Insulin initiation recommendations.
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Barely three months into the new year and we are happy to announce a monumental milestone reached - 150 million downloads.
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\n\nWe are so proud to have worked with so many bright minds throughout the years who have helped us spread knowledge through the power of Open Access and we look forward to continuing to support some of the greatest thinkers of our day.
\n\nThank you for making IntechOpen your place of learning, sharing, and discovery, and here’s to 150 million more!
\n\n\n\n\n'}],latestNews:[{slug:"intechopen-supports-asapbio-s-new-initiative-publish-your-reviews-20220729",title:"IntechOpen Supports ASAPbio’s New Initiative Publish Your Reviews"},{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"}]},book:{item:{type:"book",id:"7677",leadTitle:null,fullTitle:"Forecasting Volcanic Eruptions",title:"Forecasting Volcanic Eruptions",subtitle:null,reviewType:"peer-reviewed",abstract:"The chapters presented in this International Volcanological Special Issue consider the characteristic features of a single volcano and/or a number of volcanoes worldwide (Jos and Biu Plateau volcanic provinces, Nigeria; Kachchh Rift Zone, Gujarat, India; Guamsan Caldera, Cheongsong, Korea; Somma-Vesuvius volcano, Napoli, Italy) in terms of future volcanic activity. The technical methods used are wide, innovative, as well as classic and reflect the knowledge presented in each chapter. The last chapter, however, deals with a new conceptual and methodological approach for the evaluation of volcanic risk. All these volcanoes (except Somma-Vesuvius volcano) are poorly studied so they deserve more attention, which is the goal of this volcanological book. Further studies are welcome to deepen the knowledge of each of the volcanoes presented.",isbn:"978-1-78984-030-8",printIsbn:"978-1-78984-029-2",pdfIsbn:"978-1-78984-710-9",doi:"10.5772/intechopen.77483",price:119,priceEur:129,priceUsd:155,slug:"forecasting-volcanic-eruptions",numberOfPages:116,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"5afd431dd1f4f5081355b017fd17f237",bookSignature:"Angelo Paone and Sung-Hyo Yun",publishedDate:"April 22nd 2020",coverURL:"https://cdn.intechopen.com/books/images_new/7677.jpg",numberOfDownloads:6667,numberOfWosCitations:1,numberOfCrossrefCitations:6,numberOfCrossrefCitationsByBook:1,numberOfDimensionsCitations:6,numberOfDimensionsCitationsByBook:1,hasAltmetrics:1,numberOfTotalCitations:13,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"September 10th 2018",dateEndSecondStepPublish:"October 23rd 2018",dateEndThirdStepPublish:"December 22nd 2018",dateEndFourthStepPublish:"March 12th 2019",dateEndFifthStepPublish:"May 11th 2019",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,7",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"182871",title:"Prof.",name:"Angelo",middleName:null,surname:"Paone",slug:"angelo-paone",fullName:"Angelo Paone",profilePictureURL:"https://mts.intechopen.com/storage/users/182871/images/system/182871.jpg",biography:"Angelo Paone received his BS and MS at the Università degli Studi di Napoli Federico II, Italy. He completed an isotopic specialization course at the United States Geological Survey (USGS), Virginia, USA, and obtained his Ph.D. at USGS and the University of Naples Federico II, Italy. He completed a short post-doc at the American Museum of Natural History, New York, USA; a Marie Curie Fellowship (individual postdoc) at Bristol University, England; and an Italian postdoc at the University of Naples Federico II. Since 2008 he has been a science teacher at Italian College Liceo Ettore Majorana Pozzuoli and a research professor at Pusan National University (PNU), South Korea.",institutionString:"Pusan National University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"4",totalChapterViews:"0",totalEditedBooks:"2",institution:{name:"Pusan National University",institutionURL:null,country:{name:"Korea, South"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:{id:"183601",title:"Prof.",name:"Sung-Hyo",middleName:null,surname:"Yun",slug:"sung-hyo-yun",fullName:"Sung-Hyo Yun",profilePictureURL:"https://mts.intechopen.com/storage/users/183601/images/system/183601.jpg",biography:"Dr. Sung-Hyo Yun is a professor in the Department of Earth Science Education, Pusan National University (PNU), South Korea. He obtained his BSc at the College of Education, PNU, in 1980, and his MEd from the Graduate School, PNU, in 1982. Dr. Yun received his Ph.D. in Geology and Volcanology from the Graduate School, PNU, in 1987. Dr. Yun was the president of the Petrological Society of Korea and the Korean Society of Volcanic Hazards Mitigation.",institutionString:"Pusan National University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Pusan National University",institutionURL:null,country:{name:"Korea, South"}}},coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"658",title:"Volcanology",slug:"volcanology"}],chapters:[{id:"71228",title:"Introductory Chapter: New Advances and Challenges",doi:"10.5772/intechopen.91029",slug:"introductory-chapter-new-advances-and-challenges",totalDownloads:629,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:null,signatures:"Angelo Paone and Sung-Hyo Yun",downloadPdfUrl:"/chapter/pdf-download/71228",previewPdfUrl:"/chapter/pdf-preview/71228",authors:[{id:"182871",title:"Prof.",name:"Angelo",surname:"Paone",slug:"angelo-paone",fullName:"Angelo Paone"}],corrections:null},{id:"65639",title:"Is a Volcanic Eruption Possible in Nigeria?",doi:"10.5772/intechopen.84253",slug:"is-a-volcanic-eruption-possible-in-nigeria-",totalDownloads:698,totalCrossrefCites:2,totalDimensionsCites:2,hasAltmetrics:0,abstract:"The Jos and Biu Plateaux volcanic provinces occupy the northeastern half of Nigeria bordering the Cameroon Volcanic Line, dotted with conspicuously visible number of dormant volcanoes with no reported activity. These dormant volcanoes represent potential future eruption sites. The ejecta materials of these volcanoes are essentially basaltic in composition and consist of sequence of pyroclastic materials, basalts, scoria and ash and are formed by strombolian and effusive styles of eruption. The volcanoes are represented by well-preserved cones and lava flows. In places the lava flows have been lateritized and eroded leaving remnants of weathered basalt boulders and a number of plugs and dome-like outcrops lacking any preserved cones. The basalts display essentially similar compositions consisting of phenocrysts of both olivine, plagioclase (bytownite–labradorite), with minor pyroxene (diopside-augite) embedded in a groundmass of plagioclase laths (labradorite), and accessory magnetite, ilmenite, k-feldspars, and volcanic glass. Geochemical data shows that these basalts are mainly alkaline olivine basalts derived from the deep mantle source enriched in incompatible elements similar to that of the Ocean Island basalts (OIB). Preliminary 40Ar-39Ar ages on the some of the basalts revealed Quaternary ages (Pleistocene epoch). The significant change in the composition of the Pidong Lake marked by decreasing pH is indicative of a probable input of juvenile fluids into the Lake. Also, the several incidences of volcanic eruptions along the close-by Cameroon volcanic line are pointers to the possibility for the reactivation of any of the dormant volcanoes in Nigeria. This work focuses on the need to assess the hazard level of some of these volcanoes for effective monitoring, disaster preparedness and land use planning as more people live and farm in these potentially endangered volcanic prone areas, unaware of the inherent risk.",signatures:"Uriah Lar, Isah Lekmang, Cedric Longpia and Mohammed Tsalha",downloadPdfUrl:"/chapter/pdf-download/65639",previewPdfUrl:"/chapter/pdf-preview/65639",authors:[{id:"276892",title:"Prof.",name:"Uriah",surname:"Lar",slug:"uriah-lar",fullName:"Uriah Lar"},{id:"277036",title:"MSc.",name:"Isah",surname:"Lekmang",slug:"isah-lekmang",fullName:"Isah Lekmang"},{id:"277037",title:"MSc.",name:"Mohammed",surname:"Tsalha",slug:"mohammed-tsalha",fullName:"Mohammed Tsalha"},{id:"289601",title:"MSc.",name:"Cedric",surname:"Longpia",slug:"cedric-longpia",fullName:"Cedric Longpia"}],corrections:null},{id:"66703",title:"P-Wave Teleseismic Tomography: Evidence of Imprints of Deccan Mantle Plume below the Kachchh Rift Zone, Gujarat, India",doi:"10.5772/intechopen.83738",slug:"p-wave-teleseismic-tomography-evidence-of-imprints-of-deccan-mantle-plume-below-the-kachchh-rift-zon",totalDownloads:2723,totalCrossrefCites:2,totalDimensionsCites:2,hasAltmetrics:0,abstract:"The Indian plate had experienced the Deccan volcanism at 65 Ma when it moved over the Re-union hotspot, which has altered lithospheric structure below the Kachchh rift zone (KRZ). To quantify the influence of Deccan volcanism on the crust-mantle, the present chapter focuses on the delineation of the upper mantle structure below the KRZ, through the modeling of crust corrected P-residuals and P-wave teleseismic tomography. The crust corrected normalized P-residuals suggest dominant negative residuals associated with the central KRZ, indicating crustal and lithospheric thinning below the KRZ. A low velocity down to a depth of 170 km below the central KRZ is detected through the teleseismic tomography using these P-residuals. However, these residuals also show positive values for the surrounding un-rifted zones. Note that a low shear velocity zone extending from 100–120 km to 170–220 km depth beneath the central KRZ has already been revealed by the modeling of P-RFs. This reduction in seismic velocity in the upper mantle could be explained by the presence of trapped carbonatite/partial melts related to the Deccan volcanism. The influx of volatile CO2 emanating from the carbonatite melts in the asthenosphere might be generating lower crustal earthquakes occurring in the KRZ.",signatures:"Prantik Mandal",downloadPdfUrl:"/chapter/pdf-download/66703",previewPdfUrl:"/chapter/pdf-preview/66703",authors:[{id:"279344",title:"Dr.",name:"Prantik",surname:"Mandal",slug:"prantik-mandal",fullName:"Prantik Mandal"}],corrections:null},{id:"65755",title:"Eruption Types and Processes in the Guamsan Caldera, Korea",doi:"10.5772/intechopen.84647",slug:"eruption-types-and-processes-in-the-guamsan-caldera-korea",totalDownloads:1034,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The Guamsan caldera is associated with the Guamsan Tuff and rhyolitic intrusions. The Guamsan Tuff consists of dominant ash-flow tuffs with some volcanic breccias and fallout tuffs. The breccias comprise block and ash-flow breccia near a vent and caldera-collapse breccia near a ring fracture. The lower member of the ash-flow tuffs is produced from pyroclastic flow-forming eruptions with any ash-cloud falls on the flow units, whereas the upper member is formed by many ash-flow from boiling-over eruptions. The rhyolitic intrusions are divided into intracaldera plug and ring dikes. The volcanic activities in the caldera exhibit the volcanic processes along a caldera cycle together with eruption types during 63.77–60.1 Ma. The activities began with pelean eruption that occurred with block and ash-flows from lava dome collapse, progressed through expanded pyroclastic flows and ash-cloud falls by pyroclastic flow-forming eruptions from a single central vent, and transmitted with non-expanded ash-flows from boiling-over eruptions along multiple ring fissure vents. Then the caldera collapse induced any translations into multiple ring fissure vents from an earlier single central vent. The boiling-over eruptions were followed by effusive eruptions along which rhyolitic magma was injected as a small plug and ring dikes with some lava domes on the surface.",signatures:"Sang Koo Hwang",downloadPdfUrl:"/chapter/pdf-download/65755",previewPdfUrl:"/chapter/pdf-preview/65755",authors:[{id:"280222",title:"Emeritus Prof.",name:"Sang Koo",surname:"Hwang",slug:"sang-koo-hwang",fullName:"Sang Koo Hwang"}],corrections:null},{id:"65681",title:"Toward a New Conceptual and Methodological Approach for the Integral Evaluation of Volcanic Risk",doi:"10.5772/intechopen.84415",slug:"toward-a-new-conceptual-and-methodological-approach-for-the-integral-evaluation-of-volcanic-risk",totalDownloads:690,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:1,abstract:"In the world, there are very few experiences of studies oriented to the integral evaluation of risks due to natural hazards. In the case of volcanic risk, most of the scientific-technical and economic efforts have been oriented mainly toward the evaluation of threats, with few methodological considerations to assess vulnerability and much less risk. In other cases, the threat and vulnerability are evaluated independently, with many difficulties for the comprehensive risk assessment. Many of the studies called “vulnerability assessments” are only physical and functional characterizations and diagnoses of vital infrastructure and population. These characterizations can hardly be interpreted in terms of georeferenced indices and/or vulnerability maps that represent the spatial and temporal exposure of the elements exposed to each threat and, even less, that represent the intrinsic and extrinsic response capacities of these elements in comparison with the threats. In this chapter, a new conceptual and methodological approach is proposed for the integral evaluation of volcanic risk, which includes the generation and adjustment of a new equation for the determination of volcanic risk, based on the integral assessment of threats and vulnerabilities.",signatures:"Leonel Vega",downloadPdfUrl:"/chapter/pdf-download/65681",previewPdfUrl:"/chapter/pdf-preview/65681",authors:[{id:"143359",title:"Dr.",name:"Leonel",surname:"Vega",slug:"leonel-vega",fullName:"Leonel Vega"}],corrections:null},{id:"70027",title:"The Somma-Vesuvius Activity with a Focus to the AD 79 Eruption: Hazard and Risk",doi:"10.5772/intechopen.89989",slug:"the-somma-vesuvius-activity-with-a-focus-to-the-ad-79-eruption-hazard-and-risk",totalDownloads:894,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:1,abstract:"Somma-Vesuvius is a quiescent stratovolcano with a probability of Plinian style volcanic reactivation. Its stratigraphy is well known in the last 40 ka BP. The volcanic products that are part of the Somma caldera are poorly studied. Conversely, younger products have been deeply studied together with the AD 79 Plinian eruption. The impact of a Plinian eruption has been studied and summarised here. A simplified scheme is presented from what we can understand the volcanic hazard and risk that the volcano poses to the greater Neapolitan population. In the last 40 years, the demography around the Somma-Vesuvius volcano has increased; consequently, the volcanic risk has increased. It would seem that the Italian Civil Protection (ICP) has not influenced the population and the Italian authority with their massive work around Somma-Vesuvius (red zone). People still continue to build houses. Nowadays, the Somma-Vesuvius volcano does not seem to threaten people or the people that live around Vesuvius are not afraid of the volcano. But as it is usual just in this moment that the work done and to be done must be speared to all Neapolitan people, working in the school to reach the family. People around Somma-Vesuvius tend to neglect the volcanic risk appearing around Vesuvio. So ICP, all must be much more attend about the behaviour of this Hazardous volcano.",signatures:"Angelo Paone",downloadPdfUrl:"/chapter/pdf-download/70027",previewPdfUrl:"/chapter/pdf-preview/70027",authors:[{id:"182871",title:"Prof.",name:"Angelo",surname:"Paone",slug:"angelo-paone",fullName:"Angelo Paone"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"10851",title:"Progress in Volcanology",subtitle:null,isOpenForSubmission:!1,hash:"6cfc09f959efecf9ba95654b1bb4b987",slug:"progress-in-volcanology",bookSignature:"Angelo Paone and Sung-Hyo Yun",coverURL:"https://cdn.intechopen.com/books/images_new/10851.jpg",editedByType:"Edited by",editors:[{id:"182871",title:"Prof.",name:"Angelo",surname:"Paone",slug:"angelo-paone",fullName:"Angelo 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Rajesh Banu",coverURL:"https://cdn.intechopen.com/books/images_new/6839.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"218539",title:"Dr.",name:"Rajesh Banu",middleName:null,surname:"Jeyakumar",slug:"rajesh-banu-jeyakumar",fullName:"Rajesh Banu Jeyakumar"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"262546",title:"Prof.",name:"Anna",middleName:null,surname:"Schnürer",fullName:"Anna Schnürer",slug:"anna-schnurer",email:"anna.schnurer@slu.se",position:null,institution:null},{id:"263116",title:"Dr.",name:"Maria",middleName:null,surname:"Westerholm",fullName:"Maria Westerholm",slug:"maria-westerholm",email:"Maria.Westerholm@slu.se",position:null,institution:{name:"Swedish University of Agricultural Sciences",institutionURL:null,country:{name:"Sweden"}}}]}},chapter:{id:"65614",slug:"microbial-responses-to-different-operating-practices-for-biogas-production-systems",signatures:"Maria Westerholm and Anna Schnürer",dateSubmitted:"June 11th 2018",dateReviewed:"November 30th 2018",datePrePublished:"February 12th 2019",datePublished:"September 4th 2019",book:{id:"6839",title:"Anaerobic Digestion",subtitle:null,fullTitle:"Anaerobic Digestion",slug:"anaerobic-digestion",publishedDate:"September 4th 2019",bookSignature:"J. Rajesh Banu",coverURL:"https://cdn.intechopen.com/books/images_new/6839.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"218539",title:"Dr.",name:"Rajesh Banu",middleName:null,surname:"Jeyakumar",slug:"rajesh-banu-jeyakumar",fullName:"Rajesh Banu Jeyakumar"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"262546",title:"Prof.",name:"Anna",middleName:null,surname:"Schnürer",fullName:"Anna Schnürer",slug:"anna-schnurer",email:"anna.schnurer@slu.se",position:null,institution:null},{id:"263116",title:"Dr.",name:"Maria",middleName:null,surname:"Westerholm",fullName:"Maria Westerholm",slug:"maria-westerholm",email:"Maria.Westerholm@slu.se",position:null,institution:{name:"Swedish University of Agricultural Sciences",institutionURL:null,country:{name:"Sweden"}}}]},book:{id:"6839",title:"Anaerobic Digestion",subtitle:null,fullTitle:"Anaerobic Digestion",slug:"anaerobic-digestion",publishedDate:"September 4th 2019",bookSignature:"J. Rajesh Banu",coverURL:"https://cdn.intechopen.com/books/images_new/6839.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"218539",title:"Dr.",name:"Rajesh Banu",middleName:null,surname:"Jeyakumar",slug:"rajesh-banu-jeyakumar",fullName:"Rajesh Banu Jeyakumar"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}}},ofsBook:{item:{type:"book",id:"11502",leadTitle:null,title:"Manifolds - Recent Developments and Applications",subtitle:null,reviewType:"peer-reviewed",abstract:"
\r\n\tManifolds, a subject of interest for researchers in their own right, have many applications and interactions with many areas of mathematics and physics. These areas include partial differential equations, elliptic problems, boundary value problems, Schrodinger, and heat operators. Fundamentally, with Descartes and the introduction of coordinates, a line or a plane becomes via coordinates an algebraic object, more precisely an equation.
\r\n\r\n\tIn general, any coordinates replace geometry by algebra and we get a two-dimensional correspondence between the study of space and the study of equations. This process is a shift from geometry to numbers at a basic level. The coordinatization process has been used well before mathematicians accepted it as a method.
\r\n\r\n\tThe manifolds are precisely those spaces that can be piecewise provided with coordinates by means of a smooth correspondence on overlaps, and the book will intend to study these structures in mathematics, as well as the impact and applications to a variety of other areas of mathematics. Recently, there have been very deep insights into the subject, and it is intended this the book will provide readers with an interest in the subject a clear review of advances and consequences in this area of investigation.
",isbn:"978-1-80356-231-5",printIsbn:"978-1-80356-230-8",pdfIsbn:"978-1-80356-232-2",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,isSalesforceBook:!1,isNomenclature:!1,hash:"eca1aa784f719310820d6bb2cf5a7b20",bookSignature:"Prof. Paul Bracken",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11502.jpg",keywords:"Covariant Derivative, Connection, Elliptic, Boundary Value Problem, Hodge Decomposition, Differential Form, Curvature, Metric, Spin Structure, Bundle, Local Index Theorem, Clifford Algebra",numberOfDownloads:22,numberOfWosCitations:0,numberOfCrossrefCitations:0,numberOfDimensionsCitations:0,numberOfTotalCitations:0,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"February 9th 2022",dateEndSecondStepPublish:"April 12th 2022",dateEndThirdStepPublish:"June 11th 2022",dateEndFourthStepPublish:"August 30th 2022",dateEndFifthStepPublish:"October 29th 2022",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"4 months",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"Professor Paul Bracken obtained his BSc degree from the University of Toronto and holds a Ph.D. from the University of Waterloo in Canada. His research interests include mathematical problems from the area of quantum mechanics and quantum field theory, differential geometry, a study of partial differential equations as well as their overlap with other problems in physics. He has published more than 180 papers in journals and books and has given many talks at different levels over the years.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"92883",title:"Prof.",name:"Paul",middleName:null,surname:"Bracken",slug:"paul-bracken",fullName:"Paul Bracken",profilePictureURL:"https://mts.intechopen.com/storage/users/92883/images/system/92883.jpg",biography:"Professor Paul Bracken is currently a Professor in the Department of Mathematics, at the University of Texas RGV in Edinburg, TX. He obtained his BSc degree from the University of Toronto and holds a Ph.D. from the University of Waterloo in Canada. His research interests include mathematical problems from the area of quantum mechanics and quantum field theory, differential geometry, a study of partial differential equations as well as their overlap with other problems in physics. He has published more than 180 papers in journals and books and has given many talks at different levels over the years. This is the seventh volume he has worked on with IntechOpen publishers.",institutionString:"The University of Texas Rio Grande Valley",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"11",totalChapterViews:"0",totalEditedBooks:"7",institution:{name:"The University of Texas Rio Grande Valley",institutionURL:null,country:{name:"United States of America"}}}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"15",title:"Mathematics",slug:"mathematics"}],chapters:[{id:"83029",title:"Quasi Conformally Flat Quasi Einstein-Weyl Manifolds",slug:"quasi-conformally-flat-quasi-einstein-weyl-manifolds",totalDownloads:2,totalCrossrefCites:0,authors:[null]},{id:"82356",title:"Geometric Properties of Classical Yang-Mills Theory on Differentiable Manifolds",slug:"geometric-properties-of-classical-yang-mills-theory-on-differentiable-manifolds",totalDownloads:11,totalCrossrefCites:0,authors:[{id:"92883",title:"Prof.",name:"Paul",surname:"Bracken",slug:"paul-bracken",fullName:"Paul Bracken"}]},{id:"82614",title:"An Introduction to the Generalized Gauss-Bonnet-Chern Theorem",slug:"an-introduction-to-the-generalized-gauss-bonnet-chern-theorem",totalDownloads:10,totalCrossrefCites:0,authors:[{id:"92883",title:"Prof.",name:"Paul",surname:"Bracken",slug:"paul-bracken",fullName:"Paul Bracken"}]}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"441704",firstName:"Ana",lastName:"Javor",middleName:null,title:"Ms.",imageUrl:"https://mts.intechopen.com/storage/users/441704/images/20009_n.jpg",email:"ana.j@intechopen.com",biography:"As an Author Service Manager, my responsibilities include monitoring and facilitating all publishing activities for authors and editors. From chapter submission and review to approval and revision, copyediting and design, until final publication, I work closely with authors and editors to ensure a simple and easy publishing process. I maintain constant and effective communication with authors, editors, and reviewers, which allows for a level of personal support that enables contributors to fully commit and concentrate on the chapters they are writing, editing, or reviewing. I assist authors in the preparation of their full chapter submissions and track important deadlines and ensure they are met. I help to coordinate internal processes such as linguistic review and monitor the technical aspects of the process. As an ASM I am also involved in the acquisition of editors. Whether that be identifying an exceptional author and proposing an editorship collaboration, or contacting researchers who would like the opportunity to work with IntechOpen, I establish and help manage author and editor acquisition and contact."}},relatedBooks:[{type:"book",id:"3513",title:"Advances in Quantum Mechanics",subtitle:null,isOpenForSubmission:!1,hash:"bbea1c081216f267a4480707f4ead9cf",slug:"advances-in-quantum-mechanics",bookSignature:"Paul Bracken",coverURL:"https://cdn.intechopen.com/books/images_new/3513.jpg",editedByType:"Edited by",editors:[{id:"92883",title:"Prof.",name:"Paul",surname:"Bracken",slug:"paul-bracken",fullName:"Paul Bracken"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5488",title:"Manifolds",subtitle:"Current Research Areas",isOpenForSubmission:!1,hash:"e1193790ca2c8027d4ffc6911dd24365",slug:"manifolds-current-research-areas",bookSignature:"Paul Bracken",coverURL:"https://cdn.intechopen.com/books/images_new/5488.jpg",editedByType:"Edited by",editors:[{id:"92883",title:"Prof.",name:"Paul",surname:"Bracken",slug:"paul-bracken",fullName:"Paul Bracken"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5213",title:"Research Advances in Quantum Dynamics",subtitle:null,isOpenForSubmission:!1,hash:"15678b0555c714101f8d707a46b4ac60",slug:"research-advances-in-quantum-dynamics",bookSignature:"Paul Bracken",coverURL:"https://cdn.intechopen.com/books/images_new/5213.jpg",editedByType:"Edited by",editors:[{id:"92883",title:"Prof.",name:"Paul",surname:"Bracken",slug:"paul-bracken",fullName:"Paul Bracken"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10076",title:"Quantum Mechanics",subtitle:null,isOpenForSubmission:!1,hash:"78f2b316d6bb97464dbbf9b683164aff",slug:"quantum-mechanics",bookSignature:"Paul Bracken",coverURL:"https://cdn.intechopen.com/books/images_new/10076.jpg",editedByType:"Edited by",editors:[{id:"92883",title:"Prof.",name:"Paul",surname:"Bracken",slug:"paul-bracken",fullName:"Paul Bracken"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10413",title:"A Collection of Papers on Chaos Theory and Its Applications",subtitle:null,isOpenForSubmission:!1,hash:"900b71b164948830fec3d6254b7881f7",slug:"a-collection-of-papers-on-chaos-theory-and-its-applications",bookSignature:"Paul Bracken and Dimo I. 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Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"65616",title:"Insulin Therapy in Gestational Diabetes",doi:"10.5772/intechopen.84569",slug:"insulin-therapy-in-gestational-diabetes",body:'\nGestational diabetes (GD) is one of the most common pathologies in pregnancy. Gestational diabetes has been defined as any degree of glucose intolerance with onset or first recognition during pregnancy [1]. In pregnancy, there are multiple hormonal changes, including hyperinsulinemia and an insulin-resistant state; thus the pancreatic beta cell function becomes insufficient to meet the body’s reasonable needs, and insulin must be injected.
\nThere is also the possibility that hyperglycemia was present before the pregnancy; therefore International Association of Diabetes and Pregnancy Study Groups (IADPSG) defined the pregnancy hyperglycemia as either ‘overt diabetes’ or ‘gestational diabetes mellitus’ (GDM) [2].
\nConsidering the ascending trend of type 2 diabetes mellitus and obesity from the last decades, GD has intuitively the same tendency [3, 4]. The prevalence of GD is estimated at approximately 135,000 cases per year in the US [5], representing on average 3–8% of all pregnancies [6]. It is estimated that the prevalence of GD has increased by 10–100% in several racial groups during the past 20 years, increasing direct and indirect healthcare costs [5].
\nThe goal of treatment for women with GD (recommended by both American Diabetes Association-ADA, and the American College of Obstetricians and Gynecologists-ACOG) is a fasting plasma glucose level <95 mg/dl, a 1-hour post-prandial glucose level of less than 140 mg/dl and a 2-hour post-prandial glucose level of less than 120 mg/dl, whereas for the HbA1c the target is <6–6.5% (42–48 mmol/mol); lower HbA1c—6% (42 mmol/mol) is optimal if it can be achieved without significant hypoglycemia; also, the target may be relaxed to 7% (53 mmol/mol) in order to prevent hypoglycemia [7, 8].
\nAfter diagnosis GD, to reach the goals for plasma glucose levels, the first step is the initiation of a lifestyle intervention program (including medical nutrition therapy—MNT and physical activity—PA).
\nMNT is the cornerstone of the GDM treatment. MNT alone can assure glycemic targets in 80–90% of GDM patients [9]. Maternal height and weight are key factors for the medical nutrition therapy, providing adequate calories and nutrients for both maternal and fetal nutrition, maintaining glycemic targets and the absence of ketones with appropriate weight gain [10, 11, 12]. For a GDM mother with a normal body mass index (BMI) of 18.5–24.9 kg/m2, the number of adequate calories is about 30 kcal/kg [9]. Nevertheless, since more than 60% of women diagnosed with GDM are overweight or obese, a caloric restriction is needed. The ADA states that no research identifies a specific optimal calorie intake for women with GDM and that the calorie needs are no different from those of pregnant women without GDM [7]. Therefore, ADA issued only general recommendations (following the dietary reference intakes) for 175 g of carbohydrate, 71 g of protein, 28 g of fiber, emphasizing the importance of the amount and type of carbohydrate with significant impact concerning the glucose levels, especially postprandial glucose peak [7]. ADA recommends individualized nutrition plan developed by a registered dietitian familiar with the management of GDM [7]. The National Institute for Health and Care Excellence (NICE) guidelines recommend a healthy diet, emphasizing the importance of low glycemic index foods (that should replace those with a high glycemic index) for GDM women; also there is the recommendation for a dietitian when GDM is present [13].
\nThe carbohydrate intake should be reduced to 33–45% of the total calories, and distributed over 3 meals, and 2–4 snacks/day, thus reducing postprandial glucose peak [8, 14], while as the rest of the calories should be divided between protein (20%) and lipids (40%) [15].
\nExcessive weight gain during pregnancy should be avoided for GDM women [16]. The weight gain during pregnancy depends on pre-pregnancy BMI:
\n12.5–18 kg of weight gain for underweight women (BMI <18.5 kg/m2);
11.5–16 kg for normal weight (BMI 18.5–24.9 kg/m2);
7–11.5 kg for overweight (BMI 25–29.9 kg/m2)
5–9 kg for obese (BMI ≥30.0 kg/m2) [17]
Physical activity improves glycemic control in GDM women. The generally accepted recommendation is daily moderate-intensity regular exercise (walking 30 minutes/day or more—if no medical contraindications) improves blood glucose control [13, 14].
\nPharmacological treatment is recommended when lifestyle intervention does not reduce hyperglycemia to reach the glycemic target. There is no international consensus on when to start pharmacological treatment of GDM [18]. The Canadian Diabetes Association (CDA) and NICE guidelines, both recommend beginning pharmacological treatment if glycemic control is not achieved after 1–2 weeks of lifestyle intervention [13, 19].
\nOral antidiabetic medication has been described in a previous chapter. The authors want to resume the most important clinical implications and the comparisons with insulin treatment.
\nThe use of metformin in GDM after the glycemic target is not reached with lifestyle intervention is recommended by the NICE guidelines [13]. Metformin is classified as a category B drug, which implies that there is no evidence of animal, or fetal toxicity or teratogenicity. In general, metformin appears to be a safe alternative to insulin for the GDM treatment, but it crosses the placenta, and it may be present in a higher concentration in the fetal circulation than in the maternal circulation [19]. Studies were performed for the assessment of metformin exposure in-utero. There is no evidence that the metformin is affecting the fetus with regards to an early motor, linguistic, social, [20], metabolic [20, 21], and neurodevelopmental [22, 23] outcomes, but long-term follow up studies are needed. The metformin was associated with a lower risk of neonatal hypoglycemia and less maternal weight gain than insulin in two systematic reviews [24, 25]. Almost half of the patients with GDM who were initially treated with metformin needed insulin to achieve acceptable glucose control [26]. Metformin remains an option as a second line treatment in GDM women who refuse insulin treatment or who are unable to administer insulin safely.
\nGlyburide (glibenclamide) was associated with increased birth weight, macrosomia and neonatal hypoglycemia compared with insulin [20, 25], and similar to metformin, crosses the placenta [27]. Glyburide therapy during pregnancy is not recommended as first- or second-line treatment, but it may be used as third-line treatment if insulin is refused, and metformin is either refused or insufficient to reach targeted glycemic control [19].
\nThere is no human data for the use of any other antihyperglycemic medication in the treatment of GDM (DPP-4 inhibitors, GLP-1 receptor agonists or SGLT2 inhibitors) [19]. Patients treated with oral therapy should be informed that they cross the placenta. No adverse effects on the fetus have been demonstrated; long-term studies are lacking [7].
\nInsulin is the first-line antihyperglycemic medication recommended for treatment of GDM [7, 19]. None of the currently available insulin preparations has been demonstrated to cross the placenta [7]. If glycemic control is not achieved after 1–2 weeks of lifestyle intervention, insulin treatment should be initiated [19]. Insulin remains the gold standard treatment for GDM women that do not reach glycemic targets with lifestyle intervention, as recommended by several guidelines (see Table 1 below). Insulin use reduces fetal and maternal morbidity [28, 29].
\nInternational Federation of Gynecology and Obstetrics (FIGO), 2015 | \n\n
| \n
Canadian Diabetes Association (CDA), 2018 | \nIf glycemic control is not achieved in 2 weeks after the initiation of medical, nutritional intervention | \n
American Diabetes Association (ADA), 2018 | \nFirst line therapy if glycemic control is not achieved after diet intervention | \n
American College of Obstetricians and Gynecologists (ACOG), 2018 | \nFirst line therapy if glycemic control is not achieved after diet intervention | \n
Insulin initiation recommendations.
Regular insulin (U-100, U-500) is identical to human insulin, and it is used as mealtime insulin to cover postprandial hyperglycemia. Its time to onset is about 30 minutes (10–75 minutes), the peak effect is in 3 hours (2.5–5 hours), and the effect ends at about 8 hours (up to 24 hours for U500). The FDA pregnancy category is B [30].
\nHuman insulin inhalation (nasal insulin) is equivalent unit-for-unit to insulin lispro. Its onset is 15 minutes, and its peak action time is ∼50 minutes. Duration of action is about 2 hours. Inhaled human insulin carries a boxed warning for bronchospasms in patients with chronic lung disease. It is a pregnancy category C drug [30].
\nAnother analog of human insulin is insulin aspart produced from
Insulin aspart was introduced on the market with nicotinamide and L-arginine hydrochloride as excipients to enhance its absorption. Although the active molecule is identical, there are no available data for its use in pregnancy and its excretion in human milk [30].
\nInsulin lispro (U-100 and U-200) is an analog produced in
Insulin glulisine is a recombinant insulin. It is obtained using
Insulin isophane (NPH) is an intermediate-acting insulin. It is also produced in
Insulin detemir (U-100) is a long-acting analog produced in
Insulin glargine (U-100) is a long-acting analog produced in
Insulin glargine (U-300) is a long-acting insulin. It is not bioequivalent to glargine U-100, but it had the same structure and was approved in February 2015. Glargine U-300 is produced in
Insulin degludec U-100 and U-200 are considered bioequivalent. The insulin degludec’s mode of slow absorption and prolonged action is based on the formation of soluble multi-hexamers. Insulin degludec onset of action is nearly 1 hour and has no peak. It is dosed once daily. It can be dosed at any time of the day because of its long duration of action. There is no clinical experience in pregnant women [30].
\nThere are many insulin regimens proposed for treating hyperglycemia, but the multiple daily injections (MDI) is by far the most efficient and the most flexible [33].
\nThe insulin regimen should be chosen based on the blood glucose profile. Therefore, if fasting glycaemia is higher than 90–95 mg/dl, basal insulin should be initiated. It can be a long-acting insulin analog or neutral protamine Hagedorn. The basal insulin dose can be calculated according to the weight: 0.2 units/kg/day.
\nIf the hyperglycemia follows a meal, than rapid-acting insulin or regular insulin should be initiated before that m74eal (begin with 1 u of insulin for 10–15 g of carbohydrates).
\nSometimes both fasting and postprandial glycaemia are elevated, thereby needing MDI: 3 mealtime insulin and basal insulin. The total daily insulin requirement during the first trimester, is 0.7 units/kg/day, while in the second trimester it is 0.8 units/kg/day, and in the third trimester, it is 0.9–1.0 units/kg/day. This does not necessarily fit all pregnancies. Usually, in pregestational diabetes, the total insulin dose is up to twice higher than in GDM.
\nIn the case of morbid obesity, the initial doses of insulin can be increased to 1.5–2.0 units/kg to overcome the combined IR of pregnancy and obesity [9].
\nUsually, the calculated total daily dose of insulin should be divided in two as for type 1 and type 2 diabetes: 50% as basal insulin at bedtime, and 50% divided between 3 meals and given as rapid-acting, or regular insulin before meals.
\nThe doses of insulin have to be continuously optimized, so the self-monitoring blood glucose is essential.
\nRapid-acting insulin analogs are preferred over regular insulin in pregnancy because there is a lower risk of hypoglycemia, and because they provide a better postprandial blood glucose control [29, 33].
\nInsulin initiation is synthesized in Table 1.
\nBlood glucose control in important in gestational diabetes because it confers the future mother a sense of disease control and validation that diet and treatment are doing their effect as the glycemic control improves, the risk of maternal and fetal complications decreases, a principle that was demonstrated by HAPO study results [34]. The results of this landmark study and other seven randomized trials have been included in a Cochrane analysis that compared the treatment of gestational diabetes mellitus (GDM) with standard care. It demonstrated a lower risk of a composite endpoint (death, shoulder dystocia, humerus, clavicle fracture or nerve palsy), and also a lower risk of pre-eclampsia and macrosomia (birth weight over 4000 g or 90th percentile), with no differences between oral and injectable treatment [35].
\nThereby, gestational auto monitoring and surveillance by an obstetrician in collaboration with the diabetologist, nutritionist and midwife is essential for achieving glycemic targets during pregnancy, labor and after birth. These targets are synthesized in Tables 2 and 3.
\n5th International Workshop Conference Gestational Diabetes and International Association of Diabetes and Pregnancy Study Group, 2007 | \nCapillary pre-prandial glucose <95 mg/dl (5.3 mmol/l) Capillary 1 hour post-prandial glucose <140 mg/dl (7.8 mmol/l) Capillary 2 hour post-prandial glucose <120 mg/dl (6.7 mmol/l) | \n
FIGO, 2015 | \nCapillary pre-prandial glucose <95 mg/dl (5.3 mmol/l) Capillary 1 hour post-prandial glucose <140 mg/dl (7.8 mmol/l) Capillary 2 hour post-prandial glucose <120 mg/dl (6.7 mmol/l) | \n
CDA, 2018 | \nCapillary pre-prandial glucose <95 mg/dl (5.3 mmol/l) Capillary 1 hour post-prandial glucose <140 mg/dl (7.8 mmol/l) Capillary 2 hour post-prandial glucose <120 mg/dl (6.7 mmol/l) | \n
ADA, 2018 | \nCapillary pre-prandial glucose <95 mg/dl (5.3 mmol/l) Capillary 1 hour post-prandial glucose <140 mg/dl (7.8 mmol/l) Capillary 2 hour post-prandial glucose <120 mg/dl (6.7 mmol/l) | \n
Glycemic targets during pregnancy.
FIGO, 2015 | \nCapillary glucose 72–126 mg/dl (4–7 mmol/l) | \n
ACOG, 2018 | \nCapillary glucose 70–110 mg/dl (3.9–3.1 mmol/l) | \n
Glycemic targets during labor.
Although glycated hemoglobin values must be interpreted with caution in patients with dilution anemia, iron deficiency anemia or other hematological pathologies like minor thalassemia [36, 37], it proves to be useful in checking the self-reported date by the pregnant, especially if she is treated with insulin.
\nOther parameters that could be used for short-term (2–3 weeks) evaluation of blood glucose control is glycated albumin. It is not influenced by iron deficiency, but the values are low in nephrotic syndrome or thyroid disorders that sometimes are present in pregnancy. This marker was studied in GDM, but the cutoff limits are not precisely known with consideration of some population differences [38]. Molecules like fructosamine or 1,5-anhydroglucitol have not proven their utility [39, 40, 41].
\nThe efficiency of capillary blood testing (8 determinations per day) in pregnant diabetes patients has been demonstrated since the 1980s [42]. Current guidelines [7, 8, 12, 18] mention in general terms the frequency and optimal period (fasting, 1 or 2 hours postprandial) when a test should be done without customizing for treatment, previous glycemic control.
\nIn healthy adult pregnant women, 1-hour glycemia during a glucose challenge test was a better marker for insulin sensibility, being correlated with a fetal abdominal circumference in echography [43]. In Jovanovic and collab study [42], glycemia at 1 hour after food intake in the third trimester was the best predictor for birth weight. Combs et al. used the same 1-hour glycemia to establish the best threshold (130 mg/dl) for which the risk for macrosomia and small for gestational age (SGA) is reduced [44]. Metzger was the one that proposed that 2-hours postprandial glycemia should be used in GDM with the limit of 120 mg/dl [34]. Two clinical studies compared the blood glucose determination concluding that 1-hour glycemia is superior, but with two important biases—lack of randomization and low statistical power [45, 46].
\nA randomized clinical trial demonstrated that patients who adjusted insulin doses based on 1-hour postprandial glycemia had a lower risk of giving birth to a macrosomia, or to have a cesarean procedure; also, the risk for neonatal hypoglycemia was smaller [47]. Not only the glycemic values
The frequency of determination is as much as necessary. Based on a randomized control trial (RCT) the initial recommendation for SMBG is 4 tests per day, with the possibility to lessen the number of determinations according to if the patient has good control and the fetal morphology is normal [49]. In basal-bolus insulin-treated GDM 7 tests per day are recommended, but patient adherence is weak (a mean of 4.2 in an observational study) [50].
\nThe limit for SMBG consists in the accuracy bias: lowering hematocrit by dilution makes the capillary glucose to be overestimated. Some glucometers have included in their software functions to correct the hematocrit values, but the majority uses colorimetric and amperometric methods that depend on it. Considering the tight glycemic control required during pregnancy and the fact that insulin doses are adjusted based on SMBG, some researchers recommend that the bias and imprecision should be set at below 2% and the meters be verified according to international quality criteria [51].
\nSystems for interstitial glucose monitoring have been used together with insulin pumps in type 1 diabetes pregnancies in RCTs and observational studies [52, 53]. In GDM pregnancies data come from small observational studies where they showed benefit for disclosing high and low glycemic excursions missed by SMBG [54].
\nGlycemic sensors can be used as a guide for therapy initiation, as demonstrated by Kestilä et al. [55]. The anti-diabetes medication was introduced in a higher proportion of GDM women with CGMS versus SMBG. Nevertheless, there were not any significant differences for the perinatal endpoints. The long-term impact of glycemic control during pregnancy is not known; therefore, the benefit of this intervention must be balanced with unnecessary treatment. The techniques for monitoring blood glucose are summarized in Table 4.
\nRegimen | \nSBGM | \nCGMS | \n
---|---|---|
GDM with diet or oral antidiabetics | \nFasting 1 hour postprandial | \nFine-tune insulin dosing Nocturnal hypoglycemia Nocturnal hyperglycemia Postprandial hyperglycemia | \n
GDM with basal insulin | \nFasting | \n|
\n | 1 hour postprandial | \n|
\n | Bedtime | \n|
GDM with premixed insulin | \nFasting | \n|
\n | 1 hour postprandial | \n|
\n | Dinner preprandial | \n|
\n | 1 hour postprandial | \n|
GDM with basal bolus | \nFasting | \n|
\n | Preprandial (lunch, dinner) | \n|
\n | 1 hour postprandial | \n
Insulin glucose monitoring techniques [adapted from American Association of Clinical Endocrinologist and American College of Endocrinology].
All these efforts in using the best method for monitoring insulin therapy in GDM are to maintain glycemic control for preventing fetal and maternal complications.
\nGlucose is a nutrient that freely crosses the placenta from maternal to fetal circulation, to assure the energy required for growth. Immediately after birth, the glucose source disappears with a physiologic “hypoglycemia” in the blood of the newborn that triggers the secretion of counterregulatory hormones (glucagon, steroids, catecholamines, growth hormone). In GDM pregnancies, the glycemia is continuously raised and determines a consecutive higher secretion of insulin that makes hypoglycemia more severe and prolonged than in normal newborns [56, 57, 58, 59].
\nNeonatal transient hypoglycemia could have implications in the neurocognitive development as was shown by magnetic resonance imaging [60]. Also, it has psychological implications on the mother-child relationship because they are separated after birth for treatment. Hence, based on their study results, Voormolen et al. recommend screening all newborns from GDM women in the first 12 hours after birth because the majority of the events occur in this interval, with a higher incidence being in the insulin-treated group [58].
\nA series of studies demonstrated that newborns of GDM patients that were treated with metformin had fewer hypoglycemic events than those of women treated with insulin [21, 61]. Insulin analogs have a lower rise in postprandial glycemic values without elevating hypoglycemic risk and should be preferred to human insulins [29, 33].
\nRegarding sulfonylureas, a meta-analysis demonstrated that glyburide treatment GDM had a higher risk of neonatal hypoglycemia and also macrosomia that the metformin-treated GDM [62].
\nThe relationship between insulin therapy and congenital anomalies was studied, especially in type 1 diabetes. The most important confounding factor is glycemic control. Although some case reports indicate an association between the use of insulin lispro and the risk of teratogenesis [63], another meta-analysis supports the fact that it is safe for use [64]. This risk could be explained by mitogenesis stimulation by binding with a higher affinity for IGF-1 receptors. Lispro insulin has a 1.5 and insulin glargine a 6.5 fold increase of receptor binding [65]. There are only retrospective studies that indicate glargine as safe insulin in pregnancy [66].
\nA Cochrane analysis of 1481 women with GDM showed that in the treatment group there was a higher number of induced labors versus the group with standard antenatal care, but with no difference regarding the number of births by CS [35]. Another meta-analysis did not demonstrate a correlation between the use of different types of insulin-like aspart, lispro and the birth by CS [67, 68]. Although the risk is not influenced by insulin treatment, it can be reduced by induction of labor (IOL) in 38th–39th week of gestation with better outcomes for the fetus [69].
\nAlthough pre-gestational diabetes raises the risk for vacuum assisted birth (shoulder dystocia, humerus, clavicle, skull fracture, Erb’s palsy, subarachnoidian or subdural hemorrhages, asphyxia, convulsion), in GDM the risk was similar to that in the general population and could not be related to insulin therapy [68, 70]. A particular situation is with GDM that appeared in pregnancies obtained by assisted reproductive technology where the risk for perinatal and obstetrical complications is probably increased by the adverse effect of hyperglycemia, not by insulin treatment [71].
\nEvidence that indicates a higher risk for fetal morbidity and mortality in GDM a scarce and less pronounced as in pre-gestational diabetes. Current decisions of IOL as compared to expectant management should be individualized because the studies lack in this area. An RCT that showed that there is no difference between the two strategies regarding morbidity, but the IOL reduces the risk for shoulder dystocia in the macrosomic fetus [72]. The use of insulin analogs like detemir does not influence the morbidity [73].
\nHypoglycemia threshold is specific for every individual. In pregnancy, there is a reduction of this threshold by 20% [74]. Patients with GDM that are treated with insulin must maintain a glycemia above 3.7 mmol/l (66 mg/dl) according to CDA, or above 3.9 mmol/l (70 mg/dl) according to ADA [7].
\nInsulin analogs are superior to human insulin because the hypoglycemic events are less frequent in type 1 diabetic pregnancies [75]. The use of multiple daily injections is as effective as continuous subcutaneous insulin infusion [76].
\nMaternal hypoglycemia affects the fetus just in severe cases when is associated with loss of consciousness or secondary to trauma. Also, it was observed that repeated episodes could lead to growth over the 90th percentile [77]. These episodes are more likely to be present in the first trimester in women who had pregestational diabetes than in GDM [74].
\nThere is moderate quality evidence that indicates higher hypertension associated hypertension without giving details in insulin-treated GDM. This fact should be further researched because it is in contradiction with a non-modified risk for pre-eclampsia [68].
\nDuring the latent phase of labor hepatic gluconeogenesis is sufficient for providing the caloric requirements, but becomes exiguous during the active phase when intravenous glucose is perfused.
\nThe study of Rosenberg and collab. demonstrated there is no significant difference in neonatal hypoglycemia, neonatal injury, Apgar score at 1–5 minutes in patients with insulin therapy that were managed with two approaches: dextrose 5% 125 ml/h with a simultaneous insulin drip (adjustable rate 0.5–2.5 u/h) or dextrose 5% alternating with ringer lactate (125 ml/h) and insulin introduction when the targets are exceeded [77]. Other researchers recommend dextrose 10% with an insulin drip [78].
\nLowering maternal glycemia is necessary for preventing neonatal hypoglycemia, balancing this risk with that for ketosis. Capillary blood glucose should be tested every hour and urinary ketone bodies every time is possible [77]. ACOG agreed to the protocol proposed by Coustan [79] for maintaining a mean intrapartum glycemic value of 100 mg/dl. For this, blood glucose should be tested every 2 hours with adjustments in insulin perfusion rates.
\nWomen with GDM or type 2 diabetes, which were treated with oral therapy have a low insulin requirement and in most cases do not need treatment during labor. Thus, CDA recommends a “watchful waiting” and insulin initiation just in cases where glycemia is above 146 mg/dl (7.0 mmol/l) [19]. Ryan mentions the same principle in a review published before—if GDM pregnant had a necessary below 0.5 u/kg/day, they could be initially monitored. Otherwise, patients with type 1 diabetes or type 2, GDM with a necessary above this limit will need insulin perfusions [78]. Insulin perfusion rates could be adjusted using sliding scales as proposed by Dude [80].
\nAlthough most of the studies use protocols for intravenous insulin administration, patients with insulin pumps can choose to keep their device during labor [81, 82]. This is recommended in centers with experience because during labor they can become unable to handle the pump given the pain, or some incidents like catheter avulsion could appear. In these cases, the patient is informed that a switch to an insulin drip is needed [19].
\nAnother problem comes out when betamethasone is administered for premature birth. In patients with type 1 diabetes, an increase up to 40% of all doses during the next 5 days assures an adequate glycemic control [83]. A retrospective analysis of insulin drips in pregnant with GDM injected by a standard anticipatory protocol and with higher doses was associated with improving glycemic variability and decreasing by 25% the absolute risk for neonatal hypoglycemia [84].
\nInsulin requirements drop quickly after giving birth and women are exposed to hypoglycemia. Patients with GDM usually do not need insulin, and women with type 1 and type 2 diabetes return to the previous regimen, but at doses that are at 60% of the antepartum necessary [85]. In the case where the doses are not remembered, half of the third-trimester dose could be injected. Another alternative is calculating dose per kilogram. With an insulin pump, the doctor will titrate downward the basal rate and boluses on a similar algorithm or adjust based on the information from glucose sensors for newer models.
\nBreastfeeding influences insulin sensibility: as the frequency of lactation increases, the HOMA and ISI (0, 120) have better values [86], so during breastfeeding the insulin requirement falls by 10% [87].
\nThere is a lot of missing evidence in optimal treatment for GDM. Insulin treatment could be improved by developing automatic algorithms for calculating the appropriate doses like that proposed by Dinglas [88]. Moreover, fetal morbidity can be influenced by better monitoring like using glucose sensors that are more accurate in the hypoglycemic range [89, 90, 91].
\nMicro-RNAs are now extensively studied in different domains and might apply to diagnosing and selecting GDM patients that require insulin treatment [92].
\nNot eventually, the whole perspective of insulin therapy will change if the oral bioavailability of this peptide hormone will be enhanced. Polymeric nanocarriers and mucoadhesive discs were studied in diabetic rats and are the future expectation for mothers with diabetes [93].
\nAll authors had an equal contribution and shared the first authorship.
\nNone.
This chapter was financed by Novo Nordisk.
\nOver the years in Africa, changes in climate worsened by disasters and fragility are becoming increasingly common, particularly in some vulnerable Nigerian weather-impacted communities threatening disprivileged populations. With accompanying periods of extreme wet seasons and their effects on heightening flood events, there have been
Community-based approach (CBA) utilizes a solution-oriented lens to confront challenging complex issues associated with human displacement, internal dislocation, and relocation, as well as addressing the present climate-fueled flood reoccurrence events in affected communities. With its beneficial approach, CBA has been shown to increase and respond to comprehensive climate change threat(s) and its impacts on disprivileged populations [5]. Notably, CBA exhibits a partnering relational procedure between groups, such as community and institutional stakeholders, and not activities that were decided on, and imposed on the locals [6]. This procedure can build, strengthen, and bridge on existing adaptive capacities, relational values, and skills, while holding on prevailing local knowledge and technologies to encourage the communities on their community-led goals [7, 8].
For our study area: Anambra State is made of 21 Local Government Areas (LGA), and Ogbaru LGA is one of them, with Akili Ogidi as one of its main towns in this LGA. Ogbaru LGA is in the Southwest of Anambra State in Nigeria (see Figures 1 and 2). And with a population of about 221,879 [9], Ogbaru LGA occupies an area of 388 km2 and density of about 762.3/km2 [10] (see Figure 2). To the North, Akili Ogidi is bounded by Onitsha South Local Government Area, on the South by Rivers state and Imo state, while on the Western side, it is bounded by Delta state and on the East by Idemili South, Ekwusigo and Ihiala Local Government Areas. (https://en.wikipedia.org/wiki/Ogbaru?msclkid=737721afcf3911ec90c5d2cabc0b2eb2).
Map of Nigeria showing Anambra State.
Source: Department of Environment Management, COOU (2021).
Maps showing Southeast States, Anambra State and Ogbaru Local Government Area and Akili Ogidi—study area surrounded by River Niger.
Source: Department of Environment Management, COOU (2021).
Lying on the latitudes 5°42′N to 6°10′N and longitudes 6°41′E to 6°50′E, respectively, Akili Ogidi is noted for its agricultural activities [11]. The flood/alluvial plains of the Niger River are shown to form the major parts of our study site (see Figures 2 and 3). The vegetation is characterized by modified green areas and grasslands in remote areas [12]. With an elevation of 25 m above sea level, the area is dominated by shallow aquifers, while the climate is tropically characterized by high precipitation averaging between about 1800 and 2300 mm [13]. For the relative humidity in our study area, which is within an average of about 60–70% in July, the average daily annual temperature of this area is in the range of 24–28°C with a night temperature of 16–18°C [14]. Averagely from March to October, there are wet climatic conditions with dry seasonal conditions from November to February [15]. The longer wet seasons are prevalent with intense storms that cause floods displacing the residents during the entire wet season.
Satellite image showing Akili Ogidi.
Source: Google Map (2021).
For coastal cities in Nigeria, they are continually being displaced, dislocated, and relocated temporarily due to continual events of floods resulting in large population of temporary migrants, further threatening the life of the communities and individuals. In 2018, over 1.9 million persons were internally displaced by the floods across 12 States in Nigeria and over 500,000 were homeless. Unfortunately, marginalized groups, such as rural women and children majorly, have been hard hit leading to their reduction in income levels, pressure on food security, health, poor nutrition worsening health status of children, besides other impacts on the environment.
Though rural communities of these regions located around the river banks are usually the worse hit by these flood events, most Nigerian coastal cities and communities in Nigeria particularly Southeast region have experienced continual sea-level rise, from increasing rainfall. In Nigeria, all the communities within the bank of River Niger and Benue, in Anambra, Kogi, Edo, Delta, Nassarawa, Taraba, and Adamawa states, continue to be flooded almost like an annual event. These states are located along the two main Nigerian rivers: the Niger and Benue rivers. These flooding events further implicate the rising water levels of these two rivers as the primary causes behind the flooding experienced in Nigeria. Further, the ecosystem-dependent livelihoods, such as rainfed agriculture, are breaking down due to the changing temperatures and associated erratic high-volume patterns of rains impacting agricultural procedures [16, 17]. Of note, these floods threaten agricultural production levels and food security [18] aggravated by increased inter-annual variability of precipitation, which may heighten temporary displacement out of the lower rural land production areas to the urban regions.
The 2063 agenda for the African Union’s (AU) agenda is a call to strengthen humanitarian activities and to transform the continent within 10 years. IPCC Fourth Assessment Report [19] in its summary of climate change projections and impacts for Africa reported that Africa is a vulnerable continent. Africa’s vulnerability to climate change may be hinged on the wicked problems, such as extreme poverty, unregulated emissions from fossil fuel combustion, poor physical planning, governance failures, corruption, violence extremism, inequalities, food insecurity, unemployment [20], and uncontrolled population rise with an imbalanced demographics that characterize the continent. These multiple intractable problems are worsened by lifestyles, such as indiscriminate waste disposal, uncensored felling of trees, and deforestation that aggravate anthropogenic emissions leading to extensive influence on population and natural ecosystems.
Globally, World Health Organization (WHO) has estimated that in the next 30 years (by the year 2030 and 2050), climate variability may result to increasing environmental disaster-related annual deaths (about 250,000 additional deaths). In these contexts, declaring 2019 as the “Year of Refugees, Returnees and IDPs” by AU is aimed to promote lasting solutions, particularly to forced displacement witnessed in Africa. Of note, the launching of the African Climate Mobility Initiative (ACMI) will continue to assist the works of the African Union member states in addressing the complex issues of climate-related forced internal and external migration and leverage on possibilities that come with the African climate-induced migration. Notably, climate changes will escalate diverse impacts, such as rising sea level and extreme weather in the West African region, particularly Nigeria [21] in addition to the worsening socioeconomic milieu. However, in recent times, modern sophisticated modeling technologies coupled with improved research studies have provided atmospheric scientists the ability to determine and comprehend the causes of the majority of weather events, particularly the events influenced and heightened by climate change.
In light of the aforesaid discourse, the goal of our chapter is to investigate the causes and consequences of climate-driven floods and temporary displacement prevalent among community members, particularly women and children in Ogbaru LGA, Anambra State. This study provides information needs shared by affected community to reduce the risks of climate variability by involving them in planning of adaptational practices, activities, and planning.
A qualitative case study approach was employed in this study to provide a holistic and in-depth explanation of the community-based flood problem and its implications for temporary displacement on the people of the Ogbaru community, particularly women and children. Our primary data were key informant interviews, observations, semi-structured interviews, photographs, focus group discussions, and informal interactive dialogs with indigenes that were recorded. We also used secondary sources of information. For our reviews, we also included an analysis of our operational environment, livelihood sources, challenging vulnerabilities and hazards, and the dynamics of the socioeconomic milieu. Also, we used the purposive sampling technique (convenient and snowball methods) to select our informants to ensure that their core views and voices of women and the participating male informants of problems under study were appropriately represented. Forty community members were randomly interviewed using unstructured questions.
Our interview and discussion groups were carried out using the Igbo and English languages. Effective interpretation back to the English language was done by our research assistants. We included different variables from our target relative to educational background, marital status, occupation, and socioeconomic data of the perceptions of the interviewees on the effects of river flooding. We also employed the focus group discussion (FGD) to interact with 60 women using unstructured questions. There were separated into six women groups (10 in each group) namely single, married, and aged/with disabilities. Forty persons were randomly interviewed using semi-structured interviews, while eight (8) persons (5 women and 3 men) were recruited to be involved in our key in-depth interviews (see Figures 4–7).
The community chairman Mr. Uche Ijomah (red arrow) who came to receive the researchers at bank of River Niger to the study area (blue arrow).
Different FGD sessions of Akili Ogidi women.
A photo session of the researchers with the community women after the focus group discussion.
A photo session of some of the women researchers with the community chairman (red), community chief (blue), elders, and women leader (red).
Each session of the three women groups lasted for about an hour. The FGD provided the researchers with the primary information about the community women’s daily activities and how their roles intersected with their coping mechanisms and pressure from flooding. We, manually, analyzed our qualitative data, and for our photographs and the field observations, the images gave a vivid description of flood activity. The GPS obtained ground control points. We used other sources of data to confirm the results reflecting unique findings from our study area.
In Nigeria, temporary-displaced migrants from communities are majorly affected by climate-related flooding, and they move out of their indigenous lands to places of refuge making them high-risk and a vulnerable group [22]. For a qualitative study, our sample size (n = 100) was a large one, ensuring that a greater number of community members were included. Moreover, most of the participants were eager to be part of the study. Demographic variables, such as sex, age, income, and occupation, were asked, with a summary of some social data (economic, environment, gender roles, and health data).
Table 1 shows the summary of core characteristics of our participants. The highest age group was in the 30 to 40 years category, while those in the 50 to 60 years had the lowest proportion of 18%. Most of our respondents were between the ages of 18–60 years, with lived experience of flood activities. A total of 72% of the participants were females and 18% were males. For their educational levels, all the participants had completed their basic primary education, but there were no participants with complete or some level of completion of graduate-level education. More than 30% of our participants were married. A large number of the interviewed men had married several wives with large households ranging from 1 to 12 persons. For the household size, 38% of the participants had more than 10 persons within their household, while 20% had between one and four persons. Majority of the community have lived in the affected community for over 10 years or more. For their income level, more than 90% had very low income $1USD/day. From our discussions and interviews, a large number of community members were internal migrants, and women were in the majority (67%), and they migrated with their children particularly the young ones. Although we were targeting women, men wanted to be part of the study and we had to randomly select the men who consented to be part of the key in-depth interviews.
Variables | Frequency |
---|---|
Age | |
18–30 years | 22 |
30–40 years | 36 |
40–50 years | 24 |
50–60 years | 18 |
Gender | |
Male | 27 |
Female | 73 |
Education level | |
FSLC | 53 |
WAEC/WASC | 27 |
NCE/OND | 00 |
BSC/HND | 00 |
NONE | 20 |
Marital status | |
Single | 28 |
Married | 35 |
Widowed | 17 |
Divorced | 08 |
Separated | 12 |
Household size | |
1–4 | 20 |
5–9 | 42 |
10–14 | 38 |
Years of living in the community | |
1–2 | 00 |
2–5 | 08 |
5–10 | 20 |
10 years and above | 72 |
Income level (monthly) | |
₦1000–10,000 | 32 |
₦11,000–₦20,000 | 28 |
₦21,000–₦30,000 | 15 |
₦31,000–₦40,000 | 10 |
₦41,000–50,000 | 07 |
₦50,000 and above | 08 |
Internal migration of respondents | |
Gender | |
Male | 33 |
Female | 67 |
Total respondent | 100 |
The socio-economic characteristics of participants in Akili Ogidi.
Source: Researchers’ Analysis (2020).
The results from qualitative case study approach provided comprehensive discussions on reoccurring flood activity, social consequences of flooding, as well as the effect of climate-related internal migration on women and children from the study area.
Unarguably, flooding events are aggravated by changing climate and it requires emergency rescue and rehabilitation of affected population and communities, because of the high level of accompanying morbidity. For example, the Nigeria Displacement Report of 2013 reported that about 4,189,650 people suffered from food insecurity, 3,883,215 people were targeted for malnutrition challenges, and 194, 859 were harbored in IDPS from floods. Clearly, climate change is fast becoming in Nigeria a major driver of human displacement. According to International Red Cross [23], more people will be displaced from weather-related and climatic events than war (http://www.icrc.org/en/document/internally-displaced-people). Climate-driven displacement, environmental migrants, or climate migrants come with adverse effects from climate persecution and violence to temporary displacements sequel to flooding, which has been prevalent for over 10 years in Anambra state. Climate-driven temporary displacement is a previous situation in Anambra-riverine communities annually as people flee from flood disasters to become displaced and can be stranded inside their own communities. Here, the floods have been extreme, particularly the flood events of 2012, 2013, 2018, 2019, and 2020 [24, 25, 26, 27, 28, 29].
Key informant interviews reveal important insights on the major causes that contribute to the (re)occurring floods in the study area, and our findings are consistent with the past flooding events. Firstly, the community occupies a vast wet area that lies in the SouthWest part of Anambra state, at the bank of River Niger, which is a fragile and flood prone area with heavy rainfalls during the wet season. The flooding leads to a rise in water levels of River Niger, adjoining creeks, and ponds overflowing into the community. The leader for the women group described the anxiety and despair they face as the wet season ensues:
One of the male interviewees who emphasized that, apart from the floods of 2012, it was majorly influenced by the mismanagement of dams and water reservoirs in Nigeria and our neighboring countries. Undoubtedly, subsequent floods have been sourced from the overflow of the banks of River Niger. According to the elder (male):
Ajaero and Mozie [30] reported that Ogbaru LGA is continually impacted by the floods due to the low and flat nature of the area. Ogbaru LGA slopes at angle of 1°–3°. The relative low disposition of Ogbaru land makes the area to be continually flooded for longer than 6 months, and our study site is situated where the River Niger has its highest discharge rates. The overflowing river bank affects the superimposed plain land, which is one of the main geographic characteristics of Ogbaru, particularly Akili Ogidi. The people of Akili Ogidi live in the “hotspot” flood region facing limited resources and support to adapt to an increasingly hostile environment. Notably, in 2012 and 2018, NEMA [31] declared Anambra state a flood disaster region twice [32].
Additionally, the community Chief informed us that there have been elongated noticeable changes in the weather pattern indicating rising rainfall intensity, frequency, and increased destruction occurring in the past 10 years in the community:
Clearly, the location of the state and its changing climate have added to the reoccurring and increased flood status of the state. Mgbenu and Egbueri [13] confirmed in their study that Ogbaru LGA is dominated by shallow aquifers of about 25 m above sea level with a tropical climate that is characterized by high precipitation averaging between about 1800 and 2300 mm. Notably, Akanwa and Ezeomedo [17] affirmed that additionally unpredictable weather conditions have aggravated the high precipitation levels in the area resulting in increased flooding and erosional problems traceable to variable timing and intensity of rainfall from the changing climate in Anambra State. Further, Nzoiwu et al. [33] also reported about noticeable changes in climate causing a gradual shift in the rainy seasons such that the rainfall season has extended beyond June to September to the months of October and November. For the dry seasons, the months have extended from December to March. Unfortunately, these changes were proven by the report provided by NEMA [31] that Anambra state is affected by a vast range of hydro-meteorological and climatological hazardous changes, such as storms and temperatures as the State is situated by the river Niger making it flood prone.
Results indicated that about 70% of the Akili Ogidi residents’ economy, social life, and health were affected by the 2020 floods. Residential houses were totally abandoned and streets deserted as the floods made movement impossible except with the use of local canoe (see Figures 8 and 9). During the discussion session, we found that the majority of the displaced community members have nowhere to go, and within the onset of dry seasons that begin in late November and December periods when the flood has receded, they usually return back to their homes and lands but to a devastated community. In 2012, all 16 communities in Ogbaru LGA were submerged by the flood destroying more than 100 buildings and displacing hundreds of people [24]. Similarly, in 2013, Ogbaru LGA was flooded between the months of June and August causing a displacement of about 124, 859 people [25]. In 2018, about 9000 people from 1500 household were internally displaced from their homes in Ogabru LGA, and in 2020, about 5000 persons are displaced (homeless) in September during heavy storms and flooding in Ogabru LGA [33]. People could only access their homes using canoe, though movement to closer bigger cities, such as Onitsha town, can also be accessed
Flooded streets and abandoned houses where residents have migrated.
More flooded houses and streets that have become unhabitable and temporarily abandoned.
The community members fled their homes to find sanctuary with relatives and friends living on higher grounds. Some of them had to stay in public facilities such as schools and churches, designated as IDP camps though majority were stranded in their houses having nowhere to go, because of COVID-19 restrictions. The youth (female) leader reported that…
A woman elder said this:
Additionally, the secretary of the women group reported that for other flood episodes she relocated with her three children to nearby town—Onitsha to stay with relatives until the floods were over. However, the case was different because of the heightened awareness of spread of COVID-19 virus. She said:
For our observations during field surveys, the flooding impacts were aggravated by the poor-quality houses constructed with low materials that have become weak over time (see Figures 10 and 11). Also, inadequate infrastructure and the absence of physical planning aided the rapid destruction of buildings during floods (see Figure 10). Further, the situation in the study area was worsened by the absence of drainage systems to check the flood problem.
A collapsed fence and an abandoned house with the roof destroyed by the heavy storms.
Poorly developed houses, inadequate facilities, and poor living conditions of the residents.
Although the government of Anambra State provided communal shelters that were recognized as IDP camps to accommodate most of the stranded people, most of them refused to relocate to these (IDPs) camps. One of the interviewees admitted that the IDP camps were over populated having inadequate mattresses, insufficient mosquito nets and food items for their upkeep, and the affected residents to remain in their flooded houses. The temporary shelters were characterized with discomfort and pain worsening their vulnerability. This was confirmed by one of community women…
According to Punch [29], it confirmed that those who were accommodated in IDP camps experienced shortages of essential items, such as food, limited medical personnel, insecticide-treated bed nets needed for their daily survival, despite the increased numbers of women, pregnant mothers, and injured children.
Findings from discussion groups and interviewees reported that the floods submerged infrastructures, such as shops, roads and footpaths, market, schools, churches, healthcare center, electricity poles were destroyed by the flood, although the use of low-building materials has not helped the impact of the consistent flooding in the community. Following the flooding, the schools were shut down once again after the initial three (3) months COVID-19 pandemic lockdown. This was a source of worry to community members, who were not only grieved by the disruption of their academic pursuit, but by the deaths of their infants during the floods. Notably, the low standards of the learning environment and the schools built with poor-quality structures can easily give way to intense storms and floods (see Figure 12).
Poorly developed school structures and learning environment in the study area.
The pupils and teachers have been studying under a collapsing wooden building because there are no classrooms to learn as past floods have submerged the buildings. The learning environment is not conducive and may affect the teaching and learning process, in addition to the long periods of flood intervention where the schools are closed annually. Due to the absence of electricity (floods submerged poles), there are no technological structures to facilitate Internet learning.
Obviously, the early childhood educational development in the area has been consistently affected. Early childhood education is a critical time of learning and foundation to leverage other levels of education. One of the elders during the course of interview on the schools added that…
Also, the community Chief added
The closure of all socioeconomic, religious and educational activities in the community was for over 6 months for the floods to recede. Also, the flood affected infrastructure, the quality of water polluting the rivers in Ogbaru LGA, and affecting economic activities [34]. Again, the flood caused the influx of snakes and other dangerous reptiles into homes-seeking refuge from the flood placing the life of people at greater risk of attack [35].
The menace from the flooding continues to tear families and individuals apart as they seek for temporary spots or relief camps to stay alive from the flood. One of the representatives of the women group reported thus:
Generally, the close knitted and family culture of Akili Ogidi people is heavily threatened by the annual flooding [36]. Indigenous communities in Anambra State are characterized by shared learning, beliefs, and shared bonds of fellowship that set their standards or patterns of behavior [37]. A common culture such as language, livelihoods, and administration with close bond to biodiverse natural resources is threatened yearly. It is unfortunate that these underlying commitments within families, social groups and customs are threatened annually. Worse still, most families experience the fragmentation of their social family unit and ties. Similar published studies affirmed that climate-induced floods affect fragile communities forcing internal dislocation of the marginalized populations [38, 39, 40, 41, 42, 43, 44].
According to the report of the women leader during an interview session, she indicated that the severity of the floods keeps increasing and has become an annual event that the community has to deal with. She further informed us thus:
Clearly, flood in the study area was responsible for unexpected deaths, inflicting injuries on family members and also the separation of families creating societal vulnerabilities for vulnerable persons. Evidently, the displacement from the normal patterns of life creates unrest, tension, and violence (www.absradiotv.com). The flooding events have been shown to create strains on family knitting and commitment heightening intimate partner- and gender-related violence when marginalized groups, such as women, children, and the disabled, are left in relief camps exacerbating their vulnerability levels. According to a Pacific study involving six Pacifician island nations, they reported that for all the women surveyed, more than 75% of participants experienced some types of violence, either the physical or the sexual form from their close partners and significant others around them (UN Women, n.d).
The findings further showed that these women experienced major forms of violence, such as assault and violence, implicating intimate partners and family members as perpetrators. Also, according to Wan [45] separating children from their parents come with complex devastating issues. This may be as a result of effect on critical bonds in human life. Floods can traumatize its victims for a long time, and often times, survivors are left with diminishing social determinants of health. Worse still, on such occasions of flood crisis, minors are given new roles as principal care givers, earners, and heads of households that can destabilize their mental and emotional health [46].
One of the affected community women reported:
It is forecasted that there may be greater flood impacts on in Ogabru LGA, threatening community ideology, values, and belief systems as climate changes has remained unpredictable (www.channelstv.com//ag). Indeed, climatic extremes and uncertainties have become the norm where the community have to face prolonged flood crisis.
As reported by Ugwu and Ugwu [47] one of the sectors impacted by flood is the agriculture, particularly in the global South nations. The Nigerian Hydrological Service Agency (NIHSA) and Nigerian Meteorological Agency [48] predicted the year 2020 will be characterized by a wetter season with thunderstorms and heavy rainfall, worsening the rising of water levels of rivers, intensifying longer lasting and more intense flash floods in Nigerian coastal cities than the previous year. Undoubtedly, agriculture in Nigeria is a huge industry that contributes to a substantial amount of about 26.09% of the national GDP, besides employing about 36% of the total Nigerian labor force and the largest direct employer of labor [49]. The Akili Ogidi community operates an agrarian economy that is dependent on rain-fed agriculture and the (in)direct impact on sustaining livelihoods. Notably, agriculture has played prominent roles in supplying food products, giving employment to community members. Akili Ogidi supplies food items and serves as food baskets to other urban markets and locations. Egbueri [14] mentioned that the community is majorly involved in fishing and farming activities due to the presence of River Niger. Clearly, the location of the study area by the River Niger, its high dependency levels on rain-fed agriculture and its high rurality index, climate change, and poor accessibility during floods are factors that place the community at high risk of flooding annually, where the poor conditions of the inhabitants are even a much bigger challenge to deal with providing no other option than for them to migrate internally.
Flooding negatively affects plants by uprooting their stem and roots thereby limiting its growth, when runoffs from heavy storms sweep the entire farm surface. It has led to widespread damage to crops, reducing quality and quantity of livestock and farm products being transported to larger markets. NEMA [25] reported in 2013, that about 2, 217 farmlands were destroyed by flood in Ogbaru LGA. The impact of floods was also felt on soil deposits and quality from heightened erosion challenges and associated fluvial deposits worsening the deep-layered mottled Ogbaru soils making the soils unfavorable to plant growth (see Figure 11). Several households have experienced financial loss, hardship resulting from loss of farmlands, food insecurity, and hunger. Generally, this is a setback on local innovation, productivity, and development in of community.
Findings from this study confirmed the predictions of intense and last-longing floods of 2020 in Anambra state caused havoc on local farmlands, crops, and seedlings, bringing all farming activities to a halt. The inferences from interviews and discussions revealed that the community is hugely involved in the farming products such as cassava, citrus fruits, rice, and oil palm products. Also, rice cultivation is prevalent in the area, and particularly, the swamp rice cultivation and cassava farming were affected [50]. Drawing from the results of this study, about 72% of women report that their household income was from agriculture-related activities especially subsistence farming, fishing, and animal rearing. Findings from discussions revealed that women farmers were usually the worse hit during flood disaster where their farmlands are totally submerged destroying their farms and food products, economic/fruit trees, and farm animals (see Figures 9 and 10).
Generally, men and women continue to suffer from persistent floods-associated setbacks, yet women are impacted differentially as their livelihoods and general well-being are grossly depleted as they get more involved in gender roles, such as family care and nursing sick children. Women are found majorly in the agricultural sector, and invariably, the changing climate continues to impact women relative to accessibility to the resource opportunities they need to be more efficient. If the acclaimed unequal access to the resources and opportunities persists, then it will be difficult to combat food insecurity, hunger, malnutrition, and poverty that have become dire consequences. There is need for emphasis and actions that would promote gender equality while empowering women in agriculture to maximize their capacities in mitigating food insecurity, hunger, and extreme poverty. In the interview session, one of the community women leaders complained that their crops were either washed away by the floods or get rotten in the affected farmlands. She further informed that…
Majorly in Akili Ogidi, women are involved in the entire agricultural value chain, such as farm managers, suppliers of labor, harvesters, processers, and selling of farm products, making them vital and strategic in food security and agricultural production. Also, most women-headed households are all disproportionately affected by the reoccurring flood in the community. As confirmed by one of the women leaders in our group discussion, who has lost her husband, she said,
However, the women interviewees informed us that the community farmers have improvised local adaptation strategies where they farm twice in the year. The first planting season comes early in the year about late January/early February before the onset of wet season in March-April. This enables the farmers to harvest their farm products before their farms are submerged in the flood by May/June. The second planting season starts after the floods recede in late October/November, so that harvest can take place on or before January to prepare for another planting season to commence (see Figure 11). However, the floods of 2020 shattered their strategy, because the wet seasons extended longer than usual causing the floods to last longer as well. It is unfortunate that climate variability has remained unstable in recent times. One of the women interviewees responded saying…
Additionally, findings showed that the women and men were heavily dependent on the River Niger for their supply of large fish species during the floods. The community is traditionally surrounded by two Rivers Niger and Ulasi that provide various species of fishes and aquatic life. The participants informed during survey that they experience huge sales from large species of fishes caught and sold (see Figure 12). The floods provide an advantage for their fishing business because the majority of the fishes are brought to the river surface and even to their doorsteps during the flood events. During an interview session, one of the fisher women added that the supply of fishes is the only advantage of the floods …
It is on record that women face high levels of discrimination such as poverty, inadequate knowledge, and low execution of human rights among others, because women are overwhelmingly burdened with the huge roles of caring for children, the elderly, and people with disabilities and this places them at higher risks during flood disasters. A study carried out by Ihaji and Aondoaver [51] confirmed that women and children were the main casualties in flood relief camps in Cross River, Nigeria. There is need to support Akili Ogidi women to prepare for climate-driven floods. Hence, women should be given more considerations in terms of food, healthcare accommodation, and social facilities.
Findings from the study showed that flooding had extensive and significant effects on the health of community members—men, women, children, and people with disability. However, women and children were extensively affected by the harsh conditions provided by the flood. Alderman et al. [52] categorized health effects into short and long terms. Moreover, short-term health effects observed during the floods include infections, drowning, mental health challenges, physical injuries, and waterborne diseases. The longer-term health effects result from physical dislocation, shortages of safe water, injuries, depression over the loss of personal property, and death of a family member though most of the deaths in Akili Ogidi are from drowning of children and women. However, globally, it has been shown that mortality rates after major flooding increase by 50%, while with a prevalence of 8.6–53%, mental and psychological distress continue beyond 2 years after the flooding events [52].
Studies have confirmed that men and women are not affected in an equal magnitude because women have disproportionate vulnerability to flood disasters, compared with men. Considering, the flood disaster in Akili Ogidi, the women and children were more vulnerable because women are often concerned over their children’s safety. During the focus group, discussion session of the married women, a nursing mother related her experience during the flood. She reported that…
“During the 2020 floods I was pregnant and I had four other children aged 6, 5, 4 and 2years which I had to cater for. Worse still, our community health center was shut down because of the flood. I and the children suffered from exhaustion, stress, body pains, fever and physical injuries such as cuts, sprain from falls and insect bites from mosquitoes worsening my health condition”.
Understandably with the physiology of the pregnant state, such injuries may indirectly contribute to complications such as abortions, abruption placentae leading to vaginal bleeding in pregnancy (in the case of trauma or fall on the gravid abdomen), and even death from being carried away by the flood. Also, access to health facilities were further compounded by the destruction of such properties by the floods. It was noted by observation and during interactions with the women that they had restricted access to contraception, which would have been obtained as part of family planning services during postnatal care where the health facilities to function as required.
Report showed that women and children were badly affected as there were reported cases of deaths. According to Duncan [53] more women die during flooding disasters than men, which may be related partly due to less physical ability to run, and most of these women died trying to save their children. It was noted that the Anambra flood in 2019 killed four persons—a nine (9) year old boy, a (7) year girl, an (18) year boy, and a pregnant woman [28].
Flood-related or flood-prone injuries occurred as people tried to save themselves, their family, and their valuable possessions from the flood and theft. There were also reported cases of sexual violence (women and children being raped and abused), concern over missing children, and properties. Other health features seen were loss of appetite, lack of sleep, nightmares, tiredness, and irritability. All these can affect the psychological and mental health of the women and even the children whom flood has made orphans and homeless. Makwana [54] affirmed that mental and emotional/psychological trauma experienced by women and children contribute to intense impacts psychologically such as anxiety, low mood, and frustration. Even the children’s mental health was badly affected by hunger and food (in)security from intense poverty in our study area. Although the devastating mental health flood impacts on women may not be comparable to men, women will need more professional assistance to recover and stabilize their mental/emotional state due to challenging patriarchal gender biases.
Further, the flood damages the conditions of the environment (water, land and air) making it vulnerable to pollutants that sponsor increased fecal oral transmission of disease [55]. Generally, there is poor state of hygiene maintenance increasing the risk of waterborne illnesses, such as hepatitis A and cholera. With the high levels of poverty, negligence and poor access to clean water supply, and sanitation strategies, women are more susceptible to infections [56]. The major source of water supply was surrounding rivers that were polluted by the flood. Also, studies have reported post-flooding events bring an increase in cholera, nonspecific diarrhea, poliomyelitis, rotavirus, and typhoid fevers [57]. Intense precipitation influences waterborne disease outbreaks such as cholera, cryptosporidiosis, non-specific diarrhea, rotavirus, typhoid, and paratyphoid [58, 59, 60].
This is because floods can easily move (in)animate objects such as debris carrying parasites, bacteria, and viruses rapidly into the moving water systems and spread waterborne and related diseases. Also, studies showed that during the September 2012 flooding in Lagos, the flooded water came with lots of fecal pathogens and pollutants affecting major parts of Lagos. This is a challenge that pollutes drinking water, the associated poor sanitation [61], can lead to skin irritation and diseases as people wade through the polluted muddy-infested water to reach their homes.
It is recorded that over 50 million people will be uprooted in their countries when they are affected by disasters that deteriorate living conditions [62]. Achieving the sustainable development goals will not be realized, when disprivilged persons, such as women, disabled, and LGBTQ+ continue to experience one form of violence due to climate-related stressors [63], such as flooding and consequent temporary displacement. Although sexual and global based violence (SGBV) are reported in the global North, they are worse in the global South, particularly in the rural regions. These regions have a higher propensity and impact of effect of natural disasters, which have been shown to increase the risk of domestic violence.
This violence can be linked to psychosocial tensions relating to income loss from climate change impact on agricultural sector. UNFCCC [63] further reported that one in five women who are displaced from climate-related disasters has been violated sexually. With rising temperature and heightening of other related climate stressors, vulnerable groups and persons are often impacted disproportionately. Flooding exacerbated by climate changes put women and children at higher risks as they are displaced from their comfort zones worsening the link between gender-based violence (GBV) and climate-related flooding. Although any gender can experience any form of violence, such as domestic violence, sexual assault, and forced prostitution, the violence is worsened by deep-rooted sociocultural norms heightening the vulnerability of women and gender minorities, when they are not protected by laws. But these laws and policy can be gender unfriendly, particularly when they limit access to resource control of women due to scarce resources for the family. For example, early marriage and sexual exploitation are some examples of sociocultural tensions that women may go through to necessitate their survival. Also, women and children experience higher levels of vulnerability and natural weakness during flood emergencies and disasters. Findings from this study on 2020 flood disaster in Akili Ogidi provided the adverse effects on women and children. Some of the children were left in pitiable conditions without love and attention (see Figure 13 and 14). Women are forced to endure or go through issues that are not acceptable to them. During interview, one of the women reported that…
A flooded cassava farm in the study area where the farmer’s children tried to harvest some of the farm products.
Some of the hurridedly harvested Cassava tubers by the children from the flood.
Drawing from the study, limited access to basic infrastructres worsened the events that may have led to loss of human lives (Figures 15–17). Worsening family bonds and community’s social ties left people lonely, anxious and mentally oppressed, and diminishing source of income, employment, and livelihoods left community members more improvised, injured, hungry, sick, dead, and infected. Worse still, a large population were displaced, homeless, and helpless in their own town.
Soil layer washed away by the flood leaving it bare and dry and the onset of the second planting season after the floods have receded to enable early harvest.
The large fish species caught and sold during the floods at the bank of the river Niger.
The conditions of some of the children displaced by flood at the government provided IDP camp most of them were left without a care giver, guardian, or parents.
The study confirmed that flood negatively affects the many aspects of the lives of marginalized people dislocating them from their safe home to become temporary displaced. It resulted in the loss of lives and damage of infrastructure, farmlands, agricultural products, properties, and personal belongings that were worth of billions of naira. It is responsible for accidents, congestion, hunger, food insecurity, and loss of beautifying values of the environment. Also, it causes overcrowding, spreads communicable diseases, and waterborne diseases, which has become prevalent in the area. Unfortunately, predictions indicate that climate change will influence frequent intense floods across world regions [64].
Although science has proven that there is no doubt on climate change and whether it is real or a hoax. The time is now to find out what necessary actions can be taken at the community levels for a more resilient globe, and the way forward to tackle climate events and changes. Climate change is here, and we all have to do our part to lessen its detrimental impact on our communities. We must consider options for more efficient energy, renewable energy options such as solar energy and wind power, which will contribute immensely in carbon neutralization in the atmosphere and adoption of eco-relatable friendly lifestyle that is safe for the next generation.
Consequently, the behavior changes in climate protection, as an ongoing process, need not only to give tools to let people know what to do but also to provide an enabling environment and incentives. Akili Ogidi community is already an environmental hazard, and strategies must be agreed upon and with the community members on the way forward and out of these complex-wicked flooding challenges. To check and alleviate the problems of flood occurrence in Akili Ogidi, it is critical that the Federal and state governments of Nigeria set up financial aid strategies to help rural women in recovery of farmlands after the flood disaster. Further, to alleviate the situation, there should be more funding allocated to critical agencies related to disaster management and organization that support women development to enable them perform and execute their duties optimally. Also, involving the community in local environmental management has been reported as a solution for environmental problems. Hence, researchers should employ participatory methods to encourage people to change their lifestyles.
We thank the Akili Ogidi Community in Ogbaru LGA and the participants who contributed to this community-based research, particularly the women for their courage in sharing difficult and painful experiences on internal migration due to annual flooding in their native land. We also acknowledge Nigerian Coalition for Eco-health Research (NCEHR) for their research contribution to this study. The support of Intimate Vessels Church (IVC), Awka, Anambra State for their support toward this research.
There are no financial or other conflict of interest. None of the authors benefitted as a result of this study.
This study has been possible with the generous support of Spirit Filled Women International (SFWI) through their charity Fund sponsored by Intimate Vessels Church (IVC). SFWI is a non-governmental organization (NGO) and community-based research group driven toward advocacy for women’s welfare and the girl child.
This is a community-based research project and all the authors collaborated in the development, writing, data analysis, review, and finalization of this manuscript. Several authors took the lead for certain sections of the manuscript; AAO, NN, IN, and OKJ created the outline of the manuscript and developed ideas presented with the ongoing engagement and dialog with co-authors for input and feedback. AAO, NN, and EAC took the lead in writing and editing sections 4, 5, and 6. OCB AND ANI took the lead in sections 7and 8. AAO, OCE, NTO, OCA, and UUE took the lead for sections 10, 11, and 12. OJ, EAC, and ANS focused on Section 13. OKJ, AAO, and ANI took the lead for Section 14. IIP, ANA, NN, IN, OJ, UUM, OEO, and EDT took the lead in Section 15. AAO, OFA, NN, IN, OJ, and EAC took the lead in data analysis, discussion, synthesis of findings, policy development with ongoing engagement, and dialog with co-authors for input and feedback. The content and views expressed in this study are those of the authors and do not necessarily reflect those of the Government of Nigeria.
ACMI | African Climate Mobility Initiative |
AUC | African Union Commission |
GPS | Global Positioning System |
IDI | Internal Displacement Index |
IDMC | Internal Displacement Monitoring Centre |
IFRC | International Federation of the Red Cross |
IPCC | Intergovernmental Panel on Climate Change |
LGA | Local Government Area |
LGTBQ | Lesbian, Gay, Transgender Bisexual, Queer and Plus Others |
NCEHR | Nigerian Coalition for Eco-Health Research |
NAN | News Agency of Nigeria |
NEEDS | National Environmental, Economic and Development Study for Climate Change |
NEMA | National Emergency Management System |
NIHSA | Nigerian Hydrological Service Agency |
NIMET | Nigerian Meteorological Agency |
SEMA | State Emergency Management Agency |
UNFCCC | United Nations Framework Convention on Climate Change |
WHO | World Health Organization |
SFWI | Spirit Filled Women International |
SGBV | Sexual and Gender Based Violence |
GBV | Gender Based Violence |
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Aalborg University has Two Satellite Campuses, one in Copenhagen (Aalborg University Copenhagen) and the other in Esbjerg (Aalborg University Esbjerg).\n· He is a member of prestigious IEEE (Institute of Electrical and Electronics Engineers), and IAENG (International Association of Engineers) organizations. \n· He is the chief Editor of the Journal of Software Engineering.\n· He is the member of the Editorial Board of International Journal of Computer Science and Software Technology (IJCSST) and International Journal of Computer Engineering and Information Technology. \n· He is also the Editor of Communication in Computer and Information Science CCIS-20 by Springer.\n· Reviewer For Many Conferences\nHe is the lead person in making collaboration agreements between Aalborg University and many universities of Pakistan, for which the MOU’s (Memorandum of Understanding) have been signed.\nProfessor Akbar is working in Academia since 1990, he started his career as a Lab demonstrator/TA at the University of Sussex. After finishing his P. hD degree in 1992, he served in the Industry as a Scientific Officer and continued his academic career as a visiting scholar for a number of educational institutions. In 1996 he joined National University of Science & Technology Pakistan (NUST) as an Associate Professor; NUST is one of the top few universities in Pakistan. In 1999 he joined an International Company Lineo Inc, Canada as Manager Compiler Group, where he headed the group for developing Compiler Tool Chain and Porting of Operating Systems for the BLACKfin processor. The processor development was a joint venture by Intel and Analog Devices. In 2002 Lineo Inc., was taken over by another company, so he joined Aalborg University Denmark as an Assistant Professor.\nProfessor Akbar has truly a multi-disciplined career and he continued his legacy and making progress in many areas of his interests both in teaching and research. 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El-Shafie",coverURL:"https://cdn.intechopen.com/books/images_new/10739.jpg",editedByType:"Edited by",editors:[{id:"192142",title:"Dr.",name:"Hamadttu",middleName:null,surname:"Abdel Farag El-Shafie",slug:"hamadttu-abdel-farag-el-shafie",fullName:"Hamadttu Abdel Farag El-Shafie"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10423",title:"The Wonders of Diptera",subtitle:"Characteristics, Diversity, and Significance for the World's Ecosystems",isOpenForSubmission:!1,hash:"2746b4288e78c8688d1be1bd9d99a127",slug:"the-wonders-of-diptera-characteristics-diversity-and-significance-for-the-world-s-ecosystems",bookSignature:"Farzana Khan Perveen",coverURL:"https://cdn.intechopen.com/books/images_new/10423.jpg",editedByType:"Edited by",editors:[{id:"75563",title:"Dr.",name:"Farzana Khan",middleName:null,surname:"Perveen",slug:"farzana-khan-perveen",fullName:"Farzana Khan Perveen"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8929",title:"Modern Beekeeping",subtitle:"Bases for Sustainable Production",isOpenForSubmission:!1,hash:"cbf5aca68ed2c6690ad99f68aaaddcaf",slug:"modern-beekeeping-bases-for-sustainable-production",bookSignature:"Ramón Eduardo Rebolledo Ranz",coverURL:"https://cdn.intechopen.com/books/images_new/8929.jpg",editedByType:"Edited by",editors:[{id:"193813",title:"Dr.",name:"Ramón Eduardo",middleName:null,surname:"Rebolledo Ranz",slug:"ramon-eduardo-rebolledo-ranz",fullName:"Ramón Eduardo Rebolledo Ranz"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7561",title:"Beekeeping",subtitle:"New Challenges",isOpenForSubmission:!1,hash:"1c47c831256fe10ff19fb10f490930fc",slug:"beekeeping-new-challenges",bookSignature:"Ramón Eduardo Rebolledo Ranz",coverURL:"https://cdn.intechopen.com/books/images_new/7561.jpg",editedByType:"Edited by",editors:[{id:"193813",title:"Dr.",name:"Ramón Eduardo",middleName:null,surname:"Rebolledo Ranz",slug:"ramon-eduardo-rebolledo-ranz",fullName:"Ramón Eduardo Rebolledo Ranz"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6619",title:"Insect Science",subtitle:"Diversity, Conservation and Nutrition",isOpenForSubmission:!1,hash:"08241b041b2072a88452041f8fdebe7e",slug:"insect-science-diversity-conservation-and-nutrition",bookSignature:"Mohammad Manjur Shah and Umar Sharif",coverURL:"https://cdn.intechopen.com/books/images_new/6619.jpg",editedByType:"Edited by",editors:[{id:"94128",title:"Dr.",name:"Mohammad Manjur",middleName:null,surname:"Shah",slug:"mohammad-manjur-shah",fullName:"Mohammad Manjur Shah"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5163",title:"Beekeeping and Bee Conservation",subtitle:"Advances in Research",isOpenForSubmission:!1,hash:"fc469ff4d2cf6651cfdbf3c5cf90a469",slug:"beekeeping-and-bee-conservation-advances-in-research",bookSignature:"Emerson Dechechi Chambo",coverURL:"https://cdn.intechopen.com/books/images_new/5163.jpg",editedByType:"Edited by",editors:[{id:"94059",title:"Dr.",name:"Emerson",middleName:"Dechechi",surname:"Dechechi Chambó",slug:"emerson-dechechi-chambo",fullName:"Emerson Dechechi Chambó"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],booksByTopicTotal:6,seriesByTopicCollection:[],seriesByTopicTotal:0,mostCitedChapters:[{id:"50073",doi:"10.5772/62487",title:"Impacts of Pesticides on Honey Bees",slug:"impacts-of-pesticides-on-honey-bees",totalDownloads:3427,totalCrossrefCites:20,totalDimensionsCites:41,abstract:"This chapter focuses on the detrimental effects that pesticides have on managed honey bee colonies and their productivity. We examine first the routes of exposure of bees to agrochemicals used for crop protection and their application to crops, fate and contamination of water and plants around the fields. Most of the time, the exposure of bees to pesticides is through ingestion of residues found in the pollen and nectar of plants and in water. Honey bees are also exposed to pesticides used for the treatment of Varroa and other parasites. The basic concepts about the toxicity of the different kinds of pesticides are explained next. Various degrees of toxicity are found among agrochemicals, and emphasis is given to the classic tenet of toxicology, “the dose makes the poison,” and its modern version “the dose and the time of exposure makes the poison.” These two factors, dose and time, help us understand the severity of the impacts that pesticides may have on bees and their risk, which are analysed in the third section. Sublethal effects are also considered. The final section is devoted to some practical advice for avoiding adverse impacts of pesticides in beekeeping.",book:{id:"5163",slug:"beekeeping-and-bee-conservation-advances-in-research",title:"Beekeeping and Bee Conservation",fullTitle:"Beekeeping and Bee Conservation - Advances in Research"},signatures:"Francisco Sanchez-Bayo and Koichi Goka",authors:[{id:"74970",title:"Dr.",name:"Francisco",middleName:null,surname:"Sánchez-Bayo",slug:"francisco-sanchez-bayo",fullName:"Francisco Sánchez-Bayo"},{id:"192045",title:"Dr.",name:"Koichi",middleName:null,surname:"Goka",slug:"koichi-goka",fullName:"Koichi Goka"}]},{id:"59212",doi:"10.5772/intechopen.73864",title:"Insect Conservation for the Twenty-First Century",slug:"insect-conservation-for-the-twenty-first-century",totalDownloads:1968,totalCrossrefCites:7,totalDimensionsCites:15,abstract:"Insects have been immensely successful as an animal group. They dominate compositional diversity of all but the saltiest and coldest parts of the planet. Yet today insects are declining at a precipitous rate. This is of great concern in terms of impoverishment of Earth, and is also dire for us. Insects contribute to the maintenance of terrestrial and freshwater systems, their service delivery and their resilience. The meteoric impact of humans is challenging this dominance, yet so few people realize that the very fabric of life on which they depend is being unraveled at an alarming rate. Action is required, as are new perspectives, if we are to maintain insect diversity and services through the twenty-first century. Here, we review how we should view and act to have more effective insect diversity conservation based on six themes: (1) philosophy (establishing the ethical foundation), (2) research (the finding out), (3) policy (the framework for action), (4) psychology (understanding how to engage humans in insect conservation action), (5) practice (implementation of action), and (6) validation (establishing how well we are doing at conserving insects). We then overview some emergent challenges and solutions at both the species and landscape operational levels in agricultural, forestry, and urban environments.",book:{id:"6619",slug:"insect-science-diversity-conservation-and-nutrition",title:"Insect Science",fullTitle:"Insect Science-Diversity, Conservation and Nutrition"},signatures:"Michael J. Samways",authors:[{id:"233323",title:"Distinguished Prof.",name:"Michael",middleName:null,surname:"Samways",slug:"michael-samways",fullName:"Michael Samways"}]},{id:"79121",doi:"10.5772/intechopen.100416",title:"Botanical Insecticides Are a Non-Toxic Alternative to Conventional Pesticides in the Control of Insects and Pests",slug:"botanical-insecticides-are-a-non-toxic-alternative-to-conventional-pesticides-in-the-control-of-inse",totalDownloads:270,totalCrossrefCites:6,totalDimensionsCites:11,abstract:"Insect control for crops is one of the most critical global concerns. Pest management is an economic and ecological problem worldwide due to the human and environmental risks raised by most synthetic pesticide products. Botanical insecticides have resurfaced in popularity due to their low cost and low environmental impact, rather than their negative effects on human health. Botanical insecticides destroy only the insects they are meant to kill, leaving no residue on food or in the environment. Botanicals have long been used to combat pests. The compounds have many environmental advantages. However, as opposed to other bio-control pests and pathogens, their use was minimal during the twentieth century. In developing countries, botanical insecticides are well adapted for use in organic food production. Nonetheless, they may play a far bigger role in developed countries’ food production and post-harvest food protection. Consequently, the current chapter briefly addresses botanicals with active ingredients with insecticidal, antifeedant, or repellent properties.",book:{id:"10739",slug:"global-decline-of-insects",title:"Global Decline of Insects",fullTitle:"Global Decline of Insects"},signatures:"Nazeer Ahmed, Mukhtar Alam, Muhammad Saeed, Hidayat Ullah, Toheed Iqbal, Khalid Awadh Al-Mutairi, Kiran Shahjeer, Rafi Ullah, Saeed Ahmed, Nibal Abd Aleem Hassan Ahmed, Hanem Fathy Khater and Muhammad Salman",authors:[{id:"97300",title:"Prof.",name:"Khalid Awadh",middleName:"Al-Mutairi",surname:"Al-Mutairi",slug:"khalid-awadh-al-mutairi",fullName:"Khalid Awadh Al-Mutairi"},{id:"191884",title:"Dr.",name:"Toheed",middleName:null,surname:"Iqbal",slug:"toheed-iqbal",fullName:"Toheed Iqbal"},{id:"263876",title:"Dr.",name:"Hidayat",middleName:null,surname:"Ullah",slug:"hidayat-ullah",fullName:"Hidayat Ullah"},{id:"263877",title:"Dr.",name:"Mukhtar",middleName:null,surname:"Alam",slug:"mukhtar-alam",fullName:"Mukhtar Alam"},{id:"355528",title:"Dr.",name:"Nazeer",middleName:null,surname:"Ahmed",slug:"nazeer-ahmed",fullName:"Nazeer Ahmed"},{id:"420069",title:"Mrs.",name:"Kiran",middleName:null,surname:"Shahjeer",slug:"kiran-shahjeer",fullName:"Kiran Shahjeer"},{id:"420070",title:"Mr.",name:"Saeed",middleName:null,surname:"Ahmed",slug:"saeed-ahmed",fullName:"Saeed Ahmed"},{id:"420221",title:"Dr.",name:"Muhammad",middleName:null,surname:"Saeed",slug:"muhammad-saeed",fullName:"Muhammad Saeed"},{id:"420222",title:"Dr.",name:"Rafi",middleName:null,surname:"Ullah",slug:"rafi-ullah",fullName:"Rafi Ullah"},{id:"436507",title:"Dr.",name:"Nibal Abd Aleem",middleName:null,surname:"Hassan Ahmed",slug:"nibal-abd-aleem-hassan-ahmed",fullName:"Nibal Abd Aleem Hassan Ahmed"},{id:"436596",title:"Prof.",name:"Hanem Fathy",middleName:null,surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater"},{id:"485113",title:"Dr.",name:"Muhammad",middleName:null,surname:"Salman",slug:"muhammad-salman",fullName:"Muhammad Salman"}]},{id:"50307",doi:"10.5772/62654",title:"From Extraction to Meliponiculture: A Case Study of the Management of Stingless Bees in the West-Central Region of Mexico",slug:"from-extraction-to-meliponiculture-a-case-study-of-the-management-of-stingless-bees-in-the-west-cent",totalDownloads:2745,totalCrossrefCites:5,totalDimensionsCites:9,abstract:"Currently, stingless bees' populations are declining due to environmental degradation. In this context, the authors have developed a research project in the central-western region of Mexico with the goal to generate strategies for conservation and sustainable management of stingless bees. The chapter aims to present the process of this investigation and its main results in terms of a) local knowledge and management strategies of stingless bees, and b) the social process of technological appropriation of meliponiculture by beekeepers. We recognized specific knowledge on the biology and ecology of stingless bees that result in a system for identifying species and management strategies of wild populations of these bees based on the extraction of nests. The implementation of an innovative productive activity based on the principles of meliponiculture and current techniques has been well received by producers, which has led to the formation of the Meliponicultores Michoacanos del Balsas Association, which grows five species of stingless bees. The research suggests that conservation associated with the use of bees (integral meliponiculture) can be enhanced in the region. Faced with the loss of biodiversity and environmental crisis, it is essential to maintain and enhance local knowledge of stingless bees and management practices. This represents an alternative to develop management schemes that allow the raising and breeding of these bees, while its products are obtained.",book:{id:"5163",slug:"beekeeping-and-bee-conservation-advances-in-research",title:"Beekeeping and Bee Conservation",fullTitle:"Beekeeping and Bee Conservation - Advances in Research"},signatures:"Alejandro Reyes-González, Andrés Camou-Guerrero and Salvador\nGómez-Arreola",authors:[{id:"179951",title:"Dr.",name:"Andres",middleName:null,surname:"Camou-Guerrero",slug:"andres-camou-guerrero",fullName:"Andres Camou-Guerrero"},{id:"185413",title:"MSc.",name:"Alejandro",middleName:null,surname:"Reyes-González",slug:"alejandro-reyes-gonzalez",fullName:"Alejandro Reyes-González"},{id:"192049",title:"Dr.",name:"Salvador",middleName:null,surname:"Gómez-Arreola",slug:"salvador-gomez-arreola",fullName:"Salvador Gómez-Arreola"}]},{id:"50683",doi:"10.5772/63145",title:"Advances in Pharmacological Activities and Chemical Composition of Propolis Produced in Americas",slug:"advances-in-pharmacological-activities-and-chemical-composition-of-propolis-produced-in-americas",totalDownloads:2583,totalCrossrefCites:2,totalDimensionsCites:8,abstract:"Propolis is a resinous material produced by bees from the selective collection of plant exudates that are subsequently mixed with beeswax and salivary bee secretions. Propolis has been used in folk medicine, and certainly, several studies have validated its biological properties. The chemical composition and pharmacological activities of propolis collected through North (including Central America and Caribbean) and South America have been studied in the last years, and several papers have reported differences and similarities among the analysed geographical samples. Propolis has been classified according to its aspect and plant source; however, the ecological diversity present along the Americas provides a plethora of botanical resins. Herein, we summarize and discuss most of the studies performed at present on this profitable product for apiculture, attempting to compare the bioactivity, phytochemical diversity and botanical sources of honeybee propolis produced in Americas.",book:{id:"5163",slug:"beekeeping-and-bee-conservation-advances-in-research",title:"Beekeeping and Bee Conservation",fullTitle:"Beekeeping and Bee Conservation - Advances in Research"},signatures:"Efrain Alday, Moisés Navarro-Navarro, Adriana Garibay-Escobar,\nRamón Robles-Zepeda, Javier Hernandez and Carlos Velazquez",authors:[{id:"96966",title:"MSc.",name:"Moises",middleName:null,surname:"Navarro-Navarro",slug:"moises-navarro-navarro",fullName:"Moises Navarro-Navarro"},{id:"180409",title:"Dr.",name:"Carlos",middleName:null,surname:"Velazquez",slug:"carlos-velazquez",fullName:"Carlos Velazquez"},{id:"186351",title:"Dr.",name:"Ramón",middleName:null,surname:"Robles-Zepeda",slug:"ramon-robles-zepeda",fullName:"Ramón Robles-Zepeda"},{id:"186352",title:"MSc.",name:"Efrain",middleName:null,surname:"Alday",slug:"efrain-alday",fullName:"Efrain Alday"},{id:"186353",title:"Dr.",name:"Javier",middleName:null,surname:"Hernandez",slug:"javier-hernandez",fullName:"Javier Hernandez"},{id:"189161",title:"Dr.",name:"Adriana",middleName:null,surname:"Garibay-Escobar",slug:"adriana-garibay-escobar",fullName:"Adriana Garibay-Escobar"}]}],mostDownloadedChaptersLast30Days:[{id:"50170",title:"A Comprehensive Characterization of the Honeybees in Siberia (Russia)",slug:"a-comprehensive-characterization-of-the-honeybees-in-siberia-russia-",totalDownloads:2302,totalCrossrefCites:4,totalDimensionsCites:8,abstract:"A comprehensive study of some populations of honeybee (332 colonies) in Siberia (Tomsk region, Krasnoyarsk Krai (Yenisei population), Altai) using morphometric and molecular genetic methods was conducted. Infestation of bees (132 colonies) by Nosema has also been studied. Three variants of the COI-COII mtDNA locus were registered: PQQ, PQQQ (typical for Apis m. mellifera), and Q (specific for southern races). It was established that 64% of bee colonies from the Tomsk region and all colonies studied from the Krasnoyarsk and the Altai territories originate from Apis m. mellifera on the maternal line. According to the morphometric study, the majority of bee colonies of the Tomsk region are hybrids; in some colonies the mismatch of morphometric and mtDNA data was observed. Moreover, the majority of bee colonies infected by Nosema were hybrids. Yenisei population may be considered as a unique Apis m. mellifera population. Microsatellite analysis (loci А008, Ap049, AC117, AC216, Ap243, H110, A024, A113) showed the specific distribution of genotypes and alleles for some loci in the bees, which differ by geographical location. Loci A024 and Ap049 are of considerable interest for further study as candidate markers for differentiation of subspecies; locus A008 can be considered informative for determining of different ecotypes of Apis m. mellifera.",book:{id:"5163",slug:"beekeeping-and-bee-conservation-advances-in-research",title:"Beekeeping and Bee Conservation",fullTitle:"Beekeeping and Bee Conservation - Advances in Research"},signatures:"Nadezhda V. Ostroverkhova, Olga L. Konusova, Aksana N. Kucher\nand Igor V. Sharakhov",authors:[{id:"180112",title:"Ph.D.",name:"Nadezhda",middleName:null,surname:"Ostroverkhova",slug:"nadezhda-ostroverkhova",fullName:"Nadezhda Ostroverkhova"},{id:"180249",title:"Ms.",name:"Olga",middleName:null,surname:"Konusova",slug:"olga-konusova",fullName:"Olga Konusova"},{id:"180342",title:"Prof.",name:"Aksana",middleName:null,surname:"Kucher",slug:"aksana-kucher",fullName:"Aksana Kucher"},{id:"180343",title:"Prof.",name:"Igor",middleName:null,surname:"Sharakhov",slug:"igor-sharakhov",fullName:"Igor Sharakhov"}]},{id:"70501",title:"Southeast Asian Meliponiculture for Sustainable Livelihood",slug:"southeast-asian-meliponiculture-for-sustainable-livelihood",totalDownloads:1262,totalCrossrefCites:2,totalDimensionsCites:4,abstract:"Stingless bees (Apidae: Meliponini) are one of the most important pollinators of native plants and economic crops in tropical and subtropical parts of the world. They not only establish large perennial colonies with complex social organization but also have a diverse nesting biology. The economic utilization of a total of 60 stingless bee species in Asia has been reported. The current status of meliponiculture in Southeast Asia is mainly focused on pollination utilization and honey and propolis production. This chapter shows that small-scale beekeeping of stingless bees, which is suitable for the flowering pattern in the tropics, is one of the best potential alternative opportunities. The cost-effectiveness analysis based on production yield, investment cost, and profit-return rate is reviewed. Finally, a sustainable utilization of stingless bees is considered to be an enhancer of pollination services both in an agricultural crop and natural ecosystem.",book:{id:"8929",slug:"modern-beekeeping-bases-for-sustainable-production",title:"Modern Beekeeping",fullTitle:"Modern Beekeeping - Bases for Sustainable Production"},signatures:"Atsalek Rattanawannee and Orawan Duangphakdee",authors:[{id:"283087",title:"Ph.D.",name:"Atsalek",middleName:null,surname:"Rattanawannee",slug:"atsalek-rattanawannee",fullName:"Atsalek Rattanawannee"},{id:"306411",title:"Dr.",name:"Orawan",middleName:null,surname:"Duangphakdee",slug:"orawan-duangphakdee",fullName:"Orawan Duangphakdee"}]},{id:"50073",title:"Impacts of Pesticides on Honey Bees",slug:"impacts-of-pesticides-on-honey-bees",totalDownloads:3419,totalCrossrefCites:20,totalDimensionsCites:41,abstract:"This chapter focuses on the detrimental effects that pesticides have on managed honey bee colonies and their productivity. We examine first the routes of exposure of bees to agrochemicals used for crop protection and their application to crops, fate and contamination of water and plants around the fields. Most of the time, the exposure of bees to pesticides is through ingestion of residues found in the pollen and nectar of plants and in water. Honey bees are also exposed to pesticides used for the treatment of Varroa and other parasites. The basic concepts about the toxicity of the different kinds of pesticides are explained next. Various degrees of toxicity are found among agrochemicals, and emphasis is given to the classic tenet of toxicology, “the dose makes the poison,” and its modern version “the dose and the time of exposure makes the poison.” These two factors, dose and time, help us understand the severity of the impacts that pesticides may have on bees and their risk, which are analysed in the third section. Sublethal effects are also considered. The final section is devoted to some practical advice for avoiding adverse impacts of pesticides in beekeeping.",book:{id:"5163",slug:"beekeeping-and-bee-conservation-advances-in-research",title:"Beekeeping and Bee Conservation",fullTitle:"Beekeeping and Bee Conservation - Advances in Research"},signatures:"Francisco Sanchez-Bayo and Koichi Goka",authors:[{id:"74970",title:"Dr.",name:"Francisco",middleName:null,surname:"Sánchez-Bayo",slug:"francisco-sanchez-bayo",fullName:"Francisco Sánchez-Bayo"},{id:"192045",title:"Dr.",name:"Koichi",middleName:null,surname:"Goka",slug:"koichi-goka",fullName:"Koichi Goka"}]},{id:"74836",title:"Chironomidae: Biology, Ecology and Systematics",slug:"chironomidae-biology-ecology-and-systematics",totalDownloads:474,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"The family of Chironomidae is a group of Diptera insects belonging to the suborder of Nematocera, commonly called “non-biting midges” in the adult stage and “bloodworms” in the larval stage. The Chironomidae are often the most abundant group of macroinvertebrates, in number of species and individuals, encountered in all aquatic environments of freshwater, brackish, terrestrial and even the sea. Likewise, Chironomidae occur in all the continents. The Chironomidae family is divided into 11 sub-families that have diffrent ecological statues. Despite the wealth of data on Chironomidae in the Holarctic region, other parts of the world are poorly studied and few guides to identifying Chironomidae have been produced. This chapter includes a theoretical synthesis on the Chironomidae, it deals with the Biology (life cycle and description of different stages), description of all subfamilies and the ecology of this important family of Diptera.",book:{id:"10423",slug:"the-wonders-of-diptera-characteristics-diversity-and-significance-for-the-world-s-ecosystems",title:"The Wonders of Diptera",fullTitle:"The Wonders of Diptera - Characteristics, Diversity, and Significance for the World's Ecosystems"},signatures:"Zerguine Karima",authors:[{id:"334825",title:"Dr.",name:"Karima",middleName:null,surname:"Zerguine",slug:"karima-zerguine",fullName:"Karima Zerguine"}]},{id:"75438",title:"Characteristics of Dipteran Insects",slug:"characteristics-of-dipteran-insects",totalDownloads:510,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Diptera means two wings (Di: two, pteron: wing). They have complete metamorphosis and they are holometabolous insects which means there are 4 stages (egg, larvae, pupae and adult). The name of larval stage is “maggot”. Some of the dipteran insects cause damage in agricultural production. Some are harmful for humans. Dipteran insects have two wings. Hind wings are reduced and they are called “halteres”. Function of halteres is balancing when the insects fly. Except mosquitoes, dipteran insects have sponging-sucking mouthparts. Important examples for dipteran insects are Olive fruit fly and Medfly which cause damages in agricultural production. OFF is the most destructive pest in olive growing areas and Mediterranean fruit fly cause damages in fruit production.",book:{id:"10423",slug:"the-wonders-of-diptera-characteristics-diversity-and-significance-for-the-world-s-ecosystems",title:"The Wonders of Diptera",fullTitle:"The Wonders of Diptera - Characteristics, Diversity, and Significance for the World's Ecosystems"},signatures:"Murat Helvacı",authors:[{id:"301984",title:"Ph.D.",name:"Murat",middleName:null,surname:"Helvaci",slug:"murat-helvaci",fullName:"Murat Helvaci"}]}],onlineFirstChaptersFilter:{topicId:"35",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks: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:107,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:139,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:122,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:21,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:10,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:"6",title:"Infectious Diseases",doi:"10.5772/intechopen.71852",issn:"2631-6188",scope:"This series will provide a comprehensive overview of recent research trends in various Infectious Diseases (as per the most recent Baltimore classification). Topics will include general overviews of infections, immunopathology, diagnosis, treatment, epidemiology, etiology, and current clinical recommendations for managing infectious diseases. Ongoing issues, recent advances, and future diagnostic approaches and therapeutic strategies will also be discussed. This book series will focus on various aspects and properties of infectious diseases whose deep understanding is essential for safeguarding the human race from losing resources and economies due to pathogens.",coverUrl:"https://cdn.intechopen.com/series/covers/6.jpg",latestPublicationDate:"August 2nd, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:13,editor:{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales",profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",biography:"Dr. Rodriguez-Morales is an expert in tropical and emerging diseases, particularly zoonotic and vector-borne diseases (especially arboviral diseases). He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},editorTwo:null,editorThree:null},subseries:{paginationCount:5,paginationItems:[{id:"3",title:"Bacterial Infectious Diseases",coverUrl:"https://cdn.intechopen.com/series_topics/covers/3.jpg",editor:{id:"205604",title:"Dr.",name:"Tomas",middleName:null,surname:"Jarzembowski",slug:"tomas-jarzembowski",fullName:"Tomas Jarzembowski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRKriQAG/Profile_Picture_2022-06-16T11:01:31.jpg",biography:"Tomasz Jarzembowski was born in 1968 in Gdansk, Poland. He obtained his Ph.D. degree in 2000 from the Medical University of Gdańsk (UG). After specialization in clinical microbiology in 2003, he started studying biofilm formation and antibiotic resistance at the single-cell level. In 2015, he obtained his D.Sc. degree. His later study in cooperation with experts in nephrology and immunology resulted in the designation of the new diagnostic method of UTI, patented in 2017. He is currently working at the Department of Microbiology, Medical University of Gdańsk (GUMed), Poland. Since many years, he is a member of steering committee of Gdańsk branch of Polish Society of Microbiologists, a member of ESCMID. He is also a reviewer and a member of editorial boards of a number of international journals.",institutionString:"Medical University of Gdańsk, Poland",institution:null},editorTwo:{id:"484980",title:"Dr.",name:"Katarzyna",middleName:null,surname:"Garbacz",slug:"katarzyna-garbacz",fullName:"Katarzyna Garbacz",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003St8TAQAZ/Profile_Picture_2022-07-07T09:45:16.jpg",biography:"Katarzyna Maria Garbacz, MD, is an Associate Professor at the Medical University of Gdańsk, Poland and she is head of the Department of Oral Microbiology of the Medical University of Gdańsk. She has published more than 50 scientific publications in peer-reviewed journals. She has been a project leader funded by the National Science Centre of Poland. Prof. Garbacz is a microbiologist working on applied and fundamental questions in microbial epidemiology and pathogenesis. Her research interest is in antibiotic resistance, host-pathogen interaction, and therapeutics development for staphylococcal pathogens, mainly Staphylococcus aureus, which causes hospital-acquired infections. Currently, her research is mostly focused on the study of oral pathogens, particularly Staphylococcus spp.",institutionString:"Medical University of Gdańsk, Poland",institution:null},editorThree:null,editorialBoard:[{id:"190041",title:"Dr.",name:"Jose",middleName:null,surname:"Gutierrez Fernandez",slug:"jose-gutierrez-fernandez",fullName:"Jose Gutierrez Fernandez",profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institutionString:null,institution:{name:"University of Granada",institutionURL:null,country:{name:"Spain"}}},{id:"156556",title:"Prof.",name:"Maria Teresa",middleName:null,surname:"Mascellino",slug:"maria-teresa-mascellino",fullName:"Maria Teresa Mascellino",profilePictureURL:"https://mts.intechopen.com/storage/users/156556/images/system/156556.jpg",institutionString:"Sapienza University",institution:{name:"Sapienza University of Rome",institutionURL:null,country:{name:"Italy"}}},{id:"164933",title:"Prof.",name:"Mónica Alexandra",middleName:null,surname:"Sousa Oleastro",slug:"monica-alexandra-sousa-oleastro",fullName:"Mónica Alexandra Sousa Oleastro",profilePictureURL:"https://mts.intechopen.com/storage/users/164933/images/system/164933.jpeg",institutionString:"National Institute of Health Dr Ricardo Jorge",institution:{name:"National Institute of Health Dr. Ricardo Jorge",institutionURL:null,country:{name:"Portugal"}}}]},{id:"4",title:"Fungal Infectious Diseases",coverUrl:"https://cdn.intechopen.com/series_topics/covers/4.jpg",editor:{id:"174134",title:"Dr.",name:"Yuping",middleName:null,surname:"Ran",slug:"yuping-ran",fullName:"Yuping Ran",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bS9d6QAC/Profile_Picture_1630330675373",biography:"Dr. Yuping Ran, Professor, Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China. Completed the Course Medical Mycology, the Centraalbureau voor Schimmelcultures (CBS), Fungal Biodiversity Centre, Netherlands (2006). International Union of Microbiological Societies (IUMS) Fellow, and International Emerging Infectious Diseases (IEID) Fellow, Centers for Diseases Control and Prevention (CDC), Atlanta, USA. Diploma of Dermatological Scientist, Japanese Society for Investigative Dermatology. Ph.D. of Juntendo University, Japan. Bachelor’s and Master’s degree, Medicine, West China University of Medical Sciences. Chair of Sichuan Medical Association Dermatology Committee. General Secretary of The 19th Annual Meeting of Chinese Society of Dermatology and the Asia Pacific Society for Medical Mycology (2013). In charge of the Annual Medical Mycology Course over 20-years authorized by National Continue Medical Education Committee of China. Member of the board of directors of the Asia-Pacific Society for Medical Mycology (APSMM). Associate editor of Mycopathologia. Vice-chief of the editorial board of Chinses Journal of Mycology, China. Board Member and Chair of Mycology Group of Chinese Society of Dermatology.",institutionString:null,institution:{name:"Sichuan University",institutionURL:null,country:{name:"China"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"302145",title:"Dr.",name:"Felix",middleName:null,surname:"Bongomin",slug:"felix-bongomin",fullName:"Felix Bongomin",profilePictureURL:"https://mts.intechopen.com/storage/users/302145/images/system/302145.jpg",institutionString:null,institution:{name:"Gulu University",institutionURL:null,country:{name:"Uganda"}}},{id:"45803",title:"Ph.D.",name:"Payam",middleName:null,surname:"Behzadi",slug:"payam-behzadi",fullName:"Payam Behzadi",profilePictureURL:"https://mts.intechopen.com/storage/users/45803/images/system/45803.jpg",institutionString:"Islamic Azad University, Tehran",institution:{name:"Islamic Azad University, Tehran",institutionURL:null,country:{name:"Iran"}}}]},{id:"5",title:"Parasitic Infectious Diseases",coverUrl:"https://cdn.intechopen.com/series_topics/covers/5.jpg",editor:{id:"67907",title:"Dr.",name:"Amidou",middleName:null,surname:"Samie",slug:"amidou-samie",fullName:"Amidou Samie",profilePictureURL:"https://mts.intechopen.com/storage/users/67907/images/system/67907.jpg",biography:"Dr. Amidou Samie is an Associate Professor of Microbiology at the University of Venda, in South Africa, where he graduated for his PhD in May 2008. He joined the Department of Microbiology the same year and has been giving lectures on topics covering parasitology, immunology, molecular biology and industrial microbiology. He is currently a rated researcher by the National Research Foundation of South Africa at category C2. He has published widely in the field of infectious diseases and has overseen several MSc’s and PhDs. His research activities mostly cover topics on infectious diseases from epidemiology to control. His particular interest lies in the study of intestinal protozoan parasites and opportunistic infections among HIV patients as well as the potential impact of childhood diarrhoea on growth and child development. He also conducts research on water-borne diseases and water quality and is involved in the evaluation of point-of-use water treatment technologies using silver and copper nanoparticles in collaboration with the University of Virginia, USA. 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Kasenga",hash:"91cde4582ead884cb0f355a19b67cd56",volumeInSeries:4,fullTitle:"Malaria",editors:[{id:"86725",title:"Dr.",name:"Fyson",middleName:"Hanania",surname:"Kasenga",slug:"fyson-kasenga",fullName:"Fyson Kasenga",profilePictureURL:"https://mts.intechopen.com/storage/users/86725/images/system/86725.jpg",institutionString:"Malawi Adventist University",institution:{name:"Malawi Adventist University",institutionURL:null,country:{name:"Malawi"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"7123",title:"Current Topics in Neglected Tropical Diseases",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/7123.jpg",slug:"current-topics-in-neglected-tropical-diseases",publishedDate:"December 4th 2019",editedByType:"Edited by",bookSignature:"Alfonso J. Rodriguez-Morales",hash:"61c627da05b2ace83056d11357bdf361",volumeInSeries:3,fullTitle:"Current Topics in Neglected Tropical Diseases",editors:[{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales",profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"7064",title:"Current Perspectives in Human Papillomavirus",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/7064.jpg",slug:"current-perspectives-in-human-papillomavirus",publishedDate:"May 2nd 2019",editedByType:"Edited by",bookSignature:"Shailendra K. Saxena",hash:"d92a4085627bab25ddc7942fbf44cf05",volumeInSeries:2,fullTitle:"Current Perspectives in Human Papillomavirus",editors:[{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",institutionURL:null,country:{name:"India"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null}]},subseriesFiltersForPublishedBooks:[{group:"subseries",caption:"Bacterial Infectious Diseases",value:3,count:2},{group:"subseries",caption:"Parasitic Infectious Diseases",value:5,count:4},{group:"subseries",caption:"Viral Infectious Diseases",value:6,count:7}],publicationYearFilters:[{group:"publicationYear",caption:"2022",value:2022,count:2},{group:"publicationYear",caption:"2021",value:2021,count:4},{group:"publicationYear",caption:"2020",value:2020,count:3},{group:"publicationYear",caption:"2019",value:2019,count:3},{group:"publicationYear",caption:"2018",value:2018,count:1}],authors:{paginationCount:302,paginationItems:[{id:"280338",title:"Dr.",name:"Yutaka",middleName:null,surname:"Tsutsumi",slug:"yutaka-tsutsumi",fullName:"Yutaka Tsutsumi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/280338/images/7961_n.jpg",biography:null,institutionString:null,institution:{name:"Fujita Health University",country:{name:"Japan"}}},{id:"116250",title:"Dr.",name:"Nima",middleName:null,surname:"Rezaei",slug:"nima-rezaei",fullName:"Nima Rezaei",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/116250/images/system/116250.jpg",biography:"Professor Nima Rezaei obtained an MD from Tehran University of Medical Sciences, Iran. He also obtained an MSc in Molecular and Genetic Medicine, and a Ph.D. in Clinical Immunology and Human Genetics from the University of Sheffield, UK. He also completed a short-term fellowship in Pediatric Clinical Immunology and Bone Marrow Transplantation at Newcastle General Hospital, England. Dr. Rezaei is a Full Professor of Immunology and Vice Dean of International Affairs and Research, at the School of Medicine, Tehran University of Medical Sciences, and the co-founder and head of the Research Center for Immunodeficiencies. He is also the founding president of the Universal Scientific Education and Research Network (USERN). Dr. Rezaei has directed more than 100 research projects and has designed and participated in several international collaborative projects. He is an editor, editorial assistant, or editorial board member of more than forty international journals. He has edited more than 50 international books, presented more than 500 lectures/posters in congresses/meetings, and published more than 1,100 scientific papers in international journals.",institutionString:"Tehran University of Medical Sciences",institution:{name:"Tehran University of Medical Sciences",country:{name:"Iran"}}},{id:"180733",title:"Dr.",name:"Jean",middleName:null,surname:"Engohang-Ndong",slug:"jean-engohang-ndong",fullName:"Jean Engohang-Ndong",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180733/images/system/180733.png",biography:"Dr. Jean Engohang-Ndong was born and raised in Gabon. After obtaining his Associate Degree of Science at the University of Science and Technology of Masuku, Gabon, he continued his education in France where he obtained his BS, MS, and Ph.D. in Medical Microbiology. He worked as a post-doctoral fellow at the Public Health Research Institute (PHRI), Newark, NJ for four years before accepting a three-year faculty position at Brigham Young University-Hawaii. Dr. Engohang-Ndong is a tenured faculty member with the academic rank of Full Professor at Kent State University, Ohio, where he teaches a wide range of biological science courses and pursues his research in medical and environmental microbiology. Recently, he expanded his research interest to epidemiology and biostatistics of chronic diseases in Gabon.",institutionString:"Kent State University",institution:{name:"Kent State University",country:{name:"United States of America"}}},{id:"188773",title:"Prof.",name:"Emmanuel",middleName:null,surname:"Drouet",slug:"emmanuel-drouet",fullName:"Emmanuel Drouet",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/188773/images/system/188773.png",biography:"Emmanuel Drouet, PharmD, is a Professor of Virology at the Faculty of Pharmacy, the University Grenoble-Alpes, France. As a head scientist at the Institute of Structural Biology in Grenoble, Dr. Drouet’s research investigates persisting viruses in humans (RNA and DNA viruses) and the balance with our host immune system. He focuses on these viruses’ effects on humans (both their impact on pathology and their symbiotic relationships in humans). He has an excellent track record in the herpesvirus field, and his group is engaged in clinical research in the field of Epstein-Barr virus diseases. He is the editor of the online Encyclopedia of Environment and he coordinates the Universal Health Coverage education program for the BioHealth Computing Schools of the European Institute of Science.",institutionString:null,institution:{name:"Grenoble Alpes University",country:{name:"France"}}},{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",biography:"Dr. Rodriguez-Morales is an expert in tropical and emerging diseases, particularly zoonotic and vector-borne diseases (especially arboviral diseases). He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},{id:"332819",title:"Dr.",name:"Chukwudi Michael",middleName:"Michael",surname:"Egbuche",slug:"chukwudi-michael-egbuche",fullName:"Chukwudi Michael Egbuche",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/332819/images/14624_n.jpg",biography:"I an Dr. Chukwudi Michael Egbuche. I am a Senior Lecturer in the Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka.",institutionString:null,institution:{name:"Nnamdi Azikiwe University",country:{name:"Nigeria"}}},{id:"284232",title:"Mr.",name:"Nikunj",middleName:"U",surname:"Tandel",slug:"nikunj-tandel",fullName:"Nikunj Tandel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284232/images/8275_n.jpg",biography:'Mr. Nikunj Tandel has completed his Master\'s degree in Biotechnology from VIT University, India in the year of 2012. He is having 8 years of research experience especially in the field of malaria epidemiology, immunology, and nanoparticle-based drug delivery system against the infectious diseases, autoimmune disorders and cancer. He has worked for the NIH funded-International Center of Excellence in Malaria Research project "Center for the study of complex malaria in India (CSCMi)" in collaboration with New York University. The preliminary objectives of the study are to understand and develop the evidence-based tools and interventions for the control and prevention of malaria in different sites of the INDIA. Alongside, with the help of next-generation genomics study, the team has studied the antimalarial drug resistance in India. Further, he has extended his research in the development of Humanized mice for the study of liver-stage malaria and identification of molecular marker(s) for the Artemisinin resistance. At present, his research focuses on understanding the role of B cells in the activation of CD8+ T cells in malaria. Received the CSIR-SRF (Senior Research Fellow) award-2018, FIMSA (Federation of Immunological Societies of Asia-Oceania) Travel Bursary award to attend the IUIS-IIS-FIMSA Immunology course-2019',institutionString:"Nirma University",institution:{name:"Nirma University",country:{name:"India"}}},{id:"334383",title:"Ph.D.",name:"Simone",middleName:"Ulrich",surname:"Ulrich Picoli",slug:"simone-ulrich-picoli",fullName:"Simone Ulrich Picoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334383/images/15919_n.jpg",biography:"Graduated in Pharmacy from Universidade Luterana do Brasil (1999), Master in Agricultural and Environmental Microbiology from Federal University of Rio Grande do Sul (2002), Specialization in Clinical Microbiology from Universidade de São Paulo, USP (2007) and PhD in Sciences in Gastroenterology and Hepatology (2012). She is currently an Adjunct Professor at Feevale University in Medicine and Biomedicine courses and a permanent professor of the Academic Master\\'s Degree in Virology. She has experience in the field of Microbiology, with an emphasis on Bacteriology, working mainly on the following topics: bacteriophages, bacterial resistance, clinical microbiology and food microbiology.",institutionString:null,institution:{name:"Universidade Feevale",country:{name:"Brazil"}}},{id:"229220",title:"Dr.",name:"Amjad",middleName:"Islam",surname:"Aqib",slug:"amjad-aqib",fullName:"Amjad Aqib",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229220/images/system/229220.png",biography:"Dr. Amjad Islam Aqib obtained a DVM and MSc (Hons) from University of Agriculture Faisalabad (UAF), Pakistan, and a PhD from the University of Veterinary and Animal Sciences Lahore, Pakistan. Dr. Aqib joined the Department of Clinical Medicine and Surgery at UAF for one year as an assistant professor where he developed a research laboratory designated for pathogenic bacteria. Since 2018, he has been Assistant Professor/Officer in-charge, Department of Medicine, Manager Research Operations and Development-ORIC, and President One Health Club at Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan. He has nearly 100 publications to his credit. His research interests include epidemiological patterns and molecular analysis of antimicrobial resistance and modulation and vaccine development against animal pathogens of public health concern.",institutionString:"Cholistan University of Veterinary and Animal Sciences",institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"333753",title:"Dr.",name:"Rais",middleName:null,surname:"Ahmed",slug:"rais-ahmed",fullName:"Rais Ahmed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333753/images/20168_n.jpg",biography:null,institutionString:null,institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"62900",title:"Prof.",name:"Fethi",middleName:null,surname:"Derbel",slug:"fethi-derbel",fullName:"Fethi Derbel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62900/images/system/62900.jpeg",biography:"Professor Fethi Derbel was born in 1960 in Tunisia. He received his medical degree from the Sousse Faculty of Medicine at Sousse, University of Sousse, Tunisia. He completed his surgical residency in General Surgery at the University Hospital Farhat Hached of Sousse and was a member of the Unit of Liver Transplantation in the University of Rennes, France. He then worked in the Department of Surgery at the Sahloul University Hospital in Sousse. Professor Derbel is presently working at the Clinique les Oliviers, Sousse, Tunisia. His hospital activities are mostly concerned with laparoscopic, colorectal, pancreatic, hepatobiliary, and gastric surgery. He is also very interested in hernia surgery and performs ventral hernia repairs and inguinal hernia repairs. He has been a member of the GREPA and Tunisian Hernia Society (THS). During his residency, he managed patients suffering from diabetic foot, and he was very interested in this pathology. For this reason, he decided to coordinate a book project dealing with the diabetic foot. Professor Derbel has published many articles in journals and collaborates intensively with IntechOpen Access Publisher as an editor.",institutionString:"Clinique les Oliviers",institution:null},{id:"300144",title:"Dr.",name:"Meriem",middleName:null,surname:"Braiki",slug:"meriem-braiki",fullName:"Meriem Braiki",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300144/images/system/300144.jpg",biography:"Dr. Meriem Braiki is a specialist in pediatric surgeon from Tunisia. She was born in 1985. She received her medical degree from the University of Medicine at Sousse, Tunisia. She achieved her surgical residency training periods in Pediatric Surgery departments at University Hospitals in Monastir, Tunis and France.\r\nShe is currently working at the Pediatric surgery department, Sidi Bouzid Hospital, Tunisia. Her hospital activities are mostly concerned with laparoscopic, parietal, urological and digestive surgery. She has published several articles in diffrent journals.",institutionString:"Sidi Bouzid Regional Hospital",institution:null},{id:"229481",title:"Dr.",name:"Erika M.",middleName:"Martins",surname:"de Carvalho",slug:"erika-m.-de-carvalho",fullName:"Erika M. de Carvalho",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229481/images/6397_n.jpg",biography:null,institutionString:null,institution:{name:"Oswaldo Cruz Foundation",country:{name:"Brazil"}}},{id:"186537",title:"Prof.",name:"Tonay",middleName:null,surname:"Inceboz",slug:"tonay-inceboz",fullName:"Tonay Inceboz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/186537/images/system/186537.jfif",biography:"I was graduated from Ege University of Medical Faculty (Turkey) in 1988 and completed his Med. PhD degree in Medical Parasitology at the same university. I became an Associate Professor in 2008 and Professor in 2014. I am currently working as a Professor at the Department of Medical Parasitology at Dokuz Eylul University, Izmir, Turkey.\n\nI have given many lectures, presentations in different academic meetings. I have more than 60 articles in peer-reviewed journals, 18 book chapters, 1 book editorship.\n\nMy research interests are Echinococcus granulosus, Echinococcus multilocularis (diagnosis, life cycle, in vitro and in vivo cultivation), and Trichomonas vaginalis (diagnosis, PCR, and in vitro cultivation).",institutionString:"Dokuz Eylül University",institution:{name:"Dokuz Eylül University",country:{name:"Turkey"}}},{id:"71812",title:"Prof.",name:"Hanem Fathy",middleName:"Fathy",surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/71812/images/1167_n.jpg",biography:"Prof. Khater is a Professor of Parasitology at Benha University, Egypt. She studied for her doctoral degree, at the Department of Entomology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, USA. She has completed her Ph.D. degrees in Parasitology in Egypt, from where she got the award for “the best scientific Ph.D. dissertation”. She worked at the School of Biological Sciences, Bristol, England, the UK in controlling insects of medical and veterinary importance as a grant from Newton Mosharafa, the British Council. Her research is focused on searching of pesticides against mosquitoes, house flies, lice, green bottle fly, camel nasal botfly, soft and hard ticks, mites, and the diamondback moth as well as control of several parasites using safe and natural materials to avoid drug resistances and environmental contamination.",institutionString:null,institution:{name:"Banha University",country:{name:"Egypt"}}},{id:"99780",title:"Prof.",name:"Omolade",middleName:"Olayinka",surname:"Okwa",slug:"omolade-okwa",fullName:"Omolade Okwa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/99780/images/system/99780.jpg",biography:"Omolade Olayinka Okwa is presently a Professor of Parasitology at Lagos State University, Nigeria. She has a PhD in Parasitology (1997), an MSc in Cellular Parasitology (1992), and a BSc (Hons) Zoology (1990) all from the University of Ibadan, Nigeria. She teaches parasitology at the undergraduate and postgraduate levels. She was a recipient of a Commonwealth fellowship supported by British Council tenable at the Centre for Entomology and Parasitology (CAEP), Keele University, United Kingdom between 2004 and 2005. She was awarded an Honorary Visiting Research Fellow at the same university from 2005 to 2007. \nShe has been an external examiner to the Department of Veterinary Microbiology and Parasitology, University of Ibadan, MSc programme between 2010 and 2012. She is a member of the Nigerian Society of Experimental Biology (NISEB), Parasitology and Public Health Society of Nigeria (PPSN), Science Association of Nigeria (SAN), Zoological Society of Nigeria (ZSN), and is Vice Chairperson of the Organisation of Women in Science (OWSG), LASU chapter. She served as Head of Department of Zoology and Environmental Biology, Lagos State University from 2007 to 2010 and 2014 to 2016. She is a reviewer for several local and international journals such as Unilag Journal of Science, Libyan Journal of Medicine, Journal of Medicine and Medical Sciences, and Annual Research and Review in Science. \nShe has authored 45 scientific research publications in local and international journals, 8 scientific reviews, 4 books, and 3 book chapters, which includes the books “Malaria Parasites” and “Malaria” which are IntechOpen access publications.",institutionString:"Lagos State University",institution:{name:"Lagos State University",country:{name:"Nigeria"}}},{id:"273100",title:"Dr.",name:"Vijay",middleName:null,surname:"Gayam",slug:"vijay-gayam",fullName:"Vijay Gayam",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/273100/images/system/273100.jpeg",biography:"Dr. Vijay Bhaskar Reddy Gayam is currently practicing as an internist at Interfaith Medical Center in Brooklyn, New York, USA. He is also a Clinical Assistant Professor at the SUNY Downstate University Hospital and Adjunct Professor of Medicine at the American University of Antigua. He is a holder of an M.B.B.S. degree bestowed to him by Osmania Medical College and received his M.D. at Interfaith Medical Center. His career goals thus far have heavily focused on direct patient care, medical education, and clinical research. He currently serves in two leadership capacities; Assistant Program Director of Medicine at Interfaith Medical Center and as a Councilor for the American\r\nFederation for Medical Research. As a true academician and researcher, he has more than 50 papers indexed in international peer-reviewed journals. He has also presented numerous papers in multiple national and international scientific conferences. His areas of research interest include general internal medicine, gastroenterology and hepatology. He serves as an editor, editorial board member and reviewer for multiple international journals. His research on Hepatitis C has been very successful and has led to multiple research awards, including the 'Equity in Prevention and Treatment Award” from the New York Department of Health Viral Hepatitis Symposium (2018) and the 'Presidential Poster Award” awarded to him by the American College of Gastroenterology (2018). 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His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. 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Govindarajan completed his BSc degree in Zoology at Government Arts College (Autonomous), Kumbakonam, and MSc, MPhil, and PhD degrees at Annamalai University, Annamalai Nagar, Tamil Nadu, India. He is serving as an assistant professor at the Department of Zoology, Annamalai University. His research interests include isolation, identification, and characterization of biologically active molecules from plants and microbes. He has identified more than 20 pure compounds with high mosquitocidal activity and also conducted high-quality research on photochemistry and nanosynthesis. He has published more than 150 studies in journals with impact factor and 2 books in Lambert Academic Publishing, Germany. He serves as an editorial board member in various national and international scientific journals.",institutionString:null,institution:null},{id:"274660",title:"Dr.",name:"Damodar",middleName:null,surname:"Paudel",slug:"damodar-paudel",fullName:"Damodar Paudel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/274660/images/8176_n.jpg",biography:"I am DrDamodar Paudel,currently working as consultant Physician in Nepal police Hospital.",institutionString:null,institution:null},{id:"241562",title:"Dr.",name:"Melvin",middleName:null,surname:"Sanicas",slug:"melvin-sanicas",fullName:"Melvin Sanicas",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241562/images/6699_n.jpg",biography:null,institutionString:null,institution:null},{id:"322007",title:"Dr.",name:"Maria Elizbeth",middleName:null,surname:"Alvarez-Sánchez",slug:"maria-elizbeth-alvarez-sanchez",fullName:"Maria Elizbeth Alvarez-Sánchez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universidad Autónoma de la Ciudad de México",country:{name:"Mexico"}}},{id:"337443",title:"Dr.",name:"Juan",middleName:null,surname:"A. 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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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