",isbn:"978-1-80356-966-6",printIsbn:"978-1-80356-965-9",pdfIsbn:"978-1-80356-967-3",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,isSalesforceBook:!1,isNomenclature:!1,hash:"f86a9f720cc3ac0f1c385d0367ea89b9",bookSignature:"Dr. Fiaz Ahmad and Prof. Muhammad Sultan",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11624.jpg",keywords:"Agricultural Waste, Reuse, Reduction, Soil Health, Recycling, Agriculture and Environment, Modelling and Simulation, Agro-Industrial Waste, Bioresource Processing, Processing and Management, Crop Residue, Forest Waste",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"April 8th 2022",dateEndSecondStepPublish:"June 16th 2022",dateEndThirdStepPublish:"August 15th 2022",dateEndFourthStepPublish:"November 3rd 2022",dateEndFifthStepPublish:"January 2nd 2023",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"18 days",secondStepPassed:!0,areRegistrationsClosed:!1,currentStepOfPublishingProcess:3,editedByType:null,kuFlag:!1,biosketch:"Dr. Fiaz Ahmad is a researcher in the field of Agricultural Engineering with fifteen years of field and academic experience, currently in charge of the Agricultural Machinery Design Laboratory at Bahauddin Zakariya University. 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1. Introduction
Although a well-known technique, having been around from 1873 when Prof. Billroth of Vienna recorded the first procedure, total laryngectomy was constantly refined seeking to improve surgical outcome. Today, narrow-field and wide-field total laryngectomy are combined with partial pharyngectomy and neck dissection to obtain good results following surgery – regarding disease-free survival of patients as well as a good quality-of-life (especially when it comes to speech and swallowing) [1, 2, 3].
After the larynx is removed, in the anterior part of the hypopharynx, there is always a resulting defect. This lack of substance is caused by the shared anatomy of the larynx and pharynx. Because most laryngeal neoplasia that warrants a total laryngectomy is usually a locally advanced disease, and the glottis and supraglottic regions are the most frequent regions involved in the disease process, there is often an extension of the neoplasia to the adjacent hypopharynx. This requires an extended resection of the diseased pharynx – a total laryngectomy with a partial pharyngectomy.
After completing the resection, reconstruction of the area uses the principle of separation of the respiratory and digestive tracts. Thus, a permanent tracheostomy is performed by anchoring the subglottic tracheal end to the skin in the suprasternal notch and the remaining pharynx is sutured around a naso-gastric feeding tube and usually covered with the prelaryngeal muscle layers (when available). This is called a three-layer closure – with the pharynx being the first layer, the prelaryngeal strap muscles the second layer and the cervical skin the third [4]. Depending on the size and shape of the resulting pharyngeal defect, primary closure by suturing of the pharyngeal margins may be done in a horizontal pattern or by a T shape pattern (Figure 1). The horizontal closure, when feasible, offers the best healing chance and has the lowest risk of development of a pharyngeal fistula. The T shape closure has more stitching, and the tips of the 2 vertical pharyngeal tranches which form the upper part of the T have the least vascularization, which make them more susceptible to necrosis and therefore a salivary leak, which may progress towards fistula formation.
Figure 1.
Pharyngeal closure following total laryngectomy – Left (a): before suturing; Right (b): T-shaped pharyngoraphy on a naso-gastric feeding tube. Legend: F – pharynx, Tr. – trachea, Thy. – thyroid lobes, Oe – Oesophagus.
There are multiple types of suturing techniques used to close the pharynx. Choosing a closure type often depends on the size of the defect to be closed, as well as the surgeon’s personal preference. The only recommendation, which every student in Otorhinolaryngology learns from compulsory surgery textbooks is that an inverting suture should be used, similar to sutures used in digestive surgery [4]. The most frequent type of suture used is the Connell suture, which is a continuous (running) inverting suture. The needle is passed parallel to the incision line, through all the layers of the pharynx, and out on the same side, after which it runs perpendicular to the incision line to the opposite side, where it passes in similar fashion. Some authors use variations of this suture, but there is not a consensus yet on a superior technique of suturing [5].
In cases of locally advanced tumours, where surgical excision extends to the pharynx, the resulting pharyngeal defect often makes primary closure impossible (Figure 2). Such cases warrant a second, reconstructive step to obtain surgical healing, such as using a local miocutaneous pedicled flap (pectoralis major or latissimus dorsi).
Figure 2.
Resulting defect following total laryngectomy “en bloc” with right thyroid lobe, large segment of pharynx as well as right side prelaryngeal muscle and skin. The resulting defect made primary reconstruction impossible – a local pedicled miocutaneous flap was used.
After wound healing – deglution is possible by oral intake, and respiration will always remain through the tracheostomy. Advances in speech rehabilitation made tracheoesophageal fistulisation with vocal prosthesis placement the gold-standard for vocal rehabilitation after total laryngectomy, assuring the possibility for adequate communication even without the larynx.
2. Surgical healing mechanism
As with most tissue injuries, after sectioning the pharyngeal wall through all three layers and then reapproximating them to close the resulting pharyngostoma, the healing mechanism is activated by way of inflammation, angiogenesis, migration and proliferation of fibroblasts, scar formation and subsequent connective tissue remodelling [6]. Following the surgeon’s cut, the surface of the resected pharynx forms blood clots. These contain trapped red blood cells, as well as fibrin, fibronectin and complement components. Clots not only act a bleeding preventing mechanism, but also as a matrix for cells that are attracted by cytokines, chemokines and growth factors released in the area. Release of VEGF (vascular endothelial growth factor) permits increased blood vessel permeability – with subsequent inflammation and oedema. Within 24 hours from the injury, neutrophils migrate to the area and enter the local injury site by way of the blood clot matrix, to contribute to healing by releasing proteolytic enzymes. These enzymes clear debris and destroy bacteria. Between 24 and 72 hours after injury, granulation tissue is formed, by proliferating fibroblasts and vascular endothelial cells. This type of tissue has special properties, because of the high vascular permeability of new endothelial cells. This granulation tissue progressively fills all the injury space, and by 5 to 7 days the entire wound area is filled by this new tissue and neovascularization is maximal [7, 8]. Chemokines and different growth factors that are released by macrophages and neutrophils attract fibroblasts, which usually colonize the wound area in the first two days after injury. Macrophages stimulate the fibroblasts to produce IL-6 as well as epithelial growth factors, which in turn leads to epithelial cell proliferation and subsequent epithelization of the wound. During the second week after injury, the oedema, vascularity and lymphocytic infiltrate subside, and the granulation tissue scaffolding is replaced by dense collagen fibres, spindle-cell fibroblasts and other extracellular matrix components [6]. These collagen fibres are responsible for the tensile strength of the repaired wound. Shear resistance is only about 10% of normal tissue at 7 days following injury. It increases at a fast pace during the following 4 weeks, only to plateau around 70-80% of the normal tissue strength. It is of great importance to note that a repaired wound never acquires the same resistance as normal tissue [6].
3. Fistula formation – predisposing factors
One of the most important aspects in pharyngocutaneous fistulas is the lack of understanding on how the different risk factors affect and potentially cause this complications. Several factors are widely accepted as risk factors in developing a pharyngocutaneous fistula like concomitant or preexisting radiotherapy or chemotherapy, the extension and localization of the tumor – which invariably affects how large the resulting pharyngeal excision will be, the surgical technique (if a deficient surgical closure is performed – either by incorrect approximation of the tissues or improper suturing) used or septic complications of the wound (rarely encountered currently due to antibiotic therapy preoperatively as well as postoperatively) (Figure 3). Other lesser-known risk factors include preexisting comorbidities like diabetes, low hemoglobin and albumin levels, liver conditions and malnutrition as well as GERD (gastro-esophageal reflux disease).
Figure 3.
Large midline pharyngocutaneous and pharyngotracheal fistula following total laryngectomy and radiation therapy. A nasogastric feeding tube is visibile through the fistula orifice, just above the tracheostomy (Tr.)
What is highly specific about the pharyngeal segment following total laryngectomy is that it is permanently, since day 1 of surgery, in contact with saliva as well as the microbiota of the oral cavity. The chemical composition of saliva is known for its antibacterial and mucosal protection properties, however the mucin content as well as proteases in its composition are often inefficient to prevent even dental plaque formation. Modern studies aimed to use saliva as a diagnostic tool showed however that the proteases are very active and protein cleaving is a dynamic and fast-paced process, with protein degradation being a challenge for developing reliable diagnostic tests [9]. This may factor in the decision to use a salivary bypass tube after total laryngectomy (a Montgomery tube). Some authors reported favorable results using this method [10] – but the small sample size of the study groups, as well as a lack of uniform inclusion criteria and patient distribution resulted in results that were not statistically significant [11, 12].
GERD is another factor which is demonstrated to elevate the risk of fistula formation. Studies have shown that after total laryngectomy, because of upper oesophageal sphincter impairment, patients have elevated acidity and pepsin levels at this level [13, 14]. This affects pharyngeal wound healing – with a higher incidence of fistula formation. Studies showed that postoperative antisecretory and antiacid medication lower the risk for fistula formation after total laryngectomy [15, 16].
The extent of pharyngeal resection – and consequent pharyngeal tissue remaining for pharyngeal closure is one of the factors influencing the rate of postoperative fistula formation. This is probably due to tension around the suture lines, as well as postoperative tension generated by swallowing when resuming oral feeding [17]. Another factor, this time linked to the quality of remaining pharyngeal tissues, is radiation therapy. Salvage surgery, a term coined to describe surgery following other therapies of curative intent that failed (in cases of larynx cancer usually radiation therapy and conservative surgery), has a much higher rate of postoperative complications, including pharyngocutaneous fistulas [18]. In this aspect, radiation therapy is considered the main risk factor for complications because of the changes it produces in the irradiated tissues, and as important is the interval between radiation therapy and salvage surgery. Surgery in the first year after radiation therapy presents a significant higher risk for fistula formation, risk that decreases yearly after the first one [19]. Also demonstrated to present a higher risk of pharyngocutaneous fistula formation is concomitant bilateral neck dissection [20].
Systemic factors that influence wound healing, with regard to pharyngocutaneous fistula formation following total laryngectomy are linked to malnutrition and protein deficit (Figure 4). Studies showed that laryngeal cancer in itself negatively influences the nutritional status of patients, oftentimes patients presenting with malnutrition on diagnosis of laryngeal or pharyngo-laryngeal neoplasia [21]. Regarding pharyngocutaneous fistula formation after total laryngectomy, available data demonstrates that malnutrition (Figure 6) and protein deficiency (measured by albumin and prealbumin levels), is an independent risk factor. Current medical thought process encourages correcting malnutrition in the perioperative period to lower the risk of fistula formation [22].
Figure 4.
Malnourished patient suffering from neoplasia of the larynx and hypopharynx. Left (a): Tracheostomy and gastrostomy – before surgical treatment. Right (b): Postoperative lateral cervical fistula – intraoperative aspect showing the diameter of the fistula, as well as the metaplasia of the epithelium of the fistula tract.
4. Management of pharyngocutaneous fistulas
If present, managing pharyngo-cutaneous fistulas is important because their persistence can lead to increased hospital visits, a longer hospital stay and increased time for the surgical wound to heal and can prolong the time from surgery to oncological treatment. It can also have severe complication like aspiration pneumonia or carotid blowout. Although self limiting in most cases, it poses some important complications and sequelae like vessel ruptures or aspirative pneumonia if it is not resolved [23].
4.1 Conservative treatment
Conservative treatment is usually considered the first option for pharyngocutaneous fistulas. The first step in assuring a chance for spontaneous healing of the fistula is to bypass the fistula by ceasing oral feeding. This is done by either placing a naso-gastric feeding tube (which is usually kept for a limited time) or by parenteral feeding. Conservative measures consist of medical therapy with antibiotics and anti-inflammatory drugs. Daily wound care is also an important aspect with the need for fluid drainage from the fistula, local cleaning and the removal of necrotic tissues if they are present. In the same time the comorbidities of the patient must be addressed for example diabetes and hemodynamic parameters of the patient must be optimized [3] especially hemoglobin and albumin levels [4]. Applying pressure dressing above the fistula has also been seen traditionally as an important routine for daily management of the pharyngocutaneous fistula. However, traditional simple dressings are not suited for fistulas due to high output of saliva and exudate. They act more as a stopgap, so that the saliva and exudate does not come out, rather it stagnates along the fistula canal. The current concept is to move away from the simple wound dressing and use modern dressings like hydrocolloid, hydrogel or silver coated dressings [24, 25]. Sterilizing the fistula from within has also been used by different authors with substances like 0,25% acetic acid by mouth [26]. Another important aspect is the nutritional status of the patient prior and after surgery. Usually head and neck cancer patient are malnourished long time before surgery is even considered and this nutritional status is seen as a risk factor for developing complications like fistulas. Immunonutrition is a process that can modulate the immune system with certain nutrients like arginine, glutamine, omega 3 fatty acids and nucleotides, that can lead to an improvement of protein synthesis. Although not universally accepted, there is evidence that preoperative immunonutrition may lower the risk of developing fistulas [27]. Literature reviews demonstrated decreased hospital stay by an average of at least 3.5 days, but the mechanism by which this was achieved is still unclear [28]. Casas-Rodero et al. demonstrated that immunonutrition by itself did not improve fistula rate, but in the group where nutritional support was administered concomitant with immunoenhanced products the best results were obtained [29].
4.2 Negative pressure wound therapy
Negative pressure wound therapy represents a dressing process in which subatmospheric pressure is applied to the wound in a continuous or intermittent way. By decreasing local tissue swelling, improving blood flow and removing excess fluid it can trigger intracellular signals that may increase the rate of cell division and promotes the formation of granulation tissue transforming the wound into a closed controlled environment with a better management of secretions [30]. In recent years this method of wound dressing has been increasingly used by head and neck surgeons to manage pharyngocutaneous fistulas with good results. It can be used even on large size fistulas and can reduce the size and even heal the fistula. It comes with some contraindications like the presence of necrotic tissues and important wound infection that cannot be controlled. Another important aspect is the cost of this system and the accessibility of it for the patient that develop fistulas [31].
Despite being a complicated site with the presence of the tracheostomy tube which can make it difficult to maintain everything airtight negative wound pressure therapy has proven to be an effective alternative treatment for pharyngocutaneous fistula as a first line or in cases where fistulas persist after surgical revisions [32].
4.3 Hyperbaric oxygen therapy
Hyperbaric oxygen therapy involves breathing 100% oxygen in a pressurized environment with increased atmospheric pressure. Initially used for treating decompression sickness and carbon monoxide poisoning it has proven to be also effective in treating gangrene and wounds. This therapy promotes angiogenesis and cellular synthesis. The literature available on the use of hyperbaric oxygen therapy consists mostly of studies on chronic wounds such as diabetic ulcers and venous ulcers. A Cochrane database literature review demonstrated that a large part of studies had bias issues, but most had similar results, positive short-term impact on wound healing, with statistically non-significant long-term improvement [33] Published data regarding its use in treating pharyncocutaneous fistulas is scarce. Some results look promising ranging from 87,5% -100% fistula closure [34]. The drawbacks of this therapy despite the promising results are the high cost and the availability of such pressurized rooms.
4.4 Surgical management
All pharyngo-cutaneous fistulas should be promptly treated, but the urgency as well as aggressiveness of the therapeutic response should be adapted to the size of the fistula, the potential for complications (e.g.: carotid blowout by salivary erosion), the underlying conditions of the patient, and the impact the fistula has on the patient’s quality of life. For example: a small, midline fistula orifice, with little to no exudate that appeared during or immediately after radiation therapy in an otherwise healthy individual poses no immediate risk for complications and is easily tolerated by the patient with little to no impact on his quality of life, and has a large chance for spontaneous healing, which makes it ideal for conservative treatment. Unfortunately, in head and neck cancer surgery most cases of fistulas developing after laryngectomy are not so straightforward to treat and require surgical interventions. A universal set of recommendations does not exist, but basic surgical principles should be tailored and applied to each case depending on each patient’s characteristics and the surgeon’s preference and experience. These principles state that for small diameter orifices, closure by margin resection and two plane suturing is usually sufficient (Figure 5).
Figure 5.
(Up - a) Midline submandibular fistula following total laryngectomy. (Right - b) Closure of the fistula after resections of margins and 3 plane suturing – pharyngeal mucosa, platysma muscle, skin.
Larger defects require interposition of a muscle layer – usually from a local source by way of a pedicled flap. One of the closest available flaps is the sternocleidomastoid muscle, however oftentimes the skin or even the muscle has modifications following neck dissection or/and radiation, which make it not ideal for dissection and manipulation. When available, the SCM pedicled flap is an ideal solution to close small to medium midline or paramedian fistulas (Figures 6 and 7).
Figure 6.
Midline medium diameter (12 mm) pharyngocutaneous fistula following total laryngectomy and radiation therapy.
Figure 7.
Surgical closure using two opposing miocutaneous rotation flaps from the sternocleidomastoid muscle and overlying skin. 2 safety sutures placed to prevent head extension and tensioning of the wound.
The workhorse of cervical defect reconstructions, therefore including pharyngocutaneous fistula closure, is the pectoralis major miocutaneous pedicled flap. Because of the size of the muscle, the arterial supply (the pectoral artery is situated in the upper-lateral quadrant of the muscle, ideal for translation towards superior and medial) as well as the subcutaneous fatty tissue, this is ideal for closing large and deep fistulas or pharyngostomas [35] (Figure 8). Unbiased data regarding surgical closure methods is hard to obtain, because there is a great deal of variation between surgeons and centres, however some studies shown that use of the pectoralis major flap is the most morbidity prone technique, with a high rate of complications (bleeding, flap dehiscence, recurrent fistula, carotid blowout), but it remains the most used method (Figures 9 and 10) [36].
Figure 8.
Closure of a large midline pharyngocutaneous fistula after total laryngectomy. Translation of a miocutaneous pectoralis major flap to cover de defect.
Figure 9.
Final postoperative aspect of closure of an anterior pharyngocutaneous fistula using a pectoral miocutaneous flap. Notice the hair follicules on the flap skin – different from normal cervical skin.
Figure 10.
Postoperative aspect of patient with necrosis of the miocutaneous pectoral flap. After muscle tissue necrosis – large pharyngostomy, with abundant salivary leakage, as well as exposure of the underlying carotid vessels (whitish contour parallel to the NG feeding tube) with great risk of carotid blowout.
Temporoparietal fascia flap is a new addition to the increasing techniques of fistula repair and is based on the temporoparietal branch of the superficial temporalis artery. One advantage of this flap is that the pedicle is safe from radiotherapy damage but its disadvantages of pedicle length and size of flap can limit its use [37].
In recent years the need for minimal invasive surgeries has grown and endoscopic techniques have been developed to lower comorbidities, complications and try to lower hospital stay. Endoscopic techniques for fistula repair have been developed but have some limitations depending on the size of the fistula and the condition of the surrounding tissues (like the platysma muscle and the accessibility of the fistula transorally) [38].
4.5 Free flaps
Free flaps are used when proximal tissues are unavailable or cannot offer epithelial surface for the repair of the fistula. The advantages of free flaps are that the donor site is far from the primary wound and therefore safe from infection and have not been irradiated. The important limitation of using free flaps is the availability of neck vessels for anastomosis (especially in cases of previous radical neck dissection with ligation of internal jugular vein) [39]. The most common free flap used is the radial forearm flap and anterior thigh flap. Other free flaps that can be used are jejunal flap and latissimus dorsi flap. Another relative disadvantage of using free flaps is the significant longer operating time needed – with harvesting and implantation taking longer than using local pedicled flaps, as well as sometimes requiring two surgical teams [39].
One particular situation of fistula formation is in cases of vocal rehabilitation using tracheo-esophageal fistulization with vocal prosthesis implant. In these cases, a fistula is made by the surgeon, between the trachea and the upper cervical esophagus through the posterior tracheal wall right at the level of the tracheostomy. In this iatrogenic fistula the surgeon inserts a vocal prosthesis – basically a two-flanged device with a lumen that has a unidirectional valve. This is placed so as to permit air from the trachea to pass through towards the pharynx, but not so as to allow food and liquids to pass from the pharynx. This method permits a higher quality esophageal speech and is currently the gold-standard method for vocal rehabilitation following total laryngectomy and has been for the last 30 years [40]. However, long term studies showed that a number of complications may arise in these patients. The hardest to treat is enlargement of the fistula. This is currently linked to local factors, such as acid reflux in the upper esophageal and pharyngeal areas [41], as well as inflammation of the tissues surrounding the prosthesis – inflammation which in turn is caused by the biofilm that forms on the body and flanges of the device [42]. Once enlargement begins (Figure 11), one of the first signs will be leakage around the prosthesis, with coughing especially during drinking. Salivary leakage and micro aspiration are potentially very harmful, because of the risk of aspiration pneumonia, which may endanger the patient’s life. Methods to treat fistula enlargement vary from using larger and larger diameter flanges, to surgically closing the fistula using a local muscle flap (usually sternocleidomastoid) and after surgical healing refistulization in a different site. Some patients however after such complications abandon this technique of vocal rehabilitation altogether and opt for other methods of communication (esophageal speech or an electric larynx) [43, 44].
Figure 11.
Tracheoesophageal puncture orifice – enlarged, with spontaneous expulsion of vocal prosthesis. Small granulation tissue visible through opening.
6. Conclusions
Following total laryngectomy, some anatomical and functional modifications of the cervical region and especially of the pharynx and upper cervical esophagus are important for the consequent evolution of the laryngectomee. Wound healing follows the same basic principles as everywhere else in the human body, but this region presents a series of particular elements. Understanding the importance of not just the quantity of the remaining pharyngeal tissue and the pharyngeal closure technique but equally the quality of said tissues (affected by recent previous radiation therapy and malnutrition) and the intrinsic factors that influence local healing (bacterial colonization, gastro-esophageal acid reflux) – is paramount to micromanaging each total laryngectomy case, in order to decrease the risk of developing a pharyngo-cutaneous fistula. Once formed, fistulas are treated by a multitude of techniques, from conservative to radical surgical plastic reconstructions using local or distant free miocutaneous flaps. Either way, treatment of fistulas is always a more expensive and higher-risk procedure than preventing fistula formation. A particular case is vocal rehabilitation of the laryngectomees, by way of iatrogenic tracheo-esophageal fistula formation with vocal prosthesis placement. In this case, managing the fistula orifice presents another set of challenges, the goal being to maintain fistula patency without granulation tissue formation and without orifice enlargement, so as to maintain patency and prevent leakage or expulsion/aspiration of the prosthesis. The same intrinsic factors – biofilm formation and GERD have been established as risk factors for complications regarding the size of the fistula orifice.
Conflict of interest - disclosure
The authors declare that there are no conflicts of interests among them. All authors have contributed equally and would like to thank their colleagues for the considerable work and support.
\n',keywords:"fistula, laryngectomy, TEP, vocal rehabilitation, Head & Neck surgery, Wound healing",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/76812.pdf",chapterXML:"https://mts.intechopen.com/source/xml/76812.xml",downloadPdfUrl:"/chapter/pdf-download/76812",previewPdfUrl:"/chapter/pdf-preview/76812",totalDownloads:251,totalViews:0,totalCrossrefCites:0,dateSubmitted:"February 25th 2021",dateReviewed:null,datePrePublished:"May 29th 2021",datePublished:"March 2nd 2021",dateFinished:"May 20th 2021",readingETA:"0",abstract:"Total laryngectomy is still the final therapeutic solution in cases of locally advanced laryngeal cancer, as well as in cases of therapeutic failure of organ-sparing surgery or radiation therapy. Following excision of the larynx, the remaining pharynx is reconstructed to obtain continuity of the upper digestive tract. One of the most common complications in these patients, despite constant refinement of the procedure, is the development of a pharyngo-cutaneous fistula. These fistulas prolong hospital stay and often require a second surgical procedure, increasing morbidity and cost for the patient, while diminishing his quality of life. Some risk-factors have been identified, but only some may be corrected before surgery to lower this risk. Managing the fistula once present depends on multiple factors, essential being the size of the fistula as well as the position and concomitant factors, with options ranging from conservative measures to aggressive reconstructive surgery with local miocutaneous flaps. Modern vocal rehabilitation with T.E.P. (tracheo-esophageal puncture) and vocal prosthesis placement presents a new challenge – because of the risk of developing a tracheo-esophageal fistula, with an even higher risk for the patient because of tracheal aspiration. Understanding healing mechanisms of these structures is key to proper management of this complication.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/76812",risUrl:"/chapter/ris/76812",signatures:"Alexandru Nicolaescu, Șerban V.G. 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Berteșteanu",slug:"serban-v.g.-bertesteanu",email:"alexandrunicolaescu@ymail.com",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/216552/images/6646_n.jpg",institution:{name:"University of Bucharest",institutionURL:null,country:{name:"Romania"}}},{id:"216556",title:"Dr.",name:"Alexandru",middleName:null,surname:"Nicolaescu",fullName:"Alexandru Nicolaescu",slug:"alexandru-nicolaescu",email:"alexandru87nicolaescu@gmail.com",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/216556/images/6079_n.jpg",institution:{name:"University of Bucharest",institutionURL:null,country:{name:"Romania"}}},{id:"216562",title:"Dr.",name:"Raluca",middleName:null,surname:"Grigore",fullName:"Raluca Grigore",slug:"raluca-grigore",email:"raluca.grigore@3f.ro",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"222738",title:"Dr.",name:"Popescu",middleName:null,surname:"Bogdan",fullName:"Popescu Bogdan",slug:"popescu-bogdan",email:"dr.bpopescu@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null},{id:"317106",title:"Dr.",name:"Mihnea",middleName:null,surname:"Cojocarita-Condeescu",fullName:"Mihnea Cojocarita-Condeescu",slug:"mihnea-cojocarita-condeescu",email:"mihnea.condeescu@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"Carol Davila University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"350508",title:"Dr.",name:"Catrinel",middleName:null,surname:"Simion-Antonie",fullName:"Catrinel Simion-Antonie",slug:"catrinel-simion-antonie",email:"catrinel_antonie@yahoo.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"Carol Davila University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"350509",title:"Dr.",name:"Paula",middleName:null,surname:"Bejenaru",fullName:"Paula Bejenaru",slug:"paula-bejenaru",email:"pascupaula9005@yahoo.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"Carol Davila University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"350510",title:"Mrs.",name:"Gloria",middleName:null,surname:"Munteanu",fullName:"Gloria Munteanu",slug:"gloria-munteanu",email:"gloriamunteanu@gmail.com",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:{name:"Carol Davila University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Surgical healing mechanism",level:"1"},{id:"sec_3",title:"3. Fistula formation – predisposing factors",level:"1"},{id:"sec_4",title:"4. Management of pharyngocutaneous fistulas",level:"1"},{id:"sec_4_2",title:"4.1 Conservative treatment",level:"2"},{id:"sec_5_2",title:"4.2 Negative pressure wound therapy",level:"2"},{id:"sec_6_2",title:"4.3 Hyperbaric oxygen therapy",level:"2"},{id:"sec_7_2",title:"4.4 Surgical management",level:"2"},{id:"sec_8_2",title:"4.5 Free flaps",level:"2"},{id:"sec_10",title:"5. Particular case: tracheoesophageal puncture vocal rehabilitation – fistula enlargement and management",level:"1"},{id:"sec_11",title:"6. Conclusions",level:"1"},{id:"sec_15",title:"Conflict of interest - disclosure",level:"1"}],chapterReferences:[{id:"B1",body:'Donegan WL. An early history of total laryngectomy. Surgery. 1965;57(6):902-5'},{id:"B2",body:'Ceachir O, Hainarosie R, Zainea V. Total laryngectomy - past, present, future. 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Thorax. 1993;'},{id:"B26",body:'Howes N, Atkinson C, Thomas S, Lewis SJ. Immunonutrition for patients undergoing surgery for head and neck cancer. Cochrane Database of Systematic Reviews. 2018'},{id:"B27",body:'Stableforth WD, Thomas S, Lewis SJ. A systematic review of the role of immunonutrition in patients undergoing surgery for head and neck cancer. International Journal of Oral and Maxillofacial Surgery. 2009'},{id:"B28",body:'Casas Rodera P, de Luis DA, Gómez Candela C, Culebras JM. Immunoenhanced enteral nutrition formulas in head and neck cancer surgery; A systematic review. Nutrición hospitalaria: Organo oficial de la Sociedad española de nutrición parenteral y enteral. 2012;'},{id:"B29",body:'Huang C, Leavitt T, Bayer LR, Orgill DP. Effect of negative pressure wound therapy on wound healing. Current Problems in Surgery. 2014;'},{id:"B30",body:'Loaec E, Vaillant PY, Bonne L, Marianowski R. Negative-pressure wound therapy for the treatment of pharyngocutaneous fistula. European Annals of Otorhinolaryngology, Head and Neck Diseases. 2014;'},{id:"B31",body:'Teixeira S, Costa J, Bartosch I, Correia B, Silva Á. Management of Pharyngocutaneous Fistula with Negative-Pressure Wound Therapy. Journal of Craniofacial Surgery. 2017;'},{id:"B32",body:'Kranke P, Bennett MH, Martyn-St James M, Schnabel A, Debus SE, Weibel S. Hyperbaric oxygen therapy for chronic wounds. Cochrane Database of Systematic Reviews. 2015'},{id:"B33",body:'Abu Eta R, Eviatar E, Gavriel H. Hyperbaric oxygen therapy as an alternative to surgery for non-healing pharyngocutaneous fistula. European Archives of Oto-Rhino-Laryngology. 2016;'},{id:"B34",body:'Magdy EA. Surgical closure of postlaryngectomy pharyngocutaneous fistula: A defect based approach. European Archives of Oto-Rhino-Laryngology. 2008;'},{id:"B35",body:'Mclean JN, Nicholas C, Duggal P, Chen A, Grist WG, Losken A, et al. Surgical management of pharyngocutaneous fistula after total laryngectomy. 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Long-term results of vocal rehabilitation after total laryngectomy with the low-resistance, indwelling Provox TM Voice prosthesis system. Clinical Otolaryngology [Internet]. 1993 Dec;18(6):517-23. Available from: http://doi.wiley.com/10.1111/j.1365-2273.1993.tb00627.x'},{id:"B41",body:'Nicolaescu A, Berteșteanu Ș., Grigore R, Popescu B, Hainăroșie R, Zainea V. GASTRO-ESOPHAGEAL REFLUX DISEASE AND ITS IMPACT ON TRACHEO-ESOPHAGEAL SPEAKING VALVE REHABILITATION AFTER TOTAL LARYNGECTOMY. Journal of Surgical Sciences. 2019;'},{id:"B42",body:'Leonhard M, Schneider-Stickler B. Voice prostheses, microbial colonization and biofilm formation. In: Advances in Experimental Medicine and Biology. 2015. p. 123-36'},{id:"B43",body:'Frowen J, Perry a. Reasons for success or failure in surgical voice restoration after total laryngectomy: an Australian study. The Journal of laryngology and otology. 2001;115(5):393-9'},{id:"B44",body:'Gates GA, Ryan W, Cantu E, Hearne E. Current status of laryngectomee rehabilitation: II. Causes of failure. American Journal of Otolaryngology--Head and Neck Medicine and Surgery. 1982;3(1):8-14'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Alexandru Nicolaescu",address:"alexandru87nicolaescu@gmail.com",affiliation:'
“Carol Davila” University of Medicine and Pharmacy, Romania
ENT Head and Neck Surgery Compartment, “Prof. Dimitrie Gerota” Emergency Hospital of the Ministry of Internal Affairs, Romania
“Carol Davila” University of Medicine and Pharmacy, Romania
ENT Head and Neck Surgery Clinic, “Dr. Carol Davila” Central Military Hospital, Romania
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The digital NSK portal is the central gathering place for the digital collections of the National and University Library (NSK) in Croatia. It was established in 2016 to provide access to the Library’s digital and digitized material collections regardless of storage location. The digital NSK portal enables a unified search of digitized material from the NSK Special Collections - books, visual material, maps and music material. From the end of 2019, all thematic portals are available independently: Digital Books, Digitized Manuscripts, Digitized Visual Materials, Digital Music Materials and Digitized Cartographic Materials (established in 2017). Currently available only in Croatian.
The official DOI (digital object identifier) link registration agency for scholarly and professional publications. Crossref operates a cross-publisher citation linking system that allows a researcher to click on a reference citation on one publisher’s platform and link directly to the cited content on another publisher’s platform, subject to the target publisher’s access control practices. This citation-linking network covers millions of articles and other content items from several hundred scholarly and professional publishers.
Dimensions is a next-generation linked research information system that makes it easier to find and access the most relevant information, analyze the academic and broader outcomes of research, and gather insights to inform future strategy. Dimensions delivers an array of search and discovery, analytical, and research management tools, all in a single platform. Developed in collaboration with over 100 leading research organizations around the world, it brings together over 128 million publications, grants, policy, data and metrics for the first time, enabling users to explore over 4 billion connections between them.
The primary aim of DOAB (Directory of Open Access Books) is to increase discoverability of Open Access books. Metadata will be harvestable in order to maximize dissemination, visibility and impact. Aggregators can integrate the records in their commercial services and libraries can integrate the directory into their online catalogues, helping scholars and students to discover the books.
OAPEN is dedicated to open access, peer-reviewed books. OAPEN operates two platforms, the OAPEN Library (www.oapen.org), a central repository for hosting and disseminating OA books, and the Directory of Open Access Books (DOAB, www.doabooks.org), a discovery service for OA books.
OpenAIRE aims at promoting and implementing the directives of the European Commission (EC) and the European Research Council on the promotion and funding of science and research. OpenAIRE supports the Open Access Mandate and the Open Research Data Pilot developed as part of the Horizon 2020 projects.
An integrated information service combining reference databases, subscription management, online journals, books and linking services. Widely used by libraries, schools, government institutions, medical institutions, corporations and others.
SFX® link resolver gives patrons and librarians a wealth of features that optimize management of and access to resources. It provides patrons with a direct route to electronic full-text records through OpenURL linking, delivers alternative links for further resource discovery, access to journals, and more. Released in 2001 as the first OpenURL resolver, SFX is continuously enhanced to support the newest industry developments and meet the evolving needs of customers. The records include a mix of scholarly material – primarily articles and e-books – but also conference proceedings, newspaper articles, and more.
A non-profit, membership, computer library service and research organization dedicated to the public purposes of furthering access to the world's information and reducing information costs. More than 41,555 libraries in 112 countries and territories around the world use OCLC services to locate, acquire, catalogue, lend and preserve library materials.
The world’s largest collection of open access research papers. CORE's mission is to aggregate all open access research outputs from repositories and journals worldwide and make them available to the public. In this way CORE facilitates free unrestricted access to research for all.
Since 2002, Research4Life has provided researchers at more than 10,500 institutions in over 125 lower and middle-income countries with free or low-cost online access to up 151,000 leading journals and books in the fields of health, agriculture, environment, applied sciences and legal information. There are five programs through which users can access content: Research for Health (Hinari), Research in Agriculture (AGORA), Research in the Environment (OARE), Research for Development and Innovation (ARDI) and Research for Global Justice (GOALI).
Perlego is a digital online library focusing on the delivery of academic, professional and non-fiction eBooks. It is a subscription-based service that offers users unlimited access to these texts for the duration of their subscription, however IntechOpen content integrated on the platform will always be available for free. They have been billed as “the Spotify for Textbooks” by the Evening Standard. Perlego is based in London but is available to users worldwide.
MyScienceWork provides a suite of data-driven solutions for research institutions, scientific publishers and private-sector R&D companies. MyScienceWork's comprehensive database includes more than 90 million scientific publications and 12 million patents.
CNKI (China National Knowledge Infrastructure) is a key national information construction project under the lead of Tsinghua University, and supported by PRC Ministry of Education, PRC Ministry of Science, Propaganda Department of the Communist Party of China and PRC General Administration of Press and Publication. CNKI has built a comprehensive China Integrated Knowledge Resources System, including journals, doctoral dissertations, masters' theses, proceedings, newspapers, yearbooks, statistical yearbooks, ebooks, patents, standards and so on. CNKI keeps integrating new contents and developing new products in 2 aspects: full-text academic resources, software on digitization and knowledge management. Began with academic journals, CNKI has become the largest and mostly-used academic online library in China.
As one of the largest digital content platform in China,independently developed by CNPIEC, CNPeReading positions herself as “One Platform,Vast Content, Global Services”. Through their new cooperation model and service philosophy, CNPeReading provides integrated promotion and marketing solutionsfor upstream publishers, one-stop, triune, recommendation, online reading and management servicesfor downstream institutions & libraries.
ERIC (Education Resources Information Center), sponsored by the Institute of Education Sciences (IES) of the U.S. Department of Education, provides access to education literature to support the use of educational research and information to improve practice in learning, teaching, educational decision-making, and research. The ERIC website is available to the public for searching more than one million citations going back to 1966.
The ACM Digital Library is a research, discovery and networking platform containing: The Full-Text Collection of all ACM publications, including journals, conference proceedings, technical magazines, newsletters and books. A collection of curated and hosted full-text publications from select publishers.
BASE (Bielefeld Academic Search Engine) is one of the world's most voluminous search sengines especially for academic web resources, e.g. journal articles, preprints, digital collections, images / videos or research data. BASE facilitates effective and targeted searches and retrieves high quality, academically relevant results. Other than search engines like Google or Bing BASE searches the deep web as well. The sources which are included in BASE are intellectually selected (by people from the BASE team) and reviewed. That's why data garbage and spam do not occur.
Zentralblatt MATH (zbMATH) is the world’s most comprehensive and longest-running abstracting and reviewing service in pure and applied mathematics. It is edited by the European Mathematical Society (EMS), the Heidelberg Academy of Sciences and Humanities and FIZ Karlsruhe. zbMATH provides easy access to bibliographic data, reviews and abstracts from all areas of pure mathematics as well as applications, in particular to natural sciences, computer science, economics and engineering. It also covers history and philosophy of mathematics and university education. All entries are classified according to the Mathematics Subject Classification Scheme (MSC 2020) and are equipped with keywords in order to characterize their particular content.
IDEAS is the largest bibliographic database dedicated to Economics and available freely on the Internet. Based on RePEc, it indexes over 3,100,000 items of research, including over 2,900,000 that can be downloaded in full text. RePEc (Research Papers in Economics) is a large volunteer effort to enhance the free dissemination of research in Economics which includes bibliographic metadata from over 2,000 participating archives, including all the major publishers and research outlets. IDEAS is just one of several services that use RePEc data.
As the authoritative source for chemical names, structures and CAS Registry Numbers®, the CAS substance collection, CAS REGISTRY®, serves as a universal standard for chemists worldwide. Covering advances in chemistry and related sciences over the last 150 years, the CAS content collection empowers researchers, business leaders, and information professionals around the world with immediate access to the reliable information they need to fuel innovation.
BKCI is a part of Web of Science Core Collection (WoSCC) and the world’s leading citation index with multidisciplinary content from the top tier international and regional journals, conference proceedings, and books. The Book Citation Index includes over 104,500 editorially selected books, with 10,000 new books added each year. Containing more than 53.2 million cited references, coverage dates back from 2005 to present. The Book Citation Index is multidisciplinary, covering disciplines across the sciences, social sciences, and arts & humanities.
Produced by the Web Of Science group, BIOSIS Previews research database provides researchers with the most current sources of life sciences information, including journals, conferences, patents, books, review articles, and more. Researchers can also access multidisciplinary coverage via specialized indexing such as MeSH disease terms, CAS registry numbers, Sequence Databank Numbers and Major Concepts.
Produced by the Web Of Science group, Zoological Record is the world’s oldest continuing database of animal biology. It is considered the world’s leading taxonomic reference, and with coverage back to 1864, has long acted as the world’s unofficial register of animal names. The broad scope of coverage ranges from biodiversity and the environment to taxonomy and veterinary sciences.
Provides a simple way to search broadly for scholarly literature. Includes peer-reviewed papers, theses, books, abstracts and articles, from academic publishers, professsional societies, preprint repositories, universities and other scholarly organizations. Google Scholar sorts articles by weighing the full text of each article, the author, the publication in which the article appears, and how often the article has been cited in other scholarly literature, so that the most relevant results are returned on the first page.
Microsoft Academic is a project exploring how to assist human conducting scientific research by leveraging machine’s cognitive power in memory, computation, sensing, attention, and endurance. Re-launched in 2016, the tool features an entirely new data structure and search engine using semantic search technologies. The Academic Knowledge API offers information retrieval from the underlying database using REST endpoints for advanced research purposes.
The national library of the United Kingdom includes 150 million manuscripts, maps, newspapers, magazines, prints and drawings, music scores, and patents. Online catalogues, information and exhibitions can be found on its website. The library operates the world's largest document delivery service, providing millions of items a year to national and international customers.
The digital NSK portal is the central gathering place for the digital collections of the National and University Library (NSK) in Croatia. It was established in 2016 to provide access to the Library’s digital and digitized material collections regardless of storage location. The digital NSK portal enables a unified search of digitized material from the NSK Special Collections - books, visual material, maps and music material. From the end of 2019, all thematic portals are available independently: Digital Books, Digitized Manuscripts, Digitized Visual Materials, Digital Music Materials and Digitized Cartographic Materials (established in 2017). Currently available only in Croatian.
The official DOI (digital object identifier) link registration agency for scholarly and professional publications. Crossref operates a cross-publisher citation linking system that allows a researcher to click on a reference citation on one publisher’s platform and link directly to the cited content on another publisher’s platform, subject to the target publisher’s access control practices. This citation-linking network covers millions of articles and other content items from several hundred scholarly and professional publishers.
Dimensions is a next-generation linked research information system that makes it easier to find and access the most relevant information, analyze the academic and broader outcomes of research, and gather insights to inform future strategy. Dimensions delivers an array of search and discovery, analytical, and research management tools, all in a single platform. Developed in collaboration with over 100 leading research organizations around the world, it brings together over 128 million publications, grants, policy, data and metrics for the first time, enabling users to explore over 4 billion connections between them.
The primary aim of DOAB (Directory of Open Access Books) is to increase discoverability of Open Access books. Metadata will be harvestable in order to maximize dissemination, visibility and impact. Aggregators can integrate the records in their commercial services and libraries can integrate the directory into their online catalogues, helping scholars and students to discover the books.
OAPEN is dedicated to open access, peer-reviewed books. OAPEN operates two platforms, the OAPEN Library (www.oapen.org), a central repository for hosting and disseminating OA books, and the Directory of Open Access Books (DOAB, www.doabooks.org), a discovery service for OA books.
OpenAIRE aims at promoting and implementing the directives of the European Commission (EC) and the European Research Council on the promotion and funding of science and research. OpenAIRE supports the Open Access Mandate and the Open Research Data Pilot developed as part of the Horizon 2020 projects.
An integrated information service combining reference databases, subscription management, online journals, books and linking services. Widely used by libraries, schools, government institutions, medical institutions, corporations and others.
SFX® link resolver gives patrons and librarians a wealth of features that optimize management of and access to resources. It provides patrons with a direct route to electronic full-text records through OpenURL linking, delivers alternative links for further resource discovery, access to journals, and more. Released in 2001 as the first OpenURL resolver, SFX is continuously enhanced to support the newest industry developments and meet the evolving needs of customers. The records include a mix of scholarly material – primarily articles and e-books – but also conference proceedings, newspaper articles, and more.
A non-profit, membership, computer library service and research organization dedicated to the public purposes of furthering access to the world's information and reducing information costs. More than 41,555 libraries in 112 countries and territories around the world use OCLC services to locate, acquire, catalogue, lend and preserve library materials.
The world’s largest collection of open access research papers. CORE's mission is to aggregate all open access research outputs from repositories and journals worldwide and make them available to the public. In this way CORE facilitates free unrestricted access to research for all.
Since 2002, Research4Life has provided researchers at more than 10,500 institutions in over 125 lower and middle-income countries with free or low-cost online access to up 151,000 leading journals and books in the fields of health, agriculture, environment, applied sciences and legal information. There are five programs through which users can access content: Research for Health (Hinari), Research in Agriculture (AGORA), Research in the Environment (OARE), Research for Development and Innovation (ARDI) and Research for Global Justice (GOALI).
Perlego is a digital online library focusing on the delivery of academic, professional and non-fiction eBooks. It is a subscription-based service that offers users unlimited access to these texts for the duration of their subscription, however IntechOpen content integrated on the platform will always be available for free. They have been billed as “the Spotify for Textbooks” by the Evening Standard. Perlego is based in London but is available to users worldwide.
MyScienceWork provides a suite of data-driven solutions for research institutions, scientific publishers and private-sector R&D companies. MyScienceWork's comprehensive database includes more than 90 million scientific publications and 12 million patents.
CNKI (China National Knowledge Infrastructure) is a key national information construction project under the lead of Tsinghua University, and supported by PRC Ministry of Education, PRC Ministry of Science, Propaganda Department of the Communist Party of China and PRC General Administration of Press and Publication. CNKI has built a comprehensive China Integrated Knowledge Resources System, including journals, doctoral dissertations, masters' theses, proceedings, newspapers, yearbooks, statistical yearbooks, ebooks, patents, standards and so on. CNKI keeps integrating new contents and developing new products in 2 aspects: full-text academic resources, software on digitization and knowledge management. Began with academic journals, CNKI has become the largest and mostly-used academic online library in China.
As one of the largest digital content platform in China,independently developed by CNPIEC, CNPeReading positions herself as “One Platform,Vast Content, Global Services”. Through their new cooperation model and service philosophy, CNPeReading provides integrated promotion and marketing solutionsfor upstream publishers, one-stop, triune, recommendation, online reading and management servicesfor downstream institutions & libraries.
ERIC (Education Resources Information Center), sponsored by the Institute of Education Sciences (IES) of the U.S. Department of Education, provides access to education literature to support the use of educational research and information to improve practice in learning, teaching, educational decision-making, and research. The ERIC website is available to the public for searching more than one million citations going back to 1966.
The ACM Digital Library is a research, discovery and networking platform containing: The Full-Text Collection of all ACM publications, including journals, conference proceedings, technical magazines, newsletters and books. A collection of curated and hosted full-text publications from select publishers.
BASE (Bielefeld Academic Search Engine) is one of the world's most voluminous search sengines especially for academic web resources, e.g. journal articles, preprints, digital collections, images / videos or research data. BASE facilitates effective and targeted searches and retrieves high quality, academically relevant results. Other than search engines like Google or Bing BASE searches the deep web as well. The sources which are included in BASE are intellectually selected (by people from the BASE team) and reviewed. That's why data garbage and spam do not occur.
Zentralblatt MATH (zbMATH) is the world’s most comprehensive and longest-running abstracting and reviewing service in pure and applied mathematics. It is edited by the European Mathematical Society (EMS), the Heidelberg Academy of Sciences and Humanities and FIZ Karlsruhe. zbMATH provides easy access to bibliographic data, reviews and abstracts from all areas of pure mathematics as well as applications, in particular to natural sciences, computer science, economics and engineering. It also covers history and philosophy of mathematics and university education. All entries are classified according to the Mathematics Subject Classification Scheme (MSC 2020) and are equipped with keywords in order to characterize their particular content.
IDEAS is the largest bibliographic database dedicated to Economics and available freely on the Internet. Based on RePEc, it indexes over 3,100,000 items of research, including over 2,900,000 that can be downloaded in full text. RePEc (Research Papers in Economics) is a large volunteer effort to enhance the free dissemination of research in Economics which includes bibliographic metadata from over 2,000 participating archives, including all the major publishers and research outlets. IDEAS is just one of several services that use RePEc data.
As the authoritative source for chemical names, structures and CAS Registry Numbers®, the CAS substance collection, CAS REGISTRY®, serves as a universal standard for chemists worldwide. Covering advances in chemistry and related sciences over the last 150 years, the CAS content collection empowers researchers, business leaders, and information professionals around the world with immediate access to the reliable information they need to fuel innovation.
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In this paper, the basic concepts of robust optimization are developed, the different types of robustness are defined in detail, the main areas in which it has been applied are described and finally, the future lines of research that appear in this area are included.",book:{id:"6587",slug:"nature-inspired-methods-for-stochastic-robust-and-dynamic-optimization",title:"Nature-inspired Methods for Stochastic, Robust and Dynamic Optimization",fullTitle:"Nature-inspired Methods for Stochastic, Robust and Dynamic Optimization"},signatures:"José García and Alvaro Peña",authors:[{id:"227809",title:"Ph.D.",name:"Jose",middleName:null,surname:"Garcia",slug:"jose-garcia",fullName:"Jose Garcia"},{id:"240407",title:"Dr.",name:"Alvaro",middleName:null,surname:"Peña",slug:"alvaro-pena",fullName:"Alvaro Peña"}]}],mostDownloadedChaptersLast30Days:[{id:"59209",title:"Utilization of Response Surface Methodology in Optimization of Extraction of Plant Materials",slug:"utilization-of-response-surface-methodology-in-optimization-of-extraction-of-plant-materials",totalDownloads:5398,totalCrossrefCites:57,totalDimensionsCites:87,abstract:"Experimental design plays an important role in several areas of science and industry. Experimentation is an application of treatments applied to experimental units and is then part of a scientific method based on the measurement of one or more responses. It is necessary to observe the process and the operation of the system well. For this reason, in order to obtain a final result, an experimenter must plan and design experiments and analyzes the results. One of the most commonly used experimental designs for optimization is the response surface methodology (RSM). Because it allows evaluating the effects of multiple factors and their interactions on one or more response variables it is a useful method. In this section, recent studies have been compiled which aim to extraction of plant material in high yield and quality and determine optimum conditions for this extraction process.",book:{id:"5856",slug:"statistical-approaches-with-emphasis-on-design-of-experiments-applied-to-chemical-processes",title:"Statistical Approaches With Emphasis on Design of Experiments Applied to Chemical Processes",fullTitle:"Statistical Approaches With Emphasis on Design of Experiments Applied to Chemical Processes"},signatures:"Alev Yüksel Aydar",authors:[{id:"218870",title:"Dr.",name:"Alev Yüksel",middleName:null,surname:"Aydar",slug:"alev-yuksel-aydar",fullName:"Alev Yüksel Aydar"}]},{id:"74096",title:"Time Frequency Analysis of Wavelet and Fourier Transform",slug:"time-frequency-analysis-of-wavelet-and-fourier-transform",totalDownloads:1219,totalCrossrefCites:6,totalDimensionsCites:8,abstract:"Signal processing has long been dominated by the Fourier transform. However, there is an alternate transform that has gained popularity recently and that is the wavelet transform. The wavelet transform has a long history starting in 1910 when Alfred Haar created it as an alternative to the Fourier transform. In 1940 Norman Ricker created the first continuous wavelet and proposed the term wavelet. Work in the field has proceeded in fits and starts across many different disciplines, until the 1990’s when the discrete wavelet transform was developed by Ingrid Daubechies. While the Fourier transform creates a representation of the signal in the frequency domain, the wavelet transform creates a representation of the signal in both the time and frequency domain, thereby allowing efficient access of localized information about the signal.",book:{id:"10065",slug:"wavelet-theory",title:"Wavelet Theory",fullTitle:"Wavelet Theory"},signatures:"Karlton Wirsing",authors:[{id:"325178",title:"Dr.",name:"Karlton",middleName:null,surname:"Wirsing",slug:"karlton-wirsing",fullName:"Karlton Wirsing"}]},{id:"60864",title:"Statistical Methodology for Evaluating Business Cycles with the Conditions of Their Synchronization and Harmonization",slug:"statistical-methodology-for-evaluating-business-cycles-with-the-conditions-of-their-synchronization-",totalDownloads:1328,totalCrossrefCites:1,totalDimensionsCites:2,abstract:"The importance of the topic of business cycle research and their interaction is due to the fact that the cyclical nature of development is a universal feature of the market economy (regardless of the level of development of the country’s economy and the principles of its organization). In all cases, cyclical ups and downs depend not only on internal system cyclical processes and their factors in countries but also on the consequences of intercountry interaction. The ability to measure and predict business cycles, taking into account their mutual influence, is a prerequisite for the development of an adequate business policy of countries and their associations.",book:{id:"6703",slug:"statistics-growing-data-sets-and-growing-demand-for-statistics",title:"Statistics",fullTitle:"Statistics - Growing Data Sets and Growing Demand for Statistics"},signatures:"Elena Zarova",authors:null},{id:"54366",title:"Solution of Differential Equations with Applications to Engineering Problems",slug:"solution-of-differential-equations-with-applications-to-engineering-problems",totalDownloads:6815,totalCrossrefCites:5,totalDimensionsCites:7,abstract:"Over the last hundred years, many techniques have been developed for the solution of ordinary differential equations and partial differential equations. While quite a major portion of the techniques is only useful for academic purposes, there are some which are important in the solution of real problems arising from science and engineering. In this chapter, only very limited techniques for solving ordinary differential and partial differential equations are discussed, as it is impossible to cover all the available techniques even in a book form. The readers are then suggested to pursue further studies on this issue if necessary. After that, the readers are introduced to two major numerical methods commonly used by the engineers for the solution of real engineering problems.",book:{id:"5513",slug:"dynamical-systems-analytical-and-computational-techniques",title:"Dynamical Systems",fullTitle:"Dynamical Systems - Analytical and Computational Techniques"},signatures:"Cheng Yung Ming",authors:[{id:"191017",title:"Dr.",name:"Cheng",middleName:null,surname:"Y.M.",slug:"cheng-y.m.",fullName:"Cheng Y.M."}]},{id:"56538",title:"Stochastic Resonance and Related Topics",slug:"stochastic-resonance-and-related-topics",totalDownloads:1695,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"The stochastic resonance (SR) is the phenomenon which can emerge in nonlinear dynamic systems. In general, it is related with a bistable nonlinear system of Duffing type under additive excitation combining deterministic periodic force and Gaussian white noise. It manifests as a stable quasiperiodic interwell hopping between both stable states with a small random perturbation. Classical definition and basic features of SR are regarded. The most important methods of investigation outlined are: analytical, semi-analytical, and numerical procedures of governing physical systems or relevant Fokker-Planck equation. Stochastic simulation is mentioned and experimental way of results verification is recommended. Some areas in Engineering Dynamics related with SR are presented together with a particular demonstration observed in the aeroelastic stability. Interaction of stationary and quasiperiodic parts of the response is discussed. Some nonconventional definitions are outlined concerning alternative operators and driving processes are highlighted. The chapter shows a large potential of specific basic, applied and industrial research in SR. This strategy enables to formulate new ideas for both development of nonconventional measures for vibration damping and employment of SR in branches, where it represents an operating mode of the system itself. Weaknesses and empty areas where the research effort of SR should be oriented are indicated.",book:{id:"6128",slug:"resonance",title:"Resonance",fullTitle:"Resonance"},signatures:"Jiří Náprstek and Cyril Fischer",authors:[{id:"207472",title:"Dr.",name:"Jiri",middleName:null,surname:"Naprstek",slug:"jiri-naprstek",fullName:"Jiri Naprstek"},{id:"213311",title:"Dr.",name:"Cyril",middleName:null,surname:"Fischer",slug:"cyril-fischer",fullName:"Cyril Fischer"}]}],onlineFirstChaptersFilter:{topicId:"15",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"82499",title:"Modelling Agitation-Sedation (A-S) in ICU: An Empirical Transition and Time to Event Analysis of Poor and Good Tracking between Nurses Scores and Automated A-S Measures",slug:"modelling-agitation-sedation-a-s-in-icu-an-empirical-transition-and-time-to-event-analysis-of-poor-a",totalDownloads:2,totalDimensionsCites:0,doi:"10.5772/intechopen.105480",abstract:"Sedation in the intensive care unit (ICU) is challenging, as both over- and under-sedation are detrimental. Optimal sedation and analgesic strategies, are a challenge in ICU and nurses play a major role in assessing a patient’s agitation levels. Assessing the severity of agitation is a difficult clinical problem as variability related to drug metabolism for each patient. Multi-state models provide a framework for modelling complex event histories. Quantities of interest are mainly the transition probabilities e.g. between states, that can be estimated by the empirical transition matrix (ETM). Such multi-state models have had wide applications for modelling complex courses of a disease. In this chapter the ETM of multi-state and counting process (survival analytic) models which use the times for ICU patients to transition to varying states of violations (a violation being a carer’s agitation rating outside so-called wavelet-probability bands (WPB)) confirm the utility of defining so-called trackers and non-trackers according to WPB-based control limits and rules. ETM and multi-state modelling demonstrate that these control-limit scoring approaches are suitable for developing more advanced optimal infusion controllers and coding of nurses A-S scores. These offer significant clinical potential of improved agitation management and reduced length of stay in critical care.",book:{id:"10678",title:"Biostatistics",coverURL:"https://cdn.intechopen.com/books/images_new/10678.jpg"},signatures:"Irene Hudson"},{id:"82432",title:"A Modern Review of Wavelet Transform in Its Spectral Analysis",slug:"a-modern-review-of-wavelet-transform-in-its-spectral-analysis",totalDownloads:2,totalDimensionsCites:0,doi:"10.5772/intechopen.105559",abstract:"The spectral analysis, in much aspects as are the wavelet transform in its numerous versions and its relation with other transforms and special functions requires a special review, since the exploration in the frequency domain to the wavelet transform is more detailed and majorly more specific in different applications. For example, the wavelet transform of special function can be very useful to create and design special signal filters or, for example, to the interphase between reception-emission devices with sensorial parts of the human body. Also the quantum wavelet transform is very useful in the spectral study of traces of particles. Likewise, in this chapter, these aspects are considered as an inherent property of the wavelet transform in the spectral exploration of some phenomena. Finally, general results to the discrete case are given, which is analyzed to the wavelet transform and its spectra.",book:{id:"11150",title:"Recent Advances of Wavelet Transform and Their Applications",coverURL:"https://cdn.intechopen.com/books/images_new/11150.jpg"},signatures:"Francisco Bulnes"},{id:"82378",title:"Covers and Properties of Families of Real Functions",slug:"covers-and-properties-of-families-of-real-functions",totalDownloads:6,totalDimensionsCites:0,doi:"10.5772/intechopen.100555",abstract:"We present results on the relationships of the covering property GΦΨ for Φ,Ψ∈OΛΩΓ and G∈S1SfinUfin of a topological space and the selection property GΦ0Ψ0 of the corresponding family of real functions. The result already published are presented without a proof, however with a citation of the corresponding paper. We present a general Theorem that covers almost all the result of this kind. Some results about hereditary properties are enclosed. We also present Scheepers Diagram of considered covering properties for uncountable covers.",book:{id:"10677",title:"Advanced Topics of Topology",coverURL:"https://cdn.intechopen.com/books/images_new/10677.jpg"},signatures:"Lev Bukovský"},{id:"82356",title:"Geometric Properties of Classical Yang-Mills Theory on Differentiable Manifolds",slug:"geometric-properties-of-classical-yang-mills-theory-on-differentiable-manifolds",totalDownloads:2,totalDimensionsCites:0,doi:"10.5772/intechopen.105399",abstract:"Gauge theories make up a class of physical theories that attempt to describe the physics of particles at a fundamental level. The purpose here is to study Yang-Mills theory at the classical level in terms of the geometry of fiber bundles and differentiable manifolds. It is shown how fundamental particles of bosonic and fermionic nature can be described mathematically. The Lagrangian for the basic interactions is presented and then put together in a unified form. Finally, some basic theorems are proved for a Yang-Mills on compact four-dimensional manifolds.",book:{id:"11502",title:"Manifolds - Recent Developments and Applications",coverURL:"https://cdn.intechopen.com/books/images_new/11502.jpg"},signatures:"Paul Bracken"},{id:"82335",title:"Straight Rectangular Waveguide for Circular Dielectric Material in the Cross Section and for Complementary Shape of the Cross Section",slug:"straight-rectangular-waveguide-for-circular-dielectric-material-in-the-cross-section-and-for-complem",totalDownloads:5,totalDimensionsCites:0,doi:"10.5772/intechopen.104815",abstract:"This chapter presents wave propagation along a straight rectangular waveguide for practical applications where there are two complementary shapes of the dielectric profile in the cross section. In the first case, the cross section consists of circular dielectric material in the center of the cross section. In the second case, the cross section consists of a circular hollow core in the center of the cross section. These examples show two discontinuous cross sections and complementary shapes that cannot be solved by analytical methods. We will explain in detail the special technique for calculating the dielectric profile for all cases. The method is based on Laplace and Fourier transforms and inverse Laplace and Fourier transform. In order to solve any inhomogeneous problem in the cross section, more than one technique can be proposed for the same mode-model method. We will explain in detail how and where the technique can be integrated into the proposed mode-model. The image method and periodic replication are needed for fulfilling the boundary condition of the metallic waveguide. The applications are useful for straight rectangular waveguides in millimeter regimes, where the circular dielectric material is located in the center of the cross section, and also for hollow waveguides, where the circular hollow core is located in the center of the cross section.",book:{id:"11150",title:"Recent Advances of Wavelet Transform and Their Applications",coverURL:"https://cdn.intechopen.com/books/images_new/11150.jpg"},signatures:"Zion Menachem"},{id:"82204",title:"Some Solvability Problems of Differential Equations in Non-standard Sobolev Spaces",slug:"some-solvability-problems-of-differential-equations-in-non-standard-sobolev-spaces",totalDownloads:6,totalDimensionsCites:0,doi:"10.5772/intechopen.104918",abstract:"In this chapter an m-th order elliptic equation is considered in Sobolev spaces generated by the norm of a grand Lebesgue space. Subspaces are determined in which the shift operator is continuous, and local solvability (in the strong sense) is established in these subspaces. It is established an interior and up-to boundary Schauder-type estimates with respect to these Sobolev spaces for m-th order elliptic operators, the trace of functions and trace operator are determined, the boundedness of trace operator and the extension theorem are proved, the properties of the Riesz potential are studied regarding these Sobolev spaces, etc. It is considered a second-order elliptic equation, and we study the Fredholmness of the Dirichlet problem in the Sobolev space generated by a separable subspace of the grand Lebesgue space. It is also considered one spectral problem for a discontinuous second-order differential operator and proved the theorem on the basicity of eigenfunctions of this operator in subspace of Morrey space, in which the infinitely differentiable functions with compact support are dense.",book:{id:"11149",title:"Differential Equations",coverURL:"https://cdn.intechopen.com/books/images_new/11149.jpg"},signatures:"Bilal Bilalov, Sabina Sadigova and Zaur Kasumov"}],onlineFirstChaptersTotal:44},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:89,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:104,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:32,numberOfPublishedChapters:318,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:12,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:141,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:113,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:106,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:5,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:15,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}},{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}}]},series:{item:{id:"24",title:"Sustainable Development",doi:"10.5772/intechopen.100361",issn:null,scope:"
\r\n\tTransforming our World: the 2030 Agenda for Sustainable Development endorsed by United Nations and 193 Member States, came into effect on Jan 1, 2016, to guide decision making and actions to the year 2030 and beyond. Central to this Agenda are 17 Goals, 169 associated targets and over 230 indicators that are reviewed annually. The vision envisaged in the implementation of the SDGs is centered on the five Ps: People, Planet, Prosperity, Peace and Partnership. This call for renewed focused efforts ensure we have a safe and healthy planet for current and future generations.
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\r\n\tThis Series focuses on covering research and applied research involving the five Ps through the following topics:
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\r\n\t1. Sustainable Economy and Fair Society that relates to SDG 1 on No Poverty, SDG 2 on Zero Hunger, SDG 8 on Decent Work and Economic Growth, SDG 10 on Reduced Inequalities, SDG 12 on Responsible Consumption and Production, and SDG 17 Partnership for the Goals
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\r\n\t2. Health and Wellbeing focusing on SDG 3 on Good Health and Wellbeing and SDG 6 on Clean Water and Sanitation
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\r\n\t3. Inclusivity and Social Equality involving SDG 4 on Quality Education, SDG 5 on Gender Equality, and SDG 16 on Peace, Justice and Strong Institutions
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\r\n\t4. Climate Change and Environmental Sustainability comprising SDG 13 on Climate Action, SDG 14 on Life Below Water, and SDG 15 on Life on Land
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\r\n\t5. Urban Planning and Environmental Management embracing SDG 7 on Affordable Clean Energy, SDG 9 on Industry, Innovation and Infrastructure, and SDG 11 on Sustainable Cities and Communities.
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\r\n\tThe series also seeks to support the use of cross cutting SDGs, as many of the goals listed above, targets and indicators are all interconnected to impact our lives and the decisions we make on a daily basis, making them impossible to tie to a single topic.
",coverUrl:"https://cdn.intechopen.com/series/covers/24.jpg",latestPublicationDate:"June 28th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:0,editor:{id:"262440",title:"Prof.",name:"Usha",middleName:null,surname:"Iyer-Raniga",slug:"usha-iyer-raniga",fullName:"Usha Iyer-Raniga",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRYSXQA4/Profile_Picture_2022-02-28T13:55:36.jpeg",biography:"Usha Iyer-Raniga is a professor in the School of Property and Construction Management at RMIT University. Usha co-leads the One Planet Network’s Sustainable Buildings and Construction Programme (SBC), a United Nations 10 Year Framework of Programmes on Sustainable Consumption and Production (UN 10FYP SCP) aligned with Sustainable Development Goal 12. The work also directly impacts SDG 11 on Sustainable Cities and Communities. She completed her undergraduate degree as an architect before obtaining her Masters degree from Canada and her Doctorate in Australia. Usha has been a keynote speaker as well as an invited speaker at national and international conferences, seminars and workshops. Her teaching experience includes teaching in Asian countries. She has advised Austrade, APEC, national, state and local governments. She serves as a reviewer and a member of the scientific committee for national and international refereed journals and refereed conferences. She is on the editorial board for refereed journals and has worked on Special Issues. Usha has served and continues to serve on the Boards of several not-for-profit organisations and she has also served as panel judge for a number of awards including the Premiers Sustainability Award in Victoria and the International Green Gown Awards. Usha has published over 100 publications, including research and consulting reports. Her publications cover a wide range of scientific and technical research publications that include edited books, book chapters, refereed journals, refereed conference papers and reports for local, state and federal government clients. She has also produced podcasts for various organisations and participated in media interviews. She has received state, national and international funding worth over USD $25 million. Usha has been awarded the Quarterly Franklin Membership by London Journals Press (UK). Her biography has been included in the Marquis Who's Who in the World® 2018, 2016 (33rd Edition), along with approximately 55,000 of the most accomplished men and women from around the world, including luminaries as U.N. Secretary-General Ban Ki-moon. In 2017, Usha was awarded the Marquis Who’s Who Lifetime Achiever Award.",institutionString:null,institution:{name:"RMIT University",institutionURL:null,country:{name:"Australia"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:5,paginationItems:[{id:"91",title:"Sustainable Economy and Fair Society",coverUrl:"https://cdn.intechopen.com/series_topics/covers/91.jpg",isOpenForSubmission:!0,annualVolume:11975,editor:{id:"181603",title:"Dr.",name:"Antonella",middleName:null,surname:"Petrillo",slug:"antonella-petrillo",fullName:"Antonella Petrillo",profilePictureURL:"https://mts.intechopen.com/storage/users/181603/images/system/181603.jpg",biography:"Antonella Petrillo is a Professor at the Department of Engineering of the University of Naples “Parthenope”, Italy. She received her Ph.D. in Mechanical Engineering from the University of Cassino. Her research interests include multi-criteria decision analysis, industrial plant, logistics, manufacturing and safety. 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Singh",profilePictureURL:"https://mts.intechopen.com/storage/users/329385/images/system/329385.png",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",institutionURL:null,country:{name:"India"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"8018",title:"Extracellular Matrix",subtitle:"Developments and Therapeutics",coverURL:"https://cdn.intechopen.com/books/images_new/8018.jpg",slug:"extracellular-matrix-developments-and-therapeutics",publishedDate:"October 27th 2021",editedByType:"Edited by",bookSignature:"Rama Sashank Madhurapantula, Joseph Orgel P.R.O. and Zvi Loewy",hash:"c85e82851e80b40282ff9be99ddf2046",volumeInSeries:23,fullTitle:"Extracellular Matrix - Developments and Therapeutics",editors:[{id:"212416",title:"Dr.",name:"Rama Sashank",middleName:null,surname:"Madhurapantula",slug:"rama-sashank-madhurapantula",fullName:"Rama Sashank Madhurapantula",profilePictureURL:"https://mts.intechopen.com/storage/users/212416/images/system/212416.jpg",institutionString:"Illinois Institute of Technology",institution:{name:"Illinois Institute of Technology",institutionURL:null,country:{name:"United States of America"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"9759",title:"Vitamin E in Health and Disease",subtitle:"Interactions, Diseases and Health Aspects",coverURL:"https://cdn.intechopen.com/books/images_new/9759.jpg",slug:"vitamin-e-in-health-and-disease-interactions-diseases-and-health-aspects",publishedDate:"October 6th 2021",editedByType:"Edited by",bookSignature:"Pınar Erkekoglu and Júlia Scherer Santos",hash:"6c3ddcc13626110de289b57f2516ac8f",volumeInSeries:22,fullTitle:"Vitamin E in Health and Disease - Interactions, Diseases and Health Aspects",editors:[{id:"109978",title:"Prof.",name:"Pınar",middleName:null,surname:"Erkekoğlu",slug:"pinar-erkekoglu",fullName:"Pınar Erkekoğlu",profilePictureURL:"https://mts.intechopen.com/storage/users/109978/images/system/109978.jpg",institutionString:"Hacettepe University",institution:{name:"Hacettepe University",institutionURL:null,country:{name:"Turkey"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null}]},subseriesFiltersForPublishedBooks:[{group:"subseries",caption:"Proteomics",value:18,count:4},{group:"subseries",caption:"Metabolism",value:17,count:6},{group:"subseries",caption:"Cell and Molecular Biology",value:14,count:9},{group:"subseries",caption:"Chemical Biology",value:15,count:13}],publicationYearFilters:[{group:"publicationYear",caption:"2022",value:2022,count:8},{group:"publicationYear",caption:"2021",value:2021,count:7},{group:"publicationYear",caption:"2020",value:2020,count:12},{group:"publicationYear",caption:"2019",value:2019,count:3},{group:"publicationYear",caption:"2018",value:2018,count:2}],authors:{paginationCount:739,paginationItems:[{id:"158492",title:"Prof.",name:"Yusuf",middleName:null,surname:"Tutar",slug:"yusuf-tutar",fullName:"Yusuf Tutar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/158492/images/system/158492.jpeg",biography:"Prof. Dr. Yusuf Tutar conducts his research at the Hamidiye Faculty of Pharmacy, Department of Basic Pharmaceutical Sciences, Division of Biochemistry, University of Health Sciences, Turkey. He is also a faculty member in the Molecular Oncology Program. He obtained his MSc and Ph.D. at Oregon State University and Texas Tech University, respectively. He pursued his postdoctoral studies at Rutgers University Medical School and the National Institutes of Health (NIH/NIDDK), USA. 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. Prof. Emeje was a national chairman of academic pharmacists in Nigeria and the 2021 winner of the May & Baker Nigeria Plc–sponsored prize for professional service in research and innovation.",institutionString:"National Institute for Pharmaceutical Research and Development",institution:{name:"National Institute for Pharmaceutical Research and Development",country:{name:"Nigeria"}}},{id:"268659",title:"Ms.",name:"Xianquan",middleName:null,surname:"Zhan",slug:"xianquan-zhan",fullName:"Xianquan Zhan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/268659/images/8143_n.jpg",biography:"Dr. Zhan received his undergraduate and graduate training in the fields of preventive medicine and epidemiology and statistics at the West China University of Medical Sciences in China during 1989 to 1999. 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. His current main research interest focuses on the studies of cancer proteomics and biomarkers, and the use of modern omics techniques and systems biology for PPPM in cancer, and on the development and use of 2DE-LC/MS for the large-scale study of human proteoforms.",institutionString:null,institution:{name:"Xiangya Hospital Central South University",country:{name:"China"}}},{id:"40482",title:null,name:"Rizwan",middleName:null,surname:"Ahmad",slug:"rizwan-ahmad",fullName:"Rizwan Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/40482/images/system/40482.jpeg",biography:"Dr. Rizwan Ahmad is a University Professor and Coordinator, Quality and Development, College of Medicine, Imam Abdulrahman bin Faisal University, Saudi Arabia. Previously, he was Associate Professor of Human Function, Oman Medical College, Oman, and SBS University, Dehradun. Dr. Ahmad completed his education at Aligarh Muslim University, Aligarh. 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. 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\r\n\tBiodiversity provides food security and constitutes a gene pool for biotechnology, especially in the field of agriculture and medicine, and promotes the development of ecotourism.
\r\n
\r\n\tCurrently, biologists admit that we are witnessing the first phases of the seventh mass extinction caused by human intervention. It is estimated that the current rate of extinction is between a hundred and a thousand times faster than it was when man first appeared. The disappearance of species is caused not only by an accelerated rate of extinction, but also by a decrease in the rate of emergence of new species as human activities degrade the natural environment. The conservation of biological diversity is "a common concern of humanity" and an integral part of the development process. Its objectives are “the conservation of biological diversity, the sustainable use of its components, and the fair and equitable sharing of the benefits resulting from the use of genetic resources”.
\r\n
\r\n\tThe following are the main causes of biodiversity loss:
\r\n
\r\n\t• The destruction of natural habitats to expand urban and agricultural areas and to obtain timber, minerals and other natural resources.
\r\n
\r\n\t• The introduction of alien species into a habitat, whether intentionally or unintentionally which has an impact on the fauna and flora of the area, and as a result, they are reduced or become extinct.
\r\n
\r\n\t• Pollution from industrial and agricultural products, which devastate the fauna and flora, especially those in fresh water.
\r\n
\r\n\t• Global warming, which is seen as a threat to biological diversity, and will become increasingly important in the future.
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\r\n\tThe environment is subject to severe anthropic effects. Among them are those associated with pollution, resource extraction and overexploitation, loss of biodiversity, soil degradation, disorderly land occupation and planning, and many others. These anthropic effects could potentially be caused by any inadequate management of the environment. However, ecosystems have a resilience that makes them react to disturbances which mitigate the negative effects. It is critical to understand how ecosystems, natural and anthropized, including urban environments, respond to actions that have a negative influence and how they are managed. It is also important to establish when the limits marked by the resilience and the breaking point are achieved and when no return is possible. The main focus for the chapters is to cover the subjects such as understanding how the environment resilience works, the mechanisms involved, and how to manage them in order to improve our interactions with the environment and promote the use of adequate management practices such as those outlined in the United Nations’ Sustainable Development Goals.
\r\n\tPollution is caused by a wide variety of human activities and occurs in diverse forms, for example biological, chemical, et cetera. In recent years, significant efforts have been made to ensure that the environment is clean, that rigorous rules are implemented, and old laws are updated to reduce the risks towards humans and ecosystems. However, rapid industrialization and the need for more cultivable sources or habitable lands, for an increasing population, as well as fewer alternatives for waste disposal, make the pollution control tasks more challenging. Therefore, this topic will focus on assessing and managing environmental pollution. It will cover various subjects, including risk assessment due to the pollution of ecosystems, transport and fate of pollutants, restoration or remediation of polluted matrices, and efforts towards sustainable solutions to minimize environmental pollution.
\r\n\tWater is not only a crucial substance needed for biological life on Earth, but it is also a basic requirement for the existence and development of the human society. Owing to the importance of water to life on Earth, early researchers conducted numerous studies and analyses on the liquid form of water from the perspectives of chemistry, physics, earth science, and biology, and concluded that Earth is a "water polo". Water covers approximately 71% of Earth's surface. However, 97.2% of this water is seawater, 21.5% is icebergs and glaciers, and only 0.65% is freshwater that can be used directly by humans. As a result, the amount of water reserves available for human consumption is limited. The development, utilization, and protection of freshwater resources has become the focus of water science research for the continued improvement of human livelihoods and society.
\r\n
\r\n\tWater exists as solid, liquid, and gas within Earth’s atmosphere, lithosphere, and biosphere. Liquid water is used for a variety of purposes besides drinking, including power generation, ecology, landscaping, and shipping. Because water is involved in various environmental hydrological processes as well as numerous aspects of the economy and human society, the study of various phenomena in the hydrosphere, the laws governing their occurrence and development, the relationship between the hydrosphere and other spheres of Earth, and the relationship between water and social development, are all part of water science. Knowledge systems for water science are improving continuously. Water science has become a specialized field concerned with the identification of its physical, chemical, and biological properties. In addition, it reveals the laws of water distribution, movement, and circulation, and proposes methods and tools for water development, utilization, planning, management, and protection. Currently, the field of water science covers research related to topics such as hydrology, water resources and water environment. It also includes research on water related issues such as safety, engineering, economy, law, culture, information, and education.
",coverUrl:"https://cdn.intechopen.com/series_topics/covers/41.jpg",keywords:"Water, Water resources, Freshwater, Hydrological processes, Utilization, Protection"}],annualVolumeBook:{},thematicCollection:[{type:"book",id:"11672",title:"Chemokines Updates",subtitle:null,isOpenForSubmission:!0,hash:"c00855833476a514d37abf7c846e16e9",slug:null,bookSignature:"Prof. Murat Şentürk",coverURL:"https://cdn.intechopen.com/books/images_new/11672.jpg",editedByType:null,submissionDeadline:"May 6th 2022",editors:[{id:"14794",title:"Prof.",name:"Murat",middleName:null,surname:"Şentürk",slug:"murat-senturk",fullName:"Murat Şentürk",profilePictureURL:"https://mts.intechopen.com/storage/users/14794/images/system/14794.jpeg",biography:"Dr. Murat Şentürk obtained a baccalaureate degree in Chemistry in 2002, a master’s degree in Biochemistry in 2006, and a doctorate degree in Biochemistry in 2009 from Atatürk University, Turkey. Dr. Şentürk currently works as an professor of Biochemistry in the Department of Basic Pharmacy Sciences, Faculty of Pharmacy, Ağri Ibrahim Cecen University, Turkey. \nDr. Şentürk published over 120 scientific papers, reviews, and book chapters and presented several conferences to scientists. \nHis research interests span enzyme inhibitor or activator, protein expression, purification and characterization, drug design and synthesis, toxicology, and pharmacology. \nHis research work has focused on neurodegenerative diseases and cancer treatment. Dr. Şentürk serves as the editorial board member of several international journals.",institutionString:"Ağrı İbrahim Çeçen University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"Ağrı İbrahim Çeçen University",institutionURL:null,country:{name:"Turkey"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null}],selectedSeries:null,selectedSubseries:null},seriesLanding:{item:{id:"11",title:"Biochemistry",doi:"10.5772/intechopen.72877",issn:"2632-0983",scope:"Biochemistry, the study of chemical transformations occurring within living organisms, impacts all areas of life sciences, from molecular crystallography and genetics to ecology, medicine, and population biology. Biochemistry examines macromolecules - proteins, nucleic acids, carbohydrates, and lipids – and their building blocks, structures, functions, and interactions. Much of biochemistry is devoted to enzymes, proteins that catalyze chemical reactions, enzyme structures, mechanisms of action and their roles within cells. Biochemistry also studies small signaling molecules, coenzymes, inhibitors, vitamins, and hormones, which play roles in life processes. Biochemical experimentation, besides coopting classical chemistry methods, e.g., chromatography, adopted new techniques, e.g., X-ray diffraction, electron microscopy, NMR, radioisotopes, and developed sophisticated microbial genetic tools, e.g., auxotroph mutants and their revertants, fermentation, etc. More recently, biochemistry embraced the ‘big data’ omics systems. Initial biochemical studies have been exclusively analytic: dissecting, purifying, and examining individual components of a biological system; in the apt words of Efraim Racker (1913 –1991), “Don’t waste clean thinking on dirty enzymes.” Today, however, biochemistry is becoming more agglomerative and comprehensive, setting out to integrate and describe entirely particular biological systems. The ‘big data’ metabolomics can define the complement of small molecules, e.g., in a soil or biofilm sample; proteomics can distinguish all the comprising proteins, e.g., serum; metagenomics can identify all the genes in a complex environment, e.g., the bovine rumen. This Biochemistry Series will address the current research on biomolecules and the emerging trends with great promise.",coverUrl:"https://cdn.intechopen.com/series/covers/11.jpg",latestPublicationDate:"June 29th, 2022",hasOnlineFirst:!0,numberOfOpenTopics:4,numberOfPublishedChapters:318,numberOfPublishedBooks:32,editor:{id:"31610",title:"Dr.",name:"Miroslav",middleName:null,surname:"Blumenberg",fullName:"Miroslav Blumenberg",profilePictureURL:"https://mts.intechopen.com/storage/users/31610/images/system/31610.jpg",biography:"Miroslav Blumenberg, Ph.D., was born in Subotica and received his BSc in Belgrade, Yugoslavia. He completed his Ph.D. at MIT in Organic Chemistry; he followed up his Ph.D. with two postdoctoral study periods at Stanford University. Since 1983, he has been a faculty member of the RO Perelman Department of Dermatology, NYU School of Medicine, where he is codirector of a training grant in cutaneous biology. Dr. Blumenberg’s research is focused on the epidermis, expression of keratin genes, transcription profiling, keratinocyte differentiation, inflammatory diseases and cancers, and most recently the effects of the microbiome on the skin. He has published more than 100 peer-reviewed research articles and graduated numerous Ph.D. and postdoctoral students.",institutionString:null,institution:{name:"New York University Langone Medical Center",institutionURL:null,country:{name:"United States of America"}}},subseries:[{id:"14",title:"Cell and Molecular Biology",keywords:"Omics (Transcriptomics; Proteomics; Metabolomics), Molecular Biology, Cell Biology, Signal Transduction and Regulation, Cell Growth and Differentiation, Apoptosis, Necroptosis, Ferroptosis, Autophagy, Cell Cycle, Macromolecules and Complexes, Gene Expression",scope:"The Cell and Molecular Biology topic within the IntechOpen Biochemistry Series aims to rapidly publish contributions on all aspects of cell and molecular biology, including aspects related to biochemical and genetic research (not only in humans but all living beings). We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics include, but are not limited to: Advanced techniques of cellular and molecular biology (Molecular methodologies, imaging techniques, and bioinformatics); Biological activities at the molecular level; Biological processes of cell functions, cell division, senescence, maintenance, and cell death; Biomolecules interactions; Cancer; Cell biology; Chemical biology; Computational biology; Cytochemistry; Developmental biology; Disease mechanisms and therapeutics; DNA, and RNA metabolism; Gene functions, genetics, and genomics; Genetics; Immunology; Medical microbiology; Molecular biology; Molecular genetics; Molecular processes of cell and organelle dynamics; Neuroscience; Protein biosynthesis, degradation, and functions; Regulation of molecular interactions in a cell; Signalling networks and system biology; Structural biology; Virology and microbiology.",annualVolume:11410,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/14.jpg",editor:{id:"165627",title:"Dr.",name:"Rosa María",middleName:null,surname:"Martínez-Espinosa",fullName:"Rosa María Martínez-Espinosa",profilePictureURL:"https://mts.intechopen.com/storage/users/165627/images/system/165627.jpeg",institutionString:null,institution:{name:"University of Alicante",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"79367",title:"Dr.",name:"Ana Isabel",middleName:null,surname:"Flores",fullName:"Ana Isabel Flores",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRpIOQA0/Profile_Picture_1632418099564",institutionString:null,institution:{name:"Hospital Universitario 12 De Octubre",institutionURL:null,country:{name:"Spain"}}},{id:"328234",title:"Ph.D.",name:"Christian",middleName:null,surname:"Palavecino",fullName:"Christian Palavecino",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000030DhEhQAK/Profile_Picture_1628835318625",institutionString:null,institution:{name:"Central University of Chile",institutionURL:null,country:{name:"Chile"}}},{id:"186585",title:"Dr.",name:"Francisco Javier",middleName:null,surname:"Martin-Romero",fullName:"Francisco Javier Martin-Romero",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSB3HQAW/Profile_Picture_1631258137641",institutionString:null,institution:{name:"University of Extremadura",institutionURL:null,country:{name:"Spain"}}}]},{id:"15",title:"Chemical Biology",keywords:"Phenolic Compounds, Essential Oils, Modification of Biomolecules, Glycobiology, Combinatorial Chemistry, Therapeutic peptides, Enzyme Inhibitors",scope:"Chemical biology spans the fields of chemistry and biology involving the application of biological and chemical molecules and techniques. In recent years, the application of chemistry to biological molecules has gained significant interest in medicinal and pharmacological studies. This topic will be devoted to understanding the interplay between biomolecules and chemical compounds, their structure and function, and their potential applications in related fields. Being a part of the biochemistry discipline, the ideas and concepts that have emerged from Chemical Biology have affected other related areas. This topic will closely deal with all emerging trends in this discipline.",annualVolume:11411,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/15.jpg",editor:{id:"441442",title:"Dr.",name:"Şükrü",middleName:null,surname:"Beydemir",fullName:"Şükrü Beydemir",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003GsUoIQAV/Profile_Picture_1634557147521",institutionString:null,institution:{name:"Anadolu University",institutionURL:null,country:{name:"Turkey"}}},editorTwo:{id:"13652",title:"Prof.",name:"Deniz",middleName:null,surname:"Ekinci",fullName:"Deniz Ekinci",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYLT1QAO/Profile_Picture_1634557223079",institutionString:null,institution:{name:"Ondokuz Mayıs University",institutionURL:null,country:{name:"Turkey"}}},editorThree:null,editorialBoard:[{id:"219081",title:"Dr.",name:"Abdulsamed",middleName:null,surname:"Kükürt",fullName:"Abdulsamed Kükürt",profilePictureURL:"https://mts.intechopen.com/storage/users/219081/images/system/219081.png",institutionString:null,institution:{name:"Kafkas University",institutionURL:null,country:{name:"Turkey"}}},{id:"241413",title:"Dr.",name:"Azhar",middleName:null,surname:"Rasul",fullName:"Azhar Rasul",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRT1oQAG/Profile_Picture_1635251978933",institutionString:null,institution:{name:"Government College University, Faisalabad",institutionURL:null,country:{name:"Pakistan"}}},{id:"178316",title:"Ph.D.",name:"Sergey",middleName:null,surname:"Sedykh",fullName:"Sergey Sedykh",profilePictureURL:"https://mts.intechopen.com/storage/users/178316/images/system/178316.jfif",institutionString:null,institution:{name:"Novosibirsk State University",institutionURL:null,country:{name:"Russia"}}}]},{id:"17",title:"Metabolism",keywords:"Biomolecules Metabolism, Energy Metabolism, Metabolic Pathways, Key Metabolic Enzymes, Metabolic Adaptation",scope:"Metabolism is frequently defined in biochemistry textbooks as the overall process that allows living systems to acquire and use the free energy they need for their vital functions or the chemical processes that occur within a living organism to maintain life. Behind these definitions are hidden all the aspects of normal and pathological functioning of all processes that the topic ‘Metabolism’ will cover within the Biochemistry Series. Thus all studies on metabolism will be considered for publication.",annualVolume:11413,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/17.jpg",editor:{id:"138626",title:"Dr.",name:"Yannis",middleName:null,surname:"Karamanos",fullName:"Yannis Karamanos",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002g6Jv2QAE/Profile_Picture_1629356660984",institutionString:null,institution:{name:"Artois University",institutionURL:null,country:{name:"France"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"243049",title:"Dr.",name:"Anca",middleName:null,surname:"Pantea Stoian",fullName:"Anca Pantea Stoian",profilePictureURL:"https://mts.intechopen.com/storage/users/243049/images/system/243049.jpg",institutionString:null,institution:{name:"Carol Davila University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"203824",title:"Dr.",name:"Attilio",middleName:null,surname:"Rigotti",fullName:"Attilio Rigotti",profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institutionString:null,institution:{name:"Pontifical Catholic University of Chile",institutionURL:null,country:{name:"Chile"}}},{id:"300470",title:"Dr.",name:"Yanfei (Jacob)",middleName:null,surname:"Qi",fullName:"Yanfei (Jacob) Qi",profilePictureURL:"https://mts.intechopen.com/storage/users/300470/images/system/300470.jpg",institutionString:null,institution:{name:"Centenary Institute of Cancer Medicine and Cell Biology",institutionURL:null,country:{name:"Australia"}}}]},{id:"18",title:"Proteomics",keywords:"Mono- and Two-Dimensional Gel Electrophoresis (1-and 2-DE), Liquid Chromatography (LC), Mass Spectrometry/Tandem Mass Spectrometry (MS; MS/MS), Proteins",scope:"With the recognition that the human genome cannot provide answers to the etiology of a disorder, changes in the proteins expressed by a genome became a focus in research. Thus proteomics, an area of research that detects all protein forms expressed in an organism, including splice isoforms and post-translational modifications, is more suitable than genomics for a comprehensive understanding of the biochemical processes that govern life. The most common proteomics applications are currently in the clinical field for the identification, in a variety of biological matrices, of biomarkers for diagnosis and therapeutic intervention of disorders. From the comparison of proteomic profiles of control and disease or different physiological states, which may emerge, changes in protein expression can provide new insights into the roles played by some proteins in human pathologies. Understanding how proteins function and interact with each other is another goal of proteomics that makes this approach even more intriguing. Specialized technology and expertise are required to assess the proteome of any biological sample. Currently, proteomics relies mainly on mass spectrometry (MS) combined with electrophoretic (1 or 2-DE-MS) and/or chromatographic techniques (LC-MS/MS). MS is an excellent tool that has gained popularity in proteomics because of its ability to gather a complex body of information such as cataloging protein expression, identifying protein modification sites, and defining protein interactions. The Proteomics topic aims to attract contributions on all aspects of MS-based proteomics that, by pushing the boundaries of MS capabilities, may address biological problems that have not been resolved yet.",annualVolume:11414,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/18.jpg",editor:{id:"200689",title:"Prof.",name:"Paolo",middleName:null,surname:"Iadarola",fullName:"Paolo Iadarola",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSCl8QAG/Profile_Picture_1623568118342",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorTwo:{id:"201414",title:"Dr.",name:"Simona",middleName:null,surname:"Viglio",fullName:"Simona Viglio",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRKDHQA4/Profile_Picture_1630402531487",institutionString:null,institution:{name:"University of Pavia",institutionURL:null,country:{name:"Italy"}}},editorThree:null,editorialBoard:[{id:"72288",title:"Dr.",name:"Arli Aditya",middleName:null,surname:"Parikesit",fullName:"Arli Aditya Parikesit",profilePictureURL:"https://mts.intechopen.com/storage/users/72288/images/system/72288.jpg",institutionString:null,institution:{name:"Indonesia International Institute for Life Sciences",institutionURL:null,country:{name:"Indonesia"}}},{id:"40928",title:"Dr.",name:"Cesar",middleName:null,surname:"Lopez-Camarillo",fullName:"Cesar Lopez-Camarillo",profilePictureURL:"https://mts.intechopen.com/storage/users/40928/images/3884_n.png",institutionString:null,institution:{name:"Universidad Autónoma de la Ciudad de México",institutionURL:null,country:{name:"Mexico"}}},{id:"81926",title:"Dr.",name:"Shymaa",middleName:null,surname:"Enany",fullName:"Shymaa Enany",profilePictureURL:"https://mts.intechopen.com/storage/users/81926/images/system/81926.png",institutionString:"Suez Canal University",institution:{name:"Suez Canal University",institutionURL:null,country:{name:"Egypt"}}}]}]}},libraryRecommendation:{success:null,errors:{},institutions:[]},route:{name:"chapter.detail",path:"/chapters/33818",hash:"",query:{},params:{id:"33818"},fullPath:"/chapters/33818",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)}()