Statistic information obtained by measuring the diameters of silica particles from the different samples.
\r\n\tThe purpose of this book is to discuss some of the critical security challenges in today’s computing world and to discuss mechanisms for defending against those attacks by using classical and modern approaches to cryptography and other security solutions. With this objective, the book invites contributions from researchers in the field of cryptography and its applications in network security. Some illustrative topics of interest (but not limited to) are cryptography algorithms, authentication, authorization, integrity, confidentiality, privacy, security in wireless networks, security in wireless local area networks, wireless sensor networks, wireless ad hoc networks, vehicular ad hoc networks, security and privacy in the Internet of Things. Privacy of information, Blockchains, and Machine Learning in Security are three additional topics that the book will also deal with.
",isbn:"978-1-83768-196-9",printIsbn:"978-1-83769-980-3",pdfIsbn:"978-1-83768-197-6",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,isSalesforceBook:!1,isNomenclature:!1,hash:"b268e581d5e458cb91b82c518f2717eb",bookSignature:"Prof. Jaydip Sen",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11547.jpg",keywords:"Symmetric Key Cryptography, Block Ciphers, Authentication Protocols, Electronic Mail Security, User Privacy, Privacy-Preserving Data Mining, Blockchain Security, Anomaly Detection, Malware Analysis, Secure Quantum Communications, Internet of Things, Cyber Laws",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"May 4th 2022",dateEndSecondStepPublish:"July 5th 2022",dateEndThirdStepPublish:"September 3rd 2022",dateEndFourthStepPublish:"November 22nd 2022",dateEndFifthStepPublish:"January 21st 2023",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"a day",secondStepPassed:!1,areRegistrationsClosed:!1,currentStepOfPublishingProcess:2,editedByType:null,kuFlag:!1,biosketch:"Prof. Sen is a pioneering researcher in machine learning and artificial intelligence. He is an IEEE and ACM senior member who has been listed among the top 2% scientists in the world by Stanford University, USA. Prof. Sen has more than 200 publications in reputed international journals, refereed conference proceedings, and 20 book chapters in books published by internationally renowned publishing houses.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"4519",title:"Prof.",name:"Jaydip",middleName:null,surname:"Sen",slug:"jaydip-sen",fullName:"Jaydip Sen",profilePictureURL:"https://mts.intechopen.com/storage/users/4519/images/system/4519.jpeg",biography:"Jaydip Sen is associated with Praxis Business School, Kolkata, India, as a professor in the Department of Data Science. His research areas include security and privacy issues in computing and communication, intrusion detection systems, machine learning, deep learning, and artificial intelligence in the financial domain. He has more than 200 publications in reputed international journals, refereed conference proceedings, and 20 book chapters in books published by internationally renowned publishing houses, such as Springer, CRC press, IGI Global, etc. Currently, he is serving on the editorial board of the prestigious journal Frontiers in Communications and Networks and in the technical program committees of a number of high-ranked international conferences organized by the IEEE, USA, and the ACM, USA. He has been listed among the top 2% of scientists in the world for the last three consecutive years, 2019 to 2021 as per studies conducted by the Stanford University, USA.",institutionString:"Praxis Business School",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"9",totalChapterViews:"0",totalEditedBooks:"7",institution:null}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"9",title:"Computer and Information Science",slug:"computer-and-information-science"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"418641",firstName:"Iva",lastName:"Ribic",middleName:null,title:"M.Sc.",imageUrl:"https://mts.intechopen.com/storage/users/418641/images/16830_n.png",email:"iva.r@intechopen.com",biography:"As an Author Service Manager my responsibilities include monitoring and facilitating all publishing activities for authors and editors. From chapter submission and review, to approval and revision, copyediting and design, until final publication, I work closely with authors and editors to ensure a simple and easy publishing process. I maintain constant and effective communication with authors, editors and reviewers, which allows for a level of personal support that enables contributors to fully commit and concentrate on the chapters they are writing, editing, or reviewing. I assist authors in the preparation of their full chapter submissions and track important deadlines and ensure they are met. I help to coordinate internal processes such as linguistic review, and monitor the technical aspects of the process. As an ASM I am also involved in the acquisition of editors. Whether that be identifying an exceptional author and proposing an editorship collaboration, or contacting researchers who would like the opportunity to work with IntechOpen, I establish and help manage author and editor acquisition and contact."}},relatedBooks:[{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophile",surname:"Theophanides",slug:"theophile-theophanides",fullName:"Theophile Theophanides"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"371",title:"Abiotic Stress in Plants",subtitle:"Mechanisms and Adaptations",isOpenForSubmission:!1,hash:"588466f487e307619849d72389178a74",slug:"abiotic-stress-in-plants-mechanisms-and-adaptations",bookSignature:"Arun Shanker and B. Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3092",title:"Anopheles mosquitoes",subtitle:"New insights into malaria vectors",isOpenForSubmission:!1,hash:"c9e622485316d5e296288bf24d2b0d64",slug:"anopheles-mosquitoes-new-insights-into-malaria-vectors",bookSignature:"Sylvie Manguin",coverURL:"https://cdn.intechopen.com/books/images_new/3092.jpg",editedByType:"Edited by",editors:[{id:"50017",title:"Prof.",name:"Sylvie",surname:"Manguin",slug:"sylvie-manguin",fullName:"Sylvie Manguin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"72",title:"Ionic Liquids",subtitle:"Theory, Properties, New Approaches",isOpenForSubmission:!1,hash:"d94ffa3cfa10505e3b1d676d46fcd3f5",slug:"ionic-liquids-theory-properties-new-approaches",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/72.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2270",title:"Fourier Transform",subtitle:"Materials Analysis",isOpenForSubmission:!1,hash:"5e094b066da527193e878e160b4772af",slug:"fourier-transform-materials-analysis",bookSignature:"Salih Mohammed Salih",coverURL:"https://cdn.intechopen.com/books/images_new/2270.jpg",editedByType:"Edited by",editors:[{id:"111691",title:"Dr.Ing.",name:"Salih",surname:"Salih",slug:"salih-salih",fullName:"Salih Salih"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"117",title:"Artificial Neural Networks",subtitle:"Methodological Advances and Biomedical Applications",isOpenForSubmission:!1,hash:null,slug:"artificial-neural-networks-methodological-advances-and-biomedical-applications",bookSignature:"Kenji Suzuki",coverURL:"https://cdn.intechopen.com/books/images_new/117.jpg",editedByType:"Edited by",editors:[{id:"3095",title:"Prof.",name:"Kenji",surname:"Suzuki",slug:"kenji-suzuki",fullName:"Kenji Suzuki"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3828",title:"Application of Nanotechnology in Drug Delivery",subtitle:null,isOpenForSubmission:!1,hash:"51a27e7adbfafcfedb6e9683f209cba4",slug:"application-of-nanotechnology-in-drug-delivery",bookSignature:"Ali Demir Sezer",coverURL:"https://cdn.intechopen.com/books/images_new/3828.jpg",editedByType:"Edited by",editors:[{id:"62389",title:"PhD.",name:"Ali Demir",surname:"Sezer",slug:"ali-demir-sezer",fullName:"Ali Demir Sezer"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"872",title:"Organic Pollutants Ten Years After the Stockholm Convention",subtitle:"Environmental and Analytical Update",isOpenForSubmission:!1,hash:"f01dc7077e1d23f3d8f5454985cafa0a",slug:"organic-pollutants-ten-years-after-the-stockholm-convention-environmental-and-analytical-update",bookSignature:"Tomasz Puzyn and Aleksandra Mostrag-Szlichtyng",coverURL:"https://cdn.intechopen.com/books/images_new/872.jpg",editedByType:"Edited by",editors:[{id:"84887",title:"Dr.",name:"Tomasz",surname:"Puzyn",slug:"tomasz-puzyn",fullName:"Tomasz Puzyn"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3569",title:"Biodegradation",subtitle:"Life of Science",isOpenForSubmission:!1,hash:"bb737eb528a53e5106c7e218d5f12ec6",slug:"biodegradation-life-of-science",bookSignature:"Rolando Chamy and Francisca Rosenkranz",coverURL:"https://cdn.intechopen.com/books/images_new/3569.jpg",editedByType:"Edited by",editors:[{id:"165784",title:"Dr.",name:"Rolando",surname:"Chamy",slug:"rolando-chamy",fullName:"Rolando Chamy"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"64780",title:"A Simple Way to Produce Gold Nanoshells for Cancer Therapy",doi:"10.5772/intechopen.82495",slug:"a-simple-way-to-produce-gold-nanoshells-for-cancer-therapy",body:'\nThere are hundreds of types of cancer, and each one has different characteristics [1]. Therefore, science utilizes the most innovative discoveries in an effort to find new treatments, and nanotechnology offers a wide variety of options. One example of this is the nanoparticle colloids. They can be designed to concentrate on specific organs (passive targeting), or their surfaces can be modified by an antibody or ligand to get attached to a specific target (active targeting) [2]. Furthermore, metallic nanoparticles, like GNS, present interesting optical properties. The shell, formed by GNPs, confines the plasmons to the surface of the particle, changing the plasmon frequency of the gold. Therefore, the GNSs absorb different wavelengths than gold in bulk. Moreover, when the wavelength of the incident light is larger than the size of the nanoparticle exciting the plasmons at their natural resonance frequency, light is absorbed more strongly causing an increase in temperature. When the GNSs are synthesized with specific geometry and dimensions, their SPR changes causing their absorption to shift to the NIR region of the electromagnetic spectrum [3]. This shift offers a great potential for applications in the medical field because GNPs are bio-inert [4], and the cytotoxicity of the silica has been widely studied [5]. Additionally, the wavelengths of the NIR spectrum are considered the optical window of the human body. As a result, while most biological soft tissues have low absorption of these wavelengths [6], GNSs absorb them causing them to increase their temperature.
\nGNSs have been synthesized over different templates. Polystyrene cores claim to offer a narrower plasmon resonance absorption peak due to their higher reflective index [7]; iron oxide nanoparticles present a superparamagnetic template useful for magnetic resonance imaging [8]; silver nanoparticles have also been used as a mold for hollow gold nanoshells [9]. However, the functionalization of the polystyrene takes more time, reactants, and supervision which increases the chances of error as compared with the functionalization of the silica. Besides, the cytotoxicity of the silica nanoparticles makes them a good option for medical applications. Moreover, once the GNS is produced, the silica core can be diluted with hydrochloric acid to obtain hollow gold nanoparticles [10] that can be used for the controlled release of drugs [11] due to their capacity for encapsulating sensitive materials and their low thermal expansion coefficient. Therefore, providing a simpler and more efficient method of synthesis of GNS on silica templates provides a more promising variety of applications like for photothermal therapy [12], optical imaging [13], and drug release [2], as well as providing a near instantaneous in situ whole blood assay [14].
\nThe synthesis of the GNSs has been extensively explored. Different methods, like reflux systems [15] or flow micro-reactors [16], can be used as well as procedures involving high temperatures [17]. But most of those methods last over 30 h [18]. In this chapter, we present a simple and effective method of preparation that shortens the time of the traditional procedures published before and uses only a magnetic stirrer with heating for the synthesis.
\nThe reductions of the time were obtained by first modifying the Stöber method of synthesis of silica particles from 2 h to 30 min Samples were obtained at 30, 60, 90, and 120 min throughout the reaction to determine the minimum time of reaction needed. Also, the seeding process can be shortened from 2 h to 30 min. During the seeding process, where the silica is decorated with GNPs, a sample was obtained using only 30 min of resting time and compared with another sample obtained after the full 2 h of the resting time previously suggested. In both cases, SEM images were obtained showing that 30 min were sufficient to accomplish the synthesis of the silica as well as their seeding. In consequence, the total time of the process was reduced by 3 h.
\nThe “Birth of Nanotechnology” was the title used by David Thompson [19] on his article acknowledging Michael Faraday’s synthesis of gold nanoparticles in 1857. What Faraday called “Colloidal Ruby Gold” [20] was, in fact, a solution of dispersed GNPs so small that no microscope of that time was able to observe them. It wasn’t until 1985 that Turkevich et al. [21] used an electron microscope to corroborate that Faraday’s ruby gold was formed by GNPs with an average size of 6 ± 2 nm. Separately, in 1967 Werner Stöber et al. developed a method of synthesizing silica spheres in the micron size range [22] to be used especially in the medical field due to its known cytotoxicity, and in 1998 they were used by Naomi Halas et al. as the templates of GNS [23].
\nEthanol (100%), tetraethyl orthosilicate (TEOS) (98%), 3-aminopropyltriethoxysilane (APTES) (99%), trisodium citrate dihydrate, gold (III) chloride trihydrate (HAuCl4, 49%), formaldehyde (37%), and sodium borohydride (NaBH4, 98%) were purchased from Sigma-Aldrich. Potassium carbonate (K2CO3, 99%) and ammonium hydroxide (28%) were purchased from J.T. Baker. All the solutions were prepared with deionized water.
\nImages were obtained using the field-emission scanning electron microscope (SEM, JEOL JSM-7401F) and the transmission electron microscope (TEM, HT7700 Hitachi). For the ultraviolet-visible (UV-Vis) spectra, the Evolution 220 spectrophotometer UV-Vis (Thermo Scientific) was used. The FTIR spectra were obtained with an IRAffinity-1S Fourier transform infrared spectrophotometer (Shimadzu). The sample was irradiated with an 820 nm wavelength/3.1 mW laser (Multi-Channel Fiber-Coupled Laser Source, Thorlabs), and the infrared images were taken with a Non-contact Digital IR Thermometer (TrueIR Agilent Keysight U5855A). Measurement of the particles and histograms were acquired with the Image J® software [24].
\nSilica particles were prepared by modifying the Stöber method [22]. About 50 ml of ethanol, 2.5 ml of deionized water, and 4.25 ml of ammonium hydroxide were magnetically stirred in an 80 ml glass flask for 5 min. Then, 0.75 ml of TEOS was added dropwise. The solution was heated at 40°C. Temperature and agitation were kept for 2 h. The color of the solution changed from transparent to opaque white approximately 10 min after adding the TEOS as shown in Figure 1. This time corresponds to the induction period needed to form the SiO2 nucleus from the concentration used of the TEOS monomer [25]. Samples were obtained at 30, 60, 90, and 120 min after adding the TEOS to observe the evolution of the process.
\nImages of the synthesis of SiO2 particles: (a) right after adding TEOS, (b) at 10 min of reaction, (c) at 30 min of reaction, and (d) at 2 h of reaction.
In order to create open links over the silica to attach the GNPs, the silica was functionalized with APTES on a 1 ml:1 μl silica/APTES volume ratio. About 50 ml of the silica template solution was magnetically stirred for 5 min with 50 μl of APTES in an 80 ml glass flask. The solution was left still overnight at room temperature. The opaque white functionalized silica particles precipitated in the solution leaving a clear fluid at the top. To separate the functionalized silica, the mixture was centrifuged at 6000 rpm for 1.5 min and washed in deionized water three times. Finally, they were sonicated in 20 ml of deionized water final volume.
\nThe method presented by Abdollahi et al. [10] was followed to elaborate the GNPs. First, 100 ml of deionized water at room temperature was placed in a 140 ml flask under magnetic agitation. Then 1 ml of 1% HAuCl4 solution, 2 ml of 1% trisodium citrate, and 1 ml of freshly made 0.075% NaBH4 in 1% trisodium citrate were added in that order. The mixture was stirred for 10 min and used immediately to avoid the agglomeration. The GNP may also be stored at 4°C in an amber glass bottle for later use.
\nThroughout the synthesis, the gold solution changed its color from light yellow (Figure 2a) to wine red (Figure 2b). This is a characteristic of the GNP formation [26].
\nSynthesis of GNPs at (a) the beginning of the reaction and (b) after 10 min of reaction.
For the seeding process, 100 ml of GNPs and 10 ml of functionalized silica were magnetically stirred in a 140 ml glass flask for 5 min as shown in Figure 3a. Then, it was left still for 2 h. Figure 3b presents how the seeded silica spheres precipitated and changed their color from opaque white to lavender, while the mother solution changed from wine red to transparent. The mixture was centrifuged at 6000 rpm for 2 min and washed in deionized water three times. Finally, it was sonicated in 20 ml of deionized water final volume. The same procedure was followed, but the solution was left still for only 30 min to observe the development of the seeding process through time.
\nImages at (a) the beginning of the seeding process and (b) after 2 h of resting time.
For the shell growth process, a gold hydroxide solution was prepared by mixing 100 ml of 2 mM K2CO3 solution and 1.5 ml of 1% HAuCl4 in a 140 ml glass flask for 30 min. The color of the solution changed from light yellow (Figure 4a) to transparent (Figure 4b). It was left still overnight at room temperature in an amber glass bottle to facilitate the formation of Au(OH)4¯ ions [18].
\nImages illustrating the change of color of the gold hydroxide solution at (a) the beginning of the synthesis (light yellow) and (b) 30 min of reaction (transparent).
The shell was developed from the gold seeds deposited over the functionalized silica particles with the help of the Au(OH)4¯ ions. About 100 ml of the gold hydroxide solution (Figure 5a) and 5 ml of seeded silica were magnetically stirred in a 140 ml glass flask for 5 min (Figure 5b). Next, 5 ml of formaldehyde was added to the solution (Figure 5c) and stirred for 10 min (Figure 5d). The solution was left still for 50 min. Finally, it was centrifuged at 6000 rpm for 2 min, washed, and dispersed in 10 ml of deionized water final volume.
\nImages of the shell growing process. (a) Gold hydroxide solution, (b) gold hydroxide + seeded silica, (c) gold hydroxide + seeded silica + formaldehyde, and (d) solution after 10 min of reaction.
To obtain the IR images, first, the 820 nm wavelength laser was fastened to the support for it to aim directly to the sample (Figure 6a). Then the Digital IR thermometer was also secured and directed to the GNS (Figure 6b). Next, the laser was connected to the Multi-channel laser source (Figure 6c). Finally, the channel with the desired wavelength was selected (Figure 6d), and the irradiation was started.
\nImages of the installation of the (a) 820 nm wavelength laser, (b) non-contact digital IR thermometer, (c) connection to the multi-channel laser source, and (d) selection of the channel with the desired wavelength.
TEM images obtained from the silica samples taken at 30, 60, 90, and 120 min after adding the TEOS are presented in Figure 7. When comparing the images, no significant variation in the size of the silica particles is noticeable.
\nTEM images of silica particles at (a) 30, (b) 60, (c) 90, and (d) 120 min after adding TEOS.
To corroborate that the silica particles do not change substantially when the reaction time is over 30 min, the images were studied with the software Image J®, and the diameter distribution of the particles was analyzed. Over 1000 particles from the different samples were measured to obtain the histograms presented in Figure 8 where samples A, B, C, and D correspond to 30, 60, 90, and 120 min of reaction time, respectively. They illustrate that the diameter distribution of the silica spheres throughout the synthesis oscillates around the 190 ± 5 nm on all the samples.
\nHistograms illustrating the diameter distribution of the silica particles throughout their synthesis.
To have a better understanding of the information, Table 1 contains useful statistic information from the samples.
\n\n | Count | \nMean | \nStd dev. | \nMode | \n
---|---|---|---|---|
Sample A | \n250 | \n187 | \n25 | \n197 (79) | \n
Sample B | \n287 | \n162 | \n18 | \n162 (80) | \n
Sample C | \n265 | \n196 | \n16 | \n201 (92) | \n
Sample D | \n250 | \n197 | \n13 | \n198 (105) | \n
Statistic information obtained by measuring the diameters of silica particles from the different samples.
The mean, standard deviation, and mode obtained after analyzing the samples show that, in general, the silica templates keep their size and shape after 30 min of synthesis. Therefore, the objective of synthesizing silica particles with diameters of 190 ± 5 nm was achieved within 30 min of reaction time. More than 30 min of synthesis does not result in any relevant change in the sample. For this reason, the total process time can be reduced from 2 h to 30 min, shortening the reaction time by 1 h and 30 min when compared with similar published works where the synthesis time is at least 2 h [10, 17, 27, 28].
\nThe functionalization of the silica with a primary amine group (–NH2) was accomplished by the use of APTES which changed the superficial charge of the silica providing an electrostatic link for the GNPs to attach [29]. This superficial modification was verified by the FTIR spectrum shown in Figure 9 where the vibrations of primary amines are found between 3550 and 3330 cm−1 which correspond to the vibrations of a primary amine group [30].
\nFTIR spectrum of silica particles and silica particles functionalized with APTES.
The GNPs were analyzed under a TEM. Figure 10 illustrates the GNPs with a diameter of 7 ± 3 nm and spherical shape overall.
\nTEM images of GNPs.
The seeding process was followed with 2 h of still time as well as with 30 min of still time. The first and second samples were observed under the microscope. The samples were taken with the purpose of observing the development of the seeds. Figure 11a presents an SEM image of seeded silica with 30 min of resting time, while Figure 11b presents an SEM image of seeded silica with 2 h of resting time. The images show that 30 min is enough time to create the seeds because both images display approximately the same number of nucleus per silica particle.
\nSEM images illustrating the seeding process with (a) 30 min of resting time and (b) 2 h of resting time.
Even though a complete shell was not formed, the seeds are ready to grow the gold shell on the next step. A TEM image of a seeded silica particle is presented in Figure 12. This image corroborates the seeding process as well as the silica functionalization.
\nTEM image of a gold decorated silica particle.
Figure 13a and b presents SEM and TEM images of the synthesized GNS, respectably. They illustrate that the silica particles are almost surrounded by gold. The higher density of gold, the separation of the GNPs [31], and the dielectric properties of the silica [3] contribute to the absorption of the NIR wavelength, which causes the increase in temperature.
\n(a) SEM and (b) TEM images of GNS.
Figure 14 presents the UV-Vis spectrum of the particles through the process. Silica particles, as well as functionalized silica particles, do not show significant absorption on the NIR. As for the GNPs, they exhibit their characteristic absorption between 520 and 530 nm [29]. However, on the seeded silica particles, the slight shift to the NIR is noticeable. While on the GNS, the peak not only shifted to the NIR, but it kept a high absorbance all the way to 1100 nm. This range is part of the optical window of the human body [5]. The absorbance of the GNSs is due to the SPR that creates an electric field on the surface increasing the absorption of these wavelengths. SPR happens when metal nanoparticles are irradiated with a wavelength bigger than their size, exciting the electrons of the conducting band [2].
\nUV-Vis spectrum of (a) silica, (b) functionalized silica, (c) gold nanoparticles, (d) gold seeded silica, and (e) gold nanoshells.
To verify the absorbance of the GNS, they were irradiated with an 840 nm laser with a power of 3.1 mW. Figure 15a and b displays the thermography images of the sample while being irradiated at time zero and 2 min later. The temperature of the sample increased from 24.7 to 31.0°C. This confirms that GNSs are able to absorb light from the NIR and convert it in heat.
\nThermography images of the GNS taken (a) before and (b) after being irradiated with 840 nm wavelength laser for 2 min.
Synthesizing GNS by seeding and growing a gold shell over silica spheres with GNPs showed to be an effective method to tune their absorption to the NIR. The SEM and TEM images show the evolution of the process, while the absorbance spectrum displays the GNS shifting over the NIR. Therefore, we obtained a simple technique of producing GNS that can be used for medical applications thanks to the bio-inert GNPs [3] and the widely studied cytotoxicity of the silica [5]. This method does not require long periods of time, when compared with previously published mechanisms, and does not need sophisticated equipment.
\nWe thank Consejo Nacional de Ciencia y Tecnologia (Conacyt) and Centro de Investigacion en Materiales Avanzados (CIMAV) for the financial support, Dr. Jose Guadalupe Murillo Ramirez for his help with the use of 852 nm wavelength laser, Dr. Pedro Piza for lending us the thermographic camera, Ing. Wilber Antunez Flores, and M.C. Karla Campos Venegas for helping us obtain the TEM and SEM images.
\n\n gold nanoshells surface plasmon resonance near-infrared 3-aminopropyltriethoxysilane gold nanoparticles transmission electron microscope scanning electron microscope tetraethyl orthosilicate
In a report released by the Association of American Medical Colleges in June of 2020, United States could see a projected shortage of between 54,100 and 139,000 physicians, including gaps in both primary and specialty care, by 2033 [1]. The report also emphasizes the systematic differences in the annual use of health-care services by urban-rural location, insured-uninsured status, and race and ethnicity. US population is projected to grow by 10.4% from about 327 million to 361 million during the period of 2018–2033 [1]. The challenge of having sufficient doctors to serve our communities will get even worse as the nation’s population continues to grow and age [2]. In addition, COVID-19 pandemic is likely to have short- and long-term consequences on the nation’s physician workforce. The gap between the country’s increasing health-care demands and the supply of physicians to effectively fill has become even more palpable during COVID-19 pandemic [1]. Thus, it is incumbent upon governments, academic institutions, hospital systems, and us as educators to work diligently toward addressing this problem. One such way is to increase the number of quality training opportunities for medical school graduates by initiating a residency and fellowship training program. Very less has been published on the steps and benefits of starting a new residency program accredited by ACGME. The ACGME is a private, 501(c)(3), and not-for-profit organization that sets standards for US graduate medical education (residency and fellowship) programs. [3] The ACGME renders accreditation decisions based on compliance with these requirements. The process is not without challenges, however, we have tried to create a guide built on personal experiences.
The community benefits of residency programs spread far outside the teaching hospital boundaries and provide profits far beyond the standard annual hospital reports. Graduate medical education residency programs provide an overall positive impact at various levels right from residents and institutions to communities and the nation as whole.
GME programs deliver a disproportionate share of the care to historically underserved minorities and patients requiring transfer from other institutions for advanced care [4, 5]. More than 50% of the nation’s health-care “safety net” is provided by the GME training programs in the university and community-based institutions which is an important justification of the “not-for-profit” status of these institutes [6]. The probability of a family physician settling in an underserved community increases by three to four times if they train in a community health centers affiliated with a teaching hospital-based program [7].
Besides imparting the medical knowledge to resident physicians, GME residency programs support the institution by continuing the medical education of the faculty, nursing staff, and other members of the health-care team, thus improving an overall quality of care in teaching hospitals [6, 8]. Major teaching hospitals were associated with lower 30-day mortality rates for common medical and surgical conditions ranging from pneumonia to hip replacement among hospitalizations for US Medicare beneficiaries [8]. The findings in another study suggest that mortality rates for even low-severity patients seem to be lower at teaching hospitals [9]. The attention to detail inherent in a teaching setting with a focus on innovation, frequent use of current medical literature to guide clinical decision-making, and more frequent and thorough case reviews may contribute to a lower incidence of adverse occurrences [2, 4].
Resident physicians not only provide around-the-clock coverage but also provide an economic advantage with lower Medicare spending at 30 days compared with Medicare patients at nonteaching hospitals [10]. Academic medical centers had slightly lower overall total costs compared with nonteaching centers mainly because of lower spending on post-acute care and readmissions. Better intensity of care during the index hospitalization, more integrated post-acute care, and/or more robust care management services during the period immediately after discharge in teaching hospitals could be the reasons for these differences. [11].
The teaching clinics affiliated with the hospital can increase the referral, hospital-based outpatient services, hospital admissions, and eventually revenue of teaching hospitals. [6, 12, 13] It can also help retain and recruit physicians in the health systems, especially at places with physician shortage areas. By hiring their own residency program-trained physicians, the hospitals can not only save the recruitment costs but these new physicians can also hit the ground running, thus saving both time and money for the institutions.
Data from a recent American Hospital Association survey suggest that teaching hospitals tend to have superior adoption rates of telehealth. [14] Compared with nonteaching hospitals, teaching hospitals have better odds of offering telehealth visits, chronic care management remote patient monitoring, post-discharge remote patient monitoring, telepsychiatry, and tele stroke [15].
Teaching hospitals tend to attract and cultivate people who are at the top of their fields and deeply committed. Patient care, medical education, and research come together at teaching hospitals to generate an environment that not only innovates health care but also benefits individual patients.
Examining the benefits of GME programs to the institutions and communities that sponsor them can provide a fundamental approach for preparation, resource distribution, improvement, and quality impacts within those institutions [6].
Per ACGME institutional requirements, “Residency and fellowship programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) must function under the ultimate authority and oversight of one Sponsoring Institution” [16]. The ACGME’s designated institutional official (DIO) will need to gain initial support from senior leadership and the board of trustees to embark on a new endeavor of starting a residency program at the institution. This support will be integral in successfully establishing the pillars that allow for a sustainable educational vision for the health network.
Hospitals or other health-care entities that seek to start new residencies/fellows have one of two options for sponsorship. Those options include partnering with an existing entity [hospital, medical school, federally qualified health center (FQHC), consortium, etc.] that sponsors ACGME accredited programs, or becoming its own sponsoring institution. There are pros and cons to each approach.
One advantage to partnering with an existing sponsoring institution (SI) is that the new teaching site could start a new residency application process without having to first obtain the ACGME institutional accreditation. Prior to applying for a new residency, the ACGME requires that there is a sponsoring institution to ensure the provision of resources and to foster a healthy learning environment. The mechanics to do this are straightforward; an existing sponsor’s program would identify the new teaching hospital as a “participating site.” The existing sponsor’s program initiates a program letter of agreement to govern the relationship between the two entities unless the new site is under the sponsor’s existing governance structure. Residents from the existing sponsor could start rotating at the new participating site, or the new participating site could apply for new residency programs.
This leads to the second advantage of partnering with an existing SI which is that resident rotations to a new participating site gives clinicians and administrators insight into what to expect when they decide to start their own residency programs. Many administrators like the idea of recruiting, training, and retaining their own workforce; however, few are aware of the cost/benefit analysis of such a venture. Thus, gaining experience in training residents without being fully committed is beneficial to all stakeholders.
A third advantage of partnering with an existing SI is that such an academic partnership could lead to a clinical affiliation, especially if the participating site has a strong and robust clinical scope within that given specialty (e.g., orthopedic hospital) and/or provides the sponsor with access to a new patient population (e.g., rural hospital or FQHC). In return, the new participating site receives the sponsorship needed to apply for new residency programs.
One downside of partnering with an existing sponsoring institution is that it can be confusing to the internal and external stakeholders as to who has the “ultimate authority” and “oversight” of the program. Governance structures are different from organization to organization and lines of accountability can be misplaced, misunderstood, or mislabeled. As a result, the question of “who has ultimate authority” can turn a once visionary proposition into a bureaucratic quagmire, especially when there are changes in leadership, organizational objectives, and internal politics. Ambiguity around “ultimate authority” and “oversight” dissipates if a site decides to sponsor its own residency programs and, as it turns out, is one of the advantages of becoming your own sponsoring institution of GME.
Sponsoring institutions are ultimately responsible for ensuring the provision of support systems, resources, and administrative structures and to foster the clinical learning and working environment. The SI’s execution of these responsibilities becomes essential when recruiting, training, and retaining the right residents for the community. The SI’s governing body has ultimate responsibility for GME activities and must weigh the rewards and risks of sponsoring GME programs. The risks being that the sponsor provides the necessary financial support for the administrative, educational, and clinical resources, including personnel. For example, each sponsoring institution of GME must identify a designated institutional official (DIO) and provide them with sufficient resources, time, salary, and professional development to effectively execute their duties [16]. A sponsoring institution must also ensure compliance with all ACGME institutional requirements while fostering a healthy learning environment, all of which can be additional costs as compared to partnering with the existing sponsor of GME.
Essentially, the decision of whether to partner with an existing sponsor or become one on your own comes down to three factors (the three Fs): faculty, finance, and facilities. Sponsors of GME are required to provide residents a broad, diverse, and in-depth training experience regardless if they own or partner with facilities that provide the clinic scope needed to comply with residency program requirements. The key is that the sponsor has “ultimate authority” and “oversight.” Although this can be obtained through affiliation agreements, it is challenging for a sponsor to enforce oversight when they lack control of the training sites. Sponsors of GME are also required to provide a sufficient number of faculties who are interested in, qualified to, and have the time for teaching and supervising residents. Lack of sufficient faculties can have serious consequences for a sponsor as demonstrated in the 2017 case when the emergency medicine residency at Summa Health lost their accreditation and the sponsor was placed on probation for not adequately negotiating for faculty coverage when replacing their ER contract with a new ER group [17]. Lastly, sponsors of GME need to ensure adequate financing of new programs either through grants, operations, or Medicare GME reimbursement, the latter having a unique set of challenges.
A key factor to the success in the budgeting process takes in all start-up costs and projected operating expenses of the new residency program. The bulk of these costs and expenses include resident salaries, faculty stipends for teaching, and administrative personnel, which creates an efficient system of management and program organization. The budgeting process includes accounting for costs such as protected time for program leadership [program director (PD) and associate program director], core faculty, along with faculty stipends that foster continuing education and research. Gathering data from other residency programs which are already in operation can be invaluable in terms of budgeting and forecasting costs for a new residency program start-up. It is pivotal that when starting the new program, the faculty costs are as accurate as possible. This can be achieved by using a fair market value (FMV) estimation when assessing the physician compensation.
The financing of GME programs mainly includes reimbursement from the federal government via Medicare that will, in turn, help sustain a residency program in the long term. For instance, the size of the federal investment in GME—estimated at $16 billion in 2015 [18], helps to spur the growth of maintenance and conception of residency programs. The reimbursement offered through Medicare can help create profitability of a new residency program. A hospital is categorized into a certain reimbursement rate based on the guidelines set by the Centers for Medicare and Medicaid Services due to location and other factors. “In general, Medicare direct GME payments are calculated by multiplying the hospital’s updated Per Resident Amount (PRA) by the weighted number of Full-Time Equivalent (FTE) residents working in all areas of the hospital complex (and at non-provider sites, when applicable), and the hospital’s ratio of Medicare inpatient days to total inpatient days” [19]. It is important to consider that if a resident were to spend time in two different hospitals, then each hospital would count the proportion of the FTE time spent at its facility for reimbursement.
To properly plan for the space and facilities needed for a new residency program, it is important to understand the inpatient and outpatient accreditation and certifying board requirements for training. Even if most residents spend the majority of their training within an inpatient setting, it is pivotal that a resident also trains in an outpatient setting due to the high probability that they will practice in an ambulatory and community-based setting [20]. The primary training site will need adequate facilities, patient volume, and faculty for resident education. Evaluating inpatient volume data and the case mix of the hospital ensures a quality and diverse mix of patient cases for residents. Also, analyzing the capacity and forecasted volumes for outpatient sites is critical to ensure ACGME compliance and quality of resident education.
Recently, St. Luke’s Hospital - Anderson Campus in Bethlehem, Pennsylvania, built state-of-the-art facilities for new resident education. During this phase of starting up new residency programs, the GME senior leadership incorporated a full-staffed GME administrative office with on-site private program director and faculty offices, research support resources, residency program coordinators (PCs), and additional conference rooms dedicated to education. The goal of this unique GME space design was to encourage interdisciplinary collaboration between different residency programs to create a dynamic and high-quality educational experience for residents. At the St. Luke’s Anderson Campus, the collaborative model allows for more open-door discussions and sharing of ideas between program directors in specialties such as internal medicine, psychiatry, neurology, family medicine, dermatology, and emergency medicine. Additional education facilities include a full simulation center, skills lab, and standardized patient rooms for trainees to learn. Collaborative space design is also another way to model interprofessional collaboration behaviors for trainees.
The GME office, in collaboration with the network business planning, offered a “first-cut analysis” of the business and workforce feasible of starting new and right-sizing the existing programs in the network. Readiness assessments determined how “ready” a department was to start or right-size its program, identify gaps, refine relevant/expected projections, and develop action plans including time lines (Table 1). After finding the leads for various departments like Accreditation/Project Management Office (PMO), Community/FQHC, Research Reimbursement, Capital/Operational Expense, and Clinical, Physician Leads received accreditation standards and application, while GME office helped them draft a rotation schedule prior to planning meeting. The goal of the meeting was to score the department’s readiness. The readiness assessment helped to structure the way we launched the change and minimize the time and resources spent on implementing the changes. Pro-forma development and workforce forecasting were also instrumental in the assessment. With the assessment, we learnt: (1) current state of department compliance, capacity, personnel, and resource, (2) what the curriculum rotation schedule could look like, and (3) the department’s experience and belief in the value of the change.
Stakeholders and recruitment | H-M-L |
---|---|
What will be the impact of the program on St Luke’s? | |
What will be the impact of the program on the community? | |
What is the medical student market demand for this program? | |
What is the quality of the department’s relationship with needed external partners? | |
What is the department’s level of interest? Evidence of prior success? See the benefit? | |
What is the program’s cost–benefit projection? | |
What is the program’s cost–benefit revision (after a rotation schedule draft)? | |
What is the capacity of the department to provide education? | |
To what degree does the department meet faculty requirements? | |
What is the department’s existing clinical capacity? | |
What is the department’s projected clinical capacity in 5-7 years? | |
What existing resources does St. Luke’s currently have to support this program? | |
What are the legal implications of the program (lower is worse)? | |
How many rotations will SLRA be able to host? (48 total months per resident) | |
% Compliant with accreditation standards: | |
What physical space does the department currently have to run the program? | |
What is the department’s expertise with this GME program? | |
What is the department’s experience in teaching residents? | |
What is the department’s performance in producing scholarly activity? | |
Does department’s attending meet current number of faculty needed? | |
Readiness assessment.
Rating scale: H = fully ready (7-9 pts), M = partially ready (4-6 pts), and L = not ready (1-3 pts).
The initial accreditation process should be started early as the application process is the “final product” and many things need to be discussed, outlined, and developed before the application is submitted. The DIO must initiate the application process in ACGME’s Accreditation Data System (ADS). The DIO must name the program director at this time. The program director is responsible for completing the application and submitting it through Accreditation Data System (ADS) for the DIO to approve. The program director is ultimately responsible for the application submission, but the advice and expertise of key faculty, department chair, and/or recent graduates should be utilized. It is strongly advisable to become well acquainted with the ACGME requirements and have them at hand while completing the application [21]. ACGME does have a video on “Completing an Application for ACGME Accreditation” that is a great resource, providing specific details on sections of the application [22]. The ACGME has a specific section for program directors on accreditation, which should be reviewed prior to starting the application as it provides an overview of the accreditation process[23]. If a requirement is not clear, the ACGME publishes “FAQs” that may be of assistance.
Each specialty has a specialty-specific application form. Read each question carefully and answer only that question in the space provided. Ensure the answer is complete, detailed, and if requested, provide specific examples on how something may be handled within the specific program. Many applications ask about hospital data and resources, including the number of beds, average daily census, faculty numbers, and patient care resources. Plan to include the expected schedule for the residents.
Many citations occur because the application is incomplete or inaccurate, required education experiences are not demonstrated in the schedule, scholarly activity requirements for the faculty have not been met, or the minimum number of core faculty is not identified.
Once the application is completed, fellow members like faculty, residents, educators, and/or DIO should read the application and propose their suggestions and offer amendments. This is helpful to ensure that all aspects of the residency/fellowship program have been correctly presented and the document is internally consistent. It is not uncommon to have slips and/or inconsistencies in a document that has been worked on for many months. Review should include an examination of all sections of the application for accuracy, including the faculty rosters and curriculum vitaes (CVs). [24] Before submission, the program should find someone not familiar with the program but familiar with the ACGME policies and procedures to review the requirements and applications. This person should read both documents fully and identify areas that may need more details or that do not make sense.
After the application is submitted, program staff should interact with RC team to confirm that the application has been received. The RC team can also help with information about deadlines for forthcoming meetings. These meeting dates are posted on the ACGME website and are typically 8–10 weeks in advance of the meeting date. The goal for submission is several months prior to the site visit [24].
This will take a year or more from finding a sponsoring institution to matching the first class of residents. In between those two bookends is the site visit from the ACGME. From our experience as newly accredited residency programs, there are pieces of the process, that on reflection, were key to our success.
Before thinking of the site visit, becoming familiar with the ACGME common program and program-specific requirements is essential. Having established, veteran program directors review the application in advance can give you the benefit of feedback and ability to troubleshoot.
One should think of the site visit as an open book test—good preparation should yield no surprises. Dr. Ingrid Philbert, Ph.D., MBA, Senior Vice President, Director, Field Activities for the ACGME, borrowed this analysis from the five stages of grief by Elizabeth Kubler Ross. Denial: “They not coming again, already”; Bargaining: “We can get a postponement”; Anger: “She says, we cannot get a postponement”; Depression: I will never be ready”; Acceptance: “We will be ready!”
In general, information gathering for the PIF should begin approximately 1 year before the application due date. Begin focused writing 6 months before the due date and finish the first draft 3 months prior to the due date (Table 2).
One year out | Review program and institutional requirements, preview the PIF, document education meeting attended by involved and faculty, revise goals and objectives as needed, and update and organize all program letter of agreements (PLAs) |
Six months | Reread the requirements and write the PIF. |
3 months | Once notified, reread requirements, complete PIF, schedule a meeting with institutional officials and key faculty, schedule appropriate room for meetings, schedule transport, lodging and meals, and select residents for meeting |
One month | Prepare residents and faculty, impress the importance of the meetings, share the PIF, and ask to read and ask any questions. Remind to answer questions from the site visitor clearly and accurately. If they do not know the answer, they should say so and ensure the site visitor that they will find the answer and get back to them before the end of the site visit. The program director should be notified so he/she can discuss further with the site visitor if necessary. Stress the importance of having a positive and productive attitude toward the establishment of the program. Reread requirements |
One week | Meet with faculty after they have reread the PIF and clarify any questions or concerns, reconfirm all dates, times lodging, and transportation logistics. A mock interview with faculty and the PD, with the DIO acting as the site visitor can be very helpful to ensure all questions have been well thought out and all documentations are well organized and readily available. PD should have a binder with the completed application with tabs to easily and quickly find information the site visitor may inquire about. The binder should include a copy of the PIF, educational goals and objectives, written supervisory lines of responsibility, acceptance/promotion/dismissal policies, planned conference schedules, template of resident/faculty /program evaluations and plan for filing this data, copy of internal review, resident contract and manual, copies of affiliation agreements, institutional letters of agreement, and PLAs. Additionally, one should have available a copy of the program and institutional requirements as well as a block schedule of resident rotations |
One day | REREAD REQUIREMENTS AND PIF, check all documentation twice, GET A GOOD NIGHT SLEEP! |
Day of visit | Day of the visit is typically 4-5 h. The site visitor usually meets with the program director and program coordinator first, then department chair, followed by the DIO, core faculty, possibly a tour of the hospital, and then meet with residents, sometimes over a lunch. At day’s end, the site visitor will have a final meeting with the program director. The site visitor typically reports a review of the program’s history review of institutional issues or citations. They may ask for clarification of the PIF or questions raised during faculty or resident interviews and anything else that is needed. They typically provide their perceived strengths and weaknesses of the program and answer any questions. |
Preparation of site visit timeline.
Start early on accumulating and updating faculty CVs. You can use a well-written PIF as a model template, which paints the program in clear and concise manner and have another experienced PD’s critique it along with other faculty.
After the respective resident review committee (RRC) has reviewed the program, an e-mail notification of the accreditation status will be sent within 5 days. This e-mail note will not provide any details about the findings from the review, only the status. The letter of notification is sent approximately 60 days after that. This letter outlines areas not deemed to be substantially compliant by the RRC (citations), other areas in need of improvement, and actions the program is asked to take. This letter should be read carefully and discussed with faculty, residents, and department as well as institutional leadership.
As the new program application to the ACGME begins with the designated institutional official (DIO) by submitting a program application to the ACGME’s Accreditation Data System (ADS),[24] the DIO also must select a program director (PD). PD is not only responsible for completing and verifying the accuracy of application information but also responsible for running the program successfully. The program director must be approved by the sponsoring institutions’ Graduate Medical Education Committee (GMEC) as well as the RRC. The program director must be appointed for the length of the program plus 1 year. The PD must have educational and administrative expertise as well as certification in their respective specialty by the American Board of Medical Specialties. The PD must also be currently licensed and have a medical staff appointment at the sponsoring institution. Additionally, the PD must demonstrate adequate scholarly activity and be 5 years removed from residency/fellowship training or have worked as an associate program director for 3 or more years. To successfully oversee a program, the ACGME recommends at least 20% protected time for the PD. To assist the PD in running the program, each program is required to have a designated program coordinator (PC). The PC is responsible for assisting the PD in the day-to-day administration of the training program. The ACGME website precisely dictates the academic requirements while also mandating that the PD “embody personal qualities of integrity, confidence, and model outstanding professionalism, high-quality patient care, educational excellence and promote an environment where respectful discussion is welcome, with the goal of continued improvement of the educational experience.” The above should be viewed as absolute requirements for a program director; however, for a PD to maximize the potential of those individuals under his or her charge, the PD must act as a disciplinarian while maintaining the confidence and respect of the trainees. To maximize trainee morale and a conducive educational environment, the PD may act as a confidant, counselor, and at times, therapist.
Furthermore, it is imperative for the PD to establish good working relationships with the other program directors. Aside from providing support and advice, PDs must often work together. Because the ACGME does not permit integration with another sponsoring institution with the same specialty, programs are often required to work together to meet requirements. For instance, medical residents are required to rotate through cardiology; if a poor relationship exists between the two program directors, there is no option for the medical residents to rotate through another institution’s cardiology training program.
ACGME sets standards for residency and fellowship programs that are comprised of common program requirements (CPR) that all programs regardless of specialty must meet and specialty-specific program requirements. Each program must provide program-specific details in the form of the program information form (PIF), which should be provided by the program director (PD) as they will know the program best and no one has a more significant stake in the program outcome. The PIF contains questions related to the CPR and the specialty-specific requirements and provides a clear understanding of why your program’s mission and vision should exist and how it will serve the residents/fellows, hospital, and community at large.
Each program must have an accredited institution as its sponsor and designated primary training site(s). The ACGME requires accredited residency/fellowship programs to operate under the authority and control of one sponsoring institution. The sponsoring institution must comply with the ACGME institutional requirements and must ensure that all accredited programs remain in compliance with institutional-, common-, and specialty-specific program requirements as well as ACGME policies and procedures. Additionally, the sponsoring institution retains responsibility for the quality of GME, including when resident/fellow education occurs at other sites. The sponsoring institution defines and regulates compliance through affiliation agreements. Master affiliation agreements (MAAs) are the overriding agreements between the sponsoring institution and all its major participating graduate medical education sites involved in residency/fellowship education. If training was to occur at sites not governed by the sponsoring institution’s primary training site’s Board of Directors, a program letter of agreement (PLA) is required. In contrast to MAAs, PLAs are program-specific, originating at the program level, and offer details on faculty, supervision, assessment, educational content, size of the assignment, and policy and procedures for each essential assignment that occurs outside of an accredited program’s sponsoring institution. These documents are designed to protect the program’s residents/fellows by confirming a proper educational experience under sufficient supervision and must be renewed every 5 years [26].
Following initial program accreditation by the ACGME, the Residency Review Committee in your given specialty will, in subsequent years, monitor key performance measures to determine programmatic effectiveness and value. Data points are derived from the resident and faculty surveys, and board certification pass rates and performance by program graduates will determine the program accreditation status. The program must also submit every year to the ACGME program information via the Accreditation Data System (ADS). This includes reports of trainee development as measured using the specialty-specific milestones. Site review intervals will extend to 10 years if the program continues to meet performance goals. Prior to the once-a-decade site visit, it is expected that the programs will conduct, at least yearly, self-studies to consider accomplishments and opportunities for improvement [27].
The ACGME and other medical societies, especially the Association of Program Directors for the specialty, have a robust collection of resources to assist program development for everything from preparation for an ACGME initial application to the 10-year accreditation site visit and everything in between.
Developing a “successful” curriculum means designing and implementing an effective program of study and discovery in a focus area. In graduate medical education, this “focus area” may represent a rotation, that is, cardiology, ambulatory rotation, critical care, etc. It may also represent an educational activity (i.e., grand rounds presentation) or research and scholarly activity (i.e., quality improvement project). A resident’s skill level within this area is then evaluated within the “lens” of the core competencies as established by the ACGME. This “lens” includes the ACGME core competencies and their associated milestones [28]. The six core competencies include patient care, medical knowledge, systems-based practice, professionalism, practice-based learning and improvement, and professionalism [29].
The curriculum that you design for each of your focus areas should include the skill set needed within the “lens” of the competencies and milestones. Your “curriculum format” should include the following key areas:
Overview
Goals and objectives
Methods of teaching/instruction
The educational content
Evaluation and feedback
For the purposes of providing a more concrete example, consider what a curriculum for a first-year internal medicine resident [30] who is about to begin a cardiology rotation would look like using this format.
This describes and sets the tone for your “focus area.” It would provide a little background about the focus area (in this example, cardiology) and may briefly describe aspects including the subject matter and clinical interactions. It may also briefly touch on other areas including educational content and methods of teaching that you will describe more in depth later in the curriculum [29].
The goals and objectives of a rotation or activity need to be clearly defined within the framework of the ACGME core competencies. For example, the goals and objectives of an internal medicine resident on the cardiology rotation would be defined within the framework of the six core competencies. Each of the core competencies should be listed in the goals and objectives section and the milestones can be further defined considering the respective competency discussed. Each core competency should be listed as a separate heading under your Goals and Objectives section. Two examples of a cardiology-focused goals and objectives under
Demonstrate updated knowledge of assigned patients on rounds.
Demonstrate an improvement in development of a treatment plan under the cardiologist’s supervision.
The wording of the goals and objectives should be in the active voice. The first word of each objective should be a behavioral verb like: define, develop, review, identify, obtain, demonstrate, correlate, present, use/utilize, and/or communicate. They are dynamic words that are important when trying to convey each of your individual goals and objectives. Communicate, for example, may be the initial “buzzword” under specific goals and objectives under the section on
Communicate effectively with patients and families.
Use effective listening, nonverbal, questioning, and narrative skills to communicate with patients and families.
Note that the resident must have access to the curriculum, especially the goals and objectives. Many residency programs maintain these on the residency management system, whether it is New Innovations or MedHub. Another option is to save them on a shared drive on the computer which is readily accessible. The resident should review the goals and objectives portion prior to the beginning of each rotation.
This section defines the methods by which the residents learn the different topic areas. Common examples of teaching methods germane to most resident rotations include:
Direct patient care.
Didactic conferences.
Daily teaching and management rounds with team and attending physician.
Assigned reading topics depending on the focus area.
Other topic areas depending on the specialty; for example, the resident in cardiology may have dedicated sessions regarding ECG interpretation and review.
This can be considered a separate area or be included in the above Teaching Methods section. Basically, what is the nature of the clinical exposure on the rotation? Is it an inpatient or outpatient rotation or a mix of both? If it is an inpatient rotation, would patients be seen by the resident on the general medical floor or also in the ICU/CCU? Is it a general cardiology rotation or are there specific patient populations the resident would encounter on this rotation, that is, patients with congenital heart disease?
After the Goals and Objectives section, this is probably the most important section. Two of the most common questions residents ask at the beginning of any rotation are: “How am I being evaluated?” and “Is feedback provided during the rotation? These are important questions to address in this section of the curriculum so that the resident has a clear understanding how s/he will be evaluated [31]. Important aspects to consider including this section:
Your resident should review the goals and objectives of the rotation at the beginning of the rotation and your resident has easy access to these goals and objectives.
Note that the rotation evaluations for the rotation should be directly related to the goals and objectives that you define in your curriculum initially.
The foundation for starting a residency program lies in the layering of the right faculty framework. Faculty remains one of the biggest assets for any training program. Dedication to teaching, commitment to education, and passion to share the love of learning are all aspects of academic medicine that propagate scholarly activity. Historically, there are many challenges to faculty development in any department, but most especially in new program development, in an academic setting. This issue was specifically addressed at the World Conference on Medical Education in 1988. It was intended to improve medical education worldwide. The Edinburgh Declaration made 12 recommendations, the fifth recommendation was to train forerunners as educators, not just content experts, and reward distinction in this arena as in biomedical research or clinical practice [32, 33]. This was also addressed as part of the ACGME Outcome Project initiative that faculty must be qualified to provide and evaluate education that is level-specific, competency-based, standardized, integrated, and accessible [34, 35]. The evolution of a physician into an educator does not happen overnight. The acknowledgement of the importance of faculty development cannot be overemphasized, especially in training of future physicians.
There are many challenges to a sustainable faculty development curriculum. The requirement for faculty development has increased as a result of growing demands by the regulatory agencies [36, 37, 38]. American Association of Directors and Psychiatry Residency Training membership reported lack of funding and lack of time as well as excessive clinical demands as the main barriers to seeking career in graduate medical education [36]. Clinically, the concerns for excellent patient care while teaching residents or students, with the demands of RVU production can be daunting. Other barriers noted in this survey included “faculty attrition, faculty burnout, lack of recognition, and paucity of GME positions within institutions”[36].
Traditional faculty development consists of faculty development workshops, grand rounds, leadership conferences, and faculty retreats. These sessions typically require faculty to block clinical hours to be present face-to-face in one designated location. These usually occur in larger group settings due to the cohort nature of the exercises. These sessions usually address faculty development competencies including education theory. Topics can include curriculum development, competencies, milestones, and EPAs. Other helpful topics to assess teacher effectiveness would include preparation and delivery of didactic teaching skills, clinical teaching skills, specific audience targeting, and incorporation of technology into teaching sessions. Topics specific to the resident evaluation would include assessment and evaluation, giving feedback, the 1-min preceptor, small group teaching, learner styles, and flipped classroom sessions. Other models include teaching and mentoring skills. Topics to be considered under this umbrella would include advising/mentoring techniques and evaluation of any resident expressing difficulty with academic or behavioral issues. Due to new curriculum and new roles for faculty as educators, management and leadership training should also be at the foreground of new faculty training in new programs. Management and leadership styles vary greatly depending upon the physician’s prior experiences, their own role models, and their own prior mentors. Useful topics under leadership areas include time management, work hours, delegation, emotional intelligence, networking, team building theory, work/life integration, communication skills, conflict management, strategic planning, and career development of an educator’s portfolio.
Another important component in faculty development includes the incorporation of research, especially early in residency design. The expectation of quality and process improvement (QI/PI) projects for both residents and faculty fosters a foundation of evidence-based medicine and quality standard measures for patient safety. Faculty education on research study design, statistical methodology, utilizing the Plan-Do-Check-Act (PDCA) cycle for project implementation, presenting and writing study results, project feasibility, IRB submission, poster presentations, grants submissions, literature searches, publications, evidence-based medicine (EBM), and quality improvement are essential for propagation of scholarly environment. These faculty development workshops are all valuable resources for faculty to stimulate personal research opportunities but also ignite resident intellectual curiosity. New programs that initiate faculty development in all these areas show a commitment to education to the residents. Faculties are expected to have core knowledge in their specialties. This is maintained by board certifications, recertifications, Continue Medical Education (CME), faculty appointments, and recognition within the field of interest. However, a dedicated commitment by the residency programs to structured faculty education is essential to the success of the residency itself. Capturing all areas of research, leadership, education theory, and teaching skills will undoubtedly advance the program and the residents within it.
Innovative methods to faculty development can also be explored through other social platforms. Due to the explosive nature of technology in academic medicine, exercises in flipped classroom settings, online prep courses, Skype presentations, and lectures further help to spread the availability of resources outside the typical face-to-face lecture/conference settings. It is essential in the busy clinical setting to have flexibility in the location and timing of training activities. 2010 I-PASS study among 11 academic institutions was launched to determine the effectiveness of patient handoffs and patient safety [39]. It required faculty at multiple institutions to first be trained on best practices on patient handoffs, which then in turn would be taught to the residents. This study prompted the development of new faculty curriculum across multiple sites and the need for standardized training. Faculty development was in the lead to advance patient safety among various institutions through innovative modules, online conferencing, combined with live training workshops [39]. Another example is video observation with guided reflection using peer review of videotaped teaching encounters [40]. Another article from Klein and associates reviewed the use of social media with excellent participation, that is, Facebook in providing online faculty development for a larger venue. Participants were involved in knowledge exchange (discussing, questioning/answering, and learning new tools and opportunities) and social capital (networking, sharing ideas, and peer learning). Outcomes showed overall positive impressions with ease of use, rapport, and community building. The biggest challenges were the asynchronous nature of participation and concerns for privacy and professionalism using social media [41]. “Online learning in general is neither superior to nor inferior to other approaches, but simply a method that overcomes some challenges while creating others.” Educators should innovatively balance face-to-face and online approaches in teaching [42]. This mix of approaches offers the best combination for faculty adherence and feasibility.
Finally, the future recruitment of excellent faculty educators also lies in praising and rewarding those educators who are the role models for our new residents. These faculty members need to be recognized for the role they fulfill every day in teaching our future physicians and scholars. It will require making changes in academic policies and performance expectations, offering a well-defined career path and identity for educators, increasing faculty development programs, supporting health professions education scholarship units and academies of medical educators, and generating means to ensure high standards for all educators [32]. These resources need to be standardized and shared within the academic learning communities both in undergraduate and graduate forums. Many roles have shared responsibilities within the academic world. Professional development occurs at all levels in academic medicine with the same ultimate goals. “Ensuring that all educators receive the essential knowledge and skills for teaching should be a policy priority”[32]. Joining forces with other established programs can greatly help new program faculty development. This is evidenced in national meetings of educators who welcome shared input to advance both established and new programs for the ultimate advancement of excellent programs. The rewards of graduating a residency class with knowledgeable, compassionate, and competent future physicians remain the ultimate draw into a career of academic medicine.
The benefits of collaboration in industries from information technology to professional sports have been clearly demonstrated. “We are often better served by connecting ideas than protecting them”[43, 44]. Within medical education, residency collaboration has borne fruit in several fields [45, 46, 47]. A noteworthy example is the Preparing the Personal Physician for Practice (P4) project, an initiative undertaken by 14 family medicine residency programs tasked with seeking innovation in residency education [45]. The collaboration between these programs allowed for the sharing of “best practices,” while also granting participating programs latitude for experimentation that has led to significant advances in the education of residents [47, 48]. Similarly, a collaborative health advocacy training program developed by California’s pediatric residency programs allowed each of the constituent residencies to demonstrate clear adherence to the ACGME’s requirement on the subject [46]. In a publication that described this joint venture, the authors explain that the effectiveness of the project in accomplishing its goal has led the group to expand the scope of their collaboration [46].
New residency programs offer fertile ground for collaboration in several dimensions. First, the new residency may look at the other programs available for collaboration. Are there existing residencies of the same specialty in the health network or fellowships with ties to the new program’s field? What other new residency programs are starting in the network at the same time, or within several years, of the new program? Second, a new residency program should consider what domains are best suited for collaboration with other programs. Is it feasible and mutually beneficial to create collaborative educational content in the form of didactics and workshops? Would share clinical experiences offer growth opportunities that are missing in single-specialty or single-program scenarios? What research and scholarly activity might grow from inter-program collaboration? Exploring these questions and their answers allows the new residency program to capitalize on opportunities to collaborate and enhance training for all of the residents involved.
At St. Luke’s Hospital - Anderson Campus, several avenues of collaboration have been established. During the planning phase for the new family medicine and internal medicine residency programs at the Anderson Campus, the decision was made to collaborate in the implementation of a curriculum in lifestyle medicine. This approach to clinical medicine, with a focus on the modification of lifestyle as a first line for disease prevention and management, is attractive to both patients and prospective residents. Working together, with the help of lifestyle medicine-trained adjunct faculty, the family and internal medicine residencies were accepted as a pilot site for the American College of Lifestyle Medicine’s “Lifestyle Medicine Residency Curriculum,” (LMRC) which prepares residents for dual board eligibility in their core specialty as well as lifestyle medicine at the end of their training. Residents participate in shared lifestyle medicine didactics and will rotate together through a lifestyle medicine specialty clinic. It was the inter-specialty nature of this collaboration that distinguished St. Luke’s from other programs vying for acceptance as LMRC sites.
Residents in the new residency programs at St. Luke’s Hospital - Anderson Campus also participate in a scholarly activity collaborative; trainees enjoy joint sessions on foundational concepts in research and work together to develop quality improvement projects spanning inpatient and outpatient settings. In addition to the clear patient care benefits of this program, residents can enhance their skills in communicating with other health-care professionals and in considering the impact of a quality improvement initiative outside of their clinical domain.
Recruiting residents for a new program must be done in a strategic manner to allow for the best outcome for the trainees and the training institution. The first three classes of a residency program can help shape the program and the community it serves. It is important to bring in residents who will contribute to the program development and are flexible in working through the challenges a new program has to offer. Over the past decade, there have been multiple studies regarding resident selection that have seen an increasing trend that USMLE score do not correlate with performance during residency [49, 50, 51]. Many surgical and emergency medicine programs have started to look at “GRIT” as an important aspect of being successful in residency. GRIT is defined as growth, resilience, intensity, and tenacity. Identifying residents who are passionate about medicine and are willing to go beyond the job description, thus ensuring the highest patient care [52, 53, 54, 55]. This concept has been in existence since the conception of residency by William Halsted but has been forgotten as the field of medicine has become overburdened with an increasing number of applicants and more regulations in Graduate Medical Education (GME) [50, 55].
When recruiting future residents to a new residency program, it is vital to select candidates based on the following qualities: leadership ability, strong sense on comradery, willingness to adapt and learn, GRIT (resilience), and emotional intelligence.
Academic rigor and test scores will be a part of GRIT [55]. When evaluating candidates for a residency position, it is important to create a standardized procedure to prevent biases. In terms of resident leadership, we can use Kouzes and Posner’s approach to identify those who inspire a shared vision, enable others to act, and encourage contributions and positive outcomes [56, 57]. It is also important to select individuals that work well in team; candidates that have experiences of working in a team outside of medicine should be considered an important quality. High-quality teamwork will have resulted in a candidate who has effective communication skills and demonstrates a high degree of professionalism. Willingness to adapt and learn is an important quality for candidates in a new program as it requires a great degree of flexibility and the ability to learn from challenges that will be faced as a team. A well-respected psychologist who focuses on high-functioning teams, Mihaly Csikszentmihalyi, states: “Of all the virtues we can learn, no trait is more useful, more essential for survival, and more likely to improve the quality of life than the ability to transform adversity into an enjoyable challenge.”
GRIT, as previously mentioned, is defined as growth, resilience, intensity, and tenacity. This is a vital component of resident selection. It should include the resident’s previous academic abilities. A form of this characteristic was used as a part of the criteria of the original Halstead resident for training academic surgeons at Johns Hopkins. Selecting the right set of candidates will create a unique sense of community. It is also important to select candidates with a high level of emotional intelligence in a new program. Residents will be put in environments with staff who are not familiar with having physician trainees and will require residents to handle those situations with poise and humility.
A final important consideration when recruiting residents is promoting diversity. This can be done by selecting an interview panel that encompasses staff from different areas of health care with whom the residents will be required to interact. This inclusive interview team will also be responsible with creating a standardized and structured interview process. Faculty should also be trained to avoid anchoring bias based on the application or resume alone prior to interview [51].
Aside from the “3Fs” model (faculty, finance, and facilities), starting a new teaching hospital poses challenges around reimbursement and accreditation. Once sponsorship and training sites have been identified, the new teaching program must determine if it has the regulatory right to start and develop a GME resident FTE cap and to be reimbursed for the residency training through CMS. Building a resident FTE cap large enough to support the hospital and the health network’s needs, not only operationally and financially, but strategically, to provide workforce solutions in response to community health needs assessments. The Congressional Research Service (CRS) recently published an overview of how Medicare Graduate Medical Education Payments work [58]. CRS identified selected GME funding issues for the Congress to address including that Medicare GME payments do not reimburse hospitals for their up-front investment to begin new residency programs. Lack of up-front or even retro funding is a significant challenge to hospitals starting new residency programs as well as the increase in medical school enrollments and projected physician workforce shortages. As a result of absence of up-front funding, hospitals need to intertwine physician workforce initiatives into their strategic plans and business objectives rather than seeing residency training as separate from the strategy vision. By doing so, hospital executives incorporate residency training costs into their growth proformas and establish community-based recruitment, training, and retention goals as part of their growth outcomes. Hospital executives see the value of residency programs when viewing them as a workforce development initiative rather than solely an educational program that is part of a community mission.
There are many factors that determine if a hospital is eligible for Medicare GME reimbursement, which can be found at cms.gov. CMS regulations define a “new medical residency training program” simply as “a medical residency that receives initial accreditation by the appropriate accrediting body.” CMS will reimburse eligible hospitals for starting new residencies albeit under challenging and sometimes ambiguous guidelines. For example, as the end of a 5-year cap building period, CMS completes a balancing test to determine if a program is new for Medicare GME reimbursement purposes during a new teaching hospital’s 5-year cap-building window. In addition to obtaining ACGME initial accreditation status, CMS considers the following factors: (a) whether the program director is new, (b) whether the teaching staff is new, (c) whether residents came from an existing program, (d) relationship between hospitals, (e) degree to which hospital with an original program continues to operate its own program in the same specialty, (f) whether a program was relocated from a closed hospital and if so, whether it was part of that hospital’s caps, and (g) whether a program is part of any existing hospital’s caps [59]. While the balance test of “newness” might appear to be straightforward, every health-care system or entity struggles with some elements depending on their situation. There are numerous factors that could affect “newness” of a program, such as meaning all curriculum requirements, having sufficient number of qualified faculty, recruiting high quality candidates, etc. One area that programs can find challenging is recruiting residents with prior training. For a new program, this can put a damper on the depth of a recruitment pool. CMS’s guidance on the “new resident” has been that in order to maintain newness, most of the residents in the program must be residents who are also new, again, with no prior training, or the resident’s initial residency period (or IRP) not triggered.
Another CMS newness challenge faced by new programs is the comingling issues. As a new program, residents cannot participate in side-by-side training with other residents of the same specialty, as that is not deemed as “new.” Yet another area that programs can find challenging in passing the “newness” test is using new people, resources, and sites and not from existing programs. This poses a particularly significant hurdle when an organization likes to internally promote. If a health system has one family medicine program and wants to start a new family medicine program at another campus, promoting the associate program director from the existing residency to program director of the new residency can pose a problem. The keyword in this last paragraph is “can.” The CMS balance does allow for some wiggle room and, overall, much of a program should pass all elements of the balance test, hence the name “balance” in order to qualify to receive Medicare GME reimbursement.
A few tips for mitigating the risk of losing up-front investment to failure to pass the newness assessment include but are not limited to: (1) getting a Medicare GME reimbursement consultant to conduct a “newness” assessment of your new residency programs. This should be conducted at the beginning and all throughout the 5-year cap building process. (2) Hiring a project manager to help keep new program builds in sync with the larger objective which is ensure the provision of necessary financial support for administrative, educational, and clinical resources, including personnel. A project manager will also help programs remedy obstacles to pass the balance test of newness, which inevitably require logistical support. (3) Organizing the project in terms of faculty, facility, and finance tasks and activities. Accreditation work is assumed and a significant piece of the up-front feasibility study, for example, who would be interested? What rotations would we be able to keep in-house versus out-of-house? How much will things cost? etc. Physician Leads receive accreditation standards and application and work to draft a rotation schedule prior to a planning meeting. The goal of the planning meeting is to score the department’s readiness (Table 1). The readiness assessment will help to structure the way we launch the change and minimize the time and resources spent on implementing the changes. With the assessment, we can learn: (1) current state of department’s compliance, capacity, personnel, and resource; (2) what the curriculum rotation schedule could look like; and (3) the department’s experience and belief in the value of the change.
The process to start successful and dynamic residency programs appeared a bit overwhelming at times, but it was a meaningful experience. The main pillars of implementation for a successful graduate medical education program encompass all “3Fs”; program faculty, facilities, and finances to build and support a cutting-edge, competency-based medical education. The advice to other programs is to embrace the experience and help encourage growth in graduate medical training positions to create succession and increase the number of physicians to help prevent reduce of physician shortage.
IntechOpen publishes different types of publications
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On this context, this chapter summarizes the general characteristics of Actinobacteria, its habitat, systematic classification, various biotechnological applications, and negative impact on plants and animals.",book:{id:"5056",slug:"actinobacteria-basics-and-biotechnological-applications",title:"Actinobacteria",fullTitle:"Actinobacteria - Basics and Biotechnological Applications"},signatures:"Ranjani Anandan, Dhanasekaran Dharumadurai and Gopinath\nPonnusamy Manogaran",authors:[{id:"48914",title:"Dr.",name:"Dharumadurai",middleName:null,surname:"Dhanasekaran",slug:"dharumadurai-dhanasekaran",fullName:"Dharumadurai Dhanasekaran"}]},{id:"42319",doi:"10.5772/50364",title:"Lactic Acid Bacteria in Hydrogen-Producing Consortia: On Purpose or by Coincidence?",slug:"lactic-acid-bacteria-in-hydrogen-producing-consortia-on-purpose-or-by-coincidence-",totalDownloads:3796,totalCrossrefCites:32,totalDimensionsCites:89,abstract:null,book:{id:"2796",slug:"lactic-acid-bacteria-r-d-for-food-health-and-livestock-purposes",title:"Lactic Acid Bacteria",fullTitle:"Lactic Acid Bacteria - R & D for Food, Health and Livestock Purposes"},signatures:"Anna Sikora, Mieczysław Błaszczyk, Marcin Jurkowski and Urszula Zielenkiewicz",authors:[{id:"143688",title:"Dr.",name:"Urszula",middleName:null,surname:"Zielenkiewicz",slug:"urszula-zielenkiewicz",fullName:"Urszula Zielenkiewicz"},{id:"146985",title:"Dr.",name:"Anna",middleName:null,surname:"Sikora",slug:"anna-sikora",fullName:"Anna Sikora"},{id:"162424",title:"Prof.",name:"Mieczysław",middleName:null,surname:"Błaszczyk",slug:"mieczyslaw-blaszczyk",fullName:"Mieczysław Błaszczyk"},{id:"162425",title:"Mr.",name:"Marcin",middleName:null,surname:"Jurkowski",slug:"marcin-jurkowski",fullName:"Marcin Jurkowski"}]},{id:"42328",doi:"10.5772/47766",title:"Lactic Acid Bacteria as Source of Functional Ingredients",slug:"lactic-acid-bacteria-as-source-of-functional-ingredients",totalDownloads:7625,totalCrossrefCites:23,totalDimensionsCites:52,abstract:null,book:{id:"2796",slug:"lactic-acid-bacteria-r-d-for-food-health-and-livestock-purposes",title:"Lactic Acid Bacteria",fullTitle:"Lactic Acid Bacteria - R & D for Food, Health and Livestock Purposes"},signatures:"Panagiota Florou-Paneri, Efterpi Christaki and Eleftherios Bonos",authors:[{id:"140984",title:"Prof.",name:"Panagiota",middleName:null,surname:"Florou-Paneri",slug:"panagiota-florou-paneri",fullName:"Panagiota Florou-Paneri"},{id:"142773",title:"Dr.",name:"Efterpi",middleName:null,surname:"Christaki",slug:"efterpi-christaki",fullName:"Efterpi Christaki"},{id:"142774",title:"Dr.",name:"Eleftherios",middleName:null,surname:"Bonos",slug:"eleftherios-bonos",fullName:"Eleftherios Bonos"}]},{id:"42337",doi:"10.5772/50839",title:"Exopolysaccharides of Lactic Acid Bacteria for Food and Colon Health Applications",slug:"exopolysaccharides-of-lactic-acid-bacteria-for-food-and-colon-health-applications",totalDownloads:6385,totalCrossrefCites:18,totalDimensionsCites:47,abstract:null,book:{id:"2796",slug:"lactic-acid-bacteria-r-d-for-food-health-and-livestock-purposes",title:"Lactic Acid Bacteria",fullTitle:"Lactic Acid Bacteria - R & D for Food, Health and Livestock Purposes"},signatures:"Tsuda Harutoshi",authors:[{id:"141928",title:"Dr.",name:"Harutoshi",middleName:null,surname:"Tsuda",slug:"harutoshi-tsuda",fullName:"Harutoshi Tsuda"}]},{id:"42322",doi:"10.5772/51282",title:"The Current Status and Future Expectations in Industrial Production of Lactic Acid by Lactic Acid Bacteria",slug:"the-current-status-and-future-expectations-in-industrial-production-of-lactic-acid-by-lactic-acid-ba",totalDownloads:9099,totalCrossrefCites:18,totalDimensionsCites:46,abstract:null,book:{id:"2796",slug:"lactic-acid-bacteria-r-d-for-food-health-and-livestock-purposes",title:"Lactic Acid Bacteria",fullTitle:"Lactic Acid Bacteria - R & D for Food, Health and Livestock Purposes"},signatures:"Sanna Taskila and Heikki Ojamo",authors:[{id:"139705",title:"Dr.",name:null,middleName:null,surname:"Taskila",slug:"taskila",fullName:"Taskila"},{id:"142916",title:"Prof.",name:"Heikki",middleName:null,surname:"Ojamo",slug:"heikki-ojamo",fullName:"Heikki Ojamo"}]}],mostDownloadedChaptersLast30Days:[{id:"49873",title:"An Introduction to Actinobacteria",slug:"an-introduction-to-actinobacteria",totalDownloads:8089,totalCrossrefCites:29,totalDimensionsCites:101,abstract:"Actinobacteria, which share the characteristics of both bacteria and fungi, are widely distributed in both terrestrial and aquatic ecosystems, mainly in soil, where they play an essential role in recycling refractory biomaterials by decomposing complex mixtures of polymers in dead plants and animals and fungal materials. They are considered as the biotechnologically valuable bacteria that are exploited for its secondary metabolite production. Approximately, 10,000 bioactive metabolites are produced by Actinobacteria, which is 45% of all bioactive microbial metabolites discovered. Especially Streptomyces species produce industrially important microorganisms as they are a rich source of several useful bioactive natural products with potential applications. Though it has various applications, some Actinobacteria have its own negative effect against plants, animals, and humans. On this context, this chapter summarizes the general characteristics of Actinobacteria, its habitat, systematic classification, various biotechnological applications, and negative impact on plants and animals.",book:{id:"5056",slug:"actinobacteria-basics-and-biotechnological-applications",title:"Actinobacteria",fullTitle:"Actinobacteria - Basics and Biotechnological Applications"},signatures:"Ranjani Anandan, Dhanasekaran Dharumadurai and Gopinath\nPonnusamy Manogaran",authors:[{id:"48914",title:"Dr.",name:"Dharumadurai",middleName:null,surname:"Dhanasekaran",slug:"dharumadurai-dhanasekaran",fullName:"Dharumadurai Dhanasekaran"}]},{id:"55303",title:"Classification of Anti‐Bacterial Agents and Their Functions",slug:"classification-of-anti-bacterial-agents-and-their-functions",totalDownloads:9155,totalCrossrefCites:10,totalDimensionsCites:20,abstract:"Bacteria that cause bacterial infections and disease are called pathogenic bacteria. They cause diseases and infections when they get into the body and begin to reproduce and crowd out healthy bacteria or to grow into tissues that are normally sterile. To cure infectious diseases, researchers discovered antibacterial agents, which are considered to be the most promising chemotherapeutic agents. Keeping in mind the resistance phenomenon developing against antibacterial agents, new drugs are frequently entering into the market along with the existing drugs. In this chapter, we discussed a revised classification and function of the antibacterial agent based on a literature survey. The antibacterial agents can be classified into five major groups, i.e. type of action, source, spectrum of activity, chemical structure, and function.",book:{id:"5867",slug:"antibacterial-agents",title:"Antibacterial Agents",fullTitle:"Antibacterial Agents"},signatures:"Hamid Ullah and Saqib Ali",authors:[{id:"201024",title:"Dr.",name:"Hamid",middleName:null,surname:"Ullah",slug:"hamid-ullah",fullName:"Hamid Ullah"},{id:"202624",title:"Dr.",name:"Saqib",middleName:null,surname:"Ali",slug:"saqib-ali",fullName:"Saqib Ali"}]},{id:"58507",title:"Probiotics and Ruminant Health",slug:"probiotics-and-ruminant-health",totalDownloads:2820,totalCrossrefCites:5,totalDimensionsCites:9,abstract:"Probiotics are viable microorganisms with beneficial health effects for humans and animals. They are formulated into many functional foods and animal feed. There is a growing research interest in the application and benefits of probiotics in ruminant production. Several recent studies have evaluated the potential of probiotics in animal nutrition and health. In this chapter, we have reviewed current research on the benefits of probiotics on gut microbial communities in ruminants and their impact on ruminant production, health and overall wellbeing.",book:{id:"6425",slug:"probiotics-current-knowledge-and-future-prospects",title:"Probiotics",fullTitle:"Probiotics - Current Knowledge and Future Prospects"},signatures:"Sarah Adjei-Fremah, Kingsley Ekwemalor, Mulumebet Worku and\nSalam Ibrahim",authors:[{id:"107905",title:"Prof.",name:"Salam",middleName:null,surname:"Ibrahim",slug:"salam-ibrahim",fullName:"Salam Ibrahim"},{id:"218786",title:"Dr.",name:'Mulumebet "Millie"',middleName:null,surname:"Worku",slug:'mulumebet-"millie"-worku',fullName:'Mulumebet "Millie" Worku'},{id:"218789",title:"Dr.",name:"Kingsley",middleName:null,surname:"Ekwemalor",slug:"kingsley-ekwemalor",fullName:"Kingsley Ekwemalor"},{id:"223195",title:"Dr.",name:"Sarah",middleName:null,surname:"Adjei-Fremah",slug:"sarah-adjei-fremah",fullName:"Sarah Adjei-Fremah"}]},{id:"49285",title:"Morphological Identification of Actinobacteria",slug:"morphological-identification-of-actinobacteria",totalDownloads:8512,totalCrossrefCites:19,totalDimensionsCites:45,abstract:"Actinobacteria is a phylum of gram-positive bacteria with high G+C content. Among gram-positive bacteria, actinobacteria exhibit the richest morphological differentiation, which is based on a filamentous degree of organization like filamentous fungi. The actinobacteria morphological characteristics are basic foundation and information of phylogenetic systematics. Classic actinomycetes have well-developed radial mycelium, which can be divided into substrate mycelium and aerial mycelium according to morphology and function. Some actinobacteria can form complicated structures, such as spore, spore chain, sporangia, and sporangiospore. The structure of hyphae and ultrastructure of spore or sporangia can be observed with microscopy. Actinobacteria have different cultural characteristics in various kinds of culture media, which are important in the classification identification, general with spores, aerial hyphae, with or without color and the soluble pigment, different growth condition on various media as the main characteristics. The morphological differentiation of actinobacteria, especially streptomycetes, is controlled by relevant genes. Both morphogenesis and antibiotic production in the streptomycetes are initiated in response to starvation, and these events are coupled.",book:{id:"5056",slug:"actinobacteria-basics-and-biotechnological-applications",title:"Actinobacteria",fullTitle:"Actinobacteria - Basics and Biotechnological Applications"},signatures:"Qinyuan Li, Xiu Chen, Yi Jiang and Chenglin Jiang",authors:[{id:"175852",title:"Dr.",name:"Chen",middleName:null,surname:"Jiang",slug:"chen-jiang",fullName:"Chen Jiang"}]},{id:"68772",title:"Multidrug-Resistant Bacterial Foodborne Pathogens: Impact on Human Health and Economy",slug:"multidrug-resistant-bacterial-foodborne-pathogens-impact-on-human-health-and-economy",totalDownloads:1043,totalCrossrefCites:3,totalDimensionsCites:7,abstract:"The drug abuse known to occur during growth of animals intended for food production, because of their use as either a prophylactic or therapeutic treatment, promotes the emergence of bacterial drug resistance. It has been reported that at least 25% of the foodborne isolates show drug resistance to one or more classes of antimicrobials (FAO 2018). There are diverse mechanisms that promote drug resistance. It is known that the use of sub-therapeutic doses of antibiotics in animals intended for food production promotes mutations of some chromosomal genes such as gyrA-parC and mphA, which are responsible for quinolone and azithromycin resistance, respectively. Also, the horizontal transfer of resistance genes as groups (“cassettes”) or plasmids makes the spread of resistance to different bacterial genera possible, among which there could be pathogens. The World Health Organization considers the emergence of multidrug-resistant pathogenic bacteria as a health problem, since the illnesses caused by them complicate the treatment and increase the morbidity and mortality rates. The complication in the illness treatment caused by a multidrug-resistant pathogen causes economic losses to patients for the payment of long stays in hospitals and also causes economic losses to companies due to the absenteeism of their workers.",book:{id:"8133",slug:"pathogenic-bacteria",title:"Pathogenic Bacteria",fullTitle:"Pathogenic Bacteria"},signatures:"Lilia M. Mancilla-Becerra, Teresa Lías-Macías, Cristina L. 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These advances have helped foster better support for animal health, more humane animal production, and a better understanding of the physiology of endangered species to improve the assisted reproductive technologies or the pathogenesis of certain diseases, where animals can be used as models for human diseases (like cancer, degenerative diseases or fertility), and even as a guarantee of public health. Bridging Human, Animal, and Environmental health, the holistic and integrative “One Health” concept intimately associates the developments within those fields, projecting its advancements into practice. This book series aims to tackle various animal-related medicine and sciences fields, providing thematic volumes consisting of high-quality significant research directed to researchers and postgraduates. It aims to give us a glimpse into the new accomplishments in the Veterinary Medicine and Science field. 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After almost 32 years of teaching at the University of Trás-os-Montes and Alto Douro, she recently moved to the University of Évora, Department of Veterinary Medicine, where she teaches in the field of Animal Reproduction and Clinics. Her primary research areas include the molecular markers of the endometrial cycle and the embryo–maternal interaction, including oxidative stress and the reproductive physiology and disorders of sexual development, besides the molecular determinants of male and female fertility. She often supervises students preparing their master's or doctoral theses. 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Other positions she has held at the university include Vice-Dean of Master Programs, Vice-Dean of the Degree in Biology and Vice-Dean for Mobility and Enterprise and Engagement at the Faculty of Science (University of Alicante). She received her Bachelor in Biology in 1998 (University of Alicante) and her PhD in 2003 (Biochemistry, University of Alicante). She undertook post-doctoral research at the University of East Anglia (Norwich, U.K. 2004-2005; 2007-2008).\nHer multidisciplinary research focuses on investigating archaea and their potential applications in biotechnology. She has an H-index of 21. She has authored one patent and has published more than 70 indexed papers and around 60 book chapters.\nShe has contributed to more than 150 national and international meetings during the last 15 years. Her research interests include archaea metabolism, enzymes purification and characterization, gene regulation, carotenoids and bioplastics production, antioxidant\ncompounds, waste water treatments, and brines bioremediation.\nRosa María’s other roles include editorial board member for several journals related\nto biochemistry, reviewer for more than 60 journals (biochemistry, molecular biology, biotechnology, chemistry and microbiology) and president of several organizing committees in international meetings related to the N-cycle or respiratory processes.",institutionString:null,institution:{name:"University of Alicante",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"79367",title:"Dr.",name:"Ana Isabel",middleName:null,surname:"Flores",slug:"ana-isabel-flores",fullName:"Ana Isabel Flores",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRpIOQA0/Profile_Picture_1632418099564",institutionString:null,institution:{name:"Hospital Universitario 12 De Octubre",institutionURL:null,country:{name:"Spain"}}},{id:"328234",title:"Ph.D.",name:"Christian",middleName:null,surname:"Palavecino",slug:"christian-palavecino",fullName:"Christian Palavecino",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000030DhEhQAK/Profile_Picture_1628835318625",institutionString:null,institution:{name:"Central University of Chile",institutionURL:null,country:{name:"Chile"}}},{id:"186585",title:"Dr.",name:"Francisco Javier",middleName:null,surname:"Martin-Romero",slug:"francisco-javier-martin-romero",fullName:"Francisco Javier Martin-Romero",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSB3HQAW/Profile_Picture_1631258137641",institutionString:null,institution:{name:"University of Extremadura",institutionURL:null,country:{name:"Spain"}}}]},{id:"15",title:"Chemical Biology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/15.jpg",editor:{id:"441442",title:"Dr.",name:"Şükrü",middleName:null,surname:"Beydemir",slug:"sukru-beydemir",fullName:"Şükrü Beydemir",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003GsUoIQAV/Profile_Picture_1634557147521",biography:"Dr. Şükrü Beydemir obtained a BSc in Chemistry in 1995 from Yüzüncü Yıl University, MSc in Biochemistry in 1998, and PhD in Biochemistry in 2002 from Atatürk University, Turkey. He performed post-doctoral studies at Max-Planck Institute, Germany, and University of Florence, Italy in addition to making several scientific visits abroad. He currently works as a Full Professor of Biochemistry in the Faculty of Pharmacy, Anadolu University, Turkey. Dr. Beydemir has published over a hundred scientific papers spanning protein biochemistry, enzymology and medicinal chemistry, reviews, book chapters and presented several conferences to scientists worldwide. He has received numerous publication awards from various international scientific councils. He serves in the Editorial Board of several international journals. 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He is a member of the Turkish Biochemical Society, American Chemical Society, and German Genetics society. Dr. Ekinci published around ninety scientific papers, reviews and book chapters, and presented several conferences to scientists. He has received numerous publication awards from several scientific councils. 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He is also a faculty member in the Molecular Oncology Program. He obtained his MSc and Ph.D. at Oregon State University and Texas Tech University, respectively. He pursued his postdoctoral studies at Rutgers University Medical School and the National Institutes of Health (NIH/NIDDK), USA. His research focuses on biochemistry, biophysics, genetics, molecular biology, and molecular medicine with specialization in the fields of drug design, protein structure-function, protein folding, prions, microRNA, pseudogenes, molecular cancer, epigenetics, metabolites, proteomics, genomics, protein expression, and characterization by spectroscopic and calorimetric methods.",institutionString:"University of Health Sciences",institution:null},{id:"180528",title:"Dr.",name:"Hiroyuki",middleName:null,surname:"Kagechika",slug:"hiroyuki-kagechika",fullName:"Hiroyuki Kagechika",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180528/images/system/180528.jpg",biography:"Hiroyuki Kagechika received his bachelor’s degree and Ph.D. in Pharmaceutical Sciences from the University of Tokyo, Japan, where he served as an associate professor until 2004. He is currently a professor at the Institute of Biomaterials and Bioengineering (IBB), Tokyo Medical and Dental University (TMDU). From 2010 to 2012, he was the dean of the Graduate School of Biomedical Science. Since 2012, he has served as the vice dean of the Graduate School of Medical and Dental Sciences. He has been the director of the IBB since 2020. Dr. Kagechika’s major research interests are the medicinal chemistry of retinoids, vitamins D/K, and nuclear receptors. He has developed various compounds including a drug for acute promyelocytic leukemia.",institutionString:"Tokyo Medical and Dental University",institution:{name:"Tokyo Medical and Dental University",country:{name:"Japan"}}},{id:"94311",title:"Prof.",name:"Martins",middleName:"Ochubiojo",surname:"Ochubiojo Emeje",slug:"martins-ochubiojo-emeje",fullName:"Martins Ochubiojo Emeje",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94311/images/system/94311.jpeg",biography:"Martins Emeje obtained a BPharm with distinction from Ahmadu Bello University, Nigeria, and an MPharm and Ph.D. from the University of Nigeria (UNN), where he received the best Ph.D. award and was enlisted as UNN’s “Face of Research.” He established the first nanomedicine center in Nigeria and was the pioneer head of the intellectual property and technology transfer as well as the technology innovation and support center. Prof. Emeje’s several international fellowships include the prestigious Raman fellowship. He has published more than 150 articles and patents. He is also the head of R&D at NIPRD and holds a visiting professor position at Nnamdi Azikiwe University, Nigeria. He has a postgraduate certificate in Project Management from Walden University, Minnesota, as well as a professional teaching certificate and a World Bank certification in Public Procurement. Prof. Emeje was a national chairman of academic pharmacists in Nigeria and the 2021 winner of the May & Baker Nigeria Plc–sponsored prize for professional service in research and innovation.",institutionString:"National Institute for Pharmaceutical Research and Development",institution:{name:"National Institute for Pharmaceutical Research and Development",country:{name:"Nigeria"}}},{id:"268659",title:"Ms.",name:"Xianquan",middleName:null,surname:"Zhan",slug:"xianquan-zhan",fullName:"Xianquan Zhan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/268659/images/8143_n.jpg",biography:"Dr. Zhan received his undergraduate and graduate training in the fields of preventive medicine and epidemiology and statistics at the West China University of Medical Sciences in China during 1989 to 1999. He received his post-doctoral training in oncology and cancer proteomics for two years at the Cancer Research Institute of Human Medical University in China. In 2001, he went to the University of Tennessee Health Science Center (UTHSC) in USA, where he was a post-doctoral researcher and focused on mass spectrometry and cancer proteomics. Then, he was appointed as an Assistant Professor of Neurology, UTHSC in 2005. He moved to the Cleveland Clinic in USA as a Project Scientist/Staff in 2006 where he focused on the studies of eye disease proteomics and biomarkers. He returned to UTHSC as an Assistant Professor of Neurology in the end of 2007, engaging in proteomics and biomarker studies of lung diseases and brain tumors, and initiating the studies of predictive, preventive, and personalized medicine (PPPM) in cancer. In 2010, he was promoted to Associate Professor of Neurology, UTHSC. Currently, he is a Professor at Xiangya Hospital of Central South University in China, Fellow of Royal Society of Medicine (FRSM), the European EPMA National Representative in China, Regular Member of American Association for the Advancement of Science (AAAS), European Cooperation of Science and Technology (e-COST) grant evaluator, Associate Editors of BMC Genomics, BMC Medical Genomics, EPMA Journal, and Frontiers in Endocrinology, Executive Editor-in-Chief of Med One. He has\npublished 116 peer-reviewed research articles, 16 book chapters, 2 books, and 2 US patents. His current main research interest focuses on the studies of cancer proteomics and biomarkers, and the use of modern omics techniques and systems biology for PPPM in cancer, and on the development and use of 2DE-LC/MS for the large-scale study of human proteoforms.",institutionString:null,institution:{name:"Xiangya Hospital Central South University",country:{name:"China"}}},{id:"40482",title:null,name:"Rizwan",middleName:null,surname:"Ahmad",slug:"rizwan-ahmad",fullName:"Rizwan Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/40482/images/system/40482.jpeg",biography:"Dr. Rizwan Ahmad is a University Professor and Coordinator, Quality and Development, College of Medicine, Imam Abdulrahman bin Faisal University, Saudi Arabia. Previously, he was Associate Professor of Human Function, Oman Medical College, Oman, and SBS University, Dehradun. Dr. Ahmad completed his education at Aligarh Muslim University, Aligarh. He has published several articles in peer-reviewed journals, chapters, and edited books. His area of specialization is free radical biochemistry and autoimmune diseases.",institutionString:"Imam Abdulrahman Bin Faisal University",institution:{name:"Imam Abdulrahman Bin Faisal University",country:{name:"Saudi Arabia"}}},{id:"41865",title:"Prof.",name:"Farid A.",middleName:null,surname:"Badria",slug:"farid-a.-badria",fullName:"Farid A. Badria",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/41865/images/system/41865.jpg",biography:"Farid A. Badria, Ph.D., is the recipient of several awards, including The World Academy of Sciences (TWAS) Prize for Public Understanding of Science; the World Intellectual Property Organization (WIPO) Gold Medal for best invention; Outstanding Arab Scholar, Kuwait; and the Khwarizmi International Award, Iran. He has 250 publications, 12 books, 20 patents, and several marketed pharmaceutical products to his credit. He continues to lead research projects on developing new therapies for liver, skin disorders, and cancer. Dr. Badria was listed among the world’s top 2% of scientists in medicinal and biomolecular chemistry in 2019 and 2020. He is a member of the Arab Development Fund, Kuwait; International Cell Research Organization–United Nations Educational, Scientific and Cultural Organization (ICRO–UNESCO), Chile; and UNESCO Biotechnology France",institutionString:"Mansoura University",institution:{name:"Mansoura University",country:{name:"Egypt"}}},{id:"329385",title:"Dr.",name:"Rajesh K.",middleName:"Kumar",surname:"Singh",slug:"rajesh-k.-singh",fullName:"Rajesh K. Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329385/images/system/329385.png",biography:"Dr. Singh received a BPharm (2003) and MPharm (2005) from Panjab University, Chandigarh, India, and a Ph.D. (2013) from Punjab Technical University (PTU), Jalandhar, India. He has more than sixteen years of teaching experience and has supervised numerous postgraduate and Ph.D. students. He has to his credit more than seventy papers in SCI- and SCOPUS-indexed journals, fifty-five conference proceedings, four books, six Best Paper Awards, and five projects from different government agencies. He is currently an editorial board member of eight international journals and a reviewer for more than fifty scientific journals. He received Top Reviewer and Excellent Peer Reviewer Awards from Publons in 2016 and 2017, respectively. He is also on the panel of The International Reviewer for reviewing research proposals for grants from the Royal Society. He also serves as a Publons Academy mentor and Bentham brand ambassador.",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",country:{name:"India"}}},{id:"142388",title:"Dr.",name:"Thiago",middleName:"Gomes",surname:"Gomes Heck",slug:"thiago-gomes-heck",fullName:"Thiago Gomes Heck",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/142388/images/7259_n.jpg",biography:null,institutionString:null,institution:{name:"Universidade Regional do Noroeste do Estado do Rio Grande do Sul",country:{name:"Brazil"}}},{id:"336273",title:"Assistant Prof.",name:"Janja",middleName:null,surname:"Zupan",slug:"janja-zupan",fullName:"Janja Zupan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/336273/images/14853_n.jpeg",biography:"Janja Zupan graduated in 2005 at the Department of Clinical Biochemistry (superviser prof. dr. Janja Marc) in the field of genetics of osteoporosis. Since November 2009 she is working as a Teaching Assistant at the Faculty of Pharmacy, Department of Clinical Biochemistry. In 2011 she completed part of her research and PhD work at Institute of Genetics and Molecular Medicine, University of Edinburgh. She finished her PhD entitled The influence of the proinflammatory cytokines on the RANK/RANKL/OPG in bone tissue of osteoporotic and osteoarthritic patients in 2012. From 2014-2016 she worked at the Institute of Biomedical Sciences, University of Aberdeen as a postdoctoral research fellow on UK Arthritis research project where she gained knowledge in mesenchymal stem cells and regenerative medicine. She returned back to University of Ljubljana, Faculty of Pharmacy in 2016. She is currently leading project entitled Mesenchymal stem cells-the keepers of tissue endogenous regenerative capacity facing up to aging of the musculoskeletal system funded by Slovenian Research Agency.",institutionString:null,institution:{name:"University of Ljubljana",country:{name:"Slovenia"}}},{id:"357453",title:"Dr.",name:"Radheshyam",middleName:null,surname:"Maurya",slug:"radheshyam-maurya",fullName:"Radheshyam Maurya",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/357453/images/16535_n.jpg",biography:null,institutionString:null,institution:{name:"University of Hyderabad",country:{name:"India"}}},{id:"418340",title:"Dr.",name:"Jyotirmoi",middleName:null,surname:"Aich",slug:"jyotirmoi-aich",fullName:"Jyotirmoi Aich",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000038Ugi5QAC/Profile_Picture_2022-04-15T07:48:28.png",biography:"Biotechnologist with 15 years of research including 6 years of teaching experience. Demonstrated record of scientific achievements through consistent publication record (H index = 13, with 874 citations) in high impact journals such as Nature Communications, Oncotarget, Annals of Oncology, PNAS, and AJRCCM, etc. Strong research professional with a post-doctorate from ACTREC where I gained experimental oncology experience in clinical settings and a doctorate from IGIB where I gained expertise in asthma pathophysiology. A well-trained biotechnologist with diverse experience on the bench across different research themes ranging from asthma to cancer and other infectious diseases. An individual with a strong commitment and innovative mindset. Have the ability to work on diverse projects such as regenerative and molecular medicine with an overall mindset of improving healthcare.",institutionString:"DY Patil Deemed to Be University",institution:null},{id:"349288",title:"Prof.",name:"Soumya",middleName:null,surname:"Basu",slug:"soumya-basu",fullName:"Soumya Basu",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035QxIDQA0/Profile_Picture_2022-04-15T07:47:01.jpg",biography:"Soumya Basu, Ph.D., is currently working as an Associate Professor at Dr. D. Y. Patil Biotechnology and Bioinformatics Institute, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India. With 16+ years of trans-disciplinary research experience in Drug Design, development, and pre-clinical validation; 20+ research article publications in journals of repute, 9+ years of teaching experience, trained with cross-disciplinary education, Dr. Basu is a life-long learner and always thrives for new challenges.\r\nHer research area is the design and synthesis of small molecule partial agonists of PPAR-γ in lung cancer. She is also using artificial intelligence and deep learning methods to understand the exosomal miRNA’s role in cancer metastasis. Dr. Basu is the recipient of many awards including the Early Career Research Award from the Department of Science and Technology, Govt. of India. She is a reviewer of many journals like Molecular Biology Reports, Frontiers in Oncology, RSC Advances, PLOS ONE, Journal of Biomolecular Structure & Dynamics, Journal of Molecular Graphics and Modelling, etc. She has edited and authored/co-authored 21 journal papers, 3 book chapters, and 15 abstracts. She is a Board of Studies member at her university. She is a life member of 'The Cytometry Society”-in India and 'All India Cell Biology Society”- in India.",institutionString:"Dr. D.Y. Patil Vidyapeeth, Pune",institution:{name:"Dr. D.Y. Patil Vidyapeeth, Pune",country:{name:"India"}}},{id:"354817",title:"Dr.",name:"Anubhab",middleName:null,surname:"Mukherjee",slug:"anubhab-mukherjee",fullName:"Anubhab Mukherjee",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y0000365PbRQAU/ProfilePicture%202022-04-15%2005%3A11%3A18.480",biography:"A former member of Laboratory of Nanomedicine, Brigham and Women’s Hospital, Harvard University, Boston, USA, Dr. Anubhab Mukherjee is an ardent votary of science who strives to make an impact in the lives of those afflicted with cancer and other chronic/acute ailments. He completed his Ph.D. from CSIR-Indian Institute of Chemical Technology, Hyderabad, India, having been skilled with RNAi, liposomal drug delivery, preclinical cell and animal studies. He pursued post-doctoral research at College of Pharmacy, Health Science Center, Texas A & M University and was involved in another postdoctoral research at Department of Translational Neurosciences and Neurotherapeutics, John Wayne Cancer Institute, Santa Monica, California. In 2015, he worked in Harvard-MIT Health Sciences & Technology as a visiting scientist. He has substantial experience in nanotechnology-based formulation development and successfully served various Indian organizations to develop pharmaceuticals and nutraceutical products. He is an inventor in many US patents and an author in many peer-reviewed articles, book chapters and books published in various media of international repute. Dr. Mukherjee is currently serving as Principal Scientist, R&D at Esperer Onco Nutrition (EON) Pvt. Ltd. and heads the Hyderabad R&D center of the organization.",institutionString:"Esperer Onco Nutrition Pvt Ltd.",institution:null},{id:"319365",title:"Assistant Prof.",name:"Manash K.",middleName:null,surname:"Paul",slug:"manash-k.-paul",fullName:"Manash K. Paul",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/319365/images/system/319365.png",biography:"Manash K. Paul is a Principal Investigator and Scientist at the University of California Los Angeles. He has contributed significantly to the fields of stem cell biology, regenerative medicine, and lung cancer. His research focuses on various signaling processes involved in maintaining stem cell homeostasis during the injury-repair process, deciphering lung stem cell niche, pulmonary disease modeling, immuno-oncology, and drug discovery. He is currently investigating the role of extracellular vesicles in premalignant lung cell migration and detecting the metastatic phenotype of lung cancer via machine-learning-based analyses of exosomal signatures. Dr. Paul has published in more than fifty peer-reviewed international journals and is highly cited. He is the recipient of many awards, including the UCLA Vice Chancellor’s award, a senior member of the Institute of Electrical and Electronics Engineers (IEEE), and an editorial board member for several international journals.",institutionString:"University of California Los Angeles",institution:{name:"University of California Los Angeles",country:{name:"United States of America"}}},{id:"311457",title:"Dr.",name:"Júlia",middleName:null,surname:"Scherer Santos",slug:"julia-scherer-santos",fullName:"Júlia Scherer Santos",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/311457/images/system/311457.jpg",biography:"Dr. Júlia Scherer Santos works in the areas of cosmetology, nanotechnology, pharmaceutical technology, beauty, and aesthetics. Dr. Santos also has experience as a professor of graduate courses. Graduated in Pharmacy, specialization in Cosmetology and Cosmeceuticals applied to aesthetics, specialization in Aesthetic and Cosmetic Health, and a doctorate in Pharmaceutical Nanotechnology. Teaching experience in Pharmacy and Aesthetics and Cosmetics courses. She works mainly on the following subjects: nanotechnology, cosmetology, pharmaceutical technology, aesthetics.",institutionString:"Universidade Federal de Juiz de Fora",institution:{name:"Universidade Federal de Juiz de Fora",country:{name:"Brazil"}}},{id:"219081",title:"Dr.",name:"Abdulsamed",middleName:null,surname:"Kükürt",slug:"abdulsamed-kukurt",fullName:"Abdulsamed Kükürt",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/219081/images/system/219081.png",biography:"Dr. Kükürt graduated from Uludağ University in Turkey. He started his academic career as a Research Assistant in the Department of Biochemistry at Kafkas University. In 2019, he completed his Ph.D. program in the Department of Biochemistry at the Institute of Health Sciences. He is currently working at the Department of Biochemistry, Kafkas University. He has 27 published research articles in academic journals, 11 book chapters, and 37 papers. He took part in 10 academic projects. He served as a reviewer for many articles. He still serves as a member of the review board in many academic journals. He is currently working on the protective activity of phenolic compounds in disorders associated with oxidative stress and inflammation.",institutionString:null,institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"178366",title:"Dr.",name:"Volkan",middleName:null,surname:"Gelen",slug:"volkan-gelen",fullName:"Volkan Gelen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178366/images/system/178366.jpg",biography:"Volkan Gelen is a Physiology specialist who received his veterinary degree from Kafkas University in 2011. Between 2011-2015, he worked as an assistant at Atatürk University, Faculty of Veterinary Medicine, Department of Physiology. In 2016, he joined Kafkas University, Faculty of Veterinary Medicine, Department of Physiology as an assistant professor. Dr. Gelen has been engaged in various academic activities at Kafkas University since 2016. There he completed 5 projects and has 3 ongoing projects. He has 60 articles published in scientific journals and 20 poster presentations in scientific congresses. His research interests include physiology, endocrine system, cancer, diabetes, cardiovascular system diseases, and isolated organ bath system studies.",institutionString:"Kafkas University",institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"418963",title:"Dr.",name:"Augustine Ododo",middleName:"Augustine",surname:"Osagie",slug:"augustine-ododo-osagie",fullName:"Augustine Ododo Osagie",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/418963/images/16900_n.jpg",biography:"Born into the family of Osagie, a prince of the Benin Kingdom. I am currently an academic in the Department of Medical Biochemistry, University of Benin. Part of the duties are to teach undergraduate students and conduct academic research.",institutionString:null,institution:{name:"University of Benin",country:{name:"Nigeria"}}},{id:"192992",title:"Prof.",name:"Shagufta",middleName:null,surname:"Perveen",slug:"shagufta-perveen",fullName:"Shagufta Perveen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192992/images/system/192992.png",biography:"Prof. Shagufta Perveen is a Distinguish Professor in the Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. Dr. Perveen has acted as the principal investigator of major research projects funded by the research unit of King Saud University. She has more than ninety original research papers in peer-reviewed journals of international repute to her credit. She is a fellow member of the Royal Society of Chemistry UK and the American Chemical Society of the United States.",institutionString:"King Saud University",institution:{name:"King Saud University",country:{name:"Saudi Arabia"}}},{id:"49848",title:"Dr.",name:"Wen-Long",middleName:null,surname:"Hu",slug:"wen-long-hu",fullName:"Wen-Long Hu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49848/images/system/49848.jpg",biography:"Wen-Long Hu is Chief of the Division of Acupuncture, Department of Chinese Medicine at Kaohsiung Chang Gung Memorial Hospital, as well as an adjunct associate professor at Fooyin University and Kaohsiung Medical University. Wen-Long is President of Taiwan Traditional Chinese Medicine Medical Association. He has 28 years of experience in clinical practice in laser acupuncture therapy and 34 years in acupuncture. He is an invited speaker for lectures and workshops in laser acupuncture at many symposiums held by medical associations. He owns the patent for herbal preparation and producing, and for the supercritical fluid-treated needle. Dr. Hu has published three books, 12 book chapters, and more than 30 papers in reputed journals, besides serving as an editorial board member of repute.",institutionString:"Kaohsiung Chang Gung Memorial Hospital",institution:{name:"Kaohsiung Chang Gung Memorial Hospital",country:{name:"Taiwan"}}},{id:"298472",title:"Prof.",name:"Andrey V.",middleName:null,surname:"Grechko",slug:"andrey-v.-grechko",fullName:"Andrey V. Grechko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/298472/images/system/298472.png",biography:"Andrey Vyacheslavovich Grechko, Ph.D., Professor, is a Corresponding Member of the Russian Academy of Sciences. He graduated from the Semashko Moscow Medical Institute (Semashko National Research Institute of Public Health) with a degree in Medicine (1998), the Clinical Department of Dermatovenerology (2000), and received a second higher education in Psychology (2009). Professor A.V. Grechko held the position of Сhief Physician of the Central Clinical Hospital in Moscow. He worked as a professor at the faculty and was engaged in scientific research at the Medical University. Starting in 2013, he has been the initiator of the creation of the Federal Scientific and Clinical Center for Intensive Care and Rehabilitology, Moscow, Russian Federation, where he also serves as Director since 2015. He has many years of experience in research and teaching in various fields of medicine, is an author/co-author of more than 200 scientific publications, 13 patents, 15 medical books/chapters, including Chapter in Book «Metabolomics», IntechOpen, 2020 «Metabolomic Discovery of Microbiota Dysfunction as the Cause of Pathology».",institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"199461",title:"Prof.",name:"Natalia V.",middleName:null,surname:"Beloborodova",slug:"natalia-v.-beloborodova",fullName:"Natalia V. Beloborodova",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/199461/images/system/199461.jpg",biography:'Natalia Vladimirovna Beloborodova was educated at the Pirogov Russian National Research Medical University, with a degree in pediatrics in 1980, a Ph.D. in 1987, and a specialization in Clinical Microbiology from First Moscow State Medical University in 2004. She has been a Professor since 1996. Currently, she is the Head of the Laboratory of Metabolism, a division of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russian Federation. N.V. Beloborodova has many years of clinical experience in the field of intensive care and surgery. She studies infectious complications and sepsis. She initiated a series of interdisciplinary clinical and experimental studies based on the concept of integrating human metabolism and its microbiota. Her scientific achievements are widely known: she is the recipient of the Marie E. Coates Award \\"Best lecturer-scientist\\" Gustafsson Fund, Karolinska Institutes, Stockholm, Sweden, and the International Sepsis Forum Award, Pasteur Institute, Paris, France (2014), etc. Professor N.V. Beloborodova wrote 210 papers, five books, 10 chapters and has edited four books.',institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"354260",title:"Ph.D.",name:"Tércio Elyan",middleName:"Azevedo",surname:"Azevedo Martins",slug:"tercio-elyan-azevedo-martins",fullName:"Tércio Elyan Azevedo Martins",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/354260/images/16241_n.jpg",biography:"Graduated in Pharmacy from the Federal University of Ceará with the modality in Industrial Pharmacy, Specialist in Production and Control of Medicines from the University of São Paulo (USP), Master in Pharmaceuticals and Medicines from the University of São Paulo (USP) and Doctor of Science in the program of Pharmaceuticals and Medicines by the University of São Paulo. Professor at Universidade Paulista (UNIP) in the areas of chemistry, cosmetology and trichology. Assistant Coordinator of the Higher Course in Aesthetic and Cosmetic Technology at Universidade Paulista Campus Chácara Santo Antônio. Experience in the Pharmacy area, with emphasis on Pharmacotechnics, Pharmaceutical Technology, Research and Development of Cosmetics, acting mainly on topics such as cosmetology, antioxidant activity, aesthetics, photoprotection, cyclodextrin and thermal analysis.",institutionString:null,institution:{name:"University of Sao Paulo",country:{name:"Brazil"}}},{id:"334285",title:"Ph.D. Student",name:"Sameer",middleName:"Kumar",surname:"Jagirdar",slug:"sameer-jagirdar",fullName:"Sameer Jagirdar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334285/images/14691_n.jpg",biography:"I\\'m a graduate student at the center for biosystems science and engineering at the Indian Institute of Science, Bangalore, India. I am interested in studying host-pathogen interactions at the biomaterial interface.",institutionString:null,institution:{name:"Indian Institute of Science Bangalore",country:{name:"India"}}},{id:"329248",title:"Dr.",name:"Md. Faheem",middleName:null,surname:"Haider",slug:"md.-faheem-haider",fullName:"Md. Faheem Haider",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329248/images/system/329248.jpg",biography:"Dr. Md. Faheem Haider completed his BPharm in 2012 at Integral University, Lucknow, India. In 2014, he completed his MPharm with specialization in Pharmaceutics at Babasaheb Bhimrao Ambedkar University, Lucknow, India. He received his Ph.D. degree from Jamia Hamdard University, New Delhi, India, in 2018. He was selected for the GPAT six times and his best All India Rank was 34. Currently, he is an assistant professor at Integral University. Previously he was an assistant professor at IIMT University, Meerut, India. He has experience teaching DPharm, Pharm.D, BPharm, and MPharm students. He has more than five publications in reputed journals to his credit. Dr. Faheem’s research area is the development and characterization of nanoformulation for the delivery of drugs to various organs.",institutionString:"Integral University",institution:{name:"Integral University",country:{name:"India"}}},{id:"329795",title:"Dr.",name:"Mohd Aftab",middleName:"Aftab",surname:"Siddiqui",slug:"mohd-aftab-siddiqui",fullName:"Mohd Aftab Siddiqui",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329795/images/system/329795.png",biography:"Dr. Mohd Aftab Siddiqui is an assistant professor in the Faculty of Pharmacy, Integral University, Lucknow, India, where he obtained a Ph.D. in Pharmacology in 2020. He also obtained a BPharm and MPharm from the same university in 2013 and 2015, respectively. His area of research is the pharmacological screening of herbal drugs/natural products in liver cancer and cardiac diseases. He is a member of many professional bodies and has guided many MPharm and PharmD research projects. Dr. Siddiqui has many national and international publications and one German patent to his credit.",institutionString:"Integral University",institution:null},{id:"255360",title:"Dr.",name:"Usama",middleName:null,surname:"Ahmad",slug:"usama-ahmad",fullName:"Usama Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255360/images/system/255360.png",biography:"Dr. Usama Ahmad holds a specialization in Pharmaceutics from Amity University, Lucknow, India. He received his Ph.D. from Integral University, Lucknow, India, with his work titled ‘Development and evaluation of silymarin nanoformulation for hepatic carcinoma’. Currently, he is an Assistant Professor of Pharmaceutics, at the Faculty of Pharmacy, Integral University. He has been teaching PharmD, BPharm, and MPharm students and conducting research in the novel drug delivery domain. From 2013 to 2014 he worked on a research project funded by SERB-DST, Government of India. He has a rich publication record with more than twenty-four original journal articles, two edited books, four book chapters, and several scientific articles to his credit. He is a member of the American Association for Cancer Research, the International Association for the Study of Lung Cancer, and the British Society for Nanomedicine. Dr. Ahmad’s research focus is on the development of nanoformulations to facilitate the delivery of drugs.",institutionString:"Integral University",institution:{name:"Integral University",country:{name:"India"}}},{id:"333824",title:"Dr.",name:"Ahmad Farouk",middleName:null,surname:"Musa",slug:"ahmad-farouk-musa",fullName:"Ahmad Farouk Musa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333824/images/22684_n.jpg",biography:"Dato’ Dr Ahmad Farouk Musa\nMD, MMED (Surgery) (Mal), Fellowship in Cardiothoracic Surgery (Monash Health, Aust), Graduate Certificate in Higher Education (Aust), Academy of Medicine (Mal)\n\n\n\nDato’ Dr Ahmad Farouk Musa obtained his Doctor of Medicine from USM in 1992. He then obtained his Master of Medicine in Surgery from the same university in the year 2000 before subspecialising in Cardiothoracic Surgery at Institut Jantung Negara (IJN), Kuala Lumpur from 2002 until 2005. He then completed his Fellowship in Cardiothoracic Surgery at Monash Health, Melbourne, Australia in 2008. He has served in the Malaysian army as a Medical Officer with the rank of Captain upon completing his Internship before joining USM as a trainee lecturer. He is now serving as an academic and researcher at Monash University Malaysia. He is a life-member of the Malaysian Association of Thoracic & Cardiovascular Surgery (MATCVS) and a committee member of the MATCVS Database. He is also a life-member of the College of Surgeons, Academy of Medicine of Malaysia; a life-member of Malaysian Medical Association (MMA), and a life-member of Islamic Medical Association of Malaysia (IMAM). Recently he was appointed as an Interim Chairperson of Examination & Assessment Subcommittee of the UiTM-IJN Cardiothoracic Surgery Postgraduate Program. As an academic, he has published numerous research papers and book chapters. He has also been appointed to review many scientific manuscripts by established journals such as the British Medical Journal (BMJ). He has presented his research works at numerous local and international conferences such as the European Association for Cardiothoracic Surgery (EACTS) and the European Society of Cardiovascular Surgery (ESCVS), to name a few. He has also won many awards for his research presentations at meetings and conferences like the prestigious International Invention, Innovation & Technology Exhibition (ITEX); Design, Research and Innovation Exhibition, the National Conference on Medical Sciences and the Annual Scientific Meetings of the Malaysian Association for Thoracic and Cardiovascular Surgery. He was awarded the Darjah Setia Pangkuan Negeri (DSPN) by the Governor of Penang in July, 2015.",institutionString:null,institution:{name:"Monash University Malaysia",country:{name:"Malaysia"}}},{id:"30568",title:"Prof.",name:"Madhu",middleName:null,surname:"Khullar",slug:"madhu-khullar",fullName:"Madhu Khullar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/30568/images/system/30568.jpg",biography:"Dr. Madhu Khullar is a Professor of Experimental Medicine and Biotechnology at the Post Graduate Institute of Medical Education and Research, Chandigarh, India. She completed her Post Doctorate in hypertension research at the Henry Ford Hospital, Detroit, USA in 1985. She is an editor and reviewer of several international journals, and a fellow and member of several cardiovascular research societies. Dr. Khullar has a keen research interest in genetics of hypertension, and is currently studying pharmacogenetics of hypertension.",institutionString:"Post Graduate Institute of Medical Education and Research",institution:{name:"Post Graduate Institute of Medical Education and Research",country:{name:"India"}}},{id:"223233",title:"Prof.",name:"Xianquan",middleName:null,surname:"Zhan",slug:"xianquan-zhan",fullName:"Xianquan Zhan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/223233/images/system/223233.png",biography:"Xianquan Zhan received his MD and Ph.D. in Preventive Medicine at West China University of Medical Sciences. He received his post-doctoral training in oncology and cancer proteomics at the Central South University, China, and the University of Tennessee Health Science Center (UTHSC), USA. He worked at UTHSC and the Cleveland Clinic in 2001–2012 and achieved the rank of associate professor at UTHSC. Currently, he is a full professor at Central South University and Shandong First Medical University, and an advisor to MS/PhD students and postdoctoral fellows. He is also a fellow of the Royal Society of Medicine and European Association for Predictive Preventive Personalized Medicine (EPMA), a national representative of EPMA, and a member of the American Society of Clinical Oncology (ASCO) and the American Association for the Advancement of Sciences (AAAS). He is also the editor in chief of International Journal of Chronic Diseases & Therapy, an associate editor of EPMA Journal, Frontiers in Endocrinology, and BMC Medical Genomics, and a guest editor of Mass Spectrometry Reviews, Frontiers in Endocrinology, EPMA Journal, and Oxidative Medicine and Cellular Longevity. He has published more than 148 articles, 28 book chapters, 6 books, and 2 US patents in the field of clinical proteomics and biomarkers.",institutionString:"Shandong First Medical University",institution:{name:"Affiliated Hospital of Shandong Academy of Medical Sciences",country:{name:"China"}}}]}},subseries:{item:{id:"18",type:"subseries",title:"Proteomics",keywords:"Mono- and Two-Dimensional Gel Electrophoresis (1-and 2-DE), Liquid Chromatography (LC), Mass Spectrometry/Tandem Mass Spectrometry (MS; MS/MS), Proteins",scope:"With the recognition that the human genome cannot provide answers to the etiology of a disorder, changes in the proteins expressed by a genome became a focus in research. Thus proteomics, an area of research that detects all protein forms expressed in an organism, including splice isoforms and post-translational modifications, is more suitable than genomics for a comprehensive understanding of the biochemical processes that govern life. The most common proteomics applications are currently in the clinical field for the identification, in a variety of biological matrices, of biomarkers for diagnosis and therapeutic intervention of disorders. From the comparison of proteomic profiles of control and disease or different physiological states, which may emerge, changes in protein expression can provide new insights into the roles played by some proteins in human pathologies. Understanding how proteins function and interact with each other is another goal of proteomics that makes this approach even more intriguing. Specialized technology and expertise are required to assess the proteome of any biological sample. Currently, proteomics relies mainly on mass spectrometry (MS) combined with electrophoretic (1 or 2-DE-MS) and/or chromatographic techniques (LC-MS/MS). MS is an excellent tool that has gained popularity in proteomics because of its ability to gather a complex body of information such as cataloging protein expression, identifying protein modification sites, and defining protein interactions. The Proteomics topic aims to attract contributions on all aspects of MS-based proteomics that, by pushing the boundaries of MS capabilities, may address biological problems that have not been resolved yet.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/18.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11414,editor:{id:"200689",title:"Prof.",name:"Paolo",middleName:null,surname:"Iadarola",slug:"paolo-iadarola",fullName:"Paolo Iadarola",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSCl8QAG/Profile_Picture_1623568118342",biography:"Paolo Iadarola graduated with a degree in Chemistry from the University of Pavia (Italy) in July 1972. He then worked as an Assistant Professor at the Faculty of Science of the same University until 1984. In 1985, Prof. Iadarola became Associate Professor at the Department of Biology and Biotechnologies of the University of Pavia and retired in October 2017. Since then, he has been working as an Adjunct Professor in the same Department at the University of Pavia. His research activity during the first years was primarily focused on the purification and structural characterization of enzymes from animal and plant sources. During this period, Prof. Iadarola familiarized himself with the conventional techniques used in column chromatography, spectrophotometry, manual Edman degradation, and electrophoresis). Since 1995, he has been working on: i) the determination in biological fluids (serum, urine, bronchoalveolar lavage, sputum) of proteolytic activities involved in the degradation processes of connective tissue matrix, and ii) on the identification of biological markers of lung diseases. In this context, he has developed and validated new methodologies (e.g., Capillary Electrophoresis coupled to Laser-Induced Fluorescence, CE-LIF) whose application enabled him to determine both the amounts of biochemical markers (Desmosines) in urine/serum of patients affected by Chronic Obstructive Pulmonary Disease (COPD) and the activity of proteolytic enzymes (Human Neutrophil Elastase, Cathepsin G, Pseudomonas aeruginosa elastase) in sputa of these patients. More recently, Prof. Iadarola was involved in developing techniques such as two-dimensional electrophoresis coupled to liquid chromatography/mass spectrometry (2DE-LC/MS) for the proteomic analysis of biological fluids aimed at the identification of potential biomarkers of different lung diseases. He is the author of about 150 publications (According to Scopus: H-Index: 23; Total citations: 1568- According to WOS: H-Index: 20; Total Citations: 1296) of peer-reviewed international journals. He is a Consultant Reviewer for several journals, including the Journal of Chromatography A, Journal of Chromatography B, Plos ONE, Proteomes, International Journal of Molecular Science, Biotech, Electrophoresis, and others. He is also Associate Editor of Biotech.",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorTwo:{id:"201414",title:"Dr.",name:"Simona",middleName:null,surname:"Viglio",slug:"simona-viglio",fullName:"Simona Viglio",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRKDHQA4/Profile_Picture_1630402531487",biography:"Simona Viglio is an Associate Professor of Biochemistry at the Department of Molecular Medicine at the University of Pavia. She has been working since 1995 on the determination of proteolytic enzymes involved in the degradation process of connective tissue matrix and on the identification of biological markers of lung diseases. She gained considerable experience in developing and validating new methodologies whose applications allowed her to determine both the amount of biomarkers (Desmosine and Isodesmosine) in the urine of patients affected by COPD, and the activity of proteolytic enzymes (HNE, Cathepsin G, Pseudomonas aeruginosa elastase) in the sputa of these patients. Simona Viglio was also involved in research dealing with the supplementation of amino acids in patients with brain injury and chronic heart failure. She is presently engaged in the development of 2-DE and LC-MS techniques for the study of proteomics in biological fluids. The aim of this research is the identification of potential biomarkers of lung diseases. She is an author of about 90 publications (According to Scopus: H-Index: 23; According to WOS: H-Index: 20) on peer-reviewed journals, a member of the “Società Italiana di Biochimica e Biologia Molecolare,“ and a Consultant Reviewer for International Journal of Molecular Science, Journal of Chromatography A, COPD, Plos ONE and Nutritional Neuroscience.",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorThree:null,series:{id:"11",title:"Biochemistry",doi:"10.5772/intechopen.72877",issn:"2632-0983"},editorialBoard:[{id:"72288",title:"Dr.",name:"Arli Aditya",middleName:null,surname:"Parikesit",slug:"arli-aditya-parikesit",fullName:"Arli Aditya Parikesit",profilePictureURL:"https://mts.intechopen.com/storage/users/72288/images/system/72288.jpg",institutionString:null,institution:{name:"Indonesia International Institute for Life Sciences",institutionURL:null,country:{name:"Indonesia"}}},{id:"40928",title:"Dr.",name:"Cesar",middleName:null,surname:"Lopez-Camarillo",slug:"cesar-lopez-camarillo",fullName:"Cesar Lopez-Camarillo",profilePictureURL:"https://mts.intechopen.com/storage/users/40928/images/3884_n.png",institutionString:null,institution:{name:"Universidad Autónoma de la Ciudad de México",institutionURL:null,country:{name:"Mexico"}}},{id:"81926",title:"Dr.",name:"Shymaa",middleName:null,surname:"Enany",slug:"shymaa-enany",fullName:"Shymaa Enany",profilePictureURL:"https://mts.intechopen.com/storage/users/81926/images/system/81926.png",institutionString:"Suez Canal University",institution:{name:"Suez Canal University",institutionURL:null,country:{name:"Egypt"}}}]},onlineFirstChapters:{paginationCount:4,paginationItems:[{id:"82367",title:"Spatial Variation and Factors Associated with Unsuppressed HIV Viral Load among Women in an HIV Hyperendemic Area of KwaZulu-Natal, South Africa",doi:"10.5772/intechopen.105547",signatures:"Adenike O. 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