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At least 1,045 records · Page 58Linked to original sources
PubMed2005

Multiport N x N multimode air-clad holey fiber coupler for high-power combiner and splitter.

We report 2 x 2 and 4 x 4 multimode air-clad holey fiber couplers fabricated by a novel fusion and tapering technique. The devices showed excellent port-to-port coupling uniformity over a wide spectral range of 800-1650 nm. The 4 x 4 coupler showed a low insertion loss of 9.9 dB and excess loss of 3.9 dB at 1310 nm. Because of its unique air cladding and the high numerical aperture of the holey fiber structure, the device showed strong potential in high-power applications.

Journal Article↗
PubMed2005

Compensation for multimode fiber dispersion by adaptive optics.

Adaptive optics is used to compensate for modal dispersion in digital transmission through multimode fiber (MMF). At the transmitter, a spatial light modulator (SLM) controls the launched field pattern. An estimate of intersymbol interference (ISI) caused by modal dispersion is formed at the receiver and fed back to the transmitter, where the SLM is adjusted to minimize ISI. Error-free transmission of 10 Gbit/s non-return-to-zero signals through standard 50 microm graded-index MMFs up to 11.1 km long is demonstrated. It is shown that a single SLM can compensate for modal dispersion across a 600 GHz bandwidth.

Journal Article↗
PubMed2006

Multimode-diode-pumped gas (alkali-vapor) laser.

We report what we believe to be the first demonstration of a multimode-diode-pumped gas laser: Rb vapor operating on the 795 nm D1 resonance transition. Peak output of approximately 1 W was obtained using a volume-Bragg-grating stabilized pump diode array. The laser's output radiance exceeded the pump radiance by a factor greater than 2000. Power scaling (by pumping with larger diode arrays) is therefore possible.

Journal Article↗
PubMed2006

Mode power distribution effect in white-light multimode fiber extrinsic Fabry-Perot interferometric sensor systems.

Theoretical and experimental results have shown that mode power distribution (MPD) variations could significantly vary the phase of spectral fringes from multimode fiber extrinsic Fabry-Perot interferometric (MMF-EFPI) sensor systems, owing to the fact that different modes introduce different extra phase shifts resulting from the coupling of modes reflected at the second surface to the lead-in fiber end. This dependence of fringe pattern on MPD could cause measurement errors in signal demodulation methods of white-light MMF-EFPI sensors that implement the phase information of the fringes.

Journal Article↗
PubMed2006

Spectral broadening of a multimode continuous-wave optical field propagating in the normal dispersion regime of a fiber.

We investigate experimentally and theoretically the broadening of the optical spectrum of a multimode cw field propagating in the normal dispersion regime of a single-mode fiber. The width of the optical spectrum is not a monotonic function of propagation length. This behavior arising from the interplay between the Kerr effect and group-velocity dispersion contrasts with spectral broadening of mode-locked pulses.

Journal Article↗
PubMed2006

All-fiber multimode interference bandpass filter.

A novel design for an all-fiber bandpass filter based on a multimode interference reimaging phenomenon is presented. The filter has achieved low insertion loss with adequate bandwidth and isolation for coarse wavelength-division multiplexing. The filter can easily be made with any central wavelength that is compatible with the single-mode fiber used for its construction. The measured filter performance matches the theoretical predictions well. The filter can have broad applications in fiber-optic telecommunications, spectroscopy, and sensing.

Journal Article↗
PubMed1999

Clinical presentation of stage IIIA (N2) non-small cell lung cancer: role of multimodality therapy.

Neoadjuvant chemotherapy before surgical resection of locally advanced non-small cell lung cancer (NSCLC) has been shown to improve survival compared with surgery alone in several randomized clinical trials. A case report is presented describing the use of paclitaxel and carboplatin in a multimodality regimen for a patient with stage IIIA N2 NSCLC. Studies are ongoing to determine the optimal type and timing of chemotherapy.

Adenocarcinoma↗
PubMed2002

Low rate of venous thromboembolism after craniotomy for brain tumor using multimodality prophylaxis.

CONTEXT: Venous thromboembolism (VTE) is the most frequent complication following craniotomy for brain tumors. At Brigham and Women's Hospital, VTE after craniotomy for brain tumor is the leading cause of deep vein thrombosis (DVT) and pulmonary embolism (PE) among patients hospitalized for conditions other than VTE. OBJECTIVE: To minimize VTE among patients undergoing craniotomy for brain tumor. DESIGN: Randomized, prospective, double-blind clinical trial. SETTING: Brigham and Women's Hospital. PATIENTS: One hundred fifty patients undergoing craniotomy for brain tumor randomized to enoxaparin, 40 mg/d, vs heparin, 5,000 U bid, with all patients receiving graduated compression stockings and intermittent pneumatic compression. MAIN OUTCOME MEASURES: The rate of DVT detected by venous ultrasonography prior to hospital discharge. RESULTS: Symptomatic DVT or PE developed in none of the patients. The overall rate of asymptomatic VTE was 9.3%, with no significant difference in the rates between the two prophylaxis groups. Ten of the 14 patients identified with VTE had thrombus limited to the deep veins of the calf. CONCLUSIONS: Enoxaparin, 40 mg/d, or unfractionated heparin, 5,000 U bid, in combination with graduated compression stockings, intermittent pneumatic compression, and predischarge surveillance venous ultrasonography of the legs, resulted in 150 consecutive patients without symptomatic VTE. The low 9.3% frequency of asymptomatic VTE comprised mostly isolated calf DVT. Therefore, this comprehensive, multimodality approach to VTE prophylaxis achieved excellent efficacy and safety.

Bandages↗
PubMed1990

Transcatheter bronchial artery embolization in the multimodality management of massive hemoptysis.

To illustrate the potential role of transcatheter bronchial artery embolization (TBAE) in the multimodality management of massive hemoptysis, we describe a case in which TBAE was successfully employed as the definitive therapy. In recent years, the technique of TBAE has joined the armamentarium of managing methods for massive hemoptysis. While massive hemoptysis has traditionally been defined in terms of the volume of blood produced within a period of time, with a rate of 600 ml in 24 hours the most commonly used definition, a more functional definition has been proposed: bleeding into the tracheobronchial tree at a rate that poses a threat to life. It is the life-threatening nature of this symptom that often results in the early involvement of thoracic surgeons in the care of these patients.

Bronchial Arteries↗
PubMed2006

Multimodal monitoring during emergency hemicraniectomy for vein of Labbe thrombosis.

INTRODUCTION: Cortical venous thrombosis is a rarely encountered mechanism for intracerebral hemorrhage. Multimodal monitoring may guide neurosurgical and critical care treatment in the setting of cerebral venous thrombosis. METHODS: We report a 37-year-old service member who was admitted to a local field hospital for complaints of severe headache and left ear pain during Operation Iraqi Freedom. CT scan revealed a left temporal intracranial hematoma and subarachnoid hemorrhage. Angiogram revealed thrombosis of the vein of Labbe. Intracranial pressure (ICP), brain tissue oxygenation (PbO2), and cerebral blood flow (CBF) were monitored. There was a progressive increase in ICP despite ventricular drainage, sedation, and intubation. There was an ominous decrease in brain tissue oxygen and CBF became undetectable concomitantly with the increase in ICP. There was a dramatic decrease in ICP and improvement in brain tissue oxygenation and CBF after decompression and evacuation of the hematoma. Six weeks after the hemorrhage, the patient was able to follow simple commands and complete short sentences. DISCUSSION: To our knowledge, this is the first description of the use of ICP, PbO2, and laser Doppler method for obtaining CBF in the same setting. Information obtained from monitoring may lead to timely decompression and avoidance of poor outcome.

Adult↗
PubMedDate not supplied

Multimodality (auditory, visual and somatosensory) evoked potentials in the sand rat, Psammomys obesus.

Multimodality (auditory, visual and somatosensory) evoked potentials were recorded in the sand rat (Psammomys obesus) and compared to those obtained in albino rats, under almost identical conditions. Clear responses could be obtained from each species. The evoked potentials from the sand rat were qualitatively similar in waveform, latency and amplitude to those recorded in albino rats. Since there is a strain of sand rat which develops diabetes when on standard chow and since the sand rat has adapted to the desert environment, further study should involve evoked potential recordings in sand rats during hyper- and hypothermia and in diabetic sand rats.

Animals↗
PubMed2006

Selective PPAR modulators, dual and pan PPAR agonists: multimodal drugs for the treatment of type 2 diabetes and atherosclerosis.

More than 70% of patients with Type 2 diabetes mellitus (T2DM) die because of cardiovascular diseases. Current therapeutic strategies are based on separate treatment of insulin resistance and dyslipidaemia. Development of drugs with multimodal activities should improve management of the global cardiovascular risk of T2DM patients and result in better patient compliance. New therapeutic strategies are aimed at targeting the entire spectrum of dysfunctioning organs, cells and regulatory pathways implicated in the pathogenesis of T2DM, dyslipidaemia and atherosclerosis. PPAR family members play major roles in the regulation of lipid metabolism, glucose homeostasis and inflammatory processes, making these transcription factors ideal targets for therapeutic strategies against these diseases. This review discusses why PPARs and development of novel selective PPAR modulators, dual and pan PPAR agonists constitute promising approaches for the treatment of diabetes, dyslipidaemia and atherosclerosis.

Animals↗
PubMed2001

Treatment of non-incarcerated sexually compulsive/addictive offenders in an integrated, multimodal, and psychodynamic group therapy model.

Group therapy is a widely accepted model of care for sex offenders. However, most group therapy takes place in prison utilizing a cognitive-behavioral, psychoeducational model of care. Given that over 250,000 sex offenders are in ambulatory treatment, newer models of care may need to be employed to address their specific needs. I present a naturalistic outpatient study involving my private practice of 109 consecutive sex offenders treated over a 10-year period. A multimodal model of care informed by psychodynamic theory is presented with detailed case material from one group session. Preliminary results of recidivism are presented.

Adult↗
PubMed2004

National Institute of Mental Health Multimodal Treatment Study of ADHD follow-up: 24-month outcomes of treatment strategies for attention-deficit/hyperactivity disorder.

OBJECTIVE: In the Multimodal Treatment Study of ADHD (MTA), the effects of medication management (MedMgt) and behavior modification therapy (Beh) and their combination (Comb) and usual community comparison (CC) in the treatment of attention-deficit/hyperactivity disorder (ADHD) differed at the 14-month assessment as a result of superiority of the MTA MedMgt strategy (Comb or MedMgt) over Beh and CC and modest additional benefits of Comb over MedMgt alone. Here we evaluate the persistence of these beneficial effects 10 months beyond the 14 months of intensive intervention. METHODS: Of 579 children who entered the study, 540 (93%) participated in the first follow-up 10 months after the end of treatment. Mixed-effects regression models explored possible persisting effects of the MTA medication strategy, the incremental benefits of Comb over MedMgt alone, and the possible superiority of Beh over CC on 5 effectiveness and 4 service use domains. RESULTS: The MTA medication strategy showed persisting significant superiority over Beh and CC for ADHD and oppositional-defiant symptoms at 24 months, although not as great as at 14 months. Significant additional benefits of Comb over MedMgt and of Beh over CC were not found. The groups differed significantly in mean dose (methylphenidate equivalents 30.4, 37.5, 25.7, and 24.0 mg/day, respectively). Continuing medication use partly mediated the persisting superiority of Comb and MedMgt. CONCLUSION: The benefits of intensive MedMgt for ADHD extend 10 months beyond the intensive treatment phase only in symptom domains and diminish over time.

Attention Deficit Disorder with Hyperactivity↗
PubMed2004

National Institute of Mental Health Multimodal Treatment Study of ADHD follow-up: changes in effectiveness and growth after the end of treatment.

OBJECTIVE: Intent-to-treat analyses of the Multimodal Treatment Study of ADHD (MTA) revealed group differences on attention-deficit/hyperactivity disorder symptoms ratings, with better outcome in groups of participants who were assigned the medication algorithm-medication alone (MedMgt) and combined (Comb)--than in those who were not-behavior modification (Beh) alone and community comparison (CC). However, the effect size was reduced by 50% from the end of treatment to the first follow-up. The convergence of outcomes suggests differential changes by treatment group beween 14 and 24 months, which this report explores, both for benefits of treatment and for side effects on growth. METHODS: We documented reported medication use at 14- and 24-month assessments and formed 4 naturalistic subgroups (Med/Med, Med/NoMed, NoMed/Med, and NoMed/NoMed). Then we performed exploratory mediator analyses to evaluate effects of changes in medication use on 14- to 24-month change scores of effectiveness (symptom ratings) and growth (height and weight measures). RESULTS: The randomly assigned groups with the greatest improvement at the end of the treatment phase (Comb and MedMgt) deteriorated during the follow-up phase, but the other 2 groups (Beh and CC) did not. There were no significant differences in the 14- to 24-month growth rates among the randomly assigned groups, in contrast to significant growth suppression in the Comb and MedMgt at the end of the treatment phase. Changes in medication use mediated the 14- to 24-month change in attention-deficit/hyperactivity disorder symptom ratings: the subgroup that reported stopping medication (Med/NoMed) showed the largest deterioration, the subgroup that consistently reported (Med/Med) or never reported (NoMed/NoMed) medication use showed modest deterioration, and the subgroup that reported starting medication (NoMed/Med) showed improvement. Changes in medication use also mediated growth effects: the subgroup that consistently reported medication use (Med/Med) showed reduced height gain compared with the subgroup that never reported medication use (NoMed/NoMed), which actually grew faster than predicted by population norms. CONCLUSION: In the MTA follow-up, exploratory naturalistic analyses suggest that consistent use of stimulant medication was associated with maintenance of effectiveness but continued mild growth suppression.

Adolescent↗
PubMed2004

Hand hygiene practices in a neonatal intensive care unit: a multimodal intervention and impact on nosocomial infection.

OBJECTIVE: Health care-associated infections persist as a major problem in most neonatal intensive care units. Hand hygiene has been singled out as the most important measure in preventing hospital-acquired infection. However, hand hygiene compliance among health care workers (HCWs) remains low. The objective of this study was to assess the frequency and nature of patient contacts in neonatal intensive care units and observe the compliance and technique of hand hygiene among HCWs before and after the implementation of a multimodal intervention program. METHODS: The nature and frequency of patient contacts, the hand hygiene compliance, and hand-washing techniques of HCWs were observed unobtrusively to reflect the baseline compliance and to investigate factors for noncompliance. The intervention consisted of problem-based and task-orientated hand hygiene education, enhancement of minimal handling protocol and clustering of nursing care, liberal provision of alcohol-based hand antiseptic, improvement in hand hygiene facilities, ongoing regular hand hygiene audit, and implementation of health care-associated infection surveillance. The observational study was repeated 6 months after the completion of the intervention program, which extended over 1-year period. RESULTS: Overall hand hygiene compliance increased from 40% to 53% before patient contact and 39% to 59% after patient contact. More marked improvement was observed for high-risk procedures (35%-60%). The average number of patient contacts also decreased from 2.8 to 1.8 per patient per hour. There was improvement in most aspects of hand-washing technique in the postintervention stage. The health care-associated infection rate decreased from 11.3 to 6.2 per 1000 patient-days. CONCLUSION: A problem-based and task-orientated education program can improve hand hygiene compliance. Enhancement of minimal handling and clustering of nursing procedures reduced the total patient contact episodes, which could help to overcome the major barrier of time constraints. A concurrent decrease in health care-associated infection rate and increase in hand hygiene compliance was observed in this study. The observational study could form part of an ongoing audit to provide regular feedback to HCWs to sustain the compliance.

Anti-Infective Agents, Local↗
PubMedDate not supplied

Spectral properties of pro-multimodal imaging agents derived from a NIR dye and a metal chelator.

Monomolecular multimodal imaging agents (MOMIAs) are able to provide complementary diagnostic information of a target diseased tissue. We developed a convenient solid-phase approach to construct two pro-MOMIAs (before incorporating radiometal) derived from 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA) and cypate, a near-infrared (NIR) fluorescent dye analogous to indocyanine green (ICG). The possible interaction between d orbitals of transition metal DOTA complexes or free metals and the p orbitals of cypate chromophore could quench the fluorescence of pro-MOMIAs. However, we did not observe significant changes in the spectral properties of cypate upon conjugation with DOTA and subsequent chelation with metals. The fluorescence intensity of the chelated and nonmetal-chelated PRO-MOMIAs remained fairly the same in dilute 20% aqueous dimethylsulfoxide (DMSO) solution (1 x 10(-6) M). Significant reduction in the fluorescence intensity of pro-MOMIAs occurred in the presence of a large excess of metal ions (>1 molar ratio for indium and 20-fold for a copper relative to pro-MOMIA). This study suggests the feasibility of using MOMIAs for combined optical and radioisotope imaging.

Chelating Agents↗
PubMed2004

Multimodality therapy for cancers of the esophagus and gastric cardia.

The role of multimodal treatment in the management of esophageal cancer is controversial. There are conflicting results from studies on the effect of neoadjuvant and/or adjuvant treatment on long-term survival. Following a search of the Medline database, the authors examine the results of randomized studies on the various treatment protocols available and discuss future therapeutic improvements.

Carcinoma, Squamous Cell↗