Positive outcomes associated with emotional intelligence.
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Dr. Yu is a holder of 90 journal papers, with an h index of 21, is a member of A& WA (USA) and AAAR (USA), and is the holder of 24 registered patents.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"188972",title:"Prof.",name:"Mingzhou",middleName:null,surname:"Yu",slug:"mingzhou-yu",fullName:"Mingzhou Yu",profilePictureURL:"https://mts.intechopen.com/storage/users/188972/images/system/188972.jpg",biography:"Mingzhou Yu is now a Professor at China Jiliang University and a Guest Professor at Key Laboratory of Aerosol Chemistry and Physics, Chinese Academy of Science. He received his PhD degree from Zhejiang University in 2008 with the major fluid mechanism. During the time period between 2009 and 2012, he moved to Karlsruhe Institute of Technology, Germany, as a Alexander von Humboldt researcher where he worked with Prof. Gerhard Kasper and Dr. Martin Seipenbusch. Since 2013, he joined Prof. Junji Cao's research group as a guest Professor at Key Laboratory of Aerosol Chemistry and Physics, Chinese Academy of Science. During the time period between 2013 and 2016, he worked in The Hongkong Polytechnic University and Universidad Autónoma de Madrid, Spain, as a research associate or postdoc researcher. He is now leading a Aerosol Science and Technology Laboratory supported by Zhejiang Special Provincial Support in CJLU. 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Patient-centered medical homes, accountable care organizations, and various other advances will have substantial influence on the future of the US health care system. These modern paradigms involve high-level cooperation among physicians and various stakeholders. Unfortunately, physicians have often been judged by their inability to effectively collaborate. What’s more comparatively little consideration has been given to collaboration as it pertains to traditional physician education and career advancement [1]. The reasons behind sub-optimal collaboration are multifactorial; however they may be more broadly divided into personal and structural reasons. On a personal level, it may be that physicians traditionally reveled in self-sufficiency. Also, persons attracted to and selected for medical careers may have been customarily independent, self-directed, and assured [2]. Because physicians basked in autonomy, they may have inadvertently propagated a culture that prioritizes individuality. Subsequently, today healthcare systems are repeatedly designed like silos, which further undercut teamwork [1, 3, 4, 5]. Consequently, any effective health network must concentrate on a move from a philosophy that the physician is the sole provider to one that fosters and promotes strong relationships and effective communication [2]. Strong physician leadership is vital to the implementation and success of this shift.
Emotional intelligence (EI) is the ability to perceive and express emotion, assimilate emotion in thought, understand and reason with emotion, and regulate emotion in the self and others [6]. It has been considered an essential leadership proficiency [7]. In medicine, its applicability may range from the boardroom to the patient’s bedside [7, 8]. There are various representations of different evaluative methods for EI. One of the more mainstream depictions includes self-awareness, self-regulation, social awareness, and relationship management (Figure 1) [9]. The cells are further populated by component competencies that define EI (Figure 1
Four components of emotional intelligence. *Further divided into competencies self-awareness: Emotional self-awareness, accurate self-awareness, self-confidence; social awareness: Empathy, organizational awareness, service orientation; self-management: Self-control, trust-worthiness, conscientiousness, adaptability, achievement orientation, initiative; social skills: Influence, leadership, developing others, communication, change catalyst, conflict management, building bonds, team work and collaboration.
EI, rather than being something one is born with, is a set of skills that can be improved upon to boost performance [11, 12]. This is in stark contrast to hard to define views of professionalism or leadership as an EI template is clear, teachable, and allows for an honest assessment of where one is and where one needs to be in regards to development. Ample evidence supports the importance of EI as a key leadership competency in business [13, 14, 15]. Conversely, far less attention has been paid to EI as it pertains to health care.
The remainder of this chapter will focus on EI and its implications on Graduate Medical Education (GME) specifically Family Medicine Residency. The chapter will examine the association between EI and leadership traits among family physicians as well as the effects of different EI implementation strategies such as coaching, Balint Seminars, advisor and focus groups, and their impact on physician trainees as well as further commentary on future best practices.
Emotional intelligence and leadership traits are intimately linked [16, 17, 18]. A common thread that weaves these explorations is the idea that leaders with high EI are more effective in management than those with low EI [17, 19]. Leadership traits may be illustrated on an organizational and personal level (Figure 2) [16, 20].
Organizational and personal examples of leadership traits.
EI requires self-discipline, self-efficacy, self-evaluation, and self-criticism, which enhances leadership and job fulfillment [21, 22, 23]. What’s more, through the enrichment of strong relationships with their patient’s and colleagues, any physician may be considered a leader. Therefore, it behooves the physician to foster these aptitudes to deliver excellent care [16]. Moreover, physicians’ EI has bearings on their interactions and relationships with patients. Although it is crucial to exhibit competence in medicine, insufficient EI may hinder the ability to fully understand the complexities of a patient’s being during their evaluation and treatment. In fact! Compared to physicians with higher EI those will low EI are less likely to foster empathic connections with their patients and appreciate or make out their emotions [23, 24]. EI may facilitate the patient–doctor rapport [22, 23, 24]. It shapes judgments concerning patient management, encourages self-control in demanding circumstances, and the avoidance of emotionally charged behaviors and decisions. Physicians who can identify and manage their emotions can remain calm when faced with patients who are under stress, anxious, or trigger the provider in some way. EI will allow the physician to convey their thoughts and feelings empathically and without judgment to the patient, which affords the most advantageous care [25].
EI plays a part in the physicians’ ability to acclimate well with other people, optimize team-based care, and respond appropriately to external pressures. Health-care providers with noticeable levels of EI may drive forward institutional missions. Besides the personal and relational aspect of EI, there may also be administrative benefits. For example, it may lower hospital costs by reducing burnout, medical errors, and litigation [23, 24, 25].
Family physicians are indispensable health-care workers who evaluate, treat, and manage acute and chronic diseases, promote health and wellness, and enhance the well-being of patients and communities through the application of the therapeutic relationship. Because family physicians may be a patient’s first and potentially only contact with a healthcare provider, the development of EI for primary care physicians is essential to the healthcare system. What’s more, a high level of EI in family physicians may help in team-based care [22, 25].
A study by Coskun et al. aimed to determine the association of different variables and
According to Goleman, the most effective leaders are those who possess emotional intelligence [21]. Emotional understanding, emotional management, empathy, social flexibility, and adaptability are essential for individual growth and development as well as indispensable for societal regulation in the work setting [30]. Whereas low EI may lead to less effective teamwork, diminished work satisfaction, and heightened anxiety among physicians, higher EI preserves good physician–patient relationships, superior teamwork and communication skills, healthier stress management, and top-quality commitment and leadership [18, 20, 23, 31]. Personal well-being, empathy, teamwork, and leadership skills are all staples to a physician’s work [17, 18, 19, 20].
Youthful physicians with less experience may have lower EI scores compared to older, more experienced ones, which implies that EI may increase throughout training. GME programs that integrate EI and leadership competencies allow for students to attain these skills earlier and perhaps most importantly provides a platform to generate meaningful results [19]. This curriculum needs to be supplemented by coaching, mentorship, or other directives to ensure sustainable change in self-awareness and emotional intelligence among physicians.
The Accreditation Council for Graduate Medical Education (ACGME) mandates that residents be taught and assessed in six general competencies, which include: patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practices [32]. EI has been proposed for teaching interpersonal and communication skills as well as professionalism [33]. EI contains the skill to carry out precise interpretation on the subject of feelings and the aptitude to exercise emotions and emotional knowledge to boost thought [34]. Moreover, abundant positive correlations that link EI with desirable outcomes exist (Table 1) [35].
Leadership Success |
Employee Self-Esteem |
Job Satisfaction |
Job Commitment |
Teamwork |
Customer Satisfaction |
Decreased Turnover |
Less Work/Family Conflict |
Positive outcomes associated with emotional intelligence.
Although much is known about the numerous positive impacts EI may have, there is still much to elucidate in regards to proper implementation, maintenance, and enhancement of EI skills. In a quasi-experimental design, with an intervention and control group composed of one class each of family medicine residents researchers assessed the Emotional and Social Competence Inventory (ESCI), a 360-degree EI self and peer reported survey for 12 EI competencies (Table 2) to determine if coaching would enhance emotional intelligence [36].
Trait | Definition |
---|---|
Emotional self-awareness | Recognizing one’s emotions and their effects |
Emotional self-control | Keeping disruptive emotions and impulses in check |
Adaptability | Flexibility in handling change |
Achievement Orientation | Striving to improve or meeting a standard of excellence |
Positive Outlook | Persistence in pursuing goals despite obstacles, setbacks |
Empathy | Sensing others’ feelings/perspectives, taking active interest |
Organizational Awareness | Reading group’s emotional currents and power relationships |
Coach and Mentor | Sensing other’s development needs and bolstering their abilities |
Inspirational Leadership | Inspiring and guiding individuals and groups |
Influence | Wielding effective tactics for persuasion |
Conflict Management | Negotiating and resolving disagreements |
Teamwork | Working with others toward shared goal, creating group synergy |
Emotional intelligence competency definitions.
ESCI norms apply to other ratings only and are based on a North American sample of workers all ages and job levels. Achievement orientation is the highest rated competence in the norms, and self-awareness the lowest [36].
Unfortunately, there was no significant difference in ESCI scores in the intervention versus control group. Interestingly, teamwork significantly declined. Regrettably, a drop in aspects of EI during training is not unique. Specifically, Wagner et al. found a decline in self-reported medical student EI scores [37]. A deterioration in humanitarianism, enthusiasm and idealism experienced by medical students has also been ascribed to the fall of EI throughout training [38].
Despite the lack of significance, this study was plagued by implementation barriers, which are important to understand. First, no faculty were given protected time for coaching. Second, resident’s comments suggested that increasing EI was not a priority for them at this juncture in their training. Third, resident’s EI scores were already relatively high; therefore additional time spent may not have been felt to be justified. Finally, there remains a lack of validity of ESCI for the medical community.
It is vital that if EI is to be tested and enhanced in a residency program that it be implemented properly. For example, EI coaching should have built-in protected time. It may be beneficial for residents toward the end of training when they appear to be less stressed and more focused on future goals. Alternatively, in view of its time-intensive make-up, EI training could selectively center on residents with low EI ratings. Post-residency it may be provided as continuing medical education for stress management, remediation of deficiencies, or advanced training.
It should be stressed that EI coaching requires a high level of trainee engagement and commitment. This course may include cognitive behavioral assignments between coaching sessions. An EI training session may include a trainee’s initial statement of ideal career goals along with a guided review of EI survey results. The coach could then emphasize EI strengths of the trainee while simultaneously employing schemes to build upon areas of improvement for the trainee. The trainee and coach would then set performance goals, negotiate assignments, time frames, frequency of coaching sessions, and add or modify selected goals based upon progress.
EI has been proclaimed fundamental for leaders who are coping with change management [39]. This skill is all the more important as it relates to physicians and the current health care landscape. Even so, much work remains to be done to provide clear-cut proof that investment in EI training is warranted. A reasonable next phase would be to substantiate approaches that consistently boost physician EI. Advantages and disadvantages to implementation are shown (Table 3).
Advantages | Disadvantages |
---|---|
Validated 360-degree assessment instruments | Time and labor intensive |
Access to well-developed training models | Expense |
Published norms | Lack of physician norms |
Potential advantages and disadvantages to emotional intelligence training.
Potential research ought to emphasize the elaboration of an expedient reasonably priced 360-degree EI instrument for physicians. Ideally, this would be enhanced by providing established external validity measures that further correlate medical outcomes, patient satisfaction, and physician satisfaction. Multi-institution collaboration may possibly evaluate EI development in distinctive training paradigms and fields of practice. Perhaps longitudinal research will explore EI development post training, specifically in relation to physician impairment or disruptive behavior. If EI tools demonstrate sustained value in the domains of physician selection, education, training, and remediation, they may well become more generalizable and important to the medical community as a whole.
Hungarian-born British psychoanalyst Michael Balint pioneered Balint groups among practicing physicians in the 1950s to explore the doctor–patient relationship [40]. Balint groups help make physicians aware of their blind spots during their interactions with patients as well as use their feelings and responses to patients as instruments to better comprehend the physician–patient relationship [41]. These seminars consist of longitudinal experiential learning over a period of time as well as a group of residents who periodically meet and are accompanied by two Balint leaders. A case that bothers one of the residents is presented, which is followed by a discussion from the point of view of the patient, doctor, and their relationship with the caveat that medical care not be discussed [42, 43, 44]. After, Balint leaders help the residents in the expansion, consideration, and illumination of their thoughts and feelings related to the case from both the patient and physician’s perspective. Examples of benefits and detriments to these sessions are found (Table 4) [45, 46, 47].
Pros | Cons |
---|---|
Communication skills and professionalism | Time Consuming |
Awareness of feelings/values, develop appropriate treatment based on psychological needs of patient | Significant Resources required |
Positive effects on self-efficacy, burnout and job satisfaction, breaking bad news, empathy | Measurable outcomes still controversial |
Pros and cons of Balint group.
Given Balint training is closely linked with the ability to understand and regulate emotions, a quasi-experimental observational study aimed to measure the effects of Balint seminars on EI and burnout among internal medicine residents [48]. Bi-weekly Balint seminars were delivered throughout the academic year. Two major outcomes were measured using validated instruments: EI using the Mayer Salovey and Caruso Emotional Intelligence Test (MSCEIT) and burnout using the Maslach Burnout Inventory (MBI). The MSCEIT, based on a four-branch model of EI, is the most comprehensive measure of EI as an ability [49]. The MBI is the gold standard for measuring burnout [50]. Depictions of these instruments are found in Figures 3–5 respectively. A total of 20 Balint seminars were delivered; however on average, residents attended six sessions. The total post-Balint EI score improved among women versus men. Many residents showed severe burnout levels on at least one of the three domains of burnout at baseline; however, Balint seminars did not have any effect on any of the burnout domains even when accounting for gender, attendance or training level.
Four-branch model of emotional intelligence.
Scoring system of Mayer Salovey and Caruso emotional intelligence test (MSCEIT). *The MSCEIT provides 15 main scores: Total EIQ score, two area scores, four branch scores, and eight task scores. It can be scored using both the consensus and expert scoring methods. There are guidelines on how to interpret the score. The average MSCEIT score is 100 with a standard deviation of 115. There are 7 score ranges based on empirical percentiles.
Aspects of burnout according to Maslach burnout inventory.
Evidence suggests no predetermined gender differences in EI ability among medical residents according to specialty [51]. Nevertheless, Balint seminar results may be affected by gender, learning style, and training year. Indeed, Balint interventions may be more effective among women than men [52]. The openness of women to such educational activities could explain why the female residents improve their EI. Also despite lack of statistical significance in this study, EI still improved in a small number of trainees, which could be due to various learning styles, personality and level of training. Criticisms of Balint seminars include a lack of focus on problem solving and firm structure that may not meet residents’ developmental needs [53]. Different levels of training may explain the non-uniform effectiveness of this intervention [54].
Finally, EI measurement immediately post-intervention may be suboptimal. In two studies, the influence of an EI educational intervention was only measurable as a delayed positive effect several months after the intervention [55, 56]. Therefore, interventions to improve EI and decrease burnout levels may have more long term effects that may not immediately come to light.
Physician burnout remains a sobering affair [57, 58]. It may be particularly egregious in medical residency [59]. Family medicine, internal medicine, and emergency medicine residents may be at particularly high risk given they are often on the “front lines” of care [60]. The side effects of burnout may include: unethical and bad-mannered behavior [61], patient-care mistakes [60, 62], and physicians quitting their practice [63, 64].
The benefits of cultivating psychosocial proficiencies in medical learners may include mitigation of contempt, anxiety, and improvement in clinical ability [65]. It may also further reduce grave medical oversights as well as better-quality bonds with contemporaries and patients [66]. Rather than focusing on the diagnosis and treatment of emotional fatigue and depersonalization among residents, there has been a more recent push in the direction of the formation of a scholastic philosophy of wellness [67]. An alternative residency culture has been proposed as a framework [68]. Figure 6 is a schematic representation of an emotionally intelligent learning community [69].
Representation of an emotionally intelligent learning community.
With physician burnout a grave concern and a scarcity of evidence on successful tactics to diminish it during residency, an intervention to lower burnout through an emphasis on wellness, safety, and interpersonal skills in a family medicine program was proposed. In a mixed-methods case study that utilized results from three quantitative self-reported instruments for well-being, along with content analysis of transcripts from 20 focus groups and 33 resident advising sessions described experiences of family medicine residents in a single site enrolled between July 2007 and June 2012 [69].
In this intervention, no statistically significant quantitative differences in the well-being of residents compared with the family medicine faculty and staff was discovered; however residents in general recognized the nurturing culture of the program. While individuals’ commentaries about experiences during residency were unique, analysis revealed six recurrent themes (Figure 7). Although well-being scores for residents and the community did not change during the intervention, resident feedback over the five years showed they acknowledged purpose of the curriculum changes, recognized the new curricular practices, and respected the importance of physical and emotional wellness.
Six recurrent themes of an emotionally intelligent learning community.
It should be pointed out that not every learner will embrace the innovations of emotional intelligence, leadership-development, or other form of wellness curriculum and some may even have utter contempt for the methodology. Still, even being able to articulate this disdain creates a culture of safety and helps dissipate the “culture of silence” that is all too often pervasive in academic medicine [70]. What’s more, scholastic culture change utilized by a program that focuses on EI may provide ample time and space for residents to reflect on what it means to be a doctor without any modifications to the day-to-day clinical obligations of the residents. Lastly these interventions may help regulate resident’s feelings as they move between different stress levels throughout their training [71].
It has been difficult to find interventions that reduce burnout during residency. Limited evidence supports duty hour reductions, a revised grading system, mindfulness training, and self-development groups to prevent burnout in medical students and residents [72]. An electronic reflective writing portfolio has been created as a professional identity development tool, which provides opportunities for residents to explore work-life balance, resiliency, and burnout prevention [73]. There are calls for GME to reform the way medicine is taught and to place more emphasis on the heart and mind of a clinician [74]. Future research should include multisite studies and control sites with less emphasis on well-being as well as studies that follow residents into practice to determine if long-term benefits exist.
In summation, there remains a scarcity of valuable research about EI in family medicine residency that obviously welcomes more consideration. Studies are needed to further address each of the themes that emerged in this chapter. Certainly, increased focus must be given to the standardization and applicability of EI measurement in healthcare providers. Additionally, the benefits and shortcomings of the instruments that have been used in health care studies such as the Emotional Competence Inventory, Mayer-Salovery-Caruso Emotional Intelligence Test, or specially designed 360-degree evaluations must be further explored. Likewise, greater attention must be paid to the particular components of EI, the most optimal time to focus on them during the training period, and how enhancing these competencies may shape the career trajectory of physicians. A real discussion must take place if all physicians should receive formal emotional intelligence and leadership development training, or if it should be only for those who are specifically recruited or express an interest. Finally long-term outcomes of EI training on family physician, patient, and hospital systems are needed. Solutions to these enquires will command extraordinary leadership to solve imminent healthcare challenges.
Under normal physiological conditions, the production of harmful reactive species caused by oxidative processes and antioxidant defense are in balance. If the reactive oxygen species and other species production exceed the antioxidant capacity of a living system, reactive oxygen and nitrogen species (ROS and RNS) may react with macromolecules, causing structural and/or functional damage to cellular enzymes and genetic material. An excess of reactive species and damage caused by their action is called oxidative stress.
In a state of oxidative stress, an excess of ROS and RNS may damage lipids, proteins, carbohydrates, and nucleic acids. Free radicals attack unsaturated fatty acids in biological membranes causing lipid peroxidation. Lipid peroxidation is an enzymatic reaction catalyzed by the enzyme lipoxygenase [1]. This enzyme is found in the erythrocytes and leukocytes of animals, as well as in many plant organisms. Its substrate is linoleic and linolenic acid in plants, and arachidonic acid in animals, while oleic acid is not oxidized. Lipid peroxidation results in decreased membrane fluidity, loss of enzymes and receptor activity, damage to membrane proteins and other macromolecules, which leads to apoptosis [2].
Oxidative modification of proteins, reversible and irreversible, occurs during redox signaling and other cellular processes. It also occurs as a result of oxidative stress. Exposure of proteins to hydroxyl OH• and/or superoxide radicals O2•− leads to their structural modifications. Modified proteins may further undergo spontaneous fragmentation and cross-linking or show a significant increase in proteolysis. An oxidative attack of a polypeptide backbone is usually initiated by hydroxyl OH•. By an experimental generation of radicals, using water radiolysis or decomposing hydrogen peroxide H2O2 in a metal-catalyzed reaction - and in the interaction with lipids - alkyl, alkoxy, and alkylperoxyl radical intermediates can be formed, which affect peptide bond cleavage in several ways.
Tryptophan, histidine, and cysteine are the most sensitive to reactive oxygen species. In addition to fragmentation, oxidation of the amino acid residues of lysine, arginine, proline, and threonine increases carbonyl concentration, so the presence of carbonyl groups can be used as an indicator of protein oxidation.
Oxidative modification of proteins also occurs in reaction with aldehydes, which are formed during lipid peroxidation process. End products of lipid peroxidation, such as malondialdehyde (MDA) and 4-hydroxy-2-nonenal (HNE), as well as oxidation products of polyunsaturated fatty acids cause oxidative damage to proteins [3].
Oxidative modification of proteins is present in diseases and changes associated with the aging process, such as atherosclerosis, tumors, neurodegenerative diseases, and aging. Protein carbonylation occurs with a large number of modifications and is a marker of oxidative stress. During the first two-thirds of life, the level of protein carbonylation slowly increases, while its level rises sharply in the last third. Protein carbonylation negatively affects the functions of proteins themselves, which suggests that this modification may be one of the causes of the aforementioned undesirable processes [4].
Apart from the living organisms, the oxidation process occupies an important place in the food, pharmaceutical, and cosmetic industries. It includes the oxidation of protein molecules, vitamins, but above all, the oxidation of lipid molecules [5].
Oxidation of lipid molecules is a major problem in the food industry, as it leads to changes in the organoleptic properties of food, a decrease in its nutritional value, as well as the formation of radical components that can endanger consumers’ health.
Lipid oxidation in food implies a whole range of chemical changes that result from the reaction of lipids with oxygen. Triacylglycerols and phospholipids are hardly volatile molecules and do not directly affect the aroma of the product. During lipids oxidation from fatty acids, volatile compounds have formed that lead to an undesirable aroma of products known as rancidity [6].
Polyunsaturated fatty acids oxidize much faster than monounsaturated or saturated ones. The rate of lipid oxidation is influenced by the number and position of double bonds [1]. The methylene group (-CH2-) located between the two double bonds is very susceptible to oxidation. Linoleic acid is subject to oxidation, as it has a methylene group between two double bonds, at position 11. Its oxidation produces two hydroperoxides. The main secondary product of linoleic acid autooxidation is hexanal. Lipid autooxidation is an autocatalytic reaction, which means that it progresses over time due to the formation of products that catalyze the reaction themselves.
Lipid peroxidation includes three phases: initiation, propagation, and termination (Figure 1). From the peroxides formed at the beginning, secondary oxidation products are formed: aldehydes, ketones, epoxides, and other compounds, which also have negative biological effects, such as loss of essential amino acids and lipid-soluble vitamins [7].
The lipid oxidation phases [
In the first phase, oxygen from the air attacks unsaturated fatty acids (LH), creating free radicals of fatty acids (peroxy LO2•, alkoxyl LO•, or alkyl radicals L•). In the second phase of the reaction, hydroperoxides (LOOH) and free peroxide radicals (LOO•) are formed from free radicals by binding oxygen to free fatty acid radicals.
Hydroperoxides (primary oxidation products) are labile, so they are further decomposed into free radicals and decomposed oxidation products. These degradation products of oxidation (secondary oxidation products) are carbonyl compounds (aldehydes and ketones), fatty acids, alcohols, epoxides, etc., some of which give off an unpleasant, rancid odor characteristic of oxidized fat.
Lipid autooxidation is often initiated by free radicals from an unknown source. It is accelerated by rising temperatures, light and the presence of trace metals. Reductive forms of transition metals are more efficient in the hydrogen peroxide decomposition, so reductive components such as superoxide anion (O2•−) and ascorbic acid further promote lipid oxidation. Redox cycling of iron in the presence of superoxide anions in lipid oxidation is known as the Haber-Weiss reaction, while the second step of this reaction is known as the Fenton reaction:
The resulting hydroxyl radicals (OH•) are the most reactive ROS species.
Ascorbic acid can also participate in the Haber-Weiss type reaction, but unlike superoxide anions, ascorbic acid may also act as an antioxidant at higher concentrations.
The control of the level of free radicals, prooxidants, and oxidation intermediates is used to protect the lipid components of food from oxidation. Free radical scavengers (FRS) inhibit lipid oxidation by reacting faster than unsaturated fatty acids with free radicals. They can react with peroxyl(LOO•) or alkoxyl(LO•) radicals in the following reaction:
Phenolic components are known to be good free radicals scavengers, as they donate a hydrogen atom, and the resulting radical has low energy due to its delocalization in the structure of phenol ring (Figure 2) [6].
Delocalization of phenol radical [
The most commonly used synthetic antioxidants are substituted monophenolic compounds, such as 2,6-di-
For these reasons, there is a tendency to replace synthetic antioxidants, where possible, with non-toxic antioxidants of natural origin. More recently, essential oils have also been used as a substitute for synthetic antioxidants, in those food canning sectors where their use does not adversely affect product flavor [12].
In addition to oxidative damage and death of cells, tissue damage and various pathological conditions may be the consequence of oxidative stress. Numerous forms of malignant disease are thought to be the result of oxidative DNA damage and the resulting mutations. The negative impact of free radicals is believed to lead to various autoimmune diseases, diabetes, rheumatic diseases, cardiovascular disease and heart attack, kidney disease, infectious diseases, neurodegenerative diseases (Alzheimer’s disease), etc. The aging process itself is described as the process of accumulation of numerous oxidative damage accumulated over time.
Given that the oxidative stress is associated with the etiology and pathogenesis of many diseases, it is believed that eliminating the causes of oxidative stress may prevent or delay the occurrence of pathological changes and reduce the occurrence of diseases. Numerous studies show that regular intake of fruits, vegetables, grains, and beverages have a positive effect on diseases that are mediated by the activity of free radicals. Therefore, natural antioxidants – alone or in the form of extracts – may be useful in the treatment of such diseases. Thus, the reason for the great interest in researching the antioxidant activity of aromatic, medicinal, and edible plants [13].
In situations of disturbed homeostasis, as well as in the prevention of disease development, the intake of antioxidants in food may be of great importance. In this regard, essential oils, plant extracts, or their individual components with good antioxidant activity may be used. From a chemical point of view, essential oils are complex mixtures of a large number of compounds, which makes their activity difficult to test.
With the exception of some phenolic components, whose antimicrobial and antioxidant activity is well known, such data are not available for most other components of essential oils. Numerous papers on essential oils mention synergism, antagonism, additivity, but such claims are rarely accompanied by experimental confirmation [12].
A study by Ruberto and Baratta [12] examined the antioxidant activity of 100 pure compounds, common constituents of essential oils, using two methods. Of the thirteen non-oxygenated monoterpenes, terpinolene, α-terpinene, γ-terpinene, and sabinen showed very high activity. The activity of α-terpinene and γ-terpinene was similar to that shown by α-tocopherol. An active methylene group is thought to contribute to this activity of the aforementioned compounds. Of the 34 oxygenated monoterpenes tested, thymol and carvacrol showed activity as did α-tocopherol. It is known that thymol and carvacrol contribute the most to the antioxidant activity of essential oils that contain them. Alcohols were the most active in this class of compounds, with the exception of linalool, which showed prooxidative activity. Ketones showed lower activity. Non-oxygenated sesquiterpenes were not active, while oxygenated sesquiterpenes showed activity similar to that of oxygenated monoterpenes. Germacron, a cyclic ketone, showed slightly more pronounced activity, while nerolidol showed prooxidative activity. Phenols, benzene derivatives, have shown the best results. They are more effective in preventing the formation of primary oxidation products, as opposed to preventing the formation of secondary oxidation products. Non-terpene compounds, which are present in essential compounds in a smaller amount, showed weak antioxidant activity – just like non-oxygenated sesquiterpenes [12].
More recently, essential oils have also been used as a substitute for synthetic antioxidants, in those food preservation sectors where their use does not adversely affect product flavor [12].
Due to their specific chemical structure, plant phenolic compounds may act as strong antioxidants, due to their ability to interrupt chain reactions by donating hydrogen atom or electron to a free radical, while taking on a stable non-reactive conformation. However, their activity depends on a number of factors: degree of hydroxylation, polarity, solubility, reducing potential, stability of the resulting radical, etc. Hydroxycinnamic acids, the components of essential oils, show stronger activity compared to hydroxybenzoic acids because they donate hydrogen atoms more easily [14]. Polyphenols are proven to have a positive effect on cognitive abilities and neurodegenerative changes caused by aging [15].
Currently, there is a disparity in knowledge about the
The neurotransmitter acetylcholine (ACh) is present in the nervous system, where it enables cerebral-cortical activity and development, control of cerebral blood flow, control of sleep–wake cycles, as well as learning and memory processes (Figure 3). The enzyme cholineacetyltransferase (ChAT) catalyzes the production of acetylcholine (ACh) in cholinergic neurons, from choline and acetyl coenzyme A.
Structural formula of neurotransmitter acetylcholine (ACh).
Releasing acetylcholine from the synaptic vesicle of the presynaptic membrane into the synaptic cleft, it binds to cholinergic receptors (nicotinic and muscarinic receptors) on the postsynaptic membrane of the cholinergic synapse or on muscle cells. This triggers a series of processes that result in membrane depolarization and further signal transmission [18].
ACh hydrolysis controls the transmission of nerve impulses at the cholinergic synapses of the central and peripheral nervous systems. The degradation of acetylcholine in the synaptic cleft by acetylcholinesterase (AChE) establishes the polarization of the postsynaptic membrane and impulse transmission ceases.
Two types of ChE are currently known: acetylcholinesterase (AChE) and butyrylcholinesterase (BChE). AChE is also called “true cholinesterase”, while BChE is also known as “pseudocholinesterase” because it hydrolyzes many choline esters and other non-choline esters (butyrylcholine, succinylcholine, acetylcholine, acetylsalicylic acid, cocaine, and heroin).
Inhibition of AChE prevents the hydrolysis of ACh, thus prolonging its activity in the transmission of nerve impulses. This concept is applied in the treatment of diseases characterized by low ACh levels and is also being studied in toxicology because of health conditions and deaths caused by increased cholinergic stimulation [19].
Alzheimer’s disease (AD) is the most common neurodegenerative disorder and the cause of dementia in the elderly population. It affects about 2% of the population in industrialized countries. AD is characterized by the formation of neuritic plaques; extracellular accumulations of fibrils and amyloid-β-peptides, as well as neurofibrillary tangles; intracellular accumulations of τ-protein, in regions of the brain responsible for learning, memory, and emotional behavior. These changes cause neuronal degeneration, loss of choline acetyltransferase (ChAT) and acetylcholinesterase (AChE), which is manifested in the loss of neurotransmitters and other neuromodulators, and the disabling of synaptic transmission [18]. Currently, the treatment of this disease is limited to the treatment of symptoms of the disease, for which cholinesterase inhibitors (ChE) are used.
ChE inhibitors may be reversible, those which are bound by noncovalent interactions, or irreversible, which covalently bind to the serine of the catalytic triad. Reversible inhibitors bind to the active site, peripheral site or both, and the inhibition occurs as a result of conformational changes of the enzyme, electrostatic interactions of the inhibitor and the cationic part of the substrate, and steric and/or electrostatic interferences with the substrate entry into the active enzyme center.
A feature of the structure of good cholinesterase inhibitors is the presence of a positive charge and/or aromatic or hydrophobic substituents that facilitate the entry and placement of inhibitors in the active site of the enzyme [18].
Synthetic AChE inhibitors such as physostigmine, tacrine, and donepezil cause side effects such as hepatotoxicity and gastrointestinal disorders. Irreversible inhibitors may cause serious consequences and even death, as is the case with sarin, a poison gas, so reversible inhibitors are preferred in this regard [20].
Bioactive substances from fruits, vegetables, and medicinal plants play a major role in slowing down many pathogeneses and neurodegenerative disorders, such as Alzheimer’s disease. In addition to alkaloids, food rich in phytochemicals contains terpenes and polyphenols, which can be good cholinesterase inhibitors, alone or in synergy with each other [20].
Donepezil, rivastigmine, and galantamine are currently used to treat AD symptoms, such as cognitive dysfunction and memory impairment [21]. The aforementioned galantamine is a reversible inhibitor of AChE, which has been used since 2007 in the treatment of mild to moderate AD. It shows good pharmacological and pharmacokinetic properties, as well as a small number of side effects [22]. The use of most of the ChE inhibitors tested so far has been accompanied by side effects such as fatigue, sleep disorders, cardiorespiratory, gastrointestinal disorders, and low bioavailability. This was an incentive for further research with the aim of finding new ChE inhibitors of natural origin, with greater efficiency and bioavailability, as well as with fewer side effects [23].
Essential oils contain a number of bioactive components; terpenes, terpenoids, phenylpropanoid and other compounds, so a large number of them have been tested in terms of their ability to inhibit ChE. The results showed that some of the tested oils have a good ability to inhibit ChE. Comparing the results of different studies, it was noticed that some essential oils of similar composition have different abilities to inhibit ChE. The differences in the mentioned results may be attributed to the synergistic or antagonistic effect between the individual components of the essential oil. To investigate these effects, a number of studies have been conducted to identify and isolate individual constituents of essential oils with a significant ability to inhibit ChE [24].
The majority of the data obtained thus far in the research pertains to the study of the ability of smaller individual components of essential oils to inhibit AChE, while a few pertain to the study of BChE inhibition. However, given the role of BChE inhibition in the treatment of AD in the later stages of the disease, the interest in testing BChE inhibition has increased [24]. In terms of ChE inhibition, IC50 values are impacted by the enzyme concentration, inhibitors, and substrates, as well as other experimental conditions, making it difficult to compare the results obtained by different studies. It is important to standardize the protocols used in testing AChE and BChE inhibitors, so as to be able to detect them [25].
When it comes to the studies of the ability to inhibit ChE, most of these refer to the study of monoterpenes [24]. Of monoterpenes, 1,8-cineole and α-pinene are the most effective in inhibiting AChE. In addition to these two, the ability to inhibit AChE is shown by δ-2-carene (2-carene), δ-3-carene (3-carene), and mirtenal [18, 24], as well as geraniol, α-caryophyllene, and limonene [21]. Carvone also showed good AChE inhibitory activity [19].
Monoterpene carvacrol and its isomer thymol showed significant AChE inhibitory activity, with carvacrol activity being ten times higher, which indicates the importance of the hydroxyl group position for AChE inhibitory activity [26].
Among the monoterpenes with the
Some studies show the existence of a synergistic effect of monoterpenes, especially between 1,8-cineole and α-pinene [19]. A synergistic effect is also present between the enantiomers of α-pinene and β-pinene (α-
One of the ways in which terpenes inhibit AChE is through a hydrophobic ligand. The hydrophobic active site of AChE is the site where hydrophobic interactions take place, and terpene compounds, built from the skeletons of carbon and hydrogen atoms, thus contribute to the inhibition of cholinesterases [21].
Due to the differences in terpene compounds structure, it is difficult to determine the relationship between their structure and activity. When it comes to monoterpenes with a
Monoterpenes are much better inhibitors of AChE than BChE. Due to their low molecular weight, monoterpenes are more likely to inhibit ChE exerting steric or allosteric effects, whereby BChE does not affect the substrate’s access to the enzyme site [18].
In a study examining 21 monoterpenes in terms of the ability to inhibit BChE, only 3carene showed BChE inhibiting ability (IC50 = 2000 μM) [29]. Monoterpenes α-pinene, 1,8-cineole, 1,8-cineole, linalool, terpinen-4-ol, linalyl acetate, thymol, γ-terpinene, and phenylpropanoid eugenol have shown good to moderate BChE inhibitory potential (IC50 = 0,1 to 1,0 mM) in various studies [24].
Of the flavonoids, flavones and isoflavones show the best activity, while xanthones and monoterpenes show weaker activity in the inhibition of cholinesterases (Figure 4) [18].
Some monoterpenes with cholinesterase inhibition activity.
The most frequently studied sesquiterpenes for AChE inhibition are β-caryophyllene and α-humulene. In doing so, β-caryophyllene had a good ability to inhibit, in contrast to α-humulene (α-caryophyllene), which showed a weak ability to inhibit AChE [24]. In several studies, β-caryophyllene also showed good to moderate BChE inhibitory potential (IC50 = 0,1 to 1,0 mM) [24].
Diterpenes inhibit ChE at lower concentrations than monoterpenes, which indicates the importance of molecule size. Dihydrotanshinone and cryptotanshinone are non-competitive ChE inhibitors. Of triterpenes and steroids, ursolic acid, taraxerol, leucisterol, and oleanolic acid show ChE inhibitory activity [18].
Given that BChE has a regulatory role in ACh hydrolysis, therapeutics that would inhibit both ChEs could exert additional positive effects in the treatment of AD, compared to inhibitors that inhibit only AChE. Thus, rivastigmine, which inhibits both ChEs, is very successful in the AD treatment. To date, there is no evidence that BChE inhibitors are more effective in reducing AD symptoms than AchE inhibitors [18].
In traditional medicine, many herbs are used in the treatment of cognitive disorders, including neurodegenerative diseases. The ethnopharmacological approach, testing of biological activity and isolation enabled the identification of potential AChE inhibitors of plant origin. Multifunctional compounds with several complementary biological functions are of particular interest. Plant extracts are the main sources of new compounds, AChE inhibitors [21]. In this regard, polyphenols are particularly interesting due to their positive effect on human health [20].
Many phytochemicals are bioactive compounds, some of which show ChE inhibitory activity and represent a model for the development of new drugs, ChE inhibitors. As terpenes and terpenoids have shown relatively weak inhibitory capacity in studies published so far, it is necessary to develop analogues with an improved efficiency [21].
Given the above, numerous plant extracts and essential oils, as well as their components, have been studied in terms of ChE inhibitory activity [18, 19, 20].
The essential oils obtained from various
Thirty-four (34) volatile compounds (98.0% of the total oil) in
Medicinal properties of
In
The antioxidant capacity of the essential oils of
The antioxidant potential of
Low quantities of phenol compounds or monoterpenoids (such as carvacrol and thymol), which are good antioxidant compounds, may explain low antioxidant activity of
The ability of
These good results for
An excess of reactive species and damage caused by their action is called oxidative stress. In a state of oxidative stress, an excess of ROS and RNS may damage lipids, proteins, carbohydrates, and nucleic acids. Free radicals attack unsaturated fatty acids in biological membranes causing lipid peroxidation. Oxidative modification of proteins is present in diseases and changes associated with the aging process, such as atherosclerosis, tumors, neurodegenerative diseases, and the aging. In addition to fragmentation, oxidation of the amino acid residues increases carbonyl concentration, so the presence of carbonyl groups can be used as an indicator of protein oxidation.
Oxidation of lipid molecules is a major problem in the food industry, as it leads to changes in the organoleptic properties of food, a decrease in its nutritional value, as well as the formation of radical components that can endanger consumers’ health. Polyunsaturated fatty acids oxidize much faster than monounsaturated or saturated ones. Lipid autooxidation is an autocatalytic reaction, which means that it progresses over time due to the formation of products that catalyze the reaction themselves.
The use of some synthetic antioxidants has negative effects on human health due to the promotion of carcinogenesis [10, 11], and there is a tendency to replace synthetic antioxidants, where possible, with non-toxic antioxidants of natural origin. More recently, essential oils have also been used as a substitute for synthetic antioxidants, in those food canning sectors where their use does not adversely affect product flavor [12].
Given that the oxidative stress is associated with the etiology and pathogenesis of many diseases, it is believed that eliminating the causes of oxidative stress may prevent or delay the occurrence of pathological changes and reduce the occurrence of diseases. Therefore, natural antioxidants – alone or in the form of extracts – may be useful in the treatment of such diseases. Thus the reason for the great interest in researching the antioxidant activity of aromatic, medicinal, and edible plants [13]. With the exception of some phenolic components, whose antimicrobial and antioxidant activity is well known, such data are not available for most other components of essential oils.
Inhibition of acetylcholinesterase prevents the hydrolysis of acetylcholine, thus prolonging its activity in the transmission of nerve impulses. This concept is applied in the treatment of diseases characterized by low ACh levels, such as Alzheimer’s disease. Synthetic AChE inhibitors such as physostigmine, tacrine, and donepezil cause side effects such as hepatotoxicity and gastrointestinal disorders. This was an incentive for further research with the aim of finding new ChE inhibitors of natural origin, with greater efficiency and bioavailability, as well as with fewer side effects. Many phytochemicals are bioactive compounds, some of which show ChE inhibitory activity and represent a model for the development of new drugs, ChE inhibitors. As terpenes and terpenoids have shown relatively weak inhibitory capacity in studies published so far, it is necessary to develop analogues with an improved efficiency [21].
The obtained results show that the tested essential oils of
The authors declare no conflict of interest.
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His studies in robotics lead him not only to a PhD degree but also inspired him to co-found and build the International Journal of Advanced Robotic Systems - world's first Open Access journal in the field of robotics.",institutionString:null,institution:{name:"TU Wien",country:{name:"Austria"}}},{id:"441",title:"Ph.D.",name:"Jaekyu",middleName:null,surname:"Park",slug:"jaekyu-park",fullName:"Jaekyu Park",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/441/images/1881_n.jpg",biography:null,institutionString:null,institution:{name:"LG Corporation (South Korea)",country:{name:"Korea, South"}}},{id:"465",title:"Dr",name:"Christian",middleName:null,surname:"Martens",slug:"christian-martens",fullName:"Christian Martens",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"479",title:"Dr.",name:"Valentina",middleName:null,surname:"Colla",slug:"valentina-colla",fullName:"Valentina Colla",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/479/images/358_n.jpg",biography:null,institutionString:null,institution:{name:"Sant'Anna School of Advanced Studies",country:{name:"Italy"}}},{id:"494",title:"PhD",name:"Loris",middleName:null,surname:"Nanni",slug:"loris-nanni",fullName:"Loris Nanni",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/494/images/system/494.jpg",biography:"Loris Nanni received his Master Degree cum laude on June-2002 from the University of Bologna, and the April 26th 2006 he received his Ph.D. in Computer Engineering at DEIS, University of Bologna. 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. His research interests include pattern recognition, bioinformatics, and biometric systems (fingerprint classification and recognition, signature verification, face recognition).",institutionString:null,institution:null},{id:"496",title:"Dr.",name:"Carlos",middleName:null,surname:"Leon",slug:"carlos-leon",fullName:"Carlos Leon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Seville",country:{name:"Spain"}}},{id:"512",title:"Dr.",name:"Dayang",middleName:null,surname:"Jawawi",slug:"dayang-jawawi",fullName:"Dayang Jawawi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Technology Malaysia",country:{name:"Malaysia"}}},{id:"528",title:"Dr.",name:"Kresimir",middleName:null,surname:"Delac",slug:"kresimir-delac",fullName:"Kresimir Delac",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/528/images/system/528.jpg",biography:"K. 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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. 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The main global health organizations have incorporated patient safety in their review of work practices. The data provided by the medical laboratories have a direct impact on patient safety and a fault in any of processes such as strategic, operational and support, could affect it. To provide appreciate and reliable data to the physicians, it is important to emphasize the need to design risk management plan in the laboratory. Failure Mode and Effect Analysis (FMEA) is an efficient technique for error detection and reduction. Technical Committee of the International Organization for Standardization (ISO) licensed a technical specification for medical laboratories suggesting FMEA as a method for prospective risk analysis of high-risk processes. FMEA model helps to identify quality failures, their effects and risks with their reduction/elimination, which depends on severity, probability and detection. Applying FMEA in clinical approaches can lead to a significant reduction of the risk priority number (RPN).",book:{id:"9808",slug:"contemporary-topics-in-patient-safety-volume-1",title:"Contemporary Topics in Patient Safety",fullTitle:"Contemporary Topics in Patient Safety - Volume 1"},signatures:"Hoda Sabati, Amin Mohsenzadeh and Nooshin Khelghati",authors:[{id:"340486",title:"M.Sc.",name:"Hoda",middleName:null,surname:"Sabati",slug:"hoda-sabati",fullName:"Hoda Sabati"},{id:"348872",title:"M.Sc.",name:"Amin",middleName:null,surname:"Mohsenzadeh",slug:"amin-mohsenzadeh",fullName:"Amin Mohsenzadeh"},{id:"348874",title:"MSc.",name:"Nooshin",middleName:null,surname:"Khelghati",slug:"nooshin-khelghati",fullName:"Nooshin Khelghati"}]},{id:"69876",title:"Leadership Styles in Nursing",slug:"leadership-styles-in-nursing",totalDownloads:2963,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Recent developments in the field of management-organization and organizational behavior and new concepts have also led to the emergence of new leadership styles in leadership. Leadership in health services is important for following innovations and adapting to current situations. Nurses working together with other health personnel in hospitals providing health services constitute an important group in leadership. Nursing, which is a key force for patient safety and safe care, is a human-centered profession, and therefore leadership is a key skill for nurses at all levels. The leadership styles of nurse managers are believed to be an important determinant of job satisfaction and persistence of nurses. The need for nurses with leadership skills and the need for nurses to develop their leadership skills are increasing day by day. There are several leadership styles defined in nursing literature. These leadership styles are examined under the titles of relational leadership style, transformational leadership, resonant leadership, emotional intelligence leadership, and participatory leadership. The task-focused leadership style is explored under the headings of transactional and autocratic leadership, laissez-faire leadership, and instrumental leadership.",book:{id:"9047",slug:"nursing-new-perspectives",title:"Nursing",fullTitle:"Nursing - New Perspectives"},signatures:"Serpil Çelik Durmuş and Kamile Kırca",authors:null},{id:"58916",title:"Factors Affecting the Attitudes of Women toward Family Planning",slug:"factors-affecting-the-attitudes-of-women-toward-family-planning",totalDownloads:8485,totalCrossrefCites:9,totalDimensionsCites:18,abstract:"Everyone has the right to decide on the number and timing of children without discrimination, violence and oppression, to have the necessary information and facilities for it, to access sexual and reproductive health services at the highest standard. Deficient or incorrect family planning methods, wrong attitudes and behaviors toward the methods and consequent unplanned pregnancies, increased maternal and infant mortality rates are the main health problems in most countries. Individuals’ learning modern family planning methods and having positive attitude for these methods may increase the usage of these methods and contributes the formation of healthy communities. 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Over periods of time, some of these norms become standards that all members of the community are expected to adhere to. Deviance from these standards is seen as absurd, wrong, or frankly abnormal. However, many of these cultural mores have no scientific basis and, some of them actually promote behaviors with negative health consequences. This chapter examines the cultural practices of some communities in Africa and their health consequences and, explores ways to address the challenges.",book:{id:"9138",slug:"public-health-in-developing-countries-challenges-and-opportunities",title:"Public Health in Developing Countries",fullTitle:"Public Health in Developing Countries - Challenges and Opportunities"},signatures:"Radiance Ogundipe",authors:[{id:"302308",title:"Dr.",name:"Radiance",middleName:null,surname:"Ogundipe",slug:"radiance-ogundipe",fullName:"Radiance Ogundipe"}]},{id:"55808",title:"The Role of Legumes in Human Nutrition",slug:"the-role-of-legumes-in-human-nutrition",totalDownloads:5378,totalCrossrefCites:59,totalDimensionsCites:100,abstract:"Legumes are valued worldwide as a sustainable and inexpensive meat alternative and are considered the second most important food source after cereals. Legumes are nutritionally valuable, providing proteins (20–45%) with essential amino acids, complex carbohydrates (±60%) and dietary fibre (5–37%). Legumes also have no cholesterol and are generally low in fat, with ±5% energy from fat, with the exception of peanuts (±45%), chickpeas (±15%) and soybeans (±47%) and provide essential minerals and vitamins. In addition to their nutritional superiority, legumes have also been ascribed economical, cultural, physiological and medicinal roles owing to their possession of beneficial bioactive compounds. Research has shown that most of the bioactive compounds in legumes possess antioxidant properties, which play a role in the prevention of some cancers, heart diseases, osteoporosis and other degenerative diseases. Because of their composition, legumes are attractive to health conscious consumers, celiac and diabetic patients as well as consumers concerned with weight management. 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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. 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For 20 years, he has studied the analysis and processing of biomedical images, emphasizing the full automation of measurement for a large inter-individual variability of patients. Dr. Koprowski has authored more than a hundred research papers with dozens in impact factor (IF) journals and has authored or co-authored six books. Additionally, he is the author of several national and international patents in the field of biomedical devices and imaging. 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His fields of interest are anterior segment disease, keratoconus, glaucoma, corneal dystrophies, and cataracts. His research topics include\nintraocular lens power calculation, eye modification induced by refractive surgery, glaucoma progression, and validation of new diagnostic devices in ophthalmology. \nHe has published more than 100 papers in international and Italian scientific journals, more than 60 in journals with impact factors, and chapters in international and Italian books. He has also edited two international books and authored more than 150 communications or posters for the most important international and Italian ophthalmology conferences.",institutionString:'University of Campania "Luigi Vanvitelli"',institution:{name:'University of Campania "Luigi Vanvitelli"',institutionURL:null,country:{name:"Italy"}}}]},{type:"book",id:"7560",title:"Non-Invasive Diagnostic Methods",subtitle:"Image Processing",coverURL:"https://cdn.intechopen.com/books/images_new/7560.jpg",slug:"non-invasive-diagnostic-methods-image-processing",publishedDate:"December 19th 2018",editedByType:"Edited by",bookSignature:"Mariusz Marzec and Robert Koprowski",hash:"d92fd8cf5a90a47f2b8a310837a5600e",volumeInSeries:3,fullTitle:"Non-Invasive Diagnostic Methods - Image Processing",editors:[{id:"253468",title:"Dr.",name:"Mariusz",middleName:null,surname:"Marzec",slug:"mariusz-marzec",fullName:"Mariusz Marzec",profilePictureURL:"https://mts.intechopen.com/storage/users/253468/images/system/253468.png",biography:"An assistant professor at Department of Biomedical Computer Systems, at Institute of Computer Science, Silesian University in Katowice. 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His research interests include root canal morphology, functionally graded concept, dental biomaterials, epidemiology and dental education, biomimetic restoration, finite element analysis and endodontic regeneration. Dr. Madfa has numerous international publications, full articles, two patents, a book and a book chapter. Furthermore, he won 14 international scientific awards. Furthermore, he is involved in many academic activities ranging from editorial board member, reviewer for many international journals and postgraduate students' supervisor. Besides, I deliver many courses and training workshops at various scientific events. Dr. Madfa also regularly attends international conferences and holds administrative positions (Deputy Dean of the Faculty for Students’ & Academic Affairs and Deputy Head of Research Unit).",institutionString:"Thamar University",institution:null},{id:"210472",title:"Dr.",name:"Nermin",middleName:"Mohammed Ahmed",surname:"Yussif",slug:"nermin-yussif",fullName:"Nermin Yussif",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/210472/images/system/210472.jpg",biography:"Dr. Nermin Mohammed Ahmed Yussif is working at the Faculty of dentistry, University for October university for modern sciences and arts (MSA). Her areas of expertise include: periodontology, dental laserology, oral implantology, periodontal plastic surgeries, oral mesotherapy, nutrition, dental pharmacology. She is an editor and reviewer in numerous international journals.",institutionString:"MSA University",institution:null},{id:"204606",title:"Dr.",name:"Serdar",middleName:null,surname:"Gözler",slug:"serdar-gozler",fullName:"Serdar Gözler",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204606/images/system/204606.jpeg",biography:"Dr. Serdar Gözler has completed his undergraduate studies at the Marmara University Faculty of Dentistry in 1978, followed by an assistantship in the Prosthesis Department of Dicle University Faculty of Dentistry. Starting his PhD work on non-resilient overdentures with Assoc. Prof. Hüsnü Yavuzyılmaz, he continued his studies with Prof. Dr. Gürbüz Öztürk of Istanbul University Faculty of Dentistry Department of Prosthodontics, this time on Gnatology. He attended training programs on occlusion, neurology, neurophysiology, EMG, radiology and biostatistics. In 1982, he presented his PhD thesis \\Gerber and Lauritzen Occlusion Analysis Techniques: Diagnosis Values,\\ at Istanbul University School of Dentistry, Department of Prosthodontics. As he was also working with Prof. Senih Çalıkkocaoğlu on The Physiology of Chewing at the same time, Gözler has written a chapter in Çalıkkocaoğlu\\'s book \\Complete Prostheses\\ entitled \\The Place of Neuromuscular Mechanism in Prosthetic Dentistry.\\ The book was published five times since by the Istanbul University Publications. Having presented in various conferences about occlusion analysis until 1998, Dr. Gözler has also decided to use the T-Scan II occlusion analysis method. Having been personally trained by Dr. Robert Kerstein on this method, Dr. Gözler has been lecturing on the T-Scan Occlusion Analysis Method in conferences both in Turkey and abroad. Dr. Gözler has various articles and presentations on Digital Occlusion Analysis methods. He is now Head of the TMD Clinic at Prosthodontic Department of Faculty of Dentistry , Istanbul Aydın University , Turkey.",institutionString:"Istanbul Aydin University",institution:{name:"Istanbul Aydın University",country:{name:"Turkey"}}},{id:"240870",title:"Ph.D.",name:"Alaa Eddin Omar",middleName:null,surname:"Al Ostwani",slug:"alaa-eddin-omar-al-ostwani",fullName:"Alaa Eddin Omar Al Ostwani",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/240870/images/system/240870.jpeg",biography:"Dr. Al Ostwani Alaa Eddin Omar received his Master in dentistry from Damascus University in 2010, and his Ph.D. in Pediatric Dentistry from Damascus University in 2014. Dr. Al Ostwani is an assistant professor and faculty member at IUST University since 2014. \nDuring his academic experience, he has received several awards including the scientific research award from the Union of Arab Universities, the Syrian gold medal and the international gold medal for invention and creativity. Dr. Al Ostwani is a Member of the International Association of Dental Traumatology and the Syrian Society for Research and Preventive Dentistry since 2017. He is also a Member of the Reviewer Board of International Journal of Dental Medicine (IJDM), and the Indian Journal of Conservative and Endodontics since 2016.",institutionString:"International University for Science and Technology.",institution:{name:"Islamic University of Science and Technology",country:{name:"India"}}},{id:"42847",title:"Dr.",name:"Belma",middleName:null,surname:"Işik Aslan",slug:"belma-isik-aslan",fullName:"Belma Işik Aslan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/42847/images/system/42847.jpg",biography:"Dr. Belma IşIk Aslan was born in 1976 in Ankara-TURKEY. After graduating from TED Ankara College in 1994, she attended to Gazi University, Faculty of Dentistry in Ankara. She completed her PhD in orthodontic education at Gazi University between 1999-2005. Dr. Işık Aslan stayed at the Providence Hospital Craniofacial Institude and Reconstructive Surgery in Michigan, USA for three months as an observer. She worked as a specialist doctor at Gazi University, Dentistry Faculty, Department of Orthodontics between 2005-2014. She was appointed as associate professor in January, 2014 and as professor in 2021. Dr. Işık Aslan still works as an instructor at the same faculty. She has published a total of 35 articles, 10 book chapters, 39 conference proceedings both internationally and nationally. Also she was the academic editor of the international book 'Current Advances in Orthodontics'. She is a member of the Turkish Orthodontic Society and Turkish Cleft Lip and Palate Society. She is married and has 2 children. Her knowledge of English is at an advanced level.",institutionString:"Gazi University Dentistry Faculty Department of Orthodontics",institution:null},{id:"178412",title:"Associate Prof.",name:"Guhan",middleName:null,surname:"Dergin",slug:"guhan-dergin",fullName:"Guhan Dergin",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178412/images/6954_n.jpg",biography:"Assoc. Prof. Dr. Gühan Dergin was born in 1973 in Izmit. He graduated from Marmara University Faculty of Dentistry in 1999. He completed his specialty of OMFS surgery in Marmara University Faculty of Dentistry and obtained his PhD degree in 2006. In 2005, he was invited as a visiting doctor in the Oral and Maxillofacial Surgery Department of the University of North Carolina, USA, where he went on a scholarship. Dr. Dergin still continues his academic career as an associate professor in Marmara University Faculty of Dentistry. He has many articles in international and national scientific journals and chapters in books.",institutionString:null,institution:{name:"Marmara University",country:{name:"Turkey"}}},{id:"178414",title:"Prof.",name:"Yusuf",middleName:null,surname:"Emes",slug:"yusuf-emes",fullName:"Yusuf Emes",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178414/images/6953_n.jpg",biography:"Born in Istanbul in 1974, Dr. Emes graduated from Istanbul University Faculty of Dentistry in 1997 and completed his PhD degree in Istanbul University faculty of Dentistry Department of Oral and Maxillofacial Surgery in 2005. He has papers published in international and national scientific journals, including research articles on implantology, oroantral fistulas, odontogenic cysts, and temporomandibular disorders. Dr. Emes is currently working as a full-time academic staff in Istanbul University faculty of Dentistry Department of Oral and Maxillofacial Surgery.",institutionString:null,institution:{name:"Istanbul University",country:{name:"Turkey"}}},{id:"192229",title:"Ph.D.",name:"Ana Luiza",middleName:null,surname:"De Carvalho Felippini",slug:"ana-luiza-de-carvalho-felippini",fullName:"Ana Luiza De Carvalho Felippini",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192229/images/system/192229.jpg",biography:null,institutionString:"University of São Paulo",institution:{name:"University of Sao Paulo",country:{name:"Brazil"}}},{id:"256851",title:"Prof.",name:"Ayşe",middleName:null,surname:"Gülşen",slug:"ayse-gulsen",fullName:"Ayşe Gülşen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/256851/images/9696_n.jpg",biography:"Dr. Ayşe Gülşen graduated in 1990 from Faculty of Dentistry, University of Ankara and did a postgraduate program at University of Gazi. \nShe worked as an observer and research assistant in Craniofacial Surgery Departments in New York, Providence Hospital in Michigan and Chang Gung Memorial Hospital in Taiwan. \nShe works as Craniofacial Orthodontist in Department of Aesthetic, Plastic and Reconstructive Surgery, Faculty of Medicine, University of Gazi, Ankara Turkey since 2004.",institutionString:"Univeristy of Gazi",institution:null},{id:"255366",title:"Prof.",name:"Tosun",middleName:null,surname:"Tosun",slug:"tosun-tosun",fullName:"Tosun Tosun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255366/images/7347_n.jpg",biography:"Graduated at the Faculty of Dentistry, University of Istanbul, Turkey in 1989;\nVisitor Assistant at the University of Padua, Italy and Branemark Osseointegration Center of Treviso, Italy between 1993-94;\nPhD thesis on oral implantology in University of Istanbul and was awarded the academic title “Dr.med.dent.”, 1997;\nHe was awarded the academic title “Doç.Dr.” (Associated Professor) in 2003;\nProficiency in Botulinum Toxin Applications, Reading-UK in 2009;\nMastership, RWTH Certificate in Laser Therapy in Dentistry, AALZ-Aachen University, Germany 2009-11;\nMaster of Science (MSc) in Laser Dentistry, University of Genoa, Italy 2013-14.\n\nDr.Tosun worked as Research Assistant in the Department of Oral Implantology, Faculty of Dentistry, University of Istanbul between 1990-2002. \nHe worked part-time as Consultant surgeon in Harvard Medical International Hospitals and John Hopkins Medicine, Istanbul between years 2007-09.\u2028He was contract Professor in the Department of Surgical and Diagnostic Sciences (DI.S.C.), Medical School, University of Genova, Italy between years 2011-16. \nSince 2015 he is visiting Professor at Medical School, University of Plovdiv, Bulgaria. \nCurrently he is Associated Prof.Dr. at the Dental School, Oral Surgery Dept., Istanbul Aydin University and since 2003 he works in his own private clinic in Istanbul, Turkey.\u2028\nDr.Tosun is reviewer in journal ‘Laser in Medical Sciences’, reviewer in journal ‘Folia Medica\\', a Fellow of the International Team for Implantology, Clinical Lecturer of DGZI German Association of Oral Implantology, Expert Lecturer of Laser&Health Academy, Country Representative of World Federation for Laser Dentistry, member of European Federation of Periodontology, member of Academy of Laser Dentistry. Dr.Tosun presents papers in international and national congresses and has scientific publications in international and national journals. He speaks english, spanish, italian and french.",institutionString:null,institution:{name:"Istanbul Aydın University",country:{name:"Turkey"}}},{id:"171887",title:"Prof.",name:"Zühre",middleName:null,surname:"Akarslan",slug:"zuhre-akarslan",fullName:"Zühre Akarslan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/171887/images/system/171887.jpg",biography:"Zühre Akarslan was born in 1977 in Cyprus. She graduated from Gazi University Faculty of Dentistry, Ankara, Turkey in 2000. \r\nLater she received her Ph.D. degree from the Oral Diagnosis and Radiology Department; which was recently renamed as Oral and Dentomaxillofacial Radiology, from the same university. \r\nShe is working as a full-time Associate Professor and is a lecturer and an academic researcher. \r\nHer expertise areas are dental caries, cancer, dental fear and anxiety, gag reflex in dentistry, oral medicine, and dentomaxillofacial radiology.",institutionString:"Gazi University",institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"256417",title:"Associate Prof.",name:"Sanaz",middleName:null,surname:"Sadry",slug:"sanaz-sadry",fullName:"Sanaz Sadry",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/256417/images/8106_n.jpg",biography:null,institutionString:null,institution:null},{id:"272237",title:"Dr.",name:"Pinar",middleName:"Kiymet",surname:"Karataban",slug:"pinar-karataban",fullName:"Pinar Karataban",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/272237/images/8911_n.png",biography:"Assist.Prof.Dr.Pınar Kıymet Karataban, DDS PhD \n\nDr.Pınar Kıymet Karataban was born in Istanbul in 1975. After her graduation from Marmara University Faculty of Dentistry in 1998 she started her PhD in Paediatric Dentistry focused on children with special needs; mainly children with Cerebral Palsy. She finished her pHD thesis entitled \\'Investigation of occlusion via cast analysis and evaluation of dental caries prevalance, periodontal status and muscle dysfunctions in children with cerebral palsy” in 2008. She got her Assist. Proffessor degree in Istanbul Aydın University Paediatric Dentistry Department in 2015-2018. ın 2019 she started her new career in Bahcesehir University, Istanbul as Head of Department of Pediatric Dentistry. In 2020 she was accepted to BAU International University, Batumi as Professor of Pediatric Dentistry. She’s a lecturer in the same university meanwhile working part-time in private practice in Ege Dental Studio (https://www.egedisklinigi.com/) a multidisciplinary dental clinic in Istanbul. Her main interests are paleodontology, ancient and contemporary dentistry, oral microbiology, cerebral palsy and special care dentistry. She has national and international publications, scientific reports and is a member of IAPO (International Association for Paleodontology), IADH (International Association of Disability and Oral Health) and EAPD (European Association of Pediatric Dentistry).",institutionString:null,institution:null},{id:"202198",title:"Dr.",name:"Buket",middleName:null,surname:"Aybar",slug:"buket-aybar",fullName:"Buket Aybar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/202198/images/6955_n.jpg",biography:"Buket Aybar, DDS, PhD, was born in 1971. She graduated from Istanbul University, Faculty of Dentistry, in 1992 and completed her PhD degree on Oral and Maxillofacial Surgery in Istanbul University in 1997.\nDr. Aybar is currently a full-time professor in Istanbul University, Faculty of Dentistry Department of Oral and Maxillofacial Surgery. She has teaching responsibilities in graduate and postgraduate programs. Her clinical practice includes mainly dentoalveolar surgery.\nHer topics of interest are biomaterials science and cell culture studies. She has many articles in international and national scientific journals and chapters in books; she also has participated in several scientific projects supported by Istanbul University Research fund.",institutionString:null,institution:null},{id:"260116",title:"Dr.",name:"Mehmet",middleName:null,surname:"Yaltirik",slug:"mehmet-yaltirik",fullName:"Mehmet Yaltirik",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/260116/images/7413_n.jpg",biography:"Birth Date 25.09.1965\r\nBirth Place Adana- Turkey\r\nSex Male\r\nMarrial Status Bachelor\r\nDriving License Acquired\r\nMother Tongue Turkish\r\n\r\nAddress:\r\nWork:University of Istanbul,Faculty of Dentistry, Department of Oral Surgery and Oral Medicine 34093 Capa,Istanbul- TURKIYE",institutionString:null,institution:null},{id:"172009",title:"Dr.",name:"Fatma Deniz",middleName:null,surname:"Uzuner",slug:"fatma-deniz-uzuner",fullName:"Fatma Deniz Uzuner",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/172009/images/7122_n.jpg",biography:"Dr. Deniz Uzuner was born in 1969 in Kocaeli-TURKEY. After graduating from TED Ankara College in 1986, she attended the Hacettepe University, Faculty of Dentistry in Ankara. \nIn 1993 she attended the Gazi University, Faculty of Dentistry, Department of Orthodontics for her PhD education. After finishing the PhD education, she worked as orthodontist in Ankara Dental Hospital under the Turkish Government, Ministry of Health and in a special Orthodontic Clinic till 2011. Between 2011 and 2016, Dr. Deniz Uzuner worked as a specialist in the Department of Orthodontics, Faculty of Dentistry, Gazi University in Ankara/Turkey. In 2016, she was appointed associate professor. Dr. Deniz Uzuner has authored 23 Journal Papers, 3 Book Chapters and has had 39 oral/poster presentations. She is a member of the Turkish Orthodontic Society. Her knowledge of English is at an advanced level.",institutionString:null,institution:null},{id:"332914",title:"Dr.",name:"Muhammad Saad",middleName:null,surname:"Shaikh",slug:"muhammad-saad-shaikh",fullName:"Muhammad Saad Shaikh",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Jinnah Sindh Medical University",country:{name:"Pakistan"}}},{id:"315775",title:"Dr.",name:"Feng",middleName:null,surname:"Luo",slug:"feng-luo",fullName:"Feng Luo",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Sichuan University",country:{name:"China"}}},{id:"423519",title:"Dr.",name:"Sizakele",middleName:null,surname:"Ngwenya",slug:"sizakele-ngwenya",fullName:"Sizakele Ngwenya",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of the Witwatersrand",country:{name:"South Africa"}}},{id:"419270",title:"Dr.",name:"Ann",middleName:null,surname:"Chianchitlert",slug:"ann-chianchitlert",fullName:"Ann Chianchitlert",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Walailak University",country:{name:"Thailand"}}},{id:"419271",title:"Dr.",name:"Diane",middleName:null,surname:"Selvido",slug:"diane-selvido",fullName:"Diane Selvido",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Walailak University",country:{name:"Thailand"}}},{id:"419272",title:"Dr.",name:"Irin",middleName:null,surname:"Sirisoontorn",slug:"irin-sirisoontorn",fullName:"Irin Sirisoontorn",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Walailak University",country:{name:"Thailand"}}},{id:"355660",title:"Dr.",name:"Anitha",middleName:null,surname:"Mani",slug:"anitha-mani",fullName:"Anitha Mani",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"355612",title:"Dr.",name:"Janani",middleName:null,surname:"Karthikeyan",slug:"janani-karthikeyan",fullName:"Janani Karthikeyan",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"334400",title:"Dr.",name:"Suvetha",middleName:null,surname:"Siva",slug:"suvetha-siva",fullName:"Suvetha Siva",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"SRM Dental College",country:{name:"India"}}},{id:"334239",title:"Prof.",name:"Leung",middleName:null,surname:"Wai Keung",slug:"leung-wai-keung",fullName:"Leung Wai Keung",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Hong Kong",country:{name:"China"}}}]}},subseries:{item:{id:"27",type:"subseries",title:"Multi-Agent Systems",keywords:"Collaborative Intelligence, Learning, Distributed Control System, Swarm Robotics, Decision Science, Software Engineering",scope:"Multi-agent systems are recognised as a state of the art field in Artificial Intelligence studies, which is popular due to the usefulness in facilitation capabilities to handle real-world problem-solving in a distributed fashion. The area covers many techniques that offer solutions to emerging problems in robotics and enterprise-level software systems. Collaborative intelligence is highly and effectively achieved with multi-agent systems. Areas of application include swarms of robots, flocks of UAVs, collaborative software management. Given the level of technological enhancements, the popularity of machine learning in use has opened a new chapter in multi-agent studies alongside the practical challenges and long-lasting collaboration issues in the field. It has increased the urgency and the need for further studies in this field. We welcome chapters presenting research on the many applications of multi-agent studies including, but not limited to, the following key areas: machine learning for multi-agent systems; modeling swarms robots and flocks of UAVs with multi-agent systems; decision science and multi-agent systems; software engineering for and with multi-agent systems; tools and technologies of multi-agent systems.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/27.jpg",hasOnlineFirst:!1,hasPublishedBooks:!1,annualVolume:11423,editor:{id:"148497",title:"Dr.",name:"Mehmet",middleName:"Emin",surname:"Aydin",slug:"mehmet-aydin",fullName:"Mehmet Aydin",profilePictureURL:"https://mts.intechopen.com/storage/users/148497/images/system/148497.jpg",biography:"Dr. Mehmet Emin Aydin is a Senior Lecturer with the Department of Computer Science and Creative Technology, the University of the West of England, Bristol, UK. His research interests include swarm intelligence, parallel and distributed metaheuristics, machine learning, intelligent agents and multi-agent systems, resource planning, scheduling and optimization, combinatorial optimization. Dr. Aydin is currently a Fellow of Higher Education Academy, UK, a member of EPSRC College, a senior member of IEEE and a senior member of ACM. In addition to being a member of advisory committees of many international conferences, he is an Editorial Board Member of various peer-reviewed international journals. He has served as guest editor for a number of special issues of peer-reviewed international journals.",institutionString:null,institution:{name:"University of the West of England",institutionURL:null,country:{name:"United Kingdom"}}},editorTwo:null,editorThree:null,series:{id:"14",title:"Artificial Intelligence",doi:"10.5772/intechopen.79920",issn:"2633-1403"},editorialBoard:[{id:"275140",title:"Dr.",name:"Dinh Hoa",middleName:null,surname:"Nguyen",slug:"dinh-hoa-nguyen",fullName:"Dinh Hoa Nguyen",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRbnKQAS/Profile_Picture_1622204093453",institutionString:null,institution:{name:"Kyushu University",institutionURL:null,country:{name:"Japan"}}},{id:"20259",title:"Dr.",name:"Hongbin",middleName:null,surname:"Ma",slug:"hongbin-ma",fullName:"Hongbin Ma",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRhDJQA0/Profile_Picture_2022-05-02T08:25:21.jpg",institutionString:null,institution:{name:"Beijing Institute of Technology",institutionURL:null,country:{name:"China"}}},{id:"28640",title:"Prof.",name:"Yasushi",middleName:null,surname:"Kambayashi",slug:"yasushi-kambayashi",fullName:"Yasushi Kambayashi",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYOQxQAO/Profile_Picture_1625660525470",institutionString:null,institution:{name:"Nippon Institute of Technology",institutionURL:null,country:{name:"Japan"}}}]},onlineFirstChapters:{paginationCount:14,paginationItems:[{id:"82103",title:"The Role of Endoplasmic Reticulum Stress and Its Regulation in the Progression of Neurological and Infectious Diseases",doi:"10.5772/intechopen.105543",signatures:"Mary Dover, Michael Kishek, Miranda Eddins, Naneeta Desar, Ketema Paul and Milan Fiala",slug:"the-role-of-endoplasmic-reticulum-stress-and-its-regulation-in-the-progression-of-neurological-and-i",totalDownloads:5,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Updates on Endoplasmic Reticulum",coverURL:"https://cdn.intechopen.com/books/images_new/11674.jpg",subseries:{id:"14",title:"Cell and Molecular Biology"}}},{id:"80954",title:"Ion Channels and Neurodegenerative Disease Aging Related",doi:"10.5772/intechopen.103074",signatures:"Marika Cordaro, Salvatore Cuzzocrea and Rosanna Di Paola",slug:"ion-channels-and-neurodegenerative-disease-aging-related",totalDownloads:6,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Ion Channels - From Basic Properties to Medical Treatment",coverURL:"https://cdn.intechopen.com/books/images_new/10838.jpg",subseries:{id:"14",title:"Cell and Molecular Biology"}}},{id:"81647",title:"Diabetes and Epigenetics",doi:"10.5772/intechopen.104653",signatures:"Rasha A. 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Thus proteomics, an area of research that detects all protein forms expressed in an organism, including splice isoforms and post-translational modifications, is more suitable than genomics for a comprehensive understanding of the biochemical processes that govern life. The most common proteomics applications are currently in the clinical field for the identification, in a variety of biological matrices, of biomarkers for diagnosis and therapeutic intervention of disorders. From the comparison of proteomic profiles of control and disease or different physiological states, which may emerge, changes in protein expression can provide new insights into the roles played by some proteins in human pathologies. Understanding how proteins function and interact with each other is another goal of proteomics that makes this approach even more intriguing. Specialized technology and expertise are required to assess the proteome of any biological sample. 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