The demographic and laboratory baseline parameters of the patients [32].
\\n\\n
IntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
\\n\\nIntechOpen Book Series will be launching regularly to offer our authors and editors exciting opportunities to publish their research Open Access. We will begin by relaunching some of our existing Book Series in this innovative book format, and will expand in 2022 into rapidly growing research fields that are driving and advancing society.
\\n\\nLaunching 2021
\\n\\nArtificial Intelligence, ISSN 2633-1403
\\n\\nVeterinary Medicine and Science, ISSN 2632-0517
\\n\\nBiochemistry, ISSN 2632-0983
\\n\\nBiomedical Engineering, ISSN 2631-5343
\\n\\nInfectious Diseases, ISSN 2631-6188
\\n\\nPhysiology (Coming Soon)
\\n\\nDentistry (Coming Soon)
\\n\\nWe invite you to explore our IntechOpen Book Series, find the right publishing program for you and reach your desired audience in record time.
\\n\\nNote: Edited in October 2021
\\n"}]',published:!0,mainMedia:{caption:"",originalUrl:"/media/original/132"}},components:[{type:"htmlEditorComponent",content:'With the desire to make book publishing more relevant for the digital age and offer innovative Open Access publishing options, we are thrilled to announce the launch of our new publishing format: IntechOpen Book Series.
\n\nDesigned to cover fast-moving research fields in rapidly expanding areas, our Book Series feature a Topic structure allowing us to present the most relevant sub-disciplines. Book Series are headed by Series Editors, and a team of Topic Editors supported by international Editorial Board members. Topics are always open for submissions, with an Annual Volume published each calendar year.
\n\nAfter a robust peer-review process, accepted works are published quickly, thanks to Online First, ensuring research is made available to the scientific community without delay.
\n\nOur innovative Book Series format brings you:
\n\nIntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
\n\nIntechOpen Book Series will be launching regularly to offer our authors and editors exciting opportunities to publish their research Open Access. We will begin by relaunching some of our existing Book Series in this innovative book format, and will expand in 2022 into rapidly growing research fields that are driving and advancing society.
\n\nLaunching 2021
\n\nArtificial Intelligence, ISSN 2633-1403
\n\nVeterinary Medicine and Science, ISSN 2632-0517
\n\nBiochemistry, ISSN 2632-0983
\n\nBiomedical Engineering, ISSN 2631-5343
\n\nInfectious Diseases, ISSN 2631-6188
\n\nPhysiology (Coming Soon)
\n\nDentistry (Coming Soon)
\n\nWe invite you to explore our IntechOpen Book Series, find the right publishing program for you and reach your desired audience in record time.
\n\nNote: Edited in October 2021
\n'}],latestNews:[{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"10405",leadTitle:null,fullTitle:"River Basin Management - Sustainability Issues and Planning Strategies",title:"River Basin Management",subtitle:"Sustainability Issues and Planning Strategies",reviewType:"peer-reviewed",abstract:"This book addresses recent advances in the field of river systems. Chapters cover a wide range of topics including artificialization of rivers and banks, technical aspects of flood and sediment dynamics, physical processes and institutional vulnerabilities, watershed management and collaborative governance, water quality analysis and protection measures, acquisition and measurement of data, statistical and econometric procedures, adaptation and restoration measures, rehabilitation and sustainability of riparian ecosystems, and strategies to improve the ecological functions of riparian areas. All chapters contribute relevant information and useful content for scientists and other readers interested or concerned about the lack of adequate management actions and implementation of appropriate measures and protections, or their ineffectiveness in containing vulnerabilities and ecological sustainability of river systems.",isbn:"978-1-83968-131-8",printIsbn:"978-1-83968-130-1",pdfIsbn:"978-1-83968-132-5",doi:"10.5772/intechopen.91591",price:119,priceEur:129,priceUsd:155,slug:"river-basin-management-sustainability-issues-and-planning-strategies",numberOfPages:210,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"5e5ddd0f2eda107ce19c4c06a55a8351",bookSignature:"José Simão Antunes Do Carmo",publishedDate:"April 21st 2021",coverURL:"https://cdn.intechopen.com/books/images_new/10405.jpg",numberOfDownloads:3243,numberOfWosCitations:2,numberOfCrossrefCitations:2,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:4,numberOfDimensionsCitationsByBook:0,hasAltmetrics:0,numberOfTotalCitations:8,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"July 2nd 2020",dateEndSecondStepPublish:"July 23rd 2020",dateEndThirdStepPublish:"September 21st 2020",dateEndFourthStepPublish:"December 10th 2020",dateEndFifthStepPublish:"February 8th 2021",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,7",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"67904",title:"Prof.",name:"José Simão",middleName:null,surname:"Antunes Do Carmo",slug:"jose-simao-antunes-do-carmo",fullName:"José Simão Antunes Do Carmo",profilePictureURL:"https://mts.intechopen.com/storage/users/67904/images/system/67904.jpg",biography:"José Simão Antunes do Carmo obtained his master’s degree in Hydraulics and Water Resources in 1990 from the University of Lisbon and his Ph.D. in Engineering Sciences in 1995 from the University of Coimbra, Portugal. He was director of several undergraduate and master’s courses in Civil Engineering and Environmental Engineering in the period 1995-2010. He was a scientific advisor of twenty-five master’s dissertations and two Ph.D. theses in Hydraulics and Water Resources. He has published two books, sixty-five papers in scientific journals, fifteen book chapters, and more than one hundred papers in international conferences. He has edited eleven books and a special issue of a scientific journal. He is a member of the editorial board of several international journals. His main areas of scientific research are hydrodynamics, morphodynamics, coastal management, river and coastal processes, climate change, natural hazards, risks, and vulnerabilities.",institutionString:"University of Coimbra",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"4",totalChapterViews:"0",totalEditedBooks:"3",institution:{name:"University of Coimbra",institutionURL:null,country:{name:"Portugal"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"782",title:"Environmental Management",slug:"engineering-environmental-engineering-environmental-management"}],chapters:[{id:"75869",title:"The Hintze Ribeiro Bridge Collapse and the Lessons Learned",doi:"10.5772/intechopen.96711",slug:"the-hintze-ribeiro-bridge-collapse-and-the-lessons-learned",totalDownloads:281,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"In March 2001, a serious accident occurred in Portugal during a flood on the Douro River, next to Porto, Portugal. The collapse of the Hintze Ribeiro Bridge killed 59 people traveling in a bus and in three cars that fell into the Douro River. This bridge was built at the end of the 19th century on a curve of the Douro River, next to the mouth of the Tâmega River, approximately 50 km upstream of Porto. It was found that the combined effects of sand dredging in the 25 years prior to the accident (1975–2000) and the erosion produced by five consecutive floods between December 2000 and March 2001 were the main causes of this accident. Aiming to contribute to the prevention of occurrences such as that registered in Portugal with the collapse of the Hintze Ribeiro Bridge, a brief overview of this bridge is presented herein, as well as the causes that led to the collapse, some reflections on the processes involved, and, mainly, the lessons learned.",signatures:"José Simão Antunes Do Carmo",downloadPdfUrl:"/chapter/pdf-download/75869",previewPdfUrl:"/chapter/pdf-preview/75869",authors:[{id:"67904",title:"Prof.",name:"José Simão",surname:"Antunes Do Carmo",slug:"jose-simao-antunes-do-carmo",fullName:"José Simão Antunes Do Carmo"}],corrections:null},{id:"73708",title:"Management of River Basin Physical Assets",doi:"10.5772/intechopen.94226",slug:"management-of-river-basin-physical-assets",totalDownloads:290,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"River basin management involves, among other activities, the operation, maintenance and renewal of existing water and wastewater physical infrastructure assets, as well as the planning, designing, procurement and construction of new water infrastructure assets, in order to provide and secure present and future water demand, and other services, such as flood control and mitigation. Focus is set on increasing demand issues and uncertainty in available resources due to climate change. But there is a challenge also in the management of an aging portfolio of critical infrastructures, including storage, diversion and flood protection facilities, water wells, water conveyance facilities and wastewater treatment plants. Though physical asset management methodologies are well developed and established, such as ISO 55001, their application to infrastructures managed by river basin authorities is not widespread. This chapter presents key components for effective management covering the following aspects: asset monetary valuation; asset condition assessment; estimation of risks linked with asset condition; planning and prioritization of capital and maintenance expenditures; and expected impacts on water tariffs. A raw water distribution system in the Segura River Basin in Spain has been used as case study.",signatures:"Mario Andrés Urrea-Mallebrera, Luis Altarejos-García and Juan Tomás García-Bermejo",downloadPdfUrl:"/chapter/pdf-download/73708",previewPdfUrl:"/chapter/pdf-preview/73708",authors:[{id:"222238",title:"Dr.",name:"Juan T.",surname:"García",slug:"juan-t.-garcia",fullName:"Juan T. García"},{id:"327981",title:"Dr.",name:"Luis",surname:"Altarejos-García",slug:"luis-altarejos-garcia",fullName:"Luis Altarejos-García"},{id:"332045",title:"Dr.",name:"Mario Andrés",surname:"Urrea-Mallebrera",slug:"mario-andres-urrea-mallebrera",fullName:"Mario Andrés Urrea-Mallebrera"}],corrections:null},{id:"75564",title:"Transboundary River Basin Governance: A Case of the Mekong River Basin",doi:"10.5772/intechopen.95377",slug:"transboundary-river-basin-governance-a-case-of-the-mekong-river-basin",totalDownloads:367,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Conflict and cooperation are key governance challenges in transboundary river basin governance, especially in the Mekong River Basin. Hydropower dams have been at the center of such a conflict and cooperation that are useful metrics to assess the level and intensity of conflict and cooperation in transboundary river basin governance. This study examines transboundary river basin cooperation in the Mekong through the lens of hydropower dam projects. It uses a literature review and a case study of the Lower Sasan 2 (LS2) Dam to analyze the conflict and cooperation in the Mekong region, from the era of the US influence in the Cold War, the post-Cold War period, and the present-day with the rise of China. It concludes that Mekong river basin cooperation has evolved as a result of external influences and internal competition by riparian states over Mekong resources. The LS2 was identified in 1961 by US-supported hydropower studies and then by the GMS/ADB in 1998, but left unattended until 2007 when Vietnam signed an agreement with Cambodia to undertake a feasibility study in 2008. It took 16 years to get the LS2 built by a Chinese company in 2014 and completed it in 2017. Through the process, the states, powerful external actors, financial institutions, and private sector actors have politicized the LS2 studies, design, and construction. Cambodia, as a weak downstream state, has had to and must continue to position itself strategically in its relationships with these hydro-hegemons to compete for hydropower dam projects and protect its interests. The rise of China has induced the changing relationship between riparian states. Many hydropower dams were built with Chinese funding. Cambodia has also enjoyed its close ties with China, and the building of the LS2 dam by a Chinese company contributes to changing its positions in the Mekong cooperation but suffers environmental and social impacts.",signatures:"Mak Sithirith",downloadPdfUrl:"/chapter/pdf-download/75564",previewPdfUrl:"/chapter/pdf-preview/75564",authors:[{id:"328254",title:"Dr.",name:"Mak",surname:"Sithirith",slug:"mak-sithirith",fullName:"Mak Sithirith"}],corrections:null},{id:"74153",title:"uMngeni Basin Water Quality Trend Analysis for River Health and Treatability Fitness",doi:"10.5772/intechopen.94844",slug:"umngeni-basin-water-quality-trend-analysis-for-river-health-and-treatability-fitness",totalDownloads:476,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"One of the main challenges facing the potable water production industry is deterioration of the quality of raw water. Drinking water that does not meet quality standards is unfit for consumption. Yet, this quality is a function of various factors, key among them being quality of the raw water from which it is processed. This is because costs related to potable water treatment are related to the nature of raw water pollutants and the degree of pollution. Additionally, survival of aquatic species depends on self-purification of the water bodies through attenuation of pollutants, therefore, if this process is not efficient it might result in dwindling of the aquatic life. Hence, this chapter presents spatial and temporal water quality trends along uMngeni Basin, a critical raw water source for KwaZulu-Natal Province, in South Africa. As at 2014 the basin served about 3.8 million people with potable water. Results from this study are discussed in relation to uMngeni River’s health status and fitness for production of potable water treatment. Time-series and box plots of 11 water quality variables that were monitored at six stations over a period of eight years (2005 to 2012), were drawn and analysed. The Mann Kendall Trend Test and the Sen’s Slope Estimator were employed to test and quantify the magnitude of the quality trends, respectively. Findings showed that raw water (untreated) along uMngeni River was unfit for drinking purposes mainly because of high levels of Escherichia coli. However, the observed monthly average dissolved oxygen of 7 mg/L, that was observed on all stations, suggests that the raw water still met acceptable guidelines for freshwater ecosystems. It was noted that algae and turbidity levels peaked during the wet season (November to April), and these values directly relate to chlorine and polymer dosages during potable water treatment.",signatures:"Innocent Rangeti and Bloodless (Rimuka) Dzwairo",downloadPdfUrl:"/chapter/pdf-download/74153",previewPdfUrl:"/chapter/pdf-preview/74153",authors:[{id:"171647",title:"Mr.",name:"Innocent",surname:"Rangeti",slug:"innocent-rangeti",fullName:"Innocent Rangeti"},{id:"327929",title:"Dr.",name:"Bloodless",surname:"Dzwairo",slug:"bloodless-dzwairo",fullName:"Bloodless Dzwairo"}],corrections:null},{id:"74318",title:"Interpretation of Water Quality Data in uMngeni Basin (South Africa) Using Multivariate Techniques",doi:"10.5772/intechopen.94845",slug:"interpretation-of-water-quality-data-in-umngeni-basin-south-africa-using-multivariate-techniques",totalDownloads:333,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The major challenge with regular water quality monitoring programmes is making sense of the large and complex physico-chemical data-sets that are generated in a comparatively short period of time. Consequentially, this presents difficulties for water management practitioners who are expected to make informed decisions based on information extracted from the large data-sets. In addition, the nonlinear nature of water quality data-sets often makes it difficult to interpret the spatio-temporal variations. These reasons necessitated the need for effective methods of interpreting water quality results and drawing meaningful conclusions. Hence, this study applied multivariate techniques, namely Cluster Analysis and Principal Component Analysis, to interpret eight-year (2005–2012) water quality data that was generated from a monitoring exercise at six stations in uMngeni Basin, South Africa. The principal components extracted with eigenvalues of greater than 1 were interpreted while considering the pollution issues in the basin. These extracted components explain 67–76% of the water quality variation among the stations. The derived significant parameters suggest that uMngeni Basin was mainly affected by the catchment’s geological processes, surface runoff, domestic sewage effluent, seasonal variation and agricultural waste. Cluster Analysis grouped the sampling six stations into two clusters namely heavy (B) or low (A), based on the degree of pollution. Cluster A mainly consists of water sampling stations that were located in the outflow of the dam (NDO, IDO, MDO and NDI) and its water can be described as of fairly good quality due to dam retention and attenuation effects. Cluster B mainly consist of dam inflow water sampling stations (MDI and IDI), which can be described as polluted if compared to cluster A. The poor quality water observed at Cluster B sampling stations could be attributed to natural and anthropogenic activities through point source and runoff. The findings could assist in determining an appropriate set of water quality parameters that would indicate variation of water quality in the basin, with minimum loss of information. It is, therefore, recommended that this approach be used to assist decision-makers regarding strategies for minimising catchment pollution.",signatures:"Innocent Rangeti and Bloodless Dzwairo",downloadPdfUrl:"/chapter/pdf-download/74318",previewPdfUrl:"/chapter/pdf-preview/74318",authors:[{id:"171647",title:"Mr.",name:"Innocent",surname:"Rangeti",slug:"innocent-rangeti",fullName:"Innocent Rangeti"},{id:"327929",title:"Dr.",name:"Bloodless",surname:"Dzwairo",slug:"bloodless-dzwairo",fullName:"Bloodless Dzwairo"}],corrections:null},{id:"75214",title:"Riparian-Buffer Loss and Pesticide Incidence in Freshwater Matrices of Ikpoba River (Nigeria): Policy Recommendations for the Protection of Tropical River Basins",doi:"10.5772/intechopen.95521",slug:"riparian-buffer-loss-and-pesticide-incidence-in-freshwater-matrices-of-ikpoba-river-nigeria-policy-r",totalDownloads:286,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"The unregulated use of watersheds for agriculture negatively impacts the quality of river basins. In particular, the reduced quality of surface-waters, have been attributed to absence or poorly-decided riparian-buffer specifications in environmental laws. To demonstrate suitable buffer-width for protection of surface water, sediment and benthic fish populations, five riparian areas with different vegetation richness and buffer-width were selected within an organochlorine pesticide (OCP)-impacted watershed using the Normalized Differential Vegetation Index (NDVI) and multiple buffer analysis respectively. Mean OCP levels in surface water, sediment and fish sampled at each riparian stations showed site-specific differences with markedly higher levels of α-BHC, β-BHC, δ-BHC, p,p′-DDD and total pesticide residues at stations with least riparian cover. The principal component analysis further revealed more OCPs associating with sediment and fish from stations having smaller buffer-width and sparse riparian vegetation. Stations with wider buffer-width of at least 120 m provided greater protection to adjacent surface water and benthic fish populations. While this study recommends riparian buffer-widths for a typical tropical environment, further research which assesses other contaminant types in aquatic matrices adjacent to different riparian environments would be valuable and informative for regulatory guidance and strategic protection of ecosystem services.",signatures:"Azubuike Victor Chukwuka and Ozekeke Ogbeide",downloadPdfUrl:"/chapter/pdf-download/75214",previewPdfUrl:"/chapter/pdf-preview/75214",authors:[{id:"234506",title:"Dr.",name:"Azubuike",surname:"Chukwuka",slug:"azubuike-chukwuka",fullName:"Azubuike Chukwuka"},{id:"326673",title:"Dr.",name:"Ozekeke",surname:"Ogbeide",slug:"ozekeke-ogbeide",fullName:"Ozekeke Ogbeide"}],corrections:null},{id:"74207",title:"Morphoanatomical Characteristics in Riparian Vegetation and Its Adaptative Value",doi:"10.5772/intechopen.94933",slug:"morphoanatomical-characteristics-in-riparian-vegetation-and-its-adaptative-value",totalDownloads:598,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Riparian vegetation comprises plant communities that grow laterally to rivers and streams. They have multiple adaptations, which allows them to persist in these variable and dynamic habitats. This chapter focuses on the morphological and anatomical adaptations of vegetative organs, due to the fact that they are more vulnerable to environmental changes that occur in riparian ecosystems. We also discuss some dispersal mechanisms in riparian species exposed to flooding conditions. Most morphoanatomical adaptations in riparian plants reflect constraints imposed by long periods of waterlogging or complete submergence, as well as the high diversity of strategies that species have developed in order to cope with flooding. Furthermore, riparian ecosystems are being impacted by an increasing artificialization of rivers and banks with losses, or profound changes, in the natural riparian vegetation a problem that will increase with the ongoing climate change, and which must be contained. In order to reduce the vulnerability of these ecosystems, a deeper knowledge of the morphoanatomical attributes that make possible the successful adaptation of riparian flora is necessary so as to implement appropriate measures for the rehabilitation and sustainability of riparian ecosystems.",signatures:"Marina García and Damelis Jáuregui",downloadPdfUrl:"/chapter/pdf-download/74207",previewPdfUrl:"/chapter/pdf-preview/74207",authors:[{id:"328389",title:"Ph.D.",name:"Marina",surname:"García",slug:"marina-garcia",fullName:"Marina García"},{id:"333241",title:"Dr.",name:"Damelis",surname:"Jáuregui",slug:"damelis-jauregui",fullName:"Damelis Jáuregui"}],corrections:null},{id:"74917",title:"Temporary De-Poldering for a Long Term Flood/Sediment Management in the Southwestern Bangladesh",doi:"10.5772/intechopen.95265",slug:"temporary-de-poldering-for-a-long-term-flood-sediment-management-in-the-southwestern-bangladesh",totalDownloads:330,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Southwestern Bangladesh has been seriously affected by perennial waterlogging over the last few decades. It is primarily due to excessive riverbed siltation outside the polders after the construction of embankments along both sides of the tidal rivers. These embankments de-linked the huge natural floodplains and restricted a gradual process of natural deposition inside the polders. An introduction of the tidal basin concept by temporary de-poldering (embankment cut) at some designated locations has substantially solved the issues. The current chapter looks at the historical practice of flood/sediment management, the evolution of embankments and their de-poldering, inclusion of Tidal River Management (TRM) in long term flood/sediment management, and discusses a technical aspect of flood/sediment dynamics across the tidal river system. The process of restoring beneficial tidal flooding by cutting embankment at certain locations, commonly known as TRM, is not a novel method. The TRM has started from age-old practice and proves technically one of the effective methods of sustainable flood/sediment management in the tide-dominated river system. It is an example of building with nature, where little human interventions are needed, and a resilient measure for waterlogging, drainage-congestion, and river-siltation.",signatures:"Rocky Talchabhadel, Kenji Kawaike and Hajime Nakagawa",downloadPdfUrl:"/chapter/pdf-download/74917",previewPdfUrl:"/chapter/pdf-preview/74917",authors:[{id:"220385",title:"Dr.",name:"Rocky",surname:"Talchabhadel",slug:"rocky-talchabhadel",fullName:"Rocky Talchabhadel"},{id:"327627",title:"Prof.",name:"Kenji",surname:"Kawaike",slug:"kenji-kawaike",fullName:"Kenji Kawaike"},{id:"331292",title:"Dr.",name:"Hajime",surname:"Nakagawa",slug:"hajime-nakagawa",fullName:"Hajime Nakagawa"}],corrections:null},{id:"75138",title:"Agricultural Activities and Restoration of Lake Chad",doi:"10.5772/intechopen.94753",slug:"agricultural-activities-and-restoration-of-lake-chad",totalDownloads:284,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The disappearance of 90% of Lake Chad’s surface has brought riparian countries to elaborate a restoration project for this natural asset. The aim of this study is to estimate the benefits and costs associated with the realization of this project, in order to determine if it is socially profitable. The methodological approach use data from the contingent valuation survey conducted in 2011 in the Cameroonian part of Lake Chad and appropriate statistical and econometric procedures. First, we estimate the middle and long term benefits of the project to be €5,549,576.832 and €38,543,518.56 respectively. Then, we evaluate the costs generated by the implementation of such a project to €37,960,149.12. Finally, the social profitability of this project depends on the temporal horizon used by decision-makers. It is negative for an economic horizon and positive for an ecological horizon.",signatures:"Patrick Arnold Ombiono Kitoto",downloadPdfUrl:"/chapter/pdf-download/75138",previewPdfUrl:"/chapter/pdf-preview/75138",authors:[{id:"326255",title:"Dr.",name:"Patrick",surname:"Ombiono",slug:"patrick-ombiono",fullName:"Patrick Ombiono"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"6821",title:"Natural Hazards",subtitle:"Risk Assessment and Vulnerability Reduction",isOpenForSubmission:!1,hash:"855e55f0cd51410f7013bb47181d3321",slug:"natural-hazards-risk-assessment-and-vulnerability-reduction",bookSignature:"José Simão Antunes do Carmo",coverURL:"https://cdn.intechopen.com/books/images_new/6821.jpg",editedByType:"Edited by",editors:[{id:"67904",title:"Prof.",name:"José Simão",surname:"Antunes Do Carmo",slug:"jose-simao-antunes-do-carmo",fullName:"José Simão Antunes Do Carmo"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7606",title:"Coastal and Marine Environments",subtitle:"Physical Processes and Numerical Modelling",isOpenForSubmission:!1,hash:"dd1227726856d58b88116129b0de8384",slug:"coastal-and-marine-environments-physical-processes-and-numerical-modelling",bookSignature:"José Simão Antunes Do Carmo",coverURL:"https://cdn.intechopen.com/books/images_new/7606.jpg",editedByType:"Edited by",editors:[{id:"67904",title:"Prof.",name:"José Simão",surname:"Antunes Do Carmo",slug:"jose-simao-antunes-do-carmo",fullName:"José Simão Antunes Do Carmo"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"403",title:"Planet Earth 2011",subtitle:"Global Warming Challenges and Opportunities for Policy and Practice",isOpenForSubmission:!1,hash:"52a6385d63c583025b22d5e45871d054",slug:"planet-earth-2011-global-warming-challenges-and-opportunities-for-policy-and-practice",bookSignature:"Elias G. 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\r\n\r\n\tCombining Motivation and Success as a book title demonstrates that these are complementary goods. When two goods are complements, they experience join demand. Meaning that the demand for one good is linked to the demand for another good. Indeed, our esteemed authors will aim to put together their scholarly work to showcase the importance of motivation leading to success and vice versa. Defined as a drive or a need, motivation is a driving force inside an individual to pursue a designated goal. While success is a state of meeting a targeted goal. This simply implies that motivated individuals are most successful and this is the core theme of the book.
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Key factor boosting transport sector growth is the deregulation of the transport sector business environment, have been adopted by most of the economies, where new business models have been introduced (e.g. Low Cost Carriers in aviation) generated new demand by providing connectivity to/from remote destinations and stimulated demand in mature markets, [2].
Transport network today, it is totally different compared to the past, where new entries provide additional capacity by new technology fleet, larger vehicles, expanding the transport network promoting connectivity in emerging markets and remote destinations. The existing business environment is highly competitive, especially, in mature international transports corridors (e.g. US-Europe), [3]. Alliances and acquisitions have been extended taken place in transport market promoting collaboration and risk-sharing schemes towards viability of large transport enterprises and market development by offer services even in niche markets served by new entries.
Traditional transport carriers were vertically organized, covering all the operational functions in-house, an approach usually drive to higher operational cost compared to those outsource activities not in the core of transport chain make them more competitive to a globalized market. The competitive liberalized business ecosystem in transport industry, where alliances and acquisitions are key strategies for the international and the multinational enterprises resulting a fast shifting from the traditional all-in structure towards a more outsourcing oriented approach.
While the transformation of traditional carriers is in place, focused on the main advantage of outsourcing that is the cost mitigation, a new framework for subcontracting is growing where the legal responsibilities and business risks are a key challenge for transport enterprises, [4]. Therefore, the condition of contracts is a complicated task for activities related to carrier’s core values such as safety, quality of service and branding, [5]. In addition, the introduction of new digital services in sales, pricing, and communication with the client many times rise issues of intellectual property.
New entries in transport business have already establish flexible business models take the benefits of the era of digitalization and technological innovation. In mature markets, cause of rapid technology innovation in vehicles (type of fuels, energy consumption, automations etc.) and the effects of digitalization in offered services to clients (passengers or cargo), the tradition acting framework of a carrier is totally shift from a large work capital-intensive enterprise in early 90s to a more capital-intensive cooperation of today. Digitalization enables this transformation and promote new sources of revenues for the transportation companies and compromising the driving force for cost mitigation, for example, by optimizing the fleet operations (operational cost) and introducing customized services towards penetration in market segments.
In transport industry, the definition of outsourcing deals with the provision of an ongoing service even a business function for a meaningful time extended due to action lifecycle, such as fleet maintenance or rail line operation. Outsourcing not including deliverables from a specific one-off procurement process, service or deliverable, such as the construction of a building or a research project, [6].
This paper key objective deals with the depiction of outsourcing decision framework for the transport sector. Conventional wisdom is to investigate of the transport sector tendencies on keeping inside and outsource activities. The paper layout includes 4 sections, where the market tendencies in supply-delivering are highlighted, the outsourcing framework in transport business is descripted, aviation sector conditions are given presenting tendencies in the most outsource sector in transport industry, some key guidelines for managers are listed and finally the conclusion and reference section are situated.
The decision-making framework to evaluate insourcing vs. outsourcing should be based on value analysis of each business function. Each function is weighted in terms of operational capability and the criticality to company objectives including corporate targets. In the analysis several parameters should be taken into consideration, depending on the size of the business, operational complexity of the transport-delivery chain and other factors related to financing, cost mitigation, risk management and quality control. For enterprises deliver products, the different options could be categorized in three main directions: (a) leveraging internal staffing and technology; (b) outsourcing to a large third-party logistics (3PL) provider, or (c) implementing some combination of the two alternatives.
Leverage internal staffing and technology constitute crucial driver for outsourcing, especially, for companies or business formations that their supply and delivery process is not core of their expertise. Also, many companies organize in-house logistic activities simply because they do not have the scale or the complexity in their supply-delivery operations to warrant partnering with a large transport or/and logistic provider. With a fully in-house scenario, the transport and delivery functions maintain complete control over all aspects of their operations including negotiating carrier rates, planning, optimizing and contain deliveries.
The challenge for transport enterprises is to reach the appropriate level of staff and fleet resources as well as the appropriate transport management capabilities in place. Benefits to the organization include full visibility of distribution process and outputs including a full control of costs at every step. Key challenge in this option is to define the balance between in-house and outsourcing vehicles and staff towards cost control and mitigation, and a step further to determine this balance in the short- and long-term business plan.
A key challenge for the companies for all business units in all business sectors deals with the decision to outsource all supply and production delivery operations to a large transport enterprise (3PL). This option for the companies with complex and/or larger-scale delivery operations, outsourcing all activities to a 3PL transport-logistic provider can be a optimum choice, provided adequate cost control to each product or service they offer. The biggest advantage to turning the supply-delivery function over to a 3PL provider is that transport enterprises have the knowhow in delivery management, use state of the art techniques and advance technology and they have the necessary human resources and fleet to serve the transport needs over time and on demand.
The downside of fully outsourcing to a 3PL is an option frequently led to a cost overhead, meaning that depending of the range of offered services it could result a higher direct cost for the distribution cost, but an significant cost reduction in relevant investments (capex) and in-house operational inefficiencies (opex). Negotiating the 3PL outsourcing contract should include detailed analysis on contract conditions and especially regarding monitoring expectations and performance, therefore, specifications on outsourcing services it’s an area would be clearly stated.
In terms of risk management, many companies promote a combination approach, where some functions are outsourced, and some others managed in-house. In this option, they may choose to keep the functions related to corporate performance internally, such as the carrier rate negotiations, planning, and optimization of their own facilities and resources (staff and vehicles). They can then turn the execution of these orders over to the 3PL, which is a capability that all 3PL’s must provide simply to remain competitive. This gives the chance to negotiate the strongest rates with their network of carriers and to also optimize how shipments move through the supply chain. They can take advantage of company exiting resources and use of knowhow and intelligence of a large transport provider.
Strategically, there is not a straightforward best option of those presented above. A comprehensive analysis should determine the appropriateness and effectiveness of each option for each enterprise or business unit over time. These analyses may produce differing results based on a company’s varying operating geographies, production lines, market share, organizational objectives, and other factors (management obligations etc.). Also, many times the suitable of one year may not the same valuable for the next, therefore, it will be a periodically re-assessment process. These analyses must minimally consider short-term through longer-term impacts relative to costs, benefits, and risks from a financial, operational, organizational, and technological perspective.
Conclusively, in transport sector the strategy towards outsourcing should be based on utility function of the enterprise value chain. Globally, it’s a strong tendency to outsource non-transport activities such is back-office support in a range of managerial oriented activities such as marketing, branding, IT, legal services and sectorial partnerships. On the other hand, an insourcing tendency for the cost driven functions such as procurement and fuel arrangements are the success factors towards pricing and profitability, where sometimes related to long-term contracts promoting advantages in competition. By investigation of key tendencies in transport business sector in Europe (research outputs from ENIRISST project, at the acknowledgement section details are given), the strategy orientation large transportation companies is depicted in the following figure (Figure 1).
Orientation towards outsourcing based on business value at risk in transport sector.
To date, many carriers have relinquished control of lower-value functions, such as payroll, human resources management or even slivers of the value chain that are more central to their business. Many shipping, aviation or truck carriers focus their strategy to lease vehicles or fleet for a time or season (e.g., holiday summer peak) even for many years (fleet lifecycle lease contracts), and many times these leasing contracts include the staff to operate vehicles. However, these same companies have seen little reason to let go of higher-value functions, especially, those related to managerial attitudes, such as fleet management, pricing, branding etc. as their scale has enabled them to develop world-class capabilities in-house.
On the other head the data driven business planning orientation is heavily affected the corporate business strategies. In a data-driven world, transport system operators’ capabilities could be exceeded by those of their suppliers and this option may lead to greater efficiency and effectiveness, but it also comes with major risks associated with suppliers’ power and independency. These risks should be handled carefully considering that an outsourcing arrangement that delivers gains in the short term could, over time, create mismanaged dependency, eroding competitive advantage, impacting corporate strategic targets and shareholder values. Transport companies cannot afford to be isolated from the digital ecosystem’s innovation (e.g. blockchain) forming around every industry, but each action must be carefully developed into the frame of outsourcing without giving away the power of the business to 3rd parties or suppliers.
The key factors that will determine which services are into the outsourcing frame deal with (a) if the outcomes can be clearly defined and provided by a 3rd party, and (b) the supplier’s contractual conditions and obligations in terms of risk and benefits sharing mechanism. In a data-driven business actions, there are new dimensions to both, where key factor is the data control and maintenance but also the intellectual property for applications and deliverables.
Transport enterprises contemplating outsourcing a function with specific content, description and desired outcomes can be clearly defined and counterpart in a contract where the framework is developed by a collaborative agreement with a 3rd party where the risks and benefits are shared between the parties, and the progress monitored by the transport company. In other words, outsourcing dealing with a production chain task that is not traced by the transport company but for a third party (a supplier) that is fully or partially responsible for the product or function constantly evolved. In outsourcing cooperation, the contractor will commit time and resources but cannot generally guarantee a particular result and not taking transport business risks.
Hence, the key factions related to decisions for business performance, meaning the key managerial components of a company (such as the company accounting) and those actions related with the core business of transportation (such as fleet procurement or vehicle drivers) are hard to outsource, because deals with the key functions that the company specialized in the transport business ecosystem. In a high competitive business environment where agility is a key driver towards cost control and management performance, sometimes the concerns about outsourcing are essential in the terms of risk sharing and intellectual property. Therefore, the direction for spin-off business functions promoting joint ventures or gain-sharing agreements might be more suitable than an outsourcing contract when working with suppliers in this way.
Artificial intelligence is a great supporter of establishing such contracts, providing tools of monitoring and counting the contractor performance and outsourcing potential benefits. For instance, a product delivery company make it easier to assess performance of a delivery outsourcing contract in a region based on spatial (GIS) data analysis receive and storage data through sensors and tracking devices. In the cases that the outsource outcome could specified, defined, and monitored with accuracy, the more the company outsource these functions, the higher are the benefits of outsourcing.
Because the nature of transport distribution channers are to be developed in a non-interrupt operating networks, meaning that the performance in a small part of the network may affect the performance of the whole network, therefore, many times it is very trivial to estimate the added value of outsourcing in the company operational environment. This means that outsourcing may be better to include the component in supply chain it is more straightforward to define an outcome for a whole service, such as railroad line (see the case of London tube network) or bus network of a city (see the bus company in city of Nicosia in Cyprus), than for a small component of that services, such as railroad-track maintenance or just a single bus corridor. In such outsourcing contracts the level of offered activity or capacity is related to the whole performance quantified in the given spatial/geographical line, network, or region.
Key decision issue on the outsourcing content deals with the impact in the transport enterprise value chain. Therefore, many times the transport enterprises prefer more flexible options into the term of “Smart sourcing” is where the outsourcing solution combines the benefits of different suppliers to come up with the optimal solution. This option is in line with the strategy to keep control in the whole value chain and its widely used in aviation and shipping. Its compatible with alliances and merging strategies that are applied, extensively, in these sectors and the benefits for the company opex and branding are decision key drivers.
For the digital intelligent services, a similar type is widely applied, providing more flexibility to transport companies. The “niche sourcing” approach that its very close to above, but its more suitable for cases where no readily available “off-the-shelf” solution exists that fits an transport company particular needs. Smart or niche sourcing is quite often used in large transport infrastructure operators (ports, airports, logistic centers, etc) enabling an operator to combine the best technology with another supplier having a proven track record for managing IT infrastructure, service delivery, and customer service and project management.
In a data-driven economy, where the high capitalized transport enterprises listed stock market (see sectors of shipping and aviation) valuated much lower than the technological oriented enterprises with much lower capitalization, two other sources of advantage are particularly important towards data-driven services outsourcing. The supplier might have data and technology that the company would struggle to replicate, for instance access to a large data pool or a proprietary solution to finding dependencies between large data sets etc. Additionally, it might have skills and capabilities the transport enterprise cannot reach, or it is extremely costly to reach. With demand for people with big data skills outstripping supply, for example, outsourcing could be one of the few practical ways for a resources company to secure the talent required to develop algorithms for predictive maintenance.
When a technological supplier offers a structural advantage in low-value functions in transport supply value chain then the decision to outsource is not hard to be taken, as little value is at risk for the transport enterprise and the advantages could be easily assessed between the parties. But increasingly, suppliers may hold an advantage in functions deemed more critical to the business, such as data mining for the client’s profile or machine learning applications to predictive be, or in an area where, hitherto, the company has held a strong competitive advantage, such as safety, marketing, etc. or operational excellence towards customer satisfaction. In that case companies need to proceed much more cautiously when outsourcing.
The following figure presents how the companies in transportation prioritize their strategic advantages in their core business value chain, giving room for outsourcing. The results are based on reviewing the corporate strategy of large transport enterprises based on US and Europe.
The digital force for changes in the operational environment of a transport enterprise are essential. Consider an international carrier in air transport sector: it probably already has more data for their client/passenger than even and data mining applications, potentially, maintain their needs better and promote associated services (e.g. food beverage, entertainment, sales or accommodation). It might make sense, therefore, for maintain the needs of client (passengers/cargo suppliers) to outsource the catering and other on-board services (e.g. entertainment for long-haul travel) rather than develop different menu for each destination or traveler choice and maintain catering in-house.
Large transport companies already employ external technology experts to track and improve the attractiveness of the offered service (resulting additional revenues) providing a better travel experience compared to competition (thus maintain market share) by using the Internet of Things (IoT). The issue is to aggregate the data from many different companies and introduce services and procedures meet the needs of a global market or even specific market segment. The result could be the development of a large group of new services dedicated for specific passenger profiles, where at the end of the day could be a new revenues generator for the company, and a step further to be tailormade for passengers’ profile, needs and habits.
Example is the transport enterprises for passengers, in which, while the main source of revenues because from transport activities in a few decades ago, to date is transformed to a new business model where significant source of revenues could be came from a platform with real time data for consumption in non-transport services or products and algorithms which support customers to spend for their travel needs (e.g. make reservations for a hotel or restaurant or event in the destination city/region).
As with the transport carrier, the insights that a platform operator would be able to generate revenues using these data could be far greater than those any single company could hope to uncover on its own. The prospect then arises of platform companies in unrelated areas, such as product sales, accommodation, banking, and healthcare, moving into the transport value chain. They recognize that companies accommodate passengers (potential clients) for a time is a key benefit for sales or promote services. Microsoft has already launched predictive-maintenance services enabled by the IoT, while a company such as Amazon could deliver a product bought on fly to the address you choose and a company like Google could give you optimum routing in a city or best travel option to intercontinental long-haul travel to an exotic holiday destination.
It is noteworthy that above-described actions are not driven just by the large IT or software or platform companies. The rapid development and introduction to market of new applications and the growing interest for funding start-up and small flexible enterprises provide significant advantages for the smaller ones, while in a useful idea at the right time could be extremely beneficial. Therefore, a small team could, for example, develop the optimum fleet-maintenance tailormade to the actual needs of the company and to be as intellectual as those of the high branded manufacturing companies in their sector. Also, another group could develop the optimum network planning towards profit maximization or risk mitigation or both and just outsourcing management to a global supplier that can collate data from the hundreds of thousands of sensor-laden vehicles it manages to optimize the fleet’s performance. While that were a future fiction in early 90s, today it is a common practice in Travel and Accommodation (T&A) sectors.
Typical example is the aviation industry where passenger’s data used to be the core business for an airline or airport. A stream of transaction, tracking, monitoring and other functional data applications each passenger reservation, cargo shipment, or flight operation. Much of this data contains non-public personally identifiable information, especially in the PNR (passenger name record). Airlines also have volumes of proprietary and confidential information related to their business operations and IT assets. Moreover, much data is created in one country and follows a passenger or cargo shipment to its ultimate destination in another country, while often transiting numerous other countries en-route. Outsourcing adds yet another layer of complexity, in that numerous third parties will need access to airline customer data.
Airlines need to ensure that their agreements with suppliers properly protect the confidentiality of airline and third-party trade secrets and limit the use of non-public proprietary information as required in all applicable jurisdictions. Restrictions on cross-border exchanges of non-public personal information, especially following the model of the European Union, are likely to make this process even more complex. Airlines also need to examine the extent to which data flows relating to money transfers and settlement functions have special money laundering and suspicious activity reporting requirements.
Outsourcing suppliers are often perceived as “invisible” insiders or “remote” workers. From the view of top management, the confidentiality rules are crucial towards direct and honest cooperation, where a range of best practices are in place covering a range of conflict of interest during the outsourcing selection partner, non-disclosure legal terms in the contract due to prohibition and non-permission for delivering connected actions for a period after the contract termination. The non-disclosure agreements may not provide any relief against release of information by outsourcer employees, who may often be providing services to competing companies as well.
Offer services even into the company property using company assets many times are not covered by the same obligations and dissemination barriers as it happens for the company employees, and the coordination may is tight task. Outsourcing arrangements must settle who will have access to company information and especially corporate and client’s data and under what circumstances will facilitating the use and access of such data in the outsourcing arrangement. Considering outsourcing arrangements effected in transport business ecosystem, the key considerations towards efficient outsourcing contracts could be summarized as follows.
collaboration arrangements need to be based on cost-efficient and performance management schemes (e.g. bonus-malus), therefore, the price arrangements between parties should be flexible, involving from long-term payback assets to rapid development of technological innovations.
medium-long term contracts is beneficial for the sectors of aviation, shipping and inland transports, while flexibility in innovation is the cornerstone of success for short to medium term contracts in urban transport networks.
Smart sourcing and niche outsourcing arrangements, although focused, need to be integrated and include provisions dealing with relationship maintenance, substitution of parties to niche markets and partnerships in service customization and transaction services.
Appropriate outsourcing arrangements should specifically address opportunities presented by joint ventures and alliance arrangements.
Outsourcing agreements should clearly address who will have access to business confidential data, and under what circumstances, and provide enforceable confidentiality, non-disclosure even prohibit terms in appropriate jurisdictions.
The air transport industry has seen major changes in the post-deregulation era - almost 40 years after the airline deregulation first took off in the US and extended in Europe in ‘90s - primarily, because the Low-Cost Carrier (LCC) successful business model and the wide spread of hub-and-spoke networks resulting a dynamic airline industry, an incredibly competitive business ecosystem and a growing offering of capacity and services to the market, [7]. The hub-and-spoke networks enabled airlines not only provide the frame of synergies between the competitor carriers, but also to build partnerships more attractive as the spatial and temporal concentration of flights enabled efficient connectivity among the partners, [8].
The issue of “connectivity” is the cornerstone of modern air network planning and its strongly related to air transport productivity, airline efficiency and airport effectiveness, [3]. Today, the global business environment of aviation based on two main success factors: (a) the risk sharing mechanism between carriers, travelers, airports, and regional market [7]; and (b) the benefits achieved by outsourcing in internal (corporate and operational structure of aviation companies) and external business environment (extended through synergies, multilateral and globe-spanning air carrier alliances and joint ventures due to typical outsourcing contracts in catering and cleaning), [6, 7].
Outsourcing strategy for airlines, IT vendors, MROs (maintenance, repair and overhaul providers), more recent airports and other aviation-related businesses widely adopted many years ago. But last decade, the pace and scope of aviation outsourcing has significantly increased. For example, between 1985 and 1999, the 10 largest U.S. passenger airlines experienced a tenfold increase in their MRO outsourcing, representing more than $2.4 billion a year in revenues to outsource suppliers, [9]. Airlines outsource many functions to help them focus on core activities, achieve efficiencies, and maintain competitive advantages. The outsourced functions include passenger or cargo reservations systems, accounting and traffic management systems, operational systems (flight operations, crew scheduling, gate operations, ground handling, catering), fleet maintenance, and office systems and functions.
Some of these outsourced functions relate to the use of long-life span assets, such as aircraft and airport facilities, which present airlines with duration issues related to how long the activity should be outsourced – for the life cycle of the asset or a lesser period. Many airlines in the U.S. and Europe historically have provided most of their airframe and engine MRO services inhouse (Delta, Lufthansa, British airways, etc). Today, airlines need to evaluate their outsourcing opportunities at all phases of an asset’s life span.
Aviation industry is a leading sector using technology innovation and by taking the benefits of deregulation enforced in 80s in US and 90s in Europe, promote best business practices adopted or extended to other sectors. The introduction of the new type of fleet (more than 500 seats wide body aircrafts, e.g. A380), the growth of door-to-door airline integrators such as FedEx and UPS, the development of budget-oriented ticket pricing model (LCC), the public-private-partnerships in airport development and operation, have transformed the aviation industry. Todays, successful business strategy is linked with efficient and flexible in terms of technological changes outsourcing be beneficial for all involved parties, while modeling and technological innovation based on mega data is fast transforming industry towards smart and intelligent business.
Airlines are keen to take the benefits of outsourcing, as a risk sharing mechanism, a cost control tool and brand extension strategy. Airlines strategy focused on branding. They acting to keep high branding strategy promoting collaboration with world class enterprises in destination marketing, food and beverage and customized services. While in the past were followed a branding line extension strategy (by introducing additional products and services for each service under the airline brand), modern airlines are keen to adapt a brand extension strategy even an co-branding approach, by using their own brand or promote co-operation for services offered by world class suppliers. Therefore, a corporation with a famous food and beverage firm to provide on board meals are beneficial for both. On the other hand, fleet management, business intelligence and strategic alliances or bilateral corporations are the core of the modern airline and impact on branding (Figure 2).
Outsourcing functions for a typical international air carrier.
The wide-ranging changes of the aviation market impact on the airport business environment as well. While airlines are change pioneer, airports also are following an essential transformation from a typical state authority of ‘90s accommodate air traffic to a private oriented company using the benefits of high passenger’s and activities concentration in their territory, shifting airports not just as transportation hubs but also as large commercial centers and technological innovation units. While commercialization and privatization of airports are a continuing tendency around the word, supported by long-term investments and international cooperation’s, these long-term life cycle arrangements boost outsourcing arrangements at airports towards operational efficiency, corporate performance, and socioeconomic effects in local economy, [1, 2].
The outsourcing strategy for airports dealing more to control working capital cost and provide low aeronautical charges to their clients that are airlines. On the other hand, the non-aeronautical business unities are key drivers for revenues at airports. Therefore, airport operators transformed to more commercialized entities, there is plenty room for more outsourcing in terminal and land side activities. The modern airport terminal is closer to a large shopping mall, while many logistics, commercial and technological centers are spatially located at airports landside area. Therefore, airport revenues strategy encouraging business competition into non-aeronautical business and tend to reduce the barriers to entry in aeronautical business sections, [4, 6] (Figure 3).
Outsourcing functions for a typical international airport.
Furthermore, the innovation in air transport sector also including the development of drones and airspace services, are growing fast. Up to now, for commercial activities the drone enterprises provide dedicated services as alternatives of traditional transport modes. Drones enterprises acting mainly as transport service providers are taken full responsibility of the transport chain. However, it’s a very promising activity with a strong tendency to offer massive services, in urban networks (taxis, urban logistics, etc) and interurban distribution channels (remote destinations, islands etc) where other options are limited.
The operational environment in distribution channels is changing fast. The operations of a large transport company could be optimized in weeks by comparing its performance data having access to the competition and supplier’s data are uploaded in a database. In contrary, examples of extensive outsourcing of high-value functions are, for now, few and far between, with aviation and shipping be the pioneer sectors. In transport and logistics there is more room for outsourcing based on the market dynamics.
While considerable opportunities exist, transport enterprises need to prepare carefully and take into consideration a variety of strategic, business, operational and legal issues as well the key values of shareholders should be assessed towards deciding what functions or parts of function be beneficial to outsource. The key initials should be reviewed are:
How to maintain flexibility when outsourcing a particular function or service that may change over the business life-cycle;
For the high value functions the risk mitigation for smart source or niche-outsource should be carefully assessed;
Compatibility with existing strategic alliances and partnerships should be analyzed;
How to protect and manage the business sensitive data across competition and a tendency for outsourcing AI and IoT tools and applications and control the use of such data by third parties.
The key challenges for transport enterprise managers in a fast-changing industry and into the existing regulatory framework are highlighted in the following paragraphs.
Companies need to guard against outsourcing arrangements or partnerships that prevent them from adopting new technologies or contracting with new vendors. Data management is a great value for a transport enterprise so it’s a of great importance to control data produced by its activity. Those with the biggest and best databases will be those with the best models and predictive power, able to outcompete others. Giving away data increases dependency on suppliers increasing company value at risk. Hence, the data management system architecture so they can change with the times as new and unforeseen options emerge. Any outsourcing arrangement must be structured in a way that enables the architecture to be flexible, compatible, and open oriented. Key success factor for pioneers is the developed data driven business intelligent tools to help build outsourcing services, tools that are sold to competitors. Deep consideration should be given in conflict of interest, non-disclosure agreements, intellectual properties, and information shared procedures, as mentioned in above section.
Both parties must share benefits and depending on nature of outsource service to share risks as well. Therefore, incentives should be the core of the collaboration frame and the outuputs should be quantitated, determined, and monitored. Conventional wisdom is to agree in suitable incentives for an outsourcing arrangement to succeed. The usual ones—sharing gains and rewarding outcomes rather than inputs— are not extremely attractive in a digital age. But where outcomes are concerned, flexibility will be required. Eventually, it might be better to use another supplier to maintain competitive tension rather than to run existing outsourcing form of contacts. In business intelligence, hence, should avoid the deals that hinge on the use of proprietary or niche technology.
The risks of outsourcing to a single, dominant supplier might not be obvious initially, as digitization reduces the barriers to entry, prompting a proliferation of new players, all rushing to capture value and competing strongly. The risk of losing leverage over a supplier through a lack of credible competition is therefore significant. In addition, becoming too entrenched with a single supplier can make switching costs high, as many companies have found with enterprise-resource-planning systems. To help maintain a healthy level of competition, large companies spread even the same function of an activity among several suppliers and nurture smaller ones, although this does not come without a cost either. In a provocative sense, even the outsourcing for a large network in a city or region to a single supplier may the risks are significant lower to choose two or more suppliers to commit competition.
When negotiating, both suppliers and transport enterprises should consider clauses providing for asset substitution, upgrading, and modification, intellectual property and know-how issues along with adjustments in pricing and penalties. A clear “objective” for both parties along with clear and dedicate benefits-risk sharing mechanisms to maintain technological change should be considered.
In transport sector, outsourcing can be extremely beneficial, productive even crucial to capture the potential of new technologies and innovation capabilities. Decisions to outsource for some companies’ might base on buy time to build their own skills and capabilities or gain cooperation with technological driver of innovation, while smaller ones might outsource to leverage the capabilities of new suppliers. Ultimately, when up against increasingly smart and capable suppliers, many companies might have to rethink their core business. But in the meantime, they need to be highly strategic in their decisions about what or how to outsource.
With time, technology will undoubtedly break up the traditional value chain in the transport business ecosystem as companies are forced to conclude they enjoy a competitive advantage in far fewer functions than they do today. Eventually, they might be able to outsource entire parts of their business or major factions impact essential their value chain. Transport enterprises have to take the benefits of artificial intelligence and business intelligence as well. The outsourcing of research and development activities, especially, in the data management is on the top of the agenda even for the large companies.
The future impact of technology remains far too unclear. Very few years ago, for example, few businesses knew how important cloud data management would become. Open technology standards will be key to maintaining future strategic options towards outsourcing data retrieve services. While support might be sought for the execution of a technology strategy, decisions about what data to keep, where to store and process them, and how applications can access and manipulate them need to be made by the company. What companies should follow to ensure the capture of the short-term gains that outsourcing can deliver in a way that does not limit their future strategic options.
The paper outputs depict the results of a functional analysis for the transport enterprises, driven from the research outputs of ENIRISST program where transport intelligent application taken into consideration. The paper outputs given according to a System of System approach providing the changes on transport sector towards outsourcing and co-branding strategy. An area of further research could be this analysis to be extended for each sector of transport industry and to provide results in term of enterprise size, sector and market segment.
The paper use research outputs from the research project “ENIRISST – Intelligent Research Infrastructure for Shipping, Supply Chain, Transport and Logistics”, implemented in the Action “Reinforcement of the Research and Innovation Infrastructure”, funded by the Operational Programme “Competitiveness, Entrepreneurship and Innovation” (NSRF 2014-2020) and co-financed by Greece and the European Regional Development Fund. EN.I.R.I.S.S.T. is a unique and pioneering research infrastructure deals with the development of innovative techniques, AI and BI applications, and digital observatories in the fields of Shipping, Supply Chain and Transport (https://www.enirisst.gr/).
Iron deficiency (ID) is the most common nutritional deficiency worldwide, heavily concentrated in several regions including Asia, Latin America and Africa, where it may affect up to 60% of the entire population. In countries with high development rate prevalence of iron deficiency anemia (IDA) is estimated at 9% and accounts approximately for 50% of all anemia cases, representing a frequent medical condition encountered in clinical practice by general practitioners, pediatricians and several other specialists. In these countries the prevalence of ID/IDA is higher in pediatric age, especially in two life phases: one that occurs between the first and third year of life (2.3–15%) and another in adolescence (3.5–13% in males, 11–33% in females). In adults its prevalence is less than 1% in men <50 years of age, 2–4% in men >50 years of age, 9–20% in menstruating teenagers and young women, and 5 to 7% in post-menopausal women. In people older than 65 years its prevalence is 12%. World Health Organization (WHO) data show that ID/IDA in pregnancy is a significant problem throughout the world with a prevalence ranging from an average of 14% of pregnant women in industrialized countries to an average of 56% (range 35–75%) in developing countries [1, 2, 3, 4, 5].
The most frequent etiologic factors in ID/IDA are decrease iron intake, impaired iron absorption, increase iron loss and increased iron requirements. In adult females increased menstrual flows and reduced iron absorption, as occurs in celiac disease (CD), are the most common mechanisms of ID/IDA. Vegetarians, especially vegans, obese individuals, blood donors and competitive endurance athletes represent populations at risk of ID/IDA. In children increased daily requirement and CD are the leading causes of ID/IDA [1, 2, 3, 4, 5].
Iron (Fe) is an essential trace mineral naturally present in many foods, but it is also available as a dietary supplement. In the typical western diet iron is mainly (85–90%) present as inorganic form Fe2+ (ferrous) and Fe3+ (ferric), the remaining amount as heme form. The diet contains up to 20 mg of daily iron intake of which 1–2 mg are absorbed. Fe3+ is less bioavailable as it has to be converted into Fe2+ in order to be absorbed. The absorption of Fe2+ primarily occurs in the proximal duodenum, at the brush border of the mucosa cells, through a membrane transport protein called Divalent Metal Transporter 1 (DMT1). This process is regulated by the cytochrome B (DCYTB), a ferric reductase located on the apical membrane of duodenal enterocytes. Otherwise heme-iron is absorbed in the same bowel district, but separately from DMT1 and more efficiently than inorganic Fe [1, 2, 3, 4, 5].
Management of ID/IDA is primarily aimed at removing, whenever possible, the underlying cause of ID. Subsequently iron replacement is always indicated to replete iron stores. The use of oral iron formulations is the current standard treatment; however in certain situations discussion remain open if the intravenous iron might be a more suitable modality for iron supplementation [1, 2, 3, 4, 5].
Ferrous sulphate (FS) remains the mainstay of treatment since it was first introduced in 1832 by the French physician Pierre Blaud (
The optimal oral iron dose of FS is yet to be established. Traditionally recommended dose in children is 2–6 mg/kg/day in term of elemental iron [5]. In adolescents and adults recommended dose is 50–200 mg once daily or in divide doses [1, 2, 3, 4]. The optimum frequency of oral supplementation is still uncertain. It has been demonstrated that one day treatment saturates the intestinal absorption processes. According to more recent data of the literature the administration of iron on every other day might be equal or more effective than daily doses with less side effects [2, 4, 6]. When therapy is fully effective the anticipated increase in hemoglobin levels occur after 2 to 3 weeks (increase by 1–2 g/dl within 1 month) of iron treatment, and reaches normal levels by 2–3 months. When the hemoglobin levels have been corrected, treatment should be continued for 3–4 months in order to completely fill the body’s iron stores [1, 2, 3, 4, 5].
Ferrous sulphate absorption ranges between 5–28% at the fastest. During oral iron therapy non-absorbed iron is potentially toxic for the gastrointestinal mucosa due to its oxidative properties leading to occurrence of gastro-intestinal adverse events. Nausea, vomiting, diarrhea or constipation, epigastric discomfort and colicky pain often represent a limit for patient domiciliary compliance decreasing the adherence to protocols with consequent failure of therapy efficacy. Actually many patients (20–70%) experience some type of gastrointestinal discomfort during oral iron salts intake, jeopardizing the prolonged (several months) planned treatment [1, 2, 3, 4, 5, 6, 7]: up to 40% of patients may self-discontinue the medication without discussing with medical doctor [8]. It is not surprising that effectiveness of oral iron is largely compromised by lack of absorption, poor compliance, increased adverse effects and discontinuation of treatment.
In order to improve tolerability several formulations with Fe2+ or Fe3+ have been proposed by pharmaceutical laboratories during the last decades. Generally these oral iron compounds are better tolerated than FS but may be less effective in iron replacement, ferrous compounds remaining anyway more absorbed than trivalent ones. However, often these preparations have the common drawback of being less effective in malabsorptive disorders [1, 2, 3, 4, 5, 6, 7]. Clinical studies concerning these new compounds remain limited while rigorously randomized designed clinicaltrials are often lacking.
Iron amino acid chelates represent a source of iron which has proven to be highly bioavailable with decreased extent gastrointestinal adverse effects when compared to FS [9]. Ferrous Bisglycinate Chelate (FBC) is the most studied compound among these new formulations. In FBC one molecule of ferrous iron is chelated by two molecules of glycine resulting in two heterocyclic rings. Several clinical trials showed clinical bioequivalence between this source of iron at low dosage and FS at standard doses with ratio 1 to 4 [10, 11, 12]. Unfortunately, during treatment with FBC, albeit very rare, some gastro-intestinal adverse effects can occur. Another limit of FBC could be represented by “the iron taste” of the preparation that might worsen patient compliance.
To ameliorate its bioavailability, taste and tolerability, a new oral iron source named FERALGINE™ (FBC-A) has been recently developed [13, 14]. This new molecule is a patented co-processed one-to-one ratio compound between FBC and Sodium Alginate (AA), obtainedby using a spray drying technology [15, 16]. AA as well as FBC has been recognized as GRAS by FDA [17].
Sodium Alginate has usually been used as “gastro-protection”. It is a non-toxic, biocompatible, biodegradable polymer, which belongs to the polysaccharides naturally present in seaweed. The contact between AA and the acidic environment in the stomach leads to the formation of a gel layer that hasa protective effect on the mucosa membranes of the stomach and esophagus. For this reason AA is an ingredient of many medications (antacids) commonly used in the treatment of heartburn and reflux diseases [18, 19]. Mucoadhesive microsphere of AA have recently demonstrated to be a unique “carrier system” for many pharmaceuticals preparation increasing not only oral iron but also other drugs bioavailability such as metformin, amoxicillin, furosemide, ibuprofen, insulin, acyclovir, captopril, glipizide, dicumarol. This “carrier system” results really in a promising and cost-effective method drug delivery system to improve oral bioavailability and to reduce gastrointestinal drugs side effects [20, 21, 22]. Spray drying is one of the most powerful technological process for the pharmaceutical industry << being an ideal process where the moisture content, bulk density and morphology end-product must comply with precise quality standards regarding particle size distribution, residual moisture content, bulk density and morphology>> [15, 16, 23, 24, 25]. (Figure 1) Spray drying technology comes of age during World War II, with the sudden need to reduce the transport weight of foods and other materials. This technique enables the transformation of feed from a fluid state into dried particulate form by spraying the feed into a hot drying medium. It is a continuous particle processing drying operation. As well described by Gervasi et al. < <spray drying process mainly involves five steps: 1) Concentration: feedstock is normally concentrated prior to introduction into the spray dryer; 2) Atomization: the atomization stage creates the optimum condition for evaporation to a dried product having the desired characteristic; 3) Droplet-air contact: in the chamber, atomized liquids brought into contact with hot gas, resulting in evaporation of 95% of the water contained in the droplets in a matter of a few minutes; 4) Droplet drying: moisture evaporation takes place in two stages: during the first stage, there is sufficient moisture in the drop to replace the liquid evaporated at the surface and evaporation takes place at a relatively constant rate and the second stage begins when there is no longer enough moisture to maintain saturated conditions at the droplet surface, causing a dried shell to form at the surface. Evaporation then depends on the diffusion of moisture through the shell, which is increasing in thickness; 5) Separation: cyclones, bag filter, and electrostatic precipitators may be used for the final separation stage>> [14].
Spray drying system.
In FBC-A, since FBC and AA are present in 1 to 1 ratio, every little particle of the powder has the same morphology and quantity of the two different co-processed substances. The new “co-processed compound”, obtained by spray drying technology, confers to the iron powder an increased and uniform superficial area and, consequently, quick and more extensive iron absorption together with an increased gastrointestinal protection (Figure 2). In the same time, the uniform presence of AA in this product, allows theFBC to be released more constantly and slowly when confronted to FBC alone and let the DMT1 receptors to better uptake iron. DMT1 receptor saturation could be a limit in oral iron bioavailability that could be exceeded by FBC-A. In fact, slowly availability of iron by FBC-A administration could result in DMT-1 unsaturation with the consequence of increasing iron bioavailability [13, 14, 23, 24, 25].
FBC-A powder (picture making by stereomicroscopy Wild Heerbrugg Makroskop M420 linked to an OPTIKAM MICROSCOPY DIGITAL USB CAMERA) [
Preliminary clinical trials confirm the bioavailable of FBC-A whiles the “dispert effect” of AA on FBC accounts for the good tolerability at gastro-enteric levels. FBC-A also improves iron taste when compared to FBC alone, increasing patient’s compliance.
Ame et al. studied 12 patients (9 women and 3 men with medium age of 63.83 ± 20.94 years) affected by IDA (4 patients present multifactorial anemia, 2 hypermenorrhea-related anemia, 2 cancer-related anemia, 2 increased-iron loss anemia, 1 post transplantation anemia and1 hypo-regenerative anemia), enrolled in an open prospective uncontrolled pivotal clinical trial. Mean hemoglobin (Hb) levels at the beginning of study (T0) were 10.49 g/dl (range 7.8–11.9 g/dl), mean serum iron values were 27,9 μg/dL (range 13–39 μg/dL) and mean serum ferritin (SF) values were 26 μg/ml (range 4–89 μg/ml). The patients presented history of chronic fatigue and/or asthenia at enrolment. All patients received FBC-A (30 mg of elemental iron) once a day for a period lasting from 35 days to 60 days (mean 46.25 days). At the end of treatment (T1) mean Hb values were 11.6 g/dl (range 8.9–13.9 g/dl), mean serum iron values were 48.9 mg/ld. (range 34–68 mg/dl) and mean SF values were 35 μg/ml (range 9–94 μg/ml), (p < 0.0001) (Figure 3). No FBC-A adverse events or therapy interruption were reported during the trial. Significant as a small quantity of elemental iron (30 mg daily) has been able to increase the Hb as required by international guidelines (1 g/dl.Hb/month) confirming the high bioavailability ofthis new compound. Subject performances ameliorated significantly in all patients [26].
Increase in mean Hb and SF levels from time T0 to T1 after administration of FBC-A [
Celiac disease (CD) is an immunologically-mediated disorder characterized by duodenal mucosa villi atrophy. As iron is primarily absorbed at duodenum level, iron absorption is reduced in celiac patients. In fact, the most frequent extra-intestinal manifestation of CD is IDA, with a prevalence between 12 and 82% in patients with new CD diagnosis. Absorption of FS and other iron formulationsis limited in patients with undiagnosed and active CD. Iron supplementation generally results less effective in these patients leading to a form of refractory IDA. The effectiveness of iron administration may be reduced also during the first months of gluten-free diet (GFD), when the mucosa healing is yet on-going. Furthermore a poor iron compoundstolerabilityis particularly frequent in patients with CD, decreasing patient’s compliance. These events increase the risk of making every kind of oral iron treatment unhelpful [27, 28].
The oral iron absorption test (OIAT) is an old screening test to assess iron absorption. Forgotten for many years it has been recently re-evaluated in clinical practice [29, 30]. The test consists of measuring plasma iron increase in the next hours after a single dose of an oral iron preparation. It has been demonstrated that this increment reflects the real capacity of iron absorption from the gastrointestinal tract [29, 30]. In a previous study we tested FBC by OIAT in pediatric patients affected by overt CD (disease at diagnosis before starting GFD) or on GFD, showing as FBC was well absorbed in spite of duodenal mucosal lesions [31].
More recently Giancotti et al. studied 26 patients with IDA of which 14 were also affected by overt CD (mean age: 32.28 years) and 12 were not affected (mean age: 33.58 years) [32]. The demographic and laboratory baseline parameters of the patients are summarized in Table 1.
Males | Females | Hb ± SD (g/dl) | Serum ferritin±SD (ng/dl) | Serum iron ±SD μg/dL) | |
---|---|---|---|---|---|
Celiac-IDA | 2 | 12 | 11.07 ± 1.04 | 10.44 ± 15.9 | 28.21 ± 14.9 |
Non-celiac IDA | 0 | 12 | 10.80 ± 0.9 | 12.30 ± 13.8 | 34.91 ± 23.2 |
The demographic and laboratory baseline parameters of the patients [32].
An OIAT was performed in each patient by administrating FBC-A (60 milligrams of elemental iron). Serum iron was evaluated at baseline (T0) and after 2 h (T1) from the iron ingestion. The OIAT was well tolerated in all patients. There was a clear improvement in iron serum in all patients (T0 = 31.30 μg/dL vs. T1 = 105.3 μg/dL # p < 0.0001). The relationship between the severity of IDA and the absorption of iron showed that patients with severe anemia (Hb < 10 g/dL) had an higher increase in serum iron after the OIAT (about nine times) compared to patients with mild/moderate forms of anemia (TO 12.00 μg/dL and 35.76 μg/dL
Change in serum iron levels in patient with IDA and CD (group A) and without CD (group B) after OIAT [
These results clearly demonstrated that FBC-A is well tolerated and well absorbed, not only in anemic non-celiac patients but also in patients with overt CD. Furthermore as it is widely assumed that side effects limit compliance to iron oral treatment, these results confirm that FBC-A is very promising for treatment of iron deficiency also in patients affected by CD.
Talarico et al. referred a 22-year-old girl with IDA resistant to FS therapy who was finally diagnosed as a celiac patient with multiple duodenal biopsies. A strictly GFD was then prescribed and in order to evaluate the absorption of a different iron compound, an OIAT was performed with FBC-A at the dosage of 30 mg of elemental iron. The results confirmed a good iron absorption as the serum iron increased from 27 μg/dl at baseline (T0) to 93.2 μg/dl after two hours (T1). Then, treatment with FBC-A at a dosage of 30 mg/day was promptly started. A general status recovery was observed in a few days. After 3 months Hb reached 11.5 g/dl; after 6 months iron stores were replaced (SF 50 ng/dl). CD serology normalized after one year, with complete resolution of anemia and gastrointestinal symptoms [33]. This case report confirms the efficacy of FBC-A in patients with overt CD, being already well absorbed during the first months of GFD.
Rondinelli et al. performed an OIAT study after oral ingestion of FBC-A (60 mg of elemental iron) on 14 patients (8 females and 6 males) with IDA (mean age 55.28 ± 8.17 years). The mean Hb level was 9.7 g/dl (range 8.7–10.7g/dl) and mean SF level was 8.23 ng/ml (4–12 ng/ml). At baseline time (T0) mean plasma iron was 11.21 μg/dl ± 10.66. Two hours after taking FBC-Ain fasting condition (T2) mean plasma iron increased significantly to 111.00 μg/dl ± 51.56 (p < 0.00001) (Figure 5) [34].
OIAT: plasma iron before (TO) and after 2 hours (T2) from 60 mg of FBC-A [
The increase of serum iron was greater than that observed after administration of bivalent iron by others authors (Figure 6).
Expected theoretical plasma iron level after 2 hours from 200 mg of elemental iron salts administration (blue lines) versus experimental FBC-A 60 mg elemental iron oral administration (yellow line) [
Crohn’s disease and ulcerative colitis are the two expressions of the Inflammatory Bowel Disease (IBD), a complex of immunologically mediated diseases due to a dysregulated immune response to commensal flora in a genetically susceptible host. Among IBD patients, IDA is more frequent than in general population, due to multifactorial reasons including chronically inflammation, blood loss and low iron absorption. Goodhand et al. showed as children (88%) and adolescents (83%) were more often iron-deficient than adults (55%). The efficacy of oral iron treatment might be hampered by a significant incidence of gastrointestinal side effects and the exacerbation of an existing colitis, that limit adherence to therapy in near half of patients [35]. It has been shown that in adults the adherence to therapy lowers to 10–42% within 2 months. Consequently treatment with oral iron results in failure to control anemia in 2 out of 3 IBD patients as reported by Lugg et al. [36] According to the last European Crohn’s and Colitis Organization [ECCO] guidelines, oral iron therapy is recommended for patients with mild IDA and clinically inactive IBD, with no history of intolerance to oral iron; instead intravenous (IV) administration iron should be considered in patients with clinically active IBD with previous intolerance to oral iron [37]. However although adverse reactions to modern IV iron formulations are rarely severe, given the potentially fatal side effects this treatment is generally only performed in a hospital setting where ready access to resuscitation equipments is available. Furthermore IV treatment has a significant incremental cost respect to oral iron treatment [37]. A recent review by Foteinogiannopoulou et al. on 1394 Greek patients with IBD showed that among those who received iron intravenously (393) about 89.3% responded, in contrast to only 54.2% of those who received iron orally (142). Furthermore 31% of patients that received iron orally presented with adverse events, mostly gastrointestinal symptoms that eventually led to cessation ofthe treatment. On the other hand, about 7.9% that received iron intravenously experienced adverse events during infusion. The availability of a well absorbed oral compound with good tolerability would be of great benefit for these patients, avoiding the need of intravenous treatment [38].
Vernero et al. performed a study with FBC-A in patients affected by IBD. They enrolled 52 patients with IBD, mean age 47 years (range 15–86 years) presenting with IDA. Mean Hb level was 11 g/dl (range 10.72–11.47 g/dl) and mean SF level was 21.4 ng/ml (range 3.09–39.7 ng/ml). Patients received FBC-A 30 mg once a day for 3 months. Response to therapy was monitored by periodical evaluation of Hb and SF. At the end of the study Hb mean value was 12.2 g/dl (range 11.6–12.52 g/dl) (p = 0,0001). Mean SF increased to 74 ng/ml (range 14.4–133.7 ng/ml), a difference near to the statistical significance (p = 0,07). Regarding FBC-Atolerability, 90% of patients reported good tolerance to treatment, while 10% of them experienced dyspepsia and worsening of diarrhea. Only 6% of patients suspended oral iron supplementation due to gastroenteric intolerance (adherence rate 94%) [39].
Sprecacenere et al. evaluated the impact of a 4 weeks course of FBC-A (30 mg/day) on a cohort of 52 blood donors presenting with IDA (mean Hb level11.8 ± 0.7 gr/dl and mean SF level 14.8 ± 9.8 ng/ml). After treatment mean Hb level increased to 13.3 ± 1 gr/dL (p = 0,007) and mean SF level to 21.8 ± 13.5 ng/ml (p = 0,02) [40].
Iron requirements drastically increase during pregnancy to accommodate an expandingred cell volume, growing fetus and placenta. The global prevalence of anemia in pregnancy is estimated to be approximately 38–42%. ID may be present in up to 80% of women in the second/third trimester of pregnancy and postpartum, if not supplemented with iron. Oral iron treatment is still considered a frontline therapy for IDA in pregnancy but gastrointestinal side effects are common leading to a high ratio of non-adherence to treatment [41]. Bertini et al. described 21 pregnant women with moderate IDA (Hb < 11 g/dl and SF < 25 ng/ml at time T0) supplemented with 30 mg/day of elemental iron in the form of FBC-A and evaluated at 15 days (T1) and 30 days (T2) of treatment. Hb and SF levels increased in all the enrolled women at T1 and T2 interval (Hb T1
It is well documented that ID/IDA impacts negatively on the affected patients by disturbing multiple organs function possibly leading to a multitude of symptoms that compromise the general well-being, quality of life and individual performance. Successful management of ID/IDA primarily requires identification and treatment of the underlying cause(s) of the ID. After that replacement should be established for all patients with IDA/IDA with or without symptoms. Oral iron salts such as ferrous fumarate, ferrous gluconate, and ferrous sulfate have been the mainstay of oral iron supplementation as they are inexpensive, effective at restoring ironbalance, and have a good overall safety and tolerability profile. However, in several patients absorption of oral iron salts is inadequate, and poor tolerance results in reduced adherence to therapy. Some other compounds are nowavailable as alternative therapies. Usually they have a more tolerability profile over the traditional iron salts but often no studies comparing the clinical or cost effectiveness of these different oral iron products are available.This short review summarizes all clinical studies on FBC-A published so far.
Several studies demonstrated that OIAT is a good index for the evaluation of iron absorption and might a reliable test to investigate the bioavailability of the various iron formulations [29, 30, 31]. The studies of Giancotti et al. [32], Talarico et al. [33] and Rondinelli et al. [34] performing OIAT clearly show as the FBC-A is well absorbed and well tolerated. Furthermore these studies evidence as the compound is useful to restore Hb and SF levels confirming as combination between FBC and AA adds a very safe profile in terms of gastrointestinal adverse events and taste, improving patient’s compliance.
Most of patients with GI has impaired iron absorption and develop ID/IDA. They often do not tolerate FS or other ironcompounds, leading to forms of refractory IDA resistant to treatment. Our review clearly show as FBC-A may be effective in CD [32, 33] and IBD [39] that represent frequent causes of refractory IDA. Then this new oral iron formulation appears promising in terms of safety and efficacy for these patients and might be suggested as first-line treatment. So far there are not studies regarding the use of FBC-A in other rare forms of impaired iron aborption as those found in gastrectomized patients or in patients with achloridria. Parenteral iron treatment is often recommended in these conditions. We believe that FBC-A might play a role in their management. However future studies are advisable.
Our previous study clearly showed that FBC is well absorbed in pediatric patients with CD [31]. Two other studies from our group reported in this review confirmed the good absorption and tolerability also for FBC-A in celiac patients with overt CD and during the first months of GFD [32, 33]. In our opinion these results support the possibility that this preparation might be considered the treatment of choice for celiac patients with ID/IDA. Despite these clinical results the mechanism underlying the good absorption of FBC-A in CD remains unclear. Many studies have shown that aminoacid-chelated iron is better absorbed and better tolerated than FS and other types of inorganic iron [9, 10, 11, 12]. In particular it has been demonstrated that low dosage of FBCis equal or better than standard dosage of FS in adults, in infants and in children [43, 44, 45]. The intestinal absorption of non-heme iron is mediated by DMT1 that is less expressed in CD as a consequence of the mucosa’s lesions. This situation may explain why non-heme iron is less absorbed in this disease. Recent studies in pigs showed how FBC increases transcription of DMT1 and PepT1 genes, this latter coding for a heme-iron transporter. Therefore, the author suggested that FBC might be absorbed also as heme-iron, via the PepT1 [46]. Other studies revealed as FBC is absorbed intact by intestinal cells, highlighting the possibility that FBC absorption may occur also independently of the presence of DMT1 [47]. Moreover, latest findings of a slow and constant release of iron from FBC-A might explain the high bioavailability of iron, also in CD patients [25].
When to use IV versus oral iron administration in patients with IBD still represents an on-going topic of debate between clinicians [48]. According to the last ECCO consensus paper the usual treatment of IDA per os has relevant limitations in IBD patients, in factoral iron formulations use is restricted due to poor tolerability and patient compliance. The same consensus paper underlines as IV iron is more effective, shows a faster response, and is better tolerated than oral iron [37]. However although new IV iron formulations have proved to be bettertolerated and lead to a faster Hb rise than oral iron, there is still hesitancy among gastroenterologists to promote this administration due to its risk of hypersensitivity reactions [38]. The results obtained by Vernero et al. on IBD patients highlight as FBC-A is effective and well tolerated in subjects with intestinal mucosa lesions who generally are poor responders to oral iron treatment and have reduced compliance. If these data will be confirmed on larger cohorts, FBC-A might be considered a good candidate for the first-line treatment in patients with IBD and ID/IDA, avoiding IV approach. It would be interesting to compare FBC-A treatment versus IV formulations in large comparative trials.
Milman et al. showed as FBC 25 mg iron is as effective as FS 50 mg iron in the prophylaxis of ID/IDA during pregnancy in a randomized trial [43]. The paper of Bertini et al. confirmed the benefit of FBC-A 30 mg/die in pregnancy. Considering the good absorption and the low side effects, FBC-A might be an useful alternative to FS in pregnant women who often display poor compliance to oral iron preparations.
Oral iron is often poorly tolerated in patients with iron deficiency secondary to infection, inflammation, renal and malignant diseases, or in elderly, particularly because of abdominal discomfort and poor absorption [1, 2, 3, 4, 49, 50]. Considering the results obtained witha low FBC-A dose, it might be beneficial in these clinical scenarios.
Our review has some limitations, mainly related to the limited number of patients enrolled in each clinical trial and the heterogeneity of these patients. Finally no studies comparing the clinical or cost effectiveness of FCB-A to FS are available.
The major challenges in the management of ID/IDA are related to the tolerability and side effects of oral iron therapy. Therefore, it is crucial to tailor the most appropriate form, dosage and duration of treatment for each patient, in order to successfully replenish iron stores.
The data presented in this short review underline the efficacy and safety of the treatment with FBC-A, and support the use of this compound in patients with ID/IDA. This review provides also preliminary evidence to suggest FBC-A as first-line treatment of ID/IDA in patients with CD. For patients with IBD further clinical trials are warranted comparing FBC-A to IV iron replacement. Finally, as it is widely assumed that poor absorption and side effects limit iron treatment compliance in several other clinical conditions as during pregnancy and in elderly, this new iron formulation seems very promisingfor the treatment of ID/IDA in these settings.
Valentina Talarico, Laura Giancotti, Mazza Giuseppe Antonio, Roberto Miniero declare no conflict of interest. Marco Bertini is R&D in the Pharmaceutical Company Laboratori Baldacci SpA.
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Currently, she is working as a Data Scientist with an MNC in Delhi, India.",institutionString:"NSHM College of Management and Technology",institution:null},{id:"226240",title:"Dr.",name:"Andri Irfan",middleName:null,surname:"Rifai",slug:"andri-irfan-rifai",fullName:"Andri Irfan Rifai",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226240/images/7412_n.jpg",biography:"Andri IRFAN is a Senior Lecturer of Civil Engineering and Planning. He completed the PhD at the Universitas Indonesia & Universidade do Minho with Sandwich Program Scholarship from the Directorate General of Higher Education and LPDP scholarship. He has been teaching for more than 19 years and much active to applied his knowledge in the project construction in Indonesia. His research interest ranges from pavement management system to advanced data mining techniques for transportation engineering. He has published more than 50 papers in journals and 2 books.",institutionString:null,institution:{name:"Universitas Internasional Batam",country:{name:"Indonesia"}}},{id:"314576",title:"Dr.",name:"Ibai",middleName:null,surname:"Laña",slug:"ibai-lana",fullName:"Ibai Laña",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314576/images/system/314576.jpg",biography:"Dr. Ibai Laña works at TECNALIA as a data analyst. He received his Ph.D. in Artificial Intelligence from the University of the Basque Country (UPV/EHU), Spain, in 2018. He is currently a senior researcher at TECNALIA. His research interests fall within the intersection of intelligent transportation systems, machine learning, traffic data analysis, and data science. He has dealt with urban traffic forecasting problems, applying machine learning models and evolutionary algorithms. He has experience in origin-destination matrix estimation or point of interest and trajectory detection. Working with large volumes of data has given him a good command of big data processing tools and NoSQL databases. He has also been a visiting scholar at the Knowledge Engineering and Discovery Research Institute, Auckland University of Technology.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"314575",title:"Dr.",name:"Jesus",middleName:null,surname:"L. Lobo",slug:"jesus-l.-lobo",fullName:"Jesus L. Lobo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314575/images/system/314575.png",biography:"Dr. Jesús López is currently based in Bilbao (Spain) working at TECNALIA as Artificial Intelligence Research Scientist. In most cases, a project idea or a new research line needs to be investigated to see if it is good enough to take into production or to focus on it. That is exactly what he does, diving into Machine Learning algorithms and technologies to help TECNALIA to decide whether something is great in theory or will actually impact on the product or processes of its projects. So, he is expert at framing experiments, developing hypotheses, and proving whether they’re true or not, in order to investigate fundamental problems with a longer time horizon. He is also able to design and develop PoCs and system prototypes in simulation. He has participated in several national and internacional R&D projects.\n\nAs another relevant part of his everyday research work, he usually publishes his findings in reputed scientific refereed journals and international conferences, occasionally acting as reviewer and Programme Commitee member. Concretely, since 2018 he has published 9 JCR (8 Q1) journal papers, 9 conference papers (e.g. ECML PKDD 2021), and he has co-edited a book. He is also active in popular science writing data science stories for reputed blogs (KDNuggets, TowardsDataScience, Naukas). Besides, he has recently embarked on mentoring programmes as mentor, and has also worked as data science trainer.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"103779",title:"Prof.",name:"Yalcin",middleName:null,surname:"Isler",slug:"yalcin-isler",fullName:"Yalcin Isler",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRyQ8QAK/Profile_Picture_1628834958734",biography:"Yalcin Isler (1971 - Burdur / Turkey) received the B.Sc. degree in the Department of Electrical and Electronics Engineering from Anadolu University, Eskisehir, Turkey, in 1993, the M.Sc. degree from the Department of Electronics and Communication Engineering, Suleyman Demirel University, Isparta, Turkey, in 1996, the Ph.D. degree from the Department of Electrical and Electronics Engineering, Dokuz Eylul University, Izmir, Turkey, in 2009, and the Competence of Associate Professorship from the Turkish Interuniversity Council in 2019.\n\nHe was Lecturer at Burdur Vocational School in Suleyman Demirel University (1993-2000, Burdur / Turkey), Software Engineer (2000-2002, Izmir / Turkey), Research Assistant in Bulent Ecevit University (2002-2003, Zonguldak / Turkey), Research Assistant in Dokuz Eylul University (2003-2010, Izmir / Turkey), Assistant Professor at the Department of Electrical and Electronics Engineering in Bulent Ecevit University (2010-2012, Zonguldak / Turkey), Assistant Professor at the Department of Biomedical Engineering in Izmir Katip Celebi University (2012-2019, Izmir / Turkey). He is an Associate Professor at the Department of Biomedical Engineering at Izmir Katip Celebi University, Izmir / Turkey, since 2019. In addition to academics, he has also founded Islerya Medical and Information Technologies Company, Izmir / Turkey, since 2017.\n\nHis main research interests cover biomedical signal processing, pattern recognition, medical device design, programming, and embedded systems. He has many scientific papers and participated in several projects in these study fields. He was an IEEE Student Member (2009-2011) and IEEE Member (2011-2014) and has been IEEE Senior Member since 2014.",institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",country:{name:"Turkey"}}},{id:"339677",title:"Dr.",name:"Mrinmoy",middleName:null,surname:"Roy",slug:"mrinmoy-roy",fullName:"Mrinmoy Roy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/339677/images/16768_n.jpg",biography:"An accomplished Sales & Marketing professional with 12 years of cross-functional experience in well-known organisations such as CIPLA, LUPIN, GLENMARK, ASTRAZENECA across different segment of Sales & Marketing, International Business, Institutional Business, Product Management, Strategic Marketing of HIV, Oncology, Derma, Respiratory, Anti-Diabetic, Nutraceutical & Stomatological Product Portfolio and Generic as well as Chronic Critical Care Portfolio. A First Class MBA in International Business & Strategic Marketing, B.Pharm, D.Pharm, Google Certified Digital Marketing Professional. Qualified PhD Candidate in Operations and Management with special focus on Artificial Intelligence and Machine Learning adoption, analysis and use in Healthcare, Hospital & Pharma Domain. Seasoned with diverse therapy area of Pharmaceutical Sales & Marketing ranging from generating revenue through generating prescriptions, launching new products, and making them big brands with continuous strategy execution at the Physician and Patients level. Moved from Sales to Marketing and Business Development for 3.5 years in South East Asian Market operating from Manila, Philippines. Came back to India and handled and developed Brands such as Gluconorm, Lupisulin, Supracal, Absolut Woman, Hemozink, Fabiflu (For COVID 19), and many more. In my previous assignment I used to develop and execute strategies on Sales & Marketing, Commercialization & Business Development for Institution and Corporate Hospital Business portfolio of Oncology Therapy Area for AstraZeneca Pharma India Ltd. Being a Research Scholar and Student of ‘Operations Research & Management: Artificial Intelligence’ I published several pioneer research papers and book chapters on the same in Internationally reputed journals and Books indexed in Scopus, Springer and Ei Compendex, Google Scholar etc. Currently, I am launching PGDM Pharmaceutical Management Program in IIHMR Bangalore and spearheading the course curriculum and structure of the same. I am interested in Collaboration for Healthcare Innovation, Pharma AI Innovation, Future trend in Marketing and Management with incubation on Healthcare, Healthcare IT startups, AI-ML Modelling and Healthcare Algorithm based training module development. I am also an affiliated member of the Institute of Management Consultant of India, looking forward to Healthcare, Healthcare IT and Innovation, Pharma and Hospital Management Consulting works.",institutionString:null,institution:{name:"Lovely Professional University",country:{name:"India"}}},{id:"310576",title:"Prof.",name:"Erick Giovani",middleName:null,surname:"Sperandio Nascimento",slug:"erick-giovani-sperandio-nascimento",fullName:"Erick Giovani Sperandio Nascimento",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y00002pDKxDQAW/ProfilePicture%202022-06-20%2019%3A57%3A24.788",biography:"Prof. Erick Sperandio is the Lead Researcher and professor of Artificial Intelligence (AI) at SENAI CIMATEC, Bahia, Brazil, also working with Computational Modeling (CM) and HPC. He holds a PhD in Environmental Engineering in the area of Atmospheric Computational Modeling, a Master in Informatics in the field of Computational Intelligence and Graduated in Computer Science from UFES. He currently coordinates, leads and participates in R&D projects in the areas of AI, computational modeling and supercomputing applied to different areas such as Oil and Gas, Health, Advanced Manufacturing, Renewable Energies and Atmospheric Sciences, advising undergraduate, master's and doctoral students. He is the Lead Researcher at SENAI CIMATEC's Reference Center on Artificial Intelligence. In addition, he is a Certified Instructor and University Ambassador of the NVIDIA Deep Learning Institute (DLI) in the areas of Deep Learning, Computer Vision, Natural Language Processing and Recommender Systems, and Principal Investigator of the NVIDIA/CIMATEC AI Joint Lab, the first in Latin America within the NVIDIA AI Technology Center (NVAITC) worldwide program. He also works as a researcher at the Supercomputing Center for Industrial Innovation (CS2i) and at the SENAI Institute of Innovation for Automation (ISI Automação), both from SENAI CIMATEC. He is a member and vice-coordinator of the Basic Board of Scientific-Technological Advice and Evaluation, in the area of Innovation, of the Foundation for Research Support of the State of Bahia (FAPESB). He serves as Technology Transfer Coordinator and one of the Principal Investigators at the National Applied Research Center in Artificial Intelligence (CPA-IA) of SENAI CIMATEC, focusing on Industry, being one of the six CPA-IA in Brazil approved by MCTI / FAPESP / CGI.br. He also participates as one of the representatives of Brazil in the BRICS Innovation Collaboration Working Group on HPC, ICT and AI. He is the coordinator of the Work Group of the Axis 5 - Workforce and Training - of the Brazilian Strategy for Artificial Intelligence (EBIA), and member of the MCTI/EMBRAPII AI Innovation Network Training Committee. He is the coordinator, by SENAI CIMATEC, of the Artificial Intelligence Reference Network of the State of Bahia (REDE BAH.IA). He leads the working group of experts representing Brazil in the Global Partnership on Artificial Intelligence (GPAI), on the theme \"AI and the Pandemic Response\".",institutionString:"Manufacturing and Technology Integrated Campus – SENAI CIMATEC",institution:null},{id:"1063",title:"Prof.",name:"Constantin",middleName:null,surname:"Volosencu",slug:"constantin-volosencu",fullName:"Constantin Volosencu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1063/images/system/1063.png",biography:"Prof. Dr. Constantin Voloşencu graduated as an engineer from\nPolitehnica University of Timișoara, Romania, where he also\nobtained a doctorate degree. He is currently a full professor in\nthe Department of Automation and Applied Informatics at the\nsame university. Dr. Voloşencu is the author of ten books, seven\nbook chapters, and more than 160 papers published in journals\nand conference proceedings. He has also edited twelve books and\nhas twenty-seven patents to his name. He is a manager of research grants, editor in\nchief and member of international journal editorial boards, a former plenary speaker, a member of scientific committees, and chair at international conferences. His\nresearch is in the fields of control systems, control of electric drives, fuzzy control\nsystems, neural network applications, fault detection and diagnosis, sensor network\napplications, monitoring of distributed parameter systems, and power ultrasound\napplications. He has developed automation equipment for machine tools, spooling\nmachines, high-power ultrasound processes, and more.",institutionString:"Polytechnic University of Timişoara",institution:{name:"Polytechnic University of Timişoara",country:{name:"Romania"}}},{id:"221364",title:"Dr.",name:"Eneko",middleName:null,surname:"Osaba",slug:"eneko-osaba",fullName:"Eneko Osaba",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/221364/images/system/221364.jpg",biography:"Dr. Eneko Osaba works at TECNALIA as a senior researcher. He obtained his Ph.D. in Artificial Intelligence in 2015. He has participated in more than twenty-five local and European research projects, and in the publication of more than 130 papers. He has performed several stays at universities in the United Kingdom, Italy, and Malta. Dr. Osaba has served as a program committee member in more than forty international conferences and participated in organizing activities in more than ten international conferences. He is a member of the editorial board of the International Journal of Artificial Intelligence, Data in Brief, and Journal of Advanced Transportation. He is also a guest editor for the Journal of Computational Science, Neurocomputing, Swarm, and Evolutionary Computation and IEEE ITS Magazine.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"275829",title:"Dr.",name:"Esther",middleName:null,surname:"Villar-Rodriguez",slug:"esther-villar-rodriguez",fullName:"Esther Villar-Rodriguez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/275829/images/system/275829.jpg",biography:"Dr. Esther Villar obtained a Ph.D. in Information and Communication Technologies from the University of Alcalá, Spain, in 2015. She obtained a degree in Computer Science from the University of Deusto, Spain, in 2010, and an MSc in Computer Languages and Systems from the National University of Distance Education, Spain, in 2012. Her areas of interest and knowledge include natural language processing (NLP), detection of impersonation in social networks, semantic web, and machine learning. Dr. Esther Villar made several contributions at conferences and publishing in various journals in those fields. Currently, she is working within the OPTIMA (Optimization Modeling & Analytics) business of TECNALIA’s ICT Division as a data scientist in projects related to the prediction and optimization of management and industrial processes (resource planning, energy efficiency, etc).",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49813/images/system/49813.png",biography:"Prof. Dr. Javier Del Ser received his first PhD in Telecommunication Engineering (Cum Laude) from the University of Navarra, Spain, in 2006, and a second PhD in Computational Intelligence (Summa Cum Laude) from the University of Alcala, Spain, in 2013. He is currently a principal researcher in data analytics and optimisation at TECNALIA (Spain), a visiting fellow at the Basque Center for Applied Mathematics (BCAM) and a part-time lecturer at the University of the Basque Country (UPV/EHU). His research interests gravitate on the use of descriptive, prescriptive and predictive algorithms for data mining and optimization in a diverse range of application fields such as Energy, Transport, Telecommunications, Health and Industry, among others. In these fields he has published more than 240 articles, co-supervised 8 Ph.D. theses, edited 6 books, coauthored 7 patents and participated/led more than 40 research projects. He is a Senior Member of the IEEE, and a recipient of the Biscay Talent prize for his academic career.",institutionString:"Tecnalia Research & Innovation",institution:null},{id:"278948",title:"Dr.",name:"Carlos Pedro",middleName:null,surname:"Gonçalves",slug:"carlos-pedro-goncalves",fullName:"Carlos Pedro Gonçalves",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRcmyQAC/Profile_Picture_1564224512145",biography:'Carlos Pedro Gonçalves (PhD) is an Associate Professor at Lusophone University of Humanities and Technologies and a researcher on Complexity Sciences, Quantum Technologies, Artificial Intelligence, Strategic Studies, Studies in Intelligence and Security, FinTech and Financial Risk Modeling. He is also a progammer with programming experience in:\n\nA) Quantum Computing using Qiskit Python module and IBM Quantum Experience Platform, with software developed on the simulation of Quantum Artificial Neural Networks and Quantum Cybersecurity;\n\nB) Artificial Intelligence and Machine learning programming in Python;\n\nC) Artificial Intelligence, Multiagent Systems Modeling and System Dynamics Modeling in Netlogo, with models developed in the areas of Chaos Theory, Econophysics, Artificial Intelligence, Classical and Quantum Complex Systems Science, with the Econophysics models having been cited worldwide and incorporated in PhD programs by different Universities.\n\nReceived an Arctic Code Vault Contributor status by GitHub, due to having developed open source software preserved in the \\"Arctic Code Vault\\" for future generations (https://archiveprogram.github.com/arctic-vault/), with the Strategy Analyzer A.I. module for decision making support (based on his PhD thesis, used in his Classes on Decision Making and in Strategic Intelligence Consulting Activities) and QNeural Python Quantum Neural Network simulator also preserved in the \\"Arctic Code Vault\\", for access to these software modules see: https://github.com/cpgoncalves. He is also a peer reviewer with outsanding review status from Elsevier journals, including Physica A, Neurocomputing and Engineering Applications of Artificial Intelligence. Science CV available at: https://www.cienciavitae.pt//pt/8E1C-A8B3-78C5 and ORCID: https://orcid.org/0000-0002-0298-3974',institutionString:"University of Lisbon",institution:{name:"Universidade Lusófona",country:{name:"Portugal"}}},{id:"241400",title:"Prof.",name:"Mohammed",middleName:null,surname:"Bsiss",slug:"mohammed-bsiss",fullName:"Mohammed Bsiss",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241400/images/8062_n.jpg",biography:null,institutionString:null,institution:null},{id:"276128",title:"Dr.",name:"Hira",middleName:null,surname:"Fatima",slug:"hira-fatima",fullName:"Hira Fatima",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/276128/images/14420_n.jpg",biography:"Dr. Hira Fatima\nAssistant Professor\nDepartment of Mathematics\nInstitute of Applied Science\nMangalayatan University, Aligarh\nMobile: no : 8532041179\nhirafatima2014@gmal.com\n\nDr. Hira Fatima has received his Ph.D. degree in pure Mathematics from Aligarh Muslim University, Aligarh India. Currently working as an Assistant Professor in the Department of Mathematics, Institute of Applied Science, Mangalayatan University, Aligarh. She taught so many courses of Mathematics of UG and PG level. Her research Area of Expertise is Functional Analysis & Sequence Spaces. She has been working on Ideal Convergence of double sequence. She has published 17 research papers in National and International Journals including Cogent Mathematics, Filomat, Journal of Intelligent and Fuzzy Systems, Advances in Difference Equations, Journal of Mathematical Analysis, Journal of Mathematical & Computer Science etc. She has also reviewed few research papers for the and international journals. She is a member of Indian Mathematical Society.",institutionString:null,institution:null},{id:"414880",title:"Dr.",name:"Maryam",middleName:null,surname:"Vatankhah",slug:"maryam-vatankhah",fullName:"Maryam Vatankhah",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Borough of Manhattan Community College",country:{name:"United States of America"}}},{id:"414879",title:"Prof.",name:"Mohammad-Reza",middleName:null,surname:"Akbarzadeh-Totonchi",slug:"mohammad-reza-akbarzadeh-totonchi",fullName:"Mohammad-Reza Akbarzadeh-Totonchi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Ferdowsi University of Mashhad",country:{name:"Iran"}}},{id:"414878",title:"Prof.",name:"Reza",middleName:null,surname:"Fazel-Rezai",slug:"reza-fazel-rezai",fullName:"Reza Fazel-Rezai",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"American Public University System",country:{name:"United States of America"}}},{id:"302698",title:"Dr.",name:"Yao",middleName:null,surname:"Shan",slug:"yao-shan",fullName:"Yao Shan",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Dalian University of Technology",country:{name:"China"}}},{id:"125911",title:"Prof.",name:"Jia-Ching",middleName:null,surname:"Wang",slug:"jia-ching-wang",fullName:"Jia-Ching Wang",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"National Central University",country:{name:"Taiwan"}}},{id:"357085",title:"Mr.",name:"P. Mohan",middleName:null,surname:"Anand",slug:"p.-mohan-anand",fullName:"P. Mohan Anand",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Indian Institute of Technology Kanpur",country:{name:"India"}}},{id:"356696",title:"Ph.D. Student",name:"P.V.",middleName:null,surname:"Sai Charan",slug:"p.v.-sai-charan",fullName:"P.V. Sai Charan",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Indian Institute of Technology Kanpur",country:{name:"India"}}},{id:"357086",title:"Prof.",name:"Sandeep K.",middleName:null,surname:"Shukla",slug:"sandeep-k.-shukla",fullName:"Sandeep K. Shukla",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Indian Institute of Technology Kanpur",country:{name:"India"}}},{id:"356823",title:"MSc.",name:"Seonghee",middleName:null,surname:"Min",slug:"seonghee-min",fullName:"Seonghee Min",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Daegu University",country:{name:"Korea, South"}}},{id:"353307",title:"Prof.",name:"Yoosoo",middleName:null,surname:"Oh",slug:"yoosoo-oh",fullName:"Yoosoo Oh",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:"Yoosoo Oh received his Bachelor's degree in the Department of Electronics and Engineering from Kyungpook National University in 2002. He obtained his Master’s degree in the Department of Information and Communications from Gwangju Institute of Science and Technology (GIST) in 2003. In 2010, he received his Ph.D. degree in the School of Information and Mechatronics from GIST. In the meantime, he was an executed team leader at Culture Technology Institute, GIST, 2010-2012. In 2011, he worked at Lancaster University, the UK as a visiting scholar. In September 2012, he joined Daegu University, where he is currently an associate professor in the School of ICT Conver, Daegu University. Also, he served as the Board of Directors of KSIIS since 2019, and HCI Korea since 2016. From 2017~2019, he worked as a center director of the Mixed Reality Convergence Research Center at Daegu University. From 2015-2017, He worked as a director in the Enterprise Supporting Office of LINC Project Group, Daegu University. His research interests include Activity Fusion & Reasoning, Machine Learning, Context-aware Middleware, Human-Computer Interaction, etc.",institutionString:null,institution:{name:"Daegu Gyeongbuk Institute of Science and Technology",country:{name:"Korea, South"}}},{id:"262719",title:"Dr.",name:"Esma",middleName:null,surname:"Ergüner Özkoç",slug:"esma-erguner-ozkoc",fullName:"Esma Ergüner Özkoç",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Başkent University",country:{name:"Turkey"}}},{id:"346530",title:"Dr.",name:"Ibrahim",middleName:null,surname:"Kaya",slug:"ibrahim-kaya",fullName:"Ibrahim Kaya",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",country:{name:"Turkey"}}},{id:"419199",title:"Dr.",name:"Qun",middleName:null,surname:"Yang",slug:"qun-yang",fullName:"Qun Yang",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Auckland",country:{name:"New Zealand"}}}]}},subseries:{item:{id:"6",type:"subseries",title:"Viral Infectious Diseases",keywords:"Novel Viruses, Virus Transmission, Virus Evolution, Molecular Virology, Control and Prevention, Virus-host Interaction",scope:"The Viral Infectious Diseases Book Series aims to provide a comprehensive overview of recent research trends and discoveries in various viral infectious diseases emerging around the globe. The emergence of any viral disease is hard to anticipate, which often contributes to death. A viral disease can be defined as an infectious disease that has recently appeared within a population or exists in nature with the rapid expansion of incident or geographic range. This series will focus on various crucial factors related to emerging viral infectious diseases, including epidemiology, pathogenesis, host immune response, clinical manifestations, diagnosis, treatment, and clinical recommendations for managing viral infectious diseases, highlighting the recent issues with future directions for effective therapeutic strategies.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/6.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11402,editor:{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. 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Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. 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