Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
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We wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
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Throughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\n
We wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
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As breast cancer imposes a heavy burden for society due to its psychological, social and economic consequences, every step to broaden our understanding is a worthy task. The aim of this book is to provide some insights on this subject through the information given on new perspectives in genetics and diagnosis, exposed in the section on oncologic issues, as well as on recent topics on surgical treatment, presented in the sections on breast conservative and breast reconstructive surgery.",isbn:"978-1-78984-551-8",printIsbn:"978-1-78984-550-1",pdfIsbn:"978-1-83880-520-3",doi:"10.5772/intechopen.81453",price:119,priceEur:129,priceUsd:155,slug:"breast-cancer-and-breast-reconstruction",numberOfPages:184,isOpenForSubmission:!1,isInWos:1,isInBkci:!1,hash:"5947d4ba7ac1e9c39c9083e89201275c",bookSignature:"Luis Tejedor, Susana Gómez Modet, Lachezar Manchev and Arli Aditya Parikesit",publishedDate:"May 6th 2020",coverURL:"https://cdn.intechopen.com/books/images_new/8853.jpg",numberOfDownloads:7375,numberOfWosCitations:3,numberOfCrossrefCitations:2,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:3,numberOfDimensionsCitationsByBook:0,hasAltmetrics:1,numberOfTotalCitations:8,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"October 30th 2018",dateEndSecondStepPublish:"December 12th 2018",dateEndThirdStepPublish:"February 10th 2019",dateEndFourthStepPublish:"May 1st 2019",dateEndFifthStepPublish:"June 30th 2019",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"81170",title:"Dr.",name:"Luis",middleName:null,surname:"Tejedor",slug:"luis-tejedor",fullName:"Luis Tejedor",profilePictureURL:"https://mts.intechopen.com/storage/users/81170/images/system/81170.jpg",biography:"Luis Tejedor MD, FACS, EBS-SO, attended the University of Seville Medical School, Spain, where he graduated in 1981. He completed his training in General Surgery in the same city in 1987. Since them he has been working as a full time general surgeon mainly in his areas of interest: Breast Surgery, Hepato-Pancreato-Biliary Surgery and Advanced Laparoscopic Surgery.\nAmong others academic titles he holds an European Board of Surgery Qualification in Surgical Oncology, an Expert Course in Oncoplastic and Reconstructive Surgery of the Breast and a Master in Breast Diseases and Senology.\nAt present, he is the Chairman of the Committee of Breast Cancer and the Vice-chairman of the Committee of Tumors in Hospital Punta de Europa, Algeciras, Spain.",institutionString:"Cadiz University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"University of Cádiz",institutionURL:null,country:{name:"Spain"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:{id:"276547",title:"Dr.",name:"Susana",middleName:null,surname:"Gomez-Modet",slug:"susana-gomez-modet",fullName:"Susana Gomez-Modet",profilePictureURL:"https://mts.intechopen.com/storage/users/276547/images/system/276547.jpg",biography:"Susana Gómez Modet is a medical doctor who graduated from the University of Cádiz Medicine School, Spain, in 2000. She was trained as a General Surgeon in Málaga, Virgen de la Victoria Hospital from 2002 to 2007.\nSince then she has worked as a general surgeon, mainly in the Oncology Breast Surgery at Punta Europa Hospital, Algeciras, Cádiz, Spain.\nShe completed her training in Senology with other academic titles: a Masters in Breast Diseases and Senology from the Barcelona University and an Expert Course in Oncoplastic and Reconstructive Surgery of the Breast. \nShe is currently part of the Breast Unit and of the Committee of Breast Cancer in Punta Europa Hospital.",institutionString:"Cadiz University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"0",institution:null},coeditorTwo:{id:"252432",title:"Associate Prof.",name:"Lachezar",middleName:null,surname:"Manchev",slug:"lachezar-manchev",fullName:"Lachezar Manchev",profilePictureURL:"https://mts.intechopen.com/storage/users/252432/images/system/252432.jpeg",biography:"Associate Professor Lachezar Ivanov Manchev (MD, PhD) graduated in medicine from the Medical Faculty, Trakia University, Stara Zagora in 2010. Since 2010, he has worked as a radiologist in the Department of Diagnostic Imaging at the University Hospital, Stara Zagora. Between 2013 and 2018, he was assistant professor in the Department of Radiology in the Medical Faculty, Trakia Universtity, Stara Zagora. Since 2018, he has been an associate professor in Radiology at the same university. In his practice, he presents lectures and tutorials in Bulgarian to medical, nursing, midwifery and rehabilitation students, in subject areas including X-ray, CT, MRI, angiography, mammography, ultrasound and DSG. Dr Manchev also delivers lectures and tutorials in English to medical students from the United Kingdom and the Republic of Ireland. Since 2016, he works as a part-time lecturer for the Faculty of Public Health and Health Care, University Professor Doctor Asen Zlatarov, Burgas, Bulgaria.",institutionString:"Trakia University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"Trakia University",institutionURL:null,country:{name:"Bulgaria"}}},coeditorThree:{id:"72288",title:"Dr.",name:"Arli Aditya",middleName:null,surname:"Parikesit",slug:"arli-aditya-parikesit",fullName:"Arli Aditya Parikesit",profilePictureURL:"https://mts.intechopen.com/storage/users/72288/images/system/72288.jpg",biography:"Dr. rer. nat. Arli Aditya Parikesit is the Vice Rector of Research and Innovation at Indonesia International Institute for Life Sciences (I3L). He finished both his bachelor’s and master’s degrees in chemistry at the Faculty of Mathematics and Natural Sciences, University of Indonesia. In order to pursue a degree in Bioinformatics, he accepted an offer from DAAD (German Academic Exchange Service) to conduct doctorate research at the Bioinformatics Group, Faculty of Informatics and Mathematics, University of Leipzig, Germany. His doctoral research is focused on the utilization of modern protein domain annotation techniques to the three domains of life. In addition, Dr. Arli is also an expert on immunoinformatics, bioinformatics algorithm, structural bioinformatics, in silico drug design, and in silico transcriptomics. Currently, Dr. Arli is devising a pipeline to apply his expertise to COVID-19 drug and vaccine designs.",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"2",institution:{name:"Indonesia International Institute for Life Sciences",institutionURL:null,country:{name:"Indonesia"}}},coeditorFour:null,coeditorFive:null,topics:[{id:"1152",title:"Reconstructive Surgery",slug:"reconstructive-surgery"}],chapters:[{id:"69046",title:"Electrical Impedance Mammography: Screening and Basic Principles",doi:"10.5772/intechopen.89140",slug:"electrical-impedance-mammography-screening-and-basic-principles",totalDownloads:640,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:1,abstract:"Nowadays, screening uses the method of X-ray mammography for the early diagnosis of breast cancer. However, as a screening method, X-ray mammography has its limitations, such as age, periodicity of screening, ‘dense’ mammary gland and dynamic survey (repeated radiation). In order to overpass these limitations, more advanced alternative methods of breast examination should be used, which would be as effective as the ‘golden standard.’ Characteristics of electroimpedance diagnostics are given. The aim of screening is to detect breast cancer including early breast cancer (tumor size below 1 cm) and to form a survey of high-risk group. In order to reach these aims, the following actions need to be undertaken: search for areas with anomalous conductivity, detection of distorted mammographic scheme and evaluation of age-related electrical conductivity. The application of a scale for age-related breast conductivity with defined percentile limits allows to organize a survey group. Electrical properties of a cancerous tumor differ significantly from those of the surrounding tissues. Statistics of anomalous conductivity in cases of breast cancer is given. The disease development connected with the destruction of epithelial basement membrane is linked with various phenomena occurring in the tumor and the surrounding tissues. Statistics of disrupted mammographic scheme in cases of cancer is given.",signatures:"Alexander Karpov, Marina Korotkova, Gregory Shiferson and Elena Kotomina",downloadPdfUrl:"/chapter/pdf-download/69046",previewPdfUrl:"/chapter/pdf-preview/69046",authors:[{id:"201936",title:"Mr.",name:"Alexander",surname:"Karpov",slug:"alexander-karpov",fullName:"Alexander Karpov"},{id:"309920",title:"Dr.",name:"Marina",surname:"Korotkova",slug:"marina-korotkova",fullName:"Marina Korotkova"},{id:"309921",title:"Dr.",name:"Gregory",surname:"Shiferson",slug:"gregory-shiferson",fullName:"Gregory Shiferson"},{id:"309922",title:"Dr.",name:"Elena",surname:"Kotomina",slug:"elena-kotomina",fullName:"Elena Kotomina"}],corrections:null},{id:"69808",title:"Detection of Breast Cancer in Mammograms through a New Features Technique",doi:"10.5772/intechopen.89062",slug:"detection-of-breast-cancer-in-mammograms-through-a-new-features-technique",totalDownloads:522,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"This research proposes a new framework for detection of breast cancer in mammograms. It extracts certain dynamic features to distinguish between benign and malignant mammograms. To this aim, this framework uses set of various techniques. First step we have achieved improvement on breast mammogram to improve the image accuracy based on this framework, after new method has been used for features extraction. New methods named Sparse Principal Component Analysis and Weighted Sparse Principal Component Analysis are used to select the distinctive features of the mammograms. The analyzed mammograms are then identified as benign or malignant through codebook technique is more efficient than other on the MIAS data set. The proposed framework tested on MIAS data set achieved an overall classification accuracy of 98% with codebook classifier for sequential selection of benign and malignant mammograms. Suggested method achieves good results when we have verified on various mammograms.",signatures:"Anwar Yahy Ebrahim",downloadPdfUrl:"/chapter/pdf-download/69808",previewPdfUrl:"/chapter/pdf-preview/69808",authors:[{id:"308186",title:"Dr.",name:"Anwar",surname:"Ebrahim",slug:"anwar-ebrahim",fullName:"Anwar Ebrahim"}],corrections:null},{id:"70872",title:"Breast Cancer and BRCA1 and BRCA2 Pathogenic Variants",doi:"10.5772/intechopen.90926",slug:"breast-cancer-and-em-brca1-em-and-em-brca2-em-pathogenic-variants",totalDownloads:709,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Breast cancer remains the most common female cancer worldwide. The majority will arise spontaneously, with almost a third having a heritable component. Approximately 5–10% of all breast cancers will have a strong inherited element with pathogenic variants in the BRCA1 and BRCA2 amongst the most studied breast cancer genes. An overview of breast cancer is provided with references to the clinical and pathological features in BRCA1 and BRCA2 related cancers. The roles of PARP inhibitors and immunotherapy are discussed. The management of healthy individuals harbouring a pathogenic variant in the two genes is reviewed and future directions considered.",signatures:"Naren Basu and D. Gareth Evans",downloadPdfUrl:"/chapter/pdf-download/70872",previewPdfUrl:"/chapter/pdf-preview/70872",authors:[{id:"161327",title:"Mr.",name:"Naren",surname:"Basu",slug:"naren-basu",fullName:"Naren Basu"},{id:"314754",title:"Prof.",name:"D. Gareth",surname:"Evans",slug:"d.-gareth-evans",fullName:"D. Gareth Evans"}],corrections:null},{id:"70516",title:"Epidemiology and Genetic Susceptibility of Breast and Ovarian Cancer in Sardinian Population",doi:"10.5772/intechopen.90517",slug:"epidemiology-and-genetic-susceptibility-of-breast-and-ovarian-cancer-in-sardinian-population",totalDownloads:660,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The objective of this population-based study is to describe epidemiological and genetic features of breast and ovarian cancer in North Sardinia, Italy. Patients who carry a high-risk mutation in one or both of the BRCA genes (BRCA1 or BRCA2) have a significantly increased risk of developing breast/ovarian cancer (BOC) and other cancers (e.g., prostate cancer in male). Epidemiological data on incidence distribution of breast/ovarian cancer from 2016 to 2019 in North Sardinia are obtained from the local tumor registry and from the cumulative results of 209 genetic testing for BRCA gene mutations performed in all young breast cancer patients and all women (over 50 years) with family history of BOC (total of 164 cases); further, 45 genetic testing is performed, on ovarian cancer patients, at any age. The results provide a different distribution of fraction mutations carried by women and a higher prevalence of the BRCA2 mutation in the north of Sardinia than the entire population and highlight the presence of specific germline mutation associated with the “founder effect” in distinct genetic subgroups reflecting genetic drift. Advances in next-generation sequencing technology, data analysis, and clinical investigation have revolutionized efforts to identify potential targets for BRCA molecular-based therapeutic agents.",signatures:"Grazia Palomba, Giuseppe Palmieri, Antonio Cossu, Panagiotis Paliogiannis and Maria Cristina Sini",downloadPdfUrl:"/chapter/pdf-download/70516",previewPdfUrl:"/chapter/pdf-preview/70516",authors:[{id:"156674",title:"Dr.",name:"Giuseppe",surname:"Palmieri",slug:"giuseppe-palmieri",fullName:"Giuseppe Palmieri"},{id:"159145",title:"Dr.",name:"Antonio",surname:"Cossu",slug:"antonio-cossu",fullName:"Antonio Cossu"},{id:"196991",title:"Dr.",name:"Panagiotis",surname:"Paliogiannis",slug:"panagiotis-paliogiannis",fullName:"Panagiotis Paliogiannis"},{id:"311798",title:"Dr.",name:"Grazia",surname:"Palomba",slug:"grazia-palomba",fullName:"Grazia Palomba"},{id:"311993",title:"Dr.",name:"Maria Cristina",surname:"Sini",slug:"maria-cristina-sini",fullName:"Maria Cristina Sini"}],corrections:null},{id:"67658",title:"Genetic Mutation Carriers: Special Considerations for Their Influence on a Modern Breast Reconstruction Practice",doi:"10.5772/intechopen.86795",slug:"genetic-mutation-carriers-special-considerations-for-their-influence-on-a-modern-breast-reconstructi",totalDownloads:555,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"With medical advancement, increasing numbers of genetic variations and mutations are being uncovered that offer greater insight into which patients have a predisposition for the development of breast cancer. Reasonable management for these patients includes high-risk surveillance, medical prophylaxis, or bilateral prophylactic mastectomy with immediate reconstruction which is becoming increasingly popular. However, this cohort of patients differs from the average breast cancer patient in that they are typically younger and may have distinct reconstructive objectives for their outcomes. This chapter considers this unique and expanding population, as well as their expectations for surgical outcomes both aesthetically and oncologically. We will discuss the evolving role of social media in this population, with patient to patient virtual information sharing and how this may impact patient referrals in a manner diverging from traditional hospital-based patterns. Furthermore, we discuss how practices in which cutting-edge and novel surgical treatments are available, such as pre-pectoral and single stage reconstruction, and that incorporate team collaboration with the surgical oncologist to deliver aesthetically pleasing results with nipple sparing mastectomy and concealed scars may ultimately be attractive to genetic mutation carriers concerned not only with risk reduction but also post-operative aesthetics.",signatures:"Ashley A. Woodfin and Anuja K. Antony",downloadPdfUrl:"/chapter/pdf-download/67658",previewPdfUrl:"/chapter/pdf-preview/67658",authors:[{id:"290913",title:"M.D.",name:"Anuja",surname:"Antony",slug:"anuja-antony",fullName:"Anuja Antony"},{id:"292784",title:"Dr.",name:"Ashley",surname:"Woodfin",slug:"ashley-woodfin",fullName:"Ashley Woodfin"}],corrections:null},{id:"67059",title:"Oncoplastic Surgery in Breast Cancer",doi:"10.5772/intechopen.86198",slug:"oncoplastic-surgery-in-breast-cancer",totalDownloads:1049,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:1,abstract:"Oncoplastic surgery is an emerging approach which combines breast-conserving surgery and plastic surgery techniques. It aims to provide wider volume resection with oncologically clear margins and at the same time to maintain the breast shape and optimize cosmetic outcomes. Inspired from esthetic breast surgery techniques, oncoplasty consists of breast volume displacement to fill the defect of large resections and optimize the cosmetic outcomes without interfering with the oncoplastic safety. In this chapter, the concept, indications, and principles of oncoplastic techniques used in conservative breast surgeries will be exposed. A photo-based atlas for oncoplastic incisions will concern seven cases starting with the preoperative planning and marking and ending up with the long-term postoperative outcomes.",signatures:"Atallah David, Moubarak Malak and Abdallah Abdallah",downloadPdfUrl:"/chapter/pdf-download/67059",previewPdfUrl:"/chapter/pdf-preview/67059",authors:[{id:"219535",title:"Associate Prof.",name:"David",surname:"Atallah",slug:"david-atallah",fullName:"David Atallah"},{id:"221488",title:"Dr.",name:"Malak",surname:"Moubarak",slug:"malak-moubarak",fullName:"Malak Moubarak"},{id:"299454",title:"Dr.",name:"Abdallah",surname:"Abdallah",slug:"abdallah-abdallah",fullName:"Abdallah Abdallah"}],corrections:null},{id:"66658",title:"Breast Reconstruction with TRAM Flap",doi:"10.5772/intechopen.85443",slug:"breast-reconstruction-with-tram-flap",totalDownloads:758,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Traditional breast conservative therapy (BCT) is lumpectomy, sentinel lymph node biopsy and possible axillary dissection, and radiation therapy. BCT is, as known and considered all over the world, is oncologically equivalent to mastectomy with regard to overall long-term survival rates. BCT is the recommended treatment of choice for women with early stages breast cancer. The main philosophy of BCT is optimizing cosmetic goals and minimizing the psychological morbidity of a mastectomy while ensuring low rates of local recurrence. Achieving an oncologically safe resection is maintained by tumor margin clearance. Ensuring an oncologic clearance with increasing tumor size requires extensive breast parenchyma resection. And this results in large volume resection and this requires volume replacement techniques. Depending on the amount of breast volume resected, an autologous tissue transfer may be required to achieve requirement of breast restoration. Latissimus dorsi flap and TRAM flap are two autologous tissues mostly used to fulfill this restoration. This chapter focuses on the TRAM flap, one of the most commonly used autologous tissue in volume replacement reconstruction of the mastectomy defect.",signatures:"Ercan Karacaoglu",downloadPdfUrl:"/chapter/pdf-download/66658",previewPdfUrl:"/chapter/pdf-preview/66658",authors:[{id:"73035",title:"Prof.",name:"Ercan",surname:"Karacaoglu",slug:"ercan-karacaoglu",fullName:"Ercan Karacaoglu"}],corrections:null},{id:"66764",title:"Immediate Breast Reconstruction with Free Autologous Tissue Transfer",doi:"10.5772/intechopen.85652",slug:"immediate-breast-reconstruction-with-free-autologous-tissue-transfer",totalDownloads:824,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Immediate breast reconstruction in the United States is increasing with the majority of patients undergoing implant-based reconstruction. The use of pedicled autologous tissues has also been used, but due to significant donor site morbidity, free autologous tissue transfer has largely replaced it. The gold standard currently for breast reconstruction is free autologous tissue transfer from the abdomen if no contraindications exist. However, not all hospitals have the expertise available to perform free autologous tissue transfers for breast reconstruction. Other donor sites available for free autologous tissue transfer include the thigh and gluteal areas. With advances in free tissue transfer techniques, the donor site morbidity and flap failure rates are minimal. The ultimate goal for any breast reconstruction patient is to achieve the appropriate size, shape, symmetry, softness, and sensation. The goal of this chapter is to assist in achieving these goals in the immediate breast reconstruction patient through the use of free autologous tissue transfers.",signatures:"Justin Zelones, Suzanne Inchauste and Dung Nguyen",downloadPdfUrl:"/chapter/pdf-download/66764",previewPdfUrl:"/chapter/pdf-preview/66764",authors:[{id:"284810",title:"M.D.",name:"Dung",surname:"Nguyen",slug:"dung-nguyen",fullName:"Dung Nguyen"},{id:"285705",title:"Dr.",name:"Justin",surname:"Zelones",slug:"justin-zelones",fullName:"Justin Zelones"},{id:"293566",title:"Dr.",name:"Suzanne",surname:"Inchauste",slug:"suzanne-inchauste",fullName:"Suzanne Inchauste"}],corrections:null},{id:"70851",title:"Synthetic Mesh in Immediate Breast Reconstruction",doi:"10.5772/intechopen.90884",slug:"synthetic-mesh-in-immediate-breast-reconstruction",totalDownloads:906,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"The use of biological matrices in immediate implant-based breast reconstruction arose with the need to reinforce the lower pole of the breast and to cover the implant to reduce the risk of implant exposure. Synthetic mesh appears to be a lower cost alternative to biological matrices. This literature review aims to assess the usefulness of the use of synthetic meshes in breast reconstruction compared with the traditional techniques and whether outcomes and complications of synthetic meshes and biological matrices are comparable. The positioning of the implants and meshes, either submuscular or subcutaneous, has also been considered.",signatures:"Susana Gómez-Modet and Luis Tejedor",downloadPdfUrl:"/chapter/pdf-download/70851",previewPdfUrl:"/chapter/pdf-preview/70851",authors:[{id:"81170",title:"Dr.",name:"Luis",surname:"Tejedor",slug:"luis-tejedor",fullName:"Luis Tejedor"},{id:"276547",title:"Dr.",name:"Susana",surname:"Gomez-Modet",slug:"susana-gomez-modet",fullName:"Susana Gomez-Modet"}],corrections:null},{id:"69652",title:"L-Shaped Nipple Reconstruction: A Novel Technique to Improve Patient Satisfaction Outcomes",doi:"10.5772/intechopen.86068",slug:"l-shaped-nipple-reconstruction-a-novel-technique-to-improve-patient-satisfaction-outcomes",totalDownloads:755,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Nipple reconstruction is the final stage of breast reconstruction and performed after acceptable breast mound shape and symmetry has been achieved. The objectives of this study are to describe an original technique of nipple reconstruction, using a combination of random flap (for new nipple) and dermal graft (for new areola), and also measure patient satisfaction outcomes. Thirty-one patients underwent the L-shaped nipple reconstruction (2011-2016) at Liverpool Breast Unit and completed satisfaction survey of this technique. This cohort was compared to 59 patients who underwent traditional CV flap during the same period, in our Breast Unit. The study analysed the combined data of 90 patients (L flap N = 31 and CV flap N = 59). “L”-shaped flap is a random local skin flap to create new nipple and dermal graft is used to create new areola. There was no statistically significant difference in complication rates between traditional CV flap (9.7%) and L-shaped (13.6%) nipple reconstructions (Fishers exact test p = 0.74). In our L flap cohort, 94% were pleased and 93% would recommend it to a friend. Thus L flap is a viable alternative to CV flap in suitable patients and has positive patient satisfaction outcomes.",signatures:"Krishnamurthy Sreedhar Murthy",downloadPdfUrl:"/chapter/pdf-download/69652",previewPdfUrl:"/chapter/pdf-preview/69652",authors:[{id:"286314",title:"Mr.",name:"Krishnamurthy S",surname:"Murthy",slug:"krishnamurthy-s-murthy",fullName:"Krishnamurthy S Murthy"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"1305",title:"Advances in Endoscopic Surgery",subtitle:null,isOpenForSubmission:!1,hash:"84236c28c671a83f6cd1cd8bb84d873f",slug:"advances-in-endoscopic-surgery",bookSignature:"Cornel Iancu",coverURL:"https://cdn.intechopen.com/books/images_new/1305.jpg",editedByType:"Edited by",editors:[{id:"33183",title:"Prof.",name:"Cornel",surname:"Iancu",slug:"cornel-iancu",fullName:"Cornel Iancu"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"943",title:"Bone Grafting",subtitle:null,isOpenForSubmission:!1,hash:"9afab8beeb4879b2751907783a3de842",slug:"bone-grafting",bookSignature:"Alessandro Zorzi and Joao Batista de Miranda",coverURL:"https://cdn.intechopen.com/books/images_new/943.jpg",editedByType:"Edited by",editors:[{id:"80871",title:"M.D.",name:"Alessandro Rozim",surname:"Zorzi",slug:"alessandro-rozim-zorzi",fullName:"Alessandro Rozim Zorzi"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1007",title:"Xenotransplantation",subtitle:null,isOpenForSubmission:!1,hash:"45fde91777f91583197a5b5dfecb207a",slug:"xenotransplantation",bookSignature:"Shuji Miyagawa",coverURL:"https://cdn.intechopen.com/books/images_new/1007.jpg",editedByType:"Edited by",editors:[{id:"73965",title:"Prof.",name:"Shuji",surname:"Miyagawa",slug:"shuji-miyagawa",fullName:"Shuji Miyagawa"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"984",title:"Current Concepts in Plastic Surgery",subtitle:null,isOpenForSubmission:!1,hash:"46fb663adfdfb9ceeb2df2013b08038f",slug:"current-concepts-in-plastic-surgery",bookSignature:"Francisco J. 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\r\n\tThis book aims to provide a comprehensive summary of theoretical and practical aspects of diffusion and mass transfer applications within the chemical process industries. The book will cover six main areas: Fundamental basics required to formulate and solve mass transfer problems such as conservation laws and constitutive equations, in addition to their parameters; Distillation; Gas-liquid absorption and Stripping; Liquid-liquid Extraction; Drying, and Leaching.
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\r\n\tThe objective of this book is to provide a valuable resource for engineering students and professionals, to guide their learning, design and analysis activities as they relate to mass transfer applications. Chapters covering fundamental theories, calculations and optimization approaches, novel designs of equipment, and incremental improvements over standard calculation methods are welcomed and encouraged for submission. Review topics on mass transfer applications in reactor and process engineering with emphasis on the absorption of multicomponent gaseous mixtures in non-reactive volatile and non-volatile Newtonian fluids and polymeric solutions in packed-bed absorbers are also welcomed.
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Professor Morsi's research involves different aspects of Chemical, Environmental, and Petroleum Engineering. His recent research work focuses on: design and scaleup of multiphase reactors, and modeling and optimization of industrial processes with focus on Fischer-Tropsch Synthesis; CO2 sequestration in deep coal seams; CO2 capture from syngas and natural gas using chemical and physical solvents; and EOR using CO2 and alcohols. 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He was previously a Fellow at the National Energy Technology Laboratory in Pittsburgh. He obtained his Ph.D. in Chemical Engineering from the University of Pittsburgh, and his BS and MS degrees in Chemical Engineering from Texas A&M University at Qatar. 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1. Introduction
Assisted reproductive technologies (ART) have been successfully used to alleviate fertility issues in humans and to improve farm animal genetics. ART adoption has risen dramatically in recent years, and this trend is projected to continue [1].
ART has some drawbacks and restrictions. In vitro embryo production (IVEP), which was the predominant method for creating bovine embryos for transfer in 2017 [2], demonstrated reduced pregnancy rates after the transfer of in vitro-produced (IVP) embryos when compared to natural breeding, AI, or even transfer of in vivo-derived embryos [3, 4, 5].
The use of IVEP in cattle is limited due to a high percentage of pregnancy losses [6, 7]. Despite improvements in IVEP procedures over the years, current studies have found greater early and late embryo mortality in IVEP-derived pregnancies when compared to in vivo approaches such as AI or multiple ovulation and embryo transfer (MOET) [8, 9]. Calving difficulty and abnormal birth weight [10], disturbed fetal development [11, 12] and epigenetic dysregulation [13] have also been reported recently.
Cattle production accounts for a greater proportion of the economy of commercial and semi-commercialized farmers in undeveloped countries globally. It sustains the economy of most developed countries through meat, milk and skin production. Cattle have as well been on the forefront of researches in biomedicine and reproduction. With the recent promotion in biotechnology, cattle have been improved for better production efficiencies.
The cattle population in Nigeria at present is 18,404,661 million [14] and an annual growth rate of 1.5 percent is being estimated in the herd. It is disturbing that although developing countries account for about two-thirds of the World Cattle Population, while the developed countries account for about two-thirds of total beef population [15]. The three predominant production systems and their contributions to the total population are extensive (82.1%), semi-intensive (16.8%) and intensive (1.1%). Cattle population by geographic zones reveals the percentages as follows: North-West (52%), North-East (27%), North-Central (19%) and South (2%) [16] as shown in Figure 1.
Figure 1.
Cattle population by geographic zones in Nigeria.
Indigenous breeds dominate the cattle industry in Nigeria and they primarily serve the purpose meat production and for savings as well as milk production. Foreign breeds like Holstein Friesian, Brown Swiss, Jersey and their crosses can only be found in more intensive, specialized dairy farms [17]. Agricultural Policy for Nigeria [18] advocated the upgrading of local breeds of animals through the use of exotic breeds to a level not exceeding 50 percent to maintain hybrid vigor. Sequel to this, there is a high cost of importing an exotic bull or cow coupled with the physiological processes the animal must undergo before leaving a temperate region to the tropical region. Such processes like acclimation, acclimatization and adaptation must be achieved in time and space for a successful importation of an exotic breed into Nigeria. The economic implication of such venture is enormous.
An easier approach to the above processes is the integration of ART into practices in the Nigerian cattle industry to boost production. There has been a significant increase in the utilization of ART, particularly AI and MOET, by developed and developing countries to produce millions of cattle. The adoption has led to a tremendous increase in both dairy and beef cattle production in several countries such as the United States and Brazil. In the national animal production research institute (NAPRI), Zaria, Nigeria, AI has been routinely performed since 1978.
Other interests include the monitoring of reproductive hormones and the improvement of oestrus synchronization and heat detection. Crossbreeding of the indigenous breeds of cattle with the exotic breeds is also on-going in an effort to upgrade their traits for beef production. Efforts have also been made to improve the milk productivity of indigenous cattle through crossbreeding with exotic cattle (Friesian) to produce crossbred cows (Friesian-Bunaji) with a genetic potential for increased milk yield per day [19].
Apart from NAPRI, AI is also performed in a few private commercial cattle farms. Unfortunately, these efforts impact a small proportion of cattle population in Nigeria. A recent study in northern Nigeria also revealed poor extension contact among dairy farmers, which blocks farmers from access to sources of improved dairy cattle technologies [20]. Tertiary institutions in Nigeria also present platforms for the utilization of ART in research that can improve animal reproduction and productivity. Many of these institutions have made considerable efforts in some areas of animal production, and in the treatment of reproductive diseases. Regrettably, there is a low potential for the application of ART, partly due to the absence of a number of equipment and facilities but also due to shortage of human skill or training [19] and the fear of the attendant consequences of embracing ART.
Clearly, an intensive application of ART will assist in improving reproductive efficiency and productivity in dairy and beef cattle farming in Nigeria through several approaches. Tertiary institutions and research institutes should be adequately funded and provided with modern research facilities, laboratories and equipment. Skills in ARTs should be incorporated and exploited in both teaching and research in animal science and veterinary medicine curriculums. There should be an increased synergy between farmers and researchers through agricultural extension services and above all, the farmers fears of post-ART consequences should be addressed through research.
The present turn of events in Nigeria demands that the discussion of the application of reproductive biotechnologies in cattle and their impact for future achievements be done.
The current discussion summarizes ART-based successes and implications in cattle breeding while also aiming to apply it to the effective enhancement of Nigerian dairy and beef herds.
2. Cattle breeds and distribution in Nigeria
2.1 White Fulani (Bunaji)
White Fulani ranks first among number and distribution in all the cattle breeds in Nigerian [21, 22]. It is estimated that it makes up roughly 37% of the national herd [23, 24]. They can be found in Nigeria’s Western, Northern, and Middle Belt regions. They are completely missing in Borno, where Rahaji and Wadara abound, and in the south-east, where Zebu is scarce. Bunaji are said to be superior to all other Zebu breeds in terms of disease resistance and hardiness, which has favored their expansion into the derived savannah and the humid zone’s edge [21, 22]. Late sexual maturity, a long interval between calving, and a short lactation period are some of the breed’s drawbacks. The Bunaji, on the other hand, are known for their genetic aptitude to be sturdy, heat tolerant, and suited to local conditions [24]. A white coat color, a relatively large size, and a height of about 130 cm are all phenotypes. At maturity, bulls and cows weigh about 500 kg and 325 kg, respectively. They have a prominent hump, a little belly flab, and medium-length, upcurving, lyre-shaped horns. The White Fulani has three key economic characteristics: milk production capacities of around 2,300 kg per lactation, the ability to fatten for beef cum milk production, and the bull’s proclivity to be utilized as a draught animal. At NAPRI-Shika, Zaria, offspring of White Fulani and Holstein crosses have resulted in improved milk production [24]. The average age for first calving was 42–45 months, however it might go as high as 5 years in Fulani herds. They contribute a large portion of the beef consumed in Nigeria [24, 25].
2.2 Red Bororo (Rahaji)
The Rahaji cattle herd is Nigeria’s third largest, accounting for around 22% of the country’s total herd. Except for a small population in southern Kaduna during the rainy season and an isolated population in the north-east Mambila Plateau, it is generally restricted to Nigeria’s arid and semi-arid regions [21, 22]. The Red Bororo is one of the largest Zebu breeds, and it is distinguished by its rich red coat, enormous ears, and long, thick horns [26, 27]. The breed is adored by Fulani pastoralists who integrate it into their herds of ‘white’ cattle for crossbreeding purposes. It is adversely affected by poor nutrition and it is susceptible to humidity-related diseases [21]. Due to high mortality rates among the animals orchestrated by the movement of the herders down south into the Middle Belt, a Fulani clan, the Rahaji, who traditionally herded the breed and imprinted their name on it, has strikingly exchanged their stock for Bunaji [22].
2.3 Sokoto Gudali
According to [23], Gudali accounts for roughly 32% of the national herd. In Nigeria, there are two distinct forms of Gudali: the Sokoto Gudali (Bokolooji) and the Adamawa Gudali. The Bokoloji is found primarily in Nigeria’s northwestern region, but it has recently spread throughout the country [25, 26, 27]. The Bokoloji is nearly hornless and has a homogeneous cream, light gray, or dun coloration. It has a lot of dewlap and skin wrinkles on it. The hair is short, and the skin is pigmented and thickIt has droopy ears, which milkers appreciate. At the National Animal Production Research Institute (NAPRI), Shika, the Sokoto Gudali beat the White Fulani in terms of milk yield [24, 25]. The calving interval is 360–450 days. The females have well developed udders with good teats which make them to be regarded as indigenous dairy breed. The average weights at maturity are 330 kg for the female and 450 kg for the male. The average milk production per lactation of the female is 1,500 kg [25].
2.4 Adamawa Gudali
As its name suggests, the Adamawa Gudali is only found in Adamawa [21, 22]. It is thought to account for roughly 2% of the national herd [23]. In Nigeria, two prominent local kinds are recognized: the Banyo, who have Rahaji blood and big horns, as well as a white face and red eye patches, and the Yola, who have a Muturu admixture [28]. Since the 1950s, the Muturu characteristics have gradually vanished, and local herders no longer identify the Yola breed as a separate variation. Adamawa Gudali has a similar conformation to Bunaji. Its horns are normally pied and medium in length, and its size ranges from medium to giant. The coat can be white, black, red, or brown. The pendulous hump, however, is the most reliable distinguishing feature between Adamawa Gudali and Bunaji. Both Kanuri and Fulani pastoralists share ownership of the land. Kanuri and Fulani both have mixed Adamawa Gudali and Wadara herds, Bunaji or Rahaji. Many farmers consider Adamawa Gudali to be the traditional race of the region, where they work in the fields. They are normally fattened in the compound and brought to market when they become too large to pull a plow successfully [25, 29].
2.5 Wadara
Wadara cattle are another Nigerian breed. They are light, medium-sized, and dark-red, black, pied, or brown in color. They have short horns and a little upright hump, and account for approximately 6.6 percent of the national herd. They are Borno’s “indigenous” cattle, which the Koyam and other pastoralists refer to as “our” cattle. In literature, the Wadara is most commonly referred to as ‘Shuwa,’ after the Shuwa Arabs who also herd them. The Ambala, a kindred white-coated breed from Chad, is frequently imported into Nigeria [21, 22].
2.6 Azawak
The Azawak is another breed found in Nigeria and is an indigenous cattle the Azawak valley North-East of Nigeria. It is distributed along its North-Western border. It has medium-length horns. The color variations range from red for Azawak in Niger Republic to fawn, white, brown, pied and black color for those that enter Nigeria. They represent about 0.7% of the national herd. Except for minute population kept by indigenous herders in Nigeria throughout the year, the majority is seasonally transhumant [23]. They are majorly distributed along the border North and West of Sokoto but scanty populations are found in the North-West of Borgu and the border between Sokoto and Katsina [21, 22].
2.7 Muturu
The Muturu is a breed of West African dwarf shorthorn cattle with a small body. It has a blocky shape with fine-boned, short limbs. The body is compact, without a hump, and has a broad head and a straight back. Their horns are relatively short and have a somewhat dished face. In South-Central Nigeria, the Muturu are predominantly black or black and white. They are usually black and white on the Jos Plateau, but they are noticeably larger than those found in the lowlands. Northern populations are made up of brown, red, or tawny animals. Muturu cattle have a very disjointed distribution within Nigeria, implying a gradual retreat of a once-widely distributed population [25, 30]. Blench et al. [30] has examined Muturu’s management, productivity, history, and distribution. Due to insufficient maps of Muturu distribution, accurate estimates of their numbers are difficult to come by. Muturu cattle are widely spread and less apparent than Zebu cattle, and they are generally kept in stalls where they are fed. As a result, published population figures are inaccurate. Northern Muturu data is lacking, and their trypano-tolerance has not been assessed, making them ineligible for inclusion in estimations of ‘trypano-tolerant’ cattle. International Livestock Centre for Africa [31], who estimated 120,000 Muturu, should be compared to [32], who estimated 60,000 Muturu, or 0.7 percent of the national herd. Akinwumi and Ikpi [33] found 85,000 people in five southern states after conducting a poll. Nigerian National Livestock Resource Survey [23], the first survey to take into account all of the populated islands, estimated a population of 115,000 in 1990 [15]. Isolated Muturu populations exist along the Republic of Cameroon border, extending into South-Eastern Borno and merging with Adamawa’s Michika-Mubi area. In the dry savannah, small populations can be found in the Atlantika mountains, south-east of Yola, near Cham, east of Bauchi, and south-east of the Jos Plateau [21, 22]. Another Muturu group appears north of Tegina in the North-West, with widely varying coat colors, implying a link with the North-East populations. Muturu once inhabited much of southern Nigeria and the west bank of the Niger River, with its extinction in many parts occurring only recently. Either Keteku or Zebu have supplanted Muturu, or Muturu is no longer kept by communities. Muturu once inhabited much of southern Nigeria and the Niger Valley west of the river, but they have since vanished from many areas. Muturu has been replaced by Keteku or Zebu, or Muturu is no longer kept by communities.
2.8 Keteku
Blench et al. [30] investigated the distribution and productivity of Keteku cattle in greater depth. Due to an increasing amount of Zebu blood in ‘Keteku’ herds, purelines of Keteku have become difficult to come by in recent years. Zebu cattle are being used to replace village herds as Fulani pastoralists migrate southwards, invading territories traditionally restricted to trypano-tolerant stock. The progeny of a Zebu x Savannah Muturu hybrid found near Biu in southern Borno and published in the literature [28] is a good illustration of how the local Zebu gene pool has become dominant. The name Keteku for a certain animal may represent the owner’s cultural background as well as the animal’s genotype. According to [31], the population of Keteku in Nigeria is 180,000 people. Keteku is less common than previously thought, with a wide range of distribution. It’s unlikely that there are 100,000 of any kind.
Keteku is a variant of Borgu and is a stabilized Muturu x Zebu hybrid that is also trypano-tolerant [28]. It is also known as Kataku, Ketari, Borgu, Borgawa, and Kaiama. The Muturu and Bunaji characteristics are combined in this breed, with white, gray, and black being the most common colors, with red and brown appearing on occasion. It has longer horns, a smaller hump, and shorter legs than Muturu and Bunaji. In Nigeria, the populations of Keteku herds are limited to a narrow band along the Benin Republic border in the region known as ‘Borgu,’ as well as areas near to settlements in Northern Yoruba land. Throughout this region, Keteku coexisted with West African dwarf shorthorn, both filling the same niche [21, 22]. Keteku is sometimes purchased as an investment stock in the Ondo area by farmers who value its combination of size and trypano-tolerance. Keteku cattle have traditionally been raised on breeding farms and dispersed as part of livestock extension programs. Keteku is kept in the Government Livestock Centre in Ado-Ekiti [21, 22]. Crossbreeding of Zebu and Muturu is popular in various West African countries. Despite the fact that the two types came into touch, there have been few ‘new’ crossings of Zebu and Muturu in Southern Nigeria. Incompatibility and religious strictures have been cited by farmers in the South East for not crossbreeding the duo. In the Jos Plateau, ethnic competitions between the livestock farmers and animal production considerations have been cited as reasons for continuing genetic separation [21, 22].
2.9 N’dama
N’dama cattle are indigenous to Senegambia and neighboring areas in West Africa [29, 30, 34]. In 1939, N’dama cattle were introduced into Nigeria from Guinea for research purposes due to their trypanotolerance and larger size than Muturu cattle [30, 35]. N’dama cattle are humpless and have a medium-sized compact body with lyre-shaped black-tipped horns. The male has a large head and a small dewlap. Light brown N’dama are commonly brought into Nigeria, however black and pied N’dama are found in Guinea. They were sold to farmers and pastoralists in an attempt to boost local herds’ resistance to trypanosomiasis. Outside of institutions, there are few pure N’dama due to herders crossing N’dama with Zebu, yet pockets of N’dama exist in Northern Yoruba region [21, 22].
2.10 Kuri
The Kuri is a humpless long-horn with a huge body [21, 22, 29]. Its exact historical origin is uncertain. Kuri horns are unique in that they are swollen and spongy, unlike those of any other breed. It is 1.5 meters tall and weighs up to 550 kilograms. In terms of size, it is one of the largest African cow breeds. Kuri cattle come in a variety of hues and have the capacity to sustain in semi-aquatic environments. The Kuri cattle population is primarily concentrated in the old Lake Chad basin particularly along the lake’s eastern coasts. Kuri cattle can be found in Nigeria’s Yobe valley and as far west as Gashagar. Kuri cattle are sent to Kano’s North East district to be employed as traction animals. The breeds are crossed with the Zebu in Komadugu Yobe and are typically called Jetkoram in the literature [21, 22].
3. Herd size and productivity of cattle in Nigeria
3.1 Herd size
Only after several variables have been evaluated can the optimal herd size for an area and a population be estimated [34]. The notion of optimum herd size takes into account the current environmental conditions, the species biological capability (performance), herd management technique, resource utilization, and distribution in general principles [36]. The world’s cattle population stands at 1,000,967,000 with the top ten producers being the India, Brazil, China, United States, European Union, Argentina, Australia, Russia, Mexico and Uruguay. The above data are based on the 2021 ranking of countries with the most cattle [37]. The average beef cow herds are 43.5 for United States [38], 69 Canada [39] and 41 for Nigeria [40]. Nigeria with an estimated cattle population of 18,404,661 million [14] and an annual growth rate of 1.5 percent could not feature among the first 17 countries as shown in Table 1.
World
1,000,967,000
Rank
Country
2021
% of World
1
India
305,500,000
30.52%
2
Brazil
252,700,000
25.25%
3
China
95,620,000
9.55%
4
United States
93,595,000
9.35%
5
European Union
85,545,000
8.55%
6
Argentina
53,831,000
5.38%
7
Australia
23,217,000
2.32%
8
Russia
17,953,000
1.79%
9
Mexico
17,000,000
1.70%
10
Uruguay
11,946,000
1.19%
11
Canada
11,150,000
1.11%
12
New Zealand
10,063,000
1.01%
13
Egypt
7,850,000
0.78%
14
Belarus
4,300,000
0.43%
15
Japan
3,922,000
0.39%
16
Korea, South
3,744,000
0.38%
17
Ukraine
3,001,000
0.30%
Table 1.
Ranking of countries with the most cattle.
Foreign Agricultural Service/United States Department of Agriculture [37].
However, the current paper is based on the literature evidence based on the assumptions in Nigeria. Cunnings [41] estimated the size of the Fulani cattle herd to be 100–150, while [42] estimated it to be 80–100. Another study [43] found that the average cattle herd size was 41, and that the majority of herders (46.4 percent) herded 41 to 60 cattle. The pastoralist herd size ranged from 16 to 69 animals per herd, according to a recent survey of pastoralist households in Zaria and surrounds by [34]. In the humid rainforest of Imo State, Nigeria, the majority of Fulani pastoralists (63.60 percent) maintained herd sizes of 41 to 70 heads, according to [43]. With a population of more than 170 million people, Nigeria requires a large number of cattle to meet its demand for cattle and cattle products. As long as more than 80% of the cattle population is in the hands of traditional herders, supply will not be able to meet demand. Cattle importation is thus practiced in order to bridge the deficit. The imported total was 5,142 heads per year in January 1996. In a study conducted by [44], the pastoralist’s operational sizes were evaluated to determine the makeup of the herds in terms of the class of cattle—steers, lactating or non-lactating cows, and calves. Small scale pastoralists (SSP), medium scale pastoralists (MSP), and large scale pastoralists (LSP) were the three kinds of pastoralists (LSP). According to the findings, the SSP had an average herd size of roughly 17 cattle, while the MSP and LSP had 32 and 73 cattle, respectively. Furthermore, the LSP had more lactating and non-lactating cows, as well as calves, than the SSP and MSP, whereas the MSP had the most steer in the herd [45]. The herd pattern in Zaria revealed a gender disparity, with more cows than bulls, with cows accounting for 60 to 75 percent of each herd on average. Keeping more cows than bulls is advantageous to pastoralists because a simulation of herd dynamics demonstrates that when female calves outnumber male calves in the kraal, the herd’s maximum growth is achieved [36]. The herd size had a 50 percent preponderance of young animals, with females (35 percent) and males (35 percent) as the genders (15 percent). The breeding cows made up 49.1 percent of the herd, while the breeding bulls made up 6%. The number of breeding cows and young females in a herd impacts the profitability of any cattle operation to a large extent [46]. This helps to explain why the Fulani herd has such a high number of breeding cows and young females. Except for selected and retained breeding bulls, the young males, who had previously been plentiful, were sold out before to breeding to supplement the family’s revenue. Because the mating ratio is usually 1 bull: 20 cows, keeping a large number of bulls in the herd is uneconomical [47]. The ratio of cows to young animals in the herd was practically equal, according to the data (0.98). The ratio of breeding bulls to young animals was low (0.14), implying that breeding bulls and cows were almost equal (0.15). The ratio of young males to young females was 0.42, indicating that young females outnumber young males [36].
3.2 Reproductive performance
Reproduction is the major determinant of profitability in a cattle enterprise. A cow needs to be re-bred in 80 to 85 days post calving to sustain a 365-day calving interval. Percentage of body fats in cows is directly linked to poor reproductive performance. Inadequate nutrition causes poor reproductive performance and researchers have discovered that for proper functioning of the reproductive system, a certain level of body fat must be attained. It becomes easier to develop more cost-effective a nutrition program if all of the farm’s cows can be managed similarly. This is certainly relevant when a farm’s entire herd of cows is maintained as a single herd, which is common in small production units [29]. All cows suffer from poor body condition at vital times due to year-round calving. Reduced income per cow, prolonged time before rebreeding, poorly conditioned calves at birth, low quality and scarce colostrum, decreased milk production, a high rate of dystocia, and lower calf weaning weights are all possible consequences. A longer interval between rebreeding and weaning will result in a younger, smaller calf at weaning the following year, resulting in lower profits if the animal is sold at weaning. Calves that were weak at birth may find it difficult to get reasonable amount of colostrums. This may give rise to high susceptibility to diseases, light weaning weights, decreased feedlot performance and poor carcass traits. As reported by researchers, there is clear evidence cows with a moderate body condition had a shorter delay between calving and initial estrus than cows with a bad body condition [29].
According to [44], 6–10 calving per cow per reproductive cycle is allowed by about 90.90% of pastoralists in Nigeria, while about 9.10% usually allow about 11–15 calving per cow. Therefore, majority of the aged cows are often slaughtered for sale in most abattoirs [48]. However, cattle production and breeding efficiency on Northern Nigerian grazing rangelands is low, especially during the dry season [49]. Cows, for example, have a two-year age at first calving and a two-year calving interval [50, 51], steers achieve slaughter weight between 24 and 30 months of age [52], and off-take rates range from 2 to 10% per year [49]. The median age at first calving for the reproduction was 4.75 years, according to [34]. The findings corroborated previous data on Bunaji cattle herds gathered from the Jos Plateau [52]. However, the result was higher than 37-month reported at the National Veterinary Research Institute, Vom, a government farm [53]. The difference is due primarily to the dry season’s low amount and quality of feed on grazing fields [50, 54]. In such circumstances, providing feed supplements to boost cow output may be recommended. However, before any nutritional modifications are proposed, it’s critical to figure out which nutrients are restricting cattle productivity in a certain zone [55]. Akpa et al. [34] equally reported a before breeding, the average age was 4.05 years for bulls in the pastoral cattle herds. This may be probably occasioned by poor nutrition acting together with other environmental stressors. Ndlovu et al. [56] made findings that the age at which young bulls reach puberty is affected by nutrition and feed intake. However, [47] suggested that where controlled breeding is being practiced, young bulls of about 15 months of age should not run with the cows in the pasture. Some researchers have used standard technical coefficients to compare results obtained in research institutions such as the National Animal Production Research Institute in Zaria or the National Veterinary Research Institute in Vom, as well as those in Nigeria’s traditional model [44]. Data were collected on reproductive performance and milk to butter ratio. The results, inter alia showed that the proportion of milk to butter was 1 liter to 100 grams. When compared to the data above, it can be seen that the calving cycle in Nigeria ranges from 29 to 43 months. The average age at first calving is 30 to 42 months, with a productive life of between 9 and 14 years [44].
3.3 Productivity
The most important nutrients influencing milk and beef production in semi-arid environments are protein, energy, and minerals [57]. Some studies have revealed that energy and minerals are not the limiting requirements for grazing cattle, but rather protein deficits are the cause of cattle productivity losses [58, 59]. Blezinger et al. [57, 60] however, reported that rangelands fail to supply energy and minerals in adequate quantity during the early to mid-wet season. The consequence is a retarded growth rate of cattle which turns out to be a main stumbling block to boosting body weight growth [61, 62] and, as a result, impacting semi-arid beef production In the semi-arid areas, rangeland energy and mineral supplies in the late wet and dry seasons are usually perceived as sufficient to support cattle production needs on pastoral systems [59, 60]. Thus, in community rangelands in semi-arid areas, cattle production efficiency is sometimes governed by nutrient availability, which is affected primarily by temperature and seasonal rainfall distribution [54]. The traditional cattle sector in Nigeria is characterized by low productivity due to seasonality of quantitative and qualitative feed shortages, which is arguably the most significant barrier to improving smallholder enterprise production and productivity [63, 64]. Permanent land damage is prevented through grazing on large expanse of land. The pastoralists use the approach to maximize spatial resource use by allowing soil rejuvenation. Negative consequences of seasonal fluctuations in feed supplies have not been adequately established on performance parameters of pasture cattle in the Guinea Savannah Zone of Nigeria. Such data is required for the development of effective feeding and disease prevention strategies. Cattle, for example, are susceptible to stomach discomfort due to a seasonal shift in food [64]. The changeover from a forage-based to a finishing diet strong in grain aids marbling in beef, but it also causes gastric distress. This may have a negative impact on their development. Similarly, seasonal variations in the quantity and quality of feed supplies have an impact on beef cattle performance and carcass quality [64, 65].
3.4 Assisted reproductive technologies in animal production
Assisted reproductive technologies (ART) are widely used in humans and animals in many parts of the world to expand our understanding of reproductive processes and to improve reproductive efficiency. Oestrus synchronization, artificial insemination (AI), multipleovulation and embryo transfer (MOET), in vitro fertilization (IVF), sex determination, cloning, and genetic engineering are some of the technologies used in animal production [66]. These are powerful technologies capable of enhancing productivity, and when combined with bioinformatics will provide more impact in the future of animal production [66]. The cow is typically monotocous with an average gestation length of 40 weeks and therefore a relatively long generation interval. The rate at which a highly desirable cow can be used to enhance the genetic state of a herd is slow if no interference is made [67]. Hence ARTs are particularly useful in this species because of the low reproductive rates and long generation intervals. In the cattle industry, ARTs were initially developed to increase the production of calves from parent cattle with high genetic potentials, but now offer many opportunities for beef and dairy cattle production.
3.4.1 Oestrus synchronization
Oestrous synchronization involves the application of pharmacologic means to control oestrus and ovulation in farm animals. As a result, female animals are forced to go through oestrus (ovulation) at a specified, opportune time rather than when it would naturally occur. In general, the procedures rely on either artificially inducing premature luteolysis with luteolytic drugs (e.g. prostaglandin F2 alpha or its analogues) or temporarily suppressing ovarian function with progestagens.
Synchronization offers several advantages and facilitates the maximal and batch managements of AI and calving in cattle herds, thereby increasing productivity and decreasing costs in dairy and beef cattle production [68].
Synchronization may have some benefits in beef herds, such as decreasing the calving to conception gap, and hence the calving interval and possibly the calving season. Accurate detection of oestrus is critical to achieving high pregnancy rates particularly in large cattle herds. Hence oestrous synchronization offers another strategy to circumvent the critical problem of oestrus detection [69].
3.4.2 Artificial insemination (AI)
Artificial insemination has been utilized worldwide for more than 50 years. It is still the predominant technology applied for the improvement of reproductive efficiency and productivity in cattle through progeny testing and genetic improvement [67]. AI is the introduction of live spermatozoa into the genital tract of the female to cause fertilization by means other than natural mating. Semen from bulls can be extended and preserved at 4–5°C for a few days or frozen in plastic straws in liquid nitrogen at −196°C for years or decades. Semen from a few high-performance bulls can then be used to breed large number of cows leading to rapid genetic improvement and dissemination of new breeds within cattle populations [65].
Movement of preserved semen instead of live bulls would also improve trade, reduce production cost and also decrease the spread of cattle diseases usually transmitted by direct contact between cattle. The use of AI also prevents the rearing of bulls that involve added cost along with the possibility of causing injury or death to farmers or staff. Controlling and recording the time of AI helps to avoid indiscriminate mating (often observed in natural mating), thereby facilitating proper farm recordkeeping and fertility management.
3.4.3 Multiple ovulation and embryo transfer (MOET)
MOET was first proposed in 1987, and it demonstrated how MOET programs may increase genetic gains by raising selection intensity and shortening generation intervals [70]. Multiple-ovulation (superovulation) is a pharmacologic procedure that increases the number of oocytes released at ovulation by 2 to 10 times, hence raising the quantity of embryos that can be produced. Embryo transfer (ET), on the other hand, refers to the techniques used to collect embryos from a female (donor) and transfer them into the uterus of another female (recipient) where they develop to term. Typically, a cow ovulates a single oocyte during each reproductive cycle, and therefore may produce only 8 to 12 calves in her reproductive lifetime. However, utilizing the technology for MOET, it is possible to obtain 30 to 40 calves from a single cow over a period of a year [71]. Through MOET, the numbers of imported highly valuable and scarce cattle breeds could be multiplied rapidly, leading to increased genetic improvement of cattle populations [72]. Highly valued cows that are injured or too old to carry normal pregnancy could also be made to continue producing calves via MOET, rather than these animals being culled or sold for slaughter. Natural twinning ranges from 1 to 2% in beef cattle, but the efficiency of beef production could also be increased in intensively managed farms by inducing twinning using MOET. This technology also offers commercial advantage to farmers via a lower cost of importation of cryopreserved embryos compared to live cattle [68].
3.4.4 In vitro fertilization (IVF)
In vitro fertilization (IVF) is a technology via which fertilization and maturation of oocytes takes place outside of the female (in the laboratory). The method is also called in vitro embryo production. The resulting embryos are then transferred back to the same or different females for development. Mature oocytes can be collected by flushing the oviducts shortly after ovulation. Alternatively, immature oocytes can be obtained from abattoir ovaries or by aspiration of pre-ovulatory follicles using ovum pick up (OPU) from live cows. These oocytes must be cultured in vitro for 24 hours in sterile medium to allow for nuclear maturation prior to fertilization. Following in vitro maturation of oocytes, spermatozoa must also be capacitated using a capacitation medium (or alternatively by using ejaculated sperm) before they are capable of fertilizing the oocyte [66]. The technology offers the potential for large numbers of in vitro produced embryos together with exciting opportunities for other technologies in cattle reproduction such as sex determination, cloning, genetic engineering and embryo transfer.
3.4.5 Sex determination
This technology is useful when calves of a particular sex are considered to be more valuable than those of the opposite sex. For instance, dairy farmers would desire that the majority of their calves be female (replacement heifers for the milking herd) whereas beef farmers would prefer bull calves for their higher body mass and beef production potential. Sex could be determined either by semen sexing or embryo sexing. The presence of Y chromosome determines male offspring in mammals. In cattle, the X-bearing sperm contain 3.8% more DNA than the Y-bearing sperm. Thus, sperm can be separated using specific dye (Hoechst 33342) that binds to DNA and a flow cytometer/cell sorter. Embryos can also be sexed using several techniques including chromosome analysis (karyotyping), immunology, DNA analysis and detection of metabolic differences [66]. Sexed semen could be applied in farms to inseminate cows in order to create necessary sex calves, or to fertilize oocytes in vitro in order to produce required sex embryos. Sexed embryos could likewise be implanted into recipient cows to create sex-matched calves [73].
3.4.6 Cloning and nuclear transfer
These technologies involve cloning by embryo splitting to produce identical twins, triplets and quadruplets or the use of nuclear transfer to produce large numbers of genetically-identical or cloned cattle. In the nuclear transfer technique, the nuclei from either a blastomere (from early-stage embryos) or a somatic cell (other body cells) are fused individually to enucleated oocytes. The resulting zygotes are then cultured and transferred to recipient cows to develop till term. Interestingly, this technique has attracted much international attention since 1996 when the first mammal (the sheep, Dolly) was cloned [74] followed later by cloning in cattle [75]. With cloning technology, it is possible to exceed pregnancy rates of 100% in cattle farms. It also offers the potential for producing large numbers of genetically-superior cattle to drive increased dairy and beef production [69]. For instance, it normally requires 78 months to reach production flock status in cows, but this can be achieved within 33 months with the nuclear transfer technology [67]. The success rate for propagating animals by nuclear transfer is expected to increase along with a reduction in the cost as newer methods are developed in the technology.
3.4.7 Genetic engineering
Transgenic livestock (pigs and sheep) were produced for the first time in 1985 [76]. This technology involves transferring a selected gene into an embryo so that the resulting offspring carry and express that gene later in life. Animals that carry a copy of a desired foreign gene are referred to as being transgenic [69, 77]. Generally, transgenic technologies utilize embryo-mediated or cell-mediated genetic modification to generate an entire animal. In recent years, new technologies referred to as “gene editing” have also been added to the molecular tool box for genetic engineering of various organisms. Efficient and robust protocols are now available for producing sheep, goats, pigs, cattle and other species in which specific genes have been targeted for editing [78].
The technology has been applied to improve different aspects of animal production. In cattle, these include the enhancement of milk quality, muscle yield, disease resistance (mastitis, tuberculosis), or improved welfare such as the production of hornless dairy cattle [77, 79, 80]. Nevertheless, the application of genetic engineering in livestock production has been limited by several significant factors. These include the cost of large animals, long generation times, and most importantly, legal, ethical and public health concerns and considerations [78]. However, it is likely some of the newer technologies involving gene editing will become more acceptable particularly in the face of the increasing global animal protein demands and food insecurity. Already, the first genetically engineered salmon has received approval to be sold as food by regulatory agencies in the US and Canada [81]. It is likely that other international agencies will begin to reconsider regulatory gridlocks on animal products from genetic engineering. In Africa, and particularly Nigeria, genetic engineering of bovine embryos may offer opportunities for the production of cattle that retain the genetic predisposition to hardiness, adaptation to the tropical environment (e.g. heat stress) and tolerance to tropical diseases (e.g. trypanosomosis) while incorporating genetic potential for rapid growth and increased milk and beef production [82].
4. Main abnormalities observed as post-transfer consequences of bovine in vitro-produced (IVP) embryos in some breeds of cattle
4.1 Holstein x beef breeds
In Holstein x beef breeds, main abnormalities observed include problem of increased loss of embryos in Grade 2 IVP embryos, increased fetal size, increased fetal body weight in IVP, no placentomes in IVP [6]; increased birth weight, increased percentage dystocia, increased mortality in IVP in Holstein; Holstein x Angus cross-breeds [83]; increased birth weight and oversized calves at birth in IVP, increased percentage dystocia, increased heart weight at 13 months in IVP frozen in Simmental bulls [84]; increased percentage males, increased gestation length, increased percentage congenital malformations, increased birth weight, increased perinatal mortality and calving difficulty (all in IVP) in Holstein Friesian breed [85]; decreased pregnancy rates, increased percentage males, increased spontaneous abortion, increased birth weight, increased dystocia, increased calf mortality, increased abnormalities of the fetus and reduced intensity of labour in recipients (all in IVP) and removal of serum did not correct abnormalities in Holstein breed [3]; increased IGF2 expression, increased dystocia and increased mortality in IVP in Holstein breed [86]; decreased fetal size in early pregnancy, decreased number of cotyledons, increased cotyledon size, increased birth weight in Angus; Angus x Hereford cross-breeds [87] increased expression of genes (Heat shock protein family A (Hsp70) member 1A (HSP70.1), Sodium dimustase (Cu/Zn-SOD), Glucose transporter type 3 (GLUT3), Glucose transporter type43 (GLUT4), Basic fibroblast growth factor (bFGF), Insulin-like growth factor 1 receptor (IGF1R)) in blastocysts and increased calf birth weight in Holstein-Friesian breed [88].
5. Latching the lacuna
Technology adoption and transfer have been major problems in developing countries owing to so many reasons. Principal among them is lack of technical know-how, poor or near absence of funding, diversion of released funds for specific projects/corruption and weak agricultural extension agents who are either unaware of recent findings or who reluctantly refuse to diffuse information from research institutes to farmers.
ART in Nigeria should be given a linear but additive approach starting with AI which is the oldest and most pliable form of it. This can be combined with sperm sexing in the long run. Individuals and corporate bodies san train manpower on semen collection, estrous synchronization and artificial insemination. Reproductive physiologists should brace up for the challenge in this field.
Nigerian is blessed with tropical herbs which are used in unorthodox medicines by herbalists. Some of these herbs have proven to be potent in managing pregnancies and parturitions in humans. The same crude technology can be extended to N’dama and Muturu. In humans, pregnancies that exceed forty weeks without labour and parturition are managed with these herbs to prevent the fetus from becoming overfat so that labour and normal vaginal delivery will set in a short time. This will be averted if the gravid woman was placed on these herbs as a routine during the course of the pregnancy. These two breeds became animals of choice due to their resistance to trypanosomosis which has made it possible for them to thrive where other breeds have failed to thrive without inoculation against trypanosomosis. Pregnancy complications arising from using say Holstein Friesian semen to upgrade the duo will be managed with these tropical herbs which abound in Nigeria. This will open up new frontiers in research on cattle which may help to solve some of the problems outlined in Section 2.4 of this work.
6. Conclusions
It is worthy of note that the cattle population in Nigeria of above 18 million may appear false and misleading as it was not captured in the FAS/USDA 2021 ranking of countries with the most cattle. If the figure were true, Nigeria would have come displaced Russia to rank 8th in the list of countries.
Assisted reproductive technologies will not only bridge the gap in meat and milk consumption of Nigerians but it will open up a goldmine which will reduce the unemployment rate in this region. This technology undoubtedly will start in Nigeria and spread to neighboring countries in Africa.
Cattle production in Nigeria, which hitherto was business of the North will become a smooth running business in the South if N’dama and Muturu which have adapted to the more humid and disease-tolerant southern climate are improved upon using the ARTs. This will go a long way to improve the economy of Nigeria and equally mitigate the farmers-herders crisis which has consumed so many lives and properties. Above all, it well help Nigeria to attain self-sufficiency in meat production in the near future, become an exporter of beef and dairy products.
Conflict of interest
The authors do not declare any conflict of interest.
\n',keywords:"assisted reproductive technologies, N’dama, Muturu, Trypanosomosis, Nigeria",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/78831.pdf",chapterXML:"https://mts.intechopen.com/source/xml/78831.xml",downloadPdfUrl:"/chapter/pdf-download/78831",previewPdfUrl:"/chapter/pdf-preview/78831",totalDownloads:114,totalViews:0,totalCrossrefCites:0,totalDimensionsCites:0,totalAltmetricsMentions:3,impactScore:0,impactScorePercentile:0,impactScoreQuartile:0,hasAltmetrics:1,dateSubmitted:"May 13th 2021",dateReviewed:"August 23rd 2021",datePrePublished:"December 24th 2021",datePublished:"February 23rd 2022",dateFinished:"October 3rd 2021",readingETA:"0",abstract:"Assisted reproductive technologies (ART) that have come to stay and are still being improved upon in developed countries are still in their infancy stage in developing countries like Nigeria. Nigeria’s cattle population is estimated to be around 18.4 million. The number is far insufficient to meet the country’s demand for meat, milk, and other cow products, let alone contribute to GDP. N’dama and Muturu are both Nigerian breeds that are resistant to trypanosomosis. They are humpless longhorn and humpless shorthorn types of beef cattle. The dairy and beef cow industries’ inadequate adoption of ART is partly to blame for Nigeria’s low cattle output. Sex determination, multiple-ovulation and embryo transfer (MOET), oestrus synchronization, artificial insemination (AI), in vitro fertilization (IVF), cloning, and genetic engineering are all examples of assisted reproductive technologies. It has been reported in humans, rodents and domestic animals, abnormal fetuses, newborns and adult offspring arise from ART. Improper matching of breeding animals mostly leads to overfat calves. This review centers on the applications and potentials of ART in the production of trypanotolerant N’dama and Muturu cattle breeds. Some unorthodox medicines which have proven effective in human reproduction can circumvent the shortfalls in the adoption of ART.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/78831",risUrl:"/chapter/ris/78831",book:{id:"10751",slug:"bovine-science-challenges-and-advances"},signatures:"Cornelius Nwoga, Nnanna Ikeh, Matthew Onodugo, Paul Baiyeri and Ndubuisi Machebe",authors:[{id:"82918",title:"Prof.",name:"Paul",middleName:null,surname:"Baiyeri",fullName:"Paul Baiyeri",slug:"paul-baiyeri",email:"paul.baiyeri@unn.edu.ng",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"University of Nigeria, Nsukka",institutionURL:null,country:{name:"Nigeria"}}},{id:"352074",title:"Prof.",name:"Ndubuisi",middleName:null,surname:"Machebe",fullName:"Ndubuisi Machebe",slug:"ndubuisi-machebe",email:"ndubuisi.machebe@unn.edu.ng",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"356955",title:"Dr.",name:"Cornelius",middleName:"Chijioke",surname:"Nwoga",fullName:"Cornelius Nwoga",slug:"cornelius-nwoga",email:"cornelius.nwoga@unn.edu.ng",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"University of Nigeria, Nsukka",institutionURL:null,country:{name:"Nigeria"}}},{id:"418798",title:"Mr.",name:"Nnanna",middleName:"Ephraim",surname:"Ikeh",fullName:"Nnanna Ikeh",slug:"nnanna-ikeh",email:"nnanna.ikeh@unn.edu.ng",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/418798/images/17226_n.jpg",institution:{name:"University of Nigeria, Nsukka",institutionURL:null,country:{name:"Nigeria"}}},{id:"418800",title:"Mr.",name:"Mathew",middleName:null,surname:"Onodugo",fullName:"Mathew Onodugo",slug:"mathew-onodugo",email:"matthew.onodugo@unn.edu.ng",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"University of Nigeria, Nsukka",institutionURL:null,country:{name:"Nigeria"}}}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Cattle breeds and distribution in Nigeria",level:"1"},{id:"sec_2_2",title:"2.1 White Fulani (Bunaji)",level:"2"},{id:"sec_3_2",title:"2.2 Red Bororo (Rahaji)",level:"2"},{id:"sec_4_2",title:"2.3 Sokoto Gudali",level:"2"},{id:"sec_5_2",title:"2.4 Adamawa Gudali",level:"2"},{id:"sec_6_2",title:"2.5 Wadara",level:"2"},{id:"sec_7_2",title:"2.6 Azawak",level:"2"},{id:"sec_8_2",title:"2.7 Muturu",level:"2"},{id:"sec_9_2",title:"2.8 Keteku",level:"2"},{id:"sec_10_2",title:"2.9 N’dama",level:"2"},{id:"sec_11_2",title:"2.10 Kuri",level:"2"},{id:"sec_13",title:"3. Herd size and productivity of cattle in Nigeria",level:"1"},{id:"sec_13_2",title:"3.1 Herd size",level:"2"},{id:"sec_14_2",title:"3.2 Reproductive performance",level:"2"},{id:"sec_15_2",title:"3.3 Productivity",level:"2"},{id:"sec_16_2",title:"3.4 Assisted reproductive technologies in animal production",level:"2"},{id:"sec_16_3",title:"3.4.1 Oestrus synchronization",level:"3"},{id:"sec_17_3",title:"3.4.2 Artificial insemination (AI)",level:"3"},{id:"sec_18_3",title:"3.4.3 Multiple ovulation and embryo transfer (MOET)",level:"3"},{id:"sec_19_3",title:"3.4.4 In vitro fertilization (IVF)",level:"3"},{id:"sec_20_3",title:"3.4.5 Sex determination",level:"3"},{id:"sec_21_3",title:"3.4.6 Cloning and nuclear transfer",level:"3"},{id:"sec_22_3",title:"3.4.7 Genetic engineering",level:"3"},{id:"sec_25",title:"4. Main abnormalities observed as post-transfer consequences of bovine in vitro-produced (IVP) embryos in some breeds of cattle",level:"1"},{id:"sec_25_2",title:"4.1 Holstein x beef breeds",level:"2"},{id:"sec_27",title:"5. Latching the lacuna",level:"1"},{id:"sec_28",title:"6. Conclusions",level:"1"},{id:"sec_32",title:"Conflict of interest",level:"1"}],chapterReferences:[{id:"B1",body:'Adamson GD, de Mouzon J, Chambers GM, Zegers-Hochschild F., Mansour R, Ishihara O, Banker M, Dyer S. International Committee for Monitoring Assisted Reproductive Technology: world report on assisted reproductive technology, Fertil. Steril. 2011;110:1067-1080. DOI:10.1016/J.FERTNSTERT.2018.06.039'},{id:"B2",body:'Viana JHM, Vargas MSB, Siqueira LGB, Camargo LSA, Figueiredo ACS, Fernandes CAC, Palhao MP. Efficacy of induction of luteolysis in superovulated cows is dependent on time of prostaglandin F2alpha analog treatment: effects on plasma progesterone and luteinizing hormone profiles. 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Science. 1998;282:2095-2098'},{id:"B76",body:'Hammer RE, Pursel VG, Rexroad CEJr, Wall RJ, Bolt DJ, Ebert KM, Palmiter RD, Brinster RL. Production of transgenic rabbits, sheep and pigs by microinjection. Nature. 1985;315:680-683'},{id:"B77",body:'Carlson DF, Lancto CA. Production of hornless dairy cattle from genome-edited cell lines. Nature Biotechnology. 2016;34:479-482'},{id:"B78",body:'Laible G. Production of transgenic livestock: overview of transgenic technologies. In: Niemann, H., Wrenzycki, C. (eds.) Animal Biotechnology 2. Springer, Cham; 2018'},{id:"B79",body:'Wu H, Wang Y, Zhang Y, Yang M, Lv J, Liu J, Zhang Y. TALE nickase-mediated SP110 knockin endows cattle with increased resistance to tuberculosis. Proceedings of the National Academy of Sciences of the USA, 112:E1530-E1539; 2015'},{id:"B80",body:'Van Eenennaam AL. Genetic modification of food animals. Current Opinion in Biotechnology. 2017; 44:27-34'},{id:"B81",body:'Waltz E. 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1. Introduction
Xerostomia or dry mouth sensation is considered a complex condition that affects several stomatological functions and drives to the detriment of the quality of life of individuals who suffer from it. Often, xerostomia is accompanied by a decrease in salivary flow or hyposalivation with consequences such as oral lesions, alterations of taste, feeling of thick saliva, chewing problems, dental caries, dental demineralization, periodontal disease, salivary gland infection, cervical caries, fungal infections, and others [1]. Currently, the diagnosis and therapeutic methods for this condition are varied and it is difficult to achieve favorable results in all cases, since the etiology seems to be multifactorial where both local and systemic factors would participate [2, 3, 4, 5]. Although xerostomia may occur frequently in the general population, clear and defined tools for diagnosis and treatment are still needed. Today, patients suffering from xerostomia visit numerous health professionals to solve this complex condition that limits many functions of day-to-day life, and often does not find response or effective treatment. Regards the complexity of xerostomia and its importance in dental practice, this chapter reviews the relevant data about etiology, diagnosis, consequences, and the current available treatments to this condition.
2. Definition and evaluation
Xerostomia (dry mouth, oral dryness, and mouth dryness) is the dryness of oral cavity and can be caused by lower salivary flow or the complete lack of saliva [6]. Based on the etiology, the xerostomia can be classified as true xerostomia (xerostomia vera, primaria), caused by the malfunction of the salivary glands and pseudo xerostomia or symptomatic xerostomia (xerostomia spuria, symptomatica), which is described as the subjective sensation of oral dryness, despite normal secretory function of the salivary glands [7]. The xerostomia, as a symptom, is more common in older populations, but its causes are not related to aging. It has been shown it is related to some specific diseases, drugs, or therapies associated [8]. The prevalence of xerostomia varies from 13 to 28% in older populations, and increases up to 60% in patients living in long-term care facilities [9, 10, 11].
Xerostomia, although not considered a disease, may imply the presence of changes directly related to the salivary glands or be the result of systemic diseases [12]. In order for a suitable treatment to be instituted in a timely manner, it is important to carry out a thorough evaluation of the patient with the dry mouth condition, determining, if possible, the cause of the xerostomia. The patients with xerostomia, who are present with salivary gland hypofunction, are at risk of many oral complications; the persistence over time of low rates of salivary secretion causes changes in the oral environment and affects the hard and soft tissues of the mouth. Xerostomia can also be a consequence of systemic disease and its recognition is a valuable aid in the treatment [13]. It is a potentially debilitating condition that can affect up to 1 in 5 oncology patients, with higher prevalence in women and the elderly. There is evidence that the use of multiple medications may increase the risk of xerostomia [13]. This symptom represents a strong impact on the quality of life of the people affected. Over 87.6% of people with xerostomia were worried if they had to spend the rest of their lives with the dry mouth sensation [14]. The dry mouth (xerostomia) sensation has a higher incidence on individuals over 60 years old (12–40%), up to three times higher than on younger adults. It does not seem to be directly related to the normal aging process, but to some chronic diseases or treatments [15, 16]. It is estimated that about 20–30% of the 20-year-old population has xerostomia and the cause may be the increased use of antidepressants, since xerostomia is associated with depression and anxiety. In United States, up to 40% of the 20-year-old population may have xerostomia. The high consumption of antidepressants and other medications, as well as alcoholic beverages and tobacco may explain the increase in people with this condition [17].
Although xerostomia, as a symptom, entails many problems for patients who suffer from it, especially in relation to their quality of life, the decrease in the amount of saliva due to its multiple properties is what brings more consequences at the oral level. Saliva is composed of 99% water and electrolytes. The rest of the composition is organic and includes immunoglobulins, digestive enzymes such as amylase and lipase, and antibacterial and antifungal enzymes, as well as mucins [14]. Ninety-three percent of its volume is secreted by the major salivary glands and the remaining 7% by the minor glands. Saliva production is controlled by the autonomous nervous system, mainly by parasympathetic nerve signals [18]. Saliva is very important for the preservation of general and oral homeostasis. It has a participation in digestives functions, cleaning, sense of taste, oral mucosa hydration, and defense of teeth trough pH control and its remineralizing potential. In addition, it has antimicrobial properties and controls the composition of oral microbiota by its antibacterial, antiviral, and antifungal capacities [14]. A summary of the Saliva components and functions can be seen in Table 1.
Several short and long-term conditions can interrupt salivary secretion, leading to xerostomia. Xerostomia can thus result from three basic causes:
Factors affecting the salivary center: psychological problems (stress and anxiety), Parkinson’s disease, Alzheimer’s disease (changes in the ability to perceive oral sensations), menopause, and others;
Factors that alter nerve stimulation of saliva: encephalitis, brain tumors, smoking and dehydration (resulting from the deficiency of water intake, vomiting, diarrhea and polyuria), as well as the use of some drugs, including antihistamines, opioids, antidepressants, antiepileptics, anxiolytics, anticholinergics, antimuscarinics, and others;
Alterations in salivary gland function as a consequence of obstruction, infection (sialodenitis), glandular tumors, calculi (sialolithiasis), autoimmune diseases (Sjögren’s syndrome-SS-, rheumatoid arthritis, uncontrolled diabetes mellitus and systemic lupus erythematosus), and chemotherapy or radiotherapy performed as cancer therapy for the head and neck area. The extent of injury induced by radiotherapy depends on the volume of irradiated glands and the total dose and technique used [15, 19, 20, 21, 22, 23].
3. Diagnosis of xerostomia
The objective of the diagnosis is to provide treatment as early as possible, thus minimizing side effects in patients suffering from xerostomia. In order to establish a diagnosis of xerostomia, a clinical history is essential to identify the possible etiological factors [24]. It is necessary to investigate its causes. Thus, three orders of factors need to be known: the occurrence of systemic diseases, medication, and the history of radiation therapy. Questions are asked to the patient, trying to find out if he feels the dry mouth sensation, whether he needs to wet his mouth, if he can eat a wafer without drinking water, if the tongue chews the food and clings to the teeth, and the daily water intake daily among other issues [24, 25]. The qualitative clinical diagnosis of xerostomia is made through the observation of clinical signs such as palpation of the salivary glands, observation of the oral mucosa and its hydration, cracked lips, saliva under the tongue, appearance and texture of saliva, the identification of caries, candidiasis and burning sensation, and others [26].
Several methods have been developed to evaluate the level of dryness of the mouth, the discomfort being the most used: sialography, sialochemistry, sialometry and scintigraphy, salivary gland biopsy, ultrasound, magnetic resonance, and computed tomography [19]. Sialography is a technique of imaging that involves the injection of a retrograde form of radiopaque material into the salivary duct system in order to define the anatomy of the glands. This test is very important to demonstrate the presence of nodules or sialectasis, but it has its disadvantages, such as: the difficulty of the technique, since it is invasive and the patient can react acutely or chronically with the contrast material. The biopsy of the major or minor salivary glands allows the detection of inflammatory infiltrations, acinar destruction and dilation of salivary channels with thick mucus, and sometimes fibrosis [27]. Ultrasound, magnetic resonance, and computed tomography are tests that may also contribute to the diagnosis of diseases of the salivary glands.
To establish the condition of the symptom or to evaluate a possible salivary glandular dysfunction, the most used mechanisms are the questionnaire of xerostomia developed by Fox et al. [11, 28] and the determination of salivary flow rate. Sialometry and scintigraphy (an imaging diagnostic method of nuclear medicine that allows the study of the physiology of the various organs) are complementary tests that must be performed in order to evaluate the involvement of the salivary glands in patients with xerostomia. Sialometry is a relatively common procedure in normal clinical practice and include determination of stimulated salivary flow rate (s-SFR), unstimulated salivary flow rate (u-SFR), palatal secretion (PAL), and parotid secretion (PAR). These measurements are the simplest methods of evaluating the salivary glandular function. It is essential to measure the salivary flow, that is, the amount of saliva produced per unit of time. Very low unstimulated and stimulated salivary flow rates or hyposalivation are defined as <0.1 and <0.7 mL/min, respectively [7]. At rest, secretion ranges from 0.25 to 0.35 mL/min and is mostly produced by the submandibular and sublingual glands [29]. Under stimulation, the parotids account for 50% of salivary volume [30]. Determining the stimulated and unstimulated salivary flow is a procedure to measure the amount of saliva it produces a person at a given time. Generally, the stimulated salivary flow is measured for 5 min and unstimulated salivary flow is measured for 15 min [31]. This kind of measuring has the advantage of being easily implemented, low-cost, and could be available to most of the population at risk [32]. The diagnosis of salivary gland dysfunction is based on data derived from the symptoms reported by the patient, clinical examination leading to verification of the clinical signs and determination of stimulated salivary flow [33]. A severe decrease in salivary flow may lead to a poor health-related quality of life, as well as a risk condition for the development of oral pathologies such as periodontal disease, caries, and candidiasis [29, 34, 35].
4. Causes of xerostomia
The most severe conditions with effect on the salivary flow are SS and radiotherapy in the head and neck area, with the prevalence of xerostomia in almost 100% in these cases. These conditions are characterized by a progressive loss of secretory cells, and thus a progressive decline in saliva production [36, 37]. Less severe conditions may be dehydration, smoking, and inflammation or infection of the salivary glands [12]. In older people, the most common cause of xerostomia is the use of medications because the vast majority of the elderly are being treated with at least one drug that causes salivary hypofunction [32]. A summary of the main causes of xerostomia can be seen in Table 2.
Other causes of xerostomia (no drugs or systemic diseases)
Radiotherapy and chemotherapy, infections, inflammation, tumors and sialolithiasis in salivary glands, salivary gland excision, vitamin A deficiency, menopause, stress, anxiety, dehydration, neurological disorders, senility, oral sensory dysfunction, iron deficiency, folic acid deficiency, uremia, polyuria, diarrhea, mouth breathing, bone marrow transplantation, endocrine disorders, pancreatic insufficiency
Table 2.
Systemic diseases and other causes of xerostomia.
4.1. Aging
The reduced salivary flow is commonly seen in the aging populations. This can be attributed to either age-related localized degeneration of salivary glands or systemic diseases [38, 39]. As the patient ages, the organs atrophy and often result in a decrease in salivary production. It was described that in older people the loss was about 30% of acinar cells, with substitution of secretory components by fibrous and adipose tissue [40]. Besides, there are changes in salivary levels of potassium, sodium, IgA, proline-rich protein, lactoferrin, and lysozyme in elderly [28, 40]. A reduction in salivary flow of older people was identified, even in those not using systemic drugs, suggesting a relation between salivary dysfunction and aging [41]. Smith determined that a stimulated salivary flow in healthy adults older than age 70 is lower than in adults under 50 [42].
4.2. Drugs
The most common cause of xerostomia is the use of some systemic medications [43]. Several drugs are able to induce hyposalivation and xerostomia, but they rarely cause irreversible damage to the salivary glands. Over 400 medicines, many of them in common use, induce salivary gland hypofunction [44]. Some examples are: anxiolytics, anticonvulsants, antidepressants, antiemetics, antihistamines, antiparkinsonian, antipsychotics, bronchodilators, decongestants, diuretics, muscle relaxants, analgesics, sedatives and anti-hypertensives, and others (Table 3) [29]. The exact mechanisms whereby some drugs determine xerostomia or hyposalivation are still unknown. Salivary dysfunction associated to drugs may occur through anticholinergic, cytotoxic action, sympathomimetic, or by damaged ion transport pathways in the acinar cells [39, 45, 46]. Patients who consume a higher number of daily medications have been associated with complaints of xerostomia [47, 48]. The therapeutic and controlled doses of medications do not damage the salivary gland structure. For that reason, drug-induced xerostomia is reversible. The discontinued use of these drugs can restore salivary flow [49].
Medicine group
Examples
Anxiolytics
Lorazepam, diazepam
Anorectic
Fenfluramine
Anticonvulsants
Gabapentin
Antidepressants—tricyclic
Amitriptyline, imipramine
Antidepressants—SSRI
Sertraline, fluoxetine
Antiemetics
Meclizine
Antihistaminics
Loratadine
Antiparkinsonian
Biperidene, selegiline
Antipsychotics
Clozapine, chlorpromazine
Bronchodilators
Ipratropium, albuterol
Decongestants
Pseudoephedrine
Diuretics
Spironolactone, furosemide
Muscle relaxants
Baclofen
Narcotic analgesics
Meperidine, morphine
Sedatives
Flurazepam
Antihyperptensive
Prazosin hydrochloride
Antiarthritic
Piroxicam
Table 3.
Medicines and drugs with side effects on salivary secretion.
4.3. Systemic conditions
Xerostomia or hyposalivation may be caused by local factors, including salivary gland disease (sialadenitis) or salivary gland destruction associated with head and neck irradiation for the treatment of cancer [11, 50]. The effects of radiation are dose, time, and field dependent. When the damage of salivary glands by radiation happens is severe [39] permanent gland damage can be expected if the radiation exposure exceeds 50 Gy [50, 51]. Other systemic conditions that also affect the salivary flow are autoimmune diseases (SS, rheumatoid arthritis, AIDS, systemic lupus erythematosis, and scleroderma), neurological disorders (Parkinson’s), psychogenic illness such as depression and hormonal disorders (thyroid dysfunction and diabetes mellitus) [9]. Regarding diabetes, we will refer more deeply about it since it is the most frequent metabolic disease in the world and the trend demonstrates that it continues to grow. Both diabetes mellitus (DM) type 1, as type 2 have been associated with xerostomia. In diabetic subjects were shown that salivary flow was significantly lower than in nondiabetic subjects [49]. The causes of low salivary flow may be due to direct injury in the gland parenchyma, changes in the microcirculation to the salivary glands, glycemic control disorders, and dehydration. Some studies consider that this decrease in salivary flow in diabetic subjects is related to an increased diuresis or polyuria, involving a decrease in extracellular fluid and consequently in saliva production [10]. Others explain this as a consequence of dehydration from glycosuria that would be more evident in cases of metabolic decompensation [52]. Regarding neurological diseases, studies have demonstrated that the salivary flow is lower in Parkinson’s disease patients. This phenomenon could contribute to dysphagia, which affects up to 75% of patients with this disease [53]. Autonomic dysfunction could explain the decrease in salivary flow in subjects with this disease and the drugs used to their treatment could increase the problem [54]. One of the diseases most associated with a xerostomia is SS, a condition that involves dry mouth and dry eyes and that may be accompanied by rheumatoid arthritis or a related connective tissue disease. The oral manifestations observed in this disease are attributed to the involvement of the salivary glands, which leads to a decrease in salivary secretion [31, 39]. Patients with depression can have hyposalivation medication-induced. However, xerostomia may be of psychological origin. A study observed that subjects with a subjective sensation of dry mouth were significantly more depressive than non-depressive subjects [55]. Another study indicates the possibility of depression as an underlying factor of the sensation of dry mouth [56].
5. Consequences of xerostomia
Patients with xerostomia may have oral and dental consequences. Xerostomia can seriously impact quality of life and may alter speech, eating, and swallowing [13]. The most common complaints of patients with xerostomia include oral discomfort, difficulty speaking, dysphagia, dysgeusia (decreased taste), feeling of thick saliva, and generally, chewing issues, dental caries, dental demineralization, periodontal disease, salivary gland infection (sialodenitis), oral microflora alterations, burning sensation, mucosal inflammation, sore throats, hoarseness, ulcerations, halitosis, mucosal dehydration, reduced lubrication, painful tongue (glossodynia), enlarged parotid gland, oral mucosal fracture, inflammation and fissures of the lips (cheilitis). The reduction of rates of elimination of substances can affect the palate and be associated with changes in the mouth microbiota. The reduction of rates of elimination of substances can affect the palate and be associated with changes in the mouth microbiota. From the mouth, alterations of taste and intolerance to acidic or spicy foods, dry foodstuffs like biscuits can be very uncomfortable for them, and oral cavity examination may exhibit signs such as fissures on the tongue and lips, angular cheilitis, and dry mucosa. Also, caries, candidiasis, halitosis, or loss of appetite and weight could be observed [25, 57, 58]. This collection of clinical parameters has been indicated as simply estimated for recognizing most patients with xerostomia [38, 47].
The side effects associated with xerostomia are microbial colonization and proliferation in the oral cavity, dental or decreased demineralization, accumulation of stones in the teeth, dehydration of the mucosa, reduction of rates of elimination of substances from the mouth and lubrication of the oral mucosa reduced [13]. When the production of saliva decreases, the buffering capacity of the saliva is reduced, and thus the environment of the oral cavity is vulnerable to acidification, which in addition to determining changes in the normal flora (ecological imbalance) has contributed to the increase in the number of some microorganisms such as Candida albicans (a salivary flow less than 0.1 mL/min may cause an increase in the incidence of this fungus) and Streptococcus mutans (Gram-negative bacteria). A higher proportion of these microorganisms results in greater acidification of the oral cavity environment, and thus contribute to the enamel demineralization and caries progression. There is a study related to it in which subjects with low salivary flow rate also had significantly more dental caries compared to those with a higher saliva flow rate [58]. In addition, high caries prevalence has been reported to be associated with significantly poorer quality of life compared to low caries prevalence [13].
The infection of the oral mucosa with C. albicans affects the lubrication of oral tissues, favoring an increase in the risk of caries and severity of periodontal disease. Candidiasis can also cause burning sensation, glossodynia, glossitis, and angular cheilitis (in areas where the lips are dry or cracked). Patients with prostheses may have reduced retention of the prostheses, pain, and ulcers [59]. The prevalence of oral Candida in the normal population has been estimated to range from 23 to 68% and 68 to 100% among SS patients. Studies have attributed the higher prevalence of oral Candida carriage in this disease to xerostomia [60].
6. Treatments
Treatment design to alleviate dry-mouth symptoms should be personalized to the individual patient, based on available treatment. The treatments of xerostomia can be classified into the following categories: (1) patient education, (2) prevention, (3) symptomatic treatment, (4) systemic and topical salivary stimulants, and (5) regenerative and gene therapies.
6.1. Patient education
Patients should receive detailed information about the potential causes of dry mouth and the potential sequelae of impaired salivary secretion, such as dental caries, candidiasis, and mucosal complications. Therefore, patients should be encouraged to have preventive oral health care such as dental hygiene habits and regular dental visits [61]. Another palliative action to minimizing symptoms and preventing oral complications is water intake, drinking water frequently, and remaining hydrated is an important treatment for symptoms of dry mouth [1].
6.2. Preventive therapies
Pharmacological interventions for the prevention of radiation-induced salivary gland dysfunction have been studied. The use of chemical radioprotectors represents an obvious strategy to improve the therapeutic index in radiotherapy. However, the vast majority of these are either too weak in terms of radioprotection, too toxic, or without any apparent mechanisms to ensure selective normal tissue protection [62]. The sulfhydryl compound amifostine (WR-2721; 2-[(3-aminopropyl) amino] ethylphosphorothioic acid), is an oxygen scavenger that may protect salivary glands from free-radical damage during radiation therapy without attenuation of the anti-tumor effects in many experiments performed [63]. Amifostine has been approved for prevention of xerostomia, in head and neck squamous cell carcinoma patients undergoing radiotherapy [64]. A recent systematic review that included randomized controlled trials suggested that the drug amifostine prevents the feeling of dry mouth in people receiving radiotherapy to head and neck (with or without chemotherapy) in the short- (end of radiotherapy) to medium-term (3 months after radiotherapy) [65]. However, amifostine has adverse effects such as nausea, vomiting, hypotension, transient, hypocalcemia, and allergic reactions [66]. Then, the benefits of amifostine should be weighed against its high cost and side effects. Another cytoprotective compound described in literature is the bioactive factor Keratinocyte growth factor-1 (KGF-1, also known as FGF-7) [67]. In a phase II Study, recombinant KGF (Palifermin) appeared to reduce mucositis, dysphagia, and xerostomia during hyperfractionated radiotherapy but not standard radiation therapy [68].
Current preventative therapies also include surgical salivary glands relocation outside the radiation field [69]. Jha et al. described a surgical transfer of a submandibular salivary gland to the submental space in order to prevent radiation-induced xerostomia in patients with neoplasias of the pharynx and larynx [70].
6.3. Symptomatic treatment
Saliva substitutes can provide some relief since provide higher viscosity and protection to the oral mucosa [39]. An ideal saliva substitute must simulate natural human saliva, providing long lasting and intense hydration of the oral mucosa, be inexpensive, edible, easy-to-swallow but retainable in the mouth and should allow a minimal number of applications [71]. Saliva substitutes are available in various formulations, e.g., lozenges, sprays, mouth rinses, gels, oils, chewing gums, or toothpastes. Most available in the market contain carboxymethylcellulose (CMC), mucins, xanthan gum, hydroxyethylcellulose, linseed oil, or polyethylene oxide [72]. Subjective impressions of patients suffering from severe xerostomia showed that artificial saliva containing mucins and xanthan gum are better in their rheological and moisturizing properties than those with CMC [73], because mucin-based substitutes had viscosities that were more similar to natural saliva. Recently, it was reported that a polysaccharide-based oral rinse was effective in symptom control in patients with xerostomia and may lead to an increase in saliva production [74]. Other studies include the use of natural products, in this line, a recent double-blinded, placebo-controlled clinical trial, evaluated the efficacy of topical lycopene-enriched virgin olive oil. It showed an improvement of oral quality of life and reduction of xerostomia symptoms [75]. Also, gelatinous substitutes of saliva showed a significant reduction of the dryness-related complaints in patients suffering from severe xerostomia [76]. A randomized, double-blind, crossover study in patients affected by medication-induced xerostomia showed that two commercial mouthwash plus gel (GUM® Hydral versus Biotène® Oralbalance) achieve a significant improvement in oral health and xerostomia-related quality of life [77]. Recently, a novel edible saliva substitute, oral moisturizing jelly (OMJ), showed a higher grade of satisfaction than a commercially available saliva gel [78]. In addition to the persistent feeling of dry mouth, people who suffer from xerostomia are very susceptible to bacterial, fungal, and other transmittable mouth infections. It is important that products also include human saliva’s enzymes (lactoperoxidase, lysozyme, and lactoferrin). Other important feature is to obtain a continuous oral lubrication. In this context, advances in hydrogel technologies and development of buccal mucoadhesive polymers, allows the continuous release of substances that maintain oral hydration and also offer dental-care benefits for its use in treatment of xerostomia [79]. Other strategy involves the use of modified prosthetic structure designed to retain saliva or substitutes in patients who usually wear a dental prosthesis [4, 80].
6.4. Systemic and topical salivary stimulants
Pilocarpine and cevimeline are two systemic US Food and Drug Administration-approved systemic sialogogues for treatment of dry mouth; both can increase secretions and diminish xerostomic complaints in patients, although they must have functional salivary gland cells. Pilocarpine is a cholinergic parasympathomimetic agent that stimulates muscarinic cholinergic receptors on the surfaces of exocrine glands [81] and has been indicated for the treatment of xerostomia [2, 82]. The usual oral dosage for pilocarpine is 5–10 mg three times per day. The initial recommended dose is 5 mg three times per day oral route (OR), which can be increased up to 30 mg/day depending on response and tolerance. The onset of action is 30 min, and the duration of action is approximately 2–3 h. Common side effects include gastrointestinal upset, sweating, tachycardia, bradycardia, increased pulmonary secretions, increased smooth muscle tone, and blurred vision. Contraindications include gall bladder disease, angle closure glaucoma, and renal colic [39, 83]. Cevimeline is a salivary gland stimulant with a stronger affinity for M3 muscarinic receptors [84]. Since it has no effect on M2 receptors, it shows fewer adverse effects when compared to pilocarpine, and besides, it has a long lasting action. The recommended dose is 30 mg three times a day OR, and the most common associated side effect is dyspepsia. Bethanecol is another drug whose action mechanism is on M3 receptors. It has been used to decrease unwanted effects caused by antidepressant and antipsychotic drugs [85]. The dose indicated is four times a day in doses from 10 to 50 mg OR. Adverse effects, despite being infrequent, include nausea and diarrhea. Other drugs that have been put forward include drug with mucolytic properties such us bromhexine improved salivary secretion in patients with SS [86, 87]. Nizatidine, an H2 receptor antagonist alone or in combination with cisapride, showed a significant increase in salivary secretions of dry mouth patients [88, 89]. In addition, other drugs, such as neostigmine, distigmine, yohimbine, nicotinic, and malic acid have also been attributed positive effects in the treatment of xerostomia [3]. Medicinal herbs, such as jaborandi, betel nut, Iceland Moss and Longo Vital, also can stimulate salivary secretion [4].
In the case of tissue autoimmune-related xerostomia, immunologic agents have been used. Interferon alpha (IFN-α), a protein with antiviral and immunomodulating traits, was an effective treatment for xerostomia linked to SS, improved salivary output and decreased complaints of xerostomia without causing significant adverse medical events [7, 90]. Rituximab (anti-CD20 monoclonal antibody) and infliximab (anti-tumoral necrosis factor—TNF—monoclonal antibody) improved subjective and objective symptoms related to primary SS [91].
Topical salivary stimulants includes sugar-free chewing gum and jellybeans, they can increase salivary secretion by mechanical stimulation and improve the sensation of dry mouth. These products usually contain fluoride, chlorhexidine, calcium phosphate, and xylitol releasers [92, 93], which inhibits the growth of cariogenic bacteria and reduces the incidence of caries [94]. Direct stimulation with electrostimulating device mounted on an intra-oral removable appliance has been used in patients with salivary dysfunction with good results and no significant side-effects [95, 96]. Moreover, non-invasive electrical stimulation systems such as transcutaneous electrical nerve stimulation (TENS) was highly effective in stimulating whole salivary flow in patients with xerostomia and hyposalivation caused by DM and postmenopausal condition [97, 98]. Acupuncture as a method of xerostomia treatment is also cited, a recent randomized and controlled pilot trial of acupuncture showed that acupuncture has beneficial effects on SS symptoms [99]. Other pilot study showed a preliminary evidence that auricular acupressure therapy may be effective in reducing xerostomia intensity in maintenance hemodialysis patients [100].
6.5. Glandular regeneration and gene therapy
Stem cell replacement therapy may be a good option to treat radiation-induced hyposalivation. Stem cell therapy attempts the repair of damaged salivary glands at the cellular level. In this regard, bone marrow stem cells, adipose tissue-derived stromal cells, dental pulp cells have been tested as a form of treatment for hyposalivation after radiotherapy [39]. Interestingly, human salivary stem/progenitor cells (hSSPCs) (derived from parotid and submandibular glands) can be cultured using the salisphere technique and can be introduced to a damaged salivary gland tissue to replace dead or damaged cells. In this context, Pringle et al. showed the presence of SSPCs in cultured human salipheres [101]. These cells were capable of self-renewal and differentiation, which when transplanted into irradiated recipients and restored glandular function. Considering that an ultimate goal is to develop fully functioning bioengineered organs to replace lost or damaged. It was recently reported that a population of SSPCs can be reliably isolated and expanded in sufficient number, suitable for use in a unique 3D hydrogel model of a human implantable salivary gland [102]. However, independent and collaborative work in stem cells research and tissue engineering is still necessary to have fully functional human salivary glands.
Gene therapy involves injecting a vector with genetic information into a tissue to result in some beneficial change. Originally, gene transfer was considered for use in treating congenital genetic disorders, but the basic principles have now been applied virtually to every organ, for acquired as well as inherited disorders. Regarding salivary glands, Baum et al., in phase I/II study, showed an increased saliva flow rate from the targeted parotid gland, as well as a reduction in symptoms related to the radiation-induced xerostomia in subjects treated with the transferring of cDNA for human aquaporin-1 (hAQP1) through an adenoviral (Ad5) vector (AdhAQP1) [103]. Additionally, others genes (Gli1, human keratinocyte growth factor, and Tousled like kinase 1B) have been targeted and have shown promise in preventing salivary hypofunction in a preclinical mouse [104, 105]. On the other hand, the use of small-interfering RNA (siRNA)-based gene silencing has provided protection of salivary gland from radiation-induced apoptosis at preclinical level [106].
7. Conclusion
Patients with xerostomia are often a challenge regarding diagnosis and treatment, because although xerostomia is not considered a disease, it has a potential devastating effect on the oral cavity. Since dentists are generally challenged with this problem, it is important to have an appropriate comprehension of diverse causes of xerostomia to develop a systematic approach that includes collaboration with physicians to facilitate interdisciplinary patient care, which involves its systemic conditions and medication. Furthermore, a comprehensive management of xerostomia is also necessary and it should incorporate patient education, lifestyle modifications, and adequate pharmacological and non-pharmacological therapies to improve the patient’s quality of life. Since most of the successful therapies are depending on the parenchymal gland affection, it is essential to know new therapeutic approaches to fully recover in vivo the gland’s function or to develop new bioengineered salivary tissues.
Acknowledgments
This work was supported by Faculty of Dentistry, University of Chile.
\n',keywords:"xerostomia, etiology, diagnosis, clinical manifestation, treatments",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/58591.pdf",chapterXML:"https://mts.intechopen.com/source/xml/58591.xml",downloadPdfUrl:"/chapter/pdf-download/58591",previewPdfUrl:"/chapter/pdf-preview/58591",totalDownloads:2208,totalViews:996,totalCrossrefCites:3,dateSubmitted:"May 10th 2017",dateReviewed:"November 8th 2017",datePrePublished:"November 5th 2018",datePublished:"January 30th 2019",dateFinished:"January 4th 2018",readingETA:"0",abstract:"Xerostomia or dry mouth sensation is considered a complex condition that affects several stomatological functions that drives to the detriment of the quality of life of individuals who suffer from it. Often, xerostomia is accompanied by a decrease in salivary flow or hyposalivation, and this condition leads to oral health problems such as dental caries, candidiasis, and mucosal complications. Currently, the diagnosis and therapeutic methods for this condition are varied and it is difficult to achieve favorable results in all cases, since the etiology seems to be multifactorial where both local factors and systemic conditions would participate. This chapter presents, in a concise shape, the relevant data about etiology of xerostomia, such as age, autoimmune diseases, systemic diseases, infectious diseases, neuropathic complications, psychogenic factors and therapeutically consumption of drugs among others, and the current available treatments.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/58591",risUrl:"/chapter/ris/58591",signatures:"Alejandro Escobar and Juan P. Aitken-Saavedra",book:{id:"6246",type:"book",title:"Salivary Glands",subtitle:"New Approaches in Diagnostics and Treatment",fullTitle:"Salivary Glands - New Approaches in Diagnostics and Treatment",slug:"salivary-glands-new-approaches-in-diagnostics-and-treatment",publishedDate:"January 30th 2019",bookSignature:"Işıl Adadan Güvenç",coverURL:"https://cdn.intechopen.com/books/images_new/6246.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",isbn:"978-1-78984-989-9",printIsbn:"978-1-78984-988-2",pdfIsbn:"978-1-83881-358-1",isAvailableForWebshopOrdering:!0,editors:[{id:"36790",title:"M.D.",name:"Işıl",middleName:null,surname:"Adadan Güvenç",slug:"isil-adadan-guvenc",fullName:"Işıl Adadan Güvenç"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:null,sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Definition and evaluation",level:"1"},{id:"sec_3",title:"3. Diagnosis of xerostomia",level:"1"},{id:"sec_4",title:"4. Causes of xerostomia",level:"1"},{id:"sec_4_2",title:"4.1. Aging",level:"2"},{id:"sec_5_2",title:"4.2. Drugs",level:"2"},{id:"sec_6_2",title:"4.3. Systemic conditions",level:"2"},{id:"sec_8",title:"5. Consequences of xerostomia",level:"1"},{id:"sec_9",title:"6. Treatments",level:"1"},{id:"sec_9_2",title:"6.1. Patient education",level:"2"},{id:"sec_10_2",title:"6.2. Preventive therapies",level:"2"},{id:"sec_11_2",title:"6.3. Symptomatic treatment",level:"2"},{id:"sec_12_2",title:"6.4. Systemic and topical salivary stimulants",level:"2"},{id:"sec_13_2",title:"6.5. Glandular regeneration and gene therapy",level:"2"},{id:"sec_15",title:"7. Conclusion",level:"1"},{id:"sec_16",title:"Acknowledgments",level:"1"}],chapterReferences:[{id:"B1",body:'Atkinson JC, Grisius M, Massey W. Salivary hypofunction and xerostomia: Diagnosis and treatment. Dental Clinics of North America. 2005;49:309-326. 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Caries Research. 2004;38:241-246. DOI: 10.1159/000077761'},{id:"B93",body:'Itthagarun A, Wei SH. Chewing gum and saliva in oral health. The Journal of Clinical Dentistry. 1997;8:159-162'},{id:"B94",body:'Van Loveren C. Sugar alcohols: What is the evidence for caries-preventive and caries-therapeutic effects? Caries Research. 2004;38:286-293. DOI: 10.1159/000077768'},{id:"B95",body:'Alajbeg I, Falcao DP, Tran SD, Martin-Granizo R, Lafaurie GI, Matranga D, Pejda S, Vuletic L, Mantilla R, Leal SC, Bezerra AC, Menard HA, Kimoto S, Pan S, Maniegas L, Krushinski CA, Melilli D, Campisi G, Paderni C, Mendoza GR, Yepes JF, Lindh L, Koray M, Mumcu G, Elad S, Zeevi I, Barrios BC, Lopez Sanchez RM, Lassauzay C, Fromentin O, Beiski BZ, Strietzel FP, Konttinen YT, Wolff A, Zunt SL. Intraoral electrostimulator for xerostomia relief: A long-term, multicenter, open-label, uncontrolled, clinical trial. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology. 2012;113:773-781. DOI: 10.1016/j.oooo.2012.01.012'},{id:"B96",body:'Strietzel FP, Lafaurie GI, Mendoza GR, Alajbeg I, Pejda S, Vuletic L, Mantilla R, Falcao DP, Leal SC, Bezerra AC, Tran SD, Menard HA, Kimoto S, Pan S, Martin-Granizo RA, Lozano ML, Zunt SL, Krushinski CA, Melilli D, Campisi G, Paderni C, Dolce S, Yepes JF, Lindh L, Koray M, Mumcu G, Elad S, Zeevi I, Barrios BC, Lopez Sanchez RM, Beiski BZ, Wolff A, Konttinen YT. Efficacy and safety of an intraoral electrostimulation device for xerostomia relief: A multicenter, randomized trial. Arthritis and Rheumatism. 2011;63:180-190. DOI: 10.1002/art.27766'},{id:"B97",body:'Dyasnoor S, Kamath S, Khader NFA. Effectiveness of electrostimulation on whole salivary flow among patients with type 2 diabetes mellitus. The Permanente Journal. 2017;21:15-164. DOI: 10.7812/TPP/15-164'},{id:"B98",body:'Konidena A, Sharma D, Puri G, Dixit A, Jatti D, Gupta R. Effect of TENS on stimulation of saliva in postmenopausal women with or without oral dryness—An interventional study. Journal of Oral Biology and Craniofacial Research. 2016;6:S44-S50. DOI: 10.1016/j.jobcr.2016.01.004'},{id:"B99",body:'Jiang Q, Zhang H, Pang R, Chen J, Liu Z, Zhou X. Acupuncture for primary Sjogren syndrome (pSS) on symptomatic improvements: Study protocol for a randomized controlled trial. BMC Complementary and Alternative Medicine. 2017;17:61. DOI: 10.1186/s12906-017-1559-9'},{id:"B100",body:'Yang G, Lin S, Wu Y, Zhang S, Wu X, Liu X, Zou C, Lin Q. Auricular acupressure helps alleviate xerostomia in maintenance hemodialysis patients: A pilot study. Journal of Alternative and Complementary Medicine. 2017;23:278-284. DOI: 10.1089/acm.2016.0283'},{id:"B101",body:'Pringle S, Maimets M, van der Zwaag M, Stokman MA, van Gosliga D, Zwart E, Witjes MJ, de Haan G, van Os R, Coppes RP. Human salivary gland stem cells functionally restore radiation damaged salivary glands. Stem Cells. 2016;34:640-652. DOI: 10.1002/stem.2278'},{id:"B102",body:'Srinivasan PP, Patel VN, Liu S, Harrington DA, Hoffman MP, Jia X, Witt RL, Farach-Carson MC, Pradhan-Bhatt S. Primary salivary human stem/progenitor cells undergo microenvironment-driven Acinar-like differentiation in hyaluronate hydrogel culture. Stem Cells Translational Medicine. 2017;6:110-120. DOI: 10.5966/sctm.2016-0083'},{id:"B103",body:'Baum BJ, Alevizos I, Zheng C, Cotrim AP, Liu S, McCullagh L, Goldsmith CM, Burbelo PD, Citrin DE, Mitchell JB, Nottingham LK, Rudy SF, Van Waes C, Whatley MA, Brahim JS, Chiorini JA, Danielides S, Turner RJ, Patronas NJ, Chen CC, Nikolov NP, Illei GG. Early responses to adenoviral-mediated transfer of the aquaporin-1 cDNA for radiation-induced salivary hypofunction. Proceedings of the National Academy of Sciences of the United States of America. 2012;109:19403-19407. DOI: 10.1073/pnas.1210662109'},{id:"B104",body:'Hai B, Qin L, Yang Z, Zhao Q, Shangguan L, Ti X, Zhao Y, Kim S, Rangaraj D, Liu F. Transient activation of hedgehog pathway rescued irradiation-induced hyposalivation by preserving salivary stem/progenitor cells and parasympathetic innervation. Clinical Cancer Research. 2014;20:140-150. DOI: 10.1158/1078-0432.CCR-13-1434'},{id:"B105",body:'Palaniyandi S, Odaka Y, Green W, Abreo F, Caldito G, De Benedetti A, Sunavala-Dossabhoy G. Adenoviral delivery of tousled kinase for the protection of salivary glands against ionizing radiation damage. Gene Therapy. 2011;18:275-282. DOI: 10.1038/gt.2010.142'},{id:"B106",body:'Arany S, Benoit DS, Dewhurst S, Ovitt CE. Nanoparticle-mediated gene silencing confers radioprotection to salivary glands in vivo. Molecular Therapy. 2013;21:1182-1194. DOI: 10.1038/mt.2013.42'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Alejandro Escobar",address:"janodvm@gmail.com",affiliation:'
Institute for Research in Dental Sciences, Faculty of Dentistry, University of Chile, Chile
'},{corresp:null,contributorFullName:"Juan P. Aitken-Saavedra",address:null,affiliation:'
Post Graduate Program in Dentistry, Federal University of Pelotas, Brazil
Department of Oral Pathology and Medicine, Faculty of Dentistry, University of Chile, Chile
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From 1985 to 1986, he was a Research Fellow in the Research Institute for Electronic Equipment, ZZU AD, Plovdiv, Bulgaria. In 1986, he joined the Department of Control Systems, Technical University of Sofia at the Plovdiv campus, where he is presently a Full Professor. He has held long-term visiting Professor/Scholar positions at various institutions in South Korea, Turkey, Mexico, Greece, Belgium, UK, and Germany. And he has coauthored one book and authored or coauthored more than 80 research papers in conference proceedings and journals. 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Aalborg University has Two Satellite Campuses, one in Copenhagen (Aalborg University Copenhagen) and the other in Esbjerg (Aalborg University Esbjerg).\n· He is a member of prestigious IEEE (Institute of Electrical and Electronics Engineers), and IAENG (International Association of Engineers) organizations. \n· He is the chief Editor of the Journal of Software Engineering.\n· He is the member of the Editorial Board of International Journal of Computer Science and Software Technology (IJCSST) and International Journal of Computer Engineering and Information Technology. \n· He is also the Editor of Communication in Computer and Information Science CCIS-20 by Springer.\n· Reviewer For Many Conferences\nHe is the lead person in making collaboration agreements between Aalborg University and many universities of Pakistan, for which the MOU’s (Memorandum of Understanding) have been signed.\nProfessor Akbar is working in Academia since 1990, he started his career as a Lab demonstrator/TA at the University of Sussex. After finishing his P. hD degree in 1992, he served in the Industry as a Scientific Officer and continued his academic career as a visiting scholar for a number of educational institutions. In 1996 he joined National University of Science & Technology Pakistan (NUST) as an Associate Professor; NUST is one of the top few universities in Pakistan. In 1999 he joined an International Company Lineo Inc, Canada as Manager Compiler Group, where he headed the group for developing Compiler Tool Chain and Porting of Operating Systems for the BLACKfin processor. The processor development was a joint venture by Intel and Analog Devices. In 2002 Lineo Inc., was taken over by another company, so he joined Aalborg University Denmark as an Assistant Professor.\nProfessor Akbar has truly a multi-disciplined career and he continued his legacy and making progress in many areas of his interests both in teaching and research. 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We first provide the fundamentals of the technique for both downlink and uplink channels and then discuss optimizing the network capacity under fairness constraints. We further discuss the impacts of imperfect receivers on the performance of NOMA networks. Finally, we discuss the spectral efficiency (SE) of the networks that employ NOMA with its relations with energy efficiency (EE). We demonstrate that the networks with NOMA outperform other multiple access schemes in terms of sum capacity, EE and SE.",book:{id:"5480",slug:"towards-5g-wireless-networks-a-physical-layer-perspective",title:"Towards 5G Wireless Networks",fullTitle:"Towards 5G Wireless Networks - A Physical Layer Perspective"},signatures:"Refik Caglar Kizilirmak",authors:[{id:"188668",title:"Dr.",name:"Refik Caglar",middleName:null,surname:"Kizilirmak",slug:"refik-caglar-kizilirmak",fullName:"Refik Caglar Kizilirmak"}]},{id:"8493",doi:"10.5772/8006",title:"Monitoring Cold Chain Logistics by Means of RFID",slug:"monitoring-cold-chain-logistics-by-means-of-rfid",totalDownloads:8999,totalCrossrefCites:8,totalDimensionsCites:21,abstract:null,book:{id:"3341",slug:"sustainable-radio-frequency-identification-solutions",title:"Sustainable Radio Frequency Identification Solutions",fullTitle:"Sustainable Radio Frequency Identification Solutions"},signatures:"Luis Ruiz-Garcia and Loredana Lunadei",authors:null},{id:"12860",doi:"10.5772/13309",title:"Energy Issues and Energy Aware Routing in Wireless Ad Hoc Networks",slug:"energy-issues-and-energy-aware-routing-in-wireless-ad-hoc-networks",totalDownloads:4568,totalCrossrefCites:14,totalDimensionsCites:19,abstract:null,book:{id:"15",slug:"mobile-ad-hoc-networks-protocol-design",title:"Mobile Ad-Hoc Networks",fullTitle:"Mobile Ad-Hoc Networks: Protocol Design"},signatures:"Marco Fotino and Floriano De Rango",authors:[{id:"3066",title:"Dr.",name:"Floriano",middleName:null,surname:"De Rango",slug:"floriano-de-rango",fullName:"Floriano De Rango"},{id:"14362",title:"PhD.",name:"Marco",middleName:null,surname:"Fotino",slug:"marco-fotino",fullName:"Marco Fotino"}]},{id:"54645",doi:"10.5772/68088",title:"Power‐Over‐Fiber Applications for Telecommunications and for Electric Utilities",slug:"power-over-fiber-applications-for-telecommunications-and-for-electric-utilities",totalDownloads:2563,totalCrossrefCites:11,totalDimensionsCites:19,abstract:"Beyond telecommunications, optical fibers can also transport optical energy to powering electric or electronic devices remotely. This technique is called power over fiber (PoF). Besides the advantages of optical fiber (immunity to electromagnetic interferences and electrical insulation), the employment of a PoF scheme can eliminate the energy supplied by metallic cable and batteries located at remote sites, improving the reliability and the security of the system. Smart grid is a green field where PoF can be applied. Experts see smart grid as the output to a new technological level seeks to incorporate extensively technologies for sensing, monitoring, information technology, and telecommunications for the best performance electrical network. On the other hand, in telecommunications, PoF can be used in applications, such as remote antennas and extenders for passive optical networks (PONs). PoF can make them virtually passives. We reviewed the PoF concept, its main elements, technologies, and applications focusing in access networks and in smart grid developments made by the author’s research group.",book:{id:"5914",slug:"optical-fiber-and-wireless-communications",title:"Optical Fiber and Wireless Communications",fullTitle:"Optical Fiber and Wireless Communications"},signatures:"Joao Batista Rosolem",authors:[{id:"202012",title:"Dr.",name:"Joao",middleName:"Batista",surname:"Batista Rosolem",slug:"joao-batista-rosolem",fullName:"Joao Batista Rosolem"}]},{id:"8502",doi:"10.5772/8015",title:"RFID-based Information System for Patients and Medical Staff Identification and Tracking",slug:"rfid-based-information-system-for-patients-and-medical-staff-identification-and-tracking",totalDownloads:8682,totalCrossrefCites:6,totalDimensionsCites:15,abstract:null,book:{id:"3341",slug:"sustainable-radio-frequency-identification-solutions",title:"Sustainable Radio Frequency Identification Solutions",fullTitle:"Sustainable Radio Frequency Identification Solutions"},signatures:"Tudor Ioan Cerlinca, Cristina Turcu, Cornel Turcu and Marius Cerlinca",authors:null}],mostDownloadedChaptersLast30Days:[{id:"52822",title:"Non-Orthogonal Multiple Access (NOMA) for 5G Networks",slug:"non-orthogonal-multiple-access-noma-for-5g-networks",totalDownloads:14706,totalCrossrefCites:25,totalDimensionsCites:35,abstract:"In this chapter, we explore the concept of non-orthogonal multiple access (NOMA) scheme for the future radio access for 5G. We first provide the fundamentals of the technique for both downlink and uplink channels and then discuss optimizing the network capacity under fairness constraints. We further discuss the impacts of imperfect receivers on the performance of NOMA networks. Finally, we discuss the spectral efficiency (SE) of the networks that employ NOMA with its relations with energy efficiency (EE). We demonstrate that the networks with NOMA outperform other multiple access schemes in terms of sum capacity, EE and SE.",book:{id:"5480",slug:"towards-5g-wireless-networks-a-physical-layer-perspective",title:"Towards 5G Wireless Networks",fullTitle:"Towards 5G Wireless Networks - A Physical Layer Perspective"},signatures:"Refik Caglar Kizilirmak",authors:[{id:"188668",title:"Dr.",name:"Refik Caglar",middleName:null,surname:"Kizilirmak",slug:"refik-caglar-kizilirmak",fullName:"Refik Caglar Kizilirmak"}]},{id:"63215",title:"Smart Antenna Systems Model Simulation Design for 5G Wireless Network Systems",slug:"smart-antenna-systems-model-simulation-design-for-5g-wireless-network-systems",totalDownloads:2253,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"The most recent antenna array technologies such as smart antenna systems (SAS) and massive multiple input multiple output (MIMO) systems are giving a strong increasing impact relative to 5G wireless communication systems due to benefits that they could introduce in terms of performance improvements with respect to omnidirectional antennas. Although a considerable number of theoretical proposals already exist in this field, the most common used network simulators do not implement the latest wireless network standards and, consequently, they do not offer the possibility to emulate scenarios in which SAS or massive MIMO systems are employed. This aspect heavily affects the quality of the network performance analysis with regard to the next generation wireless communication systems. To overcome this issue, it is possible, for example, to extend the default features offered by one of the most used network simulators such as Omnet++ which provides a very complete suite of network protocols and patterns that can be adapted in order to support the latest antenna array systems. The main goal of the present chapter is to illustrate the improvements accomplished in this field allowing to enhance the basic functionalities of the Omnet++ simulator by implementing the most modern antenna array technologies.",book:{id:"6844",slug:"array-pattern-optimization",title:"Array Pattern Optimization",fullTitle:"Array Pattern Optimization"},signatures:"Vincenzo Inzillo, Floriano De Rango, Luigi Zampogna and Alfonso A. Quintana",authors:null},{id:"52919",title:"Waveform Design Considerations for 5G Wireless Networks",slug:"waveform-design-considerations-for-5g-wireless-networks",totalDownloads:3399,totalCrossrefCites:1,totalDimensionsCites:2,abstract:"In this chapter, we first introduce new requirements of 5G wireless network and its differences from past generations. The question “Why do we need new waveforms?” is answered in these respects. In the following sections, time‐frequency (TF) lattice structure, pulse shaping, and multicarrier schemes are discussed in detail. TF lattice structures give information about TF localization of the pulse shape of employed filters. The structures are examined for multicarrier, single‐carrier, time‐division, and frequency‐division multiplexing schemes, comparatively. Dispersion on time and frequency response of these filters may cause interference among symbols and carriers. Thus, effects of different pulse shapes, their corresponding transceiver structures, and trade‐offs are given. Finally, performance evaluations of the selected waveform structures for 5G wireless communication systems are discussed.",book:{id:"5480",slug:"towards-5g-wireless-networks-a-physical-layer-perspective",title:"Towards 5G Wireless Networks",fullTitle:"Towards 5G Wireless Networks - A Physical Layer Perspective"},signatures:"Evren Çatak and Lütfiye Durak‐Ata",authors:[{id:"19414",title:"Prof.",name:"Lutfiye",middleName:null,surname:"Durak-Ata",slug:"lutfiye-durak-ata",fullName:"Lutfiye Durak-Ata"},{id:"189749",title:"M.Sc.",name:"Evren",middleName:null,surname:"Çatak",slug:"evren-catak",fullName:"Evren Çatak"}]},{id:"54645",title:"Power‐Over‐Fiber Applications for Telecommunications and for Electric Utilities",slug:"power-over-fiber-applications-for-telecommunications-and-for-electric-utilities",totalDownloads:2566,totalCrossrefCites:11,totalDimensionsCites:19,abstract:"Beyond telecommunications, optical fibers can also transport optical energy to powering electric or electronic devices remotely. This technique is called power over fiber (PoF). Besides the advantages of optical fiber (immunity to electromagnetic interferences and electrical insulation), the employment of a PoF scheme can eliminate the energy supplied by metallic cable and batteries located at remote sites, improving the reliability and the security of the system. Smart grid is a green field where PoF can be applied. Experts see smart grid as the output to a new technological level seeks to incorporate extensively technologies for sensing, monitoring, information technology, and telecommunications for the best performance electrical network. On the other hand, in telecommunications, PoF can be used in applications, such as remote antennas and extenders for passive optical networks (PONs). PoF can make them virtually passives. We reviewed the PoF concept, its main elements, technologies, and applications focusing in access networks and in smart grid developments made by the author’s research group.",book:{id:"5914",slug:"optical-fiber-and-wireless-communications",title:"Optical Fiber and Wireless Communications",fullTitle:"Optical Fiber and Wireless Communications"},signatures:"Joao Batista Rosolem",authors:[{id:"202012",title:"Dr.",name:"Joao",middleName:"Batista",surname:"Batista Rosolem",slug:"joao-batista-rosolem",fullName:"Joao Batista Rosolem"}]},{id:"75267",title:"Wireless Power Charging in Electrical Vehicles",slug:"wireless-power-charging-in-electrical-vehicles",totalDownloads:596,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"Wireless Power Transfer (WPT) technology can transfer electrical energy from a transmitter to a receiver wirelessly. Due to its many advantages, WPT technology is a more adequate and suitable solution for many industrial applications compared to the power transfer by wires. Using WPT technology will reduce the annoyance of wires, improve the power transfer mechanisms. Recently, the WPT gain enormous attention to charging the on-board batteries of the Electric Vehicle (EV). Several well-known car manufacturing companies start efforts to adopt WPT technology and enhance its features. Therefore, WPT can be achieved through the affordable inductive coupling between two coils named a transmitter and a receiver coil. In EV charging applications, transmitter coils are located underneath the road, and receiver coils are installed in the EV. The inductive WPT of resonant type is generally applied to medium-high power transfer applications like EV charging because it achieves better energy efficiency. In this chapter, various WPT technologies are discussed and tested in EV wireless charging applications. Furthermore, extensive information is given to developing an advanced WPT technology that can transfer maximum power by achieving maximum efficiency.",book:{id:"10514",slug:"wireless-power-transfer-recent-development-applications-and-new-perspectives",title:"Wireless Power Transfer",fullTitle:"Wireless Power Transfer – Recent Development, Applications and New Perspectives"},signatures:"Nassim Iqteit, Khalid Yahya and Sajjad Ahmad Khan",authors:[{id:"270815",title:"Dr.",name:"Khalid",middleName:"O. 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The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}}]},series:{item:{id:"24",title:"Sustainable Development",doi:"10.5772/intechopen.100361",issn:null,scope:"
\r\n\tTransforming our World: the 2030 Agenda for Sustainable Development endorsed by United Nations and 193 Member States, came into effect on Jan 1, 2016, to guide decision making and actions to the year 2030 and beyond. Central to this Agenda are 17 Goals, 169 associated targets and over 230 indicators that are reviewed annually. The vision envisaged in the implementation of the SDGs is centered on the five Ps: People, Planet, Prosperity, Peace and Partnership. This call for renewed focused efforts ensure we have a safe and healthy planet for current and future generations.
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\r\n\tThis Series focuses on covering research and applied research involving the five Ps through the following topics:
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\r\n\t1. Sustainable Economy and Fair Society that relates to SDG 1 on No Poverty, SDG 2 on Zero Hunger, SDG 8 on Decent Work and Economic Growth, SDG 10 on Reduced Inequalities, SDG 12 on Responsible Consumption and Production, and SDG 17 Partnership for the Goals
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\r\n\t2. Health and Wellbeing focusing on SDG 3 on Good Health and Wellbeing and SDG 6 on Clean Water and Sanitation
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\r\n\t3. Inclusivity and Social Equality involving SDG 4 on Quality Education, SDG 5 on Gender Equality, and SDG 16 on Peace, Justice and Strong Institutions
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\r\n\t4. Climate Change and Environmental Sustainability comprising SDG 13 on Climate Action, SDG 14 on Life Below Water, and SDG 15 on Life on Land
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\r\n\t5. Urban Planning and Environmental Management embracing SDG 7 on Affordable Clean Energy, SDG 9 on Industry, Innovation and Infrastructure, and SDG 11 on Sustainable Cities and Communities.
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\r\n\tThe series also seeks to support the use of cross cutting SDGs, as many of the goals listed above, targets and indicators are all interconnected to impact our lives and the decisions we make on a daily basis, making them impossible to tie to a single topic.
",coverUrl:"https://cdn.intechopen.com/series/covers/24.jpg",latestPublicationDate:"April 24th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:0,editor:{id:"262440",title:"Prof.",name:"Usha",middleName:null,surname:"Iyer-Raniga",slug:"usha-iyer-raniga",fullName:"Usha Iyer-Raniga",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRYSXQA4/Profile_Picture_2022-02-28T13:55:36.jpeg",biography:"Usha Iyer-Raniga is a professor in the School of Property and Construction Management at RMIT University. Usha co-leads the One Planet Network’s Sustainable Buildings and Construction Programme (SBC), a United Nations 10 Year Framework of Programmes on Sustainable Consumption and Production (UN 10FYP SCP) aligned with Sustainable Development Goal 12. The work also directly impacts SDG 11 on Sustainable Cities and Communities. She completed her undergraduate degree as an architect before obtaining her Masters degree from Canada and her Doctorate in Australia. 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His research interest focuses on computational chemistry and molecular modeling of diverse systems of pharmacological, food, and alternative energy interests by resorting to DFT and Conceptual DFT. He has authored a coauthored more than 255 peer-reviewed papers, 32 book chapters, and 2 edited books. He has delivered speeches at many international and domestic conferences. He serves as a reviewer for more than eighty international journals, books, and research proposals as well as an editor for special issues of renowned scientific journals.",institutionString:"Centro de Investigación en Materiales Avanzados",institution:{name:"Centro de Investigación en Materiales Avanzados",country:{name:"Mexico"}}},{id:"76477",title:"Prof.",name:"Mirza",middleName:null,surname:"Hasanuzzaman",slug:"mirza-hasanuzzaman",fullName:"Mirza Hasanuzzaman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/76477/images/system/76477.png",biography:"Dr. Mirza Hasanuzzaman is a Professor of Agronomy at Sher-e-Bangla Agricultural University, Bangladesh. He received his Ph.D. in Plant Stress Physiology and Antioxidant Metabolism from Ehime University, Japan, with a scholarship from the Japanese Government (MEXT). Later, he completed his postdoctoral research at the Center of Molecular Biosciences, University of the Ryukyus, Japan, as a recipient of the Japan Society for the Promotion of Science (JSPS) postdoctoral fellowship. He was also the recipient of the Australian Government Endeavour Research Fellowship for postdoctoral research as an adjunct senior researcher at the University of Tasmania, Australia. Dr. Hasanuzzaman’s current work is focused on the physiological and molecular mechanisms of environmental stress tolerance. Dr. Hasanuzzaman has published more than 150 articles in peer-reviewed journals. He has edited ten books and written more than forty book chapters on important aspects of plant physiology, plant stress tolerance, and crop production. According to Scopus, Dr. Hasanuzzaman’s publications have received more than 10,500 citations with an h-index of 53. He has been named a Highly Cited Researcher by Clarivate. He is an editor and reviewer for more than fifty peer-reviewed international journals and was a recipient of the “Publons Peer Review Award” in 2017, 2018, and 2019. He has been honored by different authorities for his outstanding performance in various fields like research and education, and he has received the World Academy of Science Young Scientist Award (2014) and the University Grants Commission (UGC) Award 2018. He is a fellow of the Bangladesh Academy of Sciences (BAS) and the Royal Society of Biology.",institutionString:"Sher-e-Bangla Agricultural University",institution:{name:"Sher-e-Bangla Agricultural University",country:{name:"Bangladesh"}}},{id:"187859",title:"Prof.",name:"Kusal",middleName:"K.",surname:"Das",slug:"kusal-das",fullName:"Kusal Das",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSBDeQAO/Profile_Picture_1623411145568",biography:"Kusal K. Das is a Distinguished Chair Professor of Physiology, Shri B. M. Patil Medical College and Director, Centre for Advanced Medical Research (CAMR), BLDE (Deemed to be University), Vijayapur, Karnataka, India. Dr. Das did his M.S. and Ph.D. in Human Physiology from the University of Calcutta, Kolkata. His area of research is focused on understanding of molecular mechanisms of heavy metal activated low oxygen sensing pathways in vascular pathophysiology. He has invented a new method of estimation of serum vitamin E. His expertise in critical experimental protocols on vascular functions in experimental animals was well documented by his quality of publications. He was a Visiting Professor of Medicine at University of Leeds, United Kingdom (2014-2016) and Tulane University, New Orleans, USA (2017). For his immense contribution in medical research Ministry of Science and Technology, Government of India conferred him 'G.P. Chatterjee Memorial Research Prize-2019” and he is also the recipient of 'Dr.Raja Ramanna State Scientist Award 2015” by Government of Karnataka. He is a Fellow of the Royal Society of Biology (FRSB), London and Honorary Fellow of Karnataka Science and Technology Academy, Department of Science and Technology, Government of Karnataka.",institutionString:"BLDE (Deemed to be University), India",institution:null},{id:"243660",title:"Dr.",name:"Mallanagouda Shivanagouda",middleName:null,surname:"Biradar",slug:"mallanagouda-shivanagouda-biradar",fullName:"Mallanagouda Shivanagouda Biradar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243660/images/system/243660.jpeg",biography:"M. S. Biradar is Vice Chancellor and Professor of Medicine of\nBLDE (Deemed to be University), Vijayapura, Karnataka, India.\nHe obtained his MD with a gold medal in General Medicine and\nhas devoted himself to medical teaching, research, and administrations. He has also immensely contributed to medical research\non vascular medicine, which is reflected by his numerous publications including books and book chapters. Professor Biradar was\nalso Visiting Professor at Tulane University School of Medicine, New Orleans, USA.",institutionString:"BLDE (Deemed to be University)",institution:{name:"BLDE University",country:{name:"India"}}},{id:"289796",title:"Dr.",name:"Swastika",middleName:null,surname:"Das",slug:"swastika-das",fullName:"Swastika Das",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/289796/images/system/289796.jpeg",biography:"Swastika N. Das is Professor of Chemistry at the V. P. Dr. P. G.\nHalakatti College of Engineering and Technology, BLDE (Deemed\nto be University), Vijayapura, Karnataka, India. She obtained an\nMSc, MPhil, and PhD in Chemistry from Sambalpur University,\nOdisha, India. Her areas of research interest are medicinal chemistry, chemical kinetics, and free radical chemistry. She is a member\nof the investigators who invented a new modified method of estimation of serum vitamin E. She has authored numerous publications including book\nchapters and is a mentor of doctoral curriculum at her university.",institutionString:"BLDEA’s V.P.Dr.P.G.Halakatti College of Engineering & Technology",institution:{name:"BLDE University",country:{name:"India"}}},{id:"248459",title:"Dr.",name:"Akikazu",middleName:null,surname:"Takada",slug:"akikazu-takada",fullName:"Akikazu Takada",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248459/images/system/248459.png",biography:"Akikazu Takada was born in Japan, 1935. After graduation from\nKeio University School of Medicine and finishing his post-graduate studies, he worked at Roswell Park Memorial Institute NY,\nUSA. He then took a professorship at Hamamatsu University\nSchool of Medicine. In thrombosis studies, he found the SK\npotentiator that enhances plasminogen activation by streptokinase. He is very much interested in simultaneous measurements\nof fatty acids, amino acids, and tryptophan degradation products. By using fatty\nacid analyses, he indicated that plasma levels of trans-fatty acids of old men were\nfar higher in the US than Japanese men. . He also showed that eicosapentaenoic acid\n(EPA) and docosahexaenoic acid (DHA) levels are higher, and arachidonic acid\nlevels are lower in Japanese than US people. By using simultaneous LC/MS analyses\nof plasma levels of tryptophan metabolites, he recently found that plasma levels of\nserotonin, kynurenine, or 5-HIAA were higher in patients of mono- and bipolar\ndepression, which are significantly different from observations reported before. In\nview of recent reports that plasma tryptophan metabolites are mainly produced by\nmicrobiota. He is now working on the relationships between microbiota and depression or autism.",institutionString:"Hamamatsu University School of Medicine",institution:{name:"Hamamatsu University School of Medicine",country:{name:"Japan"}}},{id:"137240",title:"Prof.",name:"Mohammed",middleName:null,surname:"Khalid",slug:"mohammed-khalid",fullName:"Mohammed Khalid",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/137240/images/system/137240.png",biography:"Mohammed Khalid received his B.S. degree in chemistry in 2000 and Ph.D. degree in physical chemistry in 2007 from the University of Khartoum, Sudan. He moved to School of Chemistry, Faculty of Science, University of Sydney, Australia in 2009 and joined Dr. Ron Clarke as a postdoctoral fellow where he worked on the interaction of ATP with the phosphoenzyme of the Na+/K+-ATPase and dual mechanisms of allosteric acceleration of the Na+/K+-ATPase by ATP; then he went back to Department of Chemistry, University of Khartoum as an assistant professor, and in 2014 he was promoted as an associate professor. In 2011, he joined the staff of Department of Chemistry at Taif University, Saudi Arabia, where he is currently an assistant professor. His research interests include the following: P-Type ATPase enzyme kinetics and mechanisms, kinetics and mechanisms of redox reactions, autocatalytic reactions, computational enzyme kinetics, allosteric acceleration of P-type ATPases by ATP, exploring of allosteric sites of ATPases, and interaction of ATP with ATPases located in cell membranes.",institutionString:"Taif University",institution:{name:"Taif University",country:{name:"Saudi Arabia"}}},{id:"63810",title:"Prof.",name:"Jorge",middleName:null,surname:"Morales-Montor",slug:"jorge-morales-montor",fullName:"Jorge Morales-Montor",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/63810/images/system/63810.png",biography:"Dr. Jorge Morales-Montor was recognized with the Lola and Igo Flisser PUIS Award for best graduate thesis at the national level in the field of parasitology. He received a fellowship from the Fogarty Foundation to perform postdoctoral research stay at the University of Georgia. He has 153 journal articles to his credit. He has also edited several books and published more than fifty-five book chapters. He is a member of the Mexican Academy of Sciences, Latin American Academy of Sciences, and the National Academy of Medicine. He has received more than thirty-five awards and has supervised numerous bachelor’s, master’s, and Ph.D. students. Dr. Morales-Montor is the past president of the Mexican Society of Parasitology.",institutionString:"National Autonomous University of Mexico",institution:{name:"National Autonomous University of Mexico",country:{name:"Mexico"}}},{id:"217215",title:"Dr.",name:"Palash",middleName:null,surname:"Mandal",slug:"palash-mandal",fullName:"Palash Mandal",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/217215/images/system/217215.jpeg",biography:null,institutionString:"Charusat University",institution:null},{id:"49739",title:"Dr.",name:"Leszek",middleName:null,surname:"Szablewski",slug:"leszek-szablewski",fullName:"Leszek Szablewski",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49739/images/system/49739.jpg",biography:"Leszek Szablewski is a professor of medical sciences. He received his M.S. in the Faculty of Biology from the University of Warsaw and his PhD degree from the Institute of Experimental Biology Polish Academy of Sciences. He habilitated in the Medical University of Warsaw, and he obtained his degree of Professor from the President of Poland. Professor Szablewski is the Head of Chair and Department of General Biology and Parasitology, Medical University of Warsaw. Professor Szablewski has published over 80 peer-reviewed papers in journals such as Journal of Alzheimer’s Disease, Biochim. Biophys. Acta Reviews of Cancer, Biol. Chem., J. Biomed. Sci., and Diabetes/Metabol. Res. Rev, Endocrine. He is the author of two books and four book chapters. He has edited four books, written 15 scripts for students, is the ad hoc reviewer of over 30 peer-reviewed journals, and editorial member of peer-reviewed journals. Prof. Szablewski’s research focuses on cell physiology, genetics, and pathophysiology. He works on the damage caused by lack of glucose homeostasis and changes in the expression and/or function of glucose transporters due to various diseases. He has given lectures, seminars, and exercises for students at the Medical University.",institutionString:"Medical University of Warsaw",institution:{name:"Medical University of Warsaw",country:{name:"Poland"}}},{id:"173123",title:"Dr.",name:"Maitham",middleName:null,surname:"Khajah",slug:"maitham-khajah",fullName:"Maitham Khajah",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/173123/images/system/173123.jpeg",biography:"Dr. Maitham A. Khajah received his degree in Pharmacy from Faculty of Pharmacy, Kuwait University, in 2003 and obtained his PhD degree in December 2009 from the University of Calgary, Canada (Gastrointestinal Science and Immunology). Since January 2010 he has been assistant professor in Kuwait University, Faculty of Pharmacy, Department of Pharmacology and Therapeutics. His research interest are molecular targets for the treatment of inflammatory bowel disease (IBD) and the mechanisms responsible for immune cell chemotaxis. He cosupervised many students for the MSc Molecular Biology Program, College of Graduate Studies, Kuwait University. Ever since joining Kuwait University in 2010, he got various grants as PI and Co-I. He was awarded the Best Young Researcher Award by Kuwait University, Research Sector, for the Year 2013–2014. He was a member in the organizing committee for three conferences organized by Kuwait University, Faculty of Pharmacy, as cochair and a member in the scientific committee (the 3rd, 4th, and 5th Kuwait International Pharmacy Conference).",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"195136",title:"Dr.",name:"Aya",middleName:null,surname:"Adel",slug:"aya-adel",fullName:"Aya Adel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/195136/images/system/195136.jpg",biography:"Dr. Adel works as an Assistant Lecturer in the unit of Phoniatrics, Department of Otolaryngology, Ain Shams University in Cairo, Egypt. Dr. Adel is especially interested in joint attention and its impairment in autism spectrum disorder",institutionString:"Ain Shams University",institution:{name:"Ain Shams University",country:{name:"Egypt"}}},{id:"94911",title:"Dr.",name:"Boulenouar",middleName:null,surname:"Mesraoua",slug:"boulenouar-mesraoua",fullName:"Boulenouar Mesraoua",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94911/images/system/94911.png",biography:"Dr Boulenouar Mesraoua is the Associate Professor of Clinical Neurology at Weill Cornell Medical College-Qatar and a Consultant Neurologist at Hamad Medical Corporation at the Neuroscience Department; He graduated as a Medical Doctor from the University of Oran, Algeria; he then moved to Belgium, the City of Liege, for a Residency in Internal Medicine and Neurology at Liege University; after getting the Belgian Board of Neurology (with high marks), he went to the National Hospital for Nervous Diseases, Queen Square, London, United Kingdom for a fellowship in Clinical Neurophysiology, under Pr Willison ; Dr Mesraoua had also further training in Epilepsy and Continuous EEG Monitoring for two years (from 2001-2003) in the Neurophysiology department of Zurich University, Switzerland, under late Pr Hans Gregor Wieser ,an internationally known epileptologist expert. \n\nDr B. Mesraoua is the Director of the Neurology Fellowship Program at the Neurology Section and an active member of the newly created Comprehensive Epilepsy Program at Hamad General Hospital, Doha, Qatar; he is also Assistant Director of the Residency Program at the Qatar Medical School. \nDr B. Mesraoua's main interests are Epilepsy, Multiple Sclerosis, and Clinical Neurology; He is the Chairman and the Organizer of the well known Qatar Epilepsy Symposium, he is running yearly for the past 14 years and which is considered a landmark in the Gulf region; He has also started last year , together with other epileptologists from Qatar, the region and elsewhere, a yearly International Epilepsy School Course, which was attended by many neurologists from the Area.\n\nInternationally, Dr Mesraoua is an active and elected member of the Commission on Eastern Mediterranean Region (EMR ) , a regional branch of the International League Against Epilepsy (ILAE), where he represents the Middle East and North Africa(MENA ) and where he holds the position of chief of the Epilepsy Epidemiology Section; Dr Mesraoua is a member of the American Academy of Neurology, the Europeen Academy of Neurology and the American Epilepsy Society.\n\nDr Mesraoua's main objectives are to encourage frequent gathering of the epileptologists/neurologists from the MENA region and the rest of the world, promote Epilepsy Teaching in the MENA Region, and encourage multicenter studies involving neurologists and epileptologists in the MENA region, particularly epilepsy epidemiological studies. \n\nDr. Mesraoua is the recipient of two research Grants, as the Lead Principal Investigator (750.000 USD and 250.000 USD) from the Qatar National Research Fund (QNRF) and the Hamad Hospital Internal Research Grant (IRGC), on the following topics : “Continuous EEG Monitoring in the ICU “ and on “Alpha-lactoalbumin , proof of concept in the treatment of epilepsy” .Dr Mesraoua is a reviewer for the journal \"seizures\" (Europeen Epilepsy Journal ) as well as dove journals ; Dr Mesraoua is the author and co-author of many peer reviewed publications and four book chapters in the field of Epilepsy and Clinical Neurology",institutionString:"Weill Cornell Medical College in Qatar",institution:{name:"Weill Cornell Medical College in Qatar",country:{name:"Qatar"}}},{id:"282429",title:"Prof.",name:"Covanis",middleName:null,surname:"Athanasios",slug:"covanis-athanasios",fullName:"Covanis Athanasios",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/282429/images/system/282429.jpg",biography:null,institutionString:"Neurology-Neurophysiology Department of the Children Hospital Agia Sophia",institution:null},{id:"190980",title:"Prof.",name:"Marwa",middleName:null,surname:"Mahmoud Saleh",slug:"marwa-mahmoud-saleh",fullName:"Marwa Mahmoud Saleh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/190980/images/system/190980.jpg",biography:"Professor Marwa Mahmoud Saleh is a doctor of medicine and currently works in the unit of Phoniatrics, Department of Otolaryngology, Ain Shams University in Cairo, Egypt. She got her doctoral degree in 1991 and her doctoral thesis was accomplished in the University of Iowa, United States. Her publications covered a multitude of topics as videokymography, cochlear implants, stuttering, and dysphagia. She has lectured Egyptian phonology for many years. Her recent research interest is joint attention in autism.",institutionString:"Ain Shams University",institution:{name:"Ain Shams University",country:{name:"Egypt"}}},{id:"259190",title:"Dr.",name:"Syed Ali Raza",middleName:null,surname:"Naqvi",slug:"syed-ali-raza-naqvi",fullName:"Syed Ali Raza Naqvi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259190/images/system/259190.png",biography:"Dr. Naqvi is a radioanalytical chemist and is working as an associate professor of analytical chemistry in the Department of Chemistry, Government College University, Faisalabad, Pakistan. Advance separation techniques, nuclear analytical techniques and radiopharmaceutical analysis are the main courses that he is teaching to graduate and post-graduate students. In the research area, he is focusing on the development of organic- and biomolecule-based radiopharmaceuticals for diagnosis and therapy of infectious and cancerous diseases. Under the supervision of Dr. Naqvi, three students have completed their Ph.D. degrees and 41 students have completed their MS degrees. He has completed three research projects and is currently working on 2 projects entitled “Radiolabeling of fluoroquinolone derivatives for the diagnosis of deep-seated bacterial infections” and “Radiolabeled minigastrin peptides for diagnosis and therapy of NETs”. He has published about 100 research articles in international reputed journals and 7 book chapters. Pakistan Institute of Nuclear Science & Technology (PINSTECH) Islamabad, Punjab Institute of Nuclear Medicine (PINM), Faisalabad and Institute of Nuclear Medicine and Radiology (INOR) Abbottabad are the main collaborating institutes.",institutionString:"Government College University",institution:{name:"Government College University, Faisalabad",country:{name:"Pakistan"}}},{id:"58390",title:"Dr.",name:"Gyula",middleName:null,surname:"Mozsik",slug:"gyula-mozsik",fullName:"Gyula Mozsik",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/58390/images/system/58390.png",biography:"Gyula Mózsik MD, Ph.D., ScD (med), is an emeritus professor of Medicine at the First Department of Medicine, Univesity of Pécs, Hungary. He was head of this department from 1993 to 2003. His specializations are medicine, gastroenterology, clinical pharmacology, clinical nutrition, and dietetics. His research fields are biochemical pharmacological examinations in the human gastrointestinal (GI) mucosa, mechanisms of retinoids, drugs, capsaicin-sensitive afferent nerves, and innovative pharmacological, pharmaceutical, and nutritional (dietary) research in humans. He has published about 360 peer-reviewed papers, 197 book chapters, 692 abstracts, 19 monographs, and has edited 37 books. He has given about 1120 regular and review lectures. He has organized thirty-eight national and international congresses and symposia. He is the founder of the International Conference on Ulcer Research (ICUR); International Union of Pharmacology, Gastrointestinal Section (IUPHAR-GI); Brain-Gut Society symposiums, and gastrointestinal cytoprotective symposiums. He received the Andre Robert Award from IUPHAR-GI in 2014. Fifteen of his students have been appointed as full professors in Egypt, Cuba, and Hungary.",institutionString:"University of Pécs",institution:{name:"University of Pecs",country:{name:"Hungary"}}},{id:"277367",title:"M.Sc.",name:"Daniel",middleName:"Martin",surname:"Márquez López",slug:"daniel-marquez-lopez",fullName:"Daniel Márquez López",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/277367/images/7909_n.jpg",biography:"Msc Daniel Martin Márquez López has a bachelor degree in Industrial Chemical Engineering, a Master of science degree in the same área and he is a PhD candidate for the Instituto Politécnico Nacional. His Works are realted to the Green chemistry field, biolubricants, biodiesel, transesterification reactions for biodiesel production and the manipulation of oils for therapeutic purposes.",institutionString:null,institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"196544",title:"Prof.",name:"Angel",middleName:null,surname:"Catala",slug:"angel-catala",fullName:"Angel Catala",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/196544/images/system/196544.jpg",biography:"Angel Catalá studied chemistry at Universidad Nacional de La Plata, Argentina, where he received a Ph.D. in Chemistry (Biological Branch) in 1965. From 1964 to 1974, he worked as an Assistant in Biochemistry at the School of Medicine at the same university. From 1974 to 1976, he was a fellow of the National Institutes of Health (NIH) at the University of Connecticut, Health Center, USA. From 1985 to 2004, he served as a Full Professor of Biochemistry at the Universidad Nacional de La Plata. He is a member of the National Research Council (CONICET), Argentina, and the Argentine Society for Biochemistry and Molecular Biology (SAIB). His laboratory has been interested for many years in the lipid peroxidation of biological membranes from various tissues and different species. Dr. Catalá has directed twelve doctoral theses, published more than 100 papers in peer-reviewed journals, several chapters in books, and edited twelve books. He received awards at the 40th International Conference Biochemistry of Lipids 1999 in Dijon, France. He is the winner of the Bimbo Pan-American Nutrition, Food Science and Technology Award 2006 and 2012, South America, Human Nutrition, Professional Category. In 2006, he won the Bernardo Houssay award in pharmacology, in recognition of his meritorious works of research. Dr. Catalá belongs to the editorial board of several journals including Journal of Lipids; International Review of Biophysical Chemistry; Frontiers in Membrane Physiology and Biophysics; World Journal of Experimental Medicine and Biochemistry Research International; World Journal of Biological Chemistry, Diabetes, and the Pancreas; International Journal of Chronic Diseases & Therapy; and International Journal of Nutrition. He is the co-editor of The Open Biology Journal and associate editor for Oxidative Medicine and Cellular Longevity.",institutionString:"Universidad Nacional de La Plata",institution:{name:"National University of La Plata",country:{name:"Argentina"}}},{id:"186585",title:"Dr.",name:"Francisco Javier",middleName:null,surname:"Martin-Romero",slug:"francisco-javier-martin-romero",fullName:"Francisco Javier Martin-Romero",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSB3HQAW/Profile_Picture_1631258137641",biography:"Francisco Javier Martín-Romero (Javier) is a Professor of Biochemistry and Molecular Biology at the University of Extremadura, Spain. He is also a group leader at the Biomarkers Institute of Molecular Pathology. Javier received his Ph.D. in 1998 in Biochemistry and Biophysics. At the National Cancer Institute (National Institute of Health, Bethesda, MD) he worked as a research associate on the molecular biology of selenium and its role in health and disease. After postdoctoral collaborations with Carlos Gutierrez-Merino (University of Extremadura, Spain) and Dario Alessi (University of Dundee, UK), he established his own laboratory in 2008. The interest of Javier's lab is the study of cell signaling with a special focus on Ca2+ signaling, and how Ca2+ transport modulates the cytoskeleton, migration, differentiation, cell death, etc. He is especially interested in the study of Ca2+ channels, and the role of STIM1 in the initiation of pathological events.",institutionString:null,institution:{name:"University of Extremadura",country:{name:"Spain"}}},{id:"217323",title:"Prof.",name:"Guang-Jer",middleName:null,surname:"Wu",slug:"guang-jer-wu",fullName:"Guang-Jer Wu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/217323/images/8027_n.jpg",biography:null,institutionString:null,institution:null},{id:"148546",title:"Dr.",name:"Norma Francenia",middleName:null,surname:"Santos-Sánchez",slug:"norma-francenia-santos-sanchez",fullName:"Norma Francenia Santos-Sánchez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/148546/images/4640_n.jpg",biography:null,institutionString:null,institution:null},{id:"272889",title:"Dr.",name:"Narendra",middleName:null,surname:"Maddu",slug:"narendra-maddu",fullName:"Narendra Maddu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/272889/images/10758_n.jpg",biography:null,institutionString:null,institution:null},{id:"242491",title:"Prof.",name:"Angelica",middleName:null,surname:"Rueda",slug:"angelica-rueda",fullName:"Angelica Rueda",position:"Investigador Cinvestav 3B",profilePictureURL:"https://mts.intechopen.com/storage/users/242491/images/6765_n.jpg",biography:null,institutionString:null,institution:null},{id:"88631",title:"Dr.",name:"Ivan",middleName:null,surname:"Petyaev",slug:"ivan-petyaev",fullName:"Ivan Petyaev",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Lycotec (United Kingdom)",country:{name:"United Kingdom"}}},{id:"423869",title:"Ms.",name:"Smita",middleName:null,surname:"Rai",slug:"smita-rai",fullName:"Smita Rai",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Integral University",country:{name:"India"}}},{id:"424024",title:"Prof.",name:"Swati",middleName:null,surname:"Sharma",slug:"swati-sharma",fullName:"Swati Sharma",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Integral University",country:{name:"India"}}},{id:"439112",title:"MSc.",name:"Touseef",middleName:null,surname:"Fatima",slug:"touseef-fatima",fullName:"Touseef Fatima",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Integral University",country:{name:"India"}}},{id:"424836",title:"Dr.",name:"Orsolya",middleName:null,surname:"Borsai",slug:"orsolya-borsai",fullName:"Orsolya Borsai",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca",country:{name:"Romania"}}},{id:"422262",title:"Ph.D.",name:"Paola Andrea",middleName:null,surname:"Palmeros-Suárez",slug:"paola-andrea-palmeros-suarez",fullName:"Paola Andrea Palmeros-Suárez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Guadalajara",country:{name:"Mexico"}}}]}},subseries:{item:{id:"15",type:"subseries",title:"Chemical Biology",keywords:"Phenolic Compounds, Essential Oils, Modification of Biomolecules, Glycobiology, Combinatorial Chemistry, Therapeutic peptides, Enzyme Inhibitors",scope:"Chemical biology spans the fields of chemistry and biology involving the application of biological and chemical molecules and techniques. In recent years, the application of chemistry to biological molecules has gained significant interest in medicinal and pharmacological studies. This topic will be devoted to understanding the interplay between biomolecules and chemical compounds, their structure and function, and their potential applications in related fields. Being a part of the biochemistry discipline, the ideas and concepts that have emerged from Chemical Biology have affected other related areas. This topic will closely deal with all emerging trends in this discipline.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/15.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11411,editor:{id:"441442",title:"Dr.",name:"Şükrü",middleName:null,surname:"Beydemir",slug:"sukru-beydemir",fullName:"Şükrü Beydemir",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003GsUoIQAV/Profile_Picture_1634557147521",biography:"Dr. Şükrü Beydemir obtained a BSc in Chemistry in 1995 from Yüzüncü Yıl University, MSc in Biochemistry in 1998, and PhD in Biochemistry in 2002 from Atatürk University, Turkey. He performed post-doctoral studies at Max-Planck Institute, Germany, and University of Florence, Italy in addition to making several scientific visits abroad. He currently works as a Full Professor of Biochemistry in the Faculty of Pharmacy, Anadolu University, Turkey. Dr. Beydemir has published over a hundred scientific papers spanning protein biochemistry, enzymology and medicinal chemistry, reviews, book chapters and presented several conferences to scientists worldwide. He has received numerous publication awards from various international scientific councils. He serves in the Editorial Board of several international journals. Dr. Beydemir is also Rector of Bilecik Şeyh Edebali University, Turkey.",institutionString:null,institution:{name:"Anadolu University",institutionURL:null,country:{name:"Turkey"}}},editorTwo:{id:"13652",title:"Prof.",name:"Deniz",middleName:null,surname:"Ekinci",slug:"deniz-ekinci",fullName:"Deniz Ekinci",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYLT1QAO/Profile_Picture_1634557223079",biography:"Dr. Deniz Ekinci obtained a BSc in Chemistry in 2004, MSc in Biochemistry in 2006, and PhD in Biochemistry in 2009 from Atatürk University, Turkey. He studied at Stetson University, USA, in 2007-2008 and at the Max Planck Institute of Molecular Cell Biology and Genetics, Germany, in 2009-2010. Dr. Ekinci currently works as a Full Professor of Biochemistry in the Faculty of Agriculture and is the Head of the Enzyme and Microbial Biotechnology Division, Ondokuz Mayıs University, Turkey. He is a member of the Turkish Biochemical Society, American Chemical Society, and German Genetics society. Dr. Ekinci published around ninety scientific papers, reviews and book chapters, and presented several conferences to scientists. He has received numerous publication awards from several scientific councils. Dr. Ekinci serves as the Editor in Chief of four international books and is involved in the Editorial Board of several international journals.",institutionString:null,institution:{name:"Ondokuz Mayıs University",institutionURL:null,country:{name:"Turkey"}}},editorThree:null,series:{id:"11",title:"Biochemistry",doi:"10.5772/intechopen.72877",issn:"2632-0983"},editorialBoard:[{id:"241413",title:"Dr.",name:"Azhar",middleName:null,surname:"Rasul",slug:"azhar-rasul",fullName:"Azhar Rasul",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRT1oQAG/Profile_Picture_1635251978933",institutionString:null,institution:{name:"Government College University, Faisalabad",institutionURL:null,country:{name:"Pakistan"}}},{id:"178316",title:"Ph.D.",name:"Sergey",middleName:null,surname:"Sedykh",slug:"sergey-sedykh",fullName:"Sergey 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Behind these definitions are hidden all the aspects of normal and pathological functioning of all processes that the topic ‘Metabolism’ will cover within the Biochemistry Series. 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Thus proteomics, an area of research that detects all protein forms expressed in an organism, including splice isoforms and post-translational modifications, is more suitable than genomics for a comprehensive understanding of the biochemical processes that govern life. The most common proteomics applications are currently in the clinical field for the identification, in a variety of biological matrices, of biomarkers for diagnosis and therapeutic intervention of disorders. From the comparison of proteomic profiles of control and disease or different physiological states, which may emerge, changes in protein expression can provide new insights into the roles played by some proteins in human pathologies. Understanding how proteins function and interact with each other is another goal of proteomics that makes this approach even more intriguing. Specialized technology and expertise are required to assess the proteome of any biological sample. Currently, proteomics relies mainly on mass spectrometry (MS) combined with electrophoretic (1 or 2-DE-MS) and/or chromatographic techniques (LC-MS/MS). MS is an excellent tool that has gained popularity in proteomics because of its ability to gather a complex body of information such as cataloging protein expression, identifying protein modification sites, and defining protein interactions. 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