\r\n\tThere will be a chapter on secondary causes of sexual dysfunction disorders related to diabetes, cardiovascular disease, and obesity. A chapter on remedial measures to enhance sexual activity and maintain human relationships will be discussed. As there is a growing number of cancer survivors a chapter on cancer-related sexual dysfunction will be welcomed for including it.
",isbn:null,printIsbn:null,pdfIsbn:null,doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,isSalesforceBook:!1,isNomenclature:!1,hash:"b988fda30a4e2364ee9d47e417bd0ba9",bookSignature:"Dr. Dhastagir Sultan Sheriff",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11889.jpg",keywords:"Sex, Sexual Response Cycle, Erection, Premature Ejaculation, Libido, Orgasm, Painful Intercourse, Psychological, Female, Lack of Desire, Erectile Disorders, Pain Disorders",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"April 8th 2022",dateEndSecondStepPublish:"May 6th 2022",dateEndThirdStepPublish:"July 5th 2022",dateEndFourthStepPublish:"September 23rd 2022",dateEndFifthStepPublish:"November 22nd 2022",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"3 months",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"Dhastagir Sultan Sheriff is a life member of the European Society for Human Reproduction and Early Human Development, Association of Physiologists and Pharmacologists of India, member of the National Academy of Medical Sciences, New Delhi, and resource person for UNESCO for Medical and Bioethics. 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\n
The
Dioecy and a long juvenile period are the primary difficulties encountered in breeding and genetic studies of
DNA markers have played a major role in breeding programs for several decades in plants. Several molecular markers such as randomly amplified polymorphic DNA (RAPD) [15], simple sequence repeat (SSR) [16, 17], sequence-related amplified polymorphism (SRAP) [18], amplified fragment length polymorphism (AFLP) [4], inter-simple sequence repeat (ISSR) [19], selectively amplified microsatellite polymorphic loci (SAMPL) [20], and single-nucleotide polymorphisms (SNPs) [21] have been used to assess the genetic diversity, fingerprinting, phylogenetic relationships, germplasm characterization, sex determination, genetic linkage mapping, and QTL analysis in cultivated and wild
In pistachio, most of the cultivars in the production are earlier selections either by growers or breeders. Pistachio cultivars from controlled crosses are in a limited number, and selected genotypes in the current breeding programs are under evaluations in different countries. Using molecular tools in conventional breeding programs can be a good advance in pistachio. Initial molecular studies in pistachio were mainly on germplasm characterization by using different molecular marker techniques. Identification of molecular markers linked to sex determination was also studied that allows early selections of females in a cultivar breeding program [21, 22, 23]. Recently, the markers linked to sex have been used in a cultivar breeding program in Turkey [24].
\nSSRs are useful as molecular markers and very polymorphic due to the high mutation rate affecting the number of repeat units [25]. They are very useful for assaying diversity in natural populations or germplasm collections and for fingerprinting and parental identification. They are also very valuable markers especially for genetic linkage mapping and evolutionary studies [26] and have a high level of transferability between closely related species. The development of SSR markers from
The first complete genetic linkage map was constructed in pistachio by [34] who used SRAP, ISSR, and AFLP markers in an inter-specific F1 population derived from a cross between
Next-generation sequencing (NGS) has provided a new perspective for research, owing to its high throughout and speed of data generation. It made easy to perform whole genome and transcriptome sequencing in a short time and low cost. Motalebipour et al. [14] performed genome survey study in pistachio and estimated genome size of pistachio as 600 Mb.
\nIn this chapter, SSR abundance, distribution of their use as useful markers in the characterization of germplasm resources, taxonomy and phylogenetic analysis in the genus, as well as their transferability among
Motalebipour et al. [14] performed a genome survey study in pistachio and estimated genome size of pistachio as 600 Mb. The authors used 26.77 Gb Illumina PE (pair-end) reads of Siirt cultivar to estimate genome size and to reveal SSR distribution in pistachio genome. Motalebipour et al. [14] detected a total of 59,280 di-, tri-, tetra-, penta-, and hexa-nucleotide SSR motifs, and the dinucleotide motifs were the most abundant type of repeats (63.2%) in pistachio (\nFigure 1\n), followed by tri- (18.0%), tetra- (12.8%), penta- (3.8%), and hexanucleotide motifs (2.2%).
\nDistribution of 59,280 SSRs in the pistachio genome based on repeat type. Obtained from Motalebipour et al. [
Motalebipour et al. [14] searched repeat motifs in their genome survey study in pistachio, and AT/AT (23.0%) and TA/TA (21.6%) were the most abundant repeats, followed by AG/CT (7.6%) and GA/TC (6.2%), AAT/ATT (4.1%), CA/TG (2.6%), and TAA/ATT (2.6%) (\nFigure 2\n). The most abundant tetra- and penta-nucleotide repeat motif types were AAAT/ATTT (2.1%) and AAAAT/ATTTT (0.44%), respectively (\nFigure 2\n). Among hexanucleotide motifs, AAAAAT/ATTTTT and GCCCAA/TTGGGC (0.07%) were the most abundant motifs. The authors calculated one SSR per 8.67 kb in the pistachio genome.
\nDistribution of SSR motifs in pistachio at 40× coverage sequencing data. The X-axis represents motif types, and the Y-axis represents the count of motifs in the genome of pistachio. Obtained from Motalebipour et al. [
Khodaeiaminjan et al. [28] had about 10x Illumina data of three
The number of di-, tri-, tetra-, penta-, and hexanucleotide SSRs in Siirt, Ohadi, and Bağyolu
Khodaeiaminjan et al. [28] calculated the number of repeats in 4 genotypes, and 4 and 11 repeated motifs were the most abundant followed by 12, 8, 5, and 13 times repeated motifs (\nFigure 4\n).
\nThe number of motif repeats in
Jazi et al. [29] performed a transcriptome study by RNA sequencing of a pooled sample representing 24 different tissues of 2 pistachio cultivars with contrasting salinity tolerance under control and salt treatment in pistachio. The authors searched SSR motifs in transcriptome sequences of pistachio, and 11,337 SSRs were defined as di- to hexanucleotide motifs in 11,130 contigs. Di- and trinucleotide repeats were the most abundant SSRs, accounting for 40–44% of total SSRs, followed by tetra- (9.5%), penta- (3.1%), and hexanucleotide repeats (2.2%). The pistachio transcriptome was rich in GA/TC (12.13%), AG/CT (11.02%), AT/AT (8.32%), TA/TA (8.04%), GAA/TTC (5%), and AGA/TCT (4.02%). To make these SSRs useful, a total of 7605 primer pairs were generated from the microsatellites with sufficient flanking sequences. However, none of them were tested in
In
Kolahi-Zonoozi et al. [27] developed SSRs using the FIASCO protocol (Fast Isolation by AFLP of Sequences Containing Repeats) from genomic DNA of
Zaloğlu et al. [16] used enrichment method and developed SSR markers from
Topçu et al. [17] sequenced more clones from GA- and AAG-enriched libraries based on suggestion done by Zaloglu et al. [16]. A total of 192 clones was sequenced from each library, 135 primer pairs were designed, and 110 generated PCR products. Topçu et al. [17] tested 110 SSR loci in 12 diverse pistachio cultivars for amplification and polymorphism. A total of 46 loci from the GA library and 18 loci from the AAG library was polymorphic in
Motalebipour et al. [14] obtained 40× sequencing data from
Khodaeiaminjan et al. [28] used in silico approach to develop polymorphic SSR markers in pistachio. The authors compared 10× Illumina sequencing data of three
There is only one study using
Motalebipour et al. [14] developed 206 SSR loci from
Zaloğlu et al. [16] and Topçu et al. [17] developed 59 and 110 SSRs from
Arabnezhad et al. [31] were the first in developing SSRs from
Zaloğlu et al. [16] and Topçu et al. [17] developed 59 and 110 SSRs from
The first SSR development study in
Motalebipour et al. [14] developed 206 SSR loci from
Zaloğlu et al. [16] and Topçu et al. [17] developed 59 and 110 SSRs from
Ding and Lu [33] developed 12 polymorphic microsatellite loci from
Motalebipour et al. [14] developed 206 SSR loci from
Zaloğlu et al. [16] and Topçu et al. [17] developed SSRs from
Chen et al. [32] developed SSRs using the FIASCO protocol (Fast Isolation by AFLP of Sequences Containing Repeats) from genomic DNA of
Zaloğlu et al. [16] developed 59 SSRs from
There is no study in the literature developing SSRs from
Motalebipour et al. [14] developed 206 SSR loci from
There is no SSR development study also from
Zaloğlu et al. [16] and Topçu et al. [17] developed 169 SSRs from
Chen et al. [32] developed 14 SSR loci from
There are only several studies characterizing
Ahmad et al. [37] used 14 SSR loci to characterize Iranian, Turkish, and Syrian pistachio cultivars. A total of 46 alleles was produced by 14 SSR loci ranging from 2 to 5 allele per loci. Cluster analysis placed most of the Iranian samples in one group, while the Syria samples were the most diverse and did not group in a single cluster. Kolahi-Zonoozi et al. [27] described 45 Iranian pistachio accessions by 12 SSR loci. The
The SSR markers in the genus
SSR is a very useful molecular marker system due to abundance in the genomes and its codominant inheritance as well as high repeatability. They have also a high level of transferability between closely related species as in the genus
\n
In a conclusion, there are currently an adequate number of SSR markers for cultivated
The authors declare no conflict of interest.
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that characteristically affects the upper motor neuron (located in the motor cortex) and the lower motor neuron (located in the brainstem and medullary anterior horn). As a consequence, muscular weakness ensues, which progresses to paralysis, spreading from one body region to another in a way that affects motor autonomy, oral communication, swallowing and breathing [1]. ALS is an irreversible, disabling chronic disease with serious complications.
ALS is the third neurodegenerative disease in incidence, after dementia and Parkinson’s disease. It is, together with its variants, primary lateral sclerosis, progressive muscular atrophy, and progressive bulbar palsy, the most common motor neuron disease in adults. The incidence of ALS is between 1.5 and 2.5 new cases per 100,000 inhabitants per year, and the prevalence is between 4 and 6 people per 100,000 inhabitants, being relatively uniform in Western countries [2, 3].
The diagnosis of ALS is currently based on the Awaji criteria [4], respectively, the revised El-Escorial criteria [5]. Also, the Gold-Coast criteria have recently been proposed [6].
ALS occurs in two main forms: the central or bulbar form, also known as progressive bulbar palsy, and the peripheral or spinal form. In bulbar ALS, at least 80% of patients will develop dysarthria and dysphagia [7], while in the spinal or peripheral form, muscle weakness predominates, although dysphagia may appear in the evolutionary course.
Currently, there is no curative treatment, but there are some effective measures to prolong patient survival, such as nutritional management, whose aim is the prevention of malnutrition and the improvement of quality of life. Riluzole is the only medication approved for treatment of ALS by the United States Food and Drug Administration and the European Medicine Agency. Its mechanism of action is complex and includes inhibition of glutamate release, blocking of receptors for excitatory amino acids, inactivation of voltage-gated sodium channels, and stimulation of a G-protein-dependent signal transduction. Riluzole is generally well tolerated and may prolong survival by 2–3 months [8]. Recent reports suggest that riluzole could increase the survival of patients with ALS for up to 19 months [9].
Nonetheless, survival of ALS patients from diagnosis is 20% at five years after diagnosis of the disease [10]: mean survival of ALS is 3–5 years, with 5–10% living longer than 10 years [11]. The main causes of mortality are respiratory failure and malnutrition with dehydration [12, 13].
ALS patients frequently present malnutrition, this being an independent prognostic factor for survival [14]. The causes of malnutrition are the appearance of dysphagia, whose prevalence reaches 80% in the evolutionary course of ALS, as well as the decrease in intake due to loss of autonomy, muscle atrophy, fatigue and increased energy requirements.
The prevalence of malnutrition varies from 16 to 53% depending on the parameters used [15], the form of presentation of the disease and the moment in its evolutionary course. Therefore, a nutritional assessment is recommended in all patients diagnosed with ALS, whether bulbar or spinal, at the time of diagnosis of the disease [12].
The follow-up and nutritional approach of these patients is chronic, without considering the possibility of discharge or end of follow-up. However, there are no precise premises regarding follow-up (frequency of visits) [12]. Furthermore, it is important to bear in mind that the management of these patients is multidisciplinary (Pneumology, Neurology, Rehabilitation, etc.) and requires closer surveillance than other types of patients.
Swallowing is a complex act that relies on the correct coordination of motor and sensory systems of oral, pharyngeal and esophageal strictures. Dysphagia is defined as the difficulty in passing the food bolus from the mouth to the stomach caused by the anatomical or functional alteration of various structures involved in swallowing. It includes the behavioral, sensory and motor alterations that occur during swallowing, including the state of consciousness prior to the act of eating, the visual recognition of food and the physiological responses to the smell and presence of food.
Swallowing disorders can appear acutely or insidiously and progressively. Dysphagia is classified according to its etiology (mechanical or motor) or according to its location (oropharyngeal or esophageal).
In ALS patients, dysphagia is progressive, motor, and occurs both at the oropharyngeal and esophageal levels. Its prevalence is 30% at diagnosis, with an increasing incidence as the disease evolves, appearing in up to 80% of patients with ALS [7, 12].
The importance in the diagnosis of dysphagia lies in its complications, derived from a decrease in a reduction in the efficacy and safety of swallowing. Complications from dysphagia include malnutrition, dehydration, aspiration and pneumonia. Malnutrition and aspiration increase the risk of death by 7.7 times in ALS patients, hence the importance of its diagnosis and approach [11].
Swallowing is a complex act that involves the coordination of multiple sensory and motor systems. During the oral phase, the tongue forms and holds a bolus on the anterior tongue. Currently, the posterior tongue prevents the food from entering the pharynx prematurely. After bolus formation, the posterior transport of the bolus is initiated by the anterior tongue pressing against the hard palate. In the pharyngeal phase, the posterior tongue retracts against the pharyngeal wall and contributes to the downward propulsion of the bolus [16].
ALS may present with a combination of spastic and flaccid weakness that can affect swallowing significantly. Dysphagia in ALS results from bulbar sensory-motor neurodegeneration, which is a pathognomonic feature of ALS [1]. Involvement of the motor nuclei located in the brainstem causes the characteristic bulbar muscle weakness and atrophy, leading to dysphagia. Oropharyngeal impairment of the tongue has been identified, but the underlying mechanisms of its motor dysfunction are not completely understood [17].
Impairment of the tongue seems to represent a major risk factor for aspiration [18]. One study showed a correlation between tongue pressure and the severity of dysphagia and physical performance in 39 patients with ALS [19]. Although swallowing pressures are known to be considerably weaker than maximum pressure exerted by tongue-palate contact pressure tasks, specific measures of maximum tongue strength have been shown to be associated with overall swallowing performance [20].
The occurrence of dysphagia in ALS patients is also related to impairments in the upper aerodigestive tract and respiratory and laryngeal muscles to the extent that they affect the expiratory phase of voluntary cough. There is a strong connection between poor effective voluntary cough and the presence of penetration/aspiration events [21].
One study looked into the pathophysiological mechanisms of dysphagia in 43 patients with sporadic ALS, using clinical and electrophysiological methods that objectively measured the oropharyngeal phase of voluntarily initiated swallowing, and compared them with those obtained from 50 age-matched control subjects [22]. Laryngeal movements were detected by a piezoelectric sensor and muscle electromyography (EMG) of submental muscles, while needle EMG recorded the activity of the cricopharyngeal muscle of the upper esophageal sphincter (UES) during swallowing. ALS patients with dysphagia displayed the following abnormal findings: 1) submental muscle activity of the laryngeal elevators, which produce reflex upward deflection of the larynx during wet swallowing, was significantly prolonged, whereas the laryngeal relocation time of the swallowing reflex remained within normal limits; 2) concerning the cricopharyngeal sphincter muscle, EMG demonstrated severe abnormalities during voluntarily initiated swallows. The opening of the sphincter was delayed and/or the closure occurred prematurely, the total duration of opening was shortened, and, at times, unexpected motor unit bursts appeared during this period; and 3) during voluntarily initiated swallow, there was a significant lack of coordination between the laryngeal elevator muscles and the cricopharyngeal sphincter muscle. These results point at two pathophysiological mechanisms that cause dysphagia in ALS patients: 1) the triggering of the swallowing reflex for the voluntarily initiated swallow is delayed and eventually abolished, whereas the spontaneous reflexive swallows are preserved until the preterminal stage of ALS; 2) the cricopharyngeal sphincter muscle of the UES becomes hyperreflexic and hypertonic. As a result, the laryngeal protective system and the bolus transport system of deglutition lose their coordination during voluntarily initiated swallowing.
Another study investigated the variations of esophageal peristalsis in 28 ALS patients with predominantly bulbar or predominantly pseudobulbar clinical presentation by using esophageal manometry (EM) [23]. Swallowing was initiated with 5–10 mL of water (wet swallows) and saliva (dry swallows) and repeated at 30-second intervals. The manometric parameters were measured automatically and visualized by the computer system. In patients with pseudobulbar presentation, an increase of the resting pressure value in the UES >45 mmHg, a wave-like course of resting pressure, and toothed peristaltic waves were observed. In patients with bulbar presentation, a low amplitude of peristaltic waves <30 mmHg (mean: 17 ± 5) was recorded, without signs of esophageal motility disturbance at onset or during progression. EM procedure allows objectively distinguishing dysphagia in ALS patients due to bulbar syndrome from dysphagia due to pseudobulbar syndrome. It is crucial to identify patients with pseudobulbar clinical presentation due to their high risk of aspiration.
When considering management and treatment of dysphagia, visualization of physiology is the only reliable method to understand the pathophysiology of this condition [24].
The diagnosis of dysphagia is of utmost importance, given the burden of this symptom, causing malnutrition, dehydration, aspiration pneumonia, respiratory failure, and reduced quality of life. Aspiration and malnutrition increase the risk of death [25]. Early identification of dysphagia facilitates improved management, reduced risk of malnutrition and postponed percutaneous endoscopic gastrostomy (PEG) tube placement [26, 27]. The search for dysphagia as early as possible is key in order to prevent its complications.
The diagnosis of dysphagia is more easily performed at multidisciplinary clinics. A dysphagia assessment should be performed in all patients with ALS, both at diagnosis and during follow-up, with a recommended frequency of every 3 months, as part of a complete clinical and neurological evaluation [12].
Dysphagia can be underestimated in ALS due to progressive adaptation to the slow bulbar deterioration and given the inconsistencies in what patients report about the condition. Often, oral stage deficits like difficulties in chewing or oral residue are not reported by the patient until pharyngeal stage deficits, such as coughing or choking, are observed.
A clinical swallow evaluation for suspected dysphagia involves medical history, physical inspection of swallowing, instrumental evaluation, pulmonary function, and bulbar function. However, most importantly, a screening test for dysphagia should be carried out.
Medical history. This includes the reporting of symptoms related to dysphagia, kind of diet, assistance with feeding, changes in body weight, coughing or choking with meals, length of time needed for food intake and saliva management. A validated questionnaire to assess these symptoms is the Eating assessment tool 10 (EAT-10), which has been validated for use in ALS [27]. This study reported high clinical utility and ability to detect aspiration risk in ALS (86% sensitivity, 76% specificity and 95% negative predictive value). However, the validation of the test was performed only against penetration and aspiration scores on the videofluoroscopic swallowing study (VFSS) and not against any overall parameter of swallowing efficiency and safety. The kind of diet can be evaluated by the Neuromuscular Disease Swallowing Status Scale (NdSSS) and the Swallowing subscale on Amyotrophic Lateral Sclerosis Severity Scale (ALSSS). However, these scales do not detect all the patients with alterations in swallowing [28]. An important parameter related to dysphagia and intake is weight loss, which is, therefore, mandatorily recorded at all visits. Moreover, it is important to remember that weight loss and dietary intake are associated with more than just dysphagia.
Physical inspection of systems involved in swallowing and swallowing musculature should go beyond the mere observation of swallowing competence with test swallows. A dysphagia/aspiration screening evaluation is useful when determining the dysphagia risk; however, only limited validation has been completed in ALS. One study validated the volume-viscosity swallowing test (V-VST) against VFSS in 20 ALS patients and reported 93% sensitivity and 80% specificity, respectively [29]. The V-VST is a screening evaluation that involves determining safety and efficiency of swallowing, following the administration of multiple volumes and viscosities of liquids. Another method is the sequential water swallowing (SWS), which involves drinking 100 ml of water in a single, uninterrupted swallow. One study reported that 43% of patients with ALS have a disorganized pattern in their sequential swallows [30].
Instrumental evaluation, such as VFSS or functional endoscopic evaluation of swallow (FEES), is used to visualize the swallowing physiology. These techniques are essential and are the most commonly used, being considered the gold standard in the exploration of dysphagia in ALS, due to the high risk for silent aspiration that these patients have. In fact, one study suggests that up to 55% of ALS patients may present with silent aspiration [31]. VFSS can be used to evaluate problems in the oral phase of the swallowing process, and intradeglutitive silent aspiration can be detected. The interpretation of VFSS results can be done with the videofluoroscopic dysphagia scale (VDS), which contains 14 categories that represent oral functions (lip closure, mastication, bolus formation, premature bolus loss, apraxia, and oral transit time) and pharyngeal functions (pharyngeal triggering, laryngeal elevation, epiglottic closure, pharyngeal transit time, pharyngeal coating, vallecular and pyriform sinus residues, and tracheal aspiration) [32]. A modified version of VSD (mVSD) has been developed to overcome low inter-rater reliability of some categories in the VDS [33]. FEES is a valid, repeatable, and low-cost alternative, used to directly visualize the swallowing process and the saliva movement, and it is able to evaluate pharyngo-laryngeal sensitivity in addition to motility [34]. Other instrumental methods are manometry, in addition to VFSS, electromyography of submental, laryngeal, pharyngeal and diaphragmatic nerves, esophageal scintography [35], tongue sonography and electromagnetic articulography.
Pulmonary function, generally assessed with forced vital capacity (FVC) and cough function, must be explored in patients with dysphagia. Patients with deteriorated pulmonary function are more likely to aspirate.
Bulbar function consists of the evaluation of the anatomy and physiology of head and neck structures involved in swallowing, including an evaluation of the cranial nerves essential for swallowing. The Centre for Neurologic Study Bulbar Function Scale (CNS-BFS) is a useful metric for assessing bulbar function. Among bulbar muscles, the tongue musculature appears to be disproportionally more affected by ALS [36], and tongue strength is a prognostic indicator of survival at the time of ALS diagnosis [37]. Besides, measuring the maximum tongue strength is useful for early detection of dysphagia in ALS [38]. Other important signs of bulbar impairment are weak cough and dysarthria, which should be investigated.
It is imperative to derivate to a speech-language pathologist (SLP) if any bulbar dysfunction is identified. SLP plays an important role in the care of patients with speech, language, or swallowing difficulties that can result from a variety of medical condition.
One of the ways to improve reliability of clinical evaluations is to use standardized and validated protocols. A comprehensive assessment protocol, such as the Mann Assessment of Swallowing Ability (MASA), may be useful to carry out research in the ALS population. MASA, developed and validated for stroke, includes a detailed oral mechanism examination, cranial nerve testing and swallowing function evaluation [39].
Despite this, there is a lack of studies related to the diagnosis of dysphagia in patients with ALS, which is reflected in a significant variability and inconsistency in the management of dysphagia in ALS, as shown in a survey of current clinical practice patterns at 38 ALS centers in the United States in 2017 [40]. In another survey study performed in 2020, 88.9% of SLP performed an instrumental dysphagia evaluation in ALS patients, although the timing of when the evaluation occurred varied significantly; 42.2% of the clinicians carried it out at baseline even prior to the appearance of any bulbar symptoms [41].
The aim of dysphagia treatment is to attain an oral diet with safe (to avoid respiratory infections and aspiration pneumonia) and effective swallowing (to maintain an adequate level of nutrition and hydration). Several postural, hygienic and dietary measures must be adopted to achieve this aim along with rehabilitative treatment.
The following postural and hygienic measures are included [42]:
The environment must be comfortable and calm, which favors concentration, avoiding distractions during the meal.
Do not start feeding if the patient is sleepy or restless, or if he/she is tired (avoid physical therapy and previous examinations).
Sufficient time for food intake must be guaranteed.
The proper position when eating is sitting with one’s back straight, feet flat on the floor and the head slightly tilted forward when swallowing. If a person is unable to get out of bed, he/she should be positioned as upright as possible. Food intake should not take place while the head is tilted back.
Self-feeding is preferable: the patient should feed him−/herself. This reduces the risk of aspiration, but the patient should always be under the supervision of a family member.
The type of spoon indicated must be used: soup spoon, dessert spoon – candy – or coffee spoon.
It should be checked that the previous spoonful has been swallowed before another one is given.
Syringes or straws should not be used.
Good oral hygiene must be kept to avoid respiratory infections in case of infection. If dentures are worn, they must be in place and tight.
Rehabilitation treatment should be carried out whenever possible so that the patient can maintain an adequate oral intake to a greater or lesser extent. Postural maneuvers should be recommended to protect the airway during swallowing [12]. There is no strong evidence in the literature for dysphagia intervention in patients with ALS. Thus, rehabilitation treatment should be individualized. Aspects that influence the selection of the most suitable technique for each patient should be evaluated, such as the patient’s cognitive status, behavioral and emotional aspects, degree of fatigue and family support. Based on these criteria, the most rehabilitative technique will be selected for each patient. Some rehabilitation techniques are postural strategies, sensory enhancement strategies (such as mechanical tongue stimulation, bolus changes in volume, temperature, and flavor, thermal stimulation, and changes in taste or acid flavor), neuromuscular practice, compensatory swallowing maneuvers and facilitation techniques.
Some compensatory swallowing maneuvers have been studied in patients with ALS. The chin-tuck posture was found to be useful in most cases, given that it offers a valuable protection mechanism for the airways by opening the valleculae and preventing penetration into the larynx [43]. The indication of the other maneuvers differs according to the mechanism involved in relation to disease characteristics and progression. Thus, hyperextended head posture is indicated in the absence of tongue pumping. If there is hypertonicity, incomplete release, or premature closure of the UES, head rotation is indicated [43]. However, current clinical guidelines do not suggest specific postural maneuvers [12].
Also, saliva could interfere with the management of dysphagia. However, the current evidence to recommend pharmacological treatments such as antimuscarinics in affected patients is low. There is no evidence linking the treatment of saliva issues with the improvement of dysphagia [12].
The aim of nutritional management in patients with ALS is to prevent and/or treat malnutrition, to reduce the risk of aspiration, to prevent morbidity and mortality associated with malnutrition and dysphagia, and to improve quality of life. The nutritional approach in these patients includes the early detection of inefficient food intake, the need to adjust the consistency of the diet and, if oral feeding is not possible, the early indication of enteral nutrition by gastrostomy [12].
The nutritional approach modality is carried out according to the clinical situation, being conditioned in these patients by the safety and efficacy of swallowing and by the presence or absence of malnutrition.
In a malnourished patient or a patient being at nutritional risk, in whom oral feeding is possible, the first step is to optimize the diet and reduce the risk of aspiration [12].
The diet must be complete and cover the caloric-protein requirements of each patient. Energy requirements should be estimated as approx. 25–30 and 30 kcal/kg/day in ventilated and non-ventilated ALS patients, respectively [12]. Protein requirements should be calculated at a rate of 1–1.2 g/kg/day [44].
The diet composition for ALS patients does not differ from that of the general population with regard to the recommended macro- and micronutrients distribution [45, 46, 47, 48, 49, 50]:
Proteins: 15–18% of total energy intake.
Carbohydrates: 55–60% of total energy intake.
Fats: 30–35% of total energy intake.
Fiber: fiber-rich diet is recommended, with contributions equal to or greater than 25 g/day.
Water: it is advisable to ensure a water intake of at least 1 ml/Kcal/day, to prevent dehydration.
Micronutrients: following the recommendations for the general population according to age and sex of the patient [46, 47, 48, 49, 50].
Dietary counseling and modification of food texture is a fundamental aspect of dysphagia treatment. Dietary modification alters the texture of both liquid and solid foods. These modifications should be based on each patient’s swallowing capacity and must be regularly evaluated. Dietary modification allows achieving a better nutritional status and better quality of life in patients with special nutritional requirements.
There are multiple recommended methods for modifying the texture of solids and liquids. The
Texture levels for solid foods: regular, soft, and bite-sized, minced, and moist, pureed and liquidized.
Texture levels for liquids in the treatment of dysphagia: thin, slightly thick, mildly thick, moderately thick and extremely thick.
Once the diagnosis of dysphagia has been made, the most appropriate solid and liquid food texture for the patient will be established, as well as the volume in which it should be administered.
Dietary modification includes high nutritional value ground or easy-to-swallow diets; texture modifiers, such as thickeners, gel waters or thickened beverages; and diet enhancers (food or nutrient modules) [52]. Also, certain foods should be avoided since they pose a high risk of choking, i.e., foods with double textures, dry or crunchy foods, sticky foods, foods that lose liquid when being chewed, and fibrous and/or filamentary foods.
Thickener modules are products with the ability to thicken, composed of modified starches or gums or a mixture of both, available as powder and with a neutral flavor. They are exclusively intended to increase the consistency of liquid foods. Thickeners composed exclusively of gums preserve the natural appearance of the liquid (unlike those that contain starches) and, therefore, improve the compliance of the patient with dysphagia.
If these dietary modifications do not allow maintaining an adequate nutritional state, oral nutritional supplements (ONS) will be administered, in addition to a modified diet.
Nutritional supplementation is recommended for ALS patients who do not cover their nutritional requirements with an enriched diet. However, there is insufficient data to affirm that oral nutritional supplementation can improve survival in ALS patients [12]. There are no specific formulas for patients with ALS. Hypercaloric formulas with fiber and high viscosity are generally recommended to prevent constipation and reduce the use of thickeners. Thickened ONS have been marketed in recent years and are suitable for patients with difficulties in swallowing, requiring a level 3 consistency or more.
All these measures, together with the general recommendations and the rehabilitative treatment of dysphagia, are aimed at optimizing safe oral intake. However, dysphagia in ALS patients is generally progressive. Thus, if dysphagia makes oral nutritional intake impossible or the patient is severely malnourished, enteral nutrition may be required. Enteral nutrition will preferably be administered by gastrostomy tube [12].
PEG is the most widely technique and is performed under endoscopic control. Its placement and use are well tolerated by the patient and allows them to meet their nutritional needs.
The timing of PEG placement is controversial.
However, there are studies that recommend the placement of a PEG in ALS patients when forced vital capacity is still greater than 50% [53], since a lower percentage would indicate a greater deterioration in lung function that could increase the risk of complications during the procedure. The American Academy of Neurology [54] recommends rejecting gastrostomy when the FVC is below 30% and considers other forms of palliative care. However, several studies show that gastrostomy could be performed safely in patients with insufficient respiratory function [55, 56, 57]. The current clinical guidelines [12] do not take a clear position and allow recommendation, respectively, rejection of gastrostomy based on FVC. The reason is that ALS patients with dysphagia, particularly those with primary bulbar involvement, may have poor spirometry performance due to orofacial muscle weakness.
However, early gastrostomy implantation prevents the development of disease complications and improves the quality of life of these patients [58] but has not clearly shown a benefit in patient survival [59]. However, patients who still maintain oral intake tend to be reluctant to place it early.
In any case, the timing of the PEG placement must be agreed with the patient and family, respecting their wishes [12].
ALS is a complex disease, and its management requires a multidisciplinary approach that includes the figure of endocrinologists, speech therapists, pharmacists, nurses, nutritionists, and speech therapists.
The prevalence of malnutrition in patients with ALS is high, in part, due to the high prevalence of dysphagia in these patients.
A nutritional assessment should be carried out at the diagnosis of the disease and periodically to prevent and treat malnutrition.
Screening for dysphagia should be performed at the diagnosis of the disease and regularly every 3 months to avoid possible complications.
Video swallowing is the test of choice for the diagnosis of dysphagia in patients with ALS since it allows early signs to be detected, although V-MECV is a safe and effective alternative.
The diet must be adapted at all times. The use of dietary counseling and the use of thickeners enables an individualized and safe nutritional intervention, adapting the texture of liquids and solids according to the efficacy and safety of swallowing for each patient.
ONS can be used to supplement and reinforce the oral diet, making them a useful tool to prevent and treat malnutrition in patients with ALS. However, current legislation does not provide for funding for oral enteral nutrition formulas unless they are administered by tube or ostomy.
Gastrostomy is a safe method of eating. The time of placement must be agreed with the patient since it is not without risks. There is no specific formula for patients with ALS, but it is recommended that it be hypercaloric and rich in fiber.
The authors declare no conflict of interest.
This is a brief overview of the main steps involved in publishing with IntechOpen Compacts, Monographs and Edited Books. Once you submit your proposal you will be appointed a Author Service Manager who will be your single point of contact and lead you through all the described steps below.
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Aalborg University has Two Satellite Campuses, one in Copenhagen (Aalborg University Copenhagen) and the other in Esbjerg (Aalborg University Esbjerg).\n· He is a member of prestigious IEEE (Institute of Electrical and Electronics Engineers), and IAENG (International Association of Engineers) organizations. \n· He is the chief Editor of the Journal of Software Engineering.\n· He is the member of the Editorial Board of International Journal of Computer Science and Software Technology (IJCSST) and International Journal of Computer Engineering and Information Technology. \n· He is also the Editor of Communication in Computer and Information Science CCIS-20 by Springer.\n· Reviewer For Many Conferences\nHe is the lead person in making collaboration agreements between Aalborg University and many universities of Pakistan, for which the MOU’s (Memorandum of Understanding) have been signed.\nProfessor Akbar is working in Academia since 1990, he started his career as a Lab demonstrator/TA at the University of Sussex. After finishing his P. hD degree in 1992, he served in the Industry as a Scientific Officer and continued his academic career as a visiting scholar for a number of educational institutions. In 1996 he joined National University of Science & Technology Pakistan (NUST) as an Associate Professor; NUST is one of the top few universities in Pakistan. In 1999 he joined an International Company Lineo Inc, Canada as Manager Compiler Group, where he headed the group for developing Compiler Tool Chain and Porting of Operating Systems for the BLACKfin processor. The processor development was a joint venture by Intel and Analog Devices. In 2002 Lineo Inc., was taken over by another company, so he joined Aalborg University Denmark as an Assistant Professor.\nProfessor Akbar has truly a multi-disciplined career and he continued his legacy and making progress in many areas of his interests both in teaching and research. 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Her research interests include archaea metabolism, enzymes purification and characterization, gene regulation, carotenoids and bioplastics production, antioxidant\ncompounds, waste water treatments, and brines bioremediation.\nRosa María’s other roles include editorial board member for several journals related\nto biochemistry, reviewer for more than 60 journals (biochemistry, molecular biology, biotechnology, chemistry and microbiology) and president of several organizing committees in international meetings related to the N-cycle or respiratory processes.",institutionString:null,institution:{name:"University of Alicante",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"15",title:"Chemical Biology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/15.jpg",isOpenForSubmission:!0,editor:{id:"441442",title:"Dr.",name:"Şükrü",middleName:null,surname:"Beydemir",slug:"sukru-beydemir",fullName:"Şükrü Beydemir",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003GsUoIQAV/Profile_Picture_1634557147521",biography:"Dr. Şükrü Beydemir obtained a BSc in Chemistry in 1995 from Yüzüncü Yıl University, MSc in Biochemistry in 1998, and PhD in Biochemistry in 2002 from Atatürk University, Turkey. 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Dr. Beydemir is also Rector of Bilecik Şeyh Edebali University, Turkey.",institutionString:null,institution:{name:"Anadolu University",institutionURL:null,country:{name:"Turkey"}}},editorTwo:{id:"13652",title:"Prof.",name:"Deniz",middleName:null,surname:"Ekinci",slug:"deniz-ekinci",fullName:"Deniz Ekinci",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYLT1QAO/Profile_Picture_1634557223079",biography:"Dr. Deniz Ekinci obtained a BSc in Chemistry in 2004, MSc in Biochemistry in 2006, and PhD in Biochemistry in 2009 from Atatürk University, Turkey. He studied at Stetson University, USA, in 2007-2008 and at the Max Planck Institute of Molecular Cell Biology and Genetics, Germany, in 2009-2010. Dr. Ekinci currently works as a Full Professor of Biochemistry in the Faculty of Agriculture and is the Head of the Enzyme and Microbial Biotechnology Division, Ondokuz Mayıs University, Turkey. He is a member of the Turkish Biochemical Society, American Chemical Society, and German Genetics society. Dr. Ekinci published around ninety scientific papers, reviews and book chapters, and presented several conferences to scientists. He has received numerous publication awards from several scientific councils. Dr. Ekinci serves as the Editor in Chief of four international books and is involved in the Editorial Board of several international journals.",institutionString:null,institution:{name:"Ondokuz Mayıs University",institutionURL:null,country:{name:"Turkey"}}},editorThree:null},{id:"17",title:"Metabolism",coverUrl:"https://cdn.intechopen.com/series_topics/covers/17.jpg",isOpenForSubmission:!0,editor:{id:"138626",title:"Dr.",name:"Yannis",middleName:null,surname:"Karamanos",slug:"yannis-karamanos",fullName:"Yannis Karamanos",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002g6Jv2QAE/Profile_Picture_1629356660984",biography:"Yannis Karamanos, born in Greece in 1953, completed his pre-graduate studies at the Université Pierre et Marie Curie, Paris, then his Masters and Doctoral degree at the Université de Lille (1983). He was associate professor at the University of Limoges (1987) before becoming full professor of biochemistry at the Université d’Artois (1996). He worked on the structure-function relationships of glycoconjugates and his main project was the investigations on the biological roles of the de-N-glycosylation enzymes (Endo-N-acetyl-β-D-glucosaminidase and peptide-N4-(N-acetyl-β-glucosaminyl) asparagine amidase). From 2002 he contributes to the understanding of the Blood-brain barrier functioning using proteomics approaches. He has published more than 70 papers. 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Since then, he has been working as an Adjunct Professor in the same Department at the University of Pavia. His research activity during the first years was primarily focused on the purification and structural characterization of enzymes from animal and plant sources. During this period, Prof. Iadarola familiarized himself with the conventional techniques used in column chromatography, spectrophotometry, manual Edman degradation, and electrophoresis). Since 1995, he has been working on: i) the determination in biological fluids (serum, urine, bronchoalveolar lavage, sputum) of proteolytic activities involved in the degradation processes of connective tissue matrix, and ii) on the identification of biological markers of lung diseases. In this context, he has developed and validated new methodologies (e.g., Capillary Electrophoresis coupled to Laser-Induced Fluorescence, CE-LIF) whose application enabled him to determine both the amounts of biochemical markers (Desmosines) in urine/serum of patients affected by Chronic Obstructive Pulmonary Disease (COPD) and the activity of proteolytic enzymes (Human Neutrophil Elastase, Cathepsin G, Pseudomonas aeruginosa elastase) in sputa of these patients. More recently, Prof. Iadarola was involved in developing techniques such as two-dimensional electrophoresis coupled to liquid chromatography/mass spectrometry (2DE-LC/MS) for the proteomic analysis of biological fluids aimed at the identification of potential biomarkers of different lung diseases. He is the author of about 150 publications (According to Scopus: H-Index: 23; Total citations: 1568- According to WOS: H-Index: 20; Total Citations: 1296) of peer-reviewed international journals. 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}]},overviewPageOFChapters:{paginationCount:42,paginationItems:[{id:"82914",title:"Glance on the Critical Role of IL-23 Receptor Gene Variations in Inflammation-Induced Carcinogenesis",doi:"10.5772/intechopen.105049",signatures:"Mohammed El-Gedamy",slug:"glance-on-the-critical-role-of-il-23-receptor-gene-variations-in-inflammation-induced-carcinogenesis",totalDownloads:8,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Chemokines Updates",coverURL:"https://cdn.intechopen.com/books/images_new/11672.jpg",subseries:{id:"18",title:"Proteomics"}}},{id:"82875",title:"Lipidomics as a Tool in the Diagnosis and Clinical Therapy",doi:"10.5772/intechopen.105857",signatures:"María Elizbeth Alvarez Sánchez, Erick Nolasco Ontiveros, Rodrigo Arreola, Adriana Montserrat Espinosa González, Ana María García Bores, Roberto Eduardo López Urrutia, Ignacio Peñalosa Castro, María del Socorro Sánchez Correa and Edgar Antonio Estrella Parra",slug:"lipidomics-as-a-tool-in-the-diagnosis-and-clinical-therapy",totalDownloads:7,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Fatty Acids - Recent Advances",coverURL:"https://cdn.intechopen.com/books/images_new/11669.jpg",subseries:{id:"17",title:"Metabolism"}}},{id:"82440",title:"Lipid Metabolism and Associated Molecular Signaling Events in Autoimmune Disease",doi:"10.5772/intechopen.105746",signatures:"Mohan Vanditha, Sonu Das and Mathew John",slug:"lipid-metabolism-and-associated-molecular-signaling-events-in-autoimmune-disease",totalDownloads:17,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Fatty Acids - Recent Advances",coverURL:"https://cdn.intechopen.com/books/images_new/11669.jpg",subseries:{id:"17",title:"Metabolism"}}},{id:"82483",title:"Oxidative Stress in Cardiovascular Diseases",doi:"10.5772/intechopen.105891",signatures:"Laura Mourino-Alvarez, Tamara Sastre-Oliva, Nerea Corbacho-Alonso and Maria G. 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She is also the Global Harmonization Initiative (GHI)",institutionString:"Australian College of Business & Technology",institution:{name:"Kobe College",institutionURL:null,country:{name:"Japan"}}}]},{type:"book",id:"6820",title:"Keratin",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/6820.jpg",slug:"keratin",publishedDate:"December 19th 2018",editedByType:"Edited by",bookSignature:"Miroslav Blumenberg",hash:"6def75cd4b6b5324a02b6dc0359896d0",volumeInSeries:2,fullTitle:"Keratin",editors:[{id:"31610",title:"Dr.",name:"Miroslav",middleName:null,surname:"Blumenberg",slug:"miroslav-blumenberg",fullName:"Miroslav Blumenberg",profilePictureURL:"https://mts.intechopen.com/storage/users/31610/images/system/31610.jpg",biography:"Miroslav Blumenberg, Ph.D., was born in Subotica and received his BSc in Belgrade, Yugoslavia. He completed his Ph.D. at MIT in Organic Chemistry; he followed up his Ph.D. with two postdoctoral study periods at Stanford University. 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He previously worked as a post-doctoral fellow at the Ben-Gurion University of Negev, Israel; University of the Free State, South Africa; and Central University of Technology Bloemfontein, South Africa. He obtained his Ph.D. in Organic Chemistry from Nagaoka University of Technology, Japan. He has published more than seventy-four journal articles and attended several national and international conferences as speaker and chair. Dr. Kendrekar has received many international awards. He has several funded projects, namely, anti-malaria drug development, MRSA, and SARS-CoV-2 activity of curcumin and its formulations. He has filed four patents in collaboration with the University of Central Lancashire and Mayo Clinic Infectious Diseases. His present research includes organic synthesis, drug discovery and development, biochemistry, nanoscience, and nanotechnology.",institutionString:"Visiting Scientist at Lipid Nanostructures Laboratory, Centre for Smart Materials, School of Natural Sciences, University of Central Lancashire",institution:null},{id:"428125",title:"Dr.",name:"Vinayak",middleName:null,surname:"Adimule",slug:"vinayak-adimule",fullName:"Vinayak Adimule",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/428125/images/system/428125.jpg",biography:"Dr. Vinayak Adimule, MSc, Ph.D., is a professor and dean of R&D, Angadi Institute of Technology and Management, India. He has 15 years of research experience as a senior research scientist and associate research scientist in R&D organizations. He has published more than fifty research articles as well as several book chapters. He has two Indian patents and two international patents to his credit. Dr. Adimule has attended, chaired, and presented papers at national and international conferences. He is a guest editor for Topics in Catalysis and other journals. He is also an editorial board member, life member, and associate member for many international societies and research institutions. His research interests include nanoelectronics, material chemistry, artificial intelligence, sensors and actuators, bio-nanomaterials, and medicinal chemistry.",institutionString:"Angadi Institute of Technology and Management",institution:null},{id:"284317",title:"Prof.",name:"Kantharaju",middleName:null,surname:"Kamanna",slug:"kantharaju-kamanna",fullName:"Kantharaju Kamanna",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284317/images/21050_n.jpg",biography:"Prof. K. Kantharaju has received Bachelor of science (PCM), master of science (Organic Chemistry) and Doctor of Philosophy in Chemistry from Bangalore University. He worked as a Executive Research & Development @ Cadila Pharmaceuticals Ltd, Ahmedabad. He received DBT-postdoc fellow @ Molecular Biophysics Unit, Indian Institute of Science, Bangalore under the supervision of Prof. P. Balaram, later he moved to NIH-postdoc researcher at Drexel University College of Medicine, Philadelphia, USA, after his return from postdoc joined NITK-Surthakal as a Adhoc faculty at department of chemistry. Since from August 2013 working as a Associate Professor, and in 2016 promoted to Profeesor in the School of Basic Sciences: Department of Chemistry and having 20 years of teaching and research experiences.",institutionString:null,institution:{name:"Rani Channamma University, Belagavi",country:{name:"India"}}},{id:"158492",title:"Prof.",name:"Yusuf",middleName:null,surname:"Tutar",slug:"yusuf-tutar",fullName:"Yusuf Tutar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/158492/images/system/158492.jpeg",biography:"Prof. Dr. Yusuf Tutar conducts his research at the Hamidiye Faculty of Pharmacy, Department of Basic Pharmaceutical Sciences, Division of Biochemistry, University of Health Sciences, Turkey. He is also a faculty member in the Molecular Oncology Program. He obtained his MSc and Ph.D. at Oregon State University and Texas Tech University, respectively. He pursued his postdoctoral studies at Rutgers University Medical School and the National Institutes of Health (NIH/NIDDK), USA. His research focuses on biochemistry, biophysics, genetics, molecular biology, and molecular medicine with specialization in the fields of drug design, protein structure-function, protein folding, prions, microRNA, pseudogenes, molecular cancer, epigenetics, metabolites, proteomics, genomics, protein expression, and characterization by spectroscopic and calorimetric methods.",institutionString:"University of Health Sciences",institution:null},{id:"180528",title:"Dr.",name:"Hiroyuki",middleName:null,surname:"Kagechika",slug:"hiroyuki-kagechika",fullName:"Hiroyuki Kagechika",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180528/images/system/180528.jpg",biography:"Hiroyuki Kagechika received his bachelor’s degree and Ph.D. in Pharmaceutical Sciences from the University of Tokyo, Japan, where he served as an associate professor until 2004. He is currently a professor at the Institute of Biomaterials and Bioengineering (IBB), Tokyo Medical and Dental University (TMDU). From 2010 to 2012, he was the dean of the Graduate School of Biomedical Science. Since 2012, he has served as the vice dean of the Graduate School of Medical and Dental Sciences. He has been the director of the IBB since 2020. Dr. Kagechika’s major research interests are the medicinal chemistry of retinoids, vitamins D/K, and nuclear receptors. He has developed various compounds including a drug for acute promyelocytic leukemia.",institutionString:"Tokyo Medical and Dental University",institution:{name:"Tokyo Medical and Dental University",country:{name:"Japan"}}},{id:"94311",title:"Prof.",name:"Martins",middleName:"Ochubiojo",surname:"Ochubiojo Emeje",slug:"martins-ochubiojo-emeje",fullName:"Martins Ochubiojo Emeje",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94311/images/system/94311.jpeg",biography:"Martins Emeje obtained a BPharm with distinction from Ahmadu Bello University, Nigeria, and an MPharm and Ph.D. from the University of Nigeria (UNN), where he received the best Ph.D. award and was enlisted as UNN’s “Face of Research.” He established the first nanomedicine center in Nigeria and was the pioneer head of the intellectual property and technology transfer as well as the technology innovation and support center. Prof. Emeje’s several international fellowships include the prestigious Raman fellowship. He has published more than 150 articles and patents. He is also the head of R&D at NIPRD and holds a visiting professor position at Nnamdi Azikiwe University, Nigeria. He has a postgraduate certificate in Project Management from Walden University, Minnesota, as well as a professional teaching certificate and a World Bank certification in Public Procurement. Prof. Emeje was a national chairman of academic pharmacists in Nigeria and the 2021 winner of the May & Baker Nigeria Plc–sponsored prize for professional service in research and innovation.",institutionString:"National Institute for Pharmaceutical Research and Development",institution:{name:"National Institute for Pharmaceutical Research and Development",country:{name:"Nigeria"}}},{id:"436430",title:"Associate Prof.",name:"Mesut",middleName:null,surname:"Işık",slug:"mesut-isik",fullName:"Mesut Işık",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/436430/images/19686_n.jpg",biography:null,institutionString:null,institution:{name:"Bilecik University",country:{name:"Turkey"}}},{id:"268659",title:"Ms.",name:"Xianquan",middleName:null,surname:"Zhan",slug:"xianquan-zhan",fullName:"Xianquan Zhan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/268659/images/8143_n.jpg",biography:"Dr. Zhan received his undergraduate and graduate training in the fields of preventive medicine and epidemiology and statistics at the West China University of Medical Sciences in China during 1989 to 1999. He received his post-doctoral training in oncology and cancer proteomics for two years at the Cancer Research Institute of Human Medical University in China. In 2001, he went to the University of Tennessee Health Science Center (UTHSC) in USA, where he was a post-doctoral researcher and focused on mass spectrometry and cancer proteomics. Then, he was appointed as an Assistant Professor of Neurology, UTHSC in 2005. He moved to the Cleveland Clinic in USA as a Project Scientist/Staff in 2006 where he focused on the studies of eye disease proteomics and biomarkers. He returned to UTHSC as an Assistant Professor of Neurology in the end of 2007, engaging in proteomics and biomarker studies of lung diseases and brain tumors, and initiating the studies of predictive, preventive, and personalized medicine (PPPM) in cancer. In 2010, he was promoted to Associate Professor of Neurology, UTHSC. Currently, he is a Professor at Xiangya Hospital of Central South University in China, Fellow of Royal Society of Medicine (FRSM), the European EPMA National Representative in China, Regular Member of American Association for the Advancement of Science (AAAS), European Cooperation of Science and Technology (e-COST) grant evaluator, Associate Editors of BMC Genomics, BMC Medical Genomics, EPMA Journal, and Frontiers in Endocrinology, Executive Editor-in-Chief of Med One. He has\npublished 116 peer-reviewed research articles, 16 book chapters, 2 books, and 2 US patents. His current main research interest focuses on the studies of cancer proteomics and biomarkers, and the use of modern omics techniques and systems biology for PPPM in cancer, and on the development and use of 2DE-LC/MS for the large-scale study of human proteoforms.",institutionString:null,institution:{name:"Xiangya Hospital Central South University",country:{name:"China"}}},{id:"40482",title:null,name:"Rizwan",middleName:null,surname:"Ahmad",slug:"rizwan-ahmad",fullName:"Rizwan Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/40482/images/system/40482.jpeg",biography:"Dr. Rizwan Ahmad is a University Professor and Coordinator, Quality and Development, College of Medicine, Imam Abdulrahman bin Faisal University, Saudi Arabia. Previously, he was Associate Professor of Human Function, Oman Medical College, Oman, and SBS University, Dehradun. Dr. Ahmad completed his education at Aligarh Muslim University, Aligarh. He has published several articles in peer-reviewed journals, chapters, and edited books. His area of specialization is free radical biochemistry and autoimmune diseases.",institutionString:"Imam Abdulrahman Bin Faisal University",institution:{name:"Imam Abdulrahman Bin Faisal University",country:{name:"Saudi Arabia"}}},{id:"41865",title:"Prof.",name:"Farid A.",middleName:null,surname:"Badria",slug:"farid-a.-badria",fullName:"Farid A. Badria",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/41865/images/system/41865.jpg",biography:"Farid A. Badria, Ph.D., is the recipient of several awards, including The World Academy of Sciences (TWAS) Prize for Public Understanding of Science; the World Intellectual Property Organization (WIPO) Gold Medal for best invention; Outstanding Arab Scholar, Kuwait; and the Khwarizmi International Award, Iran. He has 250 publications, 12 books, 20 patents, and several marketed pharmaceutical products to his credit. He continues to lead research projects on developing new therapies for liver, skin disorders, and cancer. Dr. Badria was listed among the world’s top 2% of scientists in medicinal and biomolecular chemistry in 2019 and 2020. He is a member of the Arab Development Fund, Kuwait; International Cell Research Organization–United Nations Educational, Scientific and Cultural Organization (ICRO–UNESCO), Chile; and UNESCO Biotechnology France",institutionString:"Mansoura University",institution:{name:"Mansoura University",country:{name:"Egypt"}}},{id:"329385",title:"Dr.",name:"Rajesh K.",middleName:"Kumar",surname:"Singh",slug:"rajesh-k.-singh",fullName:"Rajesh K. Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329385/images/system/329385.png",biography:"Dr. Singh received a BPharm (2003) and MPharm (2005) from Panjab University, Chandigarh, India, and a Ph.D. (2013) from Punjab Technical University (PTU), Jalandhar, India. He has more than sixteen years of teaching experience and has supervised numerous postgraduate and Ph.D. students. He has to his credit more than seventy papers in SCI- and SCOPUS-indexed journals, fifty-five conference proceedings, four books, six Best Paper Awards, and five projects from different government agencies. He is currently an editorial board member of eight international journals and a reviewer for more than fifty scientific journals. He received Top Reviewer and Excellent Peer Reviewer Awards from Publons in 2016 and 2017, respectively. He is also on the panel of The International Reviewer for reviewing research proposals for grants from the Royal Society. He also serves as a Publons Academy mentor and Bentham brand ambassador.",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",country:{name:"India"}}},{id:"142388",title:"Dr.",name:"Thiago",middleName:"Gomes",surname:"Gomes Heck",slug:"thiago-gomes-heck",fullName:"Thiago Gomes Heck",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/142388/images/7259_n.jpg",biography:null,institutionString:null,institution:{name:"Universidade Regional do Noroeste do Estado do Rio Grande do Sul",country:{name:"Brazil"}}},{id:"336273",title:"Assistant Prof.",name:"Janja",middleName:null,surname:"Zupan",slug:"janja-zupan",fullName:"Janja Zupan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/336273/images/14853_n.jpeg",biography:"Janja Zupan graduated in 2005 at the Department of Clinical Biochemistry (superviser prof. dr. Janja Marc) in the field of genetics of osteoporosis. Since November 2009 she is working as a Teaching Assistant at the Faculty of Pharmacy, Department of Clinical Biochemistry. In 2011 she completed part of her research and PhD work at Institute of Genetics and Molecular Medicine, University of Edinburgh. She finished her PhD entitled The influence of the proinflammatory cytokines on the RANK/RANKL/OPG in bone tissue of osteoporotic and osteoarthritic patients in 2012. From 2014-2016 she worked at the Institute of Biomedical Sciences, University of Aberdeen as a postdoctoral research fellow on UK Arthritis research project where she gained knowledge in mesenchymal stem cells and regenerative medicine. She returned back to University of Ljubljana, Faculty of Pharmacy in 2016. She is currently leading project entitled Mesenchymal stem cells-the keepers of tissue endogenous regenerative capacity facing up to aging of the musculoskeletal system funded by Slovenian Research Agency.",institutionString:null,institution:{name:"University of Ljubljana",country:{name:"Slovenia"}}},{id:"357453",title:"Dr.",name:"Radheshyam",middleName:null,surname:"Maurya",slug:"radheshyam-maurya",fullName:"Radheshyam Maurya",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/357453/images/16535_n.jpg",biography:null,institutionString:null,institution:{name:"University of Hyderabad",country:{name:"India"}}},{id:"418340",title:"Dr.",name:"Jyotirmoi",middleName:null,surname:"Aich",slug:"jyotirmoi-aich",fullName:"Jyotirmoi Aich",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000038Ugi5QAC/Profile_Picture_2022-04-15T07:48:28.png",biography:"Biotechnologist with 15 years of research including 6 years of teaching experience. Demonstrated record of scientific achievements through consistent publication record (H index = 13, with 874 citations) in high impact journals such as Nature Communications, Oncotarget, Annals of Oncology, PNAS, and AJRCCM, etc. Strong research professional with a post-doctorate from ACTREC where I gained experimental oncology experience in clinical settings and a doctorate from IGIB where I gained expertise in asthma pathophysiology. A well-trained biotechnologist with diverse experience on the bench across different research themes ranging from asthma to cancer and other infectious diseases. An individual with a strong commitment and innovative mindset. Have the ability to work on diverse projects such as regenerative and molecular medicine with an overall mindset of improving healthcare.",institutionString:"DY Patil Deemed to Be University",institution:null},{id:"349288",title:"Prof.",name:"Soumya",middleName:null,surname:"Basu",slug:"soumya-basu",fullName:"Soumya Basu",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035QxIDQA0/Profile_Picture_2022-04-15T07:47:01.jpg",biography:"Soumya Basu, Ph.D., is currently working as an Associate Professor at Dr. D. Y. Patil Biotechnology and Bioinformatics Institute, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India. With 16+ years of trans-disciplinary research experience in Drug Design, development, and pre-clinical validation; 20+ research article publications in journals of repute, 9+ years of teaching experience, trained with cross-disciplinary education, Dr. Basu is a life-long learner and always thrives for new challenges.\r\nHer research area is the design and synthesis of small molecule partial agonists of PPAR-γ in lung cancer. She is also using artificial intelligence and deep learning methods to understand the exosomal miRNA’s role in cancer metastasis. Dr. Basu is the recipient of many awards including the Early Career Research Award from the Department of Science and Technology, Govt. of India. She is a reviewer of many journals like Molecular Biology Reports, Frontiers in Oncology, RSC Advances, PLOS ONE, Journal of Biomolecular Structure & Dynamics, Journal of Molecular Graphics and Modelling, etc. She has edited and authored/co-authored 21 journal papers, 3 book chapters, and 15 abstracts. She is a Board of Studies member at her university. She is a life member of 'The Cytometry Society”-in India and 'All India Cell Biology Society”- in India.",institutionString:"Dr. D.Y. Patil Vidyapeeth, Pune",institution:{name:"Dr. D.Y. Patil Vidyapeeth, Pune",country:{name:"India"}}},{id:"354817",title:"Dr.",name:"Anubhab",middleName:null,surname:"Mukherjee",slug:"anubhab-mukherjee",fullName:"Anubhab Mukherjee",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y0000365PbRQAU/ProfilePicture%202022-04-15%2005%3A11%3A18.480",biography:"A former member of Laboratory of Nanomedicine, Brigham and Women’s Hospital, Harvard University, Boston, USA, Dr. Anubhab Mukherjee is an ardent votary of science who strives to make an impact in the lives of those afflicted with cancer and other chronic/acute ailments. He completed his Ph.D. from CSIR-Indian Institute of Chemical Technology, Hyderabad, India, having been skilled with RNAi, liposomal drug delivery, preclinical cell and animal studies. He pursued post-doctoral research at College of Pharmacy, Health Science Center, Texas A & M University and was involved in another postdoctoral research at Department of Translational Neurosciences and Neurotherapeutics, John Wayne Cancer Institute, Santa Monica, California. In 2015, he worked in Harvard-MIT Health Sciences & Technology as a visiting scientist. He has substantial experience in nanotechnology-based formulation development and successfully served various Indian organizations to develop pharmaceuticals and nutraceutical products. He is an inventor in many US patents and an author in many peer-reviewed articles, book chapters and books published in various media of international repute. Dr. Mukherjee is currently serving as Principal Scientist, R&D at Esperer Onco Nutrition (EON) Pvt. Ltd. and heads the Hyderabad R&D center of the organization.",institutionString:"Esperer Onco Nutrition Pvt Ltd.",institution:null},{id:"319365",title:"Assistant Prof.",name:"Manash K.",middleName:null,surname:"Paul",slug:"manash-k.-paul",fullName:"Manash K. Paul",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/319365/images/system/319365.png",biography:"Manash K. Paul is a Principal Investigator and Scientist at the University of California Los Angeles. He has contributed significantly to the fields of stem cell biology, regenerative medicine, and lung cancer. His research focuses on various signaling processes involved in maintaining stem cell homeostasis during the injury-repair process, deciphering lung stem cell niche, pulmonary disease modeling, immuno-oncology, and drug discovery. He is currently investigating the role of extracellular vesicles in premalignant lung cell migration and detecting the metastatic phenotype of lung cancer via machine-learning-based analyses of exosomal signatures. Dr. Paul has published in more than fifty peer-reviewed international journals and is highly cited. He is the recipient of many awards, including the UCLA Vice Chancellor’s award, a senior member of the Institute of Electrical and Electronics Engineers (IEEE), and an editorial board member for several international journals.",institutionString:"University of California Los Angeles",institution:{name:"University of California Los Angeles",country:{name:"United States of America"}}},{id:"311457",title:"Dr.",name:"Júlia",middleName:null,surname:"Scherer Santos",slug:"julia-scherer-santos",fullName:"Júlia Scherer Santos",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/311457/images/system/311457.jpg",biography:"Dr. Júlia Scherer Santos works in the areas of cosmetology, nanotechnology, pharmaceutical technology, beauty, and aesthetics. Dr. Santos also has experience as a professor of graduate courses. Graduated in Pharmacy, specialization in Cosmetology and Cosmeceuticals applied to aesthetics, specialization in Aesthetic and Cosmetic Health, and a doctorate in Pharmaceutical Nanotechnology. Teaching experience in Pharmacy and Aesthetics and Cosmetics courses. She works mainly on the following subjects: nanotechnology, cosmetology, pharmaceutical technology, aesthetics.",institutionString:"Universidade Federal de Juiz de Fora",institution:{name:"Universidade Federal de Juiz de Fora",country:{name:"Brazil"}}},{id:"219081",title:"Dr.",name:"Abdulsamed",middleName:null,surname:"Kükürt",slug:"abdulsamed-kukurt",fullName:"Abdulsamed Kükürt",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/219081/images/system/219081.png",biography:"Dr. Kükürt graduated from Uludağ University in Turkey. He started his academic career as a Research Assistant in the Department of Biochemistry at Kafkas University. In 2019, he completed his Ph.D. program in the Department of Biochemistry at the Institute of Health Sciences. He is currently working at the Department of Biochemistry, Kafkas University. He has 27 published research articles in academic journals, 11 book chapters, and 37 papers. He took part in 10 academic projects. He served as a reviewer for many articles. He still serves as a member of the review board in many academic journals. He is currently working on the protective activity of phenolic compounds in disorders associated with oxidative stress and inflammation.",institutionString:null,institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"178366",title:"Dr.",name:"Volkan",middleName:null,surname:"Gelen",slug:"volkan-gelen",fullName:"Volkan Gelen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178366/images/system/178366.jpg",biography:"Volkan Gelen is a Physiology specialist who received his veterinary degree from Kafkas University in 2011. Between 2011-2015, he worked as an assistant at Atatürk University, Faculty of Veterinary Medicine, Department of Physiology. In 2016, he joined Kafkas University, Faculty of Veterinary Medicine, Department of Physiology as an assistant professor. Dr. Gelen has been engaged in various academic activities at Kafkas University since 2016. There he completed 5 projects and has 3 ongoing projects. He has 60 articles published in scientific journals and 20 poster presentations in scientific congresses. His research interests include physiology, endocrine system, cancer, diabetes, cardiovascular system diseases, and isolated organ bath system studies.",institutionString:"Kafkas University",institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"418963",title:"Dr.",name:"Augustine Ododo",middleName:"Augustine",surname:"Osagie",slug:"augustine-ododo-osagie",fullName:"Augustine Ododo Osagie",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/418963/images/16900_n.jpg",biography:"Born into the family of Osagie, a prince of the Benin Kingdom. I am currently an academic in the Department of Medical Biochemistry, University of Benin. Part of the duties are to teach undergraduate students and conduct academic research.",institutionString:null,institution:{name:"University of Benin",country:{name:"Nigeria"}}},{id:"192992",title:"Prof.",name:"Shagufta",middleName:null,surname:"Perveen",slug:"shagufta-perveen",fullName:"Shagufta Perveen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192992/images/system/192992.png",biography:"Prof. Shagufta Perveen is a Distinguish Professor in the Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. Dr. Perveen has acted as the principal investigator of major research projects funded by the research unit of King Saud University. She has more than ninety original research papers in peer-reviewed journals of international repute to her credit. She is a fellow member of the Royal Society of Chemistry UK and the American Chemical Society of the United States.",institutionString:"King Saud University",institution:{name:"King Saud University",country:{name:"Saudi Arabia"}}},{id:"49848",title:"Dr.",name:"Wen-Long",middleName:null,surname:"Hu",slug:"wen-long-hu",fullName:"Wen-Long Hu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49848/images/system/49848.jpg",biography:"Wen-Long Hu is Chief of the Division of Acupuncture, Department of Chinese Medicine at Kaohsiung Chang Gung Memorial Hospital, as well as an adjunct associate professor at Fooyin University and Kaohsiung Medical University. Wen-Long is President of Taiwan Traditional Chinese Medicine Medical Association. He has 28 years of experience in clinical practice in laser acupuncture therapy and 34 years in acupuncture. He is an invited speaker for lectures and workshops in laser acupuncture at many symposiums held by medical associations. He owns the patent for herbal preparation and producing, and for the supercritical fluid-treated needle. Dr. Hu has published three books, 12 book chapters, and more than 30 papers in reputed journals, besides serving as an editorial board member of repute.",institutionString:"Kaohsiung Chang Gung Memorial Hospital",institution:{name:"Kaohsiung Chang Gung Memorial Hospital",country:{name:"Taiwan"}}},{id:"298472",title:"Prof.",name:"Andrey V.",middleName:null,surname:"Grechko",slug:"andrey-v.-grechko",fullName:"Andrey V. Grechko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/298472/images/system/298472.png",biography:"Andrey Vyacheslavovich Grechko, Ph.D., Professor, is a Corresponding Member of the Russian Academy of Sciences. He graduated from the Semashko Moscow Medical Institute (Semashko National Research Institute of Public Health) with a degree in Medicine (1998), the Clinical Department of Dermatovenerology (2000), and received a second higher education in Psychology (2009). Professor A.V. Grechko held the position of Сhief Physician of the Central Clinical Hospital in Moscow. He worked as a professor at the faculty and was engaged in scientific research at the Medical University. Starting in 2013, he has been the initiator of the creation of the Federal Scientific and Clinical Center for Intensive Care and Rehabilitology, Moscow, Russian Federation, where he also serves as Director since 2015. He has many years of experience in research and teaching in various fields of medicine, is an author/co-author of more than 200 scientific publications, 13 patents, 15 medical books/chapters, including Chapter in Book «Metabolomics», IntechOpen, 2020 «Metabolomic Discovery of Microbiota Dysfunction as the Cause of Pathology».",institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"199461",title:"Prof.",name:"Natalia V.",middleName:null,surname:"Beloborodova",slug:"natalia-v.-beloborodova",fullName:"Natalia V. Beloborodova",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/199461/images/system/199461.jpg",biography:'Natalia Vladimirovna Beloborodova was educated at the Pirogov Russian National Research Medical University, with a degree in pediatrics in 1980, a Ph.D. in 1987, and a specialization in Clinical Microbiology from First Moscow State Medical University in 2004. 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}]}},subseries:{item:{id:"92",type:"subseries",title:"Health and Wellbeing",keywords:"Ecology, Ecological, Nature, Health, Wellbeing, Health Production",scope:"\r\n\tSustainable approaches to health and wellbeing in our COVID 19 recovery needs to focus on ecological approaches that prioritize our relationships with each other, and include engagement with nature, the arts and our heritage. This will ensure that we discover ways to live in our world that allows us and other beings to flourish. We can no longer rely on medicalized approaches to health that wait for people to become ill before attempting to treat them. We need to live in harmony with nature and rediscover the beauty and balance in our everyday lives and surroundings, which contribute to our well-being and that of all other creatures on the planet. This topic will provide insights and knowledge into how to achieve this change in health care that is based on ecologically sustainable practices.
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Possible contributions can address (but are not limited to) the following research topics: Bioinspired design and control of exoskeletons, orthoses, and prostheses; Experimental evaluation of the effect of assistive devices (e.g., influence on gait, balance, and neuromuscular system); Bioinspired technologies for rehabilitation, including clinical studies reporting evaluations; Application of neuromuscular and biomechanical models to the development of bioinspired technology.',annualVolume:11404,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",institutionString:null,institution:{name:"Federal University of Uberlândia",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"49517",title:"Prof.",name:"Hitoshi",middleName:null,surname:"Tsunashima",fullName:"Hitoshi Tsunashima",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTP4QAO/Profile_Picture_1625819726528",institutionString:null,institution:{name:"Nihon University",institutionURL:null,country:{name:"Japan"}}},{id:"425354",title:"Dr.",name:"Marcus",middleName:"Fraga",surname:"Vieira",fullName:"Marcus Vieira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003BJSgIQAX/Profile_Picture_1627904687309",institutionString:null,institution:{name:"Universidade Federal de Goiás",institutionURL:null,country:{name:"Brazil"}}},{id:"196746",title:"Dr.",name:"Ramana",middleName:null,surname:"Vinjamuri",fullName:"Ramana Vinjamuri",profilePictureURL:"https://mts.intechopen.com/storage/users/196746/images/system/196746.jpeg",institutionString:"University of Maryland, Baltimore County",institution:{name:"University of Maryland, Baltimore County",institutionURL:null,country:{name:"United States of America"}}}]},{id:"9",title:"Biotechnology - Biosensors, Biomaterials and Tissue Engineering",keywords:"Biotechnology, Biosensors, Biomaterials, Tissue Engineering",scope:"The Biotechnology - Biosensors, Biomaterials and Tissue Engineering topic within the Biomedical Engineering Series aims to rapidly publish contributions on all aspects of biotechnology, biosensors, biomaterial and tissue engineering. We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics can include but are not limited to: Biotechnology such as biotechnological products and process engineering; Biotechnologically relevant enzymes and proteins; Bioenergy and biofuels; Applied genetics and molecular biotechnology; Genomics, transcriptomics, proteomics; Applied microbial and cell physiology; Environmental biotechnology; Methods and protocols. Moreover, topics in biosensor technology, like sensors that incorporate enzymes, antibodies, nucleic acids, whole cells, tissues and organelles, and other biological or biologically inspired components will be considered, and topics exploring transducers, including those based on electrochemical and optical piezoelectric, thermal, magnetic, and micromechanical elements. Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. 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