Serotonin receptors associated with the serotonin syndrome development [10, 11, 12].
\\n\\n
IntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
\\n\\nIntechOpen Book Series will be launching regularly to offer our authors and editors exciting opportunities to publish their research Open Access. We will begin by relaunching some of our existing Book Series in this innovative book format, and will expand in 2022 into rapidly growing research fields that are driving and advancing society.
\\n\\nLaunching 2021
\\n\\nArtificial Intelligence, ISSN 2633-1403
\\n\\nVeterinary Medicine and Science, ISSN 2632-0517
\\n\\nBiochemistry, ISSN 2632-0983
\\n\\nBiomedical Engineering, ISSN 2631-5343
\\n\\nInfectious Diseases, ISSN 2631-6188
\\n\\nPhysiology (Coming Soon)
\\n\\nDentistry (Coming Soon)
\\n\\nWe invite you to explore our IntechOpen Book Series, find the right publishing program for you and reach your desired audience in record time.
\\n\\nNote: Edited in October 2021
\\n"}]',published:!0,mainMedia:{caption:"",originalUrl:"/media/original/132"}},components:[{type:"htmlEditorComponent",content:'With the desire to make book publishing more relevant for the digital age and offer innovative Open Access publishing options, we are thrilled to announce the launch of our new publishing format: IntechOpen Book Series.
\n\nDesigned to cover fast-moving research fields in rapidly expanding areas, our Book Series feature a Topic structure allowing us to present the most relevant sub-disciplines. Book Series are headed by Series Editors, and a team of Topic Editors supported by international Editorial Board members. Topics are always open for submissions, with an Annual Volume published each calendar year.
\n\nAfter a robust peer-review process, accepted works are published quickly, thanks to Online First, ensuring research is made available to the scientific community without delay.
\n\nOur innovative Book Series format brings you:
\n\nIntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
\n\nIntechOpen Book Series will be launching regularly to offer our authors and editors exciting opportunities to publish their research Open Access. We will begin by relaunching some of our existing Book Series in this innovative book format, and will expand in 2022 into rapidly growing research fields that are driving and advancing society.
\n\nLaunching 2021
\n\nArtificial Intelligence, ISSN 2633-1403
\n\nVeterinary Medicine and Science, ISSN 2632-0517
\n\nBiochemistry, ISSN 2632-0983
\n\nBiomedical Engineering, ISSN 2631-5343
\n\nInfectious Diseases, ISSN 2631-6188
\n\nPhysiology (Coming Soon)
\n\nDentistry (Coming Soon)
\n\nWe invite you to explore our IntechOpen Book Series, find the right publishing program for you and reach your desired audience in record time.
\n\nNote: Edited in October 2021
\n'}],latestNews:[{slug:"intechopen-supports-asapbio-s-new-initiative-publish-your-reviews-20220729",title:"IntechOpen Supports ASAPbio’s New Initiative Publish Your Reviews"},{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"}]},book:{item:{type:"book",id:"10331",leadTitle:null,fullTitle:"Salmonella spp. - A Global Challenge",title:"Salmonella spp",subtitle:"A Global Challenge",reviewType:"peer-reviewed",abstract:"Salmonella is one of the main bacterial pathogens worldwide. S. Typhi is responsible for typhoid fever via fecal-oral transmission through contaminated food and water, whereas nontyphoidal Salmonella is transmitted through the food chain. Typhoid fever is of particular concern in developing countries. This means that control measures and the development of effective vaccines are necessary. Infections caused by multi-drug resistant Salmonella strains are becoming increasingly common. This book presents a comprehensive overview of the genus of Salmonella, including information on vaccines, control measures, strain characterization, bacteriophages, and much more.",isbn:"978-1-83969-018-1",printIsbn:"978-1-83969-017-4",pdfIsbn:"978-1-83969-019-8",doi:"10.5772/intechopen.91517",price:119,priceEur:129,priceUsd:155,slug:"salmonella-spp-a-global-challenge",numberOfPages:254,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"131535f5d2ebf6c7cfd85fd229bbfd0e",bookSignature:"Alexandre Lamas, Patricia Regal and Carlos Manuel Franco",publishedDate:"November 10th 2021",coverURL:"https://cdn.intechopen.com/books/images_new/10331.jpg",numberOfDownloads:4010,numberOfWosCitations:0,numberOfCrossrefCitations:7,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:11,numberOfDimensionsCitationsByBook:0,hasAltmetrics:0,numberOfTotalCitations:18,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"October 5th 2020",dateEndSecondStepPublish:"November 2nd 2020",dateEndThirdStepPublish:"January 1st 2021",dateEndFourthStepPublish:"March 22nd 2021",dateEndFifthStepPublish:"May 21st 2021",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"194841",title:"Dr.",name:"Alexandre",middleName:null,surname:"Lamas",slug:"alexandre-lamas",fullName:"Alexandre Lamas",profilePictureURL:"https://mts.intechopen.com/storage/users/194841/images/system/194841.jpg",biography:"Alexandre Lamas is a postdoctoral fellow in the Department of Analytical Chemistry, Nutrition and Bromatology, University of Santiago de Compostela, Spain. He obtained a Ph.D. in Innovation in Food Safety and Technologies from the same university in 2019. He is the author of more than thirty-five scientific articles in international peer-reviewed journals as well as four book chapters and two chapters in encyclopedias. He is an active reviewer for different journals of food science and microbiology and a member of the editorial board of two international journals. His research focuses on the study of foodborne pathogens, especially Salmonella, new control methods, the study of food microbiota, and more recently the study of foodborne pathogens bacteriophages.",institutionString:"University of Santiago de Compostela",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"University of Santiago de Compostela",institutionURL:null,country:{name:"Spain"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:{id:"127648",title:"Ms.",name:"Patricia",middleName:null,surname:"Regal",slug:"patricia-regal",fullName:"Patricia Regal",profilePictureURL:"https://mts.intechopen.com/storage/users/127648/images/system/127648.png",biography:"Patricia Regal is a full-time assistant professor in the Department of Analytical Chemistry, Nutrition and Bromatology, University of Santiago de Compostela, Spain. She graduated in Veterinary Science from the Faculty of Veterinary Science of Lugo, in 2007, and obtained her Ph.D. (cum laude) in 2012. Dr. Regal has published more than fifty scientific articles in prestigious international journals. She has co-authored four book chapters, various open-access articles, national contributions, and two chapters in encyclopedias. She has wide demonstrable experience in the field of food safety, food composition, omic technologies, biostatistics, biomarkers discovery, and chromatographic techniques and mass spectrometry applied to biological matrices.",institutionString:"University of Santiago de Compostela",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"University of Santiago de Compostela",institutionURL:null,country:{name:"Spain"}}},coeditorTwo:{id:"189907",title:"Dr.",name:"Carlos",middleName:null,surname:"Franco",slug:"carlos-franco",fullName:"Carlos Franco",profilePictureURL:"https://mts.intechopen.com/storage/users/189907/images/system/189907.jpg",biography:"Carlos Manuel Franco is a full professor . He obtained a Ph.D. in Nutrition and Bromatology from the same university in 1994. He is the author of more than 120 international publications in scientific journals and several book chapters. He is currently a member of the scientific committee of the Spanish Security Agency Food and Nutrition (AESAN). He is the editor-in-chief and editorial board member of diverse food science and microbiology journals. His research is focused on new methods of food control, detection of pathogenic bacteria in food and other matrices, and the effect of various substances on pathogenic bacteria.",institutionString:"University of Santiago de Compostela",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"University of Santiago de Compostela",institutionURL:null,country:{name:"Spain"}}},coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"409",title:"Bacteriology",slug:"biochemistry-genetics-and-molecular-biology-microbiology-bacteriology"}],chapters:[{id:"74829",title:"Virulence Factors of Salmonella Typhi",doi:"10.5772/intechopen.95587",slug:"virulence-factors-of-em-salmonella-typhi-em-",totalDownloads:829,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"S. Typhi is an enteric bacillus which belongs,to the genus Salmonella in the family Enterobacteriacaea and it is a multi–organs pathogen which inhibits the lymphatic tissues of the small intestine, liver, spleen, and blood stream of infected humans. S. Typhi has a mixture of features that make it an efficient pathogen. This species contains an endotoxin that is characteristic of Gram-negative organisms, as well as the virulence-enhancing Vi antigen. Many of the S. Typhi virulence factors are clustered in some areas of the chromosome known as Salmonella pathogenicity islands (SPI), such as adhesion, invasion, and toxin genes. A protein known as invasin that permits non-phagocytic cells is also produced and excreted by the bacterium., Where it is capable of intracellular living. The oxidative burst of leukocytes may also be inhibited, making innate immune reaction ineffective.",signatures:"Noor S.K. Al-Khafaji, Ali M.K. Al-Bayati and Hussein O.M. Al-Dahmoshi",downloadPdfUrl:"/chapter/pdf-download/74829",previewPdfUrl:"/chapter/pdf-preview/74829",authors:[{id:"250698",title:"Dr.",name:"Hussein",surname:"O. M. Al-Dahmoshi",slug:"hussein-o.-m.-al-dahmoshi",fullName:"Hussein O. M. Al-Dahmoshi"},{id:"272591",title:"Dr.",name:"Noor S.K",surname:"Al-Khafaji",slug:"noor-s.k-al-khafaji",fullName:"Noor S.K Al-Khafaji"},{id:"337520",title:"MSc.",name:"Ali",surname:"M.K. Al-Bayati",slug:"ali-m.k.-al-bayati",fullName:"Ali M.K. Al-Bayati"}],corrections:null},{id:"75614",title:"Enteric Fever in Primary Care",doi:"10.5772/intechopen.96047",slug:"enteric-fever-in-primary-care",totalDownloads:243,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Enteric fever is a bacterial infection caused by Salmonella typhi and paratyphi. It is endemic in many parts of Africa and South Asia where there is poor access to safe portable water and below par food quality assurance. It is important to ensure prompt recognition, diagnosis and management of symptoms to forestall complications. Due to the rising global burden, significant effort has to be made to improve primary care services like vaccination, antimicrobial stewardship and encouragement of hygiene measures. Hence, it is imperative to be aware of its current burden and options available in primary care for its prevention and treatment.",signatures:"Abdulmaleek Idanesimhe Sado and Aduke Oluwambe Sado",downloadPdfUrl:"/chapter/pdf-download/75614",previewPdfUrl:"/chapter/pdf-preview/75614",authors:[{id:"336575",title:"Dr.",name:"Abdulmaleek",surname:"Sado",slug:"abdulmaleek-sado",fullName:"Abdulmaleek Sado"},{id:"339838",title:"Dr.",name:"Aduke",surname:"Sado",slug:"aduke-sado",fullName:"Aduke Sado"}],corrections:null},{id:"75460",title:"In-Silico Approach in the Development of Salmonella Epitope Vaccine",doi:"10.5772/intechopen.96313",slug:"in-silico-approach-in-the-development-of-em-salmonella-em-epitope-vaccine",totalDownloads:273,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"In the case of infection control, one of our primary concerns is typhoid fever. According to WHO, typhoid prevalence in Indonesia is highly endemic. There is also the problem with the low efficacy of the available vaccine to prevent the disease. Therefore, there is an urgent need to develop a highly effective typhoid vaccine. One of the phases in vaccine development is an exploratory phase, a research-intensive phase of the vaccine development process designed to identify natural or synthetic antigens that might help prevent or treat a disease through computer in silico prediction targets. The vaccines developed through epitope peptide are designed to be safer, more efficacious, and less expensive than traditional vaccines. A thorough understanding of the disease agent, particularly critical epitopes to induce the appropriate immunological reaction, is required to achieve these aims. Mapping epitope sequences or antigenic peptides from pathogenic proteins recognized by B cells and T cells is crucial for vaccine development. Once the epitopes were identified, the polypeptide production could be produced through protein recombinant technology. The polypeptide vaccine, in the end, could be delivered using a liposomal delivery system.",signatures:"Hidajah Rachmawati, Raditya Weka Nugraheni and Firasti A.N. Sumadi",downloadPdfUrl:"/chapter/pdf-download/75460",previewPdfUrl:"/chapter/pdf-preview/75460",authors:[{id:"336063",title:"Dr.",name:"Hidajah",surname:"Rachmawati",slug:"hidajah-rachmawati",fullName:"Hidajah Rachmawati"},{id:"336065",title:"Ms.",name:"Raditya Weka",surname:"Nugraheni",slug:"raditya-weka-nugraheni",fullName:"Raditya Weka Nugraheni"},{id:"336066",title:"Dr.",name:"Firasti Agung Nugrahening",surname:"Sumadi",slug:"firasti-agung-nugrahening-sumadi",fullName:"Firasti Agung Nugrahening Sumadi"}],corrections:null},{id:"75029",title:"Computational Identification of the Plausible Molecular Vaccine Candidates of Multidrug-Resistant Salmonella enterica",doi:"10.5772/intechopen.95856",slug:"computational-identification-of-the-plausible-molecular-vaccine-candidates-of-multidrug-resistant-em",totalDownloads:226,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Salmonella enterica serovars are responsible for the life-threatening, fatal, invasive diseases that are common in children and young adults. According to the most recent estimates, globally, there are approximately 11–20 million cases of morbidity and between 128,000 and 161,000 mortality per year. The high incidence rates of diseases like typhoid, caused by the serovars Typhi and Paratyphi, and gastroenteritis, caused by the non-typhoidal Salmonellae, have become worse, with the ever-increasing pathogenic strains being resistant to fluoroquinolones or almost even the third generation cephalosporins, such as ciprofloxacin and ceftriaxone. With vaccination still being one of the chosen methods of eradicating this disease, identification of candidate proteins, to be utilized for effective molecular vaccines, has probably remained a challenging issue. In our study here, we portray the usage of computational tools to analyze and predict potential vaccine candidate(s) for the multi-drug resistant serovars of S. enterica.",signatures:"Rohit Mishra, Yong Chiang Tan, Amr Adel Ahmed Abd El-Aal and Chandrajit Lahiri",downloadPdfUrl:"/chapter/pdf-download/75029",previewPdfUrl:"/chapter/pdf-preview/75029",authors:[{id:"193216",title:"Dr.",name:"Chandrajit",surname:"Lahiri",slug:"chandrajit-lahiri",fullName:"Chandrajit Lahiri"},{id:"345444",title:"Mr.",name:"Rohit",surname:"Mishra",slug:"rohit-mishra",fullName:"Rohit Mishra"},{id:"345445",title:"Mr.",name:"Yong Chiang",surname:"Tan",slug:"yong-chiang-tan",fullName:"Yong Chiang Tan"},{id:"345446",title:"Mr.",name:"Amr Adel",surname:"Ahmed Abd El-Aal",slug:"amr-adel-ahmed-abd-el-aal",fullName:"Amr Adel Ahmed Abd El-Aal"}],corrections:null},{id:"75381",title:"Non-Typhoidal Salmonellosis: A Major Concern for Poultry Industry",doi:"10.5772/intechopen.96400",slug:"non-typhoidal-salmonellosis-a-major-concern-for-poultry-industry",totalDownloads:295,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Salmonella is the most important gastrointestinal pathogen distributed ubiquitously. The major serovars involved in Non-typhoidal salmonellosis are S. Typhimurium and S. Enteritidis. In the viewpoint of ban in the export and import of the Salmonella contaminated poultry food and poultry products, the need for rapid detection and mitigation of Salmonella has increased mani-folds. The major problem associated with its control is the growing incidence of antimicrobial resistance, which has been reported worldwide in the recent years. From causing self limiting gastroenteritis they have found to be responsible for several fatal diseases like endocarditis, meningitis, lung infestations, appendicitis, pneumonia, and cerebral abscess in human beings. Targeting several proteins such as adhesive proteins, lipoproteins, outer membrane proteins (Omps) etc. as vaccine candidates may pave a way in its control. So, continuous monitoring using one health approach and development of effective treatment and control strategies are critical.",signatures:"Mamta Pandey and Emmagouni Sharath Kumar Goud",downloadPdfUrl:"/chapter/pdf-download/75381",previewPdfUrl:"/chapter/pdf-preview/75381",authors:[{id:"336126",title:"Dr.",name:"Mamta",surname:"Pandey",slug:"mamta-pandey",fullName:"Mamta Pandey"},{id:"346711",title:"MSc.",name:"Emmagouni Sharath Kumar",surname:"Goud",slug:"emmagouni-sharath-kumar-goud",fullName:"Emmagouni Sharath Kumar Goud"}],corrections:null},{id:"74886",title:"Salmonella and the Immune System",doi:"10.5772/intechopen.95673",slug:"-em-salmonella-em-and-the-immune-system",totalDownloads:442,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The human body has many mechanisms to resist invaders like pathogenic bacteria to avoid harm according to the living creature’s law “survival for the best”. On the opposite; Salmonella as pathogenic bacteria have many weapons that they utilize to invade the human body. The resistance mechanisms expressed by the human body are called immunity which represented by the immune system that has many different types of resistance processes, either specific (adaptive immune response) or non-specific (Innate Immune Response) against certain pathogenic invaders. As far as these processes are strong they will be enough to avoid infections occurrence, otherwise, the human body will get infected with Salmonella, be ill, show the disease symptoms, transmit the disease to others, and may become a carrier for the pathogen according to many circumstances. Prevention is still stood the most effective way to avoid getting infected with Salmonella by personal hygiene or suitable vaccination if available.",signatures:"Weam Saad Al-Hamadany",downloadPdfUrl:"/chapter/pdf-download/74886",previewPdfUrl:"/chapter/pdf-preview/74886",authors:[{id:"336503",title:"Assistant Prof.",name:"Weam S.",surname:"Al-Hamadany",slug:"weam-s.-al-hamadany",fullName:"Weam S. Al-Hamadany"}],corrections:null},{id:"75674",title:"Pathogenicity Island in Salmonella",doi:"10.5772/intechopen.96443",slug:"pathogenicity-island-in-em-salmonella-em-",totalDownloads:375,totalCrossrefCites:2,totalDimensionsCites:4,hasAltmetrics:0,abstract:"Considering a complex set of interplay with its host, Salmonella needs numerous genes for its full virulence. These genes responsible for invasion, survival, and extra intestinal spread are located on pathogenicity islands known as Salmonella pathogenicity islands (SPIs) that are thought to be acquired by horizontal gene transfer. A total of 17 SPIs (1–17) are recognized so far. The type III secretion system (T3SS) encoded by SPI-1 is considered as the most important virulence factor for Salmonella that delivers effector proteins necessary for invasion and production of enteritis. Among various SPIs, the role in virulence is well proven for SPI1 and SPI2 and further insight into the complex regulatory network of SPIs can contribute to drug investigation and prevention of infection.",signatures:"Sarika Kombade and Navneet Kaur",downloadPdfUrl:"/chapter/pdf-download/75674",previewPdfUrl:"/chapter/pdf-preview/75674",authors:[{id:"335866",title:"Assistant Prof.",name:"Sarika",surname:"kombade",slug:"sarika-kombade",fullName:"Sarika kombade"},{id:"347570",title:"Dr.",name:"Navneet",surname:"Kaur",slug:"navneet-kaur",fullName:"Navneet Kaur"}],corrections:null},{id:"77305",title:"Tracking Salmonella Enteritidis in the Genomics Era: Clade Definition Using a SNP-PCR Assay and Implications for Population Structure",doi:"10.5772/intechopen.98309",slug:"tracking-em-salmonella-em-enteritidis-in-the-genomics-era-clade-definition-using-a-snp-pcr-assay-and",totalDownloads:138,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Salmonella enterica serovar Enteritidis (or Salmonella Enteritidis, SE) is one of the oldest members of the genus Salmonella, based on the date of first description and has only gained prominence as a significant bacterial contaminant of food over the last three or four decades. Currently, SE is the most common Salmonella serovar causing foodborne illnesses. Control measures to alleviate human infections require that food isolates be characterized and this was until recently carried out using Pulsed-Field Gel Electrophoresis (PFGE) and phage typing as the main laboratory subtyping tools for use in demonstrating relatedness of isolates recovered from infected humans and the food source. The results provided by these analytical tools were presented with easy-to-understand and comprehensible nomenclature, however, the techniques were inherently poorly discriminatory, which is attributable to the clonality of SE. The tools have now given way to whole genome sequencing which provides a full and comprehensive genetic attributes of an organism and a very attractive and superior tool for defining an isolate and for inferring genetic relatedness among isolates. A comparative phylogenomic analysis of isolates of choice provides both a visual appreciation of relatedness as well as quantifiable estimates of genetic distance. Despite the considerable information provided by whole genome analysis and development of a phylogenetic tree, the approach does not lend itself to generating a useful nomenclature-based description of SE subtypes. To this end, a highly discriminatory, cost-effective, high throughput, validated single nucleotide based genotypic polymerase chain reaction assay (SNP-PCR) was developed focussing on 60 polymorphic loci. The procedure was used to identify 25 circulating clades of SE, the largest number so far described for this organism. The new subtyping test, which exploited whole genome sequencing data, displays the attributes of an ideal subtyping test: high discrimination, low cost, rapid, highly reproducible and epidemiological concordance. The procedure is useful for identifying the subtype designation of an isolate, for defining the population structure of the organism as well as for surveillance and outbreak detection.",signatures:"Dele Ogunremi, Ruimin Gao, Rosemarie Slowey, Shu Chen, Olga Andrievskaia, Sadjia Bekal, Lawrence Goodridge and Roger C. Levesque",downloadPdfUrl:"/chapter/pdf-download/77305",previewPdfUrl:"/chapter/pdf-preview/77305",authors:[{id:"288405",title:"Dr.",name:"Dele",surname:"Ogunremi",slug:"dele-ogunremi",fullName:"Dele Ogunremi"},{id:"305625",title:"Dr.",name:"Ruimin",surname:"Gao",slug:"ruimin-gao",fullName:"Ruimin Gao"},{id:"419291",title:"Dr.",name:"Rosemary",surname:"Slowey",slug:"rosemary-slowey",fullName:"Rosemary Slowey"},{id:"419292",title:"Dr.",name:"Shu",surname:"Chen",slug:"shu-chen",fullName:"Shu Chen"},{id:"419293",title:"Dr.",name:"Olga",surname:"Andrievskaia",slug:"olga-andrievskaia",fullName:"Olga Andrievskaia"},{id:"419294",title:"Dr.",name:"Sadjia",surname:"Bekal",slug:"sadjia-bekal",fullName:"Sadjia Bekal"},{id:"419295",title:"Dr.",name:"Lawrence",surname:"Goodridge",slug:"lawrence-goodridge",fullName:"Lawrence Goodridge"},{id:"419296",title:"Dr.",name:"Roger C.",surname:"Levesque",slug:"roger-c.-levesque",fullName:"Roger C. Levesque"}],corrections:null},{id:"74818",title:"Salmonella enterica subsp. diarizonae Serotype 61:k:1:5:(7) a Host Adapted to Sheep",doi:"10.5772/intechopen.95513",slug:"-em-salmonella-enterica-em-subsp-em-diarizonae-em-serotype-61-k-1-5-7-a-host-adapted-to-sheep",totalDownloads:300,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Salmonella genus is widely distributed in nature and causes a spectrum of diseases in man and animals. Salmonella enterica subsp. diarizonae serotype 61: k: 1,5, (7) (SED) is a host adapted to sheep and its presence as saprophytic bacteria in sheep has been described in different countries. Several studies performed in abattoirs reported the presence of SED in healthy sheep in the intestinal content and also in the respiratory tract. In addition, this microorganism has also been isolated from nostril and faecal samples in healthy live animals. For this reason, this microorganism is considered well adapted to sheep, behaving normally these animals as asymptomatic carriers. However, SED has also been reported causing health disorders such as chronic proliferative rhinitis in adult sheep, abortions, testicular lesions in rams or alimentary tract disorders in young animals. The zoonotic potential of this microorganism is also discussed.",signatures:"Inés Rubira, Luis Pedro Figueras, José Calasanz Jiménez, Marta Ruiz de Arcaute, Héctor Ruiz, José Antonio Ventura and Delia Lacasta",downloadPdfUrl:"/chapter/pdf-download/74818",previewPdfUrl:"/chapter/pdf-preview/74818",authors:[{id:"25897",title:"Dr.",name:"Delia",surname:"Lacasta",slug:"delia-lacasta",fullName:"Delia Lacasta"},{id:"319786",title:"MSc.",name:"Héctor",surname:"Ruíz",slug:"hector-ruiz",fullName:"Héctor Ruíz"},{id:"336816",title:"Ph.D. Student",name:"Inés",surname:"Rubira",slug:"ines-rubira",fullName:"Inés Rubira"},{id:"337214",title:"Dr.",name:"Luis Pedro",surname:"Figueras",slug:"luis-pedro-figueras",fullName:"Luis Pedro Figueras"},{id:"337215",title:"Dr.",name:"José Calasanz",surname:"Jiménez",slug:"jose-calasanz-jimenez",fullName:"José Calasanz Jiménez"},{id:"337216",title:"Dr.",name:"Marta",surname:"Ruiz de Arcaute",slug:"marta-ruiz-de-arcaute",fullName:"Marta Ruiz de Arcaute"},{id:"345878",title:"Dr.",name:"José Antonio",surname:"Ventura",slug:"jose-antonio-ventura",fullName:"José Antonio Ventura"}],corrections:null},{id:"76017",title:"Potential Roles for Bacteriophages in Reducing Salmonella from Poultry and Swine",doi:"10.5772/intechopen.96984",slug:"potential-roles-for-bacteriophages-in-reducing-em-salmonella-em-from-poultry-and-swine",totalDownloads:348,totalCrossrefCites:2,totalDimensionsCites:4,hasAltmetrics:0,abstract:"This chapter discusses application of natural parasites of bacteria, bacteriophages (phages), as a promising biological control for Salmonella in poultry and swine. Many studies have shown phages can be applied at different points from farm-to-fork, from pre to post slaughter, to control the spread of Salmonella in the food chain. Pre-slaughter applications include administering phages via oral gavage, in drinking water and in feed. Post slaughter applications include adding phages to carcasses and during packaging of meat products. The research discussed in this chapter demonstrate a set of promising data that relate to the ability of phages to reduce Salmonella colonisation and abundance. Collectively the studies support the viability of phage as antimicrobial prophylactics and therapeutics to prevent and control Salmonella in the food chain.",signatures:"Anisha M. Thanki, Steve Hooton, Adriano M. Gigante, Robert J. Atterbury and Martha R.J. Clokie",downloadPdfUrl:"/chapter/pdf-download/76017",previewPdfUrl:"/chapter/pdf-preview/76017",authors:[{id:"339285",title:"Prof.",name:"Martha R.J.",surname:"Clokie",slug:"martha-r.j.-clokie",fullName:"Martha R.J. Clokie"},{id:"342843",title:"Dr.",name:"Anisha M.",surname:"Thanki",slug:"anisha-m.-thanki",fullName:"Anisha M. Thanki"},{id:"350862",title:"Dr.",name:"Steve",surname:"Hooton",slug:"steve-hooton",fullName:"Steve Hooton"},{id:"351117",title:"Dr.",name:"Robert J.",surname:"Atterbury",slug:"robert-j.-atterbury",fullName:"Robert J. Atterbury"},{id:"351119",title:"Dr.",name:"Adriano M.",surname:"Gigante",slug:"adriano-m.-gigante",fullName:"Adriano M. Gigante"}],corrections:null},{id:"75489",title:"Natural Products for Salmonellosis: Last Decade Research",doi:"10.5772/intechopen.96207",slug:"natural-products-for-salmonellosis-last-decade-research",totalDownloads:278,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Salmonellosis is a disease of great relevance in terms of public health given the economic and social impact that causes both in developing and highly industrialized countries. Due to its transmission mechanism, it affects hundreds or thousands of people every year and is considered an acute disease of worldwide distribution. Causative agent of salmonellosis is salmonella specie which are small gram-negative bacilli and facultative intracellular pathogen of the Enterobacteriaceae family. Multidrug resistance is reported more frequently in strains of salmonella, raising the necessity of new strategies to combat its spread and to treat the disease. Natural products (NPs) derived from traditional medicine knowledge have become an important resource to this end. In this chapter, we present a summary of information published from 2010 to 2020, as a sample of the potentiality of NPs as agents for Salmonellosis. This search was not exhaustive, rather, we aim to obtain a random sample of information using the simplest terms on the matter of natural products for salmonellosis, hopefully, as a reference source for interested researchers.",signatures:"Nancy Jannet Ruiz-Pérez, Jaime Sánchez-Navarrete and Julia D. Toscano-Garibay",downloadPdfUrl:"/chapter/pdf-download/75489",previewPdfUrl:"/chapter/pdf-preview/75489",authors:[{id:"243113",title:"Dr.",name:"Julia D.",surname:"Toscano-Garibay",slug:"julia-d.-toscano-garibay",fullName:"Julia D. Toscano-Garibay"},{id:"338163",title:"Dr.",name:"Nancy Jannet",surname:"Ruiz-Pérez",slug:"nancy-jannet-ruiz-perez",fullName:"Nancy Jannet Ruiz-Pérez"},{id:"345778",title:"MSc.",name:"Jaime",surname:"Sánchez-Navarrete",slug:"jaime-sanchez-navarrete",fullName:"Jaime Sánchez-Navarrete"}],corrections:null},{id:"76781",title:"An Overview of Salmonella Biofilms and the Use of Bacteriocins and Bacteriophages as New Control Alternatives",doi:"10.5772/intechopen.98208",slug:"an-overview-of-em-salmonella-em-biofilms-and-the-use-of-bacteriocins-and-bacteriophages-as-new-contr",totalDownloads:267,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Salmonella is a major food-borne pathogen around the world. In the European Union (EU), this pathogen is responsible of more than 90,000 human cases of salmonellosis every year. Salmonellosis in normally linked to the consumption of contaminated food, especially poultry products as meat, eggs and the products elaborated with them. Several control measures have been implemented in the EU to reduce the prevalence of Salmonella in the food chain. However, the ability of Salmonella to form biofilm along the food chain difficult its eradication. Also, ineffective cleaning and disinfection measures favors biofilm formation. The widespread use of biocides along the food chain has led to the emergence of resistant Salmonella strains. Therefore, it is necessary to look for alternatives to biocides to eradicate Salmonella biofilms. In this chapter we evaluate the use of bacteriocins and bacteriophages and their derivatives as a new alternative to eliminate Salmonella biofilms along the food chain.",signatures:"Alexandre Lamas, Patricia Regal, Laura Sanjulián, Aroa López-Santamarina, Carlos Manuel Franco and Alberto Cepeda",downloadPdfUrl:"/chapter/pdf-download/76781",previewPdfUrl:"/chapter/pdf-preview/76781",authors:[{id:"194841",title:"Dr.",name:"Alexandre",surname:"Lamas",slug:"alexandre-lamas",fullName:"Alexandre Lamas"},{id:"127648",title:"Ms.",name:"Patricia",surname:"Regal",slug:"patricia-regal",fullName:"Patricia Regal"},{id:"189907",title:"Dr.",name:"Carlos",surname:"Franco",slug:"carlos-franco",fullName:"Carlos Franco"},{id:"194843",title:"Dr.",name:"Aberto",surname:"Cepeda",slug:"aberto-cepeda",fullName:"Aberto Cepeda"},{id:"414993",title:"MSc.",name:"Aroa",surname:"López-Santamarina",slug:"aroa-lopez-santamarina",fullName:"Aroa López-Santamarina"},{id:"414994",title:"MSc.",name:"Laura",surname:"Sanjulián",slug:"laura-sanjulian",fullName:"Laura Sanjulián"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"2796",title:"Lactic Acid Bacteria",subtitle:"R & D for Food, Health and Livestock Purposes",isOpenForSubmission:!1,hash:"8d625f084ccba1e96cc326406074fe3f",slug:"lactic-acid-bacteria-r-d-for-food-health-and-livestock-purposes",bookSignature:"Marcelino Kongo",coverURL:"https://cdn.intechopen.com/books/images_new/2796.jpg",editedByType:"Edited by",editors:[{id:"138356",title:"Dr.",name:"J. 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She is a specialist in taxonomy, ecology and resources of actinomycetes. Dr. Yiang published 93 academic articles and 3 books, obtained 9 patents, and awarded a first prize of Natural Science of Yunnan and Second prize of Kunming City.",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:null},equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2129",title:"A Search for Antibacterial Agents",subtitle:null,isOpenForSubmission:!1,hash:"1567c6402f459b018a6aabfd620aa3f7",slug:"a-search-for-antibacterial-agents",bookSignature:"Varaprasad Bobbarala",coverURL:"https://cdn.intechopen.com/books/images_new/2129.jpg",editedByType:"Edited by",editors:[{id:"90574",title:"Dr.",name:"Varaprasad",surname:"Bobbarala",slug:"varaprasad-bobbarala",fullName:"Varaprasad Bobbarala"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5867",title:"Antibacterial Agents",subtitle:null,isOpenForSubmission:!1,hash:"7834e622de76478416bdc3092c52cb15",slug:"antibacterial-agents",bookSignature:"Ranjith N. 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Annual Volume 2022",subtitle:null,fullTitle:"Animal Nutrition - Annual Volume 2022",slug:null,publishedDate:null,bookSignature:"Dr. Manuel Gonzalez Ronquillo",coverURL:"https://cdn.intechopen.com/books/images_new/11416.jpg",licenceType:"CC BY 3.0",editedByType:null,editors:[{id:"175967",title:"Dr.",name:"Manuel",middleName:null,surname:"Gonzalez Ronquillo",slug:"manuel-gonzalez-ronquillo",fullName:"Manuel Gonzalez Ronquillo"}],productType:{id:"5",title:"Annual Volume",chapterContentType:"chapter",authoredCaption:"Authored by"}},authors:null}},chapter:{id:"78849",slug:"application-of-vermicompost-fertilizer-in-aquaculture-nutrition-review",signatures:"Sonnia Nzilani Musyoka and Rita Nairuti",dateSubmitted:"August 20th 2021",dateReviewed:"September 6th 2021",datePrePublished:"October 27th 2021",datePublished:null,book:{id:"11416",title:"Animal Nutrition - Annual Volume 2022",subtitle:null,fullTitle:"Animal Nutrition - Annual Volume 2022",slug:null,publishedDate:null,bookSignature:"Dr. Manuel Gonzalez Ronquillo",coverURL:"https://cdn.intechopen.com/books/images_new/11416.jpg",licenceType:"CC BY 3.0",editedByType:null,editors:[{id:"175967",title:"Dr.",name:"Manuel",middleName:null,surname:"Gonzalez Ronquillo",slug:"manuel-gonzalez-ronquillo",fullName:"Manuel Gonzalez Ronquillo"}],productType:{id:"5",title:"Annual Volume",chapterContentType:"chapter",authoredCaption:"Authored by"}},authors:null},book:{id:"11416",title:"Animal Nutrition - 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Epigenetic modifications are essential to regulate normal gonadal development and spermatogenesis. The sperm epigenome is highly susceptible influence by a wide spectrum of environmental stimuli. This book focuses on the male reproductive system, discussing topics ranging from aspects of anatomy and risk factors for male infertility to clinical techniques and management of male reproductive health.",isbn:"978-1-83968-525-5",printIsbn:"978-1-83968-524-8",pdfIsbn:"978-1-83968-526-2",doi:"10.5772/intechopen.94696",price:119,priceEur:129,priceUsd:155,slug:"male-reproductive-anatomy",numberOfPages:210,isOpenForSubmission:!1,isSalesforceBook:!1,isNomenclature:!1,hash:"a3fdda3194735da4287e9ea193beb07e",bookSignature:"Wei Wu",publishedDate:"January 19th 2022",coverURL:"https://cdn.intechopen.com/books/images_new/10724.jpg",keywords:null,numberOfDownloads:2001,numberOfWosCitations:0,numberOfCrossrefCitations:0,numberOfDimensionsCitations:2,numberOfTotalCitations:2,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"February 4th 2021",dateEndSecondStepPublish:"March 4th 2021",dateEndThirdStepPublish:"May 3rd 2021",dateEndFourthStepPublish:"July 22nd 2021",dateEndFifthStepPublish:"September 20th 2021",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"a year",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:5,editedByType:"Edited by",kuFlag:!1,biosketch:"Dr. Wei Wu is a member of different national and international societies in the fields of human reproduction and toxicology and has received awards from many national societies for the originality and quality of his projects. He was a guest researcher at the National Institute of Environmental Health Sciences (NIEHS) between 2017 and 2018. Dr. Wu has authored 70 peer-reviewed papers in international journals.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"178661",title:"Dr.",name:"Wei",middleName:null,surname:"Wu",slug:"wei-wu",fullName:"Wei Wu",profilePictureURL:"https://mts.intechopen.com/storage/users/178661/images/system/178661.jpeg",biography:"Dr. Wei Wu is an associate professor and associate department\nchair in the Department of Toxicology, Nanjing Medical University, China, where he received his Ph.D. in Toxicology in 2012.\nHe was a guest researcher at the National Institute of Environmental Health Sciences (NIEHS) between 2017 and 2018. Dr.\nWu is a member of different national and international societies\nin the fields of human reproduction and toxicology and has\nreceived awards from many national societies for the originality and quality of his\nprojects. Dr. Wu has authored seventy-three peer-reviewed papers in international\njournals. He has edited four books and collaborated on ten others as well as seventeen patents and in the organization of three international conferences. He is a\nreviewer for ninety-eight journals.",institutionString:"Nanjing Medical University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"4",totalChapterViews:"0",totalEditedBooks:"4",institution:{name:"Nanjing Medical University",institutionURL:null,country:{name:"China"}}}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"1161",title:"Andrology",slug:"andrology"}],chapters:[{id:"79167",title:"The Concept of Male Reproductive Anatomy",slug:"the-concept-of-male-reproductive-anatomy",totalDownloads:238,totalCrossrefCites:0,authors:[{id:"348295",title:"Dr.",name:"Oyovwi",surname:"Mega Obukohwo",slug:"oyovwi-mega-obukohwo",fullName:"Oyovwi Mega Obukohwo"},{id:"421235",title:"Prof.",name:"Nwangwa",surname:"Eze Kingsley",slug:"nwangwa-eze-kingsley",fullName:"Nwangwa Eze Kingsley"},{id:"428844",title:"Dr.",name:"Rotu",surname:"Arientare Rume",slug:"rotu-arientare-rume",fullName:"Rotu Arientare Rume"}]},{id:"79287",title:"Endocrine Functions of the Testes",slug:"endocrine-functions-of-the-testes",totalDownloads:163,totalCrossrefCites:0,authors:[{id:"349696",title:"Dr.",name:"Victor",surname:"EMOJEVWE",slug:"victor-emojevwe",fullName:"Victor EMOJEVWE"},{id:"420885",title:"Ms.",name:"Osarugue",surname:"Igiehon",slug:"osarugue-igiehon",fullName:"Osarugue Igiehon"}]},{id:"79014",title:"Seminiferous Tubules and Spermatogenesis",slug:"seminiferous-tubules-and-spermatogenesis",totalDownloads:207,totalCrossrefCites:0,authors:[{id:"92657",title:"Prof.",name:"Mohamad Eid",surname:"Hammadeh",slug:"mohamad-eid-hammadeh",fullName:"Mohamad Eid Hammadeh"},{id:"337019",title:"Dr.",name:"Houda",surname:"Amor",slug:"houda-amor",fullName:"Houda Amor"},{id:"337221",title:"Dr.",name:"Nyaz",surname:"Shelko",slug:"nyaz-shelko",fullName:"Nyaz Shelko"},{id:"345468",title:"Dr.",name:"Peter Michael",surname:"Jankowski",slug:"peter-michael-jankowski",fullName:"Peter Michael Jankowski"},{id:"419473",title:"Dr.",name:"Bakry Mohamed Sobhy",surname:"Sobhy",slug:"bakry-mohamed-sobhy-sobhy",fullName:"Bakry Mohamed Sobhy Sobhy"},{id:"419475",title:"Dr.",name:"Almandouh Hussein",surname:"Bosilah",slug:"almandouh-hussein-bosilah",fullName:"Almandouh Hussein Bosilah"},{id:"419476",title:"Dr.",name:"Micu",surname:"Romeo",slug:"micu-romeo",fullName:"Micu Romeo"}]},{id:"77407",title:"Positional Relationships among Male Reproductive Organs in Insects",slug:"positional-relationships-among-male-reproductive-organs-in-insects",totalDownloads:194,totalCrossrefCites:0,authors:[{id:"348309",title:"Dr.",name:"Satoshi",surname:"Hiroyoshi",slug:"satoshi-hiroyoshi",fullName:"Satoshi Hiroyoshi"},{id:"348547",title:"Dr.",name:"Gadi",surname:"V.P. 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Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"75335",title:"Experimental Serotonin Syndrome: Effects of GABA-ergic Medications and 5-HT2-Antagonists",doi:"10.5772/intechopen.96362",slug:"experimental-serotonin-syndrome-effects-of-gaba-ergic-medications-and-5-ht-sub-2-sub-antagonists",body:'Serotonin syndrome is a drug-induced condition caused by medications that increase intrasynaptic serotonin levels. It is characterized by a triad of symptoms that includes neuromuscular hyperactivity, altered mental status and autonomic dysfunction.
The syndrome was first described in 1960 as “Indolamine syndrome” in patients on therapy with monoamine oxidase inhibitors (MAOIs) who develop symptoms of serotonin syndrome after taking tryptophan – a serotonin precursor [1]. Since then, the number of reported cases of serotonin syndrome has increased significantly. The medical community’s attention to serotonin syndrome was drawn in 1984 by the unusual death of 18-year-old Libby Zion in a New York City hospital, which may have been linked to the development of serotonin syndrome after concomitant use of an MAOI and opioid analgesic. The opioid analgesic pethidine was administered to the girl suffering from depression and taking the antidepressant phenelzine, which led to the development of a fatal serotonin syndrome [2, 3].
Of all serotonergic drugs, antidepressants are the most common cause of serotonin syndrome, and recent data suggest that the most common drug combination associated with serotonin syndrome is that between selective serotonin reuptake inhibitors (SSRIs) and opioids [2]. As a relatively rare adverse drug reaction, the incidence of serotonin syndrome is difficult to be calculated during randomized controlled trials [4]. Moreover, it is estimated that over 85% of physicians are unaware of the condition [5]. The non-specific manifestation of the syndrome leads to its difficult recognition and underreporting, which further complicates the determination of its incidence. It is considered that serotonin syndrome occurs in 15% of patients who overdose on selective serotonin reuptake inhibitors. The actual incidence of serotonin syndrome is thought to be significantly higher than reported [6, 7, 8].
Serotonin syndrome results from an increase in intrasynaptic serotonin levels caused by overstimulation of both central and peripheral serotonin receptors [9, 10]. Theoretically, serotonin syndrome can occur as a result of stimulation of any receptor of all seven serotonin receptor families [11]. However, the role of 5-HT1A and 5-HT2A is most often mentioned [6, 7, 11, 12]. Moreover, the 5-HT2A receptor is thought to mediate the most serious consequences of the serotonin syndrome (Table 1).
Receptor | Function related to serotonin toxicity | |
---|---|---|
Type | Subtype | |
5-HT1 | 5-HT1A | neuronal inhibition, thermoregulation, hyperactivity associated with anxiety, hypoactivity associated with depression |
5-HT1D | locomotion, muscle tone | |
5-HT2 | 5-HT2A | neuronal excitation, vasoconstriction, platelet aggregation |
5-HT2B | smooth muscle contraction | |
5-HT3 | — | nausea and vomiting |
5-HT4 | — | increased GIT motility |
Some authors suggest that the development of serotonin syndrome requires the accumulation of a critical amount of serotonin. However, studies show that this level of serotonin is probably different for each patient. Experimental studies in animal models of serotonin syndrome have shown that other neurotransmitters such as noradrenaline (NA), N-methyl-D-aspartate (NMDA), gamma-aminobutyric acid (GABA) and dopamine may also play a role in the development of serotonin syndrome but their role is not fully understood [6, 13].
It is shown that in serotonin syndrome CNS serotonin levels increase between 40 and 140 times. At the same time, dopamine levels are increased 10 to 44 times [14, 15]. Other studies indicate overactivation of the noradrenergic system with a rise in NA levels up to 15.9 times in serotonin syndrome, but the cause remains unknown. Some authors explain this increase in NA levels with activation of 5-HT2A receptors. This is supported by the fact that no significant increase in NA was observed with prior administration of ritanserin and pipamperone which act as antagonists of these receptors. On the other hand, there is evidence of the involvement of 5-HT1A receptors, although the administration of 5-HT1A antagonists does not prevent the increase in NA levels [14, 15]. The degree of NA increase may be related to the prognosis of serotonin syndrome, although it is not fully understood. At the same time, some of the observed symptoms of autonomic instability may be due to an overactivated noradrenergic system [14].
Drugs and substances that increase serotonin levels are known as serotonergic, and a mechanism by which they do that are as follows:
Increased serotonin synthesis
Increased serotonin release
Activation of serotonergic receptors
Serotonin reuptake inhibition
Inhibition of serotonin metabolism
The full list of all serotonergic substances is long, but antidepressants and, in recent years, some opioids take the central place. It is important to note that substances with serotonergic activity include not only antidepressants and opioids but also a number of other drugs used in everyday medical practice – some antibiotics, antiemetics, anxiolytics, antipsychotics, as well as over-the-counter drugs (OTC), dietary supplements, some illicit drugs and more [5, 6, 7, 16, 17, 18, 19].
Some of the antidepressants, opioids, and other drugs reported in the literature causing serotonin syndrome, as well as the mechanisms by which they increase serotonin levels are listed in Table 2.
Mechanism | Implicated drugs |
---|---|
Increased serotonin synthesis | |
Increased serotonin release | |
Activation of serotonergic receptors | |
Serotonin reuptake inhibition | |
Inhibition of serotonin metabolism |
The term “serotonin syndrome” in animals was first used in 1979 by Hwang and Van Woert [20, 21]. Manifestation of serotonin toxicity has been described in various animal species, however, most literature data, respectively most studies, are available on the development of serotonin syndrome in mice and rats [20].
In contrast to humans, in whom the symptoms of serotonin syndrome are well defined, the literature describes a wide variety of manifestations and different combinations of responses characterizing the development of serotonin syndrome in rodents.
There is considerable heterogeneity in the animal models reported in the literature. The use of different assessment methods, different response sets and different scales in assessing the effects of increased serotonergic tone limits quantitative comparisons of laboratory results. In this regard, Haberzettl et al. [20] conducted a systematic literature review of the described models of serotonin syndrome in rats and mice and evaluated the observed behavioral and autonomic manifestations. Based on the frequency of behavioral manifestations, the team divides them into traditional and additional, distinguishing those that reliably characterize the development of serotonin syndrome in rodents. The described behavioral and autonomic symptoms of serotonin syndrome in rats are presented in Table 3.
Behavioral manifestations | Autonomic manifestations | |
---|---|---|
Traditional | Additional | |
forepaw treading head weaving hind limb abduction low body posture Straub phenomenon tremor backward walking | body twitches chewing head shakes head twitches hyperactivity hyperreactivity locomotor activity (increased or decreased) myoclonus rearing wet dog shake | body temperature (increased or decreased) lower lip retraction penile erection pyloric erection salivation |
Serotonin syndrome manifestation in rats.
It is widely believed that 5-HT1A receptors mediate most behavioral manifestations of serotonin syndrome in rats [22, 23, 24, 25, 26, 27, 28, 29, 30, 31]. In support of this are studies demonstrating the induction of serotonin syndrome behaviors by the administration of 5-HT1A agonists [26, 32, 33] and the induction of a narrower spectrum of manifestations such as hind limb abduction, a Straub phenomenon and low body posture, from the partial 5-HT1A-agonist buspirone [31].
Other behavioral responses such as head weaving and wet dog shake, are mediated by 5-HT2A receptors [22, 34, 35, 36, 37]. For example, head weaving in rats induced by the administration of the non-selective MAO inhibitor phenelzine and the SSRI paroxetine was dose-dependently antagonized by 5-HT2 antagonists [35, 37]. In addition, head weaving caused by the administration of a 5-HT2A/2C agonist has been antagonized by the administration of a 5-HT2A antagonist, but not by a 5-HT2C/2B antagonist [38].
The analysis of Haberzettl et al. showed that the most common autonomic dysregulation manifestation observed in rats with serotonin syndrome is the change in the body temperature. The hyperthermic reaction observed is thought to be mainly related to the activation of 5-HT2A receptors [14, 39]. Experimental studies confirmed the involvement of 5-HT1A and 5-HT2A receptors in thermoregulation in rats. For example, blockade of 5-HT2 receptors by ketanserin or pirenperone causes a decrease in body temperature, while blockade of 5-HT1A receptors by pindolol results in an increase in body temperature [40].
Although not a mandatory manifestation of serotonin syndrome, hyperthermia is one of the leading causes of observed mortality in experimental serotonin syndrome. In both animals and humans, it is hyperthermia that mainly causes complications. Such complications in humans could include seizures, rhabdomyolysis, myoglobinuria, metabolic acidosis, renal failure, acute respiratory distress syndrome, respiratory failure, disseminated intravascular coagulation (DIC syndrome), coma and death [6].
The manifestation of serotonin syndrome observed in rodents resembles the manifestation of serotonin syndrome in humans (Table 4). For example, neuromuscular manifestations such as tremor and muscle rigidity have been observed in both humans and rodents. Myoclonus, which is a clinical symptom of serotonin syndrome in humans, in rodents may manifest as head twitches and forepaw treading. The Straub phenomenon observed in rodents may refer to the muscle rigidity observed in humans [21]. According to autonomic dysregulation manifestation, changes in body temperature occur in both rodents and humans.
Symptoms/manifestations of serotonin syndrome | Humans | Rodents |
---|---|---|
Neuromuscular disorders | clonus tremor hyperreflexia muscle rigidity myoclonus | head weaving tremor hind limb abduction Straub phenomenon low body posture backward walking |
Autonomic dysfunction | diaphoresis hyperthermia (>38 °C) diarrhea shivering | change in body temperature (increase or decrease) |
Mental status changes | agitation confusion hyperactivity hypomania anxiety | hyperactivity hyperreactivity |
Symptoms and manifestations of serotonin syndrome in humans and rodents – Comparison.
The most difficult to differentiate in animals is the third group of symptoms typical for the manifestation of serotonin syndrome in humans - mental status changes. However, hyperactivity and to some extent the hyperreactivity observed in rodents are associated with agitation observed in humans. Moreover, it is important to note that the current criteria for diagnosing serotonin syndrome in humans, Hunter’s criteria, do not include as a mandatory diagnostic criterion changes in mental status, which confirms the validity and applicability of the animal model of serotonin syndrome [21].
Two classical models of serotonin syndrome in rats have been described in the literature induced by concomitant administration of serotonergic substances with different mechanisms of action: 5-HTP (100 mg/kg i.p.) - a precursor of serotonin and clorgyline (2 mg/kg i.p.) - selective MAO-A inhibitor [14] and fluoxetine (10 mg/kg i.p.) - a selective serotonin reuptake inhibitor and tranylcypromine (3.5 mg/kg, i.p.) - a non-selective MAO inhibitor [12].
Many central neurotransmitters, such as serotonin, norepinephrine, dopamine, acetylcholine, GABA and glutamate, are involved in the thermoregulation. GABA is a major central inhibitory neurotransmitter involved in thermoregulatory processes. The role of GABA as a thermoregulatory neurotransmitter or modulator is suggested by the good distribution of the mediator in the hypothalamus, confirmed by autoradiographic and immunohistochemical studies [41, 42, 43] and its central action. In addition, GABA-ergic neurons, as well as postsynaptic GABAA-ergic receptors have been identified in PO/AH (preoptic area/anterior hypothalamus) [44, 45, 46].
Potentiation of the central inhibitory effect of GABA is achieved by several different mechanisms, including allosteric modulation of GABA receptors (benzodiazepines, barbiturates, Z-hypnotics, propofol and fospropofol), direct GABA- or GABA-receptor agonist action (respectively muscimol, baclofen), increased synthesis of GABA (e.g., gabapentin, pregabalin, sodium valproate), inhibition of enzymatic degradation of GABA (e.g., vigabatrin, sodium valproate) and inhibition of neuronal or glial uptake of GABA (e.g., tiagabine).
Benzodiazepines mediate their pharmacological effects by enhancing the inhibitory effect of GABA on the CNS by binding to a specific modulating site on GABAA-ergic receptors containing 1, 2, 3 or 5 alpha-subunits. Benzodiazepines have no affinity for receptor complexes containing 4 or 6 alpha-subunits [47]. Activation of specific benzodiazepine receptors by diazepam or other benzodiazepines increase the frequency of GABAA-associated chloride channel opening [48].
The pharmacological activity of valproic acid is expressed in potentiation of GABA-ergic neurotransmission and prolongation of the inactivation of voltage-dependent neuronal sodium channels [49]. Sodium valproate is thought to increase brain GABA concentration by the following mechanisms: (1) inhibition of GABA-transaminase enzyme activity and decreased GABA degradation [50] 2) stimulating GAD activity [51] and increasing GABA synthesis; (3) decreased GABA turnover [52]. Vigabatrin (gamma-vinyl GABA) is a vinyl-substituted analogue of GABA that selectively and irreversibly inhibits the activity of the enzyme GABA-transaminase (GABA-T) and significantly increases the concentration of GABA in the brain [53].
After central and systemic administration of diazepam, sodium valproate, and vigabatrin dose-dependent decreases of body temperature in rats is observed [54, 55, 56, 57]. GABA-induced hypothermia has been suggested to be mediated by GABAA and/or GABAB receptor activation [58, 59]. The hypothermic effect of sodium valproate and vigabatrin occurs later than diazepam-induced hypothermia, which can be explained by their indirect mechanism of potentiation of GABA-ergic mediation.
These results are further confirmed in our studies, where we found that substances with a GABA-ergic mechanism of action such as diazepam, sodium valproate and vigabatrin effectively reduced the hyperthermic response in experimental serotonin syndrome in rats induced by concomitant administration of 5-HTP (100 mg/kg i.p.) - a precursor of serotonin and clorgyline (2 mg/kg i.p.) - selective MAO-A inhibitor [14]. The reduction in serotonergic-induced hyperthermia with pretreatment of GABA-mimetic drugs is most likely due to an increase in central GABA-ergic neurotransmission through activation of GABAA receptors (e.g., diazepam) as well as through indirect action by increasing GABA concentration (e.g., sodium valproate, vigabatrin). These results on the hyperthermia associated with serotonin syndrome support the hypothesis of an interaction between the GABA-ergic and serotoninergic systems in thermoregulatory processes.
In our studies, after the concomitant administration of 5-HTP (100 mg/kg i.p.) and clorgyline (2 mg/kg i.p.), a model of serotonin syndrome with typical behavioral and autonomic manifestations developed. Tremor occurs 10 minutes after injection, the hyperthermic reaction develops at 30 minutes, and the maximum value is observed 60 minutes after injection of the substances. All animals in this group died between 60 and 90 minutes after injection of serotonin. Pretreatment with diazepam at a dose of 5 mg/kg i.p. reduced the hyperthermic reaction at 30 and 60 min compared to the group with a model of serotonin syndrome, in which saline was administered prior to the injection of serotonergic agent. Administration of sodium valproate at a dose of 300 mg/kg i.p. reduced the hyperthermic reaction at 30 and 60 min compared to the group with a model of serotonin syndrome, in which saline was administered before the injection of serotonergic substances [56, 60]. Additionally, in another of our experiments, we used a modified model of serotonin syndrome induced by the concomitant administration of fluoxetine (10 mg/kg i.p.) - a selective serotonin reuptake inhibitor and clorgyline (2 mg/kg i.p.) - selective MAO-A inhibitor. Vigabatrin at a dose of 300 mg/kg i.p. significantly decreased the hyperthermic response between 150 and 300 min in rats with a serotonin syndrome model, compared to the group with a model of serotonin syndrome in which only saline was administered before the injection of the serotonergic substances [57, 61].
In summary pretreatment with diazepam (5 mg/kg i.p.), sodium valproate (300 mg/kg i.p.), and vigabatrin (300 mg/kg i.p.) decreased hyperthermia in different experimental models of the serotonin syndrome. These results suggest involvement of interactions between GABA-ergic and serotonergic systems in the processes of thermoregulation.
We assume that in addition to direct GABA-ergic mechanisms, interactions between neurotransmitters or mediator systems are involved in the influence of hyperthermia in serotonin syndrome by GABA-ergic substances. Presynaptic GABAB receptors affect the release of norepinephrine, dopamine, and 5-hydroxytryptamine [62]. Expression of predominantly GABAB receptors has been found in most of the serotonin and catecholamine neurons in the nuclei of the brainstem, which are involved in the regulation of autonomic functions [63]. Interactions between the GABA-ergic and serotonergic systems are mediated by presynaptic heteroreceptor GABAB-inhibition of 5-HT release or by G-protein-coupled interaction between 5-HT1A and GABAB-ergic receptors [64].
Hyperthermia is the most common cause of complications of life-threatening forms of serotonin syndrome in humans and is one of the leading causes of mortality reported in experimental models of serotonin syndrome [6, 7].
As already mentioned, several studies indicate the role of 5-HT2A receptors in the development of a hyperthermic response in rats. In this regard, the effect of a number of 5-HT2 antagonists in influencing the hyperthermic response in experimental serotonin syndrome has been studied. Some of the serotonin antagonists investigated are cyproheptadine, ritanserin, ketanserin, mirtazapine, some antipsychotics such as chlorpromazine, risperidone and olanzapine [8, 11, 12, 13, 14, 15]. Results demonstrate a significant involvement of the 5-HT2A receptors in the development of hyperthermic response in experimental serotonin syndrome [65].
Studies have shown that cyproheptadine effectively affects the hyperthermic response in an experimental model of serotonin syndrome. Moreover, a comparative study demonstrates that, unlike other 5-HT2 antagonists, it prevents both the development of serotonin syndrome and the mortality of experimental animals [14, 66].
The role of atypical antipsychotics in the treatment of serotonin syndrome has been increasingly discussed in the last few years, given that most atypical antipsychotics work primarily by blocking 5-HT2 receptors [67].
Moreover, temperature dysregulation is a documented side effect of antipsychotic drugs [68, 69, 70, 71, 72]. That most often manifests in the development of hyperthermia, a life-threatening symptom characteristic of the malignant neuroleptic syndrome (MNS). Data from various clinical cases, summarized in recent years by van Marum [68] and Zonnenberg [69, 70], show that the use of classical or atypical antipsychotics carries the risk of developing another, less well-documented adverse drug reaction, namely hypothermia. In humans, hypothermia is defined as a body temperature below 35 ° C, distinguishing three degrees: mild (33–35 ° C), moderate (28–33 ° C) and severe (<28 ° C) hypothermia [69].
Although the hypothermic effect of antipsychotics is less known than the hyperthermic one expressed in MNS, analysis of the literature data shows that there are almost equal reports of hypothermia (480 cases) and hyperthermia (524 cases) associated with the use of antipsychotics. Zonnenberg et al. consider that the actual incidence of hypothermia associated with the use of antipsychotics is at least 10 times higher than the documented [69]. For the first time, the development of hypothermia after the use of antipsychotic drugs was described by Loughnane in a 26-year-old patient on chlorpromazine therapy [73].
The analyzes of van Marum et al. and Zonnenberg et al. indicate that hypothermia most often occurs one week after starting antipsychotic therapy or after increasing the dose. They also indicated that the use of atypical antipsychotics was more common (approximately 55% of cases), with risperidone being the most commonly reported [68, 69, 74]. Mild hypothermia associated with low-dose risperidone has also been observed in a child with verbal and physically aggressive behavior [75].
Analyzes by van Marum and Zonnenberg show that antipsychotics with a higher affinity for blocking 5-HT2A than D2 receptors are more often associated with the development of hypothermia [68, 69]. This is also confirmed by experimental and clinical studies which demonstrate that the atypical antipsychotics olanzapine and risperidone cause a decrease in body temperature indicating that the mechanism of hypothermic action is associated with blockade of 5-HT2 receptors [72, 74, 75, 76].
From all data reported thus far, it can be concluded that 5-HT2 receptors and the GABA system are strongly involved in the development of hyperthermia in serotonin syndrome and the mortality associated with it.
Drug-induced hyperthermia is resistant to the action of classical antipyretics therefore their use is not recommended. The use of acetylsalicylic acid and other classical antipyretics not only has no effect in the case of drug-induced hyperthermia but may even cause a worsening of the course of the hyperthermic reaction. In our opinion, due to the proven hypothermic effect of the mentioned GABA-ergic drugs and 5-HT2-antagonists, their use in the therapeutic regimen of hyperthermia in specific hyperthermic syndromes is appropriate.
The similarity in the manifestation of the syndrome in rats and humans can serve as a basis for further elucidation of the mechanism of development of serotonin syndrome in humans. The animal model of serotonin syndrome can be used to study drugs and drug combinations that pose a potential risk of developing serotonin syndrome in humans and the possibilities for its prevention.
Patient safety is defined by the World Health Organization (WHO) as reducing the risk of unnecessary harm associated with healthcare to an acceptable minimum [1].
The topic of patient safety has been increasingly disseminated within institutions and among healthcare professionals, about the search for the quality of care provided and the reduction of preventable incidents [2].
Patient safety addresses the risks involved in health care to reduce or eliminate Adverse Events (AEs), defined as incidents that occur during health care and result in harm to the patient, characterized as physical, social, and psychological, including illness, injury, suffering, disability or death [1].
The interest in this topic is a result of the realization that the occurrence of Adverse Events (AEs) involves considerable social and economic costs, and may involve irreversible damage to patients and their families [3].
The patient safety issue began with the publication of the Institute of Medicine (IOM) report To Err is Human. This publication provoked the mobilization of the medical class and the public in general, of North American organizations and several countries for issues related to patient safety. This mobilization is the result of the realization that the occurrence of adverse events (AE) involves considerable social and economic costs, and can cause irreversible damage to patients and their families. The IOM report estimated the occurrence of 44 to 98 thousand deaths each year, in the United States (USA), resulting from AEs [4].
According to the Institute of Medicine (1999) quality in healthcare, considering current scientific knowledge, is defined as the degree to which the services provided to the patient, on the one hand, decrease the probability of unfavorable outcomes, and, on the other, increase the probability of favorable outcomes. Unfavorable outcomes are adverse events (AEs).
Developments in patient safety and reliability of health services imply a change in the conduct practiced by most services. The safety culture of an organization is the set of values, attitudes, perceptions, competencies, and behavioral patterns that determine the commitment, style, and proficiency of the administration of a healthcare organization with safety management [5].
Health care is increasingly complex, and predisposes the occurrence of incidents, errors or failures. Injuries or damage resulting from the care provided constitute a serious problem related to the performance of health services; unsafe health care can cause increased morbidity and mortality worldwide [6].
Researches that investigate the patient safety culture in the hospital environment are increasingly present in the scientific environment. The positive safety culture favors the improvement of safe practices, through improvements in communication, teamwork and knowledge sharing [3].
The development of a safety culture, the practice of records, the discussion about the circumstances in which incidents occur, as well as the professional and organizational behaviors in front of this situation, constitute a path to be followed for the transformation of the reality in health institutions [7].
In this perspective, the development of safety culture has received increasing attention in the field of healthcare organizations. The complexity present in health care, which involves its dynamic and multifaceted nature, the use of leading-edge technology and the action of professionals from different fields, predisposes to error and, to minimize it, potential sources must be identified and prioritized [8].
It is a fact that unsafe health care can result in increased morbidity and mortality, which makes this a global concern, because many errors could be avoidable from the implementation of safety indicators in quality monitoring programs in the care offered to hospitalized patients [9].
It is currently recommended that, in assessing the impact of events related to patient safety, not only mortality but also morbidity be considered given the repercussions on the quality of life of patients who have suffered damage [5].
Chronic kidney disease (CKD) is a condition with several attributes that have the potential to increase the risk of errors and patient safety failures. People with CKD have higher rates of hospitalizations, which leaves them susceptible to interventions with the potential for errors to occur [10].
There is a high proportion of people with chronic kidney disease (CKD) who experience safety-related events. This factor highlights the vulnerability of this population to potential adverse effects of care [11].
Patients with CKD have hemodialysis as one of the treatment modalities. Regarding the Hemodialysis Service, it is emphasized that the treatment is complex, with specific activities, for example, the control of the extracorporeal blood circulation system, requiring adequate structure and trained professionals for a safe care practice, which, if not respected, may cause irreversible damage to the user [12].
Hemodialysis (HD) is a technically complex procedure, with many potential sources of error that can cause harm to patients. Carrying out hemodialysis safely requires many steps, ranging from creating the dialyzer and other equipment, accessing the bloodstream and monitoring the patient to prevent complications and ensure hemodynamic stability [13].
Dialysis is a therapy that in recent years has been benefiting many patients, but it is a care process that involves important dangers and risks. The risks of hemodialysis in situations of chronic disease comorbidities are related to the fact that the patient has a terminal disease that depends on permanent life support, in addition to the use of many medications [5].
The complexity of hemodialysis procedures specifically involves the use of advanced technologies, water quality, dialyser reuse, infection control, machine disinfection and the use of medications [8]. The complexity of chronic kidney disease (CKD): the chronicity of the disease, the involvement of multiple health care professionals, and the different activities of care [14].
Thus, in this type of procedure, considering the frequency with which patients undergo the procedure that involves the use of high technology, it is important to evaluate issues related to patient safety.
There are several risk factors for adverse events in hemodialysis, among which he highlights: invasive procedures, use of complex equipment, critical patients, high patient turnover, and administration of potentially dangerous drugs such as heparin [15].
The authors conducted a study in which they identified some avoidable variables that may have contributed to the deaths of patients on hemodialysis. They point out that these variables were related to communication, organization, and human factors, associated with five main causes, for example: the treatment of hyperkalemia, the prescription, the time of treatment, the presence of infection, and vascular access [16].
The use of Checklists is a patient safety strategy that can be effective. Checklists are tools used to improve patient safety, adherence to protocols and policies, contribute to communication, teamwork, and the standardization of procedures [17].
Authors emphasize that the use of Checklists is an important strategy to ensure that procedures are performed safely, as it allows the occurrence/recurrence of preventable harm to be identified and prevented [13].
When used properly, guidelines, protocols, and checklists can result in quality care, considerably reducing the risks presented by the procedures to which the patient has been submitted.
Checklists were initially used in surgical and intensive care environments and have been shown to be an important patient safety strategy that can improve the safety culture [18].
High-quality institutions with a good safety culture anticipate adverse events as a way to prepare professionals to deal with them at all levels of the organization. In this way, they make tools available to professionals to develop skills to convert such adverse events into improved system resistance [19].
Patient safety assessment enables hospitals to prospectively identify and manage relevant safety issues in their work routines [20].
Care for patients receiving renal replacement therapy (RRT) is complex and technology dependent; patients have a high burden of comorbidity, polypharmacy, and the physiological consequences of established kidney disease means that patients on RRT are potentially vulnerable to errors [16].
Patient safety events can have costly consequences for patients and healthcare networks, increasing length of stay, readmissions to the hospital, and the risk of death [11].
Hemodialysis units are sites susceptible to the occurrence of adverse events (AE) because they have several risk factors, such as invasive procedures, use of complex equipment, water treatment, critical patients, high patient turnover and administration of potentially dangerous drugs, such as heparin. A study performed in four hemodialysis units in the USA identified that in a 17-month period 88 adverse events occurred during 64,541 dialysis treatments (01 case for every 733 treatments) [15].
The presence of infection in the SRT population is a complex and common problem, since the prevalence of sepsis in dialysis patients is more than 100 times higher than the general population, is multifactorial, associated with high hospitalization rates, infection risks, and immunosuppression as a consequence of renal impairment, comorbidity, and immunosuppressive therapy [16].
Bloodstream infections are the main causes of death and hospitalization among hemodialysis patients, in second place are cardiovascular diseases [21].
Among the main causes of AEs in hemodialysis patients, the patient’s clinical condition is very important. Such conditions directly influence the occurrence of AEs, especially in critically ill patients, given the hemodynamic instability and the need for interventions, which make them particularly vulnerable to adverse events [22].
In addition, CKD is associated with pathophysiological changes such as anemia, osteopenia, susceptibility to hypervolemia, electrolyte changes and infection, which can increase the risk of complications and adverse events [10].
For the occurrence of AEs, there are psychological and physiological factors that can influence the behavior of professionals during care and interfere with patient safety [22].
In daily nursing care, it is clear that the number of professionals directly influences the implementation of measures related to the implementation of a culture of safety. Thus, an adequate dimensioning of the team is essential, as it interferes in the administrative process and consequent care planning [22].
About the weekly workload, 48% of nursing professionals in the hemodialysis unit work from 50 to 70 hours per week, increasing the risk of failures being committed during the provision of care. The risks of the professional committing an error increase significantly when the work day exceeds 40 hours per week, when work shifts exceed 12 hours or when overtime is performed [23].
Thus, it can be observed that the working hours and the dimensioning of nursing staff are factors that can interfere in the quality of the care provided, consequently influencing the safety of the patient on hemodialysis.
A study aiming to assess the frequency of adverse events occurred in CKD patients, shows that about half of the participants had one or two safety events. Diabetic patients were 2.9 times more likely to have three or four adverse safety events compared to non-diabetic patients. In addition, patients with stage 5 CKD were 2.8 times more likely than patients with stage 3 CKD to have multiple safety events during the study period [11].
These data reinforce the assertion that patients with CKD are more vulnerable to safety failures related to their clinical condition. CKD is a significant risk factor for many safety events.
In the other study, direct complications of CRT accounted for 2.1% of deaths, and 3.5% of deaths of patients on CRT [16].
The Pennsylvania Patient Safety Authority, an independent agency in the United States of America (USA) charged with taking action to reduce and eliminate health care failures, developed a study to understand the types of errors and AEs occurring during hemodialysis. An analysis of 526 reports of events related to hemodialysis treatment over a one-year period was performed. Medication errors were the most prevalent (28.5%), followed by failure to follow protocol (12.9%) [24].
The conditions identified as predisposing to adverse events in hemodialysis patients are: hyperkalemia, hypoglycemia, prescription of medications in a safe manner, the presence of infection, and vascular access for hemodialysis [11, 16].
In dialysis services, hand hygiene is an important infection control measure, since, in this scenario, several patients undergo dialysis treatment at the same time, in the same environment, which can contribute to the spread of microorganisms. This dissemination can occur through direct or indirect contact, through devices, equipment, surfaces or through the hands of health professionals [12].
Central venous catheter infections for hemodialysis are much more frequent when compared to arteriovenous fistulas [21].
Complications associated with vascular access can be severe, causing a high risk of morbidity and mortality for patients. Bloodstream infections represent a major impact on the morbidity and mortality of this population. Nurses must monitor, detect and intervene in complications that occur during hemodialysis sessions [22].
The arteriovenous fistula (AVF) is the most appropriate and safest venous access, because it is the long-standing access that enables effective dialysis with fewer interventions [25].
Thus, the use of double-lumen catheter can lead to a higher occurrence of adverse events, interfering with the safety of the patient on hemodialysis. CDL infection is one of the main adverse events in hemodialysis. The largest number of infections in patients undergoing hemodialysis procedure is related to the Temporary Double Lumen Catheter (TDCL). Bacteremia in patients with a catheter during HD varies from 4–18% and in most cases associated with hyperthemia. Infectious complications are causative agents of increasing morbidity and mortality in hemodialysis patients [26].
CKD is also characterized by impaired renal clearance of numerous medications, increasing the risk for incorrect dosing and toxicity of therapeutic agents [10].
In the hemodialysis community, medication errors are reported as the most common patient safety event. Medication errors are common among dialysis patients and often occur as errors of omission [11, 21].
In addition to medication omission errors, errors also occur during medication administration and communication errors among the team [21].
Obstruction of the venous catheter is a very frequent adverse event in hemodialysis sessions. It occurs when a clot forms in the catheter lumen, preventing blood flow from the patient’s body to the hemodialysis machine, which leads to the loss of the blood volume that fills the system [22].
The blood clotting of the extracorporeal system usually occurs in sessions performed without heparin, due to contraindication of the drug [22].
Problems in vascular access that lead to adequate blood flow interfere directly in the dialysis dose, reducing the Kt/V, consequently interfering with the patient’s health status.
Events of hyperkalemia and hypoglycemia were found individually, are common adverse events, as well as risk factors for mortality of patients with CKD [11].
In a hemodialysis session, it is necessary to check vital signs to avoid episodes of hypotension, consequently, the cramps, headache and nausea, verification of blood glucose to avoid episodes of hypoglycemia and, plus correct checking and noting of weight and body temperature; anticoagulation, proper functioning of the dialysis machines (temperature, roller, blood flow, dialysate flow), being important the use of a checklist to avoid negligence.
Failure to comply with this verification routine is considered negligence, which is an action diverging from the correct one, arising from the professional’s passivity or omission, which can lead to episodes of hypotension, hypoglycemia, among others, thus configuring the occurrence of an adverse event [25].
Accidental removal of the needle that punctures the arteriovenous fistula can be considered one of the most dangerous AEs in hemodialysis units, as the patient can bleed to death in a few minutes. Therefore, it is necessary for nursing to adopt measures that reduce the risk of this event occurring [22].
Infiltration of the hemodialysis access and coagulation of the hemodialysis circuit are some adverse events that can occur.
About dialysis programming, one can highlight the definition of the dry weight, the kt/v and the programming of the parameters in the dialysis machine.
The quality of the dialysis offered to the patients can be measured by the Kt/V. The Kt/V represents the adequacy of dialysis. In this study, it is observed that there is no record of Kt/V in 94% of the analyzed medical records.
There is a correlation between hemodialysis (HD) dose and patient morbidity and mortality, so to estimate whether CKD patients on HD receive adequate treatment, the HD dose should be measured. Clinical signs and symptoms are very important, but they are not sufficient indicators of dialysis dose [27].
Kt/V assessment is nursing care and refers to providing quality dialysis to the patient. There are several factors related to achieving an ideal Kt/V, and it is important to emphasize that the patient needs to adhere to the treatment as recommended, i.e., perform the dialysis time, follow the diets, take medications, take care of the vascular access.
The other part is up to the multidisciplinary team, which includes providing guidance. The dialysis service must be committed to the treatment, offering an ideal capillary according to the body mass, performing good venous access, correct adequacy during treatment [28].
The National Kidney Foundation considers the ideal hemodialysis dose a Kt/V greater than 1.2, for the patient who performs hemodialysis three times a week and for four hours each session [28].
Incorrect programming is an adverse event and can lead to significant losses to the patient, even death.
Checking the schedule is the nurse’s role, since this is the professional of the health team responsible for managing care in dialysis units. Nursing in hemodialysis treatment has great relevance regarding the uninterrupted observation of patients during the period in which the hemodialysis session occurs [29].
In the Renal Physicians Association survey, 17 percent of patients indicated that they had problems with the settings on their dialysis machines. In this study, the authors point out that patients involved in their dialysis care are significantly less likely to report having had problems with machine settings [30].
Dry weight is the target weight to be achieved post hemodialysis below which all, or most of the excess fluid has been removed, without developing symptoms of hypotension [25].
Adherence to adequate fluid intake is commonly measured by interdialytic weight gain (GPID). The adequate dry weight prevents the occurrence of hypotension or hypertension.
Studies have shown a relationship between elevated GPID and complications such as hypertension, congestive heart failure, and even death. In addition, the removal of this excess fluid during hemodialysis (HD) can result in episodes of hypotension, muscle cramps, nausea, and headache [31].
The nurse has a fundamental role as an educator, providing the necessary guidance for patients to maintain their interdialytic weight gain within the recommended values.
Adherence to dietary and fluid restrictions improves laboratory parameters, reduces complications such as hospitalizations for acute pulmonary edema and improves the quality of life of patients on HD [32].
The conventional treatment regimen of three sessions per week implies long periods without hemodialysis, especially on weekends, when the patient can consume a larger amount of fluids and not follow the diet as he should. Thus, there is an oscillation in the volume of liquids and biochemistry during the following week, where it is possible to observe an increase in complications in the sessions at the beginning of the week. The ideal would be more frequent or longer sessions, to offer more security and increase the life expectancy of these patients [33].
The mechanicity present in hemodialysis treatment leads professionals to present a posture of “doing for doing”, which lends to the activities a feeling of accommodation, which is summarized in, every shift, putting the patient on the machine, pushing the button and supervising its operation [34].
Nursing in nephrology is specialized care, but the nursing action should not be reduced to the performance of a set of techniques. In HD, it is necessary to provide care based on the training of professionals to seek the best conditions to provide quality of life for the patient. Therefore, nursing care in this scenario also involves interactive action, supported by the ethical dimension between the one who cares and the one who is cared for [35].
Patient safety deals with the risks involved in health care and seeks to minimize these risks and reduce or eliminate Adverse Events, which are incidents that result in harm to the patient [1].
Preventing adverse events can improve the quality of care and patient outcomes [11].
Quality comprises the relentless search for identifying flaws in procedures and practices that organize actions, leading to improved processes and results, aiming at the conformities established by regulatory agencies and user satisfaction [12].
Reducing errors and improving patient safety have become a national priority. Patients with chronic kidney disease (CKD) may be at higher risk for adverse consequences of medical care, but few studies have evaluated this issue [10].
The occurrence of AEs can be minimized by changing managerial and professional attitudes, strengthening leadership, improving access to information, quality, maintenance and use of equipment and environments as well as knowledge and encouraging continuing education [7].
Safety culture has received increasing attention in the field of healthcare organizations. Healthcare is becoming increasingly complex, raising the potential for incidents, errors, or failures to occur. Injuries or harm resulting from the care provided are a serious problem related to the performance of health services; unsafe health care causes significant morbidity and mortality worldwide [6].
From this perspective, health institutions must develop strategies for a patient safety culture. The development of protocols that standardize procedures makes the work process safer and more efficient [22].
Professionals should have knowledge about adverse events and their impact on health care, since the incidence of these events is an important indicator of quality [22].
Currently, there is a greater awareness, nationwide, that professionals need to be trained about the measures to be taken in case of failures, in addition to being encouraged to take an honest attitude towards the error, without fear of punishment and effectively involved in the search for safe patient care [36].
Nursing professionals are responsible for most of the care actions and, therefore, are in a privileged position to reduce the possibility of incidents affecting the patient, as well as to detect complications early and perform the necessary procedures to minimize damage [22].
The maintenance of good adequacy of hemodialysis in patients with chronic kidney disease depends directly on an efficient Vascular Access (VA), whose complications have great representativeness among the morbidities in this group. And, considering the importance of the VA, it is worth noting that the effectiveness of therapy is closely associated with its implantation, handling and proper monitoring, affecting the quality of dialysis and, consequently, the well-being and survival of the patient [12].
Adverse events related to vascular access can be avoided using improvements in the care processes used by Nursing, as well as constant evaluation of the results of the practices adopted.
Studies show that catheter-related infections can be reduced when prevention measures are properly applied, such as the use of aseptic technique before insertion, in each manipulation of the device and dressings, antisepsis at the catheter exit site with 2% alcoholic chlorhexidine, adequate staff paramentation (sterile gloves, masks, goggles and aprons), care in catheter maintenance, monitoring of infection signs, continuing education of staff professionals and self-care guidance for the patient [37, 38].
Considering that vascular accesses are an important care practice and are closely related to the quality of care and quality of life of CKD patients, it is believed that the use of checklists can be an important ally in the evaluation of vascular access, ensuring the quality of this therapeutic modality [22, 39].
The Nursing team that works in hemodialysis units must have knowledge about adverse events to be able to identify the risks and the situations that favor their occurrence, to seek alternatives to minimize failures, adopt risk analysis methods and thus ensure the quality of the services [22].
Many hospitalizations may be preventable with better care planning, adequate patient education, and early detection of complications [40].
Strategies to improve patient safety in dialysis units have emphasized the importance of effective communication, reduction of medication errors, correct dialysis, equipment preparation, and infection control [16].
Encouraging the practice of hand hygiene constitutes one of the nine solutions for patient safety, launched in 2007, in the Nine Patient Safety Solutions program, considered the primary preventive measure to avoid harm to patients [12].
The Nine Patient Safety Solutions program is based on patient safety strategies and best practices that have been identified by the WHO World Alliance for Patient Safety. They were developed with feedback from more than 50 patient safety experts from over 100 countries. The strategies come in nine titles and are being made available to WHO member states. The intention is that the strategies will be used to reexamine patient care processes to improve safety [1].
The nine points covered by the program are: Identical medication names; Patient identification; Communication; Correct procedure in the correct place; Control of concentrated electrolyte solutions; Medication accuracy; Care with connections; Single-use of injection and hand hygiene devices [1].
The theme described above is recurrent in health services and treated as a priority by programs and initiatives that focus on safety in patient care, such as the World Alliance for Patient Safety, an initiative of the WHO, which has dedicated efforts in the development of guidelines and strategies for implementation of measures, including adherence to the practice of hand hygiene and, more recently, in Brazil, by the Ordinance of the Ministry of Health No. 529/2013, which establishes the National Program for Patient Safety [41].
Organizations must safely structure the system, helping professionals not to make mistakes. All causes should be analyzed by the risk management service for the development of corrective actions, aiming at the prevention and reduction of adverse events [22].
Among the suggestions to prevent the occurrence of adverse events, continuing education was mentioned as the main measure and as an important action for human resource training and development. The nursing staff of a hemodialysis unit should develop skills to detect and prevent adverse events, adopting strategies to improve the care processes developed in daily practice [22].
Health education can also contribute to patient safety. A good level of understanding of the disease and treatment aspects also positively influences the patient’s adaptation and adherence to treatment [42].
This factor could reflect a lower occurrence of adverse events related to hemodialysis treatment.
Dialysis centers must function as high-reliability organizations to improve patient safety. These services must establish a culture of safety, which is based on communication based on mutual trust, common perceptions about the importance of safety and confidence in the effectiveness of preventive measures [21].
In the occurrence of an incident, what is important is the assimilation that the cause of errors and adverse events is multifactorial and that healthcare professionals are susceptible to committing them when technical and organizational processes are complex and poorly planned [22].
The high frequency of different events observed reveals the specialized care needs for the CKD population. Providing safe care for this population, therefore, provides some unique challenges.
Research must advance in understanding the cause of harm, identifying solutions, impact, and transposing evidence to the organization of care. They reinforce that measuring harm is fundamental to know the patient safety problem [43].
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Ollmann",authors:[{id:"157951",title:"Prof.",name:"Volker",middleName:null,surname:"Schneider",slug:"volker-schneider",fullName:"Volker Schneider"},{id:"159481",title:"Ms.",name:"Jana",middleName:null,surname:"Ollmann",slug:"jana-ollmann",fullName:"Jana Ollmann"}]},{id:"44243",doi:"10.5772/55206",title:"Climate Change and Food Security",slug:"climate-change-and-food-security",totalDownloads:4366,totalCrossrefCites:3,totalDimensionsCites:9,abstract:null,book:{id:"3364",slug:"environmental-change-and-sustainability",title:"Environmental Change and Sustainability",fullTitle:"Environmental Change and Sustainability"},signatures:"Christopher Kipkoech Saina, Daniel Kipkosgei Murgor and Florence\nA.C Murgor",authors:[{id:"159982",title:"Mr.",name:"Christopher",middleName:null,surname:"Saina",slug:"christopher-saina",fullName:"Christopher Saina"},{id:"160822",title:"Ms.",name:"Florence",middleName:null,surname:"Murgor",slug:"florence-murgor",fullName:"Florence Murgor"},{id:"160825",title:"Dr.",name:"Daniel",middleName:"Kipkosgei",surname:"Murgor",slug:"daniel-murgor",fullName:"Daniel Murgor"}]}],mostDownloadedChaptersLast30Days:[{id:"76898",title:"The Relationship between Land Use and Climate Change: A Case Study of Nepal",slug:"the-relationship-between-land-use-and-climate-change-a-case-study-of-nepal",totalDownloads:701,totalCrossrefCites:1,totalDimensionsCites:3,abstract:"Land Use and Climate change are interrelated to each other. This change influences one another at various temporal and spatial scales; however, improper land uses are the primary causal factor on climate change. It studies relevant literature and Nepal’s case to assess the relationship between land use and climate change. Similarly focuses on how land-use impacts climate change and vice versa. In recent centuries land-use change significant effects on ecological variables and climate change. Likewise, understanding the research on both topics will help decision-makers and conservation planners manage land and climate.",book:{id:"10754",slug:"the-nature-causes-effects-and-mitigation-of-climate-change-on-the-environment",title:"The Nature, Causes, Effects and Mitigation of Climate Change on the Environment",fullTitle:"The Nature, Causes, Effects and Mitigation of Climate Change on the Environment"},signatures:"Pawan Thapa",authors:[{id:"349566",title:"M.Sc.",name:"Pawan",middleName:null,surname:"Thapa",slug:"pawan-thapa",fullName:"Pawan Thapa"}]},{id:"42926",title:"Disaster Risk Management and Social Impact Assessment: Understanding Preparedness, Response and Recovery in Community Projects",slug:"disaster-risk-management-and-social-impact-assessment-understanding-preparedness-response-and-recove",totalDownloads:10048,totalCrossrefCites:3,totalDimensionsCites:11,abstract:null,book:{id:"3364",slug:"environmental-change-and-sustainability",title:"Environmental Change and Sustainability",fullTitle:"Environmental Change and Sustainability"},signatures:"Raheem A. Usman, F.B. Olorunfemi, G.P. Awotayo, A.M. Tunde and\nB.A. Usman",authors:[{id:"156875",title:"Dr.",name:"Usman A",middleName:null,surname:"Raheem",slug:"usman-a-raheem",fullName:"Usman A Raheem"},{id:"166449",title:"Dr.",name:"A.M",middleName:null,surname:"Tunde",slug:"a.m-tunde",fullName:"A.M Tunde"},{id:"167886",title:"Dr.",name:"F.B.",middleName:null,surname:"Olorunfemi",slug:"f.b.-olorunfemi",fullName:"F.B. Olorunfemi"},{id:"167887",title:"Dr.",name:"G.P.",middleName:null,surname:"Awotayo",slug:"g.p.-awotayo",fullName:"G.P. Awotayo"}]},{id:"77171",title:"Climate Change and Its Potential Impacts on Insect-Plant Interactions",slug:"climate-change-and-its-potential-impacts-on-insect-plant-interactions",totalDownloads:480,totalCrossrefCites:1,totalDimensionsCites:3,abstract:"The most dynamic and global environmental issue to date is climate change. The consequences of greenhouse effect and climate change from rising temperatures, frequent droughts, irregular rainfall, etc. are already evident. Insects and plants are affected by climate change and extreme weather events and the direct impact of anthropogenic climate change has been reported on every continent, in every ocean and in most major taxonomic groups. In the modern period, as a result of natural cycles and anthropogenic activities and their effects on the global climate, plants are typically susceptible to new environmental factors, i.e. higher levels solar radiation, rise in temperatures, greenhouse effect and changes in rainfall patterns over the seasons. Increased temperatures, CO2 and rapid changes in rainfall patterns can dramatically alter the biochemistry of plants and thus plant defence responses. This can have important implications in insect fertility, feeding rates, survival, population size, and dispersal. The relationships between plants and insects are thus changed with significant consequences for food security and natural ecosystems. Similarly, mismatches between plants and insect pollinators are caused by the acceleration of plant phenology by warming. Human nutrition which depends on insect pollination can be affected with reduction in plant reproduction and fitness. Thus, understanding abiotic stress reactions in plants and insects is relevant and challenging in agriculture. In the preparation and implementation of effective strategies for future insect pest management programmes, the impact of climate change on crop production, mediated by changes in the populations of extreme insect pests should be carefully considered.",book:{id:"10754",slug:"the-nature-causes-effects-and-mitigation-of-climate-change-on-the-environment",title:"The Nature, Causes, Effects and Mitigation of Climate Change on the Environment",fullTitle:"The Nature, Causes, Effects and Mitigation of Climate Change on the Environment"},signatures:"Somala Karthik, M.S. Sai Reddy and Gummudala Yashaswini",authors:[{id:"416107",title:"Ph.D. Student",name:"Somala",middleName:null,surname:"Karthik",slug:"somala-karthik",fullName:"Somala Karthik"},{id:"416115",title:"Prof.",name:"M.S.",middleName:null,surname:"Sai Reddy",slug:"m.s.-sai-reddy",fullName:"M.S. Sai Reddy"},{id:"416969",title:"Ms.",name:"Gummudala",middleName:null,surname:"Yashaswini",slug:"gummudala-yashaswini",fullName:"Gummudala Yashaswini"}]},{id:"44243",title:"Climate Change and Food Security",slug:"climate-change-and-food-security",totalDownloads:4366,totalCrossrefCites:3,totalDimensionsCites:9,abstract:null,book:{id:"3364",slug:"environmental-change-and-sustainability",title:"Environmental Change and Sustainability",fullTitle:"Environmental Change and Sustainability"},signatures:"Christopher Kipkoech Saina, Daniel Kipkosgei Murgor and Florence\nA.C Murgor",authors:[{id:"159982",title:"Mr.",name:"Christopher",middleName:null,surname:"Saina",slug:"christopher-saina",fullName:"Christopher Saina"},{id:"160822",title:"Ms.",name:"Florence",middleName:null,surname:"Murgor",slug:"florence-murgor",fullName:"Florence Murgor"},{id:"160825",title:"Dr.",name:"Daniel",middleName:"Kipkosgei",surname:"Murgor",slug:"daniel-murgor",fullName:"Daniel Murgor"}]},{id:"77262",title:"Evaluation of Climate Change-Induced Impact on Streamflow and Sediment Yield of Genale Watershed, Ethiopia",slug:"evaluation-of-climate-change-induced-impact-on-streamflow-and-sediment-yield-of-genale-watershed-eth",totalDownloads:328,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"In the 21st century, changes in induced climate can significantly affect the water resources system in the watershed. Understanding climate change disrupts hydrological processes can facilitate sustainable water resource strategies to resilient impacts of global warming. The hydrological response of watersheds will be accelerated by climate change, altering the rainfall, magnitude & timing of runoff, and sediment yield. The study investigates climate change aspects on the hydrological responses using Soil and Water Assessment Tool (SWAT) model interfaced with Geographical Information System (GIS) of Genale Basin, Ethiopia. The calibrated SWAT was applied to simulate the impact of climate, and the SUFI-II algorithm was used for parameter optimization & finalization. The change of climate scenarios was built using the outcomes bias-corrected CORDEX RCM daily precipitation, min/max temperature for Ethiopia under RCP 4.5 and RCP 8.5. The average monthly change of streamflow from −16.47% to 6.58% and − 3.6% to 8.27% under RCP4.5 and RCP8.5, respectively (2022–2080). The monthly average sediment yield change was −21.8% to 6.2% and − 5.6% to 4.66% for the RCP4.5 and RCP8.5 scenarios, respectively, over 2022–2080. It implies that the climate change-induced impacts on sediment yield are more significant than streamflow and suggest substantial adaptive management in watershed systems.",book:{id:"10754",slug:"the-nature-causes-effects-and-mitigation-of-climate-change-on-the-environment",title:"The Nature, Causes, Effects and Mitigation of Climate Change on the Environment",fullTitle:"The Nature, Causes, Effects and Mitigation of Climate Change on the Environment"},signatures:"Tufa Feyissa Negewo and Arup Kumar Sarma",authors:[{id:"347544",title:"Ph.D. Student",name:"Tufa",middleName:"Feyissa",surname:"Feyissa Negewo",slug:"tufa-feyissa-negewo",fullName:"Tufa Feyissa Negewo"},{id:"348198",title:"Prof.",name:"Arup",middleName:null,surname:"Kumar Sarma",slug:"arup-kumar-sarma",fullName:"Arup Kumar Sarma"}]}],onlineFirstChaptersFilter:{topicId:"870",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"82644",title:"Climate-Driven Temporary Displacement of Women and Children in Anambra State, Nigeria: The Causes and Consequences",slug:"climate-driven-temporary-displacement-of-women-and-children-in-anambra-state-nigeria-the-causes-and-",totalDownloads:24,totalDimensionsCites:0,doi:"10.5772/intechopen.104817",abstract:"With increasing periods of extreme wet seasons, low lying geographic position, with socioeconomic, and political factors; some communities in Anambra State, Nigeria experience heightened floods annually resulting in loss of shelter, displacement of people with breakdown of livelihoods, particularly in rural communities worsening their risks and vulnerabilities. In 2012, a major flood event in the state temporarily displaced about 2 million people. In this chapter, we used a community-based adaptation approach to investigate the causes and consequences of climate-related temporary displacement on community members in Ogbaru LGA, Anambra State following flood events. We used global positioning system to obtain the community’s ground control points and gathered our data via field observation, transects walks, focus group discussions, photography, and in-depth interviews. Our findings reveal a heightened magnitude of flood related disasters with decreased socio-economic activities, affecting their health and well-being. Also, the community members have a practice of returning to their land, after flood events, as a local mitigating risk management strategy. For multilevel humanitarian responses at the temporary shelter camps, it becomes imperative to meaningfully engage the community members on the challenging risks and vulnerabilities they experience following climate-driven temporary displacement to inform adaptation and resilience research, policy change and advocacy.",book:{id:"7724",title:"Climate Change in Asia and Africa - Examining the Biophysical and Social Consequences, and Society's Responses",coverURL:"https://cdn.intechopen.com/books/images_new/7724.jpg"},signatures:"Akanwa Angela Oyilieze, Ngozi N. Joe-Ikechebelu, Ijeoma N. Okedo-Alex, Kenebechukwu J. Okafor, Fred A. Omoruyi, Jennifer Okeke, Sophia N. Amobi, Angela C. Enweruzor, Chinonye E. Obioma, Princess I. Izunobi, Theresa O. Nwakacha, Chinenye B. Oranu, Nora I. Anazodo, Chiamaka A. Okeke, Uwa-Abasi E. Ugwuoke, Uche M. Umeh, Emmanuel O. Ogbuefi and Sylvia T. Echendu"},{id:"79637",title:"Evaluation of the Spatial Distribution of the Annual Extreme Precipitation Using Kriging and Co-Kriging Methods in Algeria Country",slug:"evaluation-of-the-spatial-distribution-of-the-annual-extreme-precipitation-using-kriging-and-co-krig",totalDownloads:54,totalDimensionsCites:0,doi:"10.5772/intechopen.101563",abstract:"In this chapter, we have conducted a statistical study of the annual extreme precipitation (AMP) for 856 grid cells and during the period of 1979–2012 in Algeria. In the first step, we compared graphically the forecasts of the three parameters of the generalized extreme value (GEV) distribution (location, scale and shape) which are estimated by the Spherical model. We used the Cross validation method to compare the two methods kriging and Co-kriging, based on the based on some statistical indicators such as Mean Errors (ME), Root Mean Square Errors (RMSE) and Squared Deviation Ratio (MSDR). The Kriging forecast error map shows low errors expected near the stations, while co-Kriging gives the lowest errors on average at the national level, which means that the method of co-Kriging is the best. From the results of the return periods, we calculate that after 50 years the estimated of the annual extreme precipitation will exceed the maximum AMP is observed in the 33-year.",book:{id:"7724",title:"Climate Change in Asia and Africa - Examining the Biophysical and Social Consequences, and Society's Responses",coverURL:"https://cdn.intechopen.com/books/images_new/7724.jpg"},signatures:"Hicham Salhi"},{id:"77854",title:"Flooding and Flood Modeling in a Typhoon Belt Environment: The Case of the Philippines",slug:"flooding-and-flood-modeling-in-a-typhoon-belt-environment-the-case-of-the-philippines",totalDownloads:162,totalDimensionsCites:0,doi:"10.5772/intechopen.98738",abstract:"Flooding is a perennial world-wide problem and is a serious hazard in areas where the amount of precipitable water has potential to dump excessive amount of water. The warming of the Earth’s climate due to the increase in greenhouse gases (GHGs) increases the availability of water vapor and hence, of extreme precipitation as observed and forecasted by researchers. With rainfall intensity too high, the torrential rains coupled with weather systems that enhances its effects, flooding not only submerges anything low-lying, it also washes away living and non-living things along the course of the river and the floodplain. The flooding is even worsened by the increase in velocity of flow caused by unsustainable urbanization and denudation of the watershed at the headwaters. Nature’s strength is an order of a magnitude that is way beyond that of the strength of men but human ingenuity enables us to transform our living environment into models that could help us better understand it. Flood modeling provides us decision support tools to deal better with nature. It also enables us to simulate the future especially nowadays that changes in our climate is imminent and even happening already in many parts of the world. Therefore, strategies on how to cope with our ever changing environment is very important particularly to countries that are at more risk to climate change such as the archipelagic Philippines.",book:{id:"7724",title:"Climate Change in Asia and Africa - Examining the Biophysical and Social Consequences, and Society's Responses",coverURL:"https://cdn.intechopen.com/books/images_new/7724.jpg"},signatures:"Fibor J. Tan"},{id:"77797",title:"Adapting to Climatic Extremes through Climate Resilient Industrial Landscapes: Building Capacities in the Southern Indian States of Telangana and Andhra Pradesh",slug:"adapting-to-climatic-extremes-through-climate-resilient-industrial-landscapes-building-capacities-in",totalDownloads:98,totalDimensionsCites:0,doi:"10.5772/intechopen.98732",abstract:"There is now greater confidence and understanding of the consequences of anthropogenic caused climate change. One of the many impacts of climate change, has been the occurrence of extreme climatic events, recent studies indicate that the magnitude, frequency, and intensity of hydro-meteorological events such as heat waves, cyclones, droughts, wildfires, and floods are expected to increase several fold in the coming decades. These climatic extremes are likely to have social, economic, and environmental costs to nations across the globe. There is an urgent need to prepare various stakeholders to these disasters through capacity building and training measures. Here, we present an analysis of the capacity needs assessment of various stakeholders to climate change adaptation in industrial parks in two southern states of India. Adaptation to climate change in industrial areas is an understudied yet highly urgent requirement to build resilience among stakeholders in the Indian subcontinent. The capacity needs assessment was conducted in two stages, participatory rural appraisal (PRA) and focus group discussion (FGD) were conducted among various stakeholders to determine the current capacities for climate change adaptation (CCA) for both, stakeholders and functional groups. Our analysis indicates that in the states of Telangana and Andhra Pradesh, all stakeholder groups require low to high levels of retraining in infrastructure and engineering, planning, and financial aspects related to CCA. Our study broadly supports the need for capacity building and retraining of functionaries at local and state levels in various climate change adaptation measures; likewise industry managers need support to alleviate the impacts of climate change. Specific knowledge, skills, and abilities, with regard to land zoning, storm water management, developing building codes, green financing for CCA, early warning systems for climatic extremes, to name a few are required to enhance and build resilience to climate change in the industrial landscapes of the two states.",book:{id:"7724",title:"Climate Change in Asia and Africa - Examining the Biophysical and Social Consequences, and Society's Responses",coverURL:"https://cdn.intechopen.com/books/images_new/7724.jpg"},signatures:"Narendran Kodandapani"},{id:"77460",title:"Changing Climatic Hazards in the Coast: Risks and Impacts on Satkhira, One of the Most Vulnerable Districts in Bangladesh",slug:"changing-climatic-hazards-in-the-coast-risks-and-impacts-on-satkhira-one-of-the-most-vulnerable-dist",totalDownloads:211,totalDimensionsCites:0,doi:"10.5772/intechopen.98623",abstract:"Changes in the climate due to anthropogenic and natural variation are indicated by parameters including temperature and rainfall. Climate change variability with changing trends of the two have been unpredictable and unprecedented globally leading to changing weather patterns, natural disasters, leading to sectoral impacts on food and water security, livelihood, human health among others. This research analyses the changing patterns of these parameters over the last 35/37 years of Satkhira district of Bangladesh to assess the state and trend across spatial and temporal dimensions. Such, the study validates to rationalize the observed seasonal changes that persist in Satkhira of Bangladesh. Both in terms of intensity and frequency of the occurrences of natural disasters, the series of natural events have been triangulated, with impacts and vulnerability being assessed from temperature variations, erratic rainfall, cyclone, flood and water logging etc. The study’s prime contribution remains in attribution of climate change in relation contextual circumstances in the region including sea level rise, salinity intrusion. Therefore, the risk and climatic hazards and its resulting impacts over time has been assessed to draw deeper connection between theoretical and practical values. The series of analyses also draw conclusion that assets are at risk from changing climatic condition.",book:{id:"7724",title:"Climate Change in Asia and Africa - Examining the Biophysical and Social Consequences, and Society's Responses",coverURL:"https://cdn.intechopen.com/books/images_new/7724.jpg"},signatures:"Md. Golam Rabbani, Md. Nasir Uddin and Sirazoom Munira"},{id:"76915",title:"The Impacts of Climate Change in Lwengo, Uganda",slug:"the-impacts-of-climate-change-in-lwengo-uganda",totalDownloads:101,totalDimensionsCites:0,doi:"10.5772/intechopen.97279",abstract:"Climate Change has become a threat worldwide. Vulnerable communities are at foremost risk of repercussions of climate change. The present study aimed at highlighting a case study of climate change impacts on Lwengo District of Uganda. Out of the total geographical area of the district, 85% hectares are under cultivation and most of its population depends majorly on the rain- fed agriculture sector to meet the food requirement and as a major income source. With the changing climatic conditions, agriculture is the major sector which is being impacted. The region has experienced disasters from some time, usually the second seasons rains used to result in such disasters but since 2016 both seasons have occurred disasters, which majorly include hailstorm, strong wind, long dry spells, pests and diseases. The situation became more severe due to shortage of availability of skilled human resources, quality equipment for disaster management, limited financial resources and weak institutional capacity, which resulted in increasing vulnerability of small farm holders. Some of the adaptation strategies are being taken up by the government but there is a need to understand prospects of decision-making that are site specific and more sustainable for smallholder communities. Climatic changes possess many obstacles to farming communities which require sustainable adaptation to enhance the adaptive capacities of the communities through continued production systems, which are more resilient to the vagaries of weather. Farmers are practising such options which are location specific, governed by policy framework and dependent on dynamism of farmers. This study investigated how these drivers influence farmers’ decision- making in relation to climate change adaptations.",book:{id:"7724",title:"Climate Change in Asia and Africa - Examining the Biophysical and Social Consequences, and Society's Responses",coverURL:"https://cdn.intechopen.com/books/images_new/7724.jpg"},signatures:"Shyamli Singh and Ovamani Olive Kagweza"}],onlineFirstChaptersTotal:13},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:90,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:107,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:330,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:9,numberOfPublishedChapters:139,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:122,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:21,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:10,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"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:"August 2nd, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:13,editor:{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales",profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",biography:"Dr. Rodriguez-Morales is an expert in tropical and emerging diseases, particularly zoonotic and vector-borne diseases (especially arboviral diseases). He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},editorTwo:null,editorThree:null},subseries:{paginationCount:4,paginationItems:[{id:"3",title:"Bacterial Infectious Diseases",coverUrl:"https://cdn.intechopen.com/series_topics/covers/3.jpg",isOpenForSubmission:!0,editor:{id:"205604",title:"Dr.",name:"Tomas",middleName:null,surname:"Jarzembowski",slug:"tomas-jarzembowski",fullName:"Tomas Jarzembowski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRKriQAG/Profile_Picture_2022-06-16T11:01:31.jpg",biography:"Tomasz Jarzembowski was born in 1968 in Gdansk, Poland. He obtained his Ph.D. degree in 2000 from the Medical University of Gdańsk (UG). After specialization in clinical microbiology in 2003, he started studying biofilm formation and antibiotic resistance at the single-cell level. In 2015, he obtained his D.Sc. degree. 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Singh",profilePictureURL:"https://mts.intechopen.com/storage/users/329385/images/system/329385.png",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",institutionURL:null,country:{name:"India"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"8018",title:"Extracellular Matrix",subtitle:"Developments and Therapeutics",coverURL:"https://cdn.intechopen.com/books/images_new/8018.jpg",slug:"extracellular-matrix-developments-and-therapeutics",publishedDate:"October 27th 2021",editedByType:"Edited by",bookSignature:"Rama Sashank Madhurapantula, Joseph Orgel P.R.O. and Zvi Loewy",hash:"c85e82851e80b40282ff9be99ddf2046",volumeInSeries:23,fullTitle:"Extracellular Matrix - Developments and Therapeutics",editors:[{id:"212416",title:"Dr.",name:"Rama Sashank",middleName:null,surname:"Madhurapantula",slug:"rama-sashank-madhurapantula",fullName:"Rama Sashank Madhurapantula",profilePictureURL:"https://mts.intechopen.com/storage/users/212416/images/system/212416.jpg",institutionString:"Illinois Institute of Technology",institution:{name:"Illinois Institute of Technology",institutionURL:null,country:{name:"United States of America"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null}]},subseriesFiltersForPublishedBooks:[{group:"subseries",caption:"Proteomics",value:18,count:4},{group:"subseries",caption:"Metabolism",value:17,count:6},{group:"subseries",caption:"Cell and Molecular Biology",value:14,count:9},{group:"subseries",caption:"Chemical Biology",value:15,count:14}],publicationYearFilters:[{group:"publicationYear",caption:"2022",value:2022,count:9},{group:"publicationYear",caption:"2021",value:2021,count:7},{group:"publicationYear",caption:"2020",value:2020,count:12},{group:"publicationYear",caption:"2019",value:2019,count:3},{group:"publicationYear",caption:"2018",value:2018,count:2}],authors:{paginationCount:250,paginationItems:[{id:"274452",title:"Dr.",name:"Yousif",middleName:"Mohamed",surname:"Abdallah",slug:"yousif-abdallah",fullName:"Yousif Abdallah",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/274452/images/8324_n.jpg",biography:"I certainly enjoyed my experience in Radiotherapy and Nuclear Medicine, particularly it has been in different institutions and hospitals with different Medical Cultures and allocated resources. Radiotherapy and Nuclear Medicine Technology has always been my aspiration and my life. As years passed I accumulated a tremendous amount of skills and knowledge in Radiotherapy and Nuclear Medicine, Conventional Radiology, Radiation Protection, Bioinformatics Technology, PACS, Image processing, clinically and lecturing that will enable me to provide a valuable service to the community as a Researcher and Consultant in this field. My method of translating this into day to day in clinical practice is non-exhaustible and my habit of exchanging knowledge and expertise with others in those fields is the code and secret of success.",institutionString:null,institution:{name:"Majmaah University",country:{name:"Saudi Arabia"}}},{id:"313277",title:"Dr.",name:"Bartłomiej",middleName:null,surname:"Płaczek",slug:"bartlomiej-placzek",fullName:"Bartłomiej Płaczek",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/313277/images/system/313277.jpg",biography:"Bartłomiej Płaczek, MSc (2002), Ph.D. (2005), Habilitation (2016), is a professor at the University of Silesia, Institute of Computer Science, Poland, and an expert from the National Centre for Research and Development. His research interests include sensor networks, smart sensors, intelligent systems, and image processing with applications in healthcare and medicine. He is the author or co-author of more than seventy papers in peer-reviewed journals and conferences as well as the co-author of several books. He serves as a reviewer for many scientific journals, international conferences, and research foundations. Since 2010, Dr. Placzek has been a reviewer of grants and projects (including EU projects) in the field of information technologies.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"35000",title:"Prof.",name:"Ulrich H.P",middleName:"H.P.",surname:"Fischer",slug:"ulrich-h.p-fischer",fullName:"Ulrich H.P Fischer",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/35000/images/3052_n.jpg",biography:"Academic and Professional Background\nUlrich H. P. has Diploma and PhD degrees in Physics from the Free University Berlin, Germany. He has been working on research positions in the Heinrich-Hertz-Institute in Germany. Several international research projects has been performed with European partners from France, Netherlands, Norway and the UK. He is currently Professor of Communications Systems at the Harz University of Applied Sciences, Germany.\n\nPublications and Publishing\nHe has edited one book, a special interest book about ‘Optoelectronic Packaging’ (VDE, Berlin, Germany), and has published over 100 papers and is owner of several international patents for WDM over POF key elements.\n\nKey Research and Consulting Interests\nUlrich’s research activity has always been related to Spectroscopy and Optical Communications Technology. Specific current interests include the validation of complex instruments, and the application of VR technology to the development and testing of measurement systems. He has been reviewer for several publications of the Optical Society of America\\'s including Photonics Technology Letters and Applied Optics.\n\nPersonal Interests\nThese include motor cycling in a very relaxed manner and performing martial arts.",institutionString:null,institution:{name:"Charité",country:{name:"Germany"}}},{id:"341622",title:"Ph.D.",name:"Eduardo",middleName:null,surname:"Rojas Alvarez",slug:"eduardo-rojas-alvarez",fullName:"Eduardo Rojas Alvarez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/341622/images/15892_n.jpg",biography:null,institutionString:null,institution:{name:"University of Cuenca",country:{name:"Ecuador"}}},{id:"215610",title:"Prof.",name:"Muhammad",middleName:null,surname:"Sarfraz",slug:"muhammad-sarfraz",fullName:"Muhammad Sarfraz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/215610/images/system/215610.jpeg",biography:"Muhammad Sarfraz is a professor in the Department of Information Science, Kuwait University. His research interests include computer graphics, computer vision, image processing, machine learning, pattern recognition, soft computing, data science, intelligent systems, information technology, and information systems. Prof. Sarfraz has been a keynote/invited speaker on various platforms around the globe. He has advised various students for their MSc and Ph.D. theses. He has published more than 400 publications as books, journal articles, and conference papers. He is a member of various professional societies and a chair and member of the International Advisory Committees and Organizing Committees of various international conferences. Prof. Sarfraz is also an editor-in-chief and editor of various international journals.",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"32650",title:"Prof.",name:"Lukas",middleName:"Willem",surname:"Snyman",slug:"lukas-snyman",fullName:"Lukas Snyman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/32650/images/4136_n.jpg",biography:"Lukas Willem Snyman received his basic education at primary and high schools in South Africa, Eastern Cape. He enrolled at today's Nelson Metropolitan University and graduated from this university with a BSc in Physics and Mathematics, B.Sc Honors in Physics, MSc in Semiconductor Physics, and a Ph.D. in Semiconductor Physics in 1987. After his studies, he chose an academic career and devoted his energy to the teaching of physics to first, second, and third-year students. After positions as a lecturer at the University of Port Elizabeth, he accepted a position as Associate Professor at the University of Pretoria, South Africa.\r\n\r\nIn 1992, he motivates the concept of 'television and computer-based education” as means to reach large student numbers with only the best of teaching expertise and publishes an article on the concept in the SA Journal of Higher Education of 1993 (and later in 2003). The University of Pretoria subsequently approved a series of test projects on the concept with outreach to Mamelodi and Eerste Rust in 1993. In 1994, the University established a 'Unit for Telematic Education ' as a support section for multiple faculties at the University of Pretoria. In subsequent years, the concept of 'telematic education” subsequently becomes well established in academic circles in South Africa, grew in popularity, and is adopted by many universities and colleges throughout South Africa as a medium of enhancing education and training, as a method to reaching out to far out communities, and as a means to enhance study from the home environment.\r\n\r\nProfessor Snyman in subsequent years pursued research in semiconductor physics, semiconductor devices, microelectronics, and optoelectronics.\r\n\r\nIn 2000 he joined the TUT as a full professor. Here served for a period as head of the Department of Electronic Engineering. Here he makes contributions to solar energy development, microwave and optoelectronic device development, silicon photonics, as well as contributions to new mobile telecommunication systems and network planning in SA.\r\n\r\nCurrently, he teaches electronics and telecommunications at the TUT to audiences ranging from first-year students to Ph.D. level.\r\n\r\nFor his research in the field of 'Silicon Photonics” since 1990, he has published (as author and co-author) about thirty internationally reviewed articles in scientific journals, contributed to more than forty international conferences, about 25 South African provisional patents (as inventor and co-inventor), 8 PCT international patent applications until now. Of these, two USA patents applications, two European Patents, two Korean patents, and ten SA patents have been granted. A further 4 USA patents, 5 European patents, 3 Korean patents, 3 Chinese patents, and 3 Japanese patents are currently under consideration.\r\n\r\nRecently he has also published an extensive scholarly chapter in an internet open access book on 'Integrating Microphotonic Systems and MOEMS into standard Silicon CMOS Integrated circuitry”.\r\n\r\nFurthermore, Professor Snyman recently steered a new initiative at the TUT by introducing a 'Laboratory for Innovative Electronic Systems ' at the Department of Electrical Engineering. The model of this laboratory or center is to primarily combine outputs as achieved by high-level research with lower-level system development and entrepreneurship in a technical university environment. Students are allocated to projects at different levels with PhDs and Master students allocated to the generation of new knowledge and new technologies, while students at the diploma and Baccalaureus level are allocated to electronic systems development with a direct and a near application for application in industry or the commercial and public sectors in South Africa.\r\n\r\nProfessor Snyman received the WIRSAM Award of 1983 and the WIRSAM Award in 1985 in South Africa for best research papers by a young scientist at two international conferences on electron microscopy in South Africa. He subsequently received the SA Microelectronics Award for the best dissertation emanating from studies executed at a South African university in the field of Physics and Microelectronics in South Africa in 1987. In October of 2011, Professor Snyman received the prestigious Institutional Award for 'Innovator of the Year” for 2010 at the Tshwane University of Technology, South Africa. This award was based on the number of patents recognized and granted by local and international institutions as well as for his contributions concerning innovation at the TUT.",institutionString:null,institution:{name:"University of South Africa",country:{name:"South Africa"}}},{id:"317279",title:"Mr.",name:"Ali",middleName:"Usama",surname:"Syed",slug:"ali-syed",fullName:"Ali Syed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/317279/images/16024_n.png",biography:"A creative, talented, and innovative young professional who is dedicated, well organized, and capable research fellow with two years of experience in graduate-level research, published in engineering journals and book, with related expertise in Bio-robotics, equally passionate about the aesthetics of the mechanical and electronic system, obtained expertise in the use of MS Office, MATLAB, SolidWorks, LabVIEW, Proteus, Fusion 360, having a grasp on python, C++ and assembly language, possess proven ability in acquiring research grants, previous appointments with social and educational societies with experience in administration, current affiliations with IEEE and Web of Science, a confident presenter at conferences and teacher in classrooms, able to explain complex information to audiences of all levels.",institutionString:null,institution:{name:"Air University",country:{name:"Pakistan"}}},{id:"75526",title:"Ph.D.",name:"Zihni Onur",middleName:null,surname:"Uygun",slug:"zihni-onur-uygun",fullName:"Zihni Onur Uygun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/75526/images/12_n.jpg",biography:"My undergraduate education and my Master of Science educations at Ege University and at Çanakkale Onsekiz Mart University have given me a firm foundation in Biochemistry, Analytical Chemistry, Biosensors, Bioelectronics, Physical Chemistry and Medicine. After obtaining my degree as a MSc in analytical chemistry, I started working as a research assistant in Ege University Medical Faculty in 2014. In parallel, I enrolled to the MSc program at the Department of Medical Biochemistry at Ege University to gain deeper knowledge on medical and biochemical sciences as well as clinical chemistry in 2014. In my PhD I deeply researched on biosensors and bioelectronics and finished in 2020. Now I have eleven SCI-Expanded Index published papers, 6 international book chapters, referee assignments for different SCIE journals, one international patent pending, several international awards, projects and bursaries. In parallel to my research assistant position at Ege University Medical Faculty, Department of Medical Biochemistry, in April 2016, I also founded a Start-Up Company (Denosens Biotechnology LTD) by the support of The Scientific and Technological Research Council of Turkey. Currently, I am also working as a CEO in Denosens Biotechnology. The main purposes of the company, which carries out R&D as a research center, are to develop new generation biosensors and sensors for both point-of-care diagnostics; such as glucose, lactate, cholesterol and cancer biomarker detections. My specific experimental and instrumental skills are Biochemistry, Biosensor, Analytical Chemistry, Electrochemistry, Mobile phone based point-of-care diagnostic device, POCTs and Patient interface designs, HPLC, Tandem Mass Spectrometry, Spectrophotometry, ELISA.",institutionString:null,institution:{name:"Ege University",country:{name:"Turkey"}}},{id:"267434",title:"Dr.",name:"Rohit",middleName:null,surname:"Raja",slug:"rohit-raja",fullName:"Rohit Raja",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/267434/images/system/267434.jpg",biography:"Dr. Rohit Raja received Ph.D. in Computer Science and Engineering from Dr. CVRAMAN University in 2016. His main research interest includes Face recognition and Identification, Digital Image Processing, Signal Processing, and Networking. Presently he is working as Associate Professor in IT Department, Guru Ghasidas Vishwavidyalaya (A Central University), Bilaspur (CG), India. He has authored several Journal and Conference Papers. He has good Academics & Research experience in various areas of CSE and IT. He has filed and successfully published 27 Patents. He has received many time invitations to be a Guest at IEEE Conferences. He has published 100 research papers in various International/National Journals (including IEEE, Springer, etc.) and Proceedings of the reputed International/ National Conferences (including Springer and IEEE). He has been nominated to the board of editors/reviewers of many peer-reviewed and refereed Journals (including IEEE, Springer).",institutionString:"Guru Ghasidas Vishwavidyalaya",institution:{name:"Guru Ghasidas Vishwavidyalaya",country:{name:"India"}}},{id:"246502",title:"Dr.",name:"Jaya T.",middleName:"T",surname:"Varkey",slug:"jaya-t.-varkey",fullName:"Jaya T. Varkey",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/246502/images/11160_n.jpg",biography:"Jaya T. Varkey, PhD, graduated with a degree in Chemistry from Cochin University of Science and Technology, Kerala, India. She obtained a PhD in Chemistry from the School of Chemical Sciences, Mahatma Gandhi University, Kerala, India, and completed a post-doctoral fellowship at the University of Minnesota, USA. She is a research guide at Mahatma Gandhi University and Associate Professor in Chemistry, St. Teresa’s College, Kochi, Kerala, India.\nDr. Varkey received a National Young Scientist award from the Indian Science Congress (1995), a UGC Research award (2016–2018), an Indian National Science Academy (INSA) Visiting Scientist award (2018–2019), and a Best Innovative Faculty award from the All India Association for Christian Higher Education (AIACHE) (2019). She Hashas received the Sr. Mary Cecil prize for best research paper three times. She was also awarded a start-up to develop a tea bag water filter. \nDr. Varkey has published two international books and twenty-seven international journal publications. She is an editorial board member for five international journals.",institutionString:"St. Teresa’s College",institution:null},{id:"250668",title:"Dr.",name:"Ali",middleName:null,surname:"Nabipour Chakoli",slug:"ali-nabipour-chakoli",fullName:"Ali Nabipour Chakoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/250668/images/system/250668.jpg",biography:"Academic Qualification:\r\n•\tPhD in Materials Physics and Chemistry, From: Sep. 2006, to: Sep. 2010, School of Materials Science and Engineering, Harbin Institute of Technology, Thesis: Structure and Shape Memory Effect of Functionalized MWCNTs/poly (L-lactide-co-ε-caprolactone) Nanocomposites. Supervisor: Prof. Wei Cai,\r\n•\tM.Sc in Applied Physics, From: 1996, to: 1998, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Determination of Boron in Micro alloy Steels with solid state nuclear track detectors by neutron induced auto radiography, Supervisors: Dr. M. Hosseini Ashrafi and Dr. A. Hosseini.\r\n•\tB.Sc. in Applied Physics, From: 1991, to: 1996, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Design of shielding for Am-Be neutron sources for In Vivo neutron activation analysis, Supervisor: Dr. M. Hosseini Ashrafi.\r\n\r\nResearch Experiences:\r\n1.\tNanomaterials, Carbon Nanotubes, Graphene: Synthesis, Functionalization and Characterization,\r\n2.\tMWCNTs/Polymer Composites: Fabrication and Characterization, \r\n3.\tShape Memory Polymers, Biodegradable Polymers, ORC, Collagen,\r\n4.\tMaterials Analysis and Characterizations: TEM, SEM, XPS, FT-IR, Raman, DSC, DMA, TGA, XRD, GPC, Fluoroscopy, \r\n5.\tInteraction of Radiation with Mater, Nuclear Safety and Security, NDT(RT),\r\n6.\tRadiation Detectors, Calibration (SSDL),\r\n7.\tCompleted IAEA e-learning Courses:\r\nNuclear Security (15 Modules),\r\nNuclear Safety:\r\nTSA 2: Regulatory Protection in Occupational Exposure,\r\nTips & Tricks: Radiation Protection in Radiography,\r\nSafety and Quality in Radiotherapy,\r\nCourse on Sealed Radioactive Sources,\r\nCourse on Fundamentals of Environmental Remediation,\r\nCourse on Planning for Environmental Remediation,\r\nKnowledge Management Orientation Course,\r\nFood Irradiation - Technology, Applications and Good Practices,\r\nEmployment:\r\nFrom 2010 to now: Academic staff, Nuclear Science and Technology Research Institute, Kargar Shomali, Tehran, Iran, P.O. Box: 14395-836.\r\nFrom 1997 to 2006: Expert of Materials Analysis and Characterization. Research Center of Agriculture and Medicine. Rajaeeshahr, Karaj, Iran, P. O. Box: 31585-498.",institutionString:"Atomic Energy Organization of Iran",institution:{name:"Atomic Energy Organization of Iran",country:{name:"Iran"}}},{id:"248279",title:"Dr.",name:"Monika",middleName:"Elzbieta",surname:"Machoy",slug:"monika-machoy",fullName:"Monika Machoy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248279/images/system/248279.jpeg",biography:"Monika Elżbieta Machoy, MD, graduated with distinction from the Faculty of Medicine and Dentistry at the Pomeranian Medical University in 2009, defended her PhD thesis with summa cum laude in 2016 and is currently employed as a researcher at the Department of Orthodontics of the Pomeranian Medical University. She expanded her professional knowledge during a one-year scholarship program at the Ernst Moritz Arndt University in Greifswald, Germany and during a three-year internship at the Technical University in Dresden, Germany. She has been a speaker at numerous orthodontic conferences, among others, American Association of Orthodontics, European Orthodontic Symposium and numerous conferences of the Polish Orthodontic Society. She conducts research focusing on the effect of orthodontic treatment on dental and periodontal tissues and the causes of pain in orthodontic patients.",institutionString:"Pomeranian Medical University",institution:{name:"Pomeranian Medical University",country:{name:"Poland"}}},{id:"252743",title:"Prof.",name:"Aswini",middleName:"Kumar",surname:"Kar",slug:"aswini-kar",fullName:"Aswini Kar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252743/images/10381_n.jpg",biography:"uploaded in cv",institutionString:null,institution:{name:"KIIT University",country:{name:"India"}}},{id:"204256",title:"Dr.",name:"Anil",middleName:"Kumar",surname:"Kumar Sahu",slug:"anil-kumar-sahu",fullName:"Anil Kumar Sahu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204256/images/14201_n.jpg",biography:"I have nearly 11 years of research and teaching experience. I have done my master degree from University Institute of Pharmacy, Pt. Ravi Shankar Shukla University, Raipur, Chhattisgarh India. I have published 16 review and research articles in international and national journals and published 4 chapters in IntechOpen, the world’s leading publisher of Open access books. I have presented many papers at national and international conferences. I have received research award from Indian Drug Manufacturers Association in year 2015. My research interest extends from novel lymphatic drug delivery systems, oral delivery system for herbal bioactive to formulation optimization.",institutionString:null,institution:{name:"Chhattisgarh Swami Vivekanand Technical University",country:{name:"India"}}},{id:"253468",title:"Dr.",name:"Mariusz",middleName:null,surname:"Marzec",slug:"mariusz-marzec",fullName:"Mariusz Marzec",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/253468/images/system/253468.png",biography:"An assistant professor at Department of Biomedical Computer Systems, at Institute of Computer Science, Silesian University in Katowice. Scientific interests: computer analysis and processing of images, biomedical images, databases and programming languages. He is an author and co-author of scientific publications covering analysis and processing of biomedical images and development of database systems.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"212432",title:"Prof.",name:"Hadi",middleName:null,surname:"Mohammadi",slug:"hadi-mohammadi",fullName:"Hadi Mohammadi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/212432/images/system/212432.jpeg",biography:"Dr. Hadi Mohammadi is a biomedical engineer with hands-on experience in the design and development of many engineering structures and medical devices through various projects that he has been involved in over the past twenty years. Dr. Mohammadi received his BSc. and MSc. degrees in Mechanical Engineering from Sharif University of Technology, Tehran, Iran, and his PhD. degree in Biomedical Engineering (biomaterials) from the University of Western Ontario. He was a postdoctoral trainee for almost four years at University of Calgary and Harvard Medical School. He is an industry innovator having created the technology to produce lifelike synthetic platforms that can be used for the simulation of almost all cardiovascular reconstructive surgeries. He’s been heavily involved in the design and development of cardiovascular devices and technology for the past 10 years. He is currently an Assistant Professor with the University of British Colombia, Canada.",institutionString:"University of British Columbia",institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"254463",title:"Prof.",name:"Haisheng",middleName:null,surname:"Yang",slug:"haisheng-yang",fullName:"Haisheng Yang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/254463/images/system/254463.jpeg",biography:"Haisheng Yang, Ph.D., Professor and Director of the Department of Biomedical Engineering, College of Life Science and Bioengineering, Beijing University of Technology. He received his Ph.D. degree in Mechanics/Biomechanics from Harbin Institute of Technology (jointly with University of California, Berkeley). Afterwards, he worked as a Postdoctoral Research Associate in the Purdue Musculoskeletal Biology and Mechanics Lab at the Department of Basic Medical Sciences, Purdue University, USA. He also conducted research in the Research Centre of Shriners Hospitals for Children-Canada at McGill University, Canada. Dr. Yang has over 10 years research experience in orthopaedic biomechanics and mechanobiology of bone adaptation and regeneration. He earned an award from Beijing Overseas Talents Aggregation program in 2017 and serves as Beijing Distinguished Professor.",institutionString:null,institution:{name:"Beijing University of Technology",country:{name:"China"}}},{id:"89721",title:"Dr.",name:"Mehmet",middleName:"Cuneyt",surname:"Ozmen",slug:"mehmet-ozmen",fullName:"Mehmet Ozmen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/89721/images/7289_n.jpg",biography:null,institutionString:null,institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"265335",title:"Mr.",name:"Stefan",middleName:"Radnev",surname:"Stefanov",slug:"stefan-stefanov",fullName:"Stefan Stefanov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/265335/images/7562_n.jpg",biography:null,institutionString:null,institution:{name:"Medical University Plovdiv",country:{name:"Bulgaria"}}},{id:"242893",title:"Ph.D. Student",name:"Joaquim",middleName:null,surname:"De Moura",slug:"joaquim-de-moura",fullName:"Joaquim De Moura",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/242893/images/7133_n.jpg",biography:"Joaquim de Moura received his degree in Computer Engineering in 2014 from the University of A Coruña (Spain). In 2016, he received his M.Sc degree in Computer Engineering from the same university. He is currently pursuing his Ph.D degree in Computer Science in a collaborative project between ophthalmology centers in Galicia and the University of A Coruña. His research interests include computer vision, machine learning algorithms and analysis and medical imaging processing of various kinds.",institutionString:null,institution:{name:"University of A Coruña",country:{name:"Spain"}}},{id:"294334",title:"B.Sc.",name:"Marc",middleName:null,surname:"Bruggeman",slug:"marc-bruggeman",fullName:"Marc Bruggeman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/294334/images/8242_n.jpg",biography:"Chemical engineer graduate, with a passion for material science and specific interest in polymers - their near infinite applications intrigue me. \n\nI plan to continue my scientific career in the field of polymeric biomaterials as I am fascinated by intelligent, bioactive and biomimetic materials for use in both consumer and medical applications.",institutionString:null,institution:null},{id:"255757",title:"Dr.",name:"Igor",middleName:"Victorovich",surname:"Lakhno",slug:"igor-lakhno",fullName:"Igor Lakhno",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255757/images/system/255757.jpg",biography:"Igor Victorovich Lakhno was born in 1971 in Kharkiv (Ukraine). \nMD – 1994, Kharkiv National Medical Univesity.\nOb&Gyn; – 1997, master courses in Kharkiv Medical Academy of Postgraduate Education.\nPh.D. – 1999, Kharkiv National Medical Univesity.\nDSC – 2019, PL Shupik National Academy of Postgraduate Education \nProfessor – 2021, Department of Obstetrics and Gynecology of VN Karazin Kharkiv National University\nHead of Department – 2021, Department of Perinatology, Obstetrics and gynecology of Kharkiv Medical Academy of Postgraduate Education\nIgor Lakhno has been graduated from international training courses on reproductive medicine and family planning held at Debrecen University (Hungary) in 1997. Since 1998 Lakhno Igor has worked as an associate professor in the department of obstetrics and gynecology of VN Karazin National University and an associate professor of the perinatology, obstetrics, and gynecology department of Kharkiv Medical Academy of Postgraduate Education. Since June 2019 he’s been a professor in the department of obstetrics and gynecology of VN Karazin National University and a professor of the perinatology, obstetrics, and gynecology department. He’s affiliated with Kharkiv Medical Academy of Postgraduate Education as a Head of Department from November 2021. Igor Lakhno has participated in several international projects on fetal non-invasive electrocardiography (with Dr. J. A. Behar (Technion), Prof. D. Hoyer (Jena University), and José Alejandro Díaz Méndez (National Institute of Astrophysics, Optics, and Electronics, Mexico). He’s an author of about 200 printed works and there are 31 of them in Scopus or Web of Science databases. Igor Lakhno is a member of the Editorial Board of Reproductive Health of Woman, Emergency Medicine, and Technology Transfer Innovative Solutions in Medicine (Estonia). He is a medical Editor of “Z turbotoyu pro zhinku”. Igor Lakhno is a reviewer of the Journal of Obstetrics and Gynaecology (Taylor and Francis), British Journal of Obstetrics and Gynecology (Wiley), Informatics in Medicine Unlocked (Elsevier), The Journal of Obstetrics and Gynecology Research (Wiley), Endocrine, Metabolic & Immune Disorders-Drug Targets (Bentham Open), The Open Biomedical Engineering Journal (Bentham Open), etc. He’s defended a dissertation for a DSc degree “Pre-eclampsia: prediction, prevention, and treatment”. Three years ago Igor Lakhno has participated in a training course on innovative technologies in medical education at Lublin Medical University (Poland). Lakhno Igor has participated as a speaker in several international conferences and congresses (International Conference on Biological Oscillations April 10th-14th 2016, Lancaster, UK, The 9th conference of the European Study Group on Cardiovascular Oscillations). His main scientific interests: are obstetrics, women’s health, fetal medicine, and cardiovascular medicine. \nIgor Lakhno is a consultant at Kharkiv municipal perinatal center. He’s graduated from training courses on endoscopy in gynecology. He has 28 years of practical experience in the field.",institutionString:null,institution:null},{id:"244950",title:"Dr.",name:"Salvatore",middleName:null,surname:"Di Lauro",slug:"salvatore-di-lauro",fullName:"Salvatore Di Lauro",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0030O00002bSF1HQAW/ProfilePicture%202021-12-20%2014%3A54%3A14.482",biography:"Name:\n\tSALVATORE DI LAURO\nAddress:\n\tHospital Clínico Universitario Valladolid\nAvda Ramón y Cajal 3\n47005, Valladolid\nSpain\nPhone number: \nFax\nE-mail:\n\t+34 983420000 ext 292\n+34 983420084\nsadilauro@live.it\nDate and place of Birth:\nID Number\nMedical Licence \nLanguages\t09-05-1985. Villaricca (Italy)\n\nY1281863H\n474707061\nItalian (native language)\nSpanish (read, written, spoken)\nEnglish (read, written, spoken)\nPortuguese (read, spoken)\nFrench (read)\n\t\t\nCurrent position (title and company)\tDate (Year)\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. Private practise.\t2017-today\n\n2019-today\n\t\n\t\nEducation (High school, university and postgraduate training > 3 months)\tDate (Year)\nDegree in Medicine and Surgery. University of Neaples 'Federico II”\nResident in Opthalmology. Hospital Clinico Universitario Valladolid\nMaster in Vitreo-Retina. IOBA. University of Valladolid\nFellow of the European Board of Ophthalmology. Paris\nMaster in Research in Ophthalmology. University of Valladolid\t2003-2009\n2012-2016\n2016-2017\n2016\n2012-2013\n\t\nEmployments (company and positions)\tDate (Year)\nResident in Ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl.\nFellow in Vitreo-Retina. IOBA. University of Valladolid\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. \n\t2012-2016\n2016-2017\n2017-today\n\n2019-Today\n\n\n\t\nClinical Research Experience (tasks and role)\tDate (Year)\nAssociated investigator\n\n' FIS PI20/00740: DESARROLLO DE UNA CALCULADORA DE RIESGO DE\nAPARICION DE RETINOPATIA DIABETICA BASADA EN TECNICAS DE IMAGEN MULTIMODAL EN PACIENTES DIABETICOS TIPO 1. Grant by: Ministerio de Ciencia e Innovacion \n\n' (BIO/VA23/14) Estudio clínico multicéntrico y prospectivo para validar dos\nbiomarcadores ubicados en los genes p53 y MDM2 en la predicción de los resultados funcionales de la cirugía del desprendimiento de retina regmatógeno. Grant by: Gerencia Regional de Salud de la Junta de Castilla y León.\n' Estudio multicéntrico, aleatorizado, con enmascaramiento doble, en 2 grupos\nparalelos y de 52 semanas de duración para comparar la eficacia, seguridad e inmunogenicidad de SOK583A1 respecto a Eylea® en pacientes con degeneración macular neovascular asociada a la edad' (CSOK583A12301; N.EUDRA: 2019-004838-41; FASE III). Grant by Hexal AG\n\n' Estudio de fase III, aleatorizado, doble ciego, con grupos paralelos, multicéntrico para comparar la eficacia y la seguridad de QL1205 frente a Lucentis® en pacientes con degeneración macular neovascular asociada a la edad. (EUDRACT: 2018-004486-13). Grant by Qilu Pharmaceutical Co\n\n' Estudio NEUTON: Ensayo clinico en fase IV para evaluar la eficacia de aflibercept en pacientes Naive con Edema MacUlar secundario a Oclusion de Vena CenTral de la Retina (OVCR) en regimen de tratamientO iNdividualizado Treat and Extend (TAE)”, (2014-000975-21). Grant by Fundacion Retinaplus\n\n' Evaluación de la seguridad y bioactividad de anillos de tensión capsular en conejo. Proyecto Procusens. Grant by AJL, S.A.\n\n'Estudio epidemiológico, prospectivo, multicéntrico y abierto\\npara valorar la frecuencia de la conjuntivitis adenovírica diagnosticada mediante el test AdenoPlus®\\nTest en pacientes enfermos de conjuntivitis aguda”\\n. National, multicenter study. Grant by: NICOX.\n\nEuropean multicentric trial: 'Evaluation of clinical outcomes following the use of Systane Hydration in patients with dry eye”. Study Phase 4. Grant by: Alcon Labs'\n\nVLPs Injection and Activation in a Rabbit Model of Uveal Melanoma. Grant by Aura Bioscience\n\nUpdating and characterization of a rabbit model of uveal melanoma. Grant by Aura Bioscience\n\nEnsayo clínico en fase IV para evaluar las variantes genéticas de la vía del VEGF como biomarcadores de eficacia del tratamiento con aflibercept en pacientes con degeneración macular asociada a la edad (DMAE) neovascular. Estudio BIOIMAGE. IMO-AFLI-2013-01\n\nEstudio In-Eye:Ensayo clínico en fase IV, abierto, aleatorizado, de 2 brazos,\nmulticçentrico y de 12 meses de duración, para evaluar la eficacia y seguridad de un régimen de PRN flexible individualizado de 'esperar y extender' versus un régimen PRN según criterios de estabilización mediante evaluaciones mensuales de inyecciones intravítreas de ranibizumab 0,5 mg en pacientes naive con neovascularización coriodea secunaria a la degeneración macular relacionada con la edad. CP: CRFB002AES03T\n\nTREND: Estudio Fase IIIb multicéntrico, randomizado, de 12 meses de\nseguimiento con evaluador de la agudeza visual enmascarado, para evaluar la eficacia y la seguridad de ranibizumab 0.5mg en un régimen de tratar y extender comparado con un régimen mensual, en pacientes con degeneración macular neovascular asociada a la edad. CP: CRFB002A2411 Código Eudra CT:\n2013-002626-23\n\n\n\nPublications\t\n\n2021\n\n\n\n\n2015\n\n\n\n\n2021\n\n\n\n\n\n2021\n\n\n\n\n2015\n\n\n\n\n2015\n\n\n2014\n\n\n\n\n2015-16\n\n\n\n2015\n\n\n2014\n\n\n2014\n\n\n\n\n2014\n\n\n\n\n\n\n\n2014\n\nJose Carlos Pastor; Jimena Rojas; Salvador Pastor-Idoate; Salvatore Di Lauro; Lucia Gonzalez-Buendia; Santiago Delgado-Tirado. Proliferative vitreoretinopathy: A new concept of disease pathogenesis and practical\nconsequences. Progress in Retinal and Eye Research. 51, pp. 125 - 155. 03/2016. DOI: 10.1016/j.preteyeres.2015.07.005\n\n\nLabrador-Velandia S; Alonso-Alonso ML; Di Lauro S; García-Gutierrez MT; Srivastava GK; Pastor JC; Fernandez-Bueno I. Mesenchymal stem cells provide paracrine neuroprotective resources that delay degeneration of co-cultured organotypic neuroretinal cultures.Experimental Eye Research. 185, 17/05/2019. DOI: 10.1016/j.exer.2019.05.011\n\nSalvatore Di Lauro; Maria Teresa Garcia Gutierrez; Ivan Fernandez Bueno. Quantification of pigment epithelium-derived factor (PEDF) in an ex vivo coculture of retinal pigment epithelium cells and neuroretina.\nJournal of Allbiosolution. 2019. ISSN 2605-3535\n\nSonia Labrador Velandia; Salvatore Di Lauro; Alonso-Alonso ML; Tabera Bartolomé S; Srivastava GK; Pastor JC; Fernandez-Bueno I. Biocompatibility of intravitreal injection of human mesenchymal stem cells in immunocompetent rabbits. Graefe's archive for clinical and experimental ophthalmology. 256 - 1, pp. 125 - 134. 01/2018. DOI: 10.1007/s00417-017-3842-3\n\n\nSalvatore Di Lauro, David Rodriguez-Crespo, Manuel J Gayoso, Maria T Garcia-Gutierrez, J Carlos Pastor, Girish K Srivastava, Ivan Fernandez-Bueno. A novel coculture model of porcine central neuroretina explants and retinal pigment epithelium cells. Molecular Vision. 2016 - 22, pp. 243 - 253. 01/2016.\n\nSalvatore Di Lauro. Classifications for Proliferative Vitreoretinopathy ({PVR}): An Analysis of Their Use in Publications over the Last 15 Years. Journal of Ophthalmology. 2016, pp. 1 - 6. 01/2016. DOI: 10.1155/2016/7807596\n\nSalvatore Di Lauro; Rosa Maria Coco; Rosa Maria Sanabria; Enrique Rodriguez de la Rua; Jose Carlos Pastor. Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study. Journal of Ophthalmology. 2015:821864, 2015. DOI: 10.1155/2015/821864\n\nIvan Fernandez-Bueno; Salvatore Di Lauro; Ivan Alvarez; Jose Carlos Lopez; Maria Teresa Garcia-Gutierrez; Itziar Fernandez; Eva Larra; Jose Carlos Pastor. Safety and Biocompatibility of a New High-Density Polyethylene-Based\nSpherical Integrated Porous Orbital Implant: An Experimental Study in Rabbits. Journal of Ophthalmology. 2015:904096, 2015. DOI: 10.1155/2015/904096\n\nPastor JC; Pastor-Idoate S; Rodríguez-Hernandez I; Rojas J; Fernandez I; Gonzalez-Buendia L; Di Lauro S; Gonzalez-Sarmiento R. Genetics of PVR and RD. Ophthalmologica. 232 - Suppl 1, pp. 28 - 29. 2014\n\nRodriguez-Crespo D; Di Lauro S; Singh AK; Garcia-Gutierrez MT; Garrosa M; Pastor JC; Fernandez-Bueno I; Srivastava GK. Triple-layered mixed co-culture model of RPE cells with neuroretina for evaluating the neuroprotective effects of adipose-MSCs. Cell Tissue Res. 358 - 3, pp. 705 - 716. 2014.\nDOI: 10.1007/s00441-014-1987-5\n\nCarlo De Werra; Salvatore Condurro; Salvatore Tramontano; Mario Perone; Ivana Donzelli; Salvatore Di Lauro; Massimo Di Giuseppe; Rosa Di Micco; Annalisa Pascariello; Antonio Pastore; Giorgio Diamantis; Giuseppe Galloro. Hydatid disease of the liver: thirty years of surgical experience.Chirurgia italiana. 59 - 5, pp. 611 - 636.\n(Italia): 2007. ISSN 0009-4773\n\nChapters in books\n\t\n' Salvador Pastor Idoate; Salvatore Di Lauro; Jose Carlos Pastor Jimeno. PVR: Pathogenesis, Histopathology and Classification. Proliferative Vitreoretinopathy with Small Gauge Vitrectomy. Springer, 2018. ISBN 978-3-319-78445-8\nDOI: 10.1007/978-3-319-78446-5_2. \n\n' Salvatore Di Lauro; Maria Isabel Lopez Galvez. Quistes vítreos en una mujer joven. Problemas diagnósticos en patología retinocoroidea. Sociedad Española de Retina-Vitreo. 2018.\n\n' Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor Jimeno. iOCT in PVR management. OCT Applications in Opthalmology. pp. 1 - 8. INTECH, 2018. DOI: 10.5772/intechopen.78774.\n\n' Rosa Coco Martin; Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor. amponadores, manipuladores y tinciones en la cirugía del traumatismo ocular.Trauma Ocular. Ponencia de la SEO 2018..\n\n' LOPEZ GALVEZ; DI LAURO; CRESPO. OCT angiografia y complicaciones retinianas de la diabetes. PONENCIA SEO 2021, CAPITULO 20. (España): 2021.\n\n' Múltiples desprendimientos neurosensoriales bilaterales en paciente joven. Enfermedades Degenerativas De Retina Y Coroides. SERV 04/2016. \n' González-Buendía L; Di Lauro S; Pastor-Idoate S; Pastor Jimeno JC. Vitreorretinopatía proliferante (VRP) e inflamación: LA INFLAMACIÓN in «INMUNOMODULADORES Y ANTIINFLAMATORIOS: MÁS ALLÁ DE LOS CORTICOIDES. 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Gharieb",profilePictureURL:"https://mts.intechopen.com/storage/users/225387/images/system/225387.jpg",institutionString:"Assiut University",institution:{name:"Assiut University",institutionURL:null,country:{name:"Egypt"}}}]},{id:"8",title:"Bioinspired Technology and Biomechanics",keywords:"Bioinspired Systems, Biomechanics, Assistive Technology, Rehabilitation",scope:'Bioinspired technologies take advantage of understanding the actual biological system to provide solutions to problems in several areas. Recently, bioinspired systems have been successfully employing biomechanics to develop and improve assistive technology and rehabilitation devices. The research topic "Bioinspired Technology and Biomechanics" welcomes studies reporting recent advances in bioinspired technologies that contribute to individuals\' health, inclusion, and rehabilitation. Possible contributions can address (but are not limited to) the following research topics: Bioinspired design and control of exoskeletons, orthoses, and prostheses; Experimental evaluation of the effect of assistive devices (e.g., influence on gait, balance, and neuromuscular system); Bioinspired technologies for rehabilitation, including clinical studies reporting evaluations; Application of neuromuscular and biomechanical models to the development of bioinspired technology.',annualVolume:11404,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",institutionString:null,institution:{name:"Federal University of Uberlândia",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"49517",title:"Prof.",name:"Hitoshi",middleName:null,surname:"Tsunashima",fullName:"Hitoshi Tsunashima",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTP4QAO/Profile_Picture_1625819726528",institutionString:null,institution:{name:"Nihon University",institutionURL:null,country:{name:"Japan"}}},{id:"425354",title:"Dr.",name:"Marcus",middleName:"Fraga",surname:"Vieira",fullName:"Marcus Vieira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003BJSgIQAX/Profile_Picture_1627904687309",institutionString:null,institution:{name:"Universidade Federal de Goiás",institutionURL:null,country:{name:"Brazil"}}},{id:"196746",title:"Dr.",name:"Ramana",middleName:null,surname:"Vinjamuri",fullName:"Ramana Vinjamuri",profilePictureURL:"https://mts.intechopen.com/storage/users/196746/images/system/196746.jpeg",institutionString:"University of Maryland, Baltimore County",institution:{name:"University of Maryland, Baltimore County",institutionURL:null,country:{name:"United States of America"}}}]},{id:"9",title:"Biotechnology - Biosensors, Biomaterials and Tissue Engineering",keywords:"Biotechnology, Biosensors, Biomaterials, Tissue Engineering",scope:"The Biotechnology - Biosensors, Biomaterials and Tissue Engineering topic within the Biomedical Engineering Series aims to rapidly publish contributions on all aspects of biotechnology, biosensors, biomaterial and tissue engineering. We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics can include but are not limited to: Biotechnology such as biotechnological products and process engineering; Biotechnologically relevant enzymes and proteins; Bioenergy and biofuels; Applied genetics and molecular biotechnology; Genomics, transcriptomics, proteomics; Applied microbial and cell physiology; Environmental biotechnology; Methods and protocols. Moreover, topics in biosensor technology, like sensors that incorporate enzymes, antibodies, nucleic acids, whole cells, tissues and organelles, and other biological or biologically inspired components will be considered, and topics exploring transducers, including those based on electrochemical and optical piezoelectric, thermal, magnetic, and micromechanical elements. Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. 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