Clinical symptoms in patients with positive samples for DENV, ZIKV, and CHIKV.
\\n\\n
IntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\\n\\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\\n\\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\\n\\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\\n\\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\\n\\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\\n\\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\\n\\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\\n\\nFeel free to share this news on social media and help us mark this memorable moment!
\\n\\n\\n"}]',published:!0,mainMedia:{caption:"",originalUrl:"/media/original/237"}},components:[{type:"htmlEditorComponent",content:'
After years of being acknowledged as the world's leading publisher of Open Access books, today, we are proud to announce we’ve successfully launched a portfolio of Open Science journals covering rapidly expanding areas of interdisciplinary research.
\n\n\n\nIntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\n\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\n\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\n\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\n\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\n\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\n\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\n\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\n\nFeel free to share this news on social media and help us mark this memorable moment!
\n\n\n'}],latestNews:[{slug:"intechopen-supports-asapbio-s-new-initiative-publish-your-reviews-20220729",title:"IntechOpen Supports ASAPbio’s New Initiative Publish Your Reviews"},{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"}]},book:{item:{type:"book",id:"7000",leadTitle:null,fullTitle:"Legume Crops - Characterization and Breeding for Improved Food Security",title:"Legume Crops",subtitle:"Characterization and Breeding for Improved Food Security",reviewType:"peer-reviewed",abstract:"Legumes are flowering plants found in most of the archeological records of plants. Legumes are efficiently used as food crops for humans and animals, pulps for paper and timber manufacturing, sources for fuel and oil production, ornamental plants, and cover crops such as cereals and other staple foods. Additionally, they can be utilized for other purposes, including the production of massive amounts of organic nitrogen. This book reviews the fundamental advances related to the characterization and breeding of legume crops for improved food security. Moreover, it sheds new light on the current research trends and future research directions related to legume crop studies. This book will provoke interest for various readers, researchers, and scientists, who may find this information useful for the advancement of legume productivity.",isbn:"978-1-83968-087-8",printIsbn:"978-1-83968-086-1",pdfIsbn:"978-1-83968-088-5",doi:"10.5772/intechopen.73753",price:119,priceEur:129,priceUsd:155,slug:"legume-crops-characterization-and-breeding-for-improved-food-security",numberOfPages:122,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"4d0f73bf883bbb984cc2feef1259a9a7",bookSignature:"Mohamed Ahmed El-Esawi",publishedDate:"December 11th 2019",coverURL:"https://cdn.intechopen.com/books/images_new/7000.jpg",numberOfDownloads:7576,numberOfWosCitations:5,numberOfCrossrefCitations:8,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:17,numberOfDimensionsCitationsByBook:0,hasAltmetrics:1,numberOfTotalCitations:30,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"August 30th 2018",dateEndSecondStepPublish:"September 20th 2018",dateEndThirdStepPublish:"November 19th 2018",dateEndFourthStepPublish:"February 7th 2019",dateEndFifthStepPublish:"April 8th 2019",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"191770",title:"Dr.",name:"Mohamed A.",middleName:null,surname:"El-Esawi",slug:"mohamed-a.-el-esawi",fullName:"Mohamed A. El-Esawi",profilePictureURL:"https://mts.intechopen.com/storage/users/191770/images/system/191770.jpeg",biography:"Dr. Mohamed A. El-Esawi is a visiting research fellow at the University of Cambridge, United Kingdom, and Associate Professor of Molecular Genetics, Botany Department, Faculty of Science, Tanta University, Egypt. Dr. El-Esawi received his BSc and MSc from Tanta University, and his Ph.D. degree in Plant Genetics and Molecular Biology from Dublin Institute of Technology, Technological University Dublin, Ireland. After obtaining his Ph.D., Dr. El-Esawi joined the University of Warwick, United Kingdom; University of Sorbonne, France; and University of Leuven (KU Leuven), Belgium as a visiting research fellow. His research focuses on plant genetics, genomics, molecular biology, molecular physiology, developmental biology, plant-microbe interaction, and bioinformatics. He has authored several international peer-reviewed articles, book chapters, and books, and has participated in more than sixty conferences and workshops worldwide. Dr. El-Esawi is currently involved in several biological science research projects.",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"8",totalChapterViews:"0",totalEditedBooks:"9",institution:{name:"Tanta University",institutionURL:null,country:{name:"Egypt"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"350",title:"Agrology",slug:"agrology"}],chapters:[{id:"69148",title:"Introductory Chapter: Characterization and Improvement of Legume Crops",doi:"10.5772/intechopen.89369",slug:"introductory-chapter-characterization-and-improvement-of-legume-crops",totalDownloads:599,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:null,signatures:"Mohamed A. El-Esawi",downloadPdfUrl:"/chapter/pdf-download/69148",previewPdfUrl:"/chapter/pdf-preview/69148",authors:[{id:"191770",title:"Dr.",name:"Mohamed A.",surname:"El-Esawi",slug:"mohamed-a.-el-esawi",fullName:"Mohamed A. El-Esawi"}],corrections:null},{id:"68094",title:"Novel Therapeutic Uses of Legume Crops in Southern South America",doi:"10.5772/intechopen.85659",slug:"novel-therapeutic-uses-of-legume-crops-in-southern-south-america",totalDownloads:1139,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"The Argentine flora comprises more than 10,000 species, and many of them have been recorded as having medicinal, antimicrobial, and nutraceutical uses in humans as well as veterinary uses. In this chapter, native species/populations from the north of Argentina have been identified, selected, and characterized using morphological, chemical, and molecular techniques. Bauhinia forficata subsp. pruinosa was found to have anti-inflammatory, antidiabetic, diuretic, and analgesic activity and Senna spectabilis var. spectabilis has been found to have antibacterial, antibiofilm, antifungal, and antioxidant properties. The characterization and conservation of the native germplasm will allow us to propose future protocols of adaptation and technological processes to improve the quality of life in the rural areas and sustainable growth. This process will be achieved through a future integral and rational use that contemplates the conservation of the wild populations and their habitat. Thus, new resources will be generated, and the native flora of the country will gain value, strengthening the regional and territorial development of the agricultural and agroindustrial system. In addition, the domestication practices oriented to an integral management of the crop without extraction of the biological resource from the natural habitat minimize the impact of ecosystem degradation by overexploitation associated with landscape fragmentation.",signatures:"Renée Hersilia Fortunato, Virginia Fuentes Baluzzi, Fernando De Diego, Rodrigo T. Biagioni and Alejandro Daniel Esquivel",downloadPdfUrl:"/chapter/pdf-download/68094",previewPdfUrl:"/chapter/pdf-preview/68094",authors:[{id:"272187",title:"Dr.",name:"Renée",surname:"Fortunato",slug:"renee-fortunato",fullName:"Renée Fortunato"},{id:"288386",title:"BSc.",name:"Virginia",surname:"Fuentes Baluzzi",slug:"virginia-fuentes-baluzzi",fullName:"Virginia Fuentes Baluzzi"},{id:"288387",title:"MSc.",name:"Fernando",surname:"De Diego",slug:"fernando-de-diego",fullName:"Fernando De Diego"},{id:"288388",title:"Mr.",name:"Rodrigo",surname:"Biagioni",slug:"rodrigo-biagioni",fullName:"Rodrigo Biagioni"},{id:"288390",title:"Mr.",name:"Alejandro",surname:"Esquivel",slug:"alejandro-esquivel",fullName:"Alejandro Esquivel"}],corrections:null},{id:"64900",title:"Ethnomedicinal Values of Legume Plants in Pakistan",doi:"10.5772/intechopen.82762",slug:"ethnomedicinal-values-of-legume-plants-in-pakistan",totalDownloads:693,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The data on medicinal plants in the vegetation of Pakistan was studied and surveyed from September to November, 2018. Different ethnomedicinal species were recorded which are used by local inhabitants as a medicine, fodder, fuel, and for agricultural purpose. Many of the medicinal plants recorded are used for the treatment of two or more diseases by the local people. The family Fabaceae was dominant with respect to medicinal plants. The precious knowledge of medicinal flora is rapidly vanishing due to the illiteracy among the local people and also due to destruction of the medicinal plants. The present study was designed to convey the knowledge and importance of medicinal flora as well as traditional uses of such plants in daily life.",signatures:"Faisal Hussain and Farzana Usman",downloadPdfUrl:"/chapter/pdf-download/64900",previewPdfUrl:"/chapter/pdf-preview/64900",authors:[{id:"199137",title:"Dr.",name:"Faisal",surname:"Hussain",slug:"faisal-hussain",fullName:"Faisal Hussain"},{id:"272448",title:"Dr.",name:"Farzana",surname:"Usman",slug:"farzana-usman",fullName:"Farzana Usman"}],corrections:null},{id:"66497",title:"Starch Granules from Cowpea, Black, and Carioca Beans in Raw and Cooked Forms",doi:"10.5772/intechopen.85656",slug:"starch-granules-from-cowpea-black-and-carioca-beans-in-raw-and-cooked-forms",totalDownloads:1121,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:1,abstract:"Starch applications in food systems are mainly influenced by solubility, gelatinization, paste viscosity, digestibility, and retrogradation. These characteristics result from properties such as the size and shape of granules, amylose and amylopectin contents, distribution of polymer chains, degree of crystallinity, and extraction of waste. In beans, the percentage of starch contents on dry basis is between 45 and 60%, being 24–65% amylose. This chapter evaluated the structure of common beans starch granules (Phaseolus vulgaris) and cowpea (Vigna unguiculata) in raw and cooked forms, by optical microscopy (OM) and scanning electron microscopy (SEM). Thus it was possible to observe the gelatinization of the starch granules especially in cowpea and carioca beans, as well as the “hard-to-cook” phenomenon in the black beans.",signatures:"Joyce Aparecida Tavares de Miranda, Lucia Maria Jaeger de Carvalho, Izabela Miranda de Castro, José Luiz Viana de Carvalho, André Luiz de Alcântara Guimarães and Ana Cláudia de Macêdo Vieira",downloadPdfUrl:"/chapter/pdf-download/66497",previewPdfUrl:"/chapter/pdf-preview/66497",authors:[{id:"97047",title:"Prof.",name:"Lucia Maria Jaeger",surname:"De Carvalho",slug:"lucia-maria-jaeger-de-carvalho",fullName:"Lucia Maria Jaeger De Carvalho"},{id:"200652",title:"Dr.",name:"André",surname:"Guimarães",slug:"andre-guimaraes",fullName:"André Guimarães"},{id:"209351",title:"Dr.",name:"Joyce",surname:"Miranda",slug:"joyce-miranda",fullName:"Joyce Miranda"},{id:"209473",title:"Dr.",name:"Izabela Miranda De",surname:"Castro",slug:"izabela-miranda-de-castro",fullName:"Izabela Miranda De Castro"},{id:"276507",title:"Dr.",name:"Ana",surname:"Vieira",slug:"ana-vieira",fullName:"Ana Vieira"},{id:"295486",title:"MSc.",name:"Jose",surname:"Carvalho",slug:"jose-carvalho",fullName:"Jose Carvalho"}],corrections:null},{id:"66478",title:"Mungbean (Vigna radiata L. Wilczek): Retrospect and Prospects",doi:"10.5772/intechopen.85657",slug:"mungbean-em-vigna-radiata-em-l-wilczek-retrospect-and-prospects",totalDownloads:1273,totalCrossrefCites:2,totalDimensionsCites:4,hasAltmetrics:0,abstract:"Mungbean (Vigna radiata L. Wilczek) is economically most important crop of Vigna group. It is also known as green gram, golden gram, moong, Chickasaw, Oregon pea, and chop suey bean and this legumes have a strategic position in Southeast Asian countries for nutritional security and sustainable crop production. Being rich in quality protein, minerals and vitamins, they are inseparable ingredients in the diets of a vast majority of Indian population. When supplemented with cereals, they provide a perfect mix of essential amino acids with high biological value. These crops have the ability to fix atmospheric nitrogen (58–109 kg per ha in kg per ha mungbean) in symbiotic association with Rhizobium bacteria, which enables them to meet their own nitrogen requirement and also benefit the succeeding crops. This crop has also been reported to smother weed flora appreciably (20–45%) when intercropped with tall cereals or pigeonpea and consequently, minimize the cost incurred on weed control. On account of short duration and photo-thermo insensitivity, they are considered excellent crops for crop intensification and diversification. A seed of mungbean is highly nutritious containing 24–28% protein, 1.0–1.5% fat, 3.5–4.5% fibre, 4.5–5.5% ash and 59–65% carbohydrates on dry weight basis and provide 334–344 kcal energy. Mungbean protein is considered to be easily digestible. Mungbean are tropical grain legumes widely grown in the sub-tropical countries of South and Southeast Asia. Nevertheless, these crops are cultivated over a wide range of latitudes in the regions where average diurnal temperatures during the growing season are warmer than about 20°C.",signatures:"Suhel Mehandi, Syed Mohd. Quatadah, Sudhakar Prasad Mishra, Indra Prakash Singh, Nagmi Praveen and Namrata Dwivedi",downloadPdfUrl:"/chapter/pdf-download/66478",previewPdfUrl:"/chapter/pdf-preview/66478",authors:[{id:"275243",title:"Dr.",name:"Suhel",surname:"Mehandi",slug:"suhel-mehandi",fullName:"Suhel Mehandi"},{id:"275245",title:"Dr.",name:"Indra Prakash",surname:"Singh",slug:"indra-prakash-singh",fullName:"Indra Prakash Singh"},{id:"275246",title:"Prof.",name:"Sudhakar",surname:"Prasad Mishra",slug:"sudhakar-prasad-mishra",fullName:"Sudhakar Prasad Mishra"},{id:"290295",title:"Dr.",name:"Syed",surname:"Mohd. Quatadah",slug:"syed-mohd.-quatadah",fullName:"Syed Mohd. Quatadah"},{id:"290728",title:"MSc.",name:"Nagmi",surname:"Praveen",slug:"nagmi-praveen",fullName:"Nagmi Praveen"},{id:"290731",title:"Dr.",name:"Namrata",surname:"Dwivedi",slug:"namrata-dwivedi",fullName:"Namrata Dwivedi"}],corrections:null},{id:"64941",title:"The Productivity of Selected Species and Cultivars of Legumes Grown for Seeds in Organic Production System",doi:"10.5772/intechopen.82686",slug:"the-productivity-of-selected-species-and-cultivars-of-legumes-grown-for-seeds-in-organic-production-",totalDownloads:554,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The aim of the study was to assess the yielding of selected legume species with diversified morphological structure cultivated for seeds in ecological system. The field experiment was carried out in 2016–2018. The first factor was legume species: faba bean, field pea, yellow lupine, and blue lupine, and the second factor was varieties of legumes: faba bean (Granit and Amulet), field pea (Hubal and Batuta), blue lupine (Kurant and Regent), and yellow lupine (Bursztyn and Perkoz). After the harvest, the grain yield of legume plants and the weight of a thousand seeds were determined. The plant structure was determined (length of the part of fruiting stem, number of pods and seeds per plant, number of seeds in the pod, number of fruiting nodes, number of pods and seeds from the node). In addition, the content of selected nutrients (protein, fiber, fat, macroelements) was determined in seeds. Studies showed that in ecological conditions, the pea cultivation, especially Hubal variety (with bipinnate leaves), enabled obtaining the largest seed yield, while the smallest seed yields yellow lupine independent of the morphological type. The self-completing varieties of faba bean, yellow lupine, and blue lupines were yielded at a higher level than varieties with a traditional growth type. Among the pea varieties assessed, the variety Hubal yielded better (with bipinnate leaves). Significantly, higher yield of protein is provided by faba bean cultivation, while the smaller level of pea and yellow lupine.",signatures:"Księżak Jerzy and Bojarszczuk Jolanta",downloadPdfUrl:"/chapter/pdf-download/64941",previewPdfUrl:"/chapter/pdf-preview/64941",authors:[{id:"170281",title:"Prof.",name:"Jerzy",surname:"Księżak",slug:"jerzy-ksiezak",fullName:"Jerzy Księżak"},{id:"170282",title:"Dr.",name:"Jolanta",surname:"Bojarszczuk",slug:"jolanta-bojarszczuk",fullName:"Jolanta Bojarszczuk"}],corrections:null},{id:"64927",title:"Influence of Adjuvants on Efficacy of Postemergence Herbicides Commonly Used in Peanut (Arachis hypogaea L.)",doi:"10.5772/intechopen.82708",slug:"influence-of-adjuvants-on-efficacy-of-postemergence-herbicides-commonly-used-in-peanut-em-arachis-hy",totalDownloads:925,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Field studies were conducted for 2 years in the High Plains of Texas (34.1826o N, 101.9505o W) and in South Texas (29.1634o N, 97.0725o W) to evaluate weed control when using different adjuvants with commonly used peanut herbicides. In the High Plains, Amaranthus palmeri L. control with acifluorfen, imazapic, lactofen, and 2,4-DB at the 1X dose improved with the use of an adjuvant over no adjuvant. A. palmeri control with imazethapyr was similar to that seen with imazapic and lactofen with the exception of the 1/2X rate of imazethapyr, which showed improved control with Agridex over the use of no adjuvant or Induce in 1 year, while Induce was better than no adjuvant or Agridex in the other year. In 1 year in South Texas, A. palmeri control with imazapic at the 1X dose was ≥73% with/without an adjuvant. In another year, the 1X dose of imazapic controlled A. palmeri 64% without an adjuvant, while the addition of Cide Kick II resulted in 83% control. An adjuvant did not improve A. palmeri control with lactofen or Cucumis melo L. control with either imazapic or lactofen. Urochloa texana (Buckl.) control with clethodim at the 1X dose was not improved by the addition of an adjuvant in either year. U. texana control was not improved when using the 1X dose of fluazifop-P with any adjuvant.",signatures:"William James Grichar, Peter A. Dotray and Mark A. Matocha",downloadPdfUrl:"/chapter/pdf-download/64927",previewPdfUrl:"/chapter/pdf-preview/64927",authors:[{id:"13502",title:"Prof.",name:"W. James",surname:"Grichar",slug:"w.-james-grichar",fullName:"W. James Grichar"},{id:"14656",title:"Dr.",name:"Peter A.",surname:"Dotray",slug:"peter-a.-dotray",fullName:"Peter A. Dotray"},{id:"283163",title:"Prof.",name:"Mark",surname:"Matocha",slug:"mark-matocha",fullName:"Mark Matocha"}],corrections:null},{id:"65957",title:"Breeding Elite Cowpea [Vigna unguiculata (L.) Walp] Varieties for Improved Food Security and Income in Africa: Opportunities and Challenges",doi:"10.5772/intechopen.84985",slug:"breeding-elite-cowpea-em-vigna-unguiculata-em-l-walp-varieties-for-improved-food-security-and-income",totalDownloads:1273,totalCrossrefCites:4,totalDimensionsCites:11,hasAltmetrics:0,abstract:"Cowpea, Vigna unguiculata (L.) Walp, is among the most important grain legumes in Africa. Its nutritional value and biological nitrogen fixation (BNF) potential coupled with a high plasticity to environmental conditions places this legume in a unique position in Sub-Saharan Africa (SSA) in the context of food and nutritional security. However, cowpea yield and BNF contribution to agricultural systems in this sub-continent is far behind the average global values. The inability to run effective breeding programs to timely generate and deliver high yielding, nutritious and climate smart cowpea varieties, coupled with poor crop husbandry practices has been in the forefront of the current situation. In this chapter, the main constrains and opportunities to establish and run successful and effective cowpea production and breading programs in SSA are discussed. The discussion is built around the argument that SSA can benefit from its rich collection of landraces, as well as from high-throughput methodologies to assist the screening and the development of adapted, high yielding and nutritious varieties.",signatures:"Ana Maria Figueira Gomes, Nascimento Nhantumbo, Manuela Ferreira-Pinto, Rafael Massinga, José C. Ramalho and Ana Ribeiro-Barros",downloadPdfUrl:"/chapter/pdf-download/65957",previewPdfUrl:"/chapter/pdf-preview/65957",authors:[{id:"171036",title:"Dr.",name:"Ana I.",surname:"Ribeiro-Barros",slug:"ana-i.-ribeiro-barros",fullName:"Ana I. 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Coastal El Niño is a weather phenomenon that is caused by abnormal warming (above 0.4°C) of the Pacific Ocean waters near the coasts of Ecuador and Peru, and it can even reach the central and southern Peruvian coasts. As a result, it produces intense rains that, in turn, cause overflow of streams, floods, and allow the accumulation of stagnant waters, which forms the ideal scenario for the appearance of outbreaks of vector-borne diseases such as dengue (DENV), other arbovirosis, and zoonotics such as leptospirosis [1, 2, 3, 4]. This phenomenon was presented more clearly in the summer of 2017; however, rains and floods have been reported for Peru even since December 2016 [5].
\nAs a result of the climatic phenomenon, the
Number of dengue cases, according to epidemiological weeks. Peru, 2013–2017. Taken from: Ministry of Health of Peru MINSA [
Among the most frequently reported forms were dengue without warning signs (88.6%), dengue with warning signs (11%), and severe dengue (0.3%). The cumulative national incidence for 2017 was 239.1 cases per 100,000 inhabitants and there were 93 deaths, of which 79 were confirmed cases and 14 were probable [8].
\nThere was a marked increase in cases, in those places where there was a greater presence of rain and floods. Thus, for example, Piura concentrated 64% of dengue cases: this place being one of the most affected cities and even presented an overflow from its main river that crosses through the same city, the river Piura [9].
\nDo not forget that northern Peru is an endemic area due to climate, geography, and other factors that make it a vector-friendly ecosystem, being considered one of the countries with the greatest impact due to climate change [10].
\nDengue transmission occurs through an insect vector, predominantly
The geographical and climatic conditions of the cities most affected by the El Niño Costero phenomenon turned them into zones of epidemics; in these places, there is an important population growth, from urbanization to sectorization in young towns, urban slums, where in many there is no basic infrastructure and water supply is insufficient, which requires temporary water storage, as well as high temperatures, migratory movement, and beaches with influx of people, which make not only dengue proliferate but also other arbovirosis such as chikungunya [13].
\nThe propagation of the vector for decades is conditioned by the climatic changes. For example, in May 2004, heat waves and droughts were observed in the coastal areas of Kenya, toward Lamu and Mombasa, two large coastal cities. That period was also the beginning of a large chikungunya outbreak in these two cities (with reported attack rates of 75%) before its spread to the Indian Ocean [14]. Entomologists have explained how and why droughts can be associated with increases in diseases transmitted by
In Peru, the consequence of this weather phenomenon allowed the dissemination of the
Distribution of indigenous cases of Zika by onset of symptoms. Peru 2016–2017. Taken from: Ministry of Health of Peru MINSA [
The fluvial precipitations that the phenomenon of the coastal El Niño brought with it during 2017 triggered the collapse of the sewerage system, generating floods and the exposure of wastewater, which together with the rains gave an adequate environment for the transmission of leptospirosis in urban areas of the Lambayeque region. It was even possible to demonstrate that during this period, laboratory findings compatible with dengue and leptospirosis were reported simultaneously. While it is true that many of the immunoglobulin can remain for years in the patient and do not necessarily require an acute infection, the similarity of clinical symptoms between dengue and leptospirosis makes both pathologies confusing to health personnel, even more so during the appearance of a weather phenomenon where there is an outbreak [18].
\nDengue in Ecuador fluctuates with a very similar seasonality. The season is an important determinant of infectious disease rates, including mosquito-propagated arboviruses, such as dengue, chikungunya, and Zika. Seasonal disease patterns are driven by a combination of climatic or environmental factors, such as temperature or rainfall, and trends in human behavior time, such as school year schedules, vacations, and weekend patterns. These factors affect both disease rates and medical care-seeking behavior. The seasonality of dengue fever has been studied in the context of climatic factors. Thus, between 2009 and 2016, a predictive model of dengue detection was studied using data from the same patients in rural areas in Ecuador. Thus, compared to the average of every day, cases were more likely to be diagnosed on Tuesdays (relative risk [RR]: 1.26; 95% confidence interval [CI]: 1.05–1.51) and Thursdays (RR: 1.25; 95% CI: 1.02–1.53), and were less likely to be diagnosed on Saturdays (RR: 0.81; 95% CI: 0.65–1.01) and Sundays (RR: 0.74; 95% CI: 0.58–0.95). The holidays were not significant predictors of dengue diagnoses, except for an increase in diagnoses the day after Christmas (RR: 2.77; 95% CI: 1.46–5.24) [19].
\nFrom the political sphere, the coastal El Niño phenomenon caused the Ministry of Health and the Ministry of Defense of Ecuador to take into account the declaration of emergency for the Peruvian city of Piura, issued by the Ministry of Health of that country. This is because that city is close to the border of Ecuador, and the trade between the two countries is very high, which makes it necessary to work in a multisectoral way to eradicate the vector [20].
\nIt is very necessary to maintain entomological surveillance, especially in those cities where the phenomenon left vector presence. Migration and population increase, in addition to raising awareness and educating the population about the risk factors of dengue occurrence, should always be taken into account to avoid a disease that was installed in the Americas decades ago, precisely because of migration from other areas. The consequences of climate change must be learned as it not only destroys our habitat but directly interferes with our health [21]. Health authorities have the responsibility to plan strategies and evaluate their impact progressively. Many times it is not enough to plan, but to change strategies to avoid having the same results.
\nClassically, the disease presents with an incubation period of 3–14 days; after that a febrile phase (1–4 days); viremia, the critical phase from 4 to 7 days; and a recovery phase from day 7 onward [22]. This disease course depends on the virus serotype and whether or not the individual has previously had a dengue infection. In this spectrum of disease, one can have:
Dengue without warning signs: Person with a fever of 7 or less days, with at least two of the following symptoms such as eye pain, myalgia, headache, arthralgia, low back pain, rash, and nausea [23, 24].
Dengue with warning signs: Person with a probable case of dengue with one or more of the clinical signs such as severe abdominal pain, dyspnea, serous effusion, persistent vomiting, hypothermia, mucosal bleeding, altered mental status, increased hematocrit, and hepatomegaly [23, 24].
Severe dengue: A probable case with or without warning signs presenting one of the following signs such as signs of hypovolemic shock, severe bleeding, respiratory distress syndrome due to plasma extravasation, and severe organ involvement (encephalitis, hepatitis, and myocarditis) [25].
It is known that the cross-immunity of dengue serotypes is limited, which increases the possibility of reinfections and with them more florid clinical pictures [25, 26].
\nPrevious studies observed the outbreaks from 2010 onward, observing that dengue cases occurred in a greater proportion due to DENV-2, the most frequent clinical symptom being retro-ocular pain, myalgias associated with a 7-day fever [27]. Also, it was observed that in dengue cases, many of them were reinfections and DENV-2 continued to prevail, which was one of the worst at presenting cross-immunity (Figure 3).
\nAge distribution of DENV-neutralizing antibodies in 2010. Samples were collected between March and June 2010, approximately 6 months prior to a large dengue epidemic largely caused by American/Asian genotype DENV-2. Panel A: Age distribution of serotype-specific DENV-neutralizing antibodies. Panel B: Age distribution of number of prior DENV infections. Naive indicates absence of detectable DENV-neutralizing antibodies against any serotype, monotypic indicates DENV-neutralizing antibodies against one serotype, and multitypic indicates DENV-neutralizing antibodies against two or more serotypes. Taken from: Forshey et al. [
A study conducted in the north coast of Peru found that, among the referred symptoms, 82% reported fever, being less than half quantified (values from 37to 41°C), followed by headache (75.6%), arthralgias (69.7%), myalgias (62.4%), retroocular pain (55.5%), lumbar pain (44.7%), and only 24.4% presenting rash. The presence of platelet decrease (78.4%) was the most frequent among cases with alarm signs [28] (Figure 4).
\nSymptomatology of patients diagnosed with dengue. (A) Symptoms and signs. (B) Warning signs. Taken from: Perales-Carrasco et al. [
In recent years, new viruses such as chikungunya (CHIKV) and Zika (ZIKV) have also been introduced. In recent years after the ZIKV epidemic, cases of ZIKV infection have continued to be observed, and in children, according to Salgado et al. [30], there were found patients with encephalitis with coinfection of DENV and ZIKV.
\nAnother study, also conducted in Peru, showed that the circulating serotypes during the coastal El Niño phenomenon were DENV-2 and DENV-3, as well as confirmed cases of CHIKV and ZIKV, even in high Andean areas; concomitantly, the study revealed that the main symptoms of dengue were headaches, arthralgias, and back pain associated with fever (Table 1) [27].
\nClinical symptoms | \nTotal n | \nPCR real-time confirmed cases | \n\n | |
---|---|---|---|---|
DENV (n | \nZIKV (n | \nCHIKV (n | \n||
n (%) | \nn (%) | \nn (%) | \n||
Chills | \n3 (0.6) | \n1 (0.6) | \n0 (0.0) | \n0 (0.0) | \n
Headache | \n444 (89.5) | \n152 (89.4) | \n34 (87.2) | \n20 (87.0) | \n
Dizziness | \n1 (0.2) | \n0 (0.0) | \n1 (2.6) | \n0 (0.0) | \n
Cough | \n1 (0.2) | \n1 (0.6) | \n0 (0.0) | \n0 (0.0) | \n
Sore throat | \n184 (37.1) | \n50 (29.4) | \n11 (28.2) | \n11 (47.8) | \n
Nausea and/or vomits | \n251 (50.6) | \n86 (50.6) | \n20 (51.3) | \n13 (56.5) | \n
Loss of appetite | \n312 (62.9) | \n104 (61.2) | \n23 (59.0) | \n18 (78.3) | \n
Back pain | \n270 (54.4) | \n105 (61.8) | \n23 (59.0) | \n17 (73.9) | \n
Dysuria | \n1 (0.2) | \n0 (0.0) | \n0 (0.0) | \n0 (0.0) | \n
Myalgia | \n419 (84.5) | \n147 (86.5) | \n35 (89.7) | \n17 (73.9) | \n
Arthralgia | \n396 (79.8) | \n143 (84.1) | \n32 (82.1) | \n19 (82.6) | \n
Retro-ocular pain | \n337 (67.9) | \n118 (69.4) | \n27 (69.2) | \n17 (73.9) | \n
Rash | \n89 (17.9) | \n26 (15.3) | \n8 (20.5) | \n6 (26.1) | \n
Melena | \n2 (0.4) | \n0 (0.0) | \n0 (0.0) | \n0 (0.0) | \n
Nasal bleeding | \n9 (1.8) | \n3 (1.8) | \n1 (2.6) | \n1 (4.3) | \n
Gums bleeding | \n3 (0.6) | \n2 (1.2) | \n1 (2.6) | \n0 (0.0) | \n
Petechiae | \n11 (2.2) | \n3 (1.8) | \n0 (0.0) | \n1 (4.3) | \n
Ecchymosis | \n2 (0.4) | \n1 (0.6) | \n1 (2.6) | \n0 (0.0) | \n
Blood-tinged sputum | \n1 (0.2) | \n0 (0.0) | \n0 (0.0) | \n0 (0.0) | \n
Abdominal pain | \n22 (4.4) | \n7 (4.1) | \n1 (2.6) | \n1 (4.3) | \n
Thoracic pain | \n5 (1.0) | \n2 (1.2) | \n0 (0.0) | \n0 (0.0) | \n
Fatigue | \n3 (0.6) | \n0 (0.0) | \n1 (2.6) | \n0 (0.0) | \n
Altered mental status | \n1 (0.2) | \n1 (0.6) | \n0 (0.0) | \n1 (4.3) | \n
Clinical symptoms in patients with positive samples for DENV, ZIKV, and CHIKV.
Taken from: Forshey et al. [29].
\nIn Peru, there could be a subdiagnosis or overdiagnosis of dengue and therefore of the clinical variability, on the one hand; the amount of arbovirosis that can give a similar clinical presentation is wide, and within these viruses is oropuche, which can be confused with dengue during the endemic months [31]. The contrary occurs in patients with a second dengue virus infection in which the diagnostic methods have a lower sensitivity of 60%, as is the case of non-structural (NS1), a test widely used in our environment [26].
\nThe Huánuco region, located in the center of Peru, was one of the cities that presented an increase in dengue cases, where about 90% of patients presented with myalgia, headache, and rash; being in these patients a diagnostic confirmation of 92% by PCR. This being an area with low endemicity, but as a result of coastal El Niño, it could mean a majority of primary infection, and therefore this high rate of clinical diagnostic correlation [26]. In addition, it is important to know the behavior in children under 5 years of age, in which many of them have antigens from mothers in endemic areas, which leads to more severe manifestations being possible in this particular age group [32].
\nFinally, it can be observed that, in the years before the dengue virus infection, the agent (DENV-2) and the clinical manifestations were similar, with the difference in the number of cases and the increase in coinfections of the new circulating viruses; this should make the health staff reflect on making proper use of diagnostic tests to provide better care and avoid fatal outcomes, as it was in some cases discussed above in the last phenomenon of the coastal El Niño (Table 2).
\nCharacteristics | \nCrude analysis | \nRisks for dengue | \n||
---|---|---|---|---|
\n | Chikungunya | \nDengue | \np-value | \nAdjusted odds ratio (95% CI)*\n | \n
Clinical | \n||||
Diarrhea, n (%) | \n3/37 (8) | \n13/57 (23) | \n0.064 | \n2.13 (0.29–15.66) | \n
Ascites, n (%) | \n0/37 (0) | \n1/57 (2) | \n1.000**\n | \nN.E. | \n
Pleural effusion, n (%) | \n0/37 (0) | \n2/56 (4) | \n0.516 | \nN.E. | \n
Laboratory | \n||||
Hemoglobin (mg/dl) median (interquartile range (IQR)) [n] | \n10.5 (10–12) [35] | \n10.5 (10–12) [36] | \n0.910 | \n\n |
Decrease for age, n (%) | \n26/36 (72) | \n25/53 (47) | \n0.019 | \n1.33 (0.26–6.87) | \n
Increase for age, n (%) | \n0/36 (0) | \n1/53 (2) | \n1.000**\n | \nN.E. | \n
Hematocrit (%) median (IQR) [n] | \n30.9 (29–34) [33] | \n31.5 (30–35) [37] | \na. 0.510 | \n\n |
Decrease for age, n (%) | \n24/33 (73) | \n30/52 (58) | \n0.160 | \n1.04 (0.26–4.19) | \n
Increase for age, n (%) | \n0/33 (0) | \n1/52 (2) | \n1.000**\n | \nN.E. | \n
White blood cells (1000 cells/ml) Median (IQR) [n] | \n6.4 (5–10) [33] | \n7.4 (5–12) [36] | \n0.220 | \n\n |
Decrease for age, n (%) | \n17/33 (52) | \n16/53 (30) | \n0.048 | \n0.28 (0.07–1.08) | \n
Increase for age, n (%) | \n4/33 (12) | \n5/53 (9) | \n0.728 | \n1.97 (0.27–14.17) | \n
Clinical and laboratory characteristics of chikungunya and dengue and their relative adjusted risks among children <24 months of age in Colombia.
Adjusted by age, days with symptoms, and sex.
Fisher’s exact test.
Best fit was the natural logarithm of the exposure variable.
Note: N.E.: Not estimable. Taken from: Paternina-Caicedo et al. [32].
Today, there are guidelines established by international organizations for the rational use of dengue diagnostic tests. The World Health Organization (WHO) recommends the use of polymerase chain reaction (PCR) for the early detection of dengue and its complementation with other tests such as immunoglobulin M (IgM), immunoglobulin G (IgG), and NS1 [33]; however, the use according to the clinical picture and the time of the disease will favor the optimal use of the different tests.
\nThe sensitivity and specificity of the NS1 antigen test can range from 49 to 59% and from 93 to 99%, respectively, while that of the IgM antibody test is from 71 to 80% and 46 to 90%, respectively, considering a median of 5 days of fever before the collection of the samples (interquartile range of 3–7 days) for the two tests mentioned. The diagnostic accuracy for the detection of IgM increases for late acute infection (5 days after the onset of symptoms) compared to the early one. The NS1 antigen is an early marker of acute infection, and its combined use with IgM detection can provide a definitive diagnosis of 96.9–100% for samples obtained after 3 days of illness [33]. The reported sensitivity and specificity of IgG for dengue are 92.0 and 100%, respectively [34].
\nThe patient usually has an incubation period of 4–5 days after the bite by mosquitoes of the
We can summarize the diagnostic tests used for dengue in four groups: (i) virus isolation and characterization, (ii) detection of the genomic sequence through a nucleic acid amplification test, (iii) detection of specific antibodies against the virus, and (iv) identification of dengue virus (glycoprotein) antigens. Isolation of the virus is achieved by cell culture that gives the most specific result, and the sera are usually collected in the first 3–5 days after the fever starts. Virus isolation is highly dependent on viral load, which limits the period during which the virus can be successfully isolated in the patient’s serum. In addition, its high cost makes this test little accessible to most laboratories [3]. Viral identification can also be done using dengue-specific monoclonal antibodies by immunofluorescence and reverse transcription-PCR (RT-PCR) [3].
\nOn the other hand, serological tests are relatively inexpensive and easy to perform. These characteristics make them the most used tests for dengue infection. IgM levels begin to rise on the third day of a primary infection and peak at 2 weeks after the onset of fever (Figure 5). IgG is detectable at the end of the first week of illness and may persist for life. Enzyme-linked immunosorbent assay (ELISA) tests can analyze the levels of IgM and IgG, and the IgM/IgG ratio is useful to distinguish primary from secondary infections. The IgM/IgG ratio greater than 1.4 is indicative of primary dengue infection, while the IgM/IgG ratio lesser than 1.2 is indicative of secondary dengue infection. The potential cross-reactivity of dengue virus with other flaviviridae when using serological assays remains a significant limitation for its use. Prior vaccination against yellow fever can also lead to a false positive serological test for dengue virus. The prolonged period of seroconversion also results in false negatives [3]. All flaviviruses produce a glycoprotein called NS1 and tests such as antigen capture ELISA and quick tests based on immunochromatography can be used to identify it in the bloodstream; it is detectable from days 0 to 9 after the onset of symptoms, although detection appears to be higher in the samples collected up to 3 days after the onset of symptoms. Quick tests are now available and provide results in 15 min. Rapid tests for NS1 have been estimated to have a significantly higher sensitivity for primary infections (94.7%) than for secondary infections (67.1%; p < 0.001) and now appear to be a potential alternative to culture, PCR, and serology [38].
\n(A) Primary infection by dengue. (B) Secondary infection by dengue. Source: Clinical Pathology Department, Almanzor Aguinaga Asenjo, Hospital, Essalud.
The Brazilian Ministry of Health recommends that samples of patients with suspected dengue fever taken up to 8 days (preferably 5) after the onset of symptoms should be processed using ELISA for the detection of NS1 and qRT PCR for the detection of the DENV genome and the serotype. At 8–15 days after the onset of symptoms, the samples are analyzed for IgM detection using ELISA. After 15 days, the sera are selected for IgG using ELISA. Dengue infection cannot be excluded in samples that are negative for the NS1 antigen and must be confirmed by IgM/IgG detection [35].
\nCases of DENV-2 had a higher proportion of severe dengue than among those of DENV-1 and DENV-4 [39]. Nevertheless, the secondary infection was not a predictor of severe clinical manifestation in adults, who were primarily infected with serotype DENV-3 [40]; on the other hand, the dengue in children have suggested that infection with secondary DENV-2 is more likely to result in severe disease compared with other serotypes [41].
\nThe fifth variant DENV-5 has been isolated in October 2013. This serotype follows the sylvatic cycle unlike the other four serotypes which follow the human cycle. The likely cause of emergence of the new serotype could be genetic recombination, natural selection, and genetic bottlenecks [42].
\nDuring the months of June–July of 2019, 35 cases were registered and diagnosed as the Guillain-Barre Syndrome, at the Almanzor Aguinaga Asenjo National Hospital of Chiclayo in Peru, of which 22 had electrophysiology results compatible with the said syndrome, two had a normal result, and 11 were not evaluated with the mentioned diagnostic test. Three cases had IgG for flavivirus, three cases had IgG for flavivirus and IgG for chikungunya concomitantly, four cases had IgG for chikungunya, and one case had IgM for chikungunya. In other words, there were 11 cases of patients with a history of flavivirus or chikungunya infections in the context of the presentation of Guillain-Barre syndrome [43]. These patients were evaluated with the recomLine Tropical Fever IgG and IgM tests, immunoblot of German origin that has a sensitivity for IgG of 100% for primary infection by Zika, 100% for secondary infection for dengue or Zika, and 98.6% for primary infection by dengue; also the IgM has a sensitivity of 72.7% for dengue or Zika, and both tests have a specificity of 96–100%. On the other hand, the mentioned test describes a sensitivity and specificity of 100% for both IgM and IgG for chikungunya’s diagnosis [44].
\nIn the literature, there is the case of a dengue patient who developed Guillain-Barre syndrome, who presented the NS1 antigen on the second day of symptoms with subsequent IgM and IgG positive on the sixth day of evolution [45]. There is also another case described with similar laboratory findings, but that developed the syndrome approximately 2 weeks after the onset of dengue symptoms [46]. Therefore, this syndrome could develop early or late in relation to the onset of symptoms due to infection. In our cases, we did not have positive IgM and we did not have the opportunity to evaluate the NS1 antigen, but it is noteworthy that all cases detected with flavivirus antibodies only had positive IgG in their results. The previous cases described in the existing literature may represent primary cases of dengue since they raised IgM values early.
\nIn our cases, the majority of patients did not show joint pain during the diagnosis of Guillain-Barre syndrome, which could suggest that these are non-acute cases, but as described in the case cited, this syndrome may occur during convalescence of the dengue; on the other hand, in an endemic area such as Lambayeque-Peru, the presence of cases with secondary infection that usually have low IgM values and not even increase it (Figure 5) should not attract attention [47]. In addition, Ramabhatta et al. [48] conducted a study on a sample of 568 cases diagnosed of dengue and showed that IgG-positive patients were more prone to complications than IgM-positive patients, therefore, the etiological association between dengue and Guillain-Barre syndrome in the Lambayeque region could not be ruled out.
\nIn 2014, according to WHO and Pan American Health Organization (PAHO), the average fatality rate for the Americas is 0.04%, being among the countries with the highest rate, followed by Dominican Republic with 1.54%, Peru with 0.12%, compared to Guatemala and Colombia that have 0.07% [49]. In Colombia and Peru, the most frequent serotype 2 prevailed, and in the Dominican Republic serotype 4 prevailed [50].
\nNationally, the Center for Epidemiology, Prevention and Control of Diseases of the Ministry of Health, reported in 2017, 76,093 cases of dengue in the country (3.03 times more cases in relation to 2016, and the largest number of cases reported in the last 5 years [9, 51] and 92 reports of deaths by dengue, the highest number reported in the last 10 years) (Figure 6).
\nDeath toll and dengue lethality in Peru, 2008–2017. Source: Metaxenic disease surveillance system of the Center for Epidemiology, Disease Prevention and Control of the Ministry of Health (CDC-Perú).
About 43.6% came from Piura, 17.1% from Loreto, 9.9% from Madre de Dios, 8.8% from Ucayali, 4.2% from San Martín, and the remaining 16.4% from other regions; all the age groups were affected, but with a greater proportion in people over 65 (37%) and young adults (21.7%) [9].
\nIn the Piura Healthcare Network, 30 deaths associated with dengue virus were confirmed by laboratory, and occurred between epidemiological weeks Nos. 08 and 35, over 8 months; a similar panorama reported by the Lambayeque Healthcare Network, which reported the death of six dengue-associated patients, until epidemiological week No. 20 [13, 52]; although this information could be underestimated, because in many cases it is attributed to pneumonia, and actually the cases of dengue are not properly diagnosed, causing figures not approximate to reality [53].
\nIn the departments of the north coast of Peru, such as Piura and Lambayeque, there are several conditions that favor the presence of epidemics, rainfall, and flooding due to the occurrence of the Coastal El Niño phenomenon, population growth at risk (young People, Urban Marginal Neighborhoods, etc) that is associated with the non-existence of basic infrastructure, insufficient water supply that leads to temporary water storage, constant circulation of
In the Healthcare Network of Piura, 22,562 cases of dengue were notified, 88 of which were severe dengue and 30 died, with 1.3% of lethality in general and 34.1% of lethality of severe cases; in Lambayeque there were 1384 cases; 13 being cases of severe dengue and nine deaths due to dengue, which makes 9.4% lethality in general and 43.3% lethality of severe cases, showing differences with national figures [37] (Table 3).
\nCountry | \nSerotype | \nN° dengue cases | \nN° severe cases | \nDeceased | \nGeneral lethality (×1000) | \nSevere cases lethality (×100) | \n
---|---|---|---|---|---|---|
South America | \n\n | 387,669 | \n1476 | \n318 | \n0.8 | \n21.5% | \n
Argentina | \nDEN 1,3 | \n557 | \n0 | \n0 | \n0.0 | \n0.0% | \n
Bolivia | \nDEN 1,4 | \n10,842 | \n66 | \n15 | \n1.4 | \n22.7% | \n
Colombia | \nDEN 1,2,3 | \n26,279 | \n286 | \n15 | \n0.6 | \n5.2% | \n
Chile | \nDEN 1,3 | \n10 | \n0 | \n0 | \n0.0 | \n0.0% | \n
Ecuador | \n— | \n11,387 | \n18 | \n4 | \n0.4 | \n22.2% | \n
Brazil | \nDEN 1,2,3,4 | \n252,054 | \n378 | \n133 | \n0.5 | \n35.2% | \n
Venezuela | \nDEN 1 | \n8615 | \n359 | \n16 | \n1.9 | \n4.5% | \n
Paraguay | \nDEN 1,2 | \n1832 | \n0 | \n0 | \n0.0 | \n0.0% | \n
Uruguay | \n— | \n0 | \n0 | \n0 | \n0.0 | \n0.0% | \n
Peru | \nDEN 2,3 | \n74,648 | \n251 | \n92 | \n1.2 | \n36.7% | \n
Essalud Piura* | \nDEN 2,3 | \n22,562 | \n88 | \n30 | \n1.3 | \n34.1% | \n
Essalud Lambayeque* | \nDEN 2,3 | \n1384 | \n30 | \n13 | \n9.4 | \n43.3% | \n
Although serotypes 2 and 3 were isolated in 94% of the positive cases; in Piura and Lambayeque, it was serotype 3 that was isolated in 90% of the cases and in almost all the deceased cases.
\nThe “delays” proposed by Thaddeus et al. in 1993, considered as the time between the appearance of a complication and its appropriate treatment and resolution, initiating these concepts in the framework of care for severe maternal mortality and morbidity evaluating them as autonomy factors for the search for medical care, distance, and health services [36]. The use of this approach is considered, since it would allow to identify and classify the barriers and situations related to the search for medical care in patients affected by dengue, which are part of a chain of delays or delays that would hinder risk prevention, limit the access to quality health services, and would result in the lack of timely attention to the complication and, consequently, in death [54].
\nPoor recognition of a clinical disorder is one of the factors that cause the delay in seeking attention. It includes deficiencies in health education for communities and families, which makes it difficult to recognize warning signs (signs and symptoms) in conditions that can be life-threatening [36].
\nThis delay is usually caused by limitations in the understanding of what medical care implies and could lead to a large number of patients arriving at health facilities in poor conditions, including factors such as information on dengue and institutional recognition, social and environmental situation, onset of symptoms, self-medication, gender and initial care, and motivations to make decisions [36, 55].
\nIt involves the difficulty of arriving at a health facility, either because of the difficult access to services or because it takes too long to reach the place of care, which can discourage the patient from seeking care, even when he has decided to seek care opportunely. It is generally the result of the lack of access to health services and economic, organizational, and sociocultural barriers which control the use of services. It is also possible to mention travel time, transport system used, and the socioeconomic impact of the delay [36, 55].
\nThe cumulative effect of the first and second delays helps increase the risk of arrival at the health facility in serious conditions. Some never arrive at the hospital, and even if they do, it is possible that the treatment given to them is not adequate and poor surveillance or administrative procedures hinder the care. Other studies have shown more causes for inadequate treatment: chronic lack of trained personnel and essential supplies. Other factors mentioned are: failures in the operation of the public network, which determines waiting, reconsultation, and family movements between institutions; poor staff training and high emergency saturation [36, 55].
\nIn relation to the first delay, aspects such as the delay in recognizing the health problem, absence of preventive-promotional talks, and lack of recognition of risk situations are described as the main ones, similar to studies that describe the population ignorance about the possibility of disease severity [56]. This last point reflects the poor knowledge by the population of less frequent dengue symptoms that in turn are associated with severity [57]. In the second delay, there are cases that went to non-health personnel and even self-medicating that are associated with delay as an explanation of serious or fatal cases [55, 58, 59] (Figure 7).
\nTimeline of delays in the process of care of lethal cases care of dengue in two hospitals of EsSalud, in the Departments of Piura and Lambayeque, during 2017. Taken from: Burga-Cueva et al. Analysis of Lethality by Dengue in two Essalud Hospitals, in the Departments of Piura and Lambayeque. 2017. [
In the third delay, limitations for access to health services are evidenced, and some are given references, but lack of economic resources or available transportation is evidenced, thus also describing the distance of health facilities (to go to the nearest one) [60]. Finally, the fourth delay involves aspects such as the time of transfer to establishments of greater resolving capacity and the waiting time of cases upon arrival in emergencies, as mentioned by Ardila et al. [55], who describe the feeling of discomfort generated by a new interrogation and the waiting time that involves admission to a health facility of greater complexity (Figure 7).
\nA study conducted in a population with a recent dengue outbreak showed that the level of knowledge was low in 76.2% of the population, 45% did not recognize the bite of the vector as the form of disease transmission, and 34% did not recognize the etiologic agent; of the most recognized clinical manifestations were fever, followed by headache, and musculoskeletal pain. Overall, 74.9% have a low level of knowledge about warning signs and about 93% were intermediate/low in prevention, and 43% of them are unaware of the reproduction of the vector, and 71% are unaware of the role of abate; results that show that the population despite having been exposed still does not know the prevention measures [61].
\nPAHO has planned to cooperate with member countries to stimulate the search for concrete solutions through a communication methodology to impact behavior (COMBI) [62, 63]. It should be noted that, since the introduction of dengue in America, attempts have been made to propose some integrated programs, with a community approach to the control of
Nevertheless, this improvement of the cognitive level related to the disease has not resulted in the action of preventing the disease. In this sense, even though people in a region with dengue endemicity are very well versed in the disease, they do not implement these measures that they know control vector proliferation and therefore the transmission of dengue; therefore, it is essential to reorient educational programs focused on the behavioral change of the population [66].
\nLikewise, historically in the region, efforts to control dengue vectors resulted in the elimination of populations of
It should be noted that keeping infestation with
Another preventive measure to control the rapid spread of an outbreak is to manage the infected human host and prevent it from infecting
In that sense, success in reducing the burden of dengue on public health will require an integrated multiple approach; although the concept of integrated intervention for dengue prevention is gaining increasing acceptance, to date, no consensus has been reached regarding the details of how and what combination of approaches can be implemented most effectively to control the disease [75].
\nIntegrated vector management, the strategic method promoted by WHO, is defined as, “a rational decision-making process for the optimal use of resources for vector control,” which includes lobbying, social mobilization, and legislation; planning and delegated decision-making at the lowest possible administrative level; guaranteeing the rational use of available resources; adaptation of strategies and interventions based on vector habitat, epidemiology, and local resources; and development of an essential infrastructure for integrated vector management based on the situation analysis [67].
\nHowever, the discipline of vector control has been strongly influenced by the theory developed by Ronald Ross and George Macdonald (i.e., the Ross-Macdonald model), which states that the potential for transmission of mosquito-borne pathogens depends largely on the abundance of adult vector mosquitoes, survival through the incubation period of the pathogen, and the rate of human infection [76].
\nTherefore, with this approach, interventions that reduce the population density of adult mosquitoes, the daily probability of survival, and the contact of the mosquito with humans are expected to have the greatest impact on decreasing virus transmission. It should be noted, however, that the Ross-Macdonald model was not formulated to specifically explore larval mosquito control. Recent quantitative assessments indicate that, under certain circumstances, control of the larvae may lead to greater than expected reductions in the transmission of pathogens [77]. In the context of larval control of
In this context, taking into account that there is limited efficacy and intensity of the interventions used for dengue vector control, other alternatives to combat dengue endemic persistence are explored. Sustainable community participation and school-based health education interventions have finally evolved as an effective tool in reducing the larval source over other interventions [78], since children have inherent curiosity and enthusiasm to learn new things. Therefore, they can serve as an effective change agent to achieve a change in behavior in the family and community.
\nMethods for vector control include elimination or management of larval habitats, eliminating larvae with insecticides, the use of biological agents, and the application of adulticides; being for our conviction the elimination and management of larval habitats. Habitats are eliminated by preventing the access of mosquitoes to these containers or by emptying and cleaning them frequently, eliminating the evolutionary stages with the use of insecticides or biological control agents, eliminating adult mosquitoes with insecticides, or by combining these methods [79].
\nHabitat management seeks to change the environment in order to prevent or minimize the propagation of vectors and human contact with the vector pathogen, destroying, altering (proper conservation of disused material), and eliminating or recycling nonessential containers that serve as larval habitats. Efforts to reduce solid waste should be directed against disposable or nonessential containers [78].
\nHowever, the main method of
\n | |||
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Individuals and households | \n\n
| \n\n
| \n\n
| \n
Communities, community groups, schools, NGOs | \n\n
| \n\n
| \n\n
| \n
Comprehensive behavioral monitoring of mobilization and social communication for dengue prevention and control.
Due to inadequate dengue surveillance systems, spraying does not arrive in time to prevent epidemic transmission, and adult mosquito populations return quickly after spraying. Public confidence and complacency regarding such an ineffective approach have only made the challenge of explaining the need for community participation in hatchery control greater [79].
\nTherefore, our approach, which is the most cost-effective measure to control the transmission of dengue, would be based on the design and execution of activities aimed at eradicating vector proliferation through the elimination of favorable habitats (potential hatcheries: tires, bottles, and buckets) for oviposition and allowing the development of the aquatic stages of the vector; with a participatory methodology based on the sociocultural characteristics of the population under study, with the local schools as main actors; for which, at first, the level of knowledge, attitude, and practice of dengue prevention measures of the population must be determined and from which it will design and carry out promotional, prevention interventions, with emphasis on behavioral changes.
\nFinally, the need for a good understanding and emphasis on behaviors related to the management of
Taken from: Parks W, Lloyd L. COMBI. Planning social mobilization and communication for the prevention and control of dengue. Ginebra; 2004 [65].
\nAtrial fibrillation (AF) and heart failure (HF) commonly coexist that frequently complicate one another and exert a significant detrimental effect on cardiovascular health and well-being [1]. Altered left ventricular (LV) functions may be the substrate for most HF spectrum, heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF), but in some instances, HFpEF may be the consequence of a failing left atrium (LA) including AF. It is believed that AF can induced and worsened HF due to: (1) elevated resting heart rate and exaggerated response during exercise result in reduction of diastolic filling time, leading to cardiac output reduction. Irregularity of the ventricular response will affect the cardiac output even further [2]. (2) Heart rate irregularity with calcium mishandling, even in AF with the absence of tachycardia we can observe potential deleterious interaction of AF and LV function; (3) loss of atrial contraction associated with sympathetic activation contributing to limited ventricular filling and increased filling pressures, functional mitral regurgitation, and diastolic function [3, 4]. Studies in AF patients have shown the atria structural remodeling changes; however, the impact of arrhythmia chronicity and the structural remodeling is not well understood; adaptive (dedifferentiation of cardiomyocytes) and maladaptive (degeneration of cells with replacement fibrosis) features are the changes mainly concern [5].
Management strategy of rate or rhythm control strategy has been thoroughly discussed over the last decades. Rate control strategy is considered as first-line therapy in most AF; however, the evidence keeps evolving. The decision to treat AF with a rate versus rhythm control strategy depends on multiple factors, including: medical comorbidities, age, and lifetime exposure to the risks and side effects of treatments; the duration and type of AF; and concomitant medications. Based on recent clinical trials, treatment strategies for patients with AF are increasingly focused on rhythm control by catheter ablation compared with rate control therapy [1, 3]. This chapter will discuss each strategy further.
AF is frequently considered a primary cause of arrhythmia-induced cardiomyopathy. AF by itself in the absence of tachycardia causes impaired excitation-contraction coupling associated with increased levels of reactive oxygen species and CaMKII-dependent depression of systolic Ca2+ release, clinically frequently observed as impaired ventricular function [3]. Furthermore, limited evidence suggests that controlled ventricular rate during AF does not predict the reversibility of cardiomyopathy. This has raised the question whether well-controlled heart rate in AF can reverse this process. However, early studies failed to demonstrate rhythm control superiority over rate control strategy [4, 6].
Traditionally rate control strategy is the primary option in AF with or without HF [7, 8]. AFFIRM is the landmark trial to exposed rhythm control strategy and offers no survival benefit over rate control strategy while more adverse drug effects were also seen. These findings were later confirmed by other studies [6, 9]. Nevertheless, extrapolation from these studies to patients with HF should be done with caution.
In patients with HF, similar results were also observed in landmark AF trials. AF-CHF (rhythm control vs. rate control for atrial fibrillation and heart failure) trial was the first randomized study to examine the effect of rate versus rhythm control strategy in a heart failure population; it showed pharmacological rhythm control is not superior to rate control for the prevention of cardiac death and hospitalization for heart failure, therefore extends the findings of AF without HF. Of note, most of these trials were performed before the era of catheter ablation for AF. The need for effective therapy to maintain sinus rhythm while minimizing toxicity is the highlight of the difficulty with currently available antiarrhythmic drug (AAD) [2, 4, 10, 11]. Nevertheless, up-to-date rate control strategy remained as first option in AF with HF.
There are several atrioventricular nodal blockers that can be used to obtain rate control; beta-blockers, non-dyhidropyridine calcium channel blockers, cardiac glycosides, and (in rare circumstances) low-dose amiodarone. Pharmacological rate control strategies are different for patients with HFrEF and HFpEF.
Beta-blockers and digoxin can be used in those with HFrEF. Beta-blockers are well known as of the HFrEF management pillars, suited well in HF with AF comorbidity. Beta-blockers may both control the ventricular rate to AF and improve survival of HFrEF. A meta-analysis showed that the effect of beta-blockers on outcome in HF patients with reduced left ventricular ejection fraction (LVEF) who have AF is less than in those who have sinus rhythm. This result does not suggest that there is no benefit of beta-blockers in HF and AF, but rather highlights the benefits of sinus rhythm in patients with HF [8, 12, 13]. Digoxin slows ventricular response to AF through enhancement of vagal tone and therefore is less effective in states of increased sympathetic tone such as exercise or worsening heart failure. However, digoxin may be used as adjunct therapy to beta-blockers as it exerts a synergistic effect with beta-blockers after single therapeutic option failed to achieve optimal target heart rate. Of note, digoxin should be used with caution because of its potential deleterious effects [2, 7, 14, 15].
The non-dihydropyridine calcium-channel blockers include diltiazem and verapamil, beta-blockers, and digoxin are all viable options in HFpEF. The non-dihydropyridine calcium-channel blockers are effective rate control agents; however, because of their negative inotropic effect, they may be not tolerated at optimal dose required for optimal ventricular rate control and increased mortality in HFrEF. Beta-blockers were more successful than calcium-channel blockers in achieving rate control (70% vs. 54%, consecutively) when used alone or in combination with digitalis. Amiodarone is also another option for rate control in both forms of HF, but limited only to acute settings [1, 8, 16].
Optimal target heart rate in AF is informed by several factors, including symptom management, optimization of functional capacity, and preventing HF exacerbation and tachycardia-induced cardiomyopathy. High ventricular rates are clearly harmful and can result in symptoms and especially in patients with preexisting HF [17]. The decision to use of strict or lenient as optimal level of heart rate control in AF and HF is essential in management strategy.
A major concern with lenient heart rate control is the decompensation episode of HF may occur; however, this concern was not confirmed [18]. Strict rate control cannot be advocated over lenient rate control for patients with preserved LV function; however, it potentially offers clinical benefit in patients with AF and HFrEF, but this remains unproven. The latest European Society of Cardiology (ESC) guidelines recommend a lenient rate control of <100–110 bpm as initial approach; however, tight rate control strategy can be considered in case with persistent symptoms or cardiac dysfunction likely related to tachycardia. It should be noted that these criteria were not based on strong clinical evidence [7, 8].
Atrioventricular node ablation with permanent pacemaker placement remains an important option, it should be undertaken with caution. One concern of pharmacological rate and rhythm control strategies is the risk of pauses or symptomatic bradycardia during AF or at the time of AF conversion to sinus (conversion pauses). Another common scenario is patient coexists with sinus node dysfunction, a permanent pacemaker is usually required during significant bradycardia [1, 19].
Effective rate control is often hard to achieve in patients with or without pacemaker in situ. In patients without pacemaker, symptomatic pauses during AF or at the time of conversion of paroxysmal AF to sinus rhythm make effective rate control not possible. Ineffectiveness of rate controlling drugs or intolerance to the drugs at doses that result in adequate rate control is indication for the use of permanent pacemaker. In these strategies, combination of AV nodal radiofrequency ablation and permanent pacemaker implantation can be performed as definitive strategy with a high success rate [19, 20].
In patients with symptomatic AF and rapid ventricular response refractory to pharmacological therapy, radiofrequency atrioventricular nodal ablation with subsequent pacemaker placement can improve cardiac performance. In the subgroup of patients with heart failure, the degree of improvement for LVEF and NYHA class was even greater [21]. However, long-term outcomes of the “pace and ablate” strategy have been less favorable [22]. AV nodal ablation typically results in nearly 100% right ventricular (RV) pacing, which can induce ventricular dyssynchrony and worsen systolic function. A large body of evidence has emerged recently that underscores the harmful effects of long-term right ventricular pacing.
A study showed that patients who underwent AV nodal ablation with cardiac resynchronization (CRT) achieved significantly better symptomatic relief with improvement in their LV function [23]. The CRT impact on new onset AF is controversial. CRT can reverse the remodeling of the ventricle, improve the regurgitation of the mitral valve, and theoretically reduce the incidence of new-onset AF [2]. Recently, multiple studies showed conduction system pacing (His bundle pacing and left bundle branch area pacing) is not inferior to CRT. However, the current evidence of conduction system pacing is still limited and neither has been evaluated as robustly as CRT [24, 25, 26]. AV nodal ablation in the presence of let bundle branch area pacing lead is associated with a higher success rate and fewer acute and chronic lead related complications compared with His bundle pacing [27].
AV nodal ablation and pacing for patients with AF have not been found to worsen survival in comparison with drug therapy for AF [28]. Unfortunately, this pace and ablate strategy results in permanent pacemaker dependence and irreversible. It should be performed only as a last resort when other rate and/or rhythm control strategies have been failed or are contraindicated.
Previous trials cast skepticism over the hard end point benefit of sinus-rhythm maintenance in patients with and without heart failure. Trials including patients with HF and comparing rate control and rhythm control strategies with the pharmacological approach failed to show mortality benefit of one strategy over the other [10, 29]. Consequently, previous guidelines have limited recommendations for catheter ablation (CA) in patients with HF: when tachycardiomyopathy is suspected, with pharmacological rate control the accepted standard treatment [30].
CA for AF has emerged as alternative strategy to pharmacological rhythm control, as it significantly reduces the risk of death, stroke, and hospitalization compared with medical therapy alone [13, 31, 32]. It is a well-established option for symptomatic AF that is resistant to drug therapy in patients with otherwise normal cardiac function [8].
EAST-AFNET 4 (Early Treatment of Atrial Fibrillation for Stroke Prevention Trial) has emphasized that aggressive rhythm control (with either CA or drugs) early in the course of AF reduced adverse cardiovascular outcomes compared with usual care. The effects of an early rhythm-control strategy on the primary outcome appeared to be generally consistent across predefined subgroups, including patients with or without HF [33].
In the field of CA in HF, various studies have shown that ablation is associated with positive outcomes in patients with HF. Important to note is that initial series were often single-center studies that included a limited number of patients with limited follow-up, and its effectiveness in improving rates of hard primary end points such as death or the progression of HF was not tested [34, 35]. More recently, larger trials with substantial longer duration of follow-up and cardiovascular endpoints as well as sinus rhythm maintenance have been conducted.
AF-CHF and DIAMOND-CHF trials found no difference in mortality between AAD therapy and rate control. The mortality benefit of AADs in previous trials may have been limited by their adverse effects [10, 29]. AADs may not be as efficacious as catheter ablation in providing freedom from AF in patients with HF, and there is increasing evidence that the maintenance of sinus rhythm is the key determinant of survival [11].
Several trials have reported improvements in soft end points with catheter ablation. The AATAC and CAMTAF trials showed that CA was superior to medical treatment in maintaining sinus rhythm and improving LVEF. The trial also showed a favorable effect on rates of death and hospitalization for HF [36, 37].
CASTLE-AF is notable because previous trials comparing CA versus standard medical therapy predominantly reported improvement in soft endpoints (symptoms, QOL, or surrogate endpoints). In the CASTLE-AF trial, ablation for AF in HF was superior to medical therapy in reducing composite death and hospitalization. The benefit of all-cause mortality in the ablation group was driven by lower rate of cardiovascular mortality. The mortality benefit of ablation did not emerge until after 3 years. Pursuing rhythm control with catheter ablation proved to be of significant benefit with regard to outcomes [38].
However, CASTLE-AF enrolled a highly selected population, 363 of 3013 patients were not blinded, had crossovers between the two treatment strategies, and the number of events observed was low. Both CASTLE-AF and CABANA showed a highly significant effect of catheter ablation on patients’ symptoms [38, 39, 40].
CASTLE-AF trial’s results are likely driven by two factors: Firstly, CA procedural risks have fewer risks and long-term toxicities than medical therapy. Secondly, ablation is more effective in reducing AF burden. One of the proposed mechanisms behind the improvement in prognosis in the patients treated with CA is that it significantly reduced total AF burden. Post-hoc analysis showed that AF burden below 50% after 6 months of CA was associated with an improved outcome. Another potential explanation is that part of the patients had a tachycardiomyopathy. Longer periods of sinus rhythm may, therefore, be a mechanism to improve outcome eventually [11, 38].
Furthermore, the absence of ventricular LGE on cardiac MRI imaging was associated with a greater improvement in LVEF and a higher likelihood of normalization of left ventricular function. These findings indicate that in these patients, AF may either significantly contribute to, or indeed be entirely responsible for, ventricular dysfunction [13]. Meta-analyses showed that AF ablation was associated with average LVEF improvement ranged between 11% and 13% illustrating the advantage of AF ablation. Improvement in LVEF was most pronounced in patients with non-ischemic cardiomyopathy [41, 42, 43].
Another interesting observation was seen in AF and HFpEF. Both conditions shared similar risk factors, including hypertension, sleep apnea, advanced age diastolic dysfunction, and obesity. The prevalence of HFpEF in AF ranges from 8% to 24%, and AF was found in ~20–30% patients with HFpEF [40]. Restoration and maintenance of sinus rhythm in patients with comorbid AF and HFpEF improve hemodynamic parameters, BNP, and symptoms associated with HFpEF [44].
Understanding and identification of drug deleterious effects are also another important issue for management consideration. Digoxin’s ability to reduce heart rate and improving LV function is very tempting; however, digoxin’s potential deleterious effects such as arrhythmogenic potential, narrow therapeutic window, increased sympathetic activity, and risk for serious drug interaction. A meta-analysis of nonrandomized trials showed digoxin used in HF and AF is associated with an increased risk of all-cause mortality [15]. Moreover, the use of pharmacological rhythm control also brings risk. Amiodarone carries the risk of thyroid, pulmonary, and hepatic toxicity. Dofetilide therapy is also known for prolonging QT interval and higher rate of torsade de pointes [45, 46].
Biventricular pacing was found to be superior to right ventricular pacing after atrioventricular-node ablation [47]. However, PABA-CHF trial has shown that CA for AF provides superior morphological and functional improvements compared with atrioventricular-node ablation with biventricular pacing in patients with HF who had drug-refractory AF [20].
The improvement in LVEF observed following CA may largely be dependent on successful rhythm restoration, rather than the mode of restoration, which enables regular ventricular filling time and coordinated atrial contraction [46]. CA by pulmonary vein isolation (PVI) is proven as the best technique for AF ablation, as no proven benefit shown by additional ablation.
After Haissaguerre et al. found that radiofrequency ablation on PV is efficient in treating AF in 1998, no additional ablation technique (posterior wall ablation, linear lines or ablation of complex fractional aytrial electrograms) has been proven consistently to improve ablation efficacy; however, additional ablation can be done up to the operator’s discretion. Future research endeavors should be performed into the field of high-power short duration, pulsed field ablation, and hybrid/convergent AF ablation strategies in patients with AF and HF [11, 48].
In selecting patients with HF for catheter ablation of AF, the increased risk of major peri-procedural events must be carefully weighed against the potential improvement in systolic function, quality of life, and functional status.
AF ablation can be performed safely and long-term prognosis can improve, especially in patients with a tachycardiomyopathy, that is, without other demonstrable underlying heart disease. Based on the post-hoc analysis of CASTLE-AF, patients with NYHA I/II and non-ischemic etiology of HF appear to benefit the most, suggesting that early intervention might be beneficial [49].
Furthermore, enlargement of the atria and evidence of fibrosis on CMR are an indication of poor candidate for CA. A trial of cardioversion with electrical cardioversion and/or amiodarone can be used if there is a doubt whether patients may benefit from sinus rhythm [11].
There are small but nonzero procedural risks that must be taken into account when considering CA, including risks of stroke (0.5–1%) and tamponade (1–2%); however, a second ablation is frequently required [1]. CA for AF and HF was performed at centers with experienced ablationists in most landmark trials, and the results thus may not be reproducible in all centers [20].
In the management of AF in HFrEF, there is insufficient evidence in favor of a strategy of rhythm control with antiarrhythmic drugs vs. rate control in patients with HF and AF. Pharmacological rate control strategy remained as leading option in AF and HF. More evidence is needed to weigh the short-term risks of catheter ablation versus the long-term risks associated with antiarrhythmic therapy in those with AF and HFrEF. Notably, this has led to recent guideline changes suggesting that CA may be considered as first-line therapy in patients with AF and HFrEF (Class I recommendation). Pace and ablate option should be keep as last resort, because this becomes pacemaker-dependent and irreversible. Conduction system pacing as alternative pacing site in AF and HF should be an interesting area to watch in the future. On the other hand, pharmacological approach remained as preferred strategy in HFpEF; non-dihydropyridine calcium-channel blockers are the additional alternative medication compared with HFrEF. Evidence on nonpharmacological approach for AF in HFpEF is still limited.
"Open access contributes to scientific excellence and integrity. It opens up research results to wider analysis. It allows research results to be reused for new discoveries. And it enables the multi-disciplinary research that is needed to solve global 21st century problems. Open access connects science with society. It allows the public to engage with research. To go behind the headlines. And look at the scientific evidence. And it enables policy makers to draw on innovative solutions to societal challenges".
\n\nCarlos Moedas, the European Commissioner for Research Science and Innovation at the STM Annual Frankfurt Conference, October 2016.
",metaTitle:"About Open Access",metaDescription:"Open access contributes to scientific excellence and integrity. It opens up research results to wider analysis. It allows research results to be reused for new discoveries. And it enables the multi-disciplinary research that is needed to solve global 21st century problems. Open access connects science with society. It allows the public to engage with research. To go behind the headlines. And look at the scientific evidence. And it enables policy makers to draw on innovative solutions to societal challenges.\n\nCarlos Moedas, the European Commissioner for Research Science and Innovation at the STM Annual Frankfurt Conference, October 2016.",metaKeywords:null,canonicalURL:"about-open-access",contentRaw:'[{"type":"htmlEditorComponent","content":"The Open Access publishing movement started in the early 2000s when academic leaders from around the world participated in the formation of the Budapest Initiative. They developed recommendations for an Open Access publishing process, “which has worked for the past decade to provide the public with unrestricted, free access to scholarly research—much of which is publicly funded. Making the research publicly available to everyone—free of charge and without most copyright and licensing restrictions—will accelerate scientific research efforts and allow authors to reach a larger number of readers” (reference: http://www.budapestopenaccessinitiative.org)
\\n\\nIntechOpen’s co-founders, both scientists themselves, created the company while undertaking research in robotics at Vienna University. Their goal was to spread research freely “for scientists, by scientists’ to the rest of the world via the Open Access publishing model. The company soon became a signatory of the Budapest Initiative, which currently has more than 1000 supporting organizations worldwide, ranging from universities to funders.
\\n\\nAt IntechOpen today, we are still as committed to working with organizations and people who care about scientific discovery, to putting the academic needs of the scientific community first, and to providing an Open Access environment where scientists can maximize their contribution to scientific advancement. By opening up access to the world’s scientific research articles and book chapters, we aim to facilitate greater opportunity for collaboration, scientific discovery and progress. We subscribe wholeheartedly to the Open Access definition:
\\n\\n“By “open access” to [peer-reviewed research literature], we mean its free availability on the public internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from gaining access to the internet itself. The only constraint on reproduction and distribution, and the only role for copyright in this domain, should be to give authors control over the integrity of their work and the right to be properly acknowledged and cited” (reference: http://www.budapestopenaccessinitiative.org)
\\n\\nOAI-PMH
\\n\\nAs a firm believer in the wider dissemination of knowledge, IntechOpen supports the Open Access Initiative Protocol for Metadata Harvesting (OAI-PMH Version 2.0). Read more
\\n\\nLicense
\\n\\nBook chapters published in edited volumes are distributed under the Creative Commons Attribution 3.0 Unported License (CC BY 3.0). IntechOpen upholds a very flexible Copyright Policy. There is no copyright transfer to the publisher and Authors retain exclusive copyright to their work. All Monographs/Compacts are distributed under the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Read more
\\n\\nPeer Review Policies
\\n\\nAll scientific works are Peer Reviewed prior to publishing. Read more
\\n\\nOA Publishing Fees
\\n\\nThe Open Access publishing model employed by IntechOpen eliminates subscription charges and pay-per-view fees, enabling readers to access research at no cost. In order to sustain operations and keep our publications freely accessible we levy an Open Access Publishing Fee for manuscripts, which helps us cover the costs of editorial work and the production of books. Read more
\\n\\nDigital Archiving Policy
\\n\\nIntechOpen is committed to ensuring the long-term preservation and the availability of all scholarly research we publish. We employ a variety of means to enable us to deliver on our commitments to the scientific community. Apart from preservation by the Croatian National Library (for publications prior to April 18, 2018) and the British Library (for publications after April 18, 2018), our entire catalogue is preserved in the CLOCKSS archive.
\\n\\nOpen Science is transparent and accessible knowledge that is shared and developed through collaborative networks.
\\n\\nOpen Science is about increased rigour, accountability, and reproducibility for research. It is based on the principles of inclusion, fairness, equity, and sharing, and ultimately seeks to change the way research is done, who is involved and how it is valued. It aims to make research more open to participation, review/refutation, improvement and (re)use for the world to benefit.
\\n\\nOpen Science refers to doing traditional science with more transparency involved at various stages, for example by openly sharing code and data. It implies a growing set of practices - within different disciplines - aiming at:
\\n\\nWe aim at improving the quality and availability of scholarly communication by promoting and practicing:
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The Open Access publishing movement started in the early 2000s when academic leaders from around the world participated in the formation of the Budapest Initiative. They developed recommendations for an Open Access publishing process, “which has worked for the past decade to provide the public with unrestricted, free access to scholarly research—much of which is publicly funded. Making the research publicly available to everyone—free of charge and without most copyright and licensing restrictions—will accelerate scientific research efforts and allow authors to reach a larger number of readers” (reference: http://www.budapestopenaccessinitiative.org)
\n\nIntechOpen’s co-founders, both scientists themselves, created the company while undertaking research in robotics at Vienna University. Their goal was to spread research freely “for scientists, by scientists’ to the rest of the world via the Open Access publishing model. The company soon became a signatory of the Budapest Initiative, which currently has more than 1000 supporting organizations worldwide, ranging from universities to funders.
\n\nAt IntechOpen today, we are still as committed to working with organizations and people who care about scientific discovery, to putting the academic needs of the scientific community first, and to providing an Open Access environment where scientists can maximize their contribution to scientific advancement. By opening up access to the world’s scientific research articles and book chapters, we aim to facilitate greater opportunity for collaboration, scientific discovery and progress. We subscribe wholeheartedly to the Open Access definition:
\n\n“By “open access” to [peer-reviewed research literature], we mean its free availability on the public internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from gaining access to the internet itself. The only constraint on reproduction and distribution, and the only role for copyright in this domain, should be to give authors control over the integrity of their work and the right to be properly acknowledged and cited” (reference: http://www.budapestopenaccessinitiative.org)
\n\nOAI-PMH
\n\nAs a firm believer in the wider dissemination of knowledge, IntechOpen supports the Open Access Initiative Protocol for Metadata Harvesting (OAI-PMH Version 2.0). Read more
\n\nLicense
\n\nBook chapters published in edited volumes are distributed under the Creative Commons Attribution 3.0 Unported License (CC BY 3.0). IntechOpen upholds a very flexible Copyright Policy. There is no copyright transfer to the publisher and Authors retain exclusive copyright to their work. All Monographs/Compacts are distributed under the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Read more
\n\nPeer Review Policies
\n\nAll scientific works are Peer Reviewed prior to publishing. Read more
\n\nOA Publishing Fees
\n\nThe Open Access publishing model employed by IntechOpen eliminates subscription charges and pay-per-view fees, enabling readers to access research at no cost. In order to sustain operations and keep our publications freely accessible we levy an Open Access Publishing Fee for manuscripts, which helps us cover the costs of editorial work and the production of books. Read more
\n\nDigital Archiving Policy
\n\nIntechOpen is committed to ensuring the long-term preservation and the availability of all scholarly research we publish. We employ a variety of means to enable us to deliver on our commitments to the scientific community. Apart from preservation by the Croatian National Library (for publications prior to April 18, 2018) and the British Library (for publications after April 18, 2018), our entire catalogue is preserved in the CLOCKSS archive.
\n\nOpen Science is transparent and accessible knowledge that is shared and developed through collaborative networks.
\n\nOpen Science is about increased rigour, accountability, and reproducibility for research. It is based on the principles of inclusion, fairness, equity, and sharing, and ultimately seeks to change the way research is done, who is involved and how it is valued. It aims to make research more open to participation, review/refutation, improvement and (re)use for the world to benefit.
\n\nOpen Science refers to doing traditional science with more transparency involved at various stages, for example by openly sharing code and data. It implies a growing set of practices - within different disciplines - aiming at:
\n\nWe aim at improving the quality and availability of scholarly communication by promoting and practicing:
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Sunnapwar"}]},{id:"43383",title:"Improving Operations Performance with World Class Manufacturing Technique: A Case in Automotive Industry",slug:"improving-operations-performance-with-world-class-manufacturing-technique-a-case-in-automotive-indus",totalDownloads:26585,totalCrossrefCites:11,totalDimensionsCites:23,abstract:null,book:{id:"3216",slug:"operations-management",title:"Operations Management",fullTitle:"Operations Management"},signatures:"Fabio De Felice, Antonella Petrillo and Stanislao Monfreda",authors:[{id:"161682",title:"Prof.",name:"Fabio",middleName:null,surname:"De Felice",slug:"fabio-de-felice",fullName:"Fabio De Felice"},{id:"167280",title:"Dr.",name:"Stanislao",middleName:null,surname:"Monfreda",slug:"stanislao-monfreda",fullName:"Stanislao Monfreda"},{id:"181603",title:"Dr.",name:"Antonella",middleName:null,surname:"Petrillo",slug:"antonella-petrillo",fullName:"Antonella Petrillo"}]},{id:"63005",title:"Industry 3.0 to Industry 4.0: Exploring the Transition",slug:"industry-3-0-to-industry-4-0-exploring-the-transition",totalDownloads:1803,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"This work is a How-To-Guide for DigitALIZAtion of Industry 4.0 Manufacturing. It provides a novel ALIZA Canvas and ALIZA Process supported by a comprehensive ALIZA Toolset. This output is derived from observed, tangible deficiencies in contemporary functional communications in manufacturing. This study proposes an innovative approach with robust methodologies for strategic alignment of the technical and business components in manufacturing. The requirement for a supplementary educational infrastructure, to address the pronounced educational shortcomings and knowledge gaps in the transition to Industry 4.0 is outlined. An explanation is provided of how E-Cubers (our own educational organization) will design, develop, and deliver educational programmes on Topics relevant to achieving Industry 4.0 Equipment Engineering Excellence. It defines and tests the novel concept of the E-Cubers Eight Ps; encompassing prioritized problem solving, via portfolios and projects, through peer collaboration within a defined technology playground with emphasis on learning and playing with passion. The E-Cubers Eight Ps is combined with The E-Cubers Library to deliver a truly comprehensive specialist, national learning framework. This holistic approach will ultimately enable Ireland to lead the way in Industry 4.0 by doing what we do best “ag spraoi agus ag imirt” (Gaelic – playing by having fun and competing).",book:{id:"7436",slug:"new-trends-in-industrial-automation",title:"New Trends in Industrial Automation",fullTitle:"New Trends in Industrial Automation"},signatures:"Shane Loughlin",authors:null}],onlineFirstChaptersFilter:{topicId:"119",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"1082338",title:"Capacitated Clustering Models to Real Life Applications",slug:null,totalDownloads:5,totalDimensionsCites:0,doi:"10.5992/intechopen.1000213",abstract:'
This chapter considers the use of different capacitated clustering problems and models that fits better in real-life applications such as household waste collection, IT teams layout in software factories, wholesales distribution, and staff’s home collection or delivery to/from workplace. Each application is explored in its regular form as it is being developed by contractors and/or users. We consider for each application the aspects of solving the problem by the appropriate mathematical programming model and decision support methodology (using aggregated Geographical Information System and mobile technology) to hold correctly and most precisely the problems and difficulties related to instances in evaluation. The experience on these fields is here revealed in detailed form as the results obtained by using the techniques here explained.
',book:{id:"11082",title:"Operations Management",coverURL:"https://cdn.intechopen.com/books/images_new/11082.jpg"},signatures:"Marcos J. Negreiros, Nelson Maculan, Augusto W.C. Palhano, Albert E.F. Muritiba and Pablo L.F. Batista"},{id:"81676",title:"Multiscale Modeling Framework for Defect Generation in Metal Powder Bed Fusion Process to Correlate Process Parameters and Structural Properties",slug:"multiscale-modeling-framework-for-defect-generation-in-metal-powder-bed-fusion-process-to-correlate-",totalDownloads:10,totalDimensionsCites:0,doi:"10.5772/intechopen.104493",abstract:"Powder Bed Fusion (PBF) is one of the most popular additive manufacturing methods employed extensively to fabricate complex parts especially in industries with stringent standard criteria, including aerospace, medical, and defense. DMLS/PBF fabrication of parts that is free of defects represents major challenges. A comprehensive study of thermal defects, contributing parameters, and their correlation is necessary to better understand how process specifications initiate these defects. Monitoring & controlling temperature and its distribution throughout a layer under fabrication is an effective and efficient proxy to controlling process thermal evolution, which is a completely experimental technique. This being highly costly specifically for metal printing, computer-based numerical simulation can significantly help the identification of temperature distribution during the printing process. In this paper, a multiscale modeling technique is demonstrated with commercially available software tools to correlate the defect generation in metal PBF process and significant process parameters. This technique can help efficiently design the process setting in addition to or even absence of experimental monitoring data. This research work is a part of a larger project of closed-loop control strategy development using physics-based modeling and graph-based artificial neural network implementation for reducing thermally induced part defects in metal 3D printed process.",book:{id:"11171",title:"Trends and Opportunities of Rapid Prototyping Technologies",coverURL:"https://cdn.intechopen.com/books/images_new/11171.jpg"},signatures:"Suchana Akter Jahan and Hazim El-Mounayri"},{id:"1089787",title:"Differences between Universal-Deterministic and Probabilistic Hypotheses in Operations Management Research",slug:null,totalDownloads:4,totalDimensionsCites:0,doi:"10.5992/intechopen.1000218",abstract:'Very few papers in the operations management (OM) field have taken the themes of universal-deterministic (UD) and probabilistic hypotheses as their main topics of investigation and discussion. Our investigation continues a recent line of research that focuses on a better understanding of these critical issues. Specifically, we attempt to respond to some pointed criticisms that experts in the field have made when the topic UD and probabilistic hypotheses have emerged in academic settings/discussions. A detailed analysis of those criticisms shows that they lack merit, thereby reinforcing our argument that it is most important to distinguish between the two types of scientific hypotheses in order to advance in the rigor of OM theoretical and empirical research. Ideas for future research are outlined.
',book:{id:"11082",title:"Operations Management",coverURL:"https://cdn.intechopen.com/books/images_new/11082.jpg"},signatures:"Roberto Sarmiento"},{id:"1083885",title:"Design and Planning Robust and Competitive Supply Chains",slug:null,totalDownloads:5,totalDimensionsCites:0,doi:"10.5992/intechopen.1000208",abstract:'In recent years, supply chains in the manufacturing industry have become more and more complicated, and many cases of supply chain disruptions due to natural disasters have been confirmed. It is necessary for manufacturers to build a system that can help them alleviate losses and shorten recovery periods due to supply chain disruptions. Supplier diversification, as well as supplier evaluation and selection, are discussed as risk aversion measures in many papers. However, even if the procurement source has been evaluated enough, there are problems, such as opportunity loss during recovery periods and soaring procurement costs during normal periods. In this chapter, to help Japanese manufacturers to alleviate opportunity loss under component procurement disruption situations and keep cost competitiveness in normal periods, decision-making models of supply chain structure assessment, supplier selection, procurement allocation, and trading contracts are designed and verified.
',book:{id:"11082",title:"Operations Management",coverURL:"https://cdn.intechopen.com/books/images_new/11082.jpg"},signatures:"Kotomichi Matsuno, Jiahua Weng, Noriyuki Hosokawa and Takahiro Ohno"},{id:"1085055",title:"Performance Measurement Using Deterministic and Stochastic Multiplicative Directional Distance Functions",slug:null,totalDownloads:5,totalDimensionsCites:0,doi:"10.5992/intechopen.1000179",abstract:'Performance measurement is essential for fostering continuous improvement of the production and operation management in a firm or organization. We consider a deterministic scenario based on a flexible structure of production technology and establish a multiplicative relationship between the generalized multiplicative directional distance function (GMDDF) and geometric distance function (GDF). We also introduce a stochastic multiplicative directional distance function (SMDDF). Based on a stochastic scenario, the SMDDF can be estimated by the method of convex nonparametric least squares. As an illustrative application, we investigate the productive performance of Japanese life insurance companies using a panel dataset spanning 2016 to 2020.
',book:{id:"11082",title:"Operations Management",coverURL:"https://cdn.intechopen.com/books/images_new/11082.jpg"},signatures:"Yu Zhao"},{id:"1085559",title:"Assessment of Medical Equipment Maintenance Management",slug:null,totalDownloads:21,totalDimensionsCites:0,doi:"10.5992/intechopen.1000210",abstract:'Today's modern hospital is highly dependent on different types of medical equipment to help diagnose, monitor, and treat patients. Medical equipment maintenance is important to reduce costs, reduce patient dissatisfaction, treat the patient in a timely manner, and reduce mortality and risks during patient care. Good maintenance management is important to have well-planned and implemented programs through which hospitals can minimize medical device failures or other problems with the operation of medical equipment. Medical equipment plays an important role in the hospital system; therefore, the acquisition, maintenance, and replacement of medical equipment are key factors in hospitals for the implementation of the health service. Thus, in order to ensure the quality of medical devices for the provision of medical care, it is imperative to evaluate the safety of using hospital maintenance management. In order to achieve these goals, hospitals must develop checklists that identify the state of performance of medical equipment maintenance. It is essential for clinical managers and engineers not only to increase the capacity of the hospital but also to predict the risks of sudden failure. Given the lack of unique and comprehensive maintenance management checklists, the current goal is to design and develop medical equipment maintenance management checklists.
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The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}},{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"}}}}]},series:{item:{id:"11",title:"Biochemistry",doi:"10.5772/intechopen.72877",issn:"2632-0983",scope:"Biochemistry, the study of chemical transformations occurring within living organisms, impacts all areas of life sciences, from molecular crystallography and genetics to ecology, medicine, and population biology. Biochemistry examines macromolecules - proteins, nucleic acids, carbohydrates, and lipids – and their building blocks, structures, functions, and interactions. Much of biochemistry is devoted to enzymes, proteins that catalyze chemical reactions, enzyme structures, mechanisms of action and their roles within cells. Biochemistry also studies small signaling molecules, coenzymes, inhibitors, vitamins, and hormones, which play roles in life processes. Biochemical experimentation, besides coopting classical chemistry methods, e.g., chromatography, adopted new techniques, e.g., X-ray diffraction, electron microscopy, NMR, radioisotopes, and developed sophisticated microbial genetic tools, e.g., auxotroph mutants and their revertants, fermentation, etc. More recently, biochemistry embraced the ‘big data’ omics systems. Initial biochemical studies have been exclusively analytic: dissecting, purifying, and examining individual components of a biological system; in the apt words of Efraim Racker (1913 –1991), “Don’t waste clean thinking on dirty enzymes.” Today, however, biochemistry is becoming more agglomerative and comprehensive, setting out to integrate and describe entirely particular biological systems. The ‘big data’ metabolomics can define the complement of small molecules, e.g., in a soil or biofilm sample; proteomics can distinguish all the comprising proteins, e.g., serum; metagenomics can identify all the genes in a complex environment, e.g., the bovine rumen. This Biochemistry Series will address the current research on biomolecules and the emerging trends with great promise.",coverUrl:"https://cdn.intechopen.com/series/covers/11.jpg",latestPublicationDate:"August 2nd, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:33,editor:{id:"31610",title:"Dr.",name:"Miroslav",middleName:null,surname:"Blumenberg",slug:"miroslav-blumenberg",fullName:"Miroslav Blumenberg",profilePictureURL:"https://mts.intechopen.com/storage/users/31610/images/system/31610.jpg",biography:"Miroslav Blumenberg, Ph.D., was born in Subotica and received his BSc in Belgrade, Yugoslavia. He completed his Ph.D. at MIT in Organic Chemistry; he followed up his Ph.D. with two postdoctoral study periods at Stanford University. Since 1983, he has been a faculty member of the RO Perelman Department of Dermatology, NYU School of Medicine, where he is codirector of a training grant in cutaneous biology. Dr. Blumenberg’s research is focused on the epidermis, expression of keratin genes, transcription profiling, keratinocyte differentiation, inflammatory diseases and cancers, and most recently the effects of the microbiome on the skin. He has published more than 100 peer-reviewed research articles and graduated numerous Ph.D. and postdoctoral students.",institutionString:null,institution:{name:"New York University Langone Medical Center",institutionURL:null,country:{name:"United States of America"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:4,paginationItems:[{id:"14",title:"Cell and Molecular Biology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/14.jpg",isOpenForSubmission:!0,editor:{id:"165627",title:"Dr.",name:"Rosa María",middleName:null,surname:"Martínez-Espinosa",slug:"rosa-maria-martinez-espinosa",fullName:"Rosa María Martínez-Espinosa",profilePictureURL:"https://mts.intechopen.com/storage/users/165627/images/system/165627.jpeg",biography:"Dr. Rosa María Martínez-Espinosa has been a Spanish Full Professor since 2020 (Biochemistry and Molecular Biology) and is currently Vice-President of International Relations and Cooperation development and leader of the research group 'Applied Biochemistry” (University of Alicante, Spain). Other positions she has held at the university include Vice-Dean of Master Programs, Vice-Dean of the Degree in Biology and Vice-Dean for Mobility and Enterprise and Engagement at the Faculty of Science (University of Alicante). She received her Bachelor in Biology in 1998 (University of Alicante) and her PhD in 2003 (Biochemistry, University of Alicante). She undertook post-doctoral research at the University of East Anglia (Norwich, U.K. 2004-2005; 2007-2008).\nHer multidisciplinary research focuses on investigating archaea and their potential applications in biotechnology. She has an H-index of 21. She has authored one patent and has published more than 70 indexed papers and around 60 book chapters.\nShe has contributed to more than 150 national and international meetings during the last 15 years. Her research interests include archaea metabolism, enzymes purification and characterization, gene regulation, carotenoids and bioplastics production, antioxidant\ncompounds, waste water treatments, and brines bioremediation.\nRosa María’s other roles include editorial board member for several journals related\nto biochemistry, reviewer for more than 60 journals (biochemistry, molecular biology, biotechnology, chemistry and microbiology) and president of several organizing committees in international meetings related to the N-cycle or respiratory processes.",institutionString:null,institution:{name:"University of Alicante",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"15",title:"Chemical Biology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/15.jpg",isOpenForSubmission:!0,editor:{id:"441442",title:"Dr.",name:"Şükrü",middleName:null,surname:"Beydemir",slug:"sukru-beydemir",fullName:"Şükrü Beydemir",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003GsUoIQAV/Profile_Picture_1634557147521",biography:"Dr. Şükrü Beydemir obtained a BSc in Chemistry in 1995 from Yüzüncü Yıl University, MSc in Biochemistry in 1998, and PhD in Biochemistry in 2002 from Atatürk University, Turkey. He performed post-doctoral studies at Max-Planck Institute, Germany, and University of Florence, Italy in addition to making several scientific visits abroad. He currently works as a Full Professor of Biochemistry in the Faculty of Pharmacy, Anadolu University, Turkey. Dr. Beydemir has published over a hundred scientific papers spanning protein biochemistry, enzymology and medicinal chemistry, reviews, book chapters and presented several conferences to scientists worldwide. He has received numerous publication awards from various international scientific councils. He serves in the Editorial Board of several international journals. Dr. Beydemir is also Rector of Bilecik Şeyh Edebali University, Turkey.",institutionString:null,institution:{name:"Anadolu University",institutionURL:null,country:{name:"Turkey"}}},editorTwo:{id:"13652",title:"Prof.",name:"Deniz",middleName:null,surname:"Ekinci",slug:"deniz-ekinci",fullName:"Deniz Ekinci",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYLT1QAO/Profile_Picture_1634557223079",biography:"Dr. Deniz Ekinci obtained a BSc in Chemistry in 2004, MSc in Biochemistry in 2006, and PhD in Biochemistry in 2009 from Atatürk University, Turkey. He studied at Stetson University, USA, in 2007-2008 and at the Max Planck Institute of Molecular Cell Biology and Genetics, Germany, in 2009-2010. Dr. Ekinci currently works as a Full Professor of Biochemistry in the Faculty of Agriculture and is the Head of the Enzyme and Microbial Biotechnology Division, Ondokuz Mayıs University, Turkey. He is a member of the Turkish Biochemical Society, American Chemical Society, and German Genetics society. Dr. Ekinci published around ninety scientific papers, reviews and book chapters, and presented several conferences to scientists. He has received numerous publication awards from several scientific councils. Dr. Ekinci serves as the Editor in Chief of four international books and is involved in the Editorial Board of several international journals.",institutionString:null,institution:{name:"Ondokuz Mayıs University",institutionURL:null,country:{name:"Turkey"}}},editorThree:null},{id:"17",title:"Metabolism",coverUrl:"https://cdn.intechopen.com/series_topics/covers/17.jpg",isOpenForSubmission:!0,editor:{id:"138626",title:"Dr.",name:"Yannis",middleName:null,surname:"Karamanos",slug:"yannis-karamanos",fullName:"Yannis Karamanos",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002g6Jv2QAE/Profile_Picture_1629356660984",biography:"Yannis Karamanos, born in Greece in 1953, completed his pre-graduate studies at the Université Pierre et Marie Curie, Paris, then his Masters and Doctoral degree at the Université de Lille (1983). He was associate professor at the University of Limoges (1987) before becoming full professor of biochemistry at the Université d’Artois (1996). He worked on the structure-function relationships of glycoconjugates and his main project was the investigations on the biological roles of the de-N-glycosylation enzymes (Endo-N-acetyl-β-D-glucosaminidase and peptide-N4-(N-acetyl-β-glucosaminyl) asparagine amidase). From 2002 he contributes to the understanding of the Blood-brain barrier functioning using proteomics approaches. He has published more than 70 papers. His teaching areas are energy metabolism and regulation, integration and organ specialization and metabolic adaptation.",institutionString:null,institution:{name:"Artois University",institutionURL:null,country:{name:"France"}}},editorTwo:null,editorThree:null},{id:"18",title:"Proteomics",coverUrl:"https://cdn.intechopen.com/series_topics/covers/18.jpg",isOpenForSubmission:!0,editor:{id:"200689",title:"Prof.",name:"Paolo",middleName:null,surname:"Iadarola",slug:"paolo-iadarola",fullName:"Paolo Iadarola",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSCl8QAG/Profile_Picture_1623568118342",biography:"Paolo Iadarola graduated with a degree in Chemistry from the University of Pavia (Italy) in July 1972. He then worked as an Assistant Professor at the Faculty of Science of the same University until 1984. In 1985, Prof. Iadarola became Associate Professor at the Department of Biology and Biotechnologies of the University of Pavia and retired in October 2017. Since then, he has been working as an Adjunct Professor in the same Department at the University of Pavia. His research activity during the first years was primarily focused on the purification and structural characterization of enzymes from animal and plant sources. During this period, Prof. Iadarola familiarized himself with the conventional techniques used in column chromatography, spectrophotometry, manual Edman degradation, and electrophoresis). Since 1995, he has been working on: i) the determination in biological fluids (serum, urine, bronchoalveolar lavage, sputum) of proteolytic activities involved in the degradation processes of connective tissue matrix, and ii) on the identification of biological markers of lung diseases. In this context, he has developed and validated new methodologies (e.g., Capillary Electrophoresis coupled to Laser-Induced Fluorescence, CE-LIF) whose application enabled him to determine both the amounts of biochemical markers (Desmosines) in urine/serum of patients affected by Chronic Obstructive Pulmonary Disease (COPD) and the activity of proteolytic enzymes (Human Neutrophil Elastase, Cathepsin G, Pseudomonas aeruginosa elastase) in sputa of these patients. More recently, Prof. Iadarola was involved in developing techniques such as two-dimensional electrophoresis coupled to liquid chromatography/mass spectrometry (2DE-LC/MS) for the proteomic analysis of biological fluids aimed at the identification of potential biomarkers of different lung diseases. He is the author of about 150 publications (According to Scopus: H-Index: 23; Total citations: 1568- According to WOS: H-Index: 20; Total Citations: 1296) of peer-reviewed international journals. He is a Consultant Reviewer for several journals, including the Journal of Chromatography A, Journal of Chromatography B, Plos ONE, Proteomes, International Journal of Molecular Science, Biotech, Electrophoresis, and others. He is also Associate Editor of Biotech.",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorTwo:{id:"201414",title:"Dr.",name:"Simona",middleName:null,surname:"Viglio",slug:"simona-viglio",fullName:"Simona Viglio",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRKDHQA4/Profile_Picture_1630402531487",biography:"Simona Viglio is an Associate Professor of Biochemistry at the Department of Molecular Medicine at the University of Pavia. She has been working since 1995 on the determination of proteolytic enzymes involved in the degradation process of connective tissue matrix and on the identification of biological markers of lung diseases. She gained considerable experience in developing and validating new methodologies whose applications allowed her to determine both the amount of biomarkers (Desmosine and Isodesmosine) in the urine of patients affected by COPD, and the activity of proteolytic enzymes (HNE, Cathepsin G, Pseudomonas aeruginosa elastase) in the sputa of these patients. Simona Viglio was also involved in research dealing with the supplementation of amino acids in patients with brain injury and chronic heart failure. She is presently engaged in the development of 2-DE and LC-MS techniques for the study of proteomics in biological fluids. The aim of this research is the identification of potential biomarkers of lung diseases. 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He previously worked as a post-doctoral fellow at the Ben-Gurion University of Negev, Israel; University of the Free State, South Africa; and Central University of Technology Bloemfontein, South Africa. He obtained his Ph.D. in Organic Chemistry from Nagaoka University of Technology, Japan. He has published more than seventy-four journal articles and attended several national and international conferences as speaker and chair. Dr. Kendrekar has received many international awards. He has several funded projects, namely, anti-malaria drug development, MRSA, and SARS-CoV-2 activity of curcumin and its formulations. He has filed four patents in collaboration with the University of Central Lancashire and Mayo Clinic Infectious Diseases. His present research includes organic synthesis, drug discovery and development, biochemistry, nanoscience, and nanotechnology.",institutionString:"Visiting Scientist at Lipid Nanostructures Laboratory, Centre for Smart Materials, School of Natural Sciences, University of Central Lancashire",institution:null},{id:"428125",title:"Dr.",name:"Vinayak",middleName:null,surname:"Adimule",slug:"vinayak-adimule",fullName:"Vinayak Adimule",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/428125/images/system/428125.jpg",biography:"Dr. Vinayak Adimule, MSc, Ph.D., is a professor and dean of R&D, Angadi Institute of Technology and Management, India. He has 15 years of research experience as a senior research scientist and associate research scientist in R&D organizations. He has published more than fifty research articles as well as several book chapters. He has two Indian patents and two international patents to his credit. Dr. Adimule has attended, chaired, and presented papers at national and international conferences. He is a guest editor for Topics in Catalysis and other journals. He is also an editorial board member, life member, and associate member for many international societies and research institutions. His research interests include nanoelectronics, material chemistry, artificial intelligence, sensors and actuators, bio-nanomaterials, and medicinal chemistry.",institutionString:"Angadi Institute of Technology and Management",institution:null},{id:"284317",title:"Prof.",name:"Kantharaju",middleName:null,surname:"Kamanna",slug:"kantharaju-kamanna",fullName:"Kantharaju Kamanna",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284317/images/21050_n.jpg",biography:"Prof. K. Kantharaju has received Bachelor of science (PCM), master of science (Organic Chemistry) and Doctor of Philosophy in Chemistry from Bangalore University. He worked as a Executive Research & Development @ Cadila Pharmaceuticals Ltd, Ahmedabad. He received DBT-postdoc fellow @ Molecular Biophysics Unit, Indian Institute of Science, Bangalore under the supervision of Prof. P. Balaram, later he moved to NIH-postdoc researcher at Drexel University College of Medicine, Philadelphia, USA, after his return from postdoc joined NITK-Surthakal as a Adhoc faculty at department of chemistry. Since from August 2013 working as a Associate Professor, and in 2016 promoted to Profeesor in the School of Basic Sciences: Department of Chemistry and having 20 years of teaching and research experiences.",institutionString:null,institution:{name:"Rani Channamma University, Belagavi",country:{name:"India"}}},{id:"158492",title:"Prof.",name:"Yusuf",middleName:null,surname:"Tutar",slug:"yusuf-tutar",fullName:"Yusuf Tutar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/158492/images/system/158492.jpeg",biography:"Prof. Dr. Yusuf Tutar conducts his research at the Hamidiye Faculty of Pharmacy, Department of Basic Pharmaceutical Sciences, Division of Biochemistry, University of Health Sciences, Turkey. 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:"94311",title:"Prof.",name:"Martins",middleName:"Ochubiojo",surname:"Ochubiojo Emeje",slug:"martins-ochubiojo-emeje",fullName:"Martins Ochubiojo Emeje",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94311/images/system/94311.jpeg",biography:"Martins Emeje obtained a BPharm with distinction from Ahmadu Bello University, Nigeria, and an MPharm and Ph.D. from the University of Nigeria (UNN), where he received the best Ph.D. award and was enlisted as UNN’s “Face of Research.” He established the first nanomedicine center in Nigeria and was the pioneer head of the intellectual property and technology transfer as well as the technology innovation and support center. Prof. Emeje’s several international fellowships include the prestigious Raman fellowship. He has published more than 150 articles and patents. He is also the head of R&D at NIPRD and holds a visiting professor position at Nnamdi Azikiwe University, Nigeria. He has a postgraduate certificate in Project Management from Walden University, Minnesota, as well as a professional teaching certificate and a World Bank certification in Public Procurement. Prof. Emeje was a national chairman of academic pharmacists in Nigeria and the 2021 winner of the May & Baker Nigeria Plc–sponsored prize for professional service in research and innovation.",institutionString:"National Institute for Pharmaceutical Research and Development",institution:{name:"National Institute for Pharmaceutical Research and Development",country:{name:"Nigeria"}}},{id:"436430",title:"Associate Prof.",name:"Mesut",middleName:null,surname:"Işık",slug:"mesut-isik",fullName:"Mesut Işık",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/436430/images/19686_n.jpg",biography:null,institutionString:null,institution:{name:"Bilecik University",country:{name:"Turkey"}}},{id:"268659",title:"Ms.",name:"Xianquan",middleName:null,surname:"Zhan",slug:"xianquan-zhan",fullName:"Xianquan Zhan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/268659/images/8143_n.jpg",biography:"Dr. Zhan received his undergraduate and graduate training in the fields of preventive medicine and epidemiology and statistics at the West China University of Medical Sciences in China during 1989 to 1999. He received his post-doctoral training in oncology and cancer proteomics for two years at the Cancer Research Institute of Human Medical University in China. In 2001, he went to the University of Tennessee Health Science Center (UTHSC) in USA, where he was a post-doctoral researcher and focused on mass spectrometry and cancer proteomics. Then, he was appointed as an Assistant Professor of Neurology, UTHSC in 2005. He moved to the Cleveland Clinic in USA as a Project Scientist/Staff in 2006 where he focused on the studies of eye disease proteomics and biomarkers. He returned to UTHSC as an Assistant Professor of Neurology in the end of 2007, engaging in proteomics and biomarker studies of lung diseases and brain tumors, and initiating the studies of predictive, preventive, and personalized medicine (PPPM) in cancer. In 2010, he was promoted to Associate Professor of Neurology, UTHSC. Currently, he is a Professor at Xiangya Hospital of Central South University in China, Fellow of Royal Society of Medicine (FRSM), the European EPMA National Representative in China, Regular Member of American Association for the Advancement of Science (AAAS), European Cooperation of Science and Technology (e-COST) grant evaluator, Associate Editors of BMC Genomics, BMC Medical Genomics, EPMA Journal, and Frontiers in Endocrinology, Executive Editor-in-Chief of Med One. He has\npublished 116 peer-reviewed research articles, 16 book chapters, 2 books, and 2 US patents. His current main research interest focuses on the studies of cancer proteomics and biomarkers, and the use of modern omics techniques and systems biology for PPPM in cancer, and on the development and use of 2DE-LC/MS for the large-scale study of human proteoforms.",institutionString:null,institution:{name:"Xiangya Hospital Central South University",country:{name:"China"}}},{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:"418340",title:"Dr.",name:"Jyotirmoi",middleName:null,surname:"Aich",slug:"jyotirmoi-aich",fullName:"Jyotirmoi Aich",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000038Ugi5QAC/Profile_Picture_2022-04-15T07:48:28.png",biography:"Biotechnologist with 15 years of research including 6 years of teaching experience. Demonstrated record of scientific achievements through consistent publication record (H index = 13, with 874 citations) in high impact journals such as Nature Communications, Oncotarget, Annals of Oncology, PNAS, and AJRCCM, etc. Strong research professional with a post-doctorate from ACTREC where I gained experimental oncology experience in clinical settings and a doctorate from IGIB where I gained expertise in asthma pathophysiology. A well-trained biotechnologist with diverse experience on the bench across different research themes ranging from asthma to cancer and other infectious diseases. An individual with a strong commitment and innovative mindset. Have the ability to work on diverse projects such as regenerative and molecular medicine with an overall mindset of improving healthcare.",institutionString:"DY Patil Deemed to Be University",institution:null},{id:"349288",title:"Prof.",name:"Soumya",middleName:null,surname:"Basu",slug:"soumya-basu",fullName:"Soumya Basu",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035QxIDQA0/Profile_Picture_2022-04-15T07:47:01.jpg",biography:"Soumya Basu, Ph.D., is currently working as an Associate Professor at Dr. D. Y. Patil Biotechnology and Bioinformatics Institute, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India. With 16+ years of trans-disciplinary research experience in Drug Design, development, and pre-clinical validation; 20+ research article publications in journals of repute, 9+ years of teaching experience, trained with cross-disciplinary education, Dr. Basu is a life-long learner and always thrives for new challenges.\r\nHer research area is the design and synthesis of small molecule partial agonists of PPAR-γ in lung cancer. She is also using artificial intelligence and deep learning methods to understand the exosomal miRNA’s role in cancer metastasis. Dr. Basu is the recipient of many awards including the Early Career Research Award from the Department of Science and Technology, Govt. of India. She is a reviewer of many journals like Molecular Biology Reports, Frontiers in Oncology, RSC Advances, PLOS ONE, Journal of Biomolecular Structure & Dynamics, Journal of Molecular Graphics and Modelling, etc. She has edited and authored/co-authored 21 journal papers, 3 book chapters, and 15 abstracts. She is a Board of Studies member at her university. She is a life member of 'The Cytometry Society”-in India and 'All India Cell Biology Society”- in India.",institutionString:"Dr. D.Y. Patil Vidyapeeth, Pune",institution:{name:"Dr. D.Y. Patil Vidyapeeth, Pune",country:{name:"India"}}},{id:"354817",title:"Dr.",name:"Anubhab",middleName:null,surname:"Mukherjee",slug:"anubhab-mukherjee",fullName:"Anubhab Mukherjee",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y0000365PbRQAU/ProfilePicture%202022-04-15%2005%3A11%3A18.480",biography:"A former member of Laboratory of Nanomedicine, Brigham and Women’s Hospital, Harvard University, Boston, USA, Dr. Anubhab Mukherjee is an ardent votary of science who strives to make an impact in the lives of those afflicted with cancer and other chronic/acute ailments. He completed his Ph.D. from CSIR-Indian Institute of Chemical Technology, Hyderabad, India, having been skilled with RNAi, liposomal drug delivery, preclinical cell and animal studies. He pursued post-doctoral research at College of Pharmacy, Health Science Center, Texas A & M University and was involved in another postdoctoral research at Department of Translational Neurosciences and Neurotherapeutics, John Wayne Cancer Institute, Santa Monica, California. In 2015, he worked in Harvard-MIT Health Sciences & Technology as a visiting scientist. He has substantial experience in nanotechnology-based formulation development and successfully served various Indian organizations to develop pharmaceuticals and nutraceutical products. He is an inventor in many US patents and an author in many peer-reviewed articles, book chapters and books published in various media of international repute. Dr. Mukherjee is currently serving as Principal Scientist, R&D at Esperer Onco Nutrition (EON) Pvt. Ltd. and heads the Hyderabad R&D center of the organization.",institutionString:"Esperer Onco Nutrition Pvt Ltd.",institution:null},{id:"319365",title:"Assistant Prof.",name:"Manash K.",middleName:null,surname:"Paul",slug:"manash-k.-paul",fullName:"Manash K. Paul",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/319365/images/system/319365.png",biography:"Manash K. Paul is a Principal Investigator and Scientist at the University of California Los Angeles. He has contributed significantly to the fields of stem cell biology, regenerative medicine, and lung cancer. His research focuses on various signaling processes involved in maintaining stem cell homeostasis during the injury-repair process, deciphering lung stem cell niche, pulmonary disease modeling, immuno-oncology, and drug discovery. He is currently investigating the role of extracellular vesicles in premalignant lung cell migration and detecting the metastatic phenotype of lung cancer via machine-learning-based analyses of exosomal signatures. Dr. Paul has published in more than fifty peer-reviewed international journals and is highly cited. He is the recipient of many awards, including the UCLA Vice Chancellor’s award, a senior member of the Institute of Electrical and Electronics Engineers (IEEE), and an editorial board member for several international journals.",institutionString:"University of California Los Angeles",institution:{name:"University of California Los Angeles",country:{name:"United States of America"}}},{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://mts.intechopen.com/storage/users/219081/images/system/219081.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. He is currently working on the protective activity of phenolic compounds in disorders associated with oxidative stress and inflammation.",institutionString:null,institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"178366",title:"Dr.",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. 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