Proportion of declining and threatened species per taxa according to IUCN criteria.
\\n\\n
IntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\\n\\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\\n\\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\\n\\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\\n\\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\\n\\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\\n\\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\\n\\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\\n\\nFeel free to share this news on social media and help us mark this memorable moment!
\\n\\n\\n"}]',published:!0,mainMedia:{caption:"",originalUrl:"/media/original/237"}},components:[{type:"htmlEditorComponent",content:'
After years of being acknowledged as the world's leading publisher of Open Access books, today, we are proud to announce we’ve successfully launched a portfolio of Open Science journals covering rapidly expanding areas of interdisciplinary research.
\n\n\n\nIntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\n\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\n\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\n\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\n\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\n\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\n\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\n\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\n\nFeel free to share this news on social media and help us mark this memorable moment!
\n\n\n'}],latestNews:[{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"8158",leadTitle:null,fullTitle:"Veganism - a Fashion Trend or Food as a Medicine",title:"Veganism",subtitle:"a Fashion Trend or Food as a Medicine",reviewType:"peer-reviewed",abstract:"Veganism is a way of eating and living that avoids using animals and their products for food, clothing, and other purposes. Vegans do not consume meat, fish, seafood, eggs, honey, and dairy products, nor do they wear or carry items made of fur, wool, leather, and other materials of animal origin. Many vegans also avoid animal-tested products.",isbn:"978-1-83962-849-8",printIsbn:"978-1-83962-848-1",pdfIsbn:"978-1-83962-861-0",doi:"10.5772/intechopen.78107",price:119,priceEur:129,priceUsd:155,slug:"veganism-a-fashion-trend-or-food-as-a-medicine",numberOfPages:112,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"d8e51fc25a379e5b92a270addbb4351d",bookSignature:"Miljana Z. Jovandaric",publishedDate:"March 31st 2021",coverURL:"https://cdn.intechopen.com/books/images_new/8158.jpg",numberOfDownloads:3471,numberOfWosCitations:0,numberOfCrossrefCitations:4,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:5,numberOfDimensionsCitationsByBook:0,hasAltmetrics:1,numberOfTotalCitations:9,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"June 23rd 2020",dateEndSecondStepPublish:"July 14th 2020",dateEndThirdStepPublish:"September 12th 2020",dateEndFourthStepPublish:"December 1st 2020",dateEndFifthStepPublish:"January 30th 2021",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"268043",title:"Dr.",name:"Miljana Z.",middleName:"Z",surname:"Jovandaric",slug:"miljana-z.-jovandaric",fullName:"Miljana Z. Jovandaric",profilePictureURL:"https://mts.intechopen.com/storage/users/268043/images/system/268043.jpg",biography:"Miljana Z. Jovandaric was born in Serbia. She graduated from the Faculty of Medicine, University of Belgrade, Serbia, in 1989, and completed a specialization in Pediatrics at the University Children\\'s Hospital, Belgrade, in 1999. She completed her specialization in Neonatology in 2003. Dr. Jovandaric completed her master’s thesis on 'Analysis of lipid infants of women suffering from gestational diabetes mellitus (GDM)” in 2006 and her doctoral dissertation on 'Effect of hypoxia on electrolyte and lipid levels in term newborns” in 2018, both at the School of Medicine, University of Belgrade. She is the author and co-author of eighty-four scientific papers presented at national and international conferences and published in scientific journals. Dr. Jovandaric is currently head of the Department of Sick Newborns at the Clinic for Gynecology and Obstetrics, Department of Neonatology, Clinical Centre of Serbia.",institutionString:"Klinički centar Srbije",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"4",totalChapterViews:"0",totalEditedBooks:"2",institution:{name:"Klinički centar Srbije",institutionURL:null,country:{name:"Serbia"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"323",title:"Food and Nutrition",slug:"food-and-nutrition"}],chapters:[{id:"73622",title:"The Increase of Amines Content in the Intake of a Vegan Diet",doi:"10.5772/intechopen.94095",slug:"the-increase-of-amines-content-in-the-intake-of-a-vegan-diet",totalDownloads:557,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:1,abstract:"Vegetarian and vegan consumers have increased in the last years. However, the food industry is facing problems responding to this growing market, since the food safety of several plant-based products is not well established. Fruits, vegetables and fermented products, such as nut and grains milks and cheeses, may be rich sources of biogenic amines; whereas, the levels of these compounds should be considered before the inclusion on a daily diet. Biogenic amines are a class of compounds with wide physiological activities as antioxidant properties, inductors of cell division and allergic processes, and sleep, sexual and behavioral disorders. In addition to the levels of biogenic amines, the levels of some of its precursors as tryptophan, 5-hydroxytryptophan and tryptamine will be presented. The foods eaten by vegans are consumed raw, cooked, fried, fermented and mainly through homemade processing methods, which have influence on the levels of bioactive compounds from the food matrix. Exposure to processing conditions such as handling, sanitary conditions, high temperatures, preparing methods (cooking in water or oil) influencing the levels of amines, will be discussed in this chapter to enrich the knowledge on food safety associated to vegan diets.",signatures:"Cristine Vanz Borges, Hector Gomez Gomez, Igor Otavio Minatel and Giuseppina Pace Pereira Lima",downloadPdfUrl:"/chapter/pdf-download/73622",previewPdfUrl:"/chapter/pdf-preview/73622",authors:[{id:"146379",title:"Dr.",name:"Giuseppina",surname:"Lima",slug:"giuseppina-lima",fullName:"Giuseppina Lima"},{id:"194002",title:"MSc.",name:"Cristine",surname:"Vanz Borges",slug:"cristine-vanz-borges",fullName:"Cristine Vanz Borges"},{id:"194003",title:"Prof.",name:"Igor Otavio",surname:"Minatel",slug:"igor-otavio-minatel",fullName:"Igor Otavio Minatel"},{id:"327376",title:"Prof.",name:"Hector",surname:"Gomez",slug:"hector-gomez",fullName:"Hector Gomez"}],corrections:null},{id:"74243",title:"Vegetarian or Vegan Diet: Stimulating or at Risk to Mental Health?",doi:"10.5772/intechopen.94371",slug:"vegetarian-or-vegan-diet-stimulating-or-at-risk-to-mental-health-",totalDownloads:630,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:1,abstract:"Vegetarians and vegans are more preoccupied with their health and conscious of their food habits than omnivores and often have pronounced views on killing animals for food. They are generally aware of a healthy lifestyle. Their mental attitudes, strengths and vulnerabilities may differ from meat eaters. Nowadays, health considerations would seem to play a role in the decision to become vegetarian/vegan. This chapter presents an overview of the most recent scientific literature with some emphasis on aspects of the relation between psychiatric disorders and personality characteristics in subjects with a vegetarian or vegan lifestyle compared to subjects who do not follow this lifestyle.",signatures:"Alie N.R. Meesters and Ybe Meesters",downloadPdfUrl:"/chapter/pdf-download/74243",previewPdfUrl:"/chapter/pdf-preview/74243",authors:[{id:"328049",title:"Ph.D.",name:"Ybe",surname:"Meesters",slug:"ybe-meesters",fullName:"Ybe Meesters"},{id:"328050",title:"MSc.",name:"Alie N.R.",surname:"Meesters",slug:"alie-n.r.-meesters",fullName:"Alie N.R. Meesters"}],corrections:null},{id:"74694",title:"Veganism: A New Approach to Health",doi:"10.5772/intechopen.95441",slug:"veganism-a-new-approach-to-health",totalDownloads:438,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:1,abstract:"The word vegan was given by Donald Watson in 1944 in Leicester, England, who, together with several other members of the Vegetarian Society, wanted to establish a group of vegetarians who did not consume milk or dairy products. When the proposal was rejected, Watson and like-minded people founded The Vegan Society, which advocated a complete plant-based diet, excluding meat, fish, eggs, milk and dairy products (cheese, butter) and honey. Vegans do not wear fur items, wool, bone, goat, coral, pearl or any other material of animal origin. According to surveys, vegans make up between 0.2% and 1.3% of the US population and between 0.25% and 7% of the UK population. Vegan foods contain lower levels of cholesterol and fat than the usual diet.",signatures:"Miljana Z. Jovandaric",downloadPdfUrl:"/chapter/pdf-download/74694",previewPdfUrl:"/chapter/pdf-preview/74694",authors:[{id:"268043",title:"Dr.",name:"Miljana Z.",surname:"Jovandaric",slug:"miljana-z.-jovandaric",fullName:"Miljana Z. Jovandaric"}],corrections:null},{id:"73632",title:"Health Effects of Plant Foods and the Possibility of Reducing Health Risk",doi:"10.5772/intechopen.94096",slug:"health-effects-of-plant-foods-and-the-possibility-of-reducing-health-risk",totalDownloads:364,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Many nutritional studies point to an inverse relationship between diet with predominant consumption of plant foods and the incidence of diseases of civilization. The health benefits of plant foods come from a sufficient intake of protective nutrients, which are key food commodities of the vegetarian diet. These include vegetables, fruits, whole grains, legumes and oilseeds, including various types of nuts. The nutritional and non-nutritional components of plant foods reduce the risk of chronic diseases by various mechanisms, so a well-planned vegetarian diet is nutritionally adequate, fully healthy and able to provide health benefits in the prevention of many diseases. The data we find agree that the benefits far outweigh the potential risks.",signatures:"Martina Valachovičová and Lucia Bírošová",downloadPdfUrl:"/chapter/pdf-download/73632",previewPdfUrl:"/chapter/pdf-preview/73632",authors:[{id:"304320",title:"Ph.D.",name:"Martina",surname:"Valachovičová",slug:"martina-valachovicova",fullName:"Martina Valachovičová"},{id:"328040",title:"Prof.",name:"Lucia",surname:"Birošová",slug:"lucia-birosova",fullName:"Lucia Birošová"}],corrections:null},{id:"73556",title:"Vegetarianism and Veganism: Conflicts in Everyday Life",doi:"10.5772/intechopen.94063",slug:"vegetarianism-and-veganism-conflicts-in-everyday-life",totalDownloads:483,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:1,abstract:"In everyday situations, the experience of being a vegetarian or a vegan occurs within a process of conflict and practices of negotiation involving decisions, refusals, consumption acts, and proximity and distance between people in their relationships, mainly including the family. Many dilemmas result from the inconsistency between theory and difficult practices to be obeyed. To understand how this phenomenon, the chapter uses the interviews with vegetarians considering different alimentary restrictions and data obtained from observation in virtual groups of vegan activists. We have conducted the research between 2015 and 2017 as part of a larger project entitled: The Social Place of Animals in Contemporaneity.",signatures:"Juliana Abonizio",downloadPdfUrl:"/chapter/pdf-download/73556",previewPdfUrl:"/chapter/pdf-preview/73556",authors:[{id:"326137",title:"Ph.D.",name:"Juliana",surname:"Abonizio",slug:"juliana-abonizio",fullName:"Juliana Abonizio"}],corrections:null},{id:"74234",title:"Plant Proteins as Healthy, Sustainable and Integrative Meat Alternates",doi:"10.5772/intechopen.94094",slug:"plant-proteins-as-healthy-sustainable-and-integrative-meat-alternates",totalDownloads:629,totalCrossrefCites:3,totalDimensionsCites:3,hasAltmetrics:0,abstract:"Vegetarian protein diet based food industry have emerged as one of the fastest growing industries with largest than ever shelf space it has created in today’s market. The rapid growth of plant protein industry is attributed to increased health awareness, economic and environmental sustainability issues of animal proteins and their nutritious, economical, and healthy food image among masses. Technological interventions like extrusion texturization has enabled the food engineers to create the imitation meat which approximates the esthetic attributes (texture, flavor, and appearance, binding ability, chewiness, firmness or softness) and/or chemical nature of meat. These texturized plant proteins are healthier and economical meat substitutes with sufficient opportunity to manage modify or change their functional properties in accordance to specific consumer demands.",signatures:"Satish Kumar, Vikas Kumar, Rakesh Sharma, Anna Aleena Paul, Priyanka Suthar and Rajni Saini",downloadPdfUrl:"/chapter/pdf-download/74234",previewPdfUrl:"/chapter/pdf-preview/74234",authors:[{id:"85013",title:"Dr.",name:"Rakesh",surname:"Sharma",slug:"rakesh-sharma",fullName:"Rakesh Sharma"},{id:"326252",title:"Assistant Prof.",name:"Satish",surname:"Kumar",slug:"satish-kumar",fullName:"Satish Kumar"},{id:"328958",title:"M.Sc.",name:"Anna Aleena",surname:"Paul",slug:"anna-aleena-paul",fullName:"Anna Aleena Paul"},{id:"330175",title:"M.Sc.",name:"Priyanka",surname:"Suthar",slug:"priyanka-suthar",fullName:"Priyanka Suthar"},{id:"341396",title:"Dr.",name:"Vikas",surname:"Kumar",slug:"vikas-kumar",fullName:"Vikas Kumar"},{id:"341397",title:"Dr.",name:"Rajni",surname:"Saini",slug:"rajni-saini",fullName:"Rajni Saini"}],corrections:null},{id:"75589",title:"Breeding Vegetables for Nutritional Security",doi:"10.5772/intechopen.95349",slug:"breeding-vegetables-for-nutritional-security",totalDownloads:371,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"The most dominant vegetables in the global food economy are tomato, cucurbits, (pumpkin, squash, cucumber and gherkin), allium (onion, shallot, garlic) and chili. These vegetables are consumed in nearly all countries although with much variation in shape, size, color and taste, while the marketing of global vegetables accounts for significant revenue streams, traditional vegetables often have superior nutritional properties. Biodiversity is considered essential for food security and nutrition and can contribute to the achievement through improved dietary choices and positive health impacts Through conventional breeding approach, it is possible to develop new vegetable varieties or integrate the favorable genes for neutraceuticals, bioactive compounds and edible color into cultivated varieties. Advances in molecular biology and recombinant technology have paved the way for enhancing the pace of special trait variety development using marker assisted breeding and designing new vegetable crop plants following transgenic approach.",signatures:"V. Rajasree and L. 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Dobrzański",coverURL:"https://cdn.intechopen.com/books/images_new/5951.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"15880",title:"Prof.",name:"Leszek A.",middleName:null,surname:"Dobrzański",slug:"leszek-a.-dobrzanski",fullName:"Leszek A. Dobrzański"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}}},ofsBook:{item:{type:"book",id:"11695",leadTitle:null,title:"Biomechanical and Mechanobiological Analysis of Bone Mineral Density",subtitle:null,reviewType:"peer-reviewed",abstract:"
\r\n\tBone mineral density (BMD) measures the percentage of inorganic minerals in the bones. BMD represents one of the most informative assessments of bone quality and strength in biomechanical and clinical studies. BMD depends on several factors, such as age, sex, disease, genetics, lifestyle as well as bone mechanobiology (cellular activities and bone remodeling process), which directly affect bone mass and density. Low BMD is directly associated with osteoporosis and a high risk of bone fracture.
\r\n\r\n\tThere are several techniques for measuring and qualifying BMD, such as single and dual-energy photon absorptiometry, quantitative computed tomography, and magnetic resonance imaging. Each has advantages and limitations, depending on the objective of the analysis and the bone site to be examined. Modeling and simulation are also widely used to understand and study the variation and evolution of BMD, mechanical behavior, and the risk of bone fracture.
\r\n\r\n\tThis book aims to represent a collection of original research works, literature reviews, and technical notes related to topics that deal with bone mineral density:
\r\n\t- BMD measurement technology
\r\n\t- Osteoporosis and fracture risk
\r\n\t- Bone growth and remodeling
\r\n\t
\r\n\tThe submission is also open to any other original study related to these research topics.
Obesity and overweight have increasingly become major global health issues. Data from the World Health Organization (WHO) reports a near doubling of the prevalence of obesity worldwide from 1998 to 2008 [1]. In the European Region, an average of over 50% of adults are overweight and nearly 23% obese, with the prevalence of overweight and obesity being highest in Finland (67.1%), Germany (67.2%), the United Kingdom (67.8%), Malta (73.3%), and Greece (77.5%) [2]. Similar alarming trends are seen in the United States NHANES data where 68% of adults have a body mass index (BMI) greater than 25 (overweight or obese) and nearly 37% of the population is considered obese [3-7]. A large burden of health care costs can be attributed to overweight and obesity since multiple disease states such as diabetes, cancer, heart disease can be linked overweight and obesity [8-10]. The WHO estimates that up to 6% of health care expenditures in the European Region, while estimates for the United States have been estimated at 5.7% of the National Health Expenditure [8-11]. Most major organizations, like the WHO, and governmental agencies such as the U.S. Department of Agriculture Center for Nutrition Policy and Promotion have a major focus on the treatment of the obesity epidemic through promotion of proper healthy lifestyle changes [11, 12]. Although multiple anti-obesity agents have progressed through the development process, few drug products have made it through the approval process due to safety or lack of efficacy concerns. Several products, such as amphetamine, fenfluramine and sibutramine, have had their approval removed and/or have been removed from the market following reports linking the drugs to cardiovascular side effects (e.g. hypertension and myocardial infarction), addiction, and death [13-15]. As an alternative, overweight or obese patients may turn to less regulated dietary supplements as a means to assist in weight loss. Multiple herbal products are available that are indicated, often without significant scientific basis, for the treatment of overweight and obesity. The safety and efficacy of herbal products is often unknown, especially given the presence of multiple chemical compounds, lack of known active constituents or lack of standardization of known compounds [16-19].This chapter presents a review of the chemistry and pharmacology of approved anti-obesity drug products, the proposed mechanism of action for common dietary supplements used in the management of weight loss, and potential drug-drug or herb-drug interactions.
Diethylpropion HCl (amfepramone, Figure 1a) is a sympathomimetic aminoketone agent with some similarity both chemically and pharmacologically to amphetamines and other related stimulant drugs. Similarly to amphetamine, diethylpropion stimulates release while inhibiting reuptake of dopamine, norepinephrine, and 5-hydroxytryptamine [20, 21]. The increase in norepinephrine and dopamine levels along with inhibition of their reuptake is proposed as the mechanism of diethylpropion anorectic effects [22]. Diethylpropion is indicated for short term management of obesity in patients with a body mass index (BMI) of > 30 kg/m2 who have not responded to diet and exercise alone [23]. Because of its similarity to amphetamine, some patients become psychologically dependent on diethylpropion with an increased risk of self-medicating at higher dosages, increasing potential for drug interactions.
Diethylpropion is a monoamine and therefore can interact with monoamine oxidase inhibitors (MAOI), resulting in hypertension [23]. The manufacturer recommends avoiding use of diethylpropion during or within 14 days of discontinuation of MAOI administration. There is also one reported case of diethylpropion -induced psychosis in a 26 year old female patient taking phenelzine [24]. The authors hypothesized that chronic diethylpropion use led to an increased sensitivity to MAOI psychosis-inducing effects. Although the additive effects of diethylpropion in combination with other anorectic agents has not been studied, combined use of these agents is contraindicated due to the potential increased risk of cardiovascular issues [23]. In an early study of diethylpropion in 32 obese hypertensive patients, a drop in blood pressure was observed [25]. However, it was unclear if the drop in blood pressure in these subjects was due to weight loss or the additive effect of additional hypertensive agents that the patients were taking. The manufacturer also recommends potential modification of insulin dosing, although no strong evidence to support this statement can be found. In one study done in the rat, it was determined that anorectic drugs acting via the dopaminergic system antagonize hyperphagia induced by 2-deoxy-D-glucose, although the authors did not find any modifications to insulin-induced hypoglycemia [26]. There are no reported cases of drug-herb interactions with diethylpropion. However, theoretically herbal products with CNS stimulant properties (e.g. ephedra, caffeine, bitter orange), potential for interaction with sympathomimetic agents (e.g. Indian snakeroot), or MAOI activity (e.g. yohimbe) should be avoided due to an increased risk of hypertension, cardiovascular effects, and changes in blood pressure [27].
Molecular structures of anorectic drugs.
Phentermine (Figure 1b), a member of the β-phenylethylamine family of compounds, exerts anorectic activity centrally through appetite suppression and is indicated in the short term treatment of obesity in patients with a BMI ≥ 30 kg/m2 [28]. A meta-analysis of six randomized controlled trials of phentermine cumulatively show an added 3.6 kg weight loss over 2 to 24 weeks compared to control groups [29]. Phentermine acts by increasing the release of and inhibiting the reuptake of norepinephrine or dopamine [22]. Although one of the oldest approved anti-obesity drugs, the safety of monotherapy of phentermine is relatively scarce due to the long history of combination products, most notably phentermine/fenfluramine (Phen-Fen), which was removed from the market due to serious and potentially fatal cardiovascular effects [30, 31]. More recently a combination product containing phentermine and topiramate has been investigated (see
Because of the similarity in activity and mechanism of action, drug interactions with phentermine are similar to those for diethylpropion (see
Several antiepileptic agents are known to have an effect on weight gain [33]. However, two newer antiepileptic agents, topiramate and zonisamide, have shown an associated decrease in weight in patients taking these medications [34]. Therefore, these two drugs are being looked at as potential anorectic agents.
Topiramate is a carbonic anhydrase inhibitor (Figure 1c) that is typically used in the treatment of migraines and as an anticonvulsant [35]. Topiramate is proposed to exert its antiepileptic activity via gamma-aminobutyric acid (GABA)-A-mediated inhibition via a benzodiazepine insensitive pathway, although the drug also blocks voltage dependent sodium channels [35-37]. Weight loss has been a commonly reported adverse effect of topiramate; therefore, the drug has recently come into focus as a potential anorectic agent [38-42]. Topiramate has shown promise as a combination low-dose therapy with phentermine (Qsymia(R) (originally Qnexa(R), Vivus Pharmaceuticals, Mountain View, CA, USA) for long term treatment of obesity [43-46]. Despite, safety concerns related to teratogenicity and cardiovascular effects, the product has recently been approved by the U.S. Food and Drug Administration.”
Drug interactions with topiramate include coadministration with other antiepileptic agents. Although no changes in carbamazepine or phenytoin levels were seen, topiramate levels decreased by 40% or 48%, respectively [35]. However, there have been two case reports of antiepileptic drug intoxications in patients initiated on topiramate who were already taking the maximum carbamazepine dose [47]. Decrease in carbamazepine dosage resolved the interaction. Hyperammonemia, hypothermia and potentially encephalopathy can result from a synergistic interaction between topiramate, valproic acid, and phenobarbital, although the exact mechanism of this interaction is unknown [35, 48-50]. Levels of ethinyl estradiol can be significantly decreased in patients taking topiramate as an adjunctive therapy with valproic acid [35]. As a carbonic anhydrase inhibitor, topiramate can cause metabolic acidosis, and therefore is contraindicated in patients taking metformin, while patients taking other carbonic anhydrase inhibitors should be monitored due to the potential additive effects when coadministered with topiramate [51-55]. High doses of topiramate (600 mg/day) can increase systemic exposure to lithium. However, since topiramate dosage proposed to anorectic effects is low, this interaction may not be a significant concern when used as anti-obesity treatment [56]. No clinical studies or case studies are available for interactions with CNS depressants (e.g alcohol), although combined use is contraindicated by the manufacturer due to combined CNS depression [35]. No data supporting herb-drug interactions are available specifically related to use of topiramate at low doses as an anorectic agent [27].
Zonisamide (Figure 1d), a methanesulfonamide, is an antiepileptic agent which has broad spectrum activity and has proven to be useful in patients not responding to other antiepileptic treatments [57]. The drug blocks sustained and repetitive neuronal firing by blocking voltage sensitive sodium channels and decreasing voltage sensitive T-type calcium channels [58, 59]. Additionally, it was found that zonisamide has dopaminergic and serotonergic activity, which contributes to the anorectic effects of the drug [60, 61]. In one randomized placebo-controlled trial, 30 subjects were administered zonisamide 100 mg daily along with a low calorie diet (500 kcal/day) for a period of 16 weeks. Dosage was increased to up to 600 mg/day for patients not losing >5% of their initial body weight within the first 12 weeks. The zonisamide group lost significantly more body weight at the end of the trial compared to the placebo group (approx. 6% loss vs. 1% loss) [62].
Zonisamide is metabolized by the cytochrome P450 3A4 system and therefore can potentially interact with other drugs metabolized via this route. In one study, the half-life of zonisamide (t½ = 60 h) was decreased in patients receiving both zonisamide and phenytoin (t½ = 27 h), carbamazepine (t½ = 38 h, and sodium valproate (t½ = 46 h) [57, 63]. Another study in the dog demonstrated decreased plasma levels of zonisamide during administration of phenobarbital [64]. However, any associated decrease in levels of other antiepileptic drugs was not found to be clinically significant [65, 66]. Cigarette smoking may alter the pharmacokinetics of zonisamide. Coadministration of carbonic anhydrase inhibitors may increase risk of metabolic acidosis and kidney stone formation, therefore monitoring is recommended in this patient population [66]. One study on the effects of cigarette smoke on zonisamide concentrations in rats suggests that cigarette smoke may decrease plasma levels of the drug due to decreased oral absorption [67]. Brain, but not plasma levels of zonisamide may be affected by chronic ethanol consumption. In one study inbred EL mice were administered zonisamide 75 mg/kg for 1 – 4 weeks along with 10% ethanol
Orlistat (Figure 1e) is a gastrointestinal lipase inhibitor approved both as a prescription (Xenical®) and over-the-counter (Alli®) weight loss aid in the long term treatment of obesity [69]. The drug exhibits antiobesity activity by inhibiting the absorption of dietary fat from the lumen of the stomach and small intestine through covalent binding with gastric and pancreatic lipase active serine residues [70]. Multiple randomized controlled trials have reported significant weight loss in patients taking orlistat compared to placebo controlled groups. One meta-analysis cites mean weight loss compared to control of -2.59 kg [95%CI, -3.46 to -1.74] or -2.9 kg [95%CI, -3.2 to -2.5] over 6 or 12 months, respectively, with a corresponding decrease in waist circumference, blood pressure, and blood glucose and lipid profiles [71-73].
A large number of preclinical and clinical studies and case reports related to potential drug interactions with orlistat have been published. There have been several cases of orlistat interaction with cyclosporine [74-79]. In all cases, significant decreases in plasma cyclosporine levels were observed following adjunct treatment with orlistat for cyclosporine-associated weight gain. Although one proposed mechanism for the reduction in plasma cyclosporine is a decrease in drug absorption, decreased levels may be due to rapid gastrointestinal transit time resulting from contraindicated high fat diets rather than a true drug-drug interaction [80]. Because orlistat is designed to inhibit gastrointestinal lipases, theoretically absorption of lipophilic molecules would also be inhibited [81-83]. In one open-label, placebo-controlled randomized two-way crossover study, orlistat (120 mg) was administered to 12 healthy subjects three times daily for 9 days followed by administration of Vitamin A (25,000 IU) or Vitamin E (400 IU) [82]. Although no effect was seen on Vitamin A levels, a significant reduction in Cmax (approx. 43%) and AUC (approx. 60%) were observed for Vitamin E, suggesting impaired absorption of Vitamin E by orlistat. In another study, approximately a 30% reduction in beta-carotene levels was observed after administration of orlistat (120 mg) for four days followed by administration of 0 – 120 mg of beta-carotene three times a day for six days [83]. Absorption of lipophilic drugs such as the CNS agent lamotrigene can also be affected by orlistat. In one report, increased frequency of seizures was reported in an 18 year old female taking lamotrigene following initiation of an orlistat regimen [84]. One case of hypothyroidism in thyroid carcinoma was reported, presumably due to decreased absorption of thyroxine [85]. Although orlistat was not found to alter warfarin kinetics
Rimonabant (Figure 1f) is a cannabanoid receptor antagonist that suppresses appetite by preventing activation of CB1 receptors by the endogenous cannabanoids anandamide and 2-arachidonoyl-glycerol [87]. In clinical trials the drug resulted in improvement of multiple endpoints associated with obesity and metabolic syndrome compared to control groups including significant weight loss, reduction in waist circumference, decreased triglycerides, blood glucose, fasting insulin, and leptin levels with increased HDL cholesterol and adiponectin levels [88-96]. Although rimonabant proved a potentially successful drug in the treatment of obesity, especially given lack of cardiovascular risks compared to other weight loss drugs (see
Given the limited and short-lived approval status of rimonabant, there is little information regarding potential drug-drug and herb-drug interactions available. According to package insert data submitted to the EMEA, rimonabant is known to be eliminated hepatically and into the bile by amidohydrolase and CYP3A4, with a 104% increase in rimonabant AUC (95% CI 40 – 197%) upon coadministration of ketoconazole [92, 96, 104, 105]. Therefore, the manufacturer indicated potential interactions with strong CYP3A4 inhibitors (e.g. ketoconazole, itraconazole, ritonavir, telithromycin, clarithromycin, and nefazodone) and inducers (e.g. rifampicin, phenytoin, phenobarbital, carbamazepine, and St. John’s Wort). Because rimonabant can decrease levels of fasting insulin and blood sugar, use of rimonabant in diabetic patients taking anti-diabetic agents is cautioned [92, 96, 104, 105].
Sibutramine hydrocholoride (Figure 1g), and its active primary (M1) and secondary (M2) metabolites, is a selective serotonin (5-hydroxytryptamine, 5-HT) and norepinephrine reuptake inhibitor [106-110]. Clinical data supported the efficacy of sibutramine as a weight loss agent, reporting significant weight loss compared to placebo for patients taking at least 10 mg/day for up to one year [107, 110-114]. The drug was approved as an anti-obesity agent in 1997 by the U.S. FDA and in 2002 by the EMEA, despite evidence of increased risk of hypertension and tachycardia, with a requirement that additional post-marketing safety data be collected relative to cardiotoxicity. As a result, the SCOUT (Sibutramine Cardiovascular OUTcomes) trial was implemented, which enrolled 10,000 overweight or obese patients aged 55 and older with coexisting diabetes and/or heart disease in a randomized controlled trial with a 6-month lead in period [115-118]. At the end of the six year study period, data showed a significant decrease in body weight compared to placebo but increased cardiovascular morbidity in the randomized sibutramine group [115-118]. Following publication of the SCOUT trial results in 2010, the EMEA and most other major markets pulled sibutramine while the United States and Australia required stricter labeling. By 2011 sibutramine was pulled from all major markets globally. However, as with the case of rimonabant (see above), sibutramine is of note since it is the primary contaminant found in dietary weight loss supplements (see
Sibutramine is known to be metabolized by CYP 3A4 into two active metabolites (M1 and M2). Data reported by the manufacturer in limited clinical trials (n = 12 – 27 patients) suggest potential pharmacokinetic changes in AUC and Cmax for sibutramine when taken in combination with CYP 3A4 inhibitors such as cimetidine, ketoconazole, erythromycin, simvastatin, and omeprazole; while sibutramine does not generally have a significant impact on the levels of these drugs in return [106]. Because of the role of CYP 3A4 in sibutramine elimination, use of the drug with other CYP 3A4 substrates, including coadministration with grapefruit juice, is contraindicated [111]. One case report describes a possible interaction between sibutramine and citalopram in a 43 year old female patient who experienced hypomanic symptoms shortly after adding 10 mg sibutramine to her current citalopram and fluoxetine regimen [119]. Symptoms ceased within one day of discontinuing sibutramine. Although the exact mechanism of the interaction is unknown, the author hypothesized a possible amphetamine-like hypomania or serotonin syndrome due to increased brain serotonin levels via the combination of a serotonin reuptake inhibitor and serotonin-norepinephrine reuptake inhibitor. Another case report notes a possible interaction between sibutramine and cyclosporine in a 26 year old transplant patient resulting in significant increases in cyclosporine trough plasma levels, likely due to inhibition of CYP 3A4 metabolism [120]. Coadministration of α2 adrenergic blockers, such as the herb yohimbine, with sibutramine has been recognized as potentially life threatening due to potential sympathetic side effects resulting in hypertension and tachycardia [121]. Due to the potential risk of bleeding caused by sibutramine, the drug should be used with caution in patients taking warfarin and other anticoagulants [106].
The açaí berry is harvested from the palm species
Bitter orange is the fruit of
Interactions with bitter orange are varied. Synephrine, like ephedrine, is known to cause adverse cardiovascular effects at high doses, the risk of which are heightened when combination products also including caffeine are ingested and therefore patients taking cardiac medications should be cautioned on its use [135, 136]. Some evidence demonstrates that bitter orange can inhibit cytochrome P450 3A4, although to a lesser extent than with grapefruit [137-140]. A 76% increase in AUC was observed following administration of 10 mg extended release felodipine administered with 240 mL Seville orange juice compared to control [139]; while a significant increase in indinavir tmax was observed with administration of 8 ounces of Seville orange juice compared to control [140]. Because synephrine and octopamine, both endogenous substances, can interact with monoamine oxidase there is a theoretical interaction of bitter orange with MAOIs [141, 142].
Caffeine is a methylxanthine that is commonly found in food, beverages, and dietary supplements. It is used as an additive in beverages and dietary supplements for its energy enhancing properties. Many dietary supplements marketed for weight loss contain high levels of caffeine, often from multiple sources, for increased thermogenesis and lipid metabolism [143, 144]. Most studies investigating the anti-obesity effects of caffeine have been done using combination products that include ephedra, or have looked at enhancement of athletic endurance [145-151]. Therefore, it is difficult to assess the effect of caffeine alone on weight loss. One study demonstrated an increase in thermogenic metabolic rate in subjects drinking coffee along with food, compared to ingestion of decaffeinated coffee [144].
Adverse effects associated with caffeine consumption include restlessness, jitteriness, anxiety, insomnia, and cardiovascular effects [152-156]. Most drug and herb interactions with caffeine are mild to moderate and are related to increased adverse effects resulting from decreased caffeine elimination or additive effects with other methylxanthine containing products [157]. For example, estrogen drugs (e.g. oral contraceptives and estrogen replacement therapy) have been shown to decrease clearance of caffeine up to 50 – 65% [158, 159]. The most significant caffeine interaction occurs with coadministration of
Green tea has gained in popularity for the treatment of a wide variety of diseases and for promotion of general wellbeing. The addition of green tea to weight loss supplements is due in part to the caffeine content of
As expected, the majority of drug interactions associated with green tea are related to caffeine content. However, a few interactions described in the literature are due to other constituents of green tea. Green tea may be contraindicated, especially at high doses, in patients taking anticoagulants such as warfarin due to the high Vitamin K content of the herb. There is one case report of a patient taking warfarin who experienced a significant reduction in INR following initiation of daily consumption of one-half to one gallon of green tea [166]. Once green tea consumption was stopped INR normalized. Green tea is also thought to cause decreased estrogen levels and combination products containing the herb have been used to improve fertility and relieve menopausal symptoms [167-170]. Therefore, use of high doses of green tea in patients taking oral contraceptives or estrogen replacement therapy may be cautioned.
Guarana (
Dandelion is a perennial herb of multiple global varieties that has traditionally been used for liver, spleen, kidney, and gastrointestinal disorders, although there have been no clinical trials investigating the effects of dandelion in weight loss [27, 178]. It is commonly added to weight loss supplements, mainly for its diuretic properties, although the herb does possess some mild laxative properties [179-181]. There are no known drugs interactions between
Ephedra, derived from the evergreen shrub
Because of the controversial nature of ephedra related to cardiac toxicity and its eventual ban via the U.S. FDA, there are a significant number of clinical studies and case reports related to toxicities and interactions with ephedra and ephedrine. Ephedra can potentially interact with anesthetics since it is known that administration of ephedrine can reverse anesthesia induced hypotension and regression of analgesia following epidural blockade [213, 214]. Ephedrine has both chrontropic and inotropic effects, and therefore interactions with cardiovascular agents may be possible [184, 211, 215, 216]. However, no effects on heart rate or blood pressure were seen in clinical trials investigating the efficacy of ephedra in weight loss [192, 217, 218]. Theoretically interactions with antiadrenergic agents and MAOIs can occur due to sympathomimetic effects of ephedrine, potentially increasing risk of hypertensive crisis. There is a case report of a patient taking a product containing caffeine, ephedrine, and theophylline who experienced multiple adverse effects including encephalopathy, hypotension, tachycardia, and hypothermia 24 hours following discontinuation of phenelzine [219]. Interactions with ephedrine and tricyclic antidepressants are also possible [220]. Some evidence from clinical trials suggests that ephedra in combination with caffeine can cause hyperglycemia, and therefore interactions with antidiabetic agents is possible [147, 148, 221]. A lowering of seizure threshold has been observed in patients taking ephedrine, and therefore use of ephedra in this patient population is cautioned [222]. A major interaction between ephedra and methylxanthines (e.g. caffeine, theophylline) is possible due to increased risk of cardiovascular, neurologic and psychiatric adverse effects due to additive sympathomimetic and CNS stimulant activity [184, 223, 224]. One case study reports a 21 year old male patient admitted to the hospital emergency room with a blood pressure of 220/110 mmHg and ventricular arrhythmia following ingestion of a caffeine/ephedra containing product (“Herbal Ecstasy”) [225].
Glucomannan is a soluble but highly viscous dietary fiber derived from the root of the
There are relatively few reported drug interactions with glucomannan, most of which are likely due to associated decreases in cholesterol and lipid levels as well as interference with absorption of some drugs. Monitoring of patients taking antihypertensives, antilipemics, and other anti-obesity agents is warranted. Several studies note a significant decrease in fasting blood glucose levels following glucomannan administration while decreased absorption of the sulfonylurea drugs is possible [230, 231, 233-237]. Glucomannan can significantly decrease circulating levels of T3, T4, and FT3 in the treatment of thyrotoxicosis and therefore its use may be contraindicated in patients taking thyroid medications [238]. Glucomannan can potentially affect the absorption of certain drugs and supplements as demonstrated in one study in which absorption of the fat soluble Vitamin E was decreased potentially via the reduction of bile acids necessary for absorption of the vitamin [239].
Frequently laxatives and diuretics are used alone or in combination products to promote weight loss. However, there is little to no evidence supporting these supplements as anti-obesity agents, although subgroups of this patient population may abuse laxatives and diuretics for the purpose of weight loss [250].
Bulk laxatives generally consist of soluble dietary fiber which expands in the gastrointestinal tract in the presence of water resulting in improved bowel function. Common sources of bulk laxatives include
Stimulant laxatives act by irritating the lining of the gastrointestinal tract, resulting in increased propulsive muscle contractions that aid elimination of intestinal contents. Because of the quick and efficacious activity, stimulant laxatives are most frequently abused to promote weight loss by increasing gastrointestinal transit time [273, 274]. The most common stimulant laxative herbs are senna (
Stimulant laxatives share multiple common adverse effects and potential drug interactions. Because of decreased gastrointestinal transit time, absorption of some drugs, especially those with poor permeability, may be decreased [303, 304]. Experimental evidence in rats suggests absorption of carbohydrates may result in decreased blood glucose levels and therefore monitoring of patients receiving hypoglycemic agents or insulin is warranted [305-307]. Concomitant use of stimulant laxatives with diuretics, cardiac glycosides and licorice is contraindicated due to hypokalemic effects, especially with long term use of these laxatives [27, 178, 304, 308, 309]. Senna can potentially interfere with antiplatelet and anticoagulant activity by causing excessive bleeding [310]. There is one case report of a possible interaction of aloe and sevoflurane, in which a 35 year old female patient undergoing surgery for hemangioma experienced perioperative bleeding [311]. Although the size and vascularization of the hemangioma were noted as partial root causes of the bleeding episodes, the authors felt that the combination of anesthetic and aloe administration (4 tablets daily for 2 weeks prior to surgery) may have contributed to the adverse event.
Licorice has historically been used both medicinally and as a food product and its relative safety at low doses has placed it on the U.S. FDA GRAS (generally recognized as safe) list, although at high doses licorice can cause severe adverse effects [27]. The main active components of licorice are glycyrrhizin and glycyrrhizic acid, although several other active constituents have been identified [312, 313]. One of the main adverse effects of high licorice consumption includes mineralocorticoid excess syndrome and resulting hypokalemia with associated increases in blood pressure, as well as secondary pseudohyperaldosteronism [314-338]. Licorice consumption may also alter blood glucose levels, potentially via binding to PPAR-γ [339, 340]. Although licorice is used in dietary supplements for weight loss, contradictory evidence reports weight gain with licorice consumption [341-343]. However, one study in which 3.5 grams daily licorice consumption was administered to 15 normal weight subjects for two months reports a significant decrease in body fat mass but not body mass index [344, 345].
Acquisition of mineralocorticoid excess syndrome following high dose consumption of licorice results in the potential for licorice-drug interactions with multiple drug classes, including aldosterone receptor antagonists, antiarrhythmics, antihypertensives, cardiac glycosides, corticosteroids, diuretics, and potassium lowering agents [321-324, 326]. In one study, 10 healthy subjects were given 32 grams of licorice daily for two weeks along with 25 mg of hydrochlorothiazide (HCTZ); a significant reduction in potassium levels was observed, while two patients experience hypokalemia, compared to HCTZ alone [346]. Glycyrrhizin and β-glycyrrhetinic acid may also affect complement activity and decrease neutrophil generated oxides and peroxides, resulting in anti-inflammatory activity [347-350]. Therefore, licorice should be used with caution in patients taking other anti-inflammatory medications. Licorice constituents may also have an effect on hormonal agents via anti-estrogenic activity, inhibition of 17β-hydroxysteroid dehydrogenase, or associated decreases in prolactin levels [351-358]. In
St. John’s Wort (SJW) is a perennial herb native to Europe that is commonly used to treat depression, anxiety, post-menopausal symptoms, attention deficit hyperactivity disorder (ADHD), and other mood disorders [362-367]. The active constituents of SJW are hypericin and hyperforin, which are thought to act by inhibiting the synaptic uptake of serotonin (5-HT), GABA, noradrenaline, dopamine, and L-glutamate via a novel mechanism compared to synthetic antidepressants [362, 368-373]. Although there are no official studies regarding the use of SJW for weight loss, anecdotal reports suggest a positive effect on satiety, which may be attributable to the serotonergic uptake inhibition (see
Drug interactions with SJW are primarily related to binding of active constituents to the pregnane X receptor leading to induction of cytochrome P450 metabolizing or induction of p-glycoprotein efflux mechanisms via the MDR-1 drug transporter [374-388]. As a result, pharmacokinetics of many cytochrome P450 drug substrates is altered, often leading to decreased plasma concentrations and reduced efficacy [27]. There have been numerous studies that have demonstrated potential metabolism-related drug interactions with CYP 3A4, 1A2, 2C9 and 2C19 [389]. Kinetics of antiplatelet and anticoagulant agents may be altered in the presence of SJW [390, 391]. In one open-label, three-way crossover randomized study, 12 healthy male subjects were given 1 gram of SJW (standardized to hypericin 0.825 mg/g and hyperforin 12.5 mg/g) for 21 days, with administration of a single 25 mg dose of warfarin on day 14 [390]. A significant increase in warfarin (Cl/F) was observed compared to warfarin alone, with a corresponding decrease in AUC and half-life. However, there was no significant impact on INR or platelet aggregation. The interaction is likely caused not only by alteration of drug metabolism via CYP 450 induction, but also binding of warfarin to the SJW constituents hypericin and pseudohypericin, leading to decreased absorption of the drug [392]. In another study, patients not responding to clopidogrel therapy alone experienced an increase in therapeutic activity when clopidogrel and SJW were coadministered; therefore it is possible that patients responding to stand alone clopidogrel treatment may be at increased risk of bleeding [391]. There has been one case report of a possible interaction between theophylline and SJW in which theophylline levels significantly increased following discontinuation of SJW in a smoker also taking 11 other drugs [393]. However, another study in healthy subjects showed no impact of SJW on theophylline kinetics [394]. Plasma concentrations of protease inhibitors such as indinavir may be reduced in the presence of SJW due to induction of p-glycoprotein efflux in the gastrointestinal tract [395-398]. Decreased plasma levels of the “statins” simvastatin and atorvastatin have been reported in controlled, randomized, crossover studies [399, 400]. Reports of pharmacokinetic interactions have also been reported for digoxin, gliclazide, imatinib, irinotecan, methadone, omeprazole, verapamil, and voriconazole have also been published [401-412]. In general, coadministration of SJW with drugs significantly eliminated via these enzymes should be avoided.
Several studies and case reports describe interactions between SJW and oral contraceptives, resulting in breakthrough or irregular bleeding and unplanned pregnancy [413-416]. In one case report, an unwanted pregnancy occurred in a 36-year old patient while taking an ethinyl estradiol/dinogesterol oral contraceptive (Valette®). The patient had previously been taking fluvastatin (20 mg/day) for 2 years, but had discontinued the drug and started 1700 mg SJW extract daily for 3 months prior to conception [414]. One randomized controlled trial in 18 female subjects taking low dose oral contraceptives (0.02 mg ethinyl estradiol / 0.150 mg desogestrel) in combination with 300 mg SJW twice daily reported a significant increase in breakthrough bleeding compared to subjects taking oral contraceptive alone [417]. Progestins and estrogens contained in oral contraceptives are known to be metabolized by various CYP enzymes and therefore induction of these enzymes by SJW results in decreased plasma concentrations and therapeutic failure [417-420].
Interactions between SJW and with drugs used in the prevention of organ transplant rejection such as tacrolimus and cyclosporine have been reported [421-431]. Several transplant patients have experienced transplant rejection potentially related to coadministration of SJW. In one case report a patient treated with 75 mg cyclosporine daily for several years following kidney transplant experienced a drop in cyclosporin plasma levels attributed to SJW administration [427]. Levels returned to normal when SJW was discontinued and dropped upon rechallenge with SJW extract. Similarly, tacrolimus plasma levels markedly decreased in a study involving 10 stabilized renal transplant patients administered 600 mg SJW extract for two weeks, requiring dosage adjustments during and for up to two weeks following discontinuation of SJW [431].
SJW may interact with selective serotonin reuptake inhibitors (SSRIs), monoamines, and other antidepressant and psychiatric medications due to the serotonin uptake inhibitory properties of hypericin and hyperforin, although metabolic induction plays a role for some drugs [368, 370-373, 432-446]. In one case report, a patient who had been taking paroxetine 40 mg daily for treatment of depression discontinued her medication and began taking SJW 600 mg daily [434]. No adverse events were reported with the switch, but upon coadministration of a 20 mg dose of paroxetine to aid in sleep the patient experience extreme grogginess, weakness, fatigue, and incoherency. The author cited the potential for additive serotonin uptake inhibition resulting in “serotonin syndrome”. One case of a male adult patient stabilized on methylphenidate for attention deficit hyperactivity disorder (ADHD) is reported in which the patient experienced increased ADHD symptoms after taking SJW 600 mg daily for four months [438]. The mechanism of the interaction is unknown. Interactions have also been reported for amitriptyline, clozapine, fexofenadine, and sertraline; therefore administration of SJW in patients taking these and similar drugs should be avoided [440, 443, 444, 446, 447].
An interaction between SJW and drugs known to cause phototoxic adverse reactions is also possible, due to the photosensitizing nature of hypericin [448-450]. In one study, 11 subjects were exposed to UVA1 radiation at baseline and following 10 days treatment with 1020 mg (3000 mcg hypericin) extract [449]. Minimum erythemal dose (MED) as measured 8, 24 and 48 hours after exposure to radiation and was found to be significantly lower at 8 and 48, but not 24 hours, after exposure compared to control. There is one case report of a patient experiencing severe phototoxicity upon exposure to laser light (532 nm) and pulsed dye laser light (585 nm), presumably due to ingestion of SJW [451]. SJW may also increase the sensitivity and skin toxicity of radiation treatment in patients undergoing radiation therapy, possibly through photosensitizing effects although the exact underlying mechanism is not known [452].
Willow bark from the
A final note is necessary regarding the adulteration of weight loss supplements with drug products and other chemical substances. This adulteration is often the underlying cause for the purported activity of a dietary supplement and can result in serious toxicity. The most commonly cited contaminant in weight loss supplements is sibutramine (Meridia®; see above), a weight loss supplement removed from the market in October 2010 for significant cardiac toxicities [462-466]. One U.S. FDA report cites 72 different herbal products containing adulterants, 94.4% of which contained sibutramine as an additive [102]. Multiple products listed in the report were contaminated with phenolphthalein (11.1%) or the anti-seizure drug phenytoin (2.8%). Other reported contaminants (1.4%) included the experimental anti-obesity agent cetilistat, the recalled anti-obesity agent rimonabant (see above), the anti-obesity amphetamine stimulant drug fenproporex, the antidepressant fluoxetine, or the diuretics furosemide and bumetanide[103]. Phenophthalein was previously used as a laxative in over-the-counter products but was removed from the U.S. market in 1999 due to concerns of carcinogenicity and genotoxicity [467]. Another study investigating contamination of 20 different dietary supplements using 1H-NMR methods found contamination of 14 of the products (70%), with eight products containing sibutramine, five containing both sibutramine and phenolphthalein, and one formulation containing undeclared synephrine [468]. There have been other reports of contamination of weight loss supplements with the diuretic hydrochlorothiazide [462, 469]. Given that tainting of weight loss supplements is common, patients and health care professionals should be made aware of the risks associated with ingestion of herbal products, especially those with minimal evidence backing their claims of efficacy.
Global decline of biodiversity of many terrestrial and aquatic invertebrates, particularly insects, has been a major concern to biologists and ecologists. This is because biodiversity provides many important ecosystem services due their abundance and diversity [1, 2, 3]. Much of the decline has been blamed on human activities such as hunting, habitat loss through deforestation, agricultural expansion and intensification, industrialization and urbanization [4, 5], which together accounted for 30–50% encroachment on natural ecosystems at the end of the twentieth century [6]. Agricultural intensification is considered the key driver of this biodiversity loss in many taxa including birds, insectivorous mammals and insects. The removal of natural habitat elements such as hedgerows, trees and other landscape features together with the recurrent use of chemical fertilizers and pesticides in agricultural intensification systems negatively affect overall biodiversity of insects [7]. Extensive use of pesticides is reported as the primary factor responsible for the decline of birds in grasslands [8] and aquatic organisms in streams [9], with probably other factors contributing to or amplifying their effects.
Long-term population monitoring study at several protected areas of Germany revealed a 76% decline in flying insect biomass with an annual loss of 2.8% [10]. Similarly, a study in the rainforests of Puerto Rico showed biomass losses between 98 and 78% for ground-foraging and canopy-dwelling arthropods over a 36-year period, with annual losses between 2.7 and 2.2%, respectively [11]. The authors showed parallel declines in birds, frogs and lizards at the same areas, which they attributed to invertebrate food shortages. The studies above (10–11) confirm the declining trend in flying insects (mainly Diptera) reported earlier for parts of Southern Britain [12]. While climate change may be a contributory factor to arthropod declines, intensification practices including deforestation were reported to be responsible for the annual loss of insect biomass in the tropical rainforest of Germany [10]. The authors also pointed to the effect of synthetic pesticides as a likely driver of the losses in insect biomass.
The above studies demonstrate general knowledge about biodiversity decline in insects. It appears that insect declines are substantially greater than those observed in birds or plants [13], and this could have far reaching consequences on several of the world’s ecosystems. This review summarizes current knowledge about insect declines; that is, the changes in species richness (biodiversity) and population abundance through time in intensive agricultural systems point to the likely drivers of these declines and conclude with management practices that could mitigate these declines in sustainable agricultural systems. Previous reviews are limited in scope to one or a few insect taxa (e.g., butterflies, carabids) in specific regions and made no comparisons across taxa in different geographical regions (e.g., Sequera et al. 2014; Zhao et al. 2015).
Agricultural production has struggled over the past few centuries to keep pace with the ever-increasing world population of humans, which exceeded 7 billion in late 2011 and is expected to reach 9.3 billion by 2050 [14]. In sub-Saharan Africa, for example, the current population of 1.1 billion people is projected to double over the next 30 years [15]. The increasing population increased demand for food and also brought in its wake increased demand for land for housing, roads and other infrastructural needs, which limited land availability for other purposes including agriculture. Thus, the hitherto traditional agricultural practices such as low-input agriculture with inherent low yields and shifting cultivation appeared no longer tenable in the quest to produce enough food for the growing population. This led to the intensification of agricultural practices more especially after World War II. In Europe and North America, the intensification of agriculture began in the first half of the twentieth century, whereas in South America, Africa and Asia, it started mainly in the second half of the century [16].
The agricultural intensification practices include expansion of farms into large commercial enterprises, accompanied by a changed emphasis to monocultures, and the application of increasing inputs of fertilizers and synthetic pesticides [14, 17]. Today’s farmlands are larger in scope than their predecessors, more of monocultures, and more rely more on external inputs such as fertilizer, insecticide, and herbicide. In such systems, there is also greater emphasis on the elimination of weeds, cutting down hedgerows and trees in order to facilitate mechanization of fields. Surface waterways are also modified including stream channelization to ease flow and improve irrigation and drainage of fields. These intensification practices drastically reduce the level of refugia available for insects, herbaceous plants, vertebrate insectivores, and other organisms and consequently an overall decline in biodiversity, both in species numbers and in biomass [14, 18, 19].
More than a quarter of the world tropical forests have been cut since the ratification of the Convention on Biological Diversity in 1992, leaving many to wonder whether there will be any substantial stands of tropical forest remaining by the end of this century. Many grasslands and forested areas have also been converted into croplands and plantations [17]. The effects of these practices on biodiversity loss is further exacerbated by the effect climate change, which limit the location of favored regions for crops and other life forms [17].
A lot has been reported about the effects of agricultural intensification practices on biodiversity loss in insects. Zabel et al. [19] discussed the trade-offs between increasing agricultural intensification and biodiversity decline. Inevitably, increased structural modification of habitats and change in the heterogeneity of farmlands in agricultural intensification systems affect biodiversity. The intensive practices alter the availability of food and shelter for insects and other life forms, which affect the abundance and diversity of species (14). Consequently, major insect declines were observed when agricultural practices shifted from the hitherto low-input traditional farming to the intensive, industrial-scale production brought about by the Green Revolution [19]. In its wake, rare species associated with protected ecosystems and natural habitats retreated or were lost completely [18, 19]. Monocultures led to a great simplification of insect biodiversity among pollinators, insect natural enemies and nutrient recyclers, and created the suitable conditions for agricultural pests to flourish. Thus, agricultural intensification serves as the main driver of insect declines in both terrestrial and aquatic ecosystems [20, 21, 22].
Raven and Wagner [17] reported of increased clearing of forests in the tropics for crops, pasture and wood fuel in Central Africa, Central America, many parts of South America and Southeast Asia. An average of 5 million acres of the forest was lost annually to industrial-scale agriculture between 2001 and 2015 [23, 24]. This huge deforestation poses serious threats to the world’s insect biodiversity as the majority of insect species diversity is found in the tropics. Deforestation is one of the major drivers of biodiversity loss and insect declines [17, 18, 19, 20, 21, 22, 23, 24, 25]. Moreover, deforestation on larger scales has the potential to change weather and rainfall patterns that may further impact negatively on insect populations [24, 25]. Insect biodiversity is very important for successful agriculture in providing many ecosystem services such as pollination, nutrient recycling and biological pest control.
In [26, 27], it was reported that agriculture is the primary contributing factor in insect losses in California and Ohio. According to [27, 28], butterfly diversity in southwest Germany began declining two centuries ago, but with steeper rate of declines observed after World War II, when intensification practices increased. Over the past half century, two-thirds of the common moth species in Great Britain are decreasing in number. Powney et al. [29] analyzed the long-term abundance trends of moths in Great Britain and reported that moth abundances had decreased by 31% over the past five decades [19]. Similarly, in [17], the elevated rate of loss was reported in diverse group of insect fauna of the grassland world, including butterflies and noctuid moths (Lepidoptera); ants, bees and wasps (Hymenoptera); scarab and ground beetles (Coleoptera); crickets, grasshoppers and katydids (Orthoptera); leaf and plant hoppers, seed bugs and their kin (Heteroptera). Further, there are reports of declines of wild bees, particularly from northwestern Europe due to agricultural intensification [30].
This part of the chapter discusses in detail biodiversity declines of selected insect groups caused by the effect of agricultural intensification practices across the globe.
Butterflies and moths have high level of host plant specialization and are therefore vulnerable to habitat deterioration [31]. They also have a wide range of distribution and important for the delivery of key ecosystem services such as biological pest control and pollination [32]. Moths, which are about 10 times more different than butterflies, constitute important prey items for bats and sustain population levels of a myriad of other insectivorous animals [33].
Maes and Van Dyck [34] pioneered report of drastic changes in butterfly biodiversity in Flanders (Belgium) during the twentieth century. They observed that habitat loss due to urbanization and agricultural intensification expansion resulted in a steady decline of 69% of 45 extant species [34]. A follow-up study in the Netherlands by van Dyck [35] also found that 11 out of 20 most common and widespread butterfly species declined in both distribution and abundance between 1992 and 2007. Moreover, local populations of
Long-term monitoring data of butterflies are limited in the United States. However, surveys in prairie habitats and bogs of Wisconsin and Iowa showed fluctuating populations of certain species. These fluctuations were driven by habitat modification and moisture levels dependent on climate change [43]. Surveys of 67 butterfly species in California between 1972 and 2012 showed initially stable populations until 1997 when populations dropped steeply to 23 species. The observed declines correlated significantly with percentage of land converted to agriculture and usage of insecticide, with neonicotinoid being the most important. The declining trend in 1997 followed the introduction of the neonicotinoid insecticides in that State [44]. In Massachusetts, the distributional ranges of 116 species shifted northward between 1992 and 2010. Two southern species adapted to warmer conditions expanded in range (
Insect taxon | Declining (%) | Threatened (%) | Extinction rate (%) | Reference |
---|---|---|---|---|
Coleoptera | 49 | 34 | 6.6 | [48] |
Diptera | 25 | 0.7 | n.a | [49] |
Ephemeroptera | 37 | 27 | 27 | [50] |
Hemiptera | 8 | n.a | n.a | [51] |
Hymenoptera | 46 | 44 | 15 | [52] |
Lepidoptera | 53 | 34 | 11 | [13] |
Odonata | 37 | 13 | 6 | [53] |
Orthoptera | 49 | n.a | n.a | [1] |
Plecoptera | 35 | 29 | 19 | [54] |
Trichoptera | 68 | 63 | 6.8 | [49] |
Proportion of declining and threatened species per taxa according to IUCN criteria.
Members of this group include bees, ants and wasps. They provide many important ecosystem services such as pollination and biological control of insect pests. Bees are essential pollinators of flowering plants and constitute a third of all pollinators [19]. Also, honey bees have been managed for millennia as a source of honey and beeswax. Hence, a need for information about their population status because of the important ecosystem services they provide [55].
A report on 18 bee species in Britain showed declining trends for seven species since the 1960s. The species with the most declines were
In general, studies [83, 84, 85] identified four major phases of bee extinction particularly in Britain. These are as follows: i) the second half of the nineteenth century, with the introduction of guano fertilizers and conversion of arable crops to permanent grasslands, which reduced floral resources; ii) after the First World War, when florally-diverse crop rotations were replaced with chemical fertilizers; iii) between 1930 and 1960, when most species went extinct probably due to changes in agricultural policy (i.e., Green Revolution) that fostered agricultural intensification; and iv) from 1987 to 1994, when rates of decline slowed down perhaps because the most sensitive species were already lost or reduced substantially [20].
Apart from bees, the status of most other hymenopterans (i.e., ants, wasps and parasitoids) that provide important ecosystem services remains practically unknown to date (Table 2). There is, therefore, a need for intensive research on these species.
Taxon | Abundance | Decline | Location | Reference |
---|---|---|---|---|
Bumble bees | 18 species | 7 species | England | [56] |
Bumble bees | 14 species | 8 species | Canada | [61] |
Bumble bees | 60 species | 48 species | Central Europe | [59] |
Honey bees | 6-m colonies | 3.5-m colonies | USA | [67] |
Wild bees | 52% population | Britain | [85] | |
Wild bees | 67% population | Netherlands | [63] | |
Wild bees | 32% population | North America | [64] | |
Cuckoo wasps | 23% population | Finland | [85] | |
Stingless bees | 30 species | 11 species | USA | [64] |
Orchid bees | 24 species | 64% species | Brazil | [72] |
Parasitic wasps | 48 species | 23% species | Finland | [85] |
Ground beetles | 419 species | 34% species | Belgium, Denmark | [86] |
Ground beetles | 49 species | 16% species | UK | [87] |
Ladybird beetles | 68% species | USA | [86] | |
Dung beetles | 31% population | Italy | [88] | |
Saproxylic beetles | 436 species | 57% species | Europe | [89] |
Dragonflies | 52 species | 65% population | USA | [90] |
Odonata species | 200 species | 57 species | Japan | [91] |
Odonata species | 155 species | 13 species | South Africa | [92] |
Stoneflies | 14 species | 5 species | Czech Republic | [93] |
Stoneflies | 77 species | 29% species | USA | [94] |
Mayflies | 107 species | 43% species | Czech Republic | [95] |
Status of some taxa and their geographical areas.
Hoverflies (Syrphidae) are not only important pollinators, but vital biological pest control agent for pest such as aphids, with a preference for damp habitats. Most studies in the Mediterranean countries showed significant differences in diversity within this taxon, with 249 species alone in Greece [77] and 429 in Spain [96]. This notwithstanding, the only long-term study to date shows reductions in species richness among hoverflies in the Netherlands and the U.K. [76].
This insect group contributes greatly to ecosystem management through control of pests and decomposition of organic matter [97]. Habitat destruction, extensive application of toxic chemicals and urbanization are the main causes of their decline. Of 419 species surveyed in the Netherlands, Belgium, Luxemburg and Denmark, there was a 34% decline for carabids, with over 50% of xerophilic species of the genera
A study of 62 historical datasets of ladybird species in the USA and Canada showed stable species richness and population abundance [86]. However, a 68% decline was observed over a 20-year period in 1986 [86]. Two local species (i.e.,
Studies on the trends of dung beetle abundance and distribution are obtainable only for the Mediterranean region, which has the largest range of dung beetles in Europe [108]. A study in Spain indicated that out of the 55 native species, nine had declined from 28 to 7% loss, while their distributional range contracted from 48 to 29% [108].
Studies of scarab beetles showed that two
These are distinctive phytophagous insects of plane regions, associated with natural and anthropogenic grasslands areas [85]. Sweep-net samples collected from 1963 to 1967 were compared with those collected from 2008 to 2010 at the same sites regarding species diversity, species composition and abundance. Generally, there was no change in species richness, irrespective of the strong interannual variability in abundance and weather condition. However, a decline in 14 species was observed while there was an increase in nine others and one species (
A wide-ranging study on grasshoppers and crickets was conducted in Germany [116]. There was no fluctuation in their biodiversity and abundance over four decades (median nine species per site), and variations in species groupings were small. The only significant change was a steep decline in the Grasshopper of bare soils,
Dragonflies (Anisoptera) and damselflies (Zygoptera) are a small group of insects that contribute to the management of nuisance mosquitoes and agricultural pests [117, 118]. Of 118 aquatic insect species that are threatened, 106 are from the order Odonata [94, 119]. A study of 42 sites across USA recorded a decline in 52 species of dragonflies and damselflies, while there was an increase in 29 species over the 98-year period. Nine pollution-tolerant species declined significantly, including four species (
Freshwater insect taxa mostly exhibit inflexible life cycles, with several species being univoltine, thus making them vulnerable to habitat modifications. Flow changes, habitat fragmentation, pollution and invasive species are the main threats to all aquatic organisms, including insects [124, 125]. Data for three main orders of freshwater insects, Plecoptera, Ephemeroptera and Trichoptera, are reported here. There were no records found for Coleoptera (e.g., Dytiscidae, Hydrophilidae), Hemiptera (e.g., Notonectidae, Gerridae) or Diptera (e.g., Chironomidae, Tipulidae).
Stoneflies are ecologically important and characterized by high degrees of endemism and narrow ecological requirements [126]. Previous report in Europe showed a disappearance of
Unlike terrestrial taxa, most declines were found among habitat generalists and less in specialized species (60–70%), which are tolerant to organic pollution. Sites affected by organic pollution showed only 17–33% decline of subtle and eurytopic species since the mid-1990s [93]; certain amount of species recovery has been detected following pollution modification in acidified habitats [131]. In Switzerland, 50% of the species of stoneflies and mayflies were lost between 1940s and 1980s [132], and similar trend occurred in other European countries and the USA, where 29% of the 77 local stonefly species were lost and 62% of the remainder became endangered over the past century [94]. Main losses occurred in the large rivers and agricultural areas during the 1940s and 1950s, when both agricultural intensification and urban expansion took place. Modification of river flows, channels and drainages structures was considered the driving factors for the declines. The large, long-lived species of Perlidae (summer stones) and Perlodidae (spring stones) were impacted the most, and 36% of summer stones had gone extinct since 1860. For sensitive genera such as
A checklist of mayfly species in the Czech Republic identified 107 species of which four are considered extinct, seven critically threatened, another seven endangered, 16 vulnerable and 14 near threatened [95]. A comparison of local mayfly also showed variations in species abundance, distribution and composition, but no major declines were observed in biodiversity except for the large lowland rivers, which lost five specialist species [133]. Biodiversity improved slightly in the mid- and upper streams and rivers, possibly because of substantial reduction in water pollution post-1989 [93]. Two species became extinct (
A comprehensive study on caddiflies species recorded 278 species in comparatively uninterrupted regions of Minnesota (USA) since the 1890s. Among the 278 species, 6–37% have declined in different areas, especially within the Limnephilidae (44% of species), Phryganeidae (21%) and Leptoceridae (12%) families [137].
The reports above show clearly that although agricultural intensification practices improve yields, they also impact negatively on the environment as evidenced by the decline in insect biodiversity. Biodiversity is an integral part of the natural resource base for agricultural production and therefore must be protected to sustain and safeguard the increased yields for the present and future generations. Over time, plant productivity decreases as biodiversity is lost [14]. A large proportion of studies (49.7%) point to habitat change as the main driver of insect declines, a factor equally implicated in global bird and mammal declines [135, 136]. Thus, habitat management practices are a key for sustainability of agricultural intensification practices. According to [136, 137], sustainable agricultural intensification is the management and conservation of the natural resource base and the orientation of technological and institutional change to ensure the attainment and continued satisfaction of human needs for present and future generations. It involves a process to produce high yields for existing land resource without affecting the environment. Sustainable intensification must include natural resource management practices that maintain the diversity of habitats as an intrinsic part of the agro-ecosystem or as additional land use interspersed among the fields (Firbank et al. 2008). These practices include crop rotation, reduced tillage, soil and water conservation, application of organic manure, intercropping and agroforestry [136, 138]. The practices will among other benefits ensure sustainable soil fertility through improved soil structure and soil microbial activities. Thus, sustainability requires the integration of multiple practices on a long-term basis to achieve desired environmental and agricultural outcomes. Intercropping with improved cultivars as well as integration of mixed crops with agroforestry and livestock could promote sustainable intensification and food security [137]. Also, the judicious implementation of integrated pest management (IPM) will minimize the use of toxic pesticides and enhance environmental safety for sustainable crop production [138]. Furthermore, in many of the world’s farming systems, biological control constitutes an under-utilized and yet cost-effective tactic for pest control. The effect of biological control will be felt more in sustainable intensification systems such as those that involve IPM practices that are benign to natural enemies of pests and/or conserve biodiversity [139]. For aquatic insects, rehabilitation of marshlands and improved water quality are essential for biodiversity conservation and enhancement [140]. This may require the implementation of effective remediation technologies to clean the existing polluted waters [141, 142].
This chapter has provided a comprehensive discussion of effects of agricultural intensification on decline in insect biodiversity. Intensification practices highlighted as causes of this decline include expansion of farms into large commercial enterprises, cutting down hedgerows and trees in order to facilitate mechanization of farms, changed emphasis to monocultures, and increasing application of external input of fertilizers and synthetic pesticides. These practices largely reduce the level of refugia available for insects, herbaceous plants, vertebrate insectivores, and other organisms and consequently an overall decline in biodiversity, both in species numbers and in biomass. Insect biodiversity is integral to the resource base of the plant ecosystem that provides essential services for increased crop productivity and, therefore, must be protected to safeguard the survival of the present and future generations. To mitigate this decline therefore, the chapter highlights sustainable intensification practices to include habitat restoration practices such as intercropping, crop rotation, reduced tillage, agroforestry, application of organic manures coupled with drastic reductions in application of synthetic pesticides.
The authors gratefully acknowledge management and staff of the Entomology Section of CSIR – SARI for their support in diverse ways during the preparation of this book chapter.
The authors declare no conflict of interest in the publication of this book chapter.
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Saleh"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10696",title:"Applications of Calorimetry",subtitle:null,isOpenForSubmission:!1,hash:"8c87f7e2199db33b5dd7181f56973a97",slug:"applications-of-calorimetry",bookSignature:"José Luis Rivera Armenta and Cynthia Graciela Flores Hernández",coverURL:"https://cdn.intechopen.com/books/images_new/10696.jpg",editedByType:"Edited by",publishedDate:"June 23rd 2022",editors:[{id:"107855",title:"Dr.",name:"Jose Luis",middleName:null,surname:"Rivera Armenta",slug:"jose-luis-rivera-armenta",fullName:"Jose Luis Rivera Armenta"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},subject:{topic:{id:"282",title:"Biomedical Engineering",slug:"technology-biomedical-engineering",parent:{id:"24",title:"Technology",slug:"technology"},numberOfBooks:8,numberOfSeries:0,numberOfAuthorsAndEditors:173,numberOfWosCitations:122,numberOfCrossrefCitations:128,numberOfDimensionsCitations:284,videoUrl:null,fallbackUrl:null,description:null},booksByTopicFilter:{topicId:"282",sort:"-publishedDate",limit:12,offset:0},booksByTopicCollection:[{type:"book",id:"9973",title:"Data Acquisition",subtitle:"Recent Advances and Applications in Biomedical Engineering",isOpenForSubmission:!1,hash:"75ea6cdd241216c9db28aa734ab34446",slug:"data-acquisition-recent-advances-and-applications-in-biomedical-engineering",bookSignature:"Bartłomiej Płaczek",coverURL:"https://cdn.intechopen.com/books/images_new/9973.jpg",editedByType:"Edited by",editors:[{id:"313277",title:"Dr.",name:"Bartłomiej",middleName:null,surname:"Płaczek",slug:"bartlomiej-placzek",fullName:"Bartłomiej Płaczek"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9048",title:"Current and Future Aspects of Nanomedicine",subtitle:null,isOpenForSubmission:!1,hash:"c34656bf6a7c08401e1108338c2a1bf6",slug:"current-and-future-aspects-of-nanomedicine",bookSignature:"Islam Ahmed Hamed Khalil",coverURL:"https://cdn.intechopen.com/books/images_new/9048.jpg",editedByType:"Edited by",editors:[{id:"226598",title:"Dr.",name:"Islam",middleName:null,surname:"A. 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Dobrzański"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5874",title:"Structural Health Monitoring",subtitle:"Measurement Methods and Practical Applications",isOpenForSubmission:!1,hash:"72f61895d84252f6f5b92b7625741743",slug:"structural-health-monitoring-measurement-methods-and-practical-applications",bookSignature:"Moises Rivas-Lopez, Wendy Flores Fuentes and Oleg Sergiyenko",coverURL:"https://cdn.intechopen.com/books/images_new/5874.jpg",editedByType:"Edited by",editors:[{id:"178178",title:"Dr.",name:"Moises",middleName:null,surname:"Rivas-Lopez",slug:"moises-rivas-lopez",fullName:"Moises Rivas-Lopez"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1649",title:"Electrostatics",subtitle:null,isOpenForSubmission:!1,hash:"c0630d15c7e3fc8f85f239750051ef7f",slug:"electrostatics",bookSignature:"Huseyin Canbolat",coverURL:"https://cdn.intechopen.com/books/images_new/1649.jpg",editedByType:"Edited by",editors:[{id:"5887",title:"Dr.",name:"Hüseyin",middleName:null,surname:"Canbolat",slug:"huseyin-canbolat",fullName:"Hüseyin Canbolat"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],booksByTopicTotal:8,seriesByTopicCollection:[],seriesByTopicTotal:0,mostCitedChapters:[{id:"62943",doi:"10.5772/intechopen.80238",title:"Silver Nanoparticles as Multi-Functional Drug Delivery Systems",slug:"silver-nanoparticles-as-multi-functional-drug-delivery-systems",totalDownloads:3469,totalCrossrefCites:25,totalDimensionsCites:57,abstract:"Nanoparticles can surmount some essential problems of conventional small molecules or biomacromolecules (e.g., DNA, RNA, and protein) used in some diseases by allowing targeted delivery and overcome through biological barriers. Recently, silver nanoparticles have been harnessed as delivery vehicles for therapeutic agents, including antisense oligonucleotides, and other small molecules. Silver is the most profit-oriented precious metal used in the preparation of nanoparticles and nanomaterials because of its antibacterial, antiviral, antifungal, antioxidant and unusually enhanced physicochemical properties compared to the bulk material such as optical, thermal, electrical, and catalytic properties. Small silver nanoparticles offer many advantages as drug carriers, including adjustable size and shape, enhanced stability of surface-bound nucleic acids, high-density surface ligand attachment, transmembrane delivery without harsh transfection agents, protection of the attached therapeutics from degradation, and potential for improved timed/controlled intracellular drug-delivery. Plant-mediated synthesis of silver nanoparticles is gaining interest due to its inexpensiveness, providing a healthier work environment, and protecting human health leading to lessening waste and safer products. The chapter presents the essential physicochemical characteristics, antibacterial, and anticancer properties which silver nanoparticles obtained by plant-mediated methods possess, and their application as drug-delivery systems with a critical view on the possible toxicity on the human body.",book:{id:"7437",slug:"nanomedicines",title:"Nanomedicines",fullTitle:"Nanomedicines"},signatures:"Nadezhda Ivanova, Viliana Gugleva, Mirena Dobreva, Ivaylo\nPehlivanov, Stefan Stefanov and Velichka Andonova",authors:[{id:"202958",title:"Dr.",name:"Velichka",middleName:null,surname:"Andonova",slug:"velichka-andonova",fullName:"Velichka Andonova"},{id:"265332",title:"MSc.",name:"Nadezhda",middleName:null,surname:"Ivanova",slug:"nadezhda-ivanova",fullName:"Nadezhda Ivanova"},{id:"265333",title:"MSc.",name:"Viliana",middleName:null,surname:"Gugleva",slug:"viliana-gugleva",fullName:"Viliana Gugleva"},{id:"265334",title:"MSc.",name:"Mirena",middleName:null,surname:"Dobreva",slug:"mirena-dobreva",fullName:"Mirena Dobreva"},{id:"265335",title:"Mr.",name:"Stefan",middleName:"Radnev",surname:"Stefanov",slug:"stefan-stefanov",fullName:"Stefan Stefanov"},{id:"265336",title:"MSc.",name:"Ivaylo",middleName:null,surname:"Pehlivanov",slug:"ivaylo-pehlivanov",fullName:"Ivaylo Pehlivanov"}]},{id:"63035",doi:"10.5772/intechopen.80225",title:"Biological Function of Exosomes as Diagnostic Markers and Therapeutic Delivery Vehicles in Carcinogenesis and Infectious Diseases",slug:"biological-function-of-exosomes-as-diagnostic-markers-and-therapeutic-delivery-vehicles-in-carcinoge",totalDownloads:2209,totalCrossrefCites:12,totalDimensionsCites:23,abstract:"Exosomes are nano-sized vesicles that are formed during inward budding of multivesicular bodies and the maturation of endosomes. They are secreted by almost all cell types under normal, pathological, and physiological conditions. They are found in mostly all biological fluids, such as breast milk, blood, urine, and semen. Exosomes are involved in cell-to-cell communication through the biological transfer of lipids, proteins, DNAs, RNAs, mRNAs, and miRNAs. Exosomes are enriched in tetraspanins, enzymes, heat shock proteins, and membrane trafficking proteins. There are numerous techniques that are used to isolate, purify, and characterize exosomes from biofluids. Isolation/purification techniques include ultracentrifugation, filtration, sucrose density gradient centrifugation, etc. Characterization techniques include flow cytometry, electron microscopy, NanoSight tracking analysis, Western blot, etc. These techniques are often used to help principal investigators understand the properties and biological functions of exosomes. However, some of these techniques can be very complicated and challenging, resulting in various drawbacks. Exosomes can be used as potential carriers for therapeutics. Thus, they can serve as biomarkers to diagnosis various diseases that are associated with cancer, genetics, viruses, bacteria, parasites, etc. Therefore, with advances in science and technology, many innovative techniques have been established to exploit the biological properties of exosomes.",book:{id:"7437",slug:"nanomedicines",title:"Nanomedicines",fullTitle:"Nanomedicines"},signatures:"Brennetta J. Crenshaw, Brian Sims and Qiana L. Matthews",authors:[{id:"254038",title:"Ph.D.",name:"Qiana",middleName:null,surname:"Matthews",slug:"qiana-matthews",fullName:"Qiana Matthews"},{id:"254039",title:"Ms.",name:"Brennetta",middleName:null,surname:"Crenshaw",slug:"brennetta-crenshaw",fullName:"Brennetta Crenshaw"},{id:"266042",title:"Dr.",name:"Brian",middleName:null,surname:"Sims",slug:"brian-sims",fullName:"Brian Sims"}]},{id:"56634",doi:"10.5772/intechopen.70122",title:"Biomaterials and Stem Cells: Promising Tools in Tissue Engineering and Biomedical Applications",slug:"biomaterials-and-stem-cells-promising-tools-in-tissue-engineering-and-biomedical-applications",totalDownloads:1584,totalCrossrefCites:7,totalDimensionsCites:15,abstract:"Biomaterial sciences and tissue engineering approaches are currently fundamental strategies for the development of regenerative medicine. Stem cells (SCs) are a unique cell type capable of self‐renewal and reconstructing damaged tissues. At the present time, adult SCs isolated from postnatal tissues are widely used in clinical applications. Their characteristics such as a multipotent differentiation capacity and immunomodulatory activity make them a promising tool to use in patients. Modern material technologies allow for the development of innovative biomaterials that closely correspond to requirements of the current biomedical application. Biomaterials, such as ceramics and metals, are already used as implants to replace or improve the functionality of the damaged tissue or organ. However, the continuous development of modern technology opens new insights of polymeric and smart material applications. Moreover, biomaterials may enhance the SCs biological activity and their implementation by establishing a specific microenvironment mimicking natural cell niche. Thus, the synergistic advancement in the fields of biomaterial and medical sciences constitutes a challenge for the development of effective therapies in humans including combined applications of novel biomaterials and SCs populations.",book:{id:"5951",slug:"biomaterials-in-regenerative-medicine",title:"Biomaterials in Regenerative Medicine",fullTitle:"Biomaterials in Regenerative Medicine"},signatures:"Małgorzata Sekuła and Ewa K. Zuba‐Surma",authors:[{id:"202773",title:"Prof.",name:"Ewa",middleName:null,surname:"Zuba-Surma",slug:"ewa-zuba-surma",fullName:"Ewa Zuba-Surma"},{id:"202775",title:"Dr.",name:"Malgorzata",middleName:null,surname:"Sekula",slug:"malgorzata-sekula",fullName:"Malgorzata Sekula"}]},{id:"56100",doi:"10.5772/intechopen.69718",title:"Properties of Co-Cr Dental Alloys Fabricated Using Additive Technologies",slug:"properties-of-co-cr-dental-alloys-fabricated-using-additive-technologies",totalDownloads:1613,totalCrossrefCites:5,totalDimensionsCites:14,abstract:"The aim of the present paper is to make a review of the properties of dental alloys, fabricated using Additive Technologies (AT). The microstructure and mechanical properties of Co-Cr alloys as well as the accuracy and surface roughness of dental constructions are discussed. In dentistry two different approaches can be applied for production of metal frameworks using AT. According to the first one the wax/polymeric cast patterns are fabricated by 3D printing, than the constructions are cast from dental alloy with as-printed patterns. Through the second one the metal framework is manufactured form powder alloy directly from 3D virtual model by Selective Electron Beam Melting (SEBM) or Selective Laser Melting (SLM). The microstructure and mechanical properties of Co-Cr dental alloys, cast using 3D printed patterns, are typical for cast alloys. Their dimensional and adjustment accuracy is higher comparing to constructions, produced by traditional lost-wax casting or by SLM. The surface roughness is higher than that of the samples, cast by conventional technology, but lower comparing to the SLM objects. The microstructure of SLM Co-Cr dental alloys is fine grained and more homogeneous comparing that of the cast alloys, which defines higher hardness and mechanical properties, higher wear and corrosion resistance.",book:{id:"5951",slug:"biomaterials-in-regenerative-medicine",title:"Biomaterials in Regenerative Medicine",fullTitle:"Biomaterials in Regenerative Medicine"},signatures:"Tsanka Dikova",authors:[{id:"205539",title:"Dr.",name:"Tsanka",middleName:null,surname:"Dikova",slug:"tsanka-dikova",fullName:"Tsanka Dikova"}]},{id:"31995",doi:"10.5772/35937",title:"Air-Solids Flow Measurement Using Electrostatic Techniques",slug:"air-solids-flow-measurement-using-electrostatic-techniques",totalDownloads:5015,totalCrossrefCites:6,totalDimensionsCites:11,abstract:null,book:{id:"1649",slug:"electrostatics",title:"Electrostatics",fullTitle:"Electrostatics"},signatures:"Jianyong Zhang",authors:[{id:"106435",title:"Dr.",name:"Jianyong",middleName:null,surname:"Zhang",slug:"jianyong-zhang",fullName:"Jianyong Zhang"}]}],mostDownloadedChaptersLast30Days:[{id:"69398",title:"New Generation Peptide-Based Vaccine Prototype",slug:"new-generation-peptide-based-vaccine-prototype",totalDownloads:1157,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"Synthetic peptide-based vaccine prototypes are the future potential vaccination. Antigens, which belong to minimal microbial component and produce antibodies such as peptides and polysaccharides, can promote long-term protection against pathogens that can cause infectious diseases. Production of peptides becomes simple with solid phase peptide synthesis and microwave-assisted solid phase peptide synthesis using automatic synthesizers. The use of synthetic peptides was approved by the health authorities for vaccine design. Peptides are themselves very weak immunogens and need adjuvants to provide an effective autoimmune response. For this reason, peptide antigens are conjugated with biopolymers and loaded with nanoparticles. The toxicity of vaccine prototypes is evaluated in cell culture, and non-toxic prototypes are selected for vaccinating experimental animals. The most effective peptide-based vaccine prototype is determined as the one with the highest antibody level. The goal of this book chapter is to illustrate the use of peptides vaccine systems and present their opportunities with their future development.",book:{id:"9048",slug:"current-and-future-aspects-of-nanomedicine",title:"Current and Future Aspects of Nanomedicine",fullTitle:"Current and Future Aspects of Nanomedicine"},signatures:"Öznur Özge Özcan, Mesut Karahan, Palanirajan Vijayaraj Kumar, Shen Leng Tan and Yi Na Tee",authors:[{id:"305705",title:"Dr.",name:"Mesut",middleName:null,surname:"Karahan",slug:"mesut-karahan",fullName:"Mesut Karahan"},{id:"310005",title:"MSc.",name:"Öznur Özge",middleName:null,surname:"Özcan",slug:"oznur-ozge-ozcan",fullName:"Öznur Özge Özcan"},{id:"310006",title:"Prof.",name:"Palanirajan Vijayaraj",middleName:null,surname:"Kumar",slug:"palanirajan-vijayaraj-kumar",fullName:"Palanirajan Vijayaraj Kumar"},{id:"310008",title:"MSc.",name:"Shen Leng",middleName:null,surname:"Tan",slug:"shen-leng-tan",fullName:"Shen Leng Tan"},{id:"310009",title:"MSc.",name:"Yi Na",middleName:null,surname:"Tee",slug:"yi-na-tee",fullName:"Yi Na Tee"}]},{id:"56614",title:"Systematic Study of Ethylene-Vinyl Acetate (EVA) in the Manufacturing of Protector Devices for the Orofacial System",slug:"systematic-study-of-ethylene-vinyl-acetate-eva-in-the-manufacturing-of-protector-devices-for-the-oro",totalDownloads:1706,totalCrossrefCites:3,totalDimensionsCites:4,abstract:"Fracture of facial bones and dental elements, and laceration of soft tissue, have increased in sports over recent years. Dentist is the only professional responsible for the mouth protection design, the knowledge about suitable materials is essential. EVA is a thermoplastic material, available in the market, easy of handling and processing, and low-cost. However, it is important to understand the mechanical properties and ability to absorb and to dissipate the impact energy, when this material is submitted to different environments, such as oral cavity with saliva and different temperatures. This chapter show provides a systematic evaluation of the EVA application in orofacial protectors while focusing on sports. The research comprises two aspects: experimental tests and numerical analyses. During experimental tests, EVA was analyzed in special buccal conditions, concerning temperature and presence of saliva. Regarding the presence of saliva, more specific studies about its influence on the mechanical behavior of EVA were performed. In the numerical analyses of the EVA orofacial protector, the studies focused on its effect on the nasal bone integrity, and in the zygomatic bone protection. However, life cycle should be analyzed, since its performance deteriorates over time. Mainly due to the saliva-originated changes to the EVA mechanical characteristics, it can behave as a rigid material. For facial protection, a better performance is obtained with a combination of rigid and soft EVA material. According to the experimental and numerical results from a systematic study of EVA, its application to orofacial protection can be considered satisfactory.",book:{id:"5951",slug:"biomaterials-in-regenerative-medicine",title:"Biomaterials in Regenerative Medicine",fullTitle:"Biomaterials in Regenerative Medicine"},signatures:"Reinaldo Brito e Dias, Neide Pena Coto, Gilmar Ferreira Batalha and\nLarissa Driemeier",authors:[{id:"204968",title:"Dr.",name:"Neide",middleName:null,surname:"Pena Coto",slug:"neide-pena-coto",fullName:"Neide Pena Coto"}]},{id:"63035",title:"Biological Function of Exosomes as Diagnostic Markers and Therapeutic Delivery Vehicles in Carcinogenesis and Infectious Diseases",slug:"biological-function-of-exosomes-as-diagnostic-markers-and-therapeutic-delivery-vehicles-in-carcinoge",totalDownloads:2209,totalCrossrefCites:12,totalDimensionsCites:23,abstract:"Exosomes are nano-sized vesicles that are formed during inward budding of multivesicular bodies and the maturation of endosomes. They are secreted by almost all cell types under normal, pathological, and physiological conditions. They are found in mostly all biological fluids, such as breast milk, blood, urine, and semen. Exosomes are involved in cell-to-cell communication through the biological transfer of lipids, proteins, DNAs, RNAs, mRNAs, and miRNAs. Exosomes are enriched in tetraspanins, enzymes, heat shock proteins, and membrane trafficking proteins. There are numerous techniques that are used to isolate, purify, and characterize exosomes from biofluids. Isolation/purification techniques include ultracentrifugation, filtration, sucrose density gradient centrifugation, etc. Characterization techniques include flow cytometry, electron microscopy, NanoSight tracking analysis, Western blot, etc. These techniques are often used to help principal investigators understand the properties and biological functions of exosomes. However, some of these techniques can be very complicated and challenging, resulting in various drawbacks. Exosomes can be used as potential carriers for therapeutics. Thus, they can serve as biomarkers to diagnosis various diseases that are associated with cancer, genetics, viruses, bacteria, parasites, etc. Therefore, with advances in science and technology, many innovative techniques have been established to exploit the biological properties of exosomes.",book:{id:"7437",slug:"nanomedicines",title:"Nanomedicines",fullTitle:"Nanomedicines"},signatures:"Brennetta J. Crenshaw, Brian Sims and Qiana L. Matthews",authors:[{id:"254038",title:"Ph.D.",name:"Qiana",middleName:null,surname:"Matthews",slug:"qiana-matthews",fullName:"Qiana Matthews"},{id:"254039",title:"Ms.",name:"Brennetta",middleName:null,surname:"Crenshaw",slug:"brennetta-crenshaw",fullName:"Brennetta Crenshaw"},{id:"266042",title:"Dr.",name:"Brian",middleName:null,surname:"Sims",slug:"brian-sims",fullName:"Brian Sims"}]},{id:"64869",title:"Transethosomes and Nanoethosomes: Recent Approach on Transdermal Drug Delivery System",slug:"transethosomes-and-nanoethosomes-recent-approach-on-transdermal-drug-delivery-system",totalDownloads:1630,totalCrossrefCites:3,totalDimensionsCites:9,abstract:"In the past few decades, an emerging drug delivery system that came into light is transdermal drug delivery system. It has become the talk of the town in the field of drug delivery because of its better and easy accessibility. Though it is one of the attractive routes, transport of drug through the skin has remained a challenge. To overcome the challenge, vesicular system has been adopted so as to have better skin permeation of bioactive agents. Vesicular system like liposome has shown inefficiency to cross the layers of skin. Then transethosomes and nanoethosomes are employed for delivering drug into the deeper layer of skin. Nanoethosomes and transethosomes have same composition that is water, ethanol and phospholipid. Transethosome contains edge activator additionally. Due to the presence of ethanol and edge activator, it displayed enhanced skin permeation. Vesicular system gives a better patient compliance, being a non-invasive method of drug administration. In this chapter, we attempted to provide brief information about methods of preparation, characterization and pharmaceutical uses of nanoethosomes and transethosomes.",book:{id:"7437",slug:"nanomedicines",title:"Nanomedicines",fullTitle:"Nanomedicines"},signatures:"Koushlesh Kumar Mishra, Chanchal Deep Kaur, Shekhar Verma, Anil\nKumar Sahu, Deepak Kumar Dash, Pankaj Kashyap and Saraswati\nPrasad Mishra",authors:[{id:"204256",title:"Dr.",name:"Anil",middleName:"Kumar",surname:"Kumar Sahu",slug:"anil-kumar-sahu",fullName:"Anil Kumar Sahu"},{id:"211230",title:"Mr.",name:"Pankaj",middleName:null,surname:"Kashyap",slug:"pankaj-kashyap",fullName:"Pankaj Kashyap"},{id:"221419",title:"Mr.",name:"Koushlesh",middleName:null,surname:"Mishra",slug:"koushlesh-mishra",fullName:"Koushlesh Mishra"},{id:"221420",title:"Mr.",name:"Sarawati Prasad",middleName:null,surname:"Mishra",slug:"sarawati-prasad-mishra",fullName:"Sarawati Prasad Mishra"},{id:"250558",title:"Dr.",name:"Deepak Kumar",middleName:null,surname:"Dash",slug:"deepak-kumar-dash",fullName:"Deepak Kumar Dash"},{id:"270359",title:"Dr.",name:"Chanchal Deep",middleName:null,surname:"Kaur",slug:"chanchal-deep-kaur",fullName:"Chanchal Deep Kaur"},{id:"270998",title:"Prof.",name:"Shekhar",middleName:null,surname:"Verma",slug:"shekhar-verma",fullName:"Shekhar Verma"}]},{id:"68412",title:"Self-Emulsifying Drug Delivery Systems: Easy to Prepare Multifunctional Vectors for Efficient Oral Delivery",slug:"self-emulsifying-drug-delivery-systems-easy-to-prepare-multifunctional-vectors-for-efficient-oral-de",totalDownloads:1135,totalCrossrefCites:2,totalDimensionsCites:3,abstract:"Self-emulsifying drug delivery systems (SEDDS) have been mainly investigated to enhance the oral bioavailability of drugs belonging to class II of the Biopharmaceutics Classification System. However, in the past few years, they have shown promising outcomes in the oral delivery of various types of therapeutic agents. In this chapter, we discuss the recent progress in the application of SEDDS for oral delivery of protein therapeutics and genetic materials. The role of SEDDS in enhancing the oral bioavailability of P-glycoprotein and cytochrome P450 3A4 substrate drugs is also highlighted. Also, we discuss the most critical evaluation criteria of SEDDS. Additionally, we summarize various solidification techniques employed to transform liquid SEDDS to the more stable solid self-emulsifying drug delivery systems (s-SEDDS) that are associated with high patient compliance. This chapter provides a comprehensive approach to develop high utility SEDDS and their further transformation into s-SEDDS.",book:{id:"9048",slug:"current-and-future-aspects-of-nanomedicine",title:"Current and Future Aspects of Nanomedicine",fullTitle:"Current and Future Aspects of Nanomedicine"},signatures:"Khaled AboulFotouh, Ayat A. Allam and Mahmoud El-Badry",authors:[{id:"299910",title:"Prof.",name:"Mahmoud",middleName:null,surname:"El-Badry",slug:"mahmoud-el-badry",fullName:"Mahmoud El-Badry"},{id:"299914",title:"MSc.",name:"Khaled",middleName:null,surname:"Abulftooh",slug:"khaled-abulftooh",fullName:"Khaled Abulftooh"},{id:"299916",title:"Dr.",name:"Ayat",middleName:null,surname:"Allam",slug:"ayat-allam",fullName:"Ayat Allam"}]}],onlineFirstChaptersFilter:{topicId:"282",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:0,limit:8,total:null},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:89,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:104,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:31,numberOfPublishedChapters:314,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:11,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:141,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:113,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:105,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:19,numberOfOpenTopics:2,numberOfUpcomingTopics:1,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:5,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:14,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:null,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:"7",title:"Biomedical Engineering",doi:"10.5772/intechopen.71985",issn:"2631-5343",scope:"Biomedical Engineering is one of the fastest-growing interdisciplinary branches of science and industry. The combination of electronics and computer science with biology and medicine has improved patient diagnosis, reduced rehabilitation time, and helped to facilitate a better quality of life. Nowadays, all medical imaging devices, medical instruments, or new laboratory techniques result from the cooperation of specialists in various fields. The series of Biomedical Engineering books covers such areas of knowledge as chemistry, physics, electronics, medicine, and biology. 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Dr. Koprowski has authored more than a hundred research papers with dozens in impact factor (IF) journals and has authored or co-authored six books. Additionally, he is the author of several national and international patents in the field of biomedical devices and imaging. Since 2011, he has been a reviewer of grants and projects (including EU projects) in biomedical engineering.",institutionString:null,institution:{name:"University of Silesia",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:3,paginationItems:[{id:"7",title:"Bioinformatics and Medical Informatics",coverUrl:"https://cdn.intechopen.com/series_topics/covers/7.jpg",isOpenForSubmission:!0,editor:{id:"351533",title:"Dr.",name:"Slawomir",middleName:null,surname:"Wilczynski",slug:"slawomir-wilczynski",fullName:"Slawomir Wilczynski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035U1loQAC/Profile_Picture_1630074514792",biography:"Professor Sławomir Wilczyński, Head of the Chair of Department of Basic Biomedical Sciences, Faculty of Pharmaceutical Sciences, Medical University of Silesia in Katowice, Poland. 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He completed a one-year Post-Doctoral Fellowship awarded by the DFAIT (Foreign Affairs and International Trade Canada) at the Institute of Biomedical Engineering of the University of New Brunswick (Canada) in 2010. Currently, he is Professor in the Faculty of Electrical Engineering (UFU). He has authored and co-authored more than 200 peer-reviewed publications in Biomedical Engineering. He has been a researcher of The National Council for Scientific and Technological Development (CNPq-Brazil) since 2009. He has served as an ad-hoc consultant for CNPq, CAPES (Coordination for the Improvement of Higher Education Personnel), FINEP (Brazilian Innovation Agency), and other funding bodies on several occasions. He was the Secretary of the Brazilian Society of Biomedical Engineering (SBEB) from 2015 to 2016, President of SBEB (2017-2018) and Vice-President of SBEB (2019-2020). He was the head of the undergraduate program in Biomedical Engineering of the Federal University of Uberlândia (2015 - June/2019) and the head of the Centre for Innovation and Technology Assessment in Health (NIATS/UFU) since 2010. He is the head of the Postgraduate Program in Biomedical Engineering (UFU, July/2019 - to date). He was the secretary of the Parkinson's Disease Association of Uberlândia (2018-2019). Dr. Andrade's primary area of research is focused towards getting information from the neuromuscular system to understand its strategies of organization, adaptation and controlling in the context of motor neuron diseases. His research interests include Biomedical Signal Processing and Modelling, Assistive Technology, Rehabilitation Engineering, Neuroengineering and Parkinson's Disease.",institutionString:null,institution:{name:"Federal University of Uberlândia",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null},{id:"9",title:"Biotechnology - Biosensors, Biomaterials and Tissue Engineering",coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",isOpenForSubmission:!0,editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",slug:"luis-villarreal-gomez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",biography:"Dr. Luis Villarreal is a research professor from the Facultad de Ciencias de la Ingeniería y Tecnología, Universidad Autónoma de Baja California, Tijuana, Baja California, México. Dr. Villarreal is the editor in chief and founder of the Revista de Ciencias Tecnológicas (RECIT) (https://recit.uabc.mx/) and is a member of several editorial and reviewer boards for numerous international journals. He has published more than thirty international papers and reviewed more than ninety-two manuscripts. 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His fields of interest are anterior segment disease, keratoconus, glaucoma, corneal dystrophies, and cataracts. His research topics include\nintraocular lens power calculation, eye modification induced by refractive surgery, glaucoma progression, and validation of new diagnostic devices in ophthalmology. \nHe has published more than 100 papers in international and Italian scientific journals, more than 60 in journals with impact factors, and chapters in international and Italian books. He has also edited two international books and authored more than 150 communications or posters for the most important international and Italian ophthalmology conferences.",institutionString:'University of Campania "Luigi Vanvitelli"',institution:{name:'University of Campania "Luigi Vanvitelli"',institutionURL:null,country:{name:"Italy"}}}]},{type:"book",id:"7560",title:"Non-Invasive Diagnostic Methods",subtitle:"Image Processing",coverURL:"https://cdn.intechopen.com/books/images_new/7560.jpg",slug:"non-invasive-diagnostic-methods-image-processing",publishedDate:"December 19th 2018",editedByType:"Edited by",bookSignature:"Mariusz Marzec and Robert Koprowski",hash:"d92fd8cf5a90a47f2b8a310837a5600e",volumeInSeries:3,fullTitle:"Non-Invasive Diagnostic Methods - Image Processing",editors:[{id:"253468",title:"Dr.",name:"Mariusz",middleName:null,surname:"Marzec",slug:"mariusz-marzec",fullName:"Mariusz Marzec",profilePictureURL:"https://mts.intechopen.com/storage/users/253468/images/system/253468.png",biography:"An assistant professor at Department of Biomedical Computer Systems, at Institute of Computer Science, Silesian University in Katowice. Scientific interests: computer analysis and processing of images, biomedical images, databases and programming languages. He is an author and co-author of scientific publications covering analysis and processing of biomedical images and development of database systems.",institutionString:"University of Silesia",institution:null}]},{type:"book",id:"6843",title:"Biomechanics",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/6843.jpg",slug:"biomechanics",publishedDate:"January 30th 2019",editedByType:"Edited by",bookSignature:"Hadi Mohammadi",hash:"85132976010be1d7f3dbd88662b785e5",volumeInSeries:4,fullTitle:"Biomechanics",editors:[{id:"212432",title:"Prof.",name:"Hadi",middleName:null,surname:"Mohammadi",slug:"hadi-mohammadi",fullName:"Hadi Mohammadi",profilePictureURL:"https://mts.intechopen.com/storage/users/212432/images/system/212432.jpeg",biography:"Dr. Hadi Mohammadi is a biomedical engineer with hands-on experience in the design and development of many engineering structures and medical devices through various projects that he has been involved in over the past twenty years. Dr. Mohammadi received his BSc. and MSc. degrees in Mechanical Engineering from Sharif University of Technology, Tehran, Iran, and his PhD. degree in Biomedical Engineering (biomaterials) from the University of Western Ontario. He was a postdoctoral trainee for almost four years at University of Calgary and Harvard Medical School. He is an industry innovator having created the technology to produce lifelike synthetic platforms that can be used for the simulation of almost all cardiovascular reconstructive surgeries. He’s been heavily involved in the design and development of cardiovascular devices and technology for the past 10 years. He is currently an Assistant Professor with the University of British Colombia, Canada.",institutionString:"University of British Columbia",institution:{name:"University of British Columbia",institutionURL:null,country:{name:"Canada"}}}]}]},openForSubmissionBooks:{paginationCount:3,paginationItems:[{id:"11601",title:"Econometrics - Recent Advances and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/11601.jpg",hash:"bc8ab49e2cf436c217a49ca8c12a22eb",secondStepPassed:!0,currentStepOfPublishingProcess:3,submissionDeadline:"May 13th 2022",isOpenForSubmission:!0,editors:[{id:"452331",title:"Dr.",name:"Brian",surname:"Sloboda",slug:"brian-sloboda",fullName:"Brian Sloboda"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{id:"12141",title:"Leadership - Advancing Great Leadership Practices and Good Leaders",coverURL:"https://cdn.intechopen.com/books/images_new/12141.jpg",hash:"85f77453916f1d80d80d88ee4fd2f2d1",secondStepPassed:!1,currentStepOfPublishingProcess:2,submissionDeadline:"July 1st 2022",isOpenForSubmission:!0,editors:[{id:"420133",title:"Dr.",name:"Joseph",surname:"Crawford",slug:"joseph-crawford",fullName:"Joseph Crawford"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{id:"12139",title:"Global Market and Trade",coverURL:"https://cdn.intechopen.com/books/images_new/12139.jpg",hash:"fa34af07c3a9657fa670404202f8cba5",secondStepPassed:!1,currentStepOfPublishingProcess:2,submissionDeadline:"July 21st 2022",isOpenForSubmission:!0,editors:[{id:"243649",title:"Dr.Ing.",name:"Ireneusz",surname:"Miciuła",slug:"ireneusz-miciula",fullName:"Ireneusz Miciuła"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null}]},onlineFirstChapters:{paginationCount:43,paginationItems:[{id:"82374",title:"The Potential of the Purinergic System as a Therapeutic Target of Natural Compounds in Cutaneous Melanoma",doi:"10.5772/intechopen.105457",signatures:"Gilnei Bruno da Silva, Daiane Manica, Marcelo Moreno and Margarete Dulce Bagatini",slug:"the-potential-of-the-purinergic-system-as-a-therapeutic-target-of-natural-compounds-in-cutaneous-mel",totalDownloads:4,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Purinergic System",coverURL:"https://cdn.intechopen.com/books/images_new/10801.jpg",subseries:{id:"17",title:"Metabolism"}}},{id:"82103",title:"The Role of Endoplasmic Reticulum Stress and Its Regulation in the Progression of Neurological and Infectious Diseases",doi:"10.5772/intechopen.105543",signatures:"Mary Dover, Michael Kishek, Miranda Eddins, Naneeta Desar, Ketema Paul and Milan Fiala",slug:"the-role-of-endoplasmic-reticulum-stress-and-its-regulation-in-the-progression-of-neurological-and-i",totalDownloads:5,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Updates on Endoplasmic Reticulum",coverURL:"https://cdn.intechopen.com/books/images_new/11674.jpg",subseries:{id:"14",title:"Cell and Molecular Biology"}}},{id:"82212",title:"Protein Prenylation and Their Applications",doi:"10.5772/intechopen.104700",signatures:"Khemchand R. 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She is now a lecturer at the University of Witwatersrand, South Africa, and a principal researcher at the Health Economics and Epidemiology Research Office (HE2RO), South Africa. Dr. Moolla holds a Ph.D. in Psychology with her research being focused on mental health and resilience. In her professional work capacity, her research has further expanded into the fields of early childhood development, mental health, the HIV and TB care cascades, as well as COVID. She is also a UNESCO-trained International Bioethics Facilitator.",institutionString:"University of the Witwatersrand",institution:{name:"University of the Witwatersrand",country:{name:"South Africa"}}},{id:"342152",title:"Dr.",name:"Santo",middleName:null,surname:"Grace Umesh",slug:"santo-grace-umesh",fullName:"Santo Grace Umesh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/342152/images/16311_n.jpg",biography:null,institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"333647",title:"Dr.",name:"Shreya",middleName:null,surname:"Kishore",slug:"shreya-kishore",fullName:"Shreya Kishore",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333647/images/14701_n.jpg",biography:"Dr. Shreya Kishore completed her Bachelor in Dental Surgery in Chettinad Dental College and Research Institute, Chennai, and her Master of Dental Surgery (Orthodontics) in Saveetha Dental College, Chennai. She is also Invisalign certified. She’s working as a Senior Lecturer in the Department of Orthodontics, SRM Dental College since November 2019. She is actively involved in teaching orthodontics to the undergraduates and the postgraduates. Her clinical research topics include new orthodontic brackets, fixed appliances and TADs. She’s published 4 articles in well renowned indexed journals and has a published patency of her own. Her private practice is currently limited to orthodontics and works as a consultant in various clinics.",institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"323731",title:"Prof.",name:"Deepak M.",middleName:"Macchindra",surname:"Vikhe",slug:"deepak-m.-vikhe",fullName:"Deepak M. Vikhe",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/323731/images/13613_n.jpg",biography:"Dr Deepak M.Vikhe .\n\n\t\n\tDr Deepak M.Vikhe , completed his Masters & PhD in Prosthodontics from Rural Dental College, Loni securing third rank in the Pravara Institute of Medical Sciences Deemed University. He was awarded Dr.G.C.DAS Memorial Award for Research on Implants at 39th IPS conference Dubai (U A E).He has two patents under his name. He has received Dr.Saraswati medal award for best research for implant study in 2017.He has received Fully funded scholarship to Spain ,university of Santiago de Compostela. He has completed fellowship in Implantlogy from Noble Biocare. \nHe has attended various conferences and CDE programmes and has national publications to his credit. His field of interest is in Implant supported prosthesis. Presently he is working as a associate professor in the Dept of Prosthodontics, Rural Dental College, Loni and maintains a successful private practice specialising in Implantology at Rahata.\n\nEmail: drdeepak_mvikhe@yahoo.com..................",institutionString:null,institution:{name:"Pravara Institute of Medical Sciences",country:{name:"India"}}},{id:"204110",title:"Dr.",name:"Ahmed A.",middleName:null,surname:"Madfa",slug:"ahmed-a.-madfa",fullName:"Ahmed A. Madfa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204110/images/system/204110.jpg",biography:"Dr. Madfa is currently Associate Professor of Endodontics at Thamar University and a visiting lecturer at Sana'a University and University of Sciences and Technology. He has more than 6 years of experience in teaching. His research interests include root canal morphology, functionally graded concept, dental biomaterials, epidemiology and dental education, biomimetic restoration, finite element analysis and endodontic regeneration. Dr. Madfa has numerous international publications, full articles, two patents, a book and a book chapter. Furthermore, he won 14 international scientific awards. Furthermore, he is involved in many academic activities ranging from editorial board member, reviewer for many international journals and postgraduate students' supervisor. Besides, I deliver many courses and training workshops at various scientific events. Dr. Madfa also regularly attends international conferences and holds administrative positions (Deputy Dean of the Faculty for Students’ & Academic Affairs and Deputy Head of Research Unit).",institutionString:"Thamar University",institution:null},{id:"210472",title:"Dr.",name:"Nermin",middleName:"Mohammed Ahmed",surname:"Yussif",slug:"nermin-yussif",fullName:"Nermin Yussif",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/210472/images/system/210472.jpg",biography:"Dr. Nermin Mohammed Ahmed Yussif is working at the Faculty of dentistry, University for October university for modern sciences and arts (MSA). Her areas of expertise include: periodontology, dental laserology, oral implantology, periodontal plastic surgeries, oral mesotherapy, nutrition, dental pharmacology. She is an editor and reviewer in numerous international journals.",institutionString:"MSA University",institution:null},{id:"204606",title:"Dr.",name:"Serdar",middleName:null,surname:"Gözler",slug:"serdar-gozler",fullName:"Serdar Gözler",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204606/images/system/204606.jpeg",biography:"Dr. Serdar Gözler has completed his undergraduate studies at the Marmara University Faculty of Dentistry in 1978, followed by an assistantship in the Prosthesis Department of Dicle University Faculty of Dentistry. Starting his PhD work on non-resilient overdentures with Assoc. Prof. Hüsnü Yavuzyılmaz, he continued his studies with Prof. Dr. Gürbüz Öztürk of Istanbul University Faculty of Dentistry Department of Prosthodontics, this time on Gnatology. He attended training programs on occlusion, neurology, neurophysiology, EMG, radiology and biostatistics. In 1982, he presented his PhD thesis \\Gerber and Lauritzen Occlusion Analysis Techniques: Diagnosis Values,\\ at Istanbul University School of Dentistry, Department of Prosthodontics. As he was also working with Prof. Senih Çalıkkocaoğlu on The Physiology of Chewing at the same time, Gözler has written a chapter in Çalıkkocaoğlu\\'s book \\Complete Prostheses\\ entitled \\The Place of Neuromuscular Mechanism in Prosthetic Dentistry.\\ The book was published five times since by the Istanbul University Publications. Having presented in various conferences about occlusion analysis until 1998, Dr. Gözler has also decided to use the T-Scan II occlusion analysis method. Having been personally trained by Dr. Robert Kerstein on this method, Dr. Gözler has been lecturing on the T-Scan Occlusion Analysis Method in conferences both in Turkey and abroad. Dr. Gözler has various articles and presentations on Digital Occlusion Analysis methods. He is now Head of the TMD Clinic at Prosthodontic Department of Faculty of Dentistry , Istanbul Aydın University , Turkey.",institutionString:"Istanbul Aydin University",institution:{name:"Istanbul Aydın University",country:{name:"Turkey"}}},{id:"240870",title:"Ph.D.",name:"Alaa Eddin Omar",middleName:null,surname:"Al Ostwani",slug:"alaa-eddin-omar-al-ostwani",fullName:"Alaa Eddin Omar Al Ostwani",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/240870/images/system/240870.jpeg",biography:"Dr. Al Ostwani Alaa Eddin Omar received his Master in dentistry from Damascus University in 2010, and his Ph.D. in Pediatric Dentistry from Damascus University in 2014. Dr. Al Ostwani is an assistant professor and faculty member at IUST University since 2014. \nDuring his academic experience, he has received several awards including the scientific research award from the Union of Arab Universities, the Syrian gold medal and the international gold medal for invention and creativity. Dr. Al Ostwani is a Member of the International Association of Dental Traumatology and the Syrian Society for Research and Preventive Dentistry since 2017. He is also a Member of the Reviewer Board of International Journal of Dental Medicine (IJDM), and the Indian Journal of Conservative and Endodontics since 2016.",institutionString:"International University for Science and Technology.",institution:{name:"Islamic University of Science and Technology",country:{name:"India"}}},{id:"42847",title:"Dr.",name:"Belma",middleName:null,surname:"Işik Aslan",slug:"belma-isik-aslan",fullName:"Belma Işik Aslan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/42847/images/system/42847.jpg",biography:"Dr. Belma IşIk Aslan was born in 1976 in Ankara-TURKEY. After graduating from TED Ankara College in 1994, she attended to Gazi University, Faculty of Dentistry in Ankara. She completed her PhD in orthodontic education at Gazi University between 1999-2005. Dr. Işık Aslan stayed at the Providence Hospital Craniofacial Institude and Reconstructive Surgery in Michigan, USA for three months as an observer. She worked as a specialist doctor at Gazi University, Dentistry Faculty, Department of Orthodontics between 2005-2014. She was appointed as associate professor in January, 2014 and as professor in 2021. Dr. Işık Aslan still works as an instructor at the same faculty. She has published a total of 35 articles, 10 book chapters, 39 conference proceedings both internationally and nationally. Also she was the academic editor of the international book 'Current Advances in Orthodontics'. She is a member of the Turkish Orthodontic Society and Turkish Cleft Lip and Palate Society. She is married and has 2 children. Her knowledge of English is at an advanced level.",institutionString:"Gazi University Dentistry Faculty Department of Orthodontics",institution:null},{id:"178412",title:"Associate Prof.",name:"Guhan",middleName:null,surname:"Dergin",slug:"guhan-dergin",fullName:"Guhan Dergin",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178412/images/6954_n.jpg",biography:"Assoc. Prof. Dr. Gühan Dergin was born in 1973 in Izmit. He graduated from Marmara University Faculty of Dentistry in 1999. He completed his specialty of OMFS surgery in Marmara University Faculty of Dentistry and obtained his PhD degree in 2006. In 2005, he was invited as a visiting doctor in the Oral and Maxillofacial Surgery Department of the University of North Carolina, USA, where he went on a scholarship. Dr. Dergin still continues his academic career as an associate professor in Marmara University Faculty of Dentistry. He has many articles in international and national scientific journals and chapters in books.",institutionString:null,institution:{name:"Marmara University",country:{name:"Turkey"}}},{id:"178414",title:"Prof.",name:"Yusuf",middleName:null,surname:"Emes",slug:"yusuf-emes",fullName:"Yusuf Emes",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178414/images/6953_n.jpg",biography:"Born in Istanbul in 1974, Dr. Emes graduated from Istanbul University Faculty of Dentistry in 1997 and completed his PhD degree in Istanbul University faculty of Dentistry Department of Oral and Maxillofacial Surgery in 2005. He has papers published in international and national scientific journals, including research articles on implantology, oroantral fistulas, odontogenic cysts, and temporomandibular disorders. Dr. Emes is currently working as a full-time academic staff in Istanbul University faculty of Dentistry Department of Oral and Maxillofacial Surgery.",institutionString:null,institution:{name:"Istanbul University",country:{name:"Turkey"}}},{id:"192229",title:"Ph.D.",name:"Ana Luiza",middleName:null,surname:"De Carvalho Felippini",slug:"ana-luiza-de-carvalho-felippini",fullName:"Ana Luiza De Carvalho Felippini",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192229/images/system/192229.jpg",biography:null,institutionString:"University of São Paulo",institution:{name:"University of Sao Paulo",country:{name:"Brazil"}}},{id:"256851",title:"Prof.",name:"Ayşe",middleName:null,surname:"Gülşen",slug:"ayse-gulsen",fullName:"Ayşe Gülşen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/256851/images/9696_n.jpg",biography:"Dr. Ayşe Gülşen graduated in 1990 from Faculty of Dentistry, University of Ankara and did a postgraduate program at University of Gazi. \nShe worked as an observer and research assistant in Craniofacial Surgery Departments in New York, Providence Hospital in Michigan and Chang Gung Memorial Hospital in Taiwan. \nShe works as Craniofacial Orthodontist in Department of Aesthetic, Plastic and Reconstructive Surgery, Faculty of Medicine, University of Gazi, Ankara Turkey since 2004.",institutionString:"Univeristy of Gazi",institution:null},{id:"255366",title:"Prof.",name:"Tosun",middleName:null,surname:"Tosun",slug:"tosun-tosun",fullName:"Tosun Tosun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255366/images/7347_n.jpg",biography:"Graduated at the Faculty of Dentistry, University of Istanbul, Turkey in 1989;\nVisitor Assistant at the University of Padua, Italy and Branemark Osseointegration Center of Treviso, Italy between 1993-94;\nPhD thesis on oral implantology in University of Istanbul and was awarded the academic title “Dr.med.dent.”, 1997;\nHe was awarded the academic title “Doç.Dr.” (Associated Professor) in 2003;\nProficiency in Botulinum Toxin Applications, Reading-UK in 2009;\nMastership, RWTH Certificate in Laser Therapy in Dentistry, AALZ-Aachen University, Germany 2009-11;\nMaster of Science (MSc) in Laser Dentistry, University of Genoa, Italy 2013-14.\n\nDr.Tosun worked as Research Assistant in the Department of Oral Implantology, Faculty of Dentistry, University of Istanbul between 1990-2002. \nHe worked part-time as Consultant surgeon in Harvard Medical International Hospitals and John Hopkins Medicine, Istanbul between years 2007-09.\u2028He was contract Professor in the Department of Surgical and Diagnostic Sciences (DI.S.C.), Medical School, University of Genova, Italy between years 2011-16. \nSince 2015 he is visiting Professor at Medical School, University of Plovdiv, Bulgaria. \nCurrently he is Associated Prof.Dr. at the Dental School, Oral Surgery Dept., Istanbul Aydin University and since 2003 he works in his own private clinic in Istanbul, Turkey.\u2028\nDr.Tosun is reviewer in journal ‘Laser in Medical Sciences’, reviewer in journal ‘Folia Medica\\', a Fellow of the International Team for Implantology, Clinical Lecturer of DGZI German Association of Oral Implantology, Expert Lecturer of Laser&Health Academy, Country Representative of World Federation for Laser Dentistry, member of European Federation of Periodontology, member of Academy of Laser Dentistry. Dr.Tosun presents papers in international and national congresses and has scientific publications in international and national journals. He speaks english, spanish, italian and french.",institutionString:null,institution:{name:"Istanbul Aydın University",country:{name:"Turkey"}}},{id:"171887",title:"Prof.",name:"Zühre",middleName:null,surname:"Akarslan",slug:"zuhre-akarslan",fullName:"Zühre Akarslan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/171887/images/system/171887.jpg",biography:"Zühre Akarslan was born in 1977 in Cyprus. She graduated from Gazi University Faculty of Dentistry, Ankara, Turkey in 2000. \r\nLater she received her Ph.D. degree from the Oral Diagnosis and Radiology Department; which was recently renamed as Oral and Dentomaxillofacial Radiology, from the same university. \r\nShe is working as a full-time Associate Professor and is a lecturer and an academic researcher. \r\nHer expertise areas are dental caries, cancer, dental fear and anxiety, gag reflex in dentistry, oral medicine, and dentomaxillofacial radiology.",institutionString:"Gazi University",institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"256417",title:"Associate Prof.",name:"Sanaz",middleName:null,surname:"Sadry",slug:"sanaz-sadry",fullName:"Sanaz Sadry",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/256417/images/8106_n.jpg",biography:null,institutionString:null,institution:null},{id:"272237",title:"Dr.",name:"Pinar",middleName:"Kiymet",surname:"Karataban",slug:"pinar-karataban",fullName:"Pinar Karataban",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/272237/images/8911_n.png",biography:"Assist.Prof.Dr.Pınar Kıymet Karataban, DDS PhD \n\nDr.Pınar Kıymet Karataban was born in Istanbul in 1975. After her graduation from Marmara University Faculty of Dentistry in 1998 she started her PhD in Paediatric Dentistry focused on children with special needs; mainly children with Cerebral Palsy. She finished her pHD thesis entitled \\'Investigation of occlusion via cast analysis and evaluation of dental caries prevalance, periodontal status and muscle dysfunctions in children with cerebral palsy” in 2008. She got her Assist. Proffessor degree in Istanbul Aydın University Paediatric Dentistry Department in 2015-2018. ın 2019 she started her new career in Bahcesehir University, Istanbul as Head of Department of Pediatric Dentistry. In 2020 she was accepted to BAU International University, Batumi as Professor of Pediatric Dentistry. She’s a lecturer in the same university meanwhile working part-time in private practice in Ege Dental Studio (https://www.egedisklinigi.com/) a multidisciplinary dental clinic in Istanbul. Her main interests are paleodontology, ancient and contemporary dentistry, oral microbiology, cerebral palsy and special care dentistry. She has national and international publications, scientific reports and is a member of IAPO (International Association for Paleodontology), IADH (International Association of Disability and Oral Health) and EAPD (European Association of Pediatric Dentistry).",institutionString:null,institution:null},{id:"202198",title:"Dr.",name:"Buket",middleName:null,surname:"Aybar",slug:"buket-aybar",fullName:"Buket Aybar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/202198/images/6955_n.jpg",biography:"Buket Aybar, DDS, PhD, was born in 1971. She graduated from Istanbul University, Faculty of Dentistry, in 1992 and completed her PhD degree on Oral and Maxillofacial Surgery in Istanbul University in 1997.\nDr. Aybar is currently a full-time professor in Istanbul University, Faculty of Dentistry Department of Oral and Maxillofacial Surgery. She has teaching responsibilities in graduate and postgraduate programs. Her clinical practice includes mainly dentoalveolar surgery.\nHer topics of interest are biomaterials science and cell culture studies. She has many articles in international and national scientific journals and chapters in books; she also has participated in several scientific projects supported by Istanbul University Research fund.",institutionString:null,institution:null},{id:"260116",title:"Dr.",name:"Mehmet",middleName:null,surname:"Yaltirik",slug:"mehmet-yaltirik",fullName:"Mehmet Yaltirik",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/260116/images/7413_n.jpg",biography:"Birth Date 25.09.1965\r\nBirth Place Adana- Turkey\r\nSex Male\r\nMarrial Status Bachelor\r\nDriving License Acquired\r\nMother Tongue Turkish\r\n\r\nAddress:\r\nWork:University of Istanbul,Faculty of Dentistry, Department of Oral Surgery and Oral Medicine 34093 Capa,Istanbul- TURKIYE",institutionString:null,institution:null},{id:"172009",title:"Dr.",name:"Fatma Deniz",middleName:null,surname:"Uzuner",slug:"fatma-deniz-uzuner",fullName:"Fatma Deniz Uzuner",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/172009/images/7122_n.jpg",biography:"Dr. Deniz Uzuner was born in 1969 in Kocaeli-TURKEY. After graduating from TED Ankara College in 1986, she attended the Hacettepe University, Faculty of Dentistry in Ankara. \nIn 1993 she attended the Gazi University, Faculty of Dentistry, Department of Orthodontics for her PhD education. After finishing the PhD education, she worked as orthodontist in Ankara Dental Hospital under the Turkish Government, Ministry of Health and in a special Orthodontic Clinic till 2011. Between 2011 and 2016, Dr. Deniz Uzuner worked as a specialist in the Department of Orthodontics, Faculty of Dentistry, Gazi University in Ankara/Turkey. In 2016, she was appointed associate professor. Dr. Deniz Uzuner has authored 23 Journal Papers, 3 Book Chapters and has had 39 oral/poster presentations. She is a member of the Turkish Orthodontic Society. 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