Mineral content of whole grains
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Barely three months into the new year and we are happy to announce a monumental milestone reached - 150 million downloads.
\n\nThis achievement solidifies IntechOpen’s place as a pioneer in Open Access publishing and the home to some of the most relevant scientific research available through Open Access.
\n\nWe are so proud to have worked with so many bright minds throughout the years who have helped us spread knowledge through the power of Open Access and we look forward to continuing to support some of the greatest thinkers of our day.
\n\nThank you for making IntechOpen your place of learning, sharing, and discovery, and here’s to 150 million more!
\n\n\n\n\n'}],latestNews:[{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"},{slug:"intechopen-identified-as-one-of-the-most-significant-contributor-to-oa-book-growth-in-doab-20210809",title:"IntechOpen Identified as One of the Most Significant Contributors to OA Book Growth in DOAB"}]},book:{item:{type:"book",id:"10764",leadTitle:null,fullTitle:"Antenna Systems",title:"Antenna Systems",subtitle:null,reviewType:"peer-reviewed",abstract:"This book offers an up-to-date and comprehensive review of modern antenna systems and their applications in the fields of contemporary wireless systems. It constitutes a useful resource of new material, including stochastic versus ray tracing wireless channel modeling for 5G and V2X applications and implantable devices. Chapters discuss modern metalens antennas in microwaves, terahertz, and optical domain. Moreover, the book presents new material on antenna arrays for 5G massive MIMO beamforming. Finally, it discusses new methods, devices, and technologies to enhance the performance of antenna systems.",isbn:"978-1-83968-829-4",printIsbn:"978-1-83968-828-7",pdfIsbn:"978-1-83968-830-0",doi:"10.5772/intechopen.94787",price:119,priceEur:129,priceUsd:155,slug:"antenna-systems",numberOfPages:266,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"2fbf1c7a5d92723f08198fc9b526a8ad",bookSignature:"Hussain Al-Rizzo and Said Abushamleh",publishedDate:"April 28th 2022",coverURL:"https://cdn.intechopen.com/books/images_new/10764.jpg",numberOfDownloads:1929,numberOfWosCitations:0,numberOfCrossrefCitations:3,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:3,numberOfDimensionsCitationsByBook:0,hasAltmetrics:0,numberOfTotalCitations:6,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"February 2nd 2021",dateEndSecondStepPublish:"March 2nd 2021",dateEndThirdStepPublish:"May 1st 2021",dateEndFourthStepPublish:"July 20th 2021",dateEndFifthStepPublish:"September 18th 2021",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,7",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"153384",title:"Prof.",name:"Hussain",middleName:null,surname:"Al-Rizzo",slug:"hussain-al-rizzo",fullName:"Hussain Al-Rizzo",profilePictureURL:"https://mts.intechopen.com/storage/users/153384/images/system/153384.png",biography:"Hussain Al-Rizzo received his Ph.D. in Electrical and Computer Engineering from the University of New Brunswick, Fredericton, NB, Canada. Since 2000, he has been Professor of Telecommunication Systems Engineering in the Systems Engineering Department, at the University of Arkansas at Little Rock. He has published more than 250 papers in peer-reviewed journals and conference proceedings, one book, seven book chapters, and four patents. His research areas include V2V, V2X, and V2I wireless systems, smart antennas, massive MIMO, electromagnetic wave scattering by complex objects, design, modeling and testing of high-power microwave applicators, precipitation effects on terrestrial and satellite frequency re-use communication systems, field operation of NAVSTAR GPS receivers, data processing, and accuracy assessment, effects of the ionosphere, troposphere, and multipath on code, and carrier-beat phase GPS observations.",institutionString:"University of Arkansas at Little Rock",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"2",institution:{name:"University of Arkansas at Little Rock",institutionURL:null,country:{name:"United States of America"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:{id:"341387",title:"Dr.",name:"Said",middleName:null,surname:"Abushamleh",slug:"said-abushamleh",fullName:"Said Abushamleh",profilePictureURL:"https://mts.intechopen.com/storage/users/341387/images/system/341387.jpg",biography:"Said Abushamleh received the B.Sc. degree in Electrical and Computer Engineering from the Hashemite University, Zarqa, Jordan, and M.Sc. in Wireless Communications from Lund University, Lund, Sweden in 2007 and 2009, respectively. He received a Ph.D. degree in antenna engineering, and electromagnetics from the University of Arkansas at Little Rock, AR, USA, in 2015. During the year 2015-2016, Dr. Abushamleh was a postdoctoral research associate with the Advanced Radar Research Center, University of Oklahoma, Norman, OK, USA. In 2016, he joined the Department of Physics and Engineering, at the University of Nebraska at Kearney (UNK), Kearney, NE, USA, where he was an Assistant Professor of Electrical Engineering. In 2020, he joined the Indiana Institute of Technology as an Assistant Professor in the Department of Electrical Engineering. His research areas include design and analysis of microstrip antennas for mobile radio systems, Electromagnetic Band Gap structures (EBG) and their applications in antenna engineering, planar soft surfaces for mutual coupling reduction between patch antennas, microwave filters, and metamaterials. Dr. Abushamleh authored and co-authored thirty peer-reviewed journal papers, conference papers and book chapters.",institutionString:"Indiana Institute of Technology",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Indiana Institute of Technology",institutionURL:null,country:{name:"United States of America"}}},coeditorTwo:{id:"310217",title:"Ph.D. Student",name:"Sulaiman",middleName:null,surname:"Tariq",slug:"sulaiman-tariq",fullName:"Sulaiman Tariq",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00002pCaekQAC/Profile_Picture_1615363795907",biography:"Mr. Sulaiman received his B.Sc. in Electrical and Electronics Engineering from Khalifa University, Abu Dhabi, UAE in 2017. He is currently pursuing his Ph.D. degree in Telecommunication Systems Engineering, University of Arkansas, Little Rock. He has published two IEEE and IET journal papers and one book chapter. He is currently working on two patents, two IEEE journal papers and two book chapters. Sulaiman’s research areas include miniaturized antenna array design, RF circuits, MIMO/Massive MIMO, 5G, Wi-Fi-6, V2X communications and ray-tracing and stochastic channel modeling.",institutionString:"University of Arkansas at Little Rock",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"University of Arkansas at Little Rock",institutionURL:null,country:{name:"United States of America"}}},coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"762",title:"Wireless Communication System",slug:"electrical-and-electronic-engineering-wireless-communication-system"}],chapters:[{id:"79793",title:"Stochastic versus Ray Tracing Wireless Channel Modeling for 5G and V2X Applications: Opportunities and Challenges",doi:"10.5772/intechopen.101625",slug:"stochastic-versus-ray-tracing-wireless-channel-modeling-for-5g-and-v2x-applications-opportunities-an",totalDownloads:138,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Due to the rapid development of wireless communication applications, the study of Multiple Input Multiple Output (MIMO) communication systems has gained comprehensive research activities since it can significantly increase the channel capacity and link reliability without sacrificing bandwidth and/or transmitted power levels. Researchers tend to evaluate the performance of their MIMO antenna arrays using various channel modeling tools. These channel models are mainly categorized into either deterministic channels based on Ray Tracing (RT) tools or Stochastic Channel Models (SCM). In this chapter, we compare these two categories in terms of the MIMO channel capacity using a complete description of the antennas at the transmitting and receiving ends in terms of 3D polarimetric radiation patterns and scattering parameters. The performance is evaluated for 5G New Radio (NR) Enhanced Mobile Broadband (eMBB) and Ultra-Reliable Low-Latency Communication (URLLC) services and Vehicle-to-Everything (V2X) systems using state-of-the-art commercial SCM and RT tools to provide information regarding the capabilities and limitations of each approach under different channel environments and the Quality of Experience (QoE) for high data rate and low latency content delivery in the 5G NR sub-6GHz mid-band Frequency Range-1 (FR1) N77/N78 bands.",signatures:"Sulaiman Tariq, Hussain Al-Rizzo, Md Nazmul Hasan, Nijas Kunju and Said Abushamleh",downloadPdfUrl:"/chapter/pdf-download/79793",previewPdfUrl:"/chapter/pdf-preview/79793",authors:[{id:"153384",title:"Prof.",name:"Hussain",surname:"Al-Rizzo",slug:"hussain-al-rizzo",fullName:"Hussain Al-Rizzo"},{id:"341387",title:"Dr.",name:"Said",surname:"Abushamleh",slug:"said-abushamleh",fullName:"Said Abushamleh"},{id:"310217",title:"Ph.D. Student",name:"Sulaiman",surname:"Tariq",slug:"sulaiman-tariq",fullName:"Sulaiman Tariq"},{id:"348984",title:"Ph.D. Student",name:"Md Nazmul",surname:"Hasan",slug:"md-nazmul-hasan",fullName:"Md Nazmul Hasan"},{id:"420583",title:"Dr.",name:"Nijas",surname:"Kunju",slug:"nijas-kunju",fullName:"Nijas Kunju"}],corrections:null},{id:"77499",title:"Performance Analysis of Multiple Antenna Systems with New Capacity Improvement Algorithm for MIMO Based 4G/5G Systems",doi:"10.5772/intechopen.98883",slug:"performance-analysis-of-multiple-antenna-systems-with-new-capacity-improvement-algorithm-for-mimo-ba",totalDownloads:149,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"For a time varying channel, the channel capacity is determined by the Channel State Information (CSI) or its fading distribution at a transmitter or receiver. If CSI is perfectly known at both the transmitter and receiver, then the transmitter can adapt to its optimal transmission strategy (i.e., optimal antenna selection by power allocation scheme) relative to its instantaneous channel state for capacity enhancement. In the case where the channel information is not available at the transmitter (No CSIT), the transmitted power has to be distributed equally (i.e., uniform power allocation) between the transmitting antennas to improve the channel capacity. The IWFA (Iterative water filling allocation) strategy therefore allocates power to those spatial channels with positive non-zero singular values i.e. good quality channels and discards the lower eigenmodes channels resulting in maximum capacity in MIMO systems for perfect CSIT. In this chapter, the performance analysis of Multi Antenna systems under ICSIT/ICSIR, Perfect CSIT, No CSIT channel conditions have been implemented and a novel adaptive power allocation algorithm (SVD-based IWFAA) is considered to improve the spectral efficiency of next generation wireless MIMO communication (4G–5G). The algorithm considered is more efficient at high noise levels (low SNRs) under Perfect CSIT conditions because the strongest channel eigenmodes are allocated more power.",signatures:"Vinodh Kumar Minchula and Gottapu Sasibhushana Rao",downloadPdfUrl:"/chapter/pdf-download/77499",previewPdfUrl:"/chapter/pdf-preview/77499",authors:[{id:"355124",title:"Dr.",name:"Vinodh",surname:"Minchula",slug:"vinodh-minchula",fullName:"Vinodh Minchula"},{id:"414482",title:"Prof.",name:"Sashibhushana Rao",surname:"Gottapu",slug:"sashibhushana-rao-gottapu",fullName:"Sashibhushana Rao Gottapu"}],corrections:null},{id:"78731",title:"Steered Beam Adaptive Antenna Arrays",doi:"10.5772/intechopen.100168",slug:"steered-beam-adaptive-antenna-arrays",totalDownloads:129,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"In this chapter, the performance of steered beam adaptive arrays is presented with its corresponding analytical expressions. Computer simulations are used to illustrate the performance of the array under various operating conditions. In this chapter, we ignore the presence of mutual coupling between the array elements. The principal system elements of the adaptive array consist of an array of sensors (antennas), a pattern-forming network, and an adaptive pattern control unit or adaptive processor that adjusts the variable weights in the pattern-forming network. The adaptive pattern control unit may furthermore be conveniently subdivided into a signal processor unit and an adaptive control algorithm. The manner in which these elements are actually implemented depends on the propagation medium in which the array is to operate, the frequency spectrum of interest, and the user’s knowledge of the operational signal environment.",signatures:"Amin H. Al Ka’bi",downloadPdfUrl:"/chapter/pdf-download/78731",previewPdfUrl:"/chapter/pdf-preview/78731",authors:[{id:"349002",title:"Associate Prof.",name:"Amin H.",surname:"Al Ka'bi",slug:"amin-h.-al-ka'bi",fullName:"Amin H. Al Ka'bi"}],corrections:null},{id:"77356",title:"Co-Design Block PA (Power Amplifier)-Antenna for 5G Application at 28 GHz Frequency Band",doi:"10.5772/intechopen.98653",slug:"co-design-block-pa-power-amplifier-antenna-for-5g-application-at-28-ghz-frequency-band",totalDownloads:136,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"This subject addresses the issue related to Transmitters for the new communication standard, namely 5G. Indeed to respond to the problems of radio coverage, the speed of services as well as the rise in user demand, transmitters must have ideal characteristics to be able to meet these requirements. This chapter proposes in order to answer such a problem a block made up of a linear array of antennas has 4 elements and a transistor amplifier operating at the 28 GHz frequency band. The Design of the Block is done first by the design of the antenna then the design of the amplifier and finally the junction of the two devices with a matching network to therefore form the block of transmitters Speaking of the design of the antenna, the prepared antenna is a patch antenna with a patch shape excluding the classic shapes which is printed on a Rogers-Duriod 5880 substrate so the thickness is 0.127 mm, the linear antenna array proposed has a gain greater than 15 dB and a Good Bandwidth, the transistor amplifier is in turn printed on the same substrate has the same thickness to minimize the losses during the junction of this one with the antenna, this amplifier offers a higher gain than device 15 dB and therefore the Bandwidth is greater than 2 GHz, each transmitter has an input and output reflection coefficient of less than −10 db. The simulation of each transmitter is made with the CST-microwave software for the Antenna and the ADS (Advanced Design System) software for the amplifier and the Block PA-Antenna. It is important to note that the Block output impedance is 50 ohms making our device more practical and easily commercial.",signatures:"Ange Joel Nounga Njanda and Paul Samuel Mandeng",downloadPdfUrl:"/chapter/pdf-download/77356",previewPdfUrl:"/chapter/pdf-preview/77356",authors:[{id:"348809",title:"M.A.",name:"Ange Joel",surname:"Nounga Njanda",slug:"ange-joel-nounga-njanda",fullName:"Ange Joel Nounga Njanda"},{id:"423671",title:"Dr.",name:"Paul Samuel",surname:"Mandeng",slug:"paul-samuel-mandeng",fullName:"Paul Samuel Mandeng"}],corrections:null},{id:"77479",title:"Bi-Ellipse Microstripline Antenna Array Varians",doi:"10.5772/intechopen.98834",slug:"bi-ellipse-microstripline-antenna-array-varians",totalDownloads:109,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The objectives of this research include obtaining and verifying the impedance formula of the designed bi-ellipse microstrip antenna and correlating the results obtained through simulation and experimentation. The research also aims to obtain the structure and dimensions that provide optimal characteristics of the designed bi-ellipse microstrip antenna and produce a prototype at S, C and X-Band frequencies. This research produced the structure and dimensions of a bi-ellipse microstrip antenna that provide optimal characteristics of antenna. The characteristics results of the antenna parameters in this research include a 8x2 array, with a bandwidth value of around 100.0 MHz obtained at a working frequency of 7.09GHz (7.04 GHz - 7.14 GHz), with a reflection coefficient value of 0.02, Voltage Standing Wave Ratio (VSWR) of 1.06, return loss of −30.00 dB and a gain of 7.30 dB. For the 8x4 array, a bandwidth value of approximately 210.0 MHz is obtained at a working frequency range of 2.85GHz, which ranges from 2.74GHz - 2.95GHz, with a reflection coefficient value of 0.04, Voltage Standing Wave Ratio (VSWR) of 1.09, return loss of −27.06 dB and a gain of 8.19 dB. The results presented above fulfill the indicators of good antenna characteristics parameters applicable to radar communication systems.",signatures:"Putu Artawan",downloadPdfUrl:"/chapter/pdf-download/77479",previewPdfUrl:"/chapter/pdf-preview/77479",authors:[{id:"349806",title:"Dr.",name:"Putu",surname:"Artawan",slug:"putu-artawan",fullName:"Putu Artawan"}],corrections:null},{id:"78401",title:"Sparse Linear Antenna Arrays: A Review",doi:"10.5772/intechopen.99444",slug:"sparse-linear-antenna-arrays-a-review",totalDownloads:281,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Linear sparse antenna arrays have been widely studied in array processing literature. They belong to the general class of non-uniform linear arrays (NULAs). Sparse arrays need fewer sensor elements than uniform linear arrays (ULAs) to realize a given aperture. Alternately, for a given number of sensors, sparse arrays provide larger apertures and higher degrees of freedom than full arrays (ability to detect more source signals through direction-of-arrival (DOA) estimation). Another advantage of sparse arrays is that they are less affected by mutual coupling compared to ULAs. Different types of linear sparse arrays have been studied in the past. While minimum redundancy arrays (MRAs) and minimum hole arrays (MHAs) existed for more than five decades, other sparse arrays such as nested arrays, co-prime arrays and super-nested arrays have been introduced in the past decade. Subsequent to the introduction of co-prime and nested arrays in the past decade, many modifications, improvements and alternate sensor array configurations have been presented in the literature in the past five years (2015–2020). The use of sparse arrays in future communication systems is promising as they operate with little or no degradation in performance compared to ULAs. In this chapter, various linear sparse arrays have been compared with respect to parameters such as the aperture provided for a given number of sensors, ability to provide large hole-free co-arrays, higher degrees of freedom (DOFs), sharp angular resolutions and susceptibility to mutual coupling. The chapter concludes with a few recommendations and possible future research directions.",signatures:"Ashish Patwari",downloadPdfUrl:"/chapter/pdf-download/78401",previewPdfUrl:"/chapter/pdf-preview/78401",authors:[{id:"348267",title:"Dr.",name:"Ashish",surname:"Patwari",slug:"ashish-patwari",fullName:"Ashish Patwari"}],corrections:null},{id:"77760",title:"Implantable Wireless Systems: A Review of Potentials and Challenges",doi:"10.5772/intechopen.99064",slug:"implantable-wireless-systems-a-review-of-potentials-and-challenges",totalDownloads:224,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"With the current advancement in micro-and nano-fabrication processes and the newly developed approaches, wireless implantable devices are now able to meet the demand for compact, self-powered, wireless, and long-lasting implantable devices for medical and health-care applications. The demonstrated fabrication advancement enabled the wireless implantable devices to overcome the previous limitations of electromagnetic-based wireless devices such as the high volume due to large antenna size and to overcome the tissue and bone losses related to the ultrasound implantable devices. Recent state-of-the-are wireless implantable devices can efficiently harvest electromagnetic energy and detect RF signals with minimum losses. Most of the current implanted devices are powered by batteries, which is not an ideal solution as these batteries need periodic charging and replacement. On the other hand, the implantable devices that are powered by energy harvesters are operating continuously, patient-friendly, and are easy to use. Future wireless implantable devices face a strong demand to be linked with IoT-based applications and devices with data visualization on mobile devices. This type of application requires additional units, which means more power consumption. Thus, the challenge here is to reduce the overall power consumption and increase the wireless power transfer efficiency. This chapter presents the state-of-the-art wireless power transfer techniques and approaches that are used to drive implantable devices. These techniques include inductive coupling, radiofrequency, ultrasonic, photovoltaic, and heat. The advantages and disadvantages of these approaches and techniques along with the challenges and limitations of each technique will be discussed. Furthermore, the performance parameters such as operating distance, energy harvesting efficiency, and size will be discussed and analyzed to introduce a comprehensive comparison. Finally, the recent advances in materials development and wireless communication strategies, are also discussed.",signatures:"Amenah I. Kanaan and Ahmed M.A. Sabaawi",downloadPdfUrl:"/chapter/pdf-download/77760",previewPdfUrl:"/chapter/pdf-preview/77760",authors:[{id:"348834",title:"M.Sc.",name:"Amenah I.",surname:"Kanaan",slug:"amenah-i.-kanaan",fullName:"Amenah I. Kanaan"},{id:"349568",title:"Dr.",name:"Ahmed M.A.",surname:"Sabaawi",slug:"ahmed-m.a.-sabaawi",fullName:"Ahmed M.A. Sabaawi"}],corrections:null},{id:"80111",title:"Microwave Antennas Suggested for Biomedical Implantation",doi:"10.5772/intechopen.101060",slug:"microwave-antennas-suggested-for-biomedical-implantation",totalDownloads:96,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"In the twenty-first century, there is an enormous development in various areas: microwave sensors have played an important role in medical devices, because of population growth and public awareness of the health of medical devices, they have become an ever-increasing technology. Microwave antenna sensors can be used to monitor human body temperature, implantable defibrillators, pacemakers, continuous glucose monitoring, heart failure detection, and so on. Antennas are also used as flexible sensors to monitor physiological parameters. Therefore, microwave sensors are used for wireless communication in various biomedical applications. The design of such antennas has gained considerable attention for dealing with issues such as miniaturization, biocompatibility, patient safety, improvement in communication quality, etc. The objective of this paper is to prove an overview of the requirements, design steps, and testing of a microwave antenna used in biomedical implantation. In this chapter, various antennas used in medical applications are described in detail. Also, antenna designing and testing requirements are discussed.",signatures:"Kasturi Sudam Patil and Elizabeth Rufus",downloadPdfUrl:"/chapter/pdf-download/80111",previewPdfUrl:"/chapter/pdf-preview/80111",authors:[{id:"348800",title:"Ph.D. Student",name:"Kasturi",surname:"Sudam Patil",slug:"kasturi-sudam-patil",fullName:"Kasturi Sudam Patil"},{id:"439709",title:"Dr.",name:"Elizabeth",surname:"Rufus",slug:"elizabeth-rufus",fullName:"Elizabeth Rufus"}],corrections:null},{id:"77613",title:"Metalens Antennas in Microwave, Terahertz and Optical Domain Applications",doi:"10.5772/intechopen.99034",slug:"metalens-antennas-in-microwave-terahertz-and-optical-domain-applications",totalDownloads:207,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Metamaterial is the artificial structure under sub-wavelength dimension and could be designed to manipulate the electromagnetic wave radiation across the broad frequency range through microwave to much higher frequency, such as terahertz and optical regime. Lens antenna can generate the focused beam with high gain and shrink the bulky refractive body and feeds into a shape of flat form. This chapter will discuss the general concepts of metalens and the technology of metalens-based antenna at microwave, terahertz and optical frequency. The recent progress in the research and development of metalens antennas is reviewed with designs principle and typical applications. At last part, some innovative techniques such as dynamic focus-tuning of metalen are discussed in details.",signatures:"Qi Song, Yan Gong, Nianxi Xu and Ruoqian Gao",downloadPdfUrl:"/chapter/pdf-download/77613",previewPdfUrl:"/chapter/pdf-preview/77613",authors:[{id:"347961",title:"Dr.",name:"Qi",surname:"Song",slug:"qi-song",fullName:"Qi Song"},{id:"349601",title:"Dr.",name:"Nianxi",surname:"Xu",slug:"nianxi-xu",fullName:"Nianxi Xu"},{id:"417058",title:"Dr.",name:"Ruoqian",surname:"Gao",slug:"ruoqian-gao",fullName:"Ruoqian Gao"},{id:"417059",title:"Prof.",name:"Yan",surname:"Gong",slug:"yan-gong",fullName:"Yan Gong"}],corrections:null},{id:"78824",title:"Blue Laser Diode-Based Visible Light Communication and Solid-State Lighting",doi:"10.5772/intechopen.100106",slug:"blue-laser-diode-based-visible-light-communication-and-solid-state-lighting",totalDownloads:161,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"In this chapter, we review our recent work on blue laser diode-based visible light communication and solid-state lighting. Gallium nitride (GaN) phosphor-converted white light-emitting diodes (Pc-WLEDs) are emerging as an indispensable solid-state lighting (SSL) source for next-generation display system and the lighting industry. Together with the function of lighting, visible light communication (VLC) using Pc-WLEDs has gained increasing attention to fulfill the growing demand for wireless data communication. Practically, the low modulation response and low emitting intensity of light-emitting diodes (LED) are the drawbacks for the development of ultrahigh-speed VLC and high-quality SSL system. Blue GaN laser diode (LD) and remote phosphor-based white light can be used for both high-speed VLC and SSL simultaneously. We demonstrated a color-rendering index (CRI) of 93.8, a correlated color temperature (CCT) of 4435 K, and a data rate of 1.6 Gbps under NRZ-OOK modulation by an exciting blue laser diode on narrowband green−/red-emitting composite phosphor film. This work opens up exciting possibilities for future high-speed indoor VLC and high-quality SSL.",signatures:"Amjad Ali, Qian Li, Hongyan Fu and Syed Raza Mehdi",downloadPdfUrl:"/chapter/pdf-download/78824",previewPdfUrl:"/chapter/pdf-preview/78824",authors:[{id:"349652",title:"Dr.",name:"Amjad",surname:"Ali",slug:"amjad-ali",fullName:"Amjad Ali"},{id:"436926",title:"Prof.",name:"Qian",surname:"Li",slug:"qian-li",fullName:"Qian Li"},{id:"436927",title:"Prof.",name:"Hongyan",surname:"Fu",slug:"hongyan-fu",fullName:"Hongyan Fu"},{id:"436928",title:"Dr.",name:"Syed Raza",surname:"Mehdi",slug:"syed-raza-mehdi",fullName:"Syed Raza Mehdi"}],corrections:null},{id:"79218",title:"Near-Field Propagation Analysis for Traveling-Wave Antennas",doi:"10.5772/intechopen.100856",slug:"near-field-propagation-analysis-for-traveling-wave-antennas",totalDownloads:159,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The evolution of ElectroMagnetic (EM) models and modern EM solvers permit resolving a variety of real-life EM propagation and radiation problems, in which antenna design and optimization account a large proportion. However, understanding of EM propagation processes on antenna structures and design achievements can be limited when only total antenna responses are considered and there is lacking of near-field analysis. This chapter provides a better insight into the EM propagation processes on traveling-wave antennas. A near-field propagation analysis method is proposed based on simulated near-field data with corresponding meshed structure data. This overcomes the insufficiencies and obstacles for observation of the conventional analysis methods. The EM-solver-run optimization and accurate sampling for field and structure data are the first important steps for the analysis. For general propagation problems such as paths recognition and characterization of the propagation, the EM signal models, impulse response analysis and super-resolution algorithms for Time of Arrival (ToA) estimation are studied and proposed. 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Over the years, several definitions have been used to describe whole grains. Though these definitions exist, a harmonized definition is yet to be agreed upon with many nations rather adopting the definition of whole grains as used by the American Association of Cereal Chemist (AACC) international due primarily to its comprehensiveness [1]. Accordingly in 1999, the AACC defined whole grains as grains that consist of an intact, milled, cracked or flaked caryopsis whose primary components; starchy endosperm, germ and bran are present in the same relative proportions as they exist in the intact caryopsis. Plant produce that can be classified as whole grains include amaranth, brown and coloured rice, sorghum, teff, wheat, faro, wild rice, triticale, millet, quinoa, oats, buckwheat, whole rye, barley, corn (including popcorn) and bulgur. According to the Food and Drug Administration (FDA) of the United States, foods such as soybeans, oilseeds (sunflower seeds), roots and corn flour or corn meal without the pericarp and other essential fractions cannot be classified as whole grains [1,2]. The term grains can also be used as a collective name given to seeds of cereals (wheat, barley, oats, corn/maize and sorghum) and legumes like peanuts and cowpea (
Whole grains are rich in phytochemicals and provide unique bioactive compounds that are complementary to those in fruits and vegetables when consumed together. The additive and synergistic effects of phytochemicals in fruits, vegetables and whole grains are responsible for their health benefits [3]. Important groups of phytochemicals with great beneficial nutritional and health effects are phenolics, carotenoids, vitamin E compounds, lignans, β-glucan and insulin. Phenolic compounds are the most common antioxidants in whole grains and are generally categorized as phenolic acids, flavonoids, stilbenes, coumarines and tannins [4]. The most abundant phenolic compounds found in whole grains are phenolic acids and flavonoids (Figure 1).
Structures of common phenolic compounds
\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t||||||||
\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t|
Phosphorus | \n\t\t\t1170 | \n\t\t\t3010 | \n\t\t\t2460 | \n\t\t\t990 | \n\t\t\t4110 | \n\t\t\t1030 | \n\t\t\t1550 | \n\t\t\t2400 | \n\t\t\t350 | \n\t\t
Potassium | \n\t\t\t1550 | \n\t\t\t4380 | \n\t\t\t3290 | \n\t\t\t1200 | \n\t\t\t4000 | \n\t\t\t1500 | \n\t\t\t2420 | \n\t\t\t2200 | \n\t\t\t240 | \n\t\t
Magnesium | \n\t\t\t250 | \n\t\t\t930 | \n\t\t\t670 | \n\t\t\t470 | \n\t\t\t1170 | \n\t\t\t350 | \n\t\t\t1010 | \n\t\t\t1000 | \n\t\t\t188 | \n\t\t
Calcium | \n\t\t\t170 | \n\t\t\t330 | \n\t\t\t270 | \n\t\t\t60 | \n\t\t\t530 | \n\t\t\t60 | \n\t\t\t110 | \n\t\t\t100 | \n\t\t\t27 | \n\t\t
Sodium | \n\t\t\t20 | \n\t\t\t50 | \n\t\t\t40 | \n\t\t\t10 | \n\t\t\t40 | \n\t\t\t20 | \n\t\t\t10 | \n\t\t\tNA | \n\t\t\t5 | \n\t\t
Zinc | \n\t\t\t8 | \n\t\t\t28 | \n\t\t\t13 | \n\t\t\t5 | \n\t\t\t30 | \n\t\t\t17 | \n\t\t\t25 | \n\t\t\t34 | \n\t\t\t3 | \n\t\t
Iron | \n\t\t\t12 | \n\t\t\t28 | \n\t\t\t24 | \n\t\t\t11 | \n\t\t\t38 | \n\t\t\t12 | \n\t\t\t15 | \n\t\t\t48 | \n\t\t\t11 | \n\t\t
Manganese | \n\t\t\t5 | \n\t\t\t22 | \n\t\t\t13 | \n\t\t\tNA | \n\t\t\t58 | \n\t\t\t9 | \n\t\t\t15 | \n\t\t\t7 | \n\t\t\t1 | \n\t\t
Copper | \n\t\t\t1 | \n\t\t\t3 | \n\t\t\t1 | \n\t\t\tNA | \n\t\t\t2 | \n\t\t\t2 | \n\t\t\t6 | \n\t\t\t5 | \n\t\t\t0.2 | \n\t\t
According to the FDA, a whole grain food is said to meet the whole grain health claim when it contains 51% whole grain flour by weight of its final product. It is also said to meet the whole grain health claims when it contains all components of the intact grain, has about 1.7 g of dietary fibre and also contains 16 g whole grain per serving [5].
Whole cereal grains contain a wide range of bioactive components with antioxidant effect [10] such as dietary fibre (DF) and phytochemicals [11,12] that are beneficial against diabetes, colon cancer and cardiovascular disease (CVD) [13,6,14]. Antioxidants present in whole grain cereals act in defense to remove the reactive oxygen species (ROS) thereby preventing and curing oxidative stress-related diseases. In [15], it was reported that vitamin E, folates, polyphenols, minerals, trace elements, carotenoids, phytic acid, lignin and alkylresorcinols are the bioactive compounds available in cereal grains. Polyphenols that are predominant in cereals are hydroxycinnamic, ferulic, gallic, vanillic and ρ-coumaric acids, of which, ferulic acid is the most potent. Phenolic compounds [16] are said to be present in cereal grains in free and bound form, as conjugates with sugars, fatty acids or as proteins. These polyphenols have several biological functions such as antioxidant, anti-inflammatory and anti-cancer activities that can protect the human body, which is constantly exposed to endogenous and exogenous free radicals [17]. Plant sterols, also called phytosterols, found in plants, have been clinically shown to lower low-density lipoprotein (LDL) cholesterol by about 8 to 15% as part of a heart-healthy diet. Also, wholegrains that serve as source of DF are useful in the prevention and treatment of constipation, CVD and hypertension [8,12].
Grains can be classified as typical and pseudo-cereals. Typical cereals include sorghum, wheat, rice, barley, millet, rye, oat, maize, buckwheat, triticale, fonio, canary grass. Pseudo-cereals include amaranth, buckwheat, quinoa, kaniwa, and pitseed. Cereals reported with high antioxidant capacity include sorghum, wheat, barley, millet and amaranth. It has also been reported that bioactive substances occur in grains at different concentrations and identities depending on genotypes and phenotypes [9]. Sorghum, millet and barley adapted to the UAE environment, were found to contain reasonable levels of DF and antioxidant properties [9]. Experimental evidence has shown that certain cereals such as sorghum are rich in antioxidants that are comparable to those in fruits and vegetables [19]. Varieties of sorghum such as black sorghum, have been shown to contain significant amount of antioxidants; condensed tannins, anthocyanins (Figure 2 and 3) and other phytochemicals with properties that complement the phytochemicals present in fruits and vegetables [19]. Whole wheat and wheat bran-based ready-to-eat breakfast cereals have also been reported to be an important source of dietary antioxidants [20]. It has been shown [21] that buckwheat constitutes high amount of total phenolics, with the highest DPPH radical scavenging activity and capacity for Fe3+ reduction. Phenolic acids from breakfast cereals exhibit strong antioxidant activity
Condensed tannin
Chemical structure of anthocyanin
Cereals naturally contain a wide variety of polyphenols such as the hydroxycinnamic, ferulic, vanillic, and ρ-coumaric acids [20], which show a strong antioxidant power and may help to protect oxidative stress thus decreasing the risk of contracting several diseases [23,24]. Whole grains including wheat, contains several essential compounds that impact on the oxidative stability of cells. These compounds include selenium, β-carotene, vitamins C and E, phytate, proteins, polysaccharides, phenolics, lignans and tocopherols [20]. Phytic acid can protect tissues against oxidative reactions through its ability to sequester and inactivate pro-oxidative transition metals [25,20]. In addition, acid conditions and enzymic hydrolysis has been reported to increase the solubility and activity of wheat phenolics, suggesting that the digestive process could be important in altering the antioxidant potential of wheat-based foods [20]. Simulated gastrointestinal pH treatment and enzymatic hydrolysis also increase the antioxidant activity of wheat and wheat-based breakfast cereal extracts, suggesting that the digestive process could be important in further enhancing the antioxidant potential of wheat-based foods [20]. However, it is still unclear if the consumption of cereal causes better health or whether it is a case of health status influencing food choice [26,27,23].
Processed products from cereals contain different antioxidant contents at varying amounts (Table 2). The cereals containing most antioxidants include barley, millet, maize and oats. Notably, polished rice and refined wheat, which are the main cereals eaten by humans globally are among the cereals with the lowest content of antioxidants [28]. In contrast, common millet and sorghum, which are important in particular regions in sub-Saharan Africa, South America and Asia, contains medium to high concentrations of antioxidants. The predominant types of antioxidants in corn are ferulic acid, anthocyanins, catechin and ρ-caomaric acid. Wheat is high in β-glucan, β-cryptoxanthin, catechins, lutein, zeaxanthin and phytosterols. Barley is rich in tocopherols, tocotrienols and ferulic acids. Millet is high in tricin, luteolin and serotonin, whilst buckwheat contains rutin and catechins. Oats and rice are rich in avertramidin, catechins, proanthocyanidins and anthocyanins [3].
\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t
Barley, whole meal flour | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t1.09 | \n\t\t
Common millet, wholemeal flour | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t0.82 | \n\t\t
Maize, white flour | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t0.62 | \n\t\t
Oats, rough oatmeal | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t0.59 | \n\t\t
Barley, white flour | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t0.58 | \n\t\t
Rye, wholemeal flour | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t0.47 | \n\t\t
Wheat, wholemeal flour | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t0.33 | \n\t\t
Oats, white flour | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t0.32 | \n\t\t
Bulgur wheat, wholemeal flour | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t0.31 | \n\t\t
Sorghum, wholemeal flour | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t0.30 | \n\t\t
Common millet, white flour | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t0.25 | \n\t\t
Rye, white flour | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t0.23 | \n\t\t
Rice, grains | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t0.17 | \n\t\t
Wheat, white flour | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t0.13 | \n\t\t
Durum wheat, white flour | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t0.05 | \n\t\t
Rice, white flour | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t0.04 | \n\t\t
Pseudo-cereals | \n\t\t\t\n\t\t\t | \n\t\t\t | \n\t\t |
Buckwheat, wholemeal flour | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t1.99 | \n\t\t
Buckwheat, white flour | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t1.23 | \n\t\t
In the case of whole grains, corn, wheat, rice and oats are regarded as grains with high antioxidant activities. Corn has the highest total antioxidant activity compared to the other three grain types, followed by wheat and then oats. Rice has the lowest antioxidant activity compared to corn, wheat and oats [29]. Corn shows the highest total phenolic content at 1560 ± 60 µmol gallic acid equivalents/100 g, followed by wheat at 800 ± 40 µmol gallic acid equivalents/100 g, oats at 650 ± 20 µmol gallic acid equivalents/100 g and rice at 560 ± 20 µmol gallic acid equivalents/100 g. A study designed to investigate the complete phytochemical profiles in free, soluble conjugated, and insoluble bound forms, as well as their antioxidant activities in uncooked whole grains [30] showed that corn had the highest total antioxidant activity (181.42 ± 0.86 μmol of vitamin C equivalent/g of grain), followed by wheat (76.70 ± 1.38 μmol of vitamin C equivalent/g of grain), oats (74.67 ± 1.49 μmol of vitamin C equivalent/g of grain), and rice (55.77 ± 1.62 μmol of vitamin C equivalent/g of grain). Bound phytochemicals were the major contributors to the total antioxidant activity; 90% in wheat, 87% in corn, 71% in rice and 58% in oats. Bound phytochemicals can survive stomach and intestinal digestion to reach the colon. This may partly explain the mechanism of grain consumption in the prevention of colon cancer, other digestive cancers, breast cancer and prostate cancer as supported by epidemiological studies. Antioxidant activity of methanolic extracts from some grains consumed in Korea [31] revealed that the methanolic extracts prepared from red sorghum and black rice showed significantly higher antioxidant activities and contained higher polyphenolic contents than other grains such as white rice, brown rice, mungbean, foxtail millet, prosomillet, barley and adlay. Polyphenolic compounds were found to be the major naturally occurring antioxidants in grains. Antioxidant activity of small grain cereals caused by phenolics and lipid soluble antioxidants as investigated in [32] showed a general considerable variation in antioxidant activities and phytochemical contents between cereals. A higher DPPH radical scavenging ability and reducing power were detected in hull-less barley, followed by rye and hull-less oat and durum and bread wheat, indicating that small grain species have different major antioxidants with different properties. Hull-less barley was found to have the highest content of total free phenols, flavonoids, PVPP bound phenolics and contained flavan-3-ols, not found in other species. Hull-less oat had the highest content of tocopherols, very high content of yellow pigments and PVPP bound phenolics. Ferulic acid was the major free phenolic acid in small grain cereals tested. A study designed to determine the composition in hydroxycinnamic acids and the antioxidant properties of soluble extracts from wheat, rye and buckwheat [33] revealed that the highest levels of total hydroxycinnamic acids and derivatives were found in the wheat bran and rye bran fractions whereas the buckwheat flours had only trace quantities of these compounds. The most abundant compound present in the wheat and rye fractions was ferulic acid but small quantities of diferulic acids, sinapic acid, ρ-coumaric acid and benzoic acid derivatives were also present. The largest proportions of these phenolic compounds were found as covalently bound (esters) in the insoluble pellet but between 10% and 30% of the total compounds were solubilized, mostly in water. Most of the antioxidant capacity was found in the water extracts from all the cereal fractions. Overall, buckwheat and wheat germ products exhibited the highest antioxidant capacity whereas the rye products had the lowest antioxidant values, an indication that the consumption of buckwheat and wheat germ could be an important source of antioxidants required for healthy living.
The phytochemical content and antioxidant activity of six diverse varieties of whole wheat as reported in [34] showed free phenolic content ranging from 255 (KanQueen) to 499 (Roane) 1mol gallic acid equivalents/100 g DW. The bound phenolic content ranged from 582 (Roane) to 662 (Cham1) 1mol gallic acid equivalents/100 g DW. The bound fraction contributed 53.8 - 69.7% of the total phenolic content of the wheat varieties analysed. Ferulic acid was the predominant phenolic acid found in whole wheat. Total ferulic acid content ranged from 310.8 (Caledonia) to 496.1 (KanQueen) 1mol ferulic acid/100 g DW. The percentage of ferulic acid found in the insoluble-bound fraction ranged from 87.4% (Caledonia) to 97.2% (KanQueen). Other phenolic acids, ρ-coumaric acid, syringic acid, vanillic acid, and caffeic acid were also detected. Lutein was the predominant carotenoid found in the whole wheat varieties analysed. Zeaxanthin, β-carotene, and β-cryptoxanthin were also detected. Mainly α- and β-tocopherols and α- and β-tocotrienols were found in all varieties of whole wheat though δ-tocopherol was detected in all but two varieties. β-tocotrienol was the predominant form of vitamin E found in all varieties of whole wheat (Table 3). The antioxidant activity was assessed using the oxygen radical absorbance capacity (ORAC) assay. The ORAC of the free fraction ranged from 1958 to 3749 1mol Trolox equivalents/100 g DW. The ORAC of the bound fraction ranged from 3190 to 5945 1mol Trolox equivalents/100 g DW. Total phenolic content correlated with oxygen radical absorbance capacity (R2 = 0.810; p < 0.001). They concluded that phytochemicals found in whole grains may be responsible for the health benefit derived from whole grain consumption.
\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t||||||
\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t|
Wheat | \n\t\t\t10 | \n\t\t\t7 | \n\t\t\tNA | \n\t\t\tNA | \n\t\t\t4 | \n\t\t\t28 | \n\t\t\tNA | \n\t\t\tNA | \n\t\t
Rye | \n\t\t\t16 | \n\t\t\t4 | \n\t\t\tNA | \n\t\t\tNA | \n\t\t\t15 | \n\t\t\t8 | \n\t\t\tNA | \n\t\t\tNA | \n\t\t
Barley | \n\t\t\t8.6 | \n\t\t\t0.9 | \n\t\t\t5.6 | \n\t\t\t0.7 | \n\t\t\t40.3 | \n\t\t\t8.7 | \n\t\t\t10.4 | \n\t\t\t0.9 | \n\t\t
Oats | \n\t\t\t14.9 | \n\t\t\t3.0 | \n\t\t\t0.4 | \n\t\t\tNA | \n\t\t\t56.4 | \n\t\t\t5.4 | \n\t\t\tNA | \n\t\t\tNA | \n\t\t
Maize | \n\t\t\t3.7 | \n\t\t\t0.2 | \n\t\t\t45.0 | \n\t\t\t1.0 | \n\t\t\t5.3 | \n\t\t\tNA | \n\t\t\t11.3 | \n\t\t\t0.4 | \n\t\t
Rice | \n\t\t\t14.6 | \n\t\t\t1.0 | \n\t\t\t1.3 | \n\t\t\t0.1 | \n\t\t\t8.7 | \n\t\t\tNA | \n\t\t\t11.9 | \n\t\t\t0.5 | \n\t\t
Rice is rich in phytochemicals that are present in lipophilic, hydrophilic and insoluble forms. In reference [38], it was indicated that tocopherols, tocotrienols (Figure 4) and ץ-oryzanol, are major lipophilic fractions of whole grain rice and are beneficial to human health. It also contains tricin, ferulic acid, caffeic acid and methoxycinnamic acid which are hydrophilic phenolic compounds reported to have cancer protective potential. Barley grains contain DFs, β-glucans, arabinoxylans and polyphenols [39,40]. β-glucans and arabinoxylans present in barley are critical nutrients that determine wort viscosity, foam stability and beer filtration rates, thus playing a significant role in beer brewing process [41,42]. Barley β-glucans also plays health beneficial roles in the reduction of blood cholesterol level, glucose level and helps in weight loss by increasing satiety, thereby reducing susceptibility to heart disease and type-2 diabetes [40]. Oats and psyllium husk which contains fibres have also been implicated in the reduction of homocysteine, cholesterol and risk of CVD [43]. Millets are rich source of DF, phytochemicals, micronutrients, nutraceuticals, and could be rightly termed as nutricereals.
Tocopherols and tocotrienols in grains
Dietary antioxidants are food compounds that impede the deleterious effects of reactive oxygen species, reactive nitrogen species, or both, on the normal physiological function in humans [44,27]. Dietary antioxidants include ascorbate, tocopherols, carotenoids and bioactive plant phenols. ROS; oxygen ions, free radicals, and peroxides and reactive nitrogen species (RNS); nitrous anhydride, peroxynitrite, and nitrogen dioxide radicals, causes oxidation, nitration, halogenation and deamination of biomolecules of all types, including lipids, proteins, carbohydrates, and nucleic acids, with the resultant formation of toxic and mutagenic products [45,46]. Biological systems control these oxidative factors by a variety of antioxidative mechanisms that restrict the reactivity of ROS and RNS and oxidation catalysts [20]. In human cells,
Phenolic compounds present in whole grains are known to be effective in protecting against CVDs and some cancer (Table 4). This protective effect is thought to be mediated through their action as antioxidants to prevent oxidative damage induced by ROS to some biomolecules (DNA, lipids and proteins) under pathological conditions [47]. In reference [48], it was reported that phenolic compounds could be responsible for chelating metals as well as inhibiting the free radicals capitation by limiting the action of the lipoxygenase enzyme. Phytate compounds on the other hand may exert antioxidant activity by complexing with iron, reducing the formation of free radicals and peroxidation of membranes, which could provide anticarcinogenic power. Lignans on their part are a group of dietary phytoestrogen found in a variety of plant foods like corn, oats, rye, wheat, flaxseeds, legumes, fruits and vegetables. These plant lignans when consumed are converted to the mammalian lignans, enterodiol and enterolactone which have strong antioxidant activity. β-glucan is mostly found in cell walls of oats, barley and wheat. Its major biological effects include lowering of blood cholesterol level, controlling blood sugar, promotion of weight management, encouraging the growth of beneficial gut microflora and enhancing the immune system. This is probably due to its high viscosity property as a soluble fibre to bind cholesterol and bile acids and facilitate their elimination from the body. It has been [93] indicated that β-glucan had an effect in controlling blood sugar in diabetes subjects, and was helpful in reducing the elevation in blood sugar levels after a meal. The authors further indicated that this is probably as a result of delaying gastric emptying, allowing dietary sugar to be absorbed more gradually, as well as by possibly increasing the tissue sensitivity to insulin. The United States Food and Drug Administration (FDA) is allowing whole grain barley products that can supply β-glucan at levels of 0.75 g per serving or 3 g per day to carry a claim that they reduce the risk of coronary heart disease [49].
\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t\t\n\t\t\t\t | \n\t\t
Vitamins (Tocopherols and tocotrienols) | \n\t\t\tGerm of all cereal grains. | \n\t\t\tHPLC | \n\t\t\tInduction of immune responses; lowering of cholesterol levels; defence against oxidative stress; antimutagenic and anticancer. | \n\t\t\t[50,51,52] | \n\t\t
Phytosterols (Sitosterol, campesterol, stigmasterol, brassicasterol) | \n\t\t\tAleurone, pericap and germ of rice, wheat, rye, oat and barley. | \n\t\t\tGas chromatography analysis | \n\t\t\tPrevent CVDs. | \n\t\t\t[53,54,55] | \n\t\t
Phenolics (Lignans, phenolic acids, alkylresorcinols, avenathramide, coumarins) | \n\t\t\tBran layer of most cereals e.g. barley, sorghum, rice, rye, wheat, millet and oat. | \n\t\t\tHPLC, GC-MS | \n\t\t\tBelieved to have anticancer activity; prevent oxidative stress, cholesterolemia, atherosclerosis and aging; anti-inflammatory and anti-irritant. | \n\t\t\t[56,57,52,58] | \n\t\t
Carotenoids | \n\t\t\tYellow endosperm of durum wheat. | \n\t\t\tUV/Vis spectrometry, HPLC and MS spectrometry | \n\t\t\tPrevent cataracts, age-related muscular degeneration, cancer and cardiovascular disease. | \n\t\t\t[59,52,60] | \n\t\t
Flavonoids (anthocyanidins, flavonols, flavanones) | \n\t\t\tYellow lemon sorghum, aleurone of blue and red coloured maize. | \n\t\t\tUV/Vis spectrometry, HPLC, mass spectrometry | \n\t\t\tInhibitory effects on cancer, anti-inflammatory properties, reduce glycemia, combats complications of diabetes. | \n\t\t\t[61,52,62,63] | \n\t\t
Phytate (Inositol hexaphosphate) | \n\t\t\tAleurone layer and scutellum cells of germ of most cereals. | \n\t\t\tHPLC, HPIC | \n\t\t\tGene regulation, anti-inflammatory, prevents complications of diabetes, antineoplastic in breast, colon and liver. | \n\t\t\t[64,65,66] | \n\t\t
Antioxidant compounds in cereals, human effects and methods of determination
According to [67], these antioxidant compounds may offer protection against heart disease, hormone-related breast and prostate cancers. Enterodiol and enterolactone inhibited colon cancer cell growth, induced cell cycle and apoptosis
Whole grains, oilseeds, nuts and legumes are rich in sterols and stanols. In humans, high intake of sterols or stanols is associated with lowering of serum and LDL cholesterol concentrations. Phytosterols compete with cholesterol for micelle formation in the intestinal lumen and inhibits cholesterol absorption [73],. Whole grains are good sources of health beneficial phytochemicals. These phytochemicals are in free soluble-conjugated and bound forms [74]. Most of them are bound to the cell wall materials and insoluble. This makes it difficult for these phytochemicals to be released during the upper gastrointestinal tract digestion. As a result of this, colonic digestion of such materials by microflora results in the release of the bulk of bound phytochemicals to exert their health benefits. Hence, the reduced risk of colon cancer associated with increased consumption of whole grain products. Higher beans consumption apart from being associated with reduced risk of diabetes and obesity, is inversely associated with prostate, breast and colon cancers [10]. This is due to the presence of elements which are able to retard the glycemic response, slowing the release of glucose into the blood [75]. This antioxidant and anticarcinogenic effect of beans has been attributed to the presence of phenolic and phytate acids, which were previously regarded as unwanted compounds with antinutritional factors.
Consuming whole grains and their products regularly is associated with risk reduction of developing chronic diseases such as CVDs, type 2 diabetes and some cancers. Therefore, dietary modification by increasing the consumption of wide variety of fruits, vegetables and whole grains daily is a practical strategy for consumers to optimize their health and reduce the risk of chronic diseases [76].
Cereal extruded products are mainly composed of starches, and or vegetable proteins. The role of these constituents is mainly to impart structure, texture, bulk, mouth feel and other desired characteristics for finished products [77]. Infant cereals are one of the most common weaning foods. However, these foods in their natural form may lack some vital infant nutritional requirements for proper growth. The nutritional quality of raw cereal based infant products is low, hence they have to be processed (fortified) to improve their overall nutritional quality [78].
A novel way of consuming grain products is the consumption of functional foods. Functional here refers to foods that provide other health benefits to the body apart from those derived from its nutrients. Eating whole grain meals and functional food products will therefore enhance the nutritional intake derived from whole grain related diets [79].
Recent dramatic increases in food prices are having severe consequences for poor countries and their populace. The Food and Agriculture Organization (FAO) of the United Nations, reports that food prices rose by nearly 40% in 2007 and made further large jumps in early 2008. Nearly all agricultural commodities including rice, maize, wheat, meat, dairy products, soybeans, palm oil, and cassava are affected. In response to the price hikes, food riots have occurred in many developing countries, including Burkina Faso, Cameroon, Côte d’Ivoire, Egypt, Haiti, Indonesia, Senegal, and Somalia. According to the FAO, 37 countries are now facing food crises [80].
Many investigations continue to establish the protective cancer-preventive and healthful compounds in cereal grains [81-83,12]. In [84], it was reported that many epidemiological studies suggested that consumption of whole grain cereal is highly correlated to reduced incidences of chronic diseases. Experimental and epidemiological studies have shown that consumption of grains, lower the incidence of aging diseases, as well as other non-communicable diseases such as colorectal cancer, hypertension, stroke and heart diseases [85-87]. There is strong epidemiological evidence that whole-grain cereals protect the body against age-related diseases such as diabetes, CVDs and some cancers. This may be due to the fibre and micronutrients in the outer layer and germ fractions of the grain acting together to combat oxidative stress, inflammation, hyperglycaemia and carcinogenesis. It has been shown that the whole wheat flours of different wheat varieties contain significant amounts of phenolic antioxidants and dietary fibres). Cereal bran fibres, good for colon health, show good potential for high incorporation into extruded foods [88]. Sorghum phytochemicals have been shown to have potential impact on human [19]. There is now evidence that the consumption of whole grains and whole-grain products is implicated in the prevention of cancer and other chronic diseases [83]. Studies have shown that plant food material with polyphenolic constituents have more potent antioxidant and anti-inflammatory activities. In many epidemiologic studies, an inverse association between high cereal intake and low cancer incidence has been observed [83,11].
Future research in antioxidant rich grains may address regional health issues. In Africa, future research on antioxidant- rich foods can also be directed to address nutritional issues. It was suggested that while corn starch provides all the features for production of highly acceptable extruded snack foods its nutritional value is far from satisfying the needs of health conscience consumers [78]. In the US, future prospective studies may address the question of whether whole grain intake is directly related to body weight and obesity and whether the associations are primarily driven by fiber, other dietary component of whole-grain foods, or some other related aspect of the diet [89].
Epidemiological studies have shown that the consumption of whole grain cereal foods reduces the risk of chronic diseases linked with metabolic syndrome, such as CVD and diabetes. Aggressive and consistent consumer education needs to be put in place by the government or relevant agencies to educate consumers on the health benefits of cereal foods especially in the developing countries where the level of ignorance is high and literacy is low. Furthermore, food scientists and engineers, nutritionists and consumer scientists should look into developing more varieties of appealing cereal based products from the already identified cereal grains rich in antioxidants and bioactive components. More clinical trials are required to strengthen the proposed link between the phenolic compounds found in rice and chronic disease prevention. Research is needed to evaluate the effects of both hydrophilic and lipophilic antioxidants on their antioxidant capacity. Clinical trials that ascertain the phytochemicals found in whole grains may be responsible for the health benefit derived from whole grain consumption.
The beneficial effects associated with whole grain consumption are in part due to the existence of the unique phytochemicals of whole grains [9]. Based on the epidemiological data, consumption of whole wheat grain has been recommended to improve insulin sensitivity and to lower serum insulin concentration [90,91].
In the United States (US), stroke is the fifth leading cause of mortality with a stroke occurring approximately every 40 seconds and stroke-related death approximately every 4 minutes [1, 2]. In 2011, stroke was found to be the leading cause of disability in the US, with around 7 million stroke survivors [3]. In 2016, the World Health Organization designated stroke as the second leading cause of mortality worldwide. Acute ischemic strokes account for about 80% of all stroke-related deaths [4]. Intravenous tissue plasminogen activator (tPA) has been shown to improve outcomes in acute ischemic stroke [5, 6]. In patients who receive tPA, early administration has been shown to reduce morbidity, mortality, and adverse events such as intracranial hemorrhages, promoting early discharges and higher rates of independent ambulation at discharge [5, 7]. Mechanical thrombectomies performed by neuro-interventionists have shown to improve outcomes for patients with proximal intracranial arterial occlusion [8, 9, 10, 11] and have become the standard of care for patients who qualify for intervention. However, this procedure is performed only at tertiary care centers and is not available at smaller hospitals around the country.
\nDespite the obvious benefits of tPA administration, only a small percentage of patients presenting with acute ischemic strokes are eligible to receive it [12, 13, 14, 15]. The most common reason attributed to this is a delay between the development of stroke symptoms and the patient seeking treatment at a hospital [16, 17]. There are also marked rural–urban disparities in stroke care [18, 19, 20]. These disparities are, in part, a result of the scarcity of neurologists [21, 22, 23, 24]. Studies have shown better outcomes in stroke patients under the care of neurologists as compared to physicians of other specialties, such as Internal Medicine or Family Medicine [22, 25, 26]. Telestroke aims to bridge this gap by providing neurology expertise in remote areas around the world through high-quality audio-video conferencing and digital image sharing.
\nCommunication of medical information across long distances has occurred throughout history. It is well documented that bonfires and heliographs were used to send communications about the bubonic plague in Europe [27]. Telegraph communication was used in the civil war and radio communication was used in World War I, and wars thereafter, to send information about casualties and to request medical dispatches and transport for wounded soldiers [28]. Telemedicine in its current form was developed by NASA to monitor the physiologic states of astronauts during manned space missions [29]. The first interactive video telemedicine systems were established for psychiatry [30] and radiology [31] but later expanded to critical care [32] and oncology [33] to bridge the shortage of specialists in these fields. In 1999, the term
Before discussing telestroke models, it is important to understand the terminology used to describe telestroke systems, as described by the American Telemedicine Association [39].
Distant site: the distant telestroke provider location.
Originating site: the site where the patient is initially located.
Telestroke network: a group of primary, secondary, and tertiary care settings that provide acute stroke care to patient populations. Telestroke networks consist of originating sites where the patients are located and distant sites where the telestroke provider is located.
Spoke: the affiliate or partner site in a telestroke network that is underserviced or under-supported by neurologists where patient services are delivered.
Hub: a comprehensive tertiary care center where vascular neurologists and other acute stroke specialists compose a call panel delivering telestroke services to network partner sites (i.e., spoke sites). This is also the center where the patient may be transferred if a higher level of care is needed.
Several different telestroke models have been described and are listed below [38, 39].
Hub and spoke within a single healthcare system.
Hub and spoke with external sites.
Horizontal hubless network: interconnected sites within a large hospital system for on-call clinical coverage.
Third-party distribution model: telestroke services are provided to multiple originating sites through arrangements with an independent corporation or an affiliated network of telestroke providers.
Supervisory training model: academic teleneurology programs to assist trainees within the hospital system.
Hub and Spoke with external sites and third-party distribution models are the most commonly used models within telestroke [35]. In telestroke networks, the majority of spoke sites are small hospitals (i.e., 0–99 beds) [37], but the spoke hospital size may vary from 25 to 500 beds in different telestroke networks [17]. A telestroke consult typically starts with a patient presenting to a spoke site with a suspected stroke. After an initial assessment by the physician at the spoke site, a triage process is conducted through telephone operators, followed by a video teleconferencing call with the neurologist at the distant site [see flow diagram of a telestroke system]. After reviewing the National Institute of Health Stroke Scale (NIHSS) and brain imaging (typically a non-contrasted CT scan of the head) and reviewing the patient’s history for indications/contraindications for tPA, a decision is made for administration of tPA. After this initial process, the decision of transferring the patient to the hub site is made, depending upon the need for further investigation, possible thrombectomy/neurosurgical intervention, or requirement of a higher level of care as compared to the spoke site. The term “Drip and Ship” is often used to describe transfer from spoke to hub sites, where after receiving the bolus dose of tPA, the patient is started on tPA drip and transferred emergently for further management [40].
\nThe majority of the hospitals in telestroke systems have formal written contracts between the hub and the spoke site with a closed-loop communication system in place [37]. A vast array of Food and Drug Administration (FDA) approved two-way video-conferencing modalities with picture archiving and communication system are available for use by these networks that provide Health Insurance Portability and Accountability Act (HIPPA) compliant, secure, encrypted multipoint data sharing with evolving functionality through the use of desktops, robotic carts, laptops, tablets, and even mobile phones with provider-to-provider interfaces [37, 38].
\nMore recent advancements in telestroke systems include an ambulance-based telemedicine system that provides a feasible tool for prehospital stroke assessment [41, 42, 43, 44]. Early attempts at prehospital telestroke consults were limited due to technical difficulties [44]. Newer studies have shown a high level of agreement in evaluation and treatment by mobile stroke units with a vascular neurologist on board compared to telestroke consults by a vascular neurologist [45] at a distant site who guides immediate treatment [46]. The data, however, is still limited and requires further investigation before the utility and efficacy of telestroke programs can be ascertained.
\nThe primary goal of telestroke models is to establish a network of neurology consults across underserved areas that do not have in-house neurology consultants available, thereby expediting the initial stroke exam and care. As the effective tPA window is time-sensitive, and early administration of tPA is known to improve outcomes [5, 6, 13, 47], delay in transport of patients to tertiary care centers can lead to loss of the crucial intervention time window in acute ischemic stroke patients. After adequate training, the use of telestroke systems to measure NIHSS scores is viable and scoring is reliable, with inter-rater reliability comparable to that of in-person measurements [48, 49] even in telemedicine-naïve stroke practitioners [50]. Such assessment has also been found to be reliable when performed by neurology trained nurse practitioners [51], on laptop-based workstations [52], or even mobile-based video telestroke consults [53, 54]. Also, the FDA has approved teleradiology systems that enable effective and rapid evaluation of images by stroke specialists [55]. Stroke specialist evaluation via teleradiology systems has been found to be comparable to assessment by a neuroradiologist in aiding the decision making for tPA administration [56, 57].
\nStudies have shown that telestroke facilitated administration of tPA to patients in community hospitals and rural hospitals (as small as 100 beds or less) has outcomes comparable to those of in-person treatment at comprehensive stroke care centers [58, 59, 60, 61]. Even with in a stroke network, the performance of spoke sites is similar regardless of the bedsize [62]. Also, the use of telestroke at rural hospitals can provide patients with comparable or reduced time between symptom onset and tPA administration [door-to-needle time (DTN)] compared to those directly presenting to tertiary care centers [63]. A non-blinded randomized control trial in the Telemedic Pilot Project for Integrative Stroke Care (TEMPiS) network in Germany showed that patients treated in telestroke network hospitals had significantly fewer poor outcomes compared to patients treated in community hospitals without telestroke capabilities [64]. Telestroke consults are becoming exceedingly cost-effective in dealing with acute strokes in the community [65, 66, 67, 68, 69].
\nTelestroke consults also have utility beyond acute stroke. Patients receiving tPA or those with subacute strokes with milder symptoms not requiring emergent intravascular intervention can remain at the spoke site for further investigation. Telestroke follow-up consults can aid in guiding the physicians at the spoke sites to continue further stroke workup and discharge patients from the spoke site. This may also reduce the cost of transport and limit patients being transferred to hub sites to only those requiring urgent neurosurgical/intravascular intervention. A randomized control trial by Evans et al. showed that the management of stroke patients in dedicated stroke units showed better outcomes for large vessel infarcts but not for small lacunar infarcts when compared to those in general medical wards with stroke team support [70]. Based on this hypothesis, small lacunar strokes could potentially be managed by the medical team at spokes sites with telestroke consults and follow-ups. The Telemedicine in Stroke in Swabia Project and The Order of St. Francis Stroke Network study experience demonstrated the safety and reliability of such telestroke models [71, 72]. Even for patients requiring treatment in an intensive care unit, teleneurointensive care units are providing valuable support for prevention, diagnosis, and the timely management of cerebrovascular conditions induced secondary to neurologic injuries [73] and have shown improved outcomes [74].
\nTelestroke has also been studied in in-home and ambulatory post-stroke rehabilitation settings for serial neurologic assessments and timely adjustments of therapies. These studies have shown that telerehabilitation approaches are comparable to conventional rehabilitation in improving activities of daily living and motor function for stroke survivors [75, 76]. Virtual neurovascular clinics aimed at secondary stroke prevention are another evolving avenue for follow-up visits for stroke patients [77].
\nIn the field of clinical research, telestroke consults may aid in identifying patients who are eligible for trials of therapies for ischemic or hemorrhagic strokes, neuroprotective agents, or innovative diagnostic tests, thereby facilitating expedited enrollment at the originating sites after transfer to stroke centers [78]. Telestroke models are being incorporated into the education and training of neurologists, emergency teams, and nursing staff [77, 79, 80, 81, 82]. With the ever-expanding horizons of telestroke, training in telemedicine will likely become mainstream for all future physician and medical personnel training programs. However, the data regarding the use of telestroke beyond acute stroke care is still limited and needs further investigation.
\nZaidi et al. showed that outcomes at 90 days were no different between patients treated with tPA by telemedicine and patients treated by the same neurologists over the same time interval at the stroke center hub hospital [83]. They also found no difference in time from stroke onset to treatment. Switzer et al. found that the average time between symptom onset and treatment at the spoke sites in their telestroke system was lower than the emergency department at their hub site [63]. As previously mentioned, several studies have found post-tPA outcomes at spoke sites were comparable to those of in-person treatment at comprehensive stroke care centers [58, 59, 60, 61]. Implementation of a standardized regional telestroke program in a community setting increased utilization of alteplase, improved DTN time, decreased length of stay, and significantly increased the chances of patients going home [84].
\nEstablishing a telestroke network requires infrastructure and technology-related expenses along with the expenses of round-the-clock neurology coverage and the cost of transport. Initial projects around the country were supported by government funds and research grants, but to develop a self-sustaining model, telestroke networks need to be cost-effective. For a Danish telestroke system consisting of five hubs and five spokes, a 2008 study by Ehlers et al. calculated an incremental cost-effectiveness ratio (the cost of thrombolysis per quality-adjusted life year [QALY]) to be approximately US$50,000 after 1 year [69]. In 2011, Nelson et al. conducted cost data analyses of telestroke networks in rural Arizona and Utah and found the incremental cost-effectiveness ratio using a 90-day horizon of $108,363 per QALY and a lifetime horizon of $2449 per QALY [66], which reflected a high initial cost but overall long-term cost reduction, likely due to rehabilitation cost reduction from early tPA administration. Also, the highest cost-effectiveness was seen in the most severe stroke cases. In a 2013 study by Switzer et al., cost savings of $358,435 per year over 5 years were observed in a telestroke system consisting of one hub and seven spokes, as well as an improvement in patients’ quality of life associated with increased numbers of individuals being discharged to home [67]. Growing evidence for the cost-effectiveness of telestroke networks and improved patient outcomes has spurred the growth of telestroke networks around the world.
\nContinuous quality improvement is a key element for any successful telestroke program. Several elements play a role in this improvement, including adaptation to local laws and statues, effective training programs, identification of competency issues, and overcoming challenges with technical and manpower issues at both provider and recipient sites. In 1988, Donebedian was the first to describe the model of structure, process, and outcomes measurements for assessing the quality of healthcare [85]. Systematic collection and analysis of quality data has been shown to improve the quality of stroke care that is delivered [86], and telestroke is no exception to this. Several quality measures help assess and quantify the overall function of telestroke systems. Most hub hospitals have stroke certification and emergency and ICU staff training through standards set by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) process.
\nThe capacity of the healthcare system, staffing ratios of specialists, availability of specialized units and equipment, and the organization structure with hospital networking should all be carefully studied and analyzed for any telehealth network systems. Defined protocols should be in place both at the originating and distant sites.
\nAnalogous to the traditional stroke pathway, the key global component of telestroke quality is still DTN time. Median DTN with telestroke varies from 106 to 121 minutes, even though the recommendation is less than 1 hour [58]. Several aspects of stroke chain-of-care that play an important role in DTN include Emergency Department (ED) door to CT scan (D-CT) time, ED door to teleneurologist consult time, teleneurologist to camera/phone time, and teleconsult duration (Con).
\nClear definitions of these times are important as no uniform definitions currently exist. In some centers, a consult with teleneurologist occurs after CT scan results are obtained, while in other centers, a consult is initiated even before the CT scan is ordered. The time from ED to consult differs in these situations, which can affect these measures. Similarly, the definition of consult time varies between centers. At some centers, consult time is defined as the time spent on camera evaluating patients, and at other centers, it is defined as time spent on camera along with the time spent reviewing the images and other diagnostic results. Because of these variations, consult duration varied from 14 to 32 minutes in different studies [87, 88]. Studies showed that telestroke by itself might not decrease the DTN as there are variations in the subsects of stroke chain-of-care [89].
\nIt has been shown that D-NC and Con play a major role in DTN [90]. Various factors including, when the consultant is notified, the time a consultant takes to interview the patient, and the experience level of the staff aiding with the examination will have to be considered while analyzing such data. The percentage of patients transferred after a telestroke consult to a destination hospital is also an important factor as it involves significant costs [67]. Data should be collected quantifying the rate of transfers after the consult and steps should be taken to minimize unnecessary transfers.
\nThe success of any program is ultimately decided by measuring outcomes, which could be patient related or system related. A modified Rankin scale, which is measured 90 days after a stroke, is the most commonly used measurement of stroke outcome [83]. Steps should be taken to ensure a 90-day follow-up on all the telestroke treated patients. No significant differences in mortality or morbidity were noted in patients in the hub and spoke hospitals of the TEMPiS network [91]. Even though 90-day outcomes after stroke are reported in most clinical trials, this data is not routinely collected by hospitals because of the cost and complexity involved. Data on stroke mimics that were treated by telestroke networks is an important factor as it plays a big role in minimizing costs, even though tPA administration might not increase the risk to these patients. Similarly, data on the percentage of patients receiving tPA through telestroke networks is very useful to compare with in-person stroke treatment numbers. In a study that examined several telestroke networks, the rate of tPA via telestroke was 18–36% compared to the national average tPA administration rate of 5–8% [91].
\nData collection regarding patient characteristics, NIHSS score pre/post-treatment and before discharge, length of hospital stay, discharge disposition (home vs. rehab vs. sub-acute rehab), readmission rate, complications including intracranial hemorrhage, other significant hemorrhages, mortality, and 90-day follow-up outcomes are recommended by the American Heart Association and the American Stroke Association [92]. One of the highest priorities for several healthcare systems is patient satisfaction. Attempts should be made to follow-up with the treated patients and family members about their satisfaction with the telestroke process. LaMonte et al. found that the telestroke process enhanced patient satisfaction in their study [93]. Measuring provider satisfaction is equally important for improving telestroke service quality. Studies showed that patients are more enthusiastic about telemedicine compared to providers even though both of the groups were satisfied [94]. Providers having less of a personal benefit was one of the possible reasons behind this discrepancy [92].
\nIn a good telestroke program, the technology involved is as important as the physicians’ clinical expertise. Video and audio conferencing equipment quality, transmission clarity, internet speed, user-friendliness of the software, accessibility of personnel training modules, and encryption of patient information in transit to protect patient privacy all play a role for effective delivery of telestroke care. All technical difficulties, failures, and limitations should be continuously monitored, documented, and analyzed promptly to prevent repeated occurrences.
\nLastly, apart from the issues unique to telestroke, data on regular measures as recommended by National Quality Forum for stroke patients, including use of tPA, anti-thrombolysis therapy by day 2, thromboembolism prophylaxis, lipid-lowering medications on discharge, anti-thrombotic therapy on discharge, anticoagulation in the setting of atrial fibrillation, rehabilitation evaluation, and stroke education should be collected and evaluated regularly [95].
\nThere are still challenges with current models. In the last 15 years, there has been a substantial improvement in stroke quality measures. Most of the measures are already being performed with a high compliance rate and innovation. They should be expanded to pre-hospitalization and post-hospitalization settings as well as to telestroke for further improvement of stroke care [62, 96, 97, 98, 99]. Universal guidelines about definitions of times in stroke chain-of-care, protocols for consultant notification, and specific standard stepwise processes that can be applied universally for telestroke networks will be useful in standardizing telestroke models. As telestroke is becoming more popular in delivering care for acute stroke patients, there is a need for strict quality metrics to ensure safe and effective care for the patients. Even though in several aspects telestroke is as effective as in-person stroke care, there are several issues pertinent to telestroke like technology, policies, and challenges with data collection due to distant participating sites that need to be refined for effective and timely management of stroke patients.
\nLack of neurology coverage is not unique to the US; it is a problem worldwide [100]. Several countries in Europe have developed efficient telestroke networks [59, 64, 69, 101, 102, 103], with the TEMPiS network in Germany showing remarkable results [64, 104, 105]. The Telestroke Committee of the European Stroke Organization has recently published recommendations regarding telestroke networks in Europe concerning infrastructure, teleconsultation service, transfer options, standard operating procedures, professional training, and quality monitoring and improvement. They have also made recommendations about the technical and ethical aspects of telemedicine [106], which are similar to ones in the US.
\nAsia is quite heterogeneous in terms of variability in language, governments, culture, historical links, socioeconomic development, and organization of health services. In China, the National Telestroke Center, established in 2014, was designed to provide neurological coverage to 300 rural hospitals throughout the country through the telestroke network [107]. This was also the first platform where Google Glasses were used for real-time telestroke consults. The system is still evolving and data from China is still limited. In India, telestroke systems are still uncommon, but they show prospects for expansion, aiming to provide care to rural communities that are limited in their resources [108, 109]. Japan, Singapore, and South Korea have rather advanced nationwide medical systems, but telemedicine experience in these countries is still limited [110, 111, 112]. Teleneurology and telestroke have great potential to extend neurology expertise to underserved populations in the world; however, further investment in creating infrastructure and technology is needed before their impact on healthcare is realized.
\nIn December 2019, the first case of the novel coronavirus COVID-19 was identified in China [113]. Since then, the rapid spread of the virus has led to a worldwide pandemic [114]. The US has become the epicenter of this pandemic with the largest number of reported cases worldwide. Of all COVID-19 cases, an estimated 19% are healthcare personnel [115]. The COVID-19 pandemic has put a significant strain on healthcare personnel in providing in-person care, especially in an acute setting. Several States in the US and countries around the world have implemented stay-at-home orders. Hospitals have canceled elective procedures and outpatient in-person clinic visits to minimize the exposure risk to patients and healthcare workers. Additionally, COVID-19 is associated with an increased risk of thromboembolic complications [116]. This puts neurologists at risk of exposure while assessing patients with acute neurological deficits. Screening for symptoms of COVID-19 has also become difficult in the setting of neurological deficits, especially aphasia and encephalopathy. Most countries around the world, including the US, already suffer from a lack of adequate neurology coverage [100] and COVID-19 exposure not only puts neurologists’ wellbeing and life at risk but also exacerbates this deficiency. This pandemic has brought the need and utility of telemedicine, teleneurology, and telestroke into the limelight [117, 118, 119, 120]. Teleconsults are an effective way of providing outpatient care as well was acute care inside the hospitals, limiting the exposure risk to physicians and patients, as well as limiting the use of personal protective equipment which is in short supply. The pandemic may change the paradigm of teleneurology and telestroke permanently and force the system to adapt to its growing need at a much faster pace.
\nDespite the utility and efficacy of telestroke networks, there exist significant hurdles in establishing and efficiently sustaining a viable telestroke program.
\nThe most important hurdle is third party reimbursement. It took decades for the concept of telemedicine to come to fruition, and pay parity kept telemedicine programs across the country from flourishing, sustaining, and expanding [121, 122, 123, 124, 125, 126]. Without appropriate reimbursement, the burden of financial overhead in maintaining the high-quality video interface, teleneurology and teleradiology coverage, and costs of emergent care including imaging, tPA, and transportation to hub hospitals would make telestroke network unsustainable. The Centers for Medicare and Medicaid Services (CMS) has addressed the need for reimbursement for telemedicine services and third-party payers have followed suit [37, 121]. Appropriate reimbursement for teleservices remains a concern among providers [127] and continues to be a barrier for the expansion of telestroke networks to underserved areas of the country.
\nLicensure and hospital credentialing, often across state lines, further burdens physicians and hospitals to spend resources, thus putting additional constraints on the expansion of these services. Physicians are required to maintain a license in the state where the spoke site is located in addition to the hub site where they usually work. This requires unrestricted licensure to be maintained in every state where the teleconsult is requested. A national or multistate license for telemedicine would reduce the necessity for a consultant to be licensed in multiple individual states, but this kind of license does not currently exist [128]. In 2011, CMS began allowing credentialing and privileging by proxy at small and critical-access hospitals, which has allowed these hospitals to rely on the credentialing and privileging process performed at the hub site [92, 129]. However, this policy needs to be adopted by all 50 states to mitigate the onus of licensing and credentialing on physicians and small hospitals. Also, reimbursement in cases where the patient receives tPA at the spoke site and is transferred to the hub hospital remains an issue, as neither the spoke nor hub facility is eligible to bill the higher Medicare diagnosis-related group codes that are associated with thrombolytic administration [128].
\nEstablishing and maintaining the infrastructure for high-quality video conferencing in small rural hospitals also adds to the financial burden on these hospitals. There is also marked heterogeneity in the platforms available, which spoke sites need to take into account before joining a telestroke model [37, 128]. Platform differences also limit the flexibility of these rural hospitals in terms of associating with more than one network or transitioning to a different network as the platforms utilized by these networks may be incompatible. Additionally, to comply with CMS billing requirements, a high-quality, two-way video connection is recommended and a minimum frame rate of at least 20 frames per second has been suggested [130]. Thus, high-speed internet is an essential component of telestroke networks. The availability of high-speed internet connections in rural parts of the country is limited and is a separate problem limiting the implementation of telestroke networks. These issues become exceedingly challenging in resource-limited countries around the world.
\nConvincing the leadership of potential spoke sites of the cost-effectiveness of joining a telestroke system requires time and effort on the part of the hub telestroke providers. Joining a telestroke system not only requires investment in infrastructure but also requires extensive training and development of protocols for teleconsults and transfers. These requirements may appear daunting to the leadership and hospital staff, especially at small rural hospitals with limited resources. However, the literature supporting the safety, cost-effectiveness, and improved patient outcomes related to telestroke networks may help encourage their buy-in to such programs. Joining such a system implies a long-term partnership between the hub and the spoke sites. Trust also needs to be established between the spoke site ED staff and consulting neurologists. Endorsements and testimony from the leadership of existing spoke sites in similar settings, hearing patient experiences from those who benefitted from these networks, and meeting with the team of consulting neurologists may prove useful in building this trust.
\nAlong with the establishment of infrastructure for telestroke, medical staff at spokes sites need to be trained for ever-evolving telestroke protocols and joint commission requirements. They need to be able to recognize the early signs and symptoms of acute stroke, perform NIHSS exams, screen for eligibility for tPA, and to be proficient at using the teleconsult interface to facilitate the process efficiently. Telestroke systems can include stroke patient management training to spoke medical staff on education NIHSS exam demonstrations, reviews of alteplase reconstitution, administration and considerations, alteplase dosage calculations and telemedicine cart demonstration and review. Other patient management training can be provided to paramedics local to the spoke sites, these sessions typically include; impact of and time sensitivity of strokes, what is a stroke, types of stroke, stroke mimics, EMS neurological assessments, stroke management/prehospital guidelines and telemedicine and alteplase through an organizational system of care.
\nGiven the wide variability of telestroke systems based on AHA/ASA guidelines and local governing factors, each network should develop an standard operating protocol (SOP) that suits their needs (Tables 1–3) [131]. The volume of teleconsults can vary greatly between the spoke hospitals, thus training needs to be reinforced at specified intervals to ensure efficient and seamless consults and to maintain high-quality patient care. This may lead to telemedicine fatigue in the staff at low-volume hospitals that needs to be mitigated during the training by emphasizing the importance of their work in the teleconsult system in their community at improving outcomes in patients who may have otherwise not had an opportunity for timely stroke intervention due to time lost in transportation to larger centers.
\nAmerican College of Cardiology/American Heart Association class of recommendation and level of evidence to clinical strategies, interventions, treatments, or diagnostic testing in patient care*\n | \n
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American Heart Association summary of recommendations for telestrokes [131].
The outcome or result of the intervention should be specified (an improved clinical outcome or increased diagnostic accuracy or incremental prognostic information).
For comparative-effectiveness recommendations (COR I and IIa; LOE A and B only), studies that support the use of comparator verbs should involve direct comparisons of the treatments or strategies being evaluated.
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The method of assessing quality is evolving, including the application of standardized, widely used, and preferably validated evidence grading tools; and for systematic reviews, the incorporation of an Evidence Review Committee.
COR, class of recommendation; EO, expert opinion; LD, limited data; LOE, level of evidence; NR, nonrandomized; R, randomized; and RCT, randomized controlled trial.
Class of recommendation (COR) and level of evidence (LOE) are determined independently (any COR may be paired with any LOE). A recommendation with LOE C does not imply that the recommendation is weak. Many important clinical questions addressed in guidelines do not lend themselves to clinical trials. Although RCTs are unavailable, there may be a very clear clinical consensus that a specific test or therapy is useful or effective.
Telemedicine | \nCOR | \nLOE | \n
---|---|---|
1. For sites without in-house imaging interpretation expertise, teleradiology systems approved by the US Food and Drug Administration are recommended for timely review of brain imaging in patients with suspected acute stroke. | \nI | \nA | \n
2. When implemented within a telestroke network, teleradiology systems approved by the US Food and Drug Administration are useful in supporting rapid imaging interpretation in time for IV alteplase administration decision making. | \nI | \nA | \n
3. Telestroke/teleradiology evaluations of acute ischemic stroke (AIS) patients can be effective for correct IV alteplase eligibility decision making. | \nIIa | \nB-R | \n
4. Administration of IV alteplase guided by telestroke consultation for patients with AIS may be as safe and as beneficial as that of stroke centers. | \nIIb | \nB-NR | \n
5. Providing alteplase decision-making support via telephone consultation to community physicians is feasible and safe and may be considered when a hospital has access to neither an in-person stroke team nor a telestroke system. | \nIIb | \nC-LD | \n
6. Telestroke networks may be reasonable for triaging patients with AIS who may be eligible for interfacility transfer to be considered for acute mechanical thrombectomy. | \nIIb | \nB-NR | \n
American Heart Association/American Stroke Association guidelines for telemedicine [131].
Telestroke networks, like traditional practices, are required to be compliant with HIPAA, which governs protected health information in the US. Given that telestroke networks rely on real-time data sharing between the spoke and the hub, data security becomes a concern. Data security requires end-to-end encryption on the sharing platform, reliable documentation and storage, strict control of access to users within the network, and cooperation between the information technology staff at both sites. To ensure 24-hour coverage, consulting physicians often use a mobile device for such calls and must be cognizant of their surroundings while consulting remotely. For example, most telestroke systems provide home accessibility for physician consults. Currently due to HIPPA rules the use of hand held mobile phones remains limited for detection of stroke. Given the renewed interest in telehealth with the COVID-19 pandemic, there is a potential for use of mobile phone application technology.
\nHealthcare data breaches have been on the rise with larger and teaching hospitals being at a greater risk [132, 133]. Given multiple points of entry and the potential for data breaches in telestroke networks, extra care is needed at the hub and spokes sites to ensure data safety. Despite these challenges, telestroke networks have shown to provide safe, efficient, and cost-effective stroke care to underserved communities. There is still enormous potential for telestroke networks to expand into rural areas of the country as well as around the world.
\nSince its conception, telestroke has expanded greatly in its scope and utility in bridging the gap in stroke care between the rural and urban communities, in both acute and continued care. Despite the challenges faced in establishing and sustaining telestroke networks, these networks are flourishing and expanding, creating an ever-evolving paradigm for stroke care throughout the country and around the world.
\nThe authors have no conflicts of interest to disclose.
Ove Odredbe i uvjeti ističu pravila i regulacije u svezi korištenja IntechOpenove stranice www.intechopen.com i svih poddomena u vlasništvu IntechOpena, tvrtke sa sjedištem u 5 Princes Gate Court, London, SW7 2QJ, Ujedinjeno Kraljevstvo.
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\\n\\nSljedeća terminologija odnosi se na Odredbe i uvjete, te na sve naše ugovore:
\\n\\nKlijent, stranka, vi, vaš odnosi se na vas, osobu koja pristupa ovoj stranici i prihvaća IntechOpenove Odredbe i uvjete;
\\n\\nKompanija, tvrtka, mi, naše odnosi se na tvrtku IntechOpen;
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\\n\\nMi koristimo kolačiće. Korištenjem IntechOpenove stranice slažete se s korištenjem kolačića u skladu s IntechOpenovom Politikom privatnosti. Većina modernih, interaktivnih stranica koristi kolačiće kako bi omogućila ponovno pronalaženje korisničkih detalja kod svakog posjeta. Na našoj stranici kolačići se uglavnom koriste kako bi omogućili funkcionalnost i olakšali posjetiteljima korištenje stranice.
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\n\nSljedeća terminologija odnosi se na Odredbe i uvjete, te na sve naše ugovore:
\n\nKlijent, stranka, vi, vaš odnosi se na vas, osobu koja pristupa ovoj stranici i prihvaća IntechOpenove Odredbe i uvjete;
\n\nKompanija, tvrtka, mi, naše odnosi se na tvrtku IntechOpen;
\n\nStranke, strane odnosi se na klijenta i na nas, ili samo na klijenta ili nas.
\n\nSve odredbe koje se odnose na ponudu, prihvat ili razmatranje plaćanja, a za koja mi pružamo asistenciju klijentu, bilo na ugovoreni ili fiksni način, a s ciljem da se ostvare potrebe i želje klijenta u svezi s našim uslugama, su podložne zakonskim odredbama Ujedinjenog Kraljevstva.
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\n\nMi koristimo kolačiće. Korištenjem IntechOpenove stranice slažete se s korištenjem kolačića u skladu s IntechOpenovom Politikom privatnosti. Većina modernih, interaktivnih stranica koristi kolačiće kako bi omogućila ponovno pronalaženje korisničkih detalja kod svakog posjeta. Na našoj stranici kolačići se uglavnom koriste kako bi omogućili funkcionalnost i olakšali posjetiteljima korištenje stranice.
\n\nIntechOpen ili njegovi suradnici niti u jednom slučaju neće biti odgovorni za štete (štete uključuju gubitak podataka ili profita, druge poslovne prekide, te sve ostale štete) koje nastanu zbog korištenja materijala na IntechOpenovoj stranici ili nemogućnosti da se iste koriste, čak i ako je IntechOpen ili njegov predstavnik o takvoj šteti obaviješten pismenim ili usmenim putem. Neke jurisdikcije ne dozvoljavaju ograničenja garancija ili ograničenja obveza za posljedične ili slučajne štete pa se u tom slučaju ova ograničenja možda ne odnose na vas.
\n\nMaterijali koji se pojavljuju na IntechOpenovoj stranici mogu sadržavati manje greške, tipfelere ili fotografske greške. IntechOpen može napraviti promjene na bilo kojem materijalu koji se nalazi na stranici u bilo koje vrijeme.
\n\nIntechOpen nije formalno povezan niti s jednom vanjskom stranicom čije poveznice vode na www.intechopen.com, osim ako to nije izravno navedeno. Iz tog razloga IntechOpen nije odgovoran za sadržaj koji se pojavljuje na takvim stranicama. Poveznica na IntechOpenovu stranicu ne implicira povezanost sa IntechOpenom. Korištenje takvih poveznica isključiva je odgovornost korisnika.
\n\nZadržavamo pravo vlasništva nad cjelokupnom stranicom www.intechopen.com i nad svim materijalom na toj stranici. Koristeći se našim uslugama, slažete se da maknete sve poveznice na našu stranicu odmah nakon što to od vas zatražimo. Također, zadržavamo pravo da ove Odredbe i uvjete, i politiku o poveznicama izmjenimo u bilo koje vrijeme. Koristeći se poveznicama na naše stranice slažete se s ovim Odredbama i uvjetima.
\n\nAko smatrate da je bilo koja poveznica na našoj stranici sumnjiva iz bilo kojeg razloga, molimo vas da nas kontaktirate. U tom slučaju razmotrit ćemo micanje poveznice s naše stranice, iako nismo obvezni to napraviti.
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\n"}]},successStories:{items:[]},authorsAndEditors:{filterParams:{},profiles:[{id:"396",title:"Dr.",name:"Vedran",middleName:null,surname:"Kordic",slug:"vedran-kordic",fullName:"Vedran Kordic",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/396/images/7281_n.png",biography:"After obtaining his Master's degree in Mechanical Engineering he continued his education at the Vienna University of Technology where he obtained his PhD degree in 2004. He worked as a researcher at the Automation and Control Institute, Faculty of Electrical Engineering, Vienna University of Technology until 2008. 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Yet, little is known about the HRQoL of Turkish and Polish migrants and German natives.",book:{id:"5598",slug:"people-s-movements-in-the-21st-century-risks-challenges-and-benefits",title:"People's Movements in the 21st Century",fullTitle:"People's Movements in the 21st Century - Risks, Challenges and Benefits"},signatures:"Johanna Buchcik, Joachim Westenhöfer, Mick Fleming and Colin R.\nMartin",authors:[{id:"192396",title:"Dr.",name:"Johanna",middleName:null,surname:"Buchcik",slug:"johanna-buchcik",fullName:"Johanna Buchcik"},{id:"193514",title:"Prof.",name:"Joachim",middleName:null,surname:"Westenhöfer",slug:"joachim-westenhofer",fullName:"Joachim Westenhöfer"},{id:"193515",title:"Prof.",name:"Mick",middleName:null,surname:"Fleming",slug:"mick-fleming",fullName:"Mick Fleming"},{id:"193516",title:"Prof.",name:"Colin R.",middleName:null,surname:"Martin",slug:"colin-r.-martin",fullName:"Colin R. Martin"}]},{id:"53700",doi:"10.5772/67013",title:"Migration and Health from a Public Health Perspective",slug:"migration-and-health-from-a-public-health-perspective",totalDownloads:2349,totalCrossrefCites:3,totalDimensionsCites:8,abstract:"One of the main dimensions related to migration is that of health; this correlation is dynamic by nature and complex. Health is strongly related to the social determinants of health (job, income, education, and housing). When not properly supported by appropriate inter-sectoral policies, migration can expose the most vulnerable socioeconomic groups to significant problems. The protection of the health of migrants is an important investment of the public health because it promises benefits to both migrant population and natives. An essential aspect is to properly analyze the health needs of ethnic minorities. Both quantitative and qualitative research is necessary, and the involvement of the target communities is important. Another important aspect is the education and training of social and health workers involved in the care of migrants (with a multidisciplinary teamwork and “transcultural” approach), and the organization of services that can effectively be used. Finally, it is also essential to carry out an evaluation of health outcomes of the migrant population and the impact of adopted health policies. Protecting the health of ethnic minorities is both a challenge for governments and a test of the quality of their health systems.",book:{id:"5598",slug:"people-s-movements-in-the-21st-century-risks-challenges-and-benefits",title:"People's Movements in the 21st Century",fullTitle:"People's Movements in the 21st Century - Risks, Challenges and Benefits"},signatures:"Maurizio Marceca",authors:[{id:"192600",title:"Prof.",name:"Maurizio",middleName:null,surname:"Marceca",slug:"maurizio-marceca",fullName:"Maurizio Marceca"}]},{id:"53657",doi:"10.5772/66827",title:"Asians as Model Minorities: A Myth or Reality among Scientists and Engineers in Academia",slug:"asians-as-model-minorities-a-myth-or-reality-among-scientists-and-engineers-in-academia",totalDownloads:1505,totalCrossrefCites:4,totalDimensionsCites:4,abstract:"Asians from China, India, South Korea, and Taiwan constitute the largest non‐White group in academic science and engineering (S&E). Most of the studies in relation to race/ethnicity combine Asians into one category whether they are immigrants (foreign born) or US citizens. Research has suggested that job satisfaction differs with the type of citizenship status held by faculty members. However, what studies fail to notice is that Asian faculty members who are either born in the United States or are naturalized might experience very different levels of attitudes and satisfaction toward their job when compared with Asian faculty members who are foreign born and on temporary visa status, impacting retention. Do institutions recognize the differences between these two groups, or are Asian faculty members considered a “model minority” group and “problem‐free?” This is the question that this study aims to examine. Given the growing competition in S&E globally, matters pertaining to faculty members’ satisfaction, retention, and persistence will take a front seat among policy makers and university administrators. Data for this study come from the National Science Foundation’s Survey of Doctorate Recipients (SDR).",book:{id:"5598",slug:"people-s-movements-in-the-21st-century-risks-challenges-and-benefits",title:"People's Movements in the 21st Century",fullTitle:"People's Movements in the 21st Century - Risks, Challenges and Benefits"},signatures:"Meghna Sabharwal",authors:[{id:"192631",title:"Associate Prof.",name:"Meghna",middleName:null,surname:"Sabharwal",slug:"meghna-sabharwal",fullName:"Meghna Sabharwal"}]},{id:"53671",doi:"10.5772/67004",title:"The New Actors of International Migration: A Comparative Analysis of Foreign Students’ Experiences in a Medium-Sized City in Turkey",slug:"the-new-actors-of-international-migration-a-comparative-analysis-of-foreign-students-experiences-in-",totalDownloads:1237,totalCrossrefCites:0,totalDimensionsCites:4,abstract:"International or foreign student migration is one of the topics that started to become a hot topic in many different countries because of various aspects. Lately, Turkey, especially in terms of higher education, can be seen as a country that sends students to study abroad but also attracts foreign students. With regard to Adnan Menderes University which is located in a medium‐sized city (Aydın), the main focus of this study is based on experiences of foreign students regarding prejudice, discrimination and racism. In addition to this, the topics such as to what extent are foreign students having difficulty to adapt to the life in Turkey, to what extent are the students satisfied with their lives in the country, in what way could foreign students who currently study in Turkey help to increase the foreign student population or sustain the student migration were examined. In this context, six different categories, such as students from Africa, Asia, South Caucasia, Middle East, Europe/Balkans and Europe/Other, were created. Surveys were applied to participants of the study group in line with a quantitative research scope.",book:{id:"5598",slug:"people-s-movements-in-the-21st-century-risks-challenges-and-benefits",title:"People's Movements in the 21st Century",fullTitle:"People's Movements in the 21st Century - Risks, Challenges and Benefits"},signatures:"Serdar Ünal",authors:[{id:"192402",title:"Dr.",name:"Serdar",middleName:null,surname:"Ünal",slug:"serdar-unal",fullName:"Serdar Ünal"}]},{id:"53486",doi:"10.5772/66824",title:"Immigration and Food Insecurity: The Canadian Experience—A Literature Review",slug:"immigration-and-food-insecurity-the-canadian-experience-a-literature-review",totalDownloads:2547,totalCrossrefCites:1,totalDimensionsCites:3,abstract:"Canada is a popular destination for immigrants and integration of newcomers is an important strategy for its demographic growth and economic development. Food insecurity disproportionately affects newcomers in Canada; unfortunately, they occupy the lower end of the socio‐economic spectrum and thus adding to the burden of socio‐cultural challenges they are already facing. The high level of food insecurity contributes to poor diet quality and the rise in overweight and other chronic health conditions and therefore to the loss of healthy immigrant status. Indeed, statistical evidence, mainly of the overall Canadian population, demonstrates that individuals living in food‐insecure households have higher rates of self‐reported poor health and chronic health conditions. Therefore, understanding and properly addressing the factors associated with food insecurity among Canadian immigrants is crucial for an adequate integration of immigrants. This chapter suggests that an adequate and appropriate understanding of food security for Canadian immigrant populations requires consideration of a cultural perspective in addition to the traditional individual, household and community levels and the development of measurement tools to capture this cultural dimension. It is proposed the concept of cultural food insecurity encompasses the four usual dimensions (availability, accessibility, utilization, and stability) and a newly proposed fifth cultural dimension. Future research should aim at validating the relevance of this cultural perspective as a fifth pillar for food security and developing measurement tools to assess it.",book:{id:"5598",slug:"people-s-movements-in-the-21st-century-risks-challenges-and-benefits",title:"People's Movements in the 21st Century",fullTitle:"People's Movements in the 21st Century - Risks, Challenges and Benefits"},signatures:"Diana Tarraf, Dia Sanou and Isabelle Giroux",authors:[{id:"192842",title:"M.Sc.",name:"Diana",middleName:null,surname:"Tarraf",slug:"diana-tarraf",fullName:"Diana Tarraf"},{id:"193533",title:"Dr.",name:"Dia",middleName:null,surname:"Sanou",slug:"dia-sanou",fullName:"Dia Sanou"},{id:"193603",title:"Dr.",name:"Isabelle",middleName:null,surname:"Giroux",slug:"isabelle-giroux",fullName:"Isabelle Giroux"}]}],mostDownloadedChaptersLast30Days:[{id:"53486",title:"Immigration and Food Insecurity: The Canadian Experience—A Literature Review",slug:"immigration-and-food-insecurity-the-canadian-experience-a-literature-review",totalDownloads:2552,totalCrossrefCites:1,totalDimensionsCites:3,abstract:"Canada is a popular destination for immigrants and integration of newcomers is an important strategy for its demographic growth and economic development. Food insecurity disproportionately affects newcomers in Canada; unfortunately, they occupy the lower end of the socio‐economic spectrum and thus adding to the burden of socio‐cultural challenges they are already facing. The high level of food insecurity contributes to poor diet quality and the rise in overweight and other chronic health conditions and therefore to the loss of healthy immigrant status. Indeed, statistical evidence, mainly of the overall Canadian population, demonstrates that individuals living in food‐insecure households have higher rates of self‐reported poor health and chronic health conditions. Therefore, understanding and properly addressing the factors associated with food insecurity among Canadian immigrants is crucial for an adequate integration of immigrants. This chapter suggests that an adequate and appropriate understanding of food security for Canadian immigrant populations requires consideration of a cultural perspective in addition to the traditional individual, household and community levels and the development of measurement tools to capture this cultural dimension. It is proposed the concept of cultural food insecurity encompasses the four usual dimensions (availability, accessibility, utilization, and stability) and a newly proposed fifth cultural dimension. Future research should aim at validating the relevance of this cultural perspective as a fifth pillar for food security and developing measurement tools to assess it.",book:{id:"5598",slug:"people-s-movements-in-the-21st-century-risks-challenges-and-benefits",title:"People's Movements in the 21st Century",fullTitle:"People's Movements in the 21st Century - Risks, Challenges and Benefits"},signatures:"Diana Tarraf, Dia Sanou and Isabelle Giroux",authors:[{id:"192842",title:"M.Sc.",name:"Diana",middleName:null,surname:"Tarraf",slug:"diana-tarraf",fullName:"Diana Tarraf"},{id:"193533",title:"Dr.",name:"Dia",middleName:null,surname:"Sanou",slug:"dia-sanou",fullName:"Dia Sanou"},{id:"193603",title:"Dr.",name:"Isabelle",middleName:null,surname:"Giroux",slug:"isabelle-giroux",fullName:"Isabelle Giroux"}]},{id:"53470",title:"Sociocultural Models of Second-Language Learning of Young Immigrants in Canada",slug:"sociocultural-models-of-second-language-learning-of-young-immigrants-in-canada",totalDownloads:1614,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"The most significant challenge for the minority immigrant is learning a new language. They arrive in a new culture and community hoping to master English quickly in order to achieve their academic and career goals. However, many immigrants have mentioned general barriers resulting from being unable to communicate with peers outside their cultural and linguistic group. Recent research has identified several cognitive variables such as vocabulary, reading aloud, and grammatical judgment related to second-language learning in immigrants; however, little attention was given to sociocultural factors such as acculturation, motivation, and cultural learning because learning a language is a necessary aspect of being socialized into a particular culture. This chapter reviews research of sociocultural models in relation to second-language learning of immigrant youth in Canada. We address this paradigm for research by incorporating both acculturation and sociolinguistic approaches, as well as more traditional cognitive-linguistic approaches, to models of second-language learning in immigrants.",book:{id:"5598",slug:"people-s-movements-in-the-21st-century-risks-challenges-and-benefits",title:"People's Movements in the 21st Century",fullTitle:"People's Movements in the 21st Century - Risks, Challenges and Benefits"},signatures:"Fanli Jia, Alexandra Gottardo and Aline Ferreira",authors:[{id:"192435",title:"Dr.",name:"Fanli",middleName:null,surname:"Jia",slug:"fanli-jia",fullName:"Fanli Jia"},{id:"194425",title:"Dr.",name:"Alexandra",middleName:null,surname:"Gottardo",slug:"alexandra-gottardo",fullName:"Alexandra Gottardo"},{id:"194656",title:"Dr.",name:"Aline",middleName:null,surname:"Ferreira",slug:"aline-ferreira",fullName:"Aline Ferreira"}]},{id:"53700",title:"Migration and Health from a Public Health Perspective",slug:"migration-and-health-from-a-public-health-perspective",totalDownloads:2354,totalCrossrefCites:3,totalDimensionsCites:8,abstract:"One of the main dimensions related to migration is that of health; this correlation is dynamic by nature and complex. Health is strongly related to the social determinants of health (job, income, education, and housing). When not properly supported by appropriate inter-sectoral policies, migration can expose the most vulnerable socioeconomic groups to significant problems. The protection of the health of migrants is an important investment of the public health because it promises benefits to both migrant population and natives. An essential aspect is to properly analyze the health needs of ethnic minorities. Both quantitative and qualitative research is necessary, and the involvement of the target communities is important. Another important aspect is the education and training of social and health workers involved in the care of migrants (with a multidisciplinary teamwork and “transcultural” approach), and the organization of services that can effectively be used. Finally, it is also essential to carry out an evaluation of health outcomes of the migrant population and the impact of adopted health policies. Protecting the health of ethnic minorities is both a challenge for governments and a test of the quality of their health systems.",book:{id:"5598",slug:"people-s-movements-in-the-21st-century-risks-challenges-and-benefits",title:"People's Movements in the 21st Century",fullTitle:"People's Movements in the 21st Century - Risks, Challenges and Benefits"},signatures:"Maurizio Marceca",authors:[{id:"192600",title:"Prof.",name:"Maurizio",middleName:null,surname:"Marceca",slug:"maurizio-marceca",fullName:"Maurizio Marceca"}]},{id:"53859",title:"Introductory Chapter: People's Movements in the 21st Century",slug:"introductory-chapter-people-s-movements-in-the-21st-century",totalDownloads:1477,totalCrossrefCites:0,totalDimensionsCites:0,abstract:null,book:{id:"5598",slug:"people-s-movements-in-the-21st-century-risks-challenges-and-benefits",title:"People's Movements in the 21st Century",fullTitle:"People's Movements in the 21st Century - Risks, Challenges and Benefits"},signatures:"Ingrid Muenstermann",authors:[{id:"77112",title:"Dr.",name:"Ingrid",middleName:null,surname:"Muenstermann",slug:"ingrid-muenstermann",fullName:"Ingrid Muenstermann"}]},{id:"53701",title:"The Immigrant Experience in V.S. Naipaul's The Enigma of Arrival and Z. Smith's White Teeth: An Exploration of Homi Bhabha's Postcolonial Theory",slug:"the-immigrant-experience-in-v-s-naipaul-s-the-enigma-of-arrival-and-z-smith-s-white-teeth-an-explora",totalDownloads:2065,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"V.S. Naipaul and Z. Smith, prominent postcolonial authors, reflect the condition of the immigrants suffering from cultural shock, hybridity, fragmentation and mimicry in the postcolonial Western societies in their novels, The Enigma of Arrival and White Teeth. The former portrays the desperate condition of an author doing his best to create his work in the post‐war West, in London and New York, trying to overcome his hybridity and adaptation problems due to his cultural background, and the latter sheds light on the cultural distress of two families from Bangladesh, immigrating to London, by stressing the conflicts between the Westerners and the Easterners and between the first and the second generations of immigrants. Thus, these two novels highlight the immigrant experience illustrating the impact of power relations between the former colonized and the former colonizer upon their relationship in the postcolonial era. In this study, the problems of immigrants in the post‐war West in these novels will be analysed in the light of Homi Bhabha's postcolonial theory, which puts forward such concepts as hybridity, mimicry, ambivalence, cultural differentiation and otherness. In this regard, Bhabha's theory will be adapted into these novels to identify cultural problems of immigrants in these works.",book:{id:"5598",slug:"people-s-movements-in-the-21st-century-risks-challenges-and-benefits",title:"People's Movements in the 21st Century",fullTitle:"People's Movements in the 21st Century - Risks, Challenges and Benefits"},signatures:"Berna Köseoğlu",authors:[{id:"148215",title:"Dr.",name:"Berna",middleName:null,surname:"Köseoğlu",slug:"berna-koseoglu",fullName:"Berna Köseoğlu"}]}],onlineFirstChaptersFilter:{topicId:"271",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:8,numberOfPublishedChapters:87,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:98,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:27,numberOfPublishedChapters:286,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:9,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:139,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:0,numberOfUpcomingTopics:2,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!1},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:105,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:9,numberOfPublishedChapters:101,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:11,numberOfOpenTopics:2,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:0,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!1},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:9,numberOfOpenTopics:4,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. 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Science",numberOfPublishedBooks:9,numberOfPublishedChapters:100,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:11,numberOfOpenTopics:2,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:0,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!1},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:9,numberOfOpenTopics:4,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],subseriesList:[{id:"22",title:"Applied Intelligence",scope:"This field is the key in the current industrial revolution (Industry 4.0), where the new models and developments are based on the knowledge generation on applied intelligence. The motor of the society is the industry and the research of this topic has to be empowered in order to increase and improve the quality of our lives.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/22.jpg",keywords:"Machine Learning, Intelligence Algorithms, Data Science, Artificial Intelligence, Applications on Applied Intelligence"},{id:"23",title:"Computational Neuroscience",scope:"Computational neuroscience focuses on biologically realistic abstractions and models validated and solved through computational simulations to understand principles for the development, structure, physiology, and ability of the nervous system. This topic is dedicated to biologically plausible descriptions and computational models - at various abstraction levels - of neurons and neural systems. This includes, but is not limited to: single-neuron modeling, sensory processing, motor control, memory, and synaptic plasticity, attention, identification, categorization, discrimination, learning, development, axonal patterning, guidance, neural architecture, behaviors, and dynamics of networks, cognition and the neuroscientific basis of consciousness. Particularly interesting are models of various types of more compound functions and abilities, various and more general fundamental principles (e.g., regarding architecture, organization, learning, development, etc.) found at various spatial and temporal levels.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/23.jpg",keywords:"Single-Neuron Modeling, Sensory Processing, Motor Control, Memory and Synaptic Pasticity, Attention, Identification, Categorization, Discrimination, Learning, Development, Axonal Patterning and Guidance, Neural Architecture, Behaviours and Dynamics of Networks, Cognition and the Neuroscientific Basis of Consciousness"},{id:"24",title:"Computer Vision",scope:"The scope of this topic is to disseminate the recent advances in the rapidly growing field of computer vision from both the theoretical and practical points of view. Novel computational algorithms for image analysis, scene understanding, biometrics, deep learning and their software or hardware implementations for natural and medical images, robotics, VR/AR, applications are some research directions relevant to this topic.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/24.jpg",keywords:"Image Analysis, Scene Understanding, Biometrics, Deep Learning, Software Implementation, Hardware Implementation, Natural Images, Medical Images, Robotics, VR/AR"},{id:"25",title:"Evolutionary Computation",scope:"Evolutionary computing is a paradigm that has grown dramatically in recent years. This group of bio-inspired metaheuristics solves multiple optimization problems by applying the metaphor of natural selection. It so far has solved problems such as resource allocation, routing, schedule planning, and engineering design. Moreover, in the field of machine learning, evolutionary computation has carved out a significant niche both in the generation of learning models and in the automatic design and optimization of hyperparameters in deep learning models. This collection aims to include quality volumes on various topics related to evolutionary algorithms and, alternatively, other metaheuristics of interest inspired by nature. For example, some of the issues of interest could be the following: Advances in evolutionary computation (Genetic algorithms, Genetic programming, Bio-inspired metaheuristics, Hybrid metaheuristics, Parallel ECs); Applications of evolutionary algorithms (Machine learning and Data Mining with EAs, Search-Based Software Engineering, Scheduling, and Planning Applications, Smart Transport Applications, Applications to Games, Image Analysis, Signal Processing and Pattern Recognition, Applications to Sustainability).",coverUrl:"https://cdn.intechopen.com/series_topics/covers/25.jpg",keywords:"Genetic Algorithms, Genetic Programming, Evolutionary Programming, Evolution Strategies, Hybrid Algorithms, Bioinspired Metaheuristics, Ant Colony Optimization, Evolutionary Learning, Hyperparameter Optimization"},{id:"26",title:"Machine Learning and Data Mining",scope:"The scope of machine learning and data mining is immense and is growing every day. It has become a massive part of our daily lives, making predictions based on experience, making this a fascinating area that solves problems that otherwise would not be possible or easy to solve. This topic aims to encompass algorithms that learn from experience (supervised and unsupervised), improve their performance over time and enable machines to make data-driven decisions. It is not limited to any particular applications, but contributions are encouraged from all disciplines.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/26.jpg",keywords:"Intelligent Systems, Machine Learning, Data Science, Data Mining, Artificial Intelligence"},{id:"27",title:"Multi-Agent Systems",scope:"Multi-agent systems are recognised as a state of the art field in Artificial Intelligence studies, which is popular due to the usefulness in facilitation capabilities to handle real-world problem-solving in a distributed fashion. The area covers many techniques that offer solutions to emerging problems in robotics and enterprise-level software systems. Collaborative intelligence is highly and effectively achieved with multi-agent systems. Areas of application include swarms of robots, flocks of UAVs, collaborative software management. Given the level of technological enhancements, the popularity of machine learning in use has opened a new chapter in multi-agent studies alongside the practical challenges and long-lasting collaboration issues in the field. It has increased the urgency and the need for further studies in this field. We welcome chapters presenting research on the many applications of multi-agent studies including, but not limited to, the following key areas: machine learning for multi-agent systems; modeling swarms robots and flocks of UAVs with multi-agent systems; decision science and multi-agent systems; software engineering for and with multi-agent systems; tools and technologies of multi-agent systems.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/27.jpg",keywords:"Collaborative Intelligence, Learning, Distributed Control System, Swarm Robotics, Decision Science, Software Engineering"}],annualVolumeBook:{},thematicCollection:[],selectedSeries:{title:"Artificial Intelligence",id:"14"},selectedSubseries:null},seriesLanding:{item:{id:"7",title:"Biomedical Engineering",doi:"10.5772/intechopen.71985",issn:"2631-5343",scope:"Biomedical Engineering is one of the fastest-growing interdisciplinary branches of science and industry. The combination of electronics and computer science with biology and medicine has improved patient diagnosis, reduced rehabilitation time, and helped to facilitate a better quality of life. Nowadays, all medical imaging devices, medical instruments, or new laboratory techniques result from the cooperation of specialists in various fields. The series of Biomedical Engineering books covers such areas of knowledge as chemistry, physics, electronics, medicine, and biology. This series is intended for doctors, engineers, and scientists involved in biomedical engineering or those wanting to start working in this field.",coverUrl:"https://cdn.intechopen.com/series/covers/7.jpg",latestPublicationDate:"May 7th, 2022",hasOnlineFirst:!0,numberOfOpenTopics:3,numberOfPublishedChapters:96,numberOfPublishedBooks:12,editor:{id:"50150",title:"Prof.",name:"Robert",middleName:null,surname:"Koprowski",fullName:"Robert Koprowski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTYNQA4/Profile_Picture_1630478535317",biography:"Robert Koprowski, MD (1997), PhD (2003), Habilitation (2015), is an employee of the University of Silesia, Poland, Institute of Computer Science, Department of Biomedical Computer Systems. For 20 years, he has studied the analysis and processing of biomedical images, emphasizing the full automation of measurement for a large inter-individual variability of patients. Dr. Koprowski has authored more than a hundred research papers with dozens in impact factor (IF) journals and has authored or co-authored six books. Additionally, he is the author of several national and international patents in the field of biomedical devices and imaging. Since 2011, he has been a reviewer of grants and projects (including EU projects) in biomedical engineering.",institutionString:null,institution:{name:"University of Silesia",institutionURL:null,country:{name:"Poland"}}},subseries:[{id:"7",title:"Bioinformatics and Medical Informatics",keywords:"Biomedical Data, Drug Discovery, Clinical Diagnostics, Decoding Human Genome, AI in Personalized Medicine, Disease-prevention Strategies, Big Data Analysis in Medicine",scope:"Bioinformatics aims to help understand the functioning of the mechanisms of living organisms through the construction and use of quantitative tools. The applications of this research cover many related fields, such as biotechnology and medicine, where, for example, Bioinformatics contributes to faster drug design, DNA analysis in forensics, and DNA sequence analysis in the field of personalized medicine. Personalized medicine is a type of medical care in which treatment is customized individually for each patient. Personalized medicine enables more effective therapy, reduces the costs of therapy and clinical trials, and also minimizes the risk of side effects. Nevertheless, advances in personalized medicine would not have been possible without bioinformatics, which can analyze the human genome and other vast amounts of biomedical data, especially in genetics. The rapid growth of information technology enabled the development of new tools to decode human genomes, large-scale studies of genetic variations and medical informatics. The considerable development of technology, including the computing power of computers, is also conducive to the development of bioinformatics, including personalized medicine. In an era of rapidly growing data volumes and ever lower costs of generating, storing and computing data, personalized medicine holds great promises. Modern computational methods used as bioinformatics tools can integrate multi-scale, multi-modal and longitudinal patient data to create even more effective and safer therapy and disease prevention methods. Main aspects of the topic are: Applying bioinformatics in drug discovery and development; Bioinformatics in clinical diagnostics (genetic variants that act as markers for a condition or a disease); Blockchain and Artificial Intelligence/Machine Learning in personalized medicine; Customize disease-prevention strategies in personalized medicine; Big data analysis in personalized medicine; Translating stratification algorithms into clinical practice of personalized medicine.",annualVolume:11403,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/7.jpg",editor:{id:"351533",title:"Dr.",name:"Slawomir",middleName:null,surname:"Wilczynski",fullName:"Slawomir Wilczynski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035U1loQAC/Profile_Picture_1630074514792",institutionString:null,institution:{name:"Medical University of Silesia",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"5886",title:"Dr.",name:"Alexandros",middleName:"T.",surname:"Tzallas",fullName:"Alexandros Tzallas",profilePictureURL:"https://mts.intechopen.com/storage/users/5886/images/system/5886.png",institutionString:"University of Ioannina, Greece & Imperial College London",institution:{name:"University of Ioannina",institutionURL:null,country:{name:"Greece"}}},{id:"257388",title:"Distinguished Prof.",name:"Lulu",middleName:null,surname:"Wang",fullName:"Lulu Wang",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRX6kQAG/Profile_Picture_1630329584194",institutionString:null,institution:{name:"Shenzhen Technology University",institutionURL:null,country:{name:"China"}}},{id:"225387",title:"Prof.",name:"Reda",middleName:"R.",surname:"Gharieb",fullName:"Reda Gharieb",profilePictureURL:"https://mts.intechopen.com/storage/users/225387/images/system/225387.jpg",institutionString:"Assiut University",institution:{name:"Assiut University",institutionURL:null,country:{name:"Egypt"}}}]},{id:"8",title:"Bioinspired Technology and Biomechanics",keywords:"Bioinspired Systems, Biomechanics, Assistive Technology, Rehabilitation",scope:'Bioinspired technologies take advantage of understanding the actual biological system to provide solutions to problems in several areas. Recently, bioinspired systems have been successfully employing biomechanics to develop and improve assistive technology and rehabilitation devices. The research topic "Bioinspired Technology and Biomechanics" welcomes studies reporting recent advances in bioinspired technologies that contribute to individuals\' health, inclusion, and rehabilitation. Possible contributions can address (but are not limited to) the following research topics: Bioinspired design and control of exoskeletons, orthoses, and prostheses; Experimental evaluation of the effect of assistive devices (e.g., influence on gait, balance, and neuromuscular system); Bioinspired technologies for rehabilitation, including clinical studies reporting evaluations; Application of neuromuscular and biomechanical models to the development of bioinspired technology.',annualVolume:11404,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",institutionString:null,institution:{name:"Federal University of Uberlândia",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"49517",title:"Prof.",name:"Hitoshi",middleName:null,surname:"Tsunashima",fullName:"Hitoshi Tsunashima",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTP4QAO/Profile_Picture_1625819726528",institutionString:null,institution:{name:"Nihon University",institutionURL:null,country:{name:"Japan"}}},{id:"425354",title:"Dr.",name:"Marcus",middleName:"Fraga",surname:"Vieira",fullName:"Marcus Vieira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003BJSgIQAX/Profile_Picture_1627904687309",institutionString:null,institution:{name:"Universidade Federal de Goiás",institutionURL:null,country:{name:"Brazil"}}},{id:"196746",title:"Dr.",name:"Ramana",middleName:null,surname:"Vinjamuri",fullName:"Ramana Vinjamuri",profilePictureURL:"https://mts.intechopen.com/storage/users/196746/images/system/196746.jpeg",institutionString:"University of Maryland, Baltimore County",institution:{name:"University of Maryland, Baltimore County",institutionURL:null,country:{name:"United States of America"}}}]},{id:"9",title:"Biotechnology - Biosensors, Biomaterials and Tissue Engineering",keywords:"Biotechnology, Biosensors, Biomaterials, Tissue Engineering",scope:"The Biotechnology - Biosensors, Biomaterials and Tissue Engineering topic within the Biomedical Engineering Series aims to rapidly publish contributions on all aspects of biotechnology, biosensors, biomaterial and tissue engineering. We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics can include but are not limited to: Biotechnology such as biotechnological products and process engineering; Biotechnologically relevant enzymes and proteins; Bioenergy and biofuels; Applied genetics and molecular biotechnology; Genomics, transcriptomics, proteomics; Applied microbial and cell physiology; Environmental biotechnology; Methods and protocols. Moreover, topics in biosensor technology, like sensors that incorporate enzymes, antibodies, nucleic acids, whole cells, tissues and organelles, and other biological or biologically inspired components will be considered, and topics exploring transducers, including those based on electrochemical and optical piezoelectric, thermal, magnetic, and micromechanical elements. Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. Osma",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSDv7QAG/Profile_Picture_1626602531691",institutionString:null,institution:{name:"Universidad de Los Andes",institutionURL:null,country:{name:"Colombia"}}},{id:"69697",title:"Dr.",name:"Mani T.",middleName:null,surname:"Valarmathi",fullName:"Mani T. Valarmathi",profilePictureURL:"https://mts.intechopen.com/storage/users/69697/images/system/69697.jpg",institutionString:"Religen Inc. | A Life Science Company, United States of America",institution:null},{id:"205081",title:"Dr.",name:"Marco",middleName:"Vinícius",surname:"Chaud",fullName:"Marco Chaud",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSDGeQAO/Profile_Picture_1622624307737",institutionString:null,institution:{name:"Universidade de Sorocaba",institutionURL:null,country:{name:"Brazil"}}}]}]}},libraryRecommendation:{success:null,errors:{},institutions:[]},route:{name:"profile.detail",path:"/profiles/68326",hash:"",query:{},params:{id:"68326"},fullPath:"/profiles/68326",meta:{},from:{name:null,path:"/",hash:"",query:{},params:{},fullPath:"/",meta:{}}}},function(){var e;(e=document.currentScript||document.scripts[document.scripts.length-1]).parentNode.removeChild(e)}()