodal psychotherapy in the contrast “empathy with anger”—“control.” Our results are in line with psychoanalytical concepts about somatoform disorder. They suggest the parahippocampal gyrus is crucially involved in the neurobiological mechanisms which underly the emotional deficits of somatoform disorder patients. PMID:23966922

Performance of Series Connected GaAs Photovoltaic Converters under Multimode Optical Fiber Illumination

Directory of Open Access Journals (Sweden)

Tiqiang Shan

2014-01-01

Full Text Available In many military and industrial applications, GaAs photovoltaic (PV converters are connected in series in order to generate the required voltage compatible with most common electronics. Multimode optical fibers are usually used to carry high-intensity laser and illuminate the series connected GaAs PV converters in real time. However, multimode optical fiber illumination has a speckled intensity pattern. The series connected PV array is extremely sensitive to nonuniform illumination; its performance is limited severely by the converter that is illuminated the least. This paper quantifies the effects of multimode optical fiber illumination on the performance of series connected GaAs PV converters, analyzes the loss mechanisms due to speckles, and discusses the maximum illumination efficiency. In order to describe the illumination dependent behavior detailedly, modeling of the series connected PV array is accomplished based on the equivalent circuit for PV cells. Finally, a series of experiments are carried out to demonstrate the theory analysis.

Single-pulse CARS based multimodal nonlinear optical microscope for bioimaging.

Science.gov (United States)

Kumar, Sunil; Kamali, Tschackad; Levitte, Jonathan M; Katz, Ori; Hermann, Boris; Werkmeister, Rene; Považay, Boris; Drexler, Wolfgang; Unterhuber, Angelika; Silberberg, Yaron

2015-05-18

Noninvasive label-free imaging of biological systems raises demand not only for high-speed three-dimensional prescreening of morphology over a wide-field of view but also it seeks to extract the microscopic functional and molecular details within. Capitalizing on the unique advantages brought out by different nonlinear optical effects, a multimodal nonlinear optical microscope can be a powerful tool for bioimaging. Bringing together the intensity-dependent contrast mechanisms via second harmonic generation, third harmonic generation and four-wave mixing for structural-sensitive imaging, and single-beam/single-pulse coherent anti-Stokes Raman scattering technique for chemical sensitive imaging in the finger-print region, we have developed a simple and nearly alignment-free multimodal nonlinear optical microscope that is based on a single wide-band Ti:Sapphire femtosecond pulse laser source. Successful imaging tests have been realized on two exemplary biological samples, a canine femur bone and collagen fibrils harvested from a rat tail. Since the ultra-broad band-width femtosecond laser is a suitable source for performing high-resolution optical coherence tomography, a wide-field optical coherence tomography arm can be easily incorporated into the presented multimodal microscope making it a versatile optical imaging tool for noninvasive label-free bioimaging.

A Multimodal Neural Network Recruited by Expertise with Musical Notation

Science.gov (United States)

Wong, Yetta Kwailing; Gauthier, Isabel

2010-01-01

Prior neuroimaging work on visual perceptual expertise has focused on changes in the visual system, ignoring possible effects of acquiring expert visual skills in nonvisual areas. We investigated expertise for reading musical notation, a skill likely to be associated with multimodal abilities. We compared brain activity in music-reading experts…

Could a multimodal dictionary serve as a learning tool? An examination of the impact of technologically enhanced visual glosses on L2 text comprehension

Directory of Open Access Journals (Sweden)

Takeshi Sato

2016-09-01

Full Text Available This study examines the efficacy of a multimodal online bilingual dictionary based on cognitive linguistics in order to explore the advantages and limitations of explicit multimodal L2 vocabulary learning. Previous studies have examined the efficacy of the verbal and visual representation of words while reading L2 texts, concluding that it facilitates incidental word retention. This study explores other potentials of multimodal L2 vocabulary learning: explicit learning with a multimodal dictionary could enhance not only word retention, but also text comprehension; the dictionary could serve not only as a reference tool, but also as a learning tool; and technology-enhanced visual glosses could facilitate deeper text comprehension. To verify these claims, this study investigates the multimodal representations’ effects on Japanese students learning L2 locative prepositions by developing two online dictionaries, one with static pictures and one with animations. The findings show the advantage of such dictionaries in explicit learning; however, no significant differences are found between the two types of visual glosses, either in the vocabulary or in the listening tests. This study confirms the effectiveness of multimodal L2 materials, but also emphasizes the need for further research into making the technologically enhanced materials more effective.

Progression of hydroxychloroquine toxic effects after drug therapy cessation: new evidence from multimodal imaging.

Science.gov (United States)

Mititelu, Mihai; Wong, Brandon J; Brenner, Marie; Bryar, Paul J; Jampol, Lee M; Fawzi, Amani A

2013-09-01

Given the infrequent occurrence of hydroxychloroquine toxic effects, few data are available about the presenting features and long-term follow-up of patients with hydroxychloroquine retinopathy, making it difficult to surmise the clinical course of patients after cessation of drug treatment. To report functional and structural findings of hydroxychloroquine retinal toxic effects after drug therapy discontinuation. A retrospective medical record review was performed to identify patients taking hydroxychloroquine who were screened for toxic effects from January 1, 2009, through August 31, 2012, in the eye centers of Northwestern University and the University of Southern California. Northwestern University Sorrel Rosin Eye Center, Chicago, Illinois, and the Doheny Eye Institute at the University of Southern California, Los Angeles. Seven consecutive patients diagnosed as having hydroxychloroquine retinal toxic effects. Retinal toxic effects. Seven patients (1 man and 6 women) with a mean age of 55.9 years (age range, 25-74 years) developed retinal toxic effects after using hydroxychloroquine for a mean of 10.4 years (range, 3-19 years). Fundus examination revealed macular pigmentary changes in all 7 patients, corresponding to abnormal fundus autofluorescence (FAF). On spectral domain optical coherence tomography, there was outer retinal foveal resistance (preservation of the external limiting membrane and the photoreceptor layer) in 6 patients. After drug therapy discontinuation, 5 patients experienced outer retinal regeneration (3 subfoveally and 2 parafoveally), with associated functional visual improvement on static perimetry in 2 patients. Over time, FAF remained stable in 3 patients, whereas the remaining patients had a pattern of hypoautofluorescence that replaced areas of initial hyperautofluorescence (2 patients) and enlargement of the total area of abnormal FAF (2 patients). Preservation of the external limiting membrane carries a positive prognostic value in

Quantitative multi-modal NDT data analysis

International Nuclear Information System (INIS)

Heideklang, René; Shokouhi, Parisa

2014-01-01

A single NDT technique is often not adequate to provide assessments about the integrity of test objects with the required coverage or accuracy. In such situations, it is often resorted to multi-modal testing, where complementary and overlapping information from different NDT techniques are combined for a more comprehensive evaluation. Multi-modal material and defect characterization is an interesting task which involves several diverse fields of research, including signal and image processing, statistics and data mining. The fusion of different modalities may improve quantitative nondestructive evaluation by effectively exploiting the augmented set of multi-sensor information about the material. It is the redundant information in particular, whose quantification is expected to lead to increased reliability and robustness of the inspection results. There are different systematic approaches to data fusion, each with its specific advantages and drawbacks. In our contribution, these will be discussed in the context of nondestructive materials testing. A practical study adopting a high-level scheme for the fusion of Eddy Current, GMR and Thermography measurements on a reference metallic specimen with built-in grooves will be presented. Results show that fusion is able to outperform the best single sensor regarding detection specificity, while retaining the same level of sensitivity

Patients with more severe symptoms benefit the most from an intensive multimodal programme in patients with fibromyalgia

NARCIS (Netherlands)

Van Abbema, Renske; Van Wilgen, C. Paul; Van der Schans, Cees P.; Van Ittersum, Miriam W.

2011-01-01

Purpose. Patients with fibromyalgia (FM) experience symptoms over a long period of time impacting their quality of life (QoL). Patients are often treated in multimodal programmes that combine physical and cognitive treatment modalities. Purpose of this study was to identify prognostic factors of

Strategy development management of Multimodal Transport Network

Directory of Open Access Journals (Sweden)

Nesterova Natalia S.

2016-01-01

Full Text Available The article gives a brief overview of works on the development of transport infrastructure for multimodal transportation and integration of Russian transport system into the international transport corridors. The technology for control of the strategy, that changes shape and capacity of Multi-modal Transport Network (MTN, is considered as part of the methodology for designing and development of MTN. This technology allows to carry out strategic and operational management of the strategy implementation based on the use of the balanced scorecard.

Use of multimodality imaging and artificial intelligence for diagnosis and prognosis of early stages of Alzheimer's disease.

Science.gov (United States)

Liu, Xiaonan; Chen, Kewei; Wu, Teresa; Weidman, David; Lure, Fleming; Li, Jing

2018-04-01

Alzheimer's disease (AD) is a major neurodegenerative disease and the most common cause of dementia. Currently, no treatment exists to slow down or stop the progression of AD. There is converging belief that disease-modifying treatments should focus on early stages of the disease, that is, the mild cognitive impairment (MCI) and preclinical stages. Making a diagnosis of AD and offering a prognosis (likelihood of converting to AD) at these early stages are challenging tasks but possible with the help of multimodality imaging, such as magnetic resonance imaging (MRI), fluorodeoxyglucose (FDG)-positron emission topography (PET), amyloid-PET, and recently introduced tau-PET, which provides different but complementary information. This article is a focused review of existing research in the recent decade that used statistical machine learning and artificial intelligence methods to perform quantitative analysis of multimodality image data for diagnosis and prognosis of AD at the MCI or preclinical stages. We review the existing work in 3 subareas: diagnosis, prognosis, and methods for handling modality-wise missing data-a commonly encountered problem when using multimodality imaging for prediction or classification. Factors contributing to missing data include lack of imaging equipment, cost, difficulty of obtaining patient consent, and patient drop-off (in longitudinal studies). Finally, we summarize our major findings and provide some recommendations for potential future research directions. Copyright © 2018 Elsevier Inc. All rights reserved.

Multimodal Behavior Therapy: Case Study of a High School Student.

Science.gov (United States)

Seligman, Linda

1981-01-01

A case study of a high school student concerned with weight problems illustrates multimodal behavior therapy and its use in a high school setting. Multimodal therapy allows the school counselor to maximize referral sources while emphasizing growth and actualization. (JAC)

Acting rehearsal in collaborative multimodal mixed reality environments

OpenAIRE

Steptoe, William; Normand, Jean-Marie; Oyekoya, Oyewole; Pece, Fabrizio; Giannopoulos, Elias; Tecchia, Franco; Steed, Anthony; Weyrich, Tim; Kautz, Jan; Slater, Mel

2012-01-01

This paper presents the use of our multimodal mixed reality telecommunication system to support remote acting rehearsal. The rehearsals involved two actors, located in London and Barcelona, and a director in another location in London. This triadic audiovisual telecommunication was performed in a spatial and multimodal collaborative mixed reality environment based on the 'destination-visitor' paradigm, which we define and put into use. We detail our heterogeneous system architecture, which sp...

Effects of multimodal feedback on the usability of mobile diet diary for older adults

NARCIS (Netherlands)

Bojic, M.; Blanson Henkemans, O.A.; Neerincx, M.A.; Mast, C.A.P.G. van der; Lindenberg, J.

2009-01-01

Globally, overweight is an increasing problem and this especially the case for older adults, facing physical challenges and who need to maintain a healthy diet. eHealth services, such as a digital diet diary could support them. Consequently, we designed a multimodal mobile diet diary supporting

MIDA - Optimizing control room performance through multi-modal design

International Nuclear Information System (INIS)

Ronan, A. M.

2006-01-01

Multi-modal interfaces can support the integration of humans with information processing systems and computational devices to maximize the unique qualities that comprise a complex system. In a dynamic environment, such as a nuclear power plant control room, multi-modal interfaces, if designed correctly, can provide complementary interaction between the human operator and the system which can improve overall performance while reducing human error. Developing such interfaces can be difficult for a designer without explicit knowledge of Human Factors Engineering principles. The Multi-modal Interface Design Advisor (MIDA) was developed as a support tool for system designers and developers. It provides design recommendations based upon a combination of Human Factors principles, a knowledge base of historical research, and current interface technologies. MIDA's primary objective is to optimize available multi-modal technologies within a human computer interface in order to balance operator workload with efficient operator performance. The purpose of this paper is to demonstrate MIDA and illustrate its value as a design evaluation tool within the nuclear power industry. (authors)

[Multimodal pain therapy - implementation of process management - an attempt to consider management approaches].

Science.gov (United States)

Dunkel, Marion; Kramp, Melanie

2012-07-01

The combination of medical and economical proceedings allows new perspectives in the illustration of medical workflows. Considering structural and developmental aspects multimodal therapy programs show similarities with typical subjects of economic process systems. By pointing out the strategic appearance of the multimodal pain therapy concept multimodal approaches can be described to some extent by using management approaches. E. g., an economic process landscape can be used to represent procedures of a multimodal pain therapy program. © Georg Thieme Verlag Stuttgart · New York.

Pattern recognition of neurotransmitters using multimode sensing.

Science.gov (United States)

Stefan-van Staden, Raluca-Ioana; Moldoveanu, Iuliana; van Staden, Jacobus Frederick

2014-05-30

Pattern recognition is essential in chemical analysis of biological fluids. Reliable and sensitive methods for neurotransmitters analysis are needed. Therefore, we developed for pattern recognition of neurotransmitters: dopamine, epinephrine, norepinephrine a method based on multimode sensing. Multimode sensing was performed using microsensors based on diamond paste modified with 5,10,15,20-tetraphenyl-21H,23H-porphyrine, hemin and protoporphyrin IX in stochastic and differential pulse voltammetry modes. Optimized working conditions: phosphate buffer solution of pH 3.01 and KCl 0.1mol/L (as electrolyte support), were determined using cyclic voltammetry and used in all measurements. The lowest limits of quantification were: 10(-10)mol/L for dopamine and epinephrine, and 10(-11)mol/L for norepinephrine. The multimode microsensors were selective over ascorbic and uric acids and the method facilitated reliable assay of neurotransmitters in urine samples, and therefore, the pattern recognition showed high reliability (RSDneurotransmitters on biological fluids at a lower determination level than chromatographic methods. The sampling of the biological fluids referees only to the buffering (1:1, v/v) with a phosphate buffer pH 3.01, while for chromatographic methods the sampling is laborious. Accordingly with the statistic evaluation of the results at 99.00% confidence level, both modes can be used for pattern recognition and quantification of neurotransmitters with high reliability. The best multimode microsensor was the one based on diamond paste modified with protoporphyrin IX. Copyright © 2014 Elsevier B.V. All rights reserved.

MO-DE-202-03: Image-Guided Surgery and Interventions in the Advanced Multimodality Image-Guided Operating (AMIGO) Suite

Energy Technology Data Exchange (ETDEWEB)

Kapur, T. [Brigham & Women’s Hospital (United States)

2016-06-15

At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guided neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504

MO-DE-202-03: Image-Guided Surgery and Interventions in the Advanced Multimodality Image-Guided Operating (AMIGO) Suite

International Nuclear Information System (INIS)

Kapur, T.

2016-01-01

At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guided neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504

Olfactory neuroblastoma: the long-term outcome and late toxicity of multimodal therapy including radiotherapy based on treatment planning using computed tomography

International Nuclear Information System (INIS)

Mori, Takashi; Onimaru, Rikiya; Onodera, Shunsuke; Tsuchiya, Kazuhiko; Yasuda, Koichi; Hatakeyama, Hiromitsu; Kobayashi, Hiroyuki; Terasaka, Shunsuke; Homma, Akihiro; Shirato, Hiroki

2015-01-01

Olfactory neuroblastoma (ONB) is a rare tumor originating from olfactory epithelium. Here we retrospectively analyzed the long-term treatment outcomes and toxicity of radiotherapy for ONB patients for whom computed tomography (CT) and three-dimensional treatment planning was conducted to reappraise the role of radiotherapy in the light of recent advanced technology and chemotherapy. Seventeen patients with ONB treated between July 1992 and June 2013 were included. Three patients were Kadish stage B and 14 were stage C. All patients were treated with radiotherapy with or without surgery or chemotherapy. The radiation dose was distributed from 50 Gy to 66 Gy except for one patient who received 40 Gy preoperatively. The median follow-up time was 95 months (range 8–173 months). The 5-year overall survival (OS) and relapse-free survival (RFS) rates were estimated at 88% and 74%, respectively. Five patients with stage C disease had recurrence with the median time to recurrence of 59 months (range 7–115 months). Late adverse events equal to or above Grade 2 in CTCAE v4.03 were observed in three patients. Multimodal therapy including radiotherapy with precise treatment planning based on CT simulation achieved an excellent local control rate with acceptable toxicity and reasonable overall survival for patients with ONB

Joint sparse representation for robust multimodal biometrics recognition.

Science.gov (United States)

Shekhar, Sumit; Patel, Vishal M; Nasrabadi, Nasser M; Chellappa, Rama

2014-01-01

Traditional biometric recognition systems rely on a single biometric signature for authentication. While the advantage of using multiple sources of information for establishing the identity has been widely recognized, computational models for multimodal biometrics recognition have only recently received attention. We propose a multimodal sparse representation method, which represents the test data by a sparse linear combination of training data, while constraining the observations from different modalities of the test subject to share their sparse representations. Thus, we simultaneously take into account correlations as well as coupling information among biometric modalities. A multimodal quality measure is also proposed to weigh each modality as it gets fused. Furthermore, we also kernelize the algorithm to handle nonlinearity in data. The optimization problem is solved using an efficient alternative direction method. Various experiments show that the proposed method compares favorably with competing fusion-based methods.

OSM-ORIENTED METHOD OF MULTIMODAL ROUTE PLANNING

Directory of Open Access Journals (Sweden)

X. Li

2015-07-01

Full Text Available With the increasing pervasiveness of basic facilitate of transportation and information, the need of multimodal route planning is becoming more essential in the fields of communication and transportation, urban planning, logistics management, etc. This article mainly described an OSM-oriented method of multimodal route planning. Firstly, it introduced how to extract the information we need from OSM data and build proper network model and storage model; then it analysed the accustomed cost standard adopted by most travellers; finally, we used shortest path algorithm to calculate the best route with multiple traffic means.

Fiber Optic Pressure Sensor using Multimode Interference

International Nuclear Information System (INIS)

Ruiz-Perez, V I; Sanchez-Mondragon, J J; Basurto-Pensado, M A; LiKamWa, P; May-Arrioja, D A

2011-01-01

Based on the theory of multimode interference (MMI) and self-image formation, we developed a novel intrinsic optical fiber pressure sensor. The sensing element consists of a section of multimode fiber (MMF) without cladding spliced between two single mode fibers (SMF). The MMI pressure sensor is based on the intensity changes that occur in the transmitted light when the effective refractive index of the MMF is changed. Basically, a thick layer of Polydimethylsiloxane (PDMS) is placed in direct contact with the MMF section, such that the contact area between the PDMS and the fiber will change proportionally with the applied pressure, which results in a variation of the transmitted light intensity. Using this configuration, a good correlation between the measured intensity variations and the applied pressure is obtained. The sensitivity of the sensor is 3 μV/psi, for a range of 0-60 psi, and the maximum resolution of our system is 0.25 psi. Good repeatability is also observed with a standard deviation of 0.0019. The key feature of the proposed pressure sensor is its low fabrication cost, since the cost of the MMF is minimal.

Fiber Optic Pressure Sensor using Multimode Interference

Energy Technology Data Exchange (ETDEWEB)

Ruiz-Perez, V I; Sanchez-Mondragon, J J [INAOE, Apartado Postal 51 y 216, Puebla 72000 (Mexico); Basurto-Pensado, M A [CIICAp, Universidad Autonoma del Estado de Morelos (Mexico); LiKamWa, P [CREOL, University of Central Florida, Orlando, FL 32816 (United States); May-Arrioja, D A, E-mail: iruiz@inaoep.mx, E-mail: mbasurto@uaem.mx, E-mail: delta_dirac@hotmail.com, E-mail: daniel_may_arrioja@hotmail.com [UAT Reynosa Rodhe, Universidad Autonoma de Tamaulipas (Mexico)

2011-01-01

Based on the theory of multimode interference (MMI) and self-image formation, we developed a novel intrinsic optical fiber pressure sensor. The sensing element consists of a section of multimode fiber (MMF) without cladding spliced between two single mode fibers (SMF). The MMI pressure sensor is based on the intensity changes that occur in the transmitted light when the effective refractive index of the MMF is changed. Basically, a thick layer of Polydimethylsiloxane (PDMS) is placed in direct contact with the MMF section, such that the contact area between the PDMS and the fiber will change proportionally with the applied pressure, which results in a variation of the transmitted light intensity. Using this configuration, a good correlation between the measured intensity variations and the applied pressure is obtained. The sensitivity of the sensor is 3 {mu}V/psi, for a range of 0-60 psi, and the maximum resolution of our system is 0.25 psi. Good repeatability is also observed with a standard deviation of 0.0019. The key feature of the proposed pressure sensor is its low fabrication cost, since the cost of the MMF is minimal.

Optical Splitters Based on Self-Imaging Effect in Multi-Mode Waveguide Made by Ion Exchange in Glass

Directory of Open Access Journals (Sweden)

O. Barkman

2013-04-01

Full Text Available Design and modeling of single mode optical multi-mode interference structures with graded refractive index is reported. Several samples of planar optical channel waveguides were obtained by Ag+, Na+ and K+, Na+ one step thermal ion exchange process in molten salt on GIL49 glass substrate and new special optical glass for ion exchange technology. Waveguide properties were measured by optical mode spectroscopy. Obtained data were used for further design and modeling of single mode channel waveguide and subsequently for the design of 1 to 3 multimode interference power splitter in order to improve simulation accuracy. Designs were developed by utilizing finite difference beam propagation method.

An atlas-based multimodal registration method for 2D images with discrepancy structures.

Science.gov (United States)

Lv, Wenchao; Chen, Houjin; Peng, Yahui; Li, Yanfeng; Li, Jupeng

2018-06-04

An atlas-based multimodal registration method for 2-dimension images with discrepancy structures was proposed in this paper. Atlas was utilized for complementing the discrepancy structure information in multimodal medical images. The scheme includes three steps: floating image to atlas registration, atlas to reference image registration, and field-based deformation. To evaluate the performance, a frame model, a brain model, and clinical images were employed in registration experiments. We measured the registration performance by the squared sum of intensity differences. Results indicate that this method is robust and performs better than the direct registration for multimodal images with discrepancy structures. We conclude that the proposed method is suitable for multimodal images with discrepancy structures. Graphical Abstract An Atlas-based multimodal registration method schematic diagram.

A new piezoelectric energy harvesting design concept: multimodal energy harvesting skin.

Science.gov (United States)

Lee, Soobum; Youn, Byeng D

2011-03-01

This paper presents an advanced design concept for a piezoelectric energy harvesting (EH), referred to as multimodal EH skin. This EH design facilitates the use of multimodal vibration and enhances power harvesting efficiency. The multimodal EH skin is an extension of our previous work, EH skin, which was an innovative design paradigm for a piezoelectric energy harvester: a vibrating skin structure and an additional thin piezoelectric layer in one device. A computational (finite element) model of the multilayered assembly - the vibrating skin structure and piezoelectric layer - is constructed and the optimal topology and/or shape of the piezoelectric layer is found for maximum power generation from multiple vibration modes. A design rationale for the multimodal EH skin was proposed: designing a piezoelectric material distribution and external resistors. In the material design step, the piezoelectric material is segmented by inflection lines from multiple vibration modes of interests to minimize voltage cancellation. The inflection lines are detected using the voltage phase. In the external resistor design step, the resistor values are found for each segment to maximize power output. The presented design concept, which can be applied to any engineering system with multimodal harmonic-vibrating skins, was applied to two case studies: an aircraft skin and a power transformer panel. The excellent performance of multimodal EH skin was demonstrated, showing larger power generation than EH skin without segmentation or unimodal EH skin.

Increased discriminability of authenticity from multimodal laughter is driven by auditory information.

Science.gov (United States)

Lavan, Nadine; McGettigan, Carolyn

2017-10-01

We present an investigation of the perception of authenticity in audiovisual laughter, in which we contrast spontaneous and volitional samples and examine the contributions of unimodal affective information to multimodal percepts. In a pilot study, we demonstrate that listeners perceive spontaneous laughs as more authentic than volitional ones, both in unimodal (audio-only, visual-only) and multimodal contexts (audiovisual). In the main experiment, we show that the discriminability of volitional and spontaneous laughter is enhanced for multimodal laughter. Analyses of relationships between affective ratings and the perception of authenticity show that, while both unimodal percepts significantly predict evaluations of audiovisual laughter, it is auditory affective cues that have the greater influence on multimodal percepts. We discuss differences and potential mismatches in emotion signalling through voices and faces, in the context of spontaneous and volitional behaviour, and highlight issues that should be addressed in future studies of dynamic multimodal emotion processing.

[Effectiveness of education based on neuroscience in the treatment of musculoskeletal chronic pain].

Science.gov (United States)

Cuenda-Gago, J D; Espejo-Antunez, L

2017-07-01

Chronic pain is one of the most frequent health, economic and social problems. Given this, numerous approaches have been described, one of which is pain neuroscience education. To examine the effectiveness of pain neuroscience education in the treatment of musculoskeletal disorders with chronic pain and to explore the impact of specific aspects of the technique on its effectiveness. Relevant studies published between 2000 and 2015 were identified by searching PubMed, Scopus and Web of Science. Studies identified by electronic searches were screened against a set of pre-defined inclusion criteria. PEDro and SIGN scales were used to evaluate the methodological quality of the included studies. Ten studies were included in this systematic review. The main outcomes that were measured were pain, disability, neurophysiology pain test, attitudes and beliefs, fear-avoidance beliefs, self-care, kinesiophobia, quality of life and algometry. The results suggest that pain neuroscience education is effective in the short term and medium/long term for pain relief, either alone or combined with multimodal treatment. It was also effective in normalizing cognitions about pain, fear-avoidance beliefs, and self-care. Despite some evidence for a positive effect in the short and medium/long term, the heterogeneity in the technical aspects used does not allow the obtaining of conclusive results.

Multimodal analgesia versus traditional opiate based analgesia after cardiac surgery, a randomized controlled trial

DEFF Research Database (Denmark)

Rafiq, Sulman; Steinbrüchel, Daniel Andreas; Wanscher, Michael Jaeger

2014-01-01

BACKGROUND: To evaluate if an opiate sparing multimodal regimen of dexamethasone, gabapentin, ibuprofen and paracetamol had better analgesic effect, less side effects and was safe compared to a traditional morphine and paracetamol regimen after cardiac surgery. METHODS: Open-label, prospective...

MULTIMODAL ANALGESIA AFTER TOTAL HIP ARTHROPLASTY

Directory of Open Access Journals (Sweden)

I. G. Mukutsa

2012-01-01

Full Text Available Purpose - to assess the effect of multimodal analgesia in the early rehabilitation of patients after hip replacement. Materials and methods. A prospective single-centre randomized research, which included 32 patients. Patients of the 1st group received paracetamol, ketorolac and tramadol, the 2nd group of patients - ketorolac intravenously and the 3rd group of patients - etoricoxib and gabapentin. Patients of the 2nd and the 3rd groups underwent epidural analgesia with ropivacaine. Multimodal analgesia was carried out for 48 hours after the surgery. Assessment of pain intensity was performed by the VAS (visual analogue scale, a neuropathic pain component - on the DN4 questionnaire . Time was recorded during the first and second verticalization of patients, using the distance walkers and by fixing the distance covered with in 2 minutes. Results. The intensity of pain for more than 50 mm on VAS at movement at least once every 48 hours after the surgery was occurred among 9% of the 1st group, 22% of patients from the 2nd group and 8% of patients of the 3rd group. Number of patients with neuropathic pain component decreased from 25% to 3% (p ≤ 0.05. The first verticalization was performed 10 ± 8 hours after the surgery, the second - 21 ± 8 hours later. Two-minute walk distance was 5 ± 3 and 8 ± 4 m, respectively. It is noted more frequent adverse events in patients of the 1st group was noted compared to patients of the 2nd and the 3rd groups during first (91%, 33% and 25%, p ≤ 0.05 and the second verticalization (70%, 25% and 17%, p ≤ 0.05. Multimodal analgesia allows to proceed with the successful activation of patients after hip replacement with in the first day after the surgery. The 3rd group patients are noted with a tendency for the optimal combination of efficient and safe of analgetic therapy.

Interactivity in Educational Apps for Young Children: A Multimodal Analysis

Science.gov (United States)

Blitz-Raith, Alexandra H.; Liu, Jianxin

2017-01-01

Interactivity is an important indicator of an educational app's reception. Since most educational apps are multimodal, it justifies a methodological initiative to understand meaningful involvement of multimodality in enacting and even amplifying interactivity in an educational app. Yet research so far has largely concentrated on algorithm…

Multimodal Desktop Interaction: The Face –Object-Gesture–Voice Example

DEFF Research Database (Denmark)

Vidakis, Nikolas; Vlasopoulos, Anastasios; Kounalakis, Tsampikos

2013-01-01

This paper presents a natural user interface system based on multimodal human computer interaction, which operates as an intermediate module between the user and the operating system. The aim of this work is to demonstrate a multimodal system which gives users the ability to interact with desktop...

Applications of Elpasolites as a Multimode Radiation Sensor

Science.gov (United States)

Guckes, Amber

This study consists of both computational and experimental investigations. The computational results enabled detector design selections and confirmed experimental results. The experimental results determined that the CLYC scintillation detector can be applied as a functional and field-deployable multimode radiation sensor. The computational study utilized MCNP6 code to investigate the response of CLYC to various incident radiations and to determine the feasibility of its application as a handheld multimode sensor and as a single-scintillator collimated directional detection system. These simulations include: • Characterization of the response of the CLYC scintillator to gamma-rays and neutrons; • Study of the isotopic enrichment of 7Li versus 6Li in the CLYC for optimal detection of both thermal neutrons and fast neutrons; • Analysis of collimator designs to determine the optimal collimator for the single CLYC sensor directional detection system to assay gamma rays and neutrons; Simulations of a handheld CLYC multimode sensor and a single CLYC scintillator collimated directional detection system with the optimized collimator to determine the feasibility of detecting nuclear materials that could be encountered during field operations. These nuclear materials include depleted uranium, natural uranium, low-enriched uranium, highly-enriched uranium, reactor-grade plutonium, and weapons-grade plutonium. The experimental study includes the design, construction, and testing of both a handheld CLYC multimode sensor and a single CLYC scintillator collimated directional detection system. Both were designed in the Inventor CAD software and based on results of the computational study to optimize its performance. The handheld CLYC multimode sensor is modular, scalable, low?power, and optimized for high count rates. Commercial?off?the?shelf components were used where possible in order to optimize size, increase robustness, and minimize cost. The handheld CLYC multimode

Source signature estimation from multimode surface waves via mode-separated virtual real source method

Science.gov (United States)

Gao, Lingli; Pan, Yudi

2018-05-01

The correct estimation of the seismic source signature is crucial to exploration geophysics. Based on seismic interferometry, the virtual real source (VRS) method provides a model-independent way for source signature estimation. However, when encountering multimode surface waves, which are commonly seen in the shallow seismic survey, strong spurious events appear in seismic interferometric results. These spurious events introduce errors in the virtual-source recordings and reduce the accuracy of the source signature estimated by the VRS method. In order to estimate a correct source signature from multimode surface waves, we propose a mode-separated VRS method. In this method, multimode surface waves are mode separated before seismic interferometry. Virtual-source recordings are then obtained by applying seismic interferometry to each mode individually. Therefore, artefacts caused by cross-mode correlation are excluded in the virtual-source recordings and the estimated source signatures. A synthetic example showed that a correct source signature can be estimated with the proposed method, while strong spurious oscillation occurs in the estimated source signature if we do not apply mode separation first. We also applied the proposed method to a field example, which verified its validity and effectiveness in estimating seismic source signature from shallow seismic shot gathers containing multimode surface waves.

New Technologies, New Possibilities for the Arts and Multimodality in English Language Arts

Science.gov (United States)

Williams, Wendy R.

2014-01-01

This article discusses the arts, multimodality, and new technologies in English language arts. It then turns to the example of the illuminated text--a multimodal book report consisting of animated text, music, and images--to consider how art, multimodality, and technology can work together to support students' reading of literature and inspire…

Cross-media communication in advertising: exploring multimodal connections between television commercials and websites

DEFF Research Database (Denmark)

Jessen, Iben Bredahl; Graakjær, Nicolai Jørgensgaard

2013-01-01

The aim of this article is to advance current understandings of cross-media communication in advertising. The study is based on a sample of 80 television commercials and their announced websites, and the article is inspired by recent studies of cross-media advertising effectiveness as well...... as semiotic perspectives on multimodal analysis. The authors present three dimensions to be considered when examining multimodal connections between television commercials and websites: announcements, participants and address strategy. These dimensions are brought together in an analytical framework that can...... serve as inspiration for further research on cross-media communication in advertising and possibly in other types of communication....

A randomized trial on the effect of a multimodal intervention on physical capacity, functional performance and quality of life in adult patients undergoing allogeneic SCT

DEFF Research Database (Denmark)

Jarden, M; Baadsgaard, M T; Hovgaard, D J

2009-01-01

The aim of this randomized controlled trial was to investigate the effect of a 4- to 6-week multimodal program of exercise, relaxation and psychoeducation on physical capacity, functional performance and quality of life (QOL) in allogeneic hematopoietic cell transplantation (allo-HSCT) adult...

Multi-modal RGB–Depth–Thermal Human Body Segmentation

DEFF Research Database (Denmark)

Palmero, Cristina; Clapés, Albert; Bahnsen, Chris

2016-01-01

This work addresses the problem of human body segmentation from multi-modal visual cues as a first stage of automatic human behavior analysis. We propose a novel RGB-Depth-Thermal dataset along with a multi-modal seg- mentation baseline. The several modalities are registered us- ing a calibration...... to other state-of-the-art meth- ods, obtaining an overlap above 75% on the novel dataset when compared to the manually annotated ground-truth of human segmentations....

Multimodal Strategies of Theorization

DEFF Research Database (Denmark)

Cartel, Melodie; Colombero, Sylvain; Boxenbaum, Eva

This paper examines the role of multimodal strategies in processes of theorization. Empirically, we investigate the theorization process of a highly disruptive innovation in the history of architecture: reinforced concrete. Relying on archival data from a dominant French architectural journal from...... with well-known rhetorical strategies and develop a process model of theorization....

Quantitative multimodality imaging in cancer research and therapy.

Science.gov (United States)

Yankeelov, Thomas E; Abramson, Richard G; Quarles, C Chad

2014-11-01

Advances in hardware and software have enabled the realization of clinically feasible, quantitative multimodality imaging of tissue pathophysiology. Earlier efforts relating to multimodality imaging of cancer have focused on the integration of anatomical and functional characteristics, such as PET-CT and single-photon emission CT (SPECT-CT), whereas more-recent advances and applications have involved the integration of multiple quantitative, functional measurements (for example, multiple PET tracers, varied MRI contrast mechanisms, and PET-MRI), thereby providing a more-comprehensive characterization of the tumour phenotype. The enormous amount of complementary quantitative data generated by such studies is beginning to offer unique insights into opportunities to optimize care for individual patients. Although important technical optimization and improved biological interpretation of multimodality imaging findings are needed, this approach can already be applied informatively in clinical trials of cancer therapeutics using existing tools. These concepts are discussed herein.

Toward multimodal signal detection of adverse drug reactions.

Science.gov (United States)

Harpaz, Rave; DuMouchel, William; Schuemie, Martijn; Bodenreider, Olivier; Friedman, Carol; Horvitz, Eric; Ripple, Anna; Sorbello, Alfred; White, Ryen W; Winnenburg, Rainer; Shah, Nigam H

2017-12-01

Improving mechanisms to detect adverse drug reactions (ADRs) is key to strengthening post-marketing drug safety surveillance. Signal detection is presently unimodal, relying on a single information source. Multimodal signal detection is based on jointly analyzing multiple information sources. Building on, and expanding the work done in prior studies, the aim of the article is to further research on multimodal signal detection, explore its potential benefits, and propose methods for its construction and evaluation. Four data sources are investigated; FDA's adverse event reporting system, insurance claims, the MEDLINE citation database, and the logs of major Web search engines. Published methods are used to generate and combine signals from each data source. Two distinct reference benchmarks corresponding to well-established and recently labeled ADRs respectively are used to evaluate the performance of multimodal signal detection in terms of area under the ROC curve (AUC) and lead-time-to-detection, with the latter relative to labeling revision dates. Limited to our reference benchmarks, multimodal signal detection provides AUC improvements ranging from 0.04 to 0.09 based on a widely used evaluation benchmark, and a comparative added lead-time of 7-22 months relative to labeling revision dates from a time-indexed benchmark. The results support the notion that utilizing and jointly analyzing multiple data sources may lead to improved signal detection. Given certain data and benchmark limitations, the early stage of development, and the complexity of ADRs, it is currently not possible to make definitive statements about the ultimate utility of the concept. Continued development of multimodal signal detection requires a deeper understanding the data sources used, additional benchmarks, and further research on methods to generate and synthesize signals. Copyright © 2017 Elsevier Inc. All rights reserved.

Multimodal Imaging Brain Connectivity Analysis (MIBCA toolbox

Directory of Open Access Journals (Sweden)

Andre Santos Ribeiro

2015-07-01

Full Text Available Aim. In recent years, connectivity studies using neuroimaging data have increased the understanding of the organization of large-scale structural and functional brain networks. However, data analysis is time consuming as rigorous procedures must be assured, from structuring data and pre-processing to modality specific data procedures. Until now, no single toolbox was able to perform such investigations on truly multimodal image data from beginning to end, including the combination of different connectivity analyses. Thus, we have developed the Multimodal Imaging Brain Connectivity Analysis (MIBCA toolbox with the goal of diminishing time waste in data processing and to allow an innovative and comprehensive approach to brain connectivity.Materials and Methods. The MIBCA toolbox is a fully automated all-in-one connectivity toolbox that offers pre-processing, connectivity and graph theoretical analyses of multimodal image data such as diffusion-weighted imaging, functional magnetic resonance imaging (fMRI and positron emission tomography (PET. It was developed in MATLAB environment and pipelines well-known neuroimaging softwares such as Freesurfer, SPM, FSL, and Diffusion Toolkit. It further implements routines for the construction of structural, functional and effective or combined connectivity matrices, as well as, routines for the extraction and calculation of imaging and graph-theory metrics, the latter using also functions from the Brain Connectivity Toolbox. Finally, the toolbox performs group statistical analysis and enables data visualization in the form of matrices, 3D brain graphs and connectograms. In this paper the MIBCA toolbox is presented by illustrating its capabilities using multimodal image data from a group of 35 healthy subjects (19–73 years old with volumetric T1-weighted, diffusion tensor imaging, and resting state fMRI data, and 10 subjets with 18F-Altanserin PET data also.Results. It was observed both a high inter

40Gbit/s MDM-WDM Laguerre-Gaussian Mode with Equalization for Multimode Fiber in Access Networks

Science.gov (United States)

Fazea, Yousef; Amphawan, Angela

2018-04-01

Modal dispersion is seen as the primary impairment for multimode fiber. Mode division multiplexing (MDM) is a promising technology that has been realized as a favorable technology for considerably upsurges the capacity and distance of multimode fiber in conjunction with Wavelength Division Multiplexing (WDM) for fiber-to-the-home. This paper reveals the importance of an equalization technique in conjunction with controlling the modes spacing of mode division multiplexing-wavelength division multiplexing of Laguerre-Gaussian modes to alleviate modal dispersion for multimode fiber. The effects of channel spacing of 20 channels MDM-WDM were examined through controlling the azimuthal mode number and the radial mode number of Laguerre-Gaussian modes. A data rate of 40Gbit/s was achieved for a distance of 1,500 m for MDM-WDM.

The effect of a pretest in an interactive, multimodal pretraining system for learning science concepts

NARCIS (Netherlands)

Bos, Floor/Floris; Terlouw, C.; Pilot, Albert

2009-01-01

In line with the cognitive theory of multimedia learning by Moreno and Mayer (2007), an interactive, multimodal learning environment was designed for the pretraining of science concepts in the joint area of physics, chemistry, biology, applied mathematics, and computer sciences. In the experimental

Multimodal Transportation: The Case of Laptop from Chongqing in China to Rotterdam in Europe

Directory of Open Access Journals (Sweden)

Young Joon Seo

2017-09-01

Full Text Available Multimodal transportation is a key component of modern logistics systems, especially for long-distance transnational transportation. This paper explores the various alternative routes for laptop exports from Chongqing, China to Rotterdam, the Netherlands. It selects seven available routes for laptop transportation from Chongqing to Rotterdam. The multimodal model was adopted to demonstrate alternative routes using various factors such as transport cost, transfer cost, transit time, transport distance, document charge, port congestion surcharge, customs charge, confidence index and so on. Among possible alternative routes, the results indicate that the route 6 was the fastest routes except for the air transport (route 7, while the route 1 was the cheapest and safest way. Nonetheless, route 1 may be not suitable for the laptop transport due to the importance of timeliness. The logisticians may able to utilize this research's findings to make a balance between transit time and transport cost for effective multimodal transport of laptops from Chongqing to Rotterdam.

Multimodal quantitative phase and fluorescence imaging of cell apoptosis

Science.gov (United States)

Fu, Xinye; Zuo, Chao; Yan, Hao

2017-06-01

Fluorescence microscopy, utilizing fluorescence labeling, has the capability to observe intercellular changes which transmitted and reflected light microscopy techniques cannot resolve. However, the parts without fluorescence labeling are not imaged. Hence, the processes simultaneously happen in these parts cannot be revealed. Meanwhile, fluorescence imaging is 2D imaging where information in the depth is missing. Therefore the information in labeling parts is also not complete. On the other hand, quantitative phase imaging is capable to image cells in 3D in real time through phase calculation. However, its resolution is limited by the optical diffraction and cannot observe intercellular changes below 200 nanometers. In this work, fluorescence imaging and quantitative phase imaging are combined to build a multimodal imaging system. Such system has the capability to simultaneously observe the detailed intercellular phenomenon and 3D cell morphology. In this study the proposed multimodal imaging system is used to observe the cell behavior in the cell apoptosis. The aim is to highlight the limitations of fluorescence microscopy and to point out the advantages of multimodal quantitative phase and fluorescence imaging. The proposed multimodal quantitative phase imaging could be further applied in cell related biomedical research, such as tumor.

Spatial sound in the use of multimodal interfaces for the acquisition of motor skills

DEFF Research Database (Denmark)

Hoffmann, Pablo F.

2008-01-01

This paper discusses the potential effectiveness of spatial sound in the use of multimodal interfaces and virtual environment technologies for the acquisition of motor skills. Because skills are generally of multimodal nature, spatial sound is discussed in terms of the role that it may play...... as to convey information considered critical for the transfer of motor skills....... in facilitating skill acquisition by complementing, or substituting, other sensory modalities. An overview of related research areas on audiovisual and audiotactile interaction is given in connection to the potential benefits of spatial sound as a means to improve the perceptual quality of the interfaces as well...

Multimodal human communication--targeting facial expressions, speech content and prosody.

Science.gov (United States)

Regenbogen, Christina; Schneider, Daniel A; Gur, Raquel E; Schneider, Frank; Habel, Ute; Kellermann, Thilo

2012-05-01

Human communication is based on a dynamic information exchange of the communication channels facial expressions, prosody, and speech content. This fMRI study elucidated the impact of multimodal emotion processing and the specific contribution of each channel on behavioral empathy and its prerequisites. Ninety-six video clips displaying actors who told self-related stories were presented to 27 healthy participants. In two conditions, all channels uniformly transported only emotional or neutral information. Three conditions selectively presented two emotional channels and one neutral channel. Subjects indicated the actors' emotional valence and their own while fMRI was recorded. Activation patterns of tri-channel emotional communication reflected multimodal processing and facilitative effects for empathy. Accordingly, subjects' behavioral empathy rates significantly deteriorated once one source was neutral. However, emotionality expressed via two of three channels yielded activation in a network associated with theory-of-mind-processes. This suggested participants' effort to infer mental states of their counterparts and was accompanied by a decline of behavioral empathy, driven by the participants' emotional responses. Channel-specific emotional contributions were present in modality-specific areas. The identification of different network-nodes associated with human interactions constitutes a prerequisite for understanding dynamics that underlie multimodal integration and explain the observed decline in empathy rates. This task might also shed light on behavioral deficits and neural changes that accompany psychiatric diseases. Copyright © 2012 Elsevier Inc. All rights reserved.

A robo-pigeon based on an innovative multi-mode telestimulation system.

Science.gov (United States)

Yang, Junqing; Huai, Ruituo; Wang, Hui; Lv, Changzhi; Su, Xuecheng

2015-01-01

In this paper, we describe a new multi-mode telestimulation system for brain-microstimulation for the navigation of a robo-pigeon, a new type of bio-robot based on Brain-Computer Interface (BCI) techniques. The multi-mode telestimulation system overcomes neuron adaptation that was a key shortcoming of the previous single-mode stimulation by the use of non-steady TTL biphasic pulses accomplished by randomly alternating pulse modes. To improve efficiency, a new behavior model ("virtual fear") is proposed and applied to the robo-pigeon. Unlike the previous "virtual reward" model, the "virtual fear" behavior model does not require special training. The performance and effectiveness of the system to alleviate the adaptation of neurons was verified by a robo-pigeon navigation test, simultaneously confirming the practicality of the "virtual fear" behavioral model.

A multimodal image sensor system for identifying water stress in grapevines

Science.gov (United States)

Zhao, Yong; Zhang, Qin; Li, Minzan; Shao, Yongni; Zhou, Jianfeng; Sun, Hong

2012-11-01

Water stress is one of the most common limitations of fruit growth. Water is the most limiting resource for crop growth. In grapevines, as well as in other fruit crops, fruit quality benefits from a certain level of water deficit which facilitates to balance vegetative and reproductive growth and the flow of carbohydrates to reproductive structures. A multi-modal sensor system was designed to measure the reflectance signature of grape plant surfaces and identify different water stress levels in this paper. The multi-modal sensor system was equipped with one 3CCD camera (three channels in R, G, and IR). The multi-modal sensor can capture and analyze grape canopy from its reflectance features, and identify the different water stress levels. This research aims at solving the aforementioned problems. The core technology of this multi-modal sensor system could further be used as a decision support system that combines multi-modal sensory data to improve plant stress detection and identify the causes of stress. The images were taken by multi-modal sensor which could output images in spectral bands of near-infrared, green and red channel. Based on the analysis of the acquired images, color features based on color space and reflectance features based on image process method were calculated. The results showed that these parameters had the potential as water stress indicators. More experiments and analysis are needed to validate the conclusion.

Cultural Shifts, Multimodal Representations, and Assessment Practices: A Case Study

Science.gov (United States)

Curwood, Jen Scott

2012-01-01

Multimodal texts involve the presence, absence, and co-occurrence of alphabetic text with visual, audio, tactile, gestural, and spatial representations. This article explores how teachers' evaluation of students' multimodal work can be understood in terms of cognition and culture. When teachers apply a paradigm of assessment rooted in print-based…

Multiscale climate emulator of multimodal wave spectra: MUSCLE-spectra

Science.gov (United States)

Rueda, Ana; Hegermiller, Christie A.; Antolinez, Jose A. A.; Camus, Paula; Vitousek, Sean; Ruggiero, Peter; Barnard, Patrick L.; Erikson, Li H.; Tomás, Antonio; Mendez, Fernando J.

2017-02-01

Characterization of multimodal directional wave spectra is important for many offshore and coastal applications, such as marine forecasting, coastal hazard assessment, and design of offshore wave energy farms and coastal structures. However, the multivariate and multiscale nature of wave climate variability makes this complex problem tractable using computationally expensive numerical models. So far, the skill of statistical-downscaling model-based parametric (unimodal) wave conditions is limited in large ocean basins such as the Pacific. The recent availability of long-term directional spectral data from buoys and wave hindcast models allows for development of stochastic models that include multimodal sea-state parameters. This work introduces a statistical downscaling framework based on weather types to predict multimodal wave spectra (e.g., significant wave height, mean wave period, and mean wave direction from different storm systems, including sea and swells) from large-scale atmospheric pressure fields. For each weather type, variables of interest are modeled using the categorical distribution for the sea-state type, the Generalized Extreme Value (GEV) distribution for wave height and wave period, a multivariate Gaussian copula for the interdependence between variables, and a Markov chain model for the chronology of daily weather types. We apply the model to the southern California coast, where local seas and swells from both the Northern and Southern Hemispheres contribute to the multimodal wave spectrum. This work allows attribution of particular extreme multimodal wave events to specific atmospheric conditions, expanding knowledge of time-dependent, climate-driven offshore and coastal sea-state conditions that have a significant influence on local nearshore processes, coastal morphology, and flood hazards.

Tractography-Based Score for Learning Effective Connectivity From Multimodal Imaging Data Using Dynamic Bayesian Networks.

Science.gov (United States)

Dang, Shilpa; Chaudhury, Santanu; Lall, Brejesh; Roy, Prasun K

2018-05-01

Effective connectivity (EC) is the methodology for determining functional-integration among the functionally active segregated regions of the brain. By definition EC is "the causal influence exerted by one neuronal group on another" which is constrained by anatomical connectivity (AC) (axonal connections). AC is necessary for EC but does not fully determine it, because synaptic communication occurs dynamically in a context-dependent fashion. Although there is a vast emerging evidence of structure-function relationship using multimodal imaging studies, till date only a few studies have done joint modeling of the two modalities: functional MRI (fMRI) and diffusion tensor imaging (DTI). We aim to propose a unified probabilistic framework that combines information from both sources to learn EC using dynamic Bayesian networks (DBNs). DBNs are probabilistic graphical temporal models that learn EC in an exploratory fashion. Specifically, we propose a novel anatomically informed (AI) score that evaluates fitness of a given connectivity structure to both DTI and fMRI data simultaneously. The AI score is employed in structure learning of DBN given the data. Experiments with synthetic-data demonstrate the face validity of structure learning with our AI score over anatomically uninformed counterpart. Moreover, real-data results are cross-validated by performing classification-experiments. EC inferred on real fMRI-DTI datasets is found to be consistent with previous literature and show promising results in light of the AC present as compared to other classically used techniques such as Granger-causality. Multimodal analyses provide a more reliable basis for differentiating brain under abnormal/diseased conditions than the single modality analysis.

Unifying framework for multimodal brain MRI segmentation based on Hidden Markov Chains.

Science.gov (United States)

Bricq, S; Collet, Ch; Armspach, J P

2008-12-01

In the frame of 3D medical imaging, accurate segmentation of multimodal brain MR images is of interest for many brain disorders. However, due to several factors such as noise, imaging artifacts, intrinsic tissue variation and partial volume effects, tissue classification remains a challenging task. In this paper, we present a unifying framework for unsupervised segmentation of multimodal brain MR images including partial volume effect, bias field correction, and information given by a probabilistic atlas. Here-proposed method takes into account neighborhood information using a Hidden Markov Chain (HMC) model. Due to the limited resolution of imaging devices, voxels may be composed of a mixture of different tissue types, this partial volume effect is included to achieve an accurate segmentation of brain tissues. Instead of assigning each voxel to a single tissue class (i.e., hard classification), we compute the relative amount of each pure tissue class in each voxel (mixture estimation). Further, a bias field estimation step is added to the proposed algorithm to correct intensity inhomogeneities. Furthermore, atlas priors were incorporated using probabilistic brain atlas containing prior expectations about the spatial localization of different tissue classes. This atlas is considered as a complementary sensor and the proposed method is extended to multimodal brain MRI without any user-tunable parameter (unsupervised algorithm). To validate this new unifying framework, we present experimental results on both synthetic and real brain images, for which the ground truth is available. Comparison with other often used techniques demonstrates the accuracy and the robustness of this new Markovian segmentation scheme.

The Work of Comics Collaborations: Considerations of Multimodal Composition for Writing Scholarship and Pedagogy

Science.gov (United States)

Scanlon, Molly J.

2015-01-01

Though multimodality is increasingly incorporated into our pedagogies and scholarship, explorations of collaborative multimodal composition are lacking. Existing literature on collaborative writing focuses predominately on texts either composed in singular modes or by a single author, neglecting the ways in which multimodal texts are composed…

All-fiber multimode interference micro-displacement sensor

International Nuclear Information System (INIS)

Antonio-Lopez, J E; LiKamWa, P; Sanchez-Mondragon, J J; May-Arrioja, D A

2013-01-01

We report an all-fiber micro-displacement sensor based on multimode interference (MMI) effects. The micro-displacement sensor consists of a segment of No-Core multimode fiber (MMF) with one end spliced to a segment of single mode fiber (SMF) which acts as the input. The other end of the MMF and another SMF are inserted into a capillary ferrule filled with index matching liquid. Since the refractive index of the liquid is higher than that of the ferrule, a liquid MMF with a diameter of 125 µm is formed between the fibers inside the ferrule. When the fibers are separated this effectively increases the length of the MMF. Since the peak wavelength response of MMI devices is very sensitive to changes in the MMF's length, this can be used to detect micro-displacements. By measuring spectral changes we have obtained a sensing range of 3 mm with a sensitivity of 25 nm mm −1 and a resolution of 20 µm. The sensor can also be used to monitor small displacements by using a single wavelength to interrogate the transmission of the MMI device close to the resonance peak. Under this latter regime we were able to obtain a sensitivity of 7000 mV mm −1 and a sensing range of 100 µm, with a resolution up to 1 µm. The simplicity and versatility of the sensor make it very suitable for many diverse applications. (paper)

The semiotics of typography in literary texts. A multimodal approach

DEFF Research Database (Denmark)

Nørgaard, Nina

2009-01-01

to multimodal discourse proposed, for instance, by Kress & Van Leeuwen (2001) and Baldry & Thibault (2006), and, more specifically, the multimodal approach to typography suggested by Van Leeuwen (2005b; 2006), in order to sketch out a methodological framework applicable to the description and analysis...... of the semiotic potential of typography in literary texts....

A Multimodal Search Engine for Medical Imaging Studies.

Science.gov (United States)

Pinho, Eduardo; Godinho, Tiago; Valente, Frederico; Costa, Carlos

2017-02-01

The use of digital medical imaging systems in healthcare institutions has increased significantly, and the large amounts of data in these systems have led to the conception of powerful support tools: recent studies on content-based image retrieval (CBIR) and multimodal information retrieval in the field hold great potential in decision support, as well as for addressing multiple challenges in healthcare systems, such as computer-aided diagnosis (CAD). However, the subject is still under heavy research, and very few solutions have become part of Picture Archiving and Communication Systems (PACS) in hospitals and clinics. This paper proposes an extensible platform for multimodal medical image retrieval, integrated in an open-source PACS software with profile-based CBIR capabilities. In this article, we detail a technical approach to the problem by describing its main architecture and each sub-component, as well as the available web interfaces and the multimodal query techniques applied. Finally, we assess our implementation of the engine with computational performance benchmarks.

Multimodal designs for learning in contexts of diversity

Directory of Open Access Journals (Sweden)

Arlene Archer

2014-12-01

Full Text Available This paper aims to identify multimodal designs for learning in diverse and developing contexts, where access to resources remains vastly unequal. Using case studies from South African education, the paper explores ways of surfacing the range of students’ resources which are often not noticed or valued in formal educational settings. The studies showcased here demonstrate how ethnographic and textually-based approaches can be combined. Opening up the semiotic space of the classroom through multimodal designs for learning is important for finding innovative ways of addressing access, diversity, and past inequalities. This is of relevance not only to South Africa, but a range of global contexts. The paper argues that multimodal designs for learning can involve interrogating the relation between ‘tradition’ and ‘modernity’; harnessing students’ creative practices as resources for pedagogy; developing metalanguages for critical reflection; creating less regulated pedagogical spaces in order to enable useful teaching and learning practices.

Study of internalization and viability of multimodal nanoparticles for labeling of human umbilical cord mesenchymal stem cells; Estudo de internalizacao e viabilidade de nanoparticulas multimodal para marcacao de celulas-tronco mesenquimais de cordao umbilical humano

Energy Technology Data Exchange (ETDEWEB)

Miyaki, Liza Aya Mabuchi [Faculdade de Enfermagem, Hospital Israelita Albert Einstein - HIAE, Sao Paulo, SP (Brazil); Sibov, Tatiana Tais; Pavon, Lorena Favaro; Mamani, Javier Bustamante; Gamarra, Lionel Fernel, E-mail: tatianats@einstein.br [Instituto do Cerebro - InCe, Hospital Israelita Albert Einstein - HIAE, Sao Paulo, SP (Brazil)

2012-04-15

Objective: To analyze multimodal magnetic nanoparticles-Rhodamine B in culture media for cell labeling, and to establish a study of multimodal magnetic nanoparticles-Rhodamine B detection at labeled cells evaluating they viability at concentrations of 10 {mu}g Fe/mL and 100{mu}g Fe/mL. Methods: We performed the analysis of stability of multimodal magnetic nanoparticles-Rhodamine B in different culture media; the mesenchymal stem cells labeling with multimodal magnetic nanoparticles-Rhodamine B; the intracellular detection of multimodal magnetic nanoparticles-Rhodamine B in mesenchymal stem cells, and assessment of the viability of labeled cells by kinetic proliferation. Results: The stability analysis showed that multimodal magnetic nanoparticles-Rhodamine B had good stability in cultured Dulbecco's Modified Eagle's-Low Glucose medium and RPMI 1640 medium. The mesenchymal stem cell with multimodal magnetic nanoparticles-Rhodamine B described location of intracellular nanoparticles, which were shown as blue granules co-localized in fluorescent clusters, thus characterizing magnetic and fluorescent properties of multimodal magnetic nanoparticles Rhodamine B. Conclusion: The stability of multimodal magnetic nanoparticles-Rhodamine B found in cultured Dulbecco's Modified Eagle's-Low Glucose medium and RPMI 1640 medium assured intracellular mesenchymal stem cells labeling. This cell labeling did not affect viability of labeled mesenchymal stem cells since they continued to proliferate for five days. (author)

Multimodal treatment combining chemotherapy, hyperthermia and radiotherapy for ovarian cancer

International Nuclear Information System (INIS)

Nagashima, Kei

1992-01-01

There has been increasing interest in the use of heat in the treatment of cancer. Theoretically cells are the most sensitive to ionizing radiation at mitosis, whereas the cycle phase that is the most resistant to ionizing radiation namely late in the DNA. Synthetic phase (late S) is the most sensitive to hyperthermia. Hyperthermia has been reported to enhance the cytocidal effects of several active chemotherapeutic agents. When thermal potentiation of chemotherapeutic agents against malignant cells is contemplated, normal tissues have a relatively high ambient blood flow which increases in response to thermal stress, thereby dissipating heat, compared to tumors. Tumors, with relatively poor blood flow and a responsive neovasculature, are in capable of augmenting flow and acting as a heat reservoir. This is the phenomenon of a heat reservoir which is one factor to enhance the cytocidal effects of several active anticancer agents for enhancing the uptake in tumor. The importance is in the adjuvant chemotherapy treated for post operative, advanced and recurrent ovarian cancer. Heating enhances the effects of radiotherapy and chemotherapy. Thirty patients with ovarian cancer were subjected to the multidisciplinary treatment with combination of hyperthermochemotherapy and radiation. The 30 patients consisted of 18 with endometrioid adenocarcinoma and 7 with serious post operative or recurrent status. Two types of equipments with rediofrequencies of 70 MHz (BSD-1000) or 434 MHZ (TAG MED·HS 434) were used for hyperthermia. Chemotherapeutic agents such as adriamycin, cis DDP, cyclophosphamide and etoposide were injected intravenously. Arterial infusion with reservoir was very effective in advanced stage of ovarian cancer. No severe or fatal side effects were observed. Hyperthermochemotherapy is useful and effective for the postoperative management or the treatment of recurrent cancer of the ovary. (J.P.N.)

ADMultiImg: a novel missing modality transfer learning based CAD system for diagnosis of MCI due to AD using incomplete multi-modality imaging data

Science.gov (United States)

Liu, Xiaonan; Chen, Kewei; Wu, Teresa; Weidman, David; Lure, Fleming; Li, Jing

2018-02-01

Alzheimer's Disease (AD) is the most common cause of dementia and currently has no cure. Treatments targeting early stages of AD such as Mild Cognitive Impairment (MCI) may be most effective to deaccelerate AD, thus attracting increasing attention. However, MCI has substantial heterogeneity in that it can be caused by various underlying conditions, not only AD. To detect MCI due to AD, NIA-AA published updated consensus criteria in 2011, in which the use of multi-modality images was highlighted as one of the most promising methods. It is of great interest to develop a CAD system based on automatic, quantitative analysis of multi-modality images and machine learning algorithms to help physicians more adequately diagnose MCI due to AD. The challenge, however, is that multi-modality images are not universally available for many patients due to cost, access, safety, and lack of consent. We developed a novel Missing Modality Transfer Learning (MMTL) algorithm capable of utilizing whatever imaging modalities are available for an MCI patient to diagnose the patient's likelihood of MCI due to AD. Furthermore, we integrated MMTL with radiomics steps including image processing, feature extraction, and feature screening, and a post-processing for uncertainty quantification (UQ), and developed a CAD system called "ADMultiImg" to assist clinical diagnosis of MCI due to AD using multi-modality images together with patient demographic and genetic information. Tested on ADNI date, our system can generate a diagnosis with high accuracy even for patients with only partially available image modalities (AUC=0.94), and therefore may have broad clinical utility.

A multi-modal training programme to improve physical activity, physical fitness and perceived physical ability in obese children.

Science.gov (United States)

Morano, Milena; Colella, Dario; Rutigliano, Irene; Fiore, Pietro; Pettoello-Mantovani, Massimo; Campanozzi, Angelo

2014-01-01

Actual and perceived physical abilities are important correlates of physical activity (PA) and fitness, but little research has explored these relationships over time in obese children. This study was designed: (a) to assess the feasibility of a multi-modal training programme promoting changes in PA, fundamental motor skills and real and perceived physical abilities of obese children; and (b) to explore cross-sectional and longitudinal relationships between real and perceived physical competence in boys and girls. Forty-one participants (9.2 ± 1.2 years) were assessed before and after an 8-month intervention with respect to body composition, physical fitness, self-reported PA and perceived physical ability. After treatment, obese children reported improvements in the body mass index, PA levels, gross motor performance and actual and perceived physical abilities. Real and perceived physical competence was correlated in boys, but not in girls. Results indicate that a multi-modal programme focused on actual and perceived physical competence as associated with the gradual increase in the volume of activity might be an effective strategy to improve adherence of the participants and to increase the lifelong exercise skills of obese children.

Effect on health-related quality of life of a multimodal physiotherapy program in patients with chronic musculoskeletal disorders

Directory of Open Access Journals (Sweden)

Cuesta-Vargas Antonio Ignacio

2013-02-01

Full Text Available Abstract Background Musculoskeletal disorders are major causes of morbidity in the world, and these conditions have a strong negative influence in terms of health-related quality of life. The purpose of this study was to evaluate the effect of an 8-week multimodal physical therapy program on general health state and health-related quality of life in patients with chronic musculoskeletal disorders. Methods There were 244 participants in this prospective cohort analysis with 8-week follow-up. The primary outcome was general health state (physical and mental components, determined with the Short Form-12 Health Survey (SF-12. The secondary outcome was health related quality of life, determined with the EuroQoL-5D and VAS. The intervention was evaluated by comparing pre- and post-outcome measurements. T-tests were performed for paired data. Results Differences were statistically significant for physical health state: +1.68 (p  Conclusions Eight weeks of a Multimodal Physical Therapy Program seemed to moderately enhance the general health state and HRQoL of patients with chronic musculoskeletal diseases. This kind of therapeutic exercise can be recommended to patients with chronic low back pain, chronic neck pain and osteoarthritis, at least in the short term.

Does multi-modal cervical physical therapy improve tinnitus in patients with cervicogenic somatic tinnitus?

Science.gov (United States)

Michiels, S; Van de Heyning, P; Truijen, S; Hallemans, A; De Hertogh, W

2016-12-01

Tinnitus can be related to many different aetiologies such as hearing loss or a noise trauma, but it can also be related to the somatosensory system of the cervical spine, called cervicogenic somatic tinnitus (CST). Case studies suggest a positive effect of cervical spine treatment on tinnitus complaints in patients with CST, but no experimental studies are available. To investigate the effect of a multimodal cervical physical therapy treatment on tinnitus complaints in patients with CST. Randomized controlled trial. Patients with a combination of severe subjective tinnitus (Tinnitus Functional Index (TFI): 25-90 points) and neck complaints (Neck Bournemouth Questionnaire (NBQ) > 14 points). All patients received cervical physical therapy for 6 weeks (12 sessions). Patients were randomized in an immediate-start therapy group (n = 19) and a 6-week delayed-start therapy group (n = 19). TFI and NBQ-scores were documented at baseline, after the wait-and-see period in the delayed-start group, after treatment and after 6 weeks follow-up. The Global Perceived Effect (GPE) was documented at all measuring moments, except at baseline. In all patients (n = 38) TFI and NBQ-scores decreased significantly after treatment (p = 0.04 and p tinnitus. This effect was maintained in 24% of patients after follow-up at six weeks. Cervical physical therapy can have a positive effect on subjective tinnitus complaints in patients with a combination of tinnitus and neck complaints. Larger studies, using more responsive outcome measures, are however necessary to prove this effect. NCT02016313. Copyright © 2016 Elsevier Ltd. All rights reserved.

Timing of Multimodal Robot Behaviors during Human-Robot Collaboration

DEFF Research Database (Denmark)

Jensen, Lars Christian; Fischer, Kerstin; Suvei, Stefan-Daniel

2017-01-01

In this paper, we address issues of timing between robot behaviors in multimodal human-robot interaction. In particular, we study what effects sequential order and simultaneity of robot arm and body movement and verbal behavior have on the fluency of interactions. In a study with the Care-O-bot, ...... output plays a special role because participants carry their expectations from human verbal interaction into the interactions with robots....

Optical sensor in planar configuration based on multimode interference

Science.gov (United States)

Blahut, Marek

2017-08-01

In the paper a numerical analysis of optical sensors based on multimode interference in planar one-dimensional step-index configuration is presented. The structure consists in single-mode input and output waveguides and multimode waveguide which guide only few modes. Material parameters discussed refer to a SU8 polymer waveguide on SiO2 substrate. The optical system described will be designed to the analysis of biological substances.

[Utilization of multimodal therapy concepts in stomach carcinoma in Germany].

Science.gov (United States)

Bösing, N M; Heise, J W; Röher, H D

2000-01-01

In view of disappointing results after surgery alone multimodal therapeutic regimes are used to improve long-term prognosis in locally advanced gastric carcinomas. In presence of many reports about encouraging results ("down staging", improved R0-resection rates) but simultaneously missing evidence of efficiency of neoadjuvant therapies in respect to long-term survival (large randomized multicenter trials do not exist until today) and the herewith related uncertainties, we started an inquiry among many surgical units with the intention to evaluate the clinical practice of multimodal treatment for gastric cancer patients in Germany today. In a questionnaire (3/99) we asked among 97 surgical units (41 university hospitals, 56 big community hospitals) in Germany for the management of gastric cancer patients with special interest to practice and state of adjuvant and neoadjuvant therapeutic strategies. Further we analyzed all resected gastric cancer patients (1986-1995) without neoadjuvant treatment in advanced stage of disease (pT3/4NxMx; stage III/IV (UICC'92) in respect to R0-resection rate and long-term prognosis (Kaplan-Meier). Overall feedback amounted to 78% (76/97) and was higher in university hospitals (90%) than in big community hospitals (70%). Today, neoadjuvant therapies are of more interest than adjuvant therapeutic regimes. But also neoadjuvant therapy is only used in 32% as a rule (in 16% with, in 16% without study conditions). 25% of all surgical units do not employ any neoadjuvant therapy in locally advanced gastric cancer until today. In all other surgical units neoadjuvant treatment is performed more individually and sporadically (43%) only in some patients. Neoadjuvant therapies are practiced by haematooncologists in 50%, gastroenterologists in 32% and surgeons in 27%. The predominant neoadjuvant therapeutic strategy is chemotherapy alone (84%). Many surgical units in Germany are interested to participate in a multicenter trial with more interest

Multimodal Stepped Care Approach Involving Topical Analgesics for Severe Intractable Neuropathic Pain in CRPS Type 1: A Case Report

Directory of Open Access Journals (Sweden)

David J. Kopsky

2011-01-01

Full Text Available A multimodal stepped care approach has been successfully applied to a patient with complex regional pain syndrome type 1 and severe intractable pain, not responding to regular neuropathic pain medication. The choice to administer drugs in creams was made because of the intolerable adverse effects to oral medication. With this method, peak-dose adverse effects did not occur. The multimodal stepped care approach resulted in considerable and clinically relevant decrease in pain after every step, using topical amitriptyline, ketamine, and dimethylsulphoxide.

Investigation of protein selectivity in multimodal chromatography using in silico designed Fab fragment variants.

Science.gov (United States)

Karkov, Hanne Sophie; Krogh, Berit Olsen; Woo, James; Parimal, Siddharth; Ahmadian, Haleh; Cramer, Steven M

2015-11-01

In this study, a unique set of antibody Fab fragments was designed in silico and produced to examine the relationship between protein surface properties and selectivity in multimodal chromatographic systems. We hypothesized that multimodal ligands containing both hydrophobic and charged moieties would interact strongly with protein surface regions where charged groups and hydrophobic patches were in close spatial proximity. Protein surface property characterization tools were employed to identify the potential multimodal ligand binding regions on the Fab fragment of a humanized antibody and to evaluate the impact of mutations on surface charge and hydrophobicity. Twenty Fab variants were generated by site-directed mutagenesis, recombinant expression, and affinity purification. Column gradient experiments were carried out with the Fab variants in multimodal, cation-exchange, and hydrophobic interaction chromatographic systems. The results clearly indicated that selectivity in the multimodal system was different from the other chromatographic modes examined. Column retention data for the reduced charge Fab variants identified a binding site comprising light chain CDR1 as the main electrostatic interaction site for the multimodal and cation-exchange ligands. Furthermore, the multimodal ligand binding was enhanced by additional hydrophobic contributions as evident from the results obtained with hydrophobic Fab variants. The use of in silico protein surface property analyses combined with molecular biology techniques, protein expression, and chromatographic evaluations represents a previously undescribed and powerful approach for investigating multimodal selectivity with complex biomolecules. © 2015 Wiley Periodicals, Inc.

Multimodal network design and assessment

NARCIS (Netherlands)

Brands, Ties; Alkim, T.P.; van Eck, Gijs; van Arem, Bart; Arentze, T.

2010-01-01

A framework is proposed for the design of an optimal multimodal transport network for the Randstad area. This research framework consists of a multi-objective optimization heuristic and a fast network assessment module, which results in a set of Pareto optimal solutions. Subsequently, a proper

Multimodal Hyper-connectivity Networks for MCI Classification.

Science.gov (United States)

Li, Yang; Gao, Xinqiang; Jie, Biao; Yap, Pew-Thian; Kim, Min-Jeong; Wee, Chong-Yaw; Shen, Dinggang

2017-09-01

Hyper-connectivity network is a network where every edge is connected to more than two nodes, and can be naturally denoted using a hyper-graph. Hyper-connectivity brain network, either based on structural or functional interactions among the brain regions, has been used for brain disease diagnosis. However, the conventional hyper-connectivity network is constructed solely based on single modality data, ignoring potential complementary information conveyed by other modalities. The integration of complementary information from multiple modalities has been shown to provide a more comprehensive representation about the brain disruptions. In this paper, a novel multimodal hyper-network modelling method was proposed for improving the diagnostic accuracy of mild cognitive impairment (MCI). Specifically, we first constructed a multimodal hyper-connectivity network by simultaneously considering information from diffusion tensor imaging and resting-state functional magnetic resonance imaging data. We then extracted different types of network features from the hyper-connectivity network, and further exploited a manifold regularized multi-task feature selection method to jointly select the most discriminative features. Our proposed multimodal hyper-connectivity network demonstrated a better MCI classification performance than the conventional single modality based hyper-connectivity networks.

Discrimination of skin diseases using the multimodal imaging approach

Science.gov (United States)

Vogler, N.; Heuke, S.; Akimov, D.; Latka, I.; Kluschke, F.; Röwert-Huber, H.-J.; Lademann, J.; Dietzek, B.; Popp, J.

2012-06-01

Optical microspectroscopic tools reveal great potential for dermatologic diagnostics in the clinical day-to-day routine. To enhance the diagnostic value of individual nonlinear optical imaging modalities such as coherent anti-Stokes Raman scattering (CARS), second harmonic generation (SHG) or two-photon excited fluorescence (TPF), the approach of multimodal imaging has recently been developed. Here, we present an application of nonlinear optical multimodal imaging with Raman-scattering microscopy to study sizable human-tissue cross-sections. The samples investigated contain both healthy tissue and various skin tumors. This contribution details the rich information content, which can be obtained from the multimodal approach: While CARS microscopy, which - in contrast to spontaneous Raman-scattering microscopy - is not hampered by single-photon excited fluorescence, is used to monitor the lipid and protein distribution in the samples, SHG imaging selectively highlights the distribution of collagen structures within the tissue. This is due to the fact, that SHG is only generated in structures which lack inversion geometry. Finally, TPF reveals the distribution of autofluorophores in tissue. The combination of these techniques, i.e. multimodal imaging, allows for recording chemical images of large area samples and is - as this contribution will highlight - of high clinically diagnostic value.

Efficacy and safety of a modular multi-modal exercise program in prostate cancer patients with bone metastases: a randomized controlled trial

International Nuclear Information System (INIS)

Galvão, Daniel A; Groom, Geoff; Newton, Robert U; Taaffe, Dennis R; Cormie, Prue; Spry, Nigel; Chambers, Suzanne K; Peddle-McIntyre, Carolyn; Baker, Michael; Denham, James; Joseph, David

2011-01-01

The presence of bone metastases has excluded participation of prostate cancer patients in exercise intervention studies to date and is also a relative contraindication to supervised exercise in the community setting because of concerns of fragility fracture. However, this group of patients often have developed significant muscle atrophy and functional impairments from prior and continuing androgen deprivation that is exacerbated by subsequent and more intensive interventions such as chemotherapy. The aim of this study is to determine the efficacy and safety of a modular multi-modal exercise program in prostate cancer patients with bone metastases. Multi-site randomized controlled trial in Western Australia and New South Wales to examine the efficacy and safety of a modular multi-modal physical exercise program in 90 prostate cancer survivors with bone metastases. Participants will be randomized to (1) modular multi-modal exercise intervention group or (2) usual medical care group. The modular multi-modal exercise group will receive a 3-month supervised exercise program based on bone lesion location/extent. Measurements for primary and secondary endpoints will take place at baseline, 3 months (end of the intervention) and 6 months follow-up. Delaying or preventing skeletal complication and improving physical function for men with bone metastases would provide clinically meaningful benefits to patients. However, exercise programs must be designed and executed with careful consideration of the skeletal complications associated with bone metastatic disease and cumulative toxicities from androgen deprivation such as osteoporosis and increased risk of fractures. The results from this study will form the basis for the development of a specific exercise prescription in this patient group in order to alleviate disease burden, counteract the adverse treatment related side-effects and enhance quality of life. ACTRN: http://www.anzctr.org.au/ACTRN12611001158954.aspx

A 3?week multimodal intervention involving high?intensity interval training in female cancer survivors: a randomized controlled trial

OpenAIRE

Schmitt, Joachim; Lindner, Nathalie; Reuss?Borst, Monika; Holmberg, Hans?Christer; Sperlich, Billy

2016-01-01

Abstract To compare the effects of a 3?week multimodal rehabilitation involving supervised high?intensity interval training (HIIT) on female breast cancer survivors with respect to key variables of aerobic fitness, body composition, energy expenditure, cancer?related fatigue, and quality of life to those of a standard multimodal rehabilitation program. A randomized controlled trial design was administered. Twenty?eight women, who had been treated for cancer were randomly assigned to either a ...

The integration of audio-tactile information is modulated by multimodal social interaction with physical contact in infancy.

Science.gov (United States)

Tanaka, Yukari; Kanakogi, Yasuhiro; Kawasaki, Masahiro; Myowa, Masako

2018-04-01

Interaction between caregivers and infants is multimodal in nature. To react interactively and smoothly to such multimodal signals, infants must integrate all these signals. However, few empirical infant studies have investigated how multimodal social interaction with physical contact facilitates multimodal integration, especially regarding audio - tactile (A-T) information. By using electroencephalogram (EEG) and event-related potentials (ERPs), the present study investigated how neural processing involved in A-T integration is modulated by tactile interaction. Seven- to 8-months-old infants heard one pseudoword both whilst being tickled (multimodal 'A-T' condition), and not being tickled (unimodal 'A' condition). Thereafter, their EEG was measured during the perception of the same words. Compared to the A condition, the A-T condition resulted in enhanced ERPs and higher beta-band activity within the left temporal regions, indicating neural processing of A-T integration. Additionally, theta-band activity within the middle frontal region was enhanced, which may reflect enhanced attention to social information. Furthermore, differential ERPs correlated with the degree of engagement in the tickling interaction. We provide neural evidence that the integration of A-T information in infants' brains is facilitated through tactile interaction with others. Such plastic changes in neural processing may promote harmonious social interaction and effective learning in infancy. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

The integration of audio−tactile information is modulated by multimodal social interaction with physical contact in infancy

Directory of Open Access Journals (Sweden)

Yukari Tanaka

2018-04-01

Full Text Available Interaction between caregivers and infants is multimodal in nature. To react interactively and smoothly to such multimodal signals, infants must integrate all these signals. However, few empirical infant studies have investigated how multimodal social interaction with physical contact facilitates multimodal integration, especially regarding audio − tactile (A-T information. By using electroencephalogram (EEG and event-related potentials (ERPs, the present study investigated how neural processing involved in A-T integration is modulated by tactile interaction. Seven- to 8-months-old infants heard one pseudoword both whilst being tickled (multimodal ‘A-T’ condition, and not being tickled (unimodal ‘A’ condition. Thereafter, their EEG was measured during the perception of the same words. Compared to the A condition, the A-T condition resulted in enhanced ERPs and higher beta-band activity within the left temporal regions, indicating neural processing of A-T integration. Additionally, theta-band activity within the middle frontal region was enhanced, which may reflect enhanced attention to social information. Furthermore, differential ERPs correlated with the degree of engagement in the tickling interaction. We provide neural evidence that the integration of A-T information in infants’ brains is facilitated through tactile interaction with others. Such plastic changes in neural processing may promote harmonious social interaction and effective learning in infancy. Keywords: Electroencephalogram (EEG, Infants, Multisensory integration, Touch interaction

ALERT. Adverse late effects of cancer treatment. Vol. 2. Normal tissue specific sites and systems

Energy Technology Data Exchange (ETDEWEB)

Rubin, Philip; Constine, Louis S. [Univ. Rochester Medical Center, NY (United States). Dept. of Radiation Oncology; Marks, Lawrence B. (ed.) [Univ. North Carolina and Lineberger, Comprehensive Cancer Center, Chapel Hill, NC (United States). Dept. of Radiation Oncology

2014-09-01

Comprehensively documents potential late effects in all the normal tissue sites in the human body. Considers in detail the detection, diagnosis, management and prevention of effects and discusses prognostic outcomes. Clearly presents radiation risk factors and interactions with chemotherapy effects. Provides the most current evidence-based medicine for cancer care survivorship guidelines. The literature on the late effects of cancer treatment is widely scattered in different journals since all major organ systems are affected and management is based on a variety of medical and surgical treatments. The aim of ALERT - Adverse Late Effects of Cancer Treatment is to offer a coherent multidisciplinary approach to the care of cancer survivors. The central paradigm is that cytotoxic multimodal therapy results in a perpetual cascade of events that affects each major organ system differently and is expressed continually over time. Essentially, radiation and chemotherapy are intense biologic modifiers that allow for cancer cure and cancer survivorship but accelerate senescence of normal tissues and increase the incidence of age-related diseases and second malignant tumors. Volume 2 of this two-volume work comprehensively documents potential late effects in all the normal tissue anatomic sites in the human body. The detection, diagnosis, management and prevention of effects are all considered in detail, and prognostic outcomes are discussed. Radiation risk factors and interactions with chemotherapy effects are clearly presented. The text is accompanied by numerous supportive illustrations and tables.

Cycling in multimodal transport behaviours: Exploring modality styles in the Danish population

DEFF Research Database (Denmark)

Olafsson, Anton Stahl; Nielsen, Thomas Alexander Sick; Carstensen, Trine Agervig

2016-01-01

and small towns. Thus, the way in which travel modes relate to the urban environment and variations in modality styles must serve as the starting point for policies aiming to fulfil the potential of multimodal transport behaviour and promote cycling. (C) 2016 Elsevier Ltd. All rights reserved....... explores how cycling forms part of multimodal transport behaviour based on survey data on transport modes and travel purposes and the weekly frequency of out-of-home activities and travel mode use in a representative sample of adult Danes (n = 1957). The following five distinct multimodal travel segments...... or 'modality styles' are identified: 'education transport'; 'public-based transport'; 'limited transport'; 'bicycle-based transport'; and 'car-based transport'. Travel behaviour is predominantly multimodal with few unimodal car-drivers being identified. Substantial cycling takes place in all modality styles...

Multimodality with Eye tracking and Haptics: A New Horizon for Serious Games?

Directory of Open Access Journals (Sweden)

Shujie Deng

2014-10-01

Full Text Available The goal of this review is to illustrate the emerging use of multimodal virtual reality that can benefit learning-based games. The review begins with an introduction to multimodal virtual reality in serious games and we provide a brief discussion of why cognitive processes involved in learning and training are enhanced under immersive virtual environments. We initially outline studies that have used eye tracking and haptic feedback independently in serious games, and then review some innovative applications that have already combined eye tracking and haptic devices in order to provide applicable multimodal frameworks for learning-based games. Finally, some general conclusions are identified and clarified in order to advance current understanding in multimodal serious game production as well as exploring possible areas for new applications.

Treatment of malignant pleural mesothelioma

International Nuclear Information System (INIS)

Yusa, Toshikazu

2007-01-01

In Japan, it is predicted that mesothelioma will rapidly increase in the future. Malignant pleural mesothelioma that accounts for approximately 90% of mesothelioma as a whole has a median survival time of approximately nine months which is considered a poor prognosis. As for the treatment of this disease, extrapleural pneumonectomy or pleurectomy/decortication are available for those patients who can be surgically operated on. However, since a complete cure rate is low when only surgical treatment is performed, generally a multimodality treatment is performed wherein chemotherapy and/or radiotherapy are combined. For chemotherapy, a large-scale randomized phase III study demonstrated that a treatment using two agents: pemetrexed, which is a new multitargeted antifolate, and cisplatin is effective. Pemetrexed will be the drug of first choice for mesothelioma in the future. As other treatment methods, chemohyperthermia, treatments using various kinds of cytokines and angiogenesis inhibitors, genetic treatment and photodynamic therapy have been attempted. The current treatment results for this disease are very poor, and there has been a strong demand for establishing an effective treatment method. (author)

Multimodal microscopy and the stepwise multi-photon activation fluorescence of melanin

Science.gov (United States)

Lai, Zhenhua

The author's work is divided into three aspects: multimodal microscopy, stepwise multi-photon activation fluorescence (SMPAF) of melanin, and customized-profile lenses (CPL) for on-axis laser scanners, which will be introduced respectively. A multimodal microscope provides the ability to image samples with multiple modalities on the same stage, which incorporates the benefits of all modalities. The multimodal microscopes developed in this dissertation are the Keck 3D fusion multimodal microscope 2.0 (3DFM 2.0), upgraded from the old 3DFM with improved performance and flexibility, and the multimodal microscope for targeting small particles (the "Target" system). The control systems developed for both microscopes are low-cost and easy-to-build, with all components off-the-shelf. The control system have not only significantly decreased the complexity and size of the microscope, but also increased the pixel resolution and flexibility. The SMPAF of melanin, activated by a continuous-wave (CW) mode near-infrared (NIR) laser, has potential applications for a low-cost and reliable method of detecting melanin. The photophysics of melanin SMPAF has been studied by theoretical analysis of the excitation process and investigation of the spectra, activation threshold, and photon number absorption of melanin SMPAF. SMPAF images of melanin in mouse hair and skin, mouse melanoma, and human black and white hairs are compared with images taken by conventional multi-photon fluorescence microscopy (MPFM) and confocal reflectance microscopy (CRM). SMPAF images significantly increase specificity and demonstrate the potential to increase sensitivity for melanin detection compared to MPFM images and CRM images. Employing melanin SMPAF imaging to detect melanin inside human skin in vivo has been demonstrated, which proves the effectiveness of melanin detection using SMPAF for medical purposes. Selective melanin ablation with micrometer resolution has been presented using the Target system

Design, Performance and Optimization for Multimodal Radar Operation

Directory of Open Access Journals (Sweden)

Surendra S. Bhat

2012-09-01

Full Text Available This paper describes the underlying methodology behind an adaptive multimodal radar sensor that is capable of progressively optimizing its range resolution depending upon the target scattering features. It consists of a test-bed that enables the generation of linear frequency modulated waveforms of various bandwidths. This paper discusses a theoretical approach to optimizing the bandwidth used by the multimodal radar. It also discusses the various experimental results obtained from measurement. The resolution predicted from theory agrees quite well with that obtained from experiments for different target arrangements.

Spectral space-time coding for optical communications through a multimode fiber

NARCIS (Netherlands)

Alonso, A.; Berghmans, F.; Thienpont, H.; Danckaert, J.; Desmet, L.

2001-01-01

We propose a method for coding the mode structure of a multimode optical fiber by spectral coding mixed with space-time modulation. With this system we can improve the data carrying capacity of a multimode fiber for optical communications and optical interconnects, and encode and decode the

Wide range optofluidically tunable multimode interference fiber laser

International Nuclear Information System (INIS)

Antonio-Lopez, J E; LiKamWa, P; Sanchez-Mondragon, J J; May-Arrioja, D A

2014-01-01

An optofluidically tunable fiber laser based on multimode interference (MMI) effects with a wide tuning range is proposed and demonstrated. The tunable mechanism is based on an MMI fiber filter fabricated using a special fiber known as no-core fiber, which is a multimode fiber (MMF) without cladding. Therefore, when the MMI filter is covered by liquid the optical properties of the no-core fiber are modified, which allow us to tune the peak wavelength response of the MMI filter. Rather than applying the liquid on the entire no-core fiber, we change the liquid level along the no-core fiber, which provides a highly linear tuning response. In addition, by selecting the adequate refractive index of the liquid we can also choose the tuning range. We demonstrate the versatility of the optofluidically tunable MMI filter by wavelength tuning two different gain media, erbium doped fiber and a semiconductor optical amplifier, achieving tuning ranges of 55 and 90 nm respectively. In both cases, we achieve side-mode suppression ratios (SMSR) better than 50 dBm with output power variations of less than 0.76 dBm over the whole tuning range. (paper)

Does the diagnosis influence the outcome in multimodal outpatient pain management program for low back pain and sciatica? a comparative study

Directory of Open Access Journals (Sweden)

Artner J

2012-07-01

Full Text Available Juraj Artner, Stephan Kurz, Balkan Cakir, Heiko Reichel, Friederike LattigDepartment of Orthopaedic Surgery, University of Ulm, GermanyAbstract: The literature describes multimodal pain-management programs as successful therapy options in the conservative treatment of chronic low back pain. Yet, the intensity and inclusion criteria of such programs remain debatable. In many studies, the pain originating from spinal structures is described as nonspecific low back pain – a diffuse diagnosis without serious implications. The purpose of this study is to compare the short-term outcomes between patients suffering from sciatica due to a discus intervertebralis herniation and those suffering from low back pain caused by facet joint disease after 3 weeks of treatment in an intense multimodal outpatient program in the Department of Orthopaedic Surgery at the university hospital.Keywords: chronic low back pain, sciatica, interdisciplinary management, discus herniation, spondylarthritis

Multimodal Imaging Nanoparticles Derived from Hyaluronic Acid for Integrated Preoperative and Intraoperative Cancer Imaging

Directory of Open Access Journals (Sweden)

William M. Payne

2017-01-01

Full Text Available Surgical resection remains the most promising treatment strategy for many types of cancer. Residual malignant tissue after surgery, a consequence in part due to positive margins, contributes to high mortality and disease recurrence. In this study, multimodal contrast agents for integrated preoperative magnetic resonance imaging (MRI and intraoperative fluorescence image-guided surgery (FIGS are developed. Self-assembled multimodal imaging nanoparticles (SAMINs were developed as a mixed micelle formulation using amphiphilic HA polymers functionalized with either GdDTPA for T1 contrast-enhanced MRI or Cy7.5, a near infrared fluorophore. To evaluate the relationship between MR and fluorescence signal from SAMINs, we employed simulated surgical phantoms that are routinely used to evaluate the depth at which near infrared (NIR imaging agents can be detected by FIGS. Finally, imaging agent efficacy was evaluated in a human breast tumor xenograft model in nude mice, which demonstrated contrast in both fluorescence and magnetic resonance imaging.

Semiconductor laser using multimode interference principle

Science.gov (United States)

Gong, Zisu; Yin, Rui; Ji, Wei; Wu, Chonghao

2018-01-01

Multimode interference (MMI) structure is introduced in semiconductor laser used in optical communication system to realize higher power and better temperature tolerance. Using beam propagation method (BPM), Multimode interference laser diode (MMI-LD) is designed and fabricated in InGaAsP/InP based material. As a comparison, conventional semiconductor laser using straight single-mode waveguide is also fabricated in the same wafer. With a low injection current (about 230 mA), the output power of the implemented MMI-LD is up to 2.296 mW which is about four times higher than the output power of the conventional semiconductor laser. The implemented MMI-LD exhibits stable output operating at the wavelength of 1.52 μm and better temperature tolerance when the temperature varies from 283.15 K to 293.15 K.

The Treatment of Neck Pain-Associated Disorders and Whiplash-Associated Disorders: A Clinical Practice Guideline.

Science.gov (United States)

Bussières, André E; Stewart, Gregory; Al-Zoubi, Fadi; Decina, Philip; Descarreaux, Martin; Hayden, Jill; Hendrickson, Brenda; Hincapié, Cesar; Pagé, Isabelle; Passmore, Steven; Srbely, John; Stupar, Maja; Weisberg, Joel; Ornelas, Joseph

2016-10-01

The objective was to develop a clinical practice guideline on the management of neck pain-associated disorders (NADs) and whiplash-associated disorders (WADs). This guideline replaces 2 prior chiropractic guidelines on NADs and WADs. Pertinent systematic reviews on 6 topic areas (education, multimodal care, exercise, work disability, manual therapy, passive modalities) were assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR) and data extracted from admissible randomized controlled trials. We incorporated risk of bias scores in the Grading of Recommendations Assessment, Development, and Evaluation. Evidence profiles were used to summarize judgments of the evidence quality, detail relative and absolute effects, and link recommendations to the supporting evidence. The guideline panel considered the balance of desirable and undesirable consequences. Consensus was achieved using a modified Delphi. The guideline was peer reviewed by a 10-member multidisciplinary (medical and chiropractic) external committee. For recent-onset (0-3 months) neck pain, we suggest offering multimodal care; manipulation or mobilization; range-of-motion home exercise, or multimodal manual therapy (for grades I-II NAD); supervised graded strengthening exercise (grade III NAD); and multimodal care (grade III WAD). For persistent (>3 months) neck pain, we suggest offering multimodal care or stress self-management; manipulation with soft tissue therapy; high-dose massage; supervised group exercise; supervised yoga; supervised strengthening exercises or home exercises (grades I-II NAD); multimodal care or practitioner's advice (grades I-III NAD); and supervised exercise with advice or advice alone (grades I-II WAD). For workers with persistent neck and shoulder pain, evidence supports mixed supervised and unsupervised high-intensity strength training or advice alone (grades I-III NAD). A multimodal approach including manual therapy, self-management advice, and exercise is an

Multimodal MEMPRAGE, FLAIR, and R2* Segmentation to Resolve Dura and Vessels from Cortical Gray Matter

Directory of Open Access Journals (Sweden)

Roberto Viviani

2017-05-01

Full Text Available While widely in use in automated segmentation approaches for the detection of group differences or of changes associated with continuous predictors in gray matter volume, T1-weighted images are known to represent dura and cortical vessels with signal intensities similar to those of gray matter. By considering multiple signal sources at once, multimodal segmentation approaches may be able to resolve these different tissue classes and address this potential confound. We explored here the simultaneous use of FLAIR and apparent transverse relaxation rates (a signal related to T2* relaxation maps and having similar contrast with T1-weighted images. Relative to T1-weighted images alone, multimodal segmentation had marked positive effects on 1. the separation of gray matter from dura, 2. the exclusion of vessels from the gray matter compartment, and 3. the contrast with extracerebral connective tissue. While obtainable together with the T1-weighted images without increasing scanning times, apparent transverse relaxation rates were less effective than added FLAIR images in providing the above mentioned advantages. FLAIR images also improved the detection of cortical matter in areas prone to susceptibility artifacts in standard MPRAGE T1-weighted images, while the addition of transverse relaxation maps exacerbated the effect of these artifacts on segmentation. Our results confirm that standard MPRAGE segmentation may overestimate gray matter volume by wrongly assigning vessels and dura to this compartment and show that multimodal approaches may greatly improve the specificity of cortical segmentation. Since multimodal segmentation is easily implemented, these benefits are immediately available to studies focusing on translational applications of structural imaging.

Driver Education for New Multimodal Facilities

Science.gov (United States)

2016-05-24

Local and state transportation agencies are redesigning roads to accommodate multimodal travel, including the addition of new configurations, infrastructures, and rules that may be unfamiliar to current drivers and other road users. Education and out...

[Trends in world science and practice of pain treatment].

Science.gov (United States)

Osipova, N A

2014-01-01

In recent days there are two main conceptions of the treatment of strong pain. The first conception is a system multimodal analgesia and the second is a multidisciplinary therapy including invasive techniques (local nervous blockades, neuroaxial blockades, neurostimulating or drug therapy with implanted systems etc.), physical, manual, and psychological effecting on peripheral and central nervous system. A physician (anaesthesiologist, oncologist, neurologist etc.) treats the pain according to interests of a patient. Multidisciplinary pain treatment, which is recommended by the American Pain Association, requires the use of special equipment for effecting on nervous system of the patient and contains conflict of interests of managers, medical workers, equipment providing companies and other parts of the multidisciplinary process. Therefore there is a risk that commercial benefit can get a main role in the process of pain treatment, but not interests of the patient. The "industrial" approach in the pain treatment is connected with many negative outcomes such as a minimizing of the role of pain science, increasing of complications risks due to invasive techniques of the pain relief etc. Therefore an objective analysis of pain treatment outcomes is needed Helsinki Declaration of a patient safety in surgery approved by European Society of Anaesthesiology in June, 2010 requires an accounting system of critical incidents, complications and assessment of outcomes in perioperative anaesthesiological practice. The same study is very actual for Russia especially to compare a safety of the system multimodal anaesthesia/analgesia and epidural blockades in major surgery.

A Multimodal System with Synergistic Effects of Magneto-Mechanical, Photothermal, Photodynamic and Chemo Therapies of Cancer in Graphene-Quantum Dot-Coated Hollow Magnetic Nanospheres.

Science.gov (United States)

Wo, Fangjie; Xu, Rujiao; Shao, Yuxiang; Zhang, Zheyu; Chu, Maoquan; Shi, Donglu; Liu, Shupeng

2016-01-01

In this study, a multimodal therapeutic system was shown to be much more lethal in cancer cell killing compared to a single means of nano therapy, be it photothermal or photodynamic. Hollow magnetic nanospheres (HMNSs) were designed and synthesized for the synergistic effects of both magneto-mechanical and photothermal cancer therapy. By these combined stimuli, the cancer cells were structurally and physically destroyed with the morphological characteristics distinctively different from those by other therapeutics. HMNSs were also coated with the silica shells and conjugated with carboxylated graphene quantum dots (GQDs) as a core-shell composite: HMNS/SiO2/GQDs. The composite was further loaded with an anticancer drug doxorubicin (DOX) and stabilized with liposomes. The multimodal system was able to kill cancer cells with four different therapeutic mechanisms in a synergetic and multilateral fashion, namely, the magnetic field-mediated mechanical stimulation, photothermal damage, photodynamic toxicity, and chemotherapy. The unique nanocomposites with combined mechanical, chemo, and physical effects will provide an alternative strategy for highly improved cancer therapy efficiency.

Optical modelling of far-infrared astronomical instrumentation exploiting multimode horn antennas

Science.gov (United States)

O'Sullivan, Créidhe; Murphy, J. Anthony; Mc Auley, Ian; Wilson, Daniel; Gradziel, Marcin L.; Trappe, Neil; Cahill, Fiachra; Peacocke, T.; Savini, G.; Ganga, K.

2014-07-01

In this paper we describe the optical modelling of astronomical telescopes that exploit bolometric detectors fed by multimoded horn antennas. In cases where the horn shape is profiled rather than being a simple cone, we determine the beam at the horn aperture using an electromagnetic mode-matching technique. Bolometers, usually placed in an integrating cavity, can excite many hybrid modes in a corrugated horn; we usually assume they excite all modes equally. If the waveguide section feeding the horn is oversized these modes can propagate independently, thereby increasing the throughput of the system. We use an SVD analysis on the matrix that describes the scattering between waveguide (TE/TM) modes to recover the independent orthogonal fields (hybrid modes) and then propagate these to the sky independently where they are added in quadrature. Beam patterns at many frequencies across the band are then added with a weighting appropriate to the source spectrum. Here we describe simulations carried out on the highest-frequency (857-GHz) channel of the Planck HFI instrument. We concentrate in particular on the use of multimode feedhorns and consider the effects of possible manufacturing tolerances on the beam on the sky. We also investigate the feasibility of modelling far-out sidelobes across a wide band for electrically large structures and bolometers fed by multi-mode feedhorns. Our optical simulations are carried out using the industry-standard GRASP software package.

Maxillofacial prosthodontic rehabilitation of a patient with oral complications during and after multimodality therapy for the management of oral squamous cell carcinoma.

Science.gov (United States)

Acharya, Varun; Chambers, Mark S

2015-06-01

Multimodality cancer therapy involving surgical resection, chemotherapy, and radiation therapy is frequently employed in the management of head and neck cancer. Patients who have undergone such therapy face substantial challenges during and after treatment. Prosthodontic rehabilitation is essential during and after tumor ablation to restore function, esthetics, and minimize interruption in daily routine. This clinical report describes the challenges faced by a patient undergoing multimodality therapy for a squamous cell carcinoma of the maxillary sinus and the stages involved in prosthodontic rehabilitation. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Modelling multimodal expression of emotion in a virtual agent.

Science.gov (United States)

Pelachaud, Catherine

2009-12-12

Over the past few years we have been developing an expressive embodied conversational agent system. In particular, we have developed a model of multimodal behaviours that includes dynamism and complex facial expressions. The first feature refers to the qualitative execution of behaviours. Our model is based on perceptual studies and encompasses several parameters that modulate multimodal behaviours. The second feature, the model of complex expressions, follows a componential approach where a new expression is obtained by combining facial areas of other expressions. Lately we have been working on adding temporal dynamism to expressions. So far they have been designed statically, typically at their apex. Only full-blown expressions could be modelled. To overcome this limitation, we have defined a representation scheme that describes the temporal evolution of the expression of an emotion. It is no longer represented by a static definition but by a temporally ordered sequence of multimodal signals.

Study on multimodal transport route under low carbon background

Science.gov (United States)

Liu, Lele; Liu, Jie

2018-06-01

Low-carbon environmental protection is the focus of attention around the world, scientists are constantly researching on production of carbon emissions and living carbon emissions. However, there is little literature about multimodal transportation based on carbon emission at home and abroad. Firstly, this paper introduces the theory of multimodal transportation, the multimodal transport models that didn't consider carbon emissions and consider carbon emissions are analyzed. On this basis, a multi-objective programming 0-1 programming model with minimum total transportation cost and minimum total carbon emission is proposed. The idea of weight is applied to Ideal point method for solving problem, multi-objective programming is transformed into a single objective function. The optimal solution of carbon emission to transportation cost under different weights is determined by a single objective function with variable weights. Based on the model and algorithm, an example is given and the results are analyzed.

Interactivity in Educational Apps for Young children: A Multimodal Analysis

Directory of Open Access Journals (Sweden)

Alexandra H. Blitz-Raith

2017-11-01

Full Text Available Interactivity is an important indicator of an educational app's reception. Since most educational apps are multimodal, it justifies a methodological initiative to understand meaningful involvement of multimodality in enacting and even amplifying interactivity in an educational app. Yet research so far has largely concentrated on algorithm construct and user feedback rather than on multimodal interactions, especially from a social semiotics perspective. Drawing from social semiotics approaches, this article proposes a multimodal analytic framework to examine three layers of mode in engendering interaction; namely, multiplicity, function, and relationship. Using the analytic framework in an analysis of The Farm Adventure for Kids, a popular educational app for pre-school children, we found that still images are dominant proportionally and are central in the interactive process. We also found that tapping still images of animals on screen is the main action, with other screen actions deliberately excluded. Such findings suggest that aligning children’s cognitive and physical capabilities to the use of mode become the primary consideration in educational app design and that consistent attendance to this alignment in mobilizing modes significantly affect an educational app’s interactivity, and consequently its reception by young children

Suppression of dynamic laser speckle signals in multimode fibers of various lengths

NARCIS (Netherlands)

Petoukhova, Anna; Cleven, Ester; de Mul, F.F.M.; Steenbergen, Wiendelt

2004-01-01

The effects of fiber coupling and fiber length on photocurrent fluctuations are studied when the light of a laser diode transmitted to and from a dynamic turbid medium by a step-index multimode fiber is studied. When the laser light is coupled asymmetrically, filling only the higher-order modes, the

Recent advances in acute pain management: understanding the mechanisms of acute pain, the prescription of opioids, and the role of multimodal pain therapy [version 1; referees: 3 approved

Directory of Open Access Journals (Sweden)

Richa Wardhan

2017-11-01

Full Text Available In this review, we discuss advances in acute pain management, including the recent report of the joint American Pain Society and American Academy of Pain Medicine task force on the classification of acute pain, the role of psychosocial factors, multimodal pain management, new non-opioid therapy, and the effect of the “opioid epidemic”. In this regard, we propose that a fundamental principle in acute pain management is identifying patients who are most at risk and providing an “opioid free anesthesia and postoperative analgesia”. This can be achieved by using a multimodal approach that includes regional anesthesia and minimizing the dose and the duration of opioid prescription. This allows prescribing medications that work through different mechanisms. We shall also look at the recent pharmacologic and treatment advances made in acute pain and regional anesthesia.

MODELING PARTICLE SIZE DISTRIBUTION IN HETEROGENEOUS POLYMERIZATION SYSTEMS USING MULTIMODAL LOGNORMAL FUNCTION

Directory of Open Access Journals (Sweden)

J. C. Ferrari

Full Text Available Abstract This work evaluates the usage of the multimodal lognormal function to describe Particle Size Distributions (PSD of emulsion and suspension polymerization processes, including continuous reactions with particle re-nucleation leading to complex multimodal PSDs. A global optimization algorithm, namely Particle Swarm Optimization (PSO, was used for parameter estimation of the proposed model, minimizing the objective function defined by the mean squared errors. Statistical evaluation of the results indicated that the multimodal lognormal function could describe distinctive features of different types of PSDs with accuracy and consistency.

An evaluation framework for multimodal interaction determining quality aspects and modality choice

CERN Document Server

Wechsung, Ina

2014-01-01

This book presents (1) an exhaustive and empirically validated taxonomy of quality aspects of multimodal interaction as well as respective measurement methods, (2) a validated questionnaire specifically tailored to the evaluation of multimodal systems and covering most of the taxonomy‘s quality aspects, (3) insights on how the quality perceptions of multimodal systems relate to the quality perceptions of its individual components, (4) a set of empirically tested factors which influence modality choice, and (5) models regarding the relationship of the perceived quality of a modality and the actual usage of a modality.

Superparamagnetic nanoparticles for enhanced magnetic resonance and multimodal imaging

Science.gov (United States)

Sikma, Elise Ann Schultz

Magnetic resonance imaging (MRI) is a powerful tool for noninvasive tomographic imaging of biological systems with high spatial and temporal resolution. Superparamagnetic (SPM) nanoparticles have emerged as highly effective MR contrast agents due to their biocompatibility, ease of surface modification and magnetic properties. Conventional nanoparticle contrast agents suffer from difficult synthetic reproducibility, polydisperse sizes and weak magnetism. Numerous synthetic techniques and nanoparticle formulations have been developed to overcome these barriers. However, there are still major limitations in the development of new nanoparticle-based probes for MR and multimodal imaging including low signal amplification and absence of biochemical reporters. To address these issues, a set of multimodal (T2/optical) and dual contrast (T1/T2) nanoparticle probes has been developed. Their unique magnetic properties and imaging capabilities were thoroughly explored. An enzyme-activatable contrast agent is currently being developed as an innovative means for early in vivo detection of cancer at the cellular level. Multimodal probes function by combining the strengths of multiple imaging techniques into a single agent. Co-registration of data obtained by multiple imaging modalities validates the data, enhancing its quality and reliability. A series of T2/optical probes were successfully synthesized by attachment of a fluorescent dye to the surface of different types of nanoparticles. The multimodal nanoparticles generated sufficient MR and fluorescence signal to image transplanted islets in vivo. Dual contrast T1/T2 imaging probes were designed to overcome disadvantages inherent in the individual T1 and T2 components. A class of T1/T2 agents was developed consisting of a gadolinium (III) complex (DTPA chelate or DO3A macrocycle) conjugated to a biocompatible silica-coated metal oxide nanoparticle through a disulfide linker. The disulfide linker has the ability to be reduced

In-Patient Treatment of Fibromyalgia: A Controlled Nonrandomized Comparison of Conventional Medicine versus Integrative Medicine including Fasting Therapy

Directory of Open Access Journals (Sweden)

Andreas Michalsen

2013-01-01

Full Text Available Fibromyalgia poses a challenge for therapy. Recent guidelines suggest that fibromyalgia should be treated within a multidisciplinary therapy approach. No data are available that evaluated multimodal treatment strategies of Integrative Medicine (IM. We conducted a controlled, nonrandomized pilot study that compared two inpatient treatment strategies, an IM approach that included fasting therapy and a conventional rheumatology (CM approach. IM used fasting cure and Mind-Body-Medicine as specific methods. Of 48 included consecutive patients, 28 were treated with IM, 20 with CM. Primary outcome was change in the Fibromyalgia Impact Questionnaire (FIQ score after the 2-week hospital stay. Secondary outcomes included scores of pain, depression, anxiety, and well being. Assessments were repeated after 12 weeks. At 2 weeks, there were significant improvements in the FIQ (P<0.014 and for most of secondary outcomes for the IM group compared to the CM group. The beneficial effects for the IM approach were reduced after 12 weeks and no longer statistically significant with the exception of anxiety. Findings indicate that a multimodal IM treatment with fasting therapy might be superior to CM in the short term and not inferior in the mid term. Longer-term studies are warranted to assess the clinical impact of integrative multimodal treatment in fibromyalgia.

Multimodal Therapy for the Treatment of Severe Ischemic Stroke Combining Endovascular Embolectomy and Stenting of Long Intracranial Artery Occlusion

Science.gov (United States)

Bunc, Matjaž; Kocijančič, Igor J.; Pregelj, Rado; Dolenc, Vinko V.

2010-01-01

Embolic occlusion of cerebral arteries is a major cause for stroke. Intravenous thrombolysis showed positive results in this condition, however even when strict criteria are used, the risk of hemorrhagic transformation is possible. Microsurgical embolectomy has been described earlier. Purpose. We performed multimodal therapy of cerebral artery occlusion. Case Report. We present a case of a 49-year-old female patient who—according to the National Institute of Health Stroke Scale (NIHSS)—was rated as 19 due to acute occlusion of the horizontal segment of the left middle cerebral artery (MCA). After failed i.v. thrombolysis, only a part of the clot could be evacuated by the endovascular approach—without restoration of blood flow. Normal patency of the left MCA was re-established after stenting. Within 72 hours, the patient had an NIHSS score of 14, with a small haematoma in the left hemisphere. Conclusion. In our case multimodal therapy combining i.v. thrombolysis, mechanical disruption of thrombus, MCA stenting and platelet function antagonists, resulted in successful recanalization of the acutely occluded left MCA. PMID:20671974

Multimodal therapy for the treatment of severe ischemic stroke combining endovascular embolectomy and stenting of long intracranial artery occlusion.

Science.gov (United States)

Bunc, Matjaz; Kocijancic, Igor J; Pregelj, Rado; Dolenc, Vinko V

2010-01-01

Embolic occlusion of cerebral arteries is a major cause for stroke. Intravenous thrombolysis showed positive results in this condition, however even when strict criteria are used, the risk of hemorrhagic transformation is possible. Microsurgical embolectomy has been described earlier. Purpose. We performed multimodal therapy of cerebral artery occlusion. Case Report. We present a case of a 49-year-old female patient who-according to the National Institute of Health Stroke Scale (NIHSS)-was rated as 19 due to acute occlusion of the horizontal segment of the left middle cerebral artery (MCA). After failed i.v. thrombolysis, only a part of the clot could be evacuated by the endovascular approach-without restoration of blood flow. Normal patency of the left MCA was re-established after stenting. Within 72 hours, the patient had an NIHSS score of 14, with a small haematoma in the left hemisphere. Conclusion. In our case multimodal therapy combining i.v. thrombolysis, mechanical disruption of thrombus, MCA stenting and platelet function antagonists, resulted in successful recanalization of the acutely occluded left MCA.

Cognitive-behavioral therapy for externalizing disorders: A meta-analysis of treatment effectiveness.

Science.gov (United States)

Battagliese, Gemma; Caccetta, Maria; Luppino, Olga Ines; Baglioni, Chiara; Cardi, Valentina; Mancini, Francesco; Buonanno, Carlo

2015-12-01

Externalizing disorders are the most common and persistent forms of maladjustment in childhood. The aim of this study was to conduct a meta-analysis evaluating the effectiveness of Cognitive Behavioral Therapy (CBT) to reduce externalizing symptoms in two disorders: Attention Deficit Hyperactivity Disorder (ADHD) and Oppositive Defiant Disorder (ODD). The efficacy of CBT to improve social competence and positive parenting and reduce internalizing behaviors, parent stress and maternal depression was also explored. The database PsycInfo, PsycARTICLES, Medline and PubMed were searched to identify relevant studies. Twenty-one trials met the inclusion criteria. Results showed that the biggest improvement, after CBT, was in ODD symptoms (-0.879) followed by parental stress (-0.607), externalizing symptoms (-0.52), parenting skills (-0.381), social competence (-0.390) and ADHD symptoms (-0.343). CBT was also associated with improved attention (-0.378), aggressive behaviors (-0.284), internalizing symptoms (-0.272) and maternal depressive symptoms (-0.231). Overall, CBT is an effective treatment option for externalizing disorders and is also associated with reduced parental distress and maternal depressive symptoms. Multimodal treatments targeting both children and caregivers' symptoms (e.g. maternal depressive symptoms) appear important to produce sustained and generalized benefits. Copyright © 2015 Elsevier Ltd. All rights reserved.

EXPLICITATION AND ADDITION TECHNIQUES IN AUDIOVISUAL TRANSLATION: A MULTIMODAL APPROACH OF ENGLISHINDONESIAN SUBTITLES

Directory of Open Access Journals (Sweden)

Ichwan Suyudi

2017-12-01

Full Text Available In audiovisual translation, the multimodality of the audiovisual text is both a challenge and a resource for subtitlers. This paper illustrates how multi-modes provide information that helps subtitlers to gain a better understanding of meaning-making practices that will influence them to make a decision-making in translating a certain verbal text. Subtitlers may explicit, add, and condense the texts based on the multi-modes as seen on the visual frames. Subtitlers have to consider the distribution and integration of the meanings of multi-modes in order to create comprehensive equivalence between the source and target texts. Excerpts of visual frames in this paper are taken from English films Forrest Gump (drama, 1996, and James Bond (thriller, 2010.

Multimodal Representations: A Fifth-Grade Teacher Influences Students' Design and Production

Science.gov (United States)

Shanahan, Lynn E.

2013-01-01

The purpose of this interpretive case study is to explore--through a close analysis of one fifth-grade class project--teacher's scaffolding and students' use of visual and linguistic modes when composing multimodally. Using Kress and van Leeuwen's multimodal theory of communication as a framework, this case study examines why teachers, whose…

Targeting Inflammation and Downstream Protein Metabolism in Sarcopenia: A Brief Up-Dated Description of Concurrent Exercise and Leucine-Based Multimodal Intervention

Directory of Open Access Journals (Sweden)

Zhi Xia

2017-06-01

Full Text Available Sarcopenia is defined as the progressive loss of muscle mass with age, and poses a serious threat to the physiological and psychological health of the elderly population with consequential economic and social burdens. Chronic low-grade inflammation plays a central role in the development of sarcopenia such that it alters cellular protein metabolism to favor proteolysis over synthesis, and thereby accelerates muscular atrophy. The purpose of this review is to highlight how exercise and nutrition intervention strategies can attenuate or treat sarcopenia. Resistance exercise increases not only muscle mass but also muscle strength, while aerobic exercise is able to ameliorate the age-related metabolic disorders. Concurrent exercise training integrates the advantages of both aerobic and resistance exercise, and may exert a significant synergistic effect in the aging organism. Higher protein intakes rich in the amino acid leucine appear to restore skeletal muscle protein metabolism balance by rescuing protein synthesis in older adults. There is good reason to believe that a multimodal treatment, a combination of exercise and increased leucine consumption in the diet, can combat some of the muscle loss associated with aging. Future research is needed to consolidate these findings to humans, and to further clarify to what extent and by which mechanisms protein metabolism might be directly involved in sarcopenia pathogenesis and the multimodal treatment responses.

Study of internalization and viability of multimodal nanoparticles for labeling of human umbilical cord mesenchymal stem cells

International Nuclear Information System (INIS)

Miyaki, Liza Aya Mabuchi; Sibov, Tatiana Tais; Pavon, Lorena Favaro; Mamani, Javier Bustamante; Gamarra, Lionel Fernel

2012-01-01

Objective: To analyze multimodal magnetic nanoparticles-Rhodamine B in culture media for cell labeling, and to establish a study of multimodal magnetic nanoparticles-Rhodamine B detection at labeled cells evaluating they viability at concentrations of 10 μg Fe/mL and 100μg Fe/mL. Methods: We performed the analysis of stability of multimodal magnetic nanoparticles-Rhodamine B in different culture media; the mesenchymal stem cells labeling with multimodal magnetic nanoparticles-Rhodamine B; the intracellular detection of multimodal magnetic nanoparticles-Rhodamine B in mesenchymal stem cells, and assessment of the viability of labeled cells by kinetic proliferation. Results: The stability analysis showed that multimodal magnetic nanoparticles-Rhodamine B had good stability in cultured Dulbecco's Modified Eagle's-Low Glucose medium and RPMI 1640 medium. The mesenchymal stem cell with multimodal magnetic nanoparticles-Rhodamine B described location of intracellular nanoparticles, which were shown as blue granules co-localized in fluorescent clusters, thus characterizing magnetic and fluorescent properties of multimodal magnetic nanoparticles Rhodamine B. Conclusion: The stability of multimodal magnetic nanoparticles-Rhodamine B found in cultured Dulbecco's Modified Eagle's-Low Glucose medium and RPMI 1640 medium assured intracellular mesenchymal stem cells labeling. This cell labeling did not affect viability of labeled mesenchymal stem cells since they continued to proliferate for five days. (author)

Behavior change, acceptance, and coping flexibility in highly distressed patients with rheumatic diseases: feasibility of a cognitive-behavioral therapy in multimodal rehabilitation.

Science.gov (United States)

Vriezekolk, Johanna E; Geenen, Rinie; van den Ende, Cornelia H M; Slot, Helma; van Lankveld, Wim G J M; van Helmond, Toon

2012-05-01

To describe the development and feasibility of the integration of a cognitive-behavioral therapy (CBT) within a multimodal rehabilitation program for highly distressed patients with rheumatic diseases. Development included the detailed specification of the theoretical and empirical-based underpinnings of the CBT and the comprehensive description of its design and content. Feasibility was assessed by percentage of eligible patients, attrition and attendance rates, and patient satisfaction. The developed CBT component seeks to decrease psychological distress and improve activities and participation across multiple life domains by accomplishing behavior change, acceptance, and coping flexibility. Motivational interviewing was applied to endorse patients' own reasons to change. Forty percent (35/87) of the eligible patients were admitted to the program. Attendance rate (>95%) was high. Patient satisfaction ranged from 6.8 to 8.0 (10-point scale). Integrating CBT within a multimodal rehabilitation program is feasible. An acceptable proportion of the intended patient sample is eligible and patient's attendance and satisfaction is high. Patients with impaired physical and psychosocial functioning despite adequate medical treatment pose a great challenge. Their treatment outcome may be improved by screening and selecting highly distressed patients and offering them a CBT embedded in multimodal rehabilitation program. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

A 3‐week multimodal intervention involving high‐intensity interval training in female cancer survivors: a randomized controlled trial

OpenAIRE

Schmitt, Joachim; Lindner, Nathalie

2017-01-01

To compare the effects of a 3‐week multimodal rehabilitation involving supervised high‐intensity interval training (HIIT) on female breast cancer survivors with respect to key variables of aerobic fitness, body composition, energy expenditure, cancer‐related fatigue, and quality of life to those of a standard multimodal rehabilitation program. A randomized controlled trial design was administered. Twenty‐eight women, who had been treated for cancer were randomly assigned to either a group per...

Multimodal approaches to use mobile, digital devices in learning practies

DEFF Research Database (Denmark)

Buhl, Mie

, anthropology, psychology and sociology) and outlines the prospect of a trans-disciplinary learning mode. The learning mode reflects the current society where knowledge production is social collaborative process and is produced in formal as well as informal and non-formal contexts. My discussion’s theoretical......In this paper, I discuss the potential of multimodal approaches to enhance learning processes. I draw on a case based on Danish Master Courses in ICT and didactic designs where multimodal approaches are in the center of students’ practical design experience as well as in generation of theoretical...... knowledge. The design of the master courses takes its starting point in the assumption that theoretical knowledge generates from practical experiences. Thus, the organization of the students’ learning processes revolves around practical multimodal experiences followed by iterative reflexive sessions...

Multimodal Feature Integration in the Angular Gyrus during Episodic and Semantic Retrieval

Science.gov (United States)

Bonnici, Heidi M.; Richter, Franziska R.; Yazar, Yasemin

2016-01-01

Much evidence from distinct lines of investigation indicates the involvement of angular gyrus (AnG) in the retrieval of both episodic and semantic information, but the region's precise function and whether that function differs across episodic and semantic retrieval have yet to be determined. We used univariate and multivariate fMRI analysis methods to examine the role of AnG in multimodal feature integration during episodic and semantic retrieval. Human participants completed episodic and semantic memory tasks involving unimodal (auditory or visual) and multimodal (audio-visual) stimuli. Univariate analyses revealed the recruitment of functionally distinct AnG subregions during the retrieval of episodic and semantic information. Consistent with a role in multimodal feature integration during episodic retrieval, significantly greater AnG activity was observed during retrieval of integrated multimodal episodic memories compared with unimodal episodic memories. Multivariate classification analyses revealed that individual multimodal episodic memories could be differentiated in AnG, with classification accuracy tracking the vividness of participants' reported recollections, whereas distinct unimodal memories were represented in sensory association areas only. In contrast to episodic retrieval, AnG was engaged to a statistically equivalent degree during retrieval of unimodal and multimodal semantic memories, suggesting a distinct role for AnG during semantic retrieval. Modality-specific sensory association areas exhibited corresponding activity during both episodic and semantic retrieval, which mirrored the functional specialization of these regions during perception. The results offer new insights into the integrative processes subserved by AnG and its contribution to our subjective experience of remembering. SIGNIFICANCE STATEMENT Using univariate and multivariate fMRI analyses, we provide evidence that functionally distinct subregions of angular gyrus (An

Multimodal Feature Integration in the Angular Gyrus during Episodic and Semantic Retrieval.

Science.gov (United States)

Bonnici, Heidi M; Richter, Franziska R; Yazar, Yasemin; Simons, Jon S

2016-05-18

Much evidence from distinct lines of investigation indicates the involvement of angular gyrus (AnG) in the retrieval of both episodic and semantic information, but the region's precise function and whether that function differs across episodic and semantic retrieval have yet to be determined. We used univariate and multivariate fMRI analysis methods to examine the role of AnG in multimodal feature integration during episodic and semantic retrieval. Human participants completed episodic and semantic memory tasks involving unimodal (auditory or visual) and multimodal (audio-visual) stimuli. Univariate analyses revealed the recruitment of functionally distinct AnG subregions during the retrieval of episodic and semantic information. Consistent with a role in multimodal feature integration during episodic retrieval, significantly greater AnG activity was observed during retrieval of integrated multimodal episodic memories compared with unimodal episodic memories. Multivariate classification analyses revealed that individual multimodal episodic memories could be differentiated in AnG, with classification accuracy tracking the vividness of participants' reported recollections, whereas distinct unimodal memories were represented in sensory association areas only. In contrast to episodic retrieval, AnG was engaged to a statistically equivalent degree during retrieval of unimodal and multimodal semantic memories, suggesting a distinct role for AnG during semantic retrieval. Modality-specific sensory association areas exhibited corresponding activity during both episodic and semantic retrieval, which mirrored the functional specialization of these regions during perception. The results offer new insights into the integrative processes subserved by AnG and its contribution to our subjective experience of remembering. Using univariate and multivariate fMRI analyses, we provide evidence that functionally distinct subregions of angular gyrus (AnG) contribute to the retrieval of

Multi-Modal Intelligent Traffic Signal Systems GPS

Data.gov (United States)

Department of Transportation — Data were collected during the Multi-Modal Intelligent Transportation Signal Systems (MMITSS) study. MMITSS is a next-generation traffic signal system that seeks to...

A study of time- and sex-dependent effects of vortioxetine on rat sexual behavior : Possible roles of direct receptor modulation

NARCIS (Netherlands)

Li, Yan; Pehrson, Alan L; Oosting, Ronald S; Gulinello, Maria; Olivier, Berend; Sanchez, Connie

2017-01-01

Treatment-related sexual dysfunction is a common side effect of antidepressants and contributes to patient non-compliance or treatment cessation. However, the multimodal antidepressant, vortioxetine, demonstrates low sexual side effects in depressed patients. To investigate the mechanisms involved,

Real-Time Management of Multimodal Streaming Data for Monitoring of Epileptic Patients.

Science.gov (United States)

Triantafyllopoulos, Dimitrios; Korvesis, Panagiotis; Mporas, Iosif; Megalooikonomou, Vasileios

2016-03-01

New generation of healthcare is represented by wearable health monitoring systems, which provide real-time monitoring of patient's physiological parameters. It is expected that continuous ambulatory monitoring of vital signals will improve treatment of patients and enable proactive personal health management. In this paper, we present the implementation of a multimodal real-time system for epilepsy management. The proposed methodology is based on a data streaming architecture and efficient management of a big flow of physiological parameters. The performance of this architecture is examined for varying spatial resolution of the recorded data.

Breast conservation in the setting of contemporary multimodality treatment provides excellent outcomes for patients with occult primary breast cancer.

Science.gov (United States)

Rueth, Natasha M; Black, Dalliah M; Limmer, Angela R; Gabriel, Emmanuel; Huo, Lei; Fornage, Bruno D; Dogan, Basak E; Chavez-MacGregor, Mariana; Yi, Min; Hunt, Kelly K; Strom, Eric A

2015-01-01

To evaluate recurrence and survival for patients with occult (T0N+) breast cancer who underwent contemporary treatment, assessing outcomes for breast conservation and mastectomy. We performed a single-institution review of women with occult breast cancer presenting with axillary metastasis without identifiable breast tumor or distant metastasis. We excluded patients with tumors in the axillary tail or mastectomy specimen, patients with additional nonbreast cancer diagnoses, and patients with a history of breast cancer. Breast conservation was defined as axillary node dissection with radiation therapy, without breast surgery. We evaluated patient, tumor, treatment, and outcome variables. Patients were assessed for local, regional, and distant recurrences. Overall survival was calculated using the Kaplan-Meier method. Thirty-six patients met criteria for occult breast cancer. Most of these patients (77.8 %) had N1 disease. Fifty percent of cancers (n = 18) were estrogen receptor-positive; 12 (33.3 %) were triple-negative. All patients were evaluated with mammography. Thirty-five patients had breast ultrasound (97.2 %) and 33 (91.7 %) had an MRI. Thirty-four patients (94.4 %) were treated with chemotherapy and 33 (91.7 %) with radiotherapy. Twenty-seven patients (75.0 %) were treated with breast conservation. The median follow-up was 64 months. There were no local or regional failures. One distant recurrence occurred >5 years after diagnosis, resulting in a 5-years overall survival rate of 100 %. There were no significant survival differences between patients receiving breast conservation versus mastectomy (p = 0.7). Breast conservation-performed with contemporary imaging and multimodality treatment-provides excellent local control and survival for women with T0N+ breast cancer and can be safely offered instead of mastectomy.

Assessment of Common Anaesthetic and Clinical Indices of Multimodal Therapy of Propofol, Xylazine, and Ketamine in Total Intravenous Anaesthesia in West African Dwarf Goat

Directory of Open Access Journals (Sweden)

Ukwueze Celestine Okwudili

2014-01-01

Full Text Available The assessment of anaesthetic and clinical indices of multimodal therapy of propofol, xylazine, and ketamine was done in West African Dwarf (WAD goat. Sixteen healthy male WAD goats were assigned into four treatment groups, namely, control (group A (ketamine 5 mg/kg + xylazine 0.05 mg/kg, group B (propofol 5 mg/kg + xylazine 0.05 mg/kg, group C (propofol 5 mg/kg + ketamine 5 mg/kg, and group D (propofol 2.5 mg/kg + ketamine 2.5 mg/kg + xylazine 0.05 mg/kg. All drugs were administered intravenously. The multimodal therapy decreased significantly (P<0.05 the heart rate in groups A, B, and D. Also respiratory rate significantly (P<0.05 decreased in groups A, B, and D but significantly (P<0.05 increased at 20 min after induction in group C. However, temperature significantly (P<0.05 decreased in groups A, B, and C. The induction was good and smooth in groups B and D. Surgical anaesthetic time was longer in groups B and D and shorter in group C. The quality of recovery was good in groups B and D. Side effects such as salivation and apnoea were observed in all groups. In conclusion, the multimodal therapy could be used successfully. However, group D could be the best combination considering the parameters measured.

Multimodal strategies to improve surgical outcome

DEFF Research Database (Denmark)

Kehlet, Henrik; Wilmore, Douglas W

2002-01-01

OBJECTIVE: To evaluate the effect of modifying perioperative care in noncardiac surgical patients on morbidity, mortality, and other outcome measures. BACKGROUND: New approaches in pain control, introduction of techniques that reduce the perioperative stress response, and the more frequent use...... anesthesia in elective operations, and pilot studies of fast track surgical procedures using the multimodality approach. RESULTS: The introduction of newer approaches to perioperative care has reduced both morbidity and mortality in surgical patients. In the future, most elective operations will become day...... surgical procedures or require only 1 to 2 days of postoperative hospitalization. Reorganization of the perioperative team (anesthesiologists, surgeons, nurses, and physical therapists) will be essential to achieve successful fast track surgical programs. CONCLUSIONS: Understanding perioperative...

Multimodal Feature Learning for Video Captioning

Directory of Open Access Journals (Sweden)

Sujin Lee

2018-01-01

Full Text Available Video captioning refers to the task of generating a natural language sentence that explains the content of the input video clips. This study proposes a deep neural network model for effective video captioning. Apart from visual features, the proposed model learns additionally semantic features that describe the video content effectively. In our model, visual features of the input video are extracted using convolutional neural networks such as C3D and ResNet, while semantic features are obtained using recurrent neural networks such as LSTM. In addition, our model includes an attention-based caption generation network to generate the correct natural language captions based on the multimodal video feature sequences. Various experiments, conducted with the two large benchmark datasets, Microsoft Video Description (MSVD and Microsoft Research Video-to-Text (MSR-VTT, demonstrate the performance of the proposed model.

Compressive multi-mode superresolution display

KAUST Repository

Heide, Felix

2014-01-01

Compressive displays are an emerging technology exploring the co-design of new optical device configurations and compressive computation. Previously, research has shown how to improve the dynamic range of displays and facilitate high-quality light field or glasses-free 3D image synthesis. In this paper, we introduce a new multi-mode compressive display architecture that supports switching between 3D and high dynamic range (HDR) modes as well as a new super-resolution mode. The proposed hardware consists of readily-available components and is driven by a novel splitting algorithm that computes the pixel states from a target high-resolution image. In effect, the display pixels present a compressed representation of the target image that is perceived as a single, high resolution image. © 2014 Optical Society of America.

Exploring Multimodal Registers in and Across Organizations and Institutional Fields

DEFF Research Database (Denmark)

Meyer, Renate; Jancsary, Dennis; Höllerer, Markus

In this article, we develop methodology that enables a systematic analysis of the structuralaspects of multimodal discourse from larger amounts of data. While existing research in visualorganization studies has provided interesting insights into the content and meaning(s) of visualand multimodal ......Responsibility (CSR), a complex and multivocal management idea that touches a variety oftopics and incorporates multiple levels of audience engagement with regard to a substantialdiversity of audiences....

Approaching Athenian Graffiti as a Multimodal Genre with GIS Application

OpenAIRE

Stampoulidis, Georgios

2017-01-01

Graffiti as an ever-changing form of urban art and visual communication is naturally multimodal, focusing on text–image relations (Bateman 2014; Forceville 2008; Kress 2006), which owe their existence mainly to the sociocultural and historical knowledge of the represented world of our experience – Husserlian Lebenswelt [Lifeworld] (Sonesson 2008; 2015). These relations constitute an interesting challenge to multimodal interpretations, because both verbal and/or pictorial representations can i...

Multimodal human-machine interaction for service robots in home-care environments

OpenAIRE

Goetze, Stefan; Fischer, S.; Moritz, Niko; Appell, Jens-E.; Wallhoff, Frank

2012-01-01

This contribution focuses on multimodal interaction techniques for a mobile communication and assistance system on a robot platform. The system comprises of acoustic, visual and haptic input modalities. Feedback is given to the user by a graphical user interface and a speech synthesis system. By this, multimodal and natural communication with the robot system is possible.

Multimodal imaging of vascular network and blood microcirculation by optical diagnostic techniques

International Nuclear Information System (INIS)

Kuznetsov, Yu L; Kalchenko, V V; Meglinski, I V

2011-01-01

We present a multimodal optical diagnostic approach for simultaneous non-invasive in vivo imaging of blood and lymphatic microvessels, utilising a combined use of fluorescence intravital microscopy and a method of dynamic light scattering. This approach makes it possible to renounce the use of fluorescent markers for visualisation of blood vessels and, therefore, significantly (tenfold) reduce the toxicity of the technique and minimise side effects caused by the use of contrast fluorescent markers. We demonstrate that along with the ability to obtain images of lymph and blood microvessels with a high spatial resolution, current multimodal approach allows one to observe in real time permeability of blood vessels. This technique appears to be promising in physiology studies of blood vessels, and especially in the study of peripheral cardiovascular system in vivo. (optical technologies in biophysics and medicine)

Arbitrary-ratio power splitter based on nonlinear multimode interference coupler

International Nuclear Information System (INIS)

Tajaldini, Mehdi; Jafri, Mohd Zubir Mat

2015-01-01

We propose an ultra-compact multimode interference (MMI) power splitter based on nonlinear effects from simulations using nonlinear modal propagation analysis (NMPA) cooperation with finite difference Method (FDM) to access free choice of splitting ratio. Conventional multimode interference power splitter could only obtain a few discrete ratios. The power splitting ratio may be adjusted continuously while the input set power is varying by a tunable laser. In fact, using an ultra- compact MMI with a simple structure that is launched by a tunable nonlinear input fulfills the problem of arbitrary-ratio in integrated photonics circuits. Silicon on insulator (SOI) is used as the offered material due to the high contrast refractive index and Centro symmetric properties. The high-resolution images at the end of the multimode waveguide in the simulated power splitter have a high power balance, whereas access to a free choice of splitting ratio is not possible under the linear regime in the proposed length range except changes in the dimension for any ratio. The compact dimensions and ideal performance of the device are established according to optimized parameters. The proposed regime can be extended to the design of M×N arbitrary power splitters ratio for programmable logic devices in all optical digital signal processing. The results of this study indicate that nonlinear modal propagation analysis solves the miniaturization problem for all-optical devices based on MMI couplers to achieve multiple functions in a compact planar integrated circuit and also overcomes the limitations of previously proposed methods for nonlinear MMI

Arbitrary-ratio power splitter based on nonlinear multimode interference coupler

Energy Technology Data Exchange (ETDEWEB)

Tajaldini, Mehdi [School of Physics, Universiti Sains Malaysia, 11800 Pulau Pinang (Malaysia); Young Researchers and Elite Club, Baft Branch, Islamic Azad University, Baft (Iran, Islamic Republic of); Jafri, Mohd Zubir Mat [School of Physics, Universiti Sains Malaysia, 11800 Pulau Pinang (Malaysia)

2015-04-24

We propose an ultra-compact multimode interference (MMI) power splitter based on nonlinear effects from simulations using nonlinear modal propagation analysis (NMPA) cooperation with finite difference Method (FDM) to access free choice of splitting ratio. Conventional multimode interference power splitter could only obtain a few discrete ratios. The power splitting ratio may be adjusted continuously while the input set power is varying by a tunable laser. In fact, using an ultra- compact MMI with a simple structure that is launched by a tunable nonlinear input fulfills the problem of arbitrary-ratio in integrated photonics circuits. Silicon on insulator (SOI) is used as the offered material due to the high contrast refractive index and Centro symmetric properties. The high-resolution images at the end of the multimode waveguide in the simulated power splitter have a high power balance, whereas access to a free choice of splitting ratio is not possible under the linear regime in the proposed length range except changes in the dimension for any ratio. The compact dimensions and ideal performance of the device are established according to optimized parameters. The proposed regime can be extended to the design of M×N arbitrary power splitters ratio for programmable logic devices in all optical digital signal processing. The results of this study indicate that nonlinear modal propagation analysis solves the miniaturization problem for all-optical devices based on MMI couplers to achieve multiple functions in a compact planar integrated circuit and also overcomes the limitations of previously proposed methods for nonlinear MMI.

User habits and multimodal route planning

Directory of Open Access Journals (Sweden)

Géza Katona

2017-10-01

Full Text Available The results of route planning researches are monitored by logistic and automotive industries. The economic aspects of the cost saving are in the focus of the attention. An optimal route could cause time or fuel savings. An effective driving or an optimal route is a good basis to achieve an economical aim. Moreover the spread of new automotive solutions especially in case of electric cars the optimisation has particular significance regarding the limited battery storage. Additionally the autonomous car development could not be neglected. As a result the society could expect safer roads, better space usage and effective resource management. Nevertheless the requirements of users are extremely diverse, which is not negligible. Supporting these aims, in this paper the connection between the multimodal route planning and the user requirements are investigated. The examination is focused to a sensitivity analysis and a survey to evaluate the data and support the settings of a user habit effect to the final route.

Structure with improved self-imaging in its graded-index multimode interference region

International Nuclear Information System (INIS)

Yin Rui; Jiang Xiaoqing; Yang Jianyi; Wang Minghua

2002-01-01

Propagation constant errors (PCEs) of guided modes in regions of multimode interference in optical networks were analyzed. Results show that a graded-index waveguide can effectively decrease the PCEs. An example based on an exponential function is presented. Numerical results show that addition of a graded-index waveguide greatly improves device performance in this structure

Bi-objective optimization for multi-modal transportation routing planning problem based on Pareto optimality

Directory of Open Access Journals (Sweden)

Yan Sun

2015-09-01

Full Text Available Purpose: The purpose of study is to solve the multi-modal transportation routing planning problem that aims to select an optimal route to move a consignment of goods from its origin to its destination through the multi-modal transportation network. And the optimization is from two viewpoints including cost and time. Design/methodology/approach: In this study, a bi-objective mixed integer linear programming model is proposed to optimize the multi-modal transportation routing planning problem. Minimizing the total transportation cost and the total transportation time are set as the optimization objectives of the model. In order to balance the benefit between the two objectives, Pareto optimality is utilized to solve the model by gaining its Pareto frontier. The Pareto frontier of the model can provide the multi-modal transportation operator (MTO and customers with better decision support and it is gained by the normalized normal constraint method. Then, an experimental case study is designed to verify the feasibility of the model and Pareto optimality by using the mathematical programming software Lingo. Finally, the sensitivity analysis of the demand and supply in the multi-modal transportation organization is performed based on the designed case. Findings: The calculation results indicate that the proposed model and Pareto optimality have good performance in dealing with the bi-objective optimization. The sensitivity analysis also shows the influence of the variation of the demand and supply on the multi-modal transportation organization clearly. Therefore, this method can be further promoted to the practice. Originality/value: A bi-objective mixed integer linear programming model is proposed to optimize the multi-modal transportation routing planning problem. The Pareto frontier based sensitivity analysis of the demand and supply in the multi-modal transportation organization is performed based on the designed case.

Adhesion of multimode adhesives to enamel and dentin after one year of water storage.

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Vermelho, Paulo Moreira; Reis, André Figueiredo; Ambrosano, Glaucia Maria Bovi; Giannini, Marcelo

2017-06-01

This study aimed to evaluate the ultramorphological characteristics of tooth-resin interfaces and the bond strength (BS) of multimode adhesive systems to enamel and dentin. Multimode adhesives (Scotchbond Universal (SBU) and All-Bond Universal) were tested in both self-etch and etch-and-rinse modes and compared to control groups (Optibond FL and Clearfil SE Bond (CSB)). Adhesives were applied to human molars and composite blocks were incrementally built up. Teeth were sectioned to obtain specimens for microtensile BS and TEM analysis. Specimens were tested after storage for either 24 h or 1 year. SEM analyses were performed to classify the failure pattern of beam specimens after BS testing. Etching increased the enamel BS of multimode adhesives; however, BS decreased after storage for 1 year. No significant differences in dentin BS were noted between multimode and control in either evaluation period. Storage for 1 year only reduced the dentin BS for SBU in self-etch mode. TEM analysis identified hybridization and interaction zones in dentin and enamel for all adhesives. Silver impregnation was detected on dentin-resin interfaces after storage of specimens for 1 year only with the SBU and CSB. Storage for 1 year reduced enamel BS when adhesives are applied on etched surface; however, BS of multimode adhesives did not differ from those of the control group. In dentin, no significant difference was noted between the multimode and control group adhesives, regardless of etching mode. In general, multimode adhesives showed similar behavior when compared to traditional adhesive techniques. Multimode adhesives are one-step self-etching adhesives that can also be used after enamel/dentin phosphoric acid etching, but each product may work better in specific conditions.

A 10-Week Multimodal Nutrition Education Intervention Improves Dietary Intake among University Students: Cluster Randomised Controlled Trial

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Mohd Razif Shahril

2013-01-01

Full Text Available The aim of the study was to evaluate the effectiveness of implementing multimodal nutrition education intervention (NEI to improve dietary intake among university students. The design of study used was cluster randomised controlled design at four public universities in East Coast of Malaysia. A total of 417 university students participated in the study. They were randomly selected and assigned into two arms, that is, intervention group (IG or control group (CG according to their cluster. The IG received 10-week multimodal intervention using three modes (conventional lecture, brochures, and text messages while CG did not receive any intervention. Dietary intake was assessed before and after intervention and outcomes reported as nutrient intakes as well as average daily servings of food intake. Analysis of covariance (ANCOVA and adjusted effect size were used to determine difference in dietary changes between groups and time. Results showed that, compared to CG, participants in IG significantly improved their dietary intake by increasing their energy intake, carbohydrate, calcium, vitamin C and thiamine, fruits and 100% fruit juice, fish, egg, milk, and dairy products while at the same time significantly decreased their processed food intake. In conclusion, multimodal NEI focusing on healthy eating promotion is an effective approach to improve dietary intakes among university students.

Cardiac risks in multimodal breast cancer treatment

Energy Technology Data Exchange (ETDEWEB)

Budach, W. [Dept. of Radiation Oncology, Univ. of Duesseldorf (Germany)

2007-12-15

Almost all breast cancer patients receive one or more adjuvant treatments consisting of tamoxifen, aromatase inhibitors, LHRH-antogonists, chemotherapy, trastuzumab, and radiotherapy. These treatments have been shown to considerably improve overall survival. As a result, long term survival for 15 and more years is achieved in more than two thirds of newly diagnosed breast cancer patients. Therefore, more interest in short and long term risks of adjuvant treatments has been arisen. The focus of this article is the long term cardiac risks of adjuvant radiotherapy in breast cancer patients and possible interactions with chemotherapy and trastuzumab. (orig.)

Multimodality imaging in macular telangiectasia 2: A clue to its pathogenesis

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Lihteh Wu

2015-01-01

Full Text Available Macular telangiectasia type 2 also known as idiopathic perifoveal telangiectasia and juxtafoveolar retinal telangiectasis type 2A is an acquired bilateral neurodegenerative macular disease that manifests itself during the fifth or sixth decades of life. It is characterized by minimal dilatation of the parafoveal capillaries with graying of the retinal area involved, a lack of lipid exudation, right-angled retinal venules, refractile deposits in the superficial retina, hyperplasia of the retinal pigment epithelium, foveal atrophy, and subretinal neovascularization (SRNV. Our understanding of the disease has paralleled advances in multimodality imaging of the fundus. Optical coherence tomography (OCT images typically demonstrate the presence of intraretinal hyporeflective spaces that are usually not related to retinal thickening or fluorescein leakage. The typical fluorescein angiographic (FA finding is a deep intraretinal hyperfluorescent staining in the temporal parafoveal area. With time, the staining may involve the whole parafoveal area but does not extend to the center of the fovea. Long-term prognosis for central vision is poor, because of the development of SRNV or macular atrophy. Its pathogenesis remains unclear but multimodality imaging with FA, spectral domain OCT, adaptive optics, confocal blue reflectance and short wave fundus autofluorescence implicate Müller cells and macular pigment. Currently, there is no known treatment for this condition.

Alternative modalities – A Review of Graphic Encounters: Comics and the Sponsorship of Multimodal Literacy

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Aaron Scott Humphrey

2014-05-01

Full Text Available Research exploring the multimodal characteristics of comics has recently flourished, and Dale Jacobs has been one of the early prolific authors on this topic. Jacobs expands these ideas further in 'Graphic Encounters: Comics and the Sponsorship of Multimodal Literacy', a monograph which engages with theories of multimodality, but shifts its focus primarily to literacy sponsorship.

Analysis and synthesis of multi-qubit, multi-mode quantum devices

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Solgun, Firat

2015-03-27

In this thesis we propose new methods in multi-qubit multi-mode circuit quantum electrodynamics (circuit-QED) architectures. First we describe a direct parity measurement method for three qubits, which can be realized in 2D circuit-QED with a possible extension to four qubits in a 3D circuit-QED setup for the implementation of the surface code. In Chapter 3 we show how to derive Hamiltonians and compute relaxation rates of the multi-mode superconducting microwave circuits consisting of single Josephson junctions using an exact impedance synthesis technique (the Brune synthesis) and applying previous formalisms for lumped element circuit quantization. In the rest of the thesis we extend our method to multi-junction (multi-qubit) multi-mode circuits through the use of state-space descriptions which allows us to quantize any multiport microwave superconducting circuit with a reciprocal lossy impedance response.

A Literature Review On Multimodal Freight Transportation Planning Under Disruptions

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Rosyida, E. E.; Santosa, B.; Pujawan, I. N.

2018-04-01

This paper reviews publication that focuses on multimodal freight transportation planning under disruptions. In this paper, disruptions are specified by the level of the disruptions occurs and the scope of its effect. This becomes an important distinction since the cause and effect that may occur at different levels. The failure to make this distinction has implications for how we understand and manage. The reviewed papers include those that develop framework, model, and technical procedure for freight transportation. Finally, we provide an outlook of future research directions on the domain of transportation planning.

Drug-related webpages classification based on multi-modal local decision fusion

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Hu, Ruiguang; Su, Xiaojing; Liu, Yanxin

2018-03-01

In this paper, multi-modal local decision fusion is used for drug-related webpages classification. First, meaningful text are extracted through HTML parsing, and effective images are chosen by the FOCARSS algorithm. Second, six SVM classifiers are trained for six kinds of drug-taking instruments, which are represented by PHOG. One SVM classifier is trained for the cannabis, which is represented by the mid-feature of BOW model. For each instance in a webpage, seven SVMs give seven labels for its image, and other seven labels are given by searching the names of drug-taking instruments and cannabis in its related text. Concatenating seven labels of image and seven labels of text, the representation of those instances in webpages are generated. Last, Multi-Instance Learning is used to classify those drugrelated webpages. Experimental results demonstrate that the classification accuracy of multi-instance learning with multi-modal local decision fusion is much higher than those of single-modal classification.

Body-insensitive Multi-Mode MIMO Terminal Antenna of Double-Ring Structure

DEFF Research Database (Denmark)

Zhao, Kun; Zhang, Shuai; Ishimiya, Katsunori

2015-01-01

of mobile terminals. With the multimode excitation, the MIMO cellular antenna can operate at 830-900 MHz, 1700-2200 MHz, and 2400-2700 MHz, for 2G, 3G, and LTE bands, respectively. The MIMO Wi-Fi antenna can cover two Wi-Fi bands from 2.4 to 2.5 GHz and from 5.2 to 5.8 GHz. The effect of a user's body......In this paper, we propose a novel multimode multi-input multi-output (MIMO) antenna system composed of a dual-element MIMO cellular antenna and dual-element MIMO Wi-Fi antenna for mobile terminal applications. The antenna system has a double-ring structure and can be integrated with the metal frame...... on the MIMO cellular antenna is investigated on CTIA standard phantoms and a real user. Since our antenna mainly operates in the loop mode, it has a much lower efficiency loss than conventional mobile antennas in both talking and data modes. Our theoretical analysis and experiments have shown that our design...

Experimental Study on Bioluminescence Tomography with Multimodality Fusion

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Yujie Lv

2007-01-01

Full Text Available To verify the influence of a priori information on the nonuniqueness problem of bioluminescence tomography (BLT, the multimodality imaging fusion based BLT experiment is performed by multiview noncontact detection mode, which incorporates the anatomical information obtained by the microCT scanner and the background optical properties based on diffuse reflectance measurements. In the reconstruction procedure, the utilization of adaptive finite element methods (FEMs and a priori permissible source region refines the reconstructed results and improves numerical robustness and efficiency. The comparison between the absence and employment of a priori information shows that multimodality imaging fusion is essential to quantitative BLT reconstruction.

Multimodal medical information retrieval with unsupervised rank fusion.

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Mourão, André; Martins, Flávio; Magalhães, João

2015-01-01

Modern medical information retrieval systems are paramount to manage the insurmountable quantities of clinical data. These systems empower health care experts in the diagnosis of patients and play an important role in the clinical decision process. However, the ever-growing heterogeneous information generated in medical environments poses several challenges for retrieval systems. We propose a medical information retrieval system with support for multimodal medical case-based retrieval. The system supports medical information discovery by providing multimodal search, through a novel data fusion algorithm, and term suggestions from a medical thesaurus. Our search system compared favorably to other systems in 2013 ImageCLEFMedical. Copyright © 2014 Elsevier Ltd. All rights reserved.

Current and future multimodal learning analytics data challenges

DEFF Research Database (Denmark)

Spikol, Daniel; Prieto, Luis P.; Rodriguez-Triana, M.J.

2017-01-01

Multimodal Learning Analytics (MMLA) captures, integrates and analyzes learning traces from different sources in order to obtain a more holistic understanding of the learning process, wherever it happens. MMLA leverages the increasingly widespread availability of diverse sensors, high......-frequency data collection technologies and sophisticated machine learning and artificial intelligence techniques. The aim of this workshop is twofold: first, to expose participants to, and develop, different multimodal datasets that reflect how MMLA can bring new insights and opportunities to investigate complex...... learning processes and environments; second, to collaboratively identify a set of grand challenges for further MMLA research, built upon the foundations of previous workshops on the topic....

Multimodal Teacher Input and Science Learning in a Middle School Sheltered Classroom

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Zhang, Ying

2016-01-01

This article reports the results of an ethnographic research about the multimodal science discourse in a sixth-grade sheltered classroom involving English Language Learners (ELLs) only. Drawing from the perspective of multimodality, this study examines how science learning is constructed in science lectures through multiple semiotic resources,…

Feasibility Study of Increasing Multimodal Interaction between Private and Public Transport Based on the Use of Intellectual Transport Systems and Services

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Ulrich Weidmann

2011-04-01

Full Text Available The introduction of intellectual transport systems and services (ITS into the public and private transport sectors is closely connected with the development of multimodality in transport system (particularly, in towns and their suburbs. Taking into consideration the problems of traffic jams, the need for increasing the efficiency of power consumption and reducing the amount of burnt gases ejected into the air and the harmful effect of noise, the use of multimodal transport concept has been growing fast recently in most cities. It embraces a system of integrated tickets, the infrastructure, allowing a passenger to leave a car or a bike near a public transport station and to continue his/her travel by public transport (referred to as ‘Park&Ride’, ‘Bike&Ride’, as well as, real-time information system, universal design, and computer-aided traffic control. These concepts seem to be even more effective, when multimodal intellectual transport systems and services (ITS are introduced. In Lithuania, ITS is not widely used in passenger transportation, though its potential is great, particularly, taking into consideration the critical state of the capacity of public transport infrastructure. The paper considers the possibilities of increasing the effectiveness of public transport system ITS by increasing its interaction with private transport in the context of multimodal concept realization.Article in Lithuanian

Palmprint and face multi-modal biometric recognition based on SDA-GSVD and its kernelization.

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Jing, Xiao-Yuan; Li, Sheng; Li, Wen-Qian; Yao, Yong-Fang; Lan, Chao; Lu, Jia-Sen; Yang, Jing-Yu

2012-01-01

When extracting discriminative features from multimodal data, current methods rarely concern themselves with the data distribution. In this paper, we present an assumption that is consistent with the viewpoint of discrimination, that is, a person's overall biometric data should be regarded as one class in the input space, and his different biometric data can form different Gaussians distributions, i.e., different subclasses. Hence, we propose a novel multimodal feature extraction and recognition approach based on subclass discriminant analysis (SDA). Specifically, one person's different bio-data are treated as different subclasses of one class, and a transformed space is calculated, where the difference among subclasses belonging to different persons is maximized, and the difference within each subclass is minimized. Then, the obtained multimodal features are used for classification. Two solutions are presented to overcome the singularity problem encountered in calculation, which are using PCA preprocessing, and employing the generalized singular value decomposition (GSVD) technique, respectively. Further, we provide nonlinear extensions of SDA based multimodal feature extraction, that is, the feature fusion based on KPCA-SDA and KSDA-GSVD. In KPCA-SDA, we first apply Kernel PCA on each single modal before performing SDA. While in KSDA-GSVD, we directly perform Kernel SDA to fuse multimodal data by applying GSVD to avoid the singular problem. For simplicity two typical types of biometric data are considered in this paper, i.e., palmprint data and face data. Compared with several representative multimodal biometrics recognition methods, experimental results show that our approaches outperform related multimodal recognition methods and KSDA-GSVD achieves the best recognition performance.

Palmprint and Face Multi-Modal Biometric Recognition Based on SDA-GSVD and Its Kernelization

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