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He was an awardee of MEXT and JASSO fellowships (from the Japanese\r\nGovernment) during Ph.D. and Postdoc studies, respectively. He also did a Postdoc as\r\na Canadian Queen Elizabeth Advance Scholar at Simon Fraser University (Canada) in\r\nthe field of Mechatronic Systems Engineering. He worked for Kyushu University\r\nInternational Institute for Carbon-Neutral Energy Research (WPI-I2CNER) for two years.\r\nCurrently, he is working on 4 research projects funded by the Higher Education\r\nCommission (HEC) of Pakistan. He has completed six projects in past in the field of\r\nagricultural engineering. He has supervised 10+ M.Eng. and Ph.D. thesis and 10+\r\nstudents are currently working under his supervision. He has published 120+ journal\r\narticles, 100+ conference articles, 13 book chapters, and 6 books. 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1. Introduction
An anastomosis is a surgical connection between two structures. It usually means a connection that is created between tubular structures, such as blood vessels or loops of the intestine. Surgeons can choose to join together the two parts of the intestine by using either sewing (sutures) or staples. Sewing by hand has been used successfully for over 100 years. However, stapling takes less time to perform. As with any intervention, anastomosis carries some risks. These include blood clots, bleeding, scarring, blockage, stricture, or abnormal narrowing, damage to the surrounding structures, and infections, all of which can lead to anastomotic leakage, sepsis, septic shock, or even death (Figures 1 and 2).
Figure 1.
Intraoperative aspect of an anastomosis performed manually at the level of the small bowel.
Figure 2.
Intraoperative aspect of an anastomosis performed mechanically at the level of the small bowel.
2. General aspects of bowel anastomoses and modern variations that impacted the outcome
Barbed sutures are available in a variety of both absorbable and nonabsorbable monofilament materials. Specifically, currently available bidirectional and unidirectional barbed suture materials include PDO, polyglyconate, poliglecaprone 25, glycomer 631, nylon, and polypropylene. A study performed by Wiggins [1] searched through a systematic review and meta-analysis for the benefits of barbed suture utilization in gastrointestinal anastomosis. The conclusion was that the use of barbed sutures for gastrointestinal anastomosis appears to be associated with shorter overall operative times. There was no difference in rates of complications (including anastomotic leak, bleeding, or stricture) compared with standard suture materials.
The study included consecutive CD patients with ileal/ileocolonic strictures who had SWE shear wave elastography within one week of surgical resection.
The SWE of the stenotic bowel wall was compared to the biofragmentable anastomosis ring used for gastrointestinal anastomoses in a literature review conducted by Bobkiewicz and coauthors [2].
The theoretical idea was that a biofragmentable anastomosis ring (BAR) could be used instead of manual and stapled anastomoses in the upper and lower GI tracts.
The aim of this study was to see how effective BAR was for bowel anastomoses using our own content. Methodologies: Between 2004 and 2014, a retrospective study was conducted on a total of 203 patients who underwent bowel surgery with BAR anastomosis in the upper and lower gastrointestinal tract. The study concluded that using BAR for GI tract anastomoses is an easy and quick procedure with a low rate of perioperative mortality (0.5%) and complication rates (Figures 3 and 4).
Figure 3.
Foreign body reaction at the level of the tissues containing suture material.
Figure 4.
Colorful surgical nylon monofilament suture with a curved needle.
3. Colorectal anastomosis: General facts and variations of the techniques used
3.1 Manual versus mechanic
The ideal stapling device should be capable of rapid creation of an anastomosis with serosal apposition without the persistence of a foreign body or a foreign body reaction, which potentially contributes to early anastomotic dehiscence or late anastomotic stricture (Figures 5 and 6).
Figure 5.
Linear surgical stapler.
Figure 6.
(a and b) circular stapling device and its mode of appliance.
3.2 Debating issues of the mechanical colorectal anastomosis
While 2-row stapling has become normal in low anterior resections (LARs), it has no effect on morbidity or the incidence of AL.
Conducted by Nekliudov [3] is the first prospective, randomized clinical trial that compares the success rate of modern 3-row circular staplers to that of traditional 2-row staplers.
According to the hypothesis, the frequency of AL in the 3-row stapler group is not significantly higher than in the 2-row stapler group.
The rate of AL, as determined by imaging studies and measured using the Pearson chi-squared test and Fisher exact test, is the primary endpoint.
Secondary outcomes include AL severity (A, B, or C), anastomotic bleeding, postoperative complication rate (graded using the Clavien-Dindo classification), reintervention rate, stapler dysfunction rate, complications of nonfunctioning stoma, overall and cancer-specific quality of life (measured using short-form (36) questionnaire and quality-of-life (30) questionnaire core, respectively), fecal incontinence, and overall and cancer-specific quality of life.
Following the LAR, both patients will be tracked for a period of 12 months.
This is the first prospective randomized trial to look at the efficacy of 3-row staplers for colorectal anastomosis following rectal cancer surgery.
It could show that 3-row circular staplers are feasible in LAR in terms of short- and long-term patient outcomes (Figures 7 and 8).
Figure 7.
2-row staple lines.
Figure 8.
3-row staple lines.
3.3 MIS and colorectal anastomosis
A study performed by Jeong and coauthors [4] was assembled to report an institution’s experiences with transanal total mesorectal excision (TME) of rectal cancer using single-port equipment and to discuss the feasibility and safety of the technique. In the institution mentioned, 10 patients (6:4) treated with transanal TME with colorectal anastomosis were examined (Figure 9).
Figure 9.
Complete TME specimen (a) and sectioned (b) after abdomino-perineal resection with intact mesorectum.
In six of 10 patients, TME was done without the use of a laparoscope.
The average time spent on the operating table was 303.5 minutes.
The distal margin was 2.1 (0.2–4.2) cm on average.
The average number of lymph nodes harvested is 17.5.
Except for one patient who had an anastomotic leak, the majority of patients began dietary intake on POD 3 and were discharged on POD 7.
The only postoperative complication was an anastomotic leak.
Conclusions: In selected cases of rectal cancer, pure natural orifice transluminal endoscopic surgery (NOTES) TME with coloanal anastomosis was found to be healthy and feasible.
4. Postoperative complications of colorectal anastomoses and their prevention
4.1 Anastomotic leakage
Anastomotic leak (AL) is a common problem in colorectal surgery, and its prevalence has remained steady in recent years.
The use of an intra-abdominal drain or mechanical bowel preparation to prevent AL has been shown to be ineffective and should be avoided.
The function of oral antibiotic preparation regimens should be explained and compared to other routes of administration, such as intravenous or enema, according to a study conducted by Meyer and coauthors [5].
Parallel to this, preoperative antibiotherapy should target pathogens that induce collagenase, as defined by the microbiome study.
Fluorescence angiography may minimize AL even further, resulting in major intraoperative improvements in surgical strategies.
Fluorescence angiography can be used more often.
There have been studies, such as the one by Gained and coauthors [6], that looked at the literature’s connection between colorectal cancer recurrence, microbiome, and anastomotic leakage, and among the findings, one can find the aspect according to which the numerous mechanisms by which environmental factors act on the microbiome to alter its composition and function, with the net effect of adversely affecting oncological outcomes following surgery, are well documented and increasing.
Diet, antibiotic use, the procedures used to prepare the colon for surgery, and the physiological discomfort of the procedure are all examples of environmental causes.
Furthermore, using next-generation sequencing technologies to investigate the intestinal microbiome has the ability to affect cancer outcomes following colon resection. In a systematic review that targeted the endoscopic management of early postoperative complications, a literature search was performed by Clifford and coauthors [7] for published full text articles using the PubMed, Cochrane, and Scopus databases using the search criteria string “colorectal anastomotic (“leak” or “bleed”),” “endoscopy,” and “endoscopic management.” Endoscopic therapy in the management of stable patients with colorectal anastomotic leaks appears safe and is associated with the high rates of technical performance in selected patients, according to a review of 89 papers.
The most suitable method, patient selection, and considering the practical and long-term consequences of this approach remain challenging.
To fully assess the function of these novel strategies, further data from large prospective cohort studies are needed.
Shalaby and coauthors [8] conducted another systematic review on endoluminal vacuum-assisted therapy as a salvage treatment for rectal anastomotic leakage and found the following findings among 476 articles identified, 17 studies reporting on 276 patients:
The weighted mean success rate was 853% (95% confidence interval [CI]: 801–905), with a median time from the start of EVT to full healing of 47 (range 40–105) days.
The weighted mean rate of stoma reversal was 759% (646–872%) across the studies.
After EVT, twenty-five patients (91%) needed additional interventions.
Thirty-eight patients (138%) experienced complications as a result of the procedure.
The weighted mean complication rate was 111% (60–162%) across all tests.
Preoperative radiotherapy, the absence of a diverting stoma, complications, and male sex were all found to be significantly associated with failure.
According to the findings of the study, EVT is linked to a high rate of full healing of anastomotic leakage and stoma reversal.
In appropriately selected patients with anastomotic leakage, it is a viable choice.
Colorectal cancer surgery is thought to involve “high tie” and “low tie” of the inferior mesenteric artery (IMA).
However, the blood supply of the anastomosis is closely linked to the ligation stage, which can increase the leakage rate, and it is unclear which technique confers a lower anastomotic leakage rate (AL) and survival advantage.
The aim of the literature review, as stated by Yang and coauthors [9], was to compare the efficacy and impact of IMA high ligation versus IMA low ligation on anastomotic leakage, lymph node yield rates, and 5-year survival.
Finally, after reviewing studies from 1990 to 2017, researchers came to the conclusion that neither the high-tie nor the low-tie approach has any data in terms of anastomotic leakage, harvested lymph nodes, or 5-year survival rates.
More RCT is needed.
A study conducted by Simianu and coauthors [10] looked at the recency effect, which means that people place disproportionate emphasis on events that occurred recently when making decisions, but the magnitude of this influence on surgeons’ decisions is uncertain.
The use of preventative leak testing before and after colorectal operations with anastomotic leaks is examined in this study to see whether there is a recency effect in surgeons.
A prospective cohort of adult patients (aged 18 years) undergoing elective colorectal surgery at Washington State hospitals participating in the Surgical Care and Outcomes Assessment Program was used to develop the materials and methods (2006–2013).
The key outcome measure was the difference in leak monitoring between 6 months before and 6 months after an anastomotic leak.
A leak rate of 2.6% (n = 124) was found in 4854 elective colorectal operations performed by 282 surgeons at 44 hospitals.
The anastomosis was not checked in 40 leaks (32%), which were spread through 25 surgeons.
While the small sample size restricted the ability to detect an overall difference in leak testing use, 9 (36%) of the 25 surgeons increased their leak testing by 5% or more after leaks in cases where the anastomosis was not checked.
The above facts led to the conclusion that only one-third of qualified surgeons demonstrated the recency effect.
Understanding the degree to which the recency effect influences clinical decisions may be useful in developing quality management strategies that involve clinician’s behavior change.
Wang and colleagues [11] contrasted many aspects of robot-assisted versus laparoscopic surgery for rectal cancer by reviewing 20 studies with a total of 5496 patients, divided into a robot-assisted surgery group (n = 2168, 39.4%) and a laparoscopic surgery group (n = 3328, 60.6%).
Longer operating period (OR: 0.48, 95% CI: 0.14, 0.82), lower conversion to open surgery rate (OR: 0.55, 95% CI: 0.44, 0.69), shorter LOS (Length Of Stay) (OR: −0.15, 95% CI: −0.30, 0.00), faster bowel function recovery (OR: −0.38, 95% CI: −0.74, −0.02), and lower postoperative complications were all correlated with the robot-assisted surgery community (OR: 0.79, 95% CI: 0.65, 0.97).
There were no substantial differences between groups in EBL, anastomosis leak rate, or oncological outcomes such as the number of lymph nodes removed, the DRM, or the PCRM (Figures 10 and 11).
Figure 10.
Dehiscence at the level of the anastomosis.
Figure 11.
Methylene blue test.
4.2 Postoperative ileus
Postoperative ileus generates a high impact on morbidity, hospital stay, and costs. Vergara Fernandez and coauthors [12] conducted a randomized controlled trial of 64 patients who had elective colorectal surgery with primary anastomosis in a tertiary referral center. Patients were divided into two groups: (i) those who chewed their gums (n = 32) and (ii) those who had a typical postoperative recovery (n = 32). Chewing gum after colorectal surgery was found to be associated with less postoperative ileus and vomiting, as well as improved flatus passage within the first 48 hours after surgery (Figure 12).
Figure 12.
Illustration of a simple abdominal X-ray exam in a patient with bowel obstruction.
4.3 Anastomotic stenosis
It can sometimes be treated endoscopically, when surgery is contraindicated, by performing, as was found in a case report by Deng and team [13] with minimally invasive endoscopic approach was adopted to repair the obstruction. A needle knife was used to puncture the linear white scar, and contrast agent was injected under endoscopy and fluoroscopic guidance. Fluoroscopically, the proximal bowel was identified and a dual knife-mediated membrane puncture was performed. A guidewire was then passed through the incision into the proximal bowel and progressive pneumatic dilatation was performed successively with a controlled radial expansion balloon dilator until a 1.8-cm-diameter dilation was achieved. After conventional balloon dilatation, the endoscope easily passed through the anastomosis without any patient discomfort. There were no postoperative signs of immediate or delayed complications (Figure 13).
Figure 13.
Colonoscopic aspect of a anastomotic stenosis.
4.4 Anterior resection syndrome
Following TME, postoperative defecation dysfunctions known as “anterior resection syndrome” might appear.
Straight colorectal anastomosis (SCA), colon J-pouch (CJP), and side-to-end anastomosis are all common reconstruction techniques (SEA) (Figures 14 and 15).
Figure 14.
Types of anastomoses illustrated.
Figure 15.
Aspect of the J-pouch.
There are no prospective, randomized, multi-center trials that compare their functional results, including long-term evaluations.
As a result, the primary endpoint of a study designed by Marti and collab [14] that included 336 patients from 15 hospitals who were randomized had a comparison of composite evacuation scores 12 months after TME as a primary endpoint.
Secondary endpoints included a comparison of composite evacuation and incontinence ratings at 6, 18, and 24 months after surgery, as well as morbidity and overall survival.
The study looked at the “per protocol” (PP) population, which complied with all-trial criteria, as well as the “intention-to-treat” (ITT) population.
At any time point, there were no statistically significant variations in the composite evacuation ratings of the PP and ITT populations.
Similarly, at any time point, there was no statistically significant difference in composite incontinence scores for the PP and ITT populations among the three trial weapons.
Conclusions: Within the scope of the investigation, surgeons in charge can continue to conduct intestinal continuity reconstruction following TME at their discretion.
In addition to the studies previously reported, Hou and collab [15] investigated whether the use of side-to-end anastomosis (SEA) in sphincter-preserving resection (SPR) is problematic and conducted a meta-analysis to compare the safety and efficacy of SEA with colonic J-pouch (CJP) anastomosis, which has been shown to improve postoperative bowel function.
The meta-analysis included a total of 864 patients from 10 RCTs.
At 12 months after SPR, patients who underwent SEA had a higher defecation frequency and a lower incidence of incomplete defecation than those who underwent CJP anastomosis with low heterogeneity and a lower incidence of incomplete defecation at 3 months after surgery.
The SEA group also had a shorter operating period with no substantial heterogeneity.
The SEA group had a higher anorectal resting strain, but there was a lot of heterogeneity.
There were no significant differences between the groups in terms of efficacy outcomes such as defecation frequency, urgency, incomplete defecation, use of pads, enema, medications, anorectal squeeze pressure, and maximum rectal volume, or safety outcomes such as operating time, blood loss, use of protective stoma, postoperative complications, clinical outcomes, and complication rates.
In comparison with CJP anastomosis, the current evidence indicates that SEA is a successful anastomotic technique for achieving comparable postoperative bowel function without raising the risk of complications.
Shorter operating times, a lower occurrence of incomplete defecation three months after surgery, and improved sphincter function are all advantages of SEA.
However, after SPR, long-term defecation frequency should be closely monitored.
5. Intraoperative factors that interfere with the outcome of the anastomosis: testing methods of blood flow and patency at the level of the colorectal anastomosis
Assessing intraoperative perfusion with indocyanine green (ICG) and near-infrared (NIR) visualization can aid in selecting the degree of intestinal transection and subsequent anastomotic vascular sufficiency, according to the theory.
In a prospective study of nonselected patients undergoing any elective colorectal surgery with anastomosis in three tertiary hospitals over a 3-year span, NIR-ICG was used to look at anastomosis perfusion.
In addition to standard operator visual evaluation alone, a standard procedure was followed to evaluate NIR-ICG perfusion before and after anastomosis construction.
The researchers looked at 540 patients (median age 64 years, 279 men) who had surgery for neoplastic (330) and benign (174) pathology.
A total of 425 operations (853%) were initiated laparoscopically, with a 59% conversion rate.
In total, 220 patients (437%) had high anterior resection or reversal of Hartmann’s procedure, and 90 patients (179%) had low anterior resection.
ICG angiography was effective in every patient, with leak rates of 24% (12 of 504) overall, 26% for colorectal anastomoses, and 3% for low anterior resection.
The anastomotic leak rates were lower when NIR-ICG imaging was used than in the participating centers from over 1000 related operations conducted with the same technique but without NIR-ICG technology. As a result, the study’s findings were as follows:
Patients undergoing elective colorectal surgery should have their NIR-ICG levels checked on a regular basis.
The use of NIR-ICG can alter intraoperative decisions, potentially lowering anastomotic leak rates.
Kryzauskas conducted a systematic review and meta-analysis of publications, which included a total of 23 studies, with a total of 7115 patients, that were conducted to see whether intraoperative testing of the mechanical integrity and perfusion of the colorectal anastomosis could minimize the risk of AL. Intraoperative checks for the integrity (OR: 0.52, 95% CI: 0.34–0.82, P.001) and perfusion (OR: 0.40, 95% CI: 0.22–0.752, P.001) of the lower gastrointestinal tract anastomoses are linked to a substantially lower AL rate, according to a pooled study. The researchers came to the conclusion that intraoperative monitoring for anastomosis integrity or perfusion both reduced the AL dose. Studies combining these two anastomosis testing methods, especially intraoperative endoscopy and indocyanine green fluorescence angiography, could be very promising for further AL reduction. Since diabetes is a well-established independent factor that results in higher anastomotic leakage rates, the effects of biological sealants on colorectal anastomosis and their potential impact in patients with severe diabetes were studied in depth.
Fibrin sealants have been used to avoid anastomotic dehiscence in both laboratory and clinical trials.
We looked for existing evidence in the field by searching Medline (1966–2016) and Scopus (2004–2016). There is no evidence to support the use of fibrin sealants as a supplement in diabetic patients undergoing colorectal surgery at this time.
Experimental animal models with severe diabetes may be very useful in this area, and more research is required before fibrin sealants are used in a clinical environment.
In a systematic study and meta-analysis, Wu and team [16] analyzed the air leak test conducted intraoperatively.
The intraoperative air leak test (ALT) is a standard intraoperative test used to detect anastomosis that is mechanically inadequate.
The aim of this meta-analysis is to see whether ALT can help reduce postoperative colorectal anastomotic leakage (CAL).
The report included 22 experiments, with the following being the most notable.
According to the data, conducting an ALT using the recorded technique does not substantially reduce the clinical CAL rate, but it is still important due to the increased risk of CAL in ALT(+) cases.
Additional repairs, unfortunately, may not be successful in reducing this risk using current methods.
The findings of this study call for the standardization of ALT methodology and the creation of successful methods for repairing ALT(+) anastomoses.
A meta-analysis of randomized controlled trials on the use of suction drains following rectal surgery was conducted by Guerra and coauthors [17], and after looking at 760 patients from four RCTs that were eligible (RCT comparing drained with undrained anastomoses following rectal surgery), the use of drains showed little benefit in terms of anastomotic leak, pelvic complications, or reintervention.
On the other hand, the drained party had a slightly higher rate of postoperative bowel obstruction.
The researchers concluded that using pelvic drains routinely does not provide a major benefit in preventing postoperative complications following rectal surgery with extraperitoneal anastomosis.
Furthermore, a higher risk of bowel obstruction following surgery should be considered.
Non-surgery-based intraoperative risk factors for anastomotic healing also influence surgical outcome.
After analyzing 117 papers, a review by van Rooijen and team [18] provided an overview of potential modifiable risk factors that could play a role during the operation, and the results (the main outcome measure was the risk of anastomotic leakage and other postoperative complications during colorectal surgery) revealed that diabetes mellitus, hyperglycemia and a high HbA1c, anemia, and data on blood pressure, inotropes/vasopressors, oxygen supplementation, form of analgesia, and goal-directed fluid therapy are all unequivocal.
There was no research that looked into the effect of body core temperature or mean arterial pressure on CAL.
Subjective considerations including the surgeon’s own evaluation of local perfusion and the visibility of the operating field have not been studied for incidence in CAL patients.
The findings revealed that in order to enhance colorectal treatment, both surgery-related and non-surgery-related risk factors that can be changed must be established.
In their ongoing attempt to minimize the number of CAL, surgeons and anesthesiologists can collaborate on these issues.
In the Netherlands, a multicenter cohort study is currently being conducted to determine individual intraoperative risk factors for CAL.
6. The anastomosis in an “emergency” setting, scared of a (potential) higher risk or do we still do the same?
In perforated diverticulitis, for example, there has been no consensus in the management, which is why the Shaban and coauthors [19] felt compelled to perform a systematic review and meta-analysis, particularly because many surgeons choose the Hartmann’s procedure to avoid the risk of an anastomotic leak.
As a result, we proposed that in certain patients, resection with primary anastomosis is a healthy option.
The study found 1933 abstracts, of which 14 trials (2 RCTs, 4 prospective non-randomized, and 8 retrospective non-randomized) with 765 patients met the inclusion criteria, with 482 in the Hartmann’s group and 283 in the primary anastomosis group.
Primary anastomosis had a slightly lower mortality rate (10.6%) than Hartmann’s (20.7%) (p = 0.0003).
The rate of morbidity was also lower (41.8 vs. 51.2%) (p = 0.0483).
Primary anastomosis had a risk ratio of 0.92 in favor of mortality (p = 0.0019).
The average rate of anastomotic leak was 5.9%.
Resection and primary anastomosis should be considered as a feasible and secure operative technique in selected patients with perforated diverticulitis, according to the findings of the study.
However, there is a scarcity of high-level data, and further research is needed.
Resection with primary anastomosis (PRA) with or without diverting ileostomy (DI), Hartmann’s procedure (HP), laparoscopic lavage (LL), and damage control surgery were among the aspects reviewed in another and more complicated approach to damage control strategy in perforated diverticulitis with generalized peritonitis performed by Sohn and team [20] (DCS).
DCS is divided into two levels.
Limited resection of the diseased colon, oral and aboral closure, lavage, and vacuum-assisted abdominal closure are all options for emergency surgery.
After proper resuscitation, a second look operation is performed: definitive reconstruction with colorectal anastomosis (±DI) or HP.
The inclusion criteria were fulfilled by eight observational studies involving 256 patients.
There was no randomized study available.
Purulent peritonitis affected 67% of the patients, while feculent peritonitis affected 30%. Hinchey stage II diverticulitis was observed in 3% of the patients. The Mannheim peritonitis index (MPI) was greater than 26 in 49% of the cases. In 73% of cases, a colorectal anastomosis was developed during the second surgery. DI was used in 15% of the above group. HP was given to the remaining 27%. The postoperative mortality rate was 9%, and the morbidity rate was 31%. The rate of anastomotic leak was 13%. Without a stoma, 55% of patients were discharged.
Conclusions: DCS is a safe treatment for acute perforated diverticulitis with generalized peritonitis, with a high incidence of colorectal anastomosis and stoma-free hospital discharge in more than half of patients.
7. Long-term surveillance of the anastomosis
Pickhardt [21] compared the accuracy of CT colonography versus optical colonoscopy for neoplastic involvement at the surgical anastomosis 1 year after curative-intent colorectal cancer resection for neoplastic involvement at the surgical anastomosis.
As part of a prospective, multicenter study, 201 patients (mean age 58.6 years; 117 men, 84 women) underwent same-day contrast-enhanced CT colonography and colonoscopy approximately 1 year (mean, 12.1 months; median, 11.9 months) after colorectal cancer resection.
Many of the patients enrolled had no clinical signs of illness and were found to have a low risk of recurrence (stage I–III).
Relevant intraluminal anastomotic pathology tends to be very rare 1 year after colorectal cancer resection in lower-risk cohorts, according to the findings.
Diagnostic contrast-enhanced CT colonography, unlike colonoscopy, successfully measures both the intraluminal and extraluminal dimensions of the anastomosis.
Yang and collab [22] investigated the use of stents as a bridge to surgery in the treatment of acute left-sided obstructive colorectal cancer.
In a meta-analysis of randomized controlled trials, the factor according to which the trials were conducted was taken into account.
The use of self-expanding metallic stents (SEMS) as a bridge to surgery in the treatment of acute left-sided obstructive colorectal cancer has remained contentious.
The following were the outcomes:
We chose 8 RCTs papers with a total of 497 instances.
The stent group had significantly lower directly stoma rates, significantly higher active primary anastomosis rates, and significantly lower post-procedural complication rates.
The stent party, on the other hand, had substantially higher tumor recurrence rates, leading to the following conclusions:
This meta-analysis confirms that SEMS placement can lower the rate of direct stomas and increase the rate of active primary anastomosis; however, it is linked to a higher rate of tumor recurrence.
8. Conclusions
Laparoscopic anterior resection (LAR) is nowadays routine practice in specialized high-volume centers, with equivalent oncological outcomes to open surgery. Anastomotic leakage (AL) remains one of the most threatening complications in colorectal surgery with the incidence of up to 20%. Therefore, recognition of the risk factors of postoperative complications is essential in order to be prevented. Moreover, one must underline the importance of some risk factors such as age, nutrition status of the patient, experience of the surgeon, and many other factors that influence outcome of colorectal surgery. Some risk factors can be modified before the intervention to prevent postoperative complications. Contrary to that, long-term postoperative complications may promote tumor recurrence and decrease survival.
Conflict of interest
The author declares no conflict of interest.
\n',keywords:"colonic fistula, anastomotic leakage, colorectal anastomosis, colorectal surgery complications",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/78969.pdf",chapterXML:"https://mts.intechopen.com/source/xml/78969.xml",downloadPdfUrl:"/chapter/pdf-download/78969",previewPdfUrl:"/chapter/pdf-preview/78969",totalDownloads:174,totalViews:0,totalCrossrefCites:0,dateSubmitted:"March 25th 2021",dateReviewed:"September 5th 2021",datePrePublished:"October 15th 2021",datePublished:null,dateFinished:"October 15th 2021",readingETA:"0",abstract:"Colorectal anastomosis is defined as a surgical procedure in which the colon is attached to the remainder of the rectum after most or some part of it was removed during an intervention. A straight colorectal anastomosis implies a direct attachment, while a J-pouch colorectal anastomosis implies a previous creation of a reservoir, or “pouch” out of bowel material. The problem of colorectal anastomosis safety and outcome is among the most important and persistent issues in colorectal surgery, mainly due to the anastomotic leakage, a threatening and dangerous complication, with an incidence of up to 20% or even more in case of surgical oncology. Various prediction models and anastomosis testing techniques have been described in order to prevent or identify early any possible imperfection of the anastomosis, each with pros and cons. The measures generally used to increase the safety and reliability of the colorectal anastomosis are to evaluate the blood supply of the tissues anastomosed with indocyanine green, or to test the mechanical integrity of the anastomosis for leakage by employing air, methylene blue, or tension.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/78969",risUrl:"/chapter/ris/78969",signatures:"Sinziana Ionescu",book:{id:"10865",type:"book",title:"Current Topics in Colorectal Surgery",subtitle:null,fullTitle:"Current Topics in Colorectal Surgery",slug:null,publishedDate:null,bookSignature:"Associate Prof. John Camilleri-Brennan",coverURL:"https://cdn.intechopen.com/books/images_new/10865.jpg",licenceType:"CC BY 3.0",editedByType:null,isbn:"978-1-83962-336-3",printIsbn:"978-1-83962-335-6",pdfIsbn:"978-1-83962-337-0",isAvailableForWebshopOrdering:!0,editors:[{id:"169437",title:"Associate Prof.",name:"John",middleName:null,surname:"Camilleri-Brennan",slug:"john-camilleri-brennan",fullName:"John Camilleri-Brennan"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:null,sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. General aspects of bowel anastomoses and modern variations that impacted the outcome",level:"1"},{id:"sec_3",title:"3. Colorectal anastomosis: General facts and variations of the techniques used",level:"1"},{id:"sec_3_2",title:"3.1 Manual versus mechanic",level:"2"},{id:"sec_4_2",title:"3.2 Debating issues of the mechanical colorectal anastomosis",level:"2"},{id:"sec_5_2",title:"3.3 MIS and colorectal anastomosis",level:"2"},{id:"sec_7",title:"4. Postoperative complications of colorectal anastomoses and their prevention",level:"1"},{id:"sec_7_2",title:"4.1 Anastomotic leakage",level:"2"},{id:"sec_8_2",title:"4.2 Postoperative ileus",level:"2"},{id:"sec_9_2",title:"4.3 Anastomotic stenosis",level:"2"},{id:"sec_10_2",title:"4.4 Anterior resection syndrome",level:"2"},{id:"sec_12",title:"5. Intraoperative factors that interfere with the outcome of the anastomosis: testing methods of blood flow and patency at the level of the colorectal anastomosis",level:"1"},{id:"sec_13",title:"6. The anastomosis in an “emergency” setting, scared of a (potential) higher risk or do we still do the same?",level:"1"},{id:"sec_14",title:"7. Long-term surveillance of the anastomosis",level:"1"},{id:"sec_15",title:"8. Conclusions",level:"1"},{id:"sec_19",title:"Conflict of interest",level:"1"}],chapterReferences:[{id:"B1",body:'Wiggins T, Majid MS, Markar SR, Loy J, Agrawal S, Koak Y. Benefits of barbed suture utilisation in gastrointestinal anastomosis: A systematic review and meta-analysis. Annals of the Royal College of Surgeons of England. 2020;102(2):153-159. DOI: 10.1308/rcsann.2019.0106'},{id:"B2",body:'Bobkiewicz A, Studniarek A, Krokowicz L, Szmyt K, Borejsza-Wysocki M, Szmeja J, et al. Gastrointestinal tract anastomoses with the biofragmentable anastomosis ring: Is it still a valid technique for bowel anastomosis? Analysis of 203 cases and review of the literature. International Journal of Colorectal Disease. 2017;32(1):107-111. DOI: 10.1007/s00384-016-2661-z'},{id:"B3",body:'Nekliudov NA, Tsarkov PV, Tulina IA. Uni-center, patient-blinded, randomized, 12-month, parallel group, noninferiority study to compare outcomes of 3-row vs 2-row circular staplers for colorectal anastomosis formation after low anterior resection for rectal cancer. Medicine. 2019;98(24):e15978. DOI: 10.1097/MD.0000000000015978'},{id:"B4",body:'Jeong WJ, Choi BJ, Lee SC. Pure natural orifice transluminal endoscopic surgery for rectal cancer: Ta-TME and CME without abdominal assistance. Asian Journal of Surgery. 2019;42(2):450-457. DOI: 10.1016/j.asjsur.2018.08.010'},{id:"B5",body:'Meyer J, Naiken S, Christou N, Liot E, Toso C, Buchs NC, et al. Reducing anastomotic leak in colorectal surgery: The old dogmas and the new challenges. World Journal of Gastroenterology. 2019;25(34):5017-5025. DOI: 10.3748/wjg.v25.i34.5017'},{id:"B6",body:'Gaines S, Shao C, Hyman N, Alverdy JC. Gut microbiome influences on anastomotic leak and recurrence rates following colorectal cancer surgery. The British Journal of Surgery. 2018;105(2):e131-e141. DOI: 10.1002/bjs.10760'},{id:"B7",body:'Clifford RE, Fowler H, Govindarajah N, Vimalachandran D, Sutton PA. Early anastomotic complications in colorectal surgery: A systematic review of techniques for endoscopic salvage. Surgical Endoscopy. 2019;33(4):1049-1065. DOI: 10.1007/s00464-019-06670-9'},{id:"B8",body:'Shalaby M, Emile S, Elfeki H, Sakr A, Wexner SD, Sileri P. Systematic review of endoluminal vacuum-assisted therapy as salvage treatment for rectal anastomotic leakage. BJS Open. 2018;3(2):153-160. DOI: 10.1002/bjs5.50124'},{id:"B9",body:'Yang Y, Wang G, He J, Zhang J, Xi J, Wang F. High tie versus low tie of the inferior mesenteric artery in colorectal cancer: A meta-analysis. International Journal of Surgery. 2018;52:20-24. DOI: 10.1016/j.ijsu.2017.12.030'},{id:"B10",body:'Simianu VV, Basu A, Alfonso-Cristancho R, Thirlby RC, Flaxman AD, Flum DR. Assessing surgeon behavior change after anastomotic leak in colorectal surgery. The Journal of Surgical Research. 2016;205(2):378-383. DOI: 10.1016/j.jss.2016.06.075'},{id:"B11",body:'Wang X, Cao G, Mao W, Lao W, He C. Robot-assisted versus laparoscopic surgery for rectal cancer: A systematic review and meta-analysis. Journal of Cancer Research and Therapeutics. 2020;16(5):979-989. DOI: 10.4103/jcrt.JCRT_533_18'},{id:"B12",body:'Vergara-Fernandez O, Gonzalez-Vargas AP, Castellanos-Juarez JC, Salgado-Nesme N, Sanchez-Garcia RE. Usefulness of gum chewing to decrease postoperative ileus in colorectal surgery with primary anastomosis: A randomized controlled trial. Revista de Investigación Clínica. 2016;68(6):314-318'},{id:"B13",body:'Deng S, Cao Y, Gu J, Wu K, Li J, Tao K, et al. Endoscopic diagnosis and treatment of complete anastomosis stenosis after colorectal resection without protective ileostomy: Report of two cases and literature review. The Journal of International Medical Research. 2020;48(4):300060520914833. DOI: 10.1177/0300060520914833'},{id:"B14",body:'Marti WR, Curti G, Wehrli H, Grieder F, Graf M, Gloor B, et al. Clinical outcome after rectal replacement with side-to-end, colon-J-pouch, or straight colorectal anastomosis following total mesorectal excision: A Swiss prospective, randomized, multicenter trial (SAKK 40/04). Annals of Surgery. 2019;269(5):827-835. DOI: 10.1097/SLA.0000000000003057'},{id:"B15",body:'Hou S, Wang Q, Zhao S, Liu F, Guo P, Ye Y. Safety and efficacy of side-to-end anastomosis versus colonic J-pouch anastomosis in sphincter-preserving resections: An updated meta-analysis of randomized controlled trials. World Journal of Surgical Oncology. 2021;19(1):130. DOI: 10.1186/s12957-021-02243-0'},{id:"B16",body:'Wu Z, van de Haar RC, Sparreboom CL, Boersema GS, Li Z, Ji J, et al. Is the intraoperative air leak test effective in the prevention of colorectal anastomotic leakage? A systematic review and meta-analysis. International Journal of Colorectal Disease. 2016;31(8):1409-1417. DOI: 10.1007/s00384-016-2616-4'},{id:"B17",body:'Guerra F, Giuliani G, Coletta D, Boni M, Rondelli F, Bianchi PP, et al. A meta-analysis of randomized controlled trials on the use of suction drains following rectal surgery. Digestive Surgery. 2018;35(6):482-490. DOI: 10.1159/000485139'},{id:"B18",body:'van Rooijen SJ, Huisman D, Stuijvenberg M, Stens J, Roumen RMH, Daams F, et al. Intraoperative modifiable risk factors of colorectal anastomotic leakage: Why surgeons and anesthesiologists should act together. International Journal of Surgery. 2016;36(Pt A):183-200. DOI: 10.1016/j.ijsu.2016.09.098'},{id:"B19",body:'Shaban F, Carney K, McGarry K, Holtham S. Perforated diverticulitis: To anastomose or not to anastomose? A systematic review and meta-analysis. International Journal of Surgery. 2018;58:11-21. DOI: 10.1016/j.ijsu.2018.08.009'},{id:"B20",body:'Sohn M, Agha A, Iesalnieks I, Gundling F, Presl J, Hochrein A, et al. Damage control strategy in perforated diverticulitis with generalized peritonitis. BMC Surgery. 2021;21(1):135. DOI: 10.1186/s12893-021-01130-5'},{id:"B21",body:'Pickhardt PJ, Edwards K, Bruining DH, Gollub M, Kupfer S, Lubner SJ, et al. Prospective trial evaluating the surgical anastomosis at one-year colorectal cancer surveillance: CT colonography versus optical colonoscopy and implications for patient care. Diseases of the Colon and Rectum. 2017;60(11):1162-1167. DOI: 10.1097/DCR.0000000000000845'},{id:"B22",body:'Yang P, Lin XF, Lin K, Li W. The role of stents as bridge to surgery for acute left-sided obstructive colorectal cancer: Meta-analysis of randomized controlled trials. Revista de Investigación Clínica. 2018;70(6):269-278. DOI: 10.24875/RIC.18002516'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Sinziana Ionescu",address:"sinzianaionescu30@gmail.com",affiliation:'
Bucharest Oncology Institute, Romania
Carol Davila University of Medicine and Pharmacy, Romania
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He also held positions such as Director of Division of General Surgery, Director of Residency School of General Surgery, Director of Department of Surgical Sciences, and President of Course of Degree of Medicine and Surgery at the same university. He also served as an assistant professor (1974–1982) and associate professor (1982–2001) at the School of Medicine and Surgery, University of Bari, Italy, where he obtained a degree in Medicine and Surgery and completed postgraduate training in General Surgery and Emergency Surgery. He obtained a diploma of 'Maitrise Universitaire en Pedagogie des Sciences de la Santè” from the University Paris-Nord Bobigny in 1995. Dr. Neri’s research interests include hepatobiliary pancreatic surgery, acute pancreatitis, and treatment of pancreatic and liver tumors. He has published research papers, reviews, congress proceedings, and book chapters. 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The block must be complete and permanent. Obstruction may be mechanical, simple or strangulated, and paralytic. The purpose of this chapter is to clarify, also evaluating our surgical experience, the steps to diagnose and the ways to treat intestinal obstructions.",signatures:"Vincenzo Neri",authors:[{id:"170938",title:"Prof.",name:"Vincenzo",surname:"Neri",fullName:"Vincenzo Neri",slug:"vincenzo-neri",email:"vincenzo.neri@unifg.it"}],book:{id:"5280",title:"Actual Problems of Emergency Abdominal Surgery",slug:"actual-problems-of-emergency-abdominal-surgery",productType:{id:"1",title:"Edited Volume"}}},{id:"52308",title:"Management of Pancreatic Cystic Lesions",slug:"management-of-pancreatic-cystic-lesions",abstract:"Objectives: In the last several decades, the knowledge of the cystic neoplasms has enlarged and the management has changed. 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The aim of this chapter is to underline, also by submitting our surgical experience, some diagnostic deceptions and the timing of treatment.",signatures:"Pasquale Cianci, Nicola Tartaglia, Alberto Fersini, Sabino Capuzzolo,\nLibero Luca Giambavicchio, Antonio Ambrosi and Vincenzo Neri",authors:[{id:"170938",title:"Prof.",name:"Vincenzo",surname:"Neri",fullName:"Vincenzo Neri",slug:"vincenzo-neri",email:"vincenzo.neri@unifg.it"},{id:"196216",title:"Dr.",name:"Alberto",surname:"Fersini",fullName:"Alberto Fersini",slug:"alberto-fersini",email:"alberto.fersini@unifg.it"},{id:"196217",title:"Prof.",name:"Nicola",surname:"Tartaglia",fullName:"Nicola Tartaglia",slug:"nicola-tartaglia",email:"nicola.tartaglia@unifg.it"},{id:"196218",title:"Dr.",name:"Pasquale",surname:"Cianci",fullName:"Pasquale Cianci",slug:"pasquale-cianci",email:"ciancidoc1@virgilio.it"},{id:"196219",title:"Dr.",name:"Libero Luca",surname:"Giambavicchio",fullName:"Libero Luca Giambavicchio",slug:"libero-luca-giambavicchio",email:"liberogiambavicchio@gmail.com"},{id:"196220",title:"Dr.",name:"Sabino",surname:"Capuzzolo",fullName:"Sabino Capuzzolo",slug:"sabino-capuzzolo",email:"sabino.capuzzolo@gmail.com"},{id:"196221",title:"Prof.",name:"Antonio",surname:"Ambrosi",fullName:"Antonio Ambrosi",slug:"antonio-ambrosi",email:"antonio.ambrosi@unifg.it"}],book:{id:"5744",title:"Updates in Gallbladder Diseases",slug:"updates-in-gallbladder-diseases",productType:{id:"1",title:"Edited Volume"}}},{id:"55454",title:"Current Approaches in the Minimally Invasive Surgical Treatment of Adrenal Tumors",slug:"current-approaches-in-the-minimally-invasive-surgical-treatment-of-adrenal-tumors",abstract:"The use of imaging modalities and minimally invasive surgery plays an important role in the current management of adrenal tumors. Ultrasonography frequently allows for the incidental diagnosis of adrenal masses. The most frequent adrenal pathologies encountered are hypercortisolism (Cushing’s syndrome), primary hyperaldosteronism (Conn’s syndrome), and pheochromocytomas. Clinical presentation of these adrenal tumors can often be non-specific, or such lesions may present as “incidentalomas” in patients who undergo imaging for clinical reasons unrelated to the adrenal glands. Adrenal malignancy is suggested by morphologic characteristics found on imaging studies: increased size, irregular borders, local invasion, and large necrotic areas. The risk of malignancy increases for larger adrenal masses. Minimally invasive surgery has become the initial choice for the treatment of adrenal tumors with retroperitoneal and transperitoneal approaches. This chapter describes the surgical indications and compares the various minimally invasive surgical approaches for the therapeutic management of adrenal masses.",signatures:"Pasquale Cianci, Alberto Fersini, Nicola Tartaglia, Sabino Capuzzolo,\nLibero Luca Giambavicchio, Antonio Ambrosi and Vincenzo Neri",authors:[{id:"170938",title:"Prof.",name:"Vincenzo",surname:"Neri",fullName:"Vincenzo Neri",slug:"vincenzo-neri",email:"vincenzo.neri@unifg.it"}],book:{id:"5489",title:"Clinical Management of Adrenal Tumors",slug:"clinical-management-of-adrenal-tumors",productType:{id:"1",title:"Edited Volume"}}},{id:"70049",title:"Introductory Chapter: Role of Colostomy in the Colorectal Pathologies",slug:"introductory-chapter-role-of-colostomy-in-the-colorectal-pathologies",abstract:null,signatures:"Vincenzo Neri",authors:[{id:"170938",title:"Prof.",name:"Vincenzo",surname:"Neri",fullName:"Vincenzo Neri",slug:"vincenzo-neri",email:"vincenzo.neri@unifg.it"}],book:{id:"8443",title:"Gastrointestinal Stomas",slug:"gastrointestinal-stomas",productType:{id:"1",title:"Edited Volume"}}},{id:"71967",title:"Introductory Chapter: Surgical Infections",slug:"introductory-chapter-surgical-infections",abstract:null,signatures:"Vincenzo Neri",authors:[{id:"170938",title:"Prof.",name:"Vincenzo",surname:"Neri",fullName:"Vincenzo Neri",slug:"vincenzo-neri",email:"vincenzo.neri@unifg.it"}],book:{id:"7920",title:"Infectious Process and Sepsis",slug:"infectious-process-and-sepsis",productType:{id:"1",title:"Edited Volume"}}},{id:"75336",title:"Gastroduodenal Lesions Associated with Portal Hypertension: An Extensive Review",slug:"gastroduodenal-lesions-associated-with-portal-hypertension-an-extensive-review",abstract:"The block of the portal flow by obstacles in prehepatic, hepatic or posthepatic site and alterations of the splanchnic blood flow are the pathological conditions that lead to portal hypertension. The portal hypertension can cause also others gastroduodenal lesions, potentially hemorrhagic, in addition to esophageal varices commonly developed and habitual source of bleeding in these patients. The gastroduodenal lesions associated with portal hypertension, usually encountered in the clinical practice, are portal hypertensive gastropaty, gastric antral vascular ectasia, gastric and duodenal ulcer, isolated gastric varices. The pathophysiology and clinical, diagnostic and therapeutic features of these lesions are examined.",signatures:"Vincenzo Neri, Nicola Tartaglia, Alberto Fersini, Pasquale Cianci, Mario Pacilli, Giovanna Pavone and Antonio Ambrosi",authors:[{id:"170938",title:"Prof.",name:"Vincenzo",surname:"Neri",fullName:"Vincenzo Neri",slug:"vincenzo-neri",email:"vincenzo.neri@unifg.it"},{id:"196216",title:"Dr.",name:"Alberto",surname:"Fersini",fullName:"Alberto Fersini",slug:"alberto-fersini",email:"alberto.fersini@unifg.it"},{id:"196217",title:"Prof.",name:"Nicola",surname:"Tartaglia",fullName:"Nicola Tartaglia",slug:"nicola-tartaglia",email:"nicola.tartaglia@unifg.it"},{id:"196218",title:"Dr.",name:"Pasquale",surname:"Cianci",fullName:"Pasquale Cianci",slug:"pasquale-cianci",email:"ciancidoc1@virgilio.it"},{id:"196221",title:"Prof.",name:"Antonio",surname:"Ambrosi",fullName:"Antonio Ambrosi",slug:"antonio-ambrosi",email:"antonio.ambrosi@unifg.it"},{id:"345038",title:"Dr.",name:"Mario",surname:"Pacilli",fullName:"Mario Pacilli",slug:"mario-pacilli",email:"m.pacilli2010@gmail.com"},{id:"345039",title:"Dr.",name:"Giovanna",surname:"Pavone",fullName:"Giovanna Pavone",slug:"giovanna-pavone",email:"giovanna.pavone@unifg.it"}],book:{id:"10314",title:"Esophagitis and Gastritis",slug:"esophagitis-and-gastritis-recent-updates",productType:{id:"1",title:"Edited Volume"}}},{id:"79534",title:"Introductory Chapter: Complications of Gastroduodenal Ulcers",slug:"introductory-chapter-complications-of-gastroduodenal-ulcers",abstract:null,signatures:"Vincenzo Neri and Monjur Ahmed",authors:[{id:"170938",title:"Prof.",name:"Vincenzo",surname:"Neri",fullName:"Vincenzo Neri",slug:"vincenzo-neri",email:"vincenzo.neri@unifg.it"},{id:"206355",title:"Associate Prof.",name:"Monjur",surname:"Ahmed",fullName:"Monjur Ahmed",slug:"monjur-ahmed",email:"monjur.ahmed@jefferson.edu"}],book:{id:"10314",title:"Esophagitis and Gastritis",slug:"esophagitis-and-gastritis-recent-updates",productType:{id:"1",title:"Edited Volume"}}}],collaborators:[{id:"68864",title:"Dr.",name:"Olivia",surname:"Mateescu",slug:"olivia-mateescu",fullName:"Olivia Mateescu",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Medicine and Pharmacy of Craiova",institutionURL:null,country:{name:"Romania"}}},{id:"121119",title:"Dr.",name:"Bogdan",surname:"Oprea",slug:"bogdan-oprea",fullName:"Bogdan Oprea",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Medicine and Pharmacy of Craiova",institutionURL:null,country:{name:"Romania"}}},{id:"171162",title:"Prof.",name:"Mukaddes",surname:"Esrefoglu",slug:"mukaddes-esrefoglu",fullName:"Mukaddes Esrefoglu",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Acıbadem University",institutionURL:null,country:{name:"Turkey"}}},{id:"171281",title:"Prof.",name:"Marcel",surname:"Machado",slug:"marcel-machado",fullName:"Marcel Machado",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Sao Paulo",institutionURL:null,country:{name:"Brazil"}}},{id:"173006",title:"Dr.",name:"Liliana",surname:"Stanca",slug:"liliana-stanca",fullName:"Liliana Stanca",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"173007",title:"Dr.",name:"Mihaela",surname:"Hincu",slug:"mihaela-hincu",fullName:"Mihaela Hincu",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"173008",title:"Dr.",name:"Malina",surname:"Coman",slug:"malina-coman",fullName:"Malina Coman",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"173010",title:"Dr.",name:"Dragos",surname:"Voicu",slug:"dragos-voicu",fullName:"Dragos Voicu",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"173011",title:"Dr.",name:"Relu",surname:"Stanescu",slug:"relu-stanescu",fullName:"Relu Stanescu",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"173012",title:"Dr.",name:"Ion",surname:"Rogoveanu",slug:"ion-rogoveanu",fullName:"Ion Rogoveanu",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null}]},generic:{page:{slug:"why-publish-with-intechopen",title:"Why publish with IntechOpen?",intro:"
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Delac received his B.Sc.E.E. degree in 2003 and is currentlypursuing a Ph.D. degree at the University of Zagreb, Faculty of Electrical Engineering andComputing. His current research interests are digital image analysis, pattern recognition andbiometrics.",institutionString:null,institution:{name:"University of Zagreb",country:{name:"Croatia"}}},{id:"557",title:"Dr.",name:"Andon",middleName:"Venelinov",surname:"Topalov",slug:"andon-topalov",fullName:"Andon Topalov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/557/images/1927_n.jpg",biography:"Dr. Andon V. Topalov received the MSc degree in Control Engineering from the Faculty of Information Systems, Technologies, and Automation at Moscow State University of Civil Engineering (MGGU) in 1979. He then received his PhD degree in Control Engineering from the Department of Automation and Remote Control at Moscow State Mining University (MGSU), Moscow, in 1984. From 1985 to 1986, he was a Research Fellow in the Research Institute for Electronic Equipment, ZZU AD, Plovdiv, Bulgaria. In 1986, he joined the Department of Control Systems, Technical University of Sofia at the Plovdiv campus, where he is presently a Full Professor. He has held long-term visiting Professor/Scholar positions at various institutions in South Korea, Turkey, Mexico, Greece, Belgium, UK, and Germany. And he has coauthored one book and authored or coauthored more than 80 research papers in conference proceedings and journals. 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After finishing his P. hD degree in 1992, he served in the Industry as a Scientific Officer and continued his academic career as a visiting scholar for a number of educational institutions. In 1996 he joined National University of Science & Technology Pakistan (NUST) as an Associate Professor; NUST is one of the top few universities in Pakistan. In 1999 he joined an International Company Lineo Inc, Canada as Manager Compiler Group, where he headed the group for developing Compiler Tool Chain and Porting of Operating Systems for the BLACKfin processor. The processor development was a joint venture by Intel and Analog Devices. In 2002 Lineo Inc., was taken over by another company, so he joined Aalborg University Denmark as an Assistant Professor.\nProfessor Akbar has truly a multi-disciplined career and he continued his legacy and making progress in many areas of his interests both in teaching and research. 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Raja",coverURL:"https://cdn.intechopen.com/books/images_new/11331.jpg",editedByType:"Edited by",publishedDate:"August 17th 2022",editors:[{id:"176044",title:"Dr.",name:"Ramasamy",middleName:null,surname:"Vijayakumar",slug:"ramasamy-vijayakumar",fullName:"Ramasamy Vijayakumar"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10820",title:"Data Clustering",subtitle:null,isOpenForSubmission:!1,hash:"086d299ffd05aacd2311c3ca4ebf0d3a",slug:"data-clustering",bookSignature:"Niansheng Tang",coverURL:"https://cdn.intechopen.com/books/images_new/10820.jpg",editedByType:"Edited by",publishedDate:"August 17th 2022",editors:[{id:"221831",title:"Prof.",name:"Niansheng",middleName:null,surname:"Tang",slug:"niansheng-tang",fullName:"Niansheng Tang"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited 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Saleh and Amal I. Hassan",coverURL:"https://cdn.intechopen.com/books/images_new/11139.jpg",editedByType:"Edited by",publishedDate:"August 17th 2022",editors:[{id:"144691",title:"Prof.",name:"Hosam M.",middleName:null,surname:"Saleh",slug:"hosam-m.-saleh",fullName:"Hosam M. Saleh"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},subject:{topic:{id:"238",title:"Psycholinguistics",slug:"psycholinguistics",parent:{id:"21",title:"Psychology",slug:"psychology"},numberOfBooks:3,numberOfSeries:0,numberOfAuthorsAndEditors:80,numberOfWosCitations:15,numberOfCrossrefCitations:31,numberOfDimensionsCitations:89,videoUrl:null,fallbackUrl:null,description:null},booksByTopicFilter:{topicId:"238",sort:"-publishedDate",limit:12,offset:0},booksByTopicCollection:[{type:"book",id:"10889",title:"Aphasia Compendium",subtitle:null,isOpenForSubmission:!1,hash:"f2c0b1c302f68d0c86ae8e057d1cc90e",slug:"aphasia-compendium",bookSignature:"Dragoș Cătălin Jianu and Dafin Fior Mureșanu",coverURL:"https://cdn.intechopen.com/books/images_new/10889.jpg",editedByType:"Edited by",editors:[{id:"45925",title:"Prof.",name:"Dragoș",middleName:null,surname:"Cătălin Jianu",slug:"dragos-catalin-jianu",fullName:"Dragoș Cătălin Jianu"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7311",title:"Cognitive and Intermedial Semiotics",subtitle:null,isOpenForSubmission:!1,hash:"2b7d636f6a78bfa31a39bab658a4b18c",slug:"cognitive-and-intermedial-semiotics",bookSignature:"Marta Silvera-Roig and Asunción López-Varela Azcárate",coverURL:"https://cdn.intechopen.com/books/images_new/7311.jpg",editedByType:"Edited by",editors:[{id:"302728",title:"Dr.",name:"Marta",middleName:null,surname:"Silvera-Roig",slug:"marta-silvera-roig",fullName:"Marta Silvera-Roig"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5957",title:"Advances in Speech-language Pathology",subtitle:null,isOpenForSubmission:!1,hash:"0aa9183a00d31fd1970187a4452a62d8",slug:"advances-in-speech-language-pathology",bookSignature:"Fernanda Dreux M. Fernandes",coverURL:"https://cdn.intechopen.com/books/images_new/5957.jpg",editedByType:"Edited by",editors:[{id:"28286",title:"Dr.",name:"Fernanda Dreux Miranda",middleName:null,surname:"Fernandes",slug:"fernanda-dreux-miranda-fernandes",fullName:"Fernanda Dreux Miranda Fernandes"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],booksByTopicTotal:3,seriesByTopicCollection:[],seriesByTopicTotal:0,mostCitedChapters:[{id:"56330",doi:"10.5772/intechopen.69932",title:"Russian Scientific Trends on Specific Language Impairment in Childhood",slug:"russian-scientific-trends-on-specific-language-impairment-in-childhood",totalDownloads:1955,totalCrossrefCites:0,totalDimensionsCites:23,abstract:"In Russia, there are many decades of experience in the scientific study of the problem of impaired language development in children. Today, the term “Systemic speech-and-language underdevelopment (SLU)” has firmly established in Russian science and practice, implying a complex developmental disorder of speech and language in children with a primary normal hearing and a conserved intellect, in which the main components of the language system are violated: vocabulary, grammar, phonetics, and, as a consequence, dialogic and monologic speech. Traditionally, a differentiated level-by-level analysis of the speech and language abilities of children is used. The variability of the manifestations and severity of speech-and-language disorders were initially systematized and characterized in four levels of underdevelopment: from the complete absence of phrase speech to the availability of simple and complex sentences with lexico-grammatical errors. Effective algorithms of speech therapist work with SLU are introduced. The effectiveness of the application of these models and algorithms on the material of various language groups is proved.",book:{id:"5957",slug:"advances-in-speech-language-pathology",title:"Advances in Speech-language Pathology",fullTitle:"Advances in Speech-language Pathology"},signatures:"Tatiana Tumanova and Tatiana Filicheva",authors:[{id:"204529",title:"Dr.",name:"Tatiana Volodarovna",middleName:null,surname:"Tumanova",slug:"tatiana-volodarovna-tumanova",fullName:"Tatiana Volodarovna Tumanova"},{id:"208704",title:"Dr.",name:"Tatiana Borisovna",middleName:null,surname:"Filicheva",slug:"tatiana-borisovna-filicheva",fullName:"Tatiana Borisovna Filicheva"}]},{id:"56560",doi:"10.5772/intechopen.70235",title:"The Role of Speech and Language Therapist in Autism Spectrum Disorders Intervention – An Inclusive Approach",slug:"the-role-of-speech-and-language-therapist-in-autism-spectrum-disorders-intervention-an-inclusive-app",totalDownloads:2373,totalCrossrefCites:2,totalDimensionsCites:16,abstract:"The chapter describes the possibilities of involving a speech-language therapist in the assessment of the pragmatic level of communication in autism spectrum disorders (ASD), where one of the most frequently impaired areas is communication pragmatics. These difficulties lead to a disruption of social interaction, which might be one of the obstacles to speech-language intervention in these children. The text is based on an originally developed testing material aimed at selected pragmatic-oriented communication situations relating to everyday activities and real life. Based on a comparison of domestic and international resources in this area, as well as mediated and own empirical experience, our assessment approach is based on the conclusion that pragmatics can be understood in different contexts and perspectives. The text presents the results of a partial survey comparing the performance of children with ASD and children with typical development. The assessment focused on the children’s election of the correct picture of a pair of pictures that represent usual communication and social situations. The results of the research suggest fewer incorrect responses in children with ASD and in different areas compared with children with typical development. However, the results of a qualitative analysis indicate a necessity to expand the assessment of communication pragmatics by adding an individually specific qualitative analysis of children’s performance.",book:{id:"5957",slug:"advances-in-speech-language-pathology",title:"Advances in Speech-language Pathology",fullTitle:"Advances in Speech-language Pathology"},signatures:"Kateřina Vitásková and Lucie Kytnarová",authors:[{id:"203061",title:"Associate Prof.",name:"Kateřina",middleName:null,surname:"Vitásková",slug:"katerina-vitaskova",fullName:"Kateřina Vitásková"},{id:"212035",title:"MSc.",name:"Lucie",middleName:null,surname:"Kytnarová",slug:"lucie-kytnarova",fullName:"Lucie Kytnarová"}]},{id:"56266",doi:"10.5772/intechopen.69894",title:"Discourse: Assessment and Therapy",slug:"discourse-assessment-and-therapy",totalDownloads:3152,totalCrossrefCites:7,totalDimensionsCites:9,abstract:"Discourse is essential for interaction and for the expression of ideas, feelings and opinions. Telling personal stories, such as talking about your day or recounting what happened in the playground, is essential for communication and establishing relationships. However, due to their language impairments, people with aphasia (PWA) and children with developmental language disorder (DLD) often have problems with everyday discourse which impact on their lives more widely. While improvement in language skills is supported by speech-language pathology (therapy), it tends to focus on smaller linguistic components, such as single words and sentences. This chapter outlines how speakers construct discourse in everyday situations and focuses on the meanings that people use discourse to convey, as well as the lexical and grammatical resources they use to convey these meanings. Current methods for discourse analysis will be outlined and key developments in narrative discourse production therapy will be reviewed.",book:{id:"5957",slug:"advances-in-speech-language-pathology",title:"Advances in Speech-language Pathology",fullTitle:"Advances in Speech-language Pathology"},signatures:"Lucy T. Dipper and Madeleine Pritchard",authors:[{id:"201158",title:"Dr.",name:"Lucy",middleName:null,surname:"Dipper",slug:"lucy-dipper",fullName:"Lucy Dipper"},{id:"208542",title:"Dr.",name:"Madeleine",middleName:null,surname:"Pritchard",slug:"madeleine-pritchard",fullName:"Madeleine Pritchard"}]},{id:"70186",doi:"10.5772/intechopen.90173",title:"Computational Model for the Construction of Cognitive Maps",slug:"computational-model-for-the-construction-of-cognitive-maps",totalDownloads:798,totalCrossrefCites:5,totalDimensionsCites:7,abstract:"The chapter considers an option for solving the problem of storing data in the Web environment and providing an access to the data, taking into account their semantics, i.e., in accordance with the nature of the tasks solved by users of different classes. The proposed solution is based on the use of presentation of the data in the form of semantic networks. As the main technical tool for describing access methods, the chapter proposes cognitive maps (CMs), which can also be considered as semantic networks of special type. When access is done, the presentation of information consistent with the semantic description of the user is provided. The suggested method of constructing CMs is based on the intensional logic. The solution is presented in the form of a computational model, which provides for the construction of CM’s dependence on the parameter. The proposed method of parametrization makes it possible to take into account the semantic characteristics of users of various classes. Some CM constructions for problem domain description are presented. A method for semantically oriented naming of CMs is proposed. The method is based on building of a functor of special type.",book:{id:"7311",slug:"cognitive-and-intermedial-semiotics",title:"Cognitive and Intermedial Semiotics",fullTitle:"Cognitive and Intermedial Semiotics"},signatures:"Larisa Yu. Ismailova, Sergey V. Kosikov and Viacheslav E. Wolfengagen",authors:[{id:"299703",title:"Dr.",name:"Larisa",middleName:"Yusifovna",surname:"Ismailova",slug:"larisa-ismailova",fullName:"Larisa Ismailova"},{id:"299704",title:"Prof.",name:"Viacheslav",middleName:null,surname:"Wolfengagen",slug:"viacheslav-wolfengagen",fullName:"Viacheslav Wolfengagen"},{id:"299711",title:"Mr.",name:"Sergey V.",middleName:null,surname:"Kosikov",slug:"sergey-v.-kosikov",fullName:"Sergey V. Kosikov"}]},{id:"56281",doi:"10.5772/intechopen.70106",title:"Remote Speech-Language Intervention, with the Participation of Parents of Children with Autism",slug:"remote-speech-language-intervention-with-the-participation-of-parents-of-children-with-autism",totalDownloads:1541,totalCrossrefCites:1,totalDimensionsCites:5,abstract:"The question about the possibility of identifying the best therapeutic approach for children with autism spectrum disorder (ASD) has also been discussed in the literature. The intervention should be individualized, in order to involve the current level of development of the child and to identify the profile of the facilities and difficulties of each child. The families are constantly involved in complex and changeable context and are aware of the importance of access and participation to the treatment chosen, since that service delays can directly affect efficacy. In general, studies on language acquisition and development in autism focus on the child’s communication, and some analyze the mother seeking to understand how the role of parents and caregivers influences the communication of the children with autism. Observing the importance of the active inclusion of parents in the speech and language therapy of children with ASD, a Distance Speech Therapy Intervention project, was developed that would allow language stimulation of a greater number of children and adolescents with autism.",book:{id:"5957",slug:"advances-in-speech-language-pathology",title:"Advances in Speech-language Pathology",fullTitle:"Advances in Speech-language Pathology"},signatures:"Milene Rossi Pereira Barbosa and Fernanda Dreux Miranda\nFernandes",authors:[{id:"28286",title:"Dr.",name:"Fernanda Dreux Miranda",middleName:null,surname:"Fernandes",slug:"fernanda-dreux-miranda-fernandes",fullName:"Fernanda Dreux Miranda Fernandes"},{id:"171244",title:"Dr.",name:"Milene Rossi P.",middleName:null,surname:"Barbosa",slug:"milene-rossi-p.-barbosa",fullName:"Milene Rossi P. Barbosa"}]}],mostDownloadedChaptersLast30Days:[{id:"56698",title:"Risk Factors for Speech-Language Pathologies in Children",slug:"risk-factors-for-speech-language-pathologies-in-children",totalDownloads:1637,totalCrossrefCites:2,totalDimensionsCites:5,abstract:"Risk factors are understood to encompass “aspects of individual behavior or lifestyle, environmental exposure, hereditary or congenital characteristics that are associated with a health related condition”. These are conditions that increase the chances of the child presenting speech-language disorders and that can be avoided, controlled, or treated. Risk is defined as the chance of a child exposed to certain factors (environmental or biological) to acquire or develop speech-language disorders. The objectives of the present study were: to identify the risk factors for speech-language disorders in children up to five years of age and to verify the relationship between risk factors and speech-language diagnostic hypotheses. The aspects of being male gender, prematurity, shyness, being an only child or youngest child, presenting deleterious oral habits, having a family history of speech-language disorders, and use of licit or illicit drugs during pregnancy seem to be the factors that should draw the attention of the health professionals in child development. Therefore, the monitoring of children who have these risk factors should be performed in order to promote the necessary stimulation and the construction of healthy environments.",book:{id:"5957",slug:"advances-in-speech-language-pathology",title:"Advances in Speech-language Pathology",fullTitle:"Advances in Speech-language Pathology"},signatures:"Daniela Regina Molini-Avejonas, Laís Vignati Ferreira and Cibelle\nAlbuquerque de La Higuera Amato",authors:[{id:"38599",title:"Prof.",name:"Daniela",middleName:null,surname:"Molini-Avejonas",slug:"daniela-molini-avejonas",fullName:"Daniela Molini-Avejonas"},{id:"204612",title:"Prof.",name:"Cibelle",middleName:null,surname:"Amato",slug:"cibelle-amato",fullName:"Cibelle Amato"},{id:"210543",title:"Ms.",name:"Laís",middleName:null,surname:"Ferreira",slug:"lais-ferreira",fullName:"Laís Ferreira"}]},{id:"56385",title:"Formulaic Language: The Building Block of Aphasic Speech",slug:"formulaic-language-the-building-block-of-aphasic-speech",totalDownloads:1899,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Aphasia is a condition that may appear when parts of the brain (Broca’s or Wernicke’s area) responsible for language production and processing are damaged. In most cases, patients have the left side of their brain affected. Thus, formulaic language remains intact in most cases. During speech therapy, this can be a solid base to build on. Formulaic language consists of formulas that are fixed phrases, stereotypes that behave as a single-unit lexical item. They have a significant role in language acquisition and fluent discourse production. These ready-made parts of speech are stored in the long-term memory. Studies suggest that the processing of formulaic language engages right hemisphere areas of the brain. Due to their language impairment, people with aphasia often have a lower quality of life, consequently social and professional integration for them being problematic. The investigation of preserved patterns, such as formulaic language and impairments related to different aspects of discourse, may provide insights both for clinical practice and for cognitive science, therefore, facilitating a more efficient approach to treatment.",book:{id:"5957",slug:"advances-in-speech-language-pathology",title:"Advances in Speech-language Pathology",fullTitle:"Advances in Speech-language Pathology"},signatures:"Annamária Győrfi",authors:[{id:"200880",title:"Dr.",name:"Annamaria",middleName:null,surname:"Gyorfi",slug:"annamaria-gyorfi",fullName:"Annamaria Gyorfi"}]},{id:"72178",title:"Cognitive Semiotics and Conceptual Blend: A Case Study from The Crying of Lot 49",slug:"cognitive-semiotics-and-conceptual-blend-a-case-study-from-em-the-crying-of-lot-49-em-",totalDownloads:725,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Cognitive semiotics has been defined by the linguist Jordan Zlatev as “the need to unify or at least to ‘defragment’ our world-views, the need to come to terms with increasingly higher levels of dynamism and complexity”. If we consider, as it is clear from the second cognitive revolution, when embodiment claimed its leading role, that meaning emerges from the constant interaction of body-brain-environment, we need to redefine the field that asks “what is meaning and how does it emerge.” New theories about metaphors as neural nodes and image schemas would shed light over the emergence of meaning in human communication, and, to do so, the study of conceptual blends as essential cognitive tools and as an integrative theory should be put in the center of the debate. In words of Brandt and Brandt, “blends occur as signs and are therefore a natural subject of cognitive semiotics”. Here, we will represent the emergence of meaning in a blend from the highly dynamic and complex narrative The Crying of Lot 49 by Pynchon and propose a conceptual story (or mental space sequence of the story) of the mentioned blend.",book:{id:"7311",slug:"cognitive-and-intermedial-semiotics",title:"Cognitive and Intermedial Semiotics",fullTitle:"Cognitive and Intermedial Semiotics"},signatures:"Marta Silvera-Roig",authors:[{id:"302728",title:"Dr.",name:"Marta",middleName:null,surname:"Silvera-Roig",slug:"marta-silvera-roig",fullName:"Marta Silvera-Roig"}]},{id:"56266",title:"Discourse: Assessment and Therapy",slug:"discourse-assessment-and-therapy",totalDownloads:3149,totalCrossrefCites:7,totalDimensionsCites:9,abstract:"Discourse is essential for interaction and for the expression of ideas, feelings and opinions. Telling personal stories, such as talking about your day or recounting what happened in the playground, is essential for communication and establishing relationships. However, due to their language impairments, people with aphasia (PWA) and children with developmental language disorder (DLD) often have problems with everyday discourse which impact on their lives more widely. While improvement in language skills is supported by speech-language pathology (therapy), it tends to focus on smaller linguistic components, such as single words and sentences. This chapter outlines how speakers construct discourse in everyday situations and focuses on the meanings that people use discourse to convey, as well as the lexical and grammatical resources they use to convey these meanings. Current methods for discourse analysis will be outlined and key developments in narrative discourse production therapy will be reviewed.",book:{id:"5957",slug:"advances-in-speech-language-pathology",title:"Advances in Speech-language Pathology",fullTitle:"Advances in Speech-language Pathology"},signatures:"Lucy T. Dipper and Madeleine Pritchard",authors:[{id:"201158",title:"Dr.",name:"Lucy",middleName:null,surname:"Dipper",slug:"lucy-dipper",fullName:"Lucy Dipper"},{id:"208542",title:"Dr.",name:"Madeleine",middleName:null,surname:"Pritchard",slug:"madeleine-pritchard",fullName:"Madeleine Pritchard"}]},{id:"56414",title:"Evidence for Speech Sound Disorder (SSD) Assessment",slug:"evidence-for-speech-sound-disorder-ssd-assessment",totalDownloads:1651,totalCrossrefCites:1,totalDimensionsCites:2,abstract:"Comprehensive studies on aspects related to the assessment of different biomedical parameters (acoustic and laryngeal signs and oral airflow amplitude), as well as parameters for speech disorders, articulation rate, speech inconsistency, and speech stimulability, are essential for better professional practice and to understand misarticulations in children with speech sound disorders (SSDs). Different equipments that enable noninvasive collection and analysis of data have become more common in speech-language pathology practice. Studies recently conducted by our research group have emphasized the evaluation of auditory-perceptual processing by means of assessments of central auditory processing, electrophysiology of hearing—considering that pure-tone, speech audiometry, and tympanometry are routinely used with children during the diagnostic phase and motor speech production performed by acoustic analysis of speech, electroglottography, aerodynamic measures, and ultrasound tongue imaging. This chapter presents the recent advances observed in studies with Brazilian-Portuguese speakers aiming to improve the assessment of speech sound disorders and to understand better the relationship between the different processing mechanisms involved in speech.",book:{id:"5957",slug:"advances-in-speech-language-pathology",title:"Advances in Speech-language Pathology",fullTitle:"Advances in Speech-language Pathology"},signatures:"Haydée Fiszbein Wertzner, Danira T. Francisco, Tatiane F. Barrozo\nand Luciana O. 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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. He is also a peer reviewer with outsanding review status from Elsevier journals, including Physica A, Neurocomputing and Engineering Applications of Artificial Intelligence. Science CV available at: https://www.cienciavitae.pt//pt/8E1C-A8B3-78C5 and ORCID: https://orcid.org/0000-0002-0298-3974',institutionString:"University of Lisbon",institution:{name:"Universidade Lusófona",country:{name:"Portugal"}}},{id:"241400",title:"Prof.",name:"Mohammed",middleName:null,surname:"Bsiss",slug:"mohammed-bsiss",fullName:"Mohammed Bsiss",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241400/images/8062_n.jpg",biography:null,institutionString:null,institution:null},{id:"276128",title:"Dr.",name:"Hira",middleName:null,surname:"Fatima",slug:"hira-fatima",fullName:"Hira Fatima",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/276128/images/14420_n.jpg",biography:"Dr. Hira Fatima\nAssistant Professor\nDepartment of Mathematics\nInstitute of Applied Science\nMangalayatan University, Aligarh\nMobile: no : 8532041179\nhirafatima2014@gmal.com\n\nDr. Hira Fatima has received his Ph.D. degree in pure Mathematics from Aligarh Muslim University, Aligarh India. Currently working as an Assistant Professor in the Department of Mathematics, Institute of Applied Science, Mangalayatan University, Aligarh. She taught so many courses of Mathematics of UG and PG level. Her research Area of Expertise is Functional Analysis & Sequence Spaces. She has been working on Ideal Convergence of double sequence. She has published 17 research papers in National and International Journals including Cogent Mathematics, Filomat, Journal of Intelligent and Fuzzy Systems, Advances in Difference Equations, Journal of Mathematical Analysis, Journal of Mathematical & Computer Science etc. She has also reviewed few research papers for the and international journals. She is a member of Indian Mathematical Society.",institutionString:null,institution:null},{id:"414880",title:"Dr.",name:"Maryam",middleName:null,surname:"Vatankhah",slug:"maryam-vatankhah",fullName:"Maryam Vatankhah",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Borough of Manhattan Community College",country:{name:"United States of America"}}},{id:"414879",title:"Prof.",name:"Mohammad-Reza",middleName:null,surname:"Akbarzadeh-Totonchi",slug:"mohammad-reza-akbarzadeh-totonchi",fullName:"Mohammad-Reza Akbarzadeh-Totonchi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Ferdowsi University of Mashhad",country:{name:"Iran"}}},{id:"414878",title:"Prof.",name:"Reza",middleName:null,surname:"Fazel-Rezai",slug:"reza-fazel-rezai",fullName:"Reza Fazel-Rezai",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"American Public University System",country:{name:"United States of America"}}},{id:"426586",title:"Dr.",name:"Oladunni A.",middleName:null,surname:"Daramola",slug:"oladunni-a.-daramola",fullName:"Oladunni A. Daramola",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Federal University of Technology",country:{name:"Nigeria"}}},{id:"357014",title:"Prof.",name:"Leon",middleName:null,surname:"Bobrowski",slug:"leon-bobrowski",fullName:"Leon Bobrowski",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Bialystok University of Technology",country:{name:"Poland"}}},{id:"302698",title:"Dr.",name:"Yao",middleName:null,surname:"Shan",slug:"yao-shan",fullName:"Yao Shan",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Dalian University of Technology",country:{name:"China"}}},{id:"354126",title:"Dr.",name:"Setiawan",middleName:null,surname:"Hadi",slug:"setiawan-hadi",fullName:"Setiawan Hadi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Padjadjaran University",country:{name:"Indonesia"}}},{id:"125911",title:"Prof.",name:"Jia-Ching",middleName:null,surname:"Wang",slug:"jia-ching-wang",fullName:"Jia-Ching Wang",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"National Central University",country:{name:"Taiwan"}}},{id:"332603",title:"Prof.",name:"Kumar S.",middleName:null,surname:"Ray",slug:"kumar-s.-ray",fullName:"Kumar S. 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\r\n\tSustainable development focuses on linking economic development with environmental protection and social development to ensure future prosperity for people and the planet. To tackle global challenges of development and environment, the United Nations General Assembly in 2015 adopted the 17 Sustainable Development Goals. SDGs emphasize that environmental sustainability should be strongly linked to socio-economic development, which should be decoupled from escalating resource use and environmental degradation for the purpose of reducing environmental stress, enhancing human welfare, and improving regional equity. Moreover, sustainable development seeks a balance between human development and decrease in ecological/environmental marginal benefits. Under the increasing stress of climate change, many environmental problems have emerged causing severe impacts at both global and local scales, driving ecosystem service reduction and biodiversity loss. Humanity’s relationship with resource exploitation and environment protection is a major global concern, as new threats to human and environmental security emerge in the Anthropocene. Currently, the world is facing significant challenges in environmental sustainability to protect global environments and to restore degraded ecosystems, while maintaining human development with regional equality. Thus, environmental sustainability with healthy natural ecosystems is critical to maintaining human prosperity in our warming planet.
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After that, he was a postdoc research fellow at the University of British Columbia in Canada to do research on large-scale stream experimental manipulation and watershed ecological survey in temperate rainforests of BC. He was a faculty member at the University of Hong Kong to run ecological research projects on aquatic insects, fishes, and newts in Tropical Asian streams. He also conducted research in streams, rivers, and caves in Texas, USA, to study the ecology of macroinvertebrates, big-claw river shrimp, fish, turtles, and bats. 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\r\n\tThe era of antibiotics led us to the illusion that the problem of bacterial infection is over. However, bacterial flexibility and adaptation mechanisms allow them to survive and grow in extreme conditions. The best example is the formation of a sophisticated society of bacteria defined as a biofilm. Understanding the mechanism of bacterial biofilm formation has changed our perception of the development of bacterial infection but successfully eradicating biofilm remains a challenge. Considering the above, it is not surprising that bacteria remain a major public health threat despite the development of many groups of antibiotics. Additionally, increasing prevalence of acquired antibiotic resistance forces us to realize that we are far from controlling the development of bacterial infections. On the other hand, many infections are endogenous and result from an unbalanced relationship between the host and the microorganism. The increasing use of immunosuppressants, such as chemotherapy or organ transplantation, increases the incidence of patients highly susceptible to bacterial infections in the population.
\r\n
\r\n\tThis topic will focus on the current challenges and advantages in the diagnosis and treatment of bacterial infections. We will discuss the host-microbiota relationship, the treatment of chronic infections due to biofilm formation, and the development of new diagnostic tools to rapidly distinguish between colonization and probable infection.
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Hematogenous candidiasis is a worrisome issue that affects people all over the world, particularly ICU patients. CARD9 deficiency and fungal infection have been major issues in recent years. Invasive aspergillosis is associated with a significant death rate. Special attention should be given to endemic fungal infections, identification of important clinical fungal infections advanced in yeasts, filamentous fungal infections, skin mycobiome and fungal genomes, and immunity to fungal infections.\r\nIn addition, endemic fungal diseases or uncommon fungal infections caused by Mucor irregularis, dermatophytosis, Malassezia, cryptococcosis, chromoblastomycosis, coccidiosis, blastomycosis, histoplasmosis, sporotrichosis, and other fungi, should be monitored. \r\nThis topic includes the research progress on the etiology and pathogenesis of fungal infections, new methods of isolation and identification, rapid detection, drug sensitivity testing, new antifungal drugs, schemes and case series reports. It will provide significant opportunities and support for scientists, clinical doctors, mycologists, antifungal drug researchers, public health practitioners, and epidemiologists from all over the world to share new research, ideas and solutions to promote the development and progress of medical mycology.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/4.jpg",keywords:"Emerging Fungal Pathogens, Invasive Infections, Epidemiology, Cell Membrane, Fungal Virulence, Diagnosis, Treatment"},{id:"5",title:"Parasitic Infectious Diseases",scope:"Parasitic diseases have evolved alongside their human hosts. In many cases, these diseases have adapted so well that they have developed efficient resilience methods in the human host and can live in the host for years. Others, particularly some blood parasites, can cause very acute diseases and are responsible for millions of deaths yearly. Many parasitic diseases are classified as neglected tropical diseases because they have received minimal funding over recent years and, in many cases, are under-reported despite the critical role they play in morbidity and mortality among human and animal hosts. The current topic, Parasitic Infectious Diseases, in the Infectious Diseases Series aims to publish studies on the systematics, epidemiology, molecular biology, genomics, pathogenesis, genetics, and clinical significance of parasitic diseases from blood borne to intestinal parasites as well as zoonotic parasites. We hope to cover all aspects of parasitic diseases to provide current and relevant research data on these very important diseases. In the current atmosphere of the Coronavirus pandemic, communities around the world, particularly those in different underdeveloped areas, are faced with the growing challenges of the high burden of parasitic diseases. At the same time, they are faced with the Covid-19 pandemic leading to what some authors have called potential syndemics that might worsen the outcome of such infections. Therefore, it is important to conduct studies that examine parasitic infections in the context of the coronavirus pandemic for the benefit of all communities to help foster more informed decisions for the betterment of human and animal health.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/5.jpg",keywords:"Blood Borne Parasites, Intestinal Parasites, Protozoa, Helminths, Arthropods, Water Born Parasites, Epidemiology, Molecular Biology, Systematics, Genomics, Proteomics, Ecology"},{id:"6",title:"Viral Infectious Diseases",scope:"The Viral Infectious Diseases Book Series aims to provide a comprehensive overview of recent research trends and discoveries in various viral infectious diseases emerging around the globe. The emergence of any viral disease is hard to anticipate, which often contributes to death. A viral disease can be defined as an infectious disease that has recently appeared within a population or exists in nature with the rapid expansion of incident or geographic range. 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