Grain quality of maize as affected by the different quality of irrigation water in the first and third year of crop rotation [75].
\r\n\t
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Besides soil salinity, utilization of saline water for irrigation purposes, particularly in the low-lying coastal regions of many countries, has also been identified as a major yield-limiting factor for boosting agriculture production [5, 6]. The detrimental impacts of salt stress manifest through a reduction in the relative water potential of plants which causes decline in plants growth [7], coupled to a negative effect in soil and water quality both in the short and long term [8, 9]. Salt stress is associated with the moisture stress that decreases plant growth and ultimately reduces plant yield even at soil moisture contents that are not limiting for crop productivity (Figure 1) [10, 11].
Effect of salt stress on the initial growth of maize (adapted from Farooq et al. [
Similar to other C4 plants, maize is able to grow in both saline and non-saline conditions due to its stress adaptive potential and relatively tolerance against salinity [12, 13, 14]. Although salinity adversely affects maize growth and yield attributes throughout most of the plant cycle, the final impact on plant productivity depends upon the length and severity of the stress and the growth phase when the stress occurs [15, 16]. In general, and similar to the case for other row crops, the initial growth stage of maize is highly sensitive to salt stress. In a hydroponically grown study, Farooq et al. [12] observed the growth of roots and shoots of salt-treated (1.0 and 100 mM NaCl, applied one week after transplanting) maize variety cv. ‘Pioneer 3906’. Authors reported a significant reduction in the plant height and dry matter biomass of plants treated with the highest salt concentration just 21 days after the beginning of the salt soaking study [12]. However, lower salt concentrations can severely impact normal crop growth and several studies have demonstrated that very low salt concentrations can reduce the growth cycle of maize plant due to oxidative stress before the occurrence of sodium toxicity in the plant [17, 18, 19]. The objectives of this chapter are to discuss a) the current and most recent knowledge regarding the influence of salinity stress on physio-biochemical processes and yield components in maize, and b) the seed enhancement technologies, phytohormones exogenous application and genetic improvement of maize against soil salinity stress.
Seedling establishment is an important phase in the plant life cycle. Salt stress adversely affects seed germination [20], due to the decrease in the osmotic potential created in the soil solution that prevents the entry of water into the seed [21]. During seedling establishment, intake of sodium and chloride ions causes toxicity in the plant cells, thus reducing seed germination rates and the growth of seedlings that have already germinated [22]. Besides its negative impact in the germination rates, salinity stress also delays the overall germination process, thus reducing the survival chances of those seeds that were able to germinate [23, 24]. Because of its potential to drastically reduce crop productivity, it is of paramount importance to recognize these early deleterious impacts of soil and water salinity in plant growth and development [25].
Salinity reduces seedling establishment by increasing the oxidative stress through the absorption of Na+ and Cl− ions in the seeds that cause toxicity in the embryogenesis and protein synthesis. Maximum oxidative stress caused by Na+ and Cl− ions toxicity during germination lowers or stunts the germination of plants [26]. In case of maize production, just Na+ toxicity was found more detrimental in reducing the germination under salt-stressed environments.
Under arid and semi-arid conditions salt stress is commonly considered as the more threatening factor reducing the seed emergence rates and the overall crop stands [9, 27, 28]. Therefore, salinity constitutes one of the most significant abiotic factors limiting crop productivity, while changing climate scenario has even further worsened the situation [29]. The ability of seeds to germinate at high salt concentrations in the soil is of crucial importance for the survival of many plant species. However, the effects of salinity are modified by its interactions with other environmental factors such as temperature and light [30]. In saline habitats, satisfactory seed germination typically takes place after high precipitation events, when soil salinity is reduced [31]. Seed priming stimulates numerous metabolic processes involved in the early phases of germination, and it was observed that seedlings from primed seeds can grow more vigorously and perform better under adverse environmental conditions compared to non-primed seeds [32].
El Sayed, [33] observed dramatic decreases in maize plant root elongation, plant height, leaf area, photosynthesis, mitotic division and root and shoot biomass in a sandy soil under salt stress conditions. Salinity promotes suberization of the hypodermis and endodermis, and the Casparian strip develops closer to the root tip compared to roots growing in non-saline soils [34]. Although roots are the first organ exposed to salt stress, shoots are more sensitive to salt stress [35]. Salinity reduces shoot growth by suppressing leaf initiation and expansion, as well as internode growth, and by accelerating leaf abscission [36]. Salt stress rapidly reduces leaf growth rate due to a reduction in the number of elongating cells and the rate of cell elongation [37, 38]. As a salt-sensitive crop, shoot growth in maize is strongly inhibited in the first phase of salt stress [38]. Schubert et al. [39] observed stunted maize growth with dark green leaves without any toxicity symptoms during the first phase of salt stress, owing to impaired extension growth as osmotic adjustment and turgor maintenance were not limiting. Likewise, growth of salt-resistant hybrids has shown that it was not turgor but cell wall extensibility which restricted cell extension growth during the first phase of salt stress [39].
Salt stress may also displace Ca+2 ions from plasma membrane-binding sites, thus causing membrane leakiness as a primary cellular response to salt stress [40]. When the integrity of the plasma membrane is affected by high salt concentrations in soil, a cell wall acidification process occurs due to the reduction in the cell wall ability to pump protons out across the intact plasma membrane [41]. Conversely, pH in the apoplastic space tends to increase in salt-sensitive maize genotypes subjected to salt stress and this reduces the extension growth of the cell due to less acidification of the apoplast [41, 42]. Comparing salt tolerant and susceptible genotypes of maize, Pitann et al. [43] found that salt-tolerant genotypes better regulated hydrogen ions concentration and decreased the pH in the apoplastic space, while also loosen the cell wall turgidity according to the acid growth theory [44]. According to this theory, the increased in the cell wall expansion triggers a protein synthesis process that ultimately results in cell growth. The enzymes that are responsible for the loosening process in the cell wall and the regulation of cell elongation are present in the apoplastic space of cells located in the leaves [42]. The extent to which these enzymes will loosen the cell wall for further extension depends upon the acid concentration in the apoplastic space and the existence of a cell wall pH under 5 [45, 46]. Research shows that, when grown under salt stress conditions, the amount and activity of β-expansion proteins decreased in salt susceptible genotypes of maize, while it was only slightly affected in salt-tolerant genotypes [47, 48]. In general, β-expansions proteins have been more heavily studied than α-expansion proteins in salt-stress related research [49]. These β-expansion proteins are responsible for important cell functions and have a specific set of matrix polysaccharides and structural proteins in maize [49].
Early in the growth cycle, high salt concentrations reduced the growth of tissues in corn which may be partially accountable for a reduction in the overall photosynthetic capacity of the plant [50]. Moreover, salt stress has shown to produce structural variations in the cell wall that alter its correct functioning [51]. For instance, salt stress stimulates the production of ROS (Reactive Oxygen Species) such as peroxidase and hydrogen peroxide in the cell apoplastic space, and this increases the biosynthesis of diferulates which inhibits maize cell wall growth [52, 53, 54]. Moreover, increased in the ROS results in peroxidation of lipid and DNA damage [55, 56, 57]. In other studies, a temporary increase in the concentration of apoplastic peroxidase terminated cell wall elongation [58, 59], and increased the oxidation of phenolics compounds in maize [60]. A persistent salt stress condition across the plant growth cycle can result in a significant decrease in the length of the shoots and the extent and duration of the flowering process in the plant, which ultimately affects the reproduction and the productivity of crops. In this context, salt stress resulted in the deterioration and further abscission of old leaves of plants while the growth of young leaves was not affected by salt stress at grain cob initiation stage [1].
The number and weight of kernels are the two most important yield components to calculate grain yield in maize [61, 62, 63, 64]. In a recent study, and compared to non-saline conditions, a salt concentration of 100 mM NaCl applied at the reproductive phase of maize reduced the kernel yield and the kernel weight by 25% and 8%, respectively (Figure 2) [65]. Katerji et al. [66] studied the effect of three irrigation water treatments [i.e., fresh, unsalted water; 15 and 30 mEQ l−1 (NaCl and CaCl2)] in maize yield and yield components in a clay and a loamy soil. Compared to non-saline treatment, authors found that 15 mEQ l−1 reduced maize grain yield by 11.3% in the clay soil through a reduction of 7.6% in the kernel set without changes in the kernel weight. Conversely, the 15 mEQ l−1 salt treatment did not affect grain yield in the loamy soil. Application of 30 mEQ l−1 salt treatment reduced the grain yield by 24.5% in the clay, and by 21.4% in the loamy soil as a result of decreases in both the kernel set and kernel weight in the two soils.
Salt stress effects on maize plant growth and yield (from Kaya et al. [
Photosynthesis reduction and sink limitation induced by salinity are among the main reasons for poor kernel setting and reduced grain number [67]. Under salt stress conditions, a sink limitation disrupts kernel setting more than the resulting reduction in the photo-assimilation production in maize. Research showed that the salt stress-induced reduction in the sink activity in maize causes a reduction in the acid invertase activity, which further reduces the final grain number in maize [68]. At the eco-physiological level, however, a decrease in the translocation of assimilates from leaves to the emerging grains is the main driver for poor kernel set and reduced grain weight, and thus final grain yield, in maize plant stands subjected to salt stress conditions [69].
In salt-stressed maize plant, growth is affected by lack of nitrogen due to the antagonistic action of nitrate ions with chloride ions [34, 70]; hence, maize yield significantly improved with the addition of nitrogen under salt stress. Application of nitrogen in the amount of 120 kg ha−1 neutralized the harmful effects of salinity; in particular, it improved nitrogen absorption, growth and productivity under of salt stress conditions [71].
Different environmental conditions can greatly affect the grain quality in maize [72]. Among these, the negative impact of salt stress in grain quality has not been extensively studied. Working with five saline irrigation levels [1, 2, 3, 4, and 5 g L−1 of total dissolved solids (TDS)] in a 2-yr study in China, Li et al. [73] found no difference in the oil, crude fiber and ash contents of maize grain. Conversely, grain moisture and starch content decreased with increased salinity, with maximum values ocurring with 1, 2 and 3 g L−1 of TDS in both cases, while protein content increased with increased salinity, reaching maximum values >12% with 4 and 5 g L−1 of TDS. While the impacts of different salinity treatments were antagonistic for starch and protein content, two of the key quality components in maize grain, salt levels in the irrigation water should balance the content of each component. Low grain moisture content can be beneficial for storing purposes, as these conditions are detrimental for proliferation of fungal pathogens, which can cause mycotoxin contamination and reduction in the maize grain quality (Table 1) [74].
Years | Water Quality | Protein % | Starch % | Fats % | Grain Moisture % |
---|---|---|---|---|---|
Brackish water | 9.1a | 72.1a | 4.2a | 15.2a | |
Fresh water | 8.9a | 71.8a | 4.1a | 15.5a | |
Brackish water | 9.2a | 71.6a | 4.1a | 14.6b | |
Fresh water | 8.6b | 71.7a | 4.3a | 16.1a |
Grain quality of maize as affected by the different quality of irrigation water in the first and third year of crop rotation [75].
Different letters indicate significant difference according to Duncan test (p = 0.05).
Cucci et al. [75] found no difference in the kernel composition due to irrigation water quality in the first year of a study conducted in Italy. Contrarily, in the third year, brackish water irrigation increased the grain protein content by 6.9% and decreased the moisture content by 9.3% compared to grain irrigated with freshwater, which is similar to the findings from Li et al. (2019) [73]. Finally, there was no effect of irrigation scheduling and the interaction among salinity and irrigation scheduling on grain quality either in the first or the third year under study.
Exogenous applications of growth hormones and osmolytes have been found to be effective to cope against the negative impacts of soil and water salinity. The role of plant growth regulators and osmoprotectants under salt stress is important in modulating physiological responses leading to adaptation to such unfavorable environments. Accumulation of osmolytes under low water potential conditions, such as those occurring soils with elevated salt concentrations, helps to maintain the plant water status in a process known as osmoregulation [76]. More than 20 years ago, osmoprotectants were chemically grouped as amino acids (proline), ammonium compounds (glycine betaine), polyols and sugars (mannitol, dononitol, trehalose, fructans) [77]. In a recent study, osmoprotectants were classified into two major groups, namely organic (eg. glycine betaine, proline, sugars, and proteins) and inorganic (eg. Ca, K, PO4, NO3, SO4) osmoprotectant solutes preserving water without impairing the regular metabolism of the plant [78]. Among them, proline, glycine betaine, and mannitol are commonly found in cytosol and chloroplast in plants. Under stressed environments, exogenous application of osmoprotectants act to maintain the regular plant cellular functions [79, 80, 81], by playing key roles in regulating the enzyme activity, ROS homeostasis, maintaining the membrane integrity, and balancing the ionic transport across the cell membrane [82].
The exogenous application of gibberellic acid (GA) and cytokinin (CK) at the maize vegetative stage was effective to remediate the damage in the cellular membranes of maize plants subjected to water deficit stress [83], by decreasing the electrolyte leakage and lipid peroxidation [84].
Similarly, exogenously applied GA, CK and auxin improved the tolerance to water deficit resistance in maize plants growing in saline soils by mitigating the membrane oxidative damage and improving the overall plant water status [85]. Moreover, application of GA, Indole-acetic acid and proline combined with organic amendment enhanced heavy metal tolerance and increased protection against oxidative stress in maize compared to non-applied control, thus providing a promising approach as an osmoprotectant that could be used in saline soils [86].
Salicylic acid (SA) plays dual roles as both a plant growth regulator and an antioxidant, improving crop performance under abiotic and biotic stresses [87, 88]. Salicylic acid-induced antioxidant system was reported in maize in water deficit environments [89]. Foliar application of SA in maize has a potential to increase the relative water content and membrane stability index in maize grown under water deficit environments [90]. Moreover, in salt stressed maize plants, exogenous application of SA improved plant growth, antioxidant enzyme contents and stabilized the overall photosynthetic process [91]. In this regard, foliar application of SA in maize seedlings reversed the negative impacts of soil salinity in the plant gas exchange, rubisco activity and photosynthetic efficiency [92, 93], while also increasing the production of soluble sugars, proline and nutrient uptake particularly K+ [94]. When SA was applied to roots, increases in the photosynthetic rates, gas exchange levels, and internal CO2 exchange and grain yield of maize were observed in saline soils [95, 96]. Pre-treatment of maize seeds by exogenous application of SA (2 mM) exhibited improved seedling emergence and stand establishment maize [97].
The exogenously applied methyl jasmonate (MeJA) can ameliorate the plant tolerance to abiotic stresses such as drought and salinity by enhancing the defense-oriented metabolism of plants [98, 99]. Pre-treatment of maize seeds with MeJA can suppress the harmful effects of water stress by maintaining the total protein, proline, carbohydrate contents and antioxidant activities under saline conditions [100]. Additionally, seed and foliar pre-treatments with exogenous MeJa showed positive effects on drought-induced oxidative stress responses of maize seedlings by modulating the levels of osmolytes, endogenous abscisic acid (ABA), and the activities of antioxidant enzymes [101].
The occurrence of an even and fast germination process has long been considered as a critical stage for final yield determination in most crops [102]. The seedling stage of maize plant is more sensitive to salinity [103] than mature stages [104]. Seed priming entails pre-sowing seed treatment with different priming agents including water, growth regulators [105], which facilitates the germination process by increasing the energy metabolism of the plant, promoting a more efficient mobilization of food reserves, enhancing expansion of the seed embryo [106], inducing formation of stress-responsive systems such as heat shock proteins, catalase and other antioxidant scavenging enzymes and upregulating the genes encoding peroxiredoxin [2, 107]. Increased germination rate and vigorous seedling establishment have been documented for primed seeds especially hydro-priming, and priming with growth regulators [108, 109]. The use of seed priming in the form of inorganic chemicals, plant extracts or microorganisms is one of the most efficient technologies to improve the germination rates and the synchronization of seedling emergence in plants [110]. Seed priming technique tend to boost water status of the seed which leads to activation of the pre-germination metabolism of the seed. In the second stage, the seed is dried to prevent radicle emergence before seed sowing [111].
Seed priming techniques utilize different osmotic solutions as seed priming agents including inorganic salts, sugars, growth regulators and polyethylene glycol [111]. Broadly, there are two seed priming techniques, known as uncontrolled hydration or hydro-priming [112], and controlled hydration, which includes methods such as osmotic priming, solid matrix priming, and hormonal priming [113]. Among others, polyethylene glycol (PEG), chlorides, sulphates, nitrates, glycerol, sorbitol have also been commonly used as osmotic priming agents having germination enhancing effect for different cereals including maize [23].
Nutrient priming with various inorganic compounds has been effectively applied to enhance germination and growth of maize under saline environment. For example, KNO3 has shown better establishment of seedlings at low temperatures in maize [114]. Micronutrients have been reported as nano-seed priming agents for boosting germination percentage and seedling development and vigor [115]. Also, priming maize seeds with NaCl before sowing induced physiological and biochemical changes thereby enhancing salinity tolerance and better performances under varying degree of saline environments [116]. Priming of maize seeds with CaCl2 increased the germination rate, and both the fresh and dry biomasses of plumules and radicles in maize compared to untreated control and hydro primed seeds under salinity stress [117]. Further, authors measured significantly higher concentrations of Na+, K+ and Ca2+ in growing seedling tissues when seeds were primed with inorganic salts such as NaC1, KCI, or CaC12 [117]. Maize seeds priming with 1% ZnSO4 exhibited improved plant growth, increased final grain yield and enriched Zn2+ contents in seed on soils with limited Zn2+ availability, and a more efficient translocation of Zn2+ to growing shoots during germination and early seedling development [118], in saline environments. Moreover, use of Zn as a seed primer increased the accumulation of Zn2+ in the aleurone layer of maize seeds, and resulted in a higher plant biomass production and mineral nutrient uptake in plants subjected to salt stress [119].
Maize seeds primed by SA (2 mM) exhibited improved seedling emergence and establishment maize under salt stress [97]. Kinetin and indole acetic acid application on foliage negate the harmful effects of salt stress, while it does not affect maize plant salinity resistance. In addition, the salt content increases the sodium concentration in corn leaves at the disbursement of potassium and calcium, while kinetin and indole acetic acid foliar applications correct these effects and raise the potassium and calcium content in the leaves. Thus, 2 mM concentration of kinetin and indole acetic acid foliar application counteracted the adverse effects of salt on maize growth and yield by increasing membrane permeability and absorption of essential nutrients [40]. Yang et al. [120] reported that exogenous application of glycine betaine on maize plant under salt stress enhanced growth, net photosynthesis, leaf water content, and quantum yield of photosynthesis.
In the recent past, molecular marker-assisted selection and other biotechnological techniques are being used in the context of the physiological basis of stress tolerance along with conventional breeding strategies to increase tolerance to abiotic stresses (heat, drought, and salinity) in maize. However, poor success in establishing maize cultivars tolerant to stress is mainly due to poor screening and selection techniques, poor selection criteria, and poor understanding mechanism of stress tolerance. However, some reports, in other species, are available which demonstrated the successful use of molecular marker for the development of tolerant cultivars against abiotic stresses [121]. As an illustration, the maintenance of potassium homeostasis in salt-tolerant plants was regulated by
The scope of breeding for the salinity, heat and drought is limited due to less selection efficiency, inadequate screening techniques, and the minimum understanding of the interaction between environment and stress. Now the molecular marker technology is helpful to develop the new maize cultivars with improved traits. However, the reasonable way at this stage is the improvement of transgenic maize with enhanced resistance against heat, drought and salt stresses. The high-throughput integrated approaches that are provided by the genomic technologies are helpful to examine the expression of the genes for all abiotic stresses including drought [2]. Microarray profiling under drought stress effects has been studied in different plant species i.e.,
Gene Family | Gene | Tolerance Mechanism | Reference |
---|---|---|---|
WRKY | Overexpression of | [125] | |
Upstream intergenic regions from each gene that were sufficient to confer stress-inducible expression on a reporter gene; W-box in their upstream regions also might be responsible to confer salt tolerance | [126] | ||
MYB | Overexpression of | [127] | |
Ectopic expression of | [128] | ||
AP2/ERF | Overexpression of | [129] | |
bZIP | Overexpression of | [130] | |
Overexpression of | [131] | ||
[132] |
Transcription factors mediated salinity tolerance in maize.
The changing climate scenario has worsened the salinity problem while global warming has caused significant increase in salt affected lands and thus has jeopardized the food security of millions of people across the globe. As a C4 plant, maize can moderately tolerate salinity; however, the initial growth stage of maize is highly sensitive to salinity stress. The adverse effect of salinity can be mitigated through understanding the adaptability of maize in saline environments. Several seed enhancement and genetic approaches can be adapted to overcome the adverse effects of salinity stress. Among them, biological enhancement through seed priming, application of antioxidants and growth hormones, genetic and molecular techniques for development of tolerant cultivars, and several agronomic management practices such as optimizing sowing time and seed rate etc. can be useful to cope with the adverse effect of salinity. Ultimately, these approaches have the potential to multiply maize production and nutritional quality in saline environments under current and future scenario of climate change.
The authors declare no conflict of interest.
Hepatitis A is a viral disease whose prevention is possible through improvements in the population’s basic sanitation conditions and vaccination.
The incidence, even in developing countries, has been reduced since the introduction of vaccines against hepatitis A.
The vaccine is recommended in two doses for children, starting at the age of 1.
Argentina and, more recently, Brazil have adopted the universal vaccination of all children upon 12 months of age in a single-dose regimen.
While dealing with hepatitis A diagnosis, be aware of the signs of acute hepatic encephalopathy, because although it is a rare complication, it may require hepatic transplantation.
\nHepatitis A is an acute viral disease caused by the hepatitis A virus (HAV), a picornavirus that infects only primates and has a low mutation rate compared to the other viruses capable of causing acute viral hepatitis [1, 2, 3].
\nThe hepatitis A virus is transmitted by the fecal-oral route, either through ingestion of contaminated food [1] and water [4] or person-to-person contact. It has the ability to survive on surfaces for up to 60 days, and it is relatively resistant to alcohol and ether. As a result, the hygiene of bathrooms and toys in day care facilities must be meticulous [2, 5, 6].
\nThe disease endemic character is related to poor sanitation conditions. That explains why its prevalence is higher in developing countries, where children generally become infected during the first years of life. That justifies the predominance of the asymptomatic form of the disease in such places [2].
\nAlthough it is related to inadequate sanitation conditions, there are records of the disease even in developed countries where the major concern is the people, mainly adults, who travel to exotic locations or developing countries. Besides that, some outbreaks due to food contamination are also described. Adult’s disease, unlike the one that occurs in children, is symptomatic in 80% of cases [2]. Fortunately, since the introduction of vaccines, there has been a progressive decrease in the number of the cases of hepatitis A [7].
\nHepatitis A virus (HAV) is one of the five etiological agents of viral hepatic inflammation (HAV, HBV, HCV, HDV, and HEV), whose incidence, according to the WHO, is sporadic and occurs in the form of epidemics around the whole world, which tend to present cyclical recurrences [8]. It belongs to the genus
HAV is described as being a naked virus; however, there is evidence that it can be released from a preinfected cell, through a non-lytic path, inside a small extracellular vesicle whose membrane surrounds the entire capsid and provides protection against the mechanisms of the host immune system [10].
\nThe HAV presents as a genetic material a single-strand RNA with positive polarity, which confers the ability to act as messenger RNA (mRNA) and to interact directly with the ribosome to initiate the synthesis of the viral proteins. Its genome is divided in three parts [11]:
Noncoding region 5′UTR covalently linked to viral protein VPg [11]
A single open reading frame (ORF) subdivided into P1, which encodes the viral capsid proteins (VP1, VP2, VP3, and VP4), and P2 and P3, which encode nonstructural proteins that act during viral multiplication [11]
Noncoding region 3′UTR which has a poly-A tail [11]
The HAV is transmitted through fecal-oral route; the individual becomes infected from the ingestion of water and food contaminated by fecal material from another individual who had been previously infected.
\nAfter ingestion, the virus falls into the blood vessels and, through the portal circulation, reaches the hepatocytes. The first contact occurs through the basolateral membrane of the hepatocytes in the space of Disse [9]. After the processes of adsorption, penetration, denudation, and synthesis of viral genome and viral proteins, the virus is assembled and released from the host cell through a non-cytolytic process and undergoes cell exocytosis [12]. This release can occur through the apical membrane of the hepatocyte, which will cause the new virus to go to the bile canaliculi and, consequently, be sent to the intestine along with the bile. In addition, the release can also occur by the basolateral membrane, which causes the virus to return to the bloodstream [10, 12].
\nAfter being sent to the intestine, the virus will be sent to the external environment through the feces. During excretion, a large amount of virus is eliminated. This starts about 10 days before the onset of clinical manifestations [13]. The period of greatest transmissibility occurs between the previous 15 days and 7 days after the onset of symptoms [4].
\nThe immune response built by the host leads to the destruction of the hepatocytes infected by the virus and causes the appearance of the symptoms and signs of the disease. The HAV’s slow replication does not appear to cause cytopathic effects [13].
\nIt is possible that several mechanisms are involved in the development of signs of the disease. In one study fibroblasts and peripheral blood lymphocytes from patients with acute hepatitis A were used to demonstrate that the IFN-γ produced by HAV-specific cytotoxic T lymphocytes might play an important role in the pathogenesis of the disease [14].
\nAnother analysis evidenced the presence of IFN-γ, TNF, IL-2, and IL-21 produced by polyfunctional CD4 + T cells. These results place the immune response modulated by CD4 + T lymphocytes as being more crucial in the control of HAV replication [15].
\nIn contrast to studies that propose that adaptive immunity is more important in the pathogenesis and resolution of hepatitis A, it has been proposed that cells of the innate immune system, especially natural killer and lymphokine-activated killer (LAK) cells, play a crucial role in hepatic cell damage, which is inflicted prior to that performed by cytotoxic T lymphocytes [16].
\nIn addition, there is an antibody-mediated response. HAV-specific immunoglobulin M (IgM) antibody and IgA antibodies can be detected, from the onset of the first clinical signs, in the patient’s serum or plasma during the acute phase of the disease. IgG antibodies appear 1 week after the onset of the disease and can be detected for years even after healing. IgG can also be detected in vaccinated individuals. IgM and IgG immunoglobulins can neutralize the virus by recognizing epitopes of the HAV’s structural proteins, VP1, VP2, and VP3, located in the capsid [17].
\nThe hepatitis A virus is distributed worldwide. However, the highest incidence of hepatitis A occurs in developing countries and in the ones with poor health conditions. In developed countries the disease acquired by traveler accounts for almost half of the cases reported.
\nThe introduction of universal vaccination of children can change this general picture. The implementation of this program may reduce the rate of seropositive children against hepatitis A virus [18].
\nLuxemburger and Dutta show Brazil as a country with high endemicity of hepatitis A, meaning that more than 90% of children between 5 and 14 years old were seropositive for hepatitis A [19].
\nAfter that date there have been modifications in epidemiology of this disease. Checking the Epidemiological Bulletin of the Ministry of Health of Brazil in 2018, it’s possible to notice that after 2007 the incidence rate of hepatitis A has shown a progressive tendency of falling, going from 7.1 cases to 1.0 per 100,000 inhabitants in 2017.
\nBetween 1997 and 2017, most cases of hepatitis A occurred in children under 10 years of age (53.8%). In the last 2 years, there has been not only an increase in the incidence of the disease among people from 20 to 39 years of age but also a modification in the route of contamination. There was a significant reduction in cases related to food contamination and an increase in those related to sexual transmission. The incidence reduction preceded the universal vaccine. Universal vaccination of children from 12 months onwards was introduced in Brazil’s vaccination calendar only in 2014 [20].
\nIn relation to hepatitis A mortality in Brazil, between 2000 and 2016, there were 1125 deaths associated with viral hepatitis A. There is no data yet to compare mortality after the onset of the universal vaccine of Brazilian children [20]. Considering the distribution of deaths associated with all viral hepatitis in Brazil between 2000 and 2016 (66,196 obits), the proportion of obits was 1.7% associated with viral hepatitis A; 21.4% to hepatitis B; 75.8% to hepatitis C; and 1.1% to hepatitis D. In the document there is no report of viral hepatitis E [20].
\nRecently, the person-to-person HAV outbreaks involving people who use drugs or people experiencing homelessness are ongoing in United States, and this could signal a shift in HAV infection epidemiology in the United States [21].
\nThe virus’s incubation period is long (15–50 days), and the first symptoms are non-specific and reminiscent of common viral disease. The following may be present: fever, malaise, headache, and abdominal pain. Eventually, jaundice, hepatomegaly, splenomegaly, and bradycardia can appear. The icteric phase has a variable duration, on average from 4 to 30 days, and is associated with dark urine and acholic stools. Laboratory elevation of aminotransferases and direct hyperbilirubinemia is observed [2].
\nHepatitis A can have different forms of evolution, although most patients progress to healing within 2 months. Approximately 10% of hepatitis A patients present a biphasic form, in which relapses are observed in the first 6 months of evolution. Other forms considered atypical [6] may also be observed as the prolonged form, in which the symptoms persist for up to 120 days [22], and the cholestatic form presents the following alterations: elevation of the direct fraction of bilirubin, presence of significant pruritus, malabsorption of nutrients, and weight loss. Fortunately, all these forms present evolution for healing. Only a small fraction of patients will develop acute liver failure that is associated with increased morbidity and mortality [22].
\nAccording to CDC [23], suspected hepatitis A occurs in the presence of a suggestive clinical picture, characterized by the presence of fever, headache, malaise, anorexia, nausea, vomiting, diarrhea, abdominal pain, or dark urine, associated with suggestive laboratory alterations of the direct bilirubin fraction or ALT > 200 IU/L, in the absence of another diagnosis that explains such alterations.
\nThe presence of immunoglobulin M (IgM) antibody against hepatitis A virus or viral RNA detection provides laboratory evidence for the diagnosis [23].
\nThe presence of sensorineural alterations should raise the suspicion of acute liver failure, and the diagnosis is confirmed if there is an association of sensory alterations with a high prothrombin time in more than 4–6 s (INR ≥ 1.5) [24, 25].
\nHepatitis A has no specific treatment, and usually only support and monitoring measures are adopted. Although the disease is self-limiting in the vast majority of cases, some patients develop severe hepatitis, which can lead to fulminant hepatic insufficiency, and need liver transplantation.
\nThe fulminant hepatic insufficiency diagnosis should be considered in those patients with viral hepatitis who present any alteration of consciousness accompanied by some coagulation disorder [23] characterized by INR ≥ 1.5. Those findings indicate hospitalization of the patient in an intensive care unit with possibility of transfer to a liver transplant center.
\nIt is important to be aware of the fact that the symptoms of fulminant hepatic insufficiency become noticeable late when most of the liver functions are already compromised [26]. And so, the patient need to be transferred to a transplant center as soon as possible if he or she presents metabolic acidosis with arterial pH < 7.3, arterial lactate > 3 mmol/L (27 mg/dL), INR > 6.5, creatinine > 3.4 mg/dL, and presence of grade 3 or 4 hepatic encephalopathy all within the 24-h period [25].
\nSpecial attention should also be given to the child who evolves with the cholestatic form due to the nutritional risk secondary to malabsorption of fat-soluble nutrients and vitamins. During disease, until the cholestasis is fully treated, it may be necessary to provide increased caloric intake in addition to vitamins A, D, and E. Nutritional care should be maintained until cholestasis improves [27].
\nThe Brazilian Ministry of Health advices that the prevention of the disease is best achieved by improving basic sanitation and personal hygiene conditions as follows [28]:
Wash the hands after going to the bathroom and before eating or preparing food [28].
Wash, with treated water, foods that are consumed raw [28].
Cook the food before eating it [28].
Wash dishes, glasses, cutlery, and bottles properly [28].
Avoid the construction of ditches near wells and river springs, so as not to compromise the water table that feeds the well [28].
If there is a patient with hepatitis A at home, use 2.5% sodium hypochlorite, or bleach when washing the restroom [28].
In nurseries, preschools, cafeterias, restaurants, and closed institutions, adopt strict hygiene measures, such as disinfection of objects, benches, and floors using 2.5% sodium hypochlorite or bleach [28].
As a prophylactic measure for travelers, the vaccine has replaced immunoglobulin (Ig). The protection achieved by Ig when used before exposure is approximately 80–90% [20], whereas a single dose of hepatitis A vaccine provides protection of 85% of cases in the first 6 weeks and up to 95–00% after this time period [29]. Postexposure prophylaxis (PEP) with hepatitis A vaccine prevents hepatitis A virus infection when administered within 2 weeks of exposure [25, 30]. The use of Ig for PEP is indicated in the following situations: children aged <12 months; immunocompromised people; patients with chronic liver disease; and those for whom the vaccine is contraindicated. For people over 40, immunoglobulin is preferred, but the vaccine can be used on a non-distant immunoglobulin obtained [25, 28]. The recommended dose of IG was modified to 0.1 mL/kg [30].
\nPre-exposure prevention for travelers aged 12 months to 40 years should be given by vaccination as soon as traveling to endemic sites is considered, and the second dose should be administered at the regular interval recommended by the vaccine manufacturer. The vaccine can be administered between 6 and 11 months for pre-exposure prophylaxis, but this dose should not be considered when the child initiates the usual vaccination schedule at 12 months of age. In the case of infants <6 months of age, Ig should be given. The dose in these cases depends on the duration of the trip: for trips with a duration of up to 1 month 0.1 mL/kg is recommended; and with longer duration, the dose will be 0.2 mL/kg repeated every 2 months until the end of the trip. Travelers aged >40 years, immunocompromised or with chronic liver disease, are recommended to be vaccinated against hepatitis A and use Ig at the dose of 0.1 mL/kg at the same time but applied at separate sites [30].
\nSince the introduction of vaccines, there has been a reduction in the prevalence of the disease. The vaccine is effective, even if given as a single dose, although it is usually recommended in two doses. The initial dose should be administered at 1 year of age, especially in endemic areas where contact with the virus is early. The booster dose may occur at varying intervals, usually 6–18 months after the first dose.
\nThe effectiveness of the single-dose vaccine was initially described among people vaccinated for travel to exotic locations or with inadequate sanitary conditions [31, 32]. In 2003 a randomized, double blind study in Nicaragua showed that one dose of the vaccine had good efficacy, reaching up to 100% of children after 6 weeks (95% CI: 79.8–100%) [29].
\nYoung children who present hepatitis A are asymptomatic and therefore able to spread the virus in the community. That is why universal vaccination of all children between 1 and 5 years of age is recommended in populations where the incidence of the disease is >20 cases/100,000 inhabitants. The monovalent vaccine (Havrix®, Vaqta®) should be administered via intramuscular injection in two doses at a 6- to 12-month interval between doses [21, 25].
\nIn 2005, Argentina adopted a universal vaccination schedule for children aged 12 months in a single dose, and since then the incidence of hepatitis A has decreased by >80% in all age groups [33, 34].
\nFor developing countries, this may be a cheaper and simpler strategy than two-dose schedules; however, it is necessary to deploy a surveillance system to determine in the long run whether the booster dose will be needed [34].
\nIn Brazil, the hepatitis A vaccine was added to the national immunization program (NIP) only in 2014. Universal vaccination of children with a single dose of the inactivated vaccine was adopted at 12 months of age. In an official document, the NIP undertook to monitor the epidemiological situation of hepatitis A, aiming at the definition of whether or not to include a second dose in the child’s immunization schedule [35].
\nThe United Nations (UN) reports that viral hepatitis is a serious threat to global health, mainly related to hepatitis B and C viruses that cause chronic liver disease. The UN estimates suggest that 325 million people are infected worldwide, with 70 million on the African continent alone. Although the reports focus on hepatitis B and C because of their chronicity, the UN and WHO are committed to reducing hepatitis A-related deaths by 10 percent by the year 2030. According to the WHO, viral hepatitis A is a viral infection of the disease. It can be eliminated from Africa with vaccination and improved sanitation and access to safe drinking water. This latter measure may also reduce the incidence of viral hepatitis E [36, 37].
\nIn order to make vaccination against HAV feasible for developing countries, it is necessary to evaluate effective and cost-effective strategies. Vizzotti et al. [38] evaluated the impact of single-dose vaccination in Argentina and found an impressive decline in hepatitis A cases accompanied by a decrease in medical and nonmedical costs in the first 5 years. The authors then suggested that this could be a simpler and less costly strategy thus becoming an economically viable alternative to other countries where hepatitis A is also endemic.
\nSince both the world population and the life expectancy are increasing, it’s imperative that new techniques, fast, accessible, and sensitive ones, are developed in order to guarantee accurate diagnosis and proper treatment to anyone who is suffering from a disease. With new technologies being released in a daily basis and several researches being done in fields like molecular diagnostics, immunodiagnostics, and gene therapy, it’s possible that this goal may be achieved within the following decades.
\nSo as to improve the diagnosis of hepatitis and several other diseases, either through the detection of pathogens or elements present due to the host’s immune response, it’s essential that new, highly sensitive tests become available in healthcare facilities, especially in endemic regions.
\nOne possibility is to use new techniques that are being developed and allow the detection of antibodies. One example is the capacitive immunosensor developed to detect anti-Zika virus and anti-chikungunya virus antibodies in low concentrations using microwire electrodes [39].
\nAnother possibility is to use the CRISPR-Cas technology to detect the pathogen’s genetic material. This technique was developed based on the analysis of a specific defense mechanism of bacteria and archaea, organisms in which clusters of regularly interspaced short palindromic repeats (CRISPR), a specific region of the DNA, are transcribed into CRISPR RNA (crRNA) when they are infected by viruses [40, 41]. When the crRNA and the trans-activating crRNA (tracrRNA) associate with Cas9, an enzyme, the crRNA-Cas9 complex will then target a foreign DNA and cut it [40, 41].
\nStudies have shown that, through modification, the CRISPR-Cas complex is capable of targeting RNA [42] and adapting to different intracellular environments, such as the eukaryotic one [43]. Other experiments with CRISPR-Cas demonstrate that it can detect both Zika virus and dengue virus, RNA viruses [44]. Besides, this last analysis has also shown that a test based on this technique would be fast and sensitive and the costs would be low [44].
\nRegarding the treatment, some studies have shown that genome editing using the CRISPR-Cas system might also allow the development of effective antiviral therapies. Experiments done in vitro using human cells demonstrate that this system can target herpesvirus and provide either clearance of some strains of this virus or cause decay in other strains’ replication [45]. Another work, by demonstrating that the CRISPR-Cas system was able to inhibit the accumulation of hepatitis B virus (HBV) DNA in human cells, has shown that this system has the capacity to be developed into an effective therapy for viral diseases [46].
\nNevertheless, to ensure a decrease in the number of people infected with hepatitis, it’s also important to develop strategies to prevent the spread of the virus. Since hepatitis A is transmitted through a fecal-oral pathway, to achieve this goal, it’s essential that the water used by the population receives proper treatment in order to guarantee that all the pathogenic organisms are eliminated. In this context, water and sanitation projects developed by humanitarian organizations can contribute to the decrease in the number of people infected with fecal-oral transmitted diseases.
\nSome examples are the water safety plans (WSPs), created by the World Health Organization, and the Sustainable Development Goal 6, created by the United Nations. The former focusses on assembling a team that will develop a WSP considering all the hazardous events that can affect the safety of a water supply so as to determine and validate control measures that will be used to develop and implement improvements, which ensure that the drinking water supply is safe and accepted by the population [47]. The latter sets the goals for the following decades and analyzes indicators in order to monitor and promote the implementation of plans of action made to ensure universal and equitable access to safe and affordable drinking water for all, access to adequate and equitable sanitation, hygiene for all, end open defecation [48], and several other measures that can help control fecal-oral transmitted diseases.
\nHepatitis A is a viral disease whose prevention is possible through improvements in basic sanitation and vaccination of the population. The vaccine provides good protection and is recommended in two doses for children, starting at the age of 1 year. The efficacy of the single-dose vaccine has been reported between people traveling to exotic locations and then by developing countries that have adopted this single-dose schedule. In those places where the single-dose schedule has been adopted, a surveillance system should be in place to determine whether the booster dose will be necessary over the long term. Patients with hepatitis A present evolution to the healing in the majority of the cases, but it is necessary to be aware that, in rare occasions, they can develop acute hepatic insufficiency, which is associated to greater morbimortality.
\nThe authors declare no conflict of interest.
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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:"5",type:"subseries",title:"Parasitic Infectious Diseases",keywords:"Blood Borne Parasites, Intestinal Parasites, Protozoa, Helminths, Arthropods, Water Born Parasites, Epidemiology, Molecular Biology, Systematics, Genomics, Proteomics, Ecology",scope:"Parasitic diseases have evolved alongside their human hosts. In many cases, these diseases have adapted so well that they have developed efficient resilience methods in the human host and can live in the host for years. Others, particularly some blood parasites, can cause very acute diseases and are responsible for millions of deaths yearly. Many parasitic diseases are classified as neglected tropical diseases because they have received minimal funding over recent years and, in many cases, are under-reported despite the critical role they play in morbidity and mortality among human and animal hosts. The current topic, Parasitic Infectious Diseases, in the Infectious Diseases Series aims to publish studies on the systematics, epidemiology, molecular biology, genomics, pathogenesis, genetics, and clinical significance of parasitic diseases from blood borne to intestinal parasites as well as zoonotic parasites. We hope to cover all aspects of parasitic diseases to provide current and relevant research data on these very important diseases. In the current atmosphere of the Coronavirus pandemic, communities around the world, particularly those in different underdeveloped areas, are faced with the growing challenges of the high burden of parasitic diseases. At the same time, they are faced with the Covid-19 pandemic leading to what some authors have called potential syndemics that might worsen the outcome of such infections. 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