Recommendations on the treatment of noncomplicated acute left diverticulitis.
\\n\\n
IntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\\n\\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\\n\\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\\n\\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\\n\\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\\n\\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\\n\\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\\n\\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\\n\\nFeel free to share this news on social media and help us mark this memorable moment!
\\n\\n\\n"}]',published:!0,mainMedia:{caption:"",originalUrl:"/media/original/237"}},components:[{type:"htmlEditorComponent",content:'
After years of being acknowledged as the world's leading publisher of Open Access books, today, we are proud to announce we’ve successfully launched a portfolio of Open Science journals covering rapidly expanding areas of interdisciplinary research.
\n\n\n\nIntechOpen was founded by scientists, for scientists, in order to make book publishing accessible around the globe. Over the last two decades, this has driven Open Access (OA) book publishing whilst levelling the playing field for global academics. Through our innovative publishing model and the support of the research community, we have now published over 5,700 Open Access books and are visited online by over three million academics every month. These researchers are increasingly working in broad technology-based subjects, driving multidisciplinary academic endeavours into human health, environment, and technology.
\n\nBy listening to our community, and in order to serve these rapidly growing areas which lie at the core of IntechOpen's expertise, we are launching a portfolio of Open Science journals:
\n\nAll three journals will publish under an Open Access model and embrace Open Science policies to help support the changing needs of academics in these fast-moving research areas. There will be direct links to preprint servers and data repositories, allowing full reproducibility and rapid dissemination of published papers to help accelerate the pace of research. Each journal has renowned Editors in Chief who will work alongside a global Editorial Board, delivering robust single-blind peer review. Supported by our internal editorial teams, this will ensure our authors will receive a quick, user-friendly, and personalised publishing experience.
\n\n"By launching our journals portfolio we are introducing new, dedicated homes for interdisciplinary technology-focused researchers to publish their work, whilst embracing Open Science and creating a unique global home for academics to disseminate their work. We are taking a leap toward Open Science continuing and expanding our fundamental commitment to openly sharing scientific research across the world, making it available for the benefit of all." Dr. Sara Uhac, IntechOpen CEO
\n\n"Our aim is to promote and create better science for a better world by increasing access to information and the latest scientific developments to all scientists, innovators, entrepreneurs and students and give them the opportunity to learn, observe and contribute to knowledge creation. Open Science promotes a swifter path from research to innovation to produce new products and services." Alex Lazinica, IntechOpen founder
\n\nIn conclusion, Natalia Reinic Babic, Head of Journal Publishing and Open Science at IntechOpen adds:
\n\n“On behalf of the journal team I’d like to thank all our Editors in Chief, Editorial Boards, internal supporting teams, and our scientific community for their continuous support in making this portfolio a reality - we couldn’t have done it without you! With your support in place, we are confident these journals will become as impactful and successful as our book publishing program and bring us closer to a more open (science) future.”
\n\nWe invite you to visit the journals homepage and learn more about the journal’s Editorial Boards, scope and vision as all three journals are now open for submissions.
\n\nFeel free to share this news on social media and help us mark this memorable moment!
\n\n\n'}],latestNews:[{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"799",leadTitle:null,fullTitle:"Salmonella - A Dangerous Foodborne Pathogen",title:"Salmonella",subtitle:"A Dangerous Foodborne Pathogen",reviewType:"peer-reviewed",abstract:"More than 2,500 serotypes of Salmonella exist. However, only some of these serotypes have been frequently associated with food-borne illnesses. Salmonella is the second most dominant bacterial cause of food-borne gastroenteritis worldwide. Often, most people who suffer from Salmonella infections have temporary gastroenteritis, which usually does not require treatment. However, when infection becomes invasive, antimicrobial treatment is mandatory. Symptoms generally occur 8 to 72 hours after ingestion of the pathogen and can last 3 to 5 days. Children, the elderly, and immunocompromised individuals are the most susceptible to salmonellosis infections. The annual economic cost due to food-borne Salmonella infections in the United States alone is estimated at $2.4 billion, with an estimated 1.4 million cases of salmonellosis and more than 500 deaths annually. This book contains nineteen chapters which cover a range of different topics, such as the role of foods in Salmonella infections, food-borne outbreaks caused by Salmonella, biofilm formation, antimicrobial drug resistance of Salmonella isolates, methods for controlling Salmonella in food, and Salmonella isolation and identification methods.",isbn:null,printIsbn:"978-953-307-782-6",pdfIsbn:"978-953-51-4378-9",doi:"10.5772/1308",price:139,priceEur:155,priceUsd:179,slug:"salmonella-a-dangerous-foodborne-pathogen",numberOfPages:452,isOpenForSubmission:!1,isInWos:1,isInBkci:!0,hash:"ba452d8a24ef16b1267d2854b28f6e6a",bookSignature:"Barakat S. M. Mahmoud",publishedDate:"January 20th 2012",coverURL:"https://cdn.intechopen.com/books/images_new/799.jpg",numberOfDownloads:139968,numberOfWosCitations:115,numberOfCrossrefCitations:35,numberOfCrossrefCitationsByBook:5,numberOfDimensionsCitations:122,numberOfDimensionsCitationsByBook:8,hasAltmetrics:0,numberOfTotalCitations:272,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"February 23rd 2011",dateEndSecondStepPublish:"March 23rd 2011",dateEndThirdStepPublish:"July 28th 2011",dateEndFourthStepPublish:"August 27th 2011",dateEndFifthStepPublish:"December 25th 2011",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,8,9",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"92016",title:"Dr.",name:"Barakat",middleName:null,surname:"Mahmoud",slug:"barakat-mahmoud",fullName:"Barakat Mahmoud",profilePictureURL:"https://mts.intechopen.com/storage/users/92016/images/system/92016.jpg",biography:"Dr. Mahmoud is an international food safety expert with 30 years of experience in food safety. He was an Associate Professor in the Department of Food Science, Nutrition and Health Promotion at MSU. Prior to that, he held a postdoctoral position (in Food Safety) at Purdue University. He earned his Ph.D. in Marine Biosciences (Food Safety) from Hokkaido University (Japan). Prior to that he was a Visiting Scientist at the University of Lisbon (Portugal). He held a researcher position at the NRC (Egypt) between 1994 and 2000. He received his BSc/MSc degrees in Agricultural Sciences from Cairo University. The main goal of Dr. Mahmoud’s work is to protect public health, reduce the prevalence of foodborne illness and promote the introduction of safer food using novel technologies. Dr. Mahmoud received more than $1M from the USDA, States and Food Industry to support his research (between 2008 and 2016). Dr. Mahmoud published about 100 publications (in international journals and/or conferences), two book chapters and edited a book entitled \\'Salmonella-A Dangerous Foodborne Pathogen” (His publications have been cited more than 1200 times). He served as an editor-in-chief, editor/editorial board member for several international journals including Food Microbiology, Journal of Food Protection, Foodborne Pathogens & Disease, and African Journal of Food Science. Dr. Mahmoud has provided technical assistance in food safety in several developing countries in Africa, Asia, Central America, Middle East, and the Caribbean including Egypt, Malawi, Mozambique, Lebanon, Guatemala, the Dominican Republic, etc.",institutionString:"United States Department of Agriculture",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"2",institution:null}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"1046",title:"Infectious Diseases",slug:"infectious-diseases"}],chapters:[{id:"26420",title:"The Burden of Salmonellosis in the United States",doi:"10.5772/28019",slug:"the-burden-of-salmonellosis-in-the-united-states",totalDownloads:4994,totalCrossrefCites:0,totalDimensionsCites:6,hasAltmetrics:0,abstract:null,signatures:"Patricia L. 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Diverticulosis is a common disease among the Western and developed nations; its prevalence increases with age, being 10% in adults over 40 years and around 70% in patients over 80 years. Approximately 20% of patients with diverticulosis will become symptomatic [1].
Worldwide, the incidence of diverticular disease is rising. Lifestyle and Western diet seem to be the factors influencing this epidemiological change, increasing most dramatically among age groups between 18 and 64 years old. Amid young patients, diverticular disease is more common in men, while in the elderly population, the prevalence is similar between both sexes [2]. Diverticular disease can occur in any part of the colon, but the left side is more frequently affected in Western countries, while up to 70% of cases in Asia appear on the right side [3].
Different classifications exist to categorize acute diverticulitis, but it is generally classified as uncomplicated or complicated. The computed tomography of the abdomen and pelvis is the best way to assess its severity. Further investigations to characterize it include white blood cell count and C-reactive protein levels [4]. About 85% of patients that attend to the emergency department for an acute onset of diverticular disease will have an uncomplicated form of it, and they may be treated conservatively [5]. The rest of the cases will present with abscess, fistula, perforation, stricture, or peritonitis, where surgical treatment is advised in an urgent or elective setting. Surgical options are diverse, but the indications and recommendations to choose one strategy over the other are beyond the scope of this chapter.
Regarding nonoperative management, patients can be hospitalized or sent home with or without antibiotics. Treatment should be tailored according to the patient’s characteristics [6]. Patients with uncomplicated diverticulitis by CT may develop severe complications in 1.4% of the cases [7], while recurrence rates have been described to be from 5 to 20% [8]. Recurrence risk tends to be higher in patients with a previous episode of complicated diverticulitis (24% vs. 23.4%,
Diverticulitis treatment has been modified throughout time. The prescription of antibiotics used to be the therapeutic foundation of it, but it could be avoided now in well-selected patients [10]. The nonantibiotic treatment strategy was formulated more than a decade ago when diverticular physiopathology was reassessed. At first, it was known that diverticular occlusion, micro-perforation, and peritoneal infection were the origin of diverticulitis [11]. Later, with the finding of TNF-a overexpression, it was concluded that inflammation plays a crucial role in diverticulitis development [12]. Even more, patients with diverticular disease seem to have changed in the gastrointestinal flora, including the depletion of some fecal microbiota species that have anti-inflammatory properties [13]. Subjects with diverticula seem to have more macrophages in the intestinal wall than their healthier counterparts, promoting inflammation rather than infection [14] and therefore raising the question about the actual need for antibiotics for its treatment during an acute flare.
Under this hypothesis, anti-inflammatory medication has been suggested as a treatment for acute uncomplicated diverticulitis, spearing the use of antibiotics as long as complications are not present.
Two of the most important contributions regarding the avoidance of the use of antibiotics were made by the AVOD (Antibiotika Vid Okomplicerad Divertikulit—Swedish for “antibiotics in uncomplicated diverticulitis”) and DIABOLO (DIverticulitis: AntiBiotics Or cLose Observation?) randomized control trials (RCT), published in 2011 and 2016, respectively.
The DIABOLO study [15] was a multicentric trial evaluating two different approaches for the management of uncomplicated acute diverticulitis, either observation or antibiotic treatment. The patients included were those with the first episode of left-sided uncomplicated diverticulitis, classified according to Hinchey’s or Ambrosetti’s scale. The diagnosis was confirmed with a CT scan in the first 24 h of presentation.
The antibiotic used was amoxicillin-clavulanic acid (unless allergic), and it was handed intravenously four times a day for the first 2 days and then switched to oral three times a day until a 10-day course was completed. For the initial doses, all the patients had to be admitted contrary to the observational group, which was treated in the outpatient setting as long as the patient could tolerate a regular diet, there was no fever, and there was reasonable pain control. Only 34 patients were sent home under this premise.
The primary analyses included 528 patients. The median time to recovery during 6 months follow-up was 14 days for patients who had conservative management vs. 12 days among those with antibiotics. Readmission rates were comparable: 17.6% in the observation vs. 12.0% in the antibiotic group (
The proportion of patients with recurrent diverticulitis was similar in the two groups (3.4 vs. 3.0%;
Another multicenter trial was the AVOD [7], where 10 surgical departments in Sweden and one in Iceland participated. Uncomplicated diverticulitis was defined as an episode of clinical signs compatible with diverticulitis, including fever and raised inflammatory markers complemented with computed tomography (CT). The randomization was done with sealed envelopes, and the patients were treated with just intravenous fluids or with antibiotic therapy, but in any case, hospital admission was required. A total of 623 patients were enrolled in the study—309 patients in the no-antibiotics arm and 314 in the antibiotics group. In the antibiotics group, the treatment was initiated with an intravenous combination of a cephalosporin (cefuroxime or cefotaxime) and metronidazole, or with carbapenem antibiotics or piperacillin-tazobactam, and then changed to an oral regimen for completion of 7 days. The discharge was made after the improvement of clinical and biochemical parameters in both groups. Further investigations with colonoscopy, barium enema, or CT colonography were made if none of these were performed within 1 year before admission at 6 or 8 weeks. No significant differences were found between patients treated with or without antibiotics. Neither did between the frequencies in surgery, length of hospital stay, recurrence of diverticulitis, chronic pain, or changes in bowel habit after 12 months.
This study group recently published a long-term follow-up of this cohort. At a median time of 11 years, the authors found no significant differences between the two groups in terms of recurrences (both 31.3%), complications, surgery for diverticulitis, or reported quality of life (EQ-5DTM) [16].
It is extremely important to mention that both trials supporting the avoidance of antibiotics included only patients with early-stage disease (Hinchey I and Ia). These RCTs are also prone to perform a selection bias because no blinding was made, and actual rates among centers were variable. Antibiotic treatment was also not standardized [17].
van Dijk et al. [18] made an individual-patient data meta-analysis with 1109 patients of the DIABOLO and AVOD trials: 545 in the observational group and 564 in the antibiotics group. To make results comparable, he redefined some of the concepts evaluated—ongoing diverticulitis, recurrent diverticulitis, and complicated diverticulitis. Ongoing diverticulitis was the persistence of symptoms during the following 3 months after initial discharge, and recurrent diverticulitis was defined as any episode occurring after discharge. The mean duration of follow-up was 12 months. Baseline characteristics were similar among groups; however, primary diverticulitis was slightly and significantly more common in the antibiotics group 454 cases vs. 408 in the nonantibiotic (
Other studies with less statistical power (non RCT) have had the same findings as to the DIABOLO and AVOD. Some meta-analyses have been made trying to gather more evidence about this topic, and the main outcomes address the recurrence, need for surgery, complication rate, and treatment failure.
A meta-analysis from Desai et al. [19], with seven studies for a total of 2241 patients, concluded that recurrent diverticulitis was actually slightly higher among patients who received antibiotics compared with those who did not 12.6% vs. 11.5% [pooled rate of recurrent diverticulitis OR = 1.27 (95%, CI = 0.90–1.79);
Emile et al. [20] published a systematic review of nine studies with 2565 patients. Failure was defined as the deterioration of symptoms requiring an antibiotic prescription or the readmission within 1 month of discharge due to persistency of them, with or without complications. Recurrence was defined as a new episode of diverticulitis within 1 month after discharge, and readmission was defined as a hospital admission within 1 year after discharge. They concluded that there were no differences in treatment failure, (OR = 1.5,
A Cochrane systematic review from 2012 [21], including three randomized control trials, found no difference in outcomes between patients with uncomplicated diverticulitis treated with or without antibiotics. The patients included in the analyzed studies were healthy with a Hinchey I or Ia stage of the disease.
Mege and Yeo [22] made a meta-analysis including 2321 patients from 11 different studies. The primary endpoint was treatment failure, recognizing this as the need for emergency surgery (0.7% vs. 1.4%;
The reason why elective surgery may be more frequently performed in patients in the nonantibiotic group might be the misperception of being undertreated, so they sought a definitive treatment. Antibiotics may reduce low-grade colonic inflammation avoiding complications such as obstruction, recurrence, or ongoing diverticulitis [11].
Another meta-analysis included nine studies; two RCT, five cohort studies, and two case-control studies, with a total of 1164 patients. In this, patients treated without antibiotics required an additional intervention or treatment in 5.3% of the cases vs. the 3.6% on the antibiotic group but without statistical significance (risk ratio = 1.48;
Mocanu et al. [23] performed another meta-analysis considering two RCT, one single-center cohort, two retrospective cohorts, one prospective cohort, one retrospective case control, and one prospective cohort single arm with a total of 2469 patients. The outcomes included were—recurrence (readmission greater than 1 month following intervention), treatment failure (recurrence of symptoms within 1 month of intervention), abscess, bleeding, fistula, perforation, stenosis, and need for elective or emergent surgery. The overall complication rate was 18.7%, and there was no difference among groups 17.7% in the nonantibiotic group vs. 20.2% in the antibiotic group (OR = 0.72; CI = 0.45–1.16;
Daniels et al. [24] ran a pragmatic RCT with the analysis of the information from 528 patients. His observational strategy proved no inferiority when compared to the antibiotic treatment for the first episode of uncomplicated diverticulitis. The duration of initial admission was longer, and the rate of antibiotic-related adverse events was higher in the antibiotic group, suggesting that antibiotics can be omitted. He also mentions that 7.3% of the patients treated without antibiotics had ongoing diverticulitis vs. 4.7% in the antibiotic group
Quality of life between both treatments has not been adequately addressed; there is a lack of information regarding this critical outcome. Ongoing diverticulitis might not be a precise indicator of the quality of life, but it does make reference to the persistency of symptoms, which may affect the quality of life of patients [24].
The number of days, type of antibiotics, and inpatient or outpatient administration are the other questions arousing in regard to uncomplicated diverticulitis treatment. Antibiotic therapy must be effective against aerobic (
A prospective, single-arm study overviewed [26] the safety and efficacy of symptomatic (nonantibiotic) treatment for CT-proven uncomplicated acute diverticulitis during a 30-day follow-up period. A total of 153 patients (95%) completed the follow-up. A total of 14 (9%) patients had pericolic gas. Altogether, 140 (87%) patients were treated as outpatients, and four (3%) of them were admitted to the hospital at some point. The primary outcome of this study was to find the progression to complicated diverticulitis. None of the subjects developed it or needed surgery, but 2 days (median) after inclusion, antibiotics were given to 14 (9%, six orally, eight intravenously) patients.
Jackson and Hammond [27] did a systematic review back in 2014 justified by the lack of evidence to support the traditional inpatient treatment with bowel rest, intravenous fluids, and intravenous antibiotics. This review included nine studies (415 patients) where all, except for one, used either CT scan or US to confirm uncomplicated diverticulitis. Once the diagnosis was made, some protocols would discharge patients immediately on oral antibiotics and a liquid diet for 10 days. Other protocols would keep patients in the hospital for 24 h before sending them home. Three of the studies allowed some patients to have outpatient care even with abscesses between 2 and 3 cm. About 403 patients out of a total of 415 (97%) participants were successfully treated in the outpatient setting, concluding that a more progressive, ambulatory-based approach is effective and safe.
Another systematic review including 21 studies (11 prospectives, nine retrospectives, and only one randomized trial) with 1781 patients was recently published by Cirocchi et al. [28]. Outpatient management for acute left diverticulitis was the primary outcome evaluated. The meta-analysis concluded that outpatient management is safe. The overall failure rate was 4.3% (95% CI = 2.6–6.3%). Ambulatory treatment was associated with an estimated daily cost savings of between €600 and €1900 per patient treated.
With the growing evidence that antibiotic therapy is not essential for the treatment of acute uncomplicated diverticulitis, several guidelines support the observational management in afebrile clinically stable cases.
A survey conducted in 2011 [29] between gastroenterologists and surgeons found a general opinion about antibiotics not being for everyone any longer. The Danish and Dutch guidelines from 2011 to 2012, respectively, do not recommend the routine use of antibiotics [30].
The American Gastroenterological Association in 2015 advised that antibiotics should be used selectively rather than routinely in patients [31]. Stating also that treatment with broad-spectrum antibiotics may not solve the symptomatology in patients with acute uncomplicated diverticulitis. However, antibiotics may decrease the risk of recurrence and diverticular complications in comparison with no antibiotics. The effect of antibiotics on the development of sepsis and the need for surgery or colostomy remains uncertain.
Recent guidelines from associations all over the world now consider nonantibiotic therapy as a valid strategy for uncomplicated acute diverticulitis, among this associations the American Society of Colorectal Surgeons Clinical practice guidelines for the treatment of left-sided colonic diverticulitis (2020) [32], the Second International Symposium on Diverticular Disease [33], held in Rome in 2016, and the 2020 WSES guidelines [34] address that CT scan findings must be compatible with uncomplicated acute diverticulitis and patients must not show signs of sepsis. The WSES established that immunocompetent patients with uncomplicated diverticulitis without signs of systemic inflammation should not receive antibiotic therapy. This was supported too by last year’s ESCP guidelines [35]; the commissioning guide for colonic diverticular disease made by the Royal College of Surgeons of England [36] in 2014, and the Japanese Gastroenterological Association [37] in 2019.
The EAES and SAGES [38] guidelines also make a remark about the immunocompetence of the patients, establishing those healthy individuals with uncomplicated acute diverticulitis will have similar outcomes with just symptomatic treatment. The antibiotic prescription should be reserved for immunocompromised patients and cases with sepsis. The recommendations from other societies can be found in Table 1.
Society | Recommendation | Grade of evidence | References |
---|---|---|---|
World Society of Emergency Surgery (WSES): update of the guidelines for the management of acute colonic diverticulitis in the emergency setting (2020) | In immunocompetent patients with uncomplicated diverticulitis without signs of systemic inflammation, we recommend not to prescribe antibiotic therapy | 1A | Cochrane Review, AVOD, Mali et al., DIABOLO and DIABOLO LONG TERM |
American Society of Colon and Rectal Surgeons (ASCRS): clinical practice guidelines for the treatment of left-sided colonic diverticulitis (2020) | Selected patients with uncomplicated diverticulitis can be treated without antibiotics | 1A | AVOD, DIABOLO, Mege et al., Sánchez-Velázquez: systematic review, Isacson et al., Van Dijk ST, COCHRANE, Estrada Ferrer et al., Desai et al., Au S et al., Emile et al. Mocanu et al., Bolkenstein |
European Society of Coloproctology (ESCP): Guidelines for the management of diverticular disease of the colon (2020) | Patients with acute uncomplicated diverticulitis do not require antibiotics routinely. Antibiotic treatment should be reserved for immunocompromised patients and patients with sepsis | Strong | AVOD, Isacson et al., van Dijk ST et al., Desai M et al., Daniels L et al. |
EAES and SAGES 2018 consensus conference on acute diverticulitis management: evidence-based recommendations for clinical practice | In immunocompetent individuals presenting with uncomplicated acute diverticulitis, symptomatic treatment without antibiotics provides similar outcomes to treatment with antibiotics | Weak | Galetin T et al., Kohler L et al. |
American Gastroenterological Association Institute Guideline on the Management of Acute Diverticulitis | Antibiotics should be used selectively rather than routinely in acute uncomplicated diverticulitis | Low quality | AVOD, DIABOLO, Stollman AGA, Sultan S AGA, Graham et al., Peery AF, Feingold D, et al., Morris et al. |
American Gastroenterological Association Institute Technical Review on the Management of Acute Diverticulitis (2015) | Treatment with broad-spectrum antibiotics for at least seven days may not improve symptom resolution. Nevertheless, it may decrease the risk of recurrence and diverticular complications | Low quality | COCHRANE, Morris AM et al., DIABOLO, Daniels LUC, de Korte N A et al., Hjern F et al. |
Guidelines of Diagnostics and Treatment of Acute Left-Sided Colonic Diverticulitis (Netherlands) | Antibiotic treatment is recommended when signs of generalized infection and affected general condition or signs of bacteremia or septicemia are present. Antibiotic treatment is recommended in immunocompromised patients | Level A2 | Ridgway PF et al., AVOD Schug-Pass C et al. |
Danish national guidelines for the treatment of diverticular disease | The use of antibiotics in uncomplicated diverticulitis is justified by septicemia, affected general condition, pregnancy, or immuno-suppression. Antibiotics are not routinely recommended | Ib | Kaiser et al., Sarin S, Chautems et al., Schug-Pass C et al., Byrnes MC et al., AVOD , Hjern F et al |
Italian Society of Colon and Rectal Surgery. Practice parameters for the treatment of colonic diverticular disease: Guidelines | The suggestion of avoiding antibiotics in acute uncomplicated diverticulitis may not improve short- or long-term outcomes. Use only on a case-by-case basis | Ib | AVOD, Andersen JC, et al., Westwood DA et al., Hjern F et al., DIABOLO |
Diverticular disease: guidelines of the German Society for Gastroenterology, Digestive and Metabolic Diseases and the German Society for General and Visceral Surgery | In acute uncomplicated left-sided diverticulitis with no risk indicators for a challenging course, antibiotic therapy can be omitted subject to close clinical monitoring | Open recommendations | AVOD, Hjern F et al., Schug-Pass C et al. |
Royal College of Surgeons (RCS) of England: Commissioning guide—Colonic diverticular disease (2014) | There is low-level evidence that patients suitable for management at home may be managed without the use of antibiotics | COCHRANE | |
Japan Gastroenterological Association (JGA): Guidelines for colonic diverticular bleeding and colonic diverticulitis (2019) | Antibiotic therapy has been reported to be unnecessary for colonic diverticulitis without abscess or perforation, but no studies have been conducted in Japan. Therefore, the efficacy of antibiotic therapy among Japanese patients is currently unclear. Antibiotic therapy is considered acceptable in current clinical practice | C | Brochmann ND et al., AVOD, DIABOLO, Isacson D et al., Daniels L et al. |
Recommendations on the treatment of noncomplicated acute left diverticulitis.
Right-sided diverticulosis is a rare condition in the Western population, but it is often seen in Asian countries. Its prevalence does not increase with age as it happens with the sigmoid diverticula. Right colon diverticula are usually solitary, true (all layers), and congenital; muscle hypertrophy is not observed [39]. Acute right diverticulitis episodes generally occur in middle-aged men [40]. Differential diagnosis is complex, and it is frequently misinterpreted as acute appendicitis. There is not much literature regarding the treatment for right-sided diverticulitis.
The only study we were able to find about this subject was the one made by Destek and Gül [41] with 22 patients. Nine (40.9%) were female, and 13 (59%) were male. The age range was 26–84 years, with a mean age of 50.9 years. The duration of symptoms (nausea, diarrhea, and pain) prior to hospitalization was 1–5 days. In general, leukocytosis was detected in 77.2% of all patients, and high CRP levels were found in all of them (100%). About 59% of the patients had diverticulitis in the right colon, and 41% of them had diverticulitis in the cecum. Patients were classified as Hinchey stage I or II. Symptomatic conservative treatment was applied in 19 patients (86.3%). Oral intake was discontinued for 2 or 3 days, intravenous hydration therapy with balanced solutions was given, intravenous dual antibiotic therapy was applied, and after 2–8 days, they were discharged with oral regimes. A percutaneous drainage catheter was placed under sonography in four patients (18.1%) in whom the localized abscess did not regress with conservative treatment.
Generally speaking, most recent guidelines support the use of the same principles already discussed for the treatment of right-sided diverticulitis.
For years, patients have been instructed to consume a clear-liquid or low-residue diet (low fiber), or even to deprive themselves of food for bowel rest during the diverticulitis flare [42, 43]. Several guidelines have supported this. A survey conducted in the Netherlands in 2011 showed that 83.2% of participating gastroenterologists and surgeons advised some form of bowel rest [42], but the Dutch guideline of 2012 stated that an unrestricted diet could also be advised [44].
In the prospective, observational study published by Isacson et al. [45] in 2015, patients with confirming CT scan for uncomplicated diverticulitis were enrolled to receive recommendations on oral intake of fluids for the first 48 h followed by a liquid diet and then moving on to a complete diet as tolerated. Readmission within 1 month with or without complications was defined as a management failure. In total, 155 patients were included in the study, and only four patients had treatment failure. Five patients (3.3%) had a recurrence within the 3-month follow-up period.
A prospective, uncontrolled study of an unrestricted diet in 86 patients with uncomplicated diverticulitis concluded that this was well tolerated, although 8% had serious adverse events and 20% had ongoing symptoms [46].
A high-dietary fiber diet is hypothesized to prevent diverticulitis reoccurrence by reducing the contact time between stool and diverticula [47]. There has been an increased in the use of probiotic supplementation under the assumption of them decreasing the risk of infection and inflammation of the diverticula [48].
The systematic review of Dahl et al. [49] addressed the lack of high-quality reports and research about the dietary management of adults with acute, uncomplicated diverticulitis. However, generalized observations tended to agree that either a free diet or a restricted one is equal in terms of recovery. A multicenter trial is underway to evaluate an unrestricted vs. a progressive diet in uncomplicated diverticulitis.
The nonantibiotic management in patients with uncomplicated diverticulitis still has some unsettled topics like management of the right-sided or recurrent uncomplicated disease; further investigation in different populations and world regions is needed. More supervision on antibiotic prescription needs to be encouraged in patients who receive therapy for acute diverticulitis to make a cost-effect analysis for each case [50].
In conclusion, antibiotics may not improve outcomes in acute uncomplicated diverticulitis, but the high mortality associated with sepsis requires clinicians to maintain a low threshold in high-risk individuals such as immunocompromised patients, the elderly, and those with comorbidities [51]. Therefore, recommendations should be made on a case-by-case basis. If antibiotic therapy is necessary, oral administration is equally as effective as intravenous administration, and an expeditious switch from intravenous to oral may allow the fastest patient discharge.
Authors declare no conflict of interests.
Sexual slavery and exploitation have been a worldwide problem for a very long time. This specifically applies to women and children due to factors which include a lack of employment, education and opportunities to improve their living conditions [1].
Despite human solidarity and a common humanity, gender inequality globally flourishes, and many women experience exclusion, marginalisation, denigration, abuse and violence at the hands of “macho” men [1]. Patriarchy and male domination thrive in many societies. Evidence strongly suggests that there are men who experience entertainment and self-gratification at the expense of women, while women and girls, who become the victims of these men, experience shame, humiliation, indignity, loss of self-respect and meaninglessness [1].
Statistically, according to Kristof and Wudunn, more “women and girls are now shipped into brothels each year than were slaves from Africa shipped each year into slave plantations in the early eighteenth and nineteenth centuries” [2]. According to a
It is argued [1] that we should collectively call for responsibility, greater awareness and participative engagement in order to tackle this multi-faceted problem of slavery for sexual exploitation. Leaders must constantly be called upon to prevent trafficking to the extent they can and to keep perpetrators accountable. According to Tlhagale the “enslavement of human beings, especially women and children, in this day and age, simply weakens humanity’s claim to human progress and civilisation” [1].
Following these introductory remarks, the aim of this chapter is to explore the extent of sex slavery, sex work and exploitation in South Africa. It evaluates the latest statistics available and deals with the most reliable resources on this matter. There are however weaknesses in South African literature in this respect. There is a shortage of primary research and data regarding this issue [5], although this is slowly changing. Popular publications in this regard were mostly avoided due to doubtful information they may contain. Part of the aim of this chapter is thus to gain a foundational overview of sex slavery and exploitation in South Africa. Definitions regarding sex work and sex slavery are briefly discussed, and the anti-trafficking law in South Africa is looked at—in order to protect the victims of sex slavery and prosecute the perpetrators. The necessity of decriminalising sex work in South Africa, among others, to respect the dignity of sex workers, is also discussed. Then Sara Baartman, a famous South African woman on her day, who was seen by Westerners as “attractive” and primitive, while reflecting their fears and suppressed desires, is brought into the discussion. Who was this illusive figure who confronts us with gender inequality and violence, and what can we learn from her narrative? This chapter demonstrates how, despite global interconnectedness and human solidarity, gender inequality and slavery for sexual exploitation are still a reality. It shows how essential it is for the way forward to design more extensive and representative investigations (although difficult) into sexual slavery and exploitation in South Africa in order to address this problem more effectively.
The chapter starts with the contextualisation and extent of sexual slavery in South Africa.
There are organisations and individuals who claim that as many as 30,000 children are “trafficked” into the sex trade every year in South Africa. According to media articles (
Overestimated claims in this respect are not new. Gould1, a South African researcher at the Institute for Security Studies and author of a book outlining research about the sex work industry, suggests no one knows “for certain the size of the problem, and argued that the 40 000 figure was ‘unfounded’” [10]. This was supported by Khokhar from the International Organisation for Migration who said this “figure had been nothing but ‘hype’” [10]. Pharaoh states that one has to look critically at this data. She refers to Kelly who alludes to
According to Gould and Fick, research on trafficking especially in South Africa is “frequently methodologically weak and resorts to the reiteration of commonly agreed myths about the nature of the activity” [12]. For them the question arose: “is ‘trafficking’ a useful lens through which to consider issues of exploitation and abuse in the sex work industry?” [12]. In total their research “identified eight women (of 164 canvassed) who could possibly be considered victims of trafficking” [12]. The research was carried out to “gather data about the sex industry in Cape Town and about any evidence of human trafficking into the industry” [13]. They came to the following conclusion: “We acknowledge that some cases of trafficking may have escaped our notice, but on the strength of the evidence we gathered we have to conclude that in Cape Town the incidence of trafficking for the purposes of prostitution is very low” [12].
The United Nations Office on Drugs and Crime’s 2012
During 2016 “150 women were rescued from being sold into slavery in South Africa… in operations across the country in co-ordination with authorities from the US and neighbouring countries” [14]. Research done by Wilkinson and Chiumia (2013) estimates that the
However, we cannot deny the fact that there is probably more trafficking taking place in South Africa than we are aware of. The reason for this is that there are no reliable enough or indeed enough research done on this issue. A very important finding in this respect by Motseki2 has to do with the modus operandi of perpetrators on human trafficking in three selected areas of the Gauteng province in South Africa. He indicates that these perpetrators have become “so organised that many victims are not even aware that they have been trafficked…” [15]. The participants, when asked about the modus operandi of these perpetrators, “explained that social media is mostly used by perpetrators to lure the victims. They emphasised that the perpetrators use the media to advise fake jobs, scholarships, modelling opportunities and employment opportunities” [15]. Motseki further notes that “it emerged that the majority of perpetrators were mostly Nigerians, Somalians, [and] Chinese followed by South Africans” [15].
To fight human trafficking, effective legislation and protective rights are needed.
South Africa was very slow to criminalise human trafficking. South Africa’s former President, Jacob Zuma, “signed into law the country’s first comprehensive legislation on human trafficking, the Prevention and Combating of Trafficking in Persons Bill (PCTPB), which, among other goals, seeks to implement South Africa’s international obligations with respect to the problem” [16].
The legislation deals with a general definition of what constitutes trafficking. It includes
According to the Global Legal Monitor, the “legislation criminalizes various acts that constitute or relate to trafficking in persons and imposes harsh penalties for violations” [16]. It further refers to the fact that “legislation gives South African courts extra-territorial jurisdiction in certain circumstances” [16] including that “the suspect or victim is a South African citizen and present in South Africa; the suspect is a juridical person registered in South Africa [and] not extradited from South Africa…” [16]. This legislation also provides protection for victims of human trafficking, including persons coming from another country [16]. It provides that
In this regard it is also important to refer to certain instruments, rights and laws that protect children against sexual exploitation in South Africa. Compared to a number of sub-Saharan African countries,
In addressing this issue in a credible way, it is important to distinguish between human trafficking into sexual slavery and sex work. According to Ditmore “even those who mean well sometimes confuse the human rights abuse of trafficking in persons with the human occupation of prostitution, or sex work” [18]. She accentuates that the “trafficking of women and children into sexual slavery is undeniably a gross abuse of human rights. Like all trafficking, it involves coercion or trickery or both. Sex trafficking is an odious form of trafficking…” [18]. When a person on the other hand willingly takes part in the sale of sex and it is consensual, it is called sex work [19].
However, the difference between sexual slavery and sex work can almost be invisible. On the one hand you may not recognise the trafficked girl or woman, because she may look like someone who is looking for “work,” but in reality she is not. On the other hand women’s oppression, unemployment, lack of education, poverty and social and economic challenges (as in South Africa) may slide and force certain women into sex work, while the “outsider” may not be aware of this. In other words, it is not as voluntary as one may sometimes think [19].
The important question that should be asked is how should we think about sex work and the law if we distinguish it in principle from human trafficking and if we want to respect the dignity of sex workers?
There are approximately “182,000 sex workers who make a living selling sexual services in South Africa”, and they “remain vulnerable to abuse and have no resource if they experience violence” [20].3 Of these sex workers, specifically in South Africa, 90% are female and 10% are male or transgender [22, 23]. “All aspects of sex work are illegal in our country. The basis for the criminalisation of sex work has been seen as a social ill that needs to be eradicated”. However, sex work despite prosecution and severe penalties continues. “Criminalising sex work has proved ineffective, maintaining high levels of violence, exploitation and abuse, and leads to the spread of illness” [21].
“An outdated criminal legal framework regarding sex work like ours in South Africa, can easily drive sex workers underground” and away from services [24], “increases stigma, discrimination and social exclusion, creates obstacles to accessing health and social programmes, and reduces sex workers’ power, rendering them vulnerable to human rights violence and corruption” [21, 25].
There are however good reasons to decriminalise sex work in South Africa. Among others, “it reflects respect for human rights [26] and personal dignity… [21, 27]; it reduces police abuse and violence” [21, 27, 28]; it promotes safer working conditions [21]; it increases access to health and social services [27]; and it reduces sex workers’ risk of HIV and other STIs [27]. “Sex workers in South Africa are heavily affected by HIV and other sexually transmitted infections (STIs). HIV and STI prevalence among sex workers is higher than among other population groups. It is estimated that 60% of female sex workers in South Africa are infected with HIV [29]. An estimated 20% of the 350,000 people annually infected with HIV are connected with sex work. Approximately 6% of all new infections are estimated to occur among sex workers and 14% among sex worker clients or the sexual partners of the clients of sex workers [30]. In some settings, half to two thirds of sex workers have a curable STI at any time” [31, 32]. Decriminalising sex work further challenges stigma, discrimination and the consequences of having a criminal record [27]; it is argued that it does not result in an increase in the population of sex workers [27, 33, 34]; it facilitates effective responses to trafficking [27]; and it challenges state control over bodies and sexuality. Decriminalisation is an issue of gender equality, sexual rights and freedom4 and the right to bodily and psychological integrity [27].
“Where sex work is recognised as ‘work,’ workers experience the full protection of labour and occupational health laws, they have access to the necessary police services, could visit clinics without fear of harassment, and could work in any location” [21].
The first country in the world to decriminalise sex work was New Zealand in 2003. “In a review 5 years after the implementation of the new legislation sex workers reported that their working conditions and well-being had improved, they felt safer, and they were more likely to report abuse to the police” [21, 27, 36, 37, 38].
“Furthermore, researchers found that sex workers were generally practising safer sex, there was no increase in the number of sex workers in the industry, and many of the social evils predicted by some who opposed decriminalization have not occurred” [21]. There are many supporting bodies that assist women (and others) who are sexually exploited such as, among others, the Commission for Gender Equality in South Africa.
The current legal system criminalising sex work in its entirety is impractical and ineffective. The law needs to be reformed to make it consistent with South Africa’s constitutional obligations from a human right perspective.
Gould reasons that
Changing the law would be a huge symbolic act of inclusion, although it is understood that stigmatisation of sex workers will not change overnight. If this happens it will make South Africa the first African country to decriminalise sex work.
This now brings us to one of South Africa’s most iconic and mythologised sex slaves of all times. Many women trapped in sex slavery would probably strongly relate with her experience regarding gender inequality, sexual exploitation and abuse, humiliation and indignity.
Our South African history is characterised by sexual slavery and exploitation. A prominent story formerly unknown for many South Africans came to light in 1994 after former President Nelson Mandela requested that the remains of Saartjie Baartman be returned to South Africa.
In short her story goes as follows: at the beginning of the nineteenth century, this Khoikhoi woman, a mere 20-year-old, was taken from the Cape to England and Ireland by William Dunlop and Hendrik Cezar to work as a “domestic servant, and be exhibited for entertainment purposes” [39]. She was exhibited almost completely naked in a cage in various circuses under the artistic name Hottentot Venus, although she never wanted to pose naked [40]. But “she became an attraction for people from various parts of Europe” [39]. In France she was exhibited in a “cage alongside a baby rhinoceros” [39]. Baartman was especially popular with the general public because of her physique. She was exploited for most of her life, as well as humiliated, and after her death, a plaster cast was made of her body, and her brain and genitals were pickled in jars and placed on display until 1974. Baartman was used “to help emphasize the stereotype that Africans were oversexed and a lesser race” [39]. Following the African National Congress’s victory in the 1994 elections
According to Crais and Scully in their well-documented book
Sara Baartman has well into the twentieth century shaped French culture, particularly with regard to female sexuality. “Writers on prostitution consistently tied it to the savage woman, the ‘terrible voluptuousness’ of the ‘wild Venus,’ according to a 1930 play” [41]. Sara was especially known for her bottom, according to Simenon as quoted by Crais and Scully, “the most famous bottom in the world. It must be the only bottom which has become the centre of a cult. And it is everywhere” [41, 42, 43].
Sara Baartman has been reduced to men’s image, not only of her body but of her genitals and “the ways the organs of sexual pleasure stood for character, her very being. White women, even the most civilised, were liable to fall victim to their animal instincts and passions, to revert to their Hottentot selves” [41]. This led to European prostitutes becoming degenerate women, “literally women who had become more Hottentot” [41].
People were fascinated by these women’s genitals, even their rough faces [41]. In light of this, laws throughout Europe have been devised by politicians and bureaucrats to
Even today, just in Africa, approximately 2 million cases of genital mutilation are performed on women every year5 [46, 47].
Sara Baartman’s story became the story, actually
Sara Baartman was repatriated not to her family, but to a nation. According to a final report of the Department of Arts and Culture, “[i]t was victory over colonialism, racism and sexism. It very visibly and publically restored the dignity of a South African woman exploited and humiliated in her lifetime” [41]. In laying to rest Sara’s remains, many women flew from all over the world to attend the ceremony. Although she has become a national symbol, icon and a symbol for women all over, the ceremonies largely entailed men “speaking on behalf of women and their rights as South African citizens” [41]. Laying her to rest on National Women’s Day reminded South Africans and the world of the long history of women’s oppression. At her funeral, Thabo Mbeki, then State President of South Africa, spoke of “the persistence of gender violence and of the necessity of gender equality to realising a truly democratic South Africa” [41]. The restoration of the dignity of Sara Baartman implied the restoration of the dignity of black South Africans, especially of the Khoisan.
Sadly her grave was vandalised, and today it is surrounded by tall green metal bars. The important question to be asked: although Sara Baartman returned to South Africa, is not she still behind bars, imprisoned—like so many other sexually exploited and trafficked women? [41].
Sara Baartman, this famous South African woman, confronts the historical past of South Africa with current gender inequality, exploitation, violence, humiliation and indignity.6 There might be many women today who could identify with what happened to her, and (re)telling her story will hopefully connect her not only with her descendants but also with other women who are trapped in some form of sex slavery, especially those who are forced to work between and among different cultures to earn an income [41].
Some of the important drivers of human trafficking and sexual slavery are poverty, oppression and a lack of equal human rights for women, like we have seen in the case of Sara Baartman. “Worldwide prevention has to begin at these points” [47]. According to Schirrmacher, “women are frequently affected by unemployment, low wages, violence, and economic hardship. Through the general lack of prospects, women are drawn into situations where they can be exploited by human traffickers” [47].
In a place like South Africa, with so many young people and huge gap between the rich and the poor, it really becomes a battle with poverty, patriarchy and economic justice. “If we do not deal with some of the push factors, such as gross poverty, vulnerable women and children will continue to be exploited by outsiders and their own alike” [49].
In this regard, without discussing it in detail, it will increasingly be important for South Africans to deal with gender as a cultural concept. We are not born with gender roles and they are not biologically determined. Rakoczy reasons that as cultural beings, discrimination is in the first place played out in our bodies which usually results in the objectification of women [50].
Men can easily “assert power over women by using violence” which could make women “silent and submissive” [49]. As South Africa constantly pushes for gender equality, there is still in many respects inequality that has to be addressed and transformed. South Africa’s Gender Inequality Index score (2017) is 0.389 which places our country at 90 out of 143 countries [51]. According to O’Connor, “gender equality and empowering women in South Africa must not be seen just to promote economic and social development and sustainable peace and security but as a human rights issue” [49]. She further states that this “necessitates that women’s issues are kept on the public agenda and that both men and women work together at meaningful transformation of conditions that govern the lives of both” [49].
South Africa will also have to deal with traditional practices that lend themselves to the trafficking of women and girls. In light of the South African Constitution that protects women’s rights to equality and prohibits any form of discrimination, certain traditional practices will have to be addressed which include myths, forced marriages, female genital mutilation or cutting, virginity testing and priority in educating boys, to name a few. Although the Children’s Act of 2005 safeguards the rights of children and “traditional institutions are subject to the principles of the constitution and promulgated laws… civil law is at times ineffective in replacing the prevailing customary law, particularly in rural areas” [1]. This causes such practices to continue especially to oppress females. If we are serious, in South Africa as well as globally, to address gender inequality effectively in order to combat sex slavery, we need to challenge the abovementioned practices but also the gender inequalities which we so often find in so many South African faith-based contexts [49].
Some of the key elements to enhance gender equality and address sexual slavery is education—to convey critical important information, honest law enforcement, political will, responsible government action in trying to create the best and most viable solution to sexual slavery and economic support for all the role players involved in addressing this important issue and in rehabilitating survivors of sexual slavery.
In addressing these elements, government, communities and organisations follow the prevention, protection and prosecution approach. This includes more specifically capacity building workshops, counter-trafficking committees, networking between concerned role players, awareness campaigns, challenging unethical traditional practices and a national hotline, to name a few. The South African government, through a multidimensional programme, further promote “gender equality in all spheres of life… [and] basic human rights…” which includes “the right to the necessities of survival and development”. This programme “is set out in various laws” and in the “National Policy Framework for Women’s Empowerment and Gender Equality” [1].
Motseki argues that a “focus on vulnerability will enhance the human rights component of trafficking prevention policies” and that an “improved cohesion between relevant role-players, would go a long way to align day-to-day tactics into… long term anti-trafficking strategies and national responses” [15]. He further pleads for a “multi-disciplinary unit within the Directorate for Priority Crime Investigation” which includes officials from different relevant departments, services and authorities [15].
However, Bello7 argues in this respect that as currently structured, “the South African criminal justice system cannot effect long-term combating strategies against human trafficking” [53]. He refers to findings that “indicate that the solution to the precipitating factors that fuel the trade in human commodity lies outside the scope and mandate of the criminal justice system” [53]. For an effective response, he continues, “it is expedient for the State to first address the socio-economic, cultural and political nuances that fuel the trade, rather than mount impracticable pressure on its criminal justice institutions to perform an unrealistic task” [53]. Unfortunately, according to him, “since the enactment of the anti-trafficking law in 2013, and its implementation in 2015, the South African criminal justice system have not really made headway in the fight against this heinous crime” [53].
However, gender justice presupposes equality of outcome and opportunity which has clear consequences for sex slavery, sex work and exploitation. South Africa’s Constitution reflects sighs from around the world to promote gender justice. The South African Human Rights Commission has been awarded to support constitutional democracy through promoting, protecting and monitoring the attainment of everyone’s human rights, including women and children, in South Africa without fear, favour or prejudice.
The Sustainable Development Goals of the United Nations has as one of its objectives “a world in which every woman and girl enjoys full gender equality” [4]. South Africa is a signatory to this quest. To further augment this journey South African politics has elevated gender justice to the highest echelons of decision-making by establishing a Department of Women in the Presidency tasked to “champion the advancement of women’s socio-economic empowerment and the promotion of gender equality” [54].
In order to achieve an ongoing analysis of the extent of the problem of sex slavery and exploitation in South Africa, we need much more reliable data and well-researched literature to establish a platform for reform and progress.8 Anti-trafficking legislation in South Africa “requires annual reports to Parliament on the implementation of the Act and the number of cases of human trafficking” [6]. If done properly on an ongoing basis, it must consequently result in more reliable data and research by (academic) scholars in order to learn more about the prevalence and nature of trafficking in South Africa—to fill the knowledgeable gap. This can unfortunately create a situation in which “policies may be made and resources be allocated on the basis of what may not be an accurate reflection of the reality of the problem” [5]. Opposed to this, there is a need for reliable data on the extent of sex slavery, the profile and motivations of victims and traffickers, how many South Africans are trafficked to other countries, the nature of the exploitation, the environment in which it occurs, activities to prevent sex slavery and what kind of support infrastructure is available to victims, to name a few [5]. According to Geldenhuys [56] “there should [also] be intensified training of police officials and other role players in identification and policing of trafficking” [57].
It is crucially important that South Africa will learn from international literature, reports and studies on sex slavery, exploitation and gender justice. This will help us to adopt a more sophisticated approach in this regard, although it must be stated that there are (methodological) weaknesses in some of the international literature and studies on sex slavery and exploitation. Discernment is needed in order to study this and other literature critically for a better analysis regarding the extent of sex slavery and exploitation in South Africa [5].
With regard to the way forward, it must be acknowledged that it is very difficult to access sex slavery victims and/or to infiltrate trafficking networks to gather more comprehensive data. Thorough unemotional research is however needed to further ground and stimulate this debate with credibility in South Africa.
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Lemma",authors:[{id:"25594",title:"Dr.",name:"Alemayehu",middleName:null,surname:"Lemma",slug:"alemayehu-lemma",fullName:"Alemayehu Lemma"}]},{id:"57645",doi:"10.5772/intechopen.71780",title:"Antibiotics in Chilean Aquaculture: A Review",slug:"antibiotics-in-chilean-aquaculture-a-review",totalDownloads:1914,totalCrossrefCites:15,totalDimensionsCites:28,abstract:"Aquaculture in Chile has been practiced since the 1920s; however, it was not until the 1990s that aquaculture became an important sector here. Important species in Chilean aquaculture include salmonids, algae, mollusks, and turbot. Salmonids are the dominant species in Chilean aquaculture for both harvest volume and export value, their production reaching greater than 800-thousand tons in 2015. However, this growth has been accompanied by an increase in disease presence, requiring greater drug use to control. This increase in drug use is an environmental and public health concern for the authorities, the salmon industry itself, and the destination markets. In this chapter, we review the literature on drug use, antibiotic resistance, regulatory framework, and alternatives, with focus on Chile.",book:{id:"6179",slug:"antibiotic-use-in-animals",title:"Antibiotic Use in Animals",fullTitle:"Antibiotic Use in Animals"},signatures:"Ivonne Lozano, Nelson F. Díaz, Susana Muñoz and Carlos Riquelme",authors:[{id:"208847",title:"Dr.",name:"Ivonne",middleName:null,surname:"Lozano",slug:"ivonne-lozano",fullName:"Ivonne Lozano"},{id:"208895",title:"Dr.",name:"Nelson F.",middleName:null,surname:"Díaz",slug:"nelson-f.-diaz",fullName:"Nelson F. Díaz"},{id:"208897",title:"Dr.",name:"Carlos",middleName:null,surname:"Riquelme",slug:"carlos-riquelme",fullName:"Carlos Riquelme"},{id:"208898",title:"MSc.",name:"Susana",middleName:null,surname:"Muñoz",slug:"susana-munoz",fullName:"Susana Muñoz"}]}],mostDownloadedChaptersLast30Days:[{id:"56612",title:"Reproduction in Goats",slug:"reproduction-in-goats",totalDownloads:2865,totalCrossrefCites:3,totalDimensionsCites:4,abstract:"Reproductive activity of the goat begins when the females reach puberty, which happens at 5 months of age. The ovarian or estrous cycle is the period between two consecutive estrus. It is also the time that lasts the development of the follicle in the ovary, until rupture occurs and ovulation takes place, which coincides with the appearance of estrus. This chapter will describe the physiological and endocrinological bases of estrus in the goat. Likewise, factors affecting the presence of estrus and ovulation will be described. At another point, synchronization of estrus and ovulation, factors affecting the presence of estrus and external symptoms of estrus, will be described. To achieve synchronization of estrus or induction of ovulation within or outside the breeding season, it may be necessary to manage light hours, male effect, and/or use of hormones. The importance of artificial insemination is described, as well as the current situation of this technique worldwide. Currently, the techniques of artificial insemination in goats have been limited worldwide, due to the lack of resources of producers and trained technicians. The techniques of artificial insemination with estrous synchronization programs and ovulation with current research results will be described.",book:{id:"5987",slug:"goat-science",title:"Goat Science",fullTitle:"Goat Science"},signatures:"Fernando Sánchez Dávila, Alejandro Sergio del Bosque González\nand Hugo Bernal Barragán",authors:[{id:"201830",title:"Dr.",name:"Fernando",middleName:"Sanchez",surname:"Davila",slug:"fernando-davila",fullName:"Fernando Davila"},{id:"206127",title:"Dr.",name:"Alejandro Sergio",middleName:null,surname:"Del Bosque-Gonzalez",slug:"alejandro-sergio-del-bosque-gonzalez",fullName:"Alejandro Sergio Del Bosque-Gonzalez"},{id:"206128",title:"Dr.",name:"Hugo",middleName:null,surname:"Bernal-Barragán",slug:"hugo-bernal-barragan",fullName:"Hugo Bernal-Barragán"}]},{id:"58095",title:"The Innovative Techniques in Animal Husbandry",slug:"the-innovative-techniques-in-animal-husbandry",totalDownloads:3725,totalCrossrefCites:3,totalDimensionsCites:7,abstract:"Technology is developing rapidly. In this development, the transfer of computer systems and software to the application has made an important contribution. Technologic instruments made farmers can work more comfortable and increased animal production efficiency and profitability. Therefore, technologic developments are the main research area for animal productivity and sustainability. Many technologic equipment and tools made animal husbandry easier and comfortable. Especially management decisions and applications are effected highly ratio with this rapid development. In animal husbandry management decisions that need to be done daily are configured according to the correctness of the decisions to be made. At this point, smart systems give many opportunities to farmers. Milking, feeding, environmental control, reproductive performance constitute everyday jobs most affected by correct management decisions. Human errors in this works and decisions made big effect on last product quality and profitability are not able to be risked. This chapter deal with valuable information on the latest challenges and key innovations affecting the animal husbandry. Also, innovative approaches and applications for animal husbandry are tried to be summarized with detail latest research results.",book:{id:"6384",slug:"animal-husbandry-and-nutrition",title:"Animal Husbandry and Nutrition",fullTitle:"Animal Husbandry and Nutrition"},signatures:"Serap Göncü and Cahit Güngör",authors:[{id:"215579",title:"Prof.",name:"Serap",middleName:null,surname:"Goncu",slug:"serap-goncu",fullName:"Serap Goncu"},{id:"218971",title:"Dr.",name:"Cahit",middleName:null,surname:"Güngör",slug:"cahit-gungor",fullName:"Cahit Güngör"}]},{id:"58486",title:"Quality of Chicken Meat",slug:"quality-of-chicken-meat",totalDownloads:3247,totalCrossrefCites:17,totalDimensionsCites:24,abstract:"Chicken meat is considered as an easily available source of high-quality protein and other nutrients that are necessary for proper body functioning. In order to meet the consumers’ growing demands for high-quality protein, the poultry industry focused on selection of fast-growing broilers, which reach a body mass of about 2.5 kg within 6-week-intensive fattening. Relatively low sales prices of chicken meat, in comparison to other types of meat, speak in favor of the increased chicken meat consumption. In addition, chicken meat is known by its nutritional quality, as it contains significant amount of high-quality and easily digestible protein and a low portion of saturated fat. Therefore, chicken meat is recommended for consumption by all age groups. The technological parameters of chicken meat quality are related to various factors (keeping conditions, feeding treatment, feed composition, transport, stress before slaughter, etc.). Composition of chicken meat can be influenced through modification of chicken feed composition (addition of different types of oils, vitamins, microelements and amino acids), to produce meat enriched with functional ingredients (n-3 PUFA, carnosine, selenium and vitamin E). By this way, chicken meat becomes a foodstuff with added value, which, in addition to high-quality nutritional composition, also contains ingredients that are beneficial to human health.",book:{id:"6384",slug:"animal-husbandry-and-nutrition",title:"Animal Husbandry and Nutrition",fullTitle:"Animal Husbandry and Nutrition"},signatures:"Gordana Kralik, Zlata Kralik, Manuela Grčević and Danica Hanžek",authors:[{id:"207236",title:"Dr.",name:"Gordana",middleName:null,surname:"Kralik",slug:"gordana-kralik",fullName:"Gordana Kralik"},{id:"227281",title:"Prof.",name:"Zlata",middleName:null,surname:"Kralik",slug:"zlata-kralik",fullName:"Zlata Kralik"},{id:"227283",title:"Dr.",name:"Manuela",middleName:null,surname:"Grčević",slug:"manuela-grcevic",fullName:"Manuela Grčević"},{id:"227284",title:"BSc.",name:"Danica",middleName:null,surname:"Hanžek",slug:"danica-hanzek",fullName:"Danica Hanžek"}]},{id:"56453",title:"Goat System Productions: Advantages and Disadvantages to the Animal, Environment and Farmer",slug:"goat-system-productions-advantages-and-disadvantages-to-the-animal-environment-and-farmer",totalDownloads:4304,totalCrossrefCites:4,totalDimensionsCites:20,abstract:"Goats have always been considered very useful animals. Goats success is related to its excellent adaptability to the difficult mountain conditions, extreme weather and low value feed acceptance, versatile habits and high production considering their size. These are some reasons because goats are among the first animals to be domesticated. In terms of evolution, goats could be separated by their dispersion area in three large groups: the European, the Asian, and the African. Global goat populations, mainly in Africa and in Asia, have increased for centuries but very strongly in the past decades, well above the world population growth. They are also used for forest grazing, an integrated and alternative production system, very useful to control weed growth reducing fire risk. Despite some exceptions, no large‐scale effort to professionalize this industry has been made so far. There are consumers for goat dairy products and there is enough global production, but misses a professional network between both. Regarding goat meat, the world leadership also stays in Africa and Asia, namely in China, and there is a new phenomenon, the spreading of goat meat tradition through Europe due to migrants from Africa and other places with strong goat meat consumption.",book:{id:"5987",slug:"goat-science",title:"Goat Science",fullTitle:"Goat Science"},signatures:"António Monteiro, José Manuel Costa and Maria João Lima",authors:[{id:"190314",title:"Prof.",name:"António",middleName:"Cardoso",surname:"Monteiro",slug:"antonio-monteiro",fullName:"António Monteiro"},{id:"203680",title:"Prof.",name:"Maria João",middleName:null,surname:"Lima",slug:"maria-joao-lima",fullName:"Maria João Lima"},{id:"203683",title:"MSc.",name:"José Manuel",middleName:null,surname:"Costa",slug:"jose-manuel-costa",fullName:"José Manuel Costa"}]},{id:"70760",title:"Induction and Synchronization of Estrus",slug:"induction-and-synchronization-of-estrus",totalDownloads:1683,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"Estrus cycle is a rhythmic change that occur in the reproductive system of females starting from one estrus phase to another. The normal duration of estrus cycle is 21 days in cow, sow, and mare, 17 days in ewe, and 20 days in doe. The species which exhibit a single estrus cycle are known as monstrous and species which come into estrus twice or more are termed polyestrous animals. Among them some species have estrus cycles in a particular season and defined as seasonal polyestrous. It includes goats, sheep, and horses. On the other hand, cattle undergo estrus throughout the year. The estrus inducers can grossly be divided into two parts, that is, non-hormonal and hormonal. Non-hormonal treatments include plant-derived heat inducers, mineral supplementation, uterine and ovarian massage, and use of Lugol’s iodine. The hormones that are used in estrus induction are estrogen, progesterone, GnRH, prostaglandin, insulin, and anti-prolactin-based treatment. Synchronization can shorten the breeding period to less than 5 days, instead of females being bred over a 21-day period, depending on the treatment regimen. The combination of GnRH with the prostaglandin F2α (PGF2α)- and progesterone-based synchronization program has shown a novel direction in the estrus synchronization of cattle with the follicular development manipulation.",book:{id:"8545",slug:"animal-reproduction-in-veterinary-medicine",title:"Animal Reproduction in Veterinary Medicine",fullTitle:"Animal Reproduction in Veterinary Medicine"},signatures:"Prasanna Pal and Mohammad Rayees Dar",authors:[{id:"299126",title:"Dr.",name:"Mohammad Rayees",middleName:null,surname:"Dar",slug:"mohammad-rayees-dar",fullName:"Mohammad Rayees Dar"},{id:"311663",title:"Dr.",name:"Prasanna",middleName:null,surname:"Pal",slug:"prasanna-pal",fullName:"Prasanna Pal"}]}],onlineFirstChaptersFilter:{topicId:"25",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"81793",title:"Canine parvovirus-2: An Emerging Threat to Young Pets",slug:"canine-parvovirus-2-an-emerging-threat-to-young-pets",totalDownloads:9,totalDimensionsCites:0,doi:"10.5772/intechopen.104846",abstract:"Canine parvovirus-2 (CPV-2) is a highly contagious and key enteropathogen affecting the canine population around the globe by causing canine parvoviral enteritis (CPVE) and vomition. CPVE is one of the the leading causes of morbidity and mortality in puppies and young dogs. Over the years, five distinct antigenic variants of CPV-2, namely CPV-2a, CPV-2b, new CPV-2a, new CPV-2b, and CPV-2c, have emerged throughout the world. CPV-2 infects a diverse range of wild animals, and the newer variants of CPV-2 have expanded their host range to include felines. Despite the availability of highly specific diagnostics and efficacious vaccines, CPV-2 outbreaks have been reported globally due to the emergence of newer antigenic variants, expansion of the viral host range, and vaccination failures. The present chapter describes the latest information pertaining to virus properties and replication, disease manifestations in animals, and an additional recent updates on diagnostic, prevention and control strategies of CPV-2.",book:{id:"11580",title:"Recent Advances in Canine Medicine",coverURL:"https://cdn.intechopen.com/books/images_new/11580.jpg"},signatures:"Mithilesh Singh, Rajendran Manikandan, Ujjwal Kumar De, Vishal Chander, Babul Rudra Paul, Saravanan Ramakrishnan and Darshini Maramreddy"},{id:"81271",title:"The Diversity of Parvovirus Telomeres",slug:"the-diversity-of-parvovirus-telomeres",totalDownloads:26,totalDimensionsCites:0,doi:"10.5772/intechopen.102684",abstract:"Parvoviridae are small viruses composed of a 4–6 kb linear single-stranded DNA protected by an icosahedral capsid. The viral genes coding non-structural (NS), capsid, and accessory proteins are flanked by intriguing sequences, namely the telomeres. Telomeres are essential for parvovirus genome replication, encapsidation, and integration. Similar (homotelomeric) or different (heterotelomeric) at the two ends, they all contain imperfect palindromes that fold into hairpin structures. Up to 550 nucleotides in length, they harbor a wide variety of motifs and structures known to be recognized by host cell factors. Our study aims to comprehensively analyze parvovirus ends to better understand the role of these particular sequences in the virus life cycle. Forty Parvoviridae terminal repeats (TR) were publicly available in databases. The folding and specific DNA secondary structures, such as G4 and triplex, were systematically analyzed. A principal component analysis was carried out from the prediction data to determine variables signing parvovirus groups. A special focus will be put on adeno-associated virus (AAV) inverted terminal repeats (ITR), a member of the genus Dependoparvovirus used as vectors for gene therapy. This chapter highlights the diversity of the Parvoviridae telomeres regarding shape and secondary structures, providing information that could be relevant for virus-host interactions studies.",book:{id:"11580",title:"Recent Advances in Canine Medicine",coverURL:"https://cdn.intechopen.com/books/images_new/11580.jpg"},signatures:"Marianne Laugel, Emilie Lecomte, Eduard Ayuso, Oumeya Adjali, Mathieu Mével and Magalie Penaud-Budloo"},{id:"79209",title:"Virtual Physiology: A Tool for the 21st Century",slug:"virtual-physiology-a-tool-for-the-21st-century",totalDownloads:141,totalDimensionsCites:0,doi:"10.5772/intechopen.99671",abstract:"Veterinary physiology is a basic curricular unit for every course within the veterinary field. It is mandatory to understand how the animal body works, and what to expect of a healthy body, in order to recognize any misfunction, and to be able to treat it. Classic physiology teaching involves wet labs, much equipment, many reagents, some animals, and a lot of time. But times are changing. In the 21st century, it is expected that the teaching and learning process can be more active and attractive, motivating students to learn better. It is necessary to understand what students like, and to introduce novelties into the school routine. The use of a game-based learning, using “new” technologies, creating virtual experiences and labs, reducing the costs of reagents, equipment, and especially reducing the use of animals, will be the future for physiology teaching.",book:{id:"10665",title:"Updates on Veterinary Anatomy and Physiology",coverURL:"https://cdn.intechopen.com/books/images_new/10665.jpg"},signatures:"Carmen Nóbrega, Maria Aires Pereira, Catarina Coelho, Isabel Brás, Ana Cristina Mega, Carla Santos, Fernando Esteves, Rita Cruz, Ana I. Faustino-Rocha, Paula A. Oliveira, João Mesquita and Helena Vala"},{id:"78543",title:"Pulmonary Vein: Embryology, Anatomy, Function and Disease",slug:"pulmonary-vein-embryology-anatomy-function-and-disease",totalDownloads:172,totalDimensionsCites:0,doi:"10.5772/intechopen.100051",abstract:"Four pulmonary veins come from respective lung lobes drain oxygen-rich blood back to the left atrium. Failure of incorporation with the left atrium can lead to a condition, called Cor triatriatum sinister, that the left atrium is separated into two chambers by an abortive fibrous tissue. The venous system of lung and whole body communicate with each other in the earlier time and they will be disconnected in the following developmental process. Total or partial anomalous pulmonary venous connection refers to that there is/are some degree of the communication exists after birth, which can occur in different sites. In the veterinary field, retrospective studies and several case reports have been published to describe these rare congenital cardiovascular diseases in several species. More cases are need for better understanding their clinical manifestation, treatment options and outcomes.",book:{id:"10665",title:"Updates on Veterinary Anatomy and Physiology",coverURL:"https://cdn.intechopen.com/books/images_new/10665.jpg"},signatures:"Chan I-Ping and Hsueh Tung"},{id:"78564",title:"Anatomy of the Rhesus Monkey (Macaca mulatta): The Essentials for the Biomedical Researcher",slug:"anatomy-of-the-rhesus-monkey-macaca-mulatta-the-essentials-for-the-biomedical-researcher",totalDownloads:315,totalDimensionsCites:0,doi:"10.5772/intechopen.99067",abstract:"Amongst the non-human primates, the rhesus monkey (Macaca mulatta) is the most commonly investigated species in biomedical research. Its similarity to humans regarding the anatomy and physiology has resulted in an increasing number of studies in which the rhesus monkey serves as a model. This book chapter aims to fulfill the researcher’s need for easily accessible anatomical data on the rhesus monkey by presenting the essentials of its various anatomical systems. The cadavers of several rhesus monkeys of either gender were dissected for gross anatomical study of the muscular, digestive, respiratory and urogenital systems. The circulatory system was studied after injection of latex into the blood vessels. Not only did this technique allow for better visualization of the blood vessels, but it was also valuable during the description of the peripheral nerves. In addition, methyl methacrylate casts were prepared to gain insight into the organization of the arterial system. The arthrology of the rhesus monkey was studied during the maceration of several cadavers, which ultimately revealed the individual bones that were described. From one such cadaver the skeleton was mounted. The results of the dissections are textually described and illustrated by means of numerous figures.",book:{id:"10665",title:"Updates on Veterinary Anatomy and Physiology",coverURL:"https://cdn.intechopen.com/books/images_new/10665.jpg"},signatures:"Christophe Casteleyn and Jaco Bakker"},{id:"77999",title:"Bronchus-Associated Lymphoid Tissue (BALT) Histology and Its Role in Various Pathologies",slug:"bronchus-associated-lymphoid-tissue-balt-histology-and-its-role-in-various-pathologies",totalDownloads:196,totalDimensionsCites:0,doi:"10.5772/intechopen.99366",abstract:"The lower respiratory tract is in direct communication with the external environment for gas exchange to occur. Therefore, it is constantly exposed to allergens, antigens, bacteria, viruses, and a wide variety of airborne foreign bodies. Bronchus-associated lymphoid tissue (BALT), which develops in response to these exposures and is one of the most prominent representatives of mucosa-associated lymphoid tissue (MALT), is important for generating rapid and specific bronchopulmonary adaptive immune responses. Therefore, this chapter focuses on the lymphoid architecture of BALT, which was first discovered in the bronchial wall of rabbits, its inducible form called inducible BALT (iBALT), its immunological response mechanisms, and its roles in certain pathologies including infectious and autoimmune diseases as well as in allergic and malignant conditions. In conclusion, it is hypothesized that BALT plays an important role in maintaining health and in the development of lower respiratory tract diseases; thanks to the pulmonary immune system in which it functions as a functional lymphoid tissue.",book:{id:"10665",title:"Updates on Veterinary Anatomy and Physiology",coverURL:"https://cdn.intechopen.com/books/images_new/10665.jpg"},signatures:"Tuba Parlak Ak"}],onlineFirstChaptersTotal:11},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:0,limit:8,total:null},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:87,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:99,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:27,numberOfPublishedChapters:290,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:10,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:139,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:0,numberOfUpcomingTopics:2,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!1},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:108,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:104,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:12,numberOfOpenTopics:2,numberOfUpcomingTopics:1,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:1,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!1},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:12,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}},{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}}]},series:{item:{id:"10",title:"Physiology",doi:"10.5772/intechopen.72796",issn:"2631-8261",scope:"Modern physiology requires a comprehensive understanding of the integration of tissues and organs throughout the mammalian body, including the cooperation between structure and function at the cellular and molecular levels governed by gene and protein expression. While a daunting task, learning is facilitated by identifying common and effective signaling pathways mediated by a variety of factors employed by nature to preserve and sustain homeostatic life. \r\nAs a leading example, the cellular interaction between intracellular concentration of Ca+2 increases, and changes in plasma membrane potential is integral for coordinating blood flow, governing the exocytosis of neurotransmitters, and modulating gene expression and cell effector secretory functions. Furthermore, in this manner, understanding the systemic interaction between the cardiovascular and nervous systems has become more important than ever as human populations' life prolongation, aging and mechanisms of cellular oxidative signaling are utilised for sustaining life. \r\nAltogether, physiological research enables our identification of distinct and precise points of transition from health to the development of multimorbidity throughout the inevitable aging disorders (e.g., diabetes, hypertension, chronic kidney disease, heart failure, peptic ulcer, inflammatory bowel disease, age-related macular degeneration, cancer). With consideration of all organ systems (e.g., brain, heart, lung, gut, skeletal and smooth muscle, liver, pancreas, kidney, eye) and the interactions thereof, this Physiology Series will address the goals of resolving (1) Aging physiology and chronic disease progression (2) Examination of key cellular pathways as they relate to calcium, oxidative stress, and electrical signaling, and (3) how changes in plasma membrane produced by lipid peroxidation products can affect aging physiology, covering new research in the area of cell, human, plant and animal physiology.",coverUrl:"https://cdn.intechopen.com/series/covers/10.jpg",latestPublicationDate:"May 14th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:11,editor:{id:"35854",title:"Prof.",name:"Tomasz",middleName:null,surname:"Brzozowski",slug:"tomasz-brzozowski",fullName:"Tomasz Brzozowski",profilePictureURL:"https://mts.intechopen.com/storage/users/35854/images/system/35854.jpg",biography:"Prof. Dr. Thomas Brzozowski works as a professor of Human Physiology and is currently Chairman at the Department of Physiology and is V-Dean of the Medical Faculty at Jagiellonian University Medical College, Cracow, Poland. His primary area of interest is physiology and pathophysiology of the gastrointestinal (GI) tract, with the major focus on the mechanism of GI mucosal defense, protection, and ulcer healing. He was a postdoctoral NIH fellow at the University of California and the Gastroenterology VA Medical Center, Irvine, Long Beach, CA, USA, and at the Gastroenterology Clinics Erlangen-Nuremberg and Munster in Germany. He has published 290 original articles in some of the most prestigious scientific journals and seven book chapters on the pathophysiology of the GI tract, gastroprotection, ulcer healing, drug therapy of peptic ulcers, hormonal regulation of the gut, and inflammatory bowel disease.",institutionString:null,institution:{name:"Jagiellonian University",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:7,paginationItems:[{id:"10",title:"Animal Physiology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/10.jpg",editor:{id:"202192",title:"Dr.",name:"Catrin",middleName:null,surname:"Rutland",slug:"catrin-rutland",fullName:"Catrin Rutland",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. Dr. Rutland has also written popular science books for the public. https://orcid.org/0000-0002-2009-4898. www.nottingham.ac.uk/vet/people/catrin.rutland",institutionString:null,institution:{name:"University of Nottingham",institutionURL:null,country:{name:"United Kingdom"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"306970",title:"Mr.",name:"Amin",middleName:null,surname:"Tamadon",slug:"amin-tamadon",fullName:"Amin Tamadon",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002oHR5wQAG/Profile_Picture_1623910304139",institutionString:null,institution:{name:"Bushehr University of Medical Sciences",institutionURL:null,country:{name:"Iran"}}},{id:"251314",title:"Dr.",name:"Juan Carlos",middleName:null,surname:"Gardón",slug:"juan-carlos-gardon",fullName:"Juan Carlos Gardón",profilePictureURL:"https://mts.intechopen.com/storage/users/251314/images/system/251314.jpeg",institutionString:"Catholic University of Valencia San Vicente Mártir, Spain",institution:null},{id:"245306",title:"Dr.",name:"María Luz",middleName:null,surname:"Garcia Pardo",slug:"maria-luz-garcia-pardo",fullName:"María Luz Garcia Pardo",profilePictureURL:"https://mts.intechopen.com/storage/users/245306/images/system/245306.png",institutionString:null,institution:{name:"Miguel Hernandez University",institutionURL:null,country:{name:"Spain"}}},{id:"283315",title:"Prof.",name:"Samir",middleName:null,surname:"El-Gendy",slug:"samir-el-gendy",fullName:"Samir El-Gendy",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRduYQAS/Profile_Picture_1606215849748",institutionString:null,institution:{name:"Alexandria University",institutionURL:null,country:{name:"Egypt"}}}]},{id:"11",title:"Cell Physiology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/11.jpg",editor:{id:"133493",title:"Prof.",name:"Angel",middleName:null,surname:"Catala",slug:"angel-catala",fullName:"Angel Catala",profilePictureURL:"https://mts.intechopen.com/storage/users/133493/images/3091_n.jpg",biography:"Prof. Dr. Angel Catalá \r\nShort Biography Angel Catalá was born in Rodeo (San Juan, Argentina). He studied \r\nchemistry at the Universidad Nacional de La Plata, Argentina, where received aPh.D. degree in chemistry (Biological Branch) in 1965. From\r\n1964 to 1974, he worked as Assistant in Biochemistry at the School of MedicineUniversidad Nacional de La Plata, Argentina. From 1974 to 1976, he was a Fellowof the National Institutes of Health (NIH) at the University of Connecticut, Health Center, USA. From 1985 to 2004, he served as a Full Professor oBiochemistry at the Universidad Nacional de La Plata, Argentina. He is Member ofthe National Research Council (CONICET), Argentina, and Argentine Society foBiochemistry and Molecular Biology (SAIB). His laboratory has been interested for manyears in the lipid peroxidation of biological membranes from various tissues and different species. Professor Catalá has directed twelve doctoral theses, publishedover 100 papers in peer reviewed journals, several chapters in books andtwelve edited books. Angel Catalá received awards at the 40th InternationaConference Biochemistry of Lipids 1999: Dijon (France). W inner of the Bimbo PanAmerican Nutrition, Food Science and Technology Award 2006 and 2012, South AmericaHuman Nutrition, Professional Category. 2006 award in pharmacology, Bernardo\r\nHoussay, in recognition of his meritorious works of research. Angel Catalá belongto the Editorial Board of Journal of lipids, International Review of Biophysical ChemistryFrontiers in Membrane Physiology and Biophysics, World Journal oExperimental Medicine and Biochemistry Research International, W orld Journal oBiological Chemistry, Oxidative Medicine and Cellular Longevity, Diabetes and thePancreas, International Journal of Chronic Diseases & Therapy, International Journal oNutrition, Co-Editor of The Open Biology Journal.",institutionString:null,institution:{name:"National University of La Plata",institutionURL:null,country:{name:"Argentina"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"186048",title:"Prof.",name:"Ines",middleName:null,surname:"Drenjančević",slug:"ines-drenjancevic",fullName:"Ines Drenjančević",profilePictureURL:"https://mts.intechopen.com/storage/users/186048/images/5818_n.jpg",institutionString:null,institution:{name:"University of Osijek",institutionURL:null,country:{name:"Croatia"}}},{id:"187859",title:"Prof.",name:"Kusal",middleName:"K.",surname:"Das",slug:"kusal-das",fullName:"Kusal Das",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSBDeQAO/Profile_Picture_1623411145568",institutionString:"BLDE (Deemed to be University), India",institution:null},{id:"79615",title:"Dr.",name:"Robson",middleName:null,surname:"Faria",slug:"robson-faria",fullName:"Robson Faria",profilePictureURL:"https://mts.intechopen.com/storage/users/79615/images/system/79615.png",institutionString:null,institution:{name:"Oswaldo Cruz Foundation",institutionURL:null,country:{name:"Brazil"}}},{id:"84459",title:"Prof.",name:"Valerie",middleName:null,surname:"Chappe",slug:"valerie-chappe",fullName:"Valerie Chappe",profilePictureURL:"https://mts.intechopen.com/storage/users/84459/images/system/84459.jpg",institutionString:null,institution:{name:"Dalhousie University",institutionURL:null,country:{name:"Canada"}}}]},{id:"12",title:"Human Physiology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/12.jpg",editor:{id:"195829",title:"Prof.",name:"Kunihiro",middleName:null,surname:"Sakuma",slug:"kunihiro-sakuma",fullName:"Kunihiro Sakuma",profilePictureURL:"https://mts.intechopen.com/storage/users/195829/images/system/195829.jpg",biography:"Professor Kunihiro Sakuma, Ph.D., currently works in the Institute for Liberal Arts at the Tokyo Institute of Technology. He is a physiologist working in the field of skeletal muscle. He was awarded his sports science diploma in 1995 by the University of Tsukuba and began his scientific work at the Department of Physiology, Aichi Human Service Center, focusing on the molecular mechanism of congenital muscular dystrophy and normal muscle regeneration. His interest later turned to the molecular mechanism and attenuating strategy of sarcopenia (age-related muscle atrophy). His opinion is to attenuate sarcopenia by improving autophagic defects using nutrient- and pharmaceutical-based treatments.",institutionString:null,institution:{name:"Tokyo Institute of Technology",institutionURL:null,country:{name:"Japan"}}},editorTwo:null,editorThree:{id:"331519",title:"Dr.",name:"Kotomi",middleName:null,surname:"Sakai",slug:"kotomi-sakai",fullName:"Kotomi Sakai",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000031QtFXQA0/Profile_Picture_1637053227318",biography:"Senior researcher Kotomi Sakai, Ph.D., MPH, works at the Research Organization of Science and Technology in Ritsumeikan University. She is a researcher in the geriatric rehabilitation and public health field. She received Ph.D. from Nihon University and MPH from St.Luke’s International University. Her main research interest is sarcopenia in older adults, especially its association with nutritional status. Additionally, to understand how to maintain and improve physical function in older adults, to conduct studies about the mechanism of sarcopenia and determine when possible interventions are needed.",institutionString:null,institution:{name:"Ritsumeikan University",institutionURL:null,country:{name:"Japan"}}},editorialBoard:[{id:"213786",title:"Dr.",name:"Henrique P.",middleName:null,surname:"Neiva",slug:"henrique-p.-neiva",fullName:"Henrique P. Neiva",profilePictureURL:"https://mts.intechopen.com/storage/users/213786/images/system/213786.png",institutionString:null,institution:{name:"University of Beira Interior",institutionURL:null,country:{name:"Portugal"}}},{id:"39275",title:"Prof.",name:"Herbert Ryan",middleName:null,surname:"Marini",slug:"herbert-ryan-marini",fullName:"Herbert Ryan Marini",profilePictureURL:"https://mts.intechopen.com/storage/users/39275/images/9459_n.jpg",institutionString:null,institution:{name:"University of Messina",institutionURL:null,country:{name:"Italy"}}},{id:"196218",title:"Dr.",name:"Pasquale",middleName:null,surname:"Cianci",slug:"pasquale-cianci",fullName:"Pasquale Cianci",profilePictureURL:"https://mts.intechopen.com/storage/users/196218/images/system/196218.png",institutionString:null,institution:{name:"University of Foggia",institutionURL:null,country:{name:"Italy"}}}]},{id:"13",title:"Plant Physiology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/13.jpg",editor:{id:"332229",title:"Prof.",name:"Jen-Tsung",middleName:null,surname:"Chen",slug:"jen-tsung-chen",fullName:"Jen-Tsung Chen",profilePictureURL:"https://mts.intechopen.com/storage/users/332229/images/system/332229.png",biography:"Dr. Jen-Tsung Chen is currently a professor at the National University of Kaohsiung, Taiwan. 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Science",value:19,count:5}],publicationYearFilters:[{group:"publicationYear",caption:"2022",value:2022,count:3},{group:"publicationYear",caption:"2021",value:2021,count:3},{group:"publicationYear",caption:"2020",value:2020,count:3},{group:"publicationYear",caption:"2019",value:2019,count:1},{group:"publicationYear",caption:"2018",value:2018,count:1}],authors:{paginationCount:249,paginationItems:[{id:"274452",title:"Dr.",name:"Yousif",middleName:"Mohamed",surname:"Abdallah",slug:"yousif-abdallah",fullName:"Yousif Abdallah",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/274452/images/8324_n.jpg",biography:"I certainly enjoyed my experience in Radiotherapy and Nuclear Medicine, particularly it has been in different institutions and hospitals with different Medical Cultures and allocated resources. Radiotherapy and Nuclear Medicine Technology has always been my aspiration and my life. As years passed I accumulated a tremendous amount of skills and knowledge in Radiotherapy and Nuclear Medicine, Conventional Radiology, Radiation Protection, Bioinformatics Technology, PACS, Image processing, clinically and lecturing that will enable me to provide a valuable service to the community as a Researcher and Consultant in this field. My method of translating this into day to day in clinical practice is non-exhaustible and my habit of exchanging knowledge and expertise with others in those fields is the code and secret of success.",institutionString:null,institution:{name:"Majmaah University",country:{name:"Saudi Arabia"}}},{id:"313277",title:"Dr.",name:"Bartłomiej",middleName:null,surname:"Płaczek",slug:"bartlomiej-placzek",fullName:"Bartłomiej Płaczek",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/313277/images/system/313277.jpg",biography:"Bartłomiej Płaczek, MSc (2002), Ph.D. (2005), Habilitation (2016), is a professor at the University of Silesia, Institute of Computer Science, Poland, and an expert from the National Centre for Research and Development. His research interests include sensor networks, smart sensors, intelligent systems, and image processing with applications in healthcare and medicine. He is the author or co-author of more than seventy papers in peer-reviewed journals and conferences as well as the co-author of several books. He serves as a reviewer for many scientific journals, international conferences, and research foundations. Since 2010, Dr. Placzek has been a reviewer of grants and projects (including EU projects) in the field of information technologies.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"35000",title:"Prof.",name:"Ulrich H.P",middleName:"H.P.",surname:"Fischer",slug:"ulrich-h.p-fischer",fullName:"Ulrich H.P Fischer",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/35000/images/3052_n.jpg",biography:"Academic and Professional Background\nUlrich H. P. has Diploma and PhD degrees in Physics from the Free University Berlin, Germany. He has been working on research positions in the Heinrich-Hertz-Institute in Germany. Several international research projects has been performed with European partners from France, Netherlands, Norway and the UK. He is currently Professor of Communications Systems at the Harz University of Applied Sciences, Germany.\n\nPublications and Publishing\nHe has edited one book, a special interest book about ‘Optoelectronic Packaging’ (VDE, Berlin, Germany), and has published over 100 papers and is owner of several international patents for WDM over POF key elements.\n\nKey Research and Consulting Interests\nUlrich’s research activity has always been related to Spectroscopy and Optical Communications Technology. Specific current interests include the validation of complex instruments, and the application of VR technology to the development and testing of measurement systems. He has been reviewer for several publications of the Optical Society of America\\'s including Photonics Technology Letters and Applied Optics.\n\nPersonal Interests\nThese include motor cycling in a very relaxed manner and performing martial arts.",institutionString:null,institution:{name:"Charité",country:{name:"Germany"}}},{id:"341622",title:"Ph.D.",name:"Eduardo",middleName:null,surname:"Rojas Alvarez",slug:"eduardo-rojas-alvarez",fullName:"Eduardo Rojas Alvarez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/341622/images/15892_n.jpg",biography:null,institutionString:null,institution:{name:"University of Cuenca",country:{name:"Ecuador"}}},{id:"215610",title:"Prof.",name:"Muhammad",middleName:null,surname:"Sarfraz",slug:"muhammad-sarfraz",fullName:"Muhammad Sarfraz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/215610/images/system/215610.jpeg",biography:"Muhammad Sarfraz is a professor in the Department of Information Science, Kuwait University, Kuwait. His research interests include optimization, computer graphics, computer vision, image processing, machine learning, pattern recognition, soft computing, data science, and intelligent systems. Prof. Sarfraz has been a keynote/invited speaker at various platforms around the globe. He has advised/supervised more than 110 students for their MSc and Ph.D. theses. He has published more than 400 publications as books, journal articles, and conference papers. He has authored and/or edited around seventy books. Prof. Sarfraz is a member of various professional societies. He is a chair and member of international advisory committees and organizing committees of numerous international conferences. He is also an editor and editor in chief for various international journals.",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"32650",title:"Prof.",name:"Lukas",middleName:"Willem",surname:"Snyman",slug:"lukas-snyman",fullName:"Lukas Snyman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/32650/images/4136_n.jpg",biography:"Lukas Willem Snyman received his basic education at primary and high schools in South Africa, Eastern Cape. He enrolled at today's Nelson Metropolitan University and graduated from this university with a BSc in Physics and Mathematics, B.Sc Honors in Physics, MSc in Semiconductor Physics, and a Ph.D. in Semiconductor Physics in 1987. After his studies, he chose an academic career and devoted his energy to the teaching of physics to first, second, and third-year students. After positions as a lecturer at the University of Port Elizabeth, he accepted a position as Associate Professor at the University of Pretoria, South Africa.\r\n\r\nIn 1992, he motivates the concept of 'television and computer-based education” as means to reach large student numbers with only the best of teaching expertise and publishes an article on the concept in the SA Journal of Higher Education of 1993 (and later in 2003). The University of Pretoria subsequently approved a series of test projects on the concept with outreach to Mamelodi and Eerste Rust in 1993. In 1994, the University established a 'Unit for Telematic Education ' as a support section for multiple faculties at the University of Pretoria. In subsequent years, the concept of 'telematic education” subsequently becomes well established in academic circles in South Africa, grew in popularity, and is adopted by many universities and colleges throughout South Africa as a medium of enhancing education and training, as a method to reaching out to far out communities, and as a means to enhance study from the home environment.\r\n\r\nProfessor Snyman in subsequent years pursued research in semiconductor physics, semiconductor devices, microelectronics, and optoelectronics.\r\n\r\nIn 2000 he joined the TUT as a full professor. Here served for a period as head of the Department of Electronic Engineering. Here he makes contributions to solar energy development, microwave and optoelectronic device development, silicon photonics, as well as contributions to new mobile telecommunication systems and network planning in SA.\r\n\r\nCurrently, he teaches electronics and telecommunications at the TUT to audiences ranging from first-year students to Ph.D. level.\r\n\r\nFor his research in the field of 'Silicon Photonics” since 1990, he has published (as author and co-author) about thirty internationally reviewed articles in scientific journals, contributed to more than forty international conferences, about 25 South African provisional patents (as inventor and co-inventor), 8 PCT international patent applications until now. Of these, two USA patents applications, two European Patents, two Korean patents, and ten SA patents have been granted. A further 4 USA patents, 5 European patents, 3 Korean patents, 3 Chinese patents, and 3 Japanese patents are currently under consideration.\r\n\r\nRecently he has also published an extensive scholarly chapter in an internet open access book on 'Integrating Microphotonic Systems and MOEMS into standard Silicon CMOS Integrated circuitry”.\r\n\r\nFurthermore, Professor Snyman recently steered a new initiative at the TUT by introducing a 'Laboratory for Innovative Electronic Systems ' at the Department of Electrical Engineering. The model of this laboratory or center is to primarily combine outputs as achieved by high-level research with lower-level system development and entrepreneurship in a technical university environment. Students are allocated to projects at different levels with PhDs and Master students allocated to the generation of new knowledge and new technologies, while students at the diploma and Baccalaureus level are allocated to electronic systems development with a direct and a near application for application in industry or the commercial and public sectors in South Africa.\r\n\r\nProfessor Snyman received the WIRSAM Award of 1983 and the WIRSAM Award in 1985 in South Africa for best research papers by a young scientist at two international conferences on electron microscopy in South Africa. He subsequently received the SA Microelectronics Award for the best dissertation emanating from studies executed at a South African university in the field of Physics and Microelectronics in South Africa in 1987. In October of 2011, Professor Snyman received the prestigious Institutional Award for 'Innovator of the Year” for 2010 at the Tshwane University of Technology, South Africa. This award was based on the number of patents recognized and granted by local and international institutions as well as for his contributions concerning innovation at the TUT.",institutionString:null,institution:{name:"University of South Africa",country:{name:"South Africa"}}},{id:"317279",title:"Mr.",name:"Ali",middleName:"Usama",surname:"Syed",slug:"ali-syed",fullName:"Ali Syed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/317279/images/16024_n.png",biography:"A creative, talented, and innovative young professional who is dedicated, well organized, and capable research fellow with two years of experience in graduate-level research, published in engineering journals and book, with related expertise in Bio-robotics, equally passionate about the aesthetics of the mechanical and electronic system, obtained expertise in the use of MS Office, MATLAB, SolidWorks, LabVIEW, Proteus, Fusion 360, having a grasp on python, C++ and assembly language, possess proven ability in acquiring research grants, previous appointments with social and educational societies with experience in administration, current affiliations with IEEE and Web of Science, a confident presenter at conferences and teacher in classrooms, able to explain complex information to audiences of all levels.",institutionString:null,institution:{name:"Air University",country:{name:"Pakistan"}}},{id:"75526",title:"Ph.D.",name:"Zihni Onur",middleName:null,surname:"Uygun",slug:"zihni-onur-uygun",fullName:"Zihni Onur Uygun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/75526/images/12_n.jpg",biography:"My undergraduate education and my Master of Science educations at Ege University and at Çanakkale Onsekiz Mart University have given me a firm foundation in Biochemistry, Analytical Chemistry, Biosensors, Bioelectronics, Physical Chemistry and Medicine. After obtaining my degree as a MSc in analytical chemistry, I started working as a research assistant in Ege University Medical Faculty in 2014. In parallel, I enrolled to the MSc program at the Department of Medical Biochemistry at Ege University to gain deeper knowledge on medical and biochemical sciences as well as clinical chemistry in 2014. In my PhD I deeply researched on biosensors and bioelectronics and finished in 2020. Now I have eleven SCI-Expanded Index published papers, 6 international book chapters, referee assignments for different SCIE journals, one international patent pending, several international awards, projects and bursaries. In parallel to my research assistant position at Ege University Medical Faculty, Department of Medical Biochemistry, in April 2016, I also founded a Start-Up Company (Denosens Biotechnology LTD) by the support of The Scientific and Technological Research Council of Turkey. Currently, I am also working as a CEO in Denosens Biotechnology. The main purposes of the company, which carries out R&D as a research center, are to develop new generation biosensors and sensors for both point-of-care diagnostics; such as glucose, lactate, cholesterol and cancer biomarker detections. My specific experimental and instrumental skills are Biochemistry, Biosensor, Analytical Chemistry, Electrochemistry, Mobile phone based point-of-care diagnostic device, POCTs and Patient interface designs, HPLC, Tandem Mass Spectrometry, Spectrophotometry, ELISA.",institutionString:null,institution:{name:"Ege University",country:{name:"Turkey"}}},{id:"246502",title:"Dr.",name:"Jaya T.",middleName:"T",surname:"Varkey",slug:"jaya-t.-varkey",fullName:"Jaya T. Varkey",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/246502/images/11160_n.jpg",biography:"Jaya T. Varkey, PhD, graduated with a degree in Chemistry from Cochin University of Science and Technology, Kerala, India. She obtained a PhD in Chemistry from the School of Chemical Sciences, Mahatma Gandhi University, Kerala, India, and completed a post-doctoral fellowship at the University of Minnesota, USA. She is a research guide at Mahatma Gandhi University and Associate Professor in Chemistry, St. Teresa’s College, Kochi, Kerala, India.\nDr. Varkey received a National Young Scientist award from the Indian Science Congress (1995), a UGC Research award (2016–2018), an Indian National Science Academy (INSA) Visiting Scientist award (2018–2019), and a Best Innovative Faculty award from the All India Association for Christian Higher Education (AIACHE) (2019). She Hashas received the Sr. Mary Cecil prize for best research paper three times. She was also awarded a start-up to develop a tea bag water filter. \nDr. Varkey has published two international books and twenty-seven international journal publications. She is an editorial board member for five international journals.",institutionString:"St. Teresa’s College",institution:null},{id:"250668",title:"Dr.",name:"Ali",middleName:null,surname:"Nabipour Chakoli",slug:"ali-nabipour-chakoli",fullName:"Ali Nabipour Chakoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/250668/images/system/250668.jpg",biography:"Academic Qualification:\r\n•\tPhD in Materials Physics and Chemistry, From: Sep. 2006, to: Sep. 2010, School of Materials Science and Engineering, Harbin Institute of Technology, Thesis: Structure and Shape Memory Effect of Functionalized MWCNTs/poly (L-lactide-co-ε-caprolactone) Nanocomposites. Supervisor: Prof. Wei Cai,\r\n•\tM.Sc in Applied Physics, From: 1996, to: 1998, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Determination of Boron in Micro alloy Steels with solid state nuclear track detectors by neutron induced auto radiography, Supervisors: Dr. M. Hosseini Ashrafi and Dr. A. Hosseini.\r\n•\tB.Sc. in Applied Physics, From: 1991, to: 1996, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Design of shielding for Am-Be neutron sources for In Vivo neutron activation analysis, Supervisor: Dr. M. Hosseini Ashrafi.\r\n\r\nResearch Experiences:\r\n1.\tNanomaterials, Carbon Nanotubes, Graphene: Synthesis, Functionalization and Characterization,\r\n2.\tMWCNTs/Polymer Composites: Fabrication and Characterization, \r\n3.\tShape Memory Polymers, Biodegradable Polymers, ORC, Collagen,\r\n4.\tMaterials Analysis and Characterizations: TEM, SEM, XPS, FT-IR, Raman, DSC, DMA, TGA, XRD, GPC, Fluoroscopy, \r\n5.\tInteraction of Radiation with Mater, Nuclear Safety and Security, NDT(RT),\r\n6.\tRadiation Detectors, Calibration (SSDL),\r\n7.\tCompleted IAEA e-learning Courses:\r\nNuclear Security (15 Modules),\r\nNuclear Safety:\r\nTSA 2: Regulatory Protection in Occupational Exposure,\r\nTips & Tricks: Radiation Protection in Radiography,\r\nSafety and Quality in Radiotherapy,\r\nCourse on Sealed Radioactive Sources,\r\nCourse on Fundamentals of Environmental Remediation,\r\nCourse on Planning for Environmental Remediation,\r\nKnowledge Management Orientation Course,\r\nFood Irradiation - Technology, Applications and Good Practices,\r\nEmployment:\r\nFrom 2010 to now: Academic staff, Nuclear Science and Technology Research Institute, Kargar Shomali, Tehran, Iran, P.O. Box: 14395-836.\r\nFrom 1997 to 2006: Expert of Materials Analysis and Characterization. Research Center of Agriculture and Medicine. Rajaeeshahr, Karaj, Iran, P. O. Box: 31585-498.",institutionString:"Atomic Energy Organization of Iran",institution:{name:"Atomic Energy Organization of Iran",country:{name:"Iran"}}},{id:"248279",title:"Dr.",name:"Monika",middleName:"Elzbieta",surname:"Machoy",slug:"monika-machoy",fullName:"Monika Machoy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248279/images/system/248279.jpeg",biography:"Monika Elżbieta Machoy, MD, graduated with distinction from the Faculty of Medicine and Dentistry at the Pomeranian Medical University in 2009, defended her PhD thesis with summa cum laude in 2016 and is currently employed as a researcher at the Department of Orthodontics of the Pomeranian Medical University. She expanded her professional knowledge during a one-year scholarship program at the Ernst Moritz Arndt University in Greifswald, Germany and during a three-year internship at the Technical University in Dresden, Germany. She has been a speaker at numerous orthodontic conferences, among others, American Association of Orthodontics, European Orthodontic Symposium and numerous conferences of the Polish Orthodontic Society. She conducts research focusing on the effect of orthodontic treatment on dental and periodontal tissues and the causes of pain in orthodontic patients.",institutionString:"Pomeranian Medical University",institution:{name:"Pomeranian Medical University",country:{name:"Poland"}}},{id:"252743",title:"Prof.",name:"Aswini",middleName:"Kumar",surname:"Kar",slug:"aswini-kar",fullName:"Aswini Kar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252743/images/10381_n.jpg",biography:"uploaded in cv",institutionString:null,institution:{name:"KIIT University",country:{name:"India"}}},{id:"204256",title:"Dr.",name:"Anil",middleName:"Kumar",surname:"Kumar Sahu",slug:"anil-kumar-sahu",fullName:"Anil Kumar Sahu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204256/images/14201_n.jpg",biography:"I have nearly 11 years of research and teaching experience. I have done my master degree from University Institute of Pharmacy, Pt. Ravi Shankar Shukla University, Raipur, Chhattisgarh India. I have published 16 review and research articles in international and national journals and published 4 chapters in IntechOpen, the world’s leading publisher of Open access books. I have presented many papers at national and international conferences. I have received research award from Indian Drug Manufacturers Association in year 2015. My research interest extends from novel lymphatic drug delivery systems, oral delivery system for herbal bioactive to formulation optimization.",institutionString:null,institution:{name:"Chhattisgarh Swami Vivekanand Technical University",country:{name:"India"}}},{id:"253468",title:"Dr.",name:"Mariusz",middleName:null,surname:"Marzec",slug:"mariusz-marzec",fullName:"Mariusz Marzec",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/253468/images/system/253468.png",biography:"An assistant professor at Department of Biomedical Computer Systems, at Institute of Computer Science, Silesian University in Katowice. Scientific interests: computer analysis and processing of images, biomedical images, databases and programming languages. He is an author and co-author of scientific publications covering analysis and processing of biomedical images and development of database systems.",institutionString:"University of Silesia",institution:null},{id:"212432",title:"Prof.",name:"Hadi",middleName:null,surname:"Mohammadi",slug:"hadi-mohammadi",fullName:"Hadi Mohammadi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/212432/images/system/212432.jpeg",biography:"Dr. Hadi Mohammadi is a biomedical engineer with hands-on experience in the design and development of many engineering structures and medical devices through various projects that he has been involved in over the past twenty years. Dr. Mohammadi received his BSc. and MSc. degrees in Mechanical Engineering from Sharif University of Technology, Tehran, Iran, and his PhD. degree in Biomedical Engineering (biomaterials) from the University of Western Ontario. He was a postdoctoral trainee for almost four years at University of Calgary and Harvard Medical School. He is an industry innovator having created the technology to produce lifelike synthetic platforms that can be used for the simulation of almost all cardiovascular reconstructive surgeries. He’s been heavily involved in the design and development of cardiovascular devices and technology for the past 10 years. He is currently an Assistant Professor with the University of British Colombia, Canada.",institutionString:"University of British Columbia",institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"254463",title:"Prof.",name:"Haisheng",middleName:null,surname:"Yang",slug:"haisheng-yang",fullName:"Haisheng Yang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/254463/images/system/254463.jpeg",biography:"Haisheng Yang, Ph.D., Professor and Director of the Department of Biomedical Engineering, College of Life Science and Bioengineering, Beijing University of Technology. He received his Ph.D. degree in Mechanics/Biomechanics from Harbin Institute of Technology (jointly with University of California, Berkeley). Afterwards, he worked as a Postdoctoral Research Associate in the Purdue Musculoskeletal Biology and Mechanics Lab at the Department of Basic Medical Sciences, Purdue University, USA. He also conducted research in the Research Centre of Shriners Hospitals for Children-Canada at McGill University, Canada. Dr. Yang has over 10 years research experience in orthopaedic biomechanics and mechanobiology of bone adaptation and regeneration. He earned an award from Beijing Overseas Talents Aggregation program in 2017 and serves as Beijing Distinguished Professor.",institutionString:"Beijing University of Technology",institution:null},{id:"255757",title:"Dr.",name:"Igor",middleName:"Victorovich",surname:"Lakhno",slug:"igor-lakhno",fullName:"Igor Lakhno",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255757/images/system/255757.jpg",biography:"Lakhno Igor Victorovich was born in 1971 in Kharkiv (Ukraine). \nMD – 1994, Kharkiv National Medical Univesity.\nOb&Gyn; – 1997, master courses in Kharkiv Medical Academy of Postgraduate Education.\nPhD – 1999, Kharkiv National Medical Univesity.\nDSc – 2019, PL Shupik National Academy of Postgraduate Education \nLakhno Igor has been graduated from an international training courses on reproductive medicine and family planning held in Debrecen University (Hungary) in 1997. Since 1998 Lakhno Igor has worked as an associate professor of the department of obstetrics and gynecology of VN Karazin National University and an associate professor of the perinatology, obstetrics and gynecology department of Kharkiv Medical Academy of Postgraduate Education. Since June 2019 he’s a professor of the department of obstetrics and gynecology of VN Karazin National University and a professor of the perinatology, obstetrics and gynecology department of Kharkiv Medical Academy of Postgraduate Education . He’s an author of about 200 printed works and there are 17 of them in Scopus or Web of Science databases. Lakhno Igor is a rewiever of Journal of Obstetrics and Gynaecology (Taylor and Francis), Informatics in Medicine Unlocked (Elsevier), The Journal of Obstetrics and Gynecology Research (Wiley), Endocrine, Metabolic & Immune Disorders-Drug Targets (Bentham Open), The Open Biomedical Engineering Journal (Bentham Open), etc. He’s defended a dissertation for DSc degree \\'Pre-eclampsia: prediction, prevention and treatment”. Lakhno Igor has participated as a speaker in several international conferences and congresses (International Conference on Biological Oscillations April 10th-14th 2016, Lancaster, UK, The 9th conference of the European Study Group on Cardiovascular Oscillations). His main scientific interests: obstetrics, women’s health, fetal medicine, cardiovascular medicine.",institutionString:"V.N. Karazin Kharkiv National University",institution:{name:"Kharkiv Medical Academy of Postgraduate Education",country:{name:"Ukraine"}}},{id:"89721",title:"Dr.",name:"Mehmet",middleName:"Cuneyt",surname:"Ozmen",slug:"mehmet-ozmen",fullName:"Mehmet Ozmen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/89721/images/7289_n.jpg",biography:null,institutionString:null,institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"243698",title:"M.D.",name:"Xiaogang",middleName:null,surname:"Wang",slug:"xiaogang-wang",fullName:"Xiaogang Wang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243698/images/system/243698.png",biography:"Dr. Xiaogang Wang, a faculty member of Shanxi Eye Hospital specializing in the treatment of cataract and retinal disease and a tutor for postgraduate students of Shanxi Medical University, worked in the COOL Lab as an international visiting scholar under the supervision of Dr. David Huang and Yali Jia from October 2012 through November 2013. Dr. Wang earned an MD from Shanxi Medical University and a Ph.D. from Shanghai Jiao Tong University. Dr. Wang was awarded two research project grants focused on multimodal optical coherence tomography imaging and deep learning in cataract and retinal disease, from the National Natural Science Foundation of China. He has published around 30 peer-reviewed journal papers and four book chapters and co-edited one book.",institutionString:"Shanxi Eye Hospital",institution:{name:"Shanxi Eye Hospital",country:{name:"China"}}},{id:"242893",title:"Ph.D. Student",name:"Joaquim",middleName:null,surname:"De Moura",slug:"joaquim-de-moura",fullName:"Joaquim De Moura",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/242893/images/7133_n.jpg",biography:"Joaquim de Moura received his degree in Computer Engineering in 2014 from the University of A Coruña (Spain). In 2016, he received his M.Sc degree in Computer Engineering from the same university. He is currently pursuing his Ph.D degree in Computer Science in a collaborative project between ophthalmology centers in Galicia and the University of A Coruña. His research interests include computer vision, machine learning algorithms and analysis and medical imaging processing of various kinds.",institutionString:null,institution:{name:"University of A Coruña",country:{name:"Spain"}}},{id:"267434",title:"Dr.",name:"Rohit",middleName:null,surname:"Raja",slug:"rohit-raja",fullName:"Rohit Raja",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRZkkQAG/Profile_Picture_2022-05-09T12:55:18.jpg",biography:null,institutionString:null,institution:null},{id:"294334",title:"B.Sc.",name:"Marc",middleName:null,surname:"Bruggeman",slug:"marc-bruggeman",fullName:"Marc Bruggeman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/294334/images/8242_n.jpg",biography:"Chemical engineer graduate, with a passion for material science and specific interest in polymers - their near infinite applications intrigue me. \n\nI plan to continue my scientific career in the field of polymeric biomaterials as I am fascinated by intelligent, bioactive and biomimetic materials for use in both consumer and medical applications.",institutionString:null,institution:null},{id:"244950",title:"Dr.",name:"Salvatore",middleName:null,surname:"Di Lauro",slug:"salvatore-di-lauro",fullName:"Salvatore Di Lauro",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0030O00002bSF1HQAW/ProfilePicture%202021-12-20%2014%3A54%3A14.482",biography:"Name:\n\tSALVATORE DI LAURO\nAddress:\n\tHospital Clínico Universitario Valladolid\nAvda Ramón y Cajal 3\n47005, Valladolid\nSpain\nPhone number: \nFax\nE-mail:\n\t+34 983420000 ext 292\n+34 983420084\nsadilauro@live.it\nDate and place of Birth:\nID Number\nMedical Licence \nLanguages\t09-05-1985. Villaricca (Italy)\n\nY1281863H\n474707061\nItalian (native language)\nSpanish (read, written, spoken)\nEnglish (read, written, spoken)\nPortuguese (read, spoken)\nFrench (read)\n\t\t\nCurrent position (title and company)\tDate (Year)\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. Private practise.\t2017-today\n\n2019-today\n\t\n\t\nEducation (High school, university and postgraduate training > 3 months)\tDate (Year)\nDegree in Medicine and Surgery. University of Neaples 'Federico II”\nResident in Opthalmology. Hospital Clinico Universitario Valladolid\nMaster in Vitreo-Retina. IOBA. University of Valladolid\nFellow of the European Board of Ophthalmology. Paris\nMaster in Research in Ophthalmology. University of Valladolid\t2003-2009\n2012-2016\n2016-2017\n2016\n2012-2013\n\t\nEmployments (company and positions)\tDate (Year)\nResident in Ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl.\nFellow in Vitreo-Retina. IOBA. University of Valladolid\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. \n\t2012-2016\n2016-2017\n2017-today\n\n2019-Today\n\n\n\t\nClinical Research Experience (tasks and role)\tDate (Year)\nAssociated investigator\n\n' FIS PI20/00740: DESARROLLO DE UNA CALCULADORA DE RIESGO DE\nAPARICION DE RETINOPATIA DIABETICA BASADA EN TECNICAS DE IMAGEN MULTIMODAL EN PACIENTES DIABETICOS TIPO 1. Grant by: Ministerio de Ciencia e Innovacion \n\n' (BIO/VA23/14) Estudio clínico multicéntrico y prospectivo para validar dos\nbiomarcadores ubicados en los genes p53 y MDM2 en la predicción de los resultados funcionales de la cirugía del desprendimiento de retina regmatógeno. Grant by: Gerencia Regional de Salud de la Junta de Castilla y León.\n' Estudio multicéntrico, aleatorizado, con enmascaramiento doble, en 2 grupos\nparalelos y de 52 semanas de duración para comparar la eficacia, seguridad e inmunogenicidad de SOK583A1 respecto a Eylea® en pacientes con degeneración macular neovascular asociada a la edad' (CSOK583A12301; N.EUDRA: 2019-004838-41; FASE III). Grant by Hexal AG\n\n' Estudio de fase III, aleatorizado, doble ciego, con grupos paralelos, multicéntrico para comparar la eficacia y la seguridad de QL1205 frente a Lucentis® en pacientes con degeneración macular neovascular asociada a la edad. (EUDRACT: 2018-004486-13). Grant by Qilu Pharmaceutical Co\n\n' Estudio NEUTON: Ensayo clinico en fase IV para evaluar la eficacia de aflibercept en pacientes Naive con Edema MacUlar secundario a Oclusion de Vena CenTral de la Retina (OVCR) en regimen de tratamientO iNdividualizado Treat and Extend (TAE)”, (2014-000975-21). Grant by Fundacion Retinaplus\n\n' Evaluación de la seguridad y bioactividad de anillos de tensión capsular en conejo. Proyecto Procusens. Grant by AJL, S.A.\n\n'Estudio epidemiológico, prospectivo, multicéntrico y abierto\\npara valorar la frecuencia de la conjuntivitis adenovírica diagnosticada mediante el test AdenoPlus®\\nTest en pacientes enfermos de conjuntivitis aguda”\\n. National, multicenter study. Grant by: NICOX.\n\nEuropean multicentric trial: 'Evaluation of clinical outcomes following the use of Systane Hydration in patients with dry eye”. Study Phase 4. Grant by: Alcon Labs'\n\nVLPs Injection and Activation in a Rabbit Model of Uveal Melanoma. Grant by Aura Bioscience\n\nUpdating and characterization of a rabbit model of uveal melanoma. Grant by Aura Bioscience\n\nEnsayo clínico en fase IV para evaluar las variantes genéticas de la vía del VEGF como biomarcadores de eficacia del tratamiento con aflibercept en pacientes con degeneración macular asociada a la edad (DMAE) neovascular. Estudio BIOIMAGE. IMO-AFLI-2013-01\n\nEstudio In-Eye:Ensayo clínico en fase IV, abierto, aleatorizado, de 2 brazos,\nmulticçentrico y de 12 meses de duración, para evaluar la eficacia y seguridad de un régimen de PRN flexible individualizado de 'esperar y extender' versus un régimen PRN según criterios de estabilización mediante evaluaciones mensuales de inyecciones intravítreas de ranibizumab 0,5 mg en pacientes naive con neovascularización coriodea secunaria a la degeneración macular relacionada con la edad. CP: CRFB002AES03T\n\nTREND: Estudio Fase IIIb multicéntrico, randomizado, de 12 meses de\nseguimiento con evaluador de la agudeza visual enmascarado, para evaluar la eficacia y la seguridad de ranibizumab 0.5mg en un régimen de tratar y extender comparado con un régimen mensual, en pacientes con degeneración macular neovascular asociada a la edad. CP: CRFB002A2411 Código Eudra CT:\n2013-002626-23\n\n\n\nPublications\t\n\n2021\n\n\n\n\n2015\n\n\n\n\n2021\n\n\n\n\n\n2021\n\n\n\n\n2015\n\n\n\n\n2015\n\n\n2014\n\n\n\n\n2015-16\n\n\n\n2015\n\n\n2014\n\n\n2014\n\n\n\n\n2014\n\n\n\n\n\n\n\n2014\n\nJose Carlos Pastor; Jimena Rojas; Salvador Pastor-Idoate; Salvatore Di Lauro; Lucia Gonzalez-Buendia; Santiago Delgado-Tirado. Proliferative vitreoretinopathy: A new concept of disease pathogenesis and practical\nconsequences. Progress in Retinal and Eye Research. 51, pp. 125 - 155. 03/2016. DOI: 10.1016/j.preteyeres.2015.07.005\n\n\nLabrador-Velandia S; Alonso-Alonso ML; Di Lauro S; García-Gutierrez MT; Srivastava GK; Pastor JC; Fernandez-Bueno I. Mesenchymal stem cells provide paracrine neuroprotective resources that delay degeneration of co-cultured organotypic neuroretinal cultures.Experimental Eye Research. 185, 17/05/2019. DOI: 10.1016/j.exer.2019.05.011\n\nSalvatore Di Lauro; Maria Teresa Garcia Gutierrez; Ivan Fernandez Bueno. Quantification of pigment epithelium-derived factor (PEDF) in an ex vivo coculture of retinal pigment epithelium cells and neuroretina.\nJournal of Allbiosolution. 2019. ISSN 2605-3535\n\nSonia Labrador Velandia; Salvatore Di Lauro; Alonso-Alonso ML; Tabera Bartolomé S; Srivastava GK; Pastor JC; Fernandez-Bueno I. Biocompatibility of intravitreal injection of human mesenchymal stem cells in immunocompetent rabbits. Graefe's archive for clinical and experimental ophthalmology. 256 - 1, pp. 125 - 134. 01/2018. DOI: 10.1007/s00417-017-3842-3\n\n\nSalvatore Di Lauro, David Rodriguez-Crespo, Manuel J Gayoso, Maria T Garcia-Gutierrez, J Carlos Pastor, Girish K Srivastava, Ivan Fernandez-Bueno. A novel coculture model of porcine central neuroretina explants and retinal pigment epithelium cells. Molecular Vision. 2016 - 22, pp. 243 - 253. 01/2016.\n\nSalvatore Di Lauro. Classifications for Proliferative Vitreoretinopathy ({PVR}): An Analysis of Their Use in Publications over the Last 15 Years. Journal of Ophthalmology. 2016, pp. 1 - 6. 01/2016. DOI: 10.1155/2016/7807596\n\nSalvatore Di Lauro; Rosa Maria Coco; Rosa Maria Sanabria; Enrique Rodriguez de la Rua; Jose Carlos Pastor. Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study. Journal of Ophthalmology. 2015:821864, 2015. DOI: 10.1155/2015/821864\n\nIvan Fernandez-Bueno; Salvatore Di Lauro; Ivan Alvarez; Jose Carlos Lopez; Maria Teresa Garcia-Gutierrez; Itziar Fernandez; Eva Larra; Jose Carlos Pastor. Safety and Biocompatibility of a New High-Density Polyethylene-Based\nSpherical Integrated Porous Orbital Implant: An Experimental Study in Rabbits. Journal of Ophthalmology. 2015:904096, 2015. DOI: 10.1155/2015/904096\n\nPastor JC; Pastor-Idoate S; Rodríguez-Hernandez I; Rojas J; Fernandez I; Gonzalez-Buendia L; Di Lauro S; Gonzalez-Sarmiento R. Genetics of PVR and RD. Ophthalmologica. 232 - Suppl 1, pp. 28 - 29. 2014\n\nRodriguez-Crespo D; Di Lauro S; Singh AK; Garcia-Gutierrez MT; Garrosa M; Pastor JC; Fernandez-Bueno I; Srivastava GK. Triple-layered mixed co-culture model of RPE cells with neuroretina for evaluating the neuroprotective effects of adipose-MSCs. Cell Tissue Res. 358 - 3, pp. 705 - 716. 2014.\nDOI: 10.1007/s00441-014-1987-5\n\nCarlo De Werra; Salvatore Condurro; Salvatore Tramontano; Mario Perone; Ivana Donzelli; Salvatore Di Lauro; Massimo Di Giuseppe; Rosa Di Micco; Annalisa Pascariello; Antonio Pastore; Giorgio Diamantis; Giuseppe Galloro. Hydatid disease of the liver: thirty years of surgical experience.Chirurgia italiana. 59 - 5, pp. 611 - 636.\n(Italia): 2007. ISSN 0009-4773\n\nChapters in books\n\t\n' Salvador Pastor Idoate; Salvatore Di Lauro; Jose Carlos Pastor Jimeno. PVR: Pathogenesis, Histopathology and Classification. Proliferative Vitreoretinopathy with Small Gauge Vitrectomy. Springer, 2018. ISBN 978-3-319-78445-8\nDOI: 10.1007/978-3-319-78446-5_2. \n\n' Salvatore Di Lauro; Maria Isabel Lopez Galvez. Quistes vítreos en una mujer joven. Problemas diagnósticos en patología retinocoroidea. Sociedad Española de Retina-Vitreo. 2018.\n\n' Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor Jimeno. iOCT in PVR management. OCT Applications in Opthalmology. pp. 1 - 8. INTECH, 2018. DOI: 10.5772/intechopen.78774.\n\n' Rosa Coco Martin; Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor. amponadores, manipuladores y tinciones en la cirugía del traumatismo ocular.Trauma Ocular. Ponencia de la SEO 2018..\n\n' LOPEZ GALVEZ; DI LAURO; CRESPO. OCT angiografia y complicaciones retinianas de la diabetes. PONENCIA SEO 2021, CAPITULO 20. (España): 2021.\n\n' Múltiples desprendimientos neurosensoriales bilaterales en paciente joven. Enfermedades Degenerativas De Retina Y Coroides. SERV 04/2016. \n' González-Buendía L; Di Lauro S; Pastor-Idoate S; Pastor Jimeno JC. Vitreorretinopatía proliferante (VRP) e inflamación: LA INFLAMACIÓN in «INMUNOMODULADORES Y ANTIINFLAMATORIOS: MÁS ALLÁ DE LOS CORTICOIDES. RELACION DE PONENCIAS DE LA SOCIEDAD ESPAÑOLA DE OFTALMOLOGIA. 10/2014.",institutionString:null,institution:null},{id:"265335",title:"Mr.",name:"Stefan",middleName:"Radnev",surname:"Stefanov",slug:"stefan-stefanov",fullName:"Stefan Stefanov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/265335/images/7562_n.jpg",biography:null,institutionString:null,institution:null},{id:"318905",title:"Prof.",name:"Elvis",middleName:"Kwason",surname:"Tiburu",slug:"elvis-tiburu",fullName:"Elvis Tiburu",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Ghana",country:{name:"Ghana"}}},{id:"336193",title:"Dr.",name:"Abdullah",middleName:null,surname:"Alamoudi",slug:"abdullah-alamoudi",fullName:"Abdullah Alamoudi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Majmaah University",country:{name:"Saudi Arabia"}}},{id:"318657",title:"MSc.",name:"Isabell",middleName:null,surname:"Steuding",slug:"isabell-steuding",fullName:"Isabell Steuding",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Harz University of Applied Sciences",country:{name:"Germany"}}},{id:"318656",title:"BSc.",name:"Peter",middleName:null,surname:"Kußmann",slug:"peter-kussmann",fullName:"Peter Kußmann",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Harz University of Applied Sciences",country:{name:"Germany"}}},{id:"338222",title:"Mrs.",name:"María José",middleName:null,surname:"Lucía Mudas",slug:"maria-jose-lucia-mudas",fullName:"María José Lucía Mudas",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Carlos III University of Madrid",country:{name:"Spain"}}},{id:"147824",title:"Mr.",name:"Pablo",middleName:null,surname:"Revuelta Sanz",slug:"pablo-revuelta-sanz",fullName:"Pablo Revuelta Sanz",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Carlos III University of Madrid",country:{name:"Spain"}}}]}},subseries:{item:{id:"12",type:"subseries",title:"Human Physiology",keywords:"Anatomy, Cells, Organs, Systems, Homeostasis, Functions",scope:"Human physiology is the scientific exploration of the various functions (physical, biochemical, and mechanical properties) of humans, their organs, and their constituent cells. 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It has become a massive part of our daily lives, making predictions based on experience, making this a fascinating area that solves problems that otherwise would not be possible or easy to solve. This topic aims to encompass algorithms that learn from experience (supervised and unsupervised), improve their performance over time and enable machines to make data-driven decisions. It is not limited to any particular applications, but contributions are encouraged from all disciplines.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/26.jpg",keywords:"Intelligent Systems, Machine Learning, Data Science, Data Mining, Artificial Intelligence"},{id:"27",title:"Multi-Agent Systems",scope:"Multi-agent systems are recognised as a state of the art field in Artificial Intelligence studies, which is popular due to the usefulness in facilitation capabilities to handle real-world problem-solving in a distributed fashion. 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The search for this knowledge grows in importance as rapid increases in population and economic development intensify humans’ stresses on ecosystems. Fortunately, rapid increases in multiple scientific areas are advancing our understanding of environmental sciences. Breakthroughs in computing, molecular biology, ecology, and sustainability science are enhancing our ability to utilize environmental sciences to address real-world problems.
\r\n\tThe four topics of this book series - Pollution; Environmental Resilience and Management; Ecosystems and Biodiversity; and Water Science - will address important areas of advancement in the environmental sciences. They will represent an excellent initial grouping of published works on these critical topics.
\r\n\tPollution is caused by a wide variety of human activities and occurs in diverse forms, for example biological, chemical, et cetera. In recent years, significant efforts have been made to ensure that the environment is clean, that rigorous rules are implemented, and old laws are updated to reduce the risks towards humans and ecosystems. However, rapid industrialization and the need for more cultivable sources or habitable lands, for an increasing population, as well as fewer alternatives for waste disposal, make the pollution control tasks more challenging. Therefore, this topic will focus on assessing and managing environmental pollution. It will cover various subjects, including risk assessment due to the pollution of ecosystems, transport and fate of pollutants, restoration or remediation of polluted matrices, and efforts towards sustainable solutions to minimize environmental pollution.
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",annualVolume:11967,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/39.jpg",editor:{id:"137040",title:"Prof.",name:"Jose",middleName:null,surname:"Navarro-Pedreño",fullName:"Jose Navarro-Pedreño",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRAXrQAO/Profile_Picture_2022-03-09T15:50:19.jpg",institutionString:"Miguel Hernández University of Elche, Spain",institution:null},editorTwo:null,editorThree:null,editorialBoard:[{id:"177015",title:"Prof.",name:"Elke Jurandy",middleName:null,surname:"Bran Nogueira Cardoso",fullName:"Elke Jurandy Bran Nogueira Cardoso",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRGxzQAG/Profile_Picture_2022-03-25T08:32:33.jpg",institutionString:"Universidade de São Paulo, Brazil",institution:null},{id:"211260",title:"Dr.",name:"Sandra",middleName:null,surname:"Ricart",fullName:"Sandra Ricart",profilePictureURL:"https://mts.intechopen.com/storage/users/211260/images/system/211260.jpeg",institutionString:null,institution:{name:"University of Alicante",institutionURL:null,country:{name:"Spain"}}}]},{id:"40",title:"Ecosystems and Biodiversity",keywords:"Ecosystems, Biodiversity, Fauna, Taxonomy, Invasive species, Destruction of habitats, Overexploitation of natural resources, Pollution, Global warming, Conservation of natural spaces, Bioremediation",scope:"