Multimodal Combination Research Articles

Interventions to improve hand hygiene compliance in patient care.

Health care-associated infection is a major cause of morbidity and mortality. Hand hygiene is regarded as an effective preventive measure. This is an update of a previously published review. To assess the short- and long-term success of strategies to improve compliance to recommendations for hand hygiene, and to determine whether an increase in hand hygiene compliance can reduce rates of health care-associated infection. We conducted electronic searches of the Cochrane Register of Controlled Trials, PubMed, Embase, and CINAHL. We conducted the searches from November 2009 to October 2016. We included randomised trials, non-randomised trials, controlled before-after studies, and interrupted time series analyses (ITS) that evaluated any intervention to improve compliance with hand hygiene using soap and water or alcohol-based hand rub (ABHR), or both. Two review authors independently screened citations for inclusion, extracted data, and assessed risks of bias for each included study. Meta-analysis was not possible, as there was substantial heterogeneity across studies. We assessed the certainty of evidence using the GRADE approach and present the results narratively in a 'Summary of findings' table. This review includes 26 studies: 14 randomised trials, two non-randomised trials and 10 ITS studies. Most studies were conducted in hospitals or long-term care facilities in different countries, and collected data from a variety of healthcare workers. Fourteen studies assessed the success of different combinations of strategies recommended by the World Health Organization (WHO) to improve hand hygiene compliance. Strategies consisted of the following: increasing the availability of ABHR, different types of education for staff, reminders (written and verbal), different types of performance feedback, administrative support, and staff involvement. Six studies assessed different types of performance feedback, two studies evaluated education, three studies evaluated cues such as signs or scent, and one study assessed placement of ABHR. Observed hand hygiene compliance was measured in all but three studies which reported product usage. Eight studies also reported either infection or colonisation rates. All studies had two or more sources of high or unclear risks of bias, most often associated with blinding or independence of the intervention.Multimodal interventions that include some but not all strategies recommended in the WHO guidelines may slightly improve hand hygiene compliance (five studies; 56 centres) and may slightly reduce infection rates (three studies; 34 centres), low certainty of evidence for both outcomes.Multimodal interventions that include all strategies recommended in the WHO guidelines may slightly reduce colonisation rates (one study; 167 centres; low certainty of evidence). It is unclear whether the intervention improves hand hygiene compliance (five studies; 184 centres) or reduces infection (two studies; 16 centres) because the certainty of this evidence is very low.Multimodal interventions that contain all strategies recommended in the WHO guidelines plus additional strategies may slightly improve hand hygiene compliance (six studies; 15 centres; low certainty of evidence). It is unclear whether this intervention reduces infection rates (one study; one centre; very low certainty of evidence).Performance feedback may improve hand hygiene compliance (six studies; 21 centres; low certainty of evidence). This intervention probably slightly reduces infection (one study; one centre) and colonisation rates (one study; one centre) based on moderate certainty of evidence.Education may improve hand hygiene compliance (two studies; two centres), low certainty of evidence.Cues such as signs or scent may slightly improve hand hygiene compliance (three studies; three centres), low certainty of evidence.Placement of ABHR close to point of use probably slightly improves hand hygiene compliance (one study; one centre), moderate certainty of evidence. With the identified variability in certainty of evidence, interventions, and methods, there remains an urgent need to undertake methodologically robust research to explore the effectiveness of multimodal versus simpler interventions to increase hand hygiene compliance, and to identify which components of multimodal interventions or combinations of strategies are most effective in a particular context.

Treatment of Adult Acute Lymphocytic Leukemia (ALL) in 2017

In pediatric ALL, intensive multi-modal combination chemotherapy with induction-consolidation-maintenance-intrathecal chemotherapy (2.5 to 3 years) results in cure rates of 80 to 90%. In adult ALL, similar regimens result in cure rates of 40 to 50%. Therefore additional modalities are needed to increase the cure rates 1.

Prognosis and treatment of FOLFOX therapy related interstitial pneumonia: a plea for multimodal immune modulating therapy in the respiratory insufficient patient

BackgroundThe FOLFOX regimen, i.e., folinic acid (FOL), fluorouracil (F) and oxaliplatin (OX), is a drug cocktail that is used to treat gastric and colorectal cancers. Despite the concomitant improvements in response rate, duration of response and patient survival, reports of serious toxic pulmonary side effects have progressively emerged.Case presentationWe describe a patient who was treated with FOLFOX as an adjuvant to a rectosigmoidal resection of a rectosigmoidal carcinoma and who developed respiratory insufficiency requiring mechanical ventilation. Computed tomography (CT) imaging and open lung biopsy findings were compatible with interstitial pneumonia (IP). She received multimodal combination treatment (acetylcysteine, corticosteroids, immune globulins and cyclophosphamide) and survived.We performed a systematic literature search and reviewed all 45 reported cases of FOLFOX-related lung toxicity and/or pulmonary fibrosis for their clinical characteristics and their outcomes related to therapy.ConclusionsWe found that for the 45 cases with available data, the median age was 70 years, and the male–female ratio was 3.5: 1. In the patients exhibiting only mild respiratory symptoms, discontinuation of the culprit drug (oxaliplatin) resulted in a 100% regression of the symptoms. However the prognosis of the respiratory insufficient patient proved to be grim: death occurred in 76.9% of the cases despite conventional treatment with corticosteroids. We therefore urge oncologists and critical care specialists not to limit their interventions to the discontinuation of chemotherapy, artificial ventilation, corticosteroids and glutathione replenishment and to consider the gradual introduction of additional immune-modulating agents whenever life-threatening respiratory symptoms in oxaliplatin-treated patients do not subside; all the more so considering the fact that our analysis showed that every patient who survived intubation and mechanical ventilation experienced a full clinical recovery.

Molecular imaging in early diagnosis, differential diagnosis and follow-up of patients with neurodegenerative diseases

Current disease models suggest that many neurodegenerative disorders are associated with pathological protein aggregations that start to develop in the brain long before the onset of clinical symptoms. Therefore, biomarkers allowing early and reliable characterization of neurodegenerative disease are required. Here we illustrate the potential value of neuroimaging procedures by means of selected examples. Multimodal imaging data of exemplary patients who underwent FDG, Amyloid and AV-1451-PET, FP-CIT-SPECT and MRI imaging in the routine clinical workup in our department is presented and the currently available literature on the topic of imaging in neurodegenerative diseases was reviewed. The complementary value of the applied imaging methods is demonstrated in pairs of representative cases. Depending on the clinical question, individual methods or a meaningful multimodal combination is required to achieve optimal diagnostic benefit. Imaging biomarkers have high potential for early diagnosis, differential diagnosis and follow-up of patients with neurodegenerative diseases already and will gain an even higher importance in the future, when specific pathology-targeted therapies will be evaluated in clinical trials.

Optimizing tumor immune response through combination of radiation and immunotherapy.

Radiation therapy and immunotherapy are two highly evolving modalities for the treatment of solid tumors. Immunotherapeutic drugs can either stimulate the immune system via immunogenic pathways or target co-inhibitory checkpoints. An augmented tumor cell recognition by host immune cells can be achieved post-irradiation, as irradiated tissues can release chemical signals which are sensed by the immune system resulting in its activation. Different strategies combining both treatment modalities were tested in order to achieve a better therapeutic response and longer tumor control. Both regimens act synergistically to one another with complimentary mechanisms. In this review, we explore the scientific basis behind such a combination, starting initially with a brief historical overview behind utilizing radiation and immunotherapies for solid tumors, followed by the different types of these two modalities, and the biological concept behind their synergistic effect. We also shed light on the common side effects and toxicities associated with radiation and immunotherapy. Finally, we discuss previous clinical trials tackling this multimodality combination and highlight future ongoing research.

Biophysical technologies for understanding circulating tumor cell biology and metastasis.

An understanding of cancer evolution in lung cancer with its associated resistance to therapy can only be achieved with repeated sampling and analysis of the cancer. Given the high risks and costs associated with repeat physical biopsy, alternative technologies must be applied. Several modalities exist for analysis and re-analysis of cancer biology. Among them are the CellSearch platform, the CTC chip, and the high-definition CTC platform. While the former is primarily able to provide prognosticating information in the form of CTC enumeration, the latter two have the advantage of serving as a platform to study tumor biology. Techniques for analysis of single cell genomics, as well as protein expression on a single cell basis provide scientists with the capacity to understand cancer cell populations as a collection of individual cells, rather than as an average of all cells. A multimodal combination of circulating tumor DNAs (ctDNAs), CTCs, proteomics, and CTC-derived xenografts (CDXs) to create computational models useful in diagnosis, prognostication, and predictiveness to treatment is likely the future of tailoring individualized cancer care.

1kW fiber-coupled pump-module at 976nm with 50% efficiency.

We present a fiber-coupled pump-module emitting more than 1kW of mode-stripped power at 976nm from a detachable 225µm, 0.22NA fiber. The electrical-to-optical efficiency at 1kW is ~50%. Six of these pump modules attached to a (6 + 1):1 multimode combiner enable a 5-6kW, single-mode, Yb-doped fiber amplifier.

Core-Satellite Polydopamine-Gadolinium-Metallofullerene Nanotheranostics for Multimodal Imaging Guided Combination Cancer Therapy.

Integration of magnetic resonance imaging (MRI) and other imaging modalities is promising to furnish complementary information for accurate cancer diagnosis and imaging-guided therapy. However, most gadolinium (Gd)-chelator MR contrast agents are limited by their relatively low relaxivity and high risk of released-Gd-ions-associated toxicity. Herein, a radionuclide-64 Cu-labeled doxorubicin-loaded polydopamine (PDA)-gadolinium-metallofullerene core-satellite nanotheranostic agent (denoted as CDPGM) is developed for MR/photoacoustic (PA)/positron emission tomography (PET) multimodal imaging-guided combination cancer therapy. In this system, the near-infrared (NIR)-absorbing PDA acts as a platform for the assembly of different moieties; Gd3 N@C80 , a kind of gadolinium metallofullerene with three Gd ions in one carbon cage, acts as a satellite anchoring on the surface of PDA. The as-prepared CDPGM NPs show good biocompatibility, strong NIR absorption, high relaxivity (r 1 = 14.06 mM-1 s-1 ), low risk of release of Gd ions, and NIR-triggered drug release. In vivo MR/PA/PET multimodal imaging confirms effective tumor accumulation of the CDPGM NPs. Moreover, upon NIR laser irradiation, the tumor is completely eliminated with combined chemo-photothermal therapy. These results suggest that the CDPGM NPs hold great promise for cancer theranostics.

MRI-BASED CLASSIFICATION ACCURACY OF DEMENTIA TYPE IS DETERMINED BY MRI MODALITY

Background: Multimodal MRI may support single-subject differentiation diagnosis of Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD). Yet, what MRI modality combinations maximize classification accuracy is not yet known. We analyzed various MRI modality combinations to determine what combinations suit single-subject classification of AD patients, bvFTD patients, and control subjects best. Methods: Thirty-seven patients with probable AD, 28 patients with bvFTD, and 40 cognitively normal subjects (Controls) (Table 1) underwent diffusion tensor imaging (DTI), resting-state functional, and T1-weighted structural MRI at 3T. From each T1-w image, probabilistic gray matter (GM) maps were calculated and used to estimate local GM density (GMD) within 96 Harvard-Oxford cortical and 14 deep GM regions. 20 tracts of the Johns-Hopkins-University tractography atlas were used to determine local white matter density (WMD) values and, after projection on the study-specific skeleton calculated with tract-based spatial statistics, local measures of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity, and radial diffusivity. Seventy rs-fMRI components, derived from a temporally concatenated independent component analysis, were used to calculate the components' pairwise correlations and partial correlations. These features were used to establish classification accuracy using nested cross-validation classification analyses with elastic net classifiers. Individual and combinations of MRI modalities were step-wise evaluated to determine classification accuracy, expressed as area under the receiver operating characteristic curves (AUC). A three-group classification model was used to determine the accuracy for differentiating between AD, bvFTD, and Control subjects. Three two-group models were calculated to differentiate AD from Controls, bvFTD from Controls, and AD from bvFTD subjects. Results: Classification accuracy for three-group and AD versus Control classifications were highest with GMD-based features ((AUC [min-max]) 0.7±5[0.711-0.847] and 0.933[0.886- 0.963]) (Table 2). bvFTD versus Control and AD versus bvFTD classification models were most accurate using DTI-based features (FA: 0.860[0.807-0.913], MD: 0.693[0.614-0.821]). Overall, rsfMRI features did not improve classification accuracy. Conclusions: MRI-based differentiation of dementia forms may depend on dementia- type and MRI modality. T1-w-based measures particularly supported AD classifications, whereas DTI-based measurements facilitated bvFTD classifications. Functional connectivity measures and multimodal combinations did not substantially improve dementia- type discrimination. For MRI-based differential dementiatype diagnosis careful selection of MRI modalities is warranted.

Effects of multimodal combination dialysis on Klotho protein, FGF-23 and BNP in patients with maintenance hemodialysis

To discuss the effects of multimodal combination dialysis on Klotho protein, fibroblast growth factor-23 (FGF-23) and brain natriuretic peptide (BNP) in patients with maintenance hemodialysis (MHD). A randomized controlled trial (RCT) was conducted. 120 patients who was diagnosed with chronic renal failure (CRF) uremia receiving MHD over 3 months admitted to Blood Purification Centre of Department of Nephrology of the Second People's Hospital of Guiyang from December 2015 to December 2016 were enrolled, who were randomly divided into hemodialysis (HD) group (HD for 8 times a month), HD + hemofiltration (HF) group (HD for 8 times a month + HF once a month), and HD + HF + hemoperfusion (HP) group (HD for 8 times a month + HF for 4 times a month + HP once a month), with 40 patients in each group. Before and after treatment for 6 months and 12 months, blood was taken from venous circuit tube, the serum Klotho protein and FGF-23 levels were determined by enzyme linked immunosorbent assay (ELISA), and the serum BNP level was determined by electrochemiluminescence. 120 patients with MHD were enrolled in the final analysis without withdrawal. There were no significant differences in the levels of Klotho protein, FGF-23, or BNP before enrollment among the three groups (all P > 0.05). Compared with those before enrollment, the levels of serum Klotho protein after enrollment in three groups showed a sustained upward tendency, which were higher in HD + HF + HP group than in HD + HF group and HD group (μg/L: 2.59±0.61, 1.63±0.35, 1.13±0.26 at 6 months, F = 119.374, P = 0.000; 6.98±1.21, 3.57±1.03, 2.12±0.43 at 12 months, F = 275.675, P = 0.000); the levels of FGF-23 showed a sustained downward tendency, which were lower in HD + HF + HP group than in HD + HF group and HD group (ng/L: 69.22±38.26, 132.28±61.18, 178.50±74.64 at 6 months, F = 33.509, P = 0.000; 32.81±17.32, 87.93±43.27, 146.33±69.28 at 12 months, F = 55.466, P = 0.000); the BNP showed a similar tendency as FGF-23 (ng/L: 4 083.39±2 864.53, 7 245.69±4 643.81, 7 969.12±5 360.85 at 6 months, F = 8.758, P = 0.000; 1 521.86±894.63, 4 554.32±1 969.84, 5 013.89±2 033.64 at 12 months, F = 49.003, P = 0.000). Multimodal combination dialysis can increase the Klotho protein level, and decrease the levels of FGF-23 and BNP in MHD patients with CRF uremia.

High-power homogeneous illumination for super-resolution localization microscopy with large field-of-view.

As a wide-field imaging technique, super-resolution localization microscopy (SRLM) is theoretically capable of increasing field-of-view (FOV) without sacrificing either imaging speed or spatial resolution. There are two key factors for realizing large FOV SRLM: one is high-power illumination over the whole FOV with sufficient illumination homogeneity and the other is large FOV signal detection by a camera that has large number of pixels and sufficient detection sensitivity. However nowadays, even though the state-of-art scientific complementary metal-oxide semiconductor (sCMOS) cameras provide single molecule fluorescence signal detection ability over an FOV of more than 200 μm × 200 μm, large FOV SRLM still has not been achieved due to the lack of high-power homogeneous illumination. In this paper, we report large FOV SRLM with a high-power homogeneous illumination system. We demonstrate experimentally that our illumination system, which is based on a newly designed multimode fiber combiner, is capable of providing sufficient illumination intensity (~4.7 kW/cm2 @ 640 nm) and excellent illumination homogeneity. Compared with the reported approaches, our illumination system is advantageous in laser power scaling and square-shape illumination without beam clipping. As a result, our system makes full use of the sensor of a representative Hamamatsu Flash 4.0 V2 sCMOS camera (2048 × 2048 active pixels) and achieves a FOV as large as 221 μm × 221 μm with homogeneous spatial resolution. The flexible solution for realizing large FOV SRLM reported in this paper pushes a significant step toward the development of SRLM.

Pentazocine versus pentazocine with piroxicam for postoperative pain relief after cesarean section: an open label, comparative study

Background: The concept of multimodal analgesia was introduced more than a decade ago as a technique to improve analgesia and reduce the incidence of opioid-related adverse events. The rationale for this strategy is the achievement of sufficient analgesia due to the additive or synergistic effects between different classes of analgesics. Objectives of the study was to compare the efficacy and safety of pentazocine and its combination with piroxicam in the management of post cesarean pain.Methods: Cases were randomly assigned to 2 groups of 30 cases each. One group received pentazocine 30mg and another; pentazocine 30mg + piroxicam 20mg. Injections were given intramuscularly, postoperatively after skin closure. Diclofenac 75mg was the rescue analgesia. Primary outcome measure was control of pain, assessed by visual analogue scale (VAS). Secondary outcomes were sedation and time to rescue analgesia. Safety of the drugs was assessed by adverse drug reactions. Data was analysed by student’s t test, analysis of variance and post-hoc test.Results: Multimodal group showed better analgesia compared to unimodal group (p<0001). Drowsiness was the main adverse effect in both treatment groups.Conclusions: Multimodal analgesic combination of pentazocine and piroxicam showed superior analgesic effect with better pain control and longer duration of action compared to pentazocine alone.

Hybrid-array-based optoacoustic and ultrasound (OPUS) imaging of biological tissues

Hybrid optoacoustic and pulse-echo ultrasound imaging is an attractive multi-modal combination owing to the highly complementary contrast of the two techniques. Efficient hybridization is often hampered by significant dissimilarities between their optimal data acquisition and image formation strategies. Herein, we introduce an approach for combined optoacoustic and ultrasound imaging based on a plano-concave detector array design with a non-uniform pitch distribution. The hybrid design optimized for both modalities allows for maintaining an extended field of view for efficient ultrasound navigation while simultaneously providing broad tomographic coverage for optimal optoacoustic imaging performance. Imaging sessions performed in tissue-mimicking phantoms and healthy volunteers demonstrate that the suggested approach renders an enhanced imaging performance as compared with the previously reported hybrid optoacoustic and ultrasound imaging approaches. Thus, it can greatly facilitate clinical translation of the optoacoustic imaging technology by means of its efficient combination with ultrasonography, a well-established clinical imaging modality.

An expected consequence approach to assessing the viability of multimodal transportation of crude oil in eastern Canada

The refineries in eastern Canada depend primarily on the marine networks to meet their crude demand. This exclusive reliance on a single mode results in overloaded marine networks, which in turn increases the associated risk for oil spills and relevant environmental costs. This paper considers the geography of the region, and investigates the viability of using marine-railroad multimodal combination to move shipments in the region. The most popular measure of risk viz., expected consequence is used to analyze a case study in eastern Canada, and to arrive at an affirmative conclusion. However, given the dearth of a comprehensive empirical dataset, one needs to exercise caution in making deductions.

Chemotherapeutic drug-photothermal agent co-self-assembling nanoparticles for near-infrared fluorescence and photoacoustic dual-modal imaging-guided chemo-photothermal synergistic therapy

Multimodal imaging-guided synergistic combination therapy has shown great potential for cancer treatment. However, the nanocarrier-based theranostic systems suffer from batch-to-batch variation, complexity of multicomponent, poor drug loading, and carrier-related toxicity issues. To address these issues, herein we developed a novel carrier-free theranostic system with nanoscale characteristics for near-infrared fluorescence (NIRF) and photoacoustic (PA) dual-modal imaging-guided synergistic chemo-photothermal therapy (PTT). Indocyanine green (ICG) and epirubicin (EPI) could co-self-assemble into small molecular nanoparticles (NPs) in aqueous solution without any molecular precursor or excipient via collaborative interactions (electrostatic, π–π stacking, and hydrophobic interactions). The exceptionally high dual-drug loading (∼92wt%) ICG-EPI NPs showed good physiological stability, preferable photothermal response, excellent NIRF/PA imaging properties, pH-/photo-responsive drug release behavior, and promoted cellular endocytosis compared with free ICG or EPI. Importantly, the ICG-EPI NPs showed excellent tumor targeting ability with high spatial resolution and deep penetration via in vivo NIRF/PA dual-modal imaging. Moreover, in comparison with individual chemotherapy or PTT, the combinational chemo-PTT therapy of ICG-EPI NPs with NIR laser irradiation synergistically induced apoptosis and death of cancer cells in vitro, and showed synergistic chemo-PTT efficiency in vivo as evidenced by highly efficient tumor ablation. Furthermore, the ICG-EPI NPs exhibited inappreciable toxicity. This co-self-assembly of both FDA-approved agents provides a safe and “Molecular economical” strategy in the rational design of multifunctional nano-theranostic systems for real-time self-monitoring intracellular drug delivery and targeting multimodal imaging-guided synergistic combination therapy.

Appetitive Olfactory Learning and Long-Term Associative Memory in Caenorhabditis elegans.

Because of the relative simplicity of its nervous system, Caenorhabditis elegans is a useful model organism to study learning and memory at cellular and molecular levels. For appetitive conditioning in C. elegans, food has exclusively been used as an unconditioned stimulus (US). It may be difficult to analyze neuronal circuits for associative memory since food is a multimodal combination of olfactory, gustatory, and mechanical stimuli. Here, we report classical appetitive conditioning and associative memory in C. elegans, using 1-nonanol as a conditioned stimulus (CS), and potassium chloride (KCl) as a US. Before conditioning, C. elegans innately avoided 1-nonanol, an aversive olfactory stimulus, and was attracted by KCl, an appetitive gustatory stimulus, on assay agar plates. Both massed training without an intertrial interval (ITI) and spaced training with a 10-min ITI induced significant levels of memory of association regarding the two chemicals. Memory induced by massed training decayed within 6 h, while that induced by spaced training was retained for more than 6 h. Animals treated with inhibitors of transcription or translation formed the memory induced by spaced training less efficiently than untreated animals, whereas the memory induced by massed training was not significantly affected by such treatments. By definition, therefore, memories induced by massed training and spaced training are classified as short-term memory (STM) and long-term memory (LTM), respectively. When animals conditioned by spaced training were exposed to 1-nonanol alone, their learning index was lower than that of untreated animals, suggesting that extinction learning occurs in C. elegans. In support of these results, C. elegans mutants defective in nmr-1, encoding an NMDA receptor subunit, formed both STM and LTM less efficiently than wild-type animals, while mutations in crh-1, encoding a ubiquitous transcription factor CREB required for memory consolidation, affected LTM, but not STM. The paradigm established in the present study should allow us to elucidate neuronal circuit plasticity for appetitive learning and memory in C. elegans.

CLT panels in Japan from cradle to construction site gate: global warming potential and freight costs impact of three supply options

ABSTRACTThis study investigates the effect of three different multimodal transport combinations for cross laminated timber (CLT) supply on global warming potential and freight costs from cradle to the construction site gate. It attempts to demonstrate to what extent a local approach could be beneficial, both environmentally and economically. It was found that emissions during the transportation modules will be more than those from the manufacturing stages in the case of intercontinental routes, contrary to the environment-friendly idea usually associated with timber products. Also, the results showed that it is crucial to locate CLT manufacturing facilities as close as possible to wood supply sources, in order to reduce the freight costs of low value-added products.

Full-Field Optical Coherence Tomography as a Diagnosis Tool: Recent Progress with Multimodal Imaging

Full-field optical coherence tomography (FF-OCT) is a variant of OCT that is able to register 2D en face views of scattering samples at a given depth. Thanks to its superior resolution, it can quickly reveal information similar to histology without the need to physically section the sample. Sensitivity and specificity levels of diagnosis performed with FF-OCT are 80% to 95% of the equivalent histological diagnosis performances and could therefore benefit from improvement. Therefore, multimodal systems have been designed to increase the diagnostic performance of FF-OCT. In this paper, we will discuss which contrasts can be measured with such multimodal systems in the context of ex vivo biological tissue examination. We will particularly emphasize three multimodal combinations to measure the tissue mechanics, dynamics, and molecular content respectively.

Bumblebees require visual pollen stimuli to initiate and multimodal stimuli to complete a full behavioral sequence in close-range flower orientation.

Flower visits are complex encounters, in which animals are attracted by floral signals, guided toward the site of the first physical contact with a flower, land, and finally take up floral rewards. At close range, signals of stamens and pollen play an important role to facilitate flower handling in bees, yet the pollen stimuli eliciting behavioral responses are poorly known. In this study, we test the response of flower‐naive bumblebees (Bombus terrestris) toward single and multimodal pollen stimuli as compared to natural dandelion pollen. As artificial pollen stimuli, we used the yellow flavonoid pigment quercetin, the scent compound eugenol, the amino acid proline, the monosaccharide glucose, and the texture of pollen‐grain‐sized glass pellets as a tactile stimulus. Three test stimuli, dandelion pollen, one out of various uni‐ and multimodal stimulus combinations, and a solvent control were presented simultaneously to individual bumblebees, whose response was recorded. The results indicate that bumblebees respond in an irreversible sequence of behavioral reactions. Bumblebees approached the visual stimulus quercetin as often as natural dandelion pollen. An additional olfactory stimulus resulted in slightly more frequent landings. The multimodal stimulus combinations including visual, olfactory, gustatory, and tactile stimuli elicited approaches, antennal contacts, and landings as often as natural pollen. Subsequent reactions like proboscis extension, mandible biting, and buzzing were more often but not regularly observed at dandelion pollen. Our study shows that visual signals of pollen are sufficient to trigger initial responses of bumblebees, whereas multimodal pollen stimuli elicit full behavioral response as compared to natural pollen. Our results suggest a major role of pollen cues for the attraction of bees toward flowers and also explain, why many floral guides mimic the visual signals of pollen and anthers, that is, the yellow and UV‐absorbing color, to direct bumblebees toward the site where they access the floral rewards.

Multimodal Crowdsourcing for Transcribing Handwritten Documents

Transcription of handwritten documents is an important research topic for multiple applications, such as document classification or information extraction. In the case of historical documents, their transcription allows to preserve cultural heritage because of the amount of historical data contained in those documents. The transcription process can employ state-of-the-art handwritten text recognition systems in order to obtain an initial transcription. This transcription is usually not good enough for the quality standards, but that may speed up the final transcription of the expert. In this framework, the use of collaborative transcription applications (crowdsourcing) has risen in the recent years, but these platforms are mainly limited by the use of non-mobile devices. Thus, the recruiting initiatives get reduced to a smaller set of potential volunteers. In this paper, an alternative that allows the use of mobile devices is presented. The proposal consists of using speech dictation of handwritten text lines. Then, by using multimodal combination of speech and handwritten text images, a draft transcription can be obtained, presenting more quality than that obtained by only using handwritten text recognition. The speech dictation platform is implemented as a mobile device application, which allows for a wider range of population for recruiting volunteers. A real acquisition on the contents of a Spanish historical handwritten book was obtained with the platform. This data was used to perform experiments on the behaviour of the proposed framework. Some experiments were performed to study how to optimise the collaborators effort in terms of number of collaborations, including how many lines and which lines should be selected for the speech dictation.