Reducing Non-Through Body Energy Transfer in Microwave Imaging Systems.

On-body antennas for use in microwave imaging (MI) systems can direct energy around the body instead of through the body, thus degrading the overall signal-to-noise ratio (SNR) of the system. This work introduces and quantifies the usage of modern metal-backed RF absorbing foam in conjunction with on-body antennas to dampen energy flowing around the body, using both simulations and experiments. A head imaging system is demonstrated herein but the principle can be applied to any part of the body including the torso or extremities. A computational model was simulated numerically using Ansys HFSS. A physical prototype in the form of a helmet with embedded antennas was built to compare simulations with measured data. Simulations and measurements demonstrate that usage of such metal-backed RF-absorbing foams can significantly reduce around-body coupling from Transmit (Tx) and Receive (Rx) antennas by approximately 10dB. Thus, the overall SNR of the MI system can be substantially improved using this low-cost and affordable method.

Miniaturized Dual Antiphase Patch Antenna Radiating into the Human Body at 2.4 GHz.

An on-body antenna, comprised of two closely-spaced antiphase patch elements, for microwave imaging may provide enhanced signal penetration into the tissue. By further integrating a 180-degree on-chip power combiner with the dual antiphase patch antenna element, a low-profile miniaturized antenna, integrated into a single 18.5 mm x 10 mm x 1.6 mm circuit board assembly, is designed and evaluated both numerically and experimentally. This is the smallest on-body antenna known to the authors for the given frequency band. This linearly polarized antenna may potentially serve as a building block of a dense antenna array for prospective high-resolution microwave imaging. A 2.4 GHz band was chosen as the design target. The final antenna size was a compromise between the miniaturization, the SNR (Signal-to-Noise Ratio), and the targeted antenna bandwidth (2.3-2.5 GHz). The effect of surface waves (the secondary radiating components) was also factored in the design consideration, while maximizing the detected signals' SNR.

Amitriptyline and Sexual Function: A Systematic Review Updated for Sexual Health Practice.

Amitriptyline is an old drug but is still prevalently used as the first-line treatment for a variety of common diseases. Surprisingly, knowledge of sexual risks with amitriptyline comes from only one clinical trial and several case reports from three decades ago. In the current study, a systematic review of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) related to amitriptyline and sexual dysfunction (SD) was performed. The frequency, gender-difference, types, disease-specificity and time course of SD, and the relationship between SD and nonsexual adversity were studied. A total of 14 publications, including 8 qualified randomized clinical trials, were eligible. The frequency of SD in overall, male and female patients was 5.7, 11.9 and 1.7%, respectively. SD was six-fold higher in men than women. The frequency of SD was 6.9% in depressive patients compared with 0.8% in non-depressive patients ( p = .008), and gradually decreased at 8 weeks after treatment ( p = .02). Amitriptyline impacted arousal and libido more than orgasm and ejaculation in male patients but mainly libido in female patients. SD was significantly correlated with insomnia linearly whereas somnolence and nausea dually. Therefore, amitriptyline-associated SD mainly occurs in depressive and male patients, disturbs each phase of the sexual response cycle in men but mainly libido in women, gradually decreases under long-term treatment, and can be predicted by the co-existence of insomnia, somnolence or nausea during treatment. Clinicians should caution and tailor the gender and disease vulnerability of amitriptyline in their practice.

Acupuncture for the Treatment of Chronic Pain in the Military Population: Factors Associated With Treatment Outcomes.

OBJECTIVES: Acupuncture is characterized as an alternative or complementary medicine with a low complication rate and minimal side effects. There is a lack of robust evidence that shows acupuncture is an effective treatment for chronic pain. The purpose of this study was to determine which (if any) characteristics can predict successful response to acupuncture in chronic pain patients treated at military treatment facilities. METHODS: Data from 222 patients who received treatment for a chronic pain condition were collected from 2 medical centers. The patients underwent at least 4 acupuncture treatments and had an average pain score of 4 or higher on a 0- to 10-point numerical rating scale or visual analog scale in the week before treatment initiation. A successful outcome was defined to be a 2-point or greater reduction on the numerical rating scale or visual analog scale 12 weeks postinitial treatment. RESULTS: The overall treatment success rate was 42.3%. Multivariate logistic regression found a higher baseline pain rating and the use of stimulation needles to be associated with a positive outcome (odds ratio [OR]=1.26; 95% confidence interval [CI], 1.03-1.55; P=0.02 and OR=2.73; 95% CI, 1.39-5.32; P=0.03, respectively). Only the presence of one or more psychological comorbidities was found to be associated with treatment failure (OR=0.67; 95% CI, 0.49-0.92; P=0.01). DISCUSSION: The use of electrical stimulation and higher baseline pain score were associated with a positive treatment outcome, while the presence of a psychological comorbidity diminished the likelihood of treatment success. Practitioners should consider using electrical stimulation more frequently, and addressing psychopathology before or concurrent to treatment, when initiating acupuncture.

Topiramate-associated sexual dysfunction: A systematic review.

INTRODUCTION: Sexual pharmacotoxicity renders patients with epilepsy at a risk for sexual dysfunction (SD). This study is aimed to analyze the relationship between sexual function and topiramate to avoid topiramate-associated SD. METHODS: A systematic review following the PRISMA guidelines was performed to elucidate any SD occurrence in patients receiving topiramate. RESULTS: A total of 17 publications were reviewed. Based on limited polytherapy observational studies, the frequency of self-reported topiramate-associated SD, libido disorder, and orgasmic disorder in patients with polytherapy was 9.0%, 9.0%, and 2.6%, respectively (grade C evidence). Female patients mainly had anorgasmia, whereas male patients principally had erectile dysfunction. The daily dose of topiramate in patients with SD was within the recommended dose. Sexual adversity usually occurred from 4weeks after topiramate use but favorably subsided without eventful complications after topiramate substitution or dose reduction in all patients. CONCLUSIONS: Topiramate can elicit different patterns of SD, especially anorgasmia in women and erectile dysfunction in men, even with a therapeutic dose. Detailed drug education and careful monitoring are necessary to maximize sexual health, especially in persons undergoing polytherapy and with other risks for SD. Moreover, a rapid response, such as substitution or reduction of the dose, is suggested when SD occurs during its use.

Alterations in T2 relaxation magnetic resonance imaging of the ovine intervertebral disc due to nonenzymatic glycation.

STUDY DESIGN: An in vitro study using ovine intervertebral discs to correlate the effects of increasing advanced glycation end-products (AGEs) with disc hydration evaluated by magnetic resonance imaging (MRI). OBJECTIVE: To determine the relationship between the level of AGEs and tissue water content in intervertebral discs using T2 relaxation MRI. SUMMARY OF BACKGROUND DATA: AGEs result from nonenzymatic glycation, and AGEs have been shown to accumulate in the intervertebral disc tissue with aging and degeneration. AGEs can alter biochemical properties, including the hydrophobicity of the extracellular matrix. Because one of the degenerative signs of the intervertebral disc (IVD) is reduced hydration, we hypothesized that increased levels of tissue AGEs contribute to disc hydration. T2 relaxation MRI has been shown to be sensitive to the hydration status of the disc and may be valuable in detecting the changes in the IVD mediated by the increase of AGEs. METHODS: Thirty-eight IVDs were obtained from 4 ovine spines, and the annulus fibrosis (AF) and nucleus pulposus (NP) tissues were isolated from these discs. The tissues were incubated in either a ribosylation or control solution for up to 8 days to induce the formation of AGEs. T2 relaxation times were obtained from these tissues after ribosylation. These tissues were subsequently analyzed for hydration, proteoglycan, collagen, and AGEs content. RESULTS: In vitro ribosylation led to the increased accumulation of AGEs and reduced water content in both the AF and NP in a dose-dependent manner, but did not affect the proteoglycan and collagen composition. When analyzed by MRI, ribosylation significantly altered the mean T2 relaxation times in the NP (P = 0.001), but not in the AF (P = 0.912). Furthermore, the mean T2 values in the NP significantly decreased with increasing periods of incubation time (P < 0.001). CONCLUSION: This study demonstrates that levels of AGEs in the IVD may affect the tissue water content. Moreover, these ribosylation-mediated changes in tissue hydration were detectable using T2 relaxation MRI. T2 relaxation MRI may provide a noninvasive tool to measure in vivo changes in disc hydration that are negatively correlated with the accumulation of AGEs.

First reported case of unilateral Graves' disease in the left lobe of a bilobar thyroid gland.

BACKGROUND: Unilateral Graves' disease is a rare disease variant that can occur in a bilobar thyroid gland. We report the first documented case of unilateral Graves' disease in the left lobe of a bilobar thyroid gland and review the pertinent literature. PATIENT FINDINGS: A 48-year-old man presented in June 2010 with thyrotoxicosis. I-131 radioisotope uptake was elevated at 33.4%, and scintigraphy revealed that uptake of the radioisotope was uniformly increased in the left lobe of the thyroid gland. Ultrasonography of the thyroid gland revealed a non-nodular, enlarged, and heterogeneous left lobe; Doppler investigation of the lobe showed hypervascularity classically seen in Graves' disease. The right lobe of the thyroid, on the other hand, appeared homogeneous and hypovascular on ultrasonography. Thyroid-stimulating immunoglobulin was significantly elevated at 191% (reference range <140%). Unilateral Graves' disease was the most likely diagnosis. SUMMARY: As has occasionally been described in the literature, unilateral involvement of the thyroid gland is a rare presentation of Graves' disease. Pre-existing functional or structural differences (either congenital or acquired) between the two lobes may contribute to this rare presentation. To our knowledge, this is the first reported case of unilateral Graves' disease presenting in the left lobe of a bilobar thyroid gland. CONCLUSION: Although the pathophysiology of unilateral Graves's disease has not been clearly elucidated, clinicians should be aware that Graves' disease can present unilaterally in either lobe of the thyroid gland.

Importance sampling of word patterns in DNA and protein sequences.

Monte Carlo methods can provide accurate p-value estimates of word counting test statistics and are easy to implement. They are especially attractive when an asymptotic theory is absent or when either the search sequence or the word pattern is too short for the application of asymptotic formulae. Naive direct Monte Carlo is undesirable for the estimation of small probabilities because the associated rare events of interest are seldom generated. We propose instead efficient importance sampling algorithms that use controlled insertion of the desired word patterns on randomly generated sequences. The implementation is illustrated on word patterns of biological interest: palindromes and inverted repeats, patterns arising from position-specific weight matrices (PSWMs), and co-occurrences of pairs of motifs.

Nonrandom clusters of palindromes in herpesvirus genomes.

Palindromes are symmetrical words of DNA in the sense that they read exactly the same as their reverse complementary sequences. Representing the occurrences of palindromes in a DNA molecule as points on the unit interval, the scan statistics can be used to identify regions of unusually high concentration of palindromes. These regions have been associated with the replication origins on a few herpesviruses in previous studies. However, the use of scan statistics requires the assumption that the points representing the palindromes are independently and uniformly distributed on the unit interval. In this paper, we provide a mathematical basis for this assumption by showing that in randomly generated DNA sequences, the occurrences of palindromes can be approximated by a Poisson process. An easily computable upper bound on the Wasserstein distance between the palindrome process and the Poisson process is obtained. This bound is then used as a guide to choose an optimal palindrome length in the analysis of a collection of 16 herpesvirus genomes. Regions harboring significant palindrome clusters are identified and compared to known locations of replication origins. This analysis brings out a few interesting extensions of the scan statistics that can help formulate an algorithm for more accurate prediction of replication origins.