Internet users statistics for Africa as at March 2019.
\r\n\tFurthermore, during the preparation of high-quality dairy products, several physical, chemical, enzymatic, and microbial transformations take place. We will consciously focus on this interaction of different constituents of milk under different processing conditions for the development of the products.
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Veena has been involved in different research projects such as Milkfed (Punjab), ICAR, DST, and RKVY as PI and Co-PI. She has published 17 research papers in peer-reviewed journals, edited 2 books, and authored 13 book chapters, 15 popular articles, and 7 practical manuals. She is a member of various professional bodies such as the SASNET-Fermented Foods, the Indian Dairy Association, the Association of Food Scientists and Technologists (India), and the Dairy Technology Society of India.",coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"107905",title:"Prof.",name:"Salam",middleName:null,surname:"Ibrahim",slug:"salam-ibrahim",fullName:"Salam Ibrahim",profilePictureURL:"https://mts.intechopen.com/storage/users/107905/images/system/107905.jfif",biography:"Dr. Salam A. Ibrahim is a food science research professor in the food and nutritional sciences program at North Carolina A&T State University. 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Thus, modern communication technologies or information and communications technologies (ICTs) have been ascribed to not only improving efficiency or productivity in the business world but also with improving the standard of living for the global citizens. One of the strategies is the application of e-governance which entails the use of Information and communication technologies (ICTs) in managing governmental business in the region. Information and communication technologies (ICTs) were the stimuli behind the economic, political and social revolution since the invention of the digital computer (mid-1940s), which were accelerated with the advent of the Internet (the early 90s). Currently, the work of public institutions depends increasingly more on the technical and architectural choices that are made at the level of technology. Most of the principles of good governance are expressed in the roles of e-government; in other words, focus on transparency, openness, citizen participation, effectiveness, efficiency, accountability and the likes [1]. The implementation of e-governance to carry out public services has become a global drive in public administration. It is aimed to develop a robust environment for efficiency in managing public affairs. Since 1960s through 1970s, as information technology emerged, it has been envisaged that the use of modern technology would bring revolution to the way and manner of running governmental businesses. As information communication continues to dominate the space of all organizations especially in the 1980s and 1990s, the political office holders’ arrogated recognition for the implementation of information communication technologies (ICTs). Toward the beginning of twenty-first century, the application and the use of ICTs became more popular among the citizens and public officials [2].
In the management of public affairs, corruption has been recognized as one of the dominant problems in promoting economic growth and the welfare of the citizens [3]. Corruption has been acknowledged as a fundamental challenge to good governance and development, habitually embedded in the Global South. Although, it is not only restricted to the region, nonetheless, chronic poverty, conflict and discrimination embedded in developing states are accredited to be responsible for promoting corruption [4]. To combat the increasing level of corruption in developing nations, there are sundry measures put in place to checkmate the syndrome in the public sector. One of such approaches is the e-platform which provides a modern approach to promote anti-corruption agenda, resulting in accountability and transparency in the overall management of public affairs [1]. Thus, e-governance should be considered as a digital mechanism for mitigating corrupt practices in the public sector. Accessible public information for all citizenry can bring about transparency, which limiting public official to demand or accept bribe. One of the major approaches in reducing corruption in the public sector is to limit interaction between the citizens and public officials. This can ensure not only providing accessible information regarding government activities but removing the bureaucratic bottleneck inherent in public administration. Even though e-governance is not the first and last method to be employed for anti-corruption campaign in the public sector, it is being practiced very efficiently in the developed countries and in a few developing countries as well. In general, both developed and developing countries have succeeded much in implementing e-governance, although with relatively uneven attainments. Their efforts to apply the tools and strategies of e-governance have been visible since the last couple of decades. There are countries especially in Asia which have effectively utilized e-governance in reducing corrupt practices and promote good governance. These include The Republic of Korea, Singapore, Japan, Israel, Bahrain, Malaysia, and Sri Lanka [5]. There are other countries in developing nations that have embarked on such a giant stride to fight corruption, albeit they have lagged behind in the effective implementation of e-governance. International organizations such as Transparency International (TI), United Nations Development Programme (UNDP) and World Bank (WB) among others have reinvigorated the need to implement modern technology against the traditional approach in managing government activities [4]. Therefore, this chapter aims to provide the nexus between e-governance and anti-corruption strategies in Africa by exploring the application of e-governance in Nigerian anti-corruption campaign.
The traditional concept of governance emerged from the Greek language (κυβερνᾶν), which connotes “to steer”. The concept transcends a mere existence of government. In all societies, people employ governance in their daily lives to manage human relationship, interaction and activities. In this context, the use of governance can be metaphorically referred to steering of a ship. Actually, steering of a ship requires navigation toward a particular direction, and this necessitates an existence of seamanship who is saddled with the responsibility of navigating the ship toward certain destination. Thus, governance as a process requires steering of people toward development [6]. Moreover, governance is the capacity of the government to steer society [7]. Nonetheless, to avoid absolutism and self-steering capacity of the appointed/elected leaders, the modern perspective of governance requires peoples’ participation in decision making process. The conceptualization of governance in a modern expression stipulates citizens’ involvement in public decision making. This makes governance a participatory task by both the ruler and the ruled. The participation of every citizen in allocating and managing public resources defines the modern approach of governance across the globe. According to World Bank, governance implies the management of social, political and economic affairs for sustainable development. The World Bank acknowledged three fundamental elements of governance which include the nature of political regime; the strength and ability of the governments to effectively formulate, implement and discharge responsibilities; and the way and manner the regime in power manage the social and economic resources for development [8]. Therefore, governance entails institutional environment in which individual citizen and the political actors interact and participate in the public decision making. It requires the management of public affairs in a transparent, inclusive, participatory, responsive and accountable manners. Allocating resources and judicious use of these resources for development purpose becomes sacrosanct [9]. Hence, it can be argued that governance articulates and accommodates both the formal and informal actors in public decision making. This is to facilitate equal participation in a more inclusive, transparent and accountable management of public resources guided by the rule of law.
In line with the above, the digital revolution which provides transformation in all human societies delineates the concept of governance from primordial model to a modern perspective which indulges the application of information communication technologies (ICTs) in public decision making. e-Governance as a concept emerged at the inception of 21st century in the management of public sector. There is a paradigm shift from traditionalism to modernism in public administration. The emergence of e-governance therefore radicalized the nature of doing governmental businesses around the world. This opportunity paves way for a new path in conducting and managing public affairs, and this introduced e-services in public sector. Thus, e-governance has been acknowledged as capable of increasing the impact of government on the people [2]. e-Governance implies political and civil operation of government using information and communication technologies (ICTs) by which both the government and citizens interact. It is a strategy employed by the government through the use of ICTs with the aimed of encouraging citizens to participate in governance and make the government more transparent and accountable to the general citizenry [10]. e-Governance entails the use of web-based internet application to interact with citizens, employees, other government agencies, associate or business partners. It encourages participation of every citizen in the government business through technological platform [11]. It has been further argued that “the application of information communication technology (ICT) by the government to enhance accountability, create awareness and ensures transparency in the management of governmental business”. It further explained that e-governance can be recognized as a political tool employed by government to promote public oriented services [12]. Therefore, it can be acknowledged from the above view that e-governance appears to be a paradigm shift from traditional model of carrying out governmental businesses which emphasizes compliance with the hierarchical chain of command to the application of internet that allowed the citizens to source for information on government services at their own convenience time which does not necessarily need physical presence in government offices. The primary focus of e-governance is to ensure that citizens have access to government services without direct contact with the public official. The service often delivered through government internet platform. It is believed that the use of internet will reduce the negative impression toward public officials that have been denounced as corrupt. The government websites provide a landscape for the citizens to interact with the government and receive feedback regarding the services provided by the government. In this context, e-governance has the potential to minimize corrupt practices in government establishment [13]. Thus, it can be argued that the major single focus of every e-governance project is to reduce corruption in the management of public affairs across the world.
Many governments around the world have chosen the path of e-governance to manage all government departments and agencies (Figure 1). This requires all activities and services provided by the government to be available online such as income tax, customs, property tax and sales tax. The government services are delivered through online platform to the citizenry. e-Governance often necessitates the centralization of data to improve audit and analysis. The inability of the public official to follow online procedures in the conduct of government businesses usually leads to exposure of such act. The citizen complains can also be recounted through e-platform created by government which often requires feedback from the appropriate authority. This environment may facilitate successive strategy to expose corrupt civil servants within the government agencies [11].
Definition of e-governance. Source: Misuraca [
In the world over, governments have supported the use of electronic means to provide cost effective services as well as improving the way and manner in which government businesses are carried out. As a result of global acceptance of this strategy, Africa has initiated policies, mechanism and programs toward ensuring effective implementation of e-governance in the region. e-Governance has been one of the key strategies to strengthening democratic governance and as an important instrument in achieving developmental agenda in Africa. The realization and implementation of e-governance has penetrated the social and political space in the region. This makes it possible for all the stakeholders to participate in governance processes. Moreover, the intra-governmental communication provided as a result of the implementation of e-governance makes it easier to reduce the cost of service and also provides wider reach to the general citizens [14]. Among the several strategies for the actualization of e-governance is the creation of websites, linking the citizens with the numerous services provided by the government – Federal, State and Local. The creation of websites therefore becomes interactive space where the citizens and the government can share their views regarding the activities of government while receiving feedbacks on the same platform. Some of the services available to the citizens range from birth certificate, identity card, voter’s registration, payment of tenement rate, taxes and levies etc. One of the countries that showcased e-governance capacity in the management of public is South Africa government. The web provides detail information about the government’s services. The South African government offers services within the following spectrum: services for the citizens; services for organization; and services for foreign nationals. The services to the citizens revolves around information concerning youth, education and training, retirement and old age, birth, social benefits, relationship, living with disability, parenting, death, citizenship, sports and recreation, law, transport among others. Services implying organizations include import and export, health and safety, labor related issues, business tax, transport, health and safety at work place, intellectual property among others. Information related to foreign national include immigration and working in South Africa. Similar features are also found in Kenya where the issues related to e-civil service, e-business, e-citizenship, e-education, e-taxes and revenue among several other categories [15]. A comparable features are found in Nigeria where activities such as tourism, drug administration, company registration, immigration, tax, investment, driver’s license, education, health, housing projects, corruption reporting, national identity management are embedded in government portal. Thus, it can be deduced that e-governance has facilitates citizen’s participation as well as reducing cumbersome nature of traditional mode of governance in Africa. The table and figures below reveals the population of internet users and the level of penetration as compared to the rest of the world.
From the above, Figure 2 reveals that Asia region constitutes 50.4% of the world internet users, it further shows that Europe has 16.5%. The data also found that Africa has 10.9%, Latin America and Caribbean 10.1%, North America 7.5%, Middle East 3.9% while Oceania and Australia constitutes 0.7%. In this context, Asia has the largest number of internet users across the world, followed by Europe. The implication of this as related to e-governance is that the more accessible internet is, the more the people interact with the government on electronic platforms. In Figure 3, the data shows internet world penetration rates by geographic regions. The data found that North America 89.1% which constitutes the highest level of penetration globally. This is followed by Europe which has 86.6%. Australia and Oceania has 68.0% while Latin America and Caribbean has 66.8%. The Middle East constitutes 65.8% while the world average is equated to 56.3%. Asia has 51.7% while Africa has 35.9% which is considered as the lowest rate when compared with other regions.
Internet users in the world by region as at March 2019.
Internet world penetration rates by geographic regions as at March 2019.
Table 1 shows the Internet Users Statistics for Africa as at March 2019. The table revealed all the countries in Africa with the divergence population, number of internet users, level of penetration and internet growth. In Figure 4, the data reveals internet users in Africa as at March 2019. It shows that Africa has 10.9% while the rest of the world constitutes 89.1%. In Figure 5, it shows the level of penetration rate in Africa compared to the rest of the world as at March 2019. The data reveals that Africa has 35.9% while world average constitutes 56.1%. The data further shows that 60.2% constitutes the rest of the world. This indicates that, there is a need to reduce the cost of access to digital technology in order to make it affordable for the wider segment of the population. In all, it is acknowledged that Africa has lagged behind in the implementation of digital technology, as indicates in the above data, many African nations have not fully implemented e-governance in managing public affairs. Even though some of these African nations have continually promote the use of ICTs in major government activities, it is believed that the affordability of digital technology will encourage the citizens to employ these platforms to interact more with the government especially regarding governance and anti-corruption campaign.
Africa | Population (2019 Est.) | Internet users 31-Dec-2000 | Internet users 31-Mar-2019 | Penetration (% population) | Internet growth % 2000–2019 |
---|---|---|---|---|---|
Algeria | 42,679,018 | 50,000 | 21,000,000 | 49.2 | 41,900 |
Angola | 31,787,566 | 30,000 | 7,078,067 | 22.3 | 23.493 |
Benin | 11,801,595 | 15,000 | 3,801,758 | 32.2 | 25.245 |
Botswana | 2,374,636 | 15,000 | 923,528 | 38.9 | 6057 |
Burkina Faso | 20,321,560 | 10,000 | 3,704,265 | 18.2 | 36,942 |
Burundi | 11, 575,964 | 3000 | 617,116 | 5.3 | 20,470 |
Cabo Verde | 560,349 | 8000 | 265,972 | 47.5 | 3225 |
Cameroon | 25,312,993 | 20,000 | 6,128,422 | 24.2 | 30,542 |
Central African Rep | 4,825,711 | 1500 | 256,432 | 5.3 | 16,995 |
Chad | 15,814,345 | 1000 | 768,274 | 4.9 | 76,727 |
Comoros | 850,910 | 1500 | 130,578 | 15.3 | 8605 |
Congo | 5,542,197 | 500 | 650,000 | 11.7 | 129,900 |
Congo Dem Rep | 86,727,573 | 500 | 5,137,271 | 5.9 | 1,027,354 |
Cote d’Ivoire | 25,531,083 | 40,000 | 6,318,355 | 25.6 | 16.246 |
Djibouti | 985,690 | 1400 | 180,000 | 18.3 | 12,757 |
Egypt | 101,168,745 | 450,000 | 49,231,493 | 48.7 | 10,840 |
Equatorial Guinea | 1,360,104 | 500 | 312,704 | 23.0 | 62,441 |
Eritrea | 5,309,659 | 5000 | 71,000 | 1.3 | 1320 |
Ethiopia | 110,135,636 | 10,000 | 16,437,811 | 14.9 | 164,270 |
Gabon | 2,109,099 | 15,000 | 985,492 | 46.7 | 6470 |
Gambia | 2,228,075 | 4000 | 392,277 | 17.6 | 9707 |
Ghana | 30,096,970 | 30,000 | 10,110,0001 | 33.6 | 33,600 |
Guinea | 13,398,180 | 8000 | 1,602,485 | 12.0 | 19,931 |
Guinea-Bissau | 1,953,723 | 1500 | 120,000 | 6.1 | 7900 |
Kenya | 52,214,791 | 200,000 | 43,329,434 | 83.0 | 21,564 |
Lesotho | 2,292,682 | 4000 | 627,860 | 27.4 | 15,596 |
Liberia | 4,977,720 | 500 | 4,028,418 | 80.9 | 805,583 |
Libya | 6,569,864 | 10,000 | 3,800,000 | 57.8 | 37,900 |
Madagascar | 26,969,642 | 30,000 | 1,900,000 | 7.0 | 6233 |
Malawi | 19,718,743 | 15,000 | 1,828,503 | 9.3 | 12,090 |
Mali | 19,689,140 | 18,800 | 12,480,176 | 63.4 | 66,283 |
Mauritania | 4,661,149 | 5000 | 810,000 | 17.4 | 16,100 |
Mauritius | 1,271,368 | 87,000 | 803,896 | 63.2 | 824 |
Mayotte (FR) | 266,380 | N/A | 107,940 | 40.5 | N/A |
Morocco | 36,635,156 | 100,000 | 22,567,154 | 61.6 | 22,467 |
Mozambique | 31,408,823 | 30,000 | 5,279,135 | 16.8 | 17,497 |
Namibia | 2,641,996 | 30,000 | 797,027 | 30.2 | 2557 |
Niger | 23,176,691 | 5000 | 951,548 | 4.1 | 18,931 |
Nigeria | 200,962,417 | 200,000 | 111,632,516 | 55.5 | 55,716 |
Reunion (ER) | 889,918 | 130,000 | 480,000 | 53.9 | 269 |
Rwanda | 12,794,412 | 5000 | 3,724,678 | 29.1 | 74,393 |
Saint Helena (UK) | 4096 | N/A | 2200 | 53.7 | N/A |
Sao Tome & Principe | 213,379 | 6500 | 57,875 | 27.1 | 790 |
Senegal | 16,743,859 | 40,000 | 9,749,527 | 58.2 | 24,274 |
Seychelles | 95,702 | 6000 | 67,119 | 70.1 | 1018 |
Sierra Leone | 7,883,123 | 5000 | 902,462 | 11.4 | 17,949 |
Somalia | 15,636,171 | 200 | 1,200,000 | 7.7 | 599,900 |
South Africa | 58,065,097 | 2,400,000 | 31,185,634 | 53.7 | 1199 |
South Sudan | 13,263,184 | N/A | 2,229,963 | 16.8 | N/A |
Sudan | 42,514,094 | 30,000 | 11,816,570 | 27.8 | 39,288 |
Swaziland | 1,415,414 | 10,000 | 446,051 | 31.5 | 4360 |
Tanzania | 60,913,557 | 115,000 | 23,000,000 | 37.8 | 19,900 |
Togo | 8,186,384 | 100,000 | 899,956 | 11.0 | 800 |
Tunisia | 11,783,168 | 100,000 | 7,898,534 | 67.0 | 7798 |
Uganda | 45,711,874 | 40,000 | 19,000,000 | 41.6 | 47,400 |
Western Sahara | 582,478 | N/A | 28,000 | 4.8 | N/A |
Zambia | 18,137,369 | 20,000 | 7,248,773 | 40.0 | 36,144 |
Zimbabwe | 17,297,495 | 50,000 | 6,796,314 | 39.3 | 13,492 |
Total Africa | 1320,038,716 | 4,514,400 | 474,120,563 | 35.9 | 10,402 |
Rest of World | 6,433,444,493 | 83.0 | 3,872,441,290 | 60.2 | 89.1 |
World Total | 7,753,483,209 | 100% | 4,346,561,853 | 56.1 | 100.0 |
Internet users statistics for Africa as at March 2019.
Source: The data was adapted from Internet World Stats. Available at https://www.internetworldstats.com/stats1.htm
Internet users in Africa as at March 2019.
Penetration rate in Africa as compared to the rest of the world as at March 2019.
Corruption is the abuse of public office for personal gain. Corruption may occur at any levels of government – local, state and national. It can also manifest at the legislative, executive and judicial arms of governments. By and large, corruption exists in every sphere of life, be it public or private establishments. Irrespective of where it occurs, it tends to have a mammoth impact in the general lives of the citizenry especially on the provision of the basic services [16]. Before the introduction of e-governance system, a vast number Nigerian public employees at the local, state and federal levels acknowledged to be terrifically corrupt. The employees in the public sector are recognized to be smart in inflating government contracts and procurements; the system was moribund with ghost worker syndrome in which the names of non-existing public officials were used to pay fraudulent salaries. The committers of such offense initiated a system that bypass banking measure in the payment of salary. In such an environment, they pay public personnel by cash through their ministries cashiers. A huge amount of funds was diverted to the pocket of perpetrators through this channel. Several regimes have contended with this challenge through the inauguration of special staff audit committees, the committee introduced “Table Payment” which requires physical presence of staff. However, this measure was unable to rule out the corrupt elements in the public sector [13]. Consequently, the diversion of government revenue and foreign aid into the individual personal purse within the public sector has contributed to the deprivation of some basic social services. It has been estimated that approximately 400 billion was stolen from Nigerian public treasury from 1960 to 1999, between 2005 and 2004, the sum of $182 billion was diverted from the public accounts via illegitimate financial flows. The stolen common wealth meant for educational development, health sector and general infrastructural development was diverted by public office holders for personal aggrandizement [17]. The culture of corruption entrenched in Nigerian public sector has a great impact in the life of the citizens. Its effect on infrastructural development has been acknowledged and its corollary has being experienced by the citizens in their daily engagement (Figure 6).
How e-Governance can prevent corruption. Source: Iqbal and Seo [
In Figures 7 and 8, these platforms showcase the electronic model designed to mitigate corruption in Nigeria. On these platforms, several activities are embedded, ranging from corruption reporting, whistleblower channel, number of people prosecuted for corruption, complaint and observation of the citizens against the mandate of anti-corruption institutions, petition among other related activities. These platforms have encouraged the citizens to report several cases of corruption which the anti-corruption institutions have investigated in recent time. Without physical presence of the citizens, corrupt practices can be reported on the website of the Independent Corrupt Practices and Other Related Offenses Commission (ICPC) and Economic and Financial Crimes Commission (EFCC). This effort has yielded an expected outcome following the adoption of e-governance in combatting corruption in Nigerian domain. Therefore, anti-corruption war is considered as government and citizens’ struggle, it is believed that if government co-opted the citizens in fighting corruption, corruption will be mitigated to a barest minimum level in the country.
Independent corrupt practices and other related offenses commission.
Economic and financial crimes commission.
The nexus between e-governance and anti-corruption war has been globally pronounced by a number of scholars [12, 18, 19, 20, 21]. Information communication technology is considered as a fundamental instrument that can be employed to tame the ugly trend of corruption. ICT is capable of mitigating corruption by promoting good governance, monitoring the activities of government and the governed. The use of electronic measure in the daily governmental business has a great impact in the fight against corruption among other measures put in place by the government in many developing nations of the world [1]. Several efforts have been put forward to prevent corruption by different regimes. The creation of Independent Corrupt Practices Commission (ICPC), Economic and Financial Crimes Commission (EFCC) and Code of Conduct Bureau among others. Despite the creation of different institutions to checkmate the spreading wave of corruption in both the public and private sector in the country, it appears that these measures were not absolutely capable of reducing corrupt practices in Nigerian society. The ineptitude of the above-mentioned measures triggered the development of e-governance scheme which was strengthened to foster transparency in the conduct of public affairs. The implementation of e-governance approach was made possible with the adoption of Information Communication technologies (ICTs) revolution. The implementation process was initiated as a pilot scheme initiated in some ministries and federal parastatals. Following this event, other levels of governments began to adopt this policy to tackle the high level of corruption in the country. The adoption of this policy aimed at block the manifold sources by which public officials employed in siphoning public funds such as double payment of contracts and ghost workers. A huge amount of public funds has been saved by the three tiers of government due to implementation of e-governance project. The philosophy behind this policy is to reduce corruption and increase the level of transparency and accountability in the public and private sectors [22]. It is a by-product of ICT, which is an efficient and effective strategy to tackle corruption idiosyncrasy. Even though e-governance is not the first and last method to curb corruption in the public sector, it is being practiced very efficiently in the developed countries and in a few developing countries as well. In general, developing countries have succeeded much in implementing e-governance. Their efforts to apply the tools and strategies have been discernible since the last couple of decades [4]. The services delivered through electronic means such as tax payment, rate, license are capable of mitigating human error and corruption in the public arena. In an environment where public administration is digitalized, physical contact which has the potential of promoting corrupt practices is mitigated. e-Governance serves the purpose of bringing transparency, accountability and openness to the public service [3]. Nigeria has embarked on numerous strategies in reducing corruption especially through e-governance within the public sector. The public sector reform includes Treasury Single Account (TSA), Biometric Time and Attendance, Integrated Payroll and Personnel Information System (IPPIS), Prepaid Meter. Other initiatives include e-passport, online registration of Joint Admission Matriculation Board (JAMB) by candidates, introduction of computer based examination to reduce exam malpractice, the use of card reader during election, e-reporting of human rights abuse, monthly publishing of local and state governments allocation by the ministry of finance which allows citizens to be aware of how the government use their public resources [22]. According to Davies and Fumega, there are eight kinds of ICT mechanism that can be used to prevent corruption, these include the following:
Online services: Platforms offer public self-services that citizens can explore
Transparency portals: These platforms provide periodic government publication of important documents which are accessible to the citizens online;
Open data portals: These platforms offer free access to data sets in machine-readable formats.
Crowd sourced reporting: This entails the citizens to report grievances regarding the activities of government;
Online corruption reporting: The platforms that provide opportunity for citizens to report cases;
Online right-to-information requests: platforms that allow citizens to file right-to-information requests.
Issue reporting: platforms that allow citizens to report problems with public services
Service automation: platforms that replace discretionary decision-making by public officials with auditable software processes [23].
In Nigeria, there are policies implemented by the government to curb corruption in the public domain, some of these policies are discussed below:
The TSA policy was initiated as part of Economic Reform and Governance program in 2004 by the Federal government in Nigeria. TSA is an integrated national bank account in which all the federal government ministries, departments and agencies (MDAs) remit daily government revenue. The implementation of this policy by the national government aimed to block all leakages in Nigerian revenue generating agencies as well as to guarantee judicious use of government resources for the benefit of the citizens. The TSA is one of the components of public financial management (PFM) reforms which was under the third pillar of National Strategy for public service reforms geared toward achieving vision 20:20:20 aimed to address the challenge of ineffective and inefficient cash management in the country. The implementation of this policy necessitates adoption of e-payment system for every single financial transaction, and it came into full force in January 2009. The adoption of this policy aimed at ensuring efficiency, effectiveness, transparency, openness and accountability in the management of the country’s financial resources. Although, before the implementation of TSA, the country was moribund with challenge of monitoring all government accounts by the Office of the Accountant General of the Federation (AOGF). The TSA was guided by three fundamental principles: the unification and synchronization of government treasury accounts; only the chief financial agents of the government are saddled with the oversight responsibility in managing cash resources of the government; and there should be comprehensive coverage of both the budgetary and extra-budgetary as well as consolidation government’s cash resources [24].
In 2012, the Central Bank of Nigeria (CBN) inaugurated the implementation of cashless policy, projected to eliminate the physical cash flow in the national economy so as to promote e-transaction. The policy was first implemented in Lagos in January 2012. The policy is aimed to reduce the primary cost of banking services; promote modernization and development of Nigeria’s payment system in accordance with vision 20:20 goal to be among the top 20 economies by the year 20:20; reducing high cash usage outside the formal sector and therefore provide opportunity for effective management of inflation to promote economic growth; reducing the risk of high handling of cash which encourages robberies and related crimes; and to mitigate systemic leakage that promote corruption. The fundamental objective of this policy is to encourage cashless economy. The cashless economy inculcates the promotion of payment without the involvement of physical cash. It does not totally exclude the use of physical cash from the economy but an economy where the use of cash is reduced to a bearable minimum level. In such a cashless environment, electronic based payments dominate the economy with the use of credit cards or mobile or bank transfer. Some of the components of cashless policy may incorporate e-exchange, e-money, e-brokering, e-finance among others. The primary measures for the cashless policy in Nigeria imply:
Daily cumulative cash limit: N500, 000 and N3 million on free cash withdrawals and lodgments by individual and corporate customers respectively. These are upward reviews from the daily cumulative limits of N150, 000 and N1 million set in January, 2012.
Processing fees for withdrawals above limit: 3% for individual and 5% for corporate. These are downward reviews from the respective 10% and 20% fees set in January, 2012.
Processing fees for lodgments above limit: 2% for individual and 3% for corporate. These are downward reviews from the respective 10% and 20% fees set in January, 2012.
Exemptions from processing fees: this applies to accounts operated by ministries, departments and agencies (MDAs) of the federal and state governments, solely for the purpose of revenue collections. Exemptions also extended to embassies, diplomatic missions and multi-lateral and aid-donor agencies, as well as micro finance banks.
The major goal of this policy is to ensure that the larger percentage of Nigerian populace utilizes electronic platform in their daily transaction. Several measures put in place to accomplish the cashless policy include the following methods:
Automated Teller Machine (ATM). ATM can be used for the payment of bill, deposit cash, funds transfer, recharge airtime for mobile phone
Internet banking: This can be employed to make instant balance enquiry, funds transfer, payment of application fees and utility bills. Some of the banks require the customers to use token in order to guarantee security and safeguard the account against fraudsters.
Point-of-Sale (POS) Terminals: This can be used to make payment of any transaction made by the customers.
Electronic Transfer: This can be employed to transfer funds electronically from the customer’s account to other sources or destinations [25].
This is an integral component of the ERGP initiative targeted toward tackling corruption through information technology. It was implemented to provide support to public resource management by employing integrated and automated mechanism to ensure effective and efficient economic system. The implementation of this policy is aimed to enhance transparency, accountability and cost effective public service delivery. The primary objective of the GIFMIS is to key into computerized financial information system for the federal government to increase:
Federal government capacity to effectively control and monitor the general expenditure and receipts of MDAs
The capability to understand the general costs of collections of activities
The ability to exhibit transparency and accountability to the public and partners
The ability to access information on government’s economic performance and cash flow
Medium term planning through a medium term expenditure framework (MTEF).
Internal controls to identify and prevent possible fraudulent actions
The access to information on financial operation
Ultimately, the focus of the GIFMIS is to support and improve the federal government public financial management performance. The financial management obligations constitutes the overall financial management cycle of government which includes budget preparation, budget execution and financial reporting. GIFMIS aimed to be used in all areas of government budget preparation, execution and general management of financial resources. Additionally, GIFMIS enables effective revenue collection through integrated system of revenue collection especially in some agencies like Federal Inland Revenue Service (FIRS), Customs, Nigerian National Petroleum Corporation (NNPC) and providing effective revenue remittance and transfer to the TSA [24].
This chapter has examined e-governance as an effective mechanism in tackling corruption in Nigeria. Although, there have been several efforts by the past political regimes in fighting corruption in the public sector, it appears that some of the efforts put in place were able to yield minimal outcomes. The recent initiative regarding application of information communication technologies (ICTs) in the general management of public affairs has been considered as effective mechanism to complement the effort in curbing corrupt practices in the public sector. This chapter demonstrates that e-governance as a modern technological tool is capable of reducing high level of corruption in the public sector in the country. The current initiative to reduce the level of corruption in Nigeria necessitates the implementation of e-governance strategy which revolves around the Treasury Single Account (TSA), internet banking, limitation in cash withdrawal, the Government Integrated Financial Management Information System, cashless policy among others. These numerous strategies have been utilized to minimize corrupt practices in Nigeria. Some of these strategies have provided opportunity to prevent ghost workers from continuous existence in Nigerian public sector. Although, the adoption of these measures has been producing positive outcomes, however, there are numerous challenges affecting the effective functioning of e-governance especially among the citizens. These challenges range from social arena where there is low literacy level, poor basic education, lack of access to internet by rural populace, lack of feedback, low level of technological adaptation, different languages, shortage of skills, poor IT literacy as well as political aspects that revolves around lack of cyber laws, poor reform agenda, low budget allocation among others. To make the use of ICTs more effective in the public sector, the government needs to ensure training and retraining of its staff in handling ICTs for effective service delivery, provide affordable market for internet users, re-orientate the local community of its benefits and provide enabling environment for effective implementation of e-governance at the local, state and national levels.
Acute exacerbations of Idiopathic Pulmonary fibrosis (AE-IPF) represent important milestone in the disease course of IPF, which is the most common disease among the group of Idiopathic interstitial pneumonia (IIP). The IPF is more common among males and in the elderly age group [1]. Although the exact etiology of AE-IPF is unknown, there are many important risk factors as well as triggers that have been identified. There is associated accelerated decline in lung function which leads to poor prognosis [1]. It is estimated that about 35 to 46% of deaths in IPF are caused by AE-IPF [2]. In hospital mortality is more than 50% and follow up after hospitalization shows a mortality up to 73% at the end of 90 days [2, 3]. Although treatment with high dose Gluco corticoids have been used extensively, there is lack of controlled well designed trials to support its use and in fact survival has been shown to be decreased with steroids and or other immune suppressants [4, 5]. Some newer anti-fibrotic agents like Pirfenidone and Nintedanib may improve survival, the latter may be helpful in preventing AE-IPF [1, 6, 7].
Acute exacerbation of IPF is recognized with the help of a set of criteria laid out by the International IPF Working group network which is as follows [2, 4, 8, 9, 10, 11, 12].
“An acute, clinically significant respiratory deterioration characterized by evidence of new widespread alveolar abnormality”.
The following four diagnostic criteria have to be met as shown in Table 1.
A known or concurrent diagnosis of IPF |
Clinical respiratory deterioration noted “typically” in the preceding 30 days. |
Presence of typical UIP pattern on CT chest including bilateral basilar reticular changes with honeycombing and traction bronchiectasis. Superimposed ground glass attenuation and /or consolidation is necessary in exacerbation. When possible specific UIP pattern may be combined with histopathological information to make a more robust diagnosis. |
Absence of heart failure, Pulmonary embolism, fluid overload or any other differential pathology. |
Note that endotracheal aspirate is not necessary as per new diagnostic criteria. |
The 30-day time limit of clinical deterioration is not strictly enforced. |
Exclude other causes of Interstitial Lung disease such as drug toxicity, connective tissue disease, hypersensitivity pneumonitis, etc. |
Criteria for diagnosing IPF exacerbation as per working group idiopathic pulmonary fibrosis network (IPF net).
The guidelines also provided certain clarifications that help in making a diagnosis [11].
Events that are clinically considered to meet the definition of acute exacerbation of IPF but fail to meet all four diagnostic criteria owing to missing computed tomography data are to be termed “suspected acute exacerbations.” For example, if CT scan shows unilateral ground glass attenuation or data available is incomplete [2].
If the diagnosis of IPF is not previously established, this criterion can be met by the presence of radiologic and/or histopathologic changes consistent with usual interstitial pneumonia pattern on the current evaluation [11].
It is to be noted that the term “idiopathic” was removed from the older definition, as it was seen to be restrictive [11]. Making a distinction between idiopathic and non-idiopathic respiratory events is not easy as there are not well defined clinical or biological criteria [11]. So, although the acute deterioration could be due to an infectious etiology and it is not necessary to rule this out for the purpose of definition, at a practical level infection needs to be diagnosed and treated empirically or definitely as it does have a definite therapeutic recourse [11, 13]. It also follows from this that Broncho alveolar lavage (BAL) is not needed for diagnosis and hence it will help capture more of such events, but at the expense of specificity [11, 13]. BAL may not be needed when HRCT pattern is consistent with UIP, but when the Usual interstitial pneumonia (UIP) pattern is indeterminate or suspect then BAL can be useful [12]. Similarly, surgical lung biopsy (SLB) is recommended only when UIP is indeterminate or suspect [12]. However there is considerable morbidity and mortality associated with BAL or surgical biopsy in the context of AE and hence such procedures are to be generally avoided [11].
Similar to Acute lung injury in non-IPF lungs precipitated by triggers such as aspiration, post-operative, medication etc., exacerbation in IPF can be sub-categorized as either “triggered” when a known precipitating etiology is documented or “Idiopathic” when no such etiology is apparent [11].
The new definition also replaced the 30-day time restriction for the acute deterioration to “typically or generally of less than one-month duration” [11]. The phrase “typically less than 1 month” was included to provide precision but allow for the inclusion of exceptions that clinicians believe represent acute exacerbations [11]. A more flexible time interval may lead to “heterogeneity” among clinicians and clinical trial endpoint definitions for acute exacerbation [11].
The incidence of acute exacerbations is variably reported in literature. This is because exacerbations could be more common in certain populations like more elderly people who are also likely to have severe disease, inconsistent definitions and its use, statistical design, follow up time and other factors [2, 9]. Exacerbations are less common in mild to moderate disease compared to severe disease [3, 14]. Reporting can vary depending on the type of study as well. Prospective trials may lack sufficient data to report all exacerbations [2, 4, 8],typically include younger patients with less comorbidities, with mild to moderate disease and therefore may under report incidence [15]. Retrospective studies may over report depending on the criteria used, by including events with pulmonary embolism, heart failure etc. [2, 13, 16].
Suspected exacerbations, which may not satisfy the definition of definitive AE-IPF are also important as they are associated with poor outcomes [4].
A meta-analysis analyzed six trials and reported acute exacerbation rate of 41 acute exacerbations per 1000 patient/years [14]. Rate of acute exacerbations were much lower in trials that included only mild to moderate disease [14].
In a retrospective study from Korea, which included 461 patients with IPF of which 269 cases were biopsy-proven and the median follows up period was 22.9 months, acute exacerbation occurred in 96 (20.8%) patients, and 17 (17.7%) of those acute exacerbation patients experienced multiple episodes of acute exacerbations (range 2–3 episodes). The incidence of acute exacerbation was noted to be 14.2, 18.8 and 20.7 percent at the end of 1, 2 and 3 years respectively [17].
It is to be noted that exacerbation of IPF may even occur in individuals with limited fibrosis and well-preserved lung function [2]. In the STEP-IPF trail, definite AE-IPF was reported as 40 per 1000 patient-years. However, the combined definite and suspected AE-IPF increased the exacerbation rate to 200 per 1000 patient-year [2, 4, 8, 13].
There have been reports of increased rate of AE-IPF in people of Asian descent in the far east such as Japan and Korea, however this has not been proven by randomized control trials [7, 8, 18].
There are many risk factors for acute exacerbation. However, the most important risk factor is advanced disease [2, 14]. Other factors described in literature include low Forced vital capacity [8, 17], recent decline in FVC [19, 20], Low diffusion capacity for carbon monoxide [4], low 6 min walk test [4], pulmonary hypertension [21], poor baseline oxygenation [4, 22], increased dyspnea score [4], younger age group [2], presence of concurrent coronary artery disease [4], higher body mass index [22], previous history of acute exacerbation of IPF [19, 23].
Some important triggers for acute exacerbation have been described.
Infections are very common causes of respiratory deterioration. Exacerbations are more common in winter and spring season [24] and in those who are immunosuppressed [2, 25]. Postmortem analysis, multiplex polymerase chain reaction (PCR), pan viral micro array, high output cDNA sequencing and other techniques have demonstrated that infectious etiology is incriminated in many but not all acute exacerbations [23]. Based on the cumulative evidence which demonstrates infection to be causing some but not all acute exacerbations, it is thought to be an important but not exclusive trigger for precipitating acute exacerbations.
Aspiration of gastric contents has been postulated to be a causative factor for IPF and exacerbations in IPF.
In a case control study involving 24 acute exacerbations and 30 controls, Pepsin level in Broncho alveolar lavage (BAL) was found to be fairly commonly present, suggestive of gastric aspiration being fairly common in IPF.8 of the 24 acute exacerbation IPF patients had very high levels of Pepsin suggesting that aspiration of gastric contents could be a contributor for acute exacerbation [26].
In a study involving 32 patients with asymmetric idiopathic pulmonary fibrosis (AIPF) compared with 64 matched controls with symmetrical IPF, Gastro esophageal reflux disease (GERD) and AE-IPF was significantly higher in patients with AIPF with the left side being less commonly involved [27].
On the contrary, in a post hoc analysis of the two Phase III randomized placebo-controlled INPULSIS trials of Nintedanib in patients with IPF, the rate of decline of FVC in the placebo group was much higher in patients who were taking an antacid (Proton pump inhibitor or H2-receptor antagonists) at baseline when compared to those who were not [difference of − 47.5 mL/year (95% CI: −105.1, 10.1); p = 0.1057] [28].
The data as it is apparent, that although gastro esophageal reflex has been widely debated to be causative, is not very definitive. Therefore, it can be likely that the aspiration of gastro esophageal contents can trigger acute exacerbations like infections but is not the sole causative factor.
Many surgical procedures like bronchoscopy and BAL, lung biopsy, lung resection, non-thoracic surgery and others can precipitate acute exacerbation [24, 29, 30, 31, 32]. The mechanism of action is unclear but could be related to stress like volutrauma, barotrauma, free oxygen radicals, or intra operative fluid balance.
Air pollution can be a cause for interstitial lung disease. In a retrospective south Korean longitudinal cohort, out of 505 IPF patients 436 patients were included in the final analysis.75 patients experienced at least one exacerbation. There were 89 acute exacerbation events occurring over 1699 patient-years, for an incidence rate of 5.2 exacerbations per 100 patient-years. [23].
Air pollution data for each of the five pollutants Ozone (O3),Nitrogen di oxide (NO2), particles with a 50% cut-off aerodynamic diameter of <10 μm (PM10), sulfur dioxide (SO2) and carbon monoxide (CO) were measured prospectively at Tele-Monitoring-Systems (TMS) situated throughout Korea. Each TMS recorded hourly measurements of each pollutant during the study period. Mean and maximum exposures of all these 5 pollutants were recorded over the 42-day period prior to the exacerbation period. Acute exacerbation of IPF was significantly associated with important measurement metrics of O3 and NO2 during the exposure period. Mean Ozone and Nitrogen dioxide levels were weakly correlated; however, both were statistically significant independent predictors of AE-IPF [23].
Medications can provoke respiratory deterioration in interstitial pneumonia which closely resembles acute exacerbation. Such drugs include everolimus, interferon-gamma and others [33, 34]. Drugs and surgery used to treat Lung cancer patients with interstitial pneumonia did not appear to cause more exacerbations compared to best supportive care and hence should not be withheld when treating Lung cancer with interstitial pneumonia patients [35].
As noted, there have been many triggers associated with acute exacerbation of IPF. However currently the most accepted theory is that exacerbation is thought to be “an acceleration of the underlying inflammatory fibro proliferative disease process”.
This theory is supported by markers of cell injury as well as genetic expressions.
In one study by Collard et al., 47 patients with acute exacerbation of IPF, 20 patients with stable IPF and 20 patients with acute lung injury were studied. Plasma from these patients were collected and measured for biomarkers of cell activity/injury-receptor for advanced glycation end (RAGE) products, surfactant protein D, KL-6, von Willebrand factor; systemic inflammation-Interleukin-6; and biomarkers of coagulation/fibrinolysis-protein C, thrombomodulin, plasminogen activator inhibitor-1. Plasma from patients with AE-IPF showed higher levels of markers of type II alveolar epithelial cell injury/proliferation, endothelial cell injury, and coagulation/fibrinolysis very much like stable IPF but the response was much more exaggerated. This biomarker profile was different from patients with acute lung injury which was consistent with type I alveolar epithelial injury [36].
In another study, RNA was extracted from 23 stable IPF lungs, 8 IPF lungs with acute exacerbation of IPF and 15 control lungs. The gene expressions were studied. Results indicated that 579 genes were differentially expressed between stable IPF and acute exacerbation of IPF. Functional analysis of these genes was not suggestive of infectious or inflammatory etiology. Gene expression patterns in acute exacerbations of IPF and IPF samples were quite similar and different from the control lung arm [37].
Other immunological theories have also been proposed. Annexin 1 is an antigen found in human body which is increased in patients who have AE of IPF [38]. This antigen can induce both humoral and cell mediated immune responses and certain parts of this antigen have been implicated in the pathogenesis of AE of IPF [38]. Certain molecular studies have also been performed. Heat shock protein 47 (HSP47), has been studied and found to be a good bio marker for collagen production and secretion [39]. In studies comparing stable and AE-IPF patients, serum HSP47 were significantly elevated in AE-IPF patients in comparison to stable IPF patients [39]. Ironically patients who have anti-HSP70 autoantibodies in smaller studies have much poor prognosis due to AE of IPF when compared to controls or even those patients who have IPF but negative anti-HSP70 autoantibodies [40, 41].
Epithelial damage and impaired healing by abundance fibrosis has been an important theory that tries to explain the pathologic damage in IPF patients. When compared to IPF patients, patients with AE of IPF have higher bio markers of neutrophilic damage such as Alpha-defensins which are produced by activated neutrophils [37, 42] and also increased levels of Fibrocytes have been noted which have been found to be associated with worser outcomes in patients with AE of IPF [42, 43].
Patients present with worsening respiratory symptoms generally which are less than 30 days in duration. It consists of cough, worsening dyspnea especially on exertion, fever, malaise, and other flu like symptoms. Criteria for diagnosis include PaO2/FiO2 ratio < 225 or a decrease in PaO2 of ≥10 mmHg over time [8, 16].
Physical examination is consistent with IPF including bibasilar crackles on auscultation, but with increased respiratory rate [37].
Laboratory testing and imaging are directed to rule out other differentials like congestive heart failure, Myocardial infarction, pulmonary embolism, pulmonary hypertension, pulmonary infections etc. [2, 8]. Accordingly, complete blood count, B-type natriuretic peptide, C-reactive protein, chemistry profile including Blood urea nitrogen and serum creatinine can be performed along with highly sensitive troponins. Laboratory values are consistent with an infectious or inflammatory process but there is no evidence of infection on Blood culture, Urine antigen tests or Broncho alveolar lavage (BAL) if these tests are undertaken [8]. BAL if performed typically shows neutrophilic predominance [8]. BNP is typically elevated in heart failure and pulmonary hypertension [44]. Echo may be beneficial in heart failure and pulmonary hypertension [44]. CRP is typically elevated in infections and inflammation [44]. Pro calcitonin can guide when infection is suspected and even helping with limiting duration of antibiotic use [45]. D-dimer and CT pulmonary angiogram can help with ruling in or ruling out Pulmonary embolism [44].
High resolution computed tomography (HRCT) reveals bilateral ground glass or consolidative opacities superimposed on a background of typical HRCT features of IPF which includes bibasilar reticular opacities, honeycomb changes, and traction bronchiectasis [2].
Acute exacerbation of IPF is essentially a clinical diagnosis aided by predominantly noninvasive test. Although surgical biopsy can be performed for diagnosis which may show diffuse alveolar damage, the mortality and morbidity in the acute situation appear to be prohibitively high and not recommended [46].
Treatment is primarily supportive in nature.
Supplemental oxygen consisting of low flow and high flow oxygen can be used to keep Oxygen saturation (Spo2) more than 92%. Noninvasive ventilation mechanical ventilation (NIMV) and Mechanical ventilation (MV) is used as needed.
In a retrospective review of 19 hospitalized patients with IPF and AE, 1/3rd of patients had an infectious etiology, the percentage of patients who were discharged alive was 37% and only 14.8% of patients were alive at 1 year [47]. Patients with IPF experience AE very commonly. In IPF, about 40% of patients may die due to AE [48, 49]. In another observational study of 112 patients, 56 patients (42.9%) died due to AE [48]. The five-year survival rate of all patients with IPF was 38.3% and the Median survival time was 3.1 years post diagnosis. However, in patients who had an AE, the five-year survival rate was 10.7% and median survival time was 0.6 years [48].
In a pooled data consisting of nine studies, including 135 patients who were intubated for AE of IPF the cumulative mortality was 118 (87%) and short-term mortality (within 3 months of discharge) was 127 (94%) [50]. Therefore AE of IPF is not only common, but also a very poor predictor of survival. Based on these observations, the 2011 IPF guidelines discouraged MV in the vast majority and recommended its use in a selective minority of patients after careful weighing of risks and benefits [11]. However, this data pertains to a time period before 2007. In a study that reported US national data of 1703 patients who received Mechanical ventilation (MV)and 778 patients who received Noninvasive mechanical ventilation (NIMV),mortality was about 50% in those who received MV compared to 30% for those who received NIMV. The mortality of IPF patients treated with MV improved from 58.4% in 2006 to 49.3% in 2012 which was significant [51]. Overall this is suggestive that survival of patients treated with MV has seen a marginal improvement which could be due to various factors such as relative changes in diagnostic criteria and their use, difference in variables used and study design, differences in the severity of disease (patients with decreased FVC have poorer prognosis), judicious selection of patients who were placed on MV and widespread adoption and use of lung protective ventilation strategies [52]. Hence it is imperative that well informed discussions relating to advance care directives are made at the time of diagnosis and re visited when hospitalized [50]. In patients who are candidates for Lung transplant, the use of mechanical ventilation and extra corporeal membrane oxygenation, can be effective and lifesaving [11, 52, 53, 54, 55].
Ventilator induced lung injury (VILI) secondary to use of MV results in lung damage and poor prognosis [52]. In IPF, the lungs are fibrotic and non-compliant. Lower PEEP may be more beneficial and protective along with low tidal volume ventilation, hence minimizing both volutrauma and barotrauma [52, 56]. NIMV and high flow oxygen are being increasingly used and may be beneficial [56, 57]. Both NIMV and High flow Oxygen could be beneficial in patients who are not appropriate or choose to forego intubation, the survival may be the same with both modalities [57, 58],with high flow nasal oxygen being better tolerated, allowing patients to even eat and drink [57, 58, 59]. Hence they could be very effective means for palliative care [57, 58].
In patients who undergo thoracic surgery, VILI may be a potential etiological mechanism and can be minimized by the aforementioned lung protective ventilation including reducing lung volume, low PEEP, low partial pressure of inspired oxygen (Fio2), and less invasive surgical techniques [52, 56, 60, 61].
Symptoms such as dyspnea are treated with a palliative intent [8, 11]. Oxygen and opioids can also be given for symptom control [8, 11].
In IPF, a combination of inflammation, epithelial cell injury, fibro proliferative repair, and tissue remodeling which interact with the coagulation system help characterize IPF as a procoagulant state [62]. The use of therapeutic anticoagulation such as Warfarin or Alfa-Thrombomodulin has proven to be either harmful or non-beneficial in well conducted studies [63, 64, 65]. There is no evidence supporting therapeutic anticoagulation in patients experiencing acute exacerbation [63]. Nevertheless, patients with IPF have almost twice the risk of venous thromboembolism compared to general population and hence pharmacological venous thromboprophylaxis should be routinely used in hospitalized patients [66, 67].
There is not enough evidence of protective role from the use of antacids, but patients who are already using them can continue with their use [68, 69]. Evidence is often contradictory if antacids protect or may potentiate or worsen AE of IPF [70, 71].
Corticosteroids have been used extensively but the practice is driven by expert opinion and anecdotal reports and not driven by good data. Expert guidelines give a weak recommendation to the use of steroids [2, 6]. Acute IPF is characterized by high degree of inflammation with areas of diffuse alveolar damage secondary to Acute Lung injury and organizing pneumonia [9]. Therefore, the use of high dose steroids is intuitively thought to be beneficial [9, 72, 73, 74], in spite of absence of good data from randomized control trials [9]. Dosage and duration are also not well defined in literature, although it is typical to use initially high dose corticosteroids followed by a rapid tapering course, as longer duration of steroids may be harmful in IPF [9, 62]. In EXAFIP, a randomized control trial comparing Cyclophosphamide with corticosteroids against placebo with corticosteroids in AE of IPF, the steroid regimen used in all patients was Methylprednisolone 10 mg/kg per day for 3 days followed by a progressive taper to 10 mg per day for patients above 65 kg and 7·5 mg per day for patients below 65 kg at the end of 6 months [75]. Similarly in a RCT involving 77 patients in Japan, Alpha-Thrombomodulin (ART-123) was compared against placebo. All patients received glucocorticoids in two courses of pulse Methylprednisolone (500–1000 mg/day) for 3 days followed by Prednisolone 0.5–1.0 mg/kg/day for 4 days followed by gradual taper [64]. Smaller retrospective studies have shown that using high dose of glucocorticoids used in first 30 days prevent recurrence of exacerbation when compared to lower doses in the same duration or after 30 days but this has not been substantiated by other studies [76, 77]. The use of high dose steroids has been noted to increase survival in non-IPF exacerbation of Interstitial lung disease [76]. It is noteworthy that some studies and even guidelines recommend using no immunosuppressives in select patients, as mortality was no better in the immunosuppressed group when compared to the non-immunosuppressed, with higher incidence of infection in the immune suppressed group, especially in severe disease [11, 14].
Concomitant Immunosuppressive therapy with steroids have also been used and the evidence base for this practice is also not very sound [2, 48]. While treatments such as Alfa-Thrombomodulin and Cyclophosphamide along with concomitant glucocorticoids have been subjected to randomized control trials and have not been shown to improve outcomes [64, 75], others do not have much evidence as they were too small, were uncontrolled, used historical data as control or had no control arm [2]. The latter studies have used medications like Tacrolimus, Cyclosporin-A, Rituximab combined with plasma exchange, Intravenous Immunoglobulin, and polymyxin B-immobilized fiber column (PMX) [6]. Other medications that have been used include Acetylcysteine as standalone therapy, sildenafil, bosentan, interferon-gamma 1b, warfarin, ambrisentan, and imatinib [8].
In a small retrospective study consisting of 11 patients in each group, Corticosteroids alone were compared with Cyclosporin-A and Corticosteroids. The mortality was similar in each group but the Cyclosporin-A group appeared to have longer survival [78]. However in a larger retrospective review with 384 patients in Cyclosporin-A and high dose Corticosteroids and 7605 patients treated with high dose Corticosteroids alone in Japan, no change in survival was noted [79].
Other considerations include empiric treatment of a course of antibiotics since infectious etiology can be treated but cannot be ruled out conclusively in the vast majority of cases [2]. Procalcitonin has been used in clinical trials and can reduce the duration of antibiotics (8.7 ± 6.6 compared to 14.2 ± 5.2 days in the routine treatment group), without any effect on treatment success, mortality rate, days of hospitalization and ventilation therapy [45]. Tacrolimus, an immunosuppressive drug used widely in solid organ transplant patients including Lung transplant was found to have beneficial survival effects and protection against future exacerbations in small retrospective studies, with lack of data from better designed controlled studies [80]. Direct hemoperfusion with Polymyxin B immobilized fiber column (PMX-DHP) has been used in AE of IPF to absorb endotoxins and reactive oxygen species, among other toxic substances, as well as selectively remove activated neutrophils and preventing activation of monocytes with a goal to limit endothelial damage [81, 82]. PMX-DHP may act by adsorbing harmful cytokines such as vascular endothelial growth factor and may have anti-fibrotic effect [83, 84]. The adsorption of proinflammatory, profibrotic and proangiogenic cytokines is postulated to be an important mechanistic action of PMX-DHP [83]. The use of PMX-DHP along with Corticosteroids has demonstrated improvement in oxygenation, with possible improvement in survival in a multicentric Japanese retrospective study with 73 patient who had AE of IPF [82]. There is a prevailing hypothesis that auto antibodies may have a role in IPF progression. Removal of these auto antibodies by plasma exchange and Rituximab followed by IVIG subsequently may be beneficial in AE-IPF [62, 85]. A small pilot study involving 11 patients has shown the safety and possible efficacy, paving way for a Phase 3 randomized control trial [85].
Interestingly in a retrospective study, patients who were not on any immunosuppression had better survival than those who were on immunosuppression [5].
There has been considerable interest in developing prognostication scores for AE of IPF. A number of markers have been used in different studies and Forced vital capacity %, Diffusion capacity for Carbon monoxide, Pao2/Fio2 (P/F) ratio, HRCT patterns, Acute Physiology and Chronic Health Evaluation II score (APACHE II), Glasgow prognostic score and serum biomarkers like C-reactive protein (CRP), Krebs von den Lungen-6 (KL-6) have all been considered [86]. In a retrospective study of 108 patients, a lower FVC % at baseline (1 year before AE) and P/F ratio on AE presentation were predictive of mortality [86]. In another study of 103 AE-IPF cases, a combination of P/F ratio less than 250 (P), CRP ≥ 5.5 (C), and diffuse HRCT pattern (radiological) (R), together called as PCR index was used to stratify and predict mortality at the end of 3 months [87]. In a systematic review and meta-analysis, 37 studies and 31 prognostic factors were analyzed [88]. Five independent variables after multivariate analysis were found to be helpful with prognostication namely APACHE II score, P/F ratio, LDH level, white blood cell (WBC) count, and oxygen therapy before AE [88]. Interestingly the latter did not find use of FVC or imaging scores to be helpful in terms of prognostication [88]. Prognostication scores and models are certainly good research tools but not commonly used in clinical practise as no intervention other than good supportive care has been found to be useful.
Prevention of exacerbation in IPF is the most effective strategy as we do not seem to have very effective therapies once the exacerbation gets underway. Avoidance of air pollutants [23], preventing infections like Streptococcal pneumonia and Influenza by vaccination [26, 61], general hygiene measures like handwashing again to prevent infections [52], and judicious use of antacids may be helpful strategies [68, 69].
Many medications have been tested, using prevention of acute exacerbation as an end point. Acetylcysteine monotherapy, bosentan, interferon-gamma,sildenafil, showed no effect [8]. Others like imatinib, ambrisentan, triple therapy (prednisone, azathioprine, acetylcysteine combination) and warfarin showed increased risk of exacerbation [8].
Azuma et al. studied 107 IPF patients in a phase 2 Randomized placebo-controlled trial comparing Pirfenidone and placebo. Although there were no acute exacerbations noted in the Pirfenidone arm compared to placebo [89], the same results could not be reproduced in a phase 3 RCT with 275 patients, showing no difference between the intervention and control arm [18]. In the large phase 3 RCT’s, CAPACITY and ASCEND which compared Pirfenidone with placebo yet again, unfortunately AE of IPF as an end point was not studied [90, 91]. Nevertheless, a pooled analysis of the CAPACITY and ASCEND trial did reveal a reduction in non-elective respiratory related hospitalization favoring Pirfenidone [92]. Interestingly Pirfenidone in small studies has proven to be safe and effective in preventing exacerbations in peri operative period in patients who were given 2–4 weeks of medication prior to surgery and continued post operatively when compared against historical controls [93, 94]. Larger RCTs need to be performed for this promising intervention [94].
Another antifibrotic agent Nintedanib was studied after Pirfenidone, which showed a favorable effect against placebo for preventing AE of IPF in the phase 2 TOMORROW trial and phase 3 INPULSIS-2 trial, but no such effect was seen in the phase 3 INPULSIS-1 trial [95, 96]. However the pooled analysis of patients from TOMORROW and INPULSIS trials [6],consisting of 1231 patients (Nintedanib n = 723, placebo n = 508), the hazard ratio for time to first acute exacerbation was 0.53 (95% CI: 0.34, 0.83; p = 0.0047) favoring Nintedanib. The proportion of patients with ≥1 acute exacerbation was 4.6% in the Nintedanib group and 8.7% in the placebo group [6]. Nintedanib can be added after recovering from an exacerbation or continued if it was previously being used.
In a systematic review and meta-analysis, 12,956 patients were included comparing the use of anti fibrotics (Pirfenidone or Nintedanib) vs. nonuse of antifibrotics, which showed that the use of antifibrotics decreased all-cause mortality, RR 0.55 (95% CI, 0.45–0.66). The same review included seven studies involving 2002 treated and 1323 non-treated patients, and showed a decrease in AE, which was statistically significant for Nintedanib (RR 0.62 [95% CI, 0.43–0.89) but only non-significant decrease for Pirfenidone, RR of 0.57 (95% CI, 0.29–1.12) [1].
Overall, the evidence favors Nintedanib over Pirfenidone in terms of preventing AE of IPF. However, there are no head to head comparisons between these two approved medications and real world data could produce results to the contrary [97]. Hence it would be prudent to plan design and conduct appropriate RCT that would give an unambiguous answer to this very important question.
Episodes of Acute exacerbation are important events in the disease course of IPF. Up to 40% of deaths in IPF are caused by acute exacerbations. After the initial diagnosis, the median survival of patients with acute exacerbation was much shorter (15.5 months) than that of patients without respiratory deterioration (60.6 months). The 5 year rate of survival of patients with acute exacerbation was 18.4%, whereas 50.0% of patients without respiratory deterioration survived.
While medications like Nintedanib can slow down progression of disease and prevent exacerbations, once diagnosed it has no known effective treatment. Hence more research is needed to alter the disease course of IPF as well as prevent the occurrence of these exacerbations which invariably is an indicator of poor prognosis.
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On grounds of above it is implied, the process of solidification constitutes an important aspects in the production of a defect free casting.",book:{id:"10432",slug:"casting-processes-and-modelling-of-metallic-materials",title:"Casting Processes and Modelling of Metallic Materials",fullTitle:"Casting Processes and Modelling of Metallic Materials"},signatures:"Upendra Kumar Mohanty and Hrushikesh Sarangi",authors:[{id:"328540",title:"Prof.",name:"Hrushikesh",middleName:null,surname:"Sarangi",slug:"hrushikesh-sarangi",fullName:"Hrushikesh Sarangi"},{id:"328543",title:"Prof.",name:"Upendra Kumar",middleName:null,surname:"Mohanty",slug:"upendra-kumar-mohanty",fullName:"Upendra Kumar Mohanty"}]},{id:"48856",title:"Silicon Carbide in Microsystem Technology — Thin Film Versus Bulk Material",slug:"silicon-carbide-in-microsystem-technology-thin-film-versus-bulk-material",totalDownloads:2887,totalCrossrefCites:4,totalDimensionsCites:10,abstract:"This chapter looks at the role of silicon carbide (SiC) in microsystem technology. It starts with an introduction into the wide bandgap (WBG) materials and the properties that make them potential candidates to enable the development of harsh environment microsystems. The future commercial success of WBG microsystems depends mainly on the availability of high-quality materials, well-established microfabrication processes, and economic viability. In such aspects SiC platform, in relation to other WBG materials, provides a clear and competitive advantage. The reasons for this will be detailed. Furthermore, the current status of the SiC thin film and bulk material technologies will also be discussed. Both SiC material forms have played important roles in different microsystem types.",book:{id:"4721",slug:"advanced-silicon-carbide-devices-and-processing",title:"Advanced Silicon Carbide Devices and Processing",fullTitle:"Advanced Silicon Carbide Devices and Processing"},signatures:"Mariana Amorim Fraga, Matteo Bosi and Marco Negri",authors:[{id:"9292",title:"Dr.",name:"matteo",middleName:null,surname:"bosi",slug:"matteo-bosi",fullName:"matteo bosi"},{id:"38456",title:"Dr.",name:"Mariana",middleName:null,surname:"Amorim Fraga",slug:"mariana-amorim-fraga",fullName:"Mariana Amorim Fraga"},{id:"175671",title:"MSc.",name:"Marco",middleName:null,surname:"Negri",slug:"marco-negri",fullName:"Marco Negri"}]},{id:"46237",title:"Corrosion Resistance Through the Application of Anti- Corrosion Coatings",slug:"corrosion-resistance-through-the-application-of-anti-corrosion-coatings",totalDownloads:7398,totalCrossrefCites:11,totalDimensionsCites:32,abstract:null,book:{id:"3817",slug:"developments-in-corrosion-protection",title:"Developments in Corrosion Protection",fullTitle:"Developments in Corrosion Protection"},signatures:"Api Popoola, OE Olorunniwo and OO Ige",authors:[{id:"169258",title:"Dr.",name:"Patricia",middleName:null,surname:"Popoola",slug:"patricia-popoola",fullName:"Patricia Popoola"}]},{id:"46235",title:"Corrosion Detection for Automated Visual Inspection",slug:"corrosion-detection-for-automated-visual-inspection",totalDownloads:3578,totalCrossrefCites:18,totalDimensionsCites:32,abstract:null,book:{id:"3817",slug:"developments-in-corrosion-protection",title:"Developments in Corrosion Protection",fullTitle:"Developments in Corrosion Protection"},signatures:"Francisco Bonnin-Pascual and Alberto Ortiz",authors:[{id:"124589",title:"Prof.",name:"Alberto",middleName:null,surname:"Ortiz",slug:"alberto-ortiz",fullName:"Alberto Ortiz"},{id:"169256",title:"Ph.D. Student",name:"Francisco",middleName:null,surname:"Bonnin-Pascual",slug:"francisco-bonnin-pascual",fullName:"Francisco Bonnin-Pascual"}]}],onlineFirstChaptersFilter:{topicId:"944",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"82118",title:"Surface Hardening of Stainless Steel",slug:"surface-hardening-of-stainless-steel",totalDownloads:24,totalDimensionsCites:0,doi:"10.5772/intechopen.105036",abstract:"The addition of nitrogen to stainless steel improves mechanical and corrosion properties. Nitrogen-bearing stainless steel (HNSS) is a new corrosion-resistant alloy class exhibiting better tribological properties. High-pressure and powder metallurgy techniques were developed for the fabrication of HNSS. Solid-state routes allow nitrogen introduction through thermochemical, implantation, or plasma surface treatments. High-temperature gas nitriding (HTGN), carried out in an N2 atmosphere in the 1000°C range, allows N uptake, obtaining thick, ~0.5–1.0 wt.% N austenitic cases. HTGN is different from conventional nitriding, performed in the 500°C range, where intense CrxNy precipitation occurs, impairing the corrosion resistance. Low-temperature plasma nitriding (LTPN) introduces more N in solution, and colossal supersaturated expanded phases (~45 at.%N) are formed. N supersaturation and compressive stresses increase the hardness of the surface layer to 10–14 GPa. Ferritic, martensitic, duplex, and precipitation-hardened stainless steels can be surface-treated by LTPN, obtaining expanded ferrite and martensite. However, single LTPN stainless steel may prematurely fail when submitted to high loading, as the thin and hard expanded layers collapse due to lack of load-bearing capacity. Duplex-nitriding treatment (HTGN + LTPN) results in a thick nitrogen-rich hardened austenite substrate layer, granting mechanical support and adhesion to the expanded austenite layer.",book:{id:"11076",title:"Stainless Steels",coverURL:"https://cdn.intechopen.com/books/images_new/11076.jpg"},signatures:"André Paulo Tschiptschin and Carlos Eduardo Pinedo"},{id:"81579",title:"Welding Based Additive Manufacturing: Fundamentals",slug:"welding-based-additive-manufacturing-fundamentals",totalDownloads:34,totalDimensionsCites:0,doi:"10.5772/intechopen.104768",abstract:"Additive Manufacturing (AM) has drawn abundant attention over the past decades in the manufacturing and fabrication industries, especially to make part models and prototypes. This chapter introduces a potential welding based AM process called Wire Arc Additive Manufacturing (WAAM) for the fabrication of near-net shaped metal components including stainless steel components. To start with traditional AM processes, various fundamental traditional AM for the fabrication of components have been presented. Wire Arc Additive Manufacturing (WAAM) has been explained with its variants, synonyms, different welding processes to suit WAAM particularly to weld stainless steel metal; primary process selections for working with WAAM, important metals, and alloys that could be used in WAAM have been elaborated. A case study for WAAM fabrication of AISI 316 L stainless steel plate is included to introduce the fabrication of metal components using WAAM. Further, the most common defects which possibly play a vital role in WAAM components fabrication and a few of the future challenges regarding WAAM development are discussed. Fundamental information covered in this chapter could be more beneficial to beginners for the understanding of WAAM process generally including stainless steel component fabrication in a lucid tactic.",book:{id:"11076",title:"Stainless Steels",coverURL:"https://cdn.intechopen.com/books/images_new/11076.jpg"},signatures:"Maruthasalam Sowrirajan, Selvaraj Vijayan and Munusamy Arulraj"},{id:"80664",title:"Dependence of Corrosion Resistance of Austenitic Chromium-Nickel Steels on the Magnetic State of Austenite",slug:"dependence-of-corrosion-resistance-of-austenitic-chromium-nickel-steels-on-the-magnetic-state-of-aus",totalDownloads:59,totalDimensionsCites:0,doi:"10.5772/intechopen.102388",abstract:"Corrosive behavior of austenitic chromium-nickel steels from the magnetic state (parameter χ0) of austenite, pre-formed to interact with aggressive media are research. Correlation between the rate K of pitting corrosion and the specific magnetic susceptibility χ0 of austenite was experimentally established. It is experimentally established that the corrosion resistance of austenitic steels AISI304, 08Cr18Ni10, AISI 321, 08Cr18Ni10Тi (containing a low amount of δ-ferrite ∼0.005…0.5%) depends on the magnetic state of austenite: the corrosion rate of steel decreases with increases χ0 austenite. The tendency of change in the corrosion rate of austenitic alloy with a high nickel content 06Crh28NiMoCuTi (not contain δ-ferrite) has the opposite character: with increasing χ0, the corrosion rate of the alloy increases is revealed. For austenitic chromium-nickel steels, the corrosion rates of the individual (austenite (A), δ-ferrite (F), strain-induced α′-martensite (M)) and total (A + F, A + M and A + F + M) phases are determined. It is proposed to predict corrosion according to the specific magnetic susceptibility χ0 of austenite and the amount δ-ferrite.",book:{id:"11076",title:"Stainless Steels",coverURL:"https://cdn.intechopen.com/books/images_new/11076.jpg"},signatures:"Gennadii Snizhnoi"},{id:"80199",title:"The Evaluation of the Comparative Corrosion Behaviour of Conventional and Low-Nickel Austenitic Stainless Steel: Hercules™ Alloy",slug:"the-evaluation-of-the-comparative-corrosion-behaviour-of-conventional-and-low-nickel-austenitic-stai",totalDownloads:56,totalDimensionsCites:0,doi:"10.5772/intechopen.102381",abstract:"Austenitic stainless steels require approximately 8% Ni to maintain austenitic microstructure at room temperature for alloys such as 304 stainless steel (304SS). Ni contributes approximately 60% of the total material cost and its price fluctuates, making the cost of austenitic stainless steel unpredictable. The use of low-nickel austenitic stainless steels as a substitute has been considered in order to remedy costs associated with Ni price fluctuations. Alloying elements such as Mn and N have been considered, however they have been found to reduce corrosion resistance. A new alloy namely Hercules™ has been developed with reduced Ni content (1.8–2% Ni). This chapter presents a comparative study of the corrosion behavior of Hercules™ and 304SS in different solutions. The alloys were evaluated using cyclic polarisation technique and immersion tests. The results demonstrated that the corrosion resistance of Hercules™ is comparable to that of 304SS. This presents the alloys as potential industrial substitutes of each other.",book:{id:"11076",title:"Stainless Steels",coverURL:"https://cdn.intechopen.com/books/images_new/11076.jpg"},signatures:"Duduzile Nkomo and Nomsombuluko Masia"},{id:"80346",title:"Nitrogen Supersaturation of AISI316 Base Stainless Steels at 673 K and 623 K for Hardening and Microstructure Control",slug:"nitrogen-supersaturation-of-aisi316-base-stainless-steels-at-673-k-and-623-k-for-hardening-and-micro",totalDownloads:59,totalDimensionsCites:1,doi:"10.5772/intechopen.102387",abstract:"The high-density plasma nitriding at 673 K and 623 K was employed to make 10% of nitrogen supersaturation on AISI316 base austenitic stainless steels. The processing parameters and nitrogen-hydrogen gas flow ratio were optimized to increase the yield of N2+ ion and NH-radical for efficient nitriding. The nitrided AISI316 specimens were prepared for multidimensional analysis to describe the fundamental features of low-temperature plasma nitriding. First, macroscopic evaluation revealed that nitrogen supersaturation induced the γ-lattice expansion and the higher nitrogen content than 4% of mass in depth. The mesoscopic analysis describes the holding temperature and initial grain-size effects on the microstructure changes. Plastic straining, grain-size refinement, and nitrogen zone-boundary diffusion processes advance with nitrogen supersaturation to drive the inner nitriding behavior. The microscopic analysis explains the microstructure refinement, the two-phase structuring, and the microstructure modification. Through this multi-dimensional analysis, the essential characteristics of the low-temperature plasma nitriding of 316 austenitic stainless steels were precisely understood to extend the engineering treatise on the bulk nitrogen stainless steels for surface modification and treatment of stainless steels by nitriding. This plasma nitriding was applied to strengthen and harden the AISI316 wire surfaces toward its application on surgery wires.",book:{id:"11076",title:"Stainless Steels",coverURL:"https://cdn.intechopen.com/books/images_new/11076.jpg"},signatures:"Tatsuhiko Aizawa, Tomomi Shiratori, Tomoaki Yoshino, Yohei Suzuki and Takafumi Komatsu"},{id:"79904",title:"Corrosion Resistance, Evaluation Methods, and Surface Treatments of Stainless Steels",slug:"corrosion-resistance-evaluation-methods-and-surface-treatments-of-stainless-steels",totalDownloads:106,totalDimensionsCites:1,doi:"10.5772/intechopen.101430",abstract:"Stainless steels are widely recognized and find applications in many engineering industries and companies due to their excellent properties including high resistance to corrosion as a result of their minimum 10.5% chromium content, exceptional strength and durability, temperature resistance, high recyclability, and easy formability. In the present book chapter, the basic concepts of stainless steel including its applications, classifications, and corrosion properties will first be discussed. Thereafter, their corrosion behaviour will then be explained. The various methods by which the corrosion resistance behaviour can be significantly improved including surface treatments such as coatings/electrodepositions, alloying, mechanical treatment, and others will be discussed in detail.",book:{id:"11076",title:"Stainless Steels",coverURL:"https://cdn.intechopen.com/books/images_new/11076.jpg"},signatures:"Temitope Olumide Olugbade"}],onlineFirstChaptersTotal:8},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:11,numberOfPublishedChapters:91,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:108,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:333,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:11,numberOfPublishedChapters:143,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:124,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:23,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:12,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}},{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. 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Ongoing issues, recent advances, and future diagnostic approaches and therapeutic strategies will also be discussed. This book series will focus on various aspects and properties of infectious diseases whose deep understanding is essential for safeguarding the human race from losing resources and economies due to pathogens.",coverUrl:"https://cdn.intechopen.com/series/covers/6.jpg",latestPublicationDate:"August 16th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:13,editor:{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales",profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",biography:"Dr. Rodriguez-Morales is an expert in tropical and emerging diseases, particularly zoonotic and vector-borne diseases (especially arboviral diseases). He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},editorTwo:null,editorThree:null},subseries:{paginationCount:4,paginationItems:[{id:"3",title:"Bacterial Infectious Diseases",coverUrl:"https://cdn.intechopen.com/series_topics/covers/3.jpg",isOpenForSubmission:!0,editor:{id:"205604",title:"Dr.",name:"Tomas",middleName:null,surname:"Jarzembowski",slug:"tomas-jarzembowski",fullName:"Tomas Jarzembowski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRKriQAG/Profile_Picture_2022-06-16T11:01:31.jpg",biography:"Tomasz Jarzembowski was born in 1968 in Gdansk, Poland. He obtained his Ph.D. degree in 2000 from the Medical University of Gdańsk (UG). After specialization in clinical microbiology in 2003, he started studying biofilm formation and antibiotic resistance at the single-cell level. In 2015, he obtained his D.Sc. degree. His later study in cooperation with experts in nephrology and immunology resulted in the designation of the new diagnostic method of UTI, patented in 2017. He is currently working at the Department of Microbiology, Medical University of Gdańsk (GUMed), Poland. Since many years, he is a member of steering committee of Gdańsk branch of Polish Society of Microbiologists, a member of ESCMID. He is also a reviewer and a member of editorial boards of a number of international journals.",institutionString:"Medical University of Gdańsk, Poland",institution:null},editorTwo:{id:"484980",title:"Dr.",name:"Katarzyna",middleName:null,surname:"Garbacz",slug:"katarzyna-garbacz",fullName:"Katarzyna Garbacz",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003St8TAQAZ/Profile_Picture_2022-07-07T09:45:16.jpg",biography:"Katarzyna Maria Garbacz, MD, is an Associate Professor at the Medical University of Gdańsk, Poland and she is head of the Department of Oral Microbiology of the Medical University of Gdańsk. She has published more than 50 scientific publications in peer-reviewed journals. She has been a project leader funded by the National Science Centre of Poland. Prof. Garbacz is a microbiologist working on applied and fundamental questions in microbial epidemiology and pathogenesis. Her research interest is in antibiotic resistance, host-pathogen interaction, and therapeutics development for staphylococcal pathogens, mainly Staphylococcus aureus, which causes hospital-acquired infections. Currently, her research is mostly focused on the study of oral pathogens, particularly Staphylococcus spp.",institutionString:"Medical University of Gdańsk, Poland",institution:null},editorThree:null},{id:"4",title:"Fungal Infectious Diseases",coverUrl:"https://cdn.intechopen.com/series_topics/covers/4.jpg",isOpenForSubmission:!0,editor:{id:"174134",title:"Dr.",name:"Yuping",middleName:null,surname:"Ran",slug:"yuping-ran",fullName:"Yuping Ran",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bS9d6QAC/Profile_Picture_1630330675373",biography:"Dr. Yuping Ran, Professor, Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China. Completed the Course Medical Mycology, the Centraalbureau voor Schimmelcultures (CBS), Fungal Biodiversity Centre, Netherlands (2006). International Union of Microbiological Societies (IUMS) Fellow, and International Emerging Infectious Diseases (IEID) Fellow, Centers for Diseases Control and Prevention (CDC), Atlanta, USA. Diploma of Dermatological Scientist, Japanese Society for Investigative Dermatology. Ph.D. of Juntendo University, Japan. Bachelor’s and Master’s degree, Medicine, West China University of Medical Sciences. Chair of Sichuan Medical Association Dermatology Committee. General Secretary of The 19th Annual Meeting of Chinese Society of Dermatology and the Asia Pacific Society for Medical Mycology (2013). In charge of the Annual Medical Mycology Course over 20-years authorized by National Continue Medical Education Committee of China. Member of the board of directors of the Asia-Pacific Society for Medical Mycology (APSMM). Associate editor of Mycopathologia. Vice-chief of the editorial board of Chinses Journal of Mycology, China. Board Member and Chair of Mycology Group of Chinese Society of Dermatology.",institutionString:null,institution:{name:"Sichuan University",institutionURL:null,country:{name:"China"}}},editorTwo:null,editorThree:null},{id:"5",title:"Parasitic Infectious Diseases",coverUrl:"https://cdn.intechopen.com/series_topics/covers/5.jpg",isOpenForSubmission:!0,editor:{id:"67907",title:"Dr.",name:"Amidou",middleName:null,surname:"Samie",slug:"amidou-samie",fullName:"Amidou Samie",profilePictureURL:"https://mts.intechopen.com/storage/users/67907/images/system/67907.jpg",biography:"Dr. Amidou Samie is an Associate Professor of Microbiology at the University of Venda, in South Africa, where he graduated for his PhD in May 2008. He joined the Department of Microbiology the same year and has been giving lectures on topics covering parasitology, immunology, molecular biology and industrial microbiology. He is currently a rated researcher by the National Research Foundation of South Africa at category C2. He has published widely in the field of infectious diseases and has overseen several MSc’s and PhDs. His research activities mostly cover topics on infectious diseases from epidemiology to control. His particular interest lies in the study of intestinal protozoan parasites and opportunistic infections among HIV patients as well as the potential impact of childhood diarrhoea on growth and child development. He also conducts research on water-borne diseases and water quality and is involved in the evaluation of point-of-use water treatment technologies using silver and copper nanoparticles in collaboration with the University of Virginia, USA. He also studies the use of medicinal plants for the control of infectious diseases as well as antimicrobial drug resistance.",institutionString:null,institution:{name:"University of Venda",institutionURL:null,country:{name:"South Africa"}}},editorTwo:null,editorThree:null},{id:"6",title:"Viral Infectious Diseases",coverUrl:"https://cdn.intechopen.com/series_topics/covers/6.jpg",isOpenForSubmission:!0,editor:{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. 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He has been listed among the top 2% of scientists in the world for the last three consecutive years, 2019 to 2021 as per studies conducted by the Stanford University, USA.",institutionString:"Praxis Business School",institution:null},{id:"320071",title:"Dr.",name:"Sidra",middleName:null,surname:"Mehtab",slug:"sidra-mehtab",fullName:"Sidra Mehtab",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00002v6KHoQAM/Profile_Picture_1584512086360",biography:"Sidra Mehtab has completed her BS with honors in Physics from Calcutta University, India in 2018. She has done MS in Data Science and Analytics from Maulana Abul Kalam Azad University of Technology (MAKAUT), Kolkata, India in 2020. Her research areas include Econometrics, Time Series Analysis, Machine Learning, Deep Learning, Artificial Intelligence, and Computer and Network Security with a particular focus on Cyber Security Analytics. Ms. Mehtab has published seven papers in international conferences and one of her papers has been accepted for publication in a reputable international journal. She has won the best paper awards in two prestigious international conferences – BAICONF 2019, and ICADCML 2021, organized in the Indian Institute of Management, Bangalore, India in December 2019, and SOA University, Bhubaneswar, India in January 2021. Besides, Ms. Mehtab has also published two book chapters in two books. Seven of her book chapters will be published in a volume shortly in 2021 by Cambridge Scholars’ Press, UK. Currently, she is working as the joint editor of two edited volumes on Time Series Analysis and Forecasting to be published in the first half of 2021 by an international house. Currently, she is working as a Data Scientist with an MNC in Delhi, India.",institutionString:"NSHM College of Management and Technology",institution:{name:"Association for Computing Machinery",country:{name:"United States of America"}}},{id:"226240",title:"Dr.",name:"Andri Irfan",middleName:null,surname:"Rifai",slug:"andri-irfan-rifai",fullName:"Andri Irfan Rifai",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226240/images/7412_n.jpg",biography:"Andri IRFAN is a Senior Lecturer of Civil Engineering and Planning. He completed the PhD at the Universitas Indonesia & Universidade do Minho with Sandwich Program Scholarship from the Directorate General of Higher Education and LPDP scholarship. He has been teaching for more than 19 years and much active to applied his knowledge in the project construction in Indonesia. His research interest ranges from pavement management system to advanced data mining techniques for transportation engineering. He has published more than 50 papers in journals and 2 books.",institutionString:null,institution:{name:"Universitas Internasional Batam",country:{name:"Indonesia"}}},{id:"314576",title:"Dr.",name:"Ibai",middleName:null,surname:"Laña",slug:"ibai-lana",fullName:"Ibai Laña",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314576/images/system/314576.jpg",biography:"Dr. Ibai Laña works at TECNALIA as a data analyst. He received his Ph.D. in Artificial Intelligence from the University of the Basque Country (UPV/EHU), Spain, in 2018. He is currently a senior researcher at TECNALIA. His research interests fall within the intersection of intelligent transportation systems, machine learning, traffic data analysis, and data science. He has dealt with urban traffic forecasting problems, applying machine learning models and evolutionary algorithms. He has experience in origin-destination matrix estimation or point of interest and trajectory detection. Working with large volumes of data has given him a good command of big data processing tools and NoSQL databases. He has also been a visiting scholar at the Knowledge Engineering and Discovery Research Institute, Auckland University of Technology.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"314575",title:"Dr.",name:"Jesus",middleName:null,surname:"L. Lobo",slug:"jesus-l.-lobo",fullName:"Jesus L. Lobo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314575/images/system/314575.png",biography:"Dr. Jesús López is currently based in Bilbao (Spain) working at TECNALIA as Artificial Intelligence Research Scientist. In most cases, a project idea or a new research line needs to be investigated to see if it is good enough to take into production or to focus on it. That is exactly what he does, diving into Machine Learning algorithms and technologies to help TECNALIA to decide whether something is great in theory or will actually impact on the product or processes of its projects. So, he is expert at framing experiments, developing hypotheses, and proving whether they’re true or not, in order to investigate fundamental problems with a longer time horizon. He is also able to design and develop PoCs and system prototypes in simulation. He has participated in several national and internacional R&D projects.\n\nAs another relevant part of his everyday research work, he usually publishes his findings in reputed scientific refereed journals and international conferences, occasionally acting as reviewer and Programme Commitee member. Concretely, since 2018 he has published 9 JCR (8 Q1) journal papers, 9 conference papers (e.g. ECML PKDD 2021), and he has co-edited a book. He is also active in popular science writing data science stories for reputed blogs (KDNuggets, TowardsDataScience, Naukas). Besides, he has recently embarked on mentoring programmes as mentor, and has also worked as data science trainer.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"103779",title:"Prof.",name:"Yalcin",middleName:null,surname:"Isler",slug:"yalcin-isler",fullName:"Yalcin Isler",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRyQ8QAK/Profile_Picture_1628834958734",biography:"Yalcin Isler (1971 - Burdur / Turkey) received the B.Sc. degree in the Department of Electrical and Electronics Engineering from Anadolu University, Eskisehir, Turkey, in 1993, the M.Sc. degree from the Department of Electronics and Communication Engineering, Suleyman Demirel University, Isparta, Turkey, in 1996, the Ph.D. degree from the Department of Electrical and Electronics Engineering, Dokuz Eylul University, Izmir, Turkey, in 2009, and the Competence of Associate Professorship from the Turkish Interuniversity Council in 2019.\n\nHe was Lecturer at Burdur Vocational School in Suleyman Demirel University (1993-2000, Burdur / Turkey), Software Engineer (2000-2002, Izmir / Turkey), Research Assistant in Bulent Ecevit University (2002-2003, Zonguldak / Turkey), Research Assistant in Dokuz Eylul University (2003-2010, Izmir / Turkey), Assistant Professor at the Department of Electrical and Electronics Engineering in Bulent Ecevit University (2010-2012, Zonguldak / Turkey), Assistant Professor at the Department of Biomedical Engineering in Izmir Katip Celebi University (2012-2019, Izmir / Turkey). He is an Associate Professor at the Department of Biomedical Engineering at Izmir Katip Celebi University, Izmir / Turkey, since 2019. In addition to academics, he has also founded Islerya Medical and Information Technologies Company, Izmir / Turkey, since 2017.\n\nHis main research interests cover biomedical signal processing, pattern recognition, medical device design, programming, and embedded systems. He has many scientific papers and participated in several projects in these study fields. He was an IEEE Student Member (2009-2011) and IEEE Member (2011-2014) and has been IEEE Senior Member since 2014.",institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",country:{name:"Turkey"}}},{id:"339677",title:"Dr.",name:"Mrinmoy",middleName:null,surname:"Roy",slug:"mrinmoy-roy",fullName:"Mrinmoy Roy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/339677/images/16768_n.jpg",biography:"An accomplished Sales & Marketing professional with 12 years of cross-functional experience in well-known organisations such as CIPLA, LUPIN, GLENMARK, ASTRAZENECA across different segment of Sales & Marketing, International Business, Institutional Business, Product Management, Strategic Marketing of HIV, Oncology, Derma, Respiratory, Anti-Diabetic, Nutraceutical & Stomatological Product Portfolio and Generic as well as Chronic Critical Care Portfolio. A First Class MBA in International Business & Strategic Marketing, B.Pharm, D.Pharm, Google Certified Digital Marketing Professional. Qualified PhD Candidate in Operations and Management with special focus on Artificial Intelligence and Machine Learning adoption, analysis and use in Healthcare, Hospital & Pharma Domain. Seasoned with diverse therapy area of Pharmaceutical Sales & Marketing ranging from generating revenue through generating prescriptions, launching new products, and making them big brands with continuous strategy execution at the Physician and Patients level. Moved from Sales to Marketing and Business Development for 3.5 years in South East Asian Market operating from Manila, Philippines. Came back to India and handled and developed Brands such as Gluconorm, Lupisulin, Supracal, Absolut Woman, Hemozink, Fabiflu (For COVID 19), and many more. In my previous assignment I used to develop and execute strategies on Sales & Marketing, Commercialization & Business Development for Institution and Corporate Hospital Business portfolio of Oncology Therapy Area for AstraZeneca Pharma India Ltd. Being a Research Scholar and Student of ‘Operations Research & Management: Artificial Intelligence’ I published several pioneer research papers and book chapters on the same in Internationally reputed journals and Books indexed in Scopus, Springer and Ei Compendex, Google Scholar etc. Currently, I am launching PGDM Pharmaceutical Management Program in IIHMR Bangalore and spearheading the course curriculum and structure of the same. I am interested in Collaboration for Healthcare Innovation, Pharma AI Innovation, Future trend in Marketing and Management with incubation on Healthcare, Healthcare IT startups, AI-ML Modelling and Healthcare Algorithm based training module development. I am also an affiliated member of the Institute of Management Consultant of India, looking forward to Healthcare, Healthcare IT and Innovation, Pharma and Hospital Management Consulting works.",institutionString:null,institution:{name:"Lovely Professional University",country:{name:"India"}}},{id:"1063",title:"Prof.",name:"Constantin",middleName:null,surname:"Volosencu",slug:"constantin-volosencu",fullName:"Constantin Volosencu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1063/images/system/1063.png",biography:"Prof. Dr. Constantin Voloşencu graduated as an engineer from\nPolitehnica University of Timișoara, Romania, where he also\nobtained a doctorate degree. He is currently a full professor in\nthe Department of Automation and Applied Informatics at the\nsame university. Dr. Voloşencu is the author of ten books, seven\nbook chapters, and more than 160 papers published in journals\nand conference proceedings. He has also edited twelve books and\nhas twenty-seven patents to his name. He is a manager of research grants, editor in\nchief and member of international journal editorial boards, a former plenary speaker, a member of scientific committees, and chair at international conferences. His\nresearch is in the fields of control systems, control of electric drives, fuzzy control\nsystems, neural network applications, fault detection and diagnosis, sensor network\napplications, monitoring of distributed parameter systems, and power ultrasound\napplications. He has developed automation equipment for machine tools, spooling\nmachines, high-power ultrasound processes, and more.",institutionString:'"Politechnica" University Timişoara',institution:null},{id:"221364",title:"Dr.",name:"Eneko",middleName:null,surname:"Osaba",slug:"eneko-osaba",fullName:"Eneko Osaba",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/221364/images/system/221364.jpg",biography:"Dr. Eneko Osaba works at TECNALIA as a senior researcher. He obtained his Ph.D. in Artificial Intelligence in 2015. He has participated in more than twenty-five local and European research projects, and in the publication of more than 130 papers. He has performed several stays at universities in the United Kingdom, Italy, and Malta. Dr. Osaba has served as a program committee member in more than forty international conferences and participated in organizing activities in more than ten international conferences. He is a member of the editorial board of the International Journal of Artificial Intelligence, Data in Brief, and Journal of Advanced Transportation. He is also a guest editor for the Journal of Computational Science, Neurocomputing, Swarm, and Evolutionary Computation and IEEE ITS Magazine.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"275829",title:"Dr.",name:"Esther",middleName:null,surname:"Villar-Rodriguez",slug:"esther-villar-rodriguez",fullName:"Esther Villar-Rodriguez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/275829/images/system/275829.jpg",biography:"Dr. Esther Villar obtained a Ph.D. in Information and Communication Technologies from the University of Alcalá, Spain, in 2015. She obtained a degree in Computer Science from the University of Deusto, Spain, in 2010, and an MSc in Computer Languages and Systems from the National University of Distance Education, Spain, in 2012. Her areas of interest and knowledge include natural language processing (NLP), detection of impersonation in social networks, semantic web, and machine learning. Dr. Esther Villar made several contributions at conferences and publishing in various journals in those fields. Currently, she is working within the OPTIMA (Optimization Modeling & Analytics) business of TECNALIA’s ICT Division as a data scientist in projects related to the prediction and optimization of management and industrial processes (resource planning, energy efficiency, etc).",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49813/images/system/49813.png",biography:"Prof. Dr. Javier Del Ser received his first PhD in Telecommunication Engineering (Cum Laude) from the University of Navarra, Spain, in 2006, and a second PhD in Computational Intelligence (Summa Cum Laude) from the University of Alcala, Spain, in 2013. He is currently a principal researcher in data analytics and optimisation at TECNALIA (Spain), a visiting fellow at the Basque Center for Applied Mathematics (BCAM) and a part-time lecturer at the University of the Basque Country (UPV/EHU). His research interests gravitate on the use of descriptive, prescriptive and predictive algorithms for data mining and optimization in a diverse range of application fields such as Energy, Transport, Telecommunications, Health and Industry, among others. In these fields he has published more than 240 articles, co-supervised 8 Ph.D. theses, edited 6 books, coauthored 7 patents and participated/led more than 40 research projects. He is a Senior Member of the IEEE, and a recipient of the Biscay Talent prize for his academic career.",institutionString:"Tecnalia Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"278948",title:"Dr.",name:"Carlos Pedro",middleName:null,surname:"Gonçalves",slug:"carlos-pedro-goncalves",fullName:"Carlos Pedro Gonçalves",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRcmyQAC/Profile_Picture_1564224512145",biography:'Carlos Pedro Gonçalves (PhD) is an Associate Professor at Lusophone University of Humanities and Technologies and a researcher on Complexity Sciences, Quantum Technologies, Artificial Intelligence, Strategic Studies, Studies in Intelligence and Security, FinTech and Financial Risk Modeling. He is also a progammer with programming experience in:\n\nA) Quantum Computing using Qiskit Python module and IBM Quantum Experience Platform, with software developed on the simulation of Quantum Artificial Neural Networks and Quantum Cybersecurity;\n\nB) Artificial Intelligence and Machine learning programming in Python;\n\nC) Artificial Intelligence, Multiagent Systems Modeling and System Dynamics Modeling in Netlogo, with models developed in the areas of Chaos Theory, Econophysics, Artificial Intelligence, Classical and Quantum Complex Systems Science, with the Econophysics models having been cited worldwide and incorporated in PhD programs by different Universities.\n\nReceived an Arctic Code Vault Contributor status by GitHub, due to having developed open source software preserved in the \\"Arctic Code Vault\\" for future generations (https://archiveprogram.github.com/arctic-vault/), with the Strategy Analyzer A.I. module for decision making support (based on his PhD thesis, used in his Classes on Decision Making and in Strategic Intelligence Consulting Activities) and QNeural Python Quantum Neural Network simulator also preserved in the \\"Arctic Code Vault\\", for access to these software modules see: https://github.com/cpgoncalves. He is also a peer reviewer with outsanding review status from Elsevier journals, including Physica A, Neurocomputing and Engineering Applications of Artificial Intelligence. Science CV available at: https://www.cienciavitae.pt//pt/8E1C-A8B3-78C5 and ORCID: https://orcid.org/0000-0002-0298-3974',institutionString:"University of Lisbon",institution:{name:"Universidade Lusófona",country:{name:"Portugal"}}},{id:"310576",title:"Prof.",name:"Erick Giovani",middleName:null,surname:"Sperandio Nascimento",slug:"erick-giovani-sperandio-nascimento",fullName:"Erick Giovani Sperandio Nascimento",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y00002pDKxDQAW/ProfilePicture%202022-06-20%2019%3A57%3A24.788",biography:"Prof. Erick Sperandio is the Lead Researcher and professor of Artificial Intelligence (AI) at SENAI CIMATEC, Bahia, Brazil, also working with Computational Modeling (CM) and HPC. He holds a PhD in Environmental Engineering in the area of Atmospheric Computational Modeling, a Master in Informatics in the field of Computational Intelligence and Graduated in Computer Science from UFES. He currently coordinates, leads and participates in R&D projects in the areas of AI, computational modeling and supercomputing applied to different areas such as Oil and Gas, Health, Advanced Manufacturing, Renewable Energies and Atmospheric Sciences, advising undergraduate, master's and doctoral students. He is the Lead Researcher at SENAI CIMATEC's Reference Center on Artificial Intelligence. In addition, he is a Certified Instructor and University Ambassador of the NVIDIA Deep Learning Institute (DLI) in the areas of Deep Learning, Computer Vision, Natural Language Processing and Recommender Systems, and Principal Investigator of the NVIDIA/CIMATEC AI Joint Lab, the first in Latin America within the NVIDIA AI Technology Center (NVAITC) worldwide program. He also works as a researcher at the Supercomputing Center for Industrial Innovation (CS2i) and at the SENAI Institute of Innovation for Automation (ISI Automação), both from SENAI CIMATEC. He is a member and vice-coordinator of the Basic Board of Scientific-Technological Advice and Evaluation, in the area of Innovation, of the Foundation for Research Support of the State of Bahia (FAPESB). He serves as Technology Transfer Coordinator and one of the Principal Investigators at the National Applied Research Center in Artificial Intelligence (CPA-IA) of SENAI CIMATEC, focusing on Industry, being one of the six CPA-IA in Brazil approved by MCTI / FAPESP / CGI.br. He also participates as one of the representatives of Brazil in the BRICS Innovation Collaboration Working Group on HPC, ICT and AI. He is the coordinator of the Work Group of the Axis 5 - Workforce and Training - of the Brazilian Strategy for Artificial Intelligence (EBIA), and member of the MCTI/EMBRAPII AI Innovation Network Training Committee. He is the coordinator, by SENAI CIMATEC, of the Artificial Intelligence Reference Network of the State of Bahia (REDE BAH.IA). He leads the working group of experts representing Brazil in the Global Partnership on Artificial Intelligence (GPAI), on the theme \"AI and the Pandemic Response\".",institutionString:null,institution:null},{id:"241400",title:"Prof.",name:"Mohammed",middleName:null,surname:"Bsiss",slug:"mohammed-bsiss",fullName:"Mohammed Bsiss",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241400/images/8062_n.jpg",biography:null,institutionString:null,institution:null},{id:"276128",title:"Dr.",name:"Hira",middleName:null,surname:"Fatima",slug:"hira-fatima",fullName:"Hira Fatima",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/276128/images/14420_n.jpg",biography:"Dr. Hira Fatima\nAssistant Professor\nDepartment of Mathematics\nInstitute of Applied Science\nMangalayatan University, Aligarh\nMobile: no : 8532041179\nhirafatima2014@gmal.com\n\nDr. Hira Fatima has received his Ph.D. degree in pure Mathematics from Aligarh Muslim University, Aligarh India. Currently working as an Assistant Professor in the Department of Mathematics, Institute of Applied Science, Mangalayatan University, Aligarh. She taught so many courses of Mathematics of UG and PG level. Her research Area of Expertise is Functional Analysis & Sequence Spaces. She has been working on Ideal Convergence of double sequence. She has published 17 research papers in National and International Journals including Cogent Mathematics, Filomat, Journal of Intelligent and Fuzzy Systems, Advances in Difference Equations, Journal of Mathematical Analysis, Journal of Mathematical & Computer Science etc. She has also reviewed few research papers for the and international journals. She is a member of Indian Mathematical Society.",institutionString:null,institution:null},{id:"417317",title:"Mrs.",name:"Chiedza",middleName:null,surname:"Elvina Mashiri",slug:"chiedza-elvina-mashiri",fullName:"Chiedza Elvina Mashiri",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Midlands State University",country:{name:"Zimbabwe"}}},{id:"352140",title:"Dr.",name:"Edina",middleName:null,surname:"Chandiwana",slug:"edina-chandiwana",fullName:"Edina Chandiwana",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Midlands State University",country:{name:"Zimbabwe"}}},{id:"342259",title:"B.Sc.",name:"Leonard",middleName:null,surname:"Mushunje",slug:"leonard-mushunje",fullName:"Leonard Mushunje",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Midlands State University",country:{name:"Zimbabwe"}}},{id:"347042",title:"Mr.",name:"Maxwell",middleName:null,surname:"Mashasha",slug:"maxwell-mashasha",fullName:"Maxwell Mashasha",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Midlands State University",country:{name:"Zimbabwe"}}},{id:"2941",title:"Dr.",name:"Alberto J.",middleName:"Jorge",surname:"Rosales-Silva",slug:"alberto-j.-rosales-silva",fullName:"Alberto J. Rosales-Silva",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"437913",title:"Dr.",name:"Guillermo",middleName:null,surname:"Urriolagoitia-Sosa",slug:"guillermo-urriolagoitia-sosa",fullName:"Guillermo Urriolagoitia-Sosa",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"435126",title:"Prof.",name:"Joaquim",middleName:null,surname:"José de Castro Ferreira",slug:"joaquim-jose-de-castro-ferreira",fullName:"Joaquim José de Castro Ferreira",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Aveiro",country:{name:"Portugal"}}},{id:"437899",title:"MSc.",name:"Miguel Angel",middleName:null,surname:"Ángel Castillo-Martínez",slug:"miguel-angel-angel-castillo-martinez",fullName:"Miguel Angel Ángel Castillo-Martínez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"289955",title:"Dr.",name:"Raja",middleName:null,surname:"Kishor Duggirala",slug:"raja-kishor-duggirala",fullName:"Raja Kishor Duggirala",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Jawaharlal Nehru Technological University, Hyderabad",country:{name:"India"}}}]}},subseries:{item:{id:"8",type:"subseries",title:"Bioinspired Technology and Biomechanics",keywords:"Bioinspired Systems, Biomechanics, Assistive Technology, Rehabilitation",scope:'Bioinspired technologies take advantage of understanding the actual biological system to provide solutions to problems in several areas. Recently, bioinspired systems have been successfully employing biomechanics to develop and improve assistive technology and rehabilitation devices. The research topic "Bioinspired Technology and Biomechanics" welcomes studies reporting recent advances in bioinspired technologies that contribute to individuals\' health, inclusion, and rehabilitation. Possible contributions can address (but are not limited to) the following research topics: Bioinspired design and control of exoskeletons, orthoses, and prostheses; Experimental evaluation of the effect of assistive devices (e.g., influence on gait, balance, and neuromuscular system); Bioinspired technologies for rehabilitation, including clinical studies reporting evaluations; Application of neuromuscular and biomechanical models to the development of bioinspired technology.',coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11404,editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",slug:"adriano-andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",biography:"Dr. Adriano de Oliveira Andrade graduated in Electrical Engineering at the Federal University of Goiás (Brazil) in 1997. He received his MSc and PhD in Biomedical Engineering respectively from the Federal University of Uberlândia (UFU, Brazil) in 2000 and from the University of Reading (UK) in 2005. He completed a one-year Post-Doctoral Fellowship awarded by the DFAIT (Foreign Affairs and International Trade Canada) at the Institute of Biomedical Engineering of the University of New Brunswick (Canada) in 2010. Currently, he is Professor in the Faculty of Electrical Engineering (UFU). He has authored and co-authored more than 200 peer-reviewed publications in Biomedical Engineering. He has been a researcher of The National Council for Scientific and Technological Development (CNPq-Brazil) since 2009. He has served as an ad-hoc consultant for CNPq, CAPES (Coordination for the Improvement of Higher Education Personnel), FINEP (Brazilian Innovation Agency), and other funding bodies on several occasions. He was the Secretary of the Brazilian Society of Biomedical Engineering (SBEB) from 2015 to 2016, President of SBEB (2017-2018) and Vice-President of SBEB (2019-2020). He was the head of the undergraduate program in Biomedical Engineering of the Federal University of Uberlândia (2015 - June/2019) and the head of the Centre for Innovation and Technology Assessment in Health (NIATS/UFU) since 2010. He is the head of the Postgraduate Program in Biomedical Engineering (UFU, July/2019 - to date). He was the secretary of the Parkinson's Disease Association of Uberlândia (2018-2019). Dr. Andrade's primary area of research is focused towards getting information from the neuromuscular system to understand its strategies of organization, adaptation and controlling in the context of motor neuron diseases. 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