Eigenvalue output.
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Barely three months into the new year and we are happy to announce a monumental milestone reached - 150 million downloads.
\n\nThis achievement solidifies IntechOpen’s place as a pioneer in Open Access publishing and the home to some of the most relevant scientific research available through Open Access.
\n\nWe are so proud to have worked with so many bright minds throughout the years who have helped us spread knowledge through the power of Open Access and we look forward to continuing to support some of the greatest thinkers of our day.
\n\nThank you for making IntechOpen your place of learning, sharing, and discovery, and here’s to 150 million more!
\n\n\n\n\n'}],latestNews:[{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"},{slug:"intechopen-identified-as-one-of-the-most-significant-contributor-to-oa-book-growth-in-doab-20210809",title:"IntechOpen Identified as One of the Most Significant Contributors to OA Book Growth in DOAB"}]},book:{item:{type:"book",id:"8018",leadTitle:null,fullTitle:"Extracellular Matrix - Developments and Therapeutics",title:"Extracellular Matrix",subtitle:"Developments and Therapeutics",reviewType:"peer-reviewed",abstract:"Understanding extracellular matrix (ECM) structure and function is important for developing biomedical applications that are as close to ‘native’ as possible. Written by pioneering scientists from all over the world, this book reports research and new developments in the field of collagen structure, function, and biomechanics and discusses the relevance of hyaluronic acid and its therapeutic uses. It gives readers a glimpse of what is current in this area and we hope it piques their interest in learning more about ECM biology.",isbn:"978-1-83968-236-0",printIsbn:"978-1-83968-235-3",pdfIsbn:"978-1-83968-237-7",doi:"10.5772/intechopen.77848",price:119,priceEur:129,priceUsd:155,slug:"extracellular-matrix-developments-and-therapeutics",numberOfPages:170,isOpenForSubmission:!1,isInWos:1,isInBkci:!1,hash:"c85e82851e80b40282ff9be99ddf2046",bookSignature:"Rama Sashank Madhurapantula, Joseph Orgel P.R.O. and Zvi Loewy",publishedDate:"October 27th 2021",coverURL:"https://cdn.intechopen.com/books/images_new/8018.jpg",numberOfDownloads:1745,numberOfWosCitations:1,numberOfCrossrefCitations:5,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:7,numberOfDimensionsCitationsByBook:0,hasAltmetrics:1,numberOfTotalCitations:13,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"July 3rd 2020",dateEndSecondStepPublish:"July 24th 2020",dateEndThirdStepPublish:"September 22nd 2020",dateEndFourthStepPublish:"December 11th 2020",dateEndFifthStepPublish:"February 9th 2021",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,7",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,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",biography:"Rama Sashank Madhurapantula is a research assistant professor in the Biology Department, Illinois Institute of Technology, Chicago. His current research involves developing microscopy techniques to establish macroscopic stress vs strain relations in body tissues that present mixed-tissue compositions, in conjunction with X-ray diffraction scanning techniques to establish tissue composition.\t\nHis doctoral work was in understanding molecular changes to collagens with diseases and changes in fibrous structures such as myelin. In recognition of scientific endeavors and achievements, Dr. Madhurapantula was elected as chair to the Fiber Diffraction Special Interest Group of the American Crystallographic Association in 2020 and awarded the Margaret C. Etter Student Lecturer award in 2014.",institutionString:"Illinois Institute of Technology",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"Illinois Institute of Technology",institutionURL:null,country:{name:"United States of America"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:{id:"212413",title:"Prof.",name:"Joseph",middleName:null,surname:"Orgel P.R.O.",slug:"joseph-orgel-p.r.o.",fullName:"Joseph Orgel P.R.O.",profilePictureURL:"https://mts.intechopen.com/storage/users/212413/images/system/212413.jpg",biography:"Professor Joseph Orgel is a British American scientist based at the Illinois Institute of Technology (Illinois Tech), Chicago, with appointments in biology and biomedical engineering. His research explores fundamental structural biochemistry underlying disease and possible treatments. Using novel techniques, Dr. Orgel and his group have been able to visualize the molecular organization of connective and neurological tissues at nanometer (or better) resolution. He leads investigations of diseases such as Alzheimer’s, traumatic brain injury, heart disease, and arthritis in collaboration with the US Army. An awardee of the NSF CAREER award, he has been Biochemistry Section Editor of PLOS ONE since 2008. In early 2021, he was named Vice Provost for Academic Affairs at Illinois Tech.",institutionString:"Illinois Institute of Technology",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"1",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Illinois Institute of Technology",institutionURL:null,country:{name:"United States of America"}}},coeditorTwo:{id:"235950",title:"Ph.D.",name:"Zvi",middleName:null,surname:"Loewy",slug:"zvi-loewy",fullName:"Zvi Loewy",profilePictureURL:"https://mts.intechopen.com/storage/users/235950/images/system/235950.png",biography:"Dr. Zvi Loewy is a senior academic leader and an experienced global pharmaceutical–biotechnology executive. He leverages a diversified background in big-pharma senior management, biotech startup creation, and academia. Dr. Loewy has served as a board member of the New Jersey Bioscience Center Incubator since 2010. From 2005 to 2020 he was a board member of the Jerusalem College of Technology. His international experience has included leading international research teams; championing the penetration and commercial launch of healthcare products worldwide; and leading open innovation in the Mideast. Dr. Loewy received his BA from Yeshiva University, New York, his MS from Rensselaer Polytechnic Institute, New York, and his Ph.D. in Molecular Biology from the Albert Einstein College of Medicine, New York. He has more than twenty-five issued patents to his credit.",institutionString:"New York Medical College",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"1",institution:{name:"New York Medical College",institutionURL:null,country:{name:"United States of America"}}},coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"919",title:"Tissue Engineering",slug:"biomaterials-tissue-engineering"}],chapters:[{id:"74538",title:"The Cellular Stress Response Interactome and Extracellular Matrix Cross-Talk during Fibrosis: A Stressed Extra-Matrix Affair",doi:"10.5772/intechopen.95066",slug:"the-cellular-stress-response-interactome-and-extracellular-matrix-cross-talk-during-fibrosis-a-stres",totalDownloads:342,totalCrossrefCites:1,totalDimensionsCites:1,hasAltmetrics:1,abstract:"Diverse internal and external pathologic stimuli can trigger cellular stress response pathways (CSRPs) that are usually counteracted by intrinsic homeostatic machinery, which responds to stress by initiating complex signaling mechanisms to eliminate either the stressor or the damaged cells. There is growing evidence that CSRPs can have context-dependent homeostatic or pathologic functions that may result in tissue fibrosis under persistence of stress. CSRPs can drive intercellular communications through exosomes (trafficking and secretory pathway determinants) secreted in response to stress-induced proteostasis rebalancing. The injured tissue environment upon sensing the stress turns on a precisely orchestrated network of immune responses by regulating cytokine-chemokine production, recruitment of immune cells, and modulating fibrogenic niche and extracellular matrix (ECM) cross-talk during fibrotic pathologies like cardiac fibrosis, liver fibrosis, laryngotracheal stenosis, systemic scleroderma, interstitial lung disease and inflammatory bowel disease. Immunostimulatory RNAs (like double stranded RNAs) generated through deregulated RNA processing pathways along with RNA binding proteins (RBPs) of RNA helicase (RNA sensors) family are emerging as important components of immune response pathways during sterile inflammation. The paradigm-shift in RNA metabolism associated interactome has begun to offer new therapeutic windows by unravelling the novel RBPs and splicing factors in context of developmental and fibrotic pathways. We would like to review emerging regulatory nodes and their interaction with CSRPs, and tissue remodeling with major focus on cardiac fibrosis, and inflammatory responses underlying upper airway fibrosis.",signatures:"Maryada Sharma, Kavita Kaushal, Sanjay Singh Rawat, Manjul Muraleedharan, Seema Chhabra, Nipun Verma, Anupam Mittal, Ajay Bahl, Madhu Khullar, Anurag Ramavat and Naresh K. Panda",downloadPdfUrl:"/chapter/pdf-download/74538",previewPdfUrl:"/chapter/pdf-preview/74538",authors:[{id:"30568",title:"Prof.",name:"Madhu",surname:"Khullar",slug:"madhu-khullar",fullName:"Madhu Khullar"},{id:"41185",title:"Dr.",name:"Ajay",surname:"Bahl",slug:"ajay-bahl",fullName:"Ajay Bahl"},{id:"121502",title:"Prof.",name:"Naresh",surname:"Panda",slug:"naresh-panda",fullName:"Naresh Panda"},{id:"327124",title:"Dr.",name:"Maryada",surname:"Sharma",slug:"maryada-sharma",fullName:"Maryada Sharma"},{id:"336274",title:"MSc.",name:"Kavita",surname:"Kaushal",slug:"kavita-kaushal",fullName:"Kavita Kaushal"},{id:"336275",title:"M.Sc.",name:"Sanjay",surname:"Rawat",slug:"sanjay-rawat",fullName:"Sanjay Rawat"},{id:"336276",title:"Dr.",name:"Manjul",surname:"Muraleedharan",slug:"manjul-muraleedharan",fullName:"Manjul Muraleedharan"},{id:"336277",title:"Dr.",name:"Seema",surname:"Chhabra",slug:"seema-chhabra",fullName:"Seema Chhabra"},{id:"336279",title:"Dr.",name:"Nipun",surname:"Verma",slug:"nipun-verma",fullName:"Nipun Verma"},{id:"336280",title:"Dr.",name:"Anupam",surname:"Mittal",slug:"anupam-mittal",fullName:"Anupam Mittal"},{id:"336281",title:"Dr.",name:"Anuarg",surname:"Ramavat",slug:"anuarg-ramavat",fullName:"Anuarg Ramavat"}],corrections:null},{id:"75606",title:"Extracellular Matrix in Cardiac Tissue Mechanics and Physiology: Role of Collagen Accumulation",doi:"10.5772/intechopen.96585",slug:"extracellular-matrix-in-cardiac-tissue-mechanics-and-physiology-role-of-collagen-accumulation",totalDownloads:297,totalCrossrefCites:1,totalDimensionsCites:2,hasAltmetrics:0,abstract:"The extracellular matrix (ECM) forms a mesh surrounding tissue, made up of fibrous and non-fibrous proteins that contribute to the cellular function, mechanical properties of the tissue and physiological function of the organ. The cardiac ECM remodels in response to mechanical alterations (e.g., pressure overload, volume overload) or injuries (e.g., myocardial infarction, bacterial infection), which further leads to mechanical and functional changes of the heart. Collagen, the most prevalent ECM protein in the body, contributes significantly to the mechanical behavior of myocardium during disease progression. Alterations in collagen fiber morphology and alignment, isoform, and cross-linking occur during the progression of various cardiac diseases. Acute or compensatory remodeling of cardiac ECM maintains normal cardiac function. However, chronic or decompensatory remodeling eventually results in heart failure, and the exact mechanism of transition into maladaptation remains unclear. This review aims to summarize the primary role of collagen accumulation (fibrosis) in heart failure progression, with a focus on its effects on myocardial tissue mechanical properties and cellular and organ functions.",signatures:"Kristen LeBar and Zhijie Wang",downloadPdfUrl:"/chapter/pdf-download/75606",previewPdfUrl:"/chapter/pdf-preview/75606",authors:[{id:"328709",title:"Assistant Prof.",name:"Zhijie",surname:"Wang",slug:"zhijie-wang",fullName:"Zhijie Wang"},{id:"344999",title:"BSc.",name:"Kristen",surname:"LeBar",slug:"kristen-lebar",fullName:"Kristen LeBar"}],corrections:null},{id:"75952",title:"The Extracellular Matrix of the Human and Whale Cornea and Sclera: Implications in Glaucoma and Other Pathologies",doi:"10.5772/intechopen.97023",slug:"the-extracellular-matrix-of-the-human-and-whale-cornea-and-sclera-implications-in-glaucoma-and-other",totalDownloads:148,totalCrossrefCites:3,totalDimensionsCites:3,hasAltmetrics:0,abstract:"The cornea is the transparent part of the eye that allows light to enter into the eye and reach the retina, thereby activating the neurons that will send messages to the brain. The sclera is the hard-white part of the eye, and its main function is to provide structure and form to the eye, and to support the retina. Indeed, while the cornea best performs its main functions when transparent and it is capable of adapting its curvature to allow the eye to focus, the sclera must be opaque and hard to function correctly. Both structures are mainly composed of collagen, some elastic fibres and ground substance, all components of the Extracellular Matrix. The disposition of the collagen fibres and the amount of ground substance around the fibres is responsible for the differences in the aspect of both these structures. In this chapter, for the first time we have compared the structure and ultrastructure of the cornea and sclera in humans and the whale adult (18mts) Balaenoptera physalus, the second largest animal on the planet. We will discuss how the differences in their structure may be related to the maintenance of intraocular pressure in their distinct environments, which is of particular clinical interest as increased intraocular pressure is one of the main causes underlying the development of open angle glaucoma.",signatures:"Elena Vecino, Noelia Ruzafa, Xandra Pereiro, Ane Zulueta, Alfredo Sarmiento and Alejandro Díez",downloadPdfUrl:"/chapter/pdf-download/75952",previewPdfUrl:"/chapter/pdf-preview/75952",authors:[{id:"31685",title:"Prof.",name:"Elena",surname:"Vecino",slug:"elena-vecino",fullName:"Elena Vecino"},{id:"345872",title:"Dr.",name:"Xandra",surname:"Pereiro",slug:"xandra-pereiro",fullName:"Xandra Pereiro"},{id:"345873",title:"Dr.",name:"Noelia",surname:"Ruzafa",slug:"noelia-ruzafa",fullName:"Noelia Ruzafa"},{id:"346752",title:"MSc.",name:"Ane",surname:"Zulueta",slug:"ane-zulueta",fullName:"Ane Zulueta"},{id:"346754",title:"Dr.",name:"Alfredo",surname:"Sarmiento",slug:"alfredo-sarmiento",fullName:"Alfredo Sarmiento"},{id:"346756",title:"Dr.",name:"Alejandro",surname:"Diez",slug:"alejandro-diez",fullName:"Alejandro Diez"}],corrections:null},{id:"74739",title:"The Evolutionary Origin of Elastin: Is Fibrillin the Lost Ancestor?",doi:"10.5772/intechopen.95411",slug:"the-evolutionary-origin-of-elastin-is-fibrillin-the-lost-ancestor-",totalDownloads:222,totalCrossrefCites:0,totalDimensionsCites:1,hasAltmetrics:1,abstract:"Elastin is the extracellular matrix protein providing large arteries, lung parenchyma and skin with the properties of extensibility and elastic recoil. Within these tissues, elastin is found as a polymer formed by tropoelastin monomers assembled and cross-linked. In addition to specific protein regions supporting the covalent cross-links, tropoelastin is featured by the presence of highly repetitive sequences rich in proline and glycine making up the so-called hydrophobic domains. These protein segments promote structural flexibility and disordered protein properties, a fundamental aspect to explain its elastomeric behavior. Unlike other matrix proteins such as collagens or laminins, elastin emerged relatively late in evolution, appearing at the divergence of jawed and jawless fishes, therefore present in all species from sharks to humans, but absent in lampreys and other lower chordates and invertebrates. In spite of an intense interrogation of the key aspects in the evolution of elastin, its origin remains still elusive and an ancestral protein that could give rise to a primordial elastin is not known. In this chapter, I review the main molecular features of tropoelastin and the available knowledge on its evolutionary history as well as establish hypotheses for its origin. Considering the remarkable similarities between the hydrophobic domains of the first recognizable elastin gene from the elasmobranch Callorhinchus milii with certain fibrillin regions from related fish species, I raise the possibility that fibrillins might have provided protein domains to an ancestral elastin that thereafter underwent significant evolutionary changes to give the elastin forms found today.",signatures:"Fernando Rodriguez-Pascual",downloadPdfUrl:"/chapter/pdf-download/74739",previewPdfUrl:"/chapter/pdf-preview/74739",authors:[{id:"327242",title:"Ph.D.",name:"Fernando",surname:"Rodriguez-Pascual",slug:"fernando-rodriguez-pascual",fullName:"Fernando Rodriguez-Pascual"}],corrections:null},{id:"75828",title:"The Interplay of ECM-Based Graft Materials and Mechanisms of Tissue Remodeling",doi:"10.5772/intechopen.96954",slug:"the-interplay-of-ecm-based-graft-materials-and-mechanisms-of-tissue-remodeling",totalDownloads:205,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Wound healing is a complex natural process that involves the recruitment of cells, the renewal of tissue composition, and the reinforcement of structural tissue architecture. Following ischemic injury or chronic disease, wound healing is delayed, and can often result in chronic inflammation or permanent morbidity. Tissue engineering strategies to harness the wound healing process include the use of naturally derived extracellular matrix (ECM) scaffolds with inherent bioactivity to both passively facilitate and actively direct healing toward a successful resolution. As the body heals, the properly designed ECM scaffold is gradually remodeled and integrated into the body, leaving behind organized tissue that provides long-term strength. Herein we explain the interplay of the ECM (i.e., its complex composition and bioactivity) with the cells of the body throughout the process of tissue remodeling, thus explaining how even a tissue-engineered xenograft material can direct the body to restore itself.",signatures:"Jason P. Hodde and Michael C. Hiles",downloadPdfUrl:"/chapter/pdf-download/75828",previewPdfUrl:"/chapter/pdf-preview/75828",authors:[{id:"328075",title:"M.Sc.",name:"Jason P.",surname:"Hodde",slug:"jason-p.-hodde",fullName:"Jason P. Hodde"},{id:"332682",title:"Dr.",name:"Michael C.",surname:"Hiles",slug:"michael-c.-hiles",fullName:"Michael C. Hiles"}],corrections:null},{id:"76149",title:"Hyaluronic Acid Fillers: Where We Have Been and Where We Are Going",doi:"10.5772/intechopen.97264",slug:"hyaluronic-acid-fillers-where-we-have-been-and-where-we-are-going",totalDownloads:103,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Since the approval of the United States’ first hyaluronic acid (HA) filler in December 2003, HA fillers have become mainstays of soft tissue augmentation due to their favorable safety profile and minimally invasive treatment nature. The past two decades have not only brought an expansion in the popularity of HA fillers, but also in the number of available HA filler products and indications for cosmetic enhancement. Accordingly, HA filler injection has become one of the most commonly performed cosmetic procedures worldwide. The progression of HA filler products is a study in both biomedical engineering advancements, as well as evolving concepts of beauty and cosmesis. In this chapter, we review the history of these products, including their composition and indications for use. We then explore the prospect of HA fillers for the future of esthetic medicine, as they remain a vital component of nonsurgical soft tissue augmentation.",signatures:"Alexander Daoud and Robert Weiss",downloadPdfUrl:"/chapter/pdf-download/76149",previewPdfUrl:"/chapter/pdf-preview/76149",authors:[{id:"328230",title:"Associate Prof.",name:"Robert",surname:"Weiss",slug:"robert-weiss",fullName:"Robert Weiss"},{id:"329813",title:"Dr.",name:"Alexander",surname:"Daoud",slug:"alexander-daoud",fullName:"Alexander Daoud"}],corrections:null},{id:"76651",title:"Hyaluronic Acid Derivatives for Targeted Cancer Therapy",doi:"10.5772/intechopen.97224",slug:"hyaluronic-acid-derivatives-for-targeted-cancer-therapy",totalDownloads:202,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Targeted therapeutics are considered next generation cancer therapy because they overcome many limitations of traditional chemotherapy. Cancerous cells may be targeted by various hyaluronic acid modified nanovehicles that kill these cells. Particularly, hyaluronic acid and its derivatives bind with high affinity to cell surface protein, CD44 enriched tumor cells. Moreover, these molecules have the added advantage of being biocompatible and biodegradable, and may be conjugated with a variety of drugs and drug carriers for developing various formulations as anti-cancer therapies such as nanogels, self-assembled and metallic nanoparticulates. In this chapter, we have covered various aspects of hyaluronic acid-modified delivery systems including strategies for synthesis, characterization, and biocompatibility. Next, the use of hyaluronic acid-modified systems as anti-cancer therapies is discussed. Finally, the delivery of small molecules, and other pharmaceutical agents are also elaborated in this chapter.",signatures:"Nilkamal Pramanik and Sameer Kumar Jagirdar",downloadPdfUrl:"/chapter/pdf-download/76651",previewPdfUrl:"/chapter/pdf-preview/76651",authors:[{id:"327038",title:"Dr.",name:"Nilkamal",surname:"Pramanik",slug:"nilkamal-pramanik",fullName:"Nilkamal Pramanik"},{id:"334285",title:"Ph.D. Student",name:"Sameer",surname:"Jagirdar",slug:"sameer-jagirdar",fullName:"Sameer Jagirdar"}],corrections:null},{id:"77440",title:"Plant Natural Products: A Promising Source of Hyaluronidase Enzyme Inhibitors",doi:"10.5772/intechopen.98814",slug:"plant-natural-products-a-promising-source-of-hyaluronidase-enzyme-inhibitors",totalDownloads:226,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Hyaluronidase enzyme degrades hyaluronan, the primary component of the extracellular matrix found in connective tissues animals and on the surface of certain pathogenic bacteria. The degradation of hyaluronan is linked to a wide range of physiological and pathological process. Inhibiting the hyaluronidase enzyme is thus significant as an approach to treat a variety of diseases and health conditions such as anti-fertility, anti-tumor, antimicrobial, and anti-venom/toxin agents. HAase inhibitors of different chemical types have been identified include both synthetic compounds and constituents obtained from naturally sources. Plant natural products as HAase inhibitors are unique due to their structural features and diversity. Medicinal plants have historically been used as contraceptives, antidote for snakebites and to promote wound healing. In recent years, small molecules, particularly plant natural products (alkaloids, flavonoids, polyphenol and flavonoids, triterpenes and steroids) possessing potent HAase have been discovered. A number of plant species from various families, which have folk medicinal claims for these ailments (related to hyaluronan disturbances) were scientifically proven for their potential to block HAase enzymes.",signatures:"Muhammad Zeeshan Bhatti and Aman Karim",downloadPdfUrl:"/chapter/pdf-download/77440",previewPdfUrl:"/chapter/pdf-preview/77440",authors:[{id:"328295",title:"Dr.",name:"Aman",surname:"Karim",slug:"aman-karim",fullName:"Aman Karim"},{id:"345782",title:"Dr.",name:"Muhammad Zeeshan",surname:"Bhatti",slug:"muhammad-zeeshan-bhatti",fullName:"Muhammad Zeeshan Bhatti"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:{id:"14",series:{id:"11",title:"Biochemistry",issn:"2632-0983",editor:{id:"31610",title:"Dr.",name:"Miroslav",middleName:null,surname:"Blumenberg",slug:"miroslav-blumenberg",fullName:"Miroslav Blumenberg",profilePictureURL:"https://mts.intechopen.com/storage/users/31610/images/system/31610.jpg",biography:"Miroslav Blumenberg, Ph.D., was born in Subotica and received his BSc in Belgrade, Yugoslavia. He completed his Ph.D. at MIT in Organic Chemistry; he followed up his Ph.D. with two postdoctoral study periods at Stanford University. Since 1983, he has been a faculty member of the RO Perelman Department of Dermatology, NYU School of Medicine, where he is codirector of a training grant in cutaneous biology. Dr. Blumenberg’s research is focused on the epidermis, expression of keratin genes, transcription profiling, keratinocyte differentiation, inflammatory diseases and cancers, and most recently the effects of the microbiome on the skin. He has published more than 100 peer-reviewed research articles and graduated numerous Ph.D. and postdoctoral students.",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"5",totalChapterViews:"0",totalEditedBooks:"6",institution:{name:"New York University Langone Medical Center",institutionURL:null,country:{name:"United States of America"}}}}},tags:null},relatedBooks:[{type:"book",id:"3420",title:"Advances in Biomaterials Science and Biomedical Applications",subtitle:null,isOpenForSubmission:!1,hash:"381d506a331ddc9ae4d423dea265e0a2",slug:"advances-in-biomaterials-science-and-biomedical-applications",bookSignature:"Rosario Pignatello",coverURL:"https://cdn.intechopen.com/books/images_new/3420.jpg",editedByType:"Edited by",editors:[{id:"64447",title:"Prof.",name:"Rosario",surname:"Pignatello",slug:"rosario-pignatello",fullName:"Rosario 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\r\n\tMalaria is an acute febrile illness caused by Plasmodium parasites, which are spread to people through the bites of infected female Anopheles mosquitoes. It’s the second commonest infectious disease worldwide (following hepatitis B). Despite being potentially preventable and curable, in 2020 there were an estimated 241 million cases; the estimated number of deaths being 627,000. Nearly half of the world's population is at risk of malaria. However, some population groups are at considerably higher risk of contracting malaria and developing the severe disease: children, pregnant women, and patients with low immunity. Noteworthy, 95% of malaria cases and 96% of malaria deaths occur in African Countries, with 80% of all deaths being in children under 5. Recent advancements include more accurate vectors control, chemotherapies, and possibly vaccine development. In this book, the current and most advanced knowledge about malaria is discussed, by focusing on pathobiology, diagnosis, clinical features, and management.
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Nuclear power industry seems to take a key role over the continuously increasing energy demand. First known nuclear power station for the generations of electricity was built for commercial use in Russia in 1954, with an output of 5 MW(e). Afterwards, USA constructed a pressurized light water reactor (PWR) with 60 MW(e) which first produced electricity. Many countries over the world followed this first attempt and a rapid growth of nuclear energy production started. Though renewable energy seems to take role in the approaching era, it is estimated that the percentage of the generated electricity from these sources will not be deemed to nuclear power plants. It can be forecasted that up to 2050, nuclear energy and nuclear power plants (NPP) will play a major role in producing electricity worldwide.
Nowadays, supporters of nuclear power admit that this is indeed a technology which is more expensive than its counterparts. Throughout its development, starting from the 1980s, the sector improved the design of reactors. Furthermore, the scientists working in this era aimed to overcome human error or equipment malfunctions. These resulted more robust, fuel efficient and advanced reactor designs where the cost of the construction is also reduced.
Next generation nuclear reactors may be classified into two broad categories: evolutionary and revolutionary [1]. While the Generation III and III+ types belong to the former, Generation IV reactors fell into the latter category. Crimello [2] reported that the design of Generation III type nuclear reactors based on minimizing the risk and thus increase safety. Advanced Boiling and Pressurized Water reactors and Enhanced CANDU 6 are all examples to this type. Passive safety features are incorporated into Generation III type reactors to reach the revolutionary reactors Generation III+. Some examples to these reactors may be: AP1000, VVER 1200 and APR 1400.
Generally, an NPP is composed of five principal buildings: the nuclear island, the annex building, the turbine building, the diesel generator building and radwaste buildings. The nuclear island consists of the containment building, the shield building and the auxiliary building. The containment is one of the most important components of an NPP because it serves as the final barrier under postulated accident conditions.
In the last decade, there is a keen interest on modeling the reactor buildings by using simplified 2D lumped-mass stick model [3, 4, 5, 6, 7]. The results of the analysis may not be considered as accurate as 3D finite element modeling, although the latter one is more time consuming. In the 3D approach, a containment building is generally modeled using either by shell or 3D brick elements [8, 9, 10]. In a recent approach to save time, 3D lumped mass stick models were developed and used in the literature to represent the seismic behavior of containment building [11]. This approach is mostly preferred when the coupling effects between the containment building and auxiliary buildings are considered. Improvements in computational efficiency increased the use of 3D finite element models which are capable of defining high levels of structural detail.
While a possible damage in an infra-structure can be repaired or retrofitted within mean time, a possible damage in an NPP may cause catastrophic damage. The massive damage in an NPP may be observed when an internal accident happens such as loss of coolant accident (LOCA) or when an external event (airplane crash, earthquake, explosions etc.) happens. To overcome these deficiencies the majority of the latest NPP’s are constructed with double containment. Further, in advance, the containment structure constitutes an ultimate barrier against the dissemination of fissile products towards the general public [12].
Kwak and Kim [13] highlighted that most of the recent containments are composed of a dome, a wall and a foundation which are laterally prestressed. The International Federation for Structural Concrete (fib) [14] reported that the response of these shell-type concrete structures due to external events should be experimentally and analytically studied to evaluate their safety. There are numerous experiments in the literature which can be regarded as representative experimental studies. Sandia National Laboratories [15] brought foreword the cost and time-consuming features of the conducted experiments and emphasized that these costly experiments often do not precisely simulate the loading and support conditions of the actual structure.
In this study, seismic behavior of the prestressed outer containment of a third-generation nuclear reactor building is evaluated. Since Turkish Building Earthquake Code (TBEC) [16] does not cover the earthquake resistant design of nuclear structures, international standards such as ASCE 4-16 [17] and ASCE 43-05 [18] have been adopted for the analysis. First, a 3D model of the outer containment vessel has been set up using ABAQUS finite element program. Afterwards, modal analysis is conducted to determine the mode shapes and followed by nonlinear dynamic time history analysis using previously selected ground motions to determine the stress distribution and crack propagation.
Both the Sandia National Laboratories and United States Nuclear Regulatory Commission (USNRC) conducted test programs concerning about the seismic performance of prestressed containments under severe accident conditions. The experiment model was 1:4 prestressed containment and it was conducted in two phases. Determination of the ultimate load capacity and seismic response were carried in the first phase, whereas beyond design basis response was the aim of second phase. More details about this experiment may be found in Hessheimer et al. [19, 20].
A sectional view of the considered test building is illustrated in Figure 1. The structure has an overall height of 16.4 m, the inner radius of the dome is 5.37 m and the cylinder wall has a thickness of 0.325 m. The bottom part of the structure is fixed, gallery and buttresses are incorporated into the system. Prestressing force is applied by using horizontal and vertical tendons which are anchored at the buttresses and gallery, respectively. Around the gallery and buttresses steel rebars are used to enhance the capacity of the double-shell containment building.
Sectional view of the considered test building.
The three-dimensional model of the test structure has been modeled using shell elements. Smeared steel layers have been used to simulate both the steel reinforcements and prestressing tendons. The created three-dimensional model has been illustrated in Figure 2. To satisfy the experiment conditions the containment is assumed as fix, thus boundary conditions are assigned to the structure at the bottom. In literature two alternatives are valid to define the prestressing force: assigning an initial stress value and altering with the temperature of the structure. Here the former methodology is applied to properly simulate the prestressing force. The abrupt changes around the openings are neglected. Incremental load steps are used to define the internal pressure values.
Illustration of the three-dimensional model of the reactor building.
Yielding of reinforcing steel and prestressed tendons has been selected as the criteria of failure in any location in the containment. The total mass of the structure has been calculated as 2,956,294 kg and the results of the eigenvalue analysis are summarized in Table 1.
Mode No | Eigenvalue | Frequency | |
---|---|---|---|
(rad/time) | (cycles/time) | ||
1 | 0.36315 | 0.60262 | 9.5910E-02 |
2 | 0.52506 | 0.72461 | 0.11533 |
3 | 4.6031 | 2.1455 | 0.34146 |
4 | 6.6812 | 2.5848 | 0.41138 |
5 | 12.831 | 3.5820 | 0.57009 |
6 | 18.840 | 4.3405 | 0.69081 |
7 | 31.426 | 5.6059 | 0.89220 |
8 | 40.622 | 6.3735 | 1.0144 |
9 | 43.410 | 6.5887 | 1.0486 |
10 | 45.345 | 6.7339 | 1.0717 |
Eigenvalue output.
The constitutive relation of concrete material is simulated by concrete damaged plasticity model (CDP) of ABAQUS, which is proposed by Lubliner et al. [21] and by Lee and Fenves [22]. This model is preferred by the scientists owing the fact that the model is capable of defining the concrete behavior under cyclic or dynamic loading properly. Further, the material model aims to properly simulate the effects of residual damage. Both the tensile and compressive damages are taken into account in the CDP model. Main contents of the CDP model have been discussed and summarized in the followings.
This is done by assuming an additional strain rate decomposition for the rate independent model which is defined by Eq. (1).
where
This is dominated by scalar damaged elasticity value which can easily be calculated using Eq. (2).
where
It is also possible to relate
These variables control the yield surface, the degradation of the elastic stiffness and the dissipated fracture energy.
The yield function,
When
The
Defining a flow potential value
Using the Drucker-Prager hyperbolic function, the
This section will be considered for both uniaxial and cyclic loading protocols.
Uniaxial loading
The assumption relies on the fact that the uniaxial stress–strain curves can be represented in terms of stress and plastic strain values using Eq. (14).
In Eq. (14) the subscripts
Response of concrete to uniaxial loading.
To properly evaluate the degraded response of concrete two independent damage variables which are assumed as functions of the strain values are introduced:
Defining
When tension loading protocol is the case, cracks propagate in a direction transverse to the stresses. Further, cracks reduce the load bearing capacity of the material and this increases the
Cyclic loading
The interaction of the cracks makes this type of loading protocol more complex to understand the behavior. Previous experiments revealed the fact that there is indeed some recovery of the stiffness and this is named as “the stiffness recovery effect (SRE)”. This is a significant behavior of concrete under cyclic loading, especially when the load changes from tension to compression. To correlate
It is previously shown that
Introducing
This observation in concrete may be accepted as a proof of SRE when cracks close as the load goes from tension to compression. When vice versa is valid, then the tensile stiffness is not recovered. This is ensured in ABAQUS by assuming \t
Cyclic loading protocol for
Isotropic hardening model is used to simulate the elastic–plastic steel behavior. As well as the rebars, prestressed tendons are defined using steel material. This indicates that the yield surface changes in all directions. To define the yield function
Rice [23] brought forward the use of this model especially when the Bauschinger effect is forceful. The strain rate decomposition may be calculated from Eq. (27). When Eq. (27) is integrated through the contour of the yield surface Eq. (28) is obtained.
The elasticity can be then written in terms of two temperature-dependent material parameters. These parameters are generally selected as the bulk modulus,
The constitutive material parameters used in this study for concrete and steel are as given in Tables 2 and 3, respectively.
Parameters | Values |
---|---|
Elastic modulus (MPa) | 3.6 × 104 |
Ultimate tensile strength (MPa) | 2.85 |
Ultimate compressive strength (MPa) | 38.5 |
Poisson ratio | 0.2 |
Density (kg/m3) | 2400 |
Thermal expansion coefficient | 1 × 10−5 |
Viscosity parameter | 0.005 |
Dilation angle | 36.31 |
Eccentricity | 0.1 |
1.16 | |
0.667 |
Parameters of the concrete material.
Parameters | Rebars | Tendons |
---|---|---|
Elastic modulus (MPa) | 2 × 105 | 1.95 × 105 |
Yield strength (MPa) | 486.55 | 1860 |
Yield strain (m/m) | 0.002613 | 0.008745 |
Poisson ratio | 0.3 | 0.3 |
Density (kg/m3) | 7850 | 7850 |
Thermal expansion coefficient | 1 × 10−5 | 1 × 10−5 |
Parameters of the steel material.
Two basic regulations for NPP’s may be named as the 10 CFR 50 and 10 CFR 100 which are published by the Nuclear Regulatory Commission (USNRC) [24, 25]. The former one covers the licensing issues and the latter one explains the steps of evaluating a license. In the latter regulation, two basic earthquakes are defined when performing a seismic hazard assessment: safe shutdown earthquake (SSE) and operating basis earthquake (OBE). While SSE is considered to be the maximum earthquake which could occur at the investigation site, OBE is defined as the earthquake which could be expected to occur at the site during the lifetime of the plant. Further in the regulation, it is stated that the maximum vibratory ground acceleration of the OBE must be at least 33% of the maximum vibratory ground acceleration of the SSE [24, 25].
Nowadays, the methodology for risk analysis involves the use of component fragility curves developed using ground-motion parameters. To obtain the fragility curves the capacity and the demand parameters should be evaluated at first instance. It is a well-known fact that failure of both structural and nonstructural components of an NPP are much more involved with the structural response than the ground parameters.
The FEMA P-58-1 Guidelines [26] provide a basis to improve the risk assessment procedure for NPPs. The guideline develops next-generation tools and new approaches for performance assessment of buildings, with a focus on measuring performance in terms of direct economic loss, casualties and downtime. The FEMA P-58 Guidelines [26] present procedures for performance assessment using a probabilistic framework, which provides a robust methodology to integrate hazard curves, component fragility curves and consequence functions and to capture the dispersions in each of these elements for evaluating the performance of a building. Importantly, the fragility curves used in the analysis are defined in terms of structural response parameters.
ASCE 43-05 [18] provides seismic design criteria for structures, systems, and components (SSC) that are used in nuclear facilities. This is executed by using a graded approach where the design criteria are proportional with the relative importance to safety, magnitude of the seismic event and other factors. To achieve this 20 Seismic Design Bases (SDB) are defined, where for each Seismic Design Category (SDC) probabilistic target performance goals are used. This graded approach is summarized in Table 4. Further in the same guide for each Limit State (LS) an acceptable level of structural response goal is defined. While International Building Code (IBC) [27] may be followed for SDBs defined by SDC1 and 2; for SDBs defined by SDC 3, 4, and 5, ASCE standard should be followed as illustrated in Figure 5. Further in the mentioned code, the Design Basis Earthquake (DBE) is defined by Uniform Hazard Response Spectra (UHRS).
SDC | Limit state | |||
---|---|---|---|---|
A Large permanent distortion (short of collapse) | B Moderate permanent distortion | C Limited permanent distortion | D Essentially elastic | |
SDB-1A ASCE7 | SDB-1B ASCE7 | SDB-1C ASCE7 | SDB-1D NA | |
SDB-2A ASCE7 | SDB-2B ASCE7 | SDB-2C NA | SDB-2D NA | |
SDB-3A ASCE 43-05 | SDB-3B ASCE 43-05 | SDB-3C ASCE 43-05 | SDB-3D ASCE 43-05 | |
SDB-4A ASCE 43-05 | SDB-4B ASCE 43-05 | SDB-4C ASCE 43-05 | SDB-4D ASCE 43-05 | |
SDB-5A ASCE 43-05 | SDB-5B ASCE 43-05 | SDB-5C ASCE 43-05 | SDB-5D ASCE 43-05 |
Graded approach defined in ASCE 43-05 [18].
Seismic design procedure defined in ASCE 43-05 [
For DBE, Limit State A and D are defined as the intensity of the high and low structural damage, respectively. In other words, Limit State D is where complete elastic behavior is dominant. Damage regions between A and D are called the intermediate levels. The deformation limits associated with each Limit State are described in Table 5.
Limit state | Structural deformation limit |
---|---|
Large permanent distortion, short of collapse | |
Moderate permanent distortion | |
Limited permanent distortion | |
Essentially elastic behavior |
Structural deformation limits for limit state defined in ASCE 43-05 [18].
To properly determine the seismic demand, ASCE 43-05 [18] allows use of
The 3D finite element model has been subjected to gravity, wind and snow loads in accordance with Eurocode 1 [30], Section 4. First, to determine the fundamental periods and vibration modes of the considered structure, eigenvalue analyses are performed and eigenvectors have been determined. Figure 6 shows the results of the modal analysis considering first six modes.
Calculated mode shapes and periods.
As it can be inferred from Figure 6, first three modal results reveal the fact that the dome of the reactor building is the most vulnerable section. The displacement value of the dome is calculated approximately 1 mm for the fundamental mode. When considered the higher modes, stress concentrations around operational gaps are observed.
After determining the mode shapes of the outer containment vessel, nonlinear dynamic time history analyses are conducted to assess the seismic behavior of the structure and the stress distribution. For this purpose, PEER database has been used and seven earthquake excitations are first selected in accordance with ATC 58 [31] and scaled to fit Eurocode 8 [32] Soil type B design spectrum. Figure 7 compares Eurocode 8 [32] design spectrum with the spectra of the selected ground motions. The details of the selected strong ground motions are presented in Table 6. Following, an artificial time history record which is compatible with the mean spectrum has been generated and used in the nonlinear dynamic analyses. Figure 8 represents the artificial ground motion.
Comparison of Eurocode 8 design spectrum with the selected ground motions spectra.
No | Earthquake | Station | Mw | Mechanism | Vs30 (m/s) | Rjb (km) | Rrup (km) |
---|---|---|---|---|---|---|---|
1 | Imperial Valley (1979) | Cerro Prieto | 6.53 | Strike slip | 471.53 | 15.19 | — |
2 | Irpinia Italy (1980) | Rionero In Vulture | 6.2 | Normal | 574.88 | 22.68 | 22.69 |
3 | Loma Prieta (1989) | Coyote Lake Dam - Southwest Abutment | 6.93 | Reverse Oblique | 561.43 | 19.97 | 20.34 |
4 | Chi-Chi Taiwan (1999) | CHY010 | 7.63 | Reverse Oblique | 538.69 | 19.93 | 19.96 |
5 | Chi-Chi Taiwan (1999) | TCU075 | 6.3 | Reverse | 573.02 | 24.34 | 26.31 |
6 | Landers (1992) | North Palm Springs Fire Sta #36 | 7.28 | Strike slip | 367.84 | 26.95 | 26.95 |
7 | Chuetsu-oki Japan (2007) | Matsushiro Tokamachi | 6.8 | Reverse | 640.14 | 18.16 | 25.03 |
Details of the selected strong ground motions.
Artificial ground motion.
Modified Newton–Raphson iterative procedure has been followed during the dynamic analysis. ABAQUS offers several convergence norms. Besides stopping the iteration in case of convergence, the iteration process is also stopped if a specified maximum number of iterations has been reached or if the iteration obviously leads to divergence. The detection of divergence is based on the same norms as the detection of convergence. A preferred way to check the convergence is the energy norm.
As the consequence of dynamic analysis total displacement, total deformation and total stress concentration values are illustrated in Figure 9. It should also be highlighted that results of the modal analysis are in good correlation with the dynamic results and the most vulnerable section is assessed as the dome of the structure. In Figure 9(a), total displacement graph has been presented. The maximum displacement value has been calculated as 7.625 mm at the roof. The deformation graph, which is represented in Figure 9(b), is compatible with the stress concentration that is represented in Figure 9(c). Total displacement and stress concentration graphs of the prestressed tendons are given in Figure 10(a) and (b), respectively.
Nonlinear dynamic time history results of the outer containment: (a) total displacement, (b) total deformation and (c) total stress concentration.
Nonlinear dynamic time history results of the prestressed tendons: (a) total displacement and (b) total stress concentration.
In this study, seismic behavior of the outer containment of a sample reactor building has been analyzed. First, details of the 3D model have been presented, and material models are described in detail. Following that, results of the eigenvalue analysis are discussed. Then, nonlinear time history analyses are conducted using the artificial record which is compatible with the mean design spectrum of the selected ground motions that are previously scaled to Eurocode 8 Soil Type B design spectrum.
The primary outcome of the study is that the most critical section of a reactor building may be assessed as the dome of the structure. More care should be given while designing the dome. In the recent literature, to overcome the deficiencies of prestressed concrete, use of fiber reinforced concrete is proposed due to the fact that these fibers in plain concrete directly effects both the ultimate capacity and post-cracking behavior of a conventional prestressed containment. It may also be interpreted from these ongoing studies that the structural performance of components of an NPP improves when these fibers are used with plain concrete.
It is believed that the study should be developed to consider inelastic behavior of soil and soil-structure interaction effects should be taken into account in the dynamic analysis.
This paper is generated from the PhD study of the corresponding author. The author is grateful for the endless support of her supervisor.
The authors declare no conflict of interest.
In general term, the ventral hernia is the protrusion of intra-abdominal contents, through the anterior abdominal wall fascia defect [1], except groin hernia. In this way ventral hernia may be umbilical, paraumbilical, epigastric, incisional, Spigelian, parastomal, and lumbar. Sometimes this term creates confusion, because in Europe the term “ventral hernia” is used for incisional hernia, while in USA, this term is used for abdominal wall hernia, other than groin hernias [2]. In this chapter we will focus more on incisional hernias because worldwide this is a more common surgical problem.
Primary abdominal hernia can occur spontaneously at any area of natural weakness of abdominal fascia and muscles. Unlike abdominal wall hernias, which occur through a weak anatomical point, incisional hernias occur through a weakness at the site of abdominal wall closure after surgery. Ventral (incision) hernia is a common complication after open abdominal surgeries with an incidence of approximately 10% [3]. The true incidence is difficult to determine; the reasons for this are the lack of standardized definition, the inconsistency of data sources, and short length of follow-up. The reported incidence of incisional hernia after midline laparotomy is 3–20% and becomes doubled if the wound gets an infection [4]. Usually 50% of incisional hernias are detected within 1 year of surgery, but they can occur several years after surgery, with a subsequent risk of 2% per year [5].
Every year in the world, millions of abdominal surgeries are performed for different indications, and incisional hernia is one of the major complications of these surgeries, resulting in an increased morbidity and putting burden of cost on patients. It is estimated that each year approximately 10,000 repairs are performed in the UK, and 100,000 are performed in the USA [6].
Ventral hernias occur through anteriolateral abdominal wall; the structure of this wall consists of many layers including the skin, fat, fascia, muscles, and peritoneum. The order of abdominal wall layers change at different location. Above the arcuate line (imaginary line between the umbilicus and pubic symphysis), the fascia of internal oblique aponeurosis envelopes the rectus sheath. The external oblique aponeurosis always lays anterior to the internal oblique aponeurosis and the transversus abdominis aponeurosis always posterior to it. Below the arcuate line, all three layers of aponeurosis become anterior to the rectus muscle, and it is no longer enveloped. The only fascial layer below the rectus is the transversalis fascia which is separated from the transversus abdominis aponeurosis [7, 8]. These layers work together to give strength to the abdominal wall and prevent the intestine, omentum, and other tissues from bulging out.
Causes of ventral hernia may be congenital (Ehlers-Danlos syndrome, Marfan’s syndrome, etc.) or acquired (surgery, trauma). If patient developed abdominal hernia having no previous surgery at the hernia site, these are often due to weakness in the abdominal wall present at birth. As the patient becomes older or injured, these weaknesses can worsen, leading to hernia. Other risk factors are:
Pregnancy
Obesity
History of previous hernia
History of abdominal surgeries
Injuries to abdominal wall
Family history of hernia
Frequently lifting or pushing heavy objects
Chronic cough
Straining during defecation or micturition
Some medicines, such as steroid
Incision hernia (ventral) can occur after any abdominal surgery, but they are more common in some patients, such as:
Old patient
Obese patient
Diabetics
Patients using steroid
Lung disease
Smoking
Surgical site infection
Postoperative repeated vomiting
Postoperative abdominal distention (intestinal obstruction)
All these have been related to increased incisional hernia rate. This occur most often after a long incision in the middle of the abdomen, but they can occur through incisions anywhere on the abdomen [9]. Sometimes these hernias developed only in part of the incision.
After abdominal surgery, if persistent or repeated, intra-abdominal pressure increased from any cause (ileus, ascites, etc.) can lead to microscopic tears of scar. Over time this can decrease the strength of tissue, predisposing patient to develop hernia. Tissue strength following surgery can only achieve an 80% tensile strength of previous healthy tissue; this is an additional effect in the formation of incisional hernia. In this way after second midline laparotomy, the maximum tissue strength would be 80% of 80%, which will be 64%, and this 80% predicted tensile strength in under perfect conditions, assuming no evidence of malnutrition or wound infection. If these conditions are present, the chance of incisional hernia formation further increases.
Until now it is thought that incisional hernia results mainly from a technical failure in the surgical closure of the abdominal wall. However it is known that, there are complex patients, surgical and post operative, variables influence incisional hernia development.
Patients with some connective tissue diseases (Marfan’s syndrome, osteogenesis imperfecta, and Ehlers-Danlos syndrome) have increased the incidence of incisional hernia [10, 11]. It is concluded from research that collagen metabolism in patients with a hernia is changed at three levels.
The ratio between type I collagen (strong) and type III collagen (weak) is decreased.
The quality of collagen is poor.
Collagen breakdown is increased via increased matrix metalloproteinase (MMP) activity [12].
However it has not been clear and established whether these changes are localized to the hernia site or whether it affects all body tissues. Other patient-related risk factors are shown in Table 1.
Risk factors | Effect on wound healing |
---|---|
Old age (>65 year) | Decreased collagen formation and reduced tissue perfusion |
Atherosclerosis | Wound blood perfusion reduced |
Diabetes | Alteration in microcirculation and reduced inflammatory response |
Obesity | Increased risk of wound infection, presence of obesity related comorbid diseases (diabetes, atherosclerosis, etc.) |
Malignancy or debilitating diseases | Increase chance of malnutrition, wound infection, wound dehiscence, poor wound healing |
Renal failure | Abnormal metabolic conditions prevent normal granulation tissue |
Protein deficiency | Reduced collagen formation |
Immunosuppression | Increased chance of wound infection, alteration in normal tissue regeneration |
Smoking | Vasoconstriction and repeated increased intra-abdominal pressure from coughing |
Drugs (steroid, etc.) | Immunosuppression, reduced vascular perfusion |
Vitamin C deficiency | Reduced collagen formation |
Patient-related risk factors for incisional hernia development.
Though incisional hernias can occur after any type of laparotomy incision, they are most common after midline (especially upper midline) and transverse incisions [5] .The incidence of incisional hernia after midline abdominal incision is approximately 10.5, and 7.5% after transverse incisions [9]. Research shows that a continuous closure technique with simple running sutures is the best option for closure of laparotomy incisions [13, 14]. The use of slowly absorbable monofilament suture material versus nonabsorbable or braided material decreases the rate of incisional hernia and reduces the postoperative wound infection [13, 14]. Suture length used with ratio to wound length between 4:1 to 5:1 minimizes the risk of incisional hernia [15, 16]. Traditionally surgeons close laparotomy wound with continuous suture placed 10 mm apart and 10 mm away from edge. Recent studies shows that large tissue bites have been shown to be associated with an increase in the amount of necrotic tissue and slackening of the stitches, resulting in increased risk of wound infection and the development of an incisional hernia [17, 18]. Small stitches placed 4–6 mm from the wound edge and 4 mm apart (in the aponeurotic layer only) minimized the risk of incisional hernia from 18 to 5.6% and reduced wound infection rates by 50% [19]. According to recent studies, the surgeon should adopt a small bite technique instead of large bite technique; it may result in better outcome. Surgical factors are summarized in Table 2.
Risk factors | Effect on wound |
---|---|
Midline incisions | Result in increased incidence of incision hernia |
Suture material | The use of slowly absorbable monofilament has a better result |
Suture technique | Sutures having small bite reduce the incidence of incision hernia and wound infection |
Homeostasis | Good bleeding control reduces the chance of wound infection |
Ratio of suture length to wound length | If it is >5.1, it may result in an increased incidence of wound infection |
Overuse of diathermy | Result in more necrotic tissue in wound; this increases the incidence of wound infection |
Prophylactic use of mesh | Reduces the incidence of incision hernia |
Prophylactic antibiotic | Reduces the chance of wound infection |
Showing surgical factors that affect incidence of incision hernia.
The most important and common factor that results in incision hernia formation is wound infection, and it is thought to double the risk1/4. Other factors are increase in intra-abdominal pressure in the immediate postoperative period, such as postoperative ileus, coughing, vomiting, and mechanical ventilation, and also increase in the risk of incisional hernia [20].
After laparotomy, the risk of incisional hernia cannot be eliminated except by avoiding a laparotomy incision. However the risk can be minimized by reducing systemic risk factors, especially smoking, obesity, and nutritional deficiencies, and by optimizing diabetic management. The risk can be further minimized by meticulous surgical technique; when closing the abdominal wall, homeostasis should be secured properly; diathermy use should be avoided to lessen the necrotic tissue in wound; if surgeon suspects that the wound may ooze, drain can be used, but it should be removed as early as possible, to reduce the incidence of wound infection. Prophylactic use of antibiotic at the time of anesthesia induction reduces the incidence of wound infection.
Ventral hernia usually presents as painless bulge or lump in abdomen under the skin, which increases in size over time. Sometimes it presents as only discomfort in abdomen and sometimes discomfort or pain with bulge. Sometimes ventral hernia may cause pain when a patient:
Cough
Strains during defecation
Stands or sit for long time
Lifts or pushes heavy objects
Usually in initial stage, the hernia disappears when the patient lies down and then reappears or enlarges when a patient stands or lifts or pushes something heavy; this is reducible hernia. When the tissues or content inside the hernia becomes adherent to the sac or with each other, then the hernia becomes irreducible. When hernia content becomes stuck or trapped in abdominal muscle, it can cause pain, nausea, vomiting, constipation, etc. If the hernia content especially intestine gets tightly trapped in the tear in the muscles, layer or intestine loop is constricted at the narrow neck of hernia sac or apex of loop of intestine adherent to hernial sac especially at fundus and becomes twisted; the blood supply to the intestine can become cut off or reduced, resulting in bowel necrosis or rupture; this may lead to a potentially life-threatening condition known as “strangulation.” This condition requires emergency surgery. Other symptoms of strangulated hernia include severe abdominal pain, abdominal distention, severe nausea and vomiting, profuse sweating, increased pulse rate, and fever. Initially pain is colicky in nature; if strangulation is not relieved, it will change in character and become continuous or disappear; this is an ominous sign that the intestine becomes necrosed or dead. Figure 1 shows necrosed/gangrenous bowel in strangulated ventral hernia.
Gangrenous bowel of patient in
Strangulated ventral hernia and content are shown in
Usually ventral hernia can be diagnosed by history and clinical examination only. If there is confusion in diagnosis or hernia is complex and complicated, one can advise ultrasound, CT scan or MRI scan, to make the diagnosis confirm and elaborate the anatomy of hernia (Figure 3).
Showing portion of small bowel that is stuck at narrow neck of hernia.
Patients usually present ventral hernia as reducible swelling in abdomen or at the site or near the incision scar of previous surgery; it disappears when the patient lies down and enlarges when the patient stands, coughs, or defecates. On clinical examination, expansile cough impulse will be present. In some cases when a hernia is incarcerated or strangulated, the swelling may be erythematous. Obesity can limit the examination; it is important that the patient should be examined in a different position, as hernia can change with exertion or standing. If incision in there it should be palpated in whole length, because sometimes incisional hernia form at multiple site in a incision, and try to palpate the neck of hernia(whole in fascia at the site of incision), whether it is narrow or broad, narrow neck more prone to strangulate. Sometimes size of fascial defect may be difficult to discern clinically. The size of the peritoneal sac and associated contents is often large, although the fascial defect may be small, particularly in obese patients and after multiple abdominal operations, where there may be many small fascial defects. Usually incisional hernias are asymptomatic, but 20–50% present with pain. Skin changes may present in large and longstanding hernias.
Ultrasonography is commonly used to confirm the clinical diagnosis. The ultrasonography in hernia can reveal the fascial gap with protruding hernia contents. The hernia should increase in size or change location when the patient coughs. Bowels are characterized by peristaltic movement and inside air, whereas the omentum appears as a stationary, space-occupying structure.
In some patients of ventral hernia, detailed diagnostic imaging (ultrasonography, CT scan, and MRI) is indicated; these are:
Obese patients (BMI > 35)
Patients with recurrent incisional hernia
Patient having huge hernia (second abdomen)
Patients having pain within the abdominal wall but with no physical and detectable hernia.
In these patients CT scan with 3D reconstruction is useful. Occult hernia is accurately delineated; the content of sac is defined.
Whenever the patient develops hernia, it will not get better on its own and can get worsen (enlarge) over time. The most common treatment of ventral hernia is surgery. Some hernias are repaired on an elective basis like asymptomatic hernia, but hernia which presents with strangulation requires immediate surgery. Irreducible or incarcerated hernia without strangulation is not a surgical emergency. The risks and benefits of surgery should be discussed with the patient. The patients with reasonable operative risks should have their hernia repaired within a sensible time frame. Nonsurgical management of ventral hernias with the use of binders, trusses, or corsets is considered to be ineffective. This may be the only option in a patient who is not a reasonable candidate for surgery [21, 22, 23].
In the past, before appropriate meshes and techniques for implanting them were available, sutures alone were used to close the weakness in the abdominal wall. These often were unsuccessful in the long term, as in most patients hernia would recur. For some very small ventral hernias, suturing alone remains acceptable.
Commonly ventral hernias are repaired by making an incision over the fascial defect in the abdominal wall. The intestine, fat, or other organs in the hernia are placed back in the abdomen. The defect in muscle or fascia is then closed with sutures alone or is reinforced with mesh. The abdominal wall is then closed with suture over the mesh. Sometime drainage tubes are placed through the skin to prevent serum or blood collection.
At present many types of surgical techniques have been developed to repair hernias. The most important tension-free repair is using mesh. If mesh is used, it should be placed 3 to 5 cm overlapping the edges of the fascial defect. Mesh should be handled meticulously to prevent surgical site infection. The most basic approach is primary open repair without mesh; this is typically reserved for defect in the fascia of less than 2 cm. Open mesh repair has several options, including what type of mesh and where to place the mesh. Main methods of ventral hernia repair are:
Open hernia repair
Minimally invasive hernia repair (laparoscopic)
Robotic ventral hernia repair
Laparoscopic ventral hernia repair, when we compare it with open hernia repair, showed decreased overall complication rate, decreased hospital length of stay, and a quicker return to work. The disadvantage of laparoscopy includes a higher potential for visceral injury, and it is technically more difficult.
Robotic ventral hernia repair has also become popular secondary to increased freedom of motion during surgery. Closing the fascial defect robotically is far easier from a technical standpoint than attempting it with classical laparoscopic instruments. Robotic surgery is more expensive and has longer operative times than laparoscopy.
Not all patients of incisional hernia are suitable for surgical repair, and the risk of surgery must be balanced against the risk of complication if the hernia is left untreated. Small incisional hernia invariably enlarges with times as a result of the continuous intra-abdominal pressure, diaphragmatic contractions, and increased pressure from coughing or straining. Despite recent advances in the management of incisional hernias, the recurrence rate is still high. The method of choice for repair of incisional hernia is still debatable.
It is found that incisional hernia repair without prosthetic mesh is associated with high recurrence rate, whereas hernia repair with mesh results in low recurrence rate. It is accepted that only the small(less than 3 cm) incisional hernia can be repaired by primary tissue approximation with sutures.
Worldwide surgeons use laparoscope to repair the incisional/ventral hernias with promising results. A composite or coated mesh (to reduce the bowel and visceral adhesions) is placed in the intra-peritoneal position, and the hernia is usually not closed. This is said to be an intra-peritoneal onlay mesh. The advantages of the laparoscopic approach are that it allows the whole of the previous incision to be visualized and small fascial defect can be identified, but at the same time it has the disadvantage of relying fully on the strength of the mesh and its fixation. Another disadvantage of laparoscopic repair is that it is criticized for producing cosmetically worse results than the open repair because the hernia sac is not excised and the defect is not closed. Furthermore, laparoscopic repair is not always possible for large incisional hernias or when the hernia extends towards the costal margin or pelvis because adequate mesh overlap cannot easily be achieved.
In practice there are three types of open repair for incisional hernia with mesh—the inlay, onlay, and sublay techniques.
In the inlay method, the mesh is placed between the muscles in a bridging position. Polypropylene mesh anchors to all adjacent tissues and can therefore induce extensive adhesions to the viscera if placed in position where it becomes adjacent to the bowel. The mesh can erode into the intestine and may result in entero-cutaneous fistulas. Recurrence rate for inlay technique is also high: These are the main drawbacks of this method. Therefore this technique is not recommended. Furthermore, the force needed to dislocate a bridged mesh is much lower than for a closed defect.
In the onlay method, the mesh is placed in the subcutaneous prefascial space, over the abdominal wall closure. The main criticism of this method is the high incidence of wound infection and seroma formation.
In the sublay technique, the mesh is placed over the closed posterior rectus sheath and peritoneum. In case if hernia is large and the posterior sheath cannot be closed, the mesh is sometimes used to bridge the defect (gap). The European Hernia Society has adopted a sublay mesh repair as a gold standard open repair.
Common surgical complications after ventral hernias repair are wound infection, mesh infection, seroma, hematoma, recurrence, ileus, intestinal adhesions, injury to abdominal organs, and chronic pain. If pain presents for more than 3 months postoperatively after incisional hernia repair, it is termed as chronic pain. The cause of the pain is poorly understood but probably includes a combination of mesh associated inflammation and nerve damage from mesh fixation.
If incisional hernia has a fascial defect more than 10 cm in transverse diameter, it can be considered as giant incisional hernia. If the patient is obese (BMI > 35), then there are more surgical and anesthetic challenges. These patients often have poor quality abdomen wall musculature; in addition there may be multiple comorbid medical problems. In giant incisional hernia, a further problem that has to be overcome is the risk of serious “loss of domain” once the hernia is repaired, which can result in an abdominal compartment syndrome. Loss of domain implies that a proportion of the abdominal contents entered in the hernia sac permanently outside the natural abdominal cavity. With time abdominal cavity become small, and after long time, if these abdominal contents again reduced to abdominal cavity in hernia repair, it will result in increase intra-abdominal pressure, which result in respiratory compromised and reduced venous drainage, and reduced abdominal organs perfusion.
In such cases to prevent this catastrophe complication, it is necessary to increase the intra-abdominal cavity space, before hernia repair, so that abdominal cavity could be able to accommodate hernia contents easily without increasing intra-abdominal pressure. Preoperative pneumoperitoneum has been used to overcome the problem of loss of domain by increasing the size of the abdominal cavity before hernia repair. Although this technique may be effective, it has not been widely adopted.
The compartment separation technique allows a flap of the rectus muscles, anterior rectus sheath, internal oblique, and transversus abdominis muscle to slide medially, enabling giant hernia defect to be closed. It can be reinforced with mesh.
In premenopausal women, the repair of large incisional hernia imposed especial problems, because elasticity and expansion of the abdominal wall will be needed if the patient subsequent becomes pregnant. Prosthetic mesh reduced the elasticity of abdominal wall enough to cause complication during pregnancy. Small incisional hernia can be left safely until the completion of family. If hernia is large and symptomatic, then it should be fixed, and in these cases it may be better to avoid the use of mesh and to use a sutured repair such as the shoelace technique. It is necessary to warn the patient about the high risk of recurrence with subsequent pregnancy.
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Therefore, two different configurations of holographic lenses (lenses with spherical and cylindrical symmetry) are described in terms of both recording process and optical response characterization. Finally, we propose the possibility to use this new photopolymer to realize holographic solar concentrator for space applications.",book:{id:"5518",slug:"holographic-materials-and-optical-systems",title:"Holographic Materials and Optical Systems",fullTitle:"Holographic Materials and Optical Systems"},signatures:"Maria Antonietta Ferrara, Gaetano Bianco, Fabio Borbone, Roberto\nCentore, Valerio Striano and Giuseppe Coppola",authors:[{id:"104314",title:"Dr.",name:"Maria Antonietta",middleName:null,surname:"Ferrara",slug:"maria-antonietta-ferrara",fullName:"Maria Antonietta Ferrara"},{id:"106792",title:"Dr.",name:"Giuseppe",middleName:null,surname:"Coppola",slug:"giuseppe-coppola",fullName:"Giuseppe Coppola"},{id:"192658",title:"Dr.",name:"Gaetano",middleName:null,surname:"Bianco",slug:"gaetano-bianco",fullName:"Gaetano Bianco"},{id:"192659",title:"Dr.",name:"Fabio",middleName:null,surname:"Borbone",slug:"fabio-borbone",fullName:"Fabio Borbone"},{id:"192660",title:"Dr.",name:"Roberto",middleName:null,surname:"Centore",slug:"roberto-centore",fullName:"Roberto Centore"},{id:"192661",title:"Dr.",name:"Valerio",middleName:null,surname:"Striano",slug:"valerio-striano",fullName:"Valerio Striano"}]},{id:"53837",title:"Volume Bragg Gratings: Fundamentals and Applications in Laser Beam Combining and Beam Phase Transformations",slug:"volume-bragg-gratings-fundamentals-and-applications-in-laser-beam-combining-and-beam-phase-transform",totalDownloads:3060,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"Two major volume Bragg grating (VBG) applications will be presented and in particular laser beam combining and holographically encoded phase masks. 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The chapter also demonstrates that binary phase profiles may be encoded into volume Bragg gratings, and that for any probe beam capable of satisfying the Bragg condition of the hologram, this phase profile will be present in the diffracted beam. A multiplexed set of these holographic phase masks (HPMs) can simultaneously combine beams while also performing mode conversion. 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Main aspects of the topic are: Applying bioinformatics in drug discovery and development; Bioinformatics in clinical diagnostics (genetic variants that act as markers for a condition or a disease); Blockchain and Artificial Intelligence/Machine Learning in personalized medicine; Customize disease-prevention strategies in personalized medicine; Big data analysis in personalized medicine; Translating stratification algorithms into clinical practice of personalized medicine.",annualVolume:11403,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/7.jpg",editor:{id:"351533",title:"Dr.",name:"Slawomir",middleName:null,surname:"Wilczynski",fullName:"Slawomir Wilczynski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035U1loQAC/Profile_Picture_1630074514792",institutionString:null,institution:{name:"Medical University of Silesia",institutionURL:null,country:{name:"Poland"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"5886",title:"Dr.",name:"Alexandros",middleName:"T.",surname:"Tzallas",fullName:"Alexandros Tzallas",profilePictureURL:"https://mts.intechopen.com/storage/users/5886/images/system/5886.png",institutionString:"University of Ioannina, Greece & Imperial College London",institution:{name:"University of Ioannina",institutionURL:null,country:{name:"Greece"}}},{id:"257388",title:"Distinguished Prof.",name:"Lulu",middleName:null,surname:"Wang",fullName:"Lulu Wang",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRX6kQAG/Profile_Picture_1630329584194",institutionString:null,institution:{name:"Shenzhen Technology University",institutionURL:null,country:{name:"China"}}},{id:"225387",title:"Prof.",name:"Reda",middleName:"R.",surname:"Gharieb",fullName:"Reda Gharieb",profilePictureURL:"https://mts.intechopen.com/storage/users/225387/images/system/225387.jpg",institutionString:"Assiut University",institution:{name:"Assiut University",institutionURL:null,country:{name:"Egypt"}}}]},{id:"8",title:"Bioinspired Technology and Biomechanics",keywords:"Bioinspired Systems, Biomechanics, Assistive Technology, Rehabilitation",scope:'Bioinspired technologies take advantage of understanding the actual biological system to provide solutions to problems in several areas. Recently, bioinspired systems have been successfully employing biomechanics to develop and improve assistive technology and rehabilitation devices. The research topic "Bioinspired Technology and Biomechanics" welcomes studies reporting recent advances in bioinspired technologies that contribute to individuals\' health, inclusion, and rehabilitation. Possible contributions can address (but are not limited to) the following research topics: Bioinspired design and control of exoskeletons, orthoses, and prostheses; Experimental evaluation of the effect of assistive devices (e.g., influence on gait, balance, and neuromuscular system); Bioinspired technologies for rehabilitation, including clinical studies reporting evaluations; Application of neuromuscular and biomechanical models to the development of bioinspired technology.',annualVolume:11404,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",institutionString:null,institution:{name:"Federal University of Uberlândia",institutionURL:null,country:{name:"Brazil"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"49517",title:"Prof.",name:"Hitoshi",middleName:null,surname:"Tsunashima",fullName:"Hitoshi Tsunashima",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYTP4QAO/Profile_Picture_1625819726528",institutionString:null,institution:{name:"Nihon University",institutionURL:null,country:{name:"Japan"}}},{id:"425354",title:"Dr.",name:"Marcus",middleName:"Fraga",surname:"Vieira",fullName:"Marcus Vieira",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003BJSgIQAX/Profile_Picture_1627904687309",institutionString:null,institution:{name:"Universidade Federal de Goiás",institutionURL:null,country:{name:"Brazil"}}},{id:"196746",title:"Dr.",name:"Ramana",middleName:null,surname:"Vinjamuri",fullName:"Ramana Vinjamuri",profilePictureURL:"https://mts.intechopen.com/storage/users/196746/images/system/196746.jpeg",institutionString:"University of Maryland, Baltimore County",institution:{name:"University of Maryland, Baltimore County",institutionURL:null,country:{name:"United States of America"}}}]},{id:"9",title:"Biotechnology - Biosensors, Biomaterials and Tissue Engineering",keywords:"Biotechnology, Biosensors, Biomaterials, Tissue Engineering",scope:"The Biotechnology - Biosensors, Biomaterials and Tissue Engineering topic within the Biomedical Engineering Series aims to rapidly publish contributions on all aspects of biotechnology, biosensors, biomaterial and tissue engineering. We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics can include but are not limited to: Biotechnology such as biotechnological products and process engineering; Biotechnologically relevant enzymes and proteins; Bioenergy and biofuels; Applied genetics and molecular biotechnology; Genomics, transcriptomics, proteomics; Applied microbial and cell physiology; Environmental biotechnology; Methods and protocols. Moreover, topics in biosensor technology, like sensors that incorporate enzymes, antibodies, nucleic acids, whole cells, tissues and organelles, and other biological or biologically inspired components will be considered, and topics exploring transducers, including those based on electrochemical and optical piezoelectric, thermal, magnetic, and micromechanical elements. Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. Osma",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSDv7QAG/Profile_Picture_1626602531691",institutionString:null,institution:{name:"Universidad de Los Andes",institutionURL:null,country:{name:"Colombia"}}},{id:"69697",title:"Dr.",name:"Mani T.",middleName:null,surname:"Valarmathi",fullName:"Mani T. Valarmathi",profilePictureURL:"https://mts.intechopen.com/storage/users/69697/images/system/69697.jpg",institutionString:"Religen Inc. | A Life Science Company, United States of America",institution:null},{id:"205081",title:"Dr.",name:"Marco",middleName:"Vinícius",surname:"Chaud",fullName:"Marco Chaud",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSDGeQAO/Profile_Picture_1622624307737",institutionString:null,institution:{name:"Universidade de Sorocaba",institutionURL:null,country:{name:"Brazil"}}}]}]}},libraryRecommendation:{success:null,errors:{},institutions:[]},route:{name:"chapter.detail",path:"/chapters/74272",hash:"",query:{},params:{id:"74272"},fullPath:"/chapters/74272",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)}()