Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “multimodal data”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,207 records · Page 67Linked to original sources

Analysis of acrylamide in food by isotope-dilution liquid chromatography coupled with electrospray ionization tandem mass spectrometry.

A confirmatory method for the determination of low levels of acrylamide in different food products is presented. The method entails extraction of acrylamide with water, precipitation of matrix constituents with acetonitrile, and two clean-up steps consecutively over Isolute Multimode and cation-exchange cartridges. The final extract is analyzed by liquid chromatography (LC) coupled to positive electrospray ionization tandem mass spectrometry employing [13C3]-acrylamide as internal standard. For the chromatographic step, a LC column based on a polymethacrylate gel is employed which shows good retention of acrylamide under isocratic flow conditions (k' = 1.2). Mass spectral acquisition is done by selected reaction monitoring, choosing the characteristic transitions m/z 72-->55, 72-->54 and 72-->27. In-house validation data for breakfast cereals and crackers show good precision of the method, with intra- and interassay variation below 10%. The limits of detection for crackers and breakfast cereals, respectively are estimated at 15 and 20 microg/kg, and recoveries of fortified samples ranged between 58 and 76%. Furthermore, the method is applicable to a number of different food products, including biscuits, crisp bread, wafers, confectionery cocoa liquor, and nuts. Finally, the good results obtained in several small-scale interlaboratory tests provided additional confidence in the performance of the method.

Acrylamide↗

Worklists, preloading and archiving strategies; 3 years of clinical experience in the Barcelona PACS.

We present data on 3 years of clinical experience using PACS involving developments on worklists, preloading and archiving strategies in a teaching paediatric hospital with all modalities connected to a commercial PACS. A method allowing generation of and handling of different worklists for computed radiography examinations has been developed in our centre. Worklists and archiving strategies are presented and discussed. We conclude that, with adequate worklists and efficient preloading implementation, current PACS could be used successfully in several clinical settings of a multimodality department.

Algorithms↗

Advances in brain imaging: a new ethical challenge.

Technical advances in the past 25 years permitted substantial advances in the neuroimaging field, expanding the diagnostic and research potentials and significantly reducing the use of old invasive imaging techniques for research purposes. The safer procedures now available allow acquisition of reference data, morphological assessment and functional characterisation from healthy volunteers. However, enrollment of volunteers is still a sensitive ethical issue. Ethical problems related to informed consent, for both research and diagnostic procedures, in patients with neuropsychiatric disorders represent an additional crucial issue. Furthermore, with both functional and structural neuroimaging studies, there is a theoretical risk of violation of individual privacy. Research in the neuroimaging field should tend to increase the amount of information obtained through appropriate post-processing procedures, including multimodality image fusion, and to limit stress and discomfort.

Brain↗

Nursing theory based changes of work organisation in an ICU: effects on quality of care.

The study evaluated the effects of an organisational change programme on quality of care in a Swedish intensive care unit (ICU). The programme included: structural components e.g. converting assistant nurse positions to nurse positions; behavioural components e.g. improvements of report routines; and attitudinal components e.g. explication of what quality of care could mean in the ICU. Planning and implementation of the programme took about 1 year. Quality of care was studied on 40 patients 3 months before the intervention and on 40 patients 18 months after. An observation and question scheme was used for data collection. using Henderson's (1960) nursing model of patient's needs as point of departure. Statistically significant improvements of quality of care were noted on several observations at the postintervention assessment. Most of the improvements were noted on activities aimed at assisting the patient with basic physical needs such as breathing, nutrition, elimination, movement, sleep and rest, and avoiding dangers. No effects were noted on activities aimed at assisting the patient with psychological and spiritual needs. Discussing the results, the multimodal character of the intervention programme was believed to be a significant factor.

Clinical Nursing Research↗

A Cochrane review of manipulation and mobilization for mechanical neck disorders.

STUDY DESIGN AND OBJECTIVES: Our systematic review of randomized trials assessed whether manipulation and mobilization relieve pain or improve function/disability, patient satisfaction, and global perceived effect in adults with mechanical neck disorders. SUMMARY OF BACKGROUND DATA: Neck disorders are common, disabling, and costly. METHODS: Computerized bibliographic databases were searched up to March 2002. Two independent reviewers conducted study selection, data abstraction, and methodologic quality assessment. Relative risk and standardized mean differences were calculated. In the absence of heterogeneity, pooled effect measures were calculated using a random effects model. RESULTS: Of the 33 selected trials, 42% were high quality trials. Single or multiple (3-11) sessions of manipulation or mobilization showed no benefit in pain relief when assessed against placebo, control groups, or other treatments for acute/subacute/chronic mechanical neck disorders with or without headache. There was strong evidence of benefit favoring multimodal care (mobilization and/or manipulation plus exercise) over a waiting list control for pain reduction [pooled standardized mean differences -0.85 (95% CI: -1.20 to -0.50)], improvement in function [pooled SMD -0.57 (95% CI: -0.94 to -0.21)] and global perceived effect [standardized mean differences -2.73 (95% CI: -3.30 to -2.16)] for subacute/chronic mechanical neck disorders with or without headache. CONCLUSIONS: Mobilization and/or manipulation when used with exercise are beneficial for persistent mechanical neck disorders with or without headache. Done alone, manipulation and/or mobilization were not beneficial; when compared to one another, neither was superior. There was insufficient evidence available to draw conclusions for neck disorder with radicular findings. Factorial design would help determine the active agent(s) within a treatment mix.

Adult↗

Flow cytometry and squamous cell carcinoma of the maxillary sinus: A possible prognostic indicator for multimodality intervention.

Malignant tumors of the paranasal sinuses constitute less than 1% of all malignancies. Unfortunately, few prognostic factors have been identified regarding the efficacy of interventional therapy. Patients with carcinoma of the maxillary sinus frequently present with an advanced stage of disease and multimodality therapy is often proposed. Although some tumors appear to be more sensitive to preoperative chemotherapy and radiation therapy, a method of predicting and evaluating tumor behavior has not been recognized. Introduced as a means of identifying cell populations with abnormalities in total DNA content, flow-cytometric DNA analysis provides a quick and reliable means of tumor characterization for many malignancies. Although nuclear DNA content has been implicated as a prognostic factor in an increasing number of tumor types, current data on the role of DNA content in head and neck carcinoma is conflicting and incomplete. To evaluate the role of flow-cytometric DNA analysis in predicting therapeutic alternatives, 22 patients with squamous cell carcinoma of the maxillary sinus were reviewed. Patient outcome and histopathologic grade were retrospectively compared with flow-cytometric evaluations of paraffin-embedded formalin-fixed tumor specimens. Four of sixteen tumors (25%) were found to be aneuploid and were also associated with an increased survival rate (p < 0.01). This initial data emphasizes the possible usefulness of DNA measurement for characterization of squamous cell carcinoma of the maxillary sinus and stresses the need for further evaluation.

Adult↗

Efficacy of navigation in skull base surgery using composite computer graphics of magnetic resonance and computed tomography images.

The efficacy of a neurosurgical navigation system using three-dimensional composite computer graphics (CGs) of magnetic resonance (MR) and computed tomography (CT) images was evaluated in skull base surgery. Three-point transformation was used for integration of MR and CT images. MR and CT image data were obtained with three skin markers placed on the patient's scalp. Volume-rendering manipulations of the data produced three-dimensional CGs of the scalp, brain, and lesions from the MR images, and the scalp and skull from the CT. Composite CGs of the scalp, skull, brain, and lesion were created by registering the three markers on the three-dimensional rendered scalp images obtained from MR imaging and CT in the system. This system was used for 14 patients with skull base lesions. Three-point transformation using three-dimensional CGs was easily performed for multimodal registration. Simulation of surgical procedures on composite CGs aided in comprehension of the skull base anatomy and selection of the optimal approaches. Intraoperative navigation aided in determination of actual spatial position in the skull base and the optimal trajectory to the tumor during surgical procedures.

Computer Graphics↗

[Application and potential of day hospital treatment for patients with eating disorders--a questionnaire survey on the day hospital program in Japan].

Eating disorders (ED) is an important cause of physical and psychological morbidity in 21st century mental health. Recent advances of day treatment for eating disorders in North America, Germany, and Australia advocate us to investigate the utility and possibility of the Day Hospital Program (DHP) in Japan. We reviewed previous reports and summarized the advantages and disadvantages of this approach. Also, we conducted a preliminary survey to clarify the detailed application of the DHP by sending a questionnaire to University hospitals, registered institutes of the Japanese Association of Psychosomatic Medicine, and prefectural mental health and welfare centers. The results revealed the strong need for the DHP for ED (about 75%), strong expectations to link hospitalization and outpatient treatment, and the strong possibility of a multimodal approach. The survey showed the importance of CBT, psychoeducation, and other modalities including nutritional education, exercise, or the family approach. Various types of structures were proposed concerning the duration of a session or treatment (half day and 2 or 3 times a week) and numbers of members (about 6 to 10). Over 75% of the participants answered regardless of the inclusion of diagnostic criteria, which exceeded our expectations. Economic background is one of the problems left pending. Based on the data, we discussed the potential and problems of the DHP in Japan.

Day Care, Medical↗

[Multimodality in the amplitude distribution of miniature endplate potentials due to the action of spatially discrete areas of transmitter release].

Miniature end plate potentials (MEPPs) were simultaneously recorded in frog sartorius muscle by two intracellular microelectrodes. Some isolated groups of points (clouds) were found on the diagram of MEPPs scatter. Several peaks each of which was composed of signals from certain clouds (or from several clouds) on the scatter diagram were found on the histograms of MEPPs amplitude distribution. It is assumed that the clouds on the scatter histogram and the peaks on the histogram of MEPPs amplitudes are formed at the cost of secretion of quantum acetylcholine from spatial separate areas of transmitter release. The data obtained do not correspond with the subquantum hypothesis of transmitter release in neuromuscular junctions.

Animals↗

Effects of fMRI-EEG mismatches in cortical current density estimation integrating fMRI and EEG: a simulation study.

OBJECTIVE: Multimodal functional neuroimaging by combining functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) has been studied to achieve high-resolution reconstruction of the spatiotemporal cortical current density (CCD) distribution. However, mismatches between these two imaging modalities may occur due to their different underlying mechanisms. The aim of the present study is to investigate the effects of different types of fMRI-EEG mismatches, including fMRI invisible sources, fMRI extra regions and fMRI displacement, on the fMRI-constrained cortical imaging in a computer simulation based on realistic-geometry boundary-element-method (BEM) model. METHODS: Two methods have been adopted to integrate the synthetic fMRI and EEG data for CCD imaging. In addition to the well-known 90% fMRI-constrained Wiener filter approach (Liu AK, Belliveau JW, Dale AM. PNAS 1998;95:8945-8950.), we propose a novel two-step algorithm (referred to as 'Twomey algorithm') for fMRI-EEG integration. In the first step, a 'hard' spatial prior derived from fMRI is imposed to solve the EEG inverse problem with a reduced source space; in the second step, the fMRI constraint is removed and the source estimate from the first step is re-entered as the initial guess of the desired solution into an EEG least squares fitting procedure with Twomey regularization. Twomey regularization is a modified Tikhonov technique that attempts to simultaneously minimize the distance between the desired solution and the initial estimate, and the residual errors of fitness to EEG data. The performance of the proposed Twomey algorithm has been evaluated both qualitatively and quantitatively along with the lead-field normalized minimum norm (WMN) and the 90% fMRI-weighted Wiener filter approach, under repeated and randomized source configurations. Point spread function (PSF) and localization error (LE) are used to measure the performance of different imaging approaches with or without a variety of fMRI-EEG mismatches. RESULTS: The results of the simulation show that the Twomey algorithm can successfully reduce the PSF of fMRI invisible sources compared to the Wiener estimation, without losing the merit of having much lower PSF of fMRI visible sources relative to the WMN solution. In addition, the existence of fMRI extra sources does not significantly affect the accuracy of the fMRI-EEG integrated CCD estimation for both the Wiener filter method and the proposed Twomey algorithm, while the Twomey algorithm may further reduce the chance of occurring spurious sources in the extra fMRI regions. The fMRI displacement away from the electrical source causes enlarged localization error in the imaging results of both the Twomey and Wiener approaches, while Twomey gives smaller LE than Wiener with the fMRI displacement ranging from 1-2 cm. With less than 2 cm fMRI displacement, the LEs for the Twomey and Wiener approaches are still smaller than in the WMN solution. CONCLUSIONS: The present study suggests that the presence of fMRI invisible sources is the most problematic factor responsible for the error of fMRI-EEG integrated imaging based on the Wiener filter approach, whereas this approach is relatively robust against the fMRI extra regions and small displacement between fMRI activation and electrical current sources. While maintaining the above advantages possessed by the Wiener filter approach, the Twomey algorithm can further effectively alleviate the underestimation of fMRI invisible sources, suppress fMRI spurious sources and improve the robustness against fMRI displacement. Therefore, the Twomey algorithm is expected to improve the reliability of multimodal cortical source imaging against fMRI-EEG mismatches. SIGNIFICANCE: The proposed method promises to provide a useful alternative for multimodal neuroimaging integrating fMRI and EEG.

Analysis of Variance↗

Intraarterial chemotherapy as an adjuvant treatment in locally advanced gastric cancer.

BACKGROUND AND AIMS: D2 gastrectomy has improved survival in gastric cancer. Adjuvant intravenous chemotherapy, radiotherapy, or multimodal therapy has failed to demonstrate improved survival. The results of intraarterial chemotherapy (IARC) as an adjuvant have been encouraging in a few studies. A prospective randomized trial was designed to evaluate the toxicity and survival in locally advanced gastric cancer using IARC as an adjuvant after potentially curative gastrectomy. PATIENTS AND METHODS: Forty patients with locally advanced gastric cancer were randomly selected to undergo either potentially curative gastrectomy and receive IARC (study group) or gastrectomy only (control group). Clinical and histopathologic data were analyzed and the toxicity related to IARC was recorded. RESULTS: The groups were comparable (p>0.05). Three patients in the study group had minor toxicity. Five-year survival rate for the study and the control group was 52 and 54%, respectively (p>0.05). Mean survival for the study and the control group was 50+/-8 and 62+/-10 months, respectively (p>0.05). The number of recurrences and the failure sites were comparable (p>0.05). CONCLUSION: Intraarterial chemotherapy can be safely applied to gastric cancer patients. As proposed by the protocol, the method cannot be recommended as an adjuvant treatment for locally advanced tumors because it appears that there is no survival benefit compared to potentially curative gastrectomy alone.

Aged↗

Review of postoperative ileus.

Postoperative ileus (POI) is an inevitable adverse consequence of surgical procedures. In fact, prolonged POI can lead to patient discomfort, decreased mobility, delayed enteral feeding, and ultimately, prolonged hospitalizations and increased costs. It is believed that POI occurs as a result of inhibitory neural reflexes and inflammatory processes. The use of postoperative opioids also appears to contribute to ileus. Recently, the potential influence of endogenous opioids, in addition to exogenous opioids, on the pathogenesis of ileus has come to light and spurred investigations into new treatment strategies. Over the years, several treatment modalities have become accepted management options for POI; chief among these are nasogastric suction and prokinetic agents. However, data demonstrating that these agents reduce the duration of POI are limited. Of current treatment modalities, use of epidural local anesthetics appears to be the most effective means of reducing POI. Other potentially effective treatments include early enteral feeding and less invasive surgical procedures. Together, these techniques have reduced the length of stay after colonic surgery to 2 to 3 days. Future studies, including those incorporating investigational agents, such as kappa-opioid agonists and peripheral mu-opioid antagonists, into a multimodal regimen, may offer new treatment options to further impact POI duration.

Analgesics, Opioid↗

[Postoperative nausea and vomiting in adult patients].

OBJECTIVE: Identifying risk factors and predictive models for Postoperative Nausea and Vomiting (PONV) and developing antiemetic guidelines for its prevention and treatment. DATA SOURCES: Medline (1997-2002) searches, using "postoperative nausea and vomiting" [MESH], complemented by handsearch. STUDY SELECTION AND DATA EXTRACTION: Published randomised controlled trials, systematic reviews and multivariable analysis of large cohort studies were evaluated. DATA SYNTHESIS: Avoiding PONV seems to be one of the highest priority for most patients. Its most important risk factors are volatile anaesthetics and opioids. If these are given to susceptible patients such as female, those with previous history of PONV or motion sickness and non-smoker, this is likely to result in PONV. For patients receiving volatile anaesthesia, simplified risk scores are available to estimate the individual risk of PONV. Patients at high risk for PONV may benefit from a multimodal approach which involves a) lowering the baseline risk (e.g. by total intravenous anaesthesia with propofol) with b) prophylactically given antiemetics such as droperidol, dexamethasone and serotonin antagonists, alone or in combination. In these selected patients, antiemetics are cost effective. CONCLUSIONS: A strategy to prevent and treat PONV should depend on the individuals risk. However, its clinical usefulness and economic implications needs to be validated.

Adult↗

Impact of surgery, chemotherapy and irradiation on long term outcome of intracranial malignant non-germinomatous germ cell tumors: results of the German Cooperative Trial MAKEI 89.

UNLABELLED: Malignant non-germinomatous intracranial germ cell tumors (MNGGCTs) are a heterogenous group of neoplastic lesions. Their treatment concept follows a multimodal concept that may include tumor resection for local tumor control, craniospinal irradiation to cover leptomenigeal tumor spread and chemotherapy to eliminate systemic tumor dissemination. A Platinum-based chemotherapy proven to be highly effective in testicular and non-testicular malignant germ cell tumors in adults as well as in children has also been chosen for intracranial sites. While therapeutic concepts have been thoroughly evaluated for children and adolescents with extracranial nongonadal GCTs, no such detailed long term follow-up data are available for intracranial MNGGCTs. This paper reports on the long-term outcome of 41 patients with intracranial malignant non-germinomatous GCTs enrolled into the German prospective protocol MAKEI 89. The analysis focuses on the impact of surgery, radio- and chemotherapy. PATIENTS AND METHODS: Between January 1989 and January 1994, 41 patients with malignant intracranial non-germinomatous GCTs were registered. Patients were compared in respect to protocol (n = 27) and non-protocol treatment (n = 14). Estimated were with chi (2) and Fisher exact test the impact of surgery, chemotherapy and irradiation on outcome. RESULTS: The estimated (Kaplan-Meier) 5-year event free survival (EFS) of patients treated according to protocol recommendations was 0.59 +/- 0.06 (n = 27), compared to an EFS of 0.37 +/- 0.33 for patients with different treatments (n = 14) (p = 0.70, log-rank). The 5-year relapse-free survival rate (RFS) was 0.74 +/- 0.06 in protocol patients and 0.38 +/- 0.33 in non-protocol patients (median observation time of 112 months after diagnosis for surviving patients) (p = 0.14, log-rank). Surgery, complete or incomplete had no significant impact on survival (p = 0.12). Radiotherapy, in terms of craniospinal irradiation had a significant influence on survival (p = 0.035) as well as a cumulative cisplatin dose >/= 400 mg/m (2) (p = 0.002). CONCLUSION: Cisplatin chemotherapy and craniospinal irradiation with tumor boost are of significant influence on long term survival in patients with MNGGCTs. The exclusion of major surgery at diagnosis using modern advances in neurosurgery or related tumor resection after neoadjuvant chemotherapy will allow a further reduction of treatment related mortality and long lasting morbidity. The analysis reveals that, given effective treatment, intracranial malignant non-germinomatous GCTs should not longer carry a poor prognosis.

Adolescent↗

Clinical evaluation of biofiltration in uremic patients undergoing chronic hemodialysis.

The clinical efficiency of biofiltration (BF) was evaluated in six hemodialysis patients with poor clinical tolerance for standard hemodialysis. Three were adults (mean age 34 years, mean body weight 67 kg) and three adolescents (mean age 17 years, mean body weight 38 kg). Mean maintenance hemodialysis time was 90.5 months (range 49-132). BF treatments lasted three hours in all cases, for a total of nine hours weekly, with AN69 S membranes and infusion of 3 liters of HCO3 solution (100 mEq/l for the adults, 80 mEq/l for the adolescents). We recorded intra- and inter-dialytic symptoms daily, hematological values and acid-base status monthly. Multimodality evoked potentials were recorded after 3 and 9 months. Biochemical values reached a steady state 9 months from the beginning of the study, metabolic acidosis was corrected more efficiently in both groups at the end of dialysis, but only in the adult patients, were pre-dialysis plasma bicarbonates within normal limits. A clear drop in the number of episodes of intradialytic hypotension was noticed in both groups, but the adolescent patients' tolerance for dialysis did not improve. In conclusion our data show that in adult patients with poor tolerance BF offers a dependable alternative to standard hemodialysis, and the length of treatment can be reduced.

Acid-Base Equilibrium↗

Detecting multimodality in saccadic reaction time distributions in gap and overlap tasks.

In many cases the distribution of saccadic reaction times (SRT) deviates considerably from a unimodal distribution and may often exhibit several peaks. We present a statistical approach to determining the number and form of the individual peaks. The overall density of the reaction times fi(t), i = 1...M obtained in M different experiments with the same subject is described as the sum of K basis functions xk(t), k = 1...K with different weights and an error term. A change in the experimental conditions is assumed to cause a change in the weights, not in the basis functions. We minimize the square of the difference (measured data minus approximation), divided by the error of the data. Incrementing K step by step we determine the necessary number of basis functions. This method is applied to data of six subjects tested in different saccade tasks. We detect five different modes: two in the range 80-140 ms (express modes), two in the range 145-190 ms (fast-regular mode) and one at about 230 ms (slow-regular mode). These modes are located at about the same positions for different subjects. The method presented here not only proves statistically the existence of several modes in SRT distributions but also allows the distributions to be described by a few characteristic numbers that go beyond the mean values and standard deviations.

Adult↗

Psychosocial effects of age-related macular degeneration.

BACKGROUND: Age-related macular degeneration (AMD) affects approximately 10% of persons aged 65-74 years and 30% of those aged 75 and older and is the major cause of blindness in old age. AMD is progressive and irreversible. AIM: To review the psychosocial effects of AMD. METHOD: OVID data bases (MEDLINE, psycINFO and CINAHL) from 1966 to 2004 were reviewed. RESULTS: AMD is associated with functional impairment, high rates of depression, anxiety and emotional distress and increased mortality. Risk factors for depression are not well-defined, except for the degree of functional impairment and impending or actual loss of vision in the second eye. Behavioral and self-management programs may be effective in managing depression associated with AMD, but few studies have been performed, and none using drugs or multimodal therapy. CONCLUSION: AMD will become even more prevalent as the population ages. Identification of risk factors for psychological consequences and of effective interventions remain to be recognized.

Activities of Daily Living↗

Practices and attitudes about cathode-ray tube-based and film-based image interpretation.

A questionnaire was mailed to 708 practicing radiologists and 348 members of the Society for Computer applications in Radiology (SCAR) in order to evaluate current practices and attitudes regarding the perceived advantages or disadvantages of film- and CRT-based image interpretation. A total of 27% of the 1,056 questionnaires (137 practicing radiologists; 145 SCAR members were returned. Ninety percent of practicing radiologists used film at least 75% of the time. Advantages of film-based reading listed by more than 75% of the respondents included: film reading is faster, and facilitates viewing multiple images. Advantages of CRT-based reading included: access to the entire dynamic range and potential imaging processing. Desirable attributes of existing displays included: adjustable grey scale, magnification, ability to view multiple images, allow quick review, and viewing by several individuals. Valued potential advances included: multiple higher resolution monitors, image processing and multimodality display. Practicing radiologists and computer applications society members had similar attitudes. Film-based reading is still nearly universal, but radiologists are interested in CRT-based reading if such devices have the proper features and become more available.

Attitude of Health Personnel↗