Barely three months into the new year and we are happy to announce a monumental milestone reached - 150 million downloads.
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This achievement solidifies IntechOpen’s place as a pioneer in Open Access publishing and the home to some of the most relevant scientific research available through Open Access.
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We are so proud to have worked with so many bright minds throughout the years who have helped us spread knowledge through the power of Open Access and we look forward to continuing to support some of the greatest thinkers of our day.
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Thank you for making IntechOpen your place of learning, sharing, and discovery, and here’s to 150 million more!
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Now, the laser wavelength can cover the range from ultraviolet to terahertz and output laser performance has significantly progressed in recent years. This book is focused on the advanced diode laser, fiber laser, and their applications in laser ablation, laser-introduced fluorescence, and laser treatment. The advantages of laser technology are shown comprehensively.",isbn:"978-1-78984-918-9",printIsbn:"978-1-78984-917-2",pdfIsbn:"978-1-83881-817-3",doi:"10.5772/intechopen.75224",price:119,priceEur:129,priceUsd:155,slug:"laser-technology-and-its-applications",numberOfPages:132,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"e3e216f156485832df705942fb8eb1f8",bookSignature:"Yufei Ma",publishedDate:"January 3rd 2019",coverURL:"https://cdn.intechopen.com/books/images_new/7349.jpg",numberOfDownloads:9219,numberOfWosCitations:17,numberOfCrossrefCitations:15,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:40,numberOfDimensionsCitationsByBook:0,hasAltmetrics:1,numberOfTotalCitations:72,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"March 28th 2018",dateEndSecondStepPublish:"April 18th 2018",dateEndThirdStepPublish:"June 17th 2018",dateEndFourthStepPublish:"September 5th 2018",dateEndFifthStepPublish:"November 4th 2018",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,7",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"238529",title:"Dr.",name:"Yufei",middleName:null,surname:"Ma",slug:"yufei-ma",fullName:"Yufei Ma",profilePictureURL:"https://mts.intechopen.com/storage/users/238529/images/system/238529.jpeg",biography:"Yufei Ma received his Ph.D. degree in physical electronics from the Harbin Institute of Technology, China. From September 2010 to September 2011, he spent as a visiting scholar at Rice University, USA. Currently, he is a group leader at Harbin Institute of Technology, China. His research interests include optical sensors, trace gas detection, laser spectroscopy, solid-state laser and optoelectronics. He has published 74 first/corresponding author, peer-reviewed papers, including 5 invited papers. He has two book chapters published by international publishers, in which the editors are two Nobel Prize winners in physics. Now, Prof. Ma serves as an editor of three journals.",institutionString:"Harbin Institute of Technology",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"Harbin Institute of Technology",institutionURL:null,country:{name:"China"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"226",title:"Laser Physics",slug:"laser-physics"}],chapters:[{id:"62687",title:"Tunable High-Power External-Cavity GaN Diode Laser Systems in the Visible Spectral Range",doi:"10.5772/intechopen.79703",slug:"tunable-high-power-external-cavity-gan-diode-laser-systems-in-the-visible-spectral-range",totalDownloads:1232,totalCrossrefCites:3,totalDimensionsCites:4,hasAltmetrics:0,abstract:"In this chapter, both blue and green high-power tunable diode laser systems based on GaN broad-area diode laser (BAL) in Littrow external cavity are demonstrated. For blue diode laser system, for high-power application, an output power around 530 mW over a 1.4 nm tunable range is obtained; for wide tunable range application, an output power around 80 mW over a 6.0 nm tunable range is obtained. For the green diode laser system, for high-power application, an output power around 480 mW with a tunable range of 2.1 nm is achieved; for wide tunable range application, an output power of 50 mW with a tunable range of 9.2 nm is achieved. The tuning range and output power optimization of an external-cavity diode laser system is investigated based on the experimental results obtained in the blue and green external-cavity GaN diode laser systems. The obtained results can be used as a guide for selecting gratings for external-cavity diode lasers for different requirements. The temporal dynamics of the green diode laser system is studied experimentally, and pulse package oscillation is observed, for the first time to our knowledge, in a BAL with an external-cavity grating feedback.",signatures:"Mingjun Chi, Ole Bjarlin Jensen, Anders Kragh Hansen and Paul Michael Petersen",downloadPdfUrl:"/chapter/pdf-download/62687",previewPdfUrl:"/chapter/pdf-preview/62687",authors:[null],corrections:null},{id:"63738",title:"Cladding Pumped Thulium-Ytterbium Short Pulse Fiber Lasers",doi:"10.5772/intechopen.81060",slug:"cladding-pumped-thulium-ytterbium-short-pulse-fiber-lasers",totalDownloads:1247,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"This chapter describes double clad fiber along with cladding pump technique in which pump light is coupled in the inner cladding of fiber thereby interacting with doped core through total internal reflection. Lasers operating in continuous wave mode have limited output power. Their output power can be enhanced to a great extent by concentrating the available energy in a single or in a periodic sequence of optical pulses. This is achieved by Q-switch and modelock techniques. Q-switched and modelocked lasers can be realized by active and passive means. Active technique is based on active loss modulation by using mechanical, electro-optic or acousto-optic based modulators. However, such techniques require complicated electronic circuits and have limited gain bandwidth. The attention then moves towards the passive technique which is low cost, compact in size, gives reliable operation without high voltages and provides simple cavity design without need for external electronics. Passive technique employs a saturable absorber, based on materials like carbon nanotubes, graphene, molybdenum di-sulfide etc. A brief description of pulsed fiber lasers and solitons in view of modelocking are described in the text. Moreover examples of Q-switched and modelocked lasers are also presented by using Thulium-Ytterbium co-doped double clad fiber. A cladding pump technique is employed for the purpose.",signatures:"Babar Ibrahim Muhammad",downloadPdfUrl:"/chapter/pdf-download/63738",previewPdfUrl:"/chapter/pdf-preview/63738",authors:[null],corrections:null},{id:"63522",title:"Nonlinear Optical Response of Noble Metal Nanoparticles",doi:"10.5772/intechopen.80841",slug:"nonlinear-optical-response-of-noble-metal-nanoparticles",totalDownloads:1469,totalCrossrefCites:2,totalDimensionsCites:6,hasAltmetrics:0,abstract:"The special nonlinear optical response of noble metal nanoparticles (MNPs) when exposed to intense laser radiation has induced novel applications in nonlinear spectroscopy, optoelectronics, and optical switchers and limiters. In this chapter, recent results on the nonlinear optical properties of MNPs (including gold, silver, palladium, and platinum) have been discussed. Some specific optical nonlinear properties, such as nonlinear refraction, saturable absorption and reverse saturable absorption, two-photon absorption, and optical limiting, for femtosecond, picosecond, and nanosecond laser pulses, have been covered.",signatures:"Yachen Gao and Deigui Kong",downloadPdfUrl:"/chapter/pdf-download/63522",previewPdfUrl:"/chapter/pdf-preview/63522",authors:[null],corrections:null},{id:"63129",title:"Laser Ablation Technique for Synthesis of Metal Nanoparticle in Liquid",doi:"10.5772/intechopen.80374",slug:"laser-ablation-technique-for-synthesis-of-metal-nanoparticle-in-liquid",totalDownloads:2620,totalCrossrefCites:10,totalDimensionsCites:28,hasAltmetrics:1,abstract:"Recently, the synthesis and application of metal and ceramic nanoparticle are significant subject in science and engineering. The metal nanoparticles such as silver, gold, and copper nanoparticles have more application in material science, nanomedicine, electronic, photonic, and art. One of the green methods for preparation of metal nanoparticles is laser ablation technique that offers a unique tool for nanofabrication of nanoparticles. In this technique, the high-power laser ablates the metal plate and the nanoparticles are formed in the liquid. The properties of nanoparticles using laser ablation are unique, and they are not reproducible by any other method such as chemical methods. The important parameters to produce the metal nanoparticles are energy, wavelength, repetition rate of laser, ablation time, and absorption of an aqueous solution. Laser ablation is a simple method for fabricating the metal nanoparticles without surfactant or chemical addition. In this chapter, the mechanism of formation of metal nanoparticles in liquid, significant parameters for using the laser ablation technique to prepare the metal nanoparticles, and the preparation of silver, gold and copper nanoparticles will be reviewed.",signatures:"Amir Reza Sadrolhosseini, Mohd Adzir Mahdi, Farideh Alizadeh and\nSuraya Abdul Rashid",downloadPdfUrl:"/chapter/pdf-download/63129",previewPdfUrl:"/chapter/pdf-preview/63129",authors:[null],corrections:null},{id:"62688",title:"Quantitative Planar Laser-Induced Fluorescence Technology",doi:"10.5772/intechopen.79702",slug:"quantitative-planar-laser-induced-fluorescence-technology",totalDownloads:1471,totalCrossrefCites:0,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Planar laser-induced fluorescence (PLIF) is a highly sensitive and space-time-resolved laser diagnostic technique. It is widely used in the diagnosis of combustion and flow fields to obtain the thermodynamic information of active components and interested molecules in flames. Nowadays, the PLIF technology is developing in two directions: high speed and quantification. In view of the high spatial and temporal resolution characteristics of PLIF technology that other laser diagnostics do not possess, this chapter will focus on the basic principle of laser-induced fluorescence and the current research status of quantitative PLIF technology. In addition, the advantages and disadvantages of various quantitative technologies of component concentration in flames based on laser-induced fluorescence technology are analyzed. At last, the latest works on the quantification of species concentration using planar laser-induced fluorescence in combustion are introduced.",signatures:"Zhen Yang, Xin Yu, Jiangbo Peng and Jianlong Zhang",downloadPdfUrl:"/chapter/pdf-download/62688",previewPdfUrl:"/chapter/pdf-preview/62688",authors:[null],corrections:null},{id:"62837",title:"Indirect Diode Laser in the Treatment of Retinopathy of Prematurity",doi:"10.5772/intechopen.79828",slug:"indirect-diode-laser-in-the-treatment-of-retinopathy-of-prematurity",totalDownloads:1183,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Retinopathy of prematurity (ROP) is a largely preventable cause of visual impairment in children. The golden standard of treatment in ROP is the laser photocoagulation of the non-vascularized retina. The most vulnerable period when ROP is at high risk of rapid progression is comprised between 34 and 35 weeks postconceptional age (PCA) and 36–37 weeks PCA. We carried out a retrospective study in which we included all the ROP cases treated by indirect diode laser photocoagulation between January 1, 2006, and December 31, 2017, totalizing 110 premature infants of which, 60 were males (54.54%) and 50, females (45.45%). Mean gestational age (GA) was 28.30 weeks and mean birth weight (BW) was 1121 grams in our series. Of the 110 preterm infants, 74 were the result of single pregnancies (67.27%) and 36 of multiple pregnancies (32.72%). At the moment of treatment, the mean postnatal age (PNA) was 8.38 weeks and the mean PCA, 37.02 weeks. ROP regressed after laser treatment in 185 eyes (88.09%). Statistical tests proved that regression rate was significantly worse in aggressive posterior ROP as compared with stage 3 zone 2 and stage 3 zone 1 ROP (odds ratio = 13.53, relative risk = 7.79, P < .001).",signatures:"Simona Delia Nicoară",downloadPdfUrl:"/chapter/pdf-download/62837",previewPdfUrl:"/chapter/pdf-preview/62837",authors:[{id:"87785",title:"Prof.",name:"Simona-Delia",surname:"Nicoara",slug:"simona-delia-nicoara",fullName:"Simona-Delia Nicoara"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:[{id:"65",label:"highly cited contributor"}]},relatedBooks:[{type:"book",id:"6467",title:"Optical Amplifiers",subtitle:"A Few Different Dimensions",isOpenForSubmission:!1,hash:"86c6992b53c2bbf8f9021210a0edeb2d",slug:"optical-amplifiers-a-few-different-dimensions",bookSignature:"Pankaj Kumar Choudhury",coverURL:"https://cdn.intechopen.com/books/images_new/6467.jpg",editedByType:"Edited by",editors:[{id:"205744",title:"Dr.",name:"Pankaj",surname:"Kumar Choudhury",slug:"pankaj-kumar-choudhury",fullName:"Pankaj Kumar Choudhury"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"5757",title:"High Power Laser Systems",subtitle:null,isOpenForSubmission:!1,hash:"9e6dfb9321678bdd24ae54776c292c7b",slug:"high-power-laser-systems",bookSignature:"Masoud Harooni",coverURL:"https://cdn.intechopen.com/books/images_new/5757.jpg",editedByType:"Edited by",editors:[{id:"184282",title:"Dr.",name:"Masoud",surname:"Harooni",slug:"masoud-harooni",fullName:"Masoud Harooni"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"10481",title:"Practical Applications of Laser Ablation",subtitle:null,isOpenForSubmission:!1,hash:"e9f235e98a88813c08a9dba80525b195",slug:"practical-applications-of-laser-ablation",bookSignature:"Dongfang Yang",coverURL:"https://cdn.intechopen.com/books/images_new/10481.jpg",editedByType:"Edited by",editors:[{id:"177814",title:"Dr.",name:"Dongfang",surname:"Yang",slug:"dongfang-yang",fullName:"Dongfang Yang"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and Technology",isOpenForSubmission:!1,hash:"99b4b7b71a8caeb693ed762b40b017f4",slug:"infrared-spectroscopy-materials-science-engineering-and-technology",bookSignature:"Theophile Theophanides",coverURL:"https://cdn.intechopen.com/books/images_new/1591.jpg",editedByType:"Edited by",editors:[{id:"37194",title:"Dr.",name:"Theophile",surname:"Theophanides",slug:"theophile-theophanides",fullName:"Theophile Theophanides"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3161",title:"Frontiers in Guided Wave Optics and Optoelectronics",subtitle:null,isOpenForSubmission:!1,hash:"deb44e9c99f82bbce1083abea743146c",slug:"frontiers-in-guided-wave-optics-and-optoelectronics",bookSignature:"Bishnu Pal",coverURL:"https://cdn.intechopen.com/books/images_new/3161.jpg",editedByType:"Edited by",editors:[{id:"4782",title:"Prof.",name:"Bishnu",surname:"Pal",slug:"bishnu-pal",fullName:"Bishnu Pal"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"371",title:"Abiotic Stress in Plants",subtitle:"Mechanisms and Adaptations",isOpenForSubmission:!1,hash:"588466f487e307619849d72389178a74",slug:"abiotic-stress-in-plants-mechanisms-and-adaptations",bookSignature:"Arun Shanker and B. 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1. Introduction
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Adaptation to climate change by increasing the reflectance of human settlements has been proposed as a simple and cost-effective geo-engineering strategy to offset the rise of temperatures associated with global warming at local and regional scales [1]. The use of higher albedo roofs and/or pavements (cool roofs and pavements) has shown effective surface air cooling in simulation experiments over many cities in the world [2]. Due to lower surface temperatures, an improvement in air quality can be obtained by slowing temperature-dependent photochemical reaction rates of formation of secondary pollutants, such as ozone, and reducing biogenic hydrocarbon emissions. Additional indirect benefits are linked to lower energy demand for summer cooling of buildings and its associated emissions in power plants [3]. On the contrary, due to the depression of the planetary boundary layer level (PBL) height caused by cooler temperatures, and to possible changes in local wind patterns, reduced mixing and dilution of pollutants can raise their levels by accumulation in some areas. Ground-level ozone (O3), particulate matter (PM), nitrogen oxides (NOx), and sulfur oxides (SO2) are most health-concerned pollutants, and their urban concentration levels can be affected by surface modification. O3 is a secondary pollutant resulting from the reaction between NOx oxides and volatile organic compounds (VOCs) in the presence of sunlight. Higher O3 concentration levels are directly related to warming in urban heat islands, reaching peak levels in summertime [4].
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Most numerical simulations of the impact of albedo increase on pollutants have been developed over US cities, in general with different urban fabrics than in Europe, where compact mid-rise urban categories occupy most of the city centers. In pioneering mesoscale numerical simulations [5], extreme surface albedo enhancement resulted in ozone reductions in California. Simulating a more feasible albedo increase over southern US cities with high insolation levels, [6] obtained ozone reductions linked to cooler summer ambient air temperatures. However, only Sacramento showed significant peak ozone-level reductions due to a wider urban surface (25,000 ha). Applying comparable albedo increase levels, it has been simulated significant air quality benefits over California [7], suggesting that there is a maximum albedo increase implementation threshold above which no further benefits are obtained that should be determined for every urban case. There are scarce mesoscale simulation experiments to investigate the impact of albedo enhancement on pollutants other than ozone. In another simulation the effect on air quality during a heat wave episode of albedo increase at high latitudes (Montreal, Canada) was reported [8], with no significant effect on ozone levels, and slight reductions in PM2.5 levels (2 ppb), associated with a decrease in PBL height, that counteracted the cooling impact on ozone formation. Applying an extreme albedo increase over Stuttgart (Germany), a peak urban temperature cooling down to −1.7°C and decreases in mean ozone concentration were reported [9]. However, secondary undesirable effects were an increase of primary pollutants (NOx and CO) and an increase in peak ozone concentration due to a higher intensity of reflected UV shortwave radiation. To date, the impact of urban albedo enhancement on temperatures and air quality has never been assessed over Spanish urban areas by numerical modeling. Spanish cities may give key information for this research, due to the high levels of annual and summer insolation and to the hot summer Mediterranean climate in most of the country, with high annual number of clear skies that maximize the thermal and energy-saving potential benefits of changes in solar reflectivity [10]. On the other hand, an undetermined minimum critical intervention surface is also needed to obtain significant modifications in local atmospheric variables by land cover changes [6]. Madrid city is the biggest urban area in Spain, with broadly five million inhabitants in its metropolitan area, and the fourth most populated city in Europe. Emissions of air pollutants in Madrid are mostly originated from anthropogenic sources, with the traffic sector as the main contribution activity to the emissions of the whole region. In the last years, the Regional Government of Madrid has developed an ambitious action plan to improve the air quality for the period 2013–2020, called Plan Azul+. A WRF mesoscale simulation [11] showed that the Plan Azul+ measurements were effective in the reduction of NO2 levels over urban areas with high traffic influence. However, this simulation showed slight increases in ozone concentration (1–2%) in areas where typically ozone levels were low, and mitigation measures did not cause remarkable reductions in the rest of pollutants selected in the plan. Thus, prior to the establishment of recommendations for policymakers to include albedo enhancement in urban planning, the balance between potential climatic and air quality benefits and disturbances of widespread cooling the urban air must be assessed. Here, we have used a meteorological model (WRF), an emission model (AEMM), and a photochemical model (CMAQ) to assess the impact on meteorology and air quality of widespread urban albedo increase at two feasible levels of implementation: cool roofs (Alb1) and Alb2 (cool roofs + cool pavements). Changes in surface air temperatures and main pollutants are given for two 72-h period representative of summer and winter seasons.
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2. Materials and methods
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Numerical simulations of urban surface modification over Madrid city have been designed to test the impact of two increasing surface albedo scenarios, conducted by coupling WRF/AEMM/CMAQ. Urban layer was simulated by an urban energy model (BEM) coupled with an urban canopy model for simulations [12]. We have considered up to 10 urban categories. Air quality analysis has been focused over the main pollutants of health concern, namely O3, NO2, SO2, CO, PM2.5, and PM10.
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2.1. Study area
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Surface modification was simulated over the urban land cover of Madrid city, which is located in the center of the Iberian Peninsula. Its geographical position and topography determine a temperate continental Mediterranean climate with cold humid winters, with temperatures usually below 0°C, and warm dry summer, with temperatures above 30°C, frequently reaching peak values over 40°C, and high nocturnal temperatures[13, 14].
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2.2. Simulation domains
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In Figure 1 we show nested modeling domains over the city of Madrid. Modeling is built over a mother domain (d01) with 27 km spatial resolution, centered at 40.383° N 3.717°W, and a domain size of 2727 × 2727 km2. This domain is intended to capture synoptic features and general circulation patterns. The first nested domain (d02), with a spatial resolution of 9 km, covers a domain size of 1575 × 1413 km2. The third domain (d03) with 3 km of spatial resolution has a domain size of 660 × 561 km2. The fourth domain covers the province of Madrid and nearest provinces, with an extension of 217 × 199 km2 and grid resolution of 1 km2. The innermost fifth domain encloses Madrid metropolitan area, covering 80.3 × 90.3 km2, and grid resolution 333 m.
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Figure 1.
Up: Modelling domains for simulations: d01, d02, d03, d04 and d05 (left), and d04 and d05 (right). Down: Madrid local municipality (red line) and surrounding metropolitan area [Images generated using Google Earth].
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2.3. Modeling approach
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The air quality modeling system used to evaluate albedo scenarios was composed by a coupled WRF/AEMM/CMAQ model. To configure it, we have followed the guidelines indicated in the Guide on the use of models for the European Air Quality Directive [15]. Emission and photochemical modeling configuration used here have been previously validated elsewhere [11], using a numerical deterministic evaluation during the development of the Plan Azul+, considering the Maximum Relative Directive Error [15] referred in the European Directive EC/2008/50. Meteorological simulations have been performed using the Weather Research and Forecasting-Advanced Research WRF (WRF-ARW) version 3.2 [16], developed by the National Center of Atmospheric Research (NCAR). Urban categories have been adapted from The World Urban Database and Access Portal Tools [17, 18]. URBPARM.TBL was an adapted file for Madrid city according to our knowledge of urban morphology. Meteorology-Chemistry Interface Processor (MCIP) version 4.3 was used to prepare WRF output to the photochemical model. The annual anthropogenic emissions inventory of the Regional Government of Madrid has been used (version 2010). This inventory has a horizontal resolution of 1 × 1 km2 and includes emissions classified by Selected Nomenclature for Air Pollution (SNAP) sectors. We have used an Air Emission Model (AEMM) [11, 19] to adapt emissions to domains d04 and d05, using monthly and weekly profiles from the Unified EMEP model and vertical profiles from [20]. Emissions have been adapted under the requirements of the chemical modules considered in the photochemical model CMAQ. We have considered only anthropogenic emissions to avoid the influence of albedo modifications over the natural emissions, since the parameterizations that define them depend on meteorological conditions. This assumption is valid considering that the urban metropolitan area of Madrid is strongly dominated by anthropogenic local sources, being the natural emissions not very important, and only provide a remarkable contribution in areas far away of the city of Madrid [11]. To simulate the physical and chemical processes into the atmosphere, the US Environmental Protection Agency models-3/CMAQ model has been used [21]. Here, we have used CMAQ v5.0.1, considering CB-5 chemical mechanism and associated EBI solver [22] and AERO5 aerosol module [23]. Initial and boundary conditions for d04 domain are used from inner profiles and for d05 conditions are provided by the results of simulation of d04 domain. Coupled WRF/AEMM/CMAQ has been validated over Madrid city [11]. Another assessment of coupled WRF/CMAQ over Madrid city was reported [24], for an annual period and 1 km resolution, including a comparison of meteorological and air quality observations between WRF bulk urban canopy parameterization (UCP) (used here) and an alternative building energy model (BEP). As temperature predictions were not improved by WRF-BEP and the differences on wind direction and PBL height were not remarkable, we decided to use bulk UCP for computing time savings. Simulations have been executed over a computing cluster owned by Meteosim SL (Spain) and formed by 28 nodes and 308 cores.
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2.4. Simulation results
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Meteorological, emissions, and photochemical simulations have been conducted for two 72 h periods representative of both summer and winter of the year 2008: the period between June 30, 2008 and July 2, 2008 (hereinafter referred to as summer), and the period between January 1, 2008 and January 3, 2008 (hereinafter referred to as winter). The previous 24 h were taken as spin-up time to minimize the effects of initial conditions. A total amount of six simulations have been done for each period and three increasing albedo scenarios, defined from feasible levels of intervention obtained from literature [2, 25] as: (a) default scenario: using default value of albedo for all urban categories; (b) cool roofs scenario (Alb1): increasing from 0.20 to 0.55 the roof surface albedo for all urban categories; (c) cool roofs + pavement scenario (Alb2), with the same roof albedo increase as Alb1 plus an increase in pavement surface albedo from 0.15 to 0.30 for all urban categories. Spatial distributions and changes in pollutants levels at the innermost domain are reported, given as recommended time-weighted exposure parameters [26].
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3. Results and discussion
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3.1. Albedo changes
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Averaged changes in surface albedo at the innermost domain resulting from the modification of roofs and pavements albedo over urban land cover are shown in Figure 2a and b. Maximum albedo change occurred as expected at the most compact area of town center, with +0.2 for both scenarios. No significant difference observed in this peak albedo increase between both intervention levels (data not shown for Alb2), was due to low ratio pavements/roofs at the dense urban structure of the urban category where they occur, tagged as compact mid-rise in the WUDAPT. On the contrary, surface albedo change differences were observed between scenarios at the open mid-rise category (enclosing most of the rest of the urban area inside the M40 highway belt), with +0.06 for Alb1 and +0.1 for Alb2, respectively. These two categories of residential use encompass the major proportion of urban potential intervention areas, along with the southeast belt of industrial-commercial use, where albedo increased +0.14 and +0.18, in Alb1 and Alb2, respectively.
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Figure 2.
Spatial distribution of average albedo (a, b), and midday (12 UTC) temperature differences (°C) between default and both Alb1 (c, d) and Alb2 (e, f) scenarios, and for the winter (a, c, e) and summer periods (b, d, f) at 12 UTC. Black lines limit municipalities, the biggest and innermost boundary is Madrid city (605.77 km²).
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3.2. Temperature changes
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The spatial distribution of temperature changes was dependent on both the distribution and the level of albedo change. In Figure 2c–f, 72-h averaged changes at 12 h UTC are given. City center (compact mid-rise urban category) showed the most intense cooling in all cases, reaching the highest midday cooling intensity in summer of −1.4 and −1.6°C, for Alb1 and Alb2, respectively (Figure 2d and f). Little temperature change was observed in non-urbanized areas with small surface modification. In winter, much lower but significant cooling occurred, with maximum levels of −0.4 and −0.5°C, for Alb1 and Alb2, respectively, at the city center as well (Figure 2c and e). Thus, albedo enhancement was much more efficient in cooling air surface temperatures during summer periods, due to higher solar incidence angle. The spread of cooler air from city center toward the NE was due to predominant SW winds during the summer period, with averaging speed of 9.7 m s−1 (data not shown).
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3.3. Changes in pollutant levels
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After albedo enhancement, changes in pollutants were characterized by a decrease in O3 in both periods, but higher in summer, and an increase in NO2 in both periods. Averaged values for every 72-h period and scenarios are given in Figure 3. Spatial distributions of changes for ozone are given in Figure 4, in both scenarios and at the innermost domain. For the rest of pollutants, Alb1 scenario changes are given in Figures 5 and 6. Slight increases in PMx and in SO2 occurred in winter with negligible changes in summer. Little changes were observed in CO levels.
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Figure 3.
Mean change in pollutants concentration after albedo increase averaged for the winter (a) and the summer period (b).
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Figure 4.
Spatial distribution of changes in O3 maximum 8 h levels between default and Alb1 (a, b) and Alb2 scenarios (c, d) and for winter (a, c) and summer (b, d) (μg m−3).
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Figure 5.
Spatial distribution of changes in NO2 (a, b) and SO2 (c, d) maximum 1 h levels between default and Alb1 scenario for winter (a, c) and summer (b, d) (μg m−3).
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Figure 6.
Spatial distribution of changes in PM2.5 daily value (a, b) and CO 8-h maximum levels (c, d) between default and Alb1 scenarios for winter (a, c) and summer (b, d) scenarios (μg m−3).
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When cool pavements were added to cool roofs (Alb2), differences in distribution of pollutants other than ozone were not remarkable (Alb2 changes in Figure 3). Areas of major changes in pollutants after albedo increase extended through city center and NE rural areas in summer. This NE spread during the summer period was again associated due to dominant SW winds in those days (data not shown). Highest reduction in O3 levels occurred during the summer period (Figure 4b and d), when more intense cooling occurred as well. Eight-hour maximum reductions of around −4 μg m−3 were reached at the city center. These results show that widespread cool roofs deployment over Madrid would benefit ozone levels at the city center, with additional reductions upwind depending on meteorological conditions. If additional cool pavements were implemented (Alb2), ozone reduction would extend further across most of the city, though reductions below the −4 μg m−3 threshold were not observed in this scenario. In winter period both scenarios show scarce benefits for ozone reduction, as expected from limited surface air temperature cooling and lower rates of ozone formation in default scenario (data not shown). Our ranges of O3 reduction are in accordance with similar mesoscale experiments of albedo modification [7, 9] with no local increases detected in our case, as other simulation studies have reported [3]. After albedo modification, NO2 levels increased, mainly at the city center and at Barajas airport in winter (Figure 5a and b) only Alb1 data are shown. Winter reductions were observed at some highly populated areas NW of Madrid city. At both periods, peak increases in 1 h—maximum concentrations reached up to +20 μg m−3. At the city center, summer increases were below winter changes, though peaks of +20 μg m−3 were reached at the pollutants spreading area NW of the city due to wind conditions. However, and contrary to O3 changes, spatially averaged changes in NO2 were very similar at both periods (Figure 5).
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Increases in SO2 occurred in winter at the highly populated municipalities SW of the city and around the airport and NE corridor, with peak 1 h maximum differences of 10 μg m−3 (Figure 5c and d). Decreased levels were observed in some municipalities west of the city. No significant changes occurred for summer in SO2 levels in Madrid city, with slight increases NE of the airport and SE of the municipality. Spatial changes between scenarios were not remarkable for the rest of pollutants (data not shown).
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Slight differences were observed in the distribution of changes between PM2.5 (Figure 6a and b). Increases in PM2.5 were much higher in winter. Peak daily values increased above 2 μg m−3 in both scenarios, located around Barajas airport and south of the city. In summer on the contrary, little changes in PM2.5 were observed for both scenarios, with small increases in the city center below 0.4 μg m−3. For CO, small increases were detected in city center (Figure 6c and d), with maximum +0.1 mg m−3 also around the airport and SW of the city.
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According to our simulations, it was clear that albedo enhancement caused citywide air cooling with associated pollutant changes directly linked to temperature reduction. Our model shows that cool roofs and pavements reduce outdoor temperatures slowing reaction rates of ozone formation [3]. However, observed increases in the levels of other pollutants were caused by depression of PBL height associated with cooler air, limiting pollutant dispersion, and vertical mixing. Spatial distribution matches with cooling and shows peak change levels below 100 m (Figure 7), in areas where pollutants show higher increments. In summer, PBL height can fall to 90 m, but lower emissions and meteorological conditions generated lower increments. O3 summer reductions by slower formation rates must probably be partly offset by PBL fall. In terms of averaged changes from maximum levels at default scenario inside the limits of Madrid city after implementing the highest level of surface modification (Alb2 scenario) were approximately summer reductions in O3 around to −4.4% and winter increments around +16% for NO2, +10% for SO2 and PM2.5, and +5% of CO. If only cool roofs were implemented (Alb1), these maximum thresholds would be the same for all pollutants but with a lower spatial reduction at the urban center for O3 (data not shown)
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Figure 7.
Temperature at 2m (a) and PBL height (b) differences between Alb2 scenario and default scenario for the winter period at 14 UTC.
\n
Thus, our results confirm that citywide cool roofs deployment is a feasible effective measure to reduce summer air temperatures and control the ozone pollution over Madrid metropolitan area. Further benefits can be obtained extending albedo enhancement with cool pavements. In consequence, this surface modification strategy should be considered along with other actions in air quality plans over Madrid. According to numeric simulations of the application of measures proposed in Plan Azul+, carried out with a similar modeling approach [11], 2% O3 increases would be expected over Madrid region and up to +6 μg m−3 (1 h-maximum) at the center of town. For the rest of pollutants, the simulated effect of the Plan predicted reductions in NO2 up to 11 μg m−3 but only slight global reductions below 5% of CO, PM10, PM2.5, and SO2. However, our simulation shows undesired impacts of albedo enhancement that need further research before a real implementation was to be considered, as in winter cool roofs might partly offset the reductions predicted in the plan for pollutants other than ozone. Anyhow, and given the nonlinear dynamics of the atmospheric processes, it would be advisable to make new simulations for longer representative seasonal periods, combining measures of Plan Azul+ with increasing levels of intervention of surface albedo change, to determine the balance between benefits and disadvantages on air quality of a global action plan. A key outcome of our simulation is that the increment in pollutants other than ozone occurs mainly in winter period, where ozone formation rates are low and the concentration of other pollutants is higher. On the contrary, in our summer simulation, albedo caused limited increases in these pollutants, along with a maximized ozone reduction. According to our results, an ideal implementation of cool roofs and/or pavements would be a seasonally changing system of increased reflectance only on warm periods, with little or no albedo change for colder months. Furthermore, such a system would avoid winter penalty due to increased heating demand [27]. A real experience of seasonal surface albedo change is applied over 20,000 reflective greenhouses in Almeria province, 500 km south of Madrid, where whitewash slaked/lime painting is applied over the roofs to limit excess heating inside the greenhouses in summer and is washed out in September to allow enough winter radiation inside them. The implementation of high albedo in the area has caused mean outdoor surface air temperature cooling, locally offsetting the impact of global warming [28, 29]. The levels of albedo enhancement simulated here (round +0.1 at the pixel level) are similar to those implemented on the field over Almeria area, but with more than double intervention surface at Madrid urban area, well above the minimum critical intervention area for efficient cooling at similar comparable latitudes and insolation. As our temperature data show, expected changes in net solar income at the surface should be comparable in both observed and simulated experiences, with differences in air temperature impact due mostly to location and surface canopy parameters of the urban fabric. However, our results are site and time dependent and have been generated from the specific coupled modeling configuration applied over Madrid city, for the periods simulated, and for the emissions inventory used. Further extensive research with optimized mesoscale modeling should also include the impact of albedo enhancement on cloud cover and precipitation pattern, as rain causes wet deposition of pollutants improving air quality. As our results show, depression of PBL height and dynamics of cooler air over the city might cause reduced vertical mixing and affect to the dilution of pollutants [30]. Other undesirable effects on the microclimate of the city and surrounded areas cannot be discarded and should be studied, such as modifications in the wind pattern and the hydrological cycle in the region [31]. Finally, these results do not account for additional benefits such as reduced cooling energy use and associated reductions in emissions from point sources, neither on the potential negative impacts on heating energy use in winter [3].
\n
\n
\n
Acknowledgments
\n
This study has been supported by the Spanish Government, Ministry of Economy and Competitiveness, Grant No. CGL2013-46873-R. The author is grateful to the Environmental Agency of the Regional Government of Madrid for providing emissions inventory.
\n
Conflict of interest
The author declares no competing financial interest.
\n',keywords:"WRF, BEM, CMAQ, urban albedo, air quality, Madrid city, cool roofs",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/64879.pdf",chapterXML:"https://mts.intechopen.com/source/xml/64879.xml",downloadPdfUrl:"/chapter/pdf-download/64879",previewPdfUrl:"/chapter/pdf-preview/64879",totalDownloads:659,totalViews:48,totalCrossrefCites:0,totalDimensionsCites:1,totalAltmetricsMentions:0,introChapter:null,impactScore:0,impactScorePercentile:45,impactScoreQuartile:2,hasAltmetrics:0,dateSubmitted:"March 22nd 2018",dateReviewed:"July 24th 2018",datePrePublished:"December 21st 2018",datePublished:"May 2nd 2019",dateFinished:"December 21st 2018",readingETA:"0",abstract:"Meteorological and photochemical impacts of increasing urban albedo or reflectance over Madrid city have been simulated using a mesoscale climatic model (WRF) coupled to an air quality modeling system (AEMM/CMAQ). We have evaluated the influence over the concentration of the main pollutants of two different interventions with increasing levels of albedo enhancement over all urban categories: a low albedo or cool roofs scenario (Alb1), where only roof albedo was modified (+0.35), and a high albedo scenario (Alb2), increasing both roof albedo (+0.35) and pavement albedo (+0.15). Simulations were run for two periods of 72 h, representative of summer and winter conditions. In both scenarios, surface air temperatures were cooled, with averaged midday reductions at the urban area of −0.2 (−0.5)°C for winter (summer) for Alb1 and −0.3 (−0.7)°C for winter (summer) for Alb2. Peak summer midday cooling at city center was −1.4°C and −1.6 ºC for Alb1 and Alb2, respectively. Pollutant concentrations were modified, with reductions in O3 levels, higher in summer, and increases in NO2 levels, bigger in winter period. Slight increases were also observed in winter for SO2 and particulate matter (PM2.5 and PM10) in both scenarios.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/64879",risUrl:"/chapter/ris/64879",book:{id:"7517",slug:"understanding-of-atmospheric-systems-with-efficient-numerical-methods-for-observation-and-prediction"},signatures:"Pablo Campra",authors:[{id:"51429",title:"Dr.",name:"Pablo",middleName:null,surname:"Campra",fullName:"Pablo Campra",slug:"pablo-campra",email:"pcampra@ual.es",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",institution:null}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Materials and methods",level:"1"},{id:"sec_2_2",title:"2.1. Study area",level:"2"},{id:"sec_3_2",title:"2.2. Simulation domains",level:"2"},{id:"sec_4_2",title:"2.3. Modeling approach",level:"2"},{id:"sec_5_2",title:"2.4. Simulation results",level:"2"},{id:"sec_7",title:"3. Results and discussion",level:"1"},{id:"sec_7_2",title:"3.1. Albedo changes",level:"2"},{id:"sec_8_2",title:"3.2. Temperature changes",level:"2"},{id:"sec_9_2",title:"3.3. Changes in pollutant levels",level:"2"},{id:"sec_11",title:"Acknowledgments",level:"1"},{id:"sec_14",title:"Conflict of interest",level:"1"}],chapterReferences:[{id:"B1",body:'Betts RA. Biogeophysical impacts of land use on present-day climate: Near-surface temperature change and radiative forcing. Atmospheric Science Letters. 2001;2:39-51\n'},{id:"B2",body:'Akbari H, Menon S, Rosenfeld A. Global cooling: Increasing world-wide urban albedos to offset CO2. Climatic Change. 2009;94(4):275\n'},{id:"B3",body:'Akbari H, Pomerantz M, Taha H. Cool surfaces and shade trees to reduce energy use and improve air quality in urban areas. Solar Energy. 2001;70:295-310\n'},{id:"B4",body:'Stathopoulou E, Mihalakakou G, Santamouris M, Bagiorgas HS. 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World Health Organization Regional Publications; 2000. European Series No. 91\n'},{id:"B27",body:'Akbari H, Konopacki S. Calculating energy-saving potentials of heat-island reduction strategies. Energy Policy. 2005;33:721-756\n'},{id:"B28",body:'Campra P, Garcia M, Canton Y, Palacios-Orueta A. Surface temperature cooling trends and negative radiative forcing due to land use change toward greenhouse farming in Southeastern Spain. Journal of Geophysical Research. 2008;113:D18109\n'},{id:"B29",body:'Campra P, Millstein D. Mesoscale climatic simulation of surface air temperature cooling by highly reflective greenhouses in SE Spain. Environmental Science and Technology. 2013;47(21):12284-12290. DOI: 10.1021/es402093q\n'},{id:"B30",body:'Sailor DJ. Simulated urban climate response to modifications in surface albedo and vegetative cover. Journal of Applied Meteorology. 1995;34:1694-1704\n'},{id:"B31",body:'Georgescu M, Mahalov A, Moustaoui M. Seasonal hydroclimatic impacts of Sun Corridor expansion. Environmental Research Letters. 2012;7:034026/1-034026/9\n'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Pablo Campra",address:"pcampra@ual.es",affiliation:'
High School of Engineering, University of Almeria, Almeria, Spain
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1. Introduction
In patients with non-valvular atrial fibrillation (NVAF), oral anticoagulation (OAC) is part of mainstream therapy to prevent ischemic stroke [1], and the left atrial appendage (LAA) remains a focus of thrombus formation [2]. However, there are several situations that oral anticoagulation may be unsuitable, due to any individual history of major bleeding, personal risks of bleeding (e.g., fall risk in elderly or cerebral anomalies), noncompliant patients to OAC, or patients with high-risk occupation. Left atrial appendage occlusion (LAAO) has emerged as an alternative management to prevent stroke in NVAF patients who are not eligible for continuous OAC [3].
2. Left atrial appendage anatomy
The embryonic origin of LAA is different to atria. It is originated from the embryonic remnant of left atrium (LA) during first trimester, with a multilobed structure positioned anteriorly in the atrioventricular sulcus close to the left circumflex artery, the left phrenic nerve, and the left pulmonary veins [4]. The appendage contains numerous trabeculae, with a complex and highly variable anatomy. The LAA typically consists of three major components:
Ostium or “os,” which defines its junction with body of the LA;
Lobar region, which is known to be the most variable anatomically. The difference of lobar region of LAA as seen by computed tomography angiography (CTA) is categorized into: (1) chicken wing; (2) cactus; (3) windsocks; and (4) cauliflower. It has been shown that the difference in the LAA morphology was independently associated with thromboembolic events [5, 6]. The first type of chicken-wing LAA can be a challenge for device implantation; [7] however, it has been associated with a lower stroke risk compared with the other three main morphologies described [8]. Multiple lobes with LAA greater than 40 mm will limit the use of certain devices. Deployment of LAAO device will be difficult for LAA with multiple lobes with branching close to ostium.
“Neck” is a narrow junction between the ostium, lobar region, and the landing zone for LAAO device. The size of the neck determines the applicability to use of certain occlude devices. The Watchman requires an equivalent implant depth and the device diameter. The Amplatzer device requires 10 mm space for deployment from the ostium [7].
3. Rationale for LAAO
Thromboembolic events in AF are correlated to loss of atrial contraction, stasis of blood flow, and thrombus formation, particularly in the LAA. The LAA is notoriously labeled as “human most lethal attachment,” as it has been demonstrated that thrombus in the LAA is the primary source for thromboemboli [2]. A review of studies in patients with nonrheumatic heart disease demonstrated that 90% of LA thrombi examined by transesophageal echocardiography (TEE), cardiac surgery, or autopsy, were located in the LAA [9]. Another study also showed that LA thrombus was evident in 15% of patients without OAC after 48 hours of AF, in which almost all thrombi were found in LAA. The LAA is particularly prone to thrombus formation in AF due to its inherent anatomy with extensive trabeculations, increased blood stasis and hypercoagulability, and endothelial damage [10].
The role of the LAA as a source for thromboemboli in AF patients provides the rationale for ligation, amputation, or occlusion of the LAA structure, especially if patients are indicated for stroke prevention strategy; on the other hand, they are either contraindicated or noncompliant to long-term OAC. In addition, some LAAO techniques may have an additional role in sinus rhythm maintenance through non-pulmonary vein triggers elimination, atrial mass decrease, and atrial electrical remodeling reversion [11, 12].
4. Techniques for LAAO
Currently, there are two major different strategies in LAA exclusion from systemic circulation:
4.1 Surgical approach
The first reported resection of LAA in a human was by John Madden in 1949 [13]. In his report, he performed surgical excision of LAA structure during open heart surgery specifically aimed for stroke prevention in AF patients. This approach was not routinely done after this report was published. Nevertheless, LAA surgical closure is now class IIa indication in the 2020 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for management of patients with valvular heart disease undergoing heart surgery [14] and has currently become widely performed. Similarly, in patients with AF undergoing cardiac surgery, surgical LAA closure is also a class IIb indication based on 2019 ACC/AHA/Heart Rhythm Society (HRS) guidelines [15].
The method of LAA exclusion is usually dictated by the concomitant cardiosurgical procedure.
4.2 Percutaneous LAAO device
To date, several LAAO devices have been approved to be used worldwide (Figure 1).
Figure 1.
LAAO devices (modified from [10, 16, 17, 18]).
4.2.1 Endocardial system
the Watchman (Boston Scientific, Natick, MA)
This device has been approved by the Federal Drug Administration (FDA) in the year of 2015 as an alternative to warfarin OAC based upon data from the PREVAIL and PROTECT-AF trials. The device system comprises of a 14 Fr (outer diameter), frame with fixation barbs, and fabric cover [16].
the Amplatzer Cardiac Plug/ACP (St. Jude Medical, St. Paul, MN)
The Amulet is a second-generation self-expanded LAAO. The device system includes 14.4–16.5 Fr delivery sheath, lobe and stabilization hook, and fixed-size cover disk [16].
LAmbreTM LAA Closure System (Lifetech Scientific Corporation)
LAmbre occluder is a Conformité Européenne (CE) recognized LAA closure device. It is a self-expanded device consisting of a 10.4–12.3 Fr sheath (delivery system), hook-embedded umbrella, and size adaptive cover [19]. In 2020, LAmbreTM LAA Closure System has obtained the approval by FDA for the commencement of an investigator-initiated clinical trial in the United States.
4.2.2 Epicardial system
the LARIAT suture delivery system (SentreHeart, Redwood City, CA)
The LARIAT device is a percutaneous epicardial ligation of the LAA. The device comprises of a snare with a pre-tied suture for LAA ligation, a 15-mm compliant occlusion balloon catheter, magnet-tipped guidewires, and a 12-F suture delivery device.
5. Indications and current recommendation
Indication for LAAO occlusion procedure is similar to standard indication of OAC in patients with AF. The need of OAC is justified by stroke risk factors that are summarized in the clinical risk-factor-based on established CHA2DS2-VASc score [Congestive heart failure, Hypertension, Age, Diabetes mellitus, Stroke, Vascular disease, and Sex category (female)]. However, when initiation of OAC strategy, individual potential risk of bleeding also needs to be assessed (Table 1).
There are few absolute contraindications that potentially prevent some patients to have OAC as stroke prevention therapies. These include active major bleeding with unidentified and untreated source, comorbidities [e.g., severe anemia (Hb<80 g/L) or thrombocytopenia (<50 platelets/microliter)], or a high-risk bleeding episode such as intracranial hemorrhage. In such cases, non-drug options such as LAAO should be considered. Based on current existing guidelines, the recommendations of LAAO as stroke prevention option are:
5.1 Percutaneous approaches
Currently available recommendation for percutaneous LAAO is described in Table 2.
Non-modifiable
Potentially modifiable
Modifiable
Biomarkers
Age > 65 years
Previous major bleeding
Severe renal impairment (on dialysis or renal transplant)
Severe hepatic dysfunction (cirrhosis)
Malignancy
Genetic factors (e.g. CYP 2C9 polymorphisms)
Previous stroke, small-vessel disease, etc.
Diabetes mellitus
Cognitive impairment/dementia
Extreme frailty ± excessive risk of falls
Anemia
Reduced platelet count or function
Renal impairment with CrCl <60 mL/min
VKA management strategy
Hypertension/elevated SBP
Concomitant antiplatelet/NSAID
Excessive alcohol intake
Non-adherence to OAC
Hazardous hobbies/occupations
Bridging therapy with heparin
INR control (target 2.0–3.0), target TTR >70%c
Appropriate choice of OAC and
correct dosing
GDF-15
Cystatin C/CKD-EPI
cTnT-hs
von Willebrand factor
other coagulation markers
Table 1.
Risk factors for bleeding with OAC and antiplatelet therapy (ESC guidelines 2020) [1].
Surgical occlusion of the LAA may be considered in patients with AF undergoing cardiac surgery, as a component of an overall heart team approach to the management of AF
For patients with AF or atrial flutter who are undergoing valve surgery, LA appendage ligation/excision is reasonable to reduce the risk of thromboembolic events In patients undergoing LA surgical ablation of atrial arrhythmias and/or LA appendage ligation/excision, anticoagulation therapy is reasonable for at least 3 months after the procedure
For patients without atrial arrhythmias who are undergoing valvular surgery, LA appendage occlusion/exclusion/amputation is potentially harmful
Table 4.
Current recommendation for surgical LAAO.
ACC = American College of Cardiology; AF = atrial fibrillation; AHA = American Heart association; ESC = European Society of Cardiology; HRS = Heart Rhythm Society; LA = Left atrium; LAA = Left atrial appendage; NR = Non-randomized; NVAF = Non-valvular atrial fibrillation; VAF = Valvular atrial fibrillation.
6. Post-procedural management and complications of percutaneous LAAO
6.1 Acute procedural-related complications
Access-related complications
The most common complication for percutaneous LAA closure is the risk of having vascular complications, including bleeding or hematoma in the groin, arteriovenous fistula, pseudoaneurysm, or retroperitoneal bleed. Some of these complications may require further intervention or blood transfusion. These risks are slightly higher than other interventional procedure, especially due to large delivery sheath used, and the procedure is commonly performed under oral anticoagulation [21]. Furthermore, frailty or tortuosity in the vascular anatomy is also very common in elderly patients [22].
Transeptal access-related complications
There are few complications that can be related to transeptal access. Large delivery sheath for this procedure increases the risk of air embolism and subsequently increases the risk of stroke or myocardial infarction. In addition, transeptal puncture is also correlated with increased risk of pericardial effusion or tamponade that may require pericardiocentesis, with incidence of 1.39% [22, 23]. The risk of incidental aortic puncture from transeptal was also reported, which was closed by percutaneous approach with Amplatzer Septal Occluder [24].
Device embolization
Due to anatomical variability of LAA, the risk of embolization of LAAO is higher. The incidence of LAA device embolization ranges between 0% and 2%. Recent reports suggest that The Amplatzer family of devices carries a higher risk of embolization as compared with the Watchman device, with incidence of 0.78% (3,585 patients) vs. 0.26% (7,236 patients)]; p < 0.001) [25]. Device embolization can be located either in the LA, left ventricle (LV), or aorta (Ao). Although the majority cases can be managed in semi-elective manner, some can be life-threatening and need emergency procedure. Limited data of secondary adverse events related to LAA device embolization such as mitral or aortic valve damage, LV outflow tract obstruction, cardiogenic shock, or death have been described [26]. Percutaneous retrieval is preferable as compared with surgical approach. Identification of the location of the embolized device is crucial to determine the retrieval strategy. Successful retrieval using percutaneous snare has been reported [27]. However, several complications such as iatrogenic aortic rupture requiring endovascular repair may occur [28].
Other complication
Complications related to traumatic damage to surrounding structures (i.e., the circumflex coronary artery, pulmonary arteries, or pulmonary veins) have been previously described [29]. The NCDR registry showed that major complications, including in-hospital adverse events (2.16%), major bleeding (1.25%), were quite prevalent, whereas stroke (0.17%) and death (0.19%) were rare [23].
6.2 Long-term issues related to percutaneous LAAO
Iatrogenic atrial septal defects
Following transseptal LA access, iatrogenic atrial septal defects can be notable from either transthoracic or transesophageal echocardiogram. This complication can either disappear within 6 months after the procedure or persist in a small proportion of patients. Nevertheless, no hemodynamic consequences have been reported from this [30].
Peri-device leakage
The target of LAAO procedure is to get a complete closure of the LAA in order to lower the risk of thromboembolism in AF patients. In the early experience of LAAO, peri-device leakage was quite prevalent. The PROTECT-AF study showed that approximately 32% of patients still have residual leak at 1 year after procedure. However, this did not seem to increase the risk of thromboembolism [31]. Furthermore, the incidence of this outcome has markedly reduced in the more recent registries, which ranging from 0.2 to1% [23, 32].
Device-related thrombosis (DRT)
The main reasons of DRT remain unknown. It is postulated that the incidence of DRT is combination of either procedural factors (i.e., technique of implant or type of devices used), patient factors (i.e. patient frailty, LV dysfunction, or AF duration), or post-implant management factors (i.e., duration and type of antithrombotic therapies used) [33]. Few large studies of DRT for Watchman device such as the PROTECT AF, PREVAIL trials, CAP, and CAP2 evaluated procedural outcomes with TOE at 45 days and 12 months and at 6 months in the RCTs. Over 4 years of mean follow-up, it was demonstrated that the rate of DRT was 3.74%. The main characteristics of patients with DRT observed in this study are higher CHA2DS2VASc scores, permanent AF, and larger LAAs. The presence of DRT was also shown to be associated with a 3.55-fold increase rate of thromboembolic events [34].
7. Current evidence of short- and long-term outcomes after LAAO
The difficulties in managing patients with AF and high bleeding risk pursued a new approach of stroke prevention in AF patients. The first randomized study of LAAC with Watchman device, PROTECT AF [21], which was published in 2009, showed non-inferiority results as compared with standard warfarin therapy. This study randomized AF patients with a CHADS2 score ≥ 1, to either Watchman implantation or OAC with warfarin. At 1.5 years of follow-up, it is shown that LAAC was equivalent for stroke prevention or all-cause mortality. The efficacy of LAA occlusion was also demonstrated in a longer-term follow-up of PROTECT AF trial. At a mean follow-up of 2.3 years, the primary efficacy endpoint is shown to be non-inferior for device [35].
Similar results were shown by the second randomized trial, PREVAIL (Evaluation of the WATCHMAN LAA Closure Device in Patients With Atrial Fibrillation Versus Long-Term Warfarin Therapy) [36]. The PREVAIL trial has given additional information to PROTECT AF trial by a Bayesian non-inferiority design approach. The study showed that LAAO with the Watchman device was not non-inferior to warfarin for the primary efficacy composite endpoint, including all-cause stroke, cardiovascular or unexplained death, and serious events (SE). In addition, LAAO was non-inferior to warfarin for the occurrence of late ischemic events after the first 7 days following randomization. Furthermore, the safety endpoint and successful rate of LAAO are high, even in the center with high numbers of limited experience operators of LAAO implantation within a higher-risk patient population.
In a long-term 5-year outcomes report from the PREVAIL trial and PROTECT AF trial [37], it was demonstrated that LAAC with the Watchman device provides a similar degree of stroke prevention in non-valvular AF patients to OAC with warfarin. Furthermore, with its ability to minimize major bleeding, particularly hemorrhagic stroke. LAAC results in less death than Warfarin [37].
The more recent randomized prospective, multicenter, randomized noninferiority study, PRAGUE-17, compared two treatment strategies in moderate to high-risk AF patients (i.e., patients with history of significant bleeding or history of cardiovascular event(s) or a with CHA2DS2VASc ≥3 and HAS-BLED score ≥ 2) [38]. This study randomized 402 patients with AF into percutaneous LAAC versus NOAC. After median follow-up of 3.5 year, LAAC was shown to be non-inferior to DOACs for the primary endpoint and the components of the composite endpoint, such as cardiovascular death, all-stroke/transient ischemic attack, clinically relevant bleeding, and for nonprocedural clinically relevant bleeding [39].
8. Conclusion
LAA is an important anatomic area that is involved in thrombus formation in the left atrium, which is also a determinant in the risk of thromboembolic events in patients with AF. LAAO procedure provides an important alternative to pharmacological strategy in AF patients, especially for patients with stroke prevention indication and contraindicated or noncompliant to oral anticoagulation. It is evident that LAAO is safe and effective with high implant success rate and improving complication rate. Long-term data regarding in the stroke outcomes as compared with standard strategy are necessary.
\n',keywords:"atrial fibrillation, left atrial appendage closure, left atrial appendage device, ischemic stroke, oral anticoagulation",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/82910.pdf",chapterXML:"https://mts.intechopen.com/source/xml/82910.xml",downloadPdfUrl:"/chapter/pdf-download/82910",previewPdfUrl:"/chapter/pdf-preview/82910",totalDownloads:4,totalViews:0,totalCrossrefCites:0,dateSubmitted:"May 20th 2022",dateReviewed:"June 8th 2022",datePrePublished:"August 9th 2022",datePublished:null,dateFinished:"August 2nd 2022",readingETA:"0",abstract:"Patients with non-valvular atrial fibrillation (NVAF) are at an increased risk of ischemic stroke due to the risks of thrombus formation. The left atrial appendage (LAA) is shown to be “the culprit” of thromboembolic events in NVAF and is currently a therapeutic target to prevent stroke. The absolute benefit of oral anticoagulation in the management of NVAF to improve cardiovascular outcomes has been well established. However, some patients are not good long-term candidates for oral anticoagulation for many reasons, including risks of bleeding, noncompliant to oral anticoagulation (OAC). Left atrial appendage occlusion (LAAO) provides an attractive alternative to reduce the risk of stroke for those who are contraindicated to OAC therapy.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/82910",risUrl:"/chapter/ris/82910",signatures:"Dian Andina Munawar, Anggia Chairuddin Lubis and Muhammad Munawar",book:{id:"11655",type:"book",title:"Atrial Fibrillation - Diagnosis and Management in the 21st Century",subtitle:null,fullTitle:"Atrial Fibrillation - Diagnosis and Management in the 21st Century",slug:null,publishedDate:null,bookSignature:"Prof. Ozgur Karcioglu and Associate Prof. Funda Karbek Akarca",coverURL:"https://cdn.intechopen.com/books/images_new/11655.jpg",licenceType:"CC BY 3.0",editedByType:null,isbn:"978-1-80356-123-3",printIsbn:"978-1-80356-122-6",pdfIsbn:"978-1-80356-124-0",isAvailableForWebshopOrdering:!0,editors:[{id:"221195",title:"Prof.",name:"Ozgur",middleName:null,surname:"Karcioglu",slug:"ozgur-karcioglu",fullName:"Ozgur Karcioglu"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:null,sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Left atrial appendage anatomy",level:"1"},{id:"sec_3",title:"3. Rationale for LAAO",level:"1"},{id:"sec_4",title:"4. Techniques for LAAO",level:"1"},{id:"sec_4_2",title:"4.1 Surgical approach",level:"2"},{id:"sec_5_2",title:"4.2 Percutaneous LAAO device",level:"2"},{id:"sec_5_3",title:"4.2.1 Endocardial system",level:"3"},{id:"sec_6_3",title:"4.2.2 Epicardial system",level:"3"},{id:"sec_9",title:"5. Indications and current recommendation",level:"1"},{id:"sec_9_2",title:"5.1 Percutaneous approaches",level:"2"},{id:"sec_10_2",title:"5.2 Surgical approaches",level:"2"},{id:"sec_12",title:"6. Post-procedural management and complications of percutaneous LAAO",level:"1"},{id:"sec_12_2",title:"6.1 Acute procedural-related complications",level:"2"},{id:"sec_13_2",title:"6.2 Long-term issues related to percutaneous LAAO",level:"2"},{id:"sec_15",title:"7. Current evidence of short- and long-term outcomes after LAAO",level:"1"},{id:"sec_16",title:"8. Conclusion",level:"1"}],chapterReferences:[{id:"B1",body:'Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, et al. ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. European Heart Journal. 2020;42(5):373-498. DOI: 10.1093/eurheartj/ehaa612'},{id:"B2",body:'Johnson WD, Ganjoo AK, Stone CD, Srivyas RC, Howard M. The left atrial appendage: Our most lethal human attachment! Surgical implications. European Journal of Cardiothoracic Surgery. 2000;17(6):718-722. 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Circulation of Cardiovascular Intervention. 2017 Nov;10(11):e005359.'},{id:"B26",body:'Jazayeri MA, Vuddanda V, Turagam MK, et al. Safety profiles of percutaneous left atrial appendage closure devices: An analysis of the Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database from 2009 to 2016. Journal of Cardiovascular Electrophysiology. 2018;29(1):5-13. DOI: 10.1111/jce.13362'},{id:"B27",body:'Lubis AC, Iqbal M, Munawar DA, Hartono B, Munawar M. A simple percutaneous retrieval technique for an embolized watchman left atrial appendage closure device in the thoracic aorta using a homemade snare. International Heart Journal. 2021;62(5):1153-1155'},{id:"B28",body:'Mastrangelo A, Galli S, Montorsi P, Bartorelli AL. Aortic rupture and hemorrhagic shock after percutaneous retrieval of an embolized left atrial appendage occluder. JACC Case Reports. 2022;4(8):486-490. DOI: 10.1016/j.jaccas.2022.03.004'},{id:"B29",body:'Sepahpour A, Ng MK, Storey P, McGuire MA. Death from pulmonary artery erosion complicating implantation of percutaneous left atrial appendage occlusion device. Heart Rhythm. 2013;10(12):1810-1811. DOI: 10.1016/j.hrthm.2013.07.046'},{id:"B30",body:'Onalan O, Crystal E. Left atrial appendage exclusion for stroke prevention in patients with nonrheumatic atrial fibrillation. Stroke. 2007;38(2 Suppl):624-630. DOI: 10.1161/01.Str.0000250166.06949.95'},{id:"B31",body:'Viles-Gonzalez JF, Kar S, Douglas P, et al. The clinical impact of incomplete left atrial appendage closure with the Watchman Device in patients with atrial fibrillation: A PROTECT AF (Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation) substudy. Journal of American College of Cardiology. 2012;59(10):923-929. DOI: 10.1016/j.jacc.2011.11.028'},{id:"B32",body:'Boersma LV, Ince H, Kische S, et al. Evaluating Real-World Clinical Outcomes in Atrial Fibrillation Patients Receiving the WATCHMAN Left Atrial Appendage Closure Technology: Final 2-Year Outcome Data of the EWOLUTION Trial Focusing on History of Stroke and Hemorrhage. Circulation. Arrhythmia and Electrophysiology. 2019;12(4):e006841. DOI: 10.1161/circep.118.006841'},{id:"B33",body:'Alfadhel M, Nestelberger T, Samuel R, McAlister C, Saw J. Left atrial appendage closure – Current status and future directions. Progress in Cardiovascular Diseases. 2021;69:101-109. DOI: 10.1016/j.pcad.2021.11.013'},{id:"B34",body:'Dukkipati SR, Kar S, Holmes DR, et al. Device-related thrombus after left atrial appendage closure: Incidence, predictors, and outcomes. Circulation. 2018;138(9):874-885. DOI: 10.1161/CIRCULATIONAHA.118.035090'},{id:"B35",body:'Reddy VY, Doshi SK, Sievert H, et al. Percutaneous left atrial appendage closure for stroke prophylaxis in patients with atrial fibrillation: 2.3-Year Follow-up of the PROTECT AF (Watchman Left Atrial Appendage System for Embolic Protection in Patients with Atrial Fibrillation) Trial. Circulation. 2013;127(6):720-729'},{id:"B36",body:'Holmes DR Jr, Kar S, Price MJ, et al. Prospective randomized evaluation of the Watchman Left Atrial Appendage Closure device in patients with atrial fibrillation versus long-term warfarin therapy: The PREVAIL trial. Journal of American Colege of Cardiology. 2014;64(1):1-12. DOI: 10.1016/j.jacc.2014.04.029'},{id:"B37",body:'Reddy VY, Doshi SK, Kar S, et al. 5-year outcomes after left atrial appendage closure: From the PREVAIL and PROTECT AF Trials. Journal of American Colege of Cardiology. 2017;70(24):2964-2975'},{id:"B38",body:'Osmancik P, Tousek P, Herman D, et al. Interventional left atrial appendage closure vs novel anticoagulation agents in patients with atrial fibrillation indicated for long-term anticoagulation (PRAGUE-17 study). American Heart Journal. 2017;183:108-114. DOI: 10.1016/j.ahj.2016.10.003'},{id:"B39",body:'Osmancik P, Herman D, Neuzil P, et al. 4-year outcomes after left atrial appendage closure versus Nonwarfarin oral anticoagulation for atrial fibrillation. Journal of American Colege of Cardiology. 2022;79(1):1-14. DOI: 10.1016/j.jacc.2021.10.023'}],footnotes:[],contributors:[{corresp:null,contributorFullName:"Dian Andina Munawar",address:null,affiliation:'
Faculty of Medicine, Department of Cardiology and Vascular Medicine, Universitas Indonesia, Indonesia
Faculty of Medicine, Department of Cardiology and Vascular Medicine, Universitas Indonesia, Indonesia
Binawaluya Cardiac Centre, Indonesia
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All of our IntechOpen sponsors are in good company! The research in past IntechOpen books and chapters have been funded by:
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Singh",profilePictureURL:"https://mts.intechopen.com/storage/users/329385/images/system/329385.png",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",institutionURL:null,country:{name:"India"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null},{type:"book",id:"8018",title:"Extracellular Matrix",subtitle:"Developments and Therapeutics",coverURL:"https://cdn.intechopen.com/books/images_new/8018.jpg",slug:"extracellular-matrix-developments-and-therapeutics",publishedDate:"October 27th 2021",editedByType:"Edited by",bookSignature:"Rama Sashank Madhurapantula, Joseph Orgel P.R.O. and Zvi Loewy",hash:"c85e82851e80b40282ff9be99ddf2046",volumeInSeries:23,fullTitle:"Extracellular Matrix - Developments and Therapeutics",editors:[{id:"212416",title:"Dr.",name:"Rama Sashank",middleName:null,surname:"Madhurapantula",slug:"rama-sashank-madhurapantula",fullName:"Rama Sashank Madhurapantula",profilePictureURL:"https://mts.intechopen.com/storage/users/212416/images/system/212416.jpg",institutionString:"Illinois Institute of Technology",institution:{name:"Illinois Institute of Technology",institutionURL:null,country:{name:"United States of America"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null}]},subseriesFiltersForPublishedBooks:[{group:"subseries",caption:"Proteomics",value:18,count:4},{group:"subseries",caption:"Metabolism",value:17,count:6},{group:"subseries",caption:"Cell and Molecular Biology",value:14,count:9},{group:"subseries",caption:"Chemical Biology",value:15,count:14}],publicationYearFilters:[{group:"publicationYear",caption:"2022",value:2022,count:9},{group:"publicationYear",caption:"2021",value:2021,count:7},{group:"publicationYear",caption:"2020",value:2020,count:12},{group:"publicationYear",caption:"2019",value:2019,count:3},{group:"publicationYear",caption:"2018",value:2018,count:2}],authors:{paginationCount:148,paginationItems:[{id:"165328",title:"Dr.",name:"Vahid",middleName:null,surname:"Asadpour",slug:"vahid-asadpour",fullName:"Vahid Asadpour",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/165328/images/system/165328.jpg",biography:"Vahid Asadpour, MS, Ph.D., is currently with the Department of Research and Evaluation, Kaiser Permanente Southern California. He has both an MS and Ph.D. in Biomedical Engineering. He was previously a research scientist at the University of California Los Angeles (UCLA) and visiting professor and researcher at the University of North Dakota. He is currently working in artificial intelligence and its applications in medical signal processing. In addition, he is using digital signal processing in medical imaging and speech processing. Dr. Asadpour has developed brain-computer interfacing algorithms and has published books, book chapters, and several journal and conference papers in this field and other areas of intelligent signal processing. He has also designed medical devices, including a laser Doppler monitoring system.",institutionString:"Kaiser Permanente Southern California",institution:null},{id:"169608",title:"Prof.",name:"Marian",middleName:null,surname:"Găiceanu",slug:"marian-gaiceanu",fullName:"Marian Găiceanu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/169608/images/system/169608.png",biography:"Prof. Dr. Marian Gaiceanu graduated from the Naval and Electrical Engineering Faculty, Dunarea de Jos University of Galati, Romania, in 1997. He received a Ph.D. (Magna Cum Laude) in Electrical Engineering in 2002. Since 2017, Dr. Gaiceanu has been a Ph.D. supervisor for students in Electrical Engineering. He has been employed at Dunarea de Jos University of Galati since 1996, where he is currently a professor. Dr. Gaiceanu is a member of the National Council for Attesting Titles, Diplomas and Certificates, an expert of the Executive Agency for Higher Education, Research Funding, and a member of the Senate of the Dunarea de Jos University of Galati. He has been the head of the Integrated Energy Conversion Systems and Advanced Control of Complex Processes Research Center, Romania, since 2016. He has conducted several projects in power converter systems for electrical drives, power quality, PEM and SOFC fuel cell power converters for utilities, electric vehicles, and marine applications with the Department of Regulation and Control, SIEI S.pA. (2002–2004) and the Polytechnic University of Turin, Italy (2002–2004, 2006–2007). He is a member of the Institute of Electrical and Electronics Engineers (IEEE) and cofounder-member of the IEEE Power Electronics Romanian Chapter. He is a guest editor at Energies and an academic book editor for IntechOpen. He is also a member of the editorial boards of the Journal of Electrical Engineering, Electronics, Control and Computer Science and Sustainability. Dr. Gaiceanu has been General Chairman of the IEEE International Symposium on Electrical and Electronics Engineering in the last six editions.",institutionString:'"Dunarea de Jos" University of Galati',institution:{name:'"Dunarea de Jos" University of Galati',country:{name:"Romania"}}},{id:"4519",title:"Prof.",name:"Jaydip",middleName:null,surname:"Sen",slug:"jaydip-sen",fullName:"Jaydip Sen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/4519/images/system/4519.jpeg",biography:"Jaydip Sen is associated with Praxis Business School, Kolkata, India, as a professor in the Department of Data Science. His research areas include security and privacy issues in computing and communication, intrusion detection systems, machine learning, deep learning, and artificial intelligence in the financial domain. He has more than 200 publications in reputed international journals, refereed conference proceedings, and 20 book chapters in books published by internationally renowned publishing houses, such as Springer, CRC press, IGI Global, etc. Currently, he is serving on the editorial board of the prestigious journal Frontiers in Communications and Networks and in the technical program committees of a number of high-ranked international conferences organized by the IEEE, USA, and the ACM, USA. He has been listed among the top 2% of scientists in the world for the last three consecutive years, 2019 to 2021 as per studies conducted by the Stanford University, USA.",institutionString:"Praxis Business School",institution:null},{id:"320071",title:"Dr.",name:"Sidra",middleName:null,surname:"Mehtab",slug:"sidra-mehtab",fullName:"Sidra Mehtab",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00002v6KHoQAM/Profile_Picture_1584512086360",biography:"Sidra Mehtab has completed her BS with honors in Physics from Calcutta University, India in 2018. She has done MS in Data Science and Analytics from Maulana Abul Kalam Azad University of Technology (MAKAUT), Kolkata, India in 2020. Her research areas include Econometrics, Time Series Analysis, Machine Learning, Deep Learning, Artificial Intelligence, and Computer and Network Security with a particular focus on Cyber Security Analytics. Ms. Mehtab has published seven papers in international conferences and one of her papers has been accepted for publication in a reputable international journal. She has won the best paper awards in two prestigious international conferences – BAICONF 2019, and ICADCML 2021, organized in the Indian Institute of Management, Bangalore, India in December 2019, and SOA University, Bhubaneswar, India in January 2021. Besides, Ms. Mehtab has also published two book chapters in two books. Seven of her book chapters will be published in a volume shortly in 2021 by Cambridge Scholars’ Press, UK. Currently, she is working as the joint editor of two edited volumes on Time Series Analysis and Forecasting to be published in the first half of 2021 by an international house. Currently, she is working as a Data Scientist with an MNC in Delhi, India.",institutionString:"NSHM College of Management and Technology",institution:{name:"Association for Computing Machinery",country:{name:"United States of America"}}},{id:"226240",title:"Dr.",name:"Andri Irfan",middleName:null,surname:"Rifai",slug:"andri-irfan-rifai",fullName:"Andri Irfan Rifai",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226240/images/7412_n.jpg",biography:"Andri IRFAN is a Senior Lecturer of Civil Engineering and Planning. He completed the PhD at the Universitas Indonesia & Universidade do Minho with Sandwich Program Scholarship from the Directorate General of Higher Education and LPDP scholarship. He has been teaching for more than 19 years and much active to applied his knowledge in the project construction in Indonesia. His research interest ranges from pavement management system to advanced data mining techniques for transportation engineering. He has published more than 50 papers in journals and 2 books.",institutionString:null,institution:{name:"Universitas Internasional Batam",country:{name:"Indonesia"}}},{id:"314576",title:"Dr.",name:"Ibai",middleName:null,surname:"Laña",slug:"ibai-lana",fullName:"Ibai Laña",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314576/images/system/314576.jpg",biography:"Dr. Ibai Laña works at TECNALIA as a data analyst. He received his Ph.D. in Artificial Intelligence from the University of the Basque Country (UPV/EHU), Spain, in 2018. He is currently a senior researcher at TECNALIA. His research interests fall within the intersection of intelligent transportation systems, machine learning, traffic data analysis, and data science. He has dealt with urban traffic forecasting problems, applying machine learning models and evolutionary algorithms. He has experience in origin-destination matrix estimation or point of interest and trajectory detection. Working with large volumes of data has given him a good command of big data processing tools and NoSQL databases. He has also been a visiting scholar at the Knowledge Engineering and Discovery Research Institute, Auckland University of Technology.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"314575",title:"Dr.",name:"Jesus",middleName:null,surname:"L. Lobo",slug:"jesus-l.-lobo",fullName:"Jesus L. Lobo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314575/images/system/314575.png",biography:"Dr. Jesús López is currently based in Bilbao (Spain) working at TECNALIA as Artificial Intelligence Research Scientist. In most cases, a project idea or a new research line needs to be investigated to see if it is good enough to take into production or to focus on it. That is exactly what he does, diving into Machine Learning algorithms and technologies to help TECNALIA to decide whether something is great in theory or will actually impact on the product or processes of its projects. So, he is expert at framing experiments, developing hypotheses, and proving whether they’re true or not, in order to investigate fundamental problems with a longer time horizon. He is also able to design and develop PoCs and system prototypes in simulation. He has participated in several national and internacional R&D projects.\n\nAs another relevant part of his everyday research work, he usually publishes his findings in reputed scientific refereed journals and international conferences, occasionally acting as reviewer and Programme Commitee member. Concretely, since 2018 he has published 9 JCR (8 Q1) journal papers, 9 conference papers (e.g. ECML PKDD 2021), and he has co-edited a book. He is also active in popular science writing data science stories for reputed blogs (KDNuggets, TowardsDataScience, Naukas). Besides, he has recently embarked on mentoring programmes as mentor, and has also worked as data science trainer.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"103779",title:"Prof.",name:"Yalcin",middleName:null,surname:"Isler",slug:"yalcin-isler",fullName:"Yalcin Isler",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRyQ8QAK/Profile_Picture_1628834958734",biography:"Yalcin Isler (1971 - Burdur / Turkey) received the B.Sc. degree in the Department of Electrical and Electronics Engineering from Anadolu University, Eskisehir, Turkey, in 1993, the M.Sc. degree from the Department of Electronics and Communication Engineering, Suleyman Demirel University, Isparta, Turkey, in 1996, the Ph.D. degree from the Department of Electrical and Electronics Engineering, Dokuz Eylul University, Izmir, Turkey, in 2009, and the Competence of Associate Professorship from the Turkish Interuniversity Council in 2019.\n\nHe was Lecturer at Burdur Vocational School in Suleyman Demirel University (1993-2000, Burdur / Turkey), Software Engineer (2000-2002, Izmir / Turkey), Research Assistant in Bulent Ecevit University (2002-2003, Zonguldak / Turkey), Research Assistant in Dokuz Eylul University (2003-2010, Izmir / Turkey), Assistant Professor at the Department of Electrical and Electronics Engineering in Bulent Ecevit University (2010-2012, Zonguldak / Turkey), Assistant Professor at the Department of Biomedical Engineering in Izmir Katip Celebi University (2012-2019, Izmir / Turkey). He is an Associate Professor at the Department of Biomedical Engineering at Izmir Katip Celebi University, Izmir / Turkey, since 2019. In addition to academics, he has also founded Islerya Medical and Information Technologies Company, Izmir / Turkey, since 2017.\n\nHis main research interests cover biomedical signal processing, pattern recognition, medical device design, programming, and embedded systems. He has many scientific papers and participated in several projects in these study fields. He was an IEEE Student Member (2009-2011) and IEEE Member (2011-2014) and has been IEEE Senior Member since 2014.",institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",country:{name:"Turkey"}}},{id:"339677",title:"Dr.",name:"Mrinmoy",middleName:null,surname:"Roy",slug:"mrinmoy-roy",fullName:"Mrinmoy Roy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/339677/images/16768_n.jpg",biography:"An accomplished Sales & Marketing professional with 12 years of cross-functional experience in well-known organisations such as CIPLA, LUPIN, GLENMARK, ASTRAZENECA across different segment of Sales & Marketing, International Business, Institutional Business, Product Management, Strategic Marketing of HIV, Oncology, Derma, Respiratory, Anti-Diabetic, Nutraceutical & Stomatological Product Portfolio and Generic as well as Chronic Critical Care Portfolio. A First Class MBA in International Business & Strategic Marketing, B.Pharm, D.Pharm, Google Certified Digital Marketing Professional. Qualified PhD Candidate in Operations and Management with special focus on Artificial Intelligence and Machine Learning adoption, analysis and use in Healthcare, Hospital & Pharma Domain. Seasoned with diverse therapy area of Pharmaceutical Sales & Marketing ranging from generating revenue through generating prescriptions, launching new products, and making them big brands with continuous strategy execution at the Physician and Patients level. Moved from Sales to Marketing and Business Development for 3.5 years in South East Asian Market operating from Manila, Philippines. Came back to India and handled and developed Brands such as Gluconorm, Lupisulin, Supracal, Absolut Woman, Hemozink, Fabiflu (For COVID 19), and many more. In my previous assignment I used to develop and execute strategies on Sales & Marketing, Commercialization & Business Development for Institution and Corporate Hospital Business portfolio of Oncology Therapy Area for AstraZeneca Pharma India Ltd. Being a Research Scholar and Student of ‘Operations Research & Management: Artificial Intelligence’ I published several pioneer research papers and book chapters on the same in Internationally reputed journals and Books indexed in Scopus, Springer and Ei Compendex, Google Scholar etc. Currently, I am launching PGDM Pharmaceutical Management Program in IIHMR Bangalore and spearheading the course curriculum and structure of the same. I am interested in Collaboration for Healthcare Innovation, Pharma AI Innovation, Future trend in Marketing and Management with incubation on Healthcare, Healthcare IT startups, AI-ML Modelling and Healthcare Algorithm based training module development. I am also an affiliated member of the Institute of Management Consultant of India, looking forward to Healthcare, Healthcare IT and Innovation, Pharma and Hospital Management Consulting works.",institutionString:null,institution:{name:"Lovely Professional University",country:{name:"India"}}},{id:"310576",title:"Prof.",name:"Erick Giovani",middleName:null,surname:"Sperandio Nascimento",slug:"erick-giovani-sperandio-nascimento",fullName:"Erick Giovani Sperandio Nascimento",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y00002pDKxDQAW/ProfilePicture%202022-06-20%2019%3A57%3A24.788",biography:"Prof. Erick Sperandio is the Lead Researcher and professor of Artificial Intelligence (AI) at SENAI CIMATEC, Bahia, Brazil, also working with Computational Modeling (CM) and HPC. He holds a PhD in Environmental Engineering in the area of Atmospheric Computational Modeling, a Master in Informatics in the field of Computational Intelligence and Graduated in Computer Science from UFES. He currently coordinates, leads and participates in R&D projects in the areas of AI, computational modeling and supercomputing applied to different areas such as Oil and Gas, Health, Advanced Manufacturing, Renewable Energies and Atmospheric Sciences, advising undergraduate, master's and doctoral students. He is the Lead Researcher at SENAI CIMATEC's Reference Center on Artificial Intelligence. In addition, he is a Certified Instructor and University Ambassador of the NVIDIA Deep Learning Institute (DLI) in the areas of Deep Learning, Computer Vision, Natural Language Processing and Recommender Systems, and Principal Investigator of the NVIDIA/CIMATEC AI Joint Lab, the first in Latin America within the NVIDIA AI Technology Center (NVAITC) worldwide program. He also works as a researcher at the Supercomputing Center for Industrial Innovation (CS2i) and at the SENAI Institute of Innovation for Automation (ISI Automação), both from SENAI CIMATEC. He is a member and vice-coordinator of the Basic Board of Scientific-Technological Advice and Evaluation, in the area of Innovation, of the Foundation for Research Support of the State of Bahia (FAPESB). He serves as Technology Transfer Coordinator and one of the Principal Investigators at the National Applied Research Center in Artificial Intelligence (CPA-IA) of SENAI CIMATEC, focusing on Industry, being one of the six CPA-IA in Brazil approved by MCTI / FAPESP / CGI.br. He also participates as one of the representatives of Brazil in the BRICS Innovation Collaboration Working Group on HPC, ICT and AI. He is the coordinator of the Work Group of the Axis 5 - Workforce and Training - of the Brazilian Strategy for Artificial Intelligence (EBIA), and member of the MCTI/EMBRAPII AI Innovation Network Training Committee. He is the coordinator, by SENAI CIMATEC, of the Artificial Intelligence Reference Network of the State of Bahia (REDE BAH.IA). He leads the working group of experts representing Brazil in the Global Partnership on Artificial Intelligence (GPAI), on the theme \"AI and the Pandemic Response\".",institutionString:"Manufacturing and Technology Integrated Campus – SENAI CIMATEC",institution:null},{id:"1063",title:"Prof.",name:"Constantin",middleName:null,surname:"Volosencu",slug:"constantin-volosencu",fullName:"Constantin Volosencu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1063/images/system/1063.png",biography:"Prof. Dr. Constantin Voloşencu graduated as an engineer from\nPolitehnica University of Timișoara, Romania, where he also\nobtained a doctorate degree. He is currently a full professor in\nthe Department of Automation and Applied Informatics at the\nsame university. Dr. Voloşencu is the author of ten books, seven\nbook chapters, and more than 160 papers published in journals\nand conference proceedings. He has also edited twelve books and\nhas twenty-seven patents to his name. He is a manager of research grants, editor in\nchief and member of international journal editorial boards, a former plenary speaker, a member of scientific committees, and chair at international conferences. His\nresearch is in the fields of control systems, control of electric drives, fuzzy control\nsystems, neural network applications, fault detection and diagnosis, sensor network\napplications, monitoring of distributed parameter systems, and power ultrasound\napplications. He has developed automation equipment for machine tools, spooling\nmachines, high-power ultrasound processes, and more.",institutionString:'"Politechnica" University Timişoara',institution:null},{id:"221364",title:"Dr.",name:"Eneko",middleName:null,surname:"Osaba",slug:"eneko-osaba",fullName:"Eneko Osaba",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/221364/images/system/221364.jpg",biography:"Dr. Eneko Osaba works at TECNALIA as a senior researcher. He obtained his Ph.D. in Artificial Intelligence in 2015. He has participated in more than twenty-five local and European research projects, and in the publication of more than 130 papers. He has performed several stays at universities in the United Kingdom, Italy, and Malta. Dr. Osaba has served as a program committee member in more than forty international conferences and participated in organizing activities in more than ten international conferences. He is a member of the editorial board of the International Journal of Artificial Intelligence, Data in Brief, and Journal of Advanced Transportation. He is also a guest editor for the Journal of Computational Science, Neurocomputing, Swarm, and Evolutionary Computation and IEEE ITS Magazine.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"275829",title:"Dr.",name:"Esther",middleName:null,surname:"Villar-Rodriguez",slug:"esther-villar-rodriguez",fullName:"Esther Villar-Rodriguez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/275829/images/system/275829.jpg",biography:"Dr. Esther Villar obtained a Ph.D. in Information and Communication Technologies from the University of Alcalá, Spain, in 2015. She obtained a degree in Computer Science from the University of Deusto, Spain, in 2010, and an MSc in Computer Languages and Systems from the National University of Distance Education, Spain, in 2012. Her areas of interest and knowledge include natural language processing (NLP), detection of impersonation in social networks, semantic web, and machine learning. Dr. Esther Villar made several contributions at conferences and publishing in various journals in those fields. Currently, she is working within the OPTIMA (Optimization Modeling & Analytics) business of TECNALIA’s ICT Division as a data scientist in projects related to the prediction and optimization of management and industrial processes (resource planning, energy efficiency, etc).",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49813/images/system/49813.png",biography:"Prof. Dr. Javier Del Ser received his first PhD in Telecommunication Engineering (Cum Laude) from the University of Navarra, Spain, in 2006, and a second PhD in Computational Intelligence (Summa Cum Laude) from the University of Alcala, Spain, in 2013. He is currently a principal researcher in data analytics and optimisation at TECNALIA (Spain), a visiting fellow at the Basque Center for Applied Mathematics (BCAM) and a part-time lecturer at the University of the Basque Country (UPV/EHU). His research interests gravitate on the use of descriptive, prescriptive and predictive algorithms for data mining and optimization in a diverse range of application fields such as Energy, Transport, Telecommunications, Health and Industry, among others. In these fields he has published more than 240 articles, co-supervised 8 Ph.D. theses, edited 6 books, coauthored 7 patents and participated/led more than 40 research projects. He is a Senior Member of the IEEE, and a recipient of the Biscay Talent prize for his academic career.",institutionString:"Tecnalia Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"278948",title:"Dr.",name:"Carlos Pedro",middleName:null,surname:"Gonçalves",slug:"carlos-pedro-goncalves",fullName:"Carlos Pedro Gonçalves",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRcmyQAC/Profile_Picture_1564224512145",biography:'Carlos Pedro Gonçalves (PhD) is an Associate Professor at Lusophone University of Humanities and Technologies and a researcher on Complexity Sciences, Quantum Technologies, Artificial Intelligence, Strategic Studies, Studies in Intelligence and Security, FinTech and Financial Risk Modeling. He is also a progammer with programming experience in:\n\nA) Quantum Computing using Qiskit Python module and IBM Quantum Experience Platform, with software developed on the simulation of Quantum Artificial Neural Networks and Quantum Cybersecurity;\n\nB) Artificial Intelligence and Machine learning programming in Python;\n\nC) Artificial Intelligence, Multiagent Systems Modeling and System Dynamics Modeling in Netlogo, with models developed in the areas of Chaos Theory, Econophysics, Artificial Intelligence, Classical and Quantum Complex Systems Science, with the Econophysics models having been cited worldwide and incorporated in PhD programs by different Universities.\n\nReceived an Arctic Code Vault Contributor status by GitHub, due to having developed open source software preserved in the \\"Arctic Code Vault\\" for future generations (https://archiveprogram.github.com/arctic-vault/), with the Strategy Analyzer A.I. module for decision making support (based on his PhD thesis, used in his Classes on Decision Making and in Strategic Intelligence Consulting Activities) and QNeural Python Quantum Neural Network simulator also preserved in the \\"Arctic Code Vault\\", for access to these software modules see: https://github.com/cpgoncalves. He is also a peer reviewer with outsanding review status from Elsevier journals, including Physica A, Neurocomputing and Engineering Applications of Artificial Intelligence. Science CV available at: https://www.cienciavitae.pt//pt/8E1C-A8B3-78C5 and ORCID: https://orcid.org/0000-0002-0298-3974',institutionString:"University of Lisbon",institution:{name:"Universidade Lusófona",country:{name:"Portugal"}}},{id:"241400",title:"Prof.",name:"Mohammed",middleName:null,surname:"Bsiss",slug:"mohammed-bsiss",fullName:"Mohammed Bsiss",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241400/images/8062_n.jpg",biography:null,institutionString:null,institution:null},{id:"276128",title:"Dr.",name:"Hira",middleName:null,surname:"Fatima",slug:"hira-fatima",fullName:"Hira Fatima",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/276128/images/14420_n.jpg",biography:"Dr. Hira Fatima\nAssistant Professor\nDepartment of Mathematics\nInstitute of Applied Science\nMangalayatan University, Aligarh\nMobile: no : 8532041179\nhirafatima2014@gmal.com\n\nDr. Hira Fatima has received his Ph.D. degree in pure Mathematics from Aligarh Muslim University, Aligarh India. Currently working as an Assistant Professor in the Department of Mathematics, Institute of Applied Science, Mangalayatan University, Aligarh. She taught so many courses of Mathematics of UG and PG level. Her research Area of Expertise is Functional Analysis & Sequence Spaces. She has been working on Ideal Convergence of double sequence. She has published 17 research papers in National and International Journals including Cogent Mathematics, Filomat, Journal of Intelligent and Fuzzy Systems, Advances in Difference Equations, Journal of Mathematical Analysis, Journal of Mathematical & Computer Science etc. She has also reviewed few research papers for the and international journals. 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\r\n\tThe era of antibiotics led us to the illusion that the problem of bacterial infection is over. However, bacterial flexibility and adaptation mechanisms allow them to survive and grow in extreme conditions. The best example is the formation of a sophisticated society of bacteria defined as a biofilm. Understanding the mechanism of bacterial biofilm formation has changed our perception of the development of bacterial infection but successfully eradicating biofilm remains a challenge. Considering the above, it is not surprising that bacteria remain a major public health threat despite the development of many groups of antibiotics. Additionally, increasing prevalence of acquired antibiotic resistance forces us to realize that we are far from controlling the development of bacterial infections. On the other hand, many infections are endogenous and result from an unbalanced relationship between the host and the microorganism. The increasing use of immunosuppressants, such as chemotherapy or organ transplantation, increases the incidence of patients highly susceptible to bacterial infections in the population.
\r\n
\r\n\tThis topic will focus on the current challenges and advantages in the diagnosis and treatment of bacterial infections. We will discuss the host-microbiota relationship, the treatment of chronic infections due to biofilm formation, and the development of new diagnostic tools to rapidly distinguish between colonization and probable infection.
",coverUrl:"https://cdn.intechopen.com/series_topics/covers/3.jpg",keywords:"Antibiotics, Biofilm, Antibiotic Resistance, Host-microbiota Relationship, Treatment, Diagnostic Tools"},{id:"4",title:"Fungal Infectious Diseases",scope:"Fungi are ubiquitous and there are almost no non-pathogenic fungi. Fungal infectious illness prevalence and prognosis are determined by the exposure between fungi and host, host immunological state, fungal virulence, and early and accurate diagnosis and treatment. \r\nPatients with both congenital and acquired immunodeficiency are more likely to be infected with opportunistic mycosis. Fungal infectious disease outbreaks are common during the post- disaster rebuilding era, which is characterised by high population density, migration, and poor health and medical conditions.\r\nSystemic or local fungal infection is mainly associated with the fungi directly inhaled or inoculated in the environment during the disaster. The most common fungal infection pathways are human to human (anthropophilic), animal to human (zoophilic), and environment to human (soilophile). Diseases are common as a result of widespread exposure to pathogenic fungus dispersed into the environment. \r\nFungi that are both common and emerging are intertwined. In Southeast Asia, for example, Talaromyces marneffei is an important pathogenic thermally dimorphic fungus that causes systemic mycosis. Widespread fungal infections with complicated and variable clinical manifestations, such as Candida auris infection resistant to several antifungal medicines, Covid-19 associated with Trichoderma, and terbinafine resistant dermatophytosis in India, are among the most serious disorders. \r\nInappropriate local or systemic use of glucocorticoids, as well as their immunosuppressive effects, may lead to changes in fungal infection spectrum and clinical characteristics. Hematogenous candidiasis is a worrisome issue that affects people all over the world, particularly ICU patients. CARD9 deficiency and fungal infection have been major issues in recent years. Invasive aspergillosis is associated with a significant death rate. Special attention should be given to endemic fungal infections, identification of important clinical fungal infections advanced in yeasts, filamentous fungal infections, skin mycobiome and fungal genomes, and immunity to fungal infections.\r\nIn addition, endemic fungal diseases or uncommon fungal infections caused by Mucor irregularis, dermatophytosis, Malassezia, cryptococcosis, chromoblastomycosis, coccidiosis, blastomycosis, histoplasmosis, sporotrichosis, and other fungi, should be monitored. \r\nThis topic includes the research progress on the etiology and pathogenesis of fungal infections, new methods of isolation and identification, rapid detection, drug sensitivity testing, new antifungal drugs, schemes and case series reports. It will provide significant opportunities and support for scientists, clinical doctors, mycologists, antifungal drug researchers, public health practitioners, and epidemiologists from all over the world to share new research, ideas and solutions to promote the development and progress of medical mycology.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/4.jpg",keywords:"Emerging Fungal Pathogens, Invasive Infections, Epidemiology, Cell Membrane, Fungal Virulence, Diagnosis, Treatment"},{id:"5",title:"Parasitic Infectious Diseases",scope:"Parasitic diseases have evolved alongside their human hosts. In many cases, these diseases have adapted so well that they have developed efficient resilience methods in the human host and can live in the host for years. Others, particularly some blood parasites, can cause very acute diseases and are responsible for millions of deaths yearly. Many parasitic diseases are classified as neglected tropical diseases because they have received minimal funding over recent years and, in many cases, are under-reported despite the critical role they play in morbidity and mortality among human and animal hosts. The current topic, Parasitic Infectious Diseases, in the Infectious Diseases Series aims to publish studies on the systematics, epidemiology, molecular biology, genomics, pathogenesis, genetics, and clinical significance of parasitic diseases from blood borne to intestinal parasites as well as zoonotic parasites. We hope to cover all aspects of parasitic diseases to provide current and relevant research data on these very important diseases. In the current atmosphere of the Coronavirus pandemic, communities around the world, particularly those in different underdeveloped areas, are faced with the growing challenges of the high burden of parasitic diseases. At the same time, they are faced with the Covid-19 pandemic leading to what some authors have called potential syndemics that might worsen the outcome of such infections. Therefore, it is important to conduct studies that examine parasitic infections in the context of the coronavirus pandemic for the benefit of all communities to help foster more informed decisions for the betterment of human and animal health.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/5.jpg",keywords:"Blood Borne Parasites, Intestinal Parasites, Protozoa, Helminths, Arthropods, Water Born Parasites, Epidemiology, Molecular Biology, Systematics, Genomics, Proteomics, Ecology"},{id:"6",title:"Viral Infectious Diseases",scope:"The Viral Infectious Diseases Book Series aims to provide a comprehensive overview of recent research trends and discoveries in various viral infectious diseases emerging around the globe. The emergence of any viral disease is hard to anticipate, which often contributes to death. A viral disease can be defined as an infectious disease that has recently appeared within a population or exists in nature with the rapid expansion of incident or geographic range. This series will focus on various crucial factors related to emerging viral infectious diseases, including epidemiology, pathogenesis, host immune response, clinical manifestations, diagnosis, treatment, and clinical recommendations for managing viral infectious diseases, highlighting the recent issues with future directions for effective therapeutic strategies.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/6.jpg",keywords:"Novel Viruses, Virus Transmission, Virus Evolution, Molecular Virology, Control and Prevention, Virus-host Interaction"}],annualVolumeBook:{},thematicCollection:[],selectedSeries:null,selectedSubseries:null},seriesLanding:{item:null},libraryRecommendation:{success:null,errors:{},institutions:[]},route:{name:"chapter.detail",path:"/chapters/64879",hash:"",query:{},params:{id:"64879"},fullPath:"/chapters/64879",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)}()