Groups at increased risk of progression from LTBI to active tuberculosis.
\\n\\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\\n\\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\\n"}]',published:!0,mainMedia:{caption:"Highly Cited",originalUrl:"/media/original/117"}},components:[{type:"htmlEditorComponent",content:'IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\nThroughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\nReleased this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\n'}],latestNews:[{slug:"intechopen-supports-asapbio-s-new-initiative-publish-your-reviews-20220729",title:"IntechOpen Supports ASAPbio’s New Initiative Publish Your Reviews"},{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"}]},book:{item:{type:"book",id:"10997",leadTitle:null,fullTitle:"Arsenic Monitoring, Removal and Remediation",title:"Arsenic Monitoring, Removal and Remediation",subtitle:null,reviewType:"peer-reviewed",abstract:"Arsenic Monitoring, Removal and Remediation discusses methods for determining arsenic levels in the environment and removing arsenic pollution. Chapters in the first section comment on the principal methods for arsenic determination in environmental samples with emphasis on sample pretreatment, extraction, separation, and method validation techniques for speciation analysis. Attention is paid to the electrochemical methods for arsenic quantification as an alternative to the commonly used techniques and to the potential of the differential alternative pulses voltammetry for arsenic determination in the presence of interferences. Chapters in the second section highlight the benefits of using adsorption for arsenic species removal and suggest remedial approaches against arsenic pollution, including bioremediation, along with traditional techniques.",isbn:"978-1-83969-666-4",printIsbn:"978-1-83969-665-7",pdfIsbn:"978-1-83969-667-1",doi:"10.5772/intechopen.95693",price:119,priceEur:129,priceUsd:155,slug:"arsenic-monitoring-removal-and-remediation",numberOfPages:106,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"a40cc5d83f2f1233db31ef10c547b35c",bookSignature:"Margarita Stoytcheva and Roumen Zlatev",publishedDate:"March 30th 2022",coverURL:"https://cdn.intechopen.com/books/images_new/10997.jpg",numberOfDownloads:636,numberOfWosCitations:0,numberOfCrossrefCitations:0,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:1,numberOfDimensionsCitationsByBook:0,hasAltmetrics:0,numberOfTotalCitations:1,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"March 11th 2021",dateEndSecondStepPublish:"April 8th 2021",dateEndThirdStepPublish:"June 7th 2021",dateEndFourthStepPublish:"August 26th 2021",dateEndFifthStepPublish:"October 25th 2021",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"170080",title:"Dr.",name:"Margarita",middleName:null,surname:"Stoytcheva",slug:"margarita-stoytcheva",fullName:"Margarita Stoytcheva",profilePictureURL:"https://mts.intechopen.com/storage/users/170080/images/system/170080.jpg",biography:"Prof. Margarita Stoytcheva graduated from the University of Chemical Technology and Metallurgy of Sofia, Bulgaria. She has a Ph.D. and DSc in Chemistry and Technical Sciences. She has been a researcher and teacher at several universities in Bulgaria, Algeria, and France. From 2006 to the present, she has participated in activities of scientific research, technological development, and teaching at the Institute of Engineering, University of Baja California, Mexicali, Mexico, as a full-time researcher. Since 2008 she has been a member of the National System of Researchers of Mexico, and since 2011 she has been a regular member of the Mexican Academy of Sciences. Her interests and areas of research are electroanalytical chemistry and biotechnology.",institutionString:"Autonomous University of Baja California",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"6",totalChapterViews:"0",totalEditedBooks:"5",institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:{id:"128534",title:"Dr.",name:"Roumen",middleName:null,surname:"Zlatev",slug:"roumen-zlatev",fullName:"Roumen Zlatev",profilePictureURL:"https://mts.intechopen.com/storage/users/128534/images/system/128534.jpeg",biography:"Dr. Zlatev obtained his master’s degree from the University of Chemical Technology and Metallurgy of Sofia, Bulgaria, and his Ph.D. from the Grenoble Institute of Technology, France. After his work as a researcher at the Bulgarian Academy of Sciences, Dr. Zlatev began working as a senior researcher and laboratory head at the Institute of Engineering, University of Baja California, Mexicali, Mexico. He is a regular member of the Mexican Academy of Sciences and the Mexican National System of Researchers. Dr. Zlatev has authored more than 110 publications in prestigious scientific journals and holds 10 patents in analytical and electroanalytical chemistry, spectroscopy, corrosion, and analytical instrumentation.",institutionString:"Autonomous University of Baja California",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"846",title:"Ecotoxicology",slug:"environmental-sciences-ecology-ecotoxicology"}],chapters:[{id:"80678",title:"Introductory Chapter: Advanced Electrochemical Technique for Arsenic Determination in Complex Samples",doi:"10.5772/intechopen.102627",slug:"introductory-chapter-advanced-electrochemical-technique-for-arsenic-determination-in-complex-samples",totalDownloads:25,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:null,signatures:"Margarita Stoytcheva and Roumen Zlatev",downloadPdfUrl:"/chapter/pdf-download/80678",previewPdfUrl:"/chapter/pdf-preview/80678",authors:[{id:"170080",title:"Dr.",name:"Margarita",surname:"Stoytcheva",slug:"margarita-stoytcheva",fullName:"Margarita Stoytcheva"},{id:"128534",title:"Dr.",name:"Roumen",surname:"Zlatev",slug:"roumen-zlatev",fullName:"Roumen Zlatev"}],corrections:null},{id:"78293",title:"Arsenic Speciation Techniques in Soil Water and Plant: An Overview",doi:"10.5772/intechopen.99273",slug:"arsenic-speciation-techniques-in-soil-water-and-plant-an-overview",totalDownloads:183,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"There are more than 100 different arsenic with different characteristics in the soil-water-plant ecosystem. The identification and quantification of individual arsenic species is essential for understanding the distribution, environmental fate and behavior, metabolism and toxicity of arsenic. Due to the hazardous nature of arsenic, people have a high interest in the measurement of arsenic species. The reaction of the formation of arsenic speciation in the soil-water-plant environment is briefly studied. There is little information on methods used to quantify arsenic forms and species in contaminated soil, water and plant. The purpose of this article is to understand the available sample pretreatment, extraction, separation, detection and method validation techniques for arsenic speciation analysis of arsenic species in soil, water and plant. The performances of various sample preparation and extraction processes, as well as effective separation techniques, that contribute greatly to excellent sensitivity and selectivity in arsenic speciation when coupling with suitable detection mode, and method validity are discussed. The outlines of arsenic speciation techniques are discussed in view of the importance to the completeness and accuracy of analytical data in the soil-water-plant samples. To develop cheap, fast, sensitive, and reproducible techniques with low detection limits, still needed to confine research on arsenic speciation present in environmental matrices.",signatures:"Mohammed Zia Uddin Kamal and Md. Yunus Miah",downloadPdfUrl:"/chapter/pdf-download/78293",previewPdfUrl:"/chapter/pdf-preview/78293",authors:[{id:"355774",title:"Prof.",name:"Mohammed",surname:"Zia Uddin Kamal",slug:"mohammed-zia-uddin-kamal",fullName:"Mohammed Zia Uddin Kamal"},{id:"425069",title:"Prof.",name:"Md.",surname:"Yunus Miah",slug:"md.-yunus-miah",fullName:"Md. Yunus Miah"}],corrections:null},{id:"77547",title:"Removal of Arsenic - “A Silent Killer” in the Environment by Adsorption Methods",doi:"10.5772/intechopen.98985",slug:"removal-of-arsenic-a-silent-killer-in-the-environment-by-adsorption-methods",totalDownloads:153,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Water is one of the most essential requirements for living being to survive because 70–80% of the mass of most living bodies consists of water and various mineral and organic salts. Water is also most important component of our environment. Large amount of water is used in various industries or commercial level or domestic level and finally effluent water is loaded with large amount of pollutants such as organic chemicals (surfactants, dyes, phenols etc.), inorganic hazardous heavy metals (As in present case) microbes (bacteria, fungi etc.) pollutants particulate etc. Arsenic is a natural metalloid chemical that may be present in groundwater and surface water gets polluted, hence, aquatic life of plants and animals is disturbed and cause abnormal growth and various diseases, hence, short term or long term changes occurs in ecosystem. Hence, treatment of wastewater is essentially required before discharge effluent wastewater into ponds or lagoons, drains and rivers. Arsenic is one such element that contaminates the environment as reported in several countries. The largest population at risk is in Bangladesh followed by India (West Bengal). Arsenic is familiar as silent killer because dissolved in water, it is colorless, odorless, and tasteless, yet consumption of relatively small doses of this element in its most toxic forms can cause rapid and violent death. It is a human carcinogen in water over a wide range of pH values, having harmful effects on both human health and environment, even at low concentration. Because of this effect, the World Health Organization (WHO) and the US Environmental Protection Agency (USEPA) set the arsenic standard for drinking water at .010 ppm to protect consumers served by public water systems. Ingestion only poses health problems if a dangerous amount of arsenic enters the body. Then, it can lead to cancer, liver disease, coma, and death. There is no effective treatment for arsenic toxicity. Only the removal of arsenic from aqueous system can prevent the toxicity. A great deal of research over recent decades has been done to lower the concentration of arsenic in drinking water and still there is a need to develop ecofriendly techniques. Existing major arsenic removal technologies include oxidation, adsorption, precipitation, coagulation and membrane separation. This book chapter presents a systematic description of current status of research in the area of arsenic removal from contaminated water and comparison of all technologies available with more emphasis on adsorption.",signatures:"Ashok Kumar, Kaman Singh, Utkarsh Dixit, Rayees Ahmad Bhat and Satya Prakash Gupta",downloadPdfUrl:"/chapter/pdf-download/77547",previewPdfUrl:"/chapter/pdf-preview/77547",authors:[{id:"289139",title:"Mr.",name:"Ashok",surname:"Kumar",slug:"ashok-kumar",fullName:"Ashok Kumar"},{id:"347915",title:"Mr.",name:"Utkarsh",surname:"Dixit",slug:"utkarsh-dixit",fullName:"Utkarsh Dixit"},{id:"347916",title:"Prof.",name:"Kaman",surname:"Singh",slug:"kaman-singh",fullName:"Kaman Singh"},{id:"352103",title:"Dr.",name:"Satya Prakash",surname:"Gupta",slug:"satya-prakash-gupta",fullName:"Satya Prakash Gupta"},{id:"418990",title:"Dr.",name:"Rayees",surname:"Ahmad Bhat",slug:"rayees-ahmad-bhat",fullName:"Rayees Ahmad Bhat"}],corrections:null},{id:"77387",title:"Remedial Approaches against Arsenic Pollution",doi:"10.5772/intechopen.98779",slug:"remedial-approaches-against-arsenic-pollution",totalDownloads:203,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The study is devoted to a very urgent and acute problem for Georgia – remediation/restoration of the arsenic (As) mining and storage sites. The approach of a given work is based on using capabilities of nature itself, which has a great adaptive potential to chemical environmental pollution. The aim of the study is to identify the bacterial strains from the endemic soil microbiota, characteristic to a specific localization of arsenic contaminated sites and able to resist to the toxicant. To determine the level of arsenic contamination, soil samples have been analyzed using Inductively Coupled Plasma - Optical Emission Spectrometry method. The distribution of arsenic in soil samples splits them into categories according to the degree of contamination, ranging from 50 ppm to 13000 ppm. The local bacteria community has been studied using conventional cultivation method along with modern method of bioindication – a biochip. The low density biochip contains the relevant probes for the identification of the bacterial consortium in soil microbiota. Chemical and microbiological analysis was based on the standards and methodologies developed by International Standards Organizations – ISO and Environmental Protection Agency – EPA. It is prospected that bioremediation can become essential part of remediation against arsenic pollution in the context of circular economy.",signatures:"Gia Khatisashvili, Tamar Varazi, Maritsa Kurashvili, Marina Pruidze, Evgeni Bunin, Kakha Didebulidze, Tinatin Butkhuzi, Elina Bakradze, Nino Asatiani, Tamar Kartvelishvili and Nelly Sapojnikova",downloadPdfUrl:"/chapter/pdf-download/77387",previewPdfUrl:"/chapter/pdf-preview/77387",authors:[{id:"357460",title:"Prof.",name:"Tamar",surname:"Varazi",slug:"tamar-varazi",fullName:"Tamar Varazi"},{id:"357466",title:"Dr.",name:"Gia",surname:"Khatisashvili",slug:"gia-khatisashvili",fullName:"Gia Khatisashvili"},{id:"357469",title:"Prof.",name:"Maritsa",surname:"Kurashvili",slug:"maritsa-kurashvili",fullName:"Maritsa Kurashvili"},{id:"357470",title:"Prof.",name:"Marine",surname:"Pruidze",slug:"marine-pruidze",fullName:"Marine Pruidze"},{id:"357472",title:"Prof.",name:"Kakha",surname:"Didebulidze",slug:"kakha-didebulidze",fullName:"Kakha Didebulidze"},{id:"357476",title:"Dr.",name:"Tinatin",surname:"Butkhuzi",slug:"tinatin-butkhuzi",fullName:"Tinatin Butkhuzi"},{id:"357477",title:"Dr.",name:"Elina",surname:"Bakradze",slug:"elina-bakradze",fullName:"Elina Bakradze"},{id:"357478",title:"Dr.",name:"Nina",surname:"Asatiani",slug:"nina-asatiani",fullName:"Nina Asatiani"},{id:"357479",title:"Dr.",name:"Tamar",surname:"Kartvelishvili",slug:"tamar-kartvelishvili",fullName:"Tamar Kartvelishvili"},{id:"357480",title:"Dr.",name:"Nelly",surname:"Sapojnikova",slug:"nelly-sapojnikova",fullName:"Nelly Sapojnikova"},{id:"421832",title:"Mr.",name:"Evgeni",surname:"Bunin",slug:"evgeni-bunin",fullName:"Evgeni Bunin"}],corrections:null},{id:"77874",title:"A Call to Action: Incentivizing Arsenic Remediation",doi:"10.5772/intechopen.99376",slug:"a-call-to-action-incentivizing-arsenic-remediation",totalDownloads:72,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Arsenic is a threat to human health. Long-term Arsenic exposure can lead to numerous cancers and non-carcinogenic diseases. Over 230 million across 107 countries are drinking groundwater Arsenic concentrations above the maximum concentration limit of 10 μg/L. The number of affected individuals is expected to rise in parallel with a growing dependence on groundwater, driven by diminishing surface water quality and quantity. A growing number of people will come in contact with Arsenic-contaminated water at new locations, while excessive pumping, geogenic processes, and industrial sources raise Arsenic concentrations at active groundwater sites. It is time to begin implementing Arsenic remediation techniques to save human lives, boost the global economy, and instill the foundations of a global collaborative framework. The continued research and development of remediation technologies is crucial, but these technologies will remain ineffective unless implemented. This chapter reviews the ongoing Arsenic crisis and suggests a simplified plan of action for resolving this problem. This is a transcontinental endeavor, which must begin with world leaders identifying and engaging new stakeholders. This will require education and awareness campaigns to boost involvement of the public sector, private sector, and the general public.",signatures:"Bartlomiej K. Bancewicz",downloadPdfUrl:"/chapter/pdf-download/77874",previewPdfUrl:"/chapter/pdf-preview/77874",authors:[{id:"354559",title:"M.Sc.",name:"Bartlomiej K.",surname:"Bancewicz",slug:"bartlomiej-k.-bancewicz",fullName:"Bartlomiej K. 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CMV can develop in people who are immunocompromised and immunodeficient, called opportunistic infections. Opportunistic infections only occur if your immune system is quite weakened. Most adults carry CMV but are unaware of it because the virus cannot produce disease. In people with severely weakened immune systems, CMV can make a person feel as though they have mono. CMV can also cause serious diseases in different parts of the body. CMV spreads from person to person through body fluids, such as blood, saliva, urine, semen, and breast milk. Women who develop an active CMV infection during pregnancy can pass the virus to their neonates, who might then experience symptoms. Human cytomegalovirus (HCMV) infection induces both innate immune responses including Natural Killer cells as well as adaptive humoral and cell-mediated (CD4+ helper, CD8+ cytotoxic and γδ T cell) responses which lead to the resolution of acute primary infection. 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TB is also the primary killer due to a single infectious disease and, after HIV/AIDS, is the second single disease which causes more deaths in the world [2]. The World Health Organization (WHO) estimates that one‐third of the world population harbors latent TB infections (LTBI), 14.1 million people have active cases, 9 million are newly diagnosed per year (9.6 million new TB cases in 2014, of which 58% in the Southeast Asia and Western Pacific regions), and 1.5 million deaths are attributable to TB annually [1–4]. This death toll equals 2% of global mortality, even if it is a disease for which a cure has existed for 70 years.
In relation to HIV infection, more than 48% of TB patients globally had a documented positive HIV test result. In the African region, which has the highest TB/HIV burden, three out of four TB patients knew their HIV status [4].
Although the general decrease [1, 4] of TB cases (globally, the TB mortality rate fell by an estimated 45% between 1990 and 2013 and the TB prevalence rate fell by 41% during the same period) in recent decades has led the medical profession to pay less attention to the presence of high‐risk patients, TB continues to be a public health concern in high‐income countries, primarily among the foreign‐born and migrant population [5]. In fact, a reappearance of this disease was observed since the early 1990s due to other than the spread of HIV infection and the increase in poor living conditions and immunosuppression; it is due to the migratory phenomenon, and an interplay of various push and pull factors are a consequence of wealth disparity, poverty, wars, and political persecutions [6, 7].
There are 244 million migrants worldwide, which is 41% more since 2000. Note that 76 million are in Europe, the continent with the highest number of migrants, followed by Asia (75 million), United States (54 million), Africa (21 million), Latin America and the Caribbean (9 million), and Oceania (8 million), according to the calculations of the latest International Migration Report of the United Nations [8]. Of all the immigrants living in Europe, Germany and Russia have 12 million, the United Kingdom has 9 million, France has 8 million, Spain and Italy have 6 million; while Saudi Arabia has 10 million and Canada and Australia have 7 million, respectively. According to the previous report of the UN [8], the largest number of citizens migrated abroad come mainly from India (16 million), Mexico (12 million), Russia (11 million), China (10 million), Bangladesh (7 million), Pakistan and Ukraine (6,000,000), and the Philippines and Syria with about 5 million migrants.
Immigrants from TB endemic countries account for a significant proportion of TB cases in industrialized countries. It can be anticipated that this proportion will continue to increase, and will represent an important cause of the overall resurgence of the TB epidemic in Western EU and the USA. Most migrants are healthy, but conditions surrounding the migration process can pose health risks such as inequalities in accessing health services, substandard quality of care, marginalization, and discrimination. Thus, the particular condition of “immigrant” predisposes to an increased risk of developing TB, either for increased incidence rates in their countries of origin, or the high rate of LTBI which predisposes to TB for conditions of social fragility and complexity related to the process of migration and multiculturalism found in the host country.
The chapter is structured as follows:
Overview and epidemiological features of TB among immigrants in low‐TB burden countries.
Definition of LTBI and risk of progression toward TB.
Management of LTBI among immigrants and screening practices.
Essentials of diagnosis of infectious TB among immigrants in low TB burden countries.
Management and treatment of drug‐resistant TB.
Conclusions and social issues.
Many Low TB burden or low TB incidence countries are defined as those with a TB notification rate of ≤100 cases (all forms) per million population a year. The high‐TB burden or incidence countries are countries with the highest estimated numbers of incident TB cases that account for 80% of the global total.
TB remains one of the major public health challenges in North Africa with decreasing gradient incidence from Morocco (the highest) with more than 27,000 new cases per year, to intermediate in Algeria and lowest in Tunisia and Egypt (30 and 17 cases per 100,000, respectively) [11]. In the European Economic Area (EEA), the majority of subjects of foreign origin with TB in 2009 originated from Asia, Africa, and other European countries (34, 28, and 9.5%, respectively) [9, 10, 12]. This proportion continues to increase, and represents an important cause of the overall resurgence of the TB epidemic in the USA and Western Europe (EU) [12]. It can be anticipated that, despite efforts of the industrialized countries to conquer the disease, the incidence of new TB cases in EU varies from very low rates in Scandinavian countries (6–8 cases/100,000 population) to rates as high as 231 cases/100,000 populations in Tajikistan; the Russian Federation is eleventh among the 22 high‐burden TB countries [12]. In Italy, where over the last decade the TB notification has been stable at approximately 7 cases per 100,000 people annually, the immigrant population has a relative risk of suffering from TB, 10–15 times higher than the Italian‐born population [4]. In fact, the proportion of TB cases of foreigners increased from 22% in 1999 to 46% in 2008 of the total [13]; at the same time, the proportion of drug‐resistant TB cases rose to 83% [14]. Almost two‐thirds of the cases of TB in foreigners in 2008 occurred in northern Italy, where immigration is more prominent than in other areas of the country [13]. The most affected age group was of young adults [13]. Concurrently in Italy, while the proportion of African‐born persons with TB decreased from 51 to 30%, the proportion of cases with TB born in Eastern EU, including former Soviet Union countries, increased from 16 to 33% [14, 15]. In the Italian population, the two most affected population groups are the elderly and the foreign born. The elderly population, due to progressive weakening of both, their general conditions and their immune system, caused by the aging process itself, is at increased risk of reactivation of LTBI. Foreign‐born residents, which are at increased risk of developing TB either because of the high incidence rates of TB in their countries of origin or because of the social fragility deriving from the migration process itself [16], account for the increase of TB in people less than 65 years of age and for the great majority of drug‐resistant TB cases.
Summarizing, the European countries share a TB epidemiology which is characterized by a decrease of TB incidence in natives but an increasing incidence in foreign‐born persons; occurrence of the majority of TB cases in recent migrants and younger age groups, especially those experiencing inadequate living and health conditions; and high percentage of drug‐resistant TB among immigrants and previously treated patients [11].
Factors that influence the risk of TB reactivation among immigrants in low TB burden countries include the prevalence of TB in the country of origin, the duration of residence in the host country, and the efficiency and quality of curative and preventive services. As mentioned previously, after the actual migration process, immigrants are exposed to additional risk of acquiring reactivated TB infection because of stressful living in overcrowded conditions, social isolation, poverty, malnutrition, unemployment, and difficulties to access to health care. Generally, TB in immigrants in low‐burden countries arises from an active TB infection which occurred overseas. There are also reactivations of remotely acquired LTBI, which occurs months to years after settlement in the host country, or acquired TB as new infection postarrival in the host county through local transmission or during a return travel to the country of origin [17]. Second‐generation migrants, who often keep a link with their country of origin, or international travellers including visiting friends and relatives (VFR), especially children, are known to represent high‐risk groups for TB [18]. Finally, homeless immigrants and other deprived groups in low‐burden countries can have transmission rates as high as some high‐burden countries [19].
Migrants currently play an important role in determining the current epidemiology of TB in low TB burden countries where they are settled. As a consequence, although reports from different high‐income countries with well‐performing immigration medical screening have demonstrated that foreign‐born TB patients do not contribute to the transmission of TB in the native population [20], there is an increasing interest on how best to enhance TB control through coordinated medical screening of documented as well as undocumented migrants such as migrants or refugees that are arriving presently at the Greek and Italian coasts. Undocumented migrants have been shown to be at higher TB risk than other migrants, as their entry and TB infection is often more recent and their migration and living conditions are worse than those of documented migrants [21].
Immigration TB screening programs for high immigration and low TB incidence countries vary according to the national legislation, resource availability, and public health risk management practices. Moreover, programs differ by whether screening is done for active TB or LTBI, or both. The programs also differ in relation to arrival in the host country, i.e., the migrants’ status, such as refugees or asylum seekers, the countries of origin, and tools used to screen for active TB or LTBI [22, 23]. The rationale of these programs is the early detection and treatment of active and often contagious TB cases in order to prevent
In most of cases, active TB immigrant medical screening in high‐income industrialized countries for both documented migrants, refugees, or asylum seekers is performed on or soon after the entry (borders such as airport, reception centers/holding camps, migrant centers); 36% (9 of 25 countries including Australia, Canada, Israel, Jordan, New Zealand, France, the UK, and the USA) have a pre‐entry TB screening in country of origin for people who intend to migrate; 20% (5 of 25 countries including Norway, Sweden, Switzerland, the Netherlands, and the UK) perform screening at entry [24, 25]. Literature shows that 88% of countries use chest X‐rays (CXR) alone or in combination with clinical examination or TST [5, 24]. The sensitivity and specificity of CXR vary from 86–97% to 75–89%, respectively, and according to the criteria of imaging interpretation. CXR alone does not detect extrapulmonary TB (EPTB) which is increasing in comparison to pulmonary TB, especially in low‐burden and high immigrant receiving countries [26], and in HIV‐positive persons that have higher rates of EPTB compared with those who are HIV‐negative.
Sputum smear and culture follow CXR only if this is found to be abnormal. The destiny of migrants to enter the host country depends on the outcome of these tests.
An interesting and original active TB finding approach was recently investigated by Schepisi [27] in Italy, a country where there is no TB national screening policy for new entrants [28]. Italy is a country with a TB incidence rate of 5.3/100,000 persons with 3.153 cases in 2013 [29]. TB cases are especially concentrated among high‐risk TB groups, including migrants from high‐incidence countries, homeless people, and drug and alcohol abusers. The study analyzed TB case finding intervention based on verbal symptoms screening, Presence of cough, fever, fatigue, hemoptysis and weight loss.
Although many countries have developed and documented immigration TB screening programs to suit the needs of adults, attention to migrant children lacks intensive studies.
Screening migrant children for TB is particularly important, as they have a higher risk of developing active disease due to recent infection. Furthermore, due to its “paucibacillary” nature, which makes it rarely infectious, when they develop the disease, it is more severe, resulting in increased morbidity and mortality compared with adults. Thus, TB screening in high‐risk children from high‐incidence countries should form part of all immigration TB screening programs. A recent survey compared various screening tools (history, physical examination, TST, interferon‐gamma release assays (IGRAs), CXR, Mainly employed in children ages from 11 to 16 years.
Although the word LTBI should be “reconsidered” considering that both “latent” and “infection” terms indicate lack of disease and thus are redundant [32], LTBI is defined as a state of persistent immune response to previously acquired TB antigens without evidence of clinically manifested active TB disease. It is an asymptomatic and nontransmissible condition that is maintained for the lifetime of the infected person. Current tools are insufficient to measure the global prevalence of LTBI, but investigations carried out a decade ago estimated that approximately one‐third of the world population (>2 billion people) is latently infected with
A relatively small proportion, 5–15% of screen‐test‐positive patients of the estimated >2 billion people with LTBI will develop TB disease (TB reactivation) within the first 5 years after initial infection, with the remaining risk distributed over the rest of the life span [33, 34]. The likelihood of progression from LTBI to active clinical TB disease is determined by bacterial, host, and environmental factors, potentially favoring TB evolution. A schematic diagram showing TB evolution following exposition is illustrated in Figure 1.
Evolution of TB from latent infection to active disease following exposition.
The risk factors for acquiring LTBI infection involve people at increased risk which include infants, children (<5 years), and adolescents who have intimate contact with high‐risk adults, as well as persons who have had close contact with someone known or suspected to have active TB, health care workers, high‐risk racial and ethnic minorities, prisoners, residents in nursing homes, hospitals, and homeless shelters [34]. LTBI also occurs in the migrant population coming from low‐income countries with a high burden of disease, especially from the Indian subcontinent and sub‐Saharan Africa (the highest burden in the world), as well as in asylum seekers and refugees, a subgroup of immigrants at particular risk for TB. Persons coming from tropical areas are also at an increased risk for developing TB. The probability of developing TB is much higher among people with cellular immunity impairment due to: human immunodeficiency virus (HIV) infection, tumor necrosis factor α inhibitors, glucocorticoids administration, and organ or hematologic transplantation. Diabetes mellitus and chronic kidney disease are also more common in migrant populations and significantly increase the risk of reactivation from LTBI to active TB [34, 35].
Among all the considered conditions, HIV infection is the most potent risk factor for progression from LTBI to active TB disease [36]. TB in fact is the leading cause of death among people living with HIV, estimated to account for around 33% of all HIV‐related deaths globally [4] and individuals with both, LTBI and HIV infection, have a risk of reactivation of 10% per year of life compared with 10% for life for those who do not have an HIV infection [23]. Many HIV‐positive people in developing countries develop TB as the first manifestation of AIDS [4]. The major risk factors for progression from latent infection to active disease are wide ranging and are listed in Table 1.
• Children younger than 5 years |
• Persons with immunocompromising conditions (HIV, leukemia, lymphoma) |
• Persons infected with |
• Persons with a history of untreated or inadequately treated TB, including those with CXR findings consistent with previous tuberculosis (e.g., apical fibronodular changes on CXR) |
• Homeless adults, elderly, health care workers, and medical students |
• Persons with recent conversion of a negative tuberculin skin test to a positive test |
• Persons with the following clinical conditions or other conditions compromising immunity: disorders requiring long‐term use of corticosteroids or other immunosuppressant medications (including tumor necrosis factor‐alpha antagonists), body weight 10% or more below the ideal, chronic renal failure, and end‐stage renal disease requiring dialysis, diabetes mellitus *, gastrectomy or intestinal bypass, malignancy (cancer of the head, neck, or lung), silicosis |
• Tropical parasitic diseases including helminthic infestations ** |
• Black race, black skin individuals *** |
Groups at increased risk of progression from LTBI to active tuberculosis.
*Diabetes can increase the relative TB risk (range 1.16–7.83) [37].
**These can negatively impact on TB disease inducing immunological weakening throughout Th1 impairment [38].
***Black skin individuals are constitutively more susceptible than white skin persons owing to environmental and genetic factors [39].
Given that the majority of active TB in foreign‐born persons in low‐incidence countries arises from reactivation of LTBI, acquired many years previously in the country of origin, as also demonstrated by epidemiological studies based on
Guidelines for LTBI screening among immigrants are not homogenous and vary among regions; moreover, evidence supporting their effectiveness is lacking and identifying models of best practice remains difficult, so that there are no perfect methods for the diagnosis and management of LTBI [43–45] whose identification provides opportunity for early treatment and the prevention of significant health sequelae for the individual. Diagnosis of TB is currently based on a positive result of either a tuberculin skin test (TST) or IGRA test indicating an immune response to
Individuals should be asked about symptoms of TB before being tested for LTBI. In this setting, WHO guidelines [4] suggest an algorithm for targeted diagnosis and treatment of LTBI in individuals of risk groups (Figure 2).
Algorithm for the management of LTBI in individuals at risk for TB. Modified and adapted from Guidelines on the Management of Latent Tuberculosis Infection. Available from:
A recent survey found that only 55.2%, 16 out of the previously mentioned 29 countries (see p. 6), screen for LTBI most frequently postarrival in their country using TST in 68.8% of cases, TST plus a confirmatory IGRA in 25%, and IGRA alone in 18.8%. In 11 of these countries, the screening is compulsory for documented migrants [5, 24, 25].
The screening may decrease the period of infectiousness by as much as 33% in some situations [5]. LTBI screening is effective in persons at risk of contracting
The decision to screen for TB is a decision to treat. LTBI can be effectively treated in order to prevent progression to active TB, thus resulting in a substantial benefit for both the individual and the community. Currently available treatment options allow to reduce the risk of developing active TB by at least 60%. However, safety concerns exist, mainly related to the development of drug‐related adverse events including hepatotoxicity. The following regimens recommended by the WHO TB Report 2015 [4] for the treatment of LTBI are: daily therapy with INH for 6–9 months; 12 weeks rifapentine plus INH weekly; 3–4 months INH plus rifampicin daily; rifampicin plus pyrazinamide for 2 months or 3–4 months RIF alone. While the safety of 2 months of RIF and PZA has shown to be acceptable in HIV‐infected persons and children, in non‐HIV‐infected adults, this regimen has demonstrated a high rate of severe liver toxicity [52].
Identification of latently infected individuals and their treatment has lowered TB incidence in rich, advanced countries. Similar approaches also hold great promise for countries with low to intermediate rates of TB incidence. Wide variations are observed for the cost of screening of eligible candidates for LTBI treatment and the costs for treatment. For reasons of practicality and cost effectiveness, most high‐income countries consider and check as eligible population refugees or asylum seekers or those individuals arriving from high TB burden settings. The available evidence suggests that screening for and treatment of LTBI may be a cost‐effective intervention in population groups characterized by high prevalence of LTBI and/or high risk of progression to active TB, such as persons migrating from high TB incidence countries, contacts with active TB cases, and persons living with HIV.
Owing difficulties in access to health system, TB diagnosis and treatment are lower in migrant populations compared to native subjects. This is in part due the fact that migrants, in general, have a longer patient diagnostic delay for TB (time elapsed from the onset of symptoms and the first medical visit) possibly due to a combination of reasons including language barriers, unemployment, or interruption due to lack of medical insurance that hinder migrants from using the available health TB services, while natives have a longer health care diagnostic delay (defined as the time elapsed between the first medical consultation and the initiation of treatment) [53]. Although the reliability of epidemiological assessments has progressively improved in recent years, no more than 30% of the estimated number of people suffering from TB, including migrants, is actually diagnosed with a method of proven efficacy [54]. Moreover, current diagnostic tests have poor performance on forms of TB which are intrinsically difficult to diagnose, such as childhood TB, smear‐negative pulmonary TB and EPTB, TB in HIV/AIDS patients, and drug‐resistant TB.
To date, the most common methods for diagnosing TB worldwide which constitute the backbone of TB diagnosis remain the “old” sputum smear microscopy test and bacteriological culture which is also the test necessary for monitoring patients’ response to treatment [2, 3]. These methods, however, represent a major constraint even in high‐tech, high‐resources western countries, when the mycobacterial load is low or the district of infection is not easily accessible. TB diagnosis includes suspicion as first step. All patients with TB, including migrants, can present with almost any symptom including cough, shortness of breath, chest pain, hemoptysis, together with the presence of constitutional symptoms (weight loss, fever, fatigue, and night sweats) which meet the definition of a suspected TB case according to WHO [55]. These symptoms must be considered in differential diagnosis in patients with epidemiologic risk (exposure to infectious patients, travel to or residence in a high prevalence area, previous TB) [2, 54]. The clinical suspicion of TB is then investigated through radiographic imaging, microbiology, and histopathology. Radiology could also have an important role in the diagnosis of TB in low‐resource countries, especially as pre‐entry TB screening in country of origin for those migrants who intend to migrate and refugees. However, the equipment is expensive and it needs qualified and experienced staff to be able to interpret the radiological signs—they are not always available in these settings [23, 45, 56, 57]. Moreover, CXR cannot provide a conclusive diagnosis on its own and needs to be followed by sputum testing. Although inexpensive and potentially easy to perform, conventional smear microscopy has a number of limitations including the variable (from 20 to 80%) sensitivity which is low, particularly among all persons coinfected with TB and HIV, including migrants and children, due to the reduced pulmonary bacillary load in these subjects [58]; it cannot distinguish between MBT complex and non‐TB mycobacteria and it does not provide information on the resistance profile of the bacilli. In this setting, phenotypic drug‐susceptibility testing (DST) on cultured specimens is the conventional method used to detect resistance to first‐ and SLD‐TB drugs in MDR‐TB and monitoring patients’ response to treatment [4]. Finally, the challenge of TB diagnosis in the low‐income countries including the tropics, must also take into account the differential diagnosis with a wide spectrum of microbial agents causing respiratory infections of which migrants can be affected and include viruses, bacteria (
Current‐generation MTB‐specific nucleic acid amplification tests (NAATs) can be a valid surrogate to direct observation or isolation of tubercular bacilli and to replace culture [33] and detect new TB cases within few hours. Although NAATs are widely used in Europe [33, 59], their high cost and level of technical support hindered the widespread adoption in TB endemic countries. Improving diagnosis in high‐income countries is a strategic goal in TB research, and the pipeline of diagnostic tools is rapidly growing: new ways of performing sputum smear microscopy and innovative technologies for molecular diagnosis have already been endorsed by WHO, or are under investigation [60]. To respond to the urgent need for simple and rapid diagnostic tools at the point of treatment in high‐burden countries, a fully automated molecular test for Respiratory rate >30/min, temperature >39°C, heart rate >120/min, severe difficulty to walk unaided.
So far TB treatment in migrant populations represents a challenge as it contributes considerably to illness and death especially in western countries. There are not only the economic but also the social costs. A number of social determinants, such as limited language, sociopsychological barriers, lack of employment, fear of expulsion, and access to health care facilities, often lead to a protracted diagnosis. Thus, TB treatment of these patients can be limited or inadequate and this is fundamental for conferring TB drug resistance.
The current standard of care of drug‐susceptible MTB requires 6–9 months of combination therapy which includes a 2‐month “intensive” phase of a four‐drug cocktail containing RIF, INH, PZA, and EMB; followed by a longer “continuation” phase of RIF and INH to eradicate the remaining bacilli that have entered a dormant, slowly replicating the latent phase. Currently, standardized regimens require that patients’ daily ingest up to four drugs under direct observation of a healthcare worker for a period of 6–9 months. In this setting, directly observed treatment (DOT) of TB reduces TB‐related death, disability, and transmission; it is a highly cost‐effective intervention, even in the lowest income countries [54]. Treatment of TB represents a therapeutic challenge because of not only the natural level high resistance of That is, MDR strains resistant to any FC and to at least one of three injectable SLD: KM, CM, AK.
Patients with MDR‐TB strains should receive therapy based on individual DST including residual first‐line (SM), EMB, PZA drugs, and SLD such as oxacin, KM, CM, ET, PAS, and CS. As with other antimicrobial agents, the use of SLD can generate resistant mutants. DST often shows poor reproducibility and lack of correlation with clinical response. The initial intensive phase of therapy should last 6–8 months and includes at least 4 months after culture conversion. Compared with the treatment of drug‐susceptible TB, the treatment of MDR‐ and XDR‐TB requires more drugs that are less well tolerated for a more prolonged duration. The available TB drugs against MDR/XDR‐TB are included among a hierarchy of five groups, with first‐line TB drugs listed in Group 1 and second‐line drugs in Groups 2 through 5 [76]. Group 1 is composed of first‐line TB drugs RIF, INH, PZA, and EMB; Group 2 contains the injectable agents embracing the bactericidal aminoglycosides (SM, AK, and KM) and CM, whereas Group 3 consists of FC including gatifloxacin and moxifloxacin. The remaining SLD ethionamide/prothionamide, CS, and PAS are inside Group 4 and are considered less potent and often less well tolerated by patients. Group 5 contains new antimicrobial agents, those with less clinical experience, and drugs with less proven efficacy in the management of drug‐resistant TB such as clofazimine, developed in the 1950s to treat leprosy. Bedaquiline, delamanid, linezolid, clofazimine, meropenem, amoxicillin‐clavulanate, and clarithromycin are included in this category. Although adherence to therapeutic programs is often impossible for immigrants as they are often lost in follow‐up, at least five drugs (including an injectable agent) should be given for an “intensive phase” of up to 8 months. The specific drugs chosen depend on a patient\'s previous TB drug therapies and individual DST results. Thereafter, a “continuation phase” of least four oral drugs should be continued until a total minimum duration of 20 months. Prolonged therapy presents a range of practical challenges including prolonged hospitalization with conspicuous health care cost, toxicity (i.e., nephro‐ and ototoxicity with aminoglycoside drugs), and high loss to follow‐up during continuation therapy. Finally, drug‐resistant TB can represent in Africa a particular risk to individuals with HIV with high transmission of infection and high mortality [77]. Treatment success rates of MDR/XDR‐TB vary between 36 and 79% [78, 79]. Surgery can have a positive adjunctive role with combination of antimicrobial drug therapy in the management of drug‐resistant TB, but does not allow for shortening the duration of therapy [80].
Three groups of people deserve special attention in MDR/XDR TB management: children, pregnant women, and HIV‐positive patients.
There are not enough data regarding optimal duration of MDR/XDR‐TB treatment in children which may vary from case to case. Depending on the extent of the disease, the TB DST pattern and the immune status of the child, a total duration of treatment between 12 and 18 months following culture conversion could be acceptable, with the recommendation to continue the treatment only in particular cases to avoid relapse [30]. However, the clinical trials in children so far carried out are not enough to supporting this approach.
Regarding pregnancy, there is consensus that neither LTBI following contact of a patient with MDR/XDR‐TB nor active MDR/XDR‐TB requires cessation of pregnancy [81]. While safety of many drugs for the unborn child is unknown, treatment of pregnant females who develop MDR/XDR‐TB or become pregnant during treatment can be successful without adverse events for the newborn, although aminoglycosides/polypeptides are not recommended for MDR/XDR‐TB treatment during pregnancy [82]. Theoretically, breastfeeding should be recommended only in females who are not infectious. However, the known and theoretical benefits of continuing treatment seem to outweigh theoretical risks to the mother and fetus.
Being TB and HIV strictly related, HIV exacerbates TB and the phenomenon of MDR/XDR‐TB is somehow increasing in these patients in whom HIV testing is not always evaluated especially in particular countries, thereby delaying the initiation of antiretroviral therapy (ART) which could significantly reduce mortality, relapse rates, and development of resistant strains [83]. This is especially true for immigrants in whom not only it is difficult the access HIV testing, but also ART testing. A large body of research has in fact shown that migrants are more likely to enter into the healthcare system late and are less likely to be retained at successive stages of the HIV treatment cascade.
MDR/XDR‐TB has higher mortality rates especially in South Africa [83, 84] among MDR/XDR‐TB and HIV coinfected cases with very low CD4 cell counts and limited access to ART. Timely diagnosis based on molecular assays is crucial to reduce the mortality associated with MDR/XDR‐TB patients among HIV‐infected persons. Owing to high case detection rates compared to smear microscopy, WHO recommends Xpert®MTB/RIF as a primary diagnostic test for TB in persons living with AIDS [4].
In conclusion, treatment for MDR/XDR‐TB is far from optimal at present. In particular, treatment of MDR/XDR‐TB in migrants living in high‐income countries is associated with increased risk of therapy nonadherence, loss to follow‐up, and in general, noncontinuity of anti‐TB care that worsens drug‐resistant TB. Migrants’ slow progression through the TB or HIV treatment cascade can be attributed to feelings of confusion, inability to effectively communicate in the native language, and poor knowledge about administrative or logistical requirements of the healthcare system.
Novel therapeutic interventions with shorter treatment regimens with higher efficacy and better tolerability than those currently available are required. In addition, new drugs need to be developed and existing drugs for anti‐TB properties should be reevaluated for their potential efficacy in the treatment of MDR/XDR‐TB. In receiving high‐income countries, the international community has responded with financial and scientific support, leading to new drugs [85] and regimens in advanced clinical development and an increasingly sophisticated understanding of resistance mechanisms and their application to all aspects of TB control and treatment. In the absence of a preventive vaccine, more effective diagnostic tools, and novel drugs, the control of MDR/XDR‐TB will be extremely difficult. Moreover, the increasing rates of drug‐resistant TB in Eastern EU, Asia, and sub‐Saharan Africa is now threatening the gains made by TB control programs worldwide.
Although the WHO Report 2015 [4] with its “STOP TB” strategy has the goal to eliminate TB as a public health problem (defined as <1 case per 1 million population per year) by 2050, TB shows no signs of disappearing in the near future despite declining incidence in most high‐income countries. TB is still one of the top three infectious killing diseases in the world, after HIV/AIDS that kills 3 million people each year, TB kills 2 million, and malaria kills 1 million [4]. In order to intensify the fights against this deadly disease, further efforts aimed to strength surveillance programs to accurately estimate the burden of all kinds of TB are of great significance. Considering the enormous number of migrants around the world [8] with its high rates in the USA and Europe (54 and 76 million, respectively), particularly in Germany, Russia, the UK, France, Spain, and Italy, other than Saudi Arabia, Canada, and Australia, the problem of TB is of foremost importance and deserves great attention in order to act promptly to find solutions.
Although migration in itself is not a definitive risk for TB, several factors can put migrants in vulnerable situations that push factors (desertification, famine/drought, political fear/persecution, poor medical care, loss of wealth, and natural disasters), and pull factors (search of job opportunities, better living conditions, better medical care, political and/or religious freedom and security) migrant people in and out of TB-endemic areas [86]. Social fragility of migrant populations, despite its heterogeneity, shows areas of health suffering in large part due to highly uncertain circumstances and integration policies in receiving countries, especially at the local level, difficulties in access to services, and to relational communicative problems. In fact, the slow or less rapid deterioration of the migrant health in the host country creates serious problems, both to the person who is sick, and to the community which is forced to support the social and economic costs that this entails. Therefore, understanding the changing socioenvironmental situation as well as population movements and their associated risks for TB infection is critical for control, containment, and elimination of this disease which still poses infection‐control and public‐health challenges in the twenty‐first century. Providing services aimed to identify and treat TB in migrants, refugees, or asylum seekers who are at high TB risk is challenging and requires a multidisciplinary approach and a high rate of investment of resources, human, structural, and material [87]. In immigrants living in high‐income countries there are crucial factors that play an important role in TB‐drug adherence which include length of treatment course, complex regimens, medication side effects, poor access to health care services, poor communication with health care providers, lack of social support, negative perceptions, stigma, and discrimination. The lack of laboratory facilities in their country of origin made the laboratory diagnosis of infectious diseases, including TB, difficult in many parts of the African continent as well as in the majority of other poor and low resource countries, where the diagnosis continues to rely on century‐old sputum microscopy. In recent years, a growing number of rapid and more sensitive tests for TB and drug‐resistant TB, based on molecular methods, including Xpert®MTB/RIF, have become available to replace or parallel exist to conventional tests; however, current TB diagnostics are still suboptimal in their performance for childhood TB, smear‐negative TB, EPTB, HIV‐TB, and drug‐resistant TB. Furthermore, there is no standard test for the identification of LTBI, which, if correctly identified in particular risk groups including migrants, could be appropriately treated in order to prevent the onset of TB. So far, neither test can reliably predict future disease among persons with positive tests, and strong positive tests do not suggest a higher risk.
Looking at the movement of people today, at world politics, and at the increasing gap between the rich and the poor, it is expected that the number of immigrants will increase and with it health risks of those on the move and, to a lesser extent, the risk of those in the receiving countries can also be anticipated. It is argued here that a substantial increase in funding for TB research is required. There is no vaccine with adequate effectiveness, and TB treatment regimens are protracted and have a risk of toxic effects. Moreover, fundamental understanding of the pathogenesis of this disease is inadequate. In order to achieve the ambitious targets of the End‐TB strategy 2035 (95% reduction in TB deaths, compared with 2015), 90% reduction in TB incidence rate (less than 100 TB cases per million population, no affected families facing catastrophic costs due to TB), greater efforts are needed also regarding migrants interventions, such as support services to receive and treat migrants, improving their access to health facilities, preventing the development of drug resistance through high quality treatment of drug‐susceptible TB, improving adherence to anti‐TB treatment, and offering vaccination for TB especially to prevent TB meningitis in children in endemic areas. Control strategies need to be adapted to local realities after evaluation of data prevalence/incidence, feasibility, and cost effectiveness. TB transmission among immigrants and natives is still rare, although it could increase in case of limited TB control. Thus, interventions such as expansion of the free service package and education about TB diagnosis among community health personnel are urgently required for early LTBI or case detection among migrants, particularly those born in a country with a high incidence of disease or in those persons exposed to the contact with TB, like close relatives of infectious patients [87]. It is recommended that high‐income countries and their institutions cooperate in the near future with high‐burden countries [4]. One important goal inside the “Global Action Framework for Research towards TB Elimination,” developed by WHO [4] for the period 2016–2025 will be in fact to translate the new technologies and innovative approaches into policies and practices and then adapt to particular country contexts as appropriate. This is only another rational approach that in future will help to reach some of the ambitious targets to control, perhaps stop TB, in the coming decades.
RIF | Rifampicin |
INH | Isoniazid |
PZA | Pyrazinamide |
EMB | Ethambutol |
KM | Kanamycin |
CM | Capreomycin |
AK | Amikacin |
CS | Cycloserine |
PAS | P‐aminosalicylic acid |
FC | Fluoroquinolones |
MDR‐TB | Multi drug‐resistant tuberculosis |
XDR‐TB | Extensive drug resistant‐TB |
SLD | Second‐line drugs |
There has been an increased interest in amaranth since it appeared in the 1980s, when the US National Academy of Sciences carried out a research project entitled
Figure 1 shows the
Amaranth grain from which a nutritional beverage is prepared.
Amaranth (
Component | Amaranth grain (value per 100 g) |
---|---|
Protein | 13.56 |
Lipids | 7.02 |
Carbohydrates | 65.25 |
Dietary fiber | 6.70 |
Ash | 2.88 |
Water | 11.29 |
Energy (kcal; kJ) | 371; 1554 |
Nutrient composition and energy content of amaranth grain [7].
Amaranth grain (g per 100 g) | |
---|---|
Minerals | |
Calcium | 159 mg |
Copper | 0.53 mg |
Iron | 7.61 mg |
Magnesium | 248 mg |
Manganese | 3.33 mg |
Phosphorus | 557 mg |
Potassium | 508 mg |
Sodium | 4 mg |
Zinc | 2.87 mg |
Selenium | 18.7 mcg |
Vitamins | |
Ascorbic acid | 4.20 mg |
Riboflavin | 0.20 mg |
Folate | 82 mcg |
Niacin | 0.92 mg |
Thiamin | 0.12 mg |
Vitamin A | 2 IU |
Pantothenic acid, vit. B55 | 1.46 mg |
Vitamin B-6 | 0.59 mg |
Vitamin E (alpha-tocopherol) | 1.19 mg |
Vitamin E (beta-tocopherol) | 0.96 mg |
Vitamin E (delta-tocopherol) | 0.69 mg |
Choline | 69.8 mg |
Betaine | 67.6 mg |
Lutein | 28 mcg |
Minerals and vitamins composition of amaranth grain [7].
It is known that celiac disease is a serious autoimmune disease that occurs in genetically predisposed people where the ingestion of gluten leads to damage in the small intestine. It is estimated to affect 1 in 100 people worldwide. Amaranth seed is gluten-free and may be used to prepare nutritious and suitable food products for people with this type of food allergy.
Herein essential amino acids, fatty acid composition, and phytonutrients of amaranth grain are given in Tables 3–5, respectively.
Components | Amaranth grain (g per 100 g) |
---|---|
Arginine | 1.06 |
Histidine | 0.39 |
Isoleucine | 0.58 |
Leucine | 0.88 |
Lysine | 0.75 |
Methionine | 0.23 |
Phenylalanine | 0.54 |
Threonine | 0.56 |
Tryptophan | 0.18 |
Valine | 0.68 |
Essential amino acid profile of amaranth grain [7].
Component | Amaranth grain (value per 100 g) |
---|---|
Palmitic acid (C16:0) | 1.154 |
Stearic acid (C18:0) | 0.223 |
Oleic acid (C18:1) | 1.671 |
Linoleic acid (C18:2) ω-6 | 2.736 |
Linolenic acid (C18:3) ω-3 | 0.042 |
Fatty acid composition of amaranth grain oil [7].
The essential amino acid profile of amaranth grain is given in Table 3.
The lipid contents in amaranth grain is around 7–9% higher as the values found in other cereals such as wheat and maize with values of 2.1 and 4.5%, respectively. Amaranth grain contains mainly unsaturated fats, containing linoleic (or omega-6) fatty acid (25–62%) and alpha-linolenic (or omega-3) fatty acid (0.3–2.2%) [7]. The fatty acid composition of amaranth grain is given in Table 4.
Amaranth grain flour contains mainly polyphenols (flavonoids) and phenolic acids with relatively high antioxidant activity. Both flavonoids and phenolic acid composition of amaranth grain are given in Table 5.
The amaranth grain contains more protein than other crops as corn and rice [13] and a relatively high content of several essential amino acids as shown in Table 3. Lysine is the principal component which limits amino acid in cereals like maize, wheat, and rice. Lysine in protein ranges from 40 to 50 g/kg. The essential amino acid index (EAAI) value of 90.4% showed that amaranth’s protein is comparable with egg protein and can be used as a substitute for a meal [14]. Also there is a high amount of protein in amaranth’s leaves [15]. Additionally, in amaranth’s grain, besides omega-6, omega-3, oleic, palmitic, and stearic acids (Table 4), also another nutraceutical constituent is squalene [16]. As shown herein through Tables 1–4, amaranth grain contains a well-balanced proportion as relevant nutrient for human diet. Starch is the main component of amaranth grain and has been used in many healthy and organic food preparations [17]. As compared to the starch in corn and wheat, the starches of
Besides proteins, carbohydrates, and lipids, amaranth seeds contain various other constituents (Tables 4 and 5), making amaranth a superfood because it also counts with elevated levels of vitamin E, vitamin B2 (riboflavin), and vitamin C (ascorbic acid). It is also important to mention that saponins are found in very low levels (0.1%) in amaranth grain which makes it completely safe for human consumption [19].
Among other relevant facts that convert amaranth into a superfood is that it is considered as a good source of insoluble fiber with a content of 4.2% [17]. Both insoluble and soluble fibers have known health benefits such as reducing cholesterol and promoting gut health. Amaranth flours have been shown to have antioxidant activity due to flavonoids (polyphenols from secondary metabolites) found in the seed. Three flavonoids have been identified, rutin, isoquercitrin, and nicotiflorin, and several health benefits are known to be caused by these compounds [8] (see Table 5).
Mexican consumers are looking for natural products that improve their health. However, our modern society tends to consume processed foods. These foods typically contain increased amounts of salt, sugar, fat, additives, or preservatives in order to improve their taste and texture or to extend shelf life—all of which are known as harmful. In my research group, we have special interest in using plants that were used in our ancient civilizations. This is the case of
The protein contained in amaranth is of an unusually high quality due to its outstanding balance and high content of essential amino acids (Table 3). The essential amino acids in amaranth grain are ideal according to the World Health Organization (WHO) and Food and Agriculture Organization of the United Nations (FAO). For instance, the amount of lysine and tryptophan present in amaranth grain are relatively higher than those found in wheat, rice, and maize grains, but it is deficient in leucine.
Protein is used in every single cell in our bodies and is critical for building muscle mass, supporting neurological function, aiding in digestion, helping to balance hormones naturally, and keeping an upbeat mood which suggests that this protein is useful for muscle recovery and the immune system for athletic performance [20, 21].
It is well documented that inflammation is a normal immune response designed to protect the body against injury and infection. If the inflammation process continues in your body, this could contribute and be associated with chronic diseases, such as cancer, diabetes, and autoimmune disorders.
The intake of amaranth could help to avoid diseases caused by inflammation because it has been described that extruded amaranth protein hydrolysates prevented inflammation by the activation of bioactive peptides that reduced the expression of several pro-inflammatory markers [22]. That is the reason why consumption of amaranth grain could help to reduce inflammation [23]. In this context, it is recommended to include amaranth grain in the diet in order to reduce inflammation and may help to prevent chronic diseases derived from inflammation process.
Calcium is a key player in the generation and maintenance of healthy bones as it supports mineralization [24]. Amaranth contains more calcium than other seeds, which makes it a valuable food that helps to have a healthy development of bones helping to prevent osteoporosis [25, 26]. Therefore, the intake of extruded amaranth products could help to improve the proper intake of calcium to support healthier bones [27].
It has been proven that amaranth’s oil can reduce total and bad cholesterol (LDL) increasing good cholesterol as tested in animal models by Berger et al. [28]. Also it has been proven that amaranth affected absorption of cholesterol and bile acids, cholesterol lipoprotein distribution, hepatic cholesterol content, and cholesterol biosynthesis [29].
It is well known that various plant-originated “gastroprotectors” with different compositions have been used in clinical and folk medicine due to their beneficial effects on the mucosa of gastrointestinal tract. Ethanolic and ethyl-acetate leaf extracts of
It has been found that duodenal peptic ulcer and chronic gastritis caused by
Diabetes is a metabolic disorder where the body does not produce insulin or does not use it efficiently during the body’s ability to process blood glucose.Consequently, it can lead to dangerous complications, including stroke, heart disease, kidney failure, and diabetic retinopathy, among other problems, it has been reported that amaranth grain and oil have an antioxidative effect on streptozotocin-induced diabetic rats [33]; grains and oils used as supplements may be beneficial for correcting hyperglycemia as part of an antioxidant therapy.
Manganese, besides regulating blood glucose, can boost the immune function [34]. Also it is known that manganese is needed in adequate levels to avoid abnormalities in cholesterol levels, skin and bone health [35], and renal health [36]. Another relevant benefit obtained when amaranth is included in diet is that due to its high amount of manganese, it represents a good option for regulating sugar levels. In the organism as manganese helps during gluconeogenesis, in this way, when manganese is obtained in a sufficient amount by consuming amaranth, it is possible to protect against diet-induced diabetes [37].
It has been shown that the influence of dietary therapy which uses sunflower and amaranth oils on parameters of immune reactivity in patients with diabetes mellitus type 2 [38] and the activation of aerobic metabolism by amaranth oil improve heart rate variability both in athletes and patients with diabetes [39].
Celiac disease is a serious disorder in which eating gluten, a protein found in wheat, barley, and rye, triggers an immune response in the body, causing inflammation and damaging the lining of the small intestine. The damage of the small intestine’s lining causes a poor absorption of some nutrients, diarrhea, fatigue, weight loss, poor memory, joint paint, bloating, and anemia, among other symptoms.
Recently amaranth grain has gained more relevance because it is a gluten-free pseudocereal being an alternative option when cereals, such as wheat, barley, and rye, which do contain gluten, cannot be consumed because they cause food allergies. Amaranth is also an excellent protein choice for a healthier life and better performance for athletes, vegans, vegetarians, and those persons that had acquired allergies or have celiac disease.
Amaranth is an excellent protein source for persons that are non-celiac gluten sensitivity (NCGS) who later on acquire gluten intolerance and also for those that born with celiac disease [40, 41, 42].
Folic acid is the synthesized stable oxidized form of an essential water-soluble B9-complex vitamin that occurs naturally as various folates, usually in reduced form. Folic acid is very important for the development of a healthy fetus. Folic acid can be taken as a supplement tablet and food fortification, while folates are found naturally in foods. Folates play an important role in single-carbon transfer reactions, in several metabolic pathways including the synthesis of purines and pyrimidines, and, hence, in the formation of DNA and RNA. These actions have complex relations with other essential vitamins, especially vitamin B12 [43]. Prior to 1996, the principal food sources for folates were dark green leafy vegetables, organ meats, eggs, and citrus fruits. A severe deficiency of folate manifests as an anemia characterized by many large immature and dysfunctional red blood cells (megaloblasts).
For pregnant women, a folate deficiency can lead to neural tube defects such as spina bifida. A deficiency can also cause defects such as heart and limb malformations. The folate in amaranth helps the body make new cells, specifically by playing a role in copying and synthesizing DNA. There is 88.0 mcg of folate in amaranth grain (see Table 2). Fortification of foods with folate by the FDA has decreased the risk for neural tube defects by 26% [44].
Amaranth is an excellent source of high soluble fiber. The daily recommended dietary fiber intake for men and women are 38 and 25 g, respectively. Dietary fiber may help prevent constipation, making one’s bowel movement easier to manage. Constipation clearly means the gut is overburdened, so it helps to combine amaranth grain with dark leafy greens, specially spinach; most nuts; seeds, specially pumpkin and sunflower seeds; fish; beans; whole grains; avocados; yogurt; bananas; dried fruit; eggplant; and unsweetened cocoa.
Amaranth starch binds water and thus helps to prevent constipation. The large content of fiber in amaranth grain is of great advantage [45]. Fiber is an important part of human nutrition. In developed industrial countries, i.e., to the Czech Republic, there is lack of dietary fiber in food, and the content of fiber corresponds to the figures recommended by the World Health Organization (WHO) [46].
Antioxidants are substances that reduce the effect of free radicals. These compounds inhibit oxidation; they help your heart health and may lower your risk of infections and some forms of cancer and degenerative disorders. Antioxidant potential has been attributed to the presence of appreciable levels of phenolics and flavonoids. Leaves and flowers of
An antimicrobial is a natural or synthetic agent that kills microorganisms or slows the spread of microorganisms such as bacteria, fungi, and algae.
A study carried out by Zeashan et al. [51] showed the hepatoprotective and antioxidant activity of 50% ethanolic extract of a whole plant of
According to the Cancer Research Institute, cancer is the name given to a collection of related diseases. In all types of cancer, some of the body’s cells begin to divide without stopping and spread into surrounding tissues. Cancer can start almost anywhere in the human body, which is made up of trillions of cells. Normally, human cells grow and divide to form new cells as the body needs them. It happens that when cells grow old or become damaged, they die, and new cells take their place. When cancer develops, however, this orderly process breaks down. As cells become more and more abnormal, old or damaged cells survive when they should die, and new cells form when they are not needed. These extra cells can divide without stopping and may form growths called tumors.
In vitro assay of antiproliferative potential of
Recently, Peters and Gandhi reported more experimental evidence regarding the antitumor potential of various amaranth leaf extracts using different solvent with significant antitumor potential. These authors stated that leaf extract should further be explored as a novel source of cancer therapy [47].
Malaria is an infectious disease caused by protozoan parasites from the
Extracts obtained from two Burkinabe folk medicine plants, both spiny amaranth (
A combination of two plant extracts of
Anemia is defined as a low level of hemoglobin in red blood cells. The major clinical symptom of anemia and iron deficiency shows a pale color of the skin, and its physical symptom is fatigue. According to the UNICEF, anemia has an impact on the intellectual development of children; it reduces learning ability and growth and damages the immune system.
Mexico is an underdeveloped country with malnutrition conditions. In our country, anemia is a public health problem generalized in all social socioeconomic status.
Iron deficiency anemia is a major public health problem in young children in developing countries and is associated with impaired cognitive development and morbidity. Our research group had been developing a nutraceutical formulation in a powder form that treats the prevalence of anemia in Mexican children, adolescents, and in general all adults in México. The nutraceutical formulation is called “Naturalmente Alegría” (Naturally Joy) (Figure 3), and it has been approved by the Federal Committee for Protection from Sanitary Risks in Mexico (COFEPRIS). The product has been consumed by several thousands of Mexicans with anemia to date.
Naturalmente Alegría (Naturally Joy), a nutraceutical product from
Extracts of all plant parts of
Since pre-Hispanic time, every part of the
The importance of amaranth as a functional food has resurged in the last years.
The Amaranthaceae family consists of 60 genera and about 800 species. Sixty of these species are cosmopolitan and grow particularly in areas of human activities where they are regarded as weeds. Of these 60 species, only 3 are considered good seed producers:
The amaranth composition includes carbohydrates, dietary fiber, lipids and proteins, and other important constituents, such as squalene, tocopherols, phenolic compounds, flavonoids, phytates, vitamins, and minerals. This comprehensive chapter is focused on amaranth composition and antioxidant properties and provides several potential medical benefits of its valuable components. Thus, amaranth and their products should be considered as a future crop with nutritional and medical purposes in many countries.
Existing evidence suggests that nutrition, especially staple-based foods such as amaranth, when part of a balanced pattern, contributes with important protein, polyunsaturated fatty acids, minerals (calcium, zinc, iron, magnesium, and manganese, among other minerals), appropriate dietary fiber, vitamins, and antioxidants that can help mitigate or reduce the risk of several diseases.
This chapter is based on scientific knowledge and personal experience working with amaranth plant. I would like to apologize to anyone who finds my description of his or her work inadequate or whose work I have accidentally omitted on this chapter.
It is obvious that amaranth seed surpasses traditional cereals in a number of nutritional and therapeutical values. Amaranth is considered as a millennium superfood with high nutraceutical values as it is used for several clinical/medical applications because it is a reasonably well-balanced food with functional properties that have been shown to provide clinical/medicinal benefits. Thanks to its properties, amaranth gives us a wide range of possibilities for using it in human nutrition, including active health support. Also it can be applied when we need more easily digestible quality proteins, e.g., in children, sportsmen, and the elderly. Further studies using more sophisticated and appropriate in vivo model systems are needed to draw solid conclusions on the subject of a nutritional functional value and therapeutic utilization of amaranth.
Authors declare that there is no conflict of interest.
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Applying FMEA in clinical approaches can lead to a significant reduction of the risk priority number (RPN).",book:{id:"9808",slug:"contemporary-topics-in-patient-safety-volume-1",title:"Contemporary Topics in Patient Safety",fullTitle:"Contemporary Topics in Patient Safety - Volume 1"},signatures:"Hoda Sabati, Amin Mohsenzadeh and Nooshin Khelghati",authors:[{id:"340486",title:"M.Sc.",name:"Hoda",middleName:null,surname:"Sabati",slug:"hoda-sabati",fullName:"Hoda Sabati"},{id:"348872",title:"M.Sc.",name:"Amin",middleName:null,surname:"Mohsenzadeh",slug:"amin-mohsenzadeh",fullName:"Amin Mohsenzadeh"},{id:"348874",title:"MSc.",name:"Nooshin",middleName:null,surname:"Khelghati",slug:"nooshin-khelghati",fullName:"Nooshin Khelghati"}]},{id:"65467",title:"Anesthesia Management for Large-Volume Liposuction",slug:"anesthesia-management-for-large-volume-liposuction",totalDownloads:6231,totalCrossrefCites:1,totalDimensionsCites:2,abstract:"The apparent easiness with which liposuction is performed favors that patients, young surgeons, and anesthesiologists without experience in this field ignore the many events that occur during this procedure. Liposuction is a procedure to improve the body contour and not a surgery to reduce weight, although recently people who have failed in their plans to lose weight look at liposuction as a means to contour their body figure. Tumescent liposuction of large volumes requires a meticulous selection of each patient; their preoperative evaluation and perioperative management are essential to obtain the expected results. The various techniques of general anesthesia are the most recommended and should be monitored in the usual way, as well as monitoring the total doses of infiltrated local anesthetics to avoid systemic toxicity. The management of intravenous fluids is controversial, but the current trend is the restricted use of hydrosaline solutions. The most feared complications are deep vein thrombosis, pulmonary thromboembolism, fat embolism, lung edema, hypothermia, infections and even death. The adherence to the management guidelines and prophylaxis of venous thrombosis/thromboembolism is mandatory.",book:{id:"6221",slug:"anesthesia-topics-for-plastic-and-reconstructive-surgery",title:"Anesthesia Topics for Plastic and Reconstructive Surgery",fullTitle:"Anesthesia Topics for Plastic and Reconstructive Surgery"},signatures:"Sergio Granados-Tinajero, Carlos Buenrostro-Vásquez, Cecilia\nCárdenas-Maytorena and Marcela Contreras-López",authors:[{id:"273532",title:"Dr.",name:"Sergio Octavio",middleName:null,surname:"Granados Tinajero",slug:"sergio-octavio-granados-tinajero",fullName:"Sergio Octavio Granados Tinajero"}]},{id:"30178",title:"Chest Mobilization Techniques for Improving Ventilation and Gas Exchange in Chronic Lung Disease",slug:"chest-mobilization-techniques-for-improving-ventilation-and-gas-exchange-in-chronic-lung-disease",totalDownloads:31230,totalCrossrefCites:1,totalDimensionsCites:6,abstract:null,book:{id:"648",slug:"chronic-obstructive-pulmonary-disease-current-concepts-and-practice",title:"Chronic Obstructive Pulmonary Disease",fullTitle:"Chronic Obstructive Pulmonary Disease - Current Concepts and Practice"},signatures:"Donrawee Leelarungrayub",authors:[{id:"73709",title:"Associate Prof.",name:"Jirakrit",middleName:null,surname:"Leelarungrayub",slug:"jirakrit-leelarungrayub",fullName:"Jirakrit Leelarungrayub"}]},{id:"46082",title:"Fecal Incontinence",slug:"fecal-incontinence",totalDownloads:3900,totalCrossrefCites:0,totalDimensionsCites:0,abstract:null,book:{id:"3835",slug:"fecal-incontinence-causes-management-and-outcome",title:"Fecal Incontinence",fullTitle:"Fecal Incontinence - Causes, Management and Outcome"},signatures:"Arzu Ilce",authors:[{id:"30672",title:"Dr.",name:"Arzu",middleName:null,surname:"Ilce",slug:"arzu-ilce",fullName:"Arzu Ilce"}]}],onlineFirstChaptersFilter:{topicId:"16",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"83136",title:"Vector Control: Insights Arising from the Post-Genomics Findings on Insects’ Reproductive Biology",slug:"vector-control-insights-arising-from-the-post-genomics-findings-on-insects-reproductive-biology",totalDownloads:1,totalDimensionsCites:0,doi:"10.5772/intechopen.106273",abstract:"The high prevalence of neglected vector-borne diseases, such as Chagas disease and dengue fever, imposes enormous health and financial burdens in developing countries. Historically, and still, to this day, the main effective methods to manage those diseases rely on vector population control. Although early efforts in understanding vector-specific biology resulted in important advancements in the development of strategies for the management of vector-borne diseases, studies regarding the complex physiology of local vector species were weakened by the expanding use of insecticide-based tools, which were, at the time, proven simpler and effective. The rising threat of insecticide resistance and climate change (which can expand endemic areas) has reemphasized the need to rely on thorough species-specific vector biology. One approach to controlling vector populations is to disrupt molecular processes or antagonize the metabolic targets required to produce viable eggs. Here, we discuss new findings arising from post-genomics molecular studies on vector reproductive biology and discuss their potential for the elaboration of new effective vector control interventions.",book:{id:"11227",title:"New Advances in Neglected Tropical Diseases",coverURL:"https://cdn.intechopen.com/books/images_new/11227.jpg"},signatures:"Isabela Ramos and Fabio Gomes"},{id:"82798",title:"Biomarkers in Multiple Sclerosis",slug:"biomarkers-in-multiple-sclerosis",totalDownloads:1,totalDimensionsCites:null,doi:"10.5772/intechopen.106052",abstract:"Clinical, biological, and radiological evidence are currently needed to diagnose MS, but lack of preclinical biomarkers hinders the earliest possible diagnosis and treatment. Conventional biomarkers target immunity, blood-brain barrier disruption, demyelination, and neuronal and axonal damage, as well as mitochondrial activity. An increase of specific brain metabolites with 30–40% is registered before detection of MRI lesions in MS. Potential lipid biomarkers are fatty acids, phospholipids, and oxysterols. The role of proteoforms in the pathogenesis of MS was confirmed. Serum neurofilament light chains (sNfL) are currently being studied as a readily available biomarker for prognosis and response to treatment in MS. The sNfL levels reflect ongoing neuroaxonal damage caused by inflammation, and the sNfL levels predict disease activity over the next few years. The retinal nerve fiber layer (RNFL) thinning is reliable as a biomarker of disability worsening. The neutrophil-to-lymphocyte ratio and CRP are also MS biomarkers. The development of rationally targeted therapeutic agents that allow preventive treatment to stop the disease is also delayed without definite biomarkers.",book:{id:"11312",title:"Multiple Sclerosis - Genetics, Disease Mechanisms and Clinical Developments",coverURL:"https://cdn.intechopen.com/books/images_new/11312.jpg"},signatures:"Valentina Ignatova"},{id:"83129",title:"Airborne Transmission and Control of Influenza and Other Respiratory Pathogens",slug:"airborne-transmission-and-control-of-influenza-and-other-respiratory-pathogens",totalDownloads:1,totalDimensionsCites:null,doi:"10.5772/intechopen.106446",abstract:"Despite uncertainty about the specific transmission risk posed by airborne, spray-borne, and contact modes for influenza, SARS-CoV-2, and other respiratory viruses, there is evidence that airborne transmission via inhalation is important and often predominates. An early study of influenza transmission via airborne challenge quantified infectious doses as low as one influenza virion leading to illness characterized by cough and sore throat. Other studies that challenged via intranasal mucosal exposure observed high doses required for similarly symptomatic respiratory illnesses. Analysis of the Evaluating Modes of Influenza Transmission (EMIT) influenza human-challenge transmission trial—of 52 H3N2 inoculated viral donors and 75 sero-susceptible exposed individuals—quantifies airborne transmission and provides context and insight into methodology related to airborne transmission. Advances in aerosol sampling and epidemiologic studies examining the role of masking, and engineering-based air hygiene strategies provide a foundation for understanding risk and directions for new work.",book:{id:"11570",title:"Influenza - New Approaches",coverURL:"https://cdn.intechopen.com/books/images_new/11570.jpg"},signatures:"Jacob Bueno de Mesquita"},{id:"82831",title:"Survival Fate of Hepatic Stem/Progenitor and Immune Cells in a Liver Fibrosis/Cirrhosis Animal Model and Clinical Implications",slug:"survival-fate-of-hepatic-stem-progenitor-and-immune-cells-in-a-liver-fibrosis-cirrhosis-animal-model",totalDownloads:1,totalDimensionsCites:null,doi:"10.5772/intechopen.106220",abstract:"This chapter provides novel information about the survival features of hepatic resident stem/progenitor cells (NG2+ HSPs) during liver fibrosis/cirrhotic development. A well-defined diethylnitrosamine (DEN)-induced liver fibrosis/cirrhotic/cancer mouse model was developed to evaluate the fate of the HSPs and its clinical implications. This model possess three time-zones during the disease development: fibrosis (3–5 weeks post-DEN), cirrhosis (6–10 weeks post-DEN), and cancers (up to 10 weeks post-DEN). During this process, the model represents histological patterns similar to those described in humans and shows better survival of the HSPs in the fibrotic zone, which was correlated with inflammatory signals, as compared to the cirrhotic zone. It has also been discovered that immune CD8+ T cells in the fibrotic zone are beneficial in liver fibrosis resolution, suggesting that the fibrotic time zone is important for mobilizing endogenous HSPs and cell-based therapy. As such, we hypothesize that clinical strategies in fibrotic/cirrhotic liver treatment are necessary either in time at the fibrotic phase or to adopt an approach of regulating HSP viability when the disease develops into the cirrhotic phase.",book:{id:"11711",title:"Animal Models and Experimental Research in Medicine",coverURL:"https://cdn.intechopen.com/books/images_new/11711.jpg"},signatures:"Min Yan, Deyu Hu, Zhenyu Wu, Jiejuan Lai, Leida Zhang, Hongyu Zhang, Sijin Li and Lianhua Bai"},{id:"83119",title:"Exploration of Multi-Aspect Development of Chronic Obstructive Pulmonary Disease Pathogenesis, Diagnosis, and Treatment Management",slug:"exploration-of-multi-aspect-development-of-chronic-obstructive-pulmonary-disease-pathogenesis-diagno",totalDownloads:3,totalDimensionsCites:null,doi:"10.5772/intechopen.106643",abstract:"Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable chronic respiratory disease, which is characterized by persistent airflow limitation and respiratory symptoms. Pathological changes are mainly airway and/or alveolar structural abnormalities. Numerous factors, such as exposure to harmful particles or gases, genetic susceptibility, abnormal inflammatory responses, and abnormal lung development, are involved in the pathogenesis of COPD, those which determine the heterogeneity of COPD. Individuals show different pathophysiological changes, different disease evolution rules, and different clinical manifestations due to different etiologies, different susceptibility genes, and different chronic processes of “injury-inflammation-repair.” Therefore, disease managers need to conduct a multifaceted assessment of the whole body and the local area from the individual characteristics of COPD. With the sustained advancement of new technologies, from multiple perspectives, including genomics, exposomes, transcriptomics, mechanisms related to inflammation and immune regulation, microbiota, metabolomics, imaging features and radiomics, and the interaction of lungs and systemic organs to further explore the law of the occurrence and development of COPD, and finally, form an optimized prevention and treatment strategy. On the basis of thorough exploration, a COPD evaluation system that can meet clinical needs will be finally formed, so as to formulate scientific and effective individualized management strategies.",book:{id:"11827",title:"Chronic Obstructive Pulmonary Disease - A Compendium of Medicine and the Humanities",coverURL:"https://cdn.intechopen.com/books/images_new/11827.jpg"},signatures:"Lei Zhang, Xiang He, Jiliu Liu, Yi Zhang, Xiaohui Zuo and Guoping Li"},{id:"82864",title:"Complications after Total Knee Arthroplasty: Stiffness, Periprosthetic Joint Infection, and Periprosthetic Fracture",slug:"complications-after-total-knee-arthroplasty-stiffness-periprosthetic-joint-infection-and-periprosthe",totalDownloads:1,totalDimensionsCites:null,doi:"10.5772/intechopen.105745",abstract:"Total knee arthroplasty (TKA) is one of the most successful surgical procedures with effective treatment in patients suffering from end-stage knee osteoarthritis. The goal of the operation is to improve pain, correct the deformity, and increase function. However, complications after surgery are the important factors related to dissatisfied TKA. Stiffness, periprosthetic joint infection (PJI), and periprosthetic fracture are among the most common complications following TKA and usually raise issues as concern points for both patients and the surgeons. Each complication needs precise assessment and specific care to prevent further serious issues. In this chapter, the authors will focus and describe all of these three frequent complications in details from their definition to management.",book:{id:"11873",title:"Arthroplasty - Advanced Techniques and Future Perspectives",coverURL:"https://cdn.intechopen.com/books/images_new/11873.jpg"},signatures:"Atthakorn Jarusriwanna and Chaturong Pornrattanamaneewong"}],onlineFirstChaptersTotal:696},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:11,numberOfPublishedChapters:91,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:108,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:333,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:11,numberOfPublishedChapters:144,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:125,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:113,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:23,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:12,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}},{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}}]},series:{item:{id:"11",title:"Biochemistry",doi:"10.5772/intechopen.72877",issn:"2632-0983",scope:"Biochemistry, the study of chemical transformations occurring within living organisms, impacts all areas of life sciences, from molecular crystallography and genetics to ecology, medicine, and population biology. Biochemistry examines macromolecules - proteins, nucleic acids, carbohydrates, and lipids – and their building blocks, structures, functions, and interactions. Much of biochemistry is devoted to enzymes, proteins that catalyze chemical reactions, enzyme structures, mechanisms of action and their roles within cells. Biochemistry also studies small signaling molecules, coenzymes, inhibitors, vitamins, and hormones, which play roles in life processes. Biochemical experimentation, besides coopting classical chemistry methods, e.g., chromatography, adopted new techniques, e.g., X-ray diffraction, electron microscopy, NMR, radioisotopes, and developed sophisticated microbial genetic tools, e.g., auxotroph mutants and their revertants, fermentation, etc. More recently, biochemistry embraced the ‘big data’ omics systems. Initial biochemical studies have been exclusively analytic: dissecting, purifying, and examining individual components of a biological system; in the apt words of Efraim Racker (1913 –1991), “Don’t waste clean thinking on dirty enzymes.” Today, however, biochemistry is becoming more agglomerative and comprehensive, setting out to integrate and describe entirely particular biological systems. The ‘big data’ metabolomics can define the complement of small molecules, e.g., in a soil or biofilm sample; proteomics can distinguish all the comprising proteins, e.g., serum; metagenomics can identify all the genes in a complex environment, e.g., the bovine rumen. This Biochemistry Series will address the current research on biomolecules and the emerging trends with great promise.",coverUrl:"https://cdn.intechopen.com/series/covers/11.jpg",latestPublicationDate:"August 17th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:33,editor:{id:"31610",title:"Dr.",name:"Miroslav",middleName:null,surname:"Blumenberg",slug:"miroslav-blumenberg",fullName:"Miroslav Blumenberg",profilePictureURL:"https://mts.intechopen.com/storage/users/31610/images/system/31610.jpg",biography:"Miroslav Blumenberg, Ph.D., was born in Subotica and received his BSc in Belgrade, Yugoslavia. He completed his Ph.D. at MIT in Organic Chemistry; he followed up his Ph.D. with two postdoctoral study periods at Stanford University. Since 1983, he has been a faculty member of the RO Perelman Department of Dermatology, NYU School of Medicine, where he is codirector of a training grant in cutaneous biology. Dr. Blumenberg’s research is focused on the epidermis, expression of keratin genes, transcription profiling, keratinocyte differentiation, inflammatory diseases and cancers, and most recently the effects of the microbiome on the skin. He has published more than 100 peer-reviewed research articles and graduated numerous Ph.D. and postdoctoral students.",institutionString:null,institution:{name:"New York University Langone Medical Center",institutionURL:null,country:{name:"United States of America"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:6,paginationItems:[{id:"22",title:"Applied Intelligence",coverUrl:"https://cdn.intechopen.com/series_topics/covers/22.jpg",isOpenForSubmission:!0,editor:{id:"27170",title:"Prof.",name:"Carlos",middleName:"M.",surname:"Travieso-Gonzalez",slug:"carlos-travieso-gonzalez",fullName:"Carlos Travieso-Gonzalez",profilePictureURL:"https://mts.intechopen.com/storage/users/27170/images/system/27170.jpeg",biography:"Carlos M. Travieso-González received his MSc degree in Telecommunication Engineering at Polytechnic University of Catalonia (UPC), Spain in 1997, and his Ph.D. degree in 2002 at the University of Las Palmas de Gran Canaria (ULPGC-Spain). He is a full professor of signal processing and pattern recognition and is head of the Signals and Communications Department at ULPGC, teaching from 2001 on subjects on signal processing and learning theory. His research lines are biometrics, biomedical signals and images, data mining, classification system, signal and image processing, machine learning, and environmental intelligence. He has researched in 52 international and Spanish research projects, some of them as head researcher. He is co-author of 4 books, co-editor of 27 proceedings books, guest editor for 8 JCR-ISI international journals, and up to 24 book chapters. He has over 450 papers published in international journals and conferences (81 of them indexed on JCR – ISI - Web of Science). He has published seven patents in the Spanish Patent and Trademark Office. He has been a supervisor on 8 Ph.D. theses (11 more are under supervision), and 130 master theses. He is the founder of The IEEE IWOBI conference series and the president of its Steering Committee, as well as the founder of both the InnoEducaTIC and APPIS conference series. He is an evaluator of project proposals for the European Union (H2020), Medical Research Council (MRC, UK), Spanish Government (ANECA, Spain), Research National Agency (ANR, France), DAAD (Germany), Argentinian Government, and the Colombian Institutions. He has been a reviewer in different indexed international journals (<70) and conferences (<250) since 2001. He has been a member of the IASTED Technical Committee on Image Processing from 2007 and a member of the IASTED Technical Committee on Artificial Intelligence and Expert Systems from 2011. \n\nHe has held the general chair position for the following: ACM-APPIS (2020, 2021), IEEE-IWOBI (2019, 2020 and 2020), A PPIS (2018, 2019), IEEE-IWOBI (2014, 2015, 2017, 2018), InnoEducaTIC (2014, 2017), IEEE-INES (2013), NoLISP (2011), JRBP (2012), and IEEE-ICCST (2005)\n\nHe is an associate editor of the Computational Intelligence and Neuroscience Journal (Hindawi – Q2 JCR-ISI). He was vice dean from 2004 to 2010 in the Higher Technical School of Telecommunication Engineers at ULPGC and the vice dean of Graduate and Postgraduate Studies from March 2013 to November 2017. He won the “Catedra Telefonica” Awards in Modality of Knowledge Transfer, 2017, 2018, and 2019 editions, and awards in Modality of COVID Research in 2020.\n\nPublic References:\nResearcher ID http://www.researcherid.com/rid/N-5967-2014\nORCID https://orcid.org/0000-0002-4621-2768 \nScopus Author ID https://www.scopus.com/authid/detail.uri?authorId=6602376272\nScholar Google https://scholar.google.es/citations?user=G1ks9nIAAAAJ&hl=en \nResearchGate https://www.researchgate.net/profile/Carlos_Travieso",institutionString:null,institution:{name:"University of Las Palmas de Gran Canaria",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"23",title:"Computational Neuroscience",coverUrl:"https://cdn.intechopen.com/series_topics/covers/23.jpg",isOpenForSubmission:!0,editor:{id:"14004",title:"Dr.",name:"Magnus",middleName:null,surname:"Johnsson",slug:"magnus-johnsson",fullName:"Magnus Johnsson",profilePictureURL:"https://mts.intechopen.com/storage/users/14004/images/system/14004.png",biography:"Dr Magnus Johnsson is a cross-disciplinary scientist, lecturer, scientific editor and AI/machine learning consultant from Sweden. \n\nHe is currently at Malmö University in Sweden, but also held positions at Lund University in Sweden and at Moscow Engineering Physics Institute. \nHe holds editorial positions at several international scientific journals and has served as a scientific editor for books and special journal issues. \nHis research interests are wide and include, but are not limited to, autonomous systems, computer modeling, artificial neural networks, artificial intelligence, cognitive neuroscience, cognitive robotics, cognitive architectures, cognitive aids and the philosophy of mind. \n\nDr. Johnsson has experience from working in the industry and he has a keen interest in the application of neural networks and artificial intelligence to fields like industry, finance, and medicine. \n\nWeb page: www.magnusjohnsson.se",institutionString:null,institution:{name:"Malmö University",institutionURL:null,country:{name:"Sweden"}}},editorTwo:null,editorThree:null},{id:"24",title:"Computer Vision",coverUrl:"https://cdn.intechopen.com/series_topics/covers/24.jpg",isOpenForSubmission:!0,editor:{id:"294154",title:"Prof.",name:"George",middleName:null,surname:"Papakostas",slug:"george-papakostas",fullName:"George Papakostas",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002hYaGbQAK/Profile_Picture_1624519712088",biography:"George A. Papakostas has received a diploma in Electrical and Computer Engineering in 1999 and the M.Sc. and Ph.D. degrees in Electrical and Computer Engineering in 2002 and 2007, respectively, from the Democritus University of Thrace (DUTH), Greece. Dr. Papakostas serves as a Tenured Full Professor at the Department of Computer Science, International Hellenic University, Greece. Dr. Papakostas has 10 years of experience in large-scale systems design as a senior software engineer and technical manager, and 20 years of research experience in the field of Artificial Intelligence. Currently, he is the Head of the “Visual Computing” division of HUman-MAchines INteraction Laboratory (HUMAIN-Lab) and the Director of the MPhil program “Advanced Technologies in Informatics and Computers” hosted by the Department of Computer Science, International Hellenic University. He has (co)authored more than 150 publications in indexed journals, international conferences and book chapters, 1 book (in Greek), 3 edited books, and 5 journal special issues. His publications have more than 2100 citations with h-index 27 (GoogleScholar). His research interests include computer/machine vision, machine learning, pattern recognition, computational intelligence. \nDr. Papakostas served as a reviewer in numerous journals, as a program\ncommittee member in international conferences and he is a member of the IAENG, MIR Labs, EUCogIII, INSTICC and the Technical Chamber of Greece (TEE).",institutionString:null,institution:{name:"International Hellenic University",institutionURL:null,country:{name:"Greece"}}},editorTwo:null,editorThree:null},{id:"25",title:"Evolutionary Computation",coverUrl:"https://cdn.intechopen.com/series_topics/covers/25.jpg",isOpenForSubmission:!0,editor:{id:"136112",title:"Dr.",name:"Sebastian",middleName:null,surname:"Ventura Soto",slug:"sebastian-ventura-soto",fullName:"Sebastian Ventura Soto",profilePictureURL:"https://mts.intechopen.com/storage/users/136112/images/system/136112.png",biography:"Sebastian Ventura is a Spanish researcher, a full professor with the Department of Computer Science and Numerical Analysis, University of Córdoba. Dr Ventura also holds the positions of Affiliated Professor at Virginia Commonwealth University (Richmond, USA) and Distinguished Adjunct Professor at King Abdulaziz University (Jeddah, Saudi Arabia). Additionally, he is deputy director of the Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI) and heads the Knowledge Discovery and Intelligent Systems Research Laboratory. He has published more than ten books and over 300 articles in journals and scientific conferences. Currently, his work has received over 18,000 citations according to Google Scholar, including more than 2200 citations in 2020. In the last five years, he has published more than 60 papers in international journals indexed in the JCR (around 70% of them belonging to first quartile journals) and he has edited some Springer books “Supervised Descriptive Pattern Mining” (2018), “Multiple Instance Learning - Foundations and Algorithms” (2016), and “Pattern Mining with Evolutionary Algorithms” (2016). He has also been involved in more than 20 research projects supported by the Spanish and Andalusian governments and the European Union. He currently belongs to the editorial board of PeerJ Computer Science, Information Fusion and Engineering Applications of Artificial Intelligence journals, being also associate editor of Applied Computational Intelligence and Soft Computing and IEEE Transactions on Cybernetics. Finally, he is editor-in-chief of Progress in Artificial Intelligence. He is a Senior Member of the IEEE Computer, the IEEE Computational Intelligence, and the IEEE Systems, Man, and Cybernetics Societies, and the Association of Computing Machinery (ACM). Finally, his main research interests include data science, computational intelligence, and their applications.",institutionString:null,institution:{name:"University of Córdoba",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"26",title:"Machine Learning and Data Mining",coverUrl:"https://cdn.intechopen.com/series_topics/covers/26.jpg",isOpenForSubmission:!0,editor:{id:"24555",title:"Dr.",name:"Marco Antonio",middleName:null,surname:"Aceves Fernandez",slug:"marco-antonio-aceves-fernandez",fullName:"Marco Antonio Aceves Fernandez",profilePictureURL:"https://mts.intechopen.com/storage/users/24555/images/system/24555.jpg",biography:"Dr. Marco Antonio Aceves Fernandez obtained his B.Sc. (Eng.) in Telematics from the Universidad de Colima, Mexico. He obtained both his M.Sc. and Ph.D. from the University of Liverpool, England, in the field of Intelligent Systems. He is a full professor at the Universidad Autonoma de Queretaro, Mexico, and a member of the National System of Researchers (SNI) since 2009. Dr. Aceves Fernandez has published more than 80 research papers as well as a number of book chapters and congress papers. He has contributed in more than 20 funded research projects, both academic and industrial, in the area of artificial intelligence, ranging from environmental, biomedical, automotive, aviation, consumer, and robotics to other applications. He is also a honorary president at the National Association of Embedded Systems (AMESE), a senior member of the IEEE, and a board member of many institutions. 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His research focuses on biochemistry, biophysics, genetics, molecular biology, and molecular medicine with specialization in the fields of drug design, protein structure-function, protein folding, prions, microRNA, pseudogenes, molecular cancer, epigenetics, metabolites, proteomics, genomics, protein expression, and characterization by spectroscopic and calorimetric methods.",institutionString:"University of Health Sciences",institution:null},{id:"180528",title:"Dr.",name:"Hiroyuki",middleName:null,surname:"Kagechika",slug:"hiroyuki-kagechika",fullName:"Hiroyuki Kagechika",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180528/images/system/180528.jpg",biography:"Hiroyuki Kagechika received his bachelor’s degree and Ph.D. in Pharmaceutical Sciences from the University of Tokyo, Japan, where he served as an associate professor until 2004. 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Prof. Emeje was a national chairman of academic pharmacists in Nigeria and the 2021 winner of the May & Baker Nigeria Plc–sponsored prize for professional service in research and innovation.",institutionString:"National Institute for Pharmaceutical Research and Development",institution:{name:"National Institute for Pharmaceutical Research and Development",country:{name:"Nigeria"}}},{id:"436430",title:"Associate Prof.",name:"Mesut",middleName:null,surname:"Işık",slug:"mesut-isik",fullName:"Mesut Işık",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/436430/images/19686_n.jpg",biography:null,institutionString:null,institution:{name:"Bilecik University",country:{name:"Turkey"}}},{id:"268659",title:"Ms.",name:"Xianquan",middleName:null,surname:"Zhan",slug:"xianquan-zhan",fullName:"Xianquan Zhan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/268659/images/8143_n.jpg",biography:"Dr. Zhan received his undergraduate and graduate training in the fields of preventive medicine and epidemiology and statistics at the West China University of Medical Sciences in China during 1989 to 1999. He received his post-doctoral training in oncology and cancer proteomics for two years at the Cancer Research Institute of Human Medical University in China. In 2001, he went to the University of Tennessee Health Science Center (UTHSC) in USA, where he was a post-doctoral researcher and focused on mass spectrometry and cancer proteomics. Then, he was appointed as an Assistant Professor of Neurology, UTHSC in 2005. He moved to the Cleveland Clinic in USA as a Project Scientist/Staff in 2006 where he focused on the studies of eye disease proteomics and biomarkers. He returned to UTHSC as an Assistant Professor of Neurology in the end of 2007, engaging in proteomics and biomarker studies of lung diseases and brain tumors, and initiating the studies of predictive, preventive, and personalized medicine (PPPM) in cancer. In 2010, he was promoted to Associate Professor of Neurology, UTHSC. Currently, he is a Professor at Xiangya Hospital of Central South University in China, Fellow of Royal Society of Medicine (FRSM), the European EPMA National Representative in China, Regular Member of American Association for the Advancement of Science (AAAS), European Cooperation of Science and Technology (e-COST) grant evaluator, Associate Editors of BMC Genomics, BMC Medical Genomics, EPMA Journal, and Frontiers in Endocrinology, Executive Editor-in-Chief of Med One. He has\npublished 116 peer-reviewed research articles, 16 book chapters, 2 books, and 2 US patents. His current main research interest focuses on the studies of cancer proteomics and biomarkers, and the use of modern omics techniques and systems biology for PPPM in cancer, and on the development and use of 2DE-LC/MS for the large-scale study of human proteoforms.",institutionString:null,institution:{name:"Xiangya Hospital Central South University",country:{name:"China"}}},{id:"40482",title:null,name:"Rizwan",middleName:null,surname:"Ahmad",slug:"rizwan-ahmad",fullName:"Rizwan Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/40482/images/system/40482.jpeg",biography:"Dr. Rizwan Ahmad is a University Professor and Coordinator, Quality and Development, College of Medicine, Imam Abdulrahman bin Faisal University, Saudi Arabia. Previously, he was Associate Professor of Human Function, Oman Medical College, Oman, and SBS University, Dehradun. Dr. Ahmad completed his education at Aligarh Muslim University, Aligarh. He has published several articles in peer-reviewed journals, chapters, and edited books. His area of specialization is free radical biochemistry and autoimmune diseases.",institutionString:"Imam Abdulrahman Bin Faisal University",institution:{name:"Imam Abdulrahman Bin Faisal University",country:{name:"Saudi Arabia"}}},{id:"41865",title:"Prof.",name:"Farid A.",middleName:null,surname:"Badria",slug:"farid-a.-badria",fullName:"Farid A. Badria",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/41865/images/system/41865.jpg",biography:"Farid A. Badria, Ph.D., is the recipient of several awards, including The World Academy of Sciences (TWAS) Prize for Public Understanding of Science; the World Intellectual Property Organization (WIPO) Gold Medal for best invention; Outstanding Arab Scholar, Kuwait; and the Khwarizmi International Award, Iran. He has 250 publications, 12 books, 20 patents, and several marketed pharmaceutical products to his credit. He continues to lead research projects on developing new therapies for liver, skin disorders, and cancer. Dr. Badria was listed among the world’s top 2% of scientists in medicinal and biomolecular chemistry in 2019 and 2020. He is a member of the Arab Development Fund, Kuwait; International Cell Research Organization–United Nations Educational, Scientific and Cultural Organization (ICRO–UNESCO), Chile; and UNESCO Biotechnology France",institutionString:"Mansoura University",institution:{name:"Mansoura University",country:{name:"Egypt"}}},{id:"329385",title:"Dr.",name:"Rajesh K.",middleName:"Kumar",surname:"Singh",slug:"rajesh-k.-singh",fullName:"Rajesh K. Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329385/images/system/329385.png",biography:"Dr. Singh received a BPharm (2003) and MPharm (2005) from Panjab University, Chandigarh, India, and a Ph.D. (2013) from Punjab Technical University (PTU), Jalandhar, India. He has more than sixteen years of teaching experience and has supervised numerous postgraduate and Ph.D. students. He has to his credit more than seventy papers in SCI- and SCOPUS-indexed journals, fifty-five conference proceedings, four books, six Best Paper Awards, and five projects from different government agencies. He is currently an editorial board member of eight international journals and a reviewer for more than fifty scientific journals. He received Top Reviewer and Excellent Peer Reviewer Awards from Publons in 2016 and 2017, respectively. He is also on the panel of The International Reviewer for reviewing research proposals for grants from the Royal Society. He also serves as a Publons Academy mentor and Bentham brand ambassador.",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",country:{name:"India"}}},{id:"142388",title:"Dr.",name:"Thiago",middleName:"Gomes",surname:"Gomes Heck",slug:"thiago-gomes-heck",fullName:"Thiago Gomes Heck",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/142388/images/7259_n.jpg",biography:null,institutionString:null,institution:{name:"Universidade Regional do Noroeste do Estado do Rio Grande do Sul",country:{name:"Brazil"}}},{id:"336273",title:"Assistant Prof.",name:"Janja",middleName:null,surname:"Zupan",slug:"janja-zupan",fullName:"Janja Zupan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/336273/images/14853_n.jpeg",biography:"Janja Zupan graduated in 2005 at the Department of Clinical Biochemistry (superviser prof. dr. Janja Marc) in the field of genetics of osteoporosis. Since November 2009 she is working as a Teaching Assistant at the Faculty of Pharmacy, Department of Clinical Biochemistry. In 2011 she completed part of her research and PhD work at Institute of Genetics and Molecular Medicine, University of Edinburgh. She finished her PhD entitled The influence of the proinflammatory cytokines on the RANK/RANKL/OPG in bone tissue of osteoporotic and osteoarthritic patients in 2012. From 2014-2016 she worked at the Institute of Biomedical Sciences, University of Aberdeen as a postdoctoral research fellow on UK Arthritis research project where she gained knowledge in mesenchymal stem cells and regenerative medicine. She returned back to University of Ljubljana, Faculty of Pharmacy in 2016. She is currently leading project entitled Mesenchymal stem cells-the keepers of tissue endogenous regenerative capacity facing up to aging of the musculoskeletal system funded by Slovenian Research Agency.",institutionString:null,institution:{name:"University of Ljubljana",country:{name:"Slovenia"}}},{id:"357453",title:"Dr.",name:"Radheshyam",middleName:null,surname:"Maurya",slug:"radheshyam-maurya",fullName:"Radheshyam Maurya",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/357453/images/16535_n.jpg",biography:null,institutionString:null,institution:{name:"University of Hyderabad",country:{name:"India"}}},{id:"418340",title:"Dr.",name:"Jyotirmoi",middleName:null,surname:"Aich",slug:"jyotirmoi-aich",fullName:"Jyotirmoi Aich",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000038Ugi5QAC/Profile_Picture_2022-04-15T07:48:28.png",biography:"Biotechnologist with 15 years of research including 6 years of teaching experience. Demonstrated record of scientific achievements through consistent publication record (H index = 13, with 874 citations) in high impact journals such as Nature Communications, Oncotarget, Annals of Oncology, PNAS, and AJRCCM, etc. Strong research professional with a post-doctorate from ACTREC where I gained experimental oncology experience in clinical settings and a doctorate from IGIB where I gained expertise in asthma pathophysiology. A well-trained biotechnologist with diverse experience on the bench across different research themes ranging from asthma to cancer and other infectious diseases. An individual with a strong commitment and innovative mindset. Have the ability to work on diverse projects such as regenerative and molecular medicine with an overall mindset of improving healthcare.",institutionString:"DY Patil Deemed to Be University",institution:null},{id:"349288",title:"Prof.",name:"Soumya",middleName:null,surname:"Basu",slug:"soumya-basu",fullName:"Soumya Basu",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035QxIDQA0/Profile_Picture_2022-04-15T07:47:01.jpg",biography:"Soumya Basu, Ph.D., is currently working as an Associate Professor at Dr. D. Y. Patil Biotechnology and Bioinformatics Institute, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India. With 16+ years of trans-disciplinary research experience in Drug Design, development, and pre-clinical validation; 20+ research article publications in journals of repute, 9+ years of teaching experience, trained with cross-disciplinary education, Dr. Basu is a life-long learner and always thrives for new challenges.\r\nHer research area is the design and synthesis of small molecule partial agonists of PPAR-γ in lung cancer. She is also using artificial intelligence and deep learning methods to understand the exosomal miRNA’s role in cancer metastasis. Dr. Basu is the recipient of many awards including the Early Career Research Award from the Department of Science and Technology, Govt. of India. She is a reviewer of many journals like Molecular Biology Reports, Frontiers in Oncology, RSC Advances, PLOS ONE, Journal of Biomolecular Structure & Dynamics, Journal of Molecular Graphics and Modelling, etc. She has edited and authored/co-authored 21 journal papers, 3 book chapters, and 15 abstracts. She is a Board of Studies member at her university. She is a life member of 'The Cytometry Society”-in India and 'All India Cell Biology Society”- in India.",institutionString:"Dr. D.Y. Patil Vidyapeeth, Pune",institution:{name:"Dr. D.Y. Patil Vidyapeeth, Pune",country:{name:"India"}}},{id:"354817",title:"Dr.",name:"Anubhab",middleName:null,surname:"Mukherjee",slug:"anubhab-mukherjee",fullName:"Anubhab Mukherjee",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y0000365PbRQAU/ProfilePicture%202022-04-15%2005%3A11%3A18.480",biography:"A former member of Laboratory of Nanomedicine, Brigham and Women’s Hospital, Harvard University, Boston, USA, Dr. Anubhab Mukherjee is an ardent votary of science who strives to make an impact in the lives of those afflicted with cancer and other chronic/acute ailments. He completed his Ph.D. from CSIR-Indian Institute of Chemical Technology, Hyderabad, India, having been skilled with RNAi, liposomal drug delivery, preclinical cell and animal studies. He pursued post-doctoral research at College of Pharmacy, Health Science Center, Texas A & M University and was involved in another postdoctoral research at Department of Translational Neurosciences and Neurotherapeutics, John Wayne Cancer Institute, Santa Monica, California. In 2015, he worked in Harvard-MIT Health Sciences & Technology as a visiting scientist. He has substantial experience in nanotechnology-based formulation development and successfully served various Indian organizations to develop pharmaceuticals and nutraceutical products. He is an inventor in many US patents and an author in many peer-reviewed articles, book chapters and books published in various media of international repute. Dr. Mukherjee is currently serving as Principal Scientist, R&D at Esperer Onco Nutrition (EON) Pvt. Ltd. and heads the Hyderabad R&D center of the organization.",institutionString:"Esperer Onco Nutrition Pvt Ltd.",institution:null},{id:"319365",title:"Assistant Prof.",name:"Manash K.",middleName:null,surname:"Paul",slug:"manash-k.-paul",fullName:"Manash K. Paul",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/319365/images/system/319365.png",biography:"Manash K. Paul is a scientist and Principal Investigator at the University of California Los Angeles. He has contributed significantly to the fields of stem cell biology, regenerative medicine, and lung cancer. His research focuses on various signaling processes involved in maintaining stem cell homeostasis during the injury-repair process, deciphering the lung stem cell niche, pulmonary disease modeling, immuno-oncology, and drug discovery. He is currently investigating the role of extracellular vesicles in premalignant lung cell migration and detecting the metastatic phenotype of lung cancer via artificial intelligence-based analyses of exosomal Raman signatures. Dr. Paul also works on spatial multiplex immunofluorescence-based tissue mapping to understand the immune repertoire in lung cancer. Dr. Paul has published in more than sixty-five peer-reviewed international journals and is highly cited. He is the recipient of many awards, including the UCLA Vice Chancellor’s award and the 2022 AAISCR-R Vijayalaxmi Award for Innovative Cancer Research. He is a senior member of the Institute of Electrical and Electronics Engineers (IEEE) and an editorial board member for several international journals.",institutionString:"University of California Los Angeles",institution:{name:"University of California Los Angeles",country:{name:"United States of America"}}},{id:"311457",title:"Dr.",name:"Júlia",middleName:null,surname:"Scherer Santos",slug:"julia-scherer-santos",fullName:"Júlia Scherer Santos",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/311457/images/system/311457.jpg",biography:"Dr. Júlia Scherer Santos works in the areas of cosmetology, nanotechnology, pharmaceutical technology, beauty, and aesthetics. Dr. Santos also has experience as a professor of graduate courses. Graduated in Pharmacy, specialization in Cosmetology and Cosmeceuticals applied to aesthetics, specialization in Aesthetic and Cosmetic Health, and a doctorate in Pharmaceutical Nanotechnology. Teaching experience in Pharmacy and Aesthetics and Cosmetics courses. She works mainly on the following subjects: nanotechnology, cosmetology, pharmaceutical technology, aesthetics.",institutionString:"Universidade Federal de Juiz de Fora",institution:{name:"Universidade Federal de Juiz de Fora",country:{name:"Brazil"}}},{id:"219081",title:"Dr.",name:"Abdulsamed",middleName:null,surname:"Kükürt",slug:"abdulsamed-kukurt",fullName:"Abdulsamed Kükürt",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/219081/images/system/219081.png",biography:"Dr. Kükürt graduated from Uludağ University in Turkey. He started his academic career as a Research Assistant in the Department of Biochemistry at Kafkas University. In 2019, he completed his Ph.D. program in the Department of Biochemistry at the Institute of Health Sciences. He is currently working at the Department of Biochemistry, Kafkas University. He has 27 published research articles in academic journals, 11 book chapters, and 37 papers. He took part in 10 academic projects. He served as a reviewer for many articles. He still serves as a member of the review board in many academic journals. He is currently working on the protective activity of phenolic compounds in disorders associated with oxidative stress and inflammation.",institutionString:null,institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"178366",title:"Dr.",name:"Volkan",middleName:null,surname:"Gelen",slug:"volkan-gelen",fullName:"Volkan Gelen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178366/images/system/178366.jpg",biography:"Volkan Gelen is a Physiology specialist who received his veterinary degree from Kafkas University in 2011. Between 2011-2015, he worked as an assistant at Atatürk University, Faculty of Veterinary Medicine, Department of Physiology. In 2016, he joined Kafkas University, Faculty of Veterinary Medicine, Department of Physiology as an assistant professor. Dr. Gelen has been engaged in various academic activities at Kafkas University since 2016. There he completed 5 projects and has 3 ongoing projects. He has 60 articles published in scientific journals and 20 poster presentations in scientific congresses. His research interests include physiology, endocrine system, cancer, diabetes, cardiovascular system diseases, and isolated organ bath system studies.",institutionString:"Kafkas University",institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"418963",title:"Dr.",name:"Augustine Ododo",middleName:"Augustine",surname:"Osagie",slug:"augustine-ododo-osagie",fullName:"Augustine Ododo Osagie",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/418963/images/16900_n.jpg",biography:"Born into the family of Osagie, a prince of the Benin Kingdom. I am currently an academic in the Department of Medical Biochemistry, University of Benin. Part of the duties are to teach undergraduate students and conduct academic research.",institutionString:null,institution:{name:"University of Benin",country:{name:"Nigeria"}}},{id:"192992",title:"Prof.",name:"Shagufta",middleName:null,surname:"Perveen",slug:"shagufta-perveen",fullName:"Shagufta Perveen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192992/images/system/192992.png",biography:"Prof. Shagufta Perveen is a Distinguish Professor in the Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. Dr. Perveen has acted as the principal investigator of major research projects funded by the research unit of King Saud University. She has more than ninety original research papers in peer-reviewed journals of international repute to her credit. She is a fellow member of the Royal Society of Chemistry UK and the American Chemical Society of the United States.",institutionString:"King Saud University",institution:{name:"King Saud University",country:{name:"Saudi Arabia"}}},{id:"49848",title:"Dr.",name:"Wen-Long",middleName:null,surname:"Hu",slug:"wen-long-hu",fullName:"Wen-Long Hu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49848/images/system/49848.jpg",biography:"Wen-Long Hu is Chief of the Division of Acupuncture, Department of Chinese Medicine at Kaohsiung Chang Gung Memorial Hospital, as well as an adjunct associate professor at Fooyin University and Kaohsiung Medical University. Wen-Long is President of Taiwan Traditional Chinese Medicine Medical Association. He has 28 years of experience in clinical practice in laser acupuncture therapy and 34 years in acupuncture. He is an invited speaker for lectures and workshops in laser acupuncture at many symposiums held by medical associations. He owns the patent for herbal preparation and producing, and for the supercritical fluid-treated needle. Dr. Hu has published three books, 12 book chapters, and more than 30 papers in reputed journals, besides serving as an editorial board member of repute.",institutionString:"Kaohsiung Chang Gung Memorial Hospital",institution:{name:"Kaohsiung Chang Gung Memorial Hospital",country:{name:"Taiwan"}}},{id:"298472",title:"Prof.",name:"Andrey V.",middleName:null,surname:"Grechko",slug:"andrey-v.-grechko",fullName:"Andrey V. Grechko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/298472/images/system/298472.png",biography:"Andrey Vyacheslavovich Grechko, Ph.D., Professor, is a Corresponding Member of the Russian Academy of Sciences. He graduated from the Semashko Moscow Medical Institute (Semashko National Research Institute of Public Health) with a degree in Medicine (1998), the Clinical Department of Dermatovenerology (2000), and received a second higher education in Psychology (2009). Professor A.V. Grechko held the position of Сhief Physician of the Central Clinical Hospital in Moscow. He worked as a professor at the faculty and was engaged in scientific research at the Medical University. Starting in 2013, he has been the initiator of the creation of the Federal Scientific and Clinical Center for Intensive Care and Rehabilitology, Moscow, Russian Federation, where he also serves as Director since 2015. He has many years of experience in research and teaching in various fields of medicine, is an author/co-author of more than 200 scientific publications, 13 patents, 15 medical books/chapters, including Chapter in Book «Metabolomics», IntechOpen, 2020 «Metabolomic Discovery of Microbiota Dysfunction as the Cause of Pathology».",institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"199461",title:"Prof.",name:"Natalia V.",middleName:null,surname:"Beloborodova",slug:"natalia-v.-beloborodova",fullName:"Natalia V. Beloborodova",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/199461/images/system/199461.jpg",biography:'Natalia Vladimirovna Beloborodova was educated at the Pirogov Russian National Research Medical University, with a degree in pediatrics in 1980, a Ph.D. in 1987, and a specialization in Clinical Microbiology from First Moscow State Medical University in 2004. She has been a Professor since 1996. Currently, she is the Head of the Laboratory of Metabolism, a division of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russian Federation. N.V. Beloborodova has many years of clinical experience in the field of intensive care and surgery. She studies infectious complications and sepsis. She initiated a series of interdisciplinary clinical and experimental studies based on the concept of integrating human metabolism and its microbiota. Her scientific achievements are widely known: she is the recipient of the Marie E. Coates Award \\"Best lecturer-scientist\\" Gustafsson Fund, Karolinska Institutes, Stockholm, Sweden, and the International Sepsis Forum Award, Pasteur Institute, Paris, France (2014), etc. Professor N.V. Beloborodova wrote 210 papers, five books, 10 chapters and has edited four books.',institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"354260",title:"Ph.D.",name:"Tércio Elyan",middleName:"Azevedo",surname:"Azevedo Martins",slug:"tercio-elyan-azevedo-martins",fullName:"Tércio Elyan Azevedo Martins",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/354260/images/16241_n.jpg",biography:"Graduated in Pharmacy from the Federal University of Ceará with the modality in Industrial Pharmacy, Specialist in Production and Control of Medicines from the University of São Paulo (USP), Master in Pharmaceuticals and Medicines from the University of São Paulo (USP) and Doctor of Science in the program of Pharmaceuticals and Medicines by the University of São Paulo. Professor at Universidade Paulista (UNIP) in the areas of chemistry, cosmetology and trichology. Assistant Coordinator of the Higher Course in Aesthetic and Cosmetic Technology at Universidade Paulista Campus Chácara Santo Antônio. Experience in the Pharmacy area, with emphasis on Pharmacotechnics, Pharmaceutical Technology, Research and Development of Cosmetics, acting mainly on topics such as cosmetology, antioxidant activity, aesthetics, photoprotection, cyclodextrin and thermal analysis.",institutionString:null,institution:{name:"University of Sao Paulo",country:{name:"Brazil"}}},{id:"334285",title:"Ph.D. Student",name:"Sameer",middleName:"Kumar",surname:"Jagirdar",slug:"sameer-jagirdar",fullName:"Sameer Jagirdar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334285/images/14691_n.jpg",biography:"I\\'m a graduate student at the center for biosystems science and engineering at the Indian Institute of Science, Bangalore, India. I am interested in studying host-pathogen interactions at the biomaterial interface.",institutionString:null,institution:{name:"Indian Institute of Science Bangalore",country:{name:"India"}}},{id:"329248",title:"Dr.",name:"Md. Faheem",middleName:null,surname:"Haider",slug:"md.-faheem-haider",fullName:"Md. Faheem Haider",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329248/images/system/329248.jpg",biography:"Dr. Md. Faheem Haider completed his BPharm in 2012 at Integral University, Lucknow, India. In 2014, he completed his MPharm with specialization in Pharmaceutics at Babasaheb Bhimrao Ambedkar University, Lucknow, India. He received his Ph.D. degree from Jamia Hamdard University, New Delhi, India, in 2018. He was selected for the GPAT six times and his best All India Rank was 34. Currently, he is an assistant professor at Integral University. Previously he was an assistant professor at IIMT University, Meerut, India. He has experience teaching DPharm, Pharm.D, BPharm, and MPharm students. He has more than five publications in reputed journals to his credit. Dr. Faheem’s research area is the development and characterization of nanoformulation for the delivery of drugs to various organs.",institutionString:"Integral University",institution:{name:"Integral University",country:{name:"India"}}},{id:"329795",title:"Dr.",name:"Mohd Aftab",middleName:"Aftab",surname:"Siddiqui",slug:"mohd-aftab-siddiqui",fullName:"Mohd Aftab Siddiqui",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329795/images/system/329795.png",biography:"Dr. Mohd Aftab Siddiqui is an assistant professor in the Faculty of Pharmacy, Integral University, Lucknow, India, where he obtained a Ph.D. in Pharmacology in 2020. He also obtained a BPharm and MPharm from the same university in 2013 and 2015, respectively. His area of research is the pharmacological screening of herbal drugs/natural products in liver cancer and cardiac diseases. He is a member of many professional bodies and has guided many MPharm and PharmD research projects. Dr. Siddiqui has many national and international publications and one German patent to his credit.",institutionString:"Integral University",institution:null}]}},subseries:{item:{id:"8",type:"subseries",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.',coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11404,editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",slug:"adriano-andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",biography:"Dr. Adriano de Oliveira Andrade graduated in Electrical Engineering at the Federal University of Goiás (Brazil) in 1997. He received his MSc and PhD in Biomedical Engineering respectively from the Federal University of Uberlândia (UFU, Brazil) in 2000 and from the University of Reading (UK) in 2005. He completed a one-year Post-Doctoral Fellowship awarded by the DFAIT (Foreign Affairs and International Trade Canada) at the Institute of Biomedical Engineering of the University of New Brunswick (Canada) in 2010. Currently, he is Professor in the Faculty of Electrical Engineering (UFU). He has authored and co-authored more than 200 peer-reviewed publications in Biomedical Engineering. He has been a researcher of The National Council for Scientific and Technological Development (CNPq-Brazil) since 2009. He has served as an ad-hoc consultant for CNPq, CAPES (Coordination for the Improvement of Higher Education Personnel), FINEP (Brazilian Innovation Agency), and other funding bodies on several occasions. He was the Secretary of the Brazilian Society of Biomedical Engineering (SBEB) from 2015 to 2016, President of SBEB (2017-2018) and Vice-President of SBEB (2019-2020). He was the head of the undergraduate program in Biomedical Engineering of the Federal University of Uberlândia (2015 - June/2019) and the head of the Centre for Innovation and Technology Assessment in Health (NIATS/UFU) since 2010. He is the head of the Postgraduate Program in Biomedical Engineering (UFU, July/2019 - to date). He was the secretary of the Parkinson's Disease Association of Uberlândia (2018-2019). Dr. Andrade's primary area of research is focused towards getting information from the neuromuscular system to understand its strategies of organization, adaptation and controlling in the context of motor neuron diseases. 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