\\n\\n
More than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\\n\\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\\n\\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\\n\\nAdditionally, each book published by IntechOpen contains original content and research findings.
\\n\\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\\n\\n\\n\\n
\\n"}]',published:!0,mainMedia:{caption:"IntechOpen Maintains",originalUrl:"/media/original/113"}},components:[{type:"htmlEditorComponent",content:'
Simba Information has released its Open Access Book Publishing 2020 - 2024 report and has again identified IntechOpen as the world’s largest Open Access book publisher by title count.
\n\nSimba Information is a leading provider for market intelligence and forecasts in the media and publishing industry. The report, published every year, provides an overview and financial outlook for the global professional e-book publishing market.
\n\nIntechOpen, De Gruyter, and Frontiers are the largest OA book publishers by title count, with IntechOpen coming in at first place with 5,101 OA books published, a good 1,782 titles ahead of the nearest competitor.
\n\nSince the first Open Access Book Publishing report published in 2016, IntechOpen has held the top stop each year.
\n\n\n\nMore than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\n\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\n\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\n\nAdditionally, each book published by IntechOpen contains original content and research findings.
\n\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\n\n\n\n
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\r\n\tIn March 2022, another book on human migration seems important when the events or tragedies unfolding in Eastern Europe are considered. People have always migrated and have moved, but, specifically looking at the last three hundred years, involuntary migration is on the rise. Involuntary migration does not only affect Europe; Asia, Africa, and North as well as South America, have had their fair share of natural catastrophes, invasions, and wars.
\r\n\tThis book will intend to look at different migrant patterns, voluntary and involuntary migration, over the last three centuries. What influenced people to leave their home countries, family, and friends and settle somewhere else? The book may include histories of the 19th century, consider tragedies and movements activated by political events in the 20th century, and/or look at recent events of the 21st century. Push and pull factors are important points. While most of us may be influenced in a negative way by the current happenings in Eastern Europe, the Russian invasion and resulting tragedies also demonstrate some very positive human traits – the preparedness of Ukraine’s surrounding countries to help those in need and to provide a safe place for the present.
\r\n\tWhether one looks at voluntary or involuntary migration into any country, after a period of adjustment, migrants do play a positive role. The research found that migrants contribute to the economy (food, shelter, employment, tax) and enrich a country’s cultural norms. Prerequisites for successful settlements are that the host society adopts a tolerant approach and that the migrants recognize the law and the language of the host country. Nothing is ever easy or without controversy, but I am a migrant (German Australian), and life in Australia has been relatively harmonious. Issues that could be considered in the book are multicultural societies (do monocultural societies still exist?) and theories of acculturation versus integration (settlement processes).
\r\n\tTwo further issues are very important in relation to human migration. There is climate change, global warming, and the environment, which clearly affect people’s movement. Small island populations are very concerned about rising sea levels. 2021 has also seen floods costing human lives: Turkey (August 2021), Brazil (December 2021), Chile (January 2021), and South India (November 2021), to name but a few. In Australia (March 2022), farms and whole townships in New South Wales and Queensland have been flooded for the second time in five years, and plans to resettle these towns are considered. Official and social media provide ample coverage of the events, which leads me to the next issue. There is today’s very important role of the media, of the official and social media. We are constantly bombarded with images of human war tragedies and flood victims. People in industrialized, western countries must be the best-informed populace. How far do the images and up-to-date TV news influence us, make us change our behavior, and perhaps even consider us more generous than we have been?
\r\n\tClimate change and the media are relatively new to the human migration debate, but both issues play important parts, and some interesting discussions are appreciated.
\r\n\t
Respiratory compromise due to embolization is one of the leading causes of death among hospitalized patients, a condition known as acute pulmonary embolism (PE). In the United States alone, for every 100,000 individuals, about 70 people will experience pulmonary embolism each calendar year [1].
Simply put, acute pulmonary embolism is a restriction of arterial blood flow in the lung that can be detrimental when misdiagnosed. When the cause of obstruction is blood itself, it is known as venous thromboembolism (VTE). This being the most common cause of pulmonary embolism. It is apropos to mention that blood flow is not the only substance that can cause mechanical lung obstructions. Other substances include, but not limited to fat (traumatic bone fracture, especially of long bones, leads to bone marrow/fat freely circulating systemically), amniotic fluid (as a complication of labor), air (a complication of central venous access), septic embolism (heart valve damage by micro-organism) or even tumor cells metastasizing. The broad array of materials that can lead to this obstructive shock makes it imperative for a clinician to put the clinical picture with the patient’s symptoms to make the diagnosis early. Failure to do so in a timely manner can lead to catastrophic cardiopulmonary compromise and even death.
When PE is caused by venous thromboembolism, greater than 50% of patients will have some clot burden in their lower extremities or a deep vein thrombosis (DVT). The culprit vessels being the femoral and popliteal veins. Some patients may present with symptoms of DVT without PE. Therefore, a thorough investigation is warranted to diagnose, treat and prevent future propagation.
Acute pulmonary embolism is a mechanical obstruction of the blood flow to the lung vasculature and the functional unit involved in respiration, the parenchyma. The parenchyma being starved of oxygen leads to an inflammatory response and cellular death made evident by respiratory compromise and the compensatory respiratory alkalosis on patient presentation. It is imperative to note that both PE and DVT share a spectrum in the realm of VTE. The main difference between these two disease states lies in the location. The main mechanism that leads to PE and DVT, known as the Virchow’s triad, comprises of endothelial injury, venous statis and a hypercoagulable state.
Endothelial injury refers to damage to the vasculature which can lead to an inflammatory response in an attempt to heal with thrombus formation. Most commonly, this occurs in acute trauma, previous history of trauma or prior surgery. Venous stasis, which comprises of a no flow state of blood, can lead to thrombus formation as blood has an affinity to coagulate when not freely flowing. Venous stasis is mostly seen as a complication from immobility (postoperative states) or in patients with major strokes. Lastly, a hypercoagulable state can be a complication of disease states, such as active cancer, medications such as hormonal replacement therapy or oral contraceptives, and finally genetic mutations, most common being factor V Leiden. Other genetic mutations include: protein C and S deficiency, prothrombin gene mutation, antithrombin III deficiency.
Hemodynamically, there are many alterations that occur in the presence of an acute PE that is related to the size of the embolus, the duration of blood flow obstruction as well as the patient’s cardiopulmonary history. Large PEs tend to obstruct the main pulmonary artery along with its branches while smaller PEs are culprits of the smaller peripheral vessels. The obstructive burden coupled with neurohormonal release contribute to hemodynamic compromise and ischemic propagation is presence of neurohormonal release that progress propagate ongoing damage. Common neurohormones present include serotonin, thrombin and histamine [2].
Hypoxic vasoconstriction, a reflex response to acute PE, leads to increase in mean arterial pulmonary pressure. This increase is significantly high in patients with history of pulmonary hypertension. Increased pulmonary artery pressure contributes to increased right ventricular (RV) afterload causing right ventricular enlargement and a leftward bulging of the interventricular septum commonly found on echocardiography. Cardiac arrest is hence from the vascular compromise from increased pressure on the right coronary artery, causing myocardial ischemia.
Acute PE impairs efficient gas exchange. Hypoxemia and increase in the alveolar-arterial oxygen tension gradient are the most common gas exchange abnormalities. Total dead space increases. Ventilation and perfusion become mismatched, with blood flow from obstructed pulmonary arteries redirected to other gas exchange units [2]. The obstruction of blood flow in the pulmonary arteries leads to a redistribution of blood flow causing some alveoli to have low ratios of ventilation to perfusion, whereas others have excessively high ratios of ventilation to perfusion [2].
Assessment of PE in patients can be challenging as symptoms can be nonspecific. The patient could present with an array of different possibilities but a history of dyspnea, progressive or sudden onset in nature is a common complaint. Other complaints include pleuritic chest pain, cough and hemoptysis mostly in patients with pulmonary infarction. Due to the nonspecific symptoms that acute PE could present with, it is imperative to garner the appropriate risk factors that could lead to the suspicion. Another complaint that should increase the index of suspicion is a patient with dyspnea coupled with recent onset lower extremity tenderness or swelling.
Most patients with PE have tachypnea and tachycardia associated with hypoxemia. Similar findings can occur in disorders such as heart failure, pneumonia, or chronic obstructive pulmonary disease [2]. A good clinical examination is apropos to ascertain any other possible disease pathology that may mimic PE.
The diagnosis of PE relies on a high clinical suspicion along with the patient’s history and physical exam. After suspicion, confirmation with appropriate testing leads to the final diagnosis. Diagnostic tests alone are not the reflex course of action with a high index of suspicion due to the fact that there are many disease states that could present similarly. In patients with a high index of suspicion, the Wells criteria, developed by Wells et al., is a simple clinical model to predict the likelihood of PE. Scoring system has a maximum of 12.5 points, based on 7 variables: 3 points each for clinical evidence of DVT and an alternative diagnosis being less likely than PE, 1.5 points each for heart rate > 100 per minute, immobilization/surgery within 4 weeks, and previous deep vein thrombosis/PE, and 1 point each for hemoptysis or cancer [2, 3]. The pretest probability for PE after utilization of the Wells scoring system categorizes PE into low (score < 2), moderate (score between 2 and 6) or high risk (score > 6). This will then guide a clinician on subsequent tests such as a D-dimer assay, a byproduct of ineffective fibrinolysis released into systemic circulation. D-dimer elevation has high sensitivity for acute PE, as high as 98%, albeit poor sensitivity. Instances such as malignancy, advanced age and chronic inflammatory conditions are all reasons for an elevated d-dimer besides PE. Therefore, the benefit of a d-dimer assay lies in its high negative predictive value and its ability to effectively reduce further diagnostic testing in patients with an already low to moderate pretest probability with Wells scoring [4, 5].
Imaging studies in patients with acute PE in recent times have been with computed tomography pulmonary angiography (CT-PA). The benefit of CT-PA is direct thrombi visualization in the pulmonary arteries and effectively ruling out patients without PE [2]. The use of radiocontrast dye should be taken into consideration in patients with a suspicion of PE, but in patients with decompensation coupled with a high index of suspicion, the benefits of imaging clearly outweigh the risk. Furthermore, CT-PA with evidence of thrombus in the pulmonary arteries up to the segmental level provides strong evidence of PE. When negative, it does exclude PE but the presence of PE in the subsegmental regions, sometimes missed by CT-PA, does not alter patient outcome as these patients have at least as good an outcome as patients with a negative lung scan [2, 6].
There are indeed other modalities for investigation of acute PE, though by far a CT-PA has emerged as the more favorable option. Other modalities include a ventilation-perfusion (V/Q) scan, a two-part exam with a ventilation phase and perfusion phase. Diagnosis of PE based on a V/Q scan is made when PE-associated lung areas fail to enhance on the perfusion phase using technetium-labeled albumin macroaggregates. Magnetic resonance imaging (MRI) with gadolinium-enhancement has been shown to have similar efficacy to that of CT-PA.
Anticoagulation has become the mainstay treatment for acute PE though the degree of severity influences the length of treatment. The severity of acute PE depends on parameters such as hemodynamics, right ventricular dysfunction, presence of troponin and/or brain natriuretic peptide (BNP). Risk stratification using the appropriate criteria not only guides the choice of treatment, but also provides outpatient management options. It is also highly important to know if the patient has any contraindications to anticoagulation prior to initiation of treatment. Massive (high-risk) PE is the presence of hemodynamic compromise, right ventricular dysfunction and increased troponin and/or BNP levels. In such patients, the most common cause of death is not the PE, but the complication of acute right ventricular failure. To mitigate this complication, hemodynamic and respiratory support early is crucial. Due to the dependence of preload in right ventricular failure, both fluid expansion and inotropic agents, such as dobutamine, dopamine and/or norepinephrine, are needed to manage shock [2]. In patients with presence of right ventricular dysfunction and increased troponin and/or BNP levels without hemodynamic compromise, are classified as sub-massive (intermediate-risk) PE with consideration of fibrinolytic therapy if very symptomatic. Lastly, low-risk PE classification is in the group of patients with no hemodynamic compromise, right ventricular dysfunction or increased troponin or BNP levels. In such patients, a consideration of outpatient management is acceptable.
Anticoagulation has become the cornerstone modality of treatment in patients with acute PE. In patients with a very high index of suspicion or massive PE, anticoagulation should be initiated prior to confirmatory test. The most extensively studied anticoagulant in PE is heparin. Heparin, an anti-thrombin III inhibitor, acts mainly by inactivation of factor Xa in the clotting cascade, preventing the conversion of prothrombin to thrombin. Other options include low molecular weight heparin (LMWH), fondaparinux or the direct factor Xa inhibitors, rivaroxaban and apixaban. Dosing for heparin is usually 80 U/kg bolus followed by an infusion at the rate of 18 U/kg per hour with subsequent doses based on aPTT results [4]. Additionally, it is important to monitor platelet count while heparin is administered due to the risk of heparin-induced thrombocytopenia (HIT). After the initial heparinization phase, continued treatment is with an oral direct thrombin inhibitor, factor Xa inhibitor or warfarin.
The duration of treatment of PE is directly related to the precipitating factors that led to the PE. In other words, whether the PE was provoked or unprovoked. Special considerations in terms of treatment modality and duration are made for certain populations such as pregnant females or patients with active cancer. For all other patient populations with who present with a first time PE, the minimum duration of treatment is 3 months. If the PE is provoked and the factors are withdrawn such as a female stopping hormonal treatment, then a 3-month period of oral anticoagulation is sufficient. In patients with an unprovoked or life-threatening PE, indefinite anticoagulation is ideal due to a higher risk of recurrence. There must be a risk and benefit analysis when indefinite anticoagulation is being pursued, especially in patients with a higher bleeding risk [4].
Systemic thrombolytic therapy is an effective therapy in preventing deaths from PE, however it markedly increases bleeding risks, including intracranial and fatal bleeding [7]. The PEITHO (Pulmonary Embolism Thrombolysis Study), which compared tenecteplase with placebo in 1000 PE patients without hypotension but with right ventricular dysfunction, found no clear net benefit from systemic thrombolytic therapy; the reduction in cardiovascular collapse (odds ratio: 0.30) was offset by the increase in major bleeding (odds ratio: 5.2) [8]. Consequently, systemic thrombolytic therapy is usually reserved for PE patients with hypotension. Catheter-directed thrombolysis (CDT) was initially developed for treatment of arterial, dialysis graft, and deep vein thromboses (leg or arm). When used to treat acute PE, a wire is usually passed through the embolus, followed by placement of a multi-sidehole infusion catheter through which a thrombolytic drug is infused over 12–24 h. The delivery of the drug directly into the thrombus is expected to be as effective as systemic therapy but to cause less bleeding because a much lower dose of the drug is used.
SEATTLE II is a single-arm prospective cohort study in which 150 patients with lobar artery or more central PE (31 with and 119 without hypotension) were treated with ultrasound-assisted CDT using a standardized protocol [9]. Tissue plasminogen activator was infused into each treated lung at a rate of 1 mg/h, to a total dose of 24 mg (over 12 h for bilateral lung infusions), and no additional mechanical maneuvers were used to disrupt or aspirate thrombus. When computed tomography pulmonary angiography was repeated after 48 h, the right ventricular to left ventricular ratio was decreased by 27% and thrombus burden was reduced by 30%. Pulmonary artery pressure also decreased by 27% between the start to the end of CDT. These 3 improvements were each highly statistically significant. There were 17 episodes of major bleeding in 15 patients (10%): one was associated with hypotension; all required transfusion; none was intracranial; and none was fatal.
Acute pulmonary ischemia due to pulmonary embolism results in a cascade of events, from decreasing lung compliance to increasing pulmonary resistance ultimately resulting in RV dysfunction and hemodynamic collapse. Thus, in certain cases more rapid thrombus removal is required, and mechanical techniques are now available.
The FlowTriever System (Figure 1) is a mechanical thrombectomy device indicated for use in the peripheral vasculature and pulmonary arteries (PAs). FlowTriever received U.S. Food and Drug Administration 510(k) clearance for PE in May 2018—the first mechanical thrombectomy device to receive that indication. The FlowTriever System includes Triever aspiration catheters (16-F, 20-F, 24-F) capable of removing large amounts of thrombus via aspiration with a 60 cc syringe. The FlowTriever System also includes FlowTriever catheters with three self-expanding nitinol mesh disks of different sizes designed to aid in extraction, if needed, by engaging and disrupting thrombus. Anticoagulation with heparin is recommended per routine catheterization laboratory practice to prevent thrombosis of the catheter. The aspiration catheter is advanced over a 0.035-inch wire to the level of the right or left PA, just proximal to the occlusive thrombus. Once engaged, the clot is extracted via aspiration through the catheter. The procedure can be repeated several times per side at the discretion of the physician, depending on the amount of clot retrieved and the improvement in distal flow on repeat angiography.
The FlowTriever® system. The Triever aspiration catheter is shown in purple, and the optional FlowTriever® catheter with nitinol disks is shown emerging from the distal end of the Triever catheter.
The FlowTriever System has been evaluated in several clinical studies both prospectively and retrospectively. The first of these was a prospective multi-center study, the FLARE (FlowTriever Pulmonary Embolectomy Clinical Study) trial, which was the largest systematic evaluation of the effectiveness of mechanical thrombectomy for PE at the time [10]. From April 2016 to October 2017, 106 patients were treated with the FlowTriever System at 18 U.S. sites. Two patients (1.9%) received adjunctive thrombolytics. The mean procedural time was 94 min, and the mean intensive care unit stay was 1.5 days. Forty-three patients (41.3%) did not require any intensive care unit stay. At 48 h post-procedure, average RV/LV ratio reduction was 0.38 (25.1%; p < 0.0001). Four patients (3.8%) experienced 6 major adverse events, with 1 patient (1.0%) experiencing major bleeding. One patient (1.0%) died from undiagnosed breast cancer through 30-day follow-up. The trial concluded that percutaneous mechanical thrombectomy with the FlowTriever System appears safe and effective in patients with acute intermediate-risk PE, achieved significant improvement in RV/LV ratio, and resulted in minimal major bleeding.
Large-bore aspiration mechanical thrombectomy with the FlowTriever System was also evaluated in two retrospective single-arm clinical studies. The first of these [11] was a single-center study of 46 patients with both massive (high-risk) and submassive (intermediate-risk) PE. The authors reported a significant reduction in mean PA pressure from 33.9 ± 8.9 mmHg to 27.0 ± 9.0 mmHg (
More recently, the FlowTriever System was studied in a nonrandomized two-arm retrospective analysis versus routine care [13]. This single-center study compared outcomes for 28 patients who underwent mechanical thrombectomy with the FlowTriever System to those for 30 patients who received routine care, which consisted of anticoagulation alone, anticoagulation with CDT, or systemic thrombolysis. In-hospital mortality was significantly lower for patients undergoing mechanical thrombectomy versus routine care (3.6% vs. 23.3%,
Pre procedure planning\t\t
Patient Information
Prior to any pulmonary embolism procedure several patient conditions must be made clear. Several questions that all operators should ask include, what are the current hemodynamics and does that patient require vasopressor support? What is the current respiratory status (Ie O2 supplementation or on mechanical ventilation)? What is the bleeding risk and can the patient be anticoagulated? During our procedure we maintain and actual clotting time (ACT) of >250 secs.
Pre case Imaging
CT is the most rapid and common imaging tool used. Specific items to look for include, location and size of clot, RV/LV Ratio, and pulmonary infarct.
Echocardiography will not only show LV and RV size but RV systolic function.
Additional things to consider:
History or current DVT
IVC Filter in Place
Clot in Transit (is TEE or TTE available urgently)
Recent Surgery/Extended immobile time (travel)
Cancer History
History of PE
Infarct consideration (reperfusion injury/elevated wire perforation risk)
Anesthesia:
Conscious sedation is recommended. General Anesthesia has a risk of worsening hypotension and reducing preload to the RV. If systemic pressure is tenuous, a rapid reduction in RV filling can result in immediate hemodynamic collapse.
Patient Selection
Avoidance of thrombolytics
There are several advantages to the decision making for who would benefit from thrombolytic therapy for pulmonary embolism. The immediate decision is to determine who is at highest risk and thus has the largest to gain. Any patient with right ventricular (RV) dysfunction, we feel should be considered for thrombolytic therapy. Patients with an elevated RV: LV ratio; greater than 0.9, elevated pro-bnp, elevated troponins, and hemodynamics suggestive of reduced cardiac output, should be considered for thrombolytic therapy.
Patients need to be able to lay either supine or prone for a minimum of 30 minutes, thus taking oxygen requirements and body habitus into consideration.
Any patient with a relative contraindication to thrombolytic therapy, or felt to be at elevated risk, immediately should be considered for thrombotic intervention.
Access
US guidance
Access to venous circulation, when using large bore sheaths should always be performed with ultrasound guidance. It is advantageous in the venous system to evaluate for upper or lower extremity deep venous thrombosis, prior to starting the procedure, as well as avoidance of an arterial puncture.
Femoral
The most common access site for pulmonary thrombectomy is the common femoral vein
Jugular
When an alternative access is required another option is the internal jugular vein.
Pulmonary angiogram
Difficulties
Image quality tends to be the dis-advantage. Morbid obesity, patient movement, as well as variations in imaging acquisition (ie dye load, manual vs. power injection), can result in wide range of image quality.
Aspiration thrombectomy catheters
Inari Medical
Twenty-four french aspiration guide catheter that navigates through the right heart and delivers the catheter directly into the pulmonary artery. Aspiration is performed by a manual pull. The large bore catheter maximizes aspiration and collection of thrombus. The 24 F catheter creates an aspiration flow rate of 143 mLs/second.
Sixteen french curve
Due to the natural curvature of the pulmonary artery to the right, the 24 F catheter takes a turn to the right pulmonary artery typically with little difficulty. The catheter when placed in the left pulmonary artery, typically does not engage the left lower lobe. The 16 french curve catheter is placed within the 24F catheter and is preshaped to point down into the left pulmonary artery for selective thrombus aspiration.
Bloodloss technology
The FlowSaver blood return system is designed to be used with the FlowTriever aspiration catheter to reduced blood loss by filtering aspirated thrombi and blood for reinfusion back to the patient, thus enabling bloodless thrombectomy for pulmonary embolism procedure. The filtration system includes a 40-micro filter. Filtered blood can be reintroduced using a 60-cc collection syringe.
Penumbra, Inc.
The Indigo aspiration system is indicated for use in the peripheral arterial system and the pulmonary arteries, receiving U.S. Food and Drug Administration 510(k) clearance for PE in December 2019.
The Indigo system lightning 12 aspiration catheter that navigates through the right heart and into the selected pulmonary artery. The 12F system, unlike the manual aspiration of the Inari device, is connected to the Penumbra aspiration pump, resulting in a continuous vacuum system at −28.5 mmHg. If thrombus is not aspirated, the system also has a separator wire that can be advanced through the catheter to disrupt thrombus at the distal tip.
Intraprocedural complications
Perforation
The most common cause of pulmonary artery perforation is due to a wire complication. Wire perforation causes include treating distal clot, poor wire positioning and overlapping vessel (specifically on the left side)
Avoidance and Management
Limit use of guide wires, and always use Amplatz wire to work over
Use multiple shots to confirm location of wire and catheter
Use multiple angles of monitor to confirm locations
If Perforation does occur, increase supplemental oxygen, stop and reverse anticoagulation and consider placing a occlusion balloon proximal to the perforation.
Right heart trauma
If the tricuspid valve crossed safely with angled pigtail catheter or balloon tip catheter, typically not as concerned. If a end hold catheter was used, through a chordae tendinea of the tricuspid valve.
Always advance with caution as advancing through heart monitoring pain, excessive tension advancing catheter, and any arrhythmias happening
Never advance large bore catheters without dilators
Use buddy wires to assist stability in accessing multiple vessels to avoid kick back
Shock/RV failure
There are several methods of determining right ventricular systolic function. A calculated PAPi in the cardiac cath lab can determine who would benefit from RV mechanical support (ie Abiomed Impella RP). If the PAPi is calculated to be less than 1, and you have achieved enough thrombolytic therapy to allow for distal perfusion, mechanical support should be considered. Extracorporeal membrane oxygenation (ECMO) can also be considered for both hemodynamic support and oxygenation.
Closure
Most venous access sites can be closed with manual pressure alone. However, with large bore access we have using the Abbott Medical proglide perclose suture mediated closure. This device has been shown to reduce time to hemostasis, ambulation and discharge compared to manual compression
Post Procedure management
ICU avoidance
The use of thrombolysis for the treatment of PE at some institutions requires ICU level care.
Mechanical thrombectomy is a means of direct therapy which can result in immediate clinical response and will commonly not require intensive care management.
Additionally with the avoidance of tissue plasminogen activator (tPA), ICU admission post procedure is commonly unnecessary.
Venous dopplers
The most common source of PE is DVT. Thus, all patients require bilateral venous duplex for confirmation of residual disease.
Based on these results, it is a clinical decision whether therapy is required for DVT.
Hypercoagulable work up
Patients who benefit from this work up include:
those with/without a family history of VTE
patients age < 45 years
recurrent thrombosis or thrombosis in unusual sites
arterial thrombosis
history of warfarin-induced dermatologic necrosis
These patients will benefit from testing: activated protein C resistance, factor V Leiden, Prothrombin gene mutation, Protein C and S deficiency, Antithrombin deficiency.
DOAC
DOACS such as Factor Xa inhibitors, Apixaban or Rivaroxaban, have become more favorable than Warfarin for anticoagulation due to lower bleeding risk, monitoring for therapeutic INR levels and easier dosing. Apixaban is dosed twice daily while Rivaroxaban is daily dosing. A lower dose is required based on age ≥80, weight ≤60kg and creatinine ≥1.5
Follow up Echo
A follow up echo is used to determine RV dimensions, RV dysfunction and residual pulmonary hypertension.
It is our practice that if there is residual elevation of pulmonary systolic pressure, we refer the patient to a pulmonary hypertension specialist.
Case 1
A 33-year-old woman with no significant past medical history presented to our emergency department after multiple syncopal episodes. An ambulance service was called by family and the patient arrived hypotensive and poorly responsive. She required 6 L of supplemental oxygen and vasopressor support to keep a mean arterial pressure greater than 60 mmHg and oxygen saturation greater than 92%. A bedside anterior-posterior chest X-ray showed a normal cardiac silhouette and clear lung fields. A 12-lead electrocardiogram was consistent with a sinus tachycardia and right bundle branch block. Initial laboratory data was positive for an elevated d-dimer (> 5000 ng/mL), positive troponin (0.4 ng/mL), and pro-brain natriuretic peptide (> 10,000 pg/mL). A stat CT angiogram of the chest demonstrated a massive PE with complete occlusion of the left lower lobe and a RV/LV ratio of 1.5.
The patient was moved emergently to the cardiac catheterization laboratory for immediate therapeutic aspiration thrombectomy. Access was obtained in the right femoral vein using ultrasound guidance. Initial systolic PA pressure was 60 mmHg and the mean PA pressure was 35 mmHg. A pulmonary angiogram confirmed complete occlusion of the left lower lobe (Figure 2). The 24-F Triever aspiration catheter (Triever24) was positioned in the left pulmonary artery. A 20-F Triever Curve catheter, capable of curving up to 260° to aid in navigating in difficult anatomies, (Figure 3) was used coaxially with the Triever24 catheter to angle to the lower lobe where two aspirations were performed. A large amount of thrombus was removed (Figure 4) and repeat pulmonary angiography showed almost complete pulmonary artery opacification and large reduction in thrombus burden (Figure 5). Within minutes there was hemodynamic improvement and oxygen requirements returned to room air alone. Post-thrombectomy pulmonary artery systolic pressure was 33 mmHg. The patient was transferred to the general medical ward and started on oral Factor Xa inhibitor and discharged home the following day.
Case 2
A 75-year-old man with a past medical history of metastatic prostate cancer with known spinal involvement, presented to our emergency room with acute onset of shortness of breath and chest tightness. Initial oxygen saturation was 82% requiring high flow oxygen with a non-rebreather mask. Initial blood pressure was 110/80 mmHg and heart rate of 110 bpm. The pretest probability of PE was high thus the first diagnostic test was a CT pulmonary angiogram, which confirmed a saddle pulmonary embolism and large thrombus burden in the left and right lobes. The RV/LV ratio was 1.4.
Pulmonary angiography was consistent with CT findings (Figure 6). With a known history of spinal metastasis, thrombolytic therapy was contraindicated. The femoral vein access site was dilated to accommodate a 24-F sheath, the Flowtriever System was positioned into the mainstem pulmonary artery and a single aspiration was performed. The catheter was then positioned into the left pulmonary artery performing a single aspiration, followed by the right pulmonary artery, again requiring a single aspiration. Repeat angiography confirmed thrombus resolution and large clot removal (Figure 7). The patient was transferred to the general medical floor on room air. An echocardiogram performed the next day demonstrated normal right ventricular size and function with normal pulmonary pressures. The patient was discharged home the following day.
Case 3
A 44-year-old woman with a recent history of COVID-19 pneumonia presented from home with acute worsening of dyspnea and new pleuritic chest pain. Prior to this admission she required no supplemental oxygen, however, now was on 10 L of oxygen to maintain a saturation > 96%. A CT angiogram of the chest was consistent with a massive right middle lobe pulmonary embolism. The patient was taken to the cardiac catheterization laboratory for emergent intervention. Due to rapid decline in respiratory status and acute hypoxic respiratory failure, the patient was placed on mechanical ventilation. In order to provide rapid therapy, aspiration thrombectomy was performed in the right pulmonary artery. Initial pulmonary angiogram clearly demonstrated large thrombus burden of the right pulmonary artery (Figure 8, left). After a single aspiration was performed, repeat angiogram confirmed almost complete resolution (Figure 8, right), and large thrombus debulking (Figure 9). At the conclusion of the procedure, the patient required <40% fraction of inspired oxygen (Fio2) and positive end-expiratory pressure (PEEP) of 5, maintaining an oxygen saturation > 99%. That evening while in the intensive care unit she was successfully extubated and required 2 L of oxygen by nasal cannula. Seventy-two hours after her initial presentation, she was discharged home on room air.
Pre-treatment pulmonary angiogram showing complete occlusion of the left lower lobe in a patient with massive pulmonary embolism.
Intra-procedure pulmonary angiogram showing the Triever20 curve catheter coaxial within the larger Triever24 catheter in the left lower lobe of the lung in a PE patient.
A large amount of thrombus extracted with the FlowTriever® system from a PE patient.
Post-thrombectomy pulmonary angiogram showing almost complete pulmonary artery opacification and large reduction in thrombus burden.
Pre-thrombectomy pulmonary angiography of the right and left lungs demonstrating a saddle pulmonary embolism with large thrombus burden.
Thrombus extracted using the FlowTriever
Pre- (left) and post-thrombectomy (right) pulmonary angiograms demonstrating large thrombus burden prior to thrombectomy with the FlowTriever
Large amount of thrombus extracted with the FlowTriever
"Open access contributes to scientific excellence and integrity. It opens up research results to wider analysis. It allows research results to be reused for new discoveries. And it enables the multi-disciplinary research that is needed to solve global 21st century problems. Open access connects science with society. It allows the public to engage with research. To go behind the headlines. And look at the scientific evidence. And it enables policy makers to draw on innovative solutions to societal challenges".
\n\nCarlos Moedas, the European Commissioner for Research Science and Innovation at the STM Annual Frankfurt Conference, October 2016.
",metaTitle:"About Open Access",metaDescription:"Open access contributes to scientific excellence and integrity. It opens up research results to wider analysis. It allows research results to be reused for new discoveries. And it enables the multi-disciplinary research that is needed to solve global 21st century problems. Open access connects science with society. It allows the public to engage with research. To go behind the headlines. And look at the scientific evidence. And it enables policy makers to draw on innovative solutions to societal challenges.\n\nCarlos Moedas, the European Commissioner for Research Science and Innovation at the STM Annual Frankfurt Conference, October 2016.",metaKeywords:null,canonicalURL:"about-open-access",contentRaw:'[{"type":"htmlEditorComponent","content":"The Open Access publishing movement started in the early 2000s when academic leaders from around the world participated in the formation of the Budapest Initiative. They developed recommendations for an Open Access publishing process, “which has worked for the past decade to provide the public with unrestricted, free access to scholarly research—much of which is publicly funded. Making the research publicly available to everyone—free of charge and without most copyright and licensing restrictions—will accelerate scientific research efforts and allow authors to reach a larger number of readers” (reference: http://www.budapestopenaccessinitiative.org)
\\n\\nIntechOpen’s co-founders, both scientists themselves, created the company while undertaking research in robotics at Vienna University. Their goal was to spread research freely “for scientists, by scientists’ to the rest of the world via the Open Access publishing model. The company soon became a signatory of the Budapest Initiative, which currently has more than 1000 supporting organizations worldwide, ranging from universities to funders.
\\n\\nAt IntechOpen today, we are still as committed to working with organizations and people who care about scientific discovery, to putting the academic needs of the scientific community first, and to providing an Open Access environment where scientists can maximize their contribution to scientific advancement. By opening up access to the world’s scientific research articles and book chapters, we aim to facilitate greater opportunity for collaboration, scientific discovery and progress. We subscribe wholeheartedly to the Open Access definition:
\\n\\n“By “open access” to [peer-reviewed research literature], we mean its free availability on the public internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from gaining access to the internet itself. The only constraint on reproduction and distribution, and the only role for copyright in this domain, should be to give authors control over the integrity of their work and the right to be properly acknowledged and cited” (reference: http://www.budapestopenaccessinitiative.org)
\\n\\nOAI-PMH
\\n\\nAs a firm believer in the wider dissemination of knowledge, IntechOpen supports the Open Access Initiative Protocol for Metadata Harvesting (OAI-PMH Version 2.0). Read more
\\n\\nLicense
\\n\\nBook chapters published in edited volumes are distributed under the Creative Commons Attribution 3.0 Unported License (CC BY 3.0). IntechOpen upholds a very flexible Copyright Policy. There is no copyright transfer to the publisher and Authors retain exclusive copyright to their work. All Monographs/Compacts are distributed under the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Read more
\\n\\nPeer Review Policies
\\n\\nAll scientific works are Peer Reviewed prior to publishing. Read more
\\n\\nOA Publishing Fees
\\n\\nThe Open Access publishing model employed by IntechOpen eliminates subscription charges and pay-per-view fees, enabling readers to access research at no cost. In order to sustain operations and keep our publications freely accessible we levy an Open Access Publishing Fee for manuscripts, which helps us cover the costs of editorial work and the production of books. Read more
\\n\\nDigital Archiving Policy
\\n\\nIntechOpen is committed to ensuring the long-term preservation and the availability of all scholarly research we publish. We employ a variety of means to enable us to deliver on our commitments to the scientific community. Apart from preservation by the Croatian National Library (for publications prior to April 18, 2018) and the British Library (for publications after April 18, 2018), our entire catalogue is preserved in the CLOCKSS archive.
\\n\\nOpen Science is transparent and accessible knowledge that is shared and developed through collaborative networks.
\\n\\nOpen Science is about increased rigour, accountability, and reproducibility for research. It is based on the principles of inclusion, fairness, equity, and sharing, and ultimately seeks to change the way research is done, who is involved and how it is valued. It aims to make research more open to participation, review/refutation, improvement and (re)use for the world to benefit.
\\n\\nOpen Science refers to doing traditional science with more transparency involved at various stages, for example by openly sharing code and data. It implies a growing set of practices - within different disciplines - aiming at:
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The Open Access publishing movement started in the early 2000s when academic leaders from around the world participated in the formation of the Budapest Initiative. They developed recommendations for an Open Access publishing process, “which has worked for the past decade to provide the public with unrestricted, free access to scholarly research—much of which is publicly funded. Making the research publicly available to everyone—free of charge and without most copyright and licensing restrictions—will accelerate scientific research efforts and allow authors to reach a larger number of readers” (reference: http://www.budapestopenaccessinitiative.org)
\n\nIntechOpen’s co-founders, both scientists themselves, created the company while undertaking research in robotics at Vienna University. Their goal was to spread research freely “for scientists, by scientists’ to the rest of the world via the Open Access publishing model. The company soon became a signatory of the Budapest Initiative, which currently has more than 1000 supporting organizations worldwide, ranging from universities to funders.
\n\nAt IntechOpen today, we are still as committed to working with organizations and people who care about scientific discovery, to putting the academic needs of the scientific community first, and to providing an Open Access environment where scientists can maximize their contribution to scientific advancement. By opening up access to the world’s scientific research articles and book chapters, we aim to facilitate greater opportunity for collaboration, scientific discovery and progress. We subscribe wholeheartedly to the Open Access definition:
\n\n“By “open access” to [peer-reviewed research literature], we mean its free availability on the public internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from gaining access to the internet itself. The only constraint on reproduction and distribution, and the only role for copyright in this domain, should be to give authors control over the integrity of their work and the right to be properly acknowledged and cited” (reference: http://www.budapestopenaccessinitiative.org)
\n\nOAI-PMH
\n\nAs a firm believer in the wider dissemination of knowledge, IntechOpen supports the Open Access Initiative Protocol for Metadata Harvesting (OAI-PMH Version 2.0). Read more
\n\nLicense
\n\nBook chapters published in edited volumes are distributed under the Creative Commons Attribution 3.0 Unported License (CC BY 3.0). IntechOpen upholds a very flexible Copyright Policy. There is no copyright transfer to the publisher and Authors retain exclusive copyright to their work. All Monographs/Compacts are distributed under the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Read more
\n\nPeer Review Policies
\n\nAll scientific works are Peer Reviewed prior to publishing. Read more
\n\nOA Publishing Fees
\n\nThe Open Access publishing model employed by IntechOpen eliminates subscription charges and pay-per-view fees, enabling readers to access research at no cost. In order to sustain operations and keep our publications freely accessible we levy an Open Access Publishing Fee for manuscripts, which helps us cover the costs of editorial work and the production of books. Read more
\n\nDigital Archiving Policy
\n\nIntechOpen is committed to ensuring the long-term preservation and the availability of all scholarly research we publish. We employ a variety of means to enable us to deliver on our commitments to the scientific community. Apart from preservation by the Croatian National Library (for publications prior to April 18, 2018) and the British Library (for publications after April 18, 2018), our entire catalogue is preserved in the CLOCKSS archive.
\n\nOpen Science is transparent and accessible knowledge that is shared and developed through collaborative networks.
\n\nOpen Science is about increased rigour, accountability, and reproducibility for research. It is based on the principles of inclusion, fairness, equity, and sharing, and ultimately seeks to change the way research is done, who is involved and how it is valued. It aims to make research more open to participation, review/refutation, improvement and (re)use for the world to benefit.
\n\nOpen Science refers to doing traditional science with more transparency involved at various stages, for example by openly sharing code and data. It implies a growing set of practices - within different disciplines - aiming at:
\n\nWe aim at improving the quality and availability of scholarly communication by promoting and practicing:
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His studies in robotics lead him not only to a PhD degree but also inspired him to co-found and build the International Journal of Advanced Robotic Systems - world's first Open Access journal in the field of robotics.",institutionString:null,institution:{name:"TU Wien",country:{name:"Austria"}}},{id:"441",title:"Ph.D.",name:"Jaekyu",middleName:null,surname:"Park",slug:"jaekyu-park",fullName:"Jaekyu Park",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/441/images/1881_n.jpg",biography:null,institutionString:null,institution:{name:"LG Corporation (South Korea)",country:{name:"Korea, South"}}},{id:"465",title:"Dr.",name:"Christian",middleName:null,surname:"Martens",slug:"christian-martens",fullName:"Christian Martens",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Rheinmetall (Germany)",country:{name:"Germany"}}},{id:"479",title:"Dr.",name:"Valentina",middleName:null,surname:"Colla",slug:"valentina-colla",fullName:"Valentina Colla",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/479/images/358_n.jpg",biography:null,institutionString:null,institution:{name:"Sant'Anna School of Advanced Studies",country:{name:"Italy"}}},{id:"494",title:"PhD",name:"Loris",middleName:null,surname:"Nanni",slug:"loris-nanni",fullName:"Loris Nanni",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/494/images/system/494.jpg",biography:"Loris Nanni received his Master Degree cum laude on June-2002 from the University of Bologna, and the April 26th 2006 he received his Ph.D. in Computer Engineering at DEIS, University of Bologna. 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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Delac received his B.Sc.E.E. degree in 2003 and is currentlypursuing a Ph.D. degree at the University of Zagreb, Faculty of Electrical Engineering andComputing. His current research interests are digital image analysis, pattern recognition andbiometrics.",institutionString:null,institution:{name:"University of Zagreb",country:{name:"Croatia"}}},{id:"557",title:"Dr.",name:"Andon",middleName:"Venelinov",surname:"Topalov",slug:"andon-topalov",fullName:"Andon Topalov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/557/images/1927_n.jpg",biography:"Dr. Andon V. Topalov received the MSc degree in Control Engineering from the Faculty of Information Systems, Technologies, and Automation at Moscow State University of Civil Engineering (MGGU) in 1979. He then received his PhD degree in Control Engineering from the Department of Automation and Remote Control at Moscow State Mining University (MGSU), Moscow, in 1984. From 1985 to 1986, he was a Research Fellow in the Research Institute for Electronic Equipment, ZZU AD, Plovdiv, Bulgaria. In 1986, he joined the Department of Control Systems, Technical University of Sofia at the Plovdiv campus, where he is presently a Full Professor. He has held long-term visiting Professor/Scholar positions at various institutions in South Korea, Turkey, Mexico, Greece, Belgium, UK, and Germany. And he has coauthored one book and authored or coauthored more than 80 research papers in conference proceedings and journals. 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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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High cacao loss to diseases is a prime factor limiting production; consequently, significant effort is required to deal with problems associated with disease control to ensure a sustainable cacao. The effective and sustainable management of black pod disease requires integrated approach encompassing different control measures.",book:{id:"7005",slug:"theobroma-cacao-deploying-science-for-sustainability-of-global-cocoa-economy",title:"Theobroma Cacao",fullTitle:"Theobroma Cacao - Deploying Science for Sustainability of Global Cocoa Economy"},signatures:"Dele Adeniyi",authors:null},{id:"67634",title:"Cacao Growth and Development Under Different Nursery and Field Conditions",slug:"cacao-growth-and-development-under-different-nursery-and-field-conditions",totalDownloads:1299,totalCrossrefCites:2,totalDimensionsCites:2,abstract:"Experiments were conducted between 2004 and 2018 to examine cacao growth, development, establishment and yield under varying experimental conditions comprised of seed mucilage handling before sowing, sowing methods and its effects on seedling growth and development, timing of mycorrhizal inoculation on root and shoot growth and development and effects of shade and dry season drip irrigation on growth and yield of field-grown cacao. Results show that cleaning cacao seed mucilage before sowing enhanced sprouting rate and percent germination. The use of manure mixed with sawdust and loamy soil aided excellent seed germination, seedling vigor and root development. Inoculating cacao seeds with arbuscular mycorrhizal fungi (AMF) at point of sowing and early stages in the nursery aided root development and enhanced field establishment and survival during the dry season. Dense shade retarded cacao growth and development during the rainy season, while no shade enhances optimum growth and canopy development. The use of drip irrigation strategies in young cacao plantations increased seedling survival from less than 45% under no irrigation to above 95% at the end of the second dry season. This showed that irrigation during dry season can significantly enhance cacao establishment and survival.",book:{id:"7005",slug:"theobroma-cacao-deploying-science-for-sustainability-of-global-cocoa-economy",title:"Theobroma Cacao",fullTitle:"Theobroma Cacao - Deploying Science for Sustainability of Global Cocoa Economy"},signatures:"Idowu Babadele Famuwagun and Samuel Ohi Agele",authors:null},{id:"68383",title:"Major Natural Vegetation in Coastal and Marine Wetlands: Edible Seaweeds",slug:"major-natural-vegetation-in-coastal-and-marine-wetlands-edible-seaweeds",totalDownloads:771,totalCrossrefCites:0,totalDimensionsCites:1,abstract:"For thousands of years, seaweeds grown in coastal and marine have been used as food, materials and medicines by the people. Edible seaweeds directly consumed, especially in Asian, are used for preparing food due to the their components containing minerals, essential trace elements, and various natural compounds. At the last decades, they have been getting more and more attention in food and pharmaceutical industries because of their biological activities such as anti-cancer, anti-obesity, anti-diabetes, anti-microbial, and anti-oxidant activity. Therefore, in the present study, we have worked on to understand the structure of edible seaweeds. It is worthy to mention that they can be considered as source of some proteins, polyunsaturated fatty acids, minerals, vitamins, dietary fibers, antioxidants, and phytochemicals.",book:{id:"8667",slug:"plant-communities-and-their-environment",title:"Plant Communities and Their Environment",fullTitle:"Plant Communities and Their Environment"},signatures:"Ilknur Babahan, Birsen Kirim and Hamideh Mehr",authors:null},{id:"67540",title:"Aphid-Plant Interactions: Implications for Pest Management",slug:"aphid-plant-interactions-implications-for-pest-management",totalDownloads:1093,totalCrossrefCites:2,totalDimensionsCites:4,abstract:"Aphids are important herbivores and important pest of many field and forest crops. They have specialized long and flexible stylets which are adapted to feeding on phloem sap. To establish successful feeding on host plant, they need to counter a range of both physical and chemical defenses. The defenses employed by plants can have direct effect on the aphid species through difficulty in establishing successful feeding due to the presence of trichomes, thick cell wall, etc. or effect on their biology with lethal consequences in extreme cases (direct defenses). In contrast to this, plants can attract natural enemies of aphids through the release of volatile compounds (the so-called “cry or call for help”) (indirect defense). The information on different defense strategies employed by plants can be utilized to enhance the level of resistance (R) to develop sustainable pest management strategies.",book:{id:"8667",slug:"plant-communities-and-their-environment",title:"Plant Communities and Their Environment",fullTitle:"Plant Communities and Their Environment"},signatures:"Sarwan Kumar",authors:null},{id:"72336",title:"Plant Phenology and An Assessment of the Effects Regarding Heavy Metals, Nanoparticles, and Nanotubes on Plant Development: Runner Bean, Artichoke, and Chickpea Seedlings",slug:"plant-phenology-and-an-assessment-of-the-effects-regarding-heavy-metals-nanoparticles-and-nanotubes-",totalDownloads:665,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"The relationship between environmental pollution and nutrition in particular, which forms the basis of health, is fundamentally important for protecting human health. Therefore, the data obtained from the examination of how plants and animals consumed as food are affected by environmental pollution can be seen as an indicator of their effects on humans. On the other hand, the role of technology and nanotechnology in life has been increasing in this century, and a considerable amount of heavy metals, nanoparticles (NPs), and nanotubes (NTs) are released to the environment. The results of morphological or anatomical examination of runner bean (Phaseolus coccineus L) and artichoke (Cynara scolymus L.) plants subjected to copper (Cu) and lead (Pb) heavy metals and chickpea (Cicer arietinum L) plants subjected to Au nanoparticles and C70 single-walled carbon nanotubes (SWNTs) are presented with this study in the point of their phenological development process. The three taxa belonging to Fabaceae and Asteraceae families with high economic status and having flowers with characteristic features were chosen deliberately as representatives. 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He is a full professor of signal processing and pattern recognition and is head of the Signals and Communications Department at ULPGC, teaching from 2001 on subjects on signal processing and learning theory. His research lines are biometrics, biomedical signals and images, data mining, classification system, signal and image processing, machine learning, and environmental intelligence. He has researched in 52 international and Spanish research projects, some of them as head researcher. He is co-author of 4 books, co-editor of 27 proceedings books, guest editor for 8 JCR-ISI international journals, and up to 24 book chapters. He has over 450 papers published in international journals and conferences (81 of them indexed on JCR – ISI - Web of Science). He has published seven patents in the Spanish Patent and Trademark Office. He has been a supervisor on 8 Ph.D. theses (11 more are under supervision), and 130 master theses. 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His research interests include computer/machine vision, machine learning, pattern recognition, computational intelligence. \nDr. Papakostas served as a reviewer in numerous journals, as a program\ncommittee member in international conferences and he is a member of the IAENG, MIR Labs, EUCogIII, INSTICC and the Technical Chamber of Greece (TEE).",institutionString:null,institution:{name:"International Hellenic University",institutionURL:null,country:{name:"Greece"}}},editorTwo:null,editorThree:null},{id:"25",title:"Evolutionary Computation",coverUrl:"https://cdn.intechopen.com/series_topics/covers/25.jpg",isOpenForSubmission:!0,editor:{id:"136112",title:"Dr.",name:"Sebastian",middleName:null,surname:"Ventura Soto",slug:"sebastian-ventura-soto",fullName:"Sebastian Ventura Soto",profilePictureURL:"https://mts.intechopen.com/storage/users/136112/images/system/136112.png",biography:"Sebastian Ventura is a Spanish researcher, a full professor with the Department of Computer Science and Numerical Analysis, University of Córdoba. 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His research focuses on biochemistry, biophysics, genetics, molecular biology, and molecular medicine with specialization in the fields of drug design, protein structure-function, protein folding, prions, microRNA, pseudogenes, molecular cancer, epigenetics, metabolites, proteomics, genomics, protein expression, and characterization by spectroscopic and calorimetric methods.",institutionString:"University of Health Sciences",institution:null},{id:"180528",title:"Dr.",name:"Hiroyuki",middleName:null,surname:"Kagechika",slug:"hiroyuki-kagechika",fullName:"Hiroyuki Kagechika",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180528/images/system/180528.jpg",biography:"Hiroyuki Kagechika received his bachelor’s degree and Ph.D. in Pharmaceutical Sciences from the University of Tokyo, Japan, where he served as an associate professor until 2004. He is currently a professor at the Institute of Biomaterials and Bioengineering (IBB), Tokyo Medical and Dental University (TMDU). From 2010 to 2012, he was the dean of the Graduate School of Biomedical Science. Since 2012, he has served as the vice dean of the Graduate School of Medical and Dental Sciences. He has been the director of the IBB since 2020. Dr. Kagechika’s major research interests are the medicinal chemistry of retinoids, vitamins D/K, and nuclear receptors. He has developed various compounds including a drug for acute promyelocytic leukemia.",institutionString:"Tokyo Medical and Dental University",institution:{name:"Tokyo Medical and Dental University",country:{name:"Japan"}}},{id:"94311",title:"Prof.",name:"Martins",middleName:"Ochubiojo",surname:"Ochubiojo Emeje",slug:"martins-ochubiojo-emeje",fullName:"Martins Ochubiojo Emeje",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94311/images/system/94311.jpeg",biography:"Martins Emeje obtained a BPharm with distinction from Ahmadu Bello University, Nigeria, and an MPharm and Ph.D. from the University of Nigeria (UNN), where he received the best Ph.D. award and was enlisted as UNN’s “Face of Research.” He established the first nanomedicine center in Nigeria and was the pioneer head of the intellectual property and technology transfer as well as the technology innovation and support center. Prof. Emeje’s several international fellowships include the prestigious Raman fellowship. He has published more than 150 articles and patents. He is also the head of R&D at NIPRD and holds a visiting professor position at Nnamdi Azikiwe University, Nigeria. He has a postgraduate certificate in Project Management from Walden University, Minnesota, as well as a professional teaching certificate and a World Bank certification in Public Procurement. 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He received his post-doctoral training in oncology and cancer proteomics for two years at the Cancer Research Institute of Human Medical University in China. In 2001, he went to the University of Tennessee Health Science Center (UTHSC) in USA, where he was a post-doctoral researcher and focused on mass spectrometry and cancer proteomics. Then, he was appointed as an Assistant Professor of Neurology, UTHSC in 2005. He moved to the Cleveland Clinic in USA as a Project Scientist/Staff in 2006 where he focused on the studies of eye disease proteomics and biomarkers. He returned to UTHSC as an Assistant Professor of Neurology in the end of 2007, engaging in proteomics and biomarker studies of lung diseases and brain tumors, and initiating the studies of predictive, preventive, and personalized medicine (PPPM) in cancer. In 2010, he was promoted to Associate Professor of Neurology, UTHSC. Currently, he is a Professor at Xiangya Hospital of Central South University in China, Fellow of Royal Society of Medicine (FRSM), the European EPMA National Representative in China, Regular Member of American Association for the Advancement of Science (AAAS), European Cooperation of Science and Technology (e-COST) grant evaluator, Associate Editors of BMC Genomics, BMC Medical Genomics, EPMA Journal, and Frontiers in Endocrinology, Executive Editor-in-Chief of Med One. He has\npublished 116 peer-reviewed research articles, 16 book chapters, 2 books, and 2 US patents. 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He has published several articles in peer-reviewed journals, chapters, and edited books. His area of specialization is free radical biochemistry and autoimmune diseases.",institutionString:"Imam Abdulrahman Bin Faisal University",institution:{name:"Imam Abdulrahman Bin Faisal University",country:{name:"Saudi Arabia"}}},{id:"41865",title:"Prof.",name:"Farid A.",middleName:null,surname:"Badria",slug:"farid-a.-badria",fullName:"Farid A. Badria",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/41865/images/system/41865.jpg",biography:"Farid A. Badria, Ph.D., is the recipient of several awards, including The World Academy of Sciences (TWAS) Prize for Public Understanding of Science; the World Intellectual Property Organization (WIPO) Gold Medal for best invention; Outstanding Arab Scholar, Kuwait; and the Khwarizmi International Award, Iran. He has 250 publications, 12 books, 20 patents, and several marketed pharmaceutical products to his credit. He continues to lead research projects on developing new therapies for liver, skin disorders, and cancer. Dr. Badria was listed among the world’s top 2% of scientists in medicinal and biomolecular chemistry in 2019 and 2020. He is a member of the Arab Development Fund, Kuwait; International Cell Research Organization–United Nations Educational, Scientific and Cultural Organization (ICRO–UNESCO), Chile; and UNESCO Biotechnology France",institutionString:"Mansoura University",institution:{name:"Mansoura University",country:{name:"Egypt"}}},{id:"329385",title:"Dr.",name:"Rajesh K.",middleName:"Kumar",surname:"Singh",slug:"rajesh-k.-singh",fullName:"Rajesh K. Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329385/images/system/329385.png",biography:"Dr. Singh received a BPharm (2003) and MPharm (2005) from Panjab University, Chandigarh, India, and a Ph.D. (2013) from Punjab Technical University (PTU), Jalandhar, India. He has more than sixteen years of teaching experience and has supervised numerous postgraduate and Ph.D. students. He has to his credit more than seventy papers in SCI- and SCOPUS-indexed journals, fifty-five conference proceedings, four books, six Best Paper Awards, and five projects from different government agencies. He is currently an editorial board member of eight international journals and a reviewer for more than fifty scientific journals. He received Top Reviewer and Excellent Peer Reviewer Awards from Publons in 2016 and 2017, respectively. He is also on the panel of The International Reviewer for reviewing research proposals for grants from the Royal Society. He also serves as a Publons Academy mentor and Bentham brand ambassador.",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",country:{name:"India"}}},{id:"142388",title:"Dr.",name:"Thiago",middleName:"Gomes",surname:"Gomes Heck",slug:"thiago-gomes-heck",fullName:"Thiago Gomes Heck",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/142388/images/7259_n.jpg",biography:null,institutionString:null,institution:{name:"Universidade Regional do Noroeste do Estado do Rio Grande do Sul",country:{name:"Brazil"}}},{id:"336273",title:"Assistant Prof.",name:"Janja",middleName:null,surname:"Zupan",slug:"janja-zupan",fullName:"Janja Zupan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/336273/images/14853_n.jpeg",biography:"Janja Zupan graduated in 2005 at the Department of Clinical Biochemistry (superviser prof. dr. Janja Marc) in the field of genetics of osteoporosis. Since November 2009 she is working as a Teaching Assistant at the Faculty of Pharmacy, Department of Clinical Biochemistry. In 2011 she completed part of her research and PhD work at Institute of Genetics and Molecular Medicine, University of Edinburgh. She finished her PhD entitled The influence of the proinflammatory cytokines on the RANK/RANKL/OPG in bone tissue of osteoporotic and osteoarthritic patients in 2012. From 2014-2016 she worked at the Institute of Biomedical Sciences, University of Aberdeen as a postdoctoral research fellow on UK Arthritis research project where she gained knowledge in mesenchymal stem cells and regenerative medicine. She returned back to University of Ljubljana, Faculty of Pharmacy in 2016. She is currently leading project entitled Mesenchymal stem cells-the keepers of tissue endogenous regenerative capacity facing up to aging of the musculoskeletal system funded by Slovenian Research Agency.",institutionString:null,institution:{name:"University of Ljubljana",country:{name:"Slovenia"}}},{id:"357453",title:"Dr.",name:"Radheshyam",middleName:null,surname:"Maurya",slug:"radheshyam-maurya",fullName:"Radheshyam Maurya",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/357453/images/16535_n.jpg",biography:null,institutionString:null,institution:{name:"University of Hyderabad",country:{name:"India"}}},{id:"418340",title:"Dr.",name:"Jyotirmoi",middleName:null,surname:"Aich",slug:"jyotirmoi-aich",fullName:"Jyotirmoi Aich",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000038Ugi5QAC/Profile_Picture_2022-04-15T07:48:28.png",biography:"Biotechnologist with 15 years of research including 6 years of teaching experience. Demonstrated record of scientific achievements through consistent publication record (H index = 13, with 874 citations) in high impact journals such as Nature Communications, Oncotarget, Annals of Oncology, PNAS, and AJRCCM, etc. Strong research professional with a post-doctorate from ACTREC where I gained experimental oncology experience in clinical settings and a doctorate from IGIB where I gained expertise in asthma pathophysiology. A well-trained biotechnologist with diverse experience on the bench across different research themes ranging from asthma to cancer and other infectious diseases. An individual with a strong commitment and innovative mindset. Have the ability to work on diverse projects such as regenerative and molecular medicine with an overall mindset of improving healthcare.",institutionString:"DY Patil Deemed to Be University",institution:null},{id:"349288",title:"Prof.",name:"Soumya",middleName:null,surname:"Basu",slug:"soumya-basu",fullName:"Soumya Basu",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035QxIDQA0/Profile_Picture_2022-04-15T07:47:01.jpg",biography:"Soumya Basu, Ph.D., is currently working as an Associate Professor at Dr. D. Y. Patil Biotechnology and Bioinformatics Institute, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India. With 16+ years of trans-disciplinary research experience in Drug Design, development, and pre-clinical validation; 20+ research article publications in journals of repute, 9+ years of teaching experience, trained with cross-disciplinary education, Dr. Basu is a life-long learner and always thrives for new challenges.\r\nHer research area is the design and synthesis of small molecule partial agonists of PPAR-γ in lung cancer. She is also using artificial intelligence and deep learning methods to understand the exosomal miRNA’s role in cancer metastasis. Dr. Basu is the recipient of many awards including the Early Career Research Award from the Department of Science and Technology, Govt. of India. She is a reviewer of many journals like Molecular Biology Reports, Frontiers in Oncology, RSC Advances, PLOS ONE, Journal of Biomolecular Structure & Dynamics, Journal of Molecular Graphics and Modelling, etc. She has edited and authored/co-authored 21 journal papers, 3 book chapters, and 15 abstracts. She is a Board of Studies member at her university. She is a life member of 'The Cytometry Society”-in India and 'All India Cell Biology Society”- in India.",institutionString:"Dr. D.Y. Patil Vidyapeeth, Pune",institution:{name:"Dr. D.Y. Patil Vidyapeeth, Pune",country:{name:"India"}}},{id:"354817",title:"Dr.",name:"Anubhab",middleName:null,surname:"Mukherjee",slug:"anubhab-mukherjee",fullName:"Anubhab Mukherjee",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y0000365PbRQAU/ProfilePicture%202022-04-15%2005%3A11%3A18.480",biography:"A former member of Laboratory of Nanomedicine, Brigham and Women’s Hospital, Harvard University, Boston, USA, Dr. Anubhab Mukherjee is an ardent votary of science who strives to make an impact in the lives of those afflicted with cancer and other chronic/acute ailments. He completed his Ph.D. from CSIR-Indian Institute of Chemical Technology, Hyderabad, India, having been skilled with RNAi, liposomal drug delivery, preclinical cell and animal studies. He pursued post-doctoral research at College of Pharmacy, Health Science Center, Texas A & M University and was involved in another postdoctoral research at Department of Translational Neurosciences and Neurotherapeutics, John Wayne Cancer Institute, Santa Monica, California. In 2015, he worked in Harvard-MIT Health Sciences & Technology as a visiting scientist. He has substantial experience in nanotechnology-based formulation development and successfully served various Indian organizations to develop pharmaceuticals and nutraceutical products. He is an inventor in many US patents and an author in many peer-reviewed articles, book chapters and books published in various media of international repute. Dr. Mukherjee is currently serving as Principal Scientist, R&D at Esperer Onco Nutrition (EON) Pvt. Ltd. and heads the Hyderabad R&D center of the organization.",institutionString:"Esperer Onco Nutrition Pvt Ltd.",institution:null},{id:"319365",title:"Assistant Prof.",name:"Manash K.",middleName:null,surname:"Paul",slug:"manash-k.-paul",fullName:"Manash K. Paul",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/319365/images/system/319365.png",biography:"Manash K. Paul is a Principal Investigator and Scientist at the University of California Los Angeles. He has contributed significantly to the fields of stem cell biology, regenerative medicine, and lung cancer. His research focuses on various signaling processes involved in maintaining stem cell homeostasis during the injury-repair process, deciphering lung stem cell niche, pulmonary disease modeling, immuno-oncology, and drug discovery. He is currently investigating the role of extracellular vesicles in premalignant lung cell migration and detecting the metastatic phenotype of lung cancer via machine-learning-based analyses of exosomal signatures. Dr. Paul has published in more than fifty peer-reviewed international journals and is highly cited. He is the recipient of many awards, including the UCLA Vice Chancellor’s award, a senior member of the Institute of Electrical and Electronics Engineers (IEEE), and an editorial board member for several international journals.",institutionString:"University of California Los Angeles",institution:{name:"University of California Los Angeles",country:{name:"United States of America"}}},{id:"311457",title:"Dr.",name:"Júlia",middleName:null,surname:"Scherer Santos",slug:"julia-scherer-santos",fullName:"Júlia Scherer Santos",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/311457/images/system/311457.jpg",biography:"Dr. Júlia Scherer Santos works in the areas of cosmetology, nanotechnology, pharmaceutical technology, beauty, and aesthetics. Dr. Santos also has experience as a professor of graduate courses. Graduated in Pharmacy, specialization in Cosmetology and Cosmeceuticals applied to aesthetics, specialization in Aesthetic and Cosmetic Health, and a doctorate in Pharmaceutical Nanotechnology. Teaching experience in Pharmacy and Aesthetics and Cosmetics courses. She works mainly on the following subjects: nanotechnology, cosmetology, pharmaceutical technology, aesthetics.",institutionString:"Universidade Federal de Juiz de Fora",institution:{name:"Universidade Federal de Juiz de Fora",country:{name:"Brazil"}}},{id:"219081",title:"Dr.",name:"Abdulsamed",middleName:null,surname:"Kükürt",slug:"abdulsamed-kukurt",fullName:"Abdulsamed Kükürt",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/219081/images/system/219081.png",biography:"Dr. Kükürt graduated from Uludağ University in Turkey. He started his academic career as a Research Assistant in the Department of Biochemistry at Kafkas University. In 2019, he completed his Ph.D. program in the Department of Biochemistry at the Institute of Health Sciences. He is currently working at the Department of Biochemistry, Kafkas University. He has 27 published research articles in academic journals, 11 book chapters, and 37 papers. He took part in 10 academic projects. He served as a reviewer for many articles. He still serves as a member of the review board in many academic journals. He is currently working on the protective activity of phenolic compounds in disorders associated with oxidative stress and inflammation.",institutionString:null,institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"178366",title:"Dr.",name:"Volkan",middleName:null,surname:"Gelen",slug:"volkan-gelen",fullName:"Volkan Gelen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178366/images/system/178366.jpg",biography:"Volkan Gelen is a Physiology specialist who received his veterinary degree from Kafkas University in 2011. Between 2011-2015, he worked as an assistant at Atatürk University, Faculty of Veterinary Medicine, Department of Physiology. In 2016, he joined Kafkas University, Faculty of Veterinary Medicine, Department of Physiology as an assistant professor. Dr. Gelen has been engaged in various academic activities at Kafkas University since 2016. There he completed 5 projects and has 3 ongoing projects. He has 60 articles published in scientific journals and 20 poster presentations in scientific congresses. His research interests include physiology, endocrine system, cancer, diabetes, cardiovascular system diseases, and isolated organ bath system studies.",institutionString:"Kafkas University",institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"418963",title:"Dr.",name:"Augustine Ododo",middleName:"Augustine",surname:"Osagie",slug:"augustine-ododo-osagie",fullName:"Augustine Ododo Osagie",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/418963/images/16900_n.jpg",biography:"Born into the family of Osagie, a prince of the Benin Kingdom. I am currently an academic in the Department of Medical Biochemistry, University of Benin. Part of the duties are to teach undergraduate students and conduct academic research.",institutionString:null,institution:{name:"University of Benin",country:{name:"Nigeria"}}},{id:"192992",title:"Prof.",name:"Shagufta",middleName:null,surname:"Perveen",slug:"shagufta-perveen",fullName:"Shagufta Perveen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192992/images/system/192992.png",biography:"Prof. Shagufta Perveen is a Distinguish Professor in the Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. Dr. Perveen has acted as the principal investigator of major research projects funded by the research unit of King Saud University. She has more than ninety original research papers in peer-reviewed journals of international repute to her credit. She is a fellow member of the Royal Society of Chemistry UK and the American Chemical Society of the United States.",institutionString:"King Saud University",institution:{name:"King Saud University",country:{name:"Saudi Arabia"}}},{id:"49848",title:"Dr.",name:"Wen-Long",middleName:null,surname:"Hu",slug:"wen-long-hu",fullName:"Wen-Long Hu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49848/images/system/49848.jpg",biography:"Wen-Long Hu is Chief of the Division of Acupuncture, Department of Chinese Medicine at Kaohsiung Chang Gung Memorial Hospital, as well as an adjunct associate professor at Fooyin University and Kaohsiung Medical University. Wen-Long is President of Taiwan Traditional Chinese Medicine Medical Association. He has 28 years of experience in clinical practice in laser acupuncture therapy and 34 years in acupuncture. He is an invited speaker for lectures and workshops in laser acupuncture at many symposiums held by medical associations. He owns the patent for herbal preparation and producing, and for the supercritical fluid-treated needle. Dr. Hu has published three books, 12 book chapters, and more than 30 papers in reputed journals, besides serving as an editorial board member of repute.",institutionString:"Kaohsiung Chang Gung Memorial Hospital",institution:{name:"Kaohsiung Chang Gung Memorial Hospital",country:{name:"Taiwan"}}},{id:"298472",title:"Prof.",name:"Andrey V.",middleName:null,surname:"Grechko",slug:"andrey-v.-grechko",fullName:"Andrey V. Grechko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/298472/images/system/298472.png",biography:"Andrey Vyacheslavovich Grechko, Ph.D., Professor, is a Corresponding Member of the Russian Academy of Sciences. He graduated from the Semashko Moscow Medical Institute (Semashko National Research Institute of Public Health) with a degree in Medicine (1998), the Clinical Department of Dermatovenerology (2000), and received a second higher education in Psychology (2009). Professor A.V. Grechko held the position of Сhief Physician of the Central Clinical Hospital in Moscow. He worked as a professor at the faculty and was engaged in scientific research at the Medical University. Starting in 2013, he has been the initiator of the creation of the Federal Scientific and Clinical Center for Intensive Care and Rehabilitology, Moscow, Russian Federation, where he also serves as Director since 2015. He has many years of experience in research and teaching in various fields of medicine, is an author/co-author of more than 200 scientific publications, 13 patents, 15 medical books/chapters, including Chapter in Book «Metabolomics», IntechOpen, 2020 «Metabolomic Discovery of Microbiota Dysfunction as the Cause of Pathology».",institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"199461",title:"Prof.",name:"Natalia V.",middleName:null,surname:"Beloborodova",slug:"natalia-v.-beloborodova",fullName:"Natalia V. Beloborodova",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/199461/images/system/199461.jpg",biography:'Natalia Vladimirovna Beloborodova was educated at the Pirogov Russian National Research Medical University, with a degree in pediatrics in 1980, a Ph.D. in 1987, and a specialization in Clinical Microbiology from First Moscow State Medical University in 2004. She has been a Professor since 1996. Currently, she is the Head of the Laboratory of Metabolism, a division of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russian Federation. N.V. Beloborodova has many years of clinical experience in the field of intensive care and surgery. She studies infectious complications and sepsis. She initiated a series of interdisciplinary clinical and experimental studies based on the concept of integrating human metabolism and its microbiota. Her scientific achievements are widely known: she is the recipient of the Marie E. Coates Award \\"Best lecturer-scientist\\" Gustafsson Fund, Karolinska Institutes, Stockholm, Sweden, and the International Sepsis Forum Award, Pasteur Institute, Paris, France (2014), etc. Professor N.V. Beloborodova wrote 210 papers, five books, 10 chapters and has edited four books.',institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"354260",title:"Ph.D.",name:"Tércio Elyan",middleName:"Azevedo",surname:"Azevedo Martins",slug:"tercio-elyan-azevedo-martins",fullName:"Tércio Elyan Azevedo Martins",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/354260/images/16241_n.jpg",biography:"Graduated in Pharmacy from the Federal University of Ceará with the modality in Industrial Pharmacy, Specialist in Production and Control of Medicines from the University of São Paulo (USP), Master in Pharmaceuticals and Medicines from the University of São Paulo (USP) and Doctor of Science in the program of Pharmaceuticals and Medicines by the University of São Paulo. Professor at Universidade Paulista (UNIP) in the areas of chemistry, cosmetology and trichology. Assistant Coordinator of the Higher Course in Aesthetic and Cosmetic Technology at Universidade Paulista Campus Chácara Santo Antônio. Experience in the Pharmacy area, with emphasis on Pharmacotechnics, Pharmaceutical Technology, Research and Development of Cosmetics, acting mainly on topics such as cosmetology, antioxidant activity, aesthetics, photoprotection, cyclodextrin and thermal analysis.",institutionString:null,institution:{name:"University of Sao Paulo",country:{name:"Brazil"}}},{id:"334285",title:"Ph.D. Student",name:"Sameer",middleName:"Kumar",surname:"Jagirdar",slug:"sameer-jagirdar",fullName:"Sameer Jagirdar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334285/images/14691_n.jpg",biography:"I\\'m a graduate student at the center for biosystems science and engineering at the Indian Institute of Science, Bangalore, India. I am interested in studying host-pathogen interactions at the biomaterial interface.",institutionString:null,institution:{name:"Indian Institute of Science Bangalore",country:{name:"India"}}},{id:"329248",title:"Dr.",name:"Md. Faheem",middleName:null,surname:"Haider",slug:"md.-faheem-haider",fullName:"Md. Faheem Haider",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329248/images/system/329248.jpg",biography:"Dr. Md. Faheem Haider completed his BPharm in 2012 at Integral University, Lucknow, India. In 2014, he completed his MPharm with specialization in Pharmaceutics at Babasaheb Bhimrao Ambedkar University, Lucknow, India. He received his Ph.D. degree from Jamia Hamdard University, New Delhi, India, in 2018. He was selected for the GPAT six times and his best All India Rank was 34. Currently, he is an assistant professor at Integral University. Previously he was an assistant professor at IIMT University, Meerut, India. He has experience teaching DPharm, Pharm.D, BPharm, and MPharm students. He has more than five publications in reputed journals to his credit. Dr. Faheem’s research area is the development and characterization of nanoformulation for the delivery of drugs to various organs.",institutionString:"Integral University",institution:{name:"Integral University",country:{name:"India"}}},{id:"329795",title:"Dr.",name:"Mohd Aftab",middleName:"Aftab",surname:"Siddiqui",slug:"mohd-aftab-siddiqui",fullName:"Mohd Aftab Siddiqui",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329795/images/system/329795.png",biography:"Dr. Mohd Aftab Siddiqui is an assistant professor in the Faculty of Pharmacy, Integral University, Lucknow, India, where he obtained a Ph.D. in Pharmacology in 2020. He also obtained a BPharm and MPharm from the same university in 2013 and 2015, respectively. His area of research is the pharmacological screening of herbal drugs/natural products in liver cancer and cardiac diseases. He is a member of many professional bodies and has guided many MPharm and PharmD research projects. Dr. Siddiqui has many national and international publications and one German patent to his credit.",institutionString:"Integral University",institution:null}]}},subseries:{item:{id:"22",type:"subseries",title:"Applied Intelligence",keywords:"Machine Learning, Intelligence Algorithms, Data Science, Artificial Intelligence, Applications on Applied Intelligence",scope:"This field is the key in the current industrial revolution (Industry 4.0), where the new models and developments are based on the knowledge generation on applied intelligence. The motor of the society is the industry and the research of this topic has to be empowered in order to increase and improve the quality of our lives.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/22.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11418,editor:{id:"27170",title:"Prof.",name:"Carlos",middleName:"M.",surname:"Travieso-Gonzalez",slug:"carlos-travieso-gonzalez",fullName:"Carlos Travieso-Gonzalez",profilePictureURL:"https://mts.intechopen.com/storage/users/27170/images/system/27170.jpeg",biography:"Carlos M. Travieso-González received his MSc degree in Telecommunication Engineering at Polytechnic University of Catalonia (UPC), Spain in 1997, and his Ph.D. degree in 2002 at the University of Las Palmas de Gran Canaria (ULPGC-Spain). He is a full professor of signal processing and pattern recognition and is head of the Signals and Communications Department at ULPGC, teaching from 2001 on subjects on signal processing and learning theory. His research lines are biometrics, biomedical signals and images, data mining, classification system, signal and image processing, machine learning, and environmental intelligence. He has researched in 52 international and Spanish research projects, some of them as head researcher. He is co-author of 4 books, co-editor of 27 proceedings books, guest editor for 8 JCR-ISI international journals, and up to 24 book chapters. He has over 450 papers published in international journals and conferences (81 of them indexed on JCR – ISI - Web of Science). He has published seven patents in the Spanish Patent and Trademark Office. He has been a supervisor on 8 Ph.D. theses (11 more are under supervision), and 130 master theses. He is the founder of The IEEE IWOBI conference series and the president of its Steering Committee, as well as the founder of both the InnoEducaTIC and APPIS conference series. He is an evaluator of project proposals for the European Union (H2020), Medical Research Council (MRC, UK), Spanish Government (ANECA, Spain), Research National Agency (ANR, France), DAAD (Germany), Argentinian Government, and the Colombian Institutions. He has been a reviewer in different indexed international journals (<70) and conferences (<250) since 2001. He has been a member of the IASTED Technical Committee on Image Processing from 2007 and a member of the IASTED Technical Committee on Artificial Intelligence and Expert Systems from 2011. \n\nHe has held the general chair position for the following: ACM-APPIS (2020, 2021), IEEE-IWOBI (2019, 2020 and 2020), A PPIS (2018, 2019), IEEE-IWOBI (2014, 2015, 2017, 2018), InnoEducaTIC (2014, 2017), IEEE-INES (2013), NoLISP (2011), JRBP (2012), and IEEE-ICCST (2005)\n\nHe is an associate editor of the Computational Intelligence and Neuroscience Journal (Hindawi – Q2 JCR-ISI). 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Possible contributions can address (but are not limited to) the following research topics: Bioinspired design and control of exoskeletons, orthoses, and prostheses; Experimental evaluation of the effect of assistive devices (e.g., influence on gait, balance, and neuromuscular system); Bioinspired technologies for rehabilitation, including clinical studies reporting evaluations; Application of neuromuscular and biomechanical models to the development of bioinspired technology.',annualVolume:11404,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",institutionString:null,institution:{name:"Federal University of Uberlândia",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"49517",title:"Prof.",name:"Hitoshi",middleName:null,surname:"Tsunashima",fullName:"Hitoshi Tsunashima",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTP4QAO/Profile_Picture_1625819726528",institutionString:null,institution:{name:"Nihon University",institutionURL:null,country:{name:"Japan"}}},{id:"425354",title:"Dr.",name:"Marcus",middleName:"Fraga",surname:"Vieira",fullName:"Marcus Vieira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003BJSgIQAX/Profile_Picture_1627904687309",institutionString:null,institution:{name:"Universidade Federal de Goiás",institutionURL:null,country:{name:"Brazil"}}},{id:"196746",title:"Dr.",name:"Ramana",middleName:null,surname:"Vinjamuri",fullName:"Ramana Vinjamuri",profilePictureURL:"https://mts.intechopen.com/storage/users/196746/images/system/196746.jpeg",institutionString:"University of Maryland, Baltimore County",institution:{name:"University of Maryland, Baltimore County",institutionURL:null,country:{name:"United States of America"}}}]},{id:"9",title:"Biotechnology - Biosensors, Biomaterials and Tissue Engineering",keywords:"Biotechnology, Biosensors, Biomaterials, Tissue Engineering",scope:"The Biotechnology - Biosensors, Biomaterials and Tissue Engineering topic within the Biomedical Engineering Series aims to rapidly publish contributions on all aspects of biotechnology, biosensors, biomaterial and tissue engineering. We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics can include but are not limited to: Biotechnology such as biotechnological products and process engineering; Biotechnologically relevant enzymes and proteins; Bioenergy and biofuels; Applied genetics and molecular biotechnology; Genomics, transcriptomics, proteomics; Applied microbial and cell physiology; Environmental biotechnology; Methods and protocols. Moreover, topics in biosensor technology, like sensors that incorporate enzymes, antibodies, nucleic acids, whole cells, tissues and organelles, and other biological or biologically inspired components will be considered, and topics exploring transducers, including those based on electrochemical and optical piezoelectric, thermal, magnetic, and micromechanical elements. Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. 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Valarmathi",profilePictureURL:"https://mts.intechopen.com/storage/users/69697/images/system/69697.jpg",institutionString:"Religen Inc. | A Life Science Company, United States of America",institution:null},{id:"205081",title:"Dr.",name:"Marco",middleName:"Vinícius",surname:"Chaud",fullName:"Marco Chaud",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSDGeQAO/Profile_Picture_1622624307737",institutionString:null,institution:{name:"Universidade de Sorocaba",institutionURL:null,country:{name:"Brazil"}}}]}]}},libraryRecommendation:{success:null,errors:{},institutions:[]},route:{name:"chapter.detail",path:"/chapters/29178",hash:"",query:{},params:{id:"29178"},fullPath:"/chapters/29178",meta:{},from:{name:null,path:"/",hash:"",query:{},params:{},fullPath:"/",meta:{}}}},function(){var e;(e=document.currentScript||document.scripts[document.scripts.length-1]).parentNode.removeChild(e)}()