Main milk isolates from lactating bitches in the periparturient period [15].
\\n\\n
\\n"}]',published:!0,mainMedia:{caption:"Milestone",originalUrl:"/media/original/124"}},components:[{type:"htmlEditorComponent",content:'
Barely three months into the new year and we are happy to announce a monumental milestone reached - 150 million downloads.
\n\nThis achievement solidifies IntechOpen’s place as a pioneer in Open Access publishing and the home to some of the most relevant scientific research available through Open Access.
\n\nWe are so proud to have worked with so many bright minds throughout the years who have helped us spread knowledge through the power of Open Access and we look forward to continuing to support some of the greatest thinkers of our day.
\n\nThank you for making IntechOpen your place of learning, sharing, and discovery, and here’s to 150 million more!
\n\n\n\n\n'}],latestNews:[{slug:"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:"8762",leadTitle:null,fullTitle:"Melatonin - The Hormone of Darkness and its Therapeutic Potential and Perspectives",title:"Melatonin",subtitle:"The Hormone of Darkness and its Therapeutic Potential and Perspectives",reviewType:"peer-reviewed",abstract:"This book, on the pineal hormone melatonin, is addressed to a wide non-cognizant and cognizant readership. The hormone appears to be involved in sleep onset and other functions associated with the body’s clock, the suprachiasmic nucleus. It is ubiquitous throughout both the animal and plant kingdoms and has a long evolutionary history as a hormone. Melatonin has a major role in the regulation of circadian rhythms in non-mammalian vertebrates and forms part of their control in mammals. The present text emphasizes the positive role of exogenously administered melatonin, and its synthetic derivatives, on disrupted circadian rhythm-related dysfunctions. This is effected by resetting the clock in jet lag sufferers and those with seasonal affective disorders, insomnia, and various neurological conditions.",isbn:"978-1-83962-909-9",printIsbn:"978-1-83962-908-2",pdfIsbn:"978-1-83962-910-5",doi:"10.5772/intechopen.80180",price:119,priceEur:129,priceUsd:155,slug:"melatonin-the-hormone-of-darkness-and-its-therapeutic-potential-and-perspectives",numberOfPages:156,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"bfbc5538173f11acb0f9549a85b70489",bookSignature:"Marilena Vlachou",publishedDate:"June 24th 2020",coverURL:"https://cdn.intechopen.com/books/images_new/8762.jpg",numberOfDownloads:6381,numberOfWosCitations:4,numberOfCrossrefCitations:5,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:11,numberOfDimensionsCitationsByBook:1,hasAltmetrics:0,numberOfTotalCitations:20,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"October 28th 2019",dateEndSecondStepPublish:"February 13th 2020",dateEndThirdStepPublish:"April 13th 2020",dateEndFourthStepPublish:"July 2nd 2020",dateEndFifthStepPublish:"August 31st 2020",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"246279",title:"Associate Prof.",name:"Marilena",middleName:null,surname:"Vlachou",slug:"marilena-vlachou",fullName:"Marilena Vlachou",profilePictureURL:"https://mts.intechopen.com/storage/users/246279/images/system/246279.jpg",biography:"Marilena Vlachou is an Assistant Professor at the National and Kapodistrian University of Athens (NKUoA), Greece. She obtained her Pharmacy and PhD (Pharmaceutical Technology) degrees from the NKUoA. Just prior to obtaining her PhD she moved to the University of Rhode Island, United States, as a Visiting Research Scientist to conduct state-of-the art research on Pharmaceutical Technology techniques. Her research interests include: the formulation and in vitro release of bioactive substances from topical formulations; the efficacy and safety of formulations in skin disease therapies; the modified release of novel synthetic derivatives, with diverse activity; the investigation of the physicochemical properties of new excipients, including those of marine origin (Ulvans), and nanomaterials, with respect to their interaction with active pharmaceutical ingredients (APIs).",institutionString:"National and Kapodistrian University of Athens",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"National and Kapodistrian University of Athens",institutionURL:null,country:{name:"Greece"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"178",title:"Endocrinology",slug:"medicine-endocrinology"}],chapters:[{id:"71292",title:"Synthetic Melatonin Receptor Agonists and Antagonists",doi:"10.5772/intechopen.91424",slug:"synthetic-melatonin-receptor-agonists-and-antagonists",totalDownloads:791,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The functions of the pineal hormone melatonin are of intense and continuous interest. Synthetic melatonin receptor analogues, as agonists and antagonists, have been explored, and the molecule can be viewed as consisting of an indole nucleus, acting mainly as a spacer, and the C5-OMe and the C3-ethylamido side chains, acting as pharmacophoric components. The present chapter focuses on the synthetic routes towards these melatonin derivatives, first the aromatic nucleus, then the functionalities that have been introduced to the nucleus, and finally those analogues with restrained conformations and those that are optically active. The importance of the various parameters involved in the agonist and antagonist profile of the compounds is indicated, as is the difference in the action of the chiral melatoninergics.",signatures:"Andrew Tsotinis and Ioannis P. Papanastasiou",downloadPdfUrl:"/chapter/pdf-download/71292",previewPdfUrl:"/chapter/pdf-preview/71292",authors:[null],corrections:null},{id:"72304",title:"Clinical Use of Melatonin in the Treatment of Sleep Disorders",doi:"10.5772/intechopen.92656",slug:"clinical-use-of-melatonin-in-the-treatment-of-sleep-disorders",totalDownloads:981,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Sleep disorders are a group of conditions that affect the circadian rhythm of sleep-wake, leading to social and professional maladaptation. At the moment, there is a wide range of medications aimed at the treatment of sleep disorders, but the results from their use are not always satisfactory. Benzodiazepines, antidepressants, and antihistamines may cause dependence or withdrawal effects. Melatonin (N-acetyl-5-methoxytryptamine) is an endogenous hormone produced by the pineal gland that affects intraday, seasonal rhythm, and the sleep-wake cycle. Studies of the effects of melatonin have demonstrated its ability to synchronize circadian rhythms, reduce the latency of slow sleep, increase the duration of sleep, and improve its subjective quality. This review highlights the current therapeutic possibilities of using melatonin in various sleep disorders, taking into account the mechanisms of its action. Also, the prospects of using melatonin due to its chronobiological effect in other sleep disorders, such as parasomnia, sleep-dependent respiratory disorders, and hypersomnia, are emphasized. At the moment, melatonin is one of the methods for correcting intraday rhythms and some types of insomnia.",signatures:"Alexander Zakharov and Elena Khivintseva",downloadPdfUrl:"/chapter/pdf-download/72304",previewPdfUrl:"/chapter/pdf-preview/72304",authors:[null],corrections:null},{id:"71288",title:"Melatonin as a Food Supplement for Sleep Disorders",doi:"10.5772/intechopen.91410",slug:"melatonin-as-a-food-supplement-for-sleep-disorders",totalDownloads:789,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"N-acetyl-5-methoxytryptamine commonly known as melatonin is a neurohormone produced in the pineal gland as a response to decrease in ambient light and regulates the sleep-wake cycle. Melatonin is a derivative of the amino acid tryptophan and is produced in humans and other mammals. Melatonin supplements are used to treat insomnia and sleep disorders and to adjust sleep schedules due to jet lag. Synthetic melatonin is available as a food supplement in various dosage forms such as pills, granules for oral solution, orodispersible granules, and syrups in order to address patients’ needs. Melatonin is often combined with water-soluble vitamins such as B complex vitamins and minerals like zinc in order to be more effective.",signatures:"Ioulia K. Tseti",downloadPdfUrl:"/chapter/pdf-download/71288",previewPdfUrl:"/chapter/pdf-preview/71288",authors:[null],corrections:null},{id:"71266",title:"Melatonin for a Healthy Heart Rhythm",doi:"10.5772/intechopen.91447",slug:"melatonin-for-a-healthy-heart-rhythm",totalDownloads:998,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Melatonin is a promising cardioprotective agent. Its increase during the night is associated with healthy cardiovascular function. On the other hand, reduced levels of melatonin are related to diseases. Aging and chronodisruptors reduce melatonin levels. Pharmacological supplementation reduces the deleterious effects of cardiovascular risk factors and improves the myocardial response to ischemia/reperfusion injury and other proarrhythmic conditions. The protective mechanisms of melatonin involve its antioxidant properties as well as receptor-mediated actions. Signaling pathways include membrane responses, cytoplasmic modulation of kinases, nuclear receptor interactions, and improvement of mitochondrial functions. This chapter focuses on the electrophysiological and the antiarrhythmic properties of melatonin. The acute and chronic protective mechanisms of melatonin will be analyzed with an emphasis on transmembrane potentials and intercellular communication. An outstanding antifibrillatory effect makes melatonin a novel antiarrhythmic agent worthy of further exploration in the path to clinical applications.",signatures:"Natalia Jorgelina Prado, Margarita Segovia-Roldan, Emiliano Raúl Diez and Esther Pueyo",downloadPdfUrl:"/chapter/pdf-download/71266",previewPdfUrl:"/chapter/pdf-preview/71266",authors:[null],corrections:null},{id:"71070",title:"Per Os Administered Modified-Release Solid Formulations of Melatonin: A Review of the Latest Developments Including the Design of Experiments (DoE) Approach",doi:"10.5772/intechopen.91158",slug:"-em-per-os-em-administered-modified-release-solid-formulations-of-melatonin-a-review-of-the-latest-d",totalDownloads:475,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"The pineal hormone melatonin (MLT) is a derivative of the amino acid L-tryptophan and controls the circadian diurnal rhythm and the seasonal biorhythm. Exogenous administration is aimed at alleviating sleep-related dysfunctions and jet lag, as it decreases sleep-onset latency, increases total sleep time and improves overall sleep quality. Besides these indications, MLT has been shown to have other actions, such as antioxidant, immune enhancement and anticancer. It has also been shown to be useful against cardiovascular, neurological and psychiatric diseases. In the context of this work, a review of the related literature on the modified release of MLT from its per os administered formulations is presented, including the utilization of the design of experiments (DoE) for the selection of the optimal composition of melatonin formulations. The chapter offers an account of the recent advantages on MLT’s solid dosage forms suitable for treating sleep disorders, referring either to its onset or maintenance.",signatures:"Angeliki Siamidi and Yannis Dotsikas",downloadPdfUrl:"/chapter/pdf-download/71070",previewPdfUrl:"/chapter/pdf-preview/71070",authors:[null],corrections:null},{id:"71009",title:"The Release Kinetics of Melatonin from Innovative Dosage Forms: The Role of the Fractal Geometry of the “Vehicle”",doi:"10.5772/intechopen.91155",slug:"the-release-kinetics-of-melatonin-from-innovative-dosage-forms-the-role-of-the-fractal-geometry-of-t",totalDownloads:605,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Melatonin (N-acetyl-5-methoxytryptamine) is an antioxidant active pharmaceutical ingredient with numerous applications as medicine and nutraceutical. Melatonin, a hormone synthesized by the pineal gland, has a significant role in the regulation of the circadian biological clock. The aim of this chapter is to present the conventional solid and liquid forms (i.e., tables, capsules, suspensions, etc.) and the nanoformulations (i.e., liposomes, niosomes, polymeric nanoparticles, chitosomes, calcium alginate beads, etc.) of melatonin and to give special attention to its release kinetics from the pharmaceutical vehicle. These systems have been designed and developed as platforms for the delivery and release of melatonin. In all cases, the controlled release of melatonin is the main goal of its loading into drug delivery platforms. Fractal analysis is a mathematical tool to quantify nature and physical systems’ complexity. These systems have been characterized as fractal objects, due to their fractional dimensions. In this chapter, we are probing the interrelationship between the fractal dimension of pharmaceutical vehicle and the release profile of melatonin. Several examples will be given in order to understand in depth the reason of controlled-release profile of melatonin and its added value for the development of a new medicine and/or nutraceutical.",signatures:"Natassa Pippa and Costas Demetzos",downloadPdfUrl:"/chapter/pdf-download/71009",previewPdfUrl:"/chapter/pdf-preview/71009",authors:[null],corrections:null},{id:"71248",title:"Review of Melatonin in Horticultural Crops",doi:"10.5772/intechopen.90935",slug:"review-of-melatonin-in-horticultural-crops",totalDownloads:1e3,totalCrossrefCites:3,totalDimensionsCites:8,hasAltmetrics:0,abstract:'Melatonin is an indoleamine, abundant in animals and plants, which has the functions of regulating circadian rhythm, improving immunity and anti-aging in animals, and is a good health care product beneficial to human health. Recent studies have shown that melatonin has physiological functions including regulating plant growth, promoting seed germination, controlling root development and delaying leaf senescence. The antioxidant properties of melatonin give it the ability to strengthen plants’ resistance to stress. The comprehensive researches in recent years, involving five aspects of \\"the biosynthetic pathway of melatonin in plants, the melatonin in horticultural crops and its influencing factors, the roles of melatonin in the growth and development of horticultural crops, in the response to stress of horticultural crops, the signal transduction network of melatonin in regulating plant growth and the development and stress resistance,\\" are reviewed in the present paper. The application of melatonin in horticulture production is also discussed, which can provide a theoretical reference for the application of melatonin in horticultural production.',signatures:"Yanyan Yan, Qinghua Shi and Biao Gong",downloadPdfUrl:"/chapter/pdf-download/71248",previewPdfUrl:"/chapter/pdf-preview/71248",authors:[null],corrections:null},{id:"71664",title:"Studies on Tryptophan Metabolites in Patients of Major Monopolar Depression",doi:"10.5772/intechopen.91967",slug:"studies-on-tryptophan-metabolites-in-patients-of-major-monopolar-depression",totalDownloads:742,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Plasma levels of tryptophan metabolites were compared between healthy volunteers and patients of major monopolar depression at various ages and genders. An ultrahigh-speed liquid chromatography/mass spectrometry has been used for analysis. There are significant gender and age differences in TRP metabolites of healthy volunteers. At the upper stream of metabolism, metabolites of young women and old men are higher, but at the lower stream of metabolism, their levels are higher in young men and old women. Such differences disappear in plasma of patients of major monopolar depression except for kynurenine (KYN). Daily variation of blood serotonin (5-HT) levels showed that 5-HT levels were low in the morning and increased toward evening, but blood levels of 5-HT were higher in healthy people than depressive people in the morning and decreased to ward evening. Significant age and gender differences of plasma levels of tryptophan metabolites in healthy volunteers disappear in patients of major monopolar depression. Blood levels of 5-HT were higher in healthy people than depressive patients.",signatures:"Hiroi Tomioka, Junichi Masuda, Akikazu Takada and Akira Iwanami",downloadPdfUrl:"/chapter/pdf-download/71664",previewPdfUrl:"/chapter/pdf-preview/71664",authors:[{id:"248459",title:"Dr.",name:"Akikazu",surname:"Takada",slug:"akikazu-takada",fullName:"Akikazu Takada"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:{id:"11",series:{id:"10",title:"Physiology",issn:"2631-8261",editor:{id:"35854",title:"Prof.",name:"Tomasz",middleName:null,surname:"Brzozowski",slug:"tomasz-brzozowski",fullName:"Tomasz Brzozowski",profilePictureURL:"https://mts.intechopen.com/storage/users/35854/images/system/35854.jpg",biography:"Prof. Dr. Thomas Brzozowski works as a professor of Human Physiology and is currently Chairman at the Department of Physiology and is V-Dean of the Medical Faculty at Jagiellonian University Medical College, Cracow, Poland. His primary area of interest is physiology and pathophysiology of the gastrointestinal (GI) tract, with the major focus on the mechanism of GI mucosal defense, protection, and ulcer healing. He was a postdoctoral NIH fellow at the University of California and the Gastroenterology VA Medical Center, Irvine, Long Beach, CA, USA, and at the Gastroenterology Clinics Erlangen-Nuremberg and Munster in Germany. He has published 290 original articles in some of the most prestigious scientific journals and seven book chapters on the pathophysiology of the GI tract, gastroprotection, ulcer healing, drug therapy of peptic ulcers, hormonal regulation of the gut, and inflammatory bowel disease.",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"Jagiellonian University",institutionURL:null,country:{name:"Poland"}}}}},tags:null},relatedBooks:[{type:"book",id:"6581",title:"Adipose Tissue",subtitle:null,isOpenForSubmission:!1,hash:"85899eab2d8b01653e1297b168c470d7",slug:"adipose-tissue",bookSignature:"Leszek Szablewski",coverURL:"https://cdn.intechopen.com/books/images_new/6581.jpg",editedByType:"Edited by",editors:[{id:"49739",title:"Dr.",name:"Leszek",surname:"Szablewski",slug:"leszek-szablewski",fullName:"Leszek Szablewski"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8797",title:"Adipose Tissue",subtitle:"An Update",isOpenForSubmission:!1,hash:"34880b7b450ef96fa5063c867c028b02",slug:"adipose-tissue-an-update",bookSignature:"Leszek Szablewski",coverURL:"https://cdn.intechopen.com/books/images_new/8797.jpg",editedByType:"Edited by",editors:[{id:"49739",title:"Dr.",name:"Leszek",surname:"Szablewski",slug:"leszek-szablewski",fullName:"Leszek Szablewski"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6246",title:"Salivary Glands",subtitle:"New Approaches in Diagnostics and Treatment",isOpenForSubmission:!1,hash:"de375ecbd9ac673d6464107a0c416763",slug:"salivary-glands-new-approaches-in-diagnostics-and-treatment",bookSignature:"Işıl Adadan Güvenç",coverURL:"https://cdn.intechopen.com/books/images_new/6246.jpg",editedByType:"Edited by",editors:[{id:"36790",title:"M.D.",name:"Işıl",surname:"Adadan Güvenç",slug:"isil-adadan-guvenc",fullName:"Işıl Adadan Güvenç"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7848",title:"Selected Chapters from the Renin-Angiotensin System",subtitle:null,isOpenForSubmission:!1,hash:"38e89685aa86d8cbff0718f3813ae625",slug:"selected-chapters-from-the-renin-angiotensin-system",bookSignature:"Aleksandar Kibel",coverURL:"https://cdn.intechopen.com/books/images_new/7848.jpg",editedByType:"Edited by",editors:[{id:"183303",title:"Dr.",name:"Aleksandar",surname:"Kibel",slug:"aleksandar-kibel",fullName:"Aleksandar Kibel"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7269",title:"Endocrine Disruptors",subtitle:null,isOpenForSubmission:!1,hash:"571f5c496c8b0e8db9043204fa58be2a",slug:"endocrine-disruptors",bookSignature:"Ahmed R. 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Mastitis is an inflammation of the mammary glands. It can affect a segment or the entire mammary gland, one or more glands at the same time. Usually, the milk secretion is found modified, with a yellow-greenish to brown color, with a modified consistency, but there are also cases where the milk secretion is grossly unmodified. The ill bitch presents local signs of illness such as painful hot, red, engorged mammary glands, with or without general signs of disease like depression, anorexia, neglecting puppies, tacky mucous membranes, dehydration, delayed capillary refill time with sepsis, and even
Mastitis has also been reported in
According to the pathogenesis and clinical signs, mastitis in bitches is classified as
A serous milk sample from a bitch suffering from
A mucopurulent milk secretin from a bitch diagnosed with
Subclinical mastitis is diagnosed based on clinical record, physical examination, and milk analysis (pH, cytology, and microbiology, among others). Usually, in subclinical mastitis cases, there is no visible alterations in mammary gland or milk secretion, while milk analysis indicates an alkaline pH and the increased number of somatic cell count (SCC; neutrophils, foamy cells, macrophages) (Figures 3 and 4). Bacteriological examinations are positive [3].
Clinical aspect of a healthy mammary gland.
Milk secretion, from a clinically healthy mammary gland.
In galactostasis cases, there is no sign of infection, but the glandular tissue tends to get distended (Figures 5 and 6), warm, and painful. Small litters and absence of puppies will promote the buildup of a high pressure of milk into the undrained mammary glands, which will allow for the milk pH to become alkaline but will not change the milk chloride levels. Milk cytology will reveal the presence of increased count of eosinophils [3].
Distended mammary glands with galactostasis in a bitch that just weaned. Such glands are predisposed to develop retention mastitis.
Normal milk secretion from the same bitch.
Bitches with
Bitch mastitis diagnostic is performed by laboratory assays such as chloride levels, milk pH [4], and milk cytology [5, 6] alongside microbiology susceptibility testing [7]. Hematology and biochemistry assays such as total solids (TS), total proteins (TP) [8], CRP [3], or haptoglobin (Hp) measurements [4, 9] are also taken into account.
For microbiology analysis, milk samples have to be collected aseptically into sterile vials manually [10], using sterile swabs impregnated with transport medium [7] or directly onto sterilized bacteriological loops [11]. In all cases a first milk drop has to be discarded. Some authors even describe the use of fine needle aspiration technique to collect milk samples [12], but these can be traumatic and painful.
For bacteria isolation and identification, standard microbiology techniques can be employed. Usually, milk is plated onto different media depending on the agent to isolate. For example, blood agar is used for
For the identification of bacterial species, the commercially available biochemical incorporated analytical profile index (API) systems can be used [13]. Additionally, cultural procedures on solid media are performed by 2 days of enrichment in Thioglycollate medium fluid and Trypticase Soy Broth [13].
For the particular case of the isolation of lactobacilli, the procedures consisting in sample culture in aerobic and anaerobic conditions are recommended. The aerobic condition for lactobacilli isolation consists in sample dilution with peptone water and their culture on De Man, Rogosa and Sharpe agar (MRS) plates for 24 h at 37°C in aerobic conditions. The anaerobic condition consists of the same sample culture on MRS supplemented with L-cysteine (0.5 g/L) and (MRS-Cys) agar plates, for 48 h at 37°C in anaerobic conditions (85% nitrogen, 10% hydrogen, 5% carbon dioxide) [10].
Recently, milk strains that are also found in human milk secretions [14] were also isolated from the milk of bitches suffering from both clinical and subclinical mastitis [15]. Along standard microbiology techniques [16], after isolation, bacterial strains were identified by using Vitek2 (bioMérieux, l’Étoile, France) technology, respecting the manufacturer’s guidelines [15]. A total of 57 different strains were isolated, with
No. | Milk bacterial pathogens | Percentage (%) |
---|---|---|
1. | 27.17 | |
2. | 25.00 | |
3. | 9.24 | |
4. | 7.61 | |
5. | 7.07 | |
6. | 5.43 | |
7. | 4.89 | |
8. | 3.80 | |
9. | 3.80 | |
10. | 3.26 | |
11. | 2.72 | |
12. | 2.72 | |
13. | 2.72 | |
14. | 2.72 | |
15. | 2.72 |
Main milk isolates from lactating bitches in the periparturient period [15].
Since they are often isolated from various infection sites,
Also in cases of asymptomatic females,
Nevertheless, some authors suggest that exogenous infections of the mammary glands are rare and mainly are due to endogenous pathogens [20]. This hypothesis would be supported by Martín et al., who described the presence of lactobacilli (
Ascending mammary gland infections can be caused by poor hygiene and/or the exogenous transmission by both skin and oral mucosa bacteria strains of both bitch and the offsprings [24]. This kind of infection is especially frequent in
An adequate management of mammary gland infection is of major importance. Milk samples should be aseptically obtained for cytology analysis and microbial cultures and before initiation of therapy with antibiotics [30]. Subclinical mammary infection can result in postpartum complications (i.e., mortality in pups, antibiotic resistance); for this reason many dog breeders treat bitches before and after parturition with antibiotics to reduce the neonatal mortality risk. But this practice is not recommended since it will predispose to vagina colonization by opportunistic pathogens and will increase antibiotic resistance [25, 27, 31].
After the milk samples are collected for analysis, mastitis treatment may be empirically initiated [2, 24]. However, caution should be taken when selecting the optimal antibiotic. Weak base antibiotics, like trimethoprim-sulfonamide, distribute and get trapped into milk due to the acidic nature of the milk. As milk pH will generally become alkaline due to bacterial infections, macrolides or amoxicillin-clavulanate and cephalosporins may be used before culture results arrive [2, 24]. Irrespective of milk pH, enrofloxacin can be used to start treatment, even in patients that continue to nurse by weighing the pros and cons, regarding puppy cartilage abnormalities [24].
Usually, due to the low volume of milk acquired from bitches, milk pH is evaluated using litmus paper [4]. Healthy bitches have slightly acid pH of about 6.3 similar to that recorded in cows (pH = 6.63) [32]. In terms, animals suffering from
Recent research [15] shows that milk pH value is influenced by the lactation period and each specific type of mastitis.
In the antepartum period, milk pH values ranged between 6 and 7. A total of 75% of tested samples had an acidic milk pH reaction [15].
In the postpartum period, milk pH obtained values ranged between 6 and 8.5. An alkaline milk reaction was obtained in 83% of retention mastitis cases, 80% of mammary congested and subclinical cases of mastitis, respectively, and 75% of
Postpartum | Acidic | Alkaline | Acidic | Alkaline | |
---|---|---|---|---|---|
Healthy | 73% | 73% | |||
75% | 67% | ||||
Mammary congestion | 80% | 80% | |||
Subclinical mastitis | 80% | 81% | |||
Retention mastitis | 83% | 96% |
Milk pH reaction according to the postpartum period (left) and to the mammary gland diagnostic pH reaction (right).
From
Irrespective of the lactation period, an alkaline milk pH reaction was obtained in 96% of retention mastitis cases, 81% of subclinical mastitis cases, 80% of mammary gland congestion cases, and 67% of
For the antepartum period, the normal mean pH value was 6.5, followed by the postpartum period with a mean normal pH value of 6.57 [15].
In the antepartum period for
For
Results show that an alkaline milk pH is prone to be developed in undrained mammary glands, in cases of retention mastitis and pseudopregnancy or in cases of small litters [6], where milk spends more time in the glandular tissue, thus explaining why, in some cases of
Care should be taken whenever one evaluates bitch milk pH reaction, since interpretation of results by litmus paper is very subjective and can be very deceiving to the naked eye. Future research should better adapt to the morphophysiological particularities of the bitch mammary gland in order to obtain irrefutable results whenever one should interpret bitch milk pH reaction [6].
Only few studies focused on bitch milk cytology and only two of them evaluated canine milk cytology in deep [5, 6].
Smears for milk cytology are carried out using squash technique [35]. The squash technique is a procedure used for semisolid, mucus-like, or pelleted by centrifugation cytology specimens. In case of milk analysis, a drop (~20 μL) of milk is plated onto objective glass slide, approximately 1 cm from the frosted end, covered by the second slide, gently but firmly compressed, and the sample is extended over the bottom slide by pulling the top one along the surface. In this way, the sample is redistributed, turning a multicellular mass into a thin monolayer ideal for stain penetration and optical assessment of individual cell morphology by a microscope. Properly prepared smears present a feather-shaped area with a monolayer end referred to as the “sweet spot” [35].
Smears are stained by using the Giemsa [11], Wright-Giemsa [5], Wright-Leishman [12], and Romanowsky-type stains; these last ones are preferred due to easy use and rapid turnaround [35]. Stained smears permit evaluation of different types of inflammatory cells and calculation of their amounts in percent within the smear [11].
For total SCC in milk determination, white blood cell (Unopette—Becton Dickinson) and hemocytometer counting chambers are used [5]. Diff-Quick solution II was recommended to be used in order to differentiate inflammatory milk cells from fat droplets. Total SCC of milk samples are expressed as cells/μL of milk [5].
In milk of healthy bitches, although cytology variations among mammary glands of the same animal are described, commonly somatic cells, accompanied by a high amount of cellular debris, many squamous epithelial cells (Figure 7), few neutrophils, macrophages, erythrocytes, and foamy cells are detected [6]. Polymorphonuclear leukocytes with pyknotic nuclei can be also present [5]. SCC is lower after delivery and increases afterward (mean SCC 2 weeks after delivery, 3 × 106/mL; 3–5 weeks after, <3.8 × 106 mL/L; and 6–8 weeks after delivery, <4.9 × 106/mL) [4]. Milk samples collected from milking bitches present more fat droplets than samples collected from females’ resorbing milk. Usual findings in milk smears from healthy bitches are bacteria, resulting from skin contaminants. However, caution should be taken when bacteria are detected, since if this observation is accompanied by increased SCC, it would indicate infection of mammary gland [5, 36].
Presence of many squamous epithelial cells on a basophilic background (black arrows) (MGG, ×10) [
In dams with
Presence of cellular debris on a basophilic background (red arrow) with variable-sized lipid droplets (black arrow) (MGG, ×40) [
In subclinical mastitis cases, the presence of somatic cells is moderate to high, accompanied by slightly elevated numbers of degenerated neutrophils, many foamy (Figure 9) and epithelial cells along with activated macrophages, bacteria, and phagocytosis. Scattered cellular debris, erythrocytes, and eosinophils can also be encountered [6].
Presence of agglutinated foamy cells on a vacuolar background (black arrows) (MGG, ×100) [
Episodes of galactostasis are characterized by the presence of eosinophils (Figure 10), activated macrophages, foamy cells, and degenerated neutrophils, accompanied by bacteria and phagocytosis. Cellular debris and erythrocytes had also been identified [5, 6].
Presence of eosinophils (red arrow), erythrocytes, and foamy cells (black arrow) with hemosiderin phagocytosis (arrow head) (MGG, ×100) [
Episodes of
Presence of many neutrophils and foamy cells (red arrow) on a basophilic background with discrete lipid droplets (MGG, ×100) [
Presence of foamy cells (red arrow), erythrocytes, and degenerated neutrophils with bacterial phagocytosis (black arrow) on an eosinophilic, vacuolar background (MGG, ×100) [
Presence of cluster-organized round-shaped bacteria (black arrow) on a milk smear from a septic mammary gland (MGG, ×100) [
Presence of erythrocytes (red arrow), cell debris, and many rod-shaped, respectively, round bacteria (black arrow) in a milk sample from a septic mammary gland (MGG, ×100) [
In human medicine, in cases of breast inflammatory lesions due to acute
Experimental inoculation of
Milk cytology can be of help in parasitic disease diagnosis, e.g., nematodes (
Furthermore, milk cytology helps to discriminate between mammary cancer and mastitis cases. While the prognosis is guarded to poor in cancer [44], it is usually good in mastitis, except for gangrenous cases. Thus, it is of high importance to differentiate the two pathologies, and a correct interpretation of mammary or milk cytology will lead to a correct diagnosis [27].
Hematological and biochemical analyses are recommended to evaluate the general health status of the patient and specially to evaluate and monitor the degree of inflammation that can be done by the study of the leukocytes in the hematology and the acute-phase proteins and electrophoretic separation of the proteins in the biochemical profile.
M
Recent data [8] shows that hematology and other blood tests such as packed cell volume (PCV) and TP are not very reliable (p > 0.05) when trying to diagnose or evaluate the mammary gland health status in bitch [8]. However, there are isolated cases of
In the last years, acute-phase proteins (APPs) that can be major such as serum amyloid A (SAA) and C-reactive protein (CRP); moderate such as α1-acid glycoprotein (AGP), fibrinogen (Fb), and haptoglobin (Hp); and negative such as albumin [45] had started to be used to assess and monitor inflammatory diseases in veterinary medicine [46]. Acute-phase proteins are sensitive and non-specific markers of inflammation. They indicate the existence of an inflammatory stimulus [45, 46] and cannot diagnose a specific pathology; thus the final diagnostic should be pronounced according to other laboratory assays (Table 4) and clinical status.
The acute-phase response is induced by any type of tissue injury or infections that stimulate the release of different cytokines from macrophages and monocytes [47] that induce the synthesis of APPs by hepatocytes [46, 47]. In dogs, increases in APPs (SAA, CRP, Hp, Fb, and ceruloplasmin) in response to ovariohysterectomy in both healthy and with pyometra bitches have been reported. In the same sense, altered APP levels in pregnancy and estrus have been described in healthy female dogs [48, 49, 50, 51, 52].
Recently, by using the time-resolved immunofluorometric assay (TR-IFMA) method [53], CRP levels in bitch milk and serum were evaluated [3]. In both clinical and subclinical mastitis (Table 2), CRP milk (0.3–40.0 μg/mL) and serum levels (0.3–162.3 μg/mL) were elevated than levels obtained from milk (0.1–4.9 μg/mL) and serum (2.0–8.6 μg/mL) of healthy bitches. Research shows that milk CRP levels are more specific than blood levels. However, there were no differences detected in this APP between clinical and subclinical cases of mastitis.
Taking into account this novel finding, an increase in milk and serum CRP level reveals the presence of both systemic and local inflammations (mastitis), thus providing a new specific and noninvasive method of diagnosis [3] (Table 3).
Mammary gland diagnostic | Milk CRP levels | Serum CRP levels |
---|---|---|
Healthy | 2.1 (0.1–2.5) | 5.6 (3.9–8.0) |
Subclinical mastitis | 11.3 (2.9–20.7) | 21.9 (8.1–67.9) |
6.5 (2.4–23.7) | 7.1 (8.1–67.9) | |
Mammary retention | 6.3 (3.8–10.9) | 14.6 (4.1–51.8) |
Mammary congestion | 1.7 (0.7–3.7) | 11.4 (8.2–39.0) |
8.0 (7.9–8.0) | 113.4 (112.2–113.4) |
Mean value of milk and serum CRP levels (μg/mL) in bitches suffering from clinical and subclinical mastitis [3].
Hp was also studied in milk of bitches [4]. The Hp peaks on 3–5 days after tissue injury with values between 4 and 9 mg/mL [4, 46, 54]. Hp concentration reflects the intensity of inflammation and is correlated with the degree of tissue damage [52]. Since its concentrations increase two- to threefold in response to injury, Hp in dogs is considered a moderate APP [45, 55]. In serum of healthy dogs, circulating Hp levels range between 0 and 1.69 mg/mL.
In cases of
In ruminants, Hp is considered a major APP and a valuable marker of inflammatory disease [47, 56]. In healthy cows, Hp levels range between 22 and 47 mg/L. During experimental
However, serum Hp level does not always correlate with the intensity of inflammation of mammary glands and could not discriminate the fatal
Based on literature data, it is known that in the course of subclinical infections, the levels of pro-inflammatory cytokines increase. Henceforth, determinations of APPs in slaughter houses are very common as indicators of food safety. Furthermore, mean Hp herd levels were suggested to be related to the hygiene level [54, 60, 61].
Evaluating laboratory assays such as milk and serum CRP, milk microbiology, cytology, and pH proves to be of great help when trying to early diagnose, treat, or even avoid episodes of clinical or subclinical mastitis in bitches (Table 4).
Median CRP μg/mL Milk/serum | Hematology | Cytology | pH | Milk microbiology | |
---|---|---|---|---|---|
Healthy | 2.1/5.6 | — | Few somatic cells and cellular debris | <6.5 | |
Mammary congestion | 1.7/11.4 | — | Increased number of cellular debris | <6.5 | |
Subclinical mastitis | 11.3/21.9 | Leukocytosis with left shift | Increased cell counts | ≥7 | |
Retention mastitis | 6.3/14.6 | Leukocytosis with left shift | Increased cell counts | >7 | |
6.5/7.1 | Leukocytosis with left shift | Increased cell counts | >7 |
Laboratory values of different bitch mastitis diagnostics.
The use of APPs in the diagnostic strategy of mastitis in bitch proves to be of great benefit since it provides a precise, quick, and noninvasive tool of diagnostic. Milk cytology evaluation helps to establish a definitive diagnostic, by characterizing the type of inflammatory response on milk smears.
Milk pH evaluation, alongside milk microbiology and susceptibility tests, helps establish a correct treatment strategy, by choosing the correct type of antibiotic according to its pH asset (acidic/alkaline) and antibiogram susceptibility results.
Mammary infections of bitches are widely overlooked; thus extra care should be taken to adequately revise status of mammary glands during postpartum since bacterial pathogens can migrate from the uterus and vagina to the mammary glands and cause their infection (hematogenous transmission)[39].
Laboratory analysis including determination of milk pH together with performance of biochemistry, hematology, milk cytology, and microbiology tests should be a golden standard for mammary gland infection management in dogs [27]. Taking into account the scarce milk quantities obtained from lactating bitches, further research should be carried out, in order to establish a more applicable method to evaluate bitch milk pH values. Different APP (Hp, SAA, AGP, Fb, etc.) diagnostic potentials should also be assessed, in order to complete the picture that CRP levels started to draw, regarding this novel, noninvasive diagnostic protocol.
The authors would like to express their warmest thanks to Ioana Adriana Matei-Buzura, who had helped with an excellent advice and statistical analyses; to all of our colleagues from Infectious Diseases, Microbiology, Parasitology, Necropsy, Morphopathology, Reproduction and Internal Diseases departments; and, last but not least, to the emergency hospital from the University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania, all who had helped with all the financial, moral, and logistic support.
The authors of this chapter declare that they have no conflict of interest, whatsoever.
My dear family, Cristina, Rebeca, and Filip.
In loving memory of the one we once called mother, our beautiful, kind, and gentle LIVIA.
AGP | α1-acid glycoprotein |
API | analytical profile index |
APPs | acute-phase proteins |
CRP | C-reactive protein |
Fb | fibrinogen |
Hp | haptoglobin |
MGG | May-Grünwald Giemsa |
MRS | De Man, Rogosa and Sharpe agar |
PCV | packed cell volume |
SAA | serum amyloid A |
TP | total proteins |
TR-IFMA | time-resolved immunofluorometric assay |
TS | total solids |
The unfortunate consequences of spinal injury often include paralysis, inability to stand and walk, increased cardiometabolic risks leading to metabolic syndrome, a loss of independence, social isolation, and decreased quality of life [1, 2, 3]. Spinal cord injured patients require a comprehensive multi-disciplinary team, especially during post-hospitalization [1, 2, 4]. The medical fraternity has observed that post-hospitalization, many spinal cord injured patients adopt a physically inactive lifestyle that facilitates various sedentary lifestyle pathologies commonly referred to as non-communicable diseases [5, 6]. Martin Ginis et al. and Hicks et al. encourage spinal cord injured patients to participate in habitual physical activities to combat the onset of non-communicable diseases [7, 8]. Gorgey et al. contended that prolonged sitting is a foremost risk facilitating the early onset of non-communicable diseases and premature death among those with spinal cord injuries [5]. The purpose of this chapter is to describe the role of one therapeutic profession (Biokinetics) involved with the physical and exercise rehabilitation of spinal cord injured patients in a South African context.
Medical treatment begins once the spinal cord injury has been identified by the medical doctors (trauma unit neuro and orthopedic surgeons), when the patient is admitted to an acute care center [9]. At the acute care center, the patient may undergo surgery, if necessary, and in-hospital stay rehabilitation. The acute stage of spinal cord injury falls with the pathogenic paradigm, which involves the illness-care dimension (treatment of the spinal cord injury which has been sustained) and/or illness-prevention dimension (the increased intrinsic risk of other prospective pathologies such as non-communicable diseases) [10]. The medical specialists managing the spinal cord injured patient during the pathogenic paradigm include trauma unit medical practitioners and nurses, neuro-surgeons, and orthopedic surgeons. Post-surgical rehabilitation therapy is offered by physiotherapists in the course of the patient’s hospital stay [10, 11]. The in-hospital physiotherapy of spinal cord injured patients concentrates on regaining motor tasks, such as optimal use of upper limbs, standing (with and without crutches), walking (if possible, with prosthetic devices), the patient being able to transfer him/herself from the bed to the wheelchair and vice versa, selecting the appropriate wheelchair based on the severity of the injury (motorized versus manual wheelchair), and gaining mobility with the wheelchair [2, 12]. The physiotherapist teaches the spinal cord injured patient both bed-bound and non-bed bound exercises to strengthen muscles and regain balance, proprioception, and kinesthesia [13]. The physiotherapy rehabilitation phase can vary from a few days to several weeks [2].
Successful recovery from a spinal cord injury depends on the severity of the injury and the treatment a patient receives in the course of each stage of the management spectrum [9]. The treatment of spinal cord injuries spans from hospitalization to surgical care, and rehabilitation (in-hospital stay and post-hospitalization) strategies [9]. A multidisciplinary medical team for spinal cord injuries usually consists of therapists, such as a physiotherapist (also known as physical therapist), occupational therapist, rehabilitation nurse, medical specialist physician, a dietician, psychologist, and biokineticist [14]. Physicians or general practitioners (GP’s) are recognized as the principal source for referral of spinal cord injured patients for participation in structured physical activity and/or leisure-time physical activity [6]. Gorgey and colleagues stated that the multi-disciplinary team that engages in the care and rehabilitation of spinal cord injured patients needs to comprehend the various benefits of physical activity as an integral part of the rehabilitation strategy [15]. Acute stage medical management of spinal cord injured patients focuses on decreasing additional neurological impairment to the spinal cord, and enhancing recovery and rehabilitation after an injury, commencing as soon as the individual is medically stable [2]. Spinal cord injury is considered to be a long-term neurological impairment, which requires the expertise of multiple healthcare professionals over a prolonged period of time to manage aspects related to this neurological condition [12, 16].
Once the acute and sub-acute treatment (which resides in the pathogenic healthcare paradigm) of spinal cord injury has been completed, the patient then enters the fortogenic healthcare paradigm. In the fortogenic healthcare paradigm, the spinal cord injured individual is considered apparently healthy, without increased risk of pathology, but is attentive to assume a physically active lifestyle to prevent the risk of illness (non-communicable diseases) and prevent a decrease in their quality of life. At this stage, the spinal cord injured patient requires the expertise of an occupational therapist and a biokineticist. The focus of the occupational therapist during spinal cord rehabilitation involves the adaption of the individual to their physical and social environments by reclaiming the abilities that help them to create a significant life [17]. Occupational therapy principally concentrates on the fundamental activities of daily living, home-based activities, and sensory, perceptual, and cognitive exercises [13]. The role of a biokineticist during spinal cord injury rehabilitation will be discussed in the subsequent sections.
The Health Profession Council of South Africa defines Biokinetics as a final-phase functional therapeutic health and wellness profession, concerned with improving the physical and physiological health and wellbeing of patients and apparently healthy individuals through the scientific prescription of personalized physical activity and exercise in the framework of chronic clinical and neuro-musculoskeletal pathologies and performance enhancement in both the pathogenic and fortogenic healthcare paradigms (Figure 1) [18]. Ellapen and Swanepoel contend that Biokinetics has been intermittently involved with health and wellness campaigns aimed at preventing and rehabilitating neuro-musculoskeletal injuries and non-communicable diseases. Biokinetics is an ambassador of the philosophy that
To appreciate the value of a biokineticist as a prominent member of the rehabilitation strategy for a spinal cord injured person, one needs to understand the consequence that physical inactivity has on their lives. It is important for health care professionals, governing bodies, rehabilitation centers, and community organizations to understand what factors constrain and promote physical activity in the SCI population, to be in a better position to support people with SCI in being physically active for life. This sub-section will describe the perils that physically inactive spinal cord injured persons may succumb too.
It is an accepted reality that spinal cord injured persons lead a limited physically active lifestyle as compared to their able-bodied counterparts and are more susceptible to the onset of non-communicable diseases [22, 23, 24]. Approximately 85% of spinal cord injured persons are physically inactive and the additional 15% reported participation in physical activity that is below the threshold where it has meaningful health benefits [25]. The objectives for incorporating a physically active lifestyle into the spinal cord injured person’s rehabilitation strategy is to avert and/or manage the onset of non-communicable diseases and improve the person’s quality of life [1]. Habitual compliance to a structured physical activity and exercise program as part of a spinal cord injured person’s rehabilitation strategy offers the following benefits: reducing the risk of cardiovascular diseases, metabolic syndrome, arthritis, osteoporosis, osteoarthritis, and urinary tract infections [26, 27].
Physical activity has been identified as improving or inhibiting many of the health and well-being complications associated with SCI. For example, physical activity has been proven to reduce levels of perceived musculoskeletal and neuropathic pain [28].
The upsurge of cardiovascular diseases and related co-morbidities such as diabetes mellitus, obesity, and dyslipidemia are significant concerns that are consequences of a physically inactive lifestyle and which many spinal cord injured persons contract [1]. Myers and colleagues have reported that autonomic dysfunction among physically inactive spinal cord injured individuals contributes to fluctuating blood pressure, arrhythmia, and a blunted cardiovascular response to physical activity and exercise, which hinders cardiorespiratory fitness [27].
Many physically inactive spinal cord injured persons have compromised metabolic systems, resulting in a slow basal metabolic rate leading to increased body fat and obesity, increased risk lipid profiles resulting in hypertriglyceridemia, insulin resistance, and impaired glucose tolerance resulting in diabetes mellitus [29].
Both strength and endurance activities contribute to improving overall functional capacity. Moreover, expiratory muscle training exercises help in improving inspiratory muscle function [30].
Prolonged bed rest after a spinal cord injury facilitates muscle fiber atrophy and causes spinal cord injured persons to replace their muscle mass with fat [15]. Jiang and colleagues reported that a sedentary lifestyle is associated with osteoporosis, which increases the risk of fractures, a risk that spinal cord injured persons must safeguard against [31].
Aerobic exercise helps to improve energy levels, decrease fatigue, and manage body weight. It also enhances heart and lung function and improves the body’s ability to use oxygen. Early rehabilitation improves cardiac efficiency [32].
In line with the biopsychosocial model of the International Classification of Functioning Disability and Health (ICFDH), the objective of rehabilitation is to restore “the individual to the highest level of participation, and returning individuals to the life they want as far as their disability will permit” [33].
Physical activity has shown improved psychological wellbeing through enabling experiences such as personal control, responsibility, and risk taking that further post-traumatic progress [34].
A small portion of spinal cord injured individuals forgo a physically inactive lifestyle and are instead physically active, using their wheelchairs as an exercise apparatus [19]. These individuals experience upper limb overuse injuries, which may also curtail physical activity [19, 35]. Common overuse injuries include rotator cuff tendinitis, shoulder impingement, biceps tendinitis, ulnar neuropathy, lateral epicondylitis, carpal tunnel syndrome, and De Quervain’s tenosynovitis [36]. Will and colleagues contend that inefficient wheelchair propulsion biomechanics is the primary culprit of the aforementioned overuse injuries [37]. Van der Scheer and colleagues reported that spinal cord injured wheelchair sports activists who have poor aerobic capacities, tend to adopt inefficient wheelchair propulsion biomechanics when engaged in prolonged endurance activities causing overuse injuries [38]. Sprigle and Will et al. stated that the contributors to poor biomechanical posture among spinal cord injured wheelchair users are drooping/angulated shoulders and forward leaning [37, 39]. The dorsal coronal plane kinematic analyses of the angulated shoulder girdle posture are associated with rotator cuff tendinitis and shoulder impingement [40]. Ellapen and colleagues reported that the angulated shoulder girdle posture is associated with an ineffective static passive locking mechanism of the glenohumeral joint [40]. This ineffective static locking mechanism is a result of scapular depression and downward rotation because of the eccentrically lengthened trapezius and rhomboid muscles, together with a laxed superior glenohumeral capsule [41]. The inefficient kinematic angulated shoulder girdle posture creates an abnormal force-couple relationship asymmetrically elongating the trapezius and the condensing pectoralis minor in the coronal plane [41]. The concentrically contracted pectoralis minor muscles pull in the chest, producing a sunken appearance and posteriorly hyper-flexing the thoracic vertebrae, causing kyphosis. The sagittal plane kinematic analyses indicate a rounded shoulder appearance, reminiscent of pectoralis minor and serratus anterior contractures, and elongated rhomboids. The caudally orientated humeral head is medially rotated, indicating subscapularis and pectoral minor contractures [40, 41]. Collectively, the angulated shoulder appearance diminishes the impingement interval space between the coracoacromial-arch and the humeral head, diminishing the impingement interval spacing, compressing the supraspinatus, sub-acromial bursa, and biceps brachii [40, 41]. The collective biomechanic cascades of these kinematic events describe the pathomechanics of rotator cuff tendinitis, shoulder impingement, sub-acromial bursitis, and biceps tendinopathy [40, 41].
Jordaan describes a biokineticist as a specialized exercise therapist who functions in professional association with other health and medical specialists registered with the Health Professions Council of South Africa [12]. The scientifically based physical-activity prescribed rehabilitation program denotes an explicit and individual-oriented physical-training program based on the individuals’ physical condition status [19]. Final-phase rehabilitation is the point in the rehabilitation process when structured exercise and physical activity constitute the primary therapeutic modality [12]. The collaborative relationships among therapeutic practitioners and medical staff in South Africa are strained due to competition over patients and a lack of understanding and appreciation of each other’s scope of the profession. Physiotherapists have claimed that chiropractors and biokineticists encroach on their scope of the profession [42]. Booysen and colleagues have reported that despite attempts to foster interdisciplinary collaboration among South African medical staff and therapists, there is resistance [43, 44]. Ellapen and colleagues proposed that a better understanding of the scope of expertise of each of the aforementioned professions should be taught at South African universities, which will lead to an appreciation for the specific skill set that each profession offers [42, 44]. Jordaan and colleagues have advocated that medical practitioners, including nurses, physiotherapists, occupational therapists, biokineticists, nutritionists, psychologists, neurologists, or orthopedic surgeons, need to work collaboratively to provide better quality management of spinal injured patients [1]. A multi-disciplinary collaborative clinical team provides the most efficacious healthcare of spinal cord injured patients [1, 45].
A typical biokinetic rehabilitation program will include a general warm-up, progressing into a specific warm-up. Thereafter the patient will perform stretching, moving into a series of strengthening and/or aerobic exercises. The cool-down phase involves stretching of muscles and a gentle aerobic activity to return the heart rate to normal levels.
The biokinetic rehabilitation program will include aerobic exercises to improve cardiorespiratory conditioning. The structured aerobic program will help to effectively mediate glucose metabolism, increase insulin sensitivity, reduce insulin resistance, and collectively prevent the onset of diabetes mellitus. Habitual aerobic exercises also reduce low-density lipoprotein cholesterol (LDL-cholesterol) and triglycerides, which collectively reduce the spinal cord injured person’s cardiometabolic risk for metabolic syndrome and coronary artery diseases.
The stretching component of the biokinetic rehabilitation program will elongate shortened muscles and prevent muscle contractures. The patient will start with static stretching, moving into proprioceptive neuromuscular facilitation (PNF), and finally, dynamic stretching.
Subsequently, the strengthening component of the biokinetic program will strengthen weak muscles. Collectively, the stretching and strengthening exercises will symmetrically ensure a synergistic force-couple relationship that will prevail among all active agonist-antagonist muscles.
Physical rehabilitation programs should incorporate treatments designed to prevent certain complications such as frozen joints, contractures, or bedsores.
Table 1 illustrates a comprehensive rehabilitation plan for a spinal cord injured person for a six-month mesocycle as recommended by Durstine and Moore [46].
Graphic illustration of the various treatment phases and clinical practitioners involved in the different healthcare paradigms in the rehabilitation of spinal cord injured persons.
| Duration: ranging from 20 to 60 minutes depending on person’s fitness status Intensity: ranging from 50 to 80% of the person’s maximum heart rate (HRmax) Frequency: 3–5 days per week |
| 6 months |
| PNF stretching: contract-relax, hold-relax, and/or slow reversal hold-relax performed by biokineticist Static stretching: hold stretch for 20 seconds × 2 repetitions Dynamic stretching Stretch major muscles depending on applicability to person |
| 6 months |
| Intensity: 10–20 repetitions × 2 sets Frequency: 2–4 days per week |
| 6 months |
Comprehensive overview of a spinal cord injured patient’s rehabilitation plan for a six-month mesocycle [46].
All pictures were sourced from the internet.
Table 2 is a general biokinetic rehabilitation program targeting muscle strength and endurance and extensibility.
General strength rehabilitation program for spinal cord injured person.
All pictures were sourced from the internet.
Spinal cord injury requires a multidisciplinary team of medical and paramedical experts to ensure that the person maintains the quality of life post-injury. To this end, biokineticists, as final-phase rehabilitation exercise therapists who can help the spinal cord injured patient prevent the onset of various non-communicable diseases, are fundamental to ensuring success in the strategic approach of the team. A small proportion of spinal cord injured patients continue to live a physically active life but unfortunately succumb to various neuro-musculoskeletal overuse injuries. The intervention of a biokineticist through the prescription of preventative exercise can aid in eliminating these overuse injuries and ensuring the individual enjoys an active and healthy life.
None.
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',metaTitle:"Terms and Conditions",metaDescription:"These terms and conditions outline the rules and regulations for the use of IntechOpen Website at https://intechopen.com and all its subdomains owned by Intech Limited located at 7th floor, 10 Lower Thames Street, London, EC3R 6AF, UK.",metaKeywords:null,canonicalURL:"/page/terms-and-conditions",contentRaw:'[{"type":"htmlEditorComponent","content":"By accessing the website at www.intechopen.com you are agreeing to be bound by these Terms of Service, all applicable laws and regulations, and agree that you are responsible for compliance with any applicable local laws. Use and/or access to this site is based on full agreement and compliance of these Terms. All materials contained on this website are protected by applicable copyright and trademark laws.
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Recent Advances, New Perspectives and Applications",editors:[{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser",profilePictureURL:"https://mts.intechopen.com/storage/users/49813/images/system/49813.png",institutionString:"Tecnalia Research & Innovation",institution:{name:"Tecnalia",institutionURL:null,country:{name:"Spain"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"7723",title:"Artificial Intelligence",subtitle:"Applications in Medicine and Biology",coverURL:"https://cdn.intechopen.com/books/images_new/7723.jpg",slug:"artificial-intelligence-applications-in-medicine-and-biology",publishedDate:"July 31st 2019",editedByType:"Edited by",bookSignature:"Marco Antonio Aceves-Fernandez",hash:"a3852659e727f95c98c740ed98146011",volumeInSeries:1,fullTitle:"Artificial Intelligence - Applications in Medicine and Biology",editors:[{id:"24555",title:"Dr.",name:"Marco Antonio",middleName:null,surname:"Aceves Fernandez",slug:"marco-antonio-aceves-fernandez",fullName:"Marco Antonio Aceves Fernandez",profilePictureURL:"https://mts.intechopen.com/storage/users/24555/images/system/24555.jpg",institutionString:"Universidad Autonoma de Queretaro",institution:{name:"Autonomous University of Queretaro",institutionURL:null,country:{name:"Mexico"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null}]},subseriesFiltersForPublishedBooks:[{group:"subseries",caption:"Computational Neuroscience",value:23,count:1},{group:"subseries",caption:"Evolutionary Computation",value:25,count:1},{group:"subseries",caption:"Machine Learning and Data Mining",value:26,count:3},{group:"subseries",caption:"Applied Intelligence",value:22,count:4}],publicationYearFilters:[{group:"publicationYear",caption:"2022",value:2022,count:2},{group:"publicationYear",caption:"2021",value:2021,count:3},{group:"publicationYear",caption:"2020",value:2020,count:2},{group:"publicationYear",caption:"2019",value:2019,count:2}],authors:{paginationCount:148,paginationItems:[{id:"165328",title:"Dr.",name:"Vahid",middleName:null,surname:"Asadpour",slug:"vahid-asadpour",fullName:"Vahid Asadpour",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/165328/images/system/165328.jpg",biography:"Vahid Asadpour, MS, Ph.D., is currently with the Department of Research and Evaluation, Kaiser Permanente Southern California. He has both an MS and Ph.D. in Biomedical Engineering. He was previously a research scientist at the University of California Los Angeles (UCLA) and visiting professor and researcher at the University of North Dakota. He is currently working in artificial intelligence and its applications in medical signal processing. In addition, he is using digital signal processing in medical imaging and speech processing. Dr. Asadpour has developed brain-computer interfacing algorithms and has published books, book chapters, and several journal and conference papers in this field and other areas of intelligent signal processing. He has also designed medical devices, including a laser Doppler monitoring system.",institutionString:"Kaiser Permanente Southern California",institution:null},{id:"169608",title:"Prof.",name:"Marian",middleName:null,surname:"Găiceanu",slug:"marian-gaiceanu",fullName:"Marian Găiceanu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/169608/images/system/169608.png",biography:"Prof. Dr. Marian Gaiceanu graduated from the Naval and Electrical Engineering Faculty, Dunarea de Jos University of Galati, Romania, in 1997. He received a Ph.D. (Magna Cum Laude) in Electrical Engineering in 2002. Since 2017, Dr. Gaiceanu has been a Ph.D. supervisor for students in Electrical Engineering. He has been employed at Dunarea de Jos University of Galati since 1996, where he is currently a professor. Dr. Gaiceanu is a member of the National Council for Attesting Titles, Diplomas and Certificates, an expert of the Executive Agency for Higher Education, Research Funding, and a member of the Senate of the Dunarea de Jos University of Galati. He has been the head of the Integrated Energy Conversion Systems and Advanced Control of Complex Processes Research Center, Romania, since 2016. He has conducted several projects in power converter systems for electrical drives, power quality, PEM and SOFC fuel cell power converters for utilities, electric vehicles, and marine applications with the Department of Regulation and Control, SIEI S.pA. (2002–2004) and the Polytechnic University of Turin, Italy (2002–2004, 2006–2007). He is a member of the Institute of Electrical and Electronics Engineers (IEEE) and cofounder-member of the IEEE Power Electronics Romanian Chapter. He is a guest editor at Energies and an academic book editor for IntechOpen. He is also a member of the editorial boards of the Journal of Electrical Engineering, Electronics, Control and Computer Science and Sustainability. Dr. Gaiceanu has been General Chairman of the IEEE International Symposium on Electrical and Electronics Engineering in the last six editions.",institutionString:'"Dunarea de Jos" University of Galati',institution:{name:'"Dunarea de Jos" University of Galati',country:{name:"Romania"}}},{id:"4519",title:"Prof.",name:"Jaydip",middleName:null,surname:"Sen",slug:"jaydip-sen",fullName:"Jaydip Sen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/4519/images/system/4519.jpeg",biography:"Jaydip Sen is associated with Praxis Business School, Kolkata, India, as a professor in the Department of Data Science. His research areas include security and privacy issues in computing and communication, intrusion detection systems, machine learning, deep learning, and artificial intelligence in the financial domain. He has more than 200 publications in reputed international journals, refereed conference proceedings, and 20 book chapters in books published by internationally renowned publishing houses, such as Springer, CRC press, IGI Global, etc. Currently, he is serving on the editorial board of the prestigious journal Frontiers in Communications and Networks and in the technical program committees of a number of high-ranked international conferences organized by the IEEE, USA, and the ACM, USA. He has been listed among the top 2% of scientists in the world for the last three consecutive years, 2019 to 2021 as per studies conducted by the Stanford University, USA.",institutionString:"Praxis Business School",institution:null},{id:"320071",title:"Dr.",name:"Sidra",middleName:null,surname:"Mehtab",slug:"sidra-mehtab",fullName:"Sidra Mehtab",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00002v6KHoQAM/Profile_Picture_1584512086360",biography:"Sidra Mehtab has completed her BS with honors in Physics from Calcutta University, India in 2018. She has done MS in Data Science and Analytics from Maulana Abul Kalam Azad University of Technology (MAKAUT), Kolkata, India in 2020. Her research areas include Econometrics, Time Series Analysis, Machine Learning, Deep Learning, Artificial Intelligence, and Computer and Network Security with a particular focus on Cyber Security Analytics. Ms. Mehtab has published seven papers in international conferences and one of her papers has been accepted for publication in a reputable international journal. She has won the best paper awards in two prestigious international conferences – BAICONF 2019, and ICADCML 2021, organized in the Indian Institute of Management, Bangalore, India in December 2019, and SOA University, Bhubaneswar, India in January 2021. Besides, Ms. Mehtab has also published two book chapters in two books. Seven of her book chapters will be published in a volume shortly in 2021 by Cambridge Scholars’ Press, UK. Currently, she is working as the joint editor of two edited volumes on Time Series Analysis and Forecasting to be published in the first half of 2021 by an international house. Currently, she is working as a Data Scientist with an MNC in Delhi, India.",institutionString:"NSHM College of Management and Technology",institution:{name:"Association for Computing Machinery",country:{name:"United States of America"}}},{id:"226240",title:"Dr.",name:"Andri Irfan",middleName:null,surname:"Rifai",slug:"andri-irfan-rifai",fullName:"Andri Irfan Rifai",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226240/images/7412_n.jpg",biography:"Andri IRFAN is a Senior Lecturer of Civil Engineering and Planning. He completed the PhD at the Universitas Indonesia & Universidade do Minho with Sandwich Program Scholarship from the Directorate General of Higher Education and LPDP scholarship. He has been teaching for more than 19 years and much active to applied his knowledge in the project construction in Indonesia. His research interest ranges from pavement management system to advanced data mining techniques for transportation engineering. He has published more than 50 papers in journals and 2 books.",institutionString:null,institution:{name:"Universitas Internasional Batam",country:{name:"Indonesia"}}},{id:"314576",title:"Dr.",name:"Ibai",middleName:null,surname:"Laña",slug:"ibai-lana",fullName:"Ibai Laña",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314576/images/system/314576.jpg",biography:"Dr. Ibai Laña works at TECNALIA as a data analyst. He received his Ph.D. in Artificial Intelligence from the University of the Basque Country (UPV/EHU), Spain, in 2018. He is currently a senior researcher at TECNALIA. His research interests fall within the intersection of intelligent transportation systems, machine learning, traffic data analysis, and data science. He has dealt with urban traffic forecasting problems, applying machine learning models and evolutionary algorithms. He has experience in origin-destination matrix estimation or point of interest and trajectory detection. Working with large volumes of data has given him a good command of big data processing tools and NoSQL databases. He has also been a visiting scholar at the Knowledge Engineering and Discovery Research Institute, Auckland University of Technology.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"314575",title:"Dr.",name:"Jesus",middleName:null,surname:"L. Lobo",slug:"jesus-l.-lobo",fullName:"Jesus L. Lobo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314575/images/system/314575.png",biography:"Dr. Jesús López is currently based in Bilbao (Spain) working at TECNALIA as Artificial Intelligence Research Scientist. In most cases, a project idea or a new research line needs to be investigated to see if it is good enough to take into production or to focus on it. That is exactly what he does, diving into Machine Learning algorithms and technologies to help TECNALIA to decide whether something is great in theory or will actually impact on the product or processes of its projects. So, he is expert at framing experiments, developing hypotheses, and proving whether they’re true or not, in order to investigate fundamental problems with a longer time horizon. He is also able to design and develop PoCs and system prototypes in simulation. He has participated in several national and internacional R&D projects.\n\nAs another relevant part of his everyday research work, he usually publishes his findings in reputed scientific refereed journals and international conferences, occasionally acting as reviewer and Programme Commitee member. Concretely, since 2018 he has published 9 JCR (8 Q1) journal papers, 9 conference papers (e.g. ECML PKDD 2021), and he has co-edited a book. He is also active in popular science writing data science stories for reputed blogs (KDNuggets, TowardsDataScience, Naukas). Besides, he has recently embarked on mentoring programmes as mentor, and has also worked as data science trainer.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"103779",title:"Prof.",name:"Yalcin",middleName:null,surname:"Isler",slug:"yalcin-isler",fullName:"Yalcin Isler",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRyQ8QAK/Profile_Picture_1628834958734",biography:"Yalcin Isler (1971 - Burdur / Turkey) received the B.Sc. degree in the Department of Electrical and Electronics Engineering from Anadolu University, Eskisehir, Turkey, in 1993, the M.Sc. degree from the Department of Electronics and Communication Engineering, Suleyman Demirel University, Isparta, Turkey, in 1996, the Ph.D. degree from the Department of Electrical and Electronics Engineering, Dokuz Eylul University, Izmir, Turkey, in 2009, and the Competence of Associate Professorship from the Turkish Interuniversity Council in 2019.\n\nHe was Lecturer at Burdur Vocational School in Suleyman Demirel University (1993-2000, Burdur / Turkey), Software Engineer (2000-2002, Izmir / Turkey), Research Assistant in Bulent Ecevit University (2002-2003, Zonguldak / Turkey), Research Assistant in Dokuz Eylul University (2003-2010, Izmir / Turkey), Assistant Professor at the Department of Electrical and Electronics Engineering in Bulent Ecevit University (2010-2012, Zonguldak / Turkey), Assistant Professor at the Department of Biomedical Engineering in Izmir Katip Celebi University (2012-2019, Izmir / Turkey). He is an Associate Professor at the Department of Biomedical Engineering at Izmir Katip Celebi University, Izmir / Turkey, since 2019. In addition to academics, he has also founded Islerya Medical and Information Technologies Company, Izmir / Turkey, since 2017.\n\nHis main research interests cover biomedical signal processing, pattern recognition, medical device design, programming, and embedded systems. He has many scientific papers and participated in several projects in these study fields. He was an IEEE Student Member (2009-2011) and IEEE Member (2011-2014) and has been IEEE Senior Member since 2014.",institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",country:{name:"Turkey"}}},{id:"339677",title:"Dr.",name:"Mrinmoy",middleName:null,surname:"Roy",slug:"mrinmoy-roy",fullName:"Mrinmoy Roy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/339677/images/16768_n.jpg",biography:"An accomplished Sales & Marketing professional with 12 years of cross-functional experience in well-known organisations such as CIPLA, LUPIN, GLENMARK, ASTRAZENECA across different segment of Sales & Marketing, International Business, Institutional Business, Product Management, Strategic Marketing of HIV, Oncology, Derma, Respiratory, Anti-Diabetic, Nutraceutical & Stomatological Product Portfolio and Generic as well as Chronic Critical Care Portfolio. A First Class MBA in International Business & Strategic Marketing, B.Pharm, D.Pharm, Google Certified Digital Marketing Professional. Qualified PhD Candidate in Operations and Management with special focus on Artificial Intelligence and Machine Learning adoption, analysis and use in Healthcare, Hospital & Pharma Domain. Seasoned with diverse therapy area of Pharmaceutical Sales & Marketing ranging from generating revenue through generating prescriptions, launching new products, and making them big brands with continuous strategy execution at the Physician and Patients level. Moved from Sales to Marketing and Business Development for 3.5 years in South East Asian Market operating from Manila, Philippines. Came back to India and handled and developed Brands such as Gluconorm, Lupisulin, Supracal, Absolut Woman, Hemozink, Fabiflu (For COVID 19), and many more. In my previous assignment I used to develop and execute strategies on Sales & Marketing, Commercialization & Business Development for Institution and Corporate Hospital Business portfolio of Oncology Therapy Area for AstraZeneca Pharma India Ltd. Being a Research Scholar and Student of ‘Operations Research & Management: Artificial Intelligence’ I published several pioneer research papers and book chapters on the same in Internationally reputed journals and Books indexed in Scopus, Springer and Ei Compendex, Google Scholar etc. Currently, I am launching PGDM Pharmaceutical Management Program in IIHMR Bangalore and spearheading the course curriculum and structure of the same. I am interested in Collaboration for Healthcare Innovation, Pharma AI Innovation, Future trend in Marketing and Management with incubation on Healthcare, Healthcare IT startups, AI-ML Modelling and Healthcare Algorithm based training module development. I am also an affiliated member of the Institute of Management Consultant of India, looking forward to Healthcare, Healthcare IT and Innovation, Pharma and Hospital Management Consulting works.",institutionString:null,institution:{name:"Lovely Professional University",country:{name:"India"}}},{id:"310576",title:"Prof.",name:"Erick Giovani",middleName:null,surname:"Sperandio Nascimento",slug:"erick-giovani-sperandio-nascimento",fullName:"Erick Giovani Sperandio Nascimento",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y00002pDKxDQAW/ProfilePicture%202022-06-20%2019%3A57%3A24.788",biography:"Prof. Erick Sperandio is the Lead Researcher and professor of Artificial Intelligence (AI) at SENAI CIMATEC, Bahia, Brazil, also working with Computational Modeling (CM) and HPC. He holds a PhD in Environmental Engineering in the area of Atmospheric Computational Modeling, a Master in Informatics in the field of Computational Intelligence and Graduated in Computer Science from UFES. He currently coordinates, leads and participates in R&D projects in the areas of AI, computational modeling and supercomputing applied to different areas such as Oil and Gas, Health, Advanced Manufacturing, Renewable Energies and Atmospheric Sciences, advising undergraduate, master's and doctoral students. He is the Lead Researcher at SENAI CIMATEC's Reference Center on Artificial Intelligence. In addition, he is a Certified Instructor and University Ambassador of the NVIDIA Deep Learning Institute (DLI) in the areas of Deep Learning, Computer Vision, Natural Language Processing and Recommender Systems, and Principal Investigator of the NVIDIA/CIMATEC AI Joint Lab, the first in Latin America within the NVIDIA AI Technology Center (NVAITC) worldwide program. He also works as a researcher at the Supercomputing Center for Industrial Innovation (CS2i) and at the SENAI Institute of Innovation for Automation (ISI Automação), both from SENAI CIMATEC. He is a member and vice-coordinator of the Basic Board of Scientific-Technological Advice and Evaluation, in the area of Innovation, of the Foundation for Research Support of the State of Bahia (FAPESB). He serves as Technology Transfer Coordinator and one of the Principal Investigators at the National Applied Research Center in Artificial Intelligence (CPA-IA) of SENAI CIMATEC, focusing on Industry, being one of the six CPA-IA in Brazil approved by MCTI / FAPESP / CGI.br. He also participates as one of the representatives of Brazil in the BRICS Innovation Collaboration Working Group on HPC, ICT and AI. He is the coordinator of the Work Group of the Axis 5 - Workforce and Training - of the Brazilian Strategy for Artificial Intelligence (EBIA), and member of the MCTI/EMBRAPII AI Innovation Network Training Committee. He is the coordinator, by SENAI CIMATEC, of the Artificial Intelligence Reference Network of the State of Bahia (REDE BAH.IA). He leads the working group of experts representing Brazil in the Global Partnership on Artificial Intelligence (GPAI), on the theme \"AI and the Pandemic Response\".",institutionString:"Manufacturing and Technology Integrated Campus – SENAI CIMATEC",institution:null},{id:"1063",title:"Prof.",name:"Constantin",middleName:null,surname:"Volosencu",slug:"constantin-volosencu",fullName:"Constantin Volosencu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1063/images/system/1063.png",biography:"Prof. Dr. Constantin Voloşencu graduated as an engineer from\nPolitehnica University of Timișoara, Romania, where he also\nobtained a doctorate degree. He is currently a full professor in\nthe Department of Automation and Applied Informatics at the\nsame university. Dr. Voloşencu is the author of ten books, seven\nbook chapters, and more than 160 papers published in journals\nand conference proceedings. He has also edited twelve books and\nhas twenty-seven patents to his name. He is a manager of research grants, editor in\nchief and member of international journal editorial boards, a former plenary speaker, a member of scientific committees, and chair at international conferences. His\nresearch is in the fields of control systems, control of electric drives, fuzzy control\nsystems, neural network applications, fault detection and diagnosis, sensor network\napplications, monitoring of distributed parameter systems, and power ultrasound\napplications. He has developed automation equipment for machine tools, spooling\nmachines, high-power ultrasound processes, and more.",institutionString:'"Politechnica" University Timişoara',institution:null},{id:"221364",title:"Dr.",name:"Eneko",middleName:null,surname:"Osaba",slug:"eneko-osaba",fullName:"Eneko Osaba",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/221364/images/system/221364.jpg",biography:"Dr. Eneko Osaba works at TECNALIA as a senior researcher. He obtained his Ph.D. in Artificial Intelligence in 2015. He has participated in more than twenty-five local and European research projects, and in the publication of more than 130 papers. He has performed several stays at universities in the United Kingdom, Italy, and Malta. Dr. Osaba has served as a program committee member in more than forty international conferences and participated in organizing activities in more than ten international conferences. He is a member of the editorial board of the International Journal of Artificial Intelligence, Data in Brief, and Journal of Advanced Transportation. He is also a guest editor for the Journal of Computational Science, Neurocomputing, Swarm, and Evolutionary Computation and IEEE ITS Magazine.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"275829",title:"Dr.",name:"Esther",middleName:null,surname:"Villar-Rodriguez",slug:"esther-villar-rodriguez",fullName:"Esther Villar-Rodriguez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/275829/images/system/275829.jpg",biography:"Dr. Esther Villar obtained a Ph.D. in Information and Communication Technologies from the University of Alcalá, Spain, in 2015. She obtained a degree in Computer Science from the University of Deusto, Spain, in 2010, and an MSc in Computer Languages and Systems from the National University of Distance Education, Spain, in 2012. Her areas of interest and knowledge include natural language processing (NLP), detection of impersonation in social networks, semantic web, and machine learning. Dr. Esther Villar made several contributions at conferences and publishing in various journals in those fields. Currently, she is working within the OPTIMA (Optimization Modeling & Analytics) business of TECNALIA’s ICT Division as a data scientist in projects related to the prediction and optimization of management and industrial processes (resource planning, energy efficiency, etc).",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49813/images/system/49813.png",biography:"Prof. Dr. Javier Del Ser received his first PhD in Telecommunication Engineering (Cum Laude) from the University of Navarra, Spain, in 2006, and a second PhD in Computational Intelligence (Summa Cum Laude) from the University of Alcala, Spain, in 2013. He is currently a principal researcher in data analytics and optimisation at TECNALIA (Spain), a visiting fellow at the Basque Center for Applied Mathematics (BCAM) and a part-time lecturer at the University of the Basque Country (UPV/EHU). His research interests gravitate on the use of descriptive, prescriptive and predictive algorithms for data mining and optimization in a diverse range of application fields such as Energy, Transport, Telecommunications, Health and Industry, among others. In these fields he has published more than 240 articles, co-supervised 8 Ph.D. theses, edited 6 books, coauthored 7 patents and participated/led more than 40 research projects. He is a Senior Member of the IEEE, and a recipient of the Biscay Talent prize for his academic career.",institutionString:"Tecnalia Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"278948",title:"Dr.",name:"Carlos Pedro",middleName:null,surname:"Gonçalves",slug:"carlos-pedro-goncalves",fullName:"Carlos Pedro Gonçalves",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRcmyQAC/Profile_Picture_1564224512145",biography:'Carlos Pedro Gonçalves (PhD) is an Associate Professor at Lusophone University of Humanities and Technologies and a researcher on Complexity Sciences, Quantum Technologies, Artificial Intelligence, Strategic Studies, Studies in Intelligence and Security, FinTech and Financial Risk Modeling. He is also a progammer with programming experience in:\n\nA) Quantum Computing using Qiskit Python module and IBM Quantum Experience Platform, with software developed on the simulation of Quantum Artificial Neural Networks and Quantum Cybersecurity;\n\nB) Artificial Intelligence and Machine learning programming in Python;\n\nC) Artificial Intelligence, Multiagent Systems Modeling and System Dynamics Modeling in Netlogo, with models developed in the areas of Chaos Theory, Econophysics, Artificial Intelligence, Classical and Quantum Complex Systems Science, with the Econophysics models having been cited worldwide and incorporated in PhD programs by different Universities.\n\nReceived an Arctic Code Vault Contributor status by GitHub, due to having developed open source software preserved in the \\"Arctic Code Vault\\" for future generations (https://archiveprogram.github.com/arctic-vault/), with the Strategy Analyzer A.I. module for decision making support (based on his PhD thesis, used in his Classes on Decision Making and in Strategic Intelligence Consulting Activities) and QNeural Python Quantum Neural Network simulator also preserved in the \\"Arctic Code Vault\\", for access to these software modules see: https://github.com/cpgoncalves. 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Currently working as an Assistant Professor in the Department of Mathematics, Institute of Applied Science, Mangalayatan University, Aligarh. She taught so many courses of Mathematics of UG and PG level. Her research Area of Expertise is Functional Analysis & Sequence Spaces. She has been working on Ideal Convergence of double sequence. She has published 17 research papers in National and International Journals including Cogent Mathematics, Filomat, Journal of Intelligent and Fuzzy Systems, Advances in Difference Equations, Journal of Mathematical Analysis, Journal of Mathematical & Computer Science etc. She has also reviewed few research papers for the and international journals. 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Dr. Koprowski has authored more than a hundred research papers with dozens in impact factor (IF) journals and has authored or co-authored six books. Additionally, he is the author of several national and international patents in the field of biomedical devices and imaging. Since 2011, he has been a reviewer of grants and projects (including EU projects) in biomedical engineering.",institutionString:null,institution:{name:"University of Silesia",institutionURL:null,country:{name:"Poland"}}},subseries:[{id:"7",title:"Bioinformatics and Medical Informatics",keywords:"Biomedical Data, Drug Discovery, Clinical Diagnostics, Decoding Human Genome, AI in Personalized Medicine, Disease-prevention Strategies, Big Data Analysis in Medicine",scope:"Bioinformatics aims to help understand the functioning of the mechanisms of living organisms through the construction and use of quantitative tools. The applications of this research cover many related fields, such as biotechnology and medicine, where, for example, Bioinformatics contributes to faster drug design, DNA analysis in forensics, and DNA sequence analysis in the field of personalized medicine. Personalized medicine is a type of medical care in which treatment is customized individually for each patient. Personalized medicine enables more effective therapy, reduces the costs of therapy and clinical trials, and also minimizes the risk of side effects. Nevertheless, advances in personalized medicine would not have been possible without bioinformatics, which can analyze the human genome and other vast amounts of biomedical data, especially in genetics. The rapid growth of information technology enabled the development of new tools to decode human genomes, large-scale studies of genetic variations and medical informatics. The considerable development of technology, including the computing power of computers, is also conducive to the development of bioinformatics, including personalized medicine. In an era of rapidly growing data volumes and ever lower costs of generating, storing and computing data, personalized medicine holds great promises. Modern computational methods used as bioinformatics tools can integrate multi-scale, multi-modal and longitudinal patient data to create even more effective and safer therapy and disease prevention methods. Main aspects of the topic are: Applying bioinformatics in drug discovery and development; Bioinformatics in clinical diagnostics (genetic variants that act as markers for a condition or a disease); Blockchain and Artificial Intelligence/Machine Learning in personalized medicine; Customize disease-prevention strategies in personalized medicine; Big data analysis in personalized medicine; Translating stratification algorithms into clinical practice of personalized medicine.",annualVolume:11403,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/7.jpg",editor:{id:"351533",title:"Dr.",name:"Slawomir",middleName:null,surname:"Wilczynski",fullName:"Slawomir Wilczynski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035U1loQAC/Profile_Picture_1630074514792",institutionString:null,institution:{name:"Medical University of Silesia",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"5886",title:"Dr.",name:"Alexandros",middleName:"T.",surname:"Tzallas",fullName:"Alexandros Tzallas",profilePictureURL:"https://mts.intechopen.com/storage/users/5886/images/system/5886.png",institutionString:"University of Ioannina, Greece & Imperial College London",institution:{name:"University of Ioannina",institutionURL:null,country:{name:"Greece"}}},{id:"257388",title:"Distinguished Prof.",name:"Lulu",middleName:null,surname:"Wang",fullName:"Lulu Wang",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRX6kQAG/Profile_Picture_1630329584194",institutionString:"Shenzhen Technology University",institution:{name:"Shenzhen Technology University",institutionURL:null,country:{name:"China"}}},{id:"225387",title:"Prof.",name:"Reda R.",middleName:"R.",surname:"Gharieb",fullName:"Reda R. Gharieb",profilePictureURL:"https://mts.intechopen.com/storage/users/225387/images/system/225387.jpg",institutionString:"Assiut University",institution:{name:"Assiut University",institutionURL:null,country:{name:"Egypt"}}}]},{id:"8",title:"Bioinspired Technology and Biomechanics",keywords:"Bioinspired Systems, Biomechanics, Assistive Technology, Rehabilitation",scope:'Bioinspired technologies take advantage of understanding the actual biological system to provide solutions to problems in several areas. Recently, bioinspired systems have been successfully employing biomechanics to develop and improve assistive technology and rehabilitation devices. The research topic "Bioinspired Technology and Biomechanics" welcomes studies reporting recent advances in bioinspired technologies that contribute to individuals\' health, inclusion, and rehabilitation. Possible contributions can address (but are not limited to) the following research topics: Bioinspired design and control of exoskeletons, orthoses, and prostheses; Experimental evaluation of the effect of assistive devices (e.g., influence on gait, balance, and neuromuscular system); Bioinspired technologies for rehabilitation, including clinical studies reporting evaluations; Application of neuromuscular and biomechanical models to the development of bioinspired technology.',annualVolume:11404,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",institutionString:null,institution:{name:"Federal University of Uberlândia",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"49517",title:"Prof.",name:"Hitoshi",middleName:null,surname:"Tsunashima",fullName:"Hitoshi Tsunashima",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTP4QAO/Profile_Picture_1625819726528",institutionString:null,institution:{name:"Nihon University",institutionURL:null,country:{name:"Japan"}}},{id:"425354",title:"Dr.",name:"Marcus",middleName:"Fraga",surname:"Vieira",fullName:"Marcus Vieira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003BJSgIQAX/Profile_Picture_1627904687309",institutionString:null,institution:{name:"Universidade Federal de Goiás",institutionURL:null,country:{name:"Brazil"}}},{id:"196746",title:"Dr.",name:"Ramana",middleName:null,surname:"Vinjamuri",fullName:"Ramana Vinjamuri",profilePictureURL:"https://mts.intechopen.com/storage/users/196746/images/system/196746.jpeg",institutionString:"University of Maryland, Baltimore County",institution:{name:"University of Maryland, Baltimore County",institutionURL:null,country:{name:"United States of America"}}}]},{id:"9",title:"Biotechnology - Biosensors, Biomaterials and Tissue Engineering",keywords:"Biotechnology, Biosensors, Biomaterials, Tissue Engineering",scope:"The Biotechnology - Biosensors, Biomaterials and Tissue Engineering topic within the Biomedical Engineering Series aims to rapidly publish contributions on all aspects of biotechnology, biosensors, biomaterial and tissue engineering. We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics can include but are not limited to: Biotechnology such as biotechnological products and process engineering; Biotechnologically relevant enzymes and proteins; Bioenergy and biofuels; Applied genetics and molecular biotechnology; Genomics, transcriptomics, proteomics; Applied microbial and cell physiology; Environmental biotechnology; Methods and protocols. Moreover, topics in biosensor technology, like sensors that incorporate enzymes, antibodies, nucleic acids, whole cells, tissues and organelles, and other biological or biologically inspired components will be considered, and topics exploring transducers, including those based on electrochemical and optical piezoelectric, thermal, magnetic, and micromechanical elements. Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. 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