Conditional probability for patient injury.
\r\n\tAs the subject of adhesives is in constant development, this book's purpose is to get together information about adhesives science and technology, recent advances, and applications that use adhesive technology. Also, to make these contents available to engineering students, engineers, researchers, and the people interested in this topic. The book is expected to present works that aim to contribute to the development of new technologies and the use of non-traditional materials in engineering.
",isbn:"978-1-83880-670-5",printIsbn:"978-1-83880-669-9",pdfIsbn:"978-1-83880-671-2",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,isSalesforceBook:!1,isNomenclature:!1,hash:"c58b7d4c17e2a202af1dc4b906b7becb",bookSignature:"Prof. António Bastos Pereira and Dr. Alexandre Luiz Pereira",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11819.jpg",keywords:"The Technology of the Adhesives, Recent Advances, New Perspectives, Structural Adhesives Bonding, Durability of Structural Adhesives, New Applications, Repair of Composites, Bonding of Composites, Experimental Mechanics Tests, Thermal Analysis, Finite Element Method, Numerical Analysis.",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"April 15th 2022",dateEndSecondStepPublish:"June 22nd 2022",dateEndThirdStepPublish:"August 21st 2022",dateEndFourthStepPublish:"November 9th 2022",dateEndFifthStepPublish:"January 8th 2023",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"15 days",secondStepPassed:!0,areRegistrationsClosed:!1,currentStepOfPublishingProcess:3,editedByType:null,kuFlag:!1,biosketch:"Dr. António Pereira is a professor and researcher, who graduated from the University of Porto, and gained experience as an engineer working at Renault, with an h-index of 23, and more than 1500 citations for 70 papers published in SCI journals.",coeditorOneBiosketch:"An active researcher in Solid Mechanics, Dr. Alexandre Luiz Pereira holds a degree in Mathematics from the State University of Rio de Janeiro, and a degree in Mechanical Engineering from the Fluminense Federal University in Brazil.",coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"211131",title:"Prof.",name:"António",middleName:"Bastos",surname:"Pereira",slug:"antonio-pereira",fullName:"António Pereira",profilePictureURL:"https://mts.intechopen.com/storage/users/211131/images/system/211131.png",biography:"Founding shareholder and Director of Martifer Group (ca. 3500 employees) (1990-1999) - was responsible for the planning and production of about 500 steel structures and industrial equipment with a total amount exceeding 100 million euros.\nAssistant Professor at the Department of Mechanical Engineering, University of Aveiro, since 2000. Board Member and Member of the Executive Committee at the Department of Mechanical Engineering, University of Aveiro (2011 – 2015), currently Director of TEMA - Centre for Mechanical Technology and Automation.\nHis main research area has been mechanics of composite materials, with particular emphasis on delamination fracture mechanics. He has published 44 papers in SCI journals and has delivered 30 presentations at international conferences. 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A strong patient’s safety culture in the operating room is very important to improve quality and reduce risks of adverse event and medical errors. Thus, a flexible risk analysis technique becomes crucial.
\nA lot of methods and techniques, such as fault tree analysis (FTA) and failure mode and effect criticality analysis (FMECA), have been used for safety risk analysis in the healthcare system. However, these methods have a limitation when dealing with rare event and complex systems. Khakzad indicated FTA unsuitable for complex problems with its limitation in explicitly representing dependencies of events, updating probabilities, and coping with uncertainties [3], while FMECA does not take into account multiple failure scenarios and causes. Bayesian Network (BN) is a powerful method for risk analysis. In contrast with other classical methods of dependability analysis, Bayesian networks provide a lot of benefits. Some of these benefits are the ability to model complex systems, to make predictions as well as diagnostics, to compute exactly the occurrence probability of an event, to update the calculations according to evidences, to represent multimodal variables, and to help modeling user-friendly by a graphical and compact approach [4].
\nIn this chapter, we propose two methods which can help to assess patient safety in different contexts using Bayesian network.
\nIn this part, we propose a method for the context of data availability. We will explain how we can use the classical Bayesian network for safety assessment in healthcare system.
\nIn the following, a methodology of risk analysis of the operating room using Bayesian networks is proposed. The methodology follows four steps (Figure 1) and it is part of continuous improvement process (CIP) [5].
\nMethodology of risk analysis for operating room using Bayesian network.
The first step involves determining the aim of the risk assessment process, the description of the problem, and the definition of the scope.
\nExample: risk of patient’s safety in the operating room.
\nThe second step is to identify potential risks that can affect the quality and the efficiency of the operating room process. In this step, we may encourage creativity and involvement of the operating room team.
\nThe third step is the risk modeling. It consists in the development of the Bayesian networks graph (definition and choice of the variables to represent the nodes, describe the states of each node, and build the structure of Bayesian networks in terms of links between the predefined nodes) and establishment of the quantitative relation between nodes through conditional probability. In this step, we can use the hospital data source and the expert’s judgment to feed the model.
\nThe last step is the analysis of the results: The model should give the best understanding of the risk problem. It is useful to discuss the goodness or appropriateness of the model. It is important to validate and calibrate the model using all available source of information (expert judgment, observation, statistical data…). We should then analyze and interpret the result of risk measures to support decision-making for safety improvement.
\nFinally, continuous improvement efforts must incorporate a risk assessment process to ensure the effectiveness and the quality of the process. The model must be updated with the new risks and factors.
\nThe operative processes include the preoperative, intraoperative, and postoperative stages of a surgery. We are going to study the operating room processes and in particular, the intraoperative stage. It starts when the patient enters the operating room and all members of the surgical team are expected to be in the operating room at this particular time. The process ends when the patient is able to leave the operating room. During this process, the patient is monitored, anesthetized, and prepped and the operation is performed. Because of the lack of availability of actual data risk, we will forward a risk analysis based on different sources accidents described in the international literature. We will limit our study to events that cause a significant deviation of the operating room process compared to normal process and which have serious consequences for the patient (re-intervention, hospitalization in intensive care, extension of the period of hospitalization, additional care, death…).
\nTo create and validate the structure of the network, we use Hugin software and more precisely Hugin Lite Evaluation.
\nFigure 2 illustrates the Bayesian network model of patient’s safety showing interrelationships of events that may lead to patient’s injury. The model has 13 nodes with one utility node. The nodes are assessed using a literature source. We present below the description of each nodes.
\nBayesian network for patient safety model for the operating room.
In the following, some risk factors are given:
\nThe conditional probabilities of states of different nodes and the marginal probabilities of some adverse events have been given as input data. Each risk of adverse events is considered with two states (true if the risk exists and false if not). The probabilities are given in Tables 1, 2, 3, 4, 5, 6, 7.
\nOperation error | \nTrue | \nFalse | \n||
---|---|---|---|---|
Patient risk | \nHigh | \nNormal | \nHigh | \nNormal | \n
No | \n0.01 | \n0.01 | \n0.99 | \n1 | \n
Small | \n0.18 | \n0.81 | \n0.009 | \n0 | \n
Severe | \n0.81 | \n0.18 | \n0.001 | \n0 | \n
Conditional probability for patient injury.
Age | \nAdult | \nElderly | \nChild | \n
---|---|---|---|
True | \n1.16E-5 | \n1.16E-4 | \n1.16E-4 | \n
False | \n0.9999884 | \n0.999884 | \n0.999884 | \n
Conditional probability for patient fall.
Age | \nAdult | \nElderly | \nChild | \n
---|---|---|---|
True | \n0.03 | \n0.05 | \n0.06 | \n
False | \n0.97 | \n0.95 | \n0.94 | \n
Conditional probability for medication error.
Physical state | \nWeak | \nNormal | \n||||
---|---|---|---|---|---|---|
Age | \nAdult | \nElderly | \nChild | \nAdult | \nElderly | \nChild | \n
High | \n0.6 | \n0.8 | \n0.9 | \n0 | \n0 | \n0 | \n
Normal | \n0.4 | \n0.2 | \n0.1 | \n1 | \n1 | \n1 | \n
Conditional probability for patient risk.
Anesthesia type | \nRegional | \nGeneral | \n
---|---|---|
True | \n5 × 10−5 | \n2.3 × 10−3 | \n
False | \n1–(5 × 10−5) | \n0.9977 | \n
Conditional probability for failure in anesthesia equipment.
Risk | \nProbabilities | \n
---|---|
Surgery infection | \n2.5 × 10−2 | \n
Wrong site | \n2.6 × 10−5 | \n
Foreign bodies | \n10−3 | \n
Probability of some adverse events.
Factor | \nState | \nOccurrence | \n
---|---|---|
Anesthesia type | \nRegional General | \n0.5 0.5 | \n
Physical state | \nWeak Normal | \n0.1 0.9 | \n
Age | \nAdult Elderly Child | \n0.5 0.2 0.3 | \n
Probability of some factors.
To aggregate the impact of injuries into a single risk measure, we use utility node “Patient Death.” So the task is to find the probability of patient’s death after a surgery by using only the correlations and the marginal frequencies.
\nAfter the structure of the Bayesian network is completed and probabilities are determined, the inference can be performed to estimate the probability of patient’s safety risk. We conduct the calculation using Hugin software. The dependency and the correlation among risks and factors are captured in nodes “Operation error” and “Patient injury.” Hence, the task is to find the probabilities of patient’s death after surgery by using only the correlations and the probabilities of adverse events and the frequency of influencing factors. The probability of the death of patient is 6.37 × 10−3. If the state of one or more variables is known, the model can be updated and the probability of patient injury and operation error will change. This should result in decision of not to operate the patient or postpone the surgery. For instance, the risk is much higher when the patient has a weak physical state; it is 0.02 instead of 5.03 × 10−3 for the risk of death if the patient has a normal physical state. Knowing the age of patient, we can estimate the risk of death; it is 4.98 × 10−3 for adult, 7.08 × 10−3 for elderly patient, and 8.2 × 10−3 for child (Table 8). It should be noted that the model and data used in this chapter have limitations. The model should be enhanced by taking into account different causes of adverse events. Data should be prevented from an adverse event database reporting system and from expert’s judgment.
\nRisk | \nProbabilities | \n
---|---|
Death of patient | \n6.37 × 10−3 | \n
Death of weak physical state patient | \n0.02 | \n
Death of normal physical state patient | \n5.03 × 10−3 | \n
Death of child patient | \n8.2 × 10−3 | \n
Death of adult patient | \n4.98 × 10−3 | \n
Death of elderly patient | \n7.08 × 10−3 | \n
Probability of the death of patient.
Several actions can be done to reduce risk and improve the safety of the patient in operating room. For instance, we can reduce the risk of retained foreign body during operation by using an appropriate sponge count and obtaining X-rays if needed to check for any retained foreign body. If we reduce this risk by 95%, the risk of the death of patient becomes 6.28 × 10−3. Furthermore, if we reduce the risk of surgery infection by 80%, the risk of the death of patient passes to 4.5 × 10−3 instead of 6.28 × 10−3. By acting only on “retained foreign body” and “surgery infection” adverse events, the risk can be reduced by 30%.
\nDue to the lack of data about adverse event and the fact that the adverse event reporting system does not exist, the input data of risk modeling will be provided by expert’s opinion. The quality of such data must be discussed. We must help experts to provide reliable quantitative data. This can be done with the fuzzy set theory. Including the expert’s judgment in the risk model is essential for providing a reliable risk picture supporting the decision-making. The second approach uses the FBN to analyze risk. Fuzzy Bayesian networks are a powerful approach for risk modeling and analysis. This is especially noticed when quantitative data are lacking and only qualitative or vague statements can be made as well when historical adverse events data are unavailable or insufficient to be used for safety assessment [10]. In this part, we present a real case of the children hospital in Rabat. To feed the model by the probabilities, we interviewed experts of the operating room. The calculation of probabilities is done out of Hugin software to conduct the fuzzy inference.
\nIn the following, a methodology of risk analysis of the operating room using FBN is proposed. The methodology follows five steps (Figure 3) and is part of the continuous improvement process (CIP). The first three steps are the same as the first proposed methodology explained above.
\nMethodology of risk analysis for operating room using fuzzy Bayesian network.
The fourth step is the fuzzy assessment of probability. We investigate the expert’s judgment to feed the model. Experts use a linguistic variable to describe the probabilities of occurrence of adverse events. We transform the linguistic expressions into fuzzy numbers. Since we have more than one expert, we must aggregate the different opinions. For that, we use the weight of the expert to take into account the reliability of the data.
\nThe last step is the analysis of the results: we should then analyze and interpret the results of risk measures to support decision-making for safety improvements.
\nFinally, the model must be implemented in Upgrading way as explained in the first method.
\nLet us consider the previous example that we modify according to expert’s opinion. Figure 4 illustrates the BN model of patient’s safety after modification. It shows interrelationships of events that may lead to patient’s injury. The model has eight nodes with one utility node added to estimate the risk of the patient’s death after surgery due to an error.
\nBayesian network for patient safety model for the operating room.
Surgeons and operating team of the children’s hospital IBN SINA of RABAT Morocco were asked to give judgments about the fuzzy probabilities regarding all the nodes. They use linguistic terms to describe the fuzzy probabilities and then refine them with membership functions. For example, “Very low” was assigned to node “PatientFall” and “Average” was assigned to technical defect and then were defined by the membership function (a, b, c). The other probabilities are given in Table 11 according to the answers given by experts. The likelihood of each criterion (Table 9) was represented by a range of five discrete values identified by the following linguistic terms: “extremely low” (L1), “very low” (L2), ”low” (L3), “average” (L4), and “high” (L5). The severity of each adverse event (Table 10) was represented by a range of five discrete values identified by the following linguistic terms: “negligible“ (S1), “minor“ (S2), “medium“ (S3), “major“ (S4), and “catastrophic“ (S5). These five values represent the states of the node “patient’s injury.”
\nSet | \nLinguistic variable | \nMeaning | \n
---|---|---|
L1 | \nExtremely low | \nNever seen | \n
L2 | \nVery low | \nOne time in my career | \n
L3 | \nLow | \nOccur in another hospital | \n
L4 | \nAverage | \nOccur in our hospital | \n
L5 | \nHigh | \nOccur in my domain | \n
Scale of the likelihood.
Set | \nLinguistic variable | \nMeaning | \n
---|---|---|
S1 | \nNegligible | \nConsequence minor without prejudice (simple delay) | \n
S2 | \nMinor | \nIncident with prejudice (disorganization) | \n
S3 | \nMedium | \nIncident with impact postponement, prolongation of hospitalization, not expected transfer in reanimation) | \n
S4 | \nMajor | \nSerious Consequence (re-intervention; permanent or partial disability) | \n
S5 | \nCatastrophic | \nVery serious Consequence (disability, death) | \n
Scale of the severity.
We interviewed three individuals from the operative team (surgeon, crew chief, and anesthesia nurse). They have a different point of view and confidence level toward their own subjective judgments due to the difference in background, working experience, and risk attitudes. Thus, a certain deviation exists in the data reliability among different interviewed individuals.
\nTable 11 represents the weight of each expert. Expert 1 has more experience and more precise answers about adverse events than the others, so he was given the higher weight 1/2, 1/3 was assigned to expert 2, and 1/6 to expert 3.
\nExpert | \nWeight | \n
---|---|
E1 | \nW1 = 1/2 | \n
E2 | \nW2 = 1/3 | \n
E3 | \nW3 = 1/6 | \n
Weight of expert’s opinion.
To deal with the deviation of experts answers, the aggregated fuzzy importance of each criterion, whose properties are used to produce a scalar measure of consensus degree, is computed by the weight of the criteria according to the judgment of the expert (Eq. (1)).
\nThe expert’s judgment about the likelihood and the severity of adverse events is given in Table 12. For instance, the probability (“high,” “L5”) and the severity (“catastrophic,” S5) have been assigned to the node “foreign body” by expert E1; expert E2 had a different judgment about the likelihood of the same event (L3, “Low”). As you can see, experts have different opinions; that is why we used the weight of each expert.
\nNodes | \nVariable | \nE1 | \nE2 | \nE3 | \n|||
---|---|---|---|---|---|---|---|
L | \nS | \nL | \nS | \nL | \nS | \n||
Lack of training | \nB1 | \nL4 | \nS3 | \nL3 | \nS3 | \nL4 | \nS4 | \n
Lack of materiel | \nB2 | \nL4 | \nS3 | \nL3 | \nS3 | \nL4 | \nS4 | \n
Technical defect | \nB3 | \nL4 | \nS3 | \nL3 | \nS2 | \nL4 | \nS4 | \n
Patient fall | \nB4 | \nL2 | \nS3 | \nL3 | \nS2 | \nL1 | \nS2 | \n
Medication error | \nB5 | \nL5 | \nS5 | \nL3 | \nS5 | \nL2 | \nS3 | \n
Surgery infection | \nB6 | \nL5 | \nS4 | \nL3 | \nS4 | \nL3 | \nS3 | \n
Foreign body | \nB7 | \nL5 | \nS5 | \nL3 | \nS5 | \nL2 | \nS4 | \n
Wrong site | \nB8 | \nL4 | \nS4 | \nL3 | \nS4 | \nL2 | \nS3 | \n
Expert’s judgment about the likelihood and the severity of adverse events.
Table 13 represents the fuzzification of the probabilities linguistic variable. For example, the triangular fuzzy number (0.00, 10−8, 2 × 10−8) is assigned to the linguistic variable (“Extremely low,” “L1”). The point (10−8, 1),with membership grade of 1, is the mean value; 0 and 2 × 10−8 are the left hand and right hand spreads of the triangular number, respectively (Table 13).
\nSet | \nLinguistic term | \nFunction | \n
---|---|---|
L1 | \nExtremely low | \nμ1(x) = (0.00, 10−8, 2 × 10−8) | \n
L2 | \nVery low | \nμ2(x) = (1.5 × 10−8, 10−7, 10−6) | \n
L3 | \nLow | \nμ3(x) = (0.9 × 10−6, 10−5, 2 × 10−5) | \n
L4 | \nAverage | \nμ4(x) = (1.5 × 10−5, 10−4, 2 × 10−4) | \n
L5 | \nVery high | \nμ5(x) = (1.5 × 10−4, 10−3, 2 × 10−3) | \n
Fuzzification of likelihood.
M2 represents the vector of probabilities of basic nodes obtained using Eq. (2) and the matrix of fuzzy probabilities estimated by experts and the weight of each expert are given in Table 5. This step aims to determine the fuzzy probabilities of basic events.
\nTable 14 describes the conditional probability of the node “Equipment Failure” represented by the variable N1, this variable has two states, namely true if the risk exists and false if not. If one of the three events B1, B2, and B3 occurs, the risk exists. 1f and 0f represent the crisp values 1 and 0 considered here as fuzzy number 1f (1,1,1) and 0f (0,0,0).
\nN1 | \nB4 | \nB5 | \nB6 | \nB7 | \nB8 | \nS1 | \nS2 | \nS3 | \nS4 | \nS5 | \n
---|---|---|---|---|---|---|---|---|---|---|
True | \nFalse | \nFalse | \nFalse | \nFalse | \nFalse | \n0f | \n0f | \n1f | \n0f | \n0f | \n
False | \nTrue | \nFalse | \nFalse | \nFalse | \nFalse | \n0f | \n1f | \n0f | \n0f | \n0f | \n
False | \nFalse | \nTrue | \nFalse | \nFalse | \nFalse | \n0f | \n0f | \n0f | \n0f | \n1f | \n
False | \nFalse | \nFalse | \nTrue | \nFalse | \nFalse | \n0f | \n0f | \n0f | \n1f | \n0f | \n
False | \nFalse | \nFalse | \nFalse | \nTrue | \nFalse | \n0f | \n0f | \n0f | \n0f | \n1f | \n
False | \nFalse | \nFalse | \nFalse | \nFalse | \nTrue | \n0f | \n0f | \n0f | \n1f | \n0f | \n
Conditional occurrence probability of “patient injury”.
Table 15 represents the conditional probability of the node “Patient injury,” the node has five states S1–S5 according to the severity of the harm caused to the patient. Here, the conditional probability is considered as crisp value according to the expert’s opinion. Based on the harm observed, experts gave a precise answer about severity.
\nB1 | \nB2 | \nB3 | \nN1 = True | \nN1 = False | \n
---|---|---|---|---|
True | \nTrue | \nTrue | \n1f | \n0f | \n
\n | \n | False | \n1f | \n0f | \n
\n | False | \nTrue | \n1f | \n0f | \n
\n | \n | False | \n1f | \n0f | \n
False | \nTrue | \nTrue | \n1f | \n0f | \n
\n | \n | False | \n1f | \n0f | \n
\n | False | \nTrue | \n1f | \n0f | \n
\n | \n | False | \n0f | \n1f | \n
Conditional occurrence probability of “equipment failure”.
After the structure of the BN is developed and probabilities are determined, the inference can be performed to estimate the probability of patient’s safety risk. The dependency and the correlation among risks and factors are captured in node “Patient injury.” Hence, the task is to find the probabilities of patient’s death after surgery by using the correlations and the fuzzy probabilities of adverse events. Using the fuzzy Bayesian rule, the probability that the injury severity will be catastrophic can be calculated as given in Eq. (3):
\nThe probability that the injury severity will be catastrophic (S5) is (1.5 × 10−4, 10−3, 2 × 10−3). Assuming that 80% of patients having a catastrophic injury die, the probability of the death of a patient after surgery due to an adverse event is (1.2 × 10−4, 0.8 × 10−3, 1.6 × 10−3). Using the center of the gravity method (Eq. (4)), we obtained COG = (8.4 × 10−4, 1/3). The probability of the death of a patient after surgery is the x-axis 8.4 × 10−4.
\nSeveral actions can be done to reduce risk and improve the safety of the patient in operating room. Using this model, if we reduce the risk of retained foreign body by 60%, the risk of the death of patient becomes 3.36 × 10−4.
\nIf the state of one or more variables is known, the model can be updated and the probability of patient injury will change.
\nOne of the main advantages of BN is their ability to help us to conduct inverse interference. For example, it is interesting to know, when a death is observed, what the posterior probability of a patient’s infection is. In addition, if the model contains more details witch integrate the main causes of adverse events, we can obtain more interesting results such as the probability of the death of the patient due to human error or lack of training or malfunction in the organization.
\nThe model presented must be updated when new information is available to better estimate the risk of patient safety in the operating room. The model should be enhanced by taking into account different causes of adverse events. The use of adverse event database reporting system may be very useful for getting statistics and determining the probabilities of occurrence of some adverse events. The model allows integrating a mixture source of information (probabilities from database and expert’s opinion).
\nSafety is very essential in the healthcare system. Therefore, we should use effective and flexible methods for risk analysis to improve safety. Bayesian Networks methods are used to model and analyze risk in the operating room. The second method uses, in addition to Bayesian Network, the fuzzy logic. It allows us to use the data provided by expert and deal with the vagueness and imprecision of information. Fuzzy Bayesian network seems more flexible and interpretable than conventional Bayesian network, especially in the context of lack of data concerning risk events. This approach supports human cognition using linguistic variables which is closer to reality.
\nThe application of the two approaches has been explained by the use of a simple model. The aim of this chapter is to propose flexible and effective methods in different context (data availability and lack of data) using Bayesian network.
\nHowever, when the size of the graph is important, the model becomes incomprehensive. We can resolve that by using object-oriented Bayesian network (OOBN). OOBN is a type of Bayesian network, comprising both instance node and usual node. An instance node is a subnetwork representing another Bayesian network. Using OOBNs, a large complex Bayesian network can be constructed as a hierarchy of sub-networks with desired levels of abstract and different levels of detail [11]. For instance, we can transform the node ‘surgery infection’ to a sub-network by analyzing and modeling the causes of this kind of injuries. Therefore, model construction is facilitated and communication between the model’s subnetworks is more effectively performed. OOBN has a better model readability which facilitates the extension and improvement of the model.
\nRemedy actions are always conducted by doctors and nurses upon hazardous occurrences. Timely rescue can largely reduce the practical risks of patient’s injury. By contrast, delayed remedies are of less use. It is therefore necessary to take into account the time. Consideration and incorporation of time-dependent in the risk assessment to represent equipment failure or human reliability are very important. This can be done through dynamic Bayesian network (DBN) models. DBN is an extension of Bayesian network; it is used to describe how variables influence each other over time based on the model derived from past data. A DBN can be thought as a Markov chain model with many states or a discrete time approximation of a differential equation with time steps. A dynamic Bayesian network methodology has been developed to model domino effects in [12]. Another application of DBN is presented in [13] to evaluate stochastic deterioration models.
\nThe Bayesian network presented is a model for assessing risk of patient’s safety in operating room. The model aims to capture and measure risks in the background knowledge (namely common causes and observed adverse events). Including the expert’s judgment in the risk model is essential for providing a reliable risk picture supporting the decision-making. The use of adverse event database reporting system may be very useful for getting statistics and determine the probabilities of occurrence of the adverse events.
\nIn the sports medicine field, in order to evaluate musculoskeletal conditions such as muscle strain injury (MSI), magnetic resonance imaging (MRI) is commonly used in the diagnosis and prognosis of MSI. MRI uses the power of a magnetic field to determine the amount of water present in cells and tissues in the body.
The basic mechanism of MRI is that water has two hydrogen atoms, which are composed of a central proton and surrounding electrons. When a high-frequency current is pulsed to an object, the protons are stimulated and become imbalanced by acting against the gravitational pull of the magnetic field. When the radiofrequency field is turned off, the MRI sensors can detect the energy emitted when the protons rearrange to the magnetic field.
The time it takes for the protons to realign to a magnetic field depends on the environment and nature of the chemistry of the molecule to detect pathological changes [1]. MRI usually includes two types: T1-weighted and T2-weighted images, which are basically sets of settings. In T1-weighted images, the major adipose tissue appears white and the water and liquid components appear black. On the contrary, adipose tissue and fluid components appear white on T2-weighted images and can be used to detect the presence of pathological or morphological changes. Therefore, it can be used to assess fibrotic scar tissue when returning to sports or in the chronic phase of muscle injury to show anatomical features of the tissue [2].
While ultrasound (US) is used in musculoskeletal injury, the US uses high-frequency sound waves to evaluate organs and structures including muscle or other soft tissues. High-spatial-resolution modality provides details of a structure especially superficial area. There are some advantages of using both US and MRI evaluation. MRI is better in evaluating morphological changes, such as scar tissue and deep or large areas. On the other hand, the US is excellent at assessing small areas in detail. Because of its excellent contrast, high spatial resolution, and ability to view soft tissues with multiplanar evaluation, MRI currently appears to be the best imaging method for early-phase diagnosis and follow-up cases of muscle injuries. While the US can be a well-detected imaging method to assess adjunct tissues and can determine real-time conditions of muscle injuries.
There are some kinds of diagnostic US, such as B mode US or shear wave elastography (SWE) for evaluating the musculoskeletal problems. B mode US is easy accessibility and relatively low cost, plus the possibility of real-time evaluation. Therefore, B mode US is widely used in the musculoskeletal field. However, B mode US cannot exactly investigate the biomechanical properties of tissues; therefore, it is difficult to assess the relationship with structural disorganization. In contrast, SWE is a novel noninvasive diagnostic ultrasound modality for analyzing the biomechanical properties of the soft tissues in healthy and pathological conditions.
Acoustic emission impulses are utilized to excite the tissue and measure the distribution of shear wave propagation speed by the shear wave as regards the mechanism of SWE [3]. SWE visualizes shear wave propagation and can quantify tissue stiffness based on the speed of propagation. SWE primarily assesses elasticity, also known as stiffness; the term of stiffness is basically recognized as the extent to which an object resists deformation in response to an applied force, and the speed of shear wave propagation is determined by both the elasticity and viscosity of the tissue [4]. As a result, it evaluates mechanical properties that indicate the deformity as an indicator of the quality of the object’s form and shape. Normal muscle is considered a linear relationship between shear wave modulus and muscle tone. Therefore, normal muscle shows optimal stiffness on SWE (Figure 1) [5]. However, the score of SWE is influenced by the components of collagenous fiber tissue such as epimysium or endomysium; therefore, the definitive optimal stiffness is difficult to determine.
Normal calf muscles are seen with normal echotexture on SWE [
By contrast, B-mode US uses a monitor to convert the intensity of reflected waves into a two-dimensional tomographic image in the cross section parallel to the direction of the ultrasonic wave.
Because B-mode US is operator-independent, relatively reproducible, and quantitative method, SWE is currently considered as a promising real-time visualization tool for explicitly quantifying the mechanical properties of soft tissues in sports medicine [6].
B-mode US has a limitation that it is difficult to show the biomechanical properties of tissues.
Therefore, there is a difficulty to assess certain relationships between structural disorganization and clinical features [7]. On the other hand, SWE can obtain additional morphological information with elastic value of tissue structures and mechanical properties in regard to tissue degeneration, tissue healing, or injury in the wide variety of tissues and injury phases.
Soft tissues, which are referred to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body, are generally recognized viscoelastic, inhomogeneous, and anisotropic [8]. Viscoelastic tissues have both elastic and viscous fluid properties that vary from tissue to tissue [9]. In order to evaluate elasticity, it assumes linear, elastic, solid tissues, a first-order approximation is possible without the force from viscous fluid properties. Elastography systems are based on the prerequisite assumption that object material tissues are elastic, incompressible, homogeneous, and isotropic [10]. Since the elasticity of soft tissues is nonlinear and dependent on the tissue density, strain magnitude, or applied excitation frequency, the evaluation of soft tissues still has been challenging with using diagnostic US.
Utilization of SWE for the musculoskeletal system should be taken into several considerations. Firstly, in order to evaluate swear wave values, a transducer of SWE is put on the surface of the body. As musculoskeletal tissue is heterogeneity, skeletal muscle fibers are surrounded by fascial tissues and passed through by nerve, arteries, veins, and lymphatic vessels. Besides the skin, which is a relatively tight organ, and dermis are superficial to the skeletal muscle fibers [11].
Secondly, the individual muscle fibers are thought to be parallel or oblique to the long axis of the muscle. Muscle fiber types, pennate, unipennate, or multipennate, may affect shear wave measurements; therefore, transductor positioning should be taken according to the muscle fiber architecture.
Thirdly, shear wave value may not change with depth within superficial muscles; however, if the muscle is deeper than 4 cm, the unit of measurement will be difficult to normalize [12].
Lastly, shear wave value, stiffness, can be affected by muscle activities. Changes in SWS measurements with muscle activation are shown during muscle contraction [13]. Plus, SWE measurements are different between active and passive muscles [14]. The more increased tension in the tissue, the more stiffness is measured [15]. Controlling the muscle activation and sustaining the perfect resting positioning are difficult in human in vivo study; therefore, the positioning is special care due to technical errors.
Evaluating for stiffness in MSI used to be difficult because it required a high mechanical load in a view of safety for the participants; however, SWE can have a low invasive approach besides visible in a resting position. In this regard, SWE takes an advantage to other diagnostic tools.
Furthermore, the measurement can be affected by some internal factors. Shear wave values tend to be higher in men than women. In addition, shear wave values are gradually increased according to age [16].
The general process of most MSI cases, and it leads to the typical inflammatory process. Muscle inflammation basically occurs in the following three phases: damage, repair, and remodeling; especially repair and remodeling phases happen almost at the same time. Muscle inflammation is a normal and inevitable process, which is healing tissues, and ensures optimal tissue regeneration in order to lead to proper muscle function. In the inflammatory phase, it begins with the destruction of the injured tissue. This reaction leads to an influx of extracellular calcium and the activation of calcium-dependent proteases and phospholipases. Furthermore, this destructed reaction will secrete the serum proteins deriving from disrupted tissue increase as creatine kinase, present in the cytosol of the muscle cell, and found in excessive mechanical stress or muscle degenerative diseases.
In the regeneration phase, the fibrotic scar tissue formation is built and the mature tissue recovers its muscle function as normal reaction [17]. In this phase, an increase in elastography stiffness can occur.
Recovering functional muscle tissue depends on proper joint motion at the remodeling phase. Proper fiber alignment can be one of the important factors for muscle function.
Fibroblasts play an important role in muscle tissue repair by secreting extracellular matrix (ECM) proteins including: collagen types I and III, fibronectin, elastin, proteoglycans, laminin, and growth factors. However, if fibroblasts excessively secret in ECM, the tissue alters the mechanical characteristics of the muscle, which leads to the development of fibrosis and incomplete muscle recovery [18]. Fibrotic tissue such as fibrotic scar tissue is characterized by the accumulation of ECM, primarily type I collagen. Fibrotic scar tissue is usually induced by chronic connective tissue injuries; however, the relationship between scar tissue and injuries has been still controversial [19]. Therefore, this relationship should be required further investigation and considerations.
MRI is commonly used for the diagnosis and recovery of muscle injuries [20].
T2 mapping may be useful from a musculoskeletal injury. Using a series of diffusion-weighted images and subsequent muscle fiber tracking, diffusion tensor imaging provides diffusion quantification of anisotropic tissues such as muscle tissues.
It has been shown that diffusion tensor imaging can be useful for identifying muscle fiber direction, detecting the subclinical changes after a muscle injury, and differentiating injured muscles from normal control muscles [21].
In the general clinical practice especially in sports medicine, MRI observation is suggested to monitor recovery following the injury and decide to return to play. It is basically observed increased signal intensity on fluid-sensitive sequences consistent with edema may persist after resolution of clinical symptoms 6 weeks after the onset of injury. However, even though almost all athletes that are clinically recovered and successfully returned to play showed increased signal intensities on fluid-sensitive sequences, MRI feature only should not be the decision to return to play because it is moderate correlation between clinical assessment using functional tests and MRI findings, plus it showed that functional testing was more accurate than MRI assessment [22].
B mode US offers dynamic muscle assessment in acute musculoskeletal injury. It is a fast, relatively inexpensive, easier tool for the injuries. And also, it allows serial evaluation for the healing process, and it can be used to perform real-time interventions. In addition, B mode US takes an advantage to MRI in regard that it can demonstrate relevant anatomy surrounding an injury. In acute injury, it is sometimes difficult to show the tissues on MRI images due to inflammation reactions such as an edema [23].
Normal muscle fibers are properly arranged in parallel to fibrofatty septa. The muscle fibers and fascicles are usually hypo echogenicity compared with adjacent fascial tissues. Thick hyperechoic areas are dense fibrous content, which basically contains collagen fiber.
B mode US shows that normal muscle is hypoechoic muscle bundles and the linear hyperechoic perimysium are arranged in layers (Figure 2).
Normal calf muscles are seen with proper layered fiber arrangement on B mode US [
From a clinical perspective, in grade 1 MSI injuries, B mode US images may be either negative or exhibit focal or diffuse areas of increased echogenicity within the muscle at the site of injury. As Grade 1 MSI is known with or without actual fiber disruption, it may include injuries exhibiting minimal focal fiber disruption occupying less than 5% of the cross-sectional area of the muscle. The site of injury is represented by a well-defined focal hypoechoic or anechoic area within the muscle. However, there is no consensus about this definition. Therefore, the exact classification is unclear between grade 1 and grade 2 MSI [24]. In grade 2 MSI, the presence of areas of partial fiber disruption is less than 100% of the cross-sectional area of the muscle. Discontinuous fiber arrangement is usually seen in the echogenic perimysium striae around either the myotendon junction or the myofascial junction. Obvious intramuscular hematoma is normally seen in grade 2 MSI in initial almost 24–48 h. In this inflammation phase, hematomas may solidify and display increased echogenicity in comparison to the surrounding muscle. Up to 48 h, hematomas will develop into a well-defined hypoechoic fluid collection with an echogenic margin. In grade 3 MSI, total disruption or discontinuous fiber arrangement is observed on the B mode US. Perifascial fluid may be depicted on the B mode US and with hypoechoic area, which is the presence of extravascular blood in the inflammation phase.
The evaluation of B mode US should be careful because the linear configuration of the septae makes them susceptible to anisotropy artifact leading to decreased echogenicity or absence of conspicuity of septae.
The evaluation of SWE, when MSI occurred, the stiffness as shear wave value is decreased for 4–8 weeks. Then the stiffness is gradually increased, and it can generally return to a similar value as the uninjured side. This phenomenon is well explained that muscle tissue is properly in the acute phase of the healing process (Figures 3 and 4) [25].
The healing process of gastrocnemius muscle imaging B mode US [
The healing process of gastrocnemius muscle imaging and SWE [
Furthermore, another study shows that the stiffness of the postoperative tendon initially decreases and gradually increases following the recovery phases [26].
Improper healing tissue can be potential for re-injury; therefore; these results will be the parameter for return to play [27].
After MSI injury, MRI evaluation is basically used for injury evaluation in the acute phase.
Importantly, the T2 value is highest at 5 days on MRI while shear wave value is highest at 2 days on SWE.
In the early stages of MSI, scar tissue formation can be visible as low signal intensity on T1-weighted images and high signal intensity on fluid-sensitive MRI. Scar tissue is observed almost 6 weeks after MSI, which can display low signal intensity on T1-weighted and high signal intensity on fluid-sensitive MRI at early stages.
It is typical for scar tissue to display as low signal intensity with MRI pulse sequences at the late stages. In the clinical practice, it may be misdiagnosed due to residual scar tissue and lead to over- or under-identification of new injuries [28].
During the healing phase up to a couple of months after MSI, differences in the hydrogen and proton environment due to obtained structural tissue changes including hemorrhage may contribute to susceptibility artifacts. It may be observed during follow-up evaluation. A study shows that MRI could evaluate morphologic changes of musculotendon remodeling following MSI by using quantification of the scar tissue volumes [29].
The US can observe the healing process of injured tissues depending on the nature of the original injury. The B mode US may appear hyperechogenic during the healing phase. Normal tissue healing is considered a reduction in size or resolution of the region of increased echogenicity [30]. Even though the B mode US can evaluate the chronic phase of injured tissue, it is less sensitive than MRI to residual morphologic changes after MSI for the higher soft-tissue contrast and high to extracellular fluid in MRI [31]. In clinical practice, the detection of small echogenic scar tissue by using the B mode US is difficult for a less experienced practitioner. As mentioned above, the relationship between demonstration of scar tissue and re-injury is still controversial. However, excessive scar tissue may be symptomatic that is described as “feeling tight.” It may disturb neural tension, which leads to re-injury [32].
Scar tissue is often shown as irregular thickening of the fascial tissue compared with the uninjured side on the B mode US [33].
Skeletal muscles are also composed of connective tissue, which resists and transmits the force generated by myofibrils to the tendon and bone structures to generate physical movement. When skeletal muscles are injured, any one of these components including fascial tissue can be damaged [18].
SWE can take an advantage to evaluate tissue properties in chronic phase compared with B mode US. SWE can evaluate the absolute elasticity value of soft tissue structures and obtain useful quantitative information about the mechanical properties in the chronic phase.
In the chronic phase of MSI, the stiffness is significantly higher in the chronic phase compared with the acute phase [25].
In the chronic phase of tendon rupture injury, the stiffness of the tissue gradually increased following the healing process with or without surgical repair [34].
From these results, SWE can be a useful tool for evaluating in the phase of transition of acute to chronic phase.
Tendinopathy is considered to occur from mechanical, degenerative, and overuse diseases. It is associated with degeneration and disorganization of the collagenous structure, changes in the proteoglycan and water contents, increased cellularity, fatty infiltration, and neovascularization due to repetitive mechanical stress [35]. A study of tendinopathy shows tendon stiffness is correlated with the patients’ symptom scores, demonstrating the promise of shear wave elastography during follow-up for tendinopathies [36].
Interestingly, by evaluating SWE, injured area of fascial tissue increased stiffness between injured leg and uninjured leg in 11 injured professional rugby players, mean average of shear wave modulus on injured side (17.34 ± 9.04 kPa) and maximum shear wave modulus on injured side (33.53 kPa) compared with mean average of shear wave modulus on uninjured side (12.7 ± 4.96 kPa) and maximum shear wave modulus on uninjured side (20.86 kPa) (Figures 5 and 6) [37].
The stiffness of fascial tissue of injured side by using Q box trace mode, and the unit was given automatically by machine in kilopascal units. Injured side stiffness is higher than that of uninjured side.
The stiffness of fascial tissue of uninjured side by using Q box trace mode, and the unit was given automatically by machine in kilopascal units.
Chronic cumulative injury can affect the fascial tissue in addition to the chronic phase of direct trauma. Cumulative mechanical stress leads to fibrotic tissue, thickness of tendinous tissue could be related to the injury [38]. Repetitive cumulative stress, especially eccentric contraction, causes microscopic tissue damage and increases inflammation. ECM of tissue changes plays an important role in tissue stiffness changes [39]. Change in property of ECM by cumulative stress may affect the stiffness in the chronic musculoskeletal injury.
Considering the results, in chronic musculoskeletal injury, it affects not only the muscle tissue but also a wide variety of tissues including fascial tissue. Even though a wide variety of ultrasound imaging has been used in fascial tissue, there is a lack of standardization [40]. SWE can be a more accurate diagnostic tool compared with B-mode, and the combination of SWE and B-US can be a strong diagnostic tool for fascial pathology [41].
To measure the fascial tissue, SWE provides the images reflecting the shear wave value as a tightness of the area of interest.
As considering the tissue property depending on viscoelastic property, utilization of SWE can be a useful tool for evaluating a wide variety of tissues in chronic musculoskeletal injury.
To explain fascial tissue, the term Fascia is used to be recognized as “a sheet or band of soft connective tissue that attaches, surrounds and separates internal organs and skeletal muscles.” However, according to the recognition of physiological and pathophysiological behaviors of a range of connective tissues, the definition is widely considered. With current understanding of mechanical aspects of connective tissue function, fascia is considered in the view of micro to macro as fibril to fascial system. From a morphological view, fascia is described as a sheet or any other dissectible aggregations of connective tissue that forms beneath the skin to attach, enclose, and separate muscles and other internal organs.
There are several types of fascial tissues in the fascial system. The fascial system consists of adipose tissue, adventitia, neurovascular sheaths, aponeuroses, deep and superficial fasciae, dermis, epineurium, joint capsules, ligaments, membranes, meninges, myofascial expansions, periostea, retinacula, septa, tendons. The fascial system is also considered to be included endotendon, peritendon, epitendon, and paratenson, visceral fasciae, and all the intramuscular and intermuscular connective tissues, including endomysium, perimysium, epimysium. The fascial system consists of various components, and it is built on three-dimensional soft seamless collagenous fibers. The loose and dense fibrous connective tissue fills the whole body and allows the integration of body systems.
With injured fascial tissues, it will have a very similar healing process to muscle injury. Micro or macro changes occurred by excessive or repetitive loading or direct trauma of fascial tissue. The pathological changes will modify mechanical function that compromises initial tissue or function. In the acute inflammation phase of fascial tissue, immune response proceeds by phagocytose from the injured cell. It releases proinflammatory cytokines and macrophages to promote immune cell infiltration. If the excessive loading is chronically prolonged, continuing inflammation develops, which leads to the presence of cytotoxic cytokines affected tissues. From this reaction, interleukin-1β, tumor necrosis factor (TNF) and transforming growth factor beta (TGFβ-1)) can promote fibrosis by excessive fibroblast proliferation and collagen matrix deposition that consequently develops fibrotic tissue. A study indicates that substance P stimulates TGFβ-1, which leads to fibrotic tissue development [42]. That phenomenon shows in the chronic phase of fascial injury.
Most pathological cases of fascial tissue demonstrated that a decreased tissue stiffness is present, while some cases demonstrated an increased stiffness due to fibrotic tissues.
However, the viscoelasticity is varied from tissue to tissue. The stiffness of tissue can be affected by the viscoelastic properties of ECM, especially the aponeurotic tissue containing loose connective tissue in which the ECM has ground substances, such as glycosaminoglycans (GAGs) especially hyaluronan (HA)-containing fluid between each layer [43]. The fascial component of the ECM is the main site of the inflammatory responses that occur in tissues. Thus, when the tissue reacts to an inflammatory response, the viscosity of the tissue can be increased, which could lead to increased viscoelasticity of the fascial tissue.
Evaluation of the stiffness of fascial tissue using SWE is considered as viscoelastic, inhomogeneous tissues [44]. The shear modulus value, stiffness, of fascial tissue is affected not only by the fibrotic tissue itself, but also ground substances and fluid components [45]. Therefore, stiffness is affected not only by pure elastic properties, but also by viscosity properties in the fascial tissue [46].
Fascial tissue can be affected by viscoelastic properties more than muscle [47].
Fascial tissue should include loose connective tissue, which contains rich ground substances between each layer. These properties affect the movement of loose connective tissue within and under the tissues [48].
In the chronic condition of MSI, the concentration and molecular weight of HA are altered. In this regard, binding interactions with other macromolecules may affect the sliding movement of fascial tissues [49]. Generally speaking, elastic tissues are hydrophilic and function using a tissue sliding system. However, fibrotic tissues exhibit an altered tissue sliding system, which affects the rehydration and expansion [50]. Therefore, in chronic MSI with scar tissue, there may be less function of rehydration; consequently, it will be stiffer tissue than healthy tissue. Even though SWE is considered not operator-dependent, the viscosity component will affect the results of measurement. Therefore, viscoelastic tissue such as fascial tissue must take special consideration in chronic musculoskeletal conditions.
This phenomenon may affect our daily activities for some reasons.
First, fascial tissues are rich in nerve receptors and free and encapsulated nerve endings including Pacinian corpuscles and Ruffini endings. Those receptors detect and react to mechanical stimulations [51]. As the tissue is stimulated, the nerve endings react and provide sensory feedback that translates into the human ability to detect and coordinate movement and achieve neuromuscular control. Chronic musculoskeletal issues, especially with fibrotic scar tissue, can alter the movement in daily activities.
Secondly, changes in the viscoelasticity of the tissues, basically modulated by ground substances, alter pain sensitivity as activation of nociceptors [48]. The more adhered tissue such as an inflamed tissue, the less lubricated that leads to the alteration of the tissue sliding. Thus, nociceptors can translate mechanical stimuli into pain sensation; consequently, incorrect sensory feedback will modify proprioceptors to nociceptors. Finally, myofascial network transmits to other tissues for muscle force [52]. Stiffened tissue affects this transmission and may change muscle mechanics [53]. Therefore, impaired myofascial force transmission by stiffened tissue may have a negative effect on the proper muscle biomechanics.
SWE is a newly developed diagnostic tool and is widely used in the musculoskeletal system.
SWE is a promising diagnostic modality for MSI and the accurate measurement of muscle and fascial tissues’ properties, which has a major impact in clinical practice. In this chapter, diagnostic tools of magnetic resonance imaging, B mode ultrasound, and shear wave elastography in both acute and chronic phases are compared. There are pros and cons for utilization between the tools; however, there is new insight by using SWE in MSI not only properties of muscle but also fascial tissues. SWE generally evaluates tissue stiffness as viscoelasticity. SWE visualizes the propagation of shear waves and can quantify tissue “stiffness” by the speed of propagation. In the chronic MSI cases, viscoelasticity comes from ground substances, which are contained more in fascial tissue. The stiffness increases in fascial tissue more than muscle; therefore, in the chronic case of MSI, not only muscle but also a wide variety of connective tissues can be considered. However, utilization of SWE should be careful due to technical pitfalls or internal factors. All in all, SWE is a promising diagnostic modality for MSI and the accurate measurement of muscle and fascial tissues properties, which has a major impact in clinical practice. There are few studies that investigate for chronic musculoskeletal problem including fascial tissue problem by using SWE especially in clinical trials. Furthermore, the shear wave value is different according to active muscle contraction. Therefore, further studies for chronic musculoskeletal problem will be expected in a wide variety of conditions.
The authors declare no conflict of interest.
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\\n\\nIntechOpen has collaborated with Enago, through its sister brand, Ulatus, which is one of the world’s leading providers of book translation services. The services are designed to convey the essence of your work to readers from across the globe in a language they understand. Enago’s expert translators incorporate cultural nuances in translations to make the content relevant for local audiences while retaining the original meaning and style. Enago translators are equipped to handle all complex and multiple overlapping themes encompassed in a single book and their high degree of linguistic and subject expertise enables them to deliver a superior quality output.
\\n\\nIntechOpen Authors that wish to use this service will receive a 20% discount on all translation services. To find out more information or obtain a quote, please visit: https://www.enago.com/intech.
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\\n\\nWe feel that financial barriers should never prevent researchers from publishing their work. Please consult our Open Access Funding page to explore funding opportunities and learn more about how you can finance your IntechOpen publication.
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\\n\\nFor a complete overview of all publishing process steps and descriptions, go to How Open Access Publishing Works.
\\n\\nSEND YOUR PROPOSAL
\\n\\nIf you are interested in publishing your book with IntechOpen, please submit your book proposal by completing the Publishing Proposal Form.
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\n\n*The price does not include Value-Added Tax (VAT). Residents of European Union countries need to add VAT based on the specific rate applied in their country of residence. Institutions and companies registered as VAT taxable entities in their own EU member state will not pay VAT by providing us with their VAT registration number. This is made possible by the EU reverse charge method.
\n\nOptional Services
\n\nIntechOpen has collaborated with Enago, through its sister brand, Ulatus, which is one of the world’s leading providers of book translation services. The services are designed to convey the essence of your work to readers from across the globe in a language they understand. Enago’s expert translators incorporate cultural nuances in translations to make the content relevant for local audiences while retaining the original meaning and style. Enago translators are equipped to handle all complex and multiple overlapping themes encompassed in a single book and their high degree of linguistic and subject expertise enables them to deliver a superior quality output.
\n\nIntechOpen Authors that wish to use this service will receive a 20% discount on all translation services. To find out more information or obtain a quote, please visit: https://www.enago.com/intech.
\n\nFUNDING
\n\nWe feel that financial barriers should never prevent researchers from publishing their work. Please consult our Open Access Funding page to explore funding opportunities and learn more about how you can finance your IntechOpen publication.
\n\nBENEFITS
\n\nPUBLISHING PROCESS STEPS
\n\nFor a complete overview of all publishing process steps and descriptions, go to How Open Access Publishing Works.
\n\nSEND YOUR PROPOSAL
\n\nIf you are interested in publishing your book with IntechOpen, please submit your book proposal by completing the Publishing Proposal Form.
\n\nNot sure if this is the right option for you? Please refer back to the main Publish with IntechOpen page or feel free to contact us directly at book.department@intechopen.com.
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Considering the social responsibility of universities with a large number of stakeholders (students, institutions, government, employees, companies, local community, etc.), this chapter aims to examine how these institutions establish the mission, objectives and strategic actions oriented at meeting these expectations. In this line, university in its daily management is also considered a corporate entity, which set up strategic plans and practices, an essential process to achieve its success in the long term. The chapter explores the necessary steps for adjusting these strategic plans to the new challeng e of introducing a socially responsible orientation in their management.",book:{id:"5968",slug:"corporate-governance-and-strategic-decision-making",title:"Corporate Governance and Strategic Decision Making",fullTitle:"Corporate Governance and Strategic Decision Making"},signatures:"Elva L. 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In addition, companies use a specific communication strategy to communicate the results of sustainable activities involving strategic stakeholders. In a sample of companies included in the Dow Jones Sustainability Index and Global Rep Track 100, we analyze the corporate social responsibility (CSR) strategy of these companies, how they integrate the Sustainable Development Goals, and how they create a dialogue with their stakeholders across different platforms. The study of the sample is performed by content analysis on identity values and their correspondence with the CSR values, and this study includes an analysis of activities that these companies develop communicating their impacts. The results show that companies have actively integrated their stakeholders into their business management. However, these companies incorporate the concept of value creation in a different manner, although their activities are oriented to the stakeholders as to the benefit of society.",book:{id:"5968",slug:"corporate-governance-and-strategic-decision-making",title:"Corporate Governance and Strategic Decision Making",fullTitle:"Corporate Governance and Strategic Decision Making"},signatures:"Belén López and Abel Monfort",authors:[{id:"201681",title:"Dr.",name:"Belen",middleName:null,surname:"Lopez",slug:"belen-lopez",fullName:"Belen Lopez"},{id:"203451",title:"Dr.",name:"Abel",middleName:null,surname:"Monfort",slug:"abel-monfort",fullName:"Abel Monfort"}]},{id:"56244",doi:"10.5772/intechopen.69704",title:"Corporate Governance",slug:"corporate-governance",totalDownloads:1524,totalCrossrefCites:2,totalDimensionsCites:4,abstract:"The following chapter identifies the meaning and main features of corporate governance, underlines the importance of an entity, which regulates and balances the interests of shareholders, stakeholders, and managers in order to realize a corporation’s long-run goals. Currently, all models of corporate governance can be divided by their characteristics into three types: Anglo-American, German, and Japanese; each of these models has some unique elements that are required by a particular country. The process of forming and development of corporate governance in transitional economies are described as well. As the accuracy of corporate government influences the wiliness of investors to sink their capital, it is crucial to understand the methods of corporate governance efficiency evaluation by international rating agencies. Moreover, the example of Enron Corporation’s failure shows the exceptional role of corporate governance in protecting and ensuring the rights of shareholders and stakeholders, solving the conflict between managers seeking higher bonuses and investors’ goals on stable future return and potential growth.",book:{id:"5968",slug:"corporate-governance-and-strategic-decision-making",title:"Corporate Governance and Strategic Decision Making",fullTitle:"Corporate Governance and Strategic Decision Making"},signatures:"Alla Mostepaniuk",authors:[{id:"202902",title:"Dr.",name:"Alla",middleName:null,surname:"Mostepaniuk",slug:"alla-mostepaniuk",fullName:"Alla Mostepaniuk"}]},{id:"67555",doi:"10.5772/intechopen.86748",title:"Principles of Equality: Managing Equality and Diversity in a Steiner School",slug:"principles-of-equality-managing-equality-and-diversity-in-a-steiner-school",totalDownloads:1098,totalCrossrefCites:3,totalDimensionsCites:4,abstract:"Principles of equality are examined in the context of managing equality and diversity in practice. Our case study is the Cardiff Steiner School, an independent international school located in Wales, UK with educational values guided by the philosophers and educationalists Rudolf Steiner and Millicent Mackenzie. The sustainable management referred to and assessed in this chapter is the School’s management structure and the related School pedagogical operation, with the founding Steiner value of human justice informing these. We argue that at this School the management of equality and diversity reflects theories of Diversity and Equality Management, with School managers aspiring to encourage respect for all. We appraise the philosophical and spiritual values of the founders in relation to equality and diversity, in order to demonstrate the visionary ideals of these philosophers and the extent to which their beliefs live on sustainably in contemporary society, and particularly in a Steiner education community.",book:{id:"9337",slug:"sustainable-management-practices",title:"Sustainable Management Practices",fullTitle:"Sustainable Management Practices"},signatures:"Robin Attfield and Kate Attfield",authors:[{id:"302273",title:"Emeritus Prof.",name:"Robin",middleName:"N.A.",surname:"Attfield",slug:"robin-attfield",fullName:"Robin Attfield"},{id:"302338",title:"Dr.",name:"Kate",middleName:null,surname:"Attfield",slug:"kate-attfield",fullName:"Kate Attfield"}]}],mostDownloadedChaptersLast30Days:[{id:"55244",title:"Corporate Governance and Fraud: Evolution and Considerations",slug:"corporate-governance-and-fraud-evolution-and-considerations",totalDownloads:3067,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"There are many definitions of Corporate Governance, as a structure, as process, as policies, as mechanisms, but despite their differences of focus, they mainly addressed the sustainable economic growth and protection of shareholders and other stakeholder’s rights. The purpose here is to present the evolution of the main principles and frameworks as corporate and financial environment changes and set new challenges. Some important scandals that revealed the weaknesses of corporate governance frameworks are described to complement the comprehension of the object of it. It is detached the aspects simulated or ignored and the subsequent enforcement and monitoring response. Discussion about the new challenges, what corporate governance is supposed to provide and what it can promote, closes this chapter.",book:{id:"5968",slug:"corporate-governance-and-strategic-decision-making",title:"Corporate Governance and Strategic Decision Making",fullTitle:"Corporate Governance and Strategic Decision Making"},signatures:"Ana Paula Paulino da Costa",authors:[{id:"201677",title:"Dr.",name:"Ana Paula P.",middleName:null,surname:"Costa",slug:"ana-paula-p.-costa",fullName:"Ana Paula P. Costa"}]},{id:"56123",title:"Corporate Governance Codes and Their Role in Improving Corporate Governance Practice",slug:"corporate-governance-codes-and-their-role-in-improving-corporate-governance-practice",totalDownloads:3224,totalCrossrefCites:1,totalDimensionsCites:4,abstract:"Good corporate governance (CG) is primarily the responsibility of every company, and both hard law and soft law should provide comprehensive corporate governance framework, thereby encouraging the introduction of high governance standards and best practices in the companies’ corporate governance system. The aim of this contribution is to broaden understanding on the role of codes of good governance in improving corporate governance practice on the case of Slovenia. The findings of research studies and analyses of the content of the Slovenian CG Code and its adoption in Slovenian companies show that the code has been playing an important role in developing corporate governance practice in Slovenia. Additionally, such analyses provide important cognitions on the adoption of the CG Code in Slovenian companies by revealing improvements in the governance practice and indicating those areas where changes are required. That is a way such monitoring and analyses should be done on the regular basis together with reporting on the monitoring results. This can considerably contribute to better understanding of the code’s recommendations among companies, promote debate and thus foster awareness of the underlying issues. Future analyses should address not only the statements on compliance but also how companies actually implement the code’s recommendations.",book:{id:"5968",slug:"corporate-governance-and-strategic-decision-making",title:"Corporate Governance and Strategic Decision Making",fullTitle:"Corporate Governance and Strategic Decision Making"},signatures:"Mojca Duh",authors:[{id:"202681",title:"Dr.",name:"Mojca",middleName:null,surname:"Duh",slug:"mojca-duh",fullName:"Mojca Duh"}]},{id:"56867",title:"Strategic Decision Making and Its Importance in Small Corporations",slug:"strategic-decision-making-and-its-importance-in-small-corporations",totalDownloads:2074,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"The global economic crisis has sharply affected thousands of small corporations and declared bankruptcy. It is likely that in the form in which they are working now, they will not be able to survive the economic pressure of competitors. Effective policy‐making can be an important key to success. Analysis of the process of strategic decision making in small corporations is extensive research gap that we try to fill with the contribution. We put emphasis on strategic decisions, models of the strategic decision‐making factors affecting the profile of these processes and mechanisms that make use of small corporation managers in strategic decision making. The conclusions of the research are identified the most important aspects influencing and forming process of strategic decision making by managers of small corporations.",book:{id:"5968",slug:"corporate-governance-and-strategic-decision-making",title:"Corporate Governance and Strategic Decision Making",fullTitle:"Corporate Governance and Strategic Decision Making"},signatures:"Nadežda Jankelová",authors:[{id:"202315",title:"Dr.",name:"Nadežda",middleName:null,surname:"Jankelova",slug:"nadezda-jankelova",fullName:"Nadežda Jankelova"}]},{id:"56008",title:"Gaining a Competitive Advantage through Green Human Resource Management",slug:"gaining-a-competitive-advantage-through-green-human-resource-management",totalDownloads:2222,totalCrossrefCites:8,totalDimensionsCites:16,abstract:"The practices of environmental protection and the prevention of environmental pollution have emerged as a result of recent environmental problems when the humans noticed that natural resources are limited. Environmental management practices have accelerated with the conscious acts of businesses on environmental issues since they have the greatest responsibility for environmental pollution. After the 2000s, businesses have started to prefer to be a part of the solution rather than being at the center of the problem and tended to green business and management practices. For improved environmental performance, sustainable competitive advantage, and environmental management, environmental consciousness should be taken into consideration in each and every human resource function ranging from recruitment to training of employees, from performance assessment to rewarding. In this sense, green human resources management (GHRM), allowing improved employee consciousness and commitment to environmental sustainability, has become an interesting issue. In the present study, green human resources management and practices are evaluated, significant issues are pointed out, and recommendations are made for future researchers who wish to work upon this subject.",book:{id:"5968",slug:"corporate-governance-and-strategic-decision-making",title:"Corporate Governance and Strategic Decision Making",fullTitle:"Corporate Governance and Strategic Decision Making"},signatures:"Ebru Aykan",authors:[{id:"202532",title:"Dr.",name:"Ebru",middleName:null,surname:"Aykan",slug:"ebru-aykan",fullName:"Ebru Aykan"}]},{id:"56333",title:"Universities as Corporate Entities: The Role of Social Responsibility in Their Strategic Management",slug:"universities-as-corporate-entities-the-role-of-social-responsibility-in-their-strategic-management",totalDownloads:2023,totalCrossrefCites:8,totalDimensionsCites:14,abstract:"Universities, as educational institutions, play a vital role in the development and improvement of the society, contributing to the welfare of citizens. Considering the social responsibility of universities with a large number of stakeholders (students, institutions, government, employees, companies, local community, etc.), this chapter aims to examine how these institutions establish the mission, objectives and strategic actions oriented at meeting these expectations. In this line, university in its daily management is also considered a corporate entity, which set up strategic plans and practices, an essential process to achieve its success in the long term. The chapter explores the necessary steps for adjusting these strategic plans to the new challeng e of introducing a socially responsible orientation in their management.",book:{id:"5968",slug:"corporate-governance-and-strategic-decision-making",title:"Corporate Governance and Strategic Decision Making",fullTitle:"Corporate Governance and Strategic Decision Making"},signatures:"Elva L. 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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:"13",title:"Veterinary Medicine and Science",doi:"10.5772/intechopen.73681",issn:"2632-0517",scope:"Paralleling similar advances in the medical field, astounding advances occurred in Veterinary Medicine and Science in recent decades. These advances have helped foster better support for animal health, more humane animal production, and a better understanding of the physiology of endangered species to improve the assisted reproductive technologies or the pathogenesis of certain diseases, where animals can be used as models for human diseases (like cancer, degenerative diseases or fertility), and even as a guarantee of public health. Bridging Human, Animal, and Environmental health, the holistic and integrative “One Health” concept intimately associates the developments within those fields, projecting its advancements into practice. This book series aims to tackle various animal-related medicine and sciences fields, providing thematic volumes consisting of high-quality significant research directed to researchers and postgraduates. It aims to give us a glimpse into the new accomplishments in the Veterinary Medicine and Science field. By addressing hot topics in veterinary sciences, we aim to gather authoritative texts within each issue of this series, providing in-depth overviews and analysis for graduates, academics, and practitioners and foreseeing a deeper understanding of the subject. Forthcoming texts, written and edited by experienced researchers from both industry and academia, will also discuss scientific challenges faced today in Veterinary Medicine and Science. In brief, we hope that books in this series will provide accessible references for those interested or working in this field and encourage learning in a range of different topics.",coverUrl:"https://cdn.intechopen.com/series/covers/13.jpg",latestPublicationDate:"June 29th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:11,editor:{id:"38652",title:"Prof.",name:"Rita",middleName:null,surname:"Payan-Carreira",slug:"rita-payan-carreira",fullName:"Rita Payan-Carreira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRiFPQA0/Profile_Picture_1614601496313",biography:"Rita Payan Carreira earned her Veterinary Degree from the Faculty of Veterinary Medicine in Lisbon, Portugal, in 1985. She obtained her Ph.D. in Veterinary Sciences from the University of Trás-os-Montes e Alto Douro, Portugal. After almost 32 years of teaching at the University of Trás-os-Montes and Alto Douro, she recently moved to the University of Évora, Department of Veterinary Medicine, where she teaches in the field of Animal Reproduction and Clinics. Her primary research areas include the molecular markers of the endometrial cycle and the embryo–maternal interaction, including oxidative stress and the reproductive physiology and disorders of sexual development, besides the molecular determinants of male and female fertility. She often supervises students preparing their master's or doctoral theses. She is also a frequent referee for various journals.",institutionString:null,institution:{name:"University of Évora",institutionURL:null,country:{name:"Portugal"}}},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:!1,editor:null,editorTwo:null,editorThree:null},{id:"4",title:"Fungal Infectious Diseases",coverUrl:"https://cdn.intechopen.com/series_topics/covers/4.jpg",isOpenForSubmission:!0,editor:{id:"174134",title:"Dr.",name:"Yuping",middleName:null,surname:"Ran",slug:"yuping-ran",fullName:"Yuping Ran",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bS9d6QAC/Profile_Picture_1630330675373",biography:"Dr. Yuping Ran, Professor, Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China. Completed the Course Medical Mycology, the Centraalbureau voor Schimmelcultures (CBS), Fungal Biodiversity Centre, Netherlands (2006). International Union of Microbiological Societies (IUMS) Fellow, and International Emerging Infectious Diseases (IEID) Fellow, Centers for Diseases Control and Prevention (CDC), Atlanta, USA. Diploma of Dermatological Scientist, Japanese Society for Investigative Dermatology. Ph.D. of Juntendo University, Japan. Bachelor’s and Master’s degree, Medicine, West China University of Medical Sciences. Chair of Sichuan Medical Association Dermatology Committee. General Secretary of The 19th Annual Meeting of Chinese Society of Dermatology and the Asia Pacific Society for Medical Mycology (2013). In charge of the Annual Medical Mycology Course over 20-years authorized by National Continue Medical Education Committee of China. Member of the board of directors of the Asia-Pacific Society for Medical Mycology (APSMM). Associate editor of Mycopathologia. Vice-chief of the editorial board of Chinses Journal of Mycology, China. Board Member and Chair of Mycology Group of Chinese Society of Dermatology.",institutionString:null,institution:{name:"Sichuan University",institutionURL:null,country:{name:"China"}}},editorTwo:null,editorThree:null},{id:"5",title:"Parasitic Infectious Diseases",coverUrl:"https://cdn.intechopen.com/series_topics/covers/5.jpg",isOpenForSubmission:!0,editor:{id:"67907",title:"Dr.",name:"Amidou",middleName:null,surname:"Samie",slug:"amidou-samie",fullName:"Amidou Samie",profilePictureURL:"https://mts.intechopen.com/storage/users/67907/images/system/67907.jpg",biography:"Dr. Amidou Samie is an Associate Professor of Microbiology at the University of Venda, in South Africa, where he graduated for his PhD in May 2008. He joined the Department of Microbiology the same year and has been giving lectures on topics covering parasitology, immunology, molecular biology and industrial microbiology. He is currently a rated researcher by the National Research Foundation of South Africa at category C2. He has published widely in the field of infectious diseases and has overseen several MSc’s and PhDs. His research activities mostly cover topics on infectious diseases from epidemiology to control. His particular interest lies in the study of intestinal protozoan parasites and opportunistic infections among HIV patients as well as the potential impact of childhood diarrhoea on growth and child development. He also conducts research on water-borne diseases and water quality and is involved in the evaluation of point-of-use water treatment technologies using silver and copper nanoparticles in collaboration with the University of Virginia, USA. He also studies the use of medicinal plants for the control of infectious diseases as well as antimicrobial drug resistance.",institutionString:null,institution:{name:"University of Venda",institutionURL:null,country:{name:"South Africa"}}},editorTwo:null,editorThree:null},{id:"6",title:"Viral Infectious Diseases",coverUrl:"https://cdn.intechopen.com/series_topics/covers/6.jpg",isOpenForSubmission:!0,editor:{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. He is also an international opinion leader/expert in vaccination for Japanese encephalitis by IPIC (UK).",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",institutionURL:null,country:{name:"India"}}},editorTwo:null,editorThree:null}]},overviewPageOFChapters:{paginationCount:10,paginationItems:[{id:"82380",title:"Evolution of Parasitism and Pathogenic Adaptations in Certain Medically Important Fungi",doi:"10.5772/intechopen.105206",signatures:"Gokul Shankar Sabesan, Ranjit Singh AJA, Ranjith Mehenderkar and Basanta Kumar Mohanty",slug:"evolution-of-parasitism-and-pathogenic-adaptations-in-certain-medically-important-fungi",totalDownloads:6,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Fungal Infectious Diseases - Annual Volume 2022",coverURL:"https://cdn.intechopen.com/books/images_new/11400.jpg",subseries:{id:"4",title:"Fungal Infectious Diseases"}}},{id:"82367",title:"Spatial Variation and Factors Associated with Unsuppressed HIV Viral Load among Women in an HIV Hyperendemic Area of KwaZulu-Natal, South Africa",doi:"10.5772/intechopen.105547",signatures:"Adenike O. Soogun, Ayesha B.M. Kharsany, Temesgen Zewotir and Delia North",slug:"spatial-variation-and-factors-associated-with-unsuppressed-hiv-viral-load-among-women-in-an-hiv-hype",totalDownloads:13,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"HIV-AIDS - Updates, Perspectives and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/11575.jpg",subseries:{id:"6",title:"Viral Infectious Diseases"}}},{id:"82193",title:"Enterococcal Infections: Recent Nomenclature and emerging trends",doi:"10.5772/intechopen.104792",signatures:"Kavita Raja",slug:"enterococcal-infections-recent-nomenclature-and-emerging-trends",totalDownloads:7,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Streptococcal Infections",coverURL:"https://cdn.intechopen.com/books/images_new/10828.jpg",subseries:{id:"3",title:"Bacterial Infectious Diseases"}}},{id:"82207",title:"Management Strategies in Perinatal HIV",doi:"10.5772/intechopen.105451",signatures:"Kayla Aleshire and Rima Bazzi",slug:"management-strategies-in-perinatal-hiv",totalDownloads:8,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"HIV-AIDS - Updates, Perspectives and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/11575.jpg",subseries:{id:"6",title:"Viral Infectious Diseases"}}}]},overviewPagePublishedBooks:{paginationCount:13,paginationItems:[{type:"book",id:"6667",title:"Influenza",subtitle:"Therapeutics and Challenges",coverURL:"https://cdn.intechopen.com/books/images_new/6667.jpg",slug:"influenza-therapeutics-and-challenges",publishedDate:"September 19th 2018",editedByType:"Edited by",bookSignature:"Shailendra K. 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He has been honored by different authorities for his outstanding performance in various fields like research and education, and he has received the World Academy of Science Young Scientist Award (2014) and the University Grants Commission (UGC) Award 2018. He is a fellow of the Bangladesh Academy of Sciences (BAS) and the Royal Society of Biology.",institutionString:"Sher-e-Bangla Agricultural University",institution:{name:"Sher-e-Bangla Agricultural University",country:{name:"Bangladesh"}}},{id:"187859",title:"Prof.",name:"Kusal",middleName:"K.",surname:"Das",slug:"kusal-das",fullName:"Kusal Das",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSBDeQAO/Profile_Picture_1623411145568",biography:"Kusal K. Das is a Distinguished Chair Professor of Physiology, Shri B. M. Patil Medical College and Director, Centre for Advanced Medical Research (CAMR), BLDE (Deemed to be University), Vijayapur, Karnataka, India. Dr. Das did his M.S. and Ph.D. in Human Physiology from the University of Calcutta, Kolkata. His area of research is focused on understanding of molecular mechanisms of heavy metal activated low oxygen sensing pathways in vascular pathophysiology. He has invented a new method of estimation of serum vitamin E. His expertise in critical experimental protocols on vascular functions in experimental animals was well documented by his quality of publications. He was a Visiting Professor of Medicine at University of Leeds, United Kingdom (2014-2016) and Tulane University, New Orleans, USA (2017). For his immense contribution in medical research Ministry of Science and Technology, Government of India conferred him 'G.P. Chatterjee Memorial Research Prize-2019” and he is also the recipient of 'Dr.Raja Ramanna State Scientist Award 2015” by Government of Karnataka. He is a Fellow of the Royal Society of Biology (FRSB), London and Honorary Fellow of Karnataka Science and Technology Academy, Department of Science and Technology, Government of Karnataka.",institutionString:"BLDE (Deemed to be University), India",institution:null},{id:"243660",title:"Dr.",name:"Mallanagouda Shivanagouda",middleName:null,surname:"Biradar",slug:"mallanagouda-shivanagouda-biradar",fullName:"Mallanagouda Shivanagouda Biradar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243660/images/system/243660.jpeg",biography:"M. S. Biradar is Vice Chancellor and Professor of Medicine of\nBLDE (Deemed to be University), Vijayapura, Karnataka, India.\nHe obtained his MD with a gold medal in General Medicine and\nhas devoted himself to medical teaching, research, and administrations. He has also immensely contributed to medical research\non vascular medicine, which is reflected by his numerous publications including books and book chapters. Professor Biradar was\nalso Visiting Professor at Tulane University School of Medicine, New Orleans, USA.",institutionString:"BLDE (Deemed to be University)",institution:{name:"BLDE University",country:{name:"India"}}},{id:"289796",title:"Dr.",name:"Swastika",middleName:null,surname:"Das",slug:"swastika-das",fullName:"Swastika Das",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/289796/images/system/289796.jpeg",biography:"Swastika N. Das is Professor of Chemistry at the V. P. Dr. P. G.\nHalakatti College of Engineering and Technology, BLDE (Deemed\nto be University), Vijayapura, Karnataka, India. She obtained an\nMSc, MPhil, and PhD in Chemistry from Sambalpur University,\nOdisha, India. Her areas of research interest are medicinal chemistry, chemical kinetics, and free radical chemistry. She is a member\nof the investigators who invented a new modified method of estimation of serum vitamin E. She has authored numerous publications including book\nchapters and is a mentor of doctoral curriculum at her university.",institutionString:"BLDEA’s V.P.Dr.P.G.Halakatti College of Engineering & Technology",institution:{name:"BLDE University",country:{name:"India"}}},{id:"248459",title:"Dr.",name:"Akikazu",middleName:null,surname:"Takada",slug:"akikazu-takada",fullName:"Akikazu Takada",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248459/images/system/248459.png",biography:"Akikazu Takada was born in Japan, 1935. After graduation from\nKeio University School of Medicine and finishing his post-graduate studies, he worked at Roswell Park Memorial Institute NY,\nUSA. He then took a professorship at Hamamatsu University\nSchool of Medicine. In thrombosis studies, he found the SK\npotentiator that enhances plasminogen activation by streptokinase. He is very much interested in simultaneous measurements\nof fatty acids, amino acids, and tryptophan degradation products. By using fatty\nacid analyses, he indicated that plasma levels of trans-fatty acids of old men were\nfar higher in the US than Japanese men. . He also showed that eicosapentaenoic acid\n(EPA) and docosahexaenoic acid (DHA) levels are higher, and arachidonic acid\nlevels are lower in Japanese than US people. By using simultaneous LC/MS analyses\nof plasma levels of tryptophan metabolites, he recently found that plasma levels of\nserotonin, kynurenine, or 5-HIAA were higher in patients of mono- and bipolar\ndepression, which are significantly different from observations reported before. In\nview of recent reports that plasma tryptophan metabolites are mainly produced by\nmicrobiota. He is now working on the relationships between microbiota and depression or autism.",institutionString:"Hamamatsu University School of Medicine",institution:{name:"Hamamatsu University School of Medicine",country:{name:"Japan"}}},{id:"137240",title:"Prof.",name:"Mohammed",middleName:null,surname:"Khalid",slug:"mohammed-khalid",fullName:"Mohammed Khalid",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/137240/images/system/137240.png",biography:"Mohammed Khalid received his B.S. in Chemistry in July 2000, and his Ph.D. in Physical Chemistry in 2007 from the University of Khartoum, Sudan. In 2009 he joined the Dr. Ron Clarke research group at the School of Chemistry, Faculty of Science, University of Sydney, Australia as a postdoctoral fellow where he worked on the Interaction of ATP with the phosphoenzyme of the Na+, K+-ATPase, and Dual mechanisms of allosteric acceleration of the Na+, K+-ATPase by ATP. He then worked as Assistant Professor at the Department of Chemistry, University of Khartoum, and in 2014 was promoted to Associate Professor ranking. In 2011 he joined the staff of the Chemistry Department at Taif University, Saudi Arabia, where he is currently active as an Assistant Professor. His research interests include:\r\n(1) P-type ATPase Enzyme Kinetics and Mechanisms; (2) Kinetics and Mechanism of Redox Reactions; (3) Autocatalytic reactions; (4) Computational enzyme kinetics; (5) Allosteric acceleration of P-type ATPases by ATP; (6) Exploring of allosteric sites of ATPases and interaction of ATP with ATPases located in the cell membranes.",institutionString:"Taif University",institution:{name:"Taif University",country:{name:"Saudi Arabia"}}},{id:"63810",title:"Prof.",name:"Jorge",middleName:null,surname:"Morales-Montor",slug:"jorge-morales-montor",fullName:"Jorge Morales-Montor",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/63810/images/system/63810.png",biography:"Dr. Jorge Morales-Montor was recognized with the Lola and Igo Flisser PUIS Award for best graduate thesis at the national level in the field of parasitology. He received a fellowship from the Fogarty Foundation to perform postdoctoral research stay at the University of Georgia. He has 153 journal articles to his credit. He has also edited several books and published more than fifty-five book chapters. He is a member of the Mexican Academy of Sciences, Latin American Academy of Sciences, and the National Academy of Medicine. He has received more than thirty-five awards and has supervised numerous bachelor’s, master’s, and Ph.D. students. Dr. Morales-Montor is the past president of the Mexican Society of Parasitology.",institutionString:"National Autonomous University of Mexico",institution:{name:"National Autonomous University of Mexico",country:{name:"Mexico"}}},{id:"217215",title:"Dr.",name:"Palash",middleName:null,surname:"Mandal",slug:"palash-mandal",fullName:"Palash Mandal",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/217215/images/system/217215.jpeg",biography:null,institutionString:"Charusat University",institution:null},{id:"49739",title:"Dr.",name:"Leszek",middleName:null,surname:"Szablewski",slug:"leszek-szablewski",fullName:"Leszek Szablewski",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49739/images/system/49739.jpg",biography:"Leszek Szablewski is a professor of medical sciences. He received his M.S. in the Faculty of Biology from the University of Warsaw and his PhD degree from the Institute of Experimental Biology Polish Academy of Sciences. He habilitated in the Medical University of Warsaw, and he obtained his degree of Professor from the President of Poland. Professor Szablewski is the Head of Chair and Department of General Biology and Parasitology, Medical University of Warsaw. Professor Szablewski has published over 80 peer-reviewed papers in journals such as Journal of Alzheimer’s Disease, Biochim. Biophys. Acta Reviews of Cancer, Biol. Chem., J. Biomed. Sci., and Diabetes/Metabol. Res. Rev, Endocrine. He is the author of two books and four book chapters. He has edited four books, written 15 scripts for students, is the ad hoc reviewer of over 30 peer-reviewed journals, and editorial member of peer-reviewed journals. Prof. Szablewski’s research focuses on cell physiology, genetics, and pathophysiology. He works on the damage caused by lack of glucose homeostasis and changes in the expression and/or function of glucose transporters due to various diseases. He has given lectures, seminars, and exercises for students at the Medical University.",institutionString:"Medical University of Warsaw",institution:{name:"Medical University of Warsaw",country:{name:"Poland"}}},{id:"173123",title:"Dr.",name:"Maitham",middleName:null,surname:"Khajah",slug:"maitham-khajah",fullName:"Maitham Khajah",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/173123/images/system/173123.jpeg",biography:"Dr. Maitham A. Khajah received his degree in Pharmacy from Faculty of Pharmacy, Kuwait University, in 2003 and obtained his PhD degree in December 2009 from the University of Calgary, Canada (Gastrointestinal Science and Immunology). Since January 2010 he has been assistant professor in Kuwait University, Faculty of Pharmacy, Department of Pharmacology and Therapeutics. His research interest are molecular targets for the treatment of inflammatory bowel disease (IBD) and the mechanisms responsible for immune cell chemotaxis. He cosupervised many students for the MSc Molecular Biology Program, College of Graduate Studies, Kuwait University. Ever since joining Kuwait University in 2010, he got various grants as PI and Co-I. He was awarded the Best Young Researcher Award by Kuwait University, Research Sector, for the Year 2013–2014. He was a member in the organizing committee for three conferences organized by Kuwait University, Faculty of Pharmacy, as cochair and a member in the scientific committee (the 3rd, 4th, and 5th Kuwait International Pharmacy Conference).",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"195136",title:"Dr.",name:"Aya",middleName:null,surname:"Adel",slug:"aya-adel",fullName:"Aya Adel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/195136/images/system/195136.jpg",biography:"Dr. Adel works as an Assistant Lecturer in the unit of Phoniatrics, Department of Otolaryngology, Ain Shams University in Cairo, Egypt. Dr. Adel is especially interested in joint attention and its impairment in autism spectrum disorder",institutionString:"Ain Shams University",institution:{name:"Ain Shams University",country:{name:"Egypt"}}},{id:"94911",title:"Dr.",name:"Boulenouar",middleName:null,surname:"Mesraoua",slug:"boulenouar-mesraoua",fullName:"Boulenouar Mesraoua",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94911/images/system/94911.png",biography:"Dr Boulenouar Mesraoua is the Associate Professor of Clinical Neurology at Weill Cornell Medical College-Qatar and a Consultant Neurologist at Hamad Medical Corporation at the Neuroscience Department; He graduated as a Medical Doctor from the University of Oran, Algeria; he then moved to Belgium, the City of Liege, for a Residency in Internal Medicine and Neurology at Liege University; after getting the Belgian Board of Neurology (with high marks), he went to the National Hospital for Nervous Diseases, Queen Square, London, United Kingdom for a fellowship in Clinical Neurophysiology, under Pr Willison ; Dr Mesraoua had also further training in Epilepsy and Continuous EEG Monitoring for two years (from 2001-2003) in the Neurophysiology department of Zurich University, Switzerland, under late Pr Hans Gregor Wieser ,an internationally known epileptologist expert. \n\nDr B. Mesraoua is the Director of the Neurology Fellowship Program at the Neurology Section and an active member of the newly created Comprehensive Epilepsy Program at Hamad General Hospital, Doha, Qatar; he is also Assistant Director of the Residency Program at the Qatar Medical School. \nDr B. Mesraoua's main interests are Epilepsy, Multiple Sclerosis, and Clinical Neurology; He is the Chairman and the Organizer of the well known Qatar Epilepsy Symposium, he is running yearly for the past 14 years and which is considered a landmark in the Gulf region; He has also started last year , together with other epileptologists from Qatar, the region and elsewhere, a yearly International Epilepsy School Course, which was attended by many neurologists from the Area.\n\nInternationally, Dr Mesraoua is an active and elected member of the Commission on Eastern Mediterranean Region (EMR ) , a regional branch of the International League Against Epilepsy (ILAE), where he represents the Middle East and North Africa(MENA ) and where he holds the position of chief of the Epilepsy Epidemiology Section; Dr Mesraoua is a member of the American Academy of Neurology, the Europeen Academy of Neurology and the American Epilepsy Society.\n\nDr Mesraoua's main objectives are to encourage frequent gathering of the epileptologists/neurologists from the MENA region and the rest of the world, promote Epilepsy Teaching in the MENA Region, and encourage multicenter studies involving neurologists and epileptologists in the MENA region, particularly epilepsy epidemiological studies. \n\nDr. Mesraoua is the recipient of two research Grants, as the Lead Principal Investigator (750.000 USD and 250.000 USD) from the Qatar National Research Fund (QNRF) and the Hamad Hospital Internal Research Grant (IRGC), on the following topics : “Continuous EEG Monitoring in the ICU “ and on “Alpha-lactoalbumin , proof of concept in the treatment of epilepsy” .Dr Mesraoua is a reviewer for the journal \"seizures\" (Europeen Epilepsy Journal ) as well as dove journals ; Dr Mesraoua is the author and co-author of many peer reviewed publications and four book chapters in the field of Epilepsy and Clinical Neurology",institutionString:"Weill Cornell Medical College in Qatar",institution:{name:"Weill Cornell Medical College in Qatar",country:{name:"Qatar"}}},{id:"282429",title:"Prof.",name:"Covanis",middleName:null,surname:"Athanasios",slug:"covanis-athanasios",fullName:"Covanis Athanasios",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/282429/images/system/282429.jpg",biography:null,institutionString:"Neurology-Neurophysiology Department of the Children Hospital Agia Sophia",institution:null},{id:"190980",title:"Prof.",name:"Marwa",middleName:null,surname:"Mahmoud Saleh",slug:"marwa-mahmoud-saleh",fullName:"Marwa Mahmoud Saleh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/190980/images/system/190980.jpg",biography:"Professor Marwa Mahmoud Saleh is a doctor of medicine and currently works in the unit of Phoniatrics, Department of Otolaryngology, Ain Shams University in Cairo, Egypt. She got her doctoral degree in 1991 and her doctoral thesis was accomplished in the University of Iowa, United States. Her publications covered a multitude of topics as videokymography, cochlear implants, stuttering, and dysphagia. She has lectured Egyptian phonology for many years. Her recent research interest is joint attention in autism.",institutionString:"Ain Shams University",institution:{name:"Ain Shams University",country:{name:"Egypt"}}},{id:"259190",title:"Dr.",name:"Syed Ali Raza",middleName:null,surname:"Naqvi",slug:"syed-ali-raza-naqvi",fullName:"Syed Ali Raza Naqvi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259190/images/system/259190.png",biography:"Dr. Naqvi is a radioanalytical chemist and is working as an associate professor of analytical chemistry in the Department of Chemistry, Government College University, Faisalabad, Pakistan. Advance separation techniques, nuclear analytical techniques and radiopharmaceutical analysis are the main courses that he is teaching to graduate and post-graduate students. In the research area, he is focusing on the development of organic- and biomolecule-based radiopharmaceuticals for diagnosis and therapy of infectious and cancerous diseases. Under the supervision of Dr. Naqvi, three students have completed their Ph.D. degrees and 41 students have completed their MS degrees. He has completed three research projects and is currently working on 2 projects entitled “Radiolabeling of fluoroquinolone derivatives for the diagnosis of deep-seated bacterial infections” and “Radiolabeled minigastrin peptides for diagnosis and therapy of NETs”. He has published about 100 research articles in international reputed journals and 7 book chapters. Pakistan Institute of Nuclear Science & Technology (PINSTECH) Islamabad, Punjab Institute of Nuclear Medicine (PINM), Faisalabad and Institute of Nuclear Medicine and Radiology (INOR) Abbottabad are the main collaborating institutes.",institutionString:"Government College University",institution:{name:"Government College University, Faisalabad",country:{name:"Pakistan"}}},{id:"58390",title:"Dr.",name:"Gyula",middleName:null,surname:"Mozsik",slug:"gyula-mozsik",fullName:"Gyula Mozsik",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/58390/images/system/58390.png",biography:"Gyula Mózsik MD, Ph.D., ScD (med), is an emeritus professor of Medicine at the First Department of Medicine, Univesity of Pécs, Hungary. He was head of this department from 1993 to 2003. His specializations are medicine, gastroenterology, clinical pharmacology, clinical nutrition, and dietetics. His research fields are biochemical pharmacological examinations in the human gastrointestinal (GI) mucosa, mechanisms of retinoids, drugs, capsaicin-sensitive afferent nerves, and innovative pharmacological, pharmaceutical, and nutritional (dietary) research in humans. He has published about 360 peer-reviewed papers, 197 book chapters, 692 abstracts, 19 monographs, and has edited 37 books. He has given about 1120 regular and review lectures. He has organized thirty-eight national and international congresses and symposia. He is the founder of the International Conference on Ulcer Research (ICUR); International Union of Pharmacology, Gastrointestinal Section (IUPHAR-GI); Brain-Gut Society symposiums, and gastrointestinal cytoprotective symposiums. He received the Andre Robert Award from IUPHAR-GI in 2014. Fifteen of his students have been appointed as full professors in Egypt, Cuba, and Hungary.",institutionString:"University of Pécs",institution:{name:"University of Pecs",country:{name:"Hungary"}}},{id:"277367",title:"M.Sc.",name:"Daniel",middleName:"Martin",surname:"Márquez López",slug:"daniel-marquez-lopez",fullName:"Daniel Márquez López",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/277367/images/7909_n.jpg",biography:"Msc Daniel Martin Márquez López has a bachelor degree in Industrial Chemical Engineering, a Master of science degree in the same área and he is a PhD candidate for the Instituto Politécnico Nacional. His Works are realted to the Green chemistry field, biolubricants, biodiesel, transesterification reactions for biodiesel production and the manipulation of oils for therapeutic purposes.",institutionString:null,institution:{name:"Instituto Politécnico Nacional",country:{name:"Mexico"}}},{id:"196544",title:"Prof.",name:"Angel",middleName:null,surname:"Catala",slug:"angel-catala",fullName:"Angel Catala",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/196544/images/system/196544.jpg",biography:"Angel Catalá studied chemistry at Universidad Nacional de La Plata, Argentina, where he received a Ph.D. in Chemistry (Biological Branch) in 1965. From 1964 to 1974, he worked as an Assistant in Biochemistry at the School of Medicine at the same university. From 1974 to 1976, he was a fellow of the National Institutes of Health (NIH) at the University of Connecticut, Health Center, USA. From 1985 to 2004, he served as a Full Professor of Biochemistry at the Universidad Nacional de La Plata. He is a member of the National Research Council (CONICET), Argentina, and the Argentine Society for Biochemistry and Molecular Biology (SAIB). His laboratory has been interested for many years in the lipid peroxidation of biological membranes from various tissues and different species. Dr. Catalá has directed twelve doctoral theses, published more than 100 papers in peer-reviewed journals, several chapters in books, and edited twelve books. He received awards at the 40th International Conference Biochemistry of Lipids 1999 in Dijon, France. He is the winner of the Bimbo Pan-American Nutrition, Food Science and Technology Award 2006 and 2012, South America, Human Nutrition, Professional Category. In 2006, he won the Bernardo Houssay award in pharmacology, in recognition of his meritorious works of research. Dr. Catalá belongs to the editorial board of several journals including Journal of Lipids; International Review of Biophysical Chemistry; Frontiers in Membrane Physiology and Biophysics; World Journal of Experimental Medicine and Biochemistry Research International; World Journal of Biological Chemistry, Diabetes, and the Pancreas; International Journal of Chronic Diseases & Therapy; and International Journal of Nutrition. He is the co-editor of The Open Biology Journal and associate editor for Oxidative Medicine and Cellular Longevity.",institutionString:"Universidad Nacional de La Plata",institution:{name:"National University of La Plata",country:{name:"Argentina"}}},{id:"186585",title:"Dr.",name:"Francisco Javier",middleName:null,surname:"Martin-Romero",slug:"francisco-javier-martin-romero",fullName:"Francisco Javier Martin-Romero",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSB3HQAW/Profile_Picture_1631258137641",biography:"Francisco Javier Martín-Romero (Javier) is a Professor of Biochemistry and Molecular Biology at the University of Extremadura, Spain. He is also a group leader at the Biomarkers Institute of Molecular Pathology. Javier received his Ph.D. in 1998 in Biochemistry and Biophysics. At the National Cancer Institute (National Institute of Health, Bethesda, MD) he worked as a research associate on the molecular biology of selenium and its role in health and disease. After postdoctoral collaborations with Carlos Gutierrez-Merino (University of Extremadura, Spain) and Dario Alessi (University of Dundee, UK), he established his own laboratory in 2008. The interest of Javier's lab is the study of cell signaling with a special focus on Ca2+ signaling, and how Ca2+ transport modulates the cytoskeleton, migration, differentiation, cell death, etc. He is especially interested in the study of Ca2+ channels, and the role of STIM1 in the initiation of pathological events.",institutionString:null,institution:{name:"University of Extremadura",country:{name:"Spain"}}},{id:"198499",title:"Dr.",name:"Daniel",middleName:null,surname:"Glossman-Mitnik",slug:"daniel-glossman-mitnik",fullName:"Daniel Glossman-Mitnik",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/198499/images/system/198499.jpeg",biography:"Dr. Daniel Glossman-Mitnik is currently a Titular Researcher at the Centro de Investigación en Materiales Avanzados (CIMAV), Chihuahua, Mexico, as well as a National Researcher of Level III at the Consejo Nacional de Ciencia y Tecnología, México. His research interest focuses on computational chemistry and molecular modeling of diverse systems of pharmacological, food, and alternative energy interests by resorting to DFT and Conceptual DFT. He has authored a coauthored more than 270 peer-reviewed papers, 32 book chapters, and 4 edited books. He has delivered speeches at many international and domestic conferences. He serves as a reviewer for more than eighty international journals, books, and research proposals as well as an editor for special issues of renowned scientific journals.",institutionString:null,institution:null},{id:"217323",title:"Prof.",name:"Guang-Jer",middleName:null,surname:"Wu",slug:"guang-jer-wu",fullName:"Guang-Jer Wu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/217323/images/8027_n.jpg",biography:null,institutionString:null,institution:null},{id:"148546",title:"Dr.",name:"Norma Francenia",middleName:null,surname:"Santos-Sánchez",slug:"norma-francenia-santos-sanchez",fullName:"Norma Francenia Santos-Sánchez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/148546/images/4640_n.jpg",biography:null,institutionString:null,institution:null},{id:"272889",title:"Dr.",name:"Narendra",middleName:null,surname:"Maddu",slug:"narendra-maddu",fullName:"Narendra Maddu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/272889/images/10758_n.jpg",biography:null,institutionString:null,institution:null},{id:"242491",title:"Prof.",name:"Angelica",middleName:null,surname:"Rueda",slug:"angelica-rueda",fullName:"Angelica Rueda",position:"Investigador Cinvestav 3B",profilePictureURL:"https://mts.intechopen.com/storage/users/242491/images/6765_n.jpg",biography:null,institutionString:null,institution:null},{id:"88631",title:"Dr.",name:"Ivan",middleName:null,surname:"Petyaev",slug:"ivan-petyaev",fullName:"Ivan Petyaev",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Lycotec (United Kingdom)",country:{name:"United Kingdom"}}},{id:"428313",title:"Dr.",name:"Sambangi",middleName:null,surname:"Pratyusha",slug:"sambangi-pratyusha",fullName:"Sambangi Pratyusha",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"CGIAR",country:{name:"France"}}},{id:"423869",title:"Ms.",name:"Smita",middleName:null,surname:"Rai",slug:"smita-rai",fullName:"Smita Rai",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Integral University",country:{name:"India"}}},{id:"424024",title:"Prof.",name:"Swati",middleName:null,surname:"Sharma",slug:"swati-sharma",fullName:"Swati Sharma",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Integral University",country:{name:"India"}}},{id:"439112",title:"MSc.",name:"Touseef",middleName:null,surname:"Fatima",slug:"touseef-fatima",fullName:"Touseef Fatima",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Integral University",country:{name:"India"}}}]}},subseries:{item:{id:"5",type:"subseries",title:"Parasitic Infectious Diseases",keywords:"Blood Borne Parasites, Intestinal Parasites, Protozoa, Helminths, Arthropods, Water Born Parasites, Epidemiology, Molecular Biology, Systematics, Genomics, Proteomics, Ecology",scope:"Parasitic diseases have evolved alongside their human hosts. In many cases, these diseases have adapted so well that they have developed efficient resilience methods in the human host and can live in the host for years. Others, particularly some blood parasites, can cause very acute diseases and are responsible for millions of deaths yearly. Many parasitic diseases are classified as neglected tropical diseases because they have received minimal funding over recent years and, in many cases, are under-reported despite the critical role they play in morbidity and mortality among human and animal hosts. The current topic, Parasitic Infectious Diseases, in the Infectious Diseases Series aims to publish studies on the systematics, epidemiology, molecular biology, genomics, pathogenesis, genetics, and clinical significance of parasitic diseases from blood borne to intestinal parasites as well as zoonotic parasites. We hope to cover all aspects of parasitic diseases to provide current and relevant research data on these very important diseases. In the current atmosphere of the Coronavirus pandemic, communities around the world, particularly those in different underdeveloped areas, are faced with the growing challenges of the high burden of parasitic diseases. At the same time, they are faced with the Covid-19 pandemic leading to what some authors have called potential syndemics that might worsen the outcome of such infections. Therefore, it is important to conduct studies that examine parasitic infections in the context of the coronavirus pandemic for the benefit of all communities to help foster more informed decisions for the betterment of human and animal health.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/5.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11401,editor:{id:"67907",title:"Dr.",name:"Amidou",middleName:null,surname:"Samie",slug:"amidou-samie",fullName:"Amidou Samie",profilePictureURL:"https://mts.intechopen.com/storage/users/67907/images/system/67907.jpg",biography:"Dr. Amidou Samie is an Associate Professor of Microbiology at the University of Venda, in South Africa, where he graduated for his PhD in May 2008. He joined the Department of Microbiology the same year and has been giving lectures on topics covering parasitology, immunology, molecular biology and industrial microbiology. He is currently a rated researcher by the National Research Foundation of South Africa at category C2. He has published widely in the field of infectious diseases and has overseen several MSc’s and PhDs. His research activities mostly cover topics on infectious diseases from epidemiology to control. His particular interest lies in the study of intestinal protozoan parasites and opportunistic infections among HIV patients as well as the potential impact of childhood diarrhoea on growth and child development. He also conducts research on water-borne diseases and water quality and is involved in the evaluation of point-of-use water treatment technologies using silver and copper nanoparticles in collaboration with the University of Virginia, USA. 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