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Sodhi NS, Dhillon B, Sandhu PS, Bhagat D, Gupta P, Kaur A, Sharma S, Khan ZS. Formulation of Functional Liquid Diets Under IDDSI Levels 0 to 2 for Dysphagia Patients: Physico-Chemical, Sensory, Antioxidant and Electromyographic Oral Processing Analyses. Dysphagia 2024:10.1007/s00455-024-10671-9. [PMID: 38381156 DOI: 10.1007/s00455-024-10671-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 01/11/2024] [Indexed: 02/22/2024]
Abstract
Dysphagia is a significant health concern especially amongst the old age population. It is an ailment brought on by the weakening of the swallowing muscles. To reduce the risk of choking in dysphagia patients, the food is usually diluted to suit their swallowing ability. But dilution results in reducing the nutritional density of the foods thus causing undernutrition and malnutrition in patients. In this study, functional liquid diets were formulated under International Dysphagia Diet Standardization Initiative (IDDSI) levels 0-2. The developed diets were analysed for their proximate composition, colour, antioxidant and sensory properties. Antioxidant activities were determined using 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS+), 2,2-diphenyl-1-picrylhydrazyl (DPPH), ferric reducing antioxidant power (FRAP) and total phenolic content (TPC) methods. The highest ABTS+ value was observed in pumpkin puree (level-2) i.e. 98.59%. Black carrot juice (level-1) showed the highest DPPH free radical scavenging activity and FRAP value viz. 88.43% and 689.33 µM TE/g, respectively. Electromyography (EMG) is an upcoming technique of food texture evaluation which provides real-time information about food oral processing. In this study, an EMG was conducted to measure the myoelectrical activity of human suprahyoid and masseter muscles by placing electrodes on the skin's surface during the oral processing of liquid. The EMG parameters correlated significantly with viscosity, ease of swallowing and IDDSI levels of the formulated diets. Hence EMG can be used as a tool for design and development of textured-modified diets for dysphagia patients. The sensory scores of formulated diets in this study were high indicating that these liquid diets may be incorporated into the diet plans of dysphagia patients.
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Affiliation(s)
- Navdeep Singh Sodhi
- Department of Food Science and Technology, Guru Nanak Dev University, Amritsar, 143005, Punjab, India
| | - Bhavnita Dhillon
- Department of Food Science and Technology, Guru Nanak Dev University, Amritsar, 143005, Punjab, India.
| | | | - Deepak Bhagat
- Department of Food Science and Technology, Guru Nanak Dev University, Amritsar, 143005, Punjab, India
| | - Priya Gupta
- Department of Food Science and Technology, Guru Nanak Dev University, Amritsar, 143005, Punjab, India
| | - Amritpal Kaur
- Department of Food Science and Technology, Guru Nanak Dev University, Amritsar, 143005, Punjab, India
| | - Shivangi Sharma
- Department of Food Science and Technology, Guru Nanak Dev University, Amritsar, 143005, Punjab, India
| | - Zakir Showkat Khan
- Department of Food Science and Technology, Guru Nanak Dev University, Amritsar, 143005, Punjab, India
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Kaur T, Sodhi NS, Dhillon B, Sodhi KS. Application of electromyography (EMG) for textural evaluation of raw, steamed and parboiled Basmati rice cultivars (Pusa 1121 and Pusa 1509). Food Measure 2023. [DOI: 10.1007/s11694-023-01854-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Sodhi NS, Dhillon B, Kaur R, Gurleen, Sharma S, Jaiswal S. Physico‐chemical, sensory, antioxidant and electromyographic analyses of functional liquid diets (
IDDSI
levels 0 to 2) formulated for dysphagia patients. Int J Food Sci Technol 2022. [DOI: 10.1111/ijfs.16238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Navdeep Singh Sodhi
- Department of Food Science and Technology Guru Nanak Dev University Amritsar Punjab India
| | - Bhavnita Dhillon
- Department of Food Science and Technology Guru Nanak Dev University Amritsar Punjab India
| | - Ramneet Kaur
- Department of Food Science and Technology Guru Nanak Dev University Amritsar Punjab India
| | - Gurleen
- Department of Food Science and Technology Guru Nanak Dev University Amritsar Punjab India
| | - Shivangi Sharma
- Department of Food Science and Technology Guru Nanak Dev University Amritsar Punjab India
| | - Sunanda Jaiswal
- Department of Food Science and Technology Guru Nanak Dev University Amritsar Punjab India
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Khan ZS, Sodhi NS, Fayaz S, Wani SA, Bhat MS, Mishra HN, Bakshi RA, Dar BN, Dhillon B. Seabuckthorn seed protein concentrate: a novel seed protein; emulsifying properties as affected by ultrasonication and enzymatic hydrolysis. Int J Food Sci Technol 2022. [DOI: 10.1111/ijfs.15999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Zakir Showkat Khan
- Department of Food Technology, GNDU Amritsar Punjab India
- Department of Food Technology Islamic University of Science & Technology Kashmir India
| | | | - Shemilah Fayaz
- Department of Food Technology, GNDU Amritsar Punjab India
- Department of Food Technology Islamic University of Science & Technology Kashmir India
| | - Sajad Ahmad Wani
- Department of Food Technology Islamic University of Science & Technology Kashmir India
| | - Mohmad Sayeed Bhat
- Department of Food Engineering & Technology Institute of Chemical Technology Mumbai India
| | - H. N. Mishra
- Agricultural and Food Engineering Department Indian Institute of Technology Kharagpur India
| | - Rayees Ahmad Bakshi
- Department of Food Technology, GNDU Amritsar Punjab India
- Department of Food Science & Technology University of Kashmir India
| | - B. N. Dar
- Department of Food Technology Islamic University of Science & Technology Kashmir India
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Dhillon B, Sodhi NS, Singh D, Kaur A. Analyses of functional diets formulated for dysphagia patients under international dysphagia diet standardization initiative (IDDSI) level 3 to level 7. Food Measure 2022. [DOI: 10.1007/s11694-022-01454-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Khan ZS, Sodhi NS, Dhillon B, Dar B, Bakshi RA, Shah SF. Seabuckthorn (Hippophae rhamnoides L.), a novel seed protein concentrate: isolation and modification by high power ultrasound and characterization for its functional and structural properties. Food Measure 2021. [DOI: 10.1007/s11694-021-01020-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
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Singh H, Sodhi NS, Dhillon B, Chang YH, Lin JH. Physicochemical and structural characteristics of sorghum starch as affected by acid‐ethanol hydrolysis. Food Measure 2021. [DOI: 10.1007/s11694-020-00792-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gibofsky A, Dhillon B, Pearson ME, Tundia N, Song Y, Dunlap K, Wright G. POS0666 TREATMENT EFFECTIVENESS OF UPADACITINIB AT 3 MONTHS IN US PATIENTS WITH RHEUMATOID ARTHRITIS FROM THE UNITED RHEUMATOLOGY NORMALIZED INTEGRATED COMMUNITY EVIDENCE (NICE[TM]) REAL-WORLD DATA. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Upadacitinib (UPA), an oral Janus kinase inhibitor (JAKi), has demonstrated efficacy in the phase 3 SELECT clinical program, conducted across a range of patients (pts) with rheumatoid arthritis (RA).1–6 Real-world data for UPA, including in pts previously treated with a JAKi, have not yet been reported since global approvals beginning in 2019.Objectives:To assess the characteristics of US-based pts receiving UPA and its effectiveness in clinical practice at 3 months.Methods:This observational study included US-based pts from the United Rheumatology Normalized Integrated Community Evidence (UR-NICE) database who initiated UPA 15 mg once daily from FDA approval (August 2019) to July 31, 2020 and had ≥6-month pre-baseline data available. Effectiveness was assessed in pts with a reported Clinical Disease Activity Index (CDAI) score at 3 months after UPA initiation and included proportions of pts achieving CDAI remission (≤2.8), CDAI low disease activity (≤10), other disease activity measures, and pt-reported outcomes. A subgroup analysis assessed UPA effectiveness in pts with or without prior tofacitinib (TOFA) treatment.Results:This analysis included 252 pts treated with UPA 15 mg, of whom 98 (38.9%) received UPA monotherapy and 154 (61.1%) received UPA combined with conventional synthetic (cs) disease-modifying antirheumatic drugs (DMARDs). 64.3% of pts were from the Southern region of the USA. 86.1%, 72.2%, and 47.6% of pts had been previously treated with csDMARDs, biologic DMARDs, and JAKis, respectively. Baseline characteristics were largely similar between UPA monotherapy and combination therapy groups and those with or without prior TOFA treatment (Table 1). Pts with prior TOFA treatment had a longer duration of RA since diagnosis and higher steroid use versus those without. UPA 15 mg improved disease activity scores (including CDAI) and pt-reported outcomes (including physical function and pain) after 3 months of treatment (Figure 1). Similar effectiveness was observed with UPA 15 mg in pts with or without prior TOFA treatment.Conclusion:In the UR-NICE real-world database of US-based pts, improvements in clinical and pt-reported outcomes were observed at 3 months in UPA-treated pts with RA, including those with or without prior TOFA treatment, despite the treatment-refractory population included in this dataset.References:[1]Burmester GR, et al. Lancet 2018;391:2503–12.[2]Smolen JS, et al. Lancet 2019;393:2303–11.[3]Fleischmann R, et al. Arthritis Rheumatol 2019;71:1788–800.[4]Genovese MC, et al. Lancet 2018;391:2513–24.[5]van Vollenhoven R, et al. Arthritis Rheumatol 2020;72:1607–20.[6]Rubbert-Roth A, et al. N Engl J Med 2020;383:1511–21.Table 1.Baseline characteristicsn (%), unless otherwise statedFull analysis set(n=252)Pts with prior TOFA treatment(n=113)Pts without prior TOFA treatment (n=139)Mean (SD) exposure, days219.7 (112.1)215.7 (116.7)222.9 (108.5)Female199 (79.0)85 (75.2)114 (82.0)Age ≥65 years75 (29.8)34 (30.1)41 (29.5)Oral steroid use140 (55.6)70 (61.9)70 (50.4)Prior csDMARDs217 (86.1)102 (90.3)115 (82.7)Prior TOFA113 (44.8)113 (100.0)0Prior biologic DMARDs182 (72.2)86 (76.1)96 (69.1)Tumor necrosis factor inhibitor147 (58.3)66 (58.4)81 (58.3)Interleukin-6 receptor inhibitor87 (34.5)47 (41.6)40 (28.8)nMean (SD)nMean (SD)nMean (SD)Duration of RA diagnosis, years1884.0 (3.0)895.1 (2.9)993.1 (2.8)Methotrexate dose, mg/week8817.0 (5.1)2817.8 (5.0)6016.6 (5.2)SJC282394.8 (5.7)1084.5 (5.0)1315.0 (6.2)TJC282376.5 (6.7)1076.5 (6.8)1306.5 (6.6)CDAI22520.4 (13.4)10520.2 (13.5)12020.6 (13.3)Routine assessment of patient index data 31654.2 (2.3)724.2 (2.4)934.3 (2.2)Disease Activity Score in 28 joints based on C-reactive protein1673.9 (1.5)833.9 (1.5)843.9 (1.5)Health Assessment Questionnaire-Disability Index1702.5 (2.1)742.4 (2.2)962.5 (2.1)Pain(0–10)22956.5 (28.5)10456.9 (29.3)12556.1 (28.0)SD, standard deviation; S/TJC, swollen/tender joint countAcknowledgements:AbbVie funded this study; contributed to its design; participated in data collection, analysis, and interpretation of the data; and participated in the writing, review, and approval of the abstract. No honoraria or payments were made for authorship. Medical writing support was provided by Hilary Wong, PhD, of 2 the Nth (Cheshire, UK), and was funded by AbbVie.Disclosure of Interests:Allan Gibofsky Shareholder of: AbbVie, Amgen, Johnson & Johnson, and Pfizer, Consultant of: AbbVie, Celgene, Eli Lilly, Flexion, Pfizer, Relburn Pharma, and Samumed. Paid consultant with investment analysts on behalf of the Gerson Lehrman Group, Bhavna Dhillon Shareholder of: May own stock or options in United Rheumatology, Employee of: United Rheumatology, Mark E. Pearson Shareholder of: May own AbbVie stock or options, Namita Tundia Shareholder of: May own stock or options in AbbVie, Employee of: AbbVie, Yanna Song Shareholder of: May own stock or options in AbbVie, Employee of: AbbVie, Kendall Dunlap Shareholder of: May own stocks or shares in AbbVie, Employee of: AbbVie, Grace Wright Speakers bureau: AbbVie, Amgen, Bristol-Myers Squibb, Eli Lilly, Exagen, Myriad Autoimmune, Novartis, Sanofi/Regeneron, UCB, and Vindico, Consultant of: AbbVie, Amgen, Bristol-Myers Squibb, Eli Lilly, Exagen, Gilead, Janssen, Myriad Autoimmune, Novartis, Pfizer, Sanofi/Regeneron, and UCB, Employee of: President and Founder of the Association of Women in Rheumatology
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Dhillon B, Sodhi NS, Aneja E, Kumar A, Jaiswal S. Physico-chemical and textural (sensorial and electromyographic) evaluation of cookies formulated using different ratios of brown rice flour and refined wheat flour. Food Measure 2021. [DOI: 10.1007/s11694-020-00625-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Dhillon B, Choudhary G, Sodhi NS. A study on physicochemical, antioxidant and microbial properties of germinated wheat flour and its utilization in breads. J Food Sci Technol 2020; 57:2800-2808. [PMID: 32612297 DOI: 10.1007/s13197-020-04311-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 01/19/2020] [Accepted: 02/20/2020] [Indexed: 11/26/2022]
Abstract
Wheat is consumed worldwide because of its high nutritional content and convenience to form different products. Whole wheat is an important source of dietary fiber and its consumption is known to lower the risk of colon cancer, diabetes mellitus and cardiovascular disease. Germination of wheat results in better availability of nutrients and offers many health benefits. In this study, germinated wheat flour (GWF) was prepared and analyzed for its proximate composition, functional properties, antioxidant activity and microbial count along with whole wheat flour (WWF). The GWF was having 9.2% higher protein content than that of WWF. No significant change was observed in the ash, fat and crude fiber content after germination. GWF showed higher oil absorption capacity and water solubility index. Falling number of GWF was found to be lower. The total phenolic content increased more than two folds after germination and antioxidant activity increased from an initial of 12.35% in WWF to 33.28% in GWF. The microbial counts of GWF were within acceptable range for processing. Breads were prepared by replacing WWF with GWF at 0-100% levels and were analyzed for their proximate composition and acceptance on Hedonic Scale. The 100% GWF bread was having 8.7% higher protein content than 100% WWF bread. The overall acceptability score for all breads were high (> 7.3) whereas the bread prepared with 50% GWF got the highest overall acceptability score of 8.4. The results of this study indicate that bread with improved nutrition and acceptable quality can be prepared from GWF.
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Affiliation(s)
- Bhavnita Dhillon
- Department of Food Science and Technology, Guru Nanak Dev University, Amritsar, Punjab 143005 India
| | - Garima Choudhary
- Department of Food Science and Technology, Guru Nanak Dev University, Amritsar, Punjab 143005 India
| | - Navdeep Singh Sodhi
- Department of Food Science and Technology, Guru Nanak Dev University, Amritsar, Punjab 143005 India
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Turner M, Bienek C, McGowan N, Dhillon B, Campbell J, Glover A. A phase I/II clinical trial of allogeneic ex vivo expanded corneal epithelial stem cells in patients with severe ocular surface disorder arising from limbal stem cell deficiency. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gajree S, Borooah S, Dhillon N, Goudie C, Smith C, Aspinall P, Dhillon B. Temporal artery biopsies in south-east Scotland: a five year review. J R Coll Physicians Edinb 2017; 47:124-128. [DOI: 10.4997/jrcpe.2017.203] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Webb D, Balmforth C, Ruiys T, Dhaun N, Cameron J, Borooah S, Dhillon B, Chandran S. Clinical Utility Of Optical Coherence Tomography (Oct) In High Cardiovascular Risk Patients. Clin Ther 2015. [DOI: 10.1016/j.clinthera.2015.05.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Gamal W, Borooah S, Smith S, Underwood I, Srsen V, Chandran S, Bagnaninchi PO, Dhillon B. Real-time quantitative monitoring of hiPSC-based model of macular degeneration on Electric Cell-substrate Impedance Sensing microelectrodes. Biosens Bioelectron 2015; 71:445-455. [PMID: 25950942 PMCID: PMC4456427 DOI: 10.1016/j.bios.2015.04.079] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 04/15/2015] [Accepted: 04/23/2015] [Indexed: 01/29/2023]
Abstract
Age-related macular degeneration (AMD) is the leading cause of blindness in the developed world. Humanized disease models are required to develop new therapies for currently incurable forms of AMD. In this work, a tissue-on-a-chip approach was developed through combining human induced pluripotent stem cells, Electric Cell–substrate Impedance Sensing (ECIS) and reproducible electrical wounding assays to model and quantitatively study AMD. Retinal Pigment Epithelium (RPE) cells generated from a patient with an inherited macular degeneration and from an unaffected sibling were used to test the model platform on which a reproducible electrical wounding assay was conducted to model RPE damage. First, a robust and reproducible real-time quantitative monitoring over a 25-day period demonstrated the establishment and maturation of RPE layers on the microelectrode arrays. A spatially controlled RPE layer damage that mimicked cell loss in AMD disease was then initiated. Post recovery, significant differences (P<0.01) in migration rates were found between case (8.6±0.46 μm/h) and control cell lines (10.69±0.21 μm/h). Quantitative data analysis suggested this was achieved due to lower cell–substrate adhesion in the control cell line. The ECIS cell–substrate adhesion parameter (α) was found to be 7.8±0.28 Ω1/2 cm for the case cell line and 6.5±0.15 Ω1/2 cm for the control. These findings were confirmed using cell adhesion biochemical assays. The developed disease model-on-a-chip is a powerful platform for translational studies with considerable potential to investigate novel therapies by enabling real-time, quantitative and reproducible patient-specific RPE cell repair studies. hiPSC-RPE model was established and characterised on ECIS microelectrode arrays. A reproducible electrical wound healing assay was used to mimic RPE cell damage. Significant differences in migration rates were found between case and control. Cells recovered through mesenchymal migration mirrored by impedance fluctuations. Case cell line showed significantly higher adhesion than the control cell line.
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Affiliation(s)
- W Gamal
- Institute for Bioengineering, School of Engineering, The University of Edinburgh, EH9 3DW, United Kingdom
| | - S Borooah
- MRC Centre for Regenerative Medicine, The University of Edinburgh, EH16 4UU, United Kingdom; Centre for Clinical Brain Sciences, The University of Edinburgh, EH16 4SB, United Kingdom; Euan MacDonald Centre for MND Research, The University of Edinburgh, EH16 4SB, United Kingdom; Centre for Neuroregeneration, The University of Edinburgh, EH16 4SB, United Kingdom; The Anne Rowling Regenerative Neurology Clinic, The University of Edinburgh, EH16 4SB, United Kingdom
| | - S Smith
- Institute for Bioengineering, School of Engineering, The University of Edinburgh, EH9 3DW, United Kingdom
| | - I Underwood
- Institute for Integrated Micro and Nano Systems, School of Engineering, The University of Edinburgh, EH9 3JF, United Kingdom
| | - V Srsen
- Institute for Bioengineering, School of Engineering, The University of Edinburgh, EH9 3DW, United Kingdom
| | - S Chandran
- MRC Centre for Regenerative Medicine, The University of Edinburgh, EH16 4UU, United Kingdom; Centre for Clinical Brain Sciences, The University of Edinburgh, EH16 4SB, United Kingdom; Euan MacDonald Centre for MND Research, The University of Edinburgh, EH16 4SB, United Kingdom; Centre for Neuroregeneration, The University of Edinburgh, EH16 4SB, United Kingdom; The Anne Rowling Regenerative Neurology Clinic, The University of Edinburgh, EH16 4SB, United Kingdom
| | - P O Bagnaninchi
- MRC Centre for Regenerative Medicine, The University of Edinburgh, EH16 4UU, United Kingdom.
| | - B Dhillon
- Centre for Clinical Brain Sciences, The University of Edinburgh, EH16 4SB, United Kingdom; The Anne Rowling Regenerative Neurology Clinic, The University of Edinburgh, EH16 4SB, United Kingdom; School of Clinical Sciences, The University of Edinburgh, EH16 4SB, United Kingdom
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MacGillivray TJ, Trucco E, Cameron JR, Dhillon B, Houston JG, van Beek EJR. Retinal imaging as a source of biomarkers for diagnosis, characterization and prognosis of chronic illness or long-term conditions. Br J Radiol 2014; 87:20130832. [PMID: 24936979 DOI: 10.1259/bjr.20130832] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The black void behind the pupil was optically impenetrable before the invention of the ophthalmoscope by von Helmholtz over 150 years ago. Advances in retinal imaging and image processing, especially over the past decade, have opened a route to another unexplored landscape, the retinal neurovascular architecture and the retinal ganglion pathways linking to the central nervous system beyond. Exploiting these research opportunities requires multidisciplinary teams to explore the interface sitting at the border between ophthalmology, neurology and computing science. It is from the detail and depth of retinal phenotyping that novel metrics and candidate biomarkers are likely to emerge. Confirmation that in vivo retinal neurovascular measures are predictive of microvascular change in the brain and other organs is likely to be a major area of research activity over the next decade. Unlocking this hidden potential within the retina requires integration of structural and functional data sets, that is, multimodal mapping and longitudinal studies spanning the natural history of the disease process. And with further advances in imaging, it is likely that this area of retinal research will remain active and clinically relevant for many years to come. Accordingly, this review looks at state-of-the-art retinal imaging and its application to diagnosis, characterization and prognosis of chronic illness or long-term conditions.
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Affiliation(s)
- T J MacGillivray
- Vampire Project, Clinical Research Imaging Centre, University of Edinburgh, Edinburgh, UK
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Aspinall PA, Borooah S, Al Alouch C, Roe J, Laude A, Gupta R, Gupta M, Montarzino A, Dhillon B. Gaze and pupil changes during navigation in age-related macular degeneration. Br J Ophthalmol 2014; 98:1393-7. [DOI: 10.1136/bjophthalmol-2014-305032] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Brzeszczynska J, Samuel K, Greenhough S, Ramaesh K, Dhillon B, Hay DC, Ross JA. Differentiation and molecular profiling of human embryonic stem cell-derived corneal epithelial cells. Int J Mol Med 2014; 33:1597-606. [PMID: 24676408 DOI: 10.3892/ijmm.2014.1714] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 02/14/2014] [Indexed: 11/06/2022] Open
Abstract
It has been suggested that the isolation of scalable populations of limbal stem cells may lead to radical changes in ocular therapy. In particular, the derivation and transplantation of corneal stem cells from these populations may result in therapies providing clinical normality of the diseased or damaged cornea. Although feasible in theory, the lack of donor material in sufficient quantity and quality currently limits such a strategy. A potential scalable source of corneal cells could be derived from pluripotent stem cells (PSCs). We developed an in vitro and serum-free corneal differentiation model which displays significant promise. Our stepwise differentiation model was designed with reference to development and gave rise to cells which displayed similarities to epithelial progenitor cells which can be specified to cells displaying a corneal epithelial phenotype. We believe our approach is novel, provides a robust model of human development and in the future, may facilitate the generation of corneal epithelial cells that are suitable for clinical use. Additionally, we demonstrate that following continued cell culture, stem cell-derived corneal epithelial cells undergo transdifferentiation and exhibit squamous metaplasia and therefore, also offer an in vitro model of disease.
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Affiliation(s)
- J Brzeszczynska
- Tissue Injury and Repair Group, MRC Centre for Regenerative Medicine, Chancellor's Building, University of Edinburgh, Edinburgh EH16 4SB, Scotland, UK
| | - K Samuel
- SNBTS Cellular Therapy Group, MRC Centre for Regenerative Medicine, Chancellor's Building, University of Edinburgh, Edinburgh EH16 4SB, Scotland, UK
| | - S Greenhough
- Pluripotent Stem Cell Hepatocyte Development Group, MRC Centre for Regenerative Medicine, Chancellor's Building, University of Edinburgh, Edinburgh EH16 4SB, Scotland, UK
| | - K Ramaesh
- Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow G12 0YN, Scotland, UK
| | - B Dhillon
- Department of Clinical and Surgical Sciences, Ophthalmology Section, Princess Alexandra Eye Pavilion, Royal Infirmary of Edinburgh, Edinburgh EH3 9HA, Scotland, UK
| | - D C Hay
- Pluripotent Stem Cell Hepatocyte Development Group, MRC Centre for Regenerative Medicine, Chancellor's Building, University of Edinburgh, Edinburgh EH16 4SB, Scotland, UK
| | - J A Ross
- Tissue Injury and Repair Group, MRC Centre for Regenerative Medicine, Chancellor's Building, University of Edinburgh, Edinburgh EH16 4SB, Scotland, UK
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Borooah S, Phillips M, Bilican B, Wright A, Wilmut I, Chandran S, Gamm D, Dhillon B. Using human induced pluripotent stem cells to treat retinal disease. Prog Retin Eye Res 2013; 37:163-81. [PMID: 24104210 PMCID: PMC3841575 DOI: 10.1016/j.preteyeres.2013.09.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 09/06/2013] [Accepted: 09/16/2013] [Indexed: 02/08/2023]
Abstract
The eye is an ideal target for exploiting the potential of human induced pluripotent stem cell (hiPSC) technology in order to understand disease pathways and explore novel therapeutic strategies for inherited retinal disease. The aim of this article is to map the pathway from state-of-the art laboratory-based discoveries to realising the translational potential of this emerging technique. We describe the relevance and routes to establishing hiPSCs in selected models of human retinal disease. Additionally, we define pathways for applying hiPSC technology in treating currently incurable, progressive and blinding retinal disease.
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Affiliation(s)
- S. Borooah
- MRC Centre for Regenerative Medicine, University of Edinburgh, Edinburgh EH16 4UU, UK
- Ophthalmology, School of Clinical Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK
| | - M.J. Phillips
- Waisman Center, University of Wisconsin School of Medicine and Public Health, 1500 Highland Ave, Madison, WI 53705, USA
| | - B. Bilican
- MRC Centre for Regenerative Medicine, University of Edinburgh, Edinburgh EH16 4UU, UK
| | - A.F. Wright
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH4 2XU, UK
| | - I. Wilmut
- MRC Centre for Regenerative Medicine, University of Edinburgh, Edinburgh EH16 4UU, UK
| | - S. Chandran
- MRC Centre for Regenerative Medicine, University of Edinburgh, Edinburgh EH16 4UU, UK
| | - D. Gamm
- Waisman Center, University of Wisconsin School of Medicine and Public Health, 1500 Highland Ave, Madison, WI 53705, USA
- Department of Ophthalmology and Visual Sciences, McPherson Eye Research Institute, University of Wisconsin School of Medicine and Public Health, 1500 Highland Ave, Madison, WI 53705, USA
| | - B. Dhillon
- Ophthalmology, School of Clinical Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK
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Bujarborua D, Borooah S, Dhillon B. Getting serious with retinopathy: approaching an integrated hypothesis for central serous chorioretinopathy. Med Hypotheses 2013; 81:268-73. [PMID: 23669373 DOI: 10.1016/j.mehy.2013.04.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 04/13/2013] [Accepted: 04/16/2013] [Indexed: 01/02/2023]
Abstract
Development of the prefrontal cortex is believed to play an important role in the maturation of higher cognitive functions such as decision making, cognition and control of part of the neural element of the stress response. The prefrontal cortex undergoes considerable maturation during childhood, including a reduction of synaptic and neural density, a growth of dendrites, and an increase in white matter volume, thereby forming distributed neural networks appropriate for complex cognitive processing, but maturation is not complete until approximately 25 years of age. Serotonin and its receptors (HTRs) play critical roles in brain development and in the regulation of cognition, mood, and anxiety. HTRs are highly expressed in the human prefrontal cortex and exert control over prefrontal excitability. Studies of post-mortem prefrontal brain tissue found distinct developmental patterns of expression of these receptors occurring in early postnatal development and also into adulthood. The general pattern of improved cognitive control and emotion regulation with maturation of the prefrontal cortex, suggests a linear increase in development from childhood to adulthood. Animal studies have shown that dopamine is crucial for communication between the accumbens, amygdala, and prefrontal cortex. Dopamine projections to the prefrontal cortex continue to develop into early adulthood. Central Serous Chorioretinopathy (CSC) is an eye disease affecting people of working age, commonly resulting in repeated unpredictable visually disabling serous retinal detachments and occasionally leading to irreversible reduction in central vision. The disease has been closely linked to the stress response. Despite a concerted effort to understand aetiopathogenesis, disease mechanisms are still largely unclear. This paper, supported by evidence in the literature, proposes a systemic approach to CSC and explains how interactions of the eye with the cerebral cortex could lead to disease. We propose that the lack of development of the neural element of the stress response and in particular the prefrontal cortex is the reason for the absence of CSC in childhood and adolescence. Additionally, we attempt to explain why excess stress hormones do not always result in CSC and why acute attacks occur only once in over half of cases. Finally, we summarise the implications that an integrated systemic hypothesis has for future CSC research and the requirement of a holistic management practice for the identification and treatment of patients with CSC.
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Affiliation(s)
- D Bujarborua
- Pragjyoti Eye Care & Research Centre, 29-Mother Teresa Road, Guwahati 781021, India.
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Tiong T, Borooah S, Msosa J, Dean W, Smith C, Kambewa E, Kiire C, Zondervan M, Aspinall P, Dhillon B. Clinicopathological review of ocular surface squamous neoplasia in Malawi. Br J Ophthalmol 2013; 97:961-4. [DOI: 10.1136/bjophthalmol-2012-302533] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Ramaesh T, Ramaesh K, Riley SC, West JD, Dhillon B. Effects of N-acetylcysteine on matrix metalloproteinase-9 secretion and cell migration of human corneal epithelial cells. Eye (Lond) 2012; 26:1138-44. [PMID: 22766540 DOI: 10.1038/eye.2012.135] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Matrix metalloproteinase-9 (MMP-9) secreted by corneal epithelial cells has a role in the remodelling of extracellular matrix and migration of epithelial cells. Elevated levels of MMP-9 activity in the ocular surface may be involved in the pathogenesis of corneal diseases. N-acetylcysteine (NAC) has been used to treat corneal diseases, including recurrent epithelial erosions. In this study, its effects on the MMP-9 secretion and human corneal epithelial (HCE) cell migration were evaluated in vitro. METHODS Confluent HCE cell cultures were treated with 0-20 mM NAC, and tested for MMP-9 secretion and epithelial cell migration by gelatin zymography and scratch wound assay, respectively. Comparisons between different treatment groups were made using analysis of variance, followed by multiple pairwise comparisons. RESULTS Twenty mM NAC inhibited the secretion of MMP-9 significantly. Cell migration, assessed after 24 h of wounding, showed a highly significant dose-dependent inhibitory effect. CONCLUSIONS This study shows that NAC reduces MMP-9 production by HCE cells and inhibits cell migration in vitro. This information helps to elucidate the mechanisms by which NAC may be beneficial therapeutically and suggests that NAC may be useful for managing corneal erosions and related conditions.
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Affiliation(s)
- T Ramaesh
- Division of Reproductive and Developmental Sciences, Genes and Development Group, University of Edinburgh, Edinburgh, UK
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Perez-Rovira A, MacGillivray T, Trucco E, Chin KS, Zutis K, Lupascu C, Tegolo D, Giachetti A, Wilson PJ, Doney A, Dhillon B. VAMPIRE: Vessel assessment and measurement platform for images of the REtina. Annu Int Conf IEEE Eng Med Biol Soc 2012; 2011:3391-4. [PMID: 22255067 DOI: 10.1109/iembs.2011.6090918] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We present VAMPIRE, a software application for efficient, semi-automatic quantification of retinal vessel properties with large collections of fundus camera images. VAMPIRE is also an international collaborative project of four image processing groups and five clinical centres. The system provides automatic detection of retinal landmarks (optic disc, vasculature), and quantifies key parameters used frequently in investigative studies: vessel width, vessel branching coefficients, and tortuosity. The ultimate vision is to make VAMPIRE available as a public tool, to support quantification and analysis of large collections of fundus camera images.
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Dhillon B, Wiesenborn D, Sidhu H, Wolf-Hall C. Improved Microbial Quality of Buckwheat using Antimicrobial Solutions in a Fluidized Bed. J Food Sci 2012; 77:E98-103. [DOI: 10.1111/j.1750-3841.2012.02646.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mitrut I, Chua P, Aslam T, Vani A, Ambrecht AM, Dhillon B. Short-term changes of visual hallucinations after intravitreal injection of ranibizumab in neovascular age-related macular degeneration. Eye (Lond) 2010; 24:1825. [DOI: 10.1038/eye.2010.148] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Dhillon B, Wiesenborn D, Dhillon H, Wolf-Hall C. Development and Evaluation of a Fluidized Bed System for Wheat Grain Disinfection. J Food Sci 2010; 75:E372-8. [DOI: 10.1111/j.1750-3841.2010.01668.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Doubal FN, MacGillivray TJ, Patton N, Dhillon B, Dennis MS, Wardlaw JM. Fractal analysis of retinal vessels suggests that a distinct vasculopathy causes lacunar stroke. Neurology 2010; 74:1102-7. [PMID: 20368631 DOI: 10.1212/wnl.0b013e3181d7d8b4] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES Lacunar strokes account for 25% of all ischemic strokes and may represent the cerebral manifestation of a systemic small vessel vasculopathy of unknown etiology. Altered retinal vessel fractal dimensions may act as a surrogate marker for diseased cerebral vessels. We used a cross-sectional study to investigate fractal properties of retinal vessels in lacunar stroke. METHODS We recruited patients presenting with lacunar stroke and patients with minor cortical stroke as controls. All patients were examined by a stroke expert and had MRI at presentation. Digital retinal photographs were taken of both eyes. Monofractal and multifractal analyses were performed with custom-written semiautomated software. RESULTS We recruited 183 patients. Seventeen were excluded owing to poor photographic quality, leaving 166 patients (86 with lacunar and 80 with cortical stroke). The mean age was 67.3 years (SD 11.5 years). The patients with lacunar stroke were younger but the prevalence of diabetes, hypertension, and white matter hyperintensities did not differ between the groups. The mean Dbox (monofractal dimension) was 1.42 (SD 0.02), the mean D0 (multifractal dimension) 1.67 (SD 0.03). With multivariate analysis, decreased Dbox and D0 (both representing decreased branching complexity) were associated with increasing age and lacunar stroke subtype after correcting for hypertension, diabetes, stroke severity, and white matter hyperintensity scores. CONCLUSIONS Lacunar stroke subtype and increasing age are associated with decreased fractal dimensions, suggesting a loss of branching complexity. Further studies should concentrate on longitudinal associations with other manifestations of cerebral small vessel disease.
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Affiliation(s)
- F N Doubal
- Division of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh, UK.
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Yu-Wai-Man P, Griffiths PG, Gorman GS, Lourenco CM, Wright AF, Auer-Grumbach M, Toscano A, Musumeci O, Valentino ML, Caporali L, Lamperti C, Tallaksen CM, Duffey P, Miller J, Whittaker RG, Baker MR, Jackson MJ, Clarke MP, Dhillon B, Czermin B, Stewart JD, Hudson G, Reynier P, Bonneau D, Marques W, Lenaers G, McFarland R, Taylor RW, Turnbull DM, Votruba M, Zeviani M, Carelli V, Bindoff LA, Horvath R, Amati-Bonneau P, Chinnery PF. Multi-system neurological disease is common in patients with OPA1 mutations. ACTA ACUST UNITED AC 2010; 133:771-86. [PMID: 20157015 PMCID: PMC2842512 DOI: 10.1093/brain/awq007] [Citation(s) in RCA: 314] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Additional neurological features have recently been described in seven families transmitting pathogenic mutations in OPA1, the most common cause of autosomal dominant optic atrophy. However, the frequency of these syndromal 'dominant optic atrophy plus' variants and the extent of neurological involvement have not been established. In this large multi-centre study of 104 patients from 45 independent families, including 60 new cases, we show that extra-ocular neurological complications are common in OPA1 disease, and affect up to 20% of all mutational carriers. Bilateral sensorineural deafness beginning in late childhood and early adulthood was a prominent manifestation, followed by a combination of ataxia, myopathy, peripheral neuropathy and progressive external ophthalmoplegia from the third decade of life onwards. We also identified novel clinical presentations with spastic paraparesis mimicking hereditary spastic paraplegia, and a multiple sclerosis-like illness. In contrast to initial reports, multi-system neurological disease was associated with all mutational subtypes, although there was an increased risk with missense mutations [odds ratio = 3.06, 95% confidence interval = 1.44-6.49; P = 0.0027], and mutations located within the guanosine triphosphate-ase region (odds ratio = 2.29, 95% confidence interval = 1.08-4.82; P = 0.0271). Histochemical and molecular characterization of skeletal muscle biopsies revealed the presence of cytochrome c oxidase-deficient fibres and multiple mitochondrial DNA deletions in the majority of patients harbouring OPA1 mutations, even in those with isolated optic nerve involvement. However, the cytochrome c oxidase-deficient load was over four times higher in the dominant optic atrophy + group compared to the pure optic neuropathy group, implicating a causal role for these secondary mitochondrial DNA defects in disease pathophysiology. Individuals with dominant optic atrophy plus phenotypes also had significantly worse visual outcomes, and careful surveillance is therefore mandatory to optimize the detection and management of neurological disability in a group of patients who already have significant visual impairment.
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Affiliation(s)
- P Yu-Wai-Man
- Mitochondrial Research Group, The Medical School, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK
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Dhillon B, Wiesenborn D, Wolf-Hall C, Manthey F. Development and evaluation of an ozonated water system for antimicrobial treatment of durum wheat. J Food Sci 2010; 74:E396-403. [PMID: 19895469 DOI: 10.1111/j.1750-3841.2009.01275.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Ozonated water is reported to be effective in reducing the microbial load in foods such as fruits, vegetables, and grains. Ozonated water may be an effective alternative to chlorinated water in treating durum wheat before milling. Therefore, durum wheat was washed with ozonated water and analyzed for yeast and mold count (YMC) and aerobic plate count (APC). A system for producing and monitoring ozonated water was developed. The effect of water quality (tap, distilled, and ultra-pure), temperature (7, 15, and 25 degrees C), and pH (2, 4, and 6.5) was evaluated on the following: steady-state dissolved ozone concentration, ozone decay constant, half-life, mass transfer coefficient, equilibrium ozone concentration, and solubility ratio. The study of these parameters was important to attain a stable, high dissolved ozone concentration at the outset of washing and to have information for system improvement and scale-up. A 1% acetic acid solution (pH 2) at 15 degrees C resulted in high dissolved ozone concentration (21.8 mg/L) and long half-life (9.2 min). Subsequently, wheat was washed with 5 wash water types: distilled water, ozonated water (16.5 mg/L), chlorinated water (700 mg/L), acetic acid solution (1%), and acetic acid + ozonated water (1%, 20.5 mg/L). The treated samples were analyzed for YMC and APC. The acetic acid + ozonated water treatment was the most effective, with a reduction of 4.1 and 3.2 log(10) colony forming units/g in YMC and APC, respectively. Though ozonated water was not very effective alone, it was useful in combination with acetic acid.
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Affiliation(s)
- B Dhillon
- Dept of Agricultural and Biosystems Engineering, North Dakota State Univ, Fargo, ND 58108-6050, USA
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Borooah S, Collins C, Wright A, Dhillon B. Republished review. [corrected] Late-onset retinal macular degeneration: clinical insights into an inherited retinal degeneration. Postgrad Med J 2010; 85:495-500. [PMID: 19734518 DOI: 10.1136/bjo.2008.150151] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM This study describes, in detail, the phenotype of late-onset retinal macular degeneration (L-ORMD) an inherited condition affecting both the retina and anterior segment. A staging based on clinical characteristics is proposed, and the relevance of this condition to current understanding of age-related macular degeneration is discussed. METHODS A systematic review of the literature regarding this condition supports a detailed description of the natural history. Clinical experiences in identifying, monitoring and managing patients are also presented. RESULTS L-ORMD is a rare fully penetrant autosomal dominant condition resulting from a mutation in the C1QTNF5 gene on chromosome 11. Affected individuals develop bilateral loss of vision, dark-adaptation abnormalities, fundus drusen-like yellow spots, midperipheral pigmentation, choroidal neovascularisation, chorioretinal atrophy and long anteriorly inserted lens zonules. Patients may benefit from treatment with high-dose vitamin A. CONCLUSIONS Raised awareness of L-ORMD should lead to earlier diagnosis and improved care for patients. New antivascular endothelial growth factor treatment may provide a new possibility for management. A deeper insight into molecular and genetic mechanisms of L-ORMD may suggest avenues to explore new treatments of this disorder.
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Affiliation(s)
- S Borooah
- Princess Alexandra Eye Pavilion, Chalmers Street, Edinburgh EH3 9HA, UK.
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Doubal FN, MacGillivray TJ, Hokke PE, Dhillon B, Dennis MS, Wardlaw JM. Differences in retinal vessels support a distinct vasculopathy causing lacunar stroke. Neurology 2009; 72:1773-8. [PMID: 19451533 DOI: 10.1212/wnl.0b013e3181a60a71] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Lacunar stroke is common, but the etiology of the small vessel abnormality is unknown. Retinal vessels share ontogeny, size, and physiologic characteristics with cerebral small vessels, and retinopathy is associated with stroke. We compared retinal microvessel appearance as a surrogate for cerebral small vessels in patients with lacunar and large artery cortical ischemic stroke. METHODS We prospectively recruited patients with lacunar ischemic stroke and cortical stroke controls. We took digital retinal photographs of each eye. We assessed central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE) diameters and arteriovenous ratios (AVRs) using semiautomated computer software methods and quantified arteriovenous nicking and focal arteriolar narrowing. RESULTS Among 212 patients (105 lacunar, 107 cortical strokes) of mean age 68 years (SD 12 years), AVR was decreased (0.76 vs 0.78, p = 0.03) and CRVE was increased (44.9 pixels/218 microm vs 42.8 pixels/208 microm, p = 0.01) in lacunar patients compared with cortical patients, but CRAE did not differ (33.2 pixels/161 microm vs 33.7 pixels/163 microm, p = 0.4). On multivariable analysis, increased CRVE was associated with lacunar stroke subtype (p = 0.03) and younger age (p < 0.001) after correcting for other vascular risk factors. Arteriovenous nicking and focal arteriolar narrowing did not differ between ischemic stroke subtypes. CONCLUSIONS Retinal venules are wider and arteriovenous ratios are smaller in patients with lacunar strokes compared with those in patients with cortical strokes.
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Affiliation(s)
- F N Doubal
- Western General Hospital, Edinburgh, UK.
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Affiliation(s)
- M M K Muqit
- Department of Ophthalmology, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford BD9 6RJ, UK.
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Trucco E, Buchanan CR, Aslam T, Dhillon B. Contextual detection of ischemic regions in ultra-wide-field-of-view retinal fluorescein angiograms. ACTA ACUST UNITED AC 2008; 2007:6740-43. [PMID: 18003574 DOI: 10.1109/iembs.2007.4353908] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We report a novel prototype algorithm using contextual knowledge to locate ischemic regions in ultra-wide-field-of-view retinal fluorescein angiograms. We use high-resolution images acquired by an Optos ultra-wide-field-of-view (more than 200 degrees) scanning laser ophthalmoscope. We leverage the simultaneous occurrence of ischemia with a number of other signs, detected automatically, typical for the state of progress of the condition in a diabetic patient. The specific nature of ischemic and non-ischemic regions is determined with an AdaBoost learning algorithm. Preliminary results demonstrate above 80% pixel classification accuracy against manual annotations.
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Affiliation(s)
- E Trucco
- School of Computing, University of Dundee, UK.
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Tang T, Smith S, Flynn B, Stevenson J, Gundlach A, Reekie H, Murray A, Renshaw D, Dhillon B, Ohtori A, Inoue Y, Terry J, Walton A. Implementation of wireless power transfer and communications for an implantable ocular drug delivery system. IET Nanobiotechnol 2008; 2:72-9. [DOI: 10.1049/iet-nbt:20080001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Parthasarathi S, Myint K, Singh G, Mon S, Raman GV, Dhillon B. A ring on the retina. ACTA ACUST UNITED AC 2007; 125:1240. [PMID: 17891867 DOI: 10.1001/archopht.125.9.1240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Parthasarathi S, Myint K, Singh G, Mon S, Sadasivam P, Dhillon B. Bilateral acetazolamide-induced choroidal effusion following cataract surgery. Eye (Lond) 2007; 21:870-2. [PMID: 17293785 DOI: 10.1038/sj.eye.6702741] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Aspinall PA, Hill AR, Dhillon B, Armbrecht AM, Nelson P, Lumsden C, Farini-Hudson E, Brice R, Vickers A, Buchholz P. Quality of life and relative importance: a comparison of time trade-off and conjoint analysis methods in patients with age-related macular degeneration. Br J Ophthalmol 2007; 91:766-72. [PMID: 17229802 PMCID: PMC1955576 DOI: 10.1136/bjo.2006.104679] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To investigate the relative priorities in quality of life (QoL) in patients with age-related macular degeneration (AMD). METHODS Measures of visual function, QoL and utility associated with visual loss were obtained from 122 patients with AMD classified according to macular morphology. The two methods of utility assessment were time trade-off (TTO) and conjoint analysis (CA), which have been recommended by the UK's National Institute of Clinical Excellence as techniques for the assessment of healthcare priorities. RESULTS Results show that the two methods for assessing utility are poorly related: TTO relates moderately to visual function and disease severity but CA does not. CA identified two different subgroups of patients: one with outdoor mobility and the other with reading as their main priority. CONCLUSION Further work is needed and caution required in interpreting data obtained using these methodologies for determining their relative importance in vision-related QoL studies.
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Affiliation(s)
- P A Aspinall
- Heriot-Watt University, Riccarton, Edinburgh EH14 3AZ, Scotland, UK.
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Abstract
Congenital corneal anesthesia is a rare clinical entity that poses a diagnostic dilemma, particularly in the pediatric age group. The sensory deficit may be confined to the cornea, or extend to other divisions of the trigeminal nerve. The sensory deficit may occur as an isolated abnormality, as part of a complex neurological syndrome, or it may occur in association with multiple somatic abnormalities and congenital insensitivity to pain. This condition usually presents between the ages of 8 to 12 months. Poor vision, photophobia, conjunctival injection, and corneal ulceration in the absence of pain and distress in a child should alert the clinician to the possibility of anesthetic cornea. In the early stages of presentation, punctuate keratopathy is the main feature, which may progress to non-healing persistent corneal epithelial defects. This stage may progress to acute corneal lysis and perforation. In most patients, conservative approaches such as copious lubrication, prevention of self-harm and cautious use of bandage contact lenses are effective in preventing progressive corneal damage. Tarsorrhapy is effective in promoting epithelial healing and permanent lateral tarsorraphy may prevent further development of epithelial defects. Amniotic membrane graft may be considered in order to improve epithelial healing. Corneal grafts carry a poor prognosis. Accurate initial diagnosis, evaluation, and proper management are paramount to prevent visual loss due to long-term complications of corneal anesthesia. This review of the literature outlines the problems and approaches in diagnosis, evaluation, and management of this rare condition.
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Affiliation(s)
- K Ramaesh
- Tennent Institute of Ophthalmology, Gartnaval General Hospital, Glasgow, United Kingdom
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White MM, Gupta M, Dhillon B. Patient safety and ophthalmic surgery marking: which side are you on? Br J Ophthalmol 2007; 91:123-4. [PMID: 17179134 PMCID: PMC1857586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2006] [Indexed: 05/13/2023]
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Smith S, Tang TB, Terry JG, Stevenson JTM, Flynn BW, Reekie HM, Murray AF, Gundlach AM, Renshaw D, Dhillon B, Ohtori A, Inoue Y, Walton AJ. Development of a miniaturised drug delivery system with wireless power transfer and communication. IET Nanobiotechnol 2007; 1:80-6. [PMID: 17764377 DOI: 10.1049/iet-nbt:20070022] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The development of an implantable system designed to deliver drug doses in a controlled manner over an extended time period is reported. Key performance parameters are the physical size, the power consumption and also the ability to perform wireless communications to enable the system to be externally controlled and interrogated. The system has been designed to facilitate wireless power transfer, which is very important for miniaturisation as it removes the need for a battery.
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Affiliation(s)
- S Smith
- Institute of Integrated Micro and Nano Systems, School of Engineering and Electronics, Scottish Microelectronics Centre, The University of Edinburgh, Edinburgh, UK.
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Sathyan P, Myint K, Singh G, Mon S, Sathyan P, Dhillon B. Late green discoloration of Allergan SI-40NB silicone intraocular lens. J Cataract Refract Surg 2006; 32:1584-5. [PMID: 16931280 DOI: 10.1016/j.jcrs.2006.06.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2006] [Accepted: 03/03/2006] [Indexed: 11/20/2022]
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Myint K, Sahay R, Mon S, Saravanan VR, Narendran V, Dhillon B. "Worm in the eye": the rationale for treatment of DUSN in south India. Br J Ophthalmol 2006; 90:1125-7. [PMID: 16707523 PMCID: PMC1857373 DOI: 10.1136/bjo.2006.094490] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2006] [Indexed: 11/03/2022]
Abstract
AIM To discuss the rationale for different techniques of treatment for DUSN (diffuse unilateral subacute neuroretinitis) and their effectiveness in two patients from south India. METHODS Two rare cases of live worms in DUSN from India are reported, where filarial Brugia malayi is endemic. Both cases presented with progressive unilateral loss of vision with no history of animal contact. They were 40 year old, apparently healthy men. In case 1, the worm (1500-2000 microm) was easy to identify with wriggling movements among crisscrossing diffuse subretinal tracks. The worm was destroyed by a single shot of laser to its advancing end, which was followed by oral steroid to control the inflammation caused by the dead worm. In case 2, the worm was small and difficult to identify. Initially diffuse neuroretinitis was diagnosed and treated with intravenous methylprednisolone and oral corticosteroid. A week later, a small live worm (400-600 microm) was found and subsequently destroyed by laser photocoagulation followed by a combination of anthelminthics. RESULTS The patients' vision had improved to 6/60-6/36 from counting fingers after a few weeks. CONCLUSION The role of a combination of laser treatment, systemic steroid, and anthelminthics is discussed.
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Affiliation(s)
- K Myint
- Eye Pavilion, Royal Infirmary of Edinburgh, Edinburgh EH3 9HA, UK.
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Abstract
AIMS To compare cellular contamination of diagnostic contact lenses after two different cleaning methods. METHODS Twenty-five used diagnostic contact lenses were cleaned by two different methods and the material retained on their contact surface examined for cells. Two diagnostic contact lenses were examined using electron microscopy and surface debris was subjected to x-ray photoelectron spectroscopy. RESULTS Significantly more cells were present on used lenses compared with controls (P<0.001). There was no significant difference in total cell count between the lenses subjected to the two cleaning strategies but the lenses simply wiped clean retained marginally more nucleated cells than controls (P=0.039). Electron microscopy showed the majority of the debris on or close to the rim of the lens. X-ray photoelectron spectroscopy confirmed the presence of proteinaceous material. CONCLUSIONS Regardless of cleaning method, significant cellular debris is retained on the surface of diagnostic contact lenses after use.
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Affiliation(s)
- M MacRae
- Department of Opthalmology, Princess Alexandra Eye Pavilion, Chalmers Street, Edinburgh, UK.
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Abstract
AIM To summarise the main causes and associations of conjunctival intraepithelial neoplasia (CIN) found in the literature to date. METHOD Literature search using Ovid databases on the NHS Scotland E-library, Medline, and the Cochrane Library. The internet search engine Google Scholar was also used to identify relevant articles. RESULTS The main causes and associations of CIN in the literature are sun exposure and distance from the equator; human papillomavirus infection, increased p53 expression, and HIV seropositivity. It has been found that in HIV positive individuals CIN is on the increase with people being affected with more aggressive tumours at younger ages. CONCLUSION Given that CIN is becoming more common in HIV infected populations and that it has the potential to cause severe disability, it is important to improve our understanding of the condition. Early identification of CIN by an understanding of its aetiology and associations may enable the implementation of preventative measures to reduce its incidence and potentially lead to the diagnosis and further management of conditions such as HIV. Young people presenting with CIN in particular may benefit from HIV testing.
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Affiliation(s)
- C A Kiire
- Western General Hospital, Edinburgh EH4 2XU, UK.
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Aslam TM, Patton N, Dhillon B. Analysis of posterior capsule opacification. ACTA ACUST UNITED AC 2005; 83:635-6; author reply 636. [PMID: 16188018 DOI: 10.1111/j.1600-0420.2005.00552.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Myint K, Sahay R, Mon S, Saravanan VR, Narendran V, Dhillon B. The Indian case of live worm in diffuse unilateral subacute neuroretinitis. Eye (Lond) 2005; 20:612-3. [PMID: 15920564 DOI: 10.1038/sj.eye.6701936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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