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\\n
We 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!
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\n
Throughout 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\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\n
We 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
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\r\n\tCurrently, both in science and in industry, quartz has numerous applications that continue to grow in line with technological development. In the same way, the specifications that are considered in the mineral raw material markets are diversified, from very restrictive quality, for high-tech artifacts, to the most eclectic for abrasives and glass-ceramic applications. In the same way, the diversity of contaminations that are accepted in the different industrial batches are very varied and imply a great diversity of application and behavior tests in transformation routines.
\r\n
\r\n\tFrom the outset, natural sources are more suitable for some applications, but in any case, it is necessary to ensure deposits with large monomineralic masses, as homogeneous and pure as possible, which allow viable mining in both quantity and quality. These conditions tend to occur mainly in granitic pegmatitic deposits and in metamorphic or hydrothermal quartz veins. Furthermore, more and more ornamental varieties of quartz enter architecture, design, and jewelry.
\r\n
\r\n\tIt is proposed here to present a holistic view of quartz from its descriptive mineralogy to industrial applications, including the origin and characteristics of the different types of mineral deposits and the physicochemical performance tests that distinguish the quartz batches for different forms of application with consequences for the marketing of the corresponding raw materials.
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1. Introduction
The incidence of type 2 diabetes is increasing worldwide, resulting in large measure from the increasing prevalence of obesity (Yale, 2000). Diabetes mellitus is a pandemic disease and is one of the main threats to human health (Narayan, 2005). In 2003, 194 million people worldwide, ranging in age from 20 to 79 years, had diabetes. It is projected that this number will be increased by 72% to 333 million by 2025, and nearly 80% of these cases will be in the poorer industrialized countries (IDF, 2003).Type 2 diabetes is also a major public health problem in Pakistan as the middle-aged population in that country is overweight or obese, lack of physical activity, unhealthy food and eating habits exposing this population to a high risk of type 2 diabetes (Ansari, 2009). In the local context, prevalence of Type 2 diabetes in Pakistan for the year 2000 was 7.6 % (5.2 million populations) and for 2030 it will increase to around 15% (13.8 million populations) and as such Pakistan is ranked 7th on diabetes prevalence list (WHO, 2004). It was found by Jafar et al (2006) that on the age-specific prevalence of overweight and obesity, more than 40% of women and 30% of men aged 35–54 years were classified as overweight or obese.
Despite the high prevalence of diabetes and serious long term complications, there is still lack of established evidence-based guidelines for self-management (ADA, 2006) and translation of practice recommendations to care in Asian countries (Rayappa et al. 1998) and as well as in developed countries (Chin et al. 2000). Therefore, promoting an active lifestyle or regular exercise has become the highest public health priority in that country to overcome the onslaught of type 2 diabetes and in this context this project is very significant as it addresses this important problem of type 2 diabetes. There is a need for self-management approach for patients of type 2 diabetes and the assessment of quality of diabetes care in the community can help draw attention to the need for improving diabetes self-management and provide a benchmark for monitoring changes over time.
2. Brief literature review
A systematic review of the literature was carried out to cover socio-ecological approach to self-management of type 2 diabetes. Electronic databases were searched, including Cochrane library, Medline, Embase. References of all retrieved articles were checked for relevant studies.
The selection of studies was based on the following criteria:
Interventions: educational interventions compared with usual care, physical activity and diet interventions, behavioural intervention.
Participants: middle-aged population, aged 30-65 with poorly controlled type 2 diabetes.
Outcomes: Studies must report haemoglobin (HbA1c) or hypoglycemia episodes, diabetic complications, cardiovascular disease and quality of life.
Design: The studies related to socio-ecological approach to self-management of type 2 diabetes were included. The search key words were type 2 diabetes, socio-ecological intervention and self-management.
The literature survey revealed that diabetes self-management education is the cornerstone of diabetes care (Mensing et al. 2007). There are several studies indicated an association between diabetes self-management and improved diabetes knowledge and self-management behaviours and improved clinical outcomes (Norris et al. 2001; Philis-Tsimikas et al. 2004). However, authors of a meta-analysis of diabetes self-management programmes reported sharp declines in benefits within one month post intervention (Norris et al. 2001) suggesting that self-management interventions alone do not enable individuals to maintain behaviours changes. The improved outcomes were reported when diabetes self-management was carried out for a longer duration, community-based (CDC, 2001), included follow-up support (Norris et al. 2001), and provided culturally sensitive interventions (Philis-Tsimikas et al 2004; Brown et al. 2005), and addressed psychosocial issues (Mauldon et al. 2006; Norris et al. 2001).
In addition, the social interaction between the patients and doctors is of great significance. The patients of diabetes need to engage with a range of health professionals. Gaining knowledge of the patient’s perspective builds on traditional models of physician-patient communication (Pendleton et al. 1984) provides greater clarity to the range of lay understandings that should be explored as a component of effective risk communication.
Fisher et al (2005) suggested that the quality clinical care and self management are compatible and dependent on each other and without sound care, individual’s efforts may be misdirected and expert clinical care will fall far short of its potential, through patient failure to use prescribed medications to control his blood sugar or to implement its management plans (Fisher et al. 2005).
A framework for integrating the resources and supports for self-management with key components of clinical care was also provided by Wagner et al (1996) in their chronic care model. A number of studies have also suggested that patient understanding and beliefs about health and illness may be shaped by historical and local contexts (Macfarlane and Kelleher, 2002), whether respondents are thinking about health or behaviour in general or about their own (Blaxter, 1990; French et al. 2001), and personal experience and observation (Davison et al. 1991). The following figure 1 provides a conceptual framework of self-management of type 2 diabetes using the socio-ecological approach.
Figure 1.
Conceptual framework of self-management of type 2 diabetes
3. Ecological approach to self-management
This case study would also demonstrate that the person is solely responsible to take care of his diabetes related problems and its management and therefore the issue of self-management becomes more important for those with chronic disease, where only the patient can be responsible for day to day care over the length of the illness (Lorig and Holman, 2003). It is generally agreed that self-management is required for control of chronic diseases and for prevention of disease complications; however, patients generally do not adhere to self-management recommendations (Sherbourne et al. 1992; Gochman, 1997; Glasgow and Eakin, 1998). The adherence to the recommendations and barriers are both problematic for “lifestyle” behaviour such as eating patterns and physical activity rather than medication adherence (Brown, 1990; Roter et al. 1998; Ansari, 2009). This is evident from the culture, tradition and life style behavior of the people of Pakistan that both the eating patterns and physical activity are posing a great deal of difficulties to middle-aged population with diabetes.
There is compelling evidence that higher levels of social support are related to better long-term self management and better health outcomes (Kaplan and Toshima, 1990; Uchino et al. 1996). There is also a significant relationship between support and health where support can be assessed from a variety of sources, including spouses, family, friends and neighbours (Dignam et al. 1986). The relationships between support and immunity (Cohen et al. 1997), health status and health behaviours (Glasgow and Toobert, 1988), mortality and quality of life (House et al. 1988; Glasgow et al. 1997) have also been reported in the literature. King et al (2010) has demonstrated that self-efficacy, problem solving, and social environment support are associated with diabetes self-management behaviours.
4. Health services in the local community
The health services in the community in Pakistan are not adequate and diabetes health management programme in the community health clinics does not provide enough help and support to the patients. Shortage of community doctors and expensive consultation with private doctors make the life of patients more difficult in terms of managing their diabetes in that region of Pakistan.
These clinics in Pakistan face special challenges to provide diabetes care to the poor patients as most of these clinics do not meet the evidence-based quality of care standards as compared to the targets established by the American Diabetes Association (ADA, 2000). Similar cases have been reported in several studies in diversified health care settings; including academic institutions (Peters et al. 1996), health maintenance organization (Miller and Hirsch, 1994), health centers (Chin et al. 2000) and medical providers (Chin et al. 1998) where substantial portion of diabetes care does not meet the evidence-based quality of standard care. Marshall et al (2000) have reported that community-based health clinics and their patients have fewer resources than the private clinics and the clinics often lack access to integrated delivery system, and their small size limits the financial feasibility of full-time teams devoted solely to diabetes care.
5. Interventions to improve health services in the community
The health services in the community can be improved by making use of on-going follow-up and support for the self-management of diabetes which has shown promising results (Norris et al. 2002). For the poor patients in that region of Pakistan where access to the community doctors is not easy and private doctors are not affordable, support may be provided through telephone calls (Weinberger et al. 1995) or the internet (McKay et al. 1998). It has been reported that telephone monitoring of patients, combined with nurse follow-up and tailored information has been shown to reach low income patients and helped them managed their blood sugar level and reduced levels of depression (Piette et al. 1999; Piette et al. 2000).
Another strategy to improve the health services in the community is the group visit to medical clinics by the patients of diabetes (Beck et al. 1997) in which all the patients in a particular category visit the physicians for general check-up including the educational and supportive discussions. Evaluation of this type of strategy has indicated impressive effects on glycosylated hemoglobin and other measures to usual care (Trento et al. 2001).
6. Self-management approach in local context
In order to meet the main objective of this study, the socio-ecological approach to self-management of type 2 diabetes will be applied to middle-aged population of Pakistan using case study approach. The case study is most suitable as it integrates the skills and choices of individuals with the services and support they receive from (a) the social environment of family, friends, organizations and cultures (b) the physical and policy environments of neighbourhoods, communities and governments (Stokols, 1996). The self management from an ecological perspective requires access to a variety of resources, including services provided by professionals and support for the initiation and maintenance of healthy behaviours (Glasgow, 1995; Glasgow et al. 2000).
There is only one study conducted in Pakistan on diabetes knowledge, beliefs and practices among people with diabetes (Rafique et al. 2006). The study provided further evidence that there was a lack of information available to people with diabetes in Pakistan as the large population has never received any diabetes education at all (Rafique et al. 2006). Also, the study was conducted in an urban university hospital, where diabetes education may be more readily available as compared to rural areas where people have less access to information and will have even poorer diabetes perception and practices.
This case study would make a unique contribution to public health in the rural area of Pakistan. This will be first type detailed study of diabetes self-management among the population of Pakistan. It will address the issues and the ways in which diabetes in viewed and managed in that region. The study will also be useful for health care professionals suggesting that coping with diagnosis and living with diabetes is affected by a complex constellation of factors, including life circumstances, social support, gender roles and economy.
7. Aims and objectives
The main objective of this study is to examine the role of physical inactivity and obesity in the development of type 2 diabetes and its self-management in a middle-aged population living in rural area of Pakistan and to evaluate a lifestyle intervention (Physical Activity and Diet) in the management of type 2 diabetes. The study would use the qualitative health approach conducting one-on-one interviews with a sample of informants – patients of type 2 diabetes (n=210) and to explore patients perceptions and experiences of undertaking physical activity and eating behaviour as part of their diabetes self-management. In addition, the study would analyze how the health issue related to diabetes is viewed and addressed in the community and identify the barriers to diabetes care in community and healthcare clinics and would use the concepts of socio-ecological approach to self-management of type 2 diabetes.
This research protocol design addresses the lifestyle interventions for lowering hemoglobin (HbA1c) in this randomized controlled trial and determines whether the intervention of physical activity and diet in combination of usual medical care lowers HbA1c in patients with type 2 diabetes. These types of trials are critical and significant in determining if the culturally tailored interventions are effective in the practical world in which patients live as these patients with diabetes in sub-continent may have different characteristics than those in other western countries due to their eating of different foods and drinking habits.
In addition, this study will help to minimize the gap between the physician-patient understanding and management of diabetes and to identify the barriers to self management of diabetes and quality of life. This study will contribute to improving the quality health care for diabetes in health clinics in that region and would recommend a multifactorial approach emphasizing patient education, improved training in behavioural change for providers, and enhanced delivery system (Chin et al. 2000). The understanding of people about diabetes and susceptibility to diabetes is linked to family, community and society and therefore, this study will impress upon the need to recognize that in developing strategies and interventions to address diabetes, self-care, family support, community education and community ownership are important (Weeramanthri et al. 2003; Wong et al. 2005).
Research Questions: The research questions have been formulated as follows:
Will this study help to enhance the patient understanding of self-management of diabetes and will it minimize the gap between the physician-patient interactions?
Will hemoglobin (HbA1c) improve after the 90 days trial of lifestyle interventions in patients with poorly controlled type 2 diabetes?
Will physical activity and healthy diet lead to reducing the Body Mass Index (BMI) and consequently the risk of diabetes in patients of type 2 diabetes in that region?
Hypotheses: The following hypotheses are to be tested in this study:
The lifestyle interventions (physical activity and diet) in patients with poorly controlled diabetes will lead to reduction of 1% hemoglobin (HbA1c) in 90 days trial. (HbA1c as Primary outcome variable)
The self-management of type 2 diabetes will reduce 5% weight in patients in 90 days trial and consequently the BMI (BMI as secondary outcome variable)
8. Justification of hypotheses
The justification of the first hypothesis stem from the fact that the clinical complications are significantly associated with glycemia (Stratton et al. 2000) and it has been reported that that each 1% reduction in hemoglobin (HbA1c) is associated with reductions in risk of 21% for any end point related to diabetes, 21% for deaths related to diabetes, 14% for myocardial infarction and 37% for microvascular complications (DCCT, 1996; UKPDS, 1998). The second hypothesis is related to Body Mass Index (BMI) and weight reduction which are measures of obesity and linked to the development of problems in glycemic control and are major risk factors for the development of cardiovascular disease (Michael, 2007).
9. Study design and sampling method
The patients will be recruited from the diabetic medical centre in rural area of Peshawar conducting the study of management of type 2 diabetes among the population aged 30-65 years. The eligibility of patients will be subjected to further screening if their records will not be found in the clinic database. The patients with diabetes having HbA1c >7.0% will be included in this study and patients having coexisting liver, kidney or thyroid disorder will be excluded from this study. The Word Health Organization (WHO, 2006) diabetes criteria will be followed in the selection of the patients with diabetes as indicated in Table 1.
\n\n
\n\n
\n\n
\n\n
\n\n
\n\n Condition\n\n
\n\n
\n\n 2 hour glucose\n\n
\n\n
\n\n Fasting glucose\n\n
\n\n
\n\n
\n\n
\n\n
mmol/l(mg/dl)
\n\n
mmol/l(mg/dl)
\n\n
\n\n
\n\n
Normal
\n\n
<7.8 (<140)
\n\n
<6.1 (<110)
\n\n
\n\n
\n\n
Impaired fasting glycaemia
\n\n
<7.8 (<140)
\n\n
≥ 6.1(≥110) & <7.0(<126)
\n\n
\n\n
\n\n
Impaired glucose tolerance
\n\n
≥7.8 (≥140)
\n\n
<7.0 (<126)
\n\n
\n\n
\n\n
Diabetes mellitus
\n\n
≥11.1 (≥200)
\n\n
≥7.0 (≥126)
\n\n
\n\n
Table 1.
World Health Organization (WHO, 2006). Diabetes Criteria for patients
All the participants will adhere to their usual medications as recommended by their doctors. In order to assess the effectiveness of this intervention, it was advised not to modify the medications during this trial. In addition, participants will be advised not to take any other new treatments for the management of type 2 diabetes during this study. All participants will be contacted again after 90 days (3-months) to give their blood sample for HbA1c testing, their weight will be taken and BMI will be calculated.
10. Study population and randomization
Initially 325 patients with type 2 diabetes will be invited to pre-randomized interview, out of which only 210 patients will be included in the actual trial. For the purpose of this trial, it is expected that out of the 325 patients, 93 patients will not meet the inclusion criteria and 22 patients might refuse to participate in the trial. In that case, two hundred and ten (210) patients will agree to participate and will be required to sign informed consent documents at the clinic where they usually visit for their usual medical care for diabetes. Therefore, 105 patients will be randomized to intervention group (Physical Activity and Diet) and 105 to the control group (usual medical care). Figure 2 shows their progress during the randomized controlled trial. This RCT trial will not be double-blinded as the participants receiving the education on lifestyle modifications in the community and healthcare clinics would know that they are on the active intervention.
Once the randomization phase is completed, all patients will be instructed to follow-up the usual medical care for their diabetes for the duration of the 90 days trial. The patients will not be allowed to adjust their usual medications and follow their previous prescriptions recommended by their doctors. In addition, each patient will be asked to go for blood test for HbA1c on day 1 and then return to give blood sample after 90 days. In addition, participants will be advised not to take any other new treatments for the management of type 2 diabetes during the trial periods.
Those patients randomized to adhere to physical activity and diet (intervention group) will receive education, advice, and behaviour modification skills to help them to maintain a low fat diet, lose weight (goal of 5% weight loss) and moderate intensity physical activity such as brisk walking for 150 minutes/week. Those patients randomized to usual medical care (control group) will be instructed to take their normal medicines and follow-up with their doctor as per their normal schedule.
All participants will be contacted again after 90 days (3-months) to give their blood sample for HbA1c testing, their weight will be taken and BMI will be calculated. At that time, a questionnaire will be sent via e-mail to participants in intervention group to assess the progress of the physical activity and diet intervention and to control group to assess the progress of the treatment with normal medical care only.
Figure 2.
Flow chart describing Randomized Controlled Trial of lifestyle Interventions
11. Measurement
The factors which will be measured in this study are the physical activity of participants (an intervention), hemoglobin (HbA1c – primary outcome variable), blood pressure and weight (secondary outcome) whereas the body mass index (BMI) is a calculated variable. The linear regression analysis will be performed after three months between HbA1c and on the blood glucose results to see the reliability of measurement data and to observe any relationship between the two variables.
Physical activity is a key component of lifestyle modification that can help individuals prevent or control type 2 diabetes. It is considered that diet is probably more important in the initial phases of weight loss, incorporating exercise as part of a weight loss regimen helps maintain weight and prevent weight regain (Klein et al. 2004). In this study, the message will be given to participants to do 30 minutes of moderate physical activity daily (approximately 8000 step count) and it may offer greater benefits to these patients in managing their diabetes (Wright and Royson, 1996).
For measurement of physical activity, the method of step count using pedometer will be used as it has been demonstrated to have a superior validity of step counts over a questionnaire approach in predicting health markers such as BMI and waist circumference (Ewald et al. 2008). The participants will be given pedometer for a week for the measurement of physical activities (step counts). These participants will be instructed to wear the pedometer on a waist belt, either side and wear it from the early morning till they go to bed in the night. The participants will record the start and end time for each day wearing the pedometer and in the evening record the step count showing on the display without resetting the counter. The participants will return a 7-day diary with a record of all the events. Table 2 shows the baseline characteristics of participants in intervention and control group.
\n\n
\n\n
\n\n
\n\n
\n\n
\n\n
\n\n Characteristics\n\n
\n\n
\n\n Intervention Group (n = 105)\n\n
\n\n
Control Group (n = 105)
\n\n
\n\n P-value\n\n
\n\n
\n\n
\n\n
\n\n Age (years)\n\n
\n\n
Mean (62.5) ± SD (10.5)
\n\n
Mean (59.5) ± SD (8.5)
\n\n
0.78
\n\n
\n\n
\n\n
\n\n Sex\n\n
\n\n
\n\n
\n\n
\n\n
\n\n
\n\n
Male Female
\n\n
55% (n = 58) 45% (n = 47)
\n\n
58% (n = 61) 42% (n = 44)
\n\n
\n\n
\n\n
\n\n
Body Mass Index (Kg/m2)
\n\n
Mean (30.8) ± SD (6.5)
\n\n
Mean (30.6) ± SD (6.5)
\n\n
0.40
\n\n
\n\n
\n\n
Physical Activity Adherence to diet
\n\n
95% (8000 steps) 98% (n=103) 2% (n = 2)
\n\n
- -
\n\n
\n\n
\n\n
\n\n
Baseline Hemoglobin (HbA1c) %
\n\n
Mean (8.5) ± SD (1.6)
\n\n
Mean (8.4) ± SD (0)
\n\n
0.59
\n\n
\n\n
\n\n
Diabetes Medications
\n\n
Mean (1.75) ± SD (0.8)
\n\n
Mean (1.82) ± SD (0.8)
\n\n
0.15
\n\n
\n\n
Table 2.
Baseline characteristics of intervention and control groups in RCT trial (ref: Medical Record)
12. Method of analysis
12.1. Statistical analysis
The primary outcome will be analysed by an un-paired sample t-test (mean difference between baseline and final HbA1c). The statistical analysis, using STATA will be carried out on an intention to treat basis and that will subject to the availability of data at follow up (after 90 days) as well as at entry level for individual patients. The linear regression analysis will be performed after three months between HbA1c and on the blood glucose results and it is expected that the HbA1c and the self-glucose monitoring via a glucometer will demonstrate a significant relationship ( P < 0.0001) similar to the findings of Nathan et al. (2008) who reported that the linear regression analysis carried out between the HbA1c and blood glucose (BG) values provided the tightest correlations (BG = 28.7 × A1C − 46.7, R2 = 0.84, P < 0.0001), allowing calculation of an estimated average glucose for HbA1C values. The linear regression equations did not differ significantly across subgroups based on age, sex, diabetes type, race/ethnicity, or smoking status.
12.2. Data analysis method
In this study, the thematic analysis of data will be adopted for analysing the data because the method was developed to meet the needs of investigating the experiences, meanings and the reality of the participants (Braun and Clarke, 2006). The method also allows the study to adopt the element from constructionist notions – to investigate the ways in which events, realities, meanings, experiences are the effects of a range of discourses operating within a society. There are five stages to complete this method – it follows the sequence of familiarization, generating initial codes, searching for themes, reviewing themes, defining and naming and preparing the report.
12.3. Sample size estimation
The study sample size was determined based on the assumption of the estimation of Standard Deviation (SD). Therefore, the study design was selected to detect an effect size of 0.5 SD lowering of HbA1c. It was assumed that 10% patients might be lost to follow-up in control group over the period of three months and only 5 % patients will be lost to follow-up in intervention group. This assumption was based on impact of education and advice on lifestyle behavioural modifications to patients and overall popularity of this approach among the diabetic patients in sub-continent to manage their glycemic control.
Taking into consideration all these factors, the following parameters were considered: α = Level of significance test = 0.05, Power = 0.8, m= the follow-up period 90 days (3 months), Standard Deviation (SD) = 0.5, the sample size was calculated for each group to detect an effect size of 0.5 SD. The sample size (N) for each group was =105; therefore, the total, N=210 patients were recruited to participate in both the groups. The figure 2 shows n=210 patients randomized to each group and their progress during double-blinded fenugreek randomized controlled trial.
12.4. Calculation of sample size — An alternate method
Diabetic Medical Center, Ayub Medical College, Abbottabad – Pakistan
Patients = patients of type 2 diabetes visiting the medical center
Doctors = doctors working in medical center
14. Minimizing the bias
It is possible that the outcome measures associated with physical activity and diet interventions will be subject to bias particularly when treatment will be in progress or just afterwards. The main difference between usual medical care alone for the patients and usual medical care with physical activity and dietary interventions will occur after 3 months period of trial. In order to reduce the bias, the questionnaire will be sent to patients at home or via e-mail to minimize any chance that their answers might be affected by actual or perceived influence by medical practitioners at clinic.
15. Discussions
The results of this randomized controlled trial will support the research question that lifestyle interventions (physical activity and diet) with usual medical care for type 2 diabetes is more effective than the usual medical care alone. The higher % age of lost to follow up throughout this trial (Figure 2) in those patients with usual medical care (10%) than in those in intervention group (5%) suggests greater satisfaction with physical activity and dietary education and advice. The difference at 3 months follow up is the mean change in HbA1c levels for the intervention group minus the mean change of HbA1c for the control group. Therefore, the positive differences reflect more improvement in those patients following physical activity and dietary guidelines than in those patients with medical care only.
The expected changes in HbA1c from baseline values in patients with type 2 diabetes after 3 months will be calculated by unpaired sample t-test. At 3 months follow-up, the patients would show significantly greater improvement and lower values of HbA1c by 1%. This would support the hypothesis 1 that the lifestyle interventions (physical activity and diet) in patients with poorly controlled diabetes will lead to reduction of 1% hemoglobin (HbA1c) in 90 days trial.
These finding are in agreement with the studies by Stratton et al (2000) and the United Kingdom Prospective Diabetes Studies (UKPDS, 1998), suggesting that any reduction in HbA1c is likely to reduce the risk of complications, with the lowest risk being in those with HbA1c values in the normal range (< 6.0%). Therefore, the potential results of this trial which have shown improvement in patients of diabetes by lowering HbA1c by 1% might be expected to provide similar reductions in morbidity.
The hypothesis 2 will be supported if we can provide evidence that the type 2 diabetic patients after the 90 days trial would reduce 5% weight and consequently the BMI as compared to the these values at baseline. The polynomial regression analysis will be used to generate the reference range models as these models do not make assumptions about linearity of step count with age (Wright and Royson, 1996). It is expected to find a correlation of step count with BMI similar to one of the studies (Ansari, 2009) which provided evidence that relationship between physical activity and BMI was found to be statistically significant in a cross-sectional study of a large sample of population and it was also associated with reduced risk of type 2 diabetes with (RR=0.82; 95% CI=0.68-1.00; P =0.048). The changes in BMI from the base line values will determine the level of reduction in weight and BMI based on physical activity, diet and exercise.
16. Ethical consideration
The scientific validity of the study is a fundamental ethical protection and this study has a scientific merit and clinical value as it aims at using the socio-ecological approach to self-management of type 2 diabetes and will help diabetic patients to control their hemoglobin (HbA1c) and help them to understand the importance of physical activity and healthy diet and to enjoy a healthy lifestyle.
All the patients will be provided clear instruction about the study and informed consent will be obtained and ethical clearance will be taken from a legal authority before conducting this study.
Finally, the main contribution of this trial is to provide health professionals (diabetes care providers) and patients with type 2 diabetes an insight into the ways in which diabetes is viewed and managed in that region of Pakistan which will help them in the self-management and treatment of type 2 diabetes.
17. Conclusion
It has been demonstrated in this study that the level of HbA1c (primary outcome) will reduce by 1% in the patients of poorly controlled type 2 diabetes after the 90 days trial of physical activity and dietary interventions and hence will support the hypothesis and the research question. This study will enhance the relationship between the medical practitioner and the patients of diabetes and will improve the health care system in that region of the country in managing and treating the patients with chronic disease such as diabetes. This study will improve upon the overall functioning of community healthcare clinics to diabetes care in terms of recognizing the symptoms of diabetes to early detection and diagnosis, easy access to community doctors.
\n',keywords:null,chapterPDFUrl:"https://cdn.intechopen.com/pdfs/44467.pdf",chapterXML:"https://mts.intechopen.com/source/xml/44467.xml",downloadPdfUrl:"/chapter/pdf-download/44467",previewPdfUrl:"/chapter/pdf-preview/44467",totalDownloads:2730,totalViews:720,totalCrossrefCites:0,totalDimensionsCites:1,totalAltmetricsMentions:0,impactScore:1,impactScorePercentile:73,impactScoreQuartile:3,hasAltmetrics:0,dateSubmitted:"April 28th 2012",dateReviewed:"April 6th 2013",datePrePublished:null,datePublished:"June 26th 2013",dateFinished:"April 30th 2013",readingETA:"0",abstract:null,reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/44467",risUrl:"/chapter/ris/44467",book:{id:"3383",slug:"type-2-diabetes"},signatures:"Rashid M. Ansari, John B. Dixon and Colette J. Browning",authors:[{id:"39621",title:"Dr.",name:"Rashid",middleName:"Muhammad",surname:"Ansari",fullName:"Rashid Ansari",slug:"rashid-ansari",email:"ansarirm@yahoo.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"University of Queensland",institutionURL:null,country:{name:"Australia"}}},{id:"168714",title:"Prof.",name:"John",middleName:null,surname:"Dixon",fullName:"John Dixon",slug:"john-dixon",email:"john.dixon@monash.edu",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"168715",title:"Prof.",name:"Colette",middleName:null,surname:"Browning",fullName:"Colette Browning",slug:"colette-browning",email:"colette.browning@monash.edu",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Brief literature review",level:"1"},{id:"sec_3",title:"3. Ecological approach to self-management ",level:"1"},{id:"sec_4",title:"4. Health services in the local community ",level:"1"},{id:"sec_5",title:"5. Interventions to improve health services in the community ",level:"1"},{id:"sec_6",title:"6. Self-management approach in local context",level:"1"},{id:"sec_7",title:"7. Aims and objectives ",level:"1"},{id:"sec_8",title:"8. Justification of hypotheses ",level:"1"},{id:"sec_9",title:"9. Study design and sampling method",level:"1"},{id:"sec_10",title:"10. Study population and randomization",level:"1"},{id:"sec_11",title:"11. Measurement ",level:"1"},{id:"sec_12",title:"12. Method of analysis",level:"1"},{id:"sec_12_2",title:"12.1. Statistical analysis ",level:"2"},{id:"sec_13_2",title:"12.2. Data analysis method",level:"2"},{id:"sec_14_2",title:"12.3. Sample size estimation",level:"2"},{id:"sec_15_2",title:"12.4. Calculation of sample size — An alternate method",level:"2"},{id:"sec_17",title:"13. Clinical settings in pakistan",level:"1"},{id:"sec_18",title:"14. Minimizing the bias ",level:"1"},{id:"sec_19",title:"15. Discussions ",level:"1"},{id:"sec_19_2",title:"15.1. Testing hypothesis 1 (Primary outcome variable — HbA1c)",level:"2"},{id:"sec_20_2",title:"15.2. Testing Hypothesis 2 (Secondary outcome variable)",level:"2"},{id:"sec_22",title:"16. Ethical consideration ",level:"1"},{id:"sec_23",title:"17. Conclusion ",level:"1"}],chapterReferences:[{id:"B1",body:'American Diabetes Association (2000Clinical practice recommendations 2000. Diabetes Care 23 (Suppl. 1):S1S116, 2000.'},{id:"B2",body:'American Diabetes Association (2006Standards of medical care in diabetes. Diabetes Care. 29 (suppl. 1): S4S42.'},{id:"B3",body:'AnsariR. M2009Effect of physical activity and obesity on type 2 diabetes in middle-aged population. 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STerryC. Wet al1984Effects of labelling on income, work and social function among hypertensive employees. Journal of Chronic Disease, 37417423'},{id:"B39",body:'KahnE. BRamseyL. TBrownsonR. Cet al2002The effectiveness of interventions to increase physical activity: a systematic review. Am J Prev Med. 2273107'},{id:"B40",body:'KaplanR. MGaniatsT. GSieberW. J1998The quality of well being scale: Critical similarities and differences with SF-36. International Journal of Quality of Health Care. 10509520'},{id:"B41",body:'KaplanR. Mand ToshimaM. T1990The functional effects of social relationships on chronic illness and disability. In Sarason, BS, Sarason, I.G and Pierce, G.R (eds). Social Support: An International View, Wiley, New York, 427453'},{id:"B42",body:'KingD. KGlasgowR. EToobertD. Jet al2010Self-efficacy, problem solving, and social environment support are associated with diabetes self-management behaviours. Diabetes Care 33751753'},{id:"B43",body:'KirmayerL. 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NCacioppoJ. TKiecolt-glaserJ. K1996Relationship between social support and physiological processes: A review with emphasis on underlying mechanisms and implications for health. Psychol. Bull. 119488531\n\t\t\t'},{id:"B66",body:'WagnerE. H1998Chronic disease management: What will it take to improve care for chronic illness? Effective Clinical Practice. 114'},{id:"B67",body:'WagnerE. HAustinB. TVon KorffM1996Organizing care for patients with chronic illness. Milbank Q. 74511544'},{id:"B68",body:'WagnerE. HGlasgowR. EDavisCet al2001Quality improvement in chronic illness care: a collaborative approach. Jt Comm J Qual Improv. 2001; 276380'},{id:"B69",body:'WeeramanthriTHendySConnorsCAshbridgeDet al2003The Northern Territory Preventable Chronic Disease Strategy- promoting an integrated and life course approach to chronic disease in Australia. Australian Health Review 2633142\n\t\t\t'},{id:"B70",body:'WarehamN. JByrneC. DWilliamsRet al1999Fasting proinsulin concentrations predict the development of type 2 diabetes. Diabetes Care, 22262270\n\t\t\t'},{id:"B71",body:'WeinbergerMKirkmanM. ASamsaG. Pet al1995A nurse-coordinated intervention for primary care patients with non-insulin-dependent diabetes mellitus: impact on glycemic control and health-related quality of life. J Gen Intern Med. 105966'},{id:"B72",body:'WHO Expert Consultation (2004Appropriate body-mass index for Asian populations and its implications for policy and intervention. Lancet. 36315763'},{id:"B73",body:'WilliamsRHermanWKinmonthA. Let al2002Evidence Base for Diabetes Care. Wiley, Chichester.\n\t\t\t'},{id:"B74",body:'WongMHaswell-elkinsMTamwoyEet al2005Perspectives on clinic attendance, medication and foot-care among people with diabetes in the Torres Strait Islands and Northern Peninsula Area. Australian Journal of Rural Health 135172177'}],footnotes:[],contributors:[{corresp:null,contributorFullName:"Rashid M. Ansari",address:null,affiliation:'
School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Australia
'},{corresp:null,contributorFullName:"John B. Dixon",address:null,affiliation:'
School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Australia
'},{corresp:null,contributorFullName:"Colette J. Browning",address:null,affiliation:'
School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Australia
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1. Introduction
The term “psychosis” denotes a variety of mental disorders: the presence of delusions, various types of hallucinations, usually auditory or visual, but sometimes tactile or olfactory, and grossly disorganized thinking in a clear sensorium. Schizophrenia is an enduring, disabling psychiatric illness affecting about 1% of the population globally. It is characterized by various symptoms classified into positive, negative and cognitive) [1, 2].
Plants provide the essential nutrients and remedy needed by humans, they are healthier compared to animal diets. Over time much benefits have been derived from medicinal plants due to their rich natural phytochemicals that interact favorably with the human body and neurotransmitters to produce effects that are beneficial to man. In this chapter we will look at some medicinal plant used in the pharmacotherapy of psychosis.
2. Management of psychosis
Psychosis is an immense social and economic problem, but the management of psychosis remains insufficient. Basically typical and atypical antipsychotics are used for the treatment of schizophrenia, the typical antipsychotics such as chlorpromazine and haloperidol are only effective in the treatment of positive symptoms, and are accompanied by disturbing adverse effects such as extrapyramidal side-effects [3], the atypical antipsychotic drugs such as risperidone and olanzapine provide some beneficial effects on negative symptoms and cognitive deficits [4], but they are inadequate and mild. Prolonged use also results in increased oxidative load [5] which could lead to cardiovascular disorders, diabetes, and agranulocytosis seen with clozapine, they also cause moderate to severe weight gain [2, 6, 7, 8]. The use of medicinal plants as complementary remedies for the treatment of psychosis have become necessary because of their characteristically high chemical diversity, biochemical specificity, and several other properties that make them favorable lead structures for the treatment of various disorders, including psychosis [9], for example, Alpinia zerumbet (Pers.) B. L. Burtt (Zingiberaceae) [10], Lonchocarpus cyanescens (Schumach and Thonn.) Benth. (Fabaceae) [11] etc., which have been used in the pharmacotherapy of psychosis. Interestingly many of these plants were studied and found to have lesser side effects e.g. catalepsy [12, 13, 14, 15] indicating that these plants may not cause extrapyramidal side effects in humans.
Medicinal plants are either used as an alternative or in addition to orthodox medicine [16], users search for a more holistic approach to treatment, others expect that alternative medicines have less or no side-effects, and many with chronic mental health problems justifiably feel disappointed by the apparent ineffectiveness of conventional treatment [17].
3. Review of relevant pathophysiology
Neuropsychiatric Disorders may occur as a result of a number of factors such as genetic predisposition, lifestyle factors such as substance abuse and recently diet is also believed to be a factor [18] due to certain observations that associated incidence of psychotic episodes in neuropsychiatric diseases with poor dietary patterns, such as a lower intake of omega-3 fatty acids, vegetables, fibers, fruits, vitamins and minerals [19], all these are substances that can be obtained naturally supporting the use of natural products in psychosis especially because of the high antioxidant content of these natural products, since oxidative stress is implicated in psychosis.
4. Secondary metabolites in medicinal plants for psychosis
The discovery of effective plant-based medicinal plants for the treatment of psychosis is constrained by a need to conclusively identify relevant active constituents and understand synergies within them and an inability to sufficiently standardize replicable extracts.
A large number of natural phytochemicals are claimed to have beneficial effects on the adequate functioning of the human brain [20]. Essentially, metabolites produce effects on human brain function probably due to the connection between plant, mammalian biochemistry and molecular functioning. Principally, as a result of the numerous molecular signaling pathways that are conserved between taxa and their role in the synthesis of secondary metabolite [21]. Secondly the effects might be based on the similarities between the prevalent natural herbivores of plants and the nervous systems of humans. Therefore, the phytochemicals whose synthesis has been retained by a process of natural selection and on the basis of their ability to interact with the CNS of herbivorous or symbiotic insects will also interact with the human CNS system via the same mechanisms [22]. Some of the significance of secondary metabolites involve general protective roles (such as antioxidant, ultra violet (UV) light-absorbing, free radical-scavenging and antiproliferative agents) and preservation the plant against microorganisms such as bacteria, fungi, and viruses. More intricate actions involve dictating or modifying the plant’s relationship with more complex organisms [23, 24, 25]. This is achieved primarily by their role of feeding deterrence, consequently, many phytochemicals are bitter and/or toxic to potential herbivores, with this toxicity often extending to direct interactions with the herbivore’s central and peripheral nervous systems [26] identified extracts and constituents from 85 individual medicinal plants that have potential efficacy for treating psychiatric disorder. Accordingly, secondary metabolites often act as agonists or antagonists of neurotransmitter systems [25, 27] or form structural analogs of endogenous hormones [28].
Secondary metabolites can be subdivided into many distinct groups base on their chemical structure and synthetic pathways, furthermore, these groups can be broadly categorized in terms of the nature of their ecological roles and also their eventual effects and comparative toxicity in the consuming animal. The phytochemicals are herewith, discussed base on the chemical nature of their alleged active components. The largest and most widespread of phytochemical groups are the alkaloids, phenolic compounds and terpenes.
4.1 Alkaloids
Alkaloids are a structurally diverse group of over 12,000 cyclic nitrogen-containing compounds that are found in over 20% of plant species [29]. The use of alkaloids for medicinal purposes dates as far back as the Stone Age [20].
The alkaloids are known to be the common poisons, neurotoxins, and traditional psychedelics for example atropine, scopolamine, and hyoscyamine, from Atropa Belladonna plant and social drugs such as ephedrine, nicotine, opiates, cocaine, and caffeine widely consumed for recreational purposes [30]. Despite their posoinous nature, this group of chemicals also found application in the treatment of Alzheimer’s Disease, because of their cholinesterase inhibiting effects e.g. riverstigmine, huperzine, physostigmine, and huperzine [31].
Gentianine is a major alkaloid extracted from Swertia chirata Linn (Gentianaceae), it was reported to possess antipsychotic activity in experimental animals by antagonizing amphetamine induced stereotypy [32]. 11-demethoxyreserpiline, 10- demethoxyreserpiline, α-yohimbine and reserpiline are alkaloids isolated from the leaves of Rauwolfia tetraphylla and are found to possess atypical antipsychotic-like actions [33]. alstonine an indole alkaloid isolated from Picralima nitida Alstonine was found to possess antipsychotic properties [34, 35].
4.2 Phenolic compounds
Phenolic compounds are universally found across the plant kingdom, with approximately 10,000 structures identified to date. Phenolics are synthesized from precursors produced by the phenylpropanoid pathway with the exception of a few notable compounds. Structurally, they share at least one aromatic hydrocarbon ring with one or more hydroxyl groups attached [22].
Phenolic compounds comprise of simple low-molecular weight compounds, such as the coumarins, simple phenylpropanoids, and benzoic acid derivatives, to more complex structures such as flavanoids, tannins and stilbenes [22]. These compounds play an important role in CNS functioning by interacting directly with neurotransmitter systems. In in vivo models, phenolics enhance cognition through antagonistic gamma-aminobutyric acid (GABA) receptor binding, with resultant cholinergic upregulation and exert antidepressant effects via monoamine oxidase inhibition in the brain, sedative, anxiolytic and antipsychotic effects by binding to GABA receptors, [36, 37, 38]. Flavonoids are widely distributed throughout the plant kingdom. They are constituents of medicinal plants used as herbal medicines in traditional medical practice, and are now considered valuable therapeutic agents in modern medicines [39, 40]. Many studies have reported that flavones modulate neurotransmission through enhancement of GABA activity in the central nervous system; which led to the hypothesis that they could exert tranquilizing effects in behavioral hyperactivity such as schizophrenia [41, 42]. Undeniably, a number of evidences have implicated the role of altered GABAergic transmission in the pathophysiology of schizophrenia [43, 44]. Morin a flavonoid isolated from plants was found to exhibit antipsychotic effects [45].
4.2.1 Tannins
Tannins are a group of plant secondary metabolites that have the ability to tan or convert animal skin into leather. These compounds are classified as being water soluble phenolics with the ability to precipitate alkaloids, gelatins, and other proteins. High tannin concentrations are found in nearly every part of many plants, such as in the bark, wood, leaves, fruit, roots, plant galls, and seed. Tannins may exert their biological effects in two different ways: as unabsorbables, these are usually complex structures with binding properties which may produce local effects in the gastrointestinal tract (antioxidant, radical scavenging, antimicrobial, antiviral, antimutagenic, and antinutrient effects), or as absorbable, these are usually low molecular weight structures which are easily absorbed, and produce systemic effects in various organs [46]. Gallic acid, a gallotanin found in many plants was reported to demonstrate anti-schizophrenic activity primarily due to its antioxidant and anti-inflammatory effects [47]. A novel tannin composition effective in treating mental diseases such as acute or chronic schizophrenia, was isolated from Rhubarb (Rhe; Rhi zoma) a kind of crude drug known from the past and has been frequently used as a Japanese-Chinese medicine [48].
4.2.2 Saponins
Saponins are naturally occurring, but functionally and structurally diverse phytochemicals that are broadly distributed in plants. They are a complex and chemically varied group of compounds consisting of triterpenoid or steroidal glycones linked to oligosaccharide moieties. Although there is a scarce documentation on the antipsychotic potential of saponin, polygalasaponins, a saponin isolated from Polygalae tenuifolia was reported to possessed antipsychotic effects [49].
4.3 Terpenes
Terpenes are a diverse group of more than 30,000 lipid-soluble compounds. Their structure includes 1 or more 5-carbon isoprene units, Terpenoids are classified base on the number of isoprene units they contain; isoprene, which itself is synthesized and released by plants, comprises 1 unit and is classified as a hemiterpene; monoterpenes incorporate 2 isoprene units, sesquiterpenes incorporate 3 units, diterpenes comprise 4 units, sesterpenes include 5 units, triterpenes incorporate 6 units, and tetraterpenes 8 units [22]. Some of the recognized antipsychotic terpenoids are myrcene, beta-caryophyllene and limonene. However, these terpenoids do not only have antipsychotic properties but possess anti-depressant effects due to the suppression and activation of the cannabinoid receptor 2 [20].
5. Review of medicinal plants for psychosis
Many medicinal plants are in use both in developed and developing countries for the treatment of psychosis, some of these plants have been studied for their antipsychotic properties whereas most of these plants have no scientific backings for their efficacy. Literature search of the PUBMED and Sciencedirect journals have documented a number of plants studied for their antipsychotic properties in laboratory animals, however, most of the studies carried out are preliminary, and the need for further studies to isolate the active constituents, determine the mechanism of action and conduct clinical trials to verify their efficacy and safety is necessary. Table 1 gave a list of some of the reviewed antipsychotic plants, their constituents and probable mechanism of action.
Plant name
Parts used
Constituents and effects
Probable mechanism of action
Author
Albizia zygia (DC.) J.F. Macbr. (Leguminosae)
Roots
The root extract of Albizia zygia is used to manage mental disorders in African traditional medicine. Some of the phytochemical constituents are flavonoids, alkaloids, tannins and saponins. The extract exhibited an antipsychotic-like activity in mice with potential to alleviate positive, negative and cognitive symptoms of schizophrenia.
The possible mechanism of action of Albizia zygia may be related to enhancement of N-methyl-D-aspartate (NMDA) receptors located on inhibitory GABAergic neurons.
The essential oil was extracted from the leaves of Alpinia zerumbet, the major constituents are 1,8-cineole and terpinen4-ol which may be responsible for the antipsychotic effects observed from the plant.
The possible mechanism of action might be due to antioxidant effects as well as enhancing NMDA neurotransmission.
Alstonia scholaris is used widely in the treatment of anxiety, depression and other mental illnesses. The plant was found to possess antipsychotic effects.
Mechanism of action may be attributed to dopamine antagonism in the frontal cortical regions of the brain.
Triterpenoid, saponins, and bacosides are considered to be the major constituents in the plant. Bacopa monniera has been reported to possess antipsychotic, anxiolytic and other medicinal properties.
The antipsychotic properties may be related to its normalization of dopamine and serotonergic neurotransmission and reduction of acetylcholinesterase activity.
Brassica oleracea possess excellent phytoconstituents such as flavonoids and polyphenols and is widely used as dietary supplements. It has antioxidant and anti-inflammatory properties, and was found to possess antipsychotic properties.
Brassica oleracea increase GABA levels resulting in the control of dopaminergic neurotransmission which may be its possible mechanism of action.
Cannabidiol one of the major constituent of Cannabis sativa leaves possesses atypical antipsychotic-like properties in humans and laboratory animals.
The possible mechanism of C. sativa may be due to enhancement of NMDA receptors located on inhibitory GABAergic neurons in the limbic and subcortical brain regions.
Crassocephalum bauchiense is a medicinal herb effective in the cases of cerebral deficit, anxiety, epilepsy, cerebral malaria, neuropathic pain, and behavioral disturbances in mentally retarded children. The plant contains alkaloid that was found to possess promising antipsychotic properties.
The antipsychotic properties are possibly mediated via the GABAergic neurotransmission as well as blockade of dopamine D-2 receptors
alkaloids, saponins and tannins were found to be some of the major constituents of Crinum giganteum, the plant is used traditionally for various medicinal purposes including psychiatric illnesses. The extract of C. giganteum was found to possess antipsychotic effects in laboratory animals
The possible mechanism of action of Crinum giganteum may be limited to dopamine D1 antagonism.
The major constituent in Desmodium adscendens is alkaloid, it is a medicinal herb with several uses including psychosis. The extract was found to possess antipsychotic effects against apomorphine induced climbing and stereotypic behavior.
The possible mechanism of action may be due to dopamine receptor antagonism
Embelin was isolated from Embelia ribes and found to be responsible for the antipsychotic effect of the plant. Embelin reversed apomorphine induced stereotypic behavior, confirming its antipsychotic potential.
Embelin action may be due dopamine antagonism and decreased level of neurotransmitters such as dopamine, serotonin and noradrenaline as well as antioxidant effects.
Guiera senegalensis is rich in tannin and known to possess varying medicinal effects. The extracts attenuated amphetamine-induced stereotyped behavior in mice suggesting that the plant possess antipsychotic properties that can be useful as a safe alternative.
The effect of the extract amphetamine-induced stereotyped behavior in mice suggest anti-dopaminergic actions on the limbic system
Lonchocarpus cyanescens (Schumach and Thonn.) Benth. (Fabaceae)
Leaves
Lonchocarpus cyanescens is reputed for its used in traditional medicine for the treatment of Psychosis. Studies have shown that Lonchocarpus cyanescens contains various active principles such as quercetin, kaempferol, loncocarpin, and rhamnetin which may be responsible for its antipsychotic activity. Lonchocarpus cyanescens was found to possess antipsychotic properties.
The probable mechanism of action of Lonchocarpus cyanescens might be due to antidopaminergic effects.
Triterpenes has been identified in Maytenus obtufisolia, it is known that terpenes have pharmacological actions on animal behavior. Findings revealed the antipsychotic effects of M. obtufisolia
The probable mechanism of action of Maytenus obtufisolia might be via a central dopaminergic action
scopoletin, rutin and quercetin are the major constituents of Morinda citrifolia. The plant has so many Uses for CNS disorders. The fruit juice was found to possess antipsychotic properties.
The probable mechanism of antipsychotic effect of M. citrifolia extract is attributed to antidopaminergic activity.
Saponins are present in abundance in the extract and might contribute in part for the observed CNS effects. The extract demonstrated antipsychotic effects by attenuating apomorphine induced stereotypic behavior
The effect of the extract against apomorphine is suggestive of possible interference with central dopaminergic neurotransmission.
Newbouldia laevis is a medicinal plant used in the treatment of various ailments. The plant contains alkaloids and saponins which might be responsible for its neuroleptic effects. The extract of N. laevis was found to possess antipsychotic effects.
The probable mechanism of action might be due to dopamine D1 and D2 antagonism.
Ocimum sanctum have been reported for their pharmacological actions including anti-oxidant, anti-stress, and anticonvulsant. The plant contains flavonoids, essential oil, Caffeic acid and vitamins. Ocimum sanctum leaves possesses anti-psychotic like property.
The Probable mechanism of action include antioxidant action and enhancement of NMDA neurotransmission as well as neuroprotection.
The plant’s major compound is ginseng which is known to possess numerous pharmacological effects. Panax quinquefolium extract was effective against negative and cognitive dysfunctions induced by ketamine
The antipsychotic properties may be related to its normalization of dopamine and serotonergic neurotransmission and reduction of acetylcholinesterase activity.
Picralima nitida Stampf Th. et H.Dur. (Apocynaceae)
Fruits
alstonine an indole alkaloid isolated from Picralima nitida a plant commonly used by traditional psychiatrist as part of the treatment of psychosis. Alstonine was found to possess antipsychotic properties experimental profile comparable with that of clozapine and is compatible with the alleged effects in mental patients.
Alstonine indirectly modulates DA receptors, specifically by modulating DA uptake, it also decreases glutamate uptake in acute hippocampal slices. Alstonine also increases serotonergic transmission and increases intraneuronal dopamine catabolism.
Piper guineense is a medicinal plant used in the Southern States of Nigeria to treat fever, mental disorders and febrile convulsions. β-sesquiphellandren is an essential oil isolated from the plant and was found to possess antipsychotic effects.
The antipsychotic activity may be mediated through augmentation of GABA at the GABAA–benzodiazepine receptor complex pathway, or inhibition of dopamine neurotransmission at dopamine D1/D2 receptors
Polygala tenuifolia Willdenow has been prescribed for hundreds of years to treat psychotic illnesses in Korean traditional medicine. Studies have found polygasaponin to be the major constituent responsible for its antipsychotic effect.
polygalasaponin molecular mechanism of action is dopamine (D2) and serotonin (5HT2) receptor antagonism
Rauwolfia tetraphylla L. (Syn. R. canescens/R. heterophylla/ R. hirsuta; (Apocynaceae)
Leaves
11-demethoxyreserpiline, 10- demethoxyreserpiline, α-yohimbine and reserpiline are alkaloids isolated from the leaves of Rauwolfia tetraphylla and are found to possess atypical antipsychotic-like actions
The mechanism of action of the plant is due to the blockade of dopamine (D2) and serotonin (5HT2) receptor.
The extracts of R. rosea are used in traditional medicine for various conditions related to nervous system function. Studies has shown that the extract has beneficial antipsychotic properties.
The probable antipsychotic mechanism of R. rosea is due to reversal of prepulse inhibition deficits in laboratory rodents.
Saururus cernuus has been used in folk medicine as a sedative and to treat other illnesses. Manassantin A. a neolignoid isolated from Saururus cernuus was found to demonstrate neuroleptic activity
The antipsychotic effect of Saururus cernuus may be due to weak antagonism of dopamine receptors.
Securinega virosa has been described as “cure all” in Africa traditional medicine because of its use widely in the treatment of many illnesses. The plant contains saponins, flavonoids, alkaloids and tannins, and was found to possess antipsycotic activity
The probable mechanism of action may be due to dopamine D1 and D2 antagonism.
Spinacia oleracea is reported to have beneficial effect against several neurodegenerative disorders. Phytoconstituents such as ascorbic acid, apigenin, astragalin, caffeic, lutein, β-carotene, ferulic acid, kampeferol, rutin, querecetin were isolated from the plant. The seed extract of Spinacia oleracea showed antipsychotic activity.
Spinacia oleracea’s protective effect in schizophrenia may be associated with its regulating effect on dopamine, GABA, acetylcholinesterase, glutathione, malondialdehyde levels
Spondias mombin is a medicinal plant widely use in the treatment of various ailments including mental illness. The extract contains tannins, flavonoids and saponins as its major constituents. S. mombin possess typical antipsychotic-like effects.
The antipsychotic mechanism of S. mombin may be due to dopaminergic receptor antagonism.
Gentianine is a major alkaloid isolated from Swertia chirata and was found to possess antipsychotic properties by antagonizing amphetamine induced stereotypy.
It probable mechanism of action might be due to dopamine antagonism.
The extract of the whole plant has demonstrated anticonvulsant, sedative, in vitro antioxidant and free radical scavenging properties as well as antinociceptive properties in acute and neuropathic pain. Synedrella nodiflora also possess antipsychotic properties.
The probably mechanism of the antipsychotic properties of Synedrella nodiflora might be due to central dopamine receptor antagonism.
The plant contains Flavonoids, saponins and tannins in abundance which may be responsible in part for the observed activities. T. macroptera has been used traditionally for the treatment of hallucinations, and has also being found to possess antipsychotic properties in the ketamine-induced psychosis model.
T. macroptera possible mechanism of action may be due to enhancement of NMDA receptors located on inhibitory GABAergic neurons in the limbic and subcortical brain regions and also its antioxidant properties.
Viscum album is claimed in traditional medical practice, to be useful in the treatment of psychosis and insomnia. Some of the major constituents of the extract are flavonoids and tannins. V. album was found to possess antipsychotic properties.
The mechanism of action of Viscum album maybe due to dopamine antagonism.
Some medicinal plants, their constituents, effects and probable mechanisms of action.
6. Efficacy of natural plants in the treatment of psychosis
Many medicinal plants studied for psychosis were found to have efficacy against the positive, negative and cognitive deficit of schizophrenia in laboratory animals, without the disturbing adverse effects seen with conventional antipsychotic drugs. Even those that are thought to act on the dopamine receptors had minimal or no cataleptic tendencies. The tendency for these plants to ameliorate the negative symptoms in schizophrenia, and in some cases also improve psychotic symptoms, may be owing to the ability of most plants to generally exert anti-inflammatory effects [71] and given that inflammation is a risk factor in most neuropsychiatric disorders including schizophrenia [72]. Oxidative stress is also a major factor in psychosis, plants contain diverse constituents which exhibit antioxidant, and neuroprotective effects useful in ameliorating psychotic symptoms [67].
Large number of schizophrenic patients fail to respond adequately to the initial antipsychotic drug treatment necessitating the addition of natural antipsychotic plants to their treatment regimen. As recently reviewed by Hoenders et al. [73] the inclusion of traditional medicine or Ayurvedic herbs to antipsychotics, generally improve the psychopathology of the disease, however, more studies are needed to conclusively support this finding.
7. Molecular mechanisms of antipsychotic action of medicinal plants
Many medicinal plants have been studied for their antipsychotic properties and several mechanisms of action have been proposed for their actions. A number of these plants were believed to act in a similar manner as orthodox medicines but in most cases without the disturbing adverse effects. Table 1 gave a summary of the probable antipsychotic mechanism of action of the medicinal plants. Various animal models are used to investigate the antipsychotic properties of medicinal plants, some of these models help to determine whether these plants have typical or atypical antipsychotic like effects.
Dopaminergic deregulation, hypofunction of NMDA receptors and GABAergic activity, diminished cholinergic firing, neuroinflammation and increased oxidative stress has been demonstrated to play a pathophysiological role in schizophrenia [67].
The dopamine and amphetamine animal models are basically used to study the typical antipsychotic effects of drugs, their action are similar to the conventional antipsychotics such as haloperidol, chlorpromazine, fluphenazine and thioridazine. The stereotypic behavior observed in animals following the administration of apomorphine a dopaminergic agonist, are attributed to stimulation of D1 and D2 receptors [74, 75]. Mesolimbic and nigrostriatal dopaminergic pathways play key roles in the mediation of locomotor activity and stereotyped behavior. Animal models used for assessing antipsychotic drugs are established on the neurochemical hypothesis of schizophrenia, which involve largely the neurotransmitters dopamine and glutamate [76]. The antagonism of dopamine D2 receptors in the mesolimbic-mesocortical system is thought to be the basis of the therapeutic actions of the antipsychotic drugs, especially those active against hallucinations and delusions [77]. The dopamine-based models usually employ apomorphine, a direct agonist, or amphetamine, a drug that increases the release of this neurotransmitter and blocks its re-uptake.
The term atypical refers to the reduced propensity of the of an agent to cause undesirable motor side effects, but it is also used to describe agents with a different pharmacological profile from the typical antipsychotics; several of these newer antipsychotics improve the negative as well as the positive symptoms [78]. The atypical antipsychotics are categorized base on their pharmacological properties. These include serotonin–dopamine antagonists, multi-acting receptor- Targeted antipsychotics, and dopamine partial agonists. [79]. Examples include clozapine, quetiapine, risperidone, amisulpride, sertindole, zotepine and aripiprazole. The dopamine dysregulation with hyperfunction of the mesolimbic dopamine system was the original tenet theory underlying the basis of schizophrenia [80] and the earliest animal models were established on the basis of pharmacological manipulation in an endeavor to simulate this feature [81], which respond to agents that affect primarily the dopaminergic system, but does not demonstrate the negative or cognitive symptoms seen in schizophrenia [82]. In contrast, a widely used animal model of schizophrenia involves the acute or repeated administration of sub-anesthetic doses of ketamine [83]. In rodents, N-methyl-Daspartic acid receptor (NMDAR) blockade induces hyperactivity, stereotypy, deficits in prepulse inhibition [84], social interaction and memory (Becker and Grecksch [85]), which models the positive, negative and cognitive symptoms of schizophrenia, respectively [9]. Furthermore, studies have revealed that reactive oxygen species have a significant role in the pathogenesis of many illnesses, particularly neurological and psychiatric illnesses. [86] Oxidative stress may be a common pathogenic mechanism underlying many major psychiatric disorders as the brain is relatively susceptible to oxidative damage [87]. Previous study confirmed that oxidative stress damage occurs in patients with schizophrenia and one possible therapeutic solution is to use antioxidants [88]. Reports from some of the medicinal plants studied that delineate some of the animal models used and their molecular mechanism of action are highlighted.
7.1 Morinda citrifolia Linn (Rubiaceae)
Morinda citrifolia (noni) is an evergreen tree that grows in open coastline areas at sea level and in forest regions. Four doses (1, 3, 5, 10 g/kg) of the fruit extract of noni were administered prior to apomorphine/ amphetamine administration and observed for climbing behavior and stereotypy. The extract significantly decreased the apomorphine-induced cage climbing behavior and climbing time in mice in a dose dependent manner. Demonstrating the antidopaminergic effect of the plant. The plant was found to be rich in rutin and scopoletin which might have played a role in the antipsychotic mechanism [60].
7.2 Securinega virosa (Roxb ex. Willd) Baill
Securinega virosa is a medicinal plant commonly used in Africa in the management of epilepsy and other mental illnesses. The antipsychotic prospect of the residual aqueous fraction of the plant was assessed by means of the apomorphine induced stereotypic climbing behavior model and the swim induced grooming model, all in mice. The effect of the fraction on haloperidol-induced catalepsy was also assessed. The fraction inhibited the grooming behavior and attenuated the climbing behavior of the mice. These action of S. virosa extract was associated to its involvement with the dopamine D1 receptor. Therefore, the study confirmed the antipsychotic potential of S. virosa in traditional medicine [66]. The observed effects were ascribed to the presence of alkaloid, saponin, flavonoid and tannin in the leaves.
7.3 Picralima nitida Stampf Th. et H. Dur.
Picralima nitida is the only species of the genus Picralima and it is related to Hunteria and Pleiocarpa. it belongs to the apocynaceae family. P. nitida has widely varied applications in West Africa folk medicine. The indole alkaloid alstonine was identified as the major component of the fruit rind of P. nitida, a plant-based treatment administered to psychotic patients in Nigeria [34]. Alstonine was given prior to apomorphine/ amphetamine administration and observed for climbing behavior and stereotypy, the effect of the alkaloid on haloperidol-induced catalepsy was also assessed [89]. Further studies of alstonine showed a clear antipsychotic profile in rodents, closer to atypical than to typical antipsychotics. Apparently, apomorphine induced stereotypy and amphetamine-induced lethality were significantly reduced by alstonine, suggesting a decrease in mesolimbic dopamine, alstonine reversed haloperidol-induced catalepsy, indicating that nigrostriatal dopamine transmission is not lessened [89]. Alstonine was found to reduce negative symptoms, through a mechanism involving 5HT2A,C receptors, and reverses interaction deficits induced by MK801 [90]. Further studies by Linck et al. [35] indicated that alstonine indirectly modified DA receptors, precisely by modifying DA uptake. This unique mechanism for DA transmission modulation backs the antipsychotic-like effects of alstonine and is attuned with its behavioral profile in mice and apparent effects in patients. These findings may signify an innovation in the antipsychotic development field [35].
7.4 Panax quinquefolium Linn
Panax quinquefolium is a native plant of North America, but is now cultivated widely and used in many countries. The plant contains dammarane type ginsenosides as the major biologically active constituents particularly Rb1, Rd. and Re ginsenoside saponins [91] which are responsible for most of its bioactive properties. A graded dose study with P. quinquefolium revealed differential effects against the ketamine induced hyperactivity in the Digiscan animal activity monitor, and blocked ketamine induced memory impairment in the passive avoidance paradigm. In the chronic studies, P. quinquefolium attenuated the ketamine-enhanced immobility in the forced swim test and did not produce extra-pyramidal side effects in bar test and wood block test of catalepsy. These behavioral effects were compared with standard drugs haloperidol and clozapine. P. quinquefolium was also found to reduced DA and 5-HT content after prolonged treatment. Furthermore, P. quinquefolium extract reduced acetylcholinesterase activity and nitrate levels, conversely it increased glutamate levels in hippocampus. Ultimately, the study revealed that P. quinquefolium possess antipsychotic like properties, which may be beneficial in predominant negative and cognitive symptoms of schizophrenia [9].
7.5 Spinacia oleracea Linn
Spinacia oleracea commonly known as spinach is endowed with a number of medicinal properties [92]. Ethnopharmacological studies proposed that Spinacia oleracea seeds have promising antioxidant, neuroprotective, anti-epileptic, anti-alzheimer and anti-inflammatory effects [93, 94, 95]. The study evaluated the protective effects of Spinacia oleracea seed extract in an experimental model of ketamine-induced schizophrenia in mice. Ketamine was used to induce stereotyped psychotic symptoms in mice. Behavioral studies (locomotor activity, stereotypy, immobility duration and memory retention) were carried out followed by biochemical, neurochemical and cellular alterations in the brain. Chronic treatment with Spinacia oleracea seed extract significantly attenuated stereotyped behavioral symptoms in mice. Biochemical estimations revealed that the extract reduced lipid peroxidation and restored total brain proteins. Likewise, Spinacia oleracea remarkably reduced dopamine levels, acetylcholinesterase activity & inflammatory surge serum tumor necrosis factor (TNF-α) and increased the levels of GABA and reduced glutathione in mice. The results of the study indicated that the extract could ameliorate ketamine-induced psychotic symptoms in mice, signifying a protective effect in the treatment of schizophrenia. Moreover, its protective effect in schizophrenia may be associated with its regulating effect on dopamine, GABA, acetylcholinesterase enzymes, glutathione and malondialdehyde levels [67].
7.6 Terminalia macroptera Linn
Terminalia macroptera Guill. & Perr. (Combretaceae) is a medicinal plant used commonly in Africa. Ethnomedicinal report from Mali mentions the decoction of leaves of T. macroptera in treatment of epilepsy [96], and anxiolytic effects of T. macroptera has also been reported by [97]. The study was carried out to investigate the antipsychotic effects of T. macroptera in an experimental model of ketamine-induced psychosis in mice. Ketamine and apomorphine were used to induce stereotyped psychotic behavioral symptoms in mice. Behavioral studies (stereotype behavior, locomotor activity, immobility duration and memory retention) were carried out to investigate the protective effect of the ethyl acetate fraction of T. macroptera on ketamine-induced psychotic symptoms, repeated treatment with the ethyl acetate fraction for 7 consecutive days significantly attenuated stereotyped behavioral symptoms, immobility duration and memory deficit in mice. The study revealed that T. macroptera could ameliorate psychotic symptoms indicating protective effects in psychosis. Agent that ameliorate ketamine induced psychotic symptoms are generally thought to act in a similar manner as atypical antipsychotics [12].
7.7 Crassocephalum bauchiense (Hutch.) Milne-Redh
Crassocephalum bauchiense is a medicinal plant with diverse medicinal uses. The leaves decoction of C. bauchiense is effective in the treatment of epilepsy, cerebral malaria, cerebral deficit, anxiety and behavioral disturbances in mentally retarded children. Likewise, an aqueous extract of the whole plant is useful in the treatment of insomnia, psychosis and other central nervous system disorders, [98, 99]. The antipsychotic effects of C. bauchiense extracts were evaluated using the apomorphine animal model of psychosis. The ability of the leaves extracts of C. bauchiense to modify the duration of akinesia was observed in the catalepsy test. Furthermore, gamma-aminobutyric acid concentrations in the brain of treated mice were also estimated. The aqueous extract and the alkaloid fraction of C. bauchiense attenuated the apomorphine-induced stereotypy and fighting, and had significant fall of the body temperature. In biochemical experiments, the concentration of the inhibitory amino acid, gamma-aminobutyric acid, was significantly increased in the brain of animals treated with the aqueous extract of C. bauchiense. The results revealed that the antipsychotic and sedative properties of C. bauchiense are possibly mediated via the blockade of dopamine D-2 receptors and GABAergic activation [54].
7.8 Alpinia zerumbet (Pers.) Burtt. et Smith
Alpinia zerumbet has important physiological and pharmacological functions, such as antioxidative [100], anticancer [101], anti-inflammatory [102], and antianxiety [103]. In phytotherapy, A. zerumbet is used to treat neuropsychiatric symptoms such as depression, stress and anxiety, but it is only recently that the central nervous system (CNS) effects of the essential oil from the plant leaves have been studied [10]. The essential oil of A. zerumbet (50, 100 and 200 mg/kg i.p.) was administered once to mice to evaluate antipsychotic activity assessed by ketamine-induced hyperlocomotion, hypnotic activity induced by sodium pentobarbital, antioxidant effects (determination of lipid peroxidation and GSH levels), as well as variations in nitric oxide levels (determination of nitrite content). The result revealed that the extract at doses of 100 and 200 mg/kg prevented ketamine hyperlocomotion, and at a dose of 200 mg/kg decreased sleep latency, while all doses increased sleeping time. The in-vitro antioxidant capacity of the oil caused a reduction in lipid peroxidation and increase in glutathione levels. The extract also prevented the decrease in nitrite content caused by oxidative stress. The findings indicate antipsychotic and antioxidant effects of the essential oil of A. zerumbet that may have promising efficacy for the treatment of schizophrenia [10].
7.9 Albizia zygia (DC.) J.F. Macbr. (Leguminosae)
Albizia zygia is one such plant with numerous medicinal uses. A decoction of the roots is used for the treatment of insanity [104]. Several compounds including two novel oleanane-type saponins, zygiaosides A and B, were lately isolated from the roots of A. zygia [105].
A. zygia effects were assessed against apomorphine-induced cage climbing, ketamine induced hyperlocomotion, −enhanced immobility, −impaired social interaction as well as novel object recognition. The propensity of the extract to induce catalepsy and to attenuate haloperidol-induced catalepsy were also investigated. Findings revealed that A. zygia extract significantly attenuated apomorphine-induced climbing behavior as well as ketamine-induced hyperlocomotion, immobility and object recognition deficits. Furthermore, the extract had no cataleptic effect. The root extract of A. zygia therefore exhibited antipsychotic-like activity in mice with potential to alleviate positive, negative and cognitive symptoms of schizophrenia [51].
8. Conclusions
Plants have been the mainstay for the treatment of diseases all over the world before the development of conventional medicines. The interest in the therapeutic uses of plants have been revived due to obvious reasons such as their safety, availability, and affordability as well as their efficacy. Research on medicinal plant have provided evidences for their use, and further studies in order to isolate the active constituents and also to test them in clinical studies is important for the development of new pharmacotherapies for psychosis.
Acknowledgments
The authors acknowledge all sources, and are grateful to the authors/editors of all the articles, journals, and books from where the literature for this article has been reviewed.
Conflict of interest
The authors declare no conflict of interest.
\n',keywords:"Medicinal plants, Molecular mechanisms, Psychosis, Secondary metabolites, Antipsychotics",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/78790.pdf",chapterXML:"https://mts.intechopen.com/source/xml/78790.xml",downloadPdfUrl:"/chapter/pdf-download/78790",previewPdfUrl:"/chapter/pdf-preview/78790",totalDownloads:147,totalViews:0,totalCrossrefCites:0,dateSubmitted:"May 13th 2021",dateReviewed:"August 31st 2021",datePrePublished:"November 11th 2021",datePublished:null,dateFinished:"September 28th 2021",readingETA:"0",abstract:"Substantial number of studies has been conducted to find alternatives or treatments for psychosis. Psychosis represents a variety of mental disorders characterized by the presence of delusions, hallucinations and grossly disorganized thinking in a clear sensorium. Psychosis is burdensome and difficult to treat given the inability of the typical and atypical antipsychotics to adequately manage it, accompanied by numerous disturbing adverse effects. Therefore, many with chronic mental health problems justifiably feel disappointed by the apparent ineffectiveness of conventional treatment and naturally search for a more holistic approach to treatment and alternative medicines having less or no side-effects. Plants are rich in secondary metabolites which have the ability to interact with the Central nervous system (CNS) to produce effects that can be beneficial for the management of psychosis, these phytochemicals are believed to have minimal adverse effects. A review of some of the medicinal plants used as antipsychotics, indicated that many medicinal plants possess antipsychotic effects that can improve the treatment of psychosis. Apparently, further studies are necessary in order to isolate the active constituents, ascertain their molecular mechanisms and safety, and also to test them in clinical studies for the development of new pharmacotherapies for psychosis.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/78790",risUrl:"/chapter/ris/78790",signatures:"Sunday Oritsetimenyin Otimenyin and Lydia Doosuur Ior",book:{id:"11042",type:"book",title:"Complementary Therapies",subtitle:null,fullTitle:"Complementary Therapies",slug:null,publishedDate:null,bookSignature:"Dr. Mario Bernardo-Filho, Redha Taiar, Danúbia Da Cunha De Sá-Caputo and Dr. Adérito Seixas",coverURL:"https://cdn.intechopen.com/books/images_new/11042.jpg",licenceType:"CC BY 3.0",editedByType:null,isbn:"978-1-83969-012-9",printIsbn:"978-1-83969-011-2",pdfIsbn:"978-1-83969-013-6",isAvailableForWebshopOrdering:!0,editors:[{id:"157376",title:"Dr.",name:"Mario",middleName:null,surname:"Bernardo-Filho",slug:"mario-bernardo-filho",fullName:"Mario Bernardo-Filho"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:null,sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Management of psychosis",level:"1"},{id:"sec_3",title:"3. Review of relevant pathophysiology",level:"1"},{id:"sec_4",title:"4. Secondary metabolites in medicinal plants for psychosis",level:"1"},{id:"sec_4_2",title:"4.1 Alkaloids",level:"2"},{id:"sec_5_2",title:"4.2 Phenolic compounds",level:"2"},{id:"sec_5_3",title:"4.2.1 Tannins",level:"3"},{id:"sec_6_3",title:"4.2.2 Saponins",level:"3"},{id:"sec_8_2",title:"4.3 Terpenes",level:"2"},{id:"sec_10",title:"5. Review of medicinal plants for psychosis",level:"1"},{id:"sec_11",title:"6. Efficacy of natural plants in the treatment of psychosis",level:"1"},{id:"sec_12",title:"7. Molecular mechanisms of antipsychotic action of medicinal plants",level:"1"},{id:"sec_12_2",title:"7.1 Morinda citrifolia Linn (Rubiaceae)",level:"2"},{id:"sec_13_2",title:"7.2 Securinega virosa (Roxb ex. Willd) Baill",level:"2"},{id:"sec_14_2",title:"7.3 Picralima nitida Stampf Th. et H. Dur.",level:"2"},{id:"sec_15_2",title:"7.4 Panax quinquefolium Linn",level:"2"},{id:"sec_16_2",title:"7.5 Spinacia oleracea Linn",level:"2"},{id:"sec_17_2",title:"7.6 Terminalia macroptera Linn",level:"2"},{id:"sec_18_2",title:"7.7 Crassocephalum bauchiense (Hutch.) Milne-Redh",level:"2"},{id:"sec_19_2",title:"7.8 Alpinia zerumbet (Pers.) Burtt. et Smith",level:"2"},{id:"sec_20_2",title:"7.9 Albizia zygia (DC.) J.F. Macbr. (Leguminosae)",level:"2"},{id:"sec_22",title:"8. Conclusions",level:"1"},{id:"sec_23",title:"Acknowledgments",level:"1"},{id:"sec_26",title:"Conflict of interest",level:"1"}],chapterReferences:[{id:"B1",body:'Bhugra D (2005) The global prevalence of schizophrenia. PLoS Med 2:e151 quiz e175'},{id:"B2",body:'Reus VI. Mental disorders. In: Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, Loscalzo J, editors. Harrison’s principles of internal medicine. McGraw-Hill, New York. 2008.'},{id:"B3",body:'Lieberman JA. 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Ciurean, Dagmar Schröter and Thomas Glade",authors:[{id:"163703",title:"Prof.",name:"Thomas",middleName:null,surname:"Glade",slug:"thomas-glade",fullName:"Thomas Glade"},{id:"164141",title:"Ph.D. Student",name:"Roxana",middleName:"Liliana",surname:"Ciurean",slug:"roxana-ciurean",fullName:"Roxana Ciurean"},{id:"164142",title:"Dr.",name:"Dagmar",middleName:null,surname:"Schroeter",slug:"dagmar-schroeter",fullName:"Dagmar Schroeter"}]},{id:"44219",doi:"10.5772/54973",title:"Disaster Management Discourse in Bangladesh: A Shift from Post-Event Response to the Preparedness and Mitigation Approach Through Institutional Partnerships",slug:"disaster-management-discourse-in-bangladesh-a-shift-from-post-event-response-to-the-preparedness-and",totalDownloads:4083,totalCrossrefCites:4,totalDimensionsCites:25,abstract:null,book:{id:"3054",slug:"approaches-to-disaster-management-examining-the-implications-of-hazards-emergencies-and-disasters",title:"Approaches to Disaster Management",fullTitle:"Approaches to Disaster Management - Examining the Implications of Hazards, Emergencies and Disasters"},signatures:"C. Emdad Haque and M. Salim Uddin",authors:[{id:"163390",title:"Dr.",name:"C. Emdad",middleName:null,surname:"Haque",slug:"c.-emdad-haque",fullName:"C. Emdad Haque"},{id:"168399",title:"Mr.",name:"Mohammed S",middleName:null,surname:"Uddin",slug:"mohammed-s-uddin",fullName:"Mohammed S Uddin"}]},{id:"60027",doi:"10.5772/intechopen.74964",title:"Corporate Governance in Downturn Times: Detection and Alert – The New Italian Insolvency and Crisis Code",slug:"corporate-governance-in-downturn-times-detection-and-alert-the-new-italian-insolvency-and-crisis-cod",totalDownloads:1190,totalCrossrefCites:6,totalDimensionsCites:9,abstract:"In its life cycle, an enterprise may experience periods of crisis. If the crisis is monitored promptly and appropriate measures are taken, not only may the enterprise continue to operate but it may also be able to seize opportunities for growth. The Italian legislator is introducing a procedure aimed at supporting companies to detect the very first warning signs of a crisis. The supervisory board of auditors, the audit firm, and certain qualified creditors will have the right and duty to start the early warning procedure (“allerta”). The board of statutory auditors (Collegio Sindacale) plays a fundamental role: its ex-ante supervisory and control activities over management allow it to effectively play an important role as main recipient of any crisis warning signs. The new regulatory framework lays down certain indicators and critical thresholds, which may trigger the alert process. Initially, the Delegated Legislation (Bill No.3671-bis) sets forth certain specific financial indicators. The new bill (Crisis and Insolvency Code) on the contrary refers to a more complex and sector-specific system of indicators. The findings of an empirical research conducted by analysing a sample of more than 600 enterprises and testing the discriminating capacity of the indicators initially considered are presented herein.",book:{id:"6620",slug:"crisis-management-theory-and-practice",title:"Crisis Management",fullTitle:"Crisis Management - Theory and Practice"},signatures:"Patrizia Riva, Alessandro Danovi, Maurizio Comoli and Ambra\nGarelli",authors:[{id:"230543",title:"Prof.",name:"Patrizia",middleName:null,surname:"Riva",slug:"patrizia-riva",fullName:"Patrizia Riva"},{id:"245409",title:"Prof.",name:"Alessandro",middleName:null,surname:"Danovi",slug:"alessandro-danovi",fullName:"Alessandro Danovi"},{id:"245410",title:"Prof.",name:"Maurizio",middleName:null,surname:"comoli",slug:"maurizio-comoli",fullName:"Maurizio comoli"},{id:"245411",title:"Dr.",name:"Ambra",middleName:null,surname:"Garelli",slug:"ambra-garelli",fullName:"Ambra Garelli"}]},{id:"44228",doi:"10.5772/55273",title:"The Implications of Post Disaster Recovery for Affordable Housing",slug:"the-implications-of-post-disaster-recovery-for-affordable-housing",totalDownloads:2134,totalCrossrefCites:5,totalDimensionsCites:9,abstract:null,book:{id:"3054",slug:"approaches-to-disaster-management-examining-the-implications-of-hazards-emergencies-and-disasters",title:"Approaches to Disaster Management",fullTitle:"Approaches to Disaster Management - Examining the Implications of Hazards, Emergencies and Disasters"},signatures:"Jacqueline McIntosh",authors:[{id:"162973",title:"Dr.",name:"Jacqueline",middleName:null,surname:"McIntosh",slug:"jacqueline-mcintosh",fullName:"Jacqueline McIntosh"}]},{id:"60813",doi:"10.5772/intechopen.76198",title:"Crisis Management: A Historical and Conceptual Approach for a Better Understanding of Today’s Crises",slug:"crisis-management-a-historical-and-conceptual-approach-for-a-better-understanding-of-today-s-crises",totalDownloads:4613,totalCrossrefCites:6,totalDimensionsCites:8,abstract:"We argue that the basic and contemporary concepts related to crisis management, especially in the communication field, share some similarities with what was practiced in ancient civilizations such as the importance of direct contact between the leadership and the public. Other similarities include the accurate diagnosis of the real causes of the crisis, the forbiddance of the dissemination of false news and the reassurance of the public opinion that there is a solution to the crisis, a sound management decision, and a good plan for its implementation. We link the past time crises to the contemporary era, providing a comparison framework. The history of crisis tends to show us that the study of crisis management cannot be linked to a specific civilization or era, especially when humanity had witnessed multiple and complex environmental, political, economic, and military crisis. Moreover, some of the problems and complex issues in the modern era are rooted in history. Thus, many geopolitical crises nowadays are the result of old causes. The study of crisis management from an academic point of view should be a multifaceted analysis, including a historical, a cultural, and an anthropological one, which determines the course of evolution and consequences of the crisis.",book:{id:"6620",slug:"crisis-management-theory-and-practice",title:"Crisis Management",fullTitle:"Crisis Management - Theory and Practice"},signatures:"Khaled Zamoum and Tevhide Serra Gorpe",authors:[{id:"230918",title:"Prof.",name:"T. Serra",middleName:null,surname:"Gorpe",slug:"t.-serra-gorpe",fullName:"T. 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Other similarities include the accurate diagnosis of the real causes of the crisis, the forbiddance of the dissemination of false news and the reassurance of the public opinion that there is a solution to the crisis, a sound management decision, and a good plan for its implementation. We link the past time crises to the contemporary era, providing a comparison framework. The history of crisis tends to show us that the study of crisis management cannot be linked to a specific civilization or era, especially when humanity had witnessed multiple and complex environmental, political, economic, and military crisis. Moreover, some of the problems and complex issues in the modern era are rooted in history. Thus, many geopolitical crises nowadays are the result of old causes. The study of crisis management from an academic point of view should be a multifaceted analysis, including a historical, a cultural, and an anthropological one, which determines the course of evolution and consequences of the crisis.",book:{id:"6620",slug:"crisis-management-theory-and-practice",title:"Crisis Management",fullTitle:"Crisis Management - Theory and Practice"},signatures:"Khaled Zamoum and Tevhide Serra Gorpe",authors:[{id:"230918",title:"Prof.",name:"T. Serra",middleName:null,surname:"Gorpe",slug:"t.-serra-gorpe",fullName:"T. 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Emdad Haque"},{id:"168399",title:"Mr.",name:"Mohammed S",middleName:null,surname:"Uddin",slug:"mohammed-s-uddin",fullName:"Mohammed S Uddin"}]},{id:"74444",title:"Flood Disaster Hazards; Causes, Impacts and Management: A State-of-the-Art Review",slug:"flood-disaster-hazards-causes-impacts-and-management-a-state-of-the-art-review",totalDownloads:676,totalCrossrefCites:0,totalDimensionsCites:1,abstract:"Floods are among disasters that cause widespread destruction to human lives, properties and the environment every year and occur at different places with varied scales across the globe. Flood disasters are caused by natural phenomena, but their occurrences and impacts have been intensified through human actions and inactions. The practice of flood disaster management have evolved over the years from traditional approaches of ad-hoc response measures to integrated approaches involving technologically advanced tools in flood disaster awareness, preparedness and response measures. This chapter proffers understanding into flood disaster awareness, preparedness and management, mitigation and adaptation strategies. Most importantly, the chapter presents a review on the relevance of modern technological tools namely Geographic Information System, Remote Sensing, Internet of Things and Big Data, that are available to flood managers, in the creation of efficient early warnings and Flood decision support systems that elevates the resilience of societies to flood disasters.",book:{id:"7712",slug:"natural-hazards-impacts-adjustments-and-resilience",title:"Natural Hazards",fullTitle:"Natural Hazards - Impacts, Adjustments and Resilience"},signatures:"Frank Jerome Glago",authors:[{id:"325046",title:"M.A.",name:"Frank Jerome",middleName:null,surname:"Glago",slug:"frank-jerome-glago",fullName:"Frank Jerome Glago"}]},{id:"64604",title:"Evidence-Based Contingency Planning to Enhance Local Resilience to Flood Disasters",slug:"evidence-based-contingency-planning-to-enhance-local-resilience-to-flood-disasters",totalDownloads:1449,totalCrossrefCites:2,totalDimensionsCites:3,abstract:"The Sendai Framework for Disaster Risk Reduction 2015–2030 addresses the importance of “Enhancing disaster preparedness for effective response and to ‘Build Back Better’ in recovery, rehabilitation and reconstruction” as the fourth priority action. One of the practical tools to achieve effective preparedness for flood disaster response is evidence-based contingency planning, which is based on scientific approaches such as flood simulation and quantitative risk assessment. This method, however, is not always feasible to disaster-prone areas in Asia due to the lack of data on natural and social conditions. This chapter proposes a method with six steps for local communities to conduct contingency planning by assuming the dynamic change of inundation using flood simulation, assessing flood risk with key indicators, deciding response strategies against the identified flood risk and developing a contingency plan beforehand. 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The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}}]},series:{item:{id:"24",title:"Sustainable Development",doi:"10.5772/intechopen.100361",issn:null,scope:"
\r\n\tTransforming our World: the 2030 Agenda for Sustainable Development endorsed by United Nations and 193 Member States, came into effect on Jan 1, 2016, to guide decision making and actions to the year 2030 and beyond. Central to this Agenda are 17 Goals, 169 associated targets and over 230 indicators that are reviewed annually. The vision envisaged in the implementation of the SDGs is centered on the five Ps: People, Planet, Prosperity, Peace and Partnership. This call for renewed focused efforts ensure we have a safe and healthy planet for current and future generations.
\r\n
\r\n\t
\r\n
\r\n\tThis Series focuses on covering research and applied research involving the five Ps through the following topics:
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\r\n
\r\n\t1. Sustainable Economy and Fair Society that relates to SDG 1 on No Poverty, SDG 2 on Zero Hunger, SDG 8 on Decent Work and Economic Growth, SDG 10 on Reduced Inequalities, SDG 12 on Responsible Consumption and Production, and SDG 17 Partnership for the Goals
\r\n
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\r\n\t2. Health and Wellbeing focusing on SDG 3 on Good Health and Wellbeing and SDG 6 on Clean Water and Sanitation
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\r\n\t
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\r\n\t3. Inclusivity and Social Equality involving SDG 4 on Quality Education, SDG 5 on Gender Equality, and SDG 16 on Peace, Justice and Strong Institutions
\r\n
\r\n\t
\r\n
\r\n\t4. Climate Change and Environmental Sustainability comprising SDG 13 on Climate Action, SDG 14 on Life Below Water, and SDG 15 on Life on Land
\r\n
\r\n\t
\r\n
\r\n\t5. Urban Planning and Environmental Management embracing SDG 7 on Affordable Clean Energy, SDG 9 on Industry, Innovation and Infrastructure, and SDG 11 on Sustainable Cities and Communities.
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\r\n\tThe series also seeks to support the use of cross cutting SDGs, as many of the goals listed above, targets and indicators are all interconnected to impact our lives and the decisions we make on a daily basis, making them impossible to tie to a single topic.
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Several international research projects has been performed with European partners from France, Netherlands, Norway and the UK. He is currently Professor of Communications Systems at the Harz University of Applied Sciences, Germany.\n\nPublications and Publishing\nHe has edited one book, a special interest book about ‘Optoelectronic Packaging’ (VDE, Berlin, Germany), and has published over 100 papers and is owner of several international patents for WDM over POF key elements.\n\nKey Research and Consulting Interests\nUlrich’s research activity has always been related to Spectroscopy and Optical Communications Technology. Specific current interests include the validation of complex instruments, and the application of VR technology to the development and testing of measurement systems. He has been reviewer for several publications of the Optical Society of America\\'s including Photonics Technology Letters and Applied Optics.\n\nPersonal Interests\nThese include motor cycling in a very relaxed manner and performing martial arts.",institutionString:null,institution:{name:"Charité",country:{name:"Germany"}}},{id:"341622",title:"Ph.D.",name:"Eduardo",middleName:null,surname:"Rojas Alvarez",slug:"eduardo-rojas-alvarez",fullName:"Eduardo Rojas Alvarez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/341622/images/15892_n.jpg",biography:null,institutionString:null,institution:{name:"University of Cuenca",country:{name:"Ecuador"}}},{id:"215610",title:"Prof.",name:"Muhammad",middleName:null,surname:"Sarfraz",slug:"muhammad-sarfraz",fullName:"Muhammad Sarfraz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/215610/images/system/215610.jpeg",biography:"Muhammad Sarfraz is a professor in the Department of Information Science, Kuwait University, Kuwait. His research interests include optimization, computer graphics, computer vision, image processing, machine learning, pattern recognition, soft computing, data science, and intelligent systems. Prof. Sarfraz has been a keynote/invited speaker at various platforms around the globe. He has advised/supervised more than 110 students for their MSc and Ph.D. theses. He has published more than 400 publications as books, journal articles, and conference papers. He has authored and/or edited around seventy books. Prof. Sarfraz is a member of various professional societies. He is a chair and member of international advisory committees and organizing committees of numerous international conferences. He is also an editor and editor in chief for various international journals.",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"32650",title:"Prof.",name:"Lukas",middleName:"Willem",surname:"Snyman",slug:"lukas-snyman",fullName:"Lukas Snyman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/32650/images/4136_n.jpg",biography:"Lukas Willem Snyman received his basic education at primary and high schools in South Africa, Eastern Cape. He enrolled at today's Nelson Metropolitan University and graduated from this university with a BSc in Physics and Mathematics, B.Sc Honors in Physics, MSc in Semiconductor Physics, and a Ph.D. in Semiconductor Physics in 1987. After his studies, he chose an academic career and devoted his energy to the teaching of physics to first, second, and third-year students. After positions as a lecturer at the University of Port Elizabeth, he accepted a position as Associate Professor at the University of Pretoria, South Africa.\r\n\r\nIn 1992, he motivates the concept of 'television and computer-based education” as means to reach large student numbers with only the best of teaching expertise and publishes an article on the concept in the SA Journal of Higher Education of 1993 (and later in 2003). The University of Pretoria subsequently approved a series of test projects on the concept with outreach to Mamelodi and Eerste Rust in 1993. In 1994, the University established a 'Unit for Telematic Education ' as a support section for multiple faculties at the University of Pretoria. In subsequent years, the concept of 'telematic education” subsequently becomes well established in academic circles in South Africa, grew in popularity, and is adopted by many universities and colleges throughout South Africa as a medium of enhancing education and training, as a method to reaching out to far out communities, and as a means to enhance study from the home environment.\r\n\r\nProfessor Snyman in subsequent years pursued research in semiconductor physics, semiconductor devices, microelectronics, and optoelectronics.\r\n\r\nIn 2000 he joined the TUT as a full professor. Here served for a period as head of the Department of Electronic Engineering. Here he makes contributions to solar energy development, microwave and optoelectronic device development, silicon photonics, as well as contributions to new mobile telecommunication systems and network planning in SA.\r\n\r\nCurrently, he teaches electronics and telecommunications at the TUT to audiences ranging from first-year students to Ph.D. level.\r\n\r\nFor his research in the field of 'Silicon Photonics” since 1990, he has published (as author and co-author) about thirty internationally reviewed articles in scientific journals, contributed to more than forty international conferences, about 25 South African provisional patents (as inventor and co-inventor), 8 PCT international patent applications until now. Of these, two USA patents applications, two European Patents, two Korean patents, and ten SA patents have been granted. A further 4 USA patents, 5 European patents, 3 Korean patents, 3 Chinese patents, and 3 Japanese patents are currently under consideration.\r\n\r\nRecently he has also published an extensive scholarly chapter in an internet open access book on 'Integrating Microphotonic Systems and MOEMS into standard Silicon CMOS Integrated circuitry”.\r\n\r\nFurthermore, Professor Snyman recently steered a new initiative at the TUT by introducing a 'Laboratory for Innovative Electronic Systems ' at the Department of Electrical Engineering. The model of this laboratory or center is to primarily combine outputs as achieved by high-level research with lower-level system development and entrepreneurship in a technical university environment. Students are allocated to projects at different levels with PhDs and Master students allocated to the generation of new knowledge and new technologies, while students at the diploma and Baccalaureus level are allocated to electronic systems development with a direct and a near application for application in industry or the commercial and public sectors in South Africa.\r\n\r\nProfessor Snyman received the WIRSAM Award of 1983 and the WIRSAM Award in 1985 in South Africa for best research papers by a young scientist at two international conferences on electron microscopy in South Africa. He subsequently received the SA Microelectronics Award for the best dissertation emanating from studies executed at a South African university in the field of Physics and Microelectronics in South Africa in 1987. In October of 2011, Professor Snyman received the prestigious Institutional Award for 'Innovator of the Year” for 2010 at the Tshwane University of Technology, South Africa. This award was based on the number of patents recognized and granted by local and international institutions as well as for his contributions concerning innovation at the TUT.",institutionString:null,institution:{name:"University of South Africa",country:{name:"South Africa"}}},{id:"317279",title:"Mr.",name:"Ali",middleName:"Usama",surname:"Syed",slug:"ali-syed",fullName:"Ali Syed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/317279/images/16024_n.png",biography:"A creative, talented, and innovative young professional who is dedicated, well organized, and capable research fellow with two years of experience in graduate-level research, published in engineering journals and book, with related expertise in Bio-robotics, equally passionate about the aesthetics of the mechanical and electronic system, obtained expertise in the use of MS Office, MATLAB, SolidWorks, LabVIEW, Proteus, Fusion 360, having a grasp on python, C++ and assembly language, possess proven ability in acquiring research grants, previous appointments with social and educational societies with experience in administration, current affiliations with IEEE and Web of Science, a confident presenter at conferences and teacher in classrooms, able to explain complex information to audiences of all levels.",institutionString:null,institution:{name:"Air University",country:{name:"Pakistan"}}},{id:"75526",title:"Ph.D.",name:"Zihni Onur",middleName:null,surname:"Uygun",slug:"zihni-onur-uygun",fullName:"Zihni Onur Uygun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/75526/images/12_n.jpg",biography:"My undergraduate education and my Master of Science educations at Ege University and at Çanakkale Onsekiz Mart University have given me a firm foundation in Biochemistry, Analytical Chemistry, Biosensors, Bioelectronics, Physical Chemistry and Medicine. After obtaining my degree as a MSc in analytical chemistry, I started working as a research assistant in Ege University Medical Faculty in 2014. In parallel, I enrolled to the MSc program at the Department of Medical Biochemistry at Ege University to gain deeper knowledge on medical and biochemical sciences as well as clinical chemistry in 2014. In my PhD I deeply researched on biosensors and bioelectronics and finished in 2020. Now I have eleven SCI-Expanded Index published papers, 6 international book chapters, referee assignments for different SCIE journals, one international patent pending, several international awards, projects and bursaries. In parallel to my research assistant position at Ege University Medical Faculty, Department of Medical Biochemistry, in April 2016, I also founded a Start-Up Company (Denosens Biotechnology LTD) by the support of The Scientific and Technological Research Council of Turkey. Currently, I am also working as a CEO in Denosens Biotechnology. The main purposes of the company, which carries out R&D as a research center, are to develop new generation biosensors and sensors for both point-of-care diagnostics; such as glucose, lactate, cholesterol and cancer biomarker detections. My specific experimental and instrumental skills are Biochemistry, Biosensor, Analytical Chemistry, Electrochemistry, Mobile phone based point-of-care diagnostic device, POCTs and Patient interface designs, HPLC, Tandem Mass Spectrometry, Spectrophotometry, ELISA.",institutionString:null,institution:{name:"Ege University",country:{name:"Turkey"}}},{id:"246502",title:"Dr.",name:"Jaya T.",middleName:"T",surname:"Varkey",slug:"jaya-t.-varkey",fullName:"Jaya T. Varkey",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/246502/images/11160_n.jpg",biography:"Jaya T. Varkey, PhD, graduated with a degree in Chemistry from Cochin University of Science and Technology, Kerala, India. She obtained a PhD in Chemistry from the School of Chemical Sciences, Mahatma Gandhi University, Kerala, India, and completed a post-doctoral fellowship at the University of Minnesota, USA. She is a research guide at Mahatma Gandhi University and Associate Professor in Chemistry, St. Teresa’s College, Kochi, Kerala, India.\nDr. Varkey received a National Young Scientist award from the Indian Science Congress (1995), a UGC Research award (2016–2018), an Indian National Science Academy (INSA) Visiting Scientist award (2018–2019), and a Best Innovative Faculty award from the All India Association for Christian Higher Education (AIACHE) (2019). She Hashas received the Sr. Mary Cecil prize for best research paper three times. She was also awarded a start-up to develop a tea bag water filter. \nDr. Varkey has published two international books and twenty-seven international journal publications. She is an editorial board member for five international journals.",institutionString:"St. Teresa’s College",institution:null},{id:"250668",title:"Dr.",name:"Ali",middleName:null,surname:"Nabipour Chakoli",slug:"ali-nabipour-chakoli",fullName:"Ali Nabipour Chakoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/250668/images/system/250668.jpg",biography:"Academic Qualification:\r\n•\tPhD in Materials Physics and Chemistry, From: Sep. 2006, to: Sep. 2010, School of Materials Science and Engineering, Harbin Institute of Technology, Thesis: Structure and Shape Memory Effect of Functionalized MWCNTs/poly (L-lactide-co-ε-caprolactone) Nanocomposites. Supervisor: Prof. Wei Cai,\r\n•\tM.Sc in Applied Physics, From: 1996, to: 1998, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Determination of Boron in Micro alloy Steels with solid state nuclear track detectors by neutron induced auto radiography, Supervisors: Dr. M. Hosseini Ashrafi and Dr. A. Hosseini.\r\n•\tB.Sc. in Applied Physics, From: 1991, to: 1996, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Design of shielding for Am-Be neutron sources for In Vivo neutron activation analysis, Supervisor: Dr. M. Hosseini Ashrafi.\r\n\r\nResearch Experiences:\r\n1.\tNanomaterials, Carbon Nanotubes, Graphene: Synthesis, Functionalization and Characterization,\r\n2.\tMWCNTs/Polymer Composites: Fabrication and Characterization, \r\n3.\tShape Memory Polymers, Biodegradable Polymers, ORC, Collagen,\r\n4.\tMaterials Analysis and Characterizations: TEM, SEM, XPS, FT-IR, Raman, DSC, DMA, TGA, XRD, GPC, Fluoroscopy, \r\n5.\tInteraction of Radiation with Mater, Nuclear Safety and Security, NDT(RT),\r\n6.\tRadiation Detectors, Calibration (SSDL),\r\n7.\tCompleted IAEA e-learning Courses:\r\nNuclear Security (15 Modules),\r\nNuclear Safety:\r\nTSA 2: Regulatory Protection in Occupational Exposure,\r\nTips & Tricks: Radiation Protection in Radiography,\r\nSafety and Quality in Radiotherapy,\r\nCourse on Sealed Radioactive Sources,\r\nCourse on Fundamentals of Environmental Remediation,\r\nCourse on Planning for Environmental Remediation,\r\nKnowledge Management Orientation Course,\r\nFood Irradiation - Technology, Applications and Good Practices,\r\nEmployment:\r\nFrom 2010 to now: Academic staff, Nuclear Science and Technology Research Institute, Kargar Shomali, Tehran, Iran, P.O. Box: 14395-836.\r\nFrom 1997 to 2006: Expert of Materials Analysis and Characterization. Research Center of Agriculture and Medicine. Rajaeeshahr, Karaj, Iran, P. O. Box: 31585-498.",institutionString:"Atomic Energy Organization of Iran",institution:{name:"Atomic Energy Organization of Iran",country:{name:"Iran"}}},{id:"248279",title:"Dr.",name:"Monika",middleName:"Elzbieta",surname:"Machoy",slug:"monika-machoy",fullName:"Monika Machoy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248279/images/system/248279.jpeg",biography:"Monika Elżbieta Machoy, MD, graduated with distinction from the Faculty of Medicine and Dentistry at the Pomeranian Medical University in 2009, defended her PhD thesis with summa cum laude in 2016 and is currently employed as a researcher at the Department of Orthodontics of the Pomeranian Medical University. She expanded her professional knowledge during a one-year scholarship program at the Ernst Moritz Arndt University in Greifswald, Germany and during a three-year internship at the Technical University in Dresden, Germany. She has been a speaker at numerous orthodontic conferences, among others, American Association of Orthodontics, European Orthodontic Symposium and numerous conferences of the Polish Orthodontic Society. She conducts research focusing on the effect of orthodontic treatment on dental and periodontal tissues and the causes of pain in orthodontic patients.",institutionString:"Pomeranian Medical University",institution:{name:"Pomeranian Medical University",country:{name:"Poland"}}},{id:"252743",title:"Prof.",name:"Aswini",middleName:"Kumar",surname:"Kar",slug:"aswini-kar",fullName:"Aswini Kar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252743/images/10381_n.jpg",biography:"uploaded in cv",institutionString:null,institution:{name:"KIIT University",country:{name:"India"}}},{id:"204256",title:"Dr.",name:"Anil",middleName:"Kumar",surname:"Kumar Sahu",slug:"anil-kumar-sahu",fullName:"Anil Kumar Sahu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204256/images/14201_n.jpg",biography:"I have nearly 11 years of research and teaching experience. I have done my master degree from University Institute of Pharmacy, Pt. Ravi Shankar Shukla University, Raipur, Chhattisgarh India. I have published 16 review and research articles in international and national journals and published 4 chapters in IntechOpen, the world’s leading publisher of Open access books. I have presented many papers at national and international conferences. I have received research award from Indian Drug Manufacturers Association in year 2015. My research interest extends from novel lymphatic drug delivery systems, oral delivery system for herbal bioactive to formulation optimization.",institutionString:null,institution:{name:"Chhattisgarh Swami Vivekanand Technical University",country:{name:"India"}}},{id:"253468",title:"Dr.",name:"Mariusz",middleName:null,surname:"Marzec",slug:"mariusz-marzec",fullName:"Mariusz Marzec",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/253468/images/system/253468.png",biography:"An assistant professor at Department of Biomedical Computer Systems, at Institute of Computer Science, Silesian University in Katowice. Scientific interests: computer analysis and processing of images, biomedical images, databases and programming languages. He is an author and co-author of scientific publications covering analysis and processing of biomedical images and development of database systems.",institutionString:"University of Silesia",institution:null},{id:"212432",title:"Prof.",name:"Hadi",middleName:null,surname:"Mohammadi",slug:"hadi-mohammadi",fullName:"Hadi Mohammadi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/212432/images/system/212432.jpeg",biography:"Dr. Hadi Mohammadi is a biomedical engineer with hands-on experience in the design and development of many engineering structures and medical devices through various projects that he has been involved in over the past twenty years. Dr. Mohammadi received his BSc. and MSc. degrees in Mechanical Engineering from Sharif University of Technology, Tehran, Iran, and his PhD. degree in Biomedical Engineering (biomaterials) from the University of Western Ontario. He was a postdoctoral trainee for almost four years at University of Calgary and Harvard Medical School. He is an industry innovator having created the technology to produce lifelike synthetic platforms that can be used for the simulation of almost all cardiovascular reconstructive surgeries. He’s been heavily involved in the design and development of cardiovascular devices and technology for the past 10 years. He is currently an Assistant Professor with the University of British Colombia, Canada.",institutionString:"University of British Columbia",institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"254463",title:"Prof.",name:"Haisheng",middleName:null,surname:"Yang",slug:"haisheng-yang",fullName:"Haisheng Yang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/254463/images/system/254463.jpeg",biography:"Haisheng Yang, Ph.D., Professor and Director of the Department of Biomedical Engineering, College of Life Science and Bioengineering, Beijing University of Technology. He received his Ph.D. degree in Mechanics/Biomechanics from Harbin Institute of Technology (jointly with University of California, Berkeley). Afterwards, he worked as a Postdoctoral Research Associate in the Purdue Musculoskeletal Biology and Mechanics Lab at the Department of Basic Medical Sciences, Purdue University, USA. He also conducted research in the Research Centre of Shriners Hospitals for Children-Canada at McGill University, Canada. Dr. Yang has over 10 years research experience in orthopaedic biomechanics and mechanobiology of bone adaptation and regeneration. He earned an award from Beijing Overseas Talents Aggregation program in 2017 and serves as Beijing Distinguished Professor.",institutionString:"Beijing University of Technology",institution:null},{id:"255757",title:"Dr.",name:"Igor",middleName:"Victorovich",surname:"Lakhno",slug:"igor-lakhno",fullName:"Igor Lakhno",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255757/images/system/255757.jpg",biography:"Lakhno Igor Victorovich was born in 1971 in Kharkiv (Ukraine). \nMD – 1994, Kharkiv National Medical Univesity.\nOb&Gyn; – 1997, master courses in Kharkiv Medical Academy of Postgraduate Education.\nPhD – 1999, Kharkiv National Medical Univesity.\nDSc – 2019, PL Shupik National Academy of Postgraduate Education \nLakhno Igor has been graduated from an international training courses on reproductive medicine and family planning held in Debrecen University (Hungary) in 1997. Since 1998 Lakhno Igor has worked as an associate professor of the department of obstetrics and gynecology of VN Karazin National University and an associate professor of the perinatology, obstetrics and gynecology department of Kharkiv Medical Academy of Postgraduate Education. Since June 2019 he’s a professor of the department of obstetrics and gynecology of VN Karazin National University and a professor of the perinatology, obstetrics and gynecology department of Kharkiv Medical Academy of Postgraduate Education . He’s an author of about 200 printed works and there are 17 of them in Scopus or Web of Science databases. Lakhno Igor is a rewiever of Journal of Obstetrics and Gynaecology (Taylor and Francis), Informatics in Medicine Unlocked (Elsevier), The Journal of Obstetrics and Gynecology Research (Wiley), Endocrine, Metabolic & Immune Disorders-Drug Targets (Bentham Open), The Open Biomedical Engineering Journal (Bentham Open), etc. He’s defended a dissertation for DSc degree \\'Pre-eclampsia: prediction, prevention and treatment”. Lakhno Igor has participated as a speaker in several international conferences and congresses (International Conference on Biological Oscillations April 10th-14th 2016, Lancaster, UK, The 9th conference of the European Study Group on Cardiovascular Oscillations). His main scientific interests: obstetrics, women’s health, fetal medicine, cardiovascular medicine.",institutionString:"V.N. Karazin Kharkiv National University",institution:{name:"Kharkiv Medical Academy of Postgraduate Education",country:{name:"Ukraine"}}},{id:"89721",title:"Dr.",name:"Mehmet",middleName:"Cuneyt",surname:"Ozmen",slug:"mehmet-ozmen",fullName:"Mehmet Ozmen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/89721/images/7289_n.jpg",biography:null,institutionString:null,institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"243698",title:"M.D.",name:"Xiaogang",middleName:null,surname:"Wang",slug:"xiaogang-wang",fullName:"Xiaogang Wang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243698/images/system/243698.png",biography:"Dr. Xiaogang Wang, a faculty member of Shanxi Eye Hospital specializing in the treatment of cataract and retinal disease and a tutor for postgraduate students of Shanxi Medical University, worked in the COOL Lab as an international visiting scholar under the supervision of Dr. David Huang and Yali Jia from October 2012 through November 2013. Dr. Wang earned an MD from Shanxi Medical University and a Ph.D. from Shanghai Jiao Tong University. Dr. Wang was awarded two research project grants focused on multimodal optical coherence tomography imaging and deep learning in cataract and retinal disease, from the National Natural Science Foundation of China. He has published around 30 peer-reviewed journal papers and four book chapters and co-edited one book.",institutionString:"Shanxi Eye Hospital",institution:{name:"Shanxi Eye Hospital",country:{name:"China"}}},{id:"242893",title:"Ph.D. Student",name:"Joaquim",middleName:null,surname:"De Moura",slug:"joaquim-de-moura",fullName:"Joaquim De Moura",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/242893/images/7133_n.jpg",biography:"Joaquim de Moura received his degree in Computer Engineering in 2014 from the University of A Coruña (Spain). In 2016, he received his M.Sc degree in Computer Engineering from the same university. He is currently pursuing his Ph.D degree in Computer Science in a collaborative project between ophthalmology centers in Galicia and the University of A Coruña. His research interests include computer vision, machine learning algorithms and analysis and medical imaging processing of various kinds.",institutionString:null,institution:{name:"University of A Coruña",country:{name:"Spain"}}},{id:"267434",title:"Dr.",name:"Rohit",middleName:null,surname:"Raja",slug:"rohit-raja",fullName:"Rohit Raja",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRZkkQAG/Profile_Picture_2022-05-09T12:55:18.jpg",biography:null,institutionString:null,institution:null},{id:"294334",title:"B.Sc.",name:"Marc",middleName:null,surname:"Bruggeman",slug:"marc-bruggeman",fullName:"Marc Bruggeman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/294334/images/8242_n.jpg",biography:"Chemical engineer graduate, with a passion for material science and specific interest in polymers - their near infinite applications intrigue me. \n\nI plan to continue my scientific career in the field of polymeric biomaterials as I am fascinated by intelligent, bioactive and biomimetic materials for use in both consumer and medical applications.",institutionString:null,institution:null},{id:"244950",title:"Dr.",name:"Salvatore",middleName:null,surname:"Di Lauro",slug:"salvatore-di-lauro",fullName:"Salvatore Di Lauro",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0030O00002bSF1HQAW/ProfilePicture%202021-12-20%2014%3A54%3A14.482",biography:"Name:\n\tSALVATORE DI LAURO\nAddress:\n\tHospital Clínico Universitario Valladolid\nAvda Ramón y Cajal 3\n47005, Valladolid\nSpain\nPhone number: \nFax\nE-mail:\n\t+34 983420000 ext 292\n+34 983420084\nsadilauro@live.it\nDate and place of Birth:\nID Number\nMedical Licence \nLanguages\t09-05-1985. Villaricca (Italy)\n\nY1281863H\n474707061\nItalian (native language)\nSpanish (read, written, spoken)\nEnglish (read, written, spoken)\nPortuguese (read, spoken)\nFrench (read)\n\t\t\nCurrent position (title and company)\tDate (Year)\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. Private practise.\t2017-today\n\n2019-today\n\t\n\t\nEducation (High school, university and postgraduate training > 3 months)\tDate (Year)\nDegree in Medicine and Surgery. University of Neaples 'Federico II”\nResident in Opthalmology. Hospital Clinico Universitario Valladolid\nMaster in Vitreo-Retina. IOBA. University of Valladolid\nFellow of the European Board of Ophthalmology. Paris\nMaster in Research in Ophthalmology. University of Valladolid\t2003-2009\n2012-2016\n2016-2017\n2016\n2012-2013\n\t\nEmployments (company and positions)\tDate (Year)\nResident in Ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl.\nFellow in Vitreo-Retina. IOBA. University of Valladolid\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. \n\t2012-2016\n2016-2017\n2017-today\n\n2019-Today\n\n\n\t\nClinical Research Experience (tasks and role)\tDate (Year)\nAssociated investigator\n\n' FIS PI20/00740: DESARROLLO DE UNA CALCULADORA DE RIESGO DE\nAPARICION DE RETINOPATIA DIABETICA BASADA EN TECNICAS DE IMAGEN MULTIMODAL EN PACIENTES DIABETICOS TIPO 1. Grant by: Ministerio de Ciencia e Innovacion \n\n' (BIO/VA23/14) Estudio clínico multicéntrico y prospectivo para validar dos\nbiomarcadores ubicados en los genes p53 y MDM2 en la predicción de los resultados funcionales de la cirugía del desprendimiento de retina regmatógeno. Grant by: Gerencia Regional de Salud de la Junta de Castilla y León.\n' Estudio multicéntrico, aleatorizado, con enmascaramiento doble, en 2 grupos\nparalelos y de 52 semanas de duración para comparar la eficacia, seguridad e inmunogenicidad de SOK583A1 respecto a Eylea® en pacientes con degeneración macular neovascular asociada a la edad' (CSOK583A12301; N.EUDRA: 2019-004838-41; FASE III). Grant by Hexal AG\n\n' Estudio de fase III, aleatorizado, doble ciego, con grupos paralelos, multicéntrico para comparar la eficacia y la seguridad de QL1205 frente a Lucentis® en pacientes con degeneración macular neovascular asociada a la edad. (EUDRACT: 2018-004486-13). Grant by Qilu Pharmaceutical Co\n\n' Estudio NEUTON: Ensayo clinico en fase IV para evaluar la eficacia de aflibercept en pacientes Naive con Edema MacUlar secundario a Oclusion de Vena CenTral de la Retina (OVCR) en regimen de tratamientO iNdividualizado Treat and Extend (TAE)”, (2014-000975-21). Grant by Fundacion Retinaplus\n\n' Evaluación de la seguridad y bioactividad de anillos de tensión capsular en conejo. Proyecto Procusens. Grant by AJL, S.A.\n\n'Estudio epidemiológico, prospectivo, multicéntrico y abierto\\npara valorar la frecuencia de la conjuntivitis adenovírica diagnosticada mediante el test AdenoPlus®\\nTest en pacientes enfermos de conjuntivitis aguda”\\n. National, multicenter study. Grant by: NICOX.\n\nEuropean multicentric trial: 'Evaluation of clinical outcomes following the use of Systane Hydration in patients with dry eye”. Study Phase 4. Grant by: Alcon Labs'\n\nVLPs Injection and Activation in a Rabbit Model of Uveal Melanoma. Grant by Aura Bioscience\n\nUpdating and characterization of a rabbit model of uveal melanoma. Grant by Aura Bioscience\n\nEnsayo clínico en fase IV para evaluar las variantes genéticas de la vía del VEGF como biomarcadores de eficacia del tratamiento con aflibercept en pacientes con degeneración macular asociada a la edad (DMAE) neovascular. Estudio BIOIMAGE. IMO-AFLI-2013-01\n\nEstudio In-Eye:Ensayo clínico en fase IV, abierto, aleatorizado, de 2 brazos,\nmulticçentrico y de 12 meses de duración, para evaluar la eficacia y seguridad de un régimen de PRN flexible individualizado de 'esperar y extender' versus un régimen PRN según criterios de estabilización mediante evaluaciones mensuales de inyecciones intravítreas de ranibizumab 0,5 mg en pacientes naive con neovascularización coriodea secunaria a la degeneración macular relacionada con la edad. CP: CRFB002AES03T\n\nTREND: Estudio Fase IIIb multicéntrico, randomizado, de 12 meses de\nseguimiento con evaluador de la agudeza visual enmascarado, para evaluar la eficacia y la seguridad de ranibizumab 0.5mg en un régimen de tratar y extender comparado con un régimen mensual, en pacientes con degeneración macular neovascular asociada a la edad. CP: CRFB002A2411 Código Eudra CT:\n2013-002626-23\n\n\n\nPublications\t\n\n2021\n\n\n\n\n2015\n\n\n\n\n2021\n\n\n\n\n\n2021\n\n\n\n\n2015\n\n\n\n\n2015\n\n\n2014\n\n\n\n\n2015-16\n\n\n\n2015\n\n\n2014\n\n\n2014\n\n\n\n\n2014\n\n\n\n\n\n\n\n2014\n\nJose Carlos Pastor; Jimena Rojas; Salvador Pastor-Idoate; Salvatore Di Lauro; Lucia Gonzalez-Buendia; Santiago Delgado-Tirado. Proliferative vitreoretinopathy: A new concept of disease pathogenesis and practical\nconsequences. Progress in Retinal and Eye Research. 51, pp. 125 - 155. 03/2016. DOI: 10.1016/j.preteyeres.2015.07.005\n\n\nLabrador-Velandia S; Alonso-Alonso ML; Di Lauro S; García-Gutierrez MT; Srivastava GK; Pastor JC; Fernandez-Bueno I. Mesenchymal stem cells provide paracrine neuroprotective resources that delay degeneration of co-cultured organotypic neuroretinal cultures.Experimental Eye Research. 185, 17/05/2019. DOI: 10.1016/j.exer.2019.05.011\n\nSalvatore Di Lauro; Maria Teresa Garcia Gutierrez; Ivan Fernandez Bueno. Quantification of pigment epithelium-derived factor (PEDF) in an ex vivo coculture of retinal pigment epithelium cells and neuroretina.\nJournal of Allbiosolution. 2019. ISSN 2605-3535\n\nSonia Labrador Velandia; Salvatore Di Lauro; Alonso-Alonso ML; Tabera Bartolomé S; Srivastava GK; Pastor JC; Fernandez-Bueno I. Biocompatibility of intravitreal injection of human mesenchymal stem cells in immunocompetent rabbits. Graefe's archive for clinical and experimental ophthalmology. 256 - 1, pp. 125 - 134. 01/2018. DOI: 10.1007/s00417-017-3842-3\n\n\nSalvatore Di Lauro, David Rodriguez-Crespo, Manuel J Gayoso, Maria T Garcia-Gutierrez, J Carlos Pastor, Girish K Srivastava, Ivan Fernandez-Bueno. A novel coculture model of porcine central neuroretina explants and retinal pigment epithelium cells. Molecular Vision. 2016 - 22, pp. 243 - 253. 01/2016.\n\nSalvatore Di Lauro. Classifications for Proliferative Vitreoretinopathy ({PVR}): An Analysis of Their Use in Publications over the Last 15 Years. Journal of Ophthalmology. 2016, pp. 1 - 6. 01/2016. DOI: 10.1155/2016/7807596\n\nSalvatore Di Lauro; Rosa Maria Coco; Rosa Maria Sanabria; Enrique Rodriguez de la Rua; Jose Carlos Pastor. Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study. Journal of Ophthalmology. 2015:821864, 2015. DOI: 10.1155/2015/821864\n\nIvan Fernandez-Bueno; Salvatore Di Lauro; Ivan Alvarez; Jose Carlos Lopez; Maria Teresa Garcia-Gutierrez; Itziar Fernandez; Eva Larra; Jose Carlos Pastor. Safety and Biocompatibility of a New High-Density Polyethylene-Based\nSpherical Integrated Porous Orbital Implant: An Experimental Study in Rabbits. Journal of Ophthalmology. 2015:904096, 2015. DOI: 10.1155/2015/904096\n\nPastor JC; Pastor-Idoate S; Rodríguez-Hernandez I; Rojas J; Fernandez I; Gonzalez-Buendia L; Di Lauro S; Gonzalez-Sarmiento R. Genetics of PVR and RD. Ophthalmologica. 232 - Suppl 1, pp. 28 - 29. 2014\n\nRodriguez-Crespo D; Di Lauro S; Singh AK; Garcia-Gutierrez MT; Garrosa M; Pastor JC; Fernandez-Bueno I; Srivastava GK. Triple-layered mixed co-culture model of RPE cells with neuroretina for evaluating the neuroprotective effects of adipose-MSCs. Cell Tissue Res. 358 - 3, pp. 705 - 716. 2014.\nDOI: 10.1007/s00441-014-1987-5\n\nCarlo De Werra; Salvatore Condurro; Salvatore Tramontano; Mario Perone; Ivana Donzelli; Salvatore Di Lauro; Massimo Di Giuseppe; Rosa Di Micco; Annalisa Pascariello; Antonio Pastore; Giorgio Diamantis; Giuseppe Galloro. Hydatid disease of the liver: thirty years of surgical experience.Chirurgia italiana. 59 - 5, pp. 611 - 636.\n(Italia): 2007. ISSN 0009-4773\n\nChapters in books\n\t\n' Salvador Pastor Idoate; Salvatore Di Lauro; Jose Carlos Pastor Jimeno. PVR: Pathogenesis, Histopathology and Classification. Proliferative Vitreoretinopathy with Small Gauge Vitrectomy. Springer, 2018. ISBN 978-3-319-78445-8\nDOI: 10.1007/978-3-319-78446-5_2. \n\n' Salvatore Di Lauro; Maria Isabel Lopez Galvez. Quistes vítreos en una mujer joven. Problemas diagnósticos en patología retinocoroidea. Sociedad Española de Retina-Vitreo. 2018.\n\n' Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor Jimeno. iOCT in PVR management. OCT Applications in Opthalmology. pp. 1 - 8. INTECH, 2018. DOI: 10.5772/intechopen.78774.\n\n' Rosa Coco Martin; Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor. amponadores, manipuladores y tinciones en la cirugía del traumatismo ocular.Trauma Ocular. Ponencia de la SEO 2018..\n\n' LOPEZ GALVEZ; DI LAURO; CRESPO. OCT angiografia y complicaciones retinianas de la diabetes. PONENCIA SEO 2021, CAPITULO 20. (España): 2021.\n\n' Múltiples desprendimientos neurosensoriales bilaterales en paciente joven. Enfermedades Degenerativas De Retina Y Coroides. SERV 04/2016. \n' González-Buendía L; Di Lauro S; Pastor-Idoate S; Pastor Jimeno JC. Vitreorretinopatía proliferante (VRP) e inflamación: LA INFLAMACIÓN in «INMUNOMODULADORES Y ANTIINFLAMATORIOS: MÁS ALLÁ DE LOS CORTICOIDES. 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The motor of the society is the industry and the research of this topic has to be empowered in order to increase and improve the quality of our lives.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/22.jpg",keywords:"Machine Learning, Intelligence Algorithms, Data Science, Artificial Intelligence, Applications on Applied Intelligence"},{id:"23",title:"Computational Neuroscience",scope:"Computational neuroscience focuses on biologically realistic abstractions and models validated and solved through computational simulations to understand principles for the development, structure, physiology, and ability of the nervous system. This topic is dedicated to biologically plausible descriptions and computational models - at various abstraction levels - of neurons and neural systems. This includes, but is not limited to: single-neuron modeling, sensory processing, motor control, memory, and synaptic plasticity, attention, identification, categorization, discrimination, learning, development, axonal patterning, guidance, neural architecture, behaviors, and dynamics of networks, cognition and the neuroscientific basis of consciousness. 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Novel computational algorithms for image analysis, scene understanding, biometrics, deep learning and their software or hardware implementations for natural and medical images, robotics, VR/AR, applications are some research directions relevant to this topic.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/24.jpg",keywords:"Image Analysis, Scene Understanding, Biometrics, Deep Learning, Software Implementation, Hardware Implementation, Natural Images, Medical Images, Robotics, VR/AR"},{id:"25",title:"Evolutionary Computation",scope:"Evolutionary computing is a paradigm that has grown dramatically in recent years. This group of bio-inspired metaheuristics solves multiple optimization problems by applying the metaphor of natural selection. It so far has solved problems such as resource allocation, routing, schedule planning, and engineering design. Moreover, in the field of machine learning, evolutionary computation has carved out a significant niche both in the generation of learning models and in the automatic design and optimization of hyperparameters in deep learning models. This collection aims to include quality volumes on various topics related to evolutionary algorithms and, alternatively, other metaheuristics of interest inspired by nature. For example, some of the issues of interest could be the following: Advances in evolutionary computation (Genetic algorithms, Genetic programming, Bio-inspired metaheuristics, Hybrid metaheuristics, Parallel ECs); Applications of evolutionary algorithms (Machine learning and Data Mining with EAs, Search-Based Software Engineering, Scheduling, and Planning Applications, Smart Transport Applications, Applications to Games, Image Analysis, Signal Processing and Pattern Recognition, Applications to Sustainability).",coverUrl:"https://cdn.intechopen.com/series_topics/covers/25.jpg",keywords:"Genetic Algorithms, Genetic Programming, Evolutionary Programming, Evolution Strategies, Hybrid Algorithms, Bioinspired Metaheuristics, Ant Colony Optimization, Evolutionary Learning, Hyperparameter Optimization"},{id:"26",title:"Machine Learning and Data Mining",scope:"The scope of machine learning and data mining is immense and is growing every day. It has become a massive part of our daily lives, making predictions based on experience, making this a fascinating area that solves problems that otherwise would not be possible or easy to solve. This topic aims to encompass algorithms that learn from experience (supervised and unsupervised), improve their performance over time and enable machines to make data-driven decisions. It is not limited to any particular applications, but contributions are encouraged from all disciplines.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/26.jpg",keywords:"Intelligent Systems, Machine Learning, Data Science, Data Mining, Artificial Intelligence"},{id:"27",title:"Multi-Agent Systems",scope:"Multi-agent systems are recognised as a state of the art field in Artificial Intelligence studies, which is popular due to the usefulness in facilitation capabilities to handle real-world problem-solving in a distributed fashion. The area covers many techniques that offer solutions to emerging problems in robotics and enterprise-level software systems. Collaborative intelligence is highly and effectively achieved with multi-agent systems. Areas of application include swarms of robots, flocks of UAVs, collaborative software management. Given the level of technological enhancements, the popularity of machine learning in use has opened a new chapter in multi-agent studies alongside the practical challenges and long-lasting collaboration issues in the field. It has increased the urgency and the need for further studies in this field. We welcome chapters presenting research on the many applications of multi-agent studies including, but not limited to, the following key areas: machine learning for multi-agent systems; modeling swarms robots and flocks of UAVs with multi-agent systems; decision science and multi-agent systems; software engineering for and with multi-agent systems; tools and technologies of multi-agent systems.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/27.jpg",keywords:"Collaborative Intelligence, Learning, Distributed Control System, Swarm Robotics, Decision Science, Software Engineering"}],annualVolumeBook:{},thematicCollection:[],selectedSeries:null,selectedSubseries:null},seriesLanding:{item:{id:"25",title:"Environmental Sciences",doi:"10.5772/intechopen.100362",issn:"2754-6713",scope:"
\r\n\tScientists have long researched to understand the environment and man’s place in it. The search for this knowledge grows in importance as rapid increases in population and economic development intensify humans’ stresses on ecosystems. Fortunately, rapid increases in multiple scientific areas are advancing our understanding of environmental sciences. Breakthroughs in computing, molecular biology, ecology, and sustainability science are enhancing our ability to utilize environmental sciences to address real-world problems. \r\n\tThe four topics of this book series - Pollution; Environmental Resilience and Management; Ecosystems and Biodiversity; and Water Science - will address important areas of advancement in the environmental sciences. They will represent an excellent initial grouping of published works on these critical topics.
",coverUrl:"https://cdn.intechopen.com/series/covers/25.jpg",latestPublicationDate:"April 13th, 2022",hasOnlineFirst:!1,numberOfOpenTopics:4,numberOfPublishedChapters:9,numberOfPublishedBooks:1,editor:{id:"197485",title:"Dr.",name:"J. Kevin",middleName:null,surname:"Summers",fullName:"J. Kevin Summers",profilePictureURL:"https://mts.intechopen.com/storage/users/197485/images/system/197485.jpg",biography:"J. Kevin Summers is a Senior Research Ecologist at the Environmental Protection Agency’s (EPA) Gulf Ecosystem Measurement and Modeling Division. He is currently working with colleagues in the Sustainable and Healthy Communities Program to develop an index of community resilience to natural hazards, an index of human well-being that can be linked to changes in the ecosystem, social and economic services, and a community sustainability tool for communities with populations under 40,000. He leads research efforts for indicator and indices development. Dr. Summers is a systems ecologist and began his career at the EPA in 1989 and has worked in various programs and capacities. This includes leading the National Coastal Assessment in collaboration with the Office of Water which culminated in the award-winning National Coastal Condition Report series (four volumes between 2001 and 2012), and which integrates water quality, sediment quality, habitat, and biological data to assess the ecosystem condition of the United States estuaries. He was acting National Program Director for Ecology for the EPA between 2004 and 2006. He has authored approximately 150 peer-reviewed journal articles, book chapters, and reports and has received many awards for technical accomplishments from the EPA and from outside of the agency. Dr. Summers holds a BA in Zoology and Psychology, an MA in Ecology, and Ph.D. in Systems Ecology/Biology.",institutionString:null,institution:{name:"Environmental Protection Agency",institutionURL:null,country:{name:"United States of America"}}},subseries:[{id:"38",title:"Pollution",keywords:"Human activity, Pollutants, Reduced risks, Population growth, Waste disposal, Remediation, Clean environment",scope:"
\r\n\tPollution is caused by a wide variety of human activities and occurs in diverse forms, for example biological, chemical, et cetera. In recent years, significant efforts have been made to ensure that the environment is clean, that rigorous rules are implemented, and old laws are updated to reduce the risks towards humans and ecosystems. However, rapid industrialization and the need for more cultivable sources or habitable lands, for an increasing population, as well as fewer alternatives for waste disposal, make the pollution control tasks more challenging. Therefore, this topic will focus on assessing and managing environmental pollution. It will cover various subjects, including risk assessment due to the pollution of ecosystems, transport and fate of pollutants, restoration or remediation of polluted matrices, and efforts towards sustainable solutions to minimize environmental pollution.
",annualVolume:11966,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/38.jpg",editor:{id:"110740",title:"Dr.",name:"Ismail M.M.",middleName:null,surname:"Rahman",fullName:"Ismail M.M. Rahman",profilePictureURL:"https://mts.intechopen.com/storage/users/110740/images/2319_n.jpg",institutionString:null,institution:{name:"Fukushima University",institutionURL:null,country:{name:"Japan"}}},editorTwo:{id:"201020",title:"Dr.",name:"Zinnat Ara",middleName:null,surname:"Begum",fullName:"Zinnat Ara Begum",profilePictureURL:"https://mts.intechopen.com/storage/users/201020/images/system/201020.jpeg",institutionString:null,institution:{name:"Fukushima University",institutionURL:null,country:{name:"Japan"}}},editorThree:null,editorialBoard:[{id:"252368",title:"Dr.",name:"Meng-Chuan",middleName:null,surname:"Ong",fullName:"Meng-Chuan Ong",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRVotQAG/Profile_Picture_2022-05-20T12:04:28.jpg",institutionString:null,institution:{name:"Universiti Malaysia Terengganu",institutionURL:null,country:{name:"Malaysia"}}},{id:"63465",title:"Prof.",name:"Mohamed Nageeb",middleName:null,surname:"Rashed",fullName:"Mohamed Nageeb Rashed",profilePictureURL:"https://mts.intechopen.com/storage/users/63465/images/system/63465.gif",institutionString:null,institution:{name:"Aswan University",institutionURL:null,country:{name:"Egypt"}}},{id:"187907",title:"Dr.",name:"Olga",middleName:null,surname:"Anne",fullName:"Olga Anne",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSBE5QAO/Profile_Picture_2022-04-07T09:42:13.png",institutionString:null,institution:{name:"Klaipeda State University of Applied Sciences",institutionURL:null,country:{name:"Lithuania"}}}]},{id:"39",title:"Environmental Resilience and Management",keywords:"Anthropic effects, Overexploitation, Biodiversity loss, Degradation, Inadequate Management, SDGs adequate practices",scope:"
\r\n\tThe environment is subject to severe anthropic effects. Among them are those associated with pollution, resource extraction and overexploitation, loss of biodiversity, soil degradation, disorderly land occupation and planning, and many others. These anthropic effects could potentially be caused by any inadequate management of the environment. However, ecosystems have a resilience that makes them react to disturbances which mitigate the negative effects. It is critical to understand how ecosystems, natural and anthropized, including urban environments, respond to actions that have a negative influence and how they are managed. It is also important to establish when the limits marked by the resilience and the breaking point are achieved and when no return is possible. The main focus for the chapters is to cover the subjects such as understanding how the environment resilience works, the mechanisms involved, and how to manage them in order to improve our interactions with the environment and promote the use of adequate management practices such as those outlined in the United Nations’ Sustainable Development Goals.
",annualVolume:11967,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/39.jpg",editor:{id:"137040",title:"Prof.",name:"Jose",middleName:null,surname:"Navarro-Pedreño",fullName:"Jose Navarro-Pedreño",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRAXrQAO/Profile_Picture_2022-03-09T15:50:19.jpg",institutionString:"Miguel Hernández University of Elche, Spain",institution:null},editorTwo:null,editorThree:null,editorialBoard:[{id:"177015",title:"Prof.",name:"Elke Jurandy",middleName:null,surname:"Bran Nogueira Cardoso",fullName:"Elke Jurandy Bran Nogueira Cardoso",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRGxzQAG/Profile_Picture_2022-03-25T08:32:33.jpg",institutionString:"Universidade de São Paulo, Brazil",institution:null},{id:"211260",title:"Dr.",name:"Sandra",middleName:null,surname:"Ricart",fullName:"Sandra Ricart",profilePictureURL:"https://mts.intechopen.com/storage/users/211260/images/system/211260.jpeg",institutionString:null,institution:{name:"University of Alicante",institutionURL:null,country:{name:"Spain"}}}]},{id:"40",title:"Ecosystems and Biodiversity",keywords:"Ecosystems, Biodiversity, Fauna, Taxonomy, Invasive species, Destruction of habitats, Overexploitation of natural resources, Pollution, Global warming, Conservation of natural spaces, Bioremediation",scope:"
\r\n\tIn general, the harsher the environmental conditions in an ecosystem, the lower the biodiversity. Changes in the environment caused by human activity accelerate the impoverishment of biodiversity.
\r\n
\r\n\tBiodiversity refers to “the variability of living organisms from any source, including terrestrial, marine and other aquatic ecosystems and the ecological complexes of which they are part; it includes diversity within each species, between species, and that of ecosystems”.
\r\n
\r\n\tBiodiversity provides food security and constitutes a gene pool for biotechnology, especially in the field of agriculture and medicine, and promotes the development of ecotourism.
\r\n
\r\n\tCurrently, biologists admit that we are witnessing the first phases of the seventh mass extinction caused by human intervention. It is estimated that the current rate of extinction is between a hundred and a thousand times faster than it was when man first appeared. The disappearance of species is caused not only by an accelerated rate of extinction, but also by a decrease in the rate of emergence of new species as human activities degrade the natural environment. The conservation of biological diversity is "a common concern of humanity" and an integral part of the development process. Its objectives are “the conservation of biological diversity, the sustainable use of its components, and the fair and equitable sharing of the benefits resulting from the use of genetic resources”.
\r\n
\r\n\tThe following are the main causes of biodiversity loss:
\r\n
\r\n\t• The destruction of natural habitats to expand urban and agricultural areas and to obtain timber, minerals and other natural resources.
\r\n
\r\n\t• The introduction of alien species into a habitat, whether intentionally or unintentionally which has an impact on the fauna and flora of the area, and as a result, they are reduced or become extinct.
\r\n
\r\n\t• Pollution from industrial and agricultural products, which devastate the fauna and flora, especially those in fresh water.
\r\n
\r\n\t• Global warming, which is seen as a threat to biological diversity, and will become increasingly important in the future.
",annualVolume:11968,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/40.jpg",editor:{id:"209149",title:"Prof.",name:"Salustiano",middleName:null,surname:"Mato",fullName:"Salustiano Mato",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRLREQA4/Profile_Picture_2022-03-31T10:23:50.png",institutionString:null,institution:{name:"University of Vigo",institutionURL:null,country:{name:"Spain"}}},editorTwo:{id:"60498",title:"Prof.",name:"Josefina",middleName:null,surname:"Garrido",fullName:"Josefina Garrido",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRj1VQAS/Profile_Picture_2022-03-31T10:06:51.jpg",institutionString:null,institution:{name:"University of Vigo",institutionURL:null,country:{name:"Spain"}}},editorThree:{id:"464288",title:"Dr.",name:"Francisco",middleName:null,surname:"Ramil",fullName:"Francisco Ramil",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003RI7lHQAT/Profile_Picture_2022-03-31T10:15:35.png",institutionString:null,institution:{name:"University of Vigo",institutionURL:null,country:{name:"Spain"}}},editorialBoard:[{id:"220987",title:"Dr.",name:"António",middleName:"Onofre",surname:"Soares",fullName:"António Soares",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRNtzQAG/Profile_Picture_1644499672340",institutionString:null,institution:{name:"University of the Azores",institutionURL:null,country:{name:"Portugal"}}}]},{id:"41",title:"Water Science",keywords:"Water, Water resources, Freshwater, Hydrological processes, Utilization, Protection",scope:"
\r\n\tWater is not only a crucial substance needed for biological life on Earth, but it is also a basic requirement for the existence and development of the human society. Owing to the importance of water to life on Earth, early researchers conducted numerous studies and analyses on the liquid form of water from the perspectives of chemistry, physics, earth science, and biology, and concluded that Earth is a "water polo". Water covers approximately 71% of Earth's surface. However, 97.2% of this water is seawater, 21.5% is icebergs and glaciers, and only 0.65% is freshwater that can be used directly by humans. As a result, the amount of water reserves available for human consumption is limited. The development, utilization, and protection of freshwater resources has become the focus of water science research for the continued improvement of human livelihoods and society.
\r\n
\r\n\tWater exists as solid, liquid, and gas within Earth’s atmosphere, lithosphere, and biosphere. Liquid water is used for a variety of purposes besides drinking, including power generation, ecology, landscaping, and shipping. Because water is involved in various environmental hydrological processes as well as numerous aspects of the economy and human society, the study of various phenomena in the hydrosphere, the laws governing their occurrence and development, the relationship between the hydrosphere and other spheres of Earth, and the relationship between water and social development, are all part of water science. Knowledge systems for water science are improving continuously. Water science has become a specialized field concerned with the identification of its physical, chemical, and biological properties. In addition, it reveals the laws of water distribution, movement, and circulation, and proposes methods and tools for water development, utilization, planning, management, and protection. Currently, the field of water science covers research related to topics such as hydrology, water resources and water environment. It also includes research on water related issues such as safety, engineering, economy, law, culture, information, and education.
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