Antibacterial action of manuka and medihoney against various strains of
\r\n\tThe WHO classification in 2007; was based on the histogenesis and cell origin of the tumor. In the latest classification made in 2016; to better characterize the tumor and obtain better data on its prognosis; The combination of molecular and genetic biomarkers and histopathological features of the tumor was used. Despite all current treatment approaches, the median survival time is around 12 months in most GBM patients. Compared with the situation of some types of successfully treated cancers; the survival time of GBM patients is not at an acceptable level today. In the treatment of CNS tumors; surgery, chemotherapy, and radiation treatments (x-rays, gamma rays, electron and proton beams) are used. The therapeutic potential of chemotherapy; New strategies are needed to increase drug concentration at the diseased site, as this largely depends on the ability of the chemotherapeutic agent to achieve effective concentrations at tumor localization. Based on our better understanding of the genetic and molecular characteristics of CNS tumors; Targeted therapies, including vaccines, and treatment protocols such as immunotherapy are promising developments.
\r\n\r\n\tThis book supposes to be written by many authors who have an internationally honored place in their field to share their ideas about the treatment of CNS tumors. Surgery, Radiotherapy, Chemotherapy and Antiangiogenic Therapy Protocols, Immunotherapy, Molecular Therapy, Specific target-agents therapy with Nanoparticles and Gene Therapy for CNS tumors among the book chapters.
\r\n\tIn these sections; there are many practical pieces of information that can help the students who graduated from the Medicine Faculty and specialist doctors who are interested in Neurosurgery.
MRSA is a major cause of severe healthcare-associated (HA) infections. Although during the last decade, the incidence of HA invasive infections have dropped, accounts of community-associated MRSA (CA-MRSA) infections have soared among the general populace [3, 4, 5, 6, 7]. Globally, MRSA remains one of the most important multidrug-resistant bacteria reported to account for most cSSTIs such as surgical wounds [8] and is also responsible for the high morbidity and mortality cases due to HA infections. The use of orthodox antibiotics has been the mainstay of treatment for these infections. Though the world’s encounter with antibiotics has been beneficial, several reports have suggested that many antibiotics that used to be seen as “miraculous drugs” have witnessed a low efficacy and this has threatened the life of humanity as never before. The rapid emergence of “superbugs” such as MRSA bacteria that are highly resistant to many classes of antibiotics is the major cause of this sad development. Infections due to MRSA, in comparison with MSSA, are associated with a greater risk of treatment failure, increased patient mortality, and higher costs. Owing to irrational and excessive antibiotic use, the bacterium-
Honey is a sugary thick fluid that has been in use for almost 5500 years back. In the Sumerian tablet, the earliest inscribed information on honey for nutrition and medicinal purposes was found in 2100–2000 B.C. This chapter discusses the fact that though honey is an ancient remedy, its relevance and application in complicated and chronic infected wounds in modern medicine is still relevant and should be re-visited. This piece provides data on the
Honey according to Codex Alimentarius, 2001 is “the natural sweet substance produced by honey bees from the nectar of plants or secretions of living parts of plants or excretions of plant-sucking insects on the living parts of plants, which the bees collect, transform by combining with specific substances of their own, deposit, dehydrate, supply and leave in the honeycomb to ripen and mature”. Honey is classified based on many criteria. Based on its nutritional and medicinal applications, two main kinds are known, namely medical and non-medical grades. Fresh honey which has not been exposed to irradiation are referred to as non-medical grade whereas those with radiation exposure are usually called medical grade honey (MGH). Fresh honey can contain bacterial spores, mainly those of bacillus species, and spores of the notorious pathogen Clostridium botulinum, which can cause wound botulism or gangrene. The likely presence of these microorganisms calls for the sterilization of honey through gamma-irradiation to destroy these bacterial spores and other microorganisms. Honey that has passed through this process is referred to as medical-grade honey (MGH) and approved for use in clinical settings. Manuka and medihoney (Comvita, NZ), one of the few honeys that appear to have FDA approval for clinical applications.
The limited knowledge of anti-bacterial compounds in honey and the variability of anti-bacterial activity of other types of honey are however major obstacles to the applicability in clinical use. This section presents information on the antibacterial effects of MGH mentioned earlier and the contribution of individual components in its antimicrobial action. Studies have shown that MGH comprises primarily fructose, glucose, sucrose, water, organic acids, flavonoids, phenolic acids, as well as minor components such as peptides [bee defensin-1 and 2, hemenopectin, apidaecin], enzymes [diastase, invertase, glucose oxidase] amino acids and vitamins [10, 11]. It is important to note that the bioactive components of honey can vary due to the different botanic and geographic origins [12].
In the past four decades, there have been various studies regarding honey and its components and how it drives the anti-bacteria character. Several studies have shown that no “stubborn” or resistant bacteria can be isolated after subjecting isolates of MRSA obtained from wound to various concentrations of MGH or MGH-based dressings [13, 14, 15, 16]. This is reported to be as a result of the fact that these types of honey contain various antibacterial constituents and conditions such as low pH, high sugar content, methylglyoxyl (MGO), hydrogen peroxide, antimicrobial peptides (bee defensin-1) and other active substances [10, 17, 18]. It is of interest to note that MGO has been identified as one of the principal antimicrobic ingredient of most MGHs [19, 20]. Cooper and colleagues in 2010, demonstrated that some honeys also contain an antimicrobial peptide (bee defensin-1), which contributes substantially to bactericidal activity [14].
The antimicrobial qualities are critical in dermatologic applications, owing to the presence of active constituents, like MGO and antimicrobial peptides. MGH-based dressings are appropriate for the dressing of wounds and burns and have also been included in treatment therapy against diseases such as diaper dermatitis, dandruff, pityriasis, and psoriasis. It also exerts emollient, humectant, soothing, and hair conditioning effects, keeps the skin juvenile and retards wrinkle formation, regulates pH, and prevents pathogen infections [21]. Studies have also shown that Community-associated methicillin-resistant
Type of Honey | MIC | Test method | Reference | |
---|---|---|---|---|
Manuka | 34 𝜇g | O4–277-35671 | Broth microdilution | [24] |
Manuka | 8.0 w/v % | NCTC83253 | Microdilution assay | [25] |
8.0 w/v % | RPAH181,2 | |||
8.0 w/v % | MW21,2 | |||
Medihoney | 4.2 w/v % | MRSA2 | Agar dilution method | [15] |
4.1 w/v % | Non-MRSA Clinical isolate1 | |||
4.2 w/v % | Resistant to all antibiotics4 | |||
4.4 w/v % | sensitive to all antibiotics5 | |||
Medihoney | 8.0 w/v % | NCT83253 | Microdilution assay | [25] |
8.0 w/v % | RPAH181,2 | |||
8.0 w/v % | MW21,2 | |||
Manuka | 3.0 v/v | MRSA1 | Broth dilution method | [26] |
3.0 v/v | MRSA2 | |||
3.0 v/v | MRSA3 | |||
3.0 v/v | MRSA4 | |||
3.0 v/v | MRSA5 | |||
3.0 v/v | MRSA6 | |||
3.0 v/v | MRSA7 | |||
3.0 v/v | MRSA8 | |||
3.0 v/v | MRSA9 | |||
3.0 v/v | MRSA10 | |||
3.0 v/v | MRSA11 | |||
3.0 v/v | MRSA12 | |||
3.0 v/v | MRSA13 | |||
3.0 v/v | MRSA14 | |||
3.0 v/v | MRSA15 | |||
3.0 v/v | MRSA16 | |||
2.7 v/v | MRSA17 | |||
Manuka | 12.5 v/v | MRSA ATCC 433003 | Broth dilution method | [26] |
12.5 v/v | MRSA 07912 | |||
12.5 v/v | MRSA 289652 | |||
12.5 v/v | MRSA 013222 | |||
12.5 v/v | MRSA 07452 | |||
Medihoney | 4.0 v/v | BORSA mecA neg1 | Broth dilution method | [23] |
4.0 v/v | Multiresistant mecA neg1 | |||
4.0 v/v | Multiresistant2 | |||
4.0 v/v | Non-multiresistant2 | |||
Manuka | 60000 mg/ml | EMRA-15 NCTC 131422 | E-test strip | [27] |
60000 mg/ml | Broth dilution | |||
60000 mg/ml | Checker board | |||
60000 mg/ml | Time kill curve |
Antibacterial action of manuka and medihoney against various strains of
Non-MRSA Clinical isolate1; MRSA2; Non–MRSA Lab strain3; Resistant to all antibiotics4; Isolates sensitive to all antibiotics5.
MIC- Minimum Inhibitory Concentration; ZI- Zone of Inhibition; R- Resistant.
One of the ways to curb the upsurge in antimicrobial resistance is to introduce novel approaches to combat these pathogens. Merging antimicrobial drugs with other agents such as honey that counteract and obstruct the antibiotic resistant mechanisms expressed by these pathogens is a novel strategy. The natural product, honey, is gaining acceptance as an alternative antimicrobial agent. Medical grade honey offers a favorable alternative for topical use, as a single or a multi-component agent in combination with other antibiotics [28]. One of the approaches to fight antimicrobial resistance is combination drug therapy [29]. This upturns efficacy and enhances the value of existing antimicrobials in the dearth of new antibiotics discovery and development. There are instances where, combining antimicrobial agents have made drug action synergistic. This has the benefits of lessening both the treatment costs and the risk of possible side effects owing to the reduced concentrations of both agents used [29]. This phenomenon is especially vital for chronic wounds where antibiotic therapy is usually applied for long-term. Moreover, combining antibiotics and other drug agents is reported to exhibit different, modes of action and as such reduces the risk of resistance arising during treatment.
Honey is a natural product substance applied in different forms such as gels for topical management of infected chronic wounds [30]. MGH-based dressings have been licensed by some national health authorities and are available to health professionals in many countries. Honey has a multifaceted substance [20] with well-known, broad-spectrum antibacterial activity against a various microorganism, including those that are commonly associated with chronic wounds such as
Type of Honey | Antibiotics | FICI | Test method | Reference | |
---|---|---|---|---|---|
Manuka | Rifampicin | RPAH182 | Checkerboard | [33] | |
MW22 | 0.45 | ||||
IMVS672 | Microdilution assay | ||||
O4–277-35671 | |||||
Manuka | NCTC83253 | 0.445 | Agar diffusion test | [25] | |
Rifampicin | RPAH181,2 | 0.405 | |||
MW21,2 | 0.435 | ||||
O4–277-35672 | 0.445 | ||||
Clindamycin | NCTC83253 | 0.405 | |||
RPAH181,2 | 2 | ||||
MW21,2 | 0.275 | ||||
O4–277-35672 | 0.405 | ||||
Gentamycin | NCTC83253 | 0.8782 | |||
RPAH181,2 | 2 | ||||
MW21,2 | 1.07 | ||||
O4–277-35672 | 0.955 | ||||
Oxacillin | NCTC83253 | 0.405 | |||
RPAH181,2 | 0.8782 | ||||
MW21,2 | 0.753 | ||||
O4–277-35672 | 0.407 | ||||
Medihoney | Rifampicin | NCTC83253 | 0.445 | Agar diffusion test | [25] |
RPAH181,2 | 0.405 | ||||
MW21,2 | 0.435 | ||||
O4–277-35672 | 0.445 | ||||
Clindamycin | NCTC83253 | 0.405 | |||
RPAH181,2 | 2 | ||||
MW21,2 | 0.405 | ||||
O4–277-35672 | 0.405 | ||||
Gentamycin | NCTC83253 | 1.197 | |||
RPAH181,2 | 2 | ||||
MW21,2 | 1.195 | ||||
O4–277-35672 | 0.955 | ||||
Medihoney | Oxacillin | NCTC83253 | 0.405 | ||
RPAH181,2 | 0.8782 | ||||
MW21,2 | 0.753 | ||||
O4–277-35672 | 0.407 | ||||
Manuka | Oxacillin | EMRSA-15 NCTC 131422 | 0.001 | Etest strip | [27] |
Broth dilution | |||||
Checker board | |||||
Time kill curve |
Combinatorial effects of manuka and medihoney and antibiotics against S. aureus strains.
The fractional inhibitory concentration index (FICI) range of 0.5 to 4.0 is usually used to define additivity results in most combination studies. The fractional inhibitory concentration index (FICI) is calculated as the sum of the minimum inhibitory concentration (MIC) of each compound divided by the MIC of one compound used alone. Synergy and antagonism are defined by FICI ≤ 0.5 and FICI > 4 respectively, while FICI > 0.5 or 4 ≤ is considered indifferent.
It is clear that MGH combining with gentamicin or clindamycin recorded the highest FICI compared with other antibiotics used as shown on Table 2.
Non-MRSA Clinical isolate1; MRSA2; Non–MRSA Lab strain3.
Understanding how MGH impacts the action of orthodox antibiotics and their mode on action may broaden our knowledge of how honey affects these pathogens. It is important to state that much evidence would be displayed using data on manuka honey because much research has been undertaken on it since sterile preparations of it is available commercially. According to a publication by Majtan, in 2014 there is no evidence of damage to host cells, when MGH is either consumed orally or used as a wound dressing. Honey appears to stimulate healing and reduce scarring when applied to wounds [34].
The antibacterial property of honey has been linked to some mechanisms. The high osmolarity of honey as a result of its high sugar content inhibits microbial growth [35]; the sugar molecules within the honey hold onto the water molecules, thereby denying the bacteria enough water to support their growth. However, this effect gets lessened as the honey becomes more diluted by wound exudates.
There is another mechanism that lies in the fact that its antimicrobial properties are retained, even when the honey is diluted by wound exudate. This is partly due to the presence of hydrogen peroxide, which is slowly released as a result of the action of glucose oxidase present in the honey. The latter gets diluted by the exudate and in the process becomes activated [36].
Biofilms are generally populations of cells typically covered in a self-produced extracellular matrix and usually clinging on surfaces such as teeth, implanted devices and wounds. Generally, these microbes in biofilms are safeguarded from antimicrobial agents which can lead to stubborn infections. MGH is reported to disrupt cellular aggregates and averts the formation of biofilms formed by many pathogens, including
MGH has been used on animals with accidental or surgical wounds, such as rhinos, Horses, etc., with positive outcomes [42, 43]. Case reports using MGH for non-healing wounds and ulcers have recorded substantial improvement where conventional antibiotics had failed [44, 45, 46, 47, 48].
In the intervention studies, the treatment of non-healing wounds with MGH-based dressings resulted in a higher number of completely healed wounds and a faster rate of wound size reduction. Also, it was observed that wound odor was neutralized with the provision of topical protection, and a reduction in wound pain intensity.
There is evidence from case studies of MGH-based dressing used to treat wounds that have failed with treatment with orthodox antibiotics. Though MGH has shown potent antibacterial actions in the past three decades and has high potential for use to treat chronic wounds caused by
Meanwhile there are challenges that cannot be overlooked. There are countless reasons for this, including technical challenges in performing a double-blind placebo-controlled trial on a distinctive substance like honey. The issue of ethical considerations and lack of interest by clinical practitioners are other worries that affect patronage. Additionally, the use of honey ointment has been portrayed as messy as it leaves behind a sticky residue [50]. There are also apprehensions with the application of honey to vertical wounds in ambulatory patients. The newer honey-dressings have resolved such issues and there appears to be good ease of use, retention and removal and patient comfort with MGH- impregnated tulle.
There has been a collective effort to find or develop novel agents with antimicrobial activity in order to increase the collection of drugs against methicillin-resistant
The authors declare no conflict of interest.
We are grateful to Professor Michael D. Wilson for continuous support.
This is a brief overview of the main steps involved in publishing with IntechOpen Compacts, Monographs and Edited Books. Once you submit your proposal you will be appointed a Author Service Manager who will be your single point of contact and lead you through all the described steps below.
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Her research interests include archaea metabolism, enzymes purification and characterization, gene regulation, carotenoids and bioplastics production, antioxidant\ncompounds, waste water treatments, and brines bioremediation.\nRosa María’s other roles include editorial board member for several journals related\nto biochemistry, reviewer for more than 60 journals (biochemistry, molecular biology, biotechnology, chemistry and microbiology) and president of several organizing committees in international meetings related to the N-cycle or respiratory processes.",institutionString:null,institution:{name:"University of Alicante",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"15",title:"Chemical Biology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/15.jpg",isOpenForSubmission:!0,editor:{id:"441442",title:"Dr.",name:"Şükrü",middleName:null,surname:"Beydemir",slug:"sukru-beydemir",fullName:"Şükrü Beydemir",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003GsUoIQAV/Profile_Picture_1634557147521",biography:"Dr. Şükrü Beydemir obtained a BSc in Chemistry in 1995 from Yüzüncü Yıl University, MSc in Biochemistry in 1998, and PhD in Biochemistry in 2002 from Atatürk University, Turkey. 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Waisundara",profilePictureURL:"https://mts.intechopen.com/storage/users/194281/images/system/194281.jpg",biography:"Dr. Viduranga Waisundara obtained her Ph.D. in Food Science\nand Technology from the Department of Chemistry, National\nUniversity of Singapore, in 2010. She was a lecturer at Temasek Polytechnic, Singapore from July 2009 to March 2013.\nShe relocated to her motherland of Sri Lanka and spearheaded the Functional Food Product Development Project at the\nNational Institute of Fundamental Studies from April 2013 to\nOctober 2016. She was a senior lecturer on a temporary basis at the Department of\nFood Technology, Faculty of Technology, Rajarata University of Sri Lanka. She is\ncurrently Deputy Principal of the Australian College of Business and Technology –\nKandy Campus, Sri Lanka. She is also the Global Harmonization Initiative (GHI)",institutionString:"Australian College of Business & Technology",institution:{name:"Kobe College",institutionURL:null,country:{name:"Japan"}}}]},{type:"book",id:"6820",title:"Keratin",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/6820.jpg",slug:"keratin",publishedDate:"December 19th 2018",editedByType:"Edited by",bookSignature:"Miroslav Blumenberg",hash:"6def75cd4b6b5324a02b6dc0359896d0",volumeInSeries:2,fullTitle:"Keratin",editors:[{id:"31610",title:"Dr.",name:"Miroslav",middleName:null,surname:"Blumenberg",slug:"miroslav-blumenberg",fullName:"Miroslav Blumenberg",profilePictureURL:"https://mts.intechopen.com/storage/users/31610/images/system/31610.jpg",biography:"Miroslav Blumenberg, Ph.D., was born in Subotica and received his BSc in Belgrade, Yugoslavia. He completed his Ph.D. at MIT in Organic Chemistry; he followed up his Ph.D. with two postdoctoral study periods at Stanford University. Since 1983, he has been a faculty member of the RO Perelman Department of Dermatology, NYU School of Medicine, where he is codirector of a training grant in cutaneous biology. Dr. Blumenberg’s research is focused on the epidermis, expression of keratin genes, transcription profiling, keratinocyte differentiation, inflammatory diseases and cancers, and most recently the effects of the microbiome on the skin. He has published more than 100 peer-reviewed research articles and graduated numerous Ph.D. and postdoctoral students.",institutionString:null,institution:{name:"New York University Langone Medical Center",institutionURL:null,country:{name:"United States of America"}}}]},{type:"book",id:"7978",title:"Vitamin A",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/7978.jpg",slug:"vitamin-a",publishedDate:"May 15th 2019",editedByType:"Edited by",bookSignature:"Leila Queiroz Zepka, Veridiana Vera de Rosso and Eduardo Jacob-Lopes",hash:"dad04a658ab9e3d851d23705980a688b",volumeInSeries:3,fullTitle:"Vitamin A",editors:[{id:"261969",title:"Dr.",name:"Leila",middleName:null,surname:"Queiroz Zepka",slug:"leila-queiroz-zepka",fullName:"Leila Queiroz Zepka",profilePictureURL:"https://mts.intechopen.com/storage/users/261969/images/system/261969.png",biography:"Prof. Dr. Leila Queiroz Zepka is currently an associate professor in the Department of Food Technology and Science, Federal University of Santa Maria, Brazil. She has more than fifteen years of teaching and research experience. She has published more than 550 scientific publications/communications, including 15 books, 50 book chapters, 100 original research papers, 380 research communications in national and international conferences, and 12 patents. She is a member of the editorial board of five journals and acts as a reviewer for several national and international journals. 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Working with large volumes of data has given him a good command of big data processing tools and NoSQL databases. He has also been a visiting scholar at the Knowledge Engineering and Discovery Research Institute, Auckland University of Technology.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"314575",title:"Dr.",name:"Jesus",middleName:null,surname:"L. Lobo",slug:"jesus-l.-lobo",fullName:"Jesus L. Lobo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314575/images/system/314575.png",biography:"Dr. Jesús López is currently based in Bilbao (Spain) working at TECNALIA as Artificial Intelligence Research Scientist. In most cases, a project idea or a new research line needs to be investigated to see if it is good enough to take into production or to focus on it. That is exactly what he does, diving into Machine Learning algorithms and technologies to help TECNALIA to decide whether something is great in theory or will actually impact on the product or processes of its projects. So, he is expert at framing experiments, developing hypotheses, and proving whether they’re true or not, in order to investigate fundamental problems with a longer time horizon. He is also able to design and develop PoCs and system prototypes in simulation. He has participated in several national and internacional R&D projects.\n\nAs another relevant part of his everyday research work, he usually publishes his findings in reputed scientific refereed journals and international conferences, occasionally acting as reviewer and Programme Commitee member. Concretely, since 2018 he has published 9 JCR (8 Q1) journal papers, 9 conference papers (e.g. ECML PKDD 2021), and he has co-edited a book. He is also active in popular science writing data science stories for reputed blogs (KDNuggets, TowardsDataScience, Naukas). Besides, he has recently embarked on mentoring programmes as mentor, and has also worked as data science trainer.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"103779",title:"Prof.",name:"Yalcin",middleName:null,surname:"Isler",slug:"yalcin-isler",fullName:"Yalcin Isler",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRyQ8QAK/Profile_Picture_1628834958734",biography:"Yalcin Isler (1971 - Burdur / Turkey) received the B.Sc. degree in the Department of Electrical and Electronics Engineering from Anadolu University, Eskisehir, Turkey, in 1993, the M.Sc. degree from the Department of Electronics and Communication Engineering, Suleyman Demirel University, Isparta, Turkey, in 1996, the Ph.D. degree from the Department of Electrical and Electronics Engineering, Dokuz Eylul University, Izmir, Turkey, in 2009, and the Competence of Associate Professorship from the Turkish Interuniversity Council in 2019.\n\nHe was Lecturer at Burdur Vocational School in Suleyman Demirel University (1993-2000, Burdur / Turkey), Software Engineer (2000-2002, Izmir / Turkey), Research Assistant in Bulent Ecevit University (2002-2003, Zonguldak / Turkey), Research Assistant in Dokuz Eylul University (2003-2010, Izmir / Turkey), Assistant Professor at the Department of Electrical and Electronics Engineering in Bulent Ecevit University (2010-2012, Zonguldak / Turkey), Assistant Professor at the Department of Biomedical Engineering in Izmir Katip Celebi University (2012-2019, Izmir / Turkey). He is an Associate Professor at the Department of Biomedical Engineering at Izmir Katip Celebi University, Izmir / Turkey, since 2019. In addition to academics, he has also founded Islerya Medical and Information Technologies Company, Izmir / Turkey, since 2017.\n\nHis main research interests cover biomedical signal processing, pattern recognition, medical device design, programming, and embedded systems. He has many scientific papers and participated in several projects in these study fields. He was an IEEE Student Member (2009-2011) and IEEE Member (2011-2014) and has been IEEE Senior Member since 2014.",institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",country:{name:"Turkey"}}},{id:"339677",title:"Dr.",name:"Mrinmoy",middleName:null,surname:"Roy",slug:"mrinmoy-roy",fullName:"Mrinmoy Roy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/339677/images/16768_n.jpg",biography:"An accomplished Sales & Marketing professional with 12 years of cross-functional experience in well-known organisations such as CIPLA, LUPIN, GLENMARK, ASTRAZENECA across different segment of Sales & Marketing, International Business, Institutional Business, Product Management, Strategic Marketing of HIV, Oncology, Derma, Respiratory, Anti-Diabetic, Nutraceutical & Stomatological Product Portfolio and Generic as well as Chronic Critical Care Portfolio. A First Class MBA in International Business & Strategic Marketing, B.Pharm, D.Pharm, Google Certified Digital Marketing Professional. Qualified PhD Candidate in Operations and Management with special focus on Artificial Intelligence and Machine Learning adoption, analysis and use in Healthcare, Hospital & Pharma Domain. Seasoned with diverse therapy area of Pharmaceutical Sales & Marketing ranging from generating revenue through generating prescriptions, launching new products, and making them big brands with continuous strategy execution at the Physician and Patients level. Moved from Sales to Marketing and Business Development for 3.5 years in South East Asian Market operating from Manila, Philippines. Came back to India and handled and developed Brands such as Gluconorm, Lupisulin, Supracal, Absolut Woman, Hemozink, Fabiflu (For COVID 19), and many more. In my previous assignment I used to develop and execute strategies on Sales & Marketing, Commercialization & Business Development for Institution and Corporate Hospital Business portfolio of Oncology Therapy Area for AstraZeneca Pharma India Ltd. Being a Research Scholar and Student of ‘Operations Research & Management: Artificial Intelligence’ I published several pioneer research papers and book chapters on the same in Internationally reputed journals and Books indexed in Scopus, Springer and Ei Compendex, Google Scholar etc. Currently, I am launching PGDM Pharmaceutical Management Program in IIHMR Bangalore and spearheading the course curriculum and structure of the same. I am interested in Collaboration for Healthcare Innovation, Pharma AI Innovation, Future trend in Marketing and Management with incubation on Healthcare, Healthcare IT startups, AI-ML Modelling and Healthcare Algorithm based training module development. I am also an affiliated member of the Institute of Management Consultant of India, looking forward to Healthcare, Healthcare IT and Innovation, Pharma and Hospital Management Consulting works.",institutionString:null,institution:{name:"Lovely Professional University",country:{name:"India"}}},{id:"310576",title:"Prof.",name:"Erick Giovani",middleName:null,surname:"Sperandio Nascimento",slug:"erick-giovani-sperandio-nascimento",fullName:"Erick Giovani Sperandio Nascimento",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y00002pDKxDQAW/ProfilePicture%202022-06-20%2019%3A57%3A24.788",biography:"Prof. Erick Sperandio is the Lead Researcher and professor of Artificial Intelligence (AI) at SENAI CIMATEC, Bahia, Brazil, also working with Computational Modeling (CM) and HPC. He holds a PhD in Environmental Engineering in the area of Atmospheric Computational Modeling, a Master in Informatics in the field of Computational Intelligence and Graduated in Computer Science from UFES. He currently coordinates, leads and participates in R&D projects in the areas of AI, computational modeling and supercomputing applied to different areas such as Oil and Gas, Health, Advanced Manufacturing, Renewable Energies and Atmospheric Sciences, advising undergraduate, master's and doctoral students. He is the Lead Researcher at SENAI CIMATEC's Reference Center on Artificial Intelligence. In addition, he is a Certified Instructor and University Ambassador of the NVIDIA Deep Learning Institute (DLI) in the areas of Deep Learning, Computer Vision, Natural Language Processing and Recommender Systems, and Principal Investigator of the NVIDIA/CIMATEC AI Joint Lab, the first in Latin America within the NVIDIA AI Technology Center (NVAITC) worldwide program. He also works as a researcher at the Supercomputing Center for Industrial Innovation (CS2i) and at the SENAI Institute of Innovation for Automation (ISI Automação), both from SENAI CIMATEC. He is a member and vice-coordinator of the Basic Board of Scientific-Technological Advice and Evaluation, in the area of Innovation, of the Foundation for Research Support of the State of Bahia (FAPESB). He serves as Technology Transfer Coordinator and one of the Principal Investigators at the National Applied Research Center in Artificial Intelligence (CPA-IA) of SENAI CIMATEC, focusing on Industry, being one of the six CPA-IA in Brazil approved by MCTI / FAPESP / CGI.br. He also participates as one of the representatives of Brazil in the BRICS Innovation Collaboration Working Group on HPC, ICT and AI. He is the coordinator of the Work Group of the Axis 5 - Workforce and Training - of the Brazilian Strategy for Artificial Intelligence (EBIA), and member of the MCTI/EMBRAPII AI Innovation Network Training Committee. He is the coordinator, by SENAI CIMATEC, of the Artificial Intelligence Reference Network of the State of Bahia (REDE BAH.IA). He leads the working group of experts representing Brazil in the Global Partnership on Artificial Intelligence (GPAI), on the theme \"AI and the Pandemic Response\".",institutionString:"Manufacturing and Technology Integrated Campus – SENAI CIMATEC",institution:null},{id:"1063",title:"Prof.",name:"Constantin",middleName:null,surname:"Volosencu",slug:"constantin-volosencu",fullName:"Constantin Volosencu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1063/images/system/1063.png",biography:"Prof. Dr. Constantin Voloşencu graduated as an engineer from\nPolitehnica University of Timișoara, Romania, where he also\nobtained a doctorate degree. He is currently a full professor in\nthe Department of Automation and Applied Informatics at the\nsame university. Dr. Voloşencu is the author of ten books, seven\nbook chapters, and more than 160 papers published in journals\nand conference proceedings. He has also edited twelve books and\nhas twenty-seven patents to his name. He is a manager of research grants, editor in\nchief and member of international journal editorial boards, a former plenary speaker, a member of scientific committees, and chair at international conferences. His\nresearch is in the fields of control systems, control of electric drives, fuzzy control\nsystems, neural network applications, fault detection and diagnosis, sensor network\napplications, monitoring of distributed parameter systems, and power ultrasound\napplications. He has developed automation equipment for machine tools, spooling\nmachines, high-power ultrasound processes, and more.",institutionString:'"Politechnica" University Timişoara',institution:null},{id:"221364",title:"Dr.",name:"Eneko",middleName:null,surname:"Osaba",slug:"eneko-osaba",fullName:"Eneko Osaba",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/221364/images/system/221364.jpg",biography:"Dr. Eneko Osaba works at TECNALIA as a senior researcher. He obtained his Ph.D. in Artificial Intelligence in 2015. He has participated in more than twenty-five local and European research projects, and in the publication of more than 130 papers. He has performed several stays at universities in the United Kingdom, Italy, and Malta. Dr. Osaba has served as a program committee member in more than forty international conferences and participated in organizing activities in more than ten international conferences. He is a member of the editorial board of the International Journal of Artificial Intelligence, Data in Brief, and Journal of Advanced Transportation. He is also a guest editor for the Journal of Computational Science, Neurocomputing, Swarm, and Evolutionary Computation and IEEE ITS Magazine.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"275829",title:"Dr.",name:"Esther",middleName:null,surname:"Villar-Rodriguez",slug:"esther-villar-rodriguez",fullName:"Esther Villar-Rodriguez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/275829/images/system/275829.jpg",biography:"Dr. Esther Villar obtained a Ph.D. in Information and Communication Technologies from the University of Alcalá, Spain, in 2015. She obtained a degree in Computer Science from the University of Deusto, Spain, in 2010, and an MSc in Computer Languages and Systems from the National University of Distance Education, Spain, in 2012. Her areas of interest and knowledge include natural language processing (NLP), detection of impersonation in social networks, semantic web, and machine learning. Dr. Esther Villar made several contributions at conferences and publishing in various journals in those fields. Currently, she is working within the OPTIMA (Optimization Modeling & Analytics) business of TECNALIA’s ICT Division as a data scientist in projects related to the prediction and optimization of management and industrial processes (resource planning, energy efficiency, etc).",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49813/images/system/49813.png",biography:"Prof. Dr. Javier Del Ser received his first PhD in Telecommunication Engineering (Cum Laude) from the University of Navarra, Spain, in 2006, and a second PhD in Computational Intelligence (Summa Cum Laude) from the University of Alcala, Spain, in 2013. He is currently a principal researcher in data analytics and optimisation at TECNALIA (Spain), a visiting fellow at the Basque Center for Applied Mathematics (BCAM) and a part-time lecturer at the University of the Basque Country (UPV/EHU). His research interests gravitate on the use of descriptive, prescriptive and predictive algorithms for data mining and optimization in a diverse range of application fields such as Energy, Transport, Telecommunications, Health and Industry, among others. In these fields he has published more than 240 articles, co-supervised 8 Ph.D. theses, edited 6 books, coauthored 7 patents and participated/led more than 40 research projects. He is a Senior Member of the IEEE, and a recipient of the Biscay Talent prize for his academic career.",institutionString:"Tecnalia Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"278948",title:"Dr.",name:"Carlos Pedro",middleName:null,surname:"Gonçalves",slug:"carlos-pedro-goncalves",fullName:"Carlos Pedro Gonçalves",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRcmyQAC/Profile_Picture_1564224512145",biography:'Carlos Pedro Gonçalves (PhD) is an Associate Professor at Lusophone University of Humanities and Technologies and a researcher on Complexity Sciences, Quantum Technologies, Artificial Intelligence, Strategic Studies, Studies in Intelligence and Security, FinTech and Financial Risk Modeling. He is also a progammer with programming experience in:\n\nA) Quantum Computing using Qiskit Python module and IBM Quantum Experience Platform, with software developed on the simulation of Quantum Artificial Neural Networks and Quantum Cybersecurity;\n\nB) Artificial Intelligence and Machine learning programming in Python;\n\nC) Artificial Intelligence, Multiagent Systems Modeling and System Dynamics Modeling in Netlogo, with models developed in the areas of Chaos Theory, Econophysics, Artificial Intelligence, Classical and Quantum Complex Systems Science, with the Econophysics models having been cited worldwide and incorporated in PhD programs by different Universities.\n\nReceived an Arctic Code Vault Contributor status by GitHub, due to having developed open source software preserved in the \\"Arctic Code Vault\\" for future generations (https://archiveprogram.github.com/arctic-vault/), with the Strategy Analyzer A.I. module for decision making support (based on his PhD thesis, used in his Classes on Decision Making and in Strategic Intelligence Consulting Activities) and QNeural Python Quantum Neural Network simulator also preserved in the \\"Arctic Code Vault\\", for access to these software modules see: https://github.com/cpgoncalves. He is also a peer reviewer with outsanding review status from Elsevier journals, including Physica A, Neurocomputing and Engineering Applications of Artificial Intelligence. Science CV available at: https://www.cienciavitae.pt//pt/8E1C-A8B3-78C5 and ORCID: https://orcid.org/0000-0002-0298-3974',institutionString:"University of Lisbon",institution:{name:"Universidade Lusófona",country:{name:"Portugal"}}},{id:"241400",title:"Prof.",name:"Mohammed",middleName:null,surname:"Bsiss",slug:"mohammed-bsiss",fullName:"Mohammed Bsiss",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241400/images/8062_n.jpg",biography:null,institutionString:null,institution:null},{id:"276128",title:"Dr.",name:"Hira",middleName:null,surname:"Fatima",slug:"hira-fatima",fullName:"Hira Fatima",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/276128/images/14420_n.jpg",biography:"Dr. Hira Fatima\nAssistant Professor\nDepartment of Mathematics\nInstitute of Applied Science\nMangalayatan University, Aligarh\nMobile: no : 8532041179\nhirafatima2014@gmal.com\n\nDr. Hira Fatima has received his Ph.D. degree in pure Mathematics from Aligarh Muslim University, Aligarh India. Currently working as an Assistant Professor in the Department of Mathematics, Institute of Applied Science, Mangalayatan University, Aligarh. She taught so many courses of Mathematics of UG and PG level. Her research Area of Expertise is Functional Analysis & Sequence Spaces. She has been working on Ideal Convergence of double sequence. She has published 17 research papers in National and International Journals including Cogent Mathematics, Filomat, Journal of Intelligent and Fuzzy Systems, Advances in Difference Equations, Journal of Mathematical Analysis, Journal of Mathematical & Computer Science etc. She has also reviewed few research papers for the and international journals. She is a member of Indian Mathematical Society.",institutionString:null,institution:null},{id:"414880",title:"Dr.",name:"Maryam",middleName:null,surname:"Vatankhah",slug:"maryam-vatankhah",fullName:"Maryam Vatankhah",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Borough of Manhattan Community College",country:{name:"United States of America"}}},{id:"414879",title:"Prof.",name:"Mohammad-Reza",middleName:null,surname:"Akbarzadeh-Totonchi",slug:"mohammad-reza-akbarzadeh-totonchi",fullName:"Mohammad-Reza Akbarzadeh-Totonchi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Ferdowsi University of Mashhad",country:{name:"Iran"}}},{id:"414878",title:"Prof.",name:"Reza",middleName:null,surname:"Fazel-Rezai",slug:"reza-fazel-rezai",fullName:"Reza Fazel-Rezai",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"American Public University System",country:{name:"United States of America"}}},{id:"426586",title:"Dr.",name:"Oladunni A.",middleName:null,surname:"Daramola",slug:"oladunni-a.-daramola",fullName:"Oladunni A. Daramola",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Federal University of Technology",country:{name:"Nigeria"}}},{id:"357014",title:"Prof.",name:"Leon",middleName:null,surname:"Bobrowski",slug:"leon-bobrowski",fullName:"Leon Bobrowski",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Bialystok University of Technology",country:{name:"Poland"}}},{id:"302698",title:"Dr.",name:"Yao",middleName:null,surname:"Shan",slug:"yao-shan",fullName:"Yao Shan",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Dalian University of Technology",country:{name:"China"}}},{id:"354126",title:"Dr.",name:"Setiawan",middleName:null,surname:"Hadi",slug:"setiawan-hadi",fullName:"Setiawan Hadi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Padjadjaran University",country:{name:"Indonesia"}}},{id:"125911",title:"Prof.",name:"Jia-Ching",middleName:null,surname:"Wang",slug:"jia-ching-wang",fullName:"Jia-Ching Wang",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"National Central University",country:{name:"Taiwan"}}},{id:"332603",title:"Prof.",name:"Kumar S.",middleName:null,surname:"Ray",slug:"kumar-s.-ray",fullName:"Kumar S. Ray",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Indian Statistical Institute",country:{name:"India"}}},{id:"415409",title:"Prof.",name:"Maghsoud",middleName:null,surname:"Amiri",slug:"maghsoud-amiri",fullName:"Maghsoud Amiri",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Allameh Tabataba'i University",country:{name:"Iran"}}},{id:"357085",title:"Mr.",name:"P. Mohan",middleName:null,surname:"Anand",slug:"p.-mohan-anand",fullName:"P. Mohan Anand",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Indian Institute of Technology Kanpur",country:{name:"India"}}},{id:"356696",title:"Ph.D. Student",name:"P.V.",middleName:null,surname:"Sai Charan",slug:"p.v.-sai-charan",fullName:"P.V. Sai Charan",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Indian Institute of Technology Kanpur",country:{name:"India"}}},{id:"357086",title:"Prof.",name:"Sandeep K.",middleName:null,surname:"Shukla",slug:"sandeep-k.-shukla",fullName:"Sandeep K. Shukla",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Indian Institute of Technology Kanpur",country:{name:"India"}}}]}},subseries:{item:{id:"17",type:"subseries",title:"Metabolism",keywords:"Biomolecules Metabolism, Energy Metabolism, Metabolic Pathways, Key Metabolic Enzymes, Metabolic Adaptation",scope:"Metabolism is frequently defined in biochemistry textbooks as the overall process that allows living systems to acquire and use the free energy they need for their vital functions or the chemical processes that occur within a living organism to maintain life. Behind these definitions are hidden all the aspects of normal and pathological functioning of all processes that the topic ‘Metabolism’ will cover within the Biochemistry Series. Thus all studies on metabolism will be considered for publication.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/17.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11413,editor:{id:"138626",title:"Dr.",name:"Yannis",middleName:null,surname:"Karamanos",slug:"yannis-karamanos",fullName:"Yannis Karamanos",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002g6Jv2QAE/Profile_Picture_1629356660984",biography:"Yannis Karamanos, born in Greece in 1953, completed his pre-graduate studies at the Université Pierre et Marie Curie, Paris, then his Masters and Doctoral degree at the Université de Lille (1983). He was associate professor at the University of Limoges (1987) before becoming full professor of biochemistry at the Université d’Artois (1996). He worked on the structure-function relationships of glycoconjugates and his main project was the investigations on the biological roles of the de-N-glycosylation enzymes (Endo-N-acetyl-β-D-glucosaminidase and peptide-N4-(N-acetyl-β-glucosaminyl) asparagine amidase). From 2002 he contributes to the understanding of the Blood-brain barrier functioning using proteomics approaches. He has published more than 70 papers. 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