**1. Introduction**

There are several names for this idealized and highly artificial potential, prominent among them: *The infinite square-well potential*, *the infinite potential* [1–3]. However, it is the phrase *particle in an escape-proof box* that is more likely to be intuitively appealing. Very simply it tells us about a particle moving inside the box as a *free particle* except at the box walls, which are postulated to be impenetrable by definition. The particle in an escape proof box is a sleek, easy-on-the-mathematics model for initiating students into quantum mechanics, with the added advantage that it is one of the few sectors within quantum mechanics where the Schrödinger equation can be solved analytically without resorting to approximation techniques. In the context of this simple potential, students typically find their first very intuitive understanding of the meaning of bound states, boundary conditions, stationary states, and energymomentum quantization. It is even an introduction to quantum tunneling by emphasizing by contrast *why a particle in a box cannot tunnel out of the box!* The infinite square well is then an easy introduction to a more general understanding of the time independent Schrödinger equation for bound states in more sophisticated potentials, *where the quantum tunneling phenomenon is exhibited.* It is easy stepping-stones away from this *first* potential to the more complicated structures, such as the simple harmonic oscillator, which plays a seminal role in quantum field theory. In a clear and present sense, the quantum adventure can fairly be said to begin with this humble but very remarkable particle in an escape-proof box conception. However, *genius in simplicity* is another watchword for this potential. Remarkably, from such simplicity, one is also able to extract an enormous amount of excellent physics. Never mind that there are no actual confining forces in the world that are infinitely strong, physicists successfully deploy the square well potential to model complicated physics all the time, witness the infinite square well potential, which was used by physicist Sommerfeld to model his electron gas theory, where he construed the moving electrons as free particles confined to an escape-proof box. And again, the particle in a box is also deployed to model and investigate a myriad of other complex physical systems – the Hexatriene molecule, among others, as well as in fabricated semiconductor layers. As Cartwright notes, "Of course, this is not a true description of the potentials that are actually produced by the walls and the environment. But is not exactly false either. It is just the way to achieve the results in the model that the walls and environment are supposed to achieve in reality. The infinite potential is a good piece of stage setting." [3] True, the particle in the escape proof-box is by definition a highly contrived and idealized model. Consequently, this important and well-known problem in quantum mechanics will be related to my complex probability paradigm (*CPP*) in order to express it totally deterministically.

In the end, and to conclude, this research work's first chapter is organized as follows: After the introduction in section 1, the purpose and the advantages of the present work are presented in section 2. Afterward, in section 3, the extended Kolmogorov's axioms, and hence, the complex probability paradigm with their origin nal parameters and interpretation, will be explained and summarized. Moreover, in section 4, we will explain briefly the one-dimensional case of the infinite square well problem considered in this work. Additionally, in section 5, the new paradigm will be

related to the particle in a box problem after applying *CPP* to the position wave function; hence, some corresponding simulations will be done, and afterward, the characteristics of this stochastic distribution will be computed in the probabilities sets **R**, **M**, and **C**. Finally, we conclude the work by doing a comprehensive summary in section 6, and then present in section 7 the list of references cited in the current chapter. Furthermore, in the following second chapter, the new paradigm will be related to the particle in a box problem after applying *CPP* to the momentum wave function of the problem; hence, some corresponding simulations will be done, and afterward, the characteristics of this stochastic distribution will be computed in the probabilities sets **R**, **M**, and **C**. Also, in the following chapter, *CPP* will be used to extend and verify Heisenberg uncertainty principle in **R**, **M**, and **C**. In addition, we will calculate and determine the position and the momentum wave functions entropies in **R**, **M**, and **C**.


**8. Cystic pancreatic endocrine neoplasms (CPENs)**

CPENs encompass 8% of all pancreatic cystic tumors and about 15% of pancreatic neuroen‐ docrine tumors [45, 46]. The majority of CPENs are non‐functioning and asymptomatic. These neoplasms usually are diagnosed in elderly patients (sixth–seventh decades) without sex prevalence. They can be associated with multiple endocrine neoplasia types. The diagnosis, generally incidental, is based on imaging examinations (US, MRI, and CT). Cystic mass is usually with hypervascular rim, and in several cases, there is septation or a solid component [45]. The lesions are generally well circumscribed with regular wall around areas of cystic degeneration.

EUS‐guided FNA can reveal low levels of CEA. Immunohistochemical staining for chromog‐ ranine and synaptophysin is present. Malignant potential of CPENs is not clearly defined because it is difficult to detect malignancy on biopsy. The lesions are considered premalignant, and surgical treatment is indicated especially for lesions plus than 2 cm in size. The resective surgery presents excellent results with very long survival (plus than 85% of patient treated) [46]. Observational strategy has been proposed [47] for CPENs based on the similar experience with non‐functioning pancreatic endocrine neoplasms (PENs) [48]. The results of non‐ operative choice are not defined.

### **9. Acute postnecrotic pseudocysts**

the pancreatic ductal system are characteristic of chronic pancreatitis. On the contrary, segmental and marked dilatations of the branch ducts with little calcifications are character‐

SPPNs represent 9% of all cystic pancreatic tumors and have the major incidence in young female patients (second–third decade). SPPNs are a neoplasm of unknown, not well‐defined origin: in fact, in the past, various descriptive names were employed. The macroscopic appearances of SPPNs are large solid masses (8–10 cm in size) and well encapsulated, and often the cut section shows areas of hemorrhage, cystic degeneration, and solid areas. The micro‐ scopic features are polygonal epithelioid cells that form solid pseudopapillary structures alternated hemorrhagic necrotic pseudocyst. There is also evident extensive vascular network, often with infiltrative growth pattern. Alterations in the antigen‐presenting cell/beta‐catenin pathway [42] and vimentine positive can be present. The histologic picture may resemble closely to pancreatic endocrine neoplasms (PEN) but chromogranin is negative. In some cases, histologic criteria of malignancy such as high nuclear grade, venous invasion, and atypical cells may be observed; the metastatic spread is possible (10–15% of cases). SPPNs can be located in all side of the pancreas. Clinical appearances are abdominal pain, palpable mass, nausea/ vomiting, jaundice, and weight loss. The imaging examinations (CT, MRI, and EUS) show a solid and cystic masses with a well‐defined and thick capsule with sometimes peripheral calcifications without septations. EUS‐FNA provides little information. SPPNs can be consid‐ ered lesions with low malignity and rare occurrence of metastasis, usually hepatic (10–15%). The recommended treatment is surgery and the complete resection is often possible (94%); the cure rate reaches 85–95% of patients [6, 44]. The pancreatic resection is based on the location

CPENs encompass 8% of all pancreatic cystic tumors and about 15% of pancreatic neuroen‐ docrine tumors [45, 46]. The majority of CPENs are non‐functioning and asymptomatic. These neoplasms usually are diagnosed in elderly patients (sixth–seventh decades) without sex prevalence. They can be associated with multiple endocrine neoplasia types. The diagnosis, generally incidental, is based on imaging examinations (US, MRI, and CT). Cystic mass is usually with hypervascular rim, and in several cases, there is septation or a solid component [45]. The lesions are generally well circumscribed with regular wall around areas of cystic

EUS‐guided FNA can reveal low levels of CEA. Immunohistochemical staining for chromog‐ ranine and synaptophysin is present. Malignant potential of CPENs is not clearly defined because it is difficult to detect malignancy on biopsy. The lesions are considered premalignant,

**7. Solid pseudopapillary neoplasms (SPPNs)**

istics of IPMNs.

104 Challenges in Pancreatic Pathology

of neoplasm in the gland [43, 44].

degeneration.

**8. Cystic pancreatic endocrine neoplasms (CPENs)**

Pancreatic pseudocysts are inflammatory lesions. They are evolutions and complications of chronic and acute pancreatitis. The etiologies of pancreatitis are various: alcoholic, biliary, or traumatic. The pseudocysts represent about 80% of all cystic lesions of the pancreas. The pseudocyst wall has no epithelial lining unlike the true cysts [49]. Histologically, the pseudo‐ cyst wall consists of fibrosis and inflammatory tissue. Moderate and severe acute pancreatitis are characterized by fluid necrotic collections in or near the pancreas at the beginning without wall. With the flogistic evolution, the fluid necrotic collections are surrounded by granulation and fibrous tissue [50]. Acute postnecrotic pseudocysts are the final evolution of necrotizing pancreatic gatherings, characterized by complete separation of the tissues, with liquid content and a fibrous wall [51]. The incidence of acute pseudocysts is low, at 5–16%. Several clinical imaging and chemistries features can be useful for differential diagnosis between pseudocysts and cystic pancreatic tumors. In the history, there is usually previous pancreatitis; the cystic walls are regular and thin, without calcification: in the 65–70% of cases, there is the commu‐ nication with Wirsung's duct; in the intracystic fluid, CEA, CA19‐9, and mucous cells, on the contrary increased amylase and lipase, are absent. The evolution of a lesion with a fibrous wall and the formation of a pseudocyst can be completed in several weeks and in some cases in a longer period (12–16 weeks). Small cysts (<5–6 cm) can develop for many months without clinical appearance. In some cases, spontaneous improvement until the resolution of the pseudocysts can occur [52].

Diagnosis of acute postnecrotic pseudocysts is greatly facilitated by the history of previous episodes of acute pancreatitis. The imaging examinations (transabdominal US, CT, MRI, and MRCP) are crucial for positive diagnosis (sensitivity of CT is very high 90–100%) [49]. Char‐ acteristic picture on CT is roundish cyst, fluid filled, without septations, and surrounded by a thick wall around the pancreas. EUS can be used for further evaluation but usually do not add other information on CT. EUS‐guided FNA and cyst fluid analysis can demonstrate high amylase concentration.

The size of pseudocysts (plus than 6–7 cm) and the clinical presentation and evolution (lesions symptomatic and/or persistent over many months) can direct the treatment [53].

The choice of therapeutic procedure should be based on the very frequent connection of the acute pseudocysts with pancreatic ducts [53]. The percutaneous US/CT‐guided drainage is usually complicated by pancreatic fistula with persistent leakage from the drain, infection, and repeated changes of the drain [53, 54]. Therefore, the intervention of choice must provide persistent drainage of pancreatic secretion by a cystodigestive anastomosis or fistulas [53].

Another pathological characteristic of acute pseudocysts is the close connections with various adjacent intestinal organs (stomach, duodenum, and small intestine) according to the ana‐ tomical site where the pseudocyst develops [53].

Drainage of the pseudocysts by endoscopic technique has been proposed [55, 56]: this is performed by creating a small opening between the cyst and the stomach. The disadvantage of this techniques is incomplete drainage with recurrence of pseudocysts and infections because the communication can be small and in site not declive [53, 57]. The surgical cystodi‐ gestive anastomosis can employ the more adjacent intestinal organ (stomach or duodenum or small intestine) and can perform cystogastrostomy or cystojejunostomy or cystoduodenosto‐ my [52, 53].

For cysts located in the body or tail of pancreas, the cystojejunostomy or cystogastrostomy is performed depending on the development of the cyst above or under the mesocolon. For pseudocysts located on the head of the pancreas, cystoduodenostomy is usually performed. The same surgical procedures can be performed with a laparoscopic approach with the advantage of the minimal invasiveness [53].


The Robber Crab *Birgus latro* (Linnaeus, 1767)

*Selvaraj Kumaralingam*

#### **Abstract**

The robber or coconut crab *Birgus latro* (Linnaeus, 1767) is a terrestrial hermit crab. It is the largest—land living arthropod in the world. As far as India is concerned, distribution of this crab is restricted to Great Nicobar Island and South Sentinel Island in Andaman and Nicobar Archipelago. The crab divided into a front section (cephalothorax), which has eight legs, and an abdomen. The front-most pair of legs has large chelae (claws), with the left being larger than the right. The next two pairs, as with other hermit crabs, are large, powerful walking legs with pointed tips, which allow coconut crabs to climb vertical or overhanging surfaces.

**Keywords:** *Birgus latro*, Nicobar, India, robber crab

#### **1. Introduction**

The robber or coconut crab (*Birgus latro*; Linnaeus, 1767) is a terrestrial hermit crab. It is the largest—land living arthropod in the world. As far as India is concerned, distribution of this crab is restricted to Great Nicobar Island and South Sentinel Island in Andaman and Nicobar Archipelago. In the Nicobar Islands the species has been reported from Car Nicobar [1], Little Nicobar, Katchal, Camorta and Great Nicobar [2]. The crab separated into a visible section (cephalothorax), which has eight legs, and an abdomen. The next two pairs, as with other hermit crabs, are large, powerful walking legs with pointy tips, which allow coconut crabs to climb vertical or overhanging surfaces. The fourth pair of legs is slighter with tweezer-like chelae at the end, allowing young coconut crabs to grip the inside of a shell or coconut husk to carry for protection; adults use this pair for walking and climbing. The last pair of legs is very small and is used by females to tend their eggs, and by the males in mating. In the present study, the general ecology of coconut crabs in around great Nicobar is focused.

#### **2. Methods**

Coconut crabs are generally "easy to collect" and most often hand picking is very effective in intertidal zones, Crabs can be preserved wet in 6–10% formalin for further study. Field photographs by using the following taxonomic identification keys [3].

#### **3. Results**

#### **3.1 Habitat**

Coconut crabs are viewed as a standout amongst the most earthly decapods; the crab is an all-around adjusted loner crab, it is diurnal and night-time in propensities. Coconut crabs live alone in underground tunnels and shake hole, contingent upon the nearby territory. They delve their very own tunnels in sand or free soil. During the day, the creature remains concealed to diminish water misfortune from warmth. While resting in its tunnel, the coconut crab shuts the passages with one of its hooks to make the clammy microclimate inside the tunnel fundamental for its breathing organs They live solely ashore, coming back to the ocean just to discharge their eggs.

#### **3.2 Size**

This large sized crab grows up to 40 cm long and 22 cm wide (single sighting observed).

#### **3.3 Feeding habit**

Adult coconut crabs feed on fruits, nuts, seeds, and the pith of fallen trees, smaller worms, crustaceans and molluscs. The species is popularly associated with the coconut, and has been widely reported to climb trees to pick coconuts, which it then opens to eat the flesh.

#### **3.4 Behavior**

These Hermit crabs have a series of complex physical movements to communicate with other crabs in different situations. They are active at night which makes it difficult to see slight differences in body motion. They raise a single leg out and above the rest of their body as a warning to keep away.

**23**

**Author details**

archipelago.

Selvaraj Kumaralingam

Andaman and Nicobar Islands, India

provided the original work is properly cited.

Zoological Survey of India, Andaman and Nicobar Regional Centre,

© 2020 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

\*Address all correspondence to<EMAIL_ADDRESS>
*The Robber Crab* Birgus latro *(Linnaeus, 1767) DOI: http://dx.doi.org/10.5772/intechopen.88429*

Coconut crabs are terrestrial animals whose eggs are hatched at sea. The female once her eggs have been fertilized by a male crab, will release her eggs into the sea with a new moon and a spring tide, when the humidity and temperature are right. The number of eggs she releases be a great as 138,000. The species' only dependence on the sea is for releasing eggs, which hatch in contact with seawater; the planktonic larvae then migrate onto land where they develop into long-lived adults [4]. And migrate to the shoreline with other terrestrial hermit crabs. The coconut crab reaches sexual maturity around 5 years after hatching. They reach their maximum

South Sentinel Island and Nicobar Islands in the Bay of Bengal, Central Pacific Ocean, Ryukyu Islands, Coast of Tanzania, Tropics of Cancer and Northern and Southern limits of Capricorn mark, Australia, Madagascar and Mauritius Island.

The population of this crab is dwindling due to habitat loss as a cause of coastal development and exploitation by human for food. Large populations exist on the Cook Islands especially Pukapuka, Suwarrow, Mangaia, Takutea, Mauke, Atiu, and Palmerston Island. The coconut crab *Birgus latro*, characterized as Data Deficient on the IUCN Red List [5], is the largest land crab. In worldwide conservation and management strategies have been put in place such as ban on the capture of eggbearing females and avoid the hunting of non-egg-bearing adults having above carapace length 30 mm. In India the species protected under Schedule I category of Wildlife (Protection) Act, 1972. The Conservation needs of the coconut crab *Birgus latro* on the Nicobar Islands, India [6]. We recommend that more extensive surveys be carried out in all potential coconut crab habitats on the Andaman and Nicobar

**3.5 Lifecycle**

size only after 40–60 years.

**3.6 Distribution**

**4. Discussion**

#### **3.5 Lifecycle**

*Crustacea*

**3. Results**

**3.1 Habitat**

their eggs.

observed).

**3.3 Feeding habit**

**3.4 Behavior**

then opens to eat the flesh.

**3.2 Size**

Coconut crabs are viewed as a standout amongst the most earthly decapods; the crab is an all-around adjusted loner crab, it is diurnal and night-time in propensities. Coconut crabs live alone in underground tunnels and shake hole, contingent upon the nearby territory. They delve their very own tunnels in sand or free soil. During the day, the creature remains concealed to diminish water misfortune from warmth. While resting in its tunnel, the coconut crab shuts the passages with one of its hooks to make the clammy microclimate inside the tunnel fundamental for its breathing organs They live solely ashore, coming back to the ocean just to discharge

This large sized crab grows up to 40 cm long and 22 cm wide (single sighting

Adult coconut crabs feed on fruits, nuts, seeds, and the pith of fallen trees, smaller worms, crustaceans and molluscs. The species is popularly associated with the coconut, and has been widely reported to climb trees to pick coconuts, which it

These Hermit crabs have a series of complex physical movements to communicate with other crabs in different situations. They are active at night which makes it difficult to see slight differences in body motion. They raise a single leg out and

above the rest of their body as a warning to keep away.

**22**

Coconut crabs are terrestrial animals whose eggs are hatched at sea. The female once her eggs have been fertilized by a male crab, will release her eggs into the sea with a new moon and a spring tide, when the humidity and temperature are right. The number of eggs she releases be a great as 138,000. The species' only dependence on the sea is for releasing eggs, which hatch in contact with seawater; the planktonic larvae then migrate onto land where they develop into long-lived adults [4]. And migrate to the shoreline with other terrestrial hermit crabs. The coconut crab reaches sexual maturity around 5 years after hatching. They reach their maximum size only after 40–60 years.

#### **3.6 Distribution**

South Sentinel Island and Nicobar Islands in the Bay of Bengal, Central Pacific Ocean, Ryukyu Islands, Coast of Tanzania, Tropics of Cancer and Northern and Southern limits of Capricorn mark, Australia, Madagascar and Mauritius Island.

## **4. Discussion**

The population of this crab is dwindling due to habitat loss as a cause of coastal development and exploitation by human for food. Large populations exist on the Cook Islands especially Pukapuka, Suwarrow, Mangaia, Takutea, Mauke, Atiu, and Palmerston Island. The coconut crab *Birgus latro*, characterized as Data Deficient on the IUCN Red List [5], is the largest land crab. In worldwide conservation and management strategies have been put in place such as ban on the capture of eggbearing females and avoid the hunting of non-egg-bearing adults having above carapace length 30 mm. In India the species protected under Schedule I category of Wildlife (Protection) Act, 1972. The Conservation needs of the coconut crab *Birgus latro* on the Nicobar Islands, India [6]. We recommend that more extensive surveys be carried out in all potential coconut crab habitats on the Andaman and Nicobar archipelago.

## **Author details**

Selvaraj Kumaralingam Zoological Survey of India, Andaman and Nicobar Regional Centre, Andaman and Nicobar Islands, India

\*Address all correspondence to<EMAIL_ADDRESS>
© 2020 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

#### **References**

[1] Hume AO. Contributions to the ornithology of India: The islands of the Bay of Bengal. Stray Feathers. 1874;**2**:29-324

[2] Daniel A, Premkumar VK. The coconut crab in the Great Nicobar Island. Journal of the Bombay Natural History Society. 1968;**64**:574-580

[3] Alcock A. Catalogue of the Indian Decapod Crustacea in the Collection of the Indian Museum. Kolkata, India: Zoological Survey of India; 1905

[4] Reese BS, Kinzie RA. The larval development of the coconut or robber crab *Birgus latro* (L.) in the laboratory (Anomura, Paguridae). Crustaceana Supplement. 1968;**2**:117-144

[5] Eldredge LG. *Birgus latro*. In: IUCN Red List of Threatened Species v. 2010.4. 1996. Available from: http://www. iucnredlist.org [Accessed: April 19, 2011]

[6] Patankar V, D'souza E. Conservation needs of the coconut crab *Birgus latro* on the Nicobar Islands, India. Oryx. 2012;**46**(2):175-178. DOI: 10.1017/ S0030605311000408

**25**

**Chapter 3**

**Abstract**

Ecology

Scyllarid Lobster Biology and

*Kari L. Lavalli, Ehud Spanier and Jason S. Goldstein*

focus further studies in this important group.

ecology, life history, behavior, fisheries

**1. Introduction**

The family Scyllaridae is the most speciose and diverse of all families of marine lobsters. Slipper lobsters are found in both tropical and temperate habitats with hard or soft substrates and at different depths, and exhibit a wide array of morphological, anatomical, and physiological adaptations. Among the 20 genera and at least 89 species constituting 4 subfamilies, only some members of 4 genera, *Thenus* (Theninae), *Scyllarides* (Arctidinae), *Ibacus* and *Parribacus* (Ibacinae), form significant fisheries because of their large size. While scientific information on these lobsters has increased considerably in recent decades, it is still limited compared with commercially valuable spiny and clawed lobsters, and is confined to a few key species. The present chapter presents the current available knowledge on the biology of scyllarids and attempts to point out where questions remain to help

**Keywords:** slipper lobsters, Scyllaridae, taxonomy, genetics, anatomy, physiology,

Slipper lobsters, family Scyllaridae (Latreille, 1825) have been known and described since the late 1700s and are considered part of the superfamily Palinuroidea that consists of spiny lobsters (Palinuridae), furry lobsters

genera with at least 89 extant species thus far recognized [3–6].

(Synaxidae), blind claw-footed lobsters (Polychelidae), and slipper or shovel-nosed or bulldozer lobsters (Scyllaridae) [1, 2]. The Scyllaridae are organized into four subfamilies (Ibacinae, Arctidiane, Scyllarinae, and Theninae) and comprise 20

Only four genera—*Scyllarides* (Arctidinae), *Ibacus* and *Parribacus* (Ibacinae), and *Thenus* (Theninae)—form any kind of significant fishery because these individual species tend to be large in size [7]. Of these four genera, *Scyllarides* (Gill, 1898) has been studied extensively due to their large adult size, which makes them economically important; their worldwide geographical distribution in tropical and subtropical habitats; and their numerous species (14) [1]. Considerable knowledge is also available for species within the genus *Thenus* because of some relevance in certain fisheries as well as the success in rearing these animals in aquaculture [8]. Research on other species generally arises with overfishing of and a shift away from sister species (generally palinurids) and thus always lags behind exploitation, which is problematic for the creation of sustainable fisheries. Although small in size, lobsters of the genus *Scyllarus* often become a minor target for fisheries (e.g., [9, 10]).

#### **Chapter 3**


**Abstract**

Depression significantly contributes to the disease burden of pregnant women. However, depression is often under diagnosed by health professionals especially in antenatal clinics. This is the situation in Malawi where there is no routine screening for depression in antenatal clinics. Nonetheless, screening can enable the effective management of pregnant women with depression at antenatal clinics. There is therefore a need to integrate screening for depression into routine antenatal services to enhance the early identification of antenatal depression and intervention to improve and maintain the well-being of pregnant women and contribute towards achieving the efforts of the Government of Malawi in scaling up the treatment of depression.

**Keywords:** depression, antenatal, screening, midwives, pregnancy

#### **1. Introduction**

Depression affects pregnant women during all stages of their pregnancy [1]. Currently, there is no reliable comprehensive epidemiological statistics about the prevalence of depressive disorders during pregnancy in Malawi, though one study in a rural district reported prevalence of depression as 10.7% (major depression) and 21.1% (minor depression) [2]. These figures fall within prevalence range of depressive disorders during pregnancy (8.3–41%) reported in sub-Saharan Africa [3] with highest prevalence (47%) registered in rural parts of South Africa [4]. There are numerous risk factors which are linked to antenatal depression. In Malawi, a previous study found that lower social support and intimate partner violence were linked with antenatal depression [2]. Similarly, another study revealed that being single, poverty, stressful life events, unplanned pregnancy, childhood trauma, and intimate partner violence predicted antenatal depression [5].

Evidence indicates that antenatal depression and its associated risk factors may be addressed through psychosocial interventions including screening to reduce burden they may cause on an individual [2, 6]. Depression is often under diagnosed by treating health professionals [7] which leads to poorer prognosis of co-morbid physical health conditions in primary healthcare settings [8]. This is likely to put pressure on the poor resources available in antenatal clinics in low resource settings and add an additional burden to pregnant women themselves. The lack of routine screening can also delay identification and treatment of women who are affected by antenatal depression. Delayed diagnosis and treatment of antenatal depression may lead to the early disruption of mother-infant relationships and prolong distress for a mother [6].

Antenatal depression thus causes adverse effects on the mother, family, and community which necessitate interventions of health professionals. Screening for depression can help in timely detection of pregnant women with depression [9]. Currently, there are many instruments for the screening of antenatal depression that are validated in low resource settings [10–12]. Some of these instruments were not specifically developed for use during pregnancy but have been used in these settings. Nevertheless, screening instruments for depression must be accurate (be sensitive and specific) in identifying individuals who have a condition [sensitivity (Se)] and those without a condition [specificity (Sp)] [13].

Currently, pregnant women are not routinely screened for depression in antenatal clinics in Malawi. However, mental health is integrated in general healthcare system at policy level in Malawi [14], so that people could have increased access to mental health services. This means that pregnant women should also receive mental healthcare at antenatal clinics along with the usual antenatal care as needed. Services at antenatal clinics in Malawi include history taking, physical and laboratory examination, antenatal drugs and vaccines and antenatal education [15]. This is similar to what happens in South Africa where antenatal care generally focuses on physical examinations [16].

Integrating mental health with antenatal care requires midwives to assess and deal with mental health problems affecting pregnant women in antenatal care settings in Malawi. Nonetheless, some policy makers fear that mental health interventions may deter midwives from concentrating on other 'priority' interventions [9]. Furthermore, many general healthcare workers, including midwives, in Malawi are not confident and competent enough deal with mental health problems [17]. Research studies have asserted that midwives may lack skills and confidence in screening and treating antenatal depression [18]. This is corroborated by Mathibe-Neke, Rothberg [19] who asserted that midwives from sub-Saharan Africa are not skilled enough to assess and treat common perinatal mental disorders even though they encounter many pregnant women with psychosocial problems. Nonetheless, there is evidence that nurses and midwives can effectively intervene to reduce depressive symptoms during pregnancy [6].

Dealing with antenatal depression can assist in achieving the 17 Sustainable Development Goals (SDGs), particularly, goal number three which focuses on ensuring healthy lives and promoting well-being for all ages [20]. The government of Malawi is already making efforts to achieve SDG 3 (good health and well-being) through the Essential Health Package (EHP) [21] which includes mental disorders as priority conditions for the first time. The government has gone a step further in the Malawi Health Sector Strategic Plan II 2017–2022 to emphasise the first line treatment of depression for the entire population at community, primary and secondary levels of care [22]. It is estimated that there are 847 767 people who are in need of treatment for depression, and the Government has targeted providing access to treatment for 27 822 people by 2022 [22]. In this regard, the Government of Malawi has prioritised research on mental health in the National Health Research Agenda for Malawi (2012– 2016) to promote the development of innovative and appropriate treatment strategies for mental health problems affecting the population [23].

#### **1.1 Antenatal care**

Antenatal care includes the health assessment of pregnant women, encouraging good health habits, addressing pregnancy related complications and providing

#### *Screening for Antenatal Depression by Midwives in Low Resource Settings in Primary Care… DOI: http://dx.doi.org/10.5772/intechopen.97411*

social and psychological support [24]. The World Health Organisation (WHO) recommends the implementation of new focused antenatal care which consists of a minimum of eight contacts between the pregnant woman and the healthcare providers with their first contact during the first 12 weeks' gestation, then following contacts taking place at 20, 26, 30, 34, 36, 38 and 40 weeks' gestation [25]. Malawi adopted focused antenatal care more than a decade ago [15, 26] with the aim of helping women to maintain normal pregnancies through identification of preexisting health conditions, early detection of complications arising during pregnancy, health promotion, disease prevention, birth preparedness and complication readiness planning [27]. It encourages careful identification of pregnant women with special health conditions or risk factors for complications [28]. As described in literature, detection and treatment of diseases, is one of the essential elements of care during pregnancy [29].

In Malawi midwives are frequently the first health professionals who could identify antenatal depression, or to whom a pregnant woman with antenatal depression or any other common perinatal mental disorders may go to seek for help. The country has low mental health specialists to patients ratios (0.01 psychiatrists per 100 000 and 0.22 psychiatric nurses per 100 000) [30] for more than16 million people. This shows that pregnant women attending antenatal clinics may have limited access to mental health specialists. Despite a gross shortage of mental health specialists in the country, midwives therefore could participate in the detection of pregnant women with depression when providing antenatal care.

#### **1.2 Clinical and public health significance of antenatal depression**

The lancet series on maternal mental health have established the clinical and public health importance of antenatal depression [31–34]. There is evidence that antepartum depression is highly prevalent in low resource settings [31]. Literature show that antenatal depression is associated with increased rates of adverse child outcomes in low resource settings where pregnant women have increased exposure to risk factors for depression [35]. The adverse mental health outcomes for the child include an increased risk of anxiety, depression, attention deficit hyperactivity disorder, and conduct disorder [35]. It is documented that pregnant women with untreated depression have a higher likelihood of obstetric complications, premature deliveries, and low birthweight infants [34].

Antenatal depression and HIV infection form a vicious cycle, whereby the symptoms of each disease worsen the status of the other, and each needs to be sufficiently treated for the pregnant woman to become healthy [32]. It is of public health concern that pregnant women with co-morbidity of depression and HIV infection are less likely to adhere to antiretroviral therapy, which is critical for her survival and prevention of HIV transmission to the child [33]. Stringer, Meltzer-Brody [32] recommended integration depression-screening technique in antenatal services that could identify a large proportion of affected women to break the cycle of depression and HIV infection interaction. It is documented that integrating mental health services into primary care may be the most viable way of closing treatment gap for mental health in low resource settings [31]. An important step in this direction is the incorporation of the capacity to prevent, recognise, and treat depression within antenatal care [36]. This may help to meet the immediate mental health needs of a pregnant woman, ensure better maternal and child outcomes, and contribute towards success of HIV/AIDS services [32].

Integrated antenatal services aimed at identifying and treating women with antenatal depression are needed because antenatal care is typically the first and only time of interaction with the healthcare system for many women in low resource

settings [31]. As such, antenatal care visits provide critically important opportunities for mental health interventions to occur. There is a need to develop protocols for early identification, treatment and preventing the adverse effects of antenatal depression in low resource settings because they do not exist [31]. There is also a need to develop, refine and rigorously evaluate the predictive validity and reliability of instruments for screening of antenatal depression in low resource settings [31].


**Author details**

Hetal Patel\*† and Sandesh Lodha† Maliba Pharmacy College, Uka Tarsadia University, Surat, India

\*Address all correspondence to<EMAIL_ADDRESS>
†These authors contributed equally.

© 2020 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


**3. Organic amendments**

#### **3.1. Animal manure**

by crop residues which suggests the substitution of SOM by fresh SOC derived from crop residues from 3.5 to 5.5 Mg C ha−1 [54]. The use of crop residue as a source of CS and keeping the soil in good quality helps in nutrient management and conservation. In the USA, a total of 367 × 106 Mg year−1 crop residues from 9 cereal crops, 450 × 106 Mg year−1 for 14 cereals and legumes and 488 × 106 Mg year−1 for 21 crops are produced. The amount of total crop residue production in the world is 2802 × 106 Mg year−1 from cereal crops and 3758 × 106 Mg year−1 from 27 food crops which can sequester 40–60% of total agricultural C emissions through

Biological CS is accomplished by microbial activities. Mechanisms of CS by microbes need to be developed based on experiments and field investigations to predict the CS potential and C cycling under potential global change scenarios [56, 57]. Microbes improve the physical, chemical and biological soil properties in RT or NT areas. The evaluation of the soil microbial and biochemical environment greatly in these areas aids predictions of C availability in soil and plants to quantify CS. Where microbial communities are higher, C and N were 1.32–1.82 [58, 59]. Carbon sequestration was recorded higher up to 49.9 g C kg−1 in soils which were rich

The use of cover crops for the maintenance and restoration of SOM and soil productivity is a popular option [61]. Planting cover crops is a promising option to sequester C in cropping systems by the implementation of recommended management practices. The highest CS rate up to 5.3 t C ha−1 yr.−1 is observed by cover cropping of olive orchards, vineyards and almond orchards. Soil CS rate tends to be the highest during the first years after the change of the management and progressively attains equilibrium. Soil CS rates in cover cropping are much higher than that of fields with low or no cover cropping which suggests that the adoption of

Rice-fallow-rice is one of the dominant cropping systems which has received attention to improve SOM by using organic amendments. Understanding the contributions of organic amendments in CS is important for the estimation of CS, their nutrient supply potential and their role in it. In different organic amendments, poultry manure is found to be more efficient in increasing C and other nutrients in soils and microbial activities which contribute to CS in the rice-rice cropping system [63, 64]. Raw adzuki bean (*Vigna angularis* (Willd.) Ohwi and Ohashi) and wheat (*Triticum aestivum* L.) straw residues can supply C into fields by 499 ± 119 kg C ha−1 [65]. The Mekong Delta, Vietnam, produces 21 Mt. of rough rice (*Oryza sativa* L.) and an estimated 24 Mt. of rice straw annually. The spread of these crop residues in this area can increase CS and SOM, significantly reducing GHG emissions [66].

cover cropping is a sustainable and efficient measure to mitigate CC [62].

Crop residue decomposition acceleration can enhance the SOM [67].

their incorporation in the fields [55].

22 Carbon Capture, Utilization and Sequestration

in soil microbes like fungi and soil bacteria [60].

**2.7. Soil biota management**

**2.8. Cover crops**

**2.9. Soil fertility management**

Animal manure is the source of C and the addition of animal manure to different crop fields has impacts on C contents [68]. Different researchers conducted the experiments in Germany to check the soil's C levels. The experiment showed that the annual application rate of 200 Mg ha−1 yr.−1 of manure to the crop field shows a high level of SOM with respect to adjacent fields [69]. Powlson reported that the mean annual SOC sequestration rates of three long-term (>49) years of manure applications ranged from 10 to 22 kg C ha−1 yr.−1 t −1 of dry solids, while SOC sequestration rates with shorter-term experiments (8–25 years of farmyard manure, cattle slurry and boiler litter) were from 30 to 200 kg C ha−1 yr.−1 t −1 of dry solids [70]. The experiment was conducted to improve the soil quality and crop productivity. Improved soil properties refer to better C management. Animal manure also increases the salt concentration of the soil. The long-term application of manure increases the SOM significantly [71]. In another study, the farm yard manure was applied to the rice-wheat cropping system with NPK fertilizers and results showed significantly an increase in C sequestration in farm yard manure-applied plots than NPK-applied plots [72]. The same experiment was conducted on the maize-wheat cropping system, but in this experiment, the farm yard manure is applied with green manure and indicates that green manure sequesters more C [73]. It was also observed that the high application of N has the potential to sequester C almost at the rate of 1.0–1.4 Mg ha−1 yr.−1 [74].

## **3.2. Crop residues**

The researchers investigated that the annual production of crop residues is about 3.4 × 109 tones worldwide. If 15% of the total residue is applied to the soil, it will increase the C contents of soil. The crop residues are the remains of the agricultural crops. The intensive agriculture system increases the crop residue production significantly. This may increase the SOM and soil aggregation and hence C storage [75]. The degradation of crop residue depends upon its composition. For example, it is difficult for microorganisms to start the degradation of the substances which contain a high content of lignin. There three mechanisms, which are classified by different researchers based on the stabilization of SOM, include chemical, biochemical and physical stabilization [76]. Agricultural practices such as the addition of crop residues increase the SOM as well as nutrients contents in the soil by integrated nutrient management [77]. Most studies focus on the fact that the change of crop residue traits has positive effects of the soil CS in organic farming system [78].

#### **3.3. Composting**

Composting is the systematic and controlled breakdown of different types of organic matter including animal manure, woody material and other organic waste. The C content is available in the form of plant uptake in the composting. When the compost matures, 50% of C is available in the form of humic substances [79] and is thought to be more stable practically [80]. In the long-term application of compost, about 8 years or 5 years, a mean 60 kg C ha−1 yr.−1 t −1 of dry solids were monitored [81]. The compost applied in different plots and the soil organic C stock increased significantly compared with the initial stock [82]. It is a win-win condition to increase C storage in the soil as well as plant growth and yield by chemical fertilization. The compost application at the rate of 10 Mg ha−1 yr.−1 results in higher CS. This clear cut indicates that composting not only increases the net primary production but also the C content of the soil [83].

microbial attack and hence when applied to the soil will remain stable for thousands of years

long-term benefits including increase in soil pH [93], increases in crop yield, maintaining the cation exchange capacity, nutrient retention and water-holding capacity. Biochar also reduces the emissions of others greenhouse gases like methane and nitrous oxides [94]. Increased concentration of nitrogen oxides in the atmosphere affects the plant growth by necrosis, slow photosynthetic rate and increased sensitivity of the plants. Gases usually affect the plants by entering them through the stomata of plants [95]. The B has been classified into two classes on the basis of degradation. Class 1 has the potential to store C in soil to about 21.3% and class 2 has potential of about 32.5%. The presence of alkali metals in the B reduces their stability.

the application of B to soil is profitable amendments if the B price is low enough [97]. The response of B at different pH levels was investigated and found that acidic medium emits more carbon dioxide than the alkaline medium. The enhancement of copiotrophic bacteria like gemmatimonadetes and bacteroidetes and the decrease of oligotrophic bacteria increase the C emission in the acidic medium of soil [98]. Biochar-based C management networks have

The studies in China indicate that cultivated and forest soils have the CS potential around 38.5–77 Mt., respectively [107, 108]. The research shows that due to the increase of tempera-

In Belgium in different studies, the C stock was found to be around 319 Mt. and this is due to the increase in mean elevation from Northeast coast to Southeast, and as a result, it leads to a decrease in temperature and an increase in precipitation. Carbon stock is higher in Southeast than Northeast. The C contents in topsoil were found to be 48 t C ha−1 in Luvisols while 113 t

**Strategy Area CS rate (t C ha− 1) Observational time Reference** Organic manure China 0.62 14–40 y [100]

Animal manure Belgium 0.45 20 y [102] Fertilizer plus crop residues Indonesia 0.52 ± 0.16 40 y [103] Inorganic fertilizers South Korea 0.32 ± 0.29 8 y [103] Different crop residues Nigeria 0.24 18 y [104] Crop stubbles Australia 0.19 ± 0.08 — [105] Inorganic fertilizer South Korea 0.32 ± 0.29 8 y [103] Crop residue Nigeria 0.24 18 y [104] Crop stubbles retention Australia 0.19 ± 0.08 4–40 [105, 106]

China 0.62–0.69 03–25 y [101]

the potential to mitigate CC but the quality of B should be appropriate [99] (**Table 2**).

ture from South to North, there is also a decrease of soil organic carbon (SOC) [109].

yr.−1 in soils over long time use [96]. The findings suggest that

Enhancing Carbon Sequestration Using Organic Amendments and Agricultural Practices

[92]. It has

25

http://dx.doi.org/10.5772/intechopen.79336

and thus reduce the release of terrestrial C to the atmosphere in the form of CO2

The B can store 0.55 Pg CO2

C ha−1 in Cambisols soil types [110].

**Table 2.** Different strategies and their carbon sequestration potential.

Organic matter plus in-organic

fertilizer

#### **3.4. Bagasse**

The application of different types of biomass in soil is the best technique to enhance CS in the agricultural sites. The application of bagasse as a biomass in the field showed that bagasse has the potential to sequester C at about 1200–1800 t C year−1 [84]. The application of biochar produced from bagasse is a very authentic organic amendment to soil for retaining its water content [85]. Another study suggested that Bagasse can be converted into B and applied in the soil and it has the potential to sequester C. The porous and high surface area is efficient for the sequestration of C from the atmosphere. Bagasse (B) produced at 600°C showed the most adsorption of C (73.55 mg g−1 at 25°C) [86]. The use of bagasse ash is investigated in an experiment. Different ashes like bagasse and rice husk ash were investigated on wheat soil and the soil organic C content and enzymatic activity were monitored. Bagasse ash increases the soil organic contents at the rate of 525 kg ha−1 y−1 while rice husk ash has no increase of SOM. Bagasse ash increases the soil dehydrogenase and cellulose activity. Long-term investigations are needed to check the effect of ash effects on the soil's physical, chemical and biological properties [87].

#### **3.5. Wood chips**

The world is under threat due to drastic effects of CC, energy access and availability of food. Wood is mostly used as a fuel to cook food and considered as a renewable energy source. Bamboo plantation can sequester C and fix it by producing high biomass. This biomass can be used to generate chips and pellets and as the alternative of fuel; as a result, it can sequester approximately 1.78 kg of C [88]. Another research was conducted and wood chips and straw were applied in the soil and the results showed that nitrogen mineralization and nitrification rates were higher significantly in the soil-applied wood chips. The bad thing is that when we applied wood chips in the soil, nitrogen deficiency occurs and then an additional supplement of nitrogen is required [89]. Carbon contents of early woods are higher than late woods [90]. It is produced from wood-based biomass at a low pyrolysis temperature (400°C) suitable for enhancing the cation exchange capacity, whereas B produced from wood-based biomass at a high pyrolysis temperature (800°C) can enhance nitrate adsorption [85].

#### **3.6. Biochar**

Biochar (B) is usually obtained by the breakdown of crop residues, wood chips, at a low temperature range (350–600°C) in the atmosphere having very little or no oxygen. If the condition remained optimum during the process of B formation including temperature and oxygen, then almost >50% of the C is retained by the B with respect to original biomass [91]. It is resistive to microbial attack and hence when applied to the soil will remain stable for thousands of years and thus reduce the release of terrestrial C to the atmosphere in the form of CO2 [92]. It has long-term benefits including increase in soil pH [93], increases in crop yield, maintaining the cation exchange capacity, nutrient retention and water-holding capacity. Biochar also reduces the emissions of others greenhouse gases like methane and nitrous oxides [94]. Increased concentration of nitrogen oxides in the atmosphere affects the plant growth by necrosis, slow photosynthetic rate and increased sensitivity of the plants. Gases usually affect the plants by entering them through the stomata of plants [95]. The B has been classified into two classes on the basis of degradation. Class 1 has the potential to store C in soil to about 21.3% and class 2 has potential of about 32.5%. The presence of alkali metals in the B reduces their stability. The B can store 0.55 Pg CO2 yr.−1 in soils over long time use [96]. The findings suggest that the application of B to soil is profitable amendments if the B price is low enough [97]. The response of B at different pH levels was investigated and found that acidic medium emits more carbon dioxide than the alkaline medium. The enhancement of copiotrophic bacteria like gemmatimonadetes and bacteroidetes and the decrease of oligotrophic bacteria increase the C emission in the acidic medium of soil [98]. Biochar-based C management networks have the potential to mitigate CC but the quality of B should be appropriate [99] (**Table 2**).

long-term application of compost, about 8 years or 5 years, a mean 60 kg C ha−1 yr.−1 t

**3.4. Bagasse**

24 Carbon Capture, Utilization and Sequestration

biological properties [87].

**3.5. Wood chips**

**3.6. Biochar**

solids were monitored [81]. The compost applied in different plots and the soil organic C stock increased significantly compared with the initial stock [82]. It is a win-win condition to increase C storage in the soil as well as plant growth and yield by chemical fertilization. The compost application at the rate of 10 Mg ha−1 yr.−1 results in higher CS. This clear cut indicates that composting not only increases the net primary production but also the C content of the soil [83].

The application of different types of biomass in soil is the best technique to enhance CS in the agricultural sites. The application of bagasse as a biomass in the field showed that bagasse has the potential to sequester C at about 1200–1800 t C year−1 [84]. The application of biochar produced from bagasse is a very authentic organic amendment to soil for retaining its water content [85]. Another study suggested that Bagasse can be converted into B and applied in the soil and it has the potential to sequester C. The porous and high surface area is efficient for the sequestration of C from the atmosphere. Bagasse (B) produced at 600°C showed the most adsorption of C (73.55 mg g−1 at 25°C) [86]. The use of bagasse ash is investigated in an experiment. Different ashes like bagasse and rice husk ash were investigated on wheat soil and the soil organic C content and enzymatic activity were monitored. Bagasse ash increases the soil organic contents at the rate of 525 kg ha−1 y−1 while rice husk ash has no increase of SOM. Bagasse ash increases the soil dehydrogenase and cellulose activity. Long-term investigations are needed to check the effect of ash effects on the soil's physical, chemical and

The world is under threat due to drastic effects of CC, energy access and availability of food. Wood is mostly used as a fuel to cook food and considered as a renewable energy source. Bamboo plantation can sequester C and fix it by producing high biomass. This biomass can be used to generate chips and pellets and as the alternative of fuel; as a result, it can sequester approximately 1.78 kg of C [88]. Another research was conducted and wood chips and straw were applied in the soil and the results showed that nitrogen mineralization and nitrification rates were higher significantly in the soil-applied wood chips. The bad thing is that when we applied wood chips in the soil, nitrogen deficiency occurs and then an additional supplement of nitrogen is required [89]. Carbon contents of early woods are higher than late woods [90]. It is produced from wood-based biomass at a low pyrolysis temperature (400°C) suitable for enhancing the cation exchange capacity, whereas B produced from wood-based biomass at a

Biochar (B) is usually obtained by the breakdown of crop residues, wood chips, at a low temperature range (350–600°C) in the atmosphere having very little or no oxygen. If the condition remained optimum during the process of B formation including temperature and oxygen, then almost >50% of the C is retained by the B with respect to original biomass [91]. It is resistive to

high pyrolysis temperature (800°C) can enhance nitrate adsorption [85].

−1 of dry

The studies in China indicate that cultivated and forest soils have the CS potential around 38.5–77 Mt., respectively [107, 108]. The research shows that due to the increase of temperature from South to North, there is also a decrease of soil organic carbon (SOC) [109].

In Belgium in different studies, the C stock was found to be around 319 Mt. and this is due to the increase in mean elevation from Northeast coast to Southeast, and as a result, it leads to a decrease in temperature and an increase in precipitation. Carbon stock is higher in Southeast than Northeast. The C contents in topsoil were found to be 48 t C ha−1 in Luvisols while 113 t C ha−1 in Cambisols soil types [110].

**Table 2.** Different strategies and their carbon sequestration potential.

It was found by Indonesian scientists that total SOM was higher if the high clay and silt content was found in soil. The other factors like low pH, rainfall and higher altitude were found responsible for higher soil organic content. The organic content of peatland soil was estimated to be about 33.7 Gt of the 20.9 M ha area of peat soils [111].

ZT zero tillage

N nitrogen

Muhammad Mahroz Hussain

**Author details**

**References**

CoT conventional tillage

SOC soil organic carbon

CA conservation agriculture

\*Address all correspondence to<EMAIL_ADDRESS>
Ecosystems & Environment. 2003;**99**:15-27

potential. Global Change Biology. 2000;**6**:317-327

Springer Netherlands; 2004. pp. 281-295

ronment International. 2005;**31**:575-584

Ecosystems & Environment. 2002;**91**:217-232

Zia Ur Rahman Farooqi, Muhammad Sabir\*, Nukshab Zeeshan, Khurram Naveed and

Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, Pakistan

Enhancing Carbon Sequestration Using Organic Amendments and Agricultural Practices

http://dx.doi.org/10.5772/intechopen.79336

27

[1] Lal R. Soil carbon sequestration to mitigate climate change. Geoderma. 2004;**123**:1-22

[2] Albrecht A, Kandji ST. Carbon sequestration in tropical agroforestry systems. Agriculture,

[3] West TO, Marland G. Net carbon flux from agriculture: Carbon emissions, carbon sequestration, crop yield, and land-use change. Biogeochemistry. 2003;**63**:73-83

[5] Baker JM, Ochsner TE, Venterea RT, Griffis TJ. Tillage and soil carbon sequestration— What do we really know? Agriculture, Ecosystems & Environment. 2007;**118**:1-5

[6] Post WM, Kwon KC. Soil carbon sequestration and land-use change: Processes and

[7] Montagnini F, Nair PKR. Carbon sequestration: An underexploited environmental benefit of agroforestry systems. In: Nair PKR, Rao MR, Buck LE, editors. New Vistas in Agroforestry: A Compendium for 1st World Congress of Agroforestry. Dordrecht:

[8] West TO, Marland G. A synthesis of carbon sequestration, carbon emissions, and net carbon flux in agriculture: Comparing tillage practices in the United States. Agriculture,

[9] Lal R. World crop residues production and implications of its use as a biofuel. Envi-

[4] Schlesinger WH. Carbon sequestration in soils. Science. 1999;**284**:2095

Agricultural land of South Korea is about 174 Mt. (1 m depth) for the storage of carbon. Soil organic carbon stocks in grass and agricultural lands were as large as 88 and 68 t C ha−1, respectively [112].

A study in Nigeria also revealed that 20-60 t ha-1 is found in top 0.3 m soil layer and a total of 118 Mg C ha-1 can be found in the top 1 m. Humid forest zone contains more C than any other zone [113], and the C stock of Australian topsoils was found to be around 25 Gt because of great land mass as well as low temperature [114].


**6.4 Total PSA**

Total PSA should be offered to patients with more than 10 years of life expectancy and in whom the PSA measurement may change the management of the symptoms (AUA 2010). In conjunction with digital rectal examination (DRE), total PSA measurement is the cornerstone of prostatic basic screening. PSA and prostatic volume can be used to evaluate the risks of either needing surgery or developing acute urinary retention.

### **6.5 Uroflowmetry / Peak urinary flow rate**

Uroflowmetry is a simple and noninvasive urodynamic test that allows an objective evaluation of the patient micturition. Even though uroflowmetry is an unspecific evaluation, the micturition graphic may show some recognizable patterns (e.g. meatal stenosis, urethral stricture, BPH) and represent a reproducible way to quantify the strength of the urinary stream. It is a useful preoperative test. Peak urinary flow rate (PFR), or Qmax, appears to predict surgical outcome – patients with a preoperative Qmax > 15 mL/s have poorer outcomes than patients with preoperative Qmax < 15 mL/s do. PFR is an independent predictor for CKD rather than reported LUTS by standardized questionnaires (Hong, Lee et al. 2010). A study conducted by Rule *et* al. in community-dwelling men showed that men with CKD were more likely to have a slow urinary stream (Qmax < 15 mL/s) considering CKD as serum creatinine > 133 μmol/L or as eGFR < 60 mL/min/1,73 m2. (Rule, Jacobson et al. 2005).

Fig. 1. Uroflowmetry. A) Normal patient; B) BPH patient.

Benign Prostate Hyperplasia and Chronic Kidney Disease 363

Manieri *et* al. concluded that bladder wall thickness appeared to be a useful predictor of bladder outlet obstruction, with a value exceeding that of uroflowmetry (Manieri, Carter et al. 1998). However, measurement of bladder wall thickness is currently not part of the recommended diagnostic work-up of patients with LUTS because reliable data on inter- and

Post-void residual urine volume can be measured with sufficient accuracy noninvasively by transabdominal ultrasonography. The measurement variation caused by the method is less than the biologic range of PVR variation (McConnell, Barry et al. 1994). It may also be

It has been well described that large residual urine volumes (>300 mL) affect renal function in advanced BPH (Neal, Styles et al. 1987; Rule, Jacobson et al. 2005). A PVR of more than 100 mL is defined as chronic urinary retention which is significantly associated with CKD in community-dwelling men (Rule, Jacobson et al. 2005). Nevertheless, small residual urine volumes (<100 mL) may also affect renal function as the presence of PVR relates with renal function regardless of the quantity of PVR (Yamasaki, Naganuma et al. 2011). Thus ultrasonographic evaluation of post-void residual is a useful test in the prevention of CKD secondary to BPH. Chronic urinary retention is related with CKD (Rule, Jacobson et al. 2005).

Prostate transrectal ultrasonography (TRUS) is performed to assess prostate size and shape, tissue characterization and occult carcinoma. There is no relationship between prostatic

Fig. 4. Prostate Ultrassound. Prostate transrectal ultrasonography (sagital view).

renal function (Rule, Lieber et al. 2005; Yamasaki, Naganuma et al. 2011).

It is not a routine exam for BPH evaluation. However, cystometry can help to identify high bladder pressure, low bladder compliance and detrusor instability that considerably affects

intra-observer variability, as well as reproducibility, are still lacking.

**6.8 Post-void residual urine evaluation**

**6.9 Prostate TRUS**

**6.10 Cystometry**

measured by invasive methods (catheterization).

enlargement measures and CKD (Rule, Jacobson et al. 2005).

#### **6.6 Renal ultrasonography**

Koch *et* al., performed renal ultrasound scans in a consecutive series of 556 elderly men with LUTS. 14 (2.5%) had hydronephrosis and serum creatinine levels appeared to be correlated with dilatation of the renal pelvis. The authors concluded that renal ultrasound is only indicated in patients with an elevated serum creatinine level and/or post-void residual urine volume (Koch, Ezz el Din et al. 1996). Renal ultrasonography has many advantages over intravenous urography (IVU) for upper urinary tract imaging: simultaneous evaluation of the bladder, post-void residual urine volume and prostate, better characterization of eventual renal masses, no radiation, no side-effects and lower cost.

Fig. 2. Renal Ultrassound. Two ultrasound scans in BPH patient showing bilateral (right and left kidney respectively) ureterohydronephrosis.

#### **6.7 Bladder ultrasonography**

Chronic urinary retention leads to bladder wall thickening with trabeculations via smooth muscle hypertrophy and connective tissue infiltrates (Jones, Gilpin et al. 1991). This can lead in to a decline in bladder compliance with consequent functional or mechanical obstruction at the ureterovesical junction (Sutaria and Staskin 2000). More recently, the measurement of bladder wall thickness by transabdominal ultrasound has gained considerable interest as a noninvasive tool to assess bladder outflow obstruction (Kojima, Inui et al. 1997). Ultrasonic measurement of detrusor wall thickness at the anterior wall of bladders filled with ≥ 250 mL can securely detect bladder outlet obstruction if the value is ≥ 2 mm (Gabuev and Oelke 2011).

Fig. 3. Bladder Ultrassound. Two ultrasound scans in BPH patient. It is possible to observe the trabecullation, bladder wall thickening and diverticulum.

Manieri *et* al. concluded that bladder wall thickness appeared to be a useful predictor of bladder outlet obstruction, with a value exceeding that of uroflowmetry (Manieri, Carter et al. 1998). However, measurement of bladder wall thickness is currently not part of the recommended diagnostic work-up of patients with LUTS because reliable data on inter- and intra-observer variability, as well as reproducibility, are still lacking.


**6. ET systems in Slovenia**

206 Studies on Water Management Issues

removal of dissolved and colloidal pollutants is especially important in case of a discharge into a sensitive recipient and in case of further production of drinking water. Different treatment units can be combined, e.g. coagulation, flocculation and subsequent sedimentation, plant uptake, sorption of dissolved and colloid matter to surfaces, etc. In contrast to sedimentation, the mentioned processes enable higher removal of dissolved and colloidal pollutants. Dissolved and colloidal pollutants are known for its mobile nature in

Fig. 2. An example of revitalization measures in a short segment of a watercourse (source:

Flocculation: Aluminum salts form insoluble aluminium hydroxide flocks Al(OH)3 in bulk water. The flocks have good settling properties and high sorption capacity for phosphate, heavy metals, organic micropollutants and algae (El Samrani et al., 2008). Accordingly, these pollutants are removed by sorption to the flocks in bulk water and subsequent sedimentation in the pond. Besides aluminum also lime and iron salts are used, and calcium

Sediment and media enrichment: Sediment and media in ET can be enriched with minerals that have high sorption capacity for target pollutants. E.g. Ferric iron (Fe(OH)3) binds phosphate and several heavy metals under aerobic conditions (Kadlec & Wallace, 2009). In an aqueous environment, Fe(OH)3 is least soluble at pH between 7 and 10 and provides sorption sites for a number of pollutants. Besides adsorption of pollutants to Fe(OH)3, also insoluble precipitates with iron can be formed, e.g. FePO4 and complexes with metals. Using Fe to adsorb pollutants, it is essential that the redox potential of the media is sufficiently

Sorption filters: One of the possible technologies for upgrading existing ET is an installation of sorption filters after the system. Dissolved and colloidal pollutants as heavy metals and phosphorous are thus removed by sorption to the filter media. However filter clogging and saturation of the media may be of a concern. Elimination of dissolved pollutants like

LIMNOS Ltd.)

and iron, which have similar characteristics.

high to prevent reduction of ferric iron to ferrous iron.

water systems and therefore have the highest risk of causing harmful effects.

The use of ET, as a new, wider concept of understanding of natural treatment systems has started in Slovenia in the late eighties. The idea of ET was introduced in Slovenia first by floating macrophytes and later by subsurface flow TW for water treatment. An experimental period of treating wastewater with plants, mostly as different types of TW followed. During this period experiences were based on certain European researchers such us Kickuth (1984) and Clayton (1988). The basic design was developed in a project started in 1991 in Austria (Perfler & Haberl, 1992) which was modified to select, apply, and compare various options in situ. After 1995, innovative ET were developed for different applications (*e.g.* protection of lakes and watercourses from non-point pollution) based on design and experiences of TW, primarily regarding geographical, demographical and water management characteristics of Slovenia. The introduction of ET was not systematic, since this alternative way of wastewater treatment was not accepted by the government as a state of the art before the nineties. Most installed systems were pilot-systems, destined above all for experimental work. Nevertheless, from 1989 to 2011, several ET systems were installed in Slovenia; 73 TW, 12 sections of river revitalization, 2 VDD, 2 ET for landfill restoration and 1 WSP were constructed in the Karst, coastal, mountain and agricultural lowland regions of Slovenia. The Karst region, covering about 44 % of the surface, is marked by expressive shortage of surface water and soil, and by scattered communities. All this is reflecting in pollution, which is a serious threat for the extremely sensible underground sources of drinking water, based on the complex underground systems with numerous caves (under UNESCO protection). Similar difficulties are recognized also in the coastal region at the Adriatic Sea, where treated wastewaters are discharged into the sea or in its catchment area in the mountain region, which is conserved because of its ecological and scenic values, and in agricultural lowlands characterized by a high contamination with pesticides and other agricultural contaminants. The majority of inhabitants (60 %) live in the settlements with less than 5,000, most of them even 200 to 500 inhabitants, so usually the only way of treatment is the septic tank. Particular problems are tourist centres with large quantities of wastewater in the high seasons. Nowadays, the ET development in Slovenia is mainly focused on the reduction of dispersed pollution, protection of drinking water sources, revitalization of watercourses, and wastewater separation and reuse.

Ecosystem Technologies and Ecoremediation for Water Protection, Treatment and Reuse 209

*Design:* In the period between 2000 and 2003, a pilot SFW and a pilot WSP were constructed at the outlet of wastewater treatment plant (WWTP). The SFW was planted with *Phragmites australis* and *Eichhornia crassipes*, while in the WSP development of algae was spontaneous. *Monitoring:* The systems were monitored under the same operating conditions. The efficiency was evaluated by means of physical and chemical parameters in the inflow and outflow water, by plant productivity and by the analysis of N and P contents in biomass.

*Results and Discussion:* The SFW proved more efficient in the elimination of suspended solids (64.6 %), settleable solids (91.8 %), organic N (59.3 %), total N (38 %), COD (67.2 %) and BOD5 (72.1 %) than the WSP. The WSP was more efficient in the treatment of ammonia nitrogen (48.9 %) and orthophosphate (43.9 %). The difference in treatment efficiency between the systems most probably originates from different primary producers (macrophytes vs. algae) and consequent food webs established. The results of this study provide data of help in optimising combinations of SFW and WSP (Šajn-Slak et. al., 2005).

*Design:* From 1989 to 2011, over 73 TW were constructed in different regions of Slovenia. Most TW are horizontal or/and vertical systems (VF, HSF), operating in combination or integrated in zero foot print unite. Most of them consist of several interconnected beds. Most TW were installed to treat sewage, industrial wastewater, highway run-off, gray water for toilet flushing, drinking water, water from fish farms and landfill leachate. Pre-treatment mostly comprised septic tanks or sedimentation basins. Excavations were sealed with PVC or HDPE membranes, clay or the combination of both. The medium was mostly a mixture of different material (peat, soil, sand, gravel, expended clay), varying in grain size and proportion. The depths of the TW varied from 0.5 to 0.8 m, and the bottom slope from 0 to 3 %. Most systems were between 20 and 1500 m2 in area (Table 1). Theoretical hydraulic loading of media was in each case at least 10-3 m/s. The TW for sewage vary in size with 2- 2.5 m2 per people equivalent on average. Wide adaptability to different environmental conditions, tolerance to stress, high productivity is evident characteristic of *P. australis* that favoured the use of this species in TW. Different parts of reed were used for planting, most frequently clumps. In shallow beds of integrated systems, where the depth was 0.4 m, other species, such as *Juncus effusus, J. inflexus, Carex gracilis, Schoenoplectus lacustris*, and *Thyphoides arundinacea,* were successfully tested. Systems were planted generally in spring

*Monitoring:* The efficiency of TW was monitored by sampling at the inlets and outlets in different periods between 1989 and 2011. TW for landfill leachate were monitored regularly on a long-term basis, from 1992 till 2003, while other systems were monitored monthly for one year or occasionally for one up to 5 years. The efficiency of TWs was evaluated by analyzing suspended and settlements solids, COD, BOD5, total phosphorus and ammonia nitrogen. Grab samples were taken mostly according to the measured retention time and analyzed by independent laboratories. Analyses were done according to Standard Methods (APHA, 2005). At sampling sites, flow, temperature, pH, dissolved oxygen and electric conductivity were measured. More extensive chemical and microbiological analyses were

**6.1.2 Waste stabilization ponds (WSP) / surface flow wetlands (SFW)**

**6.1.3 Treatment wetlands (TW)**

done occasionally.

or autumn when the environmental conditions were optimal.


**Abstract**

African traditional medicine is defined as one of the holistic health care system comprised of three levels of specializations namely divination, spiritualism, and herbalism. The traditional healer provides healing services based on culture, religious background, knowledge, attitudes, and beliefs that are prevalent in his community. Hence the current chapter focuses on the different types of african healing system, traditional healers, traditional practices and modern herbalism and also describes the phytochemical and pharmacological evidences of the traditional african herbs like Acanthus montanus (Acanthaceae), *Amaranthus spinosus* (Amaranthaceae), Bridelia ferruginea (Euphorbiaceae) etc.

**Keywords:** traditional African medicine, traditional healers, divination, spiritualism, and herbalism

### **1. Introduction**

As per World Health Organization (2002), The "Traditional medicine" may be defined as health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose and prevent illnesses or maintain well-being [1].

Africa is one of the heritage continent also known as cradle of human being and the concept of traditional medicine in africa is existed long back with out documentation as a hidden evidence less practices for human beings who have been struggling with various unknown diseases. African people have their own ancestral practices to heal using different methods [2].

According to World Health Organization report more than 80% of the people in Africa depend on traditional medicine for their health care needs (WHO, 2003). The African people have been depending on various plants and animals source for their drug to treat various physical and mental illness. Nearly, 4000 medicinal plants have been documented towards their various Pharmacological activities [3].

Any Traditional medicine consists of medical treatment with an ancient roots that has been passed over generations to maintain health, as well as to prevent, diagnose, improve or treat illnesses. Various cultural and historic conditions have been influenced in the development of traditional medicine. The common basis for any Traditional medicine concept is a holistic healing to maintain life equilibrium between the body, mind and soul with external environment. Even the Traditional African Medicine is not an exception from this universal holistic approach.

Some of the Traditional healing systems and concepts have been supported by huge volume of literature and are in transition towards evidence healing concepts. However

Traditional African Medicine is still has not been documented and under process of documentation as from generations to generations, this was hidden as secret concept of healing. Still to date, in most parts of the africa, the major population have been continue to rely on traditional medicine to meet their primary health care needs [4].

In Africa, Traditional medicine is a healing belief system having its own health and disease concept. This is considered as a hidden treasure or knowledge that will pass from father to his only one beloved son of that family. The various healing concepts in Traditional African medicine (TAM) includes herbalism, surgery, bone setting, spinal manipulation, psychotheraphy, hydrotherapy, occultism, hydrotheraphy etc. However, lack of indepth scientific validation of these african traditional medicine and their documentation is a greatest lacuna and very much attention is required by the modern herbalists to safegaurd this healing concept. In the herbalism, vegetable, animal, and mineral substances have been used. In the metaphysical healing concept, Spirtualism concepts like prayers, invocations, or incantations have been offered to some mysterious and powerful forces in the various belief concept system like exorcism, divination, libation etc., were also been practicing to heal several diseases, how ever, scientific validation and documentation is still challenging [5, 6]. Some of plants used in herbalism by traditional african healers are *Foeniculum vulgare* Mill [7], *Rauvolfia serpentina* Linn [8], *Cinchona pubescens* Vahl [9], *Digitalis purpurea* Linn [10], etc.

#### **1.1 Historical development of African traditional medicine**

As per the Traditional African Medicine, Illness is considered as disorder that having both natural and supernatural causes. This must be treated by both physical and spiritual means, using various procedures like divination, incantations, animal sacrifice, exorcism, and herbs. It is a type of holistic health care system based on three levels of basic principles known as divination, spiritualism, and herbalism. The health care services provided by the healers are based on culture, religious background, knowledge attitudes, and their community beliefs.

The historical Development of African Traditional Medicine consists of two periods/Eras:

#### *1.1.1 Colonial era*

In this era, the traditional medicinal practices have been considered as primitive and backward. Under colonial rule, traditional healers and their practices were not recognized by the scientific world as they were wrongly predicted as witchcraft and black magic. These practices in this era was considered by many nations as an illegal by the colonial authorities. Even in this period, attempts have been made to control the sale of herbal medicines. With the spread of colonaialism and christianity, christian missionaries built private ones and allopathy system of medicine is on widespread to treat various diseases [11].

#### *1.1.2 Modern period*

However, in this era, the modern world showed more interest in some of the medicinal plants that have been using in the african traditional healing systems as a bioprospecting tools towards discovery of drug leads and drugs. Still there are

#### *Traditional African Medicine DOI: http://dx.doi.org/10.5772/intechopen.96576*

many hidden mysteries that need to be learnt from traditional african practices by the modern world. In the writings of Dr. T. Adeoze Lambo, a Nigerian psychiatrist, stated in 1979, always there is a mystery in the african traditional healing concepts especially in the treatment of neurosis [12].


**5. Conclusion**

By taking advantage of the retrospective RP model created, one important challenge was improving the amount of healthy bone preserved compared to that of conventionally performed resections. This means reducing the healthy bone in the resected specimen and leaving a greater volume of healthy bone in the patient, while always maintaining a safe oncological margin. This objective was fulfilled thanks to the 3D control in 3D planning and the 3D control provided by the navigator during the execution of the cut, as it can be observed

Surgical precision, understood as the correspondence between a target osteotomy and an executed osteotomy, is not the only factor to consider when evaluating navigation-assisted surgery. Some complications associated with intraoperative navigation, such as increased procedure time or uncompleted navigation due to technical problems, have shown to decrease as the surgeon team familiarizes with the technology (increasing their total amount of surgeries performed under navigation) [19]. On the contrary, the accuracy level in the registration process appears to be independent of the learning curve and not decreasing with user experience. Local tumor recurrence and non-oncological complications have also been used as

The experiment designed for this chapter shows how 3D printing can be applied to build experimental models, specifically for orthopedical oncology, that can be used for multiple applications. In the first place, these models are useful to test and characterize new surgical technologies such as image-based navigation. In the second place, these models can be used

The potential of 3D printed models as surgical training tools for patient-specific procedures has been evidenced for ENT surgery. In a case report where transtemporal tumor drainage assisted with intraoperative navigation was determined as treatment, the preoperatively planned trajectory to access the tumor was executed under navigation first on a 3D model of the patient's skull and then on the real patient. The mean distance between target trajectory and executed trajectory measured in the 3D model was reduced by 73.66% when measured in the real patient. This probes how 3D printed models are a promising method to increase

3D-printed prototypes are currently gaining accessibility, as 3D printers become more massive and more economical. This manufacturing method is improving both its technical characteristics (such as the speed of printing, resolution and the variety of materials available) and its cost. Therefore, it is reasonable to believe this method can be easily available in clinical practice, turning it into a promising option for the testing of new surgical technologies and procedures.

This work was the first validation experiment of the workflow proposed, which consists of preoperative planning and image-based navigation for orthopedic precision surgery. Subsequent validation and protocolization works have followed this experiment, finally building a routine that is implemented on a weekly basis at the department of computer-assisted surgery at our hospital (Unidad de Cirugía Asistida por Computadora, Hospital Italiano de Buenos

parameters to evaluate the benefits of navigation-assisted surgery [20].

by the surgeons for training on particular procedures.

accuracy in surgeries assisted with navigation [21].

Aires) [22].

in the RP model with colors.

182 3D Printing

The ability to combine different emerging technologies gives important solutions in the field of surgery planning and preoperative surgical design. The 3D prototype as a way of reproducing a surgery is a training model for surgeons interested in knowing the behavior of 3D planning and its reproduction through the navigation of osteotomies in orthopedic oncology. It is possible, in this way, to test surgeries from RP models manufactured from real cases. This method stands out as it is easy to implement and to understand, as well as technically simple and economical.

Likewise, other benefits of this conglomerate of technologies include multiplanar or difficult osteotomies in limb deformities, pre-cast in osteosynthesis plates using the RP models as a guide mold, controlling oncological margins to avoid errors of cut in real surgery and, above all, save surgical time with its cascade of beneficial effects for the surgeon and the patient.

In our hospital department, we were able to adopt computer-assisted surgery for oncologic orthopedics as a standard routine. This includes weekly meetings of specialized medical professionals who perform the preoperative planning for challenging surgical cases, which are then executed intraoperatively under navigation guidance. More than 250 patients have been treated to date following this working protocol, since its introduction 8 years ago. This is an example of how new technologies developed in silico can rapidly reach health care activities.


**2.4 Study of the immune response against the EBV using EBV BACs**

There are three recombinant wild-type EBVs that have been generated so far (Delecluse, Hilsendegen et al. 1998; Kanda, Yajima et al. 2004; Chen, Divisconte et al. 2005). They were generated by the insertion of the prokaryotic F-plasmid (F-factor) in two B95.8 or one Akata strains. Although the insertion sites differ in these three EBV BACs, at the site of the B95.8 deletion (Delecluse, Hilsendegen et al. 1998), or at the major internal repeat region of the B95.5 strain (Chen, Divisconte et al. 2005), or at BXLF1 open reading frame (ORF) in Akata strain (Kanda, Yajima et al. 2004), the insertion site of the F-plasmid does not affect the phenotype of the virus.


**6. Conclusion**

NDFD. Moreover, they found that the inoculation of four corn silage hybrids with a combination of *L. buchneri* and *L. paracasei tolerans* enhanced NDFD by 7% [112, 113]. Several studies have confirmed that esterase enzymes can complement the effects of cellulose and hemicellulase enzymes on plant cell walls, thereby increasing DM or fiber digestibility [114]. Conversely, some studies have reported no effect from adding ferulic acid esterase-producing inoculant on fiber digestibility of silage [115]. Kang et al. reported an enhancement in fiber digestibility when corn hybrids were treated by a third-generation inoculant [116]. The author suggested these effects to the properties of the forage to which they are applied. Other studies have reported improvements in digestibility and steers performance fed barley silage treated with

There is increasing interest in using exogenous enzymes as a cost-effective method for improving animal productivity. The main enzyme products marketed for livestock are derived mainly from only four bacterial (*Bacillus subtilis*, *L. acidophilus*, *L. plantarum*, and *Streptococcus faecium*) and three fungal (*A. oryzae*, *T. reesei*, and *Saccharomyces cerevisiae*) species. Other fungal species, including *Humicola insolens* and *Thermomyces lanuginosus*, are being marketed to a lesser extent [119]. Several studies have confirmed that the addition of enzymes to feeds can

DMI (kg/day) 7.13 7.05 0.40 Average daily gain (kg) 1.43 1.41 0.70 Gain: feed DM ratio 0.20 0.20 0.65

DMI (kg/day) 7.6 7.1 0.02 Average daily gain (kg) 1.29 1.31 065 Gain: feed DM ratio 0.17 0.19 0.02

**Table 5.** Effects of silage inoculants on feedlot steers performance fed whole-crop barley silage diets inoculated or

Exogenous feed enzymes with fibrolytic activities have been reported to enhance fiber digestion in the rumen [121, 122]. Most of the commercial products that have been investigated in dairy cows have had cellulases and xylanases activates, with proteases and amylases being tested in a minor number of studies. **Table 5** showed some studies that have been performed in dairy cows fed TMR supplemented with enzymes that were characterized by cellulase and/ or xylanase activities. It appeared that the preparations of the current enzyme do not introduce novel enzyme activity into the rumen as they finally increase only the rate and not the extent of digestion of the cell wall [123, 124]. Beauchemin et al. reported that DMI would increase by

*Uninoculated Inoculated P-value*

a third-generation inoculant (**Table 2**) [117, 118].

136 Advances in Silage Production and Utilization

**5.5. Using enzymes to enhance fiber utilization**

increase DMI and fiber digestibility [120].

uninoculated using first and third generation.

*First generation*

*Third generation*

Silage contains a high content of neutral detergent fiber. Even under optimum conditions, NDF digestibility in the rumen is frequently less than 50%. Improving ruminal fiber degradability could allow cattle to consume more feed and hence increase milk yield. Selecting forage with higher NDFD could be a practical approach to increasing digestible carbohydrate and feed intake in dairy cattle. Ferulic acid-producing bacteria that are targeted at breaking the bonds between ferulic acid and hemicellulose could be the key to increasing fiber digestibility in ruminants. Addition of enzymes to feeds would increase NDFD. However, responses to feed enzymes are expected to be greatest in situations where digestible energy is the first limiting nutrient in the diet.

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Maximizing Fiber Utilization of Silage in Ruminants

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