Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
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We wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
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Throughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\n
We wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\n'}],latestNews:[{slug:"intechopen-supports-asapbio-s-new-initiative-publish-your-reviews-20220729",title:"IntechOpen Supports ASAPbio’s New Initiative Publish Your Reviews"},{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"}]},book:{item:{type:"book",id:"11007",leadTitle:null,fullTitle:"Vegetable Crops - Health Benefits and Cultivation",title:"Vegetable Crops",subtitle:"Health Benefits and Cultivation",reviewType:"peer-reviewed",abstract:"In ancient times, people benefited from ingesting different parts of various weeds (root, stem, shoot, leaf, flower, fruit, seed, etc.) to maintain a healthy life. People have obtained the vegetables we grow today by succeeding in cultivating these weeds. This book explains the health benefits of vegetable crops, organic vegetable growing, greenhouse management, and principles of irrigation management for vegetable crops.",isbn:"978-1-83969-949-8",printIsbn:"978-1-83969-948-1",pdfIsbn:"978-1-83969-950-4",doi:"10.5772/intechopen.95704",price:119,priceEur:129,priceUsd:155,slug:"vegetable-crops-health-benefits-and-cultivation",numberOfPages:292,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"9e0e217885c8c1fd39ec4a9649445df0",bookSignature:"Ertan Yildirim and Melek Ekinci",publishedDate:"April 20th 2022",coverURL:"https://cdn.intechopen.com/books/images_new/11007.jpg",numberOfDownloads:1898,numberOfWosCitations:0,numberOfCrossrefCitations:3,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:4,numberOfDimensionsCitationsByBook:0,hasAltmetrics:0,numberOfTotalCitations:7,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"May 28th 2021",dateEndSecondStepPublish:"July 30th 2021",dateEndThirdStepPublish:"September 3rd 2021",dateEndFourthStepPublish:"November 22nd 2021",dateEndFifthStepPublish:"January 21st 2022",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"186639",title:"Prof.",name:"Ertan",middleName:null,surname:"Yildirim",slug:"ertan-yildirim",fullName:"Ertan Yildirim",profilePictureURL:"https://mts.intechopen.com/storage/users/186639/images/system/186639.jpg",biography:"Ertan Yildirim is a full professor in the Department of Horticulture, Atatürk University, Turkey. He received his Ph.D. in Horticulture from the same university in 2003. His research focuses on vegetable growing, vegetable breeding, greenhouse management, seed germination and physiology, organic agriculture, and stress physiology. Dr. Yildirim has more than 200 publications to his credit.",institutionString:"Atatürk University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"6",totalChapterViews:"0",totalEditedBooks:"2",institution:{name:"Atatürk University",institutionURL:null,country:{name:"Turkey"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:{id:"247120",title:"Prof.",name:"Melek",middleName:null,surname:"Ekinci",slug:"melek-ekinci",fullName:"Melek Ekinci",profilePictureURL:"https://mts.intechopen.com/storage/users/247120/images/system/247120.png",biography:"Melek Ekinci is a professor in the Department of Horticulture, Agriculture Faculty, Atatürk University, Turkey. Her research is focused on teaching and researching vegetable growing, greenhouse management, seed germination and physiology, stress physiology, and mushroom cultivation. She has many publications to her credit and has attended many national and international courses, congresses, and symposiums.",institutionString:"Atatürk University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Atatürk University",institutionURL:null,country:{name:"Turkey"}}},coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"341",title:"Olericulture",slug:"olericulture"}],chapters:[{id:"79441",title:"Nutritional Values of Vegetables",doi:"10.5772/intechopen.101090",slug:"nutritional-values-of-vegetables",totalDownloads:58,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The incidence of chronic and incurable diseases ravaging humanity today has awakened a resolve for healthy eating and natural living. Mankind generally cultivates diverse foodstuff for survival, multiplication, replenishment, and commercial purposes. Vegetables are a variety of food that provide nourishment of essential vitamins and minerals to the body. The various categories of vegetables cut across leafy, bulb, flower, seed, root, fruit to stem. The variety of colors from different array of vegetables are evidence of the numerous phytochemicals present in vegetables. These phytochemicals have been recorded to help the body fight against diseases and reduce the incidence of occurrence. Metabolic activities of the human body are enhanced when vegetables are consumed in large quantities. Vegetables can be eaten either raw or cooked and play an important role in human nutrition. They are mostly low in fat and carbohydrates, but high in vitamins, minerals, and dietary fiber. Due to the short shelf-life of many vegetables, it is pertinent to handle them in a most hygienic way to prevent the loss of essential nutrients especially the easily volatile group like essential oil, vitamin B, and vitamin C. Handling process of vegetables include canning, freezing, dehydrating and blanching.",signatures:"Abosede Ebabhi and Raimot Adebayo",downloadPdfUrl:"/chapter/pdf-download/79441",previewPdfUrl:"/chapter/pdf-preview/79441",authors:[{id:"424433",title:"Dr.",name:"Abosede",surname:"Ebabhi",slug:"abosede-ebabhi",fullName:"Abosede Ebabhi"},{id:"435517",title:"Mrs.",name:"Raimot",surname:"Adebayo",slug:"raimot-adebayo",fullName:"Raimot Adebayo"}],corrections:null},{id:"79511",title:"Antioxidant-Rich Vegetables: Impact on Human Health",doi:"10.5772/intechopen.101126",slug:"antioxidant-rich-vegetables-impact-on-human-health",totalDownloads:153,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Antioxidants are valuable ingredients present in vegetables. Vegetables are essential and crucial in human’s health and diet because of their minerals, antioxidant vitamins, phytochemical compounds, and dietary fibre content. This is the reason why an adequate consumption of vegetables has been linked with reduced risk and protection against various chronic diseases. Notably, each vegetable belongs to a group that contains a unique quantity of phytochemical compounds, which distinguish them from other groups and even within their group. The exact mechanisms by which the consumption of vegetables protects against human diseases are yet to be fully understood. However, the phytochemicals present in vegetables could be responsible for attenuating some of them. These phytochemicals are strong antioxidants that reduce the risk of chronic diseases by mounting resistance against the generation of free radicals and their damage. They are also involved in the modification of metabolic activation, detoxification of carcinogenic compounds, or attack of tumour formation in cells. This review highlights the inherent antioxidant potentials of vegetables, their roles as an excellent source of antioxidants and their impact on human health and diseases. Information provided in this review will provide more insight into the roles of antioxidants present in vegetables.",signatures:"Anne Adebukola Adeyanju, Omolola Rebecca Oyenihi and Oluwafemi Omoniyi Oguntibeju",downloadPdfUrl:"/chapter/pdf-download/79511",previewPdfUrl:"/chapter/pdf-preview/79511",authors:[{id:"122415",title:"Prof.",name:"Oluwafemi Omoniyi",surname:"Oguntibeju",slug:"oluwafemi-omoniyi-oguntibeju",fullName:"Oluwafemi Omoniyi Oguntibeju"},{id:"276123",title:"Dr.",name:"Omolola Rebecca",surname:"Oyenihi",slug:"omolola-rebecca-oyenihi",fullName:"Omolola Rebecca Oyenihi"},{id:"422142",title:"Dr.",name:"Anne",surname:"Adebukola Adeyanju",slug:"anne-adebukola-adeyanju",fullName:"Anne Adebukola Adeyanju"}],corrections:null},{id:"78955",title:"Vegetable Proteins: Nutritional Value, Sustainability, and Future Perspectives",doi:"10.5772/intechopen.100236",slug:"vegetable-proteins-nutritional-value-sustainability-and-future-perspectives",totalDownloads:162,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"The growing world population demands more production of proteins for healthy growth and prevention of protein-energy malnutrition. The animal proteins are not sufficient to meet the requirement of daily proteins intake. Furthermore, due to limited resources of animal number, land, water, environmental impact, the demand for vegetable proteins and sustainability have been increasing tremendously. This chapter will outline the demand scenarios of vegetable proteins, nutritional aspects, and technological challenges in product development and consumer acceptance. It will summarize the potential of vegetable proteins related to health and existing diseases. The consumption of vegetable proteins, development of product, economic, sustainability, and food safety aspects will be summarized.",signatures:"Nazir Ahmed, Anwar Ali, Sakhawat Riaz, Arslan Ahmad and Muhammad Aqib",downloadPdfUrl:"/chapter/pdf-download/78955",previewPdfUrl:"/chapter/pdf-preview/78955",authors:[{id:"208335",title:"Dr.",name:"Nazir",surname:"Ahmad",slug:"nazir-ahmad",fullName:"Nazir Ahmad"},{id:"424654",title:"Dr.",name:"Anwar",surname:"Ali",slug:"anwar-ali",fullName:"Anwar Ali"},{id:"424655",title:"Mr.",name:"Sakhawat",surname:"Riaz",slug:"sakhawat-riaz",fullName:"Sakhawat Riaz"},{id:"424656",title:"Mr.",name:"Arslan",surname:"Ahmad",slug:"arslan-ahmad",fullName:"Arslan Ahmad"},{id:"429649",title:"Mr.",name:"Muhammad",surname:"Aqib",slug:"muhammad-aqib",fullName:"Muhammad Aqib"}],corrections:null},{id:"80365",title:"The Health Benefits of Vegetables; Preventive Implications for Chronic Non-Communicable Diseases",doi:"10.5772/intechopen.101303",slug:"the-health-benefits-of-vegetables-preventive-implications-for-chronic-non-communicable-diseases",totalDownloads:95,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Low vegetable consumption correlates to an increase in the prevalence of noncommunicable diseases (NCDs) such as obesity, cardiovascular disease, and cancer, which are the leading causes of mortality worldwide. As a result, the purpose of this review was to consolidate present evidence on the health benefits of vegetable consumption and their potential action of mechanism in NCDs prevention. Low vegetable consumption is related to socio-economics, psychological concerns, culture, environment, social support and vegetable practice. Vegetables contain an antihistamine, anti-inflammatory, diuretic, and notably antioxidant qualities, and they have been shown to help prevent and cure NCDs, cancer, and heart disease. Vegetables are the best providers of vitamin A, a nutrient that is essential for many metabolic processes in the body. In addition to being an antioxidant, veggies include folate and potassium, which are proven to prevent birth abnormalities, cancer, and heart disease. Several nations have created a broad strategic effort for the prevention and management of NCDs and their related risk factors. In order to accomplish the strategic plan’s goals successfully and efficiently, a greater knowledge of the burden of dietary risk factors and their contribution to NCDs is necessary.",signatures:"Gesessew Kibr",downloadPdfUrl:"/chapter/pdf-download/80365",previewPdfUrl:"/chapter/pdf-preview/80365",authors:[{id:"422854",title:"M.Sc.",name:"Gesessew",surname:"Kibr",slug:"gesessew-kibr",fullName:"Gesessew Kibr"}],corrections:null},{id:"79232",title:"Vegetable and Herbal Extracts: A Way towards Preventive and Therapeutics Regimen",doi:"10.5772/intechopen.101104",slug:"vegetable-and-herbal-extracts-a-way-towards-preventive-and-therapeutics-regimen",totalDownloads:133,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The traditional and herbal medicines play significant role in the treatment of several diseases. These medicines are the outcome of extensive research on therapeutic and preventive activity of various plant species and their specific parts. Administration of various plant parts, vegetables, fruits and other herbal constituents have significant impact on reduction of clinical, carcinogenic and genotoxic effects of various environmental toxicants. Various parts of plant such as wood, bark, stem, leaf and pod are rich in antioxidants which are known for their free radical scavenging activity. Currently, the treatment options rely significantly using natural anti-oxidants which are extracted from plant products because these are largely available, cost effective and non-toxic as compared to the synthetic drugs. Some potent natural anti-oxidants include tocopherol, ascorbic acid, flavonoids, quercetin, carotene, cinnamic acid, peptides and phenolic compounds which are extensively available in various herbal extracts. The present chapter will focus upon availability of various antioxidants in vegetables and other medicinal plants and their potential activities against xenobiotics.",signatures:"Tanya Sharma, Vinika Tyagi and Megha Bansal",downloadPdfUrl:"/chapter/pdf-download/79232",previewPdfUrl:"/chapter/pdf-preview/79232",authors:[{id:"422258",title:"Dr.",name:"Megha",surname:"Bansal",slug:"megha-bansal",fullName:"Megha Bansal"},{id:"438763",title:"Ms.",name:"Tanya",surname:"Sharma",slug:"tanya-sharma",fullName:"Tanya Sharma"},{id:"438764",title:"Ms.",name:"Vinika",surname:"Tyagi",slug:"vinika-tyagi",fullName:"Vinika Tyagi"}],corrections:null},{id:"78647",title:"How Can Flaxseed be Utilized as Functional Food",doi:"10.5772/intechopen.100201",slug:"how-can-flaxseed-be-utilized-as-functional-food",totalDownloads:214,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Although vegetables and fruits are unquestionably important components of food, incorporating herbs and spices into one’s diet has become a must to improve one’s health in today’s world. Due to rising popularity among health-conscious consumers, studies on functional foods such as herbs are a growing field in food science. Flaxseed (Linum Usitatissimum L.), which comes from the flax plant, an annual herb, is gaining interest as a functional food ingredient due to its high levels of alpha-linolenic acid (ALA), lignans, and fiber. Flaxseed consumption in the diet helps to prevent serious illnesses such as heart disease, cancer, diabetes, obesity, gastrointestinal, renal, and bone problems. Type II diabetes, in particular, is one of the great healthcare challenges of the twenty-first century, as it has engulfed children, adolescents, and young adults alike. While standard risk factors for type II diabetes are genetics, living style, and behavioral aspects, this article focuses on preventing or controlling the disease through dietary changes. To the best of our knowledge, review articles on the commercial use of flaxseed in the formulation of numerous food products with low glycemic index and their impact on diabetes are hardly available. The data from the previous 5 years is used to compile this report.",signatures:"Shama Kakkar, Runjhun Tandon and Nitin Tandon",downloadPdfUrl:"/chapter/pdf-download/78647",previewPdfUrl:"/chapter/pdf-preview/78647",authors:[{id:"421664",title:"Associate Prof.",name:"Runjhun",surname:"Tandon",slug:"runjhun-tandon",fullName:"Runjhun Tandon"},{id:"421665",title:"Dr.",name:"Nitin",surname:"Tandon",slug:"nitin-tandon",fullName:"Nitin Tandon"},{id:"421666",title:"MSc.",name:"Shamma",surname:"Kakkar",slug:"shamma-kakkar",fullName:"Shamma Kakkar"}],corrections:null},{id:"80203",title:"Harnessing Technologies for Vegetable Cultivation: A Panacea for Food and Nutrition Insecurity in Ghana",doi:"10.5772/intechopen.101877",slug:"harnessing-technologies-for-vegetable-cultivation-a-panacea-for-food-and-nutrition-insecurity-in-gha",totalDownloads:110,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Vegetable plays a key role in food and nutrition security in Ghana as the country’s food system shifts from food quantity to diet quality and health benefits. This chapter looks at the role vegetables play in the diets of humans in ensuring food and nutrition security. Traditional locally available underutilized vegetable crops as well as exotic vegetable crops could be utilized to improve nutrition and health. One of the strategies for promoting vegetable production is the development and adoption of innovative and modern technologies to address major challenges impeding the advancement of vegetable production in Ghana. These challenges include lack of improved varieties, nonfunctional seed systems, poor infrastructure for storage and processing, uncontrolled use of agrochemicals, etc. Genetic manipulation, soil and water management as well as integrated pest and disease management have been harnessed with significant achievement to boost vegetable production. Other emerging, including nursery management, controlled environment (such as a greenhouse), grafting, post-harvest handling, digital marketing, information and extension services can also be promoted. Greenhouse production increases vegetable crop quality and productivity, which results in higher economic returns. Finally, the chapter highlights the enormous prospects and contributions of vegetable production towards reducing rural poverty and unemployment.",signatures:"Michael Kwabena Osei, Peter Amoako Ofori, Joseph Adjebeng-Danquah, Stella Owusu Nketia, Kofi Frimpong-Anin, Isaac Osei-Bonsu, Richard Yaw Agyare, Jacinta Opoku-Adoma, Patrick Ofori, Emmanuel Asamoah Adjei, Isaac Newton, Joseph Gyau and Doris Puozaa",downloadPdfUrl:"/chapter/pdf-download/80203",previewPdfUrl:"/chapter/pdf-preview/80203",authors:[{id:"217760",title:"Dr.",name:"Joseph",surname:"Adjebeng-Danquah",slug:"joseph-adjebeng-danquah",fullName:"Joseph Adjebeng-Danquah"},{id:"422608",title:"Dr.",name:"Michael",surname:"Osei",slug:"michael-osei",fullName:"Michael Osei"},{id:"445027",title:"Dr.",name:"Peter",surname:"Ofori",slug:"peter-ofori",fullName:"Peter Ofori"},{id:"445029",title:"Dr.",name:"Stella",surname:"Owusu-Nketia",slug:"stella-owusu-nketia",fullName:"Stella Owusu-Nketia"},{id:"445030",title:"Dr.",name:"Kofi",surname:"Frimpong-Anin",slug:"kofi-frimpong-anin",fullName:"Kofi Frimpong-Anin"},{id:"445031",title:"Dr.",name:"Isaac",surname:"Osei-Bonsu",slug:"isaac-osei-bonsu",fullName:"Isaac Osei-Bonsu"},{id:"445032",title:"Mr.",name:"Richard",surname:"Agyare",slug:"richard-agyare",fullName:"Richard Agyare"},{id:"445033",title:"Dr.",name:"Patrick",surname:"Ofori",slug:"patrick-ofori",fullName:"Patrick Ofori"},{id:"445034",title:"Mr.",name:"Emmanuel",surname:"Adjei-Asamoah",slug:"emmanuel-adjei-asamoah",fullName:"Emmanuel Adjei-Asamoah"},{id:"445035",title:"Mr.",name:"Isaac",surname:"Newton",slug:"isaac-newton",fullName:"Isaac Newton"},{id:"445036",title:"Mr.",name:"Joseph",surname:"Gyau",slug:"joseph-gyau",fullName:"Joseph Gyau"},{id:"445039",title:"Ph.D.",name:"Doris",surname:"Puozaa",slug:"doris-puozaa",fullName:"Doris Puozaa"},{id:"465929",title:"Dr.",name:"Jacinta",surname:"Opoku-Adoma",slug:"jacinta-opoku-adoma",fullName:"Jacinta Opoku-Adoma"}],corrections:null},{id:"78571",title:"The Effect of Mosses on the Hydraulic Media of Vegetable Plants in Cirebon, West Java, Indonesia",doi:"10.5772/intechopen.100000",slug:"the-effect-of-mosses-on-the-hydraulic-media-of-vegetable-plants-in-cirebon-west-java-indonesia",totalDownloads:101,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"It’s time to eat healthy vegetables. One of the ways to get healthy vegetables is to growthem hydroponically to avoid various environmental pollution. However, it turns out that even hydroponic cultivation still has itsown downside, namely the growth of moss. This is because the conditions for moss to growhavebeen metsuch asthe supply ofwater whish is rich in nutrients and oxygen, and enough sunlight for grow. Usually, in hydroponic systems, we often find moss attached to rock wool and gutter planting media. This begins when the rock wool is submerged in water and the gutterarefed by water that containing nutrients and also exposed to sunlight. Is there an effect of moss on the productivity of hydroponic plantsand how to overcomeit? This research was conducted to find out how overcome moss so as not to interfere with the production of vegetable crops in ahydroponic maintenance system. Based on our observations, the growth of mosscertainly affectedthe development of plants. With minimal moss, the growth of kale seemedto be the mostoptimal, with wider leaves and dense stem condition. On the other hand, the spinach thatwas investedwith mossdidn’t growas optimal as our kale, with thinner leaves and sparse.",signatures:"Retno Widyani, Dein Iftitah and Mus Nilamcaya",downloadPdfUrl:"/chapter/pdf-download/78571",previewPdfUrl:"/chapter/pdf-preview/78571",authors:[{id:"414328",title:"Prof.",name:"Retno",surname:"Widyani",slug:"retno-widyani",fullName:"Retno Widyani"},{id:"435042",title:"Dr.",name:"Dein",surname:"Iftitah",slug:"dein-iftitah",fullName:"Dein Iftitah"},{id:"435043",title:"Dr.",name:"Mus",surname:"Nilamcaya",slug:"mus-nilamcaya",fullName:"Mus Nilamcaya"}],corrections:null},{id:"78169",title:"Organic Vegetable Cultivation",doi:"10.5772/intechopen.99744",slug:"organic-vegetable-cultivation",totalDownloads:136,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Present day agricultural practices are posing a serious threat to the human population due to unscrupulous use of chemical fertilizers and pesticides. Conventional agricultural practices wherein large quantities and unscrupulous use of chemical fertilizers and pesticides are no longer safer as it directly enter the food chain. Hence, organic cultivation of vegetables is gaining momentum among the growing population. Organic practices rely on crop rotations, crop residues, plant and animal manures, growing of legume and green manure crops and biological control of pests and diseases. It aims to combine tradition, innovation and science in a balanced proportion to utilize the environment in safer manner and maintain ecological balance. Organic cultivation assures protection of the environment and plays a major role on the economy of a nation. Sustainable production of organic vegetables needs to be ensured to fetch premium price in the domestic as well as international markets. Organic farming has shown expansion in the recent years in the European countries offering scope for a better price in the international market.",signatures:"Usha Nandhini Devi Harinarayanan and Pugalendhi Lakshmanan",downloadPdfUrl:"/chapter/pdf-download/78169",previewPdfUrl:"/chapter/pdf-preview/78169",authors:[{id:"424371",title:"Prof.",name:"Pugalendhi",surname:"Lakshmanan",slug:"pugalendhi-lakshmanan",fullName:"Pugalendhi Lakshmanan"},{id:"426036",title:"Dr.",name:"Usha Nandhini Devi",surname:"Harinarayanan",slug:"usha-nandhini-devi-harinarayanan",fullName:"Usha Nandhini Devi Harinarayanan"}],corrections:null},{id:"79861",title:"Organic Vegetable Farming; A Valuable Way to Ensure Sustainability and Profitability",doi:"10.5772/intechopen.101095",slug:"organic-vegetable-farming-a-valuable-way-to-ensure-sustainability-and-profitability",totalDownloads:137,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The most pressing concern in the world since independence has been producing enough food to feed an expanding population. The mix of high-yielding production techniques has helped the globe to generate a food surplus while also raising worries about soil health and environmental pollution. Though, scientists and policy makers are rethinking agricultural systems that rely heavily on biological inputs. Organic farming can provide high-quality food without compromising the health of the land or the environment; nevertheless, it is unclear if large-scale organic farming would be able to feed world’s vast population. Adoption of this emerging approach “organic vegetable farming” plays a vital role in development of agricultural sustainability through avoiding indiscriminate use of synthetic chemicals. There are numerous organic sources for organic vegetable farming but various type of composts (especially vermi-compost) and biochar are most famous among all other organic sources as they improved soil healthy and vegetables productions through improving soil physico-chemical and biological attributes. In addition, demand and prices of organically produced vegetables are much higher in market and evidence showed that organically grown vegetables are enriched with nutrients and safe for consumption because of their less exposure with residues of in-organic pesticides.",signatures:"Sidra Sohail, Aqarab Husnain Gondal, Qammar Farooq, Laaraib Tayyaba, Dua E. Zainab, Iftikhar Ali Ahmad, Asma Zafar, Shahar Yar Khosa and Mohammad Usama",downloadPdfUrl:"/chapter/pdf-download/79861",previewPdfUrl:"/chapter/pdf-preview/79861",authors:[{id:"422587",title:"MSc.",name:"Sidra",surname:"Sohail",slug:"sidra-sohail",fullName:"Sidra Sohail"},{id:"428344",title:"Mr.",name:"Aqarab",surname:"Husnain Gondal",slug:"aqarab-husnain-gondal",fullName:"Aqarab Husnain Gondal"},{id:"428345",title:"Ms.",name:"Dua",surname:"E. Zainab",slug:"dua-e.-zainab",fullName:"Dua E. Zainab"},{id:"439584",title:"Mrs.",name:"Qammar",surname:"Farooq",slug:"qammar-farooq",fullName:"Qammar Farooq"},{id:"439645",title:"Ms.",name:"Asma",surname:"Zafar",slug:"asma-zafar",fullName:"Asma Zafar"},{id:"439648",title:"Mr.",name:"Shahar Yar",surname:"Khosa",slug:"shahar-yar-khosa",fullName:"Shahar Yar Khosa"},{id:"439649",title:"Dr.",name:"Iftikhar Ali",surname:"Ahmad",slug:"iftikhar-ali-ahmad",fullName:"Iftikhar Ali Ahmad"},{id:"439650",title:"Ms.",name:"Laraib",surname:"Tayyaba",slug:"laraib-tayyaba",fullName:"Laraib Tayyaba"},{id:"439651",title:"Mr.",name:"Mohammad",surname:"Usama",slug:"mohammad-usama",fullName:"Mohammad Usama"}],corrections:null},{id:"80878",title:"Advantages of Growing Vegetable Crops in Modern Greenhouses",doi:"10.5772/intechopen.101469",slug:"advantages-of-growing-vegetable-crops-in-modern-greenhouses",totalDownloads:90,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"There are numerous advantages in growing vegetable crops in modern-equipped greenhouses and protected spaces without daylight, compared with the traditional production (open-field), or with the production in ordinary greenhouses. In modern greenhouses, particularly in the glass ones, it is possible to control the climate conditions entirely, plant nutrition, implementation of CO2 and other necessary installations, or automation of production process. That enables all-year round and/or off-season production, which is increasingly in demand in markets all over the world. It particularly goes for vegetables crops typical of warm season (tomatoes, cucumbers, peppers), but also for those of cool season (lettuce, spinach, radishes, broccoli). The USDA organization has developed a software program, which is titled a Virtual Grower. It helps growers to calculate the heating costs of their greenhouse. The software can be used to predict heating and energy consumption specific for the location, greenhouse design, crop produced, and preferences of management. The software program, and a short video, too, can be downloaded for free from the following Web site: https://ag.umass.edu/greenhouse-floriculture/fact-sheets/virtual-grower-link-to-usda-software. There is a widespread question among the expert circles whether the vegetable crops are going to be “moved” to greenhouses due to the large-scale climate changes, and in this sense, what the possibilities are for the vegetable crop production. Therefore, any innovation in science is highly important for future patents that may be applicable in agriculture and consequently in vegetable crop growing practice.",signatures:"Dubravka Savic and Zarko M. Ilin",downloadPdfUrl:"/chapter/pdf-download/80878",previewPdfUrl:"/chapter/pdf-preview/80878",authors:[{id:"421682",title:"Dr.",name:"Dubravka",surname:"Savic",slug:"dubravka-savic",fullName:"Dubravka Savic"},{id:"465934",title:"Dr.",name:"Zarko",surname:"M. Ilin",slug:"zarko-m.-ilin",fullName:"Zarko M. Ilin"}],corrections:null},{id:"79174",title:"Revising the National Framework for the Management of Drought (NFMD) to Enhance Vegetable Farmers’ Vulnerability to Drought in the Northern Cape Province of South Africa",doi:"10.5772/intechopen.100606",slug:"revising-the-national-framework-for-the-management-of-drought-nfmd-to-enhance-vegetable-farmers-vuln",totalDownloads:120,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Climate change is a global challenge which is causing persistent droughts in South Africa. This is concerning in the absence of a proper management strategies targeting small-scale vegetable farmers especially for agricultural sustainability and food security. The sustainability of agriculture and food supply is in line with the second goal (Zero Hunger) of 2030 UN sustainable development goals. The focus of this chapter is on small-scale farmers as opposed to commercial farmers because of the differential vulnerability to drought as a result of social, economic and environmental conditions. Drought persisted in the in major parts of South Africa especially the Northern Cape and existing policies and management frameworks are inadequately equipped to sustain affected famers. Although both small-scale and commercial farmers are affected, small-scale farmers are highly vulnerable as they lose their entire livelihood during droughts. The revision undertook extensive literature and focused on the national framework for the management of drought developed by the Department of Agriculture Forestry and Fisheries DAFF as a conceptual base. The chapter reveals that, drought mitigations strategies employed by the integrated drought management teams are not adequate to address the impact and sustainability on small-scale farmers.",signatures:"Elijah Mokgotha Ramafoko, Joseph Nembo Lekunze and Usapfa Luvhengo",downloadPdfUrl:"/chapter/pdf-download/79174",previewPdfUrl:"/chapter/pdf-preview/79174",authors:[{id:"422557",title:"Dr.",name:"Usapfa",surname:"Luvhengo",slug:"usapfa-luvhengo",fullName:"Usapfa Luvhengo"},{id:"436328",title:"Dr.",name:"Joseph",surname:"Nembo Lekunze",slug:"joseph-nembo-lekunze",fullName:"Joseph Nembo Lekunze"},{id:"436330",title:"Mr.",name:"Elijah Mokgotha",surname:"Ramafoko",slug:"elijah-mokgotha-ramafoko",fullName:"Elijah Mokgotha Ramafoko"}],corrections:null},{id:"79185",title:"Principles of Irrigation Management for Vegetables",doi:"10.5772/intechopen.101066",slug:"principles-of-irrigation-management-for-vegetables",totalDownloads:200,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Vegetables have a very high percentage of water content. Some of the vegetables, such as cucumber, tomato, lettuce, zucchini, and celery contain over ninety-five percent of water. As a result of the high-water content in the cells, they are extremely vulnerable plants to water stress and drought conditions. Their yield and quality are affected rapidly when subjected to drought. Therefore, irrigation is essential to the production of most vegetables in order to have an adequate yield with high quality. However, over-irrigating can inhibit germination and root development, decrease the vegetable quality and post-harvest life of the crop. Determination of suitable irrigation systems and scheduling to apply proper amount of water at the correct time is crucial for achieving the optimum benefits from irrigation. This determination requires understanding of the water demand of the vegetable, soil characteristics, and climate factors. All these factors have major impact for the success and sustainability of any vegetable irrigation. This section contains fundamentals of water requirements on different vegetables and summarizes important issues related to soil, water, and vegetable growth relations together with irrigation management concept by evaluating the challenging issues on the selection of proper irrigation system, suitable irrigation timing, and other parameters to increase vegetable yield in an irrigated agriculture.",signatures:"Selda Ors, Ustun Sahin, Melek Ekinci, Metin Turan and Ertan Yildirim",downloadPdfUrl:"/chapter/pdf-download/79185",previewPdfUrl:"/chapter/pdf-preview/79185",authors:[{id:"186639",title:"Prof.",name:"Ertan",surname:"Yildirim",slug:"ertan-yildirim",fullName:"Ertan Yildirim"},{id:"247120",title:"Prof.",name:"Melek",surname:"Ekinci",slug:"melek-ekinci",fullName:"Melek Ekinci"},{id:"140612",title:"Prof.",name:"Metin",surname:"Turan",slug:"metin-turan",fullName:"Metin Turan"},{id:"247121",title:"Prof.",name:"Selda",surname:"Ors",slug:"selda-ors",fullName:"Selda Ors"},{id:"247123",title:"Prof.",name:"Ustun",surname:"Sahin",slug:"ustun-sahin",fullName:"Ustun Sahin"}],corrections:null},{id:"79452",title:"Enhancement of Agricultural Crops: A CRISPR/Cas9-Based Approach",doi:"10.5772/intechopen.100641",slug:"enhancement-of-agricultural-crops-a-crispr-cas9-based-approach",totalDownloads:192,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Horticultural crops are indispensable agricultural food materials with all essential nutrients. Though, severe threats like pests, diseases, and adverse abiotic factors will affect their productivity and quality. This permits to promote sustainable agriculture by utilizing the recent biotechnological approach to tackle the mentioned issues. In recent year’s genome editing technologies has become one of the most executed genetic tools which altered plant molecular biology. Recently, CRISPR-Cas utilizes for its high target specificity, easier design, and higher success rate. This chapter deals with recent advances in CRISPR/Cas9 technology in horticultural crops in response to the enrichment of essential metabolites, which was achieved by introducing the viral genome to the host via CRISPR-mediated targeted mutation. Furthermore, the strategies based on CRISPR/Cas9 targeted modifications of genes in crop species such as rice, wheat, and soy will be discussed. Finally, we discuss the challenges, improvements, and prospective applications of this cutting-edge technology.",signatures:"Krishnagowdu Saravanan, Kumar Praveenkumar, Nandakumar Vidya, Kumaraguru Gowtham and Mohanasundaram Saravanan",downloadPdfUrl:"/chapter/pdf-download/79452",previewPdfUrl:"/chapter/pdf-preview/79452",authors:[{id:"423499",title:"Dr.",name:"Mohanasundaram",surname:"Saravanan",slug:"mohanasundaram-saravanan",fullName:"Mohanasundaram Saravanan"},{id:"423964",title:"Mr.",name:"Kumar",surname:"Praveenkumar",slug:"kumar-praveenkumar",fullName:"Kumar Praveenkumar"},{id:"423966",title:"Mrs.",name:"Nandakumar",surname:"Vidya",slug:"nandakumar-vidya",fullName:"Nandakumar Vidya"},{id:"423967",title:"Mr.",name:"Krishnagowdu",surname:"Saravanan",slug:"krishnagowdu-saravanan",fullName:"Krishnagowdu Saravanan"},{id:"423969",title:"Mr.",name:"Kumaraguru",surname:"Gowtham",slug:"kumaraguru-gowtham",fullName:"Kumaraguru Gowtham"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"9716",title:"Plant Roots",subtitle:null,isOpenForSubmission:!1,hash:"88def4095af38c0aa341ee29946e589d",slug:"plant-roots",bookSignature:"Ertan Yildirim, Metin Turan and Melek Ekinci",coverURL:"https://cdn.intechopen.com/books/images_new/9716.jpg",editedByType:"Edited by",editors:[{id:"186639",title:"Prof.",name:"Ertan",surname:"Yildirim",slug:"ertan-yildirim",fullName:"Ertan Yildirim"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3226",title:"Abiotic Stress",subtitle:"Plant Responses and Applications in Agriculture",isOpenForSubmission:!1,hash:"8063f7215a8655b897424c418ed0f4bc",slug:"abiotic-stress-plant-responses-and-applications-in-agriculture",bookSignature:"Kourosh Vahdati and Charles Leslie",coverURL:"https://cdn.intechopen.com/books/images_new/3226.jpg",editedByType:"Edited by",editors:[{id:"59106",title:"Dr.",name:"Kourosh",surname:"Vahdati",slug:"kourosh-vahdati",fullName:"Kourosh Vahdati"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6492",title:"Vegetables",subtitle:"Importance of Quality Vegetables to Human Health",isOpenForSubmission:!1,hash:"c9b3988b64bc40ab0eb650fe8a2b2493",slug:"vegetables-importance-of-quality-vegetables-to-human-health",bookSignature:"Md. 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Kumavath and Pratap Deverapalli",dateSubmitted:"October 10th 2012",dateReviewed:"March 18th 2013",datePrePublished:null,datePublished:"October 2nd 2013",book:{id:"3547",title:"Applied Bioremediation",subtitle:"Active and Passive Approaches",fullTitle:"Applied Bioremediation - Active and Passive Approaches",slug:"applied-bioremediation-active-and-passive-approaches",publishedDate:"October 2nd 2013",bookSignature:"Yogesh B. Patil and Prakash Rao",coverURL:"https://cdn.intechopen.com/books/images_new/3547.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"164249",title:"Dr.",name:"Yogesh",middleName:"Bhagwan",surname:"Patil",slug:"yogesh-patil",fullName:"Yogesh Patil"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"163692",title:"Dr.",name:"Ranjith",middleName:null,surname:"Kumavath",fullName:"Ranjith Kumavath",slug:"ranjith-kumavath",email:"rnkumavath@gmail.com",position:null,institution:{name:"Central University of Kerala",institutionURL:null,country:{name:"India"}}},{id:"167339",title:"Mr.",name:"Pratap",middleName:null,surname:"Devarapalli",fullName:"Pratap Devarapalli",slug:"pratap-devarapalli",email:"pratap66666@gmail.com",position:null,institution:{name:"University of Tasmania",institutionURL:null,country:{name:"Australia"}}}]}},chapter:{id:"45227",slug:"scientific-swift-in-bioremediation-an-overview",signatures:"Ranjith N. Kumavath and Pratap Deverapalli",dateSubmitted:"October 10th 2012",dateReviewed:"March 18th 2013",datePrePublished:null,datePublished:"October 2nd 2013",book:{id:"3547",title:"Applied Bioremediation",subtitle:"Active and Passive Approaches",fullTitle:"Applied Bioremediation - Active and Passive Approaches",slug:"applied-bioremediation-active-and-passive-approaches",publishedDate:"October 2nd 2013",bookSignature:"Yogesh B. 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Patil and Prakash Rao",coverURL:"https://cdn.intechopen.com/books/images_new/3547.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"164249",title:"Dr.",name:"Yogesh",middleName:"Bhagwan",surname:"Patil",slug:"yogesh-patil",fullName:"Yogesh Patil"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}}},ofsBook:{item:{type:"book",id:"11450",leadTitle:null,title:"Environmental Impacts of COVID-19 Pandemic on the World",subtitle:null,reviewType:"peer-reviewed",abstract:"
\r\n\tThe outbreak of coronavirus disease (COVID-19), which first emerged at the end of December 2019, is still affecting every part of human life. \r\n\tHowever, both positive and negative consequences of COVID-19 are emerging from this pandemic. The negative impacts are the increase in hazard use, medical waste, disposal of disinfectants, masks, and gloves, as well as the burden of untreated wastes which are continuously endangering the environment. The positive impacts of the COVID-19 pandemic on the environment are the reduction of water pollution, reduction of air pollution, reduction of noise pollution, ecological restoration, and assimilation of tourist spots. Other positive impacts on the environment include also a governance-system-controlled investment toward a sustainable energy transition and other goals related to environmental protection.
\r\n
\r\n\tDue to movement restrictions and a significant slowdown of social and economic activities, air quality has improved in many cities with a reduction in water pollution in different parts of the world.
\r\n
\r\n\tWater demand was impacted by the COVID-19 pandemic in many ways, such as frequent handwashing with soap and water for 20 seconds, disinfecting surfaces, and cleaning food containers which have forced industries, businesses, and large corporations to shut down. Although the damage caused to humans, the economy, and society was extensive, the environment began to heal from the reduced exploitation of resources. The relationship between human activity and environmental health had been observed in various public health crises in the past.
\r\n
\r\n\tThis book aims to gather recent research by outstanding experts in the field of environmental health and protection. It hopes to gather a wide readership from universities and industry alike. Also, we hope that the readers will obtain updated information on environmental health and protection.
",isbn:"978-1-80356-621-4",printIsbn:"978-1-80356-620-7",pdfIsbn:"978-1-80356-622-1",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,isSalesforceBook:!1,isNomenclature:!1,hash:"a58c7b02d07903004be70f744f2e1835",bookSignature:"Prof. Mohamed Nageeb Rashed and Prof. Wafaa M. Abd El-Rahim",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11450.jpg",keywords:"COVID-19 Pandemic, Human Health, Untreated Wastes, Food Contamination, Pollution, Wastewater, Gas Emissions, Carbon Dioxide, Hazard Use, Medical Waste, Disposal of Disinfectants, Tourist Spots Impact",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"April 12th 2022",dateEndSecondStepPublish:"May 10th 2022",dateEndThirdStepPublish:"July 9th 2022",dateEndFourthStepPublish:"September 27th 2022",dateEndFifthStepPublish:"November 26th 2022",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"3 months",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"Prof. Rashed has been considered among the Top 2% of Scientists Around the World in 2020 and 2021. Prof. Rashed acts as editor-in-chief and an editorial board member in several international journals related to chemistry and the environment. He is a member of several national and international societies. He was awarded the Egyptian Star Award for Environmental Researches in 2001, and Aswan University Merit Award for Basic Science in 2020.",coeditorOneBiosketch:"Dr. Abd El-Rahim has published 65 publications and has won funding for 9 projects dealing with the bioremediation field. She was issued patent number 25076 by the Egyptian Patent office at the Egyptian Academy of Scientific Research and Technology. She is also working in the bioremediation field, especially in textile dye bioremediation. This field is very important for the preservation of the environment from pollution.",coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"63465",title:"Prof.",name:"Mohamed Nageeb",middleName:null,surname:"Rashed",slug:"mohamed-nageeb-rashed",fullName:"Mohamed Nageeb Rashed",profilePictureURL:"https://mts.intechopen.com/storage/users/63465/images/system/63465.gif",biography:"Prof. Mohamed Nageeb Rashed is Professor of Analytical and Environmental Chemistry and former vice-dean for environmental affairs, Faculty of Science, Aswan University, Egypt. He received his Ph.D. in Environmental Analytical Chemistry from Assiut University, Egypt, in 1989. His research interest is in analytical and environmental chemistry with special emphasis on: (1) monitoring and assessing biological trace elements and toxic metals in human blood, urine, water, crops, vegetables, and medicinal plants; (2) relationships between environmental heavy metals and human diseases; (3) uses of biological indicators for monitoring water pollution; (4) environmental chemistry of lakes, rivers, and well water; (5) water and wastewater treatment by adsorption and photocatalysis techniques; (6) soil and water pollution monitoring, control, and treatment; and (7) advanced oxidation treatment. Prof. Rashed has supervised several MSc and Ph.D. theses in the field of analytical and environmental chemistry. He served as an examiner for several Ph.D. theses in analytical chemistry in India, Kazakhstan, and Botswana. He has published about ninety scientific papers in peer-reviewed international journals and several papers in national and international conferences. He participated as an invited speaker at thirty international conferences. Prof. Rashed is the editor-in-chief and an editorial board member for several international journals in the fields of chemistry and environment. He is a member of several national and international societies. He received the Egyptian State Award for Environmental Research in 2001 and the Aswan University Merit Award for Basic Science in 2020. Prof. Rashed was recognized in Stanford University’s list of the World’s Top 2% Scientists in 2020 and 2021.",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"5",institution:{name:"Aswan University",institutionURL:null,country:{name:"Egypt"}}}],coeditorOne:{id:"173470",title:"Prof.",name:"Wafaa",middleName:null,surname:"M. Abd El-Rahim",slug:"wafaa-m.-abd-el-rahim",fullName:"Wafaa M. 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1. Introduction
Sjögren’s syndrome (SS) is a chronic inflammatory disorder characterized by immune-mediated exocrinopathy (inflammation and lymphoplasmacytic infiltration of the lacrimal and salivary glands) with resulting dysfunction. It can occur primarily or in association with a second well-defined rheumatic disease (secondary form). Both ways, they produce inflammation of the exocrine glands with subsequent dry eye and dry mouth [1, 2].
Patients with Sjögren’s syndrome (SS) may present with symptoms suggestive of dry eyes. Dry eye typically manifests itself in up to 95% of SS patients; whose complaints are inability to tear, foreign body sensation, conjunctival inflammation, eye fatigue, and decreased visual acuity [3]. Dry eye disease (DED) can be complicated by keratoconjunctivitis sicca, blepharitis, bacterial keratitis, or corneal ulcer [4]. Uveitis, episcleritis, and orbital pseudotumor are systemic manifestations that rarely occur in patients with Sjogren’s syndrome [5].
2. Dry eye disease (DED)
“Dry eye disease (DED) is a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles.” [6]. The description to understand this definition implies the term “multifactorial disease” recognizes DED as a significant and complex functional disorder that cannot be characterized by a single process, sign, or symptom. The term “ocular surface” encompasses structures including the tear film, the lacrimal and meibomian glands, the cornea, the conjunctiva, and the eyelids. “Homeostasis” describes a state of dynamic equilibrium in the body with respect to its various functions and the chemical composition of fluids and tissues. The key elements that contribute to the pathophysiological process, including tear film instability, hyperosmolarity, inflammation, and damage, recognized as etiological triggers of the vicious cycle, were considered important, along with neurosensory abnormalities, which have appeared more and more in recent literature, for inclusion in the definition [6].
2.1 Classification
The DED classification is based on its pathophysiology, acuodeficiency dry eye (ADDE), and evaporative dry eye (EDE). The limit in these categories is extremely diffuse [6]. The Sjogren’s syndrome–related ADDE is a secondary phenomenon to immune-mediated exocrinopathy affecting the lacrimal and salivary glands [6]. Findings include decreased tear flow, staining of the ocular surface of injured tissue with vital dyes, and increased tear osmolarity. Meibomian gland dysfunction is also common in SS patients, with a resulting increase in tear evaporation, exacerbating decreased tear production [7, 8].
ADDE not associated with Sjogren’s syndrome may be due to primary or secondary deficiency of the lacrimal gland, obstruction of the ducts of the lacrimal gland, and reflex hyposecretion [6]. EDE is due to an excessive loss of water from the exposed ocular surface, in the presence of a normal secretory function, the causes can be extrinsic due to harmful exposure of the ocular surface or intrinsic affecting internal structures or dynamics of the eyelid, may be due to causes related to the eyelid (e.g., Meibomian gland dysfunction [MGD] or decreased blinking) [6].
2.2 Pathophysiology
Tear hyperosmolarity stimulates a cascade of events in ocular surface epithelial cells involving the signaling pathways of MAP and NFkB kinases and the generation of inflammatory cytokines (interleukin 1 [IL-1α; IL-1β]; tumor necrosis factor α [TNF-α]) and proteases, such as MMP-9. This stimulates and readies inflammatory cells on the ocular surface, which become a reservoir for inflammatory mediators. These mediators, in an environment of tear hyperosmolarity, cause a decrease in the expression of mucin in the glycocalyx, the apoptotic death of the superficial epithelial cells, and the loss of goblet cells. However, hyperosmolarity also causes corneal epithelial cell death through nonapoptotic processes. Goblet cell loss is a feature of all types of DED, which is reflected in the reduction of tear levels of MUC5AC. The alteration of mucin expression in the glycocalyx is probably one of the reasons why ocular surface staining occurs in DED and, since it affects the ocular surface wetting, leads to an early breakdown of the film tear. This amplifies or triggers hyperosmolarity on the ocular surface, with which the vicious circle is closed and the mechanism that perpetuates the disease is established [6]. In ADDE, tear hyperosmolarity occurs when tear secretion is reduced due to lack of production, under normal conditions of evaporation from the eye. In EDE, tear hyperosmolarity is caused by excessive evaporation of the tear film with a normally functioning tear gland [6].
2.3 Eye manifestations
Patients with dry eye present with eye irritation, foreign body sensation, burning, tearing, photophobia, stinging, or sharp intermittent pain. They may also complain of blurred vision that improves with blinking or the instillation of artificial tears; and they may have all, some, or none of these symptoms. A well-conducted medical history contributes greatly to a correct diagnosis and guides a more focused slit lamp examination; therefore, a thorough slit lamp examination should be performed prior to performing any other tests, which may alter or mask relevant examination data, resulting in a misdiagnosis. Signs of dry eye identified on slit lamp examination include superficial corneal erosions, inadequate tear lake volume, early tear film breakdown time, conjunctival hyperemia, conjunctival surface irregularities, and meibomian gland dysfunction [7].
2.4 Diagnosis of DED
The evaluation of the tear function is carried out by means of different tests that translate into the presence or absence of DED; however, there is no gold standard for the diagnosis of dry eye disease; therefore, they must frequently be associated with each other for a reliable diagnosis; The most used in the basic ophthalmology office are mentioned in order to compare them with the new technologies for the diagnosis of dry eye and the sequence of how they should be applied; according to diagnosis report methodology subcommittee of the international dry eye workshop (2007) [8]. This is summarized in Table 1.
Clinic history
Symptom questionnaire (OSDI)
Tear breakup time (TBUT)
Ocular surface by fluorescein staining
Tear secretion (Schirmer test with or without anesthesia)
Symptoms and signs found during history and slit lamp examination may suggest dry eye due to water deficiency, evaporation, or both. Additional tests should be performed because the ophthalmologist may be the one who detects SS in a patient with no previous medical history or who debuts with ocular symptoms. Therefore, the choice of complementary diagnostic methods plays a very important role in the diagnosis, in the same way the sequence to carry out the tests and its correctly applied methodology will be a key point for a successful diagnosis, preventing the tests from overlapping and reporting false negatives or positives [9]. The suggested sequence of evaluations and tests is shown in Figure 1.
Figure 1.
Sequence of evaluations and tests in dry eye.
2.5.1 Symptom questionnaire
The ocular surface disease index (OSDI) was developed to provide a rapid assessment of the symptoms of eye irritation caused by dry eye disease and its impact on vision-related functioning. It is a 12-item questionnaire to evaluate ocular symptoms, functional limitations, and environmental factors related to the environment. Each item has five categories with three subscales with their own type of question; emphasis is placed on symptoms such as photophobia, grit, eye pain, blurred vision, in a period of 2–4 weeks before the visit. The OSDI is a self-administered questionnaire, it contains 12 items to evaluate the symptoms of the ocular surface; that implies little burden and little time for the patient. The OSDI has an overall score and three subscale scores: (A) ocular symptoms [three items], (B) vision-related function [six items], and (C) environmental triggers [three items]. Each OSDI item is scored on a Likert-type scale ranging from 0 to 4 points, where 0 indicates none of the time and 4 all of the time.
The total OSDI score was then calculated based on the following formula; OSDI = [(Sum of the scores of all answered questions) × 100]/[(Total number of answered questions) × 4].
Overall and subscale OSDI scores range from 0 to 100. Based on their OSDI scores, patients can be classified as normal (0–12 points) or mild (13–22 points), moderate (23–32 points) or severe ocular surface disease (33–100 points) [10]. The reliability indices of the OSDI recently reported indicate that it is adequate, the Pearson correlation was higher than 0.8, and the ICC range was from 0.827 to 0.982; In addition, it was evaluated that it has a parallel reliability between the written and web versions [11].
2.5.2 Tear osmolarity
Tear osmolarity in normal subject ranges from 308 to 312 mOsm/l [12]. In individuals with DED associated with SS, osmolarity is significantly higher than in subjects with DED not associated with SS and even more than in healthy controls [13]. Also some studies have shown positive correlations between tear osmolarity and disease activity in patients with SS [14]. Dry eye can be due to both increased evaporation, deficiency in its production, and alteration of the composition, in all cases the pathophysiological sequence culminates with an increase in the osmolarity of the tear film (hyperosmolarity) [15].
The evaporation of a smaller volume for the same surface increases osmolarity during the first 24 h from the beginning of the volumetric decrease [16]. Hyperosmolarity causes epithelial damage directly as it causes cell desquamation, complete disappearance of the superficial epithelial cell layers, decrease in cytoplasmic density, and accumulation of rows of mucus product of osmotically altered goblet cells. This phenomenon is generally evident between 15 and 30 days after the osmolar change of the tear film [17]. The epithelium of the cornea and conjunctiva must be completely moistened for complete wettability; the ocular surface conditions warrant that the surface tension of the aqueous layer at the interface with the epithelium is lower than the surface tension of the epithelium that is exposed to the medium [18]. In the mucous layer, mucopolysaccharides are directly responsible for maintaining surface tension stability. Under hyperosmolar conditions, there is accumulation of mucus and destruction of mucin-secreting cells, which causes an increase in surface tension with the consequent decrease in the wettability of the corneoconjunctival epithelium. The principle of osmosis is characterized by the flow of a solvent through a semipermeable membrane, which is generated when there is a difference in concentrations on one side of the membrane; this movement tends to equalize the solute concentrations on both sides, and there the flow stops. The corneoconjunctival epithelium and the mucous layer are a semipermeable barrier on the ocular surface, by increasing osmolarity in the aqueous layer; the aqueous gradient through the water protein channels present in the stroma and toward the aqueous humor; they change in the opposite direction. This directional fluid change produced by hyperosmolarity can cause dehydration of Sulfated Glycosaminoglycan (GAGS) that occupies the spaces between the collagen fibers of the stroma [19, 20]. When these glycoprotein structures are dehydrated, the correct water balance of the stroma will be affected, which will affect the normal maintenance of corneal transparency [21].
The osmolarity of the tear film in dry eye triggers inflammation, immunological processes, and the presence of autoantigens that enhance the inflammatory process. As an example of this, inflammatory markers such as NF-Kβ that migrates from the nucleus to the cytoplasm in the inflammatory process are directly related to the phenomenon of hyperosmolarity of the tear film. Nuclear translocation of NF-Kβ has been shown to be directly proportional to increased tear film osmolarity [22].
Hyperosmolarity is so important in the pathophysiology of dry eye disease that increased osmolarity of the tear film has been suggested to induce functional and structural damage to the corneal nerves and neurotoxicity [23].
The TFOS Dry Eye Workshop II (DEWS II) subcommittee report concluded: “Tear hyperosmolarity is considered to be the trigger for a cascade of signaling events within surface epithelial cells, leading to the release of inflammatory mediators and proteases. These mediators and tear hyperosmolarity cause the loss of goblet cells, epithelial cells and damage to the epithelial glycocalyx. The inflammatory mediators of activated T cells, recruited on the ocular surface, reinforce the damage; resulting in punctiform epitheliopathy characteristic of DED and tear film instability leading to early tear film rupture. This rupture increases the hyperosmolarity of the tear and completes the vicious circle events that cause damage to the ocular surface” [24]. While sophisticated equipment is required to measure tear film osmolarity, we can assess the sodium concentration that we obtain from tears by wetting a Whatman 41 paper strip in the usual way for the Schirmer test, then colorimetrically measuring the sodium concentration in that. More specifically, the Tear Lab osmolarity system is designed to measure tear osmolarity and facilitate diagnosis in patients with suspected dry eye syndrome. Tear Lab measures osmolarity in 10 s and integrates seamlessly into clinical workflow. The evaluation of tear osmolarity has been shown to be a superior marker to determine the severity of DED, with respect to TBUT, Schirmer I, corneal and conjunctival staining, Meibomian classification and OSDI, whose specificities are (60%, 79%, 85%, 67%, 76%, and 79%) respectively. The test card in conjunction with the Tear Lab Osmolarity System offers a quick and easy method to determine tear osmolarity using nanoliter (nl) volumes of tear fluid obtained directly from the edge of the eyelid. To perform a test, a new test card must be inserted into the collecting pen; then contact the tip of the pen with the tear meniscus, located on the lower eyelid. Once the collection is complete, the pen is placed in the reader’s docking station, which will display a quantitative osmolarity test result on the liquid crystal display (LCD) (Figure 2). The Tear Lab osmolarity system simplifies the tear collection process by eliminating the need to move tear fluid samples and reducing the risk of evaporation [25].
Figure 2.
TearLab.
2.5.3 Matrix metalloproteinase 9 (MMP-9)
The matrix metalloproteinase test (MMP-9) is a useful technique to complement the diagnosis of DED recently developed. Matrix metalloproteinase 9 is an inflammatory biomarker that has been shown to be elevated in the tears of dry eye patients [26]. In tears, MMP-9 expression is normally less than 40 ng/ml and is secreted from the ocular surface epithelium [27]. MMP-9 maintains epithelial barrier function by breaking down components of the epithelial basement membrane and tight junction proteins, such as ZO-1 and occludin [28, 29]. But in addition, MMP-9 is related to the pathogenesis of various diseases, such as sterile ulceration, ocular allergy, keratoconus, conjunctivachalasia, and DED [30, 31, 32].
In the pathology of DED, since tear hyperosmolarity begins in the early phase of DED, a vicious circle probably induces inflammatory processes and triggers the release of MMP-9 in a relatively late phase of DED [33]. Detection of elevated MMP-9 in tears could be an ideal tool for the diagnosis and treatment of tear dysfunction [34].
The technique for using the MMP-9 device (InflammaDry test) is as follows: the sampling fleece is contacted three times at each location of the lower eyelid conjunctiva (temporal, middle and nasal; from nasal to temporal direction), and it rests against the temporal conjunctiva of the lower eyelid for an additional 5 s. After the sampling fleece is assembled on a sample collector and pressed, the test strip is immersed in a solution for 20 s; 10 min after taking the sample, the result is read (Figure 3).
Figure 3.
InflamaDry.
InflammaDry, this type of device has the advantages of low cost, quick analysis, and ease of device preparation. However, it has been studied that a small sample volume, the reliability of the test result can be significantly affected [35].
It has been studied that the elevation of tear MMP-9 in patients with ED appears to have a good diagnostic yield and a correlation with the clinical severity of DED [26, 27]. The reliability for this test was 85% sensitivity and 94% specificity for the diagnosis of DED [36]. But despite these very promising values, two separate reports showed moderate to low positivity in an immunoassay for MMP-9 in study subjects with DED [36, 37, 38]; reporting that there were no differences between subjective symptoms and clinical signs of DED between MMP-9 positive and negative groups [37, 38]. In general, although it is a nonspecific marker for patients with DED [39, 40], various immunoassays have reported its usefulness as an aid in the diagnosis of dry eye; however, there are factors that may influence the results of MMP-9 in tears; one of them was demonstrated in an immunoassay where it was concluded that the positivity of the test can depend on the volume of the load and that therefore it can cause false negatives in diseases with aqueous deficiency such as Sjögren’s syndrome or graft-versus-host disease [41]. Other useful benefits are the identification of patients with inflammation of the ocular surface and autoimmune disease and can facilitate the decision to establish an anti-inflammatory treatment in these patients [30]. In the same way, its usefulness for the preoperative management of the ocular surface was reported, reducing possible complications when there is an underlying disease. Additionally, this test can also help indicate the need for anti-inflammatory therapies, such as cyclosporine or steroids, and can also predict which patients are most likely to respond [42].
2.5.4 The Schirmer test
The Schirmer test was introduced by Schirmer in 1903, despite the time and disadvantages of performing it, it is still used in most parts of the world, as part of the dry eye test battery. The Schirmer test is a diagnostic method to evaluate the production of watery tears [43, 44]. Topical anesthesia may or may not be used during the procedure, depending on the physician’s preference, and may even include nasal stimulation to induce reflex tearing. The Schirmer test allows the study of total tear secretion, that is, it evaluates the sum of the basal secretion plus the reflex secretion if performed without anesthesia; but if performed under anesthesia, it measures the basal secretion produced by the accessory lacrimal glands located in the conjunctiva. The Schirmer test is a diagnostic method to evaluate the production of watery tears [44, 45].
Initially, the method described to perform the Schirmer 1 test is as follows: it should be performed a few minutes after the instillation of topical anesthetic to inhibit the reflex secretion produced by the main lacrimal gland. Whatman No. 1 filter paper 5 mm wide and 35 mm long is used. It is placed in the cul-de-sac at the level of the outer third of the lower eyelid, in a low-light environment, with the patient with his eyes open, and the length of the paper that has absorbed moisture is measured at 5 min [46].
The Schirmer test remains a useful and repeatable test; although over the years several authors have made modifications to their methodology to improve the reliability of the test results; Such studies have been justified by mentioning the lack of practicality for ophthalmologists, especially when performing it routinely due to the 5-min time frame [45]. Therefore, correlations have been evaluated between the different wetting times, the size of the paper strip, or whether it is done with eyes open or closed [45, 47, 48]. The results are controversial. Some authors support the hypothesis that the shorter durations of the 5-min Schirmer test, such as the 1-min test under anesthesia, have a high correlation with the 5-min test and will make this test much more practical for patients [45]. Others affirm that the correlation in this modification was poor and consider it inappropriate to shorten the duration of the Schirmer test [49]. As this controversy has been generated, other tests have been tried with a shorter soak time, such as the Schirmer test of 2 min under anesthesia, and that the 3 mm wide paper strip could be used instead of the standard strip of 5 mm wide; finding results that correlate well with the 5-min test [47]. Then another study was conducted with a 3-min time, the results of which reveal that the 3-min Schirmer test is a reliable alternative for the diagnosis of dry eye and is more useful in daily ophthalmic practice [50]. The position of the eyes (open or closed) when performing the Schirmer test has shown important differences in its results; moisture values in the Schirmer test with eyes open have been reported to show significantly higher results compared with eyes closed [51, 52]; this may be due to the open eyes moving during the blink, stimulating tearing under the influence of the strip.
Other factors that could influence the results of the Schirmer test are head position, lighting, strip position, corneal condition, humidity, and ambient temperature, so it is important to consider these factors to achieve the standardization of this important diagnostic tool [51].
Therefore, the recommendation to perform the Schirmer test under anesthesia is to perform it with the eyes closed; this could reduce humidity variations, evaporation, and especially reflex tearing [51, 52].
The interpretation of the results of the Schirmer test is different depending on whether anesthesia is used or not. In patients with dry eye, there are clinical differences between the ADDE and EDE types, since the presence of ADDE strongly suggests the suspicion of Sjogren’s syndrome; however, although they also present differences in the physiology of tears between these types, no significant differences are found in tear osmolarity, volume, or distribution [53]. In the Schirmer test without anesthesia, total secretion (basal and reflex) is evaluated, the cutoff point is between 10 and 15 mm, and in the Schirmer test with anesthesia, reflex secretion is evaluated, and the cutoff point for this test is ≤5.5 mm/5 min; sensitivity is 85% and specificity is 83% [54]. The Schirmer II test is used on special occasions, as it requires stimulation of the nasal surface with a cotton-tipped applicator and subsequent measurement of reflex tear production. The disadvantages of the Schirmer test, in all its variants, are the time required, patient discomfort, and the low reliability of the test [54, 55].
2.5.5 Tear breakup time (TBUT)
The tear breakup time (TBUT) measures the stability of the tear film. With instilled fluorescein, TBUT is the time interval after a patient blinks until the first appearance of dryness in the tear film [56]. TBUT is measured by inoculating fluorescein into the cul-de-sac, asking the patient to hold the eyelids open after 1–2 blinks, and counting the seconds until a dry spot appears. The appearance of dry spots in less than 10 s is considered abnormal (Figure 4) [57]. Subsequently, alternative values for BUT are determined by comparing young populations with dry eye and healthy controls, reporting that values less than 5 s occur in subjects with dry eye [58]. The TBUT presents a sensitivity of 72.2% and specificity of 61.6%. The standardization of the method to perform the tear rupture time was carried out by Johnson and Murphy in 2005 [59]. The procedure is summarized in Table 2.
Figure 4.
TBUT.
Instill 1st 5 ul sodium fluorescein 2% in cul-de-sac
The patient is asked to blink naturally, loosely so that the fluorescein is naturally distributed.
After 10–30 s, the patient is asked to look straight ahead without blinking until instructed.
Set the magnification of the biomicroscope to 10×, keep the background illumination constant (cobalt blue light) and use a 12 Wratten yellow filter to improve the observation of the tear film over the entire ocular surface.
Use a stopwatch to record the complete blink time and the appearance of a growing micelle.
Although this test is inexpensive, quick to perform, and uses readily available supplies, it is poorly reproducible and inaccurate [60, 61]. However, the average score of two separate TBUT measurements helps increase their repeatability [62].
2.5.6 Noninvasive keratograph breakup time (NIKBUT)
The tear breakup time (TBUT) was considered one of the most repeatable tear film measurements and although invasive, easy to perform, and interpret [63, 64]. TBUT traditional objective tests are often limited by their invasiveness and low test repeatability and reproducibility [64]. For this reason, new methods of evaluation of the tear film emerged and with the help of the keratograph 5M (K5M) topography, a more objective way of evaluating tear film stability emerged; calling this measurement noninvasive keratograph breakup time (NIKBUT). The time is measured in seconds between the last complete blink and the first alteration of the Placido rings projected on the corneal surface, which the device automatically detects and measures. K5M performs two measurements for NIKBUT: the time when the first tear film break occurs (NIKBUT-first) and the average time of all tear incidents (average NIKBUT) (Figure 5). Oculus K5M provides noninvasive, objective, and reproducible tear film measurements [65].
Ocular surface staining with various dyes is used to characterize the disease, assess its severity, and monitor the clinical response to therapy. Fluorescein stains macro-ulcerative and punctate epithelial defects (positive staining) and appears orange under cobalt blue light. Classification of ocular surface staining after instillation of vital dyes is a critical diagnostic component of dry eye. These changes in the ocular surface are now documented with various staining scales such as Oxford, Nei-Clek, and SICA OSS [66]. The evaluation of the ocular surface and the qualification of the three scales are carried out with the methodology described in Table 3.
Fluorescein is applied
The biomicroscope is configured with 10× magnification and use of cobalt blue light in addition to a yellow filter.
Cornea: The upper eyelid is lifted to evaluate the total score of the staining or its absence.
Conjunctiva: To determine the degree of staining of the nasal and temporal conjunctiva, the subject is asked to look to the opposite side to evaluate said area.
Table 3.
Evaluation of the ocular surface (Oxford, Nei-cleck and Sica OSS).
To evaluate the SICCA OSS, it gives the same numerical weight to the corneal and conjunctival changes, the staining must be done in two steps. Fluorescein staining is first performed and the cornea is examined with the slit lamp using the cobalt blue filter. Corneal epithelial staining is a dynamic and time-sensitive process; therefore, to ensure that the test is reproducible, the fluorescein evaluation should begin 4–8 min after instillation of the dye. Punctate epithelial erosions (PEE) that stain with fluorescein are counted and scored as follows. If there is no PEE, the score is 0. If 1–5 PEE are seen, the corneal score is 1 (Figure 1a). From 6 to 30 PEE they are scored as 2; and >30 PEE are scored as 3. An additional point is added if: (1) PEE occurred in the central 4 mm diameter part of the cornea (Figure 1b); (2) one or more filaments are seen anywhere on the cornea; or (3) one or more confluence patches. The spots, including the linear spots, are found anywhere on the cornea (Figure 1c). The fluorescein score for the cornea (the PEE grade plus any extra points for modifiers) is noted in the center square of the SICCA eye staining score form (Figure 2). The maximum possible score for each cornea is 6 [67].
The second step is the evaluation of the conjunctiva with lysamine green, it is observed in the slit lamp using a 10× magnification but with reduced illumination and using a neutral density filter. It is important to examine and grade the eyes immediately after applying the lysamine green tint because the intensity and spread of the tint in the eye rapidly diminish after the first 2 min. In addition, the patient must blink several times to prevent the dye from accumulating in the conjunctival folds, which can mimic conjunctival staining. If the dye is not properly instilled, a second drop can be administered and the test is performed immediately afterward. The evaluation of this second staining in SICCA OSS, grade 0 (Figure 3a) is defined as 0–9 points of lysamine green staining of the interpalpebral bulbar conjunctival (nasal and temporal bulbar conjunctiva classified separately); grade 1 (Figure 3b) is defined by the presence of 10–32 points; grade 2 (Figure 3c) from 33 to 100; and grade 3 (Figure 3d) >100 points. Due to the difficulty of counting individual points in a moving eye in the slit lamp, any area of confluent staining ≥4 mm2 is considered >100 points. The nasal and temporal areas of the conjunctiva are classified separately with a maximum score of 3 for each area or a maximum total score of 6 for each eye (nasal plus temporal). The total SICCA OSS value for each eye is the sum of the fluorescein score for the cornea and the lysamine green scores for the nasal and temporal bulbar conjunctiva. Therefore, the maximum possible score for each eye is 12. The eyes are classified separately and the scores are recorded on the SICCA OSS Eye Staining Scoring Form at each patient visit. Pinguecula stain, pterygium, and Schirmer’s strip artifacts should not be included in the evaluation [67].
A value greater than 0 is considered abnormal and can be a sign of KCS. But scores of 1 or 2 can also represent a late staining artifact, if in the corneal fluorescein interpretation the staining pattern is delayed more than 8 min. Since this could lead to a high level of misclassification, an abnormal OSS is defined as a score of 3 or more (Figure 6) [67].
Figure 6.
Sjogren international collaboration clinical Alliance (sicca) ocular staining score form.
In one study, the relationship between serological markers and dry eye severity was investigated in subjects with primary Sjögren’s syndrome (SS). The serum markers anti-Ro/SSA, anti-La/SSB, rheumatoid factor (RF) and antinuclear antibody (ANA), ocular surface disease index (OSDI), Schirmer test I values, time to rupture of the tear film, and SICCA ocular staining score (OSS) were determined. Finding what serum RF and ANA levels are associated with conjunctival staining scores and total OSS based on SICCA OSS in primary SS [68].
2.5.8 The tear meniscus height (TMH)
The meniscus, or lacrimal lake, is the amount of tears that rest at the junction of the bulbar conjunctiva and the margin of the lower eyelid. Measurements of the height and curvature of the tear meniscus are used to determine the presence or absence of dry eye [65]. The normal height of the tear meniscus is 0.2–0.5 mm; but in patients with dry eye, it is usually less than 0.2 mm [69, 70]. The evaluation of the tear meniscus should be carried out without having instilled artificial tears or other types of drops; since it can be higher and therefore unreliable; although measurement of the tear meniscus is a good parameter for determining tear production, a low tear lake alone does not necessarily indicate dry eye and should be used as an adjunct to other dry eye tests [69]. The tear meniscus can be reliably assessed using a slit lamp that is capable of micrometer measurements, or it can be done by taking a photograph of the tear meniscus after instilling a small amount of fluorescein. Tear meniscus height (THM) is a noninvasive test for tear quantification and is used as a reliable and repeatable adjunct to the diagnosis of DED [71]. Placido’s advanced topography, the keratograph 5M (K5M; Oculus Optikgerate GmbH, Wetzlar, Germany), has additional imaging modalities designed to measure TMH [72, 73]. TMH can also be measured using a corneal adapter, in optical coherence tomography, RTVue-100 FD-OCT system (Optovue, Fremont, AC); reliably and noninvasively. Studies comparing these technologies found that although the tear meniscus height measurements measured with keratography are lower than those taken with OCT, they are closely correlated with each other; therefore, either method could be useful to assess the height of the tear meniscus more objectively [74]. Lacrimal meniscus height (TMH) is an important test because it shows a positive correlation with the value of the Schirmer test [75, 76]. Lacrimal point occlusion in patients with dry eye has been shown to induce increases in the volumes of the upper and lower tear meniscus, but no change in lacrimal menisci of control eyes; this may indicate the presence of a self-regulatory mechanism in the lacrimal system that maintains balance in tear volume (Figure 7) [77].
Figure 7.
Tear meniscus height.
2.5.9 Meibography
The meibomian glands are highly specialized sebaceous glands that secrete a lipid compound that is responsible for tear stability. Meibomian gland disease (MGD) is defined as a chronic and diffuse abnormality of the meibomian glands (MG), commonly characterized by terminal duct obstruction and qualitative/quantitative changes in glandular secretion [78]. The prevalence of MGD in published studies ranges from 20% to 70%, depending on diagnostic criteria for evaluating MGD and geographic differences [79, 80]. MGD is considered the main cause of evaporative dry eye [81, 82].
The pathophysiology of MGD is complex and involves several mechanisms and risk factors, including primary obstructive keratinization of the MG orifices, inflammation of the eyelids, abnormal MG secretion, and changes in the microbial flora of the ocular surface or Demodex infestation [24].
Among the main mechanisms of pathophysiology of MGD in patients with SS, the following have been proposed. Women with pSS have been shown to have androgen deficiency similar to that of patients with SLE and RA [83]; in these patients there is a significant decrease in serum levels of androgen precursors (DHEA [dehydroepiandrosterone] and DHEA sulfate), which are the main substrate for androgen synthesis in peripheral tissues. Androgen deficiency in humans has been found to be associated with an increase in eyelid keratinization and the number of occluded and metaplastic orifices of MGs; reduction in the quality of meibum; altered lipid patterns of the meibum; a decrease in the breakup time of the tear film; increased corneal staining with consequent increase in DED symptoms. It has been proposed that the beneficial effect of androgens stimulates the function of this glandular tissue, increasing its lipogenesis and suppressing its keratinization, this may explain why androgen therapy relieves signs and symptoms of DGM and DED in humans [24].
Additionally, it has been proposed that androgen deficiency can lead to a decrease in the influence of insulin-like growth factor 1 (IGF-1) on the meibomian glands. These androgens increase IGF-1 production, positively regulate IGF-1 receptor expression, modulate IGF-1 signaling, and stimulate human meibomian gland epithelial cell function [84]. On the other hand, there is an accumulation of lymphocytes in the conjunctiva of patients with SS and leads to signs of tarsal and periglandular inflammation. Such conjunctival inflammation can create a toxic environment, leading to the release of proinflammatory cytokines that affect the terminal duct of the meibomian gland [85]; as evidence of this, both SSp and SSs subjects and MGD patients showed occluded metaplastic orifices of the MG, as well as decreased quality of the secretions of these glands. These signs are characteristic of obstructive MGD (hyperkeratinization of the terminal duct epithelium, reduced quality of the meibum, and posterior obstruction) [24]. It has been hypothesized that some symptoms in pSS patients, such as sleep disturbances, depressed mood, and fatigue, may also lead to GDM due to decreased blinking, as the above symptoms are already the result of a lower secretion of dopamine, positively with the frequency of blinking. In patients with SS, the lacrimal glands are severely damaged early in the disease; however, the meibomian glands in patients with SSp will undergo further deterioration when the clinical history of dry eye is more than 3 years [85].
Another mechanism contributing to MGD in SS may be that lymphocytic infiltration adjacent to the tarsal conjunctiva in SS could trigger gland destruction. However, it is possible that conjunctival inflammatory cytokines secreted in the tear film promote hyperkeratinization of the terminal duct epithelium of the meibomian gland [24]. Another process implicated in the pathophysiology of MGD in SSp may be a cytokine-induced alteration in neural-meibomian gland epithelial cell interactions. The meibomian gland is the only sebaceous gland in the human body that has elaborate sensory, sympathetic, and parasympathetic innervation. We found that parasympathetic neurotransmitters and their agonists exert a significant influence on human meibomian gland epithelial cell activity. These cells contain muscarinic acetylcholine and vasoactive intestinal peptide receptors, and the ligands of these receptors stimulate the adenylyl cyclase pathway, enhance intracellular [Ca2+], and can promote cell proliferation [85, 86].
Meibography is a diagnostic technique that allows in vivo evaluation of the morphology of the meibomian glands [87, 88]. For its evaluation, several techniques have been developed, among which are meibography with infrared light. This uses ultraviolet light to produce fluorescence of the gland, the eyelid is everted and through transillumination photographs are obtained to obtain images, which are later graded according to the loss of the meibomian glands. The classification of these images go from 0 to 3; being 0 when there is no loss, 1 when the loss of glands is less than one-third, 2 when the loss is between one-third and two-thirds and 3 when the loss is greater than two-thirds. Meibomian glands are observed differently depending on the method to evaluate them, for example, they appear as dark areas on a lighter background in the contact technique. In contrast, noncontact meibography reveals the meibomian glands as reflected images, and the glands appear as light areas on a darker background [89]. The types of meibography that allow the capture of the morphology of the Meibomian gland in the form of photographs or films are LipiView 2; Tear Science, Cobra, LipiScan, and Tearscope [89]. The meiboscore [87] and the meibo-scale [90] are classification systems to quantify the loss of area of the meibomian gland. The meiboscores of the upper and lower eyelids are summed to obtain a total score of 0–6 for each eye [87]. In contrast, meibo-scale assigns a value from 0 to 4 for each eyelid [90]. The sensitivity and specificity for the diagnosis of MGD by noncontact meibography (cutoff value for meiboscore of +3) as a single test were found to be 49.3% and 64.5%, respectively [91]. The diagnosis of obstructive MGD based on any of the three scores (ocular symptom score, eyelid margin anomaly score, and meiboscore) resulted in a sensitivity of 100% and a specificity of 68.3%; the diagnosis based on two of the three abnormal scores yielded a sensitivity of 84.9% and a specificity of 96.7%; and diagnosis based on the fact that all three scores were abnormal yielded a sensitivity of 66.0% and a specificity of 100% (Figure 8) [92].
Figure 8.
Meibography.
3. Conclusions
The new emerging technologies for the diagnosis of DED represent a more objective way of talking about this entity that does not have a gold standard for its diagnosis, they facilitate the work and are very useful for research purposes. It is also important to mention that these technologies are of great help to provide an accurate diagnosis and accurate treatment; however, the preexisting tests for the diagnosis of DED are still useful and when applied with adequate methodology and the required sequence, they provide reliable data to make a correct diagnosis of DED; therefore they continue to be valid and must continue to be transmitted to new generations, especially to take advantage of contact with the patient and clinical observation that is not substitutable with anything.
Acknowledgments
My sincere thanks to MD Jose Antonio Alameda Chavez, Laura Ximena Alameda S.; Alondra Alameda S., Angel Antonio Alameda S., for his great collaboration in the elaboration of this manuscript, and in addition to C. Luis Velez, who was involved in its elaboration, was still my source of inspiration.
Conflict of interest
I seriously declare that I have no interest whatsoever, only the academic one, in the elaboration of this chapter.
Notes/thanks/other declarations
I express special thanks for the invitation for the collaboration of this chapter and to the authors of the references included in it.
List of abbreviations
AntiRho/SSA and AntiLa/SSB
Antibodies
ANA
Antinuclear antibodies
DED
Dry eye disease
DEWS II
Dry eye workshop II
ADDE
Acuodeficiency dry eye
EDE
Evaporative dry eye
TMH
Tear meniscus height
RF
Rheumatoid factor
GAGS
Sulfated glycosaminoglycan
IL
Interleukin
K5M
Keratograph 5M
KCS
keratoconjunctivitis sicca
MMP-9
Matrix metalloproteinase 9
MGD
Meibomian gland dysfunction
MUC5A
Mucin 5A
OSDI
Ocular surface disease index
OCT
Optical Coherence Tomography
PEE
Punctate Epithelial Erosions
TBUT
Tear breakup time
TNF
Tumor Necrosis factor
NIKBUT
Noninvasive keratograph breakup time
NFkB
Nuclear factor enhancer of the kappa light chains of activated B cells
SS
Sjögren Syndrome
SICA OSS
Sjögren’s International Collaborative Clinical Alliance Ocular Surface Staining
\n',keywords:"NIKBUT (noninvasive keratograph tear rupture time), TMH (tear meniscus height), Schirmer’s test, meibography, ocular surface disease index (OSDI), vital stains of the ocular surface, matrix metalloproteinase 9 (MMP-9), tear osmolarity (TearLab)",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/82407.pdf",chapterXML:"https://mts.intechopen.com/source/xml/82407.xml",downloadPdfUrl:"/chapter/pdf-download/82407",previewPdfUrl:"/chapter/pdf-preview/82407",totalDownloads:2,totalViews:0,totalCrossrefCites:0,dateSubmitted:"September 15th 2021",dateReviewed:"February 11th 2022",datePrePublished:"August 8th 2022",datePublished:null,dateFinished:"June 27th 2022",readingETA:"0",abstract:"Sjogren’s syndrome (Sicca Syndrome) is mainly characterized by the presence of dry eye disease (DED). The diagnosis of DED in patients with Sjogren’s syndrome has been limited to tests such as the Schirmer test, tear breakup time (TBUT), and corneal stains; however, currently we can evaluate the functional unit in detail lacrimal, which is affected in patients with dry eye and Sjögren’s syndrome; thanks to technology that provides objective details for this difficult diagnostic. The newer evaluations that provide the greatest diagnostic value for Sjogren’s syndrome are: noninvasive keratograph tear rupture time (NIKBUT), tear meniscus height (TMH), Schirmer’s test, meibography, ocular surface disease index (OSDI), Vital stains of the ocular surface, Matrix Metalloproteinase 9 (MMP-9), Tear osmolarity (TearLab); all of these are important complements to the existing tests, which, although less objective, are not substitutable.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/82407",risUrl:"/chapter/ris/82407",signatures:"María del Rosario Sánchez Valerio",book:{id:"11702",type:"book",title:"Eye Diseases - Recent Advances, New Perspectives and Therapeutic Options",subtitle:null,fullTitle:"Eye Diseases - Recent Advances, New Perspectives and Therapeutic Options",slug:null,publishedDate:null,bookSignature:"Dr. Salvatore Di Lauro",coverURL:"https://cdn.intechopen.com/books/images_new/11702.jpg",licenceType:"CC BY 3.0",editedByType:null,isbn:"978-1-80356-417-3",printIsbn:"978-1-80356-416-6",pdfIsbn:"978-1-80356-418-0",isAvailableForWebshopOrdering:!0,editors:[{id:"244950",title:"Dr.",name:"Salvatore",middleName:null,surname:"Di Lauro",slug:"salvatore-di-lauro",fullName:"Salvatore Di Lauro"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:null,sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Dry eye disease (DED)",level:"1"},{id:"sec_2_2",title:"2.1 Classification",level:"2"},{id:"sec_3_2",title:"2.2 Pathophysiology",level:"2"},{id:"sec_4_2",title:"2.3 Eye manifestations",level:"2"},{id:"sec_5_2",title:"2.4 Diagnosis of DED",level:"2"},{id:"sec_6_2",title:"2.5 Current methods of diagnosis",level:"2"},{id:"sec_6_3",title:"2.5.1 Symptom questionnaire",level:"3"},{id:"sec_7_3",title:"2.5.2 Tear osmolarity",level:"3"},{id:"sec_8_3",title:"2.5.3 Matrix metalloproteinase 9 (MMP-9)",level:"3"},{id:"sec_9_3",title:"2.5.4 The Schirmer test",level:"3"},{id:"sec_10_3",title:"Table 2.",level:"3"},{id:"sec_11_3",title:"2.5.6 Noninvasive keratograph breakup time (NIKBUT)",level:"3"},{id:"sec_12_3",title:"Table 3.",level:"3"},{id:"sec_13_3",title:"2.5.8 The tear meniscus height (TMH)",level:"3"},{id:"sec_14_3",title:"2.5.9 Meibography",level:"3"},{id:"sec_17",title:"3. Conclusions",level:"1"},{id:"sec_18",title:"Acknowledgments",level:"1"},{id:"sec_21",title:"Conflict of interest",level:"1"},{id:"sec_18",title:"Notes/thanks/other declarations",level:"1"},{id:"sec_19",title:"List of abbreviations",level:"1"}],chapterReferences:[{id:"B1",body:'Mariette X, Criswell LA. Primary Sjögren\'s syndrome. The New England Journal of Medicine. 2018;378:931'},{id:"B2",body:'Wang X, Bootsma H, Terpstra J, et al. Progenitor cell niche senescence reflects pathology of the parotid salivary gland in primary Sjögren\'s syndrome. Rheumatology (Oxford). 2020;59:3003'},{id:"B3",body:'Vivino FB, Bunya VY, Massaro-Giordano G, et al. Sjogren\'s syndrome: An update on disease pathogenesis, clinical manifestations and treatment. Clinical Immunology. 2019;203:81'},{id:"B4",body:'Kassan SS, Moutsopoulos HM. Clinical manifestations and early diagnosis of Sjögren syndrome. 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Ophthalmology. 2009;116:2058-2063'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"María del Rosario Sánchez Valerio",address:"rosyoft_@hotmail.com;, rosaval79.88@gmail.com",affiliation:'
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IntechOpen’s Academic Editors and Authors have received funding for their work through many well-known funders, including: the European Commission, Bill and Melinda Gates Foundation, Wellcome Trust, Chinese Academy of Sciences, Natural Science Foundation of China (NSFC), CGIAR Consortium of International Agricultural Research Centers, National Institute of Health (NIH), National Science Foundation (NSF), National Aeronautics and Space Administration (NASA), National Institute of Standards and Technology (NIST), German Research Foundation (DFG), Research Councils United Kingdom (RCUK), Oswaldo Cruz Foundation, Austrian Science Fund (FWF), Foundation for Science and Technology (FCT), Australian Research Council (ARC).
Open Access publication costs can often be designated directly in the grants or in specific budgets allocated for that purpose. Many of the most important funding organisations encourage, and even request, that the projects they fund are made available at no cost to the wider public. IntechOpen strives to maintain excellent relationships with these funders and ensures compliance with mandates.
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In order to help Authors identify appropriate funding agencies and institutions, we have created a list, based on extensive research on various OA resources (including ROARMAP and SHERPA/JULIET) of organizations that have funds available. Before consulting our list we encourage you to petition your own institution or organization for Open Access funds or check the specifications of your grant with your funder to ascertain if publication costs are included. Where you are in receipt of a grant you should clarify:
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Please note that this list is not a definitive one and is updated regularly. To suggest possible modifications or the inclusion of your institution/funder, please contact us at funders@intechopen.com
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Please be aware that you must be a member, or grantee, of the institutions/funders listed in order to apply for their Open Access publication funds.
Open Access publication costs can often be designated directly in the grants or in specific budgets allocated for that purpose. Many of the most important funding organisations encourage, and even request, that the projects they fund are made available at no cost to the wider public. IntechOpen strives to maintain excellent relationships with these funders and ensures compliance with mandates.
\n\n
In order to help Authors identify appropriate funding agencies and institutions, we have created a list, based on extensive research on various OA resources (including ROARMAP and SHERPA/JULIET) of organizations that have funds available. Before consulting our list we encourage you to petition your own institution or organization for Open Access funds or check the specifications of your grant with your funder to ascertain if publication costs are included. Where you are in receipt of a grant you should clarify:
\n\n
\n\t
Does your institution already have a budget for covering Open Access publication costs?
\n\t
Does your grant list Open Access publication fees as legitimate direct/indirect costs?
\n
\n\n
If you are associated with any of the institutions in our list below, you can apply to receive OA publication funds by following the instructions provided in the links. Please consult the Open Access policies or grant Terms and Conditions of any institution with which you are linked to explore ways to cover your publication costs (also accessible by clicking on the link in their title).
\n\n
Please note that this list is not a definitive one and is updated regularly. To suggest possible modifications or the inclusion of your institution/funder, please contact us at funders@intechopen.com
\n\n
Please be aware that you must be a member, or grantee, of the institutions/funders listed in order to apply for their Open Access publication funds.
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He was elected a Yangtze River Scholars Distinguished Professor in 2013, a member of the International Statistical Institute (ISI) in 2016, a member of the board of the International Chinese Statistical Association (ICSA) in 2018, and a fellow of the Institute of Mathematical Statistics (IMS) in 2021. He received the ICSA Outstanding Service Award in 2018 and the National Science Foundation for Distinguished Young Scholars of China in 2012. He serves as a member of the editorial board of Statistics and Its Interface and Journal of Systems Science and Complexity. He is also a field editor for Communications in Mathematics and Statistics. His research interests include biostatistics, empirical likelihood, missing data analysis, variable selection, high-dimensional data analysis, Bayesian statistics, and data science. He has published more than 190 research papers and authored five books.",institutionString:"Yunnan University",institution:{name:"Yunnan University",country:{name:"China"}}},{id:"1177",title:"Prof.",name:"António",middleName:"J. R.",surname:"José Ribeiro Neves",slug:"antonio-jose-ribeiro-neves",fullName:"António José Ribeiro Neves",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1177/images/system/1177.jpg",biography:"Prof. António J. R. Neves received a Ph.D. in Electrical Engineering from the University of Aveiro, Portugal, in 2007. Since 2002, he has been a researcher at the Institute of Electronics and Informatics Engineering of Aveiro. Since 2007, he has been an assistant professor in the Department of Electronics, Telecommunications, and Informatics, University of Aveiro. He is the director of the undergraduate course on Electrical and Computers Engineering and the vice-director of the master’s degree in Electronics and Telecommunications Engineering. He is an IEEE Senior Member and a member of several other research organizations worldwide. His main research interests are computer vision, intelligent systems, robotics, and image and video processing. He has participated in or coordinated several research projects and received more than thirty-five awards. He has 161 publications to his credit, including books, book chapters, journal articles, and conference papers. He has vast experience as a reviewer of several journals and conferences. As a professor, Dr. Neves has supervised several Ph.D. and master’s students and was involved in more than twenty-five different courses.",institutionString:null,institution:{name:"University of Aveiro",country:{name:"Portugal"}}},{id:"11317",title:"Dr.",name:"Francisco",middleName:null,surname:"Javier Gallegos-Funes",slug:"francisco-javier-gallegos-funes",fullName:"Francisco Javier Gallegos-Funes",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/11317/images/system/11317.png",biography:"Francisco J. Gallegos-Funes received his Ph.D. in Communications and Electronics from the Instituto Politécnico Nacional de México (National Polytechnic Institute of Mexico) in 2003. He is currently an associate professor in the Escuela Superior de Ingeniería Mecánica y Eléctrica (Mechanical and Electrical Engineering Higher School) at the same institute. His areas of scientific interest are signal and image processing, filtering, steganography, segmentation, pattern recognition, biomedical signal processing, sensors, and real-time applications.",institutionString:"Instituto Politécnico Nacional",institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"428449",title:"Dr.",name:"Ronaldo",middleName:null,surname:"Ferreira",slug:"ronaldo-ferreira",fullName:"Ronaldo Ferreira",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/428449/images/21449_n.png",biography:null,institutionString:null,institution:{name:"University of Aveiro",country:{name:"Portugal"}}},{id:"165328",title:"Dr.",name:"Vahid",middleName:null,surname:"Asadpour",slug:"vahid-asadpour",fullName:"Vahid Asadpour",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/165328/images/system/165328.jpg",biography:"Vahid Asadpour, MS, Ph.D., is currently with the Department of Research and Evaluation, Kaiser Permanente Southern California. He has both an MS and Ph.D. in Biomedical Engineering. He was previously a research scientist at the University of California Los Angeles (UCLA) and visiting professor and researcher at the University of North Dakota. He is currently working in artificial intelligence and its applications in medical signal processing. In addition, he is using digital signal processing in medical imaging and speech processing. Dr. Asadpour has developed brain-computer interfacing algorithms and has published books, book chapters, and several journal and conference papers in this field and other areas of intelligent signal processing. He has also designed medical devices, including a laser Doppler monitoring system.",institutionString:"Kaiser Permanente Southern California",institution:null},{id:"169608",title:"Prof.",name:"Marian",middleName:null,surname:"Găiceanu",slug:"marian-gaiceanu",fullName:"Marian Găiceanu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/169608/images/system/169608.png",biography:"Prof. Dr. Marian Gaiceanu graduated from the Naval and Electrical Engineering Faculty, Dunarea de Jos University of Galati, Romania, in 1997. He received a Ph.D. (Magna Cum Laude) in Electrical Engineering in 2002. Since 2017, Dr. Gaiceanu has been a Ph.D. supervisor for students in Electrical Engineering. He has been employed at Dunarea de Jos University of Galati since 1996, where he is currently a professor. Dr. Gaiceanu is a member of the National Council for Attesting Titles, Diplomas and Certificates, an expert of the Executive Agency for Higher Education, Research Funding, and a member of the Senate of the Dunarea de Jos University of Galati. He has been the head of the Integrated Energy Conversion Systems and Advanced Control of Complex Processes Research Center, Romania, since 2016. He has conducted several projects in power converter systems for electrical drives, power quality, PEM and SOFC fuel cell power converters for utilities, electric vehicles, and marine applications with the Department of Regulation and Control, SIEI S.pA. (2002–2004) and the Polytechnic University of Turin, Italy (2002–2004, 2006–2007). He is a member of the Institute of Electrical and Electronics Engineers (IEEE) and cofounder-member of the IEEE Power Electronics Romanian Chapter. He is a guest editor at Energies and an academic book editor for IntechOpen. He is also a member of the editorial boards of the Journal of Electrical Engineering, Electronics, Control and Computer Science and Sustainability. Dr. Gaiceanu has been General Chairman of the IEEE International Symposium on Electrical and Electronics Engineering in the last six editions.",institutionString:'"Dunarea de Jos" University of Galati',institution:{name:'"Dunarea de Jos" University of Galati',country:{name:"Romania"}}},{id:"4519",title:"Prof.",name:"Jaydip",middleName:null,surname:"Sen",slug:"jaydip-sen",fullName:"Jaydip Sen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/4519/images/system/4519.jpeg",biography:"Jaydip Sen is associated with Praxis Business School, Kolkata, India, as a professor in the Department of Data Science. His research areas include security and privacy issues in computing and communication, intrusion detection systems, machine learning, deep learning, and artificial intelligence in the financial domain. He has more than 200 publications in reputed international journals, refereed conference proceedings, and 20 book chapters in books published by internationally renowned publishing houses, such as Springer, CRC press, IGI Global, etc. Currently, he is serving on the editorial board of the prestigious journal Frontiers in Communications and Networks and in the technical program committees of a number of high-ranked international conferences organized by the IEEE, USA, and the ACM, USA. He has been listed among the top 2% of scientists in the world for the last three consecutive years, 2019 to 2021 as per studies conducted by the Stanford University, USA.",institutionString:"Praxis Business School",institution:null},{id:"320071",title:"Dr.",name:"Sidra",middleName:null,surname:"Mehtab",slug:"sidra-mehtab",fullName:"Sidra Mehtab",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00002v6KHoQAM/Profile_Picture_1584512086360",biography:"Sidra Mehtab has completed her BS with honors in Physics from Calcutta University, India in 2018. She has done MS in Data Science and Analytics from Maulana Abul Kalam Azad University of Technology (MAKAUT), Kolkata, India in 2020. Her research areas include Econometrics, Time Series Analysis, Machine Learning, Deep Learning, Artificial Intelligence, and Computer and Network Security with a particular focus on Cyber Security Analytics. Ms. Mehtab has published seven papers in international conferences and one of her papers has been accepted for publication in a reputable international journal. She has won the best paper awards in two prestigious international conferences – BAICONF 2019, and ICADCML 2021, organized in the Indian Institute of Management, Bangalore, India in December 2019, and SOA University, Bhubaneswar, India in January 2021. Besides, Ms. Mehtab has also published two book chapters in two books. Seven of her book chapters will be published in a volume shortly in 2021 by Cambridge Scholars’ Press, UK. Currently, she is working as the joint editor of two edited volumes on Time Series Analysis and Forecasting to be published in the first half of 2021 by an international house. Currently, she is working as a Data Scientist with an MNC in Delhi, India.",institutionString:"NSHM College of Management and Technology",institution:{name:"Association for Computing Machinery",country:{name:"United States of America"}}},{id:"226240",title:"Dr.",name:"Andri Irfan",middleName:null,surname:"Rifai",slug:"andri-irfan-rifai",fullName:"Andri Irfan Rifai",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226240/images/7412_n.jpg",biography:"Andri IRFAN is a Senior Lecturer of Civil Engineering and Planning. He completed the PhD at the Universitas Indonesia & Universidade do Minho with Sandwich Program Scholarship from the Directorate General of Higher Education and LPDP scholarship. He has been teaching for more than 19 years and much active to applied his knowledge in the project construction in Indonesia. His research interest ranges from pavement management system to advanced data mining techniques for transportation engineering. He has published more than 50 papers in journals and 2 books.",institutionString:null,institution:{name:"Universitas Internasional Batam",country:{name:"Indonesia"}}},{id:"314576",title:"Dr.",name:"Ibai",middleName:null,surname:"Laña",slug:"ibai-lana",fullName:"Ibai Laña",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314576/images/system/314576.jpg",biography:"Dr. Ibai Laña works at TECNALIA as a data analyst. He received his Ph.D. in Artificial Intelligence from the University of the Basque Country (UPV/EHU), Spain, in 2018. He is currently a senior researcher at TECNALIA. His research interests fall within the intersection of intelligent transportation systems, machine learning, traffic data analysis, and data science. He has dealt with urban traffic forecasting problems, applying machine learning models and evolutionary algorithms. He has experience in origin-destination matrix estimation or point of interest and trajectory detection. Working with large volumes of data has given him a good command of big data processing tools and NoSQL databases. He has also been a visiting scholar at the Knowledge Engineering and Discovery Research Institute, Auckland University of Technology.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"314575",title:"Dr.",name:"Jesus",middleName:null,surname:"L. Lobo",slug:"jesus-l.-lobo",fullName:"Jesus L. Lobo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314575/images/system/314575.png",biography:"Dr. Jesús López is currently based in Bilbao (Spain) working at TECNALIA as Artificial Intelligence Research Scientist. In most cases, a project idea or a new research line needs to be investigated to see if it is good enough to take into production or to focus on it. That is exactly what he does, diving into Machine Learning algorithms and technologies to help TECNALIA to decide whether something is great in theory or will actually impact on the product or processes of its projects. So, he is expert at framing experiments, developing hypotheses, and proving whether they’re true or not, in order to investigate fundamental problems with a longer time horizon. He is also able to design and develop PoCs and system prototypes in simulation. He has participated in several national and internacional R&D projects.\n\nAs another relevant part of his everyday research work, he usually publishes his findings in reputed scientific refereed journals and international conferences, occasionally acting as reviewer and Programme Commitee member. Concretely, since 2018 he has published 9 JCR (8 Q1) journal papers, 9 conference papers (e.g. ECML PKDD 2021), and he has co-edited a book. He is also active in popular science writing data science stories for reputed blogs (KDNuggets, TowardsDataScience, Naukas). Besides, he has recently embarked on mentoring programmes as mentor, and has also worked as data science trainer.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"103779",title:"Prof.",name:"Yalcin",middleName:null,surname:"Isler",slug:"yalcin-isler",fullName:"Yalcin Isler",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRyQ8QAK/Profile_Picture_1628834958734",biography:"Yalcin Isler (1971 - Burdur / Turkey) received the B.Sc. degree in the Department of Electrical and Electronics Engineering from Anadolu University, Eskisehir, Turkey, in 1993, the M.Sc. degree from the Department of Electronics and Communication Engineering, Suleyman Demirel University, Isparta, Turkey, in 1996, the Ph.D. degree from the Department of Electrical and Electronics Engineering, Dokuz Eylul University, Izmir, Turkey, in 2009, and the Competence of Associate Professorship from the Turkish Interuniversity Council in 2019.\n\nHe was Lecturer at Burdur Vocational School in Suleyman Demirel University (1993-2000, Burdur / Turkey), Software Engineer (2000-2002, Izmir / Turkey), Research Assistant in Bulent Ecevit University (2002-2003, Zonguldak / Turkey), Research Assistant in Dokuz Eylul University (2003-2010, Izmir / Turkey), Assistant Professor at the Department of Electrical and Electronics Engineering in Bulent Ecevit University (2010-2012, Zonguldak / Turkey), Assistant Professor at the Department of Biomedical Engineering in Izmir Katip Celebi University (2012-2019, Izmir / Turkey). He is an Associate Professor at the Department of Biomedical Engineering at Izmir Katip Celebi University, Izmir / Turkey, since 2019. In addition to academics, he has also founded Islerya Medical and Information Technologies Company, Izmir / Turkey, since 2017.\n\nHis main research interests cover biomedical signal processing, pattern recognition, medical device design, programming, and embedded systems. He has many scientific papers and participated in several projects in these study fields. He was an IEEE Student Member (2009-2011) and IEEE Member (2011-2014) and has been IEEE Senior Member since 2014.",institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",country:{name:"Turkey"}}},{id:"339677",title:"Dr.",name:"Mrinmoy",middleName:null,surname:"Roy",slug:"mrinmoy-roy",fullName:"Mrinmoy Roy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/339677/images/16768_n.jpg",biography:"An accomplished Sales & Marketing professional with 12 years of cross-functional experience in well-known organisations such as CIPLA, LUPIN, GLENMARK, ASTRAZENECA across different segment of Sales & Marketing, International Business, Institutional Business, Product Management, Strategic Marketing of HIV, Oncology, Derma, Respiratory, Anti-Diabetic, Nutraceutical & Stomatological Product Portfolio and Generic as well as Chronic Critical Care Portfolio. A First Class MBA in International Business & Strategic Marketing, B.Pharm, D.Pharm, Google Certified Digital Marketing Professional. Qualified PhD Candidate in Operations and Management with special focus on Artificial Intelligence and Machine Learning adoption, analysis and use in Healthcare, Hospital & Pharma Domain. Seasoned with diverse therapy area of Pharmaceutical Sales & Marketing ranging from generating revenue through generating prescriptions, launching new products, and making them big brands with continuous strategy execution at the Physician and Patients level. Moved from Sales to Marketing and Business Development for 3.5 years in South East Asian Market operating from Manila, Philippines. Came back to India and handled and developed Brands such as Gluconorm, Lupisulin, Supracal, Absolut Woman, Hemozink, Fabiflu (For COVID 19), and many more. In my previous assignment I used to develop and execute strategies on Sales & Marketing, Commercialization & Business Development for Institution and Corporate Hospital Business portfolio of Oncology Therapy Area for AstraZeneca Pharma India Ltd. Being a Research Scholar and Student of ‘Operations Research & Management: Artificial Intelligence’ I published several pioneer research papers and book chapters on the same in Internationally reputed journals and Books indexed in Scopus, Springer and Ei Compendex, Google Scholar etc. Currently, I am launching PGDM Pharmaceutical Management Program in IIHMR Bangalore and spearheading the course curriculum and structure of the same. I am interested in Collaboration for Healthcare Innovation, Pharma AI Innovation, Future trend in Marketing and Management with incubation on Healthcare, Healthcare IT startups, AI-ML Modelling and Healthcare Algorithm based training module development. I am also an affiliated member of the Institute of Management Consultant of India, looking forward to Healthcare, Healthcare IT and Innovation, Pharma and Hospital Management Consulting works.",institutionString:null,institution:{name:"Lovely Professional University",country:{name:"India"}}},{id:"1063",title:"Prof.",name:"Constantin",middleName:null,surname:"Volosencu",slug:"constantin-volosencu",fullName:"Constantin Volosencu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1063/images/system/1063.png",biography:"Prof. Dr. Constantin Voloşencu graduated as an engineer from\nPolitehnica University of Timișoara, Romania, where he also\nobtained a doctorate degree. He is currently a full professor in\nthe Department of Automation and Applied Informatics at the\nsame university. Dr. Voloşencu is the author of ten books, seven\nbook chapters, and more than 160 papers published in journals\nand conference proceedings. He has also edited twelve books and\nhas twenty-seven patents to his name. He is a manager of research grants, editor in\nchief and member of international journal editorial boards, a former plenary speaker, a member of scientific committees, and chair at international conferences. His\nresearch is in the fields of control systems, control of electric drives, fuzzy control\nsystems, neural network applications, fault detection and diagnosis, sensor network\napplications, monitoring of distributed parameter systems, and power ultrasound\napplications. He has developed automation equipment for machine tools, spooling\nmachines, high-power ultrasound processes, and more.",institutionString:'"Politechnica" University Timişoara',institution:null},{id:"221364",title:"Dr.",name:"Eneko",middleName:null,surname:"Osaba",slug:"eneko-osaba",fullName:"Eneko Osaba",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/221364/images/system/221364.jpg",biography:"Dr. Eneko Osaba works at TECNALIA as a senior researcher. He obtained his Ph.D. in Artificial Intelligence in 2015. He has participated in more than twenty-five local and European research projects, and in the publication of more than 130 papers. He has performed several stays at universities in the United Kingdom, Italy, and Malta. Dr. Osaba has served as a program committee member in more than forty international conferences and participated in organizing activities in more than ten international conferences. He is a member of the editorial board of the International Journal of Artificial Intelligence, Data in Brief, and Journal of Advanced Transportation. He is also a guest editor for the Journal of Computational Science, Neurocomputing, Swarm, and Evolutionary Computation and IEEE ITS Magazine.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"275829",title:"Dr.",name:"Esther",middleName:null,surname:"Villar-Rodriguez",slug:"esther-villar-rodriguez",fullName:"Esther Villar-Rodriguez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/275829/images/system/275829.jpg",biography:"Dr. Esther Villar obtained a Ph.D. in Information and Communication Technologies from the University of Alcalá, Spain, in 2015. She obtained a degree in Computer Science from the University of Deusto, Spain, in 2010, and an MSc in Computer Languages and Systems from the National University of Distance Education, Spain, in 2012. Her areas of interest and knowledge include natural language processing (NLP), detection of impersonation in social networks, semantic web, and machine learning. Dr. Esther Villar made several contributions at conferences and publishing in various journals in those fields. Currently, she is working within the OPTIMA (Optimization Modeling & Analytics) business of TECNALIA’s ICT Division as a data scientist in projects related to the prediction and optimization of management and industrial processes (resource planning, energy efficiency, etc).",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49813/images/system/49813.png",biography:"Prof. Dr. Javier Del Ser received his first PhD in Telecommunication Engineering (Cum Laude) from the University of Navarra, Spain, in 2006, and a second PhD in Computational Intelligence (Summa Cum Laude) from the University of Alcala, Spain, in 2013. He is currently a principal researcher in data analytics and optimisation at TECNALIA (Spain), a visiting fellow at the Basque Center for Applied Mathematics (BCAM) and a part-time lecturer at the University of the Basque Country (UPV/EHU). His research interests gravitate on the use of descriptive, prescriptive and predictive algorithms for data mining and optimization in a diverse range of application fields such as Energy, Transport, Telecommunications, Health and Industry, among others. In these fields he has published more than 240 articles, co-supervised 8 Ph.D. theses, edited 6 books, coauthored 7 patents and participated/led more than 40 research projects. He is a Senior Member of the IEEE, and a recipient of the Biscay Talent prize for his academic career.",institutionString:"Tecnalia Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"278948",title:"Dr.",name:"Carlos Pedro",middleName:null,surname:"Gonçalves",slug:"carlos-pedro-goncalves",fullName:"Carlos Pedro Gonçalves",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRcmyQAC/Profile_Picture_1564224512145",biography:'Carlos Pedro Gonçalves (PhD) is an Associate Professor at Lusophone University of Humanities and Technologies and a researcher on Complexity Sciences, Quantum Technologies, Artificial Intelligence, Strategic Studies, Studies in Intelligence and Security, FinTech and Financial Risk Modeling. He is also a progammer with programming experience in:\n\nA) Quantum Computing using Qiskit Python module and IBM Quantum Experience Platform, with software developed on the simulation of Quantum Artificial Neural Networks and Quantum Cybersecurity;\n\nB) Artificial Intelligence and Machine learning programming in Python;\n\nC) Artificial Intelligence, Multiagent Systems Modeling and System Dynamics Modeling in Netlogo, with models developed in the areas of Chaos Theory, Econophysics, Artificial Intelligence, Classical and Quantum Complex Systems Science, with the Econophysics models having been cited worldwide and incorporated in PhD programs by different Universities.\n\nReceived an Arctic Code Vault Contributor status by GitHub, due to having developed open source software preserved in the \\"Arctic Code Vault\\" for future generations (https://archiveprogram.github.com/arctic-vault/), with the Strategy Analyzer A.I. module for decision making support (based on his PhD thesis, used in his Classes on Decision Making and in Strategic Intelligence Consulting Activities) and QNeural Python Quantum Neural Network simulator also preserved in the \\"Arctic Code Vault\\", for access to these software modules see: https://github.com/cpgoncalves. He is also a peer reviewer with outsanding review status from Elsevier journals, including Physica A, Neurocomputing and Engineering Applications of Artificial Intelligence. Science CV available at: https://www.cienciavitae.pt//pt/8E1C-A8B3-78C5 and ORCID: https://orcid.org/0000-0002-0298-3974',institutionString:"University of Lisbon",institution:{name:"Universidade Lusófona",country:{name:"Portugal"}}},{id:"310576",title:"Prof.",name:"Erick Giovani",middleName:null,surname:"Sperandio Nascimento",slug:"erick-giovani-sperandio-nascimento",fullName:"Erick Giovani Sperandio Nascimento",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y00002pDKxDQAW/ProfilePicture%202022-06-20%2019%3A57%3A24.788",biography:"Prof. Erick Sperandio is the Lead Researcher and professor of Artificial Intelligence (AI) at SENAI CIMATEC, Bahia, Brazil, also working with Computational Modeling (CM) and HPC. He holds a PhD in Environmental Engineering in the area of Atmospheric Computational Modeling, a Master in Informatics in the field of Computational Intelligence and Graduated in Computer Science from UFES. He currently coordinates, leads and participates in R&D projects in the areas of AI, computational modeling and supercomputing applied to different areas such as Oil and Gas, Health, Advanced Manufacturing, Renewable Energies and Atmospheric Sciences, advising undergraduate, master's and doctoral students. He is the Lead Researcher at SENAI CIMATEC's Reference Center on Artificial Intelligence. In addition, he is a Certified Instructor and University Ambassador of the NVIDIA Deep Learning Institute (DLI) in the areas of Deep Learning, Computer Vision, Natural Language Processing and Recommender Systems, and Principal Investigator of the NVIDIA/CIMATEC AI Joint Lab, the first in Latin America within the NVIDIA AI Technology Center (NVAITC) worldwide program. He also works as a researcher at the Supercomputing Center for Industrial Innovation (CS2i) and at the SENAI Institute of Innovation for Automation (ISI Automação), both from SENAI CIMATEC. He is a member and vice-coordinator of the Basic Board of Scientific-Technological Advice and Evaluation, in the area of Innovation, of the Foundation for Research Support of the State of Bahia (FAPESB). He serves as Technology Transfer Coordinator and one of the Principal Investigators at the National Applied Research Center in Artificial Intelligence (CPA-IA) of SENAI CIMATEC, focusing on Industry, being one of the six CPA-IA in Brazil approved by MCTI / FAPESP / CGI.br. He also participates as one of the representatives of Brazil in the BRICS Innovation Collaboration Working Group on HPC, ICT and AI. He is the coordinator of the Work Group of the Axis 5 - Workforce and Training - of the Brazilian Strategy for Artificial Intelligence (EBIA), and member of the MCTI/EMBRAPII AI Innovation Network Training Committee. He is the coordinator, by SENAI CIMATEC, of the Artificial Intelligence Reference Network of the State of Bahia (REDE BAH.IA). He leads the working group of experts representing Brazil in the Global Partnership on Artificial Intelligence (GPAI), on the theme \"AI and the Pandemic Response\".",institutionString:null,institution:null},{id:"241400",title:"Prof.",name:"Mohammed",middleName:null,surname:"Bsiss",slug:"mohammed-bsiss",fullName:"Mohammed Bsiss",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241400/images/8062_n.jpg",biography:null,institutionString:null,institution:null},{id:"276128",title:"Dr.",name:"Hira",middleName:null,surname:"Fatima",slug:"hira-fatima",fullName:"Hira Fatima",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/276128/images/14420_n.jpg",biography:"Dr. Hira Fatima\nAssistant Professor\nDepartment of Mathematics\nInstitute of Applied Science\nMangalayatan University, Aligarh\nMobile: no : 8532041179\nhirafatima2014@gmal.com\n\nDr. Hira Fatima has received his Ph.D. degree in pure Mathematics from Aligarh Muslim University, Aligarh India. Currently working as an Assistant Professor in the Department of Mathematics, Institute of Applied Science, Mangalayatan University, Aligarh. She taught so many courses of Mathematics of UG and PG level. Her research Area of Expertise is Functional Analysis & Sequence Spaces. She has been working on Ideal Convergence of double sequence. She has published 17 research papers in National and International Journals including Cogent Mathematics, Filomat, Journal of Intelligent and Fuzzy Systems, Advances in Difference Equations, Journal of Mathematical Analysis, Journal of Mathematical & Computer Science etc. She has also reviewed few research papers for the and international journals. She is a member of Indian Mathematical Society.",institutionString:null,institution:null},{id:"417317",title:"Mrs.",name:"Chiedza",middleName:null,surname:"Elvina Mashiri",slug:"chiedza-elvina-mashiri",fullName:"Chiedza Elvina Mashiri",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Midlands State University",country:{name:"Zimbabwe"}}},{id:"352140",title:"Dr.",name:"Edina",middleName:null,surname:"Chandiwana",slug:"edina-chandiwana",fullName:"Edina Chandiwana",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Midlands State University",country:{name:"Zimbabwe"}}},{id:"342259",title:"B.Sc.",name:"Leonard",middleName:null,surname:"Mushunje",slug:"leonard-mushunje",fullName:"Leonard Mushunje",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Midlands State University",country:{name:"Zimbabwe"}}},{id:"347042",title:"Mr.",name:"Maxwell",middleName:null,surname:"Mashasha",slug:"maxwell-mashasha",fullName:"Maxwell Mashasha",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Midlands State University",country:{name:"Zimbabwe"}}},{id:"2941",title:"Dr.",name:"Alberto J.",middleName:"Jorge",surname:"Rosales-Silva",slug:"alberto-j.-rosales-silva",fullName:"Alberto J. Rosales-Silva",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"437913",title:"Dr.",name:"Guillermo",middleName:null,surname:"Urriolagoitia-Sosa",slug:"guillermo-urriolagoitia-sosa",fullName:"Guillermo Urriolagoitia-Sosa",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"435126",title:"Prof.",name:"Joaquim",middleName:null,surname:"José de Castro Ferreira",slug:"joaquim-jose-de-castro-ferreira",fullName:"Joaquim José de Castro Ferreira",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Aveiro",country:{name:"Portugal"}}},{id:"437899",title:"MSc.",name:"Miguel Angel",middleName:null,surname:"Ángel Castillo-Martínez",slug:"miguel-angel-angel-castillo-martinez",fullName:"Miguel Angel Ángel Castillo-Martínez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"289955",title:"Dr.",name:"Raja",middleName:null,surname:"Kishor Duggirala",slug:"raja-kishor-duggirala",fullName:"Raja Kishor Duggirala",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Jawaharlal Nehru Technological University, Hyderabad",country:{name:"India"}}}]}},subseries:{item:{id:"5",type:"subseries",title:"Parasitic Infectious Diseases",keywords:"Blood Borne Parasites, Intestinal Parasites, Protozoa, Helminths, Arthropods, Water Born Parasites, Epidemiology, Molecular Biology, Systematics, Genomics, Proteomics, Ecology",scope:"Parasitic diseases have evolved alongside their human hosts. In many cases, these diseases have adapted so well that they have developed efficient resilience methods in the human host and can live in the host for years. Others, particularly some blood parasites, can cause very acute diseases and are responsible for millions of deaths yearly. Many parasitic diseases are classified as neglected tropical diseases because they have received minimal funding over recent years and, in many cases, are under-reported despite the critical role they play in morbidity and mortality among human and animal hosts. The current topic, Parasitic Infectious Diseases, in the Infectious Diseases Series aims to publish studies on the systematics, epidemiology, molecular biology, genomics, pathogenesis, genetics, and clinical significance of parasitic diseases from blood borne to intestinal parasites as well as zoonotic parasites. We hope to cover all aspects of parasitic diseases to provide current and relevant research data on these very important diseases. In the current atmosphere of the Coronavirus pandemic, communities around the world, particularly those in different underdeveloped areas, are faced with the growing challenges of the high burden of parasitic diseases. At the same time, they are faced with the Covid-19 pandemic leading to what some authors have called potential syndemics that might worsen the outcome of such infections. Therefore, it is important to conduct studies that examine parasitic infections in the context of the coronavirus pandemic for the benefit of all communities to help foster more informed decisions for the betterment of human and animal health.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/5.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11401,editor:{id:"67907",title:"Dr.",name:"Amidou",middleName:null,surname:"Samie",slug:"amidou-samie",fullName:"Amidou Samie",profilePictureURL:"https://mts.intechopen.com/storage/users/67907/images/system/67907.jpg",biography:"Dr. Amidou Samie is an Associate Professor of Microbiology at the University of Venda, in South Africa, where he graduated for his PhD in May 2008. He joined the Department of Microbiology the same year and has been giving lectures on topics covering parasitology, immunology, molecular biology and industrial microbiology. He is currently a rated researcher by the National Research Foundation of South Africa at category C2. He has published widely in the field of infectious diseases and has overseen several MSc’s and PhDs. His research activities mostly cover topics on infectious diseases from epidemiology to control. His particular interest lies in the study of intestinal protozoan parasites and opportunistic infections among HIV patients as well as the potential impact of childhood diarrhoea on growth and child development. He also conducts research on water-borne diseases and water quality and is involved in the evaluation of point-of-use water treatment technologies using silver and copper nanoparticles in collaboration with the University of Virginia, USA. He also studies the use of medicinal plants for the control of infectious diseases as well as antimicrobial drug resistance.",institutionString:null,institution:{name:"University of Venda",institutionURL:null,country:{name:"South Africa"}}},editorTwo:null,editorThree:null,series:{id:"6",title:"Infectious Diseases",doi:"10.5772/intechopen.71852",issn:"2631-6188"},editorialBoard:[{id:"188881",title:"Dr.",name:"Fernando José",middleName:null,surname:"Andrade-Narváez",slug:"fernando-jose-andrade-narvaez",fullName:"Fernando José Andrade-Narváez",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRIV7QAO/Profile_Picture_1628834308121",institutionString:null,institution:{name:"Autonomous University of Yucatán",institutionURL:null,country:{name:"Mexico"}}},{id:"269120",title:"Dr.",name:"Rajeev",middleName:"K.",surname:"Tyagi",slug:"rajeev-tyagi",fullName:"Rajeev Tyagi",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRaBqQAK/Profile_Picture_1644331884726",institutionString:"CSIR - Institute of Microbial Technology, India",institution:null},{id:"336849",title:"Prof.",name:"Ricardo",middleName:null,surname:"Izurieta",slug:"ricardo-izurieta",fullName:"Ricardo Izurieta",profilePictureURL:"https://mts.intechopen.com/storage/users/293169/images/system/293169.png",institutionString:null,institution:{name:"University of South Florida",institutionURL:null,country:{name:"United States of America"}}}]},onlineFirstChapters:{paginationCount:8,paginationItems:[{id:"83117",title:"Endothelial Secretome",doi:"10.5772/intechopen.106550",signatures:"Luiza Rusu",slug:"endothelial-secretome",totalDownloads:0,totalCrossrefCites:0,totalDimensionsCites:0,authors:[{name:"Luiza",surname:"Rusu"}],book:{title:"Periodontology - New Insights",coverURL:"https://cdn.intechopen.com/books/images_new/11566.jpg",subseries:{id:"1",title:"Oral Health"}}},{id:"83087",title:"Role of Cellular Responses in Periodontal Tissue Destruction",doi:"10.5772/intechopen.106645",signatures:"Nam Cong-Nhat Huynh",slug:"role-of-cellular-responses-in-periodontal-tissue-destruction",totalDownloads:8,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Periodontology - New Insights",coverURL:"https://cdn.intechopen.com/books/images_new/11566.jpg",subseries:{id:"1",title:"Oral Health"}}},{id:"82654",title:"Atraumatic Restorative Treatment: More than a Minimally Invasive Approach?",doi:"10.5772/intechopen.105623",signatures:"Manal A. 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\r\n\tThis topic will focus on the current challenges and advantages in the diagnosis and treatment of bacterial infections. We will discuss the host-microbiota relationship, the treatment of chronic infections due to biofilm formation, and the development of new diagnostic tools to rapidly distinguish between colonization and probable infection.
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It will provide significant opportunities and support for scientists, clinical doctors, mycologists, antifungal drug researchers, public health practitioners, and epidemiologists from all over the world to share new research, ideas and solutions to promote the development and progress of medical mycology.",annualVolume:11400,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/4.jpg",editor:{id:"174134",title:"Dr.",name:"Yuping",middleName:null,surname:"Ran",fullName:"Yuping Ran",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bS9d6QAC/Profile_Picture_1630330675373",institutionString:null,institution:{name:"Sichuan University",institutionURL:null,country:{name:"China"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"302145",title:"Dr.",name:"Felix",middleName:null,surname:"Bongomin",fullName:"Felix Bongomin",profilePictureURL:"https://mts.intechopen.com/storage/users/302145/images/system/302145.jpg",institutionString:null,institution:{name:"Gulu University",institutionURL:null,country:{name:"Uganda"}}},{id:"45803",title:"Ph.D.",name:"Payam",middleName:null,surname:"Behzadi",fullName:"Payam Behzadi",profilePictureURL:"https://mts.intechopen.com/storage/users/45803/images/system/45803.jpg",institutionString:"Islamic Azad University, Tehran",institution:{name:"Islamic Azad University, Tehran",institutionURL:null,country:{name:"Iran"}}}]},{id:"5",title:"Parasitic Infectious Diseases",keywords:"Blood Borne Parasites, Intestinal Parasites, Protozoa, Helminths, Arthropods, Water Born Parasites, Epidemiology, Molecular Biology, Systematics, Genomics, Proteomics, Ecology",scope:"Parasitic diseases have evolved alongside their human hosts. In many cases, these diseases have adapted so well that they have developed efficient resilience methods in the human host and can live in the host for years. Others, particularly some blood parasites, can cause very acute diseases and are responsible for millions of deaths yearly. Many parasitic diseases are classified as neglected tropical diseases because they have received minimal funding over recent years and, in many cases, are under-reported despite the critical role they play in morbidity and mortality among human and animal hosts. The current topic, Parasitic Infectious Diseases, in the Infectious Diseases Series aims to publish studies on the systematics, epidemiology, molecular biology, genomics, pathogenesis, genetics, and clinical significance of parasitic diseases from blood borne to intestinal parasites as well as zoonotic parasites. We hope to cover all aspects of parasitic diseases to provide current and relevant research data on these very important diseases. In the current atmosphere of the Coronavirus pandemic, communities around the world, particularly those in different underdeveloped areas, are faced with the growing challenges of the high burden of parasitic diseases. At the same time, they are faced with the Covid-19 pandemic leading to what some authors have called potential syndemics that might worsen the outcome of such infections. Therefore, it is important to conduct studies that examine parasitic infections in the context of the coronavirus pandemic for the benefit of all communities to help foster more informed decisions for the betterment of human and animal health.",annualVolume:11401,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/5.jpg",editor:{id:"67907",title:"Dr.",name:"Amidou",middleName:null,surname:"Samie",fullName:"Amidou Samie",profilePictureURL:"https://mts.intechopen.com/storage/users/67907/images/system/67907.jpg",institutionString:null,institution:{name:"University of Venda",institutionURL:null,country:{name:"South Africa"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"188881",title:"Dr.",name:"Fernando José",middleName:null,surname:"Andrade-Narváez",fullName:"Fernando José Andrade-Narváez",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRIV7QAO/Profile_Picture_1628834308121",institutionString:null,institution:{name:"Autonomous University of Yucatán",institutionURL:null,country:{name:"Mexico"}}},{id:"269120",title:"Dr.",name:"Rajeev",middleName:"K.",surname:"Tyagi",fullName:"Rajeev Tyagi",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRaBqQAK/Profile_Picture_1644331884726",institutionString:"CSIR - Institute of Microbial Technology, India",institution:null},{id:"336849",title:"Prof.",name:"Ricardo",middleName:null,surname:"Izurieta",fullName:"Ricardo Izurieta",profilePictureURL:"https://mts.intechopen.com/storage/users/293169/images/system/293169.png",institutionString:null,institution:{name:"University of South Florida",institutionURL:null,country:{name:"United States of America"}}}]},{id:"6",title:"Viral Infectious Diseases",keywords:"Novel Viruses, Virus Transmission, Virus Evolution, Molecular Virology, Control and Prevention, Virus-host Interaction",scope:"The Viral Infectious Diseases Book Series aims to provide a comprehensive overview of recent research trends and discoveries in various viral infectious diseases emerging around the globe. The emergence of any viral disease is hard to anticipate, which often contributes to death. A viral disease can be defined as an infectious disease that has recently appeared within a population or exists in nature with the rapid expansion of incident or geographic range. This series will focus on various crucial factors related to emerging viral infectious diseases, including epidemiology, pathogenesis, host immune response, clinical manifestations, diagnosis, treatment, and clinical recommendations for managing viral infectious diseases, highlighting the recent issues with future directions for effective therapeutic strategies.",annualVolume:11402,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/6.jpg",editor:{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",fullName:"Shailendra K. 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