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Introduction
Hydrocolloids are colloidal systems wherein the colloid particles are hydrophilic polymers dispersed in water and depending on the quantity of water available that can take place in different states, e.g., gel or sol (liquid) It is an intermediate between a solution and a suspension which can be distinguished from solutions using the Tyndall effect [1]. Hydrocolloids materials are available in the form of viscous liquids in the “sol” state or the form of semi-solid substances of a gelatinous consistency. Without a filler, the gel would lack stability and would have a slimy surface covered with synerate exudate [2]. They can be either irreversible (single-state) or reversible hydrocolloids (transiting from gel-sol-gel on the application of heat) [3]. Owing to their unique properties, hydrocolloids have found wide and useful applications in various fields including, dentistry, medicine and the food industries. For instance, hydrocolloids such as Xanthan, gum Arabic, Pectin are added to food as additives due to their gelling, viscosity, and stabilizing properties [4, 5]. The aforementioned hydrocolloids could significantly reduce human appetite in acute settings due to the ability to form gelation in the stomach when ingested. An important rheological property of fibers within the intestine is viscosity, which is thought to account for beneficial physiological responses in relation to appetite regulation, glycemic and lipidemic control [4, 5]. In Medicine, studies have been carried out with different strategies and approaches or a combination of both as hydrocolloid gels have found some potentials in bone regeneration in the delivery of osteo-inductive factors, bone-forming cells, or a combination of both [2].
Recently, hydrocolloid (alginate) gels have also been actively investigated for their ability to mediate the regeneration and tissue engineering of different tissues and organs, including skeletal muscle, nerves, the pancreas, and liver. Current strategies for skeletal muscle regeneration include cell transplantation, growth factor delivery, or a combination of both approaches [6, 7]. Also, Studies within the pharmacological field have demonstrated how alginate-antacid formulations can decrease post-prandial symptoms by neutralizing the acidity of gastric contents by forming a gel-like barrier to displace the “acid pocket” from the oesophagogastric junction and protect the oesophageal and gastric mucosa with controlled released drug products used as model system for mammalian cell culture in biomedical studies [6]. In Dentistry, for example, hydrocolloids are widely used in the fabrication of dental and maxillofacial prostheses impression due to their biocompatibility with the tissues, ease of use, physical properties and hydrophilicity with the oral tissues [8]. Other areas of hydrocolloids applications include orthopaedic structures and stone models in surgical cases [8]. This chapter aims to discuss the different hydrocolloids used in dentistry, their preparations, uses and storage for optimal results and application.
1.1 Overview of hydrocolloids application in dentistry
Hydrocolloids were the first elastic materials to be used in the Dentistry [2]. Elastic impression materials commonly used in the dental field include reversible hydrocolloids (agar-agar), irreversible hydrocolloids (alginate), and other synthetic and elastomeric materials such as polysulfide, polyether’s, and silicone [2]. The properties and abilities of hydrocolloids materials enables the replication of the oral tissue with little or no deformity on withdrawal while abiding to both manufacturer and mechanical stipulations of its manipulation prior to being loaded on a tray to produce the gel or sol form [3].
Agar discovered by Sears in 1937 was the first hydrocolloids used in dentistry for making impressions to circumvent the cumbersome procedure and oral lacerations of using impression compound [9]. Agar is a vegetable colloid derived from seaweed found on the sea coast of Japan, a jelly-like substance softened when heated and solidifies when cooled [9]. However, the technique of using agar was complicated because of the need for special heaters and tempering Jars for heating and holding prior to use, syringes and water-cooled trays, even though it could be used severally without losing its chemical and physical properties before been discarded [10].
In 1947, alginate was introduced during the second world war as a result of the scarcity of agar from Japan by the extraction of alginic acid from marine seaweed [10]. Unlike agar which reaction is reversible; alginate reaction was chemical which resulted in irreversible hydrocolloids when the alginate gels are mixed with water [10]. Furthermore, the physical, mechanical, biocompatibility and fatigue properties and most importantly the hydrophilic nature that allows hydrocolloids to capture accurate impressions in the presence of some saliva or blood [10].
Equally significant, its low wetting angle makes it easy to capture full or partial arch impressions moderate ability to reproduce the detail and costs relatively little compared with other elastomeric impression materials [10]. Despite this, hydrocolloids materials are not accurate enough for fixed partial dentures but are used for partial framework impressions to the modelling materials, ability to adapt to the oral tissues and the formation of an elastic resilient film [3, 11].
1.2 Types of hydrocolloids use in dentistry
Generally, hydrocolloids used in dentistry can be typified as either reversible (agar) and or irreversible (alginate). This section, therefore, focuses on the properties, composition and application of these two hydrocolloids materials.
1.2.1 Agar
Agar hydrocolloid has remained an excellent, cost-effective impression material since its discovery in 1937 from seaweed found on the coasts of Japan, and thus, has been used widely for the replication/duplication of models [12]. It is a reversible hydrocolloid which can repeatedly pass between highly viscous gel and low viscosity sol through heating and cooling [3]. In terms of its chemical composition and structure, agar is the sulfuric ester of a linear polymer of galactose extracted from seaweed [3].
1.2.1.1 Composition
The components of the agar gels are 12–15% agar, 1% potassium sulphate to ensure a proper set of the gypsum material poured in the impression, 0.2% borax as a strengthener for the gel, 0.1% alkyl benzoate as an antifungal during storage, and 85% water (Table 1). Borax and agar retard the set of gypsum products, so potassium sulphate is added to cancel out their effect [13].
Material | Composition (Approximate percentage) | Purpose |
---|
Agar | 12–15% | Colloidal particle as basis of the gel |
Potassium Sulphate | 1% | Ensures set of gypsum material |
Borax | 0.2% | Strengthens the gel |
Alkyl Benzonate | 0.1% | Antifungal agent |
Water | 85% | Dispensing medium for the colloidal suspension |
Table 1.
Composition of agar gels.
The composition described in Table 1 may differ slightly depending on the dispersing medium for the gel; which could be either loading on an impression tray or a syringe. When fine details of preparation are needed, a less concentrated gel type is used in a syringed. A more concentrated gel is used to in water-cooled tray to form the bulk of the impression. Agar possesses relatively good elastic recovery, reproduction of details, pleasant tasting and easy to clean up. But it cannot be used to produce electroplated pies due to its dissolution inside the electrolytic bath [14]. Agar is a technique sensitive impression material due to its low tear strength of 27.6 KPa. Agar is dimensionally unstable due to the loss of water from the agar gels even when stored at 100% humidity. The consequence of this is an inaccurate model if left for a while before the cast is poured [9]. Agar hydrocolloids are supplied as sticks or gel and require specific equipment for its manipulation before the impression making process. Thereby making the process cumbersome but can be reused once the setup is done. Although agar hydrocolloid is an inexpensive impression material with very good accuracy, its use has declined over the years due to the inability to pour impressions immediately, low dimensional stability, ease of manipulation and water-cooled impression trays and the inability to produce electroplated dies [9].
1.2.2 Alginate
Alginate is an irreversible hydrocolloid largely used in dentistry [15]. It is mainly used for diagnostic and planning in the rehabilitation of oral, orthodontics and maxillofacial prostheses [16, 17, 18]. The advantage of alginate materials is that it is easy to manipulate, cheap and provides a good level of comfort for patients without the need for specialized instruments and equipment [17, 19].
1.2.2.1 Composition and setting reactions
Discovered in 1945, as a substitute for agar whose importation was hampered by the outbreak of the Second World War. Alginates are salts of alginic acid, a polysaccharide extracted from the cell walls of brown algae (washed, ground and chemically treated, especially the pulp) belonging to the Phaeophyceae family, widespread especially in America [20]. Like agar, alginic acid, chemically known as anhydro-B-D-mannuronic acid has a high molecular weight (30,000 to 200,000) linear polymer [9].
The extracted alginic acid is then converted into a salt (alginate) of sodium, calcium, potassium or magnesium. Although alginate is insoluble in water, its alkaline salts are water-soluble. The production process of sodium alginate from brown algae can be done in two ways; using the calcium alginate method or the alginic acid method [21]. To extract alginic acid, the algae are placed in a sodium carbonate bath, exploiting the solubility of alkaline alginates in water. The alginic acid is recovered from the obtained solution by precipitation with hydrochloric acid or sulfuric acid [21]. The difficulty of the processes lies in the required physical separations; such as in the filtration of muddy residues from viscous solutions or in the separation of gelatinous precipitates that retain a large amount of liquid in their structure, resisting filtration and centrifugation [2].
The alginate impression materials for dental use contain several additives such as sodium alginate, calcium sulphate, trisodium phosphate, diatomaceous earth, zinc oxide, and potassium titanium fluoride, all in the form of a powder [2]. They are irreversible hydrocolloids because the picking reaction is a chemical reaction of irreversible precipitation therefore they cannot return in sol form using physical means, such as temperature, as with reversible hydrocolloids.
The chemical reaction occurs two times: a first phase called ‘slowing’ and a second phase called ‘setting’. Initially, the powder is mixed with water, a sol is formed and the sodium or potassium salts of alginic salts react with the calcium sulphate [2] to allowing crosslinking of the alginic salts [9, 22, 23]. After the sodium phosphate has reacted, the remaining calcium sulphate reacts with sodium alginate to form insoluble calcium alginate that forms a gel with water which acts as a catalyst. There are many commercial variations of alginate that vary in consistency, setting time, elasticity, strength, and dimensional stability; manufacturers also add fillers, which impact on its properties, application, setting time, and pouring time [22]. The standard composition of alginate is as described in Table 2.
Material | Percentage (Approximate) | Purpose |
---|
Sodium or potassium alginate | 15–20% | Colloidal particles as basis of the gel |
Calcium sulphate dihydrate | 14–20% | Creates irreversible gel with alginate |
Potassium sulphate | 10% | Ensures set of gypsum materials |
Trisodium phosphate | 2% | Retarder to control setting time |
Diatomaceous earth | 55–60% | Filler to increase thickness and strength |
Other additives: chemical indicators | Very small quantities | Colour change |
• Organic glycols • Flavoring agents • Coloring agents • Disinfectants | | Reduce dust when powder is handled Improve taste of material Provide pleasant colors Cause antibacterial action |
Table 2.
Composition and properties of alginate use in dentistry.
The alginates available on the market can be of two types: fast setting (hardening time of 1–2 min) or normal setting (setting time between 2 and 5 min). The setting time depends on the composition (water/powder ratio, where increasing the powder accelerates the hardening reaction) and the temperature at which mixing takes place [2]. The reaction that causes the alginate impression materials to form makes use of the different solubilities of the sodium, potassium, ammonium and calcium H2O % Na & alginate % CaSO4 ÿ (paste) Ca & alginate % Na2SO4 (gel) salts of alginic acid in water.
The setting reaction is a chemical reaction between Sodium Alginate and Calcium Sulphate, where:
2Na3PO4+3CaSO4→Ca3PO42+3Na2SO4E1
This reaction (1) can be retarded with Calcium Phosphate, which acts as a retarder, thereby increasing the setting time and obtain a type I (fast set) or type II (Normal set) setting time [20].
The irreversible hydrocolloids, which are the most commonly used, are a mixture of manual or mechanized techniques through the union of powder and water [2]. Alginate impression materials are easy to use and manipulate without specialized equipment but can be mixed manually or mechanically, it is less expensive and has more rapid setting times. The reaction time and the setting time can be controlled with the temperature of the water used. They are slightly flavoured and in recent formulations, have colour indicators according to the phases of the chemical reaction [2].
1.3 Summary
What started as a trial in the 19th century gradually became a benchmark in the history of dentistry and has today found its way into different aspects of medical, pharmaceutical and food industries with more studies on how to improve its effectiveness for optimal use. We are currently in a technologically advanced era which is gradually employing the use of CAD/CAM technologies for the diagnosis and treatment of patients which is still very expensive due to the cost of the equipment and specialized training required for the operators to interface with it. Amid all these, studies are still being carried out on convectional irreversible hydrocolloids to improve their physical, mechanical and biological properties [24].
Recent studies have shown that the dimensional stability of hydrocolloids has been improved upon with the materials which have extended cast pouring times [25]. The incorporation of disinfectant gels into the powder which when mixed with water will dissolve thereby preventing surface inaccuracies when soaked/sprayed with disinfectants [25]. Dust-free particles with the use of glycerine making the powder denser and the two-sol system like elastomeric materials to reduce inaccuracies due to annual mixing [25]. Chromatic products to indicate the different chemical reactions within the sol [25].
An important advancement is the use of agar-alginate laminate for making impressions which give better accuracy, thereby, eliminating the water-cooled trays for agar impressions. Certainly improving the quality and definition of these materials would be possible to expand their use with benefits for patients. Also, the reduced setting time and their single-footprint technique will provide added benefits for dentists in terms of time available for manipulation. The prospect is that these materials will continue to evolve as has happened since the 40s, thus producing high-performing impression materials [2].
1.4 Conclusion and recommendation
Despite the advancement in science and technology, hydrocolloids have remained relevant in dentistry, particularly as an impression material. The resilient properties of hydrocolloids coupled with the simplicity of use and biocompatibility with the oral tissues had endeared it in dental practices. While hydrocolloids had some inherent disadvantage in its properties, the advancement in material science and modification of hydrocolloids with other additivities has improved their properties and usefulness in the oral care practice.
Conflict of interest
The authors declare no conflict of interest.
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In dentistry, for example, most intricate and precise procedures are made of hydrocolloids and are found in its simplest material to the most complex material such as impression making, fillings, separating media, electro-polishing etc. The two common hydrocolloids widely used in dentistry are reversible (agar) and irreversible (alginate) materials. Hence, this chapter bring to the forefront their preparations, uses and storage for optimal results and application.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/74914",risUrl:"/chapter/ris/74914",book:{id:"10505",slug:"colloids-types-preparation-and-applications"},signatures:"Stanley Onwubu and Chibuzor Stellamaris Okonkwo",authors:[{id:"328554",title:"Dr.",name:"Stanley",middleName:null,surname:"Onwubu",fullName:"Stanley Onwubu",slug:"stanley-onwubu",email:"21445599@dut4life.ac.za",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"328555",title:"Mrs.",name:"Chibuzor Stellamaris",middleName:null,surname:"Okonkwo",fullName:"Chibuzor Stellamaris Okonkwo",slug:"chibuzor-stellamaris-okonkwo",email:"chibuzorokonkwo9@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_1_2",title:"1.1 Overview of hydrocolloids application in dentistry",level:"2"},{id:"sec_2_2",title:"1.2 Types of hydrocolloids use in dentistry",level:"2"},{id:"sec_2_3",title:"Table 1.",level:"3"},{id:"sec_2_4",title:"Table 1.",level:"4"},{id:"sec_4_3",title:"Table 2.",level:"3"},{id:"sec_4_4",title:"Table 2.",level:"4"},{id:"sec_7_2",title:"1.3 Summary",level:"2"},{id:"sec_8_2",title:"1.4 Conclusion and recommendation",level:"2"},{id:"sec_13",title:"Conflict of interest",level:"1"}],chapterReferences:[{id:"B1",body:'[Hansson O, Eklund J. A historical review of hydrocolloids and an investigation of the dimensional accuracy of the new alginates for crown and bridge impressions when using stock trays. Swedish Dental Journal 1984; 8: 81-95.]'},{id:"B2",body:'[Gabriele C, Luca F, et al. Alginate Materials and Dental Impression Technique: A Current State of the Art and Application to Dental Practice Mar Drugs. 2019 Jan; 17(1). doi: 10.3390/md17010018 PMCID: PMC6356954 PMID: 30597945]'},{id:"B3",body:'[Madhavan S. A Review on Hydrocolloids-Agar and Alginate. J. Pharm. Sci. Res Cuddalore. 2015; 7: 704-707.]'},{id:"B4",body:'[Thornton, A.J.; Alsberg, E.; Albertelli, M.; Mooney, D.J. Shape-defining scaffolds for minimally invasive tissue engineering. Transplantation 2004; 77: 1798-1803.]'},{id:"B5",body:'[Ma, H.L.; Hung, S.C.; Lin, S.Y.; Chen, Y.L.; Lo, W.H. Chondrogenesis of human mesenchymal stem cells encapsulated in alginate beads. Journal of Biomedial Materials Research Part A 2003, 64, 273-281.]'},{id:"B6",body:'[Park, H.; Kang, S.W.; Kim, B.S.; Mooney, D.J.; Lee, K.Y. Shear-reversibly cross-linked alginate hydrogels for tissue engineering. Macromolecular Bioscience 2009, 9, 895-901.]'},{id:"B7",body:'[Saxena, A.K.; Marler, J.; Benvenuto, M.; Willital, G.H.; Vacanti, J.P. Skeletal muscle tissue engineering using isolated myoblasts on synthetic biodegradable polymers: Preliminary studies. Tissue Engineering 1999, 5, 525-532.[CrossRef] [PubMed]]'},{id:"B8",body:'[Vogel, A.B.; Kilic, F.; Schmidt, F.; Rübel, S.; Lapatki, B.G. Dimensional accuracy of jaw scans performed on alginate impressions or stone models: A practice-oriented study. Journal of Orofacial Orthopedics 2015, 76, 351-365.[CrossRef] [PubMed]]'},{id:"B9",body:'[Homer Vernon Reed: Quintessence International Volume 21, Number 3/1990]'},{id:"B10",body:'[Walker MP, Burckhard J, Mitts DA, Williams KB. Dimensional change over time of extended-storage alginate impression materials. The Angle Orthodontist 2010; 80(6): 1110-5.]'},{id:"B11",body:'[https://www.edinformatics.com/math_science/hydrocolloids.htm (internet) Retrived on 2020/09/13]'},{id:"B12",body:'[Rishi D, Patel MTK, Charles J. Goodacre, Myron S. Winer MS. An in vitro investigation into the physical properties of irreversible hydrocolloid alternatives. The Journal of Prosthetic Dentistry 2010 Nov:104(5):325-32.]'},{id:"B13",body:'[Rodrigues SB. et al Influence of delayed pouring on irreversible hydrocolloid properties. Braz. oral res. [Internet]. 2012 Oct (cited 2020/09/10) 26( 5 ): 404-409. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-83242012000500005&lng=en. https://doi.org/10.1590/S1806-83242012000500005.]'},{id:"B14",body:'[Sweta P., Sharayu N, Anjali B., Yogita D. Recent Advances in Elastomeric Impression Materials. http://www.easpublisher.com/easjdom/ Copyright @ 2019: Received: 05.09.2019 Accepted: 11.09.2019 Published: 26.09.2019]'},{id:"B15",body:'[Sedda M, Casarotto A, Raustia A, Borracchini A. Effect of storage time on the accuracy of casts made from different irreversible hydrocolloids. The Journal of Contemporary Dental Practice 2008; 9(4): 59-66.]'},{id:"B16",body:'[Torassian G, Kau CH, English JD, Powers J, Bussa HI, Marie Salas- Lopez A, et al. Digital models vs plaster models using alginate and alginate substitute materials. The Angle Orthodontist 2010; 80(4): 474-81]'},{id:"B17",body:'[Rudd KD, Morrow RM, Strunk RR. Accurate alginate impressions. The Journal of Prosthetic Dentistry 1969; 22(3): 294-300.]'},{id:"B18",body:'[Fokkinga WA, Witter DJ, Bronkhorst EM, Creugers NHJ. Clinical fit of partial removable dental prostheses based on alginate or polyvinyl siloxane impressions. The International Journal of Prosthodontics 2017; 30(1): 33-7.]'},{id:"B19",body:'[Imbery TA, Nehring J, Janus C, Moon PC. Accuracy and dimensional stability of extended-pour and conventional alginate impression materials. Journal of the American Dental Association (1939) 2010 Jan; 141(1):32-9.]'},{id:"B20",body:'[Spoto, G. Materiali e Tecnologie Odontostomatologiche; AriesDue: Milano, Italy, 2013; pp. 150-153, 154-196, ISBN 978-88-98789-00-9.]'},{id:"B21",body:'[Mc Huh D J. 1987 Productgion, properties and uses of Alginates FAO Fish pp 288:58-115. http//www.FAO.org/docrep/x5822E/X5822E00.htm]'},{id:"B22",body:'[Nandini VV, Venkatesh KV, Nair KC. Alginate impressions: A practical perspective. Journal of Conservative Dentistry 2008 Jan-Mar; 11(1):37-41.]'},{id:"B23",body:'[Igarashi, T.; Iwasaki, N.; Kasahara, Y.; Minami, A. A cellular implantation system using an injectable ultra-purified alginate gel for repair of osteochondral defects in a rabbit model. Journal of Biomedial Materials Research Part A 2010, 94, 844-855.]'},{id:"B24",body:'[Onwubu, S.C., Mdluli, P.S., Singh, S. and Ngombane, Y., 2019. Alginates in Evolution of Restorative Dentistry. Alginates:Applications in the Biomedical and Food Industries, p.125.]'},{id:"B25",body:'[Ramon Vaz da COSTA; Monique Gonzaga Silva VALENTE; Sicknan Soares da ROCHA Analysis of the dimensional stability of extended-storage irreversible hydrocolloids Rev Odontol Bras Central 2017; 26(76): 7-10 ISSN 1981-3708\\]'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Stanley Onwubu",address:"profstan4christ@yahoo.com",affiliation:'- Department of Dental Sciences, Durban University of Technology, South Africa
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Introduction
The development of the coronavirus disease 2019 (COVID-19) epidemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, triggered a global scenario of socio-economic catastrophe and psychological anguish. Many psychological problems and essential mental health consequences, including stress, anxiety, depression, frustration, uncertainty during the COVID-19 outbreak, emerged progressively.
In response to this dire circumstance, specific public policies were introduced by governments globally. These measures include self-quarantine, isolation, and social distancing. Implementing these policies caused the closure of educational institutes, offices, workplaces, public places, and social gathering restrictions. People were advised to stay at home and follow advice proposed by the WHO to protect themselves and others from the spread of COVID- 19. The strict self-quarantine order (lockdown) has kept the entire population in selected jurisdictions in isolation, with a significant impact on people’s life [1]. Although social activities have been restricted in most countries, almost all non-essential individual movements were prohibited due to quarantine, while the local hospitals received suddenly thousands of critically ill COVID-19 patients and were forced to implement their emergency protocols.
In this context, the general population and most of the front-line healthcare workers became vulnerable to the emotional impact of COVID-19 infection due to both the pandemic and its consequences worldwide. The modern society, in which everyone can travel and communicate quickly, has seldom been subjected to the present social isolation and constraints associated with feelings of dissatisfaction and uncertainty. This unusual scenario surrounding the COVID-19 epidemic illustrates that people are fundamentally and emotionally unprepared for the negative impacts of biological disasters, which immediately highlight how everyone may be vulnerable and helpless.
There is a constant update about the disease available on news channels and over the Internet, highlighting the number of individuals affected and deaths due to COVID-19. Also, inadequate knowledge and overwhelming news may contribute to fear and anxiety among the public. People at large may experience disappointment, irritability, and boredom under isolation measures [2]. The communication technologies’ facilities and transmission of inaccurate or sensational information may increase unacceptable social reactions such as aggression and rage [3].
The psychological reactions to the COVID-19 pandemic may vary from panic behavior or collective hysteria to pervasive feelings of hopelessness and desperation associated with adverse outcomes, including suicidal behavior [4]. Significantly, other health measures may be compromised by abnormally elevated anxiety. According to the social role invested, the security measures adopted in managing the pandemic had different consequences on individuals. Suspected and confirmed COVID-19 cases are likely to experience anxiety, loneliness, depression, denial, insomnia, and fear [5]. Health authorities’ strict quarantine policy and mandatory contact tracing policy may lead to social rejection, discrimination, financial loss, and stigmatization. Medical health workers are first-line fighters treating patients with COVID-19. They are a unique subset of exposed individuals as they are equipped with the resources and knowledge to address the dangers imposed by a pandemic. Despite this, they are not impervious to the detrimental impact of the pandemic on their psychological health and behavior. During the challenging times of a pandemic, healthcare workers, the most exposed group, are vulnerable to psychological challenges. Every day, they face a high risk of being infected and are exposed to prolonged and distressing work shifts to meet health requirements. This has placed healthcare workers around the world in an unprecedented situation.
This epidemic, as well as the public health measures put in place to slow it down, has drastically altered people’s lifestyles and is believed to pose a threat to their physical and mental health. This significant health catastrophe is impacting numerous countries, with high rates of transmission and death, and extensive outbreaks and mortality are linked to negative mental health consequences.
2. Fear
Strasner (1987) defined fear as “an emotional reaction (rational or irrational) to an object (animate or inanimate) or event that is associated with increased risk of danger and also unpleasantness, agitation and a desire to hide, flee or seek protection.” Phobia, on the other hand, is characterized by intense, severe, and persistent fear. Such fears lead to persistent efforts to avoid (flee) the source of distress, often by undertaking a number of “safety behaviors”. As a new infection with the potential for loss of life, COVID-19 has provoked legitimate fears. However, in a minority of subjects, this has also led to extreme restrictions, which could be characterized as “coronaphobia” [6]. Adequate communication that engenders a realistic appraisal of the risks, along with clear statements of behaviors that can reduce transmission, have been effective to control these fears, while also preventing viral transmission.
2.1 Fear among patient population
SARS-CoV2 infected patients experienced a high degree of fear stemming from uncertainity of illness outcome, inability to communicate with family members, lack of complete knowledge of the disease process and the stigma associated with being infected with the virus. Morever, the fear of isolation, discrimination and stigmatization was also noted in this group [7]. Those patients suspected to have SARS-CoV2 infection are also prey to the terror of having the disease, advancement of disease, precariousness of healthcare delivery and quarantine as per government regulations. Besides, even patients suffering from other illnesses displayed features of trepidation of inability to receive proper treatment due to overwhelmed healthcare resources. Patients with chronic diseases like diabetes, TB, and heart failure, for example, were found to avoid seeking medical treatment because they were afraid of contracting the illness from others in a healthcare facility, adding to fear of contagion. The type of chronic disease is a significant predictor of fear with higher levels noted among those diagnosed with autoimmune diseases or receiving immunosuppressants [8].
2.2 Fear among HCW population
Despite being the highest risk exposure group, healthcare workers have been found to experience less fear compared to the patient population as well as the general public. In a study conducted in India it was observed that a mere 18.3% healthcare workers reported of fear of contracting the infection. Most healthcare workers displayed concern and fear of transmitting the infection to their families and loved ones, especially to their children and the elderly [9]. Higher levels of fear were present in lab technicians, X-ray technicians and nurses while physicians were found to have the lowest level of fear. A possible explanation of this is that technicians and nurse have more exposure to contracting the illness during sampling, testing and medication of patients [10]. Non-medical healthcare workers were assessed to have lowest fear quotient juxtaposed to medical healthcare workers who are usually in direct contact with SARS-CoV2 infected patients and have a better understanding of the disease and its mortality [11]. Alike patients, healthcare workers are not immune to the fear of social marginalization. Assault on doctors, eviction of resident physicians from their rented houses, and fear of infection from healthcare workers have all been reported [12, 13]. These factors alongwith the shortage of sufficient protective equipment, absence of effective therapy and the virus’s high infectivity rate might possibly play a role in their fearfulness of coronavirus pandemic. The presence of fear among HCWs poses a significant threat to their psychological adjustment skills and impede delivery of optimum care to patients.
3. Stress
Claude Bernard noted that the maintenance of life is critically dependent on keeping our internal milieu constant in the face of a changing environment. In 1956, Selye coined the term “stress” to represent the effects of anything that seriously threatens homeostasis. The actual or perceived threat to an organism is referred to as the “stressor” and the response to the stressor is called the “stress response.” Although stress responses evolved as adaptive processes, Selye observed that severe, prolonged stress responses might lead to tissue damage and disease. During pandemics, the victims and at-risk groups tend to experience stress. As a consequence of the pandemic, even the health professionals who were overworked suffered high level of psychophysical stress. Various tools and questionnaires have been devised to measure stress levels in individuals. The most commonly used are DASS-21 and SAS. Studies have shown that psychological stress can affect the immune system through neuroendocrine pathways [14].
3.1 Stress among patient population
The increasing number of confirmed cases, a lack of knowledge of COVID-19, the rapid transmission rate, infection fears, lockdown conditions, difficulties in routine medical treatments, shortages of human resources in hospitals, insufficient psychological preparation, separation from loved ones, financial loss, stigma, loss of freedom, and uncertainty over illness status act as significant stressors for patients. These patients often display features of distress such as feeling nervous, worried in certain situations of panic, tendency to overreact, inability to control things in life, inability to overcome difficulties in daily life, and coping with things. The early months of pandemic had the higher reported prevalence of stress with a significant proportion of individuals reporting being upset due to things happening unexpectedly, inability to overcome difficulties in daily life, and anger at things being outside their control. Among suspected patients, those with history of travel to areas with ongoing community transmission were found to display greater stress [15]. Patients who are kept in isolation and quarantine experience significant levels stress as well [2]. It is expected that individuals may resort to social media during corona-led social distancing for stress relief and with the aim of accessing entertaining content, such as movies, comedies, and communication with family and friends, but frequent media exposure may itself be a source of psychological stress for these patients [16, 17]. Distress and panic during pandemics can propagate and promote misinformation in various ways along with increased digital screen time and unhealthy use of technology. Amid this, there has been a hidden epidemic of “information” that makes COVID-19 stand out as a “digital infodemic” from the earlier outbreaks. Misinformation and fake news are invariable accompaniments to this “information pollution” which can add to existent superior stress levels in the population [18]. Unfortunately, even immunocompromised and chronic disease patients are under tremendous psychological and physical stress in the face of this large-scale infectious public health crisis due to lack of proper healthcare infrastructure and treatment [19, 20, 21].
3.2 Stress among HCW population
Amid the ongoing unforeseen situation of coronavirus disease 2019 (COVID-19) pandemic, health care workers of multiple disciplines have been predisposed to a considerable amount of stress. A statistically significant association was found between perceived stress and female sex, designation (postgraduate trainees), work hours ≥6 hours/day, COVID-19 positive ward duties and staying with family due to potential risk of transmission to family members [22]. Disturbed sleep time and schedules due to rotational duties exhaust these HCWs both physically and mentally. The physical discomfort and occupational dermatoses associated with the use of PPE have also been shown to be related to greater levels of stress symptoms [23]. Practicing new methods of a discipline different than what he/she has mastered over the years, long hours of working in extreme conditions under PPE kit discomfort, long duty hours with no food/water/urination allowed during the time of duty with PPE, and irritation and physical strain in PPE during the summer season have been constant precipitators of stress among the doctors of all the disciplines working as frontline warriors [22]. With a scarcity of resources and an ever increasing number of patients, life-saving decisions have to be made. Making such decisions amid intense work pressure leads to added stress within emergency departments as well as during after-duty hours [24]. All doctors are susceptible to developing higher stress irrespective of their discipline during the COVID-19 pandemic, and this is further precipitated by their quarantined living conditions [22, 25]. Older HCWs demonstrate a high level of psychological distress, possibly as a result of increased complications of COVID-19 with increasing age and also because older people may have health issues making them more prone to infection with its complications [26]. In conclusion, HCWs are exposed to a protracted source of distress which may exceed their individual coping skills and lead to further chronic psychological problems.
4. Anxiety
Anxiety is an emotion characterized by the feeling of tension, worried thoughts and physical changes such as increased heart rate, according to the American psychological association. Since the onset of pandemic, many studies have been conducted to ascertain the prevalence of COVID-19 related anxiety among various sectors of the population. Conventional tools utilized to assess anxiety are:
Depression, anxiety and stress scale-21 (DASS-21)
Self-rating anxiety scale (SAS)
Generalized anxiety disorder scale (GAD-7)
Chinese version of GAD-7 scale
Hospital anxiety and depression scale (HADS)
The magnitude of anxiety varies across the country of origin of study, measurement tool used and size of the studied sample.
4.1 Anxiety among patient population
Patients suspected or diagnosed with SARS-CoV2 infection experience significant anxiety related to disease and external factors associated with having the infection. Several patient related factors influence the vulnerability to anxiety such as sex, marital status, symptoms and sleep quality, among others [27, 28, 29, 30]. There are many patient-related factors associated with anxiety such as:
Female gender
Older age
Divorce/bereavement
Married
Residing with family
Need of oxygen inhalation
History of fever
Two or more symptoms of infection
Suspected/confirmed infection
Poor sleep quality
Quarantine/isolation
The external factors include spread of misinformation by media, government regulations such as quarantine procedure, lockdown and travel restrictions, and social stigmatization. The current pandemic underlined the vital role played by media in dissemination of information. Ideally, media should ensure that crisis communication helps in dispelling fear and uncertainty, but in the recent pandemic it played a reverse role in spreading anxiety and panic behavior [31, 32, 33]. The endless newsfeeds related to COVID-19 infection and death rates considerably increased the adverse psychological outcomes in general population as well as patients. The spread of misleading narratives, provoking controversies and advertisement of unapproved therapies resulted in widespread fear, confusion and panic with serious mental health consequences such as anxiety [34, 35]. Quarantine and isolation of suspected and confirmed cases as per government regulations also led to abnormally increased anxiety. Additional measures like lockdown and travel restrictions also contribute to feeling of uncertainty, perceived lower social support, separation from loved ones, loss of freedom and boredom [2]. Notably, individuals with a previous health disorder experienced worsening of their symptoms due to anxiety.
4.2 Anxiety among HCW population
Healthcare workers are directly involved in diagnosis, treatment and care of SARS-CoV2 patients and therefore experience the highest share of mental health issues compared to the other groups in the population. The prevalence of anxiety among healthcare workers is high and has been assessed to be between 23.2% to 30.5% [36, 37]. Several factors have been attributed to cause anxiety in healthcare workers. These include increased workload, inadequate PPE, inadequate isolation precautions, risk of contracting disease, high infectivity and mortality of disease, burnout, lack of clinical experience, young age, chronic health illness and prior history of mental health disorders [31, 32, 33]. Socio-demographic variables play a key role in determining the level of anxiety in healthcare workers with higher prevalence among those above the age 40, females, unmarried individuals and presence of offspring [38]. Anxiety in this group manifests as palpitations, tremors, dryness of mouth, feeling scared without any reason and tendency to panic [15]. These symptoms are more prevalent in workers who were assigned duties in COVID designated areas and those who encountered SARS-CoV2 suspected or confirmed patients without adequate protection [5]. Nurses have unfavorable mental health outcomes among the healthcare staff since they usually spend more time caring for patients than any other group of HCWs [11, 36, 39]. The existence of anxiety is associated with reduced performance and fatigue in healthcare workers and impedes optimum healthcare delivery to the population.
5. Depression
Depression is one of the five most incapacitating illnesses, and by 2030, it is expected to be one of the major issues in industrialized countries. It’s a common reaction to a rapid deterioration in living conditions, which involves isolation and uncertainty. When people are subjected to unpredictable circumstances, they feel helpless and unmotivated, which can lead to sadness [40]. During past epidemic outbreaks (SARS and Ebola), rates of depression in the general population have been reported with a prevalence approaching even 73.10 percent [41]. Past epidemics were more quickly contained, and infection rates were lower despite greater fatality rates, which might explain why depressive symptoms were less common [42]. Furthermore, during the SARS pandemic in Canada, Hawryluck et al. discovered that the length and unpredictability of the lockdown contributed to greater levels of depression [43]. As a result, the present global lockdown measures might explain the increased incidence of depressive symptoms reported during the COVID-19 epidemic. According to a research that looked at 69 million health data from over 62,000 persons diagnosed with COVID-19, 6% of COVID-19 patients suffered mental health problems including sadness and anxiety within three months of diagnosis, compared to 3.4 percent of non-COVID-19 patients [44]. The addition of a psychological burden to an already devastating physical burden affects the prognosis in a number of ways, with long-term consequences. Furthermore, those who are depressed are less likely to seek treatment for physical or mental problems; as a result, depression, like anxiety, can act as a barrier to reasonable medical and mental health interventions during a pandemic.
5.1 Depression among patient population
Earlier outbreaks such as SARS and MERS have displayed the presence of depressed mood among those with acute infection [45]. The COVID-19 pandemic is no different. The reported prevalence of depression at 6% in COVID-19 patients is higher to general population [44]. Females are more likely to experience depression than males [46]. According to one study, nearly one-fourth patients had intended to commit suicide or harm oneself [27]. Individuals who were married or underwent a divorce exhibited greater levels of depression than single individuals [27]. This could in part be explained by worries for one’s family and grief of separation respectively. Having a family member with confirmed COVID-19, and having two current physical symptoms are independent risk factors for depressive symptoms [28]. Suicide has become a more pressing concern as the pandemic evolved [47]. Those with psychiatric disorders experience worsening symptoms and others are predisposed to develop depression, are all associated with increased suicide risk. Media and other news platforms also affect mental health and psychological behavior [35]. Despite the fact that receiving regular updates on COVID-related health information appears to reduce sadness, it is also claimed that social media exposure is linked to depression and mixed anxiety and depression [48, 49, 50]. Unemployment, low social status, a lack of social support, and financial losses are among socioeconomic variables that might contribute to greater incidence of depression. [48, 49, 51, 52]. The added impact of quarantine has led to high occurrence of depression and even self-reported suicidal thoughts [29, 53].
5.2 Depression among HCW population
The COVID-19 pandemic has significant negative impacts on healthcare workers’ psychological health, fostering anxiety, depression, and sleep disturbance. Studies conducted during the SARS have reported a prevalence of depression among the front-line HCWs to be 38.5% [54]. The factors in play causing depression are pretty similar to those contributing to anxiety. Increased workload, burnout, inadequate PPE, the risk of contracting the disease, and the challenge of making difficult moral decisions about care priorities during the pandemic have exposed healthcare workers to severe psychological pressures leading to depression. The high infectivity and mortality rates also contribute to depression among healthcare workers around the world. Furthermore, factors such as a high-risk workplace, a lack of clinical experience, young age, and a history of psychological disorders can contribute to depression among healthcare workers. Working on the front lines was found to be an independent risk factor for poor mental health outcomes across all aspects studied, including the prevalence of depression among HCWs. Between doctors and nurses, the latter have been studied to harbor a greater level of depression [55, 56, 57]. This may be partially confounded by the fact that nurses are primarily female but could also be attributed to the fact they may face a greater risk of exposure to COVID-19 patients as they spend more time onwards, provide direct care to patients and are responsible for the collection of sputum for virus detection [55].Emotional exhaustion, depersonalization, being a nurse, 12- or 24-hour shifts or on-call hours, those who live with people who are at risk, and being very concerned about a possible infection of a family member they do not live with are all positively and significantly related to having depression symptoms [58]. Depression is also significantly higher among HCWs who did not know the latest COVID-19-related research/information. Lack of information may precipitate mental health concerns, and prior studies have suggested that updates and knowledge about COVID-19 may have psychosocial impacts, possibly as they represent an active way of coping and dealing with pandemic-related issues [59, 60]. Research also indicates that healthcare workers who take vacation days experience lower levels of depression [26]. Unfortunately, the COVID-19 pandemic crisis witnessed doctors along with other healthcare workers question their choice of profession, in part due to rising infection rates, unavailability of adequate personal protective equipment and other unexpected pandemic related experiences [60].
6. Sequelae
Long COVID is a term used to describe a condition in COVID-19 patients who have symptoms over an extended period [61]. These patients report prolonged, multisystem involvement and significant disability, which can last for more than six months in 93.2% of patients after the acute phase of illness [62]. Musculoskeletal, cardiovascular, gastrointestinal, pulmonary, and neuropsychiatric symptoms are prevalent in >85% of participants. Fatigue, breathing problems and cognitive dysfunction are among the most debilitating symptoms [62]. Such prolonged physical sequelae are associated with and often are a harbinger of psychological sequelae. Multiple studies conducted during previous pandemics also support the development of psychiatric sequelae in survivors. SARS-CoV-1 survivors exhibited posttraumatic stress disorder (PTSD) with an incidence of up to 55%, depression was observed in 39%, pain disorder in 36.4%, panic disorder in 32.5%, and obsessive–compulsive disorder in 15.6% of SARS-CoV-1 survivors [63]. Long term psychiatric complications such as depressed mood, anxiety and insomnia were also reported in 10-20% of patients following SARS and MERS infections [45]. These complications could result from central nervous system involvement of the virus or perhaps a consequence of fear associated with the infection and isolation itself.
Among the psychological sequelae, the most prominent and popular condition is posttraumatic stress disorder [64]. Surviving a critical illness is known to induce PTS symptoms [65]. Data suggests that as many as 43% of COVID-19 patients suffered posttraumatic stress symptoms [66], ‘not though true prevalence of PTSD’ prevalence. The severity of COVID-19 poses a significant risk factor for PTSD, supported by evidence of higher incidence among ICU patients juxtaposed to non-ICU patients [67, 68]. Even measures of quarantine and isolation, which help to contain the infection from the spread, can have psychological consequences leading to PTSD [2]. Healthcare workers, too, experience significant PTS symptoms. Emotional fatigue, depersonalization, working in a hospital, being highly concerned that someone they live with may become infected, and believing that becoming infected with COVID-19 is very likely are all positively and substantially associated with posttraumatic stress symptoms in the HCW population [56].
Aside from PTSD, COVID-19 infection survivors are more likely to experience depression and anxiety, similar to the acute phase of the disease [64]. The incidence of these disorders is linked to the severity of the disease and the length of hospitalization [69, 70, 71]. The baseline systemic inflammation index (SII) is strongly correlated with anxiety and depression [45, 59]. At follow-up, the prevalence of baseline comorbidities, such as mental disorders and female sex, is also linked to depression and anxiety [71, 72]. Although anxiety and depression symptoms generally go away within 1-3 months after infection, their presence increases the risk of developing PTSD later on [61].
7. Preventive interventions
7.1 Routine screening of patients and their HCWs
Worldwide epidemiological research is urgently needed to evaluate the amount of anxiety, worry, and helplessness and other mental health concerns related to COVID-19. This would aid in developing tailored mental health initiatives (e.g., those who live in villages). Experiences from past pandemics point out the urgent need for screening for mental health problems, monitoring its trend, referral of cases, and providing suitable interventions has to be routine practice during the pandemic period [73, 74]. The target groups of such screening strategies must include COVID-19 infected patients, their high risk contacts, and healthcare workers, as well as those with past history of mental health illnesses. The following questionnaires may be utilized for routine screening:
COVID-19 stress scale [75]
Perceived Stress Scale modified for COVID-19 (PSS-10-C) [76]
COVID-19 Peritraumatic Distress Index (CPDI) [1]
Anxiety of COVID Scale (CAS) [77]
Fear of COVID-19 Scale (FC-19S) [78]
COVID-19 Pandemic Mental Health Questionnaire [79]
The abovementioned questionnaires were newly developed or modified versions of existing mental health screening questionnaires. It is therefore emphasized that the pre-existing validated survey tools such as GAD-65, PSS-10, PHQ-9 and DASS-21 can be also utilized for routine screening purposes and have been validated for the same.
7.2 Provision for health services during the pandemic period
During the pandemic, marginalized groups such as those with chronic health conditions, mental health issues, and the elderly must continue to get health care. Provisions such as telemedicine and clinics independent from COVID-designated facilities should be guaranteed for optimal healthcare delivery in a continuum.
The mental health and emergency management communities should collaborate to seek, develop, and disseminate evidence-based resources on disaster mental health, mental health triage and referral, unique populations’ requirements, and death communication and bereavement support.
Health care professionals should help patients manage stress and cope (by organizing activities and sticking to routines), introduce patients to social and mental health resources, and encourage them to seek professional mental health help if necessary.
While most psychological health services can be provided in primary care settings, a few patients will require comprehensive mental health assessment and care, while others might benefit from supportive interventions targeted at enhancing wellbeing and coping such as psychoeducation or cognitive behavioral therapy.
Patients with suicidal ideation shall necessitate immediate referral, hospitalization, and therapeutic intervention by a psychiatrist.
Tele-psychiatry services are vital to maintain the continuum of care in the COVID pandemic era. Certain modifications are warranted to enhance the delivery of tele-health services – video consultations may be employed for triaging, screening, and providing first consultation services, home visits by a locally available nurse/ health care workers/ social workers augmented with video consultations with the psychiatrist, especially in cases of emergencies, and construction of telemedicine practice guidelines to enable physicians in better providing healthcare services telephonically.
7.3 Support for healthcare workers
At each institution, teams of expert psychologists should be accessible for healthcare professionals to call at any time, and quick treatment and follow-ups should be given.
Peer support and group talks should be promoted as well. HCWs must be provided with stress management training.
During pandemic conditions, vacations from work are required to reduce psychological distress among healthcare professionals, resulting in decreased levels of despair, fear, worry, and stress. Therefore, healthcare professionals are urged to take vacations from work to help them relax, which helps reduce stress.
In regions where infrastructure is lacking, the government and health authorities must work together to provide PPEs and the essential infrastructure for HCWs to safely administer healthcare to their patients.
Health-care systems are required to address the stress on individual providers and overall operations by monitoring reactions and performance indicators, modifying assignments and timetables, moderating expectations, and developing effective mechanisms to deliver psychological support as required.
HCWs should be encouraged to self-monitor their own stress reactions and seek appropriate assistance. Systems must be in place to quickly identify HCWs who require psychological assistance, send them to a professional, and provide access to specialized consultations as well as intervention, if necessary. Setting up of grievance redressal system will be of great use for all the HCWs to raise any issue pertaining to their current work and prompt resolution and solutions can be offered.
The process of testing, quarantine and re-joining work should be streamlined and communicated to everyone working in the establishment.
A rotational basis in the work from highly stressful to low stressful duties can be considered.
Encouragement and establishment of a buddy system with buddies being aware of need for confidentiality and available resources to help the person in distress.
All HCWs should be encouraged to follow a healthy lifestyle such as having a daily routine, pursuing their hobbies and stress management and relaxation techniques such as yoga and breathing exercises.
7.4 Amendments in quarantine and isolation measures
Isolation and quarantine restrict one’s activities severely, causing worry and concern over not fulfilling one’s professional and familial obligations. While the methods and processes for mental health support and monitoring in quarantine accommodation differ by jurisdiction, there are several critical areas that should be included in national mental health screening, evaluation, and support protocols. These include:
It is necessary to set up telephonic/digital contact between the patients and their family members.
Psychological counseling should be offered in quarantine centers.
Provision of a clear rationale for quarantine and information about protocols
Prior to departure, throughout travel, upon arrival, and during the quarantine period, accurate and timely information is critical.
The provision of a structured day with meaningful activities and opportunities for social connection is critical to preserving mental health. From the start, active participation is required, as well as the availability of a variety of individual and group activities from which to pick. COVID-19-compliant group activities must be delivered, if necessary using virtual methods.
Every person in quarantine should ideally have access to fresh air through windows or a balcony, space to exercise, and healthy and culturally appropriate food options.
People should be actively and assertively engaged in activities, well-being checks, and information.
Effective governance necessitates that all providers involved in assisting persons under quarantine have clear lines of communication, information exchange, and complaint handling.
7.5 Role of media
COVID-19 news, as previously discussed, has a positive linkage with depression, anxiety, and stress levels. It can be caused by erroneous statistics data and rumors that circulate through the internet. To avoid misleading information and public health statistics, the government and health authorities must offer accurate and up-to-date information. In this context, the research found that having access to current and accurate health information is linked to less stress. Up-to-date and exact data on the number of new and improved cases, available treatment methods, and transmission routes must be used to reduce the illness’s psychological and mental health effects. The psychological impact of misinformation/rumor on the mental health of HCWs and the general public might be greatly reduced if a public health information system that is accurate and updated is widely disseminated.
8. Conclusions
COVID-19 is linked to a range of psychiatric problems in addition to physical health issues. The spread of the novel coronavirus may have an influence on people’s mental health in many communities. Patients with COVID-19 have a significant rate of negative psychological occurrences. Frontline healthcare professionals caring for COVID19 patients have a high rate of stress, anxiety, and depression. As a result, health policymakers should take steps to regulate and prevent mental illnesses among hospital employees. During the COVID-19 epidemic, the mental health of HCWs is a major issue. Psychological interventions that detect and target persons with varying degrees of psychological distress are desperately required.
Conflict of interest
The authors declare no conflict of interest.
Notes/thanks/other declarations
None.
\n',keywords:"anxiousness, coronavirus, suicide, fearfulness, post-traumatic stress disorder, stress disorder",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/80640.pdf",chapterXML:"https://mts.intechopen.com/source/xml/80640.xml",downloadPdfUrl:"/chapter/pdf-download/80640",previewPdfUrl:"/chapter/pdf-preview/80640",totalDownloads:53,totalViews:0,totalCrossrefCites:0,dateSubmitted:"September 14th 2021",dateReviewed:"January 19th 2022",datePrePublished:"February 27th 2022",datePublished:null,dateFinished:"February 27th 2022",readingETA:"0",abstract:"Disease pandemics are known to cause mental impact, COVID-19 is not an exception. The ensuing mental health issues are not only restricted to the patients and their relatives/friends but affect the healthcare workers (HCWs) as well. Home isolated/quarantined patients/care takers experience a greater tendency of fear, stress, anxiety, and depression compared to those admitted in the hospital. Similarly, HCWs posted in COVID-19 designated areas of the hospital display higher levels of mental problems in comparison to those posted in non-COVID areas. Furthermore, long COVID-19 syndrome encompasses another large mental impact after 4-12 weeks of acute illness. Several instruments are available to screen for anxiety, fear, stress and depression, including the PSS 10 and DASS 21 questionnaires. These can be used by any HCW and even by educated patients or their care takers with telemedicine guidance from HCW. Treatment is also simple and cognitive behavioral therapy is a major solution and can be markedly practice with tele-consultation. The high degree of uncertainty associated with novel pathogens like COVID-19, both during acute and chronic effects has a profound effect on the mental state of asymptomatic/suspected/confirmed patients, their care takers, friends, as well as HCWs. However, by accepting pandemic with new-normal life of COVID-19 appropriate behaviors, human mankind can overcome these impacts.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/80640",risUrl:"/chapter/ris/80640",signatures:"Ashwin Parchani, Prasan Kumar Panda and Vijay Krishnan",book:{id:"10912",type:"book",title:"Psychosocial, Educational, and Economic Impacts of COVID-19",subtitle:null,fullTitle:"Psychosocial, Educational, and Economic Impacts of COVID-19",slug:null,publishedDate:null,bookSignature:"Dr. Jose C. Sánchez-García, Dr. Brizeida Hernandez-Sanchez, Dr. António Carrizo Moreira and Associate Prof. Alcides Monteiro",coverURL:"https://cdn.intechopen.com/books/images_new/10912.jpg",licenceType:"CC BY 3.0",editedByType:null,isbn:"978-1-80355-040-4",printIsbn:"978-1-80355-039-8",pdfIsbn:"978-1-80355-041-1",isAvailableForWebshopOrdering:!0,editors:[{id:"105695",title:"Dr.",name:"Jose C.",middleName:null,surname:"Sánchez-García",slug:"jose-c.-sanchez-garcia",fullName:"Jose C. Sánchez-García"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:null,sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Fear",level:"1"},{id:"sec_2_2",title:"2.1 Fear among patient population",level:"2"},{id:"sec_3_2",title:"2.2 Fear among HCW population",level:"2"},{id:"sec_5",title:"3. Stress",level:"1"},{id:"sec_5_2",title:"3.1 Stress among patient population",level:"2"},{id:"sec_6_2",title:"3.2 Stress among HCW population",level:"2"},{id:"sec_8",title:"4. Anxiety",level:"1"},{id:"sec_8_2",title:"4.1 Anxiety among patient population",level:"2"},{id:"sec_9_2",title:"4.2 Anxiety among HCW population",level:"2"},{id:"sec_11",title:"5. Depression",level:"1"},{id:"sec_11_2",title:"5.1 Depression among patient population",level:"2"},{id:"sec_12_2",title:"5.2 Depression among HCW population",level:"2"},{id:"sec_14",title:"6. Sequelae",level:"1"},{id:"sec_15",title:"7. Preventive interventions",level:"1"},{id:"sec_15_2",title:"7.1 Routine screening of patients and their HCWs",level:"2"},{id:"sec_16_2",title:"7.2 Provision for health services during the pandemic period",level:"2"},{id:"sec_17_2",title:"7.3 Support for healthcare workers",level:"2"},{id:"sec_18_2",title:"7.4 Amendments in quarantine and isolation measures",level:"2"},{id:"sec_19_2",title:"7.5 Role of media",level:"2"},{id:"sec_21",title:"8. Conclusions",level:"1"},{id:"sec_25",title:"Conflict of interest",level:"1"},{id:"sec_22",title:"Notes/thanks/other declarations",level:"1"}],chapterReferences:[{id:"B1",body:'[Qiu J, Shen B, Zhao M, Wang Z, Xie B, Xu Y. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: Implications and policy recommendations. Gen Psychiatry. 2020;33(2):e100213]'},{id:"B2",body:'[Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. 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Brain, Behavior, and Immunity. 2021;94:138-147]'},{id:"B72",body:'[Wong AW, Shah AS, Johnston JC, Carlsten C, Ryerson CJ. Patient-reported outcome measures after COVID-19: A prospective cohort study. The European Respiratory Journal. 2020;56(5):2003276]'},{id:"B73",body:'[Duan L, Zhu G. Psychological interventions for people affected by the COVID-19 epidemic. Lancet Psychiatry. 2020;7(4):300-302]'},{id:"B74",body:'[Ho CS, Chee CY, Ho RC. Mental health strategies to combat the psychological impact of coronavirus disease 2019 (COVID-19) beyond paranoia and panic. Annals of the Academy of Medicine, Singapore. 2020;49(3):155-160]'},{id:"B75",body:'[Taylor S, Landry CA, Paluszek MM, Fergus TA, McKay D, Asmundson GJG. Development and initial validation of the COVID stress scales. Journal of Anxiety Disorders. 2020;72:102232]'},{id:"B76",body:'[Pedrozo-Pupo JC, Pedrozo-Cortés MJ, Campo-Arias A. Perceived stress associated with COVID-19 epidemic in Colombia: An online survey. Cad Saúde Pública. 2020;36(5):e00090520]'},{id:"B77",body:'[Lee SA. Coronavirus anxiety scale: A brief mental health screener for COVID-19 related anxiety. Death Studies. 2020;44(7):393-401]'},{id:"B78",body:'[Tzur Bitan D, Grossman-Giron A, Bloch Y, Mayer Y, Shiffman N, Mendlovic S. Fear of COVID-19 scale: Psychometric characteristics, reliability and validity in the Israeli population. Psychiatry Research. 2020;289:113100]'},{id:"B79",body:'[Rek SV, Bühner M, Reinhard MA, Freeman D, Keeser D, Adorjan K, et al. The COVID-19 pandemic mental health questionnaire (CoPaQ): Psychometric evaluation and compliance with countermeasures in psychiatric inpatients and non-clinical individuals. BMC Psychiatry. 2021;21(1):426]'}],footnotes:[],contributors:[{corresp:null,contributorFullName:"Ashwin Parchani",address:null,affiliation:'- Department of Internal Medicine, All India Institute of Medical Sciences (AIIMS), India
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While completing our PhDs, we found it difficult to access the research we needed. So, we decided to create a new Open Access publisher. A better one, where researchers like us could find the information they needed easily. The result is IntechOpen, an Open Access publisher that puts the academic needs of the researchers before the business interests of publishers.
",metaTitle:"Our story",metaDescription:"The company was founded in Vienna in 2004 by Alex Lazinica and Vedran Kordic, two PhD students researching robotics. While completing our PhDs, we found it difficult to access the research we needed. So, we decided to create a new Open Access publisher. A better one, where researchers like us could find the information they needed easily. The result is IntechOpen, an Open Access publisher that puts the academic needs of the researchers before the business interests of publishers.",metaKeywords:null,canonicalURL:"/page/our-story",contentRaw:'[{"type":"htmlEditorComponent","content":"We started by publishing journals and books from the fields of science we were most familiar with - AI, robotics, manufacturing and operations research. Through our growing network of institutions and authors, we soon expanded into related fields like environmental engineering, nanotechnology, computer science, renewable energy and electrical engineering, Today, we are the world’s largest Open Access publisher of scientific research, with over 4,200 books and 54,000 scientific works including peer-reviewed content from more than 116,000 scientists spanning 161 countries. Our authors range from globally-renowned Nobel Prize winners to up-and-coming researchers at the cutting edge of scientific discovery.
\\n\\nIn the same year that IntechOpen was founded, we launched what was at the time the first ever Open Access, peer-reviewed journal in its field: the International Journal of Advanced Robotic Systems (IJARS).
\\n\\nThe IntechOpen timeline
\\n\\n2004
\\n\\n\\n\\t- Intech Open is founded in Vienna, Austria, by Alex Lazinica and Vedran Kordic, two PhD students, and their first Open Access journals and books are published.
\\n\\t- Alex and Vedran launch the first Open Access, peer-reviewed robotics journal and IntechOpen’s flagship publication, the International Journal of Advanced Robotic Systems (IJARS).
\\n
\\n\\n2005
\\n\\n\\n\\t- IntechOpen publishes its first Open Access book: Cutting Edge Robotics.
\\n
\\n\\n2006
\\n\\n\\n\\t- IntechOpen publishes a special issue of IJARS, featuring contributions from NASA scientists regarding the Mars Exploration Rover missions.
\\n
\\n\\n2008
\\n\\n\\n\\t- Downloads milestone: 200,000 downloads reached
\\n
\\n\\n2009
\\n\\n\\n\\t- Publishing milestone: the first 100 Open Access STM books are published
\\n
\\n\\n2010
\\n\\n\\n\\t- Downloads milestone: one million downloads reached
\\n\\t- IntechOpen expands its book publishing into a new field: medicine.
\\n
\\n\\n2011
\\n\\n\\n\\t- Publishing milestone: More than five million downloads reached
\\n\\t- IntechOpen publishes 1996 Nobel Prize in Chemistry winner Harold W. Kroto’s “Strategies to Successfully Cross-Link Carbon Nanotubes”. Find it here.
\\n\\t- IntechOpen and TBI collaborate on a project to explore the changing needs of researchers and the evolving ways that they discover, publish and exchange information. The result is the survey “Author Attitudes Towards Open Access Publishing: A Market Research Program”.
\\n\\t- IntechOpen hosts SHOW - Share Open Access Worldwide; a series of lectures, debates, round-tables and events to bring people together in discussion of open source principles, intellectual property, content licensing innovations, remixed and shared culture and free knowledge.
\\n
\\n\\n2012
\\n\\n\\n\\t- Publishing milestone: 10 million downloads reached
\\n\\t- IntechOpen holds Interact2012, a free series of workshops held by figureheads of the scientific community including Professor Hiroshi Ishiguro, director of the Intelligent Robotics Laboratory, who took the audience through some of the most impressive human-robot interactions observed in his lab.
\\n
\\n\\n2013
\\n\\n\\n\\t- IntechOpen joins the Committee on Publication Ethics (COPE) as part of a commitment to guaranteeing the highest standards of publishing.
\\n
\\n\\n2014
\\n\\n\\n\\t- IntechOpen turns 10, with more than 30 million downloads to date.
\\n\\t- IntechOpen appoints its first Regional Representatives - members of the team situated around the world dedicated to increasing the visibility of our authors’ published work within their local scientific communities.
\\n
\\n\\n2015
\\n\\n\\n\\t- Downloads milestone: More than 70 million downloads reached, more than doubling since the previous year.
\\n\\t- Publishing milestone: IntechOpen publishes its 2,500th book and 40,000th Open Access chapter, reaching 20,000 citations in Thomson Reuters ISI Web of Science.
\\n\\t- 40 IntechOpen authors are included in the top one per cent of the world’s most-cited researchers.
\\n\\t- Thomson Reuters’ ISI Web of Science Book Citation Index begins indexing IntechOpen’s books in its database.
\\n
\\n\\n2016
\\n\\n\\n\\t- IntechOpen is identified as a world leader in Simba Information’s Open Access Book Publishing 2016-2020 report and forecast. IntechOpen came in as the world’s largest Open Access book publisher by title count.
\\n
\\n\\n2017
\\n\\n\\n\\t- Downloads milestone: IntechOpen reaches more than 100 million downloads
\\n\\t- Publishing milestone: IntechOpen publishes its 3,000th Open Access book, making it the largest Open Access book collection in the world
\\n
\\n"}]'},components:[{type:"htmlEditorComponent",content:"We started by publishing journals and books from the fields of science we were most familiar with - AI, robotics, manufacturing and operations research. Through our growing network of institutions and authors, we soon expanded into related fields like environmental engineering, nanotechnology, computer science, renewable energy and electrical engineering, Today, we are the world’s largest Open Access publisher of scientific research, with over 4,200 books and 54,000 scientific works including peer-reviewed content from more than 116,000 scientists spanning 161 countries. Our authors range from globally-renowned Nobel Prize winners to up-and-coming researchers at the cutting edge of scientific discovery.
\n\nIn the same year that IntechOpen was founded, we launched what was at the time the first ever Open Access, peer-reviewed journal in its field: the International Journal of Advanced Robotic Systems (IJARS).
\n\nThe IntechOpen timeline
\n\n2004
\n\n\n\t- Intech Open is founded in Vienna, Austria, by Alex Lazinica and Vedran Kordic, two PhD students, and their first Open Access journals and books are published.
\n\t- Alex and Vedran launch the first Open Access, peer-reviewed robotics journal and IntechOpen’s flagship publication, the International Journal of Advanced Robotic Systems (IJARS).
\n
\n\n2005
\n\n\n\t- IntechOpen publishes its first Open Access book: Cutting Edge Robotics.
\n
\n\n2006
\n\n\n\t- IntechOpen publishes a special issue of IJARS, featuring contributions from NASA scientists regarding the Mars Exploration Rover missions.
\n
\n\n2008
\n\n\n\t- Downloads milestone: 200,000 downloads reached
\n
\n\n2009
\n\n\n\t- Publishing milestone: the first 100 Open Access STM books are published
\n
\n\n2010
\n\n\n\t- Downloads milestone: one million downloads reached
\n\t- IntechOpen expands its book publishing into a new field: medicine.
\n
\n\n2011
\n\n\n\t- Publishing milestone: More than five million downloads reached
\n\t- IntechOpen publishes 1996 Nobel Prize in Chemistry winner Harold W. Kroto’s “Strategies to Successfully Cross-Link Carbon Nanotubes”. Find it here.
\n\t- IntechOpen and TBI collaborate on a project to explore the changing needs of researchers and the evolving ways that they discover, publish and exchange information. The result is the survey “Author Attitudes Towards Open Access Publishing: A Market Research Program”.
\n\t- IntechOpen hosts SHOW - Share Open Access Worldwide; a series of lectures, debates, round-tables and events to bring people together in discussion of open source principles, intellectual property, content licensing innovations, remixed and shared culture and free knowledge.
\n
\n\n2012
\n\n\n\t- Publishing milestone: 10 million downloads reached
\n\t- IntechOpen holds Interact2012, a free series of workshops held by figureheads of the scientific community including Professor Hiroshi Ishiguro, director of the Intelligent Robotics Laboratory, who took the audience through some of the most impressive human-robot interactions observed in his lab.
\n
\n\n2013
\n\n\n\t- IntechOpen joins the Committee on Publication Ethics (COPE) as part of a commitment to guaranteeing the highest standards of publishing.
\n
\n\n2014
\n\n\n\t- IntechOpen turns 10, with more than 30 million downloads to date.
\n\t- IntechOpen appoints its first Regional Representatives - members of the team situated around the world dedicated to increasing the visibility of our authors’ published work within their local scientific communities.
\n
\n\n2015
\n\n\n\t- Downloads milestone: More than 70 million downloads reached, more than doubling since the previous year.
\n\t- Publishing milestone: IntechOpen publishes its 2,500th book and 40,000th Open Access chapter, reaching 20,000 citations in Thomson Reuters ISI Web of Science.
\n\t- 40 IntechOpen authors are included in the top one per cent of the world’s most-cited researchers.
\n\t- Thomson Reuters’ ISI Web of Science Book Citation Index begins indexing IntechOpen’s books in its database.
\n
\n\n2016
\n\n\n\t- IntechOpen is identified as a world leader in Simba Information’s Open Access Book Publishing 2016-2020 report and forecast. IntechOpen came in as the world’s largest Open Access book publisher by title count.
\n
\n\n2017
\n\n\n\t- Downloads milestone: IntechOpen reaches more than 100 million downloads
\n\t- Publishing milestone: IntechOpen publishes its 3,000th Open Access book, making it the largest Open Access book collection in the world
\n
\n"}]},successStories:{items:[]},authorsAndEditors:{filterParams:{},profiles:[{id:"396",title:"Dr.",name:"Vedran",middleName:null,surname:"Kordic",slug:"vedran-kordic",fullName:"Vedran Kordic",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/396/images/7281_n.png",biography:"After obtaining his Master's degree in Mechanical Engineering he continued his education at the Vienna University of Technology where he obtained his PhD degree in 2004. He worked as a researcher at the Automation and Control Institute, Faculty of Electrical Engineering, Vienna University of Technology until 2008. 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. Delac received his B.Sc.E.E. degree in 2003 and is currentlypursuing a Ph.D. degree at the University of Zagreb, Faculty of Electrical Engineering andComputing. His current research interests are digital image analysis, pattern recognition andbiometrics.",institutionString:null,institution:{name:"University of Zagreb",country:{name:"Croatia"}}},{id:"557",title:"Dr.",name:"Andon",middleName:"Venelinov",surname:"Topalov",slug:"andon-topalov",fullName:"Andon Topalov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/557/images/1927_n.jpg",biography:"Dr. Andon V. Topalov received the MSc degree in Control Engineering from the Faculty of Information Systems, Technologies, and Automation at Moscow State University of Civil Engineering (MGGU) in 1979. He then received his PhD degree in Control Engineering from the Department of Automation and Remote Control at Moscow State Mining University (MGSU), Moscow, in 1984. From 1985 to 1986, he was a Research Fellow in the Research Institute for Electronic Equipment, ZZU AD, Plovdiv, Bulgaria. In 1986, he joined the Department of Control Systems, Technical University of Sofia at the Plovdiv campus, where he is presently a Full Professor. He has held long-term visiting Professor/Scholar positions at various institutions in South Korea, Turkey, Mexico, Greece, Belgium, UK, and Germany. And he has coauthored one book and authored or coauthored more than 80 research papers in conference proceedings and journals. His current research interests are in the fields of intelligent control and robotics.",institutionString:null,institution:{name:"Technical University of Sofia",country:{name:"Bulgaria"}}},{id:"585",title:"Prof.",name:"Munir",middleName:null,surname:"Merdan",slug:"munir-merdan",fullName:"Munir Merdan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/585/images/system/585.jpg",biography:"Munir Merdan received the M.Sc. degree in mechanical engineering from the Technical University of Sarajevo, Bosnia and Herzegovina, in 2001, and the Ph.D. degree in electrical engineering from the Vienna University of Technology, Vienna, Austria, in 2009.Since 2005, he has been at the Automation and Control Institute, Vienna University of Technology, where he is currently a Senior Researcher. His research interests include the application of agent technology for achieving agile control in the manufacturing environment.",institutionString:null,institution:null},{id:"605",title:"Prof",name:"Dil",middleName:null,surname:"Hussain",slug:"dil-hussain",fullName:"Dil Hussain",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/605/images/system/605.jpg",biography:"Dr. Dil Muhammad Akbar Hussain is a professor of Electronics Engineering & Computer Science at the Department of Energy Technology, Aalborg University Denmark. Professor Akbar has a Master degree in Digital Electronics from Govt. College University, Lahore Pakistan and a P-hD degree in Control Engineering from the School of Engineering and Applied Sciences, University of Sussex United Kingdom. Aalborg University has Two Satellite Campuses, one in Copenhagen (Aalborg University Copenhagen) and the other in Esbjerg (Aalborg University Esbjerg).\n· He is a member of prestigious IEEE (Institute of Electrical and Electronics Engineers), and IAENG (International Association of Engineers) organizations. \n· He is the chief Editor of the Journal of Software Engineering.\n· He is the member of the Editorial Board of International Journal of Computer Science and Software Technology (IJCSST) and International Journal of Computer Engineering and Information Technology. \n· He is also the Editor of Communication in Computer and Information Science CCIS-20 by Springer.\n· Reviewer For Many Conferences\nHe is the lead person in making collaboration agreements between Aalborg University and many universities of Pakistan, for which the MOU’s (Memorandum of Understanding) have been signed.\nProfessor Akbar is working in Academia since 1990, he started his career as a Lab demonstrator/TA at the University of Sussex. After finishing his P. hD degree in 1992, he served in the Industry as a Scientific Officer and continued his academic career as a visiting scholar for a number of educational institutions. In 1996 he joined National University of Science & Technology Pakistan (NUST) as an Associate Professor; NUST is one of the top few universities in Pakistan. In 1999 he joined an International Company Lineo Inc, Canada as Manager Compiler Group, where he headed the group for developing Compiler Tool Chain and Porting of Operating Systems for the BLACKfin processor. The processor development was a joint venture by Intel and Analog Devices. In 2002 Lineo Inc., was taken over by another company, so he joined Aalborg University Denmark as an Assistant Professor.\nProfessor Akbar has truly a multi-disciplined career and he continued his legacy and making progress in many areas of his interests both in teaching and research. He has contributed in stochastic estimation of control area especially, in the Multiple Target Tracking and Interactive Multiple Model (IMM) research, Ball & Beam Control Problem, Robotics, Levitation Control. He has contributed in developing Algorithms for Fingerprint Matching, Computer Vision and Face Recognition. He has been supervising Pattern Recognition, Formal Languages and Distributed Processing projects for several years. He has reviewed many books on Management, Computer Science. Currently, he is an active and permanent reviewer for many international conferences and symposia and the program committee member for many international conferences.\nIn teaching he has taught the core computer science subjects like, Digital Design, Real Time Embedded System Programming, Operating Systems, Software Engineering, Data Structures, Databases, Compiler Construction. 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Ahmed"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],booksByTopicTotal:1,seriesByTopicCollection:[],seriesByTopicTotal:0,mostCitedChapters:[{id:"56417",doi:"10.5772/intechopen.69964",title:"Membrane Dynamics of Spermatozoa during Capacitation: New Insight in Germ Cells Signalling",slug:"membrane-dynamics-of-spermatozoa-during-capacitation-new-insight-in-germ-cells-signalling",totalDownloads:1303,totalCrossrefCites:0,totalDimensionsCites:4,abstract:"The study of germline stem cells and of germline cells has deep implications for the understanding of fertility, development and cancer. Nowadays, we are experiencing the very fascinating challenge of application of –OMICS technologies to this issue, which is opening new and unexpected horizons in virtually all the branches of biology. Here, we carried out a review of signalling systems involved in maturation of male germ cells and in the process that leads them to become fully fertile. In particular, we discuss the control mechanisms involved in capacitation and acrosome reaction that act at membrane level. Indeed, spermatozoa membranes play key roles in determining the achievement of fertility: they are the interface with the surrounding environment, they locate the signal transduction systems and they are active in recognizing and binding the oocyte. In addition, we discuss the effect of several compounds that could exert a negative effect on reproductive activity, by interfering with the endocrine axis, the so-called endocrine disruptors.",book:{id:"5854",slug:"germ-cell",title:"Germ Cell",fullTitle:"Germ Cell"},signatures:"Nicola Bernabò, Marina Ramal Sanchez, Luca Valbonetti, Luana\nGreco, Giulia Capacchietti, Mauro Mattioli and Barbara Barboni",authors:[{id:"88710",title:"Prof.",name:"Mauro",middleName:null,surname:"Mattioli",slug:"mauro-mattioli",fullName:"Mauro Mattioli"},{id:"88713",title:"Prof.",name:"Barbara",middleName:null,surname:"Barboni",slug:"barbara-barboni",fullName:"Barbara Barboni"},{id:"90197",title:"Dr.",name:"Nicola",middleName:null,surname:"Bernabò",slug:"nicola-bernabo",fullName:"Nicola Bernabò"},{id:"199832",title:"Dr.",name:"Luca",middleName:null,surname:"Valbonetti",slug:"luca-valbonetti",fullName:"Luca Valbonetti"},{id:"199833",title:"Dr.",name:"Marina",middleName:null,surname:"Ramal Sancez",slug:"marina-ramal-sancez",fullName:"Marina Ramal Sancez"},{id:"199834",title:"Dr.",name:"Giulia",middleName:null,surname:"Capacchietti",slug:"giulia-capacchietti",fullName:"Giulia Capacchietti"}]},{id:"58819",doi:"10.5772/intechopen.71557",title:"Germ Cell Specification: The Evolution of a Recipe to Make Germ Cells",slug:"germ-cell-specification-the-evolution-of-a-recipe-to-make-germ-cells",totalDownloads:1392,totalCrossrefCites:2,totalDimensionsCites:4,abstract:"Multicellular species use gametes for their propagation. Gametes are formed from primordial germ cells (PGCs), which develop during embryogenesis. In some species, PGCs are specified by the inheritance of a RNA granule known as germ plasm. During germ cell specification, the germ plasm conveys a unique set of properties, e.g. the germ cell specific meiotic cell cycle to the PGCs. Germ plasm assembly is controlled by independently evolving organizer proteins like Oskar in Drosophila or Bucky ball in zebrafish. These organizers are intrinsically disordered proteins, which rapidly changed their amino acid sequence during evolution. A common recipe has emerged by studies on organizer proteins for animals that use germ plasm to specify their germline. Investigating the nature of these organizers might therefore provide a clue to germ cell specification in other species, which are less accessible to molecular-genetic and embryological approaches. Moreover, we might understand how the first metazoans modified their existing cellular structures from unicellular eukaryotes to ensure their reproduction.",book:{id:"5854",slug:"germ-cell",title:"Germ Cell",fullTitle:"Germ Cell"},signatures:"Pritesh Krishnakumar and Roland Dosch",authors:[{id:"220901",title:"M.Sc.",name:"Pritesh",middleName:null,surname:"Krishnakumar",slug:"pritesh-krishnakumar",fullName:"Pritesh Krishnakumar"}]},{id:"58351",doi:"10.5772/intechopen.72556",title:"Germ Cell Tumors and their Association with Pregnancy",slug:"germ-cell-tumors-and-their-association-with-pregnancy",totalDownloads:1387,totalCrossrefCites:0,totalDimensionsCites:3,abstract:"Ovarian germ cell tumors (OGCTs) comprise 20–25% of all ovarian cancers arising from germ cells of ovary. Mature teratoma (dermoid) is the only benign and commonest germ cell tumor. Only 3–5% germ cell tumors are malignant, dysgerminomas being the most common. These tumors occur in adolescents and reproductive age group. Hence, its association with pregnancy is not uncommon. They can be reliably diagnosed with ultrasound imaging. Raised levels of tumor markers in pregnancy should be interpreted with caution. Cystectomy can be done for benign germ cell tumors. However, fertility sparing surgery with surgical staging with or without adjunctive therapy is recommended for malignant germ cell tumors (MOGTs). Surgery is safe in the second trimester of pregnancy. MOGTs are quite sensitive to chemo and radiotherapy. Three to four courses of chemotherapy with bleomycin, etoposide, and platinum is recommended. Prognosis of these germ cell tumors is excellent.",book:{id:"5854",slug:"germ-cell",title:"Germ Cell",fullTitle:"Germ Cell"},signatures:"Mamta Gupta and Vandana Saini",authors:[{id:"221469",title:"Dr.",name:"Mamta",middleName:null,surname:"Gupta",slug:"mamta-gupta",fullName:"Mamta Gupta"},{id:"222224",title:"Dr.",name:"Vandana",middleName:null,surname:"Saini",slug:"vandana-saini",fullName:"Vandana Saini"}]},{id:"57528",doi:"10.5772/intechopen.71559",title:"Challenging the Paradigms on the Origin, Specification and Development of the Female Germ Line in Placental Mammals",slug:"challenging-the-paradigms-on-the-origin-specification-and-development-of-the-female-germ-line-in-pla",totalDownloads:1196,totalCrossrefCites:0,totalDimensionsCites:2,abstract:"Most of our understanding on the origin, specification and development of the female germ line in placental mammals comes from studies in the laboratory mouse. The molecular pathway leading to the development and establishment of the female germ line in mouse has erected as the paradigm for placental mammals. It remains, however, largely unexplored whether the well-established mouse regulatory pathway is a common mechanism to other or all placental mammals. Discrete differences in mammals other than mouse reveal the existence of alternative mechanisms that challenge the currently accepted tenets on the origin and establishment of the mammalian female germinal reserve. Here, we will discuss the mouse framework in the light of emerging discrepancies seen in other placental mammals.",book:{id:"5854",slug:"germ-cell",title:"Germ Cell",fullTitle:"Germ Cell"},signatures:"Noelia P. Leopardo, Pablo I.F. Inserra and Alfredo D. Vitullo",authors:[{id:"214484",title:"Dr.",name:"Alfredo",middleName:"Daniel",surname:"Vitullo",slug:"alfredo-vitullo",fullName:"Alfredo Vitullo"},{id:"214485",title:"Dr.",name:"Noelia",middleName:null,surname:"Leopardo",slug:"noelia-leopardo",fullName:"Noelia Leopardo"},{id:"214486",title:"Dr.",name:"Pablo",middleName:"Ignacio Felipe",surname:"Inserra",slug:"pablo-inserra",fullName:"Pablo Inserra"}]},{id:"56303",doi:"10.5772/intechopen.69963",title:"The Regulation of Germline Stem Cells and Their Neighbouring Somatic Cells in the Fruit Fly (Drosophila melanogaster)",slug:"the-regulation-of-germline-stem-cells-and-their-neighbouring-somatic-cells-in-the-fruit-fly-drosophi",totalDownloads:1314,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"The Drosophila germline stem cells (GSCs) remain as one of the most well-understood adult stem cells. The number of stem cells that self-renews and differentiates must be tightly controlled to maintain tissue homeostasis. The Drosophila GSCs are maintained by local signals emanated from the niche, which is composed of the surrounding somatic cells. Notably, GSC homeostasis is also known to be influenced by systemic signals and external stimuli. The Drosophila hormone ecdysone and its signalling cascade were found to regulate GSC homeostasis. The insulin signalling pathway as well as nutrient availability can also regulate GSC number. Furthermore, neuronal sex peptide signalling induced in female flies after mating was shown to increase GSC number. Hence, the Drosophila GSC system serves as a useful model towards understanding the mammalian stem cells. Compared with the mammalian stem cell models, the Drosophila GSC system is anatomically simpler where stem cells can be easily identified, imaged and manipulated genetically. Nevertheless, recent findings have facilitated our understanding into how GSCs and their neighbouring somatic cells sense and respond to changes in a variety of local, systemic and external stimuli.",book:{id:"5854",slug:"germ-cell",title:"Germ Cell",fullTitle:"Germ Cell"},signatures:"Sharon Wui Sing Tan, Yu Cai and Gyeong Hun Baeg",authors:[{id:"198098",title:"Prof.",name:"Gyeong Hun",middleName:null,surname:"Baeg",slug:"gyeong-hun-baeg",fullName:"Gyeong Hun Baeg"},{id:"207180",title:"MSc.",name:"Sharon Wui Sing",middleName:null,surname:"Tan",slug:"sharon-wui-sing-tan",fullName:"Sharon Wui Sing Tan"},{id:"207181",title:"Dr.",name:"Yu",middleName:null,surname:"Cai",slug:"yu-cai",fullName:"Yu Cai"}]}],mostDownloadedChaptersLast30Days:[{id:"58819",title:"Germ Cell Specification: The Evolution of a Recipe to Make Germ Cells",slug:"germ-cell-specification-the-evolution-of-a-recipe-to-make-germ-cells",totalDownloads:1392,totalCrossrefCites:2,totalDimensionsCites:4,abstract:"Multicellular species use gametes for their propagation. Gametes are formed from primordial germ cells (PGCs), which develop during embryogenesis. In some species, PGCs are specified by the inheritance of a RNA granule known as germ plasm. During germ cell specification, the germ plasm conveys a unique set of properties, e.g. the germ cell specific meiotic cell cycle to the PGCs. Germ plasm assembly is controlled by independently evolving organizer proteins like Oskar in Drosophila or Bucky ball in zebrafish. These organizers are intrinsically disordered proteins, which rapidly changed their amino acid sequence during evolution. A common recipe has emerged by studies on organizer proteins for animals that use germ plasm to specify their germline. Investigating the nature of these organizers might therefore provide a clue to germ cell specification in other species, which are less accessible to molecular-genetic and embryological approaches. Moreover, we might understand how the first metazoans modified their existing cellular structures from unicellular eukaryotes to ensure their reproduction.",book:{id:"5854",slug:"germ-cell",title:"Germ Cell",fullTitle:"Germ Cell"},signatures:"Pritesh Krishnakumar and Roland Dosch",authors:[{id:"220901",title:"M.Sc.",name:"Pritesh",middleName:null,surname:"Krishnakumar",slug:"pritesh-krishnakumar",fullName:"Pritesh Krishnakumar"}]},{id:"56303",title:"The Regulation of Germline Stem Cells and Their Neighbouring Somatic Cells in the Fruit Fly (Drosophila melanogaster)",slug:"the-regulation-of-germline-stem-cells-and-their-neighbouring-somatic-cells-in-the-fruit-fly-drosophi",totalDownloads:1314,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"The Drosophila germline stem cells (GSCs) remain as one of the most well-understood adult stem cells. The number of stem cells that self-renews and differentiates must be tightly controlled to maintain tissue homeostasis. The Drosophila GSCs are maintained by local signals emanated from the niche, which is composed of the surrounding somatic cells. Notably, GSC homeostasis is also known to be influenced by systemic signals and external stimuli. The Drosophila hormone ecdysone and its signalling cascade were found to regulate GSC homeostasis. The insulin signalling pathway as well as nutrient availability can also regulate GSC number. Furthermore, neuronal sex peptide signalling induced in female flies after mating was shown to increase GSC number. Hence, the Drosophila GSC system serves as a useful model towards understanding the mammalian stem cells. Compared with the mammalian stem cell models, the Drosophila GSC system is anatomically simpler where stem cells can be easily identified, imaged and manipulated genetically. Nevertheless, recent findings have facilitated our understanding into how GSCs and their neighbouring somatic cells sense and respond to changes in a variety of local, systemic and external stimuli.",book:{id:"5854",slug:"germ-cell",title:"Germ Cell",fullTitle:"Germ Cell"},signatures:"Sharon Wui Sing Tan, Yu Cai and Gyeong Hun Baeg",authors:[{id:"198098",title:"Prof.",name:"Gyeong Hun",middleName:null,surname:"Baeg",slug:"gyeong-hun-baeg",fullName:"Gyeong Hun Baeg"},{id:"207180",title:"MSc.",name:"Sharon Wui Sing",middleName:null,surname:"Tan",slug:"sharon-wui-sing-tan",fullName:"Sharon Wui Sing Tan"},{id:"207181",title:"Dr.",name:"Yu",middleName:null,surname:"Cai",slug:"yu-cai",fullName:"Yu Cai"}]},{id:"56417",title:"Membrane Dynamics of Spermatozoa during Capacitation: New Insight in Germ Cells Signalling",slug:"membrane-dynamics-of-spermatozoa-during-capacitation-new-insight-in-germ-cells-signalling",totalDownloads:1303,totalCrossrefCites:0,totalDimensionsCites:4,abstract:"The study of germline stem cells and of germline cells has deep implications for the understanding of fertility, development and cancer. Nowadays, we are experiencing the very fascinating challenge of application of –OMICS technologies to this issue, which is opening new and unexpected horizons in virtually all the branches of biology. Here, we carried out a review of signalling systems involved in maturation of male germ cells and in the process that leads them to become fully fertile. In particular, we discuss the control mechanisms involved in capacitation and acrosome reaction that act at membrane level. Indeed, spermatozoa membranes play key roles in determining the achievement of fertility: they are the interface with the surrounding environment, they locate the signal transduction systems and they are active in recognizing and binding the oocyte. In addition, we discuss the effect of several compounds that could exert a negative effect on reproductive activity, by interfering with the endocrine axis, the so-called endocrine disruptors.",book:{id:"5854",slug:"germ-cell",title:"Germ Cell",fullTitle:"Germ Cell"},signatures:"Nicola Bernabò, Marina Ramal Sanchez, Luca Valbonetti, Luana\nGreco, Giulia Capacchietti, Mauro Mattioli and Barbara Barboni",authors:[{id:"88710",title:"Prof.",name:"Mauro",middleName:null,surname:"Mattioli",slug:"mauro-mattioli",fullName:"Mauro Mattioli"},{id:"88713",title:"Prof.",name:"Barbara",middleName:null,surname:"Barboni",slug:"barbara-barboni",fullName:"Barbara Barboni"},{id:"90197",title:"Dr.",name:"Nicola",middleName:null,surname:"Bernabò",slug:"nicola-bernabo",fullName:"Nicola Bernabò"},{id:"199832",title:"Dr.",name:"Luca",middleName:null,surname:"Valbonetti",slug:"luca-valbonetti",fullName:"Luca Valbonetti"},{id:"199833",title:"Dr.",name:"Marina",middleName:null,surname:"Ramal Sancez",slug:"marina-ramal-sancez",fullName:"Marina Ramal Sancez"},{id:"199834",title:"Dr.",name:"Giulia",middleName:null,surname:"Capacchietti",slug:"giulia-capacchietti",fullName:"Giulia Capacchietti"}]},{id:"56483",title:"Primordial Germ Cell Reprogramming",slug:"primordial-germ-cell-reprogramming",totalDownloads:1433,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Primordial germ cells (PGCs) are the embryonic precursors of the gametes. Thus, they are unipotent cells. However, PGCs share some common features with pluripotent stem cells. Among them, PGCs show alkaline phosphatase activity and express stage-specific embryonic antigens and pluripotency factors Lin28, Oct4, Sox2, and Nanog. Under specific conditions, they undergo spontaneous reprogramming in vivo. Moreover, they can be easily reprogrammed in vitro into pluripotent embryonic germ cells (EGCs) by culturing them in the presence of basic fibroblast growth factor or the epigenetic modulator trichostatin A. Previous work in our laboratory has also proven that hypoxia alone can reprogram PGCs into hypoxia-induced embryonic germ-like cells, which have a pluripotent phenotype but which do not show self-renewal capacity. Therefore, PGCs are an interesting model to further comprehensively understand the process of cell reprogramming. This chapter reviews various methods to achieve PGC reprogramming, as well as the molecular pathways involved. We focus on soluble factors and genetic strategies to obtain pluripotent cells from PGCs. Special emphasis will be given to factors implied in energetic metabolism, epigenetics, and cell signaling transduction, both in vitro and in vivo.",book:{id:"5854",slug:"germ-cell",title:"Germ Cell",fullTitle:"Germ Cell"},signatures:"Maria P. De Miguel, Yago Alcaina and Diego Sainz de la Maza",authors:[{id:"60625",title:"BSc.",name:"Yago",middleName:null,surname:"Alcaina",slug:"yago-alcaina",fullName:"Yago Alcaina"},{id:"199960",title:"Dr.",name:"Maria P",middleName:null,surname:"De Miguel",slug:"maria-p-de-miguel",fullName:"Maria P De Miguel"},{id:"207051",title:"Dr.",name:"Diego",middleName:null,surname:"Sainz De La Maza",slug:"diego-sainz-de-la-maza",fullName:"Diego Sainz De La Maza"}]},{id:"57528",title:"Challenging the Paradigms on the Origin, Specification and Development of the Female Germ Line in Placental Mammals",slug:"challenging-the-paradigms-on-the-origin-specification-and-development-of-the-female-germ-line-in-pla",totalDownloads:1196,totalCrossrefCites:0,totalDimensionsCites:2,abstract:"Most of our understanding on the origin, specification and development of the female germ line in placental mammals comes from studies in the laboratory mouse. 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After almost 32 years of teaching at the University of Trás-os-Montes and Alto Douro, she recently moved to the University of Évora, Department of Veterinary Medicine, where she teaches in the field of Animal Reproduction and Clinics. Her primary research areas include the molecular markers of the endometrial cycle and the embryo–maternal interaction, including oxidative stress and the reproductive physiology and disorders of sexual development, besides the molecular determinants of male and female fertility. She often supervises students preparing their master's or doctoral theses. 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He received his Ph.D. in Molecular Biology with his thesis “Genetic variability of the tick-borne encephalitis virus in natural foci of Novosibirsk city and its suburbs.” His primary field is molecular virology with research emphasis on vector-borne viruses, especially tick-borne encephalitis virus, Kemerovo virus and Omsk hemorrhagic fever virus, rabies virus, molecular genetics, biology, and epidemiology of virus pathogens.",institutionString:"Russian Academy of Sciences",institution:{name:"Russian Academy of Sciences",country:{name:"Russia"}}},{id:"310962",title:"Dr.",name:"Amlan",middleName:"Kumar",surname:"Patra",slug:"amlan-patra",fullName:"Amlan Patra",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/310962/images/system/310962.jpg",biography:"Amlan K. Patra, FRSB, obtained a Ph.D. in Animal Nutrition from Indian Veterinary Research Institute, India, in 2002. He is currently an associate professor at West Bengal University of Animal and Fishery Sciences. He has more than twenty years of research and teaching experience. He held previous positions at the American Institute for Goat Research, The Ohio State University, Columbus, USA, and Free University of Berlin, Germany. His research focuses on animal nutrition, particularly ruminants and poultry nutrition, gastrointestinal electrophysiology, meta-analysis and modeling in nutrition, and livestock–environment interaction. He has authored around 175 articles in journals, book chapters, and proceedings. Dr. Patra serves on the editorial boards of several reputed journals.",institutionString:null,institution:{name:"West Bengal University of Animal and Fishery Sciences",country:{name:"India"}}},{id:"53998",title:"Prof.",name:"László",middleName:null,surname:"Babinszky",slug:"laszlo-babinszky",fullName:"László Babinszky",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/53998/images/system/53998.png",biography:"László Babinszky is Professor Emeritus, Department of Animal Nutrition Physiology, University of Debrecen, Hungary. He has also worked in the Department of Animal Nutrition, University of Wageningen, Netherlands; the Institute for Livestock Feeding and Nutrition (IVVO), Lelystad, Netherlands; the Agricultural University of Vienna (BOKU); the Institute for Animal Breeding and Nutrition, Austria; and the Oscar Kellner Research Institute for Animal Nutrition, Rostock, Germany. In 1992, Dr. Babinszky obtained a Ph.D. in Animal Nutrition from the University of Wageningen. His main research areas are swine and poultry nutrition. He has authored more than 300 publications (papers, book chapters) and edited four books and fourteen international conference proceedings.",institutionString:"University of Debrecen",institution:{name:"University of Debrecen",country:{name:"Hungary"}}},{id:"201830",title:"Dr.",name:"Fernando",middleName:"Sanchez",surname:"Davila",slug:"fernando-davila",fullName:"Fernando Davila",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/201830/images/5017_n.jpg",biography:"I am a professor at UANL since 1988. My research lines are the development of reproductive techniques in small ruminants. We also conducted research on sexual and social behavior in males.\nI am Mexican and study my professional career as an engineer in agriculture and animal science at UANL. Then take a masters degree in science in Germany (Animal breeding). Take a doctorate in animal science at the UANL.",institutionString:null,institution:{name:"Universidad Autónoma de Nuevo León",country:{name:"Mexico"}}},{id:"309250",title:"Dr.",name:"Miguel",middleName:null,surname:"Quaresma",slug:"miguel-quaresma",fullName:"Miguel Quaresma",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/309250/images/9059_n.jpg",biography:"Miguel Nuno Pinheiro Quaresma was born on May 26, 1974 in Dili, Timor Island. He is married with two children: a boy and a girl, and he is a resident in Vila Real, Portugal. He graduated in Veterinary Medicine in August 1998 and obtained his Ph.D. degree in Veterinary Sciences -Clinical Area in February 2015, both from the University of Trás-os-Montes e Alto Douro. He is currently enrolled in the Alternative Residency of the European College of Animal Reproduction. He works as a Senior Clinician at the Veterinary Teaching Hospital of UTAD (HVUTAD) with a role in clinical activity in the area of livestock and equine species as well as to support teaching and research in related areas. He teaches as an Invited Professor in Reproduction Medicine I and II of the Master\\'s in Veterinary Medicine degree at UTAD. Currently, he holds the position of Chairman of the Portuguese Buiatrics Association. He is a member of the Consultive Group on Production Animals of the OMV. He has 19 publications in indexed international journals (ISIS), as well as over 60 publications and oral presentations in both Portuguese and international journals and congresses.",institutionString:"University of Trás-os-Montes and Alto Douro",institution:{name:"University of Trás-os-Montes and Alto Douro",country:{name:"Portugal"}}},{id:"38652",title:"Prof.",name:"Rita",middleName:null,surname:"Payan-Carreira",slug:"rita-payan-carreira",fullName:"Rita Payan-Carreira",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRiFPQA0/Profile_Picture_1614601496313",biography:"Rita Payan Carreira earned her Veterinary Degree from the Faculty of Veterinary Medicine in Lisbon, Portugal, in 1985. She obtained her Ph.D. in Veterinary Sciences from the University of Trás-os-Montes e Alto Douro, Portugal. After almost 32 years of teaching at the University of Trás-os-Montes and Alto Douro, she recently moved to the University of Évora, Department of Veterinary Medicine, where she teaches in the field of Animal Reproduction and Clinics. Her primary research areas include the molecular markers of the endometrial cycle and the embryo–maternal interaction, including oxidative stress and the reproductive physiology and disorders of sexual development, besides the molecular determinants of male and female fertility. She often supervises students preparing their master's or doctoral theses. She is also a frequent referee for various journals.",institutionString:null,institution:{name:"University of Évora",country:{name:"Portugal"}}},{id:"283019",title:"Dr.",name:"Oudessa",middleName:null,surname:"Kerro Dego",slug:"oudessa-kerro-dego",fullName:"Oudessa Kerro Dego",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/283019/images/system/283019.png",biography:"Dr. Kerro Dego is a veterinary microbiologist with training in veterinary medicine, microbiology, and anatomic pathology. Dr. Kerro Dego is an assistant professor of dairy health in the department of animal science, the University of Tennessee, Institute of Agriculture, Knoxville, Tennessee. He received his D.V.M. (1997), M.S. (2002), and Ph.D. (2008) degrees in Veterinary Medicine, Animal Pathology and Veterinary Microbiology from College of Veterinary Medicine, Addis Ababa University, Ethiopia; College of Veterinary Medicine, Utrecht University, the Netherlands and Western College of Veterinary Medicine, University of Saskatchewan, Canada respectively. He did his Postdoctoral training in microbial pathogenesis (2009 - 2015) in the Department of Animal Science, the University of Tennessee, Institute of Agriculture, Knoxville, Tennessee. Dr. Kerro Dego’s research focuses on the prevention and control of infectious diseases of farm animals, particularly mastitis, improving dairy food safety, and mitigation of antimicrobial resistance. Dr. Kerro Dego has extensive experience in studying the pathogenesis of bacterial infections, identification of virulence factors, and vaccine development and efficacy testing against major bacterial mastitis pathogens. Dr. Kerro Dego conducted numerous controlled experimental and field vaccine efficacy studies, vaccination, and evaluation of immunological responses in several species of animals, including rodents (mice) and large animals (bovine and ovine).",institutionString:"University of Tennessee at Knoxville",institution:{name:"University of Tennessee at Knoxville",country:{name:"United States of America"}}},{id:"251314",title:"Dr.",name:"Juan Carlos",middleName:null,surname:"Gardón",slug:"juan-carlos-gardon",fullName:"Juan Carlos Gardón",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/251314/images/system/251314.jpeg",biography:"Juan Carlos Gardón Poggi received University degree from the Faculty of Agrarian Science in Argentina, in 1983. Also he received Masters Degree and PhD from Córdoba University, Spain. He is currently a Professor at the Catholic University of Valencia San Vicente Mártir, at the Department of Medicine and Animal Surgery. He teaches diverse courses in the field of Animal Reproduction and he is the Director of the Veterinary Farm. He also participates in academic postgraduate activities at the Veterinary Faculty of Murcia University, Spain. His research areas include animal physiology, physiology and biotechnology of reproduction either in males or females, the study of gametes under in vitro conditions and the use of ultrasound as a complement to physiological studies and development of applied biotechnologies. Routinely, he supervises students preparing their doctoral, master thesis or final degree projects.",institutionString:"Catholic University of Valencia San Vicente Mártir, Spain",institution:null},{id:"125292",title:"Dr.",name:"Katy",middleName:null,surname:"Satué Ambrojo",slug:"katy-satue-ambrojo",fullName:"Katy Satué Ambrojo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/125292/images/system/125292.jpeg",biography:"Katy Satué Ambrojo received her Veterinary Medicine degree, Master degree in Equine Technology and doctorate in Veterinary Medicine from the Faculty of Veterinary, CEU-Cardenal Herrera University in Valencia, Spain. She is a Full Professor at the Department of Medicine and Animal Surgery at the same University. She developed her research activity in the field of Endocrinology, Hematology, Biochemistry and Immunology of horses. She is a scientific reviewer of several international journals : American Journal of Obstetrics and Gynecology, Comparative Clinical Pathology, Veterinary Clinical Pathology, Journal of Equine Veterinary Science, Reproduction in Domestic Animals, Research Veterinary Science, Brazilian Journal of Medical and Biological Research, Livestock Production Science and Theriogenology. Since 2014, she has been the Head of the Clinical Analysis Laboratory of the Hospital Clínico Veterinario from the Faculty of Veterinary, CEU-Cardenal Herrera University.",institutionString:"CEU-Cardenal Herrera University",institution:{name:"CEU Cardinal Herrera University",country:{name:"Spain"}}},{id:"309529",title:"Dr.",name:"Albert",middleName:null,surname:"Rizvanov",slug:"albert-rizvanov",fullName:"Albert Rizvanov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/309529/images/9189_n.jpg",biography:'Albert A. Rizvanov is a Professor and Director of the Center for Precision and Regenerative Medicine at the Institute of Fundamental Medicine and Biology, Kazan Federal University (KFU), Russia. He is the Head of the Center of Excellence “Regenerative Medicine” and Vice-Director of Strategic Academic Unit \\"Translational 7P Medicine\\". Albert completed his Ph.D. at the University of Nevada, Reno, USA and Dr.Sci. at KFU. He is a corresponding member of the Tatarstan Academy of Sciences, Russian Federation. Albert is an author of more than 300 peer-reviewed journal articles and 22 patents. He has supervised 11 Ph.D. and 2 Dr.Sci. dissertations. Albert is the Head of the Dissertation Committee on Biochemistry, Microbiology, and Genetics at KFU.\nORCID https://orcid.org/0000-0002-9427-5739\nWebsite https://kpfu.ru/Albert.Rizvanov?p_lang=2',institutionString:"Kazan Federal University",institution:{name:"Kazan Federal University",country:{name:"Russia"}}},{id:"210551",title:"Dr.",name:"Arbab",middleName:null,surname:"Sikandar",slug:"arbab-sikandar",fullName:"Arbab Sikandar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/210551/images/system/210551.jpg",biography:"Dr. Arbab Sikandar, PhD, M. Phil, DVM was born on April 05, 1981. He is currently working at the College of Veterinary & Animal Sciences as an Assistant Professor. He previously worked as a lecturer at the same University. \nHe is a Member/Secretory of Ethics committee (No. CVAS-9377 dated 18-04-18), Member of the QEC committee CVAS, Jhang (Regr/Gen/69/873, dated 26-10-2017), Member, Board of studies of Department of Basic Sciences (No. CVAS. 2851 Dated. 12-04-13, and No. CVAS, 9024 dated 20/11/17), Member of Academic Committee, CVAS, Jhang (No. CVAS/2004, Dated, 25-08-12), Member of the technical committee (No. CVAS/ 4085, dated 20,03, 2010 till 2016).\n\nDr. Arbab Sikandar contributed in five days hands-on-training on Histopathology at the Department of Pathology, UVAS from 12-16 June 2017. He received a Certificate of appreciation for contributions for Popularization of Science and Technology in the Society on 17-11-15. He was the resource person in the lecture series- ‘scientific writing’ at the Department of Anatomy and Histology, UVAS, Lahore on 29th October 2015. He won a full fellowship as a principal candidate for the year 2015 in the field of Agriculture, EICA, Egypt with ref. to the Notification No. 12(11) ACS/Egypt/2014 from 10 July 2015 to 25th September 2015.; he received a grant of Rs. 55000/- as research incentives from Director, Advanced Studies and Research, UVAS, Lahore upon publications of research papers in IF Journals (DR/215, dated 19-5-2014.. He obtained his PhD by winning a HEC Pakistan indigenous Scholarship, ‘Ph.D. fellowship for 5000 scholars – Phase II’ (2av1-147), 17-6/HEC/HRD/IS-II/12, November 15, 2012. \n\nDr. Sikandar is a member of numerous societies: Registered Veterinary Medical Practitioner (life member) and Registered Veterinary Medical Faculty of Pakistan Veterinary Medical Council. The Registration code of PVMC is RVMP/4298 and RVMF/ 0102.; Life member of the University of Veterinary and Animal Sciences, Lahore, Alumni Association with S# 664, dated: 6-4-12. ; Member 'Vets Care Organization Pakistan” with Reference No. VCO-605-149, dated 05-04-06. :Member 'Vet Crescent” (Society of Animal Health and Production), UVAS, Lahore.",institutionString:"University of Veterinary & Animal Science",institution:{name:"University of Veterinary and Animal Sciences",country:{name:"Pakistan"}}},{id:"311663",title:"Dr.",name:"Prasanna",middleName:null,surname:"Pal",slug:"prasanna-pal",fullName:"Prasanna Pal",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/311663/images/13261_n.jpg",biography:null,institutionString:null,institution:{name:"National Dairy Research Institute",country:{name:"India"}}},{id:"202192",title:"Dr.",name:"Catrin",middleName:null,surname:"Rutland",slug:"catrin-rutland",fullName:"Catrin Rutland",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/202192/images/system/202192.png",biography:"Catrin Rutland is an Associate Professor of Anatomy and Developmental Genetics at the University of Nottingham, UK. She obtained a BSc from the University of Derby, England, a master’s degree from Technische Universität München, Germany, and a Ph.D. from the University of Nottingham. She undertook a post-doctoral research fellowship in the School of Medicine before accepting tenure in Veterinary Medicine and Science. Dr. Rutland also obtained an MMedSci (Medical Education) and a Postgraduate Certificate in Higher Education (PGCHE). She is the author of more than sixty peer-reviewed journal articles, twelve books/book chapters, and more than 100 research abstracts in cardiovascular biology and oncology. She is a board member of the European Association of Veterinary Anatomists, Fellow of the Anatomical Society, and Senior Fellow of the Higher Education Academy. 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Samir worked as a member of different local projects on E-learning and he is a board member of the African Association of Veterinary Anatomists and of anatomy societies and as an associated author at local and international journals. Orcid: https://orcid.org/0000-0002-6180-389X",institutionString:null,institution:{name:"Alexandria University",country:{name:"Egypt"}}},{id:"246149",title:"Dr.",name:"Valentina",middleName:null,surname:"Kubale",slug:"valentina-kubale",fullName:"Valentina Kubale",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/246149/images/system/246149.jpg",biography:"Valentina Kubale is Associate Professor of Veterinary Medicine at the Veterinary Faculty, University of Ljubljana, Slovenia. Since graduating from the Veterinary faculty she obtained her PhD in 2007, performed collaboration with the Department of Pharmacology, University of Copenhagen, Denmark. She continued as a post-doctoral fellow at the University of Copenhagen with a Lundbeck foundation fellowship. She is the editor of three books and author/coauthor of 23 articles in peer-reviewed scientific journals, 16 book chapters, and 68 communications at scientific congresses. Since 2008 she has been the Editor Assistant for the Slovenian Veterinary Research journal. 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Dr. Fonseca-Alves currently serves as an Assistant Professor at Paulista University – UNIP teaching small animal internal medicine.",institutionString:null,institution:{name:"Universidade Paulista",country:{name:"Brazil"}}},{id:"245306",title:"Dr.",name:"María Luz",middleName:null,surname:"Garcia Pardo",slug:"maria-luz-garcia-pardo",fullName:"María Luz Garcia Pardo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/245306/images/system/245306.png",biography:"María de la Luz García Pardo is an agricultural engineer from Universitat Politècnica de València, Spain. She has a Ph.D. in Animal Genetics. Currently, she is a lecturer at the Agrofood Technology Department of Miguel Hernández University, Spain. Her research is focused on genetics and reproduction in rabbits. The major goal of her research is the genetics of litter size through novel methods such as selection by the environmental sensibility of litter size, with forays into the field of animal welfare by analysing the impact on the susceptibility to diseases and stress of the does. Details of her publications can be found at https://orcid.org/0000-0001-9504-8290.",institutionString:null,institution:{name:"Miguel Hernandez University",country:{name:"Spain"}}},{id:"41319",title:"Prof.",name:"Lung-Kwang",middleName:null,surname:"Pan",slug:"lung-kwang-pan",fullName:"Lung-Kwang Pan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/41319/images/84_n.jpg",biography:null,institutionString:null,institution:null},{id:"201721",title:"Dr.",name:"Beatrice",middleName:null,surname:"Funiciello",slug:"beatrice-funiciello",fullName:"Beatrice Funiciello",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/201721/images/11089_n.jpg",biography:"Graduated from the University of Milan in 2011, my post-graduate education included CertAVP modules mainly on equines (dermatology and internal medicine) and a few on small animal (dermatology and anaesthesia) at the University of Liverpool. After a general CertAVP (2015) I gained the designated Certificate in Veterinary Dermatology (2017) after taking the synoptic examination and then applied for the RCVS ADvanced Practitioner status. After that, I completed the Postgraduate Diploma in Veterinary Professional Studies at the University of Liverpool (2018). My main area of work is cross-species veterinary dermatology.",institutionString:null,institution:null},{id:"291226",title:"Dr.",name:"Monica",middleName:null,surname:"Cassel",slug:"monica-cassel",fullName:"Monica Cassel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/291226/images/8232_n.jpg",biography:'Degree in Biological Sciences at the Federal University of Mato Grosso with scholarship for Scientific Initiation by FAPEMAT (2008/1) and CNPq (2008/2-2009/2): Project \\"Histological evidence of reproductive activity in lizards of the Manso region, Chapada dos Guimarães, Mato Grosso, Brazil\\". Master\\\'s degree in Ecology and Biodiversity Conservation at Federal University of Mato Grosso with a scholarship by CAPES/REUNI program: Project \\"Reproductive biology of Melanorivulus punctatus\\". PhD\\\'s degree in Science (Cell and Tissue Biology Area) \n at University of Sao Paulo with scholarship granted by FAPESP; Project \\"Development of morphofunctional changes in ovary of Astyanax altiparanae Garutti & Britski, 2000 (Teleostei, Characidae)\\". She has experience in Reproduction of vertebrates and Morphology, with emphasis in Cellular Biology and Histology. She is currently a teacher in the medium / technical level courses at IFMT-Alta Floresta, as well as in the Bachelor\\\'s degree in Animal Science and in the Bachelor\\\'s degree in Business.',institutionString:null,institution:null},{id:"442807",title:"Dr.",name:"Busani",middleName:null,surname:"Moyo",slug:"busani-moyo",fullName:"Busani Moyo",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Gwanda State University",country:{name:"Zimbabwe"}}},{id:"423023",title:"Dr.",name:"Yosra",middleName:null,surname:"Soltan",slug:"yosra-soltan",fullName:"Yosra Soltan",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Alexandria University",country:{name:"Egypt"}}},{id:"349788",title:"Dr.",name:"Florencia Nery",middleName:null,surname:"Sompie",slug:"florencia-nery-sompie",fullName:"Florencia Nery Sompie",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Sam Ratulangi University",country:{name:"Indonesia"}}},{id:"345713",title:"Dr.",name:"Csaba",middleName:null,surname:"Szabó",slug:"csaba-szabo",fullName:"Csaba Szabó",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Debrecen",country:{name:"Hungary"}}},{id:"345719",title:"Mrs.",name:"Márta",middleName:null,surname:"Horváth",slug:"marta-horvath",fullName:"Márta Horváth",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Debrecen",country:{name:"Hungary"}}},{id:"420151",title:"Prof.",name:"Novirman",middleName:null,surname:"Jamarun",slug:"novirman-jamarun",fullName:"Novirman Jamarun",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Andalas University",country:{name:"Indonesia"}}},{id:"420149",title:"Dr.",name:"Rusmana",middleName:"Wijaya Setia",surname:"Wijaya Setia Ningrat",slug:"rusmana-wijaya-setia-ningrat",fullName:"Rusmana Wijaya Setia Ningrat",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Andalas University",country:{name:"Indonesia"}}},{id:"339759",title:"Mr.",name:"Abu",middleName:null,surname:"Macavoray",slug:"abu-macavoray",fullName:"Abu Macavoray",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Njala University",country:{name:"Sierra Leone"}}},{id:"339758",title:"Prof.",name:"Benjamin",middleName:null,surname:"Emikpe",slug:"benjamin-emikpe",fullName:"Benjamin Emikpe",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Ibadan",country:{name:"Nigeria"}}},{id:"339760",title:"Mr.",name:"Moinina Nelphson",middleName:null,surname:"Kallon",slug:"moinina-nelphson-kallon",fullName:"Moinina Nelphson Kallon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Njala University",country:{name:"Sierra Leone"}}}]}},subseries:{item:{id:"17",type:"subseries",title:"Metabolism",keywords:"Biomolecules Metabolism, Energy Metabolism, Metabolic Pathways, Key Metabolic Enzymes, Metabolic Adaptation",scope:"Metabolism is frequently defined in biochemistry textbooks as the overall process that allows living systems to acquire and use the free energy they need for their vital functions or the chemical processes that occur within a living organism to maintain life. Behind these definitions are hidden all the aspects of normal and pathological functioning of all processes that the topic ‘Metabolism’ will cover within the Biochemistry Series. Thus all studies on metabolism will be considered for publication.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/17.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11413,editor:{id:"138626",title:"Dr.",name:"Yannis",middleName:null,surname:"Karamanos",slug:"yannis-karamanos",fullName:"Yannis Karamanos",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002g6Jv2QAE/Profile_Picture_1629356660984",biography:"Yannis Karamanos, born in Greece in 1953, completed his pre-graduate studies at the Université Pierre et Marie Curie, Paris, then his Masters and Doctoral degree at the Université de Lille (1983). He was associate professor at the University of Limoges (1987) before becoming full professor of biochemistry at the Université d’Artois (1996). He worked on the structure-function relationships of glycoconjugates and his main project was the investigations on the biological roles of the de-N-glycosylation enzymes (Endo-N-acetyl-β-D-glucosaminidase and peptide-N4-(N-acetyl-β-glucosaminyl) asparagine amidase). From 2002 he contributes to the understanding of the Blood-brain barrier functioning using proteomics approaches. He has published more than 70 papers. 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