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PubMed2007

Complex, multimodal behavioral profile of the Homer1 knockout mouse.

Proteins of the Homer1 immediate early gene family have been associated with synaptogenesis and synaptic plasticity suggesting broad behavioral consequences of loss of function. This study examined the behavior of male Homer1 knockout (KO) mice compared with wild-type (WT) and heterozygous mice using a battery of 10 behavioral tests probing sensory, motor, social, emotional and learning/memory functions. KO mice showed mild somatic growth retardation, poor motor coordination, enhanced sensory reactivity and learning deficits. Heterozygous mice showed increased aggression in social interactions with conspecifics. The distribution of mGluR5 and N-methyl-D-aspartate receptors (NMDA) receptors appeared to be unaltered in the hippocampus (HIP) of Homer1 KO mice. The results indicate an extensive range of disrupted behaviors that should contribute to the understanding of the Homer1 gene in brain development and behavior.

Analysis of Variance↗

PubMed2004

Academic achievement and emotional status of children with ADHD treated with long-term methylphenidate and multimodal psychosocial treatment.

OBJECTIVE: To test the hypothesis that intensive multimodal psychosocial intervention (that includes academic assistance and psychotherapy) combined with methylphenidate significantly enhances the academic performance and emotional status of children with attention-deficit/hyperactivity disorder (ADHD) compared with methylphenidate alone and with methylphenidate combined with nonspecific psychosocial treatment (attention control). METHOD: One hundred three children with ADHD (ages 7-9), free of conduct and learning disorders, who responded to short-term methylphenidate were randomized for 2 years to receive one of three treatments: (1) methylphenidate alone, (2) methylphenidate plus psychosocial treatment that included academic remediation, organizational skills training, and psychotherapy as well as parent training and counseling and social skills training, or (3) methylphenidate plus attention control treatment. Children's function was assessed through academic testing, parent ratings of homework problems, and self-ratings of depression and self-esteem. RESULTS: No advantage was found on any measure of academic performance or emotional status for the combination treatment over methylphenidate alone and over methylphenidate plus attention control. Significant improvement occurred across all treatments and was maintained over 2 years. CONCLUSIONS: In stimulant-responsive young children with ADHD without learning and conduct disorders, there is no support for academic assistance and psychotherapy to enhance academic achievement or emotional adjustment. Significant short-term improvements were maintained over 2 years.

Affect↗

PubMed1984

Chronic pain management.

In the past ten years developments in social psychology, neurochemistry, learning theory, and psychophysiology have expanded the concept of chronic pain into a biopsychosocial model, in which pain is viewed as a form of abnormal illness behavior influenced by a wide range of biological, social, and psychological factors. Using the literature on chronic pain, the authors discuss the evolution of the chronic pain concept into the multidisciplinary multimodal approach used by pain clinics today, and the factors identified in the literature that influence a patient's perception of pain. Finally, based on their experiences in setting up a pain clinic and on the literature on leading pain management programs, they discuss in detail the evaluation, treatment, and management strategies of a comprehensive chronic pain management program.

Analgesics↗

PubMed2001

Attention-deficit/hyperactivity disorder: management.

Attention-deficit/hyperactivity disorder (ADHD) is the most common psychiatric disorder of childhood and often persists into adulthood. ADHD is a neurophysiologic disorder defined in behavioral terms and associated with significant morbidity in the realms of social and academic success, and self-esteem. ADHD is often associated with comorbid psychiatric disorders and learning disabilities, which further impede the successful development of these persons. It is essential that family physicians be knowledgeable about the presentation and diagnosis of ADHD. Stimulant medications continue to be the mainstay of treatment, although many other medications (such as antidepressants and alpha blockers) are helpful adjuvants to therapy. Current recommendations for treatment include an individualized, multimodal approach involving parents, teachers, counselors and the school system. Treatment follow-up includes monitoring response to medications in various settings, as well as side effects. With time and interest, the family physician can develop the skills needed to treat this disorder.

Adolescent↗

PubMed2003

Diagnosis and classification of eating disorders in adults with intellectual disability: the Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation (DC-LD) approach.

BACKGROUND: Previous classifications of eating disorders [EDs] employed a narrower concept of EDs. They did not include the wide range of abnormal eating behaviours [AEBs], persistent feeding disorders and EDs psychopathology, aetiological and comorbidity factors seen in adults with intellectual disability [ID]. METHODS: The International Classification of Diseases--10 [ICD-10], ICD-10-MR, Diagnostic and Statistical Manual--IV [DSM-IV] and Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation[DC-LD] diagnostic approaches to EDs in adults with ID are compared. RESULTS: The DC-LD encourages conceptually clearer and systematic hierarchical differential diagnostic classification of AEBs and EDs. The DC-LD also allows consideration of relevant aetiological and comorbidity issues. DC-LD-based multi-axial case formulation supports the multimodal clinical assessment of AEBs and EDs. CONCLUSIONS: Further research should develop similar systematic and evidence-based multicomponent clinical diagnostic, management and service models for adults with ID and EDs.

Diagnosis, Differential↗

PubMed2000

Vocal violence in actors: an investigation into its acoustic consequences and the effects of hygienic laryngeal release training.

Acoustic analysis techniques were used to investigate the short-term consequences of vocally violent behavior, and to compare voice production before and after training in hygienic laryngeal release (HLR) techniques. Twenty-seven actors ranging in age from 17 to 48 years were audiorecorded before and after multiple productions of 4 vocally violent behaviors: grunting, groaning, sobbing, and shouting. After training in HLR techniques, the experimental protocol was repeated. Audiorecordings of vowels (produced at 3 pitch levels: modal F0, minimum F0, maximum F0) before and after vocal violence, and before and after HLR training, were analyzed using the Multidimensional Voice Program (4305, Kay Elemetrics Corp, Lincoln Park, NJ). After vocal violence, no consistent acoustic changes were detected for voice generated at modal and minimum F0; however, significant increases in both fundamental frequency range and maximum F0 were observed. After training in HLR techniques, acoustic measures sensitive to pitch and amplitude perturbation, and non-harmonic noise, improved across pitch levels. The results also indicated that vocal training does defend the laryngeal system from undesirable changes related to vocally violent maneuvers that might surface at the extremes of an actor's pitch range. Because the HLR technique used in this investigation was multimodal, interesting questions are raised regarding which aspect of training is primarily responsible for the observed effects. Further study is required to identify such factors.

Adolescent↗

PubMed2004

Combination of hyperbolic functions for multimodal biometrics data fusion.

In this paper, we treat the problem of combining fingerprint and speech biometric decisions as a classifier fusion problem. By exploiting the specialist capabilities of each classifier, a combined classifier may yield results which would not be possible in a single classifier. The Feedforward Neural Network provides a natural choice for such data fusion as it has been shown to be a universal approximator. However, the training process remains much to be a trial-and-error effort since no learning algorithm can guarantee convergence to optimal solution within finite iterations. In this work, we propose a network model to generate different combinations of the hyperbolic functions to achieve some approximation and classification properties. This is to circumvent the iterative training problem as seen in neural networks learning. In many decision data fusion applications, since individual classifiers or estimators to be combined would have attained a certain level of classification or approximation accuracy, this hyperbolic functions network can be used to combine these classifiers taking their decision outputs as the inputs to the network. The proposed hyperbolic functions network model is first applied to a function approximation problem to illustrate its approximation capability. This is followed by some case studies on pattern classification problems. The model is finally applied to combine the fingerprint and speaker verification decisions which show either better or comparable results with respect to several commonly used methods.

Algorithms↗

PubMed2025

Predicting the First Onset of Suicidal Thoughts and Behaviors in Adolescents Using Multimodal Risk Factors: A 4-Year Longitudinal Study.

OBJECTIVE: Suicide is one of the leading causes of death among youth worldwide, yet existing studies that aimed to predict the first onset of suicidal thoughts and behaviors (STB) included a limited number of data modalities and/or focused on adult populations. This study aimed to prospectively predict first-onset STB across 4-year follow-ups in adolescents using an existing STB history classification model that was previously applied to baseline data and a new machine learning model with 195 biopsychosocial features. METHOD: Participants were 7,503 unrelated adolescents (54.5% female, ages 9-11 years at baseline) from the multisite, longitudinal Adolescent Brain Cognitive Development (ABCD) Study. An existing baseline STB history classification model was applied to predict longitudinal first-onset STB in adolescents compared with healthy controls and clinical controls (individuals with a mental health disorder but no STB). A new elastic net logistic regression model with 195 features was trained on data from 14 sites (n = 5,220), and the resulting top 15 features were validated at 7 independent sites (n = 2,283). RESULTS: The previously developed model to classify STB lifetime history also prospectively predicted first-onset STB in adolescents with an area under the curve (AUC) [95% CI] of 0.73 [0.70, 0.75], p < .001, compared with healthy controls and AUC [95% CI] of 0.63 [0.60, 0.66], p < .001, compared with clinical controls. The newly trained model with top 15 features performed similarly with AUC [95% CI] of 0.73 [0.71, 0.76], p < .001, and AUC [95% CI] of 0.64 [0.60, 0.66], p < .001, for the same comparison groups. The most consistent predictors across models included female sex, sleep disturbances, and maladaptive home and school environments. CONCLUSION: The models predicted first-onset STB in adolescents with moderate accuracy. This study also confirmed the roles of well-established psychological risk factors for STB and identified several novel neurocognitive and brain imaging risk factors. Future studies should validate these models in large-scale diverse samples before clinical translation. PLAIN LANGUAGE SUMMARY: This study followed over 7,500 adolescents for 4 years and tested 2 machine learning models using psychological, social, and brain data to identify those at risk of experiencing suicidal thoughts or behaviors. Both models predicted first-time suicidal thoughts or behaviors with moderate accuracy. Key risk factors that were identified included being female, experiencing sleep problems, and negative home and school environments. DIVERSITY & INCLUSION STATEMENT: We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. Diverse cell lines and/or genomic datasets were not available. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. One or more of the authors of this paper received support from a program designed to increase minority representation in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.

Adolescent↗

PubMed2026

CoxFormer enables spatial omics inference with multimodal generative modeling.

Gene co-expression maps transcriptome-wide gene-gene relationships, yet high-quality estimates cover less than half the genome. Meanwhile, spatial omics either profiles restricted in situ panels or lacks cellular resolution. Extending co-expression transcriptome-wide could overcome these limitations by inferring unassayed gene expression at subcellular resolution. Here we show that CoxFormer integrates literature-derived gene knowledge with co-expression networks from bulk tissues and large-scale single-cell atlases to learn 512-dimensional representations for 32,016 human genes. These embeddings capture functional gene relationships and serve as a generative prior for spatial inference across platforms and modalities. Without requiring a matched single-cell RNA-sequencing reference, CoxFormer supports four applications beyond measured genes: histology-based expression imputation, gene activity prediction from chromatin accessibility, subcellular super-resolution inference, and pathological region detection. Together, CoxFormer extends gene embedding from gene- and cell-level tasks to whole-transcriptome spatial inference, providing a unified framework for biological analysis beyond the limited gene coverage of current spatial omics technologies.

Humans↗

PubMedDate not supplied

A virtual reality patient simulation system for teaching emergency response skills to U.S. Navy medical providers.

Rapid and effective medical intervention in response to civil and military-related disasters is crucial for saving lives and limiting long-term disability. Inexperienced providers may suffer in performance when faced with limited supplies and the demands of stabilizing casualties not generally encountered in the comparatively resource-rich hospital setting. Head trauma and multiple injury cases are particularly complex to diagnose and treat, requiring the integration and processing of complex multimodal data. In this project, collaborators adapted and merged existing technologies to produce a flexible, modular patient simulation system with both three-dimensional virtual reality and two-dimensional flat screen user interfaces for teaching cognitive assessment and treatment skills. This experiential, problem-based training approach engages the user in a stress-filled, high fidelity world, providing multiple learning opportunities within a compressed period of time and without risk. The system simulates both the dynamic state of the patient and the results of user intervention, enabling trainees to watch the virtual patient deteriorate or stabilize as a result of their decision-making speed and accuracy. Systems can be deployed to the field enabling trainees to practice repeatedly until their skills are mastered and to maintain those skills once acquired. This paper describes the technologies and the process used to develop the trainers, the clinical algorithms, and the incorporation of teaching points. We also characterize aspects of the actual simulation exercise through the lens of the trainee.

Algorithms↗

PubMed2006

[Multimodal therapy patients with chronic cervical and lumbar pain. Results of a comparative prospective study].

BACKGROUND: Multimodal therapy has been established for patients with chronic low back pain, but studies reporting results in patients with chronic neck pain are rare. METHODS: This prospective clinical study compared the results in 97 patients with chronic cervical pain and 231 patients with chronic lumbar pain after three weeks of multimodal therapy. The following factors were analyzed in both groups at the beginning and after 6 months: ability to work, pain intensity and functional back capacity. RESULTS: Both groups had improved significantly after 6 months in all outcome parameters. Functional back capacity and ability to work at 6 months were not different between the two groups, but pain intensity was significantly lower in patients with low back pain compared to patients with neck pain. CONCLUSION: Multimodal therapy is also an efficient treatment strategy for patients with chronic cervical pain as has already been shown for patients with chronic lumbar pain.

Activities of Daily Living↗

PubMed2006

A curriculum in critical care medicine for maternal-fetal medicine fellows.

OBJECTIVE: Critical care education in maternal-fetal medicine has typically been limited or has been driven entirely by clinical cases. A pilot program was created to systematize critical care training within the context of an existing maternal-fetal medicine fellowship. DESIGN: The program included a lecture series, a Web-based learning module, specific scenarios played out in a human simulator lab, and a clinical intensive care unit rotation. Fellows' knowledge was assessed by pre- and posttest. RESULTS: Objective knowledge was demonstrated to increase after 1 yr of training. Fellows' impression of the curriculum was positive. CONCLUSION: More structured critical care medicine training is feasible within a maternal-fetal medicine fellowship. A multimodal curriculum to teach critical care within a maternal-fetal medicine fellowship appears promising and could be implemented elsewhere. Interest in this area should be cultivated.

Critical Care↗

PubMed2007

The development of infant discrimination of affect in multimodal and unimodal stimulation: The role of intersensory redundancy.

This research examined the developmental course of infants' ability to perceive affect in bimodal (audiovisual) and unimodal (auditory and visual) displays of a woman speaking. According to the intersensory redundancy hypothesis (L. E. Bahrick, R. Lickliter, & R. Flom, 2004), detection of amodal properties is facilitated in multimodal stimulation and attenuated in unimodal stimulation. Later in development, however, attention becomes more flexible, and amodal properties can be perceived in both multimodal and unimodal stimulation. The authors tested these predictions by assessing 3-, 4-, 5-, and 7-month-olds' discrimination of affect. Results demonstrated that in bimodal stimulation, discrimination of affect emerged by 4 months and remained stable across age. However, in unimodal stimulation, detection of affect emerged gradually, with sensitivity to auditory stimulation emerging at 5 months and visual stimulation at 7 months. Further temporal synchrony between faces and voices was necessary for younger infants' discrimination of affect. Across development, infants first perceive affect in multimodal stimulation through detecting amodal properties, and later their perception of affect is extended to unimodal auditory and visual stimulation. Implications for social development, including joint attention and social referencing, are considered.

Affect↗

PubMed1984

Teaching methodologies: knowledge acquisition and retention.

In studying the curriculum of a nursing program, knowledge acquisition and retention by nursing students is a primary concern of nursing instructors. The purpose of this study was to determine if a lecture which stimulated several senses would significantly increase knowledge acquisition and retention compared to lectures that stimulate only the auditory sense. Forty-three, junior year, diploma nursing students who had essentially the same clinical experience were the subjects randomly assigned to either Group A or B for this study. Group A (control group) attended a formal lecture on "Spinal Cord Injuries" which stimulated only the auditory sense. Group B (experimental group) attended a lecture on the same subject which stimulated the auditory, visual, and tactile senses. A pretest was given to evaluate the knowledge base prior to the lecture, a posttest was given immediately after the lecture to evaluate initial knowledge acquisition, and a retention test was given three weeks later to evaluate amount of knowledge retained. Students attending the multimodal lecture demonstrated a significantly higher retention test score at the .05 level although they did not demonstrate a significantly higher gain score from pretest to posttest.

Cognition↗

PubMed2004

Muscular and postural synergies of the human hand.

Because humans have limited ability to independently control the many joints of the hand, a wide variety of hand shapes can be characterized as a weighted combination of just two or three main patterns of covariation in joint rotations, or "postural synergies." The present study sought to align muscle synergies with these main postural synergies and to describe the form of membership of motor units in these postural/muscle synergies. Seventeen joint angles and the electromyographic (EMG) activities of several hand muscles (both intrinsic and extrinsic muscles) were recorded while human subjects held the hand statically in 52 specific shapes (i.e., shaping the hand around 26 commonly grasped objects or forming the 26 letter shapes of a manual alphabet). Principal-components analysis revealed several patterns of muscle synergy, some of which represented either coactivation of all hand muscles, or reciprocal patterns of activity (above and below average levels) in the intrinsic index finger and thumb muscles or (to a lesser extent) in the extrinsic four-tendoned extensor and flexor muscles. Single- and multiunit activity was generally a multimodal function of whole hand shape. This implies that motor-unit activation does not align with a single synergy; instead, motor units participate in multiple muscle synergies. Thus it appears that the organization of the global pattern of hand muscle activation is highly distributed. This organization mirrors the highly fractured somatotopy of cortical hand representations and may provide an ideal substrate for motor learning and recovery from injury.

Electromyography↗

PubMed1985

Multimodal amnesic syndrome following bilateral temporal and basal forebrain damage.

A 55-year-old right-handed man (patient DRB) had a major amnesic syndrome following extensive bilateral damage to the temporal lobe and basal forebrain, caused by herpes simplex encephalitis. His amnesia was both anterograde and retrograde. The retrograde amnesia spanned the five decades of his life, sparing only generic (semantic) material and shreds of previous experiences devoid of appropriate temporal and spatial placement. The anterograde amnesia encompassed both generic (semantic) and contextual (episodic) material. With the exception of preserved learning of a visuomotor skill, the patient did not show acquisition of any new information since his illness in 1975. Elementary perceptual, intellectual, and linguistic abilities remained intact. Because several anatomic and behavioral characteristics of this case are different from those of previously reported cases of amnesia, they may provide new insight into the neuroanatomic substrate of human memory.

Amnesia↗

PubMed2003

Time, space and hippocampal functions.

The hippocampus is one of the most researched structures of the brain. Studies of lesions in humans, primates and rodents have suggested to some that the primary role of the hippocampus is to act as a temporary memory buffer which is required for the consolidation of long-term memory. The famous case study of patient H.M., in particular, seemed to suggest that the hippocampus was of crucial importance for memory formation. However, recordings of single neurons in freely moving rodents did not support this notion. In such recordings, neurons were found that were active predominately when the animal passed through a particular area in space. Consequently, these neurons were termed 'place cells' and a theory was developed that suggested that the hippocampus acts as a 'cognitive map' that is required for spatial orientation. It was then found that H.M. had significant damage to his temporal lobes that included the amygdala, rhinal cortices, and other areas. Further case studies and selective hippocampal lesions in primates resulted in much milder amnestic symptoms, and lesions of defined cortical areas in the temporal lobes showed that a number of functions previously attributed to the hippocampus were in fact linked to these areas. Further analysis of neuronal activity in the hippocampus showed that not only is spatial information represented there, but also additional information, such as speed of movement, direction of movement, match or non-match detection, olfactorial identification, and others. In addition, it was found that selective lesions of the hippocampus in rodents impaired spatial navigation and memory formation only mildly. Only simultaneous lesions of several cortical areas in conjunction with the hippocamus could reproduce the impairments and symptoms that were previously thought to be observed after hippocampal lesions alone. In conclusion it is proposed that information processing and memory formation is shared by several brain areas that act as a functional system. This review presents evidence from many different studies that the hippocampus is part of this system and plays a supportive role in associating complex multimodal information and laying down new memory traces. In addition, the concept of allocating specific functions (such as the development of a cognitive map) exclusively to the hippocampus is rejected.

Animals↗

PubMed1980

The CAP control theory of drug abuse.

The CAP theory of drug abuse emphasizes the interaction of cognitive-affective-pharmacogenic effects of drug taking. The belief that one is powerless to affect the environment and cope with stress plays a central role in the theory. The CAP theory is seen as being consistent with newer cognitive models which emphasize the role of internal thoughts and beliefs in the development of maladaptive behavior. Research findings support the hypothesis that an individual's belief in the ability to control a situation strongly influences behavior. Successful treatment of the drug abuser requires a multimodal approach which alters faulty thinking, teaches new interpersonal skills, helps the abuser cope with pain and anxiety, and encourages the development of a positive self-image.

Adolescent↗