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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1. Introduction
Environmental pollution is becoming a serious global problem that society faces today. Ongoing anthropogenic activities, extensive food and agriculture practices, industrialization, and urbanization release huge amounts of pollutants into the environment that can cause air, water, and land pollution, consequently threatening to human, animal health, and ecosystem [1, 2]. These toxic pollutants can enter the human body either through inhalation, ingestion, or absorption and adversely affect health. Further, bioaccumulation of some heavy metals through the food chain and persistent organic pollutants in biota and fishes poses a huge threat to humans and wildlife and requires sustainable, efficient, and low-cost technologies to detect, monitor, and remediate the hazardous pollutants [1].
Different forms of pollutants are released into the environment; soil, water, and air. Organic substances (pesticides, insecticides, fertilizers, oil spills, phenols, chloroform, hydrocarbons), heavy metals and metalloids (Cr2+, Pb2+, Co2+, Cd2+, Cu2+, Zn2+, Mn2+, Ni2+, As, Hg), dyes, industrial effluents, sewage, as well as microbial pathogens are few contaminants in soil and water. While, contaminants such as toxic gases (nitrogen oxides, sulfur oxides, carbon oxides, ozone), suspended airborne particles, and volatile organic compounds are found in the atmosphere [3, 4].
These contaminants in soil, water, and air are remediated by using different conventional techniques, such as physical, chemical, and biological methods [4, 5, 6]. These techniques may be used in combination with one another to remediate contaminated sites. Adsorption (clay minerals, industrial wastes, biomass, biochar, activated carbon, biopolymer), chemical treatments, bioremediation, coagulation and flocculation, ion exchange, membrane-filtration, solidification/stabilization, electrokinetics, and electrochemical treatments technologies have been used in heavy metal removal from soil and water [7]. Bioremediation using microorganisms and plants helps to detoxify or remove crude oil, heavy metal removal, and pesticide degradation from soil and water [4, 5].
However, the majority of these conventional techniques are expensive, laborious, environmentally destructive, time-consuming methods, also involved in the consumption of chemicals and the generation of undesirable toxic by-products that are hazardous to the environment. Further, complexities of the mixture of different compounds, high volatility, and low reactivity of contaminants also limit the applications in environmental remediation [3, 5, 8]. New environmental remediation technologies are constantly being explored, and recent studies have focused on developing new environmental remediation technologies using various nanomaterials [3].
2. Nanotechnology in environmental remediation
2.1 Nanotechnology and its advantages and applications
Nanotechnology has gained much attention in environmental remediation over the last few decades [1]. Nanotechnology is an advanced technology that works on the material in nanometer scale (1–100 nm) and produces materials, devices, and systems with specific and novel properties and functions by controlling the size and the shape of matters [1, 4, 9]. The nanomaterials are broadly categorized as organic and inorganic nanomaterials. Some literatures is classified based on materials used in the synthesis process; inorganic (metal, metal oxide, zero-valent metals), carbon-based [graphene, carbon nanotubes (CNTs)], polymer-based (dendrimers or polyamidoamine), and composite based nanomaterials [3, 10].
Nanomaterials have several advantages in environmental remediation over conventional methods; cost-effective, simple to use, energy conservative, sustainable, and more effective methods. Due to the properties such as smaller size (1–100 nm) and higher surface area to volume ratio of nanomaterials, they provide more reaction surface area, which increases reactivity and thus its sensitivity and effectiveness. Nanoparticles have a high sorption capacity for inorganic and organic compounds because of their specific characteristics; large surface area, an increased number of surface activation sites, a good affinity to other species [11]. Further, nanotechnology helps in the development of remediation technologies that are specific and efficient for a particular pollutant [3, 9].
Nanotechnology has potential applications in many fields, including food and agriculture, packaging, pharmaceutical, drug delivery, energy, and pollution treatment [1, 12]. Of which, the application of nanotechnology in pollution control and environmental remediation has gained popularity over the last decade; wastewater treatment, cleaning groundwater, and remediation of soil contaminated with pollutants. In the field of environment, nanotechnology has been used in pollution detection (sensing and detection), prevention of pollution, and purification/remediation of contamination [9]. Thus, nanotechnology provides a sustainable solution to the global challenges of protecting water, soil and providing cleaner air [13].
2.2 Nanomaterials in environmental remediation
Various nanomaterials such as inorganic, carbonaceous nanomaterials, polymer-based nanomaterial are used in environmental remediation (air, soil, and water) as adsorbents, catalyst, photocatalyst, membrane (filtration), disinfectants, and sensors [1, 3, 14].
Metal (silver, gold), metal oxides (iron oxides, TiO2, MgO, Fe2O3, Al2O3), and zero-valent metals (Fe0, Zn0, Sn0, and Al0) based nanoparticles are mostly studied for environmental remediation including disinfection of water, treatment of drinking water, groundwater, wastewater, and air, because of their adsorption, antibacterial, antimicrobial, photocatalytic, reductive dehalogenation, desulfurization, and catalytic reduction activities [3, 15, 16]. Carbonaceous materials in different structural configurations; fullerene, single-walled carbon nanotubes (SWCNTs), multi-walled carbon nanotubes (MWCNTs), and graphene and used in the removal of organic and inorganic contaminants from air and water due to its adsorption and photocatalytic property [3].
Nanoscale zero-valent iron (nZVI) is the most widely studied nanoparticle in soil remediation [12] and is used for reductive immobilization of heavy metals in soil that decreases the bioavailability and mobility of heavy metals and prevents leaching into groundwater and transfers to the food chain [1]. Further, nanomaterials such as nanoparticles (NPs) (metal; Au, Ag, Fe, bimetal; Fe/Ni, Ag/Cu, metal oxides; TiO2, ZnO, Fe2O3), nanotubes (carbon nanotubes, halloysite nanotubes), and nanocomposites (graphene oxide) have been reported to utilize in detection, degradation, and removal by adsorption of pesticides [17].
Emission of greenhouse gases (carbon dioxide, methane, nitrous oxide, and fluorinated gases), volatile organic compounds (ethylene, aniline, benzene), are controlled either by separation or capturing, such as filtration, absorption in liquids, adsorption on solids, or a combination of these processes. In addition, bioaerosols (aerosols of biological origin such as viruses, bacteria, and fungi), an indoor air pollutant, can rapidly spread with airflow and can cause numerous diseases, including infections and allergies. The air filtration process using antimicrobial materials such as Ag NPs, Cu NPs, CNTs, and natural products is the most applied and effective technique to remove bioaerosols [1].
Various nanomaterials have also been studied for the treatment of drinking water and industrial wastewater, including adsorbents (nZVI or Fe, MnO, ZnO, MgO, Al2O3, TiO2, Magnetite or Fe3O4, CNT), photocatalysts (ZnO, TiO2, metal-based nanocomposites such as Ag/ZnO and Pt/ZnO, CdS, ZnS: Cu, CdS: Eu, CdS: Mn), electrocatalysts (Pt, Pd, Au/metal oxides TiO2, MgO, Fe2O3, Al2O3), nano-membranes (MWCNTs, electrospun PVDF, PVC, sodium titanate nanobelt membrane), disinfectants with antibacterial effects (Ag NPs, chitosan NPs, TiO2), nanosensors (Au NPs, Ag NPs) [14, 16, 18].
2.3 Hybrid nanomaterials
The term hybrid refers to fusion, joining, or mixing of characteristics at the molecular level, which generates a hybrid material owning the effective functionality of single components and eliminates undesirable characteristics [19, 20]. In this context, hybrid nanomaterials are defined as materials that are made up of two or more organic or inorganic components such as organic-organic (starch-cellulose), inorganic-inorganic (TiO2-Ag), and organic-inorganic (starch-TiO2) compounds, connected at the nanometer scale, combine the intrinsic characteristics of its individual constituents to additional properties due to synergistic effects between the components [21, 22]. These hybrid materials are synthesized by different methods such as covalent immobilization, electrostatic binding, polymerization methods, among others [21]. The properties of the hybrid material vary with the material (organic or inorganic), structure, and different component interface, and the optimum combination can enhance mechanical strength and thermosensitivity, improve thermal and chemical stability, and regulate optical, anticorrosive, magnetic, electrical, and thermal properties as well as fire retardancy [23]. Because of their excellent mechanical, physical, and tribological characteristics, hybrid nanomaterials are widely used in the area of food packaging, plant protection, electrochemistry, and various additional applications in the environmental, biotechnological, and agri-food sectors [19].
Generally, hybrid materials are classified into two categories depending on the intra- and intermolecular interactions among the organic matrix and cross-linking agent [21, 23];
Class I (organic and inorganic exhibiting weaker interactions such as noncovalent interactions; van der Waals and hydrogen bonding).
Class II (organic and inorganic exhibiting strong interactions such as covalent, ionic, ionocovalent, and coordinative bonding).
“Polymer-based composites” or “nanocomposites” can be defined as hybrid organic-inorganic composites when incorporating either component in nanoscale and generally obtained by incorporation of a small quantity of an inorganic component into an organic or a polymer matrix in order to form a new component with enhanced properties [24]. The “bio-nano composites” are the materials that comprise particles with at least one dimension in the range of 1–100 nm and a constituent(s) of the biological origin or maybe biopolymers.
Biopolymers (natural polymers) have received much attention in recent last decades due to their abundance, low toxicity, low cost, biodegradability, biocompatibility, and multiple functionalities [25]. A variety of biopolymers such as polysaccharides (cellulose, chitin, chitosan, pectin, starch, dextran, xanthan, guar gum, fucoidan, heparin, hyaluronan, and pullulan), proteins (albumin, casein, collagen, fibrinogen, and gelatin), polylactic acid (PLA), and nucleic acids have been used as alternative eco-friendly materials to replace synthetic polymers or petroleum-based polymers (PP, PE, and epoxies) partially or even totally [25, 26, 27]. Polysaccharide-based hybrid nanocomposites have become increasingly essential materials over the past decades [25, 27]. Many studies have reported the application of polysaccharide-based nanocomposites (natural polymer) in various fields such as food, biomedical, ecofriendly and sustainable food packaging, and environmental pollution control and remediation [28, 29, 30].
Due to the poor barrier, mechanical, and processing properties, natural polymers (biopolymers) are incorporated with other synthetic polymers or nanomaterials to improve their properties and applications [31]. Polysaccharides such as cellulose, chitin, chitosan, and starch are the most studied biopolymers and used in biodegradable nanocomposites with metal nanoparticles (Au, Ag, Cu, and Pd), metal oxide nanoparticles (TiO2, ZnO, CuO, Cu2O, SiO2, Fe2O3, and Fe3O4) and carbon nanomaterials (graphene and carbon nanotubes, CNTs) [25].
3. Starch hybrid nanomaterials for environmental remediation
3.1 Starch
Starch, a natural, abundant, renewable, biocompatible, and biodegradable biopolymer, is naturally found in many plants as the primary source of energy and reserved in many parts of plants such as stalks, stems, roots, tubers, and seeds; main sources being cassava, wheat, rice, barley, maize or corn, banana, and potatoes, among others. Starch is a heteropolysaccharide that comprises d-glucose monomers joined with glycosidic bonds and can be denoted as (C6H10O5)n with the basic chemical formula. Starch is a heteropolysaccharide composed of two types of macromolecules: linear amylase (around 10–30% of starch granule) and branched amylopectin (remaining 70–90% of starch granule). Amylose is a linear polysaccharide chain of d-glucose units linked by α-(1,4)-glycosidic bond with a degree of polymerization in a range of 300–10,000. Amylopectin is a very high-molecular-weight polymer with a backbone structure of amylase cross-linked through α-(1,6) glycosidic bonds. The basic structure of amylose and amylopectin are shown in Figure 1 [25, 32, 33].
Figure 1.
Structures of starch: (a) amylose and (b) amylose pectin.
3.2 Starch hybrid nanomaterials
Starch-based nanocomposites have wide applications in the fields of food and agriculture, packaging, biomedical, and environmental remediation as emulsion stabilizers, fat replacers, flexible films, carriers of bioactive compounds, drug delivery, and adsorbents in sewage treatment or wastewater treatment [34, 35, 36]. Starch nanoparticles are usually smaller than 300 nm in dimension with a high specific surface area. The various forms of starch-based nanoparticles are starch nanoparticles, starch nanospheres, starch micelles, starch vesicles, starch nanogels, and starch nanofibers [36].
Starch is a natural polymer, gained much attention because of its renewability, biodegradability, abundance, eco-friendly, relatively low cost, non-toxic, high adsorptive capacities, amenable to various chemical modifications, and cohesive film-forming properties. Starch molecules can bind with the heavy metal ions or contaminants through the functional (hydroxyl) groups on the starch structure [37, 38]. Further, high amylopectin content in starch has powerful swelling properties that are important in sorption-based applications [39]. In most published works, carbohydrates have been used as reducing, stabilizing, and/or complexing agents [40].
However, starch in a pure or native form has drawbacks such as poor processability, high brittleness, susceptibility to retrogradation, high viscosity, low adsorption capacity, and greater hydrophilicity or high-water absorption capacity, which limits its many applications in the environmental field. To overcome this problem and to obtain water-insoluble materials, starch is modified by physically [hydrothermal processing (i.e. gelatinization)] or chemically (etherification, esterification, crosslinking, grafting, oxidation, and enzymatic hydrolysis) or a combination of these two methods [41, 42, 43, 44]. Polysaccharides exhibit a great number of reactive hydroxyl groups, which can be exploited for direct esterification, etherification, and various chemical modifications [41].
Starch-based hybrid materials have numerous functionalities and/or novel properties due to the interactions between the individual constituents, mostly associated with synergetic effects, and have been reported in environmental remediation applications [25]. Several starch-based composites have been reported to have a remarkable adsorption tendency for the removal of heavy metals and dyes [45].
3.3 Starch-based hybrid nanomaterials in environmental remediation
3.3.1 Starch/metal or metal oxides or non-valent metals
Table 1 shows the recent examples of the combination of starch and different metal, metal oxide, zero-valent metal, CNTs, and other polymers nanoparticles, such as Au, Ag, Cu, Pd, ZnO, TiO2, nZVI, among others. Nanomaterials are widely used to treat different contamination because of their high specific surface area to volume ratio, rapid kinetics, and high reactivity. However, pure or unmodified nanoparticles tend to agglomerate easily into larger particles that decrease the available specific surface area and reactivity. To improve the colloidal stability of nanoparticles, surface modification has been done by coating with various polymers. Of which starch is one of the relatively cheap and green polysaccharides [53, 59].
Various starch-based hybrid nanomaterials and their applications in environmental remediation.
Rashid et al. reported that modified tapioca starch could be used as an effective surface modifier for nZVI particles for aqueous nitrate removal [53]. Starch-stabilized Fe/Cu nanoparticles in arsenic (As2+ and As5+) removal from the contaminated water where Cu as a metal catalyst was incorporated with Fe0 (nZVI) to form an iron bimetallic nanoparticle; then, the surface was modified to prevent the agglomeration [46]. Well stabilized (dispersed) iron oxides nanoparticles offer greater specific surface area and sorption capacity than the nanoparticles without any stabilizer towards a wide range of pollutants. Starch-functionalized magnetite (Fe3O4) nanoparticles showed much higher As2+ and As5+ sorption capacity than pristine magnetite nanoparticles [59]. Starch-stabilized Fe3O4 nanoparticles can be used as a “green” adsorbent for the effective removal of perfluorooctanoic acid (PFOA) in soil and groundwater [47]. Baysal et al. reported that starch-coated TiO2 NPs can be successfully used as adsorbents for the removal and determination of heavy metals such as Cd, Co, Cu, Pb, and Ni [11]. The starch-based SnO2 nanocomposite material can be used as an adsorbent for the removal of highly toxic Hg2+ metal ions from an aqueous medium [51].
3.3.2 Starch/carbon nanotubes (CNTs)
CNTs have gained increased attention in multidisciplinary studies because of their unique physical and chemical properties. However, the hydrophobicity of CNTs may limit their application. The hydrophilicity and biocompatibility of CNTs can be improved by incorporating biopolymers such as starch in the composite system. Incorporating CNTs with starch also helps to overcome the limitation of starch, i.e. weak mechanical properties and poor long-term stability [60, 61]. MWCNT-starch-iron oxide has been reported as a better adsorbent for removing anionic dye methyl orange (MO) and cationic dye methylene blue (MB) from aqueous solutions than MWCNT-iron oxide. The hydrophilic property of soluble starch improved the hydrophilicity of MWCNTs and the dispersion of MWCNT-starch-iron oxide in the aqueous solution. In addition, the increased contact surface between magnetic MWCNT and dyes reduced the aggregates of MWCNTs and facilitated the diffusion of dye molecules to the surface of MWCNTs. Nanoparticles, ZnO, TiO2, or Ag or their complex decompose the adsorbed organic contaminants on MWCNTs as the photocatalysts [60].
3.3.3 Blending starch nanoparticles with different biopolymeric matrices
Starch-based hydrogels have a good adsorption capacity, which can be used for wastewater treatment by removing various cationic or anionic dyes after modification with functional groups [44]. The incorporation of starch into synthetic polymer hydrogel networks improves their swelling and adsorption capacity [44]. Hydrogel as an adsorbent is one of the best candidates for removing soluble dyes from an aqueous solution. The study of methylene blue (MB) adsorption efficiency of NaOH-treated starch/ acrylic acid hydrogel showed high dye-capturing coefficients, which increase with the starch ratio and indicates the possibility of the hydrogels’ application for removing dyes from aqueous solution. In which, starch can be a natural-polymer superabsorbent because of a large number of hydrophilic groups (–OH) and other benefits such as renewable, very cheap, and biodegradable [62]. Biodegradable polymers, starch/cellulose nanowhiskers hydrogel composite, showed outstanding adsorption capacity to be employed in the remediation of methylene blue contaminated wastewaters [63]. Pectin-starch magnetite hybrid nanoparticles could be potential adsorbents for methylene blue dye with higher adsorption efficiency at a low polymer concentration and starch-pectin ratio and can be used to recycle water from the textile industry [58].
3.4 Limitations and future studies for using starch hybrid nanomaterials in environmental remediation
Increased nano-waste release in the environment, bioaccumulation, occupational exposure, and nanotoxicity are the major problems associated with the increased use of nanomaterials in environmental remediation. Nanoparticles incorporated in starch-based hybrid nanomaterials such as Ag, Au, nZVI, TiO2, SiO2, ZnO, Al2O3, CNTs, metal chalcogenides (CdS, CdSe), polymeric nanoparticles, among others, shows toxicity (acute or chronic) in high dose; growth inhibition of microalgae, disruption of membrane integrity, reactive oxygen species generation, oxidative stress, genotoxicity, and mutagenicity up to reproduction impairment in aquatic species and many health complications in human [41, 64, 65, 66, 67].
Because of the very small size, nanoparticles are capable of entering the human body by inhalation, ingestion via food, drink, and drugs, skin penetration, or injections and they have the potential to interact with intracellular structures and macromolecules for long periods [68]. Exposure to nanoparticles is associated with a range of acute and chronic effects ranging from inflammation, exacerbation of asthma, and metal fume fever to fibrosis, chronic inflammatory lung diseases, and carcinogenesis [64].
The effect of surface modification of nanoparticles such as nZVI is not clear. Sun et al. reported that surface modifiers enhance the stability of the nZVI that either increase the toxicity due to prolonged exposure to the living organisms or decrease the toxicity via reducing the adhesion of nZVI to living organisms or preventing the release of toxic ions. Starch stabilized nZVI produced higher phytotoxicity compared to bare nZVI, this may be due to the higher dispersity, hydrophilicity, and anti-aggregation of starch/nZVI that enhances their affinity to root surfaces and the oxidability of the Fe0, forming a coating of insoluble Fe3+ compounds on the root surface, and thus interferes the absorption of water and nutrients [69].
In the future, attention will be given to the green synthesis of nanomaterials because not all nanomaterials are produced in an eco-friendly way, as involves acid hydrolysis in multiple steps. There are several systems and methods for the green synthesis of nanoparticles, particularly enzymes, vitamins, microwave, bio-based methods, and from plants and phytochemicals [67, 70]. Green synthesis of nanoparticles using various natural sources, non-toxic solvents, and techniques (ultrasound, microwave, hydrothermal, magnetic, and bioproduction by fungi and other microorganisms) promote eco-friendly, sustainable, less expensive, and free of chemical contaminant production and applications [68].
Nano-wastes should be diluted and neutralized before disposal as they are extraordinarily toxic, hazardous, and/or chemically reactive. Proactive nano-waste management strategies need to be adopted to prevent long-term unintended consequences, and, where possible, nano-waste should be recycled [64].
4. Conclusion
Remediation is the science of removal or reduction of pollutants from the environment using chemical or biological means. Starch-based hybrid materials are a cost-effective and eco-friendly solution over petroleum-based polymers in environmental remediation. Though starch is a natural polymer with many benefits, including renewability, biodegradability, abundance, eco-friendly, relatively low cost, non-toxic, poor barrier, and mechanical properties, poor processability, high brittleness, and high hydrophilicity are major drawbacks of raw starch. Therefore, starch is modified by physical and/or chemical methods, including gelatinization, etherification, esterification, crosslinking, grafting, oxidation, and enzymatic hydrolysis.
Starch-based hybrid materials have numerous functionalities and/or novel properties, mainly associated with synergetic effects and reported in environmental remediation applications. Starches are incorporated with metal NPs, metal oxide NPs, zero-valet metals, CNTs, and other polymers as reducing, stabilizing, and/or complexing agents to remove various toxic contaminants such as heavy metal, organic contaminants, and dye wastewater and groundwater.
In future studies, various natural starch sources, green synthesis of nanomaterials, recyclability, and toxicity effect of nano-waste should be considered. Further development of biodegradable starch-based hybrids and nanomaterials focusing on new functional materials, processing technology, and cost reduction needs to be studied for commercial application.
Conflict of interest
The authors declare no conflict of interest.
\n',keywords:"environmental remediation, hybrid nanomaterials, nanomaterials, starch, starch-based hybrid nanomaterials",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/79856.pdf",chapterXML:"https://mts.intechopen.com/source/xml/79856.xml",downloadPdfUrl:"/chapter/pdf-download/79856",previewPdfUrl:"/chapter/pdf-preview/79856",totalDownloads:121,totalViews:0,totalCrossrefCites:0,totalDimensionsCites:0,totalAltmetricsMentions:0,introChapter:null,impactScore:0,impactScorePercentile:50,impactScoreQuartile:2,hasAltmetrics:0,dateSubmitted:"November 5th 2021",dateReviewed:"November 19th 2021",datePrePublished:"December 30th 2021",datePublished:"June 28th 2022",dateFinished:"December 30th 2021",readingETA:"0",abstract:"Environmental pollution is becoming a major global issue with increasing anthropogenic activities that release massive toxic pollutants into the land, air, and water. Nanomaterials have gained the most popularity in the last decades over conventional methods because of their high surface area to volume ratio and higher reactivity. Nanomaterials including metal, metal oxide, zero-valent ions, carbonaceous nanomaterials, and polymers function as adsorbents, catalysts, photocatalysts, membrane (filtration), disinfectants, and sensors in the detection and removal of various pollutants such as heavy metals, organic pollutants, dyes, industrial effluents, and pathogenic microbial. Polymer-inorganic hybrid materials or nanocomposites are highly studied for the removal of various contaminants. Starch, a heteropolysaccharide, is a natural biopolymer generally incorporated with other metal, metal oxide, and other polymeric nanoparticles and has been reported in various environmental remediation applications as a low-cost alternative for petroleum-based polymers. Therefore, this chapter mainly highlights the various nanomaterials used in environmental remediation, starch-based hybrid nanomaterials, and their application and limitations.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/79856",risUrl:"/chapter/ris/79856",book:{id:"10798",slug:"starch-evolution-and-recent-advances"},signatures:"Ashoka Gamage, Thiviya Punniamoorthy and Terrence Madhujith",authors:[{id:"418217",title:"Dr.",name:"Ashoka",middleName:null,surname:"Gamage",fullName:"Ashoka Gamage",slug:"ashoka-gamage",email:"ashogamage@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"443836",title:"Ms.",name:"Thiviya",middleName:null,surname:"Punniamoorthy",fullName:"Thiviya Punniamoorthy",slug:"thiviya-punniamoorthy",email:"thiviya904@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"443837",title:"Prof.",name:"Terrence",middleName:null,surname:"Madhujith",fullName:"Terrence Madhujith",slug:"terrence-madhujith",email:"tmadhujith@agri.pdn.ac.lk",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. Nanotechnology in environmental remediation",level:"1"},{id:"sec_2_2",title:"2.1 Nanotechnology and its advantages and applications",level:"2"},{id:"sec_3_2",title:"2.2 Nanomaterials in environmental remediation",level:"2"},{id:"sec_4_2",title:"2.3 Hybrid nanomaterials",level:"2"},{id:"sec_6",title:"3. Starch hybrid nanomaterials for environmental remediation",level:"1"},{id:"sec_6_2",title:"3.1 Starch",level:"2"},{id:"sec_7_2",title:"3.2 Starch hybrid nanomaterials",level:"2"},{id:"sec_8_2",title:"3.3 Starch-based hybrid nanomaterials in environmental remediation",level:"2"},{id:"sec_8_3",title:"Table 1.",level:"3"},{id:"sec_9_3",title:"3.3.2 Starch/carbon nanotubes (CNTs)",level:"3"},{id:"sec_10_3",title:"3.3.3 Blending starch nanoparticles with different biopolymeric matrices",level:"3"},{id:"sec_12_2",title:"3.4 Limitations and future studies for using starch hybrid nanomaterials in environmental remediation",level:"2"},{id:"sec_14",title:"4. Conclusion",level:"1"},{id:"sec_18",title:"Conflict of interest",level:"1"}],chapterReferences:[{id:"B1",body:'Ibrahim RK, Hayyan M, AlSaadi MA, Hayyan A, Ibrahim S. Environmental application of nanotechnology: Air, soil, and water. Environmental Science and Pollution Research. 2016;23:13754-13788. 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Faculty of Engineering, Department of Chemical and Process Engineering, University of Peradeniya, Sri Lanka
Faculty of Agriculture, Department of Food Science and Technology, University of Peradeniya, Sri Lanka
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1. Introduction
Coeliac disease (CD) represents an enteropathy affecting the small intestine that is exacerbated by gluten in wheat, rye and barley. The condition occurs in genetically susceptible individuals who carry either the HLA DQ2 or DQ8 genotype. [1] The prevalence of the condition, of which there is increasing awareness, is 1–2% in the US and Northern Europe. [2, 3]. Treatment of the condition comprises a gluten-free approach that involves removal of wheat, rye and barley from the diet. However, between 5 and 30% of affected subjects do not fully respond to a gluten-free diet, [2, 3, 4, 5, 6] and are considered to have refractory coeliac disease (RCD).
The precise diagnosis of RCD presents challenges, but is important in the development of new therapeutic strategies. [7, 8, 9]
2. Pathogenesis of RCD
Gluten proteins from wheat, rye and barley are divided into different groups. Wheat gluten comprises gliadin and glutenin. There are α, β, γ and ω gliadin fractions, and glutenin is composed of low and high molecular weight glutenins (HMWG). All these components of wheat gluten have been shown to be toxic to subjects with CD. [9]
In CD there is increased permeability of the small intestine associated with an increase in zonulin, a protein found between enterocytes that has been reported to be a modulator of tight junction permeability. [10, 11] It has been hypothesised that zonulin release induces increased absorption, into the lamina propria below the epithelium, of CD-toxic gluten fractions. The resultant gluten peptides in the lamina propria “stimulate aberrant adaptive and innate responses resulting in damage to the enterocytes, with infiltration of the mucosa by both intra-epithelial lymphocytes (IELs) and CD4 +ve lamina propria lymphocytes”. Most of the increased number of IELs are CD3 + ve/CD8 + ve cells that express the α/β T-cell receptor (TCR), and a minority are γ/𝛿 +ve (TCR)-expressing lymphocytes.
The adaptive response involves binding of the CD toxic peptides to HLA-DQ2 or HLA-DQ8. These reactive CD4 T-cells in the lamina propria recognise toxic gluten peptides and proteins. [12, 13] There is recognition of the gluten peptides bound to HLA-DQ2/DQ3, and to antigen presenting cells (APCs); this is enhanced by the enzyme tissue transglutaminase (tTg) that deamidates glutamine residues to glutamic acid [12]. Following activation of the T-cells, pro-inflammatory cytokines, including interferon-γ, are released. This in turn results in an inflammatory cascade, particularly affecting the proximal small intestine, that causes the observed villous atrophy [13].
The innate immune response appears to be mediated by IELs, enterocytes and dendritic cells, and is centred on increased secretion of the cytokine interleukin-15 (IL–15) [14]. It is possible that IL-15 production by enterocytes and dendritic cells is induced directly by gluten peptides. IL-15 stimulates the expression of MICA (a stress molecule) on enterocytes, and NKG2D (a natural killer receptor) on IELs. The IEL-induced NKG2D expression serves as an activating receptor with many ligands, including MICA [15]. In combination there may then be substantial cytotoxicity to enterocytes and thus the intestinal damage that is typical of CD.
It seems likely that RCD and uncomplicated CD have similar aetiopathogenic pathways. [14, 16] Most patients with RCD have increased levels of antigliadin and endomysial antibodies, although in RCD2 coeliac serology may become negative. Differentiation between RCD1 and RCD2 is based on evidence of either the polyclonal expansion of T-cells expression that occurs in RCD1, or the monoclonal expansion of T-cells in small intestinal biopsies or separated T-lymphocytes that can be demonstrated using double CD3/CD8 immuno-histochemistry in RCD2. An investigation of T-cell receptor clonal arrangements can be investigated by polymerase chain reaction on fresh tissue or by flow cytometry. [17, 18, 19, 20]
The mechanisms behind the clonal expansion of T-cells in RCD2 are not well understood but there are several possibilities under active consideration. Genetic variation in the myosin IXB gene (MY09B) located on chromosome 19, has been proposed as a possible aetiopathological factor. [21] There is increased repairing of MICA and c-myc by the enterocytes [21, 22, 23, 24, 25, 26]. An increase in IgM, Charcot-Leyden crystal proteins and apolipoprotein are observed and thought to be damaging in RCD2. [25] APO C3 apolipoprotein is also known to affect immunosurveillance cells, such as natural killer (NK) cells, and was singled out as potentially important in sustaining T-cell proliferation. [27]
IL-15 is overexpressed in untreated CD, and it is thought to play a pivotal role in the regulation of the IELs that characterise the disease and hence in in the pathogenesis of RCD. IELs show increased expression of IL-15Rα, elevated proliferation cytokine production and a reduction in apoptosis. [19]. It has been suggested also that IL-15 may induce the emergence of a clonal expression [19]. This multistep transformation may generate the pre-lymphomatous state and then progress to overt T-cell lymphoma [27]. Inhibition of IL-15 may have therapeutic value in RCD2 (see below) adding further weight to its suspected pathogenic importance.
3. Clinical features of RCD
3.1 Type 1 refractory coeliac disease
Patients with RCD1 may present with any combination of steatorrhoea, altered bowel habit (with both constipation and diarrhoea), abdominal pain, nausea, fatigue and weight loss [28]. RCD1 is also associated with thromboembolic infectious complications and autoimmune diseases. The radiological features on CT or MR scanning are similar to those of untreated CD, with increased ileal folds and decreased jejunal folds [29].
Patients with RCD1 exhibit Marsh type II or III appearances. [30] Both of these pathological gradings include villous atrophy. There is a moderate lymphoplasmacytic infiltrate in the lamina propria. [26] Collagen deposition (collagenous sprue) has been reported in 40% of patients with RCD1 [31]; this can be confirmed with a trichrome stain. Mucosal thinning with villous atrophy and crypt hyperplasia was reported in 30% of these patients.
The RCD1 IEL phenotype is equivalent to uncomplicated CD, with the majority of cells expressing CD3, CD7, CD8, CD103, and TCRβ. TCR gene rearrangement studies confirm that RCD1 cells constitute a polyclonal population. [28, 29, 30, 31, 32]
3.2 Type 2 refractory coeliac disease
RCD2 patients present with similar symptoms to those with RCD1, including malabsorption, weight loss, abdominal pain and diarrhoea. Most patients are aged 50–60. [28] The CT/MR appearances are similar to those in RCD1, but frequently also include lymphadenopathy, intussusception and hyposplenism. [29]
The standard histology of RCD2 mirrors RCD1, with the majority of patients demonstrating a degree of villous atrophy [30]. The cytological appearances of the IELs are normal. Cellier et al. [14] proposed that RCD2 (their refractory sprue) was associated with an abnormal subset of IELs that, on frozen section, were positive for CD103, CD7, and cytoplasmic CD3, but not for surface CD3, CD4, CD8, or TCRβ. This difference from RCD1 has contributed to the concept that RCD2 represents an early stage in the development of lymphoma. Aberrant IELs may also be found in gastric and colonic mucosa, and in the blood of RCD2 patients, implying that this is a diffuse gastrointestinal disease. The IELs in RCD2 patients rarely exhibit a normal CD3 + ve, CD8 + ve phenotype, and the majority have a CD3 + ve CD8 -ve pattern. However Goerres et al. [22] reported only a low frequency of loss of CD8 expression, and it is advocated that flow cytometry should be used to diagnose the condition.
Although a polyclonal IEL population has been reported in a very small proportion of RCD2 cases, it is usual to find monoclonality with a restricted rearrangement of the TCRβ gene when clonality studies are performed in RCD2.
4. Complications of RCD
4.1 Ulcerative Jejunitis
Most cases of ulcerative jejunitis (UJ) are preceded by problematic CD, such that UJ can be said to evolve from RCD. The mean age at onset of UJ is 50 years. The defining features are ulcerative lesions that are usually multifocal and which can involve the ileum as well as the jejunum. Presenting features include diarrhoea, steatorrhoea, abdominal pain and weight loss. There may be low grade fever, clubbing and nutritional deficiencies.
Mills et al. reported that the ulceration can extend through the full thickness of the mucosa, with secondary vascular changes [31] as well as submucosal oedema. There may also be fibrosis, leading to stricture formation. Complications can thus include haemorrhage, perforation and obstruction.
In some patients there is gastric metaplasia, and it is postulated that this contributes to ulcer formation. Most IELs in UJ have a phenotype identical to that of RCD2. The ulcers tend to show a mixed CD4 + ve/CD8 + ve and CD4-ve/CD8-ve phenotype. T-cell rearrangement studies identify clonality in the ulcers, the adjacent mucosa, or in both.
4.2 Enteropathy-type T-cell lymphoma
There is an increased risk of B- and T-cell lymphoma in coeliac disease. Enteropathy-associated T-cell lymphoma (EATL) is particularly linked to CD [29]. EATL usually presents with abdominal pain or overt intestinal perforation in adults with a background of RCD2 or UJ [33]. The strong association of EATL with HLA-DQB1 strengthens the inferred causal linkage between CD and EATL [33, 34, 35, 36].
There are two main histological types of EATL. Type 1 is characterised by an infiltrate of medium sized cells containing round or angular nuclei with prominent nucleoli and a moderate amount of eosinophilic cytoplasm [33]. There may be marked pleomorphism with appearances like those of large-cell lymphoma or Hodgkin’s lymphoma. The second, rarer type of EATL exhibits a monomorphic population of small, densely staining cells with hyperchromatic nuclei and minimal cytoplasm.
The malignant cells of both forms of EATL demonstrate monoclonality, with the same TCRγ gene rearrangement as seen in IELs in intestinal mucosa affected by the CD but which is uninvolved in the malignancy.
4.3 Other types of lymphoma
In addition to EATL, other types of non-Hodgkin’s lymphoma are over-represented in patients with CD. Subtypes observed include B-cell neoplasms, follicular lymphoma, extranodal marginal zone lymphoma, and T-cell neoplasms.
4.4 Carcinoma of the GI tract
CD has an association with small bowel adenocarcinoma, which usually presents after the age of 45, with abdominal pain, weight loss, and/or anaemia. There is also an increased risk of squamous cell carcinoma of the upper digestive tract, including the oesophagus and oropharynx. There are minimally increased risks of primary liver cancer and of colorectal cancer.
5. Diagnostic approach to RCD
There are many reasons for patients with CD to fail to respond to a gluten-free diet, of which an underlying diagnosis of RCD is only one. [34] Poor dietary compliance and potential confusion of CD with other conditions should be excluded.
It has been suggested that a minimum of three properly orientated crypt to villous units are necessary for reliable interpretation of villous atrophy [34]. Helicobacter pylori, giardia, tuberculosis, tropical sprue, Whipple’s disease, viral enteritis, AIDS, autoimmune enteritis, food protein intolerance, Crohn’s disease, common variable immunodeficiency, collagenous sprue and eosinophilic gastroenteritis may all mimic CD [34]. Their exclusion from the differential diagnosis is not always straightforward when histological criteria are ambivalent or when multiple conditions co-exist (eg CD and infection).
The diagnosis of RCD runs in parallel with that of an initial comprehensive diagnosis of CD, which will therefore be briefly reprised. Coeliac serology should be obtained, with IgA and IgG antibodies to tissue transglutaminase and endomysium. Gliadin antibodies are unhelpful as IgG gliadin antibodies are raised in 5% of normal subjects, and in many of the conditions documented above, particularly Crohn’s disease. HLA DQ2/DQ8 studies should be undertaken. A set of intestinal biopsies should be obtained for histological assessment. These endoscopic biopsies should be repeated after 4–6 months to confirm the diagnosis, and when RCD is suspected. [15]
In addition to evidence of villous atrophy, the biopsies will be examined for increased intraepithelial lymphocytes. The suggested normal upper limit for the small intestinal mucosa is 25 IELs per 100 enterocytes, with 25–29 considered borderline, and ≥ 30 IELs regarded as pathological lymphocytosis. In the normal small intestine there is a gradual reduction in the density of IELs between the bases and tips of the villi [37, 38]; a more even distribution of IELs along the lengths of the villi is strongly suggestive of underlying active CD [38, 39]. There is however a wide range of other conditions which cause intra-epithelial lymphocytosis, including H. pylori infection, enteric infarction, and autoimmune disease, and this may also occur with non-steroidal anti-inflammatory or other drugs.
According to the ESPGHAN diagnostic algorithm, the combination of a typical history, HLA-DQ2/8 positivity and coeliac serology at >10 x normal levels constitutes a diagnosis of coeliac disease in children [35]. Consequent to the COVID pandemic, the same diagnostic algorithm is now proposed for adults with symptoms of CD so long as they are ≤55 years of age, have no red flag symptoms, have a normal total IgA level, have an IgA tTG ≥ 10 times upper limit of normal, and a second positive antibody test such as anti-endomysial antibodies. However, most gastroenterologists feel this approach should only be temporary, as there is frequently discrepancy between the results of serology and small intestinal morphology [36, 40].
RCD will be considered in the patient who remains symptomatic or with persistently abnormal laboratory markers after apparent compliance with a gluten-free diet. Clinico-pathological correlation should first be undertaken to ensure that the initial diagnosis of CD was fully supported, including HLA DQ2/8 status, anti-endomysial and tissue transglutaminase antibodies, together with the presence of small bowel lesions, with particular attention to any history of a previous response to a gluten-free diet. RCD is however a histological diagnosis. Histological assessment will be particularly important where the initial diagnosis was made without a biopsy.
Appraisal of the gluten-free diet is crucial when contemplating RCD, as gluten contamination is the commonest cause of failure to respond to a gluten free diet. Contamination can be asymptomatic with minimal quantities, and can occur in patients who have received poor advice or are unaware of the broad range of products that can contain gluten [28].
In the absence of an aberrant IEL immunophenotype, the main differential diagnosis of CD-like histological lesions is limited to uncomplicated but inadequately treated CD, and RCD1. If there was no prior histology giving a diagnosis of CD, then a history of a previous response to a gluten-free diet is naturally highly supportive [28, 29, 30, 31, 32, 33, 34, 35, 36]. Both CD and RCD1 exhibit a polyclonal increase in IELs, mostly a CD3 + ve/CD8 + ve IEL population. Persistence or recurrence of small bowel lesions of this type, despite strict adherence to a gluten-free diet for at least one year, fulfils most observers’ criteria for a diagnosis of RCD1.
The demonstration of a predominant CD3 + ve/CD8-ve aberrant IEL phenotype leads to the consideration of RCD2 and its complications, including EATL. Polymerase chain reaction assessment of IELs and flow cytometry are now widely used to complement immunohistochemistry in the diagnosis of RCD2. These studies illustrate the importance of immune regulation in the likely pathogenesis of RCD and of RCD2 in particular.
Focal neoplasia (EATL and other forms) may be difficult to identify within the diffusely abnormal small intestine found in RCD2. Video capsule endoscopy, and PET-CT tomography scanning have been shown to be more effective in pinpointing EATL than CT alone. Video capsule endoscopy and subsequent enteroscopy are particularly useful in detecting the more subtle lesions that may be the only macroscopic evidence of an underlying lymphoma. Elwenspoel et al propose to undertake an assessment of the accuracy of all potential diagnostic routes for coeliac disease and its complications involving a systematic review, the results of which are awaited [41].
6. Treatment of RCD
6.1 RCD1
All RCD patients should be reviewed by an expert dietitian in order to help them maximise their ability to adhere to a strict gluten-free diet.
In RCD1 the addition of systemic steroids has proven useful in some patients. The anti-TNFα biologic infliximab has also been proposed for the treatment of resistant coeliac disease [42]. Subsequent proposals have suggested a regimen of prednisolone and azathioprine that led to histological and clinical improvement in the majority of RCD1 patients following treatment for one year [22]. Dosages need some personalisation, but a tapering schedule of prednisolone (from 40 mg/day to less than 10 mg) with azathioprine at 2 mg/kg seem appropriate for most patients.
Use of an elemental diet not only provided clinical and histological improvement, but also reduced epithelial expression of the cytokine IL-15.
The specific defect in permeability associated with zonulin excess appears to be improved on treatment with larazotide acetate. [11]
6.2 RCD2
Prednisolone/azathioprine has been found to be helpful in some patients with RCD2 [8, 22].
Chemotherapy agents, such as the anti T-cell nucleoside analogues including pentostatin and cladribine have also been used with some success. [43]
Recently, IAMG 714, a monoclonal antibody to IL-15, has been studied in a randomised, double-blind, placebo-controlled, parallel-group trial in patients with type 2 refractory coeliac disease [44, 45].
Stem cell transplantation has been proposed as a therapeutic option, but this invasive approach is not generally accepted.
Overt lymphoma will be treated on standard oncological criteria and will normally fall outside the responsibility of the gastroenterologist.
7. Conclusions
In conclusion, the diagnosis of RCD is not straightforward. This interpretation of the clinical picture may have been incorrect, and the original diagnosis should always be reviewed, incorporating a re-assessment of the histology of small intestinal biopsies. Assessment of the gluten-free diet and correlation with the results of serology should be undertaken. PCR evaluation of biopsies or separated lymphocytes can be used to differentiate between RCD1 and RCD2, the former resembling severe but uncomplicated CD, while the latter typically has monoclonality and potentially premalignant features.
Treatment options have included steroids, azathioprine, infliximab, cladribine, stem cell transplantation and humanised monoclonal antibody to IL-15, (IAMG 714). There is to date no established standard intervention.
Acknowledgments
Ms. Janet Schulz kindly typed the first draft of the manuscript.
Neither PJ Ciclitira nor A Forbes holds current grant funding to support generation of this manuscript and there are no other potential conflicts of interest to declare.
Acronyms and non-standard abbreviations
APC
Anti-Presenting Cells
APO
Apolipoprotein
CD
Coeliac Disease
CT
Computed Tomography
EATL
Enteropathy-associated T-cell lymphoma
IELs
Intraepithelial lymphocytes
(Ig)A and (Ig)G
Immunoglobulins
IL
Interleukin
iNK
Invariant natural killer cells
MR
Magnetic resonance
NHL
Non-Hodgkin’s lymphoma
NK
Natural killer
RCD
Refractory coeliac disease
TCR
T-cell receptor
tTG
Tissue transglutaminase
UJ
Ulcerative jejunitis
\n',keywords:"coeliac disease, refractory coeliac disease, presentation, diagnosis and treatment",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/75361.pdf",chapterXML:"https://mts.intechopen.com/source/xml/75361.xml",downloadPdfUrl:"/chapter/pdf-download/75361",previewPdfUrl:"/chapter/pdf-preview/75361",totalDownloads:307,totalViews:0,totalCrossrefCites:0,dateSubmitted:"September 23rd 2020",dateReviewed:"January 26th 2021",datePrePublished:"March 5th 2021",datePublished:"May 12th 2021",dateFinished:"February 23rd 2021",readingETA:"0",abstract:"Coeliac disease (CD) is an immune-mediated disorder affecting the small intestine. The condition represents an intolerance to gluten. Removal of dietary gluten permits recovery, with a full recovery for the majority of affected subjects. A percentage of affected subjects who do not improve with a gluten-free diet are considered to have refractory coeliac disease (RCD). Refractory coeliac disease is subdivided into type 1, characterised by a polyclonal expansion of intraepithelial lymphocytes (IELs) that have a normal phenotype, and type 2 (RCD2) which exhibits IELs with a monoclonal phenotype. Subjects with RCD carry a high risk of complications, including ulcerative jejunitis and lymphoma affecting the small intestine, the latter termed enteropathy-associated T-cell lymphoma (EATL).",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/75361",risUrl:"/chapter/ris/75361",signatures:"Paul J. Ciclitira and Alastair Forbes",book:{id:"9481",type:"book",title:"Celiac Disease",subtitle:null,fullTitle:"Celiac Disease",slug:"celiac-disease",publishedDate:"May 12th 2021",bookSignature:"Jianyuan Chai",coverURL:"https://cdn.intechopen.com/books/images_new/9481.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",isbn:"978-1-83962-536-7",printIsbn:"978-1-83962-535-0",pdfIsbn:"978-1-83962-537-4",isAvailableForWebshopOrdering:!0,editors:[{id:"28281",title:"Dr.",name:"Jianyuan",middleName:null,surname:"Chai",slug:"jianyuan-chai",fullName:"Jianyuan Chai"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"332464",title:"Prof.",name:"Paul J.",middleName:null,surname:"Ciclitira",fullName:"Paul J. Ciclitira",slug:"paul-j.-ciclitira",email:"pciclitira@btinternet.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"King's College London",institutionURL:null,country:{name:"United Kingdom"}}}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Pathogenesis of RCD",level:"1"},{id:"sec_3",title:"3. Clinical features of RCD",level:"1"},{id:"sec_3_2",title:"3.1 Type 1 refractory coeliac disease",level:"2"},{id:"sec_4_2",title:"3.2 Type 2 refractory coeliac disease",level:"2"},{id:"sec_6",title:"4. Complications of RCD",level:"1"},{id:"sec_6_2",title:"4.1 Ulcerative Jejunitis",level:"2"},{id:"sec_7_2",title:"4.2 Enteropathy-type T-cell lymphoma",level:"2"},{id:"sec_8_2",title:"4.3 Other types of lymphoma",level:"2"},{id:"sec_9_2",title:"4.4 Carcinoma of the GI tract",level:"2"},{id:"sec_11",title:"5. Diagnostic approach to RCD",level:"1"},{id:"sec_12",title:"6. Treatment of RCD",level:"1"},{id:"sec_12_2",title:"6.1 RCD1",level:"2"},{id:"sec_13_2",title:"6.2 RCD2",level:"2"},{id:"sec_15",title:"7. Conclusions",level:"1"},{id:"sec_16",title:"Acknowledgments",level:"1"},{id:"sec_16",title:"Acronyms and non-standard abbreviations",level:"1"}],chapterReferences:[{id:"B1",body:'Green PHR, Cellier C. Celiac disease. N. Engl. J. Med. 2007: 357: 1731-1743'},{id:"B2",body:'van Heel DA, West J. Recent advances in coeliac disease. Gut 2006: 55; 1037-1046'},{id:"B3",body:'Ciclitira PJ, King AL, Fraiser JS. AGA technical review on celiac sprue. American Gastroenterological Association. Gastroenterology 2001: 120; 1526-1540'},{id:"B4",body:'Cellier C, Cerf-Bensussan N. Treatment of clonal refractory celiac disease or cryptic intraepithelial lymphoma: a long road from bench to bedside. Clin. Gastroenterol. Hepatol. 2006: 4; 1320-1321'},{id:"B5",body:'Koning F. Celiac disease: caught between a rock and a hard place. 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Gut 2014; 63: 1210-1228'},{id:"B16",body:'Koning F, Schuppan D, Cerf-Bensussan N, Sollid LM. Pathomechanisms in celiac disease. Best Pract. Res. Clin. Gastroenterol. 2005; 19; 373-387'},{id:"B17",body:'Al-Toma A, Goerres MS, Meijer JWR, Peña AS, Crusius JBA, Mulder CJJ. Human leukocyte antigen-DQ2 homozygosity and the development of refractory celiac disease and enteropathy-associated T-cell lymphoma. Clin Gastroenterol Hepatol. 2006; 4(3): 315-319'},{id:"B18",body:'Brousse N, Meijer JW. Malignant complications of coeliac disease. Best Pract. Res. Clin. Gastroenterol. 2005: 19: 401-412'},{id:"B19",body:'Di Sabatino A, Ciccocioppo R. Cupelli F, et al. Epithelium derived interleukin 15 regulates intraepithelial lymphocyte Th1 cytokine production. cytotoxicity. and survival in coeliac disease. Gut 2006: 55; 469-477'},{id:"B20",body:'Cellier C, Patey N, Mauvieux L, Jabri B, Delabesse E, Cervoni JP, et al. Abnormal intestinal intraepithelial lymphocytes in refractory sprue. 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Gluten, major histocompatibility complex, and the small intestine. A molecular and immunobiologic approach to the spectrum of gluten sensitivity (\'celiac sprue\'). Gastroenterology 1992; 102(1):330-354'},{id:"B31",body:'Mills PR, Brown IL, Watkinson C. Idiopathic chronic ulcerative enteritis. Report of five cases and review of the literature. QJMed 1980: 49: 133-149'},{id:"B32",body:'Bagdi E, Diss T, Munson P, Isaacson P. Mucosal intra-epithelial lymphocytes in enteropathy-associated T-cell lymphoma, ulcerative jejunitis, and refractory celiac disease constitute a neoplastic population. Blood 1999; 94: 260-264'},{id:"B33",body:'Rooney N, Dogan A. Gastrointestinal lymphoma. Curr. Diagn. Pathol. 2004: 10; 69-78'},{id:"B34",body:'Abdulkarim A, Burgart LJ, See J, Murray JA. Etiology of nonresponsive celiac disease: results of a systematic approach. Am. J. Gastroenterol. 2002: 97: 2016-2021'},{id:"B35",body:'ESPGHAN 2020. New guidelines for the diagnosis of paediatric coeliac disease. https://www.espghan.org/knowledge-center/publications/Clinical-Advice-Guides/2020_New_Guidelines_for_the_Diagnosis_of_Paediatric_Coeliac_Disease. (Accessed 22/12/20)'},{id:"B36",body:'Penny HA, Sanders DS, Gillett H, Gillett P, Edwards CM. Progress in the serology-based diagnosis and management of adult coeliac disease. Expert Rev Gastroenterol Hepatol 2020. 13: 1-8'},{id:"B37",body:'Hayat M, Cairns A, Dixon MF, O\'Mahony S. Quantitation of intraepithelial lymphocytes in human duodenum: what is normal? J. Clin. Pathol. 2002: 55; 393-394'},{id:"B38",body:'Veress B, Franzen L, Bodin L, Borch K. Duodenal lntraepithelial lymphocyte-count revisited. Scand. ]. Gastroenterology. 2004: 39; 138-144'},{id:"B39",body:'Goldstein NS, Underhill J. Morphologic features suggestive of gluten sensitivity in architecturally normal duodenum biopsy specimens. Am. J. Clin. Pathol. 2001: 116; 63-71'},{id:"B40",body:'Goldstein NS. Proximal small-bowel mucosa! villous intraepithelial lymphocytes. Histopathology 2004: 44; 199-205'},{id:"B41",body:'Elwenspoek MMC, Jackson J, Dawson S, Everitt H, Gillett P, Hay AD, et al. Accuracy of potential diagnostic indicators for coeliac disease: a systematic review protocol. BMJ Open 2020; 10 (10): e038994'},{id:"B42",body:'Chaudhary R, Ghosh S. lnfliximab in refractory coeliac disease. Eur. J. Gastroentrol. Hepatol. 2005 : 17; 603-604'},{id:"B43",body:'Al-Toma A, Goerres MS, Meijer JWR, von Blomberg BME, Wahab PJ, Kerckhaert JAM, Mulder CJJ. Cladribine therapy in refractory celiac disease with aberrant T-cells. Clin. Gastroenterol. Hepatol. 2006; 4(11): 1322-1327'},{id:"B44",body:'Cellier C, Bouma G, van Gils T, Khater S, Malamut G, Crespo L, et al. Safety and efficacy of AMG 714 in patients with type 2 refractory coeliac disease: a phase 2a, randomised, double-blind, placebo-controlled, parallel-group study. Lancet Gastroenterol Hepatol 2019. 4(12): 960-970'},{id:"B45",body:'Vicari AP, Schoepfer AM, Meresse B, Goffin L, Léger O, Josserand S, et al. Discovery and characterization of a novel humanized anti-IL-15 antibody and its relevance for the treatment of refractory celiac disease and eosinophilic esophagitis. MAbs 2017; 9: 927-944'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Paul J. Ciclitira",address:"pciclitira@btinternet.com",affiliation:'
Department of Medicine, Norwich Medical School, University of East Anglia, UK
Department of Medicine, Norwich Medical School, University of East Anglia, UK
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UK Research and Innovation (former Research Councils UK (RCUK) - including AHRC, BBSRC, ESRC, EPSRC, MRC, NERC, STFC.) Processing charges for books/book chapters can be covered through RCUK block grants which are allocated to most universities in the UK, which then handle the OA publication funding requests. It is at the discretion of the university whether it will approve the request.)
Wellcome Trust (Funding available only to Wellcome-funded researchers/grantees)
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However, some of these heavy metals in high doses can be harmful to the body while others such as cadmium, mercury, lead, chromium, silver, and arsenic in minute quantities have delirious effects in the body causing acute and chronic toxicities in humans. The focus of this chapter is to describe the various mechanism of intoxication of some selected heavy metals in humans along with their health effects. Therefore it aims to highlight on biochemical mechanisms of heavy metal intoxication which involves binding to proteins and enzymes, altering their activity and causing damage. More so, the mechanism by which heavy metals cause neurotoxicity, generate free radical which promotes oxidative stress damaging lipids, proteins and DNA molecules and how these free radicals propagate carcinogenesis are discussed. Alongside these mechanisms, the noxious health effects of these heavy metals are discussed.",book:{id:"7111",slug:"poisoning-in-the-modern-world-new-tricks-for-an-old-dog-",title:"Poisoning in the Modern World",fullTitle:"Poisoning in the Modern World - New Tricks for an Old Dog?"},signatures:"Godwill Azeh Engwa, Paschaline Udoka Ferdinand, Friday Nweke Nwalo and Marian N. Unachukwu",authors:[{id:"241837",title:"Mr.",name:"Godwill Azeh",middleName:null,surname:"Engwa",slug:"godwill-azeh-engwa",fullName:"Godwill Azeh Engwa"},{id:"274194",title:"BSc.",name:"Paschaline Ferdinand",middleName:null,surname:"Okeke",slug:"paschaline-ferdinand-okeke",fullName:"Paschaline Ferdinand Okeke"},{id:"286975",title:"Dr.",name:"Friday",middleName:null,surname:"Nweke Nwalo",slug:"friday-nweke-nwalo",fullName:"Friday Nweke Nwalo"},{id:"286976",title:"Dr.",name:"Marian",middleName:null,surname:"Unachukwu",slug:"marian-unachukwu",fullName:"Marian Unachukwu"}]},{id:"57717",doi:"10.5772/intechopen.71923",title:"In Vitro Cytotoxicity and Cell Viability Assays: Principles, Advantages, and Disadvantages",slug:"in-vitro-cytotoxicity-and-cell-viability-assays-principles-advantages-and-disadvantages",totalDownloads:14818,totalCrossrefCites:78,totalDimensionsCites:157,abstract:"Cytotoxicity is one of the most important indicators for biological evaluation in vitro studies. In vitro, chemicals such as drugs and pesticides have different cytotoxicity mechanisms such as destruction of cell membranes, prevention of protein synthesis, irreversible binding to receptors etc. In order to determine the cell death caused by these damages, there is a need for cheap, reliable and reproducible short-term cytotoxicity and cell viability assays. Cytotoxicity and cell viability assays are based on various cell functions. A broad spectrum of cytotoxicity assays is currently used in the fields of toxicology and pharmacology. There are different classifications for these assays: (i) dye exclusion assays; (ii) colorimetric assays; (iii) fluorometric assays; and (iv) luminometric assays. Choosing the appropriate method among these assays is important for obtaining accurate and reliable results. When selecting the cytotoxicity and cell viability assays to be used in the study, different parameters have to be considered such as the availability in the laboratory where the study is to be performed, test compounds, detection mechanism, specificity, and sensitivity. In this chapter, information will be given about in vitro cytotoxicity and viability assays, these assays will be classified and their advantages and disadvantages will be emphasized. The aim of this chapter is to guide the researcher interested in this subject to select the appropriate assay for their study.",book:{id:"6310",slug:"genotoxicity-a-predictable-risk-to-our-actual-world",title:"Genotoxicity",fullTitle:"Genotoxicity - A Predictable Risk to Our Actual World"},signatures:"Özlem Sultan Aslantürk",authors:[{id:"211212",title:"Dr.",name:"Özlem Sultan",middleName:null,surname:"Aslantürk",slug:"ozlem-sultan-aslanturk",fullName:"Özlem Sultan Aslantürk"}]},{id:"66259",doi:"10.5772/intechopen.85270",title:"Antioxidant Compounds and Their Antioxidant Mechanism",slug:"antioxidant-compounds-and-their-antioxidant-mechanism",totalDownloads:7594,totalCrossrefCites:58,totalDimensionsCites:152,abstract:"An antioxidant is a substance that at low concentrations delays or prevents oxidation of a substrate. Antioxidant compounds act through several chemical mechanisms: hydrogen atom transfer (HAT), single electron transfer (SET), and the ability to chelate transition metals. The importance of antioxidant mechanisms is to understand the biological meaning of antioxidants, their possible uses, their production by organic synthesis or biotechnological methods, or for the standardization of the determination of antioxidant activity. In general, antioxidant molecules can react either by multiple mechanisms or by a predominant mechanism. The chemical structure of the antioxidant substance allows understanding of the antioxidant reaction mechanism. This chapter reviews the in vitro antioxidant reaction mechanisms of organic compounds polyphenols, carotenoids, and vitamins C against free radicals (FR) and prooxidant compounds under diverse conditions, as well as the most commonly used methods to evaluate the antioxidant activity of these compounds according to the mechanism involved in the reaction with free radicals and the methods of in vitro antioxidant evaluation that are used frequently depending on the reaction mechanism of the antioxidant.",book:{id:"8008",slug:"antioxidants",title:"Antioxidants",fullTitle:"Antioxidants"},signatures:"Norma Francenia Santos-Sánchez, Raúl Salas-Coronado, Claudia Villanueva-Cañongo and Beatriz Hernández-Carlos",authors:[{id:"143354",title:"Dr.",name:"Raúl",middleName:null,surname:"Salas-Coronado",slug:"raul-salas-coronado",fullName:"Raúl Salas-Coronado"},{id:"148546",title:"Dr.",name:"Norma Francenia",middleName:null,surname:"Santos-Sánchez",slug:"norma-francenia-santos-sanchez",fullName:"Norma Francenia Santos-Sánchez"},{id:"193718",title:"Dr.",name:"Beatriz",middleName:null,surname:"Hernández-Carlos",slug:"beatriz-hernandez-carlos",fullName:"Beatriz Hernández-Carlos"},{id:"278133",title:"Dr.",name:"Claudia",middleName:null,surname:"Villanueva-Cañongo",slug:"claudia-villanueva-canongo",fullName:"Claudia Villanueva-Cañongo"}]},{id:"40253",doi:"10.5772/50486",title:"Lipid Nanoparticulate Drug Delivery Systems: A Revolution in Dosage Form Design and Development",slug:"lipid-nanoparticulate-drug-delivery-systems-a-revolution-in-dosage-form-design-and-development",totalDownloads:11293,totalCrossrefCites:22,totalDimensionsCites:105,abstract:null,book:{id:"2509",slug:"recent-advances-in-novel-drug-carrier-systems",title:"Recent Advances in Novel Drug Carrier Systems",fullTitle:"Recent Advances in Novel Drug Carrier Systems"},signatures:"Anthony A. 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Among these heavy metals, a few have direct or indirect impact on the human body. Some of these heavy metals such as copper, cobalt, iron, nickel, magnesium, molybdenum, chromium, selenium, manganese and zinc have functional roles which are essential for various diverse physiological and biochemical activities in the body. However, some of these heavy metals in high doses can be harmful to the body while others such as cadmium, mercury, lead, chromium, silver, and arsenic in minute quantities have delirious effects in the body causing acute and chronic toxicities in humans. The focus of this chapter is to describe the various mechanism of intoxication of some selected heavy metals in humans along with their health effects. Therefore it aims to highlight on biochemical mechanisms of heavy metal intoxication which involves binding to proteins and enzymes, altering their activity and causing damage. More so, the mechanism by which heavy metals cause neurotoxicity, generate free radical which promotes oxidative stress damaging lipids, proteins and DNA molecules and how these free radicals propagate carcinogenesis are discussed. Alongside these mechanisms, the noxious health effects of these heavy metals are discussed.",book:{id:"7111",slug:"poisoning-in-the-modern-world-new-tricks-for-an-old-dog-",title:"Poisoning in the Modern World",fullTitle:"Poisoning in the Modern World - New Tricks for an Old Dog?"},signatures:"Godwill Azeh Engwa, Paschaline Udoka Ferdinand, Friday Nweke Nwalo and Marian N. Unachukwu",authors:[{id:"241837",title:"Mr.",name:"Godwill Azeh",middleName:null,surname:"Engwa",slug:"godwill-azeh-engwa",fullName:"Godwill Azeh Engwa"},{id:"274194",title:"BSc.",name:"Paschaline Ferdinand",middleName:null,surname:"Okeke",slug:"paschaline-ferdinand-okeke",fullName:"Paschaline Ferdinand Okeke"},{id:"286975",title:"Dr.",name:"Friday",middleName:null,surname:"Nweke Nwalo",slug:"friday-nweke-nwalo",fullName:"Friday Nweke Nwalo"},{id:"286976",title:"Dr.",name:"Marian",middleName:null,surname:"Unachukwu",slug:"marian-unachukwu",fullName:"Marian Unachukwu"}]},{id:"49459",title:"Pharmacokinetics of Drugs Following IV Bolus, IV Infusion, and Oral Administration",slug:"pharmacokinetics-of-drugs-following-iv-bolus-iv-infusion-and-oral-administration",totalDownloads:15480,totalCrossrefCites:16,totalDimensionsCites:24,abstract:null,book:{id:"4491",slug:"basic-pharmacokinetic-concepts-and-some-clinical-applications",title:"Basic Pharmacokinetic Concepts and Some Clinical Applications",fullTitle:"Basic Pharmacokinetic Concepts and Some Clinical Applications"},signatures:"Tarek A. Ahmed",authors:[{id:"175649",title:"Dr.",name:"Tarek A",middleName:null,surname:"Ahmed",slug:"tarek-a-ahmed",fullName:"Tarek A Ahmed"}]},{id:"29240",title:"Oral Absorption, Intestinal Metabolism and Human Oral Bioavailability",slug:"oral-absorption-intestinal-metabolism-and-human-oral-bioavailability-",totalDownloads:27175,totalCrossrefCites:28,totalDimensionsCites:58,abstract:null,book:{id:"672",slug:"topics-on-drug-metabolism",title:"Topics on Drug Metabolism",fullTitle:"Topics on Drug Metabolism"},signatures:"Ayman El-Kattan and Manthena Varma",authors:[{id:"85539",title:"Dr.",name:"Ayman",middleName:null,surname:"El-Kattan",slug:"ayman-el-kattan",fullName:"Ayman El-Kattan"},{id:"88221",title:"Dr.",name:"Manthena",middleName:null,surname:"Varma",slug:"manthena-varma",fullName:"Manthena Varma"}]},{id:"66259",title:"Antioxidant Compounds and Their Antioxidant Mechanism",slug:"antioxidant-compounds-and-their-antioxidant-mechanism",totalDownloads:7587,totalCrossrefCites:58,totalDimensionsCites:152,abstract:"An antioxidant is a substance that at low concentrations delays or prevents oxidation of a substrate. Antioxidant compounds act through several chemical mechanisms: hydrogen atom transfer (HAT), single electron transfer (SET), and the ability to chelate transition metals. The importance of antioxidant mechanisms is to understand the biological meaning of antioxidants, their possible uses, their production by organic synthesis or biotechnological methods, or for the standardization of the determination of antioxidant activity. In general, antioxidant molecules can react either by multiple mechanisms or by a predominant mechanism. The chemical structure of the antioxidant substance allows understanding of the antioxidant reaction mechanism. This chapter reviews the in vitro antioxidant reaction mechanisms of organic compounds polyphenols, carotenoids, and vitamins C against free radicals (FR) and prooxidant compounds under diverse conditions, as well as the most commonly used methods to evaluate the antioxidant activity of these compounds according to the mechanism involved in the reaction with free radicals and the methods of in vitro antioxidant evaluation that are used frequently depending on the reaction mechanism of the antioxidant.",book:{id:"8008",slug:"antioxidants",title:"Antioxidants",fullTitle:"Antioxidants"},signatures:"Norma Francenia Santos-Sánchez, Raúl Salas-Coronado, Claudia Villanueva-Cañongo and Beatriz Hernández-Carlos",authors:[{id:"143354",title:"Dr.",name:"Raúl",middleName:null,surname:"Salas-Coronado",slug:"raul-salas-coronado",fullName:"Raúl Salas-Coronado"},{id:"148546",title:"Dr.",name:"Norma Francenia",middleName:null,surname:"Santos-Sánchez",slug:"norma-francenia-santos-sanchez",fullName:"Norma Francenia Santos-Sánchez"},{id:"193718",title:"Dr.",name:"Beatriz",middleName:null,surname:"Hernández-Carlos",slug:"beatriz-hernandez-carlos",fullName:"Beatriz Hernández-Carlos"},{id:"278133",title:"Dr.",name:"Claudia",middleName:null,surname:"Villanueva-Cañongo",slug:"claudia-villanueva-canongo",fullName:"Claudia Villanueva-Cañongo"}]},{id:"66742",title:"Introductory Chapter: Alkaloids - Their Importance in Nature and for Human Life",slug:"introductory-chapter-alkaloids-their-importance-in-nature-and-for-human-life",totalDownloads:4130,totalCrossrefCites:16,totalDimensionsCites:32,abstract:null,book:{id:"6828",slug:"alkaloids-their-importance-in-nature-and-human-life",title:"Alkaloids",fullTitle:"Alkaloids - Their Importance in Nature and Human Life"},signatures:"Joanna Kurek",authors:[{id:"214632",title:"Dr.",name:"Joanna",middleName:null,surname:"Kurek",slug:"joanna-kurek",fullName:"Joanna Kurek"}]}],onlineFirstChaptersFilter:{topicId:"19",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"83076",title:"Treatments for the Infection by SARS-CoV-2",slug:"treatments-for-the-infection-by-sars-cov-2",totalDownloads:0,totalDimensionsCites:0,doi:"10.5772/intechopen.106232",abstract:"In late 2019, pneumonia cases from unknown origin were detected in Wuhan, China. The cause was a new coronavirus. The World Health Organization (WHO) named the virus SARS-CoV-2 and COVID-19 the associated disease. In the first months of 2020, this disease became a pandemic with a high lethality reported. Since then, the search for treatments began. We started by searching among treatments previously approved for human use that were not designed for COVID-19 and were considered to treat this condition. We continued searching on the therapeutics guidelines published by the WHO for the management of infection by SARS-CoV-2. Based on these results, we searched for the literature in PubMed to obtain further evidence on the drugs against SARS-CoV-2. The treatments presented in this chapter are Ivermectin, Hydroxychloroquine, Nitazoxanide, Azithromycin, Molnupiravir, Casirivimab-Imdevimab, Ritonavir-Nirmatrelvir, Ritonavir-Lopinavir, Remdesivir, and Favipiravir. Two years ahead of the start of the COVID-19 pandemic, a plenty of options for treatment have been investigated. Only a few of them have been shown to be efficient and safe. According to the WHO, Ritonavir-Nirmatrelvir outperforms other proposed therapeutics.",book:{id:"11690",title:"COVID-19 Drug Development - Recent Advances, New Perspectives, and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/11690.jpg"},signatures:"Nicolás Padilla-Raygoza, Gilberto Flores-Vargas, María de Jesús Gallardo-Luna, Efraín Navarro-Olivos, Francisco Javier Magos-Vázquez and Daniel Alberto Díaz-Martínez"},{id:"83054",title:"Pulsatory Liposome: A Possible Biotechnological Device",slug:"pulsatory-liposome-a-possible-biotechnological-device",totalDownloads:1,totalDimensionsCites:0,doi:"10.5772/intechopen.106347",abstract:"A unilamellar liposome filled with an osmotic solution is introduced into a hypotonic aqueous environment. Because of the mechanical tension induced by the osmotic flow, the vesicle swells up to a critical size, when suddenly a transbilayer pore appears and the vesicle relaxing stage starts. A part of the intracellular material leaks out through this pore, and the liposome membrane relaxes and finally recovers. The swelling begins again and the liposome experiences a periodical process. For this reason, we have named it a pulsatory liposome. The swelling of the liposome is described by a differential equation. All the processes which contribute to the vesicle relaxing and its coming back to the initial size are described by three differential equations. The pulsatory liposome can be programmed to work a number of cycles, established before. The activity of a pulsatory liposome can be characterized by the following parameters: (a) number of cycles, the length time of each cycle, and liposome activity life; (b) the length time of the swelling stage and the relaxation stage for each cycle; (c) the amount of solute leaked out through the pore in each cycle. The pulsatory liposome may be regarded as a two-stroke engine.",book:{id:"11814",title:"Liposomes - Recent Advances, New Perspectives and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/11814.jpg"},signatures:"Dumitru Popescu and Alin Gabriel Popescu"},{id:"82962",title:"Pluralism Medical Treatment, Prevention, and Control of COVID-19 Infection and Its Long-Sufferings among the Older Adults in the Northeast of Thailand from 2019 to 2022",slug:"pluralism-medical-treatment-prevention-and-control-of-covid-19-infection-and-its-long-sufferings-amo",totalDownloads:48,totalDimensionsCites:0,doi:"10.5772/intechopen.106339",abstract:"COVID-19 in 2019 has brought both changes and challenges to the world. This global pandemic has an impact on people of all age levels, especially older adults. In Thailand, older persons are at high risk of COVID-19 infection. They are included in the so-called 608 groups. The objective of this review article was to synthesize and present medical pluralism, the development of drugs from herbs, and projects conducted to treat, prevent, and control the infection and long sufferings of COVID-19. The review covers 10 studies, three projects produced at Mahasarakham University, Chaiyaphum Rajabhat University, and Khon Kaen University that were reviewed, synthesized, and analyzed. The results of the synthesis indicate that modern and Thai traditional medicine can help reduce the severity of the infection and long sufferings of COVID-19. The medical pluralism between modern and Thai traditional medicine is needed to remedy COVID-19 cases among the older adults in the Northeast of Thailand.",book:{id:"11690",title:"COVID-19 Drug Development - Recent Advances, New Perspectives, and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/11690.jpg"},signatures:"Pissamai Homchampa, Khemika Napattaradechanon, Parichat Yatniyom, Thawalrat Ratanasiri, Piyaporn Sansila, Thanawan Sirisuk, Thawalwong Ratanasiri and Amornrat Ratanasiri"},{id:"82353",title:"Pharmacovigilance of Biological Drugs",slug:"pharmacovigilance-of-biological-drugs",totalDownloads:5,totalDimensionsCites:0,doi:"10.5772/intechopen.105520",abstract:"The use of biological drugs has significantly increased over the past decades and has allowed for the treatment of many life-threatening and chronic diseases. The patent expiration of biological innovative medicines enables copies of these drugs called biosimilars. The availability of biosimilars enhances competition, with the potential to improve patient access to biological medications and contribute to the financial sustainability of the healthcare systems. Unlike equivalent drugs, biosimilars are not identical but similar to their innovator products because of the differences in the manufacturing process, which is a biological process. However, they are considered comparable to their originators in safety, quality characteristics, biological activity, and efficacy. The regulatory procedures used for generic drugs cannot be applied for biosimilars, so they are subjected to rigorous characterization as well as comparative clinical studies. Since they are highly complex molecules produced from living cells, even small change in the production process can have major implications on their safety and effectiveness profile, causing a potential risk of immune-based adverse reactions. For all these reasons, for biological drugs, a robust long-term pharmacovigilance system is necessary. It is desirable that in the future, there are further guidance and resolution of the ongoing discussions on biosimilar labeling, naming, pharmacovigilance and interchangeability/substitution, to ensure the appropriate use of these drugs in clinical practice.",book:{id:"11679",title:"Pharmacovigilance and Regulations",coverURL:"https://cdn.intechopen.com/books/images_new/11679.jpg"},signatures:"Simona Guerzoni, Flavia Lo Castro, Carlo Baraldi, Giuliana Colella and Luca Pani"},{id:"82868",title:"Recent Strategies for Ocular Drug Delivery: Promises and Challenges",slug:"recent-strategies-for-ocular-drug-delivery-promises-and-challenges",totalDownloads:9,totalDimensionsCites:0,doi:"10.5772/intechopen.106335",abstract:"Ocular diseases include various anterior and posterior segment diseases. Due to the unique anatomy and physiology of the eye, efficient ocular drug delivery is a great challenge to researchers. The emerging nanoscience is playing an important role in the development of novel strategies for ocular disease management. Various active molecules have been designed to associate with nanocarriers to overcome ocular barriers and interact with certain ocular tissues. In this chapter, highlights will be made on barrier to intraocular delivery, general pathways for ocular absorption, and factors affecting intraocular bioavailability. The recent attempts of nanotechnology for treating anterior and posterior ocular diseases will be explored. This will include nanomicelles, nanoparticles, nanosuspensions, vesicular systems, in situ gel, dendrimers, contact lenses, implants, microneedles, and cell-based delivery systems. In addition, gene-based ocular delivery systems will be discussed. In this chapter, we will also provide a comprehensive overview of drug-device combinations used for ocular diseases such as glaucoma, dry eye disease, infections, and inflammations. Furthermore, drug delivery devices for ocular surgeries are discussed. Finally, challenges and future prospective of ocular delivery systems will be explored.",book:{id:"11688",title:"Advances in Drug Delivery Methods",coverURL:"https://cdn.intechopen.com/books/images_new/11688.jpg"},signatures:"Amal H. El-Kamel and Asmaa A. Ashour"},{id:"82727",title:"Mesoporous Silica Based Cancer Theranostic: A Modern Approach in Upcoming Medicine",slug:"mesoporous-silica-based-cancer-theranostic-a-modern-approach-in-upcoming-medicine",totalDownloads:13,totalDimensionsCites:0,doi:"10.5772/intechopen.105447",abstract:"In case cancers are located deep inside the body and are very tough to diagnose, diagnostic tools like MRI/CT scans can be employed to detect these cancers. The major challenge in such cases is the delivery of MRI active agents or visualizing agents to the target site. In this context we will discuss different mesoporous nanoparticles that can be employed to target the tissue at a specific location, its functionalization to reach the target site (Folic acid), different simple dyes as well as specific dyes which offer theranostic functionality. The nanoparticles like mesoporous silica nanoparticles offer the possibility to load therapeutic and diagnostic agents. Its surface allow multiple functionalization and conjugations which offer target specific delivery of these agents. Moreover we will also overview different modern drug delivery inventions for offering theranostic application.",book:{id:"11688",title:"Advances in Drug Delivery Methods",coverURL:"https://cdn.intechopen.com/books/images_new/11688.jpg"},signatures:"Ajinkya Pote, Vikas Ahirrao and Vishal Pande"}],onlineFirstChaptersTotal:57},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:90,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:108,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:330,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:9,numberOfPublishedChapters:141,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:123,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:22,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:11,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}},{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}}]},series:{item:{id:"10",title:"Physiology",doi:"10.5772/intechopen.72796",issn:"2631-8261",scope:"Modern physiology requires a comprehensive understanding of the integration of tissues and organs throughout the mammalian body, including the cooperation between structure and function at the cellular and molecular levels governed by gene and protein expression. While a daunting task, learning is facilitated by identifying common and effective signaling pathways mediated by a variety of factors employed by nature to preserve and sustain homeostatic life. \r\nAs a leading example, the cellular interaction between intracellular concentration of Ca+2 increases, and changes in plasma membrane potential is integral for coordinating blood flow, governing the exocytosis of neurotransmitters, and modulating gene expression and cell effector secretory functions. Furthermore, in this manner, understanding the systemic interaction between the cardiovascular and nervous systems has become more important than ever as human populations' life prolongation, aging and mechanisms of cellular oxidative signaling are utilised for sustaining life. \r\nAltogether, physiological research enables our identification of distinct and precise points of transition from health to the development of multimorbidity throughout the inevitable aging disorders (e.g., diabetes, hypertension, chronic kidney disease, heart failure, peptic ulcer, inflammatory bowel disease, age-related macular degeneration, cancer). With consideration of all organ systems (e.g., brain, heart, lung, gut, skeletal and smooth muscle, liver, pancreas, kidney, eye) and the interactions thereof, this Physiology Series will address the goals of resolving (1) Aging physiology and chronic disease progression (2) Examination of key cellular pathways as they relate to calcium, oxidative stress, and electrical signaling, and (3) how changes in plasma membrane produced by lipid peroxidation products can affect aging physiology, covering new research in the area of cell, human, plant and animal physiology.",coverUrl:"https://cdn.intechopen.com/series/covers/10.jpg",latestPublicationDate:"July 20th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:14,editor:{id:"35854",title:"Prof.",name:"Tomasz",middleName:null,surname:"Brzozowski",slug:"tomasz-brzozowski",fullName:"Tomasz Brzozowski",profilePictureURL:"https://mts.intechopen.com/storage/users/35854/images/system/35854.jpg",biography:"Prof. Dr. Thomas Brzozowski works as a professor of Human Physiology and is currently Chairman at the Department of Physiology and is V-Dean of the Medical Faculty at Jagiellonian University Medical College, Cracow, Poland. His primary area of interest is physiology and pathophysiology of the gastrointestinal (GI) tract, with the major focus on the mechanism of GI mucosal defense, protection, and ulcer healing. He was a postdoctoral NIH fellow at the University of California and the Gastroenterology VA Medical Center, Irvine, Long Beach, CA, USA, and at the Gastroenterology Clinics Erlangen-Nuremberg and Munster in Germany. He has published 290 original articles in some of the most prestigious scientific journals and seven book chapters on the pathophysiology of the GI tract, gastroprotection, ulcer healing, drug therapy of peptic ulcers, hormonal regulation of the gut, and inflammatory bowel disease.",institutionString:null,institution:{name:"Jagiellonian University",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:4,paginationItems:[{id:"10",title:"Animal Physiology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/10.jpg",isOpenForSubmission:!0,editor:{id:"202192",title:"Dr.",name:"Catrin",middleName:null,surname:"Rutland",slug:"catrin-rutland",fullName:"Catrin Rutland",profilePictureURL:"https://mts.intechopen.com/storage/users/202192/images/system/202192.png",biography:"Catrin Rutland is an Associate Professor of Anatomy and Developmental Genetics at the University of Nottingham, UK. She obtained a BSc from the University of Derby, England, a master’s degree from Technische Universität München, Germany, and a Ph.D. from the University of Nottingham. She undertook a post-doctoral research fellowship in the School of Medicine before accepting tenure in Veterinary Medicine and Science. Dr. Rutland also obtained an MMedSci (Medical Education) and a Postgraduate Certificate in Higher Education (PGCHE). She is the author of more than sixty peer-reviewed journal articles, twelve books/book chapters, and more than 100 research abstracts in cardiovascular biology and oncology. She is a board member of the European Association of Veterinary Anatomists, Fellow of the Anatomical Society, and Senior Fellow of the Higher Education Academy. 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From\r\n1964 to 1974, he worked as Assistant in Biochemistry at the School of MedicineUniversidad Nacional de La Plata, Argentina. From 1974 to 1976, he was a Fellowof the National Institutes of Health (NIH) at the University of Connecticut, Health Center, USA. From 1985 to 2004, he served as a Full Professor oBiochemistry at the Universidad Nacional de La Plata, Argentina. He is Member ofthe National Research Council (CONICET), Argentina, and Argentine Society foBiochemistry and Molecular Biology (SAIB). His laboratory has been interested for manyears in the lipid peroxidation of biological membranes from various tissues and different species. Professor Catalá has directed twelve doctoral theses, publishedover 100 papers in peer reviewed journals, several chapters in books andtwelve edited books. Angel Catalá received awards at the 40th InternationaConference Biochemistry of Lipids 1999: Dijon (France). W inner of the Bimbo PanAmerican Nutrition, Food Science and Technology Award 2006 and 2012, South AmericaHuman Nutrition, Professional Category. 2006 award in pharmacology, Bernardo\r\nHoussay, in recognition of his meritorious works of research. Angel Catalá belongto the Editorial Board of Journal of lipids, International Review of Biophysical ChemistryFrontiers in Membrane Physiology and Biophysics, World Journal oExperimental Medicine and Biochemistry Research International, W orld Journal oBiological Chemistry, Oxidative Medicine and Cellular Longevity, Diabetes and thePancreas, International Journal of Chronic Diseases & Therapy, International Journal oNutrition, Co-Editor of The Open Biology Journal.",institutionString:null,institution:{name:"National University of La Plata",institutionURL:null,country:{name:"Argentina"}}},editorTwo:null,editorThree:null},{id:"12",title:"Human Physiology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/12.jpg",isOpenForSubmission:!0,editor:{id:"195829",title:"Prof.",name:"Kunihiro",middleName:null,surname:"Sakuma",slug:"kunihiro-sakuma",fullName:"Kunihiro Sakuma",profilePictureURL:"https://mts.intechopen.com/storage/users/195829/images/system/195829.jpg",biography:"Professor Kunihiro Sakuma, Ph.D., currently works in the Institute for Liberal Arts at the Tokyo Institute of Technology. He is a physiologist working in the field of skeletal muscle. He was awarded his sports science diploma in 1995 by the University of Tsukuba and began his scientific work at the Department of Physiology, Aichi Human Service Center, focusing on the molecular mechanism of congenital muscular dystrophy and normal muscle regeneration. His interest later turned to the molecular mechanism and attenuating strategy of sarcopenia (age-related muscle atrophy). His opinion is to attenuate sarcopenia by improving autophagic defects using nutrient- and pharmaceutical-based treatments.",institutionString:null,institution:{name:"Tokyo Institute of Technology",institutionURL:null,country:{name:"Japan"}}},editorTwo:{id:"331519",title:"Dr.",name:"Kotomi",middleName:null,surname:"Sakai",slug:"kotomi-sakai",fullName:"Kotomi Sakai",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000031QtFXQA0/Profile_Picture_1637053227318",biography:"Senior researcher Kotomi Sakai, Ph.D., MPH, works at the Research Organization of Science and Technology in Ritsumeikan University. She is a researcher in the geriatric rehabilitation and public health field. She received Ph.D. from Nihon University and MPH from St.Luke’s International University. Her main research interest is sarcopenia in older adults, especially its association with nutritional status. Additionally, to understand how to maintain and improve physical function in older adults, to conduct studies about the mechanism of sarcopenia and determine when possible interventions are needed.",institutionString:null,institution:{name:"Ritsumeikan University",institutionURL:null,country:{name:"Japan"}}},editorThree:null},{id:"13",title:"Plant Physiology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/13.jpg",isOpenForSubmission:!0,editor:{id:"332229",title:"Prof.",name:"Jen-Tsung",middleName:null,surname:"Chen",slug:"jen-tsung-chen",fullName:"Jen-Tsung Chen",profilePictureURL:"https://mts.intechopen.com/storage/users/332229/images/system/332229.png",biography:"Dr. Jen-Tsung Chen is currently a professor at the National University of Kaohsiung, Taiwan. He teaches cell biology, genomics, proteomics, medicinal plant biotechnology, and plant tissue culture. Dr. Chen\\'s research interests include bioactive compounds, chromatography techniques, in vitro culture, medicinal plants, phytochemicals, and plant biotechnology. He has published more than ninety scientific papers and serves as an editorial board member for Plant Methods, Biomolecules, and International Journal of Molecular Sciences.",institutionString:"National University of Kaohsiung",institution:{name:"National University of Kaohsiung",institutionURL:null,country:{name:"Taiwan"}}},editorTwo:null,editorThree:null}]},overviewPageOFChapters:{paginationCount:16,paginationItems:[{id:"82135",title:"Carotenoids in Cassava (Manihot esculenta Crantz)",doi:"10.5772/intechopen.105210",signatures:"Lovina I. Udoh, Josephine U. Agogbua, Eberechi R. Keyagha and Itorobong I. 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Buchholz and Erik J. Behringer",hash:"e373a3d1123dbd45fddf75d90e3e7c38",volumeInSeries:1,fullTitle:"Calcium and Signal Transduction",editors:[{id:"89438",title:"Dr.",name:"John N.",middleName:null,surname:"Buchholz",slug:"john-n.-buchholz",fullName:"John N. Buchholz",profilePictureURL:"https://mts.intechopen.com/storage/users/89438/images/6463_n.jpg",biography:"Full Professor and Vice Chair, Division of Pharmacology, Loma Linda University, School of Medicine. He received his B.S. Degree in Biology at La Sierra University, Riverside California (1980) and a PhD in Pharmacology from Loma Linda University School of Medicine (1988). Post-Doctoral Fellow at University of California, Irvine, College of Medicine 1989-1992 with a focus on autonomic nerve function in blood vessels and the impact of aging on the function of these nerves and overall blood vessel function. Twenty years of research funding and served on NIH R01 review panels, Editor-In-Chief of Edorium Journal of Aging Research. Serves as a peer reviewer for biomedical journals. Military Reserve Officer serving with the 100 Support Command, 100 Troop Command, 40 Infantry Division, CA National Guard.",institutionString:null,institution:{name:"Loma Linda University",institutionURL:null,country:{name:"United States of America"}}}]},{type:"book",id:"6925",title:"Endoplasmic Reticulum",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/6925.jpg",slug:"endoplasmic-reticulum",publishedDate:"April 17th 2019",editedByType:"Edited by",bookSignature:"Angel Català",hash:"a9e90d2dbdbc46128dfe7dac9f87c6b4",volumeInSeries:2,fullTitle:"Endoplasmic Reticulum",editors:[{id:"196544",title:"Prof.",name:"Angel",middleName:null,surname:"Catala",slug:"angel-catala",fullName:"Angel Catala",profilePictureURL:"https://mts.intechopen.com/storage/users/196544/images/system/196544.jpg",biography:"Angel Catalá studied chemistry at Universidad Nacional de La Plata, Argentina, where he received a Ph.D. in Chemistry (Biological Branch) in 1965. From 1964 to 1974, he worked as an Assistant in Biochemistry at the School of Medicine at the same university. From 1974 to 1976, he was a fellow of the National Institutes of Health (NIH) at the University of Connecticut, Health Center, USA. From 1985 to 2004, he served as a Full Professor of Biochemistry at the Universidad Nacional de La Plata. He is a member of the National Research Council (CONICET), Argentina, and the Argentine Society for Biochemistry and Molecular Biology (SAIB). His laboratory has been interested for many years in the lipid peroxidation of biological membranes from various tissues and different species. Dr. Catalá has directed twelve doctoral theses, published more than 100 papers in peer-reviewed journals, several chapters in books, and edited twelve books. He received awards at the 40th International Conference Biochemistry of Lipids 1999 in Dijon, France. He is the winner of the Bimbo Pan-American Nutrition, Food Science and Technology Award 2006 and 2012, South America, Human Nutrition, Professional Category. In 2006, he won the Bernardo Houssay award in pharmacology, in recognition of his meritorious works of research. Dr. Catalá belongs to the editorial board of several journals including Journal of Lipids; International Review of Biophysical Chemistry; Frontiers in Membrane Physiology and Biophysics; World Journal of Experimental Medicine and Biochemistry Research International; World Journal of Biological Chemistry, Diabetes, and the Pancreas; International Journal of Chronic Diseases & Therapy; and International Journal of Nutrition. He is the co-editor of The Open Biology Journal and associate editor for Oxidative Medicine and Cellular Longevity.",institutionString:"Universidad Nacional de La Plata",institution:{name:"National University of La Plata",institutionURL:null,country:{name:"Argentina"}}}]},{type:"book",id:"6924",title:"Adenosine Triphosphate in Health and Disease",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/6924.jpg",slug:"adenosine-triphosphate-in-health-and-disease",publishedDate:"April 24th 2019",editedByType:"Edited by",bookSignature:"Gyula Mozsik",hash:"04106c232a3c68fec07ba7cf00d2522d",volumeInSeries:3,fullTitle:"Adenosine Triphosphate in Health and Disease",editors:[{id:"58390",title:"Dr.",name:"Gyula",middleName:null,surname:"Mozsik",slug:"gyula-mozsik",fullName:"Gyula Mozsik",profilePictureURL:"https://mts.intechopen.com/storage/users/58390/images/system/58390.png",biography:"Gyula Mózsik MD, Ph.D., ScD (med), is an emeritus professor of Medicine at the First Department of Medicine, Univesity of Pécs, Hungary. He was head of this department from 1993 to 2003. His specializations are medicine, gastroenterology, clinical pharmacology, clinical nutrition, and dietetics. His research fields are biochemical pharmacological examinations in the human gastrointestinal (GI) mucosa, mechanisms of retinoids, drugs, capsaicin-sensitive afferent nerves, and innovative pharmacological, pharmaceutical, and nutritional (dietary) research in humans. He has published about 360 peer-reviewed papers, 197 book chapters, 692 abstracts, 19 monographs, and has edited 37 books. He has given about 1120 regular and review lectures. He has organized thirty-eight national and international congresses and symposia. He is the founder of the International Conference on Ulcer Research (ICUR); International Union of Pharmacology, Gastrointestinal Section (IUPHAR-GI); Brain-Gut Society symposiums, and gastrointestinal cytoprotective symposiums. He received the Andre Robert Award from IUPHAR-GI in 2014. 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He\nreceived a short-term scholarship to carry out his post-doctoral\nstudies abroad, from Japan International Cooperation Agency\n(JICA), in coordination with the Egyptian government. Dr.\nShalaby speaks fluent English and his native Arabic. He has 77\ninternationally published research papers, has attended 15 international conferences, and has contributed to 18 international books and chapters.\nDr. Shalaby works as a reviewer on over one hundred international journals and is\non the editorial board of more than twenty-five international journals. 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Ms. Mehtab has published seven papers in international conferences and one of her papers has been accepted for publication in a reputable international journal. She has won the best paper awards in two prestigious international conferences – BAICONF 2019, and ICADCML 2021, organized in the Indian Institute of Management, Bangalore, India in December 2019, and SOA University, Bhubaneswar, India in January 2021. Besides, Ms. Mehtab has also published two book chapters in two books. Seven of her book chapters will be published in a volume shortly in 2021 by Cambridge Scholars’ Press, UK. Currently, she is working as the joint editor of two edited volumes on Time Series Analysis and Forecasting to be published in the first half of 2021 by an international house. Currently, she is working as a Data Scientist with an MNC in Delhi, India.",institutionString:"NSHM College of Management and Technology",institution:{name:"Association for Computing Machinery",country:{name:"United States of America"}}},{id:"226240",title:"Dr.",name:"Andri Irfan",middleName:null,surname:"Rifai",slug:"andri-irfan-rifai",fullName:"Andri Irfan Rifai",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226240/images/7412_n.jpg",biography:"Andri IRFAN is a Senior Lecturer of Civil Engineering and Planning. He completed the PhD at the Universitas Indonesia & Universidade do Minho with Sandwich Program Scholarship from the Directorate General of Higher Education and LPDP scholarship. He has been teaching for more than 19 years and much active to applied his knowledge in the project construction in Indonesia. His research interest ranges from pavement management system to advanced data mining techniques for transportation engineering. He has published more than 50 papers in journals and 2 books.",institutionString:null,institution:{name:"Universitas Internasional Batam",country:{name:"Indonesia"}}},{id:"314576",title:"Dr.",name:"Ibai",middleName:null,surname:"Laña",slug:"ibai-lana",fullName:"Ibai Laña",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314576/images/system/314576.jpg",biography:"Dr. Ibai Laña works at TECNALIA as a data analyst. He received his Ph.D. in Artificial Intelligence from the University of the Basque Country (UPV/EHU), Spain, in 2018. He is currently a senior researcher at TECNALIA. His research interests fall within the intersection of intelligent transportation systems, machine learning, traffic data analysis, and data science. He has dealt with urban traffic forecasting problems, applying machine learning models and evolutionary algorithms. He has experience in origin-destination matrix estimation or point of interest and trajectory detection. Working with large volumes of data has given him a good command of big data processing tools and NoSQL databases. He has also been a visiting scholar at the Knowledge Engineering and Discovery Research Institute, Auckland University of Technology.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"314575",title:"Dr.",name:"Jesus",middleName:null,surname:"L. Lobo",slug:"jesus-l.-lobo",fullName:"Jesus L. Lobo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314575/images/system/314575.png",biography:"Dr. Jesús López is currently based in Bilbao (Spain) working at TECNALIA as Artificial Intelligence Research Scientist. In most cases, a project idea or a new research line needs to be investigated to see if it is good enough to take into production or to focus on it. That is exactly what he does, diving into Machine Learning algorithms and technologies to help TECNALIA to decide whether something is great in theory or will actually impact on the product or processes of its projects. So, he is expert at framing experiments, developing hypotheses, and proving whether they’re true or not, in order to investigate fundamental problems with a longer time horizon. He is also able to design and develop PoCs and system prototypes in simulation. He has participated in several national and internacional R&D projects.\n\nAs another relevant part of his everyday research work, he usually publishes his findings in reputed scientific refereed journals and international conferences, occasionally acting as reviewer and Programme Commitee member. Concretely, since 2018 he has published 9 JCR (8 Q1) journal papers, 9 conference papers (e.g. ECML PKDD 2021), and he has co-edited a book. He is also active in popular science writing data science stories for reputed blogs (KDNuggets, TowardsDataScience, Naukas). Besides, he has recently embarked on mentoring programmes as mentor, and has also worked as data science trainer.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"103779",title:"Prof.",name:"Yalcin",middleName:null,surname:"Isler",slug:"yalcin-isler",fullName:"Yalcin Isler",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRyQ8QAK/Profile_Picture_1628834958734",biography:"Yalcin Isler (1971 - Burdur / Turkey) received the B.Sc. degree in the Department of Electrical and Electronics Engineering from Anadolu University, Eskisehir, Turkey, in 1993, the M.Sc. degree from the Department of Electronics and Communication Engineering, Suleyman Demirel University, Isparta, Turkey, in 1996, the Ph.D. degree from the Department of Electrical and Electronics Engineering, Dokuz Eylul University, Izmir, Turkey, in 2009, and the Competence of Associate Professorship from the Turkish Interuniversity Council in 2019.\n\nHe was Lecturer at Burdur Vocational School in Suleyman Demirel University (1993-2000, Burdur / Turkey), Software Engineer (2000-2002, Izmir / Turkey), Research Assistant in Bulent Ecevit University (2002-2003, Zonguldak / Turkey), Research Assistant in Dokuz Eylul University (2003-2010, Izmir / Turkey), Assistant Professor at the Department of Electrical and Electronics Engineering in Bulent Ecevit University (2010-2012, Zonguldak / Turkey), Assistant Professor at the Department of Biomedical Engineering in Izmir Katip Celebi University (2012-2019, Izmir / Turkey). He is an Associate Professor at the Department of Biomedical Engineering at Izmir Katip Celebi University, Izmir / Turkey, since 2019. In addition to academics, he has also founded Islerya Medical and Information Technologies Company, Izmir / Turkey, since 2017.\n\nHis main research interests cover biomedical signal processing, pattern recognition, medical device design, programming, and embedded systems. He has many scientific papers and participated in several projects in these study fields. He was an IEEE Student Member (2009-2011) and IEEE Member (2011-2014) and has been IEEE Senior Member since 2014.",institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",country:{name:"Turkey"}}},{id:"339677",title:"Dr.",name:"Mrinmoy",middleName:null,surname:"Roy",slug:"mrinmoy-roy",fullName:"Mrinmoy Roy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/339677/images/16768_n.jpg",biography:"An accomplished Sales & Marketing professional with 12 years of cross-functional experience in well-known organisations such as CIPLA, LUPIN, GLENMARK, ASTRAZENECA across different segment of Sales & Marketing, International Business, Institutional Business, Product Management, Strategic Marketing of HIV, Oncology, Derma, Respiratory, Anti-Diabetic, Nutraceutical & Stomatological Product Portfolio and Generic as well as Chronic Critical Care Portfolio. A First Class MBA in International Business & Strategic Marketing, B.Pharm, D.Pharm, Google Certified Digital Marketing Professional. Qualified PhD Candidate in Operations and Management with special focus on Artificial Intelligence and Machine Learning adoption, analysis and use in Healthcare, Hospital & Pharma Domain. Seasoned with diverse therapy area of Pharmaceutical Sales & Marketing ranging from generating revenue through generating prescriptions, launching new products, and making them big brands with continuous strategy execution at the Physician and Patients level. Moved from Sales to Marketing and Business Development for 3.5 years in South East Asian Market operating from Manila, Philippines. Came back to India and handled and developed Brands such as Gluconorm, Lupisulin, Supracal, Absolut Woman, Hemozink, Fabiflu (For COVID 19), and many more. In my previous assignment I used to develop and execute strategies on Sales & Marketing, Commercialization & Business Development for Institution and Corporate Hospital Business portfolio of Oncology Therapy Area for AstraZeneca Pharma India Ltd. Being a Research Scholar and Student of ‘Operations Research & Management: Artificial Intelligence’ I published several pioneer research papers and book chapters on the same in Internationally reputed journals and Books indexed in Scopus, Springer and Ei Compendex, Google Scholar etc. Currently, I am launching PGDM Pharmaceutical Management Program in IIHMR Bangalore and spearheading the course curriculum and structure of the same. I am interested in Collaboration for Healthcare Innovation, Pharma AI Innovation, Future trend in Marketing and Management with incubation on Healthcare, Healthcare IT startups, AI-ML Modelling and Healthcare Algorithm based training module development. I am also an affiliated member of the Institute of Management Consultant of India, looking forward to Healthcare, Healthcare IT and Innovation, Pharma and Hospital Management Consulting works.",institutionString:null,institution:{name:"Lovely Professional University",country:{name:"India"}}},{id:"310576",title:"Prof.",name:"Erick Giovani",middleName:null,surname:"Sperandio Nascimento",slug:"erick-giovani-sperandio-nascimento",fullName:"Erick Giovani Sperandio Nascimento",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y00002pDKxDQAW/ProfilePicture%202022-06-20%2019%3A57%3A24.788",biography:"Prof. Erick Sperandio is the Lead Researcher and professor of Artificial Intelligence (AI) at SENAI CIMATEC, Bahia, Brazil, also working with Computational Modeling (CM) and HPC. He holds a PhD in Environmental Engineering in the area of Atmospheric Computational Modeling, a Master in Informatics in the field of Computational Intelligence and Graduated in Computer Science from UFES. He currently coordinates, leads and participates in R&D projects in the areas of AI, computational modeling and supercomputing applied to different areas such as Oil and Gas, Health, Advanced Manufacturing, Renewable Energies and Atmospheric Sciences, advising undergraduate, master's and doctoral students. He is the Lead Researcher at SENAI CIMATEC's Reference Center on Artificial Intelligence. In addition, he is a Certified Instructor and University Ambassador of the NVIDIA Deep Learning Institute (DLI) in the areas of Deep Learning, Computer Vision, Natural Language Processing and Recommender Systems, and Principal Investigator of the NVIDIA/CIMATEC AI Joint Lab, the first in Latin America within the NVIDIA AI Technology Center (NVAITC) worldwide program. He also works as a researcher at the Supercomputing Center for Industrial Innovation (CS2i) and at the SENAI Institute of Innovation for Automation (ISI Automação), both from SENAI CIMATEC. He is a member and vice-coordinator of the Basic Board of Scientific-Technological Advice and Evaluation, in the area of Innovation, of the Foundation for Research Support of the State of Bahia (FAPESB). He serves as Technology Transfer Coordinator and one of the Principal Investigators at the National Applied Research Center in Artificial Intelligence (CPA-IA) of SENAI CIMATEC, focusing on Industry, being one of the six CPA-IA in Brazil approved by MCTI / FAPESP / CGI.br. He also participates as one of the representatives of Brazil in the BRICS Innovation Collaboration Working Group on HPC, ICT and AI. He is the coordinator of the Work Group of the Axis 5 - Workforce and Training - of the Brazilian Strategy for Artificial Intelligence (EBIA), and member of the MCTI/EMBRAPII AI Innovation Network Training Committee. He is the coordinator, by SENAI CIMATEC, of the Artificial Intelligence Reference Network of the State of Bahia (REDE BAH.IA). He leads the working group of experts representing Brazil in the Global Partnership on Artificial Intelligence (GPAI), on the theme \"AI and the Pandemic Response\".",institutionString:"Manufacturing and Technology Integrated Campus – SENAI CIMATEC",institution:null},{id:"1063",title:"Prof.",name:"Constantin",middleName:null,surname:"Volosencu",slug:"constantin-volosencu",fullName:"Constantin Volosencu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1063/images/system/1063.png",biography:"Prof. Dr. Constantin Voloşencu graduated as an engineer from\nPolitehnica University of Timișoara, Romania, where he also\nobtained a doctorate degree. He is currently a full professor in\nthe Department of Automation and Applied Informatics at the\nsame university. Dr. Voloşencu is the author of ten books, seven\nbook chapters, and more than 160 papers published in journals\nand conference proceedings. He has also edited twelve books and\nhas twenty-seven patents to his name. He is a manager of research grants, editor in\nchief and member of international journal editorial boards, a former plenary speaker, a member of scientific committees, and chair at international conferences. His\nresearch is in the fields of control systems, control of electric drives, fuzzy control\nsystems, neural network applications, fault detection and diagnosis, sensor network\napplications, monitoring of distributed parameter systems, and power ultrasound\napplications. He has developed automation equipment for machine tools, spooling\nmachines, high-power ultrasound processes, and more.",institutionString:'"Politechnica" University Timişoara',institution:null},{id:"221364",title:"Dr.",name:"Eneko",middleName:null,surname:"Osaba",slug:"eneko-osaba",fullName:"Eneko Osaba",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/221364/images/system/221364.jpg",biography:"Dr. Eneko Osaba works at TECNALIA as a senior researcher. He obtained his Ph.D. in Artificial Intelligence in 2015. He has participated in more than twenty-five local and European research projects, and in the publication of more than 130 papers. He has performed several stays at universities in the United Kingdom, Italy, and Malta. Dr. Osaba has served as a program committee member in more than forty international conferences and participated in organizing activities in more than ten international conferences. He is a member of the editorial board of the International Journal of Artificial Intelligence, Data in Brief, and Journal of Advanced Transportation. He is also a guest editor for the Journal of Computational Science, Neurocomputing, Swarm, and Evolutionary Computation and IEEE ITS Magazine.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"275829",title:"Dr.",name:"Esther",middleName:null,surname:"Villar-Rodriguez",slug:"esther-villar-rodriguez",fullName:"Esther Villar-Rodriguez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/275829/images/system/275829.jpg",biography:"Dr. Esther Villar obtained a Ph.D. in Information and Communication Technologies from the University of Alcalá, Spain, in 2015. She obtained a degree in Computer Science from the University of Deusto, Spain, in 2010, and an MSc in Computer Languages and Systems from the National University of Distance Education, Spain, in 2012. Her areas of interest and knowledge include natural language processing (NLP), detection of impersonation in social networks, semantic web, and machine learning. Dr. Esther Villar made several contributions at conferences and publishing in various journals in those fields. Currently, she is working within the OPTIMA (Optimization Modeling & Analytics) business of TECNALIA’s ICT Division as a data scientist in projects related to the prediction and optimization of management and industrial processes (resource planning, energy efficiency, etc).",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49813/images/system/49813.png",biography:"Prof. Dr. Javier Del Ser received his first PhD in Telecommunication Engineering (Cum Laude) from the University of Navarra, Spain, in 2006, and a second PhD in Computational Intelligence (Summa Cum Laude) from the University of Alcala, Spain, in 2013. He is currently a principal researcher in data analytics and optimisation at TECNALIA (Spain), a visiting fellow at the Basque Center for Applied Mathematics (BCAM) and a part-time lecturer at the University of the Basque Country (UPV/EHU). His research interests gravitate on the use of descriptive, prescriptive and predictive algorithms for data mining and optimization in a diverse range of application fields such as Energy, Transport, Telecommunications, Health and Industry, among others. In these fields he has published more than 240 articles, co-supervised 8 Ph.D. theses, edited 6 books, coauthored 7 patents and participated/led more than 40 research projects. He is a Senior Member of the IEEE, and a recipient of the Biscay Talent prize for his academic career.",institutionString:"Tecnalia Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"278948",title:"Dr.",name:"Carlos Pedro",middleName:null,surname:"Gonçalves",slug:"carlos-pedro-goncalves",fullName:"Carlos Pedro Gonçalves",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRcmyQAC/Profile_Picture_1564224512145",biography:'Carlos Pedro Gonçalves (PhD) is an Associate Professor at Lusophone University of Humanities and Technologies and a researcher on Complexity Sciences, Quantum Technologies, Artificial Intelligence, Strategic Studies, Studies in Intelligence and Security, FinTech and Financial Risk Modeling. He is also a progammer with programming experience in:\n\nA) Quantum Computing using Qiskit Python module and IBM Quantum Experience Platform, with software developed on the simulation of Quantum Artificial Neural Networks and Quantum Cybersecurity;\n\nB) Artificial Intelligence and Machine learning programming in Python;\n\nC) Artificial Intelligence, Multiagent Systems Modeling and System Dynamics Modeling in Netlogo, with models developed in the areas of Chaos Theory, Econophysics, Artificial Intelligence, Classical and Quantum Complex Systems Science, with the Econophysics models having been cited worldwide and incorporated in PhD programs by different Universities.\n\nReceived an Arctic Code Vault Contributor status by GitHub, due to having developed open source software preserved in the \\"Arctic Code Vault\\" for future generations (https://archiveprogram.github.com/arctic-vault/), with the Strategy Analyzer A.I. module for decision making support (based on his PhD thesis, used in his Classes on Decision Making and in Strategic Intelligence Consulting Activities) and QNeural Python Quantum Neural Network simulator also preserved in the \\"Arctic Code Vault\\", for access to these software modules see: https://github.com/cpgoncalves. He is also a peer reviewer with outsanding review status from Elsevier journals, including Physica A, Neurocomputing and Engineering Applications of Artificial Intelligence. Science CV available at: https://www.cienciavitae.pt//pt/8E1C-A8B3-78C5 and ORCID: https://orcid.org/0000-0002-0298-3974',institutionString:"University of Lisbon",institution:{name:"Universidade Lusófona",country:{name:"Portugal"}}},{id:"241400",title:"Prof.",name:"Mohammed",middleName:null,surname:"Bsiss",slug:"mohammed-bsiss",fullName:"Mohammed Bsiss",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241400/images/8062_n.jpg",biography:null,institutionString:null,institution:null},{id:"276128",title:"Dr.",name:"Hira",middleName:null,surname:"Fatima",slug:"hira-fatima",fullName:"Hira Fatima",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/276128/images/14420_n.jpg",biography:"Dr. Hira Fatima\nAssistant Professor\nDepartment of Mathematics\nInstitute of Applied Science\nMangalayatan University, Aligarh\nMobile: no : 8532041179\nhirafatima2014@gmal.com\n\nDr. Hira Fatima has received his Ph.D. degree in pure Mathematics from Aligarh Muslim University, Aligarh India. Currently working as an Assistant Professor in the Department of Mathematics, Institute of Applied Science, Mangalayatan University, Aligarh. She taught so many courses of Mathematics of UG and PG level. Her research Area of Expertise is Functional Analysis & Sequence Spaces. She has been working on Ideal Convergence of double sequence. She has published 17 research papers in National and International Journals including Cogent Mathematics, Filomat, Journal of Intelligent and Fuzzy Systems, Advances in Difference Equations, Journal of Mathematical Analysis, Journal of Mathematical & Computer Science etc. She has also reviewed few research papers for the and international journals. She is a member of Indian Mathematical Society.",institutionString:null,institution:null},{id:"414880",title:"Dr.",name:"Maryam",middleName:null,surname:"Vatankhah",slug:"maryam-vatankhah",fullName:"Maryam Vatankhah",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Borough of Manhattan Community College",country:{name:"United States of America"}}},{id:"414879",title:"Prof.",name:"Mohammad-Reza",middleName:null,surname:"Akbarzadeh-Totonchi",slug:"mohammad-reza-akbarzadeh-totonchi",fullName:"Mohammad-Reza Akbarzadeh-Totonchi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Ferdowsi University of Mashhad",country:{name:"Iran"}}},{id:"414878",title:"Prof.",name:"Reza",middleName:null,surname:"Fazel-Rezai",slug:"reza-fazel-rezai",fullName:"Reza Fazel-Rezai",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"American Public University System",country:{name:"United States of America"}}},{id:"426586",title:"Dr.",name:"Oladunni A.",middleName:null,surname:"Daramola",slug:"oladunni-a.-daramola",fullName:"Oladunni A. Daramola",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Federal University of Technology",country:{name:"Nigeria"}}},{id:"357014",title:"Prof.",name:"Leon",middleName:null,surname:"Bobrowski",slug:"leon-bobrowski",fullName:"Leon Bobrowski",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Bialystok University of Technology",country:{name:"Poland"}}},{id:"302698",title:"Dr.",name:"Yao",middleName:null,surname:"Shan",slug:"yao-shan",fullName:"Yao Shan",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Dalian University of Technology",country:{name:"China"}}},{id:"354126",title:"Dr.",name:"Setiawan",middleName:null,surname:"Hadi",slug:"setiawan-hadi",fullName:"Setiawan Hadi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Padjadjaran University",country:{name:"Indonesia"}}},{id:"125911",title:"Prof.",name:"Jia-Ching",middleName:null,surname:"Wang",slug:"jia-ching-wang",fullName:"Jia-Ching Wang",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"National Central University",country:{name:"Taiwan"}}},{id:"332603",title:"Prof.",name:"Kumar S.",middleName:null,surname:"Ray",slug:"kumar-s.-ray",fullName:"Kumar S. Ray",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Indian Statistical Institute",country:{name:"India"}}},{id:"415409",title:"Prof.",name:"Maghsoud",middleName:null,surname:"Amiri",slug:"maghsoud-amiri",fullName:"Maghsoud Amiri",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Allameh Tabataba'i University",country:{name:"Iran"}}},{id:"357085",title:"Mr.",name:"P. Mohan",middleName:null,surname:"Anand",slug:"p.-mohan-anand",fullName:"P. Mohan Anand",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Indian Institute of Technology Kanpur",country:{name:"India"}}},{id:"356696",title:"Ph.D. Student",name:"P.V.",middleName:null,surname:"Sai Charan",slug:"p.v.-sai-charan",fullName:"P.V. Sai Charan",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Indian Institute of Technology Kanpur",country:{name:"India"}}},{id:"357086",title:"Prof.",name:"Sandeep K.",middleName:null,surname:"Shukla",slug:"sandeep-k.-shukla",fullName:"Sandeep K. Shukla",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Indian Institute of Technology Kanpur",country:{name:"India"}}}]}},subseries:{item:{id:"4",type:"subseries",title:"Fungal Infectious Diseases",keywords:"Emerging Fungal Pathogens, Invasive Infections, Epidemiology, Cell Membrane, Fungal Virulence, Diagnosis, Treatment",scope:"Fungi are ubiquitous and there are almost no non-pathogenic fungi. Fungal infectious illness prevalence and prognosis are determined by the exposure between fungi and host, host immunological state, fungal virulence, and early and accurate diagnosis and treatment. \r\nPatients with both congenital and acquired immunodeficiency are more likely to be infected with opportunistic mycosis. Fungal infectious disease outbreaks are common during the post- disaster rebuilding era, which is characterised by high population density, migration, and poor health and medical conditions.\r\nSystemic or local fungal infection is mainly associated with the fungi directly inhaled or inoculated in the environment during the disaster. The most common fungal infection pathways are human to human (anthropophilic), animal to human (zoophilic), and environment to human (soilophile). Diseases are common as a result of widespread exposure to pathogenic fungus dispersed into the environment. \r\nFungi that are both common and emerging are intertwined. In Southeast Asia, for example, Talaromyces marneffei is an important pathogenic thermally dimorphic fungus that causes systemic mycosis. Widespread fungal infections with complicated and variable clinical manifestations, such as Candida auris infection resistant to several antifungal medicines, Covid-19 associated with Trichoderma, and terbinafine resistant dermatophytosis in India, are among the most serious disorders. \r\nInappropriate local or systemic use of glucocorticoids, as well as their immunosuppressive effects, may lead to changes in fungal infection spectrum and clinical characteristics. Hematogenous candidiasis is a worrisome issue that affects people all over the world, particularly ICU patients. CARD9 deficiency and fungal infection have been major issues in recent years. Invasive aspergillosis is associated with a significant death rate. Special attention should be given to endemic fungal infections, identification of important clinical fungal infections advanced in yeasts, filamentous fungal infections, skin mycobiome and fungal genomes, and immunity to fungal infections.\r\nIn addition, endemic fungal diseases or uncommon fungal infections caused by Mucor irregularis, dermatophytosis, Malassezia, cryptococcosis, chromoblastomycosis, coccidiosis, blastomycosis, histoplasmosis, sporotrichosis, and other fungi, should be monitored. \r\nThis topic includes the research progress on the etiology and pathogenesis of fungal infections, new methods of isolation and identification, rapid detection, drug sensitivity testing, new antifungal drugs, schemes and case series reports. It will provide significant opportunities and support for scientists, clinical doctors, mycologists, antifungal drug researchers, public health practitioners, and epidemiologists from all over the world to share new research, ideas and solutions to promote the development and progress of medical mycology.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/4.jpg",hasOnlineFirst:!0,hasPublishedBooks:!1,annualVolume:11400,editor:{id:"174134",title:"Dr.",name:"Yuping",middleName:null,surname:"Ran",slug:"yuping-ran",fullName:"Yuping Ran",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bS9d6QAC/Profile_Picture_1630330675373",biography:"Dr. Yuping Ran, Professor, Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China. Completed the Course Medical Mycology, the Centraalbureau voor Schimmelcultures (CBS), Fungal Biodiversity Centre, Netherlands (2006). International Union of Microbiological Societies (IUMS) Fellow, and International Emerging Infectious Diseases (IEID) Fellow, Centers for Diseases Control and Prevention (CDC), Atlanta, USA. Diploma of Dermatological Scientist, Japanese Society for Investigative Dermatology. Ph.D. of Juntendo University, Japan. Bachelor’s and Master’s degree, Medicine, West China University of Medical Sciences. Chair of Sichuan Medical Association Dermatology Committee. General Secretary of The 19th Annual Meeting of Chinese Society of Dermatology and the Asia Pacific Society for Medical Mycology (2013). In charge of the Annual Medical Mycology Course over 20-years authorized by National Continue Medical Education Committee of China. Member of the board of directors of the Asia-Pacific Society for Medical Mycology (APSMM). Associate editor of Mycopathologia. Vice-chief of the editorial board of Chinses Journal of Mycology, China. 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