Various reactive oxygen species and their neutralizing antioxidants.
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Barely three months into the new year and we are happy to announce a monumental milestone reached - 150 million downloads.
\n\nThis achievement solidifies IntechOpen’s place as a pioneer in Open Access publishing and the home to some of the most relevant scientific research available through Open Access.
\n\nWe are so proud to have worked with so many bright minds throughout the years who have helped us spread knowledge through the power of Open Access and we look forward to continuing to support some of the greatest thinkers of our day.
\n\nThank you for making IntechOpen your place of learning, sharing, and discovery, and here’s to 150 million more!
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These free radicals are considered as important part of the pathological complications including diabetes mellitus, cardiovascular disorders, neurodegenerative disorders, cancer, cataracts, asthamatic conditions, rheumatoid arthritis, inflammatory conditions, intestinal complications, ischemic and postischemic conditions.
Antioxidants are those substances which at very low concentrations are capable of significantly reducing or preventing the oxidation of the substrates which can be oxidized are called as antioxidants. There is a highly complex system including enzymatic and non-enzymatic systems which is effective in synergistic way with each other, so as to protect the body cells and different organs from the damage caused b free radicals. There are different types such as endogenous antioxidants and exogenous antioxidants such as the diet or various dietary supplements. There are different examples of dietary substances which actually do not scavenge the free radicals but they stimulate the endogenous activity ultimately categorized as antioxidants. An antioxidant which are considered as ideal, should easily absorbed and eliminate the free radicals and can able to cause chelation of redox metal ions at the levels which are considered as physiologically suitable. This should be active at the aqueous and/or in the membrane domains and can result in effective expression of gene at a positive direction. These endogenous antioxidants suppose to be highly potential in maintain the optimum cellular functioning and ultimately systemic healthy conditions and the well being also. But many a times, these endogenous antioxidants are considered as insufficient to support the oxidative or nitrosative stress, so along with it dietary antioxidants are important for maintain the highest cellular functioning. The highly potential enzymatic antioxidants consist of glutathione peroxidase, catalase, superoxide dismutase. Various examples in nonenzymatic antioxidants are vitamin C, vitamin E, thiol antioxidants including lipoic acid, glutathione etc., carotenoids, melatonins, flavanoids and other resembling compounds. One of the mechanisms called as antioxidant network, which involves the regeneration of the original properties of one antioxidant after interaction with other antioxidants. In various diseased conditions, it is reported that there is established link between the raised levels in ROS or RNS and deterioration of actions related to enzymatic or non enzymatic antioxidants [1, 2, 3].
The oxidation of the glutathione directed as hydroperoxide which can be considered as hydrogen peroxide or others for example lipid hydroperoxide.
Selenium dependent that is GPx, EC 1.11.1.19 and independent on selenium for example glutathione S transferase, GST, EC 2.5.1.18 are considered as the two different forms. In the humans, reported are four types of se-dependent glutathione peroxidases which are mentioned as addition of two electrons to carry out reduction of peroxides through formation of selenole (SeOH) and these antioxidant properties of the selenoenzymes carries elimination of peroxides as important substrate for the reaction termed as Fenton reaction. Along with the tripeptide glutathione that is GSH, selenium dependent glutathione peroxides will be acting, and it exists in comparatively higher concentrations present in the cells and also catalyses the formation of hydrogen peroxide or the organic peroxide into water or alcohol, while causing oxidation of GSH simultaneously. It is able to compete with that of catalase and hydrogen peroxide as a substrate so, considered as an important source of giving protection against oxidative or the nitrosative stress which at very low levels [4].
The first antioxidant enzyme was considered as the Catalase that is EC 1.11.1.6 and it was reported to carry out the conversion of hydrogen peroxide into the water and oxygen as indicated:
Amongst all the enzymes, catalase was reported to have the highest rate of turnover, one molecule of the catalase is having capacity to converting around 6 millions of hydrogen peroxides to water and oxygen, each of minute. Some from this catalase is found in all the tissues, majorly activity of catalase is found in liver and erythrocytes [5].
One from the enzymatic antioxidants that is superoxide dismutase called as EC 1.15.1.1, can reported to be an intracellular enzymatic antioxidant and is responsible to convert superoxide dismutase anions in dioxygen and ions of hydrogen peroxide as:
This superoxide dismutase, is existing in the form of various isoforms, which majorly different in the natures of the active metal centre, composition of the amino acids, cofactors and other related features. Three different froms related to SOD are available in the human beings for example cytosolic, Zinc- SOD, mitochondrial Mn-SOD, and extracellular SOD. By undergoing successive oxidative and reductive pathways related to transition metal ions at their sites of activity, neutralization of superoxide ions by superoxide dismutase is carried out [6].
Vitamin E majorly available as fat soluble and it can be found in eight different varieties [7]. A chromanol ring along with the phytyl tail and difference in numbers and position related to methyl groups in these rings are observed in the tocopherols including α, β, γ, and δ. These substances are reported to be lipid soluble with a prominent antioxidant potential. According to the literature, these are found to be more active than that of polyunsaturated fatty acids which are having peroxyl radicals and thus show their action by breaking the lipid peroxidation [8].
The important role of this vitamin is to give protection from the lipid peroxidation and also literature is available to support this, there is synergestic effect of ɑ tocopherol and ascorbic acid, involved in cyclic type reactions. Due to the donation of the hydrogen from ɑ tocopherol to the lipid radical or lipid peroxide radical and it gets converted to ɑ tocopherol radical. Further, this ɑ tocopherol radical can get reduced in the form of ɑ tocopherol due to the ascorbic acid [9].
This considered as one of the antioxidants reported to work in an aqueous medium of the body. In the presence of metal ions it is oxidized into dehydroascorbic acid in an extracellular environment of the body, which is further carried into the cells with help of glucose transporters. It works alone with the antioxidant enzymes and also Vitamin E and carotenoids are termed as its primary partners. From the ɑ tocopherol radicals it forms ɑ tocopherol in the membranes and lipoproteins, vitamin C plays an important role along with vitamin E, ultimately it increases the levels in glutathione in cells, thus protecting the protein thiol groups against oxidative damage. It is present in the reduced form in the cells, due to reaction with glutathione, thus catalyzing protein disulfide isomerase and glutaredoxins. Ascorbic acid is reported as the best potential reducing agent that effectively causes neutralization of ROS for example hydrogen peroxide [10].
This is a very important intracellular thiol antioxidant which is present in intracellular region is tripeptideglutathione which is also known as GSH. Acoording to the literature, it is considered as a redox buffer of the cell. It is found to be present in the cytosol, mitochondria and nuclei and present in the soluble form of antioxidants in these compartments. The levels of glutathione are important for inducing the postmititic phenotype, which are confirmed based upon the studies on the human fibroblasts, and hence it is reported that the implementation of the depletion of glutathione has very important role during the control in aging at cellular level from human skin.
As this glutathione acts as cofactor for various enzymes which cause detoxifying actions, its participation in the amino acid transport through the plasma membrane, scavenging of hyrdroxyl radical and direct scavenging of the singlet oxygen, regeneration of the active forms of vitamin C and E, has a very potential role for protective action against oxidative or nitrosative stress [11].
Decrease in the glutathione levels are the signals of the oxidative stress which is increased in the ischemic brain disorders, cancer, cardiovascular disorders and decreased concentrations of glutathione are also indicative of both that is type 1 and type 2 diabetes mellitus [12, 13, 14, 15, 16].
Another potential example of the thiol antioxidants is thioredoxin which is also known as TRX system, which are the types of proteins available both in the mammalian and prokaryotic cells and capable of oxidoreductase activity. It is consisting of disulphide and two cysteins which are redox active with conserved active sites as Cys- Gly-Pro-Cys. This antioxidants consists of two –SH groups which are adjacent forms which are present in the reduction form, then are converted into disulphide units in the oxidized form as TRX after it undergoes redox reactions including multiple proteins in it. The levels of thioredoxin is comparatively lesser than that of GSH, but these may be having functions which are overlapping and in similar compartments related to the stimulation and regulation of various transcription factors. Many of the normal and neoplastic cells, secrets this thioredoxin in the oxidative or nitrosative stress and also in the inflammatory conditions [17, 18].
Metal chelating and antiglycation potentials are associated with this third thiol antioxidant which is present as natural substance called as α-Lipoic acid called as ALA. Different than other antioxidants which are either lipid soluble or soluble in aqueous medium, lipoic acid can be considered as active in the aqueous as well as lipid phases. In most of the tissues, lipoic acid is transferred to dihydrolipoic acid that is DHLA through the action of NADH or NADPH, and then it can be readily digested and absorbed too. There are various actions which are related to lipoic acid such as direct termination of the free radicals, chelation of transition metal ions for example copper and iron, glutathione levels observe to be increased, vitamin C levels and prevention of the toxicities which are associated with their loss [19].
Lipoic acid is also capable of crossing the blood brain barrier and thus it can be covered by all central and peripheral regions of nervous system. For the free radicals associated with the oxidative stress, lipid peroxides that is LPO is considered as the biomarker. A sequence of the reactions is initiated after the action of free radicals on the polyunsaturated fatty acids called as PUFA in the biological systems, which ultimately results in the production of the conjugated dienes and lipid peroxidases [20].
To decrease the conditions related oxidative or nitrosative stress, one of the thiol antioxidant is N-acetylcysteine. It prevents from liver damage related to paracetamol caused in the human beings, causes attenuation in liver damage and also reported to prevent the GSH depletion in the mice [21].
N-acetylcysteine also possesses properties such as metachelation, and is implemented in several clinical conditions. Due to the thio groups present in this N-acetylcysteine, it decreases the free radicals and supplies chelation sites to that for metals. Hence, in the metal poisoning conditions and various diseased conditions, N-acetylcysteine is found to have a potential role as is effective in renovating inbalanced prooxidant and antioxidant conditions.
The melatonin shows its free radical scavenging potential due to donation of electron so as it can release variety of ROS or RNS, containing majorly toxic hydroxyl radicals. Along with that melatonin also increases an enzymes which are considered as antioxidative such as superoxide dismutase, glutathione peroxidase, glutathione reductase, catalase etc [22].
This efficiency related to electron transport chain is reported to be increased and as a result decreased electron leakage and production of the free radicals. Due these highly potential actions of melatonin, it is considered as a very important entity used in treating variety of neurological diseases which are having oxidative damage as a part of the etiology concerned [23].
One of the potential antioxidants, which are reported to be lipid soluble and containing isoprenoid carbok skeleton is the carotenoids. These are reported to be present in the membranes along with the lipoproteins and a very useful example is ɑ- carotene. The efficiency of these antioxidants is considered to be as equivalent as that of ɑ tocopherol as they effectively scavenge singlet oxygen and also result in trapping of the peroxyl radicals at low levels of oxygen pressures (Table 1). Those caratenoids show brings are distinguished with the pro-vitamin A activity. As in β- carotene, it indicates presence of two brings on the both the ends related to carbon chain, it possesses highest activity. Vitamin A is also reported to show highly potential antioxidant activity which is independent on that of the oxygen concentration [24].
ROS | Neutralizing antioxidants |
---|---|
Hydroxyl radical | Vitamin C, glutathione, Flavonoids, lipoic acid |
Superoxide radical | Vitamin C, glutathione, Flavonoids, SOD |
Hydrogen peroxide | Vitamin C, glutathione, beta Carotene, vitamin E, CoQ10, Flavonoids, lipoic acid |
Lipid peroxides | β-carotene, vitamin E, ubiquinone, flavonoids & Glutathione peroxidase |
Various reactive oxygen species and their neutralizing antioxidants.
One of the highly potential antioxidants which are considered as a part of regular diet and considered as a wide class of plant metabolites having a low molecular weight are Flavanoids. These are considered as the groups of derivatives of benzo-γ- pyrone which are made up of phenolic and the pyrane ring with attached hydroxyl groups are added during normal metabolism. The most important activity of flavanoids is considered as their protective action against that of oxidative or nitrosative stress. The catalytic breakdown of the hydrogen peroxide radicals that is Fentonn chemistry, is resulted due to the scavenging of peroxyl radicals, minimizing lipid peroxidation, chelation of redox active metals. In other certain conditions, flavanoids are reported to indicate the poroxidant activity which is considered to be in direct proportion to the presence of total hydroxyl groups and as per literature also indicated cell signaling modulation [25].
The process called as Oxidation, involves the formation of various intermediates which are reactive and can cause aerobic cell metabolism. Thus it is reported that the cells are having a chance of damage which is protected by this antioxidant systems in the cells. Different pathological conditions such as cancerous conditions, cardiovascular disorders, cataract, diabetes mellitus, gastrointestinal disorders, liver disorders, macular degenerations periodontal disorders, other inflammatory conditions are observed due to loss of balance in the ROS production and defence to antioxidants thus causing oxidative stress as a result of deregulation of the cellular functioning [26].
Powder of Turmeric is applicable as flavoring and coloring agent in various food preparations. For maintaining oral hygiene, it has been in use from many years [28]. In India and China, turmeric is considered as the choice of treatment for jaundice and other liver problems. This is one of the potential herbs having different pharmacological potentials including anti-protozoal, anti-venom activities, antioxidant, anti-microbial, anti-angiogenic, anti-malarial, anti-inflammatory, anti-proliferative, anti-tumor and anti-aging properties [29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40]. It has also been used to treat parasitic infections, ulcers, skin disorders, immunity related disorders and curing the symptoms of colds and flus [41]. Curcumin (CUR) and two related compounds demethoxy curcumin (DMC) and bisdemethoxycurcumin (BDMC) are considered as important curcuminoids responsible for the pharmacological action of turmeric. The active constituents of present are considered as a mixture of bisdesmethoxycurcumin, curcumin (diferuloylmethane), monodexmethoxycurcumin. Around 90% of curcuminoids are present in turmeric. Apart from this it also consists of proteins, sugars, and resins 0.3–5.4% of curcumin is found to be present in the raw turmeric [42].
Turmeric is containing a mixture of three curcuminoids: curcumin (diferuloylmethane), demethoxycurcumin and bisdemethoxycurcumin, along with that volatile oil containing atlantone, zingiberone and tumerone, proteins resins and sugars. Lipophilic polyphenol that is Curcumin is nearly insoluble in water but is found to be stable in the acidic pH of the stomach [43].
Curcumin is containing phenolic groups due to which it can eliminate free radicals derived from oxygen.
The free radicals such as hydroxyl radical, singlet oxygen, superoxide radical, nitrogen dioxide and NO which can be eliminated by curcumin [44].
Curcumin and its derivatives has the most potential biological effects disease prevention and health promotion including inflammatory, antioxidant and anticancer potential [45].
Curcumin activity for inflammation after giving oral administration was comparable to that of cortisone or phenylbutazone.
Turmeric is having hepatoprotective activity similar to that of silymarin. From studies, it can be concluded that turmeric has hepatoprotective potential in various including carbon tetrachloride (CCl4), acetaminophen (paracetamol) and galactosamine. This hepatoprotective effect is mainly a observed due to the antioxidant activity of turmeric along with its ability to decrease the formation of proinflammatory cytokines. Administration of curcumin is resulted in decrease of liver injury [48, 49, 50].
All three stages of this carcinogenesis-initiation, promotion, and progression are inhibited by curcumin.
During initiation and promotion, curcumin modulates transcription factors controlling phase I and II detoxification of carcinogens; down-regulates proinflammatory cytokines, free radical-activated transcription factors, and arachidonic acid metabolism vicyclooxygenase and lipoxygenase pathways and scavenges free radicals [51, 52].
ar-turmerone, ar-turmerone, curcumin, demethoxycurcumin and bisdemethoxycurcumin present in hexane and ehanol extract had reported to stimulate adipocyte differentiation in a dose dependent manner. The results also concluded that turmeric ethanolic extract found to contain curcuminoids and sesquiterpenoids is more strongly hypoglycemic as compared to either sesquiterpenoids or curcuminoids [53].
Antibacterial, antifungal, cytotoxic, insecticidal and phytotoxic activity of an ethanolic extract of turmeric was evaluated. The extract showed antifungal activity against Trichophyton longifusus and Microsporum canis and weak antibacterial activity against Staphylococcus aureus. Toxic activity was observed against Lemna minor [54].
In cases of chronic mild stress that is CMS model, curcumin was studied for antidepressant activity.
Ethanolic extract had indicated increase in sucrose intake as compared to normal control levels, reduction in serum IL-6 and TNF-α and CRF levels in medulla oblongata and serum to limits lower than normal.
Cortisol levels were found to be reduced than the normal levels. Through the inhibition of monoamine oxidize, it had shown its antidepressant activity. It caused reversal of decreased serotonin, dopamine and noradrenalin concentrations and increase in the turnover of serotonin [55, 56].
The protective effect was observed due to lowering of triglyceride and cholesterol levels and decrease in LDL and also due to inhibition of aggregation of platelet [57].
Effect of turmeric extract on cholesterol levels may be due to decreased cholesterol uptake in the intestines and increased conversion of cholesterol to bile acids in the liver. Inhibition of platelet aggregation by C. longa constituents is thought to be via potentiation of prostacyclin synthesis and inhibition of thromboxane synthesis [58].
Oral intake of 500 mg/d of curcumin was given for 7 days and further it resulted in comparable decrease in the serum peroxide levels by 33% and increase in HDL cholesterol by 29% and decrease in level of total serum cholesterol by 12% [59].
During a phase II clinical trial for peptic ulcer which was diagnosed with endoscopically in 45 subjects, given with 600 mg curcumin five times daily for 12 weeks, it was observed that ulcers were absent in 48% patients after 8 weeks, and in 76% patients after 12 weeks. In remaining patients also within 1-2 weeks abdominal pain and other symptoms had decreased significantly [60].
The most common symptoms of irritable bowel syndrome (IBS) are considered as altered bowel habits, abdominal pain, bloating etc.
After pilot study for eight week of IBS patients, it was found that 53% and 60% reduction in IBS prevalence. In post-study analysis, abdominal pain and discomfort scores were reduced by 22 and 25% [61].
Ulcerative colitis (UC) and Crohn’s disease (CD) are considered as two types of IBD, inflammatory bowel disease. In a pilot study performed in 2005, hematological, erythrocyte sedimentation rate (ESR) and biochemical blood analysis, C-reactive protein (CRP) (the latter two inflammatory indicators), sigmoidoscopy, and biopsy were all performed. The authors from this study concluded that curcumin plus standard therapy was more effective in maintaining remission than placebo plus standard UC treatment [62, 63].
Investigations on animal models for Alzheimer’s disease (AD) was indicated a direct effect curcumin in reducing the amyloid pathology of AD.
Results have also shown that curcumin exhibited multiple effects in brain. Curcumin is considered as a future drug of therapy for the treatment of various neurological disorders including tardive dyskinesia, diabetic neuropathy and depression [64].
The two primary mechanisms as antioxidant and anti-inflammatory which explain the benefits of curcumin have proven for various pharmacological actions. Systemic marker of oxidative stress have been found to be improved due to presence of curcumin. Also, from previous literature, it had proven to increase serum activities of important antioxidants such as superoxide dismutase (SOD).
A recent data and analysis of randomized control studies related to the potential effect of supplementation with purified curcuminoids on various oxidative stress parameters had indicated a significant effect on plasma activities of SOD and catalase, as well as serum concentrations of glutathione peroxidase (GSH) and lipid peroxides. The activity of Curcumin on free radicals has been performed based upon many mechanisms. Many forms of free radicals are scavenged by Curcumin, including reactive oxygen and nitrogen species (ROS and RNS, respectively), and can also it was found to alter the activity of GSH, catalase, and SOD enzymes during the neutralization of free radicals and resulted in inhibition of ROS-generating enzymes such as lipoxygenase/cyclooxygenase and xanthine hydrogenase/oxidase. In addition to this, curcumin is considered as a lipophilic compound that makes it an effective scavenger of peroxyl radicals, hence can be effective as a chain-breaking antioxidant [65, 66, 67, 68, 69, 70, 71].
Antioxidant activity of the turmeric is evaluated by performing DPPH radical scavenging activity and FRAP values. Many of the literature suggest that, various extracts of turmeric are having antioxidant activities calculated referring to the DPPH radical-scavenging potential.
In this method, 1 mL of the extract was added to around 1.2 mL of 0.003% DPPH in methanol using at varying concentrations (2.5–80.0 μg/mL). The percentage of DPPH inhibition was then calculated using the equation: % of DPPH inhibition = [(
Ferric Reducing Antioxidant Power (FRAP) assay was carried out for confirmation of antioxidant potential of the turmeric. Complex of ferric tripyridyltriazine is reduced into ferrous form which then resulted in an intense blue color observed at low pH range. This colour intensity further confirmed by measuring its absorbance value at 593 nm. 200 𝜇L of the extract solution prepared in varying concentrations from 62.5–1000.0 μg/mL was then added to 1.5 mL of the previously prepared FRAP reagent, then reaction mixture was incubated at 370 C for 4 min. FRAP reagent was prepared by adding 10 volumes of 300 mM acetate buffer having pH 3.6 with 1 volume of 10 mM TPTZ solution in 1 volume of 20 mM ferric chloride (FeCl3.6H2O) and 40 mM hydrochloric acid. The FRAP reagent was then prewarmed to 37°C and was used when freshly prepared. Plotting of the standard curve was then done A using an aqueous solution of ferrous sulfate (FeSO4.7H2O) (100–1000 μmol), with FRAP values expressed as micromoles of ferrous equivalent (μM Fe [II] per 100 g of sample).
The obtained results from antioxidant studies indicated that the free radical scavenging activity may be due to to the high contents of phenolics and flavonoids having a higher reducing capacity. FRAP assay treats the antioxidants in the sample as reductants in a redox reaction and measures the reducing potential of the test sample. These antioxidants exert their activities by donating electron or hydrogen atoms to the ferric complex which converts to ferrous complex (Fe3+ to Fe2+ -TPTZ complex), thus breaking the radical chain reaction.
Many major diseases such as liver problem, myocardial infarction, diabetes, cancer are believed to be associated with lipid peroxidation and thus causing major cell damage. Curcuminoids and other polyphenols in turmeric can ameliorate and prevent lipid peroxidation, can stabilize the cell membrane, hence proving its significant role in prevention of atherosclerosis. Inhibitory action of turmeric polyphenols such as curcuminoids on lipid accumulation, oxidation, nitric oxide as well as the formation of inflammatory molecules, nuclear factor-kappa B- (NF-kB-) dependent gene expression, and its activation can thus influence therapeutic potential of turmeric in the treatment of pancreatic, hepatic, cancer and intestinal diseases. The ethanolic extract of turmeric can produce promisable symptomatic relief on external cancerous lesions in human. Along with this, curcumin has resulted to be effective in preventing and treatment of many of the neurodegenerative disorders as a free radical scavenger including Alzheimer’s disease. Also after giving short-term supplementation it has proved to reduce hematuria, proteinuria, including systolic blood pressure in patients with relapsed or refractory lupus nephritis. By referring all the literature, Curcumin can be considered as a safe adjuvant therapy. The previous studies had indicated that the high antioxidant properties of turmeric was found to inhibit cellular lipid peroxidation and can also ameliorate other oxidative damage caused by free radicals [72, 73, 74, 75, 76].
Thus Turmeric is proven to be an important source of high contents of flavonoids, polyphenols, tannins and ascorbic acid. Curcumin as important phytoconstituent of turmeric varieties is and effective and important antioxidant compound and which can be effective in management of various diseased conditions.
The authors declare that there are no conflicts of interest regarding the publication of this paper.
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The main global health organizations have incorporated patient safety in their review of work practices. The data provided by the medical laboratories have a direct impact on patient safety and a fault in any of processes such as strategic, operational and support, could affect it. To provide appreciate and reliable data to the physicians, it is important to emphasize the need to design risk management plan in the laboratory. Failure Mode and Effect Analysis (FMEA) is an efficient technique for error detection and reduction. Technical Committee of the International Organization for Standardization (ISO) licensed a technical specification for medical laboratories suggesting FMEA as a method for prospective risk analysis of high-risk processes. FMEA model helps to identify quality failures, their effects and risks with their reduction/elimination, which depends on severity, probability and detection. 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Leadership in health services is important for following innovations and adapting to current situations. Nurses working together with other health personnel in hospitals providing health services constitute an important group in leadership. Nursing, which is a key force for patient safety and safe care, is a human-centered profession, and therefore leadership is a key skill for nurses at all levels. The leadership styles of nurse managers are believed to be an important determinant of job satisfaction and persistence of nurses. The need for nurses with leadership skills and the need for nurses to develop their leadership skills are increasing day by day. There are several leadership styles defined in nursing literature. These leadership styles are examined under the titles of relational leadership style, transformational leadership, resonant leadership, emotional intelligence leadership, and participatory leadership. The task-focused leadership style is explored under the headings of transactional and autocratic leadership, laissez-faire leadership, and instrumental leadership.",book:{id:"9047",slug:"nursing-new-perspectives",title:"Nursing",fullTitle:"Nursing - New Perspectives"},signatures:"Serpil Çelik Durmuş and Kamile Kırca",authors:null},{id:"58916",title:"Factors Affecting the Attitudes of Women toward Family Planning",slug:"factors-affecting-the-attitudes-of-women-toward-family-planning",totalDownloads:8471,totalCrossrefCites:9,totalDimensionsCites:18,abstract:"Everyone has the right to decide on the number and timing of children without discrimination, violence and oppression, to have the necessary information and facilities for it, to access sexual and reproductive health services at the highest standard. Deficient or incorrect family planning methods, wrong attitudes and behaviors toward the methods and consequent unplanned pregnancies, increased maternal and infant mortality rates are the main health problems in most countries. Individuals’ learning modern family planning methods and having positive attitude for these methods may increase the usage of these methods and contributes the formation of healthy communities. 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Legumes are nutritionally valuable, providing proteins (20–45%) with essential amino acids, complex carbohydrates (±60%) and dietary fibre (5–37%). Legumes also have no cholesterol and are generally low in fat, with ±5% energy from fat, with the exception of peanuts (±45%), chickpeas (±15%) and soybeans (±47%) and provide essential minerals and vitamins. In addition to their nutritional superiority, legumes have also been ascribed economical, cultural, physiological and medicinal roles owing to their possession of beneficial bioactive compounds. Research has shown that most of the bioactive compounds in legumes possess antioxidant properties, which play a role in the prevention of some cancers, heart diseases, osteoporosis and other degenerative diseases. Because of their composition, legumes are attractive to health conscious consumers, celiac and diabetic patients as well as consumers concerned with weight management. 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She is currently an Adjunct Professor at Feevale University in Medicine and Biomedicine courses and a permanent professor of the Academic Master\\'s Degree in Virology. She has experience in the field of Microbiology, with an emphasis on Bacteriology, working mainly on the following topics: bacteriophages, bacterial resistance, clinical microbiology and food microbiology.",institutionString:null,institution:{name:"Universidade Feevale",country:{name:"Brazil"}}},{id:"229220",title:"Dr.",name:"Amjad",middleName:"Islam",surname:"Aqib",slug:"amjad-aqib",fullName:"Amjad Aqib",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229220/images/system/229220.png",biography:"Dr. Amjad Islam Aqib obtained a DVM and MSc (Hons) from University of Agriculture Faisalabad (UAF), Pakistan, and a PhD from the University of Veterinary and Animal Sciences Lahore, Pakistan. Dr. Aqib joined the Department of Clinical Medicine and Surgery at UAF for one year as an assistant professor where he developed a research laboratory designated for pathogenic bacteria. Since 2018, he has been Assistant Professor/Officer in-charge, Department of Medicine, Manager Research Operations and Development-ORIC, and President One Health Club at Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan. He has nearly 100 publications to his credit. His research interests include epidemiological patterns and molecular analysis of antimicrobial resistance and modulation and vaccine development against animal pathogens of public health concern.",institutionString:"Cholistan University of Veterinary and Animal Sciences",institution:null},{id:"62900",title:"Prof.",name:"Fethi",middleName:null,surname:"Derbel",slug:"fethi-derbel",fullName:"Fethi Derbel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62900/images/system/62900.jpeg",biography:"Professor Fethi Derbel was born in 1960 in Tunisia. He received his medical degree from the Sousse Faculty of Medicine at Sousse, University of Sousse, Tunisia. He completed his surgical residency in General Surgery at the University Hospital Farhat Hached of Sousse and was a member of the Unit of Liver Transplantation in the University of Rennes, France. He then worked in the Department of Surgery at the Sahloul University Hospital in Sousse. Professor Derbel is presently working at the Clinique les Oliviers, Sousse, Tunisia. His hospital activities are mostly concerned with laparoscopic, colorectal, pancreatic, hepatobiliary, and gastric surgery. He is also very interested in hernia surgery and performs ventral hernia repairs and inguinal hernia repairs. He has been a member of the GREPA and Tunisian Hernia Society (THS). During his residency, he managed patients suffering from diabetic foot, and he was very interested in this pathology. For this reason, he decided to coordinate a book project dealing with the diabetic foot. Professor Derbel has published many articles in journals and collaborates intensively with IntechOpen Access Publisher as an editor.",institutionString:"Clinique les Oliviers",institution:null},{id:"300144",title:"Dr.",name:"Meriem",middleName:null,surname:"Braiki",slug:"meriem-braiki",fullName:"Meriem Braiki",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300144/images/system/300144.jpg",biography:"Dr. Meriem Braiki is a specialist in pediatric surgeon from Tunisia. She was born in 1985. She received her medical degree from the University of Medicine at Sousse, Tunisia. She achieved her surgical residency training periods in Pediatric Surgery departments at University Hospitals in Monastir, Tunis and France.\r\nShe is currently working at the Pediatric surgery department, Sidi Bouzid Hospital, Tunisia. Her hospital activities are mostly concerned with laparoscopic, parietal, urological and digestive surgery. She has published several articles in diffrent journals.",institutionString:"Sidi Bouzid Regional Hospital",institution:null},{id:"229481",title:"Dr.",name:"Erika M.",middleName:"Martins",surname:"de Carvalho",slug:"erika-m.-de-carvalho",fullName:"Erika M. de Carvalho",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229481/images/6397_n.jpg",biography:null,institutionString:null,institution:{name:"Oswaldo Cruz Foundation",country:{name:"Brazil"}}},{id:"186537",title:"Prof.",name:"Tonay",middleName:null,surname:"Inceboz",slug:"tonay-inceboz",fullName:"Tonay Inceboz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/186537/images/system/186537.jfif",biography:"I was graduated from Ege University of Medical Faculty (Turkey) in 1988 and completed his Med. PhD degree in Medical Parasitology at the same university. I became an Associate Professor in 2008 and Professor in 2014. I am currently working as a Professor at the Department of Medical Parasitology at Dokuz Eylul University, Izmir, Turkey.\n\nI have given many lectures, presentations in different academic meetings. I have more than 60 articles in peer-reviewed journals, 18 book chapters, 1 book editorship.\n\nMy research interests are Echinococcus granulosus, Echinococcus multilocularis (diagnosis, life cycle, in vitro and in vivo cultivation), and Trichomonas vaginalis (diagnosis, PCR, and in vitro cultivation).",institutionString:"Dokuz Eylül University",institution:{name:"Dokuz Eylül University",country:{name:"Turkey"}}},{id:"71812",title:"Prof.",name:"Hanem Fathy",middleName:"Fathy",surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/71812/images/1167_n.jpg",biography:"Prof. Khater is a Professor of Parasitology at Benha University, Egypt. She studied for her doctoral degree, at the Department of Entomology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, USA. She has completed her Ph.D. degrees in Parasitology in Egypt, from where she got the award for “the best scientific Ph.D. dissertation”. She worked at the School of Biological Sciences, Bristol, England, the UK in controlling insects of medical and veterinary importance as a grant from Newton Mosharafa, the British Council. Her research is focused on searching of pesticides against mosquitoes, house flies, lice, green bottle fly, camel nasal botfly, soft and hard ticks, mites, and the diamondback moth as well as control of several parasites using safe and natural materials to avoid drug resistances and environmental contamination.",institutionString:null,institution:{name:"Banha University",country:{name:"Egypt"}}},{id:"99780",title:"Prof.",name:"Omolade",middleName:"Olayinka",surname:"Okwa",slug:"omolade-okwa",fullName:"Omolade Okwa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/99780/images/system/99780.jpg",biography:"Omolade Olayinka Okwa is presently a Professor of Parasitology at Lagos State University, Nigeria. She has a PhD in Parasitology (1997), an MSc in Cellular Parasitology (1992), and a BSc (Hons) Zoology (1990) all from the University of Ibadan, Nigeria. She teaches parasitology at the undergraduate and postgraduate levels. She was a recipient of a Commonwealth fellowship supported by British Council tenable at the Centre for Entomology and Parasitology (CAEP), Keele University, United Kingdom between 2004 and 2005. She was awarded an Honorary Visiting Research Fellow at the same university from 2005 to 2007. \nShe has been an external examiner to the Department of Veterinary Microbiology and Parasitology, University of Ibadan, MSc programme between 2010 and 2012. She is a member of the Nigerian Society of Experimental Biology (NISEB), Parasitology and Public Health Society of Nigeria (PPSN), Science Association of Nigeria (SAN), Zoological Society of Nigeria (ZSN), and is Vice Chairperson of the Organisation of Women in Science (OWSG), LASU chapter. She served as Head of Department of Zoology and Environmental Biology, Lagos State University from 2007 to 2010 and 2014 to 2016. She is a reviewer for several local and international journals such as Unilag Journal of Science, Libyan Journal of Medicine, Journal of Medicine and Medical Sciences, and Annual Research and Review in Science. \nShe has authored 45 scientific research publications in local and international journals, 8 scientific reviews, 4 books, and 3 book chapters, which includes the books “Malaria Parasites” and “Malaria” which are IntechOpen access publications.",institutionString:"Lagos State University",institution:{name:"Lagos State University",country:{name:"Nigeria"}}},{id:"273100",title:"Dr.",name:"Vijay",middleName:null,surname:"Gayam",slug:"vijay-gayam",fullName:"Vijay Gayam",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/273100/images/system/273100.jpeg",biography:"Dr. Vijay Bhaskar Reddy Gayam is currently practicing as an internist at Interfaith Medical Center in Brooklyn, New York, USA. He is also a Clinical Assistant Professor at the SUNY Downstate University Hospital and Adjunct Professor of Medicine at the American University of Antigua. He is a holder of an M.B.B.S. degree bestowed to him by Osmania Medical College and received his M.D. at Interfaith Medical Center. His career goals thus far have heavily focused on direct patient care, medical education, and clinical research. He currently serves in two leadership capacities; Assistant Program Director of Medicine at Interfaith Medical Center and as a Councilor for the American\r\nFederation for Medical Research. As a true academician and researcher, he has more than 50 papers indexed in international peer-reviewed journals. He has also presented numerous papers in multiple national and international scientific conferences. His areas of research interest include general internal medicine, gastroenterology and hepatology. He serves as an editor, editorial board member and reviewer for multiple international journals. His research on Hepatitis C has been very successful and has led to multiple research awards, including the 'Equity in Prevention and Treatment Award” from the New York Department of Health Viral Hepatitis Symposium (2018) and the 'Presidential Poster Award” awarded to him by the American College of Gastroenterology (2018). He was also awarded 'Outstanding Clinician in General Medicine” by Venus International Foundation for his extensive research expertise and services, perform over and above the standard expected in the advancement of healthcare, patient safety and quality of care.",institutionString:"Interfaith Medical Center",institution:{name:"Interfaith Medical Center",country:{name:"United States of America"}}},{id:"93517",title:"Dr.",name:"Clement",middleName:"Adebajo",surname:"Meseko",slug:"clement-meseko",fullName:"Clement Meseko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/93517/images/system/93517.jpg",biography:"Dr. Clement Meseko obtained DVM and PhD degree in Veterinary Medicine and Virology respectively. He has worked for over 20 years in both private and public sectors including the academia, contributing to knowledge and control of infectious disease. Through the application of epidemiological skill, classical and molecular virological skills, he investigates viruses of economic and public health importance for the mitigation of the negative impact on people, animal and the environment in the context of Onehealth. \r\nDr. Meseko’s field experience on animal and zoonotic diseases and pathogen dynamics at the human-animal interface over the years shaped his carrier in research and scientific inquiries. He has been part of the investigation of Highly Pathogenic Avian Influenza incursions in sub Saharan Africa and monitors swine Influenza (Pandemic influenza Virus) agro-ecology and potential for interspecies transmission. He has authored and reviewed a number of journal articles and book chapters.",institutionString:"National Veterinary Research Institute",institution:{name:"National Veterinary Research Institute",country:{name:"Nigeria"}}},{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. He is also an international opinion leader/expert in vaccination for Japanese encephalitis by IPIC (UK).",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",country:{name:"India"}}},{id:"94928",title:"Dr.",name:"Takuo",middleName:null,surname:"Mizukami",slug:"takuo-mizukami",fullName:"Takuo Mizukami",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94928/images/6402_n.jpg",biography:null,institutionString:null,institution:{name:"National Institute of Infectious Diseases",country:{name:"Japan"}}},{id:"233433",title:"Dr.",name:"Yulia",middleName:null,surname:"Desheva",slug:"yulia-desheva",fullName:"Yulia Desheva",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/233433/images/system/233433.png",biography:"Dr. Yulia Desheva is a leading researcher at the Institute of Experimental Medicine, St. Petersburg, Russia. She is a professor in the Stomatology Faculty, St. Petersburg State University. She has expertise in the development and evaluation of a wide range of live mucosal vaccines against influenza and bacterial complications. Her research interests include immunity against influenza and COVID-19 and the development of immunization schemes for high-risk individuals.",institutionString:'Federal State Budgetary Scientific Institution "Institute of Experimental Medicine"',institution:null},{id:"238958",title:"Mr.",name:"Atamjit",middleName:null,surname:"Singh",slug:"atamjit-singh",fullName:"Atamjit Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/238958/images/6575_n.jpg",biography:null,institutionString:null,institution:null},{id:"333753",title:"Dr.",name:"Rais",middleName:null,surname:"Ahmed",slug:"rais-ahmed",fullName:"Rais Ahmed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333753/images/20168_n.jpg",biography:null,institutionString:null,institution:null},{id:"252058",title:"M.Sc.",name:"Juan",middleName:null,surname:"Sulca",slug:"juan-sulca",fullName:"Juan Sulca",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252058/images/12834_n.jpg",biography:null,institutionString:null,institution:null},{id:"191392",title:"Dr.",name:"Marimuthu",middleName:null,surname:"Govindarajan",slug:"marimuthu-govindarajan",fullName:"Marimuthu Govindarajan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/191392/images/5828_n.jpg",biography:"Dr. M. Govindarajan completed his BSc degree in Zoology at Government Arts College (Autonomous), Kumbakonam, and MSc, MPhil, and PhD degrees at Annamalai University, Annamalai Nagar, Tamil Nadu, India. He is serving as an assistant professor at the Department of Zoology, Annamalai University. His research interests include isolation, identification, and characterization of biologically active molecules from plants and microbes. He has identified more than 20 pure compounds with high mosquitocidal activity and also conducted high-quality research on photochemistry and nanosynthesis. He has published more than 150 studies in journals with impact factor and 2 books in Lambert Academic Publishing, Germany. He serves as an editorial board member in various national and international scientific journals.",institutionString:null,institution:null},{id:"274660",title:"Dr.",name:"Damodar",middleName:null,surname:"Paudel",slug:"damodar-paudel",fullName:"Damodar Paudel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/274660/images/8176_n.jpg",biography:"I am DrDamodar Paudel,currently working as consultant Physician in Nepal police Hospital.",institutionString:null,institution:null},{id:"241562",title:"Dr.",name:"Melvin",middleName:null,surname:"Sanicas",slug:"melvin-sanicas",fullName:"Melvin Sanicas",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241562/images/6699_n.jpg",biography:null,institutionString:null,institution:null},{id:"337446",title:"Dr.",name:"Maria",middleName:null,surname:"Zavala-Colon",slug:"maria-zavala-colon",fullName:"Maria Zavala-Colon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Puerto Rico, Medical Sciences Campus",country:{name:"United States of America"}}},{id:"338856",title:"Mrs.",name:"Nur Alvira",middleName:null,surname:"Pascawati",slug:"nur-alvira-pascawati",fullName:"Nur Alvira Pascawati",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universitas Respati Yogyakarta",country:{name:"Indonesia"}}},{id:"441116",title:"Dr.",name:"Jovanka M.",middleName:null,surname:"Voyich",slug:"jovanka-m.-voyich",fullName:"Jovanka M. Voyich",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Montana State University",country:{name:"United States of America"}}},{id:"330412",title:"Dr.",name:"Muhammad",middleName:null,surname:"Farhab",slug:"muhammad-farhab",fullName:"Muhammad Farhab",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"349495",title:"Dr.",name:"Muhammad",middleName:null,surname:"Ijaz",slug:"muhammad-ijaz",fullName:"Muhammad Ijaz",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Veterinary and Animal Sciences",country:{name:"Pakistan"}}}]}},subseries:{item:{id:"12",type:"subseries",title:"Human Physiology",keywords:"Anatomy, Cells, Organs, Systems, Homeostasis, Functions",scope:"Human physiology is the scientific exploration of the various functions (physical, biochemical, and mechanical properties) of humans, their organs, and their constituent cells. The endocrine and nervous systems play important roles in maintaining homeostasis in the human body. Integration, which is the biological basis of physiology, is achieved through communication between the many overlapping functions of the human body's systems, which takes place through electrical and chemical means. Much of the basis of our knowledge of human physiology has been provided by animal experiments. Because of the close relationship between structure and function, studies in human physiology and anatomy seek to understand the mechanisms that help the human body function. The series on human physiology deals with the various mechanisms of interaction between the various organs, nerves, and cells in the human body.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/12.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11408,editor:{id:"195829",title:"Prof.",name:"Kunihiro",middleName:null,surname:"Sakuma",slug:"kunihiro-sakuma",fullName:"Kunihiro Sakuma",profilePictureURL:"https://mts.intechopen.com/storage/users/195829/images/system/195829.jpg",biography:"Professor Kunihiro Sakuma, Ph.D., currently works in the Institute for Liberal Arts at the Tokyo Institute of Technology. He is a physiologist working in the field of skeletal muscle. He was awarded his sports science diploma in 1995 by the University of Tsukuba and began his scientific work at the Department of Physiology, Aichi Human Service Center, focusing on the molecular mechanism of congenital muscular dystrophy and normal muscle regeneration. His interest later turned to the molecular mechanism and attenuating strategy of sarcopenia (age-related muscle atrophy). His opinion is to attenuate sarcopenia by improving autophagic defects using nutrient- and pharmaceutical-based treatments.",institutionString:null,institution:{name:"Tokyo Institute of Technology",institutionURL:null,country:{name:"Japan"}}},editorTwo:{id:"331519",title:"Dr.",name:"Kotomi",middleName:null,surname:"Sakai",slug:"kotomi-sakai",fullName:"Kotomi Sakai",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000031QtFXQA0/Profile_Picture_1637053227318",biography:"Senior researcher Kotomi Sakai, Ph.D., MPH, works at the Research Organization of Science and Technology in Ritsumeikan University. She is a researcher in the geriatric rehabilitation and public health field. She received Ph.D. from Nihon University and MPH from St.Luke’s International University. Her main research interest is sarcopenia in older adults, especially its association with nutritional status. Additionally, to understand how to maintain and improve physical function in older adults, to conduct studies about the mechanism of sarcopenia and determine when possible interventions are needed.",institutionString:null,institution:{name:"Ritsumeikan University",institutionURL:null,country:{name:"Japan"}}},editorThree:null,series:{id:"10",title:"Physiology",doi:"10.5772/intechopen.72796",issn:"2631-8261"},editorialBoard:[{id:"213786",title:"Dr.",name:"Henrique P.",middleName:null,surname:"Neiva",slug:"henrique-p.-neiva",fullName:"Henrique P. 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