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At least 451 records · Page 25Linked to original sources
PubMed2005

Fabrication of multimode interference waveguides in glass by use of a femtosecond laser.

We report on the fabrication of multimode interference (MMI) waveguides that split single-mode light into multimode light in synthesized silica by use of femtosecond laser pulses. The number of modes at the output facet is dependent on both the width and the length of the MMI waveguides. The output spectral responses of the MMI waveguides in the visible region were examined. The fabricated MMI waveguides can be used as compact power splitters with large fan-outs.

Journal Article↗
PubMed2006

Multiple parameter vector bending and high-temperature sensors based on asymmetric multimode fiber Bragg gratings inscribed by an infrared femtosecond laser.

We present a multiple parameter integrated fiber sensor that can detect vector bending and ambient temperature simultaneously with a single asymmetric multimode fiber Bragg grating. Multimode Bragg gratings were fabricated in an all-silica core fiber by an infrared femtosecond laser, which showed multiple transmission dips in the transmission spectrum. Bending and ambient temperature fluctuations affect the shapes of multiple transmission dips in different ways. In bending, different dips have different sensitivities. On the other hand, temperature fluctuations tended to influence the dips uniformly across different dips. By analyzing the changing spectrum of dips, one can distinguish the changes induced by bending or temperature fluctuations. Furthermore, the high thermal stability of Bragg gratings inscribed by an infrared femtosecond laser can make this double parameter fiber sensor work in very harsh, high-temperature environments.

Journal Article↗
PubMed2006

High-speed data transmission over a 1 km broad wavelength window multimode fiber.

For cost and design simplicity, various optical network architectures have been proposed in which downstream traffic from the optical line terminal to the optical networking unit is transmitted by carriers in the 1550 nm window, and upstream traffic by those in the 1300 nm window. A new generation of multimode fiber (MMF) has been designed to accommodate this requirement and to address technical challenges associated with fiber coupling. By restricting the number of modes at both fiber input and output, using off-the-shelf single-mode transceivers, single-wavelength 40 Gbit/s data transmission over a 1 km broad wavelength window multimode fiber has been demonstrated with only a 1.5 dB power penalty. The capacity in this new class of MMF is expected to increase with conventional technologies in single-mode fiber such as wavelength-division multiplexing and polarization multiplexing.

Journal Article↗
PubMed1993

Extrapleural pneumonectomy in the setting of a multimodality approach to malignant mesothelioma.

The use of extrapleural pneumonectomy in a multimodality treatment setting for malignant pleural mesothelioma is described, presenting first the right-sided approach and then the left-sided. This technique used in a multimodality approach with CAP chemotherapy (cyclophosphamide 600 mg/m2, doxorubicin 60 mg/m2, cisplatin 75 mg/m2) 5 cycles at 3-week intervals, and radiotherapy (55 Gy radiation to sites of previous bulky disease or residual disease) to treat 44 patients with malignant pleural mesothelioma resulted in improved operative mortality and decreased length of hospital stay.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2004

Multimodal treatment strategies combining neoadjuvant hormonal therapy and/or chemotherapy with radical prostatectomy in high-risk localised prostate cancer.

By combining the readily available clinical parameters of tumour stage, Gleason score of the diagnostic biopsy specimen and serum prostate-specific antigen level, men with newly diagnosed prostate cancer can be assessed as to their risk of treatment failure after radiotherapy or radical prostatectomy. For men considered to be at high-risk of treatment failure after local therapy alone, multimodal treatment strategies may result in improved cancer-control outcomes. This strategy has proven effective in the setting of clinical stage T3 - T4 tumours in which the combination of radiotherapy followed by hormonal therapy has improved patient survival. The benefit of neoadjuvant or adjuvant hormonal and/or chemotherapy followed by radical prostatectomy in this setting is unclear but is the subject of ongoing or planned Phase III clinical trials. These studies will help examine the role of multimodal treatment strategies in these high-risk patients.

Antineoplastic Agents, Hormonal↗
PubMed2003

High-risk localised prostate cancer: multimodal treatment strategies combining neoadjuvant hormonal therapy and/or chemotherapy with radical prostatectomy.

For patients with newly diagnosed prostate cancer, clinical tumour stage, Gleason score of the diagnostic biopsy specimen and serum prostate-specific antigen (PSA) level can be combined to identify a group of men at increased risk of treatment failure after radiotherapy or radical prostatectomy. For these high-risk, but still clinically localised prostate cancers, multimodal treatment strategies may result in improved cancer control outcomes. Indeed, in the setting of clinical stage T3 - T4 tumours, the combination of radiotherapy followed by hormonal therapy has improved patient survival. The benefits of adjuvant or neoadjuvant hormonal and/or chemotherapy followed by radical prostatectomy in this setting are unclear, but are the subject of ongoing or planned Phase III clinical trials. These studies will help define the role of multimodal treatment strategies in this high-risk patient population.

Antineoplastic Agents, Hormonal↗
PubMed2006

A multimodal analgesia protocol for total knee arthroplasty. A randomized, controlled study.

BACKGROUND: Although numerous methods of postoperative analgesia have been investigated in an attempt to improve pain control after total knee arthroplasty, parenteral narcotics still play a major role in postoperative pain management. Local anesthetics have the advantage of blocking pain conduction at its origin and minimizing the systemic side effects associated with postoperative narcotic use. This study was performed to evaluate the benefits and safety of a multimodal analgesia protocol that included periarticular injection of large doses of local anesthetics in patients undergoing total knee arthroplasty. METHODS: We compared morphine consumption during the first twenty-four hours after unilateral total knee arthroplasty in forty-two patients who had been randomized to receive either (1) a perioperative infiltration mixture, consisting principally of local anesthetic, and self-administered morphine or (2) self-administered morphine only. Narcotics consumption, pain control, medication-related side effects, plasma levels of the local anesthetic (ropivacaine), and postoperative rehabilitation were monitored. RESULTS: Although there was high satisfaction and good pain control in both groups, morphine consumption was significantly lower in the local analgesia group than it was in the control group (28.8 +/- 17.4 mg compared with 50.3 +/- 25.4 mg twenty-four hours after surgery, and 46.7 +/- 19.4 mg compared with 68.6 +/- 38.6 mg forty hours after surgery). Both groups achieved a similar amount of knee flexion on the fifth postoperative day. Over the five-day period after the procedure, the patients in the local analgesia group reported a total of 2.6 +/- 3.9 hours of nausea compared with 7.1 +/- 12.2 hours in the control group. No complications related to the infiltration of the local anesthetic were observed, and all plasma concentrations of the local anesthetic were below the toxic range. CONCLUSIONS: This multimodal perioperative analgesia protocol that included infiltration of a local anesthetic offered improved pain control and minimal side effects to patients undergoing total knee arthroplasty. Our study also confirmed the safety of the protocol.

Analgesia, Patient-Controlled↗
PubMed2003

Successful treatment of limited disease-small cell lung cancer with multimodality treatment consisting of concurrent chemoradiotherapy, high-dose chemotherapy with autologous peripheral blood stem cell transplantation and surgical resection.

A 65-year-old man with limited disease-small cell lung cancer was treated with concurrent chemoradiotherapy which resulted in a partial response. He further received high-dose chemotherapy with autologous peripheral blood stem cell transplantation. Development of non-small cell carcinoma was, however, suspected at a site of the residual nodule in cytological examination using bronchoscopy. He then underwent lobectomy, which revealed that the nodule was composed of necrotic tissue. He has been alive without recurrence for seven years. This multimodality treatment appeared to be effective for this patient. However, further investigation is necessary to clarify the role of multimodality treatment.

Aged↗
PubMed1994

Effect of multimodal stimulus presentation on recall.

This study was conducted to investigate how the mode of stimulus presentation affects recall in the classroom environment. 289 undergraduates were randomly assigned to one of 7 experimental groups. All subjects were presented the same stimuli in one of 7 possible modes: (1) Printed Word, (2) Spoken Word, (3) Picture, (4) Printed Word + Spoken Word, (5) Picture + Spoken Word, (6) Picture + Printed Word, and (7) Printed Word, Picture + Spoken Word. 30 words, 6 from each of 5 categories, were presented to each group. A new stimulus was presented every 5 sec. Subjects were to recall (in writing) as many stimuli as possible in 5 min. regardless of order. One-way between groups analyses of variance were conducted on recall and cluster index scores. A significant main effect of mode of presentation showed that recall was best for the Picture or multimodal group (Printed Word, Picture + Spoken Word). Groups receiving only the spoken or printed word showed significantly poorer recall than the multimodal groups. No statistically significant differences between groups were found on the cluster index score. It appears that the simultaneous presentation of redundant stimuli in multiple modalities does support the multiple-resource hypothesis by displaying enhanced recall when information is available from multiple attentional resources.

Adolescent↗
PubMed1991

Conventional diagnostic nomenclature versus multimodal assessment.

Standard psychiatric diagnoses (e.g., DSM-III-R) are compared with multimodal assessment and problem identification (i.e., BASIC I.D. formulations. Two case comparisons are presented as an heuristic to illustrate the way in which the multimodal framework promotes diagnostic precision and enhances clinical decision-making.

Depressive Disorder↗
PubMed1995

A multimodal therapy approach to treatment of Borderline Personality Disorder: a case study.

Agitated behaviour and poor coping skills in a patient with Borderline Personality Disorder who resided on a forensic psychiatry unit were treated using cognitive-behavioural and pharmacological interventions derived from a multimodal assessment. While a medication regime led to partial clinical improvement, the addition of interventions derived from the multimodal assessment over 9 wk. led to sufficient improvement in agitated behaviour, suicidal ideas and behaviour, and frequency of seclusions to allow transfer to the rehabilitation unit. Further supportive treatment led to continued improvement on these measures and to reduction in use of requested medication.

Acting Out↗
PubMed1977

Evaluation of brain function in severe human head trauma with multimodality evoked potentials. Part 1: Evoked brain-injury potentials, methods, and analysis.

Methods for obtaining multimodality evoked potentials, somatosensory, visual, auditory, and auditory brain-stem potentials in patients with severe head trauma are described. A method of analyzing abnormal multimodality evoked potentials (graded evoked brain-injury potentials) is proposed that defines the degree of abnormality of the electrophysiological data and expresses it simply in four grades per modality. Data from 20 normal subjects are given for comparison with the abnormal data obtained from 51 patients with head trauma.

Acoustic Stimulation↗
PubMed2002

Stereotactic radiosurgery for pilocytic astrocytomas when multimodal therapy is necessary.

OBJECT: The goal of this study was to examine the role of stereotactic radiosurgery in the treatment of patients with recurrent or unresectable pilocytic astrocytomas. METHODS: During a 13-year interval, 37 patients (median age 14 years) required multimodal treatment of recurrent or unresectable pilocytic astrocytomas. Tumors involved the brainstem in 18 patients, cerebellum in three, thalamus in five, temporal lobe in four, and parietal lobe in two, as well as the hypothalamus, optic tract, corpus callosum, insular cortex, and third ventricle in one patient each. Diagnosis was confirmed with the aid of stereotactic biopsy in 12 patients, open biopsy in five, partial resection in eight, and near-total resection in 12. Multimodal treatment included fractionated radiation therapy in 10 patients, stereotactic intracavitary irradiation of tumor in four, chemotherapy in two, cyst drainage in six, ventriculoperitoneal shunt placement in three, and additional cytoreductive surgery in four. Tumor volumes varied from 0.42 to 25 cm3. The median radiosurgical dose to the tumor margin was 15 Gy (range 9.6-22.5 Gy). After radiosurgery, serial imaging demonstrated complete tumor resolution in 10 patients, reduced tumor volume in eight, stable tumor volume in seven, and delayed tumor progression in 12. No procedure-related death was encountered. Thirty-three (89%) of 37 patients are alive at a median follow-up period of 28 months after radiosurgery and 59 months after diagnosis. Eight patients participated in follow-up review for more than 60 months. Three patients died of local tumor progression. CONCLUSIONS: Stereotactic radiosurgery is a valuable adjunctive strategy in the management of recurrent or unresectable pilocytic astrocytomas. Despite the favorable histological characteristics and prognosis usually associated with this neoplasm, an adverse location, recurrence, or progression of this disease requires alternative therapeutic approaches such as radiosurgery.

Adolescent↗
PubMed2004

Stereotactic radiation treatment planning and follow-up studies involving fused multimodality imaging.

OBJECT: Innovative new software solutions may enable image fusion to produce the desired data superposition for precise target definition and follow-up studies in radiosurgery/stereotactic radiotherapy in patients with intracranial lesions. The aim is to integrate the anatomical and functional information completely into the radiation treatment planning and to achieve an exact comparison for follow-up examinations. Special conditions and advantages of BrainLAB's fully automatic image fusion system are evaluated and described for this purpose. METHODS: In 458 patients, the radiation treatment planning and some follow-up studies were performed using an automatic image fusion technique involving the use of different imaging modalities. Each fusion was visually checked and corrected as necessary. The computerized tomography (CT) scans for radiation treatment planning (slice thickness 1.25 mm), as well as stereotactic angiography for arteriovenous malformations, were acquired using head fixation with stereotactic arc or, in the case of stereotactic radiotherapy, with a relocatable stereotactic mask. Different magnetic resonance (MR) imaging sequences (T1, T2, and fluid-attenuated inversion-recovery images) and positron emission tomography (PET) scans were obtained without head fixation. Fusion results and the effects on radiation treatment planning and follow-up studies were analyzed. The precision level of the results of the automatic fusion depended primarily on the image quality, especially the slice thickness and the field homogeneity when using MR images, as well as on patient movement during data acquisition. Fully automated image fusion of different MR, CT, and PET studies was performed for each patient. Only in a few cases was it necessary to correct the fusion manually after visual evaluation. These corrections were minor and did not materially affect treatment planning. High-quality fusion of thin slices of a region of interest with a complete head data set could be performed easily. The target volume for radiation treatment planning could be accurately delineated using multimodal information provided by CT, MR, angiography, and PET studies. The fusion of follow-up image data sets yielded results that could be successfully compared and quantitatively evaluated. CONCLUSIONS: Depending on the quality of the originally acquired image, automated image fusion can be a very valuable tool, allowing for fast (approximately 1-2 minute) and precise fusion of all relevant data sets. Fused multimodality imaging improves the target volume definition for radiation treatment planning. High-quality follow-up image data sets should be acquired for image fusion to provide exactly comparable slices and volumetric results that will contribute to quality contol.

Adult↗
PubMed2026

Integrating metagenomic next-generation sequencing into a multimodal diagnostic framework for spinal infection: enhancing etiological identification and clinical prediction.

BACKGROUND: Spinal infection (SI) remains diagnostically challenging because of heterogeneous etiologies, nonspecific clinical manifestations, and the limited sensitivity of conventional microbiological approaches, particularly following empirical antimicrobial exposure. Although metagenomic next-generation sequencing (mNGS) enables unbiased pathogen detection, its incremental clinical value beyond pathogen identification and its role within integrated diagnostic strategies remain incompletely established. METHODS: We retrospectively analyzed 208 consecutive patients with suspected SI between August 2022 and August 2025. Final diagnoses were established using a multidisciplinary-adjudicated composite reference standard incorporating clinical, radiological, microbiological, and histopathological evidence. The diagnostic performance of mNGS was compared with conventional culture and histopathology. Furthermore, multimodal predictive models integrating clinical variables and microbiological information were developed using L1-regularized logistic regression. RESULTS: In the comparative cohort, mNGS achieved a significantly higher diagnostic yield than culture (66.5% vs. 27.41%, P < 0.001). Among confirmed SI cases, mNGS demonstrated higher sensitivity than conventional culture (91.67% vs. 40.15%, P < 0.001). mNGS identified a substantially broader pathogen spectrum, ranging from fastidious organisms such as Mycobacterium tuberculosis and Brucella to rare pathogens including Talaromyces marneffei and Coxiella burnetii, and maintained robust sensitivity (98.2%) despite prior antibiotic exposure. While an integrated clinical model achieved an AUC of 0.916, mNGS as a standalone modality provided superior discriminative power (AUC = 0.889) compared to histopathology (AUC = 0.836), the Conventional Biomarker Model (AUC = 0.742), and culture (AUC = 0.693). CONCLUSIONS: mNGS is a high-yield diagnostic tool for spinal infection, particularly in culture-negative and antibiotic-pretreated scenarios. Integrating mNGS into a multimodal clinical framework facilitates etiological clarity and precision antimicrobial therapy.

Humans↗
PubMed2026

Multimodal atlas of human atherosclerosis links granular vascular cell states to coronary artery disease risk.

Advances in single-cell and spatial assays have revolutionized the scale and resolution of molecular tissue profiling. Here we present MetaPlaq, a multimodal atlas of human atherosclerotic arterial beds comprising over a million cells across single-cell transcriptomics, epigenomics and high-resolution spatial expression assays. We map granular cell states and disease-relevant transcriptional programs within the native tissue context of coronary arteries. Furthermore, we map cardiovascular GWAS signals to smooth muscle cells (SMCs) and endothelial cells (ECs) and uncover the cis-regulatory architecture governing their phenotypic transitions. Our comprehensive epigenomic reference allowed us to build cell-specific enhancer-gene link maps and multimodal gene regulatory networks (GRNs) underlying disease-relevant states such as osteogenic SMCs and ECs undergoing mesenchymal transition. We also integrate SMC and EC disease-associated gene sets with GRNs to nominate key transcription factors such as PRRX1, BNC2 and ELK3 regulating atherosclerosis-relevant transcriptional programs. Finally, we layer single-cell and spatial modalities to fine-map GWAS variants with improved cell and anatomical context. We highlight candidate cell-specific regulatory mechanisms at less characterized CAD loci, including FGD5 and MCF2L in ECs. Together, this atlas represents an important step towards fully interpreting genetic risk loci and informing new therapeutic strategies for cardiovascular disease.

Journal Article↗
PubMed1996

The expert surgical assistant. An intelligent virtual environment with multimodal input.

Virtual Reality has made computer interfaces more intuitive but not more intelligent. This paper shows how an expert system can be coupled with multimodal input in a virtual environment to provide an intelligent simulation tool or surgical assistant. This is accomplished in three steps. First, voice and gestural input is interpreted and represented in a common semantic form. Second, a rule-based expert system is used to infer context and user actions from this semantic representation. Finally, the inferred user actions are matched against steps in a surgical procedure to monitor the user's progress and provide automatic feedback. In addition, the system can respond immediately to multimodal commands for navigational assistance and/or identification of critical anatomical structures. To show how these methods are used we present a prototype sinus surgery interface. The approach described here may easily be extended to a wide variety of medical and non-medical training applications by making simple changes to the expert system database and virtual environment models. Successful implementation of an expert system in both simulated and real surgery has enormous potential for the surgeon both in training and clinical practice.

Artificial Intelligence↗
PubMed1988

Multimodality technologists: should we promote this concept?

There are approximately 7,000 hospitals in the United States and over half of them have less than 350 beds. As the American health care delivery system continues to cross the threshold of change, the directions taken by health care providers are more dynamic and the effects more consequential than ever before. We in the profession have to be sensitive to those changes and flexible enough to take advantage of opportunities as they arise. This paper will focus on the multimodality technologist within imaging areas such as diagnostic radiology, computed tomography (CT), ultrasound, nuclear medicine and magnetic resonance imaging (MRI). The multimodality technologist can be defined as an individual who is certified or competent in more than one imaging modality.

Career Mobility↗