Production of plant growth hormones and volatile compounds by
\r\n\t
",isbn:"978-1-83880-692-7",printIsbn:"978-1-83880-691-0",pdfIsbn:"978-1-83962-902-0",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,isSalesforceBook:!1,hash:"5cb54cc53caedad9ec78372563c82e2c",bookSignature:"Prof. Stefano de Luca, Dr. Roberta Di Pace and Dr. Chiara Fiori",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/10988.jpg",keywords:"Railway, Transport, Railway Planning, Railway Management, Railway Operation, Railway Level, Traffic Analysis, Dispatching, Train Control, Passenger Demand, Costumer Satisfaction, Capacity Management",numberOfDownloads:420,numberOfWosCitations:0,numberOfCrossrefCitations:0,numberOfDimensionsCitations:0,numberOfTotalCitations:0,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"March 16th 2021",dateEndSecondStepPublish:"April 13th 2021",dateEndThirdStepPublish:"June 12th 2021",dateEndFourthStepPublish:"August 31st 2021",dateEndFifthStepPublish:"October 30th 2021",remainingDaysToSecondStep:"a year",secondStepPassed:!0,currentStepOfPublishingProcess:5,editedByType:null,kuFlag:!1,biosketch:"Stefano de Luca acts as director of the “Transportation Systems Analysis” laboratory, delegate for Transport and Mobility, and for the Technological Transfer. He is a consultant for the Italian Ministry of Transportation, the Transport commission of Campania Region, and Salerno and Avellino Transportation Departments. Also, he is a member of the IEEE Intelligent Transportation Systems Society, the Italian Society of Transport Academicians, and the Italian Society of Transport Policy.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"271061",title:"Prof.",name:"Stefano",middleName:null,surname:"de Luca",slug:"stefano-de-luca",fullName:"Stefano de Luca",profilePictureURL:"https://mts.intechopen.com/storage/users/271061/images/system/271061.jpeg",biography:"Stefano de Luca is a full professor of Transportation Planning and Transportation Systems Theory, University of Salerno, Italy. Currently he is director of the Transportation Systems Analysis laboratory, and rector’s delegate to Transport and Mobility, University of Salerno. His research focus includes transportation planning techniques, choice modelling, signal settings design, traffic assignment models and algorithms, freight/passenger terminal simulation, and optimization. He serves on the Editorial Advisory Board for Transportation Research Part F, the Journal of Advanced Transportation and Sustainability. He has authored more than 100 book chapters and journal articles. He is also a consultant for the Italian Ministry of Transportation, the Transport Commission of the Campania Region, and the Salerno and Avellino Transportation Departments. 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She is an aggregate professor of Technique and Transport Economics and Transportation Systems Design. Since 2010, she has been a member of the Transportation Planning and Modelling Laboratory. Her main research fields include the development of analytical tools for advanced traveller information systems, traffic flow modelling, network signal setting design, and advanced traffic management systems. 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Her research interests include testing, modelling, and simulation of electrified vehicles’ powertrains (for personal, public, and freight mobility) and their impact assessment on eco-routing and the electric power grid; integration of microscopic traffic flow and energy consumption models, and effects on traffic control systems; well-to-wheels analysis; modeling, simulation, and impact assessment of port operations in urban contexts; and Multi-Vehicle Dynamic Traffic Assignment.",institutionString:"University of Salerno",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"University of Salerno",institutionURL:null,country:{name:"Italy"}}},coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"11",title:"Engineering",slug:"engineering"}],chapters:[{id:"81390",title:"From Nobel Prizes to Safety Risk Management: How to Identify Latent Failure Conditions in Risk Management 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The optimal management of such patients requires the following:
Diagnosis of the underlying liver disease
Assessment and stratification of the risk of surgery
Estimation of functional hepatic reserve
Correction of underlying conditions if feasible
Hepatic hemodynamic evaluation and identification of the site of upper gastrointestinal hemorrhage, if present
Impairment of the liver functions increases the risks of surgery and anesthesia in several ways, including the following [4-6]:
Bleeding risk may increase because of coagulopathy
Susceptibility to infection is increased due to altered functions of the hepatic reticuloendothelial cells and changes in the immune system and portal hypertension
Reduced hepatic blood flow
Altered drug metabolism
Hyperdynamic circulation with increased cardiac output and decreased systemic vascular resistance
Systemic and splanchnic vasodilation, with subsequent activation of the sympathetic nervous system and neurohormonal axis in an attempt to maintain arterial perfusion pressure
Alterations in the systemic circulation due to arteriovenous shunting and reduced splanchnic inflow
Anesthetic agents may reduce hepatic blood flow
The compensatory inotropic and chronotropic response to pharmacologic and physiologic stress, including surgery, is blunted
The duration of action of many drugs can be increased as a result of [10]
altered metabolism by cytochrome P450 enzymes,
decreased concentration of plasma-binding proteins,
decreased biliary excretion.
Hepatic dysfunction can significantly impair the metabolism of certain medications. Examples are as follows [10, 11]:
The volume of distribution of nondepolarizing muscle relaxants is increased, and larger doses may be required to achieve adequate neuromuscular block.
Sedatives, narcotics, and intravenous induction agents must be used with caution, as they may result in prolonged depression of consciousness and may lead to hepatic encephalopathy. The perioperative use of opioids as morphine should be avoided, as their bioavailability is increased.
Benzodiazepines should be avoided, and, if necessary, remifentanil and oxazepam are the preferred narcotic and sedative because their metabolism is not affected by liver disease.
Isoflurane is the recommended volatile anesthetic because it does not impair hepatic blood flow and undergoes the least amount of hepatic metabolism.
If liver dysfunction is suspected, elective surgery should be deferred until extensive evaluation is made. Evaluation will include the following items [12].
Thorough history and physical examination usually provide important informatation.
History of previous blood transfusions, drug abuse, or excessive alcohol intake.
Family history of jaundice, anemia, hereditary liver disease, and prior adverse reactions to anesthesia.
Medication history includes the use of analgesics and alternative medications.
Physical examination may identify signs of underlying liver disease, as temporal wasting, jaundice, palmar erythema, spider nevi, ascites, or hepatosplenomegaly.
The term “liver function tests” is a misnomer and can be misleading. Because of the complexity of liver functions, the ideal liver function test has not been invented yet. A successful liver function test, to assist with preoperative assessment of liver function, should be safe, reproducible, and easily performed.
The aims of the tests are as follows:
To determine the presence or absence of hepatic injury
To decide whether the injury is cell necrosis or cholestasis
To specify the particular disease
To determine its severity
Markers of hepatocellular injury include aminotransferases and lactate dehydrogenase
Markers of cholestasis include alkaline phosphatase, gamma glutamyl transpeptidase, 5′-nucleotidase, and bilirubin
Markers of synthetic functions of the liver are prothrombin time and albumin
Alanine aminotransferase (ALT) (normal range: 10-55 U/L)
Aspartate aminotransferase (AST) (normal range: 10-40 U/L)
Serum level rises as a result of leakage from damaged tissue
Mild to moderate elevations occur in many types of liver disease
Marked elevations occur in hepatitis (viral, toxic, autoimmune, and ischemic)
AST/ALT >2 suggests alcoholic liver disease or cirrhosis of any etiology
ALT is more specific than AST for hepatic injury
AST is nonspecific and can originate from skeletal muscle, red blood cell, kidney, pancreas, brain, and myocardium
Normal range 45-115 U/L
Serum level rises as a result of increased production and leaks into the serum
Moderate rises occur in many liver diseases
Marked rises occur in extra- and intrahepatic cholestasis, diffuse infiltrating disease (e.g., liver neoplasms), and rarely alcoholic cirrhosis
Considerable rises occur in bone diseases (e.g., tumor, fracture, Paget’s disease)
It also originates from the intestine, placenta, and some neoplasms
Normal range: 0-30 U/L
Serum level rises as a result of overproduction and leakage into serum, as for AP; induced by ethanol and drugs
GGTP/AP >2.5 suggests alcoholic liver disease
Kidney, spleen, pancreas, heart, lung, and brain are other sources
Normal range:: 0-11 U/L
Serum level rises as a result of overproduction and leakage into serum, as for AP
Found in many tissues, but serum elevation is relatively specific for liver disease
Normal range::0.0-1.0 mg/dL
Unconjugated hyperbilirubinemia
The mechanisms that result in elevation of serum unconjugated bilirubin levels include increased production (increased breakdown of hemoglobin (resulting from hemolysis, disordered erythropoiesis, and resorption of hematoma) or myoglobin (resulting from muscle injury)) and defects in hepatic uptake or conjugation.
Conjugated hyperbilirubinemia
The mechanisms that result in the elevation of serum-conjugated bilirubin levels are hepatobiliary diseases, including extrahepatic and intrahepatic bile duct obstruction, viral, alcoholic or drug-induced hepatitis, and inherited hyperbilirubinemia.
All clotting factors except factor VIII are synthesized by hepatocytes; factor VIII is produced by vascular endothelium and reticuloendothelial cells.
Serum values rise as a result of the following:
Decreased synthetic capacity as in acute or chronic liver failure (prolonged PT unresponsive to vitamin K)
Biliary obstruction (prolonged PT usually responsive to vitamin K administration)
Vitamin K deficiency (secondary to malabsorption, malnutrition, and antibiotics) and consumptive coagulopathy
Normal range: 3.5-5.0 g/dL
Serum level decreases as a result of decreased synthesis; or increased loss as in
chronic liver failure
nephrotic syndrome, protein-losing enteropathy, and vascular leak
Acute infection is confirmed by detection of IgM anti-hepatitis A antibody (IgM HAV), which appears early in the course of infection and has high sensitivity and specificity. IgG anti-HAV predominates in convalescence and persists throughout life.
Acute infection is associated with the presence of hepatitis B surface antigen (HBsAg).
Detection of HBsAg precedes serum aminotransferase elevations.
HBsAg becomes undetectable 1-3 months after jaundice.
Some time after HBsAg disappears; HBsAg antibody (anti-HBs) appears and persists for life.
In the interval between disappearance of HBsAg and appearance of anti-HBs, hepatitis core antigen antibody (anti-HBc) is present and helps as a marker for current or recent HBV infection.
Anti-HBc may remain for years after infection longer than anti-HBs.
IgM anti-HBc distinguishes recent from remote infection
Hepatitis C antibodies are detected relatively late in the course of the HCV infection.
False-positive test is a problem.
Reverse transcriptase polymerase chain reaction and branched amplification assays are the most sensitive and specific.
These tests offer attractive means to assess the liver functions. However, they have limitations, including expense, availability, invasiveness, and lack of validity.
This dye is taken up almost exclusively by hepatocytes and excreted unchanged into the bile. It is measured photometrically in blood samples taken at regular intervals after a bolus intravenous injection (0.5 mg/kg). Clearance of the dye decreases with loss of hepatocyte mass.
Radioactivity (14CO2) is measured in breath at 15-min intervals for 2 h after oral or intravenous administration of 14C-labeled methyl aminopyrine. It may predict death and histology in chronic hepatitis.
This lidocaine metabolite is measured in blood samples 15 min after intravenous administration of lidocaine (1 mg/kg). It may predict death and complications before and after liver transplantation
Ultrasound is useful for assessing liver size, spleen size, intra- and extrahepatic biliary tree, and the presence of liver masses. It can also detect ascites in its earliest stages (≥100 mL). Doppler ultrasonography is helpful in assessment of portal venous patency, direction of portal flow.
The risk of surgery in patients with impairment of liver functions depends on the severity of liver disease, nature of the surgery, and comorbid conditions. Patients with compensated cirrhosis and normal synthetic function have a low risk. The risk increases for patients with decompensated liver cirrhosis. Patients with advanced liver disease may benefit from nonsurgical therapy when appropriate.
Elective surgery should be postponed in patients with abnormal liver tests. All patients should have thorough preoperative evaluation, and their conditions are to be optimized before elective surgery. Elective surgery can be rescheduled or cancelled once the severity of underlying liver disease is assessed.
When surgery is mandatory, meticulous perioperative management is required, including hemodynamic stability, broad-spectrum antibiotics, correction of coagulopathy, improvement of nutritional status, avoidance of nephrotoxins and sedatives that could precipitate hepatic encephalopathy, and intensive care unit admission if needed.
Operative risks are markedly influenced by the severity and nature of the underlying liver disease.
The amount of perioperative risks is related to the degree of liver decompensation. An accurate assessment of the degree of liver decompensation is important for determination of the perioperative risk.
This is based on the patient’s serum bilirubin and albumin levels, prothrombin time, and severity of encephalopathy and ascites.
\n\t\t\t\t | \n\t\t|||
\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t
Ascites | \n\t\t\tNone | \n\t\t\tSmall or diuretic controlled | \n\t\t\tTense | \n\t\t
Encephalopathy | \n\t\t\tAbsent | \n\t\t\tStates I–II | \n\t\t\tStates III–IV | \n\t\t
Albumin (g/L) | \n\t\t\t>3.5 | \n\t\t\t2.8–3.5 | \n\t\t\t<2.8 | \n\t\t
Bilirubin (mg/dL) | \n\t\t\t<2 | \n\t\t\t2–3 | \n\t\t\t>3 | \n\t\t
PT(sec above control), or INR | \n\t\t\t<4 <1.7 | \n\t\t\t4–6 1.7–2.3 | \n\t\t\t>6 >2.3 | \n\t\t
In general, elective surgery is well tolerated in patients with Child class A, permitted with careful preoperative preparation in patients with Child class B, and contraindicated in patients with Child class C.
\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t
5–6 | \n\t\t\tA | \n\t\t
7–9 | \n\t\t\tB | \n\t\t
10–15 | \n\t\t\tC | \n\t\t
Other factors can also increase the perioperative risk beyond the Child classification. The perioperative risk is increased if there is portal hypertension. Emergency surgery is associated with a higher mortality rates.
Child score for estimating the perioperative risks has been shown to be quite variable. This may be explained by the following:
Patients with class A may have ascites, hyperbilirubinemia, and portal hypertension.
The variables (ascites and hepatic encephalopathy are graded subjectively) are operator dependent.
It is unable to stratify patients with severely decompensated liver disease.
For this reason, alternative systems have been sought
The MELD score is a linear regression model based on a patient’s serum bilirubin and creatinine levels and international normalized ratio (INR).
MELD score for TIPS = 0.957 × loge (creatinine [mg/dL]) + 0.378 × loge (bilirubin [mg/dL]) + 1.120 × loge (INR) + 0.643 (cause of liver disease)
MELD score for liver transplantation = 0.957 × loge(creatinine [mg/dL]) + 0.378 × loge(bilirubin [mg/dL]) + 1.120 × loge(INR) + 0.643
It was created to predict mortality after TIPS, then to stratify the risks in patients awaiting liver transplant, and recently used to predict perioperative mortality. It has several distinct advantages over the Child classification, being objective, and does not rely on cutoff values.
The general guidelines are as follows:
Patient with an MELD score below 10 can undergo elective surgery.
Patient with an MELD score of 10-15 should be managed with caution.
In patients with an MELD score above 15, elective surgery should be avoided and the patient should be considered for liver transplantation.
These guidelines should be modified for specific circumstances.
The operative risk is higher with certain types of surgery, such as hepatic resection, biliary surgery, gastric surgery, colectomy, and cardiac surgery.
Prophylactic measures to prevent complications
Early recognition and treatment of complications
Refractory ascites
Spontaneous bacterial peritonitis (SBP)
Fluid and electrolyte disturbances
Hepatorenal syndrome (HRS)
Portal hypertensive bleedings
Hepatic encephalopathy (HE)
Hepatocellular carcinoma (HCC)
Malnutrition
Progress of other medical diseases
Liver imaging and AFP, CA19-9 to exclude neoplasms
Doppler ultrasound: to exclude portal vein thrombosis
Upper GI endoscopy: to assess portal hypertension
Bone densitometry: in selected patients
Neuropsychologic testing: selected patients
ABG: to exclude hypoxemia-hepatopulmonary syndrome
Particular attention needs to be paid to the management of common complications of advanced liver disease, as coagulopathy, thrombocytopenia, ascites, renal insufficiency, encephalopathy, and malnutrition, as well as to disease-specific factors.
The cause of coagulopathy is multifactorial. It may result from poor absorption of vitamin K due to cholestasis or impaired synthesis of coagulation factors.
Parenteral vitamin K and transfusions of fresh frozen plasma can be used before surgery.
Intravenous cryoprecipitate may be infused with a minimal volume load. It contains large amounts of fibrinogen and von Willebrand factor together with clotting factors.
Intravenous recombinant factor VIIa is a safe and effective in correcting coagulopathy and normalizing the INR.
For patients with thrombocytopenia, platelet transfusion of may be recommended.
Prolonged bleeding time can be corrected bydesmopressin acetate.
Grades of ascites:
Grade 1: ascites only detected by ultrasound
Grade 2: moderate with symmetrical distention of the abdomen
Grade 3: large or tense with marked abdominal distension
Fluid restriction is not necessary in most patients.
Due to hyperkalemia, spironolactone as a single agent is recommended only in minimal fluid overload.
The usual regimen is a single morning dose of 100 mg spironolactone and 40 mg furosemide. The dose can be increased every 3-5 days, if weight loss is not satisfactory. Maximum doses are 600 mg/day spironolactone and 200 mg/day furosemide.
Side effects include volume depletion, which may precipitate encephalopathy, or renal failure.
Weekly monitoring of electrolytes and weight must be undertaken when initiating or changing therapy.
Encephalopathy, serum Na <125 mmol/L, creatinine >1.7mg/dL, should lead to cessation of diuretic use.
Treatment options include the following:
Paracentesis with albumin replacement remains the first treatment option for patients on the waiting list and are likely to undergo LT within a few months.
For large volume paracentesis, an albumin infusion of 8-10 g/L of fluid removed should be considered.
Paracentesis increases the risk of peritonitis.
TIPS is considered for the following:
Cases where the frequency of paracentesis is >3 times/month
Patients not tolerating large-volume paracentesis
Large-volume paracentesis is ineffective due to multiple adhesions or loculated ascites
Refractory hepatic hydrothorax
The major disadvantages are shunt stenosis and HE.
Peritoneovenous shunt: for historical interest only
Surgical shunts are rarely indicated
Its prevalence justifies diagnostic paracentesis in cirrhotics with ascites admitted to the hospital. Norfloxacin (400 mg/day) significantly reduces the probability of SBP.
Secondary long-term prophylaxis is recommended for all patients with a history of SBP. Antibiotic prophylaxis is recommended in patients with an upper GI bleed irrespective of the presence or absence of ascites.
Patients with ESLD are at increased risk to develop renal failure (RF), either spontaneously (hepatorenal syndrome [HRS]) or iatrogenically (diuretics, nephrotoxic drugs). Preoperative renal function significantly affects postoperative survival.
HRS can only be diagnosed after other causes of renal failure are excluded: obstruction, volume depletion, ATN, and drug-induced nephrotoxicity. All diuretics should be stopped. Fluid challenge with 1.5 L of isotonic saline should be administered to exclude volume depletion.
Combination of
vasoconstrictor drugs, such as vasopressin analogues, noradrenalin, and the combination of midodrine and octreotide together,
plasma volume expansion with albumin (1 g/kg intravenously on day 1, 20-40 daily thereafter).
It represents a late event and indicates poor prognosis. Occurs months after the onset of Na retention.
It has been proposed to incorporate serum Na concentration in the MELD score; however, this remains controversial.
As long as the serum Na remains >125 mmol/L, no specific measures are required.
If the serum Na level is <125 mmol/L, the following should be considered:
Diuretics should be stopped.
Infusion of albumin (100 g/24 h) or red blood cells is instituted attempting at expanding the effective circulating blood volume.
Na level will increase as a result of turning off ADH secretion by the increased blood volume. Once the serum sodium starts to rise, the albumin infusion is tapered.
Free water restriction.
Attempts to rapid correction with hypertonic saline can lead to more complications.
HE is a diagnosis of exclusion. Other etiologies as space-occupying lesions, vascular events, metabolic disorders, and infectious diseases should be excluded.
Slowing of consciousness
Drowsiness
Confusion, reactive only to vocal stimuli
Coma
Renal and electrolyte abnormalities
Gastrointestinal bleeding
Infection
Constipation
Benzodiazepines, narcotics, or other sedatives
Excessive dietary protein intake
Worsening liver function, e.g., portal vein thrombosis
Noncompliance with medications, especially lactulose
The mainstay is correcting the precipitating event.
Intubation has to be considered to prevent aspiration, depending on the level of consciousness.
Nasogastric tube should be placed.
Nonabsorbable disaccharides such as lactulose: The usual starting dose is 20 mL, 3-4 times daily with the aim of achieving 2-4 soft bowel movements per day.
Neomycin 3-6 g/day in divided doses might be added. Alternatively, metronidazole can be used.
Low-protein diet (minimum 30 g/day).
Gluconeogenesis is a significant source of production of endogenous ammonia and may result in worsening of the encephalopathy. Patients should be provided with at least of 400 calories daily in the form of IV glucose to reduce gluconeogenesis.
Once the patient recovers, a moderate amount of protein (40 g/day) is given and increased to the maximum tolerated dose within few days.
It is important to avoid protein restriction for a long time to prevent worsening of the nutritional state.
The role of ornithine-aspartate, sodium benzoate, and branched-chain amino acids is questioned.
Ammonia level is a poor predictor of the degree of encephalopathy. Changes in ammonia levels should not be considered an indicator of therapeutic benefit; improvement in mental status is the therapeutic end point.
The detection of PPHTN is crucial as it increases the perioperative and long-term risks.
The most common presenting symptom is progressive dyspnea on excretion; however, patients with even severe PPHTN can be completely asymptomatic. Echocardiography is the screening method of choice. A systolic right ventricular pressure (RVsys) of >50 mm Hg as a cutoff is used. Only these patients need to undergo right heart catheterization to characterize pulmonary hemodynamics.
This is defined as a triad of the following:
Chronic liver disease
Hypoxemia (PaO2 <70 mm Hg or alveolar to arterial oxygen gradient >20 mm Hg)
Intrapulmonary arteriovenous dilatation or shunts as detected by contrast echocardiography, lung perfusion scanning, or pulmonary angiography
Hypoxemia at rest is the prerequisite for the diagnosis. Medical management is disappointing, and liver transplant is advocated as the treatment of choice.
Malnutrition is common with liver impairment and is a risk factor for mortality following LT. Nutritional supplementation has not been proven to affect outcome. The total amount of calories provided should be at least 30-35 kcal/kg/day. Adults can receive daily 1-2 g protein/kg of dry body weight. Patients should take daily multivitamin and other supplements as needed. Specific fat-soluble vitamin supplements are provided if a deficiency is present.
The preoperative period can be extremely stressful. Declining health, uncertainty about the results, and inability to continue working and participating in daily activities may increase the risk of depression and/or anxiety. Patients with chronic HCV have a greater incidence of depression and anxiety. Patients who experience significant psychological distress have increased complications.
The preoperative evaluation concludes with a review of all pertinent studies and information obtained from investigative tests.
Informed consent after discussion with the patient and family members regarding the indication for the anticipated surgical procedure, as well as its risks and proposed benefits
Review the need for β-blockade, DVT prophylaxis
Antibiotic prophylaxis: The appropriate antibiotic is chosen before surgery and administered before the skin incision is made
Preoperative mechanical bowel cleansing, whenever indicated
Revision of medications
Careful review of the patient’s medications is important.
The aim is to judiciously give medications that control the patient’s illnesses and at the same time minimizing the risk associated with anesthetic and other drugs interactions.
In general, patients taking cardiac drugs, pulmonary drugs or anticonvulsants, antihypertensives, or psychiatric drugs are advised to take their medications with sips of water on the morning of operation.
Parenteral medications are used if the patient remains NPO for any significant period postoperatively.
It is important to restitute patients to their usual medications as soon as possible.
Drugs affecting platelet function are withheld for variable time: aspirin and clopidogrel (Plavix) are withheld for 7-10 days, while NSAIDs are withheld depending on the drug’s half-life between 1 day (ibuprofen and indomethacin) and 3 days (naproxen and sulindac).
Preoperative fasting
The patients are monitored for signs of hepatic decompensation, such as ascites, worsening jaundice encephalopathy, coagulopathy, and renal impairment.
If any of these occur, supportive therapy is started immediately.
Prothrombin time is the single best indicator of the synthetic function of the liver.
Elevated serum bilirubin level may result from worsening of the liver function and also may be elevated because of other conditions, as blood transfusions, blood extravasation, or infection.
Renal function must be monitored closely. If renal impairment occurs, the cause should be suspected and treatment started.
In cases of severe impairment of the liver functions, hypoglycemia may occur as a result of depletion of liver glycogen stores and impaired gluconeogenesis. Serum levels of glucose should be monitored closely if postoperative liver failure is suspected.
Careful attention should be paid to the IV fluid infusions.
Intravascular volume maintenance minimizes the risk of hepatic and renal underperfusion.
At the same time, crystalloid overinfusion results in liver congestion, venous oozing and pulmonary congestion and edema, ascites, peripheral edema, and wound disruption.
Accurate preoperative identification of patients with liver disease allows their treatment plans to be adjusted.
In patients with acute liver disease, elective surgery should be postponed until symptoms resolve.
Elective surgery should be avoided in patients with acute liver diseases such as acute viral hepatitis or alcoholic hepatitis, if there is evidence of ongoing hepatic injury.
In cases of chronic liver diseases, it is mandatory to assess the severity of underlying disease before deciding whether to proceed with surgery.
MELD and CTP scores can be used to stratify the risks of surgery for patients with chronic liver disease.
Optimal preoperative management can reduce the risk of postoperative morbidity and mortality.
Preoperative management of complications related to patients’ underlying liver disease is essential to optimize their outcomes.
The increase in the human population around the world has pushed farmers to produce more food. This pressure forced some farmers to use more chemicals in their operations, which led to concerns raised by environmentalists and health officials as some chemicals were damaging the environment and people’s health. This has raised a necessity of exploring alternative methods to improve fertilization, and manage pests and diseases.
Biofertilizer became an option as it is friendlier to the environment as well as on human health.
Phytohormones on the other hand are compounds that are responsible for the growth and development of the plant. Some are responsible for plant elongation, shoot and root developments, others are involved in plant pests and disease control [4].
Biofungicides also became an alternative to chemical or synthetic fungicides to minimize the damage caused by chemical fungicides to the environment, animals and human beings.
The objective of this book chapter is to prove that
It produces plant growth hormones and volatile compounds;
It contributes to solubilizing phosphates that are unavailable to the crop
It also takes part in promoting the uptake of macro and micro nutrients needed by the crop
Plant growth hormones are also called phytohormones. They are involved in many processes in the plant including communication, biotic and abiotic stress management, and many more processes. They have been reported for many years to play a vital role in the growth and development of a crop. Root and shoot elongation needs phyto-hormones to happen properly at the correct speed that supports high productivity. It has been reported that the presence of
Intended use | Target crop | Mode of application | Benefits/comments | Ref. (s) | |
---|---|---|---|---|---|
Growth promotion and inhibition of phytopathogen development | Lettuce | Expose plants to | Increased chlorophyll content, and carotenoids. Decreased the severity of white mold by up to 78.83% | [16] | |
Growth promotion | Tomato | Seed treatment | Phytohormone homeostasis, antioxidant activity, phenylpropanoid biosynthesis and glutathione metabolism | [17] | |
Biofertilizer | Chinese cabbage | Through irrigation | Increased yield by 37%; Increased enzyme activity in the soils (urease by 25.1%, phosphatase by 13.1%, and catalase by 14.0%, Providing more inorganic nitrogen and phosphorus to the soil | [18] | |
Soil conditioner | Maize | On soil as granules | Increased yields | [19] | |
Biofertilizer | Tomato | Seedling drenching | Produces indole-3 acetic acid and | [15] |
Production of plant growth hormones and volatile compounds by
Phosphorus is one of the critical nutrients that plants need for their growth and development. It is found in the soil but due to depletion farmers have to apply fertilizers. However, the availability of phosphorus to the crop depends on the form it is in. Acidic soils bind phosphorus and make it unavailable to the crop, which is an undesired outcome [20]. Due to this, the accuracy of the amount required by the crop may not be achieved resulting in challenges associated with lack or insufficient phosphorus in the soil [3]. Some microorganisms mediate this process by solubilizing phosphates, converting them back to be in the available form for crop utilization.
Intended use | Target crop | Mode of application | Benefits/comments | Ref. (s) | |
---|---|---|---|---|---|
Biofertilizer | Chinese cabbage | Through irrigation | Increased yield by 37%; Increased enzyme activity in the soils (urease by 25.1%, phosphatase by 13.1%, and catalase by 14.0%, Providing more inorganic nitrogen and phosphorus to the soil | [18] | |
Biofertilizer | Tomato | Seed treatment | Increase Phosphorus uptake | [23] | |
Biofertilizer | Tomato | Seedling drenching | Phosphorus solubilization | [15] |
Solubilization of phosphates by
It has been reported that plant nutrient uptake can be improved resulting in plant growth promotion. Microorganisms play a major role in accelerating nutrient uptake.
Intended use | Target crop | Mode of application | Benefits/comments | Ref. (s) | |
---|---|---|---|---|---|
Growth promotion and inhibition of phytopathogen development | Lettuce | Expose plants to | Increased the content of chlorophyll, and carotenoids. Decreased the severity of white mold by up to 78.83% | [16] | |
Biofertilizer and biofungicide | Rice | Seed treatment | Improved germination rate and enhanced vigor. Increased yields | [27] | |
Biofertilizer | Tomato | Seed treatment | Improved soil fertility, nutrient uptake, increased yields, antioxidants and minerals | [28] | |
Biofertilizer | Chinese cabbage | Through irrigation | Increased yield by 37%; Increased enzyme activity in the soils (urease by 25.1%, phosphatase by 13.1%, and catalase by 4.0%, Providing more inorganic nitrogen and phosphorus to the soil | [18] | |
Biofertilizer | Tomato | Seed treatment | Improves nutrient uptake (enhance nitrogen utilization efficiency, increase Phosphorus uptake | [23] | |
BioF/compost | Tomato | Soil amendment compost | Provided 12.9% yield increase compared to recommended fertilization | [29] | |
Soil conditioner | Maize | On soil as granules | Increased yields | [19] | |
Biofertilizer | Sugar cane | Powder broadcasted with fertilizer | Improve nutrient uptake NPK | [25] | |
Biofertilizer -micronutrient | Cucumber | Seedling drenching | Enhance Fe and Cu uptake by plants | [30] | |
Compost | Most crops | Compost | Improves the rate of Residue decomposition resulting in greater availability of soil nutrients | [31] | |
Biofertilizer | Bell pepper | Seedling drenching | Bell pepper yield increase up to 67%. Enhance tolerance to abiotic stresses | [32] | |
Biofertilizer | Tomato | Seedling drenching | Improve nutrient uptake | [15] | |
Biofertilizer BioF/compost | Tomato | Seed treatment | Improved soil fertility, nutrient uptake, increased yields, antioxidants and minerals (P, K, Ca, Mg, Cu, Fe, Mn and Zn) | [28, 29] | |
Biofertilizer -micronutrient | Cucumber | Seedling drenching | Enhance Fe and Cu uptake by plants | [30] | |
Compost | Most crops | Compost | Improves the rate of Residue decomposition resulting in greater availability of soil nutrients | [31] | |
Plant growth promoter | Chickpea | Seed treatment | mineral mobilization and their uptake | [33] |
Agriculture is an indispensable part of any country to feed the millions of people. However, production is hampered by various plant diseases posing serious yield reductions threatening global food security. Disease management employs mainly synthetic fungicides. However, with the mounting concern for human health and environmental risks, and the loss of pesticides to resistance, the search for non-chemical alternatives has been a focus of much research for more than three decades. Biocontrol agents have emerged as an important component of plant disease management, and may provide an alternative to synthetic fungicides.
They are successful antagonists having biocontrol abilities against a broad range of economically important phytopathogenic fungi such as
Competition for nutrient and ecological niche, mycoparasitism and antibiosis are the major biological mechanisms involved in their direct antagonistic activity against plant pathogenic fungi [43, 44, 45]. They can also achieve an indirect effect of antagonism on the target pathogen by interacting with the host tissue, inducing host resistance which protects against the pathogen, promoting plant and root growth as well as improving plant stress tolerance. Many successful biocontrol agents use a combination of different modes of action to produce a higher level of antagonism [38, 46].
Antibiosis involves the production of various antimicrobial compounds by
Mycoparasitism, direct contact of an antagonist with a fungal pathogen, involves sequential events, including pathogen recognition, attack and subsequent penetration of the host cell and death [10]. In this process,
Starvation is the most common cause of death for microorganisms, so the limited availability of and competition for micro- and macro nutrients results in the biological control of fungal phytopathogens [59].
During plant–pathogen interactions, plants have evolved a wide range of defense mechanisms to cope with the constant attack by invading pathogens. However, plant defense can also be triggered by biocontrol agents [2, 54]. The rhizocompetent nature of
Disease | Mode of action | Ref. (s) | |
---|---|---|---|
Antibiosis metacaspase-independent Apoptotic cell death. | [74, 75] | ||
Endo-chitinase, chitobiosidase | [63, 76, 77] | ||
Colonization and antibiosis | [10, 48, 78] | ||
Mycoparasitism | [14] | ||
Competition for space | [45] | ||
Induced resistance | [69] |
Examples of
Authors would like to acknowledge Dr. Kwasi Sackey Yobo, Bongi Kubheka, Nolitha Skenjana and Sinegugu Shude for their support during the writing of this chapter. We would also like to acknowledge our families for moral support and understanding.
The authors declare no conflict of interest.
IntechOpen has always supported new and evolving ideas in scholarly publishing. We understand the community we serve, but to provide an even better service for our IntechOpen Authors and Academic Editors, we have partnered with leading companies and associations in the scientific field and beyond.
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He is also a faculty member in the Molecular Oncology Program. He obtained his MSc and Ph.D. at Oregon State University and Texas Tech University, respectively. He pursued his postdoctoral studies at Rutgers University Medical School and the National Institutes of Health (NIH/NIDDK), USA. His research focuses on biochemistry, biophysics, genetics, molecular biology, and molecular medicine with specialization in the fields of drug design, protein structure-function, protein folding, prions, microRNA, pseudogenes, molecular cancer, epigenetics, metabolites, proteomics, genomics, protein expression, and characterization by spectroscopic and calorimetric methods.",institutionString:"University of Health Sciences",institution:null},{id:"180528",title:"Dr.",name:"Hiroyuki",middleName:null,surname:"Kagechika",slug:"hiroyuki-kagechika",fullName:"Hiroyuki Kagechika",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180528/images/system/180528.jpg",biography:"Hiroyuki Kagechika received his bachelor’s degree and Ph.D. in Pharmaceutical Sciences from the University of Tokyo, Japan, where he served as an associate professor until 2004. He is currently a professor at the Institute of Biomaterials and Bioengineering (IBB), Tokyo Medical and Dental University (TMDU). From 2010 to 2012, he was the dean of the Graduate School of Biomedical Science. Since 2012, he has served as the vice dean of the Graduate School of Medical and Dental Sciences. He has been the director of the IBB since 2020. Dr. Kagechika’s major research interests are the medicinal chemistry of retinoids, vitamins D/K, and nuclear receptors. He has developed various compounds including a drug for acute promyelocytic leukemia.",institutionString:"Tokyo Medical and Dental University",institution:{name:"Tokyo Medical and Dental University",country:{name:"Japan"}}},{id:"40482",title:null,name:"Rizwan",middleName:null,surname:"Ahmad",slug:"rizwan-ahmad",fullName:"Rizwan Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/40482/images/system/40482.jpeg",biography:"Dr. Rizwan Ahmad is a University Professor and Coordinator, Quality and Development, College of Medicine, Imam Abdulrahman bin Faisal University, Saudi Arabia. Previously, he was Associate Professor of Human Function, Oman Medical College, Oman, and SBS University, Dehradun. Dr. Ahmad completed his education at Aligarh Muslim University, Aligarh. He has published several articles in peer-reviewed journals, chapters, and edited books. His area of specialization is free radical biochemistry and autoimmune diseases.",institutionString:"Imam Abdulrahman Bin Faisal University",institution:{name:"Imam Abdulrahman Bin Faisal University",country:{name:"Saudi Arabia"}}},{id:"41865",title:"Prof.",name:"Farid A.",middleName:null,surname:"Badria",slug:"farid-a.-badria",fullName:"Farid A. Badria",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/41865/images/system/41865.jpg",biography:"Farid A. Badria, Ph.D., is the recipient of several awards, including The World Academy of Sciences (TWAS) Prize for Public Understanding of Science; the World Intellectual Property Organization (WIPO) Gold Medal for best invention; Outstanding Arab Scholar, Kuwait; and the Khwarizmi International Award, Iran. He has 250 publications, 12 books, 20 patents, and several marketed pharmaceutical products to his credit. He continues to lead research projects on developing new therapies for liver, skin disorders, and cancer. Dr. Badria was listed among the world’s top 2% of scientists in medicinal and biomolecular chemistry in 2019 and 2020. He is a member of the Arab Development Fund, Kuwait; International Cell Research Organization–United Nations Educational, Scientific and Cultural Organization (ICRO–UNESCO), Chile; and UNESCO Biotechnology France",institutionString:"Mansoura University",institution:{name:"Mansoura University",country:{name:"Egypt"}}},{id:"329385",title:"Dr.",name:"Rajesh K.",middleName:"Kumar",surname:"Singh",slug:"rajesh-k.-singh",fullName:"Rajesh K. Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329385/images/system/329385.png",biography:"Dr. Singh received a BPharm (2003) and MPharm (2005) from Panjab University, Chandigarh, India, and a Ph.D. (2013) from Punjab Technical University (PTU), Jalandhar, India. He has more than sixteen years of teaching experience and has supervised numerous postgraduate and Ph.D. students. He has to his credit more than seventy papers in SCI- and SCOPUS-indexed journals, fifty-five conference proceedings, four books, six Best Paper Awards, and five projects from different government agencies. He is currently an editorial board member of eight international journals and a reviewer for more than fifty scientific journals. He received Top Reviewer and Excellent Peer Reviewer Awards from Publons in 2016 and 2017, respectively. He is also on the panel of The International Reviewer for reviewing research proposals for grants from the Royal Society. He also serves as a Publons Academy mentor and Bentham brand ambassador.",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",country:{name:"India"}}},{id:"142388",title:"Dr.",name:"Thiago",middleName:"Gomes",surname:"Gomes Heck",slug:"thiago-gomes-heck",fullName:"Thiago Gomes Heck",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/142388/images/7259_n.jpg",biography:null,institutionString:null,institution:{name:"Universidade Regional do Noroeste do Estado do Rio Grande do Sul",country:{name:"Brazil"}}},{id:"336273",title:"Assistant Prof.",name:"Janja",middleName:null,surname:"Zupan",slug:"janja-zupan",fullName:"Janja Zupan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/336273/images/14853_n.jpeg",biography:"Janja Zupan graduated in 2005 at the Department of Clinical Biochemistry (superviser prof. dr. Janja Marc) in the field of genetics of osteoporosis. Since November 2009 she is working as a Teaching Assistant at the Faculty of Pharmacy, Department of Clinical Biochemistry. In 2011 she completed part of her research and PhD work at Institute of Genetics and Molecular Medicine, University of Edinburgh. She finished her PhD entitled The influence of the proinflammatory cytokines on the RANK/RANKL/OPG in bone tissue of osteoporotic and osteoarthritic patients in 2012. From 2014-2016 she worked at the Institute of Biomedical Sciences, University of Aberdeen as a postdoctoral research fellow on UK Arthritis research project where she gained knowledge in mesenchymal stem cells and regenerative medicine. She returned back to University of Ljubljana, Faculty of Pharmacy in 2016. She is currently leading project entitled Mesenchymal stem cells-the keepers of tissue endogenous regenerative capacity facing up to aging of the musculoskeletal system funded by Slovenian Research Agency.",institutionString:null,institution:{name:"University of Ljubljana",country:{name:"Slovenia"}}},{id:"357453",title:"Dr.",name:"Radheshyam",middleName:null,surname:"Maurya",slug:"radheshyam-maurya",fullName:"Radheshyam Maurya",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/357453/images/16535_n.jpg",biography:null,institutionString:null,institution:{name:"University of Hyderabad",country:{name:"India"}}},{id:"311457",title:"Dr.",name:"Júlia",middleName:null,surname:"Scherer Santos",slug:"julia-scherer-santos",fullName:"Júlia Scherer Santos",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/311457/images/system/311457.jpg",biography:"Dr. Júlia Scherer Santos works in the areas of cosmetology, nanotechnology, pharmaceutical technology, beauty, and aesthetics. Dr. Santos also has experience as a professor of graduate courses. Graduated in Pharmacy, specialization in Cosmetology and Cosmeceuticals applied to aesthetics, specialization in Aesthetic and Cosmetic Health, and a doctorate in Pharmaceutical Nanotechnology. Teaching experience in Pharmacy and Aesthetics and Cosmetics courses. She works mainly on the following subjects: nanotechnology, cosmetology, pharmaceutical technology, aesthetics.",institutionString:"Universidade Federal de Juiz de Fora",institution:{name:"Universidade Federal de Juiz de Fora",country:{name:"Brazil"}}},{id:"219081",title:"Dr.",name:"Abdulsamed",middleName:null,surname:"Kükürt",slug:"abdulsamed-kukurt",fullName:"Abdulsamed Kükürt",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRNVJQA4/Profile_Picture_2022-03-07T13:23:04.png",biography:"Dr. Kükürt graduated from Uludağ University in Turkey. He started his academic career as a Research Assistant in the Department of Biochemistry at Kafkas University. In 2019, he completed his Ph.D. program in the Department of Biochemistry at the Institute of Health Sciences. He is currently working at the Department of Biochemistry, Kafkas University. He has 27 published research articles in academic journals, 11 book chapters, and 37 papers. He took part in 10 academic projects. He served as a reviewer for many articles. He still serves as a member of the review board in many academic journals. His research interests include biochemistry, oxidative stress, reactive species, antioxidants, lipid peroxidation, inflammation, reproductive hormones, phenolic compounds, female infertility.",institutionString:"Kafkas University",institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"178366",title:"Associate Prof.",name:"Volkan",middleName:null,surname:"Gelen",slug:"volkan-gelen",fullName:"Volkan Gelen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178366/images/system/178366.jpg",biography:"Volkan Gelen is a Physiology specialist who received his veterinary degree from Kafkas University in 2011. Between 2011-2015, he worked as an assistant at Atatürk University, Faculty of Veterinary Medicine, Department of Physiology. In 2016, he joined Kafkas University, Faculty of Veterinary Medicine, Department of Physiology as an assistant professor. Dr. Gelen has been engaged in various academic activities at Kafkas University since 2016. There he completed 5 projects and has 3 ongoing projects. He has 60 articles published in scientific journals and 20 poster presentations in scientific congresses. His research interests include physiology, endocrine system, cancer, diabetes, cardiovascular system diseases, and isolated organ bath system studies.",institutionString:"Kafkas University",institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"418963",title:"Dr.",name:"Augustine Ododo",middleName:"Augustine",surname:"Osagie",slug:"augustine-ododo-osagie",fullName:"Augustine Ododo Osagie",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/418963/images/16900_n.jpg",biography:"Born into the family of Osagie, a prince of the Benin Kingdom. I am currently an academic in the Department of Medical Biochemistry, University of Benin. Part of the duties are to teach undergraduate students and conduct academic research.",institutionString:null,institution:{name:"University of Benin",country:{name:"Nigeria"}}},{id:"192992",title:"Prof.",name:"Shagufta",middleName:null,surname:"Perveen",slug:"shagufta-perveen",fullName:"Shagufta Perveen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192992/images/system/192992.png",biography:"Prof. Shagufta Perveen is a Distinguish Professor in the Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. Dr. Perveen has acted as the principal investigator of major research projects funded by the research unit of King Saud University. She has more than ninety original research papers in peer-reviewed journals of international repute to her credit. She is a fellow member of the Royal Society of Chemistry UK and the American Chemical Society of the United States.",institutionString:"King Saud University",institution:{name:"King Saud University",country:{name:"Saudi Arabia"}}},{id:"49848",title:"Dr.",name:"Wen-Long",middleName:null,surname:"Hu",slug:"wen-long-hu",fullName:"Wen-Long Hu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49848/images/system/49848.jpg",biography:"Wen-Long Hu is Chief of the Division of Acupuncture, Department of Chinese Medicine at Kaohsiung Chang Gung Memorial Hospital, as well as an adjunct associate professor at Fooyin University and Kaohsiung Medical University. Wen-Long is President of Taiwan Traditional Chinese Medicine Medical Association. He has 28 years of experience in clinical practice in laser acupuncture therapy and 34 years in acupuncture. He is an invited speaker for lectures and workshops in laser acupuncture at many symposiums held by medical associations. He owns the patent for herbal preparation and producing, and for the supercritical fluid-treated needle. Dr. Hu has published three books, 12 book chapters, and more than 30 papers in reputed journals, besides serving as an editorial board member of repute.",institutionString:"Kaohsiung Chang Gung Memorial Hospital",institution:{name:"Kaohsiung Chang Gung Memorial Hospital",country:{name:"Taiwan"}}},{id:"298472",title:"Prof.",name:"Andrey V.",middleName:null,surname:"Grechko",slug:"andrey-v.-grechko",fullName:"Andrey V. Grechko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/298472/images/system/298472.png",biography:"Andrey Vyacheslavovich Grechko, Ph.D., Professor, is a Corresponding Member of the Russian Academy of Sciences. He graduated from the Semashko Moscow Medical Institute (Semashko National Research Institute of Public Health) with a degree in Medicine (1998), the Clinical Department of Dermatovenerology (2000), and received a second higher education in Psychology (2009). Professor A.V. Grechko held the position of Сhief Physician of the Central Clinical Hospital in Moscow. He worked as a professor at the faculty and was engaged in scientific research at the Medical University. Starting in 2013, he has been the initiator of the creation of the Federal Scientific and Clinical Center for Intensive Care and Rehabilitology, Moscow, Russian Federation, where he also serves as Director since 2015. He has many years of experience in research and teaching in various fields of medicine, is an author/co-author of more than 200 scientific publications, 13 patents, 15 medical books/chapters, including Chapter in Book «Metabolomics», IntechOpen, 2020 «Metabolomic Discovery of Microbiota Dysfunction as the Cause of Pathology».",institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"199461",title:"Prof.",name:"Natalia V.",middleName:null,surname:"Beloborodova",slug:"natalia-v.-beloborodova",fullName:"Natalia V. Beloborodova",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/199461/images/system/199461.jpg",biography:'Natalia Vladimirovna Beloborodova was educated at the Pirogov Russian National Research Medical University, with a degree in pediatrics in 1980, a Ph.D. in 1987, and a specialization in Clinical Microbiology from First Moscow State Medical University in 2004. She has been a Professor since 1996. Currently, she is the Head of the Laboratory of Metabolism, a division of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russian Federation. N.V. Beloborodova has many years of clinical experience in the field of intensive care and surgery. She studies infectious complications and sepsis. She initiated a series of interdisciplinary clinical and experimental studies based on the concept of integrating human metabolism and its microbiota. Her scientific achievements are widely known: she is the recipient of the Marie E. Coates Award \\"Best lecturer-scientist\\" Gustafsson Fund, Karolinska Institutes, Stockholm, Sweden, and the International Sepsis Forum Award, Pasteur Institute, Paris, France (2014), etc. Professor N.V. Beloborodova wrote 210 papers, five books, 10 chapters and has edited four books.',institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"354260",title:"Ph.D.",name:"Tércio Elyan",middleName:"Azevedo",surname:"Azevedo Martins",slug:"tercio-elyan-azevedo-martins",fullName:"Tércio Elyan Azevedo Martins",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/354260/images/16241_n.jpg",biography:"Graduated in Pharmacy from the Federal University of Ceará with the modality in Industrial Pharmacy, Specialist in Production and Control of Medicines from the University of São Paulo (USP), Master in Pharmaceuticals and Medicines from the University of São Paulo (USP) and Doctor of Science in the program of Pharmaceuticals and Medicines by the University of São Paulo. Professor at Universidade Paulista (UNIP) in the areas of chemistry, cosmetology and trichology. Assistant Coordinator of the Higher Course in Aesthetic and Cosmetic Technology at Universidade Paulista Campus Chácara Santo Antônio. Experience in the Pharmacy area, with emphasis on Pharmacotechnics, Pharmaceutical Technology, Research and Development of Cosmetics, acting mainly on topics such as cosmetology, antioxidant activity, aesthetics, photoprotection, cyclodextrin and thermal analysis.",institutionString:null,institution:{name:"University of Sao Paulo",country:{name:"Brazil"}}},{id:"334285",title:"Ph.D. Student",name:"Sameer",middleName:"Kumar",surname:"Jagirdar",slug:"sameer-jagirdar",fullName:"Sameer Jagirdar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334285/images/14691_n.jpg",biography:"I\\'m a graduate student at the center for biosystems science and engineering at the Indian Institute of Science, Bangalore, India. I am interested in studying host-pathogen interactions at the biomaterial interface.",institutionString:null,institution:{name:"Indian Institute of Science Bangalore",country:{name:"India"}}},{id:"329795",title:"Dr.",name:"Mohd Aftab",middleName:"Aftab",surname:"Siddiqui",slug:"mohd-aftab-siddiqui",fullName:"Mohd Aftab Siddiqui",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329795/images/15648_n.jpg",biography:"Dr. Mohd Aftab Siddiqui is currently working as Assistant Professor in the Faculty of Pharmacy, Integral University, Lucknow for the last 6 years. He has completed his Doctor in Philosophy (Pharmacology) in 2020 from Integral University, Lucknow. He completed his Bachelor in Pharmacy in 2013 and Master in Pharmacy (Pharmacology) in 2015 from Integral University, Lucknow. He is the gold medalist in Bachelor and Master degree. He qualified GPAT -2013, GPAT -2014, and GPAT 2015. His area of research is Pharmacological screening of herbal drugs/ natural products in liver and cardiac diseases. He has guided many M. Pharm. research projects. He has many national and international publications.",institutionString:"Integral University",institution:null},{id:"255360",title:"Dr.",name:"Usama",middleName:null,surname:"Ahmad",slug:"usama-ahmad",fullName:"Usama Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255360/images/system/255360.png",biography:"Dr. Usama Ahmad holds a specialization in Pharmaceutics from Amity University, Lucknow, India. He received his Ph.D. degree from Integral University. Currently, he’s working as an Assistant Professor of Pharmaceutics in the Faculty of Pharmacy, Integral University. From 2013 to 2014 he worked on a research project funded by SERB-DST, Government of India. He has a rich publication record with more than 32 original articles published in reputed journals, 3 edited books, 5 book chapters, and a number of scientific articles published in ‘Ingredients South Asia Magazine’ and ‘QualPharma Magazine’. He is a member of the American Association for Cancer Research, International Association for the Study of Lung Cancer, and the British Society for Nanomedicine. Dr. Ahmad’s research focus is on the development of nanoformulations to facilitate the delivery of drugs that aim to provide practical solutions to current healthcare problems.",institutionString:"Integral University",institution:{name:"Integral University",country:{name:"India"}}},{id:"30568",title:"Prof.",name:"Madhu",middleName:null,surname:"Khullar",slug:"madhu-khullar",fullName:"Madhu Khullar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/30568/images/system/30568.jpg",biography:"Dr. Madhu Khullar is a Professor of Experimental Medicine and Biotechnology at the Post Graduate Institute of Medical Education and Research, Chandigarh, India. She completed her Post Doctorate in hypertension research at the Henry Ford Hospital, Detroit, USA in 1985. She is an editor and reviewer of several international journals, and a fellow and member of several cardiovascular research societies. Dr. Khullar has a keen research interest in genetics of hypertension, and is currently studying pharmacogenetics of hypertension.",institutionString:"Post Graduate Institute of Medical Education and Research",institution:{name:"Post Graduate Institute of Medical Education and Research",country:{name:"India"}}},{id:"223233",title:"Prof.",name:"Xianquan",middleName:null,surname:"Zhan",slug:"xianquan-zhan",fullName:"Xianquan Zhan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/223233/images/system/223233.png",biography:"Xianquan Zhan received his MD and Ph.D. in Preventive Medicine at West China University of Medical Sciences. He received his post-doctoral training in oncology and cancer proteomics at the Central South University, China, and the University of Tennessee Health Science Center (UTHSC), USA. He worked at UTHSC and the Cleveland Clinic in 2001–2012 and achieved the rank of associate professor at UTHSC. Currently, he is a full professor at Central South University and Shandong First Medical University, and an advisor to MS/PhD students and postdoctoral fellows. He is also a fellow of the Royal Society of Medicine and European Association for Predictive Preventive Personalized Medicine (EPMA), a national representative of EPMA, and a member of the American Society of Clinical Oncology (ASCO) and the American Association for the Advancement of Sciences (AAAS). He is also the editor in chief of International Journal of Chronic Diseases & Therapy, an associate editor of EPMA Journal, Frontiers in Endocrinology, and BMC Medical Genomics, and a guest editor of Mass Spectrometry Reviews, Frontiers in Endocrinology, EPMA Journal, and Oxidative Medicine and Cellular Longevity. He has published more than 148 articles, 28 book chapters, 6 books, and 2 US patents in the field of clinical proteomics and biomarkers.",institutionString:"Shandong First Medical University",institution:{name:"Affiliated Hospital of Shandong Academy of Medical Sciences",country:{name:"China"}}},{id:"297507",title:"Dr.",name:"Charles",middleName:"Elias",surname:"Assmann",slug:"charles-assmann",fullName:"Charles Assmann",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/297507/images/system/297507.jpg",biography:"Charles Elias Assmann is a biologist from Federal University of Santa Maria (UFSM, Brazil), who spent some time abroad at the Ludwig-Maximilians-Universität München (LMU, Germany). He has Masters Degree in Biochemistry (UFSM), and is currently a PhD student at Biochemistry at the Department of Biochemistry and Molecular Biology of the UFSM. His areas of expertise include: Biochemistry, Molecular Biology, Enzymology, Genetics and Toxicology. He is currently working on the following subjects: Aluminium toxicity, Neuroinflammation, Oxidative stress and Purinergic system. Since 2011 he has presented more than 80 abstracts in scientific proceedings of national and international meetings. Since 2014, he has published more than 20 peer reviewed papers (including 4 reviews, 3 in Portuguese) and 2 book chapters. He has also been a reviewer of international journals and ad hoc reviewer of scientific committees from Brazilian Universities.",institutionString:"Universidade Federal de Santa Maria",institution:{name:"Universidade Federal de Santa Maria",country:{name:"Brazil"}}},{id:"217850",title:"Dr.",name:"Margarete Dulce",middleName:null,surname:"Bagatini",slug:"margarete-dulce-bagatini",fullName:"Margarete Dulce Bagatini",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/217850/images/system/217850.jpeg",biography:"Dr. Margarete Dulce Bagatini is an associate professor at the Federal University of Fronteira Sul/Brazil. She has a degree in Pharmacy and a PhD in Biological Sciences: Toxicological Biochemistry. She is a member of the UFFS Research Advisory Committee\nand a member of the Biovitta Research Institute. She is currently:\nthe leader of the research group: Biological and Clinical Studies\nin Human Pathologies, professor of postgraduate program in\nBiochemistry at UFSC and postgraduate program in Science and Food Technology at\nUFFS. She has experience in the area of pharmacy and clinical analysis, acting mainly\non the following topics: oxidative stress, the purinergic system and human pathologies, being a reviewer of several international journals and books.",institutionString:"Universidade Federal da Fronteira Sul",institution:{name:"Universidade Federal da Fronteira Sul",country:{name:"Brazil"}}},{id:"226275",title:"Ph.D.",name:"Metin",middleName:null,surname:"Budak",slug:"metin-budak",fullName:"Metin Budak",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226275/images/system/226275.jfif",biography:"Metin Budak, MSc, PhD is an Assistant Professor at Trakya University, Faculty of Medicine. He has been Head of the Molecular Research Lab at Prof. Mirko Tos Ear and Hearing Research Center since 2018. His specializations are biophysics, epigenetics, genetics, and methylation mechanisms. He has published around 25 peer-reviewed papers, 2 book chapters, and 28 abstracts. He is a member of the Clinical Research Ethics Committee and Quantification and Consideration Committee of Medicine Faculty. His research area is the role of methylation during gene transcription, chromatin packages DNA within the cell and DNA repair, replication, recombination, and gene transcription. His research focuses on how the cell overcomes chromatin structure and methylation to allow access to the underlying DNA and enable normal cellular function.",institutionString:"Trakya University",institution:{name:"Trakya University",country:{name:"Turkey"}}},{id:"243049",title:"Dr.",name:"Anca",middleName:null,surname:"Pantea Stoian",slug:"anca-pantea-stoian",fullName:"Anca Pantea Stoian",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243049/images/system/243049.jpg",biography:"Anca Pantea Stoian is a specialist in diabetes, nutrition, and metabolic diseases as well as health food hygiene. She also has competency in general ultrasonography.\n\nShe is an associate professor in the Diabetes, Nutrition and Metabolic Diseases Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. She has been chief of the Hygiene Department, Faculty of Dentistry, at the same university since 2019. Her interests include micro and macrovascular complications in diabetes and new therapies. Her research activities focus on nutritional intervention in chronic pathology, as well as cardio-renal-metabolic risk assessment, and diabetes in cancer. She is currently engaged in developing new therapies and technological tools for screening, prevention, and patient education in diabetes. \n\nShe is a member of the European Association for the Study of Diabetes, Cardiometabolic Academy, CEDA, Romanian Society of Diabetes, Nutrition and Metabolic Diseases, Romanian Diabetes Federation, and Association for Renal Metabolic and Nutrition studies. She has authored or co-authored 160 papers in national and international peer-reviewed journals.",institutionString:null,institution:{name:"Carol Davila University of Medicine and Pharmacy",country:{name:"Romania"}}},{id:"279792",title:"Dr.",name:"João",middleName:null,surname:"Cotas",slug:"joao-cotas",fullName:"João Cotas",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/279792/images/system/279792.jpg",biography:"Graduate and master in Biology from the University of Coimbra.\n\nI am a research fellow at the Macroalgae Laboratory Unit, in the MARE-UC – Marine and Environmental Sciences Centre of the University of Coimbra. My principal function is the collection, extraction and purification of macroalgae compounds, chemical and bioactive characterization of the compounds and algae extracts and development of new methodologies in marine biotechnology area. \nI am associated in two projects: one consists on discovery of natural compounds for oncobiology. The other project is the about the natural compounds/products for agricultural area.\n\nPublications:\nCotas, J.; Figueirinha, A.; Pereira, L.; Batista, T. 2018. An analysis of the effects of salinity on Fucus ceranoides (Ochrophyta, Phaeophyceae), in the Mondego River (Portugal). Journal of Oceanology and Limnology. in press. DOI: 10.1007/s00343-019-8111-3",institutionString:"Faculty of Sciences and Technology of University of Coimbra",institution:null},{id:"279788",title:"Dr.",name:"Leonel",middleName:null,surname:"Pereira",slug:"leonel-pereira",fullName:"Leonel Pereira",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/279788/images/system/279788.jpg",biography:"Leonel Pereira has an undergraduate degree in Biology, a Ph.D. in Biology (specialty in Cell Biology), and a Habilitation degree in Biosciences (specialization in Biotechnology) from the Faculty of Science and Technology, University of Coimbra, Portugal, where he is currently a professor. In addition to teaching at this university, he is an integrated researcher at the Marine and Environmental Sciences Center (MARE), Portugal. His interests include marine biodiversity (algae), marine biotechnology (algae bioactive compounds), and marine ecology (environmental assessment). Since 2008, he has been the author and editor of the electronic publication MACOI – Portuguese Seaweeds Website (www.seaweeds.uc.pt). He is also a member of the editorial boards of several scientific journals. Dr. Pereira has edited or authored more than 20 books, 100 journal articles, and 45 book chapters. He has given more than 100 lectures and oral communications at various national and international scientific events. He is the coordinator of several national and international research projects. In 1998, he received the Francisco de Holanda Award (Honorable Mention) and, more recently, the Mar Rei D. Carlos award (18th edition). He is also a winner of the 2016 CHOICE Award for an outstanding academic title for his book Edible Seaweeds of the World. In 2020, Dr. Pereira received an Honorable Mention for the Impact of International Publications from the Web of Science",institutionString:"University of Coimbra",institution:{name:"University of Coimbra",country:{name:"Portugal"}}},{id:"61946",title:"Dr.",name:"Carol",middleName:null,surname:"Bernstein",slug:"carol-bernstein",fullName:"Carol Bernstein",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/61946/images/system/61946.jpg",biography:"Carol Bernstein received her PhD in Genetics from the University of California (Davis). She was a faculty member at the University of Arizona College of Medicine for 43 years, retiring in 2011. Her research interests focus on DNA damage and its underlying role in sex, aging and in the early steps of initiation and progression to cancer. In her research, she had used organisms including bacteriophage T4, Neurospora crassa, Schizosaccharomyces pombe and mice, as well as human cells and tissues. She authored or co-authored more than 140 scientific publications, including articles in major peer reviewed journals, book chapters, invited reviews and one book.",institutionString:"University of Arizona",institution:{name:"University of Arizona",country:{name:"United States of America"}}},{id:"182258",title:"Dr.",name:"Ademar",middleName:"Pereira",surname:"Serra",slug:"ademar-serra",fullName:"Ademar Serra",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/182258/images/system/182258.jpeg",biography:"Dr. Serra studied Agronomy on Universidade Federal de Mato Grosso do Sul (UFMS) (2005). He received master degree in Agronomy, Crop Science (Soil fertility and plant nutrition) (2007) by Universidade Federal da Grande Dourados (UFGD), and PhD in agronomy (Soil fertility and plant nutrition) (2011) from Universidade Federal da Grande Dourados / Escola Superior de Agricultura Luiz de Queiroz (UFGD/ESALQ-USP). Dr. Serra is currently working at Brazilian Agricultural Research Corporation (EMBRAPA). His research focus is on mineral nutrition of plants, crop science and soil science. Dr. Serra\\'s current projects are soil organic matter, soil phosphorus fractions, compositional nutrient diagnosis (CND) and isometric log ratio (ilr) transformation in compositional data analysis.",institutionString:"Brazilian Agricultural Research Corporation",institution:{name:"Brazilian Agricultural Research Corporation",country:{name:"Brazil"}}}]}},subseries:{item:{id:"23",type:"subseries",title:"Computational Neuroscience",keywords:"Single-Neuron Modeling, Sensory Processing, Motor Control, Memory and Synaptic Pasticity, Attention, Identification, Categorization, Discrimination, Learning, Development, Axonal Patterning and Guidance, Neural Architecture, Behaviours and Dynamics of Networks, Cognition and the Neuroscientific Basis of Consciousness",scope:"Computational neuroscience focuses on biologically realistic abstractions and models validated and solved through computational simulations to understand principles for the development, structure, physiology, and ability of the nervous system. This topic is dedicated to biologically plausible descriptions and computational models - at various abstraction levels - of neurons and neural systems. This includes, but is not limited to: single-neuron modeling, sensory processing, motor control, memory, and synaptic plasticity, attention, identification, categorization, discrimination, learning, development, axonal patterning, guidance, neural architecture, behaviors, and dynamics of networks, cognition and the neuroscientific basis of consciousness. Particularly interesting are models of various types of more compound functions and abilities, various and more general fundamental principles (e.g., regarding architecture, organization, learning, development, etc.) found at various spatial and temporal levels.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/23.jpg",hasOnlineFirst:!1,hasPublishedBooks:!0,annualVolume:11419,editor:{id:"14004",title:"Dr.",name:"Magnus",middleName:null,surname:"Johnsson",slug:"magnus-johnsson",fullName:"Magnus Johnsson",profilePictureURL:"https://mts.intechopen.com/storage/users/14004/images/system/14004.png",biography:"Dr Magnus Johnsson is a cross-disciplinary scientist, lecturer, scientific editor and AI/machine learning consultant from Sweden. \n\nHe is currently at Malmö University in Sweden, but also held positions at Lund University in Sweden and at Moscow Engineering Physics Institute. \nHe holds editorial positions at several international scientific journals and has served as a scientific editor for books and special journal issues. \nHis research interests are wide and include, but are not limited to, autonomous systems, computer modeling, artificial neural networks, artificial intelligence, cognitive neuroscience, cognitive robotics, cognitive architectures, cognitive aids and the philosophy of mind. \n\nDr. Johnsson has experience from working in the industry and he has a keen interest in the application of neural networks and artificial intelligence to fields like industry, finance, and medicine. \n\nWeb page: www.magnusjohnsson.se",institutionString:null,institution:{name:"Malmö University",institutionURL:null,country:{name:"Sweden"}}},editorTwo:null,editorThree:null,series:{id:"14",title:"Artificial Intelligence",doi:"10.5772/intechopen.79920",issn:"2633-1403"},editorialBoard:[{id:"13818",title:"Dr.",name:"Asim",middleName:null,surname:"Bhatti",slug:"asim-bhatti",fullName:"Asim Bhatti",profilePictureURL:"https://mts.intechopen.com/storage/users/13818/images/system/13818.jpg",institutionString:null,institution:{name:"Deakin University",institutionURL:null,country:{name:"Australia"}}},{id:"151889",title:"Dr.",name:"Joao Luis Garcia",middleName:null,surname:"Rosa",slug:"joao-luis-garcia-rosa",fullName:"Joao Luis Garcia Rosa",profilePictureURL:"https://mts.intechopen.com/storage/users/151889/images/4861_n.jpg",institutionString:null,institution:{name:"University of Sao Paulo",institutionURL:null,country:{name:"Brazil"}}},{id:"103779",title:"Prof.",name:"Yalcin",middleName:null,surname:"Isler",slug:"yalcin-isler",fullName:"Yalcin Isler",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRyQ8QAK/Profile_Picture_1628834958734",institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",institutionURL:null,country:{name:"Turkey"}}}]},onlineFirstChapters:{paginationCount:0,paginationItems:[]},publishedBooks:{paginationCount:9,paginationItems:[{type:"book",id:"9959",title:"Biomedical Signal and Image Processing",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/9959.jpg",slug:"biomedical-signal-and-image-processing",publishedDate:"April 14th 2021",editedByType:"Edited by",bookSignature:"Yongxia Zhou",hash:"22b87a09bd6df065d78c175235d367c8",volumeInSeries:10,fullTitle:"Biomedical Signal and Image Processing",editors:[{id:"259308",title:"Dr.",name:"Yongxia",middleName:null,surname:"Zhou",slug:"yongxia-zhou",fullName:"Yongxia Zhou",profilePictureURL:"https://mts.intechopen.com/storage/users/259308/images/system/259308.jpeg",institutionString:"University of Southern California",institution:{name:"University of Southern California",institutionURL:null,country:{name:"United States of America"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"9973",title:"Data Acquisition",subtitle:"Recent Advances and Applications in Biomedical Engineering",coverURL:"https://cdn.intechopen.com/books/images_new/9973.jpg",slug:"data-acquisition-recent-advances-and-applications-in-biomedical-engineering",publishedDate:"March 17th 2021",editedByType:"Edited by",bookSignature:"Bartłomiej Płaczek",hash:"75ea6cdd241216c9db28aa734ab34446",volumeInSeries:9,fullTitle:"Data Acquisition - 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Many parasitic diseases are classified as neglected tropical diseases because they have received minimal funding over recent years and, in many cases, are under-reported despite the critical role they play in morbidity and mortality among human and animal hosts. The current topic, Parasitic Infectious Diseases, in the Infectious Diseases Series aims to publish studies on the systematics, epidemiology, molecular biology, genomics, pathogenesis, genetics, and clinical significance of parasitic diseases from blood borne to intestinal parasites as well as zoonotic parasites. We hope to cover all aspects of parasitic diseases to provide current and relevant research data on these very important diseases. In the current atmosphere of the Coronavirus pandemic, communities around the world, particularly those in different underdeveloped areas, are faced with the growing challenges of the high burden of parasitic diseases. At the same time, they are faced with the Covid-19 pandemic leading to what some authors have called potential syndemics that might worsen the outcome of such infections. Therefore, it is important to conduct studies that examine parasitic infections in the context of the coronavirus pandemic for the benefit of all communities to help foster more informed decisions for the betterment of human and animal health.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/5.jpg",keywords:"Blood Borne Parasites, Intestinal Parasites, Protozoa, Helminths, Arthropods, Water Born Parasites, Epidemiology, Molecular Biology, Systematics, Genomics, Proteomics, Ecology"},{id:"6",title:"Viral Infectious Diseases",scope:"The Viral Infectious Diseases Book Series aims to provide a comprehensive overview of recent research trends and discoveries in various viral infectious diseases emerging around the globe. The emergence of any viral disease is hard to anticipate, which often contributes to death. A viral disease can be defined as an infectious disease that has recently appeared within a population or exists in nature with the rapid expansion of incident or geographic range. 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