Multimodal Test Research Articles

Abstract 4138624: Looking Beyond Respirophasic Ventricular Interdependence: A Case Report of Constrictive Pericarditis Masquerading as Cirrhosis

Case Presentation: A 67-year-old man with recurrent pleural effusions and concern for cirrhosis was referred for liver transplant. Pleural fluid was transudative by Light’s criteria with a high total protein level of 3.5 g/dL, which made hepatic hydrothorax unlikely. Liver biopsy confirmed congestive hepatopathy without advanced fibrosis. Transthoracic echocardiogram showed left ventricular (LV) ejection fraction 55%, right ventricular (RV) systolic pressure 35 mmHg, normal mitral annular tissue doppler velocities, and early diastolic septal bounce. Right and left heart catheterization showed prominent X and Y descent, elevated and equalized diastolic pressures, but no respiratory discordance in the LV-RV pressure gradient. As etiology of these findings were unclear, he underwent aggressive diuresis and hemodialysis, but repeat right heart catheterization showed persistently elevated right and left filling pressures. Cardiac MRI had no evidence of myocardial or pericardial inflammation/edema but showed pericardial thickening (7.9 mm) and septal bounce. There was no inspiratory septal shift, but the large pleural effusion appeared to limit diaphragm excursion. Given lack of respirophasic ventricular interdependence and thickened pericardium on MRI, CT was ordered, showing pericardial calcifications. Diagnosis of constrictive pericarditis was made, and patient underwent complete pericardiectomy. Pathology confirmed calcified and thick pericardium without acute inflammation. Post-operatively, patient developed RV failure, but recovered with inotrope support and was discharged with improvement in congestive symptoms. Discussion: Constrictive pericarditis classically exhibits respirophasic ventricular interdependence, but large pleural effusions may decrease respiratory variation in intrathoracic pressures, blunting this response. Normal mitral annulus tissue doppler velocities and lack of infiltrative process on cardiac MRI made restrictive cardiomyopathy unlikely. In the absence of respirophasic changes on multimodality testing, constriction can be diagnosed with other supportive features such as diastolic septal bounce, rapid Y descent, diastolic pressure equalization, and pericardial thickening and calcifications.

Developing design-basis PSD loads for spent nuclear fuel transport: Insights from cask test results

From 2020 to 2021, multimodal transportation tests were conducted in South Korea. Surrogate fuel assemblies were loaded into a full-sized transportation cask for road and sea transportation tests at Doosan Enerbility and along a South Korean seashore. The study focused on the effects of normal transport conditions on spent nuclear fuel (SNF) and its structural integrity by analyzing the data obtained. Additionally, the need to analytically assess the integrity of spent fuel under these conditions through design-basis loads has emerged. This study focuses on generating the input load. The study also addressed the practical considerations for applicants regarding the format of these design loads. For all tested conditions, design-basis power spectral density (PSD) loads were identified, covering PSDs at the basket across various transportation conditions. A comprehensive diagram capturing the PSDs at the basket, which then transmitted the load to the fuel assembly for each transport scenario, was calculated as the design load. The transportation test load data served as inputs for the shake table test, which aimed to closely evaluate the behavior of the fuel assemblies. The appropriateness and conservativeness of the derived design-basis PSD were validated through a shake table tests.

Exploring the Multimodal Approach in Pre-Service Chemistry Teacher Education: Perspective from Students and Lecturers

This study aims to investigate the implementation of a multimodal approach in the learning process and the summative tests of pre-service chemistry teacher education. Data were collected through Google Forms using semi-structured questions. Data were compared with analysis handbooks and summative test documents. The results show that most pre-service chemistry teachers have a multimodal learning style. However, the application of the multimodal approach in chemistry courses has not been extensively implemented due to several challenges. For instance, the time required for preparation can be a significant barrier, as creating and organizing multiple modes of communication can be time-consuming. The complexity of creating media is another challenge, as it requires technical skills and resources. Additionally, the characteristics of students who do not support independent learning can hinder the implementation of a multimodal approach. The most commonly used media in applying the multimodal approach are videos and PowerPoint presentations, supplemented by direct explanations from lecturers. Most of the test techniques used by lecturers were in written form, owing to the difficulties in developing multimodal tests. This study implies an urgent need for the development of multimodal test instruments to accommodate differences in students' learning styles.

Comparative analysis of two liner acoustic impedance characterization techniques

This study presents the comparison of two methodologies of small size liner acoustic impedance characterization. The first one is based on a normal incidence broadband acoustic excitation up to 160 dB inside a 30-mm diameter circular tube, and uses the two microphones method, with microphones flush-mounted inside the waveguide. This bench, called NTMM and developed at Airbus, allows to directly compute the acoustic impedance at the surface of the sample. The second one lies on a measurement inside the B2A wind tunnel at ONERA, where the sample is mounted as one of the vein walls, leading to a grazing aero-acoustic excitation, up to Mach 0.3 and 155 dB with a broadband excitation. The impedance is then educed by an inverse method. During the MAMBO research project, dedicated samples have been designed and tested with the two benches as well as on the CANNELLE multimodal test rig developed by Airbus. The full paper will analyze the results and offer a cross comparison of the methodologies, highlighting the advantages and limitations of each approach.

Effects of executive function on age-related emotion recognition decline varied by sex

This study delves into the criticality of Emotion recognition (ER) as a pivotal component of social functionality and psychological well-being, focusing on its susceptibility to aging and sex-related differences. Underpinned by the 'frontal aging hypothesis,' which posits a particular vulnerability of executive functions to the aging process, this study aims to unravel the intricate dynamics of how aging influences ER in both sexes, emphasizing the mediating role of executive functions. A cohort of 127 healthy adults underwent the Multi-Modality Emotion Recognition Test mobile application to assess facial ER and cross-modal matching abilities. Comprehensive neuropsychological assessments supplemented this to evaluate various facets of executive function. The analysis indicated a pronounced decline in ER performance among older adults, with no significant sex differences across age groups. However, gender-specific patterns emerged in the aging-ER relationship. For males, cognitive flexibility (β = 0.399, p < 0.001) and inhibition (β = 0.329, p = 0.020) were partial mediators. In females, working memory (β = −0.297, p = 0.023) and selective attention (β = 0.290, p = 0.042) moderated the aging-facial ER link, with inhibition (β = 0.284, p = 0.015) also playing a partial mediating role. Additionally, inhibition (β = 0.194, p = 0.043) moderated the relationship between aging and the female's cross-modal matching. The findings highlight a gender-differentiated impact of executive functions on age-related ER decline. This underscores the need for gender-tailored approaches in enhancing ER, particularly in an aging population.

Adapting the population size in CMA-ES using nearest-better clustering method for multimodal optimization

The covariance matrix adaptation evolution strategy (CMA-ES) is one of the advanced algorithms for solving continuous single-objective optimization. In this algorithm, the population size is an important parameter which represents the number of candidate points generated in each iteration. A larger population size allows for better exploration of the search space and is typically required for handling multimodal functions, while a smaller population size facilitates quicker convergence. Adapting the population size in this algorithm raises a question about how to increase/decrease/keep it in an efficient way to solve specific problems. In this paper, we propose a novel approach for this purpose based on the information of niches observed during the evolution process. Firstly, the nearest-better clustering (NBC) technique is employed to detect the number of niches in each iteration, then the information will be used to adapt the population size accordingly. Additionally, a quasi-Newton method, which serves as a local search, can be incorporated into the algorithm in order to speed it up. We evaluate the effectiveness of our method through numerical simulations on multimodal test functions, the black-box optimization benchmarking (BBOB) noiseless testbed, and the CEC 2014 and CEC 2017 benchmark testing suites.

Links between parental monitoring and parent-adolescent conflict: A multimodal test of bidirectional relations.

During adolescence, youth increase in both independence and conflict with parents. Parents vary in how much they know about their adolescents' whereabouts and activities and how they acquire this information (i.e., the sources of what parents know). We probed how parental knowledge of adolescents' whereabouts and activities-and their information sources-relates to (a) domains of parent-adolescent conflict (fighting about, or having different beliefs about, daily life topics) and (b) parent and adolescent attachment-related behavior during a conflict discussion task. Using the Actor-Partner Interdependence Model, we tested links between parental knowledge and its sources and conflict processes. Eighty-seven adolescents (Mage = 15.18; 55% female) and parents completed surveys about parental knowledge and its sources (i.e., parental solicitation of adolescents' activities, adolescent disclosure to parents about their activities) and separate interviews on conflict domains. A subset of parent-adolescent dyads (n = 65) interacted for 5 min about an adolescent-identified conflict topic. Different beliefs about daily life topics related to parental knowledge: parents' reports of greater different beliefs about daily life topics predicted less knowledge of adolescents' activities/whereabouts, solicitation, and disclosure, for both parent and adolescent reports of these domains. For adolescents, greater different beliefs related to less solicitation and disclosure. Only adolescent reports of parental knowledge, solicitation, and disclosure predicted attachment-related behaviors both dyad members displayed during the conflict discussion task. Findings reveal links between parental knowledge of adolescents' activities and conflict processes and demonstrate dyadic interdependence between parental knowledge of adolescents' activities and conflict processes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Dynamic Niches-Based Hybrid Breeding Optimization Algorithm for Solving Multi-Modal Optimization Problem

Some problems exist in classical optimization algorithms to solve multi-modal optimization problems and other complex systems. A Dynamic Niches-based Improved Hybrid Breeding Optimization (DNIHBO) algorithm is proposed to address the multi-modal optimization problem in the paper. By dynamically adjusting the niche scale, it effectively addresses the issue of niche parameter sensitivity. The structure of the algorithm includes three distinct groups: maintainer, restorer, and sterile lines for updating operations. However, the maintainer individuals often stagnate, leading to the risk of the local optima. To overcome this, neighborhood search and elite mutation strategies are incorporated, enhancing the balance between exploration and exploitation. To further improve individual utilization within niches, a niche restart strategy is introduced, ensuring sustained population diversity. The efficacy of DNIHBO is validated through simulations on 16 multi-modal test functions, followed by comparative analyses with various multi-modal optimization algorithms. The results convincingly demonstrate that DNIHBO not only effectively locates multiple global optima but also consistently outperforms other algorithms on test functions. These findings underscore the superiority of DNIHBO as a high-performing solution for multi-modal optimization.

Machine learning based damage identification in SiC/SiC composites from acoustic emissions using autoencoders

Developing the ability to leverage machine learning (ML) to identify damage mechanisms in heterogeneous materials from their acoustic emissions (AE) has wide-reaching ramifications for multi-modal experimentation. It would allow researchers to augment damage triangulation, lifetime prediction, and high-resolution optical studies with complementary mechanism-informed data streams. However, developing this capability hinges on the collection of ground truth acoustic libraries from damage in realistic geometries. Due to time and monetary considerations, there is a dearth of ground truth libraries which can be used to robustly characterize ML mechanism identification frameworks. Addressing this gap, we present a multi-modal acoustic emission and x-ray computed tomography study where AE is gathered, and subsequently labeled, from SiC/SiC unidirectional composites under monotonic tension. This library is used to demonstrate that acoustic signals from early fiber breaks are obscured by matrix cracking. A first-order micromechanical model is used to explain the origin of this obscuring effect, and identify fundamental limitations of unsupervised frameworks. An autoencoder-based anomaly detector approach is used for the first time to overcome these limitations, additionally demonstrating that the frequency distribution of fiber break acoustic signals is narrow. Implications of these findings for enhanced multi-modal testing and online health monitoring are discussed, and strategies for implementation of supervised damage mechanism identification frameworks are proposed.

Cardiac dysfunction in dialysing adults with end-stage kidney disease is associated with exercise intolerance: A pilot observational study.

People with end-stage kidney disease (ESKD) often exhibit impaired cardiac structure and function, which may contribute to poor exercise capacity. This study used multimodal exercise testing to investigate the central and peripheral mechanisms of exercise limitation in adults with ESKD, also comparing in-centre hemodialysis (ICHD) to home hemodialysis (HHD). Seventeen adults (55.5 ± 14.5 years; n = 14 male; n = 12 HHD) participated. Resting cardiac examinations, followed by submaximal cycling cardiopulmonary exercise testing (CPET) and functional exercise testing, revealed cardiac structural abnormalities (increased left ventricular mass) and cardiac injury. Aerobic fitness in adults with ESKD was low, with pulmonary oxygen uptake (V̇O2) at the gas exchange threshold (GET) occuring at 39 ± 8% predicted V̇O2peak. O2 pulse, an estimate of stroke volume (SV), was higher in HHD at rest (p = 0.05, ES = 0.58) and during unloaded cycling (p = 0.05, ES = 0.58) compared to ICHD. However, thoracic bioreactance derived SV at the GET was significantly higher in adults receiving ICHD versus HHD (p = 0.01, ES = 0.74). In adults with ESKD, cardiac output was positively associated with V̇O2 at the GET (r = 0.61, p = 0.04). This study highlights prevalent exercise dysfunction in adults with ESKD undergoing dialysis, with potential distinct differences between in-centre and home hemodialysis, mechanistically linked to underlying cardiac abnormalities.

Inherited platelet function disorders in children – A diagnostic conundrum solved by multimodality testing

Inherited platelet function disorders in children – A diagnostic conundrum solved by multimodality testing

Synchronous 3D Imaging of the Medial and Superior Vocal Fold Surface in an excised human Hemilarynx.

This study investigates relationships between the oscillation behavior of the medial and superior vocal fold (VF) surfaces during sustained phonation in a human cadaver hemilarynx. An experimental test stand synchronously captured the medial and superior VF surfaces of a human ex vivo hemilarynx during sustained phonation using two high-speed camera setups in 24 experimental settings. The 3D coordinates of the medial VF surface were reconstructed by triangulation of sewn-in marker points, while laser-based reconstruction was used for the superior VF surface. Correlation analysis and linear regression were used to quantify the connections of the mean and maximal vertical and lateral VF displacements and the VF velocities. Additionally, stepwise linear regression was used to analyze the impact of the measurement variables mean flow rate, adduction and elongation. Strong linear relationships between all of the tested corresponding parameter pairs of the superior and medial VF surfaces were found (p<.001). Mean and maximum vertical displacements of the medial surface were both approximately 50% of the superior surface. The mean lateral displacements for the medial surface were 12% below the superior surface but 12% higher for the maximum values. The mean and maximum VF velocities were 32% and 36% lower for the medial surface. The suggested multi-modal test stand allows efficient, comprehensive analysis of human hemilarynges and provides promising information about the interaction of the different VF areas and opens up the systematic analysis of multiple hemilarynges. In future, our results could integrate into ENT diagnostics using 3D laryngoscopy where the hidden medial VF surface dynamics may be predicted from the observable superior surface.

Takotsubo Syndrome and Gender Differences: Exploring Pathophysiological Mechanisms and Clinical Differences for a Personalized Approach in Patient Management.

Takotsubo syndrome (TTS), also known as the broken-heart syndrome, is a reversible condition typically observed in female patients presenting for acute coronary syndromes (ACS). Despite its increasing incidence, TTS often remains undiagnosed due to its overlap with ACS. The pathophysiology of TTS is complex and involves factors such as coronary vasospasm, microcirculatory dysfunction, increased catecholamine levels, and overactivity of the sympathetic nervous system. Diagnosing TTS requires a comprehensive approach, starting with clinical suspicion and progressing to both non-invasive and invasive multimodal tests guided by a specific diagnostic algorithm. Management of TTS should be personalized, considering potential complications, the presence or absence of coronary artery disease (CAD), diagnostic test results, and the patient's clinical course. The current data primarily derive from case series, retrospective analyses, prospective registries, and expert opinions. In recent years, there has been growing recognition of gender differences in the pathophysiology, presentation, and outcomes of TTS. This review provides an updated overview of gender disparities, highlighting the importance of tailored diagnostic and management strategies.

PsySuite: An android application designed to perform multimodal psychophysical testing.

In behavioral sciences, there is growing concern about the inflation of false-positive rates due to the amount of under-powered studies that have been shared in the past years. While problematic, having the possibility to recruit (lots of) participants (for a lot of time) is realistically not achievable for many research facilities. Factors that hinder the reaching of optimal sample sizes are, to name but a few, research costs, participants' availability and commitment, and logistics. We challenge these issues by introducing PsySuite, an Android app designed to foster a remote approach to multimodal behavioral testing. To validate PsySuite, we first evaluated its ability to generate stimuli appropriate to rigorous psychophysical testing, measuring both the app's accuracy (i.e., stimuli's onset, offset, and multimodal simultaneity) and precision (i.e., the stability of a given pattern across trials), using two different smartphone models. We then evaluated PsySuite's ability to replicate perceptual performances obtained using a classic psychophysical paradigm, comparing sample data collected with the app against those measured via a PC-based setup. Our results showed that PsySuite could accurately reproduce stimuli with a minimum duration of 7ms, 17ms, and 30ms for the auditory, visual, and tactile modalities, respectively, and that perceptual performances obtained with PsySuite were consistent with the perceptual behavior observed using the classical setup. Combined with the high accessibility inherently supported by PsySuite, here we ought to share the app to further boost psychophysical research, aiming at setting it to a cheap, user-friendly, and portable level.

Longitudinal assessment of female carriers of choroideremia using multimodal retinal imaging

Background/aimsFemale choroideremia carriers present with a spectrum of disease severity. Unlike in men, the rate of disease progression has not been well characterised in carriers. This longitudinal study aimed to...

Diagnostic utility of multimodal advanced molecular testing to classify metastases of unknown primaries: A case of a patient with no known medical history.

Diagnostic utility of multimodal advanced molecular testing to classify metastases of unknown primaries: A case of a patient with no known medical history.

Multimodal deep learning using on-chip diffractive optics with in situ training capability

Multimodal deep learning plays a pivotal role in supporting the processing and learning of diverse data types within the realm of artificial intelligence generated content (AIGC). However, most photonic neuromorphic processors for deep learning can only handle a single data modality (either vision or audio) due to the lack of abundant parameter training in optical domain. Here, we propose and demonstrate a trainable diffractive optical neural network (TDONN) chip based on on-chip diffractive optics with massive tunable elements to address these constraints. The TDONN chip includes one input layer, five hidden layers, and one output layer, and only one forward propagation is required to obtain the inference results without frequent optical-electrical conversion. The customized stochastic gradient descent algorithm and the drop-out mechanism are developed for photonic neurons to realize in situ training and fast convergence in the optical domain. The TDONN chip achieves a potential throughput of 217.6 tera-operations per second (TOPS) with high computing density (447.7 TOPS/mm2), high system-level energy efficiency (7.28 TOPS/W), and low optical latency (30.2 ps). The TDONN chip has successfully implemented four-class classification in different modalities (vision, audio, and touch) and achieve 85.7% accuracy on multimodal test sets. Our work opens up a new avenue for multimodal deep learning with integrated photonic processors, providing a potential solution for low-power AI large models using photonic technology.

Novel neurophysiological evidence for preserved pain habituation across chronic pain conditions

ObjectiveThe present study aimed to investigate whether subjective and objective measures of pain habituation can be used as potential markers for central sensitization across various chronic pain patients. MethodsTwo blocks of contact-heat stimuli were applied to a non-painful area in 93 chronic pain patients (low back pain, neuropathic pain, and complex regional pain syndrome) and 60 healthy controls (HC). Habituation of pain ratings, contact-heat evoked potentials (CHEP), and sympathetic skin responses (SSR) was measured. ResultsThere was no significant difference in any measure of pain habituation between patients and HC. Even patients with apparent clinical signs of central sensitization showed no reduced pain habituation. However, prolonged baseline CHEP and SSR latencies (stimulation block 1) were found in patients compared to HC (CHEP: Δ-latency = 23 ms, p = 0.012; SSR: Δ-latency = 100 ms, p = 0.022). ConclusionGiven the performed multimodal neurophysiological testing protocol, we provide evidence indicating that pain habituation may be preserved in patients with chronic pain and thereby be of limited use as a sensitive marker for central sensitization. These results are discussed within the framework of the complex interactions between pro- and antinociceptive mechanism as well as methodological issues. The prolonged latencies of CHEP and SSR after stimulation in non-painful areas may indicate subclinical changes in the integrity of thermo-nociceptive afferents, or a shift towards antinociceptive activity. This shift could potentially affect the relay of ascending signals. SignificanceOur findings challenge the prevailing views in the literature and may encourage further investigations into the peripheral and central components of pain habituation, using advanced multimodal neurophysiological techniques.

Biomarkers in Kidney Transplantation: A Rapidly Evolving Landscape.

The last decade has seen an explosion in clinical research focusing on the use of noninvasive biomarkers in kidney transplantation. Much of the published literature focuses on donor-derived cell-free DNA (dd-cfDNA). Although initially studied as a noninvasive means of identifying acute rejection, it is now clear that dd-cfDNA is more appropriately described as a marker of severe injury and irrespective of the etiology, elevated dd-cfDNA ≥0.5% portends worse graft outcomes. Blood gene expression profiling is also commercially available and has mostly been studied in the context of early identification of subclinical rejection, although additional data is needed to validate these findings. Torque teno virus, a ubiquitous DNA virus, has emerged as a biomarker of immunosuppression exposure as peripheral blood Torque teno virus copy numbers might mirror the intensity of host immunosuppression. Urinary chemokine tests including C-X-C motif chemokine ligand 9 and C-X-C motif chemokine ligand 10 have recently been assessed in large clinical trials and hold promising potential for early diagnosis of both subclinical and acute rejection, as well as, for long-term prognosis. Urinary cellular messenger RNA and exosome vesicular RNA based studies require additional validation. Although current data does not lend itself to conclusion, future studies on multimodality testing may reveal the utility of serial surveillance for individualization of immunosuppression and identify windows of opportunity to intervene early and before the irreversible allograft injury sets in.

A multimodal approach to diagnosis of neuromuscular neosporosis in dogs.

Early diagnosis of neosporosis in dogs is challenging. To evaluate the feasibility of a compound multimodal testing approach for diagnosing in dogs neuromuscular and combined forms of neosporosis. A total of 16 dogs diagnosed with solely neuromuscular neosporosis or with a combination of neuromuscular and central nervous system neosporosis. Retrospective review of clinical signs, laboratory findings, treatment, and outcome with focus on the diagnostic utility of different tests. Development of a chromogenic in situ hybridization (ISH) assay for the identification of Neospora caninum in paraffin-embedded muscle samples. 13/16 dogs had only neuromuscular signs of neosporosis, 3/16 had disease signs with concomitant central nervous system (CNS) involvement. Serology was performed in 15/16, with 10/15 showing titers >1 : 160 at admission. PCR on muscle samples detected N. caninum DNA in 11/16. Immunohistochemistry (IHC) detected N. caninum in 9/16 and ISH in 9/16. Histopathology revealed inflammatory myopathy in 10/16, necrotizing myopathy in 5/16, borderline changes in 1/16 and tachyzoites in 9/16. In 4 cases, N. caninum infection was confirmed with all 5 diagnostic methods, 3 cases with 4, 2 with 3, 6 with 2, and 1 animal with 1. Diagnosis of N. caninum infection should rely on a multimodal diagnostic approach and negativity of 1 single test should not allow for exclusion. Serology in combination with direct parasite identification via histopathology, DNA via PCR, or both modalities, appears a reliable diagnostic approach.