Mechanisms of endoscopic bariatric treatment, products and procedures are listed with mean EWL% after 12 months if available.
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Covering the “market demand” simply by further increasing the number of operations seems illusory if the prevalence of obesity is still rising. Endoluminal surgery is defined as surgery performed entirely within the lumen of the gastrointestinal tract using flexible endoscopy.
The interaction between endoscopy and surgery in the treatment of obesity is complex, essential and promising. Endoscopy is indispensable in preoperative preparation, as a primary therapeutic approach, and also in the detection and treatment of acute complications and long-term complications of obesity surgery.
The currently established and developing endoscopic procedures for bariatric therapy will be presented in this chapter. Division into pre-operative endoscopy, endoscopic bariatric therapy (EBT) and post-surgical endoscopy for early and late complications was made.
In “The clinical practice guidelines of the EAES on bariatric surgery: update 2020” the indication of a pre-operative EGD has been approved [1]. Clinically significant gastrointestinal (GI) symptoms should be evaluated before bariatric procedures with imaging studies, upper GI series, or endoscopy. All patients who where enrolled for a sleeve gastrectomy have to be examined with a gastroscopy for presence of hiatal hernia and esophageal reflux. Endoscopists have to look for signs of GERD. This diagnosis is a contraindication for a sleeve gastrectomy. Presence of hiatal hernia is also important from the surgical point of view, as it also needs to be repaired while bariatric surgery. In the diagnostic gastroscopy Helicobacter-pylorii diagnosis has to been established. Recent studies illustrate a relationship of Helicobacter pylori with the occurrence of marginal ulcers postoperatively especially following RYGB.
Primary endoscopic obesity therapy has now been given the proper name “bariatric endoscopy” or “endoscopic bariatric therapy”. This illustrates the relevance of endoscopy for the treatment of obese patients. EBT currently includes six different mechanisms:
Space occupying
Endoscopic gastroplasty
Aspiration
Malabsorption
Endoscopic bypass
Others
In Table 1 we present an overview of all endoscopic therapeutic concepts with available correlated EWL is presented.
Mechanism | Product | Time | EWL |
1. Space occupying | 1.1 Spatz3 one-year-balloon 1.2 ReShape™ Dual Balloon 1.3 ORBERA™ Intragastric Balloon 1.4 Transpyloric shuttle™ 1.5 Heliosphere bag | 12 months 6 months 6 months 6 months 6 months | 67.4% [2, 3] 29.9% [4] 25.44% [5] 30.9% [6] 31.87% [7, 8] |
2. Endoscopic gastroplasty | 2.1 POSE™ 2.2 ESG (Endoscopic Sleeve gastrectomy, Apollo OverStitch) 2.3 RESTORe (EndoCinch) 2.4 TOGA (transorale gastroplasty) 2.5 TERIS (trans-oral endoscopic restrictive implant system) 2.6 ACE-Stapler 2.7 Endomina System | permanent permanent permanent permanent 6 months permanent permanent | 49.4% [9] 61.84-68.3% [10, 11, 12] 58.1% [13, 14] 38.7% [15] 30.1% [16] 34.9% [13, 17] 41% [13] |
3. Aspiration | Aspire Assist® | 6-24 months | 31.5% [18] |
4. Malabsorption | 4.1 EndoBarrier® (Duodeno-Jejunale liner) 4.2 ValenTx™ (Gastro-Duodeno-Jejunale Liner) 4.3 DMR (endoscopic hydrothermal Duodenal Mucosal Resurfacing) | 12 months 12 months permanent | 35.3% [13, 19] 39.7% [20] - |
5. Endoscopic Bypass | Incisionless Magnetic Anastamosis System (IMAS) | permanent | 40.2% [21] |
6. Others | 6.1 Full Sense 6.2 Satisphere | - - | - - |
Mechanisms of endoscopic bariatric treatment, products and procedures are listed with mean EWL% after 12 months if available.
For the completeness of the review, the swallow balloons Elipse™ and OBALLON™ are mentioned at this point. However, they do not require endoscopic control or filling and are therefore not considered further in this review.
EAES and IFSO guidelines recommend consultation on surgical or endoscopic bariatric therapy based on initial weight, previous eating habits, expected weight loss, patient-related risk stratification (pre-existing conditions, compliance) and local availability of surgical and/or endoscopic bariatric surgery experts EAES 2020 [1, 10]. The choice of bariatric intervention should be based on the consensus of a supervising, interdisciplinary board of experts, whose members are from the fields of surgery, nutritional medicine, endocrinology and psychology, and the fully informed patient.
In Figure 1 following mechanisms and products are illustrated in a sketch:
Relevant techniques and devices of EBT are sketchily presented. A) Orbera Intragastric balloon. B) Reshape duo Intragastric balloon. C) Transpyloric shuttle-device. D) POSE
A = Orbera Intragastric Balloon
B = ReShape Duo Intragastric Balloon
C = TransPyloric Shuttle
D = POSE™
E = ESG with Apollo OverStitch™
F = Endomina
G = Aspire Assist
H = EndoBarrier
I = Satisphere device
The common gastric balloons are well accepted. Besides the expected nausea and belching, possible gastric ulcerations and perforations should be discussed with the patients.
All endoscopic, bariatric mechanisms that have a timely limit should be combined with an intensive nutritional, medical and psychological therapy. Obesity is a chronic disease, so there is always the risk of a “yo-yo” effect after removal of the space occupying device in such procedures. This development must be discussed with the patient.
The time-limited procedures are particularly suitable with a step-by-step concept prior to bariatric surgery.
The Spatz3 (Spatz FGIA, Great Neck, NY, USA) intragastric balloon is the only space occupying system for using a time of 12 months. The balloon is placed endoscopically and filled with 400-750 ml saline and methylene blue.
Results: Usuy and Brooks reported 2018 about 165 patients with implanted Spatz3 balloons in two centers. Mean EWL after one year was 67.4% [3].
Complications: Complications were nausea (89–92%), vomiting (21–71%), and abdominal pain (22–24%). Five patients developed gastric ulcers, one gastric perforation occurred at week 17 after implantation.
The ReShape IGB (Reshape, San Clemente, CA, USA) device contains of two silicone balloons attached to each other by a flexible tube. It is inserted and retrieved endoscopically. Device is placed for 6 months. The ReShape Duo is filled with 900 mL of saline solution (450 mL to each balloon). Each balloon has independent channels to prevent deflation of the other balloon if one leaks.
Results: In a seven-center study of Agnihotri and colleagues 202 patients were enrolled. EWL after 6 months was 29.9% [4]. In the REDUCE pivotal trial, including 326 patients, EWL was 25.1% in the Reshape arm compared to 11.3% in the sham arm [22].
Complications: Most common SAEs were nausea, vomiting, and abdominal pain that generally resolved after 1 week. The gastric ulceration rate was 0.9%.
The Orbera (Apollo Endosurgery, Austin, TX, USA) is a single, spherical balloon composed of silicone previously known as the BioEnterics Intragastric Balloon (BIB; Allergan, Irvine, California, USA). The balloon filling volume ranges between 400 and 700 mL of saline.
Results: Courcoulas and colleagues [23] reported in a multicenter, randomized, comparative study about 137 patients with implanted Orbera balloon. Mean EWL after 9 months was 26.5%.
Complications: Early removal of the IGB occurred in 18.75% of patients. The most common adverse events were pain and nausea [23]. Reported SAEs with this balloon were rare, and consisted of migration in 1.4% of patients and gastric perforation in 0.1% [24].
The TransPyloric Shuttle (BAROnova Inc. Goleta, CA) consists of a spherical silicone bulb attached to a smaller silicone bulb by a flexible tether. Intermitted occlusion of the gastric antrum is reached by the larger bulb when the smaller bulb entering the duodenum with peristalsis.
Results: A randomized clinical trial showed a mean EWL of 30.9% at 12 months follow-up [6].
Complications: Premature balloon removal occurred in 22.7% (46/203) of the cases. SAEs were rare (2.8%) and included: esophageal rupture, device impaction, upper abdominal pain, gastric ulcer, vomiting, pneumothorax. Premature balloon removal occurred in 22.7% (46/203) of the cases.
The Heliosphere BAG is filled with 950 mL of air rather than fluid. Balloons were implanted for six months.
Results: Lecumberri and colleagues reported about 82 patients with a EWL of 31.87% six months after insertion [8].
Complications: The Heliosphere BAG deflated and passed spontaneously in 2 cases (3%). De Castro et al. [25] described 2013 a comparative, prospective study of 91 patients: Orbera balloon (73 patients) with Heliosphere BAG (18 patients, mean BMI 45.2 kg/m2). In this study balloon extraction was difficult in 8 cases, and a rigid esophagoscope as required in 4 cases; laparoscopic surgery was required to remove BAG in 1 case. BAG was significantly more likely to result in retrieval complications.
Endoscopic gastroplasty or sleeve procedures are enjoying increasing popularity. The principle of all the procedures listed is a reduction of the stomach volume by endoluminally placed sutures or clips. The procedures are performed transorally, so that no permanent scars result. By means of a suture/clip machine placed on the endoscope, the stomach is contracted from the intraluminal side and fixed accordingly, thus reducing its lumen. The change in the shape and function of the stomach primarily leads to delayed gastric emptying and thus increased saturation. Weight loss and reduction of the diabetic metabolic state are the result. These procedures have been evaluated for patients with obesity class 1 to 3 and are associated with excellent long-term results.
Primary obesity surgery endoluminal (POSE) uses the incisionless operating platform (IOP; USGI Medical, San Clemente, CA, USA) to create full-thickness plications in the gastric fundus to reduce gastric volume. The Pose procedure targeted the gastric fundal accommodation. In 2020 López-Navada presented the POSE 2 procedure. Using the same devices, the POSE-2 procedure attempts to impair the gastric motility and restrict the gastric volume [26].
Results: Lopez-Navada et al. reported 2015 about 147 patients who underwent POSE procedure and were followed for one year [9]. Mean EWL was 44.9%. In a meta-analysis of Khan et al. with 7 included studies about POSE procedure Mean pooled EWL after 12 months was 44.91% [27].
Complications: Lopez-Navada reported that short-term adverse events included minor bleeding at the suture site, which was managed without incidence. Sullivan et al. [28], one of the included studies of the meta-analysis of Khan et al., reported that 45% of patients had post-procedure abdominal pain requiring pharmacotherapy, and 40% reported nausea and vomiting. For POSE 2 procedure no AEs were reported.
The Apollo OverStitch™ (Apollo Endosurgery, Austin, TX) is an endoscopic suturing device that applies full-thickness sutures in a variety of patterns. The system attaches to a double-channel endoscope and utilizes a curved needle driver. The OverStitch Sx™ is available for using single working channel endoscopes.
Results: In the meta-analysis of Gys and colleagues from 2019 eight clinical trials (1721 patients, 2014–2019) were included with 6–24 months follow-up. Average pooled EWL at 12 months was 68.3% [12]. In the recent meta-analysis of Singh and colleagues pooled EWL after 12 months was 61.84% [11].
Complications: In the analysis of Gys et al. major adverse events were described in 18 patients: pneumothorax (
Endoluminal Vertical Gastroplasty (EVG) is performed using the EndoCinch suturing device (C.R. Bard, Inc., Murray Hill, NJ). Since 2004 this device is used to treat obesity. The RESTORe System (Bard/Davol, Warwick, RI) is an updated version of the EndoCinch device. It is capable of deeper tissue acquisition and suture reloading inside the patient. During this procedure, in addition to an anterior to posterior plication in EVG, the greater curvature is also incorporated to mimic LGP.
Results: In 2008, Fogel performed EVG in 64 patients using a continuous running suture along the lesser curvature. No serious adverse events were reported and weight loss at 1 year was 58.1% EWL [14].
Complications: No significant adverse events were seen. Twelve-month endoscopy revealed partial or complete release of plications in 13 of 18 patients.
TOGA (Satiety Inc., Palo Alto, CA) is an endoscopic stapling device first introduced in 2008. TOGA creates a stapled sleeve and a restricted outlet. Similar to VBG, TOGA is associated with decreased ghrelin and increased GLP-1 levels.
Results: A sham-controlled trial including 67 patients showed 52.2% EWL (in patients with BMI < 40) and 41.3% EWL (in those with BMI ≥ 40) after one year [15].
Complications: Two cases of respiratory distress and an asymptomatic pneumoperitoneum from esophageal and gastric perforations that was treated conservatively however were reported.
TERIS (Barosense, Redwood City, CA) is an endoscopically implanted device introduced by Biertho and colleagues in 2009. A prosthetic diaphragm is placed at the gastric cardia to create a small reservoir with a 10-mm orifice. To anchor the device full thickness plications are used.
Results: In a study including 18 patients (mean BMI 42.1 kg/m2) Verlaan et al. reported about a median EWL after six month of 30.1% [16].
Complications: Three SAEs occurred, one gastric perforation and two cases of pneumoperitoneum. Because of the poor durability of the system the company decided to discontinue the TERIS system and to further develop the successful parts of it, such as the articulating circular endoscopic (ACE) stapler.
The ACE stapler (Boston Scientific Corporation, Natick, MA) is an endoscopic stapler. This device consist of a head capable of both 360-degree rotation and complete retroflexion. A 5-mm endoscope enables visualization; the device is 16 mm in diameter. This device use vacuum suction to mobilize gastric tissue; firing the stapler creates a full-thickness plication using a 10-mm plastic ring with 8 titanium staples. A defined number of plications is done in the fundus and antrum.
Results: Verlaan et al. [17] reported about 17 patients (BMI 40.2 kg/m2) et al. reported in a prospective safety and feasibility study of gastric volume reduction. Median EWL was 34.9%.
Complications: The most common adverse event was abdominal pain (7 patients); sore throat, diarrhea, nausea, constipation, and vomiting were also reported. All were self-limited.
The Endomina suturing system (Endo Tools Therapeutics, SA-ETT, Gosselies, Belgium) is a triangulation platform to perform large plications with transmural sutures and serosa-to-serosa apposition to reduce the gastric volume.
Results: Two studies (62 patients) by Huberty et al. reported 29% EWL at 12 months [29, 30].
Complications: No major adverse events were reported.
Nyström et al. [26] reported 2018 in a 4-year analysis on the results of the AspireAssist® system in 201 bariatric patients, including in particular class 2 and 3 obese patients. Using a modified PEG, patients can drain the food pulp and rinse with water 20 minutes after ingestion. This device could reduce the absorption of up to 30% ingested calories after a meal.
Results: EWL and TWL rates of 43.6% and 17.1%respectively were achieved after one year.
Complications: The complication rate corresponds to that of PEG (inflammation of the injection site, peritonitis, buried bumper).
The procedures that lead to a barrier development of duodeno-jejunal or gastro-duodeno-jejunal contact are endoscopic, innovative interpretations of the mode of action of the surgically created gastric bypass. The implantation of a plastic liner into the lumen of these organs can result in good glycaemic control and, in addition, weight reduction. These procedures are named gastrointestinal bypass liners (EndoBarrier®, ValenTx™). They are particularly indicated for patients with poorly adjustable diabetes mellitus type II.
The EndoBarrier consists of a single use endoscopic system including a liner, delivery system, and retrieval system. A 65 cm teflon covered sleeve is placed into the small bowel and can remain in situ for up to 3–12 months. Endoscopically implementation is done under general anesthesia. Placement of anchor and liner is controlled by endoscopy and fluoroscopic guidance. The anchors at the proximal end of the sleeve looks like a crown, consists of nitinol, which functions as a self-expandable stent. This allows fixation to the duodenal bulb distal to the pylorus, but proximal to the ampulla Vateri. The proximal and distal open liner ensures the passage of chyme from the stomach while bypassing the duodenum. Along the outside of the liner, pancreatic juices and bile will enter from the ampulla Vateri, thereby avoiding contact with gastric contents until these exit the sleeve in the jejunum. The EndoBarrier mimics the malabsorptive effects of the RYGB.
Results: Betzel and colleagues [19] reported 2020 about 44 patients treated with EndoBarrier-Devices. Twenty patients required early removal due to AEs(55%). During dwelling time, body weight decreased significantly (15.9 kg; TBWL 14.6%). HbA1c decreased non-significantly. In total, 68% of the patients experienced at least one AE. Patel et al. [31] 2018 reported about similar results in a multicenter, non-randomized clinical trial with 45 obese patients. Fourteen patients required early removal (24%). Significant reductions in weight, BMI and glycaemic control were observed during the device insertion period.
Complications: The ASGE Bariatric Endoscopy Task Force reported 2015 about an AE rate of 12.66% in 271 implantation [10]. Serious adverse events included migration (4.9%), GI bleeding (3.86%), sleeve obstruction (3.4%), liver abscess (0.126%), cholangitis (0.126%), acute cholecystitis (0.126%), and esophageal perforation(0.126%).
The ValenTx-System is a gastro-duodenal-jejunal liner system which has to be inserted in an endoscopic/laparoscopic rendezvous technique. The system, a 120 cm long fluoropolymer liner with a proximal and a distal cuff, is primarily placed into the jejunum with a delivery catheter. The proximal cuff is anchored at the level of the Z-line of the GE junction and anchored with fullthickness sutures deployed in a circumferential manner. The successor of the ValenTx is a 120 cm long fluorpolymer sleeve which could implement without laparoscopy.
Results: Sandler et al. reported 2018 in sum about 32 obese patients (Mean BMI 42.3Kg/m2) treated with the successor ValenTx for 12 months. Implantation and removal of the device according to the study concepts was possible in all patients. EWL after one year was 44.8% [20].
Complications: Implantation related AEs were mild (epigastric pain, heartburn or acid reflux, regurgitation, vomiting, dysphagia, and nausea). Longtime AEs were obstructions by knots or kinking. In one patient laparotomy for sleeve explantation was necessary.
DMR potentially mimics some of the mechanisms of action of bariatric surgery in a minimally invasive manner. The DMR procedure is performed using specially designed catheters which are advanced over a guidewire next to the endoscope. It is a single, minimally invasive endoscopic procedure that involves circumferential hydrothermal ablation of the duodenal mucosa resulting in subsequent regeneration of the mucosa. Before ablation, the mucosa is lifted with saline to protect the outer layers of the duodenum. The DMR procedure could be performed under either general anesthesia or deep sedation with propofol.
Results: Van Baar et al. reported 2020 about 37 of 46 patients underwent complete DMR (80%), 36 were finally analyzed; in remaining patients, mainly technical issues were observed [32]. Weight loss was observed in the first 4 weeks, overall was no significant weight loss registered but a significantly decrease of HbA1c and needed anti-diabetic medications. The principle of DMR also allows good glycemic control, but does not lead to significant weight loss [33].
Complications: In the study of Van Baar et al. [32] twenty-four patients had at least one AE (52%) related to DMR. Of these, 81% were mild. One SAE and no unanticipated AEs were reported.
In the context of NOTES development, endoscopically guided gastrojejunal bypass systems have already been developed and successfully performed in the pig model [34]. In the present publications magnets are used, which are applied via the working channel of the scope. These “intelligent” magnets are composed in square or hexagonal form intraluminally. Two such magnets, which act on each other with a force of 600-800 g, cause an anastomosis by reducing the blood supply of the enclosed tissue. This results in a gastro-jejunal [35] or jejuno-ileal [21] anastomosis.
The incisionless magnetic anastomotic system (IMAS; GI Windows, West Bridgewater, MA, USA) is a novel self-assembling magnetic device that allows for side-to-side anastomosis with enteral diversion.
Results: E. Machytka and colleagues [21] performed a prospective, single-arm pilot study, published in 2017. They evaluated the clinical outcomes, safety, and efficacy of IMAS placement and creation of a PJD in a total of 10 patients. At 12 months, patients had an EWL of 40.2%, and a decrease in HbA1c of 1.9% and a decrease in fasting glucose levels of 37% in diabetic patients.
Complications: No adverse events were reported.
The endoluminal mechanical device is a patent of Endosphere Inc. Columbus, OH, USA for implantation for 3 months. It is implanted endoscopically into the stomach and duodenum through an endoscope under general anesthesia and is composed of a nitinol backbone and spheres made of polyethylenterephtalat with two pigtails at each end. The stent form was made to stay in place by mimicking the anatomy of corresponding parts of the human intestine especially the duodenal C-shape down to the ligament of Treitz.
Results: Sauer et al. [36] reported about 26 treated patients. The study was prematurely terminated.
Complications: Migration of the endoluminal mechanical device was seen in 10/21 patients. Serious adverse events occurred in 10 out of 21 patients in the treatment group.
This device was introduced 2014 with an internet presentation. The Full Sense Device (Baker, Foote, Kemmeter, Walburn LLC, Grand Rapids, MI) is a temporary, reversible device that is deployed and removed endoscopically. It is a modified fully-covered stent with an esophageal component and a gastric disk component. To stretch the proximal stomach (cardia and fundus) stimulates the vagal nuclei and the vagus nervely. It is designed to induce satiety and fullness in the absence of food by applying pressure on the distal esophagus and gastric cardia.
Results: Only preliminary studies exist. Park and colleagues reported about FSD implantation in 12 pigs [37]. They used fully-covered, partially covered and uncovered stent devices. Luo and colleagues searched for the effects of this system in a rodent model [38].
Complications: There was a high migration rate (11/12) in the porcine model.
Relevant early and longtime complications can occur after bariatric surgery. Because the majority of symptomatic patients are endoscopically evaluated, the gastroenterologists must be familiar with post-surgical anatomy and complications, and their endoscopic management.
Endoluminal hemorrhage after resective procedures in bariatric patients occur with an incidence of up to 5% [39]. Depending on the pathology, endoscopic hemostasis can be achieved by clip (OTSC or TTSC), submucosal injection with fibrin glue or by endoscopic application of hematostyptics.
The insufficiency of an anastomosis or a staple line leak results in a leakage of enteral fluids into the abdomen. The visceral fat, which is present in pathological amounts, can result in occult peritonitis without typical pain symptoms this conditioned a delay of the detection of the insufficiency. Different endoscopic therapeutic procedures have been established in cases of clinical suspicion of an insufficiency or in cases of proven insufficiencies.
In the case of early detection of insufficiency, re-laparoscopy and, if necessary, overstitching may be appropriate. Often a combination of re-laparoscopy, lavage and drainage for sepsis control and endoscopic therapy is indicated. In hospitals with obesity centers and a 24-hour endoscopy rendezvous procedures with intraoperatively endoscopy could be established. Especially in cases of very small leaks, a reliable identification of the leak can be made [40].
The most frequently performed endoscopic therapy for leakages after bariatric surgery worldwide is the stent therapy [41]. A challenge is the stent fixation in bariatric patients. Stent dislocation is the most common complication of this type of therapy. Special bariatric stents have been developed. The leading brands ECBB HanaroStent® (MI-tech, Seoul, South Korea), MegaStent™ (Taewoong, Seoul, South Korea) and Gastro Seal™ (MI-tech, Seoul, South Korea) are stents 2013 [42]. In addition to the common hemo-clips, the endoscopic sewing machine (EndoStich®, Apollo endosurgery, USA) [43, 44] and a special OTSC (OTSC®Stentfix, Ovesco, Germany) can be used for stent fixation [43].
The endoscopic negative pressure therapy (ENPT) is based on an open-pored element (e.g. a sponge), which is either endoluminally inserted at the stage of the leakage or into the resulting insufficiency cavity (intracavitary). The open-pore element is fixed to a drainage with perforations, which is connected to a vacuum source. The negative pressure acts through the pores on the surrounding tissue and results in a continuous drainage of secretions, cell-detruitus and bacteria, the suction induces tissue proliferation [45]. Due to the good clinical results this therapy is used for numerous leakages of the gastrointestinal and urogenital tract [46, 47]. ENPT is also known under the synonyms E-VAC and EVT. For ENPT as primary endoscopic procedure for leakage, possibly in combination with laparoscopy, three studies are currently available with a cumulative success rate of 90.27% in a total of 31 patients [48, 49, 50]. In addition, there are numerous case reports and studies, some of which deal with the combined use of ENPT with stent procedures as first and second line therapy [51].
Closure of leakage after bariatric surgery can be successfully performed with OTSC® as first or second line therapy with good results up to closure rates of 86.3% [52, 53].
The drainage of secretions through an internal drainage by implantation of a double-pigtail-drainage to endoluminal can lead to a successful healing of the insufficiency in up to 78% according to the study results [41].
In patients after RYGB, gastrojejunal anastomosis ulceration occurs in up to 16% of cases. Typically, these ulcers occur within 1–6 months postoperatively. Possible complications of these ulcerations are pain, bleeding and possibly perforations. Endoscopic diagnosis and bleeding therapy can be established as described in “bleeding”.
Ulcerations can also occur after gastric banding operations due to the band. In this laparoscopic procedure, an adjustable silicone band is placed around the proximal corpus ventriculi, which causes a deliberate stenosis of the stomach by filling a port appropriately. Erosion of the gastric band can occur in almost 1/3 of the patients [41]. If necessary, the gastric band is then recovered endoscopically [54, 55].
With regard to stenosis after bariatric surgery, the following causes of stenosis should be divided:
Primary anastomotic stenosis according to RYGB (3–28%) [41, 56],
Primary stenosis in a sleeve stomach (0.1–3.9%) [57],
Post-therapeutic stenosis after leakage therapy [41].
Stenosis after bariatric surgery is defined as lumen constriction to less than 10 mm. The therapy consists of an endoscopic controlled balloon dilatation. For the primary stenosis after sleeve gastrectomy (30 mm) achalasia balloons with very good clinical results are used stenosis sleeve.
Weight regain after bariatric surgery is a multi-complex problem. While behavioral and genetic mechanisms a dilated gastrojejunal anastomosis (GJA) is a relevante factor of weight recidivism after Roux-en-Y gastric bypass surgery (RYGB).
Endoscopic transoral outlet reduction (TORe) is a therapeutic option for management of weight regain after RYGB. By a full thickness endoscopic suturing device (Overstitch, Apollo Endosurgery, Austin, TX) the reduction of the GJA aperture is possible.
Results: Vargas and colleagues [58] reported in a meta-analysis about 330 patients who underwent TORe procedure. The pooled weight lost at 12 months was 8.4 kg.
Complications: Overall, 14% of patients experienced nausea, 18% had pain and 8% required a repeat EGD. No serious adverse events were reported.
The OTSC®-clip (Ovesco AG, Tübingen, Germany) is made of super-elastic shape memory alloy (Nitinol) which re-takes its former unbent shape after the clip is released and thus exerts a constant compression on the tissue between the jaws of the clip. In 2020 Ovesco created a new product to reduce pouch-outlet named BARS device (Bariatric Reduction System).
Results: Heylen and colleagues [59] reported about 94 patients who underwent reducing of a post-RYGB pouch-outlet. After one year mean BMI was 27.4 kg/m2. Di Lorenzo published 2020 results of a clinical trial with BARS device in 6 patients [60]. Authors reported about safely performed procedures with a mean procedure time of 52 min and a mean weight loss of 6 kg at a 3-month FU.
Complications: No SAEs occurred. Some patients complained of a sore throat for 24 h after the intervention. In five patients with post-interventional dysphagia, a gastroscopy had to be performed. Two of patients required endoscopic dilatation.
The transoral StomaphyX device (EndoGastric Solutions) is a minimally invasive technique for revision after RYGB. Procedure seems to be safe and effective.
Results: 2014 Eid et al. [61] published a randomized clinical trial with 45 patients treated with StomaphyX and 25 patients in the sham group. The primary efficacy end point was reduction in pre-RYGB excess weight by 15% or more excess BMI. Patients undergoing StomaphyX treatment experienced significantly greater reduction in weight and BMI. Enrollment was closed prematurely because preliminary results indicated failure to achieve the primary efficacy end point in at least 50% of StomaphyX-treated patients.
Complications: There was one causally related adverse event with StomaphyX that required laparoscopic exploration and repair.
APC is a non-contact technique involving the application of an electrical current to tissues through ionized argon gas (argon plasma). It has also been successfully used in the treatment of the enlargement of the anastomosis after gastric bypass.
Results: Quadros and colleagues [62] published 2020 a randomized controlled trial with APC treatment and sham group. Authors reported about a significant weight decrease in the first months after APC.
Complications: No SAEs were reported.
The bariatric procedure can be lithogenic due to a hypersecretion of bile and the strong weight loss. A postoperative incidence of cholecystolithiasis in 50% has been described for RYGB. The current guidelines recommends primary cholecystectomy (CHE) in preoperative, symptomatic cholecytolithiasis and, if applicable, in preoperatively known gallstone disease [1]. Simultaneous CHE is not recommended in patients without gallstones. In case of a possibly resulting choledocholithiasis, RYGB is a challenge for the endoscopist. In these cases, laparoscopically assisted ERCP (LA ERCP) or double balloon enteroscopy for the establishment of ERCP (DB ERCP) has become established [41]. Furthermore, there is the possibility to place the duodenoscope laparoscopically assisted via a gastrostomy of the suspended stomach.
This overview about the role of endoscopic diagnostic and interventions in obese patients with requiremet of bariatric procedures is certainly not complete and possibly some new and specialized techniques are not listed. Nevertheless we could show the immensely dimension of endoscopy in this field. Endoscopy is an essential part of diagnostics and therapy in the treatment of bariatric patients this applies to the pre- and postoperative phase. As bariatric endoscopy or endoscopic bariatric therapy, a large number of interventions have already been developed, which impress by their minimal invasiveness, low complication rates, manageable costs and good tolerability. Further revolutionary advances in the field of bariatric endoscopy can be expected in the medium term. Interventional endoscopy requires a high level of expertise and a learning curve. It can be expected an increasing number of primary bariatric endoscopic procedures will be performed and bariatric surgery will be relegated to the background due to peri-interventional complications and higher invasiveness.
ACE | articulating circular endoscopic stapler |
AE | adverse event |
APC | argon-plasma-coagulation |
BMI | body-mass-index |
DB | double balloon |
DMR | duodenal mucosal resurfacing |
EAES | European Association for Endoscopic Surgery |
EBT | endoscopic bariatric therapy |
EGD | esophago-gastro-duodenoscopy |
EGS | endoscopic gastric sleeve |
ERCP | endoscopic retrograde cholangio-pancreaticography |
ENPT | endoscopic negative-pressure therapy |
EVAC | endoscopic vacuum-assisted closure therapy |
EVT | endoscopic vacuum-therapy |
EWL | excess weight loss |
FU | follow-up |
GERD | gastro-esophageal reflux disease |
IFSO | International Federation for the Surgery of Obesity and Metabolic Disorders |
IMAS | incisionless magnetic anastamosis system |
IOP | incisionless operating platform |
kg | kilogram |
LA ERCP | laparoscopic assisted ERCP |
LGS | laparoscopic gastric sleeve |
m | meter |
OTSC | over-the-scope-clip |
PEG | percutaneous endoscopic gastrostomy |
POSE | primary obesity surgery endoluminal |
ROSE | restorative obesity surgery endoluminal |
RYGB | Roux-Y-gastric bypass |
SAE | severe adverse event |
SLL | staple-line-leak |
TORe | trans-oral outlet reduction endoscopic |
TTSC | through-the-scope-clip |
TWL | total weight loss |
WHO | World Health Organization |
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His studies in robotics lead him not only to a PhD degree but also inspired him to co-found and build the International Journal of Advanced Robotic Systems - world's first Open Access journal in the field of robotics.",institutionString:null,institution:{name:"TU Wien",country:{name:"Austria"}}},{id:"441",title:"Ph.D.",name:"Jaekyu",middleName:null,surname:"Park",slug:"jaekyu-park",fullName:"Jaekyu Park",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/441/images/1881_n.jpg",biography:null,institutionString:null,institution:{name:"LG Corporation (South Korea)",country:{name:"Korea, South"}}},{id:"465",title:"Dr.",name:"Christian",middleName:null,surname:"Martens",slug:"christian-martens",fullName:"Christian Martens",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Rheinmetall (Germany)",country:{name:"Germany"}}},{id:"479",title:"Dr.",name:"Valentina",middleName:null,surname:"Colla",slug:"valentina-colla",fullName:"Valentina Colla",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/479/images/358_n.jpg",biography:null,institutionString:null,institution:{name:"Sant'Anna School of Advanced Studies",country:{name:"Italy"}}},{id:"494",title:"PhD",name:"Loris",middleName:null,surname:"Nanni",slug:"loris-nanni",fullName:"Loris Nanni",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/494/images/system/494.jpg",biography:"Loris Nanni received his Master Degree cum laude on June-2002 from the University of Bologna, and the April 26th 2006 he received his Ph.D. in Computer Engineering at DEIS, University of Bologna. 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El-Shafie",coverURL:"https://cdn.intechopen.com/books/images_new/10739.jpg",editedByType:"Edited by",editors:[{id:"192142",title:"Dr.",name:"Hamadttu",middleName:null,surname:"Abdel Farag El-Shafie",slug:"hamadttu-abdel-farag-el-shafie",fullName:"Hamadttu Abdel Farag El-Shafie"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10423",title:"The Wonders of Diptera",subtitle:"Characteristics, Diversity, and Significance for the World's Ecosystems",isOpenForSubmission:!1,hash:"2746b4288e78c8688d1be1bd9d99a127",slug:"the-wonders-of-diptera-characteristics-diversity-and-significance-for-the-world-s-ecosystems",bookSignature:"Farzana Khan Perveen",coverURL:"https://cdn.intechopen.com/books/images_new/10423.jpg",editedByType:"Edited by",editors:[{id:"75563",title:"Dr.",name:"Farzana Khan",middleName:null,surname:"Perveen",slug:"farzana-khan-perveen",fullName:"Farzana Khan Perveen"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8929",title:"Modern Beekeeping",subtitle:"Bases for Sustainable Production",isOpenForSubmission:!1,hash:"cbf5aca68ed2c6690ad99f68aaaddcaf",slug:"modern-beekeeping-bases-for-sustainable-production",bookSignature:"Ramón Eduardo Rebolledo Ranz",coverURL:"https://cdn.intechopen.com/books/images_new/8929.jpg",editedByType:"Edited by",editors:[{id:"193813",title:"Dr.",name:"Ramón Eduardo",middleName:null,surname:"Rebolledo Ranz",slug:"ramon-eduardo-rebolledo-ranz",fullName:"Ramón Eduardo Rebolledo Ranz"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7561",title:"Beekeeping",subtitle:"New Challenges",isOpenForSubmission:!1,hash:"1c47c831256fe10ff19fb10f490930fc",slug:"beekeeping-new-challenges",bookSignature:"Ramón Eduardo Rebolledo Ranz",coverURL:"https://cdn.intechopen.com/books/images_new/7561.jpg",editedByType:"Edited by",editors:[{id:"193813",title:"Dr.",name:"Ramón Eduardo",middleName:null,surname:"Rebolledo Ranz",slug:"ramon-eduardo-rebolledo-ranz",fullName:"Ramón Eduardo Rebolledo Ranz"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6619",title:"Insect Science",subtitle:"Diversity, Conservation and Nutrition",isOpenForSubmission:!1,hash:"08241b041b2072a88452041f8fdebe7e",slug:"insect-science-diversity-conservation-and-nutrition",bookSignature:"Mohammad Manjur Shah and Umar Sharif",coverURL:"https://cdn.intechopen.com/books/images_new/6619.jpg",editedByType:"Edited by",editors:[{id:"94128",title:"Dr.",name:"Mohammad Manjur",middleName:null,surname:"Shah",slug:"mohammad-manjur-shah",fullName:"Mohammad Manjur Shah"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5163",title:"Beekeeping and Bee Conservation",subtitle:"Advances in Research",isOpenForSubmission:!1,hash:"fc469ff4d2cf6651cfdbf3c5cf90a469",slug:"beekeeping-and-bee-conservation-advances-in-research",bookSignature:"Emerson Dechechi Chambo",coverURL:"https://cdn.intechopen.com/books/images_new/5163.jpg",editedByType:"Edited by",editors:[{id:"94059",title:"Dr.",name:"Emerson",middleName:"Dechechi",surname:"Dechechi Chambó",slug:"emerson-dechechi-chambo",fullName:"Emerson Dechechi Chambó"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],booksByTopicTotal:6,seriesByTopicCollection:[],seriesByTopicTotal:0,mostCitedChapters:[{id:"50073",doi:"10.5772/62487",title:"Impacts of Pesticides on Honey Bees",slug:"impacts-of-pesticides-on-honey-bees",totalDownloads:3427,totalCrossrefCites:20,totalDimensionsCites:41,abstract:"This chapter focuses on the detrimental effects that pesticides have on managed honey bee colonies and their productivity. We examine first the routes of exposure of bees to agrochemicals used for crop protection and their application to crops, fate and contamination of water and plants around the fields. Most of the time, the exposure of bees to pesticides is through ingestion of residues found in the pollen and nectar of plants and in water. Honey bees are also exposed to pesticides used for the treatment of Varroa and other parasites. The basic concepts about the toxicity of the different kinds of pesticides are explained next. Various degrees of toxicity are found among agrochemicals, and emphasis is given to the classic tenet of toxicology, “the dose makes the poison,” and its modern version “the dose and the time of exposure makes the poison.” These two factors, dose and time, help us understand the severity of the impacts that pesticides may have on bees and their risk, which are analysed in the third section. Sublethal effects are also considered. The final section is devoted to some practical advice for avoiding adverse impacts of pesticides in beekeeping.",book:{id:"5163",slug:"beekeeping-and-bee-conservation-advances-in-research",title:"Beekeeping and Bee Conservation",fullTitle:"Beekeeping and Bee Conservation - Advances in Research"},signatures:"Francisco Sanchez-Bayo and Koichi Goka",authors:[{id:"74970",title:"Dr.",name:"Francisco",middleName:null,surname:"Sánchez-Bayo",slug:"francisco-sanchez-bayo",fullName:"Francisco Sánchez-Bayo"},{id:"192045",title:"Dr.",name:"Koichi",middleName:null,surname:"Goka",slug:"koichi-goka",fullName:"Koichi Goka"}]},{id:"59212",doi:"10.5772/intechopen.73864",title:"Insect Conservation for the Twenty-First Century",slug:"insect-conservation-for-the-twenty-first-century",totalDownloads:1968,totalCrossrefCites:7,totalDimensionsCites:15,abstract:"Insects have been immensely successful as an animal group. They dominate compositional diversity of all but the saltiest and coldest parts of the planet. Yet today insects are declining at a precipitous rate. This is of great concern in terms of impoverishment of Earth, and is also dire for us. Insects contribute to the maintenance of terrestrial and freshwater systems, their service delivery and their resilience. The meteoric impact of humans is challenging this dominance, yet so few people realize that the very fabric of life on which they depend is being unraveled at an alarming rate. Action is required, as are new perspectives, if we are to maintain insect diversity and services through the twenty-first century. Here, we review how we should view and act to have more effective insect diversity conservation based on six themes: (1) philosophy (establishing the ethical foundation), (2) research (the finding out), (3) policy (the framework for action), (4) psychology (understanding how to engage humans in insect conservation action), (5) practice (implementation of action), and (6) validation (establishing how well we are doing at conserving insects). We then overview some emergent challenges and solutions at both the species and landscape operational levels in agricultural, forestry, and urban environments.",book:{id:"6619",slug:"insect-science-diversity-conservation-and-nutrition",title:"Insect Science",fullTitle:"Insect Science-Diversity, Conservation and Nutrition"},signatures:"Michael J. Samways",authors:[{id:"233323",title:"Distinguished Prof.",name:"Michael",middleName:null,surname:"Samways",slug:"michael-samways",fullName:"Michael Samways"}]},{id:"79121",doi:"10.5772/intechopen.100416",title:"Botanical Insecticides Are a Non-Toxic Alternative to Conventional Pesticides in the Control of Insects and Pests",slug:"botanical-insecticides-are-a-non-toxic-alternative-to-conventional-pesticides-in-the-control-of-inse",totalDownloads:270,totalCrossrefCites:6,totalDimensionsCites:11,abstract:"Insect control for crops is one of the most critical global concerns. Pest management is an economic and ecological problem worldwide due to the human and environmental risks raised by most synthetic pesticide products. Botanical insecticides have resurfaced in popularity due to their low cost and low environmental impact, rather than their negative effects on human health. Botanical insecticides destroy only the insects they are meant to kill, leaving no residue on food or in the environment. Botanicals have long been used to combat pests. The compounds have many environmental advantages. However, as opposed to other bio-control pests and pathogens, their use was minimal during the twentieth century. In developing countries, botanical insecticides are well adapted for use in organic food production. Nonetheless, they may play a far bigger role in developed countries’ food production and post-harvest food protection. Consequently, the current chapter briefly addresses botanicals with active ingredients with insecticidal, antifeedant, or repellent properties.",book:{id:"10739",slug:"global-decline-of-insects",title:"Global Decline of Insects",fullTitle:"Global Decline of Insects"},signatures:"Nazeer Ahmed, Mukhtar Alam, Muhammad Saeed, Hidayat Ullah, Toheed Iqbal, Khalid Awadh Al-Mutairi, Kiran Shahjeer, Rafi Ullah, Saeed Ahmed, Nibal Abd Aleem Hassan Ahmed, Hanem Fathy Khater and Muhammad Salman",authors:[{id:"97300",title:"Prof.",name:"Khalid Awadh",middleName:"Al-Mutairi",surname:"Al-Mutairi",slug:"khalid-awadh-al-mutairi",fullName:"Khalid Awadh Al-Mutairi"},{id:"191884",title:"Dr.",name:"Toheed",middleName:null,surname:"Iqbal",slug:"toheed-iqbal",fullName:"Toheed Iqbal"},{id:"263876",title:"Dr.",name:"Hidayat",middleName:null,surname:"Ullah",slug:"hidayat-ullah",fullName:"Hidayat Ullah"},{id:"263877",title:"Dr.",name:"Mukhtar",middleName:null,surname:"Alam",slug:"mukhtar-alam",fullName:"Mukhtar Alam"},{id:"355528",title:"Dr.",name:"Nazeer",middleName:null,surname:"Ahmed",slug:"nazeer-ahmed",fullName:"Nazeer Ahmed"},{id:"420069",title:"Mrs.",name:"Kiran",middleName:null,surname:"Shahjeer",slug:"kiran-shahjeer",fullName:"Kiran Shahjeer"},{id:"420070",title:"Mr.",name:"Saeed",middleName:null,surname:"Ahmed",slug:"saeed-ahmed",fullName:"Saeed Ahmed"},{id:"420221",title:"Dr.",name:"Muhammad",middleName:null,surname:"Saeed",slug:"muhammad-saeed",fullName:"Muhammad Saeed"},{id:"420222",title:"Dr.",name:"Rafi",middleName:null,surname:"Ullah",slug:"rafi-ullah",fullName:"Rafi Ullah"},{id:"436507",title:"Dr.",name:"Nibal Abd Aleem",middleName:null,surname:"Hassan Ahmed",slug:"nibal-abd-aleem-hassan-ahmed",fullName:"Nibal Abd Aleem Hassan Ahmed"},{id:"436596",title:"Prof.",name:"Hanem Fathy",middleName:null,surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater"},{id:"485113",title:"Dr.",name:"Muhammad",middleName:null,surname:"Salman",slug:"muhammad-salman",fullName:"Muhammad Salman"}]},{id:"50307",doi:"10.5772/62654",title:"From Extraction to Meliponiculture: A Case Study of the Management of Stingless Bees in the West-Central Region of Mexico",slug:"from-extraction-to-meliponiculture-a-case-study-of-the-management-of-stingless-bees-in-the-west-cent",totalDownloads:2745,totalCrossrefCites:5,totalDimensionsCites:9,abstract:"Currently, stingless bees' populations are declining due to environmental degradation. In this context, the authors have developed a research project in the central-western region of Mexico with the goal to generate strategies for conservation and sustainable management of stingless bees. The chapter aims to present the process of this investigation and its main results in terms of a) local knowledge and management strategies of stingless bees, and b) the social process of technological appropriation of meliponiculture by beekeepers. We recognized specific knowledge on the biology and ecology of stingless bees that result in a system for identifying species and management strategies of wild populations of these bees based on the extraction of nests. The implementation of an innovative productive activity based on the principles of meliponiculture and current techniques has been well received by producers, which has led to the formation of the Meliponicultores Michoacanos del Balsas Association, which grows five species of stingless bees. The research suggests that conservation associated with the use of bees (integral meliponiculture) can be enhanced in the region. Faced with the loss of biodiversity and environmental crisis, it is essential to maintain and enhance local knowledge of stingless bees and management practices. This represents an alternative to develop management schemes that allow the raising and breeding of these bees, while its products are obtained.",book:{id:"5163",slug:"beekeeping-and-bee-conservation-advances-in-research",title:"Beekeeping and Bee Conservation",fullTitle:"Beekeeping and Bee Conservation - Advances in Research"},signatures:"Alejandro Reyes-González, Andrés Camou-Guerrero and Salvador\nGómez-Arreola",authors:[{id:"179951",title:"Dr.",name:"Andres",middleName:null,surname:"Camou-Guerrero",slug:"andres-camou-guerrero",fullName:"Andres Camou-Guerrero"},{id:"185413",title:"MSc.",name:"Alejandro",middleName:null,surname:"Reyes-González",slug:"alejandro-reyes-gonzalez",fullName:"Alejandro Reyes-González"},{id:"192049",title:"Dr.",name:"Salvador",middleName:null,surname:"Gómez-Arreola",slug:"salvador-gomez-arreola",fullName:"Salvador Gómez-Arreola"}]},{id:"50683",doi:"10.5772/63145",title:"Advances in Pharmacological Activities and Chemical Composition of Propolis Produced in Americas",slug:"advances-in-pharmacological-activities-and-chemical-composition-of-propolis-produced-in-americas",totalDownloads:2583,totalCrossrefCites:2,totalDimensionsCites:8,abstract:"Propolis is a resinous material produced by bees from the selective collection of plant exudates that are subsequently mixed with beeswax and salivary bee secretions. Propolis has been used in folk medicine, and certainly, several studies have validated its biological properties. The chemical composition and pharmacological activities of propolis collected through North (including Central America and Caribbean) and South America have been studied in the last years, and several papers have reported differences and similarities among the analysed geographical samples. Propolis has been classified according to its aspect and plant source; however, the ecological diversity present along the Americas provides a plethora of botanical resins. Herein, we summarize and discuss most of the studies performed at present on this profitable product for apiculture, attempting to compare the bioactivity, phytochemical diversity and botanical sources of honeybee propolis produced in Americas.",book:{id:"5163",slug:"beekeeping-and-bee-conservation-advances-in-research",title:"Beekeeping and Bee Conservation",fullTitle:"Beekeeping and Bee Conservation - Advances in Research"},signatures:"Efrain Alday, Moisés Navarro-Navarro, Adriana Garibay-Escobar,\nRamón Robles-Zepeda, Javier Hernandez and Carlos Velazquez",authors:[{id:"96966",title:"MSc.",name:"Moises",middleName:null,surname:"Navarro-Navarro",slug:"moises-navarro-navarro",fullName:"Moises Navarro-Navarro"},{id:"180409",title:"Dr.",name:"Carlos",middleName:null,surname:"Velazquez",slug:"carlos-velazquez",fullName:"Carlos Velazquez"},{id:"186351",title:"Dr.",name:"Ramón",middleName:null,surname:"Robles-Zepeda",slug:"ramon-robles-zepeda",fullName:"Ramón Robles-Zepeda"},{id:"186352",title:"MSc.",name:"Efrain",middleName:null,surname:"Alday",slug:"efrain-alday",fullName:"Efrain Alday"},{id:"186353",title:"Dr.",name:"Javier",middleName:null,surname:"Hernandez",slug:"javier-hernandez",fullName:"Javier Hernandez"},{id:"189161",title:"Dr.",name:"Adriana",middleName:null,surname:"Garibay-Escobar",slug:"adriana-garibay-escobar",fullName:"Adriana Garibay-Escobar"}]}],mostDownloadedChaptersLast30Days:[{id:"50170",title:"A Comprehensive Characterization of the Honeybees in Siberia (Russia)",slug:"a-comprehensive-characterization-of-the-honeybees-in-siberia-russia-",totalDownloads:2302,totalCrossrefCites:4,totalDimensionsCites:8,abstract:"A comprehensive study of some populations of honeybee (332 colonies) in Siberia (Tomsk region, Krasnoyarsk Krai (Yenisei population), Altai) using morphometric and molecular genetic methods was conducted. Infestation of bees (132 colonies) by Nosema has also been studied. Three variants of the COI-COII mtDNA locus were registered: PQQ, PQQQ (typical for Apis m. mellifera), and Q (specific for southern races). It was established that 64% of bee colonies from the Tomsk region and all colonies studied from the Krasnoyarsk and the Altai territories originate from Apis m. mellifera on the maternal line. According to the morphometric study, the majority of bee colonies of the Tomsk region are hybrids; in some colonies the mismatch of morphometric and mtDNA data was observed. Moreover, the majority of bee colonies infected by Nosema were hybrids. Yenisei population may be considered as a unique Apis m. mellifera population. Microsatellite analysis (loci А008, Ap049, AC117, AC216, Ap243, H110, A024, A113) showed the specific distribution of genotypes and alleles for some loci in the bees, which differ by geographical location. Loci A024 and Ap049 are of considerable interest for further study as candidate markers for differentiation of subspecies; locus A008 can be considered informative for determining of different ecotypes of Apis m. mellifera.",book:{id:"5163",slug:"beekeeping-and-bee-conservation-advances-in-research",title:"Beekeeping and Bee Conservation",fullTitle:"Beekeeping and Bee Conservation - Advances in Research"},signatures:"Nadezhda V. Ostroverkhova, Olga L. Konusova, Aksana N. Kucher\nand Igor V. Sharakhov",authors:[{id:"180112",title:"Ph.D.",name:"Nadezhda",middleName:null,surname:"Ostroverkhova",slug:"nadezhda-ostroverkhova",fullName:"Nadezhda Ostroverkhova"},{id:"180249",title:"Ms.",name:"Olga",middleName:null,surname:"Konusova",slug:"olga-konusova",fullName:"Olga Konusova"},{id:"180342",title:"Prof.",name:"Aksana",middleName:null,surname:"Kucher",slug:"aksana-kucher",fullName:"Aksana Kucher"},{id:"180343",title:"Prof.",name:"Igor",middleName:null,surname:"Sharakhov",slug:"igor-sharakhov",fullName:"Igor Sharakhov"}]},{id:"70501",title:"Southeast Asian Meliponiculture for Sustainable Livelihood",slug:"southeast-asian-meliponiculture-for-sustainable-livelihood",totalDownloads:1262,totalCrossrefCites:2,totalDimensionsCites:4,abstract:"Stingless bees (Apidae: Meliponini) are one of the most important pollinators of native plants and economic crops in tropical and subtropical parts of the world. They not only establish large perennial colonies with complex social organization but also have a diverse nesting biology. The economic utilization of a total of 60 stingless bee species in Asia has been reported. The current status of meliponiculture in Southeast Asia is mainly focused on pollination utilization and honey and propolis production. This chapter shows that small-scale beekeeping of stingless bees, which is suitable for the flowering pattern in the tropics, is one of the best potential alternative opportunities. The cost-effectiveness analysis based on production yield, investment cost, and profit-return rate is reviewed. Finally, a sustainable utilization of stingless bees is considered to be an enhancer of pollination services both in an agricultural crop and natural ecosystem.",book:{id:"8929",slug:"modern-beekeeping-bases-for-sustainable-production",title:"Modern Beekeeping",fullTitle:"Modern Beekeeping - Bases for Sustainable Production"},signatures:"Atsalek Rattanawannee and Orawan Duangphakdee",authors:[{id:"283087",title:"Ph.D.",name:"Atsalek",middleName:null,surname:"Rattanawannee",slug:"atsalek-rattanawannee",fullName:"Atsalek Rattanawannee"},{id:"306411",title:"Dr.",name:"Orawan",middleName:null,surname:"Duangphakdee",slug:"orawan-duangphakdee",fullName:"Orawan Duangphakdee"}]},{id:"50073",title:"Impacts of Pesticides on Honey Bees",slug:"impacts-of-pesticides-on-honey-bees",totalDownloads:3419,totalCrossrefCites:20,totalDimensionsCites:41,abstract:"This chapter focuses on the detrimental effects that pesticides have on managed honey bee colonies and their productivity. We examine first the routes of exposure of bees to agrochemicals used for crop protection and their application to crops, fate and contamination of water and plants around the fields. Most of the time, the exposure of bees to pesticides is through ingestion of residues found in the pollen and nectar of plants and in water. Honey bees are also exposed to pesticides used for the treatment of Varroa and other parasites. The basic concepts about the toxicity of the different kinds of pesticides are explained next. Various degrees of toxicity are found among agrochemicals, and emphasis is given to the classic tenet of toxicology, “the dose makes the poison,” and its modern version “the dose and the time of exposure makes the poison.” These two factors, dose and time, help us understand the severity of the impacts that pesticides may have on bees and their risk, which are analysed in the third section. Sublethal effects are also considered. The final section is devoted to some practical advice for avoiding adverse impacts of pesticides in beekeeping.",book:{id:"5163",slug:"beekeeping-and-bee-conservation-advances-in-research",title:"Beekeeping and Bee Conservation",fullTitle:"Beekeeping and Bee Conservation - Advances in Research"},signatures:"Francisco Sanchez-Bayo and Koichi Goka",authors:[{id:"74970",title:"Dr.",name:"Francisco",middleName:null,surname:"Sánchez-Bayo",slug:"francisco-sanchez-bayo",fullName:"Francisco Sánchez-Bayo"},{id:"192045",title:"Dr.",name:"Koichi",middleName:null,surname:"Goka",slug:"koichi-goka",fullName:"Koichi Goka"}]},{id:"74836",title:"Chironomidae: Biology, Ecology and Systematics",slug:"chironomidae-biology-ecology-and-systematics",totalDownloads:474,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"The family of Chironomidae is a group of Diptera insects belonging to the suborder of Nematocera, commonly called “non-biting midges” in the adult stage and “bloodworms” in the larval stage. The Chironomidae are often the most abundant group of macroinvertebrates, in number of species and individuals, encountered in all aquatic environments of freshwater, brackish, terrestrial and even the sea. Likewise, Chironomidae occur in all the continents. The Chironomidae family is divided into 11 sub-families that have diffrent ecological statues. Despite the wealth of data on Chironomidae in the Holarctic region, other parts of the world are poorly studied and few guides to identifying Chironomidae have been produced. This chapter includes a theoretical synthesis on the Chironomidae, it deals with the Biology (life cycle and description of different stages), description of all subfamilies and the ecology of this important family of Diptera.",book:{id:"10423",slug:"the-wonders-of-diptera-characteristics-diversity-and-significance-for-the-world-s-ecosystems",title:"The Wonders of Diptera",fullTitle:"The Wonders of Diptera - Characteristics, Diversity, and Significance for the World's Ecosystems"},signatures:"Zerguine Karima",authors:[{id:"334825",title:"Dr.",name:"Karima",middleName:null,surname:"Zerguine",slug:"karima-zerguine",fullName:"Karima Zerguine"}]},{id:"75438",title:"Characteristics of Dipteran Insects",slug:"characteristics-of-dipteran-insects",totalDownloads:510,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Diptera means two wings (Di: two, pteron: wing). They have complete metamorphosis and they are holometabolous insects which means there are 4 stages (egg, larvae, pupae and adult). The name of larval stage is “maggot”. Some of the dipteran insects cause damage in agricultural production. Some are harmful for humans. Dipteran insects have two wings. Hind wings are reduced and they are called “halteres”. Function of halteres is balancing when the insects fly. Except mosquitoes, dipteran insects have sponging-sucking mouthparts. Important examples for dipteran insects are Olive fruit fly and Medfly which cause damages in agricultural production. OFF is the most destructive pest in olive growing areas and Mediterranean fruit fly cause damages in fruit production.",book:{id:"10423",slug:"the-wonders-of-diptera-characteristics-diversity-and-significance-for-the-world-s-ecosystems",title:"The Wonders of Diptera",fullTitle:"The Wonders of Diptera - Characteristics, Diversity, and Significance for the World's Ecosystems"},signatures:"Murat Helvacı",authors:[{id:"301984",title:"Ph.D.",name:"Murat",middleName:null,surname:"Helvaci",slug:"murat-helvaci",fullName:"Murat Helvaci"}]}],onlineFirstChaptersFilter:{topicId:"35",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},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:9,numberOfPublishedChapters:90,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:107,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:330,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:9,numberOfPublishedChapters:140,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:123,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:22,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:11,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:"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"}}}},{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"}}}}]},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 2nd, 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:"Dr. Rosa María Martínez-Espinosa has been a Spanish Full Professor since 2020 (Biochemistry and Molecular Biology) and is currently Vice-President of International Relations and Cooperation development and leader of the research group 'Applied Biochemistry” (University of Alicante, Spain). Other positions she has held at the university include Vice-Dean of Master Programs, Vice-Dean of the Degree in Biology and Vice-Dean for Mobility and Enterprise and Engagement at the Faculty of Science (University of Alicante). She received her Bachelor in Biology in 1998 (University of Alicante) and her PhD in 2003 (Biochemistry, University of Alicante). She undertook post-doctoral research at the University of East Anglia (Norwich, U.K. 2004-2005; 2007-2008).\nHer multidisciplinary research focuses on investigating archaea and their potential applications in biotechnology. She has an H-index of 21. She has authored one patent and has published more than 70 indexed papers and around 60 book chapters.\nShe has contributed to more than 150 national and international meetings during the last 15 years. Her research interests include archaea metabolism, enzymes purification and characterization, gene regulation, carotenoids and bioplastics production, antioxidant\ncompounds, waste water treatments, and brines bioremediation.\nRosa María’s other roles include editorial board member for several journals related\nto biochemistry, reviewer for more than 60 journals (biochemistry, molecular biology, biotechnology, chemistry and microbiology) and president of several organizing committees in international meetings related to the N-cycle or respiratory processes.",institutionString:null,institution:{name:"University of Alicante",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"15",title:"Chemical Biology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/15.jpg",isOpenForSubmission:!0,editor:{id:"441442",title:"Dr.",name:"Şükrü",middleName:null,surname:"Beydemir",slug:"sukru-beydemir",fullName:"Şükrü Beydemir",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003GsUoIQAV/Profile_Picture_1634557147521",biography:"Dr. Şükrü Beydemir obtained a BSc in Chemistry in 1995 from Yüzüncü Yıl University, MSc in Biochemistry in 1998, and PhD in Biochemistry in 2002 from Atatürk University, Turkey. 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. Dr. Ekinci serves as the Editor in Chief of four international books and is involved in the Editorial Board of several international journals.",institutionString:null,institution:{name:"Ondokuz Mayıs University",institutionURL:null,country:{name:"Turkey"}}},editorThree:null},{id:"17",title:"Metabolism",coverUrl:"https://cdn.intechopen.com/series_topics/covers/17.jpg",isOpenForSubmission:!0,editor:{id:"138626",title:"Dr.",name:"Yannis",middleName:null,surname:"Karamanos",slug:"yannis-karamanos",fullName:"Yannis Karamanos",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002g6Jv2QAE/Profile_Picture_1629356660984",biography:"Yannis Karamanos, born in Greece in 1953, completed his pre-graduate studies at the Université Pierre et Marie Curie, Paris, then his Masters and Doctoral degree at the Université de Lille (1983). He was associate professor at the University of Limoges (1987) before becoming full professor of biochemistry at the Université d’Artois (1996). He worked on the structure-function relationships of glycoconjugates and his main project was the investigations on the biological roles of the de-N-glycosylation enzymes (Endo-N-acetyl-β-D-glucosaminidase and peptide-N4-(N-acetyl-β-glucosaminyl) asparagine amidase). From 2002 he contributes to the understanding of the Blood-brain barrier functioning using proteomics approaches. He has published more than 70 papers. His teaching areas are energy metabolism and regulation, integration and organ specialization and metabolic adaptation.",institutionString:null,institution:{name:"Artois University",institutionURL:null,country:{name:"France"}}},editorTwo:null,editorThree:null},{id:"18",title:"Proteomics",coverUrl:"https://cdn.intechopen.com/series_topics/covers/18.jpg",isOpenForSubmission:!0,editor:{id:"200689",title:"Prof.",name:"Paolo",middleName:null,surname:"Iadarola",slug:"paolo-iadarola",fullName:"Paolo Iadarola",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSCl8QAG/Profile_Picture_1623568118342",biography:"Paolo Iadarola graduated with a degree in Chemistry from the University of Pavia (Italy) in July 1972. He then worked as an Assistant Professor at the Faculty of Science of the same University until 1984. In 1985, Prof. Iadarola became Associate Professor at the Department of Biology and Biotechnologies of the University of Pavia and retired in October 2017. 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. He is a Consultant Reviewer for several journals, including the Journal of Chromatography A, Journal of Chromatography B, Plos ONE, Proteomes, International Journal of Molecular Science, Biotech, Electrophoresis, and others. He is also Associate Editor of Biotech.",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorTwo:{id:"201414",title:"Dr.",name:"Simona",middleName:null,surname:"Viglio",slug:"simona-viglio",fullName:"Simona Viglio",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRKDHQA4/Profile_Picture_1630402531487",biography:"Simona Viglio is an Associate Professor of Biochemistry at the Department of Molecular Medicine at the University of Pavia. She has been working since 1995 on the determination of proteolytic enzymes involved in the degradation process of connective tissue matrix and on the identification of biological markers of lung diseases. 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. 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Saxena",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",institutionURL:null,country:{name:"India"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null}]},subseriesFiltersForPublishedBooks:[{group:"subseries",caption:"Bacterial Infectious Diseases",value:3,count:2},{group:"subseries",caption:"Parasitic Infectious Diseases",value:5,count:4},{group:"subseries",caption:"Viral Infectious Diseases",value:6,count:7}],publicationYearFilters:[{group:"publicationYear",caption:"2022",value:2022,count:2},{group:"publicationYear",caption:"2021",value:2021,count:4},{group:"publicationYear",caption:"2020",value:2020,count:3},{group:"publicationYear",caption:"2019",value:2019,count:3},{group:"publicationYear",caption:"2018",value:2018,count:1}],authors:{paginationCount:754,paginationItems:[{id:"310674",title:"Dr.",name:"Pravin",middleName:null,surname:"Kendrekar",slug:"pravin-kendrekar",fullName:"Pravin Kendrekar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/310674/images/system/310674.jpg",biography:"Dr. Pravin Kendrekar, MSc, MBA, Ph.D., is currently a visiting scientist at the Lipid Nanostructure Laboratory, University of Central Lancashire, England. He previously worked as a post-doctoral fellow at the Ben-Gurion University of Negev, Israel; University of the Free State, South Africa; and Central University of Technology Bloemfontein, South Africa. He obtained his Ph.D. in Organic Chemistry from Nagaoka University of Technology, Japan. He has published more than seventy-four journal articles and attended several national and international conferences as speaker and chair. Dr. Kendrekar has received many international awards. He has several funded projects, namely, anti-malaria drug development, MRSA, and SARS-CoV-2 activity of curcumin and its formulations. He has filed four patents in collaboration with the University of Central Lancashire and Mayo Clinic Infectious Diseases. His present research includes organic synthesis, drug discovery and development, biochemistry, nanoscience, and nanotechnology.",institutionString:"Visiting Scientist at Lipid Nanostructures Laboratory, Centre for Smart Materials, School of Natural Sciences, University of Central Lancashire",institution:null},{id:"428125",title:"Dr.",name:"Vinayak",middleName:null,surname:"Adimule",slug:"vinayak-adimule",fullName:"Vinayak Adimule",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/428125/images/system/428125.jpg",biography:"Dr. Vinayak Adimule, MSc, Ph.D., is a professor and dean of R&D, Angadi Institute of Technology and Management, India. He has 15 years of research experience as a senior research scientist and associate research scientist in R&D organizations. He has published more than fifty research articles as well as several book chapters. He has two Indian patents and two international patents to his credit. Dr. Adimule has attended, chaired, and presented papers at national and international conferences. He is a guest editor for Topics in Catalysis and other journals. He is also an editorial board member, life member, and associate member for many international societies and research institutions. His research interests include nanoelectronics, material chemistry, artificial intelligence, sensors and actuators, bio-nanomaterials, and medicinal chemistry.",institutionString:"Angadi Institute of Technology and Management",institution:null},{id:"284317",title:"Prof.",name:"Kantharaju",middleName:null,surname:"Kamanna",slug:"kantharaju-kamanna",fullName:"Kantharaju Kamanna",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284317/images/21050_n.jpg",biography:"Prof. K. Kantharaju has received Bachelor of science (PCM), master of science (Organic Chemistry) and Doctor of Philosophy in Chemistry from Bangalore University. He worked as a Executive Research & Development @ Cadila Pharmaceuticals Ltd, Ahmedabad. He received DBT-postdoc fellow @ Molecular Biophysics Unit, Indian Institute of Science, Bangalore under the supervision of Prof. P. Balaram, later he moved to NIH-postdoc researcher at Drexel University College of Medicine, Philadelphia, USA, after his return from postdoc joined NITK-Surthakal as a Adhoc faculty at department of chemistry. Since from August 2013 working as a Associate Professor, and in 2016 promoted to Profeesor in the School of Basic Sciences: Department of Chemistry and having 20 years of teaching and research experiences.",institutionString:null,institution:{name:"Rani Channamma University, Belagavi",country:{name:"India"}}},{id:"158492",title:"Prof.",name:"Yusuf",middleName:null,surname:"Tutar",slug:"yusuf-tutar",fullName:"Yusuf Tutar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/158492/images/system/158492.jpeg",biography:"Prof. Dr. Yusuf Tutar conducts his research at the Hamidiye Faculty of Pharmacy, Department of Basic Pharmaceutical Sciences, Division of Biochemistry, University of Health Sciences, Turkey. He is also a faculty member in the Molecular Oncology Program. He obtained his MSc and Ph.D. at Oregon State University and Texas Tech University, respectively. He pursued his postdoctoral studies at Rutgers University Medical School and the National Institutes of Health (NIH/NIDDK), USA. His research focuses on biochemistry, biophysics, genetics, molecular biology, and molecular medicine with specialization in the fields of drug design, protein structure-function, protein folding, prions, microRNA, pseudogenes, molecular cancer, epigenetics, metabolites, proteomics, genomics, protein expression, and characterization by spectroscopic and calorimetric methods.",institutionString:"University of Health Sciences",institution:null},{id:"180528",title:"Dr.",name:"Hiroyuki",middleName:null,surname:"Kagechika",slug:"hiroyuki-kagechika",fullName:"Hiroyuki Kagechika",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180528/images/system/180528.jpg",biography:"Hiroyuki Kagechika received his bachelor’s degree and Ph.D. in Pharmaceutical Sciences from the University of Tokyo, Japan, where he served as an associate professor until 2004. He is currently a professor at the Institute of Biomaterials and Bioengineering (IBB), Tokyo Medical and Dental University (TMDU). From 2010 to 2012, he was the dean of the Graduate School of Biomedical Science. Since 2012, he has served as the vice dean of the Graduate School of Medical and Dental Sciences. He has been the director of the IBB since 2020. Dr. Kagechika’s major research interests are the medicinal chemistry of retinoids, vitamins D/K, and nuclear receptors. He has developed various compounds including a drug for acute promyelocytic leukemia.",institutionString:"Tokyo Medical and Dental University",institution:{name:"Tokyo Medical and Dental University",country:{name:"Japan"}}},{id:"94311",title:"Prof.",name:"Martins",middleName:"Ochubiojo",surname:"Ochubiojo Emeje",slug:"martins-ochubiojo-emeje",fullName:"Martins Ochubiojo Emeje",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94311/images/system/94311.jpeg",biography:"Martins Emeje obtained a BPharm with distinction from Ahmadu Bello University, Nigeria, and an MPharm and Ph.D. from the University of Nigeria (UNN), where he received the best Ph.D. award and was enlisted as UNN’s “Face of Research.” He established the first nanomedicine center in Nigeria and was the pioneer head of the intellectual property and technology transfer as well as the technology innovation and support center. Prof. Emeje’s several international fellowships include the prestigious Raman fellowship. He has published more than 150 articles and patents. He is also the head of R&D at NIPRD and holds a visiting professor position at Nnamdi Azikiwe University, Nigeria. He has a postgraduate certificate in Project Management from Walden University, Minnesota, as well as a professional teaching certificate and a World Bank certification in Public Procurement. Prof. Emeje was a national chairman of academic pharmacists in Nigeria and the 2021 winner of the May & Baker Nigeria Plc–sponsored prize for professional service in research and innovation.",institutionString:"National Institute for Pharmaceutical Research and Development",institution:{name:"National Institute for Pharmaceutical Research and Development",country:{name:"Nigeria"}}},{id:"436430",title:"Associate Prof.",name:"Mesut",middleName:null,surname:"Işık",slug:"mesut-isik",fullName:"Mesut Işık",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/436430/images/19686_n.jpg",biography:null,institutionString:null,institution:{name:"Bilecik University",country:{name:"Turkey"}}},{id:"268659",title:"Ms.",name:"Xianquan",middleName:null,surname:"Zhan",slug:"xianquan-zhan",fullName:"Xianquan Zhan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/268659/images/8143_n.jpg",biography:"Dr. Zhan received his undergraduate and graduate training in the fields of preventive medicine and epidemiology and statistics at the West China University of Medical Sciences in China during 1989 to 1999. He received his post-doctoral training in oncology and cancer proteomics for two years at the Cancer Research Institute of Human Medical University in China. In 2001, he went to the University of Tennessee Health Science Center (UTHSC) in USA, where he was a post-doctoral researcher and focused on mass spectrometry and cancer proteomics. Then, he was appointed as an Assistant Professor of Neurology, UTHSC in 2005. He moved to the Cleveland Clinic in USA as a Project Scientist/Staff in 2006 where he focused on the studies of eye disease proteomics and biomarkers. He returned to UTHSC as an Assistant Professor of Neurology in the end of 2007, engaging in proteomics and biomarker studies of lung diseases and brain tumors, and initiating the studies of predictive, preventive, and personalized medicine (PPPM) in cancer. In 2010, he was promoted to Associate Professor of Neurology, UTHSC. Currently, he is a Professor at Xiangya Hospital of Central South University in China, Fellow of Royal Society of Medicine (FRSM), the European EPMA National Representative in China, Regular Member of American Association for the Advancement of Science (AAAS), European Cooperation of Science and Technology (e-COST) grant evaluator, Associate Editors of BMC Genomics, BMC Medical Genomics, EPMA Journal, and Frontiers in Endocrinology, Executive Editor-in-Chief of Med One. He has\npublished 116 peer-reviewed research articles, 16 book chapters, 2 books, and 2 US patents. His current main research interest focuses on the studies of cancer proteomics and biomarkers, and the use of modern omics techniques and systems biology for PPPM in cancer, and on the development and use of 2DE-LC/MS for the large-scale study of human proteoforms.",institutionString:null,institution:{name:"Xiangya Hospital Central South University",country:{name:"China"}}},{id:"40482",title:null,name:"Rizwan",middleName:null,surname:"Ahmad",slug:"rizwan-ahmad",fullName:"Rizwan Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/40482/images/system/40482.jpeg",biography:"Dr. Rizwan Ahmad is a University Professor and Coordinator, Quality and Development, College of Medicine, Imam Abdulrahman bin Faisal University, Saudi Arabia. Previously, he was Associate Professor of Human Function, Oman Medical College, Oman, and SBS University, Dehradun. Dr. Ahmad completed his education at Aligarh Muslim University, Aligarh. He has published several articles in peer-reviewed journals, chapters, and edited books. His area of specialization is free radical biochemistry and autoimmune diseases.",institutionString:"Imam Abdulrahman Bin Faisal University",institution:{name:"Imam Abdulrahman Bin Faisal University",country:{name:"Saudi Arabia"}}},{id:"41865",title:"Prof.",name:"Farid A.",middleName:null,surname:"Badria",slug:"farid-a.-badria",fullName:"Farid A. Badria",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/41865/images/system/41865.jpg",biography:"Farid A. Badria, Ph.D., is the recipient of several awards, including The World Academy of Sciences (TWAS) Prize for Public Understanding of Science; the World Intellectual Property Organization (WIPO) Gold Medal for best invention; Outstanding Arab Scholar, Kuwait; and the Khwarizmi International Award, Iran. He has 250 publications, 12 books, 20 patents, and several marketed pharmaceutical products to his credit. He continues to lead research projects on developing new therapies for liver, skin disorders, and cancer. Dr. Badria was listed among the world’s top 2% of scientists in medicinal and biomolecular chemistry in 2019 and 2020. He is a member of the Arab Development Fund, Kuwait; International Cell Research Organization–United Nations Educational, Scientific and Cultural Organization (ICRO–UNESCO), Chile; and UNESCO Biotechnology France",institutionString:"Mansoura University",institution:{name:"Mansoura University",country:{name:"Egypt"}}},{id:"329385",title:"Dr.",name:"Rajesh K.",middleName:"Kumar",surname:"Singh",slug:"rajesh-k.-singh",fullName:"Rajesh K. Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329385/images/system/329385.png",biography:"Dr. Singh received a BPharm (2003) and MPharm (2005) from Panjab University, Chandigarh, India, and a Ph.D. (2013) from Punjab Technical University (PTU), Jalandhar, India. He has more than sixteen years of teaching experience and has supervised numerous postgraduate and Ph.D. students. He has to his credit more than seventy papers in SCI- and SCOPUS-indexed journals, fifty-five conference proceedings, four books, six Best Paper Awards, and five projects from different government agencies. He is currently an editorial board member of eight international journals and a reviewer for more than fifty scientific journals. He received Top Reviewer and Excellent Peer Reviewer Awards from Publons in 2016 and 2017, respectively. He is also on the panel of The International Reviewer for reviewing research proposals for grants from the Royal Society. He also serves as a Publons Academy mentor and Bentham brand ambassador.",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",country:{name:"India"}}},{id:"142388",title:"Dr.",name:"Thiago",middleName:"Gomes",surname:"Gomes Heck",slug:"thiago-gomes-heck",fullName:"Thiago Gomes Heck",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/142388/images/7259_n.jpg",biography:null,institutionString:null,institution:{name:"Universidade Regional do Noroeste do Estado do Rio Grande do Sul",country:{name:"Brazil"}}},{id:"336273",title:"Assistant Prof.",name:"Janja",middleName:null,surname:"Zupan",slug:"janja-zupan",fullName:"Janja Zupan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/336273/images/14853_n.jpeg",biography:"Janja Zupan graduated in 2005 at the Department of Clinical Biochemistry (superviser prof. dr. Janja Marc) in the field of genetics of osteoporosis. Since November 2009 she is working as a Teaching Assistant at the Faculty of Pharmacy, Department of Clinical Biochemistry. In 2011 she completed part of her research and PhD work at Institute of Genetics and Molecular Medicine, University of Edinburgh. She finished her PhD entitled The influence of the proinflammatory cytokines on the RANK/RANKL/OPG in bone tissue of osteoporotic and osteoarthritic patients in 2012. From 2014-2016 she worked at the Institute of Biomedical Sciences, University of Aberdeen as a postdoctoral research fellow on UK Arthritis research project where she gained knowledge in mesenchymal stem cells and regenerative medicine. She returned back to University of Ljubljana, Faculty of Pharmacy in 2016. She is currently leading project entitled Mesenchymal stem cells-the keepers of tissue endogenous regenerative capacity facing up to aging of the musculoskeletal system funded by Slovenian Research Agency.",institutionString:null,institution:{name:"University of Ljubljana",country:{name:"Slovenia"}}},{id:"357453",title:"Dr.",name:"Radheshyam",middleName:null,surname:"Maurya",slug:"radheshyam-maurya",fullName:"Radheshyam Maurya",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/357453/images/16535_n.jpg",biography:null,institutionString:null,institution:{name:"University of Hyderabad",country:{name:"India"}}},{id:"418340",title:"Dr.",name:"Jyotirmoi",middleName:null,surname:"Aich",slug:"jyotirmoi-aich",fullName:"Jyotirmoi Aich",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000038Ugi5QAC/Profile_Picture_2022-04-15T07:48:28.png",biography:"Biotechnologist with 15 years of research including 6 years of teaching experience. Demonstrated record of scientific achievements through consistent publication record (H index = 13, with 874 citations) in high impact journals such as Nature Communications, Oncotarget, Annals of Oncology, PNAS, and AJRCCM, etc. Strong research professional with a post-doctorate from ACTREC where I gained experimental oncology experience in clinical settings and a doctorate from IGIB where I gained expertise in asthma pathophysiology. A well-trained biotechnologist with diverse experience on the bench across different research themes ranging from asthma to cancer and other infectious diseases. An individual with a strong commitment and innovative mindset. Have the ability to work on diverse projects such as regenerative and molecular medicine with an overall mindset of improving healthcare.",institutionString:"DY Patil Deemed to Be University",institution:null},{id:"349288",title:"Prof.",name:"Soumya",middleName:null,surname:"Basu",slug:"soumya-basu",fullName:"Soumya Basu",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035QxIDQA0/Profile_Picture_2022-04-15T07:47:01.jpg",biography:"Soumya Basu, Ph.D., is currently working as an Associate Professor at Dr. D. Y. Patil Biotechnology and Bioinformatics Institute, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India. With 16+ years of trans-disciplinary research experience in Drug Design, development, and pre-clinical validation; 20+ research article publications in journals of repute, 9+ years of teaching experience, trained with cross-disciplinary education, Dr. Basu is a life-long learner and always thrives for new challenges.\r\nHer research area is the design and synthesis of small molecule partial agonists of PPAR-γ in lung cancer. She is also using artificial intelligence and deep learning methods to understand the exosomal miRNA’s role in cancer metastasis. Dr. Basu is the recipient of many awards including the Early Career Research Award from the Department of Science and Technology, Govt. of India. She is a reviewer of many journals like Molecular Biology Reports, Frontiers in Oncology, RSC Advances, PLOS ONE, Journal of Biomolecular Structure & Dynamics, Journal of Molecular Graphics and Modelling, etc. She has edited and authored/co-authored 21 journal papers, 3 book chapters, and 15 abstracts. She is a Board of Studies member at her university. She is a life member of 'The Cytometry Society”-in India and 'All India Cell Biology Society”- in India.",institutionString:"Dr. D.Y. Patil Vidyapeeth, Pune",institution:{name:"Dr. D.Y. Patil Vidyapeeth, Pune",country:{name:"India"}}},{id:"354817",title:"Dr.",name:"Anubhab",middleName:null,surname:"Mukherjee",slug:"anubhab-mukherjee",fullName:"Anubhab Mukherjee",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y0000365PbRQAU/ProfilePicture%202022-04-15%2005%3A11%3A18.480",biography:"A former member of Laboratory of Nanomedicine, Brigham and Women’s Hospital, Harvard University, Boston, USA, Dr. Anubhab Mukherjee is an ardent votary of science who strives to make an impact in the lives of those afflicted with cancer and other chronic/acute ailments. He completed his Ph.D. from CSIR-Indian Institute of Chemical Technology, Hyderabad, India, having been skilled with RNAi, liposomal drug delivery, preclinical cell and animal studies. He pursued post-doctoral research at College of Pharmacy, Health Science Center, Texas A & M University and was involved in another postdoctoral research at Department of Translational Neurosciences and Neurotherapeutics, John Wayne Cancer Institute, Santa Monica, California. In 2015, he worked in Harvard-MIT Health Sciences & Technology as a visiting scientist. He has substantial experience in nanotechnology-based formulation development and successfully served various Indian organizations to develop pharmaceuticals and nutraceutical products. He is an inventor in many US patents and an author in many peer-reviewed articles, book chapters and books published in various media of international repute. Dr. Mukherjee is currently serving as Principal Scientist, R&D at Esperer Onco Nutrition (EON) Pvt. Ltd. and heads the Hyderabad R&D center of the organization.",institutionString:"Esperer Onco Nutrition Pvt Ltd.",institution:null},{id:"319365",title:"Assistant Prof.",name:"Manash K.",middleName:null,surname:"Paul",slug:"manash-k.-paul",fullName:"Manash K. Paul",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/319365/images/system/319365.png",biography:"Manash K. Paul is a Principal Investigator and Scientist at the University of California Los Angeles. He has contributed significantly to the fields of stem cell biology, regenerative medicine, and lung cancer. His research focuses on various signaling processes involved in maintaining stem cell homeostasis during the injury-repair process, deciphering lung stem cell niche, pulmonary disease modeling, immuno-oncology, and drug discovery. He is currently investigating the role of extracellular vesicles in premalignant lung cell migration and detecting the metastatic phenotype of lung cancer via machine-learning-based analyses of exosomal signatures. Dr. Paul has published in more than fifty peer-reviewed international journals and is highly cited. He is the recipient of many awards, including the UCLA Vice Chancellor’s award, a senior member of the Institute of Electrical and Electronics Engineers (IEEE), and an editorial board member for several international journals.",institutionString:"University of California Los Angeles",institution:{name:"University of California Los Angeles",country:{name:"United States of America"}}},{id:"311457",title:"Dr.",name:"Júlia",middleName:null,surname:"Scherer Santos",slug:"julia-scherer-santos",fullName:"Júlia Scherer Santos",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/311457/images/system/311457.jpg",biography:"Dr. Júlia Scherer Santos works in the areas of cosmetology, nanotechnology, pharmaceutical technology, beauty, and aesthetics. Dr. Santos also has experience as a professor of graduate courses. Graduated in Pharmacy, specialization in Cosmetology and Cosmeceuticals applied to aesthetics, specialization in Aesthetic and Cosmetic Health, and a doctorate in Pharmaceutical Nanotechnology. Teaching experience in Pharmacy and Aesthetics and Cosmetics courses. She works mainly on the following subjects: nanotechnology, cosmetology, pharmaceutical technology, aesthetics.",institutionString:"Universidade Federal de Juiz de Fora",institution:{name:"Universidade Federal de Juiz de Fora",country:{name:"Brazil"}}},{id:"219081",title:"Dr.",name:"Abdulsamed",middleName:null,surname:"Kükürt",slug:"abdulsamed-kukurt",fullName:"Abdulsamed Kükürt",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/219081/images/system/219081.png",biography:"Dr. Kükürt graduated from Uludağ University in Turkey. He started his academic career as a Research Assistant in the Department of Biochemistry at Kafkas University. In 2019, he completed his Ph.D. program in the Department of Biochemistry at the Institute of Health Sciences. He is currently working at the Department of Biochemistry, Kafkas University. He has 27 published research articles in academic journals, 11 book chapters, and 37 papers. He took part in 10 academic projects. He served as a reviewer for many articles. He still serves as a member of the review board in many academic journals. He is currently working on the protective activity of phenolic compounds in disorders associated with oxidative stress and inflammation.",institutionString:null,institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"178366",title:"Dr.",name:"Volkan",middleName:null,surname:"Gelen",slug:"volkan-gelen",fullName:"Volkan Gelen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178366/images/system/178366.jpg",biography:"Volkan Gelen is a Physiology specialist who received his veterinary degree from Kafkas University in 2011. Between 2011-2015, he worked as an assistant at Atatürk University, Faculty of Veterinary Medicine, Department of Physiology. In 2016, he joined Kafkas University, Faculty of Veterinary Medicine, Department of Physiology as an assistant professor. Dr. Gelen has been engaged in various academic activities at Kafkas University since 2016. There he completed 5 projects and has 3 ongoing projects. He has 60 articles published in scientific journals and 20 poster presentations in scientific congresses. His research interests include physiology, endocrine system, cancer, diabetes, cardiovascular system diseases, and isolated organ bath system studies.",institutionString:"Kafkas University",institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"418963",title:"Dr.",name:"Augustine Ododo",middleName:"Augustine",surname:"Osagie",slug:"augustine-ododo-osagie",fullName:"Augustine Ododo Osagie",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/418963/images/16900_n.jpg",biography:"Born into the family of Osagie, a prince of the Benin Kingdom. I am currently an academic in the Department of Medical Biochemistry, University of Benin. Part of the duties are to teach undergraduate students and conduct academic research.",institutionString:null,institution:{name:"University of Benin",country:{name:"Nigeria"}}},{id:"192992",title:"Prof.",name:"Shagufta",middleName:null,surname:"Perveen",slug:"shagufta-perveen",fullName:"Shagufta Perveen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192992/images/system/192992.png",biography:"Prof. Shagufta Perveen is a Distinguish Professor in the Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. Dr. Perveen has acted as the principal investigator of major research projects funded by the research unit of King Saud University. She has more than ninety original research papers in peer-reviewed journals of international repute to her credit. She is a fellow member of the Royal Society of Chemistry UK and the American Chemical Society of the United States.",institutionString:"King Saud University",institution:{name:"King Saud University",country:{name:"Saudi Arabia"}}},{id:"49848",title:"Dr.",name:"Wen-Long",middleName:null,surname:"Hu",slug:"wen-long-hu",fullName:"Wen-Long Hu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49848/images/system/49848.jpg",biography:"Wen-Long Hu is Chief of the Division of Acupuncture, Department of Chinese Medicine at Kaohsiung Chang Gung Memorial Hospital, as well as an adjunct associate professor at Fooyin University and Kaohsiung Medical University. Wen-Long is President of Taiwan Traditional Chinese Medicine Medical Association. He has 28 years of experience in clinical practice in laser acupuncture therapy and 34 years in acupuncture. He is an invited speaker for lectures and workshops in laser acupuncture at many symposiums held by medical associations. He owns the patent for herbal preparation and producing, and for the supercritical fluid-treated needle. Dr. Hu has published three books, 12 book chapters, and more than 30 papers in reputed journals, besides serving as an editorial board member of repute.",institutionString:"Kaohsiung Chang Gung Memorial Hospital",institution:{name:"Kaohsiung Chang Gung Memorial Hospital",country:{name:"Taiwan"}}},{id:"298472",title:"Prof.",name:"Andrey V.",middleName:null,surname:"Grechko",slug:"andrey-v.-grechko",fullName:"Andrey V. Grechko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/298472/images/system/298472.png",biography:"Andrey Vyacheslavovich Grechko, Ph.D., Professor, is a Corresponding Member of the Russian Academy of Sciences. He graduated from the Semashko Moscow Medical Institute (Semashko National Research Institute of Public Health) with a degree in Medicine (1998), the Clinical Department of Dermatovenerology (2000), and received a second higher education in Psychology (2009). Professor A.V. Grechko held the position of Сhief Physician of the Central Clinical Hospital in Moscow. He worked as a professor at the faculty and was engaged in scientific research at the Medical University. Starting in 2013, he has been the initiator of the creation of the Federal Scientific and Clinical Center for Intensive Care and Rehabilitology, Moscow, Russian Federation, where he also serves as Director since 2015. He has many years of experience in research and teaching in various fields of medicine, is an author/co-author of more than 200 scientific publications, 13 patents, 15 medical books/chapters, including Chapter in Book «Metabolomics», IntechOpen, 2020 «Metabolomic Discovery of Microbiota Dysfunction as the Cause of Pathology».",institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"199461",title:"Prof.",name:"Natalia V.",middleName:null,surname:"Beloborodova",slug:"natalia-v.-beloborodova",fullName:"Natalia V. Beloborodova",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/199461/images/system/199461.jpg",biography:'Natalia Vladimirovna Beloborodova was educated at the Pirogov Russian National Research Medical University, with a degree in pediatrics in 1980, a Ph.D. in 1987, and a specialization in Clinical Microbiology from First Moscow State Medical University in 2004. 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