\n
\\n\\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\\n\\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\\n"}]',published:!0,mainMedia:{caption:"Highly Cited",originalUrl:"/media/original/117"}},components:[{type:"htmlEditorComponent",content:'IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\nThroughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\nReleased this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\n'}],latestNews:[{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"1328",leadTitle:null,fullTitle:"Hydropower - Practice and Application",title:"Hydropower",subtitle:"Practice and Application",reviewType:"peer-reviewed",abstract:"Hydroelectric energy is the most widely used form of renewable energy, accounting for 16 percent of global electricity consumption. This book is primarily based on theoretical and applied results obtained by the authors during a long time of practice devoted to problems in the design and operation of a significant number of hydroelectric power plants in different countries. It was preferred to edit this book with the intention that it may partly serve as a supplementary textbook for students on hydropower plants. 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Working knowledge of MATHLAB and Dynare.\n\nResearch Fellow, Global Labor Organization (GLO), Oct.2017 to present\nAcademic and Professional Profiles \nResearch gate Profile:https: // www. researchgate. net/ profile/ Brian_ Sloboda\nORCID:https: // orcid. org/ 0000-0003-0007-1725\nGoogle Scholar Profile https: // scholar. google. com/ citations? user= RSLTrCsAAAAJ&hl= en\nEducation: Ph.D. Economics, Southern Illinois University at Carbondale,1997.\nThesis: The Economic Impact of Southern Illinois University on the State of Illinois: The Human Capital Approach\nM.S. Economics, Southern Illinois University at Carbondale,1992.\nB.A. Economics, Rowan University,1990.Minor: Mathematics.\nFields of Interest: Regional Economics, Economic Growth, Labor Economics, Economic and Statistical Education",institutionString:"University of Maryland, Global Campus",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:null}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"7",title:"Business, Management and Economics",slug:"business-management-and-economics"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"429339",firstName:"Jelena",lastName:"Vrdoljak",middleName:null,title:"Ms.",imageUrl:"https://mts.intechopen.com/storage/users/429339/images/20012_n.jpg",email:"jelena.v@intechopen.com",biography:"As an Author Service Manager, my responsibilities include monitoring and facilitating all publishing activities for authors and editors. 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Some bacteria can circumvent the innate immune response, managing to replicate within macrophages, which are the first line of defense against microbial pathogens and genetically programmed to eradicate foreign particles. Mechanisms that bacteria employ to survive in macrophages include (i) acclimating to the acidic environment within the host lysosome, (ii) escaping the phagosome to persist inside the host cell cytoplasm, and (iii) eluding the endolysosomal pathway by establishing a replication permissive vacuole within the host [1]. The Gram-negative facultative intracellular bacterium,
\n
Inter-kingdom horizontal gene transfer events and circulating mobile genetic elements over long-term coevolution with multiple hosts have extensively reshaped the plasticity of the
The prevailing thought is that the mechanisms that enable
The extensive remodeling of the vacuolar membrane is entirely dependent on a specialized Dot/Icm T4SS that delivers a staggering number of bacterial effector proteins (over 350) [8] into the host cytosol, many of which target membrane transport pathways [31, 32]. Disruption of the T4SS results in lysosomal degradation of the bacterium, indicating that the actions of effector proteins are paramount to bacterial survival [33]. However, it is often a challenge to identify an observable phenotype that can be attributed to a single effector because of functional redundancy among bacterial effectors [34]. Many advances have been made to dissect the molecular contribution of individual effectors toward bacterial infection (reviewed in [35]). A number of these effectors have been reported to hijack host vesicular trafficking pathways. An emerging feature among some of the effectors that target membrane trafficking is the ability to bind key host regulatory lipids, phosphoinositides (PIPs).
\nMembrane compartments within eukaryotic cells are highly abundant, dynamic, and functionally distinct structures. Their movement must be tightly regulated to ensure that cargo carried by these structures is delivered to the proper destination. The cellular machinery recognizes and distinguishes these compartments based on the unique protein and lipid composition on the cytosolic leaflet of the membrane lipid bilayer [11]. Phosphoinositides are glycerophospholipids that amount to less than 15% of phospholipids within membranes but are essential for coordinating the spatiotemporal regulation of membrane trafficking events [11]. Phosphatidylinositol (PI), the precursor of phosphoinositides, can be reversibly phosphorylated at positions 3, 4, and 5 of its
The PIP composition on the LCV membrane has profound effects on the fate of the bacteria-bearing vacuole. PI conversion that accompanies LCV maturation was deciphered by tracking the localization of fluorescent PI probes produced in the soil amoeba,
In a recent study, Weber and colleagues [42] pursued the source of the PI(4)P on the LCV membrane. Real-time high-resolution confocal laser scanning microscopy (CLSM) revealed that LCVs of infected
To manipulate the PIP composition on the LCV,
L. pneumophila converts the phagosome to a PI(4)P-rich vacuole. Within a minute of uptake into the host cell, the LCV acquires the endosomal phosphoinositide, PI(3)P. Within an hour of infection, the LCV starts to accumulate PI(4)P until the bacteria are completely encapsulated in a PI(4)P-rich membrane. To avoid progression down the phagosome maturation pathway, L. pneumophila translocates effectors that alter the phosphoinositide composition on the LCV membrane to a PI(4)P-positive compartment (inset). This process is a result of close association and fusion with host vesicles as well as the direct conversion of existing phosphoinositides by kinases and phosphatases. Golgi-derived PI(4)P-positive vesicles accumulate around the LCV and later fuse with the vacuolar membrane. In contrast, PI(3)P-containing vesicles traffic toward the LCV but do not fuse with it. Additionally, the Legionella effector LepB is a PI kinase that phosphorylates PI(3)P and generates PI(3,4)P2 on the LCV membrane. This PI is a substrate for SidF which dephosphorylates PI(3,4)P2 to PI(4)P. While the origin of PI(3)P that LepB utilizes as a substrate is undetermined, LegA5 is a PI 3-kinase produced by Legionella that phosphorylates PI and could lead to additional PI(3)P on the LCV for conversion to PI(4)P. In combination, LegA5, LepB, and SidF may provide a cascade of enzymatic events for converting the LCV into a PI(4)P-positive compartment. SidP, another direct modifier of phosphoinositides produced by Legionella, may also contribute to the avoidance of the endocytic pathway by removing the phosphate from PI(3)P to hinder vesicle fusion. VipD localizes to endosomes and hydrolyzes a lipid tail from PI(3)P to potentially limit their interaction with the LCV. During this phosphoinositide conversion, Legionella effectors associate with the LCV through phosphoinositide binding domains. Some effectors localize by binding PI(3)P (RavD, LidA, SetA, LpnE, RidL, LtpD, LtpM), and some can associate via PI(4)P-binding (LidA, Lem4, SidM, SidC, Lem28, SdcA). During the later stages of infection, PI(3)P is undetectable and PI(4)P has become enriched on the expanding vacuole.
As PI(3,4)P2 is generated on the LCV, it is thought that SidF can dephosphorylate this lipid to PI(4)P. SidF is a membrane protein containing a large N-terminal domain followed by two transmembrane domains triggering localization to the LCV. SidF was the first
Ultimately, the functions of LepB and SidF suggest that PI(3)P can be converted to PI(4)P through the sequential efforts of these enzymes. The deletion of
The screen that identified SidF as a PI phosphatase also yielded SidP as another direct modifier of phosphoinositides. SidP was identified as a candidate due to its CX5R motif. It was found to have PI 3-phosphatase activity, cleaving PI(3)P and PI(3,5)P2 in vitro. The
As part of an effort to determine the function of a
Aside from kinases and phosphatases that change the phosphorylation state of PIPs,
While VipD has phospholipase A activity,
Lastly, the phospholipase D effector, LpdA, was first identified due to its homology with known phospholipase D enzymes [59]. LpdA specifically cleaves the head group from PI, PI(3)P, PI(4)P, and phosphatidylglycerol
LppA is a phytase enzyme that dephosphorylates the compound
In addition to directly manipulating the phosphoinositide composition of the vacuolar membrane,
Central to the ability of
\n
Bacterial effectors translocated early during infection have been shown to facilitate the recruitment and fusion of ER/secretory vesicles with the LCV. SidM (DrrA), an effector protein translocated immediately upon infection, localizes to the LCV and plays a crucial role in ER recruitment by exploiting the activity of Rab1, a small GTPase responsible for the transport of vesicles between the ER and Golgi [71, 72, 73, 74]. SidM is a modular protein consisting of an N-terminal adenylyltransferase domain, a C-terminal PI(4)P-binding domain, and a central guanine nucleotide exchange factor (GEF) domain that activates the small GTPase Rab1 by facilitating the exchange of GDP with GTP [73]. SidM’s adenylyltransferase activity covalently adds an adenosine monophosphate moiety onto Tyr 77 of Rab1, locking this small GTPase in its active conformation. Activated Rab1 is required for the recruitment of secretory vesicles to the LCV [73, 74]. SidM then promotes the tethering and fusion of these compartments with the phagosome membrane by interacting with an exocyst complex comprised of Sec5 and Sec15 [75]. A high-resolution crystal structure of SidM revealed a novel fold within the protein structure, termed P4M, that was responsible for binding PI(4)P with an unprecedented high affinity in the nanomolar range [76]. Two additional PI(4)P-binding effectors, Lem4 and Lem28, contain C-terminal domains similar to the P4M domain [77]. While Lem4 and Lem28 localize to the LCV through their PI(4)P-binding domains, they do not act on Rab1. Lem4 was recently demonstrated to be a phosphotyrosine phosphatase [78], although how this enzymatic function contributes to infection has yet to be determined.
\nMultiple effectors manipulate Rab1 to exploit secretory trafficking [44, 79]. While SidM is required for activating this small GTPase on the LCV, the PI(3)P and PI(4)P binder, LidA, protects Rab1 from being inactivated [73, 74, 80]. LidA also localizes to the early LCV as well as other uncharacterized membrane compartments [73, 74, 80]. Unlike P4M-containing effectors, LidA interacts with PIPs through a central coiled-coil region. LidA interacts with AMPylated Rab1 through the same coiled-coil domain, preventing GAPs from accessing Rab1 to deactivate it. It is unknown whether the PIP interaction contributes to LidA’s function.
\nIn addition to SidM, the PI(4)P binders SidC and its paralogue, SdcA, are also required for the recruitment of ER proteins to the LCV. In the absence of
Multiple PI(3)P-binding effectors have been identified, and several were shown to be involved in preventing the LCV from entering the phagosomal maturation pathway. AnkX binds both PI(3)P and PI(4)P
The PI(3)P-binding effector, RavD, also contributes to preventing encounters between lysosomes and the LCV. Transmission electron microscopy and structured-illumination microscopy revealed RavD is present on the LCV membrane and vesicles adjacent to the LCV; however the identity of these vesicles has not yet been revealed. RavD binds PI(3)P via a C-terminal region [67]. A recent study reported that RavD’s N-terminal region harbors deubiquitinase activity (DUB) that specifically cleaves linear ubiquitin chains from the LCV using a Cys-His-Ser triad [87]. Deletion of
\n
The effector RidL binds PI(3)P and inhibits retrograde transport through molecular mimicry. Retrograde trafficking serves as a conduit that connects endosomes, the trans-Golgi network, and the ER [89]. Cargo that is cycled from endosomes to the Golgi is recognized and sorted by a retromer complex. Ectopically expressed RidL blocks retrograde trafficking at endosome exit sites through interactions with the retromer complex protein, Vps29 [68]. RidL is present on the LCV membrane and endosomes but does not localize to endosomes through interactions with PI(3)P. Instead, RidL inserts itself into the endosomal retromer complex through interactions with Vps29, displacing Vps29 from binding to the Rab7 GAP, TBC1D5. RidL interacts with Vps29 using a hairpin loop that mimics the same manner in which TBC1D5 interacts with Vps29 [90]. This displacement blocks the movement of retrograde vesicles through an unknown mechanism. In the absence of
PI(3)P is also present on autophagosomes [91], and studies found that indeed
RavZ localizes to autophagosome membranes through a C-terminal domain that recognizes PI(3)P. RavZ1–331 contains catalytic activity yet displays reduced LC3-PE extraction, indicating proper localization to phagosomes is needed to inhibit autophagy [94]. This high-affinity PI(3)P-binding domain, termed LED027, contains two conserved tyrosine and lysine residues that are key for PI(3)P binding. LED027 is found in two other effectors, Lpg1121 (Ceg19) and Lpg1961, although Lpg1961 did not display lipid-binding activity when tested
While effectors rely on PIPs for proper localization, binding to PIPs can also induce the enzymatic activity of some effectors. Effector protein SetA possesses an N-terminal region with glucosyltransferase activity and a C-terminal PI(3)P-binding region responsible for LCV localization [95]. Notably, PI(3)P binding enhances SetA’s glucosyltransferase activity [96].
The cohort of T4SS substrates is not conserved across all
In eukaryotes, proteins bind PIPs via domains that are highly conserved. Protein-lipid binding typically occurs through electrostatic interactions between positively charged amino acid residues and the negative phosphate(s) on the
Bacteria can acquire protein domains by horizontal gene transfer from the hosts they infect [97]. A number of
A recent study identified three conserved PI(3)P-binding domains present in 14
Biochemical analysis of a
What enables
The presence of PI(3)P on phagosomal membranes serves as a signpost for the recruitment of endocytic proteins that promote fusion with subsequent endocytic compartments and ultimately the lysosome. PI(3)P is therefore an attractive target for intracellular pathogens to eliminate entry into the phagosomal maturation pathway. It is well-established that after phagocytosis, PI(3)P on the nascent phagosome is rapidly depleted in conjunction with PI(4)P acquisition [12, 42]. Multiple studies have supported that this lipid rearrangement is accomplished through the actions of PIP-modifying effectors and effectors that promote the recruitment and fusion of PI(4)P-rich compartments with the LCV (reviewed in [105]). The recent evidence demonstrated that this lipid can also be removed from on or around the LCV in the form of PI(3)P-positive vesicles that are shed from the LCV. This would indicate that somehow microdomains of PI(3)P within membranes are being recognized, sequestered, and sorted into vesicles for removal or that perhaps PI(3)P-positive vesicles do not stably interact with the LCV. How the LCV can distinguish the simultaneous shedding of PI(3)P-compartments with the fusion of PI(4)P-compartments has yet to be determined. We can speculate that
PI(3)P is completely lost from the LCV membrane after 2 hours; however, it is unclear why there is a strong presence of PI(3)P-binding effectors that are on the LCV membrane after this time point (LpnE, SetA, LotA, RidL, LtpM, LtpD, RavD). At later stages of infection, an accumulation of stagnant PI(3)P-positive vesicles can be seen surrounding the LCV. It is possible that effectors anchored to the LCV could be interacting with these vesicles by recognizing multiple membrane compartments. Most LCV localization studies are assessed using light microscopy, in which the resolution may not be high enough to visualize smaller distinct structures around the LCV. Light microscopy showed RavD is present on the LCV membrane; however higher-resolution imaging techniques like structured illumination and transmission electron microscopy revealed RavD is also present on a subset of unidentified vesicles adjacent to the LCV. It is most likely these vesicles are PI(3)P-rich, as RavD does not localize to PI(4)P-positive compartments. Moreover, RavD does not rely on PI(3)P binding to anchor to the LCV, supporting that effectors may exhibit dual localization patterns and that RavD may interact with the LCV and vesicles through different domains.
\n\n
Despite advances in medical, surgical and locoregional therapies, hepatocellular carcinoma (HCC), the most common primary liver cancer, remains one of the most common causes of cancer-related death globally. Hepatocellular carcinoma is the fifth most common frequently occurring cancer in men, the ninth in women and is the second leading cause of death from cancer worldwide. It is estimated that by 2025 more than 1 million individuals will be affected by liver cancer annually.
HCC typically arises in the setting of chronic liver disease and cirrhosis. In fact, the rate of disease occurrence depends upon the complex interplay between the host, disease and environmental factors. This type of liver cancer contributes to up to 40% of all patient deaths in cirrhosis, making it the single most common cause of death in this patient population. The most prominent and well researched risk factors for HCC are Hepatitis B and C infections, accounting for 50% of all cases. Furthermore, there is a clear geographical distribution in the epidemiology of hepatocellular carcinoma, with the highest incidence seen in developing countries with high rates of chronic hepatitis B and aflatoxin exposure. In contrast the lowest incidence rates are seen in some European countries that also have a lower incidence of the before mentioned risk factors. Interestingly, increasing Hepatitis B vaccination, effective Hepatitis C treatment, reducing levels of aflatoxin exposure are now shifting the global epidemiology of HCC. Metabolic disorders, including Non-Alcoholic Steatohepatitis (NASH) and diabetes mellitus, along with obesity and insulin resistance, are now emerging as direct causative factors of HCC, particularly in the West. These evolving patterns of demographic and epidemiologic characteristics bear interesting implications in the diagnosis and management of patients with HCC [1, 2, 3, 4].
Cirrhosis patients should be followed within surveillance programs, that aim for early detection of suspicious nodules and effective treatment. Diagnosis of HCC is achieved with imaging and corroborated with an increased tumor marker alpha-fetoprotein blood (AFP) testing. Percutaneous biopsy is seldomly required for diagnosis.
HCC treatment in the setting of liver cirrhosis must be balanced between the biology of the tumor, and host characteristics such as the underlying liver function, presence or not of portal hypertension and ECOG status of the patient. When evaluating a patient for resection, the functional liver remnant must be carefully assessed and its adequate vascular inflow and outflow ascertained, along with biliary drainage. In the event of marginal functional liver remnant, portal vein embolization should be entertained to decrease the possibility of post-operative liver failure.
The most common staging systems for HCC include the Barcelona Clinic Liver Cancer (BCLC), Cancer of the Liver Italian Program (CLIP), and pathologic tumor-node-metastasis (pTNM). In clinical practice, there is no ideal system that can be applicable to every patient in predicting survival [5].
The Barcelona Clinic Liver Cancer (BCLC) staging system is widely used since its inception and remains the most validated and reliable system for prognostication, due to its treatment recommendations based on stage and its ability to offer predictions on patient survival. The BCLC staging system uses variables addressing tumor stage, liver functional status, physical status and cancer-related symptoms. Subsequently, the BCLC staging system can link the stages described with a treatment algorithm.
The initial authors of the BCLC staging system created a position of safety algorithm that proposes:
Surgical resection for early HCC (i.e. stages 0 and A)
Transarterial chemoembolization (TACE) or chemotherapy for patients with intermediate to advanced HCC – Stages B and C
Palliative/symptomatic-only supportive treatment for patients with end-stage disease – Stage D
The combination of tumor specific staging criteria along with host specific information regarding severity of cirrhosis and symptoms have gained the BCLC staging system wide adoption by clinicians around the world. Criticisms of the BCLC staging system focus on the outdated studies the guidelines were based on and the available surgical and intensive care techniques that were available at the time these were first reported.
In fact, using modern approaches to hepatectomy and enhanced postoperative care, several authors were able to demonstrate improved perioperative outcomes and long-term survival for well selected BCLC B and in some cases BCLC C patients managed operatively. These successes point to a trend in pushing the limits of the original more conservative guidelines, thereby offering a better survival to those patients deemed to be good candidates for resection. This endeavor however has to be taken cautiously, and patients that offered resection outside class A should be managed at high volume centers and at minimum be discussed at a multispecialty tumor board. With more and more BCLC staging system patients being considered for hepatectomy, the BCLC system should be revised to reflect modern liver surgery safety standards, and BCLC stages B should not be considered as absolute contraindications to surgery [6, 7, 8, 9, 10].
According to this system, the most important prognostic factors is the extent or vascular invasion (T1 without, T2 with) within the tumor. Another important prognosticator accounted for in the T portion of the TNM staging system is number of tumors (T3) and direct invasion of other organs (T4). Lymph nodes are only seldomly affected with a histologic diagnosis of HCC, therefore only rarely we observe a N1 status on these patients. Naturally, metastatic disease is denoted as M1 [11].
Although the BCLC staging system has been found to be applicable for all stages of HCC limitations of all of the other systems have been identified. For example, the AJCC (TNM) staging system has limited usefulness since a large portion of HCC patients do not undergo surgery. The most comprehensive comparison between HCC prognostic scores has recently been published by Marrero et al., who analyzed a population homogeneously including all HCC disease strata and drew a retrospective comparison between seven HCC staging systems on a prospectively enrolled cohort: the BCLC system proved to offer the best prognostic score [12].
An initial assessment of hepatic function involves liver function testing including measurement of serum levels of bilirubin, aspartate aminotransferase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), measurement of prothrombin time (PT) expressed as international normalized ratio (INR), albumin, and platelet count (surrogate for portal hypertension). Other recommended tests include complete blood count (CBC), blood urea nitrogen (BUN), and creatinine to assess kidney function; creatinine is also an established prognostic marker in patients with liver disease. Further assessment of hepatic functional reserve prior to hepatic resection in patients with cirrhosis may be performed with different tools such as US and MRI elastography (which may provide and quantify the degree of cirrhosis-related fibrosis), and seldomly non-focal liver biopsy, and transjugular liver biopsy with pressure measurements.
The Child-Pugh classification has been traditionally used for the assessment of hepatic functional reserve in patients with cirrhosis. The Child-Pugh score incorporates laboratory measurements (i.e., serum albumin, bilirubin, PT) as well as more subjective clinical assessments of encephalopathy and ascites. It provides a general estimate of the liver function by classifying patients as having compensated (class A) or decompensated (classes B and C) cirrhosis. Advantages of the Child-Pugh score include ease of performance and the inclusion of non-laboratory, clinical parameters.
An important additional assessment of liver function not included in the Child-Pugh score is an evaluation of signs of clinically significant portal hypertension (i.e., esophagogastric varices, splenomegaly, splenorenal shunts and recanalization of the umbilical vein, thrombocytopenia). Evidence of portal hypertension may be evident on axial imaginsg (CT/MRI). Esophageal varices may be evaluated using esophagogastroduodenoscopy (EGD) or contrast-enhanced cross – sectional imaging.
The Model for End-Stage Liver Disease (MELD) is another system for the evaluation of hepatic reserve. MELD is a mathematical model based on regression analysis which employees a numerical scale ranging from 6 (best) to 40 (worst) for individuals 12 years or older. It is derived using three laboratory values (serum bilirubin, creatinine, and INR) and was originally devised to provide an assessment of mortality for patients undergoing transjugular intrahepatic portosystemic shunts (TIPS), but has been therefore incorporated as an algorithm of gauging suitability for liver transplants [13].
Which HCC patient is a candidate for resection?
Patients being considered for resection must have a high-performance status and be medically fit for what is a major operation. In general hepatic resection is the procedure of choice as a potentially curative option in patients with good liver function (generally Child-Pugh Class A without – or with mild – portal hypertension), who harbor a solitary mass (regardless of size) albeit, without major vascular invasion. In addition, the future liver remnant should be measured at minimum 20% in patients without cirrhosis and at least 40% with Child-Pugh Class A cirrhosis. Lastly, the future liver remnant should be projected to have adequate vascular and biliary inflow/outflow. Hepatic resection is controversial in patients with limited but multifocal disease and in those where tumors are seen to invade major vessels [13].
Surgical removal of a portion of a patient’s liver (partial hepatectomy) is beneficial in removing the tumor that it harbors and thereby limiting its growth and spread to other organs. Partial hepatectomy for well-selected patients with HCC can nowadays be performed with low operative morbidity (<25%) and mortality (≤2–5%). Results of large retrospective studies have shown 5-year survival rates for patients with preserved liver function and early-stage HCC of approximately 70%.
Since liver resection for patients with HCC includes removal of functional liver parenchyma in the setting of underlying liver disease, careful patient selection, based on patient characteristics as well as characteristics of the liver and the tumor(s), is essential. Beyond functional liver remnant volume and adequacy of vascular inflow & outflow, technical considerations related to tumor and liver anatomy, must be taken into account before a patient is determined to have potentially resectable disease.
Resection is recommended only in the setting of preserved liver function. The Child-Pugh score provides an estimate of liver function, although it has been suggested that it is more useful as a tool to rule out patients for liver resection (i.e., serving as a means to identify patients with substantially decompensated liver disease). An evaluation of the presence of significant portal hypertension is also an important part of the surgical assessment.
Before the first laparoscopic hepatectomy (LH) was described as early as 1991, open hepatectomy (OH) was the only choice for surgical treatment of liver tumors. LH indications were initially based solely on tumor location, size, and type and was only used for partial resection of the anterolateral segments.
Several studies have been conducted comparing laparoscopic liver resection (LLR) versus open liver resection (OLR) for hepatocellular carcinoma (HCC), however, the optimal therapeutic approach has not been established [10, 14, 15, 16, 17, 18, 19, 20].
A 2019 systematic review and meta-analysis by the Department of Hepatobiliary Surgery of Bengbu Medical College analyzed 17 studies comparing OH and LH. This metanalysis included 2004 patients and showed the following findings: For short-term outcomes, LH was associated with less blood loss, lower blood transfusion rates, reduced occurrence of postoperative complications, wider surgical margin, shorter postoperative hospital stay, and declined rate of mortality (all
Another 2018 European systematic review and meta-analysis of individual patient data by Meidai Kasai et al. also compared outcomes of LH and OH. A total of 917 patients were divided into the laparoscopic (427) and open (490) groups from 8 selected studies. Interestingly, the hospital stay was significantly shorter, and the total morbidity was lower in the laparoscopic group. When classified by severity, the incidence of postoperative minor complications was lower in the LH group, however, that of major complications was not significantly different. The operative time was longer in the laparoscopic group; however, intraoperative blood loss, perioperative mortality, and blood transfusions were comparable between the two groups. The overall survival in the patients with colorectal liver metastases and hepatocellular carcinoma was not significantly different between the two groups in this metaanalysis [20].
It is clear that LLR has the same benefits as other laparoscopic procedures, such as earlier, recovery and discharge, and reduced postoperative pain. It is also important to underline the many benefits of the laparoscopic approach are obtained while there are no differences in oncologic outcomes compared to OLR. Furthermore, the studies showed the specific advantages of LLR: lower volume of blood loss, shorter portal clamp time and less overall and liver-specific complications, for selected patients and within the technical capabilities of each experienced center. LLR also allows for better visibility and manipulation in a small operative field under some conditions, such as repeat hepatectomy with adhesions. Laparoscopic surgery makes subsequent abdominal operations easier by reducing adhesions. It was reported that the salvage transplantation after previous LLR is associated with reductions of operation time, blood loss, and transfusion requirements, compared to that after OLR. Therefore, it is advantageous not only in reducing future adhesions but also in decreasing the need for adhesiolysis in repeat abdominal exploration.
The safety and feasibility of LLR and its short-term benefits for the patients with HCC and CLD have also been well demonstrated. Reduction of surgery-induced stress by LLR, especially in the patients with HCC and CLD, decreases the risk of refractory ascites due to the preservation of venous and lymphatic collateral flows. In result, this reduces the risk of water or electrolyte imbalances and hypoproteinemia that could lead to liver failure.
Although currently there is no established adjuvant therapy for patients with hepatocellular carcinoma who undergo resection, patients do recover fully faster after laparoscopic hepatectomy. As such, when future effective adjuvant modalities emerge, patients who undergo laparoscopic resection will be fully recovered and ready to receive these much sooner than patients who undergo an open resection. This has been shown in patients with colorectal liver metastasis who undergo laparoscopic liver resection to have a prognostic benefit compared to patients who undergo an open resection.
In general, “peripheral” liver segments can be resected laparoscopically much easier than “central”. This applies to the left lateral segment (II & III) and to segments V & VI). Segments adjacent to the diaphragm (segments II, VII, VIII), are more challenging to access and safely resect laparoscopically. A thoracoscopic approach could be considered in these situations, but this is accompanied by the challenges of entering the pleural space and lack of quick hepatic hilum access, should one be needed intraoperatively. In addition a formal hepatic lobectomy is more challenging laparoscopically than it is open. It is therefore intuitive for a novice laparoscopic surgeon to start performing the easier, peripheral, resections first, and build a routine in mobilizing the liver, addressing problems, controlling hemorrhage etc., before embarking in bigger resections. The reported learning curve is 50 cases before a surgeon can take on more challenging cases, including laparoscopic lobectomy. It should be emphasized that during the first 50 cases, conversion rate can be as high as 50%, which is never worrisome and should never be considered a sign of failure. In almost all case, conversion is a sign of surgical maturity on behalf of the surgeon.
In is important to underline that the key initial steps are standard in pursuing laparoscopic liver resection, be it for a minor segmentectomy or a lobectomy. Set up, important for all surgical operations, is of paramount significance when it comes to LLR. The wrong setup can render a straightforward case into a very difficult one, necessitating needless conversion to open exploration. During LLR there is no surgical hand in the abdomen to gently but swiftly retract the liver and enable its mobilization, and/or tamponade a bleeding vessel. Surgical ingenuity has led to utilization of gravity to assist in retracting and mobilization, or the opposite in the event of hemorrhage during LLR.
We present herein a step by step laparoscopic approach through a video which highlights key points including surgical set up, placement of trocars, full mobilization of a liver lobe, facilitating access and resection of lesions in subdiaphragmatic hepatic segments through a minimally invasive peritoneal approach.
The video presented herein concerns the laparoscopic resection of a 2 cm liver mass in segment 7. The patient had a solid mass but in Computed Tomography and Magnetic Resonance imaging, and was FDG avid on PET CT. The patient, an otherwise healthy 51-year-old woman, with no past medical or surgical history. Of note, the patient provided consent to use the recorded video of her operation while protecting her privacy and maintaining her anonymity. In this video, we summarize key steps/technical tips with laparoscopic liver resections from our experience with minimally invasive hepatectomies, and highlight the challenges of subdiaphragmatic liver lesion resections. As mentioned, several key maneuvers are highlighted which apply to laparoscopic liver resection, of all segments.
One of the most important key elements of laparoscopic liver resection especially for resection of the right lobe, is positioning the patient in a full left lateral decubitus position, with the patient’s trunk at 90-degree angle to the operating room table and the right upper extremity position securely over the patient’s right chest. Drawing from the experience of laparoscopic adrenalectomies, the full left lateral position allows for easier, lateral access to the right lobe of the liver. “Jackknifing” the table opens up the working space at the far right of the abdominal musculature even more.
This approach is taking advantage of the weight of the liver itself, which is rotated medially by gravity as mobilization progresses, and obviates the need for an additional port for a liver retractor. An arm rest for the patient’s right upper extremity should be employed to position it at a comfortable position over and above the upper right chest. Appropriate padding should be placed under the left axilla and at all pressure points of the trunk. The patient’s abdomen, particularly the right upper quadrant at a minimum, should be left unobstructed for laparoscopic port placement but also for a quick laparotomy (through a generous right subcostal incision), should the need arise intraoperatively. The patient’s body should be secured on the operating table in a fashion that will enable steep Trendelenburg and reverse Trendelenburg positioning, as well as rotation of the table to the right and left without patient slipping. We favor a belt around the patient’s hip as well as stop latches at the lower spine and suprapubic areas. Intravenous fluid administration should be kept to a minimum until parenchymal transection, as is true for all liver resections.
Initially, just three 5 mm ports are placed, as shown in image 1, one for a high definition 5 mm camera and two for the laparoscopic instruments. Insufflation of the abdomen is instituted at a pressure of 12 mm Hg, with the ability to increase the intra-abdominal pressure up to 20 mm Hg should venous or low-pressure parenchymal bleeding is encountered. Depending on the most beneficial camera view and angle of approach, one of the 5 mm working ports is converted into a 12 mm port, once the desirable degree of hepatic mobilization is obtained. The upsized port can accommodate a vascular cartridge-loaded stapler or the laparoscopic ultrasound probe for intraoperative sonographic examination of the parenchyma.
Mobilization of the right lobe can proceed working laterally to medially and freeing up the retroperitoneal attachments and the right triangular ligament of the right lobe as shown in the video, https://www.dropbox.com/s/v247mnbo385shnt/hatzaras%20lap%20hepatectomy%20S7%202.mp4?dl=0. Gravity works to the surgeon’s benefit, medializing the lobe as the dissection proceeds. Dividing fully the right triangular ligament is facilitated by additional gentle liver retraction with the right hand instrument, while a vessel-sealing device is yielded with the left hand. The right adrenal quickly comes into view, and care should be used to avoid injuring the fragile gland or its small feeding vessels (e.g. superior adrenal artery and vein). Caution is especially important in the case of a large tumor in the right lobe of the liver, which has been chronically pressing against the right adrenal gland, fusing the right adrenal with the liver capsule, and causing local venous hypertension in the small venous branches; these should be dissected carefully and clipped individually. Care should also be paid to avoiding injuring the diaphragm, which if entered, would lead to pneumothorax; if this was to occur, it can be repaired laparoscopically with heavy absorbable suture, over a suction device that will empty the air from the ipsilateral hemithorax.
Although not shown in this video, this positioning and initial hepatic mobilization allows for the inferior vena cava (IVC) to be fully exposed, if this lateral to medial dissection is continued more medially. The small direct branches from posterior of the right lobe to the IVC can be dissected, clipped and divided as needed. The IVC ligament may also be fully dissected, a vessel loop passed around it and a vascular cartridge-loaded stapler used to transect it safely. Lastly the inferior surface of the right hepatic vein can be encountered and skeletonized, and if the bare area superiorly is fully mobilized, the right hepatic vein can be encircled with a vessel loop and ligated with a vascular stapler.
To avoid the necessity of inflow control at the hilum, and outflow control at the hepatic veins, we frequently use microwave ablation to demarcate the target area of resection before transection of the parenchyma (key move#4). We aim for a 1 cm wide by 3 or 4 cm deep thermal ablation zone, which provides a safe, nearly bloodless transection zone. Alternatively, if the goal is to achieve a completely laparoscopic right hemihepatectomy, the surgeon should perform a cholecystectomy; then by using intraoperative laparoscopic ultrasound to identify the right portal bundle immediately superior and posterior the gallbladder fossa. If clearly identified, the operative surgeon can use a Glissonian approach, perform two shallow hepatotomies, each approximately half an inch long and 1 inch apart, in such a way to accommodate a vascular stapler which will ligate intrahepatically the right portal structures. Excellent demarcation of the right lobe will be seen after successful completion of this maneuver.
Once mobilization is completed we laparoscopically place “liver handles”, two number one braided sutures though and through the parenchyma of the intended specimen in a figure-of eight fashion (key move#5), ensuring to avoid the tumor itself. These “liver handles” are brought through the abdominal wall from a separate lateral stab incision using a suture passer and we secure them with a hemostatic clamp. This maneuver allows easy, gentle extracorporeal intraoperative manipulation of the liver area to be resected. An alternative option of achieving this retraction in lateral lesions is to place a vessel loop around the fully mobilized right lobe, and exteriorize it from the abdominal cavity with a suture passer through a medial separate stab incision; this allows gentle upward retraction of the right liver lobe, the soon to-be-resected portion falls to the right, “opening the book” for the surgeon to deploy the vessel-sealing device and the vascular staplers. We typically use the Harmonic scalpel (Ethicon/Johnson & Johnson, Somerville, NJ) to transect the superficial portion of the parenchyma, followed by “vascular staplers” for the deeper portion. The 12 mm Hg intra-abdominal pressure in combination with the microwave ablation transection treatment renders the transection field relatively bloodless, a clear benefit of laparoscopic hepatectomy, obviating the need for transfusion. After resection and irrigation, we place a hemostatic agent on the cut surface of the liver. The combination of energy transection and vascular stapling allows the pace of the operation to be brisk, and it is typically completed in under 3 hours. The specimen can be removed through a 5–8 cm incision usually in the Pfannenstiel position. With these maneuvers, LLR can achieve the same outcome as the open approach, in the same time, with the same if not lower risk of transfusion, alas, with a much speedier recovery.
In the last two decades, liver surgery has become a much safer surgical procedure to be offered to patients with hepatic malignancies, including Hepatocellular Carcinoma. The laparoscopic approach to liver resection has evolved in parallel. Despite a steep learning curve, LLR can achieve excellent outcomes for well selected patients with Hepatocellular Carcinoma.
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Her research interest is radiology and neuroscience technology and application. She had been trained as an imaging scientist at several prestigious institutes including Columbia University, the University of Pennsylvania, and the National Institutes of Health (NIH). Her research focuses on multi-modal neuroimaging integration such as MRI/PET and EEG/MEG instrumentation to make the best use of multiple modalities for better interpretation of underlying disease mechanisms. She is the author and editor of more than twelve books for well-known publishers including IntechOpen and Nova Science. She has published more than 100 papers and abstracts in many reputed international journals and conferences and served as reviewer and editor for several academic associations.",institutionString:"University of Southern California",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"4",institution:{name:"University of Southern California",institutionURL:null,country:{name:"United States of America"}}},equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9629",title:"Electroencephalography",subtitle:"From Basic Research to Clinical Applications",isOpenForSubmission:!1,hash:"8147834b6c6deeeec40f407c71ad60b4",slug:"electroencephalography-from-basic-research-to-clinical-applications",bookSignature:"Hideki Nakano",coverURL:"https://cdn.intechopen.com/books/images_new/9629.jpg",editedByType:"Edited 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by"}}],booksByTopicTotal:65,seriesByTopicCollection:[],seriesByTopicTotal:0,mostCitedChapters:[{id:"46296",doi:"10.5772/57398",title:"Physiological Role of Amyloid Beta in Neural Cells: The Cellular Trophic Activity",slug:"physiological-role-of-amyloid-beta-in-neural-cells-the-cellular-trophic-activity",totalDownloads:5878,totalCrossrefCites:18,totalDimensionsCites:31,abstract:null,book:{id:"3846",slug:"neurochemistry",title:"Neurochemistry",fullTitle:"Neurochemistry"},signatures:"M. del C. Cárdenas-Aguayo, M. del C. Silva-Lucero, M. Cortes-Ortiz,\nB. Jiménez-Ramos, L. Gómez-Virgilio, G. Ramírez-Rodríguez, E. Vera-\nArroyo, R. Fiorentino-Pérez, U. García, J. Luna-Muñoz and M.A.\nMeraz-Ríos",authors:[{id:"42225",title:"Dr.",name:"Jose",middleName:null,surname:"Luna-Muñoz",slug:"jose-luna-munoz",fullName:"Jose Luna-Muñoz"},{id:"114746",title:"Dr.",name:"Marco",middleName:null,surname:"Meraz-Ríos",slug:"marco-meraz-rios",fullName:"Marco Meraz-Ríos"},{id:"169616",title:"Dr.",name:"Maria del Carmen",middleName:null,surname:"Cardenas-Aguayo",slug:"maria-del-carmen-cardenas-aguayo",fullName:"Maria del Carmen Cardenas-Aguayo"},{id:"169857",title:"Dr.",name:"Maria del Carmen",middleName:null,surname:"Silva-Lucero",slug:"maria-del-carmen-silva-lucero",fullName:"Maria del Carmen Silva-Lucero"},{id:"169858",title:"Dr.",name:"Maribel",middleName:null,surname:"Cortes-Ortiz",slug:"maribel-cortes-ortiz",fullName:"Maribel Cortes-Ortiz"},{id:"169859",title:"Dr.",name:"Berenice",middleName:null,surname:"Jimenez-Ramos",slug:"berenice-jimenez-ramos",fullName:"Berenice Jimenez-Ramos"},{id:"169860",title:"Dr.",name:"Laura",middleName:null,surname:"Gomez-Virgilio",slug:"laura-gomez-virgilio",fullName:"Laura Gomez-Virgilio"},{id:"169861",title:"Dr.",name:"Gerardo",middleName:null,surname:"Ramirez-Rodriguez",slug:"gerardo-ramirez-rodriguez",fullName:"Gerardo Ramirez-Rodriguez"},{id:"169862",title:"Dr.",name:"Eduardo",middleName:null,surname:"Vera-Arroyo",slug:"eduardo-vera-arroyo",fullName:"Eduardo Vera-Arroyo"},{id:"169863",title:"Dr.",name:"Rosana Sofia",middleName:null,surname:"Fiorentino-Perez",slug:"rosana-sofia-fiorentino-perez",fullName:"Rosana Sofia Fiorentino-Perez"},{id:"169864",title:"Dr.",name:"Ubaldo",middleName:null,surname:"Garcia",slug:"ubaldo-garcia",fullName:"Ubaldo Garcia"}]},{id:"58070",doi:"10.5772/intechopen.72427",title:"MRI Medical Image Denoising by Fundamental Filters",slug:"mri-medical-image-denoising-by-fundamental-filters",totalDownloads:2553,totalCrossrefCites:17,totalDimensionsCites:30,abstract:"Nowadays Medical imaging technique Magnetic Resonance Imaging (MRI) plays an important role in medical setting to form high standard images contained in the human brain. MRI is commonly used once treating brain, prostate cancers, ankle and foot. The Magnetic Resonance Imaging (MRI) images are usually liable to suffer from noises such as Gaussian noise, salt and pepper noise and speckle noise. So getting of brain image with accuracy is very extremely task. An accurate brain image is very necessary for further diagnosis process. During this chapter, a median filter algorithm will be modified. Gaussian noise and Salt and pepper noise will be added to MRI image. A proposed Median filter (MF), Adaptive Median filter (AMF) and Adaptive Wiener filter (AWF) will be implemented. The filters will be used to remove the additive noises present in the MRI images. The noise density will be added gradually to MRI image to compare performance of the filters evaluation. The performance of these filters will be compared exploitation the applied mathematics parameter Peak Signal-to-Noise Ratio (PSNR).",book:{id:"6144",slug:"high-resolution-neuroimaging-basic-physical-principles-and-clinical-applications",title:"High-Resolution Neuroimaging",fullTitle:"High-Resolution Neuroimaging - Basic Physical Principles and Clinical Applications"},signatures:"Hanafy M. Ali",authors:[{id:"213318",title:"Dr.",name:"Hanafy",middleName:"M.",surname:"Ali",slug:"hanafy-ali",fullName:"Hanafy Ali"}]},{id:"41589",doi:"10.5772/50323",title:"The Role of the Amygdala in Anxiety Disorders",slug:"the-role-of-the-amygdala-in-anxiety-disorders",totalDownloads:9654,totalCrossrefCites:4,totalDimensionsCites:28,abstract:null,book:{id:"2599",slug:"the-amygdala-a-discrete-multitasking-manager",title:"The Amygdala",fullTitle:"The Amygdala - A Discrete Multitasking Manager"},signatures:"Gina L. Forster, Andrew M. Novick, Jamie L. Scholl and Michael J. Watt",authors:[{id:"145620",title:"Dr.",name:"Gina",middleName:null,surname:"Forster",slug:"gina-forster",fullName:"Gina Forster"},{id:"146553",title:"BSc.",name:"Andrew",middleName:null,surname:"Novick",slug:"andrew-novick",fullName:"Andrew Novick"},{id:"146554",title:"MSc.",name:"Jamie",middleName:null,surname:"Scholl",slug:"jamie-scholl",fullName:"Jamie Scholl"},{id:"146555",title:"Dr.",name:"Michael",middleName:null,surname:"Watt",slug:"michael-watt",fullName:"Michael Watt"}]},{id:"26258",doi:"10.5772/28300",title:"Excitotoxicity and Oxidative Stress in Acute Ischemic Stroke",slug:"excitotoxicity-and-oxidative-stress-in-acute-ischemic-stroke",totalDownloads:7148,totalCrossrefCites:6,totalDimensionsCites:24,abstract:null,book:{id:"931",slug:"acute-ischemic-stroke",title:"Acute Ischemic Stroke",fullTitle:"Acute Ischemic Stroke"},signatures:"Ramón Rama Bretón and Julio César García Rodríguez",authors:[{id:"73430",title:"Prof.",name:"Ramon",middleName:null,surname:"Rama",slug:"ramon-rama",fullName:"Ramon Rama"},{id:"124643",title:"Prof.",name:"Julio Cesar",middleName:null,surname:"García",slug:"julio-cesar-garcia",fullName:"Julio Cesar García"}]},{id:"62072",doi:"10.5772/intechopen.78695",title:"Brain-Computer Interface and Motor Imagery Training: The Role of Visual Feedback and Embodiment",slug:"brain-computer-interface-and-motor-imagery-training-the-role-of-visual-feedback-and-embodiment",totalDownloads:1438,totalCrossrefCites:13,totalDimensionsCites:23,abstract:"Controlling a brain-computer interface (BCI) is a difficult task that requires extensive training. Particularly in the case of motor imagery BCIs, users may need several training sessions before they learn how to generate desired brain activity and reach an acceptable performance. A typical training protocol for such BCIs includes execution of a motor imagery task by the user, followed by presentation of an extending bar or a moving object on a computer screen. In this chapter, we discuss the importance of a visual feedback that resembles human actions, the effect of human factors such as confidence and motivation, and the role of embodiment in the learning process of a motor imagery task. Our results from a series of experiments in which users BCI-operated a humanlike android robot confirm that realistic visual feedback can induce a sense of embodiment, which promotes a significant learning of the motor imagery task in a short amount of time. We review the impact of humanlike visual feedback in optimized modulation of brain activity by the BCI users.",book:{id:"6610",slug:"evolving-bci-therapy-engaging-brain-state-dynamics",title:"Evolving BCI Therapy",fullTitle:"Evolving BCI Therapy - Engaging Brain State Dynamics"},signatures:"Maryam Alimardani, Shuichi Nishio and Hiroshi Ishiguro",authors:[{id:"11981",title:"Prof.",name:"Hiroshi",middleName:null,surname:"Ishiguro",slug:"hiroshi-ishiguro",fullName:"Hiroshi Ishiguro"},{id:"231131",title:"Dr.",name:"Maryam",middleName:null,surname:"Alimardani",slug:"maryam-alimardani",fullName:"Maryam Alimardani"},{id:"231134",title:"Dr.",name:"Shuichi",middleName:null,surname:"Nishio",slug:"shuichi-nishio",fullName:"Shuichi Nishio"}]}],mostDownloadedChaptersLast30Days:[{id:"29764",title:"Underlying Causes of Paresthesia",slug:"underlying-causes-of-paresthesia",totalDownloads:192588,totalCrossrefCites:3,totalDimensionsCites:7,abstract:null,book:{id:"1069",slug:"paresthesia",title:"Paresthesia",fullTitle:"Paresthesia"},signatures:"Mahdi Sharif-Alhoseini, Vafa Rahimi-Movaghar and Alexander R. Vaccaro",authors:[{id:"91165",title:"Prof.",name:"Vafa",middleName:null,surname:"Rahimi-Movaghar",slug:"vafa-rahimi-movaghar",fullName:"Vafa Rahimi-Movaghar"}]},{id:"63258",title:"Anatomy and Function of the Hypothalamus",slug:"anatomy-and-function-of-the-hypothalamus",totalDownloads:4546,totalCrossrefCites:6,totalDimensionsCites:12,abstract:"The hypothalamus is a small but important area of the brain formed by various nucleus and nervous fibers. Through its neuronal connections, it is involved in many complex functions of the organism such as vegetative system control, homeostasis of the organism, thermoregulation, and also in adjusting the emotional behavior. The hypothalamus is involved in different daily activities like eating or drinking, in the control of the body’s temperature and energy maintenance, and in the process of memorizing. It also modulates the endocrine system through its connections with the pituitary gland. Precise anatomical description along with a correct characterization of the component structures is essential for understanding its functions.",book:{id:"6331",slug:"hypothalamus-in-health-and-diseases",title:"Hypothalamus in Health and Diseases",fullTitle:"Hypothalamus in Health and Diseases"},signatures:"Miana Gabriela Pop, Carmen Crivii and Iulian Opincariu",authors:null},{id:"57103",title:"GABA and Glutamate: Their Transmitter Role in the CNS and Pancreatic Islets",slug:"gaba-and-glutamate-their-transmitter-role-in-the-cns-and-pancreatic-islets",totalDownloads:3471,totalCrossrefCites:3,totalDimensionsCites:9,abstract:"Glutamate and gamma-aminobutyric acid (GABA) are the major neurotransmitters in the mammalian brain. Inhibitory GABA and excitatory glutamate work together to control many processes, including the brain’s overall level of excitation. The contributions of GABA and glutamate in extra-neuronal signaling are by far less widely recognized. In this chapter, we first discuss the role of both neurotransmitters during development, emphasizing the importance of the shift from excitatory to inhibitory GABAergic neurotransmission. The second part summarizes the biosynthesis and role of GABA and glutamate in neurotransmission in the mature brain, and major neurological disorders associated with glutamate and GABA receptors and GABA release mechanisms. The final part focuses on extra-neuronal glutamatergic and GABAergic signaling in pancreatic islets of Langerhans, and possible associations with type 1 diabetes mellitus.",book:{id:"6237",slug:"gaba-and-glutamate-new-developments-in-neurotransmission-research",title:"GABA And Glutamate",fullTitle:"GABA And Glutamate - New Developments In Neurotransmission Research"},signatures:"Christiane S. Hampe, Hiroshi Mitoma and Mario Manto",authors:[{id:"210220",title:"Prof.",name:"Christiane",middleName:null,surname:"Hampe",slug:"christiane-hampe",fullName:"Christiane Hampe"},{id:"210485",title:"Prof.",name:"Mario",middleName:null,surname:"Manto",slug:"mario-manto",fullName:"Mario Manto"},{id:"210486",title:"Prof.",name:"Hiroshi",middleName:null,surname:"Mitoma",slug:"hiroshi-mitoma",fullName:"Hiroshi Mitoma"}]},{id:"35802",title:"Cross-Cultural/Linguistic Differences in the Prevalence of Developmental Dyslexia and the Hypothesis of Granularity and Transparency",slug:"cross-cultural-linguistic-differences-in-the-prevalence-of-developmental-dyslexia-and-the-hypothesis",totalDownloads:3597,totalCrossrefCites:2,totalDimensionsCites:7,abstract:null,book:{id:"673",slug:"dyslexia-a-comprehensive-and-international-approach",title:"Dyslexia",fullTitle:"Dyslexia - A Comprehensive and International Approach"},signatures:"Taeko N. Wydell",authors:[{id:"87489",title:"Prof.",name:"Taeko",middleName:"N.",surname:"Wydell",slug:"taeko-wydell",fullName:"Taeko Wydell"}]},{id:"58597",title:"Testosterone and Erectile Function: A Review of Evidence from Basic Research",slug:"testosterone-and-erectile-function-a-review-of-evidence-from-basic-research",totalDownloads:1330,totalCrossrefCites:2,totalDimensionsCites:2,abstract:"Androgens are essential for male physical activity and normal erectile function. Hence, age-related testosterone deficiency, known as late-onset hypogonadism (LOH), is considered a risk factor for erectile dysfunction (ED). This chapter summarizes relevant basic research reports examining the effects of testosterone on erectile function. Testosterone affects several organs and is especially active on the erectile tissue. The mechanism of testosterone deficiency effects on erectile function and the results of testosterone replacement therapy (TRT) have been well studied. Testosterone affects nitric oxide (NO) production and phosphodiesterase type 5 (PDE-5) expression in the corpus cavernosum through molecular pathways, preserves smooth muscle contractility by regulating both contraction and relaxation, and maintains the structure of the corpus cavernosum. Interestingly, testosterone deficiency has relationship to neurological diseases, which leads to ED. Testosterone replacement therapy is widely used to treat patients with testosterone deficiency; however, this treatment might also induce some problems. Basic research suggests that PDE-5 inhibitors, L-citrulline, and/or resveratrol therapy might be effective therapeutic options for testosterone deficiency-induced ED. Future research should confirm these findings through more specific experiments using molecular tools and may shed more light on endocrine-related ED and its possible treatments.",book:{id:"5994",slug:"sex-hormones-in-neurodegenerative-processes-and-diseases",title:"Sex Hormones in Neurodegenerative Processes and Diseases",fullTitle:"Sex Hormones in Neurodegenerative Processes and Diseases"},signatures:"Tomoya Kataoka and Kazunori Kimura",authors:[{id:"219042",title:"Ph.D.",name:"Tomoya",middleName:null,surname:"Kataoka",slug:"tomoya-kataoka",fullName:"Tomoya Kataoka"},{id:"229066",title:"Prof.",name:"Kazunori",middleName:null,surname:"Kimura",slug:"kazunori-kimura",fullName:"Kazunori Kimura"}]}],onlineFirstChaptersFilter:{topicId:"18",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"81646",title:"Cortical Plasticity under Ketamine: From Synapse to Map",slug:"cortical-plasticity-under-ketamine-from-synapse-to-map",totalDownloads:14,totalDimensionsCites:0,doi:"10.5772/intechopen.104787",abstract:"Sensory systems need to process signals in a highly dynamic way to efficiently respond to variations in the animal’s environment. For instance, several studies showed that the visual system is subject to neuroplasticity since the neurons’ firing changes according to stimulus properties. This dynamic information processing might be supported by a network reorganization. Since antidepressants influence neurotransmission, they can be used to explore synaptic plasticity sustaining cortical map reorganization. To this goal, we investigated in the primary visual cortex (V1 of mouse and cat), the impact of ketamine on neuroplasticity through changes in neuronal orientation selectivity and the functional connectivity between V1 cells, using cross correlation analyses. We found that ketamine affects cortical orientation selectivity and alters the functional connectivity within an assembly. These data clearly highlight the role of the antidepressant drugs in inducing or modeling short-term plasticity in V1 which suggests that cortical processing is optimized and adapted to the properties of the stimulus.",book:{id:"11374",title:"Sensory Nervous System - Computational Neuroimaging Investigations of Topographical Organization in Human Sensory Cortex",coverURL:"https://cdn.intechopen.com/books/images_new/11374.jpg"},signatures:"Ouelhazi Afef, Rudy Lussiez and Molotchnikoff Stephane"},{id:"81582",title:"The Role of Cognitive Reserve in Executive Functioning and Its Relationship to Cognitive Decline and Dementia",slug:"the-role-of-cognitive-reserve-in-executive-functioning-and-its-relationship-to-cognitive-decline-and",totalDownloads:21,totalDimensionsCites:0,doi:"10.5772/intechopen.104646",abstract:"In this chapter, we explore how cognitive reserve is implicated in coping with the negative consequences of brain pathology and age-related cognitive decline. Individual differences in cognitive performance are based on different brain mechanisms (neural reserve and neural compensation), and reflect, among others, the effect of education, occupational attainment, leisure activities, and social involvement. These cognitive reserve proxies have been extensively associated with efficient executive functioning. We discuss and focus particularly on the compensation mechanisms related to the frontal lobe and its protective role, in maintaining cognitive performance in old age or even mitigating the clinical expression of dementia.",book:{id:"11742",title:"Neurophysiology",coverURL:"https://cdn.intechopen.com/books/images_new/11742.jpg"},signatures:"Gabriela Álvares-Pereira, Carolina Maruta and Maria Vânia Silva-Nunes"},{id:"81093",title:"Prehospital and Emergency Room Airway Management in Traumatic Brain Injury",slug:"prehospital-and-emergency-room-airway-management-in-traumatic-brain-injury",totalDownloads:48,totalDimensionsCites:0,doi:"10.5772/intechopen.104173",abstract:"Airway management in trauma is critical and may impact patient outcomes. Particularly in traumatic brain injury (TBI), depressed level of consciousness may be associated with compromised protective airway reflexes or apnea, which can increase the risk of aspiration or result in hypoxemia and worsen the secondary brain damage. Therefore, patients with TBI and Glasgow Coma Scale (GCS) ≤ 8 have been traditionally managed by prehospital or emergency room (ER) endotracheal intubation. However, recent evidence challenged this practice and even suggested that routine intubation may be harmful. This chapter will address the indications and optimal method of securing the airway, prehospital and in the ER, in patients with traumatic brain injury.",book:{id:"11367",title:"Traumatic Brain Injury",coverURL:"https://cdn.intechopen.com/books/images_new/11367.jpg"},signatures:"Dominik A. Jakob, Jean-Cyrille Pitteloud and Demetrios Demetriades"},{id:"81011",title:"Amino Acids as Neurotransmitters. The Balance between Excitation and Inhibition as a Background for Future Clinical Applications",slug:"amino-acids-as-neurotransmitters-the-balance-between-excitation-and-inhibition-as-a-background-for-f",totalDownloads:19,totalDimensionsCites:0,doi:"10.5772/intechopen.103760",abstract:"For more than 30 years, amino acids have been well-known (and essential) participants in neurotransmission. They act as both neuromediators and metabolites in nervous tissue. Glycine and glutamic acid (glutamate) are prominent examples. These amino acids are agonists of inhibitory and excitatory membrane receptors, respectively. Moreover, they play essential roles in metabolic pathways and energy transformation in neurons and astrocytes. Despite their obvious effects on the brain, their potential role in therapeutic methods remains uncertain in clinical practice. In the current chapter, a comparison of the crosstalk between these two systems, which are responsible for excitation and inhibition in neurons, is presented. The interactions are discussed at the metabolic, receptor, and transport levels. Reaction-diffusion and a convectional flow into the interstitial fluid create a balanced distribution of glycine and glutamate. Indeed, the neurons’ final physiological state is a result of a balance between the excitatory and inhibitory influences. However, changes to the glycine and/or glutamate pools under pathological conditions can alter the state of nervous tissue. Thus, new therapies for various diseases may be developed on the basis of amino acid medication.",book:{id:"10890",title:"Recent Advances in Neurochemistry",coverURL:"https://cdn.intechopen.com/books/images_new/10890.jpg"},signatures:"Yaroslav R. Nartsissov"},{id:"80821",title:"Neuroimmunology and Neurological Manifestations of COVID-19",slug:"neuroimmunology-and-neurological-manifestations-of-covid-19",totalDownloads:41,totalDimensionsCites:0,doi:"10.5772/intechopen.103026",abstract:"Infection with SARS-CoV-2 is causing coronavirus disease in 2019 (COVID-19). Besides respiratory symptoms due to an attack on the broncho-alveolar system, COVID-19, among others, can be accompanied by neurological symptoms because of the affection of the nervous system. These can be caused by intrusion by SARS-CoV-2 of the central nervous system (CNS) and peripheral nervous system (PNS) and direct infection of local cells. In addition, neurological deterioration mediated by molecular mimicry to virus antigens or bystander activation in the context of immunological anti-virus defense can lead to tissue damage in the CNS and PNS. In addition, cytokine storm caused by SARS-CoV-2 infection in COVID-19 can lead to nervous system related symptoms. Endotheliitis of CNS vessels can lead to vessel occlusion and stroke. COVID-19 can also result in cerebral hemorrhage and sinus thrombosis possibly related to changes in clotting behavior. Vaccination is most important to prevent COVID-19 in the nervous system. There are symptomatic or/and curative therapeutic approaches to combat COVID-19 related nervous system damage that are partly still under study.",book:{id:"10890",title:"Recent Advances in Neurochemistry",coverURL:"https://cdn.intechopen.com/books/images_new/10890.jpg"},signatures:"Robert Weissert"},{id:"80391",title:"COVID-19 and Seizures",slug:"covid-19-and-seizures",totalDownloads:43,totalDimensionsCites:0,doi:"10.5772/intechopen.102540",abstract:"The past two years were deeply marked by the emergence of a global pandemic caused by the worldwide spread of the virus severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection. The plethora of repercussions on the health of those affected is extensive, ranging from asymptomatic individuals, mild flu-like disease, and severe respiratory failure, eventually leading to death. Despite this predilection for the respiratory system, the virus is responsible for multisystemic manifestations and soon became clear that neurological involvement was a frequent issue of coronavirus disease 2019 (COVID-19). Much have been pointed out about the neurotropic nature of the virus, the ways by which it invades and targets specific structures of the central nervous system, and the physiopathology behind the neurologic manifestations associated with it (namely encephalomyelitis, Guillain-Barré syndrome, lacunar infarcts, and vascular dysfunction, just to list a few). This chapter aims to raise light about the association between COVID-19 and the mechanisms of acute symptomatic seizures, through neurotropism and neuroinvasion features of SARS-CoV-2, and to review the variety of clinical presentations reported so far.",book:{id:"10890",title:"Recent Advances in Neurochemistry",coverURL:"https://cdn.intechopen.com/books/images_new/10890.jpg"},signatures:"Rafael Jesus, Carolina Azoia, Paulo Coelho and Pedro Guimarães"}],onlineFirstChaptersTotal:9},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:null,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:10,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:"6",title:"Infectious Diseases",doi:"10.5772/intechopen.71852",issn:"2631-6188",scope:"This series will provide a comprehensive overview of recent research trends in various Infectious Diseases (as per the most recent Baltimore classification). Topics will include general overviews of infections, immunopathology, diagnosis, treatment, epidemiology, etiology, and current clinical recommendations for managing infectious diseases. Ongoing issues, recent advances, and future diagnostic approaches and therapeutic strategies will also be discussed. This book series will focus on various aspects and properties of infectious diseases whose deep understanding is essential for safeguarding the human race from losing resources and economies due to pathogens.",coverUrl:"https://cdn.intechopen.com/series/covers/6.jpg",latestPublicationDate:"May 19th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:13,editor:{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. 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His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. 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He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. 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Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. He is also an international opinion leader/expert in vaccination for Japanese encephalitis by IPIC (UK).",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",institutionURL:null,country:{name:"India"}}}]},{type:"book",id:"7123",title:"Current Topics in Neglected Tropical Diseases",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/7123.jpg",slug:"current-topics-in-neglected-tropical-diseases",publishedDate:"December 4th 2019",editedByType:"Edited by",bookSignature:"Alfonso J. Rodriguez-Morales",hash:"61c627da05b2ace83056d11357bdf361",volumeInSeries:3,fullTitle:"Current Topics in Neglected Tropical Diseases",editors:[{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales",profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",biography:"Dr. Rodriguez-Morales is an expert in tropical and emerging diseases, particularly zoonotic and vector-borne diseases (especially arboviral diseases). He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. 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He is an editor and reviewer for more than fifty peer-reviewed international journals and was a recipient of the “Publons Peer Review Award” in 2017, 2018, and 2019. He has been honored by different authorities for his outstanding performance in various fields like research and education, and he has received the World Academy of Science Young Scientist Award (2014) and the University Grants Commission (UGC) Award 2018. He is a fellow of the Bangladesh Academy of Sciences (BAS) and the Royal Society of Biology.",institutionString:"Sher-e-Bangla Agricultural University",institution:{name:"Sher-e-Bangla Agricultural University",country:{name:"Bangladesh"}}},{id:"187859",title:"Prof.",name:"Kusal",middleName:"K.",surname:"Das",slug:"kusal-das",fullName:"Kusal Das",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSBDeQAO/Profile_Picture_1623411145568",biography:"Kusal K. Das is a Distinguished Chair Professor of Physiology, Shri B. M. Patil Medical College and Director, Centre for Advanced Medical Research (CAMR), BLDE (Deemed to be University), Vijayapur, Karnataka, India. Dr. Das did his M.S. and Ph.D. in Human Physiology from the University of Calcutta, Kolkata. His area of research is focused on understanding of molecular mechanisms of heavy metal activated low oxygen sensing pathways in vascular pathophysiology. He has invented a new method of estimation of serum vitamin E. His expertise in critical experimental protocols on vascular functions in experimental animals was well documented by his quality of publications. He was a Visiting Professor of Medicine at University of Leeds, United Kingdom (2014-2016) and Tulane University, New Orleans, USA (2017). For his immense contribution in medical research Ministry of Science and Technology, Government of India conferred him 'G.P. Chatterjee Memorial Research Prize-2019” and he is also the recipient of 'Dr.Raja Ramanna State Scientist Award 2015” by Government of Karnataka. He is a Fellow of the Royal Society of Biology (FRSB), London and Honorary Fellow of Karnataka Science and Technology Academy, Department of Science and Technology, Government of Karnataka.",institutionString:"BLDE (Deemed to be University), India",institution:null},{id:"243660",title:"Dr.",name:"Mallanagouda Shivanagouda",middleName:null,surname:"Biradar",slug:"mallanagouda-shivanagouda-biradar",fullName:"Mallanagouda Shivanagouda Biradar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243660/images/system/243660.jpeg",biography:"M. S. Biradar is Vice Chancellor and Professor of Medicine of\nBLDE (Deemed to be University), Vijayapura, Karnataka, India.\nHe obtained his MD with a gold medal in General Medicine and\nhas devoted himself to medical teaching, research, and administrations. He has also immensely contributed to medical research\non vascular medicine, which is reflected by his numerous publications including books and book chapters. Professor Biradar was\nalso Visiting Professor at Tulane University School of Medicine, New Orleans, USA.",institutionString:"BLDE (Deemed to be University)",institution:{name:"BLDE University",country:{name:"India"}}},{id:"289796",title:"Dr.",name:"Swastika",middleName:null,surname:"Das",slug:"swastika-das",fullName:"Swastika Das",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/289796/images/system/289796.jpeg",biography:"Swastika N. Das is Professor of Chemistry at the V. P. Dr. P. G.\nHalakatti College of Engineering and Technology, BLDE (Deemed\nto be University), Vijayapura, Karnataka, India. She obtained an\nMSc, MPhil, and PhD in Chemistry from Sambalpur University,\nOdisha, India. Her areas of research interest are medicinal chemistry, chemical kinetics, and free radical chemistry. She is a member\nof the investigators who invented a new modified method of estimation of serum vitamin E. She has authored numerous publications including book\nchapters and is a mentor of doctoral curriculum at her university.",institutionString:"BLDEA’s V.P.Dr.P.G.Halakatti College of Engineering & Technology",institution:{name:"BLDE University",country:{name:"India"}}},{id:"248459",title:"Dr.",name:"Akikazu",middleName:null,surname:"Takada",slug:"akikazu-takada",fullName:"Akikazu Takada",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248459/images/system/248459.png",biography:"Akikazu Takada was born in Japan, 1935. After graduation from\nKeio University School of Medicine and finishing his post-graduate studies, he worked at Roswell Park Memorial Institute NY,\nUSA. He then took a professorship at Hamamatsu University\nSchool of Medicine. In thrombosis studies, he found the SK\npotentiator that enhances plasminogen activation by streptokinase. He is very much interested in simultaneous measurements\nof fatty acids, amino acids, and tryptophan degradation products. By using fatty\nacid analyses, he indicated that plasma levels of trans-fatty acids of old men were\nfar higher in the US than Japanese men. . He also showed that eicosapentaenoic acid\n(EPA) and docosahexaenoic acid (DHA) levels are higher, and arachidonic acid\nlevels are lower in Japanese than US people. By using simultaneous LC/MS analyses\nof plasma levels of tryptophan metabolites, he recently found that plasma levels of\nserotonin, kynurenine, or 5-HIAA were higher in patients of mono- and bipolar\ndepression, which are significantly different from observations reported before. In\nview of recent reports that plasma tryptophan metabolites are mainly produced by\nmicrobiota. He is now working on the relationships between microbiota and depression or autism.",institutionString:"Hamamatsu University School of Medicine",institution:{name:"Hamamatsu University School of Medicine",country:{name:"Japan"}}},{id:"137240",title:"Prof.",name:"Mohammed",middleName:null,surname:"Khalid",slug:"mohammed-khalid",fullName:"Mohammed Khalid",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/137240/images/system/137240.png",biography:"Mohammed Khalid received his B.S. degree in chemistry in 2000 and Ph.D. degree in physical chemistry in 2007 from the University of Khartoum, Sudan. He moved to School of Chemistry, Faculty of Science, University of Sydney, Australia in 2009 and joined Dr. Ron Clarke as a postdoctoral fellow where he worked on the interaction of ATP with the phosphoenzyme of the Na+/K+-ATPase and dual mechanisms of allosteric acceleration of the Na+/K+-ATPase by ATP; then he went back to Department of Chemistry, University of Khartoum as an assistant professor, and in 2014 he was promoted as an associate professor. In 2011, he joined the staff of Department of Chemistry at Taif University, Saudi Arabia, where he is currently an assistant professor. His research interests include the following: P-Type ATPase enzyme kinetics and mechanisms, kinetics and mechanisms of redox reactions, autocatalytic reactions, computational enzyme kinetics, allosteric acceleration of P-type ATPases by ATP, exploring of allosteric sites of ATPases, and interaction of ATP with ATPases located in cell membranes.",institutionString:"Taif University",institution:{name:"Taif University",country:{name:"Saudi Arabia"}}},{id:"63810",title:"Prof.",name:"Jorge",middleName:null,surname:"Morales-Montor",slug:"jorge-morales-montor",fullName:"Jorge Morales-Montor",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/63810/images/system/63810.png",biography:"Dr. Jorge Morales-Montor was recognized with the Lola and Igo Flisser PUIS Award for best graduate thesis at the national level in the field of parasitology. He received a fellowship from the Fogarty Foundation to perform postdoctoral research stay at the University of Georgia. He has 153 journal articles to his credit. He has also edited several books and published more than fifty-five book chapters. He is a member of the Mexican Academy of Sciences, Latin American Academy of Sciences, and the National Academy of Medicine. He has received more than thirty-five awards and has supervised numerous bachelor’s, master’s, and Ph.D. students. Dr. Morales-Montor is the past president of the Mexican Society of Parasitology.",institutionString:"National Autonomous University of Mexico",institution:{name:"National Autonomous University of Mexico",country:{name:"Mexico"}}},{id:"217215",title:"Dr.",name:"Palash",middleName:null,surname:"Mandal",slug:"palash-mandal",fullName:"Palash Mandal",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/217215/images/system/217215.jpeg",biography:null,institutionString:"Charusat University",institution:null},{id:"49739",title:"Dr.",name:"Leszek",middleName:null,surname:"Szablewski",slug:"leszek-szablewski",fullName:"Leszek Szablewski",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49739/images/system/49739.jpg",biography:"Leszek Szablewski is a professor of medical sciences. He received his M.S. in the Faculty of Biology from the University of Warsaw and his PhD degree from the Institute of Experimental Biology Polish Academy of Sciences. He habilitated in the Medical University of Warsaw, and he obtained his degree of Professor from the President of Poland. Professor Szablewski is the Head of Chair and Department of General Biology and Parasitology, Medical University of Warsaw. Professor Szablewski has published over 80 peer-reviewed papers in journals such as Journal of Alzheimer’s Disease, Biochim. Biophys. Acta Reviews of Cancer, Biol. Chem., J. Biomed. Sci., and Diabetes/Metabol. Res. Rev, Endocrine. He is the author of two books and four book chapters. He has edited four books, written 15 scripts for students, is the ad hoc reviewer of over 30 peer-reviewed journals, and editorial member of peer-reviewed journals. Prof. Szablewski’s research focuses on cell physiology, genetics, and pathophysiology. He works on the damage caused by lack of glucose homeostasis and changes in the expression and/or function of glucose transporters due to various diseases. He has given lectures, seminars, and exercises for students at the Medical University.",institutionString:"Medical University of Warsaw",institution:{name:"Medical University of Warsaw",country:{name:"Poland"}}},{id:"173123",title:"Dr.",name:"Maitham",middleName:null,surname:"Khajah",slug:"maitham-khajah",fullName:"Maitham Khajah",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/173123/images/system/173123.jpeg",biography:"Dr. Maitham A. Khajah received his degree in Pharmacy from Faculty of Pharmacy, Kuwait University, in 2003 and obtained his PhD degree in December 2009 from the University of Calgary, Canada (Gastrointestinal Science and Immunology). Since January 2010 he has been assistant professor in Kuwait University, Faculty of Pharmacy, Department of Pharmacology and Therapeutics. His research interest are molecular targets for the treatment of inflammatory bowel disease (IBD) and the mechanisms responsible for immune cell chemotaxis. He cosupervised many students for the MSc Molecular Biology Program, College of Graduate Studies, Kuwait University. Ever since joining Kuwait University in 2010, he got various grants as PI and Co-I. He was awarded the Best Young Researcher Award by Kuwait University, Research Sector, for the Year 2013–2014. He was a member in the organizing committee for three conferences organized by Kuwait University, Faculty of Pharmacy, as cochair and a member in the scientific committee (the 3rd, 4th, and 5th Kuwait International Pharmacy Conference).",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"195136",title:"Dr.",name:"Aya",middleName:null,surname:"Adel",slug:"aya-adel",fullName:"Aya Adel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/195136/images/system/195136.jpg",biography:"Dr. Adel works as an Assistant Lecturer in the unit of Phoniatrics, Department of Otolaryngology, Ain Shams University in Cairo, Egypt. Dr. Adel is especially interested in joint attention and its impairment in autism spectrum disorder",institutionString:"Ain Shams University",institution:{name:"Ain Shams University",country:{name:"Egypt"}}},{id:"94911",title:"Dr.",name:"Boulenouar",middleName:null,surname:"Mesraoua",slug:"boulenouar-mesraoua",fullName:"Boulenouar Mesraoua",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94911/images/system/94911.png",biography:"Dr Boulenouar Mesraoua is the Associate Professor of Clinical Neurology at Weill Cornell Medical College-Qatar and a Consultant Neurologist at Hamad Medical Corporation at the Neuroscience Department; He graduated as a Medical Doctor from the University of Oran, Algeria; he then moved to Belgium, the City of Liege, for a Residency in Internal Medicine and Neurology at Liege University; after getting the Belgian Board of Neurology (with high marks), he went to the National Hospital for Nervous Diseases, Queen Square, London, United Kingdom for a fellowship in Clinical Neurophysiology, under Pr Willison ; Dr Mesraoua had also further training in Epilepsy and Continuous EEG Monitoring for two years (from 2001-2003) in the Neurophysiology department of Zurich University, Switzerland, under late Pr Hans Gregor Wieser ,an internationally known epileptologist expert. \n\nDr B. Mesraoua is the Director of the Neurology Fellowship Program at the Neurology Section and an active member of the newly created Comprehensive Epilepsy Program at Hamad General Hospital, Doha, Qatar; he is also Assistant Director of the Residency Program at the Qatar Medical School. \nDr B. Mesraoua's main interests are Epilepsy, Multiple Sclerosis, and Clinical Neurology; He is the Chairman and the Organizer of the well known Qatar Epilepsy Symposium, he is running yearly for the past 14 years and which is considered a landmark in the Gulf region; He has also started last year , together with other epileptologists from Qatar, the region and elsewhere, a yearly International Epilepsy School Course, which was attended by many neurologists from the Area.\n\nInternationally, Dr Mesraoua is an active and elected member of the Commission on Eastern Mediterranean Region (EMR ) , a regional branch of the International League Against Epilepsy (ILAE), where he represents the Middle East and North Africa(MENA ) and where he holds the position of chief of the Epilepsy Epidemiology Section; Dr Mesraoua is a member of the American Academy of Neurology, the Europeen Academy of Neurology and the American Epilepsy Society.\n\nDr Mesraoua's main objectives are to encourage frequent gathering of the epileptologists/neurologists from the MENA region and the rest of the world, promote Epilepsy Teaching in the MENA Region, and encourage multicenter studies involving neurologists and epileptologists in the MENA region, particularly epilepsy epidemiological studies. \n\nDr. Mesraoua is the recipient of two research Grants, as the Lead Principal Investigator (750.000 USD and 250.000 USD) from the Qatar National Research Fund (QNRF) and the Hamad Hospital Internal Research Grant (IRGC), on the following topics : “Continuous EEG Monitoring in the ICU “ and on “Alpha-lactoalbumin , proof of concept in the treatment of epilepsy” .Dr Mesraoua is a reviewer for the journal \"seizures\" (Europeen Epilepsy Journal ) as well as dove journals ; Dr Mesraoua is the author and co-author of many peer reviewed publications and four book chapters in the field of Epilepsy and Clinical Neurology",institutionString:"Weill Cornell Medical College in Qatar",institution:{name:"Weill Cornell Medical College in Qatar",country:{name:"Qatar"}}},{id:"282429",title:"Prof.",name:"Covanis",middleName:null,surname:"Athanasios",slug:"covanis-athanasios",fullName:"Covanis Athanasios",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/282429/images/system/282429.jpg",biography:null,institutionString:"Neurology-Neurophysiology Department of the Children Hospital Agia Sophia",institution:null},{id:"190980",title:"Prof.",name:"Marwa",middleName:null,surname:"Mahmoud Saleh",slug:"marwa-mahmoud-saleh",fullName:"Marwa Mahmoud Saleh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/190980/images/system/190980.jpg",biography:"Professor Marwa Mahmoud Saleh is a doctor of medicine and currently works in the unit of Phoniatrics, Department of Otolaryngology, Ain Shams University in Cairo, Egypt. She got her doctoral degree in 1991 and her doctoral thesis was accomplished in the University of Iowa, United States. Her publications covered a multitude of topics as videokymography, cochlear implants, stuttering, and dysphagia. She has lectured Egyptian phonology for many years. Her recent research interest is joint attention in autism.",institutionString:"Ain Shams University",institution:{name:"Ain Shams University",country:{name:"Egypt"}}},{id:"259190",title:"Dr.",name:"Syed Ali Raza",middleName:null,surname:"Naqvi",slug:"syed-ali-raza-naqvi",fullName:"Syed Ali Raza Naqvi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259190/images/system/259190.png",biography:"Dr. Naqvi is a radioanalytical chemist and is working as an associate professor of analytical chemistry in the Department of Chemistry, Government College University, Faisalabad, Pakistan. Advance separation techniques, nuclear analytical techniques and radiopharmaceutical analysis are the main courses that he is teaching to graduate and post-graduate students. In the research area, he is focusing on the development of organic- and biomolecule-based radiopharmaceuticals for diagnosis and therapy of infectious and cancerous diseases. Under the supervision of Dr. Naqvi, three students have completed their Ph.D. degrees and 41 students have completed their MS degrees. He has completed three research projects and is currently working on 2 projects entitled “Radiolabeling of fluoroquinolone derivatives for the diagnosis of deep-seated bacterial infections” and “Radiolabeled minigastrin peptides for diagnosis and therapy of NETs”. He has published about 100 research articles in international reputed journals and 7 book chapters. Pakistan Institute of Nuclear Science & Technology (PINSTECH) Islamabad, Punjab Institute of Nuclear Medicine (PINM), Faisalabad and Institute of Nuclear Medicine and Radiology (INOR) Abbottabad are the main collaborating institutes.",institutionString:"Government College University",institution:{name:"Government College University, Faisalabad",country:{name:"Pakistan"}}},{id:"58390",title:"Dr.",name:"Gyula",middleName:null,surname:"Mozsik",slug:"gyula-mozsik",fullName:"Gyula Mozsik",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/58390/images/system/58390.png",biography:"Gyula Mózsik MD, Ph.D., ScD (med), is an emeritus professor of Medicine at the First Department of Medicine, Univesity of Pécs, Hungary. He was head of this department from 1993 to 2003. His specializations are medicine, gastroenterology, clinical pharmacology, clinical nutrition, and dietetics. His research fields are biochemical pharmacological examinations in the human gastrointestinal (GI) mucosa, mechanisms of retinoids, drugs, capsaicin-sensitive afferent nerves, and innovative pharmacological, pharmaceutical, and nutritional (dietary) research in humans. He has published about 360 peer-reviewed papers, 197 book chapters, 692 abstracts, 19 monographs, and has edited 37 books. He has given about 1120 regular and review lectures. He has organized thirty-eight national and international congresses and symposia. He is the founder of the International Conference on Ulcer Research (ICUR); International Union of Pharmacology, Gastrointestinal Section (IUPHAR-GI); Brain-Gut Society symposiums, and gastrointestinal cytoprotective symposiums. He received the Andre Robert Award from IUPHAR-GI in 2014. Fifteen of his students have been appointed as full professors in Egypt, Cuba, and Hungary.",institutionString:"University of Pécs",institution:{name:"University of Pecs",country:{name:"Hungary"}}},{id:"277367",title:"M.Sc.",name:"Daniel",middleName:"Martin",surname:"Márquez López",slug:"daniel-marquez-lopez",fullName:"Daniel Márquez López",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/277367/images/7909_n.jpg",biography:"Msc Daniel Martin Márquez López has a bachelor degree in Industrial Chemical Engineering, a Master of science degree in the same área and he is a PhD candidate for the Instituto Politécnico Nacional. His Works are realted to the Green chemistry field, biolubricants, biodiesel, transesterification reactions for biodiesel production and the manipulation of oils for therapeutic purposes.",institutionString:null,institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"196544",title:"Prof.",name:"Angel",middleName:null,surname:"Catala",slug:"angel-catala",fullName:"Angel Catala",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/196544/images/system/196544.jpg",biography:"Angel Catalá studied chemistry at Universidad Nacional de La Plata, Argentina, where he received a Ph.D. in Chemistry (Biological Branch) in 1965. From 1964 to 1974, he worked as an Assistant in Biochemistry at the School of Medicine at the same university. From 1974 to 1976, he was a fellow of the National Institutes of Health (NIH) at the University of Connecticut, Health Center, USA. From 1985 to 2004, he served as a Full Professor of Biochemistry at the Universidad Nacional de La Plata. He is a member of the National Research Council (CONICET), Argentina, and the Argentine Society for Biochemistry and Molecular Biology (SAIB). His laboratory has been interested for many years in the lipid peroxidation of biological membranes from various tissues and different species. Dr. Catalá has directed twelve doctoral theses, published more than 100 papers in peer-reviewed journals, several chapters in books, and edited twelve books. He received awards at the 40th International Conference Biochemistry of Lipids 1999 in Dijon, France. He is the winner of the Bimbo Pan-American Nutrition, Food Science and Technology Award 2006 and 2012, South America, Human Nutrition, Professional Category. In 2006, he won the Bernardo Houssay award in pharmacology, in recognition of his meritorious works of research. Dr. Catalá belongs to the editorial board of several journals including Journal of Lipids; International Review of Biophysical Chemistry; Frontiers in Membrane Physiology and Biophysics; World Journal of Experimental Medicine and Biochemistry Research International; World Journal of Biological Chemistry, Diabetes, and the Pancreas; International Journal of Chronic Diseases & Therapy; and International Journal of Nutrition. He is the co-editor of The Open Biology Journal and associate editor for Oxidative Medicine and Cellular Longevity.",institutionString:"Universidad Nacional de La Plata",institution:{name:"National University of La Plata",country:{name:"Argentina"}}},{id:"186585",title:"Dr.",name:"Francisco Javier",middleName:null,surname:"Martin-Romero",slug:"francisco-javier-martin-romero",fullName:"Francisco Javier Martin-Romero",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSB3HQAW/Profile_Picture_1631258137641",biography:"Francisco Javier Martín-Romero (Javier) is a Professor of Biochemistry and Molecular Biology at the University of Extremadura, Spain. He is also a group leader at the Biomarkers Institute of Molecular Pathology. Javier received his Ph.D. in 1998 in Biochemistry and Biophysics. At the National Cancer Institute (National Institute of Health, Bethesda, MD) he worked as a research associate on the molecular biology of selenium and its role in health and disease. After postdoctoral collaborations with Carlos Gutierrez-Merino (University of Extremadura, Spain) and Dario Alessi (University of Dundee, UK), he established his own laboratory in 2008. The interest of Javier's lab is the study of cell signaling with a special focus on Ca2+ signaling, and how Ca2+ transport modulates the cytoskeleton, migration, differentiation, cell death, etc. He is especially interested in the study of Ca2+ channels, and the role of STIM1 in the initiation of pathological events.",institutionString:null,institution:{name:"University of Extremadura",country:{name:"Spain"}}},{id:"217323",title:"Prof.",name:"Guang-Jer",middleName:null,surname:"Wu",slug:"guang-jer-wu",fullName:"Guang-Jer Wu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/217323/images/8027_n.jpg",biography:null,institutionString:null,institution:null},{id:"148546",title:"Dr.",name:"Norma Francenia",middleName:null,surname:"Santos-Sánchez",slug:"norma-francenia-santos-sanchez",fullName:"Norma Francenia Santos-Sánchez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/148546/images/4640_n.jpg",biography:null,institutionString:null,institution:null},{id:"272889",title:"Dr.",name:"Narendra",middleName:null,surname:"Maddu",slug:"narendra-maddu",fullName:"Narendra Maddu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/272889/images/10758_n.jpg",biography:null,institutionString:null,institution:null},{id:"242491",title:"Prof.",name:"Angelica",middleName:null,surname:"Rueda",slug:"angelica-rueda",fullName:"Angelica Rueda",position:"Investigador Cinvestav 3B",profilePictureURL:"https://mts.intechopen.com/storage/users/242491/images/6765_n.jpg",biography:null,institutionString:null,institution:null},{id:"88631",title:"Dr.",name:"Ivan",middleName:null,surname:"Petyaev",slug:"ivan-petyaev",fullName:"Ivan Petyaev",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Lycotec (United Kingdom)",country:{name:"United Kingdom"}}},{id:"423869",title:"Ms.",name:"Smita",middleName:null,surname:"Rai",slug:"smita-rai",fullName:"Smita Rai",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Integral University",country:{name:"India"}}},{id:"424024",title:"Prof.",name:"Swati",middleName:null,surname:"Sharma",slug:"swati-sharma",fullName:"Swati Sharma",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Integral University",country:{name:"India"}}},{id:"439112",title:"MSc.",name:"Touseef",middleName:null,surname:"Fatima",slug:"touseef-fatima",fullName:"Touseef Fatima",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Integral University",country:{name:"India"}}},{id:"424836",title:"Dr.",name:"Orsolya",middleName:null,surname:"Borsai",slug:"orsolya-borsai",fullName:"Orsolya Borsai",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca",country:{name:"Romania"}}},{id:"422262",title:"Ph.D.",name:"Paola Andrea",middleName:null,surname:"Palmeros-Suárez",slug:"paola-andrea-palmeros-suarez",fullName:"Paola Andrea Palmeros-Suárez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Guadalajara",country:{name:"Mexico"}}}]}},subseries:{item:{id:"12",type:"subseries",title:"Human Physiology",keywords:"Anatomy, Cells, Organs, Systems, Homeostasis, Functions",scope:"Human physiology is the scientific exploration of the various functions (physical, biochemical, and mechanical properties) of humans, their organs, and their constituent cells. The endocrine and nervous systems play important roles in maintaining homeostasis in the human body. Integration, which is the biological basis of physiology, is achieved through communication between the many overlapping functions of the human body's systems, which takes place through electrical and chemical means. Much of the basis of our knowledge of human physiology has been provided by animal experiments. Because of the close relationship between structure and function, studies in human physiology and anatomy seek to understand the mechanisms that help the human body function. The series on human physiology deals with the various mechanisms of interaction between the various organs, nerves, and cells in the human body.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/12.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11408,editor:{id:"195829",title:"Prof.",name:"Kunihiro",middleName:null,surname:"Sakuma",slug:"kunihiro-sakuma",fullName:"Kunihiro Sakuma",profilePictureURL:"https://mts.intechopen.com/storage/users/195829/images/system/195829.jpg",biography:"Professor Kunihiro Sakuma, Ph.D., currently works in the Institute for Liberal Arts at the Tokyo Institute of Technology. He is a physiologist working in the field of skeletal muscle. He was awarded his sports science diploma in 1995 by the University of Tsukuba and began his scientific work at the Department of Physiology, Aichi Human Service Center, focusing on the molecular mechanism of congenital muscular dystrophy and normal muscle regeneration. 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