Precipitating factors of pituitary apoplexy.
\r\n\tDiagnosis and management of complications while on ECMO therapy and weaning to recovery or advanced therapies will be also discussed.
\r\n\r\n\tChapters focusing on specific patient populations, such as cardiogenic shock, thoracic organ transplantation, trauma, and neonates, Covid-19 syndrome, will provide insight into the particular challenges in dealing with the unusual problems of these very diverse groups.
\r\n\r\n\tThe goal of this book is to provide, thanks to the thorough contributions by known experts in the field, a framework for successful program development. Hopefully, this text will also inspire others to further advance this delicate field.
",isbn:"978-1-80356-549-1",printIsbn:"978-1-80356-548-4",pdfIsbn:"978-1-80356-550-7",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,isSalesforceBook:!1,isNomenclature:!1,hash:"254c18981115aeda50bdf71829902141",bookSignature:"Dr. Antonio Loforte",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11718.jpg",keywords:"Heart Failure, Cardiogenic Shock, Respiratory Failure, Circulatory Failure, End-Organ Dysfunction, VA-ECMO, VV ECMO, Central ECMO, ECMO Running, Weaning off ECMO, Adverse Events While on ECMO, Survival on ECMO",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"March 10th 2022",dateEndSecondStepPublish:"April 7th 2022",dateEndThirdStepPublish:"June 6th 2022",dateEndFourthStepPublish:"August 25th 2022",dateEndFifthStepPublish:"October 24th 2022",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"3 months",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"Dr. Loforte is a dedicated and pioneering researcher in the surgical treatment of advanced heart failure in terms of LVAD, BVAD, ECLS, and TAH adoption in different clinical scenarios. 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The first index case was, described by Bailey, in 1898 [1], but the term pituitary apoplexy was coined by Broughamin in 1950 [2].
Pituitary tumor apoplexy is an uncommon acute clinical syndrome and one of the rare problems that is diagnostically and therapeutically challenging.
PA is frequently the onset of unknown preexisting pituitary adenoma. The clinical spectrum of presentation does vary but often reserved only for classical presentation in contrast to “Silent, subclinical or asymptomatic pituitary tumor apoplexy” even though the latter is the more frequent entity [3].
It is a potentially life-threatening complication requiring a rapid diagnosis and appropriate treatment.
The diagnosis of pituitary tumor apoplexy is based on imaging evaluations, mainly using magnetic resonance imaging.
The best approach in the acute phase is still controversial, and nowadays, PA is no longer considered as a neurosurgical emergency [4, 5].
The outcome of acute apoplexy is variable and remains difficult to predict; a regular input and follow-up from a multidisciplinary team including neurosurgeons, endocrinologists, neuro-ophthalmologists, neuroradiologists, and neurologists are mandatory.
Pituitary tumor apoplexy appears to be rare. The true incidence and prevalence of PA are difficult to establish either because the majority of the studies are retrospectives or because the diagnosis of PA is usually misdiagnosed and simply identified at surgery or during radiological investigation or pathological examination. According to the main retrospective series, an estimated prevalence of 6.2 cases per 100,000 inhabitants and [6] an incidence of 0.17 episodes per 100,000 person-years were reported [7].
In published series of surgically resected pituitary adenomas, PA can occur in 0.6–10% with a mean of 2% of all adenomas and has reached 21% in an unusual report [8]. Nonfunctioning pituitary adenomas (NFPA) appear to be at higher risk of apoplexy with an incidence of 0.2–0.6 events per 100 person-years [9]. In published series of nonfunctioning pituitary adenomas, the frequency of apoplexy can vary from 3.7 to 21% [10]. Nonsecreting pituitary adenomas represent an average of 45–70% of adenomas with apoplexy [3].
Apoplexy represents the first clinical manifestation of previously unknown pituitary adenoma in 60–80% of cases [5, 11, 12].
Pituitary tumor apoplexy can occur at all ages, but most cases are seen during the fifth or sixth decade of life. In adolescents, this event has been described by Jankoswski and cols as a very rare entity [13].
There is a discrete preponderance in males ranging from 1.1 to 2.3/1 [5, 12].
Macroadenomas, especially nonfunctioning, and prolactinomas are most susceptible to apoplexy; nevertheless, apoplexy in other tumor types such as GH-secreting or clinically silent ACTH adenomas has been reported [5].
Microadenomas may also be prone to apoplexy [14]. PA occurs in 0.6–10% of treated pituitary adenomas. In three series of macroprolactinomas, the ratio of apoplexy/therapy varied between 1.2 and 6.67% [14].
In a review, apoplexy was found to occur in 1–6% of macroprolactinomas. This average was comparable between treated and untreated adenomas [5].
Semple et al. have found that one-third of their 62 patients had only infarction [15]. Hemorrhage is more associated with macroprolactinoma and female gender [16].
The pathophysiological mechanisms of pituitary tumor apoplexy remain incompletely understood. There are various theories upon the pathophysiology of pituitary apoplexy in the current literature. It is uncertain whether the pathological process is a primary hemorrhage or whether the event is really a hemorrhagic infarction. Many pathogenic mechanisms have been proposed. Given that the risk of hemorrhage in a pituitary adenoma appears to be five times higher than in other intracranial neoplasms, intrinsic factors can be involved in the apoplectic event [12]. The rich and the complex vascular system makes the pituitary adenomas more vulnerable to bleed than any other brain tumor.
Understanding the vascularity of the pituitary gland and pituitary adenomas is crucial for etiopathogenesis of apoplexy.
As shown by the angiographic studies, the adenomas are mostly supplied by inferior pituitary artery, and its arterial flux is reduced compared with the normal pituitary [17].
The number and size of vessels are generally lesser than the normal pituitary vessels and are divided into irregular islets. Under electronic microscopy, they have incomplete maturation, poor fenestration, and ruptured and fragmented basal membranes with perivascular spaces filled with plasmatic proteins or red cells that may predispose to hemorrhage [18].
The fragility of the constitutional tumoral vascularization, can be explained by an increased expression of vascular endothelial growth factor “VEGF mRNA” in pituitary tumors; especially in nonfunctioning pituitary adenomas [14].
This expression of vascular endothelial growth factor could be explained by a tumoral overexpression of the pituitary tumor transforming and was found to correlate positively with the risk of pituitary hemorrhage. Other vascular markers were reported such as fetal liver kinase 1, nestin, etc. [5].
All the conditions associated with an acute increase in blood flow or coagulation disturbs may predispose these lesions to hemorrhage or hemorrhagic infarction [14].
This intratumoural vasculopathy, limited blood supply of the pituitary adenomas, and limited expression of angiogenic factors contrast with a high-energy requirement. As consequence, any extrinsic factor that alters the balance between tumor perfusion and tumor metabolism may cause an acute ischemia or infarction [17].
Moreover, an increased intratumoural and intrasellar pressure could concur to the reduction of tumor perfusion, further contributing to ischemia’s pathomechanisms. Tumor growth could thus contribute to ischemia which explains the size of the adenoma being a major factor. Macroadenomas are described to be at a much higher risk of apoplexy than microadenomas [10, 19, 20].
Germline AIP gene mutations may be associated with a rapid growth of the pituitary adenomas predisposing them to apoplexy [21].
PA can occur without any risk factors; however, numerous conditions have been linked to PA. Precipitating factors are identified in 10–40% of cases [3] (Table 1).
Precipitating factors of pituitary apoplexy.
The multiple factors reported as precipitating PA can be classified into three categories.
Procedures such as angiography, pneumoencephalography, myelography, lumbar puncture, and spinal anesthesia have been associated with PA. Blood pressure (BP) fluctuations or vasospasm may explain PA [22, 23]. Pituitary irradiation may induce vascular changes leading to chronic hypoperfusion of the pituitary gland and has been associated with both pituitary infarction and pituitary hemorrhage [24, 25]. Closed-head trauma which often minor may be a cause of PA, explained by acute changes in the intracranial pressure and in blood pressure [26].
PA has been described in postoperative states. Orthopedic and cardiac surgeries mainly cardiopulmonary bypass were the most incriminated [27, 28, 29]. Intra- or postoperative hypotension, anticoagulation, and microemboli leading to infarction were the proposed mechanisms. If a pituitary adenoma is known before the cardiac procedure, some authors recommend the use of off-pump technique maintaining an adequate systemic perfusion, as opposed to standard cardiopulmonary bypass [30].
Systemic hypertension leading to an increase in blood flow and diabetes mellitus has been associated with PA [31, 32]. However, this association was not confirmed by other studies [10, 33].
Severe vomiting/diarrhea with concomitant increased Valsalva pressure may also decrease blood supply to the pituitary adenoma and precipitate apoplexy, since tumoral cells are particularly sensitive to glucose deprivation [5].
Apoplexy can also occur after dynamic testing of the pituitary (insulin, TRH, GnRH, or GHRH tests and much more rarely CRH) particularly when different agents are combined. Numerous publications have documented the occurrence of apoplexy within minutes to hours after testing [10, 34, 35].
In this setting, TRH dynamic test may cause apoplexy by vasospasm induced by increased norepinephrine levels or by elevating systemic pressure.
Other tests of pituitary stimulation (especially use of GnRH) can increase the imbalance between the intratumoral metabolic demand and the poor tumor perfusion.
Reports of PA occurring after stimulation test are much rarer in the recent past. Currently, pituitary dynamic testing is not commonly used in the routine assessment of hypothalamic pituitary function.
Increased estrogen states, such as exogenous estrogen administration, pregnancy, and postpartum period, have been reported to cause PA [33, 36, 37, 38]. Treatment with GnRH agonists for prostate cancer has also been associated with PA [39, 40, 41].
The role of dopamine agonist (DAs) treatment as precipitating factor is more controversial, although many case reports suggested this hypothesis [42, 43]. In prospective studies analyzing the effects of DAs on macroprolactinomas, PA were very rarely or never observed [6, 44, 45, 46]. In a retrospective study [9], DA treatment of pituitary adenomas was not associated with PA. These results are not surprising, given that these agents decrease growth and activity of prolactinoma or other adenoma cells.
PA can occur in the setting of an acute systemic illness such as myocardial infarction or severe infection. Excessive stimulation of the pituitary gland by production of larger amount of steroids is a possible explanation [33].
PA has been observed after administration of anticoagulant drugs (vitamin K antagonist or platelet inhibitors) or thrombolytic agents, sometimes very soon after the initiation of treatment or after a prolonged period of treatment [6, 9, 47]. New classes of anticoagulant (dabigatran) [48, 49] may also be involved.
Thrombocytopenia has also been reported usually associated with hemorrhagic PA [50, 51].
The prevalence of apoplexy according to different subtypes of pituitary tumors shows a trend for nonfunctioning adenomas [3, 4, 5, 9, 22, 33, 52, 53, 54, 55] to develop apoplexy. It is believed that nonfunctioning tumors may be diagnosed at a later stage, so they grow to a larger size before diagnosis; in contrast, the functioning adenomas are generally revealed earlier by signs of hormonal secretion before bleeding/infarction occurs [5].
Other tumor types predisposing to apoplexy are prolactinomas and GH-secreting adenomas [27, 56, 57, 58, 59]. In the vast majority of cases, apoplexy complicates large macroadenomas [10]. Clinically silent ACTH adenomas may be particularly prone to necrosis, hemorrhage, and cyst transformation [5, 60]. These complications occur in 30–64% of cases, 2–14% in patients with all types of pituitary adenoma [16, 61, 62, 63].
Frequently, the PA episode is the first manifestation of undiagnosed pituitary adenoma [22, 57, 64].
It is important to consider that the pituitary apoplexy has a wide spectrum of clinical features, resulting from undergoing sudden mass enlargement. It ranges from silent asymptomatic necrotic and/or hemorrhagic adenoma to “classic” acute presentation and even death.
This is largely depending on the extent of hemorrhage, necrosis, and edema. Semple et al. suggested that the cases of pituitary tumor infarction alone had less severe clinical features and better outcome than those with hemorrhagic infarction or frank hemorrhage [15].
The clinical manifestations are summarized in Table 2.
Common clinical features of pituitary apoplexy.
Headache is the earliest and most common presenting symptom with an incidence of more than 90% [4, 65, 66].
The cephalalgia onset is often sudden and severe, namely, “thunderclap headache,” in patients presenting with pituitary apoplexy and creates an even greater degree of difficulty in the differential diagnoses. It is usually resistant to analgesics, mainly retro-orbital and sometimes bifrontal, suboccipital, or diffuse [67]. This feature can be explained by meningeal irritation due to extravasation of blood and necrotic material into subarachnoid space, enlargement of sella turcica walls, dura mater compression, or involvement of the superior division of the trigeminal nerve inside the cavernous sinus [18, 68].
Headache is commonly accompanied by signs of meningeal irritation, such as nausea and vomiting (57%), photophobia (40%), meningismus (25%), and fever (16%) [5]. The fifth cranial nerve (first branch) can be involved in PA, resulting in facial numbness [3].
Altered level of consciousness may occur in varying degrees ranging from lethargy to stupor or even coma as consequence of blood or necrotic tissue leaking into the subarachnoid space [69]. A concurrent cerebrovascular episode with a stroke has been previously described [70]. The involvement of the thalamus in a case of pituitary apoplexy with thalamic and midbrain infarction has been described [71]. In such cases, one of the following mechanisms was proposed: (1) compression of intracavernous portion of internal carotid artery due to expanding pituitary adenoma or a hemorrhage within it and (2) vasospasm caused by factors released from hemorrhagic or necrotic material [70].
Rare cases of sudden death following pituitary tumor apoplexy of fatal outcome of acute pituitary apoplexy due to massive hemorrhage were reported [72, 73].
The apoplectic pituitary adenoma can expand toward the cavernous sinus, compressing the III, IV, and/or IV cranial nerves (CN), leading to various degrees of ocular palsy (diplopia and ophthalmoplegia) in 40–70% of the patients [52, 55, 74, 75].
The third CN is the most frequently affected especially when there is an abutment without invasion of the cavernous sinuses. This was explained mainly by the location of the third nerve in the same horizontal plane as the pituitary gland; pressure from lateral growth of a pituitary tumor is relatively easily transmitted to the third cranial nerve. This leads to compression of the third cranial nerve between the tumor and the interclinoid ligament, commonly resulting in the development of the third cranial nerve palsy, occurring either alone or together with damage to the other cranial nerves [52, 76].
Isolated cranial nerve palsy III in PA with direct CN III compression outside the cavernous sinus was also reported. In these cases, the tumor had some mass effect on CN III at the level of the oculomotor trigone after erosion of the posterior clinoid [77]. Multiple CN palsies and even bilateral and asymmetric lesions have been reported [78, 79, 80]. Rarely, pituitary apoplexy may present as isolated sixth cranial nerve (abducens) palsy [81].
Compression of the necrotic intrasellar mass superiorly toward the optic nerves and optic chiasma causes visual symptoms in most (75%) patients [11, 76], including decreased visual acuity; visual field defects, especially bitemporal hemianopsia; and also complete blindness and monocular blindness.
As stated earlier, PA occurs in previously unknown history of pituitary mass in more than 80% of patients, the diagnosis can be challenging owing to its similarities with many other neurological conditions, and several other life-threatening conditions (Table 3) can lead to a delay in proper management [11].
Differential diagnoses of pituitary apoplexy.
The two most important diseases that should be considered are aneurysmal subarachnoid hemorrhage (SAH) and bacterial meningitis, subarachnoid hemorrhage [82, 83], bacterial meningitis, or parasellar abscess [84, 85].
Other differential diagnoses include subarachnoid hemorrhage, ophthalmoplegic migraine, suprasellar aneurysm, stroke and hypertensive encephalopathy, and cavernous sinus thrombosis [52, 82, 83, 85, 86, 87].
Nevertheless, a high degree of suspicion should exist in any patient presenting a severe sudden headache and visual disturbances. This aims to avoid delay in proper management.
Imaging studies are thus crucial for the diagnosis.
As most cases of pituitary apoplexy complicate pituitary macroadenoma, many of which are secretory.
Prolactinomas are the most common (20% of cases of pituitary apoplexy); this is related to the frequency of prolactinoma in the population and to their frequent hemorrhagic nature. Hyperprolactin can also result from stalk effect [88].
It was postulated that at presentation of PA in non-PRL-secreting macroadenomas, a normal or elevated serum PRL can predict the residual anterior pituitary cell viability. Inversely a very low serum PRL level at presentation is correlated with the necrosis of the normal pituitary tissue and predicts permanent hypopituitarism [89].
More rarely PA can occur in acromegaly and Cushing’s disease (too much adrenocorticotropic hormone, ACTH) in approximately 7 and 3% of cases, respectively. Co-secretion of more than one hormone may occur.
Several published series reported clinical and biochemical resolution of hormonally hyperfunctioning pituitary adenomas (including Cushing’s disease and acromegaly) following pituitary apoplexy on follow-up as a result of the infarction of the pituitary tumors [90, 91, 92, 93].
Reviewing the series of patients with PA, one or more endocrine deficiencies can be present at the onset [22, 67, 76] and the evaluation of hormonal levels is mandatory (Table 4).
Endocrine disorders in pituitary apoplexy.
The pathogenesis of hypopituitarism is complex and multifactorial.
As most episodes of PA occur in macroadenoma, the pituitary hormone deficiencies can precede the apoplectic event [22, 76].
This was explained earlier by mechanical compression of the pituitary stalk and/or the portal vessels. But more recent study suggested that it is tightly related to pressure effect of the macroadenoma, as they indicated that in patients with large pituitary adenomas, the intrasellar pressure, measured at surgery, was greater in patients who had hypopituitarism than those with intact pituitary function [94].
Moreover, the apoplexy itself can cause ischemic necrosis of the anterior pituitary secondary to a sudden rise in intrasellar pressure compressing the portal circulation, the pituitary stalk, and the pituitary gland itself [89, 95].
The most life-threatening deficit is that of adrenocorticotropic hormone (ACTH) resulting in acute central hypoadrenalism, which has been reported in more than 70% of patients [36, 52, 76]. It can result in severe hemodynamic problems. Indeed, the absence of cortisol can lead to insensitivity of the vessels to the pressor effects of endogenous or exogenous catecholamines and thus in hemodynamic instability.
Therefore, in patients with PA, empiric parental corticosteroid supplementation should be given immediately.
In the acute setting, other hormone deficiencies have less concerns. At presentation thyrotropic deficiency and gonadotropic deficiency were reported in 30–70% and 40–75% of patients, respectively [3].
Posterior pituitary involvement is not common in PA, and diabetes insipidus was reported in 3% of cases despite frequent and significant suprasellar extension in many cases [10, 96].
This may be attributable to the preservation of the posterior pituitary as a result of its different blood supply from the inferior hypophyseal artery rather than the superior hypophyseal artery that supplies the anterior pituitary and usually the tumor.
Hyponatremia is a common electrolyte disturbance reported in up to 40% of patients presenting with pituitary apoplexy [22].
In most cases, hyponatremia is mostly mild, but severe hyponatremia has been reported [96, 97, 98, 99].
It is often multifactorial and the most likely pathogenetic mechanism proposed of hyponatremia is adrenal insufficiency.
Other etiologies can include the syndrome of inappropriate ADH secretion (SIADH) resulting either from adrenal insufficiency itself or from hypothalamus irritation [99] and neurological deterioration late after initial presentation.
Hypothyroidism as common hormone deficiency in pituitary apoplexy may contribute to hyponatremia by reduction in glomerular filtration rate and elevated ADH secretion [100].
An association of a high level of atrial natriuretic peptide concomitant to a high level of ADH, a severe scenario in hyponatremic patients after pituitary apoplexy, has been demonstrated [99].
In emergency setting, most of the patients with symptoms related to PA will undergo computed tomography (CT) as it is readily available and a rapid screening test. It is likely that, in most of them, the clinical suspicion might be something other than PA.
CT is effective in visualizing pituitary heterogeneous intrasellar and/or expansive suprasellar lesions leading to sellar enlargement (up to 94% of cases) [5, 20, 25], with a coexistence of solid and hemorrhagic areas [4, 22, 76, 101].
The CT is also able to detect subarachnoid hemorrhage and cerebral ischemia, which are the most frequent complications of PA [101].
CT is most valuable in the acute phase (up to 48 h). The recent bleeding in this phase can be missed on MRI either because of infarction or because hemorrhage is still in the form of deoxyhemoglobin. In this context, CT is able to provide an improved detection of hyperdense intralesional areas [102].
Later, during the subacute or chronic phase, in line with blood degradation, hypodense intralesional areas can be present, which increases the difficulty to make the differential diagnosis of subacute hemorrhages from other necrotic or cystic lesions (aneurysms, meningiomas, Rathke cleft cysts, germinomas, and lymphoma) [101].
This makes MRI essential to differentiate between these conditions. MRI and MR angiogram techniques also help to distinguish an aneurysm from pituitary apoplexy [4, 22, 85, 103].
Nevertheless, magnetic resonance imaging (MRI) is the radiological investigation of choice. Its findings depend on the time of onset of bleeding.
It is possible to find a fluid in the intralesional level (Figure 1(C)), the lower area is constituted by red cell sediment, and the cranial corresponds to free extracellular methemoglobin.
MRI in a pregnant patient, with symptomatic pituitary apoplexy. The lesion is globally hypointense, hemorrhagic content of the pituitary mass, and the hemorrhagic area, in T1-weighted sequences ((A) coronal section, (B) sagittal section), with a high signal intensity (arrow (B)) corresponding to the cystic area. In the same patient, the coronal T2-weighted sequences (C) showing a fluid level (asterisk) inside the pituitary lesion: the upper compartment being hyperintense while the lower is isointense.
In the acute stage of pituitary apoplexy, the MRI signal is isointense or slightly hypointense on T1-weighted imaging with hypointensity on T2-weighted imaging (T2 W1). A “brushed” specific pattern of alternating subtle T1-hyperintense and T1-hypointense areas within the sellar mass may suggest apoplexy at the earlier stage [101].
Later, there is marginal signal reinforcement and the hematoma core remains isointense; in the subacute phase, the hemorrhage will appear hyperintense on T1WI as well as on T2WI. In the chronic phase, macrophages digest the clot, and the presence of hemosiderin and ferritin causes a strong hypointensity on both T1WI and T2WI [101].
In pituitary apoplexy patients, some authors reported the thickening of the sphenoid sinus mucosa related to venous engorgement in this region as an excellent sign that is present from the early stage, a reversible condition on follow-up studies that generally improves spontaneously [104]. This thickening does not indicate infectious sinusitis and thus does not rule out the surgical transsphenoidal route [103, 105].
Some published series have demonstrated the great value of special techniques as T2-weighted gradient echo to detect pituitary hemorrhage in the acute phase and chronic phase. MRI diffusion-weighted images (DWI) can be also be helpful in rare cases of ischemic pituitary necrosis without hemorrhage [105, 106, 107].
Semple et al. have demonstrated a correlation with the MRI findings and histopathology in 68% of patients with a histopathological diagnosis of hemorrhagic infarction/hemorrhage and in 82% of patients with infarction alone [103].
PA has long been considered as a neurosurgical emergency. However, nowadays, the conservative approach constitutes another therapeutic option in many situations. Untreated patients with apoplexy have higher morbidity and mortality. Altered consciousness, with all its associated complications, hypopituitarism, and intercurrent illnesses account for the increased morbidity and mortality of untreated patients. Although it is hard to estimate the relative increase in mortality associated without treatment, reports published before corticosteroid therapy were available indicating an approximate mortality rate of 50% [3].
The goals of treatment of PA are to improve symptoms, to decompress local structures especially the optic tract, and to avoid acute adrenal insufficiency. Hence, whether the treatment is surgical or conservative, glucocorticosteroid replacement is systematic.
As corticotropic deficiency is frequently associated with pituitary apoplexy, corticosteroid should be systematically given to these patients. Thus, hydrocortisone is administered at a dose of 50 mg every 6 h [3, 108] or in the form of a 100–200 mg bolus followed by 50–100 mg every 6 h intravenously (or intramuscularly) or by 2–4 mg per hour by continuous intravenous infusion [108, 109]. Corticosteroid substitution should be associated with a careful assessment of fluid and electrolyte balance and supportive measures ensuring hemodynamic stability. Once glucocorticoids are administered, clinical improvement is invariably observed, and hemodynamic stability becomes easier to maintain. The glucocorticoids are administered in supraphysiological doses to serve not only as replacement for endogenous hormone deficiency but also to help control the effect of edema on parasellar structures [3].
If surgical management is chosen, the transsphenoidal approach is almost always recommended, because it allows good decompression of the optic pathways and neuroanatomic structures in contact with the tumor and because it is associated with low postoperative morbidity and mortality [11]. Usually, necroticohemorrhagic material is evacuated as soon as the incision of the tumor capsule is made. The purpose of the surgery is the decompression of the optical pathways; the surgeon should try to identify the sellar diaphragm. In case of invasive pituitary adenoma, a maximum but incomplete resection is ensured by taking all the precautions to avoid damaging the cranial nerves or the carotids in case of invasion of the cavernous sinuses.
The timing of pituitary surgery is controversial, as no randomized trials comparing different strategies with strong evidence have been performed. However, most studies indicate that surgical treatment, usually within 7 days after the apoplectic event, leads to higher rates of visual impairment recovery [11, 110].
Occasionally, patients are clinically or biochemically hypothyroid at presentation. Unless the hypothyroidism is severe, the surgical decompression needs not be delayed, provided the anesthesiologists and the management team are aware of the patient’s condition to avoid medications and procedures that are particularly deleterious and that can potentially worsen clinical symptoms [3].
Surgical decompression normalizes visual acuity in about one-half of cases and improves it in another 6–36% of cases [52, 53]. Visual field defects normalize after surgery in 30–60% of cases and improve in another 50%. Ocular motility dysfunction can resolve spontaneously, with or without surgery [111].
Pituitary deficiencies are usually not expected to recover [19, 112]. In addition, it seems that apoplexy worsens endocrine outcome: hormonal prognosis after elective pituitary surgery is poorer in patients with PA than in patients without PA [9]. This is explained mainly by the damage to the normal gland from the initial apoplectic event. Another important point is that, in this acute setting, the operation may be performed by an on-call neurosurgeon rather than by a skilled pituitary neurosurgeon, as underlined in UK guidelines [11], and this may increase the risk of adverse events.
For tumoral outcome,
Surgery may also be harmful, with a risk of postoperative cerebrospinal fluid leakage, permanent diabetes insipidus caused by posterior pituitary damage, meningitis, and an increased likelihood of hypopituitarism due to removal or damage to normal pituitary tissue. Fortunately, in experienced pituitary centers, these complications are very rare [5].
Several reports have documented that spontaneous neurological recovery is possible despite unilateral ophthalmoplegia and partial visual field defects, which has suggested that nonoperative medical management of patients with PA may be appropriate in many situations. In 1995, Maccagnan et al. reported the results of a prospective study in which they treated PA with high-dose steroids (2 to 16 mg of dexamethasone daily). Only patients whose visual impairment or altered consciousness failed to improve underwent surgery. Conservative treatment was possible on 7 of 12 patients, and only 5 patients had needed surgery. Visual deficits regress in 6 of the 7 patients and improved in the remaining patients. The posttreatment prevalence of pituitary hormone deficiency and the incidence of tumor regrowth were similar in conservatively and surgically treated patients [113].
Thus, conservative therapy involved supportive therapy, continued use of supraphysiological doses of glucocorticoids for several weeks, and hormone replacement therapy. Improvement in neurological symptoms is often seen in the majority of patients treated conservatively, at times to a similar degree to that seen in surgically treated patients. However, worsening of pituitary function is usually seen in many of these patients [114]. For functioning pituitary adenomas, hormonal secretion must be also evaluated: hormonal levels could be low, be normal, or remain high after apoplexy [11]. For tumoral outcomes, additional treatment is not necessary in most cases, as tumors usually diminish and even disappear without surgical intervention [10]. It seems that a single large hypodense area within the tumor on CT might be associated with better subsequent tumor shrinkage than are several small hypodense areas [113].
PA is characterized by a highly capricious course, and randomized prospective studies with strong evidence about this syndrome are lacking, which makes optimal management of acute PA controversial. Although guidelines, as the one from the UK, proposed an algorithm for PA management, randomized trials comparing both strategies are needed for strong evidence [11, 112]. Hence, the decision of surgical treatment or conservative management should be individualized and made by experts from a multidisciplinary team including endocrinologists, neurologists, ophthalmologists, and neurosurgeon [11].
The risk-benefit ratio of conservative treatment versus surgery must be carefully evaluated, in terms of visual outcome, pituitary function and also subsequent tumor growth. On the other hand, the potentially serious complications of surgery need to be taken into consideration [115].
In spite of the methodological limits of the studies available on this subject, these data have constituted the rationale guiding the therapeutic choice of PA.
The outcome of visual acuity, field defect, or ophthalmoplegia is similar with surgery or conservative treatment. Unfortunately, visual outcome is poorer in patients with more severe disorders such as monocular or binocular blindness, irrespective of whether management is conservative or surgical [56, 116, 117]. It has been argued that conservatively treated patients may have less severe visual defects than surgically treated patients and that this might explain why the improvement is at least as good in the former as in the latter [3, 11, 118]. The number of patients with visual defects was effectively higher in the surgical groups of published series [53, 76].
For endocrine prognosis, whatever the management approach, the hormonal outcome is poor in patients with PA, who frequently suffer irreversible pituitary damage [11].
Concerning the outcome of the pituitary tumor, very few studies have compared the degree of tumor disappearance between patients receiving surgery and conservative treatment for apoplexy. The reported results were very different: the incidence of recurrence was similar between the two approaches in one study [76], higher after surgery in one other [56], and lower after surgery in two others [52]. Thus, the optimal approach for tumor control is difficult to judge. Whatever the therapeutic choice in the acute event, additional forms of therapy can be used to control residual tumor growth, depending on the type of tumor, including a dopamine agonist for documented prolactinomas or a somatostatin analogue for documented growth hormone-secreting tumors. Gamma Knife stereotactic radiosurgery can also be used on these patients and on patients with nonsecreting adenomas [3].
MRI did not predict the severity of ocular paresis or field defects. The size of the tumor on MRI is not actually a strong argument for therapeutic choice. Even when the tumor was very large, conservative management was accompanied by tumor shrinkage [76]. However, some MRI findings were found to be associated with clinical status and outcome: patients with simple infarction had less severe clinical features and better outcomes than those with hemorrhagic infarction or hemorrhage [70].
All these data from the literature have allowed deducing overall the place of, respectively, the conservative approach and the surgical treatment in the management of PA.
According to the majority of authors, surgical intervention should be considered in patients with severely reduced visual acuity, severe and persistent visual field defects, and deteriorating level of consciousness despite glucocorticoid replacement and hydroelectrolytic support [109]. Ocular paresis because of involvement of III, IV, or VI cranial nerves in the cavernous sinus is not in itself an indication for immediate surgery. Resolution will typically occur within days or weeks with conservative management [11].
The UK Guidelines for PA recommend a scoring system (Table 5), calculated using visual acuity, visual defects, cranial nerve palsies, and the Glasgow Coma Scale. The PA score ranges from 0 to 10, and surgery usually is indicated for scores ≥4 [11]. Another scoring system, from the Massachusetts General Hospital, proposes grading patients on a scale from 1 to 5: grade 1 for asymptomatic individuals, grade 2 for patients with symptoms due to endocrinopathy, grade 3 for patients with headache, grade 4 for patients with ocular paresis, and grade 5 for patients with visual deficits or a low Glasgow Coma Scale score. Patients with grade 5 should be submitted to surgery [59].
Pituitary apoplexy score (PAS).
For conservative approach, it is safe in patients with pituitary tumor apoplexy who are without any neuro-ophthalmic signs or mild and stable signs or those with evidence of early improvement after administration of glucocorticoids [76]. This would be particularly applicable in patients with prolactin-secreting adenomas, with whom dopamine agonists are very effective not only in controlling hyperprolactinemia but also in reducing the size of the adenoma [3]. “Wait-and-see” approach should be also considered in patients with significant clinical comorbidities.
If conservative treatment is chosen, then careful monitoring of visual signs and symptoms is necessary, and surgical decompression is recommended if visual disorders do not improve or if they deteriorate [5, 11, 59].
All patients with pituitary apoplexy need follow-up by endocrine and neurosurgical teams. They require repeated assessment of pituitary and visual function (visual acuity, eye movements, and visual fields), at 4–6 weeks. Thereafter, hormonal reevaluation must be performed every 6–12 months to determine whether or not the pituitary defect is permanent and the possible hypersecretory nature of the adenoma and to optimize hormonal replacement [109].
Sellar MRI should be repeated in 3–6 months, annually for 5 years, and biannually after that to monitor tumor progression/recurrence [119]. The presence of an “empty sella” is often observed [117].
Morbidity and mortality in patients with pituitary tumor apoplexy have declined in the past six decades. Four factors may have contributed to the improved survival: improved diagnostic accuracy, use of glucocorticoids, use of more sophisticated supportive therapy, and refinements in surgical techniques and postoperative care [3]. Currently, mortality in the acute setting is less than 2% [120].
PA is uncommon but a potentially life-threatening complication due to acute infarction or hemorrhage within a preexisting pituitary adenoma. Its pathophysiology, including extrinsic compression of arterial supply or intrinsic tumoral factors, is still controversial. In terms of triggering factors, the most common include major surgery. The classical presentation is highly suspected when an acute lancinating headache is combined with visual disturbance, cranial nerve palsy, and hypopituitarism. MRI is a fundamental step to evaluate the pituitary infarct and hemorrhage and to rule out other pathologies. For the management of PA, corticosteroids should be systematically administered. However, the therapeutic choice between surgery and conservative treatment is controversial and should be made by experts from a multidisciplinary team. The surgical management which used to be considered as the first-line treatment of this acute condition is now reserved for patients with severe neuro-ophthalmic signs. Improvement of the diagnostic means and the therapeutic management has allowed a better PA prognosis which is preserved in most of the cases. Reevaluation of the pituitary function and tumor mass is mandatory in the months after the acute apoplectic episode to adjust hormonal substitution, to detect the possible hypersecretory nature of the adenoma, and to initiate follow-up of a possible tumor remnant.
To improve the quality and quantity of an organism, both prokaryotes and eukaryotes, it can be approached by molecular character enhancement through the insertion of interest genes or superior genes into the cells of the desired organism. The process of genetic transformation of an organism involves the isolation and identification of the gene of interest, the technique of cloning the gene on a plasmid vector until the process of transferring the gene to the target organism’s cell. One of the important genes in the growth of organisms is the homeobox gene, which is a gene that regulates the growth and development of organisms in a very early stage. Homeobox genes were first discovered in the
In plants, overexpression of the homeobox gene at an early stage of growth will activate the formation of apical buds from apical meristems that will produce shoots. The addition of exogenous cytokinin and auxin growth regulators will activate the homeobox genes to induce cell division genes that in turn will produce somatic embryos. Theoretically, each somatic cell can grow and transform itself into somatic embryos, therefore it can produce plant seeds in large quantities and uniform phenotypic characters. This is very profitable for agriculture and industry, especially for the mass production of identical plant seeds using tissue culture techniques.
In the model plant,
Gene | Function | Organism | Ref |
---|---|---|---|
Homologous with Kn1 ( | [3, 4] | ||
Homologous with Kn1 (Zea mays). Affect the design of internodes resulting in stunted plants | [5] | ||
Morphogenesis | [6] | ||
Phyllotactic pattern and stem cell fate | [7] | ||
Accumulation of anthocyanin and in root development | [8] | ||
Mediates plant morphogenesis for light signals response | [9] | ||
MDH1 | Homologous | [10] | |
Controls plant architecture by locally restricting environmental responses | [11] | ||
Effects seed oil content in | [12] | ||
have species-specific roles in embryo and inflorescence development | [13] | ||
Regular | [14] | ||
The leaves morphological states | Tomato | [15] | |
Response to treatment for abscisic acid (ABA) | [16] | ||
Involved in Meristem Activity and Organ Separation | [17] | ||
Regulates the photoperiod sensitivity in | [18] | ||
Transcriptional activator | [19] | ||
Play a role in the embryo protoderm identity specification, organize of the primary root primordium or the L1 cell layer maintenance in the shoot apical meristem | [20] | ||
Master regulator for the gametophyte-to-sporophyte transition | [21] | ||
Athb-2 | Changes in light quality perceived by a novel phytochrome regulate plant development | Green plants | [22] |
Regulate leaf and flower morphology, accompanied by a decrease in the content of the active gibberellin | [14] |
The homeobox gene in plants.
Transient expression become a powerful tool in functional genomics study for detecting gene expression in a short time and the inserted gene do not integrate into the plant genome. A transient expression system has been developed in planta using different cells or tissues, including protoplast, onion cells, and tobacco (
Plant materials | Transformation methods | Purposes/Functions | Refs. |
---|---|---|---|
Protoplast | PEG | Subcellular localization of proteins | [24, 25] |
Agroinfiltration | Metabolite’s production (protein, secondary metabolite, etc.) | [26] | |
Onion cells | Particle bombardment | Subcellular localization of proteins | [27] |
Transient expression system and its purposes in planta.
The advantages of the transient expression system compared to stable expression are that it does not require regeneration of transformed cells, does not affect the stability of the host genome, and is independent of the effect of T-DNA integration site position [28]. Protoplast transfection can be performed using a variety of procedures commonly used for the transfection of animal cell cultures. The procedures that are often used to insert DNA into protoplasts are polyethylene glycol (PEG) and electroporation [29].
Polyethylene glycol (PEG)-mediated transformation plant cells can be transformed through certain chemicals, namely PEG (polyethylene glycol). PEG is an oligomer or hydrophilic polymer synthesized from ethylene oxide, containing repeating units of -(O-CH2-CH2)-. Polyethylene oxide (PEO) is another name for PEG. Typically, ethylene oxide macromolecules with a molecular weight of less than 20,000 g/mol are called PEGs, while macromolecules with values above 20,000 g/molar are called PEOs [29]. PEG is soluble in acetonitrile, benzene, water, ethanol, and dichloromethane, while it is insoluble in diethyl ether and hexane (Figures 1 and 2).
Agroinfiltration in tobacco (
Transient expression in onion cell and protoplast for determining the subcellular localization of the protein. (a) Subcellular localization of OsKAN1-GFP fusion protein in the nucleus of onion cell transformed using particle bombardment [
PEG is available in various structures, such as branched, stellar, and comb-like macromolecules. PEG can bind various reactive functional groups to the PEG polymer site. Homo and heterobifunctional PEG derivatives are particularly suitable as agents or spacers of two chemical entities, whereas mono-functional PEGs prevent linking reactions that can affect the PEGylation of certain compounds with bifunctional PEGs. PEGylation is an interesting process in which PEG is bound to other molecules [31, 32].
PEG was used to increase DNA uptake into the protoplast during transfection. Very high concentrations of PEG can reduce transfection efficiency because it is toxic to protoplasts [33]. PEG-mediated DNA uptake is a direct gene transfer method that utilizes the interaction between PEG, naked DNA, salts, and protoplast membranes to influence the transport of DNA into the cytoplasm. The advantage of PEG-mediated transformation is that it does not require special equipment and can be carried out in the laboratory under sterile conditions [34]. Compared to
Particle bombardment particles are coated in DNA and can penetrate plant cells without killing the plant cells themselves. Previous experiments have shown that particle bombardment has been successfully used to insert DNA into rice callus and seedlings grown in dark conditions but has the disadvantage of low efficiency and reliance on expensive equipment [36].
To understand the mechanism of how the transformation and expression of recombinant protein in a prokaryotic system,
Ribonuclease III (RNase III) is an enzyme that specifically cleaves double-stranded RNA [30, 37, 38, 39, 40]. RNase III has an important role in both the RNA transcript maturation and decay of diverse cellular and viral RNA. A primary function of RNase III, however, is the maturation of ribosomal RNA (rRNA) [30, 37, 38, 40, 41]. RNase III has been known to be widely distributed across the living kingdom of life, from bacteria to higher eukaryotes. RNase III family has common features in their molecular organization, by which it consists of catalytic domain with the common feature of HNERLFGDS located at the N-terminus and double-stranded binding domain (dsRBD) that located on their C-terminus [39]. RNase III exhibited enzymatically active in homodimeric form, by which each monomer has its catalytic mechanism and therefore the cleavage product of the RNase III exhibits a very regular length of short double-stranded RNA [39]. By such properties, RNase III can be manipulated to produce short dsRNA that can be implemented for the RNA interference technology in combination with Argonaute, Drosha, and Dicer [42]. Therefore, the production of recombinant RNase III is necessary from the scientific and technological point of view.
Production of recombinant proteins could be done in either bacterial or mammalian cells as a host. The choice of the host to produce recombinant protein may be the subject of proteins of interest. It depends on whether further processing of the proteins of interest is necessary or not. However, the bacterial cell is the most prominent host for recombinant protein production.
This report will discuss the production of recombinant RNase III from a psychrotrophic bacterium,
Protein adaptation in such low temperatures requires a strategy that is not commonly found in mesophilic, for example, psychrophilic proteins must be flexible enough to avoid the problem in protein folding and to perform the optimum catalytic activity if it is an enzyme. Therefore, the production of psychrophilic protein would be interesting due to their properties to adapt to such low temperatures. Although the production of recombinant protein in bacterial host seems to be straightforward, several difficulties that arise and how to solve the problems during the production of recombinant psychrophilic protein will be discussed.
To localize the
Molecular organization of
To overexpress the recombinant psychrophilic RNase III from
The result showed that the recombinant psychrophilic RNase III was accumulated in inclusion body form, although the overproduction was shifted at 20°C (Figure 4). Several attempts have been implemented to improve the solubility of recombinant psychrophilic RNase III in the
SDS-PAGE of recombinant psychrophilic RNase III overproduced in
Another strategy that has been carried out to improve the recombinant psychrophilic RNase III was by co-expression with the chaperone or chaperone-like proteins. Chaperon is a protein that functions for assisting another protein folding. Two types of assisting folding proteins used were GroEL-ES from
Psychrophilic enzymes have unique properties in their folding and activity. Expression of such recombinant psychrophilic enzymes in mesophilic host generally produces misfolding recombinant protein represented by the inclusion bodies formation. Overexpression of recombinant psychrophilic RNase III in
The yeast
Yeast cells are protected by a thick cell wall, a potential barrier to DNA invasion. Removing the cell wall to create protoplasts or spheroplasts increases the chances of genetic transformation. Reseachers adopted this method was adopted and widespread used by these researchers, but some changes have since been have been reported to improve efficiency. This method is based on the technique described initially for protoplast fusion yeast. Yeast cells are recovered in the late stage of growth, the cell wall is weakened with a reducing agent such as mercaptoethanol, and the wall is removed by incubation with an enzyme such as glucanase. Various formulations, such as glucanase enzyme and actinomycete extract have been successfully used. Spheroplasts were then carefully washed with an osmotically equivalent solution of the free buffer and suspended in a solution-containing polyethylene glycol (PEG) and CaCl2 [48]. DNA was added at this stage. For cells to divide, the walls need to be rebuilt. This case requires the cells to be placed in osmotically stabilized agar.
Both plasmid vectors and chromosomal integration are widely used to introduce genes and control copy numbers into
Class | Sub Class | Gene | Function | Organism | Ref |
---|---|---|---|---|---|
ANTP | EuHox | Essential for normal T lymphocyte and activated natural killer cell function | [55, 56] | ||
SuperHox | Essential for the development of the pancreas | Zebrafish | [55] | ||
ParaHox | Regulate LGE patterning but oppositely control the balance between proliferation and differentiation in the neuronal progenitor pool. | [55, 57] | |||
NK cluster | Essential for normal heart morphogenesis | [55, 58] | |||
Regulate postnatal myogenesis, including muscle maintenance during aging and regeneration of acute and chronic muscle injury. | [55, 59] | ||||
PRD | PAX | Regulate the development of the animal olfactory system | Mouse | [55, 60] | |
Involved in the development of the eye structures of | [55, 61] | ||||
Expressed in the presumptive midbrain at early developmental stages, and the hindbrain at later stages, with exclusion from the MHB | [55, 62] | ||||
LIM | Encoding gene regulation during the pituitary gland, eye, and pancreas, organs assembly that was presumably not present in the common ancestor of vertebrates. | [55] | |||
TALE | Plays a critical role in tendon differentiation by regulating type I collagen production in tendon cells. | [55, 63] | |||
POU | Essential for the active maintenance of the differentiated state of a neuron across phylogeny. | [55, 64] | |||
SINE | Play an essential role in retinal development and influence that these proteins have on cell proliferation and growth | [55, 65] | |||
CUT | Developing kidney with expression restricted to the nephrogenic zone. | [55, 66] | |||
ZF | Specification of individual anterior neural precursors and promotes the expression of | [55, 67] | |||
HNF | The inducible protective mechanism that inhibits LPS-induced ROS production and inflammation in EA.hy926 cells by the subsequent inhibition of redox-sensitive NF-κB and MAPK activation. | [55, 68] | |||
CERS | Synthesize ceramides containing mainly C20–C26 fatty acids, with little or no synthesis of C16- and C18-ceramides | [55, 69] | |||
PROSS | Expressed in the developing CNS, lens-secreting cone cells of the eye, and midgut. In the mouse, Prox 1 is expressed in many of the same tissues. Young neurons of the subventricular region of the CNS, developing eye lens, and pancreas. Expression is also detected in the developing liver and heart, as well as transiently in the skeletal muscles | Mouse, | [55, 70] |
Homeobox gene in animal.
The development of a vector system for gene transformation in animal cells is under consideration [71]. These vectors are required in biotechnology to synthesize recombinant proteins from genes that are not correctly expressed when cloned in
Currently, gene cloning in mammals is performed for one of three reasons: (1) To produce recombinant proteins in mammalian cell culture and related farming techniques. Milk. (2) In gene therapy, human cells are manipulated to treat diseases. (3) Achieve gene knockout, an important technique used to determine the function of unknown genes. These experiments are usually performed on rodents, such as mice. Viruses as a mammalian clone vector have been known to be the key to cloning mammals for many years. The first cloning experiment with mammalian cells was performed in 1970 using a vector-based on Simian virus 40 (SV40) [72, 73]. The virus can infect several mammalian species following a lysogenic cycle in some hosts and others. SV40 has the same problem as e and has a calicivirus embedded in it. This is because packaging restrictions limit the amount of new DNA inserted into the genome. Therefore, cloning with the SV40 requires replacing one or more of the existing genes with DNA to clone. The original experiment replaced the late gene region segment, but early gene replacement was also an option [73]. However, the discovery of CRISPR/Cas which is based on cloning technology is one of the essential techniques in gene therapy [74].
Genes are the universal language that controls the nature of all living things, shared homology among organisms. It is always interesting to reveal the evolution of cloning and gene expression in plant, bacteria, and animal cells. Therefore, with the discovery of genetic engineering, possible to exchange good genetic traits which beneficial for human life. In conclusion, genetic transformation is a genetic engineering technique that can be used to understand the function of a gene or several genes in various events in the life of an organism, both prokaryotes and eukaryotes, so that genetic transformation is carried out for two kinds of purposes, namely scientific purposes to determine the function of certain genes in an organism, and economic goals to improve the quality and productivity of an organism to increase the economic value of an organism. In the future, genetic engineering on prokaryotes and eukaryotes perspective can be used for various purposes in the fields of medicine, agriculture, horticulture, forestry, and food.
We thank Badan Penerbit dan Publikasi Universitas Gadjah Mada (BPP UGM) for supporting this publication.
The authors declare no conflict of interest.
Cauliflower Mozaic Virus 35S promoter a part of RNA-induced silencing complex (RISC), plays a central role in RNA silencing processes brassinosteroid Interacting protein 116b human RNase III a class III of RNase III double-strand binding domain double-strand RNA era protein-encoding gene peptidyl-prolyl isomerase protein, a chaperone-like protein from psychrophilic bacterium Shewanella sp. SIB1 chaperonin isopropyl thio-b-D-galactopyranoside signal peptidase encoding gene RNA silencing suppressor p19 bacterial expression vector bacterial expression vector bacterial expression vector ribonuclease III ribonuclease III encoding gene sodium dodecyl sulfate-polyacrylamide gel electrophoresis riboniclease III encoding gene from Shewanella sp. SIB1 transfer DNA
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\\n\\nAll Authors, Academic Editors, and Reviewers are required to declare all possible financial and material Conflicts of Interest in the last five years, although it is advisable to declare less recent Conflicts of Interest as well.
\\n\\nEXAMPLES:
\\n\\nAuthors should declare if they were or they still are Academic Editors of the publications in which they wish to publish their work.
\\n\\nAuthors should declare if they are board members of an organization that could benefit financially or materially from the publication of their work.
\\n\\nAcademic Editors should declare if they were coauthors or they have worked on the research project with the Author who has submitted a manuscript.
\\n\\nAcademic Editors should declare if the Author of a submitted manuscript is affiliated with the same department, faculty, institute, or company as they are.
\\n\\nPolicy last updated: 2016-06-09
\\n"}]'},components:[{type:"htmlEditorComponent",content:"In each instance of a possible Conflict of Interest, IntechOpen aims to disclose the situation in as transparent a way as possible in order to allow readers to judge whether a particular potential Conflict of Interest has influenced the Work of any individual Author, Editor, or Reviewer. IntechOpen takes all possible Conflicts of Interest into account during the review process and ensures maximum transparency in implementing its policies.
\n\nA Conflict of Interest is a situation in which a person's professional judgment may be influenced by a range of factors, including financial gain, material interest, or some other personal or professional interest. For IntechOpen as a publisher, it is essential that all possible Conflicts of Interest are avoided. Each contributor, whether an Author, Editor, or Reviewer, who suspects they may have a Conflict of Interest, is obliged to declare that concern in order to make the publisher and the readership aware of any potential influence on the work being undertaken.
\n\nA Conflict of Interest can be identified at different phases of the publishing process.
\n\nIntechOpen requires:
\n\nCONFLICT OF INTEREST - AUTHOR
\n\nAll Authors are obliged to declare every existing or potential Conflict of Interest, including financial or personal factors, as well as any relationship which could influence their scientific work. Authors must declare Conflicts of Interest at the time of manuscript submission, although they may exceptionally do so at any point during manuscript review. For jointly prepared manuscripts, the corresponding Author is obliged to declare potential Conflicts of Interest of any other Authors who have contributed to the manuscript.
\n\nCONFLICT OF INTEREST – ACADEMIC EDITOR
\n\nEditors can also have Conflicts of Interest. Editors are expected to maintain the highest standards of conduct, which are outlined in our Best Practice Guidelines (templates for Best Practice Guidelines). Among other obligations, it is essential that Editors make transparent declarations of any possible Conflicts of Interest that they might have.
\n\nAvoidance Measures for Academic Editors of Conflicts of Interest:
\n\nFor manuscripts submitted by the Academic Editor (or a scientific advisor), an appropriate person will be appointed to handle and evaluate the manuscript. The appointed handling Editor's identity will not be disclosed to the Author in order to maintain impartiality and anonymity of the review.
\n\nIf a manuscript is submitted by an Author who is a member of an Academic Editor's family or is personally or professionally related to the Academic Editor in any way, either as a friend, colleague, student or mentor, the work will be handled by a different Academic Editor who is not in any way connected to the Author.
\n\nCONFLICT OF INTEREST - REVIEWER
\n\nAll Reviewers are required to declare possible Conflicts of Interest at the beginning of the evaluation process. If a Reviewer feels he or she might have any material, financial or any other conflict of interest with regards to the manuscript being reviewed, he or she is required to declare such concern and, if necessary, request exclusion from any further involvement in the evaluation process. A Reviewer's potential Conflicts of Interest are declared in the review report and presented to the Academic Editor, who then assesses whether or not the declared potential or actual Conflicts of Interest had, or could be perceived to have had, any significant impact on the review itself.
\n\nEXAMPLES OF CONFLICTS OF INTEREST:
\n\nFINANCIAL AND MATERIAL
\n\nNON-FINANCIAL
\n\nAuthors are required to declare all potentially relevant non-financial, financial and material Conflicts of Interest that may have had an influence on their scientific work.
\n\nAcademic Editors and Reviewers are required to declare any non-financial, financial and material Conflicts of Interest that could influence their fair and balanced evaluation of manuscripts. If such conflict exists with regards to a submitted manuscript, Academic Editors and Reviewers should exclude themselves from handling it.
\n\nAll Authors, Academic Editors, and Reviewers are required to declare all possible financial and material Conflicts of Interest in the last five years, although it is advisable to declare less recent Conflicts of Interest as well.
\n\nEXAMPLES:
\n\nAuthors should declare if they were or they still are Academic Editors of the publications in which they wish to publish their work.
\n\nAuthors should declare if they are board members of an organization that could benefit financially or materially from the publication of their work.
\n\nAcademic Editors should declare if they were coauthors or they have worked on the research project with the Author who has submitted a manuscript.
\n\nAcademic Editors should declare if the Author of a submitted manuscript is affiliated with the same department, faculty, institute, or company as they are.
\n\nPolicy last updated: 2016-06-09
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Remote sensing techniques have proven to be powerful tools for the monitoring of the Earth’s surface and atmosphere on a global, regional, and even local scale, by providing important coverage, mapping and classification of land cover features such as vegetation, soil, water and forests. This chapter introduced the methods for monitoring the coastal environment using remote sensing and GIS techniques. Case studies of port expansion monitoring in typical coastal regions, together with the coastal environment changes analysis were also presented.",book:{id:"5096",slug:"applied-studies-of-coastal-and-marine-environments",title:"Applied Studies of Coastal and Marine Environments",fullTitle:"Applied Studies of Coastal and Marine Environments"},signatures:"Dong Jiang, Mengmeng Hao and Jingying Fu",authors:[{id:"25222",title:"Dr.",name:"Dong",middleName:null,surname:"Jiang",slug:"dong-jiang",fullName:"Dong Jiang"},{id:"176843",title:"Dr.",name:"Jingying",middleName:null,surname:"Fu",slug:"jingying-fu",fullName:"Jingying Fu"},{id:"176844",title:"MSc.",name:"Mengmeng",middleName:null,surname:"Hao",slug:"mengmeng-hao",fullName:"Mengmeng Hao"}]},{id:"49642",doi:"10.5772/61979",title:"Engineering Tools for the Estimation of Dredging-Induced Sediment Resuspension and Coastal Environmental Management",slug:"engineering-tools-for-the-estimation-of-dredging-induced-sediment-resuspension-and-coastal-environme",totalDownloads:2299,totalCrossrefCites:1,totalDimensionsCites:6,abstract:"In recent years, increasing attention has been paid to environmental impacts that may result from resuspension, sedimentation and increase in concentration of chemicals during dredging activities. Dredging dislodges and resuspends bottom sediments that are not captured by dredge-head movements. Resuspended sediments are advected far from the dredging site as a dredging plume and the increase in the suspended solid concentration (SSC) can strongly differ, in time and space, depending on site and operational conditions. Well-established international guidelines often include numerical modelling applications to support environmental studies related to dredging activities. Despite the attention that has been focused on this issue, there is a lack of verified predictive techniques of plume dynamics at progressive distances from the different dredging sources, as a function of the employed dredging techniques and work programs, i.e., spatial and temporal variation of resuspension source. This chapter illustrates predictive techniques to estimate the SSC arising from dredges with different mechanisms of sediment release and to assess the spatial and temporal variability of the resulting plume in estuarine and coastal areas. Predictive tools are aimed to support technical choices during planning and operational phases and to better plan the location and frequency of environmental monitoring activities during dredging execution.",book:{id:"5096",slug:"applied-studies-of-coastal-and-marine-environments",title:"Applied Studies of Coastal and Marine Environments",fullTitle:"Applied Studies of Coastal and Marine Environments"},signatures:"Iolanda Lisi, Marcello Di Risio, Paolo De Girolamo and Massimo\nGabellini",authors:[{id:"15209",title:"Prof.",name:"Marcello",middleName:null,surname:"Di Risio",slug:"marcello-di-risio",fullName:"Marcello Di Risio"},{id:"116232",title:"Dr.",name:"Massimo",middleName:null,surname:"Gabellini",slug:"massimo-gabellini",fullName:"Massimo Gabellini"},{id:"176998",title:"Ph.D.",name:"Iolanda",middleName:null,surname:"Lisi",slug:"iolanda-lisi",fullName:"Iolanda Lisi"},{id:"177000",title:"Prof.",name:"Paolo",middleName:null,surname:"De Girolamo",slug:"paolo-de-girolamo",fullName:"Paolo De Girolamo"}]},{id:"49688",doi:"10.5772/61991",title:"Review of Mercury Circulation Changes in the Coastal Zone of Southern Baltic Sea",slug:"review-of-mercury-circulation-changes-in-the-coastal-zone-of-southern-baltic-sea",totalDownloads:1312,totalCrossrefCites:3,totalDimensionsCites:5,abstract:"Despite its undoubted usability, mercury (Hg) is the most toxic metal and one of the most toxic elements. The problem of mercury toxicity was only widely explored in the second half of the 20th century, following cases of fatal poisonings as a result of the consumption of contaminated fish and grains preserved with mercury compounds. According to HELCOM reports, Hg emission in the Baltic region at the beginning of the 21st century was lower than during the 1980s. In addition to mercury transformation, climate warming, particularly in the autumn-winter season, is another factor contributing to the changes in mercury circulation, especially in the area of land-sea contact. The increase in rainfall, particularly in the summer, is of particular importance for the marine environment. This is related to an increased inflow of Hg with wet precipitation, but the warm season is also favourable for intensive growth of sea organisms and, consequently, a faster accumulation of chemical substances, including toxic ones. As a result, the concentration of mercury in organism biomass increases.",book:{id:"5096",slug:"applied-studies-of-coastal-and-marine-environments",title:"Applied Studies of Coastal and Marine Environments",fullTitle:"Applied Studies of Coastal and Marine Environments"},signatures:"Magdalena Bełdowska",authors:[{id:"176840",title:"Dr.",name:"Magdalena",middleName:null,surname:"Bełdowska",slug:"magdalena-beldowska",fullName:"Magdalena Bełdowska"}]},{id:"49825",doi:"10.5772/62132",title:"Management of Marine Protected Zones – Case Study of Bahrain, Arabian Gulf",slug:"management-of-marine-protected-zones-case-study-of-bahrain-arabian-gulf",totalDownloads:2897,totalCrossrefCites:2,totalDimensionsCites:5,abstract:"Coastal and marine environments in Bahrain are characterized by a variety of habitats, including seagrass beds, coral reefs, and mangroves that support some of the most endangered species such as dugongs and turtles. Marine Protected Areas (MPAs) are considered the most advocated approach for marine conservation. Several MPAs have been established in Bahrain. This study explores the ecological and legal contexts of MPAs in Bahrain and evaluates the effectiveness of these MPAs in achieving their conservation goals. Although MPAs are contributing to the protection of critical coastal and marine habitats and their associated flora and fauna, there is yet further need to strengthen efforts on conserving coastal and marine environments in Bahrain. Effectiveness of MPAs in Bahrain could be enhanced by developing management plans, implementing the necessary regulatory measures, and investing in long-term monitoring and research programs. Findings of this study could contribute to wider regional and international experience of the effectiveness of MPAs in protecting important coastal and marine environments.",book:{id:"5096",slug:"applied-studies-of-coastal-and-marine-environments",title:"Applied Studies of Coastal and Marine Environments",fullTitle:"Applied Studies of Coastal and Marine Environments"},signatures:"Humood A. Naser",authors:[{id:"50322",title:"Dr.",name:"Humood",middleName:null,surname:"Naser",slug:"humood-naser",fullName:"Humood Naser"}]},{id:"49999",doi:"10.5772/62205",title:"Fabrication and Properties of Zinc Composite Coatings for Mitigation of Corrosion in Coastal and Marine Zone",slug:"fabrication-and-properties-of-zinc-composite-coatings-for-mitigation-of-corrosion-in-coastal-and-mar",totalDownloads:1715,totalCrossrefCites:3,totalDimensionsCites:4,abstract:"Deterioration of metals and alloys during service due to corrosion and wear phenomena shortens materials’ life span and structural integrity particularly in aggressive environments such as coastal and marine. This degradation also limits the use of these materials in most industrial applications. Therefore, the improvement of the quality of these materials in order to combat these challenges in industry remains critical. Surface modification techniques are employed to enhance materials’ properties to enable better performance and to extend their applications in demanding environments. Electrodeposition has been a useful method developed to improve the corrosion and mechanical properties of materials. In the present contribution, ample knowledge about electrodeposition of Zn composite/nanocomposite coatings and their characteristics are reviewed to address coastal and marine degradation of metals and alloys.",book:{id:"5096",slug:"applied-studies-of-coastal-and-marine-environments",title:"Applied Studies of Coastal and Marine Environments",fullTitle:"Applied Studies of Coastal and Marine Environments"},signatures:"Patricia A.I. 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The marine geological map n. 502 “Agropoli,” located offshore the Cilento Promontory (southern Italy), is described and put in regional geologic setting. The study area covers water depths ranging between 30 and 200 m isobaths. The geologic map has been constructed in the frame of a research program financed by the National Geological Survey of Italy (CARG Project), finalized to the construction of an up-to-date cartography of the Campania region. Geological and geophysical data on the continental shelf and slope offshore the southern Campania region have been acquired in an area bounded northward by the Gulf of Salerno and southward by the Gulf of Policastro. A high-resolution multibeam bathymetry has permitted the construction of a digital elevation model (DEM). Sidescan sonar profiles have also been collected and interpreted, and their merging with bathymetric data has allowed for the realization of the base for the marine geologic cartography. The calibration of geophysical data has been attempted through sea-bottom samples. The morpho-structures and the seismic sequences overlying the outcrops of acoustic basement reported in the cartographic representation have been studied in detail using single-channel seismics. The interpretation of seismic profiles has been a support for the reconstruction of the stratigraphic and structural setting of the Quaternary continental shelf successions and the outcrops of rocky acoustic basement in correspondence to the Licosa Cape morpho-structural high. These areas result from the seaward prolongation of the stratigraphic and structural units, widely cropping out in the surrounding emerged sector of the Cilento Promontory. The cartographic approach is based on the recognition of laterally coeval depositional systems, interpreted in the frame of system tracts of the Late Quaternary depositional sequence.",book:{id:"5096",slug:"applied-studies-of-coastal-and-marine-environments",title:"Applied Studies of Coastal and Marine Environments",fullTitle:"Applied Studies of Coastal and Marine Environments"},signatures:"Gemma Aiello and Ennio Marsella",authors:[{id:"100661",title:"Dr.",name:"Gemma",middleName:null,surname:"Aiello",slug:"gemma-aiello",fullName:"Gemma Aiello"}]},{id:"49642",title:"Engineering Tools for the Estimation of Dredging-Induced Sediment Resuspension and Coastal Environmental Management",slug:"engineering-tools-for-the-estimation-of-dredging-induced-sediment-resuspension-and-coastal-environme",totalDownloads:2299,totalCrossrefCites:1,totalDimensionsCites:6,abstract:"In recent years, increasing attention has been paid to environmental impacts that may result from resuspension, sedimentation and increase in concentration of chemicals during dredging activities. Dredging dislodges and resuspends bottom sediments that are not captured by dredge-head movements. Resuspended sediments are advected far from the dredging site as a dredging plume and the increase in the suspended solid concentration (SSC) can strongly differ, in time and space, depending on site and operational conditions. Well-established international guidelines often include numerical modelling applications to support environmental studies related to dredging activities. Despite the attention that has been focused on this issue, there is a lack of verified predictive techniques of plume dynamics at progressive distances from the different dredging sources, as a function of the employed dredging techniques and work programs, i.e., spatial and temporal variation of resuspension source. This chapter illustrates predictive techniques to estimate the SSC arising from dredges with different mechanisms of sediment release and to assess the spatial and temporal variability of the resulting plume in estuarine and coastal areas. Predictive tools are aimed to support technical choices during planning and operational phases and to better plan the location and frequency of environmental monitoring activities during dredging execution.",book:{id:"5096",slug:"applied-studies-of-coastal-and-marine-environments",title:"Applied Studies of Coastal and Marine Environments",fullTitle:"Applied Studies of Coastal and Marine Environments"},signatures:"Iolanda Lisi, Marcello Di Risio, Paolo De Girolamo and Massimo\nGabellini",authors:[{id:"15209",title:"Prof.",name:"Marcello",middleName:null,surname:"Di Risio",slug:"marcello-di-risio",fullName:"Marcello Di Risio"},{id:"116232",title:"Dr.",name:"Massimo",middleName:null,surname:"Gabellini",slug:"massimo-gabellini",fullName:"Massimo Gabellini"},{id:"176998",title:"Ph.D.",name:"Iolanda",middleName:null,surname:"Lisi",slug:"iolanda-lisi",fullName:"Iolanda Lisi"},{id:"177000",title:"Prof.",name:"Paolo",middleName:null,surname:"De Girolamo",slug:"paolo-de-girolamo",fullName:"Paolo De Girolamo"}]},{id:"50060",title:"Depositional Environment of Phosphorites of the Sonrai Basin, Lalitpur District, Uttar Pradesh, India",slug:"depositional-environment-of-phosphorites-of-the-sonrai-basin-lalitpur-district-uttar-pradesh-india",totalDownloads:1795,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Phosphates are regarded as one of the most important fertilizer minerals used by man. In Sonrai basin of Lalitpur the phosphorites are found to occur as lenticular and detached bodies throughout the Formation of the Bijawar Group. Individual bodies range from a few meters to about 4 km in length, and width varies from thin bands to about 125 meter with P2O5 concentration ranging from 10 to 20%. The Paleoproterozoic Bijawar Group are overlain by the Archaean Bundelkhand Basement Complex and underlain by Vindhyan Supergroup. The occurrence of phosphorites is confined to the Sonrai Formation which consists of massive to brecciated phosphorite within the lower reddish shales, with at least three bands identified. Megascopic study reveals that the brecciated phosphorite is reddish brown in color and fine to medium grained with angular fragments of chert and quartz embedded in a groundmass of iron oxides and secondary silica intercalated with minor veins of chert and iron oxides. The phosphorite horizon in the Lalitpur area is associated with pink to white brecciated massive quartzite, shale, dolomite and limestone of the basal unit. The concentration trends of certain major oxides indicate that the phosphorites are more enriched in CaO, P2O5 and SiO2 than Al2O3, Fe2O3, TiO2, Na2O and K2O. The concentration trends of trace elements reveal that the phosphorites are moderately enriched in Co, Zn, Zr, Pb, U than in Sc, Ba, V, Cr, Ni, , Rb, Sr, Y and Th. The dispersion patter, correlation coefficient and mutual relationship of significant major oxides represented by plotted diagrams, indicate that SiO2, CaO, MgO are antipathetically related with P2O5. The relationship suggests a gradual replacement among these oxides during diagenesis. High values of P2O5 and CaO in the phosphorites indicate more concentration of apatite constituent. The difference in geochemical behavior of CaO and MgO may be due to ionic substitution of Ca+2 by MgO+2 in the apatite crystal lattice during alkaline environment of the basin. The strong negative relationship between P2O5 with Fe2O3 in phosphorites may be due to leaching and/mild weathering of iron from the ores and reprecipitation along with P2O5 in the pore spaces, cavities/voids, veins, etc in highly oxidizing marine environment of the basin. The minimum evidence of organic matter, absence of sulphide minerals and lower concentration of V, Ni, and Cu suggest that the phosphorites were deposited in an oxidizing environment with slightly anaerobic to highly aerobic facies.",book:{id:"5096",slug:"applied-studies-of-coastal-and-marine-environments",title:"Applied Studies of Coastal and Marine Environments",fullTitle:"Applied Studies of Coastal and Marine Environments"},signatures:"Shamim A. Dar and K. F. Khan",authors:[{id:"176685",title:"Dr.",name:"Shamim",middleName:"A",surname:"Dar",slug:"shamim-dar",fullName:"Shamim Dar"},{id:"181312",title:"Dr.",name:"K.F",middleName:null,surname:"Khan",slug:"k.f-khan",fullName:"K.F Khan"},{id:"181314",title:"Dr.",name:"Saif A",middleName:null,surname:"Khan",slug:"saif-a-khan",fullName:"Saif A Khan"}]},{id:"49930",title:"Monitoring the Coastal Environment Using Remote Sensing and GIS Techniques",slug:"monitoring-the-coastal-environment-using-remote-sensing-and-gis-techniques",totalDownloads:2666,totalCrossrefCites:7,totalDimensionsCites:10,abstract:"The coastal zone has been of importance for economic development and ecological restoration due to their rich natural resources and vulnerable ecosystems. Remote sensing techniques have proven to be powerful tools for the monitoring of the Earth’s surface and atmosphere on a global, regional, and even local scale, by providing important coverage, mapping and classification of land cover features such as vegetation, soil, water and forests. This chapter introduced the methods for monitoring the coastal environment using remote sensing and GIS techniques. Case studies of port expansion monitoring in typical coastal regions, together with the coastal environment changes analysis were also presented.",book:{id:"5096",slug:"applied-studies-of-coastal-and-marine-environments",title:"Applied Studies of Coastal and Marine Environments",fullTitle:"Applied Studies of Coastal and Marine Environments"},signatures:"Dong Jiang, Mengmeng Hao and Jingying Fu",authors:[{id:"25222",title:"Dr.",name:"Dong",middleName:null,surname:"Jiang",slug:"dong-jiang",fullName:"Dong Jiang"},{id:"176843",title:"Dr.",name:"Jingying",middleName:null,surname:"Fu",slug:"jingying-fu",fullName:"Jingying Fu"},{id:"176844",title:"MSc.",name:"Mengmeng",middleName:null,surname:"Hao",slug:"mengmeng-hao",fullName:"Mengmeng Hao"}]},{id:"49825",title:"Management of Marine Protected Zones – Case Study of Bahrain, Arabian Gulf",slug:"management-of-marine-protected-zones-case-study-of-bahrain-arabian-gulf",totalDownloads:2897,totalCrossrefCites:2,totalDimensionsCites:5,abstract:"Coastal and marine environments in Bahrain are characterized by a variety of habitats, including seagrass beds, coral reefs, and mangroves that support some of the most endangered species such as dugongs and turtles. Marine Protected Areas (MPAs) are considered the most advocated approach for marine conservation. Several MPAs have been established in Bahrain. This study explores the ecological and legal contexts of MPAs in Bahrain and evaluates the effectiveness of these MPAs in achieving their conservation goals. Although MPAs are contributing to the protection of critical coastal and marine habitats and their associated flora and fauna, there is yet further need to strengthen efforts on conserving coastal and marine environments in Bahrain. Effectiveness of MPAs in Bahrain could be enhanced by developing management plans, implementing the necessary regulatory measures, and investing in long-term monitoring and research programs. Findings of this study could contribute to wider regional and international experience of the effectiveness of MPAs in protecting important coastal and marine environments.",book:{id:"5096",slug:"applied-studies-of-coastal-and-marine-environments",title:"Applied Studies of Coastal and Marine Environments",fullTitle:"Applied Studies of Coastal and Marine Environments"},signatures:"Humood A. Naser",authors:[{id:"50322",title:"Dr.",name:"Humood",middleName:null,surname:"Naser",slug:"humood-naser",fullName:"Humood Naser"}]}],onlineFirstChaptersFilter:{topicId:"789",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:89,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:104,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:32,numberOfPublishedChapters:318,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:12,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:141,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:113,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:106,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:5,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:15,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}},{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}}]},series:{item:{id:"23",title:"Education and Human Development",doi:"10.5772/intechopen.100360",issn:null,scope:"\r\n\tEducation and Human Development is an interdisciplinary research area that aims to shed light on topics related to both learning and development. 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",coverUrl:"https://cdn.intechopen.com/series/covers/23.jpg",latestPublicationDate:"June 25th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:0,editor:{id:"280770",title:"Dr.",name:"Katherine K.M.",middleName:null,surname:"Stavropoulos",slug:"katherine-k.m.-stavropoulos",fullName:"Katherine K.M. Stavropoulos",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRdFuQAK/Profile_Picture_2022-05-24T09:03:48.jpg",biography:"Katherine Stavropoulos received her BA in Psychology from Trinity College, in Connecticut, USA. Dr. Stavropoulos received her Ph.D. in Experimental Psychology from the University of California, San Diego. She completed her postdoctoral work at the Yale Child Study Center with Dr. James McPartland. Dr. Stavropoulos’ doctoral dissertation explored neural correlates of reward anticipation to social versus nonsocial stimuli in children with and without autism spectrum disorders (ASD). She has been a faculty member at the University of California, Riverside in the School of Education since 2016. Her research focuses on translational studies to explore the reward system in ASD, as well as how anxiety contributes to social challenges in ASD. She also investigates how behavioral interventions affect neural activity, behavior, and school performance in children with ASD. She is also involved in the diagnosis of children with ASD and is a licensed clinical psychologist in California. She is the Assistant Director of the SEARCH Center at UCR and is a Faculty member in the Graduate Program in Neuroscience.",institutionString:null,institution:{name:"University of California, Riverside",institutionURL:null,country:{name:"United States of America"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:2,paginationItems:[{id:"89",title:"Education",coverUrl:"https://cdn.intechopen.com/series_topics/covers/89.jpg",isOpenForSubmission:!1,editor:{id:"260066",title:"Associate Prof.",name:"Michail",middleName:null,surname:"Kalogiannakis",slug:"michail-kalogiannakis",fullName:"Michail Kalogiannakis",profilePictureURL:"https://mts.intechopen.com/storage/users/260066/images/system/260066.jpg",biography:"Michail Kalogiannakis is an Associate Professor of the Department of Preschool Education, University of Crete, and an Associate Tutor at School of Humanities at the Hellenic Open University. He graduated from the Physics Department of the University of Crete and continued his post-graduate studies at the University Paris 7-Denis Diderot (D.E.A. in Didactic of Physics), University Paris 5-René Descartes-Sorbonne (D.E.A. in Science Education) and received his Ph.D. degree at the University Paris 5-René Descartes-Sorbonne (PhD in Science Education). His research interests include science education in early childhood, science teaching and learning, e-learning, the use of ICT in science education, games simulations, and mobile learning. He has published over 120 articles in international conferences and journals and has served on the program committees of numerous international conferences.",institutionString:"University of Crete",institution:{name:"University of Crete",institutionURL:null,country:{name:"Greece"}}},editorTwo:{id:"422488",title:"Dr.",name:"Maria",middleName:null,surname:"Ampartzaki",slug:"maria-ampartzaki",fullName:"Maria Ampartzaki",profilePictureURL:"https://mts.intechopen.com/storage/users/422488/images/system/422488.jpg",biography:"Dr Maria Ampartzaki is an Assistant Professor in Early Childhood Education in the Department of Preschool Education at the University of Crete. Her research interests include ICT in education, science education in the early years, inquiry-based and art-based learning, teachers’ professional development, action research, and the Pedagogy of Multiliteracies, among others. She has run and participated in several funded and non-funded projects on the teaching of Science, Social Sciences, and ICT in education. She also has the experience of participating in five Erasmus+ projects.",institutionString:"University of Crete",institution:{name:"University of Crete",institutionURL:null,country:{name:"Greece"}}},editorThree:null},{id:"90",title:"Human Development",coverUrl:"https://cdn.intechopen.com/series_topics/covers/90.jpg",isOpenForSubmission:!0,editor:{id:"191040",title:"Dr.",name:"Tal",middleName:null,surname:"Dotan Ben-Soussan",slug:"tal-dotan-ben-soussan",fullName:"Tal Dotan Ben-Soussan",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSBf1QAG/Profile_Picture_2022-03-18T07:56:11.jpg",biography:"Tal Dotan Ben-Soussan, Ph.D., is the director of the Research Institute for Neuroscience, Education and Didactics (RINED) – Paoletti Foundation. Ben-Soussan leads international studies on training and neuroplasticity from neurophysiological and psychobiological perspectives. As a neuroscientist and bio-psychologist, she has published numerous articles on neuroplasticity, movement and meditation. She acts as an editor and reviewer in several renowned journals and coordinates international conferences integrating theoretical, methodological and practical approaches on various topics, such as silence, logics and neuro-education. 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Thus all studies on metabolism will be considered for publication.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/17.jpg",keywords:"Biomolecules Metabolism, Energy Metabolism, Metabolic Pathways, Key Metabolic Enzymes, Metabolic Adaptation"},{id:"18",title:"Proteomics",scope:"With the recognition that the human genome cannot provide answers to the etiology of a disorder, changes in the proteins expressed by a genome became a focus in research. Thus proteomics, an area of research that detects all protein forms expressed in an organism, including splice isoforms and post-translational modifications, is more suitable than genomics for a comprehensive understanding of the biochemical processes that govern life. The most common proteomics applications are currently in the clinical field for the identification, in a variety of biological matrices, of biomarkers for diagnosis and therapeutic intervention of disorders. From the comparison of proteomic profiles of control and disease or different physiological states, which may emerge, changes in protein expression can provide new insights into the roles played by some proteins in human pathologies. Understanding how proteins function and interact with each other is another goal of proteomics that makes this approach even more intriguing. Specialized technology and expertise are required to assess the proteome of any biological sample. Currently, proteomics relies mainly on mass spectrometry (MS) combined with electrophoretic (1 or 2-DE-MS) and/or chromatographic techniques (LC-MS/MS). MS is an excellent tool that has gained popularity in proteomics because of its ability to gather a complex body of information such as cataloging protein expression, identifying protein modification sites, and defining protein interactions. The Proteomics topic aims to attract contributions on all aspects of MS-based proteomics that, by pushing the boundaries of MS capabilities, may address biological problems that have not been resolved yet.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/18.jpg",keywords:"Mono- and Two-Dimensional Gel Electrophoresis (1-and 2-DE), Liquid Chromatography (LC), Mass Spectrometry/Tandem Mass Spectrometry (MS; MS/MS), Proteins"}],annualVolumeBook:{},thematicCollection:[],selectedSeries:null,selectedSubseries:null},seriesLanding:{item:null},libraryRecommendation:{success:null,errors:{},institutions:[]},route:{name:"chapter.detail",path:"/chapters/63162",hash:"",query:{},params:{id:"63162"},fullPath:"/chapters/63162",meta:{},from:{name:null,path:"/",hash:"",query:{},params:{},fullPath:"/",meta:{}}}},function(){var e;(e=document.currentScript||document.scripts[document.scripts.length-1]).parentNode.removeChild(e)}()