Ulcerative colitis severity classification. Adapted from Truelove and Witts criteria.
\\n\\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\\n\\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\\n"}]',published:!0,mainMedia:{caption:"Highly Cited",originalUrl:"/media/original/117"}},components:[{type:"htmlEditorComponent",content:'IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\nThroughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\nReleased this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\n'}],latestNews:[{slug:"intechopen-supports-asapbio-s-new-initiative-publish-your-reviews-20220729",title:"IntechOpen Supports ASAPbio’s New Initiative Publish Your Reviews"},{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"}]},book:{item:{type:"book",id:"6598",leadTitle:null,fullTitle:"Wearable Technologies",title:"Wearable Technologies",subtitle:null,reviewType:"peer-reviewed",abstract:"This edited volume Wearable Technologies is a collection of reviewed and relevant research chapters, offering a comprehensive overview of recent developments in the field of computer engineering. The book comprises single chapters authored by various researchers and edited by an expert active in the computer engineering research area. All chapters are complete in themselves but united under a common research study topic. This publication aims at providing a thorough overview of the latest research efforts.",isbn:"978-1-78984-004-9",printIsbn:"978-1-78984-003-2",pdfIsbn:"978-1-83881-580-6",doi:"10.5772/intechopen.71472",price:119,priceEur:129,priceUsd:155,slug:"wearable-technologies",numberOfPages:268,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"90c456078d3c654876b0af2946804b7c",bookSignature:"Jesús Hamilton Ortiz",publishedDate:"October 3rd 2018",coverURL:"https://cdn.intechopen.com/books/images_new/6598.jpg",numberOfDownloads:14876,numberOfWosCitations:18,numberOfCrossrefCitations:24,numberOfCrossrefCitationsByBook:2,numberOfDimensionsCitations:39,numberOfDimensionsCitationsByBook:2,hasAltmetrics:1,numberOfTotalCitations:81,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"October 13th 2017",dateEndSecondStepPublish:"November 3rd 2017",dateEndThirdStepPublish:"January 5th 2018",dateEndFourthStepPublish:"March 23rd 2018",dateEndFifthStepPublish:"May 22nd 2018",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,7",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"97704",title:"Dr.",name:"Jesús Hamilton",middleName:null,surname:"Ortiz",slug:"jesus-hamilton-ortiz",fullName:"Jesús Hamilton Ortiz",profilePictureURL:"https://mts.intechopen.com/storage/users/97704/images/3096_n.jpg",biography:"Jesus Hamilton Ortiz obtained his bachelor degree in mathematics at the Santiago de Cali University, DEA in Telecommunication engineering in Madrid Technical University, PhD in Computer Engineering in Castilla La Mancha University and PhD (c) in Telecommunication engineering from Madrid Autonomous University. He was previously assistant professor and full researcher at the Castilla La Mancha University, Jesus is CEO Close mobile R&D. In addition to this, Jesus is associate editor in IEEE, author, reviewer, editor in different topics about mobile ad hoc networks, telecommunication networks, wearables, etc. Currently, he is working on R&D projects on swarm of UAVs, swarm AUVs, RPAs, IoT an industry 4.0.",institutionString:"Close mobile R&D",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"5",institution:null}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"758",title:"Sensor Technology",slug:"electrical-and-electronic-engineering-sensor-technology"}],chapters:[{id:"61315",title:"Advances in Wearable Sensing Technologies and Their Impact for Personalized and Preventive Medicine",doi:"10.5772/intechopen.76916",slug:"advances-in-wearable-sensing-technologies-and-their-impact-for-personalized-and-preventive-medicine",totalDownloads:1328,totalCrossrefCites:1,totalDimensionsCites:3,hasAltmetrics:1,abstract:"Recent advances in miniaturized electronics, as well as mobile access to computational power, are fostering a rapid growth of wearable technologies. In particular, the application of such wearable technologies to health care enables to access more information from the patient than standard episodically testing conducted in health provider centres. Clinical, behavioural and self-monitored data collected by wearable devices provide a means for improving the early-stage detection and management of diseases as well as reducing the overall costs over more invasive standard diagnostics approaches. In this chapter, we will discuss some of the ongoing key innovations in materials science and micro/nano-fabrication technologies that are setting the basis for future personalized and preventive medicine devices and approaches. The design of wire- and power-less ultra-thin sensors fabricated on wearable biocompatible materials that can be placed in direct contact with the body tissues such as the skin will be reviewed, focusing on emerging solutions and bottlenecks. The application of nanotechnology for the fabrication of sophisticated miniaturized sensors will be presented. Exemplary sensor designs for the non-invasive measurement of ultra-low concentrations of important biomarkers will be discussed as case studies for the application of these emerging technologies.",signatures:"Noushin Nasiri and Antonio Tricoli",downloadPdfUrl:"/chapter/pdf-download/61315",previewPdfUrl:"/chapter/pdf-preview/61315",authors:[{id:"234150",title:"Dr.",name:"Noushin",surname:"Nasiri",slug:"noushin-nasiri",fullName:"Noushin Nasiri"},{id:"236706",title:"Prof.",name:"Antonio",surname:"Tricoli",slug:"antonio-tricoli",fullName:"Antonio Tricoli"}],corrections:null},{id:"60508",title:"A Proposal for New Algorithm that Defines Gait-Induced Acceleration and Gait Cycle in Daily Parkinsonian Gait Disorders",doi:"10.5772/intechopen.75483",slug:"a-proposal-for-new-algorithm-that-defines-gait-induced-acceleration-and-gait-cycle-in-daily-parkinso",totalDownloads:988,totalCrossrefCites:2,totalDimensionsCites:2,hasAltmetrics:0,abstract:"We developed a new device, the portable gait rhythmogram (PGR), to record up to 70 hrs of movement-induced accelerations. Acceleration values induced by various movements, averaged every 10 min, showed gamma distribution, and the mean value of this distribution was used as an index of the amount of overall movements. Furthermore, the PGR algorithm can specify gait-induced accelerations using the pattern-matching method. Analysis of the relationship between gait-induced accelerations and gait cycle duration makes it possible to quantify Parkinson’s disease (PD)-specific pathophysiological mechanisms underlying gait disorders. Patients with PD showed the following disease-specific patterns: (1) reduced amount of overall movements and (2) low amplitude of gait-induced accelerations in the early stages of the disease, which was compensated by fast stepping. Loss of compensation was associated with slow stepping gait, (3) narrow range of gait-induced acceleration amplitude and gait cycle duration, suggesting monotony, and (4) evident motor fluctuations during the day by tracing changes in the above two parameters. Prominent motor fluctuation was associated with frequent switching between slow stepping mode and active mode. These findings suggest that monitoring various movement- and gait-induced accelerations allows the detection of specific changes in PD. We conclude that continuous long-term monitoring of these parameters can provide accurate quantitative assessment of parkinsonian clinical motor signs.",signatures:"Masahiko Suzuki, Makiko Yogo, Masayo Morita, Hiroo Terashi,\nMutsumi Iijima, Mitsuru Yoneyama, Masato Takada, Hiroya Utsumi,\nYasuyuki Okuma, Akito Hayashi, Satoshi Orimo and Hiroshi Mitoma",downloadPdfUrl:"/chapter/pdf-download/60508",previewPdfUrl:"/chapter/pdf-preview/60508",authors:[{id:"210486",title:"Prof.",name:"Hiroshi",surname:"Mitoma",slug:"hiroshi-mitoma",fullName:"Hiroshi Mitoma"},{id:"227967",title:"Dr.",name:"Masahiko",surname:"Suzuki",slug:"masahiko-suzuki",fullName:"Masahiko Suzuki"},{id:"229488",title:"Prof.",name:"Hiroo",surname:"Terashi",slug:"hiroo-terashi",fullName:"Hiroo Terashi"},{id:"240961",title:"Dr.",name:"Makiko",surname:"Yogo",slug:"makiko-yogo",fullName:"Makiko Yogo"},{id:"240962",title:"Dr.",name:"Masayo",surname:"Morita",slug:"masayo-morita",fullName:"Masayo Morita"},{id:"240964",title:"Prof.",name:"Mutsumi",surname:"Iijima",slug:"mutsumi-iijima",fullName:"Mutsumi Iijima"},{id:"240966",title:"Prof.",name:"Yasuyuki",surname:"Okuma",slug:"yasuyuki-okuma",fullName:"Yasuyuki Okuma"},{id:"240967",title:"Dr.",name:"Satoshi",surname:"Orimo",slug:"satoshi-orimo",fullName:"Satoshi Orimo"},{id:"240968",title:"Prof.",name:"Akito",surname:"Hayashi",slug:"akito-hayashi",fullName:"Akito Hayashi"},{id:"240969",title:"Prof.",name:"Hiroya",surname:"Utsumi",slug:"hiroya-utsumi",fullName:"Hiroya Utsumi"},{id:"240970",title:"BSc.",name:"Mitsuru",surname:"Yoneyama",slug:"mitsuru-yoneyama",fullName:"Mitsuru Yoneyama"},{id:"240971",title:"BSc.",name:"Masato",surname:"Takada",slug:"masato-takada",fullName:"Masato Takada"}],corrections:null},{id:"61336",title:"Wearable Technology as a Tool to Motivate Health Behaviour: A Case Study",doi:"10.5772/intechopen.77002",slug:"wearable-technology-as-a-tool-to-motivate-health-behaviour-a-case-study",totalDownloads:1051,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"According to the Scientific Committee on Occupational Exposure Limits, work-related exposures are estimated to account for about 15% of all adult respiratory diseases. Today, the use of personal protective equipment (PPE) is the only way for workers to prevent disease. Nevertheless, its use is highly sparse. Currently, products and systems embedded with wearable technologies are able to protect, motivate and educate users. The authors then suggested the development of a novel wearable system following the beliefs that wearable technology can be persuasive and elicit a conscious behaviour towards the use of the PPEs by consequently improving their health condition. The authors here describe the result of a Transnational Research Project named “P_O_D Plurisensorial Device to prevent Occupational Disease.” The chapter describes the findings achieved so far, the research phase and the new wearable system conceived as a possible example of how to use wearable technology as a useful tool to influence behavioural change.",signatures:"Venere Ferraro, Mila Stepanovic and Silvia Ferraris",downloadPdfUrl:"/chapter/pdf-download/61336",previewPdfUrl:"/chapter/pdf-preview/61336",authors:[{id:"227494",title:"Dr.",name:"Venere",surname:"Ferraro",slug:"venere-ferraro",fullName:"Venere Ferraro"},{id:"240690",title:"MSc.",name:"Mila",surname:"Stepanovic",slug:"mila-stepanovic",fullName:"Mila Stepanovic"},{id:"240691",title:"Dr.",name:"Silvia",surname:"Ferraris",slug:"silvia-ferraris",fullName:"Silvia Ferraris"}],corrections:null},{id:"60918",title:"Wearable Neuromodulators",doi:"10.5772/intechopen.76673",slug:"wearable-neuromodulators",totalDownloads:890,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"In neuromodulation, by delivering a form of stimulus to neural tissue the response of an associated neural circuit may be changed, enhanced or inhibited (i.e., modulated) as desired. This powerful technique may be used to treat various medical conditions as outlined in this chapter. After a brief introduction to the human nervous system, key example applications of electrical neuromodulation such as cardiac pacemakers, devices for pain relief, deep brain stimulation, cochlear implant and visual prosthesis and their respective methods of deployment are discussed. Furthermore, key features of wearable neuromodulators with reference to some existing devices are briefly reviewed. This chapter is concluded by a case study on design and development of a wearable device with non-invasive electrodes for treating lower urinary tract dysfunctions after spinal cord injury.",signatures:"Arsam N. Shiraz, Brian Leaker and Andreas Demosthenous",downloadPdfUrl:"/chapter/pdf-download/60918",previewPdfUrl:"/chapter/pdf-preview/60918",authors:[{id:"231986",title:"Dr.",name:"Arsam",surname:"Shiraz",slug:"arsam-shiraz",fullName:"Arsam Shiraz"},{id:"231987",title:"Prof.",name:"Andreas",surname:"Demosthenous",slug:"andreas-demosthenous",fullName:"Andreas Demosthenous"},{id:"249146",title:"Dr.",name:"Brian",surname:"Leaker",slug:"brian-leaker",fullName:"Brian Leaker"}],corrections:null},{id:"60301",title:"Wearable Dialysis: Current State and Perspectives",doi:"10.5772/intechopen.75552",slug:"wearable-dialysis-current-state-and-perspectives",totalDownloads:1382,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"For more than four decades, scientists and engineers are trying to miniaturise dialysis machines to make them wearable. There are many reasons for that—from increased biocompatibility and cost-efficiency to longer life expectancy and higher quality of life. That can be achieved by continuous blood treatment like in natural kidneys, which softly filter blood for 168 h a week when hemodialysis does that quickly—for approximately 20 h a week, which affects the organism in a bad way. Along with that, during hemodialysis, the patient must be near the dialysis machine, in contrary to wearable apparatus that can be carried anywhere. To achieve these advantages, dialysis fluid regeneration system must be developed, and it is a problem to be solved in the next few years. In this chapter, we describe current prototypes of wearable artificial kidneys, their design principles and results of our investigations.",signatures:"Nikolai Bazaev, Nikita Zhilo, Viktor Grinval’d and Sergey Selishchev",downloadPdfUrl:"/chapter/pdf-download/60301",previewPdfUrl:"/chapter/pdf-preview/60301",authors:[{id:"194094",title:"Dr.",name:"Nikolay",surname:"Bazaev",slug:"nikolay-bazaev",fullName:"Nikolay Bazaev"},{id:"242734",title:"BSc.",name:"Nikita",surname:"Zhilo",slug:"nikita-zhilo",fullName:"Nikita Zhilo"},{id:"242735",title:"Prof.",name:"Viktor",surname:"Grinval’d",slug:"viktor-grinval'd",fullName:"Viktor Grinval’d"},{id:"242736",title:"Prof.",name:"Sergey",surname:"Selishchev",slug:"sergey-selishchev",fullName:"Sergey Selishchev"}],corrections:null},{id:"61246",title:"Smart Materials for Wearable Healthcare Devices",doi:"10.5772/intechopen.76604",slug:"smart-materials-for-wearable-healthcare-devices",totalDownloads:1709,totalCrossrefCites:1,totalDimensionsCites:3,hasAltmetrics:0,abstract:"Wearable devices seem to have great potential that could result in a revolutionary non-clinical approach to health monitoring and diagnosing disease. With continued innovation and intensive attention to the materials and fabrication technologies, development of these healthcare devices is progressively encouraged. This chapter gives a concise review of some of the main concepts and approaches related to recent advances and developments in the scope of wearable devices from the perspective of emerging materials. A complementary section of the review linking these advanced materials with wearable device technologies is particularly specified. Some of the strong and weak points in development of each wearable material/device are clearly highlighted and criticized.",signatures:"Han Jin, Qinghui Jin and Jiawen Jian",downloadPdfUrl:"/chapter/pdf-download/61246",previewPdfUrl:"/chapter/pdf-preview/61246",authors:[{id:"230089",title:"Associate Prof.",name:"Han",surname:"Jin",slug:"han-jin",fullName:"Han Jin"}],corrections:null},{id:"61160",title:"Recent Progress in Nanostructured Zinc Oxide Grown on Fabric for Wearable Thermoelectric Power Generator with UV Shielding",doi:"10.5772/intechopen.76672",slug:"recent-progress-in-nanostructured-zinc-oxide-grown-on-fabric-for-wearable-thermoelectric-power-gener",totalDownloads:1284,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Traditional materials for thermoelectric such as bismuth telluride have been studied and utilized commercially for the last half century, but recent advancements in materials selection are one of the principal function of the active thermoelectric device as it determines the reliability of the fabrication regarding technical and economic aspects. Recently, many researcher’s efforts have been made to utilize oxide nanomaterials for wearable thermoelectric power generator (WTPG) applications which may provide environmental stable, mechanical flexibility, and light weight with low cost of manufacturing. In precise, fabric containing oxide metals have shown great promise as P−/N-type materials with improved transport and UV shielding properties. On the other hand, we have focused on ZnO nanostructures as a high-efficiency WTPG material because they are non-toxic to skin, inexpensive and easy to obtain and possess attractive electronic properties, which means that they are available for clothing with low-cost fabrication. To our observation, we are chaptering about the thermoelectric properties of ZnO and their composite nanostructures coated cotton fabric via the solvothermal method for the first time.",signatures:"Pandiyarasan Veluswamy, Suhasini Sathiyamoorthy, Hiroya Ikeda,\nManikandan Elayaperumal and Malik Maaza",downloadPdfUrl:"/chapter/pdf-download/61160",previewPdfUrl:"/chapter/pdf-preview/61160",authors:[{id:"25875",title:"Dr.",name:"Malek",surname:"Maaza",slug:"malek-maaza",fullName:"Malek Maaza"},{id:"185864",title:"Prof.",name:"Manikandan",surname:"Elayaperumal",slug:"manikandan-elayaperumal",fullName:"Manikandan Elayaperumal"},{id:"215388",title:"Dr.",name:"Pandiyarasan",surname:"Veluswamy",slug:"pandiyarasan-veluswamy",fullName:"Pandiyarasan Veluswamy"},{id:"248532",title:"Ms.",name:"Suhasini",surname:"Sathiyamoorthy",slug:"suhasini-sathiyamoorthy",fullName:"Suhasini Sathiyamoorthy"},{id:"248533",title:"Prof.",name:"Ikeda",surname:"Hiroya",slug:"ikeda-hiroya",fullName:"Ikeda Hiroya"}],corrections:null},{id:"60834",title:"Conductive Yarn Embroidered Circuits for System on Textiles",doi:"10.5772/intechopen.76627",slug:"conductive-yarn-embroidered-circuits-for-system-on-textiles",totalDownloads:1427,totalCrossrefCites:3,totalDimensionsCites:5,hasAltmetrics:1,abstract:"With the recent convergence of electronics and textile technology, various kinds of smart wearables are being developed, such as heating clothes, health monitoring clothes, and motion sensing clothes. In this study, the novel conductive embroidery yarns for touch sensing and signal transmission for system on textile (SoT) are introduced. The conductive yarn for touch sensing can be used as a user interface of smart clothes by constructing an embroidery circuit. The conductive yarn for signal transmission can be embroidered on smart clothing and used as a transmission line to transmit power and signal. The conductive yarns and their embroidered circuits were characterized and SoT prototypes using the embroidered circuit of these conductive yarns were presented. These e-textiles based on touch sensing and signal transmission can be comfortably applied for SoT and maintain electrical performance without being damaged by tensile force generated by the movement of the wearer.",signatures:"Jung-Sim Roh",downloadPdfUrl:"/chapter/pdf-download/60834",previewPdfUrl:"/chapter/pdf-preview/60834",authors:[{id:"232246",title:"Associate Prof.",name:"Jung-Sim",surname:"ROh",slug:"jung-sim-roh",fullName:"Jung-Sim ROh"}],corrections:null},{id:"60481",title:"A Wearable Heating System with a Controllable e-Textile- Based Thermal Panel",doi:"10.5772/intechopen.76192",slug:"a-wearable-heating-system-with-a-controllable-e-textile-based-thermal-panel",totalDownloads:1559,totalCrossrefCites:2,totalDimensionsCites:3,hasAltmetrics:0,abstract:"Flexible textile heating systems present great advantage due to their ability to bend and hence could ensure uniform heating for irregular geometries. In cooler outer environment, the user requires his/her body to be kept warm for monitoring vital body functions within realistic thermal body balance constraints. In this chapter, heated vest with controllable e-textile-based thermal panel has been studied. Several e-textile-based thermal panels with different conductive yarns were produced using hot air welding technology under different manufacturing parameters. E-textile-based thermal panels were tested for their heating behaviors at varying direct current (DC) power levels. Based on the experimental results, the optimum e-textile-based thermal panel design was chosen considering its flexibility and uniform heating behavior. Moreover, a control algorithm with electrical circuit and electrical connection network was designed and assembled in an electronic control module. Finally, the electronic module consisting of power control and management system was integrated to attachable e-textile-based thermal panel in order to form a wearable heating vest.",signatures:"Senem Kurşun Bahadir and Umut Kivanc Sahin",downloadPdfUrl:"/chapter/pdf-download/60481",previewPdfUrl:"/chapter/pdf-preview/60481",authors:[{id:"48882",title:"Dr.",name:"Senem",surname:"Kurşun Bahadır",slug:"senem-kursun-bahadir",fullName:"Senem Kurşun Bahadır"},{id:"116271",title:"Dr.",name:"Umut Kivanc",surname:"Sahin",slug:"umut-kivanc-sahin",fullName:"Umut Kivanc Sahin"}],corrections:null},{id:"61357",title:"The Comparison of Wearable Fitness Devices",doi:"10.5772/intechopen.76967",slug:"the-comparison-of-wearable-fitness-devices",totalDownloads:1026,totalCrossrefCites:7,totalDimensionsCites:7,hasAltmetrics:0,abstract:"The wearable devices or wearable trackers help to motivate you during daily exercise or workouts. It gives you information about your daily routine or fitness by using wearable technology in combination with your smart phone to track your daily activities and fitness without the manual calculations or records that can be intrusive. Generally, companies display advertising for these kinds of products and depict them as good, user-friendly, and accurate. However, there are no subjective research results to prove the veracity of their words. Four popular wrist band-style wearable devices currently in the market were selected at the devices which are most popular (Withings Pulse, Misfit Shine, Jawbone Up24, and Fitbit Flex). The accuracy of tracking was one of the key components for fitness tracking, with some devices performing better than others. Accuracy in the tracking of daily activities such as walking, running, and sleeping is important. This research showed subjective and objective experiment results, which were used to compare the accuracy of four wearable devices in conjunction with user-friendliness. Satisfaction levels, the accuracy of tracking, and the opinion of each subject while using wearable device to track their daily activity were compared. The results determined that the cost-effectiveness was the Withings Pulse, followed by the Fitbit Flex, Jawbone Up24, and Misfit Shine.",signatures:"Kanitthika Kaewkannate and Soochan Kim",downloadPdfUrl:"/chapter/pdf-download/61357",previewPdfUrl:"/chapter/pdf-preview/61357",authors:[{id:"228941",title:"Prof.",name:"Soochan",surname:"Kim",slug:"soochan-kim",fullName:"Soochan Kim"},{id:"228943",title:"MSc.",name:"Kanitthika",surname:"Kaewkannate",slug:"kanitthika-kaewkannate",fullName:"Kanitthika Kaewkannate"}],corrections:null},{id:"60448",title:"Bio-Inspired Wearable Antennas",doi:"10.5772/intechopen.75912",slug:"bio-inspired-wearable-antennas",totalDownloads:1258,totalCrossrefCites:5,totalDimensionsCites:11,hasAltmetrics:0,abstract:"Due to the recent miniaturization of wireless devices, the use of wearable antennas is steadily increasing. A wearable antenna is intended to be a part of the clothing used for communication purposes. In this way, a lower visual cost may be achieved. Recently, biologically inspired design, a kind of design by cross-domain analogy is a promising paradigm for innovation as well as low visual cost. The shapes of the plants are structures optimized by nature with the primary goal of light energy capture, transforming it into chemical energy. In this case, they have similar behavior to that of parabolic reflectors; this enables microwave engineers design innovative antennas using bio-inspired concepts. One of the advantages of using bio-inspired plant shapes is the design of antennas with great perimeters in compact structures. Thus, we have small antennas operating in low frequencies. This chapter presents the recent development in bio-inspired wearable antennas, easily integrated to the clothes and accessories used by the body, built in denim, low-cost flexible dielectric, and polyamide flexible dielectric, that is flexible with high resistance to twists and temperatures, for wireless body area network (WBAN) applications, operating in cellular mobile (2G, 3G, and 4G) and wireless local area network (2.4 and 5 GHz) protocols.",signatures:"Paulo Fernandes da Silva Júnior, Alexandre Jean René Serres,\nRaimundo Carlos Silvério Freire, Georgina Karla de Freitas Serres,\nEdmar Candeia Gurjão, Joabson Nogueira de Carvalho and Ewaldo\nEder Carvalho Santana",downloadPdfUrl:"/chapter/pdf-download/60448",previewPdfUrl:"/chapter/pdf-preview/60448",authors:[{id:"199230",title:"Dr.",name:"Alexandre Jean René",surname:"Serres",slug:"alexandre-jean-rene-serres",fullName:"Alexandre Jean René Serres"},{id:"205094",title:"Dr.",name:"Georgina Karla",surname:"Freitas Serres",slug:"georgina-karla-freitas-serres",fullName:"Georgina Karla Freitas Serres"},{id:"205095",title:"Ph.D.",name:"Paulo",surname:"Fernandes da Silva Junior",slug:"paulo-fernandes-da-silva-junior",fullName:"Paulo Fernandes da Silva Junior"},{id:"229216",title:"Dr.",name:"Edmar",surname:"Candeia",slug:"edmar-candeia",fullName:"Edmar Candeia"},{id:"229218",title:"Dr.",name:"Joabson",surname:"Nogueira",slug:"joabson-nogueira",fullName:"Joabson Nogueira"},{id:"229219",title:"Dr.",name:"Raimundo",surname:"Freire",slug:"raimundo-freire",fullName:"Raimundo Freire"},{id:"240706",title:"Dr.",name:"Ewaldo",surname:"Santana",slug:"ewaldo-santana",fullName:"Ewaldo Santana"}],corrections:null},{id:"61567",title:"Middleware-Driven Intelligent Glove for Industrial Applications",doi:"10.5772/intechopen.76382",slug:"middleware-driven-intelligent-glove-for-industrial-applications",totalDownloads:977,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"It is estimated that by the year 2020, 700 million wearable technology devices will be sold worldwide. One of the reasons is the industries’ need to increase their productivity. Some of the tools welcomed by industries are handheld devices such as tablets, PDAs and mobile phones. However, handheld devices are not ideal for industrial applications because they often subject users to fatigue during their long working hours. A viable solution to this problem is wearable devices. The advantage of wearable devices is that they become part of the user. Hence, they subject the user to less fatigue, thereby increasing their productivity. This chapter presents the development of an intelligent glove, which is designed to control actuators in an industrial environment. This system utilizes RTI connext data distributed service middleware to facilitate communication over WiFi. Our experiments show very promising results with maximum power consumption of 310 mW and latency as low as 23 ms. These results make the proposed system a perfect fit for most industrial applications.",signatures:"Farouq Muhammad Aliyu and Basem Almadani",downloadPdfUrl:"/chapter/pdf-download/61567",previewPdfUrl:"/chapter/pdf-preview/61567",authors:[{id:"227198",title:"Mr.",name:"Farouq",surname:"Aliyu",slug:"farouq-aliyu",fullName:"Farouq Aliyu"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"5408",title:"Ad Hoc Networks",subtitle:null,isOpenForSubmission:!1,hash:"3d8f56e9f0b5b530cd132c040fdef6c5",slug:"ad-hoc-networks",bookSignature:"Jesus Hamilton Ortiz and Alvaro Pachon de la Cruz",coverURL:"https://cdn.intechopen.com/books/images_new/5408.jpg",editedByType:"Edited by",editors:[{id:"97704",title:"Dr.",name:"Jesús Hamilton",surname:"Ortiz",slug:"jesus-hamilton-ortiz",fullName:"Jesús Hamilton 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Restorative proctocolectomy with ileal pouch-anal anastomosis (RPC-IPAA) is a complicated colorectal surgical procedure. It is mainly used to treat patients with familial adenomatous polyposis (FAP) and ulcerative colitis (UC). It is also performed to treat selected patients with Crohn’s disease (CD), indeterminate colitis, and synchronous colorectal cancer (CRC) [1]. Among these pathologies, ulcerative colitis is the primary postoperative histopathological diagnosis, as Fazio data show, in 2013 [2].
IPAA surgery, first described by Parks and Nicholls in 1978 [3], aims to definitively cure disease and prevent malignant degeneration while providing adequate continence and avoiding a permanent stoma.
The majority of patients experience long-term success but are not absent from significant surgical complications. The main ones are pelvic sepsis, pouchitis, pouch failure, fecal incontinence, female infertility, and sexual dysfunction. Others, like stenosis, pouch dysplasia/cancer, IPAA prolapse, preileal IPAA pouchitis, and anemia, are rare [4].
IPAA results depend on several factors, such as the pathology underlying and specific features, gender, age, IBM, patient comorbidities, surgical techniques, and surgeon experience.
So, before to propose or avoid RPC with IPAA, there are aspects to take into account:
What is the underlying pathology, and if the RPC indication is absolute or relative;
if the patient needs a total proctocolectomy or if it is possible to spare part of the rectum;
rule out the presence of relative or absolute contraindication for IPAA and also,
evaluation of all elements that increase the risk of IPAA failure.
There is specific colorectal pathology that, during its natural development, requires a colectomy or a proctocolectomy, with or without restorative gest. Let us analyze the characteristics of the different underlying pathology and how they can influence the surgical decision.
FAP is an inherited disease classically characterized by the development of hundreds to thousands of adenomas in the rectum and colon during the second decade of life (Figure 1). A less aggressive variant of FAP is the so-called attenuated FAP (aFAP), where the rectum is frequently spared.
Familial adenomatous polyposis – colon details.
Although FAP is responsible for less than 1% of colorectal malignancies, untreated individuals with FAP carry a 100% risk of colorectal cancer by 40–50 years.
Thus, for patients with FAP, the single way to prevent colorectal cancer is surgery.
Nowadays, it is widely accepted that RPC-IPAA is the procedure of choice to treat patients with classical FAP.
We can choose for aFAP, total abdominal colectomy with ileorectal anastomosis (TAC-IRA), or proctocolectomy with stapled ileal pouch distal rectal anastomosis (CP-IPDRA).
FAP highlights:
young population; absolute indication for surgery; if present rectal involvement, proctocolectomy is required; higher risk of desmoid in some family; RPC-IPAA is the procedure of choice to treat patients with classical FAP; RPC-IPAA easier in FAP than in UC [5].
UC is a chronic inflammatory condition characterized by continuous mucosal inflammation of the colon and rectum.
Nowadays, surgery is required in a limited number of patients with UC, either in an elective or in an emergency setting.
In patients with UC and indication for surgery, RPC is widely considered the gold standard surgical procedure. However, TAC-IRA is justified for some particular cases.
Emergent colectomy in UC is indicated in acute severe UC, not responding to medical therapy, or when complications occur such as severe bleeding, toxic megacolon, and colon perforation [6].
Acute UC is considered severe when the patient has at least 10 stools per day, tachycardia, fever, anemia, and increased erythrocyte sedimentation rate (ERS)/C reactive protein (CRP). The severity of ulcerative colitis classification by Truelove and Witts distinguishes acute severe ulcerative colitis from fulminant ulcerative colitis [7]. All authors do not recognize this division, but it makes it possible to infer the probability of failure with corticosteroid therapy and the need for a total colectomy (Table 1).
Disease severity | Features |
---|---|
Slight | <4 stools/day with +/− blood, normal ESR, Without sepsis signs |
Mild | 4–6 stools/day with occasional blood loss, minimal signs of sepsis, CRP ≤30 mg/L |
Severe | ≥6 bloody stools/day with any of the following parameters:
|
Fulminant | 10 stools/day with continued bleeding, abdominal distension and tenderness, need of blood transfusions, toxic megacolon in X-ray. |
Ulcerative colitis severity classification. Adapted from Truelove and Witts criteria.
CRP = C reactive protein; ERS = erytrocyte sedimentation rate; Hgb = hemoglobin.
Acute severe UC, not responding to medical therapy, is one of the few cases that require emergent colectomy in UC. As shown in the management of flowchart in ASUC situations (Figure 2), about 30% of cases do not respond to corticosteroid therapy, and 50% of the ASUC will require surgery during the following year [8].
Management of flowchart in acute severe ulcerative colitis.
According to Saha et al., the policy of early colectomy, within 7 days, in patients with ASUC who fail to respond to intensive steroid-based therapy improves perioperative outcomes with significantly low inhospital mortality and morbidity [9].
On the other hand, when complications occur in severe ASUC, such as severe bleeding, toxic megacolon, and perforation, emergency surgery is mandatory. In these particular situations, the timing of colectomy is of utmost importance to reduce the postoperative complication rates.
Severe bleeding, toxic megacolon, and perforation are the main complications of ASUC (Figures 3 and 4).
Severe bleeding in acute severe ulcerative colitis not a responder to corticosteroids and infliximab. Surgery was performed in the emergency room.
X-ray and surgical specimen of toxic megacolon reports. There are more frequent in extensive ulcerative colitis than in ulcerative proctosigmoiditis. Surgical mortality is 1–8% that rises to 40% in colon perforation with peritonitis.
They are rare, but their presence increases surgery morbidity and mortality. If the UC surgery is urgent or emergent, the decision to perform surgery should be made in a multidisciplinary team, including the gastroenterologist and colorectal surgeon. In those cases, surgery is usually performed in three-step. Total colectomy, the first step, is made in an emergency room. The other steps electively, after confirmed diagnosis in the resected specimen.
Elective RPC for UC is indicated in chronic refractory UC (Figure 5) and also in the presence of high-grade dysplasia (HGD) or colorectal malignancies.
Endoscopic images of chronic refractory ulceratice colitis.
The introduction of biologic therapy has added further complexity to medical management decisions, surgery, and the relative timing of these choices. Appropriate medical management of UC may induce and maintain remission and may prevent surgery. However, medical management also carries risks of adverse effects, and recent data suggest that delay of surgery during ineffective medical therapy can increase the chances of adverse surgical outcomes. To make individualized, timely treatment decisions, early collaboration between gastroenterologists and surgeons is essential, and more data on predictors of treatment response and positive outcomes are needed. Early identification of patients who would benefit from biologic therapy or surgery is challenging, and the definition of chronic refractory ulcerative colitis (CRUC) difficult. In CRUC (Figure 4), several therapeutic options have already been tried, such as infliximab, adalimumab, cyclosporine, azathioprine with 6-mercaptopurine, tacrolimus, or fecal transplantation, without success. When the therapeutic side effects are unbearable, or despite treatment, the patient has no quality of life, and RPC with IPAA may be the best solution.
The presence of high-grade dysplasia (HGD) or colorectal cancer is another indication for elective RPC with IPAA in IC.
Colorectal surveillance in UC obeys specific rules (Figure 6) [10], and chromoendoscopy has an essential role in dysplasias identification (Figure 7) [11, 12]. In UC surveillance, the chromoendoscopy allows to split the cases in visible dysplasia and invisible dysplasia (Figure 7) [13, 14].
Colorectal surveillance in UC (33 biopsies allow 90% accuracy in dysplasia diagnosis).
Role of chromoendoscopy in dysplasia endoscopic visiblility.
Nowadays, dysplasia management in UC takes into account the grade and number of dysplasia, whether visible or not, and the presence of primary sclerosing cirrhosis (PSC) (Figures 8 and 9) [11, 15, 16].
Management of visible dysplasia in ulcerative colitis.
Management of invisible dysplasia in ulcerative colitis.
In a systematic review of the literature, Fumery et al. found that among patients with UC-LGD under surveillance, the annual incidence of progression to CRC was 0.8%. Concomitant primary sclerosing cholangitis, invisible dysplasia, distal location, and multifocal LGD are high-risk features associated with dysplasia progression [17].
In UC patients with high-grade dysplasia or colorectal cancer (CRC), the colon and rectum should be removed with
The risk of colorectal cancer in UC is increased compared with the general population (Table 2) [19, 20, 21, 22, 23, 24]. Moreover, it is estimated to be around 18% after 30 years of UC duration [20].
Risk factor | Magnitude of the risk | References |
---|---|---|
Primary sclerosing cholangitis | OR: 4.0 | Soetikno RM et al. |
Disease duration | ||
Cumulative incidence 20 years | 2.5–8.0% | Eaden et al. [20] |
Cumulative incidence 30 years | 7.5–18.0% | Lakatos PL et al. |
Extent of inflammation | ||
Pancolitis | SIR: 5.1–14.8 | Eaden et al. [20] |
Left-sided colitis | SIR: 2.1–2.8 | Soderlund S et al. |
Pseupolyposis | OR: 2.1–2.5 | Velayos FS Rutter MD |
Family history of CRC | RR: 2.4–9.2 | Velayos FS Rutter MD |
Degree of inflammation | ||
Endoscopy | OR: 2.5 | Rutter MD |
Histology | OR: 5.1 |
CRC risk factors in ulcerative colitis.
Occasionally, total abdominal colectomy with ileorectal rectal anastomosis (TAC-IRA) can be considered.
Some of the patients with an acute severe colitis inaugural picture have indeterminate colitis or Crohn colitis. When they indicate emergency surgery, the first step is the colectomy. The realization of an elective restorative proctectomy with an IPAA must be individually analyzed. Patients with CD after IPAA, when compared with UC, have a fivefold higher risk of failure, twofold risk of strictures, and a sixfold risk of fistulae. This risk is much higher if the diagnosis is performed only after IPAA. However, function in those who retain the pouch seemed similar to that of patients with UC. CD does not increase the risk of pouchitis. IPAA could be offered to a selected population of CD patients after proper preoperative counseling (Figure 10).
Nine years after IPAA in a patient with Crohn’s disease.
Ileal pouch rectal anastomosis seems to be another viable alternative to permanent ileostomy in Crohn’s proctocolitis patients. IPRA offers durable preservation of bowel continuity and proper function and quality of life (QOL) in selected CC patients who might otherwise require a permanent ileostomy [25].
When the rectum can be partially spare, total abdominal colectomy with ileorectal anastomosis (TAC-IRA), a less complicated colorectal surgical procedure than RCP-IPAA, is an option. These solutions must be considered in attenuated familial adenomatous polyposis (aFAP) and synchronous colorectal cancer, and infrequently in UC and Crohn’s disease.
The assessment of the rectum state is a parameter to consider when the surgical plan procedure is made. In FAP, behind the number of polyps present in the rectum (less than 10), the aggressiveness and development of extracolonic symptoms of the disease are other aspects to take into account. The mutation site on the APC gene is associated with the FAP phenotype, including desmoid tumor (DT) development. The more distal the mutation (closer to 3′ end), the higher the risk of the patient being affected by the desmoid tumor [1, 9, 17]. Typical disease symptoms were observed in families who harbored mutations between exon 4 (codon 169) and codon 1393 of exon 15. Mutations beyond codon 1403 were associated with a more varied phenotype concerning the development of extracolonic symptoms, namely desmoid tumor (DT). Their presence is related to aggressiveness disease and usually dictates the outcome of the patient. Despite the possibility of DT arising in any location, DT related to FAP is mostly on the abdominal region: intra-abdominal, on the abdominal wall, and transabdominal. Some of them take a benign course, with slow evolution, stabilization of growth, or even remission. Others show aggressive behavior with rapid growth and mass effect on surrounding structures, particularly in intra-abdominal DT. Possible complications of intra-abdominal DT are intestinal obstruction, ischemia, hemorrhage, and perforation or ureteric obstruction [1, 4, 8]. When DT develops in FAP patients, they can be the reason for the pouch failure case, and they are the second most common cause of mortality [20].
In synchronous CRC, the rectal tumor stage and location define the surgery to perform. If the rectum can be spare, TAC-AIR is the choice. RPC-IPAA with total mesorectum excision and with or without neoadjuvant chemoradiotherapy may be the solution in selected patients with medium or distal rectal cancer, depending on if the tumor is localized or locally advanced.
In IBD with proctocolitis involvement, rectum spare is controversial, mainly is ulcerative colitis. The decision-based in the absence of activity in the rectal mucosa.
When the rectum cannot be spare, it is mandatory to rule out the presence of relative or absolute contraindication for IPAA. There are absolute contraindications for IPAA: They are the presence of poor anal sphincter function with fecal incontinence in all pathologies, the distance between the tumor and pectin line inferior to 1 cm or sphincter involvement in distal rectal cancer, and the presence of perianal disease beyond proctocolitis in Crohn disease. The aggressive phenotype in FAP, indeterminate proctocolitis, and Crohn’s disease, with involvement limited to the colon and rectum, are the relative contraindications. Morbid obesity increased technical difficulties and can be considered a relative contraindication, as the willingness in young women to get pregnant.
RCP with IPAA is, in fact, a complicated colorectal surgical procedure even in the hands of experienced high-volume surgeons. In an extensive series of 1789 patients undergoing proctocolectomy, IPAA was attempted but abandoned intraoperatively in 4.1% [26].
So, the relative indication for that type of elective surgery must be carefully considered. Several aspects must take into account for surgery plan mainly in UC cases:
the pathology underlying and specific features;
if the surgery is elective or urgent;
patient age;
patient comorbidities;
patient anal sphincter and rectum status;
and the experience of the surgeon.
Moreover, weigh the risk and frequency of IPAA morbidity and the patient is will after informed consent, which are also factors that influence the surgical decision.
RPC-IPAA is “the gold standard” procedure to treat patients with classical FAP and elective surgery in UC, although other surgical solutions are possible (Table 3).
Operation | Advantages | Disadvantages |
---|---|---|
Rectal mucosectomy with ileal pouch-anal canal Anastomosis | Complete excision of large intestinal disease Transanal defecation and fecal continence preserved No ileostomy | Two operations required At risk for pouchitis Nocturnal fecal spotting present |
Stapled ileal pouch-distal rectal anastomosis | Transanal defecation and fecal continence preserved No ileostomy Easier technically | At risk for pouchitis and cancer from residual rectal mucosa |
Continent ileostomy | Complete excision of large intestinal disease Fecal continence preserved No external appliance | Stoma present Intubation of pouch required At risk for pouchitis and need for valve revision |
Brooke ileostomy | Complete excision of large intestinal disease One operation | Stoma present, risk of parastomal hernia Incontinent for feces Need of external appliance |
Ileorectal anastomosis | Transanal defecation and fecal continence preserved No ileostomy | Diseased rectum remains to produce symptoms, require treatment, and predispose to cancer |
Bowel transit reconstruction types after a proctocolectomy/total colectomy.
RPC-IPAA is a complex procedure that pouch results also depend on technical surgical details and surgeon experience.
RPC with IPAA is a procedure that can be made in one, two, or three stage, by laparoscopic or open surgery.
The laparoscopic approach, if feasible, allows better cosmetics and outcomes.
One-stage or two-stage procedure is recommended for elective surgery and three-stage for emergent surgery.
Stage 1—An ileal pouch is made, and anastomosed to the anus is made after de proctocolectomy without a protective ileostomy. The operation is made in elective surgery and completed in a single stage (one surgery).
Stage 2—After a PC and IPAA confection, the anastomosis is protected by a loop ileostomy, and ileostomy closure is posterior realized (two surgeries).
Stage 3—At the emergency room, the first step is the total abdominal colectomy and ileostomy. The second step is the IPAA with the anastomosis protected by a loop ileostomy. The third surgery is the ileostomy closure (three surgeries).
Due to anastomotic complications (infection, fistulization, development of Crohn’s disease, disease recurrence, or poor function), an ileostomy may be required (stage 2) to prevent complications or if the pouch fails postoperatively. The authors are not unanimous about the need to do a derivative ileostomy by routine during IPAA construction (stage 1 vs. stage 2).
Lovegrove et al. found to be associated with ileostomy omission: stapled anastomosis (odds ratio [OR], 6.4), no preoperative corticosteroid use (OR, 3.2), familial adenomatous polyposis diagnosis (OR, 2.6), cancer diagnosis (OR, 3.4), female sex (OR, 1.6), and age at surgery younger than 26 years (OR, 2.1) (
The most used pouch configurations are the J-pouch and de S-pouch, wherein most centers opt for J-pouch. S-pouch is usually reserved for patients with high IBM, short mesentery, or handsewn anastomosis necessity. Wu et al. recommend using an S-pouch when constructing an IPAA with a handsewn technique. A total of 502 patients included 169 patients with an S-pouch (33.7%). The frequencies of short-term complications in the two groups were similar (
The IPAA can be made with transanal mucosectomy and handsewn anastomosis or preserving the anal transitional zone mucosa in a small rectal cuff and stapled anastomosis.
Dafni et al. refer that stapled IPAA and younger age at the onset of UC correlated with better functional results, and the HRQOL scores were high [31].
Kirat et al. studied the influence of stapler size used at IPAA on the anastomotic leak, stricture, long-term functional outcomes, and quality of life. They analyzed the stapled IPAA performed between 1983 and 2007: A (stapler size 28–29 mm) (
Surgical complications in RPC with IPAA are not unusual as functional deterioration of pouch and quality of life (QOL). Fazio et al. encountered in their data early perioperative complications in 33.5% of patients with a mortality rate of 0.1%. On the other hand, he refers to good functional outcomes and QOL in 95% [2]. Nevertheless, these results by Fazio, mainly the functional outcomes of the IPAA, are not reached in all centers, probably depending on the surgeon experience and the high patient volume. The most leading and frequent IPAA complications are described as follows:
Pelvic sepsis occurs in 9% of the procedure, and its presence increases the risk of pouch failure. Pelvic sepsis is a common early complication with far-reaching consequences of long-term pouch dysfunction, but prompt intervention (either radiological or surgical) reduces the risk of pouch failure. According to Lavryk et al., 4031 patients who underwent IPAA in 1983–2014 (patients with Crohn’s disease or cancer were excluded), 357 (8.8%) developed IPAA-related pelvic sepsis with or without anastomotic dehiscence [33].
The inflammation of the IPAA can appear in acute (60%) or chronic (60%) form.
Kayal et al. state 53% that acute pouchitis occurred in 205 patients (53%), 60 of whom (30%) progressed to chronic pouchitis [34].
Hashavia et al. followed prospectively 201 UC patients who underwent IPAA (1981–2009 for a mean of 108 months). A total of 138 (69%) of these had either a regular pouch or episodes of acute pouchitis and 63 (31%) developed chronic pouchitis [35].
Pouch failure rates range from 5.5 to 8.5%, depending upon the length of follow-up [36]. In Fazio data, 3707 patients underwent primary pouch, and 328 (8.1%) redo pouch surgery (primary surgery in other centers). Pouch failure occurred in 197 (5.5%) of the 3707. During a median follow-up of 84 months, 119 patients (3.2%) required excision of the pouch, 32 (0.8%) had a nonfunctioning pouch, and 46 patients (1.2%) had redo IPAA [2].
Mild fecal incontinence is a common complication of IPAA and seems to worsen with time [37].
Mild and severe fecal incontinence during the day: 17 and 3.7% of patients, respectively.
(Incontinence during the night: 13.1 and 4.5%; urge incontinence during the day: 7.3%).
At 12 months post-IPAA, it has been reported that 19% of patients suffered occasional daytime incontinence, and 49% suffered nocturnal incontinence [7]. Consequently, this can have a significantly negative impact on the quality of life of patients. The evidence to support the use of SNS for fecal incontinence after IPAA remains very limited.
Studies have shown that fertility in women with UC is comparable to the background population but drops following restorative proctocolectomy [38].
This problem can be restricted, opting for a laparoscopic approach and using
Laparoscopy was associated with a significantly reduced time to conceive compared with the open approach [39].
Females with RPC for UC have an increased incidence of
Sexual dysfunction can appear after RCP with IPAA. Postoperative impotence and retrograde ejaculation have been observed in approximately 1.5–4% of men, respectively. Transient dyspareunia occurs in about 7% of women [41].
About 1% of patients develop dysplasia or carcinoma after surgery, which occurs in the retained rectum, anal transitional zone, or ileal pouch, depending upon the procedure performed.
Mark-Christensen et al. analyzed 1723 patients with IPAA operated for ulcerative colitis in the period 1980–2010 that matched to 8615 individuals from the background population. They concluded that pouch cancer following IPAA is sporadic, questioning the need for general, rather than selective, surveillance. The overall cancer risk is comparable to that of the background population (Figure 11). The increased risk of hepatobiliary cancer is likely an effect of coexisting liver disease and not causally related to IPAA [42].
Nine years passed between RCP with IPAA for FAP. The residual polyps were appearing in IPAA, easily handled by endoscopic surveillance with polypectomy.
RCP with IPAA in the hands of experienced high-volume surgeons is a safe procedure associated with good functional results, provided that the risk-benefit is appropriately weighted.
RPC with IPAA is the golden standard procedure for FAP and selected UC when the rectum cannot be spared, and the patient has a normal anal sphincter function.
RPC with IPAA can also be performed in some patients with indeterminate colitis, Crohn’s disease, and synchronous CRC.
IPAA has morbidity and functional results that worsen with time, mainly if the underlying pathology is Crohn’s disease or indeterminate colitis.
To propose an RPC with IPAA, it is necessary:
to confirm a normal anal sphincter function and the need for total proctocolectomy;
know the underlying pathology and specific features;
assess the risk of pouch morbidity and disfunction taking into account beyond the underlying pathology:
patient age, gender, IBM, and comorbidities.
indication for the surgery.
the time between the onset of the disease and surgery.
experience of the center in RPC with IPAA and patient’s will.
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The comprehensive e-services system was developed and implemented in one of the higher educational institutions. The upcoming generations of students are increasingly likely to have prominent previous experience with the major use of digital technologies as a part of their elementary and secondary level education. Higher education institutions should expand the portfolio of their e-services, given that the demands of students are expected to increase in the future.",book:{id:"11914",title:"E-service Digital Innovation",coverURL:"https://cdn.intechopen.com/books/images_new/11914.jpg"},signatures:"Adam Malešević"},{id:"82995",title:"A Hybrid Genetic, Differential Evolution Optimization Algorithm",slug:"a-hybrid-genetic-differential-evolution-optimization-algorithm",totalDownloads:3,totalDimensionsCites:0,doi:"10.5772/intechopen.106204",abstract:"This chapter presents a heuristic evolutionary optimization algorithm that is loosely based on the principles of evolution and natural genetics. In particular, this chapter describes an evolutionary algorithm that is a hybrid of a genetic algorithm and a differential evolution algorithm. This algorithm uses an elitist, ranking, random selection method, several mutation methods and both two level and three level Taguchi crossover. This algorithm is applied to 13 commonly used global numerical optimization test functions, including a spherical, three hyper-ellipsoid, the sum of different powers, Rastrigin’s, Schwefel’s, Griewank’s, Rosenbrock’s valley, Styblinski-Tang, Ackley’s Path, Price-Rosenbrock, and Eggholder’s functions. This algorithm is applied 1000 times to each of the 13 test functions, and the results shows that this algorithm always converges to each of the 13 test function’s global minimum.",book:{id:"11555",title:"Ubiquitous and Pervasive Computing - New Trends and Opportunities",coverURL:"https://cdn.intechopen.com/books/images_new/11555.jpg"},signatures:"Peter Stubberud"},{id:"82921",title:"A Survey of Lightweight Image Encryption for IoT",slug:"a-survey-of-lightweight-image-encryption-for-iot",totalDownloads:4,totalDimensionsCites:0,doi:"10.5772/intechopen.104431",abstract:"IoT networks serve as a way for various devices interconnected over the internet to exchange data with each other and with other services. Most smartphones, laptops, and other communication devices are connected to the cloud today, making data accessible to everyone. There are many applications for IoT, from smart IoT applications to industrial products. Encryption is one of the best ways to make IoT networks secure since so much data is being transferred. A lightweight block cipher is one of the most sophisticated means for overcoming the security problems inherent to IoT networks. Because of the limited resources available to nodes, classical cryptography methods are costly and inefficient. In this paper, we have compared the systems, we have found that these modifications were made to the original AES algorithm, while the original algorithm security remains robust, the modified AES algorithm remains lightweight and faster, providing more satisfaction for embedding in IoT devices and sensors that consume little power. Furthermore, this algorithm enhanced the AES-ECC hybrid encryption system, which has good flexibility and versatility, and optimized the design of the ECC function according to the characteristics of wireless sensor networks. Using Salsa20/12 stream cipher, the texture images can be encrypted using bit masking and permutation procedures and as part of a new scheme for encrypting 3D objects, which complements the existing methods for 3D object encryption. With PLIE implemented in Python, the encryption time was approximately 50% faster than that of AES using the throughput increase, faster encryption time, and minimal complexity.",book:{id:"11190",title:"Lightweight Cryptographic Techniques and Cybersecurity Approaches",coverURL:"https://cdn.intechopen.com/books/images_new/11190.jpg"},signatures:"Haneen Dweik and Mohammad Abutaha"},{id:"82098",title:"Perspective chapter: Internet of Things in Healthcare - New Trends, Challenges and Hurdles",slug:"perspective-chapter-internet-of-things-in-healthcare-new-trends-challenges-and-hurdles",totalDownloads:5,totalDimensionsCites:0,doi:"10.5772/intechopen.104946",abstract:"Applied to health field, Internet of Things (IoT) systems provides continuous and ubiquitous monitoring and assistance, allowing the creation of valuable tools for diagnosis, health empowerment, and personalized treatment, among others. Advances in these systems follow different approaches, such as the integration of new protocols and standards, combination with artificial intelligence algorithms, application of big data processing methodologies, among others. These new systems and applications also should face different challenges when applying this kind of technology into health areas, such as the management of personal data sensed, integration with electronic health records, make sensing devices comfortable to wear, and achieve an accurate acquisition of the sensed data. The objective of this chapter is to present the state of the art, indicating the most current IoT trends applied to the health field, their contributions, technologies applied, and challenges faced.",book:{id:"11197",title:"Internet of Things - New Trends, Challenges and Hurdles",coverURL:"https://cdn.intechopen.com/books/images_new/11197.jpg"},signatures:"Luis Muñoz-Saavedra, Francisco Luna-Perejón, Javier Civit-Masot and Elena Escobar-Linero"},{id:"82742",title:"Activity Based Learning (ABL) Using Gamification (GBL) in Mechanical Engineering Design Education: A Studio-Based Case Study",slug:"activity-based-learning-abl-using-gamification-gbl-in-mechanical-engineering-design-education-a-stud",totalDownloads:9,totalDimensionsCites:0,doi:"10.5772/intechopen.104773",abstract:"In our research, we aim to introduce Game-based learning (GBL) activity as part of a holistic approach to supporting knowledge acquisition within a Mechanical Design module. Our case study evaluates Activity Based Learning (ABL) by use of GBL as a tool to drive collaborative student learning. The activity described targets students’ ability to engage in hands-on practical collaborative learning, utilising existing skills in order to collectively share and reinforce knowledge. It relies on knowledge acquired from several subject topics thus consolidating applications through a studio-based activity in the form of a game bringing about its own benefits in teaching and learning. Widely used in a range of subjects, the application of GBL in Engineering and Technology and its effectiveness is less explored and reported as a learning tool in Engineering education. We present an approach to underpinning engineering education as part of a studio-based activity for Mechanical Engineering Design. We explore the options and potential for collaborative learning whilst offering students the opportunity to compete with peer teams for ranked positions on a leader board. 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He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. 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Her research interests include archaea metabolism, enzymes purification and characterization, gene regulation, carotenoids and bioplastics production, antioxidant\ncompounds, waste water treatments, and brines bioremediation.\nRosa María’s other roles include editorial board member for several journals related\nto biochemistry, reviewer for more than 60 journals (biochemistry, molecular biology, biotechnology, chemistry and microbiology) and president of several organizing committees in international meetings related to the N-cycle or respiratory processes.",institutionString:null,institution:{name:"University of Alicante",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"15",title:"Chemical Biology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/15.jpg",isOpenForSubmission:!0,annualVolume:11411,editor:{id:"441442",title:"Dr.",name:"Şükrü",middleName:null,surname:"Beydemir",slug:"sukru-beydemir",fullName:"Şükrü Beydemir",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003GsUoIQAV/Profile_Picture_1634557147521",biography:"Dr. Şükrü Beydemir obtained a BSc in Chemistry in 1995 from Yüzüncü Yıl University, MSc in Biochemistry in 1998, and PhD in Biochemistry in 2002 from Atatürk University, Turkey. 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He is a member of the Turkish Biochemical Society, American Chemical Society, and German Genetics society. Dr. Ekinci published around ninety scientific papers, reviews and book chapters, and presented several conferences to scientists. He has received numerous publication awards from several scientific councils. 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She gained considerable experience in developing and validating new methodologies whose applications allowed her to determine both the amount of biomarkers (Desmosine and Isodesmosine) in the urine of patients affected by COPD, and the activity of proteolytic enzymes (HNE, Cathepsin G, Pseudomonas aeruginosa elastase) in the sputa of these patients. Simona Viglio was also involved in research dealing with the supplementation of amino acids in patients with brain injury and chronic heart failure. She is presently engaged in the development of 2-DE and LC-MS techniques for the study of proteomics in biological fluids. The aim of this research is the identification of potential biomarkers of lung diseases. She is an author of about 90 publications (According to Scopus: H-Index: 23; According to WOS: H-Index: 20) on peer-reviewed journals, a member of the “Società Italiana di Biochimica e Biologia Molecolare,“ and a Consultant Reviewer for International Journal of Molecular Science, Journal of Chromatography A, COPD, Plos ONE and Nutritional Neuroscience.",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorThree:null}]},overviewPageOFChapters:{paginationCount:20,paginationItems:[{id:"83065",title:"Interventions and Practical Approaches to Reduce the Burden of Malaria on School-Aged Children",doi:"10.5772/intechopen.106469",signatures:"Andrew Macnab",slug:"interventions-and-practical-approaches-to-reduce-the-burden-of-malaria-on-school-aged-children",totalDownloads:2,totalCrossrefCites:null,totalDimensionsCites:0,authors:[{name:"Andrew",surname:"Macnab"}],book:{title:"Malaria - Recent Advances, and New Perspectives",coverURL:"https://cdn.intechopen.com/books/images_new/11576.jpg",subseries:{id:"5",title:"Parasitic Infectious Diseases"}}},{id:"82804",title:"Psychiatric Problems in HIV Care",doi:"10.5772/intechopen.106077",signatures:"Seggane Musisi and Noeline Nakasujja",slug:"psychiatric-problems-in-hiv-care",totalDownloads:1,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"Future Opportunities and Tools for Emerging Challenges for HIV/AIDS Control",coverURL:"https://cdn.intechopen.com/books/images_new/11575.jpg",subseries:{id:"6",title:"Viral Infectious Diseases"}}},{id:"82827",title:"Epidemiology and Control of Schistosomiasis",doi:"10.5772/intechopen.105170",signatures:"Célestin Kyambikwa Bisangamo",slug:"epidemiology-and-control-of-schistosomiasis",totalDownloads:4,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"New Horizons for Schistosomiasis Research",coverURL:"https://cdn.intechopen.com/books/images_new/10829.jpg",subseries:{id:"5",title:"Parasitic Infectious Diseases"}}},{id:"82817",title:"Perspective Chapter: Microfluidic Technologies for On-Site Detection and Quantification of Infectious Diseases - The Experience with SARS-CoV-2/COVID-19",doi:"10.5772/intechopen.105950",signatures:"Andres Escobar and Chang-qing Xu",slug:"perspective-chapter-microfluidic-technologies-for-on-site-detection-and-quantification-of-infectious",totalDownloads:3,totalCrossrefCites:0,totalDimensionsCites:0,authors:null,book:{title:"SARS-CoV-2 Variants - Two Years After",coverURL:"https://cdn.intechopen.com/books/images_new/11573.jpg",subseries:{id:"6",title:"Viral Infectious Diseases"}}}]},overviewPagePublishedBooks:{paginationCount:13,paginationItems:[{type:"book",id:"6667",title:"Influenza",subtitle:"Therapeutics and Challenges",coverURL:"https://cdn.intechopen.com/books/images_new/6667.jpg",slug:"influenza-therapeutics-and-challenges",publishedDate:"September 19th 2018",editedByType:"Edited by",bookSignature:"Shailendra K. Saxena",hash:"105e347b2d5dbbe6b593aceffa051efa",volumeInSeries:1,fullTitle:"Influenza - Therapeutics and Challenges",editors:[{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",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",institutionURL:null,country:{name:"India"}}}]},{type:"book",id:"7064",title:"Current Perspectives in Human Papillomavirus",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/7064.jpg",slug:"current-perspectives-in-human-papillomavirus",publishedDate:"May 2nd 2019",editedByType:"Edited by",bookSignature:"Shailendra K. Saxena",hash:"d92a4085627bab25ddc7942fbf44cf05",volumeInSeries:2,fullTitle:"Current Perspectives in Human Papillomavirus",editors:[{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",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",institutionURL:null,country:{name:"India"}}}]},{type:"book",id:"7123",title:"Current Topics in Neglected Tropical Diseases",subtitle:null,coverURL:"https://cdn.intechopen.com/books/images_new/7123.jpg",slug:"current-topics-in-neglected-tropical-diseases",publishedDate:"December 4th 2019",editedByType:"Edited by",bookSignature:"Alfonso J. 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He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. 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