Example about PBL in Japan.
\r\n\t
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A project is a job having a new element and a certain period (start and end), a work evolving gradually with a clear purpose to be done, influencing the object, and manipulating the object. Competence has various definitions depending on the field but based on the world standard of competence of project manager here, and it makes unique meaning for each distributed project management. Then, it must be used well in the society.
\nThen, project-based learning (PBL) has been spreading into the world of education because the project-based learning method can develop and improve the competence elements for finding problems, understanding problems and solving problems of the students because the overall thought process for learners in active learning by team-based learning (TBL) is important.
\nFor this, the teachers of four departments including one leader in each class room (The parts of the leaders are project managers who show later in Section 2) should make the structure well-defined about major large problems and student missions by using various competences in the project management.
\nHere, the project management makes the initial purpose to clear and progress so that it gives skill, technique and tools for achieving the requirements (quality, cost, demand and range of products) of the project. It makes the specifications, plans and methods to clear for requirements by many stakeholders. Moreover, project management has a SPDCAF cycle, that is, Start, Plan, Do, Check, Action, Finish. Especially, start phase attached to a known PDCA cycle is important because it moves the project from idea phase to plan phase.
\nThe literatures about PBL in Japan were seen in Table 1.
\nNo. | \nAffiliation | \nContents | \n
---|---|---|
[1] | \nNitobe School | \nResults of teaching method for the first-grade since 2015 are presented, and findings through this work were shared. In Nitobe School curriculum, there are another education courses (Start-up, Global Issues, Problem-solving and Problem-finding) as four terms (spring, summer, fall and winter). | \n
[2] | \nHokkaido University of Japan | \nComparison of student attitude by PBL for radiological technologists was introduced. | \n
[3] | \nKeio University Media Institution | \nEducation for software engineers through university and industry collaboration was done. | \n
Example about PBL in Japan.
The PBL type learning was introduced to Japan as “Engineering Design” by Accreditation Board for Engineering and Technology (ABET). Japan Accreditation Board for Engineering Education (JABEE) advised in 2004 that the Japanese engineering education had only analytic subject and no subject for synthesizing.
\nThen, JABEE introduced “Engineering Design” as an essential subject to accept by JABEE accreditation. Japanese university with faculty of engineering has introduced “Engineering Design” since that time. This must be further paid attention as a very effective way for active learning. Here, active learning is a study technique by which the students are able to find problems independently, considering the solution for the problems and solving the problems.
\nIn Mechanical Engineering Department of Osaka Institute of Technology (O.I.T.), JABEE had been examined from 2000, and PBL was introduced as a new subject in the third grade (shown in
Course | \nTerm | \nPrehistory and outline | \n
---|---|---|
First-grade PBL | \nFirst grade | \nThis started as four departments joint PBL. The Departments of Mechanical Engineering, Electric Engineering, Electronics Engineering and Robotics Engineering jointly conduct the half-year PBL for freshmen. The theme is robot car with multifunction. It started in 2014. | \n
International PBL | \nSecond grade | \nThis is to establish first international PBL between National Taipei University of Technology and O.I.T. It was carried out since 2013 between Electric, Electronics and Mechanical Departments of O.I.T. and Mechanical Department of NTUT. The program is consisted of 1 week of intensive cooperation with five mixed team of students. The theme was robot car and wind turbine with wind lens. | \n
Engineering Practice | \nThird grade | \nMechanical Engineering Department introduced Engineering Practice as an Engineering Design subject. This subject is designed as the 1 year PBL of the design and manufacturing consist of six topics: electric vehicle, hovercraft, engine and motor cycle, robot, steel can recycle machine, and so on. | \n
Graduation Research | \nFourth grade | \nIn partial laboratories of Mechanical Engineering Department, few graduate researches had been done like PBL and TBL before/after starting of Engineering Practice as third-year PBL. | \n
Outline of PBL in O.I.T.
After then, the official PBL was spread to second grade and first grade, although the informal PBL was tried in fourth grade of partial laboratory as shown in Table 2.
\nThe outline of PBL in O.I.T. is summarized in Table 2.
\nNowadays, a project and program management (P2M) model in PBL has become important. Here, the program is a set of several projects assembled and integrated. Then, all the abovementioned PBL in four grades had better to be managed as a program.
\nThis section mainly focused on this joint four department PBL and the distributed project management for the Mechanical Engineering Department out of joint four departments. Here, distributed project management is a new management technique by distributed project managers who consigned partially by the main project manager.
\nNext, Table 3 presented conventional studies about project management.
\nNo. | \nAuthors | \nContents | \n
---|---|---|
[4] | \nBaumgardner CR, Shane GS, Grant KP | \nLeadership competences of sustainable construction project management have been explained in literature. The study has generated a new model to facilitate the process of sustainability in the industry and extends some of the significant components from leadership assessment in the context of construction project management in sustainable building projects. | \n
[5] | \nAmin Akhavan Tabassi, Kamand M. Roufechaei, Mahyuddin Ramli, Abu Hassan Abu Bakar, Radzi Ismail, A. Hamid Kadir Pakir | \nIt has been considered Architecture Management, Economics Evaluation of Project, Profile of Production & Risk Control, Resource Procurement, Competence of Project Management in Project and Program Management (P2M) in Japanese drug development | \n
[6] | \nIwasaki K | \nTechnical competence was perceived to be more important for the management of extremely good teams than it was for the management of reasonably good teams. | \n
[7] | \nSaito T | \n“Men, money, and material” is usually pointed out in Japan, as capitals of a general project management. The literature enlarges to five capitals, added “Information and technique” to these. In addition, they showed five competences of “Foreign adjustment competence, risk control competence, internal control competence, construction management competence, and technical improvement competence.” | \n
Conventional studies about project management.
The purpose of this chapter is to present about competences of individual distributed project management as in the case of Mechanical Engineering Department. Moreover, it is to show image of an ideal project management as one and a certain kind of ideal distributed project management taking account of the results.
\nSection 2 explains competences in distributed project management about relation, competences in each (main, sub, boss, next) project management and evaluation.
\nSection 3 presents consideration and analysis about “communication, interactions and cooperation,” “merit, week point and effect, inference,” “an Ideal project management as one” and “ideal distributed project management.”
\nSection 4 explains case study of open innovation by teamwork of enlargement meeting obtained as results of the distributed project management.
\nMoreover, Section 5 shows competences in stakeholder management including the open innovation, weekly report and joint competition. Finally, Section 6 presents the conclusion.
\nEspecially, Refs. [5, 6] are a drug field, P2M is being handled, and its contents are interesting.
\nThis section presents relation, competences and evaluation about distributed project management.
\nFirst of all, aim and purpose of distributed capital project management group (
Aim: Four
Though generally speaking,
Relation among repeated distributed project management.
Personnel purpose:
Figure 1 shows relation among the four kinds of repeated distributed project management (
Competences (ability to do well) in each distributed project management and relation among repeated distributed project management are explained in the following paragraphs.
\nFor the students in each year, as most important stakeholders changed as every project in this PBL, the individuals of each group decide their roles and group leader through hope by early investigation in the project; then, they have identified their interests by the investigation [8]. Moreover, their interests and influence to the group with students of the other departments can be identified by the teacher’s comments in their weekly reports. Original items for the stakeholder analysis are as follows:
Target of this week (group and individuals).
Content of execution of the entire group of this week.
Content of execution of the individuals (inside class time and outside class time).
Content of discussion in combination meetings.
Achievement level, reflection point and improvement idea.
Problem and work schedule for next week.
Process of the future.
The definition, purpose and description, and so on of leadership are presented in [8].
\nHere, the definition of leadership is providing direction and guidance to students and groups. It involves the ability to choose and apply appropriate styles of project management in different situations. Besides displaying leadership with his or her team, the student needs to be seen as a leader in representing the PBL to senior management and other interested parties [8]. Original items for leadership education are indicated in Section 2.6.
\nCompetences in project management for main project managers are at least to seize three pillars of capital “Person, thing and money” and “Personnel right” and “Budget authority”, involving the process of executing the responsibility of work allotment to each department. Moreover, they may have competences to present topics in a conference, decide on the schedule, settle the discussion and draw conclusions as chairpersons or sub-chairpersons.
\nThe project management competences of one subproject manager are based on experience knowledge and through dialogue with other project managers. He understands the purpose and contents of the whole project, proposing the technology necessary for the project competitively with them. He is also preparing explanatory materials for the students until the project gets on track.
\nCompetences in project management for boss project manager who conceive the project are personnel ability that can choose talented person who was suitable for content of each project as project manager and are student and teacher’s commending abilities, practical work with subproject manager, rich human nature and time management ability.
\nThe competences of project management by young next generation project manager can organize the information of the meeting as minutes and can organize the outcome information of the project cleanly without changing its contents and make an external announcement. In consideration to detail, there are also external viewpoints. They were presenting methods of PBL at external meetings [9, 10].
\nSocial basic competences expected in stakeholders of the PBL are taught like the simple followings:
Problem solution
The work that fills necessary functions can be made.
Team work
They should know members and their ability, and they can help each other.
Communication
It puts in two cents hearing others’ opinions.
Leadership
All members become leaders of something, and their roles are decided for that as the leaders.
Creativity
The aspect is changed, and they look at multipronged.
Time management
The progress report and the delay measures of the process deciding are managed.
\n
Load reduction of main project manager.
The load of the MAIN increases oppositely, while the load of the SUB has decreased. This might be a result of special circumstances in case of O.I.T.
Sufficient number of leaders of classroom.
The member of expansion joint meeting was able to be arranged as at least one leader in each classroom.
External sending by various viewpoints.
Three external sending by each different viewpoint have already been done.
Effect of feedback by BOSS.
This is not well-understood still.
The next section describes consideration and analysis for the above managements.
\nMoreover, this section adds the following consideration and analysis for the distributed project managements.
\nInteraction, communication, conversation and discussion are not same terms but similar terms [11]. Then, cooperation are noticed as one obtained by human-computer interaction [12]. Here, it is noticed that interactions and communication can draw cooperation.
\nAfter observing the proposed method of distributed project manager compared with an ordinary project manager, communication, interaction and cooperation, which are selected as most important matters, were shown in Table 4.
\nItem | \nContents | \n
---|---|
Interactions | \nThere are both positive and negative interactions among the distributed project managers. | \n
Communication | \nThe chance of conversation between PMR increases, although there is also miss-over order [13] from | \n
Cooperation | \nThey can draw cooperation by sharing the same target consideration. | \n
Interactions and communication can draw cooperation.
Effect, inference and yield in failure mode or action mode, and so on were used for analysis of various systems in conventional study [13].
\nHere, Table 5 shows merit, week point, effect and inference of proposed method of distributed project management compared with an ordinary project management briefly, although they were old and ordinary methods.
\nItem | \nContents | \n
---|---|
Merit | \nThere is a possibility that they can do something, which one project management is unable to do. They can reduce the load of main project managers. | \n
Week point | \nHuman cost up. However, it may not be a problem in the special environment like organizations for education. | \n
Effect | \nAll distributed project managers are able to know the project. | \n
Inference | \nSpread of upper-grade PBL or another PBL after long time. | \n
Merit, week point, effect and inference.
The following item and six contents, which were integrated as ideal management of one and will cause a lot of main management of project, can be obtained after seeing the project management in which capital, rights and competences were distributed.
\nTable 6 shows a certain kind of ideal project management as one.
\nItem | \nContents | \n
---|---|
Five capitals | \n“Persons, objects, time, space and money” | \n
Five rights | \n“Personnel right, budget authority, scheduling right, space securing right and greeting” | \n
Five abilities | \n“Innovation of technology, control of information, information sending to inside and outside after taking and settling, agency to various distributed managers, to honor” | \n
Five natures | \n“Cooperative, competitive, charismatic, responsibility and sympathy” | \n
Five senses | \n“Selecting themes, material, parts, terms and methods” | \n
A certain kind of ideal project management as one.
This will be important as a consensus problem in multiagent optimization systems in the future, although these contents do not obtain the consensus [14].
\nAchieving an ideal abovementioned project management alone is difficult, the example of trying ideal four distributed project management is shown in Table 7.
\nItem | \nBoss | \nMain | \nSub | \nNext/part | \n
---|---|---|---|---|
Capitals | \n\n | “Persons, objects and money.” | \n“Time, space” “Information, technology” | \n\n |
Rights | \n\n | “Personnel right, budget authority and greeting” | \n“Scheduling right and space securing right” | \n\n |
Abilities | \n“To honor and information sending to outside“ | \n“Control of information, information sending to inside and *” | \n“Innovation of technology, control of information, information sending to inside and outside after taking and settling, agency to various distributed managers” | \n“Control of information, information sending to inside and outside after taking and settling” | \n
Natures | \n“Cooperative, charismatic, sympathy” | \n“Cooperative, competitive, sense of responsibility, sympathy” | \n“Cooperative, competitive, sympathy” | \n“Cooperative, sympathy” | \n
A certain kind of ideal four distributed project management.
This may be approaching to an optimal distributed project management, although this is not different from real distributed management.
\nIt seems that repeating while deliberating integration and decentralization like this is useful for the optimization of the system that does not use the expression.
\nThis may be necessary in the future theme as a distributed optimization problem [14].
\nIn the next section, we will explain the open innovation by team works of project managers, including openly distributed departmental and interdepartmental project management.
\nThis section presents open innovation by teamwork of project managers and stakeholders.
\nOpen innovation is done in teamwork, while closed innovation is done individually.
\nIn multicultural engineering [15], a few open innovations [16] were tried by teamwork in project management. Some case studies are described in the following paragraphs.
\n\n
Awareness of scenario valued for Mechanical Engineering Department team in joint four department of PBL from a symbolic object by subproject management. (Affordance of the object: Slope course like hill excess as shown in Figure 2).
Proposal of innovation by subproject management.
Support of innovation by main project management and stakeholder management (especially for TA).
Courses with slope like hill where model cars run.
Examples of products: a mechanical sensor, controller and actuator on a car for throwing a ping pong gem from the box out of the goal wall without electric power source (Figure 3).
\nConfiguration of mechanical position ON-OFF control with position detecting SW.
\n
Motivation of innovation considered load balance by enlarged project management
Challenge and change of innovation by subproject management
Awareness of culture and value of innovation by main project management (message between the project managers in joint meetings)
Support of innovation by main project management and stakeholder management (especially for specialists and experts)
Examples of products: a set of noncontact feeding coils to transmit and receive the high-frequency power for detecting the goal wall (Figure 4).
\nNoncontact feeding twin coil.
In the next section, competences in stakeholder management are presented including open innovation.
\nThis section presents competences in stakeholder management for open innovation, weekly report and joint competition.
\nIn Case 1, TAs instructed by a main project management were active as stakeholders.
\nIn case 2, teachers asked by a main project management who did not participated in the project as stakeholders who supported the project management. To summarize, it was recognized that not only teamwork but also stakeholder management including the section manager plays an important role in the success or failure of the project.
\nThe weekly report was imposed on the administrators to properly modify the form in each department. By letting students write a report in this form, they can grasp the common problems of all divisions and individual problems of each division and draw out the direction of student behavior for problem solving. Competences for making format of weekly report may be knowledge to teach the PBL and experience for incompleteness of the first-grade students’ description matter for past weekly reports.
\nThere are two cases of innovative technology by a main project management. In both cases, technical competencies for providing web address to upload word file or excel file, information management for settling important rules and scores of competitions are needed.
\nThe following specification of action flow chart expression (Figure 5) was most innovative and easy to understand for stakeholders including mechanical department.
\nAction flow chart as explanation function of joint competition.
Grey boxes mean the charge of mechanical department. Competences for making a chart like this chart may be knowledge on sequential flow chart using sequence control.
\nBecause the rules for competition were changed by circumstances, they are managed by main project management so that wireless LAN of PC of each classroom may monitor the mission and the rules online though the joint mission and the rule for joint competition were explained in the orientation at first. Competences for making a system like this system may be knowledge about information and communication in PC. An example is shown in Figure 6.
\nAn example of online monitoring of joint mission and recent rules for joint competition.
Because the scores of each team of other class rooms in competition were not known, they were managed by main project management so that teachers can change and monitor the scores, and other stakeholders will be able to monitor them through wireless LAN of PC in each classroom. Competences for making a system like this system may also be the same as the above system. Specification of online score book is shown in Table 8 for reference.
\nClass room | \nGroup and try no | \nRunning time (s) | \nWork enter in the box | \nPing pong gem enter | \nPenalty at wall | \nBonus at goal | \nTotal score | \n||||
---|---|---|---|---|---|---|---|---|---|---|---|
to top | \nto goal | \nCollision to wall | \nStop car | \nLight LED | \nStop wheel | \n||||||
151 | \n1 Group | \n1 | \n\n | \n | \n | \n | \n | \n | \n | \n | \n |
2 | \n\n | \n | \n | \n | \n | \n | \n | \n | \n | ||
2 Group | \n1 | \n\n | \n | \n | \n | \n | \n | \n | \n | \n | |
2 | \n\n | \n | \n | \n | \n | \n | \n | \n | \n |
Specification of online score book.
The distributed project management method for the first-year PBL of joint departments was proposed and considered about some important items after presented each distributed management and shown relations among the distributed managements.
\nThe motivation leading up to this topic is the discovery of the book [14]. The problem of integrating distributed management would be a consensus problem, and there was a speculation that the method of distributed optimization could be used when decentralizing the integrated management.
\nA large advantage of such a distributed and decentralized project management method mutually supplements various project managements, goes up the perfection, executes a role each other and decreases the load concerning the project if it is compared with a conventional project management method.
\nIt is important that such a new attempt concerning the project management of the Mechanical Engineering Department is the one approved by the management of another department. (It is because those advantages are shared.) Such an attempt does not succeed without fail, and it greatly depends on the competences of the member who participates in the same meeting. Therefore, it does not necessarily succeed even if the same thing is done by another project.
\nSome case studies were described about open innovation. It was motivated by which the hill excess course of model car makes to associate the blackout measures for accident of nuclear power generation caused by tsunami.
\nThen, competences in stakeholder management were discussed. They were distinctive and superior in first-grade PBL of O.I.T.
\nThere are some future themes when you examine such context closely as follows:
It is necessary to clarify the competences by thinking about the ability of each distributed project management for clarification of conditions for the application of such distributed project management to other projects.
Problems derived from optimal controllers of projects ranging from ideal optimized project management to distributed project management [14].
Optimal consensus problem for an ideal optimized project management by distributed project management [14].
More appropriate lecture about project management may be necessary for first-grade students [17, 18].
The authors sincerely express their gratitude to Special Duty Prof. Keiichi Hirako of Keio University who lectured about the project of artificial satellite. They are also grateful to Prof. Koike, Prof. Miyabe, Part Lecturer Matsumoto and Associate Professor Yoshida who served as the teacher and member of meetings of Mechanical Engineering Department in the PBL for first-grade students and many stakeholders who manage or cooperate the PBL as deans, successive section chiefs, other project managers (Prof. Izuru Nishikawa), staffs, TAs and students.
\nFrom 1998 to 2018, we conducted a translational research project to test the concept that chronic Chagas disease cardiopathy (CCC) severity could be associated with low levels of blood selenium (Se), and if supplementation with Se could help to sustain the asymptomatic cardiac stage and reduce disease severity. Pre-clinical studies in mice [1, 2, 3], clinical studies in affected people [4], and a clinical trial [5] with patients in the early stages of CCC were performed. Here we revisit and build the narrative of this process, from the very first ideas, through all the difficulties that we faced until the present days and the perspectives to introduce a new treatment for a neglected disease.
Chagas disease (CD) is caused by infection with the protozoa
To enhance the visibility to the real dimension of CD, WHO instituted a
Five different therapeutic strategies that may be applied for Chagas disease treatment in the complexity of its multifactorial causality. Anti-parasite (AP) drugs such as benznidazole and nifurtimox, as well as others that are currently been studied, may reduce the parasite load in the early acute phase and in chronic infection when the parasite still evading the immune system. Infection in the hosts/patients triggers both local and systemic inflammation and a strong specific immune response. An adequate balance of these two mechanisms regulates the control of parasite growth and the regulation of physiopathology. Different strategies are under study in basic research for intervention in these four arms—Modulators of inflammation (MI), as cytokines, chemokines and their antagonists, immune stimulators (IS) as adjuvants, vaccines, and antioxidants, such as Se, regulators of pathology (RP) as neuro-humoral blockers, anti-fibrotic and anti-arrhythmic agents, prevention of thromboembolic events, cell therapy and others. The combination of different therapeutic strategies (CT) should help to face this complexity. However, the translation from basic to clinical studies and to patient access is still far.
The idea of using Se as a complementary treatment rises from its role in 25 human selenoproteins, some of them acting as antioxidants and others in endocrine and immune pathways [13, 14]. Therefore, the effect of Se therapy in CD development needed proof of concept related to experimental infection and in patients. Our group and other researchers are adding evidence in this direction.
However, combined therapies are scarcely being tested in basic science [15, 16], and its translation to humans must also be investigated, mainly related to more clinical trials, as we performed for Se [5], opening more new doors than solving questions. As shown in Figure 1, the strategies of using combined trypanocidal chemotherapy and other agents to mitigate inflammatory disbalance, in which cytokine networks assume pathological roles, as well as increased fibrinogenic and neurodegenerative mechanisms, became co-protagonists in CD physiopathology [9, 10, 17].
In 1996, we were introduced to Se effects in cardiopathies through contact with Belgian colleagues that worked with
We then asked Prof. Alejandro Luquetti, from the Federal University of Goiás, to give us some serum samples from CD patients at different stages of cardiac disease and measured Se levels. In the five pilot samples tested, two from non-infected and three from CD-infected people, we found that those with the lowest level of Se were the ones with the more advanced cardiac disease. It would be worth persisting in testing the hypothesis, thus starting the timeline of this long project. Figure 2 shows this 30-year timeline, writing in black the yearly landmarks, in blue the application and approval of financial support projects, and in red the main publications.
Main landmarks of the STCC clinical trial. Starting from the first ideas in 1996, three decades will lead to evidence to support public policies. Financial supports are shown in blue and main publications are shown in red; yellow dots at left indicate the critical points that threatened or delayed the project. The orange gradient background indicates the three main phases of the translational roadmap—(a) ideas, conceptualization, and basic preclinical studies, from 1996 to 2015, including the three PhD thesis, (b) pretrial activities conditioning the start of recruitment phase, from 2004 to 2014, and (c) the first clinical trial (STCC) from 2013 to 2020, with results published in 2021. This first trial used a short follow-up and showed a significant effect only in patients of the B2 stage of chronic Chagas cardiopathy, leaving some questions that implicated the design of new clinical trials to elucidate points that remained open, thus opening a fourth phase (white background) that deserves planning, financial funding, and implementation.
The next step, in 1999, was to enhance the number of patients studied to confirm whether Se levels would be lower in patients with more severe cardiac disease. The first partnership was made with Dr. Alejandro M. Hasslocher-Moreno, who was the physician responsible for the clinic management and follow-up of CD patients at the Evandro Chagas National Institute of Infectious Diseases (INI), Fiocruz, Rio de Janeiro city. Se levels were measured and a very large variation was observed. We then decided that patients with different nutritional habits from another state in Brazil should also be analyzed. It implicated a new partnership with colleagues from Belo Horizonte city and CD patients from Dr. Manoel Otávio Rocha, enrolling a total of 273 patients in the study [4]. We observed that Se levels in patients with moderate and severe cardiopathy were lower than in patients with mild cardiopathy and indeterminate form, as well as in uninfected individuals [4].
In parallel, we performed some proof-of-concept studies, showing in experimentally
In 2004, we started to move on to the clinical trials stage. We designed a placebo-controlled, double-blind trial, recruiting patients with mild heart disease (stages B1 and B2 defined by the Brazilian Consensus on CD) followed at the Chagas clinic at INI-Fiocruz, for treatment of 100 mcg/day Se for 1 year. Two outcomes were defined—50% reduction in progression of heart disease and a significant reduction in left ventricular ejection fraction (LVEF) value in 5 years of follow-up. However, we did not previously contact a Se supplier. Our first impediment was to think that it should be easy to find a Se source in the Brazilian pharmaceutical market. The saga was in the early beginning. Figure 2 represent the historical saga of the Se clinical trial, including the first step (1996–2004 period) of developing ideas, hypothesis, and pre-clinical studies.
In 2005, the Brazilian National Health Surveillance Agency (ANVISA), the drug regulatory agency, changed the criteria for daily supplementation dose of Se for 34.5 mcg. Therefore, the predicted dose of 100 mcg/day would be considered as treatment and not supplementation, implying the need to change the clinical trial regulatory licenses. Then, in June 2006, a second version of the trial was approved by the Ethics Committee.
In 2005, we found no Se supplier in Brazil under good manufacturing practices (GMP) conditions for clinical trials, either organic or inorganic. In sequence and based on the opportunity that Fiocruz has an industry sector for drugs and medicines production (FarManguinhos/Fiocruz), we tried a partnership for Se production, but it was not possible due to technical restrictions.
In 2006, the production was staggered at other Fiocruz industry sectors (BioManguinhos/Fiocruz) and we initially succeeded. One year later we signed a contract and the first batch of liquid sodium selenite in ampoules was manufactured by BioManguinhos.
In June 2009, we submitted the essay proposal to ANVISA, which approved it in 5 months, after a single meeting for clarification and adjustments.
In early 2010, we received the bad news that BioManguinhos would have to interrupt the GMP production of Se due to a priority of the factory’s response to the shortage of yellow fever vaccine.
We then started a journey to find a private industry partner. In 2011, based on the experience of the recently organized Fiocruz Clinical Research Platform (http://www.ppt.fiocruz.br/fiochagas/2021/09/27/quem-somos/), we found the
In 2013, the team that worked in the pre-clinical studies and that was initially trained for the clinical trial, was partially disarticulated with the departure of the project manager and other technicians.
In 2013, we reorganized the STCC team, with the completion of the database preparation and training of the new group in Good Clinical Research Practices (GCP). The database was structured with 389 fields to be filled in the Research Electronic Data Capture (REDCap), a web-based application to capture data for clinical research and create databases, divided into (i) Tracking and inclusion, (ii) Baseline visit for cardiac and clinical data (history and physical examination); (iii) Clinical follow-up, electrocardiogram (ECG) and echocardiogram (ECO); (iv) polymerase chain reaction for
In 2015, the manufacturer
On April 6th, 2016, a meeting of the external data safety monitoring board [24] was called to analyze some adverse effects recorded and to discuss the possible need for interrupting the clinical trial. Without the need of breaking the STCC blinding, this analysis concluded that a possibly intercurrent dengue virus endemic infection could have caused the noted effects (leukopenia/neutropenia) and the continuity of the trial was recommended. After ending the first year of STCC follow-up, the results published clearly confirmed the absence of adverse effects related to Se treatment [5].
During this long time, it occurred many advances in the knowledge about the effect of Se treatment in cancer and heart disease. It became clear that perhaps the dose provided in our clinical trial (100 mcg/day) could not be sufficient. From 2013 to 2018, four articles showed that 200 mcg was ideal for cardiovascular protection [25, 26, 27, 28], and Swedish studies in elderly people proposed the benefits of the association of Se with the co-factor coenzyme Q10 for the expected outcomes. There was then a risk that STCC could end with no significant results, due to the lower concentration of Se chosen in 2004, based on cardiovascular literature related to Se treatment available at that time.
At the end of 2014, after 1 year of patients recruitment, we noted that the rate of recruitment was very slow (Figure 3), compromising the ability to reach the 163 volunteers needed for STCC protocol. It was 2015 when the third idea was planted—how to think about strategies to bring people with Chagas disease closer together and interest them in participating in the study to test/develop new medication and vaccines? Would it be possible to make them partners in the study or in actions to engage more patients in the knowledge of their own disease?
At this point, we decided to develop what we call the social arm of the clinical project.
April 14, 2015, we organized a meeting to make a public launch of the project, and to propose workshops of playful activities to “Talk about Chagas with Science and Art,” inspired by the work of the Argentine group “Hablamos de Chagas” [29]. These initiatives quickly produced results—(i) we organized five successive editions of the course “We talk about Chagas with Science and Art” from 2015 to 2019, for people with CD, their family members, and health professionals; (ii) we created a “Rio Chagas Collective” on social media, which gave rise to the (iii) “Rio Chagas Association,” founded on April 8, 2016, in which we participate in the Scientific Council; and (iv) the Rio Chagas Association participants inspired us to conceive the “Chagas Express XXI” social technology [30].
In 2018, we created a
Chagas Express XXI was created as an “imaginary train” with around 40 ArtScience workshops, games, laboratory activities, and conversation circles. It was structured with an entry and exit point, followed by six more modules of activities that combined a focus on associations of affected people, on opportunities for the public to rediscover Carlos Chagas’ discoveries, on microscopic observations and play, on health education in approach. A One Health approach was adopted, with a focus on home care, environment and reservoirs, and wellness activities. Chagas Express XXI was conceived as a social technology since all processes were co-created by scientists and patients with Chagas disease and worked with local cross-sector partnerships. We observed that 81% of the more than 2000 participants were unaware of the possibility of treating Chagas disease and 52% requested a blood test to diagnose CD. From the 1100 adults tested, 20% were diagnosed as positive for
The fourth idea would then be: if the clinical trial of Se becomes unfeasible, we will have a social legacy to be able to continue later.
However, the problem was not only in the communication and mobilization of patients to participate in STCC, since in INI/Fiocruz cohort the number of patients in the B1 and B2 stages of CCC was small as compared to patients in other clinical stages (indeterminate, A and C/D). Besides, a new risk for the project was arising: a long time had passed and the patients in the INI/Fiocruz cohort aged, acquiring comorbidities that were predicted as exclusion criteria and entering other studies that were ongoing, almost making the trial unfeasible due to a very slow rate of inclusion, as shown in Figure 3, during the years 2016 and 2017. To overcome this problem, the clinicians proposed to increase the age of recruitment from 65 to 75 years and to consider diabetes mellitus as a non-exclusion criterion.
Besides, the statisticians carried out other scenario studies for the feasibility of the STCC. They concluded that by extending the age range to up to 75 years, reducing the time of follow-up to one year, and focusing as a primary outcome only on the reduction of LVEF values (and not on the rate of CCC progression), we would conclude the inclusion of participants and generate some valid results. Then, in 2018, we published an update of the protocol [31] and started working to include 62 patients, divided into the two groups (placebo and Se treatment) for a follow-up of one year. We were then able to include all the expected patients and on August 8th, 2018, we were able to complete the last 12 months’ visit of the last participant included.
The next step was to include all the laboratory and the nutritional data in the database, to run quality control for it, and to start the statistical analysis, both for descriptions of the clinical findings of participants and for comparisons between the placebo and Se-treated groups, as well as sub-group analyses, whenever possible. The study results were finally published in September 2021 [5]. When comparing the mean values of LVEF recorded in Se treated with the placebo group at baseline and after 1 year of follow-up, we did not find significant differences in the B1/B2 stages patients (overall), nor in the B1 stage patients, but found a significant effect (
After one year (Figure 4, gray bars), all the groups showed a lower mean of LVEF when compared to baseline values (Figure 4, black bars). However only those already on the B2 subgroup, with LVEF <45%, showed a high decrease in LVEF in 1-year, which was reversed by Se treatment. The differences in LVEF longitudinal changes between groups were evaluated using linear mixed effect models in intention-to-treat analyses. This type of analysis assesses the rate of change of the outcomes by the time X intervention group interaction term, considering the correlations between repeated measures over time and missing data. In the B2 subgroup, the worsening of cardiac dysfunction was significantly reduced by Se treatment, and while the placebo group had a drop in LVEF, the Se group remained stable. In addition, only in the Se group, we observed cases of LVEF increase of more than 10 absolute points in 5 patients (n = 3) and recovery from stage B2 to B1 (n = 2), as reported [5]. In this short-term follow-up (1 year), the secondary outcomes observed were all related to LVEF as the underlying cause and could not be weighted in the analysis. We also observed that treatment with Se was safe for patients with CCC and that the low percentage of adverse effects detected were similar in the two groups. However, there was no complete shift of patients treated with Se to a safe range of serum Se (>100mcg/L), indicating that the dose of 100 mcg per day may have been insufficient. Further studies are needed to explore higher doses and/or associations of Se at different stages of CCC (B2 and C) at a short follow-up (one year) and at early diseases stages (A and B1), with longer follow-up.
The paper with STCC results [5] discussed some possibilities and pointed that “new clinical trials with a longer follow-up are needed to investigate the effects of Se in the mild (stages A and B) or severe (stages C and D) CCC, and in the asymptomatic indeterminate clinical form”. The limitations of STCC were reported and the future outspread of the project is depicted in Figure 2 from 2022 to, at least, 2026. The design of new projects (STCC#2 and STCC#3) is underway, and when the adequate industry partnership(s) will be signed, the proposal is that the new clinical trials will have a following of 3 to 10 years to generate the necessary evidence to support public policies recommendations.
Time sequence of inclusion of participants on the STCC clinical trial. Black solid line shows the putative participants tracked, dashed line shows the participants included after signing the project voluntary consent form, and solid line with white dots shows the number of patients that completed the one-year treatment. Note that after 2015 the slope angle of the inclusion curve rise, denoting a success in the recruiting phase.
Mean values for left ventricular ejection fraction recorded for all the patients participating in the STCC clinical trial, at baseline (baseline, black bars) and after 12 months (gray bars). In the X-axis it is shown the comparison of the groups treated with placebo or selenium, considering all the participants in each group and in the subgroups B1 and B2 stages. For details, see reference #5.
From basic research to a putative public health recommendation in clinical protocols and therapeutic guidelines, the roadmap of the Se project was a real saga, with many obstacles that tested team resilience and Brazilian conditions of science development.
This resilience derived from the strength of the encounter between a basic research group (in Oswaldo Cruz Institute (IOC), founded by TCAJ) and a clinic research group (INI, founded by AMHM). Both groups were very active in producing new knowledge in CD and were excited with the idea of conceiving and performing the first Brazilian clinical trial [23] with a strategy based on one of the pathological mechanisms implicated in CCC [8, 9]. Overpassing all the difficulties that were listed in Figure 2 (item 3), one after another, and attaining the conclusion of the trial gave even more strength to this partnership, our self-confidence, and our mutual respect increased.
The progress attained in the social arm of the project was also a source of resilience. More IOC/Fiocruz laboratories are associated with the project, as we could see from the Chagas Express publication [30] in August 2021. A project recently approved is preparing a virtual version of Chagas Express (https://expressochagas.com/), integrating contents related to COVID-19 as well as new expeditions to other endemic regions, planned for 2022.
In addition, this social arm of the project was developed at a very important moment in the struggle for the rights of patients with Chagas’ disease. In 2018, the Ministry of Health, through its National Commission of Technology Incorporation, offered Therapeutic Guideline for CD Diagnosis and Treatment (PCDT Chagas) to public consultation, fostering discussions that lead to reformulations and publication in 2019. It was one of the main documents disseminated in the expedition to Minas Gerais by Expresso Chagas XXI [30]. We also participated in the advocacy movement that led to compulsory notification of chronic cases. Together with the traditional surveillance of cases in the acute phase, ordinance No. 1.061, May 18, 2020, introduced notification of chronic cases in Brazilian territory, strengthening the construction of public policies based on scientific evidence.
In a recent review [32], Morel discussed that CD is an example of successful translational research integrating basic and applied science, attaining the control of its transmission by insect vectors in large regions of the Southern Cone countries in the 90s. However, if the successful control of CD transmission by insect vectors is, in fact, a paradigmatic achievement in science translation, in addition to organizing a strong scientific community in Brazil and in Latin America, the translational research to focus on vaccines and treatments suffers extremely negative pressures as the ones we reported above. One important lesson to take home after this saga is that translational science on a neglected disease in
What are the lessons learned and the next steps?
Four lessons were learned during the STCC saga—#1: the harmonious interaction between the clinical and basic research teams is essential to allow translational research to proceed; # 2: even in the pre-clinical phase, it is essential to identify potential suppliers in the market for the formulations that are intended to be used as treatment and/or industry partners interested in leading the product to the market; #3: the inclusion of master’s and doctoral students should only be done in pre-clinical studies. In clinical trials, the stable inclusion of trained and mature professionals, economically stable, is necessary to avoid the shortage of human resources during the study; #4: a national and international network of experts is critical to overcoming the numerous doubts that arise in such a long study. In this case, we learned a lot about the clinical use of Se during the 15 years of the clinical trial, and we continue to learn about the physiopathology and clinical management of patients with Chagas disease.
Concerning the next steps, we are at the stage of preparing the reports for the sponsors and for our patients participating in the study. We will have several consequences in the clinical scope:
to carry out the cardiological follow-up of the study participants for another 4 to 10 years;
to conduct a clinical trial with Brazil nuts as a natural source of Se;
to identify PCR-
to accomplish the study of immunological biomarkers and gene polymorphism for cytokines and selenoproteins in samples from participants in the published study;
to contact suppliers and industry partners to enable further studies with Se in different settings, conditions, and associations and in multicenter and international arrangements.
As a second initiative, we will prepare a dossier for the National Commission of Technology Incorporation in the Health System (Comissão Nacional de Incorporação de Tecnologias no SUS” – CONITEC) to evaluate the recommendation of dietary supplementation for patients with Chagas disease with Se, either by supplementation with one Brazil nut per day (about R $20 per month) or by supplementation with Se and Coenzyme Q10 (about R$80 per month), due to type B levels of evidence for therapeutic studies in the literature and the safety when administering Se to elderly persons [25, 26, 27].
Last, but not least, we intend to incorporate Chagas Express XXI as cutting-edge educational technology, since we have already demonstrated its potential as an instrument of field epidemiology. In the next expeditions planned for 2022 in the states of Pernambuco, Goiás, and Minas Gerais, we will include a rapid test for a local screening of positive people and inclusion in the National Health System for diagnostic confirmation and clinical follow-up. We will also include a local digital electrocardiogram to screen for possible abnormalities related to Chagas disease in individuals with mild cardiac form/stage A. The Chagas Express XXI is a potentially useful social technology for health and science education and active search for chronic cases of disease of asymptomatic CD patients, contributing to the notification of chronic cases and their inclusion in the lines of care of PCDT-Chagas. Furthermore, this technology can be adapted to understand and cooperate in other potentially epidemic situations, especially related to other neglected diseases, such as leishmaniasis, tuberculosis, and arboviruses.
We dedicate this work to all the patients who participate in the STCC trial, some of them contributing to the creation of the Rio Chagas Association. We thank all the basic and the clinical groups´ members of the Selenium project: Maria Teresa Rivera, Jean Vanderpas, Andrea P. Souza, Bianca P. Olivieri, Solange L. de Castro, Gabriel M. Oliveira, and Andrea P. Souza. Constança Britto, Otacílio C. Moreira, Erica R. Maciel, Fernanda M. Carneiro, Sérgio S. Xavier, Priscila F. Santos, Henrique H. Veloso, Pedro E.A.A. Brasil, Andrea S. de Sousa, Paula S. da Silva and Luiz Henrique C. Sangenis. We also thank Catalent Brasil Ltda for supplying free-of-charge sodium selenite and placebo for the STCC study. T.C.A-J represents Fiocruz in the Ibero-American New Tools for the Diagnosis and Evaluation of CD (NHEPACHA) network. This work was supported by the Department of the Industrial Complex and Innovation in Health from the Brazilian Health Ministry (IOC Fiotec IOC-001-LIV-11-2-1; 25380.001603/2017-2089), the governmental agencies CNPq (306184/2010-9, 309545/2014-5;313011/2018-4), FAPERJ (E26/151.506/99; Protocol 33); and the Innovation and the Research Vice-Presidencies of Fiocruz. Students who participated in the project received fellowships from Coordenação de Aperfeiçoamento de Pessoal do Ensino Superior (CAPES) related to their respective Fiocruz post-graduation courses.
The authors declare no conflict of interest. The funders had no role in the design of the study nor in the writing of the manuscript, or in the decision to publish the results.
This is a brief overview of the main steps involved in publishing with IntechOpen Compacts, Monographs and Edited Books. Once you submit your proposal you will be appointed a Author Service Manager who will be your single point of contact and lead you through all the described steps below.
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Anti-inflammatory diet is designed to improve health and prevent the occurrence and development of chronic diseases associated with inadequate diet. Proper nutrition is based on the anti-inflammatory pyramid and changes in poor eating habits are the long-term strategy for preventing inflammation and chronic diseases. Inflammatory factors from food may play a role in the development of osteoporosis and an anti-inflammatory diet may be a way to control and reduce long-term inflammation and prevent bone loss. Pro-inflammatory cytokines from the fat tissue, through activation of the RANKL/RANK/OPG system could intervene with bone metabolism in a way of increased bone loss. Therefore the special attention need to be given to obese patients due to twofold risk, one related to pro-inflammatory cytokines release and the other related to the deprivation of the vitamin D in the fat tissue.",book:{id:"10323",slug:"osteoporosis-recent-advances-new-perspectives-and-applications",title:"Osteoporosis",fullTitle:"Osteoporosis - Recent Advances, New Perspectives and Applications"},signatures:"Olga Cvijanović Peloza, Sandra Pavičić Žeželj, Gordana Kenđel Jovanović, Ivana Pavičić, Ana Terezija Jerbić Radetić, Sanja Zoričić Cvek, Jasna Lulić Drenjak, Gordana Starčević Klasan, Ariana Fužinac Smojver and Juraj Arbanas",authors:[{id:"339281",title:"Associate Prof.",name:"Olga",middleName:null,surname:"Cvijanović Peloza",slug:"olga-cvijanovic-peloza",fullName:"Olga Cvijanović Peloza"},{id:"346420",title:"Prof.",name:"Sandra",middleName:null,surname:"Pavičić Žeželj",slug:"sandra-pavicic-zezelj",fullName:"Sandra Pavičić Žeželj"},{id:"346421",title:"BSc.",name:"Ivana",middleName:null,surname:"Pavičić",slug:"ivana-pavicic",fullName:"Ivana Pavičić"},{id:"346423",title:"Prof.",name:"Ana Terezija",middleName:null,surname:"Jerbić Radetić",slug:"ana-terezija-jerbic-radetic",fullName:"Ana Terezija Jerbić Radetić"},{id:"346424",title:"Prof.",name:"Sanja",middleName:null,surname:"Zoričić Cvek",slug:"sanja-zoricic-cvek",fullName:"Sanja Zoričić Cvek"},{id:"346426",title:"MSc.",name:"Jasna",middleName:null,surname:"Lulić Drenjak",slug:"jasna-lulic-drenjak",fullName:"Jasna Lulić Drenjak"},{id:"346427",title:"Prof.",name:"Gordana",middleName:null,surname:"Starčević Klasan",slug:"gordana-starcevic-klasan",fullName:"Gordana Starčević Klasan"},{id:"346428",title:"MSc.",name:"Ariana",middleName:null,surname:"Fužinac Smojver",slug:"ariana-fuzinac-smojver",fullName:"Ariana Fužinac Smojver"},{id:"346429",title:"Prof.",name:"Juraj",middleName:null,surname:"Arbanas",slug:"juraj-arbanas",fullName:"Juraj Arbanas"},{id:"350011",title:"Dr.",name:"Gordana",middleName:null,surname:"Kenđel Jovanović",slug:"gordana-kendjel-jovanovic",fullName:"Gordana Kenđel Jovanović"}]},{id:"76351",doi:"10.5772/intechopen.97416",title:"Glucocorticoid-Induced Osteoporosis",slug:"glucocorticoid-induced-osteoporosis",totalDownloads:254,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"The use of glucocorticoids (GC) in the medium and long term, causes several considerable side effects, being one of the main ones the reduction of bone mineral density (BMD). Prolonged corticosteroid therapy reduces BMD by up to 20% in trabecular bone and approximately 2–3% in cortical bone in the first year of use. This loss rate declines and stabilizes at approximately 2% in subsequent years. Therefore, there is a considerable increase in the incidence of pathological fractures, whether clinically symptomatic or asymptomatic (detected as a radiological finding), which varies between 30 and 50% of patients who use GC for more than three months. In view of the above, it is essential to prevent fractures and treat osteoporosis in patients using glucocorticoids for long periods (in particular, greater than or equal to 3 months), which may or may not be associated with clinical risk factors or previous fractures. The guidelines for the treatment and prevention of this comorbidity are well established for postmenopausal women and men over 50 years of age. However, for patients below this range, studies are still lacking.",book:{id:"10323",slug:"osteoporosis-recent-advances-new-perspectives-and-applications",title:"Osteoporosis",fullTitle:"Osteoporosis - Recent Advances, New Perspectives and Applications"},signatures:"José Renan Vieira da Costa Júnior and Sérgio Luchini Batista",authors:[{id:"164388",title:"Prof.",name:"Sergio",middleName:null,surname:"Luchini Batista",slug:"sergio-luchini-batista",fullName:"Sergio Luchini Batista"},{id:"354032",title:"Dr.",name:"José Renan",middleName:null,surname:"Vieira Da Costa Júnior",slug:"jose-renan-vieira-da-costa-junior",fullName:"José Renan Vieira Da Costa Júnior"}]},{id:"76677",doi:"10.5772/intechopen.97760",title:"Introductory Chapter: Osteoporosis Overview",slug:"introductory-chapter-osteoporosis-overview",totalDownloads:176,totalCrossrefCites:0,totalDimensionsCites:0,abstract:null,book:{id:"10323",slug:"osteoporosis-recent-advances-new-perspectives-and-applications",title:"Osteoporosis",fullTitle:"Osteoporosis - Recent Advances, New Perspectives and Applications"},signatures:"Luis Rodrigo",authors:[{id:"73208",title:"Prof.",name:"Luis",middleName:null,surname:"Rodrigo",slug:"luis-rodrigo",fullName:"Luis Rodrigo"}]}],mostDownloadedChaptersLast30Days:[{id:"75660",title:"Bone Quality of the Dento-Maxillofacial Complex and Osteoporosis. Opportunistic Radiographic Interpretation",slug:"bone-quality-of-the-dento-maxillofacial-complex-and-osteoporosis-opportunistic-radiographic-interpre",totalDownloads:354,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Research suggests the use of different indexes on panoramic radiography as a way to assess BMD and to be able to detect changes in bone metabolism before fractures occur. Therefore, the objective of this chapter is to describe the use of these parameters as an auxiliary mechanism in the detection of low bone mineral density, as well as to characterize the radiographic findings of patients with osteoporosis.",book:{id:"10323",slug:"osteoporosis-recent-advances-new-perspectives-and-applications",title:"Osteoporosis",fullTitle:"Osteoporosis - Recent Advances, New Perspectives and Applications"},signatures:"Plauto Christopher Aranha Watanabe, Giovani Antonio Rodrigues, Marcelo Rodrigues Azenha, Michel Campos Ribeiro, Enéas de Almeida Souza Filho, Rafael Angelo Soares Vieira and Fabio Santos Bottacin",authors:[{id:"76171",title:"Prof.",name:"Plauto C. A.",middleName:null,surname:"Watanabe",slug:"plauto-c.-a.-watanabe",fullName:"Plauto C. A. Watanabe"},{id:"337631",title:"Dr.",name:"Giovani Antonio",middleName:null,surname:"Rodrigues",slug:"giovani-antonio-rodrigues",fullName:"Giovani Antonio Rodrigues"},{id:"350577",title:"Dr.",name:"Fabio",middleName:null,surname:"Santos Bottacin",slug:"fabio-santos-bottacin",fullName:"Fabio Santos Bottacin"},{id:"350578",title:"Dr.",name:"Rafael Angelo",middleName:null,surname:"Soares Vieira",slug:"rafael-angelo-soares-vieira",fullName:"Rafael Angelo Soares Vieira"},{id:"350579",title:"Dr.",name:"Enéas de Almeida",middleName:null,surname:"Souza Filho",slug:"eneas-de-almeida-souza-filho",fullName:"Enéas de Almeida Souza Filho"},{id:"350580",title:"Dr.",name:"Michel",middleName:null,surname:"Campos Ribeiro",slug:"michel-campos-ribeiro",fullName:"Michel Campos Ribeiro"},{id:"350581",title:"Dr.",name:"Rodrigues Azenha",middleName:null,surname:"Rodrigues Azenha",slug:"rodrigues-azenha-rodrigues-azenha",fullName:"Rodrigues Azenha Rodrigues Azenha"}]},{id:"76677",title:"Introductory Chapter: Osteoporosis Overview",slug:"introductory-chapter-osteoporosis-overview",totalDownloads:176,totalCrossrefCites:0,totalDimensionsCites:0,abstract:null,book:{id:"10323",slug:"osteoporosis-recent-advances-new-perspectives-and-applications",title:"Osteoporosis",fullTitle:"Osteoporosis - Recent Advances, New Perspectives and Applications"},signatures:"Luis Rodrigo",authors:[{id:"73208",title:"Prof.",name:"Luis",middleName:null,surname:"Rodrigo",slug:"luis-rodrigo",fullName:"Luis Rodrigo"}]},{id:"76507",title:"Osteoporosis: A Multifactorial Disease",slug:"osteoporosis-a-multifactorial-disease",totalDownloads:209,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"A great achievement of modern medicine is the increased lifespan of the human population. Unfortunately, the comorbidities of aging have created a large economic and health burden on society. Osteoporosis is the most prevalent age-related disease. It is characterized by uncoupled bone resorption that leads to low bone mass, compromised microarchitecture and structural deterioration that increases the likelihood of fracture with minimal trauma, known as fragility fractures. These fractures lead to disproportionally high mortality rate and a drastic decline in quality of life for those affected. While estrogen loss is one known trigger of osteoporosis, a number of recent studies have shown that osteoporosis is a multifactorial condition in both humans and rodent models. The presence or absence of certain factors are likely to determine which subset of the population develop osteoporosis. In this chapter, we review the factors that contribute to osteoporosis with an emphasis on its multifactorial nature and the therapeutic consequences.",book:{id:"10323",slug:"osteoporosis-recent-advances-new-perspectives-and-applications",title:"Osteoporosis",fullTitle:"Osteoporosis - Recent Advances, New Perspectives and Applications"},signatures:"Di Wu, Anna Cline-Smith, Elena Shashkova and Rajeev Aurora",authors:[{id:"339667",title:"Associate Prof.",name:"Rajeev",middleName:null,surname:"Aurora",slug:"rajeev-aurora",fullName:"Rajeev Aurora"},{id:"347366",title:"Mr.",name:"Di",middleName:null,surname:"Wu",slug:"di-wu",fullName:"Di Wu"},{id:"347367",title:"Ms.",name:"Anna",middleName:null,surname:"Cline-Smith",slug:"anna-cline-smith",fullName:"Anna Cline-Smith"},{id:"347579",title:"Dr.",name:"Elena",middleName:null,surname:"Shashkova",slug:"elena-shashkova",fullName:"Elena Shashkova"}]},{id:"75742",title:"Osteoporosis and Dietary Inflammatory Index",slug:"osteoporosis-and-dietary-inflammatory-index",totalDownloads:235,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Healthy bones are constantly being renewed and proper nutrition is an important factor in this process. Anti-inflammatory diet is designed to improve health and prevent the occurrence and development of chronic diseases associated with inadequate diet. Proper nutrition is based on the anti-inflammatory pyramid and changes in poor eating habits are the long-term strategy for preventing inflammation and chronic diseases. Inflammatory factors from food may play a role in the development of osteoporosis and an anti-inflammatory diet may be a way to control and reduce long-term inflammation and prevent bone loss. Pro-inflammatory cytokines from the fat tissue, through activation of the RANKL/RANK/OPG system could intervene with bone metabolism in a way of increased bone loss. Therefore the special attention need to be given to obese patients due to twofold risk, one related to pro-inflammatory cytokines release and the other related to the deprivation of the vitamin D in the fat tissue.",book:{id:"10323",slug:"osteoporosis-recent-advances-new-perspectives-and-applications",title:"Osteoporosis",fullTitle:"Osteoporosis - Recent Advances, New Perspectives and Applications"},signatures:"Olga Cvijanović Peloza, Sandra Pavičić Žeželj, Gordana Kenđel Jovanović, Ivana Pavičić, Ana Terezija Jerbić Radetić, Sanja Zoričić Cvek, Jasna Lulić Drenjak, Gordana Starčević Klasan, Ariana Fužinac Smojver and Juraj Arbanas",authors:[{id:"339281",title:"Associate Prof.",name:"Olga",middleName:null,surname:"Cvijanović Peloza",slug:"olga-cvijanovic-peloza",fullName:"Olga Cvijanović Peloza"},{id:"346420",title:"Prof.",name:"Sandra",middleName:null,surname:"Pavičić Žeželj",slug:"sandra-pavicic-zezelj",fullName:"Sandra Pavičić Žeželj"},{id:"346421",title:"BSc.",name:"Ivana",middleName:null,surname:"Pavičić",slug:"ivana-pavicic",fullName:"Ivana Pavičić"},{id:"346423",title:"Prof.",name:"Ana Terezija",middleName:null,surname:"Jerbić Radetić",slug:"ana-terezija-jerbic-radetic",fullName:"Ana Terezija Jerbić Radetić"},{id:"346424",title:"Prof.",name:"Sanja",middleName:null,surname:"Zoričić Cvek",slug:"sanja-zoricic-cvek",fullName:"Sanja Zoričić Cvek"},{id:"346426",title:"MSc.",name:"Jasna",middleName:null,surname:"Lulić Drenjak",slug:"jasna-lulic-drenjak",fullName:"Jasna Lulić Drenjak"},{id:"346427",title:"Prof.",name:"Gordana",middleName:null,surname:"Starčević Klasan",slug:"gordana-starcevic-klasan",fullName:"Gordana Starčević Klasan"},{id:"346428",title:"MSc.",name:"Ariana",middleName:null,surname:"Fužinac Smojver",slug:"ariana-fuzinac-smojver",fullName:"Ariana Fužinac Smojver"},{id:"346429",title:"Prof.",name:"Juraj",middleName:null,surname:"Arbanas",slug:"juraj-arbanas",fullName:"Juraj Arbanas"},{id:"350011",title:"Dr.",name:"Gordana",middleName:null,surname:"Kenđel Jovanović",slug:"gordana-kendjel-jovanovic",fullName:"Gordana Kenđel Jovanović"}]},{id:"76351",title:"Glucocorticoid-Induced Osteoporosis",slug:"glucocorticoid-induced-osteoporosis",totalDownloads:254,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"The use of glucocorticoids (GC) in the medium and long term, causes several considerable side effects, being one of the main ones the reduction of bone mineral density (BMD). Prolonged corticosteroid therapy reduces BMD by up to 20% in trabecular bone and approximately 2–3% in cortical bone in the first year of use. This loss rate declines and stabilizes at approximately 2% in subsequent years. Therefore, there is a considerable increase in the incidence of pathological fractures, whether clinically symptomatic or asymptomatic (detected as a radiological finding), which varies between 30 and 50% of patients who use GC for more than three months. In view of the above, it is essential to prevent fractures and treat osteoporosis in patients using glucocorticoids for long periods (in particular, greater than or equal to 3 months), which may or may not be associated with clinical risk factors or previous fractures. The guidelines for the treatment and prevention of this comorbidity are well established for postmenopausal women and men over 50 years of age. 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He has both an MS and Ph.D. in Biomedical Engineering. He was previously a research scientist at the University of California Los Angeles (UCLA) and visiting professor and researcher at the University of North Dakota. He is currently working in artificial intelligence and its applications in medical signal processing. In addition, he is using digital signal processing in medical imaging and speech processing. Dr. Asadpour has developed brain-computer interfacing algorithms and has published books, book chapters, and several journal and conference papers in this field and other areas of intelligent signal processing. He has also designed medical devices, including a laser Doppler monitoring system.",institutionString:"Kaiser Permanente Southern California",institution:null},{id:"169608",title:"Prof.",name:"Marian",middleName:null,surname:"Găiceanu",slug:"marian-gaiceanu",fullName:"Marian Găiceanu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/169608/images/system/169608.png",biography:"Prof. Dr. Marian Gaiceanu graduated from the Naval and Electrical Engineering Faculty, Dunarea de Jos University of Galati, Romania, in 1997. He received a Ph.D. (Magna Cum Laude) in Electrical Engineering in 2002. Since 2017, Dr. Gaiceanu has been a Ph.D. supervisor for students in Electrical Engineering. He has been employed at Dunarea de Jos University of Galati since 1996, where he is currently a professor. Dr. Gaiceanu is a member of the National Council for Attesting Titles, Diplomas and Certificates, an expert of the Executive Agency for Higher Education, Research Funding, and a member of the Senate of the Dunarea de Jos University of Galati. He has been the head of the Integrated Energy Conversion Systems and Advanced Control of Complex Processes Research Center, Romania, since 2016. He has conducted several projects in power converter systems for electrical drives, power quality, PEM and SOFC fuel cell power converters for utilities, electric vehicles, and marine applications with the Department of Regulation and Control, SIEI S.pA. (2002–2004) and the Polytechnic University of Turin, Italy (2002–2004, 2006–2007). He is a member of the Institute of Electrical and Electronics Engineers (IEEE) and cofounder-member of the IEEE Power Electronics Romanian Chapter. He is a guest editor at Energies and an academic book editor for IntechOpen. He is also a member of the editorial boards of the Journal of Electrical Engineering, Electronics, Control and Computer Science and Sustainability. Dr. Gaiceanu has been General Chairman of the IEEE International Symposium on Electrical and Electronics Engineering in the last six editions.",institutionString:'"Dunarea de Jos" University of Galati',institution:{name:'"Dunarea de Jos" University of Galati',country:{name:"Romania"}}},{id:"4519",title:"Prof.",name:"Jaydip",middleName:null,surname:"Sen",slug:"jaydip-sen",fullName:"Jaydip Sen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/4519/images/system/4519.jpeg",biography:"Jaydip Sen is associated with Praxis Business School, Kolkata, India, as a professor in the Department of Data Science. His research areas include security and privacy issues in computing and communication, intrusion detection systems, machine learning, deep learning, and artificial intelligence in the financial domain. He has more than 200 publications in reputed international journals, refereed conference proceedings, and 20 book chapters in books published by internationally renowned publishing houses, such as Springer, CRC press, IGI Global, etc. Currently, he is serving on the editorial board of the prestigious journal Frontiers in Communications and Networks and in the technical program committees of a number of high-ranked international conferences organized by the IEEE, USA, and the ACM, USA. He has been listed among the top 2% of scientists in the world for the last three consecutive years, 2019 to 2021 as per studies conducted by the Stanford University, USA.",institutionString:"Praxis Business School",institution:null},{id:"320071",title:"Dr.",name:"Sidra",middleName:null,surname:"Mehtab",slug:"sidra-mehtab",fullName:"Sidra Mehtab",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00002v6KHoQAM/Profile_Picture_1584512086360",biography:"Sidra Mehtab has completed her BS with honors in Physics from Calcutta University, India in 2018. She has done MS in Data Science and Analytics from Maulana Abul Kalam Azad University of Technology (MAKAUT), Kolkata, India in 2020. Her research areas include Econometrics, Time Series Analysis, Machine Learning, Deep Learning, Artificial Intelligence, and Computer and Network Security with a particular focus on Cyber Security Analytics. Ms. Mehtab has published seven papers in international conferences and one of her papers has been accepted for publication in a reputable international journal. She has won the best paper awards in two prestigious international conferences – BAICONF 2019, and ICADCML 2021, organized in the Indian Institute of Management, Bangalore, India in December 2019, and SOA University, Bhubaneswar, India in January 2021. Besides, Ms. Mehtab has also published two book chapters in two books. Seven of her book chapters will be published in a volume shortly in 2021 by Cambridge Scholars’ Press, UK. Currently, she is working as the joint editor of two edited volumes on Time Series Analysis and Forecasting to be published in the first half of 2021 by an international house. Currently, she is working as a Data Scientist with an MNC in Delhi, India.",institutionString:"NSHM College of Management and Technology",institution:null},{id:"226240",title:"Dr.",name:"Andri Irfan",middleName:null,surname:"Rifai",slug:"andri-irfan-rifai",fullName:"Andri Irfan Rifai",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226240/images/7412_n.jpg",biography:"Andri IRFAN is a Senior Lecturer of Civil Engineering and Planning. He completed the PhD at the Universitas Indonesia & Universidade do Minho with Sandwich Program Scholarship from the Directorate General of Higher Education and LPDP scholarship. He has been teaching for more than 19 years and much active to applied his knowledge in the project construction in Indonesia. His research interest ranges from pavement management system to advanced data mining techniques for transportation engineering. He has published more than 50 papers in journals and 2 books.",institutionString:null,institution:{name:"Universitas Internasional Batam",country:{name:"Indonesia"}}},{id:"314576",title:"Dr.",name:"Ibai",middleName:null,surname:"Laña",slug:"ibai-lana",fullName:"Ibai Laña",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314576/images/system/314576.jpg",biography:"Dr. Ibai Laña works at TECNALIA as a data analyst. He received his Ph.D. in Artificial Intelligence from the University of the Basque Country (UPV/EHU), Spain, in 2018. He is currently a senior researcher at TECNALIA. His research interests fall within the intersection of intelligent transportation systems, machine learning, traffic data analysis, and data science. He has dealt with urban traffic forecasting problems, applying machine learning models and evolutionary algorithms. He has experience in origin-destination matrix estimation or point of interest and trajectory detection. Working with large volumes of data has given him a good command of big data processing tools and NoSQL databases. He has also been a visiting scholar at the Knowledge Engineering and Discovery Research Institute, Auckland University of Technology.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"314575",title:"Dr.",name:"Jesus",middleName:null,surname:"L. Lobo",slug:"jesus-l.-lobo",fullName:"Jesus L. Lobo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314575/images/system/314575.png",biography:"Dr. Jesús López is currently based in Bilbao (Spain) working at TECNALIA as Artificial Intelligence Research Scientist. In most cases, a project idea or a new research line needs to be investigated to see if it is good enough to take into production or to focus on it. That is exactly what he does, diving into Machine Learning algorithms and technologies to help TECNALIA to decide whether something is great in theory or will actually impact on the product or processes of its projects. So, he is expert at framing experiments, developing hypotheses, and proving whether they’re true or not, in order to investigate fundamental problems with a longer time horizon. He is also able to design and develop PoCs and system prototypes in simulation. He has participated in several national and internacional R&D projects.\n\nAs another relevant part of his everyday research work, he usually publishes his findings in reputed scientific refereed journals and international conferences, occasionally acting as reviewer and Programme Commitee member. Concretely, since 2018 he has published 9 JCR (8 Q1) journal papers, 9 conference papers (e.g. ECML PKDD 2021), and he has co-edited a book. He is also active in popular science writing data science stories for reputed blogs (KDNuggets, TowardsDataScience, Naukas). Besides, he has recently embarked on mentoring programmes as mentor, and has also worked as data science trainer.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"103779",title:"Prof.",name:"Yalcin",middleName:null,surname:"Isler",slug:"yalcin-isler",fullName:"Yalcin Isler",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRyQ8QAK/Profile_Picture_1628834958734",biography:"Yalcin Isler (1971 - Burdur / Turkey) received the B.Sc. degree in the Department of Electrical and Electronics Engineering from Anadolu University, Eskisehir, Turkey, in 1993, the M.Sc. degree from the Department of Electronics and Communication Engineering, Suleyman Demirel University, Isparta, Turkey, in 1996, the Ph.D. degree from the Department of Electrical and Electronics Engineering, Dokuz Eylul University, Izmir, Turkey, in 2009, and the Competence of Associate Professorship from the Turkish Interuniversity Council in 2019.\n\nHe was Lecturer at Burdur Vocational School in Suleyman Demirel University (1993-2000, Burdur / Turkey), Software Engineer (2000-2002, Izmir / Turkey), Research Assistant in Bulent Ecevit University (2002-2003, Zonguldak / Turkey), Research Assistant in Dokuz Eylul University (2003-2010, Izmir / Turkey), Assistant Professor at the Department of Electrical and Electronics Engineering in Bulent Ecevit University (2010-2012, Zonguldak / Turkey), Assistant Professor at the Department of Biomedical Engineering in Izmir Katip Celebi University (2012-2019, Izmir / Turkey). He is an Associate Professor at the Department of Biomedical Engineering at Izmir Katip Celebi University, Izmir / Turkey, since 2019. In addition to academics, he has also founded Islerya Medical and Information Technologies Company, Izmir / Turkey, since 2017.\n\nHis main research interests cover biomedical signal processing, pattern recognition, medical device design, programming, and embedded systems. He has many scientific papers and participated in several projects in these study fields. He was an IEEE Student Member (2009-2011) and IEEE Member (2011-2014) and has been IEEE Senior Member since 2014.",institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",country:{name:"Turkey"}}},{id:"339677",title:"Dr.",name:"Mrinmoy",middleName:null,surname:"Roy",slug:"mrinmoy-roy",fullName:"Mrinmoy Roy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/339677/images/16768_n.jpg",biography:"An accomplished Sales & Marketing professional with 12 years of cross-functional experience in well-known organisations such as CIPLA, LUPIN, GLENMARK, ASTRAZENECA across different segment of Sales & Marketing, International Business, Institutional Business, Product Management, Strategic Marketing of HIV, Oncology, Derma, Respiratory, Anti-Diabetic, Nutraceutical & Stomatological Product Portfolio and Generic as well as Chronic Critical Care Portfolio. A First Class MBA in International Business & Strategic Marketing, B.Pharm, D.Pharm, Google Certified Digital Marketing Professional. Qualified PhD Candidate in Operations and Management with special focus on Artificial Intelligence and Machine Learning adoption, analysis and use in Healthcare, Hospital & Pharma Domain. Seasoned with diverse therapy area of Pharmaceutical Sales & Marketing ranging from generating revenue through generating prescriptions, launching new products, and making them big brands with continuous strategy execution at the Physician and Patients level. Moved from Sales to Marketing and Business Development for 3.5 years in South East Asian Market operating from Manila, Philippines. Came back to India and handled and developed Brands such as Gluconorm, Lupisulin, Supracal, Absolut Woman, Hemozink, Fabiflu (For COVID 19), and many more. In my previous assignment I used to develop and execute strategies on Sales & Marketing, Commercialization & Business Development for Institution and Corporate Hospital Business portfolio of Oncology Therapy Area for AstraZeneca Pharma India Ltd. Being a Research Scholar and Student of ‘Operations Research & Management: Artificial Intelligence’ I published several pioneer research papers and book chapters on the same in Internationally reputed journals and Books indexed in Scopus, Springer and Ei Compendex, Google Scholar etc. Currently, I am launching PGDM Pharmaceutical Management Program in IIHMR Bangalore and spearheading the course curriculum and structure of the same. I am interested in Collaboration for Healthcare Innovation, Pharma AI Innovation, Future trend in Marketing and Management with incubation on Healthcare, Healthcare IT startups, AI-ML Modelling and Healthcare Algorithm based training module development. I am also an affiliated member of the Institute of Management Consultant of India, looking forward to Healthcare, Healthcare IT and Innovation, Pharma and Hospital Management Consulting works.",institutionString:null,institution:{name:"Lovely Professional University",country:{name:"India"}}},{id:"310576",title:"Prof.",name:"Erick Giovani",middleName:null,surname:"Sperandio Nascimento",slug:"erick-giovani-sperandio-nascimento",fullName:"Erick Giovani Sperandio Nascimento",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y00002pDKxDQAW/ProfilePicture%202022-06-20%2019%3A57%3A24.788",biography:"Prof. Erick Sperandio is the Lead Researcher and professor of Artificial Intelligence (AI) at SENAI CIMATEC, Bahia, Brazil, also working with Computational Modeling (CM) and HPC. He holds a PhD in Environmental Engineering in the area of Atmospheric Computational Modeling, a Master in Informatics in the field of Computational Intelligence and Graduated in Computer Science from UFES. He currently coordinates, leads and participates in R&D projects in the areas of AI, computational modeling and supercomputing applied to different areas such as Oil and Gas, Health, Advanced Manufacturing, Renewable Energies and Atmospheric Sciences, advising undergraduate, master's and doctoral students. He is the Lead Researcher at SENAI CIMATEC's Reference Center on Artificial Intelligence. In addition, he is a Certified Instructor and University Ambassador of the NVIDIA Deep Learning Institute (DLI) in the areas of Deep Learning, Computer Vision, Natural Language Processing and Recommender Systems, and Principal Investigator of the NVIDIA/CIMATEC AI Joint Lab, the first in Latin America within the NVIDIA AI Technology Center (NVAITC) worldwide program. He also works as a researcher at the Supercomputing Center for Industrial Innovation (CS2i) and at the SENAI Institute of Innovation for Automation (ISI Automação), both from SENAI CIMATEC. He is a member and vice-coordinator of the Basic Board of Scientific-Technological Advice and Evaluation, in the area of Innovation, of the Foundation for Research Support of the State of Bahia (FAPESB). He serves as Technology Transfer Coordinator and one of the Principal Investigators at the National Applied Research Center in Artificial Intelligence (CPA-IA) of SENAI CIMATEC, focusing on Industry, being one of the six CPA-IA in Brazil approved by MCTI / FAPESP / CGI.br. He also participates as one of the representatives of Brazil in the BRICS Innovation Collaboration Working Group on HPC, ICT and AI. He is the coordinator of the Work Group of the Axis 5 - Workforce and Training - of the Brazilian Strategy for Artificial Intelligence (EBIA), and member of the MCTI/EMBRAPII AI Innovation Network Training Committee. He is the coordinator, by SENAI CIMATEC, of the Artificial Intelligence Reference Network of the State of Bahia (REDE BAH.IA). He leads the working group of experts representing Brazil in the Global Partnership on Artificial Intelligence (GPAI), on the theme \"AI and the Pandemic Response\".",institutionString:"Manufacturing and Technology Integrated Campus – SENAI CIMATEC",institution:null},{id:"1063",title:"Prof.",name:"Constantin",middleName:null,surname:"Volosencu",slug:"constantin-volosencu",fullName:"Constantin Volosencu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1063/images/system/1063.png",biography:"Prof. Dr. Constantin Voloşencu graduated as an engineer from\nPolitehnica University of Timișoara, Romania, where he also\nobtained a doctorate degree. He is currently a full professor in\nthe Department of Automation and Applied Informatics at the\nsame university. Dr. Voloşencu is the author of ten books, seven\nbook chapters, and more than 160 papers published in journals\nand conference proceedings. He has also edited twelve books and\nhas twenty-seven patents to his name. He is a manager of research grants, editor in\nchief and member of international journal editorial boards, a former plenary speaker, a member of scientific committees, and chair at international conferences. His\nresearch is in the fields of control systems, control of electric drives, fuzzy control\nsystems, neural network applications, fault detection and diagnosis, sensor network\napplications, monitoring of distributed parameter systems, and power ultrasound\napplications. He has developed automation equipment for machine tools, spooling\nmachines, high-power ultrasound processes, and more.",institutionString:"Polytechnic University of Timişoara",institution:{name:"Polytechnic University of Timişoara",country:{name:"Romania"}}},{id:"221364",title:"Dr.",name:"Eneko",middleName:null,surname:"Osaba",slug:"eneko-osaba",fullName:"Eneko Osaba",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/221364/images/system/221364.jpg",biography:"Dr. Eneko Osaba works at TECNALIA as a senior researcher. He obtained his Ph.D. in Artificial Intelligence in 2015. He has participated in more than twenty-five local and European research projects, and in the publication of more than 130 papers. He has performed several stays at universities in the United Kingdom, Italy, and Malta. Dr. Osaba has served as a program committee member in more than forty international conferences and participated in organizing activities in more than ten international conferences. He is a member of the editorial board of the International Journal of Artificial Intelligence, Data in Brief, and Journal of Advanced Transportation. He is also a guest editor for the Journal of Computational Science, Neurocomputing, Swarm, and Evolutionary Computation and IEEE ITS Magazine.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"275829",title:"Dr.",name:"Esther",middleName:null,surname:"Villar-Rodriguez",slug:"esther-villar-rodriguez",fullName:"Esther Villar-Rodriguez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/275829/images/system/275829.jpg",biography:"Dr. Esther Villar obtained a Ph.D. in Information and Communication Technologies from the University of Alcalá, Spain, in 2015. She obtained a degree in Computer Science from the University of Deusto, Spain, in 2010, and an MSc in Computer Languages and Systems from the National University of Distance Education, Spain, in 2012. Her areas of interest and knowledge include natural language processing (NLP), detection of impersonation in social networks, semantic web, and machine learning. Dr. Esther Villar made several contributions at conferences and publishing in various journals in those fields. Currently, she is working within the OPTIMA (Optimization Modeling & Analytics) business of TECNALIA’s ICT Division as a data scientist in projects related to the prediction and optimization of management and industrial processes (resource planning, energy efficiency, etc).",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49813/images/system/49813.png",biography:"Prof. Dr. Javier Del Ser received his first PhD in Telecommunication Engineering (Cum Laude) from the University of Navarra, Spain, in 2006, and a second PhD in Computational Intelligence (Summa Cum Laude) from the University of Alcala, Spain, in 2013. He is currently a principal researcher in data analytics and optimisation at TECNALIA (Spain), a visiting fellow at the Basque Center for Applied Mathematics (BCAM) and a part-time lecturer at the University of the Basque Country (UPV/EHU). His research interests gravitate on the use of descriptive, prescriptive and predictive algorithms for data mining and optimization in a diverse range of application fields such as Energy, Transport, Telecommunications, Health and Industry, among others. In these fields he has published more than 240 articles, co-supervised 8 Ph.D. theses, edited 6 books, coauthored 7 patents and participated/led more than 40 research projects. He is a Senior Member of the IEEE, and a recipient of the Biscay Talent prize for his academic career.",institutionString:"Tecnalia Research & Innovation",institution:null},{id:"278948",title:"Dr.",name:"Carlos Pedro",middleName:null,surname:"Gonçalves",slug:"carlos-pedro-goncalves",fullName:"Carlos Pedro Gonçalves",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRcmyQAC/Profile_Picture_1564224512145",biography:'Carlos Pedro Gonçalves (PhD) is an Associate Professor at Lusophone University of Humanities and Technologies and a researcher on Complexity Sciences, Quantum Technologies, Artificial Intelligence, Strategic Studies, Studies in Intelligence and Security, FinTech and Financial Risk Modeling. He is also a progammer with programming experience in:\n\nA) Quantum Computing using Qiskit Python module and IBM Quantum Experience Platform, with software developed on the simulation of Quantum Artificial Neural Networks and Quantum Cybersecurity;\n\nB) Artificial Intelligence and Machine learning programming in Python;\n\nC) Artificial Intelligence, Multiagent Systems Modeling and System Dynamics Modeling in Netlogo, with models developed in the areas of Chaos Theory, Econophysics, Artificial Intelligence, Classical and Quantum Complex Systems Science, with the Econophysics models having been cited worldwide and incorporated in PhD programs by different Universities.\n\nReceived an Arctic Code Vault Contributor status by GitHub, due to having developed open source software preserved in the \\"Arctic Code Vault\\" for future generations (https://archiveprogram.github.com/arctic-vault/), with the Strategy Analyzer A.I. module for decision making support (based on his PhD thesis, used in his Classes on Decision Making and in Strategic Intelligence Consulting Activities) and QNeural Python Quantum Neural Network simulator also preserved in the \\"Arctic Code Vault\\", for access to these software modules see: https://github.com/cpgoncalves. He is also a peer reviewer with outsanding review status from Elsevier journals, including Physica A, Neurocomputing and Engineering Applications of Artificial Intelligence. 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Currently working as an Assistant Professor in the Department of Mathematics, Institute of Applied Science, Mangalayatan University, Aligarh. She taught so many courses of Mathematics of UG and PG level. Her research Area of Expertise is Functional Analysis & Sequence Spaces. She has been working on Ideal Convergence of double sequence. She has published 17 research papers in National and International Journals including Cogent Mathematics, Filomat, Journal of Intelligent and Fuzzy Systems, Advances in Difference Equations, Journal of Mathematical Analysis, Journal of Mathematical & Computer Science etc. She has also reviewed few research papers for the and international journals. 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He obtained his Master’s degree in the Department of Information and Communications from Gwangju Institute of Science and Technology (GIST) in 2003. In 2010, he received his Ph.D. degree in the School of Information and Mechatronics from GIST. In the meantime, he was an executed team leader at Culture Technology Institute, GIST, 2010-2012. In 2011, he worked at Lancaster University, the UK as a visiting scholar. In September 2012, he joined Daegu University, where he is currently an associate professor in the School of ICT Conver, Daegu University. Also, he served as the Board of Directors of KSIIS since 2019, and HCI Korea since 2016. From 2017~2019, he worked as a center director of the Mixed Reality Convergence Research Center at Daegu University. From 2015-2017, He worked as a director in the Enterprise Supporting Office of LINC Project Group, Daegu University. His research interests include Activity Fusion & Reasoning, Machine Learning, Context-aware Middleware, Human-Computer Interaction, etc.",institutionString:null,institution:{name:"Daegu Gyeongbuk Institute of Science and Technology",country:{name:"Korea, South"}}},{id:"262719",title:"Dr.",name:"Esma",middleName:null,surname:"Ergüner Özkoç",slug:"esma-erguner-ozkoc",fullName:"Esma Ergüner Özkoç",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Başkent University",country:{name:"Turkey"}}},{id:"346530",title:"Dr.",name:"Ibrahim",middleName:null,surname:"Kaya",slug:"ibrahim-kaya",fullName:"Ibrahim Kaya",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",country:{name:"Turkey"}}},{id:"419199",title:"Dr.",name:"Qun",middleName:null,surname:"Yang",slug:"qun-yang",fullName:"Qun Yang",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Auckland",country:{name:"New Zealand"}}}]}},subseries:{item:{id:"10",type:"subseries",title:"Animal Physiology",keywords:"Physiology, Comparative, Evolution, Biomolecules, Organ, Homeostasis, Anatomy, Pathology, Medical, Cell Division, Cell Signaling, Cell Growth, Cell Metabolism, Endocrine, Neuroscience, Cardiovascular, Development, Aging, Development",scope:"Physiology, the scientific study of functions and mechanisms of living systems, is an essential area of research in its own right, but also in relation to medicine and health sciences. The scope of this topic will range from molecular, biochemical, cellular, and physiological processes in all animal species. Work pertaining to the whole organism, organ systems, individual organs and tissues, cells, and biomolecules will be included. Medical, animal, cell, and comparative physiology and allied fields such as anatomy, histology, and pathology with physiology links will be covered in this topic. 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