Essential tremor patients experience significant burden beyond tremor: A systematic literature review.

Background: Essential tremor (ET) is among the most common movement disorders in adults. While ET is diagnosed and primarily characterized by the presence of tremor, it also can impact cognition, sleep, mood, and motor functioning more broadly. The manifestations of ET can have various consequences, including difficulty with activities of daily living (ADL), embarrassment, and overall decline in health-related quality of life, which have not been fully explored in prior studies. Objective: We performed a systematic literature review to comprehensively characterize the burden experienced by patients with ET from the clinical and humanistic perspectives, focusing on outcomes beyond tremor. Methods: This systematic literature review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches in PubMed, Embase, and Cochrane Library identified original, observational studies of the clinical and humanistic burden in adult patients with ET published in English between 2010 and 2020. Studies assessing epidemiology, treatment patterns, or disease management were excluded. Search results were screened according to pre-determined eligibility criteria. Data from included studies were collected, independently verified, and qualitatively synthesized. Results: Following the screening of 2,303 records and 145 full-text articles, 39 studies were identified. There was significant heterogeneity in study designs, statistical approaches, and patient cohorts across the included studies. Patients with ET in these studies exhibited more severe disabilities and reduced independence compared to healthy individuals, and they often struggled to perform ADL and relied on caregivers for physical and emotional support. Patients also experienced various issues with movement and balance, increased risk of falls, depression, anxiety, poor sleep quality, and psychosocial consequences including embarrassment, apathy, and enfeeblement. Conclusion: A systematic literature review of non-tremor manifestations and/or consequences of ET identified far-reaching negative impacts on patients' ability to function independently and revealed accompanying psychosocial effects, including social fear and embarrassment. The reduced function and psychosocial deficits observed in patients with ET result in significant clinical and humanistic burdens, decreasing quality of life. Future studies should evaluate this condition beyond the tremor itself to provide an improved understanding of the multi-dimensional burden of the disease, thereby highlighting the need to diagnose and appropriately manage patients with ET.

Hypoactive sexual desire disorder (HSDD) is not "female erectile dysfunction (ED)": challenges with the characterization of HSDD in women based on a systematic literature review.

Objective: Hypoactive sexual desire disorder (HSDD) in women has been viewed inaccurately by some in the medical and payer community as analogous to erectile dysfunction (ED) in men. This literature review aims to highlight the distinctions between HSDD and ED.Methods: Two systematic literature searches were conducted on the epidemiology, symptomatology and biopsychosocial outcomes of HSDD and ED. Studies published since 2007 were considered for HSDD; studies published since 2012 were considered for ED.Results: HSDD in women is primarily a central nervous system condition related to neuroendocrine factors, whereby neural pathways that regulate sexual excitation and/or inhibition appear to be involved. A combination of organic and psychogenic factors often contributes to ED. HSDD and ED are associated with similar psychological and interpersonal consequences, but affect different phases of the sexual response model (desire versus arousal) and have different pathophysiologies, therefore requiring different treatment and outcome paradigms. ED is measured by objective, physiological responses (erection and sexual function), but quantitative assessments for HSDD are more difficult because loss of desire with associated distress has to be assessed. Outcome measures used to assess ED, such as the number of satisfying sexual events, are far less informative as an endpoint for randomized clinical trials of treatments for HSDD.Conclusions: HSDD and ED are distinct conditions affecting different phases of the sexual response model, and thus require clear and unique clinical characterization and adequate communication between the health care professional and patient for appropriate diagnosis, management and treatment.

Biodistribution and Physiologically-Based Pharmacokinetic Modeling of Gold Nanoparticles in Mice with Interspecies Extrapolation.

Gold nanoparticles (AuNPs) are a focus of growing medical research applications due to their unique chemical, electrical and optical properties. Because of uncertain toxicity, "green" synthesis methods are emerging, using plant extracts to improve biological and environmental compatibility. Here we explore the biodistribution of green AuNPs in mice and prepare a physiologically-based pharmacokinetic (PBPK) model to guide interspecies extrapolation. Monodisperse AuNPs were synthesized and capped with epigallocatechin gallate (EGCG) and curcumin. 64 CD-1 mice received the AuNPs by intraperitoneal injection. To assess biodistribution, groups of six mice were sacrificed at 1, 7, 14, 28 and 56 days, and their organs were analyzed for gold content using inductively coupled plasma mass spectrometry (ICP-MS). A physiologically-based pharmacokinetic (PBPK) model was developed to describe the biodistribution data in mice. To assess the potential for interspecies extrapolation, organism-specific parameters in the model were adapted to represent rats, and the rat PBPK model was subsequently evaluated with PK data for citrate-capped AuNPs from literature. The liver and spleen displayed strong uptake, and the PBPK model suggested that extravasation and phagocytosis were key drivers. Organ predictions following interspecies extrapolation were successful for rats receiving citrate-capped AuNPs. This work lays the foundation for the pre-clinical extrapolation of the pharmacokinetics of AuNPs from mice to larger species.

Characterisation of pain in people with hereditary neuropathy with liability to pressure palsy.

Hereditary neuropathy with liability to pressure palsy (HNPP) has historically been considered a pain-free condition, though some people with HNPP also complain of pain. This study characterised persistent pain in people with HNPP. Participants provided cross-sectional demographic data, information on the presence of neurological and persistent pain symptoms, and the degree to which these interfered with daily life. The painDETECT and Central Sensitization Inventory questionnaires were used to indicate potential neuropathic, central sensitisation and musculoskeletal (nociceptive) pain mechanisms. Additionally, participants were asked if they thought that pain was related to/part of HNPP. 32/43 (74%) subjects with HNPP had persistent pain and experience this pain in the last week. Of those with pain, 24 (75%) were likely to have neuropathic pain and 27 (84%) were likely to have central sensitisation. All 32 participants felt that their pain could be related to/part of their HNPP. Significant negative impact of the pain was common. Pain characterisation identified neuropathic pain and/or central sensitisation as common, potential underlying processes. Pain may plausibly be directly related to the underlying pathophysiology of HNPP. Further consideration of including pain as a primary symptom of HNPP is warranted.

PMMA/MWCNT nanocomposite for proton radiation shielding applications.

Radiation shielding in space missions is critical in order to protect astronauts, spacecraft and payloads from radiation damage. Low atomic-number materials are efficient in shielding particle-radiation, but they have relatively weak material properties compared to alloys that are widely used in space applications as structural materials. However, the issues related to weight and the secondary radiation generation make alloys not suitable for space radiation shielding. Polymers, on the other hand, can be filled with different filler materials for reinforcement of material properties, while at the same time provide sufficient radiation shielding function with lower weight and less secondary radiation generation. In this study, poly(methyl-methacrylate)/multi-walled carbon nanotube (PMMA/MWCNT) nanocomposite was fabricated. The role of MWCNTs embedded in PMMA matrix, in terms of radiation shielding effectiveness, was experimentally evaluated by comparing the proton transmission properties and secondary neutron generation of the PMMA/MWCNT nanocomposite with pure PMMA and aluminum. The results showed that the addition of MWCNTs in PMMA matrix can further reduce the secondary neutron generation of the pure polymer, while no obvious change was found in the proton transmission property. On the other hand, both the pure PMMA and the nanocomposite were 18%-19% lighter in weight than aluminum for stopping the protons with the same energy and generated up to 5% fewer secondary neutrons. Furthermore, the use of MWCNTs showed enhanced thermal stability over the pure polymer, and thus the overall reinforcement effects make MWCNT an effective filler material for applications in the space industry.

Bismuth sulfide nanoflowers for detection of X-rays in the mammographic energy range.

The increased use of diagnostic x-rays, especially in the field of medical radiology, has necessitated a significant demand for high resolution, real-time radiation detectors. In this regard, the photoresponse of bismuth sulfide (Bi2S3), an n-type semiconducting metal chalcogenide, to low energy x-rays has been investigated in this study. In recent years, several types of nanomaterials of Bi2S3 have been widely studied for optoelectronic and thermoelectric applications. However, photoresponse of Bi2S3 nanomaterials for dosimetric applications has not yet been reported. The photosensitivity of Bi2S3 with nanoscale "flower-like" structures was characterized under x-ray tube-potentials typically used in mammographic procedures. Both dark current and photocurrent were measured under varying x-ray doses, field sizes, and bias voltages for each of the tube potentials - 20, 23, 26 and 30 kV. Results show that the Bi2S3 nanoflowers instantaneously responded to even minor changes in the dose delivered. The photoresponse was found to be relatively high (few nA) at bias voltage as low as +1 V, and fairly repeatable for both short and long exposures to mammographic x-rays with minimal or no loss in sensitivity. The overall dose-sensitivity of the Bi2S3 nanoflowers was found to be similar to that of a micro-ionization chamber.

Polymer-composite materials for radiation protection.

Unwanted exposures to high-energy or ionizing radiation can be hazardous to health. Prolonged or accumulated radiation dosage from either particle-emissions such as alpha/beta, proton, electron, neutron emissions, or high-energy electromagnetic waves such as X-rays/γ rays, may result in carcinogenesis, cell mutations, organ failure, etc. To avoid occupational hazards from these kinds of exposures, researchers have traditionally used heavy metals or their composites to attenuate the radiation. However, protective gear made of heavy metals are not only cumbersome but also are capable of producing more penetrative secondary radiations which requires additional shielding, increasing the cost and the weight factor. Consequently, significant research efforts have been focused toward designing efficient, lightweight, cost-effective, and flexible shielding materials for protection against radiation encountered in various industries (aerospace, hospitals, and nuclear reactors). In this regard, polymer composites have become attractive candidates for developing materials that can be designed to effectively attenuate photon or particle radiation. In this paper, we review the state-of-the-art of polymer composites reinforced with micro/nanomaterials, for their use as radiation shields.

Conductive polymer-based sensors for biomedical applications.

A class of organic polymers, known as conducting polymers (CPs), has become increasingly popular due to its unique electrical and optical properties. Material characteristics of CPs are similar to those of some metals and inorganic semiconductors, while retaining polymer properties such as flexibility, and ease of processing and synthesis, generally associated with conventional polymers. Owing to these characteristics, research efforts in CPs have gained significant traction to produce several types of CPs since its discovery four decades ago. CPs are often categorised into different types based on the type of electric charges (e.g., delocalized pi electrons, ions, or conductive nanomaterials) responsible for conduction. Several CPs are known to interact with biological samples while maintaining good biocompatibility and hence, they qualify as interesting candidates for use in a numerous biological and medical applications. In this paper, we focus on CP-based sensor elements and the state-of-art of CP-based sensing devices that have potential applications as tools in clinical diagnosis and surgical interventions. Representative applications of CP-based sensors (electrochemical biosensor, tactile sensing 'skins', and thermal sensors) are briefly discussed. Finally, some of the key issues related to CP-based sensors are highlighted.

Small interfering ribonucleic acid design strategies for effective targeting and gene silencing.

INTRODUCTION: Gene silencing mediated by siRNAs is becoming a promising therapeutic approach. Although many strategies and technologies have been applied to siRNA design, a key issue lies in the selection of efficient design predictors. Furthermore, the development of systemic siRNA delivery strategies, which would enhance the therapeutic effect, remains a central issue. AREAS COVERED: The review discusses the basic principles of the sequence-specific design criteria of functional siRNAs and possible chemical modifications. Some of the most recent advances in the development of siRNA design algorithms and delivery strategies are also presented. Emphasis is given to the important design rule sets and predictors which determine the functionality of an efficient siRNA. EXPERT OPINION: The potential and limitations of efficient design predictors obtained from computational algorithms play a crucial role in the development of target-specific siRNAs. Furthermore, the future success of RNA interference therapeutics will depend on their ability to efficiently cross the physiological barriers, selectively target cells-of-interest and finally silence the gene-of-interest without any side effects.