Characteristics of 1244 rural community members in South Africa.
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More than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\\n\\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\\n\\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\\n\\nAdditionally, each book published by IntechOpen contains original content and research findings.
\\n\\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\\n\\n\\n\\n
\\n"}]',published:!0,mainMedia:{caption:"IntechOpen Maintains",originalUrl:"/media/original/113"}},components:[{type:"htmlEditorComponent",content:'
Simba Information has released its Open Access Book Publishing 2020 - 2024 report and has again identified IntechOpen as the world’s largest Open Access book publisher by title count.
\n\nSimba Information is a leading provider for market intelligence and forecasts in the media and publishing industry. The report, published every year, provides an overview and financial outlook for the global professional e-book publishing market.
\n\nIntechOpen, De Gruyter, and Frontiers are the largest OA book publishers by title count, with IntechOpen coming in at first place with 5,101 OA books published, a good 1,782 titles ahead of the nearest competitor.
\n\nSince the first Open Access Book Publishing report published in 2016, IntechOpen has held the top stop each year.
\n\n\n\nMore than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\n\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\n\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\n\nAdditionally, each book published by IntechOpen contains original content and research findings.
\n\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\n\n\n\n
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Methods for obtaining energy compounds from biomass, such as ethanol, methane, and hydrogen, have been developed using environment-friendly technology, and some of these technologies have been put to practical use. It is important to establish the technologies that are able to obtain energy in various forms according to the environments and circumstances of each region. Apart from the above technologies, biofuel cells utilizing microorganisms and enzymes, which can generate renewable electrical energy from organic matters contained in biomass, begin to attract attention as a means to obtain sustainable energy. It has not been put into practical use yet, but without the problem of by-products, electricity can be directly obtained from the devices, whereby multiple operations, such as product distillation (e.g., ethanol), are not necessary. Moreover, if biomass waste is used as the fuel, no food competition will occur. Therefore, using this method, energy can be obtained sustainably (Figure 1).
\nEnvironmentally friendly energy.
There are various types of biomass, e.g., sustainably harvested wood, waste paper, food waste, sewage sludge, and various wastewaters. Taking wood-based biomass as a fuel example, when everything is burnt using available technology for thermal power generation, there will be nothing left, and we will lose some other useful compounds contained in it. On the other hand, in biofuel cells, although electricity is generated from the sugar obtained from the biomass, other components in the wood, such as lignin, can be used for purposes other than power generation. Generally, the energy density of the biomass used as a fuel for MFCs is high. For example, glucose and xylose, found in various plant biomass, can produce up to 20 or 24 electrons per molecule, provided that they are completely oxidized to carbon dioxide. It is possible to generate 4430 Wh power per kg of glucose according to the calculation described later. For reference, a typical lithium-ion battery has a weight energy density of about 200 Wh per kg. This comparison means that glucose and xylose are two biofuel sources of interest, especially as electron donors. Therefore, MFCs using glucose and/or xylose as their fuel have great potential as a means of obtaining high energy.
\nIn biofuel cells, biological reactions are used for the oxidation reaction of biomass, and they are divided into two based on the type of catalyst used: (1) enzymes and (2) microorganisms. When enzymes are used, the most widely studied mechanism is the two-electron oxidation system by glucose oxidase (GOx) or glucose dehydrogenase (GDH) [1]. Since purified enzymes are generally used, the reaction rate is faster than using microorganisms. However, the number of electrons obtained by one enzymatic reaction is smaller than that of a microorganism. For example, when GDH is used as the catalyst, glucose is oxidized to gluconic acid, and at most, only two electrons are obtained from one glucose molecule. Therefore, if only one enzyme is used, high-energy production per glucose consumed cannot be much expected. Further, the addition of cofactors, such as nicotinamide adenine dinucleotide and pyrroloquinoline quinone (PQQ), is necessary for the enzymatic reaction to enhance the energy production. Furthermore, the cost of enzyme purification is also high; hence, enzymes are better utilized in sensor applications than energy production. By contrast, as mentioned above, one completely oxidized glucose molecule gives 24 electrons when using microorganisms as the catalyst. It shows a possibility of obtaining more electrons per glucose consumed. Moreover, the addition of cofactors is not necessary, unlike when enzymes are used. These are some substantial advantages of MFCs. However, the production of low power in MFCs is still a problem because of typical processes in living organisms, such as the uptake of glucose into cells, metabolism repression, and extraction of electrons from the inside of cells (Figure 2). Many researchers are working to solve such problems, and those results are summarized in recent review articles [2, 3].
\nElectron generation and extraction in the microbial fuel cell system. Med: mediator.
Looking back at the historical background, research on the MFCs has been conducted for a long time, whereby the first idea of using microorganisms to produce electricity was conceived and reported by Potter in 1911 [4].
The performance of MFCs is evaluated based on some indicators. The electrical energy (Wh) used to express the capacity of dry batteries is also an important indicator, but only a few papers have reported it so far. In most cases, the performance is expressed as the maximum power per anode electrode area (power density per area) or the maximum power per cell volume (power density per volume). The latter is a straightforward index and important for practical use. For example, a relatively high-performance small-scale fuel cell (2.5 mL) using a complex (mixed) microorganism system was reported in 2007 with a power density of 1550 W/m3 [16]. Other fuel cells performing beyond 500 W/m3 were also reported [17, 18, 19, 20, 21, 22], but many of them are still at a microliter or milliliter scale. Owing to the low proton diffusion speed and high internal resistance, the maximum power per volume tends to be small for a large-scale fuel cell. MFCs with a volume more than 1 L were also being studied in the laboratory, but the maximum power per volume was still low at the level of several W/m3 to tens of W/m3 [23, 24]. Scaling-up is also another issue of MFCs, and further improvements are still being conducted.
\nPractical applications of MFCs are still problematic because of the high cost and low-power generation. Despite this situation, research on the implementation of MFCs has been carried out. For example, an artificial stomach called Gastrobot (aka Chew-Chew train) using
Here, we will explain the mechanism of electron generation in microorganisms, introduce the principle of MFCs, describe the microbial catalysts used for various MFCs mentioned above, and discuss the recent topics on microbial catalysts.
\nMFCs utilize the decomposition energy of organic matters by the organisms to produce ATP, known as the energy currency, based on the energy obtained from this process. Taking glucose decomposition in
Glucose metabolism (
In the case of using glucose as the fuel source, the reaction occurring in the anode tank is represented by Eq. (1), and the reduction reaction occurring in the cathode tank is represented by Eq. (2).
\nThe oxidation-reduction potential of Eq. (1) is −0.42 V, whereas the oxidation-reduction potential of Eq. (2) is 0.82 V. Therefore, the total potential difference of the MFC reaction (Eq. (1) + Eq. (2)) as represented by Eq. (3) is 1.24 V. Theoretically, the voltage exceeds 1 V, but in most cases, it has never reached that value.
\nAssuming that 24 electrons are obtained from 1 glucose molecule and that they can be recovered in 1 h, the quantity of electricity (Ah) obtained from the glucose (1 kg) can be calculated using the Faraday constant (96,485 C/mol) as shown in Eq. 4. As a result, the electrical energy of 4430 Wh can be achieved if the potential is 1.24 V; accordingly, this value is the same as the value mentioned in the Introduction section.
\nA dual-chambered fuel cell consisting of an anode tank and a cathode tank is the simplest and has been used for a long time for MFCs. In many cases, they are separated by a cation exchange membrane (CEM) to create a potential difference between the two tanks (Figure 4). CEM prevents mixing of each content and allows the protons generated in the anode to migrate to the cathode. In addition, CEM selection, especially based on its proton transfer efficiency, is important because it significantly regulates the movement of the protons responsible for the pH reduction at the anode affecting the activity of microorganisms and the delivery of electrons to the oxygen at the cathode. Also, some factors to consider, such as durability and cost, are important for selecting CEM. At present, Nafion is popular for many MFCs [30, 31].
\nGeneral dual-type MFC. Med: mediator, CEM: cation exchange membrane.
Numerous research studies are being conducted to evaluate the influence of the electrode materials on the performance and cost of the MFCs. Carbon materials, which are noncorrosive, have been widely used because of their high electrical conductivity and chemical stability, e.g., carbon rod, carbon fiber, carbon felt, and carbon cloth [3]. Biocompatibility, specific surface area, electrical conductivity, and cost are important factors for its selection. Since its discovery in 2004, graphene has been attracting much attention for its use as an electrode because of its high specific surface area, electrical conductivity, and biocompatibility [32]. In fact, graphene has been already used in lithium-ion batteries, and the development of graphene-modified materials to increase the power density has progressed actively [33, 34]. Moreover, since biofilm formation by microorganisms on the electrodes affects the performance of MFCs, the preference of electrode materials tends to shift from two-dimensional to three-dimensional surfaces, where a larger surface area is obtained; thus, the contact with microorganisms increases. Furthermore, metals are also used as the electrodes. The conductivities are higher than those of carbon materials, but they are prone to corrosion in the anode solution. Therefore, metals are problematic to use, except for stainless and titanium. To improve such problem, materials in which metal is incorporated into graphite have been made [3].
\nA phosphate buffer or bicarbonate buffer solution is often used for the anode electrode solution to achieve high performance [16, 35]. The pH of the solution affects not only the activity of microorganisms but also the transfer of hydrogen ions used from the anode to the cathode when the electrons are transferred to oxygen at the cathode. The solutions contain microorganisms as the catalyst, organic matter as the fuel, and mediator as the electron carrier. In addition, there are reports that the performance of MFCs was improved by adding NaCl to increase the ionic strength [36].
\nRegarding the fuel, many substrates have already been studied [37]. For example, acetic acid, lactic acid, glycerol, glucose, xylose, sucrose, starch, yeast extract, malt extract, various real wastewaters, and synthetic wastewater were used depending on the purpose of each research. Generally, the fermentable substrate of microorganisms is used to generate electricity more efficiently. There is a trend where glucose is used when using
Regarding the mediator, although some microorganisms can carry electrons directly to the electrode as described later, in many cases, the electrons cannot be carried, or the performance is low even if carried, so an artificial mediator that can pass through the cell membrane is added to the anode solution. The typical compounds for artificial mediators are methylene blue, neutral red, 2-hydroxy-1,4-naphthoquinone (HNQ), thionine, benzyl viologen, 2,6-dichlorophenolindophenol, and various phenazines [38]. It was reported that the hydrogenase donates electrons to the neutral red [39], but the process was not yet clearly proven as to how these mediators deprive electrons of the cell. It is thought that, depending on the type of mediator, the electrons may be taken directly from NADH or obtained from the electron transfer system of the cell membrane. On the other hand, there is also a difficult aspect of using a mediator. In order to increase the electron transfer efficiency by the mediator, it requires a high concentration, but because of its high toxicity, it has a strong influence on the cells; therefore, the level of use is necessary to be controlled.
\nFinally, the cathode solution is explained as follows. The electrons generated at the anode are carried to the cathode, where the reduction reaction takes place. When oxygen, the most common electron acceptor, is used as an oxidizing agent, aeration is necessary because oxygen has low solubility (about 8 mg/L DO). There are cases where oxygen generation by the photosynthesis of algae is used for oxygen supply [40, 41]. In the reaction at the cathode, H2O is produced by oxygen, whereby the electrons were carried from the anode via an external circuit and protons were carried from the anode solution via CEM. There is also a report that the addition of hydrogen peroxide leads to an improvement in power generation [42]. Besides oxygen, there are various electron acceptors [43]; for example, an oxidizing agent such as iron ferricyanide is also used for the cathode. In many cases, the ferricyanide has a high mass transfer efficiency and a high cathode potential so that a high output can be obtained. The combination of carbon electrodes and ferricyanides to achieve power 50–80% higher than the combination of Pt/carbon electrodes and oxygen was reported [44]. In the case of using ferricyanide, once the trivalent iron ion receives the electrons, it becomes divalent, and when it delivers the electrons to oxygen, it reverts to the trivalent state. However, the latter reaction is less likely to occur owing to the low solubility of oxygen. Ferricyanide is an excellent electron acceptor, but owing to its toxicity, its use is generally limited to the laboratory. Other than oxygen and ferricyanide, there are also many candidates, for example, nitrate, persulfate, permanganate, and manganese dioxide. It is also possible to use the nitrate contained in the wastewater because its redox potential is close to that of oxygen, and then, the nitrate is reduced to nitrogen gas at the cathode [43].
\nMFCs are typically divided into a dual-chambered cell described above and a single-chambered cell (Figure 5). In the latter, a membrane-type positive electrode with oxygen permeability called an air cathode is used [45]. The electrode is coated with the platinum catalyst, and H2O is produced from the oxygen permeated from the atmosphere, the proton in solution, and the electron from the anode. However, if the permeated excess oxygen diffuses and is delivered to the microorganisms at the anode, the electrons generated in the microorganisms are then transferred to the oxygen, and the energy recovery rate decreases. Therefore, a CEM is used between the anode solution and the cathode in order to prevent a decrease in energy recovery. This single-chambered type has already been widely used currently.
\nOther types of MFCs. Med: mediator, CEM: cation exchange membrane.
Moreover, there is a mediator-free type that does not require an artificial electron compound [46]. The microbial strains used here can synthesize mediators themselves and/or have an electron transfer function on the cell surface. In the former, the self-synthesized mediators are flavin compounds, hydroquinone, and phenazine that are able to transfer the electrons to the electrode. In the latter, membrane-bound proteins such as pili, c-type cytochromes, and filaments are known as cell surface structures that can directly transmit electrons. The biofilm formation on the electrodes, namely, biocompatibility of the electrodes, is also important for power generation via such direct electron transfer. Therefore, research on electrodes promoting the formation of the biofilm is actively being conducted.
\nIn addition, with the use of MFCs in wastewater treatment, contamination on the CEM results in reduced power generation; hence, membrane-free MFCs have also been studied [46].
\nVarious microorganisms have been studied for a long time since the first experiments on
In such a research situation, there are relatively many examples of research on
The utilization of chemical and biotechnological techniques is important to modify the microbial cells as biocatalysts in the MFC system. Molecular biology approaches are effective tools to improve the performance of the biocatalysts for the desired system. In this section, recent topics about the approaches for microbial catalyst development are discussed.
\nMediators and macromolecular catabolic enzymes, which are used for electron transfer and other metabolic activities, are abundant in the cytoplasm of the microbial cells used in the MFCs. However, it is not easy to transport the mediator molecules to the bacterial outer membrane so as to reach the electrode. The lipopolysaccharide (LPS) layer on the Gram-negative outer membrane is compact and nonconductive; thus, most microbial cells are nonconductive [55]. It was found that chemically perforated pores and channels on the cell membranes accelerated electron transfer, leading to an improved power output for an MFC using
To increase the cell permeability of biocatalysts in the MFCs, Zheng et al. proposed a new approach by inducing the biosurfactant production based on a genetic modification [59]. It is true that the efficiency of membrane permeability can be improved with a biosurfactant, which ultimately increases the transport across the membrane. In addition, overexpression of the
The sparse availability of genetic tools in manipulating electricity-generating bacteria and the multiple overlapping pathways for extracellular electron transfer make it challenging to modulate electron transfer and/or introduce other functions of interest. In response to this challenge, several studies have taken the complementary approach of engineering portions of the extracellular electron transfer pathways into the well-studied industrial microbe
An extremophilic microorganism thrives in physically or geochemically extreme conditions that are detrimental to most life on Earth. They thrive in extreme hot niches, ice, and salt solutions, as well as acid and alkaline conditions; some may grow in toxic waste, organic solvents, heavy metals, or several other habitats that were previously considered inhospitable for life. Extremophiles can be used to oxidize sulfur compounds in acidic pH to remediate wastewaters and generate electrical energy from marine sediment microbial fuel cells at low temperatures. The MFC performance of these extremophilic microorganisms has been well summarized in several review papers [49, 64]. In this section, the recent advances of MFCs using extremophilic microorganisms as catalysts are briefly introduced and discussed.
\nAn increase of cell voltage is seen at increasing anode pH because of the additional pH gradient representing a source of energy. The practical implication of an elevated cell voltage is that more energy can be gained from MFC systems at higher pH values. By contrast, operating the anode of MFCs at an acidic condition has an advantage that the protons will not cause diffusion limitations in the cathode compartment for the reduction of oxygen, and therefore, it will not limit the current production [65]. However, under a low-pH condition, the microbial cells have to maintain a near-neutral cytoplasm [66] which consumes a portion of the energy derived from the electron transport for other processes, such as proton export, that increases the anode overpotential, leading to decreasing power generation. At pH 2.5,
Meanwhile, at high pH, the lower anode potential results in an increased cell voltage. In general, the anode becomes acidified during the MFC operation, and the cathode becomes more alkaline, followed by a reduced cell voltage and power output.
Temperature also has a major impact on the output of MFCs. It influences the activity of microorganisms, the electrochemical reactions, and the Gibbs free energy change of the reactions. There exists an optimum temperature for enzymes in the MFCs, and the electrochemical reaction rate increases with increased temperatures. A lower operating temperature adversely influences the output, start-up time, and substrate oxidation rate in the MFC system. This negatively impacts the MFCs for processes such as wastewater treatment because the streams are generally at low temperatures. However, the advantage of low temperature for the MFCs is that they typically produce higher Coulombic efficiencies [72, 73]. The microbial community was enriched from the anaerobic sludge at the anode of an acetate-fed MFC operated at 15°C with psychrophiles
On the other hand, the advantages of operating at high temperatures are higher microbial activity, better substrate solubility, high mass transfer rate, and lower contamination risk. An example of an improved current generation at a high temperature (60°C) is a marine sediment MFC that generated 209–254 mA/m2 compared with 10–22 mA/m2 at 22°C [76]. Recently, an MFC with a higher operating temperature (70°C) has generated 6800 mA/m2 [77]. Furthermore, the hyperthermophilic MFCs were operated at above 80°C [78]. However, a negative point of thermophilic MFCs is higher rates of evaporation than the MFC system itself. Therefore, a continuous mode of MFCs was proposed to allow a replacement of the anolyte and catholyte [79].
\nIn this section, recent topics of microbial catalysts for MFCs were introduced. There are two approaches in developing the microbial catalysts. One is the modification of existing microorganisms using chemical treatments or biotechnological techniques, including gene editing. The other is exploring new microorganisms from the environment, including extreme conditions. Although new findings and knowledge were obtained from both approaches, a drastic improvement on the MFC performance to achieve a paradigm shift has not appeared yet. In parallel with the improvement of microbial catalysts, the development of the fuel cell system, including the electrodes, was intensively studied to increase the output of MFCs. In particular, the application of graphene-modified electrodes [33] and the investigation of electron acceptors [43] have shown remarkable progress in the past decade. In order to actualize the practical use of MFCs, a synergistic impact from the combination of microbial catalyst and fuel cell system is essential.
\nThis chapter focuses on the significance of MFC development, the historical background and fundamental principles of MFCs, and their recent developments, especially on microbial catalysts. MFCs have not reached the desirable level of power generation that supports daily life because of the problems such as scaling-up. On the other hand, developments of technology combining wastewater treatment and power generation, and application for environmental sensors are progressing to a stage close to practical use. If these popularizations continue, it will further develop its application in broader fields. Owing to their limitations, it may be difficult to force MFCs to become the main power supply in our daily life in the future, but it seems possible to use them as an auxiliary power supply. In addition, MFCs may become useful as a power supply in areas where the infrastructure is not well developed, for example, a portable power supply generating electricity if water is added. Regarding microbial catalysts, it is also known that various microorganisms can generate electricity, and if this superior power-generating function of these microorganisms can be integrated into a microbial cell using the synthetic biological method developed recently, the ability of the microbial catalyst will dramatically increase. Soon, its power generation ability could be greatly improved in combination with the progress of other constituents.
\nThis work was supported by JSPS KAKENHI Grant Number JP17K06932.
\nThe authors declare no conflicts of interest associated with this text.
For centuries, communicable diseases have been responsible for the greatest worldwide burden of premature death. Following the Second World War, medical research achievements in the development of efficient and inexpensive vaccinations and the increased availability of antibiotics decreased the toll of communicable diseases even more [1]. Non-communicable diseases (NCDs) such as cardiovascular disease (CVD), diabetes, chronic-obstructive pulmonary disease (COPD), and cancers have emerged as an emerging pandemic with a major threat to the government. These diseases undermine health gains while imposing a heavy economic burden on governments and households worldwide in recent years [2, 3]. For example, according to the World Health Organization (WHO), NCDs are the leading cause of mortality worldwide, accounting for 71% of all deaths, with CVD accounting for the majority of deaths, with around 17.9 million people dying each year, followed by cancer, respiratory illnesses, and diabetes [4]. NCDs are the second leading cause of mortality in much of Sub-Saharan Africa (SSA), accounting for 2.6 million deaths [5]. Because of the rapidly expanding epidemic of NCDs, SSA is facing a double burden of NCD and communicable illnesses in a disadvantaged environment characterized by ill-health systems [6].
It is noted that CVD mortality rates are low in SSA as compared to high-income countries; however, the deaths due to CVD has doubled in the past three decades in SSA [7]. Certain risk factors, including hypertension and diabetes, are the key modifiable risk factors for poor CVD outcomes, such as stroke, the leading cause of death globally [7]. According to a study by Kearney et al. [8] using published literature from January 1, 1980, to December 31, 2002, the prevalence of hypertension was predicted to increase by about 60% to a total of 1·56 billion in the year 2025 [8]. The risk of hypertension in the semi-urban and rural areas of South Africa increases with age. It recorded 36% and 40% among the 56+ year population in semi-urban and rural areas, respectively [9]. Globally, including SSA, certain risk factors such as physical inactivity, family history of hypertension, unhealthy diets, waist-to-hip ratio (WHR), the harmful use of alcohol, and being diabetic are associated with hypertension [9, 10, 11]. Additionally, studies in Africa have shown that socio-economic status (SES), such as household wealth status and high BMI (overweight/obesity) is associated with hypertension [12, 13].
NCDs management includes diagnosing, screening for, and treating these illnesses and providing those in need with access to palliative care [4]. Undiagnosed hypertension in a rural district remains a concern. A large proportion of the hypertensive population remains undiagnosed, untreated, or inadequately treated in developing countries with most coming from lower socio-economic status (SES) than people with higher SES [12, 14]. If left undiagnosed and untreated in rural communities, this might increase the risk of a cardiovascular event, such as heart attack, stroke, enlarged heart, or kidney damage that may occur due to high blood pressure [11].
Most recent studies showed that community members had good (14%) or intermediate (74.3%) knowledge of hypertension, and only 11.8% of the population had poor knowledge even its risk factors [11, 15]. Lifestyle characteristics have direct correlations to hypertension risk, and modifying lifestyles in a favorable direction can significantly reduce hypertension risk [16]. However, poverty was highlighted as a key risk in this group, restricting healthy lifestyle choices and timely access to health treatment [15].
NCD management interventions are essential for achieving the global target of a 25% relative reduction in the risk of premature mortality from NCDs by 2025, and the sustainable development goal target of a one-third reduction in premature deaths from NCDs by 2030 [4]. Disease self-management, or patients’ capacity to use disease information and engage in strategies that assist them in maintaining their health, helps lower death and hospitalization rates [17, 18]. Therefore, this chapter is aimed at exploring the knowledge of self-management and strategies in outpatients with hypertension under treatment in rural communities. We discuss risk factors for hypertension and discuss self-management strategies used by patients in rural communities.
The study adopted a Mixed-Methods Research (MMR) approach, known as explanatory sequential design, advocated by Edmonds and Kennedy [19]. The study used a household administered data collecting tool in which quantitative data (QUAN) were collected through the non-laboratory INTERHEART risk score tool and qualitative data (QUAL) were obtained through semi-structured interviews. The data collection tool was distributed. The population eligible for this study was people staying in those selected rural communities and 18 years and above. Only 1224 completed the data collection tool with the assistance of community health workers (CHWs) using the non-laboratory INTERHEART risk score tool. For qualitative, participants were selected and interviewed until data saturation was reached. These respondents provided the qualitative data set that sought to explore the knowledge of self-management and strategies in outpatients with hypertension under treatment in rural communities. For quantitative data, frequencies were generated using the Statistical Programme for Social Sciences (SPPS version 26.0), and eight Steps of Tesch’s inductive, descriptive open coding technique were used for qualitative data [20].
This section presents the demographic information of participants followed by risk levels findings. A standardized INTERHEART questionnaire instrument was employed in the study and 1244 individuals from a rural community in South Africa\'s Limpopo region responded (Table 1).
Variables | Median | 95% CI (lower; upper) | |
---|---|---|---|
Age | Age | 48 | (47; 49) |
Variables | Frequency | % | |
Gender | Male | 306 | 25 |
Female | 918 | 75 | |
Waist to hip ratio | Quartile 1: less than 0.873 | 654 | 54 |
Quartile 2 & 3: 0.873–0.963 | 395 | 33 | |
Quartile 4: greater than or = 0.964 | 163 | 13 | |
Smoking status | Current smoker | 97 | 8 |
Former smoker | 38 | 3 | |
Non-smoker | 1051 | 89 | |
Hypertension | Yes | 175 | 25 |
Diabetes | Yes | 91 | 8 |
Characteristics of 1244 rural community members in South Africa.
Of the 1244 participants, the majority were females (75%). In the majority of, participants their waist to hip ratio was less than 0.873 (54%). The median age of the participant was 48 years old. Regarding CVD risk factors status, 66% of adults in the rural area have hypertension while only 14% were diabetic, shown in Figure 1. Hypertension is more prevalent in rural communities than diabetes [21, 22]. However, there is substantial overlap between diabetes and hypertension, reflecting substantial overlap in their etiology and disease mechanisms [21]. Hypertension and diabetes are two of the leading risk factors for atherosclerosis and its complications, including heart attacks and strokes [23]. Making certain lifestyle changes (quit the smoke, drinking alcohol only in moderation, limiting salt intake, and eating a diet with low sugar but plenty of fruits, vegetables, fish, healthy fats, and whole grains) cannot only reduce complications from diabetes but can also greatly reduce your risk of high blood pressure [23]. The majority of the participants were non-smokers (89%) with 25% and 8% being hypertensive and diabetes, respectively.
Prime risk factor for cardiovascular disease.
Table 2 summarizes the quantitative data on the characteristics of rural community members in South Africa for hypertensive and non-hypertensive patients. Most participants in the study were females. Factors such as being female, hypertensive, and having comorbidity were associated with high risk developing coronary heart disease in the elderly than in younger patients [24]. The majority of the 175 (25%) hypertensive individuals in the study were at moderate risk of developing coronary heart disease.
Variables | Hypertensive 175 (25%) | Non-hypertensive | |
---|---|---|---|
Age | Age | 48 (20;94) | 48 (18; 94) |
Variables | |||
Gender | Male | 41 (24%) | 126 (25%) |
Female | 131 (76%) | 387 (75%) | |
Waist to hip ratio | Quartile 1: less than 0.873 | 71 (41%) | 301 (59%) |
Quartile 2 & 3: 0.873–0.963 | 68 (39%) | 152 (30%) | |
Quartile 4: greater than or =0.964 | 34 (20%) | 57 (11%) | |
Smoking status | Current smoker | 11 (7%) | 41 (8%) |
Former smoker | 4 (2%) | 25 (5%) | |
Non-smoker | 154 (91%) | 442 (87%) | |
Risk of developing CVD | High | 67 (39%) | 24 (5%) |
Moderate | 85 (49%) | 159 (31%) | |
Low | 21 (12%) | 332 (64%) |
Descriptive characteristics of rural community members in South Africa for hypertensive and non-hypertensive patients.
Thematic analysis was applied to derive themes for discussion in this section. The following themes emerged: (1) paradoxical description of self-management strategies and (2) unforeseen painful life experiences.
The findings revealed that there is a different description of self-management strategies used by patients when living with risk factors such as hypertension. The strategies include engaging in physical activity, eating a healthy balanced diet, drinking a lot of water. However, the findings further indicate that most participants perform mild exercises and a limited number perform moderate exercises. Health promotion, self-care, and education in the community and primary care settings have been shown to encourage patients to engage in smoking cessation, increased physical activity, and a healthy diet in the prevention of cardiovascular diseases, and this plays an important role in preventing CVD risk factors [16]. The stakeholders (health-care providers, health facilities, agencies involved in diabetes care, etc.) should encourage patients to understand the importance of diet, which may help in disease management, appropriate self-care and better quality of life. It is crucial to enhance basic diabetic and hypertension management and knowledge among the general population, especially in rural areas. National-level education and health intervention programs should be instigated and augmented.
It was seen that the majority of the participants indicated that physical activity, diet, and lifestyle modification are not associated with hypertension prevention. Most patients lack sufficient knowledge about NCDs and have little knowledge about physical activity [25]. It was discovered that time constraints, lack of interest, low self-esteem, lack of awareness, safety, and financial constraints, knowledge deficit, parental influence, peer pressure, and poverty were the barriers to physical activity and NCDs risk factors [25]. Knowledge plays a vital role in future disease development and early prevention and detection. Positive knowledge, attitude, and practice are important for hypertensive patients, and weight reduction should be considered in managing blood pressure [26, 27]. Knowledge, attitudes, and practices are interrelated and dependent on each other [27]. If the level of one element is higher, the other two factors should be affected positively. Knowledge regarding diabetes and hypertension varies greatly depending on socio-economic conditions, cultural beliefs and habits [27].
Patients with hypertension on treatment are encouraged to adhere to prescribed treatment and medication instructions as this will assist in controlling the symptoms and promote quality of life. Adherence to treatment is described by Burnier and Egan as an important aspect that controls the symptoms which might be unbearable lead to complications [28]. Health professionals who include physicians, pharmacists and nurses assist in making sure that patients improve and adhere to treatment. Additionally, though adherence to treatment and medical instructions is important, hypertensive patients are further advised to manage their lifestyle because that reduces the risk of developing CVDs and improves clinical outcomes.
It is important to emphasise adherence to medical follow-up scheduled dates because during such a visit, the health professionals teach patients about various issues, including all self-care strategies and pharmacological interventions that are equally effective.
The hypertensive patients are encouraged to make sure that they adhere to a healthy lifestyle which includes lifestyle modifications that require more effort to do that. A healthy lifestyle includes a healthy diet, exercise, have resting times, etc. [29].
The importance of managing emotions such as depression, anxiety, excessive worry, anger, fear, and stress needs to be emphasised when interacting with hypertensive patients. When they experience such, they must consult health professionals for help [30].
Hypertensive patients are encouraged to use the self-defence mechanism because this assists one to cope with all life’s negative situations leading to minimal symptoms of the disease [31].
Religious beliefs and practices are viewed as a method to assist people in adjusting to their situations and the physical, mental, and social difficulties brought about by clinical disease [32].
According to the findings, there is an explanation for how unforeseen painful life experiences lead to inadequate management or avoidance of risk variables. For example, hypertension and diabetes-mellitus, as most of the participants indicated that they experience challenges like not adhering to a healthy diet as they are not the ones cooking. Children are always causing problems to them that cause their blood pressure and blood glucose to increase. As a result of a lack of support for family care from health services and professionals, family vulnerability is formed or exacerbated because family potential decreases over time due to care needs, which are continually refreshed and augmented in chronic diseases [33]. In both the genesis and the potential of overcoming vulnerabilities, it appears that family support in the experience of disease and caregiving might be a crucial factor [33]. Medical illiteracy among patients (i.e., poor understanding of the disease process, medication effects, dosage regimens, and possible side effects) is a frequent cause of medication non-adherence, leading to painful experiences. The majority of uncontrolled hypertension is due to poor adherence to antihypertensive medications [34]. Understanding the types of causes that contribute to noncompliance helps address noncompliance.
Integration of the QUAN and QUAL results revealed that most of the patients are engaging in eating a healthy balanced diet (Table 3). QUAN results pointed out that more than 61% of outpatients were consuming enough fruits and vegetables daily but still eating meat and salty food one or more times a day and physical inactivity. Combining the eating plan and a lower salt consumption could provide the most effective and may reduce hypertension risk [35]. It is observed that patients still consume high salts and a lot of meat on daily basis, however, some reported that they avoid eating beef meat as compared to chicken meat and also, try to use a small amount of salt and sugar. Patients adhere to treatment and medication instructions and medical follow-up visits at the health facility as other self-management ways of hypertension. The proper use of antihypertensive medications is a critical component of hypertension management [36]. Knowledge of hypertension and its treatment, socio-demographics, treatment views, and patient-provider interaction may contribute to poor drug adherence [36]. Poor adherence might worsen diseases and increase the likelihood of cardiovascular events such as heart attack or a stroke. Most hypertensive patients in rural areas are adherent to medication and clinic visits, however, about 39% of patients were at a high risk of coronary heart disease.
Quantitative investigation | Qualitative investigation | |
---|---|---|
Quantitative findings | Sub-themes | Participants expression |
67.8% and 79.9% of survey respondents with hypertension reported consuming enough fruits and vegetables daily, respectively. 66% and 61.5% of survey respondents with hypertension reported eating meat and salty food one or more times a day. 25.9% of survey respondents with hypertension perform moderate physical activity in my leisure time | Paradoxical description of self-management strategies (physical activity, eating a healthy balanced diet, drinking a lot of water, etc.) | This is supported by the following |
38.5% of survey respondents with hypertension showed to be at a high risk of coronary heart disease | ||
Participant HP#08: | ||
33.3% of survey respondents with hypertension felt work or home life stress in the last year | Participants HP# 010 highlighted that: - | |
2.3% of survey respondents with hypertension were former smokers | Participant HP# 03 confirmed by saying: - | |
Integration of the quantitative and qualitative results.
It is observed that about 33% felt work or home life stress. A stressful situation leads to a surge of hormones and temporarily increases your blood pressure. Although stress does not directly cause hypertension, it does trigger a rush of hormones and momentarily raises your blood pressure, which may later develop into hypertension [37]. Some hypertensive patients reported managing their emotions by avoiding stress, overthinking, and becoming angry as a self-management strategy. Most patients, especially pensioners and the elderly, perform household duties every morning and clean the yard, which they believe is adequate because they have large yards. Risk behaviors such as smoking and alcohol use have direct correlations to hypertension risk, and avoiding such risk behaviors can significantly reduce hypertension risk [9, 10, 11]. Due to religious interventions, some patients eat healthy foods and avoid smoking and alcohol.
Hypertensive patients residing in rural communities seem to lack sufficient knowledge concerning hypertension self-management strategies. Additional efforts are needed in rural communities to promote hypertension and self-management measures through educational programs such as encouraging patients to engage in increased physical activity and a healthy diet.
The authors would like to thank all participants, notably community health workers, professional nurses in clinics, SPICES research participants, the University of Limpopo, and the Limpopo Provincial Department of Health. Finally, we would like to express our gratitude to the European Commission for sponsoring this initiative.
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The traditional healer provides health care services based on culture, religious background, knowledge, attitudes, and beliefs that are prevalent in his community. Illness is regarded as having both natural and supernatural causes and thus must be treated by both physical and spiritual means, using divination, incantations, animal sacrifice, exorcism, and herbs. Herbal medicine is the cornerstone of traditional medicine but may include minerals and animal parts. The adjustment is ok, but may be replaced with –‘ Herbal medicine was once termed primitive by western medicine but through scientific investigations there is a better understanding of its therapeutic activities such that many pharmaceuticals have been modeled on phytochemicals derived from it. Major obstacles to the use of African medicinal plants are their poor quality control and safety. Traditional medical practices are still shrouded with much secrecy, with few reports or documentations of adverse reactions. However, the future of African traditional medicine is bright if viewed in the context of service provision, increase of health care coverage, economic potential, and poverty reduction. Formal recognition and integration of traditional medicine into conventional medicine will hold much promise for the future.",book:{id:"6302",slug:"herbal-medicine",title:"Herbal Medicine",fullTitle:"Herbal Medicine"},signatures:"Ezekwesili-Ofili Josephine Ozioma and Okaka Antoinette Nwamaka\nChinwe",authors:[{id:"191264",title:"Prof.",name:"Josephine",middleName:"Ozioma",surname:"Ozioma Ezekwesili-Ofili",slug:"josephine-ozioma-ezekwesili-ofili",fullName:"Josephine Ozioma Ezekwesili-Ofili"},{id:"211585",title:"Prof.",name:"Antoinette",middleName:null,surname:"Okaka",slug:"antoinette-okaka",fullName:"Antoinette Okaka"}]},{id:"76640",title:"Control of Clinical Laboratory Errors by FMEA Model",slug:"control-of-clinical-laboratory-errors-by-fmea-model",totalDownloads:1214,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Patient safety is an aim for clinical applications and is a fundamental principle of healthcare and quality management. The main global health organizations have incorporated patient safety in their review of work practices. The data provided by the medical laboratories have a direct impact on patient safety and a fault in any of processes such as strategic, operational and support, could affect it. To provide appreciate and reliable data to the physicians, it is important to emphasize the need to design risk management plan in the laboratory. Failure Mode and Effect Analysis (FMEA) is an efficient technique for error detection and reduction. Technical Committee of the International Organization for Standardization (ISO) licensed a technical specification for medical laboratories suggesting FMEA as a method for prospective risk analysis of high-risk processes. FMEA model helps to identify quality failures, their effects and risks with their reduction/elimination, which depends on severity, probability and detection. Applying FMEA in clinical approaches can lead to a significant reduction of the risk priority number (RPN).",book:{id:"9808",slug:"contemporary-topics-in-patient-safety-volume-1",title:"Contemporary Topics in Patient Safety",fullTitle:"Contemporary Topics in Patient Safety - Volume 1"},signatures:"Hoda Sabati, Amin Mohsenzadeh and Nooshin Khelghati",authors:[{id:"340486",title:"M.Sc.",name:"Hoda",middleName:null,surname:"Sabati",slug:"hoda-sabati",fullName:"Hoda Sabati"},{id:"348872",title:"M.Sc.",name:"Amin",middleName:null,surname:"Mohsenzadeh",slug:"amin-mohsenzadeh",fullName:"Amin Mohsenzadeh"},{id:"348874",title:"MSc.",name:"Nooshin",middleName:null,surname:"Khelghati",slug:"nooshin-khelghati",fullName:"Nooshin Khelghati"}]},{id:"65467",title:"Anesthesia Management for Large-Volume Liposuction",slug:"anesthesia-management-for-large-volume-liposuction",totalDownloads:6231,totalCrossrefCites:1,totalDimensionsCites:2,abstract:"The apparent easiness with which liposuction is performed favors that patients, young surgeons, and anesthesiologists without experience in this field ignore the many events that occur during this procedure. Liposuction is a procedure to improve the body contour and not a surgery to reduce weight, although recently people who have failed in their plans to lose weight look at liposuction as a means to contour their body figure. Tumescent liposuction of large volumes requires a meticulous selection of each patient; their preoperative evaluation and perioperative management are essential to obtain the expected results. The various techniques of general anesthesia are the most recommended and should be monitored in the usual way, as well as monitoring the total doses of infiltrated local anesthetics to avoid systemic toxicity. The management of intravenous fluids is controversial, but the current trend is the restricted use of hydrosaline solutions. The most feared complications are deep vein thrombosis, pulmonary thromboembolism, fat embolism, lung edema, hypothermia, infections and even death. The adherence to the management guidelines and prophylaxis of venous thrombosis/thromboembolism is mandatory.",book:{id:"6221",slug:"anesthesia-topics-for-plastic-and-reconstructive-surgery",title:"Anesthesia Topics for Plastic and Reconstructive Surgery",fullTitle:"Anesthesia Topics for Plastic and Reconstructive Surgery"},signatures:"Sergio Granados-Tinajero, Carlos Buenrostro-Vásquez, Cecilia\nCárdenas-Maytorena and Marcela Contreras-López",authors:[{id:"273532",title:"Dr.",name:"Sergio Octavio",middleName:null,surname:"Granados Tinajero",slug:"sergio-octavio-granados-tinajero",fullName:"Sergio Octavio Granados Tinajero"}]},{id:"30178",title:"Chest Mobilization Techniques for Improving Ventilation and Gas Exchange in Chronic Lung Disease",slug:"chest-mobilization-techniques-for-improving-ventilation-and-gas-exchange-in-chronic-lung-disease",totalDownloads:31230,totalCrossrefCites:1,totalDimensionsCites:6,abstract:null,book:{id:"648",slug:"chronic-obstructive-pulmonary-disease-current-concepts-and-practice",title:"Chronic Obstructive Pulmonary Disease",fullTitle:"Chronic Obstructive Pulmonary Disease - Current Concepts and Practice"},signatures:"Donrawee Leelarungrayub",authors:[{id:"73709",title:"Associate Prof.",name:"Jirakrit",middleName:null,surname:"Leelarungrayub",slug:"jirakrit-leelarungrayub",fullName:"Jirakrit Leelarungrayub"}]},{id:"46082",title:"Fecal Incontinence",slug:"fecal-incontinence",totalDownloads:3900,totalCrossrefCites:0,totalDimensionsCites:0,abstract:null,book:{id:"3835",slug:"fecal-incontinence-causes-management-and-outcome",title:"Fecal Incontinence",fullTitle:"Fecal Incontinence - Causes, Management and Outcome"},signatures:"Arzu Ilce",authors:[{id:"30672",title:"Dr.",name:"Arzu",middleName:null,surname:"Ilce",slug:"arzu-ilce",fullName:"Arzu Ilce"}]}],onlineFirstChaptersFilter:{topicId:"16",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"83158",title:"Cannabis and the Brain: Friend or Foe?",slug:"cannabis-and-the-brain-friend-or-foe",totalDownloads:0,totalDimensionsCites:null,doi:"10.5772/intechopen.106669",abstract:"Legalization of cannabis in the US and other countries highlight the need to understand the health consequences of this substance use. Research indicates that some cannabis ingredients may play beneficial role in treating various medical conditions while other ingredients may pose health risks. This review is focused on the brain and mental health effects of cannabis use. The rationale for examining cannabis use in behavioral and neural conditions is that these conditions are highly widespread in the US and account for high level of medical healthcare and associated cost. The purpose of this review is to provide an overview of the known medicinal benefits of selected cannabis cannabinoids in conditions like pediatric epilepsy, attention deficit hyperactivity disorder, autism spectrum disorder, and the known side effects or contraindications in conditions such as addiction, cognition, and psychosis. Several recommendations are made as to studies that will help further understanding the increasing role of cannabis in neuropsychiatric health and disease.",book:{id:"11714",title:"Cannabinoids - Recent Perspectives and Applications in Human Health",coverURL:"https://cdn.intechopen.com/books/images_new/11714.jpg"},signatures:"Ali E. Dabiri and Ghassan S. Kassab"},{id:"83161",title:"Repurposing BCG and MMR Vaccines for Combating Covid-19: A Review and Opinion Based on Clinical Evidence",slug:"repurposing-bcg-and-mmr-vaccines-for-combating-covid-19-a-review-and-opinion-based-on-clinical-evide",totalDownloads:0,totalDimensionsCites:null,doi:"10.5772/intechopen.106788",abstract:"Our review comprehends past and recent developments encircling the two vaccines, BCG and MMR, which have efficacy lasting 10 years and are known to trigger the production of Interferon and various cytokines. BCG has depicted long-lasting effects, reduction in mortality, and hospitalizations associated with various diseases in different age groups as per studies across Sweden, West Africa, Spain, and Indonesia. Clinical trials are in progress in Holland, Australia, and Germany to study its effects on COVID-19. Most Asian countries with childhood BCG vaccination programs have shown lower COVID-19-related per capita death rates. The MMR vaccination has shown a reduction in hospitalizations and COVID-19-related deaths in about 11 countries, and a randomized clinical trial has been proposed in New Orleans. Reasons such as inhibition of pulmonary inflammation and structural similarity have been cited for such consequences. BCG and MMR may serve to shorten the duration of infection, minimize harmful pathology, reduce hospitalization rates, and curb the spread of the disease, but more research is required to assess the associated risks, especially for the elderly and people with comorbidities who are prone to severe complications of COVID-19.",book:{id:"11724",title:"COVID-19 Vaccines - Current State and Perspectives",coverURL:"https://cdn.intechopen.com/books/images_new/11724.jpg"},signatures:"Kasturi Mahesh Tawde, Aditya Manivannan Iyer and Harshal Ashok Pawar"},{id:"83136",title:"Vector Control: Insights Arising from the Post-Genomics Findings on Insects’ Reproductive Biology",slug:"vector-control-insights-arising-from-the-post-genomics-findings-on-insects-reproductive-biology",totalDownloads:1,totalDimensionsCites:0,doi:"10.5772/intechopen.106273",abstract:"The high prevalence of neglected vector-borne diseases, such as Chagas disease and dengue fever, imposes enormous health and financial burdens in developing countries. Historically, and still, to this day, the main effective methods to manage those diseases rely on vector population control. Although early efforts in understanding vector-specific biology resulted in important advancements in the development of strategies for the management of vector-borne diseases, studies regarding the complex physiology of local vector species were weakened by the expanding use of insecticide-based tools, which were, at the time, proven simpler and effective. The rising threat of insecticide resistance and climate change (which can expand endemic areas) has reemphasized the need to rely on thorough species-specific vector biology. One approach to controlling vector populations is to disrupt molecular processes or antagonize the metabolic targets required to produce viable eggs. Here, we discuss new findings arising from post-genomics molecular studies on vector reproductive biology and discuss their potential for the elaboration of new effective vector control interventions.",book:{id:"11227",title:"New Advances in Neglected Tropical Diseases",coverURL:"https://cdn.intechopen.com/books/images_new/11227.jpg"},signatures:"Isabela Ramos and Fabio Gomes"},{id:"83146",title:"Metabarcoding and Digital PCR (dPCR): Application in the Study of Neglected Tropical Diseases",slug:"metabarcoding-and-digital-pcr-dpcr-application-in-the-study-of-neglected-tropical-diseases",totalDownloads:3,totalDimensionsCites:null,doi:"10.5772/intechopen.106272",abstract:"neglected tropical diseases such as Chagas disease, dengue, Zika, chikungunya, and malaria cause millions of deaths each year and they are caused by a variety of pathogens whose diagnosis is very limited or subject to conventional testing, making a treatment less accessible, accurate and timely diagnosis for choosing their treatments. Traditional methods for pathogen detection have not been able to meet the growing need for diagnosis and control. The incorporation of new technologies such as next-generation sequencing (NGS) and digital PCR (dPCR) represent a better diagnostic possibility due to their ability to absolutely quantify pathogens with high selectivity and precision. Our planet is currently experiencing environmental changes of an unprecedented magnitude and rate, including climate change, globalized pollution, biodiversity loss, and land use changes, so neglected diseases require a comprehensive understanding of the ecology of vectors in the different eco-epidemiological contexts, as well as of the transmission cycles of pathogens and their transmission dynamics. In this sense, NGS and dPCR open a new panorama for a better understanding of these diseases with the aim of proposing new programs for their care.",book:{id:"11227",title:"New Advances in Neglected Tropical Diseases",coverURL:"https://cdn.intechopen.com/books/images_new/11227.jpg"},signatures:"María de la Soldedad Lagunes-Castro, Aracely López-Monteon, Daniel Guzmán-Gómez and Angel Ramos-Ligonio"},{id:"82798",title:"Biomarkers in Multiple Sclerosis",slug:"biomarkers-in-multiple-sclerosis",totalDownloads:1,totalDimensionsCites:null,doi:"10.5772/intechopen.106052",abstract:"Clinical, biological, and radiological evidence are currently needed to diagnose MS, but lack of preclinical biomarkers hinders the earliest possible diagnosis and treatment. Conventional biomarkers target immunity, blood-brain barrier disruption, demyelination, and neuronal and axonal damage, as well as mitochondrial activity. An increase of specific brain metabolites with 30–40% is registered before detection of MRI lesions in MS. Potential lipid biomarkers are fatty acids, phospholipids, and oxysterols. The role of proteoforms in the pathogenesis of MS was confirmed. Serum neurofilament light chains (sNfL) are currently being studied as a readily available biomarker for prognosis and response to treatment in MS. The sNfL levels reflect ongoing neuroaxonal damage caused by inflammation, and the sNfL levels predict disease activity over the next few years. The retinal nerve fiber layer (RNFL) thinning is reliable as a biomarker of disability worsening. The neutrophil-to-lymphocyte ratio and CRP are also MS biomarkers. The development of rationally targeted therapeutic agents that allow preventive treatment to stop the disease is also delayed without definite biomarkers.",book:{id:"11312",title:"Multiple Sclerosis - Genetics, Disease Mechanisms and Clinical Developments",coverURL:"https://cdn.intechopen.com/books/images_new/11312.jpg"},signatures:"Valentina Ignatova"},{id:"83129",title:"Airborne Transmission and Control of Influenza and Other Respiratory Pathogens",slug:"airborne-transmission-and-control-of-influenza-and-other-respiratory-pathogens",totalDownloads:1,totalDimensionsCites:null,doi:"10.5772/intechopen.106446",abstract:"Despite uncertainty about the specific transmission risk posed by airborne, spray-borne, and contact modes for influenza, SARS-CoV-2, and other respiratory viruses, there is evidence that airborne transmission via inhalation is important and often predominates. An early study of influenza transmission via airborne challenge quantified infectious doses as low as one influenza virion leading to illness characterized by cough and sore throat. Other studies that challenged via intranasal mucosal exposure observed high doses required for similarly symptomatic respiratory illnesses. Analysis of the Evaluating Modes of Influenza Transmission (EMIT) influenza human-challenge transmission trial—of 52 H3N2 inoculated viral donors and 75 sero-susceptible exposed individuals—quantifies airborne transmission and provides context and insight into methodology related to airborne transmission. Advances in aerosol sampling and epidemiologic studies examining the role of masking, and engineering-based air hygiene strategies provide a foundation for understanding risk and directions for new work.",book:{id:"11570",title:"Influenza - New Approaches",coverURL:"https://cdn.intechopen.com/books/images_new/11570.jpg"},signatures:"Jacob Bueno de Mesquita"}],onlineFirstChaptersTotal:701},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:11,numberOfPublishedChapters:91,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:108,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:333,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:11,numberOfPublishedChapters:144,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:126,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:113,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:23,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:13,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}},{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. 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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:"28",type:"subseries",title:"Animal Reproductive Biology and Technology",keywords:"Animal Reproduction, Artificial Insemination, Embryos, Cryopreservation, Conservation, Breeding, Epigenetics",scope:"The advances of knowledge on animal reproductive biology and technologies revolutionized livestock production. Artificial insemination, for example, was the first technology applied on a large scale, initially in dairy cattle and afterward applied to other species. Nowadays, embryo production and transfer are used commercially along with other technologies to modulate epigenetic regulation. Gene editing is also emerging as an innovative tool. This topic will discuss the potential use of these techniques, novel strategies, and lines of research in progress in the fields mentioned above.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/28.jpg",hasOnlineFirst:!1,hasPublishedBooks:!0,annualVolume:11417,editor:{id:"177225",title:"Prof.",name:"Rosa Maria Lino Neto",middleName:null,surname:"Pereira",slug:"rosa-maria-lino-neto-pereira",fullName:"Rosa Maria Lino Neto Pereira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bS9wkQAC/Profile_Picture_1624519982291",biography:"Rosa Maria Lino Neto Pereira (DVM, MsC, PhD and) is currently a researcher at the Genetic Resources and Biotechnology Unit of the National Institute of Agrarian and Veterinarian Research (INIAV, Portugal). She is the head of the Reproduction and Embryology Laboratories and was lecturer of Reproduction and Reproductive Biotechnologies at Veterinary Medicine Faculty. She has over 25 years of experience working in reproductive biology and biotechnology areas with a special emphasis on embryo and gamete cryopreservation, for research and animal genetic resources conservation, leading research projects with several peer-reviewed papers. Rosa Pereira is member of the ERFP-FAO Ex situ Working Group and of the Management Commission of the Portuguese Animal Germplasm Bank.",institutionString:"The National Institute for Agricultural and Veterinary Research. 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