\r\n\tNot all mixtures of particles and liquids can be considered slurries. A slurry has its character quite different from the carrying liquid (sometimes referred to as the vehicle). A Newtonian liquid has its shear stress directly proportional to its rate of deformation, but this is seldom the case for a slurry. In general, slurries are referred to as non-Newtonian liquids and ways of dealing with them are important threads in this text.
\r\n\r\n\tPipe blockages and pipe wear cause high costs to industry, in both maintenance and loss of production. This waste, and environmental damage which comes with it, can be shown to be reduced by careful application of slurry technology. This book will welcome recent research efforts to understand slurries related to the above-mentioned topics.
",isbn:"978-1-80356-669-6",printIsbn:"978-1-80356-668-9",pdfIsbn:"978-1-80356-670-2",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,isSalesforceBook:!1,hash:"a3de73ad02868797334aa3024ec3f018",bookSignature:"Dr. Trevor Jones",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11907.jpg",keywords:"Slurry Rheology, Non-Newtonian Flows, Wastewater Treatment, Blood Rheology, Slurry Measurement, Slurry Tomography, Pipeline Pigs, Pipeline Cleaning, Wear, Swirl Induction, Electrical Resistance Tomography, Electrical Capacitance Tomography",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"March 22nd 2022",dateEndSecondStepPublish:"May 25th 2022",dateEndThirdStepPublish:"July 24th 2022",dateEndFourthStepPublish:"October 12th 2022",dateEndFifthStepPublish:"December 11th 2022",remainingDaysToSecondStep:"5 days",secondStepPassed:!1,currentStepOfPublishingProcess:2,editedByType:null,kuFlag:!1,biosketch:"Dr. Jones is a world-leading expert in naturally-occurring particle products - slurries, sludges, coal, ore, and gravel. 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In 2004 he started his consultancy business TFJ Consulting Ltd and was responsible for high value commissions for the nuclear industry. He is an enthusiastic contributor to Hydrotransport and Transportation and Sedimentation conferences and has published many papers in the proceedings of those conferences.",institutionString:"TFJ Consulting Ltd",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"0",institution:null}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"8",title:"Chemistry",slug:"chemistry"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"444316",firstName:"Blanka",lastName:"Gugic",middleName:null,title:"Mrs.",imageUrl:"https://mts.intechopen.com/storage/users/444316/images/20016_n.jpg",email:"blanka@intechopen.com",biography:"As an Author Service Manager, my responsibilities include monitoring and facilitating all publishing activities for authors and editors. From chapter submission and review to approval and revision, copyediting and design, until final publication, I work closely with authors and editors to ensure a simple and easy publishing process. I maintain constant and effective communication with authors, editors and reviewers, which allows for a level of personal support that enables contributors to fully commit and concentrate on the chapters they are writing, editing, or reviewing. I assist authors in the preparation of their full chapter submissions and track important deadlines and ensure they are met. I help to coordinate internal processes such as linguistic review, and monitor the technical aspects of the process. As an ASM I am also involved in the acquisition of editors. 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Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"72",title:"Ionic Liquids",subtitle:"Theory, Properties, New Approaches",isOpenForSubmission:!1,hash:"d94ffa3cfa10505e3b1d676d46fcd3f5",slug:"ionic-liquids-theory-properties-new-approaches",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/72.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"314",title:"Regenerative Medicine and Tissue Engineering",subtitle:"Cells and Biomaterials",isOpenForSubmission:!1,hash:"bb67e80e480c86bb8315458012d65686",slug:"regenerative-medicine-and-tissue-engineering-cells-and-biomaterials",bookSignature:"Daniel Eberli",coverURL:"https://cdn.intechopen.com/books/images_new/314.jpg",editedByType:"Edited by",editors:[{id:"6495",title:"Dr.",name:"Daniel",surname:"Eberli",slug:"daniel-eberli",fullName:"Daniel Eberli"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"57",title:"Physics and Applications of Graphene",subtitle:"Experiments",isOpenForSubmission:!1,hash:"0e6622a71cf4f02f45bfdd5691e1189a",slug:"physics-and-applications-of-graphene-experiments",bookSignature:"Sergey Mikhailov",coverURL:"https://cdn.intechopen.com/books/images_new/57.jpg",editedByType:"Edited by",editors:[{id:"16042",title:"Dr.",name:"Sergey",surname:"Mikhailov",slug:"sergey-mikhailov",fullName:"Sergey Mikhailov"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1373",title:"Ionic Liquids",subtitle:"Applications and Perspectives",isOpenForSubmission:!1,hash:"5e9ae5ae9167cde4b344e499a792c41c",slug:"ionic-liquids-applications-and-perspectives",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/1373.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2270",title:"Fourier Transform",subtitle:"Materials Analysis",isOpenForSubmission:!1,hash:"5e094b066da527193e878e160b4772af",slug:"fourier-transform-materials-analysis",bookSignature:"Salih Mohammed Salih",coverURL:"https://cdn.intechopen.com/books/images_new/2270.jpg",editedByType:"Edited by",editors:[{id:"111691",title:"Dr.Ing.",name:"Salih",surname:"Salih",slug:"salih-salih",fullName:"Salih Salih"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"872",title:"Organic Pollutants Ten Years After the Stockholm Convention",subtitle:"Environmental and Analytical Update",isOpenForSubmission:!1,hash:"f01dc7077e1d23f3d8f5454985cafa0a",slug:"organic-pollutants-ten-years-after-the-stockholm-convention-environmental-and-analytical-update",bookSignature:"Tomasz Puzyn and Aleksandra Mostrag-Szlichtyng",coverURL:"https://cdn.intechopen.com/books/images_new/872.jpg",editedByType:"Edited by",editors:[{id:"84887",title:"Dr.",name:"Tomasz",surname:"Puzyn",slug:"tomasz-puzyn",fullName:"Tomasz Puzyn"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"47899",title:"MicroRNA in Breast Cancer — Gene Regulators and Targets for Novel Therapies",doi:"10.5772/59428",slug:"microrna-in-breast-cancer-gene-regulators-and-targets-for-novel-therapies",body:'MicroRNAs (miRNAs) are a recently discovered class of endogenously expressed, single stranded, non-protein coding RNAs of about 19-25 nucleotides in length, that bind to the 3` un-translated regions (UTR) of target messenger RNAs (mRNAs) through complementarity with the first 2-8 nucleotides at the 5` end of the miRNA. They play important roles in diverse biological and pathological processes, through the regulation of gene expression at both transcriptional and post-transcriptional level [1,2]. The miRNA-mediated gene regulation is part of a larger mechanism known as RNA interference which involves other regulatory RNAs; small interfering RNAs (siRNA), which induce silencing of specific mRNA through complementary nucleotide sequences, and piwi-interfering RNAs (piRNAs) which, through similar mechanisms, induce silencing of active mobile elements to maintain germ line integrity and fertility. To date, over 1000 miRNAs and 16,228,619 predicted mRNA target sites have been identified, affecting over 30% of the human genome [3]. What makes them important players in regulating protein expression is the ability of a single miRNA to interact with more than one target gene (due to the imperfect matching between miRNA and its target which still produces a functional effect). In addition, a single gene can be regulated by multiple miRNAs. Currently, around 200 human transcription factor-miRNA relationships have been described and collated into the TransmiR database [4]. These include transcription factors such as Nanog and Oct3/4, [5], hormones such as estradiol [6], and tumor suppressor genes such as p53 [7]. Since the initial reports of the miRNAs
This chapter will summarise and discuss recent evidence elucidating the role of these newly discovered regulators of gene expression in cancer pathogenesis, with particular emphasis on breast cancer.
The biogenesis of mature miRNA is a multistep process which requires the contribution of various enzymes, binding proteins and transporters. In the nucleus, miRNAs are transcribed from either intra-or inter-genic regions by RNA polymerase II to form the primary miRNAs (pri-miRNAs), structures of approximately 1-3 kb in length [22]. These are initially cleaved by RNase III enzyme Drosha, and the double-stranded RNA-binding partner protein Pasha (DiGeorge Syndrome Critical Region 8 Protein), into stem-loop structures of approximately 50-70 nucleotides, with a 3` overhang of a few nucleotides, termed precursor-miRNAs (pre-miRNAs) [23,24]. These pre-miRNAs are then transported into the cytoplasm by a nuclear exporter protein termed Exportin-5 (RanGTP-dependent dsRNA-binding protein) [25]. Once in the cytoplasm, the pre-miRNAs are further cleaved from their terminal loops into double-stranded oligonucleotides of approximately 18-24 bp in length into mature miRNA, by RNase-III Dicer: miRNA* duplexes [26]. These strands are then separated and one of them becomes a mature miRNA molecule to be incorporated with several argonaute (AGO) and other proteins into an RNA-induced silencing complex (RISC) which either perfectly or imperfectly hybridises with its target mRNA. In case of near-perfect to perfect matching, this results in mRNA cleavage and degradation by the action of mRNA processing bodies [27,28,29,30], while translational inhibition or sequestration of mRNA from the translational machinery results in the case of imperfect matching [27,31]. In either event, the end result is ultimately reduced protein levels. In vertebrates, most of the miRNA-mRNA interactions are of imperfect complementarity at the 5` end seed sequence [32], unlike the plant miRNA-mRNA interactions which generally target via perfect complementarity [33]. It has been suggested that the miRNA star strand is often degraded, but some evidence suggests that it plays a role in the regulation of miRNA homeostasis and other downstream effects [34,35]. For example, ectopic expression of miRNA-24-2 star strand in the estrogen receptor (ER) positive breast cancer cell line MCF-7, results in suppression of cell survival, through the targeted suppression of protein kinase Cα (PKCα), and decreased tumor formation when injected into nude mice [36]. Recent evidence suggests the existence of alternative miRNA biogenesis pathways not involving Drosha activity, from introns that bear hairpin structures similar to Drosha processed pre-miRNAs. These miRNAs are termed mitrons [37,38,39]. Both pathways merge at the point of cytoplasmic transfer via Exportin-5. In addition, another new group of miRNAs (termed smitrons) has been described as splicing-independent mitron-like miRNA, which require Drosha activity but not splicing, DGCR8 or Dicer activity [40,41,42,43]. Their subsequent mechanism of processing into the RISC is unclear. These events are illustrated in Figure 1.
miRNA biogenesis. Following transcription by RNA polymerase II from intergenic, intronic or polycistronic regions, the primary transcripts (pri-miRNA) are processed by drosha/DGCR8 enzyme complex into approximately 70 nucleotide pre-miRNA hairpin structures. Two other pathways involving short intronic hairpins have been described; mirtrons that are spliced and processed via a debranching enzyme (DRB1), and simtrons that are processed by drosha in cooperation with an unknown factor. All enter the cytoplasm through Exportin-5/RAN-GTP activity (except for the simtron-derived molecule which is processed by other undefined mechanisms) and are further processed by dicer/TRBP into a duplex form which then associates into an RNA induced silencing complex (RISC). Within this, RNase H activity degrades the passenger strand and the antisense strand guides the complex to its target mRNA sequence in the 3’ UTR sequence downstream of the open reading frame (ORF). Perfect base pairing results in mRNA degradation, and permitted imperfect matching, in mRNA de-stabilisation, both of which result in translational blockade.
Aside from their major function of inducing mRNA target gene degradation or translational inhibition, several specific actions of miRNAs have been reported. One such is in senescence-associated transcriptional gene silencing; an event triggered by cancer-initiating or promoting events, through repression of proliferation promoting genes regulated by a retinoblastoma protein (RB)/E2F repressor complex. For example, AGO2, RB1 and
A diverse range of biological processes appear to be at least partly regulated by miRNAs. These include early development and developmental timing [47,48], hematopoietic lineage differentiation [49], cellular differentiation, proliferation and apoptosis [50,51,52], development and function of innate [53,54,55,56] and adaptive [57,58,59,60] immune response, neurotransmitter synthesis [61], viral replication [62], insulin secretion [63] and cardiac rhythm [64].
Genetic deletion studies indicate that some developmental processes are absolutely dependent on miRNAs. In
Involvement of miRNAs in the development of the cardiovascular system [74] is reflected by variable expression/activity of miRNAs such as-126,-143,-145, and-218 [75]. miRNA-1 has a unique expression profile in cardiac myocytes and plays a critical role in heart development, by influencing cardiac morphogenesis, electrical conduction and cell-cycle control [76]. It is strongly expressed during heart development between ED 8.5-11.5 and represses the expression of heart and neural crest derivatives expressed-2 (Hand-2) transcription factors, which are responsible for ventricular cardiomyocyte differentiation [77]. In the nervous system, Dicer deficient zebra fish show defects in neuronal cell differentiation and development [78]. In mammals, miRNA-124 and-128 are highly expressed in neuronal progenitor cells and mature neurons, and are considered to be the main regulators of neuronal development [79,80,81]. miRNA-124a is thought to constitute 25-50% of the total brain miRNA population, and is implicated in switching brain progenitor cells into a neuron lineage [82]. miRNA-134 plays a role in central synaptic function [83,84]. miRNAs are also implicated in the development of skeletal muscles; miRNA-1 is abundantly expressed in the muscle progenitor cells and differentiating muscle [77], and facilitates myotube formation [85] by interacting with muscle differentiating factors such as serum response factor (SRF), myocyte enhancer factor-2 (MEF-2) and myogenic regulatory factors (MRFs) [77].
miRNAs have been shown to play an important role in the differentiation of pluripotent embryonic stem (ES) cells which gives rise to more than 200 cell types in the adult body. Differential expression has been observed during ES cell differentiation, with decrease in miRNA 290-295 cluster and-296, and increase in miRNA-21 and-22 [86]. Mice oocytes with targeted deletion of Dicer, failed to produce any miRNA, resulting in failure of cell division, in part due to disorganized spindle formation, reflecting the importance of maternal miRNAs in the earliest stages of embryonic development [87]. Over-expression of miRNAs 290-295/302 could overcome the proliferation defects of Dgcr8 mutant mouse ES cells, whereas over-expression of
Numerous miRNAs are involved in controlling the activity of intracellular signaling molecules (e.g. MAPK, PI3K/PTEN, NFκB, TGFβ, Notch, and Hedgehog) which are critical in regulating multiple processes linked to cancer pathogenesis such as proliferation, apoptosis, angiogenesis and immune function, emphasizing their potential value in cancer classification, as diagnostic biomarkers for staging, predictive markers of prognosis and response to therapy, and as therapeutic targets [89,90,91]. For example, miRNA-21 is described as a positive-feedback regulator of MAPK/ERK1/2 pathways. Its own expression is induced by the activation of ERK1/2, whose activity it then increases by repressing negative regulators of ERK/MAPK. Stimulation of HER2/neu signaling enhances MAPK/ERK phosphorylation, which results in enhanced miRNA-21 levels and increased invasive capacity of HER2/neu expressing breast cancer cells, by repression of the metastasis suppressor protein; programmed cell death 4 (PDCD4) [92]. The miRNA-200 family have been reported to target the downstream mediators of the TGF-β pathway, ZEB-1 and-2, resulting in inhibition of the epithelial to mesenchymal transition process (EMT), with subsequent suppression of metastasis in various cancer cell lines including those of the breast [93,94]. Interestingly, ZEB1 reduces the expression of the miRNA-200 cluster and hence promotes EMT in a feed-forward manner [95].
A multiplicity of factors, that include chromosomal instability, genomic mutations and polymorphisms, epigenetic changes, alterations in synthetic pathways, promoter methylation, or changes in the activity of their transcriptional factors, modify the expression of miRNAs [29,86]. For example, single nucleotide polymorphism (SNP) type mutations in miRNA-146a can predispose for development of various tumors [100,101,102] including those of the breast [103]. Specific G/C polymorphisms (rs2910164) in miRNA-146a precursor leads to increased production of the mature form, which binds to and modulates the BRCA1 and BRCA2 genes, whose activity is a predisposing factor for early onset familial breast cancer [103].
Although miRNAs have been found to be both over-as well as under-expressed in cancer cells as compared with normal tissues, the more frequent observation is one of decreased expression. For example, whereas miRNA-21 is elevated, miRNAs-126,-143, and-145 are all decreased in most (~ 80%) types of tumors [104]. This means that miRNAs can function both as oncogenes (e.g.-9,-17-92 cluster,-21,-27a,-103,-106,-107,-125b, and-155) or more often, as tumor suppressor genes (e.g.
Analysis of dysregulated miRNA expression may also have prognostic relevance in many cancers; for example, metastatic breast tumors show elevated miRNA-10b and reduced miRNA-126,-206, and-335 levels [112,113]. A recent report suggested that higher expression of miRNA-126 and-10a in breast cancer patients was associated with longer relapse-free survival [114]. The detection of circulating miRNA in plasma and serum also presents these molecules as potential novel biomarkers for cancer and other diseases. A pilot study showed that miRNA-155 serum levels could be a significant index to distinguish patients with breast cancer from healthy individuals, and serum levels of miRNA-34 could indicate disease prognosis [115]. Another report [116] suggested that four miRNAs,-215,-299-5p,-411, and-452, that were differentially expressed between serum samples from patients with metastatic breast cancer and healthy volunteers, could be used as biomarkers for detection and staging; requiring only a blood sample. Heneghan
Cellular transition from epithelial to mesenchymal phenotype (EMT) and
miRNA can either induce or inhibit the EMT process by modulating various target genes (Figure 2)
Deletions and/or mutations in p53 are frequently involved in the pathogenesis of many human cancers including those of the breast (mutated in 25-30% of breast cancers) [156,157]. Kim
Estrogen (E2), acting through ERα, plays a major role in controlling the normal growth and development of mammary epithelial cells, as well as in the pathogenesis of breast cancer. E2 binding induces ERα activation by the dissociation of the inactive ER-heat shock protein complex, leading to conformational changes, dimerization and autophosphorylation. The activated dimer complex binds to either estrogen response elements (EREs) or to other promoters such as the AP1/SP1 sites in target genes, to initiate events culminating in cellular proliferation. Other target genes may include transcriptional repressors or initiate anti-proliferative or pro-apoptotic function [161].
The mammary ducts are composed of an inner layer of luminal epithelial cells and an outer layer of basal or myoepithelial cells. The majority of breast cancers arise from the luminal epithelium of small mammary ducts, and are classified as luminal-A subtype, characterized as low grade, weakly proliferative and invasive. These express ERα, PR, luminal associated transcription factors such as GATA-3 and FOXA1, and epithelial markers such as E-cadherin [162]. Luminal-A cancers can progress into more aggressive and metastatic forms through the EMT process. Although ERα plays a critical role in enhancing cellular proliferation, where anti-estrogen therapy (e.g. tamoxifen) are the preferred treatment options, E2/ERα signaling also promotes the differentiation of mammary epithelial cells along the luminal/epithelial lineage and thereby
In our laboratory, we have established several endocrine resistant breast cancer cell lines that exhibit an ERα-depleted phenotype induced by shRNA transfection of the ER+ve MCF-7 cells. Such cells have all gained estrogen independence and exhibit a series of changes in morphology and enhanced motility and invasiveness accompanied by a modified gene expression profile indicative of EMT. Microarray and real time-PCR analysis have confirmed the loss of genes associated with epithelial cells such as E-cadherin, catenin, occludins, claudins, and enhanced gene expression associated with mesenchymal cells such as N-cadherin, vimentin, fibronectin, integrin β4 and α5, and various metalloproteinases [124,171,172]. This model of endocrine resistance induced by ERα loss was also confirmed by others. Moreover, ectopic ERα over-expression in ER–ve breast cancer cell lines reverses the EMT process through enhanced E-cadherin and reduced SLUG expression [173].
The ERα mRNA has a long 3\' UTR of about 4.3 kb which has been reported to reduce mRNA stability and which bears evolutionarily conserved miRNA target sites, suggesting that it might be regulated by miRNAs. Overall, ER–ve cells display generally lower levels of miRNA expression. Of the miRNAs that are up-regulated there are distinct differences between ER-ve and ER+ve cells (Figure 3).
Up-regulation of miRNA expression in relation to ER status of breast tumours
Of note, miRNA-10b,-125, and-145 were significantly down-regulated in the majority of breast cancer samples and cell lines, whereas miRNA-21,-17-5b,-29b-2,-146,-155, and 181b-1 were up-regulated [126,174]. Estrogen has been shown to induce Dicer expression; loss of ERα may contribute to reduced Dicer and consequently lower miRNAs levels in ER–ve cells. In addition, some miRNA such as miRNA-29a, 103/107 and-200c, and
Cancer cell invasion is a multi-step process which involves dissociation of extracellular matrix components by the action of various proteases and the subsequent movement of detached tumor cells from the original tumor site to distinct organs, and is associated with poor clinical outcome and reduced survival rates. Several miRNAs have been implicated in either enhancing or reducing cellular invasion by targeting various mRNAs that encode proteins crucial to the process (Figure 5).
Several miRNAs have been implicated in either enhancing or reducing cellular proliferation by targeting various mRNAs that encode proteins crucial to the process (Figure 6).
An example of miRNAs regulating the expression levels of other miRNAs was reported by Martello
Several studies, as outlined above, have highlighted the contribution of various miRNAs in multiple processes of tumor pathogenesis (proliferation, invasion, EMT and endocrine/chemotherapy resistance), making them potential tools for applications as indicators in breast cancer diagnosis and staging, as markers of response to therapy and as therapeutic agents/targets for treatment. Unlike mRNAs, miRNAs (presumably due to their smaller size) are relatively stable in formalin fixed tissue specimens and in the blood stream, which facilitates their detection/measurement. There is opportunity to develop miRNA-based drugs that target specific oncomiRs or replace down-regulated miRNAs which have tumor suppressor properties. Unlike other nucleic acid, protein or small molecule drugs, many miRNAs (such as miRNA-31) have pleiotropic actions by which they can affect several related target genes; this can have a desirable cumulative effect that has obvious advantages in treating multifactorial diseases like cancer [194]. Of course it could also produce deleterious effects, so it is important to identify all the potential targets of particular miRNAs.
The value of using miRNAs as diagnostic and/or prognostic signature in breast cancer is currently receiving some attention. For example, miRNA-7,-128a, 210, and 516-3p can be used as markers for distant metastases of ER+ve, lymph node-ve breast cancer cases [214], while miRNA-210 can be used as marker for distant metastasis in triple –ve breast tumours [214,232,233]. Some miRNAs could be used as markers for disease survival in ER+ve (e.g. miRNA-128a,-135a, 767-3p) [234], ER–ve (e.g. miRNA-27b,-30c,-144,-150,-210,-342) [234], as well as in triple negative breast tumours (e.g. miRNA-21,-205,-210,-221,-222) [235,236]. Also, some miRNA such as-30a-3p,-30c, and-182 can be used as markers for response to adjuvant tamoxifen treatment in advanced ER+ve cases [237], while miRNA-21can predict the response to neoadjuvant trastuzumab treatment in breast cancer [213,238,239].
miRNA mimics, or replacement therapy, aims to restore normal levels of certain miRNAs that are down-regulated. They usually carry the same sequence as the missing or deficient naturally occurring miRNA. Introduction would be via viral or liposomal delivery [240].
These are oligonucleotides that are chemically engineered to bind to a specific miRNA to prevent it from interacting with its mRNA target. To increase their stability, they can be chemically modified through the inclusion of 2’-O-methyl modified ribose sugars, 2’-O-methyl ribose sugars with the addition of an extra 2’-O, 4’C methylene bridge sugar [241,242,243,244]. An example of an important miRNA in breast cancer pathogenesis is miRNA-21, which is significantly up-regulated in breast tumors compared to normal tissue. Treatment of both ER+ve and ER-ve breast cancer cells with anti-miRNA-21 oligonucleotides suppressed both cell growth and migration
Another range of compounds that are under development are known as target masks [246], of which there are several types. A target mask is conceptually an oligonucleotide whose sequence has been designed to bind either to an endogenous miRNA (miR sponge) or to its target on the mRNA (sponge miR mask). Whilst the binding of the sponge miR mask will prevent the binding of all miRNA belonging to the same seed family [247], (and is therefore miRNA seed specific and not gene specific), the miR mask blocks only a particular miRNA from interacting with its target mRNA.
These interactions are illustrated in Figure 7.
Manipulation of miRNA function. Endogenous miRNAs bind to target sequences in the 3’ UTR regions of their target mRNA, downstream of the open reading frame (ORF), to produce translational arrest. miRNA mimics are synthetic oligonucleotide duplexes that have the same sequence as the endogenous miRNA and also produce the same effect. Antagomirs (also called antimiRs) are oligonucleotides that have complementarity with the miRNA and bind to it, preventing it from interacting with its target mRNA, thereby allowing normal mRNA translation. An miR mask is a construct that is complementary to a sequence in the mRNA; this binding does not initiate mRNA degradation or translational inhibition but prevents the endogenous miRNA from binding. The sponge miR mask differs from the miR mask in that it binds to any mRNA with a similar target sequence and is therefore miRNA seed specific and not gene specific.
miRNAs are endogenously synthesized single stranded RNA molecules that are 19-25 nucleotides in length, which play a vital role in the regulation of gene expression.
Their exact mechanism of regulating gene expression is determined by the degree of complementarity with their target mRNAs; perfect complementarity usually results in mRNA degradation while permitted imperfect complementarity results in translational inhibition.
miRNA biogenesis takes place in two phases; nuclear and cytoplasmic, both of which include events mainly carried out by Drosha, Argonaute and Dicer.
The expression level of miRNA is mostly found to be down-regulated in cancers, and miRNA-155 was the first to be found to actually induce tumorigenesis.
miRNAs are differently expressed in ER-ve
miRNA-221/222 targets and down-regulates ERα, induces EMT, and enhances breast cancer cell invasion and proliferation.
miRNA-9,-24, and-155 induce EMT and enhance cell invasion.
miRNA-7 and-44 inhibit EMT and decrease cell invasion.
miRNA-124 and-145 inhibit EMT, and decrease cell invasion and proliferation.
miRNAs could be used as non-invasive biomarkers for the diagnosis and prognosis, and as a promising therapeutic target for breast cancer.
miRNA mimicks, antagomiRs and miR masks are being developed as new ways to interfere with miRNA regulation of gene translation in cancer cells.
Inter-professional teamwork is where various professionals such as doctors, pharmacists, medical laboratory scientists, medical laboratory technicians, medical laboratory assistants, nurses, physiotherapists, radiographers, health information officers, human resources managers and others who work in the healthcare institutions, work together with patients, care givers, families and communities to deliver the highest quality of care [1].
\nThe World Health Organization (WHO) [2] defined inter professional teamwork or collaboration as a situation where multiple healthcare workers from different professional background work together with patients, care givers, families and host communities to deliver the highest quality of care. This is essential in a situation where health care professionals assume complementary roles and cooperatively work together, sharing responsibilities for a problem solving, and decision to formulate and carryout plans for adequate patient’s care.
\nAvailable evidence however suggest that unlike in the developed world, health care professionals do not collaborate well in Nigeria because of the claim of superiority of a particular health professional like physicians who always claim healthcare leadership and owners of patients which creates more conflict among other healthcare professions that is threatening to tear the health care sector apart, to the detriment of the patients [3].
\nMost of the challenges faced in the health care sector are due to; several month salaries owed, poor welfare, lack of appropriate healthcare facilities and other emerging factors among health workers.
\nResearchers have found out that working together reduces the number of medical errors and increases patient’s safety [4]. Teamwork also reduces issues that lead to burnout, no longer is one person responsible for the patient health. Today, an entire team of health workers come together to coordinate patients’ well-being and it reduces both surgical and diagnostic errors [5].
\nTeamwork is based on solid communication among healthcare workers with the patients and their families sometimes to feel more at ease. They accept treatments and feel more satisfied with the health care [6] when there is good communication backed up by team spirit.
\nThe teamwork significantly reduces workloads, increases job satisfaction and retention, improves patients’ satisfaction and reduces morbidity [7].
\nThis chapter shall examine the Nigerian situation on teamwork and the challenges/hindrances which affect the positive outcomes of quality health delivery. Notably, Nigerian Health workers are knowledgeable on the teamwork and the possible positive outcomes [8, 9, 10], but the challenging factors have contributed to the less concerns on the teamwork practice and if well addressed, Nigeria shall improve on the next level of positive outcome of healthcare laced with teamwork.
\nTeamwork has been advocated across the globe. The Nigerian healthcare shows interest in teamwork across healthcare institutions, however some mitigating factors hinder the teamwork spirit and the expected positive outcomes.
\nKnowing that teamwork requires collaboration and understanding within the health care sector, personal values and expectations of team members counts. Personal values have to be well maintained in other to understand each other. Guiding principles and understanding the core mission of work without letting in expectations and one’s personal interest to outweigh the team interest is essential.
\nIn Nigeria, personal values and interest, depending on the exposure and family financial base challenges professionals on how well to work as a good team member or not. Poverty and stress attached to financial crisis may limit expected outcome of services or team outcome.
\nDistribution of health workforce has been another serious challenge due to inadequacy in the recruitment and number of personnel in various health facilities. Abimbola [11] did not mince words when he puts it that the low and inequitable distributions of healthcare workers remain an elephant challenge in the Nigerian healthcare sector. Bangdiwala and colleagues [12] opined that there is a global crisis in health workforce as a system by acute shortage and uneven distribution of health workers in several settings. In Nigeria, expert have reported that historically, “brain drain in the form of migration of health workers to high income settings as a major setback in the country” [13]. Current statistics show that one in four doctors and one in twenty nurses trained in Africa are currently working in developed countries, with this contributing to the short fall of over 1.5 million healthcare workers in the African region [14]. Healthcare workforce density in Nigeria, is estimated at 1.95 per 1000 population [15]. These figures reveals disparity and shortage of health professional man-power and may contributes to less attention to team work. In order to handle the huge workload, there should be due consideration to team work and collaboration which makes workload better handled with ease.
\nIn the midst of unequal distribution of healthcare staff, there is embargo on employment of medical laboratory scientists in many healthcare institutions as compared with Doctors and Nurses. This situation leads to lopsided approach and heavy workload on a particular profession thereby stampeding teamwork especially in patients care management.
\nPersonality traits exist in addition to professional differences depending on the different roles as legalized in various countries of practice, an instance of Nigeria.
\nWhile some see the practice of medicine as an autonomous one-on-one relationship between the clinician and the patient, others see it as a team work towards a better patient outcome. The challenge emerges when a particular profession in a healthcare setting takes ownership of patient and assumes that other healthcare professionals that come in contact with the patients are not important. This relationship remains a core value in Medicine but it is challenged by many concepts of teamwork and shared care thereby, hindering the sharing of information of their patients through medico-legal implications of team-based care.
\nMany healthcare workers have shown different views and ways of doing certain thinking in this regards. This serves as a barrier to inter professional teamwork where one behavior or attitude differs from the other and sometimes, the attitudes can be traced to professional differences.
\nHierarchy among medical professionals in Nigeria is a serious challenge in teamwork practice in Nigeria. Before 1985, the headship of healthcare institutions was not specific but based on the most qualified professional to hold such office. Not until 1985 when Decree 10 was promulgated for the Teaching Hospitals to be headed by Chief Medical Director (CMD) who must be a Physician (Medical Doctor), registered and licensed. This Decree has been replicated in all health institutions without adequate legal backing. This removed the competency in administration and management in Nigerian healthcare to the hands of Doctors who may or may not have the adequate knowledge in practice of administration and management.
\nCurrently, it is difficult to have a health team where the teams’ decision would be accepted if the team leader is not a medical doctor. Strong hierarchical nature of medicine graduates rating as number one in Nigerian healthcare sector pushes for only the doctors to be both Ministers as appointed in the Federal Ministry of Health, Health Agencies, State Ministries of Health and all Hospitals. In a typical Nigerian healthcare, most decisions by a team is not accepted if not headed by a Doctor and this has really posed as a challenge to other professions within the sector.
\nSupremacy/Headship challenge especially in the health institutions leadership has developed an ugly trend of which team works stands better chance to handle. It was Alubo [16] that opined that the health workforce crisis in the country have taken unique and worrying dimension. In reality, other healthcare workers have alleged that the Nigeria health system is designed to favor doctors mainly, especially in management of health sector not minding if there is certificate or experience in management or not. The alleged dominance of doctors over the years have encouraged other health sector unions (JOHESU) to put up resistance.
\nIn the health care system, different positions and categories are allocated to the health care professionals on the basis of levels. The upper echelons of the hierarchy are superior to the ones occupying the lower level, and thus the communication and collaboration might be formed and therefore serve as a hindrance to inter-professional treatment.
\nRosanne [17] posits that difference in attitudes in inter-professional healthcare about who is ultimately in charge could be an “Achilles’ heel” across the globe. In Nigeria, the Doctors are fully in charge in all medical interdisciplinary teamwork. There is need to give further attention, because agreement with the concept of shared team decision-making is fundamental to effective interdisciplinary work of any kind. The question of who is in charge is a complex issue with complicated legal, ethical, and professional ramifications.
\nMost health workers want to be given full attention alone. When this occurs, teamwork cannot be enjoyed; because others might feel less valued and would not be listened to. This serves as a barrier in inter-professional team work.
\nThe situation where every health professional in Nigeria threatens for work to rule, strike and industrial actions based on one issue or the other with other disruptive behaviors makes it very impossible to continue team spirit in healthcare in Nigeria.
\nWhile there has been a growing acknowledgement that teamwork is important in health care, this has not necessarily been translated into changed practices, especially in emerging and developing nations like Nigeria where cultural norms of communication may mitigate against teamwork. Communication gap is huge because of Federal Character and Catchment area policies of government.
\nIn the healthcare sector in Nigeria; culture and ethnicity serves as a gap in team work. When a client and a health professional are from different background; the difficulty in language, communication and understanding occurs. It might be hard to get a translator and this therefore, ends the means of achieving a goal. Different clients come from different background; therefore the means of understanding within the healthcare system is limited.
\nSome culture or practices maybe due to religion. This may pose a challenge especially where women abhor medical attention from men or vice versa.
\nHaving a varied generation representing a team will create a barrier in inter-professional teamwork, some health workers have a particular age range; and might have some ideas, attitude or values. When these cannot be maintained, it creates so many differences. The generation gaps puts the just graduated health professional who may be probably doing Internship and full of information communication technology (ICT), savvy to have different approaches to case managements as team members with others who have grown from the ranks while working as a team. The ethical issues serves as a bridge but in some cases, the idea of a junior colleague or team member may be logical but not tolerated in terms of respect and ethics from the senior ones and creates some differences as a team.
\nFollowing the medical practice history, women were nurses and men were physicians; but recently, men are becoming nurses and more women are becoming physicians, although men represents only 7% of the nursing population, and medicine is almost equally represented by both men and women. A study by Wear & Keck-McNulty [18] and Lotan [19] supports the concept that female nurses are more collaborative with female physicians, the result from the qualitative survey shows that female nurses reported higher level of collaboration with female physicians than male physicians. Gender has always been a barrier to collaborative healthcare achievements due to issues concerning on whom to be given several position between a man and a woman [20]. Gender equity in any health team is very important [21].
\nGender sensitivity is very import in formation of good teams. In cases were professional members are dominated by men or women, such gender differences poses some challenges in the team performance.
\nIn Nigeria, the women are more among the nurses and men are more among other professionals though there is serious improvement towards mixing the gender unconsciously. In some critical cases, women are required especially to attend to women concern on special or personal preference within the team, but where they are lacking it poses more challenge to the teamwork.
\nVarious healthcare professionals have different educational backgrounds especially in Nigeria where all professions – Physicians, Pharmacists, Medical laboratory scientists, Nurses etc. have their root traced to other countries of the world. In Nigeria, most of the professions started as Certificates, Diploma, and Degrees.
\nTake for instance, the training of Medical laboratory scientists originated from London [22]. The first categories of the professionals went to London to train as medical laboratory assistants, technicians and technologist. But currently, it is in country training as medical laboratory scientist of which their background of training or professional status should not be a barrier to teamwork with other healthcare professionals. When various professionals look at historical evolution and education rather than harnessing capacities to improve teamwork, it poses a challenge.
\nThere exists fear of one profession thinking that another profession would learn the job and practice the profession without licensure and adequate certification because of collaborative work as noted in teamwork.
\nWhile teamwork enthrones collaboration and sharing of ideas based on professional skills and knowledge, the authors believe that it does not take ones professional status away or dilutes professional identification. However, this fear dominates Nigerian healthcare team practice.
\nDispute over accountability, salaries, rewards and allowances in the Nigerian healthcare sector have continued to emerge day in day out among other factors.
\nPoor remuneration and welfare has also been identified with cases of partiality depending on the professionals involved. The increasing cost of goods and services in Nigeria with increased inflation rates has made it possible that no amount paid to health workers will be enough to satisfy them. Oleribe [23], reported that poor remuneration and wages, poor welfare of the healthcare workforce have led health workers to embark in numerous industrial action due to several month salaries owed and poor working conditions. This strikes and threats of strike continues unabated even at the time of writing this chapter.
\nIn a recent survey of senior management staff of health institution in Nigeria, massive discrepancies in remuneration of health workers in the same grade level across federal, state and local government were observed [24].
\nPayment and reward are determined based on the position and levels of the professional and this therefore can be mistaken and seen as a means of underrating a particular worker.
\nIn Nigeria, various payment and salary structures exist. We have Consolidated Medical Salary Structure (CONMESS), salary scale for medical doctors and Consolidated Health Salary Structure (CONHESS) for other healthcare professionals. The challenge is that CONMESS puts medical doctors more important in healthcare as other professionals lament frequent review of CONMESS and not same for CONHESS. The argument is that the Chief Executives who are all medical doctors prefer to favor their colleagues to the detriment of other professionals.
\nThis is a major factor affecting the team spirit as it is evident that a team comprising of Doctor, Pharmacist, Medical laboratory scientist, Nurse, Radiographer, and Physiotherapist who are in the same grade level shall definitely go home with different amount as wages and emolument even though they are in the same team.
\nCurrently in Nigeria, there exists considerable changes and overlapping in the professional roles played by different health professionals. Ordinarily, from the training levels, there are basic inter-professional expositions of what the health professionals do up to practical terms for knowledge sake but all professionals are licensed to practice their profession [20]. For instance, radiographers can read plain film X-rays, Clinicians, Nurses, Pharmacists can perform some simple medical laboratory tests and their various professional license of practice may not cover such areas as prescribed by law regulating their various practices. These changing roles and task shifting leads to some team challenges in terms of role allocation and acknowledgement.
\nComplexity of care may involve changing settings based on the fact that “nature of health care is changing including, increased delivery of care for chronic conditions into community care and many surgical procedures to day-care centres. These changes require the development of new teams and the modification of existing teams” [20] thereby causing instability of teams.
\nHealth-care teams can be transitory in nature, as it is when coming together for a specific task or event (such as cardiac arrest teams or molecular testing teams). The transitory nature of these teams places great emphasis on the quality of training for team members. This raises challenges in medical care where education and training is often relegated at the expense of service delivery [25]. This is because, most healthcare managers in Nigeria lay emphasis on doing the job than more training for the healthcare professionals who do the job.
\nThe complexity of care is found in intensive care nursing, surgical cases, molecular and advanced techniques in medical practice associated with the severity of illness and the caring intensity which poses threat to teamwork.
\nDecision making with regards to teamwork helps the health workers to be open in discussions. When the decisions are made from certain workers without others involved in such discussion, it creates a teamwork challenge and thus can lead to misunderstanding among the healthcare professionals. This could be due to differences in status among the health workers. And others might feel that their ideas are not welcome, and therefore reduces their efforts. This has been the case where decisions are taken for medical laboratory services in Nigeria in absence of medical laboratory scientist in most management decision-makings in various Nigerian hospitals. Such decisions could be challenged or some approvals returned unattended to due to the lacuna or professional errors. The team spirit diminishes leading to job dissatisfaction [26] in cases where some medical laboratory reagents and consumables are approved or even purchased without adequate input by medical laboratory scientist on the validity and certification of such products towards quality outcome.
\nLack of time is a barrier to collaboration and achievement of goals. Time must be given to all team members to collaborate including the clients. Due to the shortage in nursing profession; nurses today have larger patients’ number to attend to providing for a limited amount of time to spend with each patient. Combined part-time work with increase patient loads and there is a little for health care providers to interact with each other and their patients. Collaboration requires trust and to build trust; people need time for interaction [20]. Due to shortage of health professionals in Nigeria most especially medical laboratory scientists in various hospitals possibly because of increased unemployment created by healthcare managers and Chief Executives who are Physicians, the robust interaction time in teamwork practice is affected because of the crowded patients in need of attention and numerous samples for analysis with reference to the medical laboratories.
\nIn Nigeria, associations and unions are very strong forces that affect team work in Nigerian healthcare. There are numerous associations as each professional body has their association and related ones went ahead to form unions and recently, some unions joined to form common front for strong bargaining power with the government and that lead to formation of the Joint Health Sector Union (JOHESU). JOHESU consist of five registered health professional unions; Medical And Health Workers Union Of Nigeria (MHWUN), National Association Of Nigerian Nurses And Midwives (NANNM), Senior Staff Association Of Universities Teaching Hospitals, Research Institutions and Associated Institutions (SSAUTHRIAI), Nigerian Union Of Allied Health Professional (NUAHP), and Non Academic Staff Union Of Educational And Associated Institutions (NASU).
\nOn the other hand, the Nigeria Medical Association (NMA) is umbrella association of all Medical Doctors/Physicians in Nigeria. There are other sub group associations of NMA depending on their area of specialization or the level of practice.
\nThe team work becomes a hard nut to crack in Nigerian healthcare sector for the fact that NMA do not believe that anything good can come out of JOHESU and vice versa. Such has grown to its obnoxious apogee to the extent that what government approves for JOHESU professional members are being opposed by NMA not minding how good the package may add to healthcare practice or to the motivation and job satisfaction of the beneficent. In the course of writing this chapter, the authors observed that an approval by government to Pharmacists (Figure 1) was challenged by NMA on the 16th September, 2020 when their National publicity secretary, Dr. Aniekeme Uwa posited that NMA “will find a permanent solution to the unwarranted assault on the integrity of the noble profession” followed by the JOHESU members and leadership while commending the federal government of Nigeria on behalf of Pharmacists the Secretariat released a statement of the 18th September, 2020 and “wonders how the approval of a consultant cadre in Pharmacy practice would amount to an assault on the integrity of medical practice”. JOHESU expects the government to extend the Consultant status to other healthcare professionals as the consultant cadre in health systems is not a sole attainment of a particular profession.
\nApproval of consultant cadre for Nigerian pharmacists.
NMA 24 Point agenda and JOHESU 15 Point demands has been two major causes of strike and industrial actions in Nigerian Health industry. Most of the time, the need of one is in direct opposition to the other and makes the dispute resolution not in any way near in Nigeria.
\nJOHESU demands and counter demands by NMA and vice versa has reached its obnoxious apogee that disbanding the Associations and unions may not really be the solution. For example, the NMA and JOHESU strike in 2014 were based on doctors/nurses, doctors/pharmacists, doctors/medical laboratory scientists, doctors/allied health professionals protracted supremacy challenge.
\nIn the last 10 years, there have been calls to address those prevailing issues especially on the provision of better facilities for disease diagnosis and treatment, improved health workforce and remuneration and a health care scheme. On notable response in the National Health Act, which was signed into law by the former president Goodluck Jonathan on October 31, 2014, Albeit generated diverse disagreement and interest among various health professionals and stakeholders in the preceding 5 years [27].
\nThe goal of the health sector is to ensure delivery to affordable, accessible, equitable and safe health services to the population and in achieving this, every health workforce has an important role to play. However, the challenge posed by associations and unions in Nigerian healthcare is a major hindrance to teamwork.
\nFor a healthcare sector to attain a good team work; health professionals must know how to practice collaboration with improved communication and partnership among all health providers and patients; Clarity on the role of all healthcare providers working within team environment; Better response processes in addressing issues related to healthcare; Effective utilization of health care resources. This leads to team’s provision of healthcare services and high level of satisfaction on delivery of services among team members [28, 29, 30].
\nAll effort should be in place in Nigerian healthcare institutions so as to mind every one’s values and assumptions that affect interactions with team members who are definitely other professionals. No matter the strengths and weaknesses of different team members, good teamwork helps to deliver quality and safe care [31, 32, 33].
\nPsychosocial factors of team members should not be allowed to affect team interactions. However, the impact of change on team members should be recognized. There is a need for the healthcare leadership to organize workshops and training [34] on teamwork and conflict management with the aid of role plays with small groups and ability of healthcare managers to understand the characters of stress and conflict within the system. Such programmes improves knowledge [35]. Professionals’ development among healthcare teams cannot be ignored while encouraging all professionals to show respect for each other [36, 37].
\nTraining and practice of emotional intelligence (EI) helps the care givers and healthcare managers in resolving conflicts. It is also imperative to use personality traits and characteristics instrument like crew resources management (CRM) or core self-evaluation (CSE) on conflicts to assess team members who have conflict or less conflict traits.
\nAlso, break the barriers of team communication gaps in healthcare through teaching effective communication strategies, training team members together within undergraduate and postgraduate levels and during team formation stages, stimulate team members together during training or work, redefine healthcare team members to include all healthcare professionals, and make teams democratic in nature in all strata of communication. The healthcare teams should be supported with protocols and procedures such as check lists, IT solutions and briefings and adequate development of organizational culture that support healthcare teams [38].
\nPatients are the center of every medical team and there is a need to include them as team member in any team function.
\nThe hierarchy of professionals over others should be well considered so that no one profession is exalted over other in healthcare team considering that everyone is very important. It should be however put that the heads of any team should be the most qualified and experienced based on years of service and certifications in management and administration, no matter the professional affiliation. It will not be a bad idea if postgraduate certificate in management and administration is requested from prospective Ministers of Health, Chief Executive Officers of Hospitals and healthcare institutions, no matter the profession towards health leadership in Nigeria. The authors recommend such postgraduate certificates that are not less than Master of Science (MSc) in management or administration, Master of Public Administration (MPA), Master of Business Administration (MBA), Master of Health Administration (MHA), Master of Health Management (MHM), and Master of Human Resource Management (MHRM).
\nMutual support techniques should be employed in resolving conflicts, using communication techniques [28] while changing and observing behaviors of medical teams. Such support is expected of NMA and JOHESU to each other where the success of one is success of all in the healthcare industry. The NMA is not the government and neither is JOHESU and both should partner in requesting from the government for better healthcare in Nigeria rather than sabotaging each other before the government especially in the aspect of remuneration, promotion and approval of consultant status for other medical and health professionals in the spirit of teamwork.
\nThere should be a close review and consideration by the Nigerian Federal Ministry of Finance and Budget and Planning Office to reconsider review of Salaries of all Medical and Health practitioners in Nigeria. This shall ensure that a team comprising of Doctor, Pharmacist, Medical laboratory scientist, Nurse, Radiographer, and Physiotherapist who are in the same grade level shall definitely go home with same amount as wages and emolument when they are in the same team and same salary grade level. Having considered the length of training during entry points for all professionals in Nigeria, it is germane to pay equally all team members no matter their profession when they are at the same grade level in a team. For example, if all team members are at Chief Level (Grade Level 14) all of them should be paid the same salary. The authors call the attention of Nigerian government as a measure to deal with incessant strike actions among healthcare workers in Nigeria, to work out a uniform salary structure when all health workers can be paid or revert back to normal salary grade level with adequate allowances for all and not necessarily CONHESS and CONMESS. Though entry points of various professionals may differ, when all those in same level are paid equally, the team spirit shall be encouraged and strengthened.
\nThere is an urgent need in the Nigerian health system to build sustainable leadership, through national health system administration policy that allows alignment consideration and coherence of priorities and partnership in the health workforce and among various stakeholders [39, 40] towards a formidable team work which would provide an improved outcome of patients who are the customers in the healthcare industry [41, 42].
\nRound table for all health professionals and inter-professional training may help as they may tend to table their challenges, and rub minds on the best approach to teamwork and conflict resolution.
\nTeamwork involving all professionals is urgently needed as it creates understanding of importance of all professionals involved to operate in harmony [43, 44]. Currently, the teams experiences in Nigeria are of one profession with varying levels but the team spirit should cut across all health professionals.
\nThe mutual distrust tension and supremacy challenge among the health workforce need to stop as a matter of priority. The focus of health service should be on teamwork rather than factional or individual strength [45].
\nThere is need to design a contextually adaptable framework for inter professional education and collaboration practice in the health sector as recommended by WHO, to further facilitate successful cooperative communication and teamwork in health care service delivery and ensure a healthcare needs and delivery [46].
\nThe inter-professional or interdisciplinary healthcare teams face a set of challenges that are not necessarily encountered by other types of team such as uni-disciplinary or non-health care teams. The importance of inter-professional teamwork is increasingly recognized in healthcare administration and management as possible positive outcomes outweigh the disadvantages. There is improved quality of healthcare for patients, community and healthcare professionals.
\nTeamwork is difficult to tackle, while making the environment become more complex. But if there is focus on the part of the team, the challenges can be overcomed through workshop and training, joint professional training, improved communication strategies, putting aside professional differences, adequate remuneration of the teams based on their levels and allowing all professionals who are qualified to lead a healthcare team to do so without singling out a particular profession as healthcare leaders.
\nFor teamwork to be updated and applied in the Nigerian healthcare, various healthcare professionals such as Doctors, Pharmacists, Medical Laboratory Scientists, Medical Laboratory Technicians, Medical Laboratory Assistants, Nurses, Physiotherapists, Radiographers, Health Information Officers, and Human Resources Managers should put aside personality and professional differences for the team interest; ensure qualified and certified health leadership and hierarchy; stop disruptive behaviors; neutralize culture and ethnicity interferences; blend the generational differences; ensure gender equity and fair play; work with current status and knowledge without historical inter-professional and intra-professional education; remove fears of diluted professional identification; Ensure accountability, payment and rewards to which ever profession as due without discrepancies and antagonism; Respect all professional roles and responsibilities; carry all along in decision making; provide services with a good turnaround time; and show less interest in Associations and Unions when it comes to team work but adequately manage it with government towards successful teamwork and good healthcare practices.
\nThe authors wish to acknowledge all those who are working hard to enthrone teamwork in Nigerian healthcare sector.
\nThe authors declare no competing interests.
Obeta M. Uchejeso conceptualized the Chapter, Obeta M. Uchejeso, Nkereuwem S Etukudoh, Mantu E. Chongs, and Dan M. Ime wrote the manuscript; Obeta M. Uchejeso, Nkereuwem S Etukudoh, Mantu E. Chongs, and Dan M. Ime edited the chapter and approved the final manuscript for submission.
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These physiological events occur smoothly in normal healthy individual and/or under normal conditions. However, in certain cases, these molecular events are retarded resulting in hard-to-heal or chronic wounds arising from several factors such as poor venous return, underlying physiological or metabolic conditions such as diabetes as well as external factors such as poor nutrition. In most cases, such wounds are infected and infection also presents as another complicating phenomenon which triggers inflammatory reactions, therefore delaying wound healing. There has therefore been recent interests and significant efforts in preventing and actively treating wound infections by directly targeting infection causative agents through direct application of antimicrobial agents either alone or loaded into dressings (medicated). These have the advantage of overcoming challenges such as poor circulation in diabetic and leg ulcers when administered systemically and also require lower amounts to be applied compared to that required via oral or iv administration. This chapter will review and evaluate various antimicrobial agents used to target infected wounds, the means of delivery, and current state of the art, including commercially available dressings. Data sources will include mainly peer-reviewed literature, clinical trials and reports, patents as well as government reports where available.",book:{id:"5290",slug:"wound-healing-new-insights-into-ancient-challenges",title:"Wound Healing",fullTitle:"Wound Healing - New insights into Ancient Challenges"},signatures:"Omar Sarheed, Asif Ahmed, Douha Shouqair and Joshua Boateng",authors:[{id:"183108",title:"Dr.",name:"Joshua",middleName:null,surname:"Boateng",slug:"joshua-boateng",fullName:"Joshua Boateng"},{id:"183399",title:"Dr.",name:"Omar",middleName:null,surname:"Sarheed",slug:"omar-sarheed",fullName:"Omar Sarheed"},{id:"188082",title:"Mr.",name:"Asif",middleName:null,surname:"Ahmed",slug:"asif-ahmed",fullName:"Asif Ahmed"},{id:"188083",title:"Ms.",name:"Douha",middleName:null,surname:"Shouqair",slug:"douha-shouqair",fullName:"Douha Shouqair"}]},{id:"51825",doi:"10.5772/64611",title:"Roles of Matrix Metalloproteinases in Cutaneous Wound Healing",slug:"roles-of-matrix-metalloproteinases-in-cutaneous-wound-healing",totalDownloads:3559,totalCrossrefCites:16,totalDimensionsCites:34,abstract:"Wound healing is a complex process that consists of hemostasis and inflammation, angiogenesis, re-epithelialization, and tissue remodeling. Matrix metalloproteinases (MMPs) play important roles in wound healing, and their dysregulation leads to prolonged inflammation and delayed wound healing. There are 24 MMPs in humans, and each MMP exists in three forms, of which only the active MMPs play a role in the pathology or repair of wounds. The current methodology does not distinguish between the three forms of MMPs, making it challenging to investigate the roles of MMPs in pathology and wound repair. We used a novel MMP-inhibitor-tethered affinity resin that binds only the active form of MMPs, from which we identified and quantified active MMP-8 and active MMP-9 in a murine diabetic model with delayed wound healing. We showed that up-regulation of active MMP-9 plays a detrimental role whereas active MMP-8 is involved in repairing the wound in diabetic mice. These studies identified MMP-9 as a novel target for therapeutic intervention in the treatment of chronic wounds. A selective inhibitor of MMP-9 that leaves MMP-8 unaffected would provide the most effective therapy and represents a promising strategy for therapeutic intervention in the treatment of diabetic foot ulcers.",book:{id:"5290",slug:"wound-healing-new-insights-into-ancient-challenges",title:"Wound Healing",fullTitle:"Wound Healing - New insights into Ancient Challenges"},signatures:"Trung T. Nguyen, Shahriar Mobashery and Mayland Chang",authors:[{id:"183405",title:"Prof.",name:"Mayland",middleName:null,surname:"Chang",slug:"mayland-chang",fullName:"Mayland Chang"},{id:"191152",title:"Mr.",name:"Trung",middleName:null,surname:"Nguyen",slug:"trung-nguyen",fullName:"Trung Nguyen"},{id:"191153",title:"Prof.",name:"Shahriar",middleName:null,surname:"Mobashery",slug:"shahriar-mobashery",fullName:"Shahriar Mobashery"}]},{id:"63675",doi:"10.5772/intechopen.81208",title:"Wound Healing: Contributions from Plant Secondary Metabolite Antioxidants",slug:"wound-healing-contributions-from-plant-secondary-metabolite-antioxidants",totalDownloads:1273,totalCrossrefCites:7,totalDimensionsCites:19,abstract:"Plants by their genetic makeup possess an innate ability to synthesize a wide variety of phytochemicals that help them to perform their normal physiological functions and/or to protect themselves from microbial pathogens and animal herbivores. The synthesis of these phytochemicals presents the plants their natural tendency to respond to environmental stress conditions. These phytochemicals are classified either as primary or secondary metabolites. The secondary metabolites have been identified in plants as alkaloids, terpenoids, phenolics, anthraquinones, and triterpenes. These plant-based compounds are believed to have diverse medicinal properties including antioxidant properties. Plants have therefore been a potential source of antioxidants which have received a great deal of attention since increased oxidative stress has been identified as a major causative factor in the development and progression of several life-threatening diseases, including neurodegenerative and cardiovascular diseases and wound infection. Consequently, many medicinal plants have been cited and known to effect wound healing and antioxidant properties. This chapter briefly reviews antioxidant properties of medicinal plants to highlight the important roles medicinal plants play in wound healing.",book:{id:"7046",slug:"wound-healing-current-perspectives",title:"Wound Healing",fullTitle:"Wound Healing - Current Perspectives"},signatures:"Victor Y.A. Barku",authors:[{id:"261027",title:"Prof.",name:"Victor Y. A.",middleName:null,surname:"Barku",slug:"victor-y.-a.-barku",fullName:"Victor Y. A. Barku"}]},{id:"66793",doi:"10.5772/intechopen.85020",title:"The Impact of Biofilm Formation on Wound Healing",slug:"the-impact-of-biofilm-formation-on-wound-healing",totalDownloads:1381,totalCrossrefCites:7,totalDimensionsCites:15,abstract:"Chronic wounds represent an important challenge for wound care and are universally colonized by bacteria. These bacteria can form biofilm as a survival mechanism that confers the ability to resist environmental stressors and antimicrobials due to a variety of reasons, including low metabolic activity. Additionally, the exopolymeric substance (EPS) contained in biofilm acts as a mechanical barrier to immune system cells, leading to collateral damage in the surrounding tissue as well as chronic inflammation, which eventually will delay healing of the wound. This chapter will discuss current knowledge on biofilm formation, its presence in acute and chronic wounds, how biofilm affects antibiotic resistance and tolerance, as well as the wound healing process. We will also discuss proposed methods to eliminate biofilm and improve wound healing despite its presence, including basic science and clinical studies regarding these matters.",book:{id:"7046",slug:"wound-healing-current-perspectives",title:"Wound Healing",fullTitle:"Wound Healing - Current Perspectives"},signatures:"Rafael A. Mendoza, Ji-Cheng Hsieh and Robert D. Galiano",authors:[{id:"253607",title:"M.D.",name:"Rafael",middleName:null,surname:"Mendoza",slug:"rafael-mendoza",fullName:"Rafael Mendoza"},{id:"254018",title:"Dr.",name:"Robert",middleName:null,surname:"Galiano",slug:"robert-galiano",fullName:"Robert Galiano"},{id:"271116",title:"Mr.",name:"Ji-Cheng",middleName:null,surname:"Hsieh",slug:"ji-cheng-hsieh",fullName:"Ji-Cheng Hsieh"}]},{id:"50942",doi:"10.5772/63963",title:"Cellular Therapy for Wounds: Applications of Mesenchymal Stem Cells in Wound Healing",slug:"cellular-therapy-for-wounds-applications-of-mesenchymal-stem-cells-in-wound-healing",totalDownloads:2536,totalCrossrefCites:6,totalDimensionsCites:10,abstract:"Despite progress in wound treatment including gene therapy, biological dresses and engineered skin equivalents, present treatment options for chronic wounds are restricted and not always effective. For example, inability to get consistent product from the introduced gene, biological covers may give rise to hypoxic conditions and engineered skin models are limited by their construction from substances which are hard to be degraded, and do not always result in complete replication into normal uninjured skin. A growing body of evidence suggests mesenchymal stem cells (MSCs), and their secreted growth factors and microvesicles, may potentiate the wound‐healing process and as such their addition to novel wound‐healing treatments may improve the efficacy of current therapeutic strategies. Recent studies report the ability of bone marrow‐derived MSCs (BM‐MSCs) to migrate and differentiate into skin cells in vivo.",book:{id:"5290",slug:"wound-healing-new-insights-into-ancient-challenges",title:"Wound Healing",fullTitle:"Wound Healing - New insights into Ancient Challenges"},signatures:"Moyassar B. H. Al‐Shaibani, Xiao‐nong Wang, Penny E. Lovat and\nAnne M. Dickinson",authors:[{id:"183148",title:"Dr.",name:"Moyassar",middleName:null,surname:"Al-Shaibani",slug:"moyassar-al-shaibani",fullName:"Moyassar Al-Shaibani"},{id:"183402",title:"Prof.",name:"Anne",middleName:null,surname:"Dickinson",slug:"anne-dickinson",fullName:"Anne Dickinson"},{id:"183403",title:"Prof.",name:"Penny",middleName:null,surname:"Lovat",slug:"penny-lovat",fullName:"Penny Lovat"},{id:"183404",title:"Dr.",name:"Xiao",middleName:null,surname:"Wang",slug:"xiao-wang",fullName:"Xiao Wang"}]}],mostDownloadedChaptersLast30Days:[{id:"55736",title:"Haemodynamic Monitoring in the Intensive Care Unit",slug:"haemodynamic-monitoring-in-the-intensive-care-unit",totalDownloads:3276,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"Monitoring is a cognitive aid that allows clinicians to detect the nature and extent of pathology and helps assessment of response to therapy. The cardiovascular system is the most commonly monitored organ system in the critical care setting. It helps identify the presence and nature of shock and guides response to resuscitation by detection of cardiac rate and rhythm, evaluation of volume state, cardiac contractility and systemic vascular resistance. Newer technologies allow greater assessment of oxygen delivery to vulnerable tissues. We discuss the nature, history, modalities and interpretation of the most commonly available haemodynamic monitoring methods in clinical use currently.",book:{id:"5756",slug:"intensive-care",title:"Intensive Care",fullTitle:"Intensive Care"},signatures:"Mainak Majumdar",authors:[{id:"86678",title:"Dr.",name:"Mainak",middleName:null,surname:"Majumdar",slug:"mainak-majumdar",fullName:"Mainak Majumdar"}]},{id:"51825",title:"Roles of Matrix Metalloproteinases in Cutaneous Wound Healing",slug:"roles-of-matrix-metalloproteinases-in-cutaneous-wound-healing",totalDownloads:3561,totalCrossrefCites:16,totalDimensionsCites:34,abstract:"Wound healing is a complex process that consists of hemostasis and inflammation, angiogenesis, re-epithelialization, and tissue remodeling. Matrix metalloproteinases (MMPs) play important roles in wound healing, and their dysregulation leads to prolonged inflammation and delayed wound healing. There are 24 MMPs in humans, and each MMP exists in three forms, of which only the active MMPs play a role in the pathology or repair of wounds. The current methodology does not distinguish between the three forms of MMPs, making it challenging to investigate the roles of MMPs in pathology and wound repair. We used a novel MMP-inhibitor-tethered affinity resin that binds only the active form of MMPs, from which we identified and quantified active MMP-8 and active MMP-9 in a murine diabetic model with delayed wound healing. We showed that up-regulation of active MMP-9 plays a detrimental role whereas active MMP-8 is involved in repairing the wound in diabetic mice. These studies identified MMP-9 as a novel target for therapeutic intervention in the treatment of chronic wounds. A selective inhibitor of MMP-9 that leaves MMP-8 unaffected would provide the most effective therapy and represents a promising strategy for therapeutic intervention in the treatment of diabetic foot ulcers.",book:{id:"5290",slug:"wound-healing-new-insights-into-ancient-challenges",title:"Wound Healing",fullTitle:"Wound Healing - New insights into Ancient Challenges"},signatures:"Trung T. Nguyen, Shahriar Mobashery and Mayland Chang",authors:[{id:"183405",title:"Prof.",name:"Mayland",middleName:null,surname:"Chang",slug:"mayland-chang",fullName:"Mayland Chang"},{id:"191152",title:"Mr.",name:"Trung",middleName:null,surname:"Nguyen",slug:"trung-nguyen",fullName:"Trung Nguyen"},{id:"191153",title:"Prof.",name:"Shahriar",middleName:null,surname:"Mobashery",slug:"shahriar-mobashery",fullName:"Shahriar Mobashery"}]},{id:"63086",title:"Medicinal Plants in Wound Healing",slug:"medicinal-plants-in-wound-healing",totalDownloads:2804,totalCrossrefCites:6,totalDimensionsCites:10,abstract:"Wound healing process is known as interdependent cellular and biochemical stages which are in trying to improve the wound. Wound healing can be defined as stages which is done by body and delayed in wound healing increases chance of microbial infection. Improved wound healing process can be performed by shortening the time needed for healing or lowering the inappropriate happens. The drugs were locally or systemically administrated in order to help wound healing. Antibiotics, antiseptics, desloughing agents, extracts, etc. have been used in order to wound healing. Some synthetic drugs are faced with limitations because of their side effects. Plants or combinations derived from plants are needed to investigate identify and formulate for treatment and management of wound healing. There is increasing interest to use the medicinal plants in wound healing because of lower side effects and management of wounds over the years. Studies have shown that medicinal plants improve wound healing in diabetic, infected and opened wounds. The different mechanisms have been reported to improve the wound healing by medicinal plants. In this chapter, some medicinal plants and the reported mechanisms will be discussed.",book:{id:"7046",slug:"wound-healing-current-perspectives",title:"Wound Healing",fullTitle:"Wound Healing - Current Perspectives"},signatures:"Mohammad Reza Farahpour",authors:[{id:"253340",title:"Prof.",name:"Mohammadreza",middleName:null,surname:"Farahpour",slug:"mohammadreza-farahpour",fullName:"Mohammadreza Farahpour"}]},{id:"67217",title:"Nursing Implications in the ECMO Patient",slug:"nursing-implications-in-the-ecmo-patient",totalDownloads:2461,totalCrossrefCites:3,totalDimensionsCites:3,abstract:"Effective care and positive outcomes of the extracorporeal membrane oxygenation (ECMO) patient necessitate optimal interdisciplinary management from the healthcare team, including expert care from specially trained registered nurses (RNs). It is incumbent upon the RN caring for the ECMO patient to excel in both time management and assessment skills, as this population often demands care delivery at the pinnacle of intensive care unit (ICU) acuity. Astute and nuanced monitoring of neurological status, bleeding risk with potential (often massive) transfusions, poor hemodynamics, and integrity of the ECMO pump itself are only the few specialized areas of focus that must share priority with traditional nursing considerations involving the critically ill, such as prevention of pressure injuries and bloodstream infections. These high-intensity medical foci must be balanced with ethical considerations, as the ultimate goal of returning the patient to their normal life is not always possible. These demands highlight the dynamic proficiency of the RN caring for the ECMO patient. The following chapter will highlight the importance of specialized nursing care in the critically ill patient supported with ECMO.",book:{id:"7878",slug:"advances-in-extracorporeal-membrane-oxygenation-volume-3",title:"Advances in Extracorporeal Membrane Oxygenation",fullTitle:"Advances in Extracorporeal Membrane Oxygenation - Volume 3"},signatures:"Alex Botsch, Elizabeth Protain, Amanda R. Smith and Ryan Szilagyi",authors:[{id:"298623",title:"Mr.",name:"Alexander",middleName:null,surname:"Botsch",slug:"alexander-botsch",fullName:"Alexander Botsch"}]},{id:"66239",title:"Echocardiography Evaluation in ECMO Patients",slug:"echocardiography-evaluation-in-ecmo-patients",totalDownloads:2092,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Extracorporeal membrane oxygenation (ECMO) is a special form of organ support for selected cases of cardiovascular and severe respiratory failure. Echocardiography is a diagnostic and monitoring tool widely used in all aspects of ECMO support. The pathophysiology of ECMO, and its distinct effects on cardiorespiratory physiology, requires an echocardiographer with high skills to understand the interaction between the ECMO and the patient. In this chapter, we present the main application of echocardiography in ECMO patients and some general concepts on the ECMO working. ECMO, such as the standard cardiopulmonary bypass employed in cardiac surgery, V-V (veno-venous), can support the insufficient respiratory system by oxygenating and removing carbon dioxide from the blood. VA-ECMO (venous-arterial) can support haemodynamics by providing mechanical circulatory assistance. Today, ECMO can be used as bridge to decision, waiting for the development of the clinical conditions to support with other devices the evolution of cardiorespiratory failure or stop the assistance. Echocardiography (transthoracic (TTE) or transoesophageal (TOE)) can be used primarily to take decisions regarding appropriateness of ECMO support, therefore to control cannula insertion and confirm final position, to modify number and position of the cannulae in case of malfunctioning of these, and, finally, to assess clinical progress and suitability for weaning from ECMO.",book:{id:"7878",slug:"advances-in-extracorporeal-membrane-oxygenation-volume-3",title:"Advances in Extracorporeal Membrane Oxygenation",fullTitle:"Advances in Extracorporeal Membrane Oxygenation - Volume 3"},signatures:"Luigi Tritapepe, Ernesto Greco and Carlo Gaudio",authors:[{id:"284893",title:"Prof.",name:"Luigi",middleName:null,surname:"Tritapepe",slug:"luigi-tritapepe",fullName:"Luigi Tritapepe"},{id:"294005",title:"Prof.",name:"Ernesto",middleName:null,surname:"Greco",slug:"ernesto-greco",fullName:"Ernesto Greco"},{id:"294006",title:"Prof.",name:"Carlo",middleName:null,surname:"Gaudio",slug:"carlo-gaudio",fullName:"Carlo Gaudio"}]}],onlineFirstChaptersFilter:{topicId:"173",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:0,limit:8,total:null},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:87,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:98,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:27,numberOfPublishedChapters:287,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:9,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:139,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:0,numberOfUpcomingTopics:2,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!1},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:107,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:10,numberOfPublishedChapters:103,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:12,numberOfOpenTopics:2,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:0,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!1},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:10,numberOfOpenTopics:4,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}},{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}}]},series:{item:{id:"13",title:"Veterinary Medicine and Science",doi:"10.5772/intechopen.73681",issn:"2632-0517",scope:"Paralleling similar advances in the medical field, astounding advances occurred in Veterinary Medicine and Science in recent decades. These advances have helped foster better support for animal health, more humane animal production, and a better understanding of the physiology of endangered species to improve the assisted reproductive technologies or the pathogenesis of certain diseases, where animals can be used as models for human diseases (like cancer, degenerative diseases or fertility), and even as a guarantee of public health. Bridging Human, Animal, and Environmental health, the holistic and integrative “One Health” concept intimately associates the developments within those fields, projecting its advancements into practice. This book series aims to tackle various animal-related medicine and sciences fields, providing thematic volumes consisting of high-quality significant research directed to researchers and postgraduates. It aims to give us a glimpse into the new accomplishments in the Veterinary Medicine and Science field. 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After almost 32 years of teaching at the University of Trás-os-Montes and Alto Douro, she recently moved to the University of Évora, Department of Veterinary Medicine, where she teaches in the field of Animal Reproduction and Clinics. Her primary research areas include the molecular markers of the endometrial cycle and the embryo–maternal interaction, including oxidative stress and the reproductive physiology and disorders of sexual development, besides the molecular determinants of male and female fertility. She often supervises students preparing their master's or doctoral theses. She is also a frequent referee for various journals.",institutionString:null,institution:{name:"University of Évora",institutionURL:null,country:{name:"Portugal"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:3,paginationItems:[{id:"19",title:"Animal Science",coverUrl:"https://cdn.intechopen.com/series_topics/covers/19.jpg",isOpenForSubmission:!0,annualVolume:11415,editor:{id:"259298",title:"Dr.",name:"Edward",middleName:null,surname:"Narayan",slug:"edward-narayan",fullName:"Edward Narayan",profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",biography:"Dr. Edward Narayan graduated with Ph.D. degree in Biology from the University of the South Pacific and pioneered non-invasive reproductive and stress endocrinology tools for amphibians - the novel development and validation of non-invasive enzyme immunoassays for the evaluation of reproductive hormonal cycle and stress hormone responses to environmental stressors. \nDr. Narayan leads the Stress Lab (Comparative Physiology and Endocrinology) at the University of Queensland. 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He received his Ph.D. in Environmental Analytical Chemistry from Assiut University, Egypt, in 1989. His research interest is in analytical and environmental chemistry with special emphasis on: (1) monitoring and assessing biological trace elements and toxic metals in human blood, urine, water, crops, vegetables, and medicinal plants; (2) relationships between environmental heavy metals and human diseases; (3) uses of biological indicators for monitoring water pollution; (4) environmental chemistry of lakes, rivers, and well water; (5) water and wastewater treatment by adsorption and photocatalysis techniques; (6) soil and water pollution monitoring, control, and treatment; and (7) advanced oxidation treatment. Prof. Rashed has supervised several MSc and Ph.D. theses in the field of analytical and environmental chemistry. He served as an examiner for several Ph.D. theses in analytical chemistry in India, Kazakhstan, and Botswana. He has published about ninety scientific papers in peer-reviewed international journals and several papers in national and international conferences. He participated as an invited speaker at thirty international conferences. Prof. Rashed is the editor-in-chief and an editorial board member for several international journals in the fields of chemistry and environment. He is a member of several national and international societies. He received the Egyptian State Award for Environmental Research in 2001 and the Aswan University Merit Award for Basic Science in 2020. 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He is also a faculty member in the Molecular Oncology Program. He obtained his MSc and Ph.D. at Oregon State University and Texas Tech University, respectively. He pursued his postdoctoral studies at Rutgers University Medical School and the National Institutes of Health (NIH/NIDDK), USA. His research focuses on biochemistry, biophysics, genetics, molecular biology, and molecular medicine with specialization in the fields of drug design, protein structure-function, protein folding, prions, microRNA, pseudogenes, molecular cancer, epigenetics, metabolites, proteomics, genomics, protein expression, and characterization by spectroscopic and calorimetric methods.",institutionString:"University of Health Sciences",institution:null},{id:"180528",title:"Dr.",name:"Hiroyuki",middleName:null,surname:"Kagechika",slug:"hiroyuki-kagechika",fullName:"Hiroyuki Kagechika",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180528/images/system/180528.jpg",biography:"Hiroyuki Kagechika received his bachelor’s degree and Ph.D. in Pharmaceutical Sciences from the University of Tokyo, Japan, where he served as an associate professor until 2004. He is currently a professor at the Institute of Biomaterials and Bioengineering (IBB), Tokyo Medical and Dental University (TMDU). From 2010 to 2012, he was the dean of the Graduate School of Biomedical Science. Since 2012, he has served as the vice dean of the Graduate School of Medical and Dental Sciences. He has been the director of the IBB since 2020. Dr. Kagechika’s major research interests are the medicinal chemistry of retinoids, vitamins D/K, and nuclear receptors. He has developed various compounds including a drug for acute promyelocytic leukemia.",institutionString:"Tokyo Medical and Dental University",institution:{name:"Tokyo Medical and Dental University",country:{name:"Japan"}}},{id:"40482",title:null,name:"Rizwan",middleName:null,surname:"Ahmad",slug:"rizwan-ahmad",fullName:"Rizwan Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/40482/images/system/40482.jpeg",biography:"Dr. Rizwan Ahmad is a University Professor and Coordinator, Quality and Development, College of Medicine, Imam Abdulrahman bin Faisal University, Saudi Arabia. Previously, he was Associate Professor of Human Function, Oman Medical College, Oman, and SBS University, Dehradun. Dr. Ahmad completed his education at Aligarh Muslim University, Aligarh. He has published several articles in peer-reviewed journals, chapters, and edited books. His area of specialization is free radical biochemistry and autoimmune diseases.",institutionString:"Imam Abdulrahman Bin Faisal University",institution:{name:"Imam Abdulrahman Bin Faisal University",country:{name:"Saudi Arabia"}}},{id:"41865",title:"Prof.",name:"Farid A.",middleName:null,surname:"Badria",slug:"farid-a.-badria",fullName:"Farid A. Badria",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/41865/images/system/41865.jpg",biography:"Farid A. Badria, Ph.D., is the recipient of several awards, including The World Academy of Sciences (TWAS) Prize for Public Understanding of Science; the World Intellectual Property Organization (WIPO) Gold Medal for best invention; Outstanding Arab Scholar, Kuwait; and the Khwarizmi International Award, Iran. He has 250 publications, 12 books, 20 patents, and several marketed pharmaceutical products to his credit. He continues to lead research projects on developing new therapies for liver, skin disorders, and cancer. Dr. Badria was listed among the world’s top 2% of scientists in medicinal and biomolecular chemistry in 2019 and 2020. He is a member of the Arab Development Fund, Kuwait; International Cell Research Organization–United Nations Educational, Scientific and Cultural Organization (ICRO–UNESCO), Chile; and UNESCO Biotechnology France",institutionString:"Mansoura University",institution:{name:"Mansoura University",country:{name:"Egypt"}}},{id:"329385",title:"Dr.",name:"Rajesh K.",middleName:"Kumar",surname:"Singh",slug:"rajesh-k.-singh",fullName:"Rajesh K. Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329385/images/system/329385.png",biography:"Dr. Singh received a BPharm (2003) and MPharm (2005) from Panjab University, Chandigarh, India, and a Ph.D. (2013) from Punjab Technical University (PTU), Jalandhar, India. He has more than sixteen years of teaching experience and has supervised numerous postgraduate and Ph.D. students. He has to his credit more than seventy papers in SCI- and SCOPUS-indexed journals, fifty-five conference proceedings, four books, six Best Paper Awards, and five projects from different government agencies. He is currently an editorial board member of eight international journals and a reviewer for more than fifty scientific journals. He received Top Reviewer and Excellent Peer Reviewer Awards from Publons in 2016 and 2017, respectively. He is also on the panel of The International Reviewer for reviewing research proposals for grants from the Royal Society. He also serves as a Publons Academy mentor and Bentham brand ambassador.",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",country:{name:"India"}}},{id:"142388",title:"Dr.",name:"Thiago",middleName:"Gomes",surname:"Gomes Heck",slug:"thiago-gomes-heck",fullName:"Thiago Gomes Heck",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/142388/images/7259_n.jpg",biography:null,institutionString:null,institution:{name:"Universidade Regional do Noroeste do Estado do Rio Grande do Sul",country:{name:"Brazil"}}},{id:"336273",title:"Assistant Prof.",name:"Janja",middleName:null,surname:"Zupan",slug:"janja-zupan",fullName:"Janja Zupan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/336273/images/14853_n.jpeg",biography:"Janja Zupan graduated in 2005 at the Department of Clinical Biochemistry (superviser prof. dr. Janja Marc) in the field of genetics of osteoporosis. Since November 2009 she is working as a Teaching Assistant at the Faculty of Pharmacy, Department of Clinical Biochemistry. In 2011 she completed part of her research and PhD work at Institute of Genetics and Molecular Medicine, University of Edinburgh. She finished her PhD entitled The influence of the proinflammatory cytokines on the RANK/RANKL/OPG in bone tissue of osteoporotic and osteoarthritic patients in 2012. From 2014-2016 she worked at the Institute of Biomedical Sciences, University of Aberdeen as a postdoctoral research fellow on UK Arthritis research project where she gained knowledge in mesenchymal stem cells and regenerative medicine. She returned back to University of Ljubljana, Faculty of Pharmacy in 2016. She is currently leading project entitled Mesenchymal stem cells-the keepers of tissue endogenous regenerative capacity facing up to aging of the musculoskeletal system funded by Slovenian Research Agency.",institutionString:null,institution:{name:"University of Ljubljana",country:{name:"Slovenia"}}},{id:"357453",title:"Dr.",name:"Radheshyam",middleName:null,surname:"Maurya",slug:"radheshyam-maurya",fullName:"Radheshyam Maurya",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/357453/images/16535_n.jpg",biography:null,institutionString:null,institution:{name:"University of Hyderabad",country:{name:"India"}}},{id:"311457",title:"Dr.",name:"Júlia",middleName:null,surname:"Scherer Santos",slug:"julia-scherer-santos",fullName:"Júlia Scherer Santos",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/311457/images/system/311457.jpg",biography:"Dr. Júlia Scherer Santos works in the areas of cosmetology, nanotechnology, pharmaceutical technology, beauty, and aesthetics. Dr. Santos also has experience as a professor of graduate courses. Graduated in Pharmacy, specialization in Cosmetology and Cosmeceuticals applied to aesthetics, specialization in Aesthetic and Cosmetic Health, and a doctorate in Pharmaceutical Nanotechnology. Teaching experience in Pharmacy and Aesthetics and Cosmetics courses. She works mainly on the following subjects: nanotechnology, cosmetology, pharmaceutical technology, aesthetics.",institutionString:"Universidade Federal de Juiz de Fora",institution:{name:"Universidade Federal de Juiz de Fora",country:{name:"Brazil"}}},{id:"219081",title:"Dr.",name:"Abdulsamed",middleName:null,surname:"Kükürt",slug:"abdulsamed-kukurt",fullName:"Abdulsamed Kükürt",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRNVJQA4/Profile_Picture_2022-03-07T13:23:04.png",biography:"Dr. Kükürt graduated from Uludağ University in Turkey. He started his academic career as a Research Assistant in the Department of Biochemistry at Kafkas University. In 2019, he completed his Ph.D. program in the Department of Biochemistry at the Institute of Health Sciences. He is currently working at the Department of Biochemistry, Kafkas University. He has 27 published research articles in academic journals, 11 book chapters, and 37 papers. He took part in 10 academic projects. He served as a reviewer for many articles. He still serves as a member of the review board in many academic journals. His research interests include biochemistry, oxidative stress, reactive species, antioxidants, lipid peroxidation, inflammation, reproductive hormones, phenolic compounds, female infertility.",institutionString:"Kafkas University",institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"178366",title:"Associate Prof.",name:"Volkan",middleName:null,surname:"Gelen",slug:"volkan-gelen",fullName:"Volkan Gelen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178366/images/system/178366.jpg",biography:"Volkan Gelen is a Physiology specialist who received his veterinary degree from Kafkas University in 2011. Between 2011-2015, he worked as an assistant at Atatürk University, Faculty of Veterinary Medicine, Department of Physiology. In 2016, he joined Kafkas University, Faculty of Veterinary Medicine, Department of Physiology as an assistant professor. Dr. Gelen has been engaged in various academic activities at Kafkas University since 2016. There he completed 5 projects and has 3 ongoing projects. He has 60 articles published in scientific journals and 20 poster presentations in scientific congresses. His research interests include physiology, endocrine system, cancer, diabetes, cardiovascular system diseases, and isolated organ bath system studies.",institutionString:"Kafkas University",institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"418963",title:"Dr.",name:"Augustine Ododo",middleName:"Augustine",surname:"Osagie",slug:"augustine-ododo-osagie",fullName:"Augustine Ododo Osagie",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/418963/images/16900_n.jpg",biography:"Born into the family of Osagie, a prince of the Benin Kingdom. I am currently an academic in the Department of Medical Biochemistry, University of Benin. Part of the duties are to teach undergraduate students and conduct academic research.",institutionString:null,institution:{name:"University of Benin",country:{name:"Nigeria"}}},{id:"192992",title:"Prof.",name:"Shagufta",middleName:null,surname:"Perveen",slug:"shagufta-perveen",fullName:"Shagufta Perveen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192992/images/system/192992.png",biography:"Prof. Shagufta Perveen is a Distinguish Professor in the Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. Dr. Perveen has acted as the principal investigator of major research projects funded by the research unit of King Saud University. She has more than ninety original research papers in peer-reviewed journals of international repute to her credit. She is a fellow member of the Royal Society of Chemistry UK and the American Chemical Society of the United States.",institutionString:"King Saud University",institution:{name:"King Saud University",country:{name:"Saudi Arabia"}}},{id:"49848",title:"Dr.",name:"Wen-Long",middleName:null,surname:"Hu",slug:"wen-long-hu",fullName:"Wen-Long Hu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49848/images/system/49848.jpg",biography:"Wen-Long Hu is Chief of the Division of Acupuncture, Department of Chinese Medicine at Kaohsiung Chang Gung Memorial Hospital, as well as an adjunct associate professor at Fooyin University and Kaohsiung Medical University. Wen-Long is President of Taiwan Traditional Chinese Medicine Medical Association. He has 28 years of experience in clinical practice in laser acupuncture therapy and 34 years in acupuncture. He is an invited speaker for lectures and workshops in laser acupuncture at many symposiums held by medical associations. He owns the patent for herbal preparation and producing, and for the supercritical fluid-treated needle. Dr. Hu has published three books, 12 book chapters, and more than 30 papers in reputed journals, besides serving as an editorial board member of repute.",institutionString:"Kaohsiung Chang Gung Memorial Hospital",institution:{name:"Kaohsiung Chang Gung Memorial Hospital",country:{name:"Taiwan"}}},{id:"298472",title:"Prof.",name:"Andrey V.",middleName:null,surname:"Grechko",slug:"andrey-v.-grechko",fullName:"Andrey V. Grechko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/298472/images/system/298472.png",biography:"Andrey Vyacheslavovich Grechko, Ph.D., Professor, is a Corresponding Member of the Russian Academy of Sciences. He graduated from the Semashko Moscow Medical Institute (Semashko National Research Institute of Public Health) with a degree in Medicine (1998), the Clinical Department of Dermatovenerology (2000), and received a second higher education in Psychology (2009). Professor A.V. Grechko held the position of Сhief Physician of the Central Clinical Hospital in Moscow. He worked as a professor at the faculty and was engaged in scientific research at the Medical University. Starting in 2013, he has been the initiator of the creation of the Federal Scientific and Clinical Center for Intensive Care and Rehabilitology, Moscow, Russian Federation, where he also serves as Director since 2015. He has many years of experience in research and teaching in various fields of medicine, is an author/co-author of more than 200 scientific publications, 13 patents, 15 medical books/chapters, including Chapter in Book «Metabolomics», IntechOpen, 2020 «Metabolomic Discovery of Microbiota Dysfunction as the Cause of Pathology».",institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"199461",title:"Prof.",name:"Natalia V.",middleName:null,surname:"Beloborodova",slug:"natalia-v.-beloborodova",fullName:"Natalia V. Beloborodova",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/199461/images/system/199461.jpg",biography:'Natalia Vladimirovna Beloborodova was educated at the Pirogov Russian National Research Medical University, with a degree in pediatrics in 1980, a Ph.D. in 1987, and a specialization in Clinical Microbiology from First Moscow State Medical University in 2004. She has been a Professor since 1996. Currently, she is the Head of the Laboratory of Metabolism, a division of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russian Federation. N.V. Beloborodova has many years of clinical experience in the field of intensive care and surgery. She studies infectious complications and sepsis. She initiated a series of interdisciplinary clinical and experimental studies based on the concept of integrating human metabolism and its microbiota. Her scientific achievements are widely known: she is the recipient of the Marie E. Coates Award \\"Best lecturer-scientist\\" Gustafsson Fund, Karolinska Institutes, Stockholm, Sweden, and the International Sepsis Forum Award, Pasteur Institute, Paris, France (2014), etc. Professor N.V. Beloborodova wrote 210 papers, five books, 10 chapters and has edited four books.',institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"354260",title:"Ph.D.",name:"Tércio Elyan",middleName:"Azevedo",surname:"Azevedo Martins",slug:"tercio-elyan-azevedo-martins",fullName:"Tércio Elyan Azevedo Martins",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/354260/images/16241_n.jpg",biography:"Graduated in Pharmacy from the Federal University of Ceará with the modality in Industrial Pharmacy, Specialist in Production and Control of Medicines from the University of São Paulo (USP), Master in Pharmaceuticals and Medicines from the University of São Paulo (USP) and Doctor of Science in the program of Pharmaceuticals and Medicines by the University of São Paulo. Professor at Universidade Paulista (UNIP) in the areas of chemistry, cosmetology and trichology. Assistant Coordinator of the Higher Course in Aesthetic and Cosmetic Technology at Universidade Paulista Campus Chácara Santo Antônio. Experience in the Pharmacy area, with emphasis on Pharmacotechnics, Pharmaceutical Technology, Research and Development of Cosmetics, acting mainly on topics such as cosmetology, antioxidant activity, aesthetics, photoprotection, cyclodextrin and thermal analysis.",institutionString:null,institution:{name:"University of Sao Paulo",country:{name:"Brazil"}}},{id:"334285",title:"Ph.D. Student",name:"Sameer",middleName:"Kumar",surname:"Jagirdar",slug:"sameer-jagirdar",fullName:"Sameer Jagirdar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334285/images/14691_n.jpg",biography:"I\\'m a graduate student at the center for biosystems science and engineering at the Indian Institute of Science, Bangalore, India. I am interested in studying host-pathogen interactions at the biomaterial interface.",institutionString:null,institution:{name:"Indian Institute of Science Bangalore",country:{name:"India"}}},{id:"329795",title:"Dr.",name:"Mohd Aftab",middleName:"Aftab",surname:"Siddiqui",slug:"mohd-aftab-siddiqui",fullName:"Mohd Aftab Siddiqui",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329795/images/15648_n.jpg",biography:"Dr. Mohd Aftab Siddiqui is currently working as Assistant Professor in the Faculty of Pharmacy, Integral University, Lucknow for the last 6 years. He has completed his Doctor in Philosophy (Pharmacology) in 2020 from Integral University, Lucknow. He completed his Bachelor in Pharmacy in 2013 and Master in Pharmacy (Pharmacology) in 2015 from Integral University, Lucknow. He is the gold medalist in Bachelor and Master degree. He qualified GPAT -2013, GPAT -2014, and GPAT 2015. His area of research is Pharmacological screening of herbal drugs/ natural products in liver and cardiac diseases. He has guided many M. Pharm. research projects. He has many national and international publications.",institutionString:"Integral University",institution:null},{id:"255360",title:"Dr.",name:"Usama",middleName:null,surname:"Ahmad",slug:"usama-ahmad",fullName:"Usama Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255360/images/system/255360.png",biography:"Dr. Usama Ahmad holds a specialization in Pharmaceutics from Amity University, Lucknow, India. He received his Ph.D. degree from Integral University. Currently, he’s working as an Assistant Professor of Pharmaceutics in the Faculty of Pharmacy, Integral University. From 2013 to 2014 he worked on a research project funded by SERB-DST, Government of India. He has a rich publication record with more than 32 original articles published in reputed journals, 3 edited books, 5 book chapters, and a number of scientific articles published in ‘Ingredients South Asia Magazine’ and ‘QualPharma Magazine’. He is a member of the American Association for Cancer Research, International Association for the Study of Lung Cancer, and the British Society for Nanomedicine. Dr. Ahmad’s research focus is on the development of nanoformulations to facilitate the delivery of drugs that aim to provide practical solutions to current healthcare problems.",institutionString:"Integral University",institution:{name:"Integral University",country:{name:"India"}}},{id:"30568",title:"Prof.",name:"Madhu",middleName:null,surname:"Khullar",slug:"madhu-khullar",fullName:"Madhu Khullar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/30568/images/system/30568.jpg",biography:"Dr. Madhu Khullar is a Professor of Experimental Medicine and Biotechnology at the Post Graduate Institute of Medical Education and Research, Chandigarh, India. She completed her Post Doctorate in hypertension research at the Henry Ford Hospital, Detroit, USA in 1985. She is an editor and reviewer of several international journals, and a fellow and member of several cardiovascular research societies. Dr. Khullar has a keen research interest in genetics of hypertension, and is currently studying pharmacogenetics of hypertension.",institutionString:"Post Graduate Institute of Medical Education and Research",institution:{name:"Post Graduate Institute of Medical Education and Research",country:{name:"India"}}},{id:"223233",title:"Prof.",name:"Xianquan",middleName:null,surname:"Zhan",slug:"xianquan-zhan",fullName:"Xianquan Zhan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/223233/images/system/223233.png",biography:"Xianquan Zhan received his MD and Ph.D. in Preventive Medicine at West China University of Medical Sciences. He received his post-doctoral training in oncology and cancer proteomics at the Central South University, China, and the University of Tennessee Health Science Center (UTHSC), USA. He worked at UTHSC and the Cleveland Clinic in 2001–2012 and achieved the rank of associate professor at UTHSC. Currently, he is a full professor at Central South University and Shandong First Medical University, and an advisor to MS/PhD students and postdoctoral fellows. He is also a fellow of the Royal Society of Medicine and European Association for Predictive Preventive Personalized Medicine (EPMA), a national representative of EPMA, and a member of the American Society of Clinical Oncology (ASCO) and the American Association for the Advancement of Sciences (AAAS). He is also the editor in chief of International Journal of Chronic Diseases & Therapy, an associate editor of EPMA Journal, Frontiers in Endocrinology, and BMC Medical Genomics, and a guest editor of Mass Spectrometry Reviews, Frontiers in Endocrinology, EPMA Journal, and Oxidative Medicine and Cellular Longevity. He has published more than 148 articles, 28 book chapters, 6 books, and 2 US patents in the field of clinical proteomics and biomarkers.",institutionString:"Shandong First Medical University",institution:{name:"Affiliated Hospital of Shandong Academy of Medical Sciences",country:{name:"China"}}},{id:"297507",title:"Dr.",name:"Charles",middleName:"Elias",surname:"Assmann",slug:"charles-assmann",fullName:"Charles Assmann",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/297507/images/system/297507.jpg",biography:"Charles Elias Assmann is a biologist from Federal University of Santa Maria (UFSM, Brazil), who spent some time abroad at the Ludwig-Maximilians-Universität München (LMU, Germany). He has Masters Degree in Biochemistry (UFSM), and is currently a PhD student at Biochemistry at the Department of Biochemistry and Molecular Biology of the UFSM. His areas of expertise include: Biochemistry, Molecular Biology, Enzymology, Genetics and Toxicology. He is currently working on the following subjects: Aluminium toxicity, Neuroinflammation, Oxidative stress and Purinergic system. Since 2011 he has presented more than 80 abstracts in scientific proceedings of national and international meetings. Since 2014, he has published more than 20 peer reviewed papers (including 4 reviews, 3 in Portuguese) and 2 book chapters. He has also been a reviewer of international journals and ad hoc reviewer of scientific committees from Brazilian Universities.",institutionString:"Universidade Federal de Santa Maria",institution:{name:"Universidade Federal de Santa Maria",country:{name:"Brazil"}}},{id:"217850",title:"Dr.",name:"Margarete Dulce",middleName:null,surname:"Bagatini",slug:"margarete-dulce-bagatini",fullName:"Margarete Dulce Bagatini",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/217850/images/system/217850.jpeg",biography:"Dr. Margarete Dulce Bagatini is an associate professor at the Federal University of Fronteira Sul/Brazil. She has a degree in Pharmacy and a PhD in Biological Sciences: Toxicological Biochemistry. She is a member of the UFFS Research Advisory Committee\nand a member of the Biovitta Research Institute. She is currently:\nthe leader of the research group: Biological and Clinical Studies\nin Human Pathologies, professor of postgraduate program in\nBiochemistry at UFSC and postgraduate program in Science and Food Technology at\nUFFS. She has experience in the area of pharmacy and clinical analysis, acting mainly\non the following topics: oxidative stress, the purinergic system and human pathologies, being a reviewer of several international journals and books.",institutionString:"Universidade Federal da Fronteira Sul",institution:{name:"Universidade Federal da Fronteira Sul",country:{name:"Brazil"}}},{id:"226275",title:"Ph.D.",name:"Metin",middleName:null,surname:"Budak",slug:"metin-budak",fullName:"Metin Budak",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226275/images/system/226275.jfif",biography:"Metin Budak, MSc, PhD is an Assistant Professor at Trakya University, Faculty of Medicine. He has been Head of the Molecular Research Lab at Prof. Mirko Tos Ear and Hearing Research Center since 2018. His specializations are biophysics, epigenetics, genetics, and methylation mechanisms. He has published around 25 peer-reviewed papers, 2 book chapters, and 28 abstracts. He is a member of the Clinical Research Ethics Committee and Quantification and Consideration Committee of Medicine Faculty. His research area is the role of methylation during gene transcription, chromatin packages DNA within the cell and DNA repair, replication, recombination, and gene transcription. His research focuses on how the cell overcomes chromatin structure and methylation to allow access to the underlying DNA and enable normal cellular function.",institutionString:"Trakya University",institution:{name:"Trakya University",country:{name:"Turkey"}}},{id:"243049",title:"Dr.",name:"Anca",middleName:null,surname:"Pantea Stoian",slug:"anca-pantea-stoian",fullName:"Anca Pantea Stoian",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243049/images/system/243049.jpg",biography:"Anca Pantea Stoian is a specialist in diabetes, nutrition, and metabolic diseases as well as health food hygiene. She also has competency in general ultrasonography.\n\nShe is an associate professor in the Diabetes, Nutrition and Metabolic Diseases Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. She has been chief of the Hygiene Department, Faculty of Dentistry, at the same university since 2019. Her interests include micro and macrovascular complications in diabetes and new therapies. Her research activities focus on nutritional intervention in chronic pathology, as well as cardio-renal-metabolic risk assessment, and diabetes in cancer. She is currently engaged in developing new therapies and technological tools for screening, prevention, and patient education in diabetes. \n\nShe is a member of the European Association for the Study of Diabetes, Cardiometabolic Academy, CEDA, Romanian Society of Diabetes, Nutrition and Metabolic Diseases, Romanian Diabetes Federation, and Association for Renal Metabolic and Nutrition studies. She has authored or co-authored 160 papers in national and international peer-reviewed journals.",institutionString:null,institution:{name:"Carol Davila University of Medicine and Pharmacy",country:{name:"Romania"}}},{id:"279792",title:"Dr.",name:"João",middleName:null,surname:"Cotas",slug:"joao-cotas",fullName:"João Cotas",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/279792/images/system/279792.jpg",biography:"Graduate and master in Biology from the University of Coimbra.\n\nI am a research fellow at the Macroalgae Laboratory Unit, in the MARE-UC – Marine and Environmental Sciences Centre of the University of Coimbra. My principal function is the collection, extraction and purification of macroalgae compounds, chemical and bioactive characterization of the compounds and algae extracts and development of new methodologies in marine biotechnology area. \nI am associated in two projects: one consists on discovery of natural compounds for oncobiology. The other project is the about the natural compounds/products for agricultural area.\n\nPublications:\nCotas, J.; Figueirinha, A.; Pereira, L.; Batista, T. 2018. An analysis of the effects of salinity on Fucus ceranoides (Ochrophyta, Phaeophyceae), in the Mondego River (Portugal). Journal of Oceanology and Limnology. in press. DOI: 10.1007/s00343-019-8111-3",institutionString:"Faculty of Sciences and Technology of University of Coimbra",institution:null},{id:"279788",title:"Dr.",name:"Leonel",middleName:null,surname:"Pereira",slug:"leonel-pereira",fullName:"Leonel Pereira",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/279788/images/system/279788.jpg",biography:"Leonel Pereira has an undergraduate degree in Biology, a Ph.D. in Biology (specialty in Cell Biology), and a Habilitation degree in Biosciences (specialization in Biotechnology) from the Faculty of Science and Technology, University of Coimbra, Portugal, where he is currently a professor. In addition to teaching at this university, he is an integrated researcher at the Marine and Environmental Sciences Center (MARE), Portugal. His interests include marine biodiversity (algae), marine biotechnology (algae bioactive compounds), and marine ecology (environmental assessment). Since 2008, he has been the author and editor of the electronic publication MACOI – Portuguese Seaweeds Website (www.seaweeds.uc.pt). He is also a member of the editorial boards of several scientific journals. Dr. Pereira has edited or authored more than 20 books, 100 journal articles, and 45 book chapters. He has given more than 100 lectures and oral communications at various national and international scientific events. He is the coordinator of several national and international research projects. In 1998, he received the Francisco de Holanda Award (Honorable Mention) and, more recently, the Mar Rei D. Carlos award (18th edition). He is also a winner of the 2016 CHOICE Award for an outstanding academic title for his book Edible Seaweeds of the World. In 2020, Dr. Pereira received an Honorable Mention for the Impact of International Publications from the Web of Science",institutionString:"University of Coimbra",institution:{name:"University of Coimbra",country:{name:"Portugal"}}},{id:"61946",title:"Dr.",name:"Carol",middleName:null,surname:"Bernstein",slug:"carol-bernstein",fullName:"Carol Bernstein",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/61946/images/system/61946.jpg",biography:"Carol Bernstein received her PhD in Genetics from the University of California (Davis). She was a faculty member at the University of Arizona College of Medicine for 43 years, retiring in 2011. Her research interests focus on DNA damage and its underlying role in sex, aging and in the early steps of initiation and progression to cancer. In her research, she had used organisms including bacteriophage T4, Neurospora crassa, Schizosaccharomyces pombe and mice, as well as human cells and tissues. She authored or co-authored more than 140 scientific publications, including articles in major peer reviewed journals, book chapters, invited reviews and one book.",institutionString:"University of Arizona",institution:{name:"University of Arizona",country:{name:"United States of America"}}},{id:"182258",title:"Dr.",name:"Ademar",middleName:"Pereira",surname:"Serra",slug:"ademar-serra",fullName:"Ademar Serra",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/182258/images/system/182258.jpeg",biography:"Dr. Serra studied Agronomy on Universidade Federal de Mato Grosso do Sul (UFMS) (2005). He received master degree in Agronomy, Crop Science (Soil fertility and plant nutrition) (2007) by Universidade Federal da Grande Dourados (UFGD), and PhD in agronomy (Soil fertility and plant nutrition) (2011) from Universidade Federal da Grande Dourados / Escola Superior de Agricultura Luiz de Queiroz (UFGD/ESALQ-USP). Dr. Serra is currently working at Brazilian Agricultural Research Corporation (EMBRAPA). His research focus is on mineral nutrition of plants, crop science and soil science. Dr. Serra\\'s current projects are soil organic matter, soil phosphorus fractions, compositional nutrient diagnosis (CND) and isometric log ratio (ilr) transformation in compositional data analysis.",institutionString:"Brazilian Agricultural Research Corporation",institution:{name:"Brazilian Agricultural Research Corporation",country:{name:"Brazil"}}}]}},subseries:{item:{id:"92",type:"subseries",title:"Health and Wellbeing",keywords:"Ecology, Ecological, Nature, Health, Wellbeing, Health production",scope:"
\r\n\tSustainable approaches to health and wellbeing in our COVID 19 recovery needs to focus on ecological approaches that prioritize our relationships with each other, and include engagement with nature, the arts and our heritage. This will ensure that we discover ways to live in our world that allows us and other beings to flourish. We can no longer rely on medicalized approaches to health that wait for people to become ill before attempting to treat them. We need to live in harmony with nature and rediscover the beauty and balance in our everyday lives and surroundings, which contribute to our well-being and that of all other creatures on the planet. This topic will provide insights and knowledge into how to achieve this change in health care that is based on ecologically sustainable practices.
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Fungal infectious illness prevalence and prognosis are determined by the exposure between fungi and host, host immunological state, fungal virulence, and early and accurate diagnosis and treatment. \r\nPatients with both congenital and acquired immunodeficiency are more likely to be infected with opportunistic mycosis. Fungal infectious disease outbreaks are common during the post- disaster rebuilding era, which is characterised by high population density, migration, and poor health and medical conditions.\r\nSystemic or local fungal infection is mainly associated with the fungi directly inhaled or inoculated in the environment during the disaster. The most common fungal infection pathways are human to human (anthropophilic), animal to human (zoophilic), and environment to human (soilophile). Diseases are common as a result of widespread exposure to pathogenic fungus dispersed into the environment. \r\nFungi that are both common and emerging are intertwined. In Southeast Asia, for example, Talaromyces marneffei is an important pathogenic thermally dimorphic fungus that causes systemic mycosis. Widespread fungal infections with complicated and variable clinical manifestations, such as Candida auris infection resistant to several antifungal medicines, Covid-19 associated with Trichoderma, and terbinafine resistant dermatophytosis in India, are among the most serious disorders. \r\nInappropriate local or systemic use of glucocorticoids, as well as their immunosuppressive effects, may lead to changes in fungal infection spectrum and clinical characteristics. Hematogenous candidiasis is a worrisome issue that affects people all over the world, particularly ICU patients. CARD9 deficiency and fungal infection have been major issues in recent years. Invasive aspergillosis is associated with a significant death rate. Special attention should be given to endemic fungal infections, identification of important clinical fungal infections advanced in yeasts, filamentous fungal infections, skin mycobiome and fungal genomes, and immunity to fungal infections.\r\nIn addition, endemic fungal diseases or uncommon fungal infections caused by Mucor irregularis, dermatophytosis, Malassezia, cryptococcosis, chromoblastomycosis, coccidiosis, blastomycosis, histoplasmosis, sporotrichosis, and other fungi, should be monitored. \r\nThis topic includes the research progress on the etiology and pathogenesis of fungal infections, new methods of isolation and identification, rapid detection, drug sensitivity testing, new antifungal drugs, schemes and case series reports. It will provide significant opportunities and support for scientists, clinical doctors, mycologists, antifungal drug researchers, public health practitioners, and epidemiologists from all over the world to share new research, ideas and solutions to promote the development and progress of medical mycology.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/4.jpg",keywords:"Emerging Fungal Pathogens, Invasive Infections, Epidemiology, Cell Membrane, Fungal Virulence, Diagnosis, Treatment"},{id:"5",title:"Parasitic Infectious Diseases",scope:"Parasitic diseases have evolved alongside their human hosts. In many cases, these diseases have adapted so well that they have developed efficient resilience methods in the human host and can live in the host for years. Others, particularly some blood parasites, can cause very acute diseases and are responsible for millions of deaths yearly. Many parasitic diseases are classified as neglected tropical diseases because they have received minimal funding over recent years and, in many cases, are under-reported despite the critical role they play in morbidity and mortality among human and animal hosts. The current topic, Parasitic Infectious Diseases, in the Infectious Diseases Series aims to publish studies on the systematics, epidemiology, molecular biology, genomics, pathogenesis, genetics, and clinical significance of parasitic diseases from blood borne to intestinal parasites as well as zoonotic parasites. We hope to cover all aspects of parasitic diseases to provide current and relevant research data on these very important diseases. In the current atmosphere of the Coronavirus pandemic, communities around the world, particularly those in different underdeveloped areas, are faced with the growing challenges of the high burden of parasitic diseases. At the same time, they are faced with the Covid-19 pandemic leading to what some authors have called potential syndemics that might worsen the outcome of such infections. Therefore, it is important to conduct studies that examine parasitic infections in the context of the coronavirus pandemic for the benefit of all communities to help foster more informed decisions for the betterment of human and animal health.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/5.jpg",keywords:"Blood Borne Parasites, Intestinal Parasites, Protozoa, Helminths, Arthropods, Water Born Parasites, Epidemiology, Molecular Biology, Systematics, Genomics, Proteomics, Ecology"},{id:"6",title:"Viral Infectious Diseases",scope:"The Viral Infectious Diseases Book Series aims to provide a comprehensive overview of recent research trends and discoveries in various viral infectious diseases emerging around the globe. The emergence of any viral disease is hard to anticipate, which often contributes to death. A viral disease can be defined as an infectious disease that has recently appeared within a population or exists in nature with the rapid expansion of incident or geographic range. This series will focus on various crucial factors related to emerging viral infectious diseases, including epidemiology, pathogenesis, host immune response, clinical manifestations, diagnosis, treatment, and clinical recommendations for managing viral infectious diseases, highlighting the recent issues with future directions for effective therapeutic strategies.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/6.jpg",keywords:"Novel Viruses, Virus Transmission, Virus Evolution, Molecular Virology, Control and Prevention, Virus-host Interaction"}],annualVolumeBook:{},thematicCollection:[],selectedSeries:{title:"Infectious Diseases",id:"6"},selectedSubseries:null},seriesLanding:{item:null},libraryRecommendation:{success:null,errors:{},institutions:[]},route:{name:"profile.detail",path:"/profiles/112818",hash:"",query:{},params:{id:"112818"},fullPath:"/profiles/112818",meta:{},from:{name:null,path:"/",hash:"",query:{},params:{},fullPath:"/",meta:{}}}},function(){var e;(e=document.currentScript||document.scripts[document.scripts.length-1]).parentNode.removeChild(e)}()