Summary of Randomized Controlled Trials evaluating the use of fenugreek in diabetes
\r\n\tNearly 25% - 30% of the world population is affected by neurological diseases exerting a hard financial strain on the healthcare system. The costs are estimated at around $800 billion annualy, expected to exponentially increase as the elders, at high risk of debilitating neurological diseases, will double by 2050. A varied spectrum of neuroprotective strategies has been suggested, including combined antioxidative-anti-inflammatory treatments, ozone autohemotherapy, hypothermia, cell therapy, the administration of neurotrophic factors, hemofiltration, and others. Distressingly, none of the currently available neuroprotective approaches has so far proven to prolong either life span or the cardinal symptoms of the patients suffering from brain injury. Last but not least, translational studies are still lacking.
\r\n\r\n\tThe book aims to revisit, discuss, and compile some promising current approaches in neuroprotection along with the current goals and prospects.
",isbn:"978-1-83880-440-4",printIsbn:"978-1-83880-439-8",pdfIsbn:null,doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,hash:"10acd587ca2c942616bfc09c4b79df39",bookSignature:"Dr. Matilde Otero-Losada, Dr. Francisco Capani and Dr. Santiago Perez Lloret",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/8087.jpg",keywords:"IKKβ/NF-κB pathway, neuroendocrine studies, anti-inflammatory agents, Bipolar disorder, oxidative metabolism, metabolic syndrome, Parkinson's disease, Alzheimer's disease, neurotrophins, growth factors, ATP-mediated calcium signalling, glutathione peroxidase",numberOfDownloads:162,numberOfWosCitations:0,numberOfCrossrefCitations:0,numberOfDimensionsCitations:0,numberOfTotalCitations:0,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"September 10th 2019",dateEndSecondStepPublish:"October 1st 2019",dateEndThirdStepPublish:"November 30th 2019",dateEndFourthStepPublish:"February 18th 2020",dateEndFifthStepPublish:"April 18th 2020",remainingDaysToSecondStep:"2 months",secondStepPassed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,editors:[{id:"193560",title:"Dr.",name:"Matilde",middleName:null,surname:"Otero-Losada",slug:"matilde-otero-losada",fullName:"Matilde Otero-Losada",profilePictureURL:"https://mts.intechopen.com/storage/users/193560/images/system/193560.jpeg",biography:"Dr. Matilde Otero-Losada graduated at the School of Pharmacy and Biochemistry, University of Buenos Aires (UBA) Argentina; pursued her studies in Neuropharmacology getting her Sci.D. in Neuropharmacology (UBA, Argentina); and completing her Ph.D. in Psychiatry at the Wolverhampton University, WLV, UK. \r\nHer following studies in Psychometrics and Statistical Methods, Radioisotopes and Radiochemistry, Signal Processing and Microcomputers, took her to the University of California San Diego (UCSD) for training in human Psychophysics. \r\nBack in Argentina, she carried on studying smell, taste and trigeminal perception at the Hospital de Clínicas, UBA. \r\nShe focused on the study of metabolic syndrome, soft drinks and cardiovascular-renal morbidity for the last ten years, and in the last two years she is back to her roots: Neurosciences. \r\nWith over 90 papers published in prestigious journals indexed in PubMed, Embase and Scopus and book chapters authored, as Senior Researcher of the National Research Council (Argentina), she customarily reviews manuscripts and is acknowledged for her scientific writing, and editing capacities.",institutionString:"University of Buenos Aires",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"0",institution:null}],coeditorOne:{id:"120703",title:"Dr.",name:"Francisco",middleName:null,surname:"Capani",slug:"francisco-capani",fullName:"Francisco Capani",profilePictureURL:"https://mts.intechopen.com/storage/users/120703/images/system/120703.jpeg",biography:"Dr. Francisco Capani graduated at the School of Medicine, University of Buenos Aires, (UBA) Argentina and completed his doctoral studies in Neurosciences at the Institute of Cell Biology and Neuroscience Prof E. De Robertis, School of Medicine (UBA), Argentina. Then he moved abroad to perform his postdoctoral studies at the University of California San Diego (UCSD-NCMIR) and the Karolinska Institute, Department of Neuroscience. Over an eight-year period, his research focused on synaptic organization, combining electron tomography, 3-D reconstruction, and correlative light and electron microscopy techniques. Upon his return to Argentina in 2006, he devoted to study the mechanisms involved in the pathophysiology of the perinatal asphyxia supported by his broad experience in electron microscopy. He has published 101 papers in recognized journals and has been invited assisting in a speaker capacity to several international conferences.",institutionString:"University of Buenos Aires",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"4",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"University of Buenos Aires",institutionURL:null,country:{name:"Argentina"}}},coeditorTwo:{id:"168475",title:"Dr.",name:"Santiago Perez",middleName:null,surname:"Lloret",slug:"santiago-perez-lloret",fullName:"Santiago Perez Lloret",profilePictureURL:"https://mts.intechopen.com/storage/users/168475/images/system/168475.jpeg",biography:"Dr. Santiago Perez Lloret is a leading expert in neurophysiology and neuropharmacology with more 90 papers published in international medical journals (H-index= 29). He has been recently awarded Top 1% reviewer in neurosciences (Publons.com). After obtaining his MD and PhD, he pursued master courses in pharmacoepidemiology, clinical pharmacology and biostatistics at the Universities of Bordeaux and Paris. Dr. Perez Lloret is Assistant professor of Neurophysiology at the Medicine School of the Buenos Aires University and Associate Researcher at the Cardiology Research Institute, University of Buenos Aires, National Research Council. He is member of the International Parkinson’s Disease and Movement Disorder Society (MDS), where he is Co-editor of the Webpage and collaborates in several committees, including the Educational and the Evidence-based Medicine Committees.",institutionString:"University of Buenos Aires",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"University of Buenos Aires",institutionURL:null,country:{name:"Argentina"}}},coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"16",title:"Medicine",slug:"medicine"}],chapters:[{id:"69122",title:"Lifestyle Factors, Mitochondrial Dynamics, and Neuroprotection",slug:"lifestyle-factors-mitochondrial-dynamics-and-neuroprotection",totalDownloads:83,totalCrossrefCites:0,authors:[null]},{id:"69463",title:"Polyphenols as Potential Therapeutic Drugs in Neurodegeneration",slug:"polyphenols-as-potential-therapeutic-drugs-in-neurodegeneration",totalDownloads:36,totalCrossrefCites:0,authors:[null]},{id:"69376",title:"Trends in Neuroprotective Strategies after Spinal Cord Injury: State of the Art",slug:"trends-in-neuroprotective-strategies-after-spinal-cord-injury-state-of-the-art",totalDownloads:35,totalCrossrefCites:0,authors:[null]},{id:"70228",title:"Aptamers and Possible Effects on Neurodegeneration",slug:"aptamers-and-possible-effects-on-neurodegeneration",totalDownloads:10,totalCrossrefCites:0,authors:[null]}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"301331",firstName:"Mia",lastName:"Vulovic",middleName:null,title:"Mrs.",imageUrl:"https://mts.intechopen.com/storage/users/301331/images/8498_n.jpg",email:"mia.v@intechopen.com",biography:null}},relatedBooks:[{type:"book",id:"6550",title:"Cohort Studies in Health Sciences",subtitle:null,isOpenForSubmission:!1,hash:"01df5aba4fff1a84b37a2fdafa809660",slug:"cohort-studies-in-health-sciences",bookSignature:"R. Mauricio Barría",coverURL:"https://cdn.intechopen.com/books/images_new/6550.jpg",editedByType:"Edited by",editors:[{id:"88861",title:"Dr.",name:"René Mauricio",surname:"Barría",slug:"rene-mauricio-barria",fullName:"René Mauricio Barría"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"72",title:"Ionic Liquids",subtitle:"Theory, Properties, New Approaches",isOpenForSubmission:!1,hash:"d94ffa3cfa10505e3b1d676d46fcd3f5",slug:"ionic-liquids-theory-properties-new-approaches",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/72.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophanides",surname:"Theophile",slug:"theophanides-theophile",fullName:"Theophanides Theophile"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1373",title:"Ionic Liquids",subtitle:"Applications and Perspectives",isOpenForSubmission:!1,hash:"5e9ae5ae9167cde4b344e499a792c41c",slug:"ionic-liquids-applications-and-perspectives",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/1373.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"4816",title:"Face Recognition",subtitle:null,isOpenForSubmission:!1,hash:"146063b5359146b7718ea86bad47c8eb",slug:"face_recognition",bookSignature:"Kresimir Delac and Mislav Grgic",coverURL:"https://cdn.intechopen.com/books/images_new/4816.jpg",editedByType:"Edited by",editors:[{id:"528",title:"Dr.",name:"Kresimir",surname:"Delac",slug:"kresimir-delac",fullName:"Kresimir Delac"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"57",title:"Physics and Applications of Graphene",subtitle:"Experiments",isOpenForSubmission:!1,hash:"0e6622a71cf4f02f45bfdd5691e1189a",slug:"physics-and-applications-of-graphene-experiments",bookSignature:"Sergey Mikhailov",coverURL:"https://cdn.intechopen.com/books/images_new/57.jpg",editedByType:"Edited by",editors:[{id:"16042",title:"Dr.",name:"Sergey",surname:"Mikhailov",slug:"sergey-mikhailov",fullName:"Sergey Mikhailov"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3092",title:"Anopheles mosquitoes",subtitle:"New insights into malaria vectors",isOpenForSubmission:!1,hash:"c9e622485316d5e296288bf24d2b0d64",slug:"anopheles-mosquitoes-new-insights-into-malaria-vectors",bookSignature:"Sylvie Manguin",coverURL:"https://cdn.intechopen.com/books/images_new/3092.jpg",editedByType:"Edited by",editors:[{id:"50017",title:"Prof.",name:"Sylvie",surname:"Manguin",slug:"sylvie-manguin",fullName:"Sylvie Manguin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3794",title:"Swarm Intelligence",subtitle:"Focus on Ant and Particle Swarm Optimization",isOpenForSubmission:!1,hash:"5332a71035a274ecbf1c308df633a8ed",slug:"swarm_intelligence_focus_on_ant_and_particle_swarm_optimization",bookSignature:"Felix T.S. Chan and Manoj Kumar Tiwari",coverURL:"https://cdn.intechopen.com/books/images_new/3794.jpg",editedByType:"Edited by",editors:[{id:"252210",title:"Dr.",name:"Felix",surname:"Chan",slug:"felix-chan",fullName:"Felix Chan"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3621",title:"Silver Nanoparticles",subtitle:null,isOpenForSubmission:!1,hash:null,slug:"silver-nanoparticles",bookSignature:"David Pozo Perez",coverURL:"https://cdn.intechopen.com/books/images_new/3621.jpg",editedByType:"Edited by",editors:[{id:"6667",title:"Dr.",name:"David",surname:"Pozo",slug:"david-pozo",fullName:"David Pozo"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"19832",title:"Effectiveness of Fenugreek for Lowering Hemoglobin (HbA1c) in Patients with Self-Management of Type 2 Diabetes: A Randomized Controlled Trial",doi:"10.5772/20591",slug:"effectiveness-of-fenugreek-for-lowering-hemoglobin-hba1c-in-patients-with-self-management-of-type-2-",body:'The incidence of type 2 diabetes is increasing worldwide, resulting in large measure from the increasing prevalence of obesity (Yale, 2000). Diabetes mellitus is a pandemic disease and is one of the main threats to human health (Narayan, 2005). In 2003, 194 million people worldwide, ranging in age from 20 to 79 years, had diabetes. It is projected that this number will be increased by 72% to 333 million by 2025, and nearly 80% of these cases will be in the poorer industrialized countries (IDF, 2003). According to a 2005 US Government estimate, approximately 21 million people in the United States have diabetes (Gerich, 2005). In 2002, diabetes was the sixth leading cause of death and had an estimated total cost of $132 billion (Hogan et al. 2003). Type 2 diabetes is a disease characterized by a dual defect: 1) by insulin resistance which prevents cells from using insulin properly, and 2) degrees of reduced pancreatic insulin secretion.
In the local context, according to World Health Organisation (WHO, 2004), prevalence of Type 2 diabetes in Pakistan for the year 2000 was 5.2 million and for 2030 it would be around 13.8 million. A quarter of the population of Pakistan would be classified as overweight or obese with the use of Indo-Asian-specific BMI cutoff values. Jafar et al (2006) have reported that prevalence of overweight was 25% and obesity was 10% in a large population-based sample of people over the age of 15 years in Pakistan. On the age-specific prevalence of overweight and obesity, they found that more than 40% of women and 30% of men aged 35–54 years were classified as overweight or obese.
It has been suggested in a variety of observational and epidemiological studies that physical activity may play a significant role in the prevention of type 2 diabetes mellitus. The relationships between physical activity and overweight are only beginning to be understood for the adult population, sedentary behaviours, particularly watching television (TV) and videos, surfing the internet have been found to be related to higher body mass index (BMI) for adult’s population (Struber, 2004). The literature linking physical activity levels with risk of overweight in adults is not consistent but physical activity is an important component of effective obesity treatments (Saelens, 2003).
The main health promotion intervention here is the public health education which highlights the importance of physical activity for the prevention of type 2 diabetes in the middle-aged population of sub-continent and particularly Pakistan, which is experiencing a rapid and substantial decline of physical activity levels as a result of poor eating habits, unhealthy food supply, expansion of television, computerization, and mechanization, more prevalent car ownership and sedentary behaviour. In parallel with decreasing levels of physical activity, the prevalence of overweight and obesity has increased significantly in Pakistan and as a consequence, diabetes mellitus has become a major public health issue.
Therefore, promoting an active lifestyle or regular exercise has become the highest public health priority in that country to overcome the onslaught of type 2 diabetes. Also, the search for dietary adjuncts along with usual medical care to treat this life altering disease has become more important and dietary supplements that can modulate glucose homeostasis and potentially improve lipid parameters would be desirable. Fenugreek (Trigonella foenum-graecum Linn) is a dietary supplement that may hold promise in this regard and is one of the oldest medicinal plants, originating in India and Northern Africa and dating back to ancient Egyptian times (Jensen, 1992).
In Pakistan and India, fenugreek is commonly consumed as a condiment (Yoshikawa et al. 1997) and used medicinally as a lactation stimulant (Patil et al. 1997). Fenugreek seeds also lower serum triglycerides, total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) (Al-Habori and Raman, 1998). The lipid-lowering effect of fenugreek might also be attributed to its estrogenic constituent, indirectly increasing thyroid hormones (Basch, 2003). The plant protein in fenugreek is 26%, so it might exert a lipid lowering effect (Sharma, 1986). Since a high proportion of diabetic patients in sub-continent suffer from malnutrition, the use of fenugreek which is rich in protein and fiber (48%), has a distinct advantage in these patients (Sharma, 1986).
This chapter addresses the effectiveness of fenugreek for lowering hemoglobin (HbA1c) in this randomized controlled trial and determines whether the intervention of taking fenugreek in combination of usual medical care lowers HbA1c in patients with type 2 diabetes. Effectiveness trials such as this are critical in determining if the interventions are effective in the practical world in which patients live. This randomized control trial addresses the research question “Is Fenugreek treatment with medical care for patients with type 2 diabetes more effective than usual medical care and can it help to lower the haemoglobin in patients with poorly controlled type 2 diabetes”? and test the hypothesis in relation to type 2 diabetic patients with usual medical care and usual medical care with self-management of fenugreek supplement and evaluates the effectiveness of the fenugreek treatment in comparison with the usual medical care in clinical settings.
Type 2 diabetes is associated with certain ethnic groups, obesity, family history of diabetes, and physical inactivity, among other factors. Diabetes is a metabolic disease characterized by elevated concentrations of blood glucose for prolonged periods of time, i.e., hyperglycemia (Gerich, 2005). Chronic, untreated hyperglycemia can lead to serious complications that include cardiovascular diseases, blindness, kidney failure, and stroke. Furthermore, very low values of blood glucose (hypoglycemia) for even a short duration can result in loss of consciousness and coma. The figure 1 shows the complications of type 2 diabetes which is a syndrome characterized by insulin deficiency, insulin resistance, and increased hepatic glucose production. These metabolic abnormalities are treated by use of various medications which are designed to correct one or more of these metabolic abnormalities (Saltiel & Olefsky, 2001).
Type 2 diabetes is most common in adults, although younger people are also developing this type of disease. It starts with a slow onset with thirst, frequent urination, weight loss developing over weeks to months. It is also considered to run in families but it may happen with a person without a family history of diabetes as well. Most of the people who get this disease are overweight and obese. The treatment for type 2 diabetes differs at various stages of the condition. In its early stages, many people with type 2 diabetes can control their blood glucose levels by losing weight, eating properly and exercising. Many may subsequently need oral medication, and some people with type 2 diabetes may eventually need insulin shots to control their diabetes and avoid the disease\'s serious complications (Saltiel & Olefsky, 2001).
Even though there is no cure for diabetes, proper treatment and glucose control enable people with type 2 diabetes to live normal, productive lives. A major advance for people at risk of developing type 2 diabetes - such as family members of those with the condition - occurred recently when it was shown that diet and exercise can prevent or delay type 2 diabetes. People at high risk, who already had early signs of impaired glucose tolerance, significantly reduced their risk by losing only 5-7 percent of their body weight and performing moderate physical activity for 30 minutes/day.
Complications of type 2 diabetes – Source: Saltiel & Olefsky (2001)
The figure 1 shows the complications of type 2 diabetes from microvascular and macrovascular diseases and can have a devastating effect on quality of life and impose a heavy burden on healthcare systems.
Diabetic retinopathy is present in 21% of people in the world at the time type 2 diabetes is diagnosed (DSG, 1990), more than 60% have diabetes retinopathy during the first two decades of the disease and diabetic retinopathy is the leading cause of new blindness among adults aged 20–74 years (Fong et al. 2003). Pakistan is ranked 6th among countries with the highest burden of diabetes (Wild et al. 2004), however, population-based data on the prevalence of diabetic retinopathy in Pakistan and on the visual impairment due to diabetic retinopathy is lacking and only the hospital-based data is available (Kayani et al. 2003).
Diabetic nephropathy is present in 18% of people diagnosed with diabetes (DSG, 1993) and is a leading cause of end-stage renal disease (Molitch et al. 2003)
Stroke: diabetes is associated with a 2- to 4-fold increase in cardiovascular mortality and stroke (Kannel et al. 1990).
Cardiovascular disease: 75% of individuals with type 2 diabetes die from cardiovascular causes (Gray & Yudkin, 1997).
Diabetic neuropathy is present in 12% of people at diagnosis (DSG, 1990) and diabetic neuropathy affects approximately 70% of people with diabetes and is a leading cause of non-traumatic lower extremity amputations (Mayfield et al. 2003). Therefore, early detection and treatment of diabetes is essential in order to reduce the impact of its serious complications.
Development of type 2 diabetes is the result of multifactorial influences that include lifestyle, environment and genetics. The disease arises when insulin resistance-induced compensatory insulin secretion is exhausted. A high-caloric diet coupled with a sedentary lifestyle is one of the major contributing factors in the development of the insulin resistance and pancreatic β-cell dysfunction as shown in Figure 2. However, a predisposing genetic background has long been suspected in playing a contributing role in the development of type 2 diabetes. By using whole-genome linkage analysis the entire genome of affected family members can be scanned and the family members monitored over several generations (Saltiel & Olefsky, 1996)
Development of type 2 diabetes: Adapted from Saltiel & Olefsky (1996)
Although the metabolic syndrome is not exclusively associated with type 2 diabetes and the associated insulin resistance, the increasing prevalence of obesity and associated development of type 2 diabetes places insulin resistance as a major contributor to the syndrome. The metabolic syndrome is defined as a clustering of atherosclerotic cardiovascular disease risk factors that include visceral adiposity (obesity), insulin resistance, low levels of HDLs and a systemic proinflammatory state. There are key components to the metabolic syndrome which include in addition to insulin resistance (the hallmark feature of the syndrome), hypertension, dyslipidemia, chronic inflammation, impaired fibrinolysis, procoagulation and most telling central obesity.
The multiple trials in the past have shown conflicting results of the effect of fenugreek on the patients of type 2 diabetes. These studies showed some positive results on fasting serum glucose but did not examine hemoglobin (HbA1c) levels. Gupta et al (2001) reported the results of a small randomized, controlled, double-blind trial to evaluate the effects of fenugreek seeds on glycemic control. The authors reported that there were no significant differences between groups in mean glucose tolerance test values at the study\'s end. This study suggested that fenugreek seed extract and diet/exercise may be equally effective strategies for attaining glycemic control in type 2 diabetes. However, the trial may have been too small or brief to detect significant mean differences between groups.
Raghuram et al (1994) reported the results of a randomized, controlled, crossover trial of fenugreek seeds in 10 patients with type 2 diabetes. In the fenugreek-treated patients, statistically significant mean improvements were reported for glucose-tolerance test scores and serum-clearance rates of glucose. The absolute difference in glucose between the two groups was not mentioned. Sharma and Raghuram (1990) conducted two randomized, controlled, crossover studies in patients with type 2 diabetes. Significant mean improvements in fasting blood-glucose levels and glucose-tolerance test results were described in the fenugreek-treated patients.
Moosa et al (2006) conducted study to evaluate the effect of fenugreek on serum lipid profile in hypercholesteremic type 2 diabetic patients and concluded that fenugreek seeds powder significantly reduced serum total cholesterol, triglyceride and LDL-cholesterol but serum HDL-cholesterol level elevation was not significant. Neeraja and Rajyalakshmi (1996) presented a case series including six men with type 2 diabetes and six without diabetes. The cases suggested fenugreek reduced postprandial hyperglycemia primarily in subjects with diabetes, but less so in subjects without diabetes.
The results from several additional case series (Madar et al. 1988; Sharma, 1986; Sharma et al. 1996) also reported that fenugreek seeds may improve glycemic control in type 2 diabetes. The studies conducted to date have been methodologically weak, lacking adequate descriptions of blinding, randomization, baseline patient characteristics, statistical analysis, and standardization data for the therapy used. Demonstrating the efficacy of fenugreek has also been confounded by inconsistencies in the preparations, dosing regimens, and outcome measures used in the trials. Moreover, none of the investigations have been conducted over the longer period (Basch, 2003). The following table 1 gives the summary of Randomized Controlled Trials evaluating fenugreek use in diabetic patients.
Authors | Study Type | Condition | Sample size | Results |
Gupta (2001) | Randomized Controlled Trials (Double-blinded) | Type 2 diabetes (hyperlipidemia) | N =25 | Improved fasting glucose with fenugreek seeds and diet/exercise. |
Raghuram (1994) | Randomized Controlled Trials (crossover study) | Type 2 diabetes | N =10 | Improved peripheral glucose utilization with fenugreek seed supplementation |
Sharma (1990) | Randomized Controlled Trials (crossover study | Type 2 diabetes | N =25 | Improvement in reported diabetic symptoms |
Neeraja (1996) | Case series with matched controls | Type 2 diabetes | N =12 | Improvement of acute glycemic response with raw fenugreek seed powder |
Moosa et al (2006) | Randomized Controlled Trials | Type 2 diabetes (hyperlipidemia) | N =30 | Reduced serum total cholesterol with the use of fenugreek |
Summary of Randomized Controlled Trials evaluating the use of fenugreek in diabetes
The patients were recruited from the diabetic medical centre in rural area of Peshawar conducting the study of management of type 2 diabetes among the population aged 30-65 years. The patients were eligible and subjected to further screening if their records were found in the clinic database as patients with diabetes and had HbA1c >= 7.0% on a laboratory blood test during the last 6 months. Patients having coexisting liver, kidney or thyroid disorder were not included in the study. Also, the patients with allergy to fenugreek were excluded from the study.
The Word Health Organization (WHO, 2006) diabetes criteria were followed in the selection of the patients with diabetes as indicated in Table 2.
Condition | 2 hour glucose | Fasting glucose |
mmol/l(mg/dl) | mmol/l(mg/dl) | |
Normal | <7.8 (<140) | <6.1 (<110) |
Impaired fasting glycaemia | <7.8 (<140) | ≥ 6.1(≥110) & <7.0(<126) |
Impaired glucose tolerance | ≥7.8 (≥140) | <7.0 (<126) |
Diabetes mellitus | ≥11.1 (≥200) | ≥7.0 (≥126) |
World Health Organization (WHO, 2006). Diabetes Criteria for patients
The well known standard screening test for diabetes, the fasting plasma glucose (FPG), is also a component of diagnostic testing. The FPG test and the 75-g oral glucose tolerance test (OGTT) are both suitable tests for diabetes; however, the FPG test is preferred in clinical settings because it is easier and faster to perform, more convenient and acceptable to patients, and less expensive. This test was carried out and an FPG ≥126 mg/dl (7.0 mmol/l) considered being an indication for retesting, which was repeated on a different day to confirm a diagnosis. If the FPG is <126 mg/dl (7.0 mmol/l) and there is a high suspicion for diabetes, an OGTT was performed. A 2-h postload value in the OGTT ≥200 mg/dl (11.1 mmol/l) is a positive test for diabetes and was confirmed on an alternate day.
When it was found necessary, plasma glucose testing was also performed on individuals who have taken food or drink shortly before testing. Such tests are referred to as casual plasma glucose measurements and are given without regard to time of last meal. A casual plasma glucose level ≥200 mg/dl (11.1 mmol/l) with symptoms of diabetes is considered diagnostic of diabetes. A confirmatory FPG test or OGTT was also completed on such patients on a different day if the clinical condition of the patient permits.
Laboratory measurement of plasma glucose concentration is performed on venous samples with enzymatic assay techniques, and the above-mentioned values are based on the use of such methods. The A1C test values remain a valuable tool for monitoring glycemia, but it is not currently recommended for the screening or diagnosis of diabetes. Pencil and paper tests, such as the American Diabetes Association’s risk test, may be useful for educational purposes but do not perform well as stand-alone tests. Capillary blood glucose testing using a reflectance blood glucose meter has also been used but because of the imprecision of this method, it is better used for self-monitoring rather than as a screening tool.
The study sample size was determined based on the assumption of the estimation of Standard Deviation (SD). Therefore, the study design was selected to detect an effect size of 0.5 SD lowering of HbA1c. It was assumed that 15% patients might be lost to follow-up in control group over the period of three months and only 5 % patients will be lost to follow-up in intervention group. This assumption was based on the popularity of fenugreek seeds used by diabetic patients in sub-continent to manage their glycemic control. Taking into consideration all these factors, the following parameters were considered: α = Level of significance test = 0.05, Power = 0.8, m= the follow-up period 90 days (3 months), Standard Deviation (SD) = 0.5, the sample size was calculated for each group to detect an effect size of 0.5 SD. The sample size (N) for each group was =105; therefore, the total, N=210 patients were recruited to participate in both the groups.
Initially 325 patients with type 2 diabetes were invited to pre-randomized interview, out of which only 210 patients were included in the actual trial. Out of the 325 patients, 93 patients did not meet the inclusion criteria and 22 patients refused to participate in the trial. Finally, two hundred and ten (210) patients agreed to participate and signed informed consent documents at the clinic where they used to visit for their usual medical care for diabetes. Therefore, 102 patients were randomized to intervention group (fenugreek supplements) and 108 to the control group (usual medical care). Figure 3 shows their progress during the randomized controlled trial.
Flow chart describing Randomized Controlled Trial of fenugreek treatment:
The sequence of allocation to treatments (a randomized list) was generated using the random number function in Excel worksheet. The baseline assessment was carried out prior to group allocation by an investigator/coordinator blind to the allocation sequence. The participants were issued a sealed envelope containing their group allocation. The randomization code was developed using a computer random number generator in a block size of eight patients. That helped to allocate patients to the intervention and control groups equally in each block – that is each patient would have an equal chance of allocation to either group. Once the randomization phase was completed, all patients were instructed to follow-up the usual medical care for their diabetes for the duration of the 90 days trial. The patients were allowed to adjust their usual medications as recommended by their doctors. In addition, each patient was asked to go for blood test for HbA1c on day 1 and then return to give blood sample after 90 days. In addition, participants were advised not to take any other new treatments for the management of type 2 diabetes during the trial periods.
The control group in randomized controlled trial received medical care from a physician-coordinated team. This team included physicians, nurses, dietitians, and mental health professionals with expertise and a special interest in diabetes. It is essential in this collaborative and integrated team approach that individuals with diabetes assume an active role in their care. The management plan in that group was based on individualized therapeutic alliance among the patient and family, the physician, and other members of the health care team. This plan has recognized diabetes self-management education as an integral component of care and in developing the plan, consideration was given to the patient’s age, work schedule and conditions, physical activity, eating patterns, social situation and personality, cultural factors, and presence of complications of diabetes or other medical conditions. Treatment goals were set together with the patient, family, and health care team. Patient self-management was emphasized, and the plan emphasized the involvement of the patient in problem-solving as much as possible. A variety of strategies and techniques were employed to provide adequate education and development of problem-solving skills in the various aspects of diabetes management. During the implementation of the management plan it was assured that each aspect of diabetes management was understood and agreed on by the patient and the care providers and that the goals and treatment plan were reasonable.
Those patients randomized to take fenugreek (intervention group) received 100 gms fenugreek seeds powder from the pharmacy in the clinic. They were instructed to take 50 gms doses twice a day at lunch and dinner time in addition to their normal medications for diabetes. Those patients randomized to usual medical care (control group) were instructed to take their normal medicines and follow-up with their doctor as per their normal schedule. All participants were contacted again after 90 days (3-months) to give their blood sample for HbA1c testing. At that time, a questionnaire was sent via e-mail to participants in both intervention and control groups to assess the progress of the fenugreek treatment and clinical care without fenugreek.
The clinical and demographic characteristics of the patients in the two groups were well balanced at randomization. A demographic measure included age, gender, weight, ethnicity, religion, marital status, previous episodes of glycemic control, previous and current treatments of type 2 diabetes. The table 3 gives baseline characteristics of intervention and control groups in RCT trial.
Characteristics | Intervention Group (n = 97) | Control Group (n = 92) | P-value |
Age (years) | Mean (62.5) ± SD (10.5) | Mean (59.5) ± SD (8.5) | 0.78 |
Sex Male Female | 56% (n = 54) 44% (n = 43) | 58% (n = 53) 42% (n = 39) | |
Body Mass Index (Kg/m2) | Mean (30.8) ± SD (6.5) | Mean (31.6) ± SD (6.5) | 0.40 |
Fenugreek Intake Normal High | 98% (n=95) 2% (n = 2) | - - | |
Baseline Hemoglobin (HbA1c) % | Mean (8.5) ± SD (1.6) | Mean (8.4) ± SD (1.5) | 0.59 |
Diabetes Medications | Mean (1.75) ± SD (0.8) | Mean (1.82) ± SD (0.8) | 0.15 |
Baseline characteristics of intervention and control groups in RCT trial
The treatment options of type 2 diabetes is shown in figure 4 suggesting the specific areas of actions using medications which influence the various organs of the body to correct the metabolic abnormalities such as reducing the liver glucose production, slowing down absorption of sugars from the gut and reducing the insulin resistance. There are currently six distinct classes of hypoglycemic agents available to treat type 2 diabetes. These agents are Sulfonylurea (gliclazide, glipizide etc) – increase insulin secretion; Meglitinide (repaglinide) – increase insulin secretion; Biguanides (metformin) – reduce glucose production; Alpha-glycosidase (acrobase) – slow down absorption of sugar from the gut; Thiazolidendiones (pioglitazone) – reduce insulin resistance and Incretins – increase insulin secretion.
The patients in both the groups in RCT trials received medications recommended by their physicians. The most common combinations among both the groups were Meglitinide (repaglinide) with Thiazolidendiones and Sulfonylurea with Biguanides. However, the intervention group was given fenugreek as an additional supplement. The table 4 shows the hypoglycemic medications used by the patients during fenugreek RCT trial for 90 days.
Treatment options for type 2 diabetes – Source: Saltiel & Olefsky (2001)
Medication | Doses | Action |
Sulfonylurea (Gliclazide) | 30-120 mg/day | Increase insulin secretion |
Meglitinide (Repaglinide) | 0.5-4 mg/meal | Increase insulin secretion |
Biguanides (Metformin) | 25-3000 mg/day | Decrease hepatic glucose secretion |
Thiazolidendione (Glitazone) | 15-30 mg/day | Increase the insulin receptor number |
Fenugreek (only for patients in intervention group) | 100 gm/day | Help to lower HbA1c |
Hypoglycemic medications used by patients in fenugreek RCT trial
The diabetes medications mentioned in table 4 work in different ways but the main function of all these medications include lowering blood sugar levels; help improve the body’s use of glucose, decrease the symptoms of high blood sugar, help keeping patients with diabetes functioning normally and may prevent the complications, organ-damaging effects and premature deaths diabetes can cause. Since the drugs work in different ways, these are sometimes used in combination to enhance the effectiveness of treatment. In this RCT trial Sulfonylurea was used in combination with Biguanide (metformin) and Meglitinide was used in combination with Thiazolidinedione. However, fenugreek supplementation was only given to the patients in intervention group. The advantages and disadvantages of these medications used in RCT trial are given in Table 5 and the details of their mode of actions are summarized as follows:
Sulfonylurea: The sulfonylurea (Gliclazide) is an oral hypoglycemic drug and referred to as endogenous insulin secretagogues because the drug induces the pancreatic release of endogenous insulin. The fact that this drug induces pronounced hypoglycemia, treatment is initiated with the lowest possible dose and carefully monitored until the dose is found to control glucose level at 110-140mg/dL. The main function of Sulfonylurea is to bind and inhibit the pancreatic ATP-dependent potassium channel that is normally involved in glucose-mediated insulin secretion. Sulfonylurea has no significant effects on circulating triglycerides, lipoproteins or cholesterol.
Meglitinide: The meglitinide (repaglinide) is a non-sulfonylurea insulin secretagogues that is both fast acting and of short duration. Like the sulfonylurea, meglitinide therapy results in significant reduction in fasting glucose as well as HbA1c. The mechanism of action of the meglitinide is initiated by binding to a receptor on the pancreatic β-cell that is distinct from the receptors for the sulfonylurea. However, meglitinide do exerts effects on potassium conductance. Like the sulfonylurea, the meglitinide have no direct effects on the circulating levels of plasma lipids.
Biguanide: The biguanide (metformin) is a class of drugs that function to lower serum glucose levels by enhancing insulin-mediated suppression of hepatic glucose production and enhancing insulin-stimulated glucose uptake by skeletal muscle. Metformin is a member of this class and is currently the most widely prescribed insulin-sensitizing drug in current clinical use. Metformin administration does not lead to increased insulin release from the pancreas and as such the risk of hypoglycemia is minimal. Because the major site of action for metformin is the liver its use can be contraindicated in patients with liver dysfunction. The drug is ideal for obese patients and for younger type 2 diabetics.
Thiazolidinedione: The thiazolidinedione (pioglitazone) has proven useful in treating the hyperglycemia associated with insulin-resistance in both type 2 diabetes and non-diabetic conditions. The net effect of the thiazolidinedione is a potentiation of the actions of insulin in liver, adipose tissue and skeletal muscle, increased peripheral glucose disposal and a decrease in glucose output by the liver.
Medications | Advantages | Disadvantages |
Sulfonylurea (Gliclazide) | Fast onset of action No effect on blood pressure No effect on LDL cholesterol Convenient dosing Low cost | Weight gain reported Risk of hypoglycemia |
Meglitinide (Repaglinide) | No bad effect on cholesterol Rapid onset of action | Risk of hypoglycemia Weight gain reported Inconvenient dosing High cost |
Biguanides (Metformin) | Low risk of hypoglycemia Not linked to weight gain Good effect on LDL cholesterol No ill effect on blood pressure Low cost | High risk of GI side effects (nausea and diarrhea) Risk of lactic acid build-up Less convenient dosing |
Thiazolidendione (Glitazone) | Low risk of hypoglycemia Increase in HDL cholesterol Linked to decreased triglycerides Convenient dosing | Higher risk of heart failure Linked to weight gain Linked to risk of edema Linked to risk of anemia Slower onset of action Increase in LDL cholesterol |
Advantages and disadvantages of medications used by patients in fenugreek RCT trial
The normal diabetes treatment addresses the issues related to unhealthy lifestyles, such as lack of physical activity and excessive eating, which are the main causes to initiate and propagate the majority of type 2 diabetes (Michael, 2007). Studies have demonstrated strong relationship between excess weight and the risk of developing type 2 diabetes, hypertension, and hyperlipidemia. Therefore, the objective of physicians is to motivate patients to lose weight and exercise to improve the control of diabetes and slow down or even reverse the natural course of the disease (Michael, 2007).
However, it is difficult to overstate the importance of the relationship between lifestyle and the risk of developing type 2 diabetes. It has been demonstrated in recent studies that both women and men who have a BMI >35 kg/m2 had a 20-fold increase in their risk of developing diabetes compared to people with a BMI of 18.5 – 24.9 kg/m2 (Mokdad et al. 2001; Field et al. 2001). There are prospective studies which have demonstrated that lifestyle modification in the form of diet and regular moderate exercise sharply decrease the likelihood of developing type 2 diabetes in high-risk individuals who have impaired glucose tolerance or impaired fasting glucose. The effectiveness of this intervention superseded that of metformin therapy (Knowler et al. 2002). In this RCT trial, physicians compiled the flow scheme shown in Figure 5 which represents the method of treatment of type 2 diabetes by the combination of diet, exercise and medication for diabetes monitoring and control. It has been divided into two segments: for obese and normal weight patients and the combination of medication for both the groups of patients. The supplement of fenugreek was given to the patients belonging to intervention group.
Treatment of type 2 diabetes with the combination of diet, exercise and medications.
It has been recommended that carbohydrate and monosaturated fat consumption for the patients with type 2 diabetes should comprise 60-70% of total calories. However, there is some concern that increased unsaturated fat consumption may promote weight gain in obese patients with type 2 diabetes and therefore may cause in reduction of insulin sensitivity (Bantle et al. 1993). The “glycemic index” is an attempt to compare the glycemic effects of various foods to a standard, such as white bread. Although several authors have proposed its clinical usefulness in controlling postprandial hyperglycemia, prospective studies have not demonstrated a clear improvement in hemoglobin (HbA1c) in patients using low-glycemic index diets (Michael, 2007).
The physicians in this trial have recommended the best mix of carbohydrate, protein, and fat that was adjusted to meet the metabolic goals and individual preference of the patients with diabetes in both the intervention and control groups. It has been recommended for individuals with diabetes, that the use of the glycemic index and glycemic load may provide a modest additional benefit for glycemic control over that observed when total carbohydrate is considered alone (ADA, 2011). Monitoring carbohydrate, whether by carbohydrate counting, choices, or experience-based estimation, remain a key strategy in achieving glycemic control. In addition, saturated fat intake should be less than 7% of total calories and the intake of trans fat should also be minimized.
Physical activity is a key component of lifestyle modification that can help individuals prevent or control type 2 diabetes. It is considered that diet is probably more important in the initial phases of weight loss, incorporating exercise as part of a weight loss regimen helps maintain weight and prevent weight regain (Klein et al. 2004). In this trial, the message was given to both the groups that as little as 30 minutes of moderate physical activity daily may offer greater benefits to these patients in managing their diabetes. It has also been reported that in patients with type 2 diabetes, structured regimens of physical activity for 8 weeks or longer improved HbA1c independent of changes in body mass (Sigal et al. 2006).
The evidence supports the contention that controlling blood glucose through modification of diet and lifestyle should be mainstay of diabetes therapy. It was found in this RCT that despite being one of the most time-consuming discussions with the patients in both the groups, this is probably the most important patient-physician discussion in regard to diabetes control and prevention of disease progression and complications.
We analysed the primary outcome by an un-paired sample t-test (mean difference between baseline and final HbA1c). The statistical analysis was carried out on an intention to treat basis and that was subject to the availability of data at follow up as well as at entry level for individual patients. The differences between mean changes were tested by unpaired t tests, and χ2 tests (chi-squared test) were used to test for differences in proportions between the fenugreek treatment and clinical based treatment groups. For the χ2 tests, the following formula was used.
In this study for example (using the data from Figure 3) – it shows that number of patients at three months follow-up who were allocated to intervention group to help lowering their glycemic control were 95 % as compared the patients in clinical care (85 %), so χ2 = 5.73, P=0.02). The association between the groups and outcome is considered statistically significant.
All the patients in intervention and control groups were provided glucometers to check their blood sugar three times in a day (Fasting sugar in the morning, at bed time and 2-hrs after meal) and record that on XL-worksheet prepared for them to enter the data. Then linear regression analysis was performed after three months between HbA1c and on the blood glucose results. The HbA1c and the self-glucose monitoring via a glucometer demonstrated a significant relationship (R =.90, P < 0.0001).
These findings are in agreement with the findings of Nathan et al. (2008) who reported that the linear regression analysis carried out by these authors between the HbA1c and blood glucose (BG) values provided the tightest correlations (BG = 28.7 × A1C − 46.7, R2 = 0.84, P < 0.0001), allowing calculation of an estimated average glucose for HbA1C values. The linear regression equations did not differ significantly across subgroups based on age, sex, diabetes type, race/ethnicity, or smoking status.
The results of this randomized controlled trial support the hypothesis and research question that fenugreek supplement with usual medical care for type 2 diabetes is more effective than the usual medical care alone. The changes in HbA1c from baseline values in intervention and control groups after 3 months were calculated by unpaired sample t-test, the results are given in Table 6. At 3 months follow-up, the intervention group (fenugreek treatment) has shown significantly greater improvement and lowered HbA1c by 0.92% (95% CI, 0.34-1.50), p < 0.001 as compared with usual medical care alone lowering HbA1c by 0.42% (95% CI, 0.11-0.94), p = 0.12 in patents with poorly controlled diabetes.
The higher % age of lost to follow up throughout this trial (Figure 3) in those patients with usual medical care (15%) than in those treated by fenugreek (5%) suggests greater satisfaction with fenugreek supplement. The difference at 3 months follow up is the mean change for the intervention group minus the mean change for the control group. Therefore, the positive differences reflect more improvement in those treated by fenugreek supplement than in medical care alone.
RCT (Groups) | Baseline (HbA1c) | Final (HbA1c) | Difference | P-value |
Treatment (n=97) Control (n= 92) | 9.32 ± 2.2 9.10 ± 2.1 | 8.4 ± 1.9 8.68 ± 1.6 | - 0.92 (95% CI, 0.34-1.50) - 0.42 (95% CI, 0.11- 0.94) | < .001 0.12 |
Effect of Fenugreek on Hemoglobin (HbA1c) in type 2 diabetes
In patients with type 2 diabetes previous studies have shown an association between the degree of hyperglycemia and increased risk of microvascular complications (Klein, 1995), sensory neuropathy (Alder et al 1997), myocardial infarction (Klein, 1995; UKPDS,1998), stroke (Lehto et al. 1996), macrovascular mortality (Groeneveld et al. 1999) and all cause mortality (Wei et al. 1998;Knuiman et al. 1992). Generally, these studies measured glycemia as being high or low or assessed glycemia on a single occasion, whereas repeated measurements of glycemia over several moths or year would be more informative.
The existence of thresholds of glycemia—that is, concentrations above which the risk of complications markedly increases was studied in patients with type 2 diabetes by Stratton et al. (2000). The relative risk for myocardial infarction seems to increase with any increase in glycemia above the normal range (Fuller et al. 1983) as shown in figure 6 whereas the risk for microvascular disease is thought to occur only with more extreme concentrations of glycemia (Krolewski et al. 1995). The diabetes control and complications trial (DCCT) research group showed an association between glycemia and the progression of microvascular complications in patients with diabetes for hemoglobin HbA1C over the range of 6-11% after a mean of six years of follow up (DCCT, 1996).
Relative risk of progression of diabetic complications by mean HbA1c
Source: Diabetic Control and Complications Trials (DCCT, 1996; Stratton et al. 2000)
It has been reported by Stratton et al (2000) that the incidence of clinical complications was significantly associated with glycemia. That is each 1% reduction in updated mean HbA1c was associated with reductions in risk of 21% for any end point related to diabetes (95% confidence interval 17% to 24%, P<0.0001), 21% for deaths related to diabetes (15% to 27%, P<0.0001), 14% for myocardial infarction (8% to 21%, P<0.0001), and 37% for microvascular complications (33% to 41%, P<0.0001). The current fenugreek trial has demonstrated that there is a significant improvement after 3 months follow-up in the intervention group (fenugreek treatment) which has lowered HbA1c by 0.92% (95% CI, 0.34-1.50), p < 0.001 as compared to medical care alone lowering HbA1c by 0.42% (95% CI, 0.11-0.94), p = 0.12 in patents with poorly controlled diabetes. These finding are in agreement with the studies by Stratton et al (2000) that any reduction in HbA1c is likely to reduce the risk of complications, with the lowest risk being in those with HbA1c values in the normal range (< 6.0%).
The strength of this trial is that it was an effectiveness trial that addressed the community clinical practice specific to the population in sub-continent and it has measured outcomes that are most significant to diabetes care providers. Previous trials have shown conflicting results about the efficacy of fenugreek to treat diabetes as summarized in Table 1 and none of the trials measured HbA1c as an outcome in their studies. There are several reasons of the success of this trial as compared to previous trials. The first reason is that this is the largest randomized fenugreek trial (n =210) to date in type 2 diabetes. The other reason is that we studied only patients with poorly controlled type 2 diabetes and finally, diabetics in sub-continent may have different characteristics than those in other western countries due to their eating of different foods and drinking habits.
It is possible that the outcome measures associated with fenugreek treatment are subject to bias particularly when treatment was in progress or just afterwards. The main difference between usual medical care alone for the patients and usual medical care with fenugreek treatment occurred after 3 months period of trial. In order to reduce the bias, the questionnaire was sent to patients at home or via e-mail to minimize any chance that their answers might be affected by actual or perceived influence by medical practitioners at clinic. Also, the doctors did not know about those patients who were using fenugreek supplement and were blinded to the treatment allocation.
The main contribution of this study is to provide health professionals (diabetes care providers) and patients with type 2 diabetes an easily available, safe and cheap alternative (fenugreek seeds powder) to help them in the self-management and treatment of type 2 diabetes. The United Kingdom Prospective Diabetes Study (UKPDS) reported that a reduction of HbA1c from 7.9% to 7% lowers the risk of macro-vascular disease by 16%, retinopathy by 17% to 21% and nephropathy by 24% to 33% (UKPDS, 1998). Therefore, the results of this trial which have shown improvement in patients of diabetes by lowering HbA1c by 0.92% (95% CI, 0.34-1.50) might be expected to provide similar reductions in morbidity.
The use of fenugreek as a dietary supplement hold promise in future to be used in patients who manifest abnormalities of glucose monitoring and could benefit from a low-risk, inexpensive, food-based intervention aimed at normalizing their blood sugar levels and more specifically the HbA1c targets. However, the data collected to date on the benefits of fenugreek are sparse but may be used in future research for the development of well-designed, adequately powered, large scale randomized clinical trials for evaluating the effect of fenugreek seed powder on measures of insulin resistance, insulin secretion and better glucose control among the patients with type 2 diabetes.
In this randomized controlled trial, it has been shown that the levels of HbA1c reduced in the patients of poorly controlled type 2 diabetes who were taking 50 gms doses of fenugreek twice a day in addition to their normal medications for diabetes. These results of RCT support the hypothesis and the research question that fenugreek supplement with usual medical care for type 2 diabetes is more effective than the usual medical care alone. Therefore, it is recommended that fenugreek supplementation is safe and may be considered in patients with HBA1c > 7% as a potential means to lower the high levels of HbA1c.
The authors are highly thankful to Dr. Akif Ullah Khan, medical director of Ibn-Al-Nafees Medical Center, Peshawar- Pakistan for providing extensive help and support to carry out the RCT in his clinical settings in collaboration of his medical staff and helped to acquire the specific data of middle-aged population of Pakistan from the source www.pmrc.org.pk.The authors also extend their appreciation to Pakistan Medical Research Council for providing linkage to major national health studies, digital and electronic databases for educational and research purposes.
Road traffic accidents (RTAs) are associated with an estimated 1.25 million deaths globally each year with about 50 million others injured in the process [1]. The Ghanaian situation follows a similar trend. An estimated 1800 people are killed in road traffic accidents yearly with almost 14,500 others injured [2].
\nAccording to the WHO Global Burden of Disease project 2002, road traffic injuries (RTIs) are the 10th leading cause of death for all age groups globally, accounting for 1,183,492 deaths. More specifically, RTIs is the second and third leading cause of death for persons aged 5–29 years and 30–44 years, respectively [3, 4].
\nIn low- and middle-income countries, RTIs constitute the ninth leading cause of death and the tenth leading cause of disability-adjusted life years (DALYs) [4, 5]. A number of factors account for the high RTIs in these countries including poorly maintained vehicles, inadequate traffic enforcement, inefficient pre-hospital emergency medical response and overburdened healthcare infrastructure [6]. As a result, about 80% of the injury deaths in these countries are said to occur in the pre-hospital setting [7].
\nMany of these injury deaths could be prevented with the timely arrival of competent emergency pre-hospital medical services at the accident scene [8, 9]. Timely emergency pre-hospital care to traffic accident victims at the accident scene and subsequent transportation to the health facility may reduce the probability of injury severity and deaths. Regarding injury severity and death, trauma experts consider the first 60 minutes (termed the “golden hour”) after the injury occurred as the most important period to save lives. The risk of death or severe injury is believed to increase after this period [10].
\nRecently, the World Health Organisation has proposed training of layperson first responders as the first essential step in developing Emergency Medical Services systems in settings where the formal pre-hospital system is not available [6, 11]. This system has been found to be effective in reducing traffic accident-induced mortalities in most countries [5, 11, 12, 13]. A previous study revealed that about 51% of severely injured persons in Kumasi, Ghana died in a pre-hospital setting (cited in 7). This suggests that improving pre-hospital care to RTA victims is important to reduce “the mortality of critically injured roadway casualties” [7]. This stresses the urgency to establish layperson first responder care systems in Ghana (as proposed by the WHO) where formal pre-hospital care is inadequate. Pre-hospital care and post-crash intervention happen to be the focus of the fifth pillar of the UN Decade of Action of Road Safety 2011–2020 which aims to reduce the anticipated magnitude of RTAs and casualties [14].
\nGiven the important role of layperson first responders in the chances and quality of survival of RTA victims, this study explores the experiences of residents living along the Kasoa-Mankessim road network, an accident-prone road in Ghana, in administering emergency pre-hospital care to RTA victims. We explored their knowledge of pre-hospital first-aid and trauma care and the nature of the assistance they offer at accident scenes. The study results will expose the “pre-hospital trauma care knowledge and skill gaps” which can inform future training to facilitate safe handling and rescue of RTA victims in line with best practices. The remaining part of this paper proceeds as follows: Section 2 discusses the study methodology, while Sections 3–6 presents the study findings, discussion, study limitation and conclusion and implications for practice.
\nWe adopted a phenomenological research methodology [15] to explore and provide an in-depth description of participants’ experiences/encounters with pre-hospital care for road traffic accident victims on the Kasoa-Mankessim highway (Figure 1) in the central region of Ghana. This highway is a segment of the Accra-Cape Coast road network. The entire road network is classified as a national route 1 (N1) road and also forms part of the Trans-West African Highway network.
\nMap of the study areas and road network.
Variable | \n\n | N | \n% | \n
---|---|---|---|
Sex | \nMale | \n67 | \n83.7 | \n
Female | \n13 | \n16.3 | \n|
Age | \n18–25 years | \n17 | \n21.2 | \n
26–30 years | \n20 | \n25.0 | \n|
Above 30 years | \n43 | \n53.8 | \n|
Education (attained) | \nNon-formal | \n7 | \n8.7 | \n
Junior High | \n35 | \n43.7 | \n|
Senior High | \n27 | \n33.7 | \n|
Tertiary | \n11 | \n13.7 | \n|
Total | \n\n | 80 | \n100 | \n
Study sample (n = 80).
The Kasoa-Mankessim section is a single two-lane carriageway (31.1 km in length; 7.3 m wide with 2.5 m shoulders on both sides). The road’s posted speed is between 50 and 100 kph with a weighted average annual daily traffic volume of 9661 vehicles per day. The road links many settlements in the region to Accra, the national capital [16]. There are 11 ‘police-identified blackspots’ on the road network namely Brigade, Galilea, Amanfrom, Potsin Junction, Budumburam, Okyereko Junction, Adawuku, Bible College Area, Tipper Junction, Awutu Beraku and Gomoa Buduatta Junction. These black spots are characterised by dangerous curves, slippery steeps, narrow bridges and undulating surfaces. For the year 2014 alone, 631 RTAs (i.e., 90 fatal, 137 serious, 158 slight and 246 property-damage-only accidents)1 were recorded on the entire Accra-Cape Coast road network associated with 696 casualties (119 killed, 241 serious and 336 slight injuries). These figures translate into 4.5 accidents per kilometre and 4.9 casualties per kilometre [17].
\nPrior to data collection (interviews), we carried out a reconnaissance visit to the selected communities. Our aim was to introduce the study to the community stakeholders, familiarise ourselves with the terrain, and pre-select and schedule interview appointments with potential respondents. At the data collection stage, we employed a mix of non-probability sampling techniques (i.e., purposive, convenient and snowball sampling techniques) in selecting the study participants and communities. Our study comprised of 80 purposive samples from 12 conveniently sampled communities/settlements (mostly blackspots) along the Kasoa-Mankessim road network (the communities are indicated in Figure 1). To be eligible to participate in the study, a person ought to have first-hand-on-the-spot experience assisting RTA victims on this road segment. At some stages of the data collection, we employed the snowball sampling technique to sample other eligible participants from our initial contacts. On average, we interviewed six persons in each community lasting nearly 15 minutes from March to April 2017.
\nData coding and analysis were done in stages. At the first stage, we produced a transcript of each interview in English (participants gave consent to the audio recording of the interviews) and loaded into the Atlas.ti 7.0 software. At the second stage, we conducted inductive data coding and analysis using open and In Vivo coding (to ‘honour’ participant’s voice and to ground the analysis from their unique experiences and perspectives) [18]. Lastly, we conducted a thematic analysis of the data, resulting in two main themes namely, knowledge of pre-hospital care for road traffic accident victims and the nature of assistance offered to the accident victims.
\nOur sample was mainly males (83.7%) over 30 years old (53.8%) and mostly Junior High school graduates (43.7%) Table 1. Study sample characteristics (n = 80).
\nFrom our interviews, we gathered that at least an accident occurs every month on this road as evidenced by the quotes below. Interestingly, 2 days to the interviews, an accident occurred around Okyereko (one of the selected communities) as recounted by this respondent:
\nA sprinter bus had an accident just in front of our house 2 days ago (Male, 42 years, Okyereko).
\nYes, I have witnessed a number of road accidents on this highway. I can count about six of them and the last one I witnessed, 14 people died. This happened 2 weeks ago (Male, 29 years, Apam junction).
\nOn this road, almost every month we hear of road accidents. The last one I witnessed was about 3 weeks ago where everyone on board the vehicle died. I personally have witnessed more than seven accidents on this road and heard of uncountable others (Male, 33 years, Gomoa Mprumem).
\nThe accident-prone nature of this highway is depicted by the number of cautionary billboards planted close to previous accident spots. On each billboard, the number of people killed in a particular accident at a spot is indicated as shown in Figure 2.
\nBillboard indicating previous accidents on some spots on the highway.
Below, we present the study findings based on the themes and supported by relevant quotes from the transcript.
\nAs it is customary for residents along the highway to attend to RTA victims in the event of accidents, we sought to explore their knowledge of some basic pre-hospital emergency care for RTA victims. Generally, we assessed respondents’ knowledge of care for victims bleeding, recovery position for victims with fracture (broken bones) and basic airway control in unconscious persons.
\nGenerally, we noted that the majority of the participants have no practical training in pre-hospital care for RTA victims. For those who have received some training (n = 16 or 20%), they claimed it was just talk-based with a little demonstration. The rest acquired appreciable knowledge through years of rescue care for RTA victims.
\nYes. I remember one day, a group of people came here to talk to us about how we should handle accident victims. They said whenever we hear of a road accident, we should rush to the accident scene to help and try our best to call the Ambulance service and the Police. But it was mainly a talk show with little demonstration (Male, 32 years, Apam-junction).
\nRegarding victim recovery position(s) in the event of suspected fracture (broken bone), 20% of the participants (those with some training) rightly revealed that victim recovery position(s) depends on the nature of the injury sustained. They emphasised placing the victim on the ground as it is difficult to determine the nature of the injury sustained.
\nNot all victims who are involved in road accidents sustain serious or severe injuries. So those victims who are not hurt or injured, some of them could stand and others sit on the ground. But the severely injured victims should be placed on the floor with their backs to the ground (Male, 34 years, Apam-junction).
\nIf the victim has a broken leg or hand, let the victim lie with the back to the ground. Usually, the position of the victim depends on the form of injury I suspect might have occurred (Male, 32 years, Apam-junction).
\nI think the casualty should be made to lie down at the back to get enough air because the casualty may be suffering from a spinal problem or a dislocated waist or leg and so allowing such a victim to sit or squat may result in other injuries (Male, 30 years, Potsin).
\nYet, others, like this respondent, revealed:
\nI usually do not know the affected part of the victims, so my aim is to remove the victims from the car to be transported to the hospital (Male, 35 years, Gomoa Mprumem).
\nIn case the victim is bleeding, most respondents (86%) demonstrated adequate knowledge of pre-hospital care including applying pressure to the affected area by pressing hard with the hands and subsequently applying local herbs or leaves and bandage to the bleeding part in order to stop or reduce bleeding (external compression for haemorrhage control).
\nI tear the victim’s shirt and use it to bandage the affected part. This helps to reduce the bleeding to prevent loss of blood, even if there is a delay in transporting them to the hospital (Male, 34 years, Apam-junction).
\nI am a driver, so I usually use dusters from my car or the shirts of (male) victims to tie the bleeding part before I transport them to the hospital (Male, 37 years, Apam-junction).
\nIt is evident from the interviews that bandaging or tying the bleeding area (haemorrhage control) is the common first aid most residents know of. However, others revealed different indigenous methods to stop bleeding.
\nFor me, what I normally do is to look for leaves like “Acheampong” (a local herb) and I grind it on the road and apply it on the bleeding part to reduce the bleeding, or even at times I use plantain leaves, grind it and after that, I squeeze the water content on the bleeding part. Even though it hurts when the leaves are applied to injuries, but they help to reduce bleeding as soon as possible (Male, 35 years, Gomoa Mprumem).
\nLastly, we also quizzed respondents on their knowledge on how to assist unresponsive RTA victims. About 27% of the respondents rightly suggested checking the victim’s pulse and body movements to determine the chances of survival and shouting into the victim’s ear to determine if the victim responds or not. Other participants also think because most unresponsive victims become short of breath, the best way to assist them is by placing them on the ground with the head tilted backwards to open the airway in the throat to enable the victim to take in more air (basic airway control in unconscious persons).
\nIf the victim still breaths or the heart still beats, I put the victims in an open space to get more air. But if I cannot feel the heartbeat, I conclude that the victim is dead yet still we transport them to the hospital (Male, 35 years, Gomoa Mprumem).
\nIn sum, we realised that the study respondents were more adequate in their knowledge of pre-hospital care for bleeding accident victim(s) than in the case of the recovery position for the victim(s) who suffer fracture (broken bones) or are unresponsive.
\nVaried methods, mainly indigenous, are employed in saving RTA victims. Figures 3, 4, 5 depict the kind of assistance community residents provide at accident scenes. We observed that the “scoop and run” method of pre-hospital care (which involves providing basic care at the trauma site and rushing the victim to a hospital) was the common practice among the respondents. Some respondents also call on the National Fire Service and the Ambulance Service to help. The quotes below illustrate the kind of assistance provided at accident scenes.
\nResidents trying to rescue victims stacked in a vehicle.
RTA victims put at recovery position.
Some community residents assisting RTA victims.
We have not been trained on how to administer first aid and also do not have what it takes to treat the accident victims, and so we usually arrange with an oncoming vehicle to transport them to the nearest hospital (Female, 34 years, Kwabenata).
\nA taxi had an accident here 2 weeks ago and it caught fire. We all had to run to our homes to fetch water to quench the fire before we were able to remove the victims from the car (Male, 28 years, Kwabenata).
\nHowever, the situation was different for those who had ever received some first-aid training:
\nI have received some training in first aid. As a taxi driver, I usually carry a first aid box in my car with the basic supplies. Anytime I witness an accident and the victims bleed, I wash the bleeding part with water and apply methylated spirit to the affected part(s) and subsequently put cotton wool and plaster to stop the bleeding. Shortly after, I transport the victims in my taxi to the hospital (Male, 38 years, Okyereko).
\nNotwithstanding, we noted that the rescue efforts were often saddled with challenges. The major challenge we noted was the lack of proper tools to cut open vehicles in order to bring out trapped victims. There was also the difficulty of rescuing victims in burning vehicles. Some respondents revealed sustaining burns and deep cuts by the broken glasses of the crashed vehicles in the process of rescuing victims.
\nOur ability to rescue victims from crashed vehicles depend on the extent of damage to the vehicle. We lack the necessary equipment to cut open accident vehicles. Mostly, we use cutlass, axes and any available tool to cut the vehicle in order to get the victims out. We end up injuring ourselves in the process (Male, 35 years, Gomoa Mprumem).
\nWhenever an accident occurs here and the vehicle catches fire, removing the victims becomes very difficult but because we want to help, we persist and end up sustaining injuries in the process (Male, 29 years, Kwabenata).
\nIn this study, we sought to explore the experiences of residents of communities along the Kasoa-Mankessim highway in providing pre-hospital care to RTA victims. This knowledge is important to provide the basis for future training to ensure safe victim handling in line with international best practices. Recently, WHO has encouraged layperson first responder programmes as a basic step in the development of a functioning pre-hospital system [13]. Given that communities along accident-prone highways are normally the first people to come into contact with the RTA victims (first responders), the need to train them adequately cannot be overemphasised.
\nThe current study found that there is a natural inclination to help RTA victims among the study respondents, yet only a handful of them have received proper pre-hospital training to facilitate safe victim handling and pre-hospital care in line with best practices. Of the 80 participants, only 20% had received some form of pre-hospital first-aid training, howbeit inadequate. In view of this, most participants had little knowledge in first aid care processes. As a consequence of the lack of training, participants had devised various strategies to assist RTA victims, which is likely to result in further injuries or even the death of victims.
\nIt was also apparent that even though most of the respondents have not been trained in pre-hospital care to RTA victims, through continuous victim rescue efforts, they have gained some valuable experiences. However, respondents with some training exhibited appropriate knowledge of the pre-hospital procedures in the areas of our knowledge assessment consistent with previous findings [7, 12, 13].
\nAnother important finding was that the scoop and run method of pre-hospital care [19] was common among the study participants. This could be explained by their little or no clinical (pre-hospital) know-how and appropriate tools and supplies to cater for RTA victims. This notwithstanding, available evidence suggests that the scoop and run method is effective in increasing the chance of victim survival in the event of serious injuries [19, 20]. Any delay to transport victims for definitive care decrease the chance of victim survival (which is time-critical) [20].
\nThe study results further support the establishment of layperson first responder systems in pre-hospital deficient settings. Generally, the natural inclination to help RTA victims and the success of the programme in other countries, mostly in Africa makes this workable in our study areas [5, 11, 12, 13]. These studies demonstrate that trained layperson first responders retain and appropriately use their newly acquired knowledge and skills for societal good [7, 12].
\nIt is noteworthy that similar studies were either quantitative in design or at best evaluation of the impact of a pre-hospital care or first-aid training course or a systematic review of the literature. Unlike these studies, our study was mainly qualitative and exploratory in nature and unique in its approach to exploring the knowledge of pre-hospital care for RTA victims. As a qualitative, exploratory study, it suffers from concerns with generalisability of the study findings to the population, a supposed problem associated with qualitative studies in general. However, the study findings are significant in their own right and provide a valuable first view of the processes residents of the named highway goes through to assist RTA victims which is important for further studies and intervention programmes.
\nBased on the study findings, we conclude that there is a general enthusiasm to assist RTA victims among the respondents and the communities, yet there are gaps in their knowledge of, and skills in pre-hospital care for RTA victims. The study findings thus suggest several courses of action in line with best practices.
\nTo take advantage of community members’ eagerness to assist RTA victims, the relevant stakeholders and policy-makers (Ghana Red Cross Society, National Ambulance, Ghana National Fire Service, and Ministry of Health) could undertake a couple of policy and practical actions toward ensuring efficient pre-hospital care for RTA victims.
\nThe most obvious and immediate action involves implementing a functioning layperson first responder systems in the communities along the road network. As suggested in a previous study [7], persons (e.g., taxi drivers, community leaders) who are likely to chance upon and transport RTA victims could be the target of this layperson first responder training programmes. These persons should be equipped with the needed skills and first-aid kits/supplies to provide basic life support services pending definitive care as well as transport RTA victims to the nearest health facility. Periodic refresher training and incentives for the laypersons will ensure the sustainability of the system [6, 7]. As indicated earlier, this is an important and cost-effective step to developing formal emergency pre-hospital care systems [12]. Related to this is the urgent need to establish effective communication and transportation channels between the communities, the relevant stakeholders and health facilities.
\nIt is also possible to utilise modern information and communication technology to send out messages to the relevant stakeholders in the event of RTAs. By the use of a global positioning system (GPS)-enabled devices, exact coordinates of accident locations could be sent to the national ambulance and other stakeholders for immediate deployment and assistance. For instance, the request for emergency service feature of the recently launched “GhanaPost GPS App” could be a useful system in this regard. This, however, implies that both community members and the relevant stakeholders should be trained to use it.
\nLast but not least, given that the driving population (motorists) are probably more likely to chance upon accident scenes, first-aid training/course could be made mandatory for motorists when obtaining a driving licence. This will ensure a well-equipped driving population who could promptly assist RTA victims should they chance upon an accident scene in the course of their journeys [20].
\nWe are grateful to all persons who participated in the study. Without you, this study could not have come this far. We are also grateful to all stakeholders in the selected communities where we conducted interviews.
\nThe authors declare no conflict of interest.
\nAll Works published by IntechOpen prior to October 2011 are licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported license (CC BY-BC-SA 3.0). Works published after October 2011 are licensed under a Creative Commons Attribution 3.0 Unported license (CC BY 3.0), the latter allowing for the broadest possible reuse of published material.
",metaTitle:"Translation Policy",metaDescription:"Translation of Works - Book Chapters",metaKeywords:null,canonicalURL:"/page/translation-policy",contentRaw:'[{"type":"htmlEditorComponent","content":"All Works licensed under CC BY-BC-SA 3.0 can be freely translated and used for non-commercial purposes. Works licensed under CC BY 3.0 license can be freely translated and used for both commercial and non-commercial purposes.
\\n\\nAll translated Chapters have to be properly attributed in accordance with the requirements included in IntechOpen's Attribution Policy. Besides proper attribution translated sections of Works must include the following sentence: "This is an unofficial translation of a work published by IntechOpen. The publisher has not endorsed this translation".
\\n\\nAll rights to Books and other compilations are reserved by IntechOpen. The copyright to Books and other compilations is subject to a Copyright separate from any that exists in the included Works.
\\n\\nA Book in its entirety, or a significant part of a Book, cannot be translated freely without specific written consent by the publisher. Requests for permission can be made at permissions@intechopen.com.
\\n\\nPolicy last updated: 2016-06-09
\\n"}]'},components:[{type:"htmlEditorComponent",content:'All Works licensed under CC BY-BC-SA 3.0 can be freely translated and used for non-commercial purposes. Works licensed under CC BY 3.0 license can be freely translated and used for both commercial and non-commercial purposes.
\n\nAll translated Chapters have to be properly attributed in accordance with the requirements included in IntechOpen's Attribution Policy. Besides proper attribution translated sections of Works must include the following sentence: "This is an unofficial translation of a work published by IntechOpen. The publisher has not endorsed this translation".
\n\nAll rights to Books and other compilations are reserved by IntechOpen. The copyright to Books and other compilations is subject to a Copyright separate from any that exists in the included Works.
\n\nA Book in its entirety, or a significant part of a Book, cannot be translated freely without specific written consent by the publisher. Requests for permission can be made at permissions@intechopen.com.
\n\nPolicy last updated: 2016-06-09
\n'}]},successStories:{items:[]},authorsAndEditors:{filterParams:{sort:"featured,name"},profiles:[{id:"6700",title:"Dr.",name:"Abbass A.",middleName:null,surname:"Hashim",slug:"abbass-a.-hashim",fullName:"Abbass A. Hashim",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/6700/images/1864_n.jpg",biography:"Currently I am carrying out research in several areas of interest, mainly covering work on chemical and bio-sensors, semiconductor thin film device fabrication and characterisation.\nAt the moment I have very strong interest in radiation environmental pollution and bacteriology treatment. The teams of researchers are working very hard to bring novel results in this field. I am also a member of the team in charge for the supervision of Ph.D. students in the fields of development of silicon based planar waveguide sensor devices, study of inelastic electron tunnelling in planar tunnelling nanostructures for sensing applications and development of organotellurium(IV) compounds for semiconductor applications. I am a specialist in data analysis techniques and nanosurface structure. I have served as the editor for many books, been a member of the editorial board in science journals, have published many papers and hold many patents.",institutionString:null,institution:{name:"Sheffield Hallam University",country:{name:"United Kingdom"}}},{id:"54525",title:"Prof.",name:"Abdul Latif",middleName:null,surname:"Ahmad",slug:"abdul-latif-ahmad",fullName:"Abdul Latif Ahmad",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"20567",title:"Prof.",name:"Ado",middleName:null,surname:"Jorio",slug:"ado-jorio",fullName:"Ado Jorio",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universidade Federal de Minas Gerais",country:{name:"Brazil"}}},{id:"47940",title:"Dr.",name:"Alberto",middleName:null,surname:"Mantovani",slug:"alberto-mantovani",fullName:"Alberto Mantovani",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"12392",title:"Mr.",name:"Alex",middleName:null,surname:"Lazinica",slug:"alex-lazinica",fullName:"Alex Lazinica",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/12392/images/7282_n.png",biography:"Alex Lazinica is the founder and CEO of IntechOpen. After obtaining a Master's degree in Mechanical Engineering, he continued his PhD studies in Robotics at the Vienna University of Technology. Here he worked as a robotic researcher with the university's Intelligent Manufacturing Systems Group as well as a guest researcher at various European universities, including the Swiss Federal Institute of Technology Lausanne (EPFL). During this time he published more than 20 scientific papers, gave presentations, served as a reviewer for major robotic journals and conferences and most importantly he co-founded and built the International Journal of Advanced Robotic Systems- world's first Open Access journal in the field of robotics. Starting this journal was a pivotal point in his career, since it was a pathway to founding IntechOpen - Open Access publisher focused on addressing academic researchers needs. Alex is a personification of IntechOpen key values being trusted, open and entrepreneurial. Today his focus is on defining the growth and development strategy for the company.",institutionString:null,institution:{name:"TU Wien",country:{name:"Austria"}}},{id:"19816",title:"Prof.",name:"Alexander",middleName:null,surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/19816/images/1607_n.jpg",biography:"Alexander I. Kokorin: born: 1947, Moscow; DSc., PhD; Principal Research Fellow (Research Professor) of Department of Kinetics and Catalysis, N. Semenov Institute of Chemical Physics, Russian Academy of Sciences, Moscow.\nArea of research interests: physical chemistry of complex-organized molecular and nanosized systems, including polymer-metal complexes; the surface of doped oxide semiconductors. He is an expert in structural, absorptive, catalytic and photocatalytic properties, in structural organization and dynamic features of ionic liquids, in magnetic interactions between paramagnetic centers. The author or co-author of 3 books, over 200 articles and reviews in scientific journals and books. He is an actual member of the International EPR/ESR Society, European Society on Quantum Solar Energy Conversion, Moscow House of Scientists, of the Board of Moscow Physical Society.",institutionString:null,institution:null},{id:"62389",title:"PhD.",name:"Ali Demir",middleName:null,surname:"Sezer",slug:"ali-demir-sezer",fullName:"Ali Demir Sezer",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62389/images/3413_n.jpg",biography:"Dr. Ali Demir Sezer has a Ph.D. from Pharmaceutical Biotechnology at the Faculty of Pharmacy, University of Marmara (Turkey). He is the member of many Pharmaceutical Associations and acts as a reviewer of scientific journals and European projects under different research areas such as: drug delivery systems, nanotechnology and pharmaceutical biotechnology. Dr. Sezer is the author of many scientific publications in peer-reviewed journals and poster communications. Focus of his research activity is drug delivery, physico-chemical characterization and biological evaluation of biopolymers micro and nanoparticles as modified drug delivery system, and colloidal drug carriers (liposomes, nanoparticles etc.).",institutionString:null,institution:{name:"Marmara University",country:{name:"Turkey"}}},{id:"61051",title:"Prof.",name:"Andrea",middleName:null,surname:"Natale",slug:"andrea-natale",fullName:"Andrea Natale",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"100762",title:"Prof.",name:"Andrea",middleName:null,surname:"Natale",slug:"andrea-natale",fullName:"Andrea Natale",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"St David's Medical Center",country:{name:"United States of America"}}},{id:"107416",title:"Dr.",name:"Andrea",middleName:null,surname:"Natale",slug:"andrea-natale",fullName:"Andrea Natale",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Texas Cardiac Arrhythmia",country:{name:"United States of America"}}},{id:"64434",title:"Dr.",name:"Angkoon",middleName:null,surname:"Phinyomark",slug:"angkoon-phinyomark",fullName:"Angkoon Phinyomark",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/64434/images/2619_n.jpg",biography:"My name is Angkoon Phinyomark. I received a B.Eng. degree in Computer Engineering with First Class Honors in 2008 from Prince of Songkla University, Songkhla, Thailand, where I received a Ph.D. degree in Electrical Engineering. My research interests are primarily in the area of biomedical signal processing and classification notably EMG (electromyography signal), EOG (electrooculography signal), and EEG (electroencephalography signal), image analysis notably breast cancer analysis and optical coherence tomography, and rehabilitation engineering. I became a student member of IEEE in 2008. During October 2011-March 2012, I had worked at School of Computer Science and Electronic Engineering, University of Essex, Colchester, Essex, United Kingdom. In addition, during a B.Eng. I had been a visiting research student at Faculty of Computer Science, University of Murcia, Murcia, Spain for three months.\n\nI have published over 40 papers during 5 years in refereed journals, books, and conference proceedings in the areas of electro-physiological signals processing and classification, notably EMG and EOG signals, fractal analysis, wavelet analysis, texture analysis, feature extraction and machine learning algorithms, and assistive and rehabilitative devices. I have several computer programming language certificates, i.e. Sun Certified Programmer for the Java 2 Platform 1.4 (SCJP), Microsoft Certified Professional Developer, Web Developer (MCPD), Microsoft Certified Technology Specialist, .NET Framework 2.0 Web (MCTS). I am a Reviewer for several refereed journals and international conferences, such as IEEE Transactions on Biomedical Engineering, IEEE Transactions on Industrial Electronics, Optic Letters, Measurement Science Review, and also a member of the International Advisory Committee for 2012 IEEE Business Engineering and Industrial Applications and 2012 IEEE Symposium on Business, Engineering and Industrial Applications.",institutionString:null,institution:{name:"Joseph Fourier University",country:{name:"France"}}},{id:"55578",title:"Dr.",name:"Antonio",middleName:null,surname:"Jurado-Navas",slug:"antonio-jurado-navas",fullName:"Antonio Jurado-Navas",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/55578/images/4574_n.png",biography:"Antonio Jurado-Navas received the M.S. degree (2002) and the Ph.D. degree (2009) in Telecommunication Engineering, both from the University of Málaga (Spain). He first worked as a consultant at Vodafone-Spain. From 2004 to 2011, he was a Research Assistant with the Communications Engineering Department at the University of Málaga. In 2011, he became an Assistant Professor in the same department. From 2012 to 2015, he was with Ericsson Spain, where he was working on geo-location\ntools for third generation mobile networks. Since 2015, he is a Marie-Curie fellow at the Denmark Technical University. His current research interests include the areas of mobile communication systems and channel modeling in addition to atmospheric optical communications, adaptive optics and statistics",institutionString:null,institution:{name:"University of Malaga",country:{name:"Spain"}}}],filtersByRegion:[{group:"region",caption:"North America",value:1,count:5313},{group:"region",caption:"Middle and South America",value:2,count:4819},{group:"region",caption:"Africa",value:3,count:1468},{group:"region",caption:"Asia",value:4,count:9362},{group:"region",caption:"Australia and Oceania",value:5,count:837},{group:"region",caption:"Europe",value:6,count:14778}],offset:12,limit:12,total:108153},chapterEmbeded:{data:{}},editorApplication:{success:null,errors:{}},ofsBooks:{filterParams:{topicId:"11"},books:[{type:"book",id:"6837",title:"Lithium-ion Batteries - Thin Film for Energy Materials and Devices",subtitle:null,isOpenForSubmission:!0,hash:"ea7789260b319b9a4b472257f57bfeb5",slug:null,bookSignature:"Prof. Mitsunobu Sato, Dr. Li Lu and Dr. Hiroki Nagai",coverURL:"https://cdn.intechopen.com/books/images_new/6837.jpg",editedByType:null,editors:[{id:"179615",title:"Prof.",name:"Mitsunobu",surname:"Sato",slug:"mitsunobu-sato",fullName:"Mitsunobu Sato"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6842",title:"Aerosols",subtitle:null,isOpenForSubmission:!0,hash:"efe043290c576559ee15f293bc924f65",slug:null,bookSignature:"",coverURL:"https://cdn.intechopen.com/books/images_new/6842.jpg",editedByType:null,editors:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7030",title:"Satellite Systems - Design, Modeling, Simulation and Analysis",subtitle:null,isOpenForSubmission:!0,hash:"b9db6d2645ef248ceb1b33ea75f38e88",slug:null,bookSignature:"Dr. Tien Manh Nguyen",coverURL:"https://cdn.intechopen.com/books/images_new/7030.jpg",editedByType:null,editors:[{id:"210657",title:"Dr.",name:"Tien",surname:"Nguyen",slug:"tien-nguyen",fullName:"Tien Nguyen"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7395",title:"Atmospheric Pressure Plasma",subtitle:null,isOpenForSubmission:!0,hash:"6deb4387910df1691c5b8d0d3260cbd5",slug:null,bookSignature:"",coverURL:"https://cdn.intechopen.com/books/images_new/7395.jpg",editedByType:null,editors:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7416",title:"Compound Engine",subtitle:null,isOpenForSubmission:!0,hash:"e7901967cd17843e83c855abd4014838",slug:null,bookSignature:"",coverURL:"https://cdn.intechopen.com/books/images_new/7416.jpg",editedByType:null,editors:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7638",title:"Massive Multiple-input Multiple-output Systems",subtitle:null,isOpenForSubmission:!0,hash:"f6e96802bc79d6b8b0bab9ad24980cbc",slug:null,bookSignature:"Dr. Sudhakar Radhakrishnan",coverURL:"https://cdn.intechopen.com/books/images_new/7638.jpg",editedByType:null,editors:[{id:"26327",title:"Dr.",name:"Sudhakar",surname:"Radhakrishnan",slug:"sudhakar-radhakrishnan",fullName:"Sudhakar Radhakrishnan"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7741",title:"Organic Field-Effect Transistors",subtitle:null,isOpenForSubmission:!0,hash:"787c5b02acbbf3f4efda634be5e6f3c0",slug:null,bookSignature:"Dr. Jonathan Sayago",coverURL:"https://cdn.intechopen.com/books/images_new/7741.jpg",editedByType:null,editors:[{id:"198513",title:"Dr.",name:"Jonathan",surname:"Sayago",slug:"jonathan-sayago",fullName:"Jonathan Sayago"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7771",title:"Dependability Engineering",subtitle:null,isOpenForSubmission:!0,hash:"37247080c87485c80a9fc393b2bdc50e",slug:null,bookSignature:"Dr. Leo Dimitrios Kounis",coverURL:"https://cdn.intechopen.com/books/images_new/7771.jpg",editedByType:null,editors:[{id:"111582",title:"Dr.",name:"Leo",surname:"Kounis",slug:"leo-kounis",fullName:"Leo Kounis"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7772",title:"Systems of Systems - Engineering, Modeling, Simulation and Analysis",subtitle:null,isOpenForSubmission:!0,hash:"677fbbd5fc2550e8be540f40c0969a62",slug:null,bookSignature:"Dr. Tien Manh Nguyen",coverURL:"https://cdn.intechopen.com/books/images_new/7772.jpg",editedByType:null,editors:[{id:"210657",title:"Dr.",name:"Tien",surname:"Nguyen",slug:"tien-nguyen",fullName:"Tien Nguyen"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7783",title:"Polyimide for Electronic and Electrical Engineering Applications",subtitle:null,isOpenForSubmission:!0,hash:"736e80c9bf791829c9a74ac05abb04b7",slug:null,bookSignature:"Dr. Sombel Diaham",coverURL:"https://cdn.intechopen.com/books/images_new/7783.jpg",editedByType:null,editors:[{id:"57115",title:"Dr.",name:"Sombel",surname:"Diaham",slug:"sombel-diaham",fullName:"Sombel Diaham"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8031",title:"Pavement Engineering",subtitle:null,isOpenForSubmission:!0,hash:"1d8ae1b3b3a208c2b16c1ff852e14207",slug:null,bookSignature:"Dr. Sameh Zaghloul",coverURL:"https://cdn.intechopen.com/books/images_new/8031.jpg",editedByType:null,editors:[{id:"269407",title:"Dr.",name:"Sameh",surname:"Zaghloul",slug:"sameh-zaghloul",fullName:"Sameh Zaghloul"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8084",title:"Mechanical Properties of Bamboo",subtitle:null,isOpenForSubmission:!0,hash:"93a82c83d0f81eace906cc1f99809495",slug:null,bookSignature:"",coverURL:"https://cdn.intechopen.com/books/images_new/8084.jpg",editedByType:null,editors:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],filtersByTopic:[{group:"topic",caption:"Agricultural and Biological Sciences",value:5,count:35},{group:"topic",caption:"Biochemistry, Genetics and Molecular Biology",value:6,count:32},{group:"topic",caption:"Business, Management and Economics",value:7,count:9},{group:"topic",caption:"Chemistry",value:8,count:29},{group:"topic",caption:"Computer and Information Science",value:9,count:26},{group:"topic",caption:"Earth and Planetary Sciences",value:10,count:14},{group:"topic",caption:"Engineering",value:11,count:75},{group:"topic",caption:"Environmental Sciences",value:12,count:13},{group:"topic",caption:"Immunology and Microbiology",value:13,count:3},{group:"topic",caption:"Materials Science",value:14,count:37},{group:"topic",caption:"Mathematics",value:15,count:14},{group:"topic",caption:"Medicine",value:16,count:137},{group:"topic",caption:"Nanotechnology and Nanomaterials",value:17,count:5},{group:"topic",caption:"Neuroscience",value:18,count:6},{group:"topic",caption:"Pharmacology, Toxicology and Pharmaceutical Science",value:19,count:8},{group:"topic",caption:"Physics",value:20,count:19},{group:"topic",caption:"Psychology",value:21,count:2},{group:"topic",caption:"Robotics",value:22,count:6},{group:"topic",caption:"Social Sciences",value:23,count:13},{group:"topic",caption:"Technology",value:24,count:10},{group:"topic",caption:"Veterinary Medicine and Science",value:25,count:3},{group:"topic",caption:"Intelligent System",value:535,count:1}],offset:12,limit:12,total:109},popularBooks:{featuredBooks:[{type:"book",id:"7878",title:"Advances in Extracorporeal Membrane Oxygenation",subtitle:"Volume 3",isOpenForSubmission:!1,hash:"f95bf990273d08098a00f9a1c2403cbe",slug:"advances-in-extracorporeal-membrane-oxygenation-volume-3",bookSignature:"Michael S. Firstenberg",coverURL:"https://cdn.intechopen.com/books/images_new/7878.jpg",editors:[{id:"64343",title:null,name:"Michael S.",middleName:"S",surname:"Firstenberg",slug:"michael-s.-firstenberg",fullName:"Michael S. Firstenberg"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"8299",title:"Timber Buildings and Sustainability",subtitle:null,isOpenForSubmission:!1,hash:"bccf2891cec38ed041724131aa34c25a",slug:"timber-buildings-and-sustainability",bookSignature:"Giovanna Concu",coverURL:"https://cdn.intechopen.com/books/images_new/8299.jpg",editors:[{id:"108709",title:"Dr.",name:"Giovanna",middleName:null,surname:"Concu",slug:"giovanna-concu",fullName:"Giovanna Concu"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"7614",title:"Fourier Transforms",subtitle:"Century of Digitalization and Increasing Expectations",isOpenForSubmission:!1,hash:"ff3501657ae983a3b42fef1f7058ac91",slug:"fourier-transforms-century-of-digitalization-and-increasing-expectations",bookSignature:"Goran S. Nikoli? and Dragana Z. Markovi?-Nikoli?",coverURL:"https://cdn.intechopen.com/books/images_new/7614.jpg",editors:[{id:"23261",title:"Prof.",name:"Goran",middleName:"S.",surname:"Nikolic",slug:"goran-nikolic",fullName:"Goran Nikolic"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"7062",title:"Rhinosinusitis",subtitle:null,isOpenForSubmission:!1,hash:"14ed95e155b1e57a61827ca30b579d09",slug:"rhinosinusitis",bookSignature:"Balwant Singh Gendeh and Mirjana Turkalj",coverURL:"https://cdn.intechopen.com/books/images_new/7062.jpg",editors:[{id:"67669",title:"Prof.",name:"Balwant Singh",middleName:null,surname:"Gendeh",slug:"balwant-singh-gendeh",fullName:"Balwant Singh Gendeh"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"7087",title:"Tendons",subtitle:null,isOpenForSubmission:!1,hash:"786abac0445c102d1399a1e727a2db7f",slug:"tendons",bookSignature:"Hasan Sözen",coverURL:"https://cdn.intechopen.com/books/images_new/7087.jpg",editors:[{id:"161402",title:"Dr.",name:"Hasan",middleName:null,surname:"Sözen",slug:"hasan-sozen",fullName:"Hasan Sözen"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"7955",title:"Advances in Hematologic Malignancies",subtitle:null,isOpenForSubmission:!1,hash:"59ca1b09447fab4717a93e099f646d28",slug:"advances-in-hematologic-malignancies",bookSignature:"Gamal Abdul Hamid",coverURL:"https://cdn.intechopen.com/books/images_new/7955.jpg",editors:[{id:"36487",title:"Prof.",name:"Gamal",middleName:null,surname:"Abdul Hamid",slug:"gamal-abdul-hamid",fullName:"Gamal Abdul Hamid"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"7701",title:"Assistive and Rehabilitation Engineering",subtitle:null,isOpenForSubmission:!1,hash:"4191b744b8af3b17d9a80026dcb0617f",slug:"assistive-and-rehabilitation-engineering",bookSignature:"Yves Rybarczyk",coverURL:"https://cdn.intechopen.com/books/images_new/7701.jpg",editors:[{id:"72920",title:"Prof.",name:"Yves",middleName:"Philippe",surname:"Rybarczyk",slug:"yves-rybarczyk",fullName:"Yves Rybarczyk"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"7837",title:"Geriatric Medicine and Gerontology",subtitle:null,isOpenForSubmission:!1,hash:"e277d005b23536bcd9f8550046101979",slug:"geriatric-medicine-and-gerontology",bookSignature:"Edward T. Zawada Jr.",coverURL:"https://cdn.intechopen.com/books/images_new/7837.jpg",editors:[{id:"16344",title:"Dr.",name:"Edward T.",middleName:null,surname:"Zawada Jr.",slug:"edward-t.-zawada-jr.",fullName:"Edward T. Zawada Jr."}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"7123",title:"Current Topics in Neglected Tropical Diseases",subtitle:null,isOpenForSubmission:!1,hash:"61c627da05b2ace83056d11357bdf361",slug:"current-topics-in-neglected-tropical-diseases",bookSignature:"Alfonso J. Rodriguez-Morales",coverURL:"https://cdn.intechopen.com/books/images_new/7123.jpg",editors:[{id:"131400",title:"Dr.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"7610",title:"Renewable and Sustainable Composites",subtitle:null,isOpenForSubmission:!1,hash:"c2de26c3d329c54f093dc3f05417500a",slug:"renewable-and-sustainable-composites",bookSignature:"António B. Pereira and Fábio A. O. Fernandes",coverURL:"https://cdn.intechopen.com/books/images_new/7610.jpg",editors:[{id:"211131",title:"Prof.",name:"António",middleName:"Bastos",surname:"Pereira",slug:"antonio-pereira",fullName:"António Pereira"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"8416",title:"Non-Equilibrium Particle Dynamics",subtitle:null,isOpenForSubmission:!1,hash:"2c3add7639dcd1cb442cb4313ea64e3a",slug:"non-equilibrium-particle-dynamics",bookSignature:"Albert S. Kim",coverURL:"https://cdn.intechopen.com/books/images_new/8416.jpg",editors:[{id:"21045",title:"Prof.",name:"Albert S.",middleName:null,surname:"Kim",slug:"albert-s.-kim",fullName:"Albert S. Kim"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"8008",title:"Antioxidants",subtitle:null,isOpenForSubmission:!1,hash:"76361b4061e830906267933c1c670027",slug:"antioxidants",bookSignature:"Emad Shalaby",coverURL:"https://cdn.intechopen.com/books/images_new/8008.jpg",editors:[{id:"63600",title:"Prof.",name:"Emad",middleName:null,surname:"Shalaby",slug:"emad-shalaby",fullName:"Emad Shalaby"}],productType:{id:"1",chapterContentType:"chapter"}}],offset:12,limit:12,total:4392},hotBookTopics:{hotBooks:[],offset:0,limit:12,total:null},publish:{},publishingProposal:{success:null,errors:{}},books:{featuredBooks:[{type:"book",id:"7878",title:"Advances in Extracorporeal Membrane Oxygenation",subtitle:"Volume 3",isOpenForSubmission:!1,hash:"f95bf990273d08098a00f9a1c2403cbe",slug:"advances-in-extracorporeal-membrane-oxygenation-volume-3",bookSignature:"Michael S. Firstenberg",coverURL:"https://cdn.intechopen.com/books/images_new/7878.jpg",editors:[{id:"64343",title:null,name:"Michael S.",middleName:"S",surname:"Firstenberg",slug:"michael-s.-firstenberg",fullName:"Michael S. Firstenberg"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"8299",title:"Timber Buildings and Sustainability",subtitle:null,isOpenForSubmission:!1,hash:"bccf2891cec38ed041724131aa34c25a",slug:"timber-buildings-and-sustainability",bookSignature:"Giovanna Concu",coverURL:"https://cdn.intechopen.com/books/images_new/8299.jpg",editors:[{id:"108709",title:"Dr.",name:"Giovanna",middleName:null,surname:"Concu",slug:"giovanna-concu",fullName:"Giovanna Concu"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"7614",title:"Fourier Transforms",subtitle:"Century of Digitalization and Increasing Expectations",isOpenForSubmission:!1,hash:"ff3501657ae983a3b42fef1f7058ac91",slug:"fourier-transforms-century-of-digitalization-and-increasing-expectations",bookSignature:"Goran S. Nikoli? and Dragana Z. Markovi?-Nikoli?",coverURL:"https://cdn.intechopen.com/books/images_new/7614.jpg",editors:[{id:"23261",title:"Prof.",name:"Goran",middleName:"S.",surname:"Nikolic",slug:"goran-nikolic",fullName:"Goran Nikolic"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"7062",title:"Rhinosinusitis",subtitle:null,isOpenForSubmission:!1,hash:"14ed95e155b1e57a61827ca30b579d09",slug:"rhinosinusitis",bookSignature:"Balwant Singh Gendeh and Mirjana Turkalj",coverURL:"https://cdn.intechopen.com/books/images_new/7062.jpg",editors:[{id:"67669",title:"Prof.",name:"Balwant Singh",middleName:null,surname:"Gendeh",slug:"balwant-singh-gendeh",fullName:"Balwant Singh Gendeh"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"7087",title:"Tendons",subtitle:null,isOpenForSubmission:!1,hash:"786abac0445c102d1399a1e727a2db7f",slug:"tendons",bookSignature:"Hasan Sözen",coverURL:"https://cdn.intechopen.com/books/images_new/7087.jpg",editors:[{id:"161402",title:"Dr.",name:"Hasan",middleName:null,surname:"Sözen",slug:"hasan-sozen",fullName:"Hasan Sözen"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"7955",title:"Advances in Hematologic Malignancies",subtitle:null,isOpenForSubmission:!1,hash:"59ca1b09447fab4717a93e099f646d28",slug:"advances-in-hematologic-malignancies",bookSignature:"Gamal Abdul Hamid",coverURL:"https://cdn.intechopen.com/books/images_new/7955.jpg",editors:[{id:"36487",title:"Prof.",name:"Gamal",middleName:null,surname:"Abdul Hamid",slug:"gamal-abdul-hamid",fullName:"Gamal Abdul Hamid"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"7701",title:"Assistive and Rehabilitation Engineering",subtitle:null,isOpenForSubmission:!1,hash:"4191b744b8af3b17d9a80026dcb0617f",slug:"assistive-and-rehabilitation-engineering",bookSignature:"Yves Rybarczyk",coverURL:"https://cdn.intechopen.com/books/images_new/7701.jpg",editors:[{id:"72920",title:"Prof.",name:"Yves",middleName:"Philippe",surname:"Rybarczyk",slug:"yves-rybarczyk",fullName:"Yves Rybarczyk"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"7837",title:"Geriatric Medicine and Gerontology",subtitle:null,isOpenForSubmission:!1,hash:"e277d005b23536bcd9f8550046101979",slug:"geriatric-medicine-and-gerontology",bookSignature:"Edward T. Zawada Jr.",coverURL:"https://cdn.intechopen.com/books/images_new/7837.jpg",editors:[{id:"16344",title:"Dr.",name:"Edward T.",middleName:null,surname:"Zawada Jr.",slug:"edward-t.-zawada-jr.",fullName:"Edward T. Zawada Jr."}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"7123",title:"Current Topics in Neglected Tropical Diseases",subtitle:null,isOpenForSubmission:!1,hash:"61c627da05b2ace83056d11357bdf361",slug:"current-topics-in-neglected-tropical-diseases",bookSignature:"Alfonso J. Rodriguez-Morales",coverURL:"https://cdn.intechopen.com/books/images_new/7123.jpg",editors:[{id:"131400",title:"Dr.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"7610",title:"Renewable and Sustainable Composites",subtitle:null,isOpenForSubmission:!1,hash:"c2de26c3d329c54f093dc3f05417500a",slug:"renewable-and-sustainable-composites",bookSignature:"António B. Pereira and Fábio A. O. Fernandes",coverURL:"https://cdn.intechopen.com/books/images_new/7610.jpg",editors:[{id:"211131",title:"Prof.",name:"António",middleName:"Bastos",surname:"Pereira",slug:"antonio-pereira",fullName:"António Pereira"}],productType:{id:"1",chapterContentType:"chapter"}}],latestBooks:[{type:"book",id:"8463",title:"Pediatric Surgery, Flowcharts and Clinical Algorithms",subtitle:null,isOpenForSubmission:!1,hash:"23f39beea4d557b0ae424e2eaf82bf5e",slug:"pediatric-surgery-flowcharts-and-clinical-algorithms",bookSignature:"Sameh Shehata",coverURL:"https://cdn.intechopen.com/books/images_new/8463.jpg",editedByType:"Edited by",editors:[{id:"37518",title:"Prof.",name:"Sameh",middleName:null,surname:"Shehata",slug:"sameh-shehata",fullName:"Sameh Shehata"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7187",title:"Osteosarcoma",subtitle:"Diagnosis, Mechanisms, and Translational Developments",isOpenForSubmission:!1,hash:"89096359b754beb806eca4c6d8aacaba",slug:"osteosarcoma-diagnosis-mechanisms-and-translational-developments",bookSignature:"Matthew Gregory Cable and Robert Lawrence Randall",coverURL:"https://cdn.intechopen.com/books/images_new/7187.jpg",editedByType:"Edited by",editors:[{id:"265693",title:"Dr.",name:"Matthew Gregory",middleName:null,surname:"Cable",slug:"matthew-gregory-cable",fullName:"Matthew Gregory Cable"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7955",title:"Advances in Hematologic Malignancies",subtitle:null,isOpenForSubmission:!1,hash:"59ca1b09447fab4717a93e099f646d28",slug:"advances-in-hematologic-malignancies",bookSignature:"Gamal Abdul Hamid",coverURL:"https://cdn.intechopen.com/books/images_new/7955.jpg",editedByType:"Edited by",editors:[{id:"36487",title:"Prof.",name:"Gamal",middleName:null,surname:"Abdul Hamid",slug:"gamal-abdul-hamid",fullName:"Gamal Abdul Hamid"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7701",title:"Assistive and Rehabilitation Engineering",subtitle:null,isOpenForSubmission:!1,hash:"4191b744b8af3b17d9a80026dcb0617f",slug:"assistive-and-rehabilitation-engineering",bookSignature:"Yves Rybarczyk",coverURL:"https://cdn.intechopen.com/books/images_new/7701.jpg",editedByType:"Edited by",editors:[{id:"72920",title:"Prof.",name:"Yves",middleName:"Philippe",surname:"Rybarczyk",slug:"yves-rybarczyk",fullName:"Yves Rybarczyk"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7726",title:"Swarm Intelligence",subtitle:"Recent Advances, New Perspectives and Applications",isOpenForSubmission:!1,hash:"e7ea7e74ce7a7a8e5359629e07c68d31",slug:"swarm-intelligence-recent-advances-new-perspectives-and-applications",bookSignature:"Javier Del Ser, Esther Villar and Eneko Osaba",coverURL:"https://cdn.intechopen.com/books/images_new/7726.jpg",editedByType:"Edited by",editors:[{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8256",title:"Distillation",subtitle:"Modelling, Simulation and Optimization",isOpenForSubmission:!1,hash:"c76af109f83e14d915e5cb3949ae8b80",slug:"distillation-modelling-simulation-and-optimization",bookSignature:"Vilmar Steffen",coverURL:"https://cdn.intechopen.com/books/images_new/8256.jpg",editedByType:"Edited by",editors:[{id:"189035",title:"Dr.",name:"Vilmar",middleName:null,surname:"Steffen",slug:"vilmar-steffen",fullName:"Vilmar Steffen"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7240",title:"Growing and Handling of Bacterial Cultures",subtitle:null,isOpenForSubmission:!1,hash:"a76c3ef7718c0b72d0128817cdcbe6e3",slug:"growing-and-handling-of-bacterial-cultures",bookSignature:"Madhusmita Mishra",coverURL:"https://cdn.intechopen.com/books/images_new/7240.jpg",editedByType:"Edited by",editors:[{id:"204267",title:"Dr.",name:"Madhusmita",middleName:null,surname:"Mishra",slug:"madhusmita-mishra",fullName:"Madhusmita Mishra"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8299",title:"Timber Buildings and Sustainability",subtitle:null,isOpenForSubmission:!1,hash:"bccf2891cec38ed041724131aa34c25a",slug:"timber-buildings-and-sustainability",bookSignature:"Giovanna Concu",coverURL:"https://cdn.intechopen.com/books/images_new/8299.jpg",editedByType:"Edited by",editors:[{id:"108709",title:"Dr.",name:"Giovanna",middleName:null,surname:"Concu",slug:"giovanna-concu",fullName:"Giovanna Concu"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7062",title:"Rhinosinusitis",subtitle:null,isOpenForSubmission:!1,hash:"14ed95e155b1e57a61827ca30b579d09",slug:"rhinosinusitis",bookSignature:"Balwant Singh Gendeh and Mirjana Turkalj",coverURL:"https://cdn.intechopen.com/books/images_new/7062.jpg",editedByType:"Edited by",editors:[{id:"67669",title:"Prof.",name:"Balwant Singh",middleName:null,surname:"Gendeh",slug:"balwant-singh-gendeh",fullName:"Balwant Singh Gendeh"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7837",title:"Geriatric Medicine and Gerontology",subtitle:null,isOpenForSubmission:!1,hash:"e277d005b23536bcd9f8550046101979",slug:"geriatric-medicine-and-gerontology",bookSignature:"Edward T. Zawada Jr.",coverURL:"https://cdn.intechopen.com/books/images_new/7837.jpg",editedByType:"Edited by",editors:[{id:"16344",title:"Dr.",name:"Edward T.",middleName:null,surname:"Zawada Jr.",slug:"edward-t.-zawada-jr.",fullName:"Edward T. Zawada Jr."}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},subject:{topic:{id:"548",title:"Wireless Sensor Network",slug:"wireless-sensor-network",parent:{title:"Computer Graphics",slug:"computer-and-information-science-computer-graphics"},numberOfBooks:1,numberOfAuthorsAndEditors:31,numberOfWosCitations:24,numberOfCrossrefCitations:28,numberOfDimensionsCitations:57,videoUrl:null,fallbackUrl:null,description:null},booksByTopicFilter:{topicSlug:"wireless-sensor-network",sort:"-publishedDate",limit:12,offset:0},booksByTopicCollection:[{type:"book",id:"155",title:"Sensor Fusion",subtitle:"Foundation and Applications",isOpenForSubmission:!1,hash:"4e394b8458dc49549ccf603ef6e376b8",slug:"sensor-fusion-foundation-and-applications",bookSignature:"Ciza Thomas",coverURL:"https://cdn.intechopen.com/books/images_new/155.jpg",editedByType:"Edited by",editors:[{id:"43680",title:"Prof.",name:"Ciza",middleName:null,surname:"Thomas",slug:"ciza-thomas",fullName:"Ciza Thomas"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],booksByTopicTotal:1,mostCitedChapters:[{id:"15910",doi:"10.5772/19983",title:"Sensor Fusion for Precision Agriculture",slug:"sensor-fusion-for-precision-agriculture",totalDownloads:3969,totalCrossrefCites:2,totalDimensionsCites:19,book:{slug:"sensor-fusion-foundation-and-applications",title:"Sensor Fusion",fullTitle:"Sensor Fusion - Foundation and Applications"},signatures:"Viacheslav I. Adamchuk, Raphael A. Viscarra Rossel, Kenneth A. Sudduth and Peter Schulze Lammers",authors:[{id:"37024",title:"Dr.",name:"Viacheslav",middleName:null,surname:"Adamchuk",slug:"viacheslav-adamchuk",fullName:"Viacheslav Adamchuk"},{id:"37029",title:"Dr.",name:"Raphael",middleName:null,surname:"Viscarra Rossel",slug:"raphael-viscarra-rossel",fullName:"Raphael Viscarra Rossel"}]},{id:"14978",doi:"10.5772/17384",title:"A Possibilistic Framework for Sensor Fusion with Monitoring of Sensor Reliability",slug:"a-possibilistic-framework-for-sensor-fusion-with-monitoring-of-sensor-reliability",totalDownloads:1471,totalCrossrefCites:5,totalDimensionsCites:8,book:{slug:"sensor-fusion-foundation-and-applications",title:"Sensor Fusion",fullTitle:"Sensor Fusion - Foundation and Applications"},signatures:"Volker Lohweg, Karl Voth and Stefan Glock",authors:[{id:"10388",title:"Prof.",name:"Volker",middleName:null,surname:"Lohweg",slug:"volker-lohweg",fullName:"Volker Lohweg"},{id:"28864",title:"MSc.",name:"Karl",middleName:null,surname:"Voth",slug:"karl-voth",fullName:"Karl Voth"},{id:"32061",title:"Dr.",name:"Stefan",middleName:null,surname:"Glock",slug:"stefan-glock",fullName:"Stefan Glock"}]},{id:"15915",doi:"10.5772/17666",title:"Detecting, Tracking, and Identifying Airborne Threats with Netted Sensor Fence",slug:"detecting-tracking-and-identifying-airborne-threats-with-netted-sensor-fence",totalDownloads:3085,totalCrossrefCites:4,totalDimensionsCites:6,book:{slug:"sensor-fusion-foundation-and-applications",title:"Sensor Fusion",fullTitle:"Sensor Fusion - Foundation and Applications"},signatures:"Weiqun Shi, Gus Arabadjis, Brett Bishop, Peter Hill, Rich Plasse and John Yoder",authors:[{id:"29050",title:"Dr.",name:"Weiqun",middleName:null,surname:"Shi",slug:"weiqun-shi",fullName:"Weiqun Shi"}]}],mostDownloadedChaptersLast30Days:[{id:"15910",title:"Sensor Fusion for Precision Agriculture",slug:"sensor-fusion-for-precision-agriculture",totalDownloads:3969,totalCrossrefCites:2,totalDimensionsCites:19,book:{slug:"sensor-fusion-foundation-and-applications",title:"Sensor Fusion",fullTitle:"Sensor Fusion - Foundation and Applications"},signatures:"Viacheslav I. Adamchuk, Raphael A. Viscarra Rossel, Kenneth A. Sudduth and Peter Schulze Lammers",authors:[{id:"37024",title:"Dr.",name:"Viacheslav",middleName:null,surname:"Adamchuk",slug:"viacheslav-adamchuk",fullName:"Viacheslav Adamchuk"},{id:"37029",title:"Dr.",name:"Raphael",middleName:null,surname:"Viscarra Rossel",slug:"raphael-viscarra-rossel",fullName:"Raphael Viscarra Rossel"}]},{id:"15913",title:"Sensor Fusion Techniques in Navigation Application for Mobile Robot",slug:"sensor-fusion-techniques-in-navigation-application-for-mobile-robot",totalDownloads:3600,totalCrossrefCites:4,totalDimensionsCites:4,book:{slug:"sensor-fusion-foundation-and-applications",title:"Sensor Fusion",fullTitle:"Sensor Fusion - Foundation and Applications"},signatures:"Surachai Panich and Nitin Afzulpurkar",authors:[{id:"5704",title:"Dr.",name:"Surachai",middleName:null,surname:"Panich",slug:"surachai-panich",fullName:"Surachai Panich"},{id:"39453",title:"Prof.",name:"Nitin",middleName:null,surname:"Afzulpurkar",slug:"nitin-afzulpurkar",fullName:"Nitin Afzulpurkar"}]},{id:"15915",title:"Detecting, Tracking, and Identifying Airborne Threats with Netted Sensor Fence",slug:"detecting-tracking-and-identifying-airborne-threats-with-netted-sensor-fence",totalDownloads:3085,totalCrossrefCites:4,totalDimensionsCites:6,book:{slug:"sensor-fusion-foundation-and-applications",title:"Sensor Fusion",fullTitle:"Sensor Fusion - Foundation and Applications"},signatures:"Weiqun Shi, Gus Arabadjis, Brett Bishop, Peter Hill, Rich Plasse and John Yoder",authors:[{id:"29050",title:"Dr.",name:"Weiqun",middleName:null,surname:"Shi",slug:"weiqun-shi",fullName:"Weiqun Shi"}]},{id:"15912",title:"Data Association Techniques for Non-Gaussian Measurements",slug:"data-association-techniques-for-non-gaussian-measurements",totalDownloads:1385,totalCrossrefCites:0,totalDimensionsCites:1,book:{slug:"sensor-fusion-foundation-and-applications",title:"Sensor Fusion",fullTitle:"Sensor Fusion - Foundation and Applications"},signatures:"Stephen C. Stubberud and Kathleen A. Kramer",authors:[{id:"20608",title:"Prof.",name:"Kathleen A.",middleName:null,surname:"Kramer",slug:"kathleen-a.-kramer",fullName:"Kathleen A. Kramer"},{id:"22661",title:"Dr.",name:"Stephen C.",middleName:null,surname:"Stubberud",slug:"stephen-c.-stubberud",fullName:"Stephen C. Stubberud"}]},{id:"15909",title:"A Dynamic Context Reasoning based on Evidential Fusion Networks in Home-Based Care",slug:"a-dynamic-context-reasoning-based-on-evidential-fusion-networks-in-home-based-care",totalDownloads:1245,totalCrossrefCites:2,totalDimensionsCites:2,book:{slug:"sensor-fusion-foundation-and-applications",title:"Sensor Fusion",fullTitle:"Sensor Fusion - Foundation and Applications"},signatures:"Hyun Lee, Jae Sung Choi and Ramez Elmasri",authors:[{id:"29125",title:"Dr",name:"Hyun",middleName:null,surname:"Lee",slug:"hyun-lee",fullName:"Hyun Lee"},{id:"35117",title:"Dr.",name:"Jae Sung",middleName:null,surname:"Choi",slug:"jae-sung-choi",fullName:"Jae Sung Choi"},{id:"35118",title:"Dr.",name:"Ramez",middleName:null,surname:"Elmasri",slug:"ramez-elmasri",fullName:"Ramez Elmasri"}]},{id:"15911",title:"Localization and Tracking Using Camera-Based Wireless Sensor Networks",slug:"localization-and-tracking-using-camera-based-wireless-sensor-networks",totalDownloads:1910,totalCrossrefCites:2,totalDimensionsCites:4,book:{slug:"sensor-fusion-foundation-and-applications",title:"Sensor Fusion",fullTitle:"Sensor Fusion - Foundation and Applications"},signatures:"J.R. Martinez-de Dios, A. Jimenez-Gonzalez and A. Ollero",authors:[{id:"34663",title:"Prof.",name:"Ramiro",middleName:null,surname:"Martinez",slug:"ramiro-martinez",fullName:"Ramiro Martinez"},{id:"36232",title:"MSc",name:"Adrian",middleName:null,surname:"Jimenez-Gonzalez",slug:"adrian-jimenez-gonzalez",fullName:"Adrian Jimenez-Gonzalez"},{id:"36233",title:"Prof.",name:"Anibal",middleName:null,surname:"Ollero",slug:"anibal-ollero",fullName:"Anibal Ollero"}]},{id:"14978",title:"A Possibilistic Framework for Sensor Fusion with Monitoring of Sensor Reliability",slug:"a-possibilistic-framework-for-sensor-fusion-with-monitoring-of-sensor-reliability",totalDownloads:1471,totalCrossrefCites:5,totalDimensionsCites:8,book:{slug:"sensor-fusion-foundation-and-applications",title:"Sensor Fusion",fullTitle:"Sensor Fusion - Foundation and Applications"},signatures:"Volker Lohweg, Karl Voth and Stefan Glock",authors:[{id:"10388",title:"Prof.",name:"Volker",middleName:null,surname:"Lohweg",slug:"volker-lohweg",fullName:"Volker Lohweg"},{id:"28864",title:"MSc.",name:"Karl",middleName:null,surname:"Voth",slug:"karl-voth",fullName:"Karl Voth"},{id:"32061",title:"Dr.",name:"Stefan",middleName:null,surname:"Glock",slug:"stefan-glock",fullName:"Stefan Glock"}]},{id:"14977",title:"Sensor Fusion for Enhancement in Intrusion Detection",slug:"sensor-fusion-for-enhancement-in-intrusion-detection",totalDownloads:1567,totalCrossrefCites:2,totalDimensionsCites:2,book:{slug:"sensor-fusion-foundation-and-applications",title:"Sensor Fusion",fullTitle:"Sensor Fusion - Foundation and Applications"},signatures:"Ciza Thomas and Balakrishnan Narayanaswamy",authors:[{id:"43680",title:"Prof.",name:"Ciza",middleName:null,surname:"Thomas",slug:"ciza-thomas",fullName:"Ciza Thomas"},{id:"43682",title:"Dr.",name:"Narayanaswamy",middleName:null,surname:"Balakrishnan",slug:"narayanaswamy-balakrishnan",fullName:"Narayanaswamy Balakrishnan"}]},{id:"15917",title:"Sensor Fusion-Based Activity Recognition for Parkinson Patients",slug:"sensor-fusion-based-activity-recognition-for-parkinson-patients",totalDownloads:2031,totalCrossrefCites:5,totalDimensionsCites:6,book:{slug:"sensor-fusion-foundation-and-applications",title:"Sensor Fusion",fullTitle:"Sensor Fusion - Foundation and Applications"},signatures:"Majid Bahrepour, Nirvana Meratnia, Zahra Taghikhaki, and Paul J. M. Havinga",authors:[{id:"25900",title:"Prof.",name:"Majid",middleName:null,surname:"Bahrepour",slug:"majid-bahrepour",fullName:"Majid Bahrepour"},{id:"35368",title:"Dr.",name:"Nirvana",middleName:null,surname:"Meratnia",slug:"nirvana-meratnia",fullName:"Nirvana Meratnia"},{id:"35369",title:"Prof.",name:"Paul",middleName:null,surname:"Havinga",slug:"paul-havinga",fullName:"Paul Havinga"},{id:"67114",title:"MSc.",name:"Zahra",middleName:null,surname:"Taghikhaki",slug:"zahra-taghikhaki",fullName:"Zahra Taghikhaki"}]},{id:"15916",title:"Design, Implementation and Evaluation of a Multimodal Sensor System Integrated Into an Airplane Seat",slug:"design-implementation-and-evaluation-of-a-multimodal-sensor-system-integrated-into-an-airplane-seat",totalDownloads:1544,totalCrossrefCites:0,totalDimensionsCites:2,book:{slug:"sensor-fusion-foundation-and-applications",title:"Sensor Fusion",fullTitle:"Sensor Fusion - Foundation and Applications"},signatures:"Bert Arnrich, Cornelia Kappeler-Setz, Johannes Schumm and Gerhard Trooster",authors:[{id:"30827",title:"Dr.",name:"Bert",middleName:null,surname:"Arnrich",slug:"bert-arnrich",fullName:"Bert Arnrich"},{id:"36085",title:"MSc.",name:"Cornelia",middleName:null,surname:"Kappeler-Setz",slug:"cornelia-kappeler-setz",fullName:"Cornelia Kappeler-Setz"},{id:"36086",title:"Dr.",name:"Johannes",middleName:null,surname:"Schumm",slug:"johannes-schumm",fullName:"Johannes Schumm"},{id:"36087",title:"Prof.",name:"Gerhard",middleName:null,surname:"Tröster",slug:"gerhard-troster",fullName:"Gerhard Tröster"}]}],onlineFirstChaptersFilter:{topicSlug:"wireless-sensor-network",limit:3,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[{type:"book",id:"6837",title:"Lithium-ion Batteries - Thin Film for Energy Materials and Devices",subtitle:null,isOpenForSubmission:!0,hash:"ea7789260b319b9a4b472257f57bfeb5",slug:null,bookSignature:"Prof. Mitsunobu Sato, Dr. Li Lu and Dr. Hiroki Nagai",coverURL:"https://cdn.intechopen.com/books/images_new/6837.jpg",editedByType:null,editors:[{id:"179615",title:"Prof.",name:"Mitsunobu",middleName:null,surname:"Sato",slug:"mitsunobu-sato",fullName:"Mitsunobu Sato"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9423",title:"Applications of Artificial Intelligence in Process Industry Automation, Heat and Power Generation and Smart Manufacturing",subtitle:null,isOpenForSubmission:!0,hash:"10ac8fb0bdbf61044395963028653d21",slug:null,bookSignature:"Prof. Konstantinos G. Kyprianidis and Prof. Erik Dahlquist",coverURL:"https://cdn.intechopen.com/books/images_new/9423.jpg",editedByType:null,editors:[{id:"35868",title:"Prof.",name:"Konstantinos",middleName:"G.",surname:"Kyprianidis",slug:"konstantinos-kyprianidis",fullName:"Konstantinos Kyprianidis"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"9428",title:"New Trends in the Use of Artificial Intelligence for the Industry 4.0",subtitle:null,isOpenForSubmission:!0,hash:"9e089eec484ce8e9eb32198c2d8b34ea",slug:null,bookSignature:"Dr. Luis Romeral Martinez, Dr. Roque A. Osornio-Rios and Dr. Miguel Delgado Prieto",coverURL:"https://cdn.intechopen.com/books/images_new/9428.jpg",editedByType:null,editors:[{id:"86501",title:"Dr.",name:"Luis",middleName:null,surname:"Romeral Martinez",slug:"luis-romeral-martinez",fullName:"Luis Romeral Martinez"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10107",title:"Artificial Intelligence in Oncology Drug Discovery & Development",subtitle:null,isOpenForSubmission:!0,hash:"043c178c3668865ab7d35dcb2ceea794",slug:null,bookSignature:"Dr. John Cassidy and Dr. Belle Taylor",coverURL:"https://cdn.intechopen.com/books/images_new/10107.jpg",editedByType:null,editors:[{id:"244455",title:"Dr.",name:"John",middleName:null,surname:"Cassidy",slug:"john-cassidy",fullName:"John Cassidy"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"8903",title:"Carbon Based Material for Environmental Protection and Remediation",subtitle:null,isOpenForSubmission:!0,hash:"19da699b370f320eca63ef2ba02f745d",slug:null,bookSignature:"Dr. Mattia Bartoli and Dr. Marco Frediani",coverURL:"https://cdn.intechopen.com/books/images_new/8903.jpg",editedByType:null,editors:[{id:"188999",title:"Dr.",name:"Mattia",middleName:null,surname:"Bartoli",slug:"mattia-bartoli",fullName:"Mattia Bartoli"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10132",title:"Applied Computational Near-surface Geophysics - From Integral and Derivative Formulas to MATLAB Codes",subtitle:null,isOpenForSubmission:!0,hash:"38cdbbb671df620b36ee96af1d9a3a90",slug:null,bookSignature:"Dr. Afshin Aghayan",coverURL:"https://cdn.intechopen.com/books/images_new/10132.jpg",editedByType:null,editors:[{id:"311030",title:"Dr.",name:"Afshin",middleName:null,surname:"Aghayan",slug:"afshin-aghayan",fullName:"Afshin Aghayan"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10110",title:"Advances and Technologies in Building Construction and Structural Analysis",subtitle:null,isOpenForSubmission:!0,hash:"df2ad14bc5588577e8bf0b7ebcdafd9d",slug:null,bookSignature:"Dr. Ali Kaboli and Dr. Sara Shirowzhan",coverURL:"https://cdn.intechopen.com/books/images_new/10110.jpg",editedByType:null,editors:[{id:"309192",title:"Dr.",name:"Ali",middleName:null,surname:"Kaboli",slug:"ali-kaboli",fullName:"Ali Kaboli"}],productType:{id:"1",chapterContentType:"chapter"}},{type:"book",id:"10175",title:"Ethics in Emerging Technologies",subtitle:null,isOpenForSubmission:!0,hash:"9c92da249676e35e2f7476182aa94e84",slug:null,bookSignature:"Prof. Ali Hessami",coverURL:"https://cdn.intechopen.com/books/images_new/10175.jpg",editedByType:null,editors:[{id:"108303",title:"Prof.",name:"Ali",middleName:null,surname:"Hessami",slug:"ali-hessami",fullName:"Ali Hessami"}],productType:{id:"1",chapterContentType:"chapter"}}],offset:8,limit:8,total:16},humansInSpaceProgram:{},teamHumansInSpaceProgram:{},route:{name:"profile.detail",path:"/profiles/20630/felipe-a-cruz-perez",hash:"",query:{},params:{id:"20630",slug:"felipe-a-cruz-perez"},fullPath:"/profiles/20630/felipe-a-cruz-perez",meta:{},from:{name:null,path:"/",hash:"",query:{},params:{},fullPath:"/",meta:{}}}},function(){var e;(e=document.currentScript||document.scripts[document.scripts.length-1]).parentNode.removeChild(e)}()