Refractive index of biological tissues: Review, measurement techniques, and applications

Photobiomodulation for pain relief: Model-based estimates of effective doses of light at the neural target

INTRODUCTION

Photobiomodulation (PBM) has been studied since the 1960s as a clinical tool. More recently, PBM has been observed to reduce compound action potential components and hypersensitivities associated with neuropathic pains. However, no definitive description of efficacious light parameters has been determined. Some reasons may be that previous meta-analyses and reviews have focused on emitter output rather than the light at the target tissue and have included data sets that are large but with notable variability (e.g., combining data from various disease etiologies, and data from PBM at various wavelengths). This fact has made it difficult to successfully define the range of effective parameters.

METHODS

In this study, photon propagation software was used to estimate irradiance at a target nerve using several published data sets chosen for their narrow criteria to minimize variability. Utilizing these estimates, effective and ineffective light irradiances at the nerve of interest for wavelengths of 633 nm or 808-830 nm were examined and estimated. These estimates are focused on the amount of light required to achieve a reduction in pain or a surrogate measure via a hypothesized nerve block mechanism.

RESULTS

Accounting for irradiance at the target nerve yielded a clear separation of PBM doses that achieved small-fiber nerve block from those that did not. For both the 633 nm group and the 808-830 group, the irradiance separation threshold followed a nonlinear path with respect to PBM application duration, where shorter durations required higher irradiances, and longer durations required lower irradiances. Using the same modeling methods, irradiance was estimated as a function of depth from a transcutaneous source (distance from skin surface) for emitter output power using small or large emitter sizes.

CONCLUSION

Taken together, the results of this study can be used to estimate effective PBM dosing schemes to achieve small-fiber inhibition for various anatomical scenarios.

Hydrogel for light delivery in biomedical applications

Traditional optical waveguides or mediums are often silica-based materials, but their applications in biomedicine and healthcare are limited due to the poor biocompatibility and unsuitable mechanical properties. In term of the applications in human body, a biocompatible hydrogel system with excellent optical transparency and mechanical flexibility could be beneficial. In this review, we explore the different designs of hydrogel-based optical waveguides derived from natural and synthetic sources. We highlighted key developments such as light emitting contact lenses, implantable optical fibres, biosensing systems, luminating and fluorescent materials. Finally, we expand further on the challenges and perspectives for hydrogel waveguides to achieve clinical applications.

Tissue characterization using axicon probe-assisted common-path optical coherence tomography

In this work, a common-path optical coherence tomography (OCT) system is demonstrated for characterizing the tissue in terms of some optical properties. A negative axicon structure chemically etched inside the fiber tip is employed as optical probe in the OCT. This probe generates a quality Bessel beam owning a large depth-of-field, ∼700 µm and small central spot size, ∼3 µm. The OCT system is probing the sample without using any microscopic lens. For experimental validation, the OCT imaging of chicken tissue has been obtained along with estimation of its refractive index and optical attenuation coefficient. Afterwards, the cancerous tissue is differentiated from the normal tissue based on the OCT imaging, refractive index, and optical attenuation coefficient. The respective tissue samples are collected from the human liver and pancreas. This probe could be a useful tool for endoscopic or minimal-invasive inspection of malignancy inside the tissue either at early-stage or during surgery.

Raman spectroscopy-based microfluidic platforms: A promising tool for detection of foodborne pathogens in food products

Rapid and sensitive detection of foodborne pathogens in food products is paramount for ensuring food safety and public health. In the ongoing effort to tackle this issue, detection methods are continually researched and upgraded to achieve rapidity, sensitivity, portability, and cost-effectiveness. This review addresses the critical need for improved technique by focusing on Raman spectroscopy-based microfluidic platforms, which have shown potential in revolutionizing the field of foodborne pathogen analysis offering point-of-care diagnosis and multiplex detection. The key problem lies in the persistent threat of compromised food quality and public health due to inadequate pathogen detection. The review elucidates the various trapping strategies employed in a microfluidic platform, including optical trapping, electrical trapping, mechanical trapping, and acoustic trapping for the capture of microbial cells. Subsequently, the review delves into the key aspects of the application of microbial detection in food products, highlighting recent advances and challenges in the field. The integrated technique allows point-of-care application assessment, which is an attractive quality for in-line and real-time detection of foodborne pathogens. However, the application of the technique in food products is limited and requires further research to combat the complexity of the food matrix, reduced costs of production, and ensure real-time use for diverse pathogens. Ultimately, this review aims to propel advancements in microbial detection, thus promoting enhanced food safety through state-of-the-art technologies.

Dissemination of Circulating Tumor Cells in Breast and Prostate Cancer: Implications for Early Detection

Burgeoning evidence suggests that circulating tumor cells (CTCs) may disseminate into blood vessels at an early stage, seeding metastases in various cancers such as breast and prostate cancer. Simultaneously, the early-stage CTCs that settle in metastatic sites [termed disseminated tumor cells (DTCs)] can enter dormancy, marking a potential source of late recurrence and therapy resistance. Thus, the presence of these early CTCs poses risks to patients but also holds potential benefits for early detection and treatment and opportunities for possibly curative interventions. This review delves into the role of early DTCs in driving latent metastasis within breast and prostate cancer, emphasizing the importance of early CTC detection in these diseases. We further explore the correlation between early CTC detection and poor prognoses, which contribute significantly to increased cancer mortality. Consequently, the detection of CTCs at an early stage emerges as a critical imperative for enhancing clinical diagnostics and allowing for early interventions.

Multi-harmonic structured illumination-based optical diffraction tomography

Imaging speed and spatial resolution are key factors in optical diffraction tomography (ODT), while they are mutually exclusive in 3D refractive index imaging. This paper presents a multi-harmonic structured illumination-based optical diffraction tomography (MHSI-ODT) to acquire 3D refractive index (RI) maps of transparent samples. MHSI-ODT utilizes a digital micromirror device (DMD) to generate structured illumination containing multiple harmonics. For each structured illumination orientation, four spherical spectral crowns are solved from five phase-shifted holograms, meaning that the acquisition of each spectral crown costs 1.25 raw images. Compared to conventional SI-ODT, which retrieves two spectral crowns from three phase-shifted raw images, MHSI-ODT enhances the imaging speed by 16.7% in 3D RI imaging. Meanwhile, MHSI-ODT exploits both the 1st-order and the 2nd-order harmonics; therefore, it has a better intensity utilization of structured illumination. We demonstrated the performance of MHSI-ODT by rendering the 3D RI distributions of 5 µm polystyrene (PS) microspheres and biological samples.

Dry mass photometry of single bacteria using quantitative wavefront microscopy

Quantitative phase microscopy (QPM) represents a noninvasive alternative to fluorescence microscopy for cell observation with high contrast and for the quantitative measurement of dry mass (DM) and growth rate at the single-cell level. While DM measurements using QPM have been widely conducted on mammalian cells, bacteria have been less investigated, presumably due to the high resolution and high sensitivity required by their smaller size. This article demonstrates the use of cross-grating wavefront microscopy, a high-resolution and high-sensitivity QPM, for accurate DM measurement and monitoring of single microorganisms (bacteria and archaea). The article covers strategies for overcoming light diffraction and sample focusing, and introduces the concepts of normalized optical volume and optical polarizability (OP) to gain additional information beyond DM. The algorithms for DM, optical volume, and OP measurements are illustrated through two case studies: monitoring DM evolution in a microscale colony-forming unit as a function of temperature, and using OP as a potential species-specific signature.

Biocompatible polymer optical fiber with a strongly scattering spherical end for interstitial photodynamic therapy

Interstitial photodynamic therapy (I-PDT), which utilizes optical fibers to deliver light for photosensitizer excitation and the elimination of penetration depth limitation, is a promising modality in the treatment of deeply seated tumors or thick tumors. Currently, the excitation domain of the optical fiber is extremely limited, restricting PDT performance. Here, we designed and fabricated a biocompatible polymer optical fiber (POF) with a strongly scattering spherical end (SSSE) for I-PDT applications, achieving an increased excitation domain and consequently excellent in vitro and in vivo therapeutical outcomes. The POF, which was drawn using a simple thermal drawing method, was made of polylactic acid, ensuring its superior biocompatibility. The excitation domains of POFs with different ends, including flat, spherical, conical, and strongly scattering spherical ends, were analyzed and compared. The SSSE was achieved by introducing nanopores into a spherical end, and was further optimized to achieve a large excitation domain with an even intensity distribution. The optimized POF enabled outstanding therapeutic performance of I-PDT in in vitro cancer cell ablation and in vivo anticancer therapy. All of its notable optical features, including low transmission/bending loss, superior biocompatibility, and a large excitation domain with an even intensity distribution, endow the POF with great potential for clinical I-PDT applications.

Optimizing Stability and Performance of Silver-Based Grating Structures for Surface Plasmon Resonance Sensors

The use of surface plasmon resonance sensors allows for the fabrication of highly sensitive, label-free analytical devices. This contribution reports on a grating coupler to enable surface plasmon resonance studies using silver on silicon oxide technology to build long-term stable plasmonic structures for biological molecule sensing. The structural parameters were simulated and the corresponding simulation model was optimized based on the experimental results to improve its reliability. Based on the model, optimized grating nanostructures were fabricated on an oxidized silicon wafer with different structural parameters and characterized using a dedicated optical setup and scanning electron microscopy. The combined theoretical and experimental results show that the most relevant refractive index range for biological samples from 1.32-1.46 may conveniently be covered with a highest sensitivity of 128.85°/RIU.

Assessment of middle ear structure and function with optical coherence tomography

BACKGROUND

Current clinical tests for middle ear (ME) injuries and related conductive hearing loss (CHL) are lengthy and costly, lacking the ability to noninvasively evaluate both structure and function in real time. Optical coherence tomography (OCT) provides both, but its application to the audiological clinic is currently limited.

OBJECTIVE

Adapt and use a commercial Spectral-Domain OCT (SD-OCT) to evaluate anatomy and sound-evoked vibrations of the tympanic membrane (TM) and ossicles in the human ME.

MATERIALS AND METHODS

SD-OCT was used to capture high-resolution three-dimensional (3D) ME images and measure sound-induced vibrations of the TM and ossicles in fresh human temporal bones.

RESULTS

The 3D images provided thickness maps of the TM. The system was, with some software adaptations, also capable of phase-sensitive vibrometry. Measurements revealed several modes of TM vibration that became more complex with frequency. Vibrations were also measured from the incus, through the TM. This quantified ME sound transmission, which is the essential measure to assess CHL.

CONCLUSION AND SIGNIFICANCE

We adapted a commercial SD-OCT to visualize the anatomy and function of the human ME. OCT has the potential to revolutionize point-of-care assessment of ME disruptions that lead to CHL which are otherwise indistinguishable via otoscopy.

A Regression Approach to Model Refractive Index Measurements of Novel 3D Printable Photocurable Resins for Micro-Optofluidic Applications

In this work, a quadratic polynomial regression model was developed to aid practitioners in the determination of the refractive index value of transparent 3D printable photocurable resins usable for micro-optofluidic applications. The model was experimentally determined by correlating empirical optical transmission measurements (the dependent variable) to known refractive index values (the independent variable) of photocurable materials used in optics, thus obtaining a related regression equation. In detail, a novel, simple, and cost-effective experimental setup is proposed in this study for the first time for collecting the transmission measurements of smooth 3D printed samples (roughness ranging between 0.04 and 2 μm). The model was further used to determine the unknown refractive index value of novel photocurable resins applicable in vat photopolymerization (VP) 3D printing techniques for manufacturing micro-optofluidic (MoF) devices. In the end, this study proved how knowledge of this parameter allowed us to compare and interpret collected empirical optical data from microfluidic devices made of more traditional materials, i.e., Poly(dimethylsiloxane) (PDMS), up to novel 3D printable photocurable resins suitable for biological and biomedical applications. Thus, the developed model also provides a quick method to evaluate the suitability of novel 3D printable resins for MoF device fabrication within a well-defined range of refractive index values (1.56; 1.70).

Emerging evidence for adapting radiotherapy to immunotherapy

Immunotherapy has revolutionized the clinical management of many malignancies but is infrequently associated with durable objective responses when used as a standalone treatment approach, calling for the development of combinatorial regimens with superior efficacy and acceptable toxicity. Radiotherapy, the most commonly used oncological treatment, has attracted considerable attention as a combination partner for immunotherapy owing to its well-known and predictable safety profile, widespread clinical availability, and potential for immunostimulatory effects. However, numerous randomized clinical trials investigating radiotherapy-immunotherapy combinations have failed to demonstrate a therapeutic benefit compared with either modality alone. Such a lack of interaction might reflect suboptimal study design, choice of end points and/or administration of radiotherapy according to standard schedules and target volumes. Indeed, radiotherapy has empirically evolved towards radiation doses and fields that enable maximal cancer cell killing with manageable toxicity to healthy tissues, without much consideration of potential radiation-induced immunostimulatory effects. Herein, we propose the concept that successful radiotherapy-immunotherapy combinations might require modifications of standard radiotherapy regimens and target volumes to optimally sustain immune fitness and enhance the antitumour immune response in support of meaningful clinical benefits.

Rapid and label-free histological imaging of unprocessed surgical tissues via dark-field reflectance ultraviolet microscopy

Routine examination for intraoperative histopathologic assessment is lengthy and laborious. Here, we present the dark-field reflectance ultraviolet microscopy (DRUM) that enables label-free imaging of unprocessed and thick tissues with subcellular resolution and a high signal-to-background ratio. To the best of our knowledge, DRUM provides image results for pathological assessment with the shortest turnaround time (2-3 min in total from sample preparation to tissue imaging). We also proposed a virtual staining process to convert DRUM images into pseudo-colorized images and enhance the image familiarity of pathologists. By imaging various tissues, we found DRUM can resolve cell nuclei and some extranuclear features, which are comparable to standard H&E images. Furthermore, the essential diagnostic features of intraoperatively excised tumor tissues also can be revealed by DRUM, demonstrating its potential as an additional aid for intraoperative histopathology.

Characterization of radiofrequency ablated myocardium with optical coherence tomography

Certain types of cardiac arrhythmias are best treated with radiofrequency (RF) ablation, in which an electrode is inserted into the targeted area of the myocardium and then RF electrical current is applied to heat and destroy surrounding tissue. The resulting ablation lesion usually consists of a coagulative necrotic core surrounded by a rim region of mixed viable and non-viable cells. The characterization of the RF ablated lesion is of potential clinical importance. Here we aim to elaborate optical coherence tomography (OCT) imaging for the characterization of RF-ablated myocardial tissue. In particular, the underlying principles of OCT and its polarization-sensitive counterpart (PS-OCT) are presented, followed by the knowledge needed to interpret their optical images. Studies focused on real-time monitoring of RF lesion formation in the myocardium using OCT systems are summarized. The design and development of various hybrid probes incorporating both OCT guidance and RF ablation catheters are also discussed. Finally, the challenges related to the transmission of OCT imaging systems to cardiac clinics for real-time monitoring of RF lesions are outlined.

High-throughput digital pathology via a handheld, multiplexed, and AI-powered ptychographic whole slide scanner

The recent advent of whole slide imaging (WSI) systems has moved digital pathology closer to diagnostic applications and clinical practices. Integrating WSI with machine learning promises the growth of this field in upcoming years. Here we report the design and implementation of a handheld, colour-multiplexed, and AI-powered ptychographic whole slide scanner for digital pathology applications. This handheld scanner is built using low-cost and off-the-shelf components, including red, green, and blue laser diodes for sample illumination, a modified stage for programmable sample positioning, and a synchronized image sensor pair for data acquisition. We smear a monolayer of goat blood cells on the main sensor for high-resolution lensless coded ptychographic imaging. The synchronized secondary sensor acts as a non-contact encoder for precisely tracking the absolute object position for ptychographic reconstruction. For WSI, we introduce a new phase-contrast-based focus metric for post-acquisition autofocusing of both stained and unstained specimens. We show that the scanner can resolve the 388-nm linewidth on the resolution target and acquire gigapixel images with a 14 mm × 11 mm area in ∼70 seconds. The imaging performance is validated with regular stained pathology slides, unstained thyroid smears, and malaria-infected blood smears. The deep neural network developed in this study further enables high-throughput cytometric analysis using the recovered complex amplitude. The reported do-it-yourself scanner offers a portable solution to transform the high-end WSI system into one that can be made widely available at a low cost. The capability of high-throughput quantitative phase imaging may also find applications in rapid on-site evaluations.

High index core flat fiber surface plasmon resonance bio-sensor

Due to tremendous design flexibility and ease of light control capability, the photonic crystal fiber offers efficient, flexible, and miniaturized plasmonic biosensors with attractive features. In this work, a high index (GeO₂ doped silica) core flat fiber is proposed and analyzed for RI sensing ranging from 1.53 to 1.60. A rectangular analyte channel is created on top of a flat fiber to better handle the liquid analyte. To introduce the plasmonic effect, TiO₂ and gold are deposited to the analyte channel. The sensing performance is carried out for two operating wavelengths, as two peaks are obtained for each analyte. The second operating wavelength shows better sensing performance than the first one. However, the proposed sensor offers average wavelength sensitivity of 5000 nm/RIU with a sensor resolution of 2×10^-05 RIU. In addition, the proposed sensor shows identical linearity, which is quite rare in prior sensors. Moreover, the proposed flat sensor provides outstanding detection accuracy of 0.01nm^-1, detection limit of 79.28 nm, signal to noise ratio of -4.1497dB, and figure of merit of 50RIU^-1. Owing to outstanding sensing performance and a unique detection range, this sensor can be effectively used in biological and organic analyte sensing applications.

Lightsheet Microscopy

In this paper, we review lightsheet (selective plane illumination) microscopy for mouse developmental biologists. There are different means of forming the illumination sheet, and we discuss these. We explain how we introduced the lightsheet microscope economically into our core facility and present our results on fixed and living samples. We also describe methods of clearing fixed samples for three-dimensional imaging and discuss the various means of preparing samples with particular reference to mouse cilia, adipose spheroids, and cochleae. © 2022 The Authors. Current Protocols published by Wiley Periodicals LLC.

Challenges for optical nanothermometry in biological environments

Temperature monitoring is useful in medical diagnosis, and essential during hyperthermia treatments to avoid undesired cytotoxic effects. Aiming to control heating doses, different temperature monitoring strategies have been developed, largely based on luminescent materials, a.k.a. nanothermometers. However, for such nanothermometers to work, both excitation and emission light beams must travel through tissue, making its optical properties a relevant aspect to be considered during the measurements. In complex tissues, heterogeneity, and real-time alterations as a result of therapeutic treatment may have an effect on light-tissue interaction, hindering accuracy in the thermal reading. In this Tutorial Review we discuss various methods in which nanothermometers can be used for temperature sensing within heterogeneous environments. We discuss recent developments in optical (nano)thermometry, focusing on the incorporation of luminescent nanoparticles into complex in vitro and in vivo models. Methods formulated to avoid thermal misreading are also discussed, considering their respective advantages and drawbacks.

Intensity-Modulated Polymer Optical Fiber-Based Refractive Index Sensor: A Review

The simple and highly sensitive measurement of the refractive index (RI) of liquids is critical for designing the optical instruments and important in biochemical sensing applications. Intensity modulation-based polymer optical fiber (POF) RI sensors have a lot of advantages including low cost, easy fabrication and operation, good flexibility, and working in the visible wavelength. In this review, recent developments of the intensity modulation POF-based RI sensors are summarized. The materials of the POF and the working principle of intensity modulation are introduced briefly. Moreover, the RI sensing performance of POF sensors with different structures including tapered, bent, and side-polished structures, among others, are presented in detail. Finally, the sensing performance for different structures of POF-based RI sensors are compared and discussed.

Influence of Spatial Dispersion on the Electromagnetic Properties of Magnetoplasmonic Nanostructures

Magnetoplasmonics based on composite nanostructures is widely used in many biomedical applications. Nanostructures, consisting of a magnetic core and a gold shell, exhibit plasmonic properties, that allow the concentration of electromagnetic energy in ultra-small volumes when used, for example, in imaging and therapy. Magnetoplasmonic nanostructures have become an indispensable tool in nanomedicine. The gold shell protects the core from oxidation and corrosion, providing a biocompatible platform for tumor imaging and cancer treatment. By adjusting the size of the core and the shell thickness, the maximum energy concentration can be shifted from the ultraviolet to the near infrared, where the depth of light penetration is maximum due to low scattering and absorption by tissues. A decrease in the thickness of the gold shell to several nanometers leads to the appearance of the quantum effect of spatial dispersion in the metal. The presence of the quantum effect can cause both a significant decrease in the level of energy concentration by plasmon particles and a shift of the maxima to the short-wavelength region, thereby reducing the expected therapeutic effect. In this study, to describe the influence of the quantum effect of spatial dispersion, we used the discrete sources method, which incorporates the generalized non-local optical response theory. This approach made it possible to account for the influence of the nonlocal effect on the optical properties of composite nanoparticles, including the impact of the asymmetry of the core-shell structure on the energy characteristics. It was found that taking spatial dispersion into account leads to a decrease in the maximum value of the concentration of electromagnetic energy up to 25%, while the blue shift can reach 15 nm.

Polydimethylsiloxane tissue-mimicking phantoms with tunable optical properties

SIGNIFICANCE

The polymer, polydimethylsiloxane (PDMS), has been increasingly used to make tissue simulating phantoms due to its excellent processability, durability, flexibility, and limited tunability of optical, mechanical, and thermal properties. We report on a robust technique to fabricate PDMS-based tissue-mimicking phantoms where the broad range of scattering and absorption properties are independently adjustable in the visible- to near-infrared wavelength range from 500 to 850 nm. We also report on an analysis method to concisely quantify the phantoms' broadband characteristics with four parameters.

AIM

We report on techniques to manufacture and characterize solid tissue-mimicking phantoms of PDMS polymers. Tunability of the absorption (μa  (  λ  )  ) and reduced scattering coefficient spectra (μs'(λ)) in the wavelength range of 500 to 850 nm is demonstrated by adjusting the concentrations of light absorbing carbon black powder (CBP) and light scattering titanium dioxide powder (TDP) added into the PDMS base material.

APPROACH

The μa  (  λ  )   and μs'(λ) of the phantoms were obtained through measurements with a broadband integrating sphere system and by applying an inverse adding doubling algorithm. Analyses of μa  (  λ  )   and μs'(λ) of the phantoms, by fitting them to linear and power law functions, respectively, demonstrate that independent control of μa  (  λ  )   and μs'(λ) is possible by systematically varying the concentrations of CBP and TDP.

RESULTS

Our technique quantifies the phantoms with four simple fitting parameters enabling a concise tabulation of their broadband optical properties as well as comparisons to the optical properties of biological tissues. We demonstrate that, to a limited extent, the scattering properties of our phantoms mimic those of human tissues of various types. A possible way to overcome this limitation is demonstrated with phantoms that incorporate polystyrene microbead scatterers.

CONCLUSIONS

Our manufacturing and analysis techniques may further promote the application of PDMS-based tissue-mimicking phantoms and may enable robust quality control and quality checks of the phantoms.

Assessment of tissue pathology using optical polarimetry

Optical polarimetry have been extensively used for the non-invasive assessment of biological tissues. However, the knowledge regarding differences in polarimetric signatures of different tissue pathologies is very scattered, confounding the deduction of a global trend of the polarimetric variables for healthy and pathological tissues. The purpose of this study was to bridge this gap. We conducted a rigorous online survey to collect all published studies that report the two most common polarimetric variables (i.e., depolarization and retardance) for any type of tissue pathology. A total of 101 studies describing the polarimetric assessment of tissues were collected, wherein 253 (i.e., n_human = 149, n_animal = 104) different type of tissues were optically characterized. Most tissue samples (172/253) were investigated in ex vivo settings. The data showed 32 different types of tissues pathologies, where the most common pathology was cancer and its subtypes. The skin tissues were the most frequently explored tissues, followed by tissue samples from breast, colon, liver, and cervix. Although differences in polarimetric signatures of different tissue pathologies were summarized from the included studies, generalization of the results was hindered by the presentation of polarimetric data in a non-uniform format. The analyses presented in this study may provide an important reference for future polarimetric studies that conduct optical assessment of tissues at greater depth, particularly in the context of optical biopsy/digital staining.

Ex Vivo Determination of Broadband Absorption and Effective Scattering Coefficients of Porcine Tissue

A novel approach for precise determination of the optical scattering and absorption properties of porcine tissue using an optimized integrating sphere setup was applied. Measurements on several sample types (skin, muscle, adipose tissue, bone, cartilage, brain) in the spectral range between 400 nm and 1400 nm were performed. Due to the heterogeneity of biological samples, measurements on different individual animals as well as on different sections for each sample type were carried out. For all samples, we used an index matching method to reduce surface roughness effects and to prevent dehydration. The derived absorption spectra were used to estimate the concentration of important tissue chromophores such as water, oxy- and deoxyhemoglobin, collagen and fat.