Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\\n\\n
We wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\n
Throughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\n
We wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
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\r\n\tIncreasing demand for agricultural production for human, animal, and industrial requirements is responsible for the enhancement of agricultural and agro-industrial activities. Each step of such activities produces various types of agricultural waste that include crop residue, on-farm livestock and fisheries waste, forest waste, agro-industrial waste, etc. Currently, handling and managing agricultural waste is a challenging task worldwide, especially in the context of environmental pollution control and sustainable agriculture. Thus, efficient management in terms of reuse, recycling, and reduction of agricultural waste is principally needed not only for the green economy but also for farmers' profitability. This would also contribute to minimizing environmental pollution, greenhouse gas emissions, and climate change to meet the 2030 UN-SDGs. Therefore, this book aims to address agricultural waste production and management in the multidimensional aspects of crop residue, biodegradables, biomass, composting and vermiculture, agricultural waste economics, air pollution, environmental safety, waste management, and handling, on-farm waste reuse, and agricultural waste value addition. Authors are encouraged to submit original research, reviews, modeling and simulation, case studies, and recent progress and scenarios in the above-mentioned subject areas. \r\n\t
",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:"10 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. He applied for two patents at the national level.",coeditorOneBiosketch:"A renowned researcher in the field of Agricultural Engineering with 14 years of academic experience at Bahauddin Zakariya University. Winner of various prestigious fellowships, awards, and research grants. Published 250+ articles along with several books and chapters. Guest editor of seven ISI-SCI journals for publishers like SAGE, MDPI, and Frontiers.",coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"338219",title:"Dr.",name:"Fiaz",middleName:null,surname:"Ahmad",slug:"fiaz-ahmad",fullName:"Fiaz Ahmad",profilePictureURL:"https://mts.intechopen.com/storage/users/338219/images/system/338219.png",biography:"Dr. Fiaz Ahmad is an assistant professor and lecturer at the Department of Agricultural Engineering, Bahauddin Zakariya University, Multan, Pakistan. He obtained his Ph.D. in Agricultural Bioenvironmental and Energy Engineering from Nanjing Agriculture University, China, in 2015, and completed his postdoctorate in Agricultural Engineering from Jiangsu University, Zhenjiang, China, in 2020. He was awarded a fellowship from the Higher Education Commission of Pakistan for Ph.D. studies and from the Chinese Government for post-doctoral studies. He earned a BSc and MSc (Hons) in Agricultural Engineering from the University of Agriculture, Faisalabad, Pakistan, in 2004 and 2007, respectively. He is the author of more than fifty journal and conference articles. He has supervised six master’s students to date, and is currently supervising six master and two doctoral students. Dr. Ahmad has completed three research projects with his research interest focusing on the design of agricultural machinery, agricultural waste management, artificial intelligence (AI), and agricultural bioenvironment.",institutionString:"Bahauddin Zakariya University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"Bahauddin Zakariya University",institutionURL:null,country:{name:"Pakistan"}}}],coeditorOne:{id:"199381",title:"Prof.",name:"Muhammad",middleName:null,surname:"Sultan",slug:"muhammad-sultan",fullName:"Muhammad Sultan",profilePictureURL:"https://mts.intechopen.com/storage/users/199381/images/system/199381.png",biography:"Muhammad Sultan is an Assistant Professor at the Department of Agricultural\r\nEngineering, Bahauddin Zakariya University, Multan (Pakistan). He completed his Ph.D.\r\nand Postdoc from Kyushu University (Japan) in the field of Energy & Environmental\r\nEngineering. He was an awardee of MEXT and JASSO fellowships (from the Japanese\r\nGovernment) during Ph.D. and Postdoc studies, respectively. He also did a Postdoc as\r\na Canadian Queen Elizabeth Advance Scholar at Simon Fraser University (Canada) in\r\nthe field of Mechatronic Systems Engineering. He worked for Kyushu University\r\nInternational Institute for Carbon-Neutral Energy Research (WPI-I2CNER) for two years.\r\nCurrently, he is working on 4 research projects funded by the Higher Education\r\nCommission (HEC) of Pakistan. He has completed six projects in past in the field of\r\nagricultural engineering. He has supervised 10+ M.Eng. and Ph.D. thesis and 10+\r\nstudents are currently working under his supervision. He has published 120+ journal\r\narticles, 100+ conference articles, 13 book chapters, and 6 books. He is serving as guest\r\neditor for the journals like Sustainability (MDPI), Agriculture (MDPI), Energies (MDPI),\r\nAdvances in Mechanical Engineering (SAGE), Frontiers in Mechanical Engineering, and\r\nEvergreen Journal of Kyushu University. His research is focused on developing energy-\r\nefficient temperature and humidity control systems for agricultural storage, greenhouse,\r\nlivestock, and poultry applications. His research keywords include desiccant air-\r\nconditioning, evaporative cooling, adsorption heat pump, Maisotsenko cycle (M-cycle),\r\nenergy recovery ventilators; adsorption desalination; wastewater treatment.",institutionString:"Bahauddin Zakariya University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"5",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Bahauddin Zakariya University",institutionURL:null,country:{name:"Pakistan"}}},coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"5",title:"Agricultural and Biological Sciences",slug:"agricultural-and-biological-sciences"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"440212",firstName:"Elena",lastName:"Vracaric",middleName:null,title:"Ms.",imageUrl:"https://mts.intechopen.com/storage/users/440212/images/20007_n.jpg",email:"elena@intechopen.com",biography:"As an Author Service Manager, my responsibilities include monitoring and facilitating all publishing activities for authors and editors. From chapter submission and review to approval and revision, copyediting and design, until final publication, I work closely with authors and editors to ensure a simple and easy publishing process. I maintain constant and effective communication with authors, editors and reviewers, which allows for a level of personal support that enables contributors to fully commit and concentrate on the chapters they are writing, editing, or reviewing. I assist authors in the preparation of their full chapter submissions and track important deadlines and ensure they are met. I help to coordinate internal processes such as linguistic review, and monitor the technical aspects of the process. As an ASM I am also involved in the acquisition of editors. Whether that be identifying an exceptional author and proposing an editorship collaboration, or contacting researchers who would like the opportunity to work with IntechOpen, I establish and help manage author and editor acquisition and contact."}},relatedBooks:[{type:"book",id:"6418",title:"Hyperspectral Imaging in Agriculture, Food and Environment",subtitle:null,isOpenForSubmission:!1,hash:"9005c36534a5dc065577a011aea13d4d",slug:"hyperspectral-imaging-in-agriculture-food-and-environment",bookSignature:"Alejandro Isabel Luna Maldonado, Humberto Rodríguez Fuentes and Juan Antonio Vidales Contreras",coverURL:"https://cdn.intechopen.com/books/images_new/6418.jpg",editedByType:"Edited by",editors:[{id:"105774",title:"Prof.",name:"Alejandro Isabel",surname:"Luna Maldonado",slug:"alejandro-isabel-luna-maldonado",fullName:"Alejandro Isabel Luna Maldonado"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10359",title:"Landraces",subtitle:"Traditional Variety and Natural Breed",isOpenForSubmission:!1,hash:"0600836fb2c422f7b624363d1e854f68",slug:"landraces-traditional-variety-and-natural-breed",bookSignature:"Amr Elkelish",coverURL:"https://cdn.intechopen.com/books/images_new/10359.jpg",editedByType:"Edited by",editors:[{id:"231337",title:"Dr.",name:"Amr",surname:"Elkelish",slug:"amr-elkelish",fullName:"Amr Elkelish"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophile",surname:"Theophanides",slug:"theophile-theophanides",fullName:"Theophile Theophanides"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3092",title:"Anopheles mosquitoes",subtitle:"New insights into malaria vectors",isOpenForSubmission:!1,hash:"c9e622485316d5e296288bf24d2b0d64",slug:"anopheles-mosquitoes-new-insights-into-malaria-vectors",bookSignature:"Sylvie Manguin",coverURL:"https://cdn.intechopen.com/books/images_new/3092.jpg",editedByType:"Edited by",editors:[{id:"50017",title:"Prof.",name:"Sylvie",surname:"Manguin",slug:"sylvie-manguin",fullName:"Sylvie Manguin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"371",title:"Abiotic Stress in Plants",subtitle:"Mechanisms and Adaptations",isOpenForSubmission:!1,hash:"588466f487e307619849d72389178a74",slug:"abiotic-stress-in-plants-mechanisms-and-adaptations",bookSignature:"Arun Shanker and B. 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1. Introduction
Biomineralization refers to the process of obtaining biominerals in living organisms, and can be both a pathological and a non-pathological process [1]. This term was coined at the beginning of the eighties of the past century, and opened a new way of inspiring materials for biomedical applications [2].
Nowadays, the understanding of many diseases, like gallbladder stones related to pathological aspects of biominerals’ formation in living organisms, is based on the knowledge of the chemical recognition between biological macromolecules, calcium salts and cholesterol molecules [3-5]. This kind of chemical interaction has played an important role in the development of biologically inspired biosensors. A biosensor is an analytical device consisting of two elements in spatial proximity: (1) a biological recognition element able to interact specifically with a target; (2) a transducer able to convert the recognition event into a measurable signal [6].
According to the mechanism of biological signaling used, biosensors are classified into five major types, one of them is the biomimetic one; in this sense, a biomimetic biosensor is an artificial or synthetic sensor that mimics the function of a natural biosensor [7]. Some examples of these types of sensors are the quercetin-modified wax-impregnated graphite electrode (Qu/WGE) for the purpose of detecting uric acid (UA) in the presence of ascorbic acid (AA) [8]; a cell-based biosensor platform of neuron silicon interface with acid-sensing taste receptor cells cultured on light addressable potentiometric sensor (LAPS) [9]; a Langmuir-Blodgett film of tyrosinase incorporated in a lipidic layer with lutetium bisphthalocyanine as an electron mediator for the voltammetric detection of phenol derivatives [10]; a mixed self-assembled monolayers (SAMs) functionalized with specific olfactory receptors (ODR-10) constructed on the sensitive area of surface acoustic wave (SAW) chip [11]. Recently, a new type of chemical biosensor based on intramineral proteins of eggshells for carbonate ions detection has been published elsewhere [12].
The precipitation of the cholesterol and the calcium salts are commonly found in the bladder (bile), whereas the calcium carbonate, which is the major component, is normally found in the pancreas, at alkaline pH [13]. This formation usually follows the principles of crystal growth and the simple chemical solubility rules. However, it has been recently observed that the formation of gallstones or minerals of biogenic origin (grown in these biological vesicles) leads the growth process in extreme conditions, even devoid of water in some cases. It is not clear whether some of the genes (mostly in mammals) could be involved in most of the pathological processes, however, it has been proved the ethnical influence on the medical diagnosis [14]. Recent publications have shown that there are genes already identified (mainly in marine organisms) whose role in activating biomineralization processes has been tested by molecular biology techniques [15]. Nowadays, the knowledge about the genes involved in the formation of certain skeleton in marine spicules is, in general clearly identified. However, our understanding of the role of any of the proteins in biomineralization is scarce, so is our understanding of the role of the matrix proteins as well as protein-protein, and protein-mineral interaction [16].
Concerning the crystallization of cholesterol in human bile, there are some proteins from the serum involved in this matter, the immunoglobulines IgM, IgA, IgG as well as the proteins α1-Acid Glycoprotein (AAG, usually called Orosomucoid), Phospholipase C and Aminopeptidase N. According to a recent publication, only three proteins from this list showed a potent enhancement and a promoting effect on the crystallization of cholesterol: IgM, IgA and AAG protein [17]. Particularly, orosomucoid a protein of 42 kDa, is one of the most abundant proteins of serum proteins with no well-known physiological function. However, a number of biological activities have been described for orosomucoid, such as promotion of collagen fibril formation, inhibition of platelet aggregation, inhibition of heparin accelerated antithrombin III mediated activation of thrombin and factor Xa, binding of Δ-4 Ketosteroids, sequestration of a glycosaminoglycan cofactor in the lipoprotein lipase reaction and the preferential binding of more than 60 cationic therapeutic drugs [18]. The orosomucoid protein has an unusual pI of around 3 and an extraordinary carbohydrate content of approximately 40% (w/w), comprising five N-linked glycans [19]. However, although the importance of this orosomucoid in human physiology seems to be high, there are no more structural data from the native glycoprotein obtained at high resolution. The orosomucoid was firstly crystallized in 1984 [18], and since then no more structural data of that native glycoprotein at high resolution have been published. The high-resolution crystallographic structure was not available for a long time. However, the three-dimensional structure has been recently available at 1.8Å resolution of a recombinant AAG protein crystallized in a tetragonal P41212 space group. This recombinant human AAG produced as monomeric, yet unglycosylated protein in E. coli was obtained via secretion into the bacterial periplasm, where formation of its two-disulphide bonds was facilitated in the oxidizing environment [20]. The former crystals of the native AAG protein were obtained in a hexagonal P622 or P6222 or the enantiomorph P6422 space group in the presence of chlorpromazine at 18 °C [18]. Interestedly, the co-crystallization of the tetragonal AAG by soaking method in the presence of the well-known ligands (phenothiazine tranquilizers) like chlorpromazine, bromazepam or diazepam, failed [20]. This is due to the unglycosylated 3D structure. It seems that the carbohydrates play an important role into the 3D structure-function of the native glycoprotein when making the chemical recognition between this AAG protein and some common drugs.
In this chapter we evaluate, from the electro-analytical point of view, the plausible role into the chemical interaction and chemical recognition of sodium carbonate, bilirubin, cholesterol with α1-Acid Glycoprotein (AAG) usually found in biogenic minerals in bile. Additionally, we show the effect of different gel media on the crystallographic habits of synthetically grown crystals of cholesterol. These crystals were characterized by X-ray powder diffraction. Finally, based on our results, we propose a new design of a biologically inspired biosensor.
2. Experimental
Cyclic Voltammetry. All the electroanalytical assays to investigate the analyte-protein interaction for example, sodium carbonate, cholesterol, and bilirubin with the α1-Acid Glycoprotein were performed using a Potentiostat/Galvanostat PG580 from UNISCAN Instruments (UK). The potential was ranging from 0 to 1.80 Volts versus a Saturated Calomel Electrode (as a reference electrode). The velocity for this electrochemical analysis was 50 mVs-1.
Figure 1.
Electrochemical cell used for cyclic voltammetry experiments.
Figure 1 shows the electrochemical cell used for this determination. Three electrodes were used along the experiments. The working electrode (5 mm diameter) was a gold microelectrode Au10 from Autolab Electrochemical Instruments (USA). The auxiliary electrode was a platinum wire of 0.5 mm in diameter. The gold electrode was polished using a diamond paste of 0.25 microns in particle size. The gold electrode was sonicated several times in order to remove the impurities. The auxiliary electrode was cleaned with a proper fine texture sandpaper to eliminate oxides on the surface. As an inert electrolyte 0.5M Potassium Chloride (Strem Chemicals, Inc. Newburyport, Code 7447-40-7) was used with a purity of 99.999%. The highly pure α1-Acid Glycoprotein (AAG protein) was purchased from Sigma (Code G9885) without further purification. The electroanalytical plots, as those shown in Figure 2, were obtained taking into account the gold electrode saturation for each scanning cycle as well as removing the background from the oxidation of gold at 1.3V. This value corresponds to a maximum peak into the anodic response of the voltammogram (right-hand side of the plot current versus potential) at each analyte concentration. This AAG protein (50 μg) was absorbed on the gold electrode until the water was evaporated. For each analyte five different concentrations were done as well as duplicates for each single concentration. The electrochemical experiment is carried out until the analyte is put into contact with the protein and after an equilibrium time of 2 minutes. Before running any of the experiments the oxygen was degased by bubbling pure nitrogen for 15 minutes. All dissolutions were prepared in a glass beaker of 5 mL with 0.1, 0.2, 0.3, 0.4, and 0.5 mM of each electroanalyte. The dissolutions were then transferred to the electrochemical cell. However, as bilirubin is not soluble in water, it had to be prepared in DMSO as follows: 2.92 mg were dissolved in 1 mL of DMSO-Water 80:20 and keeping the solution away from oxidation inside of an amber container. Cholesterol was prepared dissolving 1.93 mg in 1 mL of ethanol-water 80:20 and sealing it carefully to avoid any alcohol evaporation.
In order to investigate the chemical interaction between cholesterol and AAG protein, the cholesterol crystals were grown in different crystal growth media, solution, and two types of hydrogels in the Granada Crystallization Boxes via counter-diffusion methods [21]. In solution method, it was used an ethanol solution in the classic evaporation process; and in the gel method tetramethyl orthosilicate (TMOS) hydrogel was prepared by polycondesation reaction [22], and agarose hydrogel was prepared by heating and cooling method [23]. After obtaining the gel phase, the solution of cholesterol 0.5% w/v in ethanol was poured onto the top of each gel allowing cholesterol molecules to diffuse into the gel network for one week at 18 °C. After this week, the solution was removed and replaced with water to produce the crystal growth of cholesterol by reducing the solubility in water, changing the dielectric constant.
X-ray powder diffraction. Cholesterol crystals were characterized by using an Empyrean XRD system from PANalytical Instruments (Netherlands), into the following conditions: Cu Kα radiation, monochromator, time step = 0.004s, step size = 19.68, 2θ = 4 to 50 deg, at room temperature.
3. Results and discussion
The cyclic voltammetry for AAG protein showed an anodic response when interacting with carbonate, cholesterol and bilirubin (Figures 2a, 2b, and 2c). The protein alone did not show any electrochemical response in an aqueous solution of KCl 0.5M (curve not shown). This protein-substrate response was dependent of the concentration, and is characterized by an increment of current with the sequential increment of the analyte concentration. Only two of the three analytes (carbonate ions Figure 2a and bilirubin Figure 2c) investigated showed a strong protein interaction with them and generated a characteristic plot with increments of current. A small peak is observed at a potential value of 0.54 V, which corresponds to the oxygen reduction of the small amount of water electrolysis that occurs during the electrochemical response at E > 1.6 V. The peak is more evident for the cholesterol (Figure 2b) that interacts in minor proportion with the protein. This behavior decreases the strength of the interaction, which is almost imperceptible for bilirubin (Figure 2c). This demonstrates that covered electrode with a stable protein-analyte layer generates a cleaner analytical signal avoiding the water electrolysis as a parasite reaction.
In order to have a clearer visualization of the effect, the electrochemical response of the protein was measured on the gold electrode without analyte (Io). Then this curve was used to obtain a normalized plot I/Io, which allowed standardizing all the experiments respect to the chemical interaction to the analyte (see Figure 3). The chemical interaction between the AAG protein and the specific analytes can be detected by either a big difference between I/I0 or a big change value on the slope. When obtaining the normalized plots as shown in Figure 3, bilirubin showed the strongest chemical interaction, less intense followed by the carbonate ions. This behavior is particularly interesting since most of the preliminary investigations have claimed that AAG protein recognizes cholesterol molecules or works as a crystallization promoter in human bile, as that observed for different immunoglobulins like IgM, IgA, IgM or for phospholipase C and aminopeptidase N [17], but according to these results the interaction with bilirubin must not be discarded.
From these results it is clear that supersaturation of cholesterol in bile is a necessary condition though not sufficient, for the formation of cholesterol gallstones [3]. Biliary proteins, which are capable of affecting the rate at which cholesterol crystallization occurs, are important factors in pathogenesis of cholesterol gallstone diseases [3]. The pathway is as follows: (1) AAG-bilirubin complex formation, (2) cholesterol nucleation and (3), cholesterol crystal growth. The solubility of cholesterol is quite an interesting issue to take into account, when trying to investigate this chemical recognition in vivo experiments. Cholesterol in vitro is soluble in alcoholic solutions, but in vivo, cholesterol molecules should be solubilized by aqueous micellar solution or transported either by apolipoproteins or by any other biomolecules in order to make it soluble. The cholesterol can be crystallized inside the bile, or be secreted to the blood stream or sent directly to the stools [4]. This process based on the electrochemical observations, is in agreement with the enterohepatic circulation from the liver to the bile [11]. In this physiological process bilirubin needs the chemical interaction with cholesterol. Bilirubin is firstly conjugated with glucoronic acid in the liver by the enzyme glucuronyltransferase making it soluble in water, and perhaps with cholesterol too. Therefore, it makes sense that the first crystals of AAG protein were obtained by Schmidt in 1952 using ethanol as precipitating agent [24]. The α1-Acid Glycoprotein is a cholesterol crystallization promoter conjugated with a complex bilirubin-cholesterol as shown in the electroanalytical results in Figure 2.
Figure 2.
a. Cyclic voltammogram of AAG – KCl / Na2CO3 ranging the carbonates concentration from 0.1 to 0.5 mM scanning speed of 50 mVs-1. b. Cyclic voltammogram of AAG – KCl / Cholesterol ranging the cholesterol concentration from 0.1 to 0.5 mM scanning speed of 50 mVs-1. c. Cyclic voltammogram of AAG – KCl/Bilirubin ranging the bilirubin concentration from 0.1 to 0.5 mM scanning speed of 50 mVs-1
In humans, gallbladder sludge (gel-like media), a reversible pre-gallstone phase, consists of cholesterol crystals and bilirubin granules in a mesh of mocus called mucin. Mucin a glycoprotein commonly observed in bile, is the constituent of the core and non-cholesterol matrix of cholesterol gallstones. It is highly likely that gallbladder mucin is actively involved at a number of stages in cholesterol precipitation [25].
On the other hand, calcium salts are present in all pigment gallstones as compounds of one or more of the anions in bile: (i) carbonate; (ii) bilirubinate, and (iii) phosphate. In addition, since cholesterol stones have been found to contain pigment stone centers, perhaps bilirubin and AAG protein are complexed. We can postulate that the presence of calcium salts precipitation in bile is a critical event in the initiation of cholesterol gallstones, so that the latter should be considered a two-stage process: (i) precipitation of calcium salts chemically bonded to AAG protein to form a macromolecular complex plus some components of the bile, for example mucin as a growth media, and then (ii) crystallization of cholesterol from its supersaturated state on this gel-like environment. It has been published that in vivo experiments cholesterol precipitation starts with thin filamentous structures, which evolve into helical and then tubular forms before breaking into characteristic flat cholesterol monohydrate plates [26].
From the crystal growth point of view, the crystal habit of cholesterol grown in vitro and in three different media (two of them hydrogels used to emulate mucin, a gel-like component usually found in bile) shows the vicissitudes that a crystal goes through when growing (Figure 4). The crystallographic faces, shown on each gel media, describe the plausible shapes that cholesterol can display according to the transport and to the crystal growth processes, (the cholesterol keeps the same space crystallographic group). X-ray powder patterns of cholesterol lamellar-like crystals are shown in Figure 5. They have a good agreement with the pattern reported in the Powder Diffraction File (PDF, file 7-742), which corresponds to the triclinic phase, as well as those reported by several authors [26-28]. These cholesterol crystals should be grown in the presence of different combinations of AAG protein plus bilirubin, in order to check the protein as a promoter (nucleant) of cholesterol molecules.
Figure 3.
Normalized plot (I/Io, see text for details) for anodic peaks corresponds to the maximum response of each voltammogram AAG-KCl, at different molar concentration for each analyte: sodium carbonate, cholesterol and bilirubin according to Figures 2a, 2b and 2c respectively.
Figure 4.
Optical images of Cholesterol crystals grown in: A) Solution Ethanol/Water, B) Tetramethyl orthosilicate hydrogel, C) Agarose hydrogel. The pictures (A) and (C) were taken between 90 degrees overcrossed-polarizers, while (B) picture corresponds to unovercrossed-polarizers. Different scale bars are included as inset on each picture.
Figure 5.
X-ray powder diffraction characterization plots of cholesterol crystals grown in three different media: A) alcoholic solution by evaporation method, B) tetramethyl orthosilicate hydrogel, C) agarose hydrogel and D) X-ray diffraction pattern (PDF file No. 7-742) of a cholesterol of the triclinic phase P1.
In the near future, cholesterol crystals could be grown in the presence of bilirubin, glucoronic acid and most of the components of the bile extract, in order to see whether these crystals will show the same crystallographic faces or not. These crystals could be re-dissolved in alcoholic solutions and the proteins extracted. These proteins could be purified and characterized from the cholesterol crystals in order to check their similarity to the AAG protein.
Finally, the AAG protein should be co-crystallized in the presence of bilirubin-cholesterol searching for the specific bonding-sites into the crystallographic structure either by X-ray Crystallographic methods or by NMR, as performed in the crystallographic projects nowadays. In future investigations we might be looking for inhibitors for the AAG Protein, like the promising cholesterol antinucleating 120kDa glycoprotein found by Ohya et al. [29]; or look for strategies to turn the genes off related to the over-expression of this AAG protein in vivo to control the cholesterol crystallization.
4. Biosensor’s design
From these electroanalytical results, the most plausible way of producing an ad hoc cholesterol-AAG/BR biosensor based on biological macromolecules like AAG, should follow the steps from A to D as shown in the box-diagram of Figure 6. The first step (A) corresponds to the gold electrode. The AAG protein would then be deposited on the gold electrode by using a thin film of the protein, this is the second step called (B). In the following step, (C) the protein should be complexed with bilirubin either by electrochemical interaction, or by Langmuir-Blogget isotherms as proposed by Xie et al., [30]. Finally, (D) the amperometric biosensor could be tested in the presence of different concentrations of alcoholic solutions of cholesterol, based on the strategy described in the experimental set up on this contribution.
Figure 6.
It shows different steps in order to produce an ad hoc Cholesterol-Bilirubin-AAG Biosensor.
The electrochemical response using this biosensor will be used to optimize the detection limits to check cholesterol in different media either in solution or in gel (this latter which would emulate the tissue texture or the mucin usually found in the bile).
5. Conclusions
We can observe from this research, that there is no a direct interaction between α1-Acid Protein (AAG) and cholesterol molecules. The perfect biosensor for the evaluation of this chemical interaction should take into account that bilirubin is the intermediate molecule between cholesterol, and the AAG protein. This protein works as promoter, but needs some intermediate molecules like bilirubin to solubilize cholesterol in aqueous solutions when precipitating gallstones. Future investigations should be focused on co-crystallizing these proteins in the presence of bilirubin/cholesterol. The crystallographic 3D structure of the native glycoprotein can give answers about the specific sites (amino acids), where cholesterol molecules could be attached to the protein molecule working as nucleation precursor.
Acknowledgements
Two of the authors acknowledge to DGAPA-UNAM Projects PAPIIT No. IN201811 (for AM) and No. IN202011 (for BF-U) the financial support for this research. The authors (A.M. and M.E.M.) thank to CONACYT for the Consolidación de Grupos Initiative at the Instituto de Física, Benemérita Universidad Autónoma de Puebla (BUAP). The support and sponsorship for one of the authors (M.J. R-A) as a postdoctoral fellow is acknowledged to the Mexican Softmatter Network (CONACYT). The authors also acknowledge the technical support from I.Q. Leonel San Roman from the (IFBUAP).
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Introduction",level:"1"},{id:"sec_2",title:"2. Experimental",level:"1"},{id:"sec_3",title:"3. Results and discussion",level:"1"},{id:"sec_4",title:"4. Biosensor’s design",level:"1"},{id:"sec_5",title:"5. Conclusions",level:"1"},{id:"sec_6",title:"Acknowledgements",level:"1"}],chapterReferences:[{id:"B1",body:'Mann S. Biomineralization. Principles and Concepts in Bioinorganic Materials Chemistry, Oxford University Press, ISBN 0-19-850882-4, Oxford, UK. 2001:p1-5.'},{id:"B2",body:'Lowenstam HA. Minerals Formed by Organisms. Science 1981;211:1126 –31.'},{id:"B3",body:'Shaffer EA. Gallstone Disease: Epidemiology of Gallbladder Stone Disease. Best. Pract. Res. Clin. Gastroenterol. 2006;20: 981-96.'},{id:"B4",body:'Admirand WH, Small DM. The Physicochemical Basis of Cholesterol Gallstone Formation in Man. J. Clin. Invest. 1968;47:1043–52.'},{id:"B5",body:'Stolk MF, J Van Erpecum KJ, Peeters TL, Samson M, Smout AJPM, Akkermans LMA, Vanberge-Henegouwen GP. 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Instituto de Física, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
Centro Interdisciplinario de Investigaciones y Estudios sobre Medio Ambiente y Desarrollo (CIIEMAD), Departamento de Sociedad y Politica Ambiental. Instituto Politécnico Nacional, México, D.F., México
'},{corresp:null,contributorFullName:"Bernardo A. Frontana-Uribe",address:null,affiliation:'
Centro Conjunto de Investigación en Química Sustentable UAEMex-UNAM, Toluca, México, México
Permanent position at the Instituto de Química, Universidad Nacional Autonoma de Mexico, Mexico, Mexico
Instituto de Física, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
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1. Introduction
Streptococcal skin and skin-structure infection (SSTI) is associated with significant morbidity all over the world and the impact is felt predominantly in resource-poor areas with inadequate personal hygiene and over-crowded living conditions. While exact numbers are difficult to estimate on account of the lack of systematic reporting, a literature search conducted by Sims and colleagues [1] reported an estimated prevalence of 18 million cases, with an incidence rate of around 1.78 million cases per year of invasive S. pyogenes (S. pyogenes) infection in 2005, and more than 140 million cases of impetigo globally each year as reported in the 2010 Global Burden of Disease study. Rising numbers of cases of infectious diseases of the skin is also seen in Western nations, probably driven by drug abuse and homelessness [2, 3]. Increased cases result in increased costs from emergency room visits and hospital care, hence outpatient parenteral antibiotic therapy (OPAT) has proven to be a valuable alternative to hospitalization [4], and when patients are chosen appropriately, OPAT results in very significant cost-savings without compromising outcomes [5]. Advances in pharmaceutical research has contributed to development of longer acting antibiotics that can be dosed once a day and in some cases once a week. There is ongoing research to determine the optimum duration of antibiotic therapy for these conditions.
Skin infections have been variously classified based on different criteria like depth of infection or the bacterial agents causing the infections or as primary infection in contrast to infection of pre-existing wounds or skin conditions. A very practical classification of patients hospitalized with skin infections (cellulitis versus abscess versus skin infections with additional complicating factors) has been described by Jenkins et al. [6]. The authors found in their study that cutaneous abscesses were primarily caused by Staphylococcus aureus and less often by the Streptococcus spp, in contrast with cellulitis which was caused primarily by β-hemolytic streptococci and less commonly by Staphylococcus spp. This differentiation is especially helpful when choosing the appropriate narrow spectrum antibiotic therapy for individual patients with these diagnoses. In contrast, “skin infections with additional complications” require more broad antibiotic coverage on account of mixed bacterial infection or infection with unusual organisms.
The clinical features of common streptococcal SSTIs and the antibiotics used in the management of these conditions will be further elaborated in this chapter.
2. Streptococcal pyoderma
Superficial skin infection has been described as impetigo or pyoderma. This is in contrast to more invasive diseases cellulitis and erysipelas. Impetigo (and the less precise term pyoderma) refers to superficial infection that begins in the form of a papule that progresses to a vesicle and pustule, ultimately forming crusted lesions (Figure 1). They resolve with hyper or hypopigmentation. These infections are caused either by Staphylococcus or Streptococcus, and one cannot clinically differentiate between the two causative organisms. They occur as a complication of underlying skin diseases like scabies [1] or contact dermatitis. The streptococci associated with these infections are most often group A (S. pyogenes). However other serotypes can also be isolated on cultures from these infections. Although considered benign, these infections could progress to more locally invasive cutaneous diseases (see below) and are associated with post-streptococcal complications like glomerulonephritis and acute rheumatic fever in resource limited populations (as reviewed in other chapters of this textbook).
Figure 1.
Impetigo secondary to infected contact dermatitis.
3. Treatment of impetigo
Antiseptic soaks and antibacterial creams are the mainstay of therapy for impetigo. A wide variety of topical antimicrobial agents are available including silver-based products, iodides, hydrogen peroxide, zinc, chlorhexidine and potassium permanganate. There is very little data in the literature comparing benefits of one product versus the other [7, 8]. Antibacterial creams: mupirocin, Na-fusidate and bacitracin are also available for use in localized superficial skin infections [9]. Drawbacks of topical therapy include development of resistance, risk of irritant or allergic dermatitis (sensitization), and if used in high concentrations, these could cause burn injuries.
4. Invasive streptococcal infections: erysipelas and cellulitis
When skin infection results in erythematous (red in color), edematous (raised above the surface) and well demarcated (sharp boundary between involved and uninvolved skin) areas of involvement, it is referred to as Erysipelas (Figure 2). Erysipelas is characterized by marked edema in the skin, sometimes severe enough to cause skin blisters. While it could be seen at any age, it is more common in the very young and in older individuals. Classically described as occurring on the face, it can be seen in other parts of the body including the trunk and extremities. It is commonly associated with systemic symptoms like fever, chills and body ache, and blood cultures could be positive. Erysipelas is most commonly caused by S. pyogenes but could also be caused by other streptococci and less commonly by S. aureus [10]. Superficial skin culture should not be obtained, and causative organism can be established if blood cultures return positive. The diagnosis is usually clinical and it responds well to antibiotic therapy. However, in patients with uncontrolled diabetes or other immunocompromising conditions, the infection can spread deeper and the patient could develop sepsis and shock. Recurrences—especially on the extremities—are common in patients with underlying chronic lymphedema [11].
Figure 2.
Erysipelas with sharply-defined edematous red skin lesions.
When streptococcal infection involves the skin as well as the subcutaneous tissue, it results in ill-defined areas of erythema that are rapidly spreading and this is called Cellulitis. The skin appears red with irregular spreading borders (Figure 3). The entry point for the infection is a break in the skin like a surgical wound or other skin trauma, underlying dermatoses like eczema and psoriasis or a fungal infection of the intertriginous areas like web spaces of the toes: “athlete’s foot” (Figure 4). The area of the skin involved is tender to touch, and cellulitis is associated with systemic symptoms like fever, chills and body ache. Sometimes infection spreads along a lymphatic channel rather than the entire skin and this is called streptococcal lymphangitis. (Figures 5 and 6) Blood cultures are positive in around 10% of cases [12, 13] which include patients with more severe disease, older patients, patients with underlying liver cirrhosis [12] and diabetes [13]. The yield of blood cultures is higher if cultures are obtained at the time when the patient is experiencing fever and chills. Cellulitis responds very quickly to appropriate antibiotic therapy. As with erysipelas, recurrences are common in those with underlying risk factors, and left untreated, the infection can spread to deeper tissues and result in sepsis and shock.
Figure 3.
Cellulitis with irregular and ill-defined borders.
Figure 4.
Fungal infection in the webspace of the toes, also called “athlete’s foot.”
Figure 5.
Lymphangitic streaking of the upper extremity.
Figure 6.
Lymphangitic streaking (double) of the lower extremity.
In some patients there is an overlap between erysipelas and cellulitis and the clinical differences are not so clear. Importantly, management of both conditions is similar.
5. Treatment of cellulitis and erysipelas
Mild localized infections are treated with oral antibiotics, while more extensive infections or infections with systemic symptoms are treated with parenteral (intravenous) antibiotic therapy [14]. Patients with signs of sepsis: fever or hypothermia, tachycardia and hypotension, and patients with underlying conditions like uncontrolled diabetes, liver cirrhosis, severe peripheral vascular disease or severe lymphedema and patients with immunocompromising conditions like HIV, or patients on chemotherapy should be admitted to the hospital for antibiotics as well as aggressive management of the underlying conditions. Penicillins and β-lactams are considered the antibiotics of choice for treatment of streptococcal cellulitis. The addition of a second antibiotic like trimethoprim/sulfamethoxazole (TMP/SMX) or clindamycin has been shown to provide no additional benefit [6, 15, 16, 17, 18]. Penicillins are available in the form of oral as well as intravenous preparations (Table 1). Extended spectrum penicillins: dicloxacillin, amoxicillin, ampicillin, oxacillin and nafcillin can be used if there is associated methicillin susceptible S. aureus (MSSA) infection. Cephalosporins are among the most commonly used β-lactams for the treatment of cellulitis. Different preparations are available both in the oral as well as the intravenous forms (Table 2). Physician preference and dosing convenience often define the choice of the antibiotic prescribed. Ceftaroline—one of the newest cephalosporins has excellent skin penetration and has activity against methicillin resistant S. aureus (MRSA) [19]. Patients who have an allergy to penicillin will require alternate agents. It should be noted here that there is increasing evidence in the literature indicating patients who claim penicillin allergy may not have a true allergy and are able to tolerate β-lactams [20, 21]. TMP-SMX [22], doxycycline, linezolid, clindamycin and fluoroquinolones (Table 3) all have excellent skin penetration and may be used as alternate oral agents in patients with allergies to penicillin and β-lactams. Severe cellulitis in patients who have a true allergy to both penicillin and β-lactams is treated with intravenous (IV) vancomycin. IV vancomycin requires close monitoring of levels to achieve optimized benefits while avoiding nephrotoxicity [23, 24], and often therapeutic levels are difficult to achieve in obese individuals [25]. Other alternatives to β-lactams are listed in Table 3. Daptomycin is a lipopeptide antibiotic that has excellent skin penetration. [26, 27]. It has the advantage of once- a- day dosing, making daptomycin a convenient agent for outpatient antibiotic therapy (OPAT). Other antibiotics with excellent skin penetration include linezolid [28, 29] and tigecycline [27, 30]. Both these antibiotics are dosed twice a day and hence less convenient for use as OPAT. Tigecycline is only available in the parenteral form and is recommended for patients hospitalized with severe infections. Linezolid is available in both parenteral as well as oral formulations. IV linezolid is used when a patient is hospitalized with severe cellulitis, and treatment can be completed with oral formulation once the patient improves. There are a number of newer agents approved for the management of SSTIs including long acting lipo-glycopeptide agents oritavancin and dalbavancin, extended-spectrum fluoroquinolone delafloxacin, and the new tetracycline derivative omadacycline [28, 29]. Important comments regarding the advantages as well as the potential side effects of these antibiotics are listed in Tables 3 and 4.
Non β-lactam antibiotics used for streptococcal skin infections.
Require dose adjustment in patients with kidney disease.
Name
Drug class
Dose
Comments
Dalbavancin
Lipo-glycopeptide
Intravenous: 1.5 g single dose
One dose IV provides 2 weeks of therapy
Oritavancin
Lipo-glycopeptide
Intravenous: 1.2 g single dose
One dose IV provides 2 weeks of therapy
Delafloxacin
Fluoroquinolone
Intravenous: 300 mg q 12 h Oral: 450 mg twice a day
Allows transition from IV to oral. Risks as with other FQ
Omadacycline
Tetracycline derivative
Intravenous: 200 mg X 1, then 100 mg daily Oral: 450 mg once a day for 2 days, then 300 mg once a day
Allows transition from IV to oral. Gastrointestinal side effects. Effective also against anaerobes
Tedizolid
Oxazolidinone
Intravenous: 200 mg, q 24 h Oral: 200 mg once a day
Allows transition from IV to oral. Risk for cytopenias, neuropathy
Table 4.
Newer antibiotics approved for treatment of skin infections.
Effective also against MSSA, MRSA.
6. Streptococcal infection of deeper tissues
When streptococcal infection spreads deep beyond the subcutaneous tissue, it can result in extensive necrosis (gangrene) of the overlying skin and inflammation and necrosis of underlying fascia (Streptococcal Necrotizing Fasciitis) and even muscle (Streptococcal Myositis). These infections are considered surgical emergencies.
Necrotizing Fasciitis (NF) is characterized by rapidly (within hours) spreading infection of the skin, subcutaneous tissue and fascia with associated symptoms of fever, prostration, hypotension and shock. It carries a high mortality [31]. It could start as a benign appearing skin wound that rapidly spreads both on the surface as well as into deeper tissues and the entire limb or body-part could be involved in a matter of a few hours. Skin changes include a rapid progression from mild erythema to a dusky appearance followed by ecchymosis, purpura, blisters and tissue necrosis—resulting in open wounds often discharging purulent or hemorrhagic fluid. (Figures 7 and 8) “Pain out of proportion to physical findings” is a characteristic sign of NF. In other words, there may be pain when palpating areas beyond the visible area of redness or in other cases even gentle palpation of involved area elicits excruciating pain. Some authorities divide NF into type I and type II. Type I is characterized by poly-microbial infection (involving both aerobic as well as anaerobic bacteria), while type II is characterized by mono-microbial infection of which group A streptococcus is the most commonly implicated organism [32]. Mortality was found to be lower in group A streptococcus—associated NF (type II) compared to type I: 10% versus 20% in one large study [31]. NF may also be seen in persons who inject drugs. In these cases, multiple skip lesions are seen (Figure 9) and infection is usually poly-microbial. In addition to the skin lesions, the patient usually has systemic symptoms of sepsis including high fever, tachycardia, hypotension and may progress to have multi-organ failure. Streptococcal pyrogenic exotoxins (Spe) A, B and C are responsible for causing stimulation of a severe inflammatory cascade resulting in injury not only at the area of infection (local necrosis) but also to distant sites (lungs, kidneys, liver, central nervous system). Blood cultures are universally positive, and imaging of involved body-part (CT scan or MRI) will demonstrate edema and/or gas in the soft tissue planes and other changes consistent with this diagnosis [33].
Figure 7.
Necrotizing fasciitis of the lower extremity.
Figure 8.
Clinical photograph showing erythema, peeling skin, dusky hue and areas of necrosis.
Figure 9.
Necrotic areas with skip lesions on leg of patient who is abusing self with injection drugs.
When infection spreads beyond the fascial planes into the underlying muscles it is called myositis. Streptococcal myositis is often a complication of the overlying skin infection. Sometimes a deep tissue hematoma caused by blunt trauma [34] could get inoculated by the organism in a patient with bacteremia. This too is an emergency and requires rapid surgical intervention to relieve the pressure created by the severe inflammation in the muscle planes (Figure 10). Patients will also have systemic symptoms and signs of sepsis as seen in NF. There is often overlap of these two conditions in many patients.
Figure 10.
Necrosis of skin, soft tissue and muscle with exposure of tendon.
7. Management of necrotizing fasciitis and streptococcal myositis
Patients need admission to the hospital often to the intensive care unit. They require management by a team of experts involving medical, surgical, infectious diseases and critical care specialties. They often present with septic shock and require pressors like epinephrine, norepinephrine and vasopressin to maintain adequate blood pressure in order to perfuse critical organs. Patients require broad spectrum antibiotic coverage, aggressive fluid resuscitation, as well as emergent aggressive debridement of the infected areas. Surgical removal of infected/necrotic tissue is essential in order to reduce bacterial burden and hence remove the source of toxins. Often patients require a second or even third visit to the operating room because of extensive tissue necrosis not amenable to removal in a single operation [14]. Operative tissue is sent for microbiology (cultures) to help determine the infectious agent and obtain an antibiotic sensitivity profile to help guide appropriate antibiotic choices. While awaiting the results of cultures, the antibiotics chosen should cover Gram-positive bacteria including Streptococcus and S. aureus, Gram-negative bacteria including drug-resistant bacteria like Pseudomonas, as well as anaerobic bacteria. Different combinations of antibiotics from Tables 1–3 can be used. IV vancomycin (or IV daptomycin) plus cefepime (or fluoroquinolone) plus metronidazole, or IV vancomycin (or IV daptomycin) plus meropenem (or imipenem), or IV daptomycin plus piperacillin- tazobactam are some potential options for empiric therapy. Linezolid could be used in place of vancomycin and daptomycin in the above combinations. Vancomycin, daptomycin and linezolid provide Gram-positive coverage, cefepime and fluoroquinolones provide Gram-negative coverage. While metronidazole provides only anaerobic coverage, imipenem, meropenem and piperacillin-tazobactam provide Gram-negative as well as anaerobic coverage. Clindamycin is added in the initial critical stages of the infection on account of its antitoxin effect [14, 33]. If linezolid is used, additional clindamycin is not required because linezolid itself also has an antitoxin effect [33]. When culture results become available, antibiotics should be deescalated to target the organisms identified. Intravenous immunoglobulins (IVIG) is used at some centers as part of management of NF, however large studies have not shown a statistically significant benefit compared to those patients who did not receive IVIG [14, 33].
8. Toxic shock syndrome (TSS)
TSS is associated with a dramatic widespread skin rash and severe systemic symptoms. This condition is not due to direct inoculation of the skin with Streptococcus, but rather it is secondary to exotoxin [35] released by Streptococcus infection at a distant site. Originally described in children with S. aureus infection, TSS is seen with Streptococcus and Clostridial infection in children as well as adults [36]. Patients present with widespread rash associated with fever, hypotension and multi-organ system involvement as a result of circulating streptococcal exotoxins A, B and C. The rash is described as sheets of erythema (Figure 11) involving the face, trunk as well as extremities, and it subsides with characteristic desquamation (Figure 12) when the patient recovers. A detailed examination is important to determine the source of infection: either retained foreign body like menstrual tampon or surgical sponge/dressing material, necrotizing infection in a deep space, post-operative wound infection or peritonitis. Rarely, streptococcal pharyngitis is the primary event. The circulating toxins (super-antigens) are responsible for injury to internal organs—lungs, kidneys, liver [35] and the disease can be fatal in 40 to 60% cases of streptococcal TSS especially when there is delay in the diagnosis and hence delayed initiation of appropriate antibiotics. Blood cultures may be positive, as are cultures from an identified focus of infection.
Figure 11.
Clinical photograph of sheet of erythema seen in acute phase of toxic shock syndrome.
Figure 12.
Toxic shock syndrome with desquamation in the recovery phase.
9. Management of TSS
As with other severe streptococcal infection, patients with TSS require admission to the hospital. If they are hypotensive or experience multi-organ failure, management is in the intensive care unit where patients are treated with aggressive fluid resuscitation, broad antibiotic therapy (choices similar to that as described for management of necrotizing fasciitis) and pressor support. Surgery may be required if a deep focus of infection is identified. Rarely patients do not respond to standard therapy and may require intravenous immunoglobulins (IVIG) [36].
10. Discussion on general principles of systemic antibiotic therapy
Streptococcal SSTIs respond very well to antibiotic therapy. A wide range of antibiotics with excellent skin penetration are now available as noted in Table 1–4. All antibiotics carry the potential for side effects like allergic reactions and gastrointestinal disturbances. There are some side effects that are unique to certain antibiotics and patients need to be monitored for these toxicities. For example: β-lactam antibiotics have the potential for hepatotoxicity, vancomycin is associated with nephrotoxicity, daptomycin can cause rhabdomyolysis and eosinophilic pneumonitis and clindamycin is one of the most common antibiotics associated with Clostridioides difficile (C. Diff) infection. In addition, inappropriate use of broad-spectrum antibiotics—and even prolonged use of narrow spectrum antibiotics—can result in collateral damage (destruction of protective normal bacterial flora of the skin and the gastrointestinal tract) and cause antibiotic-associated diarrhea and C. Diff infection [37, 38]. Indiscriminate use of broad-spectrum antibiotics has also contributed to the development of multidrug-resistant pathogens [39]. Therefore, judicious use of antibiotics is very important to reduce the risk of these complications. Streptococcal infections should be treated with narrow spectrum antibiotics like penicillin and β-lactams. When streptococcal cellulitis or erysipelas does not seem to be responding adequately within the first 2–3 days of β-lactam therapy, antibiotics with additional coverage against MRSA will need to be used.
11. Specific points regarding treatment of SSTIs
Mild infections should be treated with oral antibiotics.
Severe infections (severe local skin infection with systemic symptoms like fever, tachycardia, hypotension or leukocytosis and bacteremia, or more extensive skin infections even without systemic symptoms) will require parenteral therapy, with step-down to oral therapy as the patient improves [40]. Antibiotics like the floroquinolones: ciprofloxacin, levofloxacin, delafloxacin [41, 42], moxifloxacin [43], the oxazolidinones: linezolid, tedizolid and the new tetracycline: omadacycline [44] have excellent oral bioavailability and allow early conversion from intravenous to oral therapy.
In the most serious cases: sepsis, septic shock, necrotizing fasciitis, myositis, toxic shock syndrome: broad-spectrum antibiotics are required initially (most often with more than one antimicrobial agent) to cover Streptococcus, S. aureus including MRSA as well as gram-negative and anaerobic bacteria. “De-escalation” can be achieved once microbiology data (blood cultures, deep tissue and intraoperative cultures) are available to guide the final antibiotic choice targeting the bacteria identified.
Duration of antibiotics: This depends on the severity of the infection as well as the clinical response to therapy. Mild infections or even severe infections in an otherwise healthy host that respond rapidly to antibiotics could be treated for as short as 5 days [14, 45, 46]. More severe infections or infections with a delayed response to therapy may need longer courses like 7, 10 or 14 days, depending upon the clinical picture. Shorter courses may be possible with some of the newer antibiotics including single dose antibiotics like dalbavancin [47] and oritavancin [28]. Relapses are found to be more common in patients with shorter courses of therapy [45]. Patients with bacteremia are usually treated for 14 days.
Dose adjustments: Antibiotics are cleared by the liver or kidney and hence dosage needs to be reduced in patients with liver or kidney disease in order to avoid toxicity. Conversely, patients who are obese require a higher dose of the antibiotic to achieve therapeutic levels in the skin [25, 48].
Suppressive therapy is attempted for patients with multiple recurrences [45, 49, 50]. Oral penicillin twice daily showed a 70–80% reduction in episodes—but recurrences occurred after discontinuation of prophylaxis. Treatment of underlying factors like athlete’s foot, chronic lymphedema, peripheral vascular disease and uncontrolled diabetes is also very important in the prevention of recurrences [11, 44, 45, 51]
.
12. Conclusions
Streptococcal skin infections cause significant morbidity all over the world, and severe infections like necrotizing fasciitis and toxic shock syndrome can be fatal. There is a wide spectrum of manifestations of skin infections ranging from mild superficial disease to deep necrotic and life-threatening infections. Skin infection is one of the most common reasons for prescriptions of antibiotics in the community as well as in hospitalized patients. Some of the most commonly used antibiotics have excellent skin penetration and hence the armamentarium to treat skin infections is quite large. Over the last few years there have been multiple new antibiotics approved for the treatment of skin infections and these should be reserved for treatment of severe infections not responding to the common antibiotics and for infections with multi-drug-resistant organisms. A thorough understanding of the different types of skin infections, as well as a detailed knowledge of the different antibiotics are essential for the early diagnosis and selection of the most appropriate antibiotic for the management of simple as well as complex skin infections.
\n',keywords:"Streptococcus, Skin and Skin-Structure Infections (SSTI), Necrotizing Fasciitis (NF), Toxic Shock syndrome (TSS)",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/80546.pdf",chapterXML:"https://mts.intechopen.com/source/xml/80546.xml",downloadPdfUrl:"/chapter/pdf-download/80546",previewPdfUrl:"/chapter/pdf-preview/80546",totalDownloads:62,totalViews:0,totalCrossrefCites:0,dateSubmitted:"November 27th 2021",dateReviewed:"January 27th 2022",datePrePublished:"February 21st 2022",datePublished:null,dateFinished:"February 21st 2022",readingETA:"0",abstract:"Infections attributable to Streptococcus are protean. These range from mild skin and soft tissue infections to life-threatening conditions like meningitis, endocarditis and toxic shock syndrome. In addition, streptococcal infection can be associated with noninfectious sequelae like rheumatic fever and post-streptococcal glomerulonephritis. There is a wide range of Streptococcus spp. causing human infections and different classifications of these organisms have been described, the most quoted being the Lancefield classification based on cell-wall antigens. Streptococci can be studied based on their species: S. pyogenes, S. pneumoniae, S. anginosus etc. or by the Lancefield classification group A, B, C, D etc. or by the clinical syndromes associated with these bacteria. This chapter will describe clinical syndromes associated with streptococcal skin and soft tissue infections ranging from mild: cellulitis and lymphangitis which can be treated in the out-patient setting, to more aggressive manifestations that require hospitalization (sepsis and toxic shock syndrome) and even surgery (necrotizing fasciitis, myositis and gangrene), It will also provide clues to clinical diagnosis as well as suggest recommendations for optimized management of these conditions.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/80546",risUrl:"/chapter/ris/80546",signatures:"Alwyn Rapose",book:{id:"10828",type:"book",title:"Streptococcal Infections",subtitle:null,fullTitle:"Streptococcal Infections",slug:null,publishedDate:null,bookSignature:"Dr. Hassan Hemeg",coverURL:"https://cdn.intechopen.com/books/images_new/10828.jpg",licenceType:"CC BY 3.0",editedByType:null,isbn:"978-1-80355-316-0",printIsbn:"978-1-80355-315-3",pdfIsbn:"978-1-80355-317-7",isAvailableForWebshopOrdering:!0,editors:[{id:"187330",title:"Dr.",name:"Hassan",middleName:null,surname:"Hemeg",slug:"hassan-hemeg",fullName:"Hassan Hemeg"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:null,sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Streptococcal pyoderma",level:"1"},{id:"sec_3",title:"3. Treatment of impetigo",level:"1"},{id:"sec_4",title:"4. Invasive streptococcal infections: erysipelas and cellulitis",level:"1"},{id:"sec_5",title:"5. Treatment of cellulitis and erysipelas",level:"1"},{id:"sec_6",title:"6. Streptococcal infection of deeper tissues",level:"1"},{id:"sec_7",title:"7. Management of necrotizing fasciitis and streptococcal myositis",level:"1"},{id:"sec_8",title:"8. Toxic shock syndrome (TSS)",level:"1"},{id:"sec_9",title:"9. Management of TSS",level:"1"},{id:"sec_10",title:"10. Discussion on general principles of systemic antibiotic therapy",level:"1"},{id:"sec_11",title:"11. Specific points regarding treatment of SSTIs",level:"1"},{id:"sec_12",title:"12. Conclusions",level:"1"}],chapterReferences:[{id:"B1",body:'Sims Sanyahumbi A, Colquhoun S, Wyber R, et al. Global disease burden of Group A Streptococcus. In: Ferretti JJ, Stevens DL, Fischetti VA, editors. Streptococcus pyogenes: Basic Biology to Clinical Manifestations. Oklahoma City (OK), USA: University of Oklahoma Health Sciences Center; 2016'},{id:"B2",body:'https://wwwnc.cdc.gov/eid/article/15/9/08-1228_article [Accessed: November 15, 2021]'},{id:"B3",body:'https://wwwnc.cdc.gov/eid/article/27/2/20-1945_article [Accessed: November 15, 2021]'},{id:"B4",body:'Norris AH, Shrestha NK, Allison GM, et al. 2018 Infectious Diseases Society of America Clinical Practice Guideline for the Management of Outpatient Parenteral Antimicrobial Therapy. Clinical Infectious Diseases. 2019;68(1):e1-e35'},{id:"B5",body:'Keyloun KR, Weber DJ, Gardstein BM, et al. Economic burden of hospital admissions for patients with acute bacterial skin and skin structure infections in the United States. Hospital Practice. 2018;46(5):278-286'},{id:"B6",body:'Jenkins TC, Sabel AL, Sarcone EE, et al. 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Ceftaroline fosamil and treatment of acute bacterial skin and skin structure infections: CAPTURE study experience. Chemotherapy. 2013;25(6):341-346'},{id:"B20",body:'Blumenthal KG, Peter JG, Trubiano JA, et al. Antibiotic allergy. Lancet. 2019;393(10167):183-198'},{id:"B21",body:'Staicu ML, Vyles D, Shenoy ES, et al. Penicillin allergy delabeling: A multidisciplinary opportunity. The Journal of Allergy and Clinical Immunology. 2020;8(9):2858-2868'},{id:"B22",body:'Bowen AC, Carapetis JR, Currie BJ, et al. Sulfamethoxazole-Trimethoprim (Cotrimoxazole) for skin and soft tissue infections including impetigo, cellulitis, and abscess. Open Forum Infectious Diseases. 2017;4(4):ofx232'},{id:"B23",body:'Rybak MJ, Le J, Lodise TP, et al. Therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus infections: A revised consensus guideline and review by the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists. American Journal of Health-System Pharmacy. 2020;77(11):835-864'},{id:"B24",body:'Jorgensen SCJ, Murray KP, Lagnf AM, et al. A multicenter evaluation of vancomycin-associated acute kidney injury in hospitalized patients with acute bacterial skin and skin structure infections. Infectious Disease and Therapy. 2020;9(1):89-106'},{id:"B25",body:'Smit C, Wasmann RE, Goulooze SC, et al. Population pharmacokinetics of vancomycin in obesity: Finding the optimal dose for (morbidly) obese individuals. British Journal of Clinical Pharmacology. 2020;86(2):303-317'},{id:"B26",body:'Sauermann R, Rothenburger M, Graninger W, et al. Daptomycin: A review 4 years after first approval. Pharmacology. 2008;81(2):79-91'},{id:"B27",body:'Eckmann C, Dryden M. Treatment of complicated skin and soft-tissue infections caused by resistant bacteria: Value of linezolid, tigecycline, daptomycin and vancomycin. European Journal of Medical Research. 2010;15(12):554-563'},{id:"B28",body:'Golan Y. Current treatment options for acute skin and skin-structure infections. Clinical Infectious Diseases. 2019;68(Suppl. 3):S206-S212'},{id:"B29",body:'Crotty MP, Krekel T, Burnham CA, et al. New gram-positive agents: The next generation of oxazolidinones and lipoglycopeptides. Journal of Clinical Microbiology. 2016;54(9):2225-2232'},{id:"B30",body:'Grolman DC. Therapeutic applications of tigecycline in the management of complicated skin and skin structure infections. International Journal of Infectious Diseases. 2007;11(Suppl. 1):S7-S15'},{id:"B31",body:'Bruun T, Rath E, Madsen MB, et al. Risk factors and predictors of mortality in streptococcal necrotizing soft-tissue infections: A multicenter prospective study. INFECT Study Group. Clinical Infectious Diseases. 2021;72(2):293-300'},{id:"B32",body:'Kiat HJ, En Natalie YH, Fatimah LJ. Necrotizing fasciitis: How reliable are the cutaneous signs? Journal of Emergencies, Trauma and Shock. 2017;10(4):205-210'},{id:"B33",body:'Bonne SL, Kadri SS. Evaluation and management of necrotizing soft tissue infections. Infectious Disease Clinics of North America. 2017;31(3):497-511'},{id:"B34",body:'Nuwayhid ZB, Aronoff DM, Mulla ZD. Blunt trauma as a risk factor for group A streptococcal necrotizing fasciitis. Annals of Epidemiology. 2007;17(11):878-881'},{id:"B35",body:'Emgård J, Bergsten H, McCormick JK, et al. MAIT cells are major contributors to the cytokine response in group A streptococcal toxic shock syndrome. Proceedings of the National Academy of Sciences of the United States of America. 2019;116(51):25923-25931'},{id:"B36",body:'Rapose A. Toxic Shock Syndrome. In: Conn’s Current Therapy. Philadelphia (PA), USA: Elsevier Health Sciences; 2021. pp. 666-668'},{id:"B37",body:'Brown KA, Khanafer N, Daneman N, et al. Meta-analysis of antibiotics and the risk of community-associated Clostridium difficile infection. Antimicrobial Agents and Chemotherapy. 2013;57(5):2326-2332'},{id:"B38",body:'Webb BJ, Subramanian A, Lopansri B, et al. Antibiotic exposure and risk for hospital-associated Clostridioides difficile infection. Antimicrobial Agents and Chemotherapy. 2020;64(4):e02169-e02119'},{id:"B39",body:'Moghnieh R, Estaitieh N, Mugharbil A, et al. Third generation cephalosporin resistant Enterobacteriaceae and multidrug resistant gram-negative bacteria causing bacteremia in febrile neutropenia adult cancer patients in Lebanon, broad spectrum antibiotics use as a major risk factor, and correlation with poor prognosis. Frontiers in Cellular and Infection Microbiology. 2015;12(5):11'},{id:"B40",body:'Nathwani D, Dryden M, Garau J. Early clinical assessment of response to treatment of skin and soft-tissue infections: How can it help clinicians? Perspectives from Europe. International Journal of Antimicrobial Agents. 2016;48(2):127-136'},{id:"B41",body:'O\'Riordan W, McManus A, Teras J, et al. A comparison of the efficacy and safety of intravenous followed by oral delafloxacin with vancomycin plus aztreonam for the treatment of acute bacterial skin and skin structure infections: A phase 3, Multinational, Double-Blind, Randomized Study. PROCEED Study Group. Clinical Infectious Diseases. 2018;67(5):657-666'},{id:"B42",body:'Kingsley J, Mehra P, Lawrence LE, et al. A randomized, double-blind, Phase 2 study to evaluate subjective and objective outcomes in patients with acute bacterial skin and skin structure infections treated with delafloxacin, linezolid or vancomycin. The Journal of Antimicrobial Chemotherapy. 2016;71(3):821-829'},{id:"B43",body:'Gyssens IC, Dryden M, Kujath P, et al. A randomized trial of the efficacy and safety of sequential intravenous/oral moxifloxacin monotherapy versus intravenous piperacillin/tazobactam followed by oral amoxicillin/clavulanate for complicated skin and skin structure infections. The Journal of Antimicrobial Chemotherapy. 2011;66(11):2632-2642'},{id:"B44",body:'Abrahamian FM, Sakoulas G, Tzanis E, et al. Omadacycline for acute bacterial skin and skin structure infections. Clinical Infectious Diseases. 2019;69(Suppl. 1):S23-S32'},{id:"B45",body:'Cranendonk DR, Opmeer BC, van Agtmael MA, et al. Antibiotic treatment for 6 days versus 12 days in patients with severe cellulitis: A multicentre randomized, double-blind, placebo-controlled, non-inferiority trial. Clinical Microbiology and Infection. 2020;26(5):606-612'},{id:"B46",body:'Morris AD. Cellulitis and erysipelas. BMJ Clinical Evidence. 2008;2008:1708'},{id:"B47",body:'Bennett JW, Lewis JS, Ellis MW. Dalbavancin in the treatment of complicated skin and soft-tissue infections: A review. Therapeutics and Clinical Risk Management. 2008;4(1):31-40'},{id:"B48",body:'Grupper M, Nicolau DP. Obesity and skin and soft tissue infections: How to optimize antimicrobial usage for prevention and treatment? Current Opinion in Infectious Diseases. 2017;30(2):180-191'},{id:"B49",body:'Thomas KS, Crook AM, Nunn AJ, et al. Penicillin to prevent recurrent leg cellulitis. The New England Journal of Medicine. 2013;368(18):1695-1703'},{id:"B50",body:'Dalal A, Eskin-Schwartz M, Mimouni D, et al. Interventions for the prevention of recurrent erysipelas and cellulitis. Cochrane Database of Systematic Reviews. 2017;6(6):CD009758'},{id:"B51",body:'Wilcox M, Yan JL, Gonzalez PL, et al. Impact of underlying comorbidities on outcomes of patients treated with Ceftaroline Fosamil for complicated skin and soft tissue infections: Pooled results from three phase III Randomized Clinical Trials. Infectious Disease and Therapy. 2022;11(1):217-230'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Alwyn Rapose",address:"Alwyn.rapose@reliantmedicalgroup.org",affiliation:'
University of Massachusetts Medical School, Reliant Medical Group, Worcester, Massachusetts, USA
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IntechOpen implements a robust policy to minimize and deal with instances of fraud or misconduct. As part of our general commitment to transparency and openness, and in order to maintain high scientific standards, we have a well-defined editorial policy regarding Retractions and Corrections.
",metaTitle:"Retraction and Correction Policy",metaDescription:"Retraction and Correction Policy",metaKeywords:null,canonicalURL:"/page/retraction-and-correction-policy",contentRaw:'[{"type":"htmlEditorComponent","content":"
IntechOpen’s Retraction and Correction Policy has been developed in accordance with the Committee on Publication Ethics (COPE) publication guidelines relating to scientific misconduct and research ethics:
\\n\\n
1. RETRACTIONS
\\n\\n
A Retraction of a Chapter will be issued by the Academic Editor, either following an Author’s request to do so or when there is a 3rd party report of scientific misconduct. Upon receipt of a report by a 3rd party, the Academic Editor will investigate any allegations of scientific misconduct, working in cooperation with the Author(s) and their institution(s).
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A formal Retraction will be issued when there is clear and conclusive evidence of any of the following:
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\\n\\t
Data fabrication
\\n\\t
Data recycling in a purportedly original research article
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Severe plagiarism - whether or not the plagiarism is to be deemed severe will be determined by the Academic Editor and verified by plagiarism checking software
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Double publication
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Copyright infringement - for example, if a Chapter uses copyrighted figures without permission.
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Unreliable findings
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Unethical research practices
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Any other practice or act considered potentially harmful to the scientific community.
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Publishing of a Retraction Notice will adhere to the following guidelines:
\\n\\n\\n\\t
All relevant bibliographic information about a retracted Chapter will be given in the title.
\\n\\t
A Retraction Notice will be published as a regular book Chapter and will be given its own Chapter number.
\\n\\n\\n
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Authors shall be required to approve a proposed retraction of their Chapter. If Authors maintain that their Chapter should not be retracted, the Academic Editor may issue a Statement of Concern (see 2. below).
\\n
\\n\\n
1.2. REMOVALS AND CANCELLATIONS
\\n\\n
\\n\\t
Additionally, a Chapter retracted on grounds of copyright infringement (e.g. double publication) may be Removed by the publisher should the original copyright owner request such action. A Chapter retracted on grounds of its potential to harm the scientific community, for example, when a Chapter is defamatory in nature, may also be subject to removal.
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No formal Removal Notice will be published but a notice citing the reason for removal will be prominently displayed in place of a retracted and subsequently removed Chapter.
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Chapters published due to inadvertent production mistakes shall be canceled and the cancellation notice will be published.
\\n
\\n\\n
2. STATEMENTS OF CONCERN
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A Statement of Concern detailing alleged misconduct will be issued by the Academic Editor or publisher following a 3rd party report of scientific misconduct when:
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\\n\\t
Authors refuse to approve a retraction proposed by the Academic Editor
\\n\\t
There is inconclusive evidence of scientific misconduct
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Authors and their respective institutions fail or refuse to provide adequate assistance in an investigation
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The publication of a Statement of Concern will adhere to the Retraction Notice guidelines outlined above
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An article PDF for which a Statement of Concern is published will remain available online without being edited or watermarked
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IntechOpen believes that the number of occasions on which a Statement of Concern is issued will be very few in number. In all cases when such a decision has been taken by the Academic Editor the decision will be reviewed by another editor to whom the author can make representations.
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3. CORRECTIONS
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A Correction will be issued by the Academic Editor when:
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Only a small portion of a Chapter is flawed in a way that does not severely affect any findings.
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It is determined that the scientific community would be better served by a Correction rather than a Retraction.
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Corrections will be issued in one of two distinct forms -- ERRATUM or CORRIGENDUM, depending on the origin of a mistake.
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\\n\\n
3.1. ERRATUM
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An Erratum will be issued by the Academic Editor when it is determined that a mistake in a Chapter originates from the production process handled by the publisher.
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A published Erratum will adhere to the Retraction Notice publishing guidelines outlined above.
\\n\\n
3.2. CORRIGENDUM
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A Corrigendum will be issued by the Academic Editor when it is determined that a mistake in a Chapter is a result of an Author’s miscalculation or oversight. A published Corrigendum will adhere to the Retraction Notice publishing guidelines outlined above.
\\n\\n
4. FINAL REMARKS
\\n\\n
IntechOpen wishes to emphasize that the final decision on whether a Retraction, Statement of Concern, or a Correction will be issued rests with the Academic Editor. The publisher is obliged to act upon any reports of scientific misconduct in its publications and to make a reasonable effort to facilitate any subsequent investigation of such claims.
\\n\\n
In the case of Retraction or removal of the Work, the publisher will be under no obligation to refund the APC.
\\n\\n
The general principles set out above apply to Retractions and Corrections issued in all IntechOpen publications.
IntechOpen’s Retraction and Correction Policy has been developed in accordance with the Committee on Publication Ethics (COPE) publication guidelines relating to scientific misconduct and research ethics:
\n\n
1. RETRACTIONS
\n\n
A Retraction of a Chapter will be issued by the Academic Editor, either following an Author’s request to do so or when there is a 3rd party report of scientific misconduct. Upon receipt of a report by a 3rd party, the Academic Editor will investigate any allegations of scientific misconduct, working in cooperation with the Author(s) and their institution(s).
\n\n
A formal Retraction will be issued when there is clear and conclusive evidence of any of the following:
\n\n
\n\t
Data fabrication
\n\t
Data recycling in a purportedly original research article
\n\t
Severe plagiarism - whether or not the plagiarism is to be deemed severe will be determined by the Academic Editor and verified by plagiarism checking software
\n\t
Double publication
\n\t
Copyright infringement - for example, if a Chapter uses copyrighted figures without permission.
\n\t
Unreliable findings
\n\t
Unethical research practices
\n\t
Any other practice or act considered potentially harmful to the scientific community.
\n
\n\n
Publishing of a Retraction Notice will adhere to the following guidelines:
\n\n\n\t
All relevant bibliographic information about a retracted Chapter will be given in the title.
\n\t
A Retraction Notice will be published as a regular book Chapter and will be given its own Chapter number.
\n\n\n
\n\t
Authors shall be required to approve a proposed retraction of their Chapter. If Authors maintain that their Chapter should not be retracted, the Academic Editor may issue a Statement of Concern (see 2. below).
\n
\n\n
1.2. REMOVALS AND CANCELLATIONS
\n\n
\n\t
Additionally, a Chapter retracted on grounds of copyright infringement (e.g. double publication) may be Removed by the publisher should the original copyright owner request such action. A Chapter retracted on grounds of its potential to harm the scientific community, for example, when a Chapter is defamatory in nature, may also be subject to removal.
\n\t
No formal Removal Notice will be published but a notice citing the reason for removal will be prominently displayed in place of a retracted and subsequently removed Chapter.
\n\t
Chapters published due to inadvertent production mistakes shall be canceled and the cancellation notice will be published.
\n
\n\n
2. STATEMENTS OF CONCERN
\n\n
A Statement of Concern detailing alleged misconduct will be issued by the Academic Editor or publisher following a 3rd party report of scientific misconduct when:
\n\n
\n\t
Authors refuse to approve a retraction proposed by the Academic Editor
\n\t
There is inconclusive evidence of scientific misconduct
\n\t
Authors and their respective institutions fail or refuse to provide adequate assistance in an investigation
\n\t
The publication of a Statement of Concern will adhere to the Retraction Notice guidelines outlined above
\n\t
An article PDF for which a Statement of Concern is published will remain available online without being edited or watermarked
\n
\n\n
IntechOpen believes that the number of occasions on which a Statement of Concern is issued will be very few in number. In all cases when such a decision has been taken by the Academic Editor the decision will be reviewed by another editor to whom the author can make representations.
\n\n
3. CORRECTIONS
\n\n
A Correction will be issued by the Academic Editor when:
\n\n
\n\t
Only a small portion of a Chapter is flawed in a way that does not severely affect any findings.
\n\t
It is determined that the scientific community would be better served by a Correction rather than a Retraction.
\n\t
Corrections will be issued in one of two distinct forms -- ERRATUM or CORRIGENDUM, depending on the origin of a mistake.
\n
\n\n
3.1. ERRATUM
\n\n
An Erratum will be issued by the Academic Editor when it is determined that a mistake in a Chapter originates from the production process handled by the publisher.
\n\n
A published Erratum will adhere to the Retraction Notice publishing guidelines outlined above.
\n\n
3.2. CORRIGENDUM
\n\n
A Corrigendum will be issued by the Academic Editor when it is determined that a mistake in a Chapter is a result of an Author’s miscalculation or oversight. A published Corrigendum will adhere to the Retraction Notice publishing guidelines outlined above.
\n\n
4. FINAL REMARKS
\n\n
IntechOpen wishes to emphasize that the final decision on whether a Retraction, Statement of Concern, or a Correction will be issued rests with the Academic Editor. The publisher is obliged to act upon any reports of scientific misconduct in its publications and to make a reasonable effort to facilitate any subsequent investigation of such claims.
\n\n
In the case of Retraction or removal of the Work, the publisher will be under no obligation to refund the APC.
\n\n
The general principles set out above apply to Retractions and Corrections issued in all IntechOpen publications.
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The existing variety of proposed approaches is classified in accordance with the “big five rules” for these assays, including proper sample, receptor, interaction, response, and output. The solutions for rapid extraction of target analytes and preventing negative influence of extractants are considered. Role to antibodies affinity and specificity is characterized. Potential of alternate bioreceptor molecules is discussed. Immunoreactants’ compositions, concentrations, and locations on the test strip are characterized as factors determining assay parameters. The existing variety of labels is compared in terms of their optical and alternate registration. Tools to modulate a sequence of analytical reactions and to form aggregates of the detected labels are considered. 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The existing variety of proposed approaches is classified in accordance with the “big five rules” for these assays, including proper sample, receptor, interaction, response, and output. The solutions for rapid extraction of target analytes and preventing negative influence of extractants are considered. Role to antibodies affinity and specificity is characterized. Potential of alternate bioreceptor molecules is discussed. Immunoreactants’ compositions, concentrations, and locations on the test strip are characterized as factors determining assay parameters. The existing variety of labels is compared in terms of their optical and alternate registration. Tools to modulate a sequence of analytical reactions and to form aggregates of the detected labels are considered. The discussed approaches are illustrated through developments of test strips for detection of mycotoxins, veterinary drugs, and other analytes.",book:{id:"6470",slug:"rapid-test-advances-in-design-format-and-diagnostic-applications",title:"Rapid Test",fullTitle:"Rapid Test - Advances in Design, Format and Diagnostic Applications"},signatures:"Anatoly V. Zherdev and Boris B. Dzantiev",authors:[{id:"175229",title:"Dr.",name:"Anatoly",middleName:null,surname:"Zherdev",slug:"anatoly-zherdev",fullName:"Anatoly Zherdev"},{id:"224281",title:"Prof.",name:"Boris",middleName:"B",surname:"Dzantiev",slug:"boris-dzantiev",fullName:"Boris Dzantiev"}]},{id:"60908",title:"Microarrays as Platform for Multiplex Assays in Biomarker and Drug Discovery",slug:"microarrays-as-platform-for-multiplex-assays-in-biomarker-and-drug-discovery",totalDownloads:1141,totalCrossrefCites:2,totalDimensionsCites:5,abstract:"Despite the tremendous advances in the understanding of the molecular mechanisms and the complexity of the diseases is one of the present challenges for the scientific community; then, novel strategies are required to be designed and developed for effective strategies for early diagnosis and treatment. As many cellular alterations are observed at protein level, high-throughput assays are dramatically needed for biomarker discovery. Herein, we describe advantages and limitations of protein microarrays, as proteomics strategy useful for multiplex and high-throughput protein characterization in clinical samples. 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Worldwide prevalence of SLE is difficult to report mainly due to difficulty in diagnosis as a result of its heterogeneous nature and nonspecific protean manifestations. Currently, circulating anti-DNA antibodies are the most specific diagnostic biomarkers for SLE where many detection assays are being employed in clinical practice. However, the diagnostic value of these techniques is challenged by the detection of only subpopulations of these antibodies with varying sensitivity and specificity. This is mainly attributed to differences in the antigen source and presentation and in the employed reaction conditions. This chapter will thoroughly discuss the technology, advantages, and limitations of each assay in addition to a special focus on the recently developed diagnostic technologies and novel biomarkers. 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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"}}}}]},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.
\r\n
\r\n\t
\r\n
\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.
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Buchholz",profilePictureURL:"https://mts.intechopen.com/storage/users/89438/images/6463_n.jpg",institutionString:null,institution:{name:"Loma Linda University",institutionURL:null,country:{name:"United States of America"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null}]},subseriesFiltersForPublishedBooks:[{group:"subseries",caption:"Plant Physiology",value:13,count:1},{group:"subseries",caption:"Human Physiology",value:12,count:2},{group:"subseries",caption:"Cell Physiology",value:11,count:8}],publicationYearFilters:[{group:"publicationYear",caption:"2022",value:2022,count:1},{group:"publicationYear",caption:"2020",value:2020,count:4},{group:"publicationYear",caption:"2019",value:2019,count:5},{group:"publicationYear",caption:"2018",value:2018,count:1}],authors:{paginationCount:148,paginationItems:[{id:"165328",title:"Dr.",name:"Vahid",middleName:null,surname:"Asadpour",slug:"vahid-asadpour",fullName:"Vahid Asadpour",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/165328/images/system/165328.jpg",biography:"Vahid Asadpour, MS, Ph.D., is currently with the Department of Research and Evaluation, Kaiser Permanente Southern California. He has both an MS and Ph.D. in Biomedical Engineering. He was previously a research scientist at the University of California Los Angeles (UCLA) and visiting professor and researcher at the University of North Dakota. He is currently working in artificial intelligence and its applications in medical signal processing. In addition, he is using digital signal processing in medical imaging and speech processing. Dr. Asadpour has developed brain-computer interfacing algorithms and has published books, book chapters, and several journal and conference papers in this field and other areas of intelligent signal processing. He has also designed medical devices, including a laser Doppler monitoring system.",institutionString:"Kaiser Permanente Southern California",institution:null},{id:"169608",title:"Prof.",name:"Marian",middleName:null,surname:"Găiceanu",slug:"marian-gaiceanu",fullName:"Marian Găiceanu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/169608/images/system/169608.png",biography:"Prof. Dr. Marian Gaiceanu graduated from the Naval and Electrical Engineering Faculty, Dunarea de Jos University of Galati, Romania, in 1997. He received a Ph.D. (Magna Cum Laude) in Electrical Engineering in 2002. Since 2017, Dr. Gaiceanu has been a Ph.D. supervisor for students in Electrical Engineering. He has been employed at Dunarea de Jos University of Galati since 1996, where he is currently a professor. Dr. Gaiceanu is a member of the National Council for Attesting Titles, Diplomas and Certificates, an expert of the Executive Agency for Higher Education, Research Funding, and a member of the Senate of the Dunarea de Jos University of Galati. He has been the head of the Integrated Energy Conversion Systems and Advanced Control of Complex Processes Research Center, Romania, since 2016. He has conducted several projects in power converter systems for electrical drives, power quality, PEM and SOFC fuel cell power converters for utilities, electric vehicles, and marine applications with the Department of Regulation and Control, SIEI S.pA. (2002–2004) and the Polytechnic University of Turin, Italy (2002–2004, 2006–2007). He is a member of the Institute of Electrical and Electronics Engineers (IEEE) and cofounder-member of the IEEE Power Electronics Romanian Chapter. He is a guest editor at Energies and an academic book editor for IntechOpen. He is also a member of the editorial boards of the Journal of Electrical Engineering, Electronics, Control and Computer Science and Sustainability. Dr. Gaiceanu has been General Chairman of the IEEE International Symposium on Electrical and Electronics Engineering in the last six editions.",institutionString:'"Dunarea de Jos" University of Galati',institution:{name:'"Dunarea de Jos" University of Galati',country:{name:"Romania"}}},{id:"4519",title:"Prof.",name:"Jaydip",middleName:null,surname:"Sen",slug:"jaydip-sen",fullName:"Jaydip Sen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/4519/images/system/4519.jpeg",biography:"Jaydip Sen is associated with Praxis Business School, Kolkata, India, as a professor in the Department of Data Science. His research areas include security and privacy issues in computing and communication, intrusion detection systems, machine learning, deep learning, and artificial intelligence in the financial domain. He has more than 200 publications in reputed international journals, refereed conference proceedings, and 20 book chapters in books published by internationally renowned publishing houses, such as Springer, CRC press, IGI Global, etc. Currently, he is serving on the editorial board of the prestigious journal Frontiers in Communications and Networks and in the technical program committees of a number of high-ranked international conferences organized by the IEEE, USA, and the ACM, USA. He has been listed among the top 2% of scientists in the world for the last three consecutive years, 2019 to 2021 as per studies conducted by the Stanford University, USA.",institutionString:"Praxis Business School",institution:null},{id:"320071",title:"Dr.",name:"Sidra",middleName:null,surname:"Mehtab",slug:"sidra-mehtab",fullName:"Sidra Mehtab",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00002v6KHoQAM/Profile_Picture_1584512086360",biography:"Sidra Mehtab has completed her BS with honors in Physics from Calcutta University, India in 2018. She has done MS in Data Science and Analytics from Maulana Abul Kalam Azad University of Technology (MAKAUT), Kolkata, India in 2020. Her research areas include Econometrics, Time Series Analysis, Machine Learning, Deep Learning, Artificial Intelligence, and Computer and Network Security with a particular focus on Cyber Security Analytics. Ms. Mehtab has published seven papers in international conferences and one of her papers has been accepted for publication in a reputable international journal. She has won the best paper awards in two prestigious international conferences – BAICONF 2019, and ICADCML 2021, organized in the Indian Institute of Management, Bangalore, India in December 2019, and SOA University, Bhubaneswar, India in January 2021. Besides, Ms. Mehtab has also published two book chapters in two books. Seven of her book chapters will be published in a volume shortly in 2021 by Cambridge Scholars’ Press, UK. Currently, she is working as the joint editor of two edited volumes on Time Series Analysis and Forecasting to be published in the first half of 2021 by an international house. Currently, she is working as a Data Scientist with an MNC in Delhi, India.",institutionString:"NSHM College of Management and Technology",institution:null},{id:"226240",title:"Dr.",name:"Andri Irfan",middleName:null,surname:"Rifai",slug:"andri-irfan-rifai",fullName:"Andri Irfan Rifai",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226240/images/7412_n.jpg",biography:"Andri IRFAN is a Senior Lecturer of Civil Engineering and Planning. He completed the PhD at the Universitas Indonesia & Universidade do Minho with Sandwich Program Scholarship from the Directorate General of Higher Education and LPDP scholarship. He has been teaching for more than 19 years and much active to applied his knowledge in the project construction in Indonesia. His research interest ranges from pavement management system to advanced data mining techniques for transportation engineering. He has published more than 50 papers in journals and 2 books.",institutionString:null,institution:{name:"Universitas Internasional Batam",country:{name:"Indonesia"}}},{id:"314576",title:"Dr.",name:"Ibai",middleName:null,surname:"Laña",slug:"ibai-lana",fullName:"Ibai Laña",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314576/images/system/314576.jpg",biography:"Dr. Ibai Laña works at TECNALIA as a data analyst. He received his Ph.D. in Artificial Intelligence from the University of the Basque Country (UPV/EHU), Spain, in 2018. He is currently a senior researcher at TECNALIA. His research interests fall within the intersection of intelligent transportation systems, machine learning, traffic data analysis, and data science. He has dealt with urban traffic forecasting problems, applying machine learning models and evolutionary algorithms. He has experience in origin-destination matrix estimation or point of interest and trajectory detection. Working with large volumes of data has given him a good command of big data processing tools and NoSQL databases. He has also been a visiting scholar at the Knowledge Engineering and Discovery Research Institute, Auckland University of Technology.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"314575",title:"Dr.",name:"Jesus",middleName:null,surname:"L. Lobo",slug:"jesus-l.-lobo",fullName:"Jesus L. Lobo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314575/images/system/314575.png",biography:"Dr. Jesús López is currently based in Bilbao (Spain) working at TECNALIA as Artificial Intelligence Research Scientist. In most cases, a project idea or a new research line needs to be investigated to see if it is good enough to take into production or to focus on it. That is exactly what he does, diving into Machine Learning algorithms and technologies to help TECNALIA to decide whether something is great in theory or will actually impact on the product or processes of its projects. So, he is expert at framing experiments, developing hypotheses, and proving whether they’re true or not, in order to investigate fundamental problems with a longer time horizon. He is also able to design and develop PoCs and system prototypes in simulation. He has participated in several national and internacional R&D projects.\n\nAs another relevant part of his everyday research work, he usually publishes his findings in reputed scientific refereed journals and international conferences, occasionally acting as reviewer and Programme Commitee member. Concretely, since 2018 he has published 9 JCR (8 Q1) journal papers, 9 conference papers (e.g. ECML PKDD 2021), and he has co-edited a book. He is also active in popular science writing data science stories for reputed blogs (KDNuggets, TowardsDataScience, Naukas). Besides, he has recently embarked on mentoring programmes as mentor, and has also worked as data science trainer.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"103779",title:"Prof.",name:"Yalcin",middleName:null,surname:"Isler",slug:"yalcin-isler",fullName:"Yalcin Isler",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRyQ8QAK/Profile_Picture_1628834958734",biography:"Yalcin Isler (1971 - Burdur / Turkey) received the B.Sc. degree in the Department of Electrical and Electronics Engineering from Anadolu University, Eskisehir, Turkey, in 1993, the M.Sc. degree from the Department of Electronics and Communication Engineering, Suleyman Demirel University, Isparta, Turkey, in 1996, the Ph.D. degree from the Department of Electrical and Electronics Engineering, Dokuz Eylul University, Izmir, Turkey, in 2009, and the Competence of Associate Professorship from the Turkish Interuniversity Council in 2019.\n\nHe was Lecturer at Burdur Vocational School in Suleyman Demirel University (1993-2000, Burdur / Turkey), Software Engineer (2000-2002, Izmir / Turkey), Research Assistant in Bulent Ecevit University (2002-2003, Zonguldak / Turkey), Research Assistant in Dokuz Eylul University (2003-2010, Izmir / Turkey), Assistant Professor at the Department of Electrical and Electronics Engineering in Bulent Ecevit University (2010-2012, Zonguldak / Turkey), Assistant Professor at the Department of Biomedical Engineering in Izmir Katip Celebi University (2012-2019, Izmir / Turkey). He is an Associate Professor at the Department of Biomedical Engineering at Izmir Katip Celebi University, Izmir / Turkey, since 2019. In addition to academics, he has also founded Islerya Medical and Information Technologies Company, Izmir / Turkey, since 2017.\n\nHis main research interests cover biomedical signal processing, pattern recognition, medical device design, programming, and embedded systems. He has many scientific papers and participated in several projects in these study fields. He was an IEEE Student Member (2009-2011) and IEEE Member (2011-2014) and has been IEEE Senior Member since 2014.",institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",country:{name:"Turkey"}}},{id:"339677",title:"Dr.",name:"Mrinmoy",middleName:null,surname:"Roy",slug:"mrinmoy-roy",fullName:"Mrinmoy Roy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/339677/images/16768_n.jpg",biography:"An accomplished Sales & Marketing professional with 12 years of cross-functional experience in well-known organisations such as CIPLA, LUPIN, GLENMARK, ASTRAZENECA across different segment of Sales & Marketing, International Business, Institutional Business, Product Management, Strategic Marketing of HIV, Oncology, Derma, Respiratory, Anti-Diabetic, Nutraceutical & Stomatological Product Portfolio and Generic as well as Chronic Critical Care Portfolio. A First Class MBA in International Business & Strategic Marketing, B.Pharm, D.Pharm, Google Certified Digital Marketing Professional. Qualified PhD Candidate in Operations and Management with special focus on Artificial Intelligence and Machine Learning adoption, analysis and use in Healthcare, Hospital & Pharma Domain. Seasoned with diverse therapy area of Pharmaceutical Sales & Marketing ranging from generating revenue through generating prescriptions, launching new products, and making them big brands with continuous strategy execution at the Physician and Patients level. Moved from Sales to Marketing and Business Development for 3.5 years in South East Asian Market operating from Manila, Philippines. Came back to India and handled and developed Brands such as Gluconorm, Lupisulin, Supracal, Absolut Woman, Hemozink, Fabiflu (For COVID 19), and many more. In my previous assignment I used to develop and execute strategies on Sales & Marketing, Commercialization & Business Development for Institution and Corporate Hospital Business portfolio of Oncology Therapy Area for AstraZeneca Pharma India Ltd. Being a Research Scholar and Student of ‘Operations Research & Management: Artificial Intelligence’ I published several pioneer research papers and book chapters on the same in Internationally reputed journals and Books indexed in Scopus, Springer and Ei Compendex, Google Scholar etc. Currently, I am launching PGDM Pharmaceutical Management Program in IIHMR Bangalore and spearheading the course curriculum and structure of the same. I am interested in Collaboration for Healthcare Innovation, Pharma AI Innovation, Future trend in Marketing and Management with incubation on Healthcare, Healthcare IT startups, AI-ML Modelling and Healthcare Algorithm based training module development. I am also an affiliated member of the Institute of Management Consultant of India, looking forward to Healthcare, Healthcare IT and Innovation, Pharma and Hospital Management Consulting works.",institutionString:null,institution:{name:"Lovely Professional University",country:{name:"India"}}},{id:"310576",title:"Prof.",name:"Erick Giovani",middleName:null,surname:"Sperandio Nascimento",slug:"erick-giovani-sperandio-nascimento",fullName:"Erick Giovani Sperandio Nascimento",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y00002pDKxDQAW/ProfilePicture%202022-06-20%2019%3A57%3A24.788",biography:"Prof. Erick Sperandio is the Lead Researcher and professor of Artificial Intelligence (AI) at SENAI CIMATEC, Bahia, Brazil, also working with Computational Modeling (CM) and HPC. He holds a PhD in Environmental Engineering in the area of Atmospheric Computational Modeling, a Master in Informatics in the field of Computational Intelligence and Graduated in Computer Science from UFES. He currently coordinates, leads and participates in R&D projects in the areas of AI, computational modeling and supercomputing applied to different areas such as Oil and Gas, Health, Advanced Manufacturing, Renewable Energies and Atmospheric Sciences, advising undergraduate, master's and doctoral students. He is the Lead Researcher at SENAI CIMATEC's Reference Center on Artificial Intelligence. In addition, he is a Certified Instructor and University Ambassador of the NVIDIA Deep Learning Institute (DLI) in the areas of Deep Learning, Computer Vision, Natural Language Processing and Recommender Systems, and Principal Investigator of the NVIDIA/CIMATEC AI Joint Lab, the first in Latin America within the NVIDIA AI Technology Center (NVAITC) worldwide program. He also works as a researcher at the Supercomputing Center for Industrial Innovation (CS2i) and at the SENAI Institute of Innovation for Automation (ISI Automação), both from SENAI CIMATEC. He is a member and vice-coordinator of the Basic Board of Scientific-Technological Advice and Evaluation, in the area of Innovation, of the Foundation for Research Support of the State of Bahia (FAPESB). He serves as Technology Transfer Coordinator and one of the Principal Investigators at the National Applied Research Center in Artificial Intelligence (CPA-IA) of SENAI CIMATEC, focusing on Industry, being one of the six CPA-IA in Brazil approved by MCTI / FAPESP / CGI.br. He also participates as one of the representatives of Brazil in the BRICS Innovation Collaboration Working Group on HPC, ICT and AI. He is the coordinator of the Work Group of the Axis 5 - Workforce and Training - of the Brazilian Strategy for Artificial Intelligence (EBIA), and member of the MCTI/EMBRAPII AI Innovation Network Training Committee. He is the coordinator, by SENAI CIMATEC, of the Artificial Intelligence Reference Network of the State of Bahia (REDE BAH.IA). He leads the working group of experts representing Brazil in the Global Partnership on Artificial Intelligence (GPAI), on the theme \"AI and the Pandemic Response\".",institutionString:"Manufacturing and Technology Integrated Campus – SENAI CIMATEC",institution:null},{id:"1063",title:"Prof.",name:"Constantin",middleName:null,surname:"Volosencu",slug:"constantin-volosencu",fullName:"Constantin Volosencu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1063/images/system/1063.png",biography:"Prof. Dr. Constantin Voloşencu graduated as an engineer from\nPolitehnica University of Timișoara, Romania, where he also\nobtained a doctorate degree. He is currently a full professor in\nthe Department of Automation and Applied Informatics at the\nsame university. Dr. Voloşencu is the author of ten books, seven\nbook chapters, and more than 160 papers published in journals\nand conference proceedings. He has also edited twelve books and\nhas twenty-seven patents to his name. He is a manager of research grants, editor in\nchief and member of international journal editorial boards, a former plenary speaker, a member of scientific committees, and chair at international conferences. His\nresearch is in the fields of control systems, control of electric drives, fuzzy control\nsystems, neural network applications, fault detection and diagnosis, sensor network\napplications, monitoring of distributed parameter systems, and power ultrasound\napplications. He has developed automation equipment for machine tools, spooling\nmachines, high-power ultrasound processes, and more.",institutionString:"Polytechnic University of Timişoara",institution:{name:"Polytechnic University of Timişoara",country:{name:"Romania"}}},{id:"221364",title:"Dr.",name:"Eneko",middleName:null,surname:"Osaba",slug:"eneko-osaba",fullName:"Eneko Osaba",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/221364/images/system/221364.jpg",biography:"Dr. Eneko Osaba works at TECNALIA as a senior researcher. He obtained his Ph.D. in Artificial Intelligence in 2015. He has participated in more than twenty-five local and European research projects, and in the publication of more than 130 papers. He has performed several stays at universities in the United Kingdom, Italy, and Malta. Dr. Osaba has served as a program committee member in more than forty international conferences and participated in organizing activities in more than ten international conferences. He is a member of the editorial board of the International Journal of Artificial Intelligence, Data in Brief, and Journal of Advanced Transportation. He is also a guest editor for the Journal of Computational Science, Neurocomputing, Swarm, and Evolutionary Computation and IEEE ITS Magazine.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"275829",title:"Dr.",name:"Esther",middleName:null,surname:"Villar-Rodriguez",slug:"esther-villar-rodriguez",fullName:"Esther Villar-Rodriguez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/275829/images/system/275829.jpg",biography:"Dr. Esther Villar obtained a Ph.D. in Information and Communication Technologies from the University of Alcalá, Spain, in 2015. She obtained a degree in Computer Science from the University of Deusto, Spain, in 2010, and an MSc in Computer Languages and Systems from the National University of Distance Education, Spain, in 2012. Her areas of interest and knowledge include natural language processing (NLP), detection of impersonation in social networks, semantic web, and machine learning. Dr. Esther Villar made several contributions at conferences and publishing in various journals in those fields. Currently, she is working within the OPTIMA (Optimization Modeling & Analytics) business of TECNALIA’s ICT Division as a data scientist in projects related to the prediction and optimization of management and industrial processes (resource planning, energy efficiency, etc).",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49813/images/system/49813.png",biography:"Prof. Dr. Javier Del Ser received his first PhD in Telecommunication Engineering (Cum Laude) from the University of Navarra, Spain, in 2006, and a second PhD in Computational Intelligence (Summa Cum Laude) from the University of Alcala, Spain, in 2013. He is currently a principal researcher in data analytics and optimisation at TECNALIA (Spain), a visiting fellow at the Basque Center for Applied Mathematics (BCAM) and a part-time lecturer at the University of the Basque Country (UPV/EHU). His research interests gravitate on the use of descriptive, prescriptive and predictive algorithms for data mining and optimization in a diverse range of application fields such as Energy, Transport, Telecommunications, Health and Industry, among others. In these fields he has published more than 240 articles, co-supervised 8 Ph.D. theses, edited 6 books, coauthored 7 patents and participated/led more than 40 research projects. 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Currently working as an Assistant Professor in the Department of Mathematics, Institute of Applied Science, Mangalayatan University, Aligarh. She taught so many courses of Mathematics of UG and PG level. Her research Area of Expertise is Functional Analysis & Sequence Spaces. She has been working on Ideal Convergence of double sequence. She has published 17 research papers in National and International Journals including Cogent Mathematics, Filomat, Journal of Intelligent and Fuzzy Systems, Advances in Difference Equations, Journal of Mathematical Analysis, Journal of Mathematical & Computer Science etc. She has also reviewed few research papers for the and international journals. 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The considerable development of technology, including the computing power of computers, is also conducive to the development of bioinformatics, including personalized medicine. In an era of rapidly growing data volumes and ever lower costs of generating, storing and computing data, personalized medicine holds great promises. Modern computational methods used as bioinformatics tools can integrate multi-scale, multi-modal and longitudinal patient data to create even more effective and safer therapy and disease prevention methods. Main aspects of the topic are: Applying bioinformatics in drug discovery and development; Bioinformatics in clinical diagnostics (genetic variants that act as markers for a condition or a disease); Blockchain and Artificial Intelligence/Machine Learning in personalized medicine; Customize disease-prevention strategies in personalized medicine; Big data analysis in personalized medicine; Translating stratification algorithms into clinical practice of personalized medicine.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/7.jpg",keywords:"Biomedical Data, Drug Discovery, Clinical Diagnostics, Decoding Human Genome, AI in Personalized Medicine, Disease-prevention Strategies, Big Data Analysis in Medicine"},{id:"8",title:"Bioinspired Technology and Biomechanics",scope:'Bioinspired technologies take advantage of understanding the actual biological system to provide solutions to problems in several areas. Recently, bioinspired systems have been successfully employing biomechanics to develop and improve assistive technology and rehabilitation devices. The research topic "Bioinspired Technology and Biomechanics" welcomes studies reporting recent advances in bioinspired technologies that contribute to individuals\' health, inclusion, and rehabilitation. 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Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",keywords:"Biotechnology, Biosensors, Biomaterials, Tissue Engineering"}],annualVolumeBook:{},thematicCollection:[],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 24th, 2022",hasOnlineFirst:!0,numberOfOpenTopics:4,numberOfPublishedChapters:314,numberOfPublishedBooks:31,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. 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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. 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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/43618",hash:"",query:{},params:{id:"43618"},fullPath:"/chapters/43618",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)}()