Summary of biosurgical hemostats in burn surgery.
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Barely three months into the new year and we are happy to announce a monumental milestone reached - 150 million downloads.
\n\nThis achievement solidifies IntechOpen’s place as a pioneer in Open Access publishing and the home to some of the most relevant scientific research available through Open Access.
\n\nWe are so proud to have worked with so many bright minds throughout the years who have helped us spread knowledge through the power of Open Access and we look forward to continuing to support some of the greatest thinkers of our day.
\n\nThank you for making IntechOpen your place of learning, sharing, and discovery, and here’s to 150 million more!
\n\n\n\n\n'}],latestNews:[{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"45",leadTitle:null,fullTitle:"Ant Colony Optimization - Methods and Applications",title:"Ant Colony Optimization",subtitle:"Methods and Applications",reviewType:"peer-reviewed",abstract:"Ants communicate information by leaving pheromone tracks. A moving ant leaves, in varying quantities, some pheromone on the ground to mark its way. While an isolated ant moves essentially at random, an ant encountering a previously laid trail is able to detect it and decide with high probability to follow it, thus reinforcing the track with its own pheromone. The collective behavior that emerges is thus a positive feedback: where the more the ants following a track, the more attractive that track becomes for being followed; thus the probability with which an ant chooses a path increases with the number of ants that previously chose the same path. This elementary ant's behavior inspired the development of ant colony optimization by Marco Dorigo in 1992, constructing a meta-heuristic stochastic combinatorial computational methodology belonging to a family of related meta-heuristic methods such as simulated annealing, Tabu search and genetic algorithms. This book covers in twenty chapters state of the art methods and applications of utilizing ant colony optimization algorithms. New methods and theory such as multi colony ant algorithm based upon a new pheromone arithmetic crossover and a repulsive operator, new findings on ant colony convergence, and a diversity of engineering and science applications from transportation, water resources, electrical and computer science disciplines are presented.",isbn:null,printIsbn:"978-953-307-157-2",pdfIsbn:"978-953-51-5980-3",doi:"10.5772/577",price:139,priceEur:155,priceUsd:179,slug:"ant-colony-optimization-methods-and-applications",numberOfPages:354,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:null,bookSignature:"Avi Ostfeld",publishedDate:"February 4th 2011",coverURL:"https://cdn.intechopen.com/books/images_new/45.jpg",numberOfDownloads:52769,numberOfWosCitations:53,numberOfCrossrefCitations:37,numberOfCrossrefCitationsByBook:7,numberOfDimensionsCitations:61,numberOfDimensionsCitationsByBook:9,hasAltmetrics:0,numberOfTotalCitations:151,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"May 4th 2010",dateEndSecondStepPublish:"June 1st 2010",dateEndThirdStepPublish:"October 6th 2010",dateEndFourthStepPublish:"November 5th 2010",dateEndFifthStepPublish:"January 4th 2011",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,7",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"15000",title:"Dr.",name:"Avi",middleName:null,surname:"Ostfeld",slug:"avi-ostfeld",fullName:"Avi Ostfeld",profilePictureURL:"https://mts.intechopen.com/storage/users/15000/images/1583_n.jpg",biography:"Avi Ostfeld, D.Sc., P.E., D.WRE (www.technion.ac.il/~avi/avi.htm) is an Associate Professor at the Faculty of Civil and Environmental Engineering at the Technion – Israel Institute of Technology, and the Editor in Chief of the Journal of Water Resources Planning and Management Division, ASCE. Dr. Ostfeld was a Senior Engineer and Project Manager at TAHAL – Consulting Engineers Ltd. in Tel – Aviv from 1997 to 2000; a Research Associate at the Department of Civil Engineering, the University of Arizona, Tucson, AZ, from 1996 to 1997; and a Research Associate at the Technion Water Research Institute from 1994 to 1996. During 2008/2009 he spent sabbaticals as Visiting Professor at the University of Illinois at Urbana Champaign and at the University of Kyoto. Dr. Ostfeld research activities are in the fields of water resources systems, hydrology, and in particular in the area of water distribution systems optimization using evolutionary computation: water distribution systems security, optimal design and operation of water distribution systems, and integrating water quality and reliability into water distribution systems management and control.",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"2",institution:null}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"609",title:"Neural Network",slug:"numerical-analysis-and-scientific-computing-neural-network"}],chapters:[{id:"13584",title:"Multi-Colony Ant Algorithm",doi:"10.5772/13991",slug:"multi-colony-ant-algorithm",totalDownloads:2884,totalCrossrefCites:1,totalDimensionsCites:3,hasAltmetrics:0,abstract:null,signatures:"Enxiu Chen and Xiyu Liu",downloadPdfUrl:"/chapter/pdf-download/13584",previewPdfUrl:"/chapter/pdf-preview/13584",authors:[{id:"16486",title:"Prof.",name:"Xiyu",surname:"Liu",slug:"xiyu-liu",fullName:"Xiyu Liu"},{id:"16890",title:"Dr.",name:"Enxiu",surname:"Chen",slug:"enxiu-chen",fullName:"Enxiu Chen"}],corrections:null},{id:"13585",title:"Continuous Dynamic Optimization",doi:"10.5772/14794",slug:"continuous-dynamic-optimization",totalDownloads:2603,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:null,signatures:"Walid Tfaili",downloadPdfUrl:"/chapter/pdf-download/13585",previewPdfUrl:"/chapter/pdf-preview/13585",authors:[{id:"15968",title:"Dr.",name:"Walid",surname:"Tfaili",slug:"walid-tfaili",fullName:"Walid Tfaili"}],corrections:null},{id:"13586",title:"An AND-OR Fuzzy Neural Network",doi:"10.5772/16224",slug:"an-and-or-fuzzy-neural-network",totalDownloads:2884,totalCrossrefCites:1,totalDimensionsCites:0,hasAltmetrics:0,abstract:null,signatures:"Jianghua Sui",downloadPdfUrl:"/chapter/pdf-download/13586",previewPdfUrl:"/chapter/pdf-preview/13586",authors:[{id:"24067",title:"Prof.",name:"Jianghua",surname:"Sui",slug:"jianghua-sui",fullName:"Jianghua Sui"}],corrections:null},{id:"13587",title:"Some Issues of ACO Algorithm Convergence",doi:"10.5772/14510",slug:"some-issues-of-aco-algorithm-convergence",totalDownloads:1829,totalCrossrefCites:1,totalDimensionsCites:3,hasAltmetrics:0,abstract:null,signatures:"Lorenzo Carvelli and Giovanni Sebastiani",downloadPdfUrl:"/chapter/pdf-download/13587",previewPdfUrl:"/chapter/pdf-preview/13587",authors:[{id:"17290",title:"Prof.",name:"Giovanni",surname:"Sebastiani",slug:"giovanni-sebastiani",fullName:"Giovanni Sebastiani"},{id:"19277",title:"Prof.",name:"Lorenzo",surname:"Carvelli",slug:"lorenzo-carvelli",fullName:"Lorenzo Carvelli"}],corrections:null},{id:"13588",title:"Ant Colony Algorithms for Multiobjective Optimization",doi:"10.5772/14237",slug:"ant-colony-algorithms-for-multiobjective-optimization",totalDownloads:5024,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:null,signatures:"Jaqueline S. 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Management of blood loss throughout a burn patient’s hospital course is a critical part of global care of those with thermal injuries. Patients suffering major (20–59% Total Body Surface Area (TBSA)) or massive (>60% TBSA) burns experience coagulopathic complications similar to those reported in major trauma or septic shock [1, 2] – a reflection of the systemic impact of such massive injury burden. Burn-related endothelial injury causes the release of tissue factor from a proportionately large surface area, contributing to the generation and consumption of thrombin, fibrin, and other coagulations factors [3, 4, 5, 6, 7]. Platelet activation and consumption leads to thrombocytopenia that nadirs between 3 and 5 days after injury [8]. In addition, there are important secondary factors that contribute to coagulopathy including hemodilution from resuscitation, hypothermia, and acidosis (Figure 1) [1, 9, 10].
Schematic presentation of pathophysiologic mechanisms affecting coagulation in patients who sustained severe burn injuries. Legend: SIRS = systemic inflammatory response syndrome. Schematic adopted from Glas, et al. 2016.
In general, greater burn size correlates with increased duration of surgery, number of required operative procedures, and need for blood transfusion [11, 12]. For every 1% of total body surface excised, including surface area of skin graft donor site, a patient can experience as much as 10% loss of their calculated blood volume [13]. Since intraoperative blood loss from both excision of primary wound and donor sites can account for about one-third of blood products administered during an average burn injury hospitalization, minimizing blood loss in the operating room (OR) is vital for minimizing overall transfusion requirements [14, 15]. Blood product resuscitation alone is not sufficient for hemostasis and carries significant associated risks, which opens up an important opportunity for the consideration of topical hemostatic adjuncts in the overall blood management of the burned patient [8, 16, 17]. This chapter focuses on the roles of biosurgical hemostats as they pertain to the transfusion reduction strategy in the setting of thermal injury (Table 1).
Biosurgical hemostat | Application method(s) | Utility in burn surgery |
---|---|---|
Topical or tumescent; a typical solution is prepared as 1:1,000,000 epinephrine in normal saline, which constitutes a dilution of 1 mL of 1:1,000 epinephrine into 1 L of normal saline; lidocaine may be added | Long utilized in burn surgery for obtaining hemostasis, decreasing intraoperative blood loss, and substantially reducing rates of blood transfusions; generally safe, without clinically significant cardiovascular effects due to systemic absorption | |
A fine spray to create a thin layer resulting in approximately 0.05–0.06 mL/cm2 material distribution | Benefits include effective graft fixation, decreased hematoma and seroma formation, and shorter operative times; graft-take may be enhanced by the fibrin clot scaffold even when wound bed is infected; can also be used on the donor site to improve the time to hemostasis; excellent safety profile; important that surgeons recognize that not all FS are the same - different formulations or products may behave in a slightly different way | |
Donor-site dressing | In comparison to epinephrine and fibrin-based products, not as effective as hemostatic agent; as donor-site dressing, has been observed to provide superior hemostasis for skin-graft donor sites when compared to plain sterile gauze or paraffin gauze dressings; risk of dermal calcifications | |
Topical application | Studies on use in burn surgery are scarce; while platelets in burn patients appear to have normal functionality, further studies focusing on the quantitative hemostatic ability of PRP in the setting of thermal injury are needed | |
Administered topically or intravenously | Few studies exist evaluating the use of TXA in burn patients; however, overall available data is promising; one study demonstrated no difference in mortality or thromboembolic disease, and some improvement of graft survival in the TXA group | |
Topical dressing | While one RCT showed clinical equivalency of NuStat® compared to historic standard of care, the overall cost of wound care was significantly lower using NuStat®; further studies are needed | |
Topical application | 2017 phase II randomized parallel double-blinded study showed promising results without causing adverse events | |
Topical (3% soak applied to the tangential excision site) | Investigators reported no complications related to corrosive damage or lipid peroxidation; needs to be sufficiently irrigated from the wound bed prior to application of the split-thickness skin graft | |
Topical application | Limited literature exists on the use of ORC in burn surgery |
Summary of biosurgical hemostats in burn surgery.
Abbreviations: RCT = randomized controlled trial.
There are different types of available biosurgical hemostats, as outlined in Table 1. For the purposes of the current chapter, it is important to recognize that a gap exists between provider awareness of this class of adjunctive hemostatic agents and their actual clinical application. Arguably, the latter is much more extensive than one might initially realize or admit. It is therefore important to bring biosurgical hemostats into focus as increasing emphasis is being placed on reduction in unnecessary blood/blood product transfusions across burn centers and critical care units.
Epinephrine has long been used in burn surgery for obtaining hemostasis at both the wound excision site and donor site, decreasing intraoperative blood loss per area excised, and substantially reducing rates of blood transfusions (in some cases by as much as 50%) [18, 19]. When applying epinephrine to any operative site, a pre-made solution can be applied topically or injected as a tumescent solution [20]. Although exact concentrations and application modality may vary between institutions, a typical solution is prepared as 1:1,000,000 epinephrine in normal saline, which constitutes a dilution of 1 mL of 1:1,000 epinephrine into 1 L of normal saline [21, 22]. Addition of lidocaine to the above solution has also been described to help decrease postoperative pain, duration of surgery, general anesthesia, and potentially accelerate re-epithelialization of the donor site [23].
The tumescent technique significantly decreases intraoperative blood loss and has been shown to be generally safe, without clinically significant cardiovascular effects due to systemic absorption [19, 24, 25]. Typically, the diluted epinephrine is injected subcutaneously with either a long 18-gauge spinal needle or a blunt liposuction cannula with injector. When properly performed, the subcutaneous injection under the desired area causes the area to become firm (tumescent) and the overlying skin to blanch. Whether used at the donor site or the eschar excision site, the firm vasoconstricted surfaces tend to be better prepared for subsequent excision [18], both in terms of technical ease of the operation and decreased blood loss.
The same diluted epinephrine solution can also be used as a topical hemostatic agent at both the donor and wound excision sites. This is most commonly performed by soaking non-adherent gauze, such as specially coated cotton pads, in the epinephrine solution and then applying the pads directly to the freshly excised area. It should be noted that this is performed as a hemostatic maneuver only after any major or brisk surgical bleeding has first been controlled. The epinephrine solution soaked non-adherent gauze can be secured in place by lightly wrapping it with a bandage roll. Typically, these are allowed to stay in place for 10–20 minutes to allow for hemostasis to occur. Careful removal is important for preventing disruption of the newly formed clot. If any residual oozing is present, new gauze can be re-applied until adequate hemostasis is achieved. In the absence of non-adherent gauze, the epinephrine solution can alternatively be applied topically as a spray or gelatinous mixture (e.g., using water-based lubricant as an application medium) [26, 27]. Other vasoactive hemostatic agents utilized in burn surgery include terlipressin and phenylephrine, with associated literature descriptions of reportedly positive effects in terms of blood loss reduction and other operative characteristics [22, 28, 29, 30, 31, 32].
Fibrin is the hemostatic product of thrombin-mediated cleavage of fibrinogen [33]. Understanding the relationship between fibrinogen and thrombin has allowed for pharmaceutical companies to develop a variety of fibrin-based products, including those designed for hemostatic applications [34, 35]. Although fibrin sealants (FS) have been used since 1909, with reported use on skin grafts as early as 1944, the first formal U.S. Food and Drug Administration (FDA) approval of a FS for use with skin grafts – including those performed in burn surgery – did not come until 2008 (Artiss®, Baxter, Westlake Village, CA) [36]. Other similar products that fall within the class of “fibrin sealants” have been effectively used in the setting of skin grafts, with similar results [37, 38, 39].
Surgeons must recognize that not all FS are the same, and that different formulations or products may not always produce identical results. There are important differences across available products that one must understand in order to optimize clinical outcomes for the burn patient. The products available provide a range of concentration ratios of fibrinogen and thrombin solutions, which are combined and “mixed” during application. For example, Artiss® (Baxter, Westlake Village, CA) contains a ratio of 67–106 mg/mL fibrinogen to 2.5–6.5 units/mL thrombin [40], whereas Tisseel® (Baxter; Deerfield, IL, US) contains a ratio of 67–106 mg/mL fibrinogen to 400–625 units/mL thrombin [41]. Although both products contain similar amount of fibrinogen, the latter has 100-fold more thrombin. Higher concentrations of thrombin will speed up the polymerization process, decreasing clotting and sealing time. With regards to the aforementioned products, increasing the thrombin concentration by 100-fold effectively shortens the polymerization time from minutes to seconds. This difference is so robust that Tisseel® is FDA approved as a hemostatic agent, while Artiss® is not. When hemostasis is less of a concern and the intended use is primarily for sealant/fixation purposes, having a slower polymerization time is better suited for manipulating a skin graft into the desired location and orientation. Similar therapeutic outcomes have been reported using a variety of component concentrations, within a pre-specified range [42].
Benefits of using FS in burn surgery include effective graft fixation, decreased hematoma and seroma formation, and shorter operative times [42, 43, 44]. There may also be an added benefit in terms of improved postoperative pain, especially when compared to alternative skin graft fixation modalities such as staples or sutures [36, 45]. When applied correctly, ideally as a fine spray to create a thin layer that is only about 0.05–0.06 mL/cm2 thick, the graft-take may be enhanced by the fibrin clot scaffold which promotes migration of fibroblasts, epithelial cells, and keratinocytes [42, 46]. Even when the wound bed is infected, FS use may improve graft take by reinforcing graft adherence to the wound bed [47]. FS can also be used on the donor site to improve the time to hemostasis [48].
Taken collectively, FS have an excellent overall safety profile [44, 49, 50]. Historically, complications from exposure to bovine-derived thrombin have been reported, including the subsequent development of anti-bovine thrombin antibodies. Associated morbidity included bleeding, thromboembolisms, hypersensitivity reactions, and prolonged activated partial thromboplastin times (aPTT) [51]. However, most currently available FS are made with recombinant thrombin, which is far less immunogenic [52]. In fact, a meta-analysis of 10 clinical trials showed that at 1 month from surgery, less than 1% of patients exposed to recombinant thrombin will develop antibodies against it [53]. Furthermore, unlike anti-bovine thrombin antibodies, anti-recombinant thrombin antibodies do not neutralize activity of native human thrombin [53, 54]. Lastly, when compared to thrombin alone, FS appear to provide significantly more effective (and generally faster) hemostasis [55].
The use of calcium alginate (CA) to help control hemorrhage and improve graft take has been described in burn surgery for quite some time [56]. In comparison to epinephrine applications and fibrin-based products, CA is not as effective as a hemostatic agent [57]. However, as a donor site dressing CA has been observed to provide superior hemostasis for skin-graft harvesting sites when compared to plain sterile gauze or paraffin gauze dressings [58, 59, 60]. The alginate dressing also has several other potential advantages, including excellent absorptive properties, biodegradability, ease of postoperative maintenance/wound care, improved healing time, as well as notably lower risk of infection [61]. Still, CA donor site dressings are not without potential complications, including reported instances of dermal calcifications [62].
Investigational studies on the use of platelet-rich plasma (PRP) in burn surgery are scarce overall, with further paucity of data on PRP’s hemostatic properties [63, 64]. Nevertheless, there is growing evidence that supports the use of PRP as a promoter of wound bed hemostasis prior to split thickness skin graft (STSG) placement, with the intent of decreasing the rates of hematoma formation under a STSG [65, 66]. Although PRP may have additional benefits, including pain reduction, improved skin graft adherence, and decreased skin graft healing times [67, 68], these findings have not been consistent among all available clinical reports [69]. One case–control study comparing PRP extracted from burn patients to that from matched healthy volunteers demonstrated similar platelet counts and levels of growth factors [70]. It is important to mention that PRP (and its various subcomponents) may also play a role as a regenerative medicine approach due to its rich growth factor content and non-immunogenic properties [71]. For example, this may be important in promoting skin graft donor site healing. Finally, while the platelets in burn patients appear to have normal functionality, further studies focusing on determining the quantitative hemostatic ability of PRP in the setting of thermal injury are needed to fully understand its potential [72].
Tranexamic acid (TXA) is an antifibrinolytic agent, whose use topically and intravenously has been shown to decrease traumatic and perioperative blood loss, reducing the need for blood transfusions in multiple surgical applications [73, 74, 75, 76]. Despite the promising overall results from the trauma literature, there are very few studies evaluating TXA use in burn patients [77, 78]. Overall, available data show promise; however, there is also evidence of cytotoxicity in the context of wound re-epithelialization, especially with prolonged use/exposure [79]. One retrospective cohort study analyzing the effect of intraoperative intravenous TXA administration in major burn patients (>20% TBSA) undergoing primary wound excision and grafting found that intravenous TXA administration significantly decreased the amount of blood administered during and up to 24 hours after the index operation. The series of patients included in the study received a TXA infusion 15 minutes prior to surgical incision as a loading dose of 10 mg/kg given over 5 minutes, followed by continuous infusion of 1 mg/kg/h until the end of the procedure. Multivariate analysis revealed TXA to be protective against transfusion (Odds Ratio of 0.2) [77]. Secondary findings revealed no difference in mortality or thromboembolic disease, and some improvement of graft survival in the TXA group [77]. A prospective randomized trial of single dose intravenous TXA (15 mg/kg diluted to 25 ml with isotonic saline over 10 min) prior to wound excision in 50 adult patients with >20% TBSA burns found that the patients who received TXA experienced, on average, about 400 mL less intraoperative blood loss and required significantly less colloid replacement in comparison to those who received an equal volume of only isotonic saline before induction of general anesthesia [78]. Further confirmatory prospective clinical trials will be helpful in clarifying intravenous TXA’s place in burn surgery blood management protocols. In terms of TXA use as a topical agent, one case report concluded that such application of TXA, in addition to standard methods, is a safe and effective way of controlling bleeding during burn surgery [80]. Future well-designed, adequately powered comparative studies analyzing blood loss, graft survival, epithelialization rate, and infections are warranted.
One prospective randomized control trial compared NuStat® (a product containing patented Hemafiber Technology™ by Beeken Miomedical, Stoughton, MA) to the institutional standard of care for controlling bleeding at both burn and donor sites. Briefly, NuStat® is a two-component product consisting of continuous filament silica and bamboo cellulose, a combination that when used together promotes hemostasis by activating the clotting cascade. Though potentially underpowered, hemostasis provided by the NuStat® dressing was found to be at least comparable to other currently utilized approaches (epinephrine- and thrombin-soaked non-adherent dressings, saline-soaked laparotomy sponges, and elastic bandage wraps) [81]. While the reported results show clinical equivalency of NuStat® compared to historic standard of care, the overall cost of wound care was significantly lower using the novel hemostatic dressing [81]. It is unlikely that these findings alone will change operative practices by most burn surgeons; however, the study does provide an important new treatment option in an area of clinical care that has seen little progress during the past few decades.
As an initiator of the coagulation cascade, tissue factor is both an intriguing and a promising candidate for use as a topical hemostatic agent. Based on compelling preclinical and clinical data [82, 83, 84], a phase II randomized parallel double-blinded study was published in 2017 comparing an investigational topical hemostatic agent “TT-173” that is based on recombinant tissue factor (rTF) to a placebo, for establishing hemostasis at the donor site in burn surgery. The investigational agent “TT-173” reportedly decreased bleeding time from 7 minutes to 3 minutes without causing adverse events, systemic absorption, immunogenic reaction, or perturbance of donor site healing [85]. Further research into rTF as a potential new adjunct in operative hemostasis in burn surgery is clearly warranted based on the above reports.
Hydrogen peroxide used as a 3% soak applied to the tangential excision site has been reported as a potentially effective and safe means of achieving hemostasis in a burn patient with platelet dysfunction. In one published experience, the investigators reported no apparent morbidity related to corrosive damage or lipid peroxidation, which is a known complication associated with higher concentrations of hydrogen peroxide. With the hydrogen peroxide sufficiently irrigated from the wound bed prior to application of the STSG, the investigators saw excellent graft take [86]. Other reported uses of hydrogen peroxide as a topical hemostat, either alone or in combination with another agent, have been described in maxillofacial and otolaryngology applications [87, 88]. Benefits of the above approach included less blood loss, shorter procedure times, and fewer surgical ties used [87, 88].
There is some evidence to suggest that the application of oxidized regenerated cellulose (ORC) products to skin graft donor sites may significantly shorten wound healing and recovery time [89]. The difference between ORC-treated donor sites and fine mesh gauze treated with nitrofurazone (FMN) was substantial, with semiclosed ORC dressing group achieving healing endpoint in 6.5 days (compared to 9.9 days for FMN) and closed ORC dressing group achieving healing in 5.4 days (compared to 8.4 days for FMN) [89]. With limited literature on the use of ORC-based products in burn surgery, further research is warranted to determine safety and efficacy of this topical hemostatic approach.
Although this chapter focuses on topical hemostats in burn surgery, one well-known and highly effective topical hemostat warrants a special mention as a risk-factor for thermal injury [90]. Granular zeolite (GZ, also known as QuikClot®) is a material derived from lava rocks and introduced for field use in the early 2000’s [91]. The material is effective via a complex mechanism that involves an exothermic reaction coupled with absorption of water and the ability to concentrate coagulation factors [91, 92, 93]. There are multiple reports of GZ causing both cutaneous and internal burns due to excessive heat generation [90, 94, 95]. In fact, the original formulation was deemed sufficiently dangerous – able to reach temperatures up to 65°C (149°F) and cause burns to the operating surgeon – that it was discontinued in 2008 and replaced with a modified QuikClot® ACS and kaolin-containing QuikClot Combat Gauze formulation [91]. Based on the above observations, GZ should not be utilized in burn surgery, at least in its currently available formulation(s).
Although their use is certainly not novel in burn surgery, the awareness of biosurgical hemostats appears to be far from adequate. Given the above, the goal of this chapter was to both review published applications of biosurgicals in burn surgery and to increase awareness of these potentially valuable adjuncts. Especially important in this context is the emergence of new research involving novel topical hemostatic agents, such as the Hemafiber Technology™ and recombinant tissue factor. Similar to other surgical specialties, the management of thermal injuries focuses increasingly on optimizing care protocols, maximizing outcomes, and minimizing the need for potentially harmful and costly interventions such as blood and blood product transfusions. The authors believe that the current chapter provides a solid foundation of relevant clinical knowledge in the emerging area of biosurgical hemostasis in burn surgery.
This is a brief overview of the main steps involved in publishing with IntechOpen Compacts, Monographs and Edited Books. Once you submit your proposal you will be appointed a Author Service Manager who will be your single point of contact and lead you through all the described steps below.
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On September, 29th 2006 he has won a post PhD fellowship from the university of Bologna (from October 2006 to October 2008), at the competitive examination he was ranked first in the industrial engineering area. He extensively served as referee for several international journals. He is author/coauthor of more than 100 research papers. He has been involved in some projects supported by MURST and European Community. 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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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Aalborg University has Two Satellite Campuses, one in Copenhagen (Aalborg University Copenhagen) and the other in Esbjerg (Aalborg University Esbjerg).\n· He is a member of prestigious IEEE (Institute of Electrical and Electronics Engineers), and IAENG (International Association of Engineers) organizations. \n· He is the chief Editor of the Journal of Software Engineering.\n· He is the member of the Editorial Board of International Journal of Computer Science and Software Technology (IJCSST) and International Journal of Computer Engineering and Information Technology. \n· He is also the Editor of Communication in Computer and Information Science CCIS-20 by Springer.\n· Reviewer For Many Conferences\nHe is the lead person in making collaboration agreements between Aalborg University and many universities of Pakistan, for which the MOU’s (Memorandum of Understanding) have been signed.\nProfessor Akbar is working in Academia since 1990, he started his career as a Lab demonstrator/TA at the University of Sussex. After finishing his P. hD degree in 1992, he served in the Industry as a Scientific Officer and continued his academic career as a visiting scholar for a number of educational institutions. In 1996 he joined National University of Science & Technology Pakistan (NUST) as an Associate Professor; NUST is one of the top few universities in Pakistan. In 1999 he joined an International Company Lineo Inc, Canada as Manager Compiler Group, where he headed the group for developing Compiler Tool Chain and Porting of Operating Systems for the BLACKfin processor. The processor development was a joint venture by Intel and Analog Devices. In 2002 Lineo Inc., was taken over by another company, so he joined Aalborg University Denmark as an Assistant Professor.\nProfessor Akbar has truly a multi-disciplined career and he continued his legacy and making progress in many areas of his interests both in teaching and research. 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Generally, the phytochemical constituents of plants fall into two categories based on their role in basic metabolic processes, namely primary and secondary metabolites. Primary plant metabolites are involved in basic life functions; therefore, they are more or less similar in all living cells. On the other hand, secondary plant metabolites are products of subsidiary pathways as the shikimic acid pathway. In the course of studying, the medicinal effect of herbals is oriented towards the secondary plant metabolites. Secondary plant metabolites played an important role in alleviating several aliments in the traditional medicine and folk uses. In modern medicine, they provided lead compounds for the production of medications for treating various diseases from migraine up to cancer. Secondary plant metabolites are classified according to their chemical structures into various classes. In this chapter, we will be presenting various classes of secondary plant metabolites, their distribution in different plant families and their important medicinal uses.",book:{id:"6302",slug:"herbal-medicine",title:"Herbal Medicine",fullTitle:"Herbal Medicine"},signatures:"Rehab A. Hussein and Amira A. El-Anssary",authors:[{id:"212117",title:"Dr.",name:"Rehab",middleName:null,surname:"Hussein",slug:"rehab-hussein",fullName:"Rehab Hussein"},{id:"221140",title:"Dr.",name:"Amira",middleName:null,surname:"El-Anssary",slug:"amira-el-anssary",fullName:"Amira El-Anssary"}]},{id:"64851",doi:"10.5772/intechopen.80348",title:"Herbal Medicines in African Traditional Medicine",slug:"herbal-medicines-in-african-traditional-medicine",totalDownloads:14206,totalCrossrefCites:30,totalDimensionsCites:52,abstract:"African traditional medicine is a form of holistic health care system organized into three levels of specialty, namely divination, spiritualism, and herbalism. The traditional healer provides health care services based on culture, religious background, knowledge, attitudes, and beliefs that are prevalent in his community. Illness is regarded as having both natural and supernatural causes and thus must be treated by both physical and spiritual means, using divination, incantations, animal sacrifice, exorcism, and herbs. Herbal medicine is the cornerstone of traditional medicine but may include minerals and animal parts. The adjustment is ok, but may be replaced with –‘ Herbal medicine was once termed primitive by western medicine but through scientific investigations there is a better understanding of its therapeutic activities such that many pharmaceuticals have been modeled on phytochemicals derived from it. Major obstacles to the use of African medicinal plants are their poor quality control and safety. Traditional medical practices are still shrouded with much secrecy, with few reports or documentations of adverse reactions. However, the future of African traditional medicine is bright if viewed in the context of service provision, increase of health care coverage, economic potential, and poverty reduction. Formal recognition and integration of traditional medicine into conventional medicine will hold much promise for the future.",book:{id:"6302",slug:"herbal-medicine",title:"Herbal Medicine",fullTitle:"Herbal Medicine"},signatures:"Ezekwesili-Ofili Josephine Ozioma and Okaka Antoinette Nwamaka\nChinwe",authors:[{id:"191264",title:"Prof.",name:"Josephine",middleName:"Ozioma",surname:"Ezekwesili-Ofili",slug:"josephine-ezekwesili-ofili",fullName:"Josephine Ezekwesili-Ofili"},{id:"211585",title:"Prof.",name:"Antoinette",middleName:null,surname:"Okaka",slug:"antoinette-okaka",fullName:"Antoinette Okaka"}]},{id:"54028",doi:"10.5772/67291",title:"Chemical Composition and Biological Activities of Mentha Species",slug:"chemical-composition-and-biological-activities-of-mentha-species",totalDownloads:7474,totalCrossrefCites:13,totalDimensionsCites:46,abstract:"The genus Mentha L. (Lamiaceae) is distributed all over the world and can be found in many environments. Mentha species, one of the world’s oldest and most popular herbs, are widely used in cooking, in cosmetics, and as alternative or complementary therapy, mainly for the treatment of gastrointestinal disorders like flatulence, indigestion, nausea, vomiting, anorexia, and ulcerative colitis. Furthermore, it is well documented that the essential oil and extracts of Mentha species possess antimicrobial, fungicidal, antiviral, insecticidal, and antioxidant properties. The economic importance of mints is also evident; mint oil and its constituents and derivatives are used as flavoring agents throughout the world in food, pharmaceutical, herbal, perfumery, and flavoring industry. To provide a scientific basis for their traditional uses, several studies have been conducted to determine the chemical composition of mints and assess their biological activities. This chapter describes the therapeutic effects and uses of Mentha species and their constituents, particularly essential oils and phenolic compounds; some additional biological activities will also be considered.",book:{id:"5612",slug:"aromatic-and-medicinal-plants-back-to-nature",title:"Aromatic and Medicinal Plants",fullTitle:"Aromatic and Medicinal Plants - Back to Nature"},signatures:"Fatiha Brahmi, Madani Khodir, Chibane Mohamed and Duez Pierre",authors:[{id:"193281",title:"Dr.",name:"Fatiha",middleName:null,surname:"Brahmi",slug:"fatiha-brahmi",fullName:"Fatiha Brahmi"},{id:"199693",title:"Prof.",name:"Khodir",middleName:null,surname:"Madani",slug:"khodir-madani",fullName:"Khodir Madani"},{id:"199694",title:"Prof.",name:"Pierre",middleName:null,surname:"Duez",slug:"pierre-duez",fullName:"Pierre Duez"},{id:"203738",title:"Prof.",name:"Mohamed",middleName:null,surname:"Chibane",slug:"mohamed-chibane",fullName:"Mohamed Chibane"}]},{id:"58270",doi:"10.5772/intechopen.72437",title:"Toxicity and Safety Implications of Herbal Medicines Used in Africa",slug:"toxicity-and-safety-implications-of-herbal-medicines-used-in-africa",totalDownloads:3376,totalCrossrefCites:16,totalDimensionsCites:39,abstract:"The use of herbal medicines has seen a great upsurge globally. In developing countries, many patronize them largely due to cultural acceptability, availability and cost. In developed countries, they are used because they are natural and therefore assumed to be safer than allopathic medicines. In recent times, however, there has been a growing concern about their safety. This has created a situation of ambivalence in discussions regarding their use. Some medicinal plants are intrinsically toxic by virtue of their constituents and can cause adverse reactions if inappropriately used. Other factors such as herb-drug interactions, lack of adherence to good manufacturing practice (GMP), poor regulatory measures and adulteration may also lead to adverse events in their use. Many in vivo tests on aqueous extracts largely support the safety of herbal medicines, whereas most in vitro tests on isolated single cells mostly with extracts other than aqueous ones show contrary results and thus continue the debate on herbal medicine safety. It is expected that toxicity studies concerning herbal medicine should reflect their traditional use to allow for rational discussions regarding their safety for their beneficial use. While various attempts continue to establish the safety of various herbal medicines in man, their cautious and responsible use is required.",book:{id:"6302",slug:"herbal-medicine",title:"Herbal Medicine",fullTitle:"Herbal Medicine"},signatures:"Merlin L.K. Mensah, Gustav Komlaga, Arnold D. Forkuo, Caleb\nFirempong, Alexander K. Anning and Rita A. Dickson",authors:[{id:"190435",title:"Dr.",name:"Caleb",middleName:null,surname:"Firempong",slug:"caleb-firempong",fullName:"Caleb Firempong"},{id:"212111",title:"Dr.",name:"Gustav",middleName:null,surname:"Komlaga",slug:"gustav-komlaga",fullName:"Gustav Komlaga"},{id:"217045",title:"Dr.",name:"Arnold Forkuo",middleName:null,surname:"Donkor",slug:"arnold-forkuo-donkor",fullName:"Arnold Forkuo Donkor"},{id:"217049",title:"Prof.",name:"Merlin Lincoln Kwao",middleName:null,surname:"Mensah",slug:"merlin-lincoln-kwao-mensah",fullName:"Merlin Lincoln Kwao Mensah"},{id:"217488",title:"Dr.",name:"Alexander K.",middleName:null,surname:"Anning",slug:"alexander-k.-anning",fullName:"Alexander K. Anning"},{id:"223959",title:"Prof.",name:"Akosua Rita",middleName:null,surname:"Dickson",slug:"akosua-rita-dickson",fullName:"Akosua Rita Dickson"}]},{id:"26489",doi:"10.5772/28224",title:"Alternative and Traditional Medicines Systems in Pakistan: History, Regulation, Trends, Usefulness, Challenges, Prospects and Limitations",slug:"alternative-and-traditional-medicines-systems-in-pakistan-history-regulation-trends-usefulness-chall",totalDownloads:9199,totalCrossrefCites:9,totalDimensionsCites:21,abstract:null,book:{id:"542",slug:"a-compendium-of-essays-on-alternative-therapy",title:"A Compendium of Essays on Alternative Therapy",fullTitle:"A Compendium of Essays on Alternative Therapy"},signatures:"Shahzad Hussain, Farnaz Malik, Nadeem Khalid, Muhammad Abdul Qayyum and Humayun Riaz",authors:[{id:"73162",title:"Dr.",name:"Shahzad",middleName:null,surname:"Hussain",slug:"shahzad-hussain",fullName:"Shahzad Hussain"},{id:"82266",title:"Dr.",name:"Farnaz",middleName:null,surname:"Malik",slug:"farnaz-malik",fullName:"Farnaz Malik"},{id:"124185",title:"Dr.",name:"Humayun",middleName:null,surname:"Riaz",slug:"humayun-riaz",fullName:"Humayun Riaz"},{id:"124186",title:"Mr.",name:"Muhammad Abdul",middleName:null,surname:"Qayyum",slug:"muhammad-abdul-qayyum",fullName:"Muhammad Abdul Qayyum"},{id:"125340",title:"Mr.",name:"Nadeem",middleName:null,surname:"Khalid",slug:"nadeem-khalid",fullName:"Nadeem Khalid"}]}],mostDownloadedChaptersLast30Days:[{id:"64851",title:"Herbal Medicines in African Traditional Medicine",slug:"herbal-medicines-in-african-traditional-medicine",totalDownloads:14149,totalCrossrefCites:29,totalDimensionsCites:52,abstract:"African traditional medicine is a form of holistic health care system organized into three levels of specialty, namely divination, spiritualism, and herbalism. The traditional healer provides health care services based on culture, religious background, knowledge, attitudes, and beliefs that are prevalent in his community. Illness is regarded as having both natural and supernatural causes and thus must be treated by both physical and spiritual means, using divination, incantations, animal sacrifice, exorcism, and herbs. Herbal medicine is the cornerstone of traditional medicine but may include minerals and animal parts. The adjustment is ok, but may be replaced with –‘ Herbal medicine was once termed primitive by western medicine but through scientific investigations there is a better understanding of its therapeutic activities such that many pharmaceuticals have been modeled on phytochemicals derived from it. Major obstacles to the use of African medicinal plants are their poor quality control and safety. Traditional medical practices are still shrouded with much secrecy, with few reports or documentations of adverse reactions. However, the future of African traditional medicine is bright if viewed in the context of service provision, increase of health care coverage, economic potential, and poverty reduction. Formal recognition and integration of traditional medicine into conventional medicine will hold much promise for the future.",book:{id:"6302",slug:"herbal-medicine",title:"Herbal Medicine",fullTitle:"Herbal Medicine"},signatures:"Ezekwesili-Ofili Josephine Ozioma and Okaka Antoinette Nwamaka\nChinwe",authors:[{id:"191264",title:"Prof.",name:"Josephine",middleName:"Ozioma",surname:"Ezekwesili-Ofili",slug:"josephine-ezekwesili-ofili",fullName:"Josephine Ezekwesili-Ofili"},{id:"211585",title:"Prof.",name:"Antoinette",middleName:null,surname:"Okaka",slug:"antoinette-okaka",fullName:"Antoinette Okaka"}]},{id:"61866",title:"Plants Secondary Metabolites: The Key Drivers of the Pharmacological Actions of Medicinal Plants",slug:"plants-secondary-metabolites-the-key-drivers-of-the-pharmacological-actions-of-medicinal-plants",totalDownloads:8839,totalCrossrefCites:55,totalDimensionsCites:138,abstract:"The vast and versatile pharmacological effects of medicinal plants are basically dependent on their phytochemical constituents. Generally, the phytochemical constituents of plants fall into two categories based on their role in basic metabolic processes, namely primary and secondary metabolites. Primary plant metabolites are involved in basic life functions; therefore, they are more or less similar in all living cells. On the other hand, secondary plant metabolites are products of subsidiary pathways as the shikimic acid pathway. In the course of studying, the medicinal effect of herbals is oriented towards the secondary plant metabolites. Secondary plant metabolites played an important role in alleviating several aliments in the traditional medicine and folk uses. In modern medicine, they provided lead compounds for the production of medications for treating various diseases from migraine up to cancer. Secondary plant metabolites are classified according to their chemical structures into various classes. In this chapter, we will be presenting various classes of secondary plant metabolites, their distribution in different plant families and their important medicinal uses.",book:{id:"6302",slug:"herbal-medicine",title:"Herbal Medicine",fullTitle:"Herbal Medicine"},signatures:"Rehab A. Hussein and Amira A. El-Anssary",authors:[{id:"212117",title:"Dr.",name:"Rehab",middleName:null,surname:"Hussein",slug:"rehab-hussein",fullName:"Rehab Hussein"},{id:"221140",title:"Dr.",name:"Amira",middleName:null,surname:"El-Anssary",slug:"amira-el-anssary",fullName:"Amira El-Anssary"}]},{id:"77433",title:"Extraction of Bioactive Compounds from Medicinal Plants and Herbs",slug:"extraction-of-bioactive-compounds-from-medicinal-plants-and-herbs",totalDownloads:1236,totalCrossrefCites:1,totalDimensionsCites:4,abstract:"Human beings have relied on herbs and medicinal plants as sources of food and remedy from time immemorial. Bioactive compounds from plants are currently the subject of much research interest, but their extraction as part of phytochemical and/or biological investigations present specific challenges. Herbalists or scientists have developed many protocols of extraction of bioactive ingredients to ensure the effectiveness and the efficacy of crude drugs that were used to get relief from sickness. With the advent of new leads from plants such as morphine, quinine, taxol, artemisinin, and alkaloids from Voacanga species, a lot of attention is paid to the mode of extraction of active phytochemicals to limit the cost linked to the synthesis and isolation. Thus, the extraction of active compounds from plants needs appropriate extraction methods and techniques that provide bioactive ingredients-rich extracts and fractions. The extraction procedures, therefore, play a critical role in the yield, the nature of phytochemical content, etc. This chapter aims to present, describe, and compare extraction procedures of bioactive compounds from herbs and medicinal plants.",book:{id:"10356",slug:"natural-medicinal-plants",title:"Natural Medicinal Plants",fullTitle:"Natural Medicinal Plants"},signatures:"Fongang Fotsing Yannick Stéphane, Bankeu Kezetas Jean Jules, Gaber El-Saber Batiha, Iftikhar Ali and Lenta Ndjakou Bruno",authors:[{id:"224515",title:"Dr.",name:"Fongang Fotsing",middleName:null,surname:"Yannick Stéphane",slug:"fongang-fotsing-yannick-stephane",fullName:"Fongang Fotsing Yannick Stéphane"},{id:"227816",title:"Dr.",name:"Bankeu Kezetas",middleName:null,surname:"Jean Jules",slug:"bankeu-kezetas-jean-jules",fullName:"Bankeu Kezetas Jean Jules"},{id:"227817",title:"Prof.",name:"Lenta Ndjakou",middleName:null,surname:"Bruno",slug:"lenta-ndjakou-bruno",fullName:"Lenta Ndjakou Bruno"},{id:"349790",title:"Prof.",name:"Gaber",middleName:null,surname:"El-Saber Batiha",slug:"gaber-el-saber-batiha",fullName:"Gaber El-Saber Batiha"},{id:"357350",title:"Dr.",name:"Iftikhar",middleName:null,surname:"Ali",slug:"iftikhar-ali",fullName:"Iftikhar Ali"}]},{id:"26491",title:"Homeopathy: Treatment of Cancer with the Banerji Protocols",slug:"homeopathy-treatment-of-cancer-with-the-banerji-protocols",totalDownloads:54022,totalCrossrefCites:1,totalDimensionsCites:2,abstract:null,book:{id:"542",slug:"a-compendium-of-essays-on-alternative-therapy",title:"A Compendium of Essays on Alternative Therapy",fullTitle:"A Compendium of Essays on Alternative Therapy"},signatures:"Prasanta Banerji and Pratip Banerji",authors:[{id:"79939",title:"Dr",name:"Prasanta",middleName:null,surname:"Banerji",slug:"prasanta-banerji",fullName:"Prasanta Banerji"},{id:"79943",title:"Dr.",name:"Pratip",middleName:null,surname:"Banerji",slug:"pratip-banerji",fullName:"Pratip Banerji"}]},{id:"54028",title:"Chemical Composition and Biological Activities of Mentha Species",slug:"chemical-composition-and-biological-activities-of-mentha-species",totalDownloads:7469,totalCrossrefCites:13,totalDimensionsCites:44,abstract:"The genus Mentha L. (Lamiaceae) is distributed all over the world and can be found in many environments. Mentha species, one of the world’s oldest and most popular herbs, are widely used in cooking, in cosmetics, and as alternative or complementary therapy, mainly for the treatment of gastrointestinal disorders like flatulence, indigestion, nausea, vomiting, anorexia, and ulcerative colitis. Furthermore, it is well documented that the essential oil and extracts of Mentha species possess antimicrobial, fungicidal, antiviral, insecticidal, and antioxidant properties. The economic importance of mints is also evident; mint oil and its constituents and derivatives are used as flavoring agents throughout the world in food, pharmaceutical, herbal, perfumery, and flavoring industry. To provide a scientific basis for their traditional uses, several studies have been conducted to determine the chemical composition of mints and assess their biological activities. This chapter describes the therapeutic effects and uses of Mentha species and their constituents, particularly essential oils and phenolic compounds; some additional biological activities will also be considered.",book:{id:"5612",slug:"aromatic-and-medicinal-plants-back-to-nature",title:"Aromatic and Medicinal Plants",fullTitle:"Aromatic and Medicinal Plants - Back to Nature"},signatures:"Fatiha Brahmi, Madani Khodir, Chibane Mohamed and Duez Pierre",authors:[{id:"193281",title:"Dr.",name:"Fatiha",middleName:null,surname:"Brahmi",slug:"fatiha-brahmi",fullName:"Fatiha Brahmi"},{id:"199693",title:"Prof.",name:"Khodir",middleName:null,surname:"Madani",slug:"khodir-madani",fullName:"Khodir Madani"},{id:"199694",title:"Prof.",name:"Pierre",middleName:null,surname:"Duez",slug:"pierre-duez",fullName:"Pierre Duez"},{id:"203738",title:"Prof.",name:"Mohamed",middleName:null,surname:"Chibane",slug:"mohamed-chibane",fullName:"Mohamed Chibane"}]}],onlineFirstChaptersFilter:{topicId:"991",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:89,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:104,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:31,numberOfPublishedChapters:314,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:11,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:141,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:113,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:105,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:18,numberOfOpenTopics:2,numberOfUpcomingTopics:1,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:5,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:14,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}},{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. 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She has been a faculty member at the University of California, Riverside in the School of Education since 2016. Her research focuses on translational studies to explore the reward system in ASD, as well as how anxiety contributes to social challenges in ASD. She also investigates how behavioral interventions affect neural activity, behavior, and school performance in children with ASD. She is also involved in the diagnosis of children with ASD and is a licensed clinical psychologist in California. She is the Assistant Director of the SEARCH Center at UCR and is a Faculty member in the Graduate Program in Neuroscience.",institutionString:null,institution:{name:"University of California, Riverside",institutionURL:null,country:{name:"United States of America"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:2,paginationItems:[{id:"89",title:"Education",coverUrl:"https://cdn.intechopen.com/series_topics/covers/89.jpg",isOpenForSubmission:!1,editor:{id:"260066",title:"Associate Prof.",name:"Michail",middleName:null,surname:"Kalogiannakis",slug:"michail-kalogiannakis",fullName:"Michail Kalogiannakis",profilePictureURL:"https://mts.intechopen.com/storage/users/260066/images/system/260066.jpg",biography:"Michail Kalogiannakis is an Associate Professor of the Department of Preschool Education, University of Crete, and an Associate Tutor at School of Humanities at the Hellenic Open University. He graduated from the Physics Department of the University of Crete and continued his post-graduate studies at the University Paris 7-Denis Diderot (D.E.A. in Didactic of Physics), University Paris 5-René Descartes-Sorbonne (D.E.A. in Science Education) and received his Ph.D. degree at the University Paris 5-René Descartes-Sorbonne (PhD in Science Education). His research interests include science education in early childhood, science teaching and learning, e-learning, the use of ICT in science education, games simulations, and mobile learning. 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She has run and participated in several funded and non-funded projects on the teaching of Science, Social Sciences, and ICT in education. She also has the experience of participating in five Erasmus+ projects.",institutionString:"University of Crete",institution:{name:"University of Crete",institutionURL:null,country:{name:"Greece"}}},editorThree:null},{id:"90",title:"Human Development",coverUrl:"https://cdn.intechopen.com/series_topics/covers/90.jpg",isOpenForSubmission:!0,editor:{id:"191040",title:"Dr.",name:"Tal",middleName:null,surname:"Dotan Ben-Soussan",slug:"tal-dotan-ben-soussan",fullName:"Tal Dotan Ben-Soussan",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSBf1QAG/Profile_Picture_2022-03-18T07:56:11.jpg",biography:"Tal Dotan Ben-Soussan, Ph.D., is the director of the Research Institute for Neuroscience, Education and Didactics (RINED) – Paoletti Foundation. 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She is currently an Adjunct Professor at Feevale University in Medicine and Biomedicine courses and a permanent professor of the Academic Master\\'s Degree in Virology. She has experience in the field of Microbiology, with an emphasis on Bacteriology, working mainly on the following topics: bacteriophages, bacterial resistance, clinical microbiology and food microbiology.",institutionString:null,institution:{name:"Universidade Feevale",country:{name:"Brazil"}}},{id:"229220",title:"Dr.",name:"Amjad",middleName:"Islam",surname:"Aqib",slug:"amjad-aqib",fullName:"Amjad Aqib",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229220/images/system/229220.png",biography:"Dr. Amjad Islam Aqib obtained a DVM and MSc (Hons) from University of Agriculture Faisalabad (UAF), Pakistan, and a PhD from the University of Veterinary and Animal Sciences Lahore, Pakistan. Dr. Aqib joined the Department of Clinical Medicine and Surgery at UAF for one year as an assistant professor where he developed a research laboratory designated for pathogenic bacteria. Since 2018, he has been Assistant Professor/Officer in-charge, Department of Medicine, Manager Research Operations and Development-ORIC, and President One Health Club at Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan. He has nearly 100 publications to his credit. His research interests include epidemiological patterns and molecular analysis of antimicrobial resistance and modulation and vaccine development against animal pathogens of public health concern.",institutionString:"Cholistan University of Veterinary and Animal Sciences",institution:null},{id:"62900",title:"Prof.",name:"Fethi",middleName:null,surname:"Derbel",slug:"fethi-derbel",fullName:"Fethi Derbel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62900/images/system/62900.jpeg",biography:"Professor Fethi Derbel was born in 1960 in Tunisia. He received his medical degree from the Sousse Faculty of Medicine at Sousse, University of Sousse, Tunisia. He completed his surgical residency in General Surgery at the University Hospital Farhat Hached of Sousse and was a member of the Unit of Liver Transplantation in the University of Rennes, France. He then worked in the Department of Surgery at the Sahloul University Hospital in Sousse. Professor Derbel is presently working at the Clinique les Oliviers, Sousse, Tunisia. His hospital activities are mostly concerned with laparoscopic, colorectal, pancreatic, hepatobiliary, and gastric surgery. He is also very interested in hernia surgery and performs ventral hernia repairs and inguinal hernia repairs. He has been a member of the GREPA and Tunisian Hernia Society (THS). During his residency, he managed patients suffering from diabetic foot, and he was very interested in this pathology. For this reason, he decided to coordinate a book project dealing with the diabetic foot. Professor Derbel has published many articles in journals and collaborates intensively with IntechOpen Access Publisher as an editor.",institutionString:"Clinique les Oliviers",institution:null},{id:"300144",title:"Dr.",name:"Meriem",middleName:null,surname:"Braiki",slug:"meriem-braiki",fullName:"Meriem Braiki",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300144/images/system/300144.jpg",biography:"Dr. Meriem Braiki is a specialist in pediatric surgeon from Tunisia. She was born in 1985. She received her medical degree from the University of Medicine at Sousse, Tunisia. She achieved her surgical residency training periods in Pediatric Surgery departments at University Hospitals in Monastir, Tunis and France.\r\nShe is currently working at the Pediatric surgery department, Sidi Bouzid Hospital, Tunisia. Her hospital activities are mostly concerned with laparoscopic, parietal, urological and digestive surgery. She has published several articles in diffrent journals.",institutionString:"Sidi Bouzid Regional Hospital",institution:null},{id:"229481",title:"Dr.",name:"Erika M.",middleName:"Martins",surname:"de Carvalho",slug:"erika-m.-de-carvalho",fullName:"Erika M. de Carvalho",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229481/images/6397_n.jpg",biography:null,institutionString:null,institution:{name:"Oswaldo Cruz Foundation",country:{name:"Brazil"}}},{id:"186537",title:"Prof.",name:"Tonay",middleName:null,surname:"Inceboz",slug:"tonay-inceboz",fullName:"Tonay Inceboz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/186537/images/system/186537.jfif",biography:"I was graduated from Ege University of Medical Faculty (Turkey) in 1988 and completed his Med. PhD degree in Medical Parasitology at the same university. I became an Associate Professor in 2008 and Professor in 2014. I am currently working as a Professor at the Department of Medical Parasitology at Dokuz Eylul University, Izmir, Turkey.\n\nI have given many lectures, presentations in different academic meetings. I have more than 60 articles in peer-reviewed journals, 18 book chapters, 1 book editorship.\n\nMy research interests are Echinococcus granulosus, Echinococcus multilocularis (diagnosis, life cycle, in vitro and in vivo cultivation), and Trichomonas vaginalis (diagnosis, PCR, and in vitro cultivation).",institutionString:"Dokuz Eylül University",institution:{name:"Dokuz Eylül University",country:{name:"Turkey"}}},{id:"71812",title:"Prof.",name:"Hanem Fathy",middleName:"Fathy",surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/71812/images/1167_n.jpg",biography:"Prof. Khater is a Professor of Parasitology at Benha University, Egypt. She studied for her doctoral degree, at the Department of Entomology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, USA. She has completed her Ph.D. degrees in Parasitology in Egypt, from where she got the award for “the best scientific Ph.D. dissertation”. She worked at the School of Biological Sciences, Bristol, England, the UK in controlling insects of medical and veterinary importance as a grant from Newton Mosharafa, the British Council. Her research is focused on searching of pesticides against mosquitoes, house flies, lice, green bottle fly, camel nasal botfly, soft and hard ticks, mites, and the diamondback moth as well as control of several parasites using safe and natural materials to avoid drug resistances and environmental contamination.",institutionString:null,institution:{name:"Banha University",country:{name:"Egypt"}}},{id:"99780",title:"Prof.",name:"Omolade",middleName:"Olayinka",surname:"Okwa",slug:"omolade-okwa",fullName:"Omolade Okwa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/99780/images/system/99780.jpg",biography:"Omolade Olayinka Okwa is presently a Professor of Parasitology at Lagos State University, Nigeria. She has a PhD in Parasitology (1997), an MSc in Cellular Parasitology (1992), and a BSc (Hons) Zoology (1990) all from the University of Ibadan, Nigeria. She teaches parasitology at the undergraduate and postgraduate levels. She was a recipient of a Commonwealth fellowship supported by British Council tenable at the Centre for Entomology and Parasitology (CAEP), Keele University, United Kingdom between 2004 and 2005. She was awarded an Honorary Visiting Research Fellow at the same university from 2005 to 2007. \nShe has been an external examiner to the Department of Veterinary Microbiology and Parasitology, University of Ibadan, MSc programme between 2010 and 2012. She is a member of the Nigerian Society of Experimental Biology (NISEB), Parasitology and Public Health Society of Nigeria (PPSN), Science Association of Nigeria (SAN), Zoological Society of Nigeria (ZSN), and is Vice Chairperson of the Organisation of Women in Science (OWSG), LASU chapter. She served as Head of Department of Zoology and Environmental Biology, Lagos State University from 2007 to 2010 and 2014 to 2016. She is a reviewer for several local and international journals such as Unilag Journal of Science, Libyan Journal of Medicine, Journal of Medicine and Medical Sciences, and Annual Research and Review in Science. \nShe has authored 45 scientific research publications in local and international journals, 8 scientific reviews, 4 books, and 3 book chapters, which includes the books “Malaria Parasites” and “Malaria” which are IntechOpen access publications.",institutionString:"Lagos State University",institution:{name:"Lagos State University",country:{name:"Nigeria"}}},{id:"273100",title:"Dr.",name:"Vijay",middleName:null,surname:"Gayam",slug:"vijay-gayam",fullName:"Vijay Gayam",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/273100/images/system/273100.jpeg",biography:"Dr. Vijay Bhaskar Reddy Gayam is currently practicing as an internist at Interfaith Medical Center in Brooklyn, New York, USA. He is also a Clinical Assistant Professor at the SUNY Downstate University Hospital and Adjunct Professor of Medicine at the American University of Antigua. He is a holder of an M.B.B.S. degree bestowed to him by Osmania Medical College and received his M.D. at Interfaith Medical Center. His career goals thus far have heavily focused on direct patient care, medical education, and clinical research. He currently serves in two leadership capacities; Assistant Program Director of Medicine at Interfaith Medical Center and as a Councilor for the American\r\nFederation for Medical Research. As a true academician and researcher, he has more than 50 papers indexed in international peer-reviewed journals. He has also presented numerous papers in multiple national and international scientific conferences. His areas of research interest include general internal medicine, gastroenterology and hepatology. He serves as an editor, editorial board member and reviewer for multiple international journals. His research on Hepatitis C has been very successful and has led to multiple research awards, including the 'Equity in Prevention and Treatment Award” from the New York Department of Health Viral Hepatitis Symposium (2018) and the 'Presidential Poster Award” awarded to him by the American College of Gastroenterology (2018). He was also awarded 'Outstanding Clinician in General Medicine” by Venus International Foundation for his extensive research expertise and services, perform over and above the standard expected in the advancement of healthcare, patient safety and quality of care.",institutionString:"Interfaith Medical Center",institution:{name:"Interfaith Medical Center",country:{name:"United States of America"}}},{id:"93517",title:"Dr.",name:"Clement",middleName:"Adebajo",surname:"Meseko",slug:"clement-meseko",fullName:"Clement Meseko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/93517/images/system/93517.jpg",biography:"Dr. Clement Meseko obtained DVM and PhD degree in Veterinary Medicine and Virology respectively. He has worked for over 20 years in both private and public sectors including the academia, contributing to knowledge and control of infectious disease. Through the application of epidemiological skill, classical and molecular virological skills, he investigates viruses of economic and public health importance for the mitigation of the negative impact on people, animal and the environment in the context of Onehealth. \r\nDr. Meseko’s field experience on animal and zoonotic diseases and pathogen dynamics at the human-animal interface over the years shaped his carrier in research and scientific inquiries. He has been part of the investigation of Highly Pathogenic Avian Influenza incursions in sub Saharan Africa and monitors swine Influenza (Pandemic influenza Virus) agro-ecology and potential for interspecies transmission. He has authored and reviewed a number of journal articles and book chapters.",institutionString:"National Veterinary Research Institute",institution:{name:"National Veterinary Research Institute",country:{name:"Nigeria"}}},{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. He is also an international opinion leader/expert in vaccination for Japanese encephalitis by IPIC (UK).",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",country:{name:"India"}}},{id:"94928",title:"Dr.",name:"Takuo",middleName:null,surname:"Mizukami",slug:"takuo-mizukami",fullName:"Takuo Mizukami",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94928/images/6402_n.jpg",biography:null,institutionString:null,institution:{name:"National Institute of Infectious Diseases",country:{name:"Japan"}}},{id:"233433",title:"Dr.",name:"Yulia",middleName:null,surname:"Desheva",slug:"yulia-desheva",fullName:"Yulia Desheva",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/233433/images/system/233433.png",biography:"Dr. Yulia Desheva is a leading researcher at the Institute of Experimental Medicine, St. Petersburg, Russia. She is a professor in the Stomatology Faculty, St. Petersburg State University. She has expertise in the development and evaluation of a wide range of live mucosal vaccines against influenza and bacterial complications. Her research interests include immunity against influenza and COVID-19 and the development of immunization schemes for high-risk individuals.",institutionString:'Federal State Budgetary Scientific Institution "Institute of Experimental Medicine"',institution:null},{id:"238958",title:"Mr.",name:"Atamjit",middleName:null,surname:"Singh",slug:"atamjit-singh",fullName:"Atamjit Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/238958/images/6575_n.jpg",biography:null,institutionString:null,institution:null},{id:"333753",title:"Dr.",name:"Rais",middleName:null,surname:"Ahmed",slug:"rais-ahmed",fullName:"Rais Ahmed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333753/images/20168_n.jpg",biography:null,institutionString:null,institution:null},{id:"252058",title:"M.Sc.",name:"Juan",middleName:null,surname:"Sulca",slug:"juan-sulca",fullName:"Juan Sulca",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252058/images/12834_n.jpg",biography:null,institutionString:null,institution:null},{id:"191392",title:"Dr.",name:"Marimuthu",middleName:null,surname:"Govindarajan",slug:"marimuthu-govindarajan",fullName:"Marimuthu Govindarajan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/191392/images/5828_n.jpg",biography:"Dr. M. Govindarajan completed his BSc degree in Zoology at Government Arts College (Autonomous), Kumbakonam, and MSc, MPhil, and PhD degrees at Annamalai University, Annamalai Nagar, Tamil Nadu, India. He is serving as an assistant professor at the Department of Zoology, Annamalai University. His research interests include isolation, identification, and characterization of biologically active molecules from plants and microbes. He has identified more than 20 pure compounds with high mosquitocidal activity and also conducted high-quality research on photochemistry and nanosynthesis. He has published more than 150 studies in journals with impact factor and 2 books in Lambert Academic Publishing, Germany. He serves as an editorial board member in various national and international scientific journals.",institutionString:null,institution:null},{id:"274660",title:"Dr.",name:"Damodar",middleName:null,surname:"Paudel",slug:"damodar-paudel",fullName:"Damodar Paudel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/274660/images/8176_n.jpg",biography:"I am DrDamodar Paudel,currently working as consultant Physician in Nepal police Hospital.",institutionString:null,institution:null},{id:"241562",title:"Dr.",name:"Melvin",middleName:null,surname:"Sanicas",slug:"melvin-sanicas",fullName:"Melvin Sanicas",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241562/images/6699_n.jpg",biography:null,institutionString:null,institution:null},{id:"337446",title:"Dr.",name:"Maria",middleName:null,surname:"Zavala-Colon",slug:"maria-zavala-colon",fullName:"Maria Zavala-Colon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Puerto Rico, Medical Sciences Campus",country:{name:"United States of America"}}},{id:"338856",title:"Mrs.",name:"Nur Alvira",middleName:null,surname:"Pascawati",slug:"nur-alvira-pascawati",fullName:"Nur Alvira Pascawati",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universitas Respati Yogyakarta",country:{name:"Indonesia"}}},{id:"441116",title:"Dr.",name:"Jovanka M.",middleName:null,surname:"Voyich",slug:"jovanka-m.-voyich",fullName:"Jovanka M. Voyich",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Montana State University",country:{name:"United States of America"}}},{id:"330412",title:"Dr.",name:"Muhammad",middleName:null,surname:"Farhab",slug:"muhammad-farhab",fullName:"Muhammad Farhab",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"349495",title:"Dr.",name:"Muhammad",middleName:null,surname:"Ijaz",slug:"muhammad-ijaz",fullName:"Muhammad Ijaz",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Veterinary and Animal Sciences",country:{name:"Pakistan"}}}]}},subseries:{item:{id:"12",type:"subseries",title:"Human Physiology",keywords:"Anatomy, Cells, Organs, Systems, Homeostasis, Functions",scope:"Human physiology is the scientific exploration of the various functions (physical, biochemical, and mechanical properties) of humans, their organs, and their constituent cells. The endocrine and nervous systems play important roles in maintaining homeostasis in the human body. Integration, which is the biological basis of physiology, is achieved through communication between the many overlapping functions of the human body's systems, which takes place through electrical and chemical means. Much of the basis of our knowledge of human physiology has been provided by animal experiments. Because of the close relationship between structure and function, studies in human physiology and anatomy seek to understand the mechanisms that help the human body function. The series on human physiology deals with the various mechanisms of interaction between the various organs, nerves, and cells in the human body.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/12.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11408,editor:{id:"195829",title:"Prof.",name:"Kunihiro",middleName:null,surname:"Sakuma",slug:"kunihiro-sakuma",fullName:"Kunihiro Sakuma",profilePictureURL:"https://mts.intechopen.com/storage/users/195829/images/system/195829.jpg",biography:"Professor Kunihiro Sakuma, Ph.D., currently works in the Institute for Liberal Arts at the Tokyo Institute of Technology. He is a physiologist working in the field of skeletal muscle. He was awarded his sports science diploma in 1995 by the University of Tsukuba and began his scientific work at the Department of Physiology, Aichi Human Service Center, focusing on the molecular mechanism of congenital muscular dystrophy and normal muscle regeneration. His interest later turned to the molecular mechanism and attenuating strategy of sarcopenia (age-related muscle atrophy). His opinion is to attenuate sarcopenia by improving autophagic defects using nutrient- and pharmaceutical-based treatments.",institutionString:null,institution:{name:"Tokyo Institute of Technology",institutionURL:null,country:{name:"Japan"}}},editorTwo:{id:"331519",title:"Dr.",name:"Kotomi",middleName:null,surname:"Sakai",slug:"kotomi-sakai",fullName:"Kotomi Sakai",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000031QtFXQA0/Profile_Picture_1637053227318",biography:"Senior researcher Kotomi Sakai, Ph.D., MPH, works at the Research Organization of Science and Technology in Ritsumeikan University. She is a researcher in the geriatric rehabilitation and public health field. She received Ph.D. from Nihon University and MPH from St.Luke’s International University. Her main research interest is sarcopenia in older adults, especially its association with nutritional status. Additionally, to understand how to maintain and improve physical function in older adults, to conduct studies about the mechanism of sarcopenia and determine when possible interventions are needed.",institutionString:null,institution:{name:"Ritsumeikan University",institutionURL:null,country:{name:"Japan"}}},editorThree:null,series:{id:"10",title:"Physiology",doi:"10.5772/intechopen.72796",issn:"2631-8261"},editorialBoard:[{id:"213786",title:"Dr.",name:"Henrique P.",middleName:null,surname:"Neiva",slug:"henrique-p.-neiva",fullName:"Henrique P. 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