Essential Tremors: A Literature Review of Current Therapeutics.

Essential tremors (ETs) commonly manifest as involuntary shaking of the hands that disrupt daily activities. These tremors involve the central motor network of the cerebellum, thalamus, and cortical networks, leading to different clinical phenotypes. The goal of this review was to establish evidence-based recommendations for effective care and simplify decisions for those dealing with ET. For this narrative literature review, we conducted a thorough search using core keywords such as "essential tremor" and "therapy." From the 27 selected articles, relevant data were presented regarding pathophysiology, medications, and other treatment options, with necessary supplemental data such as side effects and use cases. This paper examines treatments for ET, including commonly prescribed medications such as propranolol and primidone; invasive treatments such as deep brain stimulation, focused ultrasound thalamotomy, transcranial magnetic stimulation, and some surgical methods; and non-invasive methods such as the neuromodulation technique of transcutaneous afferent patterned stimulation. Overall, this study presents a synthesized understanding of the currently available modalities for managing ETs. It is intended to guide care providers in choosing the best possible method to contain symptoms.

Linkage of Microbial Parameters with Sediment Physicochemical Properties in Subsurface Fluvial Sediment Deposits of the Mahi River Basin, Western India.

The linkage between sediment physicochemical and microbial parameters within river terrace sedimentary ecosystems of semiarid regions is still in infancy. Here, we investigated microbial enzyme activities involved in C, N, P, and S cycling, and quantitative PCR (qPCR) based gene abundance of two laterally deposited sediment cores (28 and 25 m deep) comprising the Late Quaternary sediments of the Mahi River (Gujarat, India). Gene abundance indicates the presence of a sustainable bacterial population throughout both cores. The stratified subsurface sediments had notable microbial enzyme activities indicating an important role of both cores in biogeochemical cycling. Correlation between microbial and geological parameters revealed that various trace elements, rare earth elements, K2O, P2O5, EC, TDS, and salinity link significantly with microbial parameters. However, the direction and magnitude of the correlation differ in both cores under study. These results emphasize that sediment physicochemical properties influence microbial parameters differently in the laterally deposited subsurface sediments. Supplementary Information: The online version contains supplementary material available at 10.1007/s12088-021-00998-4.

Provider-Patient Interaction: Exploring Elderspeak in Simulated Preclinical Chiropractic Student Encounters.

Objective: The purpose of this study was to identify whether or not elderspeak was evident in simulated provider-patient encounters in a chiropractic education program. This study was designed to answer the following three research questions (RQs):RQ 1: Is elderspeak present in simulated patient encounters in a chiropractic education program?RQ 2: If elderspeak is present, which categorization of elderspeak is most frequently used during simulated patient encounters?RQ 3: If elderspeak is present, is gender an influencing variable? Method: The presence of elderspeak in simulated chiropractic encounters was studied using a cross-sectional mixed methods observational research design. Results: A total of 331 occurrences of elderspeak were identified in 60 digitized recordings. The most common form of elderspeak was collective pronoun usage. Conclusion: Results indicated that the chiropractic industry is susceptible to elderspeak. Understanding elderspeak is important to prevent future ageist behaviors from affecting older adult patients and to improve their health outcomes.

Tracing the Vedic Saraswati River in the Great Rann of Kachchh.

The lost Saraswati River mentioned in the ancient Indian tradition is postulated to have flown independently of the Indus River into the Arabian Sea, perhaps along courses of now defunct rivers such as Ghaggar, Hakra and Nara. The persistence of such a river during the Harappan Bronze Age and the Iron Age Vedic period is strongly debated. We drilled in the Great Rann of Kachchh (Kutch), an infilled gulf of the Arabian Sea, which must have received input from the Saraswati, if active. Nd and Sr isotopic measurements suggest that a distinct source may have been present before 10 ka. Later in Holocene, under a drying climate, sediments from the Thar Desert probably choked the signature of an independent Saraswati-like river. Alternatively, without excluding a Saraswati-like secondary source, the Indus and the Thar were the dominant sources throughout the post-glacial history of the GRK. Indus-derived sediment accelerated the infilling of GRK after ~6 ka when the Indus delta started to grow. Until its complete infilling few centuries ago, freshwater input from the Indus, and perhaps from the Ghaggar-Hakra-Nara, probably sustained a productive marine environment as well as navigability toward old coastal Harappan and historic towns in the region.

Dark Matter Search Results from the PICO-60 C_{3}F_{8} Bubble Chamber.

New results are reported from the operation of the PICO-60 dark matter detector, a bubble chamber filled with 52 kg of C_{3}F_{8} located in the SNOLAB underground laboratory. As in previous PICO bubble chambers, PICO-60 C_{3}F_{8} exhibits excellent electron recoil and alpha decay rejection, and the observed multiple-scattering neutron rate indicates a single-scatter neutron background of less than one event per month. A blind analysis of an efficiency-corrected 1167-kg day exposure at a 3.3-keV thermodynamic threshold reveals no single-scattering nuclear recoil candidates, consistent with the predicted background. These results set the most stringent direct-detection constraint to date on the weakly interacting massive particle (WIMP)-proton spin-dependent cross section at 3.4×10^{-41} cm^{2} for a 30-GeV c^{-2} WIMP, more than 1 order of magnitude improvement from previous PICO results.

Effect of ordered mesoporous carbon contact layer on the sensing performance of sputtered RuO2 thin film pH sensor.

The effect of contact layer on the pH sensing performance of a sputtered RuO2 thin film pH sensor is investigated. The response of pH sensors employing RuO2 thin film electrodes on screen-printed Pt, carbon and ordered mesoporous carbon (OMC) contact layers are measured over a pH range from 4 to 10. Working electrodes with OMC contact layer are found to have Nernstian pH sensitivity (-58.4mV/pH), low short-term drift rate (5.0mV/h), low hysteresis values (1.13mV) and fast reaction times (30s), after only 1h of conditioning. A pH sensor constructed with OMC carbon contact layer displays improved sensing performance compared to Pt and carbon-based counterparts, making this electrode more attractive for applications requiring highly-accurate pH sensing with reduced conditioning time.

Dark Matter Search Results from the PICO-2L C3F8 Bubble Chamber.

New data are reported from the operation of a 2 liter C3F8 bubble chamber in the SNOLAB underground laboratory, with a total exposure of 211.5 kg days at four different energy thresholds below 10 keV. These data show that C3F8 provides excellent electron-recoil and alpha rejection capabilities at very low thresholds. The chamber exhibits an electron-recoil sensitivity of <3.5×10(-10) and an alpha rejection factor of >98.2%. These data also include the first observation of a dependence of acoustic signal on alpha energy. Twelve single nuclear recoil event candidates were observed during the run. The candidate events exhibit timing characteristics that are not consistent with the hypothesis of a uniform time distribution, and no evidence for a dark matter signal is claimed. These data provide the most sensitive direct detection constraints on WIMP-proton spin-dependent scattering to date, with significant sensitivity at low WIMP masses for spin-independent WIMP-nucleon scattering.

Protection of radiation induced DNA and membrane damages by total triterpenes isolated from Ganoderma lucidum (Fr.) P. Karst.

The total triterpenes isolated from the fruiting bodies of Ganoderma lucidum was examined for its potential to prevent γ-radiation induced membrane damage in rat liver mitochondria and microsomes. The effects of total triterpenes on γ-radiation-induced DNA strand breaks in pBR 322 plasmid DNA in vitro and human peripheral blood lymphocytes ex vivo were evaluated. The protective effect of total triterpenes against γ-radiation-induced micronuclei formations in mice bone marrow cells in vivo were also evaluated. The results indicated the significant effectiveness of Ganoderma triterpenes in protecting the DNA and membrane damages consequent to the hazardous effects of radiation. The findings suggest the potential use of Ganoderma triterpenes in radio therapy.

Formulation and optimization of rifampicin microparticles by Box-Behnken statistical design.

The objective of the present study was to optimize and evaluate in vitro gastroretentive performance of rifampicin microparticles. Formulations were optimized using design of experiments by employing a 4-factor, 3-level Box-Behnken statistical design. Independent variables studied were the ratio of polymers (Eudragit RSPO: ethyl cellulose), inert drug dispersing agent (talc), surfactant (sodium dodecyl sulfate) and stirring speed. The dependent variables were particle size and entrapment efficiency. Response surface plots were drawn, statistical validity of the polynomials was validated and the optimized formulation was characterized by Fourier Transform-InfraRed spectroscopy (FT-IR) and differential scanning calorimetry (DSC). Entrapment efficiency and particle size were determined. The designed microparticles have average particle size from 14.10 µm to 45.63 µm and entrapment efficiency from 38.14% to 94.81%. Optimized microparticles showed particle size and drug entrapment, 51.53 µm and 83.43%, respectively with sustained drug release behavior up to 12 h. In the present study, rifampicin microspheres were successfully prepared by a quasi-emulsion solvent diffusion technique for prolonged drug release. FT-IR and DSC studies did not reveal any significant drug interactions. The drug release was found to be controlled for more than 12 h by following zero order release pattern.

Nanotechnology in ocular delivery: current and future directions.

Our knowledge in the field of ocular drug delivery is rapidly expanding. An increase in the understanding of ocular drug absorption and disposition vis-à-vis developments in nanotechnology has led to the emergence of many of the nanotechnology-based ocular drug delivery systems including nanoparticles, microemulsions, liposomes, solid lipid nanoparticles, light-sensitive nanocarrier systems, etc. The need to develop effective treatments for posterior eye segment diseases is more important than surface delivery. Treatment of blinding diseases of the eye, such as proliferative retinopathy or macular degeneration, requires effective and safe delivery of drugs to posterior eye segment tissues, and recent advances in nanotechnology have demonstrated successful outcomes. Nanoscientists should focus their efforts on nano-ophthalmology. This review describes the current status and progress made so far, and the course that needs to be pursued in the future.

Formulation and optimization of alkaline extracted ispaghula husk microparticles of isoniazid - in vitro and in vivo assessment.

Microparticles containing isoniazid were prepared by the emulsification internal ionic gelation method using a novel, alkaline extracted ispaghula husk as a wall forming material. A four-factor three-level Box-Behnken design was employed to study the effect of independent variables on dependent variables. Sodium alginate concentration (X(1)), alkaline extraction of ispaghula husk (AEISP) concentration (X(2)), concentration of cross-linking agents (X(3)) and stirring speed (X(4)) were four independent variables considered in the preparation of microparticles, while the particle size (Y(1)) and entrapment efficiency (Y(2)) were dependent variables. Optimized microparticles exhibited 83.43% drug entrapment and 51.53 µm particle size with 97.80% and 96.37% validity, respectively, at the following conditions - sodium alginate (3.55% w/v), alkaline extracted ispaghula husk (3.60% w/v), cross-linker concentration (7.82% w/v) and stirring speed (1200 rpm). The optimized formulation showed controlled drug release for more than 12 h by following Higuchi kinetics via non-Fickian diffusion. The gamma scintigraphy of the optimized formulation in Wistar rats showed that microparticles could be observed in the intestinal lumen after 1 h and were detectable in the intestine up to 12 h, with decreased percentage of radioactivity (t(1/2) of (99m)Tc 4-5 h).

Differential activation of NF-κB and nitric oxide in lymphocytes regulates in vitro and in vivo radiosensitivity.

Lymphocytes are more sensitive to radiation in vivo than in vitro. However, the mechanism of this differential response is poorly understood. In the present study, it was found that the lipid peroxidation and cell death were significantly higher in lymphocytes following whole body irradiation (WBI) as compared to lymphocytes exposed to radiation in vitro. EL-4 cells transplanted in mice were also more sensitive to radiation than EL-4 cells irradiated in vitro. DNA repair, as assessed by comet assay, was significantly faster in lymphocytes exposed to 4Gy radiation in vitro as compared to that in lymphocytes obtained from whole body irradiated mice exposed to the same dose of radiation. This was associated with increased NF-κB activation in response to genotoxic stress and lesser activation of caspase in lymphocytes in vitro compared to in vivo. To explain the differential radiosensitivity, we postulated a role of nitric oxide, an extrinsic diffusible mediator of radiosensitivity that has also been implicated in DNA repair inhibition. Nitric oxide levels were significantly elevated in the plasma of whole body irradiated mice but not in the supernatant of cells irradiated in vitro. Addition of sodium nitroprusside (SNP), a nitric oxide donor to cells irradiated in vitro inhibited the repair of DNA damage and enhanced apoptosis (increased Bax to Bcl-2 ratio). Administration of l-NAME, a nitric oxide synthase inhibitor, to mice significantly protected lymphocytes against WBI-induced DNA damage and inhibited in vivo radiation-induced production of nitric oxide. These results confirm that the observed differential radiosensitivity of lymphocytes was due to slow repair of DNA due to nitric oxide production in vivo.

Preparation and in vitro characterization of diltiazem hydrochloride loaded alginate microspheres.

The main objective of the present study was to improve bioavailability of diltiazem hydrochloride and decrease the frequency of dosage form administration by increasing the encapsulation efficiency of the drug, residence time of the dosage form at the site of absorption and sustained release of the drug from the delivery system. Alginate microspheres containing diltiazem hydrochloride were prepared by the emulsification-internal gelation method by using barium carbonate as a cross-linking agent with improved encapsulation efficiency. The effect of various factors (concentration of alginate and barium chloride) on the drug loading efficiency and in vitro release were investigated. Fourier transform infrared spectroscopy (FT-IR) analysis confirmed the absence of any drug polymer interaction. Differential scanning calorimetry (DSC) and X-ray diffraction (XRD) pattern showed that the crystallinity of the drug was decreased in the dosage forms. The in vitro drug release mechanism was non-Fickian type controlled by swelling and relaxation of polymer. The stability studies of drug-loaded microspheres showed that the drug was stable at different storage conditions.

Reversible suppression of nitric oxide system in essential hypertension.

Despite enormous research in the field of hypertension, its pathophysiology still remains largely unresolved and appears to be multifactorial. In the present communication, we have analyzed the status of nitric oxide (NO) in the patients with essential hypertension and age matched controls. We have found that the levels of NO are lowered in essential hypertension. The normalization of blood pressure by administration of antihypertensive therapy causes rise in the NO level indicating that perturbed NO status in essential hypertension is reversible. Addition of antioxidant to the antihypertensive drugs causes a further, though non significant, rise in the levels of NO, suggesting that antioxidants may be combined with antihypertensive drugs as adjunct in the management of essential hypertension.

Role of triphala in the management of peridontal disease.

Ayurvedic literature contains a wealth of information on the diagnosis and treatment of periodontal diseases. This article discusses the use of triphala in the treatment of such diseases.