\r\n\tApplied and basic studies - Field studies and lab assays of fungicides can be discussed. We also look for examples of application methods, which may include timing of application, tools for application, fungicide compatibility, phytotoxicity, etc. Field trials have to have at least two years of data; \r\n\tAdaptation of Integrated Plant Disease Management - How the IPM practice has been adapted in the field. Application of disease risk models, or use of fungicide application aids, which can be hardware or software. The introduction of a new tool for growers can also be included; \r\n\tNovel fungicides - In addition to the traditional chemical approach, alternative materials (enzymes, oils, extracts, etc.), biological control agents, or plant defense activators can be discussed; \r\n\tAdaptation of new technologies - Examples will be the use of unmanned vehicles, sensor technologies, advanced sprayers, or disease forecast systems for precision agriculture; \r\n\tFungicide resistance - Unfortunately, we cannot ignore the fact that fungicide-resistant strains are widespread. Documentation of fungicide-resistant strains, the introduction of new technologies and methods can be discussed.
",isbn:"978-1-80356-378-7",printIsbn:"978-1-80356-377-0",pdfIsbn:"978-1-80356-379-4",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,isSalesforceBook:!1,hash:"3a8c9d55c21ce8d69d2edc94f9e592f3",bookSignature:"Dr. Mizuho Nita",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11609.jpg",keywords:"Lab Assays, Application Method, In-Field IPM, Fungicide Application Aids, Alternative Materials, Biological Control Agents, Plant Defense Activators, Rapid Detection, New Technologies, Unmanned Vehicle, Disease Forecast System, Precision Agriculture",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"February 23rd 2022",dateEndSecondStepPublish:"March 23rd 2022",dateEndThirdStepPublish:"May 22nd 2022",dateEndFourthStepPublish:"August 10th 2022",dateEndFifthStepPublish:"October 9th 2022",remainingDaysToSecondStep:"2 months",secondStepPassed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"Specially appointed Associate Professor of Shinshu University in Japan and a member of the American Phytopathological Society, Dr. Nita is an Extension Plant Pathologist who specializes in grape disease management.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"98153",title:"Dr.",name:"Mizuho",middleName:null,surname:"Nita",slug:"mizuho-nita",fullName:"Mizuho Nita",profilePictureURL:"https://mts.intechopen.com/storage/users/98153/images/system/98153.jpg",biography:"Mizuho Nita is an Associate Professor and Extension Specialist of grape pathology at Virginia Tech’s Alson H. 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1. Introduction
Pancreatic necrosis is the presence of nonviable pancreatic parenchyma or peripancreatic fat which may be localized or diffuse. It is classified radiologically according to the Atlanta Criteria as an acute necrotic collection (ANC), which is defined as a non-encapsulated area of necrosis, or as walled-off necrosis (WON), which is encapsulated [1]. Although pancreatic necrosis may result from trauma, malignancy, or chronic pancreatitis, the most common cause is acute pancreatitis; 20% of patients with acute pancreatitis develop necrosis. For patients who develop necrosis, the mortality rate is 15–30% [2]. Surgery has historically been the primary treatment for pancreatic necrosis. However, the superior outcomes associated with new, less invasive techniques have narrowed the scope for surgical intervention. Despite these shifts in practice, surgical care remains an important tool for the treatment of pancreatic necrosis.
2. Diagnosis and conservative management
Although the diagnosis of pancreatitis is generally clinical, the primary diagnostic tool for pancreatic necrosis is the computed tomography (CT) scan. With this modality, normal pancreatic parenchyma is low attenuation, 40–50 Hounsfield units (HU), but increases with contrast to 100–150 HU. In comparison, areas of necrosis remain hypoattenuating, <30 HU [3]. MRI and endoscopic ultrasound are also used, but CT scan is considered to be the gold standard for diagnosis and characterization [4].
Regardless of the presence of necrosis, fluid resuscitation, and early nutritional support are paramount to the treatment of patients with acute pancreatitis. For patients who are able to tolerate enteral nutrition, there is a significant reduction in the rates of infected pancreatic necrosis, multiorgan failure, surgical intervention, and mortality when compared to patients who are given total parenteral nutrition (TPN) [5, 6]. Thus, prior to initiation of TPN, patients should be evaluated for tolerance of oral, nasogastric, and nasojejunal feeding. Route notwithstanding, nutrition should be addressed in the first 24–48 hours of admission for acute pancreatitis [7].
Sterile pancreatic necrosis does not have a specific clinical presentation, but is more common in patients with symptoms lasting more than 48 hours and with concomitant organ failure [8]. The morbidity and mortality associated with pancreatic necrosis is exacerbated by development of infection, which may result of seeding associated with bacteremia, colonic bacterial translocation, or direct contamination from a procedure (e.g. endoscopic retrograde cholangiopancreatography (ERCP) or surgery) [9]. The risk of infection correlates with the degree of necrosis. If more than 30% of the pancreatic parenchyma is necrotic, there is a 22% risk of infection. If 30–50% is necrotic, the risk of infection is 37%. If necrosis exceeds 50%, the risk of infection is 46% [10]. The signs and symptoms of infected pancreatic necrosis are similar to those of other types of infection, including: fever, leukocytosis, and worsening condition with optimal supportive care. Once the necrosis becomes infected, the incidence of organ failure increases, along with the risk of mortality [11].
Differentiating sterile from infected necrosis based on clinical presentation can be difficult. Patients with sterile necrosis can proceed to organ failure in similar fashion to patients with infected necrosis. Infection can be detected non-invasively on CT scan by looking for the presence of gas locules within the area of necrosis, suggesting microbial gas production. However, these findings are not always seen on CT, and fine-needle aspiration (FNA) may be necessary for definitive diagnosis. Multiple FNA aspirates may be required due to the 10% false negative rate of this test [12].
However, proof of infection on radiology or by tissue culture is not necessary to initiate treatment. If infection is strongly suspected due to clinical course, antibiotics are indicated regardless of radiologic or tissue diagnosis. If no antibiotic sensitivities are available from culture results, broad-spectrum antibiotics should be started. Due to the ability to penetrate the necrotic tissue, carbapenems are considered first-line treatment [13]. Prophylactic use of antibiotics has not been shown to impact the rate of developing infected necrosis, systemic complications, mortality, or need for surgical intervention and is not recommended [14, 15, 16].
Prior to any invasive management, a patient should be treated with optimal supportive care. This includes fluid resuscitation, nutritional support, and antibiotics, if infection is suspected. The need for invasive management of sterile pancreatic necrosis is rare, especially in acute phase. However intervention may be necessary during the late phase for protracted abdominal pain, obstruction, or, less often, for failure of clinical improvement. Infected necrosis requires invasive intervention more often, both in order to gain source control and in order to resolve other non-infectious symptoms [17].
3. Percutaneous and endoscopic interventions
Although percutaneous and endoscopic interventions have historically been considered temporizing measures, not definitive management, many patients with pancreatic necrosis are successfully treated with these techniques, without need for more invasive therapy. Percutaneous drainage can successfully treat acute necrotizing pancreatitis in more than 50% of patients without need for surgical necrosectomy. The success rate with endoscopic therapy can reach 80% when used in conjunction with DEN [18, 19]. Thus, development of less invasive methods for addressing pancreatic necrosis led to a decrease in the indications for surgical intervention. The choice of intervention, percutaneous or endoscopic, is dependent on the situation, timing, and accessibility of the area of necrosis (Figure 1).
Figure 1.
Flowchart for Management of Pancreatic Necrosis after Failure of conservative management. After failure of conservative management – Supportive care, antibiotics, and nutrition – The appropriate intervention depends on the nature of the necrosis. If it is associated with a disconnected duct, a separate pathway, which ends with distal pancreatectomy, internal drainage, or endoscopic translumenal stent placement, is indicated. If there is no disconnected duct, the correct pathway is dictated by the stage of necrosis, as a nonencapsulated acute necrotic collection or as walled off necrosis. Endoscopic and percutaneous strategies are preferred in each situation, and traditional, laparoscopic or open necrosectomy serves as the final option for patients that fail other management, or in hospitals without resources or staff to perform other procedures.
Endoscopic management of pancreatic necrosis is performed transmurally, either across the duodenum, for pancreatic head necrosis, or the stomach, for neck or body necrosis. Although technically feasible earlier in the clinical course, endoscopic intervention should be delayed to 4 weeks after onset of symptoms in order for an appropriate capsule to form around the necrotic tissue [20]. In cases where intervention can be delayed until WON form, and the WON is accessible transmurally, this is considered first-line intervention [18].
With or without the aid of endoscopic ultrasound (EUS), a plastic or self-expanding metal stent (SEMS) is placed from the lumen of the duodenum or stomach into the area of WON. In addition to allowing the WON to drain into the lumen, these stents also allow access to the area for debridement, via irrigation or DEN [21] (Figure 2). In DEN, an endoscope with one or two working ports is advanced through the previously placed, transluminal stent. Upon entering the WON, a number of tools, including forceps and snares are used to remove debris that would otherwise not be susceptible to removal with irrigation [21]. On average, 3–6 endoscopic interventions are necessary prior to resolution of necrosis [22].
Figure 2.
Surgical approaches to Necrosectomy. Access the lesser sac and retroperitoneum for the purposes of pancreatic necrosectomy can be achieve through a number of approaches. Direct endoscopic necrosectomy (DEN) is performed by accessing the stomach via the esophagus and then creating a posterior gastrotomy. The transgastric approach, performed laparoscopically or open, requires both an anterior and a posterior gastrotomy. The lesser sac can also be accessed by opening the gastrocolic ligament or transverse mesocolon, either by traversing a previously established, drainage tract or with a surgical approach.
DEN was first compared to surgical necrosectomy in the Pancreatitis, Endoscopic Transgastric vs. Primary Necrosectomy in Patients with Infected Necrosis (PENQUIN) Trial. In this trial, patients in the surgery group underwent a number of different operations, including 6 video-assisted retroperitoneal debridement (VARD) surgeries, 4 open necrosectomies, and 2 percutaneous drainage placements without need for more invasive therapy. The two patient who did not have a necrosectomy were excluded from final statistical analysis. All 10 patients in the endoscopic group had ultrasound guided stent placement, irrigation, and DEN. Following intervention, the rates of new-onset organ failure and pancreatic fistula were lower in the endoscopic group. The trial also compared the groups with regard to a composite clinical outcome, which included major post-operative complications and mortality, and found a lower rate in the endoscopic group [23, 24]. These findings were later replicated in the Minimally-invasive Surgery Versus Endoscopy Randomized (MISER) Trial. Additionally, MISER showed lower rates of pancreatic fistula formation and a higher quality of life at 3 months after surgery in the endoscopic group [25]. In the Transluminal Endoscopic Step-up Approach Versus Minimally-invasive Surgical Step-up Approach in Patients with Infected Necrotizing Pancreatitis (TENSION) Trial, a larger randomized trial, no difference in mortality was observed. However, the rates of pancreatic fistula and length of stay favored the endoscopic group [26].
Percutaneous drainage is preferable in patients that are deemed too unstable to tolerate endoscopic drainage or if the area of necrosis extends into a dependent space, such as the paracolic gutters or pelvis. It is also an acceptable alternative when endoscopic drainage is unavailable or not technically feasible, specifically in the setting of ANC, when there is no capsule that could support an endoscopic stent [27].
Percutaneous drainage is usually CT-guided, although ultrasound-guided drainage can also be performed. These drains may be transperitoneal, with the external portion of the drain fixed in the anterior abdominal wall. These drains may also be placed through the flank, directly into the retroperitoneum, without traversing the peritoneum. In addition to draining ANC and WON, percutaneous drains can also be used for irrigation [28].
Although percutaneous drainage is successful as monotherapy in some patients, patients with larger areas of necrosis, multifocal necrosis, incomplete liquefaction, and pre-procedural organ failure are less likely to be adequately treated. While some of these factors can be overcome with larger drainage catheters, for these reasons, percutaneous drainage remains a bridge to therapy, allowing patients to survive the acute period of disease, and undergo definitive management later, with improved outcomes [26, 29, 30].
4. General considerations for surgical management
Surgical management may be minimally-invasive or open, but has the same two primary goals: obtaining source control by removing as much necrotic tissue as possible and providing access for irrigation and drainage. As a general principle, minimally-invasive approaches are preferred to open necrosectomy as first-line treatment. The improved outcomes of minimally-invasive technique lead to development of the “step-up” approach to management, which begins with percutaneous or endoscopic intervention, followed by a progression to surgical intervention as indicated by unresolved disease. However, the final treatment decision is dictated by the patient, surgeon, and available resources. A second principle is that surgical intervention should be delayed as long as possible in order to improve outcomes. Operating during the early, acute phase of pancreatitis, especially in the presence of ANC, rather than WON, is associated with higher morbidity and mortality regardless of surgical approach. A third principle is that long-term nutritional access, through a gastrostomy or gastrojejunostomy tube, should be obtained prior to concluding the procedure if no other method for enteral feeding has been established. Fourth, a cholecystectomy may also be performed if gallstones were implicated in the etiology of pancreatitis, provided the patient is adequately stable to undergo an additional procedure (Figure 1).
5. Minimally-invasive necrosectomy
VARD is a technique, used as the final phase of the step-up approach, where the retroperitoneum is accessed through a previously established, left flank, percutaneous drainage tract (Figure 2). The tract is then serially dilated, in order to accommodate progressively larger drainage catheters. At the time of surgery, in order to facilitate introduction of laparoscopic instruments, a small, 4–6 centimeter incision is made where the tract exits the skin. After confirming entry into the WON with a probe, tissue and fluid are removed with suction. The laparoscope is then inserted, with or without CO2 insufflation, for continued debridement under direct visualization, using blunt laparoscopic forceps. Following debridement, again under direct visualization, large drainage catheters or chest tubes, 28-French or greater, are placed. After surgery, these catheters are used for repeated lavage as well as for drainage [31].
The superiority of VARD, and the step-up approach, compared to surgery for the treatment of necrotizing pancreatitis was first published in the Minimally-invasive Step-up Approach Versus Maximal Necrosectomy in Patients with Acute Necrotizing Pancreatitis (PANTER) Trial. In this study, 35% of the patients assigned to the step-up arm were successfully treated with percutaneous drainage alone. When comparing the step-up and surgical groups, the step-up group was less likely to have new-onset organ failure, less likely to develop an incisional hernia, and had an overall lower rate of endocrine insufficiency. However, the mortality rate was not significantly different, 19% in the step-up group versus 16% in surgery group [31].
A similar procedure, percutaneous endoscopic necrosectomy (PEN), can be performed utilizing a previously established percutaneous drainage tract. Unlike VARD, PEN utilizes a flexible endoscope, as compared to a rigid laparoscope. Because the endoscope has working ports, in addition to irrigation and suction, an additional incision around the tract is not needed. Also unlike VARD, PEN can be performed at bedside, with conscious sedation [32].
PEN was shown to be effective in a large, prospective study of 171 patients with infected pancreatic necrosis. The primary outcome investigated was control of sepsis and resolution of the infected collection. In this study, 18 of 26 (69%) patients with infected ANC and 23 of 27 (85%) with infected WON who underwent PEN were successfully treated, while the remainder required surgical necrosectomy. Predictors of failure included >50% parenchymal necrosis and early organ failure. ANC was not predictive. The overall mortality rate for this study was 38% [32, 33]. Although this technique has not been directly compared to surgery, VARD, or transmural endoscopy, this study demonstrated the safety and utility of PEN in patients with infected pancreatic necrosis.
Regardless of the type of minimally-invasive drainage, VARD or PEN, it has been shown that the “step-up approach,” beginning with drainage and progressing to debridement, is superior to upfront surgical approaches in terms of mortality, rates of pancreaticocutaneous fistula formation, and long-term morbidity [25, 30, 34].
6. Transgastric necrosectomy
In addition to utilizing a percutaneous drainage tract for necrosectomy, access can also be gained through the stomach. By entering the abdomen and opening the anterior wall of the stomach and then opening the posterior aspect of the stomach, access to the lesser sac and underlying pancreas is achieved (Figure 2). An aperture between the WON and posterior wall of the stomach is then created, either with sutures or by stapling, providing a definitive drainage tract. This tract is then used for necrosectomy following the same principles as DEN.
This approach is most well suited for WON limited to the lesser sac. When there is extensive necrosis extending to the retroperitoneum or paracolic gutters, VARD or traditional necrosectomy are more appropriate, due to the limited exposure with this method. These limitations are counterbalanced by the minimal amount of mobilization required to enter the lesser sac by the transgastric method [35].
When performed laparoscopically, five ports are typically placed; in addition to an umbilical port, two ports are placed in the right upper quadrant, one port is placed in the left upper quadrant, and one port in the epigastrium. After entering the abdomen and creating the anterior gastrotomy, an ultrasound is used to identify the necrosis and plan the locations of the posterior gastrotomy. Ultrasound is adjunctive to preoperative imaging, which is also essential to surgical planning. Both anterior and posterior gastrotomies should be made after placement of stay sutures. Upon entering the lesser sac, necrosectomy should be performed with blunt instruments, such as a ring forceps, taking great care to remove only loose material and avoid avulsing adherent tissue or vessels that may be bridging the area of necrosis. Following necrosectomy, a cystogastrostomy is created with an endoscopic stapler, or suture. The anterior gastrotomy is then closed with sutures or with a stapler [36].
When performed open, an upper midline incision is made, and the procedure proceeds in the same fashion as in the laparoscopic procedure. One difference in the open procedure is that many surgeons elect to use digital dissection for the necrosectomy, as opposed to instruments [37].
Open and laparoscopic approaches to transgastric drainage have been shown to have similar outcomes. In a recent retrospective review of patients from three tertiary referral centers, rates of morbidity, including rates of reoperation and hemorrhage, and mortality were not significantly different. However, the patients who underwent laparoscopic drainage had a higher rate of readmission. It should be noted that the overall mortality in this study was 2% at an average follow-up of 21 months, significantly less than reported elsewhere in the literature. The overall morbidity rate of 38% is in alignment with commonly reported rates elsewhere in literature [38].
Although surgical transgastric necrosectomy is relatively well tolerated, outcomes favor endoscopic transgastric drainage. Meta-analysis comparing the two show lower rates of overall major complications, pancreatic fistula formation, post-procedural organ failure, and hernia with an endoscopic approach. However, the overall rate of clinical resolution, post-operative bleeding, endocrine dysfunction, exocrine insufficiency, and mortality were not significantly different [39]. Thus, surgical transgastric necrosectomy is a valid alternative to other approaches of necrosectomy in the absence of an experienced endoscopist or at a center without access to advanced endoscopic tools.
7. Laparoscopic and open necrosectomy
Although utilization of a drainage tract and the transgastric approach are important for management of pancreatic necrosis, traditional laparoscopic and open necrosectomy methods also continue to be utilized.
For laparoscopic necrosectomy, patients are typically placed in lithotomy position, with the operating surgeon standing between the legs. An umbilical port is placed first. Upon entering the abdomen, a diagnostic laparoscopy should be performed. Subsequently, two left lateral ports and an epigastric port are placed. In some cases, a hand-assist port is placed to augment dissection and removal of tissue. Following lysis of adhesions, a transgastrocolic, for pancreatic head or body necrosis, or transmesocolic, for pancreatic tail necrosis, approach to retrogastric necrosectomy can be taken (Figure 2). Upon entering the area of necrosis, blunt instruments are used to remove loose, necrotic tissue. This tissue is then placed into an endocatch bag for removal from the abdomen. Dissection is alternated with irrigation and suction to remove as much necrotic tissue as possible [40]. Once the necrosectomy is complete, large drainage catheters are placed in the cavity, which also allow for post-operative irrigation. At this time, consideration should also be given to cholecystectomy, if gallstones were implicated in the development of pancreatitis, and to nutritional access. Depending on the specific study, mortality for patients who require laparoscopic necrosectomy ranges from 10 to 18%. Rates of reoperation also vary widely, ranging from 11 to 38% [41, 42].
The most invasive procedure used for the treatment of pancreatic necrosis is the open debridement. This technique is reserved for patients that fail other less invasive techniques, or patients who require concurrent intervention for another intraabdominal process, such as bowel ischemia or abdominal compartment syndrome. Unless midline laparotomy is required for another indication, the abdomen can be opened with bilateral, subcostal incisions. The gastrocolic ligament is then opened, and the stomach is reflected superiorly, exposing the lesser sac (Figure 2). The transverse mesocolon is then opened, exposing the retroperitoneum. The hepatic and splenic flexures of the transverse colon are often taken down at this point. A Kocher maneuver may also be necessary if the area of necrosis involves the head of the pancreas. Once the pancreas is adequately exposed, blunt debridement can begin. This is usually accomplished with digital dissection or with lavage in order to minimize the risk of bleeding or bile duct injury. These risks must be balances with adequate removal of loose, nonviable tissue. Wide drainage of the area with a sumping tube (i.e. Abramson drain) can facilitate continue lavage and debridement. The quality of the initial necrosectomy predicts the need for subsequent operations.
After necrosectomy, the abdomen may be kept open, with packing in place, to allow for repeated removal of necrotic tissue. Alternatively, the closed packing technique can also be used. This technique consists of filling the cavity created by the necrosectomy with gauze-filled Penrose drains. The drains are removed one at a time, until the cavity closes [43]. A third option is continuous irrigation, where large catheters are placed into the lesser sac under direct visualization. Additional drainage catheters are left in the peritoneal cavity. The abdomen is then closed and the large catheters are used for continuous installation of hypertonic fluid [44].
As in patients who undergo laparoscopic necrosectomy, the rates of morbidity and mortality following open necrosectomy are high. Rates of post-operative morbidity range from 34 to 95% and mortality ranges from 6 to 47%, depending on the pre-operative severity of illness. Rates of reoperation vary depending on the packing technique. When the abdomen is left open, reoperation is planned rather than required because of deterioration or other complications, such as hemorrhage. Depending on the study, when the abdomen is left open, patients may return to the operating room from 1 to 17 time. Comparatively, relaparotomy is required in 17% of patients treated with closed packing require and 17–27% of patients treated with continuous irrigation. Rates of pancreatic fistula also differ depending on packing technique with a 25–46% rate in open abdomens, 53% rate in closed packing, and 13–19% rate with continuous irrigation [45].
The outcomes for both of these techniques are improved when intervention can be delayed at least 3 weeks. Delayed necrosectomy is associated with lower rates of exocrine and endocrine insufficiency, adverse post-operative events, including bleeding, and mortality [17, 46]. Early surgical intervention only provides a survival benefit in the case of decompression of abdominal compartment syndrome [47, 48].
When compared directly, in a retrospective case series, the rates of pancreatic fistula, post-operative pulmonary infections, and surgical site infections were all significantly lower with laparoscopic necrosectomy. Additionally, patients who underwent laparoscopic necrosectomy also had a shorter length of stay, but a longer initial operation. There was no difference in need for reoperation, overall morbidity, or mortality. It should be noted that mortality was very low compared to other literature in this study, 5.9% in the open group and 4% in the laparoscopic group [49].
8. Disconnected pancreatic duct syndrome
While parenchymal destruction in pancreatic necrosis confers significant morbidity and mortality, the seriousness of this condition can be further compounded by concurrent disruption of the pancreatic duct. Disconnected pancreatic duct syndrome (DPDS) occurs when the remnant of pancreas distal to the necrosis, and duct disruption, remains viable and continues to release digestive enzymes into the retroperitoneum. DPDS most commonly occurs in the setting of severe acute pancreatitis, and can be found in up to 46% of patients with pancreatic necrosis [50]. DPDS can also occur as the result of trauma and chronic pancreatitis. The clinical presentation of DPDS is heterogenous. Some patients are asymptomatic and the injury is incidentally diagnosed on radiology. While others may have early satiety due to the size of the resulting fluid collection or symptomatic ascites [51, 52].
DPDS is an often overlooked complication due to the low accuracy of imaging in differentiating between full-thickness pancreatic necrosis, affecting the pancreatic duct, and partial thickness or peripancreatic necrosis. Often multiple imaging modalities are required for accurate diagnosis, which in turn leads to delays in diagnosis, increased morbidity, and increased costs [53, 54, 55]. Diagnostic criteria for DPDS include: necrosis of ≥2 cm of pancreatic parenchyma, viable pancreatic tissue distal to the area of necrosis, and extravasation of contrast when injected into the main pancreatic duct during ERCP [56].
Once DPDS is diagnosed, choice of intervention is dependent on the patient’s clinical condition and the phase of disease. As in pancreatic necrosis without DPDS, intervention during the acute phase, when inflammation is high, is not only challenging, but also hazardous. Although the historical standard of care for these patients was surgery, if a patient deteriorates during the acute phase, initial therapy should be percutaneous or endoscopic. Percutaneous drainage, although useful as a temporizing measure, especially in unstable patients, is unlikely to succeed as monotherapy [57, 58]. Although success rates are dependent on the extent of necrosis, transpapillary and transmural endoscopic interventions have better short-term outcomes, with up to an 87% success rate of fistula resolution [50, 59, 60]. However, in order for endoscopic treatment to be successful, multiple interventions are often required, including hybrid approaches with percutaneous drains. Further, long-term data regarding patency and migration of indwelling stents is not available [60, 61]. Thus, percutaneous and endoscopic treatments remain temporizing measures, rather than definitive treatment, for DPDS, except for in patients who are poor surgical candidates [62].
Once a patient reaches the late stage of disease, or if a patient deteriorates despite optimal percutaneous and endoscopic intervention during the acute phase, surgery becomes the primary treatment for DPDS. Because of the technical difficulty of operating in the retroperitoneum after tissue planes have been obscured by inflammation, and because of the frequency of splenic vein thrombosis, and resulting sinistral portal hypertension, this operation is usually performed with a midline laparotomy and not laparoscopically [63].
Surgery for DPDS consists of resection of the distal, disconnected pancreas, and creation of internal drainage tracts. These techniques may be used independently or in combination. When the entirety of the disconnected pancreas is resected, splenectomy is also performed in almost all cases. However, when a pancreatojejunostomy, pancreaticogastrostomy, or fistuloenterostomy is made with the viable distal pancreas, the spleen may be preserved, in addition to preserving the pancreatic remnant. In this way, internal drainage not only provide a conduit for pancreatic secretions, but also decreases the risk of exocrine pancreatic insufficiency and diabetes. Importantly, patients who undergo internal drainage, compared to other surgical modalities, also have lower incidence of organ failure, development of pancreatic fistula, and need for long-term percutaneous drainage [50, 64].
9. Conclusions
Pancreatic necrosis is a significant and challenging disease process with mortality reaching beyond 30% in most studies. Intervention begins with supportive care and nutritional support. However, invasive therapy is often needed, especially when necrosis becomes infected.
First-line interventions for pancreatic necrosis may be percutaneous or transmural endoscopic drainage depending on if the necrosis is encapsulated, the accessibility of the necrosis, the patient’s clinical condition, and the capabilities of the hospital. These minimally-invasive interventions are often successful as monotherapy, without the need for further intervention. They are also preferable to open or laparoscopic necrosectomy when performed as part of a step-up approach.
Despite all of the improvement in minimally-invasive management of pancreatic necrosis, some percentage of patients continue to require surgical intervention. Both laparoscopic and open approaches have been shown to be effective via transgastric, transgastrocolic, and transmesocolic routes.
When pancreatic necrosis is further complicated by a disconnected pancreatic duct, although minimally-invasive management has been described and shown to be effective, surgical management remains standard of care.
Despite the advances in care driven by clinical trials and new technology, management of pancreatic necrosis remains difficult. Further study is needed to reduce the morbidity and mortality of this devastating disease.
Acknowledgments
All authors contributed equally to the authorship of this chapter.
Conflict of interest
The authors declare no conflicts of interest.
Notes/thanks/other declarations
The authors would like to thank the leadership of the Department of Surgery at the Donald and Barbara School of Medicine at Hofstra/Northwell, including Drs. Vihas Patel and Gene Coppa, for sponsoring the writing of this chapter.
Appendices and nomenclature
ACN
acute necrotic collection
CT
computed tomography
DEN
direct endoscopic necrosectomy
DPDS
disconnected pancreatic duct syndrome
ERCP
endoscopic retrograde cholangiopancreatography
EUS
endoscopic ultrasound
FNA
fine needle aspiration
HU
Hounsfield units
PEN
percutaneous endoscopic necrosectomy
SEMS
self-expanding metal stent
TPN
total parenteral nutrition
WON
walled of necrosis
VARD
video-assisted retroperitoneal debridement
\n',keywords:"necrotizing pancreatitis, pancreatic necrosis, percutaneous, endoscopic, pancreatectomy, necrosectomy",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/75173.pdf",chapterXML:"https://mts.intechopen.com/source/xml/75173.xml",downloadPdfUrl:"/chapter/pdf-download/75173",previewPdfUrl:"/chapter/pdf-preview/75173",totalDownloads:212,totalViews:0,totalCrossrefCites:0,totalDimensionsCites:0,totalAltmetricsMentions:0,impactScore:0,impactScorePercentile:42,impactScoreQuartile:2,hasAltmetrics:0,dateSubmitted:"December 21st 2020",dateReviewed:"January 15th 2021",datePrePublished:"March 26th 2021",datePublished:"February 2nd 2022",dateFinished:"February 10th 2021",readingETA:"0",abstract:"Pancreatic necrosis is a highly morbid condition. It is most commonly associated with severe, acute pancreatitis, but can also be caused by trauma or chronic pancreatitis. Once diagnosed, management of pancreatic necrosis begins with supportive care, with an emphasis on early, and preferably, enteral nutrition. Intervention for necrosis, sterile or infected, is dictated by patient symptoms and response to conservative management. When possible, intervention should be delayed to allow the necrotic collection to form a capsule. First-line treatment for necrosis is with percutaneous drainage or endoscopic, transmural drainage. These strategies can be effective as monotherapy, but the need for repeated interventions, or for progression to more invasive interventions, is not uncommon. Necrosectomy may be performed using a previously established drainage tract, as in percutaneous endoscopic necrosectomy (PEN), video-assisted retroperitoneal debridement (VARD), and direct endoscopic necrosectomy (DEN). Although outcomes for these minimally-invasive techniques are better than for traditional necrosectomy, both laparoscopic and open techniques remain important for patients with extensive disease that cannot otherwise be adequately treated. This is especially true when pancreatic necrosis is complicated by disconnected pancreatic duct syndrome (DPDS), where necrosectomy remains standard of care.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/75173",risUrl:"/chapter/ris/75173",book:{id:"10318",slug:"recent-advances-in-pancreatitis"},signatures:"Dane Thompson, Siavash Bolourani and Matthew Giangola",authors:[{id:"333359",title:"Assistant Prof.",name:"Matthew",middleName:null,surname:"Giangola",fullName:"Matthew Giangola",slug:"matthew-giangola",email:"mgiangola@northwell.edu",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"333361",title:"Dr.",name:"Dane",middleName:null,surname:"Thompson",fullName:"Dane Thompson",slug:"dane-thompson",email:"dthompso10@northwell.edu",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"Northwell Health",institutionURL:null,country:{name:"United States of America"}}},{id:"344980",title:"Dr.",name:"Siavash",middleName:null,surname:"Bolourani",fullName:"Siavash Bolourani",slug:"siavash-bolourani",email:"sbolourani@northwell.edu",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"Northwell Health",institutionURL:null,country:{name:"United States of America"}}}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Diagnosis and conservative management",level:"1"},{id:"sec_3",title:"3. Percutaneous and endoscopic interventions",level:"1"},{id:"sec_4",title:"4. General considerations for surgical management",level:"1"},{id:"sec_5",title:"5. Minimally-invasive necrosectomy",level:"1"},{id:"sec_6",title:"6. Transgastric necrosectomy",level:"1"},{id:"sec_7",title:"7. Laparoscopic and open necrosectomy",level:"1"},{id:"sec_8",title:"8. Disconnected pancreatic duct syndrome",level:"1"},{id:"sec_9",title:"9. Conclusions",level:"1"},{id:"sec_10",title:"Acknowledgments",level:"1"},{id:"sec_13",title:"Conflict of interest",level:"1"},{id:"sec_10",title:"Notes/thanks/other declarations",level:"1"},{id:"sec_11",title:"Appendices and nomenclature",level:"1"}],chapterReferences:[{id:"B1",body:'Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, et al. 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Pancreatol Off J Int Assoc Pancreatol IAP Al 2020;20:1035-44. https://doi.org/10.1016/j.pan.2020.07.402'},{id:"B56",body:'Sandrasegaran K, Tann M, Jennings SG, Maglinte DD, Peter SD, Sherman S, et al. Disconnection of the pancreatic duct: an important but overlooked complication of severe acute pancreatitis. Radiogr Rev Publ Radiol Soc N Am Inc 2007;27:1389-400. https://doi.org/10.1148/rg.275065163'},{id:"B57",body:'Nealon WH, Bhutani M, Riall TS, Raju G, Ozkan O, Neilan R. A unifying concept: pancreatic ductal anatomy both predicts and determines the major complications resulting from pancreatitis. J Am Coll Surg 2009;208:790-9; discussion 799-801. https://doi.org/10.1016/j.jamcollsurg.2008.12.027'},{id:"B58",body:'Larsen M, Kozarek RA. Management of Disconnected Pancreatic Duct Syndrome. Curr Treat Options Gastroenterol 2016;14:348-59. https://doi.org/10.1007/s11938-016-0098-7'},{id:"B59",body:'Irani S, Gluck M, Ross A, Gan SI, Crane R, Brandabur JJ, et al. Resolving external pancreatic fistulas in patients with disconnected pancreatic duct syndrome: using rendezvous techniques to avoid surgery (with video). Gastrointest Endosc 2012;76:586-593.e1-3. https://doi.org/10.1016/j.gie.2012.05.006'},{id:"B60",body:'Varadarajulu S, Noone TC, Tutuian R, Hawes RH, Cotton PB. Predictors of outcome in pancreatic duct disruption managed by endoscopic transpapillary stent placement. Gastrointest Endosc 2005;61:568-75. https://doi.org/10.1016/s0016-5107(04)02832-9'},{id:"B61",body:'Bang JY, Wilcox CM, Navaneethan U, Hasan MK, Peter S, Christein J, et al. Impact of Disconnected Pancreatic Duct Syndrome on the Endoscopic Management of Pancreatic Fluid Collections. Ann Surg 2018;267:561-8. https://doi.org/10.1097/SLA.0000000000002082'},{id:"B62",body:'Nadkarni NA, Kotwal V, Sarr MG, Swaroop Vege S. Disconnected Pancreatic Duct Syndrome: Endoscopic Stent or Surgeon’s Knife? Pancreas 2015;44:16-22. https://doi.org/10.1097/MPA.0000000000000216'},{id:"B63",body:'Howard TJ, Moore SA, Saxena R, Matthews DE, Schmidt CM, Wiebke EA. Pancreatic duct strictures are a common cause of recurrent pancreatitis after successful management of pancreatic necrosis. Surgery 2004;136:909-16. https://doi.org/10.1016/j.surg.2004.06.028'},{id:"B64",body:'van Dijk SM, Timmerhuis HC, Verdonk RC, Reijnders E, Bruno MJ, Fockens P, et al. Treatment of disrupted and disconnected pancreatic duct in necrotizing pancreatitis: A systematic review and meta-analysis. Pancreatol Off J Int Assoc Pancreatol IAP Al 2019;19:905-15. https://doi.org/10.1016/j.pan.2019.08.006'}],footnotes:[],contributors:[{corresp:null,contributorFullName:"Dane Thompson",address:null,affiliation:'
The Feinstein Institutes for Medical Research, Manhasset, United States
Elmezzi Graduate School of Molecular Medicine, Manhasset, United States
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, United States
Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra Northwell School of Medicine, Manhasset, United States
Department of Surgery, Donald and Barbara Zucker School of Medicine at Hofstra Northwell School of Medicine, Manhasset, United States
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1. Introduction
The under-five mortality rate (U5MR) represents children who die before reaching the age of 5 per 1000 live births [1]. The definition of live birth is a sign of life such as breathing, heartbeat, or voluntary muscular movements of the newborn after separation from the mother, regardless of the gestational age [2]. The majority of these deaths occur by preventable or treatable diseases, especially in low- and middle-income countries (LMICs). The most common causes of death under 5 years old are acute respiratory infections, diarrhea, malaria, and birth complications [3]. Underlying problems are also critical in U5MR. Malnutrition is the leading cause of about 45% of all childhood deaths [4].
The World Bank divides the world’s economies into four groups according to their income status: low-income, lower-middle-income, upper-middle-income, and high-income countries. The classification is made annually based on the gross national income (GNI) per capita in US dollars (USD) of the preceding year. According to the current data for 2021, countries with a GNI per capita of less than 1046 USD are classified as low-income countries, and those with less than 12,695 USD are classified as middle-income countries [5].
Child mortality under the age of 5 consists of several subgroups. These are neonatal mortality (birth—the first month of life), infant mortality (birth—the first year of life), and child mortality (1–5 years). Looking at the U5MR in each subgroup, it is observed that the neonatal group has the highest risk. Among this population, the youngest has the highest mortality rate. A review showed that approximately one-third of all neonatal deaths occur within the first day after birth, and nearly three-fourths occur within the first week of life [6].
Data from the last three decades show that the fastest decline in U5MR occurred between 2000 and 2009. Globally, the annual rate of reduction (ARR) was 1.9 percent in 1990–1999, 4.0 percent in 2000–2009, and 3.4 percent in 2010–2019. While 1 out of every 11 children could not see their 5th birthday in the 1990s, this number dropped to 1 in 27 in 2019. In 34 LMICs, U5MR was reduced by more than two-thirds between 1990 and 2019 [7].
Although there was a similar decrease in neonatal mortality rates (NMR), it was slower than the decline in child mortality rates between 1 and 59 months. Between 1990 and 2019, the average ARR for child mortality in the first 1–59 months was 3.6 percent, compared to only 2.5 percent in the neonatal period. As a result of these rates, deaths in children under 5 years of age began to concentrate in the neonatal period. While the ratio of newborn deaths to all childhood deaths under 5 was 40 percent in 1990, this rate increased to 47 percent in 2019 (Figure 1) [7].
Figure 1.
Distribution of global under-five deaths by age, 1990–2019 [7].
The U5MR is a good indicator of the healthcare system and general social-economic development. The reasons are as follows:
First, these data precede results, not inputs. For example, the number of doctors and nurses per child is an input, it is related to child health, but positive/negative inputs do not necessarily mean that outcomes will be positive/negative. The U5MR clearly shows the extent to which these inputs achieve their goal.
The U5MR is closely related to some negative socio-economic factors (malnutrition, low immunization rates, poor maternal health, and education). Therefore, it is a strong indicator of inequality and systemic health problems.
At the same time, as many of these deaths are preventable, the rate reflects better than any other measure the lack of access to critical and essential quality health care, including family planning, antenatal and postnatal services, and disease prevention and case management.
For these and similar reasons, many global initiatives, mainly the United Nations Global Strategy for Women’s Children’s and Adolescents’ Health (2016–2030) [8] and the Sustainable Development Goals (SDG) [9], have set child survival goals to improve the U5MR.
In this chapter, we aim to examine the causes of death under the age of 5 and the methods of prevention.
2. Causes
In LMICs, maternal and neonatal diseases, respiratory infections and tuberculosis, enteric and other infections, and malaria are the leading causes of under-five mortality. While in high-income countries, complex neonatal conditions such as prematurity top the list of causes of under-five mortality, in LMICs, infectious diseases still rank high among causes of death.
2.1 Maternal and neonatal disease
Since the decline in NMR has not been achieved to a similar extent as in U5MR, the rate of deaths due to maternal and neonatal diseases among under-five mortality has increased recently, especially in high-income countries. In one study, the two most common causes of death in the neonatal period in LMICs were perinatal asphyxia and severe infections such as sepsis, meningitis, and pneumonia [10]. Approximately 23% of the 2.5 million annual infant deaths in the neonatal period are related to infections [7]. Deaths are due to complications associated with prematurity account for about one-fifth of neonatal deaths in these countries. These three causes account for 90% of total neonatal deaths in LMICs [11].
2.2 Respiratory infections and tuberculosis
Despite improvements in living conditions and increases in vaccination rates, respiratory infections are the leading cause of under-five death after neonatal diseases in LMICs. It is estimated that approximately 100 million pneumonia episodes occur annually under 5 [12]. With the increase in Pneumococcal conjugate and Haemophilus influenza type b vaccination, changes in the etiology of pneumonia have occurred recently. Among bacterial pathogens, non-type b Haemophilus influenza and Staphylococcus aureus are more common, whereas RSV stands out among viral pathogens. Although less common, CMV pneumonia can be fatal in HIV-infected and immunosuppressed patients [12].
Within this group of diseases, tuberculosis occupies a special place in LMICs. About a quarter of the world’s population is infected with Mycobacterium tuberculosis, which is not always easy to treat with its extrapulmonary involvement and resistant strains [13]. About half of all people with tuberculosis live in eight countries: Bangladesh, China, India, Indonesia, Nigeria, Pakistan, Philippines, and South Africa [14]. In 2019, there were a total of 50,000 deaths due to tuberculosis in children under 5 years of age [15].
2.3 Enteric infections
Enteral infections are the leading cause of death in children under 5 years among all infections, causing 1.5–2 million deaths per year [16, 17]. In LMICs, there are six episodes of diarrhea per year in infants and three episodes per year in children [18]. Rotavirus, Cryptosporidium, Shigella, and enterotoxigenic Escherichia coli (ETEC) are the most common pathogens observed in the moderate and severe diarrheal disease under 5 years of age in LMICs [19]. In the past, severe dehydration and fluid loss were the main causes of death from diarrhea. Other causes, such as septic bacterial infections, are now increasingly responsible for all diarrheal deaths [20].
2.4 Malaria
Infection with Plasmodium falciparum potentially is fatal and most commonly manifests as a nonspecific febrile illness often without localizing signs. About 635,000 deaths from malaria occurred in LMICs in 2019, of which more than 50% were children under 5 years of age [14]. Moreover, malaria in pregnancy leads to fetal growth retardation, low birth weight, and later malaria infection in the infant, which increases neonatal mortality [21, 22]. In sub-Saharan Africa, a region at high risk of malaria, peripheral malaria is detected in the blood of about half of pregnant women during antenatal care [23].
In addition to these main causes, some factors increase the frequency and treatability or mortality of these diseases. The Covid-19 pandemic, which has been ongoing for about two years, has placed a heavy burden on the health care system. A survey by UNICEF conducted in 77 countries shows that almost 68 percent of countries reported slight reductions in health checks and immunizations for children. In addition, 63 percent of countries reported interruptions in antenatal checkups and 59 percent in postnatal care [24]. In regions with a high burden of HIV, malaria, and tuberculosis, the Covid-19 pandemic may increase HIV-related deaths by 10%, tuberculosis-related deaths by 20%, and malaria-related deaths by up to 36% over 5 years [7].
Some other exacerbating underlying factors include food insecurity, inadequate feeding practices, household air pollution, lack of hygiene, and access to safe water or adequate sanitation.
3. Trends in under-five mortality
While the U5MR was about 85 per 1000 live births worldwide in 1990, it dropped to 38 per 1000 live births by 2019, a decline of over 50%. According to 2019 data, the global NMR was 17 per 1000 live births. While this rate was 11 per 1000 for children aged 1 month to 1 year, it was 10 per 1000 for children aged 1–5 years. The gap between the highest and lowest regional U5MR narrowed from 171 deaths per 1000 live births in 1990 to 73 in 2019. In 1990, the number of countries with a mortality rate above 100 per 1000 live births was over 50, while this number has dropped to 5 in 2019. Variation in NMR and U5MR in LMICs by year is shown in Figures 2–5.
Figure 2.
Number of under-5 deaths between 1990 and 2019. Data were obtained from the healthdata.org website.
Figure 3.
U5MR between 1990 and 2019. Data were obtained from the healthdata.org website.
Figure 4.
Number of neonatal deaths between 1990 and 2019. Data were obtained from the healthdata.org website.
Figure 5.
NMR between 1990 and 2019. Data were obtained from the healthdata.org website.
Despite these developments, U5MR in low-income countries remains high. These countries are all located in sub-Saharan Africa. In sub-Saharan Africa, the region with the highest U5MR, one in 13 children does not reach the age of five. This rate is 15–20 times higher than in developed countries. Of the 37 countries in this region, 31 have a high mortality rate (U5MR above 50 per 1000 live births). Although sub-Saharan Africa and Central and South Asia account for about 50% of children under 5, 80% of all under 5 deaths in 2019. On a country basis, nearly half of under-five deaths in 2019 occurred in five countries: Nigeria, India, Pakistan, the Democratic Republic of the Congo and, Ethiopia. Nigeria and India alone account for nearly a third. The alteration of mortality rates by regions over time is shown in Figure 6.
Figure 6.
U5MR (deaths per 1000 live births) by regions, 1990, 2000, and 2019 [7].
When evaluating neonatal mortality, sub-Saharan Africa has the highest rate in 2019 (27 per 1000), followed by Central and South Asia (24 per 1000). Nearly 80% of neonatal deaths in 2019 occurred in these two regions. From 1990 to 2019, sub-Saharan Africa was the only SDG region without a decline in neonatal mortality due to the relatively low decrease in NMR and increase in the birth rate. In this period, newborn deaths did not decline in 21 of 48 countries in sub-Saharan Africa, and the total number of newborn deaths remained stable at about 1 million per year.
The difference between the sexes has tended to narrow over time in under-five mortality. In general, the risk of death is higher for boys under the age of 5 than for girls. However, due to regional risks, the mortality rate of girls is much higher than expected in some countries. These countries are located in the South and West Asia. After 1990, there were similar developments in this area, and the number of countries with higher than expected girl mortality dropped from 25 to 7.
The SDG aims to finish under-five mortality from preventable causes by reducing the NMR to 12 and below per 1000 live births and the U5MR to 25 and below per 1000 live births by 2030. If the current trend in under-five mortality continues, 27 percent of the 195 countries evaluated in the latest UNICEF report will not meet the SDG target. Achieving the 2030 target requires high-level efforts and a focus on child mortality in the remaining 53 countries. All these countries are in the status of LMICs. In light of current data, it is estimated that 48 million children under the age of 5 will die between 2020 and 2030. Nearly 80% of these deaths are expected to occur in sub-Saharan Africa and Central and South Asia, where almost all of the countries they host are LMICs. Moreover, if current trends continue, it does not seem possible for nearly 90% of sub-Saharan African countries to reach the neonatal mortality target of the SDG [7].
4. Prevention
Access to life-saving interventions is at the forefront of consistently reducing mortality in LMICs. Examining the main causes of under-five deaths in these countries, it is observed that care during and after birth, vaccinations, and preventive and therapeutic services in early childhood play a crucial role [25]. An analysis conducted in 118 LMICs found that disrupting access to basic life-saving interventions could cause millions of under-five deaths in as little as six months [26]. We can consider protective interventions under several headings:
4.1 Perinatal care
Due to the increase in the birth rate and the dependence of mother-infant life on basic life-saving interventions, prenatal, natal and postnatal care is a priority issue in LMICs. At this point, comprehensive prenatal care, skilled and rapid care during childbirth, regular postnatal care for mother and child, and high-quality and adequate care for premature and sick newborns should be the goal. For reasons other than congenital anomalies causing one in 10 neonatal deaths [27], the following precautions should be taken:
Home visits during pregnancy can play an active role in reducing NMR. A large-scale study in India has shown that antenatal care provided by Accredited Social Health Activists significantly reduces infant mortality rates under 1-year-old [28]. All pregnant women should be visited by experienced teams at least four times during pregnancy, including one visit in the first trimester. At these visits, preeclampsia and eclampsia can be diagnosed and treatment initiated in appropriate cases. In addition, these visits provide an opportunity to start folic acid and iron supplements that improve fetal health and to test for HIV, which is at risk of transmission from mother to fetus. Home visits can also help ensure that adequate precautions are taken in areas where malaria is common. Tetanus vaccinations recommended during pregnancy can be given during these visits. Finally, these visits can encourage pregnant women to deliver in the hospital and provide information about birth complications and nutrition.
Facility-based delivery should be provided to all pregnant women and, expectant mothers should be encouraged in this regard. Basic hygiene rules such as hand washing, sterile cord-cutting, and cord care should be followed in these facilities. To achieve this, using clean delivery kits (CDK) should be expanded for both home and facility deliveries. The use of CDK containing soap, gloves, cord ties, and other sterile equipment has been shown to reduce neonatal mortality and neonatal tetanus in studies in LMIC countries [29, 30, 31]. Drugs (oxytocin, etc.) and materials (partograph, etc.) used in the active management of labor should also be available. In communities where access to facilities is not possible, the number of staff with basic emergency obstetric and newborn care (BEmONC) training should be increased. However, a fast and safe referral and transport system should be ready in case of complications where the capabilities and knowledge of these staff may be inadequate. The purpose of this transportation is to transport the patient to facilities where comprehensive emergency obstetric and newborn care (CEmONC) can be provided.
In the postnatal period, attention should be paid to hypothermia and allow the mother to feed her baby within the first hour of life. It should be ensured that the mother and newborn stay in the facility for the first 24 hours, and an early postnatal visit should be scheduled to recognize the danger signs. In cases of suspected or proven infection, neonates should be treated with antibiotics, and newborns at risk should be followed up in neonatal intensive care units with adequate personnel and equipment.
4.2 Vaccination and medication
Vaccination is an essential component of primary health care and an indisputable human right. Also, it is the single most effective prevention method for reducing mortality in children under 5. The following vaccines are at the forefront of preventing early childhood deaths: measles, polio, diphtheria, tetanus and pertussis, Haemophilus influenza type B, pneumococcal, and rotavirus vaccines. Reaching large populations with effective community health programs is crucial for vaccination success. Despite significant advances in immunization, too many children worldwide—including around 20 million infants each year—do not have adequate access to vaccines [32].
Since it is more difficult to diagnose tuberculosis (TB) in childhood, prevention may be more feasible than cure. At this point, neonatal use of the BCG vaccine, which is still the only vaccine against tuberculosis, could be the solution. Neonatal administration of BCG has been associated with a lower prevalence of TB disease [33].
Access to antibiotics and antimalarial to treat diarrhea, malaria, and lower respiratory tract infections also contribute to reducing child mortality. In diarrhea, oral rehydration solution and zinc supplementation help reduce mortality.
4.3 Community-based prevention
Community health workers play a vital role in providing health care to underprivileged communities. Public health workers organize public education programs, especially in the field of preventive health services. The performance of these workers is critical to increasing vaccination and breastfeeding rates, disseminating malaria prophylaxis devices such as insecticide-treated bed nets, and improving hygiene behaviors.
Studies in rural areas of three LMICs found that proximity to health facilities was a significant risk factor for infant, child, and general under-five mortality [34, 35, 36]. Similarly, a meta-analysis found that a distance of over 5 km from the health facility can increase mortality by up to 60% in newborns and children under five years of age [37]. In these and similar situations, governments should eliminate inequality of opportunity among communities and ensure access to health services for all. For example, maternity waiting homes, initiated under the leadership of the World Health Organization (WHO), can be expanded for pregnant women with limited access to facilities.
The integrated management of childhood diseases, in collaboration with national and international organizations, will help to address regional and cross-national disparities and share experience and knowledge. Finally, it is essential to build a people-centered and high-quality health system to implement all these preventive measures. At the same time, families’ desire for medical care and behavior to seek medical help when their children are ill should be encouraged.
4.4 Nutrition education and management of malnutrition
Encouraging breastfeeding is a practical and cost-effective method of preventing early childhood deaths. However, about two out of three infants do not have access to exclusive breastfeeding for 6 months. Breast milk provides all the energy and nutrients a baby needs in the first months of life, and continues to meet at least one-third of the baby’s nutritional needs during the second half of the first year [38]. Breastfeeding not only improves the child’s nutrition but also protects the child from the dirty water used in food preparation and cleaning kitchen utensils. Vitamin A supplementation should be encouraged as it has been proven to reduce the risk of illness and death from measles and diarrhea. Access to clean water and ensuring hygiene will be particularly effective in reducing the incidence of diarrheal diseases. Screening for acute malnutrition allows early detection of cases with a risk for mortality.
5. Conclusion
The U5MR has been significantly reduced over the last 30 years through concerted action and resource allocation. The next goal of countries achieving the SDG targets should be to ensure the protection of children by eliminating inequalities that arise for reasons such as household income, race and ethnicity, and subnational division. While there are some developments in child health globally, 75% of countries failing to meet the SDG targets are found in sub-Saharan Africa clearly showing the inequality that children face in terms of their chances of survival due to birthplace. These inequalities are exacerbated in times of crisis, such as the Covid-19 pandemic, and have an even more negative impact on vulnerable children [39]. Attention should be given to sub-Saharan Africa, where mortality rates are highest in all age groups and the population continues to grow, considering that 11 million children could be saved by 2030 if all countries achieve the SDG targets.
On the other hand, newborns, whose mortality rate is declining more slowly than other age groups and therefore continues to increase their share in the under-five mortality rate, also deserve special attention. Moreover, it is more difficult to reduce the number of deaths during this period due to the establishment of more advanced health care facilities and the need for quality health care services over a longer time, beginning with the antenatal period. In addition to these, it is necessary to provide adequate health services during childbirth and in the early postnatal period. These services, along with NMR, will also reduce maternal mortality rates, the risk of stillbirths, and disability.
When we look at under-five deaths as a whole, it is essential that evidence-based life-saving interventions are accessible and accepted in the community. In addition, the impact of contextual factors such as female empowerment, nutrition, and health system resources should not be ignored in achieving success.
Another issue that should not be ignored in child mortality is the reliability of the data. In resource-poor areas, deaths may not be reported, or the cause of death may not be identified. This information may not be made available to national authorities and international health organizations promptly. Therefore, there is a need for a high-level integrated database at local, national, regional, and global levels, especially for under-five mortality data.
In summary, ending preventable child deaths is only possible by improving access to well-equipped health care professionals during pregnancy and childbirth, life-saving interventions such as vaccinations, breastfeeding, and the provision of low-cost medicines, and access to water and sanitation, which are now lacking in low-income countries.
\n',keywords:"under-five mortality, neonatal mortality, low and middle-income countries, infections, perinatal mortality",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/79070.pdf",chapterXML:"https://mts.intechopen.com/source/xml/79070.xml",downloadPdfUrl:"/chapter/pdf-download/79070",previewPdfUrl:"/chapter/pdf-preview/79070",totalDownloads:46,totalViews:0,totalCrossrefCites:0,dateSubmitted:"September 6th 2021",dateReviewed:"September 19th 2021",datePrePublished:"December 20th 2021",datePublished:null,dateFinished:"October 20th 2021",readingETA:"0",abstract:"The under-five mortality rate (U5MR) represents children who die before reaching the age of 5 per 1000 live births. It is directly related to the development and economic income levels of countries. For this reason, high rates are observed in low- and middle-income countries (LMICs). The neonatal period deserves more attention as the decline in mortality rates has recently stalled. The most common causes of death under 5 years old are acute respiratory infections, diarrhea, malaria, and birth complications. Although neonatal disorders and birth complications have recently come to the fore, among these reasons, deaths due to infections are still high in LMICs. The crucial topics in prevention are perinatal care and vaccination. Apart from these, access to medicine, food, and clean water is essential in preventing deaths under 5. For preventive services to achieve their goal, these services must reach everyone. Ending preventable child deaths is only possible by improving access to well-equipped healthcare professionals during pregnancy and childbirth, life-saving interventions such as vaccinations, breastfeeding and the provision of low-cost medicines, and access to water and sanitation, which are now lacking in low-income countries.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/79070",risUrl:"/chapter/ris/79070",signatures:"Mehmet Tekin",book:{id:"11005",type:"book",title:"Mortality Rates in Middle and Low-Income Countries",subtitle:null,fullTitle:"Mortality Rates in Middle and Low-Income Countries",slug:null,publishedDate:null,bookSignature:"Dr. Umar Bacha",coverURL:"https://cdn.intechopen.com/books/images_new/11005.jpg",licenceType:"CC BY 3.0",editedByType:null,isbn:"978-1-83969-970-2",printIsbn:"978-1-83969-969-6",pdfIsbn:"978-1-83969-971-9",isAvailableForWebshopOrdering:!0,editors:[{id:"244265",title:"Dr.",name:"Umar",middleName:null,surname:"Bacha",slug:"umar-bacha",fullName:"Umar Bacha"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:null,sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Causes",level:"1"},{id:"sec_2_2",title:"2.1 Maternal and neonatal disease",level:"2"},{id:"sec_3_2",title:"2.2 Respiratory infections and tuberculosis",level:"2"},{id:"sec_4_2",title:"2.3 Enteric infections",level:"2"},{id:"sec_5_2",title:"2.4 Malaria",level:"2"},{id:"sec_7",title:"3. Trends in under-five mortality",level:"1"},{id:"sec_8",title:"4. Prevention",level:"1"},{id:"sec_8_2",title:"4.1 Perinatal care",level:"2"},{id:"sec_9_2",title:"4.2 Vaccination and medication",level:"2"},{id:"sec_10_2",title:"4.3 Community-based prevention",level:"2"},{id:"sec_11_2",title:"4.4 Nutrition education and management of malnutrition",level:"2"},{id:"sec_13",title:"5. Conclusion",level:"1"}],chapterReferences:[{id:"B1",body:'Black RE, Laxminarayan R, Temmerman M, et al. Reproductive, Maternal, Newborn, and Child Health: Disease Control Priorities. Third ed. Vol. 2. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2016 Chapter 1'},{id:"B2",body:'Sullivan, J. and N. K. Tureeva. INFANT AND CHILD MORTALITY. Uzbekistan Health Examination Survey 2002. Calverton, Maryland, USA: Analytical and Information Center, State Department of Statistics, and ORC Macro; 2004'},{id:"B3",body:'GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1736-1788'},{id:"B4",body:'United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO). Countdown to 2030: Tracking Progress towards Universal Coverage for Reproductive, Newborn and Child Health: The 2017 Report. Washington, DC: UNICEF and WHO; 2017'},{id:"B5",body:'https://blogs.worldbank.org/opendata/new-world-bank-country-classifications-income-level-2021-2022'},{id:"B6",body:'Jeeva SM et al. When Do Newborns Die? A systematic review of timing of overall and cause-specific neonatal deaths in developing countries. Journal of Perinatology. 2016;36(1):1-11'},{id:"B7",body:'United Nations Inter-agency Group for Child Mortality Estimation (UN IGME). Levels & Trends in Child Mortality: Report 2019, Estimates Developed by the United Nations Inter-agency Group for Child Mortality Estimation. New York, NY: United Nations Children’s Fund; 2019'},{id:"B8",body:'https://www.everywomaneverychild.org/wp-content/uploads/2017/10/EWEC_GSUpdate_Full_EN_2017_web-1.pdf'},{id:"B9",body:'http://sustainabledevelopment.un.org/'},{id:"B10",body:'Usman F, Imam A, Farouk ZL, Dayyabu AL. Newborn mortality in sub-Saharan Africa: Why is perinatal asphyxia still a major cause? Annals of Global Health. 2019;85:112'},{id:"B11",body:'Alliance for Maternal and Newborn Health Improvement (AMANHI) mortality study group. Population-based rates, timing, and causes of maternal deaths, stillbirths, and neonatal deaths in south Asia and sub-Saharan Africa: A multi-country prospective cohort study. The Lancet Global Health. 2018;6(12):1297-1308'},{id:"B12",body:'Marangu D, Zar HJ. Childhood pneumonia in low-and-middle-income countries: An update. Paediatric Respiratory Reviews. 2019;32:3-9'},{id:"B13",body:'Global tuberculosis report 2020. Geneva: World Health Organization; 2020.'},{id:"B14",body:'https://www.who.int/health-topics/tuberculosis'},{id:"B15",body:'http://ghdx.healthdata.org/gbd-results-tool'},{id:"B16",body:'Bryce J, Boschi-Pinto C, Shibuya K, Black RE, WHO Child Health Epidemiology Reference Group. WHO estimates of the causes of death in children. Lancet. 2005;365(9465):1147-1152'},{id:"B17",body:'Boschi-Pinto C, Velebit L, Shibuya K. Estimating child mortality due to diarrhoea in developing countries. Bulletin of the World Health Organization. 2008;86(9):710-717'},{id:"B18",body:'Kosek M, Bern C, Guerrant RL. The global burden of diarrhoeal disease, as estimated from studies published between 1992 and 2000. Bulletin of the World Health Organization. 2003;81(3):197-204'},{id:"B19",body:'Kotloff KL, Nataro JP, Blackwelder WC, et al. Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, GEMS): a prospective, case-control study. Lancet. 2013;382(9888):209-222'},{id:"B20",body:'https://www.who.int/health-topics/breastfeeding'},{id:"B21",body:'Guyatt HL, Snow RW. Impact of malaria during pregnancy on low birth weight in sub-Saharan Africa. Clinical Microbiology Reviews. 2004;17(4):760-769'},{id:"B22",body:'Le Port A, Cottrell G, Martin-Prevel Y, et al. First malaria infections in a cohort of infants in Benin: biological, environmental and genetic determinants. Description of the study site, population methods and preliminary results. BMJ Open. 2012;2(2):e000342'},{id:"B23",body:'Bauserman M, Conroy AL, North K, et al. An overview of malaria in pregnancy. Seminars in Perinatology. 2019;43(5):282-290'},{id:"B24",body:'https://data.unicef.org/resources/levels-and-trends-in-child-mortality/'},{id:"B25",body:'MCEE-WHO methods and data sources for child causes of death 2000-2017. Geneva: World Health Organization; 2018'},{id:"B26",body:'Roberton T et al. Early estimates of the indirect effects of the COVID- 19 pandemic on maternal and child mortality in low-income and middle- income countries: A modelling study. The Lancet Global Health. July 2020;8:E901-E908'},{id:"B27",body:'https://www.who.int/news-room/fact-sheets/detail/congenital-anomalies'},{id:"B28",body:'Nadella P, Subramanian SV, Roman-Urrestarazu A. The impact of community health workers on antenatal and infant health in India: A cross-sectional study. SSM-Population Health. 2021;15:100872'},{id:"B29",body:'Park JH, Hamer DH, Mbewe R, et al. Components of clean delivery kits and newborn mortality in the Zambia Chlorhexidine Application Trial (ZamCAT): An observational study. PLoS Medicine. 2021;18(5):e1003610'},{id:"B30",body:'Raza SA, Avan BI. Disposable clean delivery kits and prevention of neonatal tetanus in the presence of skilled birth attendants. International Journal of Gynaecology and Obstetrics. 2013;120(2):148-151'},{id:"B31",body:'Seward N, Osrin D, Li L, Costello A, Pulkki-Brannstrom AM, Houweling TAJ, et al. Association between clean delivery kit use, clean delivery practices, and neonatal survival: Pooled analysis of data from three sites in South Asia. PLoS Medicine. 2012;9(2):e1001180'},{id:"B32",body:'https://www.who.int/health-topics/vaccines-and-immunization'},{id:"B33",body:'Mangtani P, Abubakar I, Ariti C, et al. Protection by BCG vaccine against tuberculosis: A systematic review of randomized controlled trials. Clinical Infectious Diseases. 2014;58:470-480'},{id:"B34",body:'Schoeps A, Gabrysch S, Niamba L, et al. The effect of distance to health-care facilities on childhood mortality in rural Burkina Faso. American Journal of Epidemiology. 2011;173(5):492-498'},{id:"B35",body:'Okwaraji YB, Edmond KM. Proximity to health services and child survival in low- and middle-income countries: A systematic review and meta-analysis. BMJ Open. 2012;2(e001196):1-9'},{id:"B36",body:'Karra M, Fink G, Canning D. Facility distance and child mortality: A multicountry study of health facility access, service utilization, and child health outcomes. International Journal of Epidemiology. 2017;46(3):817-826'},{id:"B37",body:'Rojas-Gualdrón D, Caicedo-Velázquez B. Distance from healthcare facilities and early life mortality: A systematic review and meta-analysis. Revista Facultad Nacional de Salud Pública. 2017;35(3):420-431'},{id:"B38",body:'https://www.who.int/health-topics/diarrhoea'},{id:"B39",body:'https://www.oecd.org/coronavirus/policy-responses/covid-19-crises-and-fragility/'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Mehmet Tekin",address:"dr.mehmettekin@gmail.com",affiliation:'
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The Open Access model is applied to all of our publications and is designed to eliminate subscriptions and pay-per-view fees. This approach ensures free, immediate access to full text versions of your research.
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The nanoparticles’ unique physical and chemical properties render them most appropriate for a number of specialist applications.",book:{id:"9109",slug:"engineered-nanomaterials-health-and-safety",title:"Engineered Nanomaterials",fullTitle:"Engineered Nanomaterials - Health and Safety"},signatures:"Takalani Cele",authors:[{id:"305934",title:"Dr.",name:"Takalani",middleName:null,surname:"Cele",slug:"takalani-cele",fullName:"Takalani Cele"}]},{id:"72636",title:"Nanocomposite Materials",slug:"nanocomposite-materials",totalDownloads:2139,totalCrossrefCites:5,totalDimensionsCites:11,abstract:"Nanocomposites are the heterogeneous/hybrid materials that are produced by the mixtures of polymers with inorganic solids (clays to oxides) at the nanometric scale. Their structures are found to be more complicated than that of microcomposites. They are highly influenced by the structure, composition, interfacial interactions, and components of individual property. Most popularly, nanocomposites are prepared by the process within in situ growth and polymerization of biopolymer and inorganic matrix. With the rapid estimated demand of these striking potentially advanced materials, make them very much useful in various industries ranging from small scale to large to very large manufacturing units. With a great deal to mankind with environmental friendly, these offer advanced technologies in addition to the enhanced business opportunities to several industrial sectors like automobile, construction, electronics and electrical, food packaging, and technology transfer.",book:{id:"10072",slug:"nanotechnology-and-the-environment",title:"Nanotechnology and the Environment",fullTitle:"Nanotechnology and the Environment"},signatures:"Mousumi Sen",authors:[{id:"310218",title:"Dr.",name:"Mousumi",middleName:null,surname:"Sen",slug:"mousumi-sen",fullName:"Mousumi Sen"}]},{id:"38951",title:"Carbon Nanotube Transparent Electrode",slug:"carbon-nanotube-transparent-electrode",totalDownloads:3985,totalCrossrefCites:3,totalDimensionsCites:5,abstract:null,book:{id:"3077",slug:"syntheses-and-applications-of-carbon-nanotubes-and-their-composites",title:"Syntheses and Applications of Carbon Nanotubes and Their Composites",fullTitle:"Syntheses and Applications of Carbon Nanotubes and Their Composites"},signatures:"Jing Sun and Ranran Wang",authors:[{id:"153508",title:"Prof.",name:"Jing",middleName:null,surname:"Sun",slug:"jing-sun",fullName:"Jing Sun"},{id:"153596",title:"Ms.",name:"Ranran",middleName:null,surname:"Wang",slug:"ranran-wang",fullName:"Ranran Wang"}]},{id:"49413",title:"Electrodeposition of Nanostructure Materials",slug:"electrodeposition-of-nanostructure-materials",totalDownloads:3732,totalCrossrefCites:1,totalDimensionsCites:7,abstract:"We are conducting a multi-disciplinary research work that involves development of nanostructured thin films of semiconductors for different applications. Nanotechnology is widely considered to constitute the basis of the next technological revolution, following on from the first Industrial Revolution, which began around 1750 with the introduction of the steam engine and steelmaking. Nanotechnology is defined as the design, characterization, production, and application of materials, devices and systems by controlling shape and size of the nanoscale. The nanoscale itself is at present considered to cover the range from 1 to 100 nm. All samples prepared in thin film forms and the characterization revealed their nanostructure. The major exploitation of thin films has been in microelectronics, there are numerous and growing applications in communications, optical electronics, coatings of all kinds, and in energy generation. A great many sophisticated analytical instruments and techniques, largely developed to characterize thin films, have already become indispensable in virtually every scientific endeavor irrespective of discipline. Among all these techniques, electrodeposition is the most suitable technique for nanostructured thin films from aqueous solution served as samples under investigation. The electrodeposition of metallic layers from aqueous solution is based on the discharge of metal ions present in the electrolyte at a cathodic surface (the substrate or component.) The metal ions accept an electron from the electrically conducting material at the solid- electrolyte interface and then deposit as metal atoms onto the surface. The electrons necessary for this to occur are either supplied from an externally applied potential source or are surrendered by a reducing agent present in solution (electroless reduction). The metal ions themselves derive either from metal salts added to solution, or by the anodic dissolution of the so-called sacrificial anodes, made of the same metal that is to be deposited at the cathode.",book:{id:"4718",slug:"electroplating-of-nanostructures",title:"Electroplating of Nanostructures",fullTitle:"Electroplating of Nanostructures"},signatures:"Souad A. M. Al-Bat’hi",authors:[{id:"174793",title:"Dr.",name:"Mohamad",middleName:null,surname:"Souad",slug:"mohamad-souad",fullName:"Mohamad Souad"}]},{id:"71346",title:"Application of Nanomaterials in Environmental Improvement",slug:"application-of-nanomaterials-in-environmental-improvement",totalDownloads:1691,totalCrossrefCites:0,totalDimensionsCites:13,abstract:"In recent years, researchers used many scientific studies to improve modern technologies in the field of reducing the phenomenon of pollution resulting from them. In this chapter, methods to prepare nanomaterials are described, and the main properties such as mechanical, electrical, and optical properties and their relations are determined. The investigation of nanomaterials needed high technologies that depend on a range of nanomaterials from 1 to 100 nm; these are scanning electron microscopy (SEM), transmission electron microscopy (TEM), and X-ray diffractions (XRD). The applications of nanomaterials in environmental improvement are different from one another depending on the type of devices used, for example, solar cells for producing clean energy, nanotechnologies in coatings for building exterior surfaces, and sonochemical decolorization of dyes by the effect of nanocomposite.",book:{id:"10072",slug:"nanotechnology-and-the-environment",title:"Nanotechnology and the Environment",fullTitle:"Nanotechnology and the Environment"},signatures:"Ali Salman Ali",authors:[{id:"313275",title:"Associate Prof.",name:"Ali",middleName:null,surname:"Salman",slug:"ali-salman",fullName:"Ali Salman"}]}],onlineFirstChaptersFilter:{topicId:"208",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"81438",title:"Research Progress of Ionic Thermoelectric Materials for Energy Harvesting",slug:"research-progress-of-ionic-thermoelectric-materials-for-energy-harvesting",totalDownloads:24,totalDimensionsCites:0,doi:"10.5772/intechopen.101771",abstract:"Thermoelectric material is a kind of functional material that can mutually convert heat energy and electric energy. It can convert low-grade heat energy (less than 130°C) into electric energy. Compared with traditional electronic thermoelectric materials, ionic thermoelectric materials have higher performance. The Seebeck coefficient can generate 2–3 orders of magnitude higher ionic thermoelectric potential than electronic thermoelectric materials, so it has good application prospects in small thermoelectric generators and solar power generation. According to the thermoelectric conversion mechanism, ionic thermoelectric materials can be divided into ionic thermoelectric materials based on the Soret effect and thermocouple effect. They are widely used in pyrogen batteries and ionic thermoelectric capacitors. The latest two types of ionic thermoelectric materials are in this article. The research progress is explained, and the problems and challenges of ionic thermoelectric materials and the future development direction are also put forward.",book:{id:"10037",title:"Thermoelectricity - Recent Advances, New Perspectives and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/10037.jpg"},signatures:"Jianwei Zhang, Ying Xiao, Bowei Lei, Gengyuan Liang and Wenshu Zhao"},{id:"77670",title:"Thermoelectric Elements with Negative Temperature Factor of Resistance",slug:"thermoelectric-elements-with-negative-temperature-factor-of-resistance",totalDownloads:72,totalDimensionsCites:0,doi:"10.5772/intechopen.98860",abstract:"The method of manufacturing of ceramic materials on the basis of ferrites of nickel and cobalt by synthesis and sintering in controllable regenerative atmosphere is presented. As the generator of regenerative atmosphere the method of conversion of carbonic gas is offered. Calculation of regenerative atmosphere for simultaneous sintering of ceramic ferrites of nickel and cobalt is carried out. It is offered, methods of the dilated nonequilibrium thermodynamics to view process of distribution of a charge and heat along a thermoelement branch. The model of a thermoelement taking into account various relaxation times of a charge and warmth is constructed.",book:{id:"10037",title:"Thermoelectricity - Recent Advances, New Perspectives and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/10037.jpg"},signatures:"Yuri Bokhan"},{id:"79236",title:"Processing Techniques with Heating Conditions for Multiferroic Systems of BiFeO3, BaTiO3, PbTiO3, CaTiO3 Thin Films",slug:"processing-techniques-with-heating-conditions-for-multiferroic-systems-of-bifeo3-batio3-pbtio3-catio",totalDownloads:96,totalDimensionsCites:0,doi:"10.5772/intechopen.101122",abstract:"In this chapter, we have report a list of synthesis methods (including both synthesis steps & heating conditions) used for thin film fabrication of perovskite ABO3 (BiFeO3, BaTiO3, PbTiO3 and CaTiO3) based multiferroics (in both single-phase and composite materials). The processing of high quality multiferroic thin film have some features like epitaxial strain, physical phenomenon at atomic-level, interfacial coupling parameters to enhance device performance. Since these multiferroic thin films have ME properties such as electrical (dielectric, magnetoelectric coefficient & MC) and magnetic (ferromagnetic, magnetic susceptibility etc.) are heat sensitive, i.e. ME response at low as well as higher temperature might to enhance the device performance respect with long range ordering. The magnetoelectric coupling between ferromagnetism and ferroelectricity in multiferroic becomes suitable in the application of spintronics, memory and logic devices, and microelectronic memory or piezoelectric devices. In comparison with bulk multiferroic, the fabrication of multiferroic thin film with different structural geometries on substrate has reducible clamping effect. A brief procedure for multiferroic thin film fabrication in terms of their thermal conditions (temperature for film processing and annealing for crystallization) are described. Each synthesis methods have its own characteristic phenomenon in terms of film thickness, defects formation, crack free film, density, chip size, easier steps and availability etc. been described. A brief study towards phase structure and ME coupling for each multiferroic system of BiFeO3, BaTiO3, PbTiO3 and CaTiO3 is shown.",book:{id:"10037",title:"Thermoelectricity - Recent Advances, New Perspectives and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/10037.jpg"},signatures:"Kuldeep Chand Verma and Manpreet Singh"},{id:"78034",title:"Quantum Physical Interpretation of Thermoelectric Properties of Ruthenate Pyrochlores",slug:"quantum-physical-interpretation-of-thermoelectric-properties-of-ruthenate-pyrochlores",totalDownloads:78,totalDimensionsCites:0,doi:"10.5772/intechopen.99260",abstract:"Lead- and lead-yttrium ruthenate pyrochlores were synthesized and investigated for Seebeck coefficients, electrical- and thermal conductivity. Compounds A2B2O6.5+z with 0 ≤ z < 0.5 were defect pyrochlores and p-type conductors. The thermoelectric data were analyzed using quantum physical models to identify scattering mechanisms underlying electrical (σ) and thermal conductivity (κ) and to understand the temperature dependence of the Seebeck effect (S). In the metal-like lead ruthenates with different Pb:Ru ratios, σ (T) and the electronic thermal conductivity κe (T) were governed by ‘electron impurity scattering’, the lattice thermal conductivity κL (T) by the 3-phonon resistive process (Umklapp scattering). In the lead-yttrium ruthenate solid solutions (Pb(2-x)YxRu2O(6.5±z)), a metal–insulator transition occurred at 0.2 moles of yttrium. On the metallic side (<0.2 moles Y) ‘electron impurity scattering’ prevailed. On the semiconductor/insulator side between x = 0.2 and x = 1.0 several mechanisms were equally likely. At x > 1.5 the Mott Variable Range Hopping mechanism was active. S (T) was discussed for Pb-Y-Ru pyrochlores in terms of the effect of minority carrier excitation at lower- and a broadening of the Fermi distribution at higher temperatures. The figures of merit of all of these pyrochlores were still small (≤7.3 × 10−3).",book:{id:"10037",title:"Thermoelectricity - Recent Advances, New Perspectives and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/10037.jpg"},signatures:"Sepideh Akhbarifar"},{id:"77635",title:"Optimization of Thermoelectric Properties Based on Rashba Spin Splitting",slug:"optimization-of-thermoelectric-properties-based-on-rashba-spin-splitting",totalDownloads:125,totalDimensionsCites:0,doi:"10.5772/intechopen.98788",abstract:"In recent years, the application of thermoelectricity has become more and more widespread. Thermoelectric materials provide a simple and environmentally friendly solution for the direct conversion of heat to electricity. The development of higher performance thermoelectric materials and their performance optimization have become more important. Generally, to improve the ZT value, electrical conductivity, Seebeck coefficient and thermal conductivity must be globally optimized as a whole object. However, due to the strong coupling among ZT parameters in many cases, it is very challenging to break the bottleneck of ZT optimization currently. Beyond the traditional optimization methods (such as inducing defects, varying temperature), the Rashba effect is expected to effectively increase the S2σ and decrease the κ, thus enhancing thermoelectric performance, which provides a new strategy to develop new-generation thermoelectric materials. Although the Rashba effect has great potential in enhancing thermoelectric performance, the underlying mechanism of Rashba-type thermoelectric materials needs further research. In addition, how to introduce Rashba spin splitting into current thermoelectric materials is also of great significance to the optimization of thermoelectricity.",book:{id:"10037",title:"Thermoelectricity - Recent Advances, New Perspectives and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/10037.jpg"},signatures:"Zhenzhen Qin"},{id:"75364",title:"Challenges in Improving Performance of Oxide Thermoelectrics Using Defect Engineering",slug:"challenges-in-improving-performance-of-oxide-thermoelectrics-using-defect-engineering",totalDownloads:214,totalDimensionsCites:0,doi:"10.5772/intechopen.96278",abstract:"Oxide thermoelectric materials are considered promising for high-temperature thermoelectric applications in terms of low cost, temperature stability, reversible reaction, and so on. Oxide materials have been intensively studied to suppress the defects and electronic charge carriers for many electronic device applications, but the studies with a high concentration of defects are limited. It desires to improve thermoelectric performance by enhancing its charge transport and lowering its lattice thermal conductivity. For this purpose, here, we modified the stoichiometry of cation and anion vacancies in two different systems to regulate the carrier concentration and explored their thermoelectric properties. Both cation and anion vacancies act as a donor of charge carriers and act as phonon scattering centers, decoupling the electrical conductivity and thermal conductivity.",book:{id:"10037",title:"Thermoelectricity - Recent Advances, New Perspectives and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/10037.jpg"},signatures:"Jamil Ur Rahman, Gul Rahman and Soonil Lee"}],onlineFirstChaptersTotal:6},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:87,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:98,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:27,numberOfPublishedChapters:287,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:9,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:139,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:0,numberOfUpcomingTopics:2,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!1},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:107,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:10,numberOfPublishedChapters:103,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:12,numberOfOpenTopics:2,numberOfUpcomingTopics:1,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:0,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!1},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:11,numberOfOpenTopics:4,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{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"}}}},{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"}}}}]},series:{item:{id:"10",title:"Physiology",doi:"10.5772/intechopen.72796",issn:"2631-8261",scope:"Modern physiology requires a comprehensive understanding of the integration of tissues and organs throughout the mammalian body, including the cooperation between structure and function at the cellular and molecular levels governed by gene and protein expression. While a daunting task, learning is facilitated by identifying common and effective signaling pathways mediated by a variety of factors employed by nature to preserve and sustain homeostatic life. \r\nAs a leading example, the cellular interaction between intracellular concentration of Ca+2 increases, and changes in plasma membrane potential is integral for coordinating blood flow, governing the exocytosis of neurotransmitters, and modulating gene expression and cell effector secretory functions. Furthermore, in this manner, understanding the systemic interaction between the cardiovascular and nervous systems has become more important than ever as human populations' life prolongation, aging and mechanisms of cellular oxidative signaling are utilised for sustaining life. \r\nAltogether, physiological research enables our identification of distinct and precise points of transition from health to the development of multimorbidity throughout the inevitable aging disorders (e.g., diabetes, hypertension, chronic kidney disease, heart failure, peptic ulcer, inflammatory bowel disease, age-related macular degeneration, cancer). With consideration of all organ systems (e.g., brain, heart, lung, gut, skeletal and smooth muscle, liver, pancreas, kidney, eye) and the interactions thereof, this Physiology Series will address the goals of resolving (1) Aging physiology and chronic disease progression (2) Examination of key cellular pathways as they relate to calcium, oxidative stress, and electrical signaling, and (3) how changes in plasma membrane produced by lipid peroxidation products can affect aging physiology, covering new research in the area of cell, human, plant and animal physiology.",coverUrl:"https://cdn.intechopen.com/series/covers/10.jpg",latestPublicationDate:"May 14th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:11,editor:{id:"35854",title:"Prof.",name:"Tomasz",middleName:null,surname:"Brzozowski",slug:"tomasz-brzozowski",fullName:"Tomasz Brzozowski",profilePictureURL:"https://mts.intechopen.com/storage/users/35854/images/system/35854.jpg",biography:"Prof. Dr. Thomas Brzozowski works as a professor of Human Physiology and is currently Chairman at the Department of Physiology and is V-Dean of the Medical Faculty at Jagiellonian University Medical College, Cracow, Poland. His primary area of interest is physiology and pathophysiology of the gastrointestinal (GI) tract, with the major focus on the mechanism of GI mucosal defense, protection, and ulcer healing. He was a postdoctoral NIH fellow at the University of California and the Gastroenterology VA Medical Center, Irvine, Long Beach, CA, USA, and at the Gastroenterology Clinics Erlangen-Nuremberg and Munster in Germany. He has published 290 original articles in some of the most prestigious scientific journals and seven book chapters on the pathophysiology of the GI tract, gastroprotection, ulcer healing, drug therapy of peptic ulcers, hormonal regulation of the gut, and inflammatory bowel disease.",institutionString:null,institution:{name:"Jagiellonian University",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:7,paginationItems:[{id:"10",title:"Animal Physiology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/10.jpg",editor:{id:"202192",title:"Dr.",name:"Catrin",middleName:null,surname:"Rutland",slug:"catrin-rutland",fullName:"Catrin Rutland",profilePictureURL:"https://mts.intechopen.com/storage/users/202192/images/system/202192.png",biography:"Catrin Rutland is an Associate Professor of Anatomy and Developmental Genetics at the University of Nottingham, UK. She obtained a BSc from the University of Derby, England, a master’s degree from Technische Universität München, Germany, and a Ph.D. from the University of Nottingham. She undertook a post-doctoral research fellowship in the School of Medicine before accepting tenure in Veterinary Medicine and Science. Dr. Rutland also obtained an MMedSci (Medical Education) and a Postgraduate Certificate in Higher Education (PGCHE). She is the author of more than sixty peer-reviewed journal articles, twelve books/book chapters, and more than 100 research abstracts in cardiovascular biology and oncology. She is a board member of the European Association of Veterinary Anatomists, Fellow of the Anatomical Society, and Senior Fellow of the Higher Education Academy. Dr. Rutland has also written popular science books for the public. https://orcid.org/0000-0002-2009-4898. www.nottingham.ac.uk/vet/people/catrin.rutland",institutionString:null,institution:{name:"University of Nottingham",institutionURL:null,country:{name:"United Kingdom"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"306970",title:"Mr.",name:"Amin",middleName:null,surname:"Tamadon",slug:"amin-tamadon",fullName:"Amin Tamadon",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002oHR5wQAG/Profile_Picture_1623910304139",institutionString:null,institution:{name:"Bushehr University of Medical Sciences",institutionURL:null,country:{name:"Iran"}}},{id:"251314",title:"Dr.",name:"Juan Carlos",middleName:null,surname:"Gardón",slug:"juan-carlos-gardon",fullName:"Juan Carlos Gardón",profilePictureURL:"https://mts.intechopen.com/storage/users/251314/images/system/251314.jpeg",institutionString:"Catholic University of Valencia San Vicente Mártir, Spain",institution:null},{id:"245306",title:"Dr.",name:"María Luz",middleName:null,surname:"Garcia Pardo",slug:"maria-luz-garcia-pardo",fullName:"María Luz Garcia Pardo",profilePictureURL:"https://mts.intechopen.com/storage/users/245306/images/system/245306.png",institutionString:null,institution:{name:"Miguel Hernandez University",institutionURL:null,country:{name:"Spain"}}},{id:"283315",title:"Prof.",name:"Samir",middleName:null,surname:"El-Gendy",slug:"samir-el-gendy",fullName:"Samir El-Gendy",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRduYQAS/Profile_Picture_1606215849748",institutionString:null,institution:{name:"Alexandria University",institutionURL:null,country:{name:"Egypt"}}}]},{id:"11",title:"Cell Physiology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/11.jpg",editor:{id:"133493",title:"Prof.",name:"Angel",middleName:null,surname:"Catala",slug:"angel-catala",fullName:"Angel Catala",profilePictureURL:"https://mts.intechopen.com/storage/users/133493/images/3091_n.jpg",biography:"Prof. Dr. Angel Catalá \r\nShort Biography Angel Catalá was born in Rodeo (San Juan, Argentina). He studied \r\nchemistry at the Universidad Nacional de La Plata, Argentina, where received aPh.D. degree in chemistry (Biological Branch) in 1965. From\r\n1964 to 1974, he worked as Assistant in Biochemistry at the School of MedicineUniversidad Nacional de La Plata, Argentina. From 1974 to 1976, he was a Fellowof the National Institutes of Health (NIH) at the University of Connecticut, Health Center, USA. From 1985 to 2004, he served as a Full Professor oBiochemistry at the Universidad Nacional de La Plata, Argentina. He is Member ofthe National Research Council (CONICET), Argentina, and Argentine Society foBiochemistry and Molecular Biology (SAIB). His laboratory has been interested for manyears in the lipid peroxidation of biological membranes from various tissues and different species. Professor Catalá has directed twelve doctoral theses, publishedover 100 papers in peer reviewed journals, several chapters in books andtwelve edited books. Angel Catalá received awards at the 40th InternationaConference Biochemistry of Lipids 1999: Dijon (France). W inner of the Bimbo PanAmerican Nutrition, Food Science and Technology Award 2006 and 2012, South AmericaHuman Nutrition, Professional Category. 2006 award in pharmacology, Bernardo\r\nHoussay, in recognition of his meritorious works of research. Angel Catalá belongto the Editorial Board of Journal of lipids, International Review of Biophysical ChemistryFrontiers in Membrane Physiology and Biophysics, World Journal oExperimental Medicine and Biochemistry Research International, W orld Journal oBiological Chemistry, Oxidative Medicine and Cellular Longevity, Diabetes and thePancreas, International Journal of Chronic Diseases & Therapy, International Journal oNutrition, Co-Editor of The Open Biology Journal.",institutionString:null,institution:{name:"National University of La Plata",institutionURL:null,country:{name:"Argentina"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"186048",title:"Prof.",name:"Ines",middleName:null,surname:"Drenjančević",slug:"ines-drenjancevic",fullName:"Ines Drenjančević",profilePictureURL:"https://mts.intechopen.com/storage/users/186048/images/5818_n.jpg",institutionString:null,institution:{name:"University of Osijek",institutionURL:null,country:{name:"Croatia"}}},{id:"187859",title:"Prof.",name:"Kusal",middleName:"K.",surname:"Das",slug:"kusal-das",fullName:"Kusal Das",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSBDeQAO/Profile_Picture_1623411145568",institutionString:"BLDE (Deemed to be University), India",institution:null},{id:"79615",title:"Dr.",name:"Robson",middleName:null,surname:"Faria",slug:"robson-faria",fullName:"Robson Faria",profilePictureURL:"https://mts.intechopen.com/storage/users/79615/images/system/79615.png",institutionString:null,institution:{name:"Oswaldo Cruz Foundation",institutionURL:null,country:{name:"Brazil"}}},{id:"84459",title:"Prof.",name:"Valerie",middleName:null,surname:"Chappe",slug:"valerie-chappe",fullName:"Valerie Chappe",profilePictureURL:"https://mts.intechopen.com/storage/users/84459/images/system/84459.jpg",institutionString:null,institution:{name:"Dalhousie University",institutionURL:null,country:{name:"Canada"}}}]},{id:"12",title:"Human Physiology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/12.jpg",editor:{id:"195829",title:"Prof.",name:"Kunihiro",middleName:null,surname:"Sakuma",slug:"kunihiro-sakuma",fullName:"Kunihiro Sakuma",profilePictureURL:"https://mts.intechopen.com/storage/users/195829/images/system/195829.jpg",biography:"Professor Kunihiro Sakuma, Ph.D., currently works in the Institute for Liberal Arts at the Tokyo Institute of Technology. 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He has both an MS and Ph.D. in Biomedical Engineering. He was previously a research scientist at the University of California Los Angeles (UCLA) and visiting professor and researcher at the University of North Dakota. He is currently working in artificial intelligence and its applications in medical signal processing. In addition, he is using digital signal processing in medical imaging and speech processing. Dr. Asadpour has developed brain-computer interfacing algorithms and has published books, book chapters, and several journal and conference papers in this field and other areas of intelligent signal processing. He has also designed medical devices, including a laser Doppler monitoring system.",institutionString:"Kaiser Permanente Southern California",institution:null},{id:"169608",title:"Prof.",name:"Marian",middleName:null,surname:"Găiceanu",slug:"marian-gaiceanu",fullName:"Marian Găiceanu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/169608/images/system/169608.png",biography:"Prof. Dr. Marian Gaiceanu graduated from the Naval and Electrical Engineering Faculty, Dunarea de Jos University of Galati, Romania, in 1997. He received a Ph.D. (Magna Cum Laude) in Electrical Engineering in 2002. Since 2017, Dr. Gaiceanu has been a Ph.D. supervisor for students in Electrical Engineering. He has been employed at Dunarea de Jos University of Galati since 1996, where he is currently a professor. Dr. Gaiceanu is a member of the National Council for Attesting Titles, Diplomas and Certificates, an expert of the Executive Agency for Higher Education, Research Funding, and a member of the Senate of the Dunarea de Jos University of Galati. He has been the head of the Integrated Energy Conversion Systems and Advanced Control of Complex Processes Research Center, Romania, since 2016. He has conducted several projects in power converter systems for electrical drives, power quality, PEM and SOFC fuel cell power converters for utilities, electric vehicles, and marine applications with the Department of Regulation and Control, SIEI S.pA. (2002–2004) and the Polytechnic University of Turin, Italy (2002–2004, 2006–2007). He is a member of the Institute of Electrical and Electronics Engineers (IEEE) and cofounder-member of the IEEE Power Electronics Romanian Chapter. He is a guest editor at Energies and an academic book editor for IntechOpen. He is also a member of the editorial boards of the Journal of Electrical Engineering, Electronics, Control and Computer Science and Sustainability. Dr. Gaiceanu has been General Chairman of the IEEE International Symposium on Electrical and Electronics Engineering in the last six editions.",institutionString:'"Dunarea de Jos" University of Galati',institution:{name:'"Dunarea de Jos" University of Galati',country:{name:"Romania"}}},{id:"4519",title:"Prof.",name:"Jaydip",middleName:null,surname:"Sen",slug:"jaydip-sen",fullName:"Jaydip Sen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/4519/images/system/4519.jpeg",biography:"Jaydip Sen is associated with Praxis Business School, Kolkata, India, as a professor in the Department of Data Science. His research areas include security and privacy issues in computing and communication, intrusion detection systems, machine learning, deep learning, and artificial intelligence in the financial domain. He has more than 200 publications in reputed international journals, refereed conference proceedings, and 20 book chapters in books published by internationally renowned publishing houses, such as Springer, CRC press, IGI Global, etc. Currently, he is serving on the editorial board of the prestigious journal Frontiers in Communications and Networks and in the technical program committees of a number of high-ranked international conferences organized by the IEEE, USA, and the ACM, USA. He has been listed among the top 2% of scientists in the world for the last three consecutive years, 2019 to 2021 as per studies conducted by the Stanford University, USA.",institutionString:"Praxis Business School",institution:null},{id:"320071",title:"Dr.",name:"Sidra",middleName:null,surname:"Mehtab",slug:"sidra-mehtab",fullName:"Sidra Mehtab",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00002v6KHoQAM/Profile_Picture_1584512086360",biography:"Sidra Mehtab has completed her BS with honors in Physics from Calcutta University, India in 2018. She has done MS in Data Science and Analytics from Maulana Abul Kalam Azad University of Technology (MAKAUT), Kolkata, India in 2020. Her research areas include Econometrics, Time Series Analysis, Machine Learning, Deep Learning, Artificial Intelligence, and Computer and Network Security with a particular focus on Cyber Security Analytics. Ms. Mehtab has published seven papers in international conferences and one of her papers has been accepted for publication in a reputable international journal. She has won the best paper awards in two prestigious international conferences – BAICONF 2019, and ICADCML 2021, organized in the Indian Institute of Management, Bangalore, India in December 2019, and SOA University, Bhubaneswar, India in January 2021. Besides, Ms. Mehtab has also published two book chapters in two books. Seven of her book chapters will be published in a volume shortly in 2021 by Cambridge Scholars’ Press, UK. Currently, she is working as the joint editor of two edited volumes on Time Series Analysis and Forecasting to be published in the first half of 2021 by an international house. Currently, she is working as a Data Scientist with an MNC in Delhi, India.",institutionString:"NSHM College of Management and Technology",institution:null},{id:"226240",title:"Dr.",name:"Andri Irfan",middleName:null,surname:"Rifai",slug:"andri-irfan-rifai",fullName:"Andri Irfan Rifai",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226240/images/7412_n.jpg",biography:"Andri IRFAN is a Senior Lecturer of Civil Engineering and Planning. He completed the PhD at the Universitas Indonesia & Universidade do Minho with Sandwich Program Scholarship from the Directorate General of Higher Education and LPDP scholarship. He has been teaching for more than 19 years and much active to applied his knowledge in the project construction in Indonesia. His research interest ranges from pavement management system to advanced data mining techniques for transportation engineering. He has published more than 50 papers in journals and 2 books.",institutionString:null,institution:{name:"Universitas Internasional Batam",country:{name:"Indonesia"}}},{id:"314576",title:"Dr.",name:"Ibai",middleName:null,surname:"Laña",slug:"ibai-lana",fullName:"Ibai Laña",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314576/images/system/314576.jpg",biography:"Dr. Ibai Laña works at TECNALIA as a data analyst. He received his Ph.D. in Artificial Intelligence from the University of the Basque Country (UPV/EHU), Spain, in 2018. He is currently a senior researcher at TECNALIA. His research interests fall within the intersection of intelligent transportation systems, machine learning, traffic data analysis, and data science. He has dealt with urban traffic forecasting problems, applying machine learning models and evolutionary algorithms. He has experience in origin-destination matrix estimation or point of interest and trajectory detection. Working with large volumes of data has given him a good command of big data processing tools and NoSQL databases. He has also been a visiting scholar at the Knowledge Engineering and Discovery Research Institute, Auckland University of Technology.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"314575",title:"Dr.",name:"Jesus",middleName:null,surname:"L. Lobo",slug:"jesus-l.-lobo",fullName:"Jesus L. Lobo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314575/images/system/314575.png",biography:"Dr. Jesús López is currently based in Bilbao (Spain) working at TECNALIA as Artificial Intelligence Research Scientist. In most cases, a project idea or a new research line needs to be investigated to see if it is good enough to take into production or to focus on it. That is exactly what he does, diving into Machine Learning algorithms and technologies to help TECNALIA to decide whether something is great in theory or will actually impact on the product or processes of its projects. So, he is expert at framing experiments, developing hypotheses, and proving whether they’re true or not, in order to investigate fundamental problems with a longer time horizon. He is also able to design and develop PoCs and system prototypes in simulation. He has participated in several national and internacional R&D projects.\n\nAs another relevant part of his everyday research work, he usually publishes his findings in reputed scientific refereed journals and international conferences, occasionally acting as reviewer and Programme Commitee member. Concretely, since 2018 he has published 9 JCR (8 Q1) journal papers, 9 conference papers (e.g. ECML PKDD 2021), and he has co-edited a book. He is also active in popular science writing data science stories for reputed blogs (KDNuggets, TowardsDataScience, Naukas). Besides, he has recently embarked on mentoring programmes as mentor, and has also worked as data science trainer.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"103779",title:"Prof.",name:"Yalcin",middleName:null,surname:"Isler",slug:"yalcin-isler",fullName:"Yalcin Isler",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRyQ8QAK/Profile_Picture_1628834958734",biography:"Yalcin Isler (1971 - Burdur / Turkey) received the B.Sc. degree in the Department of Electrical and Electronics Engineering from Anadolu University, Eskisehir, Turkey, in 1993, the M.Sc. degree from the Department of Electronics and Communication Engineering, Suleyman Demirel University, Isparta, Turkey, in 1996, the Ph.D. degree from the Department of Electrical and Electronics Engineering, Dokuz Eylul University, Izmir, Turkey, in 2009, and the Competence of Associate Professorship from the Turkish Interuniversity Council in 2019.\n\nHe was Lecturer at Burdur Vocational School in Suleyman Demirel University (1993-2000, Burdur / Turkey), Software Engineer (2000-2002, Izmir / Turkey), Research Assistant in Bulent Ecevit University (2002-2003, Zonguldak / Turkey), Research Assistant in Dokuz Eylul University (2003-2010, Izmir / Turkey), Assistant Professor at the Department of Electrical and Electronics Engineering in Bulent Ecevit University (2010-2012, Zonguldak / Turkey), Assistant Professor at the Department of Biomedical Engineering in Izmir Katip Celebi University (2012-2019, Izmir / Turkey). He is an Associate Professor at the Department of Biomedical Engineering at Izmir Katip Celebi University, Izmir / Turkey, since 2019. In addition to academics, he has also founded Islerya Medical and Information Technologies Company, Izmir / Turkey, since 2017.\n\nHis main research interests cover biomedical signal processing, pattern recognition, medical device design, programming, and embedded systems. He has many scientific papers and participated in several projects in these study fields. He was an IEEE Student Member (2009-2011) and IEEE Member (2011-2014) and has been IEEE Senior Member since 2014.",institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",country:{name:"Turkey"}}},{id:"339677",title:"Dr.",name:"Mrinmoy",middleName:null,surname:"Roy",slug:"mrinmoy-roy",fullName:"Mrinmoy Roy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/339677/images/16768_n.jpg",biography:"An accomplished Sales & Marketing professional with 12 years of cross-functional experience in well-known organisations such as CIPLA, LUPIN, GLENMARK, ASTRAZENECA across different segment of Sales & Marketing, International Business, Institutional Business, Product Management, Strategic Marketing of HIV, Oncology, Derma, Respiratory, Anti-Diabetic, Nutraceutical & Stomatological Product Portfolio and Generic as well as Chronic Critical Care Portfolio. A First Class MBA in International Business & Strategic Marketing, B.Pharm, D.Pharm, Google Certified Digital Marketing Professional. Qualified PhD Candidate in Operations and Management with special focus on Artificial Intelligence and Machine Learning adoption, analysis and use in Healthcare, Hospital & Pharma Domain. Seasoned with diverse therapy area of Pharmaceutical Sales & Marketing ranging from generating revenue through generating prescriptions, launching new products, and making them big brands with continuous strategy execution at the Physician and Patients level. Moved from Sales to Marketing and Business Development for 3.5 years in South East Asian Market operating from Manila, Philippines. Came back to India and handled and developed Brands such as Gluconorm, Lupisulin, Supracal, Absolut Woman, Hemozink, Fabiflu (For COVID 19), and many more. In my previous assignment I used to develop and execute strategies on Sales & Marketing, Commercialization & Business Development for Institution and Corporate Hospital Business portfolio of Oncology Therapy Area for AstraZeneca Pharma India Ltd. Being a Research Scholar and Student of ‘Operations Research & Management: Artificial Intelligence’ I published several pioneer research papers and book chapters on the same in Internationally reputed journals and Books indexed in Scopus, Springer and Ei Compendex, Google Scholar etc. Currently, I am launching PGDM Pharmaceutical Management Program in IIHMR Bangalore and spearheading the course curriculum and structure of the same. I am interested in Collaboration for Healthcare Innovation, Pharma AI Innovation, Future trend in Marketing and Management with incubation on Healthcare, Healthcare IT startups, AI-ML Modelling and Healthcare Algorithm based training module development. I am also an affiliated member of the Institute of Management Consultant of India, looking forward to Healthcare, Healthcare IT and Innovation, Pharma and Hospital Management Consulting works.",institutionString:null,institution:{name:"Lovely Professional University",country:{name:"India"}}},{id:"1063",title:"Prof.",name:"Constantin",middleName:null,surname:"Volosencu",slug:"constantin-volosencu",fullName:"Constantin Volosencu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1063/images/system/1063.png",biography:"Prof. Dr. Constantin Voloşencu graduated as an engineer from\nPolitehnica University of Timișoara, Romania, where he also\nobtained a doctorate degree. He is currently a full professor in\nthe Department of Automation and Applied Informatics at the\nsame university. Dr. Voloşencu is the author of ten books, seven\nbook chapters, and more than 160 papers published in journals\nand conference proceedings. He has also edited twelve books and\nhas twenty-seven patents to his name. He is a manager of research grants, editor in\nchief and member of international journal editorial boards, a former plenary speaker, a member of scientific committees, and chair at international conferences. His\nresearch is in the fields of control systems, control of electric drives, fuzzy control\nsystems, neural network applications, fault detection and diagnosis, sensor network\napplications, monitoring of distributed parameter systems, and power ultrasound\napplications. He has developed automation equipment for machine tools, spooling\nmachines, high-power ultrasound processes, and more.",institutionString:"Polytechnic University of Timişoara",institution:{name:"Polytechnic University of Timişoara",country:{name:"Romania"}}},{id:"221364",title:"Dr.",name:"Eneko",middleName:null,surname:"Osaba",slug:"eneko-osaba",fullName:"Eneko Osaba",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/221364/images/system/221364.jpg",biography:"Dr. Eneko Osaba works at TECNALIA as a senior researcher. He obtained his Ph.D. in Artificial Intelligence in 2015. He has participated in more than twenty-five local and European research projects, and in the publication of more than 130 papers. He has performed several stays at universities in the United Kingdom, Italy, and Malta. Dr. Osaba has served as a program committee member in more than forty international conferences and participated in organizing activities in more than ten international conferences. He is a member of the editorial board of the International Journal of Artificial Intelligence, Data in Brief, and Journal of Advanced Transportation. He is also a guest editor for the Journal of Computational Science, Neurocomputing, Swarm, and Evolutionary Computation and IEEE ITS Magazine.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"275829",title:"Dr.",name:"Esther",middleName:null,surname:"Villar-Rodriguez",slug:"esther-villar-rodriguez",fullName:"Esther Villar-Rodriguez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/275829/images/system/275829.jpg",biography:"Dr. Esther Villar obtained a Ph.D. in Information and Communication Technologies from the University of Alcalá, Spain, in 2015. She obtained a degree in Computer Science from the University of Deusto, Spain, in 2010, and an MSc in Computer Languages and Systems from the National University of Distance Education, Spain, in 2012. Her areas of interest and knowledge include natural language processing (NLP), detection of impersonation in social networks, semantic web, and machine learning. Dr. Esther Villar made several contributions at conferences and publishing in various journals in those fields. Currently, she is working within the OPTIMA (Optimization Modeling & Analytics) business of TECNALIA’s ICT Division as a data scientist in projects related to the prediction and optimization of management and industrial processes (resource planning, energy efficiency, etc).",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49813/images/system/49813.png",biography:"Prof. Dr. Javier Del Ser received his first PhD in Telecommunication Engineering (Cum Laude) from the University of Navarra, Spain, in 2006, and a second PhD in Computational Intelligence (Summa Cum Laude) from the University of Alcala, Spain, in 2013. He is currently a principal researcher in data analytics and optimisation at TECNALIA (Spain), a visiting fellow at the Basque Center for Applied Mathematics (BCAM) and a part-time lecturer at the University of the Basque Country (UPV/EHU). His research interests gravitate on the use of descriptive, prescriptive and predictive algorithms for data mining and optimization in a diverse range of application fields such as Energy, Transport, Telecommunications, Health and Industry, among others. In these fields he has published more than 240 articles, co-supervised 8 Ph.D. theses, edited 6 books, coauthored 7 patents and participated/led more than 40 research projects. He is a Senior Member of the IEEE, and a recipient of the Biscay Talent prize for his academic career.",institutionString:"Tecnalia Research & Innovation",institution:null},{id:"278948",title:"Dr.",name:"Carlos Pedro",middleName:null,surname:"Gonçalves",slug:"carlos-pedro-goncalves",fullName:"Carlos Pedro Gonçalves",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRcmyQAC/Profile_Picture_1564224512145",biography:'Carlos Pedro Gonçalves (PhD) is an Associate Professor at Lusophone University of Humanities and Technologies and a researcher on Complexity Sciences, Quantum Technologies, Artificial Intelligence, Strategic Studies, Studies in Intelligence and Security, FinTech and Financial Risk Modeling. 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Fungal infectious illness prevalence and prognosis are determined by the exposure between fungi and host, host immunological state, fungal virulence, and early and accurate diagnosis and treatment. \r\nPatients with both congenital and acquired immunodeficiency are more likely to be infected with opportunistic mycosis. Fungal infectious disease outbreaks are common during the post- disaster rebuilding era, which is characterised by high population density, migration, and poor health and medical conditions.\r\nSystemic or local fungal infection is mainly associated with the fungi directly inhaled or inoculated in the environment during the disaster. The most common fungal infection pathways are human to human (anthropophilic), animal to human (zoophilic), and environment to human (soilophile). Diseases are common as a result of widespread exposure to pathogenic fungus dispersed into the environment. \r\nFungi that are both common and emerging are intertwined. In Southeast Asia, for example, Talaromyces marneffei is an important pathogenic thermally dimorphic fungus that causes systemic mycosis. Widespread fungal infections with complicated and variable clinical manifestations, such as Candida auris infection resistant to several antifungal medicines, Covid-19 associated with Trichoderma, and terbinafine resistant dermatophytosis in India, are among the most serious disorders. \r\nInappropriate local or systemic use of glucocorticoids, as well as their immunosuppressive effects, may lead to changes in fungal infection spectrum and clinical characteristics. Hematogenous candidiasis is a worrisome issue that affects people all over the world, particularly ICU patients. CARD9 deficiency and fungal infection have been major issues in recent years. Invasive aspergillosis is associated with a significant death rate. Special attention should be given to endemic fungal infections, identification of important clinical fungal infections advanced in yeasts, filamentous fungal infections, skin mycobiome and fungal genomes, and immunity to fungal infections.\r\nIn addition, endemic fungal diseases or uncommon fungal infections caused by Mucor irregularis, dermatophytosis, Malassezia, cryptococcosis, chromoblastomycosis, coccidiosis, blastomycosis, histoplasmosis, sporotrichosis, and other fungi, should be monitored. \r\nThis topic includes the research progress on the etiology and pathogenesis of fungal infections, new methods of isolation and identification, rapid detection, drug sensitivity testing, new antifungal drugs, schemes and case series reports. It will provide significant opportunities and support for scientists, clinical doctors, mycologists, antifungal drug researchers, public health practitioners, and epidemiologists from all over the world to share new research, ideas and solutions to promote the development and progress of medical mycology.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/4.jpg",keywords:"Emerging Fungal Pathogens, Invasive Infections, Epidemiology, Cell Membrane, Fungal Virulence, Diagnosis, Treatment"},{id:"5",title:"Parasitic Infectious Diseases",scope:"Parasitic diseases have evolved alongside their human hosts. In many cases, these diseases have adapted so well that they have developed efficient resilience methods in the human host and can live in the host for years. Others, particularly some blood parasites, can cause very acute diseases and are responsible for millions of deaths yearly. Many parasitic diseases are classified as neglected tropical diseases because they have received minimal funding over recent years and, in many cases, are under-reported despite the critical role they play in morbidity and mortality among human and animal hosts. The current topic, Parasitic Infectious Diseases, in the Infectious Diseases Series aims to publish studies on the systematics, epidemiology, molecular biology, genomics, pathogenesis, genetics, and clinical significance of parasitic diseases from blood borne to intestinal parasites as well as zoonotic parasites. We hope to cover all aspects of parasitic diseases to provide current and relevant research data on these very important diseases. In the current atmosphere of the Coronavirus pandemic, communities around the world, particularly those in different underdeveloped areas, are faced with the growing challenges of the high burden of parasitic diseases. At the same time, they are faced with the Covid-19 pandemic leading to what some authors have called potential syndemics that might worsen the outcome of such infections. Therefore, it is important to conduct studies that examine parasitic infections in the context of the coronavirus pandemic for the benefit of all communities to help foster more informed decisions for the betterment of human and animal health.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/5.jpg",keywords:"Blood Borne Parasites, Intestinal Parasites, Protozoa, Helminths, Arthropods, Water Born Parasites, Epidemiology, Molecular Biology, Systematics, Genomics, Proteomics, Ecology"},{id:"6",title:"Viral Infectious Diseases",scope:"The Viral Infectious Diseases Book Series aims to provide a comprehensive overview of recent research trends and discoveries in various viral infectious diseases emerging around the globe. The emergence of any viral disease is hard to anticipate, which often contributes to death. A viral disease can be defined as an infectious disease that has recently appeared within a population or exists in nature with the rapid expansion of incident or geographic range. This series will focus on various crucial factors related to emerging viral infectious diseases, including epidemiology, pathogenesis, host immune response, clinical manifestations, diagnosis, treatment, and clinical recommendations for managing viral infectious diseases, highlighting the recent issues with future directions for effective therapeutic strategies.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/6.jpg",keywords:"Novel Viruses, Virus Transmission, Virus Evolution, Molecular Virology, Control and Prevention, Virus-host Interaction"}],annualVolumeBook:{},thematicCollection:[],selectedSeries:null,selectedSubseries:null},seriesLanding:{item:{id:"11",title:"Biochemistry",doi:"10.5772/intechopen.72877",issn:"2632-0983",scope:"Biochemistry, the study of chemical transformations occurring within living organisms, impacts all areas of life sciences, from molecular crystallography and genetics to ecology, medicine, and population biology. Biochemistry examines macromolecules - proteins, nucleic acids, carbohydrates, and lipids – and their building blocks, structures, functions, and interactions. Much of biochemistry is devoted to enzymes, proteins that catalyze chemical reactions, enzyme structures, mechanisms of action and their roles within cells. Biochemistry also studies small signaling molecules, coenzymes, inhibitors, vitamins, and hormones, which play roles in life processes. Biochemical experimentation, besides coopting classical chemistry methods, e.g., chromatography, adopted new techniques, e.g., X-ray diffraction, electron microscopy, NMR, radioisotopes, and developed sophisticated microbial genetic tools, e.g., auxotroph mutants and their revertants, fermentation, etc. More recently, biochemistry embraced the ‘big data’ omics systems. Initial biochemical studies have been exclusively analytic: dissecting, purifying, and examining individual components of a biological system; in the apt words of Efraim Racker (1913 –1991), “Don’t waste clean thinking on dirty enzymes.” Today, however, biochemistry is becoming more agglomerative and comprehensive, setting out to integrate and describe entirely particular biological systems. The ‘big data’ metabolomics can define the complement of small molecules, e.g., in a soil or biofilm sample; proteomics can distinguish all the comprising proteins, e.g., serum; metagenomics can identify all the genes in a complex environment, e.g., the bovine rumen. This Biochemistry Series will address the current research on biomolecules and the emerging trends with great promise.",coverUrl:"https://cdn.intechopen.com/series/covers/11.jpg",latestPublicationDate:"May 18th, 2022",hasOnlineFirst:!0,numberOfOpenTopics:4,numberOfPublishedChapters:287,numberOfPublishedBooks:27,editor:{id:"31610",title:"Dr.",name:"Miroslav",middleName:null,surname:"Blumenberg",fullName:"Miroslav Blumenberg",profilePictureURL:"https://mts.intechopen.com/storage/users/31610/images/system/31610.jpg",biography:"Miroslav Blumenberg, Ph.D., was born in Subotica and received his BSc in Belgrade, Yugoslavia. He completed his Ph.D. at MIT in Organic Chemistry; he followed up his Ph.D. with two postdoctoral study periods at Stanford University. Since 1983, he has been a faculty member of the RO Perelman Department of Dermatology, NYU School of Medicine, where he is codirector of a training grant in cutaneous biology. Dr. Blumenberg’s research is focused on the epidermis, expression of keratin genes, transcription profiling, keratinocyte differentiation, inflammatory diseases and cancers, and most recently the effects of the microbiome on the skin. He has published more than 100 peer-reviewed research articles and graduated numerous Ph.D. and postdoctoral students.",institutionString:null,institution:{name:"New York University Langone Medical Center",institutionURL:null,country:{name:"United States of America"}}},subseries:[{id:"14",title:"Cell and Molecular Biology",keywords:"Omics (Transcriptomics; Proteomics; Metabolomics), Molecular Biology, Cell Biology, Signal Transduction and Regulation, Cell Growth and Differentiation, Apoptosis, Necroptosis, Ferroptosis, Autophagy, Cell Cycle, Macromolecules and Complexes, Gene Expression",scope:"The Cell and Molecular Biology topic within the IntechOpen Biochemistry Series aims to rapidly publish contributions on all aspects of cell and molecular biology, including aspects related to biochemical and genetic research (not only in humans but all living beings). We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics include, but are not limited to: Advanced techniques of cellular and molecular biology (Molecular methodologies, imaging techniques, and bioinformatics); Biological activities at the molecular level; Biological processes of cell functions, cell division, senescence, maintenance, and cell death; Biomolecules interactions; Cancer; Cell biology; Chemical biology; Computational biology; Cytochemistry; Developmental biology; Disease mechanisms and therapeutics; DNA, and RNA metabolism; Gene functions, genetics, and genomics; Genetics; Immunology; Medical microbiology; Molecular biology; Molecular genetics; Molecular processes of cell and organelle dynamics; Neuroscience; Protein biosynthesis, degradation, and functions; Regulation of molecular interactions in a cell; Signalling networks and system biology; Structural biology; Virology and microbiology.",annualVolume:11410,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/14.jpg",editor:{id:"165627",title:"Dr.",name:"Rosa María",middleName:null,surname:"Martínez-Espinosa",fullName:"Rosa María Martínez-Espinosa",profilePictureURL:"https://mts.intechopen.com/storage/users/165627/images/system/165627.jpeg",institutionString:null,institution:{name:"University of Alicante",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"79367",title:"Dr.",name:"Ana Isabel",middleName:null,surname:"Flores",fullName:"Ana Isabel Flores",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRpIOQA0/Profile_Picture_1632418099564",institutionString:null,institution:{name:"Hospital Universitario 12 De Octubre",institutionURL:null,country:{name:"Spain"}}},{id:"328234",title:"Ph.D.",name:"Christian",middleName:null,surname:"Palavecino",fullName:"Christian Palavecino",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000030DhEhQAK/Profile_Picture_1628835318625",institutionString:null,institution:{name:"Central University of Chile",institutionURL:null,country:{name:"Chile"}}},{id:"186585",title:"Dr.",name:"Francisco Javier",middleName:null,surname:"Martin-Romero",fullName:"Francisco Javier Martin-Romero",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSB3HQAW/Profile_Picture_1631258137641",institutionString:null,institution:{name:"University of Extremadura",institutionURL:null,country:{name:"Spain"}}}]},{id:"15",title:"Chemical Biology",keywords:"Phenolic Compounds, Essential Oils, Modification of Biomolecules, Glycobiology, Combinatorial Chemistry, Therapeutic peptides, Enzyme Inhibitors",scope:"Chemical biology spans the fields of chemistry and biology involving the application of biological and chemical molecules and techniques. In recent years, the application of chemistry to biological molecules has gained significant interest in medicinal and pharmacological studies. This topic will be devoted to understanding the interplay between biomolecules and chemical compounds, their structure and function, and their potential applications in related fields. Being a part of the biochemistry discipline, the ideas and concepts that have emerged from Chemical Biology have affected other related areas. This topic will closely deal with all emerging trends in this discipline.",annualVolume:11411,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/15.jpg",editor:{id:"441442",title:"Dr.",name:"Şükrü",middleName:null,surname:"Beydemir",fullName:"Şükrü Beydemir",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003GsUoIQAV/Profile_Picture_1634557147521",institutionString:null,institution:{name:"Anadolu University",institutionURL:null,country:{name:"Turkey"}}},editorTwo:{id:"13652",title:"Prof.",name:"Deniz",middleName:null,surname:"Ekinci",fullName:"Deniz Ekinci",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYLT1QAO/Profile_Picture_1634557223079",institutionString:null,institution:{name:"Ondokuz Mayıs University",institutionURL:null,country:{name:"Turkey"}}},editorThree:null,editorialBoard:[{id:"241413",title:"Dr.",name:"Azhar",middleName:null,surname:"Rasul",fullName:"Azhar Rasul",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRT1oQAG/Profile_Picture_1635251978933",institutionString:null,institution:{name:"Government College University, Faisalabad",institutionURL:null,country:{name:"Pakistan"}}},{id:"178316",title:"Ph.D.",name:"Sergey",middleName:null,surname:"Sedykh",fullName:"Sergey Sedykh",profilePictureURL:"https://mts.intechopen.com/storage/users/178316/images/system/178316.jfif",institutionString:null,institution:{name:"Novosibirsk State University",institutionURL:null,country:{name:"Russia"}}}]},{id:"17",title:"Metabolism",keywords:"Biomolecules Metabolism, Energy Metabolism, Metabolic Pathways, Key Metabolic Enzymes, Metabolic Adaptation",scope:"Metabolism is frequently defined in biochemistry textbooks as the overall process that allows living systems to acquire and use the free energy they need for their vital functions or the chemical processes that occur within a living organism to maintain life. Behind these definitions are hidden all the aspects of normal and pathological functioning of all processes that the topic ‘Metabolism’ will cover within the Biochemistry Series. Thus all studies on metabolism will be considered for publication.",annualVolume:11413,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/17.jpg",editor:{id:"138626",title:"Dr.",name:"Yannis",middleName:null,surname:"Karamanos",fullName:"Yannis Karamanos",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002g6Jv2QAE/Profile_Picture_1629356660984",institutionString:null,institution:{name:"Artois University",institutionURL:null,country:{name:"France"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"243049",title:"Dr.",name:"Anca",middleName:null,surname:"Pantea Stoian",fullName:"Anca Pantea Stoian",profilePictureURL:"https://mts.intechopen.com/storage/users/243049/images/system/243049.jpg",institutionString:null,institution:{name:"Carol Davila University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"203824",title:"Dr.",name:"Attilio",middleName:null,surname:"Rigotti",fullName:"Attilio Rigotti",profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institutionString:null,institution:{name:"Pontifical Catholic University of Chile",institutionURL:null,country:{name:"Chile"}}},{id:"300470",title:"Dr.",name:"Yanfei (Jacob)",middleName:null,surname:"Qi",fullName:"Yanfei (Jacob) Qi",profilePictureURL:"https://mts.intechopen.com/storage/users/300470/images/system/300470.jpg",institutionString:null,institution:{name:"Centenary Institute of Cancer Medicine and Cell Biology",institutionURL:null,country:{name:"Australia"}}}]},{id:"18",title:"Proteomics",keywords:"Mono- and Two-Dimensional Gel Electrophoresis (1-and 2-DE), Liquid Chromatography (LC), Mass Spectrometry/Tandem Mass Spectrometry (MS; MS/MS), Proteins",scope:"With the recognition that the human genome cannot provide answers to the etiology of a disorder, changes in the proteins expressed by a genome became a focus in research. Thus proteomics, an area of research that detects all protein forms expressed in an organism, including splice isoforms and post-translational modifications, is more suitable than genomics for a comprehensive understanding of the biochemical processes that govern life. The most common proteomics applications are currently in the clinical field for the identification, in a variety of biological matrices, of biomarkers for diagnosis and therapeutic intervention of disorders. From the comparison of proteomic profiles of control and disease or different physiological states, which may emerge, changes in protein expression can provide new insights into the roles played by some proteins in human pathologies. Understanding how proteins function and interact with each other is another goal of proteomics that makes this approach even more intriguing. Specialized technology and expertise are required to assess the proteome of any biological sample. Currently, proteomics relies mainly on mass spectrometry (MS) combined with electrophoretic (1 or 2-DE-MS) and/or chromatographic techniques (LC-MS/MS). MS is an excellent tool that has gained popularity in proteomics because of its ability to gather a complex body of information such as cataloging protein expression, identifying protein modification sites, and defining protein interactions. The Proteomics topic aims to attract contributions on all aspects of MS-based proteomics that, by pushing the boundaries of MS capabilities, may address biological problems that have not been resolved yet.",annualVolume:11414,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/18.jpg",editor:{id:"200689",title:"Prof.",name:"Paolo",middleName:null,surname:"Iadarola",fullName:"Paolo Iadarola",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSCl8QAG/Profile_Picture_1623568118342",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorTwo:{id:"201414",title:"Dr.",name:"Simona",middleName:null,surname:"Viglio",fullName:"Simona Viglio",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRKDHQA4/Profile_Picture_1630402531487",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorThree:null,editorialBoard:[{id:"72288",title:"Dr.",name:"Arli Aditya",middleName:null,surname:"Parikesit",fullName:"Arli Aditya Parikesit",profilePictureURL:"https://mts.intechopen.com/storage/users/72288/images/system/72288.jpg",institutionString:null,institution:{name:"Indonesia International Institute for Life Sciences",institutionURL:null,country:{name:"Indonesia"}}},{id:"40928",title:"Dr.",name:"Cesar",middleName:null,surname:"Lopez-Camarillo",fullName:"Cesar Lopez-Camarillo",profilePictureURL:"https://mts.intechopen.com/storage/users/40928/images/3884_n.png",institutionString:null,institution:{name:"Universidad Autónoma de la Ciudad de México",institutionURL:null,country:{name:"Mexico"}}},{id:"81926",title:"Dr.",name:"Shymaa",middleName:null,surname:"Enany",fullName:"Shymaa Enany",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRqB9QAK/Profile_Picture_1626163237970",institutionString:null,institution:{name:"Suez Canal University",institutionURL:null,country:{name:"Egypt"}}}]}]}},libraryRecommendation:{success:null,errors:{},institutions:[]},route:{name:"profile.detail",path:"/profiles/338382",hash:"",query:{},params:{id:"338382"},fullPath:"/profiles/338382",meta:{},from:{name:null,path:"/",hash:"",query:{},params:{},fullPath:"/",meta:{}}}},function(){var e;(e=document.currentScript||document.scripts[document.scripts.length-1]).parentNode.removeChild(e)}()