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Unifying multimodal single-cell data with a mixture-of-experts β-variational autoencoder framework.

Multimodal single-cell assays profile complementary layers of cell state, but integration is complicated by modality mismatch, sparsity, and uneven cohort coverage. Here, we present Unified Variational Inference (UniVI), a scalable mixture-of-experts β-variational autoencoder that learns a shared latent space while preserving modality-specific structure. UniVI couples modality-specific encoders/decoders with a shared latent prior and a symmetric cross-modal alignment objective, enabling consistent integration of paired measurements without curated feature-link graphs or preannotated reference atlases; optional supervised heads can be added when labels are available. Across paired RNA-protein (CITE-seq) and RNA-chromatin (10x Genomics Multiome, SHARE-seq) data spanning human PBMCs and mouse back skin-a nonhematopoietic tissue with continuous differentiation hierarchies-UniVI produces coherent embeddings, improves label transfer, and enables cross-modal reconstruction and denoising. Extending to trimodal measurements, UniVI maintains robust three-way alignment among RNA, chromatin accessibility, and surface proteins (TEA-seq), and accommodates DNA methylation in a paired scNMT-seq mouse gastrulation proof-of-concept under beta-binomial likelihoods. Performance degrades gracefully under severe cell type imbalance and in the presence of modality-exclusive populations. In an acute myeloid leukemia mosaic design, a paired RNA-protein bridge anchors independent RNA-only and protein+genotype cohorts, revealing genotype-associated neighborhoods that sharpen with mutation-aware fine-tuning. UniVI thus provides a flexible, interpretable framework for multimodal integration across paired, trimodal, and mosaic study designs and supports practical reference-to-query projection in partially observed studies.

Journal Article

Multimodal Therapy With Metformin, Inositol and Dietary Restriction Improves Insulin Resistance and Endocrine Outcomes in Women With Polyendocrine Metabolic Ovarian Syndrome: A Randomized Controlled Trial.

INTRODUCTION: Polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome (PCOS), is a common endocrine-metabolic disorder characterized by insulin resistance, hyperandrogenism and ovulatory dysfunction. Metformin, inositol supplementation and lifestyle modification are widely used treatments, but direct comparative evidence remains limited. Multimodal therapy combining metformin, inositol and dietary restriction produces greater metabolic and reproductive improvement than single-modality interventions. METHODS: We conducted a 12-week randomized controlled trial in 192 women aged 18-35 years diagnosed with PMOS according to Rotterdam criteria. Participants were allocated to metformin (1500-2000 mg/day), inositol (myo-inositol 2&#x2009;g plus d-chiro-inositol 50&#x2009;mg twice daily), calorie-restricted diet (1200-1500&#x2009;kcal/day), or combination therapy. Primary outcomes included changes in body mass index (BMI) and insulin resistance assessed by HOMA-IR. Secondary outcomes included testosterone, LH/FSH ratio and menstrual regularity. Analysis was performed using analysis of covariance (ANCOVA), with post-intervention values as dependent variables and corresponding baseline values as covariates. Categorical outcomes were compared using the Chi-square test. RESULTS: All interventions improved metabolic and endocrine parameters. Combination therapy resulted in the greatest reduction in HOMA-IR (-&#x2009;2.64, 95% CI&#x2009;-&#x2009;2.82 to -2.46, p&#x2009;<&#x2009;0.001) and BMI (-&#x2009;2.8&#x2009;kg/m2, 95% CI&#x2009;-&#x2009;3.05 to -2.55, p&#x2009;<&#x2009;0.001). Menstrual cyclicity improved across all groups, with the highest proportion of participants reporting cycle regularisation in the combination therapy group (85.4%), compared with dietary restriction (72.9%), inositol (64.6%), and metformin (39.6%) (p&#x2009;<&#x2009;0.001). Given the short follow-up duration, these findings reflect early improvements rather than sustained normalisation. CONCLUSION: Multimodal therapy was associated with superior metabolic and reproductive outcomes compared with single-modality interventions in women with PMOS. CLINICAL TRIAL REGISTRATION: ClinicalTrials. gov (NCT07380841).

Humans

A new multimodality correlative imaging technique for VOP/VIM (VL) thalamotomy procedures.

This paper describes our experience at Mayo Clinic with a new technique for planning ventro-oralis posterior (VOP) ventral intermediate (ventrolateral) VIM (VL) thalamotomy procedures for selected patients with medically intractable tremor. This new method employs a multimodality correlative imaging technique for determining the lesion target point on MR images. At surgery, stereotactic frame settings for the final lesion target were ultimately determined by stereotactic ventriculography modified by neurophysiological recording. Acceptable correlation was found between the multimodality correlative imaging method and the actual target coordinates determined by ventriculography and semi-microelectrode recording.

Humans

The multimodal approach to the treatment of minor depression.

The multimodal approach endeavors to achieve rapid remission of depressive symptoms and significant relapse prevention. It is predicated on the assumption that it is usually insufficient to facilitate the acquisition of insight, dispute irrational ideas, and change negative automatic thoughts. In addition to the foregoing, behavioral deficits, sensory overloads, and negative imagery must be identified and remedied, and antidepressant medication should be considered. This paper outlines a seven-pronged approach in the treatment of "minor" depression. Some of the procedures include: assertiveness training, a "sensate focus" of enjoyable events, coping imagery, time projection, cognitive disputation, role-playing, desensitization, family therapy, and biological prophylaxis. In essence, this broad-based approach recommends that attention be paid not only to cognitive issues, but also to specific behaviors, sensations, images, interpersonal relationships, and other interactive effects. The multimodal framework (BASIC I.D.) enables the practitioner to administer the necessary measures in a systematic and comprehensive manner.

Adult

Efficacy of a multimodal conservative rehabilitation program for bladder control in individuals with incomplete spinal cord injury: A randomized controlled trial.

ObjectiveThe study aimed to evaluate the efficacy of a multimodal intervention on urodynamic outcomes, urinary incontinence severity, and pelvic floor muscle strength in individuals with overactive bladder after incomplete spinal cord injury.MethodsA single-blind randomized controlled trial was conducted on 74 male participants diagnosed with overactive bladder and incomplete spinal cord injury. Participants were randomly assigned to an experimental group or a control group. Treatment was conducted for 8 weeks, three sessions per week. Outcomes were assessed at baseline, post-intervention, and the 8-week follow-up.ResultsThe experimental group showed significantly greater improvements in the measured outcomes compared with the control group (P&#x2009;<&#x2009;0.001).ConclusionIncorporating a multimodal regimen demonstrated significant efficacy in enhancing bladder capacity, continence, and muscle function in individuals with overactive bladder due to incomplete spinal cord injury.Clinical trial registry (ID: NCT07008157).https://clinicaltrials.gov/study/NCT07008157?cond=Spinal%20Cord%20Injuries&intr=Multimodal%20Rehabilitation%20Program&viewType=Card&rank=1.

Humans

Comprehensive oral X-ray diagnosis: Scanora multimodal radiography. A preliminary description.

Scanora (Soredex, Orion Corporation, Helsinki, Finland) is a multimodal radiography system which utilizes the principles of narrow beam radiography and spiral tomography. The system includes an integrated multifunction X-ray unit, a coordinate system for object localization and a wide selection of dental and maxillofacial imaging problems. All imaging procedures are computer controlled and executed automatically. Clinical experience and preliminary results show that the multimodal imaging system has great potential in the detection of pathological conditions of the maxillofacial region.

Humans

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

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

Acoustic Stimulation

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

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

Humans

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

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

Journal Article

Agoraphobia: indications for the application of the multimodal behavioral conceptualization.

Agoraphobia, characterized as fear of going into public places, vehicles, shops, streets, and so forth, is a prevalent syndrome which permeates the patient's life. The efficacy of psychoanalytic, behavioral, and pharmacological treatments has been disappointing. The pervasive nature of agoraphobia dictates that its treatment is most efficacious when a combination of separate although interactive techniques is applied in concert. A multimodal behavioral conceptualization provides the vehicle for the systematic combined application of seemingly diverse individual approaches through monitoring and treating the BASIC ID, an acronym for behavior, affect, sensation, imagery, cognition, interpersonal relationships, and drugs. In an illustrative case, application of the multimodal behavioral conceptualization was instrumental in bringing relief to an agoraphobic patient's distress and disabilities.

Adult

Visualization of multimodal image information in medicine.

Radiological and clinical practice can be enhanced by improved access to multimodal image informations. Analysis, visualization, method characteristic image processing and image synthesis is needed not only for the interpretation of the images but also for performing effective consultations with clinical colleagues and computer supported therapy planning and control strategies. The distributed system RADVIS (radiological visualization) is presented which enables the fast display, three dimensional visualization and the modality oriented analysis of multimodal image informations. Based on a unique image format, modality specific evaluation procedures and two- or three dimensional processing tools of image analysis produce the input data for therapy planning programs. The easy use of this multimedia visualisation tool enables radiologists and clinicians to deal with their image data. The description of methods and procedures of the prototype, as well as typical examples of radiologic practice will demonstrate the efficiency of the presented system.

Humans

[Multimodal treatment for advanced, ovarian cancer patients with poor performance status--its effectiveness and limitations].

We assessed the feasibility of the sequential multimodal treatment including neoadjuvant chemotherapy for far advanced ovarian cancer patients not amenable to a standard modality because of poor medical status. Seven consecutive advanced ovarian cancer patients presented with massive ascites (5 with pleural effusion). Based on the priming theory, immunotherapy with OK432 (s.c. priming with 0.2 KE of OK432 followed by a local injection with 10KE of OK432) was successfully applied to a carcinomatous effusion. Thereafter, patients were treated with 4-6 courses (13-20 wks) of "low-dose consecutive CP (CPM 500 mg/m2, day 1; CDDP 10 mg/m2, day 1-7), which delivered 1CR, 5PR and 1NC (tumor regression rate: 30-100%). Subsequently, the patients underwent radical surgery including small/large bowel resection, splenectomy and diaphragma resection in addition to hysterectomy, bilateral adenectomy and omentectomy, with tumor resectability being 100% in 4 cases and 90% < (residual 2 cm) in 3. Postoperatively, patients received intraperitoneal (IP) chemo-immunotherapy and were followed up with IP washing cytology through an implanted reservoir. Mean survival time was 17.1 months (10-32) with the follow up interval being 10-32 months. Four patients with complete tumor resection are alive with no evidence of disease for 14-32 months. Among 3 incomplete patients, 2 with persistent/recurrent disease received further IP chemotherapy and the remaining one died of the disease at 15 months from the start of therapy. Thus, the present multimodality indicates the possibility of a "cure" for far advanced ovarian cancer patients with poor performance status.

Adenocarcinoma

Angiographically occult brainstem vascular malformation: a longitudinal comparison of magnetic resonance imaging (MRI) and multimodal evoked potential (EP) recordings.

Over a period of several years, a patient with angiographically occult vascular malformation (AOVM) involving the brainstem was longitudinally studied by means of serial Magnetic Resonance Imaging (MRI) and multimodal Evoked Potential (EP) recordings (visual-VEP, brainstem auditory-BAEP, somatosensory--SEP--by stimulating median and peroneal nerves). MRI did contribute to an accurate definition of AOVM features. In particular, it was able to follow over time the AOVM size, and to discriminate between recent and old bleedings. Multimodal EP recordings displayed different pathological BAEP and peroneal SEP values, which documented a transient segmental brainstem involvement (related to the presence of hemorrhage), along with persistent and probably irreversible signs of diffuse brainstem dysfunction. Thus, MRI and EP assessment is useful in monitoring the clinical course of brainstem occult vascular malformations.

Brain Neoplasms

Integrating histology and spatial transcriptomics via multimodal transformers and contrastive representation learning for accurate gene expression prediction.

Predicting spatial gene expression from Histological images is a fundamental task in understanding tissue organization and molecular phenotypes. However, existing methods often rely on single-model representations or lack effective alignment between image and transcriptomic features. To address these limitations, we propose a unified multimodal learning framework that integrates histological imaging and spatial transcriptomics through a shared latent representation space. Specifically, histological H&E images are encoded by a ResNet50-based convolutional stem and a MobileViT Transformer backbone to extract hierarchical visual representations. Both modalities are projected into a shared latent space via linear-GELU-dropout transformation blocks, enabling cross-modal alignment through a contrastive learning objective that maximizes agreement between the corresponding image and the spot embeddings. Experimental results on the 10x Genomics Visium dataset of human liver tissue demonstrate that MViTGene achieves significantly higher prediction accuracy than existing methods across multiple gene subsets, with improvements of 20%, 33%, and 12% in predicting marker genes, highly expressed genes, and highly variable genes, respectively. The significant improvement in relevance indicates that the model can more accurately capture the true correspondence between tissue morphology and gene expression, therefore enabling more reliable biological interpretation. It provides a computational tool for high-throughput spatial gene expression prediction that balances performance and interpretability.

Humans

Breaking the Debilitating Cycle: Pathophysiology, Assessment, and Multimodal Intervention of Secondary Debilitation After Hip Fracture in Older Adults-A Narrative Review.

Hip fractures pose a serious threat to the quality of life among older adults and impose a heavy burden on both society and families. Although current surgical techniques for hip fractures have become increasingly refined, postoperative quality of life and overall function in older adult populations often steeply decline. This decline is marked by "secondary debilitation," characterized by exacerbated sarcopenia, functional impairment, and physiological reserve depletion-a process that becomes a risk factor for recurrent fractures, creating a "vicious cycle" with hip fractures. This article provides a comprehensive overview of the pathophysiological mechanisms underlying "secondary debilitation," discusses the clinical application of risk assessment tools, and presents a phased, stepwise intervention strategy aimed at interrupting the "vicious cycle." The strategy includes early rapid rehabilitation, nutritional support, and prevention of complications; a mid-phase multimodal approach involving multidisciplinary management, comanaged wards, fracture liaison services, and systematic rehabilitation; and, finally, late-phase exploration of emerging pharmacotherapies and treatment methods. This review seeks to offer an evidence-based foundation for optimizing clinical risk assessment and developing precise interventional strategies.

Humans

MOADE: a multimodal autoencoder for dissociating bulk multi-omics data.

In single cell biology, the complexity of tissues may hinder lineage cell mapping or tumor microenvironment decomposition, requiring digital dissociation of bulk tissues. Many deconvolution methods focus on transcriptomic assay, not easily applicable to other omics due to ambiguous cell markers and reference-to-target difference. Here, we present MOADE, a multimodal autoencoder pipeline linking multi-dimensional features to jointly predict personalized multi-omic profiles and cellular compositions, using pseudo-bulk data constructed by internal non-transcriptomic reference and external scRNA-seq data. MOADE is evaluated through rigorous simulation experiments and real multi-omic data from multiple tissue types, outperforming nine deconvolution pipelines with superior generalizability and fidelity.

Humans

Multimodality treatment. A one-year follow-up of 84 hyperactive boys.

This study reports findings at the end of the first year of a three-year prospective study of 84 hyperactive boys. A multidimensional approach to evaluation and an individualized multimodality treatment plan commensurate with each child's disabilities was used. Treatment plans were implemented by members of the research staff working together as a coordinated therapeutic team. Measures of the child's behavior at home and at school, academic performance, delinquent behavior, and emotional adjustment were obtained initially and at one year. Results suggest that the combination of a clinically useful medication with appropriate psychological treatments simultaneously directed to each of the child's many disabilities is associated with an unexpectedly good outcome. Whether this will continue to be true when these children are followed up over a longer period of time awaits further investigation.

Achievement

The success and failure of multimodal therapy for cancer in children.

Achievements, as well as limitation, in combination treatment of childhood malignancies are discussed. Tumor types are grouped according to response (definite, probable, unknown) to combined treatment. Improvements in survival rates have occurred following the addition of chemotherapy to surgery and radiation therapy in children with Wilmes' tumor, and Ewing's and soft tissue sarcoma, probably by suppression of microscopic metastases. So far, advances are not yet apparent following multimodal treatment of neuroblastoma, hepatoma, and ovarian tumors.

Adolescent