Cases of cholera recorded in the decade so far.
\r\n\tAbout 25 percent of all foods produced globally are lost due to microbial growth. L. monocytogenes is a microorganism ubiquitously present in the environment and affects animals and humans. L. monocytogenes can enter a factory and is able to survive in biofilms in the food processing environment. The use of adequate sanitation procedures is a prerequisite in risk prevention. Moreover, effective control measures for L. monocytogenes are very important to food operators.
\r\n\r\n\tThe safety and shelf life maximizing of food products to meet the demand of retailers and consumers is a challenge and a concern of food operators.
\r\n\r\n\tTo obtain food systems more sustainable, several developments are ongoing to ensure safe food products with an extended shelf life and a reduction of food loss and waste. The problem of antimicrobial resistance is also a great issue that must be taken into consideration.
\r\n\r\n\tThe implementation of natural antimicrobials, using food cultures, ferments, or bacteriophages, is one approach to control L. monocytogenes in food products that meet the consumer preference for clean label solutions.
\r\n\tThis book intends to provide the reader with a comprehensive overview of the current state-of-the-art about Listeria monocytogenes in terms of occurrence in humans, animals, and food-producing plants. Its control by more natural agents allows for more sustainable food systems and points future directions to transform challenges into opportunities.
Diarrheic diseases are a serious public health issue in the entire world [1, 2]. Cholera is among the deadliest gastrointestinal diarrheic maladies in tropical areas [3, 4, 5], resulting almost exclusively from ingestion of water contaminated with
In the African continent, cholera has been a significant cause of morbidity and mortality [3, 6]. The disease was introduced in Mozambique from the Indian subcontinent in 1970 and became a major cause of infectious diarrhea [4, 8, 9]. Since then, the country has been facing outbreaks, particularly in Nampula Province [6]. The most severe happened during the 1990s, resulting in one third of all cases in Africa [5]. All diarrheic diseases together are the fourth major cause of death of <5-year-old children, causing in average 13,105 demises per annum. Cholera’s epidemiological profile is changed from epidemic to endemic due to the frequent outbreaks [6]. In general, there is a virtually countrywide epidemics every 5 years, but Nampula and Cuamba cities register annual cases [1], usually during the rainy season (December to June) [8]. According to Chissaque et al. [10], the last major outbreak was in 2015. Furthermore, some issues have been worsening the situation and raising increased concern. For instance, diarrhea-causing enteric bacteria are developing resistance to antibiotics [11], possibly because of overprescription.
Cholera is endemic in Mozambique, but there is very limited research on the matter. There is little information on transmission patterns and how risk factors such as non-potable water, improper sanitation, and hygiene affect the incidence, prevalence, and severity of the disease [4, 9]; there is no local protocol for treating acute diarrhea in children, the only reference being from the World Health Organization (WHO) [4, 12, 13]; little is known about the challenges, success cases, and the extent of the impact of the struggle against cholera in Mozambique [2] and the operational cost to implement a vaccination campaign against cholera [14]. If such information gaps are filled, it will be possible to substantially improve the strategy to mitigate the disease.
Gujral et al. [15] wrote an important contribution to the overall understanding of cholera epidemiology in Mozambique up to 2013, based on the national surveillance data. Though it is a good reference for researchers and scholars, there were some updates published in at least three journal articles [9, 10, 16], reports from the United Nations [17] or other organizations, and 17 presentations [1, 2, 3, 4, 5, 6, 7, 8, 11, 14, 18, 19, 20, 21, 22, 23, 24] at the XVI Scientific Journeys organized by the Mozambican National Institute of Health [25]. This chapter aims to summarize the contributions of such publications for the current knowledge of cholera in Mozambique.
The current analysis is based on updates presented during the XVI National Health Journeys, 17–20 September 2018, in Maputo City, in Mozambique. National Health Institute organized the event under the motto “Promovendo a intersectorialidade e a participação comunitária para o alcance dos Objectivos de Desenvolvimento Sustentável” [Promoting the multi-sectoral collaboration and community participation to meet the Sustainable Development Goals]. Since the beginning, in 1976, the journeys have been arguably the country’s most relevant event on the matter, hosting presentations from leading health researchers in Mozambique [26].
Summaries of all presentations were then compiled to Revista Moçambicana de Ciências de Saúde [Mozambican Journal of Health Sciences]. There were 19 presentations directly or indirectly related to cholera. Some content was a follow-up of other previously published international journals, and it facilitated their interpretation. ATLAS.ti 8.1 (ATLAS.ti Scientific Software Development GmbH, Berlin, Germany) was used to analyze most information and Jamovi 0.9 (The Jamovi Project, Amsterdam, Netherlands) for meta-analysis when necessary.
Most studies on cholera in Mozambique conducted during the last decade were complementary, connected as part of a multidisciplinary approach for accompanying control campaigns led by the Ministry of Health, targeted to susceptible groups in areas where annual outbreaks occur during the rainy season [16]. At least half of the studies used data from Nampula City [23], but there were also studies in Tete, Moatize, Quelimane, Mocuba, Guruè, Metangula, Cuamba, and the country in general [1, 2, 5, 19, 20, 21]. Chissaque and Deus [20] presented, in the journeys, content directly related to a journal article published the same year [10].
It is perhaps important to mention the group that contributed the most with presentations about cholera during the Scientific Journeys. It was the team of Baltazar and Baloi [23], from the National Institute of Health, mostly reporting on different aspects of the immunization campaign in Nampula City, 2016. Their particular presentation was focused on the vaccine coverage and acceptability, but the same group also analyzed local media coverage and people’s reaction [21], evaluated environmental determinants [4] and post-campaign adverse effects [18], validated a rapid test to monitor the efficacy of the vaccine [7], and evaluated the economic cost of the vaccine [14].
Since most publications are interconnected, based on the same campaigns and projects, they shared some constraints and limitations. They might not be explored in full depth in the following subsections. Section 5.7.3 presents more details and respective analyses on the limitations and constraints.
The main causes of diarrhea in Mozambique, especially in children, are
According to Langa et al. [16], Mozambican
It is worth mentioning
Environmental sanitation is important to control disease for the benefit of public health [19]. For several natural, sociopolitical, cultural, and economic reasons, Mozambique is spatially heterogeneous in terms of distribution of resources, including water, housing, their conditions [30], and certainly other features potentially affecting the transmission of cholera. Thus, one shall expect to see substantial differences in terms of risk factors and health determinants in different areas throughout the country. Yet, it is possible to draw some comparisons on how one or another factor affects the dynamics of cholera transmissibility, from different authors’ points of view.
Marrufo et al. [4] evaluated water, sanitation, and hygiene in the area with more cases of cholera in Nampula City and found that 42% had improved latrines and 90% of the inhabitants had access to at least one improved water source, as defined by the World Health Organization and the United Nations Children’s Fund (UNICEF) [31]: with potential to deliver safe water by nature of its design and construction. The authors did not specify their sample size (n) in the summary for the presentation, but their sample was certainly representative because they followed the guidelines of the United Nations High Commissioner for Refugees, and they were the same research team as Baltazar et al. [23] (n = 636), besides the fact that they covered a very wide area and used a statistical treatment of the data. A major health determinant is likely the lack of drainage and sewage through the entire suburban area covering six neighborhoods, particularly when it rains [4, 8, 20]. According to Ramos et al. [19], residents of Bairro Novo [New Neighborhood], Quelimane City, claimed to frequently observe human stool and trash floating when it rains and water accumulates through the streets. This area also lacks a sewage system and has a shortage of latrines.
A different research team [22] interviewed 59 patients with suspicion of cholera in the rural community of Casacone and found the same percentage as Marrufo et al. [4] of households with latrines (42%), but there were differences: 64% used well water, and none treated it before consuming. Besides the differences in the settings (suburban and rural), the study groups were fundamentally different, as Paulo et al. [22] worked with people having acute diarrhea, while Marrufo et al. [4] worked with populations from a risky area. The former group was by definition people who had contact with contaminated water; thus it is not surprising that all used untreated water, unlike the latter group.
Borges et al. [5] found that people in Metangula District (Niassa Province) prefer using untreated water from the lake, even when they have access to potable water, and they could not find any explanation, particularly because most (98%) were aware of cholera and the associated risks. Adding to that fact, Francisco and Chindia [3] stated that in this particular area, temperature and precipitation do not seem to be major health determinants, and it reinforces the idea that the issue is led by behavior. There are perhaps sociocultural or religious reasons. For instance, the Zion Christian Church is well-known in Mozambique, and it is the third largest (17.5% of the population), only surpassed by Catholicism (23.8%) and Islam (17.8%) [32]. One notable ritual of this church is the “Jordan” baptism, performed in rivers, lakes, and sometimes the sea. Such level of exposition to waterborne pathogens is highly concerning, particularly in hotspots of cholera endemism. Furthermore, virtually all over Mozambique, there are people who believe that malicious individuals intentionally created cholera to harm others [2, 6, 33]. Thus, it is important to debunk such self-destructive mentality and the resulting attitudes.
The World Health Organization [34] identifies Mozambique among the African countries most affected by cholera epidemics. In the first decade of the millennium, cholera had an incidence of 12 to 127 per 100,000 inhabitants, especially in the rainy season [20]. The variant of
Chitio and Langa [24] and several other presenters in the XVI National Health Journeys seemed to agree that cholera has been more widespread throughout the central and northern provinces (Figure 1), particularly Niassa and Nampula in the north, where outbreaks occur annually, in contrast to the rest of the country, where it occurs every 5 years [1, 4, 22].
Draft of Mozambican map showing the areas where research and interventions related to cholera occurred since 2013. Image adapted from Wikimedia Commons [
Vanormelingen et al. [17] included Sofala in the list of affected provinces, and Chissaque et al. [20] mentioned
In Niassa Province, the most frequent reports have arisen from in two municipalities: Metangula, where the majority of the cases occur [5], and Cuamba [1]. Besides similar causes as in Nampula City, a major risk factor for cholera contamination in Niassa is the insistence on using untreated fresh water to wash dishes, take a bath, and drink, especially the population of Metangula who live at the Niassa lakeshore [5]. In their presentation, Borges et al. [5] stated that choice of fresh water is not necessarily related to the access to potable water, as there were sufficient wells for the community.
In Nampula, the six most severely affected neighborhood cities are Carrupeia, Muatala, Murrapaniua, Mutauanha, Napipine, and Natiquiri, with 193.403 inhabitants [1, 4, 18]. Other neighborhoods under risk are Namicopo, Namutequeliua, and Belenenses, especially considering a recent observation that some residents showed very low awareness on how cholera is transmitted [6]. In this decade, the city had annual outbreaks recorded at least from 2013 to 2018 [4], and it is confirmed that an outbreak is happening as this article is being written [37], but this topic will be briefly discussed in the post-conclusion note (Section 7). There was another outbreak notified 17 November 2017 in Nampula Province, Nacarôa District [22]. The most affected areas were Munana and Casaconde neighborhoods, in the administrative area also called Nacarôa, within the district.
Zambezia was another province studied, and there were studies from cities of Quelimane, Mocuba, and Gurúè [1, 2, 19]. Vanormelingen et al. [17] added Nicoadala District. First, regarding “Bairro Novo” [New Neighborhood] in Quelimane City, Ramos et al. [19] mentioned the rapid expansion of the city, hardly complying with proper urbanization planning, thus resulting in improper sanitation and hygiene. The authors decided to investigate the frequency of waterborne diseases, including diarrheic maladies, by interviewing members of 21 households, and analyzing records from the Healthcare Center from 24 July 2014 to 2017. Cholera was mentioned among the most frequent diseases, although the authors did not specify the prevalence. In general, they included the disease among the diarrheic, with 564 cases (47.3%) in 1193 recorded in the healthcare center’s registry. In Mocuba, Mesa et al. [1] analyzed 128 processes of patients carrying diarrheic diseases. Although the authors did not specify the diseases, they suspected that most had cholera considering the symptoms recorded, the fatality rate of 4% (plausible, according to the World Health Organization [38]), and the fact that there was an outbreak as they were conducting their investigation. The most affected neighborhoods were Samora Machel (33%), Marmanelo (15%), CFM (11%), carreira de tiros (10%), and Tomba de Água (8%). Carlos [2] said that various minor towns of Gurúè District have been registering outbreaks of diarrheic diseases and cholera, but in 2015 there was an outbreak in its main city, also called Gurúè.
There are other areas where cholera is endemic, but the scholarly publications from the last decade did not explore in depth the epidemiologic point of view, but they are worth mentioning. For instance, the 2015 outbreaks in the country’s north and center seemed interconnected and occurred during the same period, and they reached areas including the cities of Tete, Moatize, and Sofala Province [17]. There are also studies from the south, though in different time and context. Salomão et al. [21] presented results of a 2-year study (2017–2018) related to immunization campaigns in the cities of Tete and Moatize, after an outbreak in 2017. As the outbreaks were stabilizing in the provinces mentioned so far, in Sofala it was spreading, with reports from Beira City, Caia, and Nhamatanda. Manhiça District Hospital keeps isolates of cholera [9], and it reflects the history of the disease there and in the areas nearby. Garrine et al. [9] worked with these isolates in their research and added three from the Komati River.
Since most studies presented at the XVI Health Journeys were follow-ups of ongoing studies, they all tended to miss some details, and some were complementary to each other. For instance, the studies after the 2015 outbreak of cholera in Nampula explored different perspectives on the problematics [4, 6, 7, 8, 14, 18, 22, 23]. Table 1 shows some epidemiological data recorded after 2013. These are just some examples because it would be redundant to include some papers, particularly the studies conducted in Nampula. Still, there is plenty of information worth sharing.
Author | Year | Area | Cases of cholera | Deaths |
---|---|---|---|---|
Vanormelingen et al. [17] | 2015 | Countrywide | 7073 | 53 |
Salência et al. [11] | 2014–2017 | Countrywide (6 hospitals) | 19/784* | ns |
Dengo-Baloi et al. [18] | 2016 | Nampula City | 44/171* | ns |
Paulo et al. [22] | 2017 | Nacarôa | 135 | 3 |
Cases of cholera recorded in the decade so far.
Confirmed cases/suspected cases in children recorded in healthcare institutions; ns, non-specified.
The studies did not explain the dynamics of how the disease is spread during non-epidemic periods because virtually all were conducted during outbreaks, or at least based on them, though it might not differ much from times of outbreak, especially because the area is endemic. Phenomena such as heavy rain and natural catastrophes certainly work as amplifiers of the disease severity by increasing people’s exposition to untreated water [3, 20, 39, 40, 41, 42]. Yet, it would be a good idea to study the risk factors and disease determinants during times of low prevalence because it would, for instance, minimize the need for researchers to work under pressure or “under budget” because of non-research-driven priorities [43], avoid panic or undesirable reactions from study subjects, and perhaps be easy to prevent outbreaks or lower considerably their impact on public health. On the other hand, outbreak investigations are crucial to ensure proper intervention. Thus, the information below represents outbreak-related scenarios but somehow the best lead so far of the country’s reality with or without an outbreak.
According to Table 1, the country’s cholera fatality rate (CFR) in 2015 was 0.7%. This value is low, within the range 0–15.8% of the Global Health Observatory (GHO) in 2016, published by the World Health Organization [38]. According to the GHO, 22 countries had CFR > 1%, and only Niger, Zimbabwe, and Congo had CFR > 5%. Even the global (1.8%) was higher than Mozambique the previous year during the outbreak. Such low fatality rate was likely due to a very fast and effective response in terms of vaccination, treatment [11, 23], and other measures such as health education and support in sanitation [8, 17]. Cholera is highly virulent but also easy to treat and there is vaccine [44]. The fatality rate observed in Nacarôa (2%) was not far from the global, and it seems reasonable to expect such kind of fluctuations in a considerably small sample. It should be also reasonable to expect a value slightly higher than average in endemic areas.
It is general knowledge that cholera is spread through water and improper sanitation is a major risk factor for transmission. Thus, the disease deeply related to poverty in several ways including obviously the lack of resources for prevention or treatment and limitations in education or information. It is intuitive that the most susceptible are people living in highly crowded suburban areas when people have little access to clean water, or in rural settings, when people directly consume water from lakes or rivers without any treatment. People living around Lake Niassa use it for domestic purposes [5]. This is the reality in several areas of Mozambique. This must be understood on top of any specificity of the studies explained or discussed in this subsection. It must be implicit that all the studies’ target populations were susceptible to cholera.
The research team of Baltazar et al. [23] belongs to the National Institute of Health, and they conducted most studies related to the vaccination campaign in Nampula City, 2016. In the particular study cited, they focused on inhabitants over 1 year old living in the city’s six most susceptible neighborhoods, mentioned in Section 5.4.1 (Geographical distribution). People from surrounding areas are also at risk [4] because of mobility and interaction with residents of the endemic neighborhoods or exchange of food or drinks coming from such zones.
Children are the most susceptible to diarrheic diseases in general [11, 20] perhaps because of their immunity still under development, their unawareness of the bacterial load in the untreated water, and their behavior. In reality, they have always been the priority and focus of the vaccination campaigns [10, 45]. Among 1910 children hospitalized with acute diarrhea from May 2014 to December 2017, Salência et al. [11] found that <1-year-olds were the most affected and 19 infants (2.4%) had
There is little novelty on diagnosis in Mozambique since the beginning of the decade. It is perhaps worth mentioning that during the 2016 massive vaccination campaign in Nampula, Dengo-Baloi et al. [18] performed a rapid test to verify if it could be an alternative to the culture-based standard, as the latter takes 48 to 72 hours and the rapid test would take approximately 6 hours. They used an alkaline peptone water (APW) enrichment method, but they did not specify the origin of the kit. It was likely Crystal VC RDT (Span Divergent, Mumbai, India), previously used by George et al. [46] in Bangladesh and Ontweka et al. [47] in South Sudan. According to the latter, it is also considerably inexpensive. Dengo-Baloi et al. [18] observed exactly the same results using the standard method and the rapid test for 75 samples, demonstrating its efficacy as a good alternative for the standard in areas with limited resources.
Cholera control strategies in Mozambique have been changing over time, perhaps due to governmental priorities, an increasing knowledge, or resources available. Regarding Mozambique, it is important to keep in mind that Mozambique has undergone major political changes, there have been conflicts, including armed, natural calamities such as drought, floods, typhoons, economic crises, and fluctuations. All these phenomena resulted in mobility or affected people’s livelihoods, changing the dynamics of access to resources, including potable water, ultimately impacting public health. This ever-changing environment has been determining, at a certain extent, the way the government deals with the epidemics of infectious diseases, including cholera. Chissaque et al. [20] mentioned some key actions of the government’s strategy: vaccination, health education, introduction of zinc and salts for oral hydration, improvement of basic sanitation (construction of latrines and access to potable water), and organization of national health weeks. Dengo-Baloi et al. [18] added vigilance among the measures, and Vanormelingen et al. [17] said that the government coordinated a real-time mapping of the epidemic and supported social mobilization with the assistance of the United Nations Children’s Fund, World Health Organization, and Médecins Sans Frontières (MSF).
The most relevant actions in the last decade are perhaps related to the Ministry of Health’s implementation of vaccination campaigns using Shanchol™ (BivWC, Shantha [48], Ranga Reddy District, Telangana, India) in Nampula City’s six most vulnerable neighborhoods, in October 2016 and also the subsequent years [4, 10, 21]. It was in response to the outbreak in 2015, and the strategy was to deliver the vaccine door to door in two rounds [23]. Paulo et al. [22] mentioned another outbreak in November 2017, but it did not seem as severe. The 2016 campaign was strategically set to cover 193,403 individuals and prevent the expansion of cholera to less affected areas [4, 18]. Though the first round only covered 69.5% of the target population, and the second covered 51.2%, Baltazar et al. [23] considered the experience as a success and shared the belief that similar strategies can have more adherence in urban settings when there is no emergency. Considerably low adherence was mostly because many people were not at home during the campaign, and 17.3% of 636 people enquired said that they were unaware of the campaign. The situation was similar in the following 2 years [21]. Thus, it is important to improve or use more effectively the channels to communicate with the residents.
After vaccination, there were adverse effects such as abdominal pain, nausea, and diarrhea, but none seemed severe enough to require any medical assistance [18]. The National Institute of Health organized a vigilance of postimmunization adverse effects in nine healthcare units, and, according to Dengo-Baloi et al. [18], there were eight cases reported after the first round of vaccination, three during the second, and one case during both rounds. Yet, there were certainly more cases because Baltazar et al. [23] reported adverse effects in 47 people of 451 interviewed after receiving vaccination. A possible explanation for the discrepancy between both studies is the fact that PIAE vigilance recorded mostly cases that occurred 24 h after vaccination, and it was based on records from healthcare units, while the other study was based on inquiries directly to randomly chosen individuals from the community from 2 to 9 November 2016 [18, 23].
Among the 428 interviewees of Borges et al. [5] in Metangula, the level of awareness on cholera was very high (98%), and they said that radio (35%) and lectures at the healthcare center (28%) were the main sources of information about the disease. If the population in general is aware of the disease and still Metangula is the town most affected with cholera in Niassa Province, perhaps most inhabitants lack essential knowledge on how to prevent the disease or have very few alternatives as source of water or means to properly treat it. Yet, the investigators claim that most people from Metangula have access to potable water, but they prefer the untreated from the Lake Niassa and proposed further studies to understand their motivation. They also believe that it is necessary to intensify awareness campaigns on how to prevent cholera. However, such campaigns might not be very effective if people mistrust the authorities, as Victorino et al. [6] said. The latter authors interviewed 30 residents throughout three neighborhoods of Nampula City (the same region of the country), and they unanimously claimed that the government was responsible for the outbreak of cholera. Furthermore, the majority (18 people) did not really understand the concept of cholera (bacterial disease transmitted through water), and 12 did not know how to prevent the disease. In this case, it would be more prudent to approach the residents through authorities they might be more prone to trust, such as teachers at schools, traditional leaders and religious entities.
At a first glance, the main constraints seem related to vaccination, improper treatment and potential misdiagnosis of diarrheic diseases, unclear notion on the impact of risk factors, shortage of resources for interventions, and government mistrust. Some constraints might be related, and for this reason they will not be necessarily presented in the same order as mentioned. This subsection might seem redundant in the sense that it recapitulates some limitations from the previous subsections. However, it seems important to discuss them in more detail, as they are likely to be the starting point for future researchers aiming to study the dynamics of cholera epidemiology and control strategies in Mozambique. Furthermore, some ideas are consolidated, and some relationships are explored more critically in this subsection.
According to Baltazar et al. [23], during the 2016 vaccination campaign in Nampula, more than one third missed the vaccine because they were not at home or did not receive any information prior to the campaign, and in the second round, there were less people available, though dropout rates from the first to the second dose up to 13% is not uncommon due to factors such as migration or other reasons leading people to be absent [49, 50]. Salomão et al. [21] stated that it happened again the following year, and, according to them, the main reasons were lack of time, absence, and lack of information. The overall vaccine wastage rate was 10%, and it seems high if compared with the experience in Bangladesh between February and April 2011, where it was 1.2% [49]. Such wastage might be partially related to reasons to be discussed in the following paragraph.
It seems important to discuss the most likely motivation for the vaccination campaign’s suboptimal adherence. Since the strategy was door to door, it seems difficult to suddenly receive someone claiming to be from the government and offering substances to all family members including children. Even if the visitors show credentials, many inhabitants mistrust the government and blame it for the disease [6, 8]. In contrast, Botão et al. [8] interviewed 145 individuals from the target population, and 92% said they were willing to receive the vaccine. It is hard to clarify why they showed interest, but the actions were different, but a possible explanation would be that they just manifested agreement for the convenience of the interview or because they fear the authorities. Such attitude toward the government is not new or exclusive to Nampula or northern Mozambique. For instance, Pool et al. [33] reported a similar behavior during a campaign for immunization against malaria 10 years before in Manhiça District, southern Mozambique. Similarly, rumors stated that the local clinic was trying to poison the children. In Gurúè City, people believe that cholera is sent as spells by evil individuals [2]. It would be an asset to investigate what religious leaders or traditional healers think of cholera and government interventions, because it is common for people in Mozambique to rely on them in matters of health, in some cases even for immunization. The fact that conventional practitioners are a direct competition for their source of income cannot be underestimated, and if people, including their leaders and traditional healers, regard outbreaks of diarrhea as a spiritual matter, they might not understand the governments’ true motivations, and “conspiracy theories” will keep spreading. Botão et al. [8] reported emerging conflicts related to previous cholera interventions between health professionals, community leaders, and health activists, sometimes escalating to episodes of violence. Interventions seem to become more difficult over time as the locals create barriers for the professionals, and both Botão et al. [8] and Salomão et al. [21] believe only the notion that cholera is life-threatening can motivate the population to accept the vaccine. In any case, prior to vaccination, there should be a strong campaign targeting traditional authorities in order to promote their collaboration and influence the adults, and likewise directed to teachers, to influence the children. It would also include, in the strategy, ways to make sure that people are not absent during the campaigns.
Baltazar et al. [23] also stated that 10% of the individuals experienced side effects after vaccination, and it seems a plausible explanation for the decline of 18.3% in adherence between the two rounds. It is possible that such individuals and their families or relatives preferred not to receive the second dose, and it can still be confirmed if the interview records are available. Minor side effects to this vaccine (Shanchol™) should have been expected in some people [48, 51], and it has been observed in Bangladesh [52]. The vaccination campaign in Nampula was certainly carried with informed consent and following the WHO [53] recommendations, but if the side effects in fact led people to withdraw from the second round, it is important to reevaluate the communication with the target population. The Centers for Disease Control and Prevention [54] recommend competent authorities to explain the people to be vaccinated about the “benefits of and risks from vaccines in language that is culturally sensitive and at an appropriate educational level.”
Misdiagnoses should also not be underestimated, especially because it has impact on the choice of treatment. Chissaque et al. [20] reported lack of consistent protocols to directly relate a pathogen with a particular diarrheic profile and also the respective risk factors. Outbreak of a disease can be misleading when there are people carrying diseases with similar symptoms. For instance, Chitio et al. [24] detected
Salência et al. [11] reported the abusive use of antibiotics to treat acute diarrhea in children, including confirmed cases of cholera (2.4%), between May 2014 and December 2017 in major hospitals from all regions of Mozambique. According to the authors, antibiotics were used to treat 94% of the patients, and this represents a violation of the WHO’s protocol that recommends the use of these compounds when there is cholera, dysentery, and other “recognizable severe cases” [57]. Antibiotic misuse is frequent in developing countries but such level was extreme. For instance, Runesson et al. [58] reported the use of antibiotics in 70% of cases of children with diarrhea, randomly examined in a children’s hospital, from which at least 35% did not really need antibiotics. According to Rogawski et al. [59], antibiotics have the potential to modify the gastrointestinal microbiota and increase the risk of a reduced time to a subsequent diarrhea episode. It is also known that antibiotic abuse frequently results in resistance. In 2007, Mandomando et al. [60] reported a high incidence of resistance to chloramphenicol (57.9%), co-trimoxazole (96.6%), and tetracycline (97.3%), and low for quinolone (4.2%). Salência et al. [11] mentioned the use of ampicillin (45%), gentamicin (39%) combined with therapy, and gentamicin (10%). Thus, there should be efforts to discourage physicians to prescribe antibiotics when it is not necessary. When appropriate, they can use quinolone or third-generation cephalosporins [60].
The presentations in the XVI National Health Journeys and the recent articles on cholera offered an invaluable contribution to the current knowledge on the disease in Mozambique, particularly regarding the risk factors, health determinants, and immunization process. Such contributions showed how important the journeys were. The Ministry of Health and related institutions have been active in research and interventions to control cholera in Mozambique. The immunization campaign in 2016 certainly had high impact in reducing the incidence of cholera, as no outbreak has been as wide and severe as 2015’s (the ones this year are not considered because their extent is still to be assessed). Yet, governmental effort cannot achieve the desired results if there is no collaboration from the civil society. The etiology, risk factors, and epidemiology of the disease are fairly known, and, although the government lacks resources to provide proper sanitation, access to clean water, or vaccine coverage for all people at risk, it is now a matter of designing a strategy to tackle each the issue, and if the plan is solid, funds can be acquired and well used.
The following recommendations are not simply observations based on findings shared during the XVI Health Journeys. They are supplemental observations on their actual recommendations, in a broader context if necessary. It seemed unnecessary to bring to light ideas of improvements if the authors have already done so, this being a mere enhancement if they seem incomplete.
Environmental determinants such as water, sanitation, and hygiene synergistically impact the extent of severity of cholera. Thus, Marrufo et al. [4] strongly recommended their evaluation during outbreak-related emergencies. It is true, but such evaluation should not solely occur during outbreaks. Proper management of the way people use water is crucial to prevent outbreaks in the first place, although factors such as heavy rainfall, warm air temperature, or low river flows cannot be controlled, and they increase the exposition of humans to
Still within the context of health determinants, Borges et al. [5] manifested preoccupations with the people directly using lake water in Niassa, without any treatment, even when they have potable water available. They intended to understand why, and they recommended studies in this direction. They and other authors [6, 22] also think health education campaigns could lead people to understand the risk of such behavior and ultimately take the appropriate measures. The authors are certainly pointing to a constructive direction, but it is a delicate endeavor to convince people to abandon their values and traditions. Niassa Lake, more than a useful water source, is certainly also a source of recreation and economic activities such as fishing or
Chitio and Langa [24] called for a clear definition of cases of
After successfully performing the rapid test for cholera, Dengo-Baloi et al. [18] recommended it as an alternative tool, but they believe that the culture method shall remain to confirm the epidemics, to monitor antibiotic sensitivity, and to produce pure isolates for molecular characterization. Considering how critical outbreaks are, the authors provided a very prudent opinion, and, although their results were highly promising, it is perhaps better to keep testing the method and compare the results with others from authors in different settings before it becomes a standard.
Immunization is already a well-developed area because there are very well-crafted guidelines, based on logical, scientific, and empirical sources, and it has been practiced for many years. Still, healthcare professionals have to face contextual issues, and it results in every-evolving strategies. The door-to-door vaccination strategy seems very effective, and Baltazar et al. [23] said it is better to implement as a preventive measure against potential outbreaks. Having said so, they did not put emphasis on the strategy during outbreaks, possibly because it is preferable to manage the disease when it is easier to control. It is perhaps important to consider the Médecins Sans Frontières [63] recommendations for door-to-door strategies, some of which are already fulfilled. First, it is good that people already have experience with this approach, and there is some acceptance [23]. Second, it is important to coordinate the process with the authorities at neighborhood levels or small communities, where information is easy to spread, and it is also easy to record the number of residents or households in order to keep track of individuals absent during each round and organize catch-up rounds. Baltazar et al. [23] also suggested short-term effectiveness studies, but these have been done and reported by Dengo-Baloi et al. [7] from the same research team. Perhaps the results had not yet been analyzed when Baltazar et al. [23] had already completed their report. To maximize adherence, Botão et al. [8] suggested sensibilization of the population through identification of credible leaders and other influential individualities to function as mobilizers during the entire campaign.
Salência et al. [11] discussed about the indiscriminate use of antibiotic to children with acute diarrhea as a violation of WHO guidelines, and the authors appealed for the optimization of prescription of antibiotics for diarrhea. The authors are correct, but the issue requires perhaps more attention, considering that WHO guidelines result from the international consensus and, in general, physicians are expected to be aware of the dangers of antibiotic overprescription, and this practice is often most likely an act of negligence. Thus, there should be penalties to discourage such kind of misconduct because it is a sensitive public health matter.
The National Health Institute and partners shall keep organizing the National Health Journeys and similar events because they are very constructive platforms in which researchers, scholars, and health professionals can share information and broaden their scope regarding the reality of cholera and other diseases in Mozambique. Such events should be more frequent and organized all over the country to give opportunities to people residing in other areas than the capital city. It would perhaps be a very good idea to promote conferences about the control of cholera or diarrheic diseases in areas of high incidence and engage local health professionals or potential actors who can really influence the current situation.
The final recommendation is based on the words of Chissaque et al. [10] in their summary: the key to control cholera and other diarrheic diseases is a deep understanding of the local epidemiology. Such comprehension would facilitate predictions and planning on how to prevent outbreaks and manage them if they eventually happen. Mozambique could study carefully experiences from other countries where cholera is endemic, such as India or Bangladesh, and understand how they deal with the matter or at least draw some comparisons and interact with foreign scientists. The contexts are surely different, but the problem is similar, and solutions might arise from unexpected variables.
There will be soon more updates on cholera in Mozambique because there were two major outbreaks [40, 64, 65], one still ongoing as this manuscript is under preparation [66]. They are related to the intense tropical cyclones Idai and Kenneth that made landfall in Mozambique’s central and northern provinces, respectively [67]. According to Miller and Adebayo [37], Kenneth it is the strongest cyclone recorded in the country, and together the tragedies certainly caused the biggest losses since the flood in 2000 [68]. Briefly, Devi [40] said that up to April 20, the Ministry of Health had declared an outbreak due to Idai, and there had been at least 4979 cases of cholera and 6 deaths. Regarding Kenneth, the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) [64] declared that as of 12 May, there were 149 confirmed cases of cholera in Pemba, Metuge, and Mecufi.
The authors declare no conflict of interest.
A recurring theme in the statistical analysis is to separate the unstructured data into groups to detect the similarity or discrepancy within or between groups. This is especially true in the fields, e.g., discriminant analysis [1, 2, 3], pattern recognition [4, 5], gene expression [6, 7, 8], machine learning [9], and artificial intelligence [10]. In the literature, the clustering problem is often formulated within the
In this chapter, we pursue a Bayesian model-based method to address the heterogeneity of fraction data. Fractional data are very common in the social and economical surveys. A distinguished feature of fractional responses is that its measurements are responded on a scale in the unity interval [0,1] but suffer from excessive zeros and unities on the boundaries. In understanding such type of data, the commonly used method is to separate the whole data into three parts: two corresponding to the zeros and unities respectively, and one corresponding to the continuously positive values. Two separative logistic models are suggested to model two discrete value parts respectively while single normal linear regression model is formulated for the continuous value part. This method, though more appealing, ignores the instinct association across different parts and readily leads to inconsistence of the occurrence probabilities on each part. Instead, we propose a three-category multinomial model for the occurrence variable, in which the usual separated models can be considered as the marginal models of our proposal. Such modeling always ensures the probabilities on each part to be proper, thus avoiding parameter constraints, see for example, [19]. To assess the heterogeneity underlying data, we formulate the problem into a finite mixture analysis of which each component is specified by two-part regression model. In view of the model complexity, we implement Markov Chains Monte Carlo sampling method to implement posterior analysis. Block Gibbs sampler is implemented to draw observations from the target distributions. The posterior inference including parameters estimates, model selection, and the configuration determination of observations are obtained based on the simulated observations.
The chapter is organized as follows. Section 2 introduces a general model-based clustering method to address the heterogeneity of regression model within the Bayesian framework. In Section 3, we apply the proposed method to the fractional data. Section 4 presents a cocaine use study. And Section 5 concludes the chapter.
Suppose that for
which induces the so-called generalized linear model [20] for
More often, the single relationship such as Eq. (1) may not be sufficient when the patterns among the subjects take on the heterogeneity such as clustering. The heterogeneous data occur when the observations are generated from the different populations of which the number of populations and the membership of each observation to the population are unknown. The main objective is to separate data into different clusters to detect the possible similarity within clusters or the discrepancy between clusters. This is generally accomplished by defining a cluster’s membership/configuration function
The model-based clustering assumes that given the clusters membership
while
where
Two important issues arise when formulating data clustering problem as Eqs. (2) and (3). One is related to the number of clusters, and the other is pertained to the determination of configurations. Within the Bayesian framework, several methods have been proposed for the first issue. One can, for example, follow [21] and treat
For the second issue, the complexity of problem depends on the methods adopted in the analysis. In the frequency framework, for example, the configuration of observation
Let
The log-likelihood of the observed data conditional on
As an illustration, Figure 1 presents a three-component normal linear mixture regression model with one covariate. It can be seen clearly that the density function illustrates strong heterogeneity. The regression line is obviously different from those of components, which indicates that single model is unappreciate in fitting such data. In what follows, we suppress
Plot of the three-component normal mixture model
Bayesian analysis for analyzing Eqs. (2) and (3) especially
in which
We assign a symmetric Dirichlet distribution to
in which
Let
where
Formulating the model-based clustering problem into mixture model Eq. (2) faces the model identification. A statistical model is said to be identified if the observed likelihood is uniquely determined by unknown parameters. A less identified model may be problematic and will distort the estimates of unknown parameters. It is easily showed that the observed likelihood of data is only determined up to the permutation of the component labels. As a matter of fact, suppose that there are the pair
then there exists a permutation
Given that
Choose
For
Once the label switching is taken care of, the MCMC samples can be used to draw posterior inference. For example, the joint Bayesian estimate of
The consistent estimates of the covariance matrix of estimates can be obtained via sample covariance matrix.
Given the observations
in which
A more appreciate alternative to MAP is based on the pairwise probability matrix, an
Dahl [51] showed that the least-squares clustering has the advantage over those in Medvedovic and Sivaganesan [49] since it utilizes the information from all the clusterings and is intuitively appealing for the “average” clustering instead of forming a clustering via an external, ad hoc clustering algorithm.
In this section, we first proposed a two-part regression model for the fractional data especially for the U shaped fractional data and then extend the method discussed above to the current situation to address the possible heterogeneity of the population underlying data.
Suppose that for subject/individual
where
where
The conditional continuous model for
or equivalently
where
It follows from Eqs. (16) and (17) that marginal distribution of
where
To detect the possible heterogeneity among
For the Bayesian analysis, the general forms of full conditionals involved in the model-based clustering have been given in Section 2. We here only focus on the technical details of the conditional distribution of
We assume that the prior of
where
Gibbs sampling
in which the full conditionals of
in which
and
However, drawing
where
in which
where
with
In this section, a small portion of cocaine use data is analyzed to illustrate the practical value of the proposed methodology. The data are obtained from the 322 cocaine use patients who were admitted in 1988–89 to the West Los Angeles Veterans Affairs Medical Center. The original data set is made up of 68 measurements in which 17 items were assessed at four unequally spanned time points. In this study, we mainly focus on the measurements 1 year after treatment and ignore the initial effects at the baseline. The measurements cover the information on the cocaine use, treatment received, psychological problems, social status, employments, and so on. Among them, the measurement “cocaine use per month” (denoted by CC) plays a critical role since it identifies the severity of cocaine use of patients and therefore is treated as the dependent response. The CC is originally measured by 0–30 points but suffered from small portion of fractions. We identify CC/30 as the fraction response in [0,1]. In view of that the missing data are presented, we delete the subjects with missing values. The total sample size is 228. A primary analysis shows that CC/30 has excessive zeros and ones. Figure 2 gives the histograms of CC/30 and their fractional values in (0,1) via logistic transformation. It can be seen clearly that there is a large number of zeros and unities accumulated on the boundaries. The proportions of zeros and unities are about 15 and 4%, respectively. Moreover, panel (b) in Figure 2 indicates that single parametric model may be unappreciate for fitting the continuous valued variable.
Plots of CC in cocaine use data: (a) Histograms of CC/30; and (b) histograms of CC/30 on logistic transformation conditional on CC/30 in (0,1).
To explore the effects of exogenous factors on the cocaine use, the following measurements are selected as the explanatory variables: the occupational status of a patient (
To formulate a two-part model for the observed responses, we identity CC
We proceed data analysis by first fitting data to the
The relabeling MCMC algorithm described in Section 2 is implemented to draw observations from the posterior. The convergence of algorithm is monitored by plotting the traces of estimates against iterations under three starting values. Figure 3 presents the values of EPSR of unknown parameters against the number of iterations under three different starting values with
Plots of values of EPSR of estimates of unknown parameters against the number of iterations under three different staring values in the cocaine use example:
Model | |||||
---|---|---|---|---|---|
AIC | 921.3887 | – | – | – | |
923.0580 | 907.4485 | 901.9474 | 901.4380 | ||
929.0698 | 926.5423 | 956.4945 | 994.5039 | ||
990.7506 | 949.5966 | 1014.5477 | 1006.4228 | ||
989.2483 | 971.4688 | 1069.1561 | 1037.5005 | ||
1097.6853 | 1007.4899 | 1091.8049 | 1086.8491 | ||
AICc | 882.4025 | – | – | – | |
885.5434 | 869.9339 | 864.4329 | 863.9234 | ||
875.9005 | 873.3730 | 903.3253 | 941.3347 | ||
925.3159 | 884.1618 | 949.1130 | 940.9880 | ||
915.5836 | 897.8041 | 995.4914 | 963.8357 | ||
1020.6483 | 930.4529 | 1014.7679 | 1009.8120 | ||
BIC | 995.6821 | – | – | – | |
995.0742 | 979.4647 | 973.9637 | 973.4542 | ||
1038.8088 | 1036.2814 | 1066.2335 | 1104.2429 | ||
1138.2125 | 1097.0585 | 1162.0096 | 1153.8846 | ||
1174.4330 | 1156.6534 | 1254.3408 | 1222.6851 | ||
1320.5928 | 1230.3973 | 1314.7124 | 1309.7565 |
Summary statistics of AIC, AICcc, and BIC for model selection in cocaine use data analysis.
Examination of Table 1 shows that all measures favor the model with
Table 2 presents the estimates of unknown parameters associated with corresponding standard deviation (SD) estimates under
Para. | Component I | Component II | ||
---|---|---|---|---|
Est. | SD. | Est. | SD | |
−1.540 | 0.587 | −0.732 | 0.481 | |
0.150 | 0.317 | 0.604 | 0.322 | |
0.261 | 0.703 | 0.188 | 0.601 | |
−1.337 | 0.480 | −1.059 | 0.545 | |
−0.166 | 0.355 | −0.229 | 0.418 | |
0.232 | 0.378 | −0.184 | 0.411 | |
−2.779 | 0.144 | −0.490 | 0.215 | |
−0.029 | 0.080 | −0.011 | 0.154 | |
0.087 | 0.144 | 0.179 | 0.240 | |
0.674 | 0.150 | 0.924 | 0.234 |
Summary statistics for the Bayesian estimates of unknown parameters in the cocaine use data.
This chapter introduces a general Bayesian model-based clustering procedure for the regression model and proposed a Bayesian method for assessing the heterogeneity of fractional data within the mixture of two-part regression model framework. The heterogeneous fractional data arise mainly from two resources: one is that the excessive zeros and ones are accumulated upon the boundaries, and the other is that the underlying population may consist more than one components. For the first issue, we propose a novel two-part model, in which a three-category multinomial regression is suggested to model the occurrence probabilities of each part, and a conditional normal linear regression is used to fit the continuous positive values on logit scale. Such formulation is more appealing since it can ensure the probabilities on each part to be consistent and and at the same time maintains the coherent association across parts. For the second problem, we resort to the finite mixture model in which the cluster-specific components are specified via two-part model. MCMC sampling method is adopted to carry out the posterior analysis. The number of clusters and the configuration of observations are addressed based on the simulated observations from the posterior. We illustrate the proposed methodology in the analysis of cocaine use data.
When interest is concentrated upon the estimates, model identification is surely an important issue since it involves whether or not the estimates of component-specific quantities are meaningful. For a finite mixture model, model identification mainly stems from the label switching, in which the likelihood and the posterior are invariant under label permutation. Many efforts have devoted to alleviating such indeterminacy. Among them, parameters’ constraints may be the most popular choice. However, an unappreciated constraint fails to deal with the label switching. In this case, one can follow the routine in Frühwirth-Schnatter [18] and implement random permutation sampling to find the suitable identifiability constraints. The random permutation sampler is similar to the unconstrained MCMC sampling but only at each sweep, the labels
The methodology developed in this chapter can be extended to the case where latent factors are included to identify the unobserved heterogeneity due to some fixed convariates absent. Another possible extension is to establish a dynamic LVM, wherein model parameters vary across times. These issues may raise theoretical and computational challenges and therefore require further investigation.
The work presented here was fully supported by grant from the National Natural Science Foundation of China (NNSF 11471161). The authors are thankful to Professor Xin-Yuan Song, the Chinese University of Hong Kong, for using her cocaine use data in the real example.
The authors have no conflicts of interest to disclose.
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\n\nBut, one thing we have in common is -- we are all scientists at heart!
\n\nSara Uhac, COO
\n\nSara Uhac was appointed Managing Director of IntechOpen at the beginning of 2014. She directs and controls the company’s operations. Sara joined IntechOpen in 2010 as Head of Journal Publishing, a new strategically underdeveloped department at that time. After obtaining a Master's degree in Media Management, she completed her Ph.D. at the University of Lugano, Switzerland. She holds a BA in Financial Market Management from the Bocconi University in Milan, Italy, where she started her career in the American publishing house Condé Nast and further collaborated with the UK-based publishing company Time Out. Sara was awarded a professional degree in Publishing from Yale University (2012). She is a member of the professional branch association of "Publishers, Designers and Graphic Artists" at the Croatian Chamber of Commerce.
\n\nAdrian Assad De Marco
\n\nAdrian Assad De Marco joined the company as a Director in 2017. With his extensive experience in management, acquired while working for regional and global leaders, he took over direction and control of all the company's publishing processes. Adrian holds a degree in Economy and Management from the University of Zagreb, School of Economics, Croatia. A former sportsman, he continually strives to develop his skills through professional courses and specializations such as NLP (Neuro-linguistic programming).
\n\nDr Alex Lazinica
\n\nAlex Lazinica is co-founder and Board member of IntechOpen. After obtaining a Master's degree in Mechanical Engineering, he continued his Ph.D. in Robotics at the Vienna University of Technology. There, he worked as a robotics 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, co-founded and built the International Journal of Advanced Robotic Systems, the world's first Open Access journal in the field of robotics. Starting this journal was a pivotal point in his career since it proved to be the pathway to the foundation of IntechOpen with its focus on addressing academic researchers’ needs. Alex personifies many of IntechOpen´s key values, including the commitment to developing mutual trust, openness, and a spirit of entrepreneurialism. Today, his focus is on defining the growth and development strategy for the company.
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His current research interests are in the fields of intelligent control and robotics.",institutionString:null,institution:{name:"Technical University of Sofia",country:{name:"Bulgaria"}}},{id:"585",title:"Prof.",name:"Munir",middleName:null,surname:"Merdan",slug:"munir-merdan",fullName:"Munir Merdan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/585/images/system/585.jpg",biography:"Munir Merdan received the M.Sc. degree in mechanical engineering from the Technical University of Sarajevo, Bosnia and Herzegovina, in 2001, and the Ph.D. degree in electrical engineering from the Vienna University of Technology, Vienna, Austria, in 2009.Since 2005, he has been at the Automation and Control Institute, Vienna University of Technology, where he is currently a Senior Researcher. 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Aalborg University has Two Satellite Campuses, one in Copenhagen (Aalborg University Copenhagen) and the other in Esbjerg (Aalborg University Esbjerg).\n· He is a member of prestigious IEEE (Institute of Electrical and Electronics Engineers), and IAENG (International Association of Engineers) organizations. \n· He is the chief Editor of the Journal of Software Engineering.\n· He is the member of the Editorial Board of International Journal of Computer Science and Software Technology (IJCSST) and International Journal of Computer Engineering and Information Technology. \n· He is also the Editor of Communication in Computer and Information Science CCIS-20 by Springer.\n· Reviewer For Many Conferences\nHe is the lead person in making collaboration agreements between Aalborg University and many universities of Pakistan, for which the MOU’s (Memorandum of Understanding) have been signed.\nProfessor Akbar is working in Academia since 1990, he started his career as a Lab demonstrator/TA at the University of Sussex. After finishing his P. hD degree in 1992, he served in the Industry as a Scientific Officer and continued his academic career as a visiting scholar for a number of educational institutions. In 1996 he joined National University of Science & Technology Pakistan (NUST) as an Associate Professor; NUST is one of the top few universities in Pakistan. In 1999 he joined an International Company Lineo Inc, Canada as Manager Compiler Group, where he headed the group for developing Compiler Tool Chain and Porting of Operating Systems for the BLACKfin processor. The processor development was a joint venture by Intel and Analog Devices. In 2002 Lineo Inc., was taken over by another company, so he joined Aalborg University Denmark as an Assistant Professor.\nProfessor Akbar has truly a multi-disciplined career and he continued his legacy and making progress in many areas of his interests both in teaching and research. 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Fungi conjointly play a basic role in different physiological processes as well as mineral and water uptake, chemical change, stomatal movement, and biosynthesis of compounds termed biostimulants, auxins, lignan, and ethylene to enhance the flexibility of plants to ascertain and cope environmental stresses like drought, salinity, heat, cold, and significant metals.",book:{id:"8954",slug:"biostimulants-in-plant-science",title:"Biostimulants in Plant Science",fullTitle:"Biostimulants in Plant Science"},signatures:"Muthuraman Yuvaraj and Murugaragavan Ramasamy",authors:[{id:"280193",title:"Dr.",name:"Muthuraman",middleName:null,surname:"Yuvaraj",slug:"muthuraman-yuvaraj",fullName:"Muthuraman Yuvaraj"},{id:"289410",title:"Dr.",name:"Murugaragavan",middleName:null,surname:"Ramasamy",slug:"murugaragavan-ramasamy",fullName:"Murugaragavan Ramasamy"}]},{id:"62653",title:"Phytochemical Composition: Antioxidant Potential and Biological Activities of Corn",slug:"phytochemical-composition-antioxidant-potential-and-biological-activities-of-corn",totalDownloads:2206,totalCrossrefCites:1,totalDimensionsCites:4,abstract:"Corn seeds are used as a nutritional source for humans, and the stem and leaves are utilized as fodder for cattle throughout the world. Corn silk and corn cob are usually discarded as waste. This chapter highlights the nutritional as well as medicinal importance of various parts of corn plant. All parts of corn plant are good source of a variety of bioactive phytochemical compounds which possess antioxidant potential. The principal phytochemicals present in corn seed and corn silk include polyphenols, phenolic acids, flavonoids, anthocyanins, glycosides, carotenoids, and polysaccharides of biological importance, reducing compounds and some water-soluble vitamins. The presence of these phytochemicals makes corn a medicinal plant which shows various biological activities particularly the antioxidant, antimicrobial, antidiabetic, anti-obesity, antiproliferative, hepatoprotective, cardioprotective, and renal-protective activities. On the account of its high antioxidant potential, all parts of corn plant can be used for the management of oxidative stress and the treatment of various diseases.",book:{id:"7206",slug:"corn-production-and-human-health-in-changing-climate",title:"Corn",fullTitle:"Corn - Production and Human Health in Changing Climate"},signatures:"Haq Nawaz, Saima Muzaffar, Momna Aslam and Shakeel Ahmad",authors:[{id:"230900",title:"Mr.",name:"Haq",middleName:null,surname:"Nawaz",slug:"haq-nawaz",fullName:"Haq Nawaz"},{id:"244066",title:"Prof.",name:"Saima",middleName:null,surname:"Muzaffar",slug:"saima-muzaffar",fullName:"Saima Muzaffar"},{id:"263041",title:"Ms.",name:"Momna",middleName:null,surname:"Aslam",slug:"momna-aslam",fullName:"Momna Aslam"},{id:"263042",title:"Dr.",name:"Shakeel",middleName:null,surname:"Ahmad",slug:"shakeel-ahmad",fullName:"Shakeel Ahmad"}]},{id:"70950",title:"Role of Biofertilizers in Plant Growth and Soil Health",slug:"role-of-biofertilizers-in-plant-growth-and-soil-health",totalDownloads:1434,totalCrossrefCites:4,totalDimensionsCites:11,abstract:"Biofertilizers nowadays have been realised for shifting fortunes in agriculture. It has been proven successful technology in many developed countries while in developing countries exploitation of bioinoculants is hampered by several factors. Scientific knowledge on bioinoculants and its usage will pave way for its effective usage. At the same time overlooking the significance of ensuring and maintaining a high quality standard of the product will have negative impact. Hence a proper knowledge of bioinoculants and its functioning will pave way to tape the resources in a better way. Thus the chapter provide overview knowledge about different bacterial, fungal and algal biofertilizers, its associations with plants and transformations of nutrients in soil. Adopting a rational approach to the use and management of microbial fertilizers in sustainable agriculture thrive vast potential for the future.",book:{id:"8004",slug:"nitrogen-fixation",title:"Nitrogen Fixation",fullTitle:"Nitrogen Fixation"},signatures:"Murugaragavan Ramasamy, T. Geetha and M. Yuvaraj",authors:[{id:"289410",title:"Dr.",name:"Murugaragavan",middleName:null,surname:"Ramasamy",slug:"murugaragavan-ramasamy",fullName:"Murugaragavan Ramasamy"}]},{id:"67454",title:"Nitrogen Fertilization I: Impact on Crop, Soil, and Environment",slug:"nitrogen-fertilization-i-impact-on-crop-soil-and-environment",totalDownloads:1613,totalCrossrefCites:7,totalDimensionsCites:17,abstract:"Nitrogen (N) is a major limiting nutrient to sustain crop yields and quality. As a result, N fertilizer is usually applied in large quantity to increase crop production throughout the world. Application of N fertilizers has increased crop yields and resulted in achievement of self-sufficiency in food production in many developing countries. Excessive application of N fertilizers beyond crops’ demand, however, has resulted in undesirable consequences of degradation in soil, water, and air quality. These include soil acidification, N leaching in groundwater, and emissions of nitrous oxide (N2O), a potent greenhouse gas that contributes to global warming. Long-term application of ammonia-based N fertilizers, such as urea, has increased soil acidity which rendered to soil infertility where crops fail to respond with further application of N fertilizers. Another problem is the groundwater contamination of nitrate-N (NO3-N) which can be a health hazard to human and livestock if its concentration goes above 10 mg L−1 in drinking water. The third problem is emissions of N2O gas which is 300 times more powerful than carbon dioxide in terms of global warming potential. This chapter examines the effect of N fertilization on soil and environmental quality and crop yields.",book:{id:"8004",slug:"nitrogen-fixation",title:"Nitrogen Fixation",fullTitle:"Nitrogen Fixation"},signatures:"Upendra M. Sainju, Rajan Ghimire and Gautam P. Pradhan",authors:[{id:"214367",title:"Dr.",name:"Upendra",middleName:null,surname:"Sainju",slug:"upendra-sainju",fullName:"Upendra Sainju"},{id:"266570",title:"Prof.",name:"Rajan",middleName:null,surname:"Ghimire",slug:"rajan-ghimire",fullName:"Rajan Ghimire"},{id:"266571",title:"Prof.",name:"Gautam",middleName:null,surname:"Pradhan",slug:"gautam-pradhan",fullName:"Gautam Pradhan"}]}],onlineFirstChaptersFilter:{topicId:"349",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:90,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:107,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:330,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:9,numberOfPublishedChapters:139,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:122,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:21,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:10,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}},{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}}]},series:{item:{id:"10",title:"Physiology",doi:"10.5772/intechopen.72796",issn:"2631-8261",scope:"Modern physiology requires a comprehensive understanding of the integration of tissues and organs throughout the mammalian body, including the cooperation between structure and function at the cellular and molecular levels governed by gene and protein expression. While a daunting task, learning is facilitated by identifying common and effective signaling pathways mediated by a variety of factors employed by nature to preserve and sustain homeostatic life. \r\nAs a leading example, the cellular interaction between intracellular concentration of Ca+2 increases, and changes in plasma membrane potential is integral for coordinating blood flow, governing the exocytosis of neurotransmitters, and modulating gene expression and cell effector secretory functions. Furthermore, in this manner, understanding the systemic interaction between the cardiovascular and nervous systems has become more important than ever as human populations' life prolongation, aging and mechanisms of cellular oxidative signaling are utilised for sustaining life. \r\nAltogether, physiological research enables our identification of distinct and precise points of transition from health to the development of multimorbidity throughout the inevitable aging disorders (e.g., diabetes, hypertension, chronic kidney disease, heart failure, peptic ulcer, inflammatory bowel disease, age-related macular degeneration, cancer). With consideration of all organ systems (e.g., brain, heart, lung, gut, skeletal and smooth muscle, liver, pancreas, kidney, eye) and the interactions thereof, this Physiology Series will address the goals of resolving (1) Aging physiology and chronic disease progression (2) Examination of key cellular pathways as they relate to calcium, oxidative stress, and electrical signaling, and (3) how changes in plasma membrane produced by lipid peroxidation products can affect aging physiology, covering new research in the area of cell, human, plant and animal physiology.",coverUrl:"https://cdn.intechopen.com/series/covers/10.jpg",latestPublicationDate:"July 20th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:14,editor:{id:"35854",title:"Prof.",name:"Tomasz",middleName:null,surname:"Brzozowski",slug:"tomasz-brzozowski",fullName:"Tomasz Brzozowski",profilePictureURL:"https://mts.intechopen.com/storage/users/35854/images/system/35854.jpg",biography:"Prof. Dr. Thomas Brzozowski works as a professor of Human Physiology and is currently Chairman at the Department of Physiology and is V-Dean of the Medical Faculty at Jagiellonian University Medical College, Cracow, Poland. His primary area of interest is physiology and pathophysiology of the gastrointestinal (GI) tract, with the major focus on the mechanism of GI mucosal defense, protection, and ulcer healing. He was a postdoctoral NIH fellow at the University of California and the Gastroenterology VA Medical Center, Irvine, Long Beach, CA, USA, and at the Gastroenterology Clinics Erlangen-Nuremberg and Munster in Germany. He has published 290 original articles in some of the most prestigious scientific journals and seven book chapters on the pathophysiology of the GI tract, gastroprotection, ulcer healing, drug therapy of peptic ulcers, hormonal regulation of the gut, and inflammatory bowel disease.",institutionString:null,institution:{name:"Jagiellonian University",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:6,paginationItems:[{id:"10",title:"Animal Physiology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/10.jpg",editor:{id:"202192",title:"Dr.",name:"Catrin",middleName:null,surname:"Rutland",slug:"catrin-rutland",fullName:"Catrin Rutland",profilePictureURL:"https://mts.intechopen.com/storage/users/202192/images/system/202192.png",biography:"Catrin Rutland is an Associate Professor of Anatomy and Developmental Genetics at the University of Nottingham, UK. She obtained a BSc from the University of Derby, England, a master’s degree from Technische Universität München, Germany, and a Ph.D. from the University of Nottingham. She undertook a post-doctoral research fellowship in the School of Medicine before accepting tenure in Veterinary Medicine and Science. Dr. Rutland also obtained an MMedSci (Medical Education) and a Postgraduate Certificate in Higher Education (PGCHE). She is the author of more than sixty peer-reviewed journal articles, twelve books/book chapters, and more than 100 research abstracts in cardiovascular biology and oncology. She is a board member of the European Association of Veterinary Anatomists, Fellow of the Anatomical Society, and Senior Fellow of the Higher Education Academy. Dr. Rutland has also written popular science books for the public. https://orcid.org/0000-0002-2009-4898. www.nottingham.ac.uk/vet/people/catrin.rutland",institutionString:null,institution:{name:"University of Nottingham",institutionURL:null,country:{name:"United Kingdom"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"306970",title:"Mr.",name:"Amin",middleName:null,surname:"Tamadon",slug:"amin-tamadon",fullName:"Amin Tamadon",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002oHR5wQAG/Profile_Picture_1623910304139",institutionString:null,institution:{name:"Bushehr University of Medical Sciences",institutionURL:null,country:{name:"Iran"}}},{id:"251314",title:"Dr.",name:"Juan Carlos",middleName:null,surname:"Gardón Poggi",slug:"juan-carlos-gardon-poggi",fullName:"Juan Carlos Gardón Poggi",profilePictureURL:"https://mts.intechopen.com/storage/users/251314/images/system/251314.jpeg",institutionString:null,institution:{name:"Valencia Catholic University Saint Vincent Martyr",institutionURL:null,country:{name:"Spain"}}},{id:"245306",title:"Dr.",name:"María Luz",middleName:null,surname:"Garcia Pardo",slug:"maria-luz-garcia-pardo",fullName:"María Luz Garcia Pardo",profilePictureURL:"https://mts.intechopen.com/storage/users/245306/images/system/245306.png",institutionString:null,institution:{name:"Miguel Hernandez University",institutionURL:null,country:{name:"Spain"}}},{id:"283315",title:"Prof.",name:"Samir",middleName:null,surname:"El-Gendy",slug:"samir-el-gendy",fullName:"Samir El-Gendy",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRduYQAS/Profile_Picture_1606215849748",institutionString:null,institution:{name:"Alexandria University",institutionURL:null,country:{name:"Egypt"}}},{id:"178366",title:"Dr.",name:"Volkan",middleName:null,surname:"Gelen",slug:"volkan-gelen",fullName:"Volkan Gelen",profilePictureURL:"https://mts.intechopen.com/storage/users/178366/images/system/178366.jpg",institutionString:"Kafkas University",institution:{name:"Kafkas University",institutionURL:null,country:{name:"Turkey"}}}]},{id:"11",title:"Cell Physiology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/11.jpg",editor:{id:"133493",title:"Prof.",name:"Angel",middleName:null,surname:"Catala",slug:"angel-catala",fullName:"Angel Catala",profilePictureURL:"https://mts.intechopen.com/storage/users/133493/images/3091_n.jpg",biography:"Prof. Dr. Angel Catalá \r\nShort Biography Angel Catalá was born in Rodeo (San Juan, Argentina). He studied \r\nchemistry at the Universidad Nacional de La Plata, Argentina, where received aPh.D. degree in chemistry (Biological Branch) in 1965. From\r\n1964 to 1974, he worked as Assistant in Biochemistry at the School of MedicineUniversidad Nacional de La Plata, Argentina. From 1974 to 1976, he was a Fellowof the National Institutes of Health (NIH) at the University of Connecticut, Health Center, USA. From 1985 to 2004, he served as a Full Professor oBiochemistry at the Universidad Nacional de La Plata, Argentina. He is Member ofthe National Research Council (CONICET), Argentina, and Argentine Society foBiochemistry and Molecular Biology (SAIB). His laboratory has been interested for manyears in the lipid peroxidation of biological membranes from various tissues and different species. Professor Catalá has directed twelve doctoral theses, publishedover 100 papers in peer reviewed journals, several chapters in books andtwelve edited books. Angel Catalá received awards at the 40th InternationaConference Biochemistry of Lipids 1999: Dijon (France). W inner of the Bimbo PanAmerican Nutrition, Food Science and Technology Award 2006 and 2012, South AmericaHuman Nutrition, Professional Category. 2006 award in pharmacology, Bernardo\r\nHoussay, in recognition of his meritorious works of research. Angel Catalá belongto the Editorial Board of Journal of lipids, International Review of Biophysical ChemistryFrontiers in Membrane Physiology and Biophysics, World Journal oExperimental Medicine and Biochemistry Research International, W orld Journal oBiological Chemistry, Oxidative Medicine and Cellular Longevity, Diabetes and thePancreas, International Journal of Chronic Diseases & Therapy, International Journal oNutrition, Co-Editor of The Open Biology Journal.",institutionString:null,institution:{name:"National University of La Plata",institutionURL:null,country:{name:"Argentina"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"186048",title:"Prof.",name:"Ines",middleName:null,surname:"Drenjančević",slug:"ines-drenjancevic",fullName:"Ines Drenjančević",profilePictureURL:"https://mts.intechopen.com/storage/users/186048/images/5818_n.jpg",institutionString:null,institution:{name:"University of Osijek",institutionURL:null,country:{name:"Croatia"}}},{id:"187859",title:"Prof.",name:"Kusal",middleName:"K.",surname:"Das",slug:"kusal-das",fullName:"Kusal Das",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSBDeQAO/Profile_Picture_1623411145568",institutionString:"BLDE (Deemed to be University), India",institution:null},{id:"79615",title:"Dr.",name:"Robson",middleName:null,surname:"Faria",slug:"robson-faria",fullName:"Robson Faria",profilePictureURL:"https://mts.intechopen.com/storage/users/79615/images/system/79615.png",institutionString:null,institution:{name:"Oswaldo Cruz Foundation",institutionURL:null,country:{name:"Brazil"}}},{id:"84459",title:"Prof.",name:"Valerie",middleName:null,surname:"Chappe",slug:"valerie-chappe",fullName:"Valerie Chappe",profilePictureURL:"https://mts.intechopen.com/storage/users/84459/images/system/84459.jpg",institutionString:null,institution:{name:"Dalhousie University",institutionURL:null,country:{name:"Canada"}}}]},{id:"12",title:"Human Physiology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/12.jpg",editor:{id:"195829",title:"Prof.",name:"Kunihiro",middleName:null,surname:"Sakuma",slug:"kunihiro-sakuma",fullName:"Kunihiro Sakuma",profilePictureURL:"https://mts.intechopen.com/storage/users/195829/images/system/195829.jpg",biography:"Professor Kunihiro Sakuma, Ph.D., currently works in the Institute for Liberal Arts at the Tokyo Institute of Technology. He is a physiologist working in the field of skeletal muscle. He was awarded his sports science diploma in 1995 by the University of Tsukuba and began his scientific work at the Department of Physiology, Aichi Human Service Center, focusing on the molecular mechanism of congenital muscular dystrophy and normal muscle regeneration. His interest later turned to the molecular mechanism and attenuating strategy of sarcopenia (age-related muscle atrophy). His opinion is to attenuate sarcopenia by improving autophagic defects using nutrient- and pharmaceutical-based treatments.",institutionString:null,institution:{name:"Tokyo Institute of Technology",institutionURL:null,country:{name:"Japan"}}},editorTwo:{id:"331519",title:"Dr.",name:"Kotomi",middleName:null,surname:"Sakai",slug:"kotomi-sakai",fullName:"Kotomi Sakai",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000031QtFXQA0/Profile_Picture_1637053227318",biography:"Senior researcher Kotomi Sakai, Ph.D., MPH, works at the Research Organization of Science and Technology in Ritsumeikan University. She is a researcher in the geriatric rehabilitation and public health field. She received Ph.D. from Nihon University and MPH from St.Luke’s International University. Her main research interest is sarcopenia in older adults, especially its association with nutritional status. Additionally, to understand how to maintain and improve physical function in older adults, to conduct studies about the mechanism of sarcopenia and determine when possible interventions are needed.",institutionString:null,institution:{name:"Ritsumeikan University",institutionURL:null,country:{name:"Japan"}}},editorThree:null,editorialBoard:[{id:"213786",title:"Dr.",name:"Henrique P.",middleName:null,surname:"Neiva",slug:"henrique-p.-neiva",fullName:"Henrique P. Neiva",profilePictureURL:"https://mts.intechopen.com/storage/users/213786/images/system/213786.png",institutionString:null,institution:{name:"University of Beira Interior",institutionURL:null,country:{name:"Portugal"}}},{id:"39275",title:"Prof.",name:"Herbert Ryan",middleName:null,surname:"Marini",slug:"herbert-ryan-marini",fullName:"Herbert Ryan Marini",profilePictureURL:"https://mts.intechopen.com/storage/users/39275/images/9459_n.jpg",institutionString:null,institution:{name:"University of Messina",institutionURL:null,country:{name:"Italy"}}},{id:"319576",title:"Prof.",name:"Nikolay",middleName:null,surname:"Boyadjiev",slug:"nikolay-boyadjiev",fullName:"Nikolay Boyadjiev",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00002v4b3cQAA/Profile_Picture_2022-06-07T08:30:58.jpeg",institutionString:null,institution:{name:"Medical University Plovdiv",institutionURL:null,country:{name:"Bulgaria"}}},{id:"196218",title:"Dr.",name:"Pasquale",middleName:null,surname:"Cianci",slug:"pasquale-cianci",fullName:"Pasquale Cianci",profilePictureURL:"https://mts.intechopen.com/storage/users/196218/images/system/196218.png",institutionString:null,institution:{name:"University of Foggia",institutionURL:null,country:{name:"Italy"}}}]},{id:"13",title:"Plant Physiology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/13.jpg",editor:{id:"332229",title:"Prof.",name:"Jen-Tsung",middleName:null,surname:"Chen",slug:"jen-tsung-chen",fullName:"Jen-Tsung Chen",profilePictureURL:"https://mts.intechopen.com/storage/users/332229/images/system/332229.png",biography:"Dr. Jen-Tsung Chen is currently a professor at the National University of Kaohsiung, Taiwan. He teaches cell biology, genomics, proteomics, medicinal plant biotechnology, and plant tissue culture. Dr. Chen\\'s research interests include bioactive compounds, chromatography techniques, in vitro culture, medicinal plants, phytochemicals, and plant biotechnology. 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He has been reviewer for several publications of the Optical Society of America\\'s including Photonics Technology Letters and Applied Optics.\n\nPersonal Interests\nThese include motor cycling in a very relaxed manner and performing martial arts.",institutionString:null,institution:{name:"Charité",country:{name:"Germany"}}},{id:"341622",title:"Ph.D.",name:"Eduardo",middleName:null,surname:"Rojas Alvarez",slug:"eduardo-rojas-alvarez",fullName:"Eduardo Rojas Alvarez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/341622/images/15892_n.jpg",biography:null,institutionString:null,institution:{name:"University of Cuenca",country:{name:"Ecuador"}}},{id:"215610",title:"Prof.",name:"Muhammad",middleName:null,surname:"Sarfraz",slug:"muhammad-sarfraz",fullName:"Muhammad Sarfraz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/215610/images/system/215610.jpeg",biography:"Muhammad Sarfraz is a professor in the Department of Information Science, Kuwait University. His research interests include computer graphics, computer vision, image processing, machine learning, pattern recognition, soft computing, data science, intelligent systems, information technology, and information systems. Prof. Sarfraz has been a keynote/invited speaker on various platforms around the globe. He has advised various students for their MSc and Ph.D. theses. He has published more than 400 publications as books, journal articles, and conference papers. He is a member of various professional societies and a chair and member of the International Advisory Committees and Organizing Committees of various international conferences. Prof. Sarfraz is also an editor-in-chief and editor of various international journals.",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"32650",title:"Prof.",name:"Lukas",middleName:"Willem",surname:"Snyman",slug:"lukas-snyman",fullName:"Lukas Snyman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/32650/images/4136_n.jpg",biography:"Lukas Willem Snyman received his basic education at primary and high schools in South Africa, Eastern Cape. He enrolled at today's Nelson Metropolitan University and graduated from this university with a BSc in Physics and Mathematics, B.Sc Honors in Physics, MSc in Semiconductor Physics, and a Ph.D. in Semiconductor Physics in 1987. After his studies, he chose an academic career and devoted his energy to the teaching of physics to first, second, and third-year students. After positions as a lecturer at the University of Port Elizabeth, he accepted a position as Associate Professor at the University of Pretoria, South Africa.\r\n\r\nIn 1992, he motivates the concept of 'television and computer-based education” as means to reach large student numbers with only the best of teaching expertise and publishes an article on the concept in the SA Journal of Higher Education of 1993 (and later in 2003). The University of Pretoria subsequently approved a series of test projects on the concept with outreach to Mamelodi and Eerste Rust in 1993. In 1994, the University established a 'Unit for Telematic Education ' as a support section for multiple faculties at the University of Pretoria. In subsequent years, the concept of 'telematic education” subsequently becomes well established in academic circles in South Africa, grew in popularity, and is adopted by many universities and colleges throughout South Africa as a medium of enhancing education and training, as a method to reaching out to far out communities, and as a means to enhance study from the home environment.\r\n\r\nProfessor Snyman in subsequent years pursued research in semiconductor physics, semiconductor devices, microelectronics, and optoelectronics.\r\n\r\nIn 2000 he joined the TUT as a full professor. Here served for a period as head of the Department of Electronic Engineering. Here he makes contributions to solar energy development, microwave and optoelectronic device development, silicon photonics, as well as contributions to new mobile telecommunication systems and network planning in SA.\r\n\r\nCurrently, he teaches electronics and telecommunications at the TUT to audiences ranging from first-year students to Ph.D. level.\r\n\r\nFor his research in the field of 'Silicon Photonics” since 1990, he has published (as author and co-author) about thirty internationally reviewed articles in scientific journals, contributed to more than forty international conferences, about 25 South African provisional patents (as inventor and co-inventor), 8 PCT international patent applications until now. Of these, two USA patents applications, two European Patents, two Korean patents, and ten SA patents have been granted. A further 4 USA patents, 5 European patents, 3 Korean patents, 3 Chinese patents, and 3 Japanese patents are currently under consideration.\r\n\r\nRecently he has also published an extensive scholarly chapter in an internet open access book on 'Integrating Microphotonic Systems and MOEMS into standard Silicon CMOS Integrated circuitry”.\r\n\r\nFurthermore, Professor Snyman recently steered a new initiative at the TUT by introducing a 'Laboratory for Innovative Electronic Systems ' at the Department of Electrical Engineering. The model of this laboratory or center is to primarily combine outputs as achieved by high-level research with lower-level system development and entrepreneurship in a technical university environment. Students are allocated to projects at different levels with PhDs and Master students allocated to the generation of new knowledge and new technologies, while students at the diploma and Baccalaureus level are allocated to electronic systems development with a direct and a near application for application in industry or the commercial and public sectors in South Africa.\r\n\r\nProfessor Snyman received the WIRSAM Award of 1983 and the WIRSAM Award in 1985 in South Africa for best research papers by a young scientist at two international conferences on electron microscopy in South Africa. He subsequently received the SA Microelectronics Award for the best dissertation emanating from studies executed at a South African university in the field of Physics and Microelectronics in South Africa in 1987. In October of 2011, Professor Snyman received the prestigious Institutional Award for 'Innovator of the Year” for 2010 at the Tshwane University of Technology, South Africa. This award was based on the number of patents recognized and granted by local and international institutions as well as for his contributions concerning innovation at the TUT.",institutionString:null,institution:{name:"University of South Africa",country:{name:"South Africa"}}},{id:"317279",title:"Mr.",name:"Ali",middleName:"Usama",surname:"Syed",slug:"ali-syed",fullName:"Ali Syed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/317279/images/16024_n.png",biography:"A creative, talented, and innovative young professional who is dedicated, well organized, and capable research fellow with two years of experience in graduate-level research, published in engineering journals and book, with related expertise in Bio-robotics, equally passionate about the aesthetics of the mechanical and electronic system, obtained expertise in the use of MS Office, MATLAB, SolidWorks, LabVIEW, Proteus, Fusion 360, having a grasp on python, C++ and assembly language, possess proven ability in acquiring research grants, previous appointments with social and educational societies with experience in administration, current affiliations with IEEE and Web of Science, a confident presenter at conferences and teacher in classrooms, able to explain complex information to audiences of all levels.",institutionString:null,institution:{name:"Air University",country:{name:"Pakistan"}}},{id:"75526",title:"Ph.D.",name:"Zihni Onur",middleName:null,surname:"Uygun",slug:"zihni-onur-uygun",fullName:"Zihni Onur Uygun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/75526/images/12_n.jpg",biography:"My undergraduate education and my Master of Science educations at Ege University and at Çanakkale Onsekiz Mart University have given me a firm foundation in Biochemistry, Analytical Chemistry, Biosensors, Bioelectronics, Physical Chemistry and Medicine. After obtaining my degree as a MSc in analytical chemistry, I started working as a research assistant in Ege University Medical Faculty in 2014. In parallel, I enrolled to the MSc program at the Department of Medical Biochemistry at Ege University to gain deeper knowledge on medical and biochemical sciences as well as clinical chemistry in 2014. In my PhD I deeply researched on biosensors and bioelectronics and finished in 2020. Now I have eleven SCI-Expanded Index published papers, 6 international book chapters, referee assignments for different SCIE journals, one international patent pending, several international awards, projects and bursaries. In parallel to my research assistant position at Ege University Medical Faculty, Department of Medical Biochemistry, in April 2016, I also founded a Start-Up Company (Denosens Biotechnology LTD) by the support of The Scientific and Technological Research Council of Turkey. Currently, I am also working as a CEO in Denosens Biotechnology. The main purposes of the company, which carries out R&D as a research center, are to develop new generation biosensors and sensors for both point-of-care diagnostics; such as glucose, lactate, cholesterol and cancer biomarker detections. My specific experimental and instrumental skills are Biochemistry, Biosensor, Analytical Chemistry, Electrochemistry, Mobile phone based point-of-care diagnostic device, POCTs and Patient interface designs, HPLC, Tandem Mass Spectrometry, Spectrophotometry, ELISA.",institutionString:null,institution:{name:"Ege University",country:{name:"Turkey"}}},{id:"267434",title:"Dr.",name:"Rohit",middleName:null,surname:"Raja",slug:"rohit-raja",fullName:"Rohit Raja",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/267434/images/system/267434.jpg",biography:"Dr. Rohit Raja received Ph.D. in Computer Science and Engineering from Dr. CVRAMAN University in 2016. His main research interest includes Face recognition and Identification, Digital Image Processing, Signal Processing, and Networking. Presently he is working as Associate Professor in IT Department, Guru Ghasidas Vishwavidyalaya (A Central University), Bilaspur (CG), India. He has authored several Journal and Conference Papers. He has good Academics & Research experience in various areas of CSE and IT. He has filed and successfully published 27 Patents. He has received many time invitations to be a Guest at IEEE Conferences. He has published 100 research papers in various International/National Journals (including IEEE, Springer, etc.) and Proceedings of the reputed International/ National Conferences (including Springer and IEEE). He has been nominated to the board of editors/reviewers of many peer-reviewed and refereed Journals (including IEEE, Springer).",institutionString:"Guru Ghasidas Vishwavidyalaya",institution:{name:"Guru Ghasidas Vishwavidyalaya",country:{name:"India"}}},{id:"246502",title:"Dr.",name:"Jaya T.",middleName:"T",surname:"Varkey",slug:"jaya-t.-varkey",fullName:"Jaya T. Varkey",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/246502/images/11160_n.jpg",biography:"Jaya T. Varkey, PhD, graduated with a degree in Chemistry from Cochin University of Science and Technology, Kerala, India. She obtained a PhD in Chemistry from the School of Chemical Sciences, Mahatma Gandhi University, Kerala, India, and completed a post-doctoral fellowship at the University of Minnesota, USA. She is a research guide at Mahatma Gandhi University and Associate Professor in Chemistry, St. Teresa’s College, Kochi, Kerala, India.\nDr. Varkey received a National Young Scientist award from the Indian Science Congress (1995), a UGC Research award (2016–2018), an Indian National Science Academy (INSA) Visiting Scientist award (2018–2019), and a Best Innovative Faculty award from the All India Association for Christian Higher Education (AIACHE) (2019). She Hashas received the Sr. Mary Cecil prize for best research paper three times. She was also awarded a start-up to develop a tea bag water filter. \nDr. Varkey has published two international books and twenty-seven international journal publications. She is an editorial board member for five international journals.",institutionString:"St. Teresa’s College",institution:null},{id:"250668",title:"Dr.",name:"Ali",middleName:null,surname:"Nabipour Chakoli",slug:"ali-nabipour-chakoli",fullName:"Ali Nabipour Chakoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/250668/images/system/250668.jpg",biography:"Academic Qualification:\r\n•\tPhD in Materials Physics and Chemistry, From: Sep. 2006, to: Sep. 2010, School of Materials Science and Engineering, Harbin Institute of Technology, Thesis: Structure and Shape Memory Effect of Functionalized MWCNTs/poly (L-lactide-co-ε-caprolactone) Nanocomposites. Supervisor: Prof. Wei Cai,\r\n•\tM.Sc in Applied Physics, From: 1996, to: 1998, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Determination of Boron in Micro alloy Steels with solid state nuclear track detectors by neutron induced auto radiography, Supervisors: Dr. M. Hosseini Ashrafi and Dr. A. Hosseini.\r\n•\tB.Sc. in Applied Physics, From: 1991, to: 1996, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Design of shielding for Am-Be neutron sources for In Vivo neutron activation analysis, Supervisor: Dr. M. Hosseini Ashrafi.\r\n\r\nResearch Experiences:\r\n1.\tNanomaterials, Carbon Nanotubes, Graphene: Synthesis, Functionalization and Characterization,\r\n2.\tMWCNTs/Polymer Composites: Fabrication and Characterization, \r\n3.\tShape Memory Polymers, Biodegradable Polymers, ORC, Collagen,\r\n4.\tMaterials Analysis and Characterizations: TEM, SEM, XPS, FT-IR, Raman, DSC, DMA, TGA, XRD, GPC, Fluoroscopy, \r\n5.\tInteraction of Radiation with Mater, Nuclear Safety and Security, NDT(RT),\r\n6.\tRadiation Detectors, Calibration (SSDL),\r\n7.\tCompleted IAEA e-learning Courses:\r\nNuclear Security (15 Modules),\r\nNuclear Safety:\r\nTSA 2: Regulatory Protection in Occupational Exposure,\r\nTips & Tricks: Radiation Protection in Radiography,\r\nSafety and Quality in Radiotherapy,\r\nCourse on Sealed Radioactive Sources,\r\nCourse on Fundamentals of Environmental Remediation,\r\nCourse on Planning for Environmental Remediation,\r\nKnowledge Management Orientation Course,\r\nFood Irradiation - Technology, Applications and Good Practices,\r\nEmployment:\r\nFrom 2010 to now: Academic staff, Nuclear Science and Technology Research Institute, Kargar Shomali, Tehran, Iran, P.O. Box: 14395-836.\r\nFrom 1997 to 2006: Expert of Materials Analysis and Characterization. Research Center of Agriculture and Medicine. Rajaeeshahr, Karaj, Iran, P. O. Box: 31585-498.",institutionString:"Atomic Energy Organization of Iran",institution:{name:"Atomic Energy Organization of Iran",country:{name:"Iran"}}},{id:"248279",title:"Dr.",name:"Monika",middleName:"Elzbieta",surname:"Machoy",slug:"monika-machoy",fullName:"Monika Machoy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248279/images/system/248279.jpeg",biography:"Monika Elżbieta Machoy, MD, graduated with distinction from the Faculty of Medicine and Dentistry at the Pomeranian Medical University in 2009, defended her PhD thesis with summa cum laude in 2016 and is currently employed as a researcher at the Department of Orthodontics of the Pomeranian Medical University. She expanded her professional knowledge during a one-year scholarship program at the Ernst Moritz Arndt University in Greifswald, Germany and during a three-year internship at the Technical University in Dresden, Germany. She has been a speaker at numerous orthodontic conferences, among others, American Association of Orthodontics, European Orthodontic Symposium and numerous conferences of the Polish Orthodontic Society. She conducts research focusing on the effect of orthodontic treatment on dental and periodontal tissues and the causes of pain in orthodontic patients.",institutionString:"Pomeranian Medical University",institution:{name:"Pomeranian Medical University",country:{name:"Poland"}}},{id:"252743",title:"Prof.",name:"Aswini",middleName:"Kumar",surname:"Kar",slug:"aswini-kar",fullName:"Aswini Kar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252743/images/10381_n.jpg",biography:"uploaded in cv",institutionString:null,institution:{name:"KIIT University",country:{name:"India"}}},{id:"204256",title:"Dr.",name:"Anil",middleName:"Kumar",surname:"Kumar Sahu",slug:"anil-kumar-sahu",fullName:"Anil Kumar Sahu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204256/images/14201_n.jpg",biography:"I have nearly 11 years of research and teaching experience. I have done my master degree from University Institute of Pharmacy, Pt. Ravi Shankar Shukla University, Raipur, Chhattisgarh India. I have published 16 review and research articles in international and national journals and published 4 chapters in IntechOpen, the world’s leading publisher of Open access books. I have presented many papers at national and international conferences. I have received research award from Indian Drug Manufacturers Association in year 2015. My research interest extends from novel lymphatic drug delivery systems, oral delivery system for herbal bioactive to formulation optimization.",institutionString:null,institution:{name:"Chhattisgarh Swami Vivekanand Technical University",country:{name:"India"}}},{id:"253468",title:"Dr.",name:"Mariusz",middleName:null,surname:"Marzec",slug:"mariusz-marzec",fullName:"Mariusz Marzec",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/253468/images/system/253468.png",biography:"An assistant professor at Department of Biomedical Computer Systems, at Institute of Computer Science, Silesian University in Katowice. Scientific interests: computer analysis and processing of images, biomedical images, databases and programming languages. He is an author and co-author of scientific publications covering analysis and processing of biomedical images and development of database systems.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"212432",title:"Prof.",name:"Hadi",middleName:null,surname:"Mohammadi",slug:"hadi-mohammadi",fullName:"Hadi Mohammadi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/212432/images/system/212432.jpeg",biography:"Dr. Hadi Mohammadi is a biomedical engineer with hands-on experience in the design and development of many engineering structures and medical devices through various projects that he has been involved in over the past twenty years. Dr. Mohammadi received his BSc. and MSc. degrees in Mechanical Engineering from Sharif University of Technology, Tehran, Iran, and his PhD. degree in Biomedical Engineering (biomaterials) from the University of Western Ontario. He was a postdoctoral trainee for almost four years at University of Calgary and Harvard Medical School. He is an industry innovator having created the technology to produce lifelike synthetic platforms that can be used for the simulation of almost all cardiovascular reconstructive surgeries. He’s been heavily involved in the design and development of cardiovascular devices and technology for the past 10 years. He is currently an Assistant Professor with the University of British Colombia, Canada.",institutionString:"University of British Columbia",institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"254463",title:"Prof.",name:"Haisheng",middleName:null,surname:"Yang",slug:"haisheng-yang",fullName:"Haisheng Yang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/254463/images/system/254463.jpeg",biography:"Haisheng Yang, Ph.D., Professor and Director of the Department of Biomedical Engineering, College of Life Science and Bioengineering, Beijing University of Technology. He received his Ph.D. degree in Mechanics/Biomechanics from Harbin Institute of Technology (jointly with University of California, Berkeley). Afterwards, he worked as a Postdoctoral Research Associate in the Purdue Musculoskeletal Biology and Mechanics Lab at the Department of Basic Medical Sciences, Purdue University, USA. He also conducted research in the Research Centre of Shriners Hospitals for Children-Canada at McGill University, Canada. Dr. Yang has over 10 years research experience in orthopaedic biomechanics and mechanobiology of bone adaptation and regeneration. He earned an award from Beijing Overseas Talents Aggregation program in 2017 and serves as Beijing Distinguished Professor.",institutionString:null,institution:{name:"Beijing University of Technology",country:{name:"China"}}},{id:"89721",title:"Dr.",name:"Mehmet",middleName:"Cuneyt",surname:"Ozmen",slug:"mehmet-ozmen",fullName:"Mehmet Ozmen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/89721/images/7289_n.jpg",biography:null,institutionString:null,institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"265335",title:"Mr.",name:"Stefan",middleName:"Radnev",surname:"Stefanov",slug:"stefan-stefanov",fullName:"Stefan Stefanov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/265335/images/7562_n.jpg",biography:null,institutionString:null,institution:{name:"Medical University Plovdiv",country:{name:"Bulgaria"}}},{id:"242893",title:"Ph.D. Student",name:"Joaquim",middleName:null,surname:"De Moura",slug:"joaquim-de-moura",fullName:"Joaquim De Moura",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/242893/images/7133_n.jpg",biography:"Joaquim de Moura received his degree in Computer Engineering in 2014 from the University of A Coruña (Spain). In 2016, he received his M.Sc degree in Computer Engineering from the same university. He is currently pursuing his Ph.D degree in Computer Science in a collaborative project between ophthalmology centers in Galicia and the University of A Coruña. His research interests include computer vision, machine learning algorithms and analysis and medical imaging processing of various kinds.",institutionString:null,institution:{name:"University of A Coruña",country:{name:"Spain"}}},{id:"294334",title:"B.Sc.",name:"Marc",middleName:null,surname:"Bruggeman",slug:"marc-bruggeman",fullName:"Marc Bruggeman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/294334/images/8242_n.jpg",biography:"Chemical engineer graduate, with a passion for material science and specific interest in polymers - their near infinite applications intrigue me. \n\nI plan to continue my scientific career in the field of polymeric biomaterials as I am fascinated by intelligent, bioactive and biomimetic materials for use in both consumer and medical applications.",institutionString:null,institution:null},{id:"255757",title:"Dr.",name:"Igor",middleName:"Victorovich",surname:"Lakhno",slug:"igor-lakhno",fullName:"Igor Lakhno",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255757/images/system/255757.jpg",biography:"Igor Victorovich Lakhno was born in 1971 in Kharkiv (Ukraine). \nMD – 1994, Kharkiv National Medical Univesity.\nOb&Gyn; – 1997, master courses in Kharkiv Medical Academy of Postgraduate Education.\nPh.D. – 1999, Kharkiv National Medical Univesity.\nDSC – 2019, PL Shupik National Academy of Postgraduate Education \nProfessor – 2021, Department of Obstetrics and Gynecology of VN Karazin Kharkiv National University\nHead of Department – 2021, Department of Perinatology, Obstetrics and gynecology of Kharkiv Medical Academy of Postgraduate Education\nIgor Lakhno has been graduated from international training courses on reproductive medicine and family planning held at Debrecen University (Hungary) in 1997. Since 1998 Lakhno Igor has worked as an associate professor in the department of obstetrics and gynecology of VN Karazin National University and an associate professor of the perinatology, obstetrics, and gynecology department of Kharkiv Medical Academy of Postgraduate Education. Since June 2019 he’s been a professor in the department of obstetrics and gynecology of VN Karazin National University and a professor of the perinatology, obstetrics, and gynecology department. He’s affiliated with Kharkiv Medical Academy of Postgraduate Education as a Head of Department from November 2021. Igor Lakhno has participated in several international projects on fetal non-invasive electrocardiography (with Dr. J. A. Behar (Technion), Prof. D. Hoyer (Jena University), and José Alejandro Díaz Méndez (National Institute of Astrophysics, Optics, and Electronics, Mexico). He’s an author of about 200 printed works and there are 31 of them in Scopus or Web of Science databases. Igor Lakhno is a member of the Editorial Board of Reproductive Health of Woman, Emergency Medicine, and Technology Transfer Innovative Solutions in Medicine (Estonia). He is a medical Editor of “Z turbotoyu pro zhinku”. Igor Lakhno is a reviewer of the Journal of Obstetrics and Gynaecology (Taylor and Francis), British Journal of Obstetrics and Gynecology (Wiley), Informatics in Medicine Unlocked (Elsevier), The Journal of Obstetrics and Gynecology Research (Wiley), Endocrine, Metabolic & Immune Disorders-Drug Targets (Bentham Open), The Open Biomedical Engineering Journal (Bentham Open), etc. He’s defended a dissertation for a DSc degree “Pre-eclampsia: prediction, prevention, and treatment”. Three years ago Igor Lakhno has participated in a training course on innovative technologies in medical education at Lublin Medical University (Poland). Lakhno Igor has participated as a speaker in several international conferences and congresses (International Conference on Biological Oscillations April 10th-14th 2016, Lancaster, UK, The 9th conference of the European Study Group on Cardiovascular Oscillations). His main scientific interests: are obstetrics, women’s health, fetal medicine, and cardiovascular medicine. \nIgor Lakhno is a consultant at Kharkiv municipal perinatal center. He’s graduated from training courses on endoscopy in gynecology. He has 28 years of practical experience in the field.",institutionString:null,institution:null},{id:"244950",title:"Dr.",name:"Salvatore",middleName:null,surname:"Di Lauro",slug:"salvatore-di-lauro",fullName:"Salvatore Di Lauro",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0030O00002bSF1HQAW/ProfilePicture%202021-12-20%2014%3A54%3A14.482",biography:"Name:\n\tSALVATORE DI LAURO\nAddress:\n\tHospital Clínico Universitario Valladolid\nAvda Ramón y Cajal 3\n47005, Valladolid\nSpain\nPhone number: \nFax\nE-mail:\n\t+34 983420000 ext 292\n+34 983420084\nsadilauro@live.it\nDate and place of Birth:\nID Number\nMedical Licence \nLanguages\t09-05-1985. Villaricca (Italy)\n\nY1281863H\n474707061\nItalian (native language)\nSpanish (read, written, spoken)\nEnglish (read, written, spoken)\nPortuguese (read, spoken)\nFrench (read)\n\t\t\nCurrent position (title and company)\tDate (Year)\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. Private practise.\t2017-today\n\n2019-today\n\t\n\t\nEducation (High school, university and postgraduate training > 3 months)\tDate (Year)\nDegree in Medicine and Surgery. University of Neaples 'Federico II”\nResident in Opthalmology. Hospital Clinico Universitario Valladolid\nMaster in Vitreo-Retina. IOBA. University of Valladolid\nFellow of the European Board of Ophthalmology. Paris\nMaster in Research in Ophthalmology. University of Valladolid\t2003-2009\n2012-2016\n2016-2017\n2016\n2012-2013\n\t\nEmployments (company and positions)\tDate (Year)\nResident in Ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl.\nFellow in Vitreo-Retina. IOBA. University of Valladolid\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. \n\t2012-2016\n2016-2017\n2017-today\n\n2019-Today\n\n\n\t\nClinical Research Experience (tasks and role)\tDate (Year)\nAssociated investigator\n\n' FIS PI20/00740: DESARROLLO DE UNA CALCULADORA DE RIESGO DE\nAPARICION DE RETINOPATIA DIABETICA BASADA EN TECNICAS DE IMAGEN MULTIMODAL EN PACIENTES DIABETICOS TIPO 1. Grant by: Ministerio de Ciencia e Innovacion \n\n' (BIO/VA23/14) Estudio clínico multicéntrico y prospectivo para validar dos\nbiomarcadores ubicados en los genes p53 y MDM2 en la predicción de los resultados funcionales de la cirugía del desprendimiento de retina regmatógeno. Grant by: Gerencia Regional de Salud de la Junta de Castilla y León.\n' Estudio multicéntrico, aleatorizado, con enmascaramiento doble, en 2 grupos\nparalelos y de 52 semanas de duración para comparar la eficacia, seguridad e inmunogenicidad de SOK583A1 respecto a Eylea® en pacientes con degeneración macular neovascular asociada a la edad' (CSOK583A12301; N.EUDRA: 2019-004838-41; FASE III). Grant by Hexal AG\n\n' Estudio de fase III, aleatorizado, doble ciego, con grupos paralelos, multicéntrico para comparar la eficacia y la seguridad de QL1205 frente a Lucentis® en pacientes con degeneración macular neovascular asociada a la edad. (EUDRACT: 2018-004486-13). Grant by Qilu Pharmaceutical Co\n\n' Estudio NEUTON: Ensayo clinico en fase IV para evaluar la eficacia de aflibercept en pacientes Naive con Edema MacUlar secundario a Oclusion de Vena CenTral de la Retina (OVCR) en regimen de tratamientO iNdividualizado Treat and Extend (TAE)”, (2014-000975-21). Grant by Fundacion Retinaplus\n\n' Evaluación de la seguridad y bioactividad de anillos de tensión capsular en conejo. Proyecto Procusens. Grant by AJL, S.A.\n\n'Estudio epidemiológico, prospectivo, multicéntrico y abierto\\npara valorar la frecuencia de la conjuntivitis adenovírica diagnosticada mediante el test AdenoPlus®\\nTest en pacientes enfermos de conjuntivitis aguda”\\n. National, multicenter study. Grant by: NICOX.\n\nEuropean multicentric trial: 'Evaluation of clinical outcomes following the use of Systane Hydration in patients with dry eye”. Study Phase 4. Grant by: Alcon Labs'\n\nVLPs Injection and Activation in a Rabbit Model of Uveal Melanoma. Grant by Aura Bioscience\n\nUpdating and characterization of a rabbit model of uveal melanoma. Grant by Aura Bioscience\n\nEnsayo clínico en fase IV para evaluar las variantes genéticas de la vía del VEGF como biomarcadores de eficacia del tratamiento con aflibercept en pacientes con degeneración macular asociada a la edad (DMAE) neovascular. Estudio BIOIMAGE. IMO-AFLI-2013-01\n\nEstudio In-Eye:Ensayo clínico en fase IV, abierto, aleatorizado, de 2 brazos,\nmulticçentrico y de 12 meses de duración, para evaluar la eficacia y seguridad de un régimen de PRN flexible individualizado de 'esperar y extender' versus un régimen PRN según criterios de estabilización mediante evaluaciones mensuales de inyecciones intravítreas de ranibizumab 0,5 mg en pacientes naive con neovascularización coriodea secunaria a la degeneración macular relacionada con la edad. CP: CRFB002AES03T\n\nTREND: Estudio Fase IIIb multicéntrico, randomizado, de 12 meses de\nseguimiento con evaluador de la agudeza visual enmascarado, para evaluar la eficacia y la seguridad de ranibizumab 0.5mg en un régimen de tratar y extender comparado con un régimen mensual, en pacientes con degeneración macular neovascular asociada a la edad. CP: CRFB002A2411 Código Eudra CT:\n2013-002626-23\n\n\n\nPublications\t\n\n2021\n\n\n\n\n2015\n\n\n\n\n2021\n\n\n\n\n\n2021\n\n\n\n\n2015\n\n\n\n\n2015\n\n\n2014\n\n\n\n\n2015-16\n\n\n\n2015\n\n\n2014\n\n\n2014\n\n\n\n\n2014\n\n\n\n\n\n\n\n2014\n\nJose Carlos Pastor; Jimena Rojas; Salvador Pastor-Idoate; Salvatore Di Lauro; Lucia Gonzalez-Buendia; Santiago Delgado-Tirado. Proliferative vitreoretinopathy: A new concept of disease pathogenesis and practical\nconsequences. Progress in Retinal and Eye Research. 51, pp. 125 - 155. 03/2016. DOI: 10.1016/j.preteyeres.2015.07.005\n\n\nLabrador-Velandia S; Alonso-Alonso ML; Di Lauro S; García-Gutierrez MT; Srivastava GK; Pastor JC; Fernandez-Bueno I. Mesenchymal stem cells provide paracrine neuroprotective resources that delay degeneration of co-cultured organotypic neuroretinal cultures.Experimental Eye Research. 185, 17/05/2019. DOI: 10.1016/j.exer.2019.05.011\n\nSalvatore Di Lauro; Maria Teresa Garcia Gutierrez; Ivan Fernandez Bueno. Quantification of pigment epithelium-derived factor (PEDF) in an ex vivo coculture of retinal pigment epithelium cells and neuroretina.\nJournal of Allbiosolution. 2019. ISSN 2605-3535\n\nSonia Labrador Velandia; Salvatore Di Lauro; Alonso-Alonso ML; Tabera Bartolomé S; Srivastava GK; Pastor JC; Fernandez-Bueno I. Biocompatibility of intravitreal injection of human mesenchymal stem cells in immunocompetent rabbits. Graefe's archive for clinical and experimental ophthalmology. 256 - 1, pp. 125 - 134. 01/2018. DOI: 10.1007/s00417-017-3842-3\n\n\nSalvatore Di Lauro, David Rodriguez-Crespo, Manuel J Gayoso, Maria T Garcia-Gutierrez, J Carlos Pastor, Girish K Srivastava, Ivan Fernandez-Bueno. A novel coculture model of porcine central neuroretina explants and retinal pigment epithelium cells. Molecular Vision. 2016 - 22, pp. 243 - 253. 01/2016.\n\nSalvatore Di Lauro. Classifications for Proliferative Vitreoretinopathy ({PVR}): An Analysis of Their Use in Publications over the Last 15 Years. Journal of Ophthalmology. 2016, pp. 1 - 6. 01/2016. DOI: 10.1155/2016/7807596\n\nSalvatore Di Lauro; Rosa Maria Coco; Rosa Maria Sanabria; Enrique Rodriguez de la Rua; Jose Carlos Pastor. Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study. Journal of Ophthalmology. 2015:821864, 2015. DOI: 10.1155/2015/821864\n\nIvan Fernandez-Bueno; Salvatore Di Lauro; Ivan Alvarez; Jose Carlos Lopez; Maria Teresa Garcia-Gutierrez; Itziar Fernandez; Eva Larra; Jose Carlos Pastor. Safety and Biocompatibility of a New High-Density Polyethylene-Based\nSpherical Integrated Porous Orbital Implant: An Experimental Study in Rabbits. Journal of Ophthalmology. 2015:904096, 2015. DOI: 10.1155/2015/904096\n\nPastor JC; Pastor-Idoate S; Rodríguez-Hernandez I; Rojas J; Fernandez I; Gonzalez-Buendia L; Di Lauro S; Gonzalez-Sarmiento R. Genetics of PVR and RD. Ophthalmologica. 232 - Suppl 1, pp. 28 - 29. 2014\n\nRodriguez-Crespo D; Di Lauro S; Singh AK; Garcia-Gutierrez MT; Garrosa M; Pastor JC; Fernandez-Bueno I; Srivastava GK. Triple-layered mixed co-culture model of RPE cells with neuroretina for evaluating the neuroprotective effects of adipose-MSCs. Cell Tissue Res. 358 - 3, pp. 705 - 716. 2014.\nDOI: 10.1007/s00441-014-1987-5\n\nCarlo De Werra; Salvatore Condurro; Salvatore Tramontano; Mario Perone; Ivana Donzelli; Salvatore Di Lauro; Massimo Di Giuseppe; Rosa Di Micco; Annalisa Pascariello; Antonio Pastore; Giorgio Diamantis; Giuseppe Galloro. Hydatid disease of the liver: thirty years of surgical experience.Chirurgia italiana. 59 - 5, pp. 611 - 636.\n(Italia): 2007. ISSN 0009-4773\n\nChapters in books\n\t\n' Salvador Pastor Idoate; Salvatore Di Lauro; Jose Carlos Pastor Jimeno. PVR: Pathogenesis, Histopathology and Classification. Proliferative Vitreoretinopathy with Small Gauge Vitrectomy. Springer, 2018. ISBN 978-3-319-78445-8\nDOI: 10.1007/978-3-319-78446-5_2. \n\n' Salvatore Di Lauro; Maria Isabel Lopez Galvez. Quistes vítreos en una mujer joven. Problemas diagnósticos en patología retinocoroidea. Sociedad Española de Retina-Vitreo. 2018.\n\n' Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor Jimeno. iOCT in PVR management. OCT Applications in Opthalmology. pp. 1 - 8. INTECH, 2018. DOI: 10.5772/intechopen.78774.\n\n' Rosa Coco Martin; Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor. amponadores, manipuladores y tinciones en la cirugía del traumatismo ocular.Trauma Ocular. Ponencia de la SEO 2018..\n\n' LOPEZ GALVEZ; DI LAURO; CRESPO. OCT angiografia y complicaciones retinianas de la diabetes. PONENCIA SEO 2021, CAPITULO 20. (España): 2021.\n\n' Múltiples desprendimientos neurosensoriales bilaterales en paciente joven. Enfermedades Degenerativas De Retina Y Coroides. SERV 04/2016. \n' González-Buendía L; Di Lauro S; Pastor-Idoate S; Pastor Jimeno JC. Vitreorretinopatía proliferante (VRP) e inflamación: LA INFLAMACIÓN in «INMUNOMODULADORES Y ANTIINFLAMATORIOS: MÁS ALLÁ DE LOS CORTICOIDES. 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The applications of this research cover many related fields, such as biotechnology and medicine, where, for example, Bioinformatics contributes to faster drug design, DNA analysis in forensics, and DNA sequence analysis in the field of personalized medicine. Personalized medicine is a type of medical care in which treatment is customized individually for each patient. Personalized medicine enables more effective therapy, reduces the costs of therapy and clinical trials, and also minimizes the risk of side effects. Nevertheless, advances in personalized medicine would not have been possible without bioinformatics, which can analyze the human genome and other vast amounts of biomedical data, especially in genetics. The rapid growth of information technology enabled the development of new tools to decode human genomes, large-scale studies of genetic variations and medical informatics. The considerable development of technology, including the computing power of computers, is also conducive to the development of bioinformatics, including personalized medicine. In an era of rapidly growing data volumes and ever lower costs of generating, storing and computing data, personalized medicine holds great promises. Modern computational methods used as bioinformatics tools can integrate multi-scale, multi-modal and longitudinal patient data to create even more effective and safer therapy and disease prevention methods. Main aspects of the topic are: Applying bioinformatics in drug discovery and development; Bioinformatics in clinical diagnostics (genetic variants that act as markers for a condition or a disease); Blockchain and Artificial Intelligence/Machine Learning in personalized medicine; Customize disease-prevention strategies in personalized medicine; Big data analysis in personalized medicine; Translating stratification algorithms into clinical practice of personalized medicine.",annualVolume:11403,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/7.jpg",editor:{id:"351533",title:"Dr.",name:"Slawomir",middleName:null,surname:"Wilczynski",fullName:"Slawomir Wilczynski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035U1loQAC/Profile_Picture_1630074514792",institutionString:null,institution:{name:"Medical University of Silesia",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"5886",title:"Dr.",name:"Alexandros",middleName:"T.",surname:"Tzallas",fullName:"Alexandros Tzallas",profilePictureURL:"https://mts.intechopen.com/storage/users/5886/images/system/5886.png",institutionString:"University of Ioannina, Greece & Imperial College London",institution:{name:"University of Ioannina",institutionURL:null,country:{name:"Greece"}}},{id:"257388",title:"Distinguished Prof.",name:"Lulu",middleName:null,surname:"Wang",fullName:"Lulu Wang",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRX6kQAG/Profile_Picture_1630329584194",institutionString:"Shenzhen Technology University",institution:{name:"Shenzhen Technology University",institutionURL:null,country:{name:"China"}}},{id:"225387",title:"Prof.",name:"Reda R.",middleName:"R.",surname:"Gharieb",fullName:"Reda R. Gharieb",profilePictureURL:"https://mts.intechopen.com/storage/users/225387/images/system/225387.jpg",institutionString:"Assiut University",institution:{name:"Assiut University",institutionURL:null,country:{name:"Egypt"}}}]},{id:"8",title:"Bioinspired Technology and Biomechanics",keywords:"Bioinspired Systems, Biomechanics, Assistive Technology, Rehabilitation",scope:'Bioinspired technologies take advantage of understanding the actual biological system to provide solutions to problems in several areas. Recently, bioinspired systems have been successfully employing biomechanics to develop and improve assistive technology and rehabilitation devices. The research topic "Bioinspired Technology and Biomechanics" welcomes studies reporting recent advances in bioinspired technologies that contribute to individuals\' health, inclusion, and rehabilitation. Possible contributions can address (but are not limited to) the following research topics: Bioinspired design and control of exoskeletons, orthoses, and prostheses; Experimental evaluation of the effect of assistive devices (e.g., influence on gait, balance, and neuromuscular system); Bioinspired technologies for rehabilitation, including clinical studies reporting evaluations; Application of neuromuscular and biomechanical models to the development of bioinspired technology.',annualVolume:11404,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",institutionString:null,institution:{name:"Federal University of Uberlândia",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"49517",title:"Prof.",name:"Hitoshi",middleName:null,surname:"Tsunashima",fullName:"Hitoshi Tsunashima",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTP4QAO/Profile_Picture_1625819726528",institutionString:null,institution:{name:"Nihon University",institutionURL:null,country:{name:"Japan"}}},{id:"425354",title:"Dr.",name:"Marcus",middleName:"Fraga",surname:"Vieira",fullName:"Marcus Vieira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003BJSgIQAX/Profile_Picture_1627904687309",institutionString:null,institution:{name:"Universidade Federal de Goiás",institutionURL:null,country:{name:"Brazil"}}},{id:"196746",title:"Dr.",name:"Ramana",middleName:null,surname:"Vinjamuri",fullName:"Ramana Vinjamuri",profilePictureURL:"https://mts.intechopen.com/storage/users/196746/images/system/196746.jpeg",institutionString:"University of Maryland, Baltimore County",institution:{name:"University of Maryland, Baltimore County",institutionURL:null,country:{name:"United States of America"}}}]},{id:"9",title:"Biotechnology - Biosensors, Biomaterials and Tissue Engineering",keywords:"Biotechnology, Biosensors, Biomaterials, Tissue Engineering",scope:"The Biotechnology - Biosensors, Biomaterials and Tissue Engineering topic within the Biomedical Engineering Series aims to rapidly publish contributions on all aspects of biotechnology, biosensors, biomaterial and tissue engineering. We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics can include but are not limited to: Biotechnology such as biotechnological products and process engineering; Biotechnologically relevant enzymes and proteins; Bioenergy and biofuels; Applied genetics and molecular biotechnology; Genomics, transcriptomics, proteomics; Applied microbial and cell physiology; Environmental biotechnology; Methods and protocols. Moreover, topics in biosensor technology, like sensors that incorporate enzymes, antibodies, nucleic acids, whole cells, tissues and organelles, and other biological or biologically inspired components will be considered, and topics exploring transducers, including those based on electrochemical and optical piezoelectric, thermal, magnetic, and micromechanical elements. Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. 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