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Mohamed",authors:[{id:"42713",title:"Dr.",name:"Sunday",middleName:null,surname:"Ekesi",fullName:"Sunday Ekesi",slug:"sunday-ekesi"},{id:"53233",title:"Dr.",name:"Samira A.",middleName:null,surname:"Mohamed",fullName:"Samira A. Mohamed",slug:"samira-a.-mohamed"}]},{id:"23747",title:"Quality Control of Baculoviral Bioinsecticide Production",slug:"quality-control-of-baculoviral-bioinsecticide-production",signatures:"Solange Ana Belén Miele, Mariano Nicolás Belaich and Pablo Daniel Ghiringhelli",authors:[{id:"52118",title:"Dr.",name:"Pablo Daniel",middleName:null,surname:"Ghiringhelli",fullName:"Pablo Daniel Ghiringhelli",slug:"pablo-daniel-ghiringhelli"},{id:"54727",title:"Mrs.",name:"Solange Ana Belen",middleName:null,surname:"Miele",fullName:"Solange Ana Belen Miele",slug:"solange-ana-belen-miele"},{id:"54728",title:"Dr.",name:"Mariano Nicolas",middleName:null,surname:"Belaich",fullName:"Mariano Nicolas Belaich",slug:"mariano-nicolas-belaich"}]},{id:"23748",title:"Quality Control and Characterization of Scintillating Crystals for High Energy Physics and Medical Applications",slug:"quality-control-and-characterization-of-scintillating-crystals-for-high-energy-physics-and-medical-a",signatures:"Daniele Rinaldi, Michel Lebeau, Nicola Paone, Lorenzo Scalise and Paolo Pietroni",authors:[{id:"49866",title:"Ph.D.",name:"Lorenzo",middleName:null,surname:"Scalise",fullName:"Lorenzo Scalise",slug:"lorenzo-scalise"},{id:"54920",title:"Prof.",name:"Daniele",middleName:null,surname:"Rinaldi",fullName:"Daniele Rinaldi",slug:"daniele-rinaldi"},{id:"59026",title:"Dr.",name:"Michel",middleName:null,surname:"Lebeau",fullName:"Michel Lebeau",slug:"michel-lebeau"},{id:"59027",title:"Prof.",name:"Nicola",middleName:null,surname:"Paone",fullName:"Nicola Paone",slug:"nicola-paone"},{id:"78731",title:"Dr.",name:"Paolo",middleName:null,surname:"Pietroni",fullName:"Paolo Pietroni",slug:"paolo-pietroni"}]},{id:"23749",title:"Effect of Last Generation Additives on the Concrete Durability",slug:"effect-of-last-generation-additives-on-the-concrete-durability",signatures:"Ana M. Carvajal, M. Soledad Gómez, Pablo Maturana and Raul Molina",authors:[{id:"42072",title:"Prof.",name:"Ana",middleName:"MarÃa",surname:"Carvajal",fullName:"Ana Carvajal",slug:"ana-carvajal"},{id:"42100",title:"Prof.",name:"Pablo",middleName:null,surname:"Maturana",fullName:"Pablo Maturana",slug:"pablo-maturana"},{id:"84065",title:"Prof.",name:"Soledad",middleName:null,surname:"Gomez",fullName:"Soledad Gomez",slug:"soledad-gomez"},{id:"84067",title:"Mr.",name:"Raul",middleName:null,surname:"Molina",fullName:"Raul Molina",slug:"raul-molina"}]},{id:"23750",title:"A Convenient and Inexpensive Quality Control Method for Examining the Accuracy of Conjugate Cam Profiles",slug:"a-convenient-and-inexpensive-quality-control-method-for-examining-the-accuracy-of-conjugate-cam-prof",signatures:"Wen-Tung Chang and Long-Iong Wu",authors:[{id:"43114",title:"Prof.",name:"Wen-Tung",middleName:null,surname:"Chang",fullName:"Wen-Tung Chang",slug:"wen-tung-chang"},{id:"51808",title:"Prof.",name:"Long-Iong",middleName:null,surname:"Wu",fullName:"Long-Iong Wu",slug:"long-iong-wu"}]},{id:"23751",title:"Material Characterization and Failure Analysis for Microelectronics Assembly Processes",slug:"material-characterization-and-failure-analysis-for-microelectronics-assembly-processes",signatures:"Chien-Yi Huang, Ming-Shu Li, Shan-Yu Huang, Cheng-I Chang and Min-Hui Huang",authors:[{id:"52412",title:"Dr.",name:"Ming-Shu",middleName:null,surname:"Li",fullName:"Ming-Shu Li",slug:"ming-shu-li"},{id:"52426",title:"Prof.",name:"Chien-Yi",middleName:"Jay",surname:"Huang",fullName:"Chien-Yi Huang",slug:"chien-yi-huang"},{id:"98841",title:"MSc.",name:"Cheng-I",middleName:null,surname:"Chang",fullName:"Cheng-I Chang",slug:"cheng-i-chang"},{id:"98978",title:"BSc.",name:"Min Hui",middleName:null,surname:"Huang",fullName:"Min Hui Huang",slug:"min-hui-huang"},{id:"99353",title:"MSc.",name:"Shan-Yu",middleName:null,surname:"Huang",fullName:"Shan-Yu Huang",slug:"shan-yu-huang"}]}]}],publishedBooks:[{type:"book",id:"95",title:"Applications and Experiences of Quality Control",subtitle:null,isOpenForSubmission:!1,hash:"4bcb22b1eee68210a977a97d5a0f363a",slug:"applications-and-experiences-of-quality-control",bookSignature:"Ognyan Ivanov",coverURL:"https://cdn.intechopen.com/books/images_new/95.jpg",editedByType:"Edited by",editors:[{id:"22230",title:"Prof.",name:"Ognyan",surname:"Ivanov",slug:"ognyan-ivanov",fullName:"Ognyan Ivanov"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"632",title:"Wide Spectra of Quality Control",subtitle:null,isOpenForSubmission:!1,hash:"9f7ce64f86daee44a8c5604e8924de1c",slug:"wide-spectra-of-quality-control",bookSignature:"Isin Akyar",coverURL:"https://cdn.intechopen.com/books/images_new/632.jpg",editedByType:"Edited by",editors:[{id:"36323",title:"Dr.",name:"Isin",surname:"Akyar",slug:"isin-akyar",fullName:"Isin Akyar"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3074",title:"Practical Concepts of Quality Control",subtitle:null,isOpenForSubmission:!1,hash:"3bb079fbda0a27f91cd90dcbd0cc3a6b",slug:"practical-concepts-of-quality-control",bookSignature:"Mohammad Saber Fallah Nezhad",coverURL:"https://cdn.intechopen.com/books/images_new/3074.jpg",editedByType:"Edited by",editors:[{id:"150393",title:"Dr.",name:"Mohammad Saber Fallah",surname:"Nezhad",slug:"mohammad-saber-fallah-nezhad",fullName:"Mohammad Saber Fallah Nezhad"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited 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Navas",coverURL:"https://cdn.intechopen.com/books/images_new/9925.jpg",editedByType:"Edited by",editors:[{id:"19636",title:"Prof.",name:"Pengzhong",surname:"Li",slug:"pengzhong-li",fullName:"Pengzhong Li"}],equalEditorOne:{id:"178637",title:"Dr.",name:"Paulo",surname:"Pereira",slug:"paulo-pereira",fullName:"Paulo Pereira"},equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],publishedBooksByAuthor:[{type:"book",id:"95",title:"Applications and Experiences of Quality Control",subtitle:null,isOpenForSubmission:!1,hash:"4bcb22b1eee68210a977a97d5a0f363a",slug:"applications-and-experiences-of-quality-control",bookSignature:"Ognyan Ivanov",coverURL:"https://cdn.intechopen.com/books/images_new/95.jpg",editedByType:"Edited by",editors:[{id:"22230",title:"Prof.",name:"Ognyan",surname:"Ivanov",slug:"ognyan-ivanov",fullName:"Ognyan Ivanov"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},onlineFirst:{chapter:{type:"chapter",id:"80179",title:"Pediatric Ulcerative Colitis",doi:"10.5772/intechopen.102226",slug:"pediatric-ulcerative-colitis",body:'Inflammatory bowel disease (IBD) represents a group of chronic disorders of the digestive tract with a relapsing and remitting clinical course and a debilitating character. IBD may occur at any age [1]. Approximately 25% of incident cases of inflammatory bowel disease occur during childhood [2, 3, 4]. The majority of newly diagnosed pediatric patients are teenagers, but the disease may have an earlier manifestation [5, 6]. According to the Montreal classification of IBD the pediatric IBD (PIBD) is defined as having an age of occurrence younger than 17 years [7]. Later the Paris classification defined A1a group for those children with less than 10 years of age IBD onset and A1b for children with onset of symptoms between 10 and <17 years of age [8]. The latest modification of the IBD classification defines disease onset under the age of 17 as PIBD and this is further classified into early onset IBD (EOIBD) when it occurs under 10 years of age, very early onset IBD (VEOIBD) with less than 6 years of age IBD onset, infantile (and toddler) onset of IBD (less than 2 years of onset) and neonatal IBD (disease onset within first 28 days of age) [9].
Evidence over the last several years have shown that VEOIBD is a separate disease entity with specific clinical features and outcomes that are different from those of adolescent-onset IBD [9, 10]. In most cases VEOIBD is associated with underlying primary immunodeficiencies or has an underlying monogenic etiology. It is characterized by a severe and often treatment-refractory course of disease [11]. Not surprisingly VEOIBD is accepted currently as a unique disease that requires a specific diagnostic approach and specific treatment. A recent position paper summarized the diagnostic algorithm by suspected VEOIBD and described some of the potential treatments [12].
The classically group of IBDs in childhood includes three nosological entities: Crohn’s disease (CD), IBD-unclassified (IBDU) and ulcerative colitis (UC) and [13].
CD is a type of IBD whose predilection site for development is the terminal ileum, but it may affect any part of the gastrointestinal tract, from the mouth to the anus [14]. The changes are usually segmental, the diseased sections alternating with healthy ones—the so-called skip lesions. The inflammation in CD is transmural and may affect the entire bowel wall. Initially, infiltrates are localized around the intestinal crypts, but with the disease progression, deeper layers are involved, and specific histological structures are formed—non-caseating epithelioid granulomas [13, 14, 15, 16]. The transmural inflammation predetermines the disease-specific complications: wall thickening and narrowing of the lumen of the intestine, intestinal obstruction, fistulation, and abscess formation [16].
IBDU is the rarest of the IBD subgroups. It is more common in the pediatric population than in adults and is a diagnosis which is made in patients with IBD in whom the inflammation is confined to the colon and the disease has characteristics which do not allow to determine definitively whether it is UC or CD despite all necessary tests [7, 13, 16, 17, 18].
In UC, the inflammatory changes are usually localized in the colonic mucosa. The inflammation is ulcerative and purulent. It is continuous, usually starting from the rectum and gradually extending to the more proximal parts of the bowel. Histological findings include chronic inflammation of the mucosa with infiltration of polymorphonuclear neutrophils, accumulation of polymorphonuclear neutrophils in the crypts of the large intestine, formation of crypt abscesses, and disruption of the structure of the mucous glands. In more severe cases, inflammatory pseudopolyps are formed. The wall of the intestine becomes thick and rigid, without haustration [5, 6, 11, 13, 14, 16].
Pediatric ulcerative colitis is a different disease entity from adult-onset UC. It has a particular etiopathogenesis, unique clinical characteristics, specific disease course and outcome.
The etiopathogenesis of IBD is complex and multifactorial. It is suggested that a dysregulation of mucosal immune system leads to excessive inflammatory response to the contents of the intestinal lumen (microflora, infectious agents, nutrients, etc.). This abnormal immune response results in chronic inflammation and damaging of body’s own structures [20]. Different genetic and environmental factors may contribute to the development of the immune dysregulation and the abnormal immune response [21]. Typical for the pathogenesis of pediatric IBD is that the role of the genetic factors is stronger than in adults, while environmental factors are of major importance in later clinical manifestation [22, 23, 24].
Childhood-onset UC is often associated with a consanguinity and a positive family history of IBD which provides an additional clue to an underlying genetic predisposition [25].
Currently, over genetic 160 loci have been associated with IBD. Most of the variants lead to aberrations in several mechanisms altering the intestinal immune homeostasis and contribute to both CD and UC risk. However, some polymorphisms are unique to UC- or early-onset UC-specific risk [26, 27, 28]. Furthermore, some types of infantile IBD or VEOIBD that manifest phenotypically with UC are thought to be monogenic diseases having a Mendelian inheritance [9, 12].
The most common symptoms of pediatric UC include abdominal pain, chronic diarrhea with or without blood, weight loss, fatigue, fever, and rectorrhagia [6]. Generally, the clinical manifestation of the disease is associated with its location and the degree of inflammation [29]. Children with UC have more extended disease compared to adults with UC [30]. They are likely to present with pancolitis, whereas in adults the disease is predominantly confined to the rectum or left side of the colon [16]. The differences in disease location result in different clinical presentation in comparison with adult patients with UC. The majority of children with UC report of abdominal pain and bloody diarrhea, whereas adults tend to present most often with rectal bleeding [14, 16]. Furthermore, pediatric patients with UC have more often extraintestinal manifestations, impaired nutritional status or are at impaired general condition compared to adults with UC [30, 31, 32].
The typical endoscopic findings of UC are continuous mucosal inflammation that starts from the rectum, extends proximally, and ends at transition zone anywhere in the colon or involves the whole colon [13]. Sometimes, in case of severe pancolitis the ileocecal valve and the most distal part of the terminal ileum may also be affected. This extension of the inflammatory process is termed “backwash ileitis” [14]. The typical macroscopic features of UC include erythema, granularity, friability, purulent exudates and ulcers which usually appear as superficial small ulcers. The typical histologic findings of UC include chronic inflammation in the mucosa accompanied by cryptitis or crypt abscesses. The inflammation is most severe distally and is getting milder proximally [13].
Pediatric-onset UC may present also with atypical endoscopic findings. Recognized and described are the following 5 phenotypes [13, 19]:
Based on the specific endoscopic manifestations of pediatric UC in 2013 was introduced the term “atypical UC”: a new child-specific IBD category consisting of 5 atypical disease phenotypes. Nowadays the pediatric UC is divided into typical UC and atypical UC [13].
In contrast to adult-onset presentations, children with UC have extended disease and are likely to present with pancolitis [26, 33]. This more extended disease is consistently associated with a more severe and aggressive disease course. According to the literature, within 5 years from diagnosis a significantly higher percentage of patients with childhood-onset UC are admitted to emergency units for acute severe colitis, compared to adult-onset disease [33]. Furthermore, children with UC are more likely to receive corticosteroids, be initiated on immunomodulators, and require surgery in the first year after diagnosis than adults with UC [26, 33].
The colectomy rate is significantly higher in children compared to adult UC populations [33]. Based on the literature the colectomy rate within 10 years from diagnosis is over 40% in pediatric-onset UC compared to less than 20% in adult-onset UC [34]. However, other studies show lower colectomy rates of 25% in 6 years and 15% in 10 years [35, 36].
Another specific feature of childhood-onset UC is the possible change in the diagnosis from onset to long-term follow-up [6]. A recent study of the natural history of pediatric-onset IBD showed an increased disease reclassification over time from UC diagnosis to CD diagnosis [37]. Patients initially diagnosed as UC (a correct initial diagnosis) developed findings that led to a diagnostic change to CD [38].
In May 2009 an international group of experts in pediatric IBD met in Paris and created a classification which reflects the specific phenotypic characteristics of pediatric IBD—the so-called Paris classification (Table 1). It represents a pediatric modification of the adult Montreal Classification of IBD. The classification of pediatric UC disease according to the Paris classification. With respect to disease extent it is divided into four categories: ulcerative proctitis (E1), left-sided UC (E2), extensive UC (E3) and pancolitis (E4). Disease severity is categorized as never severe (S0) and ever severe (S1) [8].
Paris classifications for pediatric ulcerative colitis (adapted from Levine et al. [8]).
For measuring disease activity and evaluation of disease severity is used a validated, multi-item, scoring system—the so-called Pediatric Ulcerative Colitis Activity Index (PUCAI) (Table 2). The PUCAI is a score comprised of six parameters, including the assessment of abdominal pain, rectal bleeding, stool consistency, number of stools per 24 h, nocturnal stools, and activity level. Each item is assigned a value contributing to a combined total PUCAI score ranging from 0 to 85. Categories of UC disease activity are defined by the following total PUCAI scores: 0–9 (no activity), 10–34 (mild activity), 35–64 (moderate activity), and 65–85 (severe activity) [39]. The items that are included in the PUCAI score and their corresponding points are presented.
Item | Characteristics | Points |
---|---|---|
Abdominal pain | No pain Pain can be ignored Pain cannot be ignored | 0 5 10 |
Rectal bleeding | None Small amount only, in less than 50% of stools Small amount with most stools Large amount (>50% of the stool content) | 0 10 20 30 |
Stool consistency of most stools | Formed Partially formed Completely unformed | 0 5 10 |
Number of stools per 24 h | 0–2 3–5 6–8 >8 | 0 5 10 15 |
Nocturnal stools (any episode causing wakening) | No Yes | 0 10 |
Activity level | No limitation of activity Occasional limitation of activity Severe restricted activity | 0 5 10 |
Pediatric ulcerative colitis activity index (adapted from Turner et al. [39]).
The diagnosis of pediatric UC is based on standard consensus-based criteria for diagnosing IBD in pediatric patients, the so-called Porto criteria. They were prepared and issued in 2005 by the IBD Working Group of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition [16]. In 2013 the initial criteria were revised and updated [13]. According to the Porto criteria the diagnosis of pediatric UC involves history taking, physical and laboratory examination, esophagogastroduodenoscopy and ileocolonoscopy with histology, and imaging of the small bowel [11, 13, 16]:
A summary of the diagnostic algorithm for suspected pediatric UC is presented at Figure 1.
Diagnostic algorithm for pediatric ulcerative colitis. IBD: inflammatory bowel disease; VEOIBD: very early onset inflammatory bowel disease; EIM: extraintestinal manifestation; UC: ulcerative colitis; MRI: magnetic resonance imaging; WCE: wireless capsule endoscopy; CD: Crohn’s disease; IBDU: Inflammatory bowel disease unclassified.
The management of pediatric UC is based on therapeutic guidelines produced by the European Crohn’s and Colitis Organization (ECCO) and European Society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) [40, 41]. Generally, the treatment strategy should be guided by the endoscopic extent of inflammation and disease severity. However, in children with UC the therapy depends mainly on disease severity, assessed by the corresponding disease activity index: Pediatric Ulcerative Colitis Activity Index (PUCAI) [39, 40]. The treatment goal is induction and maintenance of steroid-free complete remission [40].
5-ASA are the preferred first-line therapy for induction and maintenance of remission for patients with mild (PUCAI 10–34) and some patients with moderate disease (PUCAI 35–64) [40]. The preparations are available as forms for local administration (suppositories and enemas) and forms for systemic administration (tablets and granules). Topical 5-ASA are effective in mild-to-moderate distal UC, but usually they are combined with oral 5-ASA, as the combination therapy is more effective than either treatment alone [40, 42]. Rectal 5-ASA are superior to rectal steroids for induction and maintenance of remission in distal UC [43]. Oral 5-ASA preparations are generally preferred to sulfasalazine due to a superior side effect profile combined with similar efficacy. However, sulfasalazine is cheaper and available in liquid formulation [40, 42]. The recommended dosing for oral mesalamine is 60–80 mg/kg/day (maximum 4.8 g daily) and for oral sulfasalazine 40–70 mg/kg/day (maximum 4 g daily). Both are usually given in divided doses, but according to the studies once daily dosing of 5-ASA may be as effective as twice daily dosing [44]. The recommended dosing for rectal mesalamine is 25 mg/kg up to 1 g daily (1 g daily is as effective as higher doses) [40]. Lack of meaningful response to 5-ASA within 2–3 weeks of therapy is an indication for treatment modification and initiation of steroids [40, 42].
Treatment with steroids is recommended for induction of remission in children with moderate and severe UC. It is not recommended for maintenance of remission [40]. Available are forms for oral, intravenous, and local administration. Steroid dependency is defined as response or remission with corticosteroid treatment, but recurrence of symptoms when the dose is lowered or within 3 months following complete taper [40]. Steroid refractory UC is defined as lack of clinical response to oral prednisolone at doses 0.75–1 mg/kg/day (max. 40 mg/day) within 4 weeks or lack of clinical response to intravenous prednisolone at doses 0.75–1 mg/kg/day (max. 60 mg/day) within 1 week [40, 41].
Oral steroids should be used as second-line therapy for mild or moderate UC not responding to 5-ASA (oral ± rectal) and may be considered as first line in more severe moderate disease. The recommended daily dose for oral prednisolone/prednisone is 1 mg/kg/day up to 40 mg/day administered once daily (in the morning) for 2–3 weeks followed by a tapering period of up to 8–10 weeks [40]. Second-generation oral steroids with lower systemic effect such as beclomethasone dipropionate and budesonide-MMX may be considered in patients with mild disease refractory to 5-ASA before oral prednisolone. The recommended dosing schedule for beclomethasone dipropionate is 5 mg once daily for 4 weeks and for budesonide-MMX 9 mg for 8 weeks. The recommendations are for patients with weight > 30 kg. Dosing for children <30 kg has not been established [40].
Intravenous steroids should be used as first-line therapy in patients with severe UC (PUCAI ≥ 65) (See section Acute severe ulcerative colitis) [40, 41].
Rectal steroid preparations are useful for patients who are 5-ASA intolerant and in selected patients refractory to 5-ASA before starting oral prednisolone [40].
Thiopurines are recommended for maintaining remission in children with UC. They should be used as second-line therapy for maintaining remission in children with mild or moderate UC after 5-ASA failed and as first-line therapy for maintaining remission in children with severe UC and in 5-ASA intolerant patients. Although thiopurines have been shown to be more effective than 5-ASA they should generally be reserved as second-line therapy, considering their safety profile [40]. Before starting therapy with thiopurines it is recommended the determination of thiopurines methyltransferase (TPMT) genotype or phenotype to identify patients at greater risk of early profound myelosuppression or other thiopurine associated toxicity. Dose should be reduced in heterozygous patients or in those with low activity. Thiopurines should not be used in children homozygous mutants for TPMT or those with very low TPMT activity. Concomitant use of allopurinol 50 mg once daily in patients <30 kg and 100 mg once daily in patients ≥30 kg (maximum 5 mg/kg) with reduced dose of azathioprine (to approximately 25–30% of initial dose) is a valid therapeutic option in cases of hyperactive TPMT resulting in high 6-MMP and low 6-TGN. The recommended dosing in patients with normal TPMT is 2–2.5 mg/kg/day for azathioprine and 1–1.5 mg/kg/day for mercaptopurine, in a single daily dose [40]. The therapeutic effect of thiopurines may take up to 10–14 weeks after the start of treatment. Measurement of thiopurine metabolites, 6-methyl mercaptopurine and 6-thioguanine is helpful to assess compliance, adjust therapy and avoid adverse events [40, 42].
Methotrexate may be considered as alternative therapeutic option for maintaining remission in selected children with UC. Generally, there is no evidence supporting its routine use for maintenance of remission in UC, therefore it should be used only when other alternatives are not possible or available [40, 45].
Tacrolimus is a potent immunomodulator which administration is reserved for special occasions. Oral tacrolimus may be considered in selected outpatient UC children as another option to steroids for bridging to thiopurines or vedolizumab. The target trough level should be 10–15 ng/mL when initiating the treatment, and 5–10 ng/mL during the follow up period. Rectal tacrolimus may be considered as third-line therapy in patients with ulcerative proctitis who are either refractory or intolerant to mesalamine and steroids topical therapies. The recommended dose is 0.07 mg/kg/day, maximum 3 mg/day [40].
Treatment with biologics is recommended as second- or third-line therapy for children with moderate or severe UC. Currently approved for pediatric use are three tumor necrosis factor (TNF)-alpha inhibitors:
Antibiotics should not be routinely used for induction or maintenance of remission of pediatric [40]. However, recent studies demonstrated that a combination of specific antibiotics—the so called wide-spectrum antibiotic cocktail could be used as therapeutic option for pediatric patients with severe UC resistant to other treatments [50, 51].
The use of specific probiotic agents (e.g., VSL#3 or
Despite advances in conventional therapy surgery remains an integral part of the management strategy in children with UC. It should be considered in patients with active, or steroid-dependent, UC despite optimized medical therapy, and in those with colon dysplasia [40]. The most common surgery that is carried out is a subtotal/total colectomy with a temporary stoma [42]. A minimally invasive laparoscopic approach is recommended for superior outcomes. Generally, the restorative proctocolectomy with ileal pouch-anal anastomosis and a covering loop ileostomy, performed as one- or two- or three-stage procedures is the recommended elective surgery for pediatric patients with UC [40].
Acute severe ulcerative colitis (ASC) is defined by a PUCAI score of at least 65 points [39]. According to the literature 11–23% of children with UC experience at least one severe exacerbation during the course of their disease [52, 53, 54]. ASC is an emergency which requires immediate management. Children with ASC should be treated in a hospital by a multidisciplinary team. They need close monitoring and frequent reevaluation [41].
Intravenous methylprednisolone is used as first-line treatment for ASC in children. It is preferred over hydrocortisone due to its minimal mineralocorticoid activity. The recommended dosage is 1–1.5 mg/kg/day (up to 60 mg/day) given in one or two divided daily doses. The majority of patients will respond to this treatment. However, sequential measurement of PUCAI scores is essential for identifying those patients requiring a step up in treatment with second-line (rescue) therapy [41, 42]. A PUCAI score of >45 on day 3 indicated a likelihood of steroid failure and should dictate planning for second-line therapy. In children with a PUCAI of 35–65 on day 5 intravenous steroids should be continued for an additional 2–5 days before a decision on second-line therapy is made. A PUCAI score of >65 on day 5 indicated the need for starting a rescue therapy [41].
The second-line therapy involves either
Many gastrointestinal infections have been associated with pediatric ASC. Exclusion of several specific pathogens, such as
ASC is associated with increased risk for venous thromboembolic events (VTE) [56, 57, 58]. However, thromboprophylaxis with subcutaneous low molecular weight heparin is recommended only for children or adolescents with an underlying predisposition such as smoking, use of oral contraceptives, complete immobilization, obesity, concurrent significant infection, known prothrombotic disorder, previous VTE, family history of VTE, etc. [41].
Adequate nutrient intake and early treatment of the accompanying conditions such as anemia, infections, etc., are also an integral part of the successful management of ASC and should not be overlooked.
The colitis phenotype is the most common in the VEOIBD group [40]. The clinical manifestation could be very heterogeneous and requires a different treatment approach altogether [12]. A large percentage of children with VEOIBD presenting as colitis have a mild disease which can be easily managed with 5-ASA [59]. Others demonstrate an extended disease with severe and treatment refractory course. They require escalated dosing strategies and more intensive treatments: early introduction of biologics, combination therapies, higher dosage of immunomodulators or biologics, etc. [12]. Additionally, many of the patients with VEOIBD with colitis phenotype have an underlying monogenic disorder and benefit from specific targeted therapies [12, 40]. If the molecular defect is caused by a mutation affecting predominantly immunological cells (e.g., IL10 signaling defects, XIAP and chronic granulomatous disease), hematopoietic stem cell transplantation may be curative [40]. Therapies that inhibit the hyperactive T-cell signaling could be used successfully in patients with
Pediatric UC is a disease with a heterogeneous phenotype which poses many unique challenges. The majority of children with UC present with pancolitis. Since disease extent is consistently associated with disease severity, it is not surprising that they have more aggressive disease course requiring more intensive therapies. Furthermore, children with UC have some unique age-related issues, such as delay of growth and pubertal development, nutrition disorders, psychological or emotional problems. Pediatric UC may present also atypically making the diagnosis difficult and demanding specific diagnostic tests and procedures. In addition, there is a group of patients with early-onset UC who needs a completely different diagnostic and treatment approach.
Pediatric UC is a disease with unique features and characteristics. Its correct diagnosis and successful management always require a hard teamwork and multidisciplinary approach.
The authors declare no conflict of interest.
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Elements of ecotourism fit within this context, and such tourism includes, but is not limited to, activities such as visiting natural and cultural resources without destroying nature, which are carried out with an aim toward sustainability. Ilgaz Mountain has a wealth of natural, cultural, historical, and recreational features, and its location near the Black Sea gives the area significant tourism potential. In order to evaluate the impact, potential, and possibilities of ecotourism in this protected area, we used geographic information systems (GIS) to determine the nature of protection required based on implementation availability. In this study, we used ecology-based identification of the natural and cultural values to characterize the features. The study consists of four parts: (1) the concept of ecotourism, (2) discussion of sustainable growth of tourism, (3) sustainability of ecotourism using GIS and how this is related to sustainable ecotourism in protected areas, such as in Turkey, (4) results and evaluation. By assessing these results, we aim to determine potential areas for ecotourism in terms of sustainable development, and we expect the results to provide useful ideas for further research.",book:{id:"5140",slug:"tourism-from-empirical-research-towards-practical-application",title:"Tourism",fullTitle:"Tourism - From Empirical Research Towards Practical Application"},signatures:"Mehmet Cetin and Hakan Sevik",authors:[{id:"93082",title:"Dr.",name:"Hakan",middleName:null,surname:"Sevik",slug:"hakan-sevik",fullName:"Hakan Sevik"},{id:"178455",title:"Ph.D.",name:"Mehmet",middleName:null,surname:"Cetin",slug:"mehmet-cetin",fullName:"Mehmet Cetin"}]},{id:"50032",doi:"10.5772/62293",title:"Community Participation toward Tourism Development and Conservation Program in Rural World Heritage Sites",slug:"community-participation-toward-tourism-development-and-conservation-program-in-rural-world-heritage-",totalDownloads:5033,totalCrossrefCites:9,totalDimensionsCites:17,abstract:"Community participation in tourism development and World Heritage Site (WHS) conservation management is essential for the sustainable development of WHS destinations. Local communities play a significant role in reviving and sustaining WHSs. Community participation ranges from involvement in the decision-making processes at the highest level down to economic involvement and the promotion of the destination at the lowest level. What shape community participation ultimately takes depends on the circumstance of destinations. This study attempts to review the current community participation literature with respect to rural WHS destinations, synthesising the current literature by way of a systematic review. The findings reveal a preference among rural WHS residents for economic involvement and destination promotion rather than participation in the decision-making process. The findings of this study expand upon the community participation literature, clarifying the concept in the context of rural WHS destinations. In addition, the results have practical implications for local authorities responsible for the sustainable conservation management and tourism development of rural WHS—that these seemingly competing objectives are best achieved by involving local residents in economic activities and increasing their benefits from tourism.",book:{id:"5140",slug:"tourism-from-empirical-research-towards-practical-application",title:"Tourism",fullTitle:"Tourism - From Empirical Research Towards Practical Application"},signatures:"S. Mostafa Rasoolimanesh and Mastura Jaafar",authors:[{id:"170959",title:"Dr.",name:"Mastura",middleName:null,surname:"Jaafar",slug:"mastura-jaafar",fullName:"Mastura Jaafar"},{id:"178812",title:"Dr.",name:"S. Mostafa",middleName:null,surname:"Rasoolimanesh",slug:"s.-mostafa-rasoolimanesh",fullName:"S. Mostafa Rasoolimanesh"}]},{id:"50197",doi:"10.5772/62308",title:"Ecotourism and Its Role in Sustainable Development of Nepal",slug:"ecotourism-and-its-role-in-sustainable-development-of-nepal",totalDownloads:4947,totalCrossrefCites:6,totalDimensionsCites:13,abstract:"Ecotourism helps in environmental protection, wildlife conservation, poverty alleviation and socio-economic development. It affects environmental, social and economic components of the community and the whole country. It has different forms which are named according to the preference of the country. Developed as well as developing countries , such as Nepal, are promoting ecotourism for sustainable development of the nation. Different methodologies are applied throughout the world by different researchers for assessing ecotourism. This chapter focuses on review of ecotourism researches throughout the world. It has both positive and negative impacts on environmental, social and economic aspects of the country. Due to the high rate of beneficial impacts, it is helping in the overall development of the community, country and the whole world. There is need of cooperation among different stakeholders, training of ecotourism to tourism entrepreneurs and appropriate management policy for sustainable implementation of ecotourism projects.",book:{id:"5140",slug:"tourism-from-empirical-research-towards-practical-application",title:"Tourism",fullTitle:"Tourism - From Empirical Research Towards Practical Application"},signatures:"Anup K. C.",authors:[{id:"178579",title:"Mr.",name:"Anup",middleName:null,surname:"K.C.",slug:"anup-k.c.",fullName:"Anup K.C."}]},{id:"50364",doi:"10.5772/62724",title:"Tourism Carrying Capacity for Beaches of South Andaman Island, India",slug:"tourism-carrying-capacity-for-beaches-of-south-andaman-island-india",totalDownloads:2998,totalCrossrefCites:4,totalDimensionsCites:7,abstract:"The Andaman and Nicobar Islands (ANI) is one of the largest tourist areas in India attracting both the international and domestic tourists each year. The Island Administration has a vision to develop the islands as an upmarket island destination for ecotourism. Among the island group, the South Andaman region is the most visited tourist destination and beaches of these islands have great potential for tourism attractions. The present work is an attempt to understand the potential of these beaches by assessing the carrying capacity in terms of number of visitors that can be allowed over a period of time, which will further help with better tourism management. The methodology used to estimate the tourism carrying capacity (TCC) is based on the physical and ecological conditions of each site and the existing infrastructure. The total effective carrying capacity (ECC) estimated for the beaches of Port Blair area (126,301 visitors/day) reveals that the current tourism activity is in lower level compared to its carrying capacity. Such carrying capacity assessments can be used as an input into the regular planning process. Preliminary estimates suggest that A&N Islands can be promoted for high value-low volume, eco-friendly, and environmentally sustainable tourism.",book:{id:"5140",slug:"tourism-from-empirical-research-towards-practical-application",title:"Tourism",fullTitle:"Tourism - From Empirical Research Towards Practical Application"},signatures:"R. Sridhar, E. Yuvaraj, V. Sachithanandam, T. Mageswaran, R.\nPurvaja and R. Ramesh",authors:[{id:"178784",title:"Dr.",name:"Sridhar",middleName:null,surname:"Rengarajan",slug:"sridhar-rengarajan",fullName:"Sridhar Rengarajan"},{id:"187060",title:"Mr.",name:"Yuvaraji",middleName:null,surname:"Eswaran",slug:"yuvaraji-eswaran",fullName:"Yuvaraji Eswaran"},{id:"187061",title:"Dr.",name:"Sachithanandam",middleName:null,surname:"Veeraragavan",slug:"sachithanandam-veeraragavan",fullName:"Sachithanandam Veeraragavan"},{id:"187062",title:"Dr.",name:"Mageswaran",middleName:null,surname:"Thangaraj",slug:"mageswaran-thangaraj",fullName:"Mageswaran Thangaraj"},{id:"187063",title:"Dr.",name:"Purvaja",middleName:null,surname:"Ramachandran",slug:"purvaja-ramachandran",fullName:"Purvaja Ramachandran"},{id:"187064",title:"Dr.",name:"Ramesh",middleName:null,surname:"Ramachandran",slug:"ramesh-ramachandran",fullName:"Ramesh Ramachandran"}]},{id:"50292",doi:"10.5772/62661",title:"Interaction between Cultural/Creative Tourism and Tourism/ Cultural Heritage Industries",slug:"interaction-between-cultural-creative-tourism-and-tourism-cultural-heritage-industries",totalDownloads:3282,totalCrossrefCites:2,totalDimensionsCites:6,abstract:"The chapter presents a review of the conceptions of cultural and creative tourism, their resources, objectives and their benefit and damage to the nature and the society. It is very important in the postmodern society to not only develop cultural tourism that is one of the most rapidly growing branches of economy, but also to employ cultural heritage and does not always develop the common heritage and tourism industry. This is an especially sore point because the common cultural heritage and tourism industry has an opportunity to create added financial value for cities, regions, and it also develops a responsible conserving cultural tourist. Creative tourism is different from cultural tourism in that it provides tourists with experiences through their direct participation in offered tourism activities. Another idiosyncratic feature is that creative tourism travel packs are created by not only tourism organisations, but also communities that have authentic tangible and intangible heritage. It is important to note that cultural tourism can transform into creative tourism. Heritage tourism is of great importance as well because it relates to the aforementioned types of tourism. ‘Red’ tourism can be distinguished as a type of heritage tourism that attracts tourists’ attention.",book:{id:"5140",slug:"tourism-from-empirical-research-towards-practical-application",title:"Tourism",fullTitle:"Tourism - From Empirical Research Towards Practical Application"},signatures:"Dr. Jurėnienė Virginija",authors:[{id:"178530",title:"Dr.",name:"Jureniene",middleName:null,surname:"Virginija",slug:"jureniene-virginija",fullName:"Jureniene Virginija"}]}],mostDownloadedChaptersLast30Days:[{id:"50032",title:"Community Participation toward Tourism Development and Conservation Program in Rural World Heritage Sites",slug:"community-participation-toward-tourism-development-and-conservation-program-in-rural-world-heritage-",totalDownloads:5041,totalCrossrefCites:9,totalDimensionsCites:17,abstract:"Community participation in tourism development and World Heritage Site (WHS) conservation management is essential for the sustainable development of WHS destinations. Local communities play a significant role in reviving and sustaining WHSs. Community participation ranges from involvement in the decision-making processes at the highest level down to economic involvement and the promotion of the destination at the lowest level. What shape community participation ultimately takes depends on the circumstance of destinations. This study attempts to review the current community participation literature with respect to rural WHS destinations, synthesising the current literature by way of a systematic review. The findings reveal a preference among rural WHS residents for economic involvement and destination promotion rather than participation in the decision-making process. The findings of this study expand upon the community participation literature, clarifying the concept in the context of rural WHS destinations. In addition, the results have practical implications for local authorities responsible for the sustainable conservation management and tourism development of rural WHS—that these seemingly competing objectives are best achieved by involving local residents in economic activities and increasing their benefits from tourism.",book:{id:"5140",slug:"tourism-from-empirical-research-towards-practical-application",title:"Tourism",fullTitle:"Tourism - From Empirical Research Towards Practical Application"},signatures:"S. Mostafa Rasoolimanesh and Mastura Jaafar",authors:[{id:"170959",title:"Dr.",name:"Mastura",middleName:null,surname:"Jaafar",slug:"mastura-jaafar",fullName:"Mastura Jaafar"},{id:"178812",title:"Dr.",name:"S. Mostafa",middleName:null,surname:"Rasoolimanesh",slug:"s.-mostafa-rasoolimanesh",fullName:"S. Mostafa Rasoolimanesh"}]},{id:"50197",title:"Ecotourism and Its Role in Sustainable Development of Nepal",slug:"ecotourism-and-its-role-in-sustainable-development-of-nepal",totalDownloads:4949,totalCrossrefCites:6,totalDimensionsCites:13,abstract:"Ecotourism helps in environmental protection, wildlife conservation, poverty alleviation and socio-economic development. It affects environmental, social and economic components of the community and the whole country. It has different forms which are named according to the preference of the country. Developed as well as developing countries , such as Nepal, are promoting ecotourism for sustainable development of the nation. Different methodologies are applied throughout the world by different researchers for assessing ecotourism. This chapter focuses on review of ecotourism researches throughout the world. It has both positive and negative impacts on environmental, social and economic aspects of the country. Due to the high rate of beneficial impacts, it is helping in the overall development of the community, country and the whole world. There is need of cooperation among different stakeholders, training of ecotourism to tourism entrepreneurs and appropriate management policy for sustainable implementation of ecotourism projects.",book:{id:"5140",slug:"tourism-from-empirical-research-towards-practical-application",title:"Tourism",fullTitle:"Tourism - From Empirical Research Towards Practical Application"},signatures:"Anup K. C.",authors:[{id:"178579",title:"Mr.",name:"Anup",middleName:null,surname:"K.C.",slug:"anup-k.c.",fullName:"Anup K.C."}]},{id:"73374",title:"Eco-Cultural Tourism: Sustainable Development and Promotion of Natural and Cultural Heritage",slug:"eco-cultural-tourism-sustainable-development-and-promotion-of-natural-and-cultural-heritage",totalDownloads:574,totalCrossrefCites:2,totalDimensionsCites:2,abstract:"Ecotourism has the eradication of poverty and environmental protection at its core. Both of these goals were established by the United Nations in 2012 though their development began in the 1980s. The purpose of this chapter is to analyse, using a comparative methodology, global and local eco-cultural tourism (natural, rural and urban areas) in tourist destinations of countries with emerging economies (Asia: China, Malaysia, Thailand), developed countries (Europe: Spain), and developing nations (South America: Peru, Argentina, Bolivia). The working hypothesis states that local, sustainable planning, endorsed by all the tourist agents is required, and should be led by the load capacity and the economic and environmental balance (green economies and ideologies), in order to answer to poverty and climate change problems by means of Tourist Projects directed by governmental policies and administrations. The outcomes suggest a need for a logistical change of policies, to prevent economies from generating pollution and carrying out abrasive activities associated with tourism. This change will create sustainable tourist destinations, the inclusion of populations, and the protection and conservation of natural and cultural heritage.",book:{id:"8970",slug:"tourism",title:"Tourism",fullTitle:"Tourism"},signatures:"Violante Martínez Quintana",authors:[{id:"322905",title:"Mrs.",name:"Violante",middleName:null,surname:"Martínez Quintana",slug:"violante-martinez-quintana",fullName:"Violante Martínez Quintana"}]},{id:"73322",title:"Marketing Cultural Resources as a Tourism Product",slug:"marketing-cultural-resources-as-a-tourism-product",totalDownloads:518,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"This chapter presents the marketing aspect of cultural tourism resources by taking evidence from Sidama, Southern Ethiopia. It identifies the major cultural tourism resources of Sidama, and assesses their market readiness state through the lenses of tourists. It also presents the profile of cultural tourists visiting endowments in Sidama using descriptive research approach. Brief introduction of marketing approaches to cultural tourism and a review of literature on cultural tourism products and cultural tourists is also provided. As to its significance, the chapter offers analysis of cultural tourism assets and their marketability as a tourism product in a developing destination context. Practical implications for sound cultural tourism marketing are also discussed in the chapter.",book:{id:"8970",slug:"tourism",title:"Tourism",fullTitle:"Tourism"},signatures:"Amare Yaekob Chiriko",authors:[{id:"324979",title:"Assistant Prof.",name:"Amare Yaekob",middleName:null,surname:"Chiriko",slug:"amare-yaekob-chiriko",fullName:"Amare Yaekob Chiriko"}]},{id:"50165",title:"Assessing Potential Areas of Ecotourism through a Case Study in Ilgaz Mountain National Park",slug:"assessing-potential-areas-of-ecotourism-through-a-case-study-in-ilgaz-mountain-national-park",totalDownloads:2839,totalCrossrefCites:18,totalDimensionsCites:31,abstract:"The changing demands of tourism provide greater benefits to tourists and generate competitive advantages that develop diversity in tourism. Elements of ecotourism fit within this context, and such tourism includes, but is not limited to, activities such as visiting natural and cultural resources without destroying nature, which are carried out with an aim toward sustainability. Ilgaz Mountain has a wealth of natural, cultural, historical, and recreational features, and its location near the Black Sea gives the area significant tourism potential. In order to evaluate the impact, potential, and possibilities of ecotourism in this protected area, we used geographic information systems (GIS) to determine the nature of protection required based on implementation availability. In this study, we used ecology-based identification of the natural and cultural values to characterize the features. 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Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. 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He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. 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He has developed various compounds including a drug for acute promyelocytic leukemia.",institutionString:"Tokyo Medical and Dental University",institution:{name:"Tokyo Medical and Dental University",country:{name:"Japan"}}},{id:"40482",title:null,name:"Rizwan",middleName:null,surname:"Ahmad",slug:"rizwan-ahmad",fullName:"Rizwan Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/40482/images/system/40482.jpeg",biography:"Dr. Rizwan Ahmad is a University Professor and Coordinator, Quality and Development, College of Medicine, Imam Abdulrahman bin Faisal University, Saudi Arabia. Previously, he was Associate Professor of Human Function, Oman Medical College, Oman, and SBS University, Dehradun. Dr. Ahmad completed his education at Aligarh Muslim University, Aligarh. He has published several articles in peer-reviewed journals, chapters, and edited books. His area of specialization is free radical biochemistry and autoimmune diseases.",institutionString:"Imam Abdulrahman Bin Faisal University",institution:{name:"Imam Abdulrahman Bin Faisal University",country:{name:"Saudi Arabia"}}},{id:"41865",title:"Prof.",name:"Farid A.",middleName:null,surname:"Badria",slug:"farid-a.-badria",fullName:"Farid A. Badria",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/41865/images/system/41865.jpg",biography:"Farid A. Badria, Ph.D., is the recipient of several awards, including The World Academy of Sciences (TWAS) Prize for Public Understanding of Science; the World Intellectual Property Organization (WIPO) Gold Medal for best invention; Outstanding Arab Scholar, Kuwait; and the Khwarizmi International Award, Iran. He has 250 publications, 12 books, 20 patents, and several marketed pharmaceutical products to his credit. He continues to lead research projects on developing new therapies for liver, skin disorders, and cancer. Dr. Badria was listed among the world’s top 2% of scientists in medicinal and biomolecular chemistry in 2019 and 2020. He is a member of the Arab Development Fund, Kuwait; International Cell Research Organization–United Nations Educational, Scientific and Cultural Organization (ICRO–UNESCO), Chile; and UNESCO Biotechnology France",institutionString:"Mansoura University",institution:{name:"Mansoura University",country:{name:"Egypt"}}},{id:"329385",title:"Dr.",name:"Rajesh K.",middleName:"Kumar",surname:"Singh",slug:"rajesh-k.-singh",fullName:"Rajesh K. Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329385/images/system/329385.png",biography:"Dr. Singh received a BPharm (2003) and MPharm (2005) from Panjab University, Chandigarh, India, and a Ph.D. (2013) from Punjab Technical University (PTU), Jalandhar, India. He has more than sixteen years of teaching experience and has supervised numerous postgraduate and Ph.D. students. He has to his credit more than seventy papers in SCI- and SCOPUS-indexed journals, fifty-five conference proceedings, four books, six Best Paper Awards, and five projects from different government agencies. He is currently an editorial board member of eight international journals and a reviewer for more than fifty scientific journals. He received Top Reviewer and Excellent Peer Reviewer Awards from Publons in 2016 and 2017, respectively. He is also on the panel of The International Reviewer for reviewing research proposals for grants from the Royal Society. He also serves as a Publons Academy mentor and Bentham brand ambassador.",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",country:{name:"India"}}},{id:"142388",title:"Dr.",name:"Thiago",middleName:"Gomes",surname:"Gomes Heck",slug:"thiago-gomes-heck",fullName:"Thiago Gomes Heck",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/142388/images/7259_n.jpg",biography:null,institutionString:null,institution:{name:"Universidade Regional do Noroeste do Estado do Rio Grande do Sul",country:{name:"Brazil"}}},{id:"336273",title:"Assistant Prof.",name:"Janja",middleName:null,surname:"Zupan",slug:"janja-zupan",fullName:"Janja Zupan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/336273/images/14853_n.jpeg",biography:"Janja Zupan graduated in 2005 at the Department of Clinical Biochemistry (superviser prof. dr. Janja Marc) in the field of genetics of osteoporosis. Since November 2009 she is working as a Teaching Assistant at the Faculty of Pharmacy, Department of Clinical Biochemistry. In 2011 she completed part of her research and PhD work at Institute of Genetics and Molecular Medicine, University of Edinburgh. She finished her PhD entitled The influence of the proinflammatory cytokines on the RANK/RANKL/OPG in bone tissue of osteoporotic and osteoarthritic patients in 2012. From 2014-2016 she worked at the Institute of Biomedical Sciences, University of Aberdeen as a postdoctoral research fellow on UK Arthritis research project where she gained knowledge in mesenchymal stem cells and regenerative medicine. She returned back to University of Ljubljana, Faculty of Pharmacy in 2016. She is currently leading project entitled Mesenchymal stem cells-the keepers of tissue endogenous regenerative capacity facing up to aging of the musculoskeletal system funded by Slovenian Research Agency.",institutionString:null,institution:{name:"University of Ljubljana",country:{name:"Slovenia"}}},{id:"357453",title:"Dr.",name:"Radheshyam",middleName:null,surname:"Maurya",slug:"radheshyam-maurya",fullName:"Radheshyam Maurya",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/357453/images/16535_n.jpg",biography:null,institutionString:null,institution:{name:"University of Hyderabad",country:{name:"India"}}},{id:"311457",title:"Dr.",name:"Júlia",middleName:null,surname:"Scherer Santos",slug:"julia-scherer-santos",fullName:"Júlia Scherer Santos",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/311457/images/system/311457.jpg",biography:"Dr. Júlia Scherer Santos works in the areas of cosmetology, nanotechnology, pharmaceutical technology, beauty, and aesthetics. Dr. Santos also has experience as a professor of graduate courses. Graduated in Pharmacy, specialization in Cosmetology and Cosmeceuticals applied to aesthetics, specialization in Aesthetic and Cosmetic Health, and a doctorate in Pharmaceutical Nanotechnology. Teaching experience in Pharmacy and Aesthetics and Cosmetics courses. She works mainly on the following subjects: nanotechnology, cosmetology, pharmaceutical technology, aesthetics.",institutionString:"Universidade Federal de Juiz de Fora",institution:{name:"Universidade Federal de Juiz de Fora",country:{name:"Brazil"}}},{id:"219081",title:"Dr.",name:"Abdulsamed",middleName:null,surname:"Kükürt",slug:"abdulsamed-kukurt",fullName:"Abdulsamed Kükürt",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRNVJQA4/Profile_Picture_2022-03-07T13:23:04.png",biography:"Dr. Kükürt graduated from Uludağ University in Turkey. He started his academic career as a Research Assistant in the Department of Biochemistry at Kafkas University. In 2019, he completed his Ph.D. program in the Department of Biochemistry at the Institute of Health Sciences. He is currently working at the Department of Biochemistry, Kafkas University. He has 27 published research articles in academic journals, 11 book chapters, and 37 papers. He took part in 10 academic projects. He served as a reviewer for many articles. He still serves as a member of the review board in many academic journals. His research interests include biochemistry, oxidative stress, reactive species, antioxidants, lipid peroxidation, inflammation, reproductive hormones, phenolic compounds, female infertility.",institutionString:"Kafkas University",institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"178366",title:"Associate Prof.",name:"Volkan",middleName:null,surname:"Gelen",slug:"volkan-gelen",fullName:"Volkan Gelen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178366/images/system/178366.jpg",biography:"Volkan Gelen is a Physiology specialist who received his veterinary degree from Kafkas University in 2011. Between 2011-2015, he worked as an assistant at Atatürk University, Faculty of Veterinary Medicine, Department of Physiology. In 2016, he joined Kafkas University, Faculty of Veterinary Medicine, Department of Physiology as an assistant professor. Dr. Gelen has been engaged in various academic activities at Kafkas University since 2016. There he completed 5 projects and has 3 ongoing projects. He has 60 articles published in scientific journals and 20 poster presentations in scientific congresses. His research interests include physiology, endocrine system, cancer, diabetes, cardiovascular system diseases, and isolated organ bath system studies.",institutionString:"Kafkas University",institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"418963",title:"Dr.",name:"Augustine Ododo",middleName:"Augustine",surname:"Osagie",slug:"augustine-ododo-osagie",fullName:"Augustine Ododo Osagie",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/418963/images/16900_n.jpg",biography:"Born into the family of Osagie, a prince of the Benin Kingdom. I am currently an academic in the Department of Medical Biochemistry, University of Benin. Part of the duties are to teach undergraduate students and conduct academic research.",institutionString:null,institution:{name:"University of Benin",country:{name:"Nigeria"}}},{id:"192992",title:"Prof.",name:"Shagufta",middleName:null,surname:"Perveen",slug:"shagufta-perveen",fullName:"Shagufta Perveen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192992/images/system/192992.png",biography:"Prof. Shagufta Perveen is a Distinguish Professor in the Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. Dr. Perveen has acted as the principal investigator of major research projects funded by the research unit of King Saud University. She has more than ninety original research papers in peer-reviewed journals of international repute to her credit. She is a fellow member of the Royal Society of Chemistry UK and the American Chemical Society of the United States.",institutionString:"King Saud University",institution:{name:"King Saud University",country:{name:"Saudi Arabia"}}},{id:"49848",title:"Dr.",name:"Wen-Long",middleName:null,surname:"Hu",slug:"wen-long-hu",fullName:"Wen-Long Hu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49848/images/system/49848.jpg",biography:"Wen-Long Hu is Chief of the Division of Acupuncture, Department of Chinese Medicine at Kaohsiung Chang Gung Memorial Hospital, as well as an adjunct associate professor at Fooyin University and Kaohsiung Medical University. Wen-Long is President of Taiwan Traditional Chinese Medicine Medical Association. He has 28 years of experience in clinical practice in laser acupuncture therapy and 34 years in acupuncture. He is an invited speaker for lectures and workshops in laser acupuncture at many symposiums held by medical associations. He owns the patent for herbal preparation and producing, and for the supercritical fluid-treated needle. Dr. Hu has published three books, 12 book chapters, and more than 30 papers in reputed journals, besides serving as an editorial board member of repute.",institutionString:"Kaohsiung Chang Gung Memorial Hospital",institution:{name:"Kaohsiung Chang Gung Memorial Hospital",country:{name:"Taiwan"}}},{id:"298472",title:"Prof.",name:"Andrey V.",middleName:null,surname:"Grechko",slug:"andrey-v.-grechko",fullName:"Andrey V. Grechko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/298472/images/system/298472.png",biography:"Andrey Vyacheslavovich Grechko, Ph.D., Professor, is a Corresponding Member of the Russian Academy of Sciences. He graduated from the Semashko Moscow Medical Institute (Semashko National Research Institute of Public Health) with a degree in Medicine (1998), the Clinical Department of Dermatovenerology (2000), and received a second higher education in Psychology (2009). Professor A.V. Grechko held the position of Сhief Physician of the Central Clinical Hospital in Moscow. He worked as a professor at the faculty and was engaged in scientific research at the Medical University. Starting in 2013, he has been the initiator of the creation of the Federal Scientific and Clinical Center for Intensive Care and Rehabilitology, Moscow, Russian Federation, where he also serves as Director since 2015. He has many years of experience in research and teaching in various fields of medicine, is an author/co-author of more than 200 scientific publications, 13 patents, 15 medical books/chapters, including Chapter in Book «Metabolomics», IntechOpen, 2020 «Metabolomic Discovery of Microbiota Dysfunction as the Cause of Pathology».",institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"199461",title:"Prof.",name:"Natalia V.",middleName:null,surname:"Beloborodova",slug:"natalia-v.-beloborodova",fullName:"Natalia V. Beloborodova",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/199461/images/system/199461.jpg",biography:'Natalia Vladimirovna Beloborodova was educated at the Pirogov Russian National Research Medical University, with a degree in pediatrics in 1980, a Ph.D. in 1987, and a specialization in Clinical Microbiology from First Moscow State Medical University in 2004. She has been a Professor since 1996. Currently, she is the Head of the Laboratory of Metabolism, a division of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russian Federation. N.V. Beloborodova has many years of clinical experience in the field of intensive care and surgery. She studies infectious complications and sepsis. She initiated a series of interdisciplinary clinical and experimental studies based on the concept of integrating human metabolism and its microbiota. Her scientific achievements are widely known: she is the recipient of the Marie E. Coates Award \\"Best lecturer-scientist\\" Gustafsson Fund, Karolinska Institutes, Stockholm, Sweden, and the International Sepsis Forum Award, Pasteur Institute, Paris, France (2014), etc. Professor N.V. Beloborodova wrote 210 papers, five books, 10 chapters and has edited four books.',institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"354260",title:"Ph.D.",name:"Tércio Elyan",middleName:"Azevedo",surname:"Azevedo Martins",slug:"tercio-elyan-azevedo-martins",fullName:"Tércio Elyan Azevedo Martins",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/354260/images/16241_n.jpg",biography:"Graduated in Pharmacy from the Federal University of Ceará with the modality in Industrial Pharmacy, Specialist in Production and Control of Medicines from the University of São Paulo (USP), Master in Pharmaceuticals and Medicines from the University of São Paulo (USP) and Doctor of Science in the program of Pharmaceuticals and Medicines by the University of São Paulo. Professor at Universidade Paulista (UNIP) in the areas of chemistry, cosmetology and trichology. Assistant Coordinator of the Higher Course in Aesthetic and Cosmetic Technology at Universidade Paulista Campus Chácara Santo Antônio. Experience in the Pharmacy area, with emphasis on Pharmacotechnics, Pharmaceutical Technology, Research and Development of Cosmetics, acting mainly on topics such as cosmetology, antioxidant activity, aesthetics, photoprotection, cyclodextrin and thermal analysis.",institutionString:null,institution:{name:"University of Sao Paulo",country:{name:"Brazil"}}},{id:"334285",title:"Ph.D. Student",name:"Sameer",middleName:"Kumar",surname:"Jagirdar",slug:"sameer-jagirdar",fullName:"Sameer Jagirdar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334285/images/14691_n.jpg",biography:"I\\'m a graduate student at the center for biosystems science and engineering at the Indian Institute of Science, Bangalore, India. I am interested in studying host-pathogen interactions at the biomaterial interface.",institutionString:null,institution:{name:"Indian Institute of Science Bangalore",country:{name:"India"}}},{id:"329795",title:"Dr.",name:"Mohd Aftab",middleName:"Aftab",surname:"Siddiqui",slug:"mohd-aftab-siddiqui",fullName:"Mohd Aftab Siddiqui",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329795/images/15648_n.jpg",biography:"Dr. Mohd Aftab Siddiqui is currently working as Assistant Professor in the Faculty of Pharmacy, Integral University, Lucknow for the last 6 years. He has completed his Doctor in Philosophy (Pharmacology) in 2020 from Integral University, Lucknow. He completed his Bachelor in Pharmacy in 2013 and Master in Pharmacy (Pharmacology) in 2015 from Integral University, Lucknow. He is the gold medalist in Bachelor and Master degree. He qualified GPAT -2013, GPAT -2014, and GPAT 2015. His area of research is Pharmacological screening of herbal drugs/ natural products in liver and cardiac diseases. He has guided many M. Pharm. research projects. He has many national and international publications.",institutionString:"Integral University",institution:null},{id:"255360",title:"Dr.",name:"Usama",middleName:null,surname:"Ahmad",slug:"usama-ahmad",fullName:"Usama Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255360/images/system/255360.png",biography:"Dr. Usama Ahmad holds a specialization in Pharmaceutics from Amity University, Lucknow, India. He received his Ph.D. degree from Integral University. Currently, he’s working as an Assistant Professor of Pharmaceutics in the Faculty of Pharmacy, Integral University. From 2013 to 2014 he worked on a research project funded by SERB-DST, Government of India. He has a rich publication record with more than 32 original articles published in reputed journals, 3 edited books, 5 book chapters, and a number of scientific articles published in ‘Ingredients South Asia Magazine’ and ‘QualPharma Magazine’. He is a member of the American Association for Cancer Research, International Association for the Study of Lung Cancer, and the British Society for Nanomedicine. Dr. Ahmad’s research focus is on the development of nanoformulations to facilitate the delivery of drugs that aim to provide practical solutions to current healthcare problems.",institutionString:"Integral University",institution:{name:"Integral University",country:{name:"India"}}},{id:"30568",title:"Prof.",name:"Madhu",middleName:null,surname:"Khullar",slug:"madhu-khullar",fullName:"Madhu Khullar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/30568/images/system/30568.jpg",biography:"Dr. Madhu Khullar is a Professor of Experimental Medicine and Biotechnology at the Post Graduate Institute of Medical Education and Research, Chandigarh, India. She completed her Post Doctorate in hypertension research at the Henry Ford Hospital, Detroit, USA in 1985. She is an editor and reviewer of several international journals, and a fellow and member of several cardiovascular research societies. Dr. Khullar has a keen research interest in genetics of hypertension, and is currently studying pharmacogenetics of hypertension.",institutionString:"Post Graduate Institute of Medical Education and Research",institution:{name:"Post Graduate Institute of Medical Education and Research",country:{name:"India"}}},{id:"223233",title:"Prof.",name:"Xianquan",middleName:null,surname:"Zhan",slug:"xianquan-zhan",fullName:"Xianquan Zhan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/223233/images/system/223233.png",biography:"Xianquan Zhan received his MD and Ph.D. in Preventive Medicine at West China University of Medical Sciences. He received his post-doctoral training in oncology and cancer proteomics at the Central South University, China, and the University of Tennessee Health Science Center (UTHSC), USA. He worked at UTHSC and the Cleveland Clinic in 2001–2012 and achieved the rank of associate professor at UTHSC. Currently, he is a full professor at Central South University and Shandong First Medical University, and an advisor to MS/PhD students and postdoctoral fellows. He is also a fellow of the Royal Society of Medicine and European Association for Predictive Preventive Personalized Medicine (EPMA), a national representative of EPMA, and a member of the American Society of Clinical Oncology (ASCO) and the American Association for the Advancement of Sciences (AAAS). He is also the editor in chief of International Journal of Chronic Diseases & Therapy, an associate editor of EPMA Journal, Frontiers in Endocrinology, and BMC Medical Genomics, and a guest editor of Mass Spectrometry Reviews, Frontiers in Endocrinology, EPMA Journal, and Oxidative Medicine and Cellular Longevity. He has published more than 148 articles, 28 book chapters, 6 books, and 2 US patents in the field of clinical proteomics and biomarkers.",institutionString:"Shandong First Medical University",institution:{name:"Affiliated Hospital of Shandong Academy of Medical Sciences",country:{name:"China"}}},{id:"297507",title:"Dr.",name:"Charles",middleName:"Elias",surname:"Assmann",slug:"charles-assmann",fullName:"Charles Assmann",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/297507/images/system/297507.jpg",biography:"Charles Elias Assmann is a biologist from Federal University of Santa Maria (UFSM, Brazil), who spent some time abroad at the Ludwig-Maximilians-Universität München (LMU, Germany). He has Masters Degree in Biochemistry (UFSM), and is currently a PhD student at Biochemistry at the Department of Biochemistry and Molecular Biology of the UFSM. His areas of expertise include: Biochemistry, Molecular Biology, Enzymology, Genetics and Toxicology. He is currently working on the following subjects: Aluminium toxicity, Neuroinflammation, Oxidative stress and Purinergic system. Since 2011 he has presented more than 80 abstracts in scientific proceedings of national and international meetings. Since 2014, he has published more than 20 peer reviewed papers (including 4 reviews, 3 in Portuguese) and 2 book chapters. He has also been a reviewer of international journals and ad hoc reviewer of scientific committees from Brazilian Universities.",institutionString:"Universidade Federal de Santa Maria",institution:{name:"Universidade Federal de Santa Maria",country:{name:"Brazil"}}},{id:"217850",title:"Dr.",name:"Margarete Dulce",middleName:null,surname:"Bagatini",slug:"margarete-dulce-bagatini",fullName:"Margarete Dulce Bagatini",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/217850/images/system/217850.jpeg",biography:"Dr. Margarete Dulce Bagatini is an associate professor at the Federal University of Fronteira Sul/Brazil. She has a degree in Pharmacy and a PhD in Biological Sciences: Toxicological Biochemistry. She is a member of the UFFS Research Advisory Committee\nand a member of the Biovitta Research Institute. She is currently:\nthe leader of the research group: Biological and Clinical Studies\nin Human Pathologies, professor of postgraduate program in\nBiochemistry at UFSC and postgraduate program in Science and Food Technology at\nUFFS. She has experience in the area of pharmacy and clinical analysis, acting mainly\non the following topics: oxidative stress, the purinergic system and human pathologies, being a reviewer of several international journals and books.",institutionString:"Universidade Federal da Fronteira Sul",institution:{name:"Universidade Federal da Fronteira Sul",country:{name:"Brazil"}}},{id:"226275",title:"Ph.D.",name:"Metin",middleName:null,surname:"Budak",slug:"metin-budak",fullName:"Metin Budak",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226275/images/system/226275.jfif",biography:"Metin Budak, MSc, PhD is an Assistant Professor at Trakya University, Faculty of Medicine. He has been Head of the Molecular Research Lab at Prof. Mirko Tos Ear and Hearing Research Center since 2018. His specializations are biophysics, epigenetics, genetics, and methylation mechanisms. He has published around 25 peer-reviewed papers, 2 book chapters, and 28 abstracts. He is a member of the Clinical Research Ethics Committee and Quantification and Consideration Committee of Medicine Faculty. His research area is the role of methylation during gene transcription, chromatin packages DNA within the cell and DNA repair, replication, recombination, and gene transcription. His research focuses on how the cell overcomes chromatin structure and methylation to allow access to the underlying DNA and enable normal cellular function.",institutionString:"Trakya University",institution:{name:"Trakya University",country:{name:"Turkey"}}},{id:"243049",title:"Dr.",name:"Anca",middleName:null,surname:"Pantea Stoian",slug:"anca-pantea-stoian",fullName:"Anca Pantea Stoian",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243049/images/system/243049.jpg",biography:"Anca Pantea Stoian is a specialist in diabetes, nutrition, and metabolic diseases as well as health food hygiene. She also has competency in general ultrasonography.\n\nShe is an associate professor in the Diabetes, Nutrition and Metabolic Diseases Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. She has been chief of the Hygiene Department, Faculty of Dentistry, at the same university since 2019. Her interests include micro and macrovascular complications in diabetes and new therapies. Her research activities focus on nutritional intervention in chronic pathology, as well as cardio-renal-metabolic risk assessment, and diabetes in cancer. She is currently engaged in developing new therapies and technological tools for screening, prevention, and patient education in diabetes. \n\nShe is a member of the European Association for the Study of Diabetes, Cardiometabolic Academy, CEDA, Romanian Society of Diabetes, Nutrition and Metabolic Diseases, Romanian Diabetes Federation, and Association for Renal Metabolic and Nutrition studies. She has authored or co-authored 160 papers in national and international peer-reviewed journals.",institutionString:null,institution:{name:"Carol Davila University of Medicine and Pharmacy",country:{name:"Romania"}}},{id:"279792",title:"Dr.",name:"João",middleName:null,surname:"Cotas",slug:"joao-cotas",fullName:"João Cotas",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/279792/images/system/279792.jpg",biography:"Graduate and master in Biology from the University of Coimbra.\n\nI am a research fellow at the Macroalgae Laboratory Unit, in the MARE-UC – Marine and Environmental Sciences Centre of the University of Coimbra. My principal function is the collection, extraction and purification of macroalgae compounds, chemical and bioactive characterization of the compounds and algae extracts and development of new methodologies in marine biotechnology area. \nI am associated in two projects: one consists on discovery of natural compounds for oncobiology. The other project is the about the natural compounds/products for agricultural area.\n\nPublications:\nCotas, J.; Figueirinha, A.; Pereira, L.; Batista, T. 2018. An analysis of the effects of salinity on Fucus ceranoides (Ochrophyta, Phaeophyceae), in the Mondego River (Portugal). Journal of Oceanology and Limnology. in press. DOI: 10.1007/s00343-019-8111-3",institutionString:"Faculty of Sciences and Technology of University of Coimbra",institution:null},{id:"279788",title:"Dr.",name:"Leonel",middleName:null,surname:"Pereira",slug:"leonel-pereira",fullName:"Leonel Pereira",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/279788/images/system/279788.jpg",biography:"Leonel Pereira has an undergraduate degree in Biology, a Ph.D. in Biology (specialty in Cell Biology), and a Habilitation degree in Biosciences (specialization in Biotechnology) from the Faculty of Science and Technology, University of Coimbra, Portugal, where he is currently a professor. In addition to teaching at this university, he is an integrated researcher at the Marine and Environmental Sciences Center (MARE), Portugal. His interests include marine biodiversity (algae), marine biotechnology (algae bioactive compounds), and marine ecology (environmental assessment). Since 2008, he has been the author and editor of the electronic publication MACOI – Portuguese Seaweeds Website (www.seaweeds.uc.pt). He is also a member of the editorial boards of several scientific journals. Dr. Pereira has edited or authored more than 20 books, 100 journal articles, and 45 book chapters. He has given more than 100 lectures and oral communications at various national and international scientific events. He is the coordinator of several national and international research projects. In 1998, he received the Francisco de Holanda Award (Honorable Mention) and, more recently, the Mar Rei D. Carlos award (18th edition). He is also a winner of the 2016 CHOICE Award for an outstanding academic title for his book Edible Seaweeds of the World. In 2020, Dr. Pereira received an Honorable Mention for the Impact of International Publications from the Web of Science",institutionString:"University of Coimbra",institution:{name:"University of Coimbra",country:{name:"Portugal"}}},{id:"61946",title:"Dr.",name:"Carol",middleName:null,surname:"Bernstein",slug:"carol-bernstein",fullName:"Carol Bernstein",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/61946/images/system/61946.jpg",biography:"Carol Bernstein received her PhD in Genetics from the University of California (Davis). She was a faculty member at the University of Arizona College of Medicine for 43 years, retiring in 2011. Her research interests focus on DNA damage and its underlying role in sex, aging and in the early steps of initiation and progression to cancer. In her research, she had used organisms including bacteriophage T4, Neurospora crassa, Schizosaccharomyces pombe and mice, as well as human cells and tissues. She authored or co-authored more than 140 scientific publications, including articles in major peer reviewed journals, book chapters, invited reviews and one book.",institutionString:"University of Arizona",institution:{name:"University of Arizona",country:{name:"United States of America"}}},{id:"182258",title:"Dr.",name:"Ademar",middleName:"Pereira",surname:"Serra",slug:"ademar-serra",fullName:"Ademar Serra",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/182258/images/system/182258.jpeg",biography:"Dr. Serra studied Agronomy on Universidade Federal de Mato Grosso do Sul (UFMS) (2005). He received master degree in Agronomy, Crop Science (Soil fertility and plant nutrition) (2007) by Universidade Federal da Grande Dourados (UFGD), and PhD in agronomy (Soil fertility and plant nutrition) (2011) from Universidade Federal da Grande Dourados / Escola Superior de Agricultura Luiz de Queiroz (UFGD/ESALQ-USP). Dr. Serra is currently working at Brazilian Agricultural Research Corporation (EMBRAPA). His research focus is on mineral nutrition of plants, crop science and soil science. Dr. Serra\\'s current projects are soil organic matter, soil phosphorus fractions, compositional nutrient diagnosis (CND) and isometric log ratio (ilr) transformation in compositional data analysis.",institutionString:"Brazilian Agricultural Research Corporation",institution:{name:"Brazilian Agricultural Research Corporation",country:{name:"Brazil"}}}]}},subseries:{item:{id:"9",type:"subseries",title:"Biotechnology - Biosensors, Biomaterials and Tissue Engineering",keywords:"Biotechnology, Biosensors, Biomaterials, Tissue Engineering",scope:"The Biotechnology - Biosensors, Biomaterials and Tissue Engineering topic within the Biomedical Engineering Series aims to rapidly publish contributions on all aspects of biotechnology, biosensors, biomaterial and tissue engineering. We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. 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