Essential Tremor and Essential Tremor Plus Are Essentially Similar Electrophysiologically.

BACKGROUND: The merits of classifying the heterogeneous group of essential tremors into essential tremor (ET) and essential tremor plus (ETP) are debated. OBJECTIVES: We studied the electrophysiological and spiral characteristics of tremor in ET and ETP. METHODS: We reviewed standardized videos from a tremor database and clinically classified patients into ET, ETP, or dystonic tremor (DT). The following variables were derived from combined tri-axial accelerometry-surface electromyography (EMG)-peak frequency, total power, peak power, full width half maximum, tremor stability index and EMG-coherence. We analyzed hand-drawn spirals to derive mean deviation, tremor variability, inter-, and intra-loop widths. We compared these variables among the groups. RESULTS: We recruited 72 participants (81.9% male) with mean age 47.7 ± 16.1 years and Fahn-Tolosa-Marin Tremor Rating Scale total score 31.1 ± 14.1. Patients with ET were younger (P = 0.014) and had less severe tremor (P = 0.020) compared to ETP and DT. In ETP group, 48.6% had subtle dystonia. Peak frequency was greater in ETP (7.3 ± 0.3 Hz) compared to DT (6.1 ± 0.4 Hz; P = 0.024). Peak power was greater in ETP and DT for postural tremor. Rest tremor was recordable on accelerometry in 26.7% of ET. Other variables were similar among the groups. CONCLUSION: Electrophysiological evaluation revealed postural tremor of frequency 6 to 7 Hz in ET, ETP, and DT with subtle differences more severe tremor in ETP and DT, and higher frequency in ETP compared to DT. Our findings suggest a similar tremor oscillator in these conditions, supporting the view that these entities are part of a spectrum of tremor disorders, rather than distinct etiological entities.

Neuropathic Tremor in Guillain-Barré Syndrome.

Background: Neuropathic Tremor (NT) is a postural/kinetic tremor of the upper extremity, often encountered in patients with chronic neuropathies such as paraprotein-associated and hereditary neuropathies. Objectives: To describe the clinical and electrophysiological features of NT in a previously underrecognized setting- during recovery from Guillain-Barré Syndrome (GBS). Methods: Patients with a documented diagnosis of GBS in the past, presenting with tremor were identified from review of clinical records. Participants underwent structured, videotaped neurological examination, and electrophysiological analysis using tri-axial accelerometry-surface electromyography. Tremor severity was assessed using the Fahn-Tolosa-Marin Tremor Rating Scale. Results: We describe the clinical and electrophysiological features of 5 patients with GBS associated NT. Our cohort had a fine, fast, and slightly jerky postural tremor of frequency ranging from 8 to 10 Hz. Dystonic posturing and overflow movements were noted in 4/5 patients. Tremor appeared 3 months-5 years after the onset of GBS, when patients had regained near normal muscle strength and deep tendon jerks were well elicitable. Electrophysiological analysis of tremor strongly suggested the presence of a central oscillator in all patients. Conclusion: NT is not limited to chronic inflammatory or hereditary neuropathies and may occur in the recovery phase of GBS. The tremor is characterized by a high frequency, jerky postural tremor with dystonic posturing. Electrophysiological evaluation suggests the presence of a central oscillator, hypothetically the cerebellum driven by impaired sensorimotor feedback.

Unveiling the Potential of Marine Biopolymers: Sources, Classification, and Diverse Food Applications.

Environmental concerns regarding the usage of nonrenewable materials are driving up the demand for biodegradable marine biopolymers. Marine biopolymers are gaining increasing attention as sustainable alternatives in various industries, including the food sector. This review article aims to provide a comprehensive overview of marine biopolymers and their applications in the food industry. Marine sources are given attention as innovative resources for the production of sea-originated biopolymers, such as agar, alginate, chitin/chitosan, and carrageenan, which are safe, biodegradable, and are widely employed in a broad spectrum of industrial uses. This article begins by discussing the diverse source materials of marine biopolymers, which encompass biopolymers derived from seaweed and marine animals. It explores the unique characteristics and properties of these biopolymers, highlighting their potential for food applications. Furthermore, this review presents a classification of marine biopolymers, categorizing them based on their chemical composition and structural properties. This classification provides a framework for understanding the versatility and functionality of different marine biopolymers in food systems. This article also delves into the various food applications of marine biopolymers across different sectors, including meat, milk products, fruits, and vegetables. Thus, the motive of this review article is to offer a brief outline of (a) the source materials of marine biopolymers, which incorporates marine biopolymers derived from seaweed and marine animals, (b) a marine biopolymer classification, and (c) the various food applications in different food systems such as meat, milk products, fruits, and vegetables.

Recent progress in pectin extraction, characterization, and pectin-based films for active food packaging applications: A review.

Pectin is an abundant complex polysaccharide obtained from various plants. Safe, biodegradable, and edible pectin has been extensively utilized in the food industry as a gelling agent, thickener, and colloid stabilizer. Pectin can be extracted in a variety of ways, thus affecting its structure and properties. Pectin's excellent physicochemical properties make it suitable for many applications, including food packaging. Recently, pectin has been spotlighted as a promising biomaterial for manufacturing bio-based sustainable packaging films and coatings. Functional pectin-based composite films and coatings are useful for active food packaging applications. This review discusses pectin and its use in active food packaging applications. First, basic information and characteristics of pectin, such as the source, extraction method, and structural characteristics, were described. Then, various methods of pectin modification were discussed, and the following section briefly described pectin's physicochemical properties and applications in the food sector. Finally, the recent development of pectin-based food packaging films and coatings and their use in food packaging were comprehensively discussed.

Social Cognition in Parkinson's Disease: A Case-Control Study.

Background: Social cognition is the study of how people make sense of themselves and others. Impairment in several domains of social cognition is increasingly being recognized in Parkinson's disease (PD). Objectives: We aimed to study multiple domains of social cognition in Indian PD patients using a culturally appropriate, validated instrument. Methods: We recruited 52 individuals with PD and 31 healthy volunteers (HV) and used the Social Cognition Rating Tools in Indian Setting (SOCRATIS) tool to assess theory of mind (ToM), attributional biases and social cue perception. Quality of life (QoL) was assessed using the PDQOL scale. Results: Baseline characteristics were comparable between PD and HV. The mean (SD) FOT index (first order ToM index) was 0.86(0.18) in PD and 0.99(0.07) in HV [P < 0.001]. The PD group showed higher Externalizing Bias [EB, 4.42(3.91)], compared to HV [1.58(3.22), P = 0.001]. The mean (SD) Faux Pas Composite Index (FPCI ALT) was 0.69(0.09) in PD and 0.78(0.13) in HV [P < 0.001]. Social cognition indices were not associated with QoL in PD. Clinical parameters-age, gender, HAM-D, MOCA, education, levodopa equivalent daily dose of medication, number of PD drugs and trihexyphenidyl use did not predict social cognition. Conclusion: PD patients were less successful than age, gender matched controls in understanding social situations and other's thought processes and had higher tendency to attribute undesirable events to external causes. Deficits in social cognition did not impair the quality of life.

Grapefruit Seed Extract-Added Functional Films and Coating for Active Packaging Applications: A Review.

Recently, consumers have been increasingly inclined towards natural antimicrobials and antioxidants in food processing and packaging. Several bioactive compounds have originated from natural sources, and among them, grapefruit seed extract (GSE) is widely accepted and generally safe to use in food. GSE is a very commonly used antimicrobial in food; lately, it has also been found very effective as a coating material or in edible packaging films. A lot of recent work reports the use of GSE in food packaging applications to ensure food quality and safety; therefore, this work intended to provide an up-to-date review of GSE-based packaging. This review discusses GSE, its extraction methods, and their use in manufacturing food packaging film/coatings. Various physical and functional properties of GSE-added film were also discussed. This review also provides the food preservation application of GSE-incorporated film and coating. Lastly, the opportunities, challenges, and perspectives in the GSE-added packaging film/coating are also debated.

Recent advances in metal sulfide nanoparticle-added bionanocomposite films for food packaging applications.

Metal sulfide nanoparticles have recently attracted much attention due to their unique physical and functional properties. Metal sulfide nanoparticles used as optoelectronic and biomedical materials in the past decades are promising for making functional nanocomposite films due to their low toxicity and strong antibacterial activity. Recently, copper sulfide and zinc sulfide nanomaterials have been used to produce food packaging films for active packaging. Metal sulfide nanoparticles added as nanofillers are attracting attention in packaging applications due to their excellent potential to improve mechanical, barrier properties, and antibacterial activity. This review covers the fabrication process and important applications of metal sulfide nanoparticles. The development of metal sulfides reinforcing mainly copper sulfide and zinc sulfide nanomaterials as multifunctional nanofillers in bio-based films for active packaging applications has been comprehensively reviewed. As the recognition of metal sulfide nanoparticles as a functional filler increases, the development and application potential of active packaging films using them is expected to increase.

Biomedical Application of Photoacoustics: A Plethora of Opportunities.

The photoacoustic (PA) technique is a non-invasive, non-ionizing hybrid technique that exploits laser irradiation for sample excitation and acquires an ultrasound signal generated due to thermoelastic expansion of the sample. Being a hybrid technique, PA possesses the inherent advantages of conventional optical (high resolution) and ultrasonic (high depth of penetration in biological tissue) techniques and eliminates some of the major limitations of these conventional techniques. Hence, PA has been employed for different biomedical applications. In this review, we first discuss the basic physics of PA. Then, we discuss different aspects of PA techniques, which includes PA imaging and also PA frequency spectral analysis. The theory of PA signal generation, detection and analysis is also detailed in this work. Later, we also discuss the major biomedical application area of PA technique.

Shikonin Functionalized Packaging Film for Monitoring the Freshness of Shrimp.

A shikonin embedded smart and active food packaging film was produced using a binary mixture of gelatin and cellulose nanofiber (CNF). Shikonin is an alcohol-soluble natural pigment extracted from Lithospermum erythrorhizon root. The fabricated film showed good pH-responsive color changes and volatile gas sensing properties. Moreover, the film exhibited excellent antioxidant and antibacterial activity against foodborne pathogens. The shikonin incorporated gelatin/CNF-based film showed excellent UV-light barrier properties (>95%) and high tensile strength (>80 MPa), which is useful for food packaging. The hydrodynamic properties of the film were also slightly changed in the presence of shikonin, but the thermal stability and water vapor permeability remained unaffected. Thus, the inclusion of shikonin in the gelatin/CNF-based film improves not only the physical properties but also the functional properties. The film's color indicator properties also clearly show shrimp's freshness and spoilage during storage for 48 h. The shikonin-based functional film is expected to be a promising tool for multi-purpose smart and active food packaging applications.

Micro-ultrasonic Assessment of Early Stage Clot Formation and Whole Blood Coagulation Using an All-Optical Ultrasound Transducer and Adaptive Signal Processing Algorithm.

Abnormal formation of solid thrombus inside a blood vessel can cause thrombotic morbidity and mortality. This necessitates early stage diagnosis, which requires quantitative assessment with a small volume, for effective therapy with low risk to unwanted development of various diseases. We propose a micro-ultrasonic diagnosis using an all-optical ultrasound-based spectral sensing (AOUSS) technique for sensitive and quantitative characterization of early stage and whole blood coagulation. The AOUSS technique detects and analyzes minute viscoelastic variations of blood at a micro-ultrasonic spot (<100 µm) defined by laser-generated focused ultrasound (LGFU). This utilizes (1) a uniquely designed optical transducer configuration for frequency-spectral matching and wideband operation (6 dB widths: 7-32 MHz and d.c. ∼ 46 MHz, respectively) and (2) an empirical mode decomposition (EMD)-based signal process particularly adapted to nonstationary LGFU signals backscattered from the spot. An EMD-derived spectral analysis enables one to assess viscoelastic variations during the initiation of fibrin formation, which occurs at a very early stage of blood coagulation (1 min) with high sensitivity (frequency transition per storage modulus increment = 8.81 MHz/MPa). Our results exhibit strong agreement with those obtained by conventional rheometry (Pearson's R > 0.95), which are also confirmed by optical microscopy. The micro-ultrasonic and high-sensitivity detection of AOUSS poses a potential clinical significance, serving as a screening modality to diagnose early stage clot formation (e.g., as an indicator for hypercoagulation of blood) and stages of blood-to-clot transition to check a potential risk for development into thrombotic diseases.

Current Advancements in Pectin: Extraction, Properties and Multifunctional Applications.

Pectin is a heterogeneous hydrocolloid present in the primary cell wall and middle lamella in all dicotyledonous plants, more commonly in the outer fruit coat or peel as compared to the inner matrix. Presently, citrus fruits and apple fruits are the main sources for commercial extraction of pectin, but ongoing research on pectin extraction from alternate fruit sources and fruit wastes from processing industries will be of great help in waste product reduction and enhancing the production of pectin. Pectin shows multifunctional applications including in the food industry, the health and pharmaceutical sector, and in packaging regimes. Pectin is commonly utilized in the food industry as an additive in foods such as jams, jellies, low calorie foods, stabilizing acidified milk products, thickener and emulsifier. Pectin is widely used in the pharmaceutical industry for the preparation of medicines that reduce blood cholesterol level and cure gastrointestinal disorders, as well as in cancer treatment. Pectin also finds use in numerous other industries, such as in the preparation of edible films and coatings, paper substitutes and foams. Due to these varied uses of pectin in different applications, there is a great necessity to explore other non-conventional sources or modify existing sources to obtain pectin with desired quality attributes to some extent by rational modifications of pectin with chemical and enzymatic treatments.

A Comprehensive Review of Biodegradable Polymer-Based Films and Coatings and Their Food Packaging Applications.

Food sectors are facing issues as a result of food scarcity, which is exacerbated by rising populations and demand for food. Food is ordinarily wrapped and packaged using petroleum-based plastics such as polyethylene, polyvinyl chloride, and others. However, the excessive use of these polymers has environmental and health risks. As a result, much research is currently focused on the use of bio-based materials for food packaging. Biodegradable polymers that are compatible with food products are used to make edible packaging materials. These can be ingested with food and provide consumers with additional health benefits. Recent research has shifted its focus to multilayer coatings and films-based food packaging, which can provide a material with additional distinct features. The aim of this review article is to investigate the properties and applications of several bio-based polymers in food packaging. The several types of edible film and coating production technologies are also covered separately. Furthermore, the use of edible films and coatings in the food industry has been examined, and their advantages over traditional materials are also discussed.

Natural Gum-Based Functional Bioactive Films and Coatings: A Review.

Edible films and coatings are a current and future food packaging trend. In the food and envi-ronmental sectors, there is a growing need to understand the role of edible packaging and sus-tainability. Gums are polysaccharides of natural origin that are frequently utilized as thickeners, clarifying agents, gelling agents, emulsifiers, and stabilizers in the food sector. Gums come in a variety of forms, including seed gums, mucilage gums, exudate gums, and so on. As a biodegradable and sustainable alternative to petrochemical-based film and coatings, gums could be a promising option. Natural plant gum-based edible packaging helps to ensure extension of shelf-life of fresh and processed foods while also reducing microbiological alteration and/or oxidation processes. In this review, the possible applications of gum-based polymers and their functional properties in development of edible films and coatings, were comprehensively dis-cussed. In the future, technology for developing natural gum-based edible films and coatings might be applied commercially to improve shelf life and preserve the quality of foods.

Nigrosome and Neuromelanin Imaging as Tools to Differentiate Parkinson's Disease and Parkinsonism.

Parkinson's disease (PD) lacks a definitive diagnosis due to a lack of pathological validation of patients at antemortem. The risk of misdiagnosis is high in the early stages of PD, often eluded by atypical parkinsonian symptoms. Neuroimaging and laboratory biomarkers are being sought to aid in the clinical diagnosis of PD. Nigrosome imaging and neuromelanin (NM)-sensitive magnetic resonance imaging (MRI) are the new emerging tools, both technically simple plus cost-effective for studying nigral pathology, and have shown potential for authenticating the clinical diagnosis of PD. Visual assessment of the nigrosome-1 appearance, at 3 or 7 Tesla, yields excellent diagnostic accuracy for differentiating idiopathic PD from healthy controls. Moreover, midbrain atrophy and putaminal hypointensity in nigrosome-1 imaging are valid pointers in distinguishing PD from allied parkinsonian disorders. The majority of studies employed T2 and susceptibility-weighted imaging MRI sequences to visualize nigrosome abnormalities, whereas T1-weighted fast-spin echo sequences were used for NM imaging. The diagnostic performance of NM-sensitive MRI in discriminating PD from normal HC can be improved further. Longitudinal studies with adequate sampling of varied uncertain PD cases should be designed to accurately evaluate the sensitivity and diagnostic potential of nigrosome and NM imaging techniques. Equal weightage is to be given to uniformity and standardization of protocols, data analysis, and interpretation of results. There is tremendous scope for identifying disease-specific structural changes in varied forms of parkinsonism with these low-cost imaging tools. Nigrosome-1 and midbrain NM imaging may not only provide an accurate diagnosis of PD but could mature into tools for personally tailored treatment and prognosis.

Experimental Demonstration of a Stacked Hybrid Optoacoustic-Piezoelectric Transducer for Localized Heating and Enhanced Cavitation.

Laser-generated focused ultrasound (LGFU) is an emerging modality for cavitation-based therapy. However, focal pressure amplitudes by LGFU alone to achieve pulsed cavitation are often lacking as a treatment depth increases. This requires a higher pressure from a transmitter surface and more laser energies that even approach to a damage threshold of transmitter. To mitigate the requirement for LGFU-induced cavitation, we propose LGFU configurations with a locally heated focal zone using an additional high-intensity focused ultrasound (HIFU) transmitter. After confirming heat-induced cavitation enhancement using two separate transmitters, we then developed a stacked hybrid optoacoustic-piezoelectric transmitter, which is a unique configuration made by coating an optoacoustic layer directly onto a piezoelectric substrate. This shared curvature design has great practical advantage without requiring the complex alignment of two focal zones. Moreover, this enabled the amplification of cavitation bubble density by 18.5-fold compared to the LGFU operation alone. Finally, the feasibility of tissue fragmentation was confirmed through a tissue-mimicking gel, using the combination of LGFU and HIFU (not via a stacked structure). We expect that the stacked transmitter can be effectively used for stronger and faster tissue fragmentation than the LGFU transmitter alone.

Laser-generated focused ultrasound transducer using a perforated photoacoustic lens for tissue characterization.

We demonstrate a laser-generated focused ultrasound (LGFU) transducer using a perforated-photoacoustic (PA) lens and a piezoelectric probe hydrophone suitable for high-frequency ultrasound tissue characterization. The perforated-PA lens employed a centrally located hydrophone to achieve a maximum directional response at 0° from the axial direction of the lens. Under pulsed laser irradiation, the lens produced LGFU pulses with a frequency bandwidth of 6-30 MHz and high-peak pressure amplitudes of up to 46.5 MPa at a 70-µm lateral focal width. Since the hydrophone capable of covering the transmitter frequency range (∼20 MHz) was integrated with the lens, this hybrid transducer differentiated tissue elasticity by generating and detecting high-frequency ultrasound signals. Backscattered (BS) waves from excised tissues (bone, skin, muscle, and fat) were measured and also confirmed by laser-flash shadowgraphy. We characterized the LGFU-BS signals in terms of mean frequency and spectral energy in the frequency domain, enabling to clearly differentiate tissue types. Tissue characterization was also performed with respect to the LGFU penetration depth (from the surface, 1-, and 2-mm depth). Despite acoustic attenuation over the penetration depth, LGFU-BS characterization shows consistent results that can differentiate the elastic properties of tissues. We expect that the proposed transducer can be utilized for other tissue types and also for non-destructive evaluation based on the elasticity of unknown materials.

Photoacoustic Spectral Sensing Technique for Diagnosis of Biological Tissue Coagulation: In-Vitro Study.

Thermal coagulation of abnormal tissues has evolved as a therapeutic technique for different diseases including cancer. Tissue heating beyond 55 °C causes coagulation that leads to cell death. Noninvasive diagnosis of thermally coagulated tissues is pragmatic for performing efficient therapy as well as reducing damage of surrounding healthy tissues. We propose a noninvasive, elasticity-based photoacoustic spectral sensing technique for differentiating normal and coagulated tissues. Photoacoustic diagnosis is performed for quantitative differentiation of normal and coagulated excised chicken liver and muscle tissues in vitro by characterizing a dominant frequency of photoacoustic frequency spectrum. Pronounced distinction in the spectral parameter (i.e., dominant frequency) was observed due to change in tissue elastic property. We confirmed nearly two-fold increase in dominant frequencies for the coagulated muscle and liver tissues as compared to the normal ones. A density increase caused by tissue coagulation is clearly reflected in the dominant frequency composition. Experimental results were consistent over five different sample sets, delineating the potential of proposed technique to diagnose biological tissue coagulation and thus monitor thermal coagulation therapy in clinical applications.

Application of continuous-wave photoacoustic sensing to red blood cell morphology.

The feasibility of continuous wave laser-based photoacoustic (CWPA) response technique in detecting the morphological changes in cells during the biological studies, through the features extracted from CWPA signal (i.e., amplitude) is demonstrated here. Various hematological disorders (e.g., sickle cell anemia, thalesemia) produce distinct changes at the cellular level morphologically. In order to explore the photoacoustic response technique to detect these morphological changes, we have applied CWPA technique onto the blood samples. Results of our preliminary study show a distinct change in the signal amplitude of photoacoustic (PA) signal due to a change in the concentration of blood, which signifies the sensitivity of the technique towards red blood cell (RBC) count (related to hematological disease like anemia). Further hypotonic and hypertonic solutions were induced in blood to produce morphological changes in RBCs (i.e., swollen and shrink, respectively) as compared to the normal RBCs. Experiments were performed using continuous wave laser-based photoacoustic response technique to verify the morphological changes in these RBCs. A distinct change in the PA signal amplitude was found for the distinct nature of RBCs (swollen, shrink, and normal). Thus, this can serve as a diagnostic signature for different biological studies based on morphological changes at cellular level. The experiments were also performed using conventional pulsed laser photoacoustic response technique which uses nano-second pulsed laser and the results obtained from both PA techniques were validated to produce identical changes. This demonstrates the utility of continuous wave laser-based photoacoustic technique for different biological studies related to morphological cellular disorders.

Quantitative Differentiation of Pneumonia from Normal Lungs: Diagnostic Assessment Using Photoacoustic Spectral Response.

Pneumonia is an acute lung infection that takes life of many young children in developing countries. Early stage (red hepatization) detection of pneumonia would be pragmatic to control mortality rate. Detection of this disease at early stages demands the knowledge of pathology, making it difficult to screen noninvasively. We propose photoacoustic spectral response (PASR), a noninvasive elasticity-dependent technique for early stage pneumonia detection. We report the quantitative red hepatization detection of pneumonia through median frequency, spectral energy, and variance. Significant contrast in spectral parameters due to change in sample elasticity is found. The tissue-mimicking phantom study illustrates a 39% increase in median frequency for 1.5 times the change in density. On applying to formalin-fixed pneumonia-affected goat lungs, it provides a distinct change in spectral parameters between pneumonia affected areas and normal lungs. The obtained PASR results were found to be highly correlating to standard histopathology. The proposed technique therefore has potential to be a regular diagnostic tool for early pneumonia detection.

Quantitative photoacoustic characterization of blood clot in blood: A mechanobiological assessment through spectral information.

Formation of blood clots, called thrombus, can happen due to hyper-coagulation of blood. Thrombi, while moving through blood vessels can impede blood flow, an important criterion for many critical diseases like deep vein thrombosis and heart attacks. Understanding mechanical properties of clot formation is vital for assessment of severity of thrombosis and proper treatment. However, biomechanics of thrombus is less known to clinicians and not very well investigated. Photoacoustic (PA) spectral response, a non-invasive technique, is proposed to investigate the mechanism of formation of blood clots through elasticity and also differentiate clots from blood. Distinct shift (increase in frequency) of the PA response dominant frequency during clot formation is reported. In addition, quantitative differentiation of blood clots from blood has been achieved through parameters like dominant frequency and spectral energy of PA spectral response. Nearly twofold increases in dominant frequency in blood clots compared to blood were found in the PA spectral response. Significant changes in energy also help in quantitatively differentiating clots from blood, in the blood. Our results reveal that increase in density during clot formation is reflected in the PA spectral response, a significant step towards understanding the mechanobiology of thrombus formation. Hence, the proposed tool, in addition to detecting thrombus formation, could reveal mechanical properties of the sample through quantitative photoacoustic spectral parameters.