Applications of cold engineering in a wine cellar: optimum working temperatures in wine cellars and the effect on must/wine.
\\n\\n
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Barely three months into the new year and we are happy to announce a monumental milestone reached - 150 million downloads.
\n\nThis achievement solidifies IntechOpen’s place as a pioneer in Open Access publishing and the home to some of the most relevant scientific research available through Open Access.
\n\nWe are so proud to have worked with so many bright minds throughout the years who have helped us spread knowledge through the power of Open Access and we look forward to continuing to support some of the greatest thinkers of our day.
\n\nThank you for making IntechOpen your place of learning, sharing, and discovery, and here’s to 150 million more!
\n\n\n\n\n'}],latestNews:[{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"5498",leadTitle:null,fullTitle:"Autism - Paradigms, Recent Research and Clinical Applications",title:"Autism",subtitle:"Paradigms, Recent Research and Clinical Applications",reviewType:"peer-reviewed",abstract:"This book opens with a discussion of neurodiversity and an elaboration of the diagnosis of autism. It then examines factors correlating with autism, including sex bias, month of birth, migration and impact of infant feeding. The next section is on the impact of autism. The neurobiology and genetic section deals with epigenetics and intracellular pathways associated with etiology. The development and behaviour section deals with proprioceptive profiles and joint attention in autism. The final section focuses on interventions including mindfulness, animal assisted activity, social/cultural perspective on autism intervention and physical activity. The book is relevant to all professionals and researchers working with persons with autism, including psychiatrists/psychologists, speech and language therapists, occupational therapists, teachers, nurses and care workers.",isbn:"978-953-51-3080-2",printIsbn:"978-953-51-3079-6",pdfIsbn:"978-953-51-4872-2",doi:"10.5772/63171",price:139,priceEur:155,priceUsd:179,slug:"autism-paradigms-recent-research-and-clinical-applications",numberOfPages:344,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"7a4a04bc1ec60da290315a53de5043b8",bookSignature:"Michael Fitzgerald and Jane Yip",publishedDate:"April 12th 2017",coverURL:"https://cdn.intechopen.com/books/images_new/5498.jpg",numberOfDownloads:26193,numberOfWosCitations:38,numberOfCrossrefCitations:25,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:52,numberOfDimensionsCitationsByBook:1,hasAltmetrics:1,numberOfTotalCitations:115,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"April 28th 2016",dateEndSecondStepPublish:"May 19th 2016",dateEndThirdStepPublish:"August 23rd 2016",dateEndFourthStepPublish:"November 21st 2016",dateEndFifthStepPublish:"March 22nd 2017",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"205005",title:"Dr.",name:"Michael",middleName:null,surname:"Fitzgerald",slug:"michael-fitzgerald",fullName:"Michael Fitzgerald",profilePictureURL:"https://mts.intechopen.com/storage/users/205005/images/system/205005.jpg",biography:"Professor Michael Fitzgerald was the first Professor of Child and Adolescent Psychiatry in Ireland, specialising in autism spectrum disorders (ASDs). He has diagnosed more than 5000 persons with ASDs. He has written many peer-reviewed publications and authored, co-authored and co-edited thirty-four books, some of which have been translated into Japanese, Dutch, and Polish. Professor Simon Baron-Cohen described one of Professor Fitzgerald’s books on autism as, ̔The best book on autism̕, and described him as an ̔exceptional scholar̕. He has lectured extensively throughout the world, including at The Royal Society/British Academy and the British Library in London. He was the overall winner of the ̔Excellence in Psychiatry̕ Award in 2017 and was nominated as one of the top four psychiatrists by Hospital Professional News Ireland. Professor Fitzgerald recently retired to spend more time in Brussels and continues to write on autism.",institutionString:"Independant Researcher",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"3",totalChapterViews:"0",totalEditedBooks:"4",institution:{name:"Trinity College Dublin",institutionURL:null,country:{name:"Ireland"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:{id:"156214",title:"Dr.",name:"Jane",middleName:null,surname:"Yip",slug:"jane-yip",fullName:"Jane Yip",profilePictureURL:"https://mts.intechopen.com/storage/users/156214/images/system/156214.jpg",biography:"Jane Yip obtained her PhD from the University of Newcastle, Australia, specializing in neuropharmacology. She completed her post-doctoral training at Eli Lilly and Company, Indianapolis, USA. Her research is on the brain circuit that underlies neurological disorders including autism, schizophrenia, and depression. She has published in peer-review journals. Although trained in drug development, she emphasizes the application of the science of behavior to treat mental disorders, and uses natural environment modification as a treatment modality. She pioneered the use of portable brain imaging to guide behavior treatment in autism. She has a practice that offers brain mapping. The practice also treats patients with autism using applied behavior analysis (ABA). She is the director of a clinical center for the treatment of autism, Autism Parent Care. As a member of ABA international, multicultural alliance, and an NGO member of United Nations, she works on outreach projects in Asia to advance the Universal Declaration of Human Rights Bill aiming to promote better recognition of individuals with mental disabilities, including autism. Her overarching aim to is advance treatment intervention for autism.",institutionString:"Autism Parent Care, LLC",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"0",institution:null},coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"1055",title:"Neurodiversity",slug:"neurodiversity"}],chapters:[{id:"52521",title:"A Different Point of View: The Neurodiversity Approach to Autism and Work",doi:"10.5772/65409",slug:"a-different-point-of-view-the-neurodiversity-approach-to-autism-and-work",totalDownloads:2048,totalCrossrefCites:1,totalDimensionsCites:4,hasAltmetrics:1,abstract:"With this chapter, we want to open up the debate whether neurodiversity might be the next step of diversity. The term neurodiversity was first established in the online autism community in the 1990s and has since spread both off‐ and online. It describes the idea that, throughout the human population, different brain developments and structures exist. Neuronal variances such as Autism are therefore not to be seen as disorders but as variations different from the neurotypical brain. Instead of being considered ill and cure‐worthy, neurodiverse people should be included and integrated into society. In our current research, we follow the neurodiversity approach and focus on the subject of autism in the work context. We found that certain strengths and abilities are most prominent in autistic people (such as logical reasoning, visual perception) and that autistic people are able to find different effective solutions to overcome the barriers detaining them from entering the job market. Furthermore, while many autistic individuals are employed in regular competitive jobs, more focus on autism‐specific job environments is needed. These findings lead us to the conclusion that autistic individuals have potential that is beneficial for society.",signatures:"Timo Lorenz, Nomi Reznik and Kathrin Heinitz",downloadPdfUrl:"/chapter/pdf-download/52521",previewPdfUrl:"/chapter/pdf-preview/52521",authors:[{id:"190954",title:"Dr.",name:"Timo",surname:"Lorenz",slug:"timo-lorenz",fullName:"Timo Lorenz"},{id:"195124",title:"Ms.",name:"Nomi",surname:"Reznik",slug:"nomi-reznik",fullName:"Nomi Reznik"},{id:"195125",title:"Prof.",name:"Kathrin",surname:"Heinitz",slug:"kathrin-heinitz",fullName:"Kathrin Heinitz"}],corrections:null},{id:"52787",title:"The Clinical Gestalts of Autism: Over 40 years of Clinical Experience with Autism",doi:"10.5772/65906",slug:"the-clinical-gestalts-of-autism-over-40-years-of-clinical-experience-with-autism",totalDownloads:1719,totalCrossrefCites:5,totalDimensionsCites:8,hasAltmetrics:1,abstract:"The clinical gestalts of autism are very broad and much more heterogeneous than people realise. DSM V [1] gives a more narrow and condensed description of what autism is in the twentieth century. DSM focuses on problems with socioemotional reciprocity, non-verbal communication and difficult interpersonal relationships, restricted, repetitive patterns of behaviour, early onset and functional impairment. First, I want to flesh out the autism spectrum disorder gestalts as it presents to experienced clinical practitioners. It is the opposite of the “tick box” approach to diagnosis so common today. It focuses on the phenomena as they would have been focused on in the late nineteenth and early twentieth century, an approach that has faded into the background in the late twentieth and early twenty-first century. It is critical at this point of the twenty-first century that we re-engage with phenomenology and with the clinical gestalt of psychiatric conditions which show a great deal of overlap with much mixed phenomenology. We will start by examining social relations in autism spectrum disorders. Clearly, this is central to autism.",signatures:"Michael Fitzgerald",downloadPdfUrl:"/chapter/pdf-download/52787",previewPdfUrl:"/chapter/pdf-preview/52787",authors:[{id:"191313",title:"Dr.",name:"Michael",surname:"Fitzgerald",slug:"michael-fitzgerald",fullName:"Michael Fitzgerald"}],corrections:null},{id:"54098",title:"Sex Bias in Autism",doi:"10.5772/67402",slug:"sex-bias-in-autism",totalDownloads:1413,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Autism is a neurodevelopmental disorder with unknown exact etiology. Interestingly, it affects males more than females in a striking ratio (4:1), respectively. This biased ratio served as a clue to search about the factors that are sex linked and hence sex hormones and X chromosomes were good candidates. Although understanding the basic sex dimorphism in male and female brains is essential to understand autism pathology. Theories regarding the biased sex ratio in autism have been raised, and some have been supported by evidence from human studies. Furthermore, sex-linked genetic dysregulation has also been reported in autism. In this chapter, an overview of what is known about sex bias in autism is reviewed, emphasizing the importance of carrying on in uncoding the sex bias in autism.",signatures:"Felwah S. Al-Zaid",downloadPdfUrl:"/chapter/pdf-download/54098",previewPdfUrl:"/chapter/pdf-preview/54098",authors:[{id:"191157",title:"Dr.",name:"Felwah",surname:"Al-Zaid",slug:"felwah-al-zaid",fullName:"Felwah Al-Zaid"}],corrections:null},{id:"54153",title:"Distribution of Month of Birth of Individuals with Autism Spectrum Disorder Differs from the General Population in the Netherlands",doi:"10.5772/67205",slug:"distribution-of-month-of-birth-of-individuals-with-autism-spectrum-disorder-differs-from-the-general",totalDownloads:1276,totalCrossrefCites:2,totalDimensionsCites:3,hasAltmetrics:1,abstract:"The prevalence of autism spectrum disorders (ASDs) is causally dependent on genetic and environmental influences. We investigated whether autism spectrum disorders are associated with month of birth compared to the general population using a retrospective study, comparing ASD cases (n = 3478) with the general population (n = 2,716,876) born between 1995 and 2008. Associations were examined using χ2 tests and Walter and Elwood’s seasonality χ2 tests for the total ASD group, and separately for autistic disorder and Asperger syndrome. For the total ASD group, the distribution of month of birth was different compared to the general population (p < 0.0001), with July as the highest contributor, and a season-of-birth effect was found for this group (p = 0.02). For the autistic disorder group, the months of birth distribution were different (p = 0.01), with July as the highest contributor. No season-of-birth effect over the year was found (p = 0.09). No association was found for the months of birth of individuals with Asperger syndrome (p = 0.06), with no seasonal trend over the year (p = 0.60). In conclusion, a drop in sun exposure during the first trimester of pregnancy might explain the peak in July births and the associated risk for ASD development.",signatures:"Anna Cieslinska, Jannicke Simmelink, Gosia Teodorowicz, Hans\nVerhoef, Hilde Tobi and Huub F. Savelkoul",downloadPdfUrl:"/chapter/pdf-download/54153",previewPdfUrl:"/chapter/pdf-preview/54153",authors:[{id:"191386",title:"Prof.",name:"Huub F.J",surname:"Savelkoul",slug:"huub-f.j-savelkoul",fullName:"Huub F.J Savelkoul"},{id:"194995",title:"Dr.",name:"Anna",surname:"Cieslinska",slug:"anna-cieslinska",fullName:"Anna Cieslinska"},{id:"194996",title:"MSc.",name:"Jannicke",surname:"Simmelink",slug:"jannicke-simmelink",fullName:"Jannicke Simmelink"},{id:"194997",title:"Dr.",name:"Gosia",surname:"Teodorowicz",slug:"gosia-teodorowicz",fullName:"Gosia Teodorowicz"},{id:"194998",title:"Dr.",name:"Hans",surname:"Verhoef",slug:"hans-verhoef",fullName:"Hans Verhoef"},{id:"194999",title:"Dr.",name:"Hilde",surname:"Tobi",slug:"hilde-tobi",fullName:"Hilde Tobi"}],corrections:null},{id:"53764",title:"Migration and Autism Diagnosis",doi:"10.5772/65981",slug:"migration-and-autism-diagnosis",totalDownloads:1530,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Clinicians in many countries are increasingly working with children from migrant families. Although autism is diagnosed at an approximately equal rate in children in developed countries internationally (estimated 1% of the population), many studies report that children in migrant communities are at relatively higher risk for autism. Risk factors as well as symptom rates appear to vary across cultures. This chapter reviews the current state of the science and outlines conceptual considerations for clinicians assessing foreign, migrant, and minority children for diagnosis of autism. Possible reasons for higher rates among migrant children are discussed and suggestions for clinical evaluation are made.",signatures:"Daina Crafa",downloadPdfUrl:"/chapter/pdf-download/53764",previewPdfUrl:"/chapter/pdf-preview/53764",authors:[{id:"192110",title:"Dr.",name:"Daina",surname:"Crafa",slug:"daina-crafa",fullName:"Daina Crafa"}],corrections:null},{id:"54644",title:"Impact of Infant Feeding Methods on the Development of Autism Spectrum Disorder",doi:"10.5772/67624",slug:"impact-of-infant-feeding-methods-on-the-development-of-autism-spectrum-disorder",totalDownloads:2100,totalCrossrefCites:2,totalDimensionsCites:4,hasAltmetrics:1,abstract:"There is strong and convincing evidence that infant’s sensory stimulation, which is associated with breastfeeding, contributes significantly to the infant’s neurodevelopment. Our study compared the prevalence of autism spectrum disorder (ASD) in children who were breastfed, given breast milk through a bottle (breast-milk fed), or formula-fed. We reported significant association of ASD in children who were formula-fed from birth or weaned early from the breast. The statistical data revealed that increasing the duration of breastfeeding resulted in a decrease in prevalence of ASD. The odds ratio of a child not having autism was 0.27, 0.93, and 6.67 for breastfeeding for less than 6, 6–12, or longer than 12 months, respectively. There is significant evidence that this association is mediated by the ingredients of the breast milk and infant’s endogenous oxytocin. Oxytocin is a neurotransmitter and neuromodulator and we postulate that oxytocin may increase neuroplasticity, synaptic connections, and alter ASD genes’ expression. Animal experiments and imaging studies demonstrate the central role of oxytocin in maternal love and bonding. Currently, there are no specific treatments for patients diagnosed with autism; therefore, it is imperative to identify the risk factors that contribute to the development of ASD. In this communication, we demonstrate that lack of breastfeeding is highly associated with ASD development in children with genetic susceptibility.",signatures:"Touraj Shafai, Monika Mustafa, Jeffrey Mulari and Antonio Curtis",downloadPdfUrl:"/chapter/pdf-download/54644",previewPdfUrl:"/chapter/pdf-preview/54644",authors:[{id:"192429",title:"M.D.",name:"Touraj",surname:"Shafai",slug:"touraj-shafai",fullName:"Touraj Shafai"}],corrections:null},{id:"52976",title:"Family Quality of Life in Autism Spectrum Disorders (ASD)",doi:"10.5772/66201",slug:"family-quality-of-life-in-autism-spectrum-disorders-asd-",totalDownloads:1785,totalCrossrefCites:3,totalDimensionsCites:7,hasAltmetrics:0,abstract:"In latest years the concept of quality of life (QoL) has been acknowledged as an important outcome in psychiatric pathology fields. Most researchers consider that social indicators and the perception of personal wellbeing also, should be considered when measuring the quality of life. Our purpose was to investigate the QoLof the families of children with autism spectrum disorders (ASD) and to determine whether in this population, the potential mediators (irrational cognitions, negative automatic thoughts, coping strategies) relate significantly with the emotional distress reported. We also aimed to assess the parents’ irrational cognitions and negative automatic thoughts as mediators in the relationship between the overall assessment of family QoLand their emotional distress. We found significant correlations between the emotional distress reported by the parents and their automatic negative thoughts, irrational cognitions, and different coping strategies. The relationship between the overall assessment of family QoLand the parents’ emotional distress was partially explained by their negative automatic thoughts and irrational cognitions. In this view, the specialised services should include also interventions for the parents of children with developmental disorders (ASD, ADHD) in order to improve their overall assessment of familyQoL.",signatures:"Elena Predescu and Roxana Şipoş",downloadPdfUrl:"/chapter/pdf-download/52976",previewPdfUrl:"/chapter/pdf-preview/52976",authors:[{id:"191660",title:"Dr.",name:"Elena",surname:"Predescu",slug:"elena-predescu",fullName:"Elena Predescu"},{id:"191661",title:"Dr.",name:"Roxana",surname:"Sipos",slug:"roxana-sipos",fullName:"Roxana Sipos"}],corrections:null},{id:"53617",title:"The Genetic and Epigenetic Basis Involved in the Pathophysiology of ASD: Therapeutic Implications",doi:"10.5772/66854",slug:"the-genetic-and-epigenetic-basis-involved-in-the-pathophysiology-of-asd-therapeutic-implications",totalDownloads:1784,totalCrossrefCites:1,totalDimensionsCites:3,hasAltmetrics:0,abstract:"The prevalence of autism has increased in an exponential way in the past few years. Many monogenetic mutations as well as copy number variants and single nucleotide polymorphisms have been associated with autism spectrum disorders (ASD), a large proportion of which occur in genes associated with synaptogenesis and synaptic function. However, the increase in appearance of genetic alterations does not explain the etiology of an elevated number of ASD cases. Recent research is now focusing on the role of environmental/epigenetic factors, which by themselves and/or in combination with classical genetic factors, may be the root cause of a large number of ASDs. In this chapter we review the current literature regarding the epigenetic changes involved in ASD, including their possible mechanisms of action such as oxidative stress, altered fatty acid metabolism, mitochondrial dysfunction, DNA methylation and histone methylation (via the one‐carbon metabolism cycle), histone variants, and ATP‐dependent chromatin remodeling. We discuss possible new biochemical markers related to autism as well as new lines of research for therapeutic targets.",signatures:"Maria Carmen Carrascosa-Romero and Carlos De Cabo-De La Vega",downloadPdfUrl:"/chapter/pdf-download/53617",previewPdfUrl:"/chapter/pdf-preview/53617",authors:[{id:"61718",title:"Dr.",name:"María Carmen",surname:"Carrascosa-Romero",slug:"maria-carmen-carrascosa-romero",fullName:"María Carmen Carrascosa-Romero"},{id:"61719",title:"Dr.",name:"Carlos",surname:"De Cabo De La Vega",slug:"carlos-de-cabo-de-la-vega",fullName:"Carlos De Cabo De La Vega"}],corrections:null},{id:"53845",title:"Intracellular Pathways Associated with the Etiology of Autism",doi:"10.5772/67206",slug:"intracellular-pathways-associated-with-the-etiology-of-autism",totalDownloads:1494,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"This chapter explores the relationship between the genes and proteins of the Akt and MAPK pathways and autism. This chapter presents the biology of these two pathways, their genes and cascading proteins, and then, it looks at the research that has connected these molecules to autism. Finally, it imparts current and future therapeutic modalities that might exploit abnormalities in these genes and proteins, change them and ultimately alter aberrant autistic behaviors.",signatures:"Anthony J. Russo",downloadPdfUrl:"/chapter/pdf-download/53845",previewPdfUrl:"/chapter/pdf-preview/53845",authors:[{id:"191116",title:"Ph.D.",name:"Aj",surname:"Russo",slug:"aj-russo",fullName:"Aj Russo"}],corrections:null},{id:"54101",title:"Proprioceptive and Kinematic Profiles for Customized Human‐ Robot Interaction for People Suffering from Autism",doi:"10.5772/67339",slug:"proprioceptive-and-kinematic-profiles-for-customized-human-robot-interaction-for-people-suffering-fr",totalDownloads:1220,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"In this chapter, we presented a method to define individual profiles in order to develop a new personalized robot‐based social interaction for individual with autistic spectrum disorder (ASD) with the hypothesis that hyporeactivity to visual motion and an overreliance on proprioceptive information would be linked to difficulties in integrating social cues and in engaging in successful interactions. We succeed to form three groups among our 19 participants (children, teenagers, and adults with ASD), describing each participant's response to visual and proprioceptive inputs. We conducted a first experiment to present the robot Nao as a social companion and to avoid fear or stress toward the robot in future experiment. No direct link between the behavior of the participants toward the robot and their proprioceptive and visual profiles was observed. Still, we found encouraging results going in the direction of our hypothesis. In addition, almost all of our participants showed great interest to Nao. Defining such individual profiles prior to social interactions with a robot could provide promising strategies for designing successful and adapted human‐robot interaction (HRI) for individuals with ASD.",signatures:"Pauline Chevalier, Brice Isableu, Jean‐Claude Martin, Christophe\nBazile and Adriana Tapus",downloadPdfUrl:"/chapter/pdf-download/54101",previewPdfUrl:"/chapter/pdf-preview/54101",authors:[{id:"192386",title:"Prof.",name:"Adriana",surname:"Tapus",slug:"adriana-tapus",fullName:"Adriana Tapus"},{id:"197131",title:"Dr.",name:"Pauline",surname:"Chevalier",slug:"pauline-chevalier",fullName:"Pauline Chevalier"},{id:"197135",title:"Dr.",name:"Jean-Claude",surname:"Martin",slug:"jean-claude-martin",fullName:"Jean-Claude Martin"},{id:"197136",title:"Dr.",name:"Brice",surname:"Isableu",slug:"brice-isableu",fullName:"Brice Isableu"},{id:"197137",title:"Dr.",name:"Christophe",surname:"Bazile",slug:"christophe-bazile",fullName:"Christophe Bazile"}],corrections:null},{id:"52566",title:"Joint Attention Impairment in Autism: Clinical Picture, Rationale and Functional MRI Findings",doi:"10.5772/65662",slug:"joint-attention-impairment-in-autism-clinical-picture-rationale-and-functional-mri-findings",totalDownloads:1869,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:0,abstract:"Joint attention is a keystone in social cognitive development and a skill acquired early in life. It is the triadic coordination of attention between two people and an object or event in which they are commonly interested. Language development follows in its tracks and is dependent on this early acquired skill. Its deviation from typical development is considered one of the earliest signs of autism. Consequently, its remediation has gained intensive focus in therapy. In this review, the development of joint attention skill in initiating (IJA) and responding (RJA), and its atypical development in autism and related spectrum disorders would be discussed. This would include existing problems in pointing, sharing attention with the participant, and facial recognition; and the rationale behind these deviations as covert attention. Related fMRI findings would also be reviewed, outlining the integration between the posterior involuntary parietal and superior temporal cortices (RJA) and the anterior volitional prefrontal and orbital frontal areas (IJA) in typical development, and the long‐distance underconnectivity and local overconnectivity in autism. Several cortical regions are implicated in autism, revealing the heterogeneity of the findings, but general conclusions could be drawn.",signatures:"Marwa Saleh and Aya Adel",downloadPdfUrl:"/chapter/pdf-download/52566",previewPdfUrl:"/chapter/pdf-preview/52566",authors:[{id:"190980",title:"Prof.",name:"Marwa",surname:"Mahmoud Saleh",slug:"marwa-mahmoud-saleh",fullName:"Marwa Mahmoud Saleh"},{id:"195136",title:"Dr.",name:"Aya",surname:"Adel",slug:"aya-adel",fullName:"Aya Adel"}],corrections:null},{id:"52480",title:"Mindfulness and Autism Spectrum Disorder",doi:"10.5772/65394",slug:"mindfulness-and-autism-spectrum-disorder",totalDownloads:2385,totalCrossrefCites:1,totalDimensionsCites:3,hasAltmetrics:1,abstract:"The use of mindfulness interventions for individuals with autism spectrum disorder (ASD) is a relatively new research area, which has followed a more established body of research investigating the efficacy of mindfulness interventions for parents of children with ASD. Given the chronic stress levels experienced by parents and high anxiety and stress levels in individuals with ASD, such research is well justified. The utility of mindfulness in clinical practice for individuals with ASD and their parents will be discussed. This chapter aims to evaluate the research literature, identify important limitations, and propose crucial directions for future research. Acknowledgment of the impact of attitudes, social bias, and a generational shift that may be accelerating the salience of mindfulness is discussed. The author aims to emphasize the importance of high-quality future research with robust methodological designs to clearly identify the potential role for mindfulness in this population. Despite having a solid foundation of preliminary findings, it is important that researchers refine current procedures and evaluation of mindfulness interventions for individuals with ASD and their parents while carefully selecting measures that are not solely self-report or parent report.",signatures:"Renee L. Cachia",downloadPdfUrl:"/chapter/pdf-download/52480",previewPdfUrl:"/chapter/pdf-preview/52480",authors:[{id:"190422",title:"Ph.D. Student",name:"Renee",surname:"Cachia",slug:"renee-cachia",fullName:"Renee Cachia"}],corrections:null},{id:"52453",title:"Constructing Healthy Experiences through Human-Animal Interactions for Autistic Children and Their Families: Implications for Research and Education",doi:"10.5772/65395",slug:"constructing-healthy-experiences-through-human-animal-interactions-for-autistic-children-and-their-f",totalDownloads:1487,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"A significant body of research in the field of animal assistance in autism spectrum disorder (ASD) therapy indicates that positive human-animal interactions (HAIs), such as playing with therapy dogs or dogs presence while reading Social Stories, improve the social interactions and the level of the behavioral indicators of positive moods (smiling, laughing) in autistic children. In this chapter, we aim to present a series of evidence-based modalities of including animal-assisted activities in standard therapeutic settings but also in the home environment (e.g., interactions with family animals), targeting the socio-emotional development of autistic children and their optimal communication with the family members, including the companion animals. The studies presented here are discussed from the perspective of potential mechanisms, such as oxytocin system, and several attachment-related views. Our studies point toward the valorization of companion animals in the process of development and optimizing the interpersonal communication abilities of ASD children in a positive and engaging manner for both humans and animals.",signatures:"Alina S. Rusu",downloadPdfUrl:"/chapter/pdf-download/52453",previewPdfUrl:"/chapter/pdf-preview/52453",authors:[{id:"191006",title:"Dr.",name:"Alina",surname:"Rusu",slug:"alina-rusu",fullName:"Alina Rusu"}],corrections:null},{id:"52764",title:"Sociocultural Perspective on Autism Intervention",doi:"10.5772/65965",slug:"sociocultural-perspective-on-autism-intervention",totalDownloads:1883,totalCrossrefCites:1,totalDimensionsCites:4,hasAltmetrics:0,abstract:"The landscape of the population in the United States is diversifying, as are the individuals who have a diagnosis of autism spectrum disorder. Autism spectrum disorder now affects one of out every 68 children. Although the diagnostic criteria do not differ, there are differences in time of diagnosis, treatment and acceptability of the diagnosis in various cultures, which is important for clinicians to understand. One approach to autism intervention is applied behavior analysis (ABA), which seeks to intervene on socially significant behavior. In addition, to using an approach such as ABA, which emphasis social significance, individuals may also use a cultural broker. The cultural broker can help to bridge the gap between parties and promote more effective treatment experience and thus help to ensure a more culturally sensitive approach to intervention.",signatures:"Elizabeth Hughes Fong and Helen Lee",downloadPdfUrl:"/chapter/pdf-download/52764",previewPdfUrl:"/chapter/pdf-preview/52764",authors:[{id:"195244",title:"Ph.D. Student",name:"Elizabeth",surname:"Hughes Fong",slug:"elizabeth-hughes-fong",fullName:"Elizabeth Hughes Fong"},{id:"195269",title:"Dr.",name:"Helen",surname:"Lee",slug:"helen-lee",fullName:"Helen Lee"}],corrections:null},{id:"53550",title:"Physical Activity in Individuals with Autism Spectrum Disorders (ASD): A Review",doi:"10.5772/66680",slug:"physical-activity-in-individuals-with-autism-spectrum-disorders-asd-a-review",totalDownloads:2203,totalCrossrefCites:7,totalDimensionsCites:12,hasAltmetrics:0,abstract:"Current recommendations indicate that children and youth ages 5–17 should participate in 60 min and adults in 150 min of moderate-to-vigorous physical activity daily. Research suggests that physical activity levels of individuals with autism spectrum disorder (ASD) are lower than typically developing and developed peers. Despite evidence for PA decreasing negative behaviors and promoting positive behaviors, individuals with ASD may be less motivated and less likely to participate. Individuals with ASD may be more likely to be overweight or obese than their typically developing counterparts as a result of decreased activity levels. Conflicting findings regarding PA levels in individuals with ASD have been reported. Given mixed evidence, further inquiry is warranted. The present chapter provides a review of literature pertaining to PA in individuals with ASD. Four databases were searched. Predetermined search terms and inclusion/exclusion criteria were clearly outlined to identify relevant articles which were then critically appraised. This research provides a greater understanding of the status of PA participation of individuals with ASD.",signatures:"Sara M. Scharoun, Kristen T. Wright, Jennifer E. Robertson-Wilson,\nPaula C. Fletcher and Pamela J. Bryden",downloadPdfUrl:"/chapter/pdf-download/53550",previewPdfUrl:"/chapter/pdf-preview/53550",authors:[{id:"190972",title:"Dr.",name:"Pamela",surname:"Bryden",slug:"pamela-bryden",fullName:"Pamela Bryden"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"9634",title:"Autism Spectrum Disorder",subtitle:"Profile, Heterogeneity, Neurobiology and Intervention",isOpenForSubmission:!1,hash:"b9c36a2454fac16e70ba00562cb6f009",slug:"autism-spectrum-disorder-profile-heterogeneity-neurobiology-and-intervention",bookSignature:"Michael Fitzgerald",coverURL:"https://cdn.intechopen.com/books/images_new/9634.jpg",editedByType:"Edited by",editors:[{id:"205005",title:"Dr.",name:"Michael",surname:"Fitzgerald",slug:"michael-fitzgerald",fullName:"Michael Fitzgerald"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"8430",title:"Neurodevelopment and Neurodevelopmental Disorder",subtitle:null,isOpenForSubmission:!1,hash:"696c96d038de473216e48b199613c111",slug:"neurodevelopment-and-neurodevelopmental-disorder",bookSignature:"Michael Fitzgerald",coverURL:"https://cdn.intechopen.com/books/images_new/8430.jpg",editedByType:"Edited by",editors:[{id:"205005",title:"Dr.",name:"Michael",surname:"Fitzgerald",slug:"michael-fitzgerald",fullName:"Michael Fitzgerald"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7835",title:"Autism Spectrum Disorders",subtitle:"Advances at the End of the Second Decade of the 21st Century",isOpenForSubmission:!1,hash:"2cfcf44e79e12e620251aaa9d08a4a3e",slug:"autism-spectrum-disorders-advances-at-the-end-of-the-second-decade-of-the-21st-century",bookSignature:"Michael Fitzgerald",coverURL:"https://cdn.intechopen.com/books/images_new/7835.jpg",editedByType:"Edited by",editors:[{id:"205005",title:"Dr.",name:"Michael",surname:"Fitzgerald",slug:"michael-fitzgerald",fullName:"Michael Fitzgerald"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,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"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,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"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,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"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,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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\r\n\tThe scope of systemic family therapy differs and encompasses cross-cutting contemporary issues related to clinical health, disaster, humanitarianism, displacement, migration, sexuality and reproduction, sexual orientation and gender identity, conflict, and socio-economic concerns. This book, therefore, aims to provide readers with a comprehensive overview of the current state-of-the-art advances in counseling and psychotherapies for families and couples in functional and dysfunctional settings, crisis settings, humanitarian zones, conflicts, and disaster settings. It aspires to showcase scholarly work on the practice of family systemic therapies by researchers, students, professionals, and trainees. The goal of this book is to further explore recent advances, new perspectives, and applications of systemic family therapies on issues such as basic concepts and tools, basic therapeutic skills, the therapeutic process, predominant models of family therapy, the principles of using a constructive and collaborative approach that enhances family resilience and competence in disaster-prone areas. The book will be a collection of scholarly writings on strengths-based therapies and contemporary models such as solution-focused, narrative and conversational therapies for family relationships.
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Guidance and Counselling (1999)from the University of Ibadan, Nigeria as well as a B. A. Hons English Studies (1987) from the University of Ife, Ile-Ife, Nigeria. She also had professional training in Gender Perspectives in United Nations Peacekeeping Operations (2009), Civil-Military Coordination (CIMIC) (2009), and Global Terrorism (2009) under Peace Operations Training Institute, Dispute and Conflict Analysis (2007), and Gender and Health (2013) at AMREF in Nairobi, Kenya. She is currently working at the Centre for Gender, Humanitarian and Development Studies, Redeemer’s University, Ede, Osun State, Nigeria Ado-Ekiti as a Reader. She has an enthusiastic and flexible approach to teaching and a commitment to research and publication. 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The thermal conditioning of the grapes on their arrival at the winery is already an essential requirement in some wineries, and even the grape harvesting systems are adapted to this factor (early or even night grape harvesting), which is very important in warm regions.
The prefermentation works of cold maceration and debourbage in white winemaking, the pellicular maceration in red wines, the controlled fermentations, as well as the processes of finished wine conditioning require a control and maintenance of their optimum temperatures. Table 1 shows the most important applications of refrigeration in a warehouse, as well as the optimal temperatures for each operation.
Importance | ||||
---|---|---|---|---|
Operation | V. in white wine | V. in red wine | Optimum temperature | Effects on wine/must |
Cold extraction | + | − | −5/−10°C | Must sugar concentration by elimination of frozen water |
Cold maceration | ++ | ++ | 5/10°C | Extraction of aromatic precursors Fermentation delay |
Musts Refrigeration | +++ | +++ | 10/18°C | Enable the debourbage in white wines In red wines lower the temperature until the optimum of fermentation |
Deboubarge | +++ | − | 10/15°C | Accelerate the sedimentation process |
Delay the start of fermentation | ||||
Pellicular maceration | ++ | ++ | <15°C | Extraction of polyphenolic fraction and aromatic precursor in red wines before fermentation |
Fermentation thermal control | +++ | − | 13/20°C | Aromatic enhancement in white wines |
Avoid fermentation stops | ||||
Thermal control of fermentation and meccanization | − | +++ | 25/30°C | Decrease aromatic losses |
Avoid fermentation losses | ||||
Cold storage of finished wines | +++ | +++ | 10/15°C | Slow down microorganisms metabolism |
Decrease oxidation and aromatic losses | ||||
Amicrobic stabilization | +++ | ++ | <5–10°C | Filtration process improvement |
Colloidal stabilization | − | +++ | <5–10°C | Hasten unstable coloring matter |
Tartaric stabilization | +++ | +++ | −5/1°C | Hasten tartaric salts of calcium and potassium |
Control the oxidation-reduction process and cession | ||||
Aging in oak | +++ | +++ | 15–20°C | Decrease volume losses |
Avoid undesirable microbial development | ||||
Second fermentation in bottle | +++ | 12/15°C | Control the alcoholic fermentation. Refinement of sparkling wine by slow transfer of fermentation and autolysis products. | |
Bottling | + | + | 15°C | Reduce loss of aroma and enable the process |
Bottle store | +++ | +++ | 12–18°C | Enhance wine stability |
Applications of cold engineering in a wine cellar: optimum working temperatures in wine cellars and the effect on must/wine.
The temperature control can be done from the first stages of winemaking, by cooling the freshly squeezed grape or the must at the exit of the press. Most authors recommend the entry of red wine vintage at 20°C due to an inlet temperature of 26–28°C, this can lead to a difficult start of fermentation and higher production of volatile acidity [1–3]. The prefermentative maceration applied to certain varieties (Pinot Noir) for the extraction of polyphenols needs to bring the crushed-grapes to temperatures below 13°C, to avoid starting fermentation [4].
In white wines, the pellicular maceration of aromatic grapes (Moscatel, Gewürztraminer, Verdejo, Sauvignon Blanc and Chardonnay) at low temperatures enables the extraction of aromatic compounds. The static debourbage is a slow process, which allows in its course the proliferation of microorganisms. Cold helps to stop or slow the start of fermentation, and the low temperatures increase the speed of sedimentation. Time and temperature are the keys for a quality debourbage. The use of pectolytic enzymes allows a considerable reduction of debourbage times, but on the other hand, the cold slows down the enzymatic phenomena of despectination. Therefore, in the debourbages with addition of enzymes, the temperature of the must should not be less than 10°C [5, 6]. The promptness of enzymatic debourbage is doubled when the temperature rises to 10°C, at the expense of risks of grater microbial proliferation, and is discouraged for vintages with poor sanitary quality. Temperatures under 8°C promote the inactivation of the enzymes and lengthen the fermentative latency phase. In any of the above cases, the refrigeration needs to cool the must or the crushed-grapes to the operating conditions are defined by the fundamental equations of the energy balance (Eq. (1)) [3, 7–10]:
dQ/d
∆
The fermentation of sugar by the yeast glycolytic allows the cells to transform glucose and fructose into pyruvic acid and this, through an enzymatic complex of carboxylase activity, will be transformed into acetaldehyde, which is finally reduced by the alcohol dehydrogenase into ethanol. This transformation is an exergonic reaction, releasing heat which, when accrues in the must, causes a thermic elevation.
The metabolic activity of the yeasts increases in proportion with the temperature with maximum rates between 25 and 28°C [16]. Temperatures above 32–35°C imply high risks of fermentation stops, as well as further proliferation of acetic and lactic bacteria. Fermentations below 18°C are distinguished by delayed onset (longer latency phase) and very slow fermentation development. In years of warm harvests, in large deposits or cellars in the middle of the season with several fermentation tanks, it is easy for the microbial activity itself to pass through the 35°C barrier, negatively affecting both cellular viability and the sensorial characteristics of the wine [1–3, 16, 17]. On the other hand, fermentations at moderate or even low temperature (below 18°C) allow preserving the aromatic precursors of the grape varieties and stimulating the formation of secondary compounds by yeasts. All this underlines the importance of having a temperature control of fermentation in the wine cellar. It is considered suitable for fermentation of red wines 28–30°C (aid to maceration), while for fermentation of white and rose, temperatures below 22°C are recommended. The cooling of the must or the crushed-grapes, as indicated above, allows the fermentation process to start at the desired temperature in the case of warm harvests. It is an added advantage in the case of a cold debourbage.
The low temperature fermentations (13°C or less) have a great interest for the production of white and rose wines, especially for musts arising from varieties with a great aromatic potential. In addition to avoiding their evaporation, the low temperatures considerably condition the bacteria development, allowing the use of less doses of sulfur dioxide.
It does not happen the same with the yeasts. The low temperatures influence in a different way on the different species which concur in the must. Some yeasts such as
According to Suárez and Iñigo [1], not all sugar molecules will follow the equation of Gay-Lussac, obtaining two molecules of ethanol and two of CO2 for each mole of glucose, but depending on the metabolism of the yeast, a certain number of molecules are going to be intended to glycerine and pyruvic acid, which will be the origin of secondary products in wine. As a consequence, the thermal flow originated during fermentation will depend on the importance of these secondary reactions.
Bouffards [21] using a sealed calorimetric chamber determines the heat of fermentation reaction between 83.7 and 100.5 kJ/mol. Subsequently, several authors have established a thermal flow ranking from 71 [22] to 106 kJ/mole [1], according to the purity of the fermentative process and the derivation of the glucose molecules toward other secondary metabolic routes. Assuming the most thermodynamically adverse case and the known parallel reactions always occurring to the alcoholic fermentation, the average mean value of heat flow most widely accepted by the various experts is 100.32 kJ/mole [2, 3, 10, 19, 23].
This heat released by mole of transferred sugar corresponds to the theoretical case of an instant fermentation process. In fact, the process lasts several days in which heat dissipation takes place by contact of the tank walls with the outside and by the release of volatile products released during the transformation. According to this, the data referred to by the authors mentioned above as energy released during the process are modified by a factor corresponding to the rate of consumption of sugars throughout the fermentation process with units of [mole/m3.h]. This aspect, directly related to the concentration of ethanol and CO2 produced per unit of time, depends on the physical and chemical conditions of the fermenting must (content in sugars, temperature, acidity, pH and richness in nitrogen sources), operating conditions (yeast morphology population, temperature, agitation and oxygenation) and fermentation time.
To identify and quantify the influence of these factors on the amount of heat energy released throughout the fermentation time, several authors have developed simulations and mathematical models.
Boulton [24] establishes that the loss of heat throughout the fermentation process is defined by Eq. (2):
d
∆
d
This quantification system of the energy released during the fermentation process is the most widely accepted by the experts, although there is no consensus regarding the calculation and valuation of the term d
The model proposed by El Haloui et al. [25] relates the concentration of residual sugars with the volume of CO2 released, according to Eq. (3):
where
The volume of CO2 released can be calculated by empirical analysis in laboratory scale tests with Muller valve occluded flasks [1] or at the level of experimental microvinifications using CO2 flowmeters [26, 27].
Afterwards, and based on empirical data, the same authors [28] build a model which relates fermentation curve with the density and initial concentration of sugars in the initial must (Eq. (4)):
The concentration of residual sugars in each moment of the fermentative process can be calculated, establishing the concentration of glucose-fructose by enzymatic methods or by detection systems based on measurements of radiation in that infrared spectrum.
López and Secanell [15] develop a complex model of the heat evolution curve during fermentation based on physical-chemical parameters such as initial sugar content, total acidity, fermentation temperature and duration of this one. They get expressions such as Eq. (5):
in which
where
Avilés [11] states that the heat developed in fermentation of the must is determined by the probable alcoholic strength of the wine according to Eq. (7):
where
°A is the probable alcoholic grade of the wine (%vol/vol).
Starting from a wide series of empirical data, and from the equation raised in 1978, Boulton et al. [10] established that with a fermentation ratio of 2 Brix/day the energy released is approximately 0.46 kJ/L h for white wines, while for red wine with a ratio reaching 6
According to the Federation Départamentale des Centres d’Etudes et d’Informations Oenologiques of the Gironde-France, FD-CEIOG [12], the heat released in fermentation is defined by Eq. (8):
Flanzy [3] established that the released energy during fermentation can be estimated approximately by knowing the concentration of sugars consumed per hour and liter of must, taking into account that one mole of glucose is equal to 180 g (Eq. (9)):
180 g/mole glucose.
V is the total volume of the must to ferment (L).
100.32 kJ/mole glucose.
These mathematical models are difficult to apply in the cellar, so for practical purposes it is more interesting to consider the quantity of sugar consumed per liter of must and per hour. However, there are no reproducible models of the consumption of sugars during fermentation, but the thermodynamic curve of fermentation must be determined for each specific vinification. As an operational parameter for the calculation of cold storage needs of a wine cellar, the maximum value of energy released must be considered (Eq. (10)).
This means that for a must of 12° the heat released is 133 kJ/L of must in fermentation, although for the calculation of cold production equipment it is interesting to refer the total energy produced during fermentation to the duration of the same
Part of this energy produced in fermentation is absorbed by the alcohol, the H2O and the CO2, which when released into the atmosphere partially or totally cools the system. A total of 180 g of glucose produces 88 g of CO2 and 92 g of ethanol when they ferment. Each mole of CO2 formed drags 13.62 kJ for each mole of glucose metabolized. The heat absorbed by the water and the alcohol is determined by the rate of vaporization of the substances, depending on the temperature reached during fermentation and the exterior of the premises [11]. Due to the difficulty of these calculations and the slight thermal decrease, they mean, most authors [2, 3, 10] consider that the heat lost in form of CO2, ethanol and water equals 10% of the total heat generated.
On the other hand, a certain percentage of the energy released in fermentation is dissipated by the environment, depending on the outside temperature. When the set fermentation temperature is lower than the environment temperature, it produces a thermal transfer from the environment to the tank. The calculation of the energy released or absorbed is based on the conduction/convection heat transfer equations (Eq. (11)) [8–10]:
S is the outer surface of the tank in contact with the environment.
∆T is the temperature difference between the must in fermentation with the exterior (°C or °K).
If fermentation tank (or later of storage) is located outside the winery, the solar thermal input is important in regions with high isolation. In order to calculate the energy input, it is necessary to take into account the degree of incidence of the solar rays on the surface of the deposit. Flanzy [3] considers that this thermal contribution varies between 400 w/m2 in winter and 800 w/m2 in summer for northern countries. Generally speaking, in Spain, the values can vary between 700 and 1100 w/m2, respectively. On the other hand, during the night, a significant cooling of the fermentation mas takes place. In complex calculations, involving many variables not always known, this heat dissipation is not taken into account when calculating the cold storage needs, being a margin of safety of the calculations made.
According to what has been said so far, the heat produced during the fermentation process to be dissipated by the application of cold is (Eq. (12)):
Freshly fermented wine is a saturated solution of tartaric salts whose solubility depends on the alcoholic strength and temperature. In order to avoid the presence of soaps once the wine is bottled, it is necessary to produce in the winery the insolubility and subsequent precipitation of these tartaric salts, mainly potassium bitartrate and calcium tartrate. For this, the wine is subjected to low temperatures modifying its solubility. This must refrigeration presents other side effects of great importance: precipitation of coloring matter and unstable proteins, insolubilization of colloids and reduction of the wine microbial load and facilitates the subsequent process of microbiological stabilization
According to Boulton [13], Maujean [29] and Moutonet et al. [30, 31], the formation of tartrate crystals follows a kinetic of the form (Eq. (13)):
The tartaric stabilization can be carried out discontinuously and continuously. The traditional or continuous stabilization is based on cooling the wine to a temperature close to the freezing temperature set in
which means reaching temperatures of −5/−6°C. Once the wine has been cooled at this temperature, it is stored in isothermal tanks and they remain until Tsat control data, conductivity or other stability tests result in the stabilization of the wine [2, 18, 32]. This guard time lasts between 7 and 10 days. The modern stabilization systems, continuous or semicontinuous, are based on the refrigeration of the wine to a temperature close to 0°C or slightly lower (−2.5°C) with addition of microcrystals of tartrates in variable concentration (generally 4 g/L) and continuous stirring contact method. With these procedures, the treatment time is reduced from 7–10 days to 60–90 min [12, 33]. In both cases after the treatment, the wine already treated gives its cooling energy to the wine that enters by a plate exchanger. Subsequently, it is subjected to a process of filtration by earth or plates to eliminate crystals.
The refrigeration capacity required to cool the wine until the stabilization temperature of −5/−6°C (batch system) to −2.5/0°C (continuous system) is defined by the expression (Eq. (14)) [3, 8–10]:
d
For the refrigeration of white wine must, until the temperature of the debourbage or cryomaceration and for the decrease of the temperature of red wine crushed-grapes to the one stablished in fermentation, indirect and direct systems of heat transfer may be used. Among the indirect systems of possible application in the winery, the refrigeration equipment with scraped surface evaporator or with evaporator of concentric tubes and the exchangers are described. As direct methods, CO2 solids and liquid CO2, known as carbonic snow, are used.
The indirect refrigeration systems most commonly used in the winery are plaque exchangers, tubular exchangers and spiral exchangers. The tubular exchangers consist of a central conduct, of small diameter through which the must or wine circulates, which is concentrically in the interior of a tube of greater diameter through which circulates the refrigerating fluid. The diameter of the inner tube is determined by the viscosity of the fluid flowing through it. Diameters greater than 75–90 mm are recommended for musts and crushed-grapes; for wine, diameters of 50 mm are optimal. The exchange surface and the number of tubes required by the thermal transfer equations will be seen below.
The plaque exchangers consist on fine rectangular surfaces through which the refrigerant and must circulate counterflow. The separation between the plaques does not exceed 10mm and have rough surfaces to create turbulence between the exchange fluids
In the spiral exchangers, the must/crushed-grapes enter at one end and run along a spiral path until it leaves the center axis. At the same time, the refrigerant fluid counterflows on the opposite side.
The cooling power generated by the refrigerant in the heat exchanger is defined by the general energy transfer equation (Eq. (15)) [8, 9, 24]:
where
d
d
λ is the latent heat of vaporization of the refrigerant (kJ/kg).
Geankoplis [9] and McCabe et al. [8] propose a formula (Eq. (17)) for the calculation of the thermal transfer coefficient U, the Donohue expression applied for low values of the Reynolds number,
ma, mm is the mass per unit of time of glycol water and must in circulation (kg/h).
This complex expression is difficult to apply in practice by relying on factors not always known in oenology, so in a generally accepted form empirically obtained values of U are used.
For tubular exchangers used in musts, the value of
In plate exchangers
In spiral exchangers
In direct refrigeration system, two fluids that exchange energy are physically in contact. In oenology, the inert gases N2 and CO2 are used as refrigerating fluids, since when vaporizing at low temperatures they absorb heat from the must/crushed-grapes.
Of the two inert gases mentioned above, CO2 in solid and liquid forms is the most used in oenology, due to its low sublimation temperature at atmospheric pressure –72.4°C, added contribution of inert atmosphere of conservation, possibility of partial freezing of the must with the consequent sugar concentration, ease of handling and no residues.
The cooling capacity provided by CO2 in solid form is defined by the following expression (Eq. (18)) [4, 8–10, 13]:
If ice is produced due to the freezing of the water from the must to this expression (Eq. (19)), we must add the energy due to the sublimation heat of CO2:
where
To form 1 kg of ice in the must mass, it is necessary to add 0.58 kg of CO2 to the freezing temperature of the must (–2.5 to 3.0°C). In the refrigeration of musts, wines and crushed-grapes, the formation of ice is unadvisable to increase the risk of subsequent physical and chemical instability, so that for the purpose of calculating the cooling power, generally the energetic term
According to Boulton et al. [10, 13], in order to reduce the temperature of a white wine must (5°C), it is necessary to use 4.42 kg of solid CO2 for each hectoliter of must. Geankoplis [9] stablishes that due to the energy losses by the deposit walls, this quantity must increase to 4.6 kg/hl.
The use of CO2 in liquid form supposes a decrease of the dissipated energy of the deposit in relation to the solid ice, since in the energy transfer equation the latent heat of fusion of CO2 does not come into play, resulting (Eq. (20)):
As stated above, it is not advisable to form ice from the water of constitution of the must or crushed-grapes, whereby the above expression is modified as follows (Eq. (21)):
In order to dissipate the energy produced during fermentation in the oenological industry, water spray or shower systems, refrigeration liners and internal plaques or snakes are used. The external exchangers are also used, the description of which has been made in the previous section as it is the most used mechanism in the refrigeration of musts and crushed-grapes in prefermentative operations.
It consists on spraying the walls of the fermentation tank with water from an upper ring connected to a general feed system. A very fine and homogeneous layer of laminar water is generated, which descends through the walls and is normally collected in channels arranged in the lower part of the tank. An automatic control allows the opening and closing of solenoid valves according to the temperature inside the tank and the preset. The refrigeration mechanism by conduction and convection is based on the removal of energy from the tank by partial vaporization of the circulation system water.
Thermodynamically, it is the most unfavorable refrigeration system and the one that uses the greater volume of water, which supposes a greater environmental cost. These cases are recommended where no refrigerated water is available (below 20°C). For this reason, it is used with efficiency in the control of fermentation in red wine vinifications, not being able to be applied in any case for rose and white wine vinifications.
The refrigeration power of the water curtain is defined by the heat of vaporization of the water at room temperature. The heat of its vaporization is the sum of its sensible heat in liquid state and the latent heat of vaporization corresponding to the change in water-vapor station. For calculation purposes, the refrigeration power of the water due to sensible heat is defined by (Eq. (22)):
where
The refrigeration power due to the latent heat of water vaporization is (Eq. (23)):
where
The wet bulb temperature of the air can be determined on a psychometric diagram and depends on the room temperature and the relative humidity of the air.
Only if the water temperature exceeds the humid bulb temperature of the air, vaporization has place and therefore a dissipation of energy of the tank, since if it is lower a condensation of the air humidity occurs on the tank.
The use of refrigeration shirts is currently the most widespread fermentation control system in both white and red winemaking. Traditionally, they have been constructed in stainless steel and are fixedly arranged in the upper part of the tank, occupying between 15 and 30% of the surface. In the recent years, some manufacturers are using new polymers of medium rigidity and high resistance that makes possible their installation on the tank according to the needs of the campaign. As to their disposition, and in agreement with the results of several investigations that advise for vinifications in red wine the use of fermentation tanks of equal height and base diameter, the shirts are installed covering the greatest part of the side surface of the deposit, reaching in some cases 90% of it. This new system allows a homogeneous control of fermentation, avoiding the problem of the thermal stratification that takes place with large diameters.
Similar to the tubular and plaque exchangers, the exchanged energy is defined by the general energy transfer equation (Eq. (24)) [8, 10, 13, 38]:
(ΔT)ml is the logarithmic mean temperature difference between glycol water and must (Eq. (25))
Two of the cases that take place, the refrigerating fluid changes of state for example R-717 evaporated to 5–7°C (in that case the fluid temperature is constant) or there is no change of state (glycol water), producing a heating throughout the cooling process. As approximate data, it is considered that water enters between 5 and 7°C and exits between 10 and 12°C.
For the purpose of calculating the equipment of the cold production facility, a simplified equation of the above is used (Eq. (26)):
Since the must/wine inside the tank is in steady state and this heat exchange equation is applied for counter current flowing fluids, the term (Δ
It should be noted that 50% of the refrigerating protein produced by the shirt dissipates in the environment surrounding the tank if it is not well heat-insulated. In case no insulation is available, the required shirt surface must be doubled, or, if appropriate, the cooling capacity is reduced by half for calculation purposes.
The cooling jackets have very low heat transfer coefficients due to the steady state in which the must/wine is located inside the tank. The effectiveness of the refrigeration decreases proportionally with the diameter of the tank, being considered that for normal temperatures of circulation water limiting diameters of more than 4 m, due to the vertical thermal stratification that occurs [10, 13, 35]. If only large diameter tanks are available, the effectiveness decreases in a high percentage, so to maintain it in appropriate values, very low temperatures are required in the glycolic water, close to 1–2°C. According to Bouton et al. [10, 13], if the diameter doubles the surface of the jacket, it is multiplied by four and the volume of the must/wine is refrigerated by eight, maintaining the ratio surface/volume. As an approximate value and only for approximate calculations, 2 m2 of cooling jacket per 100 hl of must in fermentation is recommended.
The cooling jackets are used in the tartaric stabilization process of the wines by the system of planting nuclei of crystallization, circulating glycolic water at −7°C to reach temperatures of −1°C.
The coolant fluid flows through an exchanger (plaque or coil) submerged in the must/wine. The refrigeration is based on convection and conduction phenomena.
It is a very economical solution as it does not require special tanks and large accessory installations. It is applied in wine cellars of small and medium capacity that have tanks with volumes never exceeding 300 hl. As an advantage, the possibility of placing them in the zones of maximum thermal generation is at any level and from the beginning of fermentation.
Both plates and coils are constructed of stainless steel and are usually mobile structures that are moved from one tank to another by flexible conducts. Glycol water circulates in its interior at temperatures of 5–7°C or refrigerating fluids with similar evaporating temperature. The refrigeration capacity generated is calculated in the same way as in the case of outer cooling jackets, taking into account that in this case the exchange surface is double as both sides are in contact with the must/wine (Eq. (27)):
taking
To carry out the tartaric stabilization, the wine is cooled to the temperature previously set according to the system used continuous or discontinuous. The temperature of the wine must be lowered to −5°C in discontinuous systems and from 0 to −2°C in continuous systems, to cause the crystallization and precipitation of potassium bitartrate and calcium tartrate. The required cold is generally supplied by a scraped surface exchanger, with glycol water or with direct expansion of the refrigerant.
An exchanger with scraped surface is constituted by a cylinder of 0.75–1 m of length and 0.15–0.20 m of diameter, in whose interior a series of pallets is located around an axial axis with a rotation movement between 300 and 600 rpm. Inside the cylinder circulates the wine to be treated. In this way, concentric to the previous one, is arranged a cylinder or cooling jacket through which the refrigerating fluid is counter flow with the wine. The mission of the pallets is to remove and circulate the ice formed and deposited on the wall of the exchanger, around 10–20% according to the treatment temperature. According to McCabe et al. [8] and Geankoplis [9], the energy transferred from the glycolic water or the refrigerating fluid to the wine in a range t is calculated according to the expression (Eq. (28)):
where
Due to the difficulty of calculation, for practical purposes, the dimensioning of a scraped surface exchanger is performed according to the simplified energy transfer equation (Eq. (29)) [10, 13, 34].
(Δ
As values of
Venous thromboembolism (VTE) is a set of diseases in which blood clot forms and occludes venous circulation and regard as the third frequent acute cardiovascular disease [1]. Clinically, VTE presents as deep vein thrombosis (DVT) and pulmonary embolism (PE) which account for two-third and one-third of VTE, respectively [2]. The estimated annual rate of incidence of VTE is 80 to 260 per 100000 population [3]. In general, the incidence of VTE increases with age. One epidemiologic study in United States showed that the incidence of VTE was 143 per 100000 in papulation at age 45–49 years and 1134 per 100000 in those at age > 80 years [4]. There is difference of incidence between ethnicities and black and white have higher incidence than other races [2]. Although patients with VTE might be asymptomatic, VTE is a potentially fatal disease. One study reported that the estimated annual VTE-related death was around 300000 in U.S [5] and nearly 30% of VTE patients died within 30 days after diagnosis. Compared to DVT, PE accounts for majority of early-stage mortality of VTE [6, 7]. In addition to VTE-related mortality and cardiovascular sequelae, such as post-thrombotic syndrome, chronic venous insufficiency and chronic thromboembolic pulmonary hypertension, etc., patients with VTE have high risk of other atherosclerotic diseases and acute cardiovascular events, such as acute myocardial infarction and ischemic stroke, in the short-term and long-term follow-up [8, 9, 10]. With a brief review of pathogenesis and risk factors of VTE, the following of this chapter focuses on percutaneous interventions for VTE.
Virchow’s triad composed of stasis, vascular damage and hypercoagulable status describes the essential components contributing to the thrombus formation [11]. In most cases of VTE, stasis plays a major role triggering the formation of venous thrombosis [12]. However, the exact pathogenesis of VTE seems to be more complex and is not fully understood [2, 13]. Only one existing contributing factor is hard to result in the development of clot formation [14]. Nonetheless, the interaction between multiple concurrent contributing factors increases the risk of formation of venous thrombosis which progresses to significant VTE clinically thereafter.
In clinical aspect, many diseases and circumstances regarded as risk factors are identified to predispose to the development of VTE. In general, these risk factors are classified into genetic and acquired risk [15, 16, 17, 18]. Genetic risk factors including protein C and S deficiency, antithrombin deficiency, the factor V Leiden gene mutation, antiphospholipid syndrome, etc. Acquired risk factors are further divided into concurrent diseases (elderly, chronic diseases, active cancer, obesity) and transient states (surgery, trauma, hospitalization, immobility, central venous catheter or device indwelling, oral contraceptives, etc.) [2]. Of note, hospitalization is an important period that multiple risk factors encounter concurrently and increase the risk of VTE greatly [2, 19]. Although predisposing factors are identified in most cases of VTE, there are still almost 20% of case having no obvious etiology. The result suggests the significance of unknown genetic or acquired risk factors to the development of VTE [2, 3].
To date, anticoagulation is still the principal treatment in VTE. In addition to traditional anticoagulation, including heparin, low molecular weight heparin and vitamin K antagonists, as well as direct thrombin inhibitors, non-vitamin K oral anticoagulants (NOACs), known as direct oral-anticoagulant (DOACs) change the strategy in medical treatment of VTE. The update of principles and strategies of medical treatment of VTM will be illustrated in another chapter. On the other hand, endovascular or surgical thrombectomy and embolectomy have role in treatment of VTE. Historically, Läwen conducted the first thrombectomy for venous thrombosis of upper extremity in 1938 [20]. After evolution in nearly 90 years, there are great advances in techniques and modalities in performing thrombectomy and embolectomy. However, thrombectomy or embolectomy is still indicated in limited population in modern treatment of VTE, especially in patients with massive or submassive thrombus burden accompanied by unstable hemodynamic status or critical complications [21, 22, 23]. Theoretically, endovascular or surgical thrombectomy removes majority of thrombus load more completely and recanalization of occluded vessels earlier [24, 25]. Moreover, some previous studies even reported that thrombectomy may have potential benefits comparing to anticoagulation alone in long-term complications and quality of life in certain VTE patients [22, 26]. The aim of this chapter will focus on the advances of modalities of endovascular and surgical thrombectomy.
Percutaneous management, also known as catheter-based therapy (CBT), for VTE can be divided into two mechanisms: thrombolysis-based and mechanical thrombectomy. There are also devices combining these two mechanisms. For certain conditions, percutaneous approaches also include balloon angioplasty and stenting. We describe different types of CBT in the following sections.
Compared to systemic thrombolysis, catheter-based thrombolysis is, by concept, more likely a local therapy. The advantage of this approach is a reduced-dose thrombolysis. Therefore, there is less risk of bleeding [27, 28]. Although with lower dosage needed, absolute contraindications for catheter-directed thrombolysis are the same as for systemic thrombolysis, including history of any intracranial hemorrhage, ischemic stroke within three months, structural intracranial lesion, active bleeding, recent head, eye or spinal surgery, and recent head trauma [29, 30].
This approach is done by placing an infusion catheter with multiple side holes and a tip occluding wire or a dedicated catheter specifically for a certain device, preferentially into the thrombus. It may sometimes require two catheters to be placed in each of the main pulmonary arteries. If there is no specialized catheter, a standard pig-tail or pulmonary artery catheter may also serve to deliver thrombolytic agent locally. When performing intervention for pulmonary embolism (PE), power injection may be necessary to take clear angiography to localizes the emboli. For each main pulmonary artery, perform contrast injection at 15–20 m/s for a total volume of 30 ml [28]. For intervention of deep venous thrombosis (DVT), careful hand injection with low-volume contrast is preferred to avoid disruption of thrombi with progression to PE [30].
Thrombolytic agent is administered via the carefully placed catheter. There is no standard for the agent and dosage used. It varies according to accompanied device, patients’ bleeding tendency, and physicians’ preferences. A commonly used regimen is tissue plasminogen activator (tPA) 0.5–1.0 mg/hr for 6–24 hours, with total dosage usually between 12 and 24 mg. Fibrinogen should be monitored during infusion of fibrinolytic agent. Dose reduction or discontinuation should be considered if level of fibrinogen falls below 150 mg/dL. During t-PA infusion, a low-dose heparin infusion is usually kept, with a partial thromboplastin time (PTT) just around the lower limit of therapeutic range, usually PTT 40–50 seconds [28, 30].
Catheter-directed thrombolysis applies for both DVT and PE. A key factor to success of lytic-based approach is that whether the thrombolytic agent is delivered into the thrombus with good penetration. A resolution to this problem is combining other method to enhance efficacy of drug delivery, such as the EkoSonic system.
EkoSonic™ Endovascular System (EKOS) is a device for ultrasound-assisted catheter-directed thrombolysis. It includes a control unit and a uniquely designed catheter to achieve better penetration of thrombolytics by so-called acoustic pulse thrombolysis. The catheter is composed of an ultrasonic core in central lumen, central coolant lumen, and drug delivery lumen. The ultrasonic core generates an acoustic field to enhance drug delivery into the clot and to unwind the fibrin for better exposure to thrombolytic agents. This system is indicated for both DVT and PE [31].
There were also devices designed for a true localized therapy. Trellis™ Peripheral Infusion System is a specialized device for isolated thrombolysis. It consists of two occlusive balloons to isolate the treatment area, an infusion zone to deliver thrombolytic agents, an oscillation drive unit to better disperse the drug to thrombi, and an aspiration window to remove the dissolved clot. Although with a unique design to ensure localized thrombolysis and thrombi removal, the devices were recalled due to incorrectly labelling of proximal and distal balloons [32].
Of note, catheter-directed thrombolysis alone may not be sufficient to clear all blood clots, although it is true that the goal of catheter-directed thrombolysis for PE is not to remove emboli completely, but to reduce the risk from high to intermediate [29]. Further intervention to remove emboli and thrombi may be needed and there are devices combining local thrombolysis and sequential blood clot removal, which would be described later.
Mechanical thrombectomy is achieved by physical disruption of thrombus via different methods, with various devices designed for this purpose. These devices have different benefits, adverse effects, and special concerns while manipulation. Overall, they are less invasive compared with traditional surgical thrombectomy. Some devices achieve thrombus removal in a single session, sparing the use of thrombolytic agents. The following section describes devices with approval. Devices still under development are not covered.
Mechanical thrombectomy without a device has long been described in both treatment for DVT and PE. It is usually done by a pigtail with manual rotation or by balloon angioplasty [28]. An important issue of fragmentation is that it might create distal emboli, causing worse distal obstruction; and fragmentation alone may not be enough to resolve obstruction. It may be followed by systemic thrombolysis, catheter-directed thrombolysis, or thrombi removal by manual aspiration. Due to lack of clinical evidence, there is no recommendation for how to combine other strategy after manual thrombus fragmentation.
Besides manual thrombus aspiration with a regular guide catheter or specialized catheters with greater power of suction, there are devices designed to remove thrombus by suction via negative pressure. The advantages are the ability to remove large thrombi or even chronic thrombi, avoidance of thrombolytic agents, and possible less risk of bleeding.
The AngioVac® system works in an extracorporeal circuit and needs two large venous access sites for AngioVac inflow cannula (22Fr) and reinfusion outflow cannula (16–20 Fr). The third generation uses funnel-shaped and different-angled tip (20 degree or 180 degree) to facilitate navigation. Besides the need of two large-bore accesses, another disadvantage of this device is that perfusionist is required. It is indicated for removal of fresh, soft thrombi or emboli in right atrium, right ventricle, superior vena cava, inferior vena cava, and iliofemoral veins during extracorporeal bypass. It is not indicated in pulmonary vasculature although there are case series [33].
The FlowTriever® system includes an Triever Aspiration Catheter, a FlowTriever catheter, and a retraction aspiration device. Thrombus removal is done by manual aspiration with a syringe via the large-lumen aspiration catheter. There are nitinol mesh disks on the tip of FlowTriever catheter to disrupt and drag residual clots into the aspiration catheter for extraction. This system is indicated for PE [34]. A similar system dedicated for DVT is the ClotTriever® system. It includes a ClotTriever sheath and a ClotTriever catheter. The procedure steps are somewhat different. The ClotTriever catheter is position beyond the thrombus. A mesh collection bag on the tip of ClotTriever catheter retracts thrombi into the ClotTriever sheath with a self-expanding funnel tip, providing embolic protection. Manual aspiration is applied if there are residual thrombi in the sheath. Since treatment is completed in a single session and there is no need for thrombolysis, care in intensive care unit (ICU) after procedure may not be necessary. However, a large-bore vascular access (20 Fr) is needed [35].
Penumbra’s Indigo® Aspiration System operates in a more “automatic” way, with less need of manual control. The main components of the system are a catheter, a Penumbra ENGINE to generate vacuum for aspiration, and a tubing system. When the catheter is in position, the system performs automatic aspiration. With different catheters, there are corresponding Separator wires to remove clot in the lumen of aspiration catheters. Compared to AngioVac® and FlowTriever®, the Indigo® system does not require large-bore vascular access but may therefore unable to remove larger thrombi. It is indicated for removal of fresh, soft thrombi or emboli in both peripheral arterial and venous system and for treatment of PE [36].
Syringed-based thrombectomy offers limited force and aspirated volume, and operators could not further manipulate. Pump systems with specific devices provide increased force and volume but usually with increased complexity of the procedure and increased cost. Control Mechanical Thrombectomy™ system (Aspire) works in a different way. The system includes a thrombectomy catheter and a control mechanical aspirator which is like a handle. Through the handle, the operator can adjust strength of the aspirated force, and switch between continuous and pulsed force. It is indicated for removal of fresh, soft thrombi in peripheral vasculature, but not PE [37].
The concept of rotational thrombectomy is thrombus disruption by a catheter with rotating head. Most devices also have the ability to remove thrombus via active suction.
Aspirex® mechanical thrombectomy device consists of a catheter with a handle and a drive system. At the tip of the catheter, there is aspiration port to suck in thrombi; and inside the catheter, there is rotational coil to break down thrombi. The fragmented thrombi are then aspirated out. The device is indicated for both arterial and venous thrombi. With limited case studies, it is not approved for treatment of PE [38].
CLEANER™ Rotational Thrombectomy System is a one-piece device. Rotating action of its sinusoidal wire breaks down thrombi. The sinusoidal shape provides atraumatic action on thrombi adhered to vessel wall. The device also enables infusion of thrombolytic agents via a distal side hole. It is indicated for removal of thrombus in peripheral vasculature, but not for PE [39].
Rheolytic thrombectomy is based on Bernoulli effect. A high-velocity saline jet creates a low-pressure, drawing thrombi into the catheter. To eliminate thrombi better, it may be accompanied with thrombolysis or other mechanical method such as aspiration.
Among this category, the mostly studied device is AngioJet™ Rheolytic Thrombectomy System, consisting of a console and a thrombectomy catheter. The system works in both pharmacological and mechanical ways. Operators can deliver thrombolytic agents directly into the clot to facilitate removal of thrombus. The console generates pressurized saline to draw thrombi into the catheter via an inflow window near the tip of the catheter, and then evacuates the thrombi. Notable adverse events include pain, cardiac arrythmia (mainly bradyarrhythmia), hypotension, transient hemolysis, bleeding, and acute kidney injury. Hydration before, during, and after the procedure may be considered. AngioJet™ system is indicated in removal of thrombi in peripheral vasculature. When used in PE, there were severe adverse events, including death; so, there is a “black box” warning for AngioJet™ in treating PE [40].
The concept of combination works in at least two modes. One is to combine multiple mechanisms at the same time, usually by devices, like EKOS or AngioJet™. The other way is to use different methods sequentially. For instance, physicians may perform balloon angioplasty first to disrupt the thrombi; and then leave an infusion catheter for thrombolysis. This concept also works in a reverse way. Physicians may place an infusion catheter for thrombolysis first, usually for 24 hours; and then break the loosen thrombi with balloon angioplasty. Theoretically, combing thrombolysis and mechanical thrombectomy improves efficacy of thrombus removal, but there is no standard for how to combine multiple strategies due to limited studies. This so-called pharmacomechanical approach is therefore, largely based on clinicians’ experience.
Besides thrombolysis and mechanical thrombectomy, some adjuvant procedures may be needed, mainly for DVT. Balloon angioplasty plays a role in chronic thromboembolic pulmonary hypertension, but not for acute PE. For DVT, placement of inferior vena cava filter before procedure may be considered to prevent PE, especially for patients with poor cardiopulmonary function and deemed unable to tolerate PE [30]. The results of studies regarding stenting for DVT were inconsistent, although some showed reduced severity in post-thrombotic syndrome and improved quality of life in some aspects [41, 42, 43]. This approach is therefore largely based on clinicians’ experience.
Stenting is considered if there is residual thrombi or residual venous outflow obstruction. It may also be considered when there is non-thrombotic cause of stenosis, such as in May-Thurner syndrome. Therefore, careful assessment of the lesion is important. It is helpful to combine other image modality such as computed tomography or intravascular ultrasound. Besides anatomical nature, clinicians should put patients’ life expectancy, bleeding risk, and likelihood of symptom improvement into consideration. When a stent is placed, there is always risk of in-stent restenosis or occlusion. Risk factors include poor inflow, external compression, inappropriate stent design, stent misplacement or migration, stent fracture, and bleeding. Patients should be notified about the possibility of reintervention [44].
The purpose of CBT is to relieve obstruction quicker, compared with traditional medical therapy. However, there is no strong evidence that CBT is better than traditional systemic thrombolysis since randomized trial assessing hard outcomes, such as mortality, is lacking. Also, among CBT, there is no trial comparing catheter-directed thrombolysis and mechanical thrombectomy or comparing different devices. It is also important to remember that published studies for CBT with devices are of small patient numbers. There are many trials still going on. Hopefully, these trials will provide evidences for more specific guidance.
For any intervention, there are always complications. Possible complications of CBT include access site bleeding, vascular injury, major bleeding (including intracranial hemorrhage), distal emboli (especially of concern with PE when performing intervention for DVT), cardiac tamponade (intervention for PE), hemodynamic deterioration, and deterioration in renal function. Some studies did not demonstrate the presumed benefit of less major bleedings (including intracranial hemorrhage) in percutaneous methods, compared with systemic thrombolysis [28, 29]. The balance between risk and benefit of these interventions should be personalized.
Generally speaking, CBT may be considered in patients with iliofemoral DVT who have severe symptoms and a low risk of bleeding [45]. For PE, CBT is an alternative to systemic thrombolysis and surgical embolectomy, considered when these approaches are contraindicated or fail [46]. For now, the choice of CBT largely remains on physicians’ experience and local availability.
Surgical intervention is an old skill compared with percutaneous intervention. Surgical embolectomy of PE requires cardiopulmonary bypass. After thoracotomy, emboli are removed manually with forceps. Balloon catheter and suction may be used for residual emboli. Although surgical embolectomy is a class I indication for massive pulmonary embolism, it is usually reserved as a salvage therapy when other therapies fail or are contraindicated, due to its invasive nature. If there is thrombus in right heart or thrombus across patent foramen ovale, surgical embolectomy would be considered the first-line therapy [27].
On the other hand, surgical thrombectomy for DVT is usually done with a special balloon catheter to pull out thrombi in the direction of venous flow, called Fogarty maneuvers [47]. Unlike for PE, surgical thrombectomy for DVT is not recommended by clinical guidelines. Although there are studies showing good patency rates after surgery, it is usually considered only in certain conditions when rapid reduction of venous obstruction is needed, such as in patients with phlegmasia cerulea dolens [48].
Although rapid evolution of modalities and relatively high successful rate in experienced center, routine use of endovascular or surgical thrombectomy and thrombolysis in patient with VTE is not recommended. To date, large-scale clinical trial assessing the efficacy and safety of invasive thrombolysis or thrombectomy is still lack. The application of endovascular or surgical strategies should be considered in selective VTE patients with unstable hemodynamic status or critical VTE-associated complications or having contraindications or high risk of bleeding while receiving systemic thrombolysis. In addition, future studies focusing on cost-effectiveness are needed to integrate these invasive procedures with medical strategies in the protocol of VTE treatment.
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All published Book Chapters are licensed under a Creative Commons Attribution 3.0 Unported License. Monographs are licensed under the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) license granted to all others. Our Copyright Policy aims to guarantee that original material is published while at the same time giving significant freedom to our Authors. IntechOpen upholds a flexible Copyright Policy meaning that there is no copyright transfer to the publisher and Authors hold exclusive copyright to their work.
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\n\n\n\nIntechOpen is committed to disseminating high-quality scientific research in a manner that exemplifies the best practice in scholarly publishing. IntechOpen is an official member of the Committee on Publication Ethics (COPE), which advocates the maintenance of the highest ethical standards for all parties involved in the act of publishing, including Authors, Academic Editors of the book, Peer Reviewers, the publisher and Societies, where applicable.
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In this review, we describe MRSA in food-producing animals (pig, cattle, chicken), horses, pet animals (dogs, cats), and food products (pork, beef, chicken, milk, and fish).",book:{id:"5471",slug:"frontiers-in-i-staphylococcus-aureus-i-",title:"Frontiers in Staphylococcus aureus",fullTitle:"Frontiers in Staphylococcus aureus"},signatures:"Jungwhan Chon, Kidon Sung and Saeed Khan",authors:[{id:"189634",title:"Dr.",name:"Kidon",middleName:null,surname:"Sung",slug:"kidon-sung",fullName:"Kidon Sung"},{id:"190400",title:"Dr.",name:"Jungwhan",middleName:null,surname:"Chon",slug:"jungwhan-chon",fullName:"Jungwhan Chon"},{id:"190401",title:"Dr.",name:"Saeed",middleName:null,surname:"Khan",slug:"saeed-khan",fullName:"Saeed Khan"}]}],mostDownloadedChaptersLast30Days:[{id:"69731",title:"Isolation and Purification of Sulfate-Reducing Bacteria",slug:"isolation-and-purification-of-sulfate-reducing-bacteria",totalDownloads:1501,totalCrossrefCites:1,totalDimensionsCites:6,abstract:"Sulfate-reducing bacteria (SRB) are a widespread group of microorganisms that are often isolated from the anoxygenic environments (lake depths, soil, or swamps), and they are also present in the human and animal intestines. This group is often detected in patients with inflammatory bowel disease, including ulcerative colitis. That is why new rapid methods for their isolation, purification, and identification are important and necessary. In this chapter, the methods of mesophilic SRB isolation from various environments are described. Particular attention is paid to the purification of mesophilic SRB since they can be in close interaction with other microorganisms (Clostridium, Bacteroides, Pseudomonas, etc.), which are their frequent satellites. Moreover, the main methods of mesophilic SRB identification based on their morphological, physiological, biochemical, and genetical characteristics are presented.",book:{id:"8997",slug:"microorganisms",title:"Microorganisms",fullTitle:"Microorganisms"},signatures:"Ivan Kushkevych",authors:[{id:"252191",title:"Associate Prof.",name:"Ivan",middleName:null,surname:"Kushkevych",slug:"ivan-kushkevych",fullName:"Ivan Kushkevych"}]},{id:"65773",title:"Life Cycle of Trypanosoma cruzi in the Invertebrate and the Vertebrate Hosts",slug:"life-cycle-of-em-trypanosoma-cruzi-em-in-the-invertebrate-and-the-vertebrate-hosts",totalDownloads:1393,totalCrossrefCites:4,totalDimensionsCites:7,abstract:"Trypanosoma cruzi (T. cruzi) is a protozoan parasite that causes Chagas disease, a zoonotic disease that can be transmitted to humans by blood-sucking triatomine bugs. T. cruzi is a single-celled eukaryote with a complex life cycle alternating between reduviid bug invertebrate vectors and vertebrate hosts. This article will look at the developmental stages of T. cruzi in the invertebrate vector and the vertebrate hosts, the different surface membrane proteins involved in different life cycle stages of T. cruzi, roles of different amino acids in the life cycle, carbon and energy sources and gene expression in the life cycle of T. cruzi. The author will also look at extracellular vesicles (EV) and its role in the dissemination and survival of T. cruzi in mammalian host.",book:{id:"8806",slug:"biology-of-em-trypanosoma-cruzi-em-",title:"Biology of Trypanosoma cruzi",fullTitle:"Biology of Trypanosoma cruzi"},signatures:"Kenechukwu C. Onyekwelu",authors:[{id:"245368",title:"Dr.",name:"Kenechukwu C.",middleName:null,surname:"Onyekwelu",slug:"kenechukwu-c.-onyekwelu",fullName:"Kenechukwu C. Onyekwelu"}]},{id:"54154",title:"Staphylococcus aureus: Overview of Bacteriology, Clinical Diseases, Epidemiology, Antibiotic Resistance and Therapeutic Approach",slug:"staphylococcus-aureus-overview-of-bacteriology-clinical-diseases-epidemiology-antibiotic-resistance-",totalDownloads:7096,totalCrossrefCites:14,totalDimensionsCites:25,abstract:"Staphylococcus aureus is an important human pathogen that causes wide range of infectious conditions both in nosocomial and community settings. The Gram-positive pathogen is armed with battery of virulence factors that facilitate to establish infections in the hosts. The organism is well known for its ability to acquire resistance to various antibiotic classes. The emergence and spread of methicillin-resistant S. aureus (MRSA) strains which are often multi-drug resistant in hospitals and subsequently in community resulted in significant mortality and morbidity. The epidemiology of MRSA has been evolving since its initial outbreak which necessitates a comprehensive medical approach to tackle this pathogen. Vancomycin has been the drug of choice for years but its utility was challenged by the emergence of resistance. In the last 10 years or so, newer anti-MRSA antibiotics were approved for clinical use. However, being notorious for developing antibiotic resistance, there is a continuous need for exploring novel anti-MRSA agents from various sources including plants and evaluation of non-antibiotic approaches.",book:{id:"5471",slug:"frontiers-in-i-staphylococcus-aureus-i-",title:"Frontiers in Staphylococcus aureus",fullTitle:"Frontiers in Staphylococcus aureus"},signatures:"Arumugam Gnanamani, Periasamy Hariharan and Maneesh Paul-\nSatyaseela",authors:[{id:"192829",title:"Dr.",name:"Arumugam",middleName:null,surname:"Gnanamani",slug:"arumugam-gnanamani",fullName:"Arumugam Gnanamani"},{id:"204388",title:"Dr.",name:"Periasamy",middleName:null,surname:"Hariharan",slug:"periasamy-hariharan",fullName:"Periasamy Hariharan"},{id:"204389",title:"Dr.",name:"Maneesh",middleName:null,surname:"Paul-Satyaseela",slug:"maneesh-paul-satyaseela",fullName:"Maneesh Paul-Satyaseela"}]},{id:"55437",title:"Biological Control of Parasites",slug:"biological-control-of-parasites-2017-07",totalDownloads:4229,totalCrossrefCites:7,totalDimensionsCites:7,abstract:"Parasites (ectoparasites or endoparasites) are a major cause of diseases in man, his livestock and crops, leading to poor yield and great economic loss. To overcome some of the major limitations of chemical control methods such as rising resistance, environmental and health risks, and the adverse effect on non‐target organisms, biological control (biocontrol) is now at the forefront of parasite (pests) control. Biocontrol is now a core component of the integrated pest management. Biocontrol is defined as “the study and uses of parasites, predators and pathogens for the regulation of host (pest) densities”. Considerable successes have been achieved in the implementation of biocontrol strategies in the past. This chapter presents a review of the history of biocontrol, its advantages and disadvantages; the different types of biological control agents (BCAs) including predators, parasites (parasitoids) and pathogens (fungi, bacteria, viruses and virus‐like particles, protozoa and nematodes); the effect of biocontrol on native biodiversity; a few case studies of the successful implementation of biocontrol methods and the challenges encountered with the implementation of biocontrol and future perspectives.",book:{id:"5527",slug:"natural-remedies-in-the-fight-against-parasites",title:"Natural Remedies in the Fight Against Parasites",fullTitle:"Natural Remedies in the Fight Against Parasites"},signatures:"Tebit Emmanuel Kwenti",authors:[{id:"191763",title:"Dr.",name:"Tebit Emmanuel",middleName:null,surname:"Kwenti",slug:"tebit-emmanuel-kwenti",fullName:"Tebit Emmanuel Kwenti"}]},{id:"70336",title:"Plastics Polymers Degradation by Fungi",slug:"plastics-polymers-degradation-by-fungi",totalDownloads:1383,totalCrossrefCites:3,totalDimensionsCites:5,abstract:"The studies on plastic degradation are very important for the development of biodegradable plastics, and for reduction of pollution, since plastic waste can remain in the environment for decades or centuries. We have showed the degradation of oxo-biodegradable plastic bags and green polyethylene by Pleurotus ostreatus. This fungus can also produce mushrooms using these plastics. The plastic degradation was possibly by three reasons: (a) presence of pro-oxidant ions or plant polymer, (b) low specificity of the lignocellulolytic enzymes, and (c) the presence of endomycotic nitrogen-fixing microorganisms. In this chapter, the plastic bags’ degradation by abiotic and microbial process using the exposure to sunlight and the use of a white-rot fungus will described. The physical, chemical, and biological alterations of plastic were analyzed after each process of degradation. The degradation of plastic bags was more effective when the abiotic and biotic degradations were combined.",book:{id:"8997",slug:"microorganisms",title:"Microorganisms",fullTitle:"Microorganisms"},signatures:"José Maria Rodrigues da Luz, Marliane de Cássia Soares da Silva, Leonardo Ferreira dos Santos and Maria Catarina Megumi Kasuya",authors:[{id:"217699",title:"Dr.",name:"Jose Maria",middleName:null,surname:"Da Luz",slug:"jose-maria-da-luz",fullName:"Jose Maria Da Luz"}]}],onlineFirstChaptersFilter:{topicId:"151",limit:6,offset:0},onlineFirstChaptersCollection:[{id:"79935",title:"Salmonellosis and Campylobacteriosis, Emerging Zoonosis in the World and Current Situation in Mexico",slug:"salmonellosis-and-campylobacteriosis-emerging-zoonosis-in-the-world-and-current-situation-in-mexico",totalDownloads:14,totalDimensionsCites:0,doi:"10.5772/intechopen.101875",abstract:"Salmonellosis and campylobacteriosis are the furthermost common zoonotic infections around the world that are transferred. The spread of Salmonella enterica serotypes Enteritidis (SE) and Typhimurium (ST) has increased dramatically in the last 50 years due to the consumption of food contaminated and the emergence of SE and ST infections with multiple antibiotic resistance. Retrospective investigations imply an epidemiological link between people and poultry. It has been argued that farm modernization and global exports of progenitor birds have had a vital role in spreading SE and ST. On the other hand, campylobacteriosis is more common than salmonellosis in affluent countries. Campylobacter jejuni has been identified as the primary cause of acute diarrheal illnesses, frequently associated with animal-derived foods, particularly poultry meat. The current review examines immunological and molecular biological techniques that allow for the quick detection of asymptomatic animal carriers, as well as recent characterizations of relevant taxonomic and pathogenic characteristics of these organisms. We further urge epidemiological research to evaluate the incidence of human diseases arising from poultry eating, based on preliminary non-publisher findings implying a prevalence of salmonellosis and campylobacteriosis in Mexican poultry farms comparable to other nations.",book:{id:"10536",title:"Campylobacter",coverURL:"https://cdn.intechopen.com/books/images_new/10536.jpg"},signatures:"Adriana del Carmen Gutiérrez-Castillo, Leopoldo Henri Paasch-Martínez and Norma Leticia Calderón-Apodaca"},{id:"76534",title:"Health Care Associated Infections (HCAIs) a New Threat for World; U-Turn from Recovery to Death",slug:"health-care-associated-infections-hcais-a-new-threat-for-world-u-turn-from-recovery-to-death",totalDownloads:224,totalDimensionsCites:0,doi:"10.5772/intechopen.97193",abstract:"Health care associated infections also termed as nosocomial infections are notable cause of morbidity and mortality especially in resource limited countries like Pakistan. Newborns and aged people have more probability of being infected by Health care associated infections because of immunosuppressant. Central line associated blood stream infections (CLABSI) are considered as one of the promising negotiator associated with Health Care associated infections. Improper health care setting and unaware medical staff play a championship protagonist in prevalence of health care associated infections. Standard hygienic measures should be adopted to reduce risk of Health care associated infections. So, there is a pressing need to take on control policies by Government to handle this dilemma. This chapter gives new intuition to healthcare associated microbes, infections and provides comprehensive detailed on ironic precaution to scientific community.",book:{id:"10536",title:"Campylobacter",coverURL:"https://cdn.intechopen.com/books/images_new/10536.jpg"},signatures:"Ayesha Noor, Ali Raza Ishaq, Laila Jafri, Faiza Jabeen, Rehana Rani, Bushra Hafeez Kiani, Nosheen Akhtar, Zeeshan Javed, Tahira Younis and Fatima Jalal"},{id:"75880",title:"Conventional and Molecular Detection Methods of the Opportunistic Bacterial Pathogen Campylobacter concisus",slug:"conventional-and-molecular-detection-methods-of-the-opportunistic-bacterial-pathogen-campylobacter-c",totalDownloads:148,totalDimensionsCites:0,doi:"10.5772/intechopen.97004",abstract:"Campylobacter concisus is an emerging pathogen that causes gastroenteritis and is a suspected cause of inflammatory bowel diseases. Its importance is enhanced by the chronic sequela that results from acute infection. This bacterium has been under-diagnosed in intestinal infectious diseases, and its clinical importance has not been determined yet. In order to establish the implication of this emerging bacterial species in human gastroenteritis and other infections, different approaches and procedure have been performed, where molecular typing methods have played a central role. The chapter provides a comprehensive past and recent updates on the detection of C. concisus by biochemical and molecular methods.",book:{id:"10536",title:"Campylobacter",coverURL:"https://cdn.intechopen.com/books/images_new/10536.jpg"},signatures:"Mohsina Huq and Taghrid Istivan"},{id:"75751",title:"The Role of Immune Response and Microbiota on Campylobacteriosis",slug:"the-role-of-immune-response-and-microbiota-on-campylobacteriosis",totalDownloads:229,totalDimensionsCites:1,doi:"10.5772/intechopen.96755",abstract:"Million cases of campylobacteriosis and complications of post-Campylobacter jejuni infection occur every year around the world with huge life losses and economic burdens of billions of dollars. Few therapy options, such as antibiotics, are available to relieve severe cases of the enteritis. The slow progression on new intervention discovery and application is partially resulted from limited mechanistic understanding on campylobacteriosis pathogenesis. As a type of intestinal disorders, campylobacteriosis shares many common features with other intestinal diseases such as inflammatory bowel diseases (IBD) and Clostridium difficile infection. In pace with the advancement of the gastroenterology field, a large body of knowledge is accumulating on the factors influencing campylobacteriosis onset, development, and outcomes, including host immune response, intestinal microbiota, and its metabolites. In this chapter, we review the intestinal immune system, intestinal microbiome, and microbiome modulation of inflammation in the development of campylobacteriosis. The interplay between immunity, microbiota, and its metabolites may play essential roles on campylobacteriosis pathogenesis and the finding on the interaction may lead to new prevention and treatment options. The purpose of this chapter is to provide updated knowledge on the role of host–microbe interaction and the therapeutic potential on campylobacteriosis.",book:{id:"10536",title:"Campylobacter",coverURL:"https://cdn.intechopen.com/books/images_new/10536.jpg"},signatures:"Ying Fu, Tahrir Alenezi, Ayidh Almansour, Hong Wang, Zhenquan Jia and Xiaolun Sun"}],onlineFirstChaptersTotal:4},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:0,limit:8,total:null},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:87,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:99,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:27,numberOfPublishedChapters:289,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:9,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:139,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:0,numberOfUpcomingTopics:2,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!1},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:108,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:104,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:12,numberOfOpenTopics:2,numberOfUpcomingTopics:1,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:0,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!1},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:11,numberOfOpenTopics:4,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}},{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. 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He has taught at Thompson Rivers University, Canada; University of Paris-Est, France; Osnabruck University of Applied Science, Germany; and Shanghai Institute of Technology and Tianjin University of Technology, China. He has published research in Research Policy, Applied Economics, Review of Economic Philosophy, Strategic Change, International Journal of Logistics, Sustainability, Journal of Environmental Management, Journal of Global Information Management, Journal of Cleaner Production, M@N@GEMENT, and more. He is a member of CEDIMES Institut (France), Academy of International Business (AIB), Strategic Management Society (SMS), Academy of Management (AOM), Administrative Science Association of Canada (ASAC), and Canadian council of small business and entrepreneurship (CCSBE). He is currently the director of the Research Group on Contemporary Asia (GERAC) at Laval University. 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