\r\n\tThis book will intend to look at different migrant patterns, voluntary and involuntary migration, over the last three centuries. What influenced people to leave their home countries, family, and friends and settle somewhere else? The book may include histories of the 19th century, consider tragedies and movements activated by political events in the 20th century, and/or look at recent events of the 21st century. Push and pull factors are important points. While most of us may be influenced in a negative way by the current happenings in Eastern Europe, the Russian invasion and resulting tragedies also demonstrate some very positive human traits – the preparedness of Ukraine’s surrounding countries to help those in need and to provide a safe place for the present. \r\n\tWhether one looks at voluntary or involuntary migration into any country, after a period of adjustment, migrants do play a positive role. The research found that migrants contribute to the economy (food, shelter, employment, tax) and enrich a country’s cultural norms. Prerequisites for successful settlements are that the host society adopts a tolerant approach and that the migrants recognize the law and the language of the host country. Nothing is ever easy or without controversy, but I am a migrant (German Australian), and life in Australia has been relatively harmonious. Issues that could be considered in the book are multicultural societies (do monocultural societies still exist?) and theories of acculturation versus integration (settlement processes). \r\n\tTwo further issues are very important in relation to human migration. There is climate change, global warming, and the environment, which clearly affect people’s movement. Small island populations are very concerned about rising sea levels. 2021 has also seen floods costing human lives: Turkey (August 2021), Brazil (December 2021), Chile (January 2021), and South India (November 2021), to name but a few. In Australia (March 2022), farms and whole townships in New South Wales and Queensland have been flooded for the second time in five years, and plans to resettle these towns are considered. Official and social media provide ample coverage of the events, which leads me to the next issue. There is today’s very important role of the media, of the official and social media. We are constantly bombarded with images of human war tragedies and flood victims. People in industrialized, western countries must be the best-informed populace. How far do the images and up-to-date TV news influence us, make us change our behavior, and perhaps even consider us more generous than we have been? \r\n\tClimate change and the media are relatively new to the human migration debate, but both issues play important parts, and some interesting discussions are appreciated. \r\n\t
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1. Introduction
The quality of financial accounting mainly determined its value. The central concept\'s accounting quality is that accounting information is better than other accounting information for business communication intended to convey. Accounting quality is very attractive to participants in the financial reporting supply chain for that reason. For example, better quality accounting can result in a lower cost of capital or equity for a reporting entity. For an investor and creditor, better accounting quality can translate into a firm’s adaptability, scalability, growth opportunities, a low-risk firm, and a more profitable capital allocation. Meanwhile, this chapter shows that the quality of financial accounting had other areas, which is government accounting. It focuses on the quality of accounting information produced by government units (agents) that political and behavioural aspects dominate this quality.
The quality of accounting is an endurable issue that will never end to be investigated. Many aspects act as proxies for accounting quality, such as earnings quality, audit quality or earning management [1, 2, 3, 4, 5, 6, 7]. Those previous studies have investigated the determining factors, both in organisations, governments and politics or its consequences. Until now, the research focuses more on financial issues, specifically in the stock market, price, or return. For example, in the context of earning quality determining factor, more researchers discuss corporate governance mechanism, unsystematic risk, type of ownership or source of investment, managerial ability, and corporate social responsibility [8, 9, 10, 11, 12, 13, 14, 15]. The impact of board diligence and audit committee attributes is negative. Foreign ownership contributes to financial reporting quality, but audit quality has a significant effect [16].
Accounting quality following applicable standards is closely related to financial information’s usefulness to the users\', especially in supporting user decision making. We could highlight this usefulness aspect not only from a financial side but also from a behavioural part. In other words, this paper presents an idea uniqueness that behavioural factors, including political hegemony, bureaucracy ratcheting, cognitive distortion and standard-setting, influence the future accounting quality. Accounting information results from a process involving many parties, either from the preparers (public or private) or parties who can guarantee the quality of the accounting information presented. Thus, the behavioural meaning of accounting quality is an important issue to be researched as well.
2. Brief of the accounting quality
The previous literature has revealed that although the concept of accounting quality is often employed in scientific discussions, that there is no single, widely accepted, or specific definition in terms of “accounting quality.” The quality of accounting is a broad concept that has a series of diverse measurable attributes. Practically, definitions of accounting quality vary significantly across individuals, projects, and organisations. Recall from Renata [17] highlights that accounting quality-related research has gained interest until now.
The previous study [1, 18, 19] showed that the qualitative characteristics of financial information (according to US GAAP or IFRS requirements) or quality of financial statements (financial reporting) defines accounting quality. Such as, Hribar et al. [1] defines accounting quality as the extent to which accounting information accurately reflects the company’s current operating performance, helps predict future performance, and helps assess firm value. Callen et al. [20] define accounting quality as the precision with which financial reports convey information to equity investors about the firm’s expected cash flows. Poor accounting quality is likely associated with uncertainty about stock valuation parameters and incomplete information. It then could lead the users of financial accounting information adversely.
The previous research mostly linked accounting quality with better-earning quality, better earnings management, more timely loss recognition, higher firm value, and a lower cost of capital or cost of equity [2, 3, 14, 18]. Hribar et al. [1] state three broad accounting quality areas related to research are 1) the accounting quality analysis in the context of accounting harmonisation; 2) analysis of firm-specific factors influencing accounting quality and its consequences; 3) assessment of how institutional factors impact changes in accounting quality which is often dedicated to IFRS adoption. Although there are many accounting quality definitions, those all ultimately act the one purpose: to enable people to make value judgments regarding accounting information. Therefore, someone that measures the quality of accounting information will create the value judgments themselves.
3. Constraints and challenges to provide qualified information
Being measure accounting quality, the researcher has used many approaches and developed new methods continually. They are usually determined to expect measures of accounting quality directly from the financial statement or report. For example, the measurement of accounting quality used to detect the earning management is the Beneish model’s “M-Score” [9], computed from eight variables. The quantitative accounting metrics based its measured, that is, sales in receivables days.
Another measurement in terms of earning quality is accrual and deferral manipulations [5, 7, 21]. Meanwhile, the information other than the financial information or an entity report may base the measurement of accounting quality, such as the fee companies should pay to the external auditors or forecasts made by securities analysts to forecast the return. Thus, in most previous research, the accounting quality measurement is based on the history, archival data, or financial approach. Meanwhile, we know that the financial statements or report is the result of the accounting system process. Therefore, many parties are involved in this process to have better accounting quality, which behavioural perspective can also do.
In the current study example, the government\'s decline in audit quality changes the audit opinion on financial statements due to political hegemony, particularly in the financial statement audit process. From the auditor\'s side, the cognitive distortion influences the quality of their judgment, representing audit quality. Then, the study predicts that accountability can mitigate this chaotic cognitive [22, 23]. Meanwhile, the quality of government financial reports also was disturbed by the bureaucracy ratcheting. Audit on financial statements is an essential tool to reduce information asymmetry or maintain accounting quality. So, to get or improve financial performance or quality financial reports, it must be supported by audit quality, including the auditors\' credibility and reliability.
Audit quality is a critical issue because the auditor\'s competence, independence, integrity, performance, and reputation are at stake in these auditing activities related to the findings of the audit opinions. As a result of the accounting system process, assessing the accounting system weaknesses found in the audit is an achievement of the auditor\'s competence. Meanwhile, the disclosure of anomalies in the results of the assessment system is an indicator in measuring the triumph of auditor independence. Thus, audit quality is part of the opinion quality produced by the auditor\'s consideration as an individual, which is affected by his competence Watkins et al., [24], including the skills and adequacy of the knowledge, experience, education, and cognition of the auditor as a requirement to carry out a professional and qualified audit. A high-quality auditor effectively ensures the credibility of financial information.
3.1 Political hegemony
Political hegemony plays a substantial role in developing countries. However, the role of the government is not vital enough to control all units or agents under it because it does not yet have maturity. In other words, the central government in developing countries are usually annexed by an imperium or superstructure. The process of annexation generally is that superstructure controls governance processes. For example, the superstructure governed the auditing process of the financial statement of government units. This process is conducted by the Audit Supreme Board (ASB) of developing countries until its implementation. However, this process could be on performativity due to superstructure influencing. In other words, the audits carried out and the audit outputs, even though they are processed, still produce low quality because the auditors are annexed. Therefore, the auditor behaves in performativity in the annexed audit process, which is unlikely to produce high-quality audited financial statements. This subsection presents in Figure 1 as follows.
Figure 1.
Role of political hegemony in auditing process.
The term hegemony was first introduced by Gramsci et al. in 1971 [1] in his book “Selection from Prison Notebooks”. There are three aspects of Gramsci\'s theory of hegemony. First, Croce\'s alleged influence over the latter is rejected, favouring equal concern with the whole generation of Italian intellectuals, not just Croce. Second, philosophy plays an essential role in Gramsci\'s theory of hegemony because it provides a fundamental critique of common sense and false consciousness. Third, the intellectual needs for a new hegemony are organic and involve traditional intellectuals in complex new formations [2]. Finally, the concept of hegemony is straightforward, which means that political leadership is based on the consent of the led, the agreement guaranteed by the diffusion and popularisation of the worldview of the ruling class [3]. Thus, we can refer to hegemony as the domination of one group over another, often supported by norms and legitimating ideas. Related terms hegemon is used to identify the actor, group, class, or state that exercises hegemonic power or is responsible for spreading hegemonic ideas.
Gramsci had identified the dominant role mode as a ruling class and was interested in explaining how concrete institutional forms and material relations of production became prominent. The supremacy of class and the subsequent reproduction of the associated mode of production can be obtained by brute domination or coercion. However, Gramsci\'s central observation is that in advanced capitalist societies, the preservation of the ruling class is achieved through consensus, mainly through intellectual and moral leadership. Gramsci also shows how hegemony requires the articulation and distribution of popular ideas beyond narrow class interests through the concept of national popularity.
Regarding audit quality as one of the accounting qualities dimensions, in the recent study, Sumiyana et al. [4] investigated political hegemony as a determinant of audit quality in public accounting. This chapter defined a political hegemony as equivalent to (as if) existed direction from the superstructure. Political hegemony can affect auditor independence and then the quality of audited financial statements. The authors highlighted that research could investigate political hegemony with auditors’ organisational and political skills [25, 26, 27]. One form of organisational skills is establishing communication and relationships between supervisors and subordinates to achieve and improve performance and organisational capacity [28]. Meanwhile, political skill is defined as a person\'s ability to understand other parties and, with his skills, can influence the thoughts and actions of others to follow his wishes [26]. Political hegemony applies to the auditor if he acts with direction, and in the context of government auditors, they accept influence by consensus and without coercion [29, 30, 31].
This study shows that organisational and political skills, as proxies for political hegemony, affect audit quality. These results confirmed that annexed auditors desire quality audits in their work regarding organisational and political skills. This chapter demonstrates that the political hegemony of the highest leadership, implemented through the mass media, affects the auditors’ cognition as subordinates. Directions or requests by the highest leadership are followed by attendants obediently. Furthermore, this study concludes that the mass media is a tool the ruling elite can convey their wishes.
If political hegemony is associated with audit quality, which requires the auditor to have competent and independent requirements, the following consequence will be decreased audit quality. This decline in audit quality includes changes in audit opinion on financial statements due to political hegemony, especially in auditing financial statements. This study enhances the understanding of how political hegemony, supported by imperium, the psychological ruling class, and spheres of influence substantially erode the constitutive role of auditors, giving rise to concerns about the value of taxpayers\' money and the effectiveness and efficiency of the public sector.
This chapter provides evidence that the audit findings of the Indonesia Audit Supreme Board (IASB) were not followed up with further investigation or by the court. The first example is the land acquisition for the Sumberwaras Hospital, for which IASB identified a loss to the local government of IDR 199 billion [32]. Supposedly, the IASB proceeded with its audit finding to the court, but the case was stalled. This chapter suggests that the imperium influenced this discontinuation because this land acquisition decision-maker was close to the state power. In other words, with its sphere of influence, the imperium affected the termination of further investigations. Another law agency stated that conflicting codes of conduct in Indonesian business law ended this process. In the second example, IASB found evidence of underlying accounting data showing that the Indonesian Ministry of Religion transferred project funds to personal bank accounts of government officials [33]. The IASB stated that the evidence of the audit findings had high validity supported by evidence of transactions it had attached. However, the IASB still issued an unqualified opinion on the financial statements of the Ministry of Religion, which should not have been possible because these transactions violated internal control procedures. Moreover, many personnel in the ministry acknowledged transfers of money into their personal bank accounts for political reasons.
The third example in this subsection shows an absence of follow-up to the IASB audit findings, specifically in the case of the Audit Results Report (ARR) on the Financial Statement (FS) of the Jakarta Provincial Government for the 2013 fiscal year [34, 35]. This ARR recorded a local (provincial) government loss of IDR 85.36 billion, a revenue shortfall of IDR 95.01 billion and wasteful budget spending of IDR 23.13 billion. However, the audit findings indicated the absence of accountability for the province’s financial management and issued an adverse opinion for its financial statements. The criminal investigation agency never followed up on this ARR. The IASB report was published, and then there was no follow-up.
This chapter infers that those managerial policies of government bureaucrats involve committing systemic violations of regulations that affect the quality of accounting information. These bureaucratic policies indicate that the quality of government accounting information in developing countries is deficient. The authors complement this evidence with many cases that have been dismissed without continuing the process through the courts. The dismissal of cases without clarity indicates that the influence of the dominant superstructure is most likely regulating and controlling the handling of cases. This study concedes that the superstructure is invisible, but the legal process is always at a standstill at a certain point without a solution. These dismissals of cases are also eliminated from the news later. However, this chapter noted that so many lawsuits being terminated is evidence of how political hegemony works.
3.2 Bureaucrat behaviours in budget ratcheting
Financial statement quality would still be ongoing for 21st because the behaviour of bureaucrats in developing countries is not yet mature, engaged, and ready enough to optimise both individual and organisational self. Budget ratcheting is usually the orientation of bureaucrats’ behaviour in developing countries. In short, government bureaucrats in developing countries always choose the maximal budget to measure activity and performance. On the other hand, the central government of developing countries has set the same policy to improve with various blocked grant systems continually. The authors defined that government agents who always choose the maximum and continuously increase cause bureaucrats’ ratchet behaviour. Moreover, these agents apply mechanistic regulations from the central government whose budget size must be improved. Furthermore, budget ratcheting dominates the low quality of the governments’ financial statements. Shorten the explanation; this subsection presents Figure 2 as follows.
Figure 2.
Flow of budget ratcheting in governmental accounting.
The qualified financial information depends on the quality of its regulation, standards and procedures applied to the accounting system [33]. However, the accounting system\'s implementation could be the technical and political practice in the government, which is low on the political agenda because politicians based their decisions primarily on budget. On the other hand, the existing system is deemed appropriate to meet information needs so that there is no strong impetus for further changes [36]. Thus, in governmental accounting, the budget has a central position. Regarding the budget, one of the behavioural problems is ratcheting. Qualified governmental accounting is impossible to achieve when bureaucrats run ratchets. Commonly, ratcheting occurs when over-spending at the last year\'s expenditures (exceeding those budgeted) lead to more significant absolute changes in current budgeted expenses than underspending with a similar magnitude. Ratcheting refers to the use of past performance to set higher future targets.
The ratchet effect refers to the motivational implications of ratcheting as agents reduce their effort to avoid further raising future targets [37]. With ratchet behaviour as praxis, the accounting information is more of a description of the desires of the bureaucrats rather than solely for public service. Bureaucratic ratchet praxis gets more support than before when there is no underlying to produce quality accounting. In governmental accounting, there is no analysis of profit or the relationship between revenue and expenses. Therefore, rachet praxis can appear both budget-maximising and budget-minimising behaviour and for both self-interest and non-self-interest reasons. The praxis of these bureaucrats is driven by their characteristics and the problems they face: regulatory-wide regimes, organisational expedience, Undecidability, and Commodification [38, 39]. These four components then become the source of performativity for the subsequent bureaucratic praxis behaviour.
In the public choice literature, bureaucrat ratchets are associated with Niskanen\'s presumption behaviour of budget maximised. He argues that bureaucrats are self-interested individuals who try to maximise their utility through larger budgets. Economic literature calls it the Leviathan model of government [40, 41]. According to this model, first, the government will grow and increase its power if it is not carefully checked by law [42]. Second, the budget maximiser is pursued because the bureau is a monopoly producer of goods and services demanded by sponsors. Many studies used Niskanen\'s theory in empirical research [43, 44, 45, 46, 47]. However, this presumption of the budget maximiser [48] still received much criticism in recent years. The authors considered that Niskanen\'s theory is that a bureaucrat oversimplifies behaviour. The motivations of bureaucrats are too varied to be captured under a budget-maximiser straightforward [49].
A study by Bowling et al. [50] uses a typology of bureaucrats [38] to offer a budget manager–budget maximiser continuum. Budget-maximising bureaucrats are more likely to be advocates and aggrandises (Climber) types, while Altruists (Statesman) or Abider (Conserver) types tend not [50]. The presumption of budget maximiser offers a more plausible theoretical basis for budget maximisation than self-interest for bureaucrats in the spirit of Public Service Motivation (PSM) [51]. Budget maximiser relates in part to the characteristics of bureaucrats. For example, Budget-Minimizer behaviour occurs in bureaucrats who are professional or career-oriented [52]. Several surveys in The American State Administrators Project (ASAP) show a preference for the Budget-Minimizer. Budget-Minimizer does not mean lowering the budget but more a tendency not to increase the budget. Several factors in the emergence of a budget minimiser are the influence of ideology in Partisanship. Partisanship in the republican party will partly use a budget minimiser compared to the democratic party [53]. However, the overall results of the reported survey of agency chiefs [50] using ASAP data still show the behaviour of bureaucrats to increase budgets. Then, why do bureaucrats generally behave to increase the budget?
A recent study was conducted to highlight the phenomenon of ratchet behaviour in public budgeting. This study offers a new insight that budget rachets are bureaucratic praxis. Praxis is the diverting process of bureaucrats’ awareness about the constraints they experience and making them explicit in practice [54, 55, 56]. This study is in the Indonesian context compared to the American state. There are differences in state tax collection, government spending, and citizens\' resistance between the United States and Indonesia. In the United States, society has reached a point where society can no longer bear taxes (tax revolt). Meanwhile, in Indonesia, such conditions have not occurred. However, there is a similarity that the two countries also continue to experience growth in spending.
This study has interviewed 24 local government officials and internal government auditors. This study found at least four reasons related to the bureaucrats\' characteristics for what bureaucrats carry out ratchet praxis. First, the applicable regulatory-wide regime may shape the bureaucratic cognition of decentralised regulatory practices in Indonesia. Second, local governments can get discretionary grants such as block grants. They are a dominant source of regional income but result in chaotic or confusing performance [57]. They also design blurs discretion and creates pseudo accountability. Third, local governments face a mismatch between revenue and expenditure responsibilities to local governments [58]. The Indonesian Government practices covering regional budgets when there are regional fiscal difficulties. This policy means that the government has a low commitment to local bureaucrats. This study notes that these two conditions encourage district and provincial governments to get budgetary slack [59].
Second, organisational expedience causes officials to focus too much on achieving goals at the expense of established rules or norms [60]. In dealing with regional problems, regional heads may make expenditure budgets, not under central regulations. This study shows that the policy actions of district and provincial bureaucrats in the regulatory regime can be called selective attention syndrome [61]. Third, the undecidability budget, which is a local government budget that certainty cannot determine. This study defines that the budget amount determines what can be decided in a specific form. Many local governments face budget undecidability by creating budget slacks to pursue security in their budget execution [62]. Fourth, Commodification means that after autonomy and decentralisation, the budget executor initiates regional economic development. People demand fiscal independence and decentralise physical infrastructures such as roads, bridges, markets, and tourist attractions. This study notes a change in the role of local government from administration to business management [63, 64, 65]. As a result, local governments rely on funds from the Government of Indonesia and always ask for additional budgets.
At the central government level, this study identifies a continuous increase in the central government budget. This condition means that government budget growth always occurs in national scope budgeting for government agencies, not a zero-sum game [66, 67, 68]. The bureaucrats are more focused on their respective institutions. However, it becomes a zero-sum game at the national level in a centralised country. An increase in budget revenues at one ministry, agency, or regional government will reduce the budget or hinder budget increases at other ones. Bureaucrats have different characteristics than their private counterparts. The disconnection between bureaucrats\' efforts and the rewards they receive makes researching bureaucratic behaviour a challenge. It seems complicated to generalise the behaviour of bureaucrats in increasing budgeting.
The government budget is a viewpoint of allocated funds contested by most of the existing government agencies. So at least, it can be concluded. First, the practices of the tendency of budget-maximiser and self-interest behaviour are not as strong a motivator as they have been believed. Previous studies on federal officials have also shown similar results [69]; second, budgets keep moving up. The opinion that is still valid regarding the budget ratchet is that the growth in government spending is stable although relatively small compared to the increase in budgets during the Great Depression, World War I and World War II [70]. According to Holcombe, the best estimate for the twenty-first century is probably the steady growth of government, but not shrinking. Thus, the era of excellent governance will still be ongoing [70]. Instead of bureaucrats’ practices as budget maximisers driven by self-interest, this article suggests that budget ratcheting is related to bureaucratic praxis. It will reflect politics, budgeting institutions, program implementations and different budget control systems in each country and performativity for bureaucrats to behave.
This chapter provides evidence that bureaucrats always choose ratchet budgeting in an emerging country, Indonesia. The first example: the preference for adding more local government programs with only 30 regional apparatus organisations running between 150 and 600 programs, so they do not focus on regional priorities [71]. Second, local government bureaucrats also often create budgetary programs that are not directly related to their performance. For example, awards night events are budgeted more than two billion for the prizes and the event itself [72]. The third is unimagined budgetary programs, such as recruiting social-media influencers, disbursing IDR 5 billion more than the COVID-19 research budget [73]. The latest is that expenses for official travel by bureaucrats are also expenditures for target fulfilment of budgetary ratcheting. This chapter noted that the official travel budget for a local government unit could spend more than IDR 514 billion [74].
The four examples show that the accounting activities of local governments in an emerging country are frequently out of control. Consequently, local governments’ accounting information can never reflect the reality of their budgetary programs. A further consequence is that many expenditures and disguised activity targets burden the quality of accounting information. Therefore, this chapter infers that the quality of (local and central) governments’ accounting information does not display the causality of effort-accomplishment. Furthermore, the authors show that, in all budgetary processes for government activities, accomplishments are in the budgetary rachets that are not deterministically related to actual output. Meanwhile, the efforts continually increase to maintain the safety margin of budgetary programs. Moreover, the motives of state civil officials’ behaviour support these disguised efforts in all objectives. Finally, the relationship between the efforts and accomplishments implies the low quality of government accounting information.
3.3 Auditors’ and users’ cognitive distortion
This section explains that financial statements are hard to achieve in high quality. We show that preparers, auditors, and users have embedded cognitive distortions, such as parataxic distortion, denial, psychological projection, and transference. As a result, even high-quality financial statements can be perceived as low by users and vice versa. Likewise, financial statement preparers who treat standards strictly have believed that the prepared financial statements are of high quality but is quiet and vice versa. Consequently, high-quality financial statements produce poor quality because the preparers, auditors, and users are in cognitive distortions. This cognitive condition results in the quality of accounting information being never-ending and durable for the 21st century. Shorten the explanation; this subsection presents Figure 3 as follows.
Figure 3.
The problem of auditors’ & users’ cognitive distortion.
A cognitive distortion is a deviated thought that occurs due to the reversal of a fact during information evaluation activities. For example, individuals with an initial preference weigh minor negative (disagreement) than positive (agreement) that has the desired impact on supporting their choice. In addition, individuals tend to be more optimistic when assessing the character of relevant information, whether it is favourable or unfavourable information, related to decisions [75]. Regarding the audit process, the affirmative process in auditor cognitive distortion occurs during evaluating evidence [76, 77]. Meanwhile, the auditor\'s judgment on decision-making (JDM) depends on the individual situational conditions [78]. This chapter also argues that the financial statement users did what auditors were on JDM.
Bonner [79] suggests that predispositions influence JDM in individuals, including knowledge, skills, emotions, cognition, and other psychological dispositions. To carry out audit considerations, the auditor needs and sorts out information following his preferences and assignments. Bedard & Biggs [80] exemplify protocol analysis (verbal reports) in analytical review studies. When the auditor reviews analytically, a sequential and interactive diagnostic process involves representing mental models, formulating hypotheses, searching for information, and evaluating hypotheses before assessing the client\'s internal control is made [81, 82, 83, 84, 85]. Furthermore, Rybowiak et al. [86] stated that cognitive and attitudinal predispositions influence current behaviour to be easily controlled in various situations. So, the predisposition to auditor cognitive distortion can be controlled by situational factors. Finally, the authors show that the users of financial statements utilise information on the financial statements with cognitive and attitudinal predispositions that influence their current behaviour.
Previous auditing research found distorted judgment and decision making based on the human tendency to generate systematic errors due to cognitive factors rather than evidence. Distortions tend to arise in auditors who already understand and are familiar with assignments because of individual self-protection mechanisms based on their experience [87]. When auditors are psychologically committed to a given position, they selectively select information and seek evidence supporting previous predispositions [77]. Information seeking helps auditors\' preferences [80, 88], and they tend to search excessively for information that supports their initial beliefs or predispositions [89]. This chapter also argues that the users of financial statements did too. The authors comprehend that the users of financial statements in utilising financial statements in their successively previous predisposition.
A study has investigated the relationship between auditors’ cognitive distortion and their decision quality as an indicator of audit quality. Previous research revealed the ties between cognitive distortions and individual behaviour from the aspect of psychological [90], in the context of Auditing [91] and accounting [92]. Rybowiak et al. [86] explained that the predisposition of cognitive and attitudinal distortions affects auditor behaviour in various situations. Thus, cognitive distortion becomes an antecedent that influences and is relevant to dysfunctional behaviour. In this chapter, cognitive distortion is defined as when the auditor\'s interests unconsciously lead to a systematic process of making wrong decisions. As a result, auditors predispose to cognitive distortions that result in dysfunctional behaviour [93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105]. We argue that the users of financial statements having their leading process in utilising the contents of financial statements.
Defence mechanisms are the auditor\'s strategy in maintaining self-image and reputation. In this study, four predisposing indicators of cognitive distortion were identified as psychological deviations in the taxonomy of defence mechanisms, namely: parataxic distortion, denial, psychological projection, and transference [87, 106, 107, 108, 109] refers to the research of Nelson et al., [110]; Pickerd et al., [111]; and Sweeney et al., [112] related to the audit process. Defence mechanisms reflect the existence of cognitive control outside of the awareness of the function of defence mechanisms as protection of one\'s integrity from excessive fear [106]. Parataxic distortion as the attachment of a false perception of others based on delusions [87, 109, 113, 114]. Auditors experience cognitive distortions in the form of attachment distortion due to long [115, 116, 117] and tied [118] engagements. We show that the users of financial statements were probably in parataxic distortion, denial, psychological projection, and transference due to their defence mechanism.
Furthermore, denial is a habit of dealing with problems interpreted as threats even though they are trivial [119, 120, 121]. There are incidents when auditors have difficulty forecasting, experience challenging uncertainties, complex, subjective, and estimative material misstatements that open opportunities for errors to occur, then they avoid them. The habit of avoiding this problem makes the auditor perform non-optimal analyses, such as estimation errors and assessments of materiality, risk, internal control, and audit evidence that impact inappropriate decision-making considerations [93]. Moreover, Buckner & Carroll [122], Harms et al. [123]; and Payne [124] defines psychological projection as thoughts, motivations, needs, and feelings that cannot be accepted as they are because they do not match the attributes of others. Psychological projection tends to make someone look down on others. This projection is a way to maintain a self-image because of the perceived threat or fear. According to their cognitive distortions, the auditors prefer client management preferences to senior choices due to economic factors [117, 125]. The authors inferred that the users, such as auditors, of financial statements have the psychological projection used to avoid threat and fear and maintain their self-preferences.
Lastly, transference is a person\'s current feelings, impulses, fantasies, and defences that are not by the truth [109, 126, 127, 128]. Andersen & Berk [129] describe transference as the activation and application of representations of others, leading to inference and memory representations, evaluations, affect, motivation, expectations and self-change. For example, auditors who identify with clients are distorted and oriented to act in their interests [130, 131]. This variation in defence mechanisms depends on the interaction between developing a person\'s level of cognitive maturity and the characteristics of the situation at hand [132]. Thus, this research analyses the different levels of cognitive distortion from denial to parataxic distortion related to cognitive complexity defence in dysfunctional auditor decisions. Moreover, this chapter revealed that the users of financial statements were on transference because of their complexity in distorted cognition. Then, this research showed that accountability could mitigate this auditor’s cognitive distortion based on the cognitive-behavioural theory.
This chapter finally presents an argumentation that could reduce auditors’ and users’ cognitive distortions. We raise accountability when it means the pressure to anticipate because of the justification of one\'s judgments and decisions against other parties [133, 134]. Accountability pressure is the ability to respond to other parties. Accountability is a mechanism to show that the previously established standards are relevant to fulfilling obligations, duties, expectations, and additional burdens. Organisations can use and condition accountability pressures as situational factors to mitigate cognitive distortions that support dysfunctional considerations that impact audit outcome decisions. Accountability pressure is a mechanism organisations use to control and direct employees [133, 134, 135]. Previous research has shown the effect of accountability pressures on decision considerations in various professions, including professional accountants, tax practitioners, the medical work and corporate accountants [112, 135, 136, 137, 138, 139].
This section provides evidence of the cognitive distortions of executive officers that probably affect the quality of accounting information. Accounting policies and discretionaries follow adverse hazards because of the defence mechanism to carry out the executive officers’ agenda. First, two members of the board of directors of Garuda Indonesia refused to sign the 2018 annual report, which is a parataxic distortion. This refusal was due to irregularities in the Annual Income Statement. The discrepancy lies in the cooperation between Garuda Indonesia and PT Mahata Aero Teknologi (a subsidiary firm) worth USD 239.94 million, which is a long-term receivable but was recorded by Garuda Indonesia executive officers as realised revenue. This designation resulted in Garuda Indonesia recording a profit of USD 809,850 in the 2018 annual report. Therefore, Garuda Indonesia would have recorded a loss if this long-term contract operation was not included [140]. The second example is the executive officers’ defence mechanism with a transference. PLN Co., Ltd. (the leading electricity company in Indonesia) recorded a loss due to the difference in the dollar exchange rate on the date of the financial statement issued, which was December 31, 2019. PLN published its financial statements and used the dollar exchange rate used on March 31, 2020, without recognising foreign exchange losses [141].
In the third example, Jiwasraya Insurance Company published errors and irregularities in recognising profits in its Financial Statements. Since 2006, the company had consistently recorded a profit. However, the accounting earnings were false due to accounting engineering or window dressing, where in fact, the company had suffered losses. These losses arose from a managerial error in making an investment decision recorded the losses as deferred charges at the end of the year. In addition, Jiwasraya Insurance Company in 2017 realised a profit of IDR 360.3 billion and got the auditor’s adverse opinion because an existing fraud of IDR 7.7 trillion was treated without adjustment for that current year [142]. The fourth example is the psychological projection distortion occurring in Pertamina with the COVID-19 pandemic. This company experienced real impacts: a decrease in oil demand, Indonesian rupiah depreciation, and very sharp fluctuations in crude oil prices in the first semester of 2020 and recorded losses of IDR 11.13 trillion. These losses greatly affected Pertamina’s financial performance, impacting executive officers who did not recognise these losses in the first semester. These CEOs published firms’ profits with optimistic behaviours as the year ended (the second semester), although changing swiftly to double or triple net income was an impossibility [143].
3.4 International accounting standard (IAS) and accounting quality
Ideally, accounting quality could increase because of changes in the financial reporting system contemporaneous with firms\' adoption of IAS, for example, more rigorous enforcement. Thus, we can predict that accounting values or amounts based on IAS are higher than those found on domestic standards. In addition, the worldwide adoption of IFRS (as one of IAS) by public interest companies drives accounting harmonisation. There have also been considerable efforts to achieve international convergence of accounting standards by reducing cross-country differences in accounting practice.
Ebaid [144] investigated the implementation of IAS and its relationship to the accounting quality in code-law countries in Egypt. This study reveals that accounting quality, as measured by earnings management, has decreased in the post-adoption period compared to the pre-adoption period. IFRS is set up to provide high-quality financial reporting. However, this cannot be achieved solely by a regulatory requirement to follow. Even if IFRS are higher quality standards, the institutional features of the Egyptian market could eliminate any improvement in accounting quality arising from adopting IFRS. Firms are applying IAS exhibit less earning smoothing, less managing earnings towards a target, more timely recognition of losses, and a higher association of accounting numbers with share prices and returns. IAS firms have a higher accounting quality between the pre-and post-adoption periods [145].
Accounting standards also are expected to act as a mediator of conflicts of interest between investors and managers. As the role of the mediator, this mediation must be able to reconcile financial reports and the role of efficient contracts from accounting information or how to determine the amount of socially correct information (right). This paper referred to the genuine motivation of the International Accounting Standards Committee (IASC). International accounting standards and the International Accounting Standards Board (IASB) aims to produce high-quality financial reporting. Thus the IASC and IASB issue principles-based standards and take steps that provide alternative accounting opportunities and require a better measure reflecting the economic position and performance [145]. However, differences in accounting quality would remain lasting due to IFRS adoption. Meanwhile, accounting quality is an influential function of the firm’s overall institutional setting, including the legal and political system of the country in which the firm resides [19]. In the end, this paper inferred that the objectives of international standard-setting could not be achieved due to differences in each country’s context and regulations.
4. Conclusions
The purpose of presenting the financial reports is to provide how general-purpose financial information must be compared with the entity\'s previous financial statements and other entities\' financial statements. The general-purpose financial statements provide information about the entities\' financial position, income statement, and cash flow statement. These statements are then useful for various users in making and evaluating decisions about resource allocation. General-purpose financial reporting aims to provide valuable information for decision making and demonstrate the entities’ managerial accountability and responsibility for the resources entrusted to these firms.
Users of financial reports vary widely, such as shareholders, creditors, suppliers, the media, or the public. The demands of the report users mainly drive the presentation of financial reports that are useful for decision making. However, the challenge to produce quality financial reports is quite heavy many factors determining it. The users, especially the public, generally do not utilise financial statement information to make decisions. For example, in the public sector, people tend to use information about the government services they receive. The implication is that the auditor\'s role in assessing the fairness of the presentation of financial statements is also less than optimal.
Moreover, the audit report on financial statements can also be distorted by the auditor\'s cognition and political hegemony, reducing audit quality. Another weakness is the attitude of the legislators, who tend to use budget information rather than financial reports as a medium for oversight of the government. Meanwhile, the budget discussed by the top executive officers and legislative is made to be carried out by ratcheting. In this case, finally, financial reports are more of a means of control from the central government to its subordinate agencies rather than presenting quality information to other users. This condition will vary significantly in each government, depending on the government system, budgeting system, demands for public accountability. The implication is the diversity of the application of accounting standards.
Finally, in the spirit of ease to compare the financial report among entities across countries, the facts revealed that accounting harmonisation is not easy to realise. Instead of this phenomenon, the financial statement among entities across countries must adapt to their condition. The other aspect, as an endurable issue in accounting research, the following study can investigate the accounting quality in various aspects. For example, to determine the earnings management activities carried out by managers, a mixed-method subsequent can carry out. It can predict using archival data related to management abilities or a behavioural perspective related to moral ethics or a manager\'s cognitive bias.
5. Future research
The audit should be held as a contract by engaging external auditors to further research government financial statements. This method is expected to exclude the ongoing political hegemony. The IASB’s auditors are part of the state civil apparatus immune from being fired, constantly under political hegemony and performativity. The state civil apparatus staffing system makes them behave in a "take it easy” way. Furthermore, this chapter raises the issue of terminating political hegemony if the IASB could implement an artificial intelligent-based auditing system. Indonesia must build an autonomous system, i.e., by applying machine learning, artificial neural networks, etc. In line with this system, an AI (artificial intelligence)-based audit [146, 147] frames all computer systems-based audit procedures and analyses so that auditors are not influenced and affected by subjective norms [148]. With AI-compliant results, in the end, the results are communicated, and there is no longer any chance for justification due to political hegemony.
As for the budgetary ratchet perspective, future research should associate with performance measurements, and what applies is likely the relationship between administrative law and business administration. Furthermore, future research should emphasise bureaucrat behavioural orientation that lets the budgetary rachet become a defence mechanism. The related concepts that could be examined for future research are the transformation of controller behaviours whose efforts and accomplishments are not directly associated with bureaucrat performance. Such a study could also focus on the budgetary system used with a multi-year perspective, not an annual cut-off system. Furthermore, the bureaucrat performance measurement would be based on a managerial-based process rather than an output-based process.
As for future research on cognitive distortion, a motive described in positive accounting theory will affect the cognitive distortion of defence mechanisms. Moral hazards such as altruism, self-interest, selfishness, and political will are dominant and support executive officers’ cognitive distortion. This chapter noted that research related to dysfunctional behaviour and cognitive distortions are extensive. Many previous studies have investigated the characteristics illustrating the deficiency of Positive Accounting Theory (PAT) as a comprehensive, contextual, and holistic analysis of accounting policy in organisations. Positive research is blamed for failing to recognise the socially constitutive character of academic knowledge and its underlying value predispositions. In devising an alternative, Chabrak [149] introduces hermeneuticphenomenology. It is a new framework that offers the possibility of exploring and constructing a new understanding of an organisation’s accounting policy to preserve its holistic and casuistic character on the epistemological level.
Kahneman et al. [150] state that there are biases in managerial decision making. Heuristics can often lead to systematic bias [151]. Bias judgment and decision-making are human tendencies to make systematic errors based on cognitive factors rather than evidence. For example, people make predictable irrational choices when choosing between alternatives, often producing the same repeatedly deviations. According to Bazerman and Moore [152], general bias can be attributed to and categorised in their radiating heuristics. Furthermore, Kahneman et al. [150] explain that the human brain\'s irrationality often influences individuals’ decisions that they and others around them fail to anticipate. Thus, errors and irregularities resulting from the cognitive bias prevent the making of sound decisions. What is more, even when executive officers have accumulated a lot of work experience and knowledge, they are still subject to that bias and, in some instances, even more so than inexperienced executives.
Acknowledgments
First, the authors’ gratitude goes to the IntechOpen to be involved in this book chapter. Secondly, our gratitude is also directed at the Doctorate Program, Faculty of Economics and Business, the University of Gadjah Mada, which has provided funding support for all the peripherals needed for the development process of this chapter. Finally, we thank the group of “Pethuk: The Pursuit of Q1|Q2,” who helped correct this material and provided some references to finish and complete this chapter.
Conflict of interest
The authors declare no conflict of interest.
\n',keywords:"accounting quality, usefulness, hegemony, ratcheting, cognitive distortion, international accounting standard",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/78825.pdf",chapterXML:"https://mts.intechopen.com/source/xml/78825.xml",downloadPdfUrl:"/chapter/pdf-download/78825",previewPdfUrl:"/chapter/pdf-preview/78825",totalDownloads:310,totalViews:0,totalCrossrefCites:0,totalDimensionsCites:0,totalAltmetricsMentions:0,introChapter:null,impactScore:0,impactScorePercentile:35,impactScoreQuartile:2,hasAltmetrics:0,dateSubmitted:"July 13th 2021",dateReviewed:"September 10th 2021",datePrePublished:"October 9th 2021",datePublished:"December 22nd 2021",dateFinished:"October 2nd 2021",readingETA:"0",abstract:"This paper describes current research to drive future research challenges in accounting quality. The definition of accounting quality is mainly varying depending on the objective that the study pointed. Previous research revealed that many proxies describe the accounting quality but most of them from the financial perspective. Furthermore, this paper tries to expose this research issue in the behavioural approach and drive future research in the mixed method. It concludes that the behavioural issues can be a research model, triggering future research challenges in accounting quality. The authors support these triggers from the perspectives of political hegemony, bureaucracy ratcheting, cognitive distortion, and international accounting standard. Finally, we infer and simultaneously predict that accounting quality would broaden its concepts and lasting impression in the 21st century.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/78825",risUrl:"/chapter/ris/78825",book:{id:"10818",slug:"accounting-and-finance-innovations"},signatures:"Sumiyana Sumiyana, Hendrian Hendrian, Ruslan Effendi, Krisnhoe Fitrijati and Sriwidharmanely Sriwidharmanely",authors:[{id:"328451",title:"Prof.",name:"Sumiyana",middleName:null,surname:"Sumiyana",fullName:"Sumiyana Sumiyana",slug:"sumiyana-sumiyana",email:"sumiyana@ugm.ac.id",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"Gadjah Mada University",institutionURL:null,country:{name:"Indonesia"}}},{id:"328452",title:"Dr.",name:"Sriwidharmanely",middleName:null,surname:"Sriwidharmanely",fullName:"Sriwidharmanely Sriwidharmanely",slug:"sriwidharmanely-sriwidharmanely",email:"widharmanely@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"University of Bengkulu",institutionURL:null,country:{name:"Indonesia"}}},{id:"350499",title:"Dr.",name:"Hendrian",middleName:null,surname:"Hendrian",fullName:"Hendrian Hendrian",slug:"hendrian-hendrian",email:"hendrizamar69@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"350500",title:"Dr.",name:"Ruslan",middleName:null,surname:"Effendi",fullName:"Ruslan Effendi",slug:"ruslan-effendi",email:"cakrush@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"350501",title:"Dr.",name:"Krisnhoe",middleName:null,surname:"Fitrijati",fullName:"Krisnhoe Fitrijati",slug:"krisnhoe-fitrijati",email:"fitriaboebakar@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Brief of the accounting quality",level:"1"},{id:"sec_3",title:"3. Constraints and challenges to provide qualified information",level:"1"},{id:"sec_3_2",title:"3.1 Political hegemony",level:"2"},{id:"sec_4_2",title:"3.2 Bureaucrat behaviours in budget ratcheting",level:"2"},{id:"sec_5_2",title:"3.3 Auditors’ and users’ cognitive distortion",level:"2"},{id:"sec_6_2",title:"3.4 International accounting standard (IAS) and accounting quality",level:"2"},{id:"sec_8",title:"4. Conclusions",level:"1"},{id:"sec_9",title:"5. Future research",level:"1"},{id:"sec_10",title:"Acknowledgments",level:"1"},{id:"sec_13",title:"Conflict of interest",level:"1"}],chapterReferences:[{id:"B1",body:'P. Hribar, T. Kravet, and R. Wilson, “A new measure of accounting quality,” Rev. Account. Stud., vol. 19, no., pp. 506-538, 2014, doi: 10.1007/s11142-013-9253-8.'},{id:"B2",body:'H. Ngoc DANG, C. Duc PHAM, T. Xuan NGUYEN, and H. 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Rada",authors:[{id:"114650",title:"Dr",name:"Eugen",middleName:null,surname:"Culea",fullName:"Eugen Culea",slug:"eugen-culea"},{id:"114653",title:"Dr.",name:"Simona",middleName:null,surname:"Rada",fullName:"Simona Rada",slug:"simona-rada"}]},{id:"36169",title:"Water in Rocks and Minerals - Species, Distributions, and Temperature Dependences",slug:"water-in-rocks-and-minerals-species-distributions-and-temperature-dependences",signatures:"Jun-ichi Fukuda",authors:[{id:"105384",title:"Dr.",name:"Jun-Ichi",middleName:null,surname:"Fukuda",fullName:"Jun-Ichi Fukuda",slug:"jun-ichi-fukuda"}]},{id:"36170",title:"Attenuated Total Reflection - Infrared Spectroscopy Applied to the Study of Mineral - Aqueous Electrolyte Solution Interfaces: A General Overview and a Case Study",slug:"attenuated-total-reflection-infrared-spectroscopy-applied-to-the-study-of-mineral-aqueous-el",signatures:"Grégory Lefèvre, Tajana Preočanin and Johannes Lützenkirchen",authors:[{id:"108416",title:"Dr.",name:"Johannes",middleName:null,surname:"Lützenkirchen",fullName:"Johannes Lützenkirchen",slug:"johannes-lutzenkirchen"},{id:"111675",title:"Dr.",name:"Gregory",middleName:null,surname:"Lefevre",fullName:"Gregory Lefevre",slug:"gregory-lefevre"},{id:"111676",title:"Prof.",name:"Tajana",middleName:null,surname:"Preocanin",fullName:"Tajana Preocanin",slug:"tajana-preocanin"}]},{id:"36171",title:"Research of Calcium Phosphates Using Fourier Transform Infrared Spectroscopy",slug:"research-of-calcium-phosphates-using-fourier-transformation-infrared-spectroscopy",signatures:"Liga Berzina-Cimdina and Natalija Borodajenko",authors:[{id:"110522",title:"Prof.",name:"Liga",middleName:null,surname:"Berzina-Cimdina",fullName:"Liga Berzina-Cimdina",slug:"liga-berzina-cimdina"},{id:"112181",title:"MSc.",name:"Natalija",middleName:null,surname:"Borodajenko",fullName:"Natalija Borodajenko",slug:"natalija-borodajenko"}]},{id:"36172",title:"FTIR Spectroscopy of Adsorbed Probe Molecules for Analyzing the Surface Properties of Supported Pt (Pd) Catalysts",slug:"ftir-spectroscopy-of-adsorbed-probe-molecules-for-analyzing-the-surface-properties-of-supported-pt-p",signatures:"Olga B. 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1. Introduction
Acute kidney injury (AKI) is a frequent complication in several clinical settings, including large surgeries [1], emergency departments [2, 3], and intensive care units (ICUs) [4]. The incidence of AKI has been increasing over the years, with about 2 million people being affected in 2010 [5], despite the efforts of researchers and organizations [6, 7, 8]. AKI is commonly followed by worse outcomes: prolonged length of ICU and hospital stay, need for dialysis, decreases in the glomerular filtration rate (GRF), development of chronic kidney disease (CKD), and increases in mortality [9, 10, 11].
In recent decades, therapeutic interventions aimed at reversing kidney dysfunction have had disappointing results in multiple settings; thus, the research focus has shifted from treatment to prevention and early detection by focusing on two main issues: diagnostic criteria and early diagnosis. In 2004, the Acute Dialysis Quality Initiative (ADQI) sought a more uniform definition of AKI, and the most recent consensus definition was published in 2012 by Kidney Disease: Improving Global Outcomes (KDIGO) [8]. The diagnosis of AKI is based on changes in serum creatinine (Scr) and urine output (UO), but neither marker is kidney specific. Efforts have been made to identify novel biomarkers that have high sensitivity and specificity.
The standardization of the diagnosis of AKI allowed us to compare the diagnoses made in different settings. However, the issue of early diagnosis is still a challenge. First, there are limitations regarding the use of Scr and UO. Second, determining the need for renal replacement therapy is difficult due to a lack of information about whether the AKI is transient or persistent. Last, the research advances identifying early biomarkers have thus far been inaccessible in clinical practice [12].
Neutrophil gelatinase-associated lipocalin (NGAL) [13] has been far and away the most promising biomarker to help fill this gap, and its diagnostic capabilities as a biomarker have been confirmed in a large number of clinical trials. This chapter aims to present information on the role of NGAL in the renal injury process, its expression in the kidney, confounding factors, the type of assay used, whether plasma or urine NGAL has better accuracy, the cutoff values in normal individuals, the accuracy of NGAL for diagnosing AKI, and the evaluation of other outcomes.
2. The role of NGAL
In 1993, Kjeldsen et al. [13] isolated lipocalin as a protease-resistant polypeptide covalently bound to neutrophil gelatinase, named neutrophil gelatinase-associated lipocalin (NGAL), also known as siderocalin, lipocalin 2 or oncogene 24p [14].
NGAL is a 25 kilodalton (kDa) protein covalently bound to gelatinase in neutrophil-specific granules. NGAL is expressed at very low levels in various human tissues, including the kidneys, uterus, prostate, salivary gland, trachea, lungs, stomach, and adult and fetal colon [15, 16]. The anti-inflammatory function of NGAL is demonstrated by increased NGAL expression in proliferative epithelia, inflammatory areas, and intestinal malignancies [17].
In normal kidneys, the expression of NGAL is mainly released by the thick ascending limb and the intercalated cells of the thick collecting duct. Some NGAL expression is also present in the proximal tubular epithelium, once NGAL is filtered by the glomerulus and reabsorbed by the proximal tubule in a megalin-dependent manner [17, 18]. The physiological function of NGAL in the kidneys is unknown; however, the role of NGAL in renal morphogenesis is under consideration [19]. NGAL also has a predominant role in the regulation of cell proliferation, repair processes, and tubular reepithelization. NGAL expression corresponds to an additional iron transport pathway, which increases the transcription of hemeoxygenase, an enzyme with proliferative and antiapoptotic effects that protects and preserves proximal tubular cells [20, 21].
Several biological functions for NGAL have been suggested; in the kidney, NGAL release is associated with ischemic or nephrotoxic insults. Additionally, a decrease in tubular reabsorption after AKI may lead to a further increase in urinary NGAL concentration, resulting acquiring a status of the “troponin” of the kidneys [22, 23, 24].
KEY POINT: The role of NGAL remains unclear, but its release mainly from the distal tubule has been associated with an increase in kidney injury.
3. Confounding factors affecting NGAL
The conditions that can interfere with the performance, sensitivity, and specificity of NGAL, already identified as a biomarker, are sepsis, chronic obstructive pulmonary disease, and cardiac dysfunction, and the presence of these conditions may act as confounding factors for NGAL measurements. The predictive performance of NGAL seems to also be influenced by age (higher predictive value in children than in older patients), sex (higher predictive value in female patients than in male patients), urinary tract infection, and impaired renal function (higher predictive value in patients with chronic kidney disease) [25, 26, 27].
Sepsis will be more thoroughly addressed in the next chapter.
KEY POINT. Controlling for confounding factors in clinical trials is vital to maintain the internal validity of a study.
4. Types of NGAL assays
The commercialization of NGAL as the gold standard for the diagnosis of AKI is somewhat controversial [28]. There are many types of NGAL assays available on the market that use different nonautomated ELISA platforms, which makes it difficult for comparisons to be made among studies from around the world.
The first kit for the quantitative and automated determination of NGAL by the ELISA method was developed by Abbott Laboratories (Abbott Park, IL, USA) for the urinary evaluation of NGAL, with a cutoff value of 141 μg/L (95% CI 125–158 μg/L). An EDTA plasma blood test was created by the Triage Meter platform (Biosite-Inverness Medical, Waltham, USA) with a cutoff value of 163 μ/L (CI 109–221 μ/L) [29].
Bioporto (Bioporto Diagnostics A/S, Gentfte, Denmark) developed a new particle-enhanced turbidimetric immunoassay (PETIA) that has the advantages of flexibility (adaptation for clinical use in different analyzers), automation (closer to clinical practice), and applicability in different biological matrices (urine and plasma) [30].
The chemiluminescence test is an alternative to assess NGAL, and it is commonly used to analyze studies with small animals since it is possible to do the analysis with few substrates [31].
Because there are three known molecular forms of NGAL, the assay of interest should differentiate the 25 kDa NGAL monomer produced by the monocyte tubular epithelial cells from other forms of NGAL: 45 kDa NGAL, from the homodimer predominantly secreted by neutrophils, and the 145 kDa NGAL/matrix metalloproteinase-9 (MMP9) covalently complexed heterodimer [32, 33].
According to Mårtensson et al. [34] and Cai et al. [33], the combination of two ELISAs, may improve the diagnostic accuracy of NGAL, one to determine the monomeric form and the other to determine the homodimeric form.
The confounding factor of sepsis is described herein and is dependent on the assay method, as well as whether the chosen kit is less sensitive to 25 kDa NGAL expressed by tubular epithelial cells. The test can also measure the 45 kDa homodimer predominantly secreted by neutrophils, which are common in sepsis, and the increase in neutrophils increases homodimeric NGAL expression and results in false positives.
KEY POINT: Choose a method closer to those used in clinical practice and a test more accurate for measuring the monomeric form of NGAL expressed by tubular epithelial cells after injury.
5. Plasma or urine NGAL measurement and normalization of urine values
The consensus is clear that NGAL measured in urine has better performance [35], because the release and increase in NGAL will occur first in urine. However, the collection of urine depends on the urine output, which is sometimes not available. Some benefits of plasma NGAL are that it is available at any time and is more accurate in anuric or oliguric patients.
The issue about the normalization of urinary NGAL by correction for the urinary creatinine level is debatable, but it has been used to correct for urine output in cases of oliguria or pollakiuria, avoiding inaccurate concentration or dilution measurements of the biomarkers. The fact is that the creatinine release time is different from the biomarker release time, and the normalized level will be affected by this difference and will not represent a real physiological value [36].
KEY POINT: Urinary NGAL is released earlier than plasma NGAL, and the accuracy of the normalization of urinary NGAL by creatinine is debatable.
6. Cutoff values of NGAL in normal individuals
The determination of normal NGAL levels in healthy adults has been inadequately described in the literature. However, some studies have been performed, such as that of Cullen et al. [26], which analyzed urine by the Abbot-Architec assay in 174 healthy people (100 men and 74 women aged between 19 and 88 years). The value of the immunoassay result was normalized by urinary creatinine, and the cut-off value was 107 μ/mmol (13 μ/mmol). There was a higher concentration of creatinine-normalized urinary NGAL in women, in the elderly and in patients with leukocyturia.
The study reported by Stejkal et al. [37] analyzed BioVendor’s NGAL assay using the serum of 136 healthy, nonobese individuals (53 men and 83 women). The authors reported median NGAL values (78.8 μg/L for men and 80 μg/L for women). Pernnemans et al. [27] analyzed the NGAL ELISA (RD System Europe, Abingdon, UK) and other urinary biomarkers in 338 healthy individuals (199 women and 139 men, aged 0 to 95 years). They reported that the NGAL reference range of the 21–95 years age group was 73.88–211.16 μg/L in women and 149.26–182.58 μg/L in men, and there was higher expression in elderly individuals.
An NGAL PETIA (Bioporto Diagnostics A/S, Gentfte, Denmark) [36] was evaluated for 200 healthy nonobese individuals (137 men and 63 women, with a mean age of 39 years (SD 11.2)). They proposed reference plasma concentrations from 38.7–157.6 ng/ml for women and 24.4–142.5 ng/ml for men and proposed reference urine concentrations of <9–54.5 ng/ml for both sexes. The authors reported that the mean values in men were higher than in women, 78.9 ng/ml vs. 73.8 ng/ml, respectively; there was a significant difference in NGAL in relation to age.
In addition to the variability of the chosen immunoassay, the unit of measurement in the interpretation of the NGAL studies should be considered—the most commonly found are ng/ml, μg/L, ng/dl, mg/ml and μg/mmol.
KEY POINT: The median cutoff value for urinary NGAL in healthy men was between 78.8 and 182.58 μg/L, and the median plasma value was between 24.4 and 142.5 ng/ml in men. The broad variability of the results difficult to interpret.
7. NGAL to predict AKI
NGAL is the most widely investigated AKI biomarker. Its performance for predicting AKI has been evaluated in various settings, such as in pediatric and adult cardiac surgery patients, in critically ill patients, and in patients in the emergency room, as well in kidney transplant and other settings [38, 39].
Numerous studies have demonstrated the ability of NGAL to diagnose AKI. For example, the study reported by Constantin et al. [40], that evaluated the plasma NGAL of 88 patients at ICU admission, found a sensitivity of 82%, specificity of 97% and AUC of 0.92 to cut-off value of 155 mmol/L to predictor of AKI.
A multicenter study, reported by Di Somma et al. [41], with 665 patients admitted to the emergency department, assessed plasma NGAL in several points after admission. Serial evaluation of NGAL at times zero and six hours provided a high negative predictive value (NPV) (98%) to rule out the diagnosis of AKI within six hours of the arrival of patients to the emergency department. The NGAL value at admission could demonstrated a strong predictive value for in-hospital mortality of the patient, with a cut-off value of 400 ng/ml.
In the meta-analysis by Haase et al. [42]—with 19 studies, totaling 2538 patients, of whom 487 (19.2%) developed AKI—NGAL was demonstrated to have diagnostic and prognostic value for AKI, with an OR of 18.6 (95% CI 9–38.1) and AUC of 0.81 (95% CI 0.73–0.89). The cut-off value ranged from 100 to 270 ng/ml, but a value of 150 ng/dl was suggested for the diagnosis of AKI.
In another recent meta-analysis by Zhou et al. [39]—with 24 studies, a total of 4066 patients from 9 countries, including studies with serum and urinary NGAL—the sensitivity for the diagnosis of AKI was 0.68 (95% CI, 65–0.70), and the specificity was 0.79 (95% CI 0.77–0.80).
In the study by Singer et al. [38], urinary NGAL was useful for classifying and stratifying patients with established AKI: the level of NGAL>104 μg/L indicated intrinsic AKI (odds ratio of 5.97), while the level of NGAL <47 μg/L indicated unlikely intrinsic AKI (odds ratio of 0.2). In the logistic regression analysis, NGAL was able to predict the worsening of the RIFLE class, the need for RRT and in-hospital mortality. The performance of NGAL to evaluate other outcomes will be discussed in the next chapter.
KEY POINT: Despite the good results of NGAL for predicting AKI, the variability of the cutoff value is still a challenge for applying NGAL in clinical practice.
8. The early timing diagnosis by NGAL versus standard serum creatinine
The study by Bennett et al. [43] clearly indicated that urinary NGAL is a powerful early biomarker of AKI after cardiopulmonary bypass that preceded the increase in serum creatinine by 2–3 days. Studies have shown that elevation of NGAL is detectable after 3 hours and peaks approximately 6–12 hours after injury. The elevation can persist up to 5 days according to the severity of injury [44, 45, 46]. In addition to Benett’s study, other studies in general have failed to reach conclusions about the early timing diagnosis of NGAL, which is the main finding required to reach a therapeutic window and better evaluate future medication targets in AKI.
KEY POINT: If you perform a study or analyze a biomarker, remember to compare the pattern of biomarker early timing diagnosis with serum creatinine.
9. Evaluation of other outcomes by NGAL
Several studies have assessed the diagnostic value of NGAL to predict AKI, but only a few have analyzed the early diagnosis in hours/days and compared it with serum creatinine, as seen in the last chapter. Still fewer studies have evaluated the predictive performance of NGAL in other outcomes, such as the need for RRT, recovery of renal function, progression to end stage renal disease (ESRD) and mortality, which will be discussed in this chapter.
In the meta-analysis by Hall et al. [47], for 91 kidney transplant patients, the incidence of need for RRT was 4.3%, and NGAL, in this scenario, had an OR of 12.9 and AUC of 0.78. In the same study, NGAL and urinary IL18 were predictors of the need for RRT up to 1 week after transplantation. NGAL presented a good AUC of 0.81 (95% CI 0.70–0.92) 6 hours after transplantation and was also a predictor of graft recovery for up to 3 months.
In the study conducted by Constantin et al. [40], the cutoff value of NGAL to assess the need for RRT was 330 mmol/L. The value of urinary NGAL (Architect, Abbot Park, IL) was correlated with the need for dialysis (r: 0.48 P: 0.01), presenting an AUC of 0.86 2 hours after cardiopulmonary bypass in children [43].
A recent meta-analysis by Klein et al. analyzed 12 studies to predict the need for RRT and found an AUC of 0.70 (95% CI 0.63–0.80) for NGAL [48].
Bhavsar et al. [49] concluded that higher levels of NGAL (measured by the Luminex assay) were associated with stage 3 CKD incidence. Some researchers have discussed whether the association of NGAL level is not exclusively related to the increase in neutrophils already described by Tian et al. [50] and maintain that further studies would be needed to elucidate this issue.
In the meta-analysis by Haase et al. [42], the incidence of mortality was 5.4%, and NGAL, in this scenario, showed an OR of 8.8 and AUC of 0.70.
In the Ariza study [51], PNGAL and UNGAL were demonstrated to be strong predictors of prognosis, and UNGAL was significantly predictive of the MELD score using the 28-day mortality score AUC of 0.88 (0.83–0.92).
In the study by Bennett et al. [43], the value of urinary NGAL (Architect, Abbot Park, IL) was also correlated with mortality (r: 0.53 p 0.01), with an AUC of 0.91, 2 hours after cardiopulmonary bypass in children.
The study by Dent et al. [52], using PNGAL (Biosite Inc., San Diego, USA) in 120 children undergoing cardiopulmonary bypass (CBP) and a cut-off value of 150 ng/ml and AKI prediction, found an AUC of 0.96 2 hours after CBP. PNGAL was also strongly correlated with the duration of AKI (r = 0.57, p < 0.001) and hospital stay time (r = 0.44, p < 0.001), and PNGAL at 12 hours was correlated with mortality (r = 0.48, p: 0.004).
In the study by Daniels et al. [53], PNGAL (Alere Inc., Waltham, USA) was measured in 1393 adult patients with cardiovascular disease (CVD) who were followed for 11 years. Of these, 436 did not survive, and 169 died from CVD. PNGAL was a predictor of CVD mortality, with a risk ratio of 1.33% and a risk ratio of 1.19% for all causes of mortality.
KEY POINT: Evaluating outcomes by NGAL beyond the limitation of only the diagnosis of AKI is important to know how more than one parameter evaluates the outcome and prognosis, and it could help physicians by indicating an early need for RRT, for example.
10. Conclusion
This brief review, based on accumulated evidence, discussed the role and value of NGAL in the diagnosis and prognosis of AKI. Studies’ findings suggest that induction of NGAL plays an important role in kidney function preservation, reducing apoptosis, and enhancing proliferative responses. In kidney injury, rapid and massive upregulated synthesis of NGAL occurs in the distal tubule, which quickly increases the concentration of NGAL in urine [54]. In addition, other important considerations have been provided as “key point” to help researchers move the NGAL analysis to clinical practice as soon possible.
Conflict of interest
The authors declare that there are no conflicts of interest regarding the publication of this chapter.
\n',keywords:"acute kidney injury, biomarkers, neutrophil gelatinase-associated lipocalin",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/73275.pdf",chapterXML:"https://mts.intechopen.com/source/xml/73275.xml",downloadPdfUrl:"/chapter/pdf-download/73275",previewPdfUrl:"/chapter/pdf-preview/73275",totalDownloads:293,totalViews:0,totalCrossrefCites:0,dateSubmitted:"August 5th 2020",dateReviewed:"August 19th 2020",datePrePublished:"September 21st 2020",datePublished:"January 26th 2022",dateFinished:"September 21st 2020",readingETA:"0",abstract:"Acute kidney injury (AKI) is a common complication in several settings inside and outside hospitals. It affects millions of people around the world, and despite high levels of research funding, there is no specific treatment that changes the disease course. The basis for unfavorable outcomes related to this disease is the failure to provide early diagnosis. Currently, the diagnosis of AKI is based on serum creatinine and urine output, and both measures have several limitations, making early diagnosis difficult. In recent decades, several biomarkers of kidney injury have been proposed, with neutrophil gelatinase-associated lipocalin (NGAL) being one of most studied and promising for use in early diagnosis. Despite there being several studies on NGAL, it has not yet been applied in clinical practice; thus, furthering the understanding of the development, interpretation, and limitations of NGAL in the diagnosis of AKI is the objective of this chapter.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/73275",risUrl:"/chapter/ris/73275",signatures:"Camila Lima, Maria de Fatima Vattimo and Etienne Macedo",book:{id:"10426",type:"book",title:"Inflammation in the 21st Century",subtitle:null,fullTitle:"Inflammation in the 21st Century",slug:"inflammation-in-the-21st-century",publishedDate:"January 26th 2022",bookSignature:"Vijay Kumar, Alexandro Aguilera Salgado and Seyyed Shamsadin Athari",coverURL:"https://cdn.intechopen.com/books/images_new/10426.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",isbn:"978-1-83968-642-9",printIsbn:"978-1-83968-641-2",pdfIsbn:"978-1-83968-643-6",isAvailableForWebshopOrdering:!0,editors:[{id:"63844",title:"Dr.",name:"Vijay",middleName:null,surname:"Kumar",slug:"vijay-kumar",fullName:"Vijay Kumar"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"324949",title:"M.D.",name:"Camila",middleName:null,surname:"Lima",fullName:"Camila Lima",slug:"camila-lima",email:"camilaxlima@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"328731",title:"Prof.",name:"Etienne",middleName:null,surname:"Macedo",fullName:"Etienne Macedo",slug:"etienne-macedo",email:"etimacedo@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"University of California San Diego Medical Center",institutionURL:null,country:{name:"United States of America"}}},{id:"328732",title:"Prof.",name:"Maria De Fatima",middleName:null,surname:"Vattimo",fullName:"Maria De Fatima Vattimo",slug:"maria-de-fatima-vattimo",email:"limmila@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"University of Sao Paulo",institutionURL:null,country:{name:"Brazil"}}}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. The role of NGAL",level:"1"},{id:"sec_3",title:"3. Confounding factors affecting NGAL",level:"1"},{id:"sec_4",title:"4. Types of NGAL assays",level:"1"},{id:"sec_5",title:"5. Plasma or urine NGAL measurement and normalization of urine values",level:"1"},{id:"sec_6",title:"6. Cutoff values of NGAL in normal individuals",level:"1"},{id:"sec_7",title:"7. NGAL to predict AKI",level:"1"},{id:"sec_8",title:"8. The early timing diagnosis by NGAL versus standard serum creatinine",level:"1"},{id:"sec_9",title:"9. Evaluation of other outcomes by NGAL",level:"1"},{id:"sec_10",title:"10. Conclusion",level:"1"},{id:"sec_14",title:"Conflict of interest",level:"1"}],chapterReferences:[{id:"B1",body:'Zhou F, Luo Q , Wang L, Han L. Diagnostic value of neutrophil gelatinase-associated lipocalin for early diagnosis of cardiac surgery-associated acute kidney injury: A meta-analysis. European Journal of Cardio-Thoracic Surgery. 2016;49(3):746-755. 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Review: Neutrophil gelatinase-associated lipocalin - A troponin-like biomarker for human acute kidney injury. Nephrology (Carlton, Vic.). 2010;15:419-428'},{id:"B45",body:'Mishra J, Dent C, Tarabishi R, Mitsnefes MM, Ma Q , Kelly C, et al. Neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker for acute renal injury after cardiac surgery. The Lancet. 2005;365:1231-1238'},{id:"B46",body:'Parikh CR, Coca SG, Thiessen-Philbrook H, Shlipak MG, Koyner JL, Wang Z, et al. Postoperative biomarkers predict acute kidney injury and poor outcomes after adult cardiac surgery. Journal of the American Society of Nephrology. 2011;22:1748-1757'},{id:"B47",body:'Hall IE, Yarlagadda SG, Coca SG, Wang Z, Doshi M, Devarajan P, et al. IL-18 and urinary NGAL predict dialysis andgraft recovery after kidney transplantation. Journal of the American Society of Nephrology. 2010;21:189-197'},{id:"B48",body:'Klein SJ, Brandtner AK, Lehner GF, Ulmer H, Bagshaw SM, Wiedermann CJ, et al. Biomarkers for prediction of renal replacement therapy in acute kidney injury: A systematic review and meta-analysis. Intensive Care Medicine. 2018;44:323-336. DOI: 10.1007/s00134-018-5126-8'},{id:"B49",body:'Bhavsar NA, Köttgen A, Coresh J, Astor BC. Neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule 1 (KIM-1) as predictors of incident CKD stage 3: The atherosclerosis risk in communities (ARIC) study. American Journal of Kidney Diseases. 2012;60(2):865-867'},{id:"B50",body:'Tian N, Penman AD, Manning RD Jr, Flessner MF, Mawson AR. Association between circulating specific leukocyte types and incident chronic kidney disease: The atherosclerosis risk in communities (ARIC) study. Journal of the American Society of Hypertension. 2012;6(2):100-108'},{id:"B51",body:'Ariza X, Graupera I, Coll M, Solà E, Barreto R, García E, et al. Neutrophil gelatinase-associated lipocalin is a biomarker of acute-on-chronic liver failure and prognosis in cirrhosis. 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Journal of the American Society of Nephrology. 2004;15:3073-3082'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Camila Lima",address:"camilaxlima@gmail.com",affiliation:'
Internal Medicine Department, Nephrology Division, University of Sao Paulo, Brazil
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Internal Medicine Department, Nephrology Division, University of Sao Paulo, Brazil
Department of Medicine, Nephrology Division, University of California, USA
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It is present in different machines we use every day; in fact, technical systems in our homes and all the industries are hard to imagine today without these concepts. Moreover, the same theories can be used for modelling life processes as a collection of inputs, outputs, plants and control loops. Feedback is one of the main concepts behind control; in particular, several examples of physiological control mechanisms for regulating life aspects can be found in the human anatomy, for example, blood pressure, cholesterol levels, body movements, the equilibrium, etc. Those processes can be damaged by the aging effects, diseases, accidents or when the mechanism has been broken and cannot be recovered naturally; consequently, it will be required external assistance. A relative new field in control theory is related with developing technology for helping with physiological and medicals problems. However, in comparison with machines, those physiological processes are highly nonlinear, with delays and slow responses. Another problem is when human becomes the operators using their capacities of decision making to close the control loop, as they are prone to errors and mistakes. For those reasons, the biomedical system needs to be carefully designed and several aspects have to be considered. This chapter gives a small review of some internal and external control processes within the human body and discusses how to interact with them for designing biomedical devices. Under this design scheme, a practical application of a smart electric wheelchair for assisting persons with strong disabilities is presented. These assistive robotic systems are in close contact with the user, and thus, it is determinant to have a user-friendly relation between the human and the interface. Therefore, intuitive interfaces were included in the design and an intelligent navigation assistant to guarantee a collision-free path.",book:{id:"5238",slug:"automation-and-control-trends",title:"Automation and Control Trends",fullTitle:"Automation and Control Trends"},signatures:"David Balderas and Mario Rojas",authors:[{id:"183076",title:"M.Sc.",name:"David",middleName:null,surname:"Balderas Silva",slug:"david-balderas-silva",fullName:"David Balderas Silva"},{id:"184877",title:"MSc.",name:"Mario",middleName:null,surname:"Rojas",slug:"mario-rojas",fullName:"Mario Rojas"}]},{id:"51070",title:"Fuzzy PD Controller in NAO System's Platform",slug:"fuzzy-pd-controller-in-nao-system-s-platform",totalDownloads:1607,totalCrossrefCites:1,totalDimensionsCites:2,abstract:"Humanoid robotic platforms rarely achieve the desire trajectory because of the deviation generated during the robot walking. This problem is due to different circumstances such as robot manufacturing, wear and tear of mechanic parts, or variations of floor flatness. Currently, one of the humanoid robots on the market is the robotic platform developed by Aldebaran Robotics called NAO robot, and it is used for different purposes where the robot needs to navigate into controlled spaces. NAO presents the issue of deviation during walking; therefore, a Fuzzy PD Controller is developed and implemented for this platform to reduce the orientation error and to ensure reliability during navigation. Inertial sensors are used to get the orientation reference and for feedback of the closed-loop control. Consequently, a robust control was implemented and tested in different conditions of floor and velocity during the robot’s navigation such as robot races and maze resolution. Experimental results show that fuzzy controller achieves significant improvements in the trajectories of NAO.",book:{id:"5238",slug:"automation-and-control-trends",title:"Automation and Control Trends",fullTitle:"Automation and Control Trends"},signatures:"Edgar Omar López‐Caudana and César Daniel González Gutiérrez",authors:[{id:"26464",title:"Dr.",name:"Edgar",middleName:"Omar",surname:"Lopez-Caudana",slug:"edgar-lopez-caudana",fullName:"Edgar Lopez-Caudana"},{id:"185936",title:"Mr.",name:"César Daniel",middleName:null,surname:"González Gutiérrez",slug:"cesar-daniel-gonzalez-gutierrez",fullName:"César Daniel González Gutiérrez"}]}],onlineFirstChaptersFilter:{topicId:"257",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:90,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:107,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:330,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:9,numberOfPublishedChapters:139,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:122,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:21,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:10,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}},{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}}]},series:{item:{id:"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:6,paginationItems:[{id:"14",title:"Cell and Molecular Biology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/14.jpg",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,editorialBoard:[{id:"79367",title:"Dr.",name:"Ana Isabel",middleName:null,surname:"Flores",slug:"ana-isabel-flores",fullName:"Ana Isabel Flores",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRpIOQA0/Profile_Picture_1632418099564",institutionString:null,institution:{name:"Hospital Universitario 12 De Octubre",institutionURL:null,country:{name:"Spain"}}},{id:"328234",title:"Ph.D.",name:"Christian",middleName:null,surname:"Palavecino",slug:"christian-palavecino",fullName:"Christian Palavecino",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000030DhEhQAK/Profile_Picture_1628835318625",institutionString:null,institution:{name:"Central University of Chile",institutionURL:null,country:{name:"Chile"}}},{id:"186585",title:"Dr.",name:"Francisco Javier",middleName:null,surname:"Martin-Romero",slug:"francisco-javier-martin-romero",fullName:"Francisco Javier Martin-Romero",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSB3HQAW/Profile_Picture_1631258137641",institutionString:null,institution:{name:"University of Extremadura",institutionURL:null,country:{name:"Spain"}}}]},{id:"15",title:"Chemical Biology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/15.jpg",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,editorialBoard:[{id:"219081",title:"Dr.",name:"Abdulsamed",middleName:null,surname:"Kükürt",slug:"abdulsamed-kukurt",fullName:"Abdulsamed Kükürt",profilePictureURL:"https://mts.intechopen.com/storage/users/219081/images/system/219081.png",institutionString:null,institution:{name:"Kafkas University",institutionURL:null,country:{name:"Turkey"}}},{id:"241413",title:"Dr.",name:"Azhar",middleName:null,surname:"Rasul",slug:"azhar-rasul",fullName:"Azhar Rasul",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRT1oQAG/Profile_Picture_1635251978933",institutionString:null,institution:{name:"Government College University, Faisalabad",institutionURL:null,country:{name:"Pakistan"}}},{id:"178316",title:"Ph.D.",name:"Sergey",middleName:null,surname:"Sedykh",slug:"sergey-sedykh",fullName:"Sergey Sedykh",profilePictureURL:"https://mts.intechopen.com/storage/users/178316/images/system/178316.jfif",institutionString:null,institution:{name:"Novosibirsk State University",institutionURL:null,country:{name:"Russia"}}}]},{id:"17",title:"Metabolism",coverUrl:"https://cdn.intechopen.com/series_topics/covers/17.jpg",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,editorialBoard:[{id:"243049",title:"Dr.",name:"Anca",middleName:null,surname:"Pantea Stoian",slug:"anca-pantea-stoian",fullName:"Anca Pantea Stoian",profilePictureURL:"https://mts.intechopen.com/storage/users/243049/images/system/243049.jpg",institutionString:null,institution:{name:"Carol Davila University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"203824",title:"Dr.",name:"Attilio",middleName:null,surname:"Rigotti",slug:"attilio-rigotti",fullName:"Attilio Rigotti",profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institutionString:null,institution:{name:"Pontifical Catholic University of Chile",institutionURL:null,country:{name:"Chile"}}},{id:"300470",title:"Dr.",name:"Yanfei (Jacob)",middleName:null,surname:"Qi",slug:"yanfei-(jacob)-qi",fullName:"Yanfei (Jacob) Qi",profilePictureURL:"https://mts.intechopen.com/storage/users/300470/images/system/300470.jpg",institutionString:null,institution:{name:"Centenary Institute of Cancer Medicine and Cell Biology",institutionURL:null,country:{name:"Australia"}}}]},{id:"18",title:"Proteomics",coverUrl:"https://cdn.intechopen.com/series_topics/covers/18.jpg",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. She is an author of about 90 publications (According to Scopus: H-Index: 23; According to WOS: H-Index: 20) on peer-reviewed journals, a member of the “Società Italiana di Biochimica e Biologia Molecolare,“ and a Consultant Reviewer for International Journal of Molecular Science, Journal of Chromatography A, COPD, Plos ONE and Nutritional Neuroscience.",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorThree:null,editorialBoard:[{id:"72288",title:"Dr.",name:"Arli Aditya",middleName:null,surname:"Parikesit",slug:"arli-aditya-parikesit",fullName:"Arli Aditya Parikesit",profilePictureURL:"https://mts.intechopen.com/storage/users/72288/images/system/72288.jpg",institutionString:null,institution:{name:"Indonesia International Institute for Life Sciences",institutionURL:null,country:{name:"Indonesia"}}},{id:"40928",title:"Dr.",name:"Cesar",middleName:null,surname:"Lopez-Camarillo",slug:"cesar-lopez-camarillo",fullName:"Cesar Lopez-Camarillo",profilePictureURL:"https://mts.intechopen.com/storage/users/40928/images/3884_n.png",institutionString:null,institution:{name:"Universidad Autónoma de la Ciudad de México",institutionURL:null,country:{name:"Mexico"}}},{id:"81926",title:"Dr.",name:"Shymaa",middleName:null,surname:"Enany",slug:"shymaa-enany",fullName:"Shymaa Enany",profilePictureURL:"https://mts.intechopen.com/storage/users/81926/images/system/81926.png",institutionString:"Suez Canal University",institution:{name:"Suez Canal University",institutionURL:null,country:{name:"Egypt"}}}]}]},overviewPageOFChapters:{paginationCount:42,paginationItems:[{id:"82914",title:"Glance on the Critical Role of IL-23 Receptor Gene Variations in Inflammation-Induced Carcinogenesis",doi:"10.5772/intechopen.105049",signatures:"Mohammed El-Gedamy",slug:"glance-on-the-critical-role-of-il-23-receptor-gene-variations-in-inflammation-induced-carcinogenesis",totalDownloads:8,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Chemokines Updates",coverURL:"https://cdn.intechopen.com/books/images_new/11672.jpg",subseries:{id:"18",title:"Proteomics"}}},{id:"82875",title:"Lipidomics as a Tool in the Diagnosis and Clinical Therapy",doi:"10.5772/intechopen.105857",signatures:"María Elizbeth Alvarez Sánchez, Erick Nolasco Ontiveros, Rodrigo Arreola, Adriana Montserrat Espinosa González, Ana María García Bores, Roberto Eduardo López Urrutia, Ignacio Peñalosa Castro, María del Socorro Sánchez Correa and Edgar Antonio Estrella Parra",slug:"lipidomics-as-a-tool-in-the-diagnosis-and-clinical-therapy",totalDownloads:7,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Fatty Acids - Recent Advances",coverURL:"https://cdn.intechopen.com/books/images_new/11669.jpg",subseries:{id:"17",title:"Metabolism"}}},{id:"82440",title:"Lipid Metabolism and Associated Molecular Signaling Events in Autoimmune Disease",doi:"10.5772/intechopen.105746",signatures:"Mohan Vanditha, Sonu Das and Mathew John",slug:"lipid-metabolism-and-associated-molecular-signaling-events-in-autoimmune-disease",totalDownloads:17,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Fatty Acids - Recent Advances",coverURL:"https://cdn.intechopen.com/books/images_new/11669.jpg",subseries:{id:"17",title:"Metabolism"}}},{id:"82483",title:"Oxidative Stress in Cardiovascular Diseases",doi:"10.5772/intechopen.105891",signatures:"Laura Mourino-Alvarez, Tamara Sastre-Oliva, Nerea Corbacho-Alonso and Maria G. 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My method of translating this into day to day in clinical practice is non-exhaustible and my habit of exchanging knowledge and expertise with others in those fields is the code and secret of success.",institutionString:null,institution:{name:"Majmaah University",country:{name:"Saudi Arabia"}}},{id:"313277",title:"Dr.",name:"Bartłomiej",middleName:null,surname:"Płaczek",slug:"bartlomiej-placzek",fullName:"Bartłomiej Płaczek",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/313277/images/system/313277.jpg",biography:"Bartłomiej Płaczek, MSc (2002), Ph.D. (2005), Habilitation (2016), is a professor at the University of Silesia, Institute of Computer Science, Poland, and an expert from the National Centre for Research and Development. His research interests include sensor networks, smart sensors, intelligent systems, and image processing with applications in healthcare and medicine. He is the author or co-author of more than seventy papers in peer-reviewed journals and conferences as well as the co-author of several books. He serves as a reviewer for many scientific journals, international conferences, and research foundations. Since 2010, Dr. Placzek has been a reviewer of grants and projects (including EU projects) in the field of information technologies.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"35000",title:"Prof.",name:"Ulrich H.P",middleName:"H.P.",surname:"Fischer",slug:"ulrich-h.p-fischer",fullName:"Ulrich H.P Fischer",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/35000/images/3052_n.jpg",biography:"Academic and Professional Background\nUlrich H. P. has Diploma and PhD degrees in Physics from the Free University Berlin, Germany. He has been working on research positions in the Heinrich-Hertz-Institute in Germany. Several international research projects has been performed with European partners from France, Netherlands, Norway and the UK. He is currently Professor of Communications Systems at the Harz University of Applied Sciences, Germany.\n\nPublications and Publishing\nHe has edited one book, a special interest book about ‘Optoelectronic Packaging’ (VDE, Berlin, Germany), and has published over 100 papers and is owner of several international patents for WDM over POF key elements.\n\nKey Research and Consulting Interests\nUlrich’s research activity has always been related to Spectroscopy and Optical Communications Technology. Specific current interests include the validation of complex instruments, and the application of VR technology to the development and testing of measurement systems. He has been reviewer for several publications of the Optical Society of America\\'s including Photonics Technology Letters and Applied Optics.\n\nPersonal Interests\nThese include motor cycling in a very relaxed manner and performing martial arts.",institutionString:null,institution:{name:"Charité",country:{name:"Germany"}}},{id:"341622",title:"Ph.D.",name:"Eduardo",middleName:null,surname:"Rojas Alvarez",slug:"eduardo-rojas-alvarez",fullName:"Eduardo Rojas Alvarez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/341622/images/15892_n.jpg",biography:null,institutionString:null,institution:{name:"University of Cuenca",country:{name:"Ecuador"}}},{id:"215610",title:"Prof.",name:"Muhammad",middleName:null,surname:"Sarfraz",slug:"muhammad-sarfraz",fullName:"Muhammad Sarfraz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/215610/images/system/215610.jpeg",biography:"Muhammad Sarfraz is a professor in the Department of Information Science, Kuwait University. His research interests include computer graphics, computer vision, image processing, machine learning, pattern recognition, soft computing, data science, intelligent systems, information technology, and information systems. Prof. Sarfraz has been a keynote/invited speaker on various platforms around the globe. He has advised various students for their MSc and Ph.D. theses. He has published more than 400 publications as books, journal articles, and conference papers. He is a member of various professional societies and a chair and member of the International Advisory Committees and Organizing Committees of various international conferences. Prof. Sarfraz is also an editor-in-chief and editor of various international journals.",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"32650",title:"Prof.",name:"Lukas",middleName:"Willem",surname:"Snyman",slug:"lukas-snyman",fullName:"Lukas Snyman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/32650/images/4136_n.jpg",biography:"Lukas Willem Snyman received his basic education at primary and high schools in South Africa, Eastern Cape. He enrolled at today's Nelson Metropolitan University and graduated from this university with a BSc in Physics and Mathematics, B.Sc Honors in Physics, MSc in Semiconductor Physics, and a Ph.D. in Semiconductor Physics in 1987. After his studies, he chose an academic career and devoted his energy to the teaching of physics to first, second, and third-year students. After positions as a lecturer at the University of Port Elizabeth, he accepted a position as Associate Professor at the University of Pretoria, South Africa.\r\n\r\nIn 1992, he motivates the concept of 'television and computer-based education” as means to reach large student numbers with only the best of teaching expertise and publishes an article on the concept in the SA Journal of Higher Education of 1993 (and later in 2003). The University of Pretoria subsequently approved a series of test projects on the concept with outreach to Mamelodi and Eerste Rust in 1993. In 1994, the University established a 'Unit for Telematic Education ' as a support section for multiple faculties at the University of Pretoria. In subsequent years, the concept of 'telematic education” subsequently becomes well established in academic circles in South Africa, grew in popularity, and is adopted by many universities and colleges throughout South Africa as a medium of enhancing education and training, as a method to reaching out to far out communities, and as a means to enhance study from the home environment.\r\n\r\nProfessor Snyman in subsequent years pursued research in semiconductor physics, semiconductor devices, microelectronics, and optoelectronics.\r\n\r\nIn 2000 he joined the TUT as a full professor. Here served for a period as head of the Department of Electronic Engineering. Here he makes contributions to solar energy development, microwave and optoelectronic device development, silicon photonics, as well as contributions to new mobile telecommunication systems and network planning in SA.\r\n\r\nCurrently, he teaches electronics and telecommunications at the TUT to audiences ranging from first-year students to Ph.D. level.\r\n\r\nFor his research in the field of 'Silicon Photonics” since 1990, he has published (as author and co-author) about thirty internationally reviewed articles in scientific journals, contributed to more than forty international conferences, about 25 South African provisional patents (as inventor and co-inventor), 8 PCT international patent applications until now. Of these, two USA patents applications, two European Patents, two Korean patents, and ten SA patents have been granted. A further 4 USA patents, 5 European patents, 3 Korean patents, 3 Chinese patents, and 3 Japanese patents are currently under consideration.\r\n\r\nRecently he has also published an extensive scholarly chapter in an internet open access book on 'Integrating Microphotonic Systems and MOEMS into standard Silicon CMOS Integrated circuitry”.\r\n\r\nFurthermore, Professor Snyman recently steered a new initiative at the TUT by introducing a 'Laboratory for Innovative Electronic Systems ' at the Department of Electrical Engineering. The model of this laboratory or center is to primarily combine outputs as achieved by high-level research with lower-level system development and entrepreneurship in a technical university environment. Students are allocated to projects at different levels with PhDs and Master students allocated to the generation of new knowledge and new technologies, while students at the diploma and Baccalaureus level are allocated to electronic systems development with a direct and a near application for application in industry or the commercial and public sectors in South Africa.\r\n\r\nProfessor Snyman received the WIRSAM Award of 1983 and the WIRSAM Award in 1985 in South Africa for best research papers by a young scientist at two international conferences on electron microscopy in South Africa. He subsequently received the SA Microelectronics Award for the best dissertation emanating from studies executed at a South African university in the field of Physics and Microelectronics in South Africa in 1987. In October of 2011, Professor Snyman received the prestigious Institutional Award for 'Innovator of the Year” for 2010 at the Tshwane University of Technology, South Africa. This award was based on the number of patents recognized and granted by local and international institutions as well as for his contributions concerning innovation at the TUT.",institutionString:null,institution:{name:"University of South Africa",country:{name:"South Africa"}}},{id:"317279",title:"Mr.",name:"Ali",middleName:"Usama",surname:"Syed",slug:"ali-syed",fullName:"Ali Syed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/317279/images/16024_n.png",biography:"A creative, talented, and innovative young professional who is dedicated, well organized, and capable research fellow with two years of experience in graduate-level research, published in engineering journals and book, with related expertise in Bio-robotics, equally passionate about the aesthetics of the mechanical and electronic system, obtained expertise in the use of MS Office, MATLAB, SolidWorks, LabVIEW, Proteus, Fusion 360, having a grasp on python, C++ and assembly language, possess proven ability in acquiring research grants, previous appointments with social and educational societies with experience in administration, current affiliations with IEEE and Web of Science, a confident presenter at conferences and teacher in classrooms, able to explain complex information to audiences of all levels.",institutionString:null,institution:{name:"Air University",country:{name:"Pakistan"}}},{id:"75526",title:"Ph.D.",name:"Zihni Onur",middleName:null,surname:"Uygun",slug:"zihni-onur-uygun",fullName:"Zihni Onur Uygun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/75526/images/12_n.jpg",biography:"My undergraduate education and my Master of Science educations at Ege University and at Çanakkale Onsekiz Mart University have given me a firm foundation in Biochemistry, Analytical Chemistry, Biosensors, Bioelectronics, Physical Chemistry and Medicine. After obtaining my degree as a MSc in analytical chemistry, I started working as a research assistant in Ege University Medical Faculty in 2014. In parallel, I enrolled to the MSc program at the Department of Medical Biochemistry at Ege University to gain deeper knowledge on medical and biochemical sciences as well as clinical chemistry in 2014. In my PhD I deeply researched on biosensors and bioelectronics and finished in 2020. Now I have eleven SCI-Expanded Index published papers, 6 international book chapters, referee assignments for different SCIE journals, one international patent pending, several international awards, projects and bursaries. In parallel to my research assistant position at Ege University Medical Faculty, Department of Medical Biochemistry, in April 2016, I also founded a Start-Up Company (Denosens Biotechnology LTD) by the support of The Scientific and Technological Research Council of Turkey. Currently, I am also working as a CEO in Denosens Biotechnology. The main purposes of the company, which carries out R&D as a research center, are to develop new generation biosensors and sensors for both point-of-care diagnostics; such as glucose, lactate, cholesterol and cancer biomarker detections. My specific experimental and instrumental skills are Biochemistry, Biosensor, Analytical Chemistry, Electrochemistry, Mobile phone based point-of-care diagnostic device, POCTs and Patient interface designs, HPLC, Tandem Mass Spectrometry, Spectrophotometry, ELISA.",institutionString:null,institution:{name:"Ege University",country:{name:"Turkey"}}},{id:"267434",title:"Dr.",name:"Rohit",middleName:null,surname:"Raja",slug:"rohit-raja",fullName:"Rohit Raja",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/267434/images/system/267434.jpg",biography:"Dr. Rohit Raja received Ph.D. in Computer Science and Engineering from Dr. CVRAMAN University in 2016. His main research interest includes Face recognition and Identification, Digital Image Processing, Signal Processing, and Networking. Presently he is working as Associate Professor in IT Department, Guru Ghasidas Vishwavidyalaya (A Central University), Bilaspur (CG), India. He has authored several Journal and Conference Papers. He has good Academics & Research experience in various areas of CSE and IT. He has filed and successfully published 27 Patents. He has received many time invitations to be a Guest at IEEE Conferences. He has published 100 research papers in various International/National Journals (including IEEE, Springer, etc.) and Proceedings of the reputed International/ National Conferences (including Springer and IEEE). He has been nominated to the board of editors/reviewers of many peer-reviewed and refereed Journals (including IEEE, Springer).",institutionString:"Guru Ghasidas Vishwavidyalaya",institution:{name:"Guru Ghasidas Vishwavidyalaya",country:{name:"India"}}},{id:"246502",title:"Dr.",name:"Jaya T.",middleName:"T",surname:"Varkey",slug:"jaya-t.-varkey",fullName:"Jaya T. Varkey",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/246502/images/11160_n.jpg",biography:"Jaya T. Varkey, PhD, graduated with a degree in Chemistry from Cochin University of Science and Technology, Kerala, India. She obtained a PhD in Chemistry from the School of Chemical Sciences, Mahatma Gandhi University, Kerala, India, and completed a post-doctoral fellowship at the University of Minnesota, USA. She is a research guide at Mahatma Gandhi University and Associate Professor in Chemistry, St. Teresa’s College, Kochi, Kerala, India.\nDr. Varkey received a National Young Scientist award from the Indian Science Congress (1995), a UGC Research award (2016–2018), an Indian National Science Academy (INSA) Visiting Scientist award (2018–2019), and a Best Innovative Faculty award from the All India Association for Christian Higher Education (AIACHE) (2019). She Hashas received the Sr. Mary Cecil prize for best research paper three times. She was also awarded a start-up to develop a tea bag water filter. \nDr. Varkey has published two international books and twenty-seven international journal publications. She is an editorial board member for five international journals.",institutionString:"St. Teresa’s College",institution:null},{id:"250668",title:"Dr.",name:"Ali",middleName:null,surname:"Nabipour Chakoli",slug:"ali-nabipour-chakoli",fullName:"Ali Nabipour Chakoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/250668/images/system/250668.jpg",biography:"Academic Qualification:\r\n•\tPhD in Materials Physics and Chemistry, From: Sep. 2006, to: Sep. 2010, School of Materials Science and Engineering, Harbin Institute of Technology, Thesis: Structure and Shape Memory Effect of Functionalized MWCNTs/poly (L-lactide-co-ε-caprolactone) Nanocomposites. Supervisor: Prof. Wei Cai,\r\n•\tM.Sc in Applied Physics, From: 1996, to: 1998, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Determination of Boron in Micro alloy Steels with solid state nuclear track detectors by neutron induced auto radiography, Supervisors: Dr. M. Hosseini Ashrafi and Dr. A. Hosseini.\r\n•\tB.Sc. in Applied Physics, From: 1991, to: 1996, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Design of shielding for Am-Be neutron sources for In Vivo neutron activation analysis, Supervisor: Dr. M. Hosseini Ashrafi.\r\n\r\nResearch Experiences:\r\n1.\tNanomaterials, Carbon Nanotubes, Graphene: Synthesis, Functionalization and Characterization,\r\n2.\tMWCNTs/Polymer Composites: Fabrication and Characterization, \r\n3.\tShape Memory Polymers, Biodegradable Polymers, ORC, Collagen,\r\n4.\tMaterials Analysis and Characterizations: TEM, SEM, XPS, FT-IR, Raman, DSC, DMA, TGA, XRD, GPC, Fluoroscopy, \r\n5.\tInteraction of Radiation with Mater, Nuclear Safety and Security, NDT(RT),\r\n6.\tRadiation Detectors, Calibration (SSDL),\r\n7.\tCompleted IAEA e-learning Courses:\r\nNuclear Security (15 Modules),\r\nNuclear Safety:\r\nTSA 2: Regulatory Protection in Occupational Exposure,\r\nTips & Tricks: Radiation Protection in Radiography,\r\nSafety and Quality in Radiotherapy,\r\nCourse on Sealed Radioactive Sources,\r\nCourse on Fundamentals of Environmental Remediation,\r\nCourse on Planning for Environmental Remediation,\r\nKnowledge Management Orientation Course,\r\nFood Irradiation - Technology, Applications and Good Practices,\r\nEmployment:\r\nFrom 2010 to now: Academic staff, Nuclear Science and Technology Research Institute, Kargar Shomali, Tehran, Iran, P.O. Box: 14395-836.\r\nFrom 1997 to 2006: Expert of Materials Analysis and Characterization. Research Center of Agriculture and Medicine. Rajaeeshahr, Karaj, Iran, P. O. Box: 31585-498.",institutionString:"Atomic Energy Organization of Iran",institution:{name:"Atomic Energy Organization of Iran",country:{name:"Iran"}}},{id:"248279",title:"Dr.",name:"Monika",middleName:"Elzbieta",surname:"Machoy",slug:"monika-machoy",fullName:"Monika Machoy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248279/images/system/248279.jpeg",biography:"Monika Elżbieta Machoy, MD, graduated with distinction from the Faculty of Medicine and Dentistry at the Pomeranian Medical University in 2009, defended her PhD thesis with summa cum laude in 2016 and is currently employed as a researcher at the Department of Orthodontics of the Pomeranian Medical University. She expanded her professional knowledge during a one-year scholarship program at the Ernst Moritz Arndt University in Greifswald, Germany and during a three-year internship at the Technical University in Dresden, Germany. She has been a speaker at numerous orthodontic conferences, among others, American Association of Orthodontics, European Orthodontic Symposium and numerous conferences of the Polish Orthodontic Society. She conducts research focusing on the effect of orthodontic treatment on dental and periodontal tissues and the causes of pain in orthodontic patients.",institutionString:"Pomeranian Medical University",institution:{name:"Pomeranian Medical University",country:{name:"Poland"}}},{id:"252743",title:"Prof.",name:"Aswini",middleName:"Kumar",surname:"Kar",slug:"aswini-kar",fullName:"Aswini Kar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252743/images/10381_n.jpg",biography:"uploaded in cv",institutionString:null,institution:{name:"KIIT University",country:{name:"India"}}},{id:"204256",title:"Dr.",name:"Anil",middleName:"Kumar",surname:"Kumar Sahu",slug:"anil-kumar-sahu",fullName:"Anil Kumar Sahu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204256/images/14201_n.jpg",biography:"I have nearly 11 years of research and teaching experience. I have done my master degree from University Institute of Pharmacy, Pt. Ravi Shankar Shukla University, Raipur, Chhattisgarh India. I have published 16 review and research articles in international and national journals and published 4 chapters in IntechOpen, the world’s leading publisher of Open access books. I have presented many papers at national and international conferences. I have received research award from Indian Drug Manufacturers Association in year 2015. My research interest extends from novel lymphatic drug delivery systems, oral delivery system for herbal bioactive to formulation optimization.",institutionString:null,institution:{name:"Chhattisgarh Swami Vivekanand Technical University",country:{name:"India"}}},{id:"253468",title:"Dr.",name:"Mariusz",middleName:null,surname:"Marzec",slug:"mariusz-marzec",fullName:"Mariusz Marzec",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/253468/images/system/253468.png",biography:"An assistant professor at Department of Biomedical Computer Systems, at Institute of Computer Science, Silesian University in Katowice. Scientific interests: computer analysis and processing of images, biomedical images, databases and programming languages. He is an author and co-author of scientific publications covering analysis and processing of biomedical images and development of database systems.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"212432",title:"Prof.",name:"Hadi",middleName:null,surname:"Mohammadi",slug:"hadi-mohammadi",fullName:"Hadi Mohammadi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/212432/images/system/212432.jpeg",biography:"Dr. Hadi Mohammadi is a biomedical engineer with hands-on experience in the design and development of many engineering structures and medical devices through various projects that he has been involved in over the past twenty years. Dr. Mohammadi received his BSc. and MSc. degrees in Mechanical Engineering from Sharif University of Technology, Tehran, Iran, and his PhD. degree in Biomedical Engineering (biomaterials) from the University of Western Ontario. He was a postdoctoral trainee for almost four years at University of Calgary and Harvard Medical School. He is an industry innovator having created the technology to produce lifelike synthetic platforms that can be used for the simulation of almost all cardiovascular reconstructive surgeries. He’s been heavily involved in the design and development of cardiovascular devices and technology for the past 10 years. He is currently an Assistant Professor with the University of British Colombia, Canada.",institutionString:"University of British Columbia",institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"254463",title:"Prof.",name:"Haisheng",middleName:null,surname:"Yang",slug:"haisheng-yang",fullName:"Haisheng Yang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/254463/images/system/254463.jpeg",biography:"Haisheng Yang, Ph.D., Professor and Director of the Department of Biomedical Engineering, College of Life Science and Bioengineering, Beijing University of Technology. He received his Ph.D. degree in Mechanics/Biomechanics from Harbin Institute of Technology (jointly with University of California, Berkeley). Afterwards, he worked as a Postdoctoral Research Associate in the Purdue Musculoskeletal Biology and Mechanics Lab at the Department of Basic Medical Sciences, Purdue University, USA. He also conducted research in the Research Centre of Shriners Hospitals for Children-Canada at McGill University, Canada. Dr. Yang has over 10 years research experience in orthopaedic biomechanics and mechanobiology of bone adaptation and regeneration. He earned an award from Beijing Overseas Talents Aggregation program in 2017 and serves as Beijing Distinguished Professor.",institutionString:null,institution:{name:"Beijing University of Technology",country:{name:"China"}}},{id:"89721",title:"Dr.",name:"Mehmet",middleName:"Cuneyt",surname:"Ozmen",slug:"mehmet-ozmen",fullName:"Mehmet Ozmen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/89721/images/7289_n.jpg",biography:null,institutionString:null,institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"265335",title:"Mr.",name:"Stefan",middleName:"Radnev",surname:"Stefanov",slug:"stefan-stefanov",fullName:"Stefan Stefanov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/265335/images/7562_n.jpg",biography:null,institutionString:null,institution:{name:"Medical University Plovdiv",country:{name:"Bulgaria"}}},{id:"242893",title:"Ph.D. Student",name:"Joaquim",middleName:null,surname:"De Moura",slug:"joaquim-de-moura",fullName:"Joaquim De Moura",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/242893/images/7133_n.jpg",biography:"Joaquim de Moura received his degree in Computer Engineering in 2014 from the University of A Coruña (Spain). In 2016, he received his M.Sc degree in Computer Engineering from the same university. He is currently pursuing his Ph.D degree in Computer Science in a collaborative project between ophthalmology centers in Galicia and the University of A Coruña. His research interests include computer vision, machine learning algorithms and analysis and medical imaging processing of various kinds.",institutionString:null,institution:{name:"University of A Coruña",country:{name:"Spain"}}},{id:"294334",title:"B.Sc.",name:"Marc",middleName:null,surname:"Bruggeman",slug:"marc-bruggeman",fullName:"Marc Bruggeman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/294334/images/8242_n.jpg",biography:"Chemical engineer graduate, with a passion for material science and specific interest in polymers - their near infinite applications intrigue me. \n\nI plan to continue my scientific career in the field of polymeric biomaterials as I am fascinated by intelligent, bioactive and biomimetic materials for use in both consumer and medical applications.",institutionString:null,institution:null},{id:"255757",title:"Dr.",name:"Igor",middleName:"Victorovich",surname:"Lakhno",slug:"igor-lakhno",fullName:"Igor Lakhno",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255757/images/system/255757.jpg",biography:"Igor Victorovich Lakhno was born in 1971 in Kharkiv (Ukraine). \nMD – 1994, Kharkiv National Medical Univesity.\nOb&Gyn; – 1997, master courses in Kharkiv Medical Academy of Postgraduate Education.\nPh.D. – 1999, Kharkiv National Medical Univesity.\nDSC – 2019, PL Shupik National Academy of Postgraduate Education \nProfessor – 2021, Department of Obstetrics and Gynecology of VN Karazin Kharkiv National University\nHead of Department – 2021, Department of Perinatology, Obstetrics and gynecology of Kharkiv Medical Academy of Postgraduate Education\nIgor Lakhno has been graduated from international training courses on reproductive medicine and family planning held at Debrecen University (Hungary) in 1997. Since 1998 Lakhno Igor has worked as an associate professor in the department of obstetrics and gynecology of VN Karazin National University and an associate professor of the perinatology, obstetrics, and gynecology department of Kharkiv Medical Academy of Postgraduate Education. Since June 2019 he’s been a professor in the department of obstetrics and gynecology of VN Karazin National University and a professor of the perinatology, obstetrics, and gynecology department. He’s affiliated with Kharkiv Medical Academy of Postgraduate Education as a Head of Department from November 2021. Igor Lakhno has participated in several international projects on fetal non-invasive electrocardiography (with Dr. J. A. Behar (Technion), Prof. D. Hoyer (Jena University), and José Alejandro Díaz Méndez (National Institute of Astrophysics, Optics, and Electronics, Mexico). He’s an author of about 200 printed works and there are 31 of them in Scopus or Web of Science databases. Igor Lakhno is a member of the Editorial Board of Reproductive Health of Woman, Emergency Medicine, and Technology Transfer Innovative Solutions in Medicine (Estonia). He is a medical Editor of “Z turbotoyu pro zhinku”. Igor Lakhno is a reviewer of the Journal of Obstetrics and Gynaecology (Taylor and Francis), British Journal of Obstetrics and Gynecology (Wiley), Informatics in Medicine Unlocked (Elsevier), The Journal of Obstetrics and Gynecology Research (Wiley), Endocrine, Metabolic & Immune Disorders-Drug Targets (Bentham Open), The Open Biomedical Engineering Journal (Bentham Open), etc. He’s defended a dissertation for a DSc degree “Pre-eclampsia: prediction, prevention, and treatment”. Three years ago Igor Lakhno has participated in a training course on innovative technologies in medical education at Lublin Medical University (Poland). Lakhno Igor has participated as a speaker in several international conferences and congresses (International Conference on Biological Oscillations April 10th-14th 2016, Lancaster, UK, The 9th conference of the European Study Group on Cardiovascular Oscillations). His main scientific interests: are obstetrics, women’s health, fetal medicine, and cardiovascular medicine. \nIgor Lakhno is a consultant at Kharkiv municipal perinatal center. He’s graduated from training courses on endoscopy in gynecology. He has 28 years of practical experience in the field.",institutionString:null,institution:null},{id:"244950",title:"Dr.",name:"Salvatore",middleName:null,surname:"Di Lauro",slug:"salvatore-di-lauro",fullName:"Salvatore Di Lauro",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0030O00002bSF1HQAW/ProfilePicture%202021-12-20%2014%3A54%3A14.482",biography:"Name:\n\tSALVATORE DI LAURO\nAddress:\n\tHospital Clínico Universitario Valladolid\nAvda Ramón y Cajal 3\n47005, Valladolid\nSpain\nPhone number: \nFax\nE-mail:\n\t+34 983420000 ext 292\n+34 983420084\nsadilauro@live.it\nDate and place of Birth:\nID Number\nMedical Licence \nLanguages\t09-05-1985. Villaricca (Italy)\n\nY1281863H\n474707061\nItalian (native language)\nSpanish (read, written, spoken)\nEnglish (read, written, spoken)\nPortuguese (read, spoken)\nFrench (read)\n\t\t\nCurrent position (title and company)\tDate (Year)\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. Private practise.\t2017-today\n\n2019-today\n\t\n\t\nEducation (High school, university and postgraduate training > 3 months)\tDate (Year)\nDegree in Medicine and Surgery. University of Neaples 'Federico II”\nResident in Opthalmology. Hospital Clinico Universitario Valladolid\nMaster in Vitreo-Retina. IOBA. University of Valladolid\nFellow of the European Board of Ophthalmology. Paris\nMaster in Research in Ophthalmology. University of Valladolid\t2003-2009\n2012-2016\n2016-2017\n2016\n2012-2013\n\t\nEmployments (company and positions)\tDate (Year)\nResident in Ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl.\nFellow in Vitreo-Retina. IOBA. University of Valladolid\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. \n\t2012-2016\n2016-2017\n2017-today\n\n2019-Today\n\n\n\t\nClinical Research Experience (tasks and role)\tDate (Year)\nAssociated investigator\n\n' FIS PI20/00740: DESARROLLO DE UNA CALCULADORA DE RIESGO DE\nAPARICION DE RETINOPATIA DIABETICA BASADA EN TECNICAS DE IMAGEN MULTIMODAL EN PACIENTES DIABETICOS TIPO 1. Grant by: Ministerio de Ciencia e Innovacion \n\n' (BIO/VA23/14) Estudio clínico multicéntrico y prospectivo para validar dos\nbiomarcadores ubicados en los genes p53 y MDM2 en la predicción de los resultados funcionales de la cirugía del desprendimiento de retina regmatógeno. Grant by: Gerencia Regional de Salud de la Junta de Castilla y León.\n' Estudio multicéntrico, aleatorizado, con enmascaramiento doble, en 2 grupos\nparalelos y de 52 semanas de duración para comparar la eficacia, seguridad e inmunogenicidad de SOK583A1 respecto a Eylea® en pacientes con degeneración macular neovascular asociada a la edad' (CSOK583A12301; N.EUDRA: 2019-004838-41; FASE III). Grant by Hexal AG\n\n' Estudio de fase III, aleatorizado, doble ciego, con grupos paralelos, multicéntrico para comparar la eficacia y la seguridad de QL1205 frente a Lucentis® en pacientes con degeneración macular neovascular asociada a la edad. (EUDRACT: 2018-004486-13). Grant by Qilu Pharmaceutical Co\n\n' Estudio NEUTON: Ensayo clinico en fase IV para evaluar la eficacia de aflibercept en pacientes Naive con Edema MacUlar secundario a Oclusion de Vena CenTral de la Retina (OVCR) en regimen de tratamientO iNdividualizado Treat and Extend (TAE)”, (2014-000975-21). Grant by Fundacion Retinaplus\n\n' Evaluación de la seguridad y bioactividad de anillos de tensión capsular en conejo. Proyecto Procusens. Grant by AJL, S.A.\n\n'Estudio epidemiológico, prospectivo, multicéntrico y abierto\\npara valorar la frecuencia de la conjuntivitis adenovírica diagnosticada mediante el test AdenoPlus®\\nTest en pacientes enfermos de conjuntivitis aguda”\\n. National, multicenter study. Grant by: NICOX.\n\nEuropean multicentric trial: 'Evaluation of clinical outcomes following the use of Systane Hydration in patients with dry eye”. Study Phase 4. Grant by: Alcon Labs'\n\nVLPs Injection and Activation in a Rabbit Model of Uveal Melanoma. Grant by Aura Bioscience\n\nUpdating and characterization of a rabbit model of uveal melanoma. Grant by Aura Bioscience\n\nEnsayo clínico en fase IV para evaluar las variantes genéticas de la vía del VEGF como biomarcadores de eficacia del tratamiento con aflibercept en pacientes con degeneración macular asociada a la edad (DMAE) neovascular. Estudio BIOIMAGE. IMO-AFLI-2013-01\n\nEstudio In-Eye:Ensayo clínico en fase IV, abierto, aleatorizado, de 2 brazos,\nmulticçentrico y de 12 meses de duración, para evaluar la eficacia y seguridad de un régimen de PRN flexible individualizado de 'esperar y extender' versus un régimen PRN según criterios de estabilización mediante evaluaciones mensuales de inyecciones intravítreas de ranibizumab 0,5 mg en pacientes naive con neovascularización coriodea secunaria a la degeneración macular relacionada con la edad. CP: CRFB002AES03T\n\nTREND: Estudio Fase IIIb multicéntrico, randomizado, de 12 meses de\nseguimiento con evaluador de la agudeza visual enmascarado, para evaluar la eficacia y la seguridad de ranibizumab 0.5mg en un régimen de tratar y extender comparado con un régimen mensual, en pacientes con degeneración macular neovascular asociada a la edad. CP: CRFB002A2411 Código Eudra CT:\n2013-002626-23\n\n\n\nPublications\t\n\n2021\n\n\n\n\n2015\n\n\n\n\n2021\n\n\n\n\n\n2021\n\n\n\n\n2015\n\n\n\n\n2015\n\n\n2014\n\n\n\n\n2015-16\n\n\n\n2015\n\n\n2014\n\n\n2014\n\n\n\n\n2014\n\n\n\n\n\n\n\n2014\n\nJose Carlos Pastor; Jimena Rojas; Salvador Pastor-Idoate; Salvatore Di Lauro; Lucia Gonzalez-Buendia; Santiago Delgado-Tirado. Proliferative vitreoretinopathy: A new concept of disease pathogenesis and practical\nconsequences. Progress in Retinal and Eye Research. 51, pp. 125 - 155. 03/2016. DOI: 10.1016/j.preteyeres.2015.07.005\n\n\nLabrador-Velandia S; Alonso-Alonso ML; Di Lauro S; García-Gutierrez MT; Srivastava GK; Pastor JC; Fernandez-Bueno I. Mesenchymal stem cells provide paracrine neuroprotective resources that delay degeneration of co-cultured organotypic neuroretinal cultures.Experimental Eye Research. 185, 17/05/2019. DOI: 10.1016/j.exer.2019.05.011\n\nSalvatore Di Lauro; Maria Teresa Garcia Gutierrez; Ivan Fernandez Bueno. Quantification of pigment epithelium-derived factor (PEDF) in an ex vivo coculture of retinal pigment epithelium cells and neuroretina.\nJournal of Allbiosolution. 2019. ISSN 2605-3535\n\nSonia Labrador Velandia; Salvatore Di Lauro; Alonso-Alonso ML; Tabera Bartolomé S; Srivastava GK; Pastor JC; Fernandez-Bueno I. Biocompatibility of intravitreal injection of human mesenchymal stem cells in immunocompetent rabbits. Graefe's archive for clinical and experimental ophthalmology. 256 - 1, pp. 125 - 134. 01/2018. DOI: 10.1007/s00417-017-3842-3\n\n\nSalvatore Di Lauro, David Rodriguez-Crespo, Manuel J Gayoso, Maria T Garcia-Gutierrez, J Carlos Pastor, Girish K Srivastava, Ivan Fernandez-Bueno. A novel coculture model of porcine central neuroretina explants and retinal pigment epithelium cells. Molecular Vision. 2016 - 22, pp. 243 - 253. 01/2016.\n\nSalvatore Di Lauro. Classifications for Proliferative Vitreoretinopathy ({PVR}): An Analysis of Their Use in Publications over the Last 15 Years. Journal of Ophthalmology. 2016, pp. 1 - 6. 01/2016. DOI: 10.1155/2016/7807596\n\nSalvatore Di Lauro; Rosa Maria Coco; Rosa Maria Sanabria; Enrique Rodriguez de la Rua; Jose Carlos Pastor. Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study. Journal of Ophthalmology. 2015:821864, 2015. DOI: 10.1155/2015/821864\n\nIvan Fernandez-Bueno; Salvatore Di Lauro; Ivan Alvarez; Jose Carlos Lopez; Maria Teresa Garcia-Gutierrez; Itziar Fernandez; Eva Larra; Jose Carlos Pastor. Safety and Biocompatibility of a New High-Density Polyethylene-Based\nSpherical Integrated Porous Orbital Implant: An Experimental Study in Rabbits. Journal of Ophthalmology. 2015:904096, 2015. DOI: 10.1155/2015/904096\n\nPastor JC; Pastor-Idoate S; Rodríguez-Hernandez I; Rojas J; Fernandez I; Gonzalez-Buendia L; Di Lauro S; Gonzalez-Sarmiento R. Genetics of PVR and RD. Ophthalmologica. 232 - Suppl 1, pp. 28 - 29. 2014\n\nRodriguez-Crespo D; Di Lauro S; Singh AK; Garcia-Gutierrez MT; Garrosa M; Pastor JC; Fernandez-Bueno I; Srivastava GK. Triple-layered mixed co-culture model of RPE cells with neuroretina for evaluating the neuroprotective effects of adipose-MSCs. Cell Tissue Res. 358 - 3, pp. 705 - 716. 2014.\nDOI: 10.1007/s00441-014-1987-5\n\nCarlo De Werra; Salvatore Condurro; Salvatore Tramontano; Mario Perone; Ivana Donzelli; Salvatore Di Lauro; Massimo Di Giuseppe; Rosa Di Micco; Annalisa Pascariello; Antonio Pastore; Giorgio Diamantis; Giuseppe Galloro. Hydatid disease of the liver: thirty years of surgical experience.Chirurgia italiana. 59 - 5, pp. 611 - 636.\n(Italia): 2007. ISSN 0009-4773\n\nChapters in books\n\t\n' Salvador Pastor Idoate; Salvatore Di Lauro; Jose Carlos Pastor Jimeno. PVR: Pathogenesis, Histopathology and Classification. Proliferative Vitreoretinopathy with Small Gauge Vitrectomy. Springer, 2018. ISBN 978-3-319-78445-8\nDOI: 10.1007/978-3-319-78446-5_2. \n\n' Salvatore Di Lauro; Maria Isabel Lopez Galvez. Quistes vítreos en una mujer joven. Problemas diagnósticos en patología retinocoroidea. Sociedad Española de Retina-Vitreo. 2018.\n\n' Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor Jimeno. iOCT in PVR management. OCT Applications in Opthalmology. pp. 1 - 8. INTECH, 2018. DOI: 10.5772/intechopen.78774.\n\n' Rosa Coco Martin; Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor. amponadores, manipuladores y tinciones en la cirugía del traumatismo ocular.Trauma Ocular. Ponencia de la SEO 2018..\n\n' LOPEZ GALVEZ; DI LAURO; CRESPO. OCT angiografia y complicaciones retinianas de la diabetes. PONENCIA SEO 2021, CAPITULO 20. (España): 2021.\n\n' Múltiples desprendimientos neurosensoriales bilaterales en paciente joven. Enfermedades Degenerativas De Retina Y Coroides. SERV 04/2016. \n' González-Buendía L; Di Lauro S; Pastor-Idoate S; Pastor Jimeno JC. Vitreorretinopatía proliferante (VRP) e inflamación: LA INFLAMACIÓN in «INMUNOMODULADORES Y ANTIINFLAMATORIOS: MÁS ALLÁ DE LOS CORTICOIDES. RELACION DE PONENCIAS DE LA SOCIEDAD ESPAÑOLA DE OFTALMOLOGIA. 10/2014.",institutionString:null,institution:null},{id:"243698",title:"Dr.",name:"Xiaogang",middleName:null,surname:"Wang",slug:"xiaogang-wang",fullName:"Xiaogang Wang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243698/images/system/243698.png",biography:"Dr. Xiaogang Wang, a faculty member of Shanxi Eye Hospital specializing in the treatment of cataract and retinal disease and a tutor for postgraduate students of Shanxi Medical University, worked in the COOL Lab as an international visiting scholar under the supervision of Dr. David Huang and Yali Jia from October 2012 through November 2013. Dr. Wang earned an MD from Shanxi Medical University and a Ph.D. from Shanghai Jiao Tong University. 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