Solvatochromic shifts of
\r\n\tThis book intends to provide the reader with a comprehensive overview of the current state-of-the-art novel imaging techniques by focusing on the most important evidence-based developments in this area.
",isbn:null,printIsbn:null,pdfIsbn:null,doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,isSalesforceBook:!1,isNomenclature:!1,hash:"d9159ce31733bf78cc2a79b18c225994",bookSignature:"Dr. Gabriel Cismaru",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11867.jpg",keywords:"Hypertrophic Cardiomyopathy, Dilated Cardiomyopathy, Restrictive Cardiomyopathy, Transesophageal Echocardiography, Intracardiac Echocardiography, 3-Dimensional Echocardiography, Adult Congenital Heart Disease, Tetralogy of Fallot, Transposition of the Great Vessels, Coronary Artery Disease, Risk Stratification, Revascularization",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"April 21st 2022",dateEndSecondStepPublish:"May 19th 2022",dateEndThirdStepPublish:"July 18th 2022",dateEndFourthStepPublish:"October 6th 2022",dateEndFifthStepPublish:"December 5th 2022",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"3 months",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"Dr. Cismaru Gabriel is an Assistant Professor at the University of Medicine and Pharmacy Cluj-Napoca, certified in Cardiology. After completing his certification in cardiology, Dr. Cismaru began his electrophysiology fellowship at the Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu. He has authored or co-authored peer-reviewed articles and book chapters in the field of cardiac pacing, defibrillation, electrophysiological study, and catheter ablation.",coeditorOneBiosketch:"Raluca Tomoaia is an MD, Ph.D. in novel techniques in Echocardiography at the University of Medicine and Pharmacy in Cluj-Napoca, Romania., assistant professor, and a researcher in echocardiography and cardiovascular imaging.",coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"191888",title:"Dr.",name:"Gabriel",middleName:null,surname:"Cismaru",slug:"gabriel-cismaru",fullName:"Gabriel Cismaru",profilePictureURL:"https://mts.intechopen.com/storage/users/191888/images/system/191888.png",biography:"Dr. Cismaru Gabriel is an assistant professor at the Cluj-Napoca University of Medicine and Pharmacy, Romania, where he has been qualified in cardiology since 2011. He obtained his Ph.D. in medicine with a research thesis on electrophysiology and pro-arrhythmic drugs in 2016. Dr. Cismaru began his electrophysiology fellowship at the Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu, France, after finishing his cardiology certification with stages in Clermont-Ferrand and Dinan, France. He began working at the Rehabilitation Hospital\\'s Electrophysiology Laboratory in Cluj-Napoca in 2011. He is an experienced operator who can implant pacemakers, CRTs, and ICDs, as well as perform catheter ablation of supraventricular and ventricular arrhythmias such as ventricular tachycardia and ventricular fibrillation. He has been qualified in pediatric cardiology since 2022, and he regularly performs device implantation and catheter ablation in children. Dr. Cismaru has authored or co-authored peer-reviewed publications and book chapters on cardiac pacing, defibrillation, electrophysiological studies, and catheter ablation.",institutionString:"Iuliu Hațieganu University of Medicine and Pharmacy",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"7",totalChapterViews:"0",totalEditedBooks:"2",institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"16",title:"Medicine",slug:"medicine"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:null},relatedBooks:[{type:"book",id:"5970",title:"Bedside Procedures",subtitle:null,isOpenForSubmission:!1,hash:"ba56d3036ac823a7155f40e4a02c030d",slug:"bedside-procedures",bookSignature:"Gabriel Cismaru",coverURL:"https://cdn.intechopen.com/books/images_new/5970.jpg",editedByType:"Edited by",editors:[{id:"191888",title:"Dr.",name:"Gabriel",surname:"Cismaru",slug:"gabriel-cismaru",fullName:"Gabriel Cismaru"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9064",title:"Epidemiology and Treatment of Atrial Fibrillation",subtitle:null,isOpenForSubmission:!1,hash:"1cd6bf2b3181eb82446347fbe478a2bc",slug:"epidemiology-and-treatment-of-atrial-fibrillation",bookSignature:"Gabriel Cismaru and Keith Andrew Chan",coverURL:"https://cdn.intechopen.com/books/images_new/9064.jpg",editedByType:"Edited by",editors:[{id:"191888",title:"Dr.",name:"Gabriel",surname:"Cismaru",slug:"gabriel-cismaru",fullName:"Gabriel Cismaru"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6550",title:"Cohort Studies in Health Sciences",subtitle:null,isOpenForSubmission:!1,hash:"01df5aba4fff1a84b37a2fdafa809660",slug:"cohort-studies-in-health-sciences",bookSignature:"R. 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Today there is a large variety of published solvatochromic dyes corresponding to different media, e.g. organic solvents [8, 10], ionic liquids [10, 11], solvent mixtures [10, 12, 13, 14, 15] or solvent comprising polarity modifiers [16]. What often appears to be challenging is the choice of a suitable solvatochromic probe for the description of a physicochemical problem encompassing solvent polarity effects. It has been observed that for the same solvent/cosolvent mixture, different solvatochromic dyes may provide different quantitative results [17, 18]. Indeed in many cases, different spectroscopic techniques applied on the same ternary system solvent/cosolvent/probe(solute) may provide different results. Therefore, probing solvent polarity effects and preferential solvation (PS) phenomena occurring in solvent mixtures of two or more solvents are considered as highly difficult tasks [17]. The complexity of those physicochemical problems is high and the interpretation of the solvent-solvent or solute-solvent effects sensed by SPs needs to be carefully undertaken. In this work, the authors examine the solvatochromic responses of two probing groups: the azo-group and the pentacyanoferrate(II) group of three molecules dissolved in binary solvent mixtures (BSMs) involving water and ethylene glycol (EG). From the three molecules employed two are [2]rotaxanes involving
The three solvatochromic compounds involved in this study.
All correlations (single or multi- parameter linear, polynomial regressions and contribution analyses were carried out using statistical software
All compounds involved in this work (
All solvatochromic compounds used in this work are isolated as stable solid compounds of green-blue color. The measurements presented were conducted in fresh solutions of each compound in the desired H2O/EG mixtures (typically prepared 15 min prior to measurement). That time corresponds to the equilibration time (each sample was vigorously stirred after mixing). Directly after this period of time their electronic absorption spectra were recorded. It was observed that in all cases the solutions remained unmodified as concluded through check of the absorbances of the bands maxima which were found to be stable for at least 30 minutes after equilibration. This observation clearly indicates that all three compounds are stable in solution and therefore suitable for the current investigation.
In this work a renowned PS model is employed in order to describe PS phenomena occurring in BSMs comprising solvatochromic solutes. The model was introduced by Bagchi and coworkers about thirty years ago and is also known as “the two-phase model of solvation” (TPMS) [32, 33, 34]. TPMS considers that solvent molecules in a BSM are distributed between a local phase and a bulk phase according to Eq. 1. The local phase lies in the vicinity of the solvation area.
In Eq. 1 S1 and S2 symbolize the two mixed solvents in the bulk phase while
In Eq. 2
Finally, Eq. 3, provides
In order to determine isosolvation points (see below) pertaining to PS occurring in solutions of
For a BSM involving solvents
For the determination of
In order to quantify the difference of the extent of PS in aqueous EG through the two different types of transitions (MLCT(PCF) or
In Eq. 5
To understand the role of various solvatochromic parameters expressing solvent polarity, single regression analyses were implemented (general Eq. (6)). SSP-LSERs
Where
Moreover a multiparametric model was employed in order to assess the relative contribution of various solvatochromic parameters expressing solvent polarity, simultaneously. That model is the LSER introduced by Kamlet Abboud and Taft (KAT equation). This renowned LSER (Eq. 7) can provide information on the importance of dipolarity/polarizability, Hydrogen bond donor (HBD) acidity and Hydrogen bond acceptor (HBA) basicity of neat solvents or solvent mixtures.
Where
Through Eqs. 8–9 it is possible to determine the relative contribution (
and
where
1 | 2a | 2b | 1 | 2a | 2b | |
---|---|---|---|---|---|---|
0 | 73.12 | 74.26 | 74.26 | 51.46 | 49.02 | 50.71 |
0.051 | 71.48 | 73.88 | 73.50 | 49.06 | 48.67 | 48.85 |
0.097 | 72.38 | 73.50 | 73.88 | 48.44 | 47.16 | 47.18 |
0.139 | 70.77 | 72.38 | 72.57 | 47.26 | 46.15 | 47.18 |
0.178 | 69.91 | 71.48 | 71.48 | 46.23 | 45.36 | 46.67 |
0.212 | 69.73 | 71.48 | 71.48 | 46.34 | 44.50 | 46.50 |
0.245 | 69.73 | 71.48 | 71.84 | 45.29 | 44.10 | 46.50 |
0.392 | 69.73 | 70.95 | 71.66 | 45.78 | 43.74 | 44.85 |
0.492 | 69.73 | 70.77 | 71.12 | 45.06 | 42.94 | 43.66 |
0.659 | 69.73 | 70.77 | 70.77 | 43.95 | 41.85 | 42.83 |
0.854 | 69.73 | 70.77 | 70.77 | 42.94 | 41.08 | 41.94 |
1 | 69.73 | 70.42 | 70.42 | 41.60 | 40.35 | 40.94 |
Solvatochromic shifts of
Data from reference: [19].
Recently Deligkiozi et al. [19] and subsequently Papadakis et al. [37] reported on the solvatochromic behavior of compounds
Interestingly, all three compounds also exhibit another transition which is significantly influenced by solvent polarity. The latter is attributed to the azobenzene group and corresponds to the forbidden
It is important to note here that the
The electronic spectra of compounds A)
Taken together, there is clear evidence that all three compounds are considered to be bisensing as they involve two functional groups (FC and azo groups) both responding to solvent polarity changes however at different extents (Table 1) as it will be thoroughly analyzed.
For a better understanding of the dual solvatochromic behavior of all compounds the analysis of their resonance structures is vital. while resonance structure
Characteristic resonance structures of compound 1.
Finally, structure
The latter interaction of the azo group with its partly reduced neighboring viologen pyridin heterocycle obviously influences the
Frontier orbital representations of the tetraanion of dye
Structure of the anion of dye
It is also noteworthy that in cases
Illustration of the possible solute-solvent interactions in A) the rotaxanes
It is known that solvents with
Plots of the type
A pertinent way to quantify, predict and rationalize solvent effects is the use of linear solvation energy relationships (LSERs). This approach has been employed in numerous research works focusing on solvent effect on a large variety of physicochemical properties [8, 10, 44, 45, 46]. The solvatochromism of PC complexes has been thoroughly investigated in this fashion as well [15, 16, 19, 31]. Particularly in case of PC complexes bearing pyridinic ligands (such as
Plots
Single solvent polarity parameter involving LSERs (SSP-LSERs) were employed in order to investigate the importance of various solvent polarity parameters on
Left column: Plots of
For all three compounds the two main solvatochromic functional groups are the PCF and azo groups which both behave as fairly good HBA-bases being prone to formation of hydrogen bonds between the –CN and –N=N– groups respectively and hydrogen atoms of protic solvents (like water and EG). Therefore, the nearly linear correlation observed between
Taken together, compound
Illustration depicting the goodness of linear fit between
Dimesionless BSM polarity parametersa | ||||
---|---|---|---|---|
0 | 1.000 | 1.20 | 1.17 | 0.14 |
0.051 | 0.971 | 1.19 | 1.01 | 0.44 |
0.097 | 0.948 | 1.18 | 0.96 | 0.49 |
0.139 | 0.930 | 1.17 | 0.92 | 0.52 |
0.178 | 0.916 | 1.16 | 0.87 | 0.53 |
0.212 | 0.904 | 1.15 | 0.87 | 0.54 |
0.245 | 0.895 | 1.14 | 0.87 | 0.55 |
0.392 | 0.861 | 1.08 | 0.88 | 0.53 |
0.492 | 0.844 | 1.04 | 0.88 | 0.55 |
0.659 | 0.821 | 0.98 | 0.87 | 0.60 |
0.854 | 0.806 | 0.93 | 0.88 | 0.55 |
1 | 0.790 | 0.92 | 0.90 | 0.52 |
An alternative way to compare and quantify the solvatochromism of the two solvatochromic chromophores for
Compound | %Pπ* | %P | %P | ||||||
---|---|---|---|---|---|---|---|---|---|
41.70 | 2.106 | 23.58 | 9.370 | 14.07 | 51.05 | 34.88 | 0.4687 | 0.8973 | |
36.73 | 6.425 | 24.15 | 11.64 | 34.70 | 39.18 | 26.12 | 0.2422 | 0.9762 | |
41.37 | 6.902 | 19.94 | 9.330 | 40.71 | 35.11 | 24.18 | 0.3461 | 0.9473 | |
5.724 | 17.50 | 20.44 | 4.753 | 51.27 | 26.63 | 22.10 | 0.6124 | 0.9630 | |
20.42 | 28.96 | 13.26 | 58.56 | 23.77 | 17.67 | 0.3999 | 0.9854 | ||
16.34 | 22.53 | 6.521 | 64.66 | 18.21 | 17.13 | 0.4214 | 0.9845 |
Results of the correlation of experimental
Units: kcal/mol.
The behavior of compound
It is well established that when a polar compound is dissolved in a BSM consisted of two solvents of different polarity, the compound/solute gets solvated selectively by one of the two solvents [17, 18]. This effect is obviously associated with preferential solute-solvent interactions developed in the vicinity of the solute molecules. Due to this effect the region around the solute (the so-called cybotactic region) is characterized by a different solvent/cosolvent molar ratio when compared to the bulk part of the solution i.e. the regions away from the cybotactic region. This interesting phenomenon, is attenuated when the two solvents consisting the BSM are similar in terms of structure and polarity [18]. There are numerous published models allowing for the quantification of selective solvation phenomena applicable to various types of solutes and BSMs. These models are generally categorized in thermodynamic and spectroscopy-based models [18]. In the latter case a solvatochromic solute is often employed in order to probe preferential solvation phenomena in BSMs and using spectrally measured shifts as inputs one can obtain various types of information pertaining to preferential solvation as output e.g. the solvent and cosolvent molar ratios in the cybotactic region. Through various spectroscopy-based models thermodynamic properties can also be determined for instance the molar free energy of transfer of the solute from one solvent to its cosolvent [18]. In this work preferential solvation of compounds
By plotting the experimentally determined MLCT and
Plots of experimental transition (MLCT or
First of all, through the TPMS quantitative treatment the composition of the cybotactic region of solutions of
Compound 1 | Compound 2a | Compound 2b | ||||
---|---|---|---|---|---|---|
0 | 0 | 0 | 0 | 0 | 0 | 0 |
0.051 | 0.569 | 0.660 | 0.510 | 0.526 | 0.553 | 0.555 |
0.097 | 0.590 | 0.561 | 0.560 | 0.555 | 0.610 | 0.526 |
0.139 | 0.635 | 0.766 | 0.599 | 0.662 | 0.610 | 0.642 |
0.178 | 0.681 | 0.952 | 0.634 | 0.784 | 0.630 | 0.784 |
0.212 | 0.675 | 1.000 | 0.676 | 0.784 | 0.637 | 0.784 |
0.245 | 0.728 | 1.000 | 0.698 | 0.784 | 0.637 | 0.731 |
0.392 | 0.702 | 1.000 | 0.719 | 0.880 | 0.714 | 0.757 |
0.492 | 0.740 | 1.000 | 0.770 | 0.917 | 0.782 | 0.846 |
0.659 | 0.807 | 1.000 | 0.853 | 0.917 | 0.838 | 0.917 |
0.854 | 0.880 | 1.000 | 0.922 | 0.917 | 0.907 | 0.917 |
1 | 1 | 1 | 1 | 1 | 1 | 1 |
Preferential solvation results obtained through the PS model.
This becomes more obvious when plotting the
Plots of TPMS- predicted
Compound 1 | Compound 2a | Compound 2b | |
---|---|---|---|
0.18 | 0.20 | 0.30 | |
0.055 | 0.15 | 0.13 | |
0.18 | 0.070 | 0.047 | |
0.12 | 0.053 | 0.17 |
Isosolvation points and
A general conclusion of the present study is that two distinct functional groups acting as chromophores (specifically the FC and azo groups) can probe solvation effects in different ways however this is true only on a quantitative basis. Qualitatively, both functional groups probed a strong negative solvatochromic effect in all cases of molecules studied. It became apparent though that FC is more sensitive to the dipolarity/polarizability of the medium whereas the azo group is slightly more responsive to polarity changes associated to the Lewis acidity and HBD-acidity of the medium. This holds true for compound
The author would like to thank Dr. D. Matiadis (NCSR Demokritos, Athens, Greece) for fruitful discussions revolving around the solvatochromism of heterocyclic compounds. IKY (Greek State Scholarship Foundation) is gratefully acknowledged for financial support to R.P. during his PhD; a part of this work is connected to the work carried out then.
The authors declare no competing financial interest.
In the trend toward minimally invasive surgery, operations for the cervical spine have followed a similar tendency. While microsurgery has been in the lexicon of neurosurgery for ages, one of the earliest uses of the term “minimally invasive” in spine surgery was used by Probst in 1989 to discuss lumbar microdiscectomy [1]. While the term “minimally invasive” has become somewhat of a generic moniker for many different approaches, its intent is to be less traumatic to the patient with lower complication rates.
In the cervical spine, midline sparing posterior procedures such as lateral [2] and far later posterior approaches have afforded the opportunity to use smaller incisions and even endoscopic [3] approaches. Anterior foraminotomy, a disc preserving approach, has also been proposed [4] with favorable results [5]. However, these approaches have given limited access to midline pathologies and offer little benefit for cases with central herniation or instability.
Anterior discectomy alone allows central pathology to be addressed with reasonable success but high reoperation rates [6]. The addition of fusion stabilizes the spine in addition to maintaining distraction and neural foramen patency. Interbody grafts were instrumental in providing this indirect decompression and additional stability. Fusion halts further disc degeneration, preserves sagittal balance, and eliminates segmental instability. Cervical fusion surgery, particularly anterior approaches has followed this minimally invasive trend and become more streamlined.
The anterior cervical discectomy and fusion (ACDF) was first reported in 1955 by Robinson and Smith [7], and this approach quickly became the dominant approach. While the competing Cloward technique [8] offered a high cancellous surface area for fusion, it had a high rate of graft collapse [9] and subsidence rates of up to 9.6% [10]. The shape of the graft provides some intrinsic stability but endplate preparation is more invasive requiring significantly more native bone removal which also predisposed patients to kyphosis [9, 11] at rates up to 9.6% [10]. Furthermore, higher complication rates include up to 4.8% of neurologic injuries [10].
The Smith-Robinson technique [12] is less invasive given that it is endplate sparing and causes minimal vertebral body destruction. It also provides better visualization of the decompression, particularly the uncovertebral joints. Arthrodesis by either technique has proven an effective treatment for cervical spondylosis and disc herniation [9, 13, 14, 15]. Anterior discectomy with fusion has been the prominent surgical treatment for symptomatic cervical spondylosis for over 60 years. Traditionally, bone dowels or spacers were harvested from autologous iliac crest contributing to hip pain rates of up to 39% [16]. This additional procedure has contributed to the relatively longer hospital stays of ACDF patients [17].
Allograft iliac crest provided a respite from further surgical trauma at a second site and was thus less invasive. However, fashioning an appropriate size graft added additional operating time on the back table. Pre-cut fibular strut grafts offered a more convenient and efficient option but are limited in terms of footprint size and have a high cortical to cancellous bone concentration. Machined structural allograft was the next iteration providing greater surface area of the graft and a higher percentage of cancellous bone contact, albeit at a greater cost.
Nonunion and graft subsidence still occurred and titanium plating developed as a more stable option [18]. The plate and four screw construct provided a solid fixation for arthrodesis to occur. With fusion rates of up to 100% [19], this technique became the gold standard for 20+ years. While the uniplate had some early adopters [20], high pseudofusion rates were reported [21].
With load-bearing limitations, limited allograft supply, and concerns over disease transmission from cadaveric bone, titanium cages had a simultaneous rise in popularity particularly in the lumbar spine. The imaging artifact and subsidence of titanium as well as its limited machining options increased the demand for synthetic polymers such as poly ether ether ketone (PEEK). In the cervical spine particularly, PEEK offered the ability to have a number of footprint options as well as height options for corpectomy and multilevel constructs.
The latest stage of cervical fusion has allowed titanium mini plates to incorporate with PEEK spacers as a stand-alone option with internal fixation (Figure 1). This integral plate allows for less bony exposure and potentially less issues with longus colli bleeding, recurrent laryngeal paresis, and sympathetic chain injury at lower levels. Furthermore, the zero- or low-profile interbody plate, as opposed to an on-lay plate, has been shown to have shorter surgical times and lower rates of dysphagia [22]. In addition, these implants have been shown to have lower rates of adjacent segment degeneration (ASD) [23, 24, 25]. However, these implants have been associated with increased rates of kyphosis [26, 27].
Cervical fusion devices showing zero-profile devicie at C5–6 and standard allograft and four screw plate at C6–7.
While the technological advances in arthrodesis have given rise to faster procedures and shorter stays, there has been a concordant rise in cost from zero-dollar autograft to modern-day single-level constructs costing $5–6 K a level. At a time when physician reimbursement is diminishing this rise in per case cost is concerning, although the cost–benefit may be worth it for reduced surgeon’s time.
Cervical fusion is known to alter spinal biomechanics by creating abnormal loads and affecting segmental motion at adjacent vertebrae [28, 29]. These changes may accelerate adjacent disc degeneration through the increased stress on the adjacent disc [29, 30, 31].
Multiple studies have documented evidence of adjacent segment level disease including radiographic findings of new anterior osteophyte formation or enlargement, increased narrowing of an interspace, new DDD, and calcification of the anterior longitudinal ligament [31]. Fusion has shown an increased rate of these compared to arthroplasty. Similarly, the rate of symptomatic disease along with the need for medical treatments related to such was also greater in the fusion cohort.
Multilevel fusion constructs demonstrate even greater stress [32]. These multilevel procedures had higher rates of reoperation, pseudoarthrosis, and complications [33, 34] compared to single-level constructs.
While the ACDF has been the gold standard for years, the well-known effects of motion loss and adjacent segment breakdown have been driving factors for cervical arthroplasty. One such mechanism is the neighboring intradiscal pressure. Fusion constructs produce greater neighboring intradiscal pressure [30] compared to arthroplasty which preserves physiologic intradiscal pressures at neighboring levels.
In essence, arthroplasty is itself less invasive than fusion because of maintained motion and reducing the need for adjacent level surgery. Like the ACDF, cervical arthroplasty has followed a similar trend toward less invasiveness with a more streamlined process and less procedural time. The nomenclature for this procedure has varied markedly to include: anterior cervical discectomy and arthroplasty (ACDA, and abbreviated ACA), artificial disc replacement (ADR), total disc replacement (TDR), cervical total disc replacement (cTDR), cervical disc replacement (CDR), and cervical disc arthroplasty (CDA).
An arthroplasty device must replicate the native disc as much as possible. Three primary considerations include: maintaining intervertebral spacing, allowing for motion with the segment, and maintaining stability with the bones neighboring the segment. The initial stability with screw fixation was the primary focus of early implants while more recent implants relied on press-fit, teeth, and/or keels as well as ligamentum taxis for initial stability. Long-term stability involves ingrowth of bone into porous endplates while at the same time allowing for revision.
The placement of an artificial disc should be done with limited disruption of surrounding anatomy. Arthroplasty by nature relies on the integrity of the neighboring facet joints and ligaments for stability. Likewise, the functioning arthroplasty device should not overload the facets nor unload them.
Replicating motion in all planes but also constraining motion means the device has to mirror physiologic tissue in terms of biomechanics. In addition to allowing loading, flexion/extension, rotation, and lateral bending, the arthroplasty device should optimally allow for translation as well (Figure 2). Ideally, the device would have some natural shock absorption for axial forces. This proved to be a limiting factor in early devices but more modern devices have incorporated this.
Flexion/extension views of the Centinel spine ProDisc-C at C5–6 show arthroplasty device flexing and extending with the spine.
The movement within the implant must be balanced by a stable bone-implant interface anchoring the implant. While a fusion allows for the remodeling of bone, arthroplasty is not afforded such long-term stability. The endplates must allow for a proper degree of bony on-growth while maintaining physiologic loads at this interface to reduce implant failure and endplate failure. The resilience of the implant over the patient’s life span is also an important factor. In the event of implant failure, the design should allow for minimal impact from this failure and ideally offer a radiographic cue to its existence.
Implant material is another factor that must be considered in normal usage. Materials should be chosen that are biocompatible, durable, minimize wear debris, and have a minimal inflammatory response. Additionally, materials should be selected that minimize diagnostic imaging artifact at the index level, but certainly preserving visualization of the adjacent segments is essential.
While fusion has been the gold standard for over sixty years, arthroplasty designs have been developing over a similar time frame. Dr. Ulf Fernstrom studied a spherical intercorporeal endoprosthesis, or simply a stainless-steel ball, placed in the disc space in the late 1950s. He implanted 191 of his “Fernstrom Balls” in the cervical and lumbar spines of 101 patients [35]. The procedure was later abandoned over high failure rates with subsidence, migration, and hypermobility. Methylmethacrylate [36] was used as an alternative to the steel ball but did not gain much traction in the spine world.
Arthroplasty progress was somewhat dormant for approximately 30 years until the stainless-steel ball and socket implants from Bristol/Cummins were developed [37]. These advanced into a ball and trough design that allowed for translational movement to become the commercially available Prestige line from Medtronic. Charite was approved in 2004 as the first FDA-approved commercial spinal arthroplasty device (lumbar spine). Prestige ST was approved in 2007 as the first cervical arthroplasty device. This steel on steel implant was simple but its stainless-steel construction caused significant artifact on MR imaging. Some patients reported clicking sounds from the saddle joint (personal experience). The esthetics and dysphagia of an on-lay plate (Prestige-ST) as well as time-consuming implant procedure with four screw fixation.
Prestige LP was first marketed OUS in 2004 and approved by FDA in 2014. It was a less invasive approach in terms of fixation. As named, the LP design relied on lower-profile press-fit rales and antimigration teeth for fixation. It also had a titanium plasma spray for additional fixation. The implant was also made with a titanium ceramic composite material that provided better imaging characteristics. Arthroplasty implants designed up to this point allowed motion but no elasticity. The elasticity component is key for load-damping properties.
Early arthroplasty devices like the Bristol and Prestige-ST had a prominent four screw construct with a locking mechanism. Subsequent revisions like the Prestige-LP had a lower profile as so named along with no need for screw fixation.
Similar to the trends toward less invasive, more modern implants have also followed the trend toward more physiologic motion. Early arthroplasty devices mirrored general orthopedic implants with two articulating surfaces. In this spine, these first-generation implants relied on metal articulations attached to the endplate above and below the index disc (Bristol and Prestige). The early Bristol disc was a ball and socket which allows lateral bending, rotation, and flexion/extension but not translation. Prestige was created with a trough on the lower articulating surface in order to allow anterior/posterior translation.
General orthopedic implants evolved to incorporate a plastic spacer in hopes of reducing metallic wear debris while also providing better wear characteristics and a minor degree of shock absorption. A high molecular weight polyethylene core was juxtaposed between the metal surfaces. These second-generation devices reduced some of the metal-on-metal concerns but still lacked elasticity like a native disc. The ProDisc returned to a ball and socket approach with the bottom half of the polyethylene core anchored to the inferior endplate. The subsequently released Secure-C preserved the superior ball and socket design but had a saddle design on the inferior endplate articulating surface. This allowed for translation.
The first generation of arthroplasty implants replicated conventional orthopedic implants with metal-on-metal articulating surfaces. These types of implants allow rotation, lateral bending, flexion and extension, and in some cases (Prestige-ST) anterolisthesis.
Implants with a polyethylene core have offered more physiologic movement and less concern over metallic deposition and blood levels. These second-generation implants like ProDisc offered a fixed core while the subsequently released Secure-C offered a sliding arthrodesis.
Keel base implants like the ProDisc and Secure-C had no additional fixation hardware relaying on press-fit, bony on-growth, and keel anchoring stability. Even within the keel-based implants, the Secure-C introduced a shorter, wider keel which required even less exposure in a cranial-caudal direction.
The Nuvasive PCM disc allowed similar translation while also incorporating an arrow-shaped row of teeth as the primary fixation modality. When Mobi-C was released, the mindset was to perform as little endplate preparation as needed. Mobi-C went a step further to offer a circumferentially mobile center of rotation and obtained FDA approval as a two-level implant in 2013 (Figure 3).
The Zimmer Mobi-C was the first arthroplasty device to gain FDA approval in the United States for two-level indications.
While Mobi-C provided even more range of motion, concerns arose regarding hypermobility [38, 39] of the joint and the inability to adequately visualize the mobile core. With a mobile core, there was now a superior and inferior articulating surface to be concerned with, especially in sheer force loading.
Third-generation implants have allowed for translation and compression forces that more closely resemble physiologic motion.
The Bryan cervical disc was under development as early as 1997 by Spinal Dynamics Corporation. This implant relied on the preservation of the natural vertebral concavities with convex titanium shells matching them. The convex portion of the implant has a rough porous coating for bony on-growth. The concave surface of the implant is surrounded by a flexible membrane and lubricant to reduce friction and prevent migration of wear debris. The inner polymer nucleus provides a full range of motion while also allowing for a full range of motion but without loading. The Bryan disc eliminated the need for chiseling of keels but required a complex endplate preparation rig and procedure to shape the vertebral endplates. Subsequent implants like M6 likewise require only a small amount of chiseling for stability.
The Orthotic M6 implant has additional design components that allow more physiologic motions and replicate the physiological phenomenon of progressive resistance to motion in all six degrees of freedom (Figure 4). This design enables the disc to move in all six degrees, with independent angular rotations (flexion-extension, lateral bending, and axial rotation) along with independent translational motions (anterior–posterior and medial-lateral translations), as well as axial compression. This unique compressive ability has been thought to reduce adjacent segment disease specifically.
The Orthofix M-6 implant allows for compressive axial loading.
The M6 is a complex, multi-component implant that contains an artificial nucleus made of Viscoelastic polymer (PCU) designed to simulate the native nucleus structure. It lies adjacent to but is not fixated to two inner titanium endplates. This core nucleus is retained circumferentially between the titanium endplates by a fiber annulus matrix.
This Ultra High Molecular Weight Polyethylene (UHMWPE) fiber matrix is designed to simulate the native annular structure and is wound in a specific pattern, with multiple redundant layers. The matrix is wound around the core and through slots in the two Ti6Al4V titanium alloy inner endplates. Surrounding the flexible portions of the implant is a jacket of viscoelastic polymer (PCU) designed to minimize tissue in-growth and debris migration.
The inner plates are welded to outer plates the surface of which includes low profile fins and are coated with titanium plasma spray (TPS).
Numerous IDE studies have shown the benefits of arthroplasty over fusion, particularly in the cervical spine. In addition to being motion sparing, arthroplasty’s perhaps greater value is in the reduction of adjacent segment breakdown. Several studies have shown lower rates of ASD in patients having undergone arthroplasty compared to their ACDF cohorts. The Secure-C study showed a 4x greater risk of having adjacent segment surgery in the ACDF group.
Lower rates of adjacent segment surgery, not only benefit patients could lower total health care costs. Ironically, this advantage has not been a motivating factor in insurance approval. The author spoke with the Medical Director of one major health insurance provider extolling the benefits of arthroplasty for a 24-year-old patient for whom a single-level ACDF was already approved. In an attempt to get authorization for an artificial disc at C5–6, I said, “I am fighting to get paid less for an operation that will potentially save the patient another surgery and in the end save you money on all accounts.” Their response was, “We don’t care. Our data shows most patients will change insurance carriers in the next five or six years and that doesn’t help us.” (Jason Highsmith, personal communication January 2009.)
Another potential benefit of this reduction of ASD is the ability to only operate on a symptomatic or freshly herniated level and leave other levels with some pathology untreated. In the past, there was a tendency to fuse everything that was abnormal, which of course exacerbates adjacent segment breakdown. This single-level approach for arthroplasty may lead to lower future costs.
ACDF patients had a higher reoperation rate at the index level in most of the IDE studies. Patients underwent a revision for nonunion as well as hardware revisions for screw pullout and plate fracture. One possible explanation is that most surgeons in the IDE study were highly skilled with ACDF procedures and took more time with the ACA procedure with better carpentry and decompression.
One explanation for this is that with arthroplasty there is only one active surface the articulating surface, whereas in ACDF there are two active surfaces of fusion to account for. Because of the need for additional decompression and resection of the uncovertebral joint, more care may be taken during ACA procedures.
Another positive factor for arthroplasty is certainly patient demand and satisfaction. The nomenclature of fusion is rarely a welcome term in clinical practice. At the same time, some patients with significant facet arthropathy or spondyloarthropathy come wanting disc replacement as the latest innovation regardless of their underlying pathology.
One limitation of the early studies was that the control group consisted of allograft spacers with a four-screw on-lay construct. While this was no doubt standard of care at the time these studies were initiated, and potentially still is, new options exist. Stand-alone devices with a cage and integrated plating are an easier construct to implant than a four screw on-lay plates.
While the clinical inclusion criteria for arthroplasty have been fairly stable over the last 20 years, the trend clinically has been more aggressive in indications. Initially, the ideal candidate was a less than 40-year-old patient with a solitary fresh disc, minimal adjacent segment disease, and little spondylosis. Now we are seeing older patients with more chronic disc issues, absent of facet pathology, undergoing arthroplasty. Based on my experience as a principal investigator for three IDE studies, we are seeing arthroplasty being offered to a broader spectrum of patients as surgeons become more comfortable with the procedure (Figures 5 and 6).
Sagittal T2 MRI of a 38-year-old woman with worsening neck pain and radiculopathy. Note multi-level cervical disc herniations with cord impingement. Given her age, nerve impingement, isolated soft tissue pathology, and failure of conservative care patient was an ideal candidate for three-level cervical arthroplasty.
Post-op lateral cervical spine x-ray demonstrating some restoration of lordosis and Orthofix M-6 arthroplasty devices at C3–4, C4–5, and C5–6.
Early in the Globus Secure-C study [40], we observed some heterotopic ossification in spite of oral NSAIDs. This led many surgeons to try additional measures to reduce this phenomenon. Several surgeons sealed the anterior edges of the adjoining bodies with bone wax, particularly where the anterior longitudinal ligament was denuded from the bone. Anecdotally, this appeared to reduce the incidence of HO.
In my experience, I’ve had a lower rate of autofusion by incorporating the same technique along the uncovertebral joints. The proximity of neighboring bone in this area after aggressive decompression puts it at risk for heterotopic bone formation. As such I seal the areas of decorticated bone with a thin layer of bone wax even into the joint.
Many devices have keels or teeth that provide initial fixation. I often “set” the implant into the neighboring bone by compressing the implant using the Caspar pins in compression. This helps reduce overdistraction of the facets as well.
When using a keel-based implant such as ProDisc, I recommend using the mill rather than chiseling. There have been case reports [41, 42] of fractures of the vertebral body using the chisel even in the low-profile Prestige-LP [43]. Similar findings have occurred in lumbar cases with ProDisc-L. [44] where there is no milling rig available. Concern over fractures like these should be even greater in multilevel cases [45]. Interestingly, all of these cases used the bone chisels to make the keel cut. While there is no data to support the use of the milling bit, it appears to be a less invasive option (Figure 7).
Long keels on the Centinel spine ProDisc-C illustrate the intervening vertebral body compromise in patients with short vertebral bodies.
A number of other implant designs have been proposed albeit with little clinical implementation. The hydrogel Prosthetic Disc Nucleus (PDN) is a hydrogel core in a polyethylene shell or jacket meant to only replace the nucleus in the lumbar spine while preserving the annulus fibrosis. This technique relied on the compressed core to be inserted and absorb fluid over the first four or five days allowing it to expand and restore disc height. In the trend toward minimally invasive, there is great potential to become percutaneous. While stem cells have proven useful in osteobiologics, there is still a great need for their development in cartilage and disc replacement. Clearly, the future lies in cellular-based disc repair and reconstruction but for now, that hope is elusive.
This is a brief overview of the main steps involved in publishing with IntechOpen Compacts, Monographs and Edited Books. Once you submit your proposal you will be appointed a Author Service Manager who will be your single point of contact and lead you through all the described steps below.
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\n\nIntechOpen authors can choose whether to publish their book online only or opt for online and print editions. IntechOpen Compacts, Monographs and Edited Books will be published on www.intechopen.com. If ordered, print copies are delivered by DHL within 12 to 15 working days.
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Aalborg University has Two Satellite Campuses, one in Copenhagen (Aalborg University Copenhagen) and the other in Esbjerg (Aalborg University Esbjerg).\n· He is a member of prestigious IEEE (Institute of Electrical and Electronics Engineers), and IAENG (International Association of Engineers) organizations. \n· He is the chief Editor of the Journal of Software Engineering.\n· He is the member of the Editorial Board of International Journal of Computer Science and Software Technology (IJCSST) and International Journal of Computer Engineering and Information Technology. \n· He is also the Editor of Communication in Computer and Information Science CCIS-20 by Springer.\n· Reviewer For Many Conferences\nHe is the lead person in making collaboration agreements between Aalborg University and many universities of Pakistan, for which the MOU’s (Memorandum of Understanding) have been signed.\nProfessor Akbar is working in Academia since 1990, he started his career as a Lab demonstrator/TA at the University of Sussex. After finishing his P. hD degree in 1992, he served in the Industry as a Scientific Officer and continued his academic career as a visiting scholar for a number of educational institutions. In 1996 he joined National University of Science & Technology Pakistan (NUST) as an Associate Professor; NUST is one of the top few universities in Pakistan. In 1999 he joined an International Company Lineo Inc, Canada as Manager Compiler Group, where he headed the group for developing Compiler Tool Chain and Porting of Operating Systems for the BLACKfin processor. The processor development was a joint venture by Intel and Analog Devices. In 2002 Lineo Inc., was taken over by another company, so he joined Aalborg University Denmark as an Assistant Professor.\nProfessor Akbar has truly a multi-disciplined career and he continued his legacy and making progress in many areas of his interests both in teaching and research. 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She created the research group in applied biochemistry in 2017 (https://web.ua.es/en/appbiochem/), and from 1999 to the present has made more than 200 contributions to Spanish and international conferences. Furthermore, she has around seventy-five scientific publications in indexed journals, eighty book chapters, and one patent to her credit. Her research work focuses on microbial metabolism (particularly on extremophile microorganisms), purification and characterization of enzymes with potential industrial and biotechnological applications, protocol optimization for genetically manipulating microorganisms, gene regulation characterization, carotenoid (pigment) production, and design and development of contaminated water and soil bioremediation processes by means of microorganisms. This research has received competitive public grants from the European Commission, the Spanish Ministry of Economy and Competitiveness, the Valencia Region Government, and the University of Alicante.",institutionString:"University of Alicante",institution:{name:"University of Alicante",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null},{id:"15",title:"Chemical Biology",coverUrl:"https://cdn.intechopen.com/series_topics/covers/15.jpg",isOpenForSubmission:!0,editor:{id:"441442",title:"Dr.",name:"Şükrü",middleName:null,surname:"Beydemir",slug:"sukru-beydemir",fullName:"Şükrü Beydemir",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003GsUoIQAV/Profile_Picture_1634557147521",biography:"Dr. Şükrü Beydemir obtained a BSc in Chemistry in 1995 from Yüzüncü Yıl University, MSc in Biochemistry in 1998, and PhD in Biochemistry in 2002 from Atatürk University, Turkey. He performed post-doctoral studies at Max-Planck Institute, Germany, and University of Florence, Italy in addition to making several scientific visits abroad. He currently works as a Full Professor of Biochemistry in the Faculty of Pharmacy, Anadolu University, Turkey. Dr. Beydemir has published over a hundred scientific papers spanning protein biochemistry, enzymology and medicinal chemistry, reviews, book chapters and presented several conferences to scientists worldwide. He has received numerous publication awards from various international scientific councils. He serves in the Editorial Board of several international journals. 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He is a member of the Turkish Biochemical Society, American Chemical Society, and German Genetics society. Dr. Ekinci published around ninety scientific papers, reviews and book chapters, and presented several conferences to scientists. He has received numerous publication awards from several scientific councils. 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He worked on the structure-function relationships of glycoconjugates and his main project was the investigations on the biological roles of the de-N-glycosylation enzymes (Endo-N-acetyl-β-D-glucosaminidase and peptide-N4-(N-acetyl-β-glucosaminyl) asparagine amidase). From 2002 he contributes to the understanding of the Blood-brain barrier functioning using proteomics approaches. He has published more than 70 papers. 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Since then, he has been working as an Adjunct Professor in the same Department at the University of Pavia. His research activity during the first years was primarily focused on the purification and structural characterization of enzymes from animal and plant sources. During this period, Prof. Iadarola familiarized himself with the conventional techniques used in column chromatography, spectrophotometry, manual Edman degradation, and electrophoresis). Since 1995, he has been working on: i) the determination in biological fluids (serum, urine, bronchoalveolar lavage, sputum) of proteolytic activities involved in the degradation processes of connective tissue matrix, and ii) on the identification of biological markers of lung diseases. In this context, he has developed and validated new methodologies (e.g., Capillary Electrophoresis coupled to Laser-Induced Fluorescence, CE-LIF) whose application enabled him to determine both the amounts of biochemical markers (Desmosines) in urine/serum of patients affected by Chronic Obstructive Pulmonary Disease (COPD) and the activity of proteolytic enzymes (Human Neutrophil Elastase, Cathepsin G, Pseudomonas aeruginosa elastase) in sputa of these patients. More recently, Prof. Iadarola was involved in developing techniques such as two-dimensional electrophoresis coupled to liquid chromatography/mass spectrometry (2DE-LC/MS) for the proteomic analysis of biological fluids aimed at the identification of potential biomarkers of different lung diseases. He is the author of about 150 publications (According to Scopus: H-Index: 23; Total citations: 1568- According to WOS: H-Index: 20; Total Citations: 1296) of peer-reviewed international journals. 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She gained considerable experience in developing and validating new methodologies whose applications allowed her to determine both the amount of biomarkers (Desmosine and Isodesmosine) in the urine of patients affected by COPD, and the activity of proteolytic enzymes (HNE, Cathepsin G, Pseudomonas aeruginosa elastase) in the sputa of these patients. Simona Viglio was also involved in research dealing with the supplementation of amino acids in patients with brain injury and chronic heart failure. She is presently engaged in the development of 2-DE and LC-MS techniques for the study of proteomics in biological fluids. The aim of this research is the identification of potential biomarkers of lung diseases. 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He previously worked as a post-doctoral fellow at the Ben-Gurion University of Negev, Israel; University of the Free State, South Africa; and Central University of Technology Bloemfontein, South Africa. He obtained his Ph.D. in Organic Chemistry from Nagaoka University of Technology, Japan. He has published more than seventy-four journal articles and attended several national and international conferences as speaker and chair. Dr. Kendrekar has received many international awards. He has several funded projects, namely, anti-malaria drug development, MRSA, and SARS-CoV-2 activity of curcumin and its formulations. He has filed four patents in collaboration with the University of Central Lancashire and Mayo Clinic Infectious Diseases. His present research includes organic synthesis, drug discovery and development, biochemistry, nanoscience, and nanotechnology.",institutionString:"Visiting Scientist at Lipid Nanostructures Laboratory, Centre for Smart Materials, School of Natural Sciences, University of Central Lancashire",institution:null},{id:"428125",title:"Dr.",name:"Vinayak",middleName:null,surname:"Adimule",slug:"vinayak-adimule",fullName:"Vinayak Adimule",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/428125/images/system/428125.jpg",biography:"Dr. Vinayak Adimule, MSc, Ph.D., is a professor and dean of R&D, Angadi Institute of Technology and Management, India. He has 15 years of research experience as a senior research scientist and associate research scientist in R&D organizations. He has published more than fifty research articles as well as several book chapters. He has two Indian patents and two international patents to his credit. Dr. Adimule has attended, chaired, and presented papers at national and international conferences. He is a guest editor for Topics in Catalysis and other journals. He is also an editorial board member, life member, and associate member for many international societies and research institutions. His research interests include nanoelectronics, material chemistry, artificial intelligence, sensors and actuators, bio-nanomaterials, and medicinal chemistry.",institutionString:"Angadi Institute of Technology and Management",institution:null},{id:"284317",title:"Prof.",name:"Kantharaju",middleName:null,surname:"Kamanna",slug:"kantharaju-kamanna",fullName:"Kantharaju Kamanna",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284317/images/21050_n.jpg",biography:"Prof. K. Kantharaju has received Bachelor of science (PCM), master of science (Organic Chemistry) and Doctor of Philosophy in Chemistry from Bangalore University. He worked as a Executive Research & Development @ Cadila Pharmaceuticals Ltd, Ahmedabad. He received DBT-postdoc fellow @ Molecular Biophysics Unit, Indian Institute of Science, Bangalore under the supervision of Prof. P. Balaram, later he moved to NIH-postdoc researcher at Drexel University College of Medicine, Philadelphia, USA, after his return from postdoc joined NITK-Surthakal as a Adhoc faculty at department of chemistry. Since from August 2013 working as a Associate Professor, and in 2016 promoted to Profeesor in the School of Basic Sciences: Department of Chemistry and having 20 years of teaching and research experiences.",institutionString:null,institution:{name:"Rani Channamma University, Belagavi",country:{name:"India"}}},{id:"158492",title:"Prof.",name:"Yusuf",middleName:null,surname:"Tutar",slug:"yusuf-tutar",fullName:"Yusuf Tutar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/158492/images/system/158492.jpeg",biography:"Prof. Dr. Yusuf Tutar conducts his research at the Hamidiye Faculty of Pharmacy, Department of Basic Pharmaceutical Sciences, Division of Biochemistry, University of Health Sciences, Turkey. He is also a faculty member in the Molecular Oncology Program. He obtained his MSc and Ph.D. at Oregon State University and Texas Tech University, respectively. He pursued his postdoctoral studies at Rutgers University Medical School and the National Institutes of Health (NIH/NIDDK), USA. His research focuses on biochemistry, biophysics, genetics, molecular biology, and molecular medicine with specialization in the fields of drug design, protein structure-function, protein folding, prions, microRNA, pseudogenes, molecular cancer, epigenetics, metabolites, proteomics, genomics, protein expression, and characterization by spectroscopic and calorimetric methods.",institutionString:"University of Health Sciences",institution:null},{id:"180528",title:"Dr.",name:"Hiroyuki",middleName:null,surname:"Kagechika",slug:"hiroyuki-kagechika",fullName:"Hiroyuki Kagechika",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180528/images/system/180528.jpg",biography:"Hiroyuki Kagechika received his bachelor’s degree and Ph.D. in Pharmaceutical Sciences from the University of Tokyo, Japan, where he served as an associate professor until 2004. He is currently a professor at the Institute of Biomaterials and Bioengineering (IBB), Tokyo Medical and Dental University (TMDU). From 2010 to 2012, he was the dean of the Graduate School of Biomedical Science. Since 2012, he has served as the vice dean of the Graduate School of Medical and Dental Sciences. He has been the director of the IBB since 2020. Dr. Kagechika’s major research interests are the medicinal chemistry of retinoids, vitamins D/K, and nuclear receptors. He has developed various compounds including a drug for acute promyelocytic leukemia.",institutionString:"Tokyo Medical and Dental University",institution:{name:"Tokyo Medical and Dental University",country:{name:"Japan"}}},{id:"94311",title:"Prof.",name:"Martins",middleName:"Ochubiojo",surname:"Ochubiojo Emeje",slug:"martins-ochubiojo-emeje",fullName:"Martins Ochubiojo Emeje",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94311/images/system/94311.jpeg",biography:"Martins Emeje obtained a BPharm with distinction from Ahmadu Bello University, Nigeria, and an MPharm and Ph.D. from the University of Nigeria (UNN), where he received the best Ph.D. award and was enlisted as UNN’s “Face of Research.” He established the first nanomedicine center in Nigeria and was the pioneer head of the intellectual property and technology transfer as well as the technology innovation and support center. Prof. Emeje’s several international fellowships include the prestigious Raman fellowship. He has published more than 150 articles and patents. He is also the head of R&D at NIPRD and holds a visiting professor position at Nnamdi Azikiwe University, Nigeria. He has a postgraduate certificate in Project Management from Walden University, Minnesota, as well as a professional teaching certificate and a World Bank certification in Public Procurement. Prof. Emeje was a national chairman of academic pharmacists in Nigeria and the 2021 winner of the May & Baker Nigeria Plc–sponsored prize for professional service in research and innovation.",institutionString:"National Institute for Pharmaceutical Research and Development",institution:{name:"National Institute for Pharmaceutical Research and Development",country:{name:"Nigeria"}}},{id:"436430",title:"Associate Prof.",name:"Mesut",middleName:null,surname:"Işık",slug:"mesut-isik",fullName:"Mesut Işık",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/436430/images/19686_n.jpg",biography:null,institutionString:null,institution:{name:"Bilecik University",country:{name:"Turkey"}}},{id:"268659",title:"Ms.",name:"Xianquan",middleName:null,surname:"Zhan",slug:"xianquan-zhan",fullName:"Xianquan Zhan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/268659/images/8143_n.jpg",biography:"Dr. Zhan received his undergraduate and graduate training in the fields of preventive medicine and epidemiology and statistics at the West China University of Medical Sciences in China during 1989 to 1999. He received his post-doctoral training in oncology and cancer proteomics for two years at the Cancer Research Institute of Human Medical University in China. In 2001, he went to the University of Tennessee Health Science Center (UTHSC) in USA, where he was a post-doctoral researcher and focused on mass spectrometry and cancer proteomics. Then, he was appointed as an Assistant Professor of Neurology, UTHSC in 2005. He moved to the Cleveland Clinic in USA as a Project Scientist/Staff in 2006 where he focused on the studies of eye disease proteomics and biomarkers. He returned to UTHSC as an Assistant Professor of Neurology in the end of 2007, engaging in proteomics and biomarker studies of lung diseases and brain tumors, and initiating the studies of predictive, preventive, and personalized medicine (PPPM) in cancer. In 2010, he was promoted to Associate Professor of Neurology, UTHSC. Currently, he is a Professor at Xiangya Hospital of Central South University in China, Fellow of Royal Society of Medicine (FRSM), the European EPMA National Representative in China, Regular Member of American Association for the Advancement of Science (AAAS), European Cooperation of Science and Technology (e-COST) grant evaluator, Associate Editors of BMC Genomics, BMC Medical Genomics, EPMA Journal, and Frontiers in Endocrinology, Executive Editor-in-Chief of Med One. He has\npublished 116 peer-reviewed research articles, 16 book chapters, 2 books, and 2 US patents. His current main research interest focuses on the studies of cancer proteomics and biomarkers, and the use of modern omics techniques and systems biology for PPPM in cancer, and on the development and use of 2DE-LC/MS for the large-scale study of human proteoforms.",institutionString:null,institution:{name:"Xiangya Hospital Central South University",country:{name:"China"}}},{id:"40482",title:null,name:"Rizwan",middleName:null,surname:"Ahmad",slug:"rizwan-ahmad",fullName:"Rizwan Ahmad",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/40482/images/system/40482.jpeg",biography:"Dr. Rizwan Ahmad is a University Professor and Coordinator, Quality and Development, College of Medicine, Imam Abdulrahman bin Faisal University, Saudi Arabia. Previously, he was Associate Professor of Human Function, Oman Medical College, Oman, and SBS University, Dehradun. Dr. Ahmad completed his education at Aligarh Muslim University, Aligarh. He has published several articles in peer-reviewed journals, chapters, and edited books. His area of specialization is free radical biochemistry and autoimmune diseases.",institutionString:"Imam Abdulrahman Bin Faisal University",institution:{name:"Imam Abdulrahman Bin Faisal University",country:{name:"Saudi Arabia"}}},{id:"41865",title:"Prof.",name:"Farid A.",middleName:null,surname:"Badria",slug:"farid-a.-badria",fullName:"Farid A. Badria",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/41865/images/system/41865.jpg",biography:"Farid A. Badria, Ph.D., is the recipient of several awards, including The World Academy of Sciences (TWAS) Prize for Public Understanding of Science; the World Intellectual Property Organization (WIPO) Gold Medal for best invention; Outstanding Arab Scholar, Kuwait; and the Khwarizmi International Award, Iran. He has 250 publications, 12 books, 20 patents, and several marketed pharmaceutical products to his credit. He continues to lead research projects on developing new therapies for liver, skin disorders, and cancer. Dr. Badria was listed among the world’s top 2% of scientists in medicinal and biomolecular chemistry in 2019 and 2020. He is a member of the Arab Development Fund, Kuwait; International Cell Research Organization–United Nations Educational, Scientific and Cultural Organization (ICRO–UNESCO), Chile; and UNESCO Biotechnology France",institutionString:"Mansoura University",institution:{name:"Mansoura University",country:{name:"Egypt"}}},{id:"329385",title:"Dr.",name:"Rajesh K.",middleName:"Kumar",surname:"Singh",slug:"rajesh-k.-singh",fullName:"Rajesh K. Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329385/images/system/329385.png",biography:"Dr. Singh received a BPharm (2003) and MPharm (2005) from Panjab University, Chandigarh, India, and a Ph.D. (2013) from Punjab Technical University (PTU), Jalandhar, India. He has more than sixteen years of teaching experience and has supervised numerous postgraduate and Ph.D. students. He has to his credit more than seventy papers in SCI- and SCOPUS-indexed journals, fifty-five conference proceedings, four books, six Best Paper Awards, and five projects from different government agencies. He is currently an editorial board member of eight international journals and a reviewer for more than fifty scientific journals. He received Top Reviewer and Excellent Peer Reviewer Awards from Publons in 2016 and 2017, respectively. He is also on the panel of The International Reviewer for reviewing research proposals for grants from the Royal Society. He also serves as a Publons Academy mentor and Bentham brand ambassador.",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",country:{name:"India"}}},{id:"142388",title:"Dr.",name:"Thiago",middleName:"Gomes",surname:"Gomes Heck",slug:"thiago-gomes-heck",fullName:"Thiago Gomes Heck",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/142388/images/7259_n.jpg",biography:null,institutionString:null,institution:{name:"Universidade Regional do Noroeste do Estado do Rio Grande do Sul",country:{name:"Brazil"}}},{id:"336273",title:"Assistant Prof.",name:"Janja",middleName:null,surname:"Zupan",slug:"janja-zupan",fullName:"Janja Zupan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/336273/images/14853_n.jpeg",biography:"Janja Zupan graduated in 2005 at the Department of Clinical Biochemistry (superviser prof. dr. Janja Marc) in the field of genetics of osteoporosis. Since November 2009 she is working as a Teaching Assistant at the Faculty of Pharmacy, Department of Clinical Biochemistry. In 2011 she completed part of her research and PhD work at Institute of Genetics and Molecular Medicine, University of Edinburgh. She finished her PhD entitled The influence of the proinflammatory cytokines on the RANK/RANKL/OPG in bone tissue of osteoporotic and osteoarthritic patients in 2012. From 2014-2016 she worked at the Institute of Biomedical Sciences, University of Aberdeen as a postdoctoral research fellow on UK Arthritis research project where she gained knowledge in mesenchymal stem cells and regenerative medicine. She returned back to University of Ljubljana, Faculty of Pharmacy in 2016. She is currently leading project entitled Mesenchymal stem cells-the keepers of tissue endogenous regenerative capacity facing up to aging of the musculoskeletal system funded by Slovenian Research Agency.",institutionString:null,institution:{name:"University of Ljubljana",country:{name:"Slovenia"}}},{id:"357453",title:"Dr.",name:"Radheshyam",middleName:null,surname:"Maurya",slug:"radheshyam-maurya",fullName:"Radheshyam Maurya",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/357453/images/16535_n.jpg",biography:null,institutionString:null,institution:{name:"University of Hyderabad",country:{name:"India"}}},{id:"418340",title:"Dr.",name:"Jyotirmoi",middleName:null,surname:"Aich",slug:"jyotirmoi-aich",fullName:"Jyotirmoi Aich",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000038Ugi5QAC/Profile_Picture_2022-04-15T07:48:28.png",biography:"Biotechnologist with 15 years of research including 6 years of teaching experience. Demonstrated record of scientific achievements through consistent publication record (H index = 13, with 874 citations) in high impact journals such as Nature Communications, Oncotarget, Annals of Oncology, PNAS, and AJRCCM, etc. Strong research professional with a post-doctorate from ACTREC where I gained experimental oncology experience in clinical settings and a doctorate from IGIB where I gained expertise in asthma pathophysiology. A well-trained biotechnologist with diverse experience on the bench across different research themes ranging from asthma to cancer and other infectious diseases. An individual with a strong commitment and innovative mindset. Have the ability to work on diverse projects such as regenerative and molecular medicine with an overall mindset of improving healthcare.",institutionString:"DY Patil Deemed to Be University",institution:null},{id:"349288",title:"Prof.",name:"Soumya",middleName:null,surname:"Basu",slug:"soumya-basu",fullName:"Soumya Basu",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y000035QxIDQA0/Profile_Picture_2022-04-15T07:47:01.jpg",biography:"Soumya Basu, Ph.D., is currently working as an Associate Professor at Dr. D. Y. Patil Biotechnology and Bioinformatics Institute, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India. With 16+ years of trans-disciplinary research experience in Drug Design, development, and pre-clinical validation; 20+ research article publications in journals of repute, 9+ years of teaching experience, trained with cross-disciplinary education, Dr. Basu is a life-long learner and always thrives for new challenges.\r\nHer research area is the design and synthesis of small molecule partial agonists of PPAR-γ in lung cancer. She is also using artificial intelligence and deep learning methods to understand the exosomal miRNA’s role in cancer metastasis. Dr. Basu is the recipient of many awards including the Early Career Research Award from the Department of Science and Technology, Govt. of India. She is a reviewer of many journals like Molecular Biology Reports, Frontiers in Oncology, RSC Advances, PLOS ONE, Journal of Biomolecular Structure & Dynamics, Journal of Molecular Graphics and Modelling, etc. She has edited and authored/co-authored 21 journal papers, 3 book chapters, and 15 abstracts. She is a Board of Studies member at her university. She is a life member of 'The Cytometry Society”-in India and 'All India Cell Biology Society”- in India.",institutionString:"Dr. D.Y. Patil Vidyapeeth, Pune",institution:{name:"Dr. D.Y. Patil Vidyapeeth, Pune",country:{name:"India"}}},{id:"354817",title:"Dr.",name:"Anubhab",middleName:null,surname:"Mukherjee",slug:"anubhab-mukherjee",fullName:"Anubhab Mukherjee",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y0000365PbRQAU/ProfilePicture%202022-04-15%2005%3A11%3A18.480",biography:"A former member of Laboratory of Nanomedicine, Brigham and Women’s Hospital, Harvard University, Boston, USA, Dr. Anubhab Mukherjee is an ardent votary of science who strives to make an impact in the lives of those afflicted with cancer and other chronic/acute ailments. He completed his Ph.D. from CSIR-Indian Institute of Chemical Technology, Hyderabad, India, having been skilled with RNAi, liposomal drug delivery, preclinical cell and animal studies. He pursued post-doctoral research at College of Pharmacy, Health Science Center, Texas A & M University and was involved in another postdoctoral research at Department of Translational Neurosciences and Neurotherapeutics, John Wayne Cancer Institute, Santa Monica, California. In 2015, he worked in Harvard-MIT Health Sciences & Technology as a visiting scientist. He has substantial experience in nanotechnology-based formulation development and successfully served various Indian organizations to develop pharmaceuticals and nutraceutical products. He is an inventor in many US patents and an author in many peer-reviewed articles, book chapters and books published in various media of international repute. Dr. Mukherjee is currently serving as Principal Scientist, R&D at Esperer Onco Nutrition (EON) Pvt. Ltd. and heads the Hyderabad R&D center of the organization.",institutionString:"Esperer Onco Nutrition Pvt Ltd.",institution:null},{id:"319365",title:"Assistant Prof.",name:"Manash K.",middleName:null,surname:"Paul",slug:"manash-k.-paul",fullName:"Manash K. Paul",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/319365/images/system/319365.png",biography:"Manash K. Paul is a scientist and Principal Investigator at the University of California Los Angeles. He has contributed significantly to the fields of stem cell biology, regenerative medicine, and lung cancer. His research focuses on various signaling processes involved in maintaining stem cell homeostasis during the injury-repair process, deciphering the lung stem cell niche, pulmonary disease modeling, immuno-oncology, and drug discovery. He is currently investigating the role of extracellular vesicles in premalignant lung cell migration and detecting the metastatic phenotype of lung cancer via artificial intelligence-based analyses of exosomal Raman signatures. Dr. Paul also works on spatial multiplex immunofluorescence-based tissue mapping to understand the immune repertoire in lung cancer. Dr. Paul has published in more than sixty-five peer-reviewed international journals and is highly cited. He is the recipient of many awards, including the UCLA Vice Chancellor’s award and the 2022 AAISCR-R Vijayalaxmi Award for Innovative Cancer Research. He is a senior member of the Institute of Electrical and Electronics Engineers (IEEE) and an editorial board member for several international journals.",institutionString:"University of California Los Angeles",institution:{name:"University of California Los Angeles",country:{name:"United States of America"}}},{id:"311457",title:"Dr.",name:"Júlia",middleName:null,surname:"Scherer Santos",slug:"julia-scherer-santos",fullName:"Júlia Scherer Santos",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/311457/images/system/311457.jpg",biography:"Dr. Júlia Scherer Santos works in the areas of cosmetology, nanotechnology, pharmaceutical technology, beauty, and aesthetics. Dr. Santos also has experience as a professor of graduate courses. Graduated in Pharmacy, specialization in Cosmetology and Cosmeceuticals applied to aesthetics, specialization in Aesthetic and Cosmetic Health, and a doctorate in Pharmaceutical Nanotechnology. Teaching experience in Pharmacy and Aesthetics and Cosmetics courses. She works mainly on the following subjects: nanotechnology, cosmetology, pharmaceutical technology, aesthetics.",institutionString:"Universidade Federal de Juiz de Fora",institution:{name:"Universidade Federal de Juiz de Fora",country:{name:"Brazil"}}},{id:"219081",title:"Dr.",name:"Abdulsamed",middleName:null,surname:"Kükürt",slug:"abdulsamed-kukurt",fullName:"Abdulsamed Kükürt",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/219081/images/system/219081.png",biography:"Dr. Kükürt graduated from Uludağ University in Turkey. He started his academic career as a Research Assistant in the Department of Biochemistry at Kafkas University. In 2019, he completed his Ph.D. program in the Department of Biochemistry at the Institute of Health Sciences. He is currently working at the Department of Biochemistry, Kafkas University. He has 27 published research articles in academic journals, 11 book chapters, and 37 papers. He took part in 10 academic projects. He served as a reviewer for many articles. He still serves as a member of the review board in many academic journals. He is currently working on the protective activity of phenolic compounds in disorders associated with oxidative stress and inflammation.",institutionString:null,institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"178366",title:"Dr.",name:"Volkan",middleName:null,surname:"Gelen",slug:"volkan-gelen",fullName:"Volkan Gelen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178366/images/system/178366.jpg",biography:"Volkan Gelen is a Physiology specialist who received his veterinary degree from Kafkas University in 2011. Between 2011-2015, he worked as an assistant at Atatürk University, Faculty of Veterinary Medicine, Department of Physiology. In 2016, he joined Kafkas University, Faculty of Veterinary Medicine, Department of Physiology as an assistant professor. Dr. Gelen has been engaged in various academic activities at Kafkas University since 2016. There he completed 5 projects and has 3 ongoing projects. He has 60 articles published in scientific journals and 20 poster presentations in scientific congresses. His research interests include physiology, endocrine system, cancer, diabetes, cardiovascular system diseases, and isolated organ bath system studies.",institutionString:"Kafkas University",institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"418963",title:"Dr.",name:"Augustine Ododo",middleName:"Augustine",surname:"Osagie",slug:"augustine-ododo-osagie",fullName:"Augustine Ododo Osagie",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/418963/images/16900_n.jpg",biography:"Born into the family of Osagie, a prince of the Benin Kingdom. I am currently an academic in the Department of Medical Biochemistry, University of Benin. Part of the duties are to teach undergraduate students and conduct academic research.",institutionString:null,institution:{name:"University of Benin",country:{name:"Nigeria"}}},{id:"192992",title:"Prof.",name:"Shagufta",middleName:null,surname:"Perveen",slug:"shagufta-perveen",fullName:"Shagufta Perveen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192992/images/system/192992.png",biography:"Prof. Shagufta Perveen is a Distinguish Professor in the Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. Dr. Perveen has acted as the principal investigator of major research projects funded by the research unit of King Saud University. She has more than ninety original research papers in peer-reviewed journals of international repute to her credit. She is a fellow member of the Royal Society of Chemistry UK and the American Chemical Society of the United States.",institutionString:"King Saud University",institution:{name:"King Saud University",country:{name:"Saudi Arabia"}}},{id:"49848",title:"Dr.",name:"Wen-Long",middleName:null,surname:"Hu",slug:"wen-long-hu",fullName:"Wen-Long Hu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49848/images/system/49848.jpg",biography:"Wen-Long Hu is Chief of the Division of Acupuncture, Department of Chinese Medicine at Kaohsiung Chang Gung Memorial Hospital, as well as an adjunct associate professor at Fooyin University and Kaohsiung Medical University. Wen-Long is President of Taiwan Traditional Chinese Medicine Medical Association. He has 28 years of experience in clinical practice in laser acupuncture therapy and 34 years in acupuncture. He is an invited speaker for lectures and workshops in laser acupuncture at many symposiums held by medical associations. He owns the patent for herbal preparation and producing, and for the supercritical fluid-treated needle. Dr. Hu has published three books, 12 book chapters, and more than 30 papers in reputed journals, besides serving as an editorial board member of repute.",institutionString:"Kaohsiung Chang Gung Memorial Hospital",institution:{name:"Kaohsiung Chang Gung Memorial Hospital",country:{name:"Taiwan"}}},{id:"298472",title:"Prof.",name:"Andrey V.",middleName:null,surname:"Grechko",slug:"andrey-v.-grechko",fullName:"Andrey V. Grechko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/298472/images/system/298472.png",biography:"Andrey Vyacheslavovich Grechko, Ph.D., Professor, is a Corresponding Member of the Russian Academy of Sciences. He graduated from the Semashko Moscow Medical Institute (Semashko National Research Institute of Public Health) with a degree in Medicine (1998), the Clinical Department of Dermatovenerology (2000), and received a second higher education in Psychology (2009). Professor A.V. Grechko held the position of Сhief Physician of the Central Clinical Hospital in Moscow. He worked as a professor at the faculty and was engaged in scientific research at the Medical University. Starting in 2013, he has been the initiator of the creation of the Federal Scientific and Clinical Center for Intensive Care and Rehabilitology, Moscow, Russian Federation, where he also serves as Director since 2015. He has many years of experience in research and teaching in various fields of medicine, is an author/co-author of more than 200 scientific publications, 13 patents, 15 medical books/chapters, including Chapter in Book «Metabolomics», IntechOpen, 2020 «Metabolomic Discovery of Microbiota Dysfunction as the Cause of Pathology».",institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"199461",title:"Prof.",name:"Natalia V.",middleName:null,surname:"Beloborodova",slug:"natalia-v.-beloborodova",fullName:"Natalia V. Beloborodova",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/199461/images/system/199461.jpg",biography:'Natalia Vladimirovna Beloborodova was educated at the Pirogov Russian National Research Medical University, with a degree in pediatrics in 1980, a Ph.D. in 1987, and a specialization in Clinical Microbiology from First Moscow State Medical University in 2004. She has been a Professor since 1996. Currently, she is the Head of the Laboratory of Metabolism, a division of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russian Federation. N.V. Beloborodova has many years of clinical experience in the field of intensive care and surgery. She studies infectious complications and sepsis. She initiated a series of interdisciplinary clinical and experimental studies based on the concept of integrating human metabolism and its microbiota. Her scientific achievements are widely known: she is the recipient of the Marie E. Coates Award \\"Best lecturer-scientist\\" Gustafsson Fund, Karolinska Institutes, Stockholm, Sweden, and the International Sepsis Forum Award, Pasteur Institute, Paris, France (2014), etc. Professor N.V. 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Assistant Coordinator of the Higher Course in Aesthetic and Cosmetic Technology at Universidade Paulista Campus Chácara Santo Antônio. Experience in the Pharmacy area, with emphasis on Pharmacotechnics, Pharmaceutical Technology, Research and Development of Cosmetics, acting mainly on topics such as cosmetology, antioxidant activity, aesthetics, photoprotection, cyclodextrin and thermal analysis.",institutionString:null,institution:{name:"University of Sao Paulo",country:{name:"Brazil"}}},{id:"334285",title:"Ph.D. Student",name:"Sameer",middleName:"Kumar",surname:"Jagirdar",slug:"sameer-jagirdar",fullName:"Sameer Jagirdar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334285/images/14691_n.jpg",biography:"I\\'m a graduate student at the center for biosystems science and engineering at the Indian Institute of Science, Bangalore, India. 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