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Results for “multimodal integration”

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At least 325 records · Page 18Linked to original sources

PubMed2002

Experiencing oneself vs another person as being the cause of an action: the neural correlates of the experience of agency.

The present study is aimed at identifying the neural correlates of two kinds of attribution: experiencing oneself as the cause of an action (the sense of agency) or experiencing another person as being the cause of that action. The experimental conditions were chosen so that they differed only in their requirement to attribute an action to another person or to oneself. The same motor task and the same visual stimuli were used in the experimental conditions. Subjects used a joystick to drive a circle along a T-shaped path. They were told that the circle would be driven either by themselves or by the experimenter. In the former case subjects were requested to drive the circle, to be aware that they drove the circle, and thus to mentally attribute the action seen on the screen to themselves. In the latter case they were also requested to perform the task, but they were aware that action seen on the screen was driven by the experimenter. In accord with previous studies, the results showed that being aware of causing an action was associated with activation in the anterior insula, whereas being aware of not causing the action and attributing it to another person was associated with activation in the inferior parietal cortex. These two regions are involved in the perception of complex representations of the self and of its interactions with the external world. We suggest that the anterior insula is concerned with the integration of all the concordant multimodal sensory signals associated with voluntary movements. The inferior parietal cortex, in contrast, represents movements in an allocentric coding system that can be applied to the actions of others as well as the self.

Adult↗

PubMed2001

Intraoperative radiation therapy.

The modern use of intraoperative radiation therapy (IORT) was initiated by the studies of Abe and colleagues at the University of Kyoto. This work stimulated significant laboratory and clinical investigation into the use of IORT throughout Japan, Europe, and the United States. Because of this experience, single high doses of irradiation can be safely delivered to a tumor volume in appropriate clinical situations. Most importantly, this high dose of additional radiation treatment yields improved local control of selected tumors. Treatment programs of external beam radiation therapy, surgical resection, and IORT for patients with locally advanced primary and recurrent rectal carcinoma and retroperitoneal sarcoma have yielded excellent local control and higher survival rates. The future of IORT will be in the successful integration of this therapy into multimodality treatment programs of chemotherapy, external beam irradiation, and surgery for locally advanced malignancies.

Animals↗

PubMedDate not supplied

Comparison of parzen density and frequency histogram as estimators of probability density functions.

In neurobiology, and in other fields, the frequency histogram is a traditional tool for determining the probability density function (pdf) of random processes, although other methods have been shown to be more efficient as their estimators. In this study, the frequency histogram is compared with the Parzen density estimator, a method that consists of convolving each measurement with a weighting function of choice (Gaussian, rectangular, etc) and using their sum as an estimate of the pdf of the random process. The difference in their performance in evaluating two types of pdfs that occur commonly in quantal analysis (monomodal and multimodal with equidistant peaks) is demonstrated numerically by using the integrated square error criterion and assuming a knowledge of the "true" pdf. The error of the Parzen density estimates decreases faster as a function of the number of observations than that of the frequency histogram, indicating that they are asymptotically more efficient. A variety of "reasonable" weighting functions can provide similarly efficient Parzen density estimates, but their efficiency greatly depends on their width. The optimal widths determined using the integrated square error criterion, the harmonic analysis (applicable only to multimodal pdfs with equidistant peaks), and the "test graphs" (the graphs of the second derivatives of the Parzen density estimates that do not assume a knowledge of the "true" pdf, but depend on the distinction between the "essential features" of the pdf and the "random fluctuations") were compared and found to be similar.

Fourier Analysis↗

PubMed2026

Multimodal alignment improves generalizability of genomic biomarker prediction in computational pathology.

Computational pathology models that use digitized histopathology whole-slide images have the potential to become a cost-effective and scalable alternative to molecular assays for the prediction of genomic biomarkers, a key task in precision oncology. However, as new genomic biomarkers are discovered or quantified, large, labeled datasets must be prospectively collected to train new models. To address this challenge, we developed multimodal alignment for biomarker learning and generalization (MARBLE), a multimodal contrastive pretraining strategy that integrates structured biomarker knowledge into representation learning of histopathology images. MARBLE aligns histopathology-derived representations with representations of genomic biomarkers generated by a large language model (LLM) and a protein language model (PLM). This biologically informed alignment enables data-efficient generalization to novel, out-of-distribution biomarkers. Using the MSK-IMPACT cohort of over 40,000 patients across multiple biomarker panel versions, we design experiments grounded in real-world data to demonstrate the value of our proposed approach.

CP: computational biology↗

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↗

PubMed1999

[Concepts for treatment of postoperative pain].

Adequate control of postoperative pain does not only improve patient satisfaction, but is also indicated from a medical point of view. Besides conventional non-opioid analgesics and opioids, more sophisticated analgesia concepts like intravenous patient-controlled analgesia (PCA) and epidural analgesia may be indicated. Modalities and practical aspects of these concepts are discussed and briefly described. It is believed that the effectiveness of improved analgesia will be increased by integrating analgesia concepts into a multimodal approach of intensified mobilisation, early enteral nutrition and frequent respiratory therapy of the postoperative patient. In conclusion, there is good evidence of improved analgesia from PCA and epidural analgesia. Data on outcome improvement by analgesia is still contradictory, but improvement of patient satisfaction is without doubt.

Analgesia↗

PubMed2025

The new frontier in understanding human and mammalian brain development.

Neurodevelopmental disorders that cause cognitive, behavioural or motor impairments affect around 15% of children and adolescents worldwide1, with diagnoses of profound autism and attention deficit hyperactivity disorder increasing in the USA and contributing to a major economic burden2,3. Yet the origins and mechanisms of these conditions remain poorly understood, limiting progress in therapies. Comprehensive cell atlases of the developing human brain, alongside those of model organisms such as mice and non-human primates, are now providing high-resolution measures of gene expression, cell-type abundance and spatial distribution. In this Perspective, we highlight recent studies that have identified novel developmental cell populations, revealed conserved and divergent patterns of cell genesis, migration and maturation across species, and begun testing hypotheses that link them to processes ranging from transcriptional control of cell fate specification to the emergence of complex behaviours. We present remaining conceptual and technical challenges and provide an outlook on how further studies of human and mammalian brain development can empower a deeper understanding of neurodevelopmental and neuropsychiatric disorders. Future efforts expanding to additional developmental stages, including adolescence, as well as whole-brain, multimodal and cross-species integration, will yield new insights into how development shapes the brain. These atlases promise to serve as essential references for unravelling mechanisms of brain function and disease vulnerability, and for advancing precision medicine.

Humans↗

PubMed2026

Baseline Computed Tomography Coronary Angiography and Polygenic Risk Profiles in Adults With Type 2 Diabetes: A Cross-Sectional Analysis From the VOLTAIRE Study.

AIMS: To characterise baseline clinical, anatomical, and genetic cardiovascular risk profiles in participants enrolled in the VOLTAIRE (Evaluation of Polygenic Scores and CT Imaging in Risk Factor Modification in Patients with Type 2 Diabetes) study and examine concordance across these domains. METHODS: This analysis included adults with T2D who completed baseline computed tomography coronary angiography (CTCA) and polygenic risk score (PRS) assessment prior to randomisation in the VOLTAIRE study. Coronary atherosclerosis was evaluated using coronary artery calcium (CAC) score and CTCA-derived stenosis severity. Clinical risk was assessed using the New Zealand Society for the Study of Diabetes 5-year cardiovascular risk calculator. Polygenic risk for coronary artery disease was assessed using a genome-wide PRS and categorised into tertiles. RESULTS: Among 126 participants with T2D (mean age 57.5 ± 8.7 years; 62.7% male), coronary atherosclerotic burden was highly heterogeneous: 34.9% had CAC = 0, whereas 19.8% had CAC ≥ 400. Moderate-to-severe coronary stenosis (≥ 50%) was present in 40.5% of participants overall, including 20.4% of those classified as low clinical risk. PRS distribution was variable (low 37.3%, intermediate 35.7%, high 27.0%). Overlap between anatomical, genetic, and clinical domains was limited, with only 8.7% of participants classified as high risk across all three. CONCLUSIONS: Substantial heterogeneity and limited overlap exist between anatomical, genetic, and clinical cardiovascular risk measures in T2D. These findings support a multimodal approach to risk assessment integrating imaging and genetic profiling. TRIAL REGISTRATION: https://www. CLINICALTRIALS: gov; ID: NCT07091162.

Aged↗

PubMed1978

Spontaneous multiquantal release at synapses in guinea-pig hypogastric ganglia: evidence that release can occur in bursts.

1. A study was made of some properties of the spontaneous synaptic potentials recorded in cells of the hypogastric ganglia of guinea-pigs. 2. The distribution of the amplitudes of the spontaneous synaptic potentials arising from a single preganglionic fibre was found to be multimodal, with peaks at roughly integral multiples of a unit peak. 3. It was found that the amplitudes of the larger spontaneous potentials were consistent with them being the result of synchronous or near-synchronous release of two or more unit-sized quanta (multiquantal release). 4. The proportion of multiquantal potentials observed was found to be dependent on the extracellular calcium ion concentration. 5. When the stochastic properties of the spontaneous potentials were examined, it was found that the spontaneous release process was not random and independent but appeared to be clustered. Indeed, the probability of occurrence of a unit spontaneous synaptic potential was greatly enhanced during the 40--60 msec immediately following any given spontaneous synaptic potential. 6. When unit spontaneous potentials were excluded from the analysis, the multiquantal potentials were still found to be clustered although the clustering was less marked than that seen in the over-all process. 7. These results suggested that the multiquantal spontaneous potentials arose from the release of unit quanta in short high frequency bursts and it was found that a mathematical model incorporating such a mechanism could describe the spontaneous quantal release process.

Animals↗

PubMed1988

Spontaneous release of multiquantal miniature excitatory junction potentials induced by a Drosophila mutant.

1. Intracellular recordings were made from muscle fibre No. 6 of the dorsal longitudinal flight muscle (DLM) of Drosophila melanogaster in both wild-type flies and the temperature-sensitive paralytic mutant, shibirets-1 (shi). 2. Continuous recordings of the miniature excitatory junction potentials (MEJPs) in this fibre were made as the temperature was changed from 19 to 29 degrees C, and back to 19 degrees C. In shi flies, synapses become depleted of vesicles at 29 degrees C due to a temperature-dependent blockage in the recycling process, while transmitter release proceeds normally. When the temperature is lowered to 19 degrees C, recycling is allowed to proceed and recovery of the full complement of synaptic vesicles gradually occurs in about 20 min. 3. It was observed that the MEJP amplitude distribution in shi flies was unimodal at 19 degrees C prior to heating (as was wild-type), but during recovery from 8 min exposure to 29 degrees C became multimodal, with peaks at roughly integral multiples of the original peak prior to heating. This effect was never seen in wild-type flies. 4. Also, during recovery, the MEJP did not occur randomly, but rather occurred in a clustered fashion. 5. It is concluded that during recovery from depletion in shi neuromuscular junctions, a condition exists which causes the synchronization of spontaneous release, causing multiquantal MEJPs or clustering of MEJPs, depending on the degree of synchronization. 6. The possible role of Ca2+ in this phenomenon is discussed.

Action Potentials↗

PubMedDate not supplied

Quantitative spatial comparison of diffuse optical imaging with blood oxygen level-dependent and arterial spin labeling-based functional magnetic resonance imaging.

Akin to functional magnetic resonance imaging (fMRI), diffuse optical imaging (DOI) is a noninvasive method for measuring localized changes in hemoglobin levels within the brain. When combined with fMRI methods, multimodality approaches could offer an integrated perspective on the biophysics, anatomy, and physiology underlying each of the imaging modalities. Vital to the correct interpretation of such studies, control experiments to test the consistency of both modalities must be performed. Here, we compare DOI with blood oxygen level-dependent (BOLD) and arterial spin labeling fMRI-based methods in order to explore the spatial agreement of the response amplitudes recorded by these two methods. Rather than creating optical images by regularized, tomographic reconstructions, we project the fMRI image into optical measurement space using the optical forward problem. We report statistically better spatial correlation between the fMRI-BOLD response and the optically measured deoxyhemoglobin (R=0.71, p=1x10(-7)) than between the BOLD and oxyhemoglobin or total hemoglobin measures (R=0.38, p=0.04|0.37, p=0.05, respectively). Similarly, we find that the correlation between the ASL measured blood flow and optically measured total and oxyhemoglobin is stronger (R=0.73, p=5x10(-6) and R=0.71, p=9x10(-6), respectively) than the flow to deoxyhemoglobin spatial correlation (R=0.26, p=0.10).

Adult↗

PubMed2026

Spatial Mapping of the Precancer-to-Cancer Transition in Breast and Prostate.

UNLABELLED: Breast and prostate cancers are both hormone-driven adenocarcinomas that undergo analogous invasion programs. Using lightsheet microscopy on intact tumors, we identified transitional junctions between precancerous and invasive regions. We then developed a multimodal serial-section workflow integrating volumetric reconstruction with spatial transcriptomics. Analysis of 319 spatial assays from 51 cases revealed gene expression features and novel structural insights defining the shift from precancer to invasive disease. In breast cancer, loss of MGP and PLAT was associated with invasive transition and promoted tumorigenesis in functional assays. In prostate cancer, GDF15, ALDH1A3, ANPEP, and FASN were upregulated along invasive progression, and their knockdown in PC-3 cells suppressed proliferation and migration. Enrichment of tumor-associated macrophages (SPP1+ and MS4A6A+) along non-triple-negative breast cancer breast cancer transitions highlights immune involvement as a potential driver of invasiveness. SIGNIFICANCE: Our method of defining precise spatial locations of invasive transition allows for the direct interrogation of transition drivers, presenting new therapeutic targets for the two most prevalent cancers and providing a framework for studying spatially defined mechanisms of tumor progression. See related commentary by Jing and Li, p. 1720.

Humans↗

PubMed2004

Progressive prosopagnosia: clinical and neuroimaging results.

The authors report the longitudinal case study of a patient with the right temporal variant of frontotemporal lobar degeneration. His deficit, initially limited to visuoperceptual disturbances, progressed 2 years later to a severe semantic breakdown. Neuroimaging data indicate that the underlying degenerative process, initially confined to unimodal visual associative cortices, progressed along the ventral pathways to multimodal areas in charge of integrating knowledge from various modalities (the anterior temporal lobes).

Aged↗

PubMedDate not supplied

Current status of adjuvant systemic therapy for primary breast cancer: progress and controversy.

Results from studies of adjuvant systemic therapy for primary breast cancer accumulated over the past 20 years have clearly established that this treatment approach improves disease-free and overall survival rates in high-risk patients. As a result, adjuvant systemic therapy has become an integral component of the modern, multimodality approach to management of primary breast cancer. However, controversies about the most effective approaches remain, and research continues. This article reviews the current status of adjuvant systemic therapy for primary breast cancer and discusses areas of persistent controversy.

Breast Neoplasms↗

PubMed2026

Development and Validation of a Multimodal Clinical, Pathologic, and Genomic Model for Breast Cancer Recurrence.

PURPOSE: To develop and validate a multimodal recurrence-risk model integrating histology, genomic testing, and clinical variables. METHODS: We developed AI-Path, a whole-slide image biomarker for recurrence prediction trained in CALGB 9344, and validated it in three independent cohorts: TAILORx, a multi-site Chicago cohort, and the MDX-BRCA cohort. We then integrated AI-Path with Oncotype DX Recurrence Score (RS), tumor size, and nodal status into a Cox model, PathClinRS, fit using 60% of cases from TAILORx, with the remaining 40% held out for validation. The primary end point was distant recurrence-free interval. Performance was assessed using Harrell's concordance index (C-index) and Kaplan-Meier analyses. RESULTS: A total of 12,418 patients were included. In TAILORx, AI-Path outperformed RS for distant recurrence (C-index, 0.682 vs 0.647; P = .038), driven by superior prediction of late recurrence (0.656 vs 0.567; P < .001). In node-negative disease, PathClinRS outperformed RSClin in the TAILORx fitting (0.72 vs 0.70; P = .016) and validation sets (0.74 vs 0.70; P = .004). In node-positive disease, PathClinRS outperformed RSClinN+ in Chicago (0.94 vs 0.74; P < .001) and MDX-BRCA (0.71 vs 0.66; P = .004) cohorts. Compared with NATALEE eligibility, PathClinRS identified nearly twice as many high-risk node-negative patients while maintaining a comparable 10-year distant recurrence risk (16.7% vs 16.6% per NATALEE eligibility in TAILORx fitting; 21.0% vs 19.4% in TAILORx validation). PathClinRS identified 68% of intermediate risk premenopausal patients as low-risk with no evidence of chemotherapy benefit, compared to only 36% identified as low risk by standard clinicopathologic criteria. CONCLUSION: Digital histopathology provides prognostic information complementary to genomic assays and has the potential to personalize therapy beyond existing clinicogenomic tools.

Journal Article↗

PubMed2001

Optimizing brain tumor resection. Midfield interventional MR imaging.

The development of the intraoperative MR imager represents an important example of creative vision and interdisciplinary teamwork. The result is a remarkable tool for neurosurgical applications. MRT allows surgical manipulation under direct visualization of the intracranial contents through the eye of the surgeon and through the volumetric images of the MR imaging system. This technology can be applied to cranial and spinal cases, and forseeably can encompass application to the entire gamut of neurosurgical efforts. The author's experience has been that this device is easy and comfortable for the surgeon to use. Image acquisition, giving views in the plane of choice, lasts no more than 2 to 60 seconds (depending on the imaging method), and does not increase the duration of a given procedure substantially. The author believes that the information received through intraoperative MR imaging scanning ultimately will contribute to decreasing the duration of surgery. Future possibilities include combining the intraoperative MR imager with other technologies, such as the endoscope, focused ultrasound, robotics, and the evaluation of brain function intraoperatively. The development of the intraoperative MR imager marks a significant advance in neurosurgery, an advance that will revolutionize intraoperative visualization as fully as the operating microscope. The combination of intraoperative visualization and precise surgical navigation is unparalleled, and its enhancement of surgical applications will be widespread. Considering the remarkable potential of the intraoperative MR imager for neurosurgical applications, optimal magnet design, image quality, and navigational methods are necessary to capitalize on the advantages of this revolutionary tool. The intraoperative MR imaging system that the author's team has developed and used has combined these features, and allows the performance of open surgical procedures without the need of patient or magnet repositioning. By using advanced navigational tools and computer technology, it represents an integration of frameless stereotactic methods with real-time interactive imaging. The midfield imager provides sufficient spatial and temporal resolution and image quality to assess anatomy and pathology adequately, to monitor a surgical procedure, and make image-based decisions. The intraoperative use of this unique system is not limited to biopsies or limited-access procedures. The entire range of neurosurgical procedures can be performed, if the requisite instrumentation is available. Much work remains to be done, however. The team did not develop this system only to enable the performance of current neurosurgical procedures. Forty years ago, the operating microscope enabled not only the performance of undreamt-of procedures but opened the door to entire new subspecialties. The entire landscape of neurosurgery will change at a fundamental level as the full ramifications of this exciting idea come to fruition. The holy grail of image-guided surgery is a seamless interface between the eye and hand in the purest sense (i.e., the mind's eye and hand). Ideally, this seamless interface represents effortless flow between the procedural goal compared with the present situation and the manipulation of the tools available to accomplish the task, whether they be the scalpel, drill, laser, ultrasonic aspirator, phased array focused ultrasound, microrobot, or high-dose irradiator. As in the realm of high-performance military jet fighters, the physical limits of the human being demarcate the confining boundary of the system. Those limits are much tighter around the domain of tool manipulation, where the surgeon will yield, early on, to the enhanced performance of robotics and other technical adjuncts. The era of large open magnet imaging systems for surgical procedures then will come to a close; however, the grander era of the surgeon's integration of precision-guided, multimodality therapeutics will just be beginning. The future will be very bright, indeed.

Adult↗

PubMed1995

[Liver transplantation in the treatment strategy of portal hypertension].

We reviewed 1000 consecutive liver transplants over a 10 year period with special attention to a pre-transplant history of portal hypertension revealed by variceal hemorrhage. Of 730 primary transplanted patients with chronic liver disease 186 (26%) experienced variceal bleeding prior to transplantation of which 130 (70%) required interventional therapy to palliate the bleeding. Sclerotherapy was performed in 93 (50%), surgical portal diversion in 27 (15%) and TIPSS in 10 (5%) patients. Moderate to severe liver dysfunction accounted for 91% of the patients with bleeding complications. The impact of both bleeding and treatment modality utilized in the pre-transplant period was analyzed in a way to integrate liver transplantation into the multimodality treatment of portal hypertension. The overall survival for all patients was 76% at five years. Previous history of variceal bleeding did not affect the outcome of patients following liver transplantation. The patients treated by initial sclerotherapy demonstrated no difference with either graft or patient survival. The patients who had TIPSS to control hemorrhage had lower, but insignificant, graft and patient survival. The group of patients with variceal hemorrhage who had prior surgical shunt did, however, demonstrate a significant increased survival of 96% when compared to the non-shunted group which had a 73% survival (p < 0.007). The strategy in treating these potential transplant patients is critical to the success of the subsequent transplant.

Adult↗

PubMed2006

[Treatment of postoperative pain--a status report].

Substantial progress has been made in our understanding of acute pain mechanisms, and our insight into postoperative convalescence and rehabilitation has increased dramatically. There is a lack of evidence for pre-emptive analgesia, whereas studies of antihyperalgesic drugs and multimodal analgesic regimens are promising. The use of opioids should be restricted, and it may be rational to develop procedure-specific pain treatment guidelines. There is a need for increased collaboration and integration of acute pain treatment and multimodal postoperative rehabilitation efforts.

Analgesia↗