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1.
Food Funct ; 15(12): 6673-6683, 2024 Jun 17.
Article in English | MEDLINE | ID: mdl-38817195

ABSTRACT

Volatile profiling was conducted on four wheat varieties Triticum aestivum cv. Chinese Spring (CS), Highbury (High), Paragon (Para), Pavon76 (Pav76), and one wild relative Triticum timopheevii (P95). Headspace solid-phase microextraction (SPME) combined with gas chromatography-mass spectrometry (GC-MS) was used to explore differences in flavor formation mechanisms in different flours before and after starch gelatinization. Solvent retention capacity (SRC) analysis revealed subtle differences in water absorption, gluten strength, and starch characteristics across wheat flour types. Rapid Visco Analysis (RVA) of whole wheat flour demonstrated significant variations in pasting properties among wheat varieties, with P95 exhibiting higher viscosities compared to CS and High potentially influenced by starch gelatinization, protein-starch interactions, and lipid content. Aroma contributions of P95 clustered positively in PCA plots, contrasting with the four main varieties, indicative of species-level differentiation. Furthermore, the study highlighted the roles of viscosity, protein structure, lipid content, and fatty acid composition in modulating the release and perception of volatile aroma compounds during heating. This study sheds light on how the distinct characteristics of wheat flour influence aroma profiles, revealing species-level differences and the pivotal role of physiochemical properties in shaping flavor development mechanisms.


Subject(s)
Flour , Gas Chromatography-Mass Spectrometry , Solid Phase Microextraction , Triticum , Volatile Organic Compounds , Triticum/chemistry , Triticum/classification , Flour/analysis , Volatile Organic Compounds/analysis , Volatile Organic Compounds/chemistry , Starch/chemistry , Humans , Odorants/analysis , Taste , Viscosity , Male , Adult , Female
2.
Food Res Int ; 164: 112311, 2023 Feb.
Article in English | MEDLINE | ID: mdl-36737905

ABSTRACT

This work reports the impact of locust bean gum (LBG) in the continuous phase of plant-based proteins, i.e. quinoa protein (QPI) and pea protein isolates (PPI). Experimental measurements such as confocal microscopy, rheological analysis and water mobility via nuclear magnetic resonance (nmr) spin-spin relaxation time (T2) were carried out. The influence of LBG on the rheological properties of QPI and PPI is consistent with an exchange-based nmr interpretation of T2 for biopolymer and water. Addition of LBG increased the viscoelastic properties (storage and loss modulus) and shear viscosities of the mixtures. LBG interacted with both plant proteins, resulting in the formation of more dense protein networks and protein coacervates. A stronger interaction between the PPI and LBG was observed, resulting in higher shear viscosities with lower water mobility as compared to QPI:LBG formulations. Results indicated that the interaction between the protein and polysaccharide played a significant role in the microstructure, its rheological properties and consequently water mobility.


Subject(s)
Chenopodium quinoa , Pisum sativum , Plant Proteins , Water/chemistry
3.
Food Funct ; 13(7): 3840-3852, 2022 Apr 04.
Article in English | MEDLINE | ID: mdl-35315467

ABSTRACT

There is an increasing awareness of the link between food breakdown during chewing and its nutrient release and absorption in the gastrointestinal tract. However, how oral processing behaviour varies among different ethnic groups, and how such difference further impacts on bolus characteristics and consequently glycemic response (GR) are not well understood. In this study, we recruited a group of Asian (Chinese) subjects in China (n = 32) and a group of Caucasian subjects in New Zealand (n = 30), both aged between 18 and 30 years, and compared their blood glucose level (BGL) over 120 min following consumption of a glucose drink and cooked white noodles. We also assessed their chewing behaviour, unstimulated saliva flow rate, and ready-to-swallow bolus characteristics to determine whether these measures explain the ethnic differences in postprandial glycaemia. Compared to New Zealand subjects, the Chinese subjects showed 35% slower saliva flow rate but around 2 times higher salivary α-amylase activity in the unstimulated state. During consumption of noodles, Chinese subjects on average took a larger mouthful size, chewed each mouthful for longer and swallowed a larger number of particles with a smaller particle size area. Total GR measured by area under the curve (IAUC) was higher among the Chinese subjects. They also experienced higher BGL at 15 min, as well as higher peak BGL. There were strong correlations observed between oral processing and GR parameters. Results of this study confirmed the significance of oral processing in determining food digestion, and will provide new insights on the role of ethnicity in influencing people's physiological response to food.


Subject(s)
Blood Glucose , Ethnicity , Adolescent , Adult , Asian People , Blood Glucose/metabolism , China , Humans , Mastication/physiology , New Zealand , Young Adult
4.
Food Funct ; 13(5): 2756-2767, 2022 Mar 07.
Article in English | MEDLINE | ID: mdl-35171166

ABSTRACT

This research used a multi-method approach to analyse the influence of different moisture levels (low, medium and high) on the structural and functional properties of cellulose with cell wall materials such as pectin, lignin, and hemicellulose present in citrus fibres. The influence of the drying and purification processes and the source of the citrus fibres on these interactions were also considered. A fluidized bed dryer results in a higher aggregation of cellulose fibres, which limits their interactions with water, pectin, lignin, and hemicellulose. Citrus fibre suspension produce by a alcohol washing in combination with a centrifugal drying process showed higher storage modulus (G'), loss modulus (G'') and water retention capacity. The compositions of the citrus fibres and the type of hydrogen bonding (analysed by FTIR) play a key role in generating stable rheological and thermal properties as well as controlling the moisture sorption behaviour of the citrus fibres.


Subject(s)
Cell Wall/chemistry , Cellulose/chemistry , Citrus , Dietary Fiber/analysis , Humans , Rheology
5.
J Biomol Struct Dyn ; 40(5): 2369-2388, 2022 Mar.
Article in English | MEDLINE | ID: mdl-33155524

ABSTRACT

The SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) is responsible for the COVID-19 outbreak. The highly contagious COVID-19 disease has spread to 216 countries in less than six months. Though several vaccine candidates are being claimed, an effective vaccine is yet to come. A novel reverse epitomics approach, 'overlapping-epitope-clusters-to-patches' method is utilized to identify the antigenic regions from the SARS-CoV-2 proteome. These antigenic regions are named as 'Ag-Patch or Ag-Patches', for Antigenic Patch or Patches. The identification of Ag-Patches is based on the clusters of overlapping epitopes rising from SARS-CoV-2 proteins. Further, we have utilized the identified Ag-Patches to design Multi-Patch Vaccines (MPVs), proposing a novel method for the vaccine design. The designed MPVs were analyzed for immunologically crucial parameters, physiochemical properties and cDNA constructs. We identified 73 CTL (Cytotoxic T-Lymphocyte) and 49 HTL (Helper T-Lymphocyte) novel Ag-Patches from the proteome of SARS-CoV-2. The identified Ag-Patches utilized to design MPVs cover 768 overlapping epitopes targeting 55 different HLA alleles leading to 99.98% of world human population coverage. The MPVs and Toll-Like Receptor ectodomain complex shows stable complex formation tendency. Further, the cDNA analysis favors high expression of the MPVs constructs in a human cell line. We identified highly immunogenic novel Ag-Patches from the entire proteome of SARS CoV-2 by a novel reverse epitomics approach and utilized them to design MPVs. We conclude that the novel MPVs could be a highly potential novel approach to combat SARS-CoV-2, with greater effectiveness, high specificity and large human population coverage worldwide. Communicated by Ramaswamy H. Sarma.


Subject(s)
COVID-19 , Vaccines , COVID-19/prevention & control , COVID-19 Vaccines , Epitopes, B-Lymphocyte , Epitopes, T-Lymphocyte , Humans , Molecular Docking Simulation , SARS-CoV-2 , Spike Glycoprotein, Coronavirus/chemistry , Spike Glycoprotein, Coronavirus/genetics , T-Lymphocytes, Cytotoxic
6.
Food Funct ; 12(10): 4535-4543, 2021 May 21.
Article in English | MEDLINE | ID: mdl-33903860

ABSTRACT

Dee are a unique and rapidly growing part of the global snack food market and are recognised as having distinct sensory properties (taste and texture). In this study, the development of important volatile aroma compounds over storage was evaluated and their chemical origin explained. Sweet potatoes were batch fried in high oleic sunflower oil (HOSO) and subjected to accelerated shelf life testing. Headspace volatiles were analysed using SPME GC-MS and correlated with sensory perception. All the components (sweet potatoes, oil and ß-carotene) showed significant degradation after 3 weeks of storage at accelerated conditions (equivalent to 12 weeks in real-time at 25 °C). Marker volatiles associated with lipid oxidation such as hexanal, octanal, pentanal were identified, in addition to norisoprenoids from ß-carotene degradation such as ß-ionon, 5,6-epoxy-ß-ionone, dihydroactinidiolide (DHA) and ß-cyclocitral. The most prominent marker of lipid oxidation (hexanal) rapidly increased at week 1, whereas the carotene degradation makers did not rapidly increase until week 3 suggesting a delayed response. The frying temperature during the batch frying process of SPC was also shown to play a significant role in the sensory perception of the product over the shelf life. Overall, the results suggest that tight control of process variables and raw material design may enable extended shelf life and potentially enhanced health credentials for the product. These findings are unique to SPC, but also of value to the wider food industry.


Subject(s)
Ipomoea batatas/anatomy & histology , Lipid Metabolism , Lipids , Taste , beta Carotene/metabolism , Aldehydes/analysis , Benzofurans/analysis , Cooking , Diterpenes , Food Industry , Gas Chromatography-Mass Spectrometry , Hot Temperature , Norisoprenoids/analysis , Odorants , Oxidation-Reduction , Sensation , Sunflower Oil , Volatile Organic Compounds/analysis , beta Carotene/analysis
7.
Food Funct ; 12(2): 781-790, 2021 Jan 21.
Article in English | MEDLINE | ID: mdl-33393571

ABSTRACT

Plant breeders are focused on creating new varieties of wheat with enhanced yield potential without affecting the quality of wheat for food. In this study, four cultivated varieties of wheat, Triticium asetivum and two wild relatives of wheat; Triticum timopheevii and Triticum urartu were studied. The impact of starch and protein content on structural, thermal and water sorption properties of four main wheat cultivars in comparison to the wild relatives has been studied. Wild relatives of wheat required higher temperatures to initiate starch gelatinisation and amylose/lipid complex formation as compared to the four main wheat cultivars. The carbohydrate region in FTIR indicates structural differences (ordered and unordered starch) in the different varieties of wheat flour. The differentiation between wild relatives and main varieties is at the species level. Both wild relatives showed a noticeable difference in moisture sorption behaviour as compared with the 4 main cultivars, especially in terms of monolayer (M0) and the strength of water binding to the primary sites (C) values.


Subject(s)
Breeding , Flour/analysis , Temperature , Triticum/chemistry , Triticum/genetics , Water , Calorimetry, Differential Scanning , Flour/standards , Spectroscopy, Fourier Transform Infrared
8.
J Anaesthesiol Clin Pharmacol ; 36(2): 255-260, 2020.
Article in English | MEDLINE | ID: mdl-33013044

ABSTRACT

BACKGROUND AND AIMS: Coronary artery bypass grafting (CABG) surgery involves various noxious stimuli resulting in stress response, which in turn increases the risk of perioperative myocardial ischemia. The present study was conducted to evaluate the effect of dexmedetomidine on the attenuation of hemodynamic response to intubation, skin incision, and sternotomy in CABG surgery. MATERIAL AND METHODS: Sixty patients were randomized into two groups of 30 each. Group D patients received dexmedetomidine 1 µg/kg as loading dose over 10 min, followed by continuous infusion of 0.5 µg/kg/h. In group P, normal saline was infused as loading and maintenance dose at similar rate. Hemodynamic parameters, total induction dose of thiopentone, and adverse effects were recorded. Statistical analysis was performed using SPSS version 20.0. Chi-square test and ANNOVA test were used and P < 0.05 was considered significant. RESULTS: The percentage increase in heart rate was significantly lesser in group D than group P after intubation (7.04% v/s 15.08%), skin incision (5.91% v/s 10.11%), and sternotomy (5.33% v/s 11.65%). Similarly increase in systolic, diastolic, and mean blood pressure were significantly lesser in group D than group P after intubation, skin incision, and sternotomy. There was a significant reduction of mean total of thiopentone in group D in comparison to group P. (1.16 mg/kg v/s 2.44 mg/kg) (P<0.001). CONCLUSION: Dexmedetomidine resulted in significant attenuation of hemodynamic response to intubation, skin incision, and sternotomy in CABG surgery without significant adverse effects. It also significantly reduced the dose of thiopentone required for induction.

9.
J Cataract Refract Surg ; 46(8): 1102-1107, 2020 Aug.
Article in English | MEDLINE | ID: mdl-32569028

ABSTRACT

PURPOSE: To evaluate long-term visual outcomes and complications after toric intraocular lens (IOL) implantation in children with preexisting corneal astigmatism undergoing cataract surgery. SETTING: Iladevi Cataract & IOL Research Center, Ahmedabad, India. DESIGN: Prospective, interventional case series. METHODS: Children with regular corneal astigmatism of at least 1.5 diopters (D) were included. A standardized surgical technique with in-the-bag implantation of a toric IOL was performed. All children were followed up on postoperative day 1 and periodically thereafter, until 36 months postoperatively. The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and residual refractive astigmatism were documented 36 months postoperatively. Rotational stability of toric IOL was also evaluated through the follow-up duration. Complications, particularly visual axis obscuration (VAO) and glaucoma, were documented. RESULTS: In total, 76 eyes (51 children) were included in the study. Mean age at surgery was 7.41 ± 2.82 years (SD) and mean preoperative keratometric astigmatism was 1.56 ± 2.13 D. The CDVA (logarithm of the minimum angle of resolution [logMAR]) improved significantly from 0.59 ± 0.43 preoperatively to 0.23 ± 0.27 36 months postoperatively (P = .03). Mean postoperative UDVA was 0.32 ± 0.26 logMAR. Mean refractive astigmatism at final follow-up was -0.55 ± 0.40 D, with 74% patients having a UDVA of at least 20/40; 5% of eyes needed VAO treatment and none developed glaucoma. No eye required repositioning of toric IOL until final follow-up. CONCLUSIONS: Toric IOL implantation reduced postoperative refractive astigmatism and gave excellent UDVA at 36 months follow-up in pediatric eyes undergoing nontraumatic cataract surgery.


Subject(s)
Astigmatism , Cataract , Lenses, Intraocular , Phacoemulsification , Astigmatism/surgery , Cataract/complications , Child , Humans , India , Lens Implantation, Intraocular , Prospective Studies , Refraction, Ocular
10.
J Anaesthesiol Clin Pharmacol ; 35(1): 41-46, 2019.
Article in English | MEDLINE | ID: mdl-31057238

ABSTRACT

BACKGROUND AND AIMS: Interscalene brachial plexus block (ISB) is the most commonly used mode of anesthesia for upper limb surgeries. Higher volume of local anesthetic used in ISB is associated with increased incidence of side effects, particularly phrenic nerve palsy. The aim of this study was to determine the minimum effective volume of 0.5% ropivacaine in 90% patients (MEV90) in ISB. MATERIAL AND METHODS: With target of 45 successful cases, phase 1 clinical trial was conducted based on the principles of biased coin design up-and-down method. After obtaining Ethical Committee's approval and patient's consent, patients with American Society of Anesthesiologist physical status (ASA PS) I and II, aged 18-60 years of either sex, undergoing upper arm surgery were recruited into the study until 45 successful cases. A 7 ml of 0.5% ropivacaine was used as starting dose, with patients receiving a higher or lower dose depending on previous patient's response. R package, SPSS 23, and Microsoft Excel were used for statistical analysis. RESULTS: MEV90 of 0.5% ropivacaine for ISB was determined as 8.64 ml [confidence interval (CI) 95%, 8.28-9.02 ml]. Time for onset of sensory block and motor block was 5 min (5-15 min) and 10 min (5-20 min), respectively, while duration of analgesia was observed as 8.2 (4.8-12.5) h. CONCLUSIONS: This study observes that surgical anesthesia can be accomplished with 8.64 ml (95% CI: 8.28-9.02 ml) of 0.5% ropivacaine with ultrasound-guided ISB with multiple injection technique, without clinical deterioration in block onset and duration of analgesia.

11.
Carbohydr Polym ; 211: 91-99, 2019 May 01.
Article in English | MEDLINE | ID: mdl-30824108

ABSTRACT

The aim of this study was 1) to investigate the influence of polymeric additives such as carboxyl methyl cellulose (CMC) and locust bean gum (LBG) added before and after homogenisation on the moisture uptake of microfibrillar cellulose (MFC) in the dry and semi-wet state; and 2) to further understand the thermally induced structural transitions of low moisture MFC in the presence of the polymeric additives. A higher moisture content in the highly dense MFC network maintains the fibrillated network structure, which is lost during the drying process resulting in MFC aggregates. The addition of polymeric additives results in the regaining of the structure upon redispersion of the dry material with CMC being more effective than LBG). Results also indicated that CMC has a high level of compatibility with MFC, whereas LBG appears to have limited distribution in the MFC dense microfibrillar network and probably exists as a separate phase when added after homogenisation, however co-processing of LBG and cellulose significantly changed this behaviour. The presence of low-temperature transitions in MFC/additives/water mixtures indicates the involvement of these semi-flexible polymeric additives in the formation of liquid crystals when added to MFC in low moisture environments (2% and 20% w/w). An insight is offered into the theory of surface interactions between MFC and polymeric additives, which prevents the agglomeration of microfibrils present in the highly fibrillated suspension upon drying.

12.
Food Funct ; 9(9): 4730-4741, 2018 Sep 19.
Article in English | MEDLINE | ID: mdl-30095140

ABSTRACT

The impact of natural cheese and onion seasoning on the sensory perception and shelf life stability of potato crisps was studied. This study was carried out to evaluate the impact of nitrogen (N2) gas flushing on the shelf-life stability and sensory attributes of cheese & onion seasoned potato crisps. Markers of lipid oxidation and flavour volatile compounds were evaluated in sliced, unwashed, batch fried potato crisps during accelerated storage at 45 °C for 10 weeks. Volatile flavour compounds were evaluated by headspace gas analysis using solid phase microextraction (SPME) GC-MS and correlated with sensory perception. Gas flushing significantly increases the shelf life of both unsalted and cheese & onion seasoned potato crisps in terms of the stability of volatile compounds and sensory perception. Further to this, the addition of the cheese & onion seasoning increased the shelf life of the base potato crisp; this is proposed to be explained by the antioxidant properties of milk proteins in the seasoning. Sensory evaluation indicated that the key negative sensory attributes reported were rancidity and stale attributes, which were correlated to the progression of lipid oxidation and loss of flavour over storage time irrespective of the packaging environment (with/without gas flushing).


Subject(s)
Cheese/analysis , Flavoring Agents/chemistry , Gases/chemistry , Nitrogen/chemistry , Onions/chemistry , Solanum tuberosum/chemistry , Taste Perception , Cooking , Female , Gas Chromatography-Mass Spectrometry , Humans , Male , Oxidation-Reduction , Snacks , Volatile Organic Compounds/chemistry
13.
Carbohydr Polym ; 185: 112-119, 2018 Apr 01.
Article in English | MEDLINE | ID: mdl-29421046

ABSTRACT

New microstructures with interesting, unique and stable textures, particularly relevant to food systems were created by redispersing Microfibrillar cellulose (MFC). This paper reports the interactions between microfibrillar cellulose and carboxymethyl cellulose (CMC) in redispersed aqueous suspensions, by using rheological measurements on variable ratios of MFC/CMC and correlating these with apparent water mobility as determined by time domain NMR. MFC is a network of cellulose fibrils produced by subjecting pure cellulose pulp to high-pressure mechanical homogenisation. A charged polymer such as CMC reduces the aggregation of microfibrillar/fibre bundles upon drying. Small amplitude oscillatory rheological analysis showed viscoelastic gel-like behaviour of suspensions which was independent of the CMC content in the MFC suspension. A viscous synergistic effect was observed when CMC was added to MFC before drying, leading to improved redispersibility of the suspension. Novel measurements using NMR relaxation suggested that the aggregated microfibrillar/fibre bundles normally dominate the relaxation times (T2). The dense microfibrillar network plays an important role in generating stable rheological properties and controlling the mobility of the polymer and hence the apparent mobility of the water in the suspensions.

14.
Food Funct ; 9(2): 1144-1151, 2018 Feb 21.
Article in English | MEDLINE | ID: mdl-29362760

ABSTRACT

The impact of different cellulosic microstructures formed by highly entangled fibre networks was studied for food applications as dietary fibre. This paper reports the impact of the microstructure on the rheological and sensory behaviour of the aqueous suspensions of particulate and fibrillated forms of softwood cellulosic fibres, and was compared with citrus fibres. An aqueous suspension of cellulosic fibres shows stable viscoelastic gel-like behaviour as a function of frequency. The particulate form of cellulosic fibres showed the lowest shear viscosity as compared with the entangled network system at comparable concentrations. To provide further insight into the relationship between the structure of cellulosic fibre and taste (salt) perception, an aqueous suspension with matched shear viscosities were studied. A hypothesis to explain why softwood cellulosic fibre (CTE) with an entangled network structure prolongs the taste perception is presented.


Subject(s)
Cellulose/chemistry , Cellulose/metabolism , Adult , Dietary Fiber , Female , Humans , Male , Rheology , Taste , Viscosity , Young Adult
15.
Minerva Endocrinol ; 41(4): 469-76, 2016 Dec.
Article in English | MEDLINE | ID: mdl-27270500

ABSTRACT

Bariatric surgery has been found to be very useful in treating established type-2 diabetes in obese persons, as well as in borderline diabetics, besides giving a good weight loss. Various modifications of the primary bariatric procedures have been introduced, with differ advantages and better efficacy. Good incretin responses from the distal gut give the best results and combining medical treatment are helping patients to get very good glycemic control over a longer term.


Subject(s)
Bariatric Surgery , Diabetes Mellitus, Type 2/etiology , Diabetes Mellitus, Type 2/prevention & control , Obesity/complications , Obesity/surgery , Humans , Incretins/metabolism
16.
J Midlife Health ; 5(3): 139-42, 2014 Jul.
Article in English | MEDLINE | ID: mdl-25317000

ABSTRACT

AIMS: The aim was to study the epidemiological factors responsible for pelvic organ prolapse (POP) in poor women of the remote village Shillai, do their POP quantification staging, to study the variety of surgeries conducted in mobile surgical camps in this area. MATERIALS AND METHODS: Retrospective analysis of surgeries conducted in five mobile surgical camps in Shillai, Himachal Pradesh from 2009 to 2013, under "Project Prolapse". RESULTS: A total number of surgeries conducted in five camps from 2009 to 2013 were 490 including 192 gynecological surgeries. Eighty-two percent of gynecological surgery was conducted for POP. Poor nutritional status (mean weight 41.1 kg), multiparty (mean 3.5), early marriage (mean age 18.2 years), unassisted home deliveries (100%), premature bearing down (23.8%), early postpartum resumption of strenuous activity (54.7%) and smoking (33%) contribute to the high incidence of POP. Anterior compartment prolapse was seen in 99% of patients undergoing surgery while posterior compartment prolapse was seen in 4% of patients. Vaginal hysterectomy with anterior repair with culdoplasty was the most common procedure performed (73.4%), and vault suspension was done in 3.6% subjects. The complication rate was negligible. CONCLUSION: Uterovaginal prolapse is not only socially embarrassing and disabling; its surgical treatment is complex and costly too. The free mobile surgical camps under Project Prolapse in Shillai, Himachal Pradesh has provided relief to old neglected, disabled women suffering from prolapse in this remote village. Parallel counseling of women and dais for safe hospital delivery and training subordinates in prolapse surgery may help in addressing the problem of POP in this area in the long run.

17.
Indian J Occup Environ Med ; 16(3): 101-7, 2012 Sep.
Article in English | MEDLINE | ID: mdl-23776317

ABSTRACT

Long-term exposure to respirable dust containing silica leads to pneumoconiosis/silicosis. The disease is irreversible and incurable, and only preventive steps such as job rotation, use of personal protective equipment, etc., remain solutions to the problem. Under such a situation, early diagnosis or prediction may become very useful to control the disease. Biomarkers are biological parameters in blood serum that change their values with deposition of dust in the lung and onset of lung fibrosis. Since these biomarkers can help us to diagnose and in the prognosis of the disease before it is actually diagnosed by the conventional X-ray technique and lung function test used for diagnosis of silicosis. The present paper describes the various types of available biomarkers, their application and usefulness. The paper also suggests that further study of the behavior/level of these biomarkers on a specific subject with time may provide more useful information of a confirmatory nature for prevention of dust-linked diseases.

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