Nutrition facts in barley/100 g.
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She joined the Center for Vascular and Inflammatory Diseases and the Program in Oncology of the University of Maryland Marlene and Stewart Greenebaum Cancer Center at University of Maryland School of Medicine in 2006 as an Assistant Professor. Dr. Chapoval’s research is focused on cellular and molecular mechanisms of lung chronic inflammatory diseases, asthma in particular, and novel molecules for disease immunotherapy. She is well-recognized for her work on HLA Class II-restricted allergen T cell epitopes, VEGF-induced lung DC modifications, and her recent discoveries on neuroimmune semaphorins 4A and 4D contributions to allergic airway inflammation and to Treg cell phenotype and function. Dr. Chapoval has served and continue to serve as a reviewer for 20+ peer-reviewed scientific journals. 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Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"878",title:"Phytochemicals",subtitle:"A Global Perspective of Their Role in Nutrition and Health",isOpenForSubmission:!1,hash:"ec77671f63975ef2d16192897deb6835",slug:"phytochemicals-a-global-perspective-of-their-role-in-nutrition-and-health",bookSignature:"Venketeshwer Rao",coverURL:"https://cdn.intechopen.com/books/images_new/878.jpg",editedByType:"Edited by",editors:[{id:"82663",title:"Dr.",name:"Venketeshwer",surname:"Rao",slug:"venketeshwer-rao",fullName:"Venketeshwer Rao"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"72890",title:"Potential Role of Plants Hordeum vulgare L. and Panax ginseng L. in Resolving the Fertility Disorders and Stress-Induced Oxidative Stress Arises from Hypothyroidism in Adult Female Rats",doi:"10.5772/intechopen.92359",slug:"potential-role-of-plants-em-hordeum-vulgare-em-l-and-em-panax-ginseng-em-l-in-resolving-the-fertilit",body:'There are many evidences revealed that food intake enriched with whole grain reduces the susceptibility of the incidence of many chronic diseases. Barley (Hordeum vulgare) is a food source deemed to be available for all disparate social classes of humankind.
In the Arab culture, Hordeum vulgare or barley syrup is used to relieve depression. It is categorized into the spring and winter types, which are considered two-rowed or six-rowed depending on the number of seed rows on each spike. Based on its grain composition, barley is further classified into normal, waxy or high amylose starch type [1].
Barley has found to be enriched with valuable minerals (iron, selenium, potassium, calcium, phosphorous; zinc), phytoestrol (β-sitosterol, campesterol, stigmasterol), polyphenol (ferulic, p-coumaric, sinapic, vanillic and p-hydroxybenzoic acids, cinnamic acid derivatives, proanthocyanidins, quinines, flavonols, chalcones, flavones, flavanones, and amino phenolic compound), water-soluble vitamins (C; B1; B2; folic acid and B12), β-glucan, dietary soluble fiber, vitamin E; nicotinic acid; pyridoxine; folic acid; essential amino acids, such as tryptophan and phenylalanine; neutral amino acids (LNAA), such as the three branched-chain aromatic amino acids leucine, isoleucine, and valine [2, 3]. So, barley grain exhibits potential antioxidant and antiproliferative actions because its powerful phytochemical compounds that have been shown to lower the risk of many diseases [4, 5]. The diverse phytonutrient of barley implicates its protection activity against certain types of cancers, cardiovascular disease, arthritis, diabetic, and hypercholesterolemia. It also increases cellular energy to sustain the body homeostasis [6, 7] and modulating endocrine and neurotransmitters functions [8].
Red ginseng represents an important position as a health functional food. It belongs to the Panax genus of the Araliaceae family, ginseng characterized by a complex activity profile that includes antioxidant, anti-inflammatory, anti-apoptotic, and immune-stimulatory properties and has the effects of stabilizing and balancing the entire physiology [9]. So, in Asian countries; Korea, China, and Japan, ginseng used as a therapeutic agent for a variety of diseases [10].
The major active ingredients of Panax ginseng are saponins, which are triterpene glycosides called “ginsenosides”. Other active components include proteins, peptides, and alkaloids, which are nitrogenous compounds; polyacetylene, which is a fat-soluble component; polysaccharides and other flavonoids; fatty acids, organic acids, vitamins, sugars, inorganic salts, sterols, oligopeptides [11, 12]. Ginsenosides can be classified into three categories: the panaxadiol group (e.g. Rb1, Rb2, Rb3, Rc, Rd., Rg3, Rh2, Rs1), the panaxatriol group (e.g. Re, Rf, Rg1, Rg2, Rh1), and the oleanolic acid group (Ro) [13, 14].
Ginsenosides are lipophilic compounds so they can pass easily through the cell membrane by simple diffusion and bind to its intracellular target proteins in the cytoplasm and nucleus. Ginseng also contains more than 10 phenolic compounds that possess antioxidant biological properties that have ability to lower the effect of oxidative stress [15]. Phytoestrogens, such as genistein is an important component of ginseng, have shown protective effects on conditions related to decreased estrogen, including menopause, osteoporosis, and cognitive disorders [13, 16].
Thyroid-stimulating hormone (TSH) is synthesized and secreted by the adenohypophysis lobe and exerts its effect by binding to the cognate thyrotropin receptor (TSHR) to stimulates the production of thyroglobulin and thyroid peroxidase proteins, which are essential for the synthesis and secretion of thyroid hormones (THs) [17]. THs bind their nuclear receptors (TRs), which are present in many tissues and organs in the human body and hence regulate their functions [18].
Thyroid hormones influence a wide range of brain developmental processes, such as myelination, neuronal and glial cell differentiation by regulating the gene involved in these processes thus hypothyroidism may reduce axonal growth and dendritic arborization in the cerebral cortex, visual cortex, auditory cortex, hippocampus, and cerebellum, as well as impaired memory, cognitive function and attentiveness [3, 19]. THs plays a role in neurotransmitter release from their storage vesicles such as norepinephrine (NE), epinephrine (E), serotonin (5-HT) and dopamine (DA) and hence maintaining good mental state, mood regulation, modulating post-receptor signal transduction, gene expression and preventing depression [19]. So, hypothyroidism is a highly prevalent condition that impairs learning, memory, induce delayed skeletal development, cardiovascular diseases, secondary hypertension, the deterioration of human reproductive health and brain dysfunction [20].
The study was carried out by using adult female Wistar albino rats weighing 180–200 g. Animals were housed at 23 ± 2°C and 55 ± 5% humidity with a 12 h light/dark cycle rats were provided a standard diet and water ad libitum.
Barley was prepared as an emulsion in water (1 g ground barley soaked in 10 ml of distilled water) and administered daily per [21]. The nutritional facts of barley per 100 g are presented in Table 1.
Carbohydrates | (78.2 g) | Vitamin B6 | (0.29 μg) | Choline | (38 mg) |
Fibers | (15.5 g) | Vitamin K | (2.5 μg) | Riboflavin (B2) | (0.124 μg) |
Energy | (350 kcal) | Niacin (B3) | (4.8 μg) | Calcium | (30 mg) |
Fat | (1.2 g) | Pantothenic acid (B5) | (0.29 μg) | Iron | (3.5 mg) |
Protein | (10 g) | Thiamine (B1) | (0.2 μg) | Magnesium | (80 mg) |
Vitamin A | (15 μg) | Folic acid | (25 μg) | Phosphorus | (200 mg) |
Zinc | (2.5 mg) | ||||
Potassium | (250 mg) |
Nutrition facts in barley/100 g.
Dried roots of the Korean Panax ginseng were obtained as a brown powder and dissolved in distilled water. Animals received a daily oral dose of 1.8 mg/200 g body weight (equivalent to the therapeutic dose [22]) for 30 days.
Neo-Mercazole is the least toxic anti-thyroid agent within therapeutic dose ranges [23] therefore it was selected for hypothyroidism induction. The animals were orally administered a daily dose of 5.0 mg.kg—of Neo-Mercazole for 1 month [24]. Hypothyroidism was manifested by the increased level of serum TSH associated with low level of fT4.
Animals randomly divided into equally four-treatment groups. Except for euthyroid animals (EU) (groups 1&2), hypothyroid animals (H) (group 3&4) were orally administered 5.0 mg kg−1 bwt Neo-Mercazole until the end of the study. Following 30 days of Neo-Mercazole administration, groups 2 and 4 orally administered 100 mg kg−1 bwt barley (B) [21] water suspension for 4 weeks. The four groups named: EU; EU + B; H; H + B.
Rats were divided equally into four groups. First group was an intact control group that received distilled water. The second group was the hypothyroid group (H group) which orally treated with 5 mg kg−1 body- weight Neo-Mercazole for 30 days for induction of hypothyroidism. The third group was orally administered Panax ginseng (G group) in a daily oral dose of 1.8 mg/200 g body weight for 30 days. The fourth group receiving both Neo-Mercazole for 30 days and followed by Panax ginseng (H + G group) for another 30 days.
At the end of treatment, the animals were anesthetized with 1% isoflurane followed by decapitation [25], blood was collected into serum preparation tube and the separated serum was collected and divided into aliquots, stored at −20°C for further hormones assay. The whole brains were removed from 10 rats from each group and the hypothalamus, hippocampus, cerebral cortex, midbrain, and cerebellum were dissected using a sharp blade. From another 10 rats’ whole brain and thyroid gland were immediately removed and stored in ice-cold saline at −20°C for further biochemical and comet assay.
Levels of fT3, fT4, ERK1/2, 8-hydroxy-2′-de-oxyguanosine (8-OhdG) and apoptotic marker Caspase-3 were determined using ELISA kit specific for rats according to manufacturer’s instruction (Glory Science Co., Ltd., USA). Serum corticosteroid and gonadal hormones were determined using the ELISA kit according to the instruction of BioCheck (BioCheck Co., Ltd., USA). DNA degradation in brain and thyroid homogenates was determined by using the Comet technique according to the method [26]. Determination of monoamines in brain areas were carried according to methods of [19, 27] while free amino acids were done according to the method of [28] using the precolumn phenylisothiocyanate (PTC) derivatization technique.
The study was conducted to address the potential ameliorative effect of barley on the disturbance in adrenal pituitary-gonadal hormones, as well as oxidative stress following hypothyroid induction. Hypothyroidism induction caused disturbances in adrenal, pituitary and gonadal hormones (Figures 1–3). Barley reversed the effect of the antithyroid drug on the levels of thyroid hormones (TSH, fT4) and their transporting proteins (TBG, TTR) as shown in Table 2 due to its higher iron (Fe) content which plays a crucial role in modulating thyroid peroxidase (TPO) enzyme activity [2, 29]. Oxidative stress is related to hormonal disorders in a reciprocal way so in our study, the hyper TSH level stimulated the synthesis of corticosterone, and generated a state of oxidative stress which inhibited the pituitary gonadotropin [30, 31], and cause FSH depletion with the non-significant decrease of LH levels in the hypothyroid group. Also, lower levels of estradiol in the hypothyroid group associated with high progesterone and prolactin levels could be attributed to high ERK1/2 level (Figure 4). Barley, with its high content of phytosterol, could modulate ER-α, and β expression, augmented estradiol levels, in turn, led to activate negative feedback mechanism of pituitary-gonadal adrenal axis function and renormalize the disturbances of endocrine gland elicited by hypothyroidism.
(A) Serum TSH mIU/L, (B) serum fT4 μg/ml, and (C) serum fT3 in control (CO) group, hypothyroid (H) group, barley treated (T) group and hypothyroid-barley-treated group (HT).
Serum corticosterone (ug/dl) (A), serum prolactin (ng/ml) (B), serum FSH (mIU/ml) (C) and serum LH (ng/l) (D) in control (CO) group, hypothyroid (H) group, barley-treated (T) group and hypothyroid-barley-treated group (HT).
(A) Serum estradiol (pmol/L), (B) serum P (ng/ml) and (C) serum T (ng/ml), in control group (CO), hypothyroid group (H), barley-treated group (T) and hypothyroid-barley-treated group (HT).
EU | EU + B | H | H + B | |
---|---|---|---|---|
fT4 (μg/ml) | 4.43 ± 0.11 | 4.21 ± 0.14 | 3.09 ± 0.25 (a*) | 4.46 ± 0.19(b**) |
TSH (mIU/ml) | 12.47 ± 0.42 | 12.73 ± 0.62 | 15.97 ± 0.26 (a*) | 12.53 ± 0.29 (b*) |
TTR (ng/ml) | 51.23 ± 2.39 | 45.64 ± 6.53 (a*) | 16.85 ± 1.88 (a***) | 34.25 ± 1.65 (a** b***) |
TBG (pg/ml) | 1.58 ± 0.04 | 2.35 ± 0.16 (a**) | 2.09 ± 0.04 (a*) | 2.57 ± 0.14 (a***b*) |
ERK1/2 (pg/ml) | 43.67 ± 1.53 | 46.33 ± 1.53(a*) | 33.19 ± 2.16 (a**) | 47.94 ± 0.60(b**) |
Effect of barley on THs, TTR and TBG in brain tissue of EU- and H-groups.
All data in tables represented by mean ± SD, n = 10 animals.
*p < 0.05, **p < 0.01 and ***p < 0.001.
a: mean significance difference from control group. B: mean significance difference from hypothyroid group.
(A) Serum E2/T ratio (B) serum ERK1/2 (pg/ml) in control group (CO), group hypothyroid (H), barley-treated group (T) and hypothyroid-barley-treated group (HT).
Oxidative stress (ROS) is an imbalance between the production of pro-oxidant substances and antioxidant defense. Hypothyroidism augments the oxidative insult, impairing the brain by increasing nitric oxide (NO) and NO synthase (NOS) levels in the hippocampus, which affects the lipid composition of rat brain tissues and induces DNA damage [32, 33]. In present work, hypothyroidism was associated with the high significant increase in 8-hydroxyguanosine (an oxidative stress marker), together with marked elevation in Caspase-3 (an apoptotic marker) in serum and brain tissue (Figures 5 and 6). These findings were confirmed by alkaline comet assays of thyroid and brain tissue homogenates. As DNA was degraded, it converted from a supercoiled form to a comet-like shape with a measurable tail length so our study revealed that the hypothyroid status induced a significant increase in the tail length, in the thyroid and brain tissues. Treatment with barley attenuated the oxidative stress status induced by hypothyroid status; it significantly decreased 8-OH guanosine levels and Caspase-3 activity. This antioxidant activity of barley could be attributed to flavonoids, ferulic, sinapic and ß- hydroxy acids (BHA) content, the major predominant polyphenol, in barley with their potent free radical scavengers by absorbing and neutralizing oxygen radicals [21, 34, 35]. Also, DNA damage was repaired by the antioxidant activity of barley as illustrated in Figures 7 and 8, which refer to vitamins A and E that essential for nucleotide, DNA biosynthesis, DNA repair, and methylation [1, 2, 19, 36]. Additionally, zinc protects against oxidative stress by stabilizing membranes through the inhibition of the enzyme nicotinamide adenine dinucleotide phosphate oxidase (NADPH oxidase) and the stimulating of the synthesis of metallothioneins, which reduce the levels of hydroxyl radicals and sequester ROS produced in response to hypothyroidism.
Serum 8-hydroxy guanosine (8-OHG) (ng/L) (A), Caspase-3 (ng/ml) (B) in control group (CO), hypothyroid group (H), barley-treated group (T) and hypothyroid-barley-treated group (HT).
Effect of barley on caspase-3 (ng/ml) and 8-OhdG (ng/ml)in brain tissue.
Effect of barley on DNA damage in thyroid tissue (A) fluorescence photomicrograph showing comets in EU-, H-, EU + B and H + B-groups. The indicated the intact DNA and indicated the degree of damaged DNA (B) tail length expressed in μm in thyroid tissue of all treated groups.
Effect of barley on DNA damage in whole brain tissue (A) fluorescence photomicrograph showing comets in EU-, H-, EU + B and H + B-groups. The indicated the intact DNA and indicated the degree of damaged DNA (B) tail length expressed in μm in whole brain tissue of all treated groups.
Neurotransmitters NE, DA, and 5-HT levels were significantly reduced in all brain areas (cerebellum, midbrain, cerebral cortex, hypothalamus, and hippocampus) with hypothyroidism induction as shown in Table 3, these could be attributed to the reduced oestradiol level as mentioned above [37, 38]. The administration of Hordeum vulgare (barley) improved the disturbances in the dopaminergic, serotonergic and noradrenergic pathways via two different mechanisms; first, the high phytosterol content modulates estrogen receptors (Erα and β) expression and elevate oestradiol levels. Second, barley is enriched with tryptophan and phenylalanine and could regulate the synthesis of 5-HT, DA and NE through the conversion of tryptophan to 5-hydroxytryptophan (5-HTP) to 5-HT and hydrolysis of phenylalanine to generate tyrosine that ultimately produces DA and NE [2, 36, 39, 40]. In the present study, hypothyroidism induced a significant increase in inhibitory amino acid, including GABA and histidine, which is an excitatory amino acid (Figures 9 and 10).
Frontal cortex | Hippocampus | Hypothalamus | Mid brain | Cerebellum | |
---|---|---|---|---|---|
NE (μg g−1tissue) | |||||
EU | 0.52 ± 0.03 | 0.69 ± 0.02 | 0.40 ± 0.01 | 0.70 ± 0.01 | 0.58 ± 0.01 |
EU + B | 0.45 ± 0.02 | 0.65 ± 0.01 | 0.40 ± 0.01 | 0.69 ± 0.01 | 0.60 ± 0.01 |
H | 0.21 ± 0.09a*** | 0.31 ± 0.01a*** | 0.13 ± 0.01a*** | 0.35 ± 0.01a*** | 0.29 ± 0.01a** |
H + B | 0.35 ± 0.01a**b* | 0.46 ± 0.01a**b** | 0.22 ± 0.01a**b** | 0.48 ± 0.01a**b** | 0.40 ± 0.01a**b** |
DA (μg g−1tissue) | |||||
EU | 0.59 ± 0.02 | 2.40 ± 0.07 | 1.473 ± 0.10 | 1.31 ± 0.01 | 0.60 ± 0.01 |
EU + B | 0.55 ± 0.01 | 2.39 ± 0.09 | 1.32 ± 0.06 | 1.32 ± 0.01 | 0.60 ± 0.01 |
H | 0.26 ± 0.01a*** | 0.93 ± 0.03a*** | 0.90 ± 0.03a* | 0.85 ± 0.01a** | 0.27 ± 0.05a*** |
H + B | 0.35 ± 0.01a**b** | 1.17 ± 0.01a**b** | 1.07 ± 0.02a*b* | 1.0 ± 0.01a*b* | 0.40 ± 0.01a**b** |
5-HT (μg g−1tissue) | |||||
EU | 0.57 ± 0.01 | 0.38 ± 0.01 | 0.78 ± 0.01 | 0.72 ± 0.01 | 0.47 ± 0.01 |
EU + B | 0.56 ± 0.02 | 0.38 ± 0.01 | 0.76 ± 0.02 | 0.65 ± 0.05 | 0.50 ± 0.01 |
H | 0.23 ± 0.01a*** | 0.11 ± 0.01a*** | 0.45 ± 0.01a** | 0.30 ± 0.01a *** | 0.18 ± 0.01a*** |
H + B | 0.35 ± 0.01a**b** | 0.18 ± 0.01a**b* | 0.54 ± 0.01a*b* | 0.41 ± 0.01a**b** | 0.28 ± 0.01a**b** |
Effect of barley on neurotransmitters level in discrete brain regions in control and treated groups.
All data in tables represented by mean ± SD, n = 10 animals.
*p < 0.05, **p < 0.01 and ***p < 0.001.
a: Mean significance difference from control group. b: Mean significance difference from hypothyroid group.
Effect of barley on inhibitory amino acids in EU and H groups. All data represented by mean ± SD, n= 10 animals, *p<0.05, **p<0.01 and ***p<0.001, (a) mean significance difference from control group, (b) mean significance difference from hypothyroid group. (C) mean significance difference from EU+B.
Effect of barley on excitatory amino acids in EU and H groups. All data represented by mean ± SD, n= 10 animals, *p<0.05, **p<0.01 and ***p<0.001, (a) mean significance difference from control group. (B) mean significance difference from hypothyroid group. (C) mean significance difference from EU+B.
These results could explain the increase in Caspase-3, which may be attributed to reduced blood oxygen–glucose levels in several brain regions as a result of increased GABA levels. The study also revealed an increase in dopamine receptors, whereas serotonin receptors were significantly decreased. The Hordeum vulgare (barley) treatment in the present study caused a renormalization the observed disturbances in the amino acid and neurotransmitter levels because it is enriched with folic acid, which is involved in the synthesis of monoamine neurotransmitters and modulate serotonergic, dopaminergic and noradrenergic systems by acting as a cofactor for enzymes that convert tryptophan to 5-HT and enzymes that convert tyrosine to noradrenaline [19]. The alteration in serotonin receptor densities was restored by the barley administration, due to its enriched levels of tryptophan, which is metabolized to serotonin [36, 40] and activates these receptors (Figure 11).
Effect of barley on relative expression of (A) mRNA 5-HT1A, (B) mRNA 5-HT2A and (C) mRNA DA2A.
The elevation in serotonin levels after barley administration in the present study also resulted in ERK1/2 improvement in brain tissue, which was reduced by hypothyroidism induction. The binding of serotonin to 5-TH2 receptors stimulates ERK1/2 phosphorylation via the release of epidermal growth factor (EGF) agonist and transactivation of (EFG) receptors [41]. The improvement of serum oestradiol in hypothyroid-barley-treated groups as mentioned before could explain the positive effect of barley on restoring dopamine levels in brain tissues because the reproductive hormones, estrogen and progesterone, modulate the dysregulated serotonergic, dopaminergic, and glutamatergic neurotransmission by regulating the expression of receptors, the synthesis, reuptake, and release of the neurotransmitter serotonin and dopamine, which interact with dopaminergic neurons directly to downregulate D2 autoreceptors and indirectly by inhibiting GABAergic transmission [42].
Based on the above findings, we conclude that barley (Hordeum vulgare) is a nutritious food with high carbohydrate, zinc, magnesium content, and a high amino acids Trp:BCAA ratio has a positive effect on ameliorating the neural dysfunction induced by hypothyroidism and recommended for relieving stress, improving mood and depression.
The present study revealed a reduction in fT3, fT4, and elevation in TSH levels as well as deterioration in THs transporting protein (TBG and TTR) in brain tissues of hypothyroid rats as shown in Table 8. This disturbance attributed to Neo-Mercazole which is an antithyroid agent that blocks thyroid hormonogenesis by inhibiting thyroid peroxidase (TPO) activity and preventing the formation of thyroglobulin from tyrosine [43, 44]. Hypothyroidism also causes elevation of cortisol that leads to inhibition of the deiodinase enzyme type 2 (D2) enzyme, responsible for the conversion of T4 into T3 [45]. Ginseng treatment improves the levels of thyroid hormones in serum and brain tissues through restoration of the impairment transporting protein (TTR & TBG) as shown in Tables 4 and 8. Moreover, ginseng boosts the activity of the enzyme responsible for converting T4 to active T3 and reduces thyroid hormone-blocking reverse T3 (rT3) which inhibits active T3 from binding to its functioning T3 receptors [46, 47].
Parameter | Control | G | H | H + G |
---|---|---|---|---|
fT3 (ng/ml) | 1.99 ± 0.06 | 1.54 ± 0.05 | 1.59 ± 0.02 | 1.80 ± 0.04 (b*) |
fT4 (μg/ml) | 6.61 ± 0.14 | 7.32 ± 0.36 | 4.07 ± 0.12 (a*) | 6.78 ± 0.34 (b**) |
TSH (mIU/ml) | 12.31 ± 0.62 | 12.81 ± 0.69 | 14.09 ± 0.42 (a*) | 10.75 ± 0.26 (b**) |
TTR (ng/ml) | 32.56 ± 2.04 | 36.93 ± 2.95 | 44.19 ± 3.34 (a*) | 27.41 ± 1.96 (b*) |
TBG(pg/ml) | 2.54 ± 0.19 | 2.49 ± 0.06 | 2.26 ± 0.07 | 2.37 ± 0.13 |
Thyroid hormones and their carrying proteins levels of in the studied groups.
All data in tables represented by mean ± SD, n= 10 animals.
*p<0.05, **p<0.01 and ***p<0.001.
a: mean significance difference from control group. B: mean significance difference from hypothyroid group.
The sexual dysfunction may be developed from psychological stress state exerted by hypothyroidism induction and this confirmed the role of the pituitary–adrenal gonadal axis (HPA) as a defense mechanism carried out by the organism against stress event [48]. So the reduction in trophic hormone (FSH & LH) associated with hypothyroidism led to decreasing the E2 hormone level and elevation of progesterone and testosterone. The inhibition in gonadal activity in hypothyroid rats in the present model as documented in Table 5 was confirmed by the lowering of E2/T (Table 6) ratio which is a marker of the aromatase enzyme activity (estrogen synthase, CYP19A1), this is a key enzyme converted testosterone into estrogen in granulosa cell [49]. Hyperprolactinemia, as recorded in the present study, negatively affected the activity of aromatase enzyme and this lead to hypoestrogenism, inhibited the release of gonadotrophic hormones (LH & FSH) from the pituitary gland and potentiated the inhibitory action of inhibin hormone that stimulated negative feedback and lowered estradiol level [50]. The administration of Panax ginseng was ameliorated these changes in trophic and steroidal gonadal hormones due to the triterpenoid saponins which steroidal in nature and considered the precursors of steroidal hormones in both plants and animals [51].
Parameter | Control | G | H | H + G |
---|---|---|---|---|
FSH (mIU/L) | 7.11 ± 0.16 | 7.98 ± 0.14 | 5.99 ± 0.18 (a*) | 7.03 ± 0.12 |
LH (ng/L) | 6.47 ± 0.29 | 7.38 ± 0.38 | 4.35 ± 0.19 (a**) | 6.73 ± 0.28 (b**) |
E2 (Pg/ml) | 20.76 ± 0.64 | 20.3 ± 0.39 | 14.7 ± 0.8 (a*) | 18.00 ± 0.77 (a*,b**) |
P (ng/ml) | 23.24 ± 1.66 | 20.66 ± 1.51 | 30.41 ± 1.18 (a*) | 20.56 ± 1.67 (b*) |
T (ng/ml) | 0.32 ± 0.06 | 0.35 ± 0.03 | 0.39 ± 0.07 (a*) | 0.35 ± 0.04 |
PRL (ng/ml) | 94.06 ± 4.89 | 104.12 ± 4.41 | 149.11 ± 11.33 (a**) | 101.02 ± 6.58 (b*) |
Serum fertility hormones levels in hypothyroid and treated adult female albino rats.
All data in tables represented by mean ± SD, n= 10 animals.
*p<0.05, **p<0.01 and ***p<0.001.
a: mean significance difference from control group. B: mean significance difference from hypothyroid group.
Parameter | Control | G | H | H + G |
---|---|---|---|---|
ERK1/2 (pg/ml) | 47.38 ± 1.93 | 50.17 ± 2.57 | 63.17 ± 3.13 (a*) | 42.26 ± 1.7 (a*b**) |
E2/T ratio | 64.87 ± 10.3 | 58.0 ± 13.0 | 37.6 ± 11.4(a***) | 51.4 ± 19.25 (b*) |
Corticosterone (μg/dl) | 1.8 ± 0.06 | 1.7 ± 0.11 | 2.82 ± 0.21 (a**) | 1.73 ± 0.10 (b*) |
ERK1/2, E2/T ratio and cortisol level in serum of hypothyroid and treated female albino rats.
All data in tables represented by mean ± SD, n= 10 animals.
*p<0.05, **p<0.01 and ***p<0.001.
a: mean significance difference from control group. B: mean significance difference from hypothyroid group.
The current study exhibited a significant increase in serum corticosterone hormone. Also, the elevation of 8-hydroxyguanosine, an oxidative stress marker, and Caspase-3, an apoptotic marker in serum and brain tissues (Table 7 and Figure 12). The administration of Panax ginseng was renormalized the cortisol and oxidative stress markers by increasing the cellular resistance to stress and potentiated the role of the immune system through triterpenes of ginsenosides [48, 52]. Serum ERK1/2 was activated in response to the elevation of oxidative stress and cell death apoptotic markers as underlined in the present study. Treatment with ginseng ameliorates 8-OHdG, Caspase-3 and ERK1/2 levels referring to its neuroprotective effect and retrieval homeostasis. Also, ginsenosides which is the pharmacologically active constituents with its adaptogenic, powerful antioxidant and radical scavenging activities, regulate the function of HPA, support neurogenesis, synaptogenesis, neuronal growth, and neurotransmission, in turn, protect the central nervous system [53, 54, 55, 56]. The study of [57] showed that the panaxatriol group of ginsenosides blocked Caspase-3 expression and increased anti-apoptotic Bcl-2 and p53, indicating that RG repressed cellular apoptosis otherwise, ginsenosides Rd and Re have neuroprotective properties by modulation of ERK1/2 signaling pathway [58]. The elevation of Caspase-3 in the present hypothyroid modal was confirmed by studying the Comet tailed DNA damage of the brain and thyroid tissues as illustrated in Figures 15 and 16. Ginseng treatment repair DNA damage in brain and thyroid tissues, this denoted to its highest content of phenolic compounds which act as antioxidants.
Parameter | Control | G | H | H + G |
---|---|---|---|---|
8-OH Guanosine (ng/L) | 48.46 ± 2.21 | 32.79 ± 0.05 | 57.99 ± 0.02 (a*) | 48.63 ± 0.08 (b*) |
Caspases (ng/ml) | 5.26 ± 0.20 | 5.94 ± 0.15 | 12.44 ± 0.67 (a***) | 5.48 ± 0.14 (b***) |
Oxidative stress markers in serum of hypothyroid and ginseng-treated female albino rats.
All data in tables represented by mean ± SD, n= 10 animals.
*p<0.05, **p<0.01 and ***p<0.001.
a: mean significance difference from control group. B: mean significance difference from hypothyroid group.
Effect of ginseng on ERK1/2, Caspase-3 and 8-OHdG in all studied groups.
Thyroid hormones control the levels of these neurotransmitters which are responsible for maintaining a good mental state and preventing depression [19]. THs regulate both the release of the neurotransmitters and their post-receptor signaling to promote mood stabilization so, their deficiency may weaken the neurogenesis, maturation and synaptic transmission (Figures 13 and 14).
Effect of ginseng on excitatory amino acids in all studied groups.
Effect of ginseng on inhibitory amino acids in all studied groups.
The present data, exhibited that the induction of hypothyroidism resulted in a significant decrease of NE, DA and 5-HT concentrations in all studied brain areas (frontal cortex, hippocampus, hypothalamus, midbrain and cerebellum) as shown in Table 9. Monoamines reduction after hypothyroidism refereed to the disturbance in the synthesis and release of these amines from impairment neurons or may be due to an alteration pattern of their synthesizing and/or degradative enzymes [59]. Ginseng treatment ameliorate the reduced monoamine levels of hypothyroid rats and this refers to its powerful ability to maintain homeostasis and modulating neurotransmitter levels hence can amend the neurodegenerative diseases [54, 60]. Also, ginseng saponins modulate dopaminergic activity at both presynaptic and postsynaptic receptors [54, 55].
Control | H | G | H + G | |
---|---|---|---|---|
fT4 (μg/ml) | 4.44 ± 0.11 | 3.97 ± 0.10 (a*) | 3.65 ± 0.34 (a*b*) | 4.08 ± 0.58 (c*) |
fT3 (μg/ml) | 1.62 ± 0.08 | 1.40 ± 0.08 (a*) | 1.49 ± 0.12 (a*b*) | 1.51 ± 0.11 (a*b*) |
TSH (mIU/ml) | 12.47 ± 0.42 | 15.81 ± 0.53 (a**) | 10.87 ± 0.48 (a***b***) | 13.57 ± 0.87 (b***c***) |
TTR (ng/ml) | 51.23 ± 2.39 | 15.07 ± 0.14 (a***) | 42.1 ± 2.88 (a**b***) | 33.28 ± 1.88 (a***b***c**) |
TBG (pg/ml) | 1.58 ± 0.04 | 2.09 ± 0.08 (a*) | 1.75 ± 0.39 (a*b*) | 1.73 ± 0.35 (a*b*) |
Effect of ginseng on f T3, f T4, TSH, TBG and TTR in brain tissue of control and hypothyroid-treated rats.
All data in tables represented by mean ± SD, n= 10 animals.
*p<0.05, **p<0.01 and ***p<0.001.
a: mean significance difference from control group. B: mean significance difference from hypothyroid group.
Frontal cortex | Hippocampus | Hypothalamus | Mid brain | Cerebellum | |
---|---|---|---|---|---|
DA (μg g−1tissue) | |||||
Control | 0.59 ± 0.04 | 2.39 ± 0.18 | 1.47 ± 0.27 | 1.31 ± 0.01 | 0.60 ± 0.02 |
H | 0.25 ± 0.02 a*** | 0.93 ± 0.07 a*** | 0.89 ± 0.08 a*** | 0.89 ± 0.03 a*** | 0.27 ± 0.01 a*** |
G | 0.58 ± 0.01b*** | 2.74 ± 0.08b*** | 1.69 ± 0.17b*** | 1.31 ± 0.01b** | 0.59 ± 0.01b*** |
H + G | 0.44 ± 0.02a***b**c*** | 1.67 ± 0.07a***b***c*** | 1.12 ± 0.04a**c*** | 1.18 ± 0.01a***b***c*** | 0.50 ± 0.01a**b***c** |
NE (μg g−1tissue) | |||||
Control | 0.51 ± 0.07 | 0.68 ± 0.04 | 0.39 ± 0.01 | 0.70 ± 0.01 | 0.58 ± 0.03 |
H | 0.21 ± 0.02 a*** | 0.31 ± 0.02 a*** | 0.13 ± 0.02 a*** | 0.35 ± 0.02 a*** | 0.29 ± 0.01 a*** |
G | 0.56 ± 0.08b*** | 0.67 ± 0.06 b*** | 0.38 ± 0.02b*** | 0.69 ± 0.01b*** | 0.6 ± 0.01b*** |
H + G | 0.35 ± 0.03a***b**c*** | 0.54 ± 0.03a***b***c*** | 0 .29 ± 0.01a***b***c*** | 0.56 ± 0.03a***b***c*** | 0.49 ± 0.01a***b***c*** |
5-HT (μg g−1tissue) | |||||
Control | 0.57 ± 0.03 | 0.38 ± 0.02 | 0.78 ± 0.03 | 0.72 ± 0.03 | 0.47 ± 0.02 |
H | 0.23 ± 0.01 a*** | 0.11 ± 0.01 a*** | 0.45 ± 0.02 a*** | 0.29 ± 0.01 a*** | 0.18 ± 0.01 a*** |
G | 0.57 ± 0.03b*** | 0.39 ± 0.01b*** | 0.77 ± 0.02b*** | 0.70 ± 0.03b*** | 0.47 ± 0.01b*** |
H + G | 0.41 ± 0.02a***b***c*** | 0.29 ± 0.01a***b***c*** | 0.56 ± 0.02a***b***c*** | 0.5 ± 0.01a***b***c*** | 0.34 ± 0.01a***b***c*** |
Effect of ginseng on monoamines levels of discrete brain regions in control and hypothyroid-treated rats.
Data in tables given are mean ± S.D. the number of animals was 10 in each group.
**Significant at p 0.01 and ***significant at p 0.001.
(a) Significant versus control group; (b) significant versus hypothyroid (H) group and (c) significant versus ginseng (G) treated group.
Improvement of monoamines after ginseng treatment refer also to gintonin which is one of the important ginseng constituents that increased the expression of learning and memory and modulate cholinergic, glutaminergic and other molecular signaling pathways that are vital for cognitive activity as stated in [16]. Ginseng which considered a potential phytoestrogen exhibits antidepressant so, ginsenosides Rb1 enhances the serotonergic system by increasing 5-HT synthesis, decreasing 5-HT degradation, stimulating 5-HT2A receptor and suppress the activity of the inhibitory 5-HT3A receptor in the brain. Also, effect via increasing 5-HT activity. This effect is mediated by the activation of estrogen receptor [61, 62]. In the present study, hypothyroidism induction by Neo-Mericazole lead to a significant increase of excitatory amino acid, histidine, and all inhibitory amino acids while excitatory glutamic acid was significantly decreased in brain tissues (Figures 15 and 16). Panax ginseng with its powerful components ameliorates the disturbance of amino acids and in turn monoamines. The induction of hypothyroidism revealed an elevation in the concentration of dopamine receptors and the reduction of serotonin receptors density (Figure 17). Treatment with ginseng restores the level of dopamine and serotonin receptors density towards the control value. This refers firstly to the genomic pathway of ginsenosides which bind to intracellular nuclear hormone receptors like androgen receptor (AR), estrogenic receptor (ER) and progesterone receptor [13].
Effect of ginseng on DNA damage in whole brain tissue, (A) Tail length expressed in μm in brain tissue of all treated groups. *Significant at p. 0.05, **significant at p. 0.01 and ***significant at p. 0.001. (a), significant versus control group, (b) significant versus hypothyroid, (H) group and (c ) significant versus ginseng, (G) treated group, (B) Fluorescence photomicrograph showing comets in control, H, G and H+G -groups. (blue arrows) indicated the intact DNA and (green arrows) indicated the degree of damaged DNA (tail).
Effect of ginseng on DNA damage in thyroid tissue. (A) Tail length expressed in μm in thyroid tissue of all treated groups. ** significant at p 0.01 and *** significant at p 0.001. (a) significant versus control group, (b) significant versus hypothyroid, (H), group and (c ), significant versus ginseng (G), treated group (B), Fluorescence photomicrograph showing comets in control, H, G and H+G -groups. (blue arrows) indicated the intact DNA and (green arrows) indicated the degree of damaged DNA (tail).
Effect of ginseng on expression of mRNA 5-HT1A, mRNA 5-HT2A and mRNA DA2A. *Significant at p 0.05, and ***significant at p 0.001. (a) Significant versus control group (b) significant versus hypothyroid (H) group and (c) significant versus ginseng (G) treated group.
In conclusion, the present study is pointed out to the pituitary-gonad-adrenal disturbances aroused from the hypothyroidism induction by Neo-Mericazole and how ginseng, one of the most Asian medicinal traditional plants, significantly normalized the fertility disorders and stress by acting as free radicals’ scavenger.
The authors declare no conflict of interest.
As a result of this pandemic, we can note the disappearance of questions and conversations related to climate change [1]. It seems that the lack of progress towards the objectives of the Paris agreement has disappeared into the background. What would once have been the center of attention in most forums and agendas does not even reach the inside pages of magazines or newscasts. Our global consciousness has shifted towards survival and transcendence, as a species, which are immediate threats to our lives [2].
\nThis desire for transcendence allows us to analyze what happens when we are closer to the top of the pyramid and all our basic concepts are covered as in Maslow’s pyramid [3]. With the pandemic around the world, we have all been taken down on some levels and we are now looking to protect ourselves and our loved ones.
\nOn the surface, it seems that all efforts, all activities and all initiatives have shifted away from the greatest threat to our planet, climate change, towards the immediate and more tangible threat to our lives of COVID-19 [4].
\nThe desire for transcendence can also be expressed towards transhumanism and environmental sustainability. Transhumanism is a social movement predicated on the belief that we can and should leave behind our biological condition by merging with technology [5]. Environmental sustainability is responsibly interacting with the planet to maintain natural resources and give the ability of future generations to meet their needs. It can be interpreted as an steady state economy [6]. This status depends on legal, thermodynamic, and economic aspects of ecosystem services [7, 8].
\nThis chapter proposes a new regard of the circular economy following analysis of the most prominent issues related with COVID-19, government responses to the crisis and sustainability.
\nThe significance of this article is that it addresses the criticisms of the circular economy paradigms by considering three dimensions of analysis related to the COVID-19 outbreak [9]. The increased demand for sustainable production processes post COVID-19 justifies the need for more effective policies with a focus on human health [1, 10].
\nThe methodology used in this paper takes sustainability, health care, economic growth and dimensions to provide an analysis related to COVID-19. Figure 1 presents the analysis of how these three dimensions might be reinterpreted using the framework proposed by Doussoulin [9]. As shown in Figure 1, when π = 100%, z = 0 and w = 0, all attention dedicated by the government are apportioned to economic growth. Alternatively, if π = 0, z = 0 and w = 100%, then all attention is given to health care. It is also possible the attention to the earth as a natural resource, this can be represented by the point where π =0, z = 100% and w = 0, which corresponds to a sustainable future [11, 12, 13].
\nThree dimensions: Economic growth, health care and sustainability. Source: [9]
This section outlines a set of matters involving the COVID-19 crisis through the exploration of three dimensions: sustainability, health care and economic growth, as follow:
\nThe circular economy has rapidly gathered momentum within sustainable development initiatives due to its potential for decoupling economic development and growth from resource consumption [14, 15]. The industrial circular economy corresponds to π =0, z = 100% and w = 0 in Figure 1. Manufacturing companies play a critical role in the implementation of the circular economy at the industrial level. Success with this role requires a rethinking of the overall value generation logic and the redefinition of business success, by reconfiguring existing business models or creating new business models for the circular economy [16, 17].
\nThe transition of manufacturing companies’ business models to the circular economy is still limited, with low market penetration across sectors. Among several external and internal barriers, manufacturing companies face shortcomings in capabilities and skills and require knowledge and scientific-based guidance for business modeling within the context of the circular economy [18, 19].
\nAcademic literature is unable to support companies adequately, due to a core gap related to the lack of systematized practices to provide guidance and advice to manufacturing companies during the design of business models for the circular economy [20]. Based on this gap, a design research methodology was applied in this research, with the objective of developing a theoretical framework to provide guidance and advice for policy-makers and stakeholders [21].
\nThe workload of the MSW (management solid waste) industry has increased due to significant rises in household consumption in Japan [22] and the construction sector in France [23].
\nThe Center for Disease Control (CDC) is saying the same as the World Health Organization and also what Ocean is saying, that solid waste is not an effective vector for the transmission of corona virus from one person to another by being within six feet of that person. Something people need to be aware of when they are at work, whether it is collecting trash, recycling material or a disposal facility. The CDC just late last week, issued a new waste specific fact sheet [24].
\nThat indicated that corona virus can live on cardboard for up to 24 hours, which causes some concerns in our industry. People are also urged to delay their spring cleaning. Individuals will admit that this has not always been succesfully communicated [25]. As people at home with a lot spare time, they are using it to clean out their attics, garages and basements, and this is generating a significant amount of material that has stressed the system to some extent. Authors are also communicating the importance of not reusing gloves and masks that people are now wearing and that they should be thrown in the trash after use [26].
\nWe can agree that generally individuals do not want to recycle. The material, even though it is mostly made of plastic, is not recycled on the curbside and unfortunately, what we have seen a great deal is many people throwing away gloves and masks on the street, in parking lots and in parks which is bad for public health in the environment [27]. The fact that some facilities are closing due to small amounts of coronavirus on things that are being handled, at a time when the commodity pricing is actually going up, is ironic. There have been a number of facilities that perform recycling that have actually closed. They closed because they were unable to provide sufficient social distancing between workers. However most facilities have been either installing Plexiglas separators between the sorters or pickers on the line or they have been separating the pickers [28, 29].
\nThe commercial sector in the United States shut down a major source of recovered paper. A major source of clean, recovered paper was lost, and so it is our hope that, as the United States returns to something like the new normal, we will see that those paper sources in the commercial sector will be available to recycling facilities [30].
\nThere is an interaction at the weighing facilities and to reduce the potential of exposure to the attendants who work there, the use of cash and the signing of documents is being eliminated. Other steps are being taken to ensure there is as little interaction as possible with customers at drop-off centers, where people go to drop off various types of materials such as glass, books or batteries. Those facilities have seen a significant increase in the number of customers that they are receiving so there is a need to keep the customers six feet apart from each other and also from the staff. Disposal facilities also pose a number of hazards and challenges when a waste, hauler or a private citizen goes through a small facility, whether it is by dumper truck or to bring some boxes from the household, hazardous waste or other material [31].
\nThese facilities are urging people to wear masks. Some people are not happy being asked to wear them at some of the facilities. Some facilities have higher safety measures to maintain distance and enforce their rules. Curbside recycling collection has been suspended in several communities [31]. For the use of vehicles, at recycling plants and composting plants, a number of issues in handling the materials and during maintenance were coming up. In the United States, the drop-off centers are adding to the burden. People are very slowly beginning to go back to work and it is our expectation that this is going to continue and some authors will argue a decrease in the amount of residential waste and an increase in the amount of commercial waste being generated [32].
\nThings were coming to a point where waste management was at risk of stopping because of the worries of the workers and some of their employees, basically there was a very short time frame to sort this out. If it is a commercial collection, maybe it could be stopped, if it is a household collection, it probably could not be, and it cannot be run by a single person because of health and safety or other issues. People could then think about transporting individuals separately through the collection point, and some local authorities in the UK have been taking that approach where they have individually taken collections, from the curbside where the transfer has been done. Other solutions might be screens in the cabs, therefore there is a guidance on screens [33].
\nThere are health and safety issues in assessing the safety of the screen and the material. Whether or not the driver can see through it, whether they can get out of a vehicle safely if there is an accident, and if it is effective in case somebody sneezes and if it will really stop an aerosol from circulating in a cab. There has been quite a lot in the media about viral load and long term exposure to viral load [34].
\nTo what extent can some of the lessons learned in UK composting sites and reducing work exposure to aerosols be translated to the virus or are the particles too small? Authors argued that the reason that has happened is because people in their homes are seeing all this waste being generated and being putting out on the curb which is not usual and seeing it taken away by trucks [35]. Normally, when the garbage truck comes to the house, people are not at home, they are at work, and so the fact that there are these people out there every single day performing this essential service when citizens are told to stay at home has been a way to reinforce the importance of the industry. Authors argue that in the long term, this will benefit the industry in a number of things, but in the short-term, we will continue to have challenges related to reducing exposure because, unfortunately, the virus is very contagious compared to other diseases. It spreads easily, and at least some component of the virus can live on cardboard for a while [36].
\nThere is limited research on the viability of this virus in the recycling stream. As pointed out earlier, we need to make sure that those workers who are working with recycling are not touching the recycled material and being infected by COVID-19 [37].
\nIt is a terrible pandemic, so in terms of waste we have to make sure that people are managing it safely. It also highlights deficiencies in the system in the past which individuals are now having to correct to ensure the health and safety of the workers properly. Maybe now people need to address how we protect our workers in general. People need to make the point and highlight the fact that the message must be quite clear to the citizens and to the overall community through different channels that separate collection and recycling services are a part of the overall waste management system and part of those essential services that must keep running [38]. It would be a bad thing if the message that was sent out was that these kinds of services can be interrupted or can be stopped. The support of the people is needed and would be difficult to get back if lost, as all international researchers assert [39].
\nIt would be interesting to analyze where facilities dedicated to hazardous waste treatment are lacking and countries where sufficient capacities exist. The import of hazardous waste from outside the EU is worrying not because of the lack of business, but because it means that potentially stockpiles of hazardous waste will grow and grow in the coming months, with all associated risks for health and the environment. Authors argue that increase is not really the right word to best define the situation. It would be better to say shift: there is a shift in terms of the nature of hazardous waste, a shift from non-dedicated to dedicated hazardous waste treatment facilities and a shift in the internal movement of waste [40].
\nIt is possible to improve recycling in the time of COVID-19. Particularly, People have to think about the fact that if houses are separating their recyclables or households, they cannot contaminate themselves. There is no reason that any city should tell its citizens not to continue recycling. The point is that only recyclables from one household, which only people in that household have touched, are put out for collection for recycling or put into a bin where somebody else will empty. It does require that cities who find recycling to be important at the city level should think about extra storage and extra capacity.
\nWe are living in unstable and uncertain times due to current health, economic and social instabilities [41]. The significant challenges to the waste industry are putting authorities and waste workers under significant pressure. That is where it is our duty to ensure that our members and the waste management industry have knowledge and information to keep our towns and cities clean and healthy. Proper waste management is an essential public service that cannot be overlooked in this time of crisis [42].
\nPandemics prove to the public worldwide that for crucial issues, scientific support of political decisions and data-driven decision-making is absolutely necessary for a proper response so a new relationship between science and policy is needed. This is something that has been lacking in waste management the last ten or fifteen years [43].
\nThis period marks a return of single-use plastics after three years of efforts to ban them under a specific framework. Thus, single-use plastics are coming back today and this time also with gloves, with masks and with personal protective equipment that might be infectious [27].
\nThis difficult period is not a reason to change our policies and circular economics for plastics and single-use plastics. Authors argue that the plastic industry is trying to use the pandemics as an excuse to delay any new regulation or secretly use plastics, both at a European or national level [44, 45].
\nWe have a range of wastes being generated at the moment and initially it comes down to segregation and while people may be seeing the volumes of personal protective equipment (PPE) and other medical wastes increasing, we have to look at the relative risk of those wastes. Waste from people who treat a COVID-19 patient, will be particularly risky. [46].
\nA lot of medical waste will be produced. There will also be some pharmaceutical waste. There will be ventilated type waste; there will be collection mechanisms for contaminated waste, and proper, genuine medical waste. These wastes need to be collected and treated appropriately, not necessarily by incineration where alternative treatments are in place. They should be genuinely treated as infectious medical wastes. There will be a lot more medical waste in our general waste. It has been argued that if we start to call them social distancing wastes rather than medical wastes, even though they look like medical wastes, some distinctions may be able to be made [47, 48].
\nAuthors claim that many of the patients who have COVID-19 who are very sick and also have other conditions as well. In addition to dealing with the pandemic, people also need to consider that those wastes may also have hepatitis or HIV, as well as those other viruses that we would normally manage as healthcare waste [40, 49]. Individuals have to be aware of the fact that, while this is a very serious pandemic, there are other people that are sick with other diseases, and we have to ensure that these other conditions are managed.
\nAs well as waste, there are other contaminants that could be present. People should be treating anything that is known to be infectious or reliably suspected, and this is where it is not necessary that PPE is classified as medical waste. While authors are seeing pressure from an increasing volume and a decrease in weight into the system, we have to still make sure that we are taking care of health. In effect, COVID-19 is like a little ball of genetic material with a fatty inside with a little protein sticking out of it. People need to ensure that people can use heat when necessary, but not necessarily high temperance in washing. It would be useful to have facilities for washing clothes and washing linen. These wastes should be kept out of the waste stream. People need to ensure that the threat against waste workers is mitigated and that may be done by social distancing and PPE. Welfare facilities that ensure that people can wash their hands should also be given because it is not a good idea that more people get sick [50].
\nIt would also be useful to have facilities to ensure that people can maintain not only their personal hygiene, but also environmental hygiene. As authors argue, as there is an increase in the volume of waste arriving to waste facilities, all need to be operating effectively in this situation. It depends on existing infrastructures and the capacities for the treatment of hazardous waste and it also depends on the strictness of lockdown and how it impacts the industrial activities. It is important to say that the other waste treatment facilities never stop during the crisis. Part of the healthcare waste is treated in hazardous waste incinerators and, during this period, where the quantity and mostly the volume of this care waste rises by twenty to forty percent, all permitted capacities are used [31, 51].
\nA change in the distribution of the different categories of hazardous waste has been observed. Some industrial activities work intensively, for example, the pharmaceutical sector, and others slow down or have even stopped completely, such as the automotive industry and all the suppliers, hazardous waste from households and hazardous waste in small quantities, drums or buckets from refuse collectors. Another important aspect is those non dedicated facilities which treat hazardous waste as a side activity, have slowed down or drastically reduced or even shut down, such as part of the cement industry due to the stopping of activity in the construction sector. Companies have dedicated operators for the treatment of hazardous waste, and they have been able to take over. If we take the case of Europe, we face an increase of transboundary shipments from within the EU to countries where treatment capacities are lacking [38].
\nWaste management has been classed as an essential public service in most countries, which means waste management professionals must navigate the health and safety risks related to coronavirus, although, information about the virus is still evolving [52]. It is essential that countries ensure that waste workers, especially frontline collection and processing employees, are afforded maximum protection and remain safe and can support communities in mitigating the spread of the virus [44]. The medical issue corresponds to π =0, z = 0 and w = 100% in Figure 1.
\nSome governments have been talking somewhat about the role of the public in protecting solid waste workers [53]. One of the byproducts of the corona virus epidemic has been a very significant increase in the amount of residential recycling and that includes making waste materials safe. The government recommends that people do not use loose tissues or wipes to clean down something that could impact the workers [10].
\nFrench and Spanish citizens claim that the first challenge at the beginning of the crisis was to state which of their activities was essential, ensuring that all employees who have to be on-site to operate the facilities can circulate freely during lockdown and be able to secure supplies opportunely. Also, subcontractors facilitate the help of authorities in case of problems. The second action concerned, behaviors and work practices. New safety measures should be applied in order to protect workers by adapting the management of operation teams and their way of working and deploying teleworking. For all others, and last but not least, all necessary personal protective equipment should be provided to everybody, which is probably the trickiest point during this crisis [54, 55].
\nWe are in the middle of the storm, which does not allow us to see clearly what is coming. But at present the most important thing is to take care of people’s health and then employment, which means that people have to understand that we are experiencing a crisis.
\nA recurring question relates to the time frame in which we will emerge from this crisis. In this sense, the recovery curve represents the impact of coronavirus on the economy. This can have a V- shape if the stoppage is abrupt and the reactivation is rapid, which would not be the effect of COVID-19 for many countries. If economic indicators take longer to reach the levels they were before the recession, a U- shape may appear. Finally, if the crisis implies a recession in the economy and a very slow recovery, we would be describing the L-shape [56].
\nThere is widespread uncertainty about the economic effects of the crisis [57]. Some authors argue that the recovery will be similar to that which occurred in China between 2005 and 2013, following the tendency of L-shaped growth [58]. This economic effect may be very different in the other countries. In this case, what counts is the adaptation of the population to this “new normality” [59].
\nThis means that people have to adapt quickly, and be flexible in how they proceed. People have to understand that spirits are exacerbated, and act accordingly, both for employees and employers [60]. The second thing is to know that we are in a situation that demands priorities, and here it is the health issue. It would be interesting to measure this problem and understand that very complex weeks are coming, and take measures to try to stop or mitigate the impacts on the environment through the application of waste management policies [44].
\nIn the first part of this chapter we described three dimensions of analysis, now we will briefly delve into the economic dimension. The economic growth and labor issues corresponds to π = 100%, z = 0 and w = 0 in Figure 1. It is useful to recognize waste management workers by definition, formal and informal, in daily contact with waste, who are more vulnerable than other categories of the population to potential health problems.
\nIn this way, one of the key issues that is arising all over the world is the need to protect waste workers, formal or informal, as a special asset that provides an essential service. Not only the International Labour Organization, but also many unions and NGOs are advocating putting the protection of waste workers in the center of our attention in this period. For countries outside of the EU and North America, outside of the high-income countries, most recycling is done by independent or informal recyclists who collect materials simply to feed their families [41].
\nSome countries which have informal recyclers are countries such as South Africa, but also some countries in Europe such as Serbia. There are many people who cannot eat because they are in lockdown. They would normally be picking up recyclables and now they are not allowed to go out. Also people who are in formalized recycling situations. For those in Colombia or Brazil, the government often tells people to stop recycling. At the same time, we even see in the Netherlands a tremendous amount of littering, and so the environment is changing quickly and nobody is really thinking about what these informal workers actually need [61].
\nSome authors claim that recycling is determined by the country’s income level. Low and middle income countries where most recycling happens by independent or informal recyclers, whether formalized as in Brazil and Colombia, or tolerated or semi formalized as in India should have these systems reestablished [62]. What is really important is to figure out a way for them to continue to provide the service that they provide for the city by managing its recyclables and giving the people and their families a way of making a living by thinking actively about how they can safely go about their work [40].
\nWe really hope that the post-crisis crisis will be the momentum for radical change in society worldwide. We also propose that people should be referring to expert guidance, not only from their national and regional governments, but also coming out of the World Health Organization and also for low-and middle-income countries.
\nThe COVID-19 crisis assumes that the effects are divided among economic growth, medical and sustainability. So how do we distribute the effect and the recovery efforts between these dimensions? How to allocate time and humans resources, not mention which trials and which patients?
\nIn this chapter we have not wanted to give specialized answers from an economic, or medical or environmental point of view, but rather to relate these answers to other topics of interest to society.
\nThere is an abundance of guidance to discuss about the economy, and to adapt it for the environment, and economically, an austere fiscal policy, which prioritizes employment and reactivation, through the optimization of resources and efforts.
\nWe need to reprioritize our priorities. What is important and what is not important is central, and this is why we also need to face changes in human behavior. We want to argue that one of the things that seem to be a very important thing is the idea of solidarity. It is just a matter of finding it with respect to health care waste because there is a great deal that has been written and it is just necessary that persons access that which it is suitable for the situation. We can build all this knowledge during this new situation, every one of us.
\nThe government response needs to act on three issues. First, to ensure that essential services are carried out without any interruption. Secondly, to ensure worker’s safety above any other measure, because we need these teams, we need these people, and we need these heroes on the streets and, thirdly, we need to ensure frequent and easy communication to the citizens to stop fake news and to avoid dissemination of misunderstanding.
\nFinally, a good way to face the crisis is to win small battles, in health, through the territorial management of contagions, in the environment avoiding very long-term objectives, and instead targeting more short- and medium-term goals.
\nThese Terms and Conditions outline the rules and regulations pertaining to the use of IntechOpen’s website www.intechopen.com and all the subdomains owned by IntechOpen located at 5 Princes Gate Court, London, SW7 2QJ, United Kingdom.
',metaTitle:"Terms and Conditions",metaDescription:"These terms and conditions outline the rules and regulations for the use of IntechOpen Website at https://intechopen.com and all its subdomains owned by Intech Limited located at 7th floor, 10 Lower Thames Street, London, EC3R 6AF, UK.",metaKeywords:null,canonicalURL:"/page/terms-and-conditions",contentRaw:'[{"type":"htmlEditorComponent","content":"By accessing the website at www.intechopen.com you are agreeing to be bound by these Terms of Service, all applicable laws and regulations, and agree that you are responsible for compliance with any applicable local laws. Use and/or access to this site is based on full agreement and compliance of these Terms. All materials contained on this website are protected by applicable copyright and trademark laws.
\\n\\nThe following terminology applies to these Terms and Conditions, Privacy Statement, Disclaimer Notice, and any or all Agreements:
\\n\\n“Client”, “Customer”, “You” and “Your” refers to you, the person accessing this website and accepting the Company’s Terms and Conditions;
\\n\\n“The Company”, “Ourselves”, “We”, “Our” and “Us”, refers to our Company, IntechOpen;
\\n\\n“Party”, “Parties”, or “Us”, refers to both the Client and ourselves, or either the Client or ourselves.
\\n\\nAll Terms refer to the offer, acceptance, and consideration of payment necessary to provide assistance to the Client in the most appropriate manner, whether by formal meetings of a fixed duration, or by any other agreed means, for the express purpose of meeting the Client’s needs in respect of provision of the Company’s stated services/products, and in accordance with, and subject to, the prevailing laws of the United Kingdom.
\\n\\nAny use of the above terminology, or other words in the singular, plural, capitalization and/or he/she or they, are taken as interchangeable.
\\n\\nUnless otherwise stated, IntechOpen and/or its licensors own the intellectual property rights for all materials on www.intechopen.com. All intellectual property rights are reserved. You may view, download, share, link and print pages from www.intechopen.com for your own personal use, subject to the restrictions set out in these Terms and Conditions.
\\n\\nWe employ the use of cookies. By using the IntechOpen website you consent to the use of cookies in accordance with IntechOpen’s Privacy Policy. Most modern day interactive websites use cookies to enable the retrieval of user details for each visit. On our site, cookies are predominantly used to enable functionality and ease of use for those visiting the site.
\\n\\nIn no circumstances shall IntechOpen or its suppliers be liable for any damages (including, without limitation, damages for loss of data or profit, or due to business interruption) arising out of the use, or inability to use, the materials on IntechOpen's websites, even if IntechOpen or an IntechOpen authorized representative has been notified orally or in writing of the possibility of such damage. Some jurisdictions do not allow limitations on implied warranties, or limitations of liability for consequential or incidental damages; consequently, these limitations may not apply to you.
\\n\\nIntechopen.com website content and services are provided on an "AS IS" and an "AS AVAILABLE" basis. Material appearing on www.intechopen.com could include minor technical, typographical, or photographic errors. IntechOpen may make changes to any material contained on its website at any time without notice.
\\n\\nIntechOpen has no formal affiliation to any external sites that link to www.intechopen.com, unless otherwise specifically stated. As such, it is not responsible for content that appears on any such sites. The inclusion of any link to IntechOpen does not imply endorsement by IntechOpen. Use of any such linked website is done solely at the user's own discretion.
\\n\\nWe reserve the right of ownership over our entire website www.intechopen.com, and all contents. By using our services, you agree to remove all links to our website immediately upon request. We also reserve the right to amend these Terms and Conditions and our linking policy at any time. By continuing to link to our website, you agree to be bound to, and abide by, these linking Terms and Conditions.
\\n\\nIf you find any link on our website, or any linked website, objectionable for any reason, please Contact Us. We will consider all requests to remove links but will have no obligation to do so.
\\n\\nWithout prior approval and express written permission, you may not create frames around our web pages or use other techniques that alter in any way the visual presentation or appearance of our website.
\\n\\nIntechOpen may revise its Terms of Service for its website at any time without notice. By using this website, you are agreeing to be bound by the current version of all Terms at the time of use.
\\n\\nThese Terms and Conditions are governed by and construed in accordance with the laws of the United Kingdom and you irrevocably submit to the exclusive jurisdiction of the courts in London, United Kingdom.
\\n\\nCroatian version of Terms and Conditions available here
\\n"}]'},components:[{type:"htmlEditorComponent",content:'By accessing the website at www.intechopen.com you are agreeing to be bound by these Terms of Service, all applicable laws and regulations, and agree that you are responsible for compliance with any applicable local laws. Use and/or access to this site is based on full agreement and compliance of these Terms. All materials contained on this website are protected by applicable copyright and trademark laws.
\n\nThe following terminology applies to these Terms and Conditions, Privacy Statement, Disclaimer Notice, and any or all Agreements:
\n\n“Client”, “Customer”, “You” and “Your” refers to you, the person accessing this website and accepting the Company’s Terms and Conditions;
\n\n“The Company”, “Ourselves”, “We”, “Our” and “Us”, refers to our Company, IntechOpen;
\n\n“Party”, “Parties”, or “Us”, refers to both the Client and ourselves, or either the Client or ourselves.
\n\nAll Terms refer to the offer, acceptance, and consideration of payment necessary to provide assistance to the Client in the most appropriate manner, whether by formal meetings of a fixed duration, or by any other agreed means, for the express purpose of meeting the Client’s needs in respect of provision of the Company’s stated services/products, and in accordance with, and subject to, the prevailing laws of the United Kingdom.
\n\nAny use of the above terminology, or other words in the singular, plural, capitalization and/or he/she or they, are taken as interchangeable.
\n\nUnless otherwise stated, IntechOpen and/or its licensors own the intellectual property rights for all materials on www.intechopen.com. All intellectual property rights are reserved. You may view, download, share, link and print pages from www.intechopen.com for your own personal use, subject to the restrictions set out in these Terms and Conditions.
\n\nWe employ the use of cookies. By using the IntechOpen website you consent to the use of cookies in accordance with IntechOpen’s Privacy Policy. Most modern day interactive websites use cookies to enable the retrieval of user details for each visit. On our site, cookies are predominantly used to enable functionality and ease of use for those visiting the site.
\n\nIn no circumstances shall IntechOpen or its suppliers be liable for any damages (including, without limitation, damages for loss of data or profit, or due to business interruption) arising out of the use, or inability to use, the materials on IntechOpen's websites, even if IntechOpen or an IntechOpen authorized representative has been notified orally or in writing of the possibility of such damage. Some jurisdictions do not allow limitations on implied warranties, or limitations of liability for consequential or incidental damages; consequently, these limitations may not apply to you.
\n\nIntechopen.com website content and services are provided on an "AS IS" and an "AS AVAILABLE" basis. Material appearing on www.intechopen.com could include minor technical, typographical, or photographic errors. IntechOpen may make changes to any material contained on its website at any time without notice.
\n\nIntechOpen has no formal affiliation to any external sites that link to www.intechopen.com, unless otherwise specifically stated. As such, it is not responsible for content that appears on any such sites. The inclusion of any link to IntechOpen does not imply endorsement by IntechOpen. Use of any such linked website is done solely at the user's own discretion.
\n\nWe reserve the right of ownership over our entire website www.intechopen.com, and all contents. By using our services, you agree to remove all links to our website immediately upon request. We also reserve the right to amend these Terms and Conditions and our linking policy at any time. By continuing to link to our website, you agree to be bound to, and abide by, these linking Terms and Conditions.
\n\nIf you find any link on our website, or any linked website, objectionable for any reason, please Contact Us. We will consider all requests to remove links but will have no obligation to do so.
\n\nWithout prior approval and express written permission, you may not create frames around our web pages or use other techniques that alter in any way the visual presentation or appearance of our website.
\n\nIntechOpen may revise its Terms of Service for its website at any time without notice. By using this website, you are agreeing to be bound by the current version of all Terms at the time of use.
\n\nThese Terms and Conditions are governed by and construed in accordance with the laws of the United Kingdom and you irrevocably submit to the exclusive jurisdiction of the courts in London, United Kingdom.
\n\nCroatian version of Terms and Conditions available here
\n'}]},successStories:{items:[]},authorsAndEditors:{filterParams:{sort:"featured,name"},profiles:[{id:"6700",title:"Dr.",name:"Abbass A.",middleName:null,surname:"Hashim",slug:"abbass-a.-hashim",fullName:"Abbass A. Hashim",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/6700/images/1864_n.jpg",biography:"Currently I am carrying out research in several areas of interest, mainly covering work on chemical and bio-sensors, semiconductor thin film device fabrication and characterisation.\nAt the moment I have very strong interest in radiation environmental pollution and bacteriology treatment. The teams of researchers are working very hard to bring novel results in this field. 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After obtaining a Master's degree in Mechanical Engineering, he continued his PhD studies in Robotics at the Vienna University of Technology. Here he worked as a robotic researcher with the university's Intelligent Manufacturing Systems Group as well as a guest researcher at various European universities, including the Swiss Federal Institute of Technology Lausanne (EPFL). During this time he published more than 20 scientific papers, gave presentations, served as a reviewer for major robotic journals and conferences and most importantly he co-founded and built the International Journal of Advanced Robotic Systems- world's first Open Access journal in the field of robotics. Starting this journal was a pivotal point in his career, since it was a pathway to founding IntechOpen - Open Access publisher focused on addressing academic researchers needs. Alex is a personification of IntechOpen key values being trusted, open and entrepreneurial. Today his focus is on defining the growth and development strategy for the company.",institutionString:null,institution:{name:"TU Wien",country:{name:"Austria"}}},{id:"19816",title:"Prof.",name:"Alexander",middleName:null,surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/19816/images/1607_n.jpg",biography:"Alexander I. Kokorin: born: 1947, Moscow; DSc., PhD; Principal Research Fellow (Research Professor) of Department of Kinetics and Catalysis, N. Semenov Institute of Chemical Physics, Russian Academy of Sciences, Moscow.\r\nArea of research interests: physical chemistry of complex-organized molecular and nanosized systems, including polymer-metal complexes; the surface of doped oxide semiconductors. He is an expert in structural, absorptive, catalytic and photocatalytic properties, in structural organization and dynamic features of ionic liquids, in magnetic interactions between paramagnetic centers. The author or co-author of 3 books, over 200 articles and reviews in scientific journals and books. He is an actual member of the International EPR/ESR Society, European Society on Quantum Solar Energy Conversion, Moscow House of Scientists, of the Board of Moscow Physical Society.",institutionString:null,institution:{name:"Semenov Institute of Chemical Physics",country:{name:"Russia"}}},{id:"62389",title:"PhD.",name:"Ali Demir",middleName:null,surname:"Sezer",slug:"ali-demir-sezer",fullName:"Ali Demir Sezer",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62389/images/3413_n.jpg",biography:"Dr. Ali Demir Sezer has a Ph.D. from Pharmaceutical Biotechnology at the Faculty of Pharmacy, University of Marmara (Turkey). He is the member of many Pharmaceutical Associations and acts as a reviewer of scientific journals and European projects under different research areas such as: drug delivery systems, nanotechnology and pharmaceutical biotechnology. Dr. Sezer is the author of many scientific publications in peer-reviewed journals and poster communications. Focus of his research activity is drug delivery, physico-chemical characterization and biological evaluation of biopolymers micro and nanoparticles as modified drug delivery system, and colloidal drug carriers (liposomes, nanoparticles etc.).",institutionString:null,institution:{name:"Marmara University",country:{name:"Turkey"}}},{id:"61051",title:"Prof.",name:"Andrea",middleName:null,surname:"Natale",slug:"andrea-natale",fullName:"Andrea Natale",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"100762",title:"Prof.",name:"Andrea",middleName:null,surname:"Natale",slug:"andrea-natale",fullName:"Andrea Natale",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"St David's Medical Center",country:{name:"United States of America"}}},{id:"107416",title:"Dr.",name:"Andrea",middleName:null,surname:"Natale",slug:"andrea-natale",fullName:"Andrea Natale",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Texas Cardiac Arrhythmia",country:{name:"United States of America"}}},{id:"64434",title:"Dr.",name:"Angkoon",middleName:null,surname:"Phinyomark",slug:"angkoon-phinyomark",fullName:"Angkoon Phinyomark",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/64434/images/2619_n.jpg",biography:"My name is Angkoon Phinyomark. I received a B.Eng. degree in Computer Engineering with First Class Honors in 2008 from Prince of Songkla University, Songkhla, Thailand, where I received a Ph.D. degree in Electrical Engineering. My research interests are primarily in the area of biomedical signal processing and classification notably EMG (electromyography signal), EOG (electrooculography signal), and EEG (electroencephalography signal), image analysis notably breast cancer analysis and optical coherence tomography, and rehabilitation engineering. I became a student member of IEEE in 2008. During October 2011-March 2012, I had worked at School of Computer Science and Electronic Engineering, University of Essex, Colchester, Essex, United Kingdom. In addition, during a B.Eng. I had been a visiting research student at Faculty of Computer Science, University of Murcia, Murcia, Spain for three months.\n\nI have published over 40 papers during 5 years in refereed journals, books, and conference proceedings in the areas of electro-physiological signals processing and classification, notably EMG and EOG signals, fractal analysis, wavelet analysis, texture analysis, feature extraction and machine learning algorithms, and assistive and rehabilitative devices. I have several computer programming language certificates, i.e. Sun Certified Programmer for the Java 2 Platform 1.4 (SCJP), Microsoft Certified Professional Developer, Web Developer (MCPD), Microsoft Certified Technology Specialist, .NET Framework 2.0 Web (MCTS). 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