Summary of the studies that evaluated the role of antireflux therapy and surgery in the management of IPF.
\\n\\n
More than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\\n\\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\\n\\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\\n\\nAdditionally, each book published by IntechOpen contains original content and research findings.
\\n\\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\\n\\n\\n\\n
\\n"}]',published:!0,mainMedia:{caption:"IntechOpen Maintains",originalUrl:"/media/original/113"}},components:[{type:"htmlEditorComponent",content:'
Simba Information has released its Open Access Book Publishing 2020 - 2024 report and has again identified IntechOpen as the world’s largest Open Access book publisher by title count.
\n\nSimba Information is a leading provider for market intelligence and forecasts in the media and publishing industry. The report, published every year, provides an overview and financial outlook for the global professional e-book publishing market.
\n\nIntechOpen, De Gruyter, and Frontiers are the largest OA book publishers by title count, with IntechOpen coming in at first place with 5,101 OA books published, a good 1,782 titles ahead of the nearest competitor.
\n\nSince the first Open Access Book Publishing report published in 2016, IntechOpen has held the top stop each year.
\n\n\n\nMore than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\n\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\n\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\n\nAdditionally, each book published by IntechOpen contains original content and research findings.
\n\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\n\n\n\n
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By integrating the best design practices with the most advanced technologies, mechatronics aims at realizing high-quality products, guaranteeing at the same time a substantial reduction of time and costs of manufacturing.\r\n\r\nMechatronic systems are manifold and range from machine components, motion generators, and power producing machines to more complex devices, such as robotic systems and transportation vehicles. With its twenty chapters, which collect contributions from many researchers worldwide, this book provides an excellent survey of recent work in the field of mechatronics with applications in various fields, like robotics, medical and assistive technology, human-machine interaction, unmanned vehicles, manufacturing, and education. We would like to thank all the authors who have invested a great deal of time to write such interesting chapters, which we are sure will be valuable to the readers.\r\n\r\nChapters 1 to 6 deal with applications of mechatronics for the development of robotic systems. Medical and assistive technologies and human-machine interaction systems are the topic of chapters 7 to 13.Chapters 14 and 15 concern mechatronic systems for autonomous vehicles. Chapters 16-19 deal with mechatronics in manufacturing contexts. Chapter 20 concludes the book, describing a method for the installation of mechatronics education in schools.",isbn:null,printIsbn:"978-953-307-040-7",pdfIsbn:"978-953-51-5892-9",doi:"10.5772/206",price:139,priceEur:155,priceUsd:179,slug:"mechatronic-systems-applications",numberOfPages:364,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:null,bookSignature:"Annalisa Milella Donato Di Paola and Grazia Cicirelli",publishedDate:"March 1st 2010",coverURL:"https://cdn.intechopen.com/books/images_new/3627.jpg",numberOfDownloads:78088,numberOfWosCitations:24,numberOfCrossrefCitations:29,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:46,numberOfDimensionsCitationsByBook:0,hasAltmetrics:0,numberOfTotalCitations:99,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:null,dateEndSecondStepPublish:null,dateEndThirdStepPublish:null,dateEndFourthStepPublish:null,dateEndFifthStepPublish:null,currentStepOfPublishingProcess:1,indexedIn:"1,2,3,4,5,6,7",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"1065",title:"Dr.",name:"Annalisa",middleName:null,surname:"Milella",slug:"annalisa-milella",fullName:"Annalisa Milella",profilePictureURL:"https://mts.intechopen.com/storage/users/1065/images/system/1065.jpg",biography:"I received the Laurea (summa cum laude) and Research Doctorate degrees from the Politecnico of Bari, Italy, in 2002 and 2006, respectively, both in Mechanical Engineering. 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Until 2001 she held grants from the Italian National Research Council (CNR) for research activities in Robotics and Image Processing. From 2001 she is a Technologist Researcher at the Institute of Intelligent Systems for Automation (ISSIA) of CNR in Bari. Her principal interests include pattern recognition, artificial intelligence, image processing for robotic applications and intelligent systems for video-surveillance. She has worked on and directed numerous research projects in different research areas such as Quality Control, Intelligent Transportation Systems, Autonomous Mobile Robotics. She is author of numerous research papers published in International Conference Proceedings, National and International Journals. 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\r\n\tEmpathy – the ability to understand and share the feeling of others - is a vital skill for social functioning since it participates in the quality of life. Empathy contributes to the interpersonal social life satisfaction between us, and the people who we care about. It improves the relationship between caregivers and care recipients, helps to avoid aggressive and unpleasant situations with others, and promotes prosocial behaviors. Due to its key role in society, clinicians, neuropsychologists, and scientific researchers have investigated the variables involved, the original methods and procedures to elicit it, and the practical implications.
\r\n\tThe present book intends to provide to the reader a comprehensive overview of the state of art in empathy studies, embracing the different theoretical points of view and illustrating the advanced research such as the application of new technologies to promote perspective-taking. The critical aspects and the future directions of the study on empathy will also be presented.
Idiopathic Pulmonary Fibrosis (IPF) is the most common type of Idiopathic Interstitial Pneumonia. It is more prevalent in men, and its incidence increases with age, especially beyond the fifth decade [1]. Its incidence is estimated to be 3–9 cases per 100,000 per year in the western hemisphere [2]. As per a systematic review, the prevalence is estimated to be 0.5–27.9/100,000 [3]. Although newer therapies such as Pirfenidone and Nintedanib are available to slow the progression of the disease, the mortality and prognosis remain dismal, comparable to that of certain malignancies [4]. A key consideration has been the lack of optimal understanding of the pathophysiological mechanisms underlying the disease process, as interventions can then be targeted to modify the disease process and achieve better outcomes for the patients [4]. In a genetically susceptible individual, many risk factors have been proposed [1]. One such factor that has been closely associated with IPF is Gastroesophageal reflux disease (GERD) [1]. Their association has been hypothesized, studied, and targeted therapeutically. However, its role as a causative and aggravating factor has not yet been crystallized. Our chapter aims to review the association of GERD with IPF, its alleged role in causing or promoting lung injury, the effect of GERD therapy on IPF, recommendations from clinical guidelines, and the direction for future research.
GERD is a disease caused by reflux of stomach contents into the esophagus and beyond, causing troublesome symptoms and complications [5]. It causes esophageal and stomach symptoms characterized by chest pain, nausea, bloating, heartburn, and regurgitation. It can also cause extraesophageal symptoms such as throat pain, burning, lump in the throat, the sensation of needing to clear the throat, hoarseness of voice, cough, wheezing, bronchospasm, etc. [5, 6]. Importantly not all reflux events are symptomatic as there could be non-acid reflux [5, 6, 7].
Prevalence of GERD is very common in the western world, with North American estimates being 18.1–27.8% [8]. Europe, similarly, has a prevalence of up to 25% [8]. In a United Kingdom general practice database, IPF was much more likely to be associated with a diagnosis of GERD (65%) or use of anti-reflux therapy (71%) when compared to controls [4, 7, 9]. The prevalence of erosive esophagitis and hiatal hernia, both of which are associated with increased reflux, is also much higher in pulmonary fibrosis patients when compared to the general population [8, 10]. Hence there is a strong epidemiological association between these two disease entities.
GERD occurs commonly as a result of increased frequency of transient lower esophageal sphincter relaxations (TLESRs), which are defined as brief moments of lower esophageal sphincter tone inhibition that are independent of a swallow [11]. Other pathophysiological mechanisms implicated in the causation of GERD are reduced lower esophageal sphincter (LES) pressure, reduced upper esophageal sphincter pressure, reduced esophageal motility, Hiatal hernias, which distorts the gastroesophageal junctional anatomy, impairment of esophageal clearance, and sluggish gastric emptying [4, 5, 7]. A combination of these factors leads to the reflux establishing contact with mucosa in the upper gastrointestinal tract, pharynx, tracheobronchial tree, and lungs, causing extra esophageal symptoms as previously described [4, 5, 7].
Evaluation of GERD can be made by direct visual examination by esophagogastroduodenoscopy (EGD). The chief advantage is that the mucosa can be visualized directly and is helpful in the diagnosis of possible complications of GERD, including Barret’s esophagitis, esophagitis, gastritis, gastric and esophageal stricture, and malignancy. However, pH monitoring better evaluates reflux, wherein a pH measuring probe is placed in the esophagus [5]. The primary measurement is the amount of time spent with a pH less than 4.0 [5]. However, it has its inherent limitations, as non-acid reflux cannot be measured and can remain totally asymptomatic. This limitation has been overcome by the placement of channels that measure impedance. Liquid reflux has low impedance and high conductance, while gaseous reflux, such as belching, has high impedance with low conductance [12]. Combined 24-hr multichannel intraluminal impedance-pH monitoring (MII-pH) are available to determine the amount of refluxate, its proximal extent, and/or the presence of both acid and weakly acidic reflux [7, 13]. The chief metric when using MII-pH is the “Total number of refluxes” (Pathological when more than 80 and normal if less than 40 in a 24-hour period) and esophageal “Acid exposure time (AET)” as the percentage of time with pH less than 4.0 in the distal esophagus [14]. The use of MII-pH in GERD associated with extra esophageal disease, particularly in IPF, is rather novel and promising to help illuminate the pathophysiological mechanisms between the two diseases [15]. It is noteworthy that IPF belongs to a group of diseases that are only possibly or likely associated with GERD, and its role is only speculated [7]. The use and application of MII-pH for the study of extraesophageal diseases and symptoms has not been as productive as for typical GERD [7].
The relationship between IPF and GERD is quite intriguing. The epidemiological association suggests that there appear to be plausible biological and mechanical factors underlying this pathophysiology.
It is suggested that GERD is associated with decreased upper and lower esophageal sphincter tone (hypotensive esophagogastric junction) with or without increased frequency of transient lower esophageal sphincter relaxations (TLESRs), leading to increased refluxate with an associated micro-aspiration of the gastric contents into the trachea and lungs [16, 17, 18]. Contrary to this proposed theory, it has been proposed that lung fibrosis causes decreased lung compliance along with lower lung elasticity, resulting in increased negative intrathoracic pressure during inspiration that is transmitted to the mediastinal structures, including the esophagus and its sphincters [17]. This causes increased transient lower esophageal sphincter relaxations (TLESRs) with lower and upper esophageal sphincters [17]. There is also a pressure gradient across the diaphragm in respiratory diseases like IPF, which may promote these favorable refluxate mechanisms, especially during coughing, increased respiratory excursions during exacerbations, and may potentially be further aggravated by hypoxia/hypercapnia, medications like antacids, glucocorticoids, and obstructive sleep apnea/hypopnea syndromes [19]. Hiatal hernia alters the physical and physiologic function of the lower esophageal sphincter, thereby promoting reflux [20, 21, 22]. Furthermore, it has been proposed that esophageal dysmotility may contribute to reflux [23, 24]. Ultimately, the result of these phenomena is that the gastric refluxate, which contains both acidic and non-acidic contents, leads to delayed esophageal clearance and micro-aspiration in the tracheobronchial tree injure the pulmonary parenchyma consisting of both alveolar and interstitial components [4, 7, 19]. The healing of this injury eventually occurs by fibrosis, and the pulmonary remodeling that ensues culminates in a distorted fibrotic architecture [4, 7].
Many studies have been performed to provide evidence and study the relationship between GERD and IPF. Most of these studies have limitations and often conclude with contradictory results. Therefore, evidence has shown a co-existence and/or association between IPF and GERD. However, causality has yet to be determined [4, 7, 25].
Gao et al. conducted a study involving 69 IPF patients, 62 healthy volunteers, and 88 IPF negative GERD patients. The prevalence of GERD was high in patients with IPF, and in relation to their comparator group showed the variable presence of esophageal dysmotility and decreased lower and upper esophageal sphincter pressure. IPF patients also had increased reflux events proximally and impaired bolus transit time [16]. Raghu et al. studied 65 patients with IPF who were subjected to 24-h pH monitoring and esophageal manometry with a comparison group of 133 asthmatic patients and symptoms of GERD. The prevalence of abnormal gastroesophageal reflux in IPF patients was high at 87%, with 76% and 63% demonstrating abnormal distal and proximal esophageal acid exposures, respectively; a finding higher than within the comparison group [18]. The study also showed that the presence of GERD was not always symptomatic, and there was no correlation with IPF severity [18]. This was further confirmed in a study involving 28 patients with histologically confirmed IPF using hypopharyngeal multichannel intraluminal impedance (HMII) [26]. HMII used a specialized impedance catheter to directly measure laryngopharyngeal reflux (LPR) and full column reflux (reflux 2 cm distal to the upper esophageal sphincter). The study included 16 males and 12 females with a mean age of 60.4 years (range, 41–78) and a BMI of 28.4 (range, 21.1–38.1), respectively. Abnormal proximal exposure was present in 54% (15/28) of patients. This latter group was more likely to have a defective lower esophageal sphincter (LES) compared with those without (93% vs. 75%). Fourteen patients (56%) had abnormal esophageal motility, including aperistaltic esophagus (n = 9), suggesting that this may be common in this patient population [26].GERD was noted to be highly prevalent at more than 70% in patients with IPF; abnormal proximal reflux events such as LPR and full column reflux were also quite common despite a frequently negative DeMeester score (It is a composite of six different parameters which measures acid exposure giving a pH score used to diagnose GERD), suggesting that nonacid reflux (25% of patients) is prevalent in this patient population [26]. A high rate of esophageal mucosal injury and a longer acid clearance time was also noted [26].67–76% of the systematic review demonstrated abnormal esophageal acid exposure off PPI treatment [27].
In another study conducted by Savarino et al. [28], 40 IPF patients were studied alongside 40 non-IPF ILD patients and 50 healthy volunteers, who served as controls. Patients were off reflux therapy and underwent a High-resolution Lung CT scan (HRCT) and pH-impedance monitoring. Patients with IPF had significantly increased esophageal acid exposure, the number of acidic, weakly acidic, and proximal reflux events relative to the comparison groups. Pulmonary fibrosis HRCT scores correlated well with reflux episodes in both the distal and proximal esophagus. Patients with IPF had more bile acids and pepsin (p < 0.03) in bronchoalveolar lavage fluid (62% and 67%, respectively) and saliva (61% and 68%, respectively) relative to the comparison groups [28]. Gavini et al. conducted an elegant study involving 45 pre-transplants patients with IPF who had received pulmonary function tests within the last 3 months. Patients were off reflux therapy and had no reflux surgery. They measured GER on multichannel intraluminal impedance and pH study (MII-pH). Six pH/acid reflux parameters with corresponding MII/bolus reflux measures were prespecified. Multivariate analyses were applied using forward stepwise logistic regression. Severe pulmonary dysfunction was defined using diffusion capacity for carbon monoxide (DLCO) ≤40%. Abnormal total reflux episodes and prolonged bolus clearance time (OR = 1.21 p = 0.05), but not the refluxate pH values, were significantly associated with pulmonary dysfunction severity on univariate and multivariate analyses [29]. Overall, it appears that esophageal dysmotility, the total number of acidic, weakly acidic, and non-acidic refluxes with prolonged bolus clearance time, appear to impact the underlying lung pathology.
Animal and human studies have shown that the presence of gastric contents (pepsin, bile acids, gastric acid) via microaspiration in bronchoalveolar lavage (BAL) fluid can cause tissue damage and inflammatory infiltrate [28, 30, 31, 32, 33, 34, 35]. Histologically presence of thickened alveolar walls, collagen deposition in the interstitium, epithelial-mesenchymal transition, and presence of various fibrogenic factors has been found [28, 34, 35]. The latter consists of TGF-beta, NFκB, Farnesoid X receptor, and others. TGF-beta can be induced by gastric contents, leading to fibroblast proliferation and fibroproliferative changes [4, 7].
There has been a long-standing interest in the use of anti-secretory therapy/anti-reflux surgery in IPF patients, given that GERD has been thought of as having a relationship with IPF [4, 7]. While it is not unreasonable to give anti-secretory therapy to patients with symptomatic GERD patients, it has certainly been hard to objectively justify the use in all patients with IPF, some of whom may not have any reflux or reflux with non-acidic gastric contents [36]. This has indeed been a recommendation from international guidelines, albeit it was a week level of recommendation [37]. As per literature, PPIs are the most frequently used medications, and further discussion will relate henceforth to PPI.
PPIs are known for increasing the pH of gastric acid; a mechanism thought to prevent microaspiration of acidic contents into the lung and hence potentially protect against acid-induced pneumonitis [37]. In vitro studies show that PPIs like Esomeprazole have pleiotropic effects, can inhibit expression of pro-inflammatory molecules like vascular cell adhesion molecule-1, inducible nitric oxide synthase, tumor necrosis factor-alpha (TNF-α), and interleukins (IL-1β and IL-6), and exhibit antioxidant and anti-fibrotic properties by downregulation of profibrotic proteins including receptors for transforming growth factor β (TGFβ), fibronectin and matrix metalloproteinases (MMPs) [38, 39]. They may also inhibit apoptosis of pneumocytes expressing Surfactant (SP-C) [38, 39]. Retrospective studies have also demonstrated that PPIs may prolong transplant-free survival of IPF patients [38, 39].
However, PPIs are not without risks. They have been shown to alter the microbiome of the respiratory tract and increase the risk of pneumonia [17]. Furthermore, they increase the risk of micronutrient deficiencies like Vitamin B12, cause dementia,
Anti-reflux surgery is an important therapeutic option in patients with GERD. Nissen fundoplication and Laparoscopic anti-reflux surgery (LARS) are the two most performed surgeries, both of which are generally safe in IPF [4, 14]. Lee JS et al. reported a retrospective cohort of 204 IPF patients consisting of individuals with symptoms of GERD (34%), a history of GERD (45%), reported use of GERD medications (47%), and Nissen fundoplication (5%). After the multivariate adjustment, the use of GERD medication was associated with a lower radiologic fibrotic score. It was also an independent predictor of longer survival time in patients with IPF [41]. Lee JS et al. also reported the combined results of 3 prospectively collected randomized controlled trial data, including 242 patients only from the placebo arm. Although the data came from RCTs, this was not an RCT. Of the total 242 patients, 124 patients were taking PPI/H2RA, and 118 patients were not taking any antisecretory therapy. In IPF, a slower decline in Forced vital capacity (FVC) has shown a correlation with improved survival time in IPF [42]. The study showed that there was a slower decline in FVC in the PPI/H2RA group, which was statistically significant. Also, there were fewer acute exacerbations in the PPI/H2RA group, and this result did not contribute to the slower decline in FVC. However, there was no change in mortality, presumably due to the follow-up period not being sufficient. This study result generated an interesting hypothesis that the use of PPI/H2RA could slow disease progression [43].
Furthermore, Fidler et al. conducted a systematic review and meta-analysis, studying the effect of pharmacological therapy of GERD in IPF patients, which showed a significant improvement in IPF related survival (adjusted risk: HR 0.45) but no effect on all-cause mortality. There was a change in progression-free survival, FVC, acute exacerbation, and other Pulmonary function test parameters. In patients with FVC less than 70% of predicted, there was an increase in pulmonary infection, which was significant as this is a known side effect of PPI affecting patients with more advanced disease [44]. It follows from this discussion that the studies once again have small numbers, mostly observational, and hence have limitations providing poor or limited quality of evidence [44].
In a randomized controlled trial, Raghu et al. analyzed data from 27 patients who underwent Laparoscopic anti-reflux surgery (LARS) and 20 patients who did not undergo surgery with FVC measurement at 48 weeks as the endpoint in an intention to treat analysis. All patients had abnormal acid GER with a confirmed DeMeester score of ≥14·7; measured by 24-h pH monitoring and preserved forced vital capacity (FVC) of more than 50%. Patients were allowed to use Nintedanib and Pirfenidone. Patients in the surgery group had a slower decline in FVC, which was not statistically significant at 48 weeks in the non-surgery group (p = 0·28)}. Acute exacerbation of IPF, hospitalization for respiratory etiology, and mortality were also less in the surgical group, however not to statistical significance [45].
GERD has been known to be co-existent with many Pulmonary disorders such as Systemic Sclerosis, Chronic obstructive pulmonary disease (COPD), Bronchial Asthma, IPF, Bronchiectasis, Aspiration Pneumonia, Lung transplant complications such as Bronchiolitis obliterans (BOS), etc. [6]. These plethora’s of lung conditions being associated with GERD are likely due to the shared common genetic embryological and developmental origin of the two organ systems from the foregut [6, 60]. In addition, they share the intrathoracic cavity and also have the same vagal innervation [6, 60]. As such, two predominant theories are in vogue, the “Refluxate theory” and the “Reflux theory,” which attempt to explain the disease mechanisms with their common origin and development as background. The “Refluxate theory,” as previously described, implicates acid reflux from the GI tract and its micro-aspiration into the Respiratory tree, causing physicochemical damage to the latter culminating in fibrosis [6]. The “Reflex theory” pertains to the reflex increase in bronchoconstriction and airway resistance in response to the presence of acid in the esophagus and respiratory tree [6]. Furthermore, as discussed previously, the presence of pulmonary fibrosis may aggravate the gastroesophageal reflux due to decreased compliance, elasticity, and need for increased negative intrathoracic pressure generated during inspiration, causing increased gradient across thoracic and abdominal compartments [6]. Hence there is possibly a bidirectional relationship between the two organ systems, as depicted in Figure 1. A Summary of the studies that evaluated the role of antireflux therapy and surgery in the management of IPF is available in Table 1.
The bidirectional relationship between IPF and GERD.
Authors | Year | Study type | Anti-reflux therapy type | Population size | Outcomes |
---|---|---|---|---|---|
Cantu et al. [46] | 2004 | Retrospective cohort study | Fundoplication | 457 |
|
Raghu et al. [18] | 2006 | Case series | PPIs | 4 |
|
Linden et al. [47] | 2006 | Retrospective cohort study | Fundoplication | 45 |
|
Lee et al. [41] | 2011 | Retrospective cohort study | PPIs–H2RAs | 204 |
|
Fisichella et al. [48] | 2011 | Prospective study | LARS | 39 |
|
Noth et al. [10] | 2012 | Retrospective cohort study | PPIs–H2RAs | 74 |
|
Raghu et al. [49] | 2016 | Retrospective cohort study | LARS | 27 |
|
Lee et al. [43] | 2013 | Post hoc analysis of RCTs | PPIs–H2RAs | 242 |
|
Ghebremariam et al. [38] | 2015 | A retrospective analysis from 2 databases | PPIs | 215 |
|
Raghu et al. [37] | 2015 | Post hoc analysis of RCTs | PPIs–H2RAs | 1061 |
|
Kreuter et al. [50] | 2016 | PPIs–H2RAs | 624 |
| |
Lee et al. [51] | 2016 | Retrospective cohort study | PPIs | 786 |
|
Kreuter et al. [52] | 2016 | Retrospective cohort study | PPIs | 272 |
|
Elkstrom et al. [53] | 2016 | Prospective population-based study | PPIs–H2RAs | 462 |
|
Kulkarni et al. [54] | 2016 | Retrospective cohort study | PPIs–H2RAs | 284 |
|
Raghu et al. [55] | 2016 | Retrospective cohort study | LARS | 27 |
|
Kreuter et al. [56] | 2017 | Post hoc analysis of RCTs | PPIs–H2Ras | 632 |
|
Restivo et al. [57] | 2017 | Population-based study | PPIs–H2RAs | 6797 |
|
Raghu et al. [45] | 2018 | A prospective randomized controlled study | LARS | 58 |
|
Costabel et al. [58] | 2018 | PPIs–H2RAs | 406 |
| |
Helen et al. [59] | 2019 | A retrospective analysis from 1 database | PPIs–H2RAs | 587 |
|
Summary of the studies that evaluated the role of antireflux therapy and surgery in the management of IPF.
Abbreviations: BOS: bronchitis obliterans syndrome; PPIs: proton pump inhibitors; PFT: pulmonary function tests; H2RAs: H2 receptor antagonists; LARS: laparoscopic anti-reflux surgery; GERD: gastroesophageal reflux disease; IPF: idiopathic pulmonary fibrosis; DLCO: diffusion lung capacity for carbon monoxide; BALF: bronchoalveolar lavage fluid; RCTs: randomized controlled trials; FVC: forced vital capacity; ILD: interstitial lung disease; CI: confidence interval; HR: hazard ratio.
Studies designed to test the relationships between the two diseases entities have several limitations. They are mostly retrospective, have small sample sizes, with poorly defined inclusion and exclusion criteria, resulting in many confounders. While these limitations can be addressed partially by conducting prospective studies, randomized controlled data with a large sample size will remain elusive due to the prolonged time required for a disease process like IPF takes to evolve and manifest [25]. Besides, diseases like IPF are not clearly recognizable early, and GERD with non-acid reflux or poorly acidic reflux may not manifest with classic symptoms [6, 25], hence denying the opportunity for early recognition and follow up. Hence, our reliance on smaller case-controlled studies with a few well-conducted meta-analyses has only revealed an association between GERD and IPF, far from the nine causality criteria propounded by “Hill” [61, 62]. Although not ruling out causality, a weak association between the two diseases still needs to be viewed with an abundance of caution as the effects of residual confounding generate sufficient bias to prevent a robust causal inference from these types of studies [62]. Although such challenges will limit future studies, investigating therapeutic interventions like LARS and PPIs along with disease-modifying therapies like Nintedanib and Pirfenidone may improve outcomes for our IPF patients [25].
The large database-based clinical studies with robust timestamping of initiation of each disease entity will be helpful in establishing a temporal relationship. A machine learning model development is the need of the hour to answer this clinical question.
The co-existence of IPF and GERD is very common. There is likely a bidirectional pathophysiological relationship between the two disease entities. Although there is no causality established, current guidelines do recommend therapy with PPI in all patients with IPF. There remain many important challenges to the study of these coexisting conditions, and it may not be possible to obtain robust data establishing causality. Nevertheless, an attempt can be made to further conduct well-designed interventional studies to benefit patients in need.
Kristina Kardum Cvitan, Author Service Manager, IntechOpen.
The authors declare no conflict of interest.
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Kessel",authors:[{id:"102383",title:"Dr.",name:"Marta",middleName:null,surname:"Suárez",slug:"marta-suarez",fullName:"Marta Suárez"},{id:"103822",title:"Dr.",name:"J.L",middleName:null,surname:"Menendez",slug:"j.l-menendez",fullName:"J.L Menendez"},{id:"103833",title:"Prof.",name:"Ramón",middleName:null,surname:"Torrecillas",slug:"ramon-torrecillas",fullName:"Ramón Torrecillas"},{id:"162633",title:"Dr.",name:"Adolfo",middleName:null,surname:"Fernández",slug:"adolfo-fernandez",fullName:"Adolfo Fernández"}]},{id:"23617",doi:"10.5772/24118",title:"Collagen- vs. Gelatine-Based Biomaterials and Their Biocompatibility: Review and Perspectives",slug:"collagen-vs-gelatine-based-biomaterials-and-their-biocompatibility-review-and-perspectives",totalDownloads:9461,totalCrossrefCites:63,totalDimensionsCites:203,abstract:null,book:{id:"1487",slug:"biomaterials-applications-for-nanomedicine",title:"Biomaterials",fullTitle:"Biomaterials Applications for Nanomedicine"},signatures:"Selestina Gorgieva and Vanja Kokol",authors:[{id:"55577",title:"Prof.",name:"Vanja",middleName:null,surname:"Kokol",slug:"vanja-kokol",fullName:"Vanja Kokol"},{id:"61285",title:"BSc",name:"Selestina",middleName:null,surname:"Gorgieva",slug:"selestina-gorgieva",fullName:"Selestina Gorgieva"}]},{id:"46243",doi:"10.5772/57255",title:"Corrosion Inhibitors – Principles, Mechanisms and Applications",slug:"corrosion-inhibitors-principles-mechanisms-and-applications",totalDownloads:13737,totalCrossrefCites:40,totalDimensionsCites:163,abstract:null,book:{id:"3817",slug:"developments-in-corrosion-protection",title:"Developments in Corrosion Protection",fullTitle:"Developments in Corrosion Protection"},signatures:"Camila G. Dariva and Alexandre F. Galio",authors:[{id:"169261",title:"Dr.",name:"Camila",middleName:"G.",surname:"Dariva",slug:"camila-dariva",fullName:"Camila Dariva"},{id:"170138",title:"Dr.",name:"Alexandre",middleName:"Ferreira",surname:"Galio",slug:"alexandre-galio",fullName:"Alexandre Galio"}]}],mostDownloadedChaptersLast30Days:[{id:"76780",title:"Basics of Clay Minerals and Their Characteristic Properties",slug:"basics-of-clay-minerals-and-their-characteristic-properties",totalDownloads:1930,totalCrossrefCites:16,totalDimensionsCites:25,abstract:"Clay minerals such as kaolinite, smectite, chlorite, micas are main components of raw materials of clay and formed in presence of water. A large number of clays used to form the different structure which completely depends on their mining source. They are known as hydrous phyllosilicate having silica, alumina and water with variable amount of inorganic ions like Mg2+, Na+, Ca2+ which are found either in interlayer space or on the planetary surface. Clay minerals are described by presence of two-dimensional sheets, tetrahedral (SiO4) and octahedral (Al2O3). There are different clay minerals which are categorized based on presence of tetrahedral and octahedral layer in their structure like kaolinite (1:1 of tetrahedral and octahedral layers), smectite group of clay minerals (2:1 of tetrahedral and octahedral layers) and chlorite (2:1:1 of tetrahedral, octahedral and octahedral layers). The particle size of clay minerals is <2microns which can be present in form of plastic in presence of water and solidified when dried. The small size and their distinctive crystal structure make clay minerals very special with their unique properties including high cation exchange capacity, swelling behavior, specific surface area, adsorption capacity, etc. which are described in this chapter. Due to all these unique properties, clay minerals are gaining interest in different fields.",book:{id:"10949",slug:"clay-and-clay-minerals",title:"Clay and Clay Minerals",fullTitle:"Clay and Clay Minerals"},signatures:"Neeraj Kumari and Chandra Mohan",authors:[{id:"258132",title:"Dr.",name:"Chandra",middleName:null,surname:"Mohan",slug:"chandra-mohan",fullName:"Chandra Mohan"},{id:"352399",title:"Dr.",name:"Neeraj",middleName:null,surname:"Kumari",slug:"neeraj-kumari",fullName:"Neeraj Kumari"}]},{id:"51535",title:"An Introduction to Hydrogels and Some Recent Applications",slug:"an-introduction-to-hydrogels-and-some-recent-applications",totalDownloads:11734,totalCrossrefCites:70,totalDimensionsCites:140,abstract:"Hydrogels have existed for more than half a century, and today they have many applications in various processes ranging from industrial to biological. There are numerous original papers, reviews, and monographs focused on the synthesis, properties, and applications of hydrogels. This chapter covers the fundamental aspects and several applications of hydrogels based on the old and the most recent publications in this field.",book:{id:"5251",slug:"emerging-concepts-in-analysis-and-applications-of-hydrogels",title:"Emerging Concepts in Analysis and Applications of Hydrogels",fullTitle:"Emerging Concepts in Analysis and Applications of Hydrogels"},signatures:"Morteza Bahram, Naimeh Mohseni and Mehdi Moghtader",authors:[{id:"179718",title:"Prof.",name:"Morteza",middleName:null,surname:"Bahram",slug:"morteza-bahram",fullName:"Morteza Bahram"},{id:"185713",title:"Dr.",name:"Naimeh",middleName:null,surname:"Mohseni",slug:"naimeh-mohseni",fullName:"Naimeh Mohseni"},{id:"185714",title:"Dr.",name:"Mehdi",middleName:null,surname:"Moghtader",slug:"mehdi-moghtader",fullName:"Mehdi Moghtader"}]},{id:"70661",title:"Bioremediation Techniques for Polluted Environment: Concept, Advantages, Limitations, and Prospects",slug:"bioremediation-techniques-for-polluted-environment-concept-advantages-limitations-and-prospects",totalDownloads:2672,totalCrossrefCites:10,totalDimensionsCites:27,abstract:"Environmental pollution has been rising in the past few decades due to increased anthropogenic activities. Bioremediation is an attractive and successful cleaning technique to remove toxic waste from polluted environment. Bioremediation is highly involved in degradation, eradication, immobilization, or detoxification diverse chemical wastes and physical hazardous materials from the surrounding through the all-inclusive and action of microorganisms. The main principle is degrading and converting pollutants to less toxic forms. Bioremediation can be carried out ex-situ and in-situ, depending on several factors, which include but not limited to cost, site characteristics, type, and concentration of pollutants. Hence, appropriate bioremediation technique is selected. Additionally, the major methodologies to develop bioremediation are biostimulation, bioaugmentation, bioventing, biopiles, and bioattenuation provided the environmental factors that decide the completion of bioremediation. Bioremediation is the most effective, economical, eco-friendly management tool to manage the polluted environment. All bioremediation techniques have its own advantage and disadvantage because it has its own specific applications.",book:{id:"9343",slug:"trace-metals-in-the-environment-new-approaches-and-recent-advances",title:"Trace Metals in the Environment",fullTitle:"Trace Metals in the Environment - New Approaches and Recent Advances"},signatures:"Indu Sharma",authors:[{id:"301262",title:"Associate Prof.",name:"Indu",middleName:null,surname:"Sharma",slug:"indu-sharma",fullName:"Indu Sharma"}]},{id:"18275",title:"Modeling and Identification of Parameters the Piezoelectric Transducers in Ultrasonic Systems",slug:"modeling-and-identification-of-parameters-the-piezoelectric-transducers-in-ultrasonic-systems",totalDownloads:10197,totalCrossrefCites:3,totalDimensionsCites:5,abstract:null,book:{id:"201",slug:"advances-in-ceramics-electric-and-magnetic-ceramics-bioceramics-ceramics-and-environment",title:"Advances in Ceramics",fullTitle:"Advances in Ceramics - Electric and Magnetic Ceramics, Bioceramics, Ceramics and Environment"},signatures:"Pawel Fabijanski and Ryszard Lagoda",authors:[{id:"13086",title:"Dr.",name:"Pawel",middleName:null,surname:"Fabijański",slug:"pawel-fabijanski",fullName:"Pawel Fabijański"}]},{id:"60680",title:"Environmental Contamination by Heavy Metals",slug:"environmental-contamination-by-heavy-metals",totalDownloads:16251,totalCrossrefCites:187,totalDimensionsCites:407,abstract:"The environment and its compartments have been severely polluted by heavy metals. This has compromised the ability of the environment to foster life and render its intrinsic values. Heavy metals are known to be naturally occurring compounds, but anthropogenic activities introduce them in large quantities in different environmental compartments. This leads to the environment’s ability to foster life being reduced as human, animal, and plant health become threatened. This occurs due to bioaccumulation in the food chains as a result of the nondegradable state of the heavy metals. Remediation of heavy metals requires special attention to protect soil quality, air quality, water quality, human health, animal health, and all spheres as a collection. Developed physical and chemical heavy metal remediation technologies are demanding costs which are not feasible, time-consuming, and release additional waste to the environment. This chapter summarises the problems related to heavy metal pollution and various remediation technologies. A case study in South Africa mines were also used.",book:{id:"6534",slug:"heavy-metals",title:"Heavy Metals",fullTitle:"Heavy Metals"},signatures:"Vhahangwele Masindi and Khathutshelo L. Muedi",authors:[{id:"225304",title:"Dr.",name:"Vhahangwele",middleName:null,surname:"Masindi",slug:"vhahangwele-masindi",fullName:"Vhahangwele Masindi"},{id:"241403",title:"M.Sc.",name:"Khathutshelo",middleName:"Lilith",surname:"Muedi",slug:"khathutshelo-muedi",fullName:"Khathutshelo Muedi"}]}],onlineFirstChaptersFilter:{topicId:"14",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"82948",title:"Study on Miniaturization of Antenna Using Metamaterials",slug:"study-on-miniaturization-of-antenna-using-metamaterials",totalDownloads:1,totalDimensionsCites:null,doi:"10.5772/intechopen.106222",abstract:"Metamaterials (MTMs) are artificially built materials intended to give its properties from the internal structure, rather than the chemical composition found in natural materials. Electric permittivity (ε) and magnetic permeability (μ) are the two basic parameters which describe the electromagnetic property of a material or medium. Permittivity describes how a material is affected when it is placed in electric field. And permeability describes how a material is affected in presence of magnetic field. Metamaterials may have either negative permittivity or permeability or both may be negative simultaneously. The concept of metamaterials has additionally been utilized to design different kinds of patches with upgraded performance, such as improved gain and enhanced efficiency. Also, it has been utilized for the scaling down of patches. Two parameters are utilized in the collected works for antennas using metamaterials. We can adjust the refractive index of the metamaterial to positive, near-zero or negative values. Utilization of epsilon negative, MNG (μ - Mu negative) or DNG (double negative) are called metamaterial- based antennas and the use of metamaterial unit cell for example complementary split ring resonator, split ring resonator and so on are alluded as metamaterial inspired antennas. The design of complementary split ring resonator and its equivalent circuit will be discussed in this work. CSRR (complementary split ring resonator) provides both isolation enhancement and miniaturization for MIMO antenna.",book:{id:"11824",title:"Metamaterials - History, Current State, Applications, and Perspectives",coverURL:"https://cdn.intechopen.com/books/images_new/11824.jpg"},signatures:"Andrews Christina Josephine Malathi"},{id:"83080",title:"Boron Doping in Next-Generation Materials for Semiconductor Device",slug:"boron-doping-in-next-generation-materials-for-semiconductor-device",totalDownloads:2,totalDimensionsCites:0,doi:"10.5772/intechopen.106450",abstract:"The article surveys the most recent achievements starting with the boron doping mechanism, mainly focused on doping in semiconductor materials such as Si, Ge, graphene, carbon nanotube, or other 2D materials. Frequently used doping methodologies are discussed, including ion implantation and solid-phase doping, mainly focused on recent developing techniques of monolayer doping. These doped materials’ structural, electronic, and chemical properties are addressed to understand the boron doping effect better. Theoretical and experimental information and data are used to support such atomic-level effects. Therefore, this review can provide valuable suggestions and guidelines for materials’ properties manipulation by boron doping for further research exploration.",book:{id:"11762",title:"Characteristics and Applications of Boron",coverURL:"https://cdn.intechopen.com/books/images_new/11762.jpg"},signatures:"Linh Chi T. Cao, Luqman Hakim and Shu-Han Hsu"},{id:"83055",title:"Boron Clusters in Biomedical Applications: A Theoretical Viewpoint",slug:"boron-clusters-in-biomedical-applications-a-theoretical-viewpoint",totalDownloads:6,totalDimensionsCites:0,doi:"10.5772/intechopen.106215",abstract:"In this chapter, we presented an analysis of the recent advances in the applications of boron clusters in biomedical fields such as the development of biosensors and drug delivery systems on the basis of quantum chemical calculations. Biosensors play an essential role in many sectors, e.g., law enforcement agencies for sensing illicit drugs, medical communities for detecting overdosed medications from human and animal bodies, etc. The drug delivery systems have theoretically been proposed for many years and subsequently implemented by experiments to deliver the drug to the targeted sites by reducing the harmful side effects significantly. Boron clusters form a rich and colorful family of atomic clusters due to their unconventional structures and bonding phenomena. Boron clusters and their complexes have various biological activities such as the drug delivery, imaging for diagnosis, treatment of cancer, and probe of protein-biomolecular interactions. For all of these reactivities, the interaction mechanisms and the corresponding energetics between biomaterials and boron clusters are of essential importance as a basic step in the understanding, and thereby design of relevant materials. During the past few years, attempts have been made to probe the nature of these interactions using quantum chemical calculations mainly with density functional theory (DFT) methods. This chapter provides a summary of the theoretical viewpoint on this issue.",book:{id:"11762",title:"Characteristics and Applications of Boron",coverURL:"https://cdn.intechopen.com/books/images_new/11762.jpg"},signatures:"Ehsan Shakerzadeh, Elham Tahmasebi, Long Van Duong and Minh Tho Nguyen"},{id:"83048",title:"Structural, Magnetic, and Magnetodielectric Properties of Bi-Based Modified Ceramic Composites",slug:"structural-magnetic-and-magnetodielectric-properties-of-bi-based-modified-ceramic-composites",totalDownloads:2,totalDimensionsCites:0,doi:"10.5772/intechopen.106569",abstract:"In this chapter, we introduce a promising composite material, which can be used as a potential candidate in the field of charge storage, sensors, and spintronic devices. The structural, magnetic, and magnetodielectric properties of the pure cum composite samples are investigated. The Rietveld refinement of the X-ray data confirmed the presence of a single (A21am) and mixed phases (A21am + R-3c + Pbam) in the pure and composite sample, correspondingly. The SEM microstructure suggests the contrasting nature of the homogeneous and heterogeneous distribution of grains in the corresponding pure and composite sample. The magnetic properties of the composite sample increase due to the enhanced exchange interaction between the different magnetic ions. The frequency-dependent dielectric subjected to a constant magnetic field indicates the signature of magnetodielectric (MD) coupling for both the samples. The field variation of the MD loop shows the symmetric hysteresis loop in the composite due to the addition of magnetostrictive La0.67Sr0.33MnO3 and the non-collinear antiferromagnetic Bi2Fe4O9 phase. The maximum value of MD% (~0.12%) is enhanced by ~13 times in the composite than in the pure sample. Therefore, the improved MD coupling and symmetric switching of the MD loop of the composite make it a suitable candidate for low power consumption storage devices.",book:{id:"11117",title:"Smart and Advanced Ceramics and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/11117.jpg"},signatures:"Rasmita Jena, Kouru Chandrakanta and Anil Kumar Singh"},{id:"83035",title:"Breaking the Property Trade-Offs by Using Entropic Conceptions",slug:"breaking-the-property-trade-offs-by-using-entropic-conceptions",totalDownloads:11,totalDimensionsCites:0,doi:"10.5772/intechopen.106532",abstract:"Entropic conception has been used as an effective strategy for developing materials to break the property recordings of current materials, for example, breaking the trade-off between the high-strength and low-ductility structural alloys. The performance of materials usually under a complex circumstance, a balance of multiple properties, for example, combined the high-strength, high ductility, high conductivity, high corrosion resistance, high irradiation resistance, etc., the strategy of high-entropy-alloy (HEA) will provide a materials design and development technology to realize the goal. Magnetic materials usually exhibit excellent magnetic properties but weak mechanical properties and corrosion resistance. The reported unique behaviors of HEAs, for example, self-healing effects may be the mechanism for the high irradiation resistance of the HEAs, and self-sharpening behaviors of the tungsten-based HEAs main closely be related to the serration behaviors.",book:{id:"11468",title:"High Entropy Materials - Microstructures and Properties",coverURL:"https://cdn.intechopen.com/books/images_new/11468.jpg"},signatures:"Yong Zhang and Xuehui Yan"},{id:"82929",title:"Prediction of Solubility and Miscibility Parameters of Bismuth-Arsenic Complex and Amorphous Mineral Compounds Using Molecular Dynamics Simulation",slug:"prediction-of-solubility-and-miscibility-parameters-of-bismuth-arsenic-complex-and-amorphous-mineral",totalDownloads:4,totalDimensionsCites:0,doi:"10.5772/intechopen.106316",abstract:"Bismuth is one of the most difficult impurities to remove in mining concentrates and low concentrations generate problems in silver and copper refineries. Therefore, financial penalties are established when concentrations exceed 0.05%. Some researchers had used arsenic to remove bismuth with results of up to 52% of extraction. Unfortunately, this mechanism is not yet fully understood. The objective of this research was to obtain the solubility parameters of amorphous mineral compounds, including bismuth-based compounds, through computational simulation using molecular dynamics. The composition of the mineral sample was determined by X-ray diffraction and the crystalline species were obtained and modeled using Materials Studio software. The nanostructures were optimized by an energy minimization methodology using the Broyden-Fletcher-Goldfarb-Shanno algorithm and were validated using the figure of merit equation and density. Simulations were performed using the Universal Force Field at constant pressure and temperature. The results of the minerals identified in the sample were compared with arsenic trioxide, indicating miscibility between As2O3 and Bi2O3, possible miscibility with 10 other minerals, and immiscibility with the rest. The results indicate that As2O3 can be successfully used for the removal of Bi2O3 without a negative effect on the recovery of other minerals of higher commercial value.",book:{id:"11467",title:"Bismuth-Based Nanostructured Materials",coverURL:"https://cdn.intechopen.com/books/images_new/11467.jpg"},signatures:"Francisco Adrián De la Torre-Martínez, Efren Delgado, María Dolores Josefina Rodríguez Rosales, Hiram Medrano-Roldán, Javier López-Miranda and Damián Reyes-Jáquez"}],onlineFirstChaptersTotal:82},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:11,numberOfPublishedChapters:91,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:108,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:332,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:11,numberOfPublishedChapters:143,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:124,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:23,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:12,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}},{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}}]},series:{item:{id:"11",title:"Biochemistry",doi:"10.5772/intechopen.72877",issn:"2632-0983",scope:"Biochemistry, the study of chemical transformations occurring within living organisms, impacts all areas of life sciences, from molecular crystallography and genetics to ecology, medicine, and population biology. Biochemistry examines macromolecules - proteins, nucleic acids, carbohydrates, and lipids – and their building blocks, structures, functions, and interactions. Much of biochemistry is devoted to enzymes, proteins that catalyze chemical reactions, enzyme structures, mechanisms of action and their roles within cells. Biochemistry also studies small signaling molecules, coenzymes, inhibitors, vitamins, and hormones, which play roles in life processes. Biochemical experimentation, besides coopting classical chemistry methods, e.g., chromatography, adopted new techniques, e.g., X-ray diffraction, electron microscopy, NMR, radioisotopes, and developed sophisticated microbial genetic tools, e.g., auxotroph mutants and their revertants, fermentation, etc. More recently, biochemistry embraced the ‘big data’ omics systems. Initial biochemical studies have been exclusively analytic: dissecting, purifying, and examining individual components of a biological system; in the apt words of Efraim Racker (1913 –1991), “Don’t waste clean thinking on dirty enzymes.” Today, however, biochemistry is becoming more agglomerative and comprehensive, setting out to integrate and describe entirely particular biological systems. The ‘big data’ metabolomics can define the complement of small molecules, e.g., in a soil or biofilm sample; proteomics can distinguish all the comprising proteins, e.g., serum; metagenomics can identify all the genes in a complex environment, e.g., the bovine rumen. This Biochemistry Series will address the current research on biomolecules and the emerging trends with great promise.",coverUrl:"https://cdn.intechopen.com/series/covers/11.jpg",latestPublicationDate:"August 17th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:33,editor:{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"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:4,paginationItems:[{id:"14",title:"Cell and Molecular Biology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/14.jpg",isOpenForSubmission:!0,editor:{id:"165627",title:"Dr.",name:"Rosa María",middleName:null,surname:"Martínez-Espinosa",slug:"rosa-maria-martinez-espinosa",fullName:"Rosa María Martínez-Espinosa",profilePictureURL:"https://mts.intechopen.com/storage/users/165627/images/system/165627.jpeg",biography:"Rosa María Martínez-Espinosa is a Full Professor of Biochemistry and Molecular Biology at the University of Alicante, Spain, and has been the vice president of International Relations and Development Cooperation at this university since 2010. She created the research group in applied biochemistry in 2017 (https://web.ua.es/en/appbiochem/), and from 1999 to the present has made more than 200 contributions to Spanish and international conferences. Furthermore, she has around seventy-five scientific publications in indexed journals, eighty book chapters, and one patent to her credit. Her research work focuses on microbial metabolism (particularly on extremophile microorganisms), purification and characterization of enzymes with potential industrial and biotechnological applications, protocol optimization for genetically manipulating microorganisms, gene regulation characterization, carotenoid (pigment) production, and design and development of contaminated water and soil bioremediation processes by means of microorganisms. This research has received competitive public grants from the European Commission, the Spanish Ministry of Economy and Competitiveness, the Valencia Region Government, and the University of Alicante.",institutionString:"University of Alicante",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. He performed post-doctoral studies at Max-Planck Institute, Germany, and University of Florence, Italy in addition to making several scientific visits abroad. He currently works as a Full Professor of Biochemistry in the Faculty of Pharmacy, Anadolu University, Turkey. Dr. Beydemir has published over a hundred scientific papers spanning protein biochemistry, enzymology and medicinal chemistry, reviews, book chapters and presented several conferences to scientists worldwide. He has received numerous publication awards from various international scientific councils. He serves in the Editorial Board of several international journals. Dr. Beydemir is also Rector of Bilecik Şeyh Edebali University, Turkey.",institutionString:null,institution:{name:"Anadolu University",institutionURL:null,country:{name:"Turkey"}}},editorTwo:{id:"13652",title:"Prof.",name:"Deniz",middleName:null,surname:"Ekinci",slug:"deniz-ekinci",fullName:"Deniz Ekinci",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYLT1QAO/Profile_Picture_1634557223079",biography:"Dr. Deniz Ekinci obtained a BSc in Chemistry in 2004, MSc in Biochemistry in 2006, and PhD in Biochemistry in 2009 from Atatürk University, Turkey. He studied at Stetson University, USA, in 2007-2008 and at the Max Planck Institute of Molecular Cell Biology and Genetics, Germany, in 2009-2010. Dr. Ekinci currently works as a Full Professor of Biochemistry in the Faculty of Agriculture and is the Head of the Enzyme and Microbial Biotechnology Division, Ondokuz Mayıs University, Turkey. He is a member of the Turkish Biochemical Society, American Chemical Society, and German Genetics society. Dr. Ekinci published around ninety scientific papers, reviews and book chapters, and presented several conferences to scientists. He has received numerous publication awards from several scientific councils. 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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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Since then, he has been working as an Adjunct Professor in the same Department at the University of Pavia. His research activity during the first years was primarily focused on the purification and structural characterization of enzymes from animal and plant sources. During this period, Prof. Iadarola familiarized himself with the conventional techniques used in column chromatography, spectrophotometry, manual Edman degradation, and electrophoresis). Since 1995, he has been working on: i) the determination in biological fluids (serum, urine, bronchoalveolar lavage, sputum) of proteolytic activities involved in the degradation processes of connective tissue matrix, and ii) on the identification of biological markers of lung diseases. In this context, he has developed and validated new methodologies (e.g., Capillary Electrophoresis coupled to Laser-Induced Fluorescence, CE-LIF) whose application enabled him to determine both the amounts of biochemical markers (Desmosines) in urine/serum of patients affected by Chronic Obstructive Pulmonary Disease (COPD) and the activity of proteolytic enzymes (Human Neutrophil Elastase, Cathepsin G, Pseudomonas aeruginosa elastase) in sputa of these patients. More recently, Prof. Iadarola was involved in developing techniques such as two-dimensional electrophoresis coupled to liquid chromatography/mass spectrometry (2DE-LC/MS) for the proteomic analysis of biological fluids aimed at the identification of potential biomarkers of different lung diseases. He is the author of about 150 publications (According to Scopus: H-Index: 23; Total citations: 1568- According to WOS: H-Index: 20; Total Citations: 1296) of peer-reviewed international journals. 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She gained considerable experience in developing and validating new methodologies whose applications allowed her to determine both the amount of biomarkers (Desmosine and Isodesmosine) in the urine of patients affected by COPD, and the activity of proteolytic enzymes (HNE, Cathepsin G, Pseudomonas aeruginosa elastase) in the sputa of these patients. Simona Viglio was also involved in research dealing with the supplementation of amino acids in patients with brain injury and chronic heart failure. She is presently engaged in the development of 2-DE and LC-MS techniques for the study of proteomics in biological fluids. The aim of this research is the identification of potential biomarkers of lung diseases. She is an author of about 90 publications (According to Scopus: H-Index: 23; According to WOS: H-Index: 20) on peer-reviewed journals, a member of the “Società Italiana di Biochimica e Biologia Molecolare,“ and a Consultant Reviewer for International Journal of Molecular Science, Journal of Chromatography A, COPD, Plos ONE and Nutritional Neuroscience.",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorThree:null}]},overviewPageOFChapters:{paginationCount:44,paginationItems:[{id:"83015",title:"Acute Changes in Lipoprotein-Associated Oxidative Stress",doi:"10.5772/intechopen.106489",signatures:"Ngoc-Anh Le",slug:"acute-changes-in-lipoprotein-associated-oxidative-stress",totalDownloads:0,totalCrossrefCites:null,totalDimensionsCites:null,authors:[{name:"Anh",surname:"Le"}],book:{title:"Importance of Oxidative Stress and Antioxidant System in Health and Disease",coverURL:"https://cdn.intechopen.com/books/images_new/11671.jpg",subseries:{id:"15",title:"Chemical Biology"}}},{id:"83041",title:"Responses of Endoplasmic Reticulum to Plant Stress",doi:"10.5772/intechopen.106590",signatures:"Vishwa Jyoti Baruah, Bhaswati Sarmah, Manny Saluja and Elizabeth H. 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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. 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He is especially interested in the genetic differentiation pattern and speciation process that correlate to the flashing pattern and mating behavior of some fireflies in Japan. He then worked for Olympus Corporation, a Japanese manufacturer of optics and imaging products, where he was involved in the development of luminescence technology and produced a bioluminescence microscope that is currently being used for gene expression analysis in chronobiology, neurobiology, and developmental biology. 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He was elected a Yangtze River Scholars Distinguished Professor in 2013, a member of the International Statistical Institute (ISI) in 2016, a member of the board of the International Chinese Statistical Association (ICSA) in 2018, and a fellow of the Institute of Mathematical Statistics (IMS) in 2021. He received the ICSA Outstanding Service Award in 2018 and the National Science Foundation for Distinguished Young Scholars of China in 2012. He serves as a member of the editorial board of Statistics and Its Interface and Journal of Systems Science and Complexity. He is also a field editor for Communications in Mathematics and Statistics. His research interests include biostatistics, empirical likelihood, missing data analysis, variable selection, high-dimensional data analysis, Bayesian statistics, and data science. He has published more than 190 research papers and authored five books.",institutionString:"Yunnan University",institution:{name:"Yunnan University",country:{name:"China"}}},{id:"1177",title:"Prof.",name:"António",middleName:"J. R.",surname:"José Ribeiro Neves",slug:"antonio-jose-ribeiro-neves",fullName:"António José Ribeiro Neves",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1177/images/system/1177.jpg",biography:"Prof. António J. R. Neves received a Ph.D. in Electrical Engineering from the University of Aveiro, Portugal, in 2007. Since 2002, he has been a researcher at the Institute of Electronics and Informatics Engineering of Aveiro. Since 2007, he has been an assistant professor in the Department of Electronics, Telecommunications, and Informatics, University of Aveiro. He is the director of the undergraduate course on Electrical and Computers Engineering and the vice-director of the master’s degree in Electronics and Telecommunications Engineering. He is an IEEE Senior Member and a member of several other research organizations worldwide. His main research interests are computer vision, intelligent systems, robotics, and image and video processing. He has participated in or coordinated several research projects and received more than thirty-five awards. He has 161 publications to his credit, including books, book chapters, journal articles, and conference papers. He has vast experience as a reviewer of several journals and conferences. As a professor, Dr. Neves has supervised several Ph.D. and master’s students and was involved in more than twenty-five different courses.",institutionString:null,institution:{name:"University of Aveiro",country:{name:"Portugal"}}},{id:"11317",title:"Dr.",name:"Francisco",middleName:null,surname:"Javier Gallegos-Funes",slug:"francisco-javier-gallegos-funes",fullName:"Francisco Javier Gallegos-Funes",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/11317/images/system/11317.png",biography:"Francisco J. Gallegos-Funes received his Ph.D. in Communications and Electronics from the Instituto Politécnico Nacional de México (National Polytechnic Institute of Mexico) in 2003. He is currently an associate professor in the Escuela Superior de Ingeniería Mecánica y Eléctrica (Mechanical and Electrical Engineering Higher School) at the same institute. His areas of scientific interest are signal and image processing, filtering, steganography, segmentation, pattern recognition, biomedical signal processing, sensors, and real-time applications.",institutionString:"Instituto Politécnico Nacional",institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"428449",title:"Dr.",name:"Ronaldo",middleName:null,surname:"Ferreira",slug:"ronaldo-ferreira",fullName:"Ronaldo Ferreira",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/428449/images/21449_n.png",biography:null,institutionString:null,institution:{name:"University of Aveiro",country:{name:"Portugal"}}},{id:"165328",title:"Dr.",name:"Vahid",middleName:null,surname:"Asadpour",slug:"vahid-asadpour",fullName:"Vahid Asadpour",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/165328/images/system/165328.jpg",biography:"Vahid Asadpour, MS, Ph.D., is currently with the Department of Research and Evaluation, Kaiser Permanente Southern California. He has both an MS and Ph.D. in Biomedical Engineering. He was previously a research scientist at the University of California Los Angeles (UCLA) and visiting professor and researcher at the University of North Dakota. He is currently working in artificial intelligence and its applications in medical signal processing. In addition, he is using digital signal processing in medical imaging and speech processing. Dr. Asadpour has developed brain-computer interfacing algorithms and has published books, book chapters, and several journal and conference papers in this field and other areas of intelligent signal processing. He has also designed medical devices, including a laser Doppler monitoring system.",institutionString:"Kaiser Permanente Southern California",institution:null},{id:"169608",title:"Prof.",name:"Marian",middleName:null,surname:"Găiceanu",slug:"marian-gaiceanu",fullName:"Marian Găiceanu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/169608/images/system/169608.png",biography:"Prof. Dr. Marian Gaiceanu graduated from the Naval and Electrical Engineering Faculty, Dunarea de Jos University of Galati, Romania, in 1997. He received a Ph.D. (Magna Cum Laude) in Electrical Engineering in 2002. Since 2017, Dr. Gaiceanu has been a Ph.D. supervisor for students in Electrical Engineering. He has been employed at Dunarea de Jos University of Galati since 1996, where he is currently a professor. Dr. Gaiceanu is a member of the National Council for Attesting Titles, Diplomas and Certificates, an expert of the Executive Agency for Higher Education, Research Funding, and a member of the Senate of the Dunarea de Jos University of Galati. He has been the head of the Integrated Energy Conversion Systems and Advanced Control of Complex Processes Research Center, Romania, since 2016. He has conducted several projects in power converter systems for electrical drives, power quality, PEM and SOFC fuel cell power converters for utilities, electric vehicles, and marine applications with the Department of Regulation and Control, SIEI S.pA. (2002–2004) and the Polytechnic University of Turin, Italy (2002–2004, 2006–2007). He is a member of the Institute of Electrical and Electronics Engineers (IEEE) and cofounder-member of the IEEE Power Electronics Romanian Chapter. He is a guest editor at Energies and an academic book editor for IntechOpen. He is also a member of the editorial boards of the Journal of Electrical Engineering, Electronics, Control and Computer Science and Sustainability. Dr. Gaiceanu has been General Chairman of the IEEE International Symposium on Electrical and Electronics Engineering in the last six editions.",institutionString:'"Dunarea de Jos" University of Galati',institution:{name:'"Dunarea de Jos" University of Galati',country:{name:"Romania"}}},{id:"4519",title:"Prof.",name:"Jaydip",middleName:null,surname:"Sen",slug:"jaydip-sen",fullName:"Jaydip Sen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/4519/images/system/4519.jpeg",biography:"Jaydip Sen is associated with Praxis Business School, Kolkata, India, as a professor in the Department of Data Science. His research areas include security and privacy issues in computing and communication, intrusion detection systems, machine learning, deep learning, and artificial intelligence in the financial domain. He has more than 200 publications in reputed international journals, refereed conference proceedings, and 20 book chapters in books published by internationally renowned publishing houses, such as Springer, CRC press, IGI Global, etc. Currently, he is serving on the editorial board of the prestigious journal Frontiers in Communications and Networks and in the technical program committees of a number of high-ranked international conferences organized by the IEEE, USA, and the ACM, USA. He has been listed among the top 2% of scientists in the world for the last three consecutive years, 2019 to 2021 as per studies conducted by the Stanford University, USA.",institutionString:"Praxis Business School",institution:null},{id:"320071",title:"Dr.",name:"Sidra",middleName:null,surname:"Mehtab",slug:"sidra-mehtab",fullName:"Sidra Mehtab",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00002v6KHoQAM/Profile_Picture_1584512086360",biography:"Sidra Mehtab has completed her BS with honors in Physics from Calcutta University, India in 2018. She has done MS in Data Science and Analytics from Maulana Abul Kalam Azad University of Technology (MAKAUT), Kolkata, India in 2020. Her research areas include Econometrics, Time Series Analysis, Machine Learning, Deep Learning, Artificial Intelligence, and Computer and Network Security with a particular focus on Cyber Security Analytics. Ms. Mehtab has published seven papers in international conferences and one of her papers has been accepted for publication in a reputable international journal. She has won the best paper awards in two prestigious international conferences – BAICONF 2019, and ICADCML 2021, organized in the Indian Institute of Management, Bangalore, India in December 2019, and SOA University, Bhubaneswar, India in January 2021. Besides, Ms. Mehtab has also published two book chapters in two books. Seven of her book chapters will be published in a volume shortly in 2021 by Cambridge Scholars’ Press, UK. Currently, she is working as the joint editor of two edited volumes on Time Series Analysis and Forecasting to be published in the first half of 2021 by an international house. Currently, she is working as a Data Scientist with an MNC in Delhi, India.",institutionString:"NSHM College of Management and Technology",institution:{name:"Association for Computing Machinery",country:{name:"United States of America"}}},{id:"226240",title:"Dr.",name:"Andri Irfan",middleName:null,surname:"Rifai",slug:"andri-irfan-rifai",fullName:"Andri Irfan Rifai",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226240/images/7412_n.jpg",biography:"Andri IRFAN is a Senior Lecturer of Civil Engineering and Planning. He completed the PhD at the Universitas Indonesia & Universidade do Minho with Sandwich Program Scholarship from the Directorate General of Higher Education and LPDP scholarship. He has been teaching for more than 19 years and much active to applied his knowledge in the project construction in Indonesia. His research interest ranges from pavement management system to advanced data mining techniques for transportation engineering. He has published more than 50 papers in journals and 2 books.",institutionString:null,institution:{name:"Universitas Internasional Batam",country:{name:"Indonesia"}}},{id:"314576",title:"Dr.",name:"Ibai",middleName:null,surname:"Laña",slug:"ibai-lana",fullName:"Ibai Laña",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314576/images/system/314576.jpg",biography:"Dr. Ibai Laña works at TECNALIA as a data analyst. He received his Ph.D. in Artificial Intelligence from the University of the Basque Country (UPV/EHU), Spain, in 2018. He is currently a senior researcher at TECNALIA. His research interests fall within the intersection of intelligent transportation systems, machine learning, traffic data analysis, and data science. He has dealt with urban traffic forecasting problems, applying machine learning models and evolutionary algorithms. He has experience in origin-destination matrix estimation or point of interest and trajectory detection. 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:"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:"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:null,institution:null},{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. 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Main aspects of the topic are: Applying bioinformatics in drug discovery and development; Bioinformatics in clinical diagnostics (genetic variants that act as markers for a condition or a disease); Blockchain and Artificial Intelligence/Machine Learning in personalized medicine; Customize disease-prevention strategies in personalized medicine; Big data analysis in personalized medicine; Translating stratification algorithms into clinical practice of personalized medicine.",annualVolume:11403,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/7.jpg",editor:{id:"351533",title:"Dr.",name:"Slawomir",middleName:null,surname:"Wilczynski",fullName:"Slawomir Wilczynski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035U1loQAC/Profile_Picture_1630074514792",institutionString:null,institution:{name:"Medical University of Silesia",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"5886",title:"Dr.",name:"Alexandros",middleName:"T.",surname:"Tzallas",fullName:"Alexandros Tzallas",profilePictureURL:"https://mts.intechopen.com/storage/users/5886/images/system/5886.png",institutionString:"University of Ioannina, Greece & Imperial College London",institution:{name:"University of Ioannina",institutionURL:null,country:{name:"Greece"}}},{id:"257388",title:"Distinguished Prof.",name:"Lulu",middleName:null,surname:"Wang",fullName:"Lulu Wang",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRX6kQAG/Profile_Picture_1630329584194",institutionString:"Shenzhen Technology University",institution:{name:"Shenzhen Technology University",institutionURL:null,country:{name:"China"}}},{id:"225387",title:"Prof.",name:"Reda R.",middleName:"R.",surname:"Gharieb",fullName:"Reda R. 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Possible contributions can address (but are not limited to) the following research topics: Bioinspired design and control of exoskeletons, orthoses, and prostheses; Experimental evaluation of the effect of assistive devices (e.g., influence on gait, balance, and neuromuscular system); Bioinspired technologies for rehabilitation, including clinical studies reporting evaluations; Application of neuromuscular and biomechanical models to the development of bioinspired technology.',annualVolume:11404,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",institutionString:null,institution:{name:"Federal University of Uberlândia",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"49517",title:"Prof.",name:"Hitoshi",middleName:null,surname:"Tsunashima",fullName:"Hitoshi Tsunashima",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTP4QAO/Profile_Picture_1625819726528",institutionString:null,institution:{name:"Nihon University",institutionURL:null,country:{name:"Japan"}}},{id:"425354",title:"Dr.",name:"Marcus",middleName:"Fraga",surname:"Vieira",fullName:"Marcus Vieira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003BJSgIQAX/Profile_Picture_1627904687309",institutionString:null,institution:{name:"Universidade Federal de Goiás",institutionURL:null,country:{name:"Brazil"}}},{id:"196746",title:"Dr.",name:"Ramana",middleName:null,surname:"Vinjamuri",fullName:"Ramana Vinjamuri",profilePictureURL:"https://mts.intechopen.com/storage/users/196746/images/system/196746.jpeg",institutionString:"University of Maryland, Baltimore County",institution:{name:"University of Maryland, Baltimore County",institutionURL:null,country:{name:"United States of America"}}}]},{id:"9",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. Topics can include but are not limited to: Biotechnology such as biotechnological products and process engineering; Biotechnologically relevant enzymes and proteins; Bioenergy and biofuels; Applied genetics and molecular biotechnology; Genomics, transcriptomics, proteomics; Applied microbial and cell physiology; Environmental biotechnology; Methods and protocols. Moreover, topics in biosensor technology, like sensors that incorporate enzymes, antibodies, nucleic acids, whole cells, tissues and organelles, and other biological or biologically inspired components will be considered, and topics exploring transducers, including those based on electrochemical and optical piezoelectric, thermal, magnetic, and micromechanical elements. Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. 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