Overview of the development of new pathological conditions in pregnancy from sleep-altering physio-pathological conditions.
\\n\\n
IntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
\\n\\nIntechOpen Book Series will be launching regularly to offer our authors and editors exciting opportunities to publish their research Open Access. We will begin by relaunching some of our existing Book Series in this innovative book format, and will expand in 2022 into rapidly growing research fields that are driving and advancing society.
\\n\\nLaunching 2021
\\n\\nArtificial Intelligence, ISSN 2633-1403
\\n\\nVeterinary Medicine and Science, ISSN 2632-0517
\\n\\nBiochemistry, ISSN 2632-0983
\\n\\nBiomedical Engineering, ISSN 2631-5343
\\n\\nInfectious Diseases, ISSN 2631-6188
\\n\\nPhysiology (Coming Soon)
\\n\\nDentistry (Coming Soon)
\\n\\nWe invite you to explore our IntechOpen Book Series, find the right publishing program for you and reach your desired audience in record time.
\\n\\nNote: Edited in October 2021
\\n"}]',published:!0,mainMedia:{caption:"",originalUrl:"/media/original/132"}},components:[{type:"htmlEditorComponent",content:'With the desire to make book publishing more relevant for the digital age and offer innovative Open Access publishing options, we are thrilled to announce the launch of our new publishing format: IntechOpen Book Series.
\n\nDesigned to cover fast-moving research fields in rapidly expanding areas, our Book Series feature a Topic structure allowing us to present the most relevant sub-disciplines. Book Series are headed by Series Editors, and a team of Topic Editors supported by international Editorial Board members. Topics are always open for submissions, with an Annual Volume published each calendar year.
\n\nAfter a robust peer-review process, accepted works are published quickly, thanks to Online First, ensuring research is made available to the scientific community without delay.
\n\nOur innovative Book Series format brings you:
\n\nIntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
\n\nIntechOpen Book Series will be launching regularly to offer our authors and editors exciting opportunities to publish their research Open Access. We will begin by relaunching some of our existing Book Series in this innovative book format, and will expand in 2022 into rapidly growing research fields that are driving and advancing society.
\n\nLaunching 2021
\n\nArtificial Intelligence, ISSN 2633-1403
\n\nVeterinary Medicine and Science, ISSN 2632-0517
\n\nBiochemistry, ISSN 2632-0983
\n\nBiomedical Engineering, ISSN 2631-5343
\n\nInfectious Diseases, ISSN 2631-6188
\n\nPhysiology (Coming Soon)
\n\nDentistry (Coming Soon)
\n\nWe invite you to explore our IntechOpen Book Series, find the right publishing program for you and reach your desired audience in record time.
\n\nNote: Edited in October 2021
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Teaching and learning methods have changed significantly since the coming of the Web and it is very likely they will keep evolving many years to come thanks to it. A good example of this changing reality is the spectacular\r\ndevelopment of e-Learning.\r\n\r\nIn a more particular way, the Web 2.0 has offered to the teaching industry a set of tools and practices that are modifying the learning systems and knowledge transmission methods. Teachers and students can use these tools in a variety of ways aimed to the general purpose of promoting collaborative work.\r\n\r\nThe editor would like to thank the authors, who have committed so much effort to the publication of this work. She is sure that this volume will certainly be of great help for students, teachers and researchers. This was, at least, the main aim of the authors.",isbn:null,printIsbn:"978-953-307-010-0",pdfIsbn:"978-953-51-5854-7",doi:"10.5772/170",price:139,priceEur:155,priceUsd:179,slug:"advanced-learning",numberOfPages:446,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:null,bookSignature:"Raquel Hijon-Neira",publishedDate:"October 1st 2009",coverURL:"https://cdn.intechopen.com/books/images_new/3613.jpg",numberOfDownloads:62972,numberOfWosCitations:17,numberOfCrossrefCitations:28,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:42,numberOfDimensionsCitationsByBook:0,hasAltmetrics:0,numberOfTotalCitations:87,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:null,dateEndSecondStepPublish:null,dateEndThirdStepPublish:null,dateEndFourthStepPublish:null,dateEndFifthStepPublish:null,currentStepOfPublishingProcess:1,indexedIn:"1,2,3,4,5,6,7",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"1267",title:"Assistant Professor",name:"Raquel",middleName:null,surname:"Hijon-Neira",slug:"raquel-hijon-neira",fullName:"Raquel Hijon-Neira",profilePictureURL:"https://mts.intechopen.com/storage/users/1267/images/system/1267.jpg",biography:"Department of Computing and Statistics, Escuela Técnica Superior de Ingenierı´a Informática, Universidad Rey Juan Carlos, Móstoles, Spain\nRaquel Hijón-Neira received the European Ph.D. degree in computer science from the Universidad Rey Juan Carlos, Madrid, Spain, in 1998 and 2010, respectively.She worked as a Computer Science Engineer for 5 years and as an Instructor at the university for 15 years. She is currently an Assistant Professor with the Universidad Rey Juan Carlos, and a member of the Laboratory of Information Technologies in Education (LITE). 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We could focus on how parenting strategies are shaped within diverse cultural contexts. We could also ask questions about how parenting is influenced by parents’ personalities and parental upbringing, or investigate the effects of lifespan development on parenting. While the above questions drive investigations into parenting from both the sociological and psychological perspectives, our perspective in this chapter shall be communicative. Thus, in this chapter, we review the literature to find out how parenting is shaped by family conversations. Our primary interest, therefore, is in the communication processes and topics that enact parent–child relationships to see how these influence child-rearing outcomes.
Communication is a process through which meanings are created [1] in all human relationships. Bochner [2] posits that communication is fundamental to all family processes. Parenting, being the chief of these processes, utilizes communication in all of its endeavors. Adapting to parenting, Turner and West [1] submission on the instrumentality of communication to family life, family relations and family functioning, we say in this chapter that parenting is not doable without communication. Thus, while parenting involves interpersonal skills and places emotional demands on parents [3, 4, 5], we propose in this chapter that communication drives all parenting processes.
At the center of parenting are the diverse strategies parents engage in nurturing their children. Literature [6, 7] has defined these strategies as all the behaviors, attitudes and values utilized by parents in interacting with their children. This is done to influence their physical, emotional, social and intellectual development. Underlining the central role of communication in all of these, Darling and Steinberg [6] point out that parents ‘communicate’ these attitudes to create an emotional atmosphere within which their parenting behaviors seek expression. This chapter thus seeks to explore communication as both a socialization tool in the art of parenting and the medium for the expression of all parenting behaviors and attitudes. We will also see how these influence child-rearing outcomes.
Family communication literature [8, 9] posit that understanding the nature of theory is the only way to fully understand the nature of families and the communication dynamics within them. Consequently, for over five decades [10], scholars have engaged diverse theories in their bid to conceptualize and expand the boundaries of family communication research. Having established the central role of family communication in parenting, we seek to interrogate a few out of the most utilized theories in parenting drawn from family communication research. Our aim in this is to seek out connections between these theories and the strategies parents engage in raising their children to see how they influence each other and consequently impact child-rearing outcomes. Our theories of focus in this chapter shall be
The purpose of this chapter is therefore to review theory and research in parenting studies from the family communication perspective. This will include discourse on the interactions between parenting and communication and how these influence child rearing outputs. Evaluating healthy parenting on the criteria of effective communication, the chapter shall focus on how communication mitigates diverse parenting challenges to bring about positive child-rearing outcomes in parent–child relationships. To do this successfully, efforts shall be made in the chapter to interrogate diverse parenting strategies recommended in the research literature and parents’ communication styles to see how these impact child-rearing in a changing society.
Over the last five decades, parenting as a domain of study has gained grounds in family communication scholarship [11]. The focus, however, in most of the studies has been purely sociological and psychological [1]. Thus, so much has been written on parenting without much emphasis on communication as the context within which most parenting behaviors and attitudes are expressed. This chapter seeks to engage parenting through the medium of communication. It hopes to do this by examining the interactions between positive parenting strategies and parents’ communication styles to see how these influence child-rearing outcomes.
Topics that shall be discussed in this chapter about how communication mediates between positive parenting strategies and parents’ communication styles to bring about positive child-rearing outputs include:
Parenting and communication
Theory in parenting studies
Parenting strategies as parents’ communication styles
Implication
Recommendations
While definitions of parenting abound, we define parenting in this chapter from O’Connor and Scott [12] perspective as the various ways that parents shape their children’s development. This definition for us encompasses covertly all the processes that parents engage to arrive at producing well-developed children: processes that involve parents’ efforts at attending to both the physical and psychological needs of their children. Over the years, parents have deployed many styles across cultures to achieve their goals towards raising well-developed children who become responsible citizens in society. Diana Baumrind’s 1971 multidimensional model of parenting summarizes these parenting styles under four different headings: authoritarian, authoritative, permissive and uninvolved parenting styles. While all these styles have their implication on parenting and child-rearing outcomes, our preoccupation in this chapter is to see how parents’ engagement of any of these styles translate into their communication styles with their children.
Communication, on the other hand, has been defined as the process of meaning-making between people [1]. Apart from the biological foundation that originates the connections between parents and children, the processes involved in creating and maintaining parent–child relationships are captured in the interactions between them. Zolten and Long [13] predicates healthy parent–child relationship on positive communication. Through positive communication, parents forge strong bonds with their children. The nature of these bonds determines how parents fare with the various developmental challenges children go through and their impact on their parenting [14]. While healthy parenting involves appropriate behavioral standards and expectations and verbal expression of maturity demands, parents who positively communicate these behavioral standards and expectations to their children succeed at achieving healthy levels of aspiration, independence, and attitudes in their children [15].
Theories give us a mechanism for understanding phenomena, and parenting is one such phenomenon. While several attempts have been made by scholars to locate parenting within specific theoretical frameworks, there is no comprehensive theory of parenting [16]. We review therefore three theories of family communication research that have found relevance in parenting studies: family systems theory, family communication patterns theory and social constructionist theory. Our preference for these three theories is informed by their ability to isolate the communication patterns within a family system and to deploy them for meaning-making purposes. We seek to identify aspects of these theories that inform parenting orientations, otherwise known in the literature as parenting styles [17] or parenting strategies [11]. We hope to make connections between these theories and the strategies parents engage in raising their children to see how they influence each other to bring about child-rearing outcomes.
Family systems theory emerged as a result of Bowen’s early research at the Menninger Foundation. It assumes that a system is characterized by the interaction of its interdependent elements, with each element mutually influencing every component in the system [9]. Utilizing the family as an interaction system, it attempts to explain social behavior and patterns of social interactions [16]. Looking at the family as the basic emotional unit, the theory upholds the view that families can be understood not through individual members’ experiences (which can vary widely from one another) but, rather, through the unique dynamics and overall climate achieved in a family. This suggests that any change in the emotional functioning of one member of the family is compensated for by changes in the emotional functioning of other members of that family.
Examining parenting through the lens of the systems theory, parents derive their different parenting behaviors from their interactions with other subsystems in the entire family system. Holden [16] supports this with the view that to fully understand behavior in the family, one cannot simply focus on an individual child in isolation or only on the parent–child dyad. Rather, relationships among all members of the family must be recognized to understand how the behavior of individuals is supported by, encouraged, or reacted to by other family members. Thus, as parents interact with other interdependent elements at the different sub-systems in the family, they come off from such interactions with notions about parenting that eventually influence their parenting. Their social context thus casts a shadow on the relationships each member of the family eventually develops [18]. We discover from this, parents’ effort to parent their children in ways not too different from how they were parented. In doing this, they struggle to transmit to their child’s values, attitudes and norms imbibed from their upbringing. This process contributes immensely to the diverse parenting strategies that parents deploy in raising their children.
Family communication patterns theory, proceeding from the works of McLeod and Chaffe in the early 70s and Ritchie and Fitzpatrick in the early 90s, has been used by scholars in the family communication field to articulate the diverse ways parents communicate with children and the implication of such communication styles on the parent–child relationship [19]. The two major patterns emerging from the literature that either grow or shrink family conversations are
Reuter and Koerner [20] further opine that families create their shared reality through these two communication orientations-the conversation orientation and the conformity orientation. Conversation orientation, characterized by frequent, spontaneous, unrestrained interactions allow family members to co-discover the meaning of symbols and objects in their relationship systems and thus encourage them to participate in the definition of their social reality. Conformity orientation, on the other hand, characterized by the uniformity of beliefs and attitudes, direct family interactions to focus on maintaining harmonious relationships that emphasize obedience to parents. These often manifest in the pressure on family members, mostly children, to agree and maintain the family hierarchy, thus placing the power to define social reality in the hands of family members in the authority roles (mostly parents) [20, 21].
Examining parenting strategies through the lens of these twin theoretical models presupposes that both models will have implications on child-rearing outcomes. Parents who engage conversational strategies are more likely to produce children who are psychologically balanced and can engage life’s issues from a balanced perspective. Communication for such parents is not a tool for control, rather it is utilized for forging connections that stabilize parent–child relationships during the storm and stress of adolescence [14, 22]. On the other hand, parents who engage in conformity-oriented strategies focus more on control than on cultivating a relationship that produces psychologically balanced children. Children from such parenting backgrounds develop more delinquent and deviant tendencies as their response to authoritarian parenting. We discuss this further in the section on Positive parenting strategies as parents’ communication style.
Social constructionism is a theory used to construct man’s attempt to come to terms with the nature of reality [5]. Traced to the works of sociologists, Peter L. Berger and Thomas Luckman in 1966 whose ideas were inspired by the thinking of Karl Marx, Emile Durkheim, and George Herbert Mead, Social Constructionism asserts that all meanings are socially constructed. It proposes that people make sense of the world by constructing their model of the social world and how it works through social interactions and language. Harach and Kuczynski [23] in their study identified the role of language in the construction of parent–child relationships.
By asking parents to describe the relationship with their children within a framework of questions concerning the nature of the relationship, questions such as how parents and children strengthen the relationship, how they damage the relationship, and how they make repairs to the relationship after interactional missteps, they sought to discover the categories and concepts that parents use to
Thus, in parenting research, while the relationship between parents and their children is enacted through communication, parents’ language use in the communication process has implications on what knowledge or understanding of the relationship gained by the children which directly or indirectly impacts their response in the relationship. Dunkeley [24] in her phenomenological study of parenting adolescents from both parents’ and adolescents’ perspectives, also identifies language as not just a vehicle for the expression or representation. Rather she reiterates that without language, higher functions of thought and imagination cannot develop. According to her, it is from language that children build concepts which make it possible for them to begin to direct their actions thus shaping the course of their own and other lives. Dunkeley [24] shares Vygotsky’s view which encourages the idea that “personalities are constituted by language from an early age in a process which continues throughout life allowing continual change and growth to take place at a higher cognitive level” (p. 44).
Thus, children and adolescents through the use of language in parent–child interaction settings can be seen as active agents, intimately involved in constructing meanings about events in their lives. These meanings contribute to shaping who they become, what notion of parenting they have and will perpetuate and what views they will hold about their own lives and other interpersonal relationships. On the other hand, parents through their parenting teach children what to think about the world, what is important or unimportant, and about their self-worth [25]. Directly or indirectly, parents mirror for child’s notions about life. These have implications on their child-rearing outcomes.
The three theoretical frameworks examined in the context above highlight the role of theory in deepening the understanding of parenting from the family communication perspective. The family systems theory highlights the interdependent relationships between parents and children as members of a family system. It also highlights how parents’ interactions with other elements at the various sub-systems in the family influence their parenting strategies, which consequently influence child outcomes. The family communication patterns theory identifies the specific communication patterns in the different parenting strategies deployed by parents in raising their children and also deepens an understanding of their impact on child-rearing outcomes. Lastly, the social constructionist theory highlights the meaning-making functions of language in parent–child interactions and their implications on child outcomes as well.
Having defined parenting strategies in this chapter as all the behaviors, attitudes and values utilized by parents in raising their children, we propose also that these strategies are parents’ communication styles because they serve as channels for all parenting activities and also provide platforms on which parents connect with their children. Without these connections, parenting becomes a struggle. Parenting research literature has tried to group these strategies according to the philosophical perspectives of their proponents. We review some of these strategies to identify elements of family communication in them and to highlight how they function as parents’ communication styles.
Eanes [26] describes positive parenting as an entirely different way of relating to children that allow parents to maintain a strong bond with them through the ages and stages of childhood while still raising kind and responsible people. Its philosophy is rooted in connection and not just a method of discipline. This strategy, according to her is directly opposed to conventional parenting methods which often pits parents against children. The goal of this strategy is to achieve more strong connection, cooperation, and joy and peace in the family. The five principles that inform positive parenting include attachment, respect, proactive parenting, empathetic leadership and positive discipline [26]. These are principles that are relationship-oriented and powered by communication. Summarizing the role of communication in positive parenting, Eanes [26] opines that:
The above submission is quite different from what most of us experienced with our parents while growing up. I see efforts on the part of parents in the above context to, not just control with instructions, but to establish connections that will produce lasting bonds between them and their children. The communication pattern adopted by parents in this context is conversational. Parents in the above context talk to their children differently [22]. Communication for them is a tool for fostering connection, and not control. They seem to have transformed notions of parenting that have shifted the way they perceive and respond to their children. Children from such parenting backgrounds are happier more emotionally balanced and readier to seek out and establish healthier relationships than their peers for the conventional parenting background.
Scream-free parenting is built on the principle that parents can ‘keep their cool’ even when events in the parenting experience get hot [27]. Its philosophy is hinged on the notion that parents can relate with children in a calm, cool, and connected way, taking hold of their emotional responses no matter how children choose to behave. The dominating principle in this school of thought is that for parents to be able to parent in a calm, cooperative and peaceful environment, they need to focus on themselves instead of the children. By focusing on themselves, they can get a handle on their ‘emotional reactivity’, which is usually the ‘greatest enemy of great relationships’ [27].
To combat emotional reactivity, parents are tasked with the duty of regulating their own emotions so they do not get in the way of calm and peaceful parenting. By getting a handle on their own emotions, parents are better disposed to respond to issues in their relationship with their children, thereby modeling for them the calmness and good behavior which they expect in return. Markham [22] describes this as “self-regulation.” Since parenting, for her, is not about what a child does, but more about how a parent responds, staying calm enough to respond constructively to all childish behavior and the stormy emotions behind it requires growth on the side of the parents. Achieving this ‘growth’ is the hardest part of parenting but the only key to positioning parents/the more peaceful parent that our children deserve.
Engaging ‘response’ as a phenomenon in scream-free parenting, scholars [22, 27] opine that an adult’s peaceful presence has a more powerful influence on a child than yelling ever could. This promotes emotional regulation as a communication strategy for achieving positive child-rearing outcomes. This also directs attention to parents’ use of language in parent–child relationships. The language of communication in such contexts is usually conformity-oriented rather than conversational. While yelling at children may force them to cower into obedience to parents’ instructions, it disregards respect for their tiny personalities and produces emotionally imbalanced children, with lots of externalizing and internalizing symptoms [28, 29].
Dermer et al. [25] define a poisonous parent as one whose ways of teaching children about life and styles of interaction damage children’s abilities to form healthy connections with family members, friends, and eventually romantic partners and offspring. In a nutshell, poisonous parenting addresses how destructive relationships with parents will lead to unhealthy relationships throughout the lifespan if they are not effectively addressed [25]. It hinges its philosophy on the notion that people who have destructive parenting styles often were the victims of malevolent parenting themselves.
Coming from such backgrounds, parents cannot help but play out their insecurities, deficiencies, and fears from childhood in their relationships with their children. Thus, when attachment anxieties are triggered in the relationship, parents resort to abusive behaviors to control children and to force emotional and physical proximity [25]. Such abusive behaviors are manifested in harsh criticisms, shaming, labelling and the use of words too big for a child’s developing emotions to handle-words that are not age-appropriate [30, 31, 32]. This suggests that the communication environment in which poisonous parenting occurs is overly conformity-oriented. Parents here strive through their communication to achieve strict obedience to parental authority and the maintenance of family hierarchy without paying attention to the sensibilities of the children in the relationship. Children from such parent–child relationships very often carry their unresolved trauma into future relationships and are incapable of emotional regulation, emotional awareness, emotional responsiveness, making an accurate assessment of people’s behaviors, and interpersonal connectedness [22, 25, 26].
Unconditional parenting is founded on the notion of lovingly parenting children without attaching the conditional strings of ‘good behavior’ and ‘achievement’ [30]. It pushes forward the idea of parents loving their kids not for
Research has shown that children raised in this kind of atmosphere come off with a healthy assessment of their personalities, can regulate their emotions and become responsible citizens of the society [17, 22, 33, 34] and are also capable of forming healthy and balanced relationships later in life. Meeting this need of acceptance for children positions them to also accept and help other people in their present and future relationships. It is noteworthy to say that the communication environment in this parenting style is conversational and makes way for frequent, spontaneous, unrestrained interactions which allow children to co-discover the meaning of symbols and objects in the parent–child relationship systems and thus encourage them to participate in the definition of their social reality [20].
From the parenting styles outlined in the chapter, two patterns of communication are identified: the conformity-oriented and the conversation-oriented communication patterns. While the conformity-oriented communication pattern is unsupportive of children’s psychosocial development because it is concerned with hierarchy and strict submission to parents’ authority, the conversation-oriented communication pattern, on the other hand, is supportive because of its preoccupation with relationship cultivation and children’s overall psychosocial development. Thus, engaging parenting from the two communication perspectives has implications on the parenting atmosphere and ultimately on child outcomes. The overarching role of communication in helping parents articulate the different values, norms and attitudes they hope to transmit through their chosen parenting styles cannot be over-emphasized. While a chosen parenting style can be supportive or unsupportive of children’s psychosocial development, an ability to identify the communication patterns inherent in them and to demonstrate their dual roles as parenting styles and parents’ communication patterns has been the preoccupation of this chapter. We make this statement in the diagram below:
While both parenting styles and parents’ communication patterns have been articulated differently by various scholars of family communication and parenting education with both having implications on child-rearing outcomes, we propose that the interconnections between them qualify them to be used interchangeably in the parenting process. We also say that the role of parents’ communication styles as platforms without which parenting styles cannot be appropriately expressed gives credence to our claim that parenting is not doable without communication. Thus, all parents’ efforts at transmitting norms and values through their chosen styles of parenting are their way of communicating with their children. The outcome from such parenting communication is indicated in the children produced from such combinations.
Sleep architecture and sleep regulation mechanisms are different depending on gender. Indeed, women are used to perceive worse subjective sleep quality when compared to men, as demonstrated by shorter circadian period in this population. Moreover, female tend go to bed earlier and fall asleep later and present a larger melatonin production pattern [1, 2, 3, 4, 5, 6]. The prevalence of sleep disorders is also different in males and females. Hence, some disturbances, such as hypersomnia, insomnia, parasomnia, and restless legs syndrome are more frequent in women, while narcolepsy, arousal disorders, Klein-Levine syndrome, and sleep behaviour disorder with rapid eye movement are more frequent in men [7, 8, 9].
Pregnancy and perinatal period (one year after childbirth) represent particularly vulnerable periods for women, due to anatomical, hormonal, and psychological changes that infuence women’s global health [10]. Poor sleep is a common condition during this period especially during the third trimester [11]. Indeed, 52-61% of women during the last eight weeks of pregnancy show reduced and poor sleep quality, with even higher prevalence among women with a diagnosis of current or previous depressive disorder or history of smoking [7].
Moreover, pre-existing sleep disorders may become more serious during pregnancy and these disturbances increase as the gestational period progresses. Sleep changes in pregnancy are detected by polysomnogram measurements, which during the third trimester usually show an increase in wakefulness after sleep onset and a decrease in Rapid Eye Movement (REM) sleep compared to non-pregnant women [12].
During pregnancy, sleep disorders may contribute to the occurrence of irritability, diurnal hypersomnia with reduction in efficiency, abuse of hypnotic/anxiolytic drugs, impulse control disturbances, also leading to the development of mood disorders and to increased suicidal ideation with a risk of suicidal behaviours [12, 13]. Moreover, low birth weight and morphological abnormalities may occur in the foetus and his/her circadian rhythms may also be disrupted, since these are regulated by maternal factors. To note, the foetus does not produce melatonin, a hormone with an essential role in sleep–wake rhythm regulation. Further circadian rhythms that may be altered as consequence of sleep–wake disorders are: body temperature, physical activities, eating patterns, and hormone secretion, particularly melatonin and glucocorticoids These alterations can also explain why pregnant shift-workers display a higher risk of low birth weight, spontaneous abortion, and premature birth, and have sons affected by insomnia or low-birth weight, but also a higher risk of infertility, miscarriage, and pre-eclampsia [7, 13, 14, 15, 16, 17].
Previous studies reported different data about the incidence of sleep disorders during pregnancy, but consensus was reached about pregnant women having more disturbed sleep than during other times in their lives. Particularly, about 25% of pregnant women report significant sleep disturbances during the first trimester, with rates rising up to almost 75% during the third trimester [18]. Some authors also argue that up to 97% women report disturbed sleep during pregnancy [19].
Poor sleep quality and insufficient sleep duration are common in the general population and can result from environmental and psychosocial factors, as well as from medical and psychiatric disorders. During pregnancy, possible causes of sleep complaints, such as hormone release alterations, increase their incidence. A relevant role is also played by anatomical and physiological changes.
Sleep disturbances seem to be caused by different factors during the three trimesters of gestation. During the first trimester, the main causes of disturbed sleep are vomiting, nausea, and history of infertility. Gastrointestinal disorders appear to be sleep-disturbing factors also in the second trimester [11], whilst in the last trimester women with muscular-skeletal pain, overweight, restless legs, reflux, uncomfortable positions, and snoring present more sleep disturbances [20].
The main precipitating factors are listed below:
Anatomical and physiological factors, such as ligament stretching, uterine contractions, or foetal movement;
Breathing difficulties due to increased uterine volume raising the diaphragm;
Nocturnal incontinence due to increased sodium excretion during the night;
Impairment in body movements;
Hormonal changes, especially ovarian ones;
Widespread pain and cramps;
Increased sympathetic nervous system activities;
Gastrointestinal disorders, such as gastro-oesophageal reflux, constipation, delayed gastric emptyng;
Anxiety, stress, and tension [10, 21, 22, 23, 24] (see Table 1).
- |
- age > 30 years old; |
- educational level |
- single marital status |
- history of infertility |
- |
- anxiety |
- depression |
- increased stress level |
- predisposing personality traits (internalisation, perfectionism, obsessive, neurotic, and dependent on gratification) |
- |
- sex hormone fluctuations (increased oestrogen and progesteron, studies about activity of two hormones are still conflicting) |
- amplified hypothalamic–pituitary–adrenal axis |
- reduced melatonin |
- inhibition of the dopaminergic system |
- increased prolactin |
- nutritional deficiency |
- joint pain |
- chronic diseases |
- cramps |
- nausea |
- enlarged abdomen and weight gain |
- respiratory disorders |
- posture restrictions |
- nocturia |
- elevate glucocorticoids levels |
- oxidative stress |
- decreased glucose tolerance |
- increased inflammatory cytokines |
- dysfunction of serotoninergic system and hyperactivity of noradrenergic system |
- deficits in neuroplasticity |
- hypertension |
- psychiatric disorders (anxiety, depression, psychosis and substance or alcohol abuse, suicidal ideation) |
- gestational diabetes |
- hypertension, pre-eclampsia and eclampsia |
- low birth weight and preterm birth |
- morphological alterations and foetal disorders |
- spontaneous abortion |
- increased risk of caesarean section |
Overview of the development of new pathological conditions in pregnancy from sleep-altering physio-pathological conditions.
Sleep is a fine mechanism regulated by different factors and its alteration presents consequences for both the mother and the child. Furthermore, discomfort and frustration experienced by women may also influence their partners, who may in turn present sleep disorders. The most frequent consequences of sleep disorders during pregnancy are discussed in this section.
Sleep plays a fundamental role in learning, by influencing the development new neuronal circuits. Subsequently, sleep restriction can lead to a disruption of neuroplasticity, thus triggering some among the pathophysiological mechanisms responsible for the development of depression. The pathophysiological mechanisms underlying both sleep disorders and depression are regulated by common neurobiological systems, i.e., hyperactivity of the hypothalamic–pituitary–adrenal axis, dysfunction of serotoninergic system, and hyperactivity of noradrenergic system [25]. Indeed, these specific systems play a role in the regulation of basic emotional responses, such as fear and reward. Therefore, insomnia may compromise adequate emotional processing and may underpin a greater susceptibility to develop psychopathology, particularly anxiety and depressive symptoms and, to a lesser extent, psychosis and substance or alcohol abuse [26].
This may explain why disturbed sleep is reported in up to 90% subjects with depression and REM sleep disturbances may precede the clinical expression of depression itself, aiding the identification of individuals at high risk for developing the disease [27].
However, there are conflicting studies on the correlation between sleep disorders and depression during pregnancy. In previous reports, insomnia did not predict post-partum depression in women with no prior history of depression, as evidenced in a longitudinal study carried out in women at the 17th and 32nd week of gestation and eight weeks after childbirth. This study underlined women suffering from depression before pregnancy also reported more severe residual insomnia symptoms compared to those who scored low for depression at both times [28]. On the contrary, another study showed that poor sleep may represent a potential risk factor for depression during both the prenatal and post-partum period [29]. An Italian study reports that pregnant women with high stress-related sleep reactivity, compared to those with low reactivity, reported more symptoms of insomnia, higher rates of depression, anxiety, and suicidality [13].
Sleep disruptions can exacerbate glucose intolerance. This mechanism can explain why mothers with gestational sleep deprivation during early pregnancy may be up to 4.5 times more likely to develop gestational diabetes than other mothers [32]. Furthermore, mothers with sleep deprivation during pregnancy more frequently give birth to children with a 40% increased risk of overweight and obesity [21].
Hypertension and pre-eclampsia present an incidence of 5–10% during pregnancy and they can be identified as the main causes of maternal and perinatal morbidity and mortality [33, 34]. Sleep disturbances during pregnancy have been associated with increased gestational weight gain, which can lead to hypertension, pre-eclampsia, and eclampsia [9, 6, 17, 32]. This risk can be even higher during the last trimester, when the increase in oestrogen levels leads to an increase the development of these complications [7].
The World Health Organisation (WHO) defines low birth weight (LBW) as a birth weight under 2,500 g, very low birth weight (VLBW) as less than 1,500 g and extremely low birth weight (ELBW) as <1,000. Pre-term delivery is the main cause of perinatal morbidity and mortality. It is also the cause of 75% deaths during childbirth and represents half of long-term neonatal morbidity causes [35]. Reduced maternal sleep duration tends to be associated with lower birth weight [36]. Indeed, LBW incidence appears to be lower among sons/daughters born from women who sleep 9-9.9 hours every night, than among those women sleeping 6-7.9 hours [37]. Sleep deprivation during pregnancy is associated with longer labour during childbirth, lower pain threshold and discomfort, higher caesarean section rates, and preterm delivery [36]. These factors can result from the increase of proinflammatory cytokines, such as interleukin-6, promoting the release of prostaglandins that trigger the onset of labour, thus leading to an increased risk of preterm delivery [36]. This is particularly evident among specific populations, i.e., Afro-American women, that show a risk of pre-term birth increased by 10 times in the presence of sleep disorders when compared to those who have good sleep quality [38]. At the same time, babies who were born prematurely cause concern in new mothers, who will sleep worse and will be more susceptible to postpartum depression [38, 39]. However, further studies on the relationship between sleep and inflammatory markers are needed to better understand their actual correlations [18].
An association among maternal breathing disorders during sleep and foetal pathologies is already known, but during recent years specific foetal problems also appeared to be associated with other sleep disorders. Indeed. sleep disorders can lead to altered hormone levels, which can activate pathophysiological mechanisms that cause dysfunctions in offspring [40]. Short sleep duration is associated with an exaggerated inflammatory response, i.e., increased circulating and stimulated levels of inflammatory cytokines and sleep disturbances, particularly during the first 20 weeks of pregnancy, may contribute to the activation of inflammatory processes, also by causing stress, which represents a well-known activator of inflammation [16, 17, 18]. This hypothesis is based on
The following is a description of the most common psychiatric disorders that can be found in pregnant women. Undoubtedly, the most common disorder is insomnia [42], but other disorders such as restless legs syndrome and narcolepsy are should also be considered in order to preserve the health of both mothers and children. Respiratory disorders, such as sleep apnoea syndrome and snoring, may also be encountered during pregnancy [9]; these disorders are not of direct psychiatric interest, but can be differentially diagnosed from other sleep disorders and can sometimes be the cause for these (as in the case of insomnia) and therefore require specialist monitoring [10].
Recent classifications listed in the Diagnostic and Statistical Manual-5th Edition (DSM-5) [43] and in the International Classification of Sleep Disorder- Third Edition (ICSD-3) [44] deleted the distinction between primary and secondary insomnia (that is, dependent on other medical and mental disorders) in favour of a single diagnostic category. Insomnia is defined whether as an independent diagnostic entity or as a comorbidity of other mental, medical, and sleep disorders without the need to establish causal relationships. Spielmann et al. in 1987 proposed the diathesis-stress model of insomnia, which relies on the conceptualisation of the 3P model: predisposing, precipitating and perpetuating factors contribute to the development and maintenance of insomnia [27, 45]. Predisposing factors are already present before the onset of insomnia. Female sex, pre-menstrual syndrome, pregnancy, post-partum, and menopause may influence the risk of developing insomnia. Moreover, reduced melatonin levels, which may be inversely related to gonadotropin secretion, play a relevant role. Anyway, the main of these is represented by sleep vulnerability in response to stress, namely sleeping difficulty due to stressful precipitating stimuli [46]. Furthermore, internalisation, perfectionism, obsessive, neurotic, and dependent personality traits are other factors that may contribute to these effects [47, 48, 49]. All this explains particular sleep vulnerability in pregnancy, both because pregnancy itself is a predisposing factor, but also since stress and sex hormones interfere with sleep [16, 17, 50]. Among precipitating factors, there are mechanisms that promote higher likelihood of developing sleep disorders, thus determining the transition from pre-morbid insomnia to acute insomnia. If these disturbing factors are not eliminated, early insomnia may evolve into a chronic form. The main among these precipitating factors are: stress, health problems, pain, anxiety, mood lowering [45].
Insomnia in pregnancy has a prevalence from 5–38% of women in early pregnancy, and it is reported as high as 60% in the eight weeks before the childbirth [7, 9]. Pregnancy is a period characterised by worries, fears and doubts about the health of the baby and this can be a precipitating factor of insomnia as well. As for perpetuating factors, these are mainly represented by behavioural, cognitive and physiological factors that persist in subjects already presenting with insomnia and may lead to chronic insomnia in 80% cases, such as drinking caffeinated beverages in the evening or engaging in stressful activities while lying in bed [45, 51]. Pregnant women with predisposing factors for insomnia and some neuroendocrine alterations can develop precipitating factors, increasing both inflammation modulating factors and amplifying hypothalamic–pituitary–adrenal axis with activation of allostatic load that can cause adverse pregnancy outcomes [16, 17]. Sleep also plays a fundamental role in learning through new neuronal circuits development, and sleep restriction can thus lead to a disruption of neuroplasticity and to the development of the pathological mechanism of depression, given the correlation between the two systems. Therefore, insomnia may compromise adequate emotional processing and may predispose to greater susceptibility to the development of psychiatric symptoms, such as anxiety, depression and, to a lesser extent, psychosis and substance or alcohol abuse [26].
Insomnia in pregnancy can be differentially diagnosed with various disorders that may in turn be comorbidities, causes or consequences of insomnia. The adequate identification of insomnia, as well as other comorbidities, is crucial in order to. The conditions that may underpin differential diagnosis issues with insomnia are the following: Major Depressive Disorder (MDD); Bipolar Disorder (BD); Generalised Anxiety Disorder (GAD); Post-Traumatic Stress Disorder (PTSD); Panic Disorder (PD); Obsessive Compulsive Disorder (OCD); Obstructive Sleep Apnea-Hypopnea (OSAH
Hormonal changes are the most important factors influencing duration, quality, and physiology of sleep. The action of sex hormones in sleep could be observed in preclinical studies conducted on ovariectomised rats [52]. Steroid hormones, namely oestrogen and progesterone, increase during pregnancy with different and often complementary effects on sleep and respiratory physiology. The early increase in progesterone during the first trimester improves slow-wave sleep and activity through induction of GABA receptors. Indeed, allopregnanolone, a metabolite of progesterone, is a strong modulator of the GABA-A receptor and produces sedative and anxiolytic effects. Progesterone acts as a stimulant of the respiratory drive, as in obese women, increasing the activity of the genioglossus muscle, thereby dilating the diameter of the upper airways. Counterpart to this protective effect against obstructive sleep apnoea (OSA) may be an increased risk of central apnoea, due to hormone-induced re-setting of chemoreceptors that favours hyperventilation/hypocapnia coupling, as well as an increased pressor response to hypercapnia and apnoea [10, 23, 53, 54]. Literature shows that high levels of oestrogens promote sleep [55]. At the same time, some studies report that during the luteal phase of the menstrual cycle (the phase where progesterone levels evidently increase) some women may experience worse sleep [56, 57]. Low levels of oestradiol (E2) due, for example, to lower ovarian production, are associated with worst sleep quality and higher prevalence of insomnia [58]. Studies in rats that were administered oestradiol after sleep deprivation have shown variable results, as sleep worsened according to some authors, while according to others sleep recovery could be facilitated [59]. In postmenopausal women that were given hormone replacement therapy with oestrogen, a subjective improvement in sleep was detected, whether oestrogen was administered orally or transdermal, or when combined with progestin [60, 61]. Different results from several reports may be consequence of a different individual sleep responses to sex hormones activities [55].
For ethical reasons, investigational drugs are never tested on pregnant women and literature focused on treatments for this population is scant. However, some reports seem to provide preliminary answers. Approximately 1% of women use melatonin during pregnancy. Melatonin is not monitored by the Food and Drug Administration and therefore doses and timing of administration are not well-known or regulated yet [62, 63]. Maternal melatonin is required to synchronise foetal circadian rhythms, but an alteration in endogenous production, including external administration, could alter the amount of melatonin receptors in the foetus. In fact, clinical studies on its use during pregnancy are inconclusive and conflicting [64] Some studies show that melatonin does not cause adverse effects in the offspring and it and may have a protective activity due to its antioxidant properties. Particularly, a study conducted in 2016 showed that prenatal treatment with melatonin significantly reduced neonatal biometry and birth weight [65]. In addition, melatonin treatment increased the duration of gestation by 7.5% and shifted childbirth time, also reducing glucose tolerance and altering hormone levels [19]. Subsequently, the use of melatonin in pregnancy is currently discouraged until more reliable data are available [63]. Although there are concerns about the administration of exogenous melatonin in pregnancy and its impact on the development of circadian rhythms and reproductive function in offspring, exogenous melatonin may also have some potential protective effects on the foetus [9].
Among the drugs most safely used in pregnancy antihistamines are listed, which are used by 10-15% of pregnant women for nausea and vomiting, and which also present sedative effects, so these properties seem to be useful for insomnia treatment [10, 63]. Trazodone can also be proposed as a sedative drug during pregnancy [10, 30] since some studies exclude an association with congenital malformations, although literature is limited [42]. Sedative-hypnotics such as zolpidem have limited data on reproductive safety and therefore their use in pregnancy is limited [33]. However, benzodiazepines can be considered for treatment during pregnancy, taking into account the risk/benefit ratio [9, 42].
Insomnia can be treated both with medication and non-pharmacological treatments. Short-duration and self-limited conditions may not need to be treated, whilst if the disorders are debilitating, it is necessary to assess maternal or foetal adverse effects and impact on quality of life [9].
Pregnant women are reluctant to the assumption of drugs, due to the fear of adverse events on the foetus. For these reasons, women are willing to accept non-pharmacological treatments such as cognitive behavioural therapy (CBT), for which promising results are demonstrated [66, 67]. Further non-pharmacological interventions, such as sleep restriction, stimulus control, relaxation techniques, sleep hygiene and sleep education led to a subjective improvement in sleep quality as well as subclinical anxiety and depressive symptoms [9].
According to DSM-5, the diagnostic criteria for circadian sleep–wake rhythm disorders are: persistent or recurrent pattern of sleep disruption due mainly to an alteration of the circadian system or a mismatch between endogenous circadian rhythm and the sleep–wake rhythm required by an individual’s physical condition or imposed by social or work commitments; sleep disruption leads to excessive sleepiness, insomnia or both and sleep disruption causes clinically significant distress or impaired functioning in cognitive, social, occupational or other important areas. The prevalence of circadian rhythms disorders is about 3-10% [68].
Circadian rhythms that may be altered as consequence of sleep–wake disorders are: body temperature, physical activities, eating patterns, melatonin and glucocorticoids secretion [14]. The activation of this system occurs through the action of light, which activates photoreceptive cells in the retina that produce melanopsin and through the retino-hypothalamic tract projected to the suprachiasmatic nucleus of the hypothalamus, regulating various pathways. Alterations in circadian rhythms are known to occur in depressed patients. Indeed, this population of subjects can present abnormalities in the secretion of cortisol, TSH and melatonin, as well as increased internal body temperature at night. Furthermore, there is a clear worsening of depressive symptoms with darkness, which may be clearly evident in seasonal affective disorder, as light therapy is effective in circadian rhythms disorder and SAD [14, 69, 70]. Of particular importance is the interaction between maternal melatonin and glucocorticoid secretion and effects in the foetus [71], as melatonin has a pleiotropic biological action with consequent antioxidant, antidepressant, antihypertensive, epigenetic, and trophic effects on the foetus [72, 73]. At the same time, increased cortisol leads to elevated levels of glucocorticoids and if these are excessive could interfere with foetal tissue [74].
Pregnant women may also be affected by circadian rhythms disorders and in this case, in addition to the mood disorders mentioned above, they may present with other pathological conditions and the effects of these alterations are clearly evident in shift workers, who have a higher risk of low birth weight, spontaneous abortion and premature birth, but also a higher risk of infertility, miscarriage, pre-eclampsia [7, 14, 15]. In pregnant rats subjected to altered sleep–wake rhythms an increase of adiposity may occur, together with impaired glucose tolerance, and insulin resistance manifesting in offspring 12 months later [75].
In this care, treatment is purely non-pharmacological, based on a correct sleep/wake pattern and bright light therapy [7], but there are still doubts about the actual beneficial effects of this therapy in adult offspring; effectiveness of alternative therapies such as: phytotherapy, acupuncture, acupressure, aromatherapy, reflexology, music therapy and yoga are unknown [71].
Restless legs syndrome (RLS) or Willis-Ekbom disease is a motor-sensory disorder of the lower limbs associated with increased likelihood of sleep–wake disorders, such as poor sleep, poor daytime function and excessive daytime sleepiness in pregnancy. This condition is almost twice as common in women as in men, but reasons for this imbalance in prevalence are not precisely understood [76]. Indeed, the first known epidemiological study of RLS during pregnancy reported a prevalence of 11.3%, but in the third trimester prevalence appeared to rise up to 30%. Pregnancy is a cause of a transitory form of the syndrome, but after several pregnancies it can also become persistent [10].
The main mechanism involved in the pathogenesis of restless legs syndrome is a dysregulation of the dopaminergic system, so a reduction in the absorption of this neurotransmitter favours the development of the disease. In general, pathogenetic factors facilitating the appearance of RLS during pregnancy appear to be:
In pregnancy, a correct treatment for RLS can be iron supplementation when needed. Other pharmacological agents, such as clonazepam, clonidine, and opioids may be needed in severe conditions, despite there is a high risk of neonatal withdrawal with these drugs [9, 18]. Non-pharmacological treatments that can be used in pregnant women with RLS are physical exercise and behavioural strategies, such as reduced caffeine intake [76].
Narcolepsy is a sleep disorder characterised by excessive sleepiness, associated with cataplexy, sleep paralysis, and hypnagogic hallucinations [79]. The prevalence of narcolepsy in the general population is 14/1,000 inhabitants and in pregnant women a similar prevalence can be described. Under a pathogenetic point of view, narcolepsy is the result of an alteration of the nuclei of the reticular system (SRA) that promote wakefulness [7, 80].
Narcolepsy in pregnancy causes adverse effects such as excessive maternal weight gain and gestational diabetes, whilst cataplexy contributes to a higher risk of emergency caesarean section [9].
Narcolepsy is less common in pregnancy than other sleep disorders, but is more difficult to manage during pregnancy and in the perinatal period, also due to possible adverse effects of the drugs that may be used. In fact, amphetamines can cause low birth weight and increased risk of miscarriage is reported in women using sodium oxybate [7, 9, 81]. Data on the safety of selective serotonin reuptake inhibitors are conflicting, since there are not significant association with birth defects with use of fluoxetine, but it may contribute to transient neonatal complications during the third-trimester and to risk of social-behavioural abnormalities in childhood [82]. Subsequently, non-pharmacological treatment options are recommended, such as avoiding drugs can cause daytime sleepiness, intermittent napping and practising good sleep hygiene [9] (See Table 2).
Disorder | Prevalence | Risk factors | Clinical features | Drug treatments | Non-pharmacological treatments |
---|---|---|---|---|---|
Insomnia | 5–38% of women in early pregnancy, 60% in the eight weeks before childbirth |
|
|
|
|
Restless legs syndrome | 11.3% (up to 30% in third trimester) |
|
|
|
|
Disorders of circadian rhythms in pregnancy | 3-10% |
|
|
|
|
Narcolepsy | 14/10000 (such as general population) |
|
|
|
|
Summary of major sleep disorders during pregnancy.
According to Immanuel Kant, ‘Heaven has given man three things to compensate for the difficulties of life: hope, sleep and a smile’. Indeed, hope and a smile can also be a consequence of satisfactory sleep, especially during pregnancy, but physical changes and conflicting emotions during this period can at the same time alter sleep patterns. Paying attention to sleep disorders during pregnancy could prevent the development of serious health consequences both for the health of mother and child. Identifying sleep disorders also encourages their adequate and early treatment, thus preventing the development of general symptoms such as asthenia, irritability, and emotional lability, or more serious psychiatric disorders, such as depression, mania and psychosis. At the same time, a multidisciplinary approach to sleep disorders in pregnancy is required. Indeed, the cooperation of psychiatrists, neurologists, gynaecologists, and psychologists may allow a improved sleep quality and increase overall well-being of women, children, and their family.
IntechOpen - where academia and industry create content with global impact
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\\n\\nBut, one thing we have in common is -- we are all scientists at heart!
\\n\\nSara Uhac, COO
\\n\\nSara Uhac was appointed Managing Director of IntechOpen at the beginning of 2014. She directs and controls the company’s operations. Sara joined IntechOpen in 2010 as Head of Journal Publishing, a new strategically underdeveloped department at that time. After obtaining a Master's degree in Media Management, she completed her Ph.D. at the University of Lugano, Switzerland. She holds a BA in Financial Market Management from the Bocconi University in Milan, Italy, where she started her career in the American publishing house Condé Nast and further collaborated with the UK-based publishing company Time Out. Sara was awarded a professional degree in Publishing from Yale University (2012). She is a member of the professional branch association of "Publishers, Designers and Graphic Artists" at the Croatian Chamber of Commerce.
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\\n\\nAdrian Assad De Marco joined the company as a Director in 2017. With his extensive experience in management, acquired while working for regional and global leaders, he took over direction and control of all the company's publishing processes. Adrian holds a degree in Economy and Management from the University of Zagreb, School of Economics, Croatia. A former sportsman, he continually strives to develop his skills through professional courses and specializations such as NLP (Neuro-linguistic programming).
\\n\\nDr Alex Lazinica
\\n\\nAlex Lazinica is co-founder and Board member of IntechOpen. After obtaining a Master's degree in Mechanical Engineering, he continued his Ph.D. in Robotics at the Vienna University of Technology. There, he worked as a robotics researcher with the university's Intelligent Manufacturing Systems Group, as well as a guest researcher at various European universities, including the Swiss Federal Institute of Technology Lausanne (EPFL). During this time he published more than 20 scientific papers, gave presentations, served as a reviewer for major robotic journals and conferences and, most importantly, co-founded and built the International Journal of Advanced Robotic Systems, the world's first Open Access journal in the field of robotics. Starting this journal was a pivotal point in his career since it proved to be the pathway to the foundation of IntechOpen with its focus on addressing academic researchers’ needs. Alex personifies many of IntechOpen´s key values, including the commitment to developing mutual trust, openness, and a spirit of entrepreneurialism. Today, his focus is on defining the growth and development strategy for the company.
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\n\nBut, one thing we have in common is -- we are all scientists at heart!
\n\nSara Uhac, COO
\n\nSara Uhac was appointed Managing Director of IntechOpen at the beginning of 2014. She directs and controls the company’s operations. Sara joined IntechOpen in 2010 as Head of Journal Publishing, a new strategically underdeveloped department at that time. After obtaining a Master's degree in Media Management, she completed her Ph.D. at the University of Lugano, Switzerland. She holds a BA in Financial Market Management from the Bocconi University in Milan, Italy, where she started her career in the American publishing house Condé Nast and further collaborated with the UK-based publishing company Time Out. Sara was awarded a professional degree in Publishing from Yale University (2012). She is a member of the professional branch association of "Publishers, Designers and Graphic Artists" at the Croatian Chamber of Commerce.
\n\nAdrian Assad De Marco
\n\nAdrian Assad De Marco joined the company as a Director in 2017. With his extensive experience in management, acquired while working for regional and global leaders, he took over direction and control of all the company's publishing processes. Adrian holds a degree in Economy and Management from the University of Zagreb, School of Economics, Croatia. A former sportsman, he continually strives to develop his skills through professional courses and specializations such as NLP (Neuro-linguistic programming).
\n\nDr Alex Lazinica
\n\nAlex Lazinica is co-founder and Board member of IntechOpen. After obtaining a Master's degree in Mechanical Engineering, he continued his Ph.D. in Robotics at the Vienna University of Technology. There, he worked as a robotics researcher with the university's Intelligent Manufacturing Systems Group, as well as a guest researcher at various European universities, including the Swiss Federal Institute of Technology Lausanne (EPFL). During this time he published more than 20 scientific papers, gave presentations, served as a reviewer for major robotic journals and conferences and, most importantly, co-founded and built the International Journal of Advanced Robotic Systems, the world's first Open Access journal in the field of robotics. Starting this journal was a pivotal point in his career since it proved to be the pathway to the foundation of IntechOpen with its focus on addressing academic researchers’ needs. Alex personifies many of IntechOpen´s key values, including the commitment to developing mutual trust, openness, and a spirit of entrepreneurialism. Today, his focus is on defining the growth and development strategy for the company.
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On September, 29th 2006 he has won a post PhD fellowship from the university of Bologna (from October 2006 to October 2008), at the competitive examination he was ranked first in the industrial engineering area. He extensively served as referee for several international journals. He is author/coauthor of more than 100 research papers. He has been involved in some projects supported by MURST and European Community. 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From 1985 to 1986, he was a Research Fellow in the Research Institute for Electronic Equipment, ZZU AD, Plovdiv, Bulgaria. In 1986, he joined the Department of Control Systems, Technical University of Sofia at the Plovdiv campus, where he is presently a Full Professor. He has held long-term visiting Professor/Scholar positions at various institutions in South Korea, Turkey, Mexico, Greece, Belgium, UK, and Germany. And he has coauthored one book and authored or coauthored more than 80 research papers in conference proceedings and journals. His current research interests are in the fields of intelligent control and robotics.",institutionString:null,institution:{name:"Technical University of Sofia",country:{name:"Bulgaria"}}},{id:"585",title:"Prof.",name:"Munir",middleName:null,surname:"Merdan",slug:"munir-merdan",fullName:"Munir Merdan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/585/images/system/585.jpg",biography:"Munir Merdan received the M.Sc. degree in mechanical engineering from the Technical University of Sarajevo, Bosnia and Herzegovina, in 2001, and the Ph.D. degree in electrical engineering from the Vienna University of Technology, Vienna, Austria, in 2009.Since 2005, he has been at the Automation and Control Institute, Vienna University of Technology, where he is currently a Senior Researcher. His research interests include the application of agent technology for achieving agile control in the manufacturing environment.",institutionString:null,institution:null},{id:"605",title:"Prof",name:"Dil",middleName:null,surname:"Hussain",slug:"dil-hussain",fullName:"Dil Hussain",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/605/images/system/605.jpg",biography:"Dr. Dil Muhammad Akbar Hussain is a professor of Electronics Engineering & Computer Science at the Department of Energy Technology, Aalborg University Denmark. Professor Akbar has a Master degree in Digital Electronics from Govt. College University, Lahore Pakistan and a P-hD degree in Control Engineering from the School of Engineering and Applied Sciences, University of Sussex United Kingdom. Aalborg University has Two Satellite Campuses, one in Copenhagen (Aalborg University Copenhagen) and the other in Esbjerg (Aalborg University Esbjerg).\n· He is a member of prestigious IEEE (Institute of Electrical and Electronics Engineers), and IAENG (International Association of Engineers) organizations. \n· He is the chief Editor of the Journal of Software Engineering.\n· He is the member of the Editorial Board of International Journal of Computer Science and Software Technology (IJCSST) and International Journal of Computer Engineering and Information Technology. \n· He is also the Editor of Communication in Computer and Information Science CCIS-20 by Springer.\n· Reviewer For Many Conferences\nHe is the lead person in making collaboration agreements between Aalborg University and many universities of Pakistan, for which the MOU’s (Memorandum of Understanding) have been signed.\nProfessor Akbar is working in Academia since 1990, he started his career as a Lab demonstrator/TA at the University of Sussex. After finishing his P. hD degree in 1992, he served in the Industry as a Scientific Officer and continued his academic career as a visiting scholar for a number of educational institutions. In 1996 he joined National University of Science & Technology Pakistan (NUST) as an Associate Professor; NUST is one of the top few universities in Pakistan. In 1999 he joined an International Company Lineo Inc, Canada as Manager Compiler Group, where he headed the group for developing Compiler Tool Chain and Porting of Operating Systems for the BLACKfin processor. The processor development was a joint venture by Intel and Analog Devices. In 2002 Lineo Inc., was taken over by another company, so he joined Aalborg University Denmark as an Assistant Professor.\nProfessor Akbar has truly a multi-disciplined career and he continued his legacy and making progress in many areas of his interests both in teaching and research. 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These physiological events occur smoothly in normal healthy individual and/or under normal conditions. However, in certain cases, these molecular events are retarded resulting in hard-to-heal or chronic wounds arising from several factors such as poor venous return, underlying physiological or metabolic conditions such as diabetes as well as external factors such as poor nutrition. In most cases, such wounds are infected and infection also presents as another complicating phenomenon which triggers inflammatory reactions, therefore delaying wound healing. There has therefore been recent interests and significant efforts in preventing and actively treating wound infections by directly targeting infection causative agents through direct application of antimicrobial agents either alone or loaded into dressings (medicated). These have the advantage of overcoming challenges such as poor circulation in diabetic and leg ulcers when administered systemically and also require lower amounts to be applied compared to that required via oral or iv administration. This chapter will review and evaluate various antimicrobial agents used to target infected wounds, the means of delivery, and current state of the art, including commercially available dressings. Data sources will include mainly peer-reviewed literature, clinical trials and reports, patents as well as government reports where available.",book:{id:"5290",slug:"wound-healing-new-insights-into-ancient-challenges",title:"Wound Healing",fullTitle:"Wound Healing - New insights into Ancient Challenges"},signatures:"Omar Sarheed, Asif Ahmed, Douha Shouqair and Joshua Boateng",authors:[{id:"183108",title:"Dr.",name:"Joshua",middleName:null,surname:"Boateng",slug:"joshua-boateng",fullName:"Joshua Boateng"},{id:"183399",title:"Dr.",name:"Omar",middleName:null,surname:"Sarheed",slug:"omar-sarheed",fullName:"Omar Sarheed"},{id:"188082",title:"Mr.",name:"Asif",middleName:null,surname:"Ahmed",slug:"asif-ahmed",fullName:"Asif Ahmed"},{id:"188083",title:"Ms.",name:"Douha",middleName:null,surname:"Shouqair",slug:"douha-shouqair",fullName:"Douha Shouqair"}]},{id:"51825",doi:"10.5772/64611",title:"Roles of Matrix Metalloproteinases in Cutaneous Wound Healing",slug:"roles-of-matrix-metalloproteinases-in-cutaneous-wound-healing",totalDownloads:3600,totalCrossrefCites:18,totalDimensionsCites:36,abstract:"Wound healing is a complex process that consists of hemostasis and inflammation, angiogenesis, re-epithelialization, and tissue remodeling. Matrix metalloproteinases (MMPs) play important roles in wound healing, and their dysregulation leads to prolonged inflammation and delayed wound healing. There are 24 MMPs in humans, and each MMP exists in three forms, of which only the active MMPs play a role in the pathology or repair of wounds. The current methodology does not distinguish between the three forms of MMPs, making it challenging to investigate the roles of MMPs in pathology and wound repair. We used a novel MMP-inhibitor-tethered affinity resin that binds only the active form of MMPs, from which we identified and quantified active MMP-8 and active MMP-9 in a murine diabetic model with delayed wound healing. We showed that up-regulation of active MMP-9 plays a detrimental role whereas active MMP-8 is involved in repairing the wound in diabetic mice. These studies identified MMP-9 as a novel target for therapeutic intervention in the treatment of chronic wounds. A selective inhibitor of MMP-9 that leaves MMP-8 unaffected would provide the most effective therapy and represents a promising strategy for therapeutic intervention in the treatment of diabetic foot ulcers.",book:{id:"5290",slug:"wound-healing-new-insights-into-ancient-challenges",title:"Wound Healing",fullTitle:"Wound Healing - New insights into Ancient Challenges"},signatures:"Trung T. Nguyen, Shahriar Mobashery and Mayland Chang",authors:[{id:"183405",title:"Prof.",name:"Mayland",middleName:null,surname:"Chang",slug:"mayland-chang",fullName:"Mayland Chang"},{id:"191152",title:"Mr.",name:"Trung",middleName:null,surname:"Nguyen",slug:"trung-nguyen",fullName:"Trung Nguyen"},{id:"191153",title:"Prof.",name:"Shahriar",middleName:null,surname:"Mobashery",slug:"shahriar-mobashery",fullName:"Shahriar Mobashery"}]},{id:"63675",doi:"10.5772/intechopen.81208",title:"Wound Healing: Contributions from Plant Secondary Metabolite Antioxidants",slug:"wound-healing-contributions-from-plant-secondary-metabolite-antioxidants",totalDownloads:1311,totalCrossrefCites:7,totalDimensionsCites:20,abstract:"Plants by their genetic makeup possess an innate ability to synthesize a wide variety of phytochemicals that help them to perform their normal physiological functions and/or to protect themselves from microbial pathogens and animal herbivores. The synthesis of these phytochemicals presents the plants their natural tendency to respond to environmental stress conditions. These phytochemicals are classified either as primary or secondary metabolites. The secondary metabolites have been identified in plants as alkaloids, terpenoids, phenolics, anthraquinones, and triterpenes. These plant-based compounds are believed to have diverse medicinal properties including antioxidant properties. Plants have therefore been a potential source of antioxidants which have received a great deal of attention since increased oxidative stress has been identified as a major causative factor in the development and progression of several life-threatening diseases, including neurodegenerative and cardiovascular diseases and wound infection. Consequently, many medicinal plants have been cited and known to effect wound healing and antioxidant properties. This chapter briefly reviews antioxidant properties of medicinal plants to highlight the important roles medicinal plants play in wound healing.",book:{id:"7046",slug:"wound-healing-current-perspectives",title:"Wound Healing",fullTitle:"Wound Healing - Current Perspectives"},signatures:"Victor Y.A. Barku",authors:[{id:"261027",title:"Prof.",name:"Victor Y. A.",middleName:null,surname:"Barku",slug:"victor-y.-a.-barku",fullName:"Victor Y. A. Barku"}]},{id:"66793",doi:"10.5772/intechopen.85020",title:"The Impact of Biofilm Formation on Wound Healing",slug:"the-impact-of-biofilm-formation-on-wound-healing",totalDownloads:1411,totalCrossrefCites:7,totalDimensionsCites:15,abstract:"Chronic wounds represent an important challenge for wound care and are universally colonized by bacteria. These bacteria can form biofilm as a survival mechanism that confers the ability to resist environmental stressors and antimicrobials due to a variety of reasons, including low metabolic activity. Additionally, the exopolymeric substance (EPS) contained in biofilm acts as a mechanical barrier to immune system cells, leading to collateral damage in the surrounding tissue as well as chronic inflammation, which eventually will delay healing of the wound. This chapter will discuss current knowledge on biofilm formation, its presence in acute and chronic wounds, how biofilm affects antibiotic resistance and tolerance, as well as the wound healing process. We will also discuss proposed methods to eliminate biofilm and improve wound healing despite its presence, including basic science and clinical studies regarding these matters.",book:{id:"7046",slug:"wound-healing-current-perspectives",title:"Wound Healing",fullTitle:"Wound Healing - Current Perspectives"},signatures:"Rafael A. Mendoza, Ji-Cheng Hsieh and Robert D. Galiano",authors:[{id:"253607",title:"M.D.",name:"Rafael",middleName:null,surname:"Mendoza",slug:"rafael-mendoza",fullName:"Rafael Mendoza"},{id:"254018",title:"Dr.",name:"Robert",middleName:null,surname:"Galiano",slug:"robert-galiano",fullName:"Robert Galiano"},{id:"271116",title:"Mr.",name:"Ji-Cheng",middleName:null,surname:"Hsieh",slug:"ji-cheng-hsieh",fullName:"Ji-Cheng Hsieh"}]},{id:"63086",doi:"10.5772/intechopen.80215",title:"Medicinal Plants in Wound Healing",slug:"medicinal-plants-in-wound-healing",totalDownloads:2853,totalCrossrefCites:7,totalDimensionsCites:13,abstract:"Wound healing process is known as interdependent cellular and biochemical stages which are in trying to improve the wound. Wound healing can be defined as stages which is done by body and delayed in wound healing increases chance of microbial infection. Improved wound healing process can be performed by shortening the time needed for healing or lowering the inappropriate happens. The drugs were locally or systemically administrated in order to help wound healing. Antibiotics, antiseptics, desloughing agents, extracts, etc. have been used in order to wound healing. Some synthetic drugs are faced with limitations because of their side effects. Plants or combinations derived from plants are needed to investigate identify and formulate for treatment and management of wound healing. There is increasing interest to use the medicinal plants in wound healing because of lower side effects and management of wounds over the years. Studies have shown that medicinal plants improve wound healing in diabetic, infected and opened wounds. The different mechanisms have been reported to improve the wound healing by medicinal plants. In this chapter, some medicinal plants and the reported mechanisms will be discussed.",book:{id:"7046",slug:"wound-healing-current-perspectives",title:"Wound Healing",fullTitle:"Wound Healing - Current Perspectives"},signatures:"Mohammad Reza Farahpour",authors:[{id:"253340",title:"Prof.",name:"Mohammadreza",middleName:null,surname:"Farahpour",slug:"mohammadreza-farahpour",fullName:"Mohammadreza Farahpour"}]}],mostDownloadedChaptersLast30Days:[{id:"55736",title:"Haemodynamic Monitoring in the Intensive Care Unit",slug:"haemodynamic-monitoring-in-the-intensive-care-unit",totalDownloads:3316,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"Monitoring is a cognitive aid that allows clinicians to detect the nature and extent of pathology and helps assessment of response to therapy. The cardiovascular system is the most commonly monitored organ system in the critical care setting. It helps identify the presence and nature of shock and guides response to resuscitation by detection of cardiac rate and rhythm, evaluation of volume state, cardiac contractility and systemic vascular resistance. Newer technologies allow greater assessment of oxygen delivery to vulnerable tissues. We discuss the nature, history, modalities and interpretation of the most commonly available haemodynamic monitoring methods in clinical use currently.",book:{id:"5756",slug:"intensive-care",title:"Intensive Care",fullTitle:"Intensive Care"},signatures:"Mainak Majumdar",authors:[{id:"86678",title:"Dr.",name:"Mainak",middleName:null,surname:"Majumdar",slug:"mainak-majumdar",fullName:"Mainak Majumdar"}]},{id:"51825",title:"Roles of Matrix Metalloproteinases in Cutaneous Wound Healing",slug:"roles-of-matrix-metalloproteinases-in-cutaneous-wound-healing",totalDownloads:3598,totalCrossrefCites:17,totalDimensionsCites:35,abstract:"Wound healing is a complex process that consists of hemostasis and inflammation, angiogenesis, re-epithelialization, and tissue remodeling. Matrix metalloproteinases (MMPs) play important roles in wound healing, and their dysregulation leads to prolonged inflammation and delayed wound healing. There are 24 MMPs in humans, and each MMP exists in three forms, of which only the active MMPs play a role in the pathology or repair of wounds. The current methodology does not distinguish between the three forms of MMPs, making it challenging to investigate the roles of MMPs in pathology and wound repair. We used a novel MMP-inhibitor-tethered affinity resin that binds only the active form of MMPs, from which we identified and quantified active MMP-8 and active MMP-9 in a murine diabetic model with delayed wound healing. We showed that up-regulation of active MMP-9 plays a detrimental role whereas active MMP-8 is involved in repairing the wound in diabetic mice. These studies identified MMP-9 as a novel target for therapeutic intervention in the treatment of chronic wounds. A selective inhibitor of MMP-9 that leaves MMP-8 unaffected would provide the most effective therapy and represents a promising strategy for therapeutic intervention in the treatment of diabetic foot ulcers.",book:{id:"5290",slug:"wound-healing-new-insights-into-ancient-challenges",title:"Wound Healing",fullTitle:"Wound Healing - New insights into Ancient Challenges"},signatures:"Trung T. Nguyen, Shahriar Mobashery and Mayland Chang",authors:[{id:"183405",title:"Prof.",name:"Mayland",middleName:null,surname:"Chang",slug:"mayland-chang",fullName:"Mayland Chang"},{id:"191152",title:"Mr.",name:"Trung",middleName:null,surname:"Nguyen",slug:"trung-nguyen",fullName:"Trung Nguyen"},{id:"191153",title:"Prof.",name:"Shahriar",middleName:null,surname:"Mobashery",slug:"shahriar-mobashery",fullName:"Shahriar Mobashery"}]},{id:"63086",title:"Medicinal Plants in Wound Healing",slug:"medicinal-plants-in-wound-healing",totalDownloads:2845,totalCrossrefCites:7,totalDimensionsCites:13,abstract:"Wound healing process is known as interdependent cellular and biochemical stages which are in trying to improve the wound. Wound healing can be defined as stages which is done by body and delayed in wound healing increases chance of microbial infection. Improved wound healing process can be performed by shortening the time needed for healing or lowering the inappropriate happens. The drugs were locally or systemically administrated in order to help wound healing. Antibiotics, antiseptics, desloughing agents, extracts, etc. have been used in order to wound healing. Some synthetic drugs are faced with limitations because of their side effects. Plants or combinations derived from plants are needed to investigate identify and formulate for treatment and management of wound healing. There is increasing interest to use the medicinal plants in wound healing because of lower side effects and management of wounds over the years. Studies have shown that medicinal plants improve wound healing in diabetic, infected and opened wounds. The different mechanisms have been reported to improve the wound healing by medicinal plants. In this chapter, some medicinal plants and the reported mechanisms will be discussed.",book:{id:"7046",slug:"wound-healing-current-perspectives",title:"Wound Healing",fullTitle:"Wound Healing - Current Perspectives"},signatures:"Mohammad Reza Farahpour",authors:[{id:"253340",title:"Prof.",name:"Mohammadreza",middleName:null,surname:"Farahpour",slug:"mohammadreza-farahpour",fullName:"Mohammadreza Farahpour"}]},{id:"67217",title:"Nursing Implications in the ECMO Patient",slug:"nursing-implications-in-the-ecmo-patient",totalDownloads:2496,totalCrossrefCites:3,totalDimensionsCites:3,abstract:"Effective care and positive outcomes of the extracorporeal membrane oxygenation (ECMO) patient necessitate optimal interdisciplinary management from the healthcare team, including expert care from specially trained registered nurses (RNs). It is incumbent upon the RN caring for the ECMO patient to excel in both time management and assessment skills, as this population often demands care delivery at the pinnacle of intensive care unit (ICU) acuity. Astute and nuanced monitoring of neurological status, bleeding risk with potential (often massive) transfusions, poor hemodynamics, and integrity of the ECMO pump itself are only the few specialized areas of focus that must share priority with traditional nursing considerations involving the critically ill, such as prevention of pressure injuries and bloodstream infections. These high-intensity medical foci must be balanced with ethical considerations, as the ultimate goal of returning the patient to their normal life is not always possible. These demands highlight the dynamic proficiency of the RN caring for the ECMO patient. The following chapter will highlight the importance of specialized nursing care in the critically ill patient supported with ECMO.",book:{id:"7878",slug:"advances-in-extracorporeal-membrane-oxygenation-volume-3",title:"Advances in Extracorporeal Membrane Oxygenation",fullTitle:"Advances in Extracorporeal Membrane Oxygenation - Volume 3"},signatures:"Alex Botsch, Elizabeth Protain, Amanda R. Smith and Ryan Szilagyi",authors:[{id:"298623",title:"Mr.",name:"Alexander",middleName:null,surname:"Botsch",slug:"alexander-botsch",fullName:"Alexander Botsch"}]},{id:"66239",title:"Echocardiography Evaluation in ECMO Patients",slug:"echocardiography-evaluation-in-ecmo-patients",totalDownloads:2145,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Extracorporeal membrane oxygenation (ECMO) is a special form of organ support for selected cases of cardiovascular and severe respiratory failure. Echocardiography is a diagnostic and monitoring tool widely used in all aspects of ECMO support. The pathophysiology of ECMO, and its distinct effects on cardiorespiratory physiology, requires an echocardiographer with high skills to understand the interaction between the ECMO and the patient. In this chapter, we present the main application of echocardiography in ECMO patients and some general concepts on the ECMO working. ECMO, such as the standard cardiopulmonary bypass employed in cardiac surgery, V-V (veno-venous), can support the insufficient respiratory system by oxygenating and removing carbon dioxide from the blood. VA-ECMO (venous-arterial) can support haemodynamics by providing mechanical circulatory assistance. Today, ECMO can be used as bridge to decision, waiting for the development of the clinical conditions to support with other devices the evolution of cardiorespiratory failure or stop the assistance. Echocardiography (transthoracic (TTE) or transoesophageal (TOE)) can be used primarily to take decisions regarding appropriateness of ECMO support, therefore to control cannula insertion and confirm final position, to modify number and position of the cannulae in case of malfunctioning of these, and, finally, to assess clinical progress and suitability for weaning from ECMO.",book:{id:"7878",slug:"advances-in-extracorporeal-membrane-oxygenation-volume-3",title:"Advances in Extracorporeal Membrane Oxygenation",fullTitle:"Advances in Extracorporeal Membrane Oxygenation - Volume 3"},signatures:"Luigi Tritapepe, Ernesto Greco and Carlo Gaudio",authors:[{id:"284893",title:"Prof.",name:"Luigi",middleName:null,surname:"Tritapepe",slug:"luigi-tritapepe",fullName:"Luigi Tritapepe"},{id:"294005",title:"Prof.",name:"Ernesto",middleName:null,surname:"Greco",slug:"ernesto-greco",fullName:"Ernesto Greco"},{id:"294006",title:"Prof.",name:"Carlo",middleName:null,surname:"Gaudio",slug:"carlo-gaudio",fullName:"Carlo Gaudio"}]}],onlineFirstChaptersFilter:{topicId:"173",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:89,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:104,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:32,numberOfPublishedChapters:318,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:12,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:141,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:133,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:113,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:107,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:19,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:5,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:15,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}},{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}}]},series:{item:{id:"11",title:"Biochemistry",doi:"10.5772/intechopen.72877",issn:"2632-0983",scope:"Biochemistry, the study of chemical transformations occurring within living organisms, impacts all areas of life sciences, from molecular crystallography and genetics to ecology, medicine, and population biology. Biochemistry examines macromolecules - proteins, nucleic acids, carbohydrates, and lipids – and their building blocks, structures, functions, and interactions. Much of biochemistry is devoted to enzymes, proteins that catalyze chemical reactions, enzyme structures, mechanisms of action and their roles within cells. Biochemistry also studies small signaling molecules, coenzymes, inhibitors, vitamins, and hormones, which play roles in life processes. Biochemical experimentation, besides coopting classical chemistry methods, e.g., chromatography, adopted new techniques, e.g., X-ray diffraction, electron microscopy, NMR, radioisotopes, and developed sophisticated microbial genetic tools, e.g., auxotroph mutants and their revertants, fermentation, etc. More recently, biochemistry embraced the ‘big data’ omics systems. Initial biochemical studies have been exclusively analytic: dissecting, purifying, and examining individual components of a biological system; in the apt words of Efraim Racker (1913 –1991), “Don’t waste clean thinking on dirty enzymes.” Today, however, biochemistry is becoming more agglomerative and comprehensive, setting out to integrate and describe entirely particular biological systems. The ‘big data’ metabolomics can define the complement of small molecules, e.g., in a soil or biofilm sample; proteomics can distinguish all the comprising proteins, e.g., serum; metagenomics can identify all the genes in a complex environment, e.g., the bovine rumen. This Biochemistry Series will address the current research on biomolecules and the emerging trends with great promise.",coverUrl:"https://cdn.intechopen.com/series/covers/11.jpg",latestPublicationDate:"June 29th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:32,editor:{id:"31610",title:"Dr.",name:"Miroslav",middleName:null,surname:"Blumenberg",slug:"miroslav-blumenberg",fullName:"Miroslav Blumenberg",profilePictureURL:"https://mts.intechopen.com/storage/users/31610/images/system/31610.jpg",biography:"Miroslav Blumenberg, Ph.D., was born in Subotica and received his BSc in Belgrade, Yugoslavia. He completed his Ph.D. at MIT in Organic Chemistry; he followed up his Ph.D. with two postdoctoral study periods at Stanford University. Since 1983, he has been a faculty member of the RO Perelman Department of Dermatology, NYU School of Medicine, where he is codirector of a training grant in cutaneous biology. Dr. Blumenberg’s research is focused on the epidermis, expression of keratin genes, transcription profiling, keratinocyte differentiation, inflammatory diseases and cancers, and most recently the effects of the microbiome on the skin. He has published more than 100 peer-reviewed research articles and graduated numerous Ph.D. and postdoctoral students.",institutionString:null,institution:{name:"New York University Langone Medical Center",institutionURL:null,country:{name:"United States of America"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:3,paginationItems:[{id:"7",title:"Bioinformatics and Medical Informatics",coverUrl:"https://cdn.intechopen.com/series_topics/covers/7.jpg",isOpenForSubmission:!0,editor:{id:"351533",title:"Dr.",name:"Slawomir",middleName:null,surname:"Wilczynski",slug:"slawomir-wilczynski",fullName:"Slawomir Wilczynski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035U1loQAC/Profile_Picture_1630074514792",biography:"Professor Sławomir Wilczyński, Head of the Chair of Department of Basic Biomedical Sciences, Faculty of Pharmaceutical Sciences, Medical University of Silesia in Katowice, Poland. His research interests are focused on modern imaging methods used in medicine and pharmacy, including in particular hyperspectral imaging, dynamic thermovision analysis, high-resolution ultrasound, as well as other techniques such as EPR, NMR and hemispheric directional reflectance. Author of over 100 scientific works, patents and industrial designs. Expert of the Polish National Center for Research and Development, Member of the Investment Committee in the Bridge Alfa NCBiR program, expert of the Polish Ministry of Funds and Regional Policy, Polish Medical Research Agency. Editor-in-chief of the journal in the field of aesthetic medicine and dermatology - Aesthetica.",institutionString:null,institution:{name:"Medical University of Silesia",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null},{id:"8",title:"Bioinspired Technology and Biomechanics",coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",isOpenForSubmission:!0,editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",slug:"adriano-andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",biography:"Dr. Adriano de Oliveira Andrade graduated in Electrical Engineering at the Federal University of Goiás (Brazil) in 1997. He received his MSc and PhD in Biomedical Engineering respectively from the Federal University of Uberlândia (UFU, Brazil) in 2000 and from the University of Reading (UK) in 2005. He completed a one-year Post-Doctoral Fellowship awarded by the DFAIT (Foreign Affairs and International Trade Canada) at the Institute of Biomedical Engineering of the University of New Brunswick (Canada) in 2010. Currently, he is Professor in the Faculty of Electrical Engineering (UFU). He has authored and co-authored more than 200 peer-reviewed publications in Biomedical Engineering. He has been a researcher of The National Council for Scientific and Technological Development (CNPq-Brazil) since 2009. He has served as an ad-hoc consultant for CNPq, CAPES (Coordination for the Improvement of Higher Education Personnel), FINEP (Brazilian Innovation Agency), and other funding bodies on several occasions. He was the Secretary of the Brazilian Society of Biomedical Engineering (SBEB) from 2015 to 2016, President of SBEB (2017-2018) and Vice-President of SBEB (2019-2020). He was the head of the undergraduate program in Biomedical Engineering of the Federal University of Uberlândia (2015 - June/2019) and the head of the Centre for Innovation and Technology Assessment in Health (NIATS/UFU) since 2010. He is the head of the Postgraduate Program in Biomedical Engineering (UFU, July/2019 - to date). He was the secretary of the Parkinson's Disease Association of Uberlândia (2018-2019). Dr. Andrade's primary area of research is focused towards getting information from the neuromuscular system to understand its strategies of organization, adaptation and controlling in the context of motor neuron diseases. His research interests include Biomedical Signal Processing and Modelling, Assistive Technology, Rehabilitation Engineering, Neuroengineering and Parkinson's Disease.",institutionString:null,institution:{name:"Federal University of Uberlândia",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null},{id:"9",title:"Biotechnology - Biosensors, Biomaterials and Tissue Engineering",coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",isOpenForSubmission:!0,editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",slug:"luis-villarreal-gomez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",biography:"Dr. Luis Villarreal is a research professor from the Facultad de Ciencias de la Ingeniería y Tecnología, Universidad Autónoma de Baja California, Tijuana, Baja California, México. Dr. Villarreal is the editor in chief and founder of the Revista de Ciencias Tecnológicas (RECIT) (https://recit.uabc.mx/) and is a member of several editorial and reviewer boards for numerous international journals. He has published more than thirty international papers and reviewed more than ninety-two manuscripts. His research interests include biomaterials, nanomaterials, bioengineering, biosensors, drug delivery systems, and tissue engineering.",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null}]},overviewPageOFChapters:{paginationCount:23,paginationItems:[{id:"82392",title:"Nanomaterials as Novel Biomarkers for Cancer Nanotheranostics: State of the Art",doi:"10.5772/intechopen.105700",signatures:"Hao Yu, Zhihai Han, Cunrong Chen and Leisheng Zhang",slug:"nanomaterials-as-novel-biomarkers-for-cancer-nanotheranostics-state-of-the-art",totalDownloads:22,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Biotechnology - Biosensors, Biomaterials and Tissue Engineering - Annual Volume 2022",coverURL:"https://cdn.intechopen.com/books/images_new/11405.jpg",subseries:{id:"9",title:"Biotechnology - Biosensors, Biomaterials and Tissue Engineering"}}},{id:"82184",title:"Biological Sensing Using Infrared SPR Devices Based on ZnO",doi:"10.5772/intechopen.104562",signatures:"Hiroaki Matsui",slug:"biological-sensing-using-infrared-spr-devices-based-on-zno",totalDownloads:4,totalCrossrefCites:0,totalDimensionsCites:0,authors:[{name:"Hiroaki",surname:"Matsui"}],book:{title:"Biosignal Processing",coverURL:"https://cdn.intechopen.com/books/images_new/11153.jpg",subseries:{id:"7",title:"Bioinformatics and Medical Informatics"}}},{id:"82122",title:"Recent Advances in Biosensing in Tissue Engineering and Regenerative Medicine",doi:"10.5772/intechopen.104922",signatures:"Alma T. Banigo, Chigozie A. Nnadiekwe and Emmanuel M. 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Prof. Emeje’s several international fellowships include the prestigious Raman fellowship. He has published more than 150 articles and patents. He is also the head of R&D at NIPRD and holds a visiting professor position at Nnamdi Azikiwe University, Nigeria. He has a postgraduate certificate in Project Management from Walden University, Minnesota, as well as a professional teaching certificate and a World Bank certification in Public Procurement. Prof. Emeje was a national chairman of academic pharmacists in Nigeria and the 2021 winner of the May & Baker Nigeria Plc–sponsored prize for professional service in research and innovation.",institutionString:"National Institute for Pharmaceutical Research and Development",institution:{name:"National Institute for Pharmaceutical Research and Development",country:{name:"Nigeria"}}},{id:"268659",title:"Ms.",name:"Xianquan",middleName:null,surname:"Zhan",slug:"xianquan-zhan",fullName:"Xianquan Zhan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/268659/images/8143_n.jpg",biography:"Dr. Zhan received his undergraduate and graduate training in the fields of preventive medicine and epidemiology and statistics at the West China University of Medical Sciences in China during 1989 to 1999. He received his post-doctoral training in oncology and cancer proteomics for two years at the Cancer Research Institute of Human Medical University in China. In 2001, he went to the University of Tennessee Health Science Center (UTHSC) in USA, where he was a post-doctoral researcher and focused on mass spectrometry and cancer proteomics. Then, he was appointed as an Assistant Professor of Neurology, UTHSC in 2005. He moved to the Cleveland Clinic in USA as a Project Scientist/Staff in 2006 where he focused on the studies of eye disease proteomics and biomarkers. He returned to UTHSC as an Assistant Professor of Neurology in the end of 2007, engaging in proteomics and biomarker studies of lung diseases and brain tumors, and initiating the studies of predictive, preventive, and personalized medicine (PPPM) in cancer. In 2010, he was promoted to Associate Professor of Neurology, UTHSC. Currently, he is a Professor at Xiangya Hospital of Central South University in China, Fellow of Royal Society of Medicine (FRSM), the European EPMA National Representative in China, Regular Member of American Association for the Advancement of Science (AAAS), European Cooperation of Science and Technology (e-COST) grant evaluator, Associate Editors of BMC Genomics, BMC Medical Genomics, EPMA Journal, and Frontiers in Endocrinology, Executive Editor-in-Chief of Med One. He has\npublished 116 peer-reviewed research articles, 16 book chapters, 2 books, and 2 US patents. His current main research interest focuses on the studies of cancer proteomics and biomarkers, and the use of modern omics techniques and systems biology for PPPM in cancer, and on the development and use of 2DE-LC/MS for the large-scale study of human proteoforms.",institutionString:null,institution:{name:"Xiangya Hospital Central South University",country:{name:"China"}}},{id:"40482",title:null,name:"Rizwan",middleName:null,surname:"Ahmad",slug:"rizwan-ahmad",fullName:"Rizwan Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/40482/images/system/40482.jpeg",biography:"Dr. Rizwan Ahmad is a University Professor and Coordinator, Quality and Development, College of Medicine, Imam Abdulrahman bin Faisal University, Saudi Arabia. Previously, he was Associate Professor of Human Function, Oman Medical College, Oman, and SBS University, Dehradun. Dr. Ahmad completed his education at Aligarh Muslim University, Aligarh. He has published several articles in peer-reviewed journals, chapters, and edited books. His area of specialization is free radical biochemistry and autoimmune diseases.",institutionString:"Imam Abdulrahman Bin Faisal University",institution:{name:"Imam Abdulrahman Bin Faisal University",country:{name:"Saudi Arabia"}}},{id:"41865",title:"Prof.",name:"Farid A.",middleName:null,surname:"Badria",slug:"farid-a.-badria",fullName:"Farid A. Badria",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/41865/images/system/41865.jpg",biography:"Farid A. Badria, Ph.D., is the recipient of several awards, including The World Academy of Sciences (TWAS) Prize for Public Understanding of Science; the World Intellectual Property Organization (WIPO) Gold Medal for best invention; Outstanding Arab Scholar, Kuwait; and the Khwarizmi International Award, Iran. He has 250 publications, 12 books, 20 patents, and several marketed pharmaceutical products to his credit. He continues to lead research projects on developing new therapies for liver, skin disorders, and cancer. Dr. Badria was listed among the world’s top 2% of scientists in medicinal and biomolecular chemistry in 2019 and 2020. He is a member of the Arab Development Fund, Kuwait; International Cell Research Organization–United Nations Educational, Scientific and Cultural Organization (ICRO–UNESCO), Chile; and UNESCO Biotechnology France",institutionString:"Mansoura University",institution:{name:"Mansoura University",country:{name:"Egypt"}}},{id:"329385",title:"Dr.",name:"Rajesh K.",middleName:"Kumar",surname:"Singh",slug:"rajesh-k.-singh",fullName:"Rajesh K. Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329385/images/system/329385.png",biography:"Dr. Singh received a BPharm (2003) and MPharm (2005) from Panjab University, Chandigarh, India, and a Ph.D. (2013) from Punjab Technical University (PTU), Jalandhar, India. He has more than sixteen years of teaching experience and has supervised numerous postgraduate and Ph.D. students. He has to his credit more than seventy papers in SCI- and SCOPUS-indexed journals, fifty-five conference proceedings, four books, six Best Paper Awards, and five projects from different government agencies. He is currently an editorial board member of eight international journals and a reviewer for more than fifty scientific journals. He received Top Reviewer and Excellent Peer Reviewer Awards from Publons in 2016 and 2017, respectively. He is also on the panel of The International Reviewer for reviewing research proposals for grants from the Royal Society. He also serves as a Publons Academy mentor and Bentham brand ambassador.",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",country:{name:"India"}}},{id:"142388",title:"Dr.",name:"Thiago",middleName:"Gomes",surname:"Gomes Heck",slug:"thiago-gomes-heck",fullName:"Thiago Gomes Heck",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/142388/images/7259_n.jpg",biography:null,institutionString:null,institution:{name:"Universidade Regional do Noroeste do Estado do Rio Grande do Sul",country:{name:"Brazil"}}},{id:"336273",title:"Assistant Prof.",name:"Janja",middleName:null,surname:"Zupan",slug:"janja-zupan",fullName:"Janja Zupan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/336273/images/14853_n.jpeg",biography:"Janja Zupan graduated in 2005 at the Department of Clinical Biochemistry (superviser prof. dr. Janja Marc) in the field of genetics of osteoporosis. Since November 2009 she is working as a Teaching Assistant at the Faculty of Pharmacy, Department of Clinical Biochemistry. In 2011 she completed part of her research and PhD work at Institute of Genetics and Molecular Medicine, University of Edinburgh. She finished her PhD entitled The influence of the proinflammatory cytokines on the RANK/RANKL/OPG in bone tissue of osteoporotic and osteoarthritic patients in 2012. From 2014-2016 she worked at the Institute of Biomedical Sciences, University of Aberdeen as a postdoctoral research fellow on UK Arthritis research project where she gained knowledge in mesenchymal stem cells and regenerative medicine. She returned back to University of Ljubljana, Faculty of Pharmacy in 2016. She is currently leading project entitled Mesenchymal stem cells-the keepers of tissue endogenous regenerative capacity facing up to aging of the musculoskeletal system funded by Slovenian Research Agency.",institutionString:null,institution:{name:"University of Ljubljana",country:{name:"Slovenia"}}},{id:"357453",title:"Dr.",name:"Radheshyam",middleName:null,surname:"Maurya",slug:"radheshyam-maurya",fullName:"Radheshyam Maurya",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/357453/images/16535_n.jpg",biography:null,institutionString:null,institution:{name:"University of Hyderabad",country:{name:"India"}}},{id:"418340",title:"Dr.",name:"Jyotirmoi",middleName:null,surname:"Aich",slug:"jyotirmoi-aich",fullName:"Jyotirmoi Aich",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000038Ugi5QAC/Profile_Picture_2022-04-15T07:48:28.png",biography:"Biotechnologist with 15 years of research including 6 years of teaching experience. Demonstrated record of scientific achievements through consistent publication record (H index = 13, with 874 citations) in high impact journals such as Nature Communications, Oncotarget, Annals of Oncology, PNAS, and AJRCCM, etc. Strong research professional with a post-doctorate from ACTREC where I gained experimental oncology experience in clinical settings and a doctorate from IGIB where I gained expertise in asthma pathophysiology. A well-trained biotechnologist with diverse experience on the bench across different research themes ranging from asthma to cancer and other infectious diseases. An individual with a strong commitment and innovative mindset. Have the ability to work on diverse projects such as regenerative and molecular medicine with an overall mindset of improving healthcare.",institutionString:"DY Patil Deemed to Be University",institution:null},{id:"349288",title:"Prof.",name:"Soumya",middleName:null,surname:"Basu",slug:"soumya-basu",fullName:"Soumya Basu",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035QxIDQA0/Profile_Picture_2022-04-15T07:47:01.jpg",biography:"Soumya Basu, Ph.D., is currently working as an Associate Professor at Dr. D. Y. Patil Biotechnology and Bioinformatics Institute, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India. With 16+ years of trans-disciplinary research experience in Drug Design, development, and pre-clinical validation; 20+ research article publications in journals of repute, 9+ years of teaching experience, trained with cross-disciplinary education, Dr. Basu is a life-long learner and always thrives for new challenges.\r\nHer research area is the design and synthesis of small molecule partial agonists of PPAR-γ in lung cancer. She is also using artificial intelligence and deep learning methods to understand the exosomal miRNA’s role in cancer metastasis. Dr. Basu is the recipient of many awards including the Early Career Research Award from the Department of Science and Technology, Govt. of India. She is a reviewer of many journals like Molecular Biology Reports, Frontiers in Oncology, RSC Advances, PLOS ONE, Journal of Biomolecular Structure & Dynamics, Journal of Molecular Graphics and Modelling, etc. She has edited and authored/co-authored 21 journal papers, 3 book chapters, and 15 abstracts. She is a Board of Studies member at her university. She is a life member of 'The Cytometry Society”-in India and 'All India Cell Biology Society”- in India.",institutionString:"Dr. D.Y. Patil Vidyapeeth, Pune",institution:{name:"Dr. D.Y. Patil Vidyapeeth, Pune",country:{name:"India"}}},{id:"354817",title:"Dr.",name:"Anubhab",middleName:null,surname:"Mukherjee",slug:"anubhab-mukherjee",fullName:"Anubhab Mukherjee",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y0000365PbRQAU/ProfilePicture%202022-04-15%2005%3A11%3A18.480",biography:"A former member of Laboratory of Nanomedicine, Brigham and Women’s Hospital, Harvard University, Boston, USA, Dr. Anubhab Mukherjee is an ardent votary of science who strives to make an impact in the lives of those afflicted with cancer and other chronic/acute ailments. He completed his Ph.D. from CSIR-Indian Institute of Chemical Technology, Hyderabad, India, having been skilled with RNAi, liposomal drug delivery, preclinical cell and animal studies. He pursued post-doctoral research at College of Pharmacy, Health Science Center, Texas A & M University and was involved in another postdoctoral research at Department of Translational Neurosciences and Neurotherapeutics, John Wayne Cancer Institute, Santa Monica, California. In 2015, he worked in Harvard-MIT Health Sciences & Technology as a visiting scientist. He has substantial experience in nanotechnology-based formulation development and successfully served various Indian organizations to develop pharmaceuticals and nutraceutical products. He is an inventor in many US patents and an author in many peer-reviewed articles, book chapters and books published in various media of international repute. Dr. Mukherjee is currently serving as Principal Scientist, R&D at Esperer Onco Nutrition (EON) Pvt. Ltd. and heads the Hyderabad R&D center of the organization.",institutionString:"Esperer Onco Nutrition Pvt Ltd.",institution:null},{id:"319365",title:"Assistant Prof.",name:"Manash K.",middleName:null,surname:"Paul",slug:"manash-k.-paul",fullName:"Manash K. Paul",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/319365/images/system/319365.png",biography:"Manash K. Paul is a Principal Investigator and Scientist at the University of California Los Angeles. He has contributed significantly to the fields of stem cell biology, regenerative medicine, and lung cancer. His research focuses on various signaling processes involved in maintaining stem cell homeostasis during the injury-repair process, deciphering lung stem cell niche, pulmonary disease modeling, immuno-oncology, and drug discovery. He is currently investigating the role of extracellular vesicles in premalignant lung cell migration and detecting the metastatic phenotype of lung cancer via machine-learning-based analyses of exosomal signatures. Dr. Paul has published in more than fifty peer-reviewed international journals and is highly cited. He is the recipient of many awards, including the UCLA Vice Chancellor’s award, a senior member of the Institute of Electrical and Electronics Engineers (IEEE), and an editorial board member for several international journals.",institutionString:"University of California Los Angeles",institution:{name:"University of California Los Angeles",country:{name:"United States of America"}}},{id:"311457",title:"Dr.",name:"Júlia",middleName:null,surname:"Scherer Santos",slug:"julia-scherer-santos",fullName:"Júlia Scherer Santos",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/311457/images/system/311457.jpg",biography:"Dr. Júlia Scherer Santos works in the areas of cosmetology, nanotechnology, pharmaceutical technology, beauty, and aesthetics. Dr. Santos also has experience as a professor of graduate courses. Graduated in Pharmacy, specialization in Cosmetology and Cosmeceuticals applied to aesthetics, specialization in Aesthetic and Cosmetic Health, and a doctorate in Pharmaceutical Nanotechnology. Teaching experience in Pharmacy and Aesthetics and Cosmetics courses. She works mainly on the following subjects: nanotechnology, cosmetology, pharmaceutical technology, aesthetics.",institutionString:"Universidade Federal de Juiz de Fora",institution:{name:"Universidade Federal de Juiz de Fora",country:{name:"Brazil"}}},{id:"219081",title:"Dr.",name:"Abdulsamed",middleName:null,surname:"Kükürt",slug:"abdulsamed-kukurt",fullName:"Abdulsamed Kükürt",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/219081/images/system/219081.png",biography:"Dr. Kükürt graduated from Uludağ University in Turkey. He started his academic career as a Research Assistant in the Department of Biochemistry at Kafkas University. In 2019, he completed his Ph.D. program in the Department of Biochemistry at the Institute of Health Sciences. He is currently working at the Department of Biochemistry, Kafkas University. He has 27 published research articles in academic journals, 11 book chapters, and 37 papers. He took part in 10 academic projects. He served as a reviewer for many articles. He still serves as a member of the review board in many academic journals. He is currently working on the protective activity of phenolic compounds in disorders associated with oxidative stress and inflammation.",institutionString:null,institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"178366",title:"Dr.",name:"Volkan",middleName:null,surname:"Gelen",slug:"volkan-gelen",fullName:"Volkan Gelen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178366/images/system/178366.jpg",biography:"Volkan Gelen is a Physiology specialist who received his veterinary degree from Kafkas University in 2011. Between 2011-2015, he worked as an assistant at Atatürk University, Faculty of Veterinary Medicine, Department of Physiology. In 2016, he joined Kafkas University, Faculty of Veterinary Medicine, Department of Physiology as an assistant professor. Dr. Gelen has been engaged in various academic activities at Kafkas University since 2016. There he completed 5 projects and has 3 ongoing projects. He has 60 articles published in scientific journals and 20 poster presentations in scientific congresses. His research interests include physiology, endocrine system, cancer, diabetes, cardiovascular system diseases, and isolated organ bath system studies.",institutionString:"Kafkas University",institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"418963",title:"Dr.",name:"Augustine Ododo",middleName:"Augustine",surname:"Osagie",slug:"augustine-ododo-osagie",fullName:"Augustine Ododo Osagie",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/418963/images/16900_n.jpg",biography:"Born into the family of Osagie, a prince of the Benin Kingdom. I am currently an academic in the Department of Medical Biochemistry, University of Benin. Part of the duties are to teach undergraduate students and conduct academic research.",institutionString:null,institution:{name:"University of Benin",country:{name:"Nigeria"}}},{id:"192992",title:"Prof.",name:"Shagufta",middleName:null,surname:"Perveen",slug:"shagufta-perveen",fullName:"Shagufta Perveen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192992/images/system/192992.png",biography:"Prof. Shagufta Perveen is a Distinguish Professor in the Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. Dr. Perveen has acted as the principal investigator of major research projects funded by the research unit of King Saud University. She has more than ninety original research papers in peer-reviewed journals of international repute to her credit. She is a fellow member of the Royal Society of Chemistry UK and the American Chemical Society of the United States.",institutionString:"King Saud University",institution:{name:"King Saud University",country:{name:"Saudi Arabia"}}},{id:"49848",title:"Dr.",name:"Wen-Long",middleName:null,surname:"Hu",slug:"wen-long-hu",fullName:"Wen-Long Hu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49848/images/system/49848.jpg",biography:"Wen-Long Hu is Chief of the Division of Acupuncture, Department of Chinese Medicine at Kaohsiung Chang Gung Memorial Hospital, as well as an adjunct associate professor at Fooyin University and Kaohsiung Medical University. Wen-Long is President of Taiwan Traditional Chinese Medicine Medical Association. He has 28 years of experience in clinical practice in laser acupuncture therapy and 34 years in acupuncture. He is an invited speaker for lectures and workshops in laser acupuncture at many symposiums held by medical associations. He owns the patent for herbal preparation and producing, and for the supercritical fluid-treated needle. Dr. Hu has published three books, 12 book chapters, and more than 30 papers in reputed journals, besides serving as an editorial board member of repute.",institutionString:"Kaohsiung Chang Gung Memorial Hospital",institution:{name:"Kaohsiung Chang Gung Memorial Hospital",country:{name:"Taiwan"}}},{id:"298472",title:"Prof.",name:"Andrey V.",middleName:null,surname:"Grechko",slug:"andrey-v.-grechko",fullName:"Andrey V. Grechko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/298472/images/system/298472.png",biography:"Andrey Vyacheslavovich Grechko, Ph.D., Professor, is a Corresponding Member of the Russian Academy of Sciences. He graduated from the Semashko Moscow Medical Institute (Semashko National Research Institute of Public Health) with a degree in Medicine (1998), the Clinical Department of Dermatovenerology (2000), and received a second higher education in Psychology (2009). Professor A.V. Grechko held the position of Сhief Physician of the Central Clinical Hospital in Moscow. He worked as a professor at the faculty and was engaged in scientific research at the Medical University. Starting in 2013, he has been the initiator of the creation of the Federal Scientific and Clinical Center for Intensive Care and Rehabilitology, Moscow, Russian Federation, where he also serves as Director since 2015. He has many years of experience in research and teaching in various fields of medicine, is an author/co-author of more than 200 scientific publications, 13 patents, 15 medical books/chapters, including Chapter in Book «Metabolomics», IntechOpen, 2020 «Metabolomic Discovery of Microbiota Dysfunction as the Cause of Pathology».",institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"199461",title:"Prof.",name:"Natalia V.",middleName:null,surname:"Beloborodova",slug:"natalia-v.-beloborodova",fullName:"Natalia V. Beloborodova",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/199461/images/system/199461.jpg",biography:'Natalia Vladimirovna Beloborodova was educated at the Pirogov Russian National Research Medical University, with a degree in pediatrics in 1980, a Ph.D. in 1987, and a specialization in Clinical Microbiology from First Moscow State Medical University in 2004. She has been a Professor since 1996. Currently, she is the Head of the Laboratory of Metabolism, a division of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russian Federation. N.V. Beloborodova has many years of clinical experience in the field of intensive care and surgery. She studies infectious complications and sepsis. She initiated a series of interdisciplinary clinical and experimental studies based on the concept of integrating human metabolism and its microbiota. Her scientific achievements are widely known: she is the recipient of the Marie E. Coates Award \\"Best lecturer-scientist\\" Gustafsson Fund, Karolinska Institutes, Stockholm, Sweden, and the International Sepsis Forum Award, Pasteur Institute, Paris, France (2014), etc. Professor N.V. Beloborodova wrote 210 papers, five books, 10 chapters and has edited four books.',institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"354260",title:"Ph.D.",name:"Tércio Elyan",middleName:"Azevedo",surname:"Azevedo Martins",slug:"tercio-elyan-azevedo-martins",fullName:"Tércio Elyan Azevedo Martins",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/354260/images/16241_n.jpg",biography:"Graduated in Pharmacy from the Federal University of Ceará with the modality in Industrial Pharmacy, Specialist in Production and Control of Medicines from the University of São Paulo (USP), Master in Pharmaceuticals and Medicines from the University of São Paulo (USP) and Doctor of Science in the program of Pharmaceuticals and Medicines by the University of São Paulo. Professor at Universidade Paulista (UNIP) in the areas of chemistry, cosmetology and trichology. Assistant Coordinator of the Higher Course in Aesthetic and Cosmetic Technology at Universidade Paulista Campus Chácara Santo Antônio. Experience in the Pharmacy area, with emphasis on Pharmacotechnics, Pharmaceutical Technology, Research and Development of Cosmetics, acting mainly on topics such as cosmetology, antioxidant activity, aesthetics, photoprotection, cyclodextrin and thermal analysis.",institutionString:null,institution:{name:"University of Sao Paulo",country:{name:"Brazil"}}},{id:"334285",title:"Ph.D. Student",name:"Sameer",middleName:"Kumar",surname:"Jagirdar",slug:"sameer-jagirdar",fullName:"Sameer Jagirdar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334285/images/14691_n.jpg",biography:"I\\'m a graduate student at the center for biosystems science and engineering at the Indian Institute of Science, Bangalore, India. I am interested in studying host-pathogen interactions at the biomaterial interface.",institutionString:null,institution:{name:"Indian Institute of Science Bangalore",country:{name:"India"}}},{id:"329248",title:"Dr.",name:"Md. Faheem",middleName:null,surname:"Haider",slug:"md.-faheem-haider",fullName:"Md. Faheem Haider",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329248/images/system/329248.jpg",biography:"Dr. Md. Faheem Haider completed his BPharm in 2012 at Integral University, Lucknow, India. In 2014, he completed his MPharm with specialization in Pharmaceutics at Babasaheb Bhimrao Ambedkar University, Lucknow, India. He received his Ph.D. degree from Jamia Hamdard University, New Delhi, India, in 2018. He was selected for the GPAT six times and his best All India Rank was 34. Currently, he is an assistant professor at Integral University. Previously he was an assistant professor at IIMT University, Meerut, India. He has experience teaching DPharm, Pharm.D, BPharm, and MPharm students. He has more than five publications in reputed journals to his credit. Dr. Faheem’s research area is the development and characterization of nanoformulation for the delivery of drugs to various organs.",institutionString:"Integral University",institution:{name:"Integral University",country:{name:"India"}}},{id:"329795",title:"Dr.",name:"Mohd Aftab",middleName:"Aftab",surname:"Siddiqui",slug:"mohd-aftab-siddiqui",fullName:"Mohd Aftab Siddiqui",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329795/images/system/329795.png",biography:"Dr. Mohd Aftab Siddiqui is an assistant professor in the Faculty of Pharmacy, Integral University, Lucknow, India, where he obtained a Ph.D. in Pharmacology in 2020. He also obtained a BPharm and MPharm from the same university in 2013 and 2015, respectively. His area of research is the pharmacological screening of herbal drugs/natural products in liver cancer and cardiac diseases. He is a member of many professional bodies and has guided many MPharm and PharmD research projects. Dr. Siddiqui has many national and international publications and one German patent to his credit.",institutionString:"Integral University",institution:null},{id:"255360",title:"Dr.",name:"Usama",middleName:null,surname:"Ahmad",slug:"usama-ahmad",fullName:"Usama Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255360/images/system/255360.png",biography:"Dr. Usama Ahmad holds a specialization in Pharmaceutics from Amity University, Lucknow, India. He received his Ph.D. from Integral University, Lucknow, India, with his work titled ‘Development and evaluation of silymarin nanoformulation for hepatic carcinoma’. Currently, he is an Assistant Professor of Pharmaceutics, at the Faculty of Pharmacy, Integral University. He has been teaching PharmD, BPharm, and MPharm students and conducting research in the novel drug delivery domain. From 2013 to 2014 he worked on a research project funded by SERB-DST, Government of India. He has a rich publication record with more than twenty-four original journal articles, two edited books, four book chapters, and several scientific articles to his credit. He is a member of the American Association for Cancer Research, the International Association for the Study of Lung Cancer, and the British Society for Nanomedicine. Dr. Ahmad’s research focus is on the development of nanoformulations to facilitate the delivery of drugs.",institutionString:"Integral University",institution:{name:"Integral University",country:{name:"India"}}},{id:"333824",title:"Dr.",name:"Ahmad Farouk",middleName:null,surname:"Musa",slug:"ahmad-farouk-musa",fullName:"Ahmad Farouk Musa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333824/images/22684_n.jpg",biography:"Dato’ Dr Ahmad Farouk Musa\nMD, MMED (Surgery) (Mal), Fellowship in Cardiothoracic Surgery (Monash Health, Aust), Graduate Certificate in Higher Education (Aust), Academy of Medicine (Mal)\n\n\n\nDato’ Dr Ahmad Farouk Musa obtained his Doctor of Medicine from USM in 1992. He then obtained his Master of Medicine in Surgery from the same university in the year 2000 before subspecialising in Cardiothoracic Surgery at Institut Jantung Negara (IJN), Kuala Lumpur from 2002 until 2005. He then completed his Fellowship in Cardiothoracic Surgery at Monash Health, Melbourne, Australia in 2008. He has served in the Malaysian army as a Medical Officer with the rank of Captain upon completing his Internship before joining USM as a trainee lecturer. He is now serving as an academic and researcher at Monash University Malaysia. He is a life-member of the Malaysian Association of Thoracic & Cardiovascular Surgery (MATCVS) and a committee member of the MATCVS Database. He is also a life-member of the College of Surgeons, Academy of Medicine of Malaysia; a life-member of Malaysian Medical Association (MMA), and a life-member of Islamic Medical Association of Malaysia (IMAM). Recently he was appointed as an Interim Chairperson of Examination & Assessment Subcommittee of the UiTM-IJN Cardiothoracic Surgery Postgraduate Program. As an academic, he has published numerous research papers and book chapters. He has also been appointed to review many scientific manuscripts by established journals such as the British Medical Journal (BMJ). He has presented his research works at numerous local and international conferences such as the European Association for Cardiothoracic Surgery (EACTS) and the European Society of Cardiovascular Surgery (ESCVS), to name a few. He has also won many awards for his research presentations at meetings and conferences like the prestigious International Invention, Innovation & Technology Exhibition (ITEX); Design, Research and Innovation Exhibition, the National Conference on Medical Sciences and the Annual Scientific Meetings of the Malaysian Association for Thoracic and Cardiovascular Surgery. He was awarded the Darjah Setia Pangkuan Negeri (DSPN) by the Governor of Penang in July, 2015.",institutionString:null,institution:{name:"Monash University Malaysia",country:{name:"Malaysia"}}},{id:"30568",title:"Prof.",name:"Madhu",middleName:null,surname:"Khullar",slug:"madhu-khullar",fullName:"Madhu Khullar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/30568/images/system/30568.jpg",biography:"Dr. Madhu Khullar is a Professor of Experimental Medicine and Biotechnology at the Post Graduate Institute of Medical Education and Research, Chandigarh, India. She completed her Post Doctorate in hypertension research at the Henry Ford Hospital, Detroit, USA in 1985. She is an editor and reviewer of several international journals, and a fellow and member of several cardiovascular research societies. Dr. Khullar has a keen research interest in genetics of hypertension, and is currently studying pharmacogenetics of hypertension.",institutionString:"Post Graduate Institute of Medical Education and Research",institution:{name:"Post Graduate Institute of Medical Education and Research",country:{name:"India"}}},{id:"223233",title:"Prof.",name:"Xianquan",middleName:null,surname:"Zhan",slug:"xianquan-zhan",fullName:"Xianquan Zhan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/223233/images/system/223233.png",biography:"Xianquan Zhan received his MD and Ph.D. in Preventive Medicine at West China University of Medical Sciences. He received his post-doctoral training in oncology and cancer proteomics at the Central South University, China, and the University of Tennessee Health Science Center (UTHSC), USA. He worked at UTHSC and the Cleveland Clinic in 2001–2012 and achieved the rank of associate professor at UTHSC. 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