Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
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We wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\n
Throughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\n
We wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
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These methods include optimal techniques that can link the processing and analysis of nonstationary ECG signals, the various statistical methods of converting ECG data into variant maps, and the application of various ways of identifying premature atrial beats, ECG characteristics of right and left ventricular tachyarrhythmia, and conditions producing left ventricular hypertrophy, including hypertrophic cardiomyopathy. This book is divided into two sections, including basic and practical applications of ECGs. We hope that it will serve as a reference for the techniques used to obtain and process electrical signals for ECGs. This book will also function as an excellent reference for atrial and ventricular tachyarrhythmia.",isbn:"978-1-78984-078-0",printIsbn:"978-1-78984-077-3",pdfIsbn:"978-1-78984-083-4",doi:"10.5772/intechopen.77737",price:119,priceEur:129,priceUsd:155,slug:"practical-applications-of-electrocardiogram",numberOfPages:118,isOpenForSubmission:!1,isInWos:null,isInBkci:!1,hash:"e6ccea0e539a40209a7d3c8507108832",bookSignature:"Umashankar Lakshmanadoss",publishedDate:"February 26th 2020",coverURL:"https://cdn.intechopen.com/books/images_new/7907.jpg",numberOfDownloads:5958,numberOfWosCitations:0,numberOfCrossrefCitations:1,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:9,numberOfDimensionsCitationsByBook:0,hasAltmetrics:1,numberOfTotalCitations:10,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"September 12th 2018",dateEndSecondStepPublish:"October 3rd 2018",dateEndThirdStepPublish:"December 2nd 2018",dateEndFourthStepPublish:"February 20th 2019",dateEndFifthStepPublish:"April 21st 2019",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"13913",title:"Dr.",name:"Umashankar",middleName:null,surname:"Lakshmanadoss",slug:"umashankar-lakshmanadoss",fullName:"Umashankar Lakshmanadoss",profilePictureURL:"https://mts.intechopen.com/storage/users/13913/images/system/13913.jpg",biography:"Dr. Umashankar Lakshmanadoss completed his training at the University of Rochester, NY, USA. 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We present typical examples of a medical case study and technical applications related to diagnosing ECG, which include (i) a recently patented data classifier on the basis of deep learning model, (ii) a deep neural network scheme to diagnose variable types of arrhythmia through wearable ECG monitoring devices, and (iii) implementation of the health cloud platform, which consists of automatic detection, data mining, and classifying via the Android terminal module. Our work establishes a cross-area study, which relates artificial intelligence (AI), deep learning, cloud computing on huge amount of data to minishape ECG monitoring devices, and portable interaction platforms. Experimental results display the technical advantages such as saving cost, better reliability, and higher accuracy of deep learning-based models in contrast to conventional schemes on cardiac diagnosis.",signatures:"Xin Gao",downloadPdfUrl:"/chapter/pdf-download/66540",previewPdfUrl:"/chapter/pdf-preview/66540",authors:[{id:"197818",title:"Mr.",name:"Xin",surname:"Gao",slug:"xin-gao",fullName:"Xin Gao"}],corrections:null},{id:"69455",title:"Combination of the CEEM Decomposition with Adaptive Noise and Periodogram Technique for ECG Signals Analysis",doi:"10.5772/intechopen.86007",slug:"combination-of-the-ceem-decomposition-with-adaptive-noise-and-periodogram-technique-for-ecg-signals-",totalDownloads:727,totalCrossrefCites:0,totalDimensionsCites:2,hasAltmetrics:0,abstract:"The electrocardiogram (ECG) signal is a fundamental tool for patient treatment, especially in the cardiology domain, due to the high mortality rate of heart diseases. The main objective of this paper is to present the most optimal techniques that can link the processing and analysis of ECG signals. This work is divided into two steps. In the first one, we propose a comparison between some denoising techniques that can reduce noise affecting the ECG signals; these techniques are the empirical mode decomposition (EMD), the ensemble empirical mode decomposition (EEMD), and the complete ensemble empirical mode decomposition with adaptive noise (CEEMDAN). In the second one, we make a comparison of three time-frequency techniques: the Choi-Williams (CW), the periodogram (PE), and the smoothed pseudo Wigner-Ville (SPWV). Firstly, the obtained results illustrate the effectiveness of the CEEMDAN in reducing noise that interferes with ECG signals compared to other denoising methods. Secondly, they show that the periodogram time-frequency technique gives a good detection and localization of the main components in the time-frequency plan of ECG signals. This work proves the utility of the combination of the periodogram and CEEMDAN techniques in analyzing the ECG signals.",signatures:"Azzedine Dliou, Samir Elouaham, Rachid Latif and Mostafa Laaboubi",downloadPdfUrl:"/chapter/pdf-download/69455",previewPdfUrl:"/chapter/pdf-preview/69455",authors:[null],corrections:null},{id:"65431",title:"Visualization of ECG Data on Variant Maps",doi:"10.5772/intechopen.83552",slug:"visualization-of-ecg-data-on-variant-maps",totalDownloads:809,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"This chapter presents variant maps for showing potential features in ECG data sets. The variant map is a visualization method different from a traditional ECG. In this chapter, the ECG data sets obtained by clinical ECG monitoring are used as the data source, and the corresponding variant maps are obtained by the variant statistics method. This chapter mainly introduces the variant statistics method about converting ECG data into variant maps. 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The experimental data in this chapter are provided by Xishan People’s Hospital of Wuxi city, including normal ECG signals and abnormal ECG signals (atrial premature beat). The two types of ECG data sequences are processed experimentally through the variant measurement model, and the differences in the variant maps are compared.",signatures:"Lihua Leng, Jeffery Zheng and Jing Zhang",downloadPdfUrl:"/chapter/pdf-download/65482",previewPdfUrl:"/chapter/pdf-preview/65482",authors:[null],corrections:null},{id:"66496",title:"Ventricular Tachycardia and Heart Failure",doi:"10.5772/intechopen.85256",slug:"ventricular-tachycardia-and-heart-failure",totalDownloads:874,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:1,abstract:"Ventricular tachycardia (VT) is a common arrhythmia seen in patients with heart failure (HF) and is now seen more frequently as these patients survive longer with modern therapies. In patients with HF, half of the deaths are sudden due to life-threatening ventricular arrhythmias, including VT. Although disease modifying drugs, such as beta blockers, mineralocorticoid drugs, and angiotensin receptor neprilysin inhibitors, prevent the occurrence of VT to some extent, the mainstay of therapy is the antiarrhythmic drug therapy, implantable cardioverter-defibrillator (ICD) implantation, and traditional radiofrequency catheter ablation. Autonomic nerve system modulation and stereotactic body radiation therapy have emerged as novel techniques for the management of refractory VT cases. Patients with refractory VT and repetitive ICD shocks should be further evaluated regarding the candidacy for left ventricular assist device and transplantation.",signatures:"Hakan Altay",downloadPdfUrl:"/chapter/pdf-download/66496",previewPdfUrl:"/chapter/pdf-preview/66496",authors:[{id:"188670",title:"Associate Prof.",name:"Hakan",surname:"Altay",slug:"hakan-altay",fullName:"Hakan Altay"}],corrections:null},{id:"65193",title:"Genetic Polymorphisms that Playing Role in Development of Hypertrophic Cardiomyopathy",doi:"10.5772/intechopen.83473",slug:"genetic-polymorphisms-that-playing-role-in-development-of-hypertrophic-cardiomyopathy",totalDownloads:738,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Hypertrophic cardiomyopathy (HCM) is a complex heart disease with various physiopathological, morphological, functional, and clinical features. In this disease, HCM is known to be an autosomal genetic disease in more than half of the cases. 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\r\n\tNowadays, the Internet of things (IoT) is a relatively new research field, so several developments and research works focused on this matter can be found in the literature and the market.
\r\n
\r\n\t \r\n\tHowever, now that this technology has advanced enough, it is important to focus our attention on the use that is being made of it to expand its field of application and improve the current systems.
\r\n
\r\n\t \r\n\tTo achieve this goal, this book aims to collect a series of multidisciplinary works and studies about security in IoT systems, reliability mechanism for data transmission, the correct use of the information provided by those systems, and the inference about the data obtained. Moreover classical IoT systems with new approaches will be included.
\r\n
\r\n\t \r\n\tThe main goal of this book is to give a new vision inside IoT systems by combining them with other new technologies, and without losing sight of the new advances and applications around these systems.
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Dr. Dominguez-Morales obtained his Ph.D. at the University of Seville where he is also a Member of the Direction Committee of the EIDUS, member of the Commission for the Dissemination and Promotion of the E.T.S.I.I., and Quality Commission of the master's degree in Computer and Network Engineering.",coeditorOneBiosketch:"An active researcher in the field of Cybersecurity, Business Process Management, and Software Product Lines, a member of the IDEA Research group, University of Seville, where he obtained his Ph.D. degree in 2013. Dr. Varela Vaca was awarded the Best Paper Award at the 3rd International Conference on Dependability(2010), a research grant from the Andalusian Government in 2009, and was nominated as a member of Program Committees such as ISD (2016), BPM Workshops (2017), SIMPDA (2018).",coeditorTwoBiosketch:"A researcher with over 13 years of teaching experience and noteworthy participation in national projects such as BioSense, Vulcano, TETRANAUTA III, and the European project CAVIAR. Dr. Miró Amarante has published her work in the magazine Assistive Technology, in the IBERDISCAP 2000 congress and International Work-Conference on Artificial and Neural Networks, rating B, one of the most important conferences in the field of Neuromorphic Engineering.",coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"144865",title:"Ph.D.",name:"Manuel",middleName:"Jesus",surname:"Dominguez-Morales",slug:"manuel-dominguez-morales",fullName:"Manuel Dominguez-Morales",profilePictureURL:"https://mts.intechopen.com/storage/users/144865/images/system/144865.jpeg",biography:"Computer Science Engineer (2008) and Ph.D in Industrial Informatics (2014) by University of Seville, with a Ms.D. in Engineering and Software Technology (2009) and a Ms.D. in Computer Engineering and Networks (2014). His research fields are focused on Computer Vision, Artificial Intelligence, e-Health, Embedded Systems, Robotics and Neuromorphic Engineering. 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Teaching experience of more than 3,500 hours teaching in undergraduate degrees (Industrial Engineering Degrees, Computer Engineering Degrees, Computer Engineering, Technical Engineering in Computer Systems) and more than 200 hours of teaching in online Master's Degree in Computer Engineering and Master in Biomedical Engineering and Digital Health by the University of Seville. I have been part of the process of implementing the Guidance and Tutorial Action Plan of the ETSII, of the University of Seville, being its coordinator (2014-16). Since 2019, I coordinate the Official Online Master in Biomedical Engineering and Digital Health at the University of Seville, and since May 2020 he has been part of the Advisory Group for Pedagogical Support of Educational Technologies and Digital Resources of the University of Seville. 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1. Introduction
Thromboembolic diseases are a leading source of morbidity and death in the United States. Thrombosis can happen in either the arteries or the veins. Acute myocardial infarction (MI), ischemic stroke, and limb gangrene are all caused by arterial thrombosis. Deep vein thrombosis (DVT), which can cause post-thrombotic syndrome, and pulmonary embolism (PE), which can be fatal or cause thromboembolic pulmonary hypertension, are both examples of venous thromboembolism (VTE). Arterial thrombosis is usually managed using antiplatelet therapy. On the other hand, VTE episodes are typically managed using anticoagulant therapy [1].
Anticoagulant drugs are the mainstay of therapy for many thrombotic disorders. The selection of one agent over the other is usually guided by balancing the risks versus the benefits of these anticoagulants. Also, it requires deep knowledge and understanding of the clinical pharmacology, efficacy, safety, and clinical outcomes for each of these anticoagulants.
Historically. Jay McLean and William Henry Howell discovered heparin a century ago, in 1914. However, it was first used in clinical practice in the 1940s. It’s given subcutaneously or intravenously, and it binds to antithrombin. This will improve its capacity to inactivate several clotting factors such as thrombin, factor Xa, and factor IXa [2]. Later on, several oral and parenteral antithrombotic agents are used to prevent and treat thrombotic episodes. In 1940, Karl Link and colleagues discovered warfarin which is a vitamin-k antagonist. Warfarin was first marketed as a rodenticide. Later on, it was adopted for therapeutic usage as an anticoagulant [3].
In 2003, the discovery of ximelagatran showed that a particular oral thrombin inhibitor might be safe and effective in a range of thrombotic diseases, paving the way for introducing a new class of anticoagulants [4]. Following these advancements, a major millstone was declared in the field of anticoagulation. Several direct oral anticoagulants (DOACs) targeting factors Xa and II were introduced from 2007 to 2014. According to several landmark randomized studies, they were shown to be equally safe and efficacious as warfarin in preventing and treating venous thromboembolism and stroke prevention in atrial fibrillation. These advancements led to an enormous change in the landscape of managing thrombotic events [5].
This chapter is intended to review the currently available oral anticoagulants, including vitamin K antagonists (VKA), such as warfarin, and the (DOACs) such as dabigatran, apixaban, rivaroxaban, and edoxaban. In addition, it will discuss periprocedural management of anticoagulants, reversal modalities and highlight the major future advancements in the field of anticoagulation.
2. Vitamin K Antagonists
Warfarin is a vitamin K antagonist that was approved by the US Food and Drug Authority (FDA) in 1954 for stroke prevention. It is approved in many other indications such as managing and preventing VTE. Until recently, it was the only oral agent approved for these indications. However, more oral anticoagulants have been approved that possess more advantages and better pharmacokinetic properties. However, warfarin still a widely used medication to prevent blood clotting disorders. Warfarin administration remains a challenge despite being used for more than 60 years. Warfarin has a narrow therapeutic index and monitored regularly using international normalized ratio (INR). Duo to it inter and intra individual variation in response and multiple drug and food interactions, warfarin was replaced as a first line anticoagulant agent [6].
2.1 Mechanism of action
Warfarin exerts it anticoagulant effect by interfering with vitamin K epoxide reductase in the liver which serve as a cofactor for the carboxylation of glutamate to γ-carboxyglutamates. This process leads to the inhibition of vitamin K–dependent γ-carboxylation of factors II, VII, IX, and X. However, Vitamin K antagonist does not inhibit the existing γ-carboxyglutamates that can lead to delay in its anticoagulant effect [6].
2.2 Pharmacology
Warfarin consists of a racemic mixture of S-warfarin and R-warfarin, in which the S- form being more active. It has high bioavailability with rapid absorption from the gastrointestinal tract. After drug administration, warfarin reaches maximum concentration within 90 mins. Warfarin is highly albumin bound with a half-life of 36–42 hours. Warfarin is metabolized mainly in the liver through the cytochrome P450 (CYP) enzymes. However, the two isomers and metabolized through a different pathway in the liver. CYP2C9 is associated with the metabolism of the more potent S-warfarin whereas R-warfarin mainly metabolized by CYP1A2 and CYP3A4 [6].
2.3 Indication and dosing
Warfarin has multiple indications including venous thrombosis, prosthetic heart valves and more commonly arterial fibrillation. Usually, the starting dose for warfarin is 5–10 mg daily. However, lower doses can be initiated for patients at high risk of bleeding. Patients with known genetic polymorphism in CYP2C9 or VKORC1 can be more sensitive to warfarin. Also, elderly patients, patients with chronic kidney disease or patients on other medications that can cause bleeding can be initiated at a lower dose and up titrated to INR goal. Duo to its delayed antithrombotic effect, patients with established clot or high risk for thrombosis are bridged with a fast-acting parenteral anticoagulant. Commonly, heparin or enoxaparin are given concomitantly with warfarin until INR is at goal for 2 consecutive days with a minimum of 5 days on parenteral anticoagulant [6].
2.4 Monitoring
Warfarin is a drug known for its narrow therapeutic index as well as having multiple drug and food interactions. Therefore, continuous monitoring is important to ensure anticoagulation efficacy is achieved and severe side effects are avoided. INR is calculated from prothrombin time which is a test that measures how long a clot is formed in a blood sample is performed when patients are on warfarin. Mostly, warfarin is given to achieve an INR goal of 2–3. However, patients with a mechanical mitral valves or mechanical aortic valve replacement with Starr-Edwards or disc valves have a higher INR target of 2.5–3.5 duo to higher thromboembolic risk [6].
2.5 Side effects
One of the major risks associated with using warfarin is bleeding and the severity of bleeding can vary. Majority of bleeding side effect is seen when INR supratherapeutic. Therefore, INR monitored and maintained at target is essential to minimize bleeding risk. There are several approaches to manage a supratherapeutic INR and the choice usually depends on the present or absent of bleeding, severity of bleeding and magnitude in which INR increased. Skin necrosis is a rare complication associated with warfarin administration in patients with protein C or S deficiency [6].
2.6 Drug interaction
Warfarin can interact with large number of medications. Drugs can cause pharmacodynamic or pharmacokinetic interaction with warfarin. Pharmacokinetic interactions involve medications that inhibit or induce CYP2C9, CYP1A2 or CYP3A4 which can alter warfarin concentration. Inhibitors of the CYP enzymes can interfere with warfarin metabolism that leads to higher warfarin concentration. However, CYP enzyme inducers can increase warfarin removal, therefore, decrease its effect. Pharmacodynamic interaction can occur when warfarin given with other anticoagulants, antiplatelet, non-steroidal anti-inflammatory drugs, or serotonin Reuptake Inhibitors. In which, these drugs can increase risk of bleeding [6].
3. Direct Oral Anticoagulants
Direct oral anticoagulants (DOACs) have been introduced to the market initially in 2010 as a potential alternative for warfarin. They possess many advantages over warfarin that placed them as the first-line anticoagulant option for many indications. These agents include apixaban, rivaroxaban, edoxaban, and dabigatran. All of these agents do not require regular monitoring of their anticoagulant effect and they achieve the target anticoagulation level shortly given their fast onset of action compared to warfarin. These significant advantages placed these agents as the preferred anticoagulant option by patients and clinicians [7].
3.1 Mechanism of action
Factor Xa is a crucial coagulation factor in the coagulation cascade that leads to the formation of thrombin and clot generation. Apixaban, rivaroxaban, and edoxaban, bind directly and reversibly to factor Xa and inhibit its action leading to a strong anticoagulation activity. On the other side, dabigatran inhibits directly factor IIa (thrombin), leading to the prevention of clot formation [8].
3.2 Pharmacology
Apixaban binds directly to factor Xa when free and when thrombin bound. It has a bioavailability of approximately 50% and reaches a plasma peak in about 2 hours with maximum plasma concentration in about 3 to 4 hours. It has a half-life of approximately 12 hours after oral administration necessitating twice-daily dosing. It is metabolized mainly by CYP3A4 and eliminated in both urine and feces. Renal elimination accounts for 27% of total clearance. Apixaban has no interaction with food but is a substrate of P-glycoprotein (P-gp) and CYP3A4 requiring vigilant review of concurrent medications for possible drug–drug interactions [9].
Dabigatran is the active form of the prodrug dabigatran etexilate, which binds thrombin directly and competitively inhibiting its activity. The approximate bioavailability of dabigatran after oral administration is 3–7%, with peak plasma concentration achievement within 2 hours. The bioavailability increased to 75% after the pellets were taken without the capsule. Therefore, the capsules should not be broken, chewed, or opened before administration. The half-life of dabigatran is approximately 12–17 hours, necessitating twice-daily dosing. Dabigatran is mainly eliminated in the urine with a renal clearance of roughly 80%. It is a substrate of P-gp and therefore, it carries a risk for drug–drug interactions [9].
Edoxaban binds selectively to factor Xa and inhibits its action without the need for a cofactor (i.e., antithrombin III). It has a bioavailability of approximately 62% and reaches a peak plasma concentration in about 1 to 2 hours. It has a half-life of approximately 10–14 hours, and 50% of the total clearance is through urine. Therefore, edoxaban blood levels are increased or decreased in patients with poor or good renal function. Edoxaban is a substrate for P-gp and CYP3A4, increasing the risk for drug–drug interactions [9].
Rivaroxaban is a selective inhibitor of factor Xa with no requirement for a cofactor (i.e., antithrombin III) with no direct effect on platelet aggregation. It has a very high bioavailability following oral administration of 2.5 mg and 10 mg doses reaching 80–100%. Administration with food increases the bioavailability of rivaroxaban. Therefore, it should be taken with food. Peak plasma concentration is achieved in about 2 to 4 hours. It has a renal clearance of up to 30%. Rivaroxaban is a substrate for P-gp increasing the risk of drug–drug interactions [9]. Table 1 summarizes the pharmacological properties of DOACs.
Apixaban
Dabigatran
Edoxaban
Rivaroxaban
Mechanism of action
Factor Xa
Thrombin
Factor Xa
Factor Xa
Pro-drug
No
Yes
No
No
Bioavailability
50%
3%-7%
62%
66%-80%
Time to peak
2 hours
2 hours
1-2 hours
2-4 hours
Half-life
12 hours
12-17 hours
12-14 hours
9-13 hours
Protein binding
87%
35%
55%
90%
Renal elimination
27%
80%
50%
30%
Substrate of CYP3A4
Yes
No
Yes
Yes
Substrate of P-gp
Yes
Yes
Yes
Yes
Dialyzable
No
Yes
No
No
Table 1.
Pharmacological properties of DOACs.
3.3 Indications and dosing
DOACs are currently used in different indications, including reducing the incidence of stroke in patients with NVAF, treatment of acute VTE, and reducing the risk of recurrent VTE. Finally, apixaban, rivaroxaban, and dabigatran have been approved by US FDA and European Medical Agency (EMA) for thromboprophylaxis post orthopedic surgeries (i.e., knee and hip replacements). Apixaban and rivaroxaban are approved for post-knee and hip replacement surgeries, and dabigatran is only approved for post-hip replacement surgery. In addition, rivaroxaban is also approved for VTE prophylaxis in acutely ill medical patients at risk for thromboembolic complications, not at high risk of bleeding [9]. Table 2 illustrates the usual dosing recommendations for the various indications.
Apixaban
Dabigatran
Edoxaban
Rivaroxaban
Stroke prevention in nonvalvular atrial fibrillation (NVAF)
5 mg PO BID 2.5 mg PO BID if two of the following occurs:
Age ≥ 80 years
Scr ≥ 1.5 mg/dl
Weight ≤ 60 kg
150 mg PO BID
60 mg PO once daily
Not recommended with CrCl > 95 ml/min
20 mg PO once daily
Treatment of acute venous thromboembolism (VTE)
10 mg PO BID for 7 days, then 5 mg PO BID
Following 5-10 days of initial parenteral therapy: 150 mg PO BID
Following 5-10 days of initial parenteral therapy:
Weight > 60 kg: 60 mg PO once daily
Weight ≤ 60 kg: 30 mg PO once daily
15 mg PO BID for 21 days, then 20 mg PO once daily
Reduction in the risk of recurrent VTE
2.5 mg PO BID
150 mg PO BID
Not approved
10 mg PO once daily
Post-knee/hip replacement DVT prophylaxis
2.5 mg PO BID 12-24 hours post-op
Hip replacement duration: 35 days
Knee replacement duration: 12 days
Hip replacement only: 110 mg PO 1-4 hours post-surgery, then 220 mg PO once daily for 28-35 days
Not approved
10 mg PO once daily 6-10 hours post-op
Hip replacement duration: 35 days
Knee replacement duration: 12 days
VTE prophylaxis in acutely ill medical patients at risk for thromboembolic complications, not at high risk of bleeding
Not approved
Not approved
Not approved
10 mg PO once daily in the hospital and after hospital discharge for a total duration of 31-39 days
Table 2.
DOACs approved indications and recommended doses for normal kidney patients.
3.4 Monitoring
DOACs possess the advantage of having predictable pharmacokinetic and pharmacodynamic properties making their regular monitoring of blood levels or coagulation factors not necessary. This provides a great advantage and more convenience to patients than the traditional anticoagulant warfarin. Currently, there are no validated and clinically feasible tests to measure the anticoagulant effect of DOACs on daily basis. Besides, routine monitoring of kidney function is necessary to ensure appropriate clearance of DOACs as all of them have varying degrees of renal elimination. This becomes of high importance when dealing with end-stage renal disease patients or patients on hemodialysis. Monitoring hepatic function every 6 to 12 months is recommended as all DOACs except dabigatran are metabolized by the liver. Regular follow-up on patient adherence is also encouraged to ensure the safety and efficacy of the anticoagulation given their short duration of action [9].
3.5 Side effects
As with all anticoagulants, the main severe and concerning side effect is bleeding. Careful watching of signs and symptoms of bleeding and proper patient education on identifying them is crucial. Dyspepsia is another reported side effect more linked to dabigatran. Taking dabigatran with food should help with minimizing dyspepsia as the body tolerates the medication with time [10].
3.6 Choosing an anticoagulant agent
Warfarin could be an appealing anticoagulant option in many cases. For example, it could be an adequate option to be sued in patients with an estimated creatinine clearance (CrCl) of less than 30 mL/min as those individuals were excluded from many clinical trials that compared warfarin to the DOACs. Also, it could be used in patients with poor medication adherence. This is mainly because many of the currently available DOACs are dosed to be taken twice daily. This could affect patient adherence. In addition, the presence of laboratory assessment modalities like the INR can identify poor medication adherence. Despite the long list of interacting medications with warfarin, the use of warfarin could be preferred as dose adjustments based on INR monitoring can facilitate titration of the anticoagulant response. Warfarin remains the least expensive anticoagulant currently available. This could make it a reasonable option for individuals who cannot afford the more costly options [11].
DOACs are considered the first line option in many indications given their predicted pharmacokinetics and pharmacodynamics which minimizes the need for regular drug monitoring compared to warfarin. They are dosed either once daily or twice daily and do not have significant drug-food interactions. Patients with various degrees of renal impairment (i.e. CrCL <30 ml/min) were excluded from the DOACs’ pivotal trials, therefore their use in this certain population is debatable. However, apixaban, for example has good pharmacokinetic data supporting its use in hemodialysis (HD) patients as it has very low renal clearance that accounts for only 25%. Currently, apixaban is recommended for stroke prevention in atrial fibrillation patients with end stage renal disease (ESRD) on HD. On the other hand, patients with poor compliance may benefit more from being on warfarin rather than DOACs as the effect of warfarin stays longer than DOACs. If a patient misses one dose of warfarin, the INR would still be in the therapeutic range for one or more days. Finally, the need to monitor kidney function with DOACs still exists and crucial to assess the need for renal dose adjustments [12, 13].
3.7 Periprocedural management of anticoagulation
Management of anticoagulation before and after surgeries such as thrombectomy is very crucial safety step to ensure safe and effective surgical interventions with minimal chances for bleedings. The appropriate knowledge of anticoagulants pharmacokinetics properties and the degree of bleeding risk of the procedure are two essential factors to formulate an appropriate periprocedural anticoagulation plan. Special considerations should be taken with individuals with impaired renal or liver functions [14].
In patients who are on a DOAC and going into a minimal risk procedure, omitting one dose of the anticoagulant on the day of the procedure is sufficient. However, in low or moderate risk procedures, the anticoagulant should be omitted for one day before the procedure and restart one day after the procedure. In high-risk procedures, omitting the DOAC agent two days before and after the procedure would reasonable. Table 3 summarizes the periprocedural management of anticoagulants.
Procedure Bleeding Risk
DOAC
Warfarin
Minimal
Omit anticoagulant on the day of procedure
No interruption needed
Low
Omit anticoagulant one day before the procedure
Reinitiate anticoagulant one day after the procedure
For individuals receiving dabigatran with CrCl 30 to 50 mL/min: omit two days before procedure.
Assess thromboembolic risk:
Low – moderate risk: interrupt 5 days before the procedure without parenteral anticoagulant bridging
High risk: interrupt 5 days before the procedure with parenteral anticoagulant bridging
Moderate
Omit anticoagulant one day before the procedure
Reinitiate anticoagulant one day after the procedure
Assess thromboembolic risk:
Low – moderate risk: interrupt 5 days before the procedure without parenteral anticoagulant bridging
High risk: interrupt 5 days before the procedure with parenteral anticoagulant bridging
Reinitiate warfarin postoperatively once hemostasis is attained
High
Omit anticoagulant two day before the procedure
Reinitiate anticoagulant two day after the procedure
For individuals receiving dabigatran with CrCl 30 to 50 mL/min: omit four days before procedure
interrupt 5 days before the procedure with parenteral anticoagulant bridging
Reinitiate warfarin postoperatively once hemostasis is attained
Table 3.
Periprocedural management of anticoagulants.
On the other side, patients who are on warfarin and undergoing minimal risk procedures, interruption of anticoagulation is not necessary. However, in other low and moderate risk procedures, warfarin should be interrupted with mostly no need for bridging. In high risk, interruption of anticoagulation is needed with bridging. Discontinuation of warfarin should be done five days before the procedure. When bridging is required, starting enoxaparin three days before the procedure is reasonable with last dose being given 24 hours before the procedure. In patients with various degrees of renal impairments may require longer interruption periods as clearance of the anticoagulant may become delayed. Table 3 summarizes the periprocedural management of anticoagulants.
4. Reversal Agents
4.1 Warfarin reversal modalities
Holding or discontinuing warfarin as a solo strategy may be adequate in asymptomatic patients with an elevated INR value and a low risk for bleeding. Certain patient may require further agents to be administered such as, Vitamin K (phytonadione), Prothrombin Complex Concentrate (PCC), and Fresh frozen plasma (FFP) [15].
4.1.1 Vitamin K (Phytonadione)
Exogenous vitamin K level helps reestablishing the hepatic formation of vitamin K–dependent clotting factors. When exogenous vitamin K is given, it can continue to be reduced and converted to its active form, KH2, which results with functional clotting factors despite recent warfarin administration. Vitamin K dose and route of administration vary depends on the bleeding magnitude. It can be given as 2–5 mg PO/IV for minor bleeding events and 5–10 IV for major bleed. Although they are rare, anaphylactic reactions and temporary warfarin resistance have been reported with vitamin K use IV vitamin K normalizes the INR quicker than PO. It only takes 8–12 hours with IV administration and might take up to 24–48 hours following oral administration [15].
4.1.2 Prothrombin Complex Concentrate (PCC)
Clotting factor replenishing, and it can enchase platelet activation. These clotting factors are 25-fold more concentrated than blood. Recombinant activated factor VII (FVIIa) (NovoSeven®) contains activated factor VII can directly activate thrombin generation by binding to tissue factor. PCC products are differentiated by the type of clotting factors they consist of. The 3-factor PCC consist of clotting factors II, IX, and X. The 4-factor PCC 4 consist of clotting factors II, IX, X, and VII (4PCC). Activated 4-factor PCC consist of II, IX, X, and VIIa. All PCC products have natural anticoagulants protein C and protein S. and all PCC products contain heparin, except Profilnine® (3-factor PCC)[15].
PCC dosing is based on factor IX and activated versus non-activated pertains to factor VII. Normally each single-dose vial of PCC is mixed with 10–40 mL of sterile water. Fixed dose PCC for non-intracranial hemorrhagic (ICH) bleed is usually 1000 units while in ICH, it is 1500–2000 units. The other modality to dose PCC is INR and weight driven dose. In patients with INR of 2 to less than 4, the dose is 25 units/kg. In patients with INR of 4–6, the dose is 35 units/kg. In patients with INR of more than 6, the dose is 50 units/kg. PCC dose might need to be rounded up or down to the nearest available vial size. The acceptable dose adjusting margin is institution dependent (usually 5–10%). Infusion related allergic reactions, heparin-induced thrombocytopenia (with exception of Profilnine®) and low acceptable risk of thrombosis have been reported in patients receiving PCC therapy [15].
4.1.3 Fresh frozen plasma (FFP)
FFP is not a specific reversal agent. It contains all coagulation factors, including II, VII, IX, and X in diluted inactive form. Moreover, it contains fibrinogen and platelet. There is no specific recommendation when it comes to FFP dosing, but usually it is given as 10–30 mL/kg (1-unit FFP has a volume of 250 mL). Transfusion reactions, volume overload, infection, and transfusion-related lung injury have been reported in patients receiving FFP therapy [15].
4.2 Direct thrombin inhibitors reversal agents
4.2.1 Idarucizumab
Idarucizumab is a humanized monoclonal antibody fragment that has been developed specifically to reverse the anticoagulation effect of dabigatran [9]. Idarucizumab is indicated for emergent surgery/urgent procedures In life-threatening or uncontrolled bleeding. It is given as a total dose of 5 grams (two separate doses of 2.5 g diluted in 50 mL vials) intravenous infusion over 5 minutes. Idarucizumab carries a warning for inducing thromboembolic events. The thrombotic rate in REVERSE-AD trial was 4.8% at 1 month. The risks of hypersensitivity and severe adverse reactions in patients with hereditary fructose intolerance are reported in the packaging insert due to sorbitol excipient. Among patients who received Idarucizumab, 5% or more experienced hypokalemia, pneumonia, pyrexia, and delirium [9].
4.2.2 Prothrombin Complex Concentrates (PCC)
Inconsistent data was reported regarding the efficacy of PCC in reversing dabigatran based on its laboratory abnormalities. When PCC is used, aPCC such as FEIBA may be preferred. The thrombin generation following PCC administration is dose dependent. Currently most guidelines recommend aPCC 50 units/kg to be given when an emergent reversal is needed for dabigatran. Because of the presence of activated clotting factors, and higher prothrombin and thrombin content in aPCC, the risk of thrombosis is expected to be higher with aPCC than with PCC [9].
4.3 Anti-Xa inhibitors reversal agents
4.3.1 Andexanet alfa
Andexanet alpha is a recombinant modified human “decoy” factor Xa protein, and it works through a competitive binding mechanism with high specificity to direct and indirect anti-Xa agents; to restore the activity of factor Xa and reverses the anticoagulant effect. In May 2018, the FDA approved Andexxa® for the reversal of apixaban and rivaroxaban in the setting of life-threatening or uncontrolled major bleeding. Later, the European Medicine Agency (EMA) gave it a ‘conditional authorization’ in 2019 using the trade name of (Ondexxya®)[9].
Andexanet alpha dosing is either 400 mg IV bolus followed by continuous IV infusion or 800 mg IV bolus followed by 960 mg continuous IV infusion, based on drug, dose, and timing. Treatment with the high dose would cost $49,500 for the drug alone. It is available as 100-mg dry powder vials. It needs to be reconstituted with 10 mL SWFI with typical dissolution time of 3 minutes. Most common reported issues related to andexanet alfa include flushing and fever which may be an infusion related side effect in study performed in healthy volunteers. Albeit the decoy mechanism of action of this drug, the most common side effects in patients with major bleeding events were thromboembolism including DVTs, myocardial infarction and ischemic stroke which was reported in 10% in the ANEXXA-4 trial.
4.3.2 Prothrombin Complex Concentrates (PCCs)
Variable data have been reported on the role of PCC in anti-Xa as potential reversal strategies. Multiple guidelines suggest using PCCs as alternative method to andexanet alfa. However, multiple reports demonstrated similar efficacy and safety profile for PCCs when used for major bleed induced by rivaroxaban, apixaban, or edoxaban. Many clinicians may prefer PCCs over andexanet alfa based on the cost difference in addition to the lack of high-quality head-to-head comparisons. Dosing may have a range between 25 and 50 units/kg based on actual body weight [9].
5. Ongoing research on anticoagulant therapy
The anti-factor Xa inhibitors have achieved so many milestones and currently are recommended by most well-respected clinical guidelines. This mechanism of action is becoming so appealing for many manufacturers to design new agents that specifically target factor Xa. Darexaban and nokxaban are two new potential agents that may see the light soon and attain the guidelines recommendations for many clinical indications. They have still not been approved by neither the US FDA nor the EMA but their Phase II trials are promising with comparable safety and efficacy data to current approved DOACs. On the other side, currently approved DOACs are being tested for many other indications and we may see further utilization of these agents on a wider range of patient population. Drugs targeting other coagulation factors such as factor XI and XII are also being developed [16, 17, 18, 19].
6. Conclusion
Several anticoagulant agents could be used to manage thrombotic events. However, it is essential to consider thrombectomy over anticoagulant therapy in acute settings. This is mainly due to the fact that limited data exist on the use of VKA or DOACs in the acute treatment of patients with ischemic stroke. Anticoagulants could be reserved as a secondary prevention strategy in many thrombotic disorders.
Conf lict of interest
The authors declare no conflict of interest.
Notes/thanks/other declarations
None.
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Introduction",level:"1"},{id:"sec_2",title:"2. Vitamin K Antagonists",level:"1"},{id:"sec_2_2",title:"2.1 Mechanism of action",level:"2"},{id:"sec_3_2",title:"2.2 Pharmacology",level:"2"},{id:"sec_4_2",title:"2.3 Indication and dosing",level:"2"},{id:"sec_5_2",title:"2.4 Monitoring",level:"2"},{id:"sec_6_2",title:"2.5 Side effects",level:"2"},{id:"sec_7_2",title:"2.6 Drug interaction",level:"2"},{id:"sec_9",title:"3. Direct Oral Anticoagulants",level:"1"},{id:"sec_9_2",title:"3.1 Mechanism of action",level:"2"},{id:"sec_10_2",title:"3.2 Pharmacology",level:"2"},{id:"sec_11_2",title:"3.3 Indications and dosing",level:"2"},{id:"sec_12_2",title:"3.4 Monitoring",level:"2"},{id:"sec_13_2",title:"3.5 Side effects",level:"2"},{id:"sec_14_2",title:"3.6 Choosing an anticoagulant agent",level:"2"},{id:"sec_15_2",title:"3.7 Periprocedural management of anticoagulation",level:"2"},{id:"sec_17",title:"4. Reversal Agents",level:"1"},{id:"sec_17_2",title:"4.1 Warfarin reversal modalities",level:"2"},{id:"sec_17_3",title:"4.1.1 Vitamin K (Phytonadione)",level:"3"},{id:"sec_18_3",title:"4.1.2 Prothrombin Complex Concentrate (PCC)",level:"3"},{id:"sec_19_3",title:"4.1.3 Fresh frozen plasma (FFP)",level:"3"},{id:"sec_21_2",title:"4.2 Direct thrombin inhibitors reversal agents",level:"2"},{id:"sec_21_3",title:"4.2.1 Idarucizumab",level:"3"},{id:"sec_22_3",title:"4.2.2 Prothrombin Complex Concentrates (PCC)",level:"3"},{id:"sec_24_2",title:"4.3 Anti-Xa inhibitors reversal agents",level:"2"},{id:"sec_24_3",title:"4.3.1 Andexanet alfa",level:"3"},{id:"sec_25_3",title:"4.3.2 Prothrombin Complex Concentrates (PCCs)",level:"3"},{id:"sec_28",title:"5. Ongoing research on anticoagulant therapy",level:"1"},{id:"sec_29",title:"6. Conclusion",level:"1"},{id:"sec_30",title:"Conf lict of interest",level:"1"},{id:"sec_31",title:"Notes/thanks/other declarations",level:"1"}],chapterReferences:[{id:"B1",body:'Dahlbäck B. Blood coagulation. Lancet. 2000;355(9215):1627-1632.'},{id:"B2",body:'Lim GB. Milestone 1: Discovery and purification of heparin. Nat Rev Cardiol. 2017 Dec 14.'},{id:"B3",body:'Lim GB. Milestone 2: Warfarin: from rat poison to clinical use. Nat Rev Cardiol. 2017 Dec 14.'},{id:"B4",body:'Cully M. Milestone 9: Ximelagatran sets the stage for NOACs. Nat Rev Cardiol. 2017 Dec 14.'},{id:"B5",body:'Huynh K. Milestone 10: Era of the NOACs. Nat Rev Cardiol. 2017 Dec 14.'},{id:"B6",body:'Harter K, Levine M, Henderson SO. Anticoagulation drug therapy: a review. West J Emerg Med. 2015 Jan;16(1):11-17.'},{id:"B7",body:'Badreldin H, Nichols H, Rimsans J, Carter D. Evaluation of anticoagulation selection for acute venous thromboembolism. J Thromb Thrombolysis. 2017 Jan;43(1):74-78.'},{id:"B8",body:'Weitz JI. Factor Xa and thrombin as targets for new oral anticoagulants. Thromb Res. 2011 Jan;127 Suppl:S5-12.'},{id:"B9",body:'Chaudhary R, Sharma T, Garg J, Sukhi A, Bliden K, Tantry U, et al. Direct oral anticoagulants: a review on the current role and scope of reversal agents. J Thromb Thrombolysis. 2020 Feb;49(2):271-286.'},{id:"B10",body:'Connors JM. Testing and monitoring direct oral anticoagulants. Blood. 2018;132(19):2009-2015.'},{id:"B11",body:'Wadsworth D, Sullivan E, Jacky T, Sprague T, Feinman H, Kim J. A review of indications and comorbidities in which warfarin may be the preferred oral anticoagulant. J Clin Pharm Ther. 2021 Jun;46(3):560-570.'},{id:"B12",body:'January CT, Wann LS, Calkins H, Chen LY, Cigarroa JE, Cleveland JC, et al. 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart R. J Am Coll Cardiol. 2019;74(1):104-132.'},{id:"B13",body:'Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the Europea. Eur Heart J. 2021;42(5):373-498.'},{id:"B14",body:'Doherty JU, Gluckman TJ, Hucker WJ, Januzzi JL, Ortel TL, Saxonhouse SJ, et al. 2017 ACC Expert Consensus Decision Pathway for Periprocedural Management of Anticoagulation in Patients With Nonvalvular Atrial Fibrillation: A Report of the American College of Cardiology Clinical Expert Consensus Document Task Force. J Am Coll Cardiol. 2017;69(7):871-898.'},{id:"B15",body:'Makris M, van Veen JJ, Maclean R. Warfarin anticoagulation reversal: management of the asymptomatic and bleeding patient. J Thromb Thrombolysis. 2010 Feb;29(2):171-181.'},{id:"B16",body:'Iwatsuki Y, Sato T, Moritani Y, Shigenaga T, Suzuki M, Kawasaki T, et al. Biochemical and pharmacological profile of darexaban, an oral direct factor Xa inhibitor. Eur J Pharmacol. 2011 Dec 30;673(1-3):49-55.'},{id:"B17",body:'Kadokura T, Kashiwa M, Groenendaal D, Heeringa M, Mol R, Verheggen F, et al. Clinical pharmacokinetics, pharmacodynamics, safety and tolerability of darexaban, an oral direct factor Xa inhibitor, in healthy Caucasian and Japanese subjects. Biopharm Drug Dispos. 2013 Nov;34(8):431-441.'},{id:"B18",body:'Choi HY, Choi S, Kim YH, Lim HS. Population Pharmacokinetic and Pharmacodynamic Modeling Analysis of GCC-4401C, a Novel Direct Factor Xa Inhibitor, in Healthy Volunteers. CPT pharmacometrics Syst Pharmacol. 2016;5(10):532-543.'},{id:"B19",body:'Weitz JI, Chan NC. Advances in Antithrombotic Therapy. Arterioscler Thromb Vasc Biol. 2019;39(1):7-12.'}],footnotes:[],contributors:[{corresp:null,contributorFullName:"Mohammed Aldhaeefi",address:null,affiliation:'
Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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UK Research and Innovation (former Research Councils UK (RCUK) - including AHRC, BBSRC, ESRC, EPSRC, MRC, NERC, STFC.) Processing charges for books/book chapters can be covered through RCUK block grants which are allocated to most universities in the UK, which then handle the OA publication funding requests. It is at the discretion of the university whether it will approve the request.)
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Often in the implementation practice of companies’ social responsibility, there can be attention focus on one or even several very significant activities, which indicated that the organization has not yet assimilated the valuable content of this idea and is developing its activity by ignoring a very important principle of inner maturity.",book:{id:"5791",slug:"management-culture-and-corporate-social-responsibility",title:"Management Culture and Corporate Social Responsibility",fullTitle:"Management Culture and Corporate Social Responsibility"},signatures:"Pranas Žukauskas, Jolita Vveinhardt and Regina Andriukaitienė",authors:[{id:"179629",title:"Prof.",name:"Jolita",middleName:null,surname:"Vveinhardt",slug:"jolita-vveinhardt",fullName:"Jolita Vveinhardt"}]},{id:"59158",doi:"10.5772/intechopen.73785",title:"Professional Social Responsibility in Engineering",slug:"professional-social-responsibility-in-engineering",totalDownloads:2892,totalCrossrefCites:5,totalDimensionsCites:6,abstract:"This chapter presents a range of viewpoints on the social responsibilities of the engineering profession. These social responsibilities of the engineering profession are in many ways synonymous with macroethics. Analysis of the engineering codes of ethics and educational requirements are used to support these arguments, and are compared with the perceptions of engineering students and working engineers. The social responsibilities of engineers include human safety and environmental protection in engineering designs. But it may extend further to include pro bono work and considerations of social justice issues. Research has found that perceptions of the professional social responsibilities of engineers vary across different countries/cultures, engineering disciplines (e.g., mechanical versus environmental engineers) and by gender. The impact of engineering education and broader college experiences on evolving notions of professional social responsibility will be described, in particular community engagement. Concerns about decreasing commitment to socially responsible engineering among college students, a so-called “culture of disengagement” will be presented, as well of the interaction of students’ social goals for engineering and leaving engineering studies.",book:{id:"6630",slug:"social-responsibility",title:"Social Responsibility",fullTitle:"Social Responsibility"},signatures:"Angela R. 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We applied a Moderated Regression Analysis using the aggregate ESG scores as a CSR proxy on a panel data of listed French Companies (SBF120) over the period 2008–2017. Our findings are in line with legitimacy theory, suggesting that social initiatives would be mean to strengthen the legitimacy and to secure “license to operate”. Furthermore, firm visibility would be a contingency variable that moderates positively CSR-FFP relationship.",book:{id:"9032",slug:"corporate-social-responsibility",title:"Corporate Social Responsibility",fullTitle:"Corporate Social Responsibility"},signatures:"Zyed Achour and Sonia Boukattaya",authors:[{id:"325022",title:"Assistant Prof.",name:"Zyed",middleName:null,surname:"Achour",slug:"zyed-achour",fullName:"Zyed Achour"},{id:"325106",title:"Dr.",name:"Sonia",middleName:null,surname:"Boukattaya",slug:"sonia-boukattaya",fullName:"Sonia Boukattaya"}]},{id:"62266",doi:"10.5772/intechopen.77373",title:"Mining Conflicts and Corporate Social Responsibility in Kenya’s Nascent Mining Industry: A Call for Legislation",slug:"mining-conflicts-and-corporate-social-responsibility-in-kenya-s-nascent-mining-industry-a-call-for-l",totalDownloads:1382,totalCrossrefCites:2,totalDimensionsCites:3,abstract:"Much of the debate in Africa with regard to mining has been on the question on whether or not mining is good for development. While some scholars agree that mining is indeed good for development, others have argued that the structural constraints found in many developing nations render mining almost untenable. Corporate social responsibility (CSR) has been suggested as one of the ways through which the difficulties associated with mining can be ameliorated. However, CSR activities in developing countries, especially in Africa, have had a questionable reputation. Many view the few programs rolled out under this program as having done little in meeting the needs of the affected mining communities. CSR in Kenya’s mining industry has, on its part, received very little attention. This work reviews mining conflicts in Africa and examines how CSR can assuage mining community disaffection over mining projects.",book:{id:"6630",slug:"social-responsibility",title:"Social Responsibility",fullTitle:"Social Responsibility"},signatures:"Willice O. Abuya",authors:[{id:"239807",title:"Dr.",name:"Willice",middleName:null,surname:"Abuya",slug:"willice-abuya",fullName:"Willice Abuya"}]}],mostDownloadedChaptersLast30Days:[{id:"58890",title:"Philosophy and Paradigm of Scientific Research",slug:"philosophy-and-paradigm-of-scientific-research",totalDownloads:14077,totalCrossrefCites:9,totalDimensionsCites:17,abstract:"Before carrying out the empirical analysis of the role of management culture in corporate social responsibility, identification of the philosophical approach and the paradigm on which the research carried out is based is necessary. Therefore, this chapter deals with the philosophical systems and paradigms of scientific research, the epistemology, evaluating understanding and application of various theories and practices used in the scientific research. The key components of the scientific research paradigm are highlighted. Theories on the basis of which this research was focused on identification of the level of development of the management culture in order to implement corporate social responsibility are identified, and the stages of its implementation are described.",book:{id:"5791",slug:"management-culture-and-corporate-social-responsibility",title:"Management Culture and Corporate Social Responsibility",fullTitle:"Management Culture and Corporate Social Responsibility"},signatures:"Pranas Žukauskas, Jolita Vveinhardt and Regina Andriukaitienė",authors:[{id:"179629",title:"Prof.",name:"Jolita",middleName:null,surname:"Vveinhardt",slug:"jolita-vveinhardt",fullName:"Jolita Vveinhardt"}]},{id:"58894",title:"Research Ethics",slug:"research-ethics",totalDownloads:3371,totalCrossrefCites:2,totalDimensionsCites:2,abstract:"Research ethics is closely related to the ethical principles of social responsibility. This research covers a wide context of working with people, so the researchers raised a task not only to gain confidence in the respondents’ eyes, to receive reliable data, but also to ensure the transparency of the science. This chapter discusses the theoretical and practical topics of research, after evaluation of which ethical principles of organization and conducting the research are presented. There is a detailed description of how and what ethical principles were followed on the different stages of the research.",book:{id:"5791",slug:"management-culture-and-corporate-social-responsibility",title:"Management Culture and Corporate Social Responsibility",fullTitle:"Management Culture and Corporate Social Responsibility"},signatures:"Pranas Žukauskas, Jolita Vveinhardt and Regina Andriukaitienė",authors:[{id:"179629",title:"Prof.",name:"Jolita",middleName:null,surname:"Vveinhardt",slug:"jolita-vveinhardt",fullName:"Jolita Vveinhardt"}]},{id:"58883",title:"Corporate Social Responsibility as the Organization’s Commitment against Stakeholders",slug:"corporate-social-responsibility-as-the-organization-s-commitment-against-stakeholders",totalDownloads:3131,totalCrossrefCites:7,totalDimensionsCites:10,abstract:"Depending on society culture, traditions, and era, understanding of companies’ social responsibility might vary. In this part, we distinguish definitions of companies’ social responsibility and discuss the roles of stakeholders. Relations between the stakeholders are discussed in the context of social capital development. We emphasize that commitment against the interested subjects can be a long-term company policy, dictated by values of an organization, rather than the strategy in the activity market. Often in the implementation practice of companies’ social responsibility, there can be attention focus on one or even several very significant activities, which indicated that the organization has not yet assimilated the valuable content of this idea and is developing its activity by ignoring a very important principle of inner maturity.",book:{id:"5791",slug:"management-culture-and-corporate-social-responsibility",title:"Management Culture and Corporate Social Responsibility",fullTitle:"Management Culture and Corporate Social Responsibility"},signatures:"Pranas Žukauskas, Jolita Vveinhardt and Regina Andriukaitienė",authors:[{id:"179629",title:"Prof.",name:"Jolita",middleName:null,surname:"Vveinhardt",slug:"jolita-vveinhardt",fullName:"Jolita Vveinhardt"}]},{id:"59034",title:"Structure of Research Design: Expert Evaluation",slug:"structure-of-research-design-expert-evaluation",totalDownloads:1149,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"This chapter presents the research design/plan. Methodological choice of quantitative and qualitative research is substantiated, and principles of design and verification of the research instrument are described. Individual stages of the research are presented in detail by describing their consistency in respect of the main objective. Statistical calculations to substantiate the reliability of the research instrument are presented and key aspects of the organization of research are described.",book:{id:"5791",slug:"management-culture-and-corporate-social-responsibility",title:"Management Culture and Corporate Social Responsibility",fullTitle:"Management Culture and Corporate Social Responsibility"},signatures:"Pranas Žukauskas, Jolita Vveinhardt and Regina Andriukaitienė",authors:[{id:"179629",title:"Prof.",name:"Jolita",middleName:null,surname:"Vveinhardt",slug:"jolita-vveinhardt",fullName:"Jolita Vveinhardt"}]},{id:"59158",title:"Professional Social Responsibility in Engineering",slug:"professional-social-responsibility-in-engineering",totalDownloads:2896,totalCrossrefCites:5,totalDimensionsCites:6,abstract:"This chapter presents a range of viewpoints on the social responsibilities of the engineering profession. These social responsibilities of the engineering profession are in many ways synonymous with macroethics. Analysis of the engineering codes of ethics and educational requirements are used to support these arguments, and are compared with the perceptions of engineering students and working engineers. The social responsibilities of engineers include human safety and environmental protection in engineering designs. But it may extend further to include pro bono work and considerations of social justice issues. Research has found that perceptions of the professional social responsibilities of engineers vary across different countries/cultures, engineering disciplines (e.g., mechanical versus environmental engineers) and by gender. The impact of engineering education and broader college experiences on evolving notions of professional social responsibility will be described, in particular community engagement. Concerns about decreasing commitment to socially responsible engineering among college students, a so-called “culture of disengagement” will be presented, as well of the interaction of students’ social goals for engineering and leaving engineering studies.",book:{id:"6630",slug:"social-responsibility",title:"Social Responsibility",fullTitle:"Social Responsibility"},signatures:"Angela R. 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The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}},{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}}]},series:{item:{id:"24",title:"Sustainable Development",doi:"10.5772/intechopen.100361",issn:"2753-6580",scope:"
\r\n\tTransforming our World: the 2030 Agenda for Sustainable Development endorsed by United Nations and 193 Member States, came into effect on Jan 1, 2016, to guide decision making and actions to the year 2030 and beyond. Central to this Agenda are 17 Goals, 169 associated targets and over 230 indicators that are reviewed annually. The vision envisaged in the implementation of the SDGs is centered on the five Ps: People, Planet, Prosperity, Peace and Partnership. This call for renewed focused efforts ensure we have a safe and healthy planet for current and future generations.
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\r\n\tThis Series focuses on covering research and applied research involving the five Ps through the following topics:
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\r\n\t1. Sustainable Economy and Fair Society that relates to SDG 1 on No Poverty, SDG 2 on Zero Hunger, SDG 8 on Decent Work and Economic Growth, SDG 10 on Reduced Inequalities, SDG 12 on Responsible Consumption and Production, and SDG 17 Partnership for the Goals
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\r\n\t2. Health and Wellbeing focusing on SDG 3 on Good Health and Wellbeing and SDG 6 on Clean Water and Sanitation
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\r\n\t3. Inclusivity and Social Equality involving SDG 4 on Quality Education, SDG 5 on Gender Equality, and SDG 16 on Peace, Justice and Strong Institutions
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\r\n\t
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\r\n\t4. Climate Change and Environmental Sustainability comprising SDG 13 on Climate Action, SDG 14 on Life Below Water, and SDG 15 on Life on Land
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\r\n\t
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\r\n\t5. Urban Planning and Environmental Management embracing SDG 7 on Affordable Clean Energy, SDG 9 on Industry, Innovation and Infrastructure, and SDG 11 on Sustainable Cities and Communities.
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\r\n\tThe series also seeks to support the use of cross cutting SDGs, as many of the goals listed above, targets and indicators are all interconnected to impact our lives and the decisions we make on a daily basis, making them impossible to tie to a single topic.
",coverUrl:"https://cdn.intechopen.com/series/covers/24.jpg",latestPublicationDate:"August 2nd, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:1,editor:{id:"262440",title:"Prof.",name:"Usha",middleName:null,surname:"Iyer-Raniga",slug:"usha-iyer-raniga",fullName:"Usha Iyer-Raniga",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRYSXQA4/Profile_Picture_2022-02-28T13:55:36.jpeg",biography:"Usha Iyer-Raniga is a professor in the School of Property and Construction Management at RMIT University. Usha co-leads the One Planet Network’s Sustainable Buildings and Construction Programme (SBC), a United Nations 10 Year Framework of Programmes on Sustainable Consumption and Production (UN 10FYP SCP) aligned with Sustainable Development Goal 12. The work also directly impacts SDG 11 on Sustainable Cities and Communities. She completed her undergraduate degree as an architect before obtaining her Masters degree from Canada and her Doctorate in Australia. Usha has been a keynote speaker as well as an invited speaker at national and international conferences, seminars and workshops. Her teaching experience includes teaching in Asian countries. She has advised Austrade, APEC, national, state and local governments. She serves as a reviewer and a member of the scientific committee for national and international refereed journals and refereed conferences. She is on the editorial board for refereed journals and has worked on Special Issues. Usha has served and continues to serve on the Boards of several not-for-profit organisations and she has also served as panel judge for a number of awards including the Premiers Sustainability Award in Victoria and the International Green Gown Awards. Usha has published over 100 publications, including research and consulting reports. Her publications cover a wide range of scientific and technical research publications that include edited books, book chapters, refereed journals, refereed conference papers and reports for local, state and federal government clients. She has also produced podcasts for various organisations and participated in media interviews. She has received state, national and international funding worth over USD $25 million. Usha has been awarded the Quarterly Franklin Membership by London Journals Press (UK). Her biography has been included in the Marquis Who's Who in the World® 2018, 2016 (33rd Edition), along with approximately 55,000 of the most accomplished men and women from around the world, including luminaries as U.N. Secretary-General Ban Ki-moon. In 2017, Usha was awarded the Marquis Who’s Who Lifetime Achiever Award.",institutionString:null,institution:{name:"RMIT University",institutionURL:null,country:{name:"Australia"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:5,paginationItems:[{id:"91",title:"Sustainable Economy and Fair Society",coverUrl:"https://cdn.intechopen.com/series_topics/covers/91.jpg",isOpenForSubmission:!0,editor:{id:"181603",title:"Dr.",name:"Antonella",middleName:null,surname:"Petrillo",slug:"antonella-petrillo",fullName:"Antonella Petrillo",profilePictureURL:"https://mts.intechopen.com/storage/users/181603/images/system/181603.jpg",biography:"Antonella Petrillo, Ph.D., is a professor in the Department of Engineering, University of Naples “Parthenope,” Italy. She received her Ph.D. in Mechanical Engineering from the University of Cassino and Southern Lazio, Italy. Her research interests include multi-criteria decision analysis, industrial plants, logistics, manufacturing, and safety. She serves as an associate editor for the International Journal of the Analytic Hierarchy Process and is an editorial board member for several other journals. 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Her focus is on quality, innovation, leadership, and personalised learning. She works primarily at the strategic and policy levels, both nationally and internationally, and with key international organisations. She is committed to promoting and improving OFDL in the context of SDG4 and the future of education. Ossiannilsson has more than 20 years of experience in her current field, but more than 40 years in the education sector. She works as a reviewer and expert for the European Commission and collaborates with the Joint Research Centre for Quality in Open Education. Ossiannilsson also collaborates with ITCILO and ICoBC (International Council on Badges and Credentials). She is a member of the ICDE Board of Directors and has previously served on the boards of EDEN and EUCEN. Ossiannilsson is a quality expert and reviewer for ICDE, EDEN and the EADTU. She chairs the ICDE OER Advocacy Committee and is a member of the ICDE Quality Network. She is regularly invited as a keynote speaker at conferences. She is a guest editor for several special issues and a member of the editorial board of several scientific journals. She has published more than 200 articles and is currently working on book projects in the field of OFDL. Ossiannilsson is a visiting professor at several international universities and was recently appointed Professor and Research Fellow at Victoria University of Wellington, NZ. Ossiannilsson has been awarded the following fellowships: EDEN Fellows, EDEN Council of Fellows, and Open Education Europe. She is a ICDE OER Ambassador, Open Education Europe Ambassador, GIZ Ambassador for Quality in Digital Learning, and part of the Globe-Community of Digital Learning and Champion of SPARC Europe. On a national level, she is a quality developer at the Swedish Institute for Standards (SIS) and for ISO. She is a member of the Digital Skills and Jobs Coalition Sweden and Vice President of the Swedish Association for Distance Education. She is currently working on a government initiative on quality in distance education at the National Council for Higher Education. She holds a Ph.D. from the University of Oulu, Finland.",institutionString:"Swedish Association for Distance Education, Sweden",institution:null},editorTwo:null,editorThree:null},{id:"94",title:"Climate Change and Environmental Sustainability",coverUrl:"https://cdn.intechopen.com/series_topics/covers/94.jpg",isOpenForSubmission:!0,editor:{id:"61855",title:"Dr.",name:"Yixin",middleName:null,surname:"Zhang",slug:"yixin-zhang",fullName:"Yixin Zhang",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYWJgQAO/Profile_Picture_2022-06-09T11:36:35.jpg",biography:"Professor Yixin Zhang is an aquatic ecologist with over 30 years of research and teaching experience in three continents (Asia, Europe, and North America) in Stream Ecology, Riparian Ecology, Urban Ecology, and Ecosystem Restoration and Aquatic Conservation, Human-Nature Interactions and Sustainability, Urbanization Impact on Aquatic Ecosystems. He got his Ph.D. in Animal Ecology at Umeå University in Sweden in 1998. He conducted postdoc research in stream ecology at the University of California at Santa Barbara in the USA. After that, he was a postdoc research fellow at the University of British Columbia in Canada to do research on large-scale stream experimental manipulation and watershed ecological survey in temperate rainforests of BC. He was a faculty member at the University of Hong Kong to run ecological research projects on aquatic insects, fishes, and newts in Tropical Asian streams. He also conducted research in streams, rivers, and caves in Texas, USA, to study the ecology of macroinvertebrates, big-claw river shrimp, fish, turtles, and bats. Current research interests include trophic flows across ecosystems; watershed impacts of land-use change on biodiversity and ecosystem functioning; ecological civilization and water resource management; urban ecology and urban/rural sustainable development.",institutionString:null,institution:{name:"Soochow University",institutionURL:null,country:{name:"China"}}},editorTwo:null,editorThree:null},{id:"95",title:"Urban Planning and Environmental Management",coverUrl:"https://cdn.intechopen.com/series_topics/covers/95.jpg",isOpenForSubmission:!0,editor:{id:"181079",title:"Dr.",name:"Christoph",middleName:null,surname:"Lüthi",slug:"christoph-luthi",fullName:"Christoph Lüthi",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRHSqQAO/Profile_Picture_2022-04-12T15:51:33.png",biography:"Dr. Christoph Lüthi is an urban infrastructure planner with over 25 years of experience in planning and design of urban infrastructure in middle and low-income countries. He holds a Master’s Degree in Urban Development Planning from the University College of London (UCL), and a Ph.D. in Urban Planning & Engineering from TU Berlin. He has conducted applied research on urban planning and infrastructure issues in over 20 countries in Africa and Asia. In 2005 he joined Eawag-Sandec as Leader of the Strategic Environmental Sanitation Planning Group. 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He received his Ph.D. in Molecular Biology with his thesis “Genetic variability of the tick-borne encephalitis virus in natural foci of Novosibirsk city and its suburbs.” His primary field is molecular virology with research emphasis on vector-borne viruses, especially tick-borne encephalitis virus, Kemerovo virus and Omsk hemorrhagic fever virus, rabies virus, molecular genetics, biology, and epidemiology of virus pathogens.",institutionString:"Russian Academy of Sciences",institution:{name:"Russian Academy of Sciences",country:{name:"Russia"}}},{id:"310962",title:"Dr.",name:"Amlan",middleName:"Kumar",surname:"Patra",slug:"amlan-patra",fullName:"Amlan Patra",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/310962/images/system/310962.jpg",biography:"Amlan K. Patra, FRSB, obtained a Ph.D. in Animal Nutrition from Indian Veterinary Research Institute, India, in 2002. He is currently an associate professor at West Bengal University of Animal and Fishery Sciences. He has more than twenty years of research and teaching experience. He held previous positions at the American Institute for Goat Research, The Ohio State University, Columbus, USA, and Free University of Berlin, Germany. His research focuses on animal nutrition, particularly ruminants and poultry nutrition, gastrointestinal electrophysiology, meta-analysis and modeling in nutrition, and livestock–environment interaction. He has authored around 175 articles in journals, book chapters, and proceedings. Dr. Patra serves on the editorial boards of several reputed journals.",institutionString:null,institution:{name:"West Bengal University of Animal and Fishery Sciences",country:{name:"India"}}},{id:"53998",title:"Prof.",name:"László",middleName:null,surname:"Babinszky",slug:"laszlo-babinszky",fullName:"László Babinszky",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/53998/images/system/53998.png",biography:"László Babinszky is Professor Emeritus, Department of Animal Nutrition Physiology, University of Debrecen, Hungary. He has also worked in the Department of Animal Nutrition, University of Wageningen, Netherlands; the Institute for Livestock Feeding and Nutrition (IVVO), Lelystad, Netherlands; the Agricultural University of Vienna (BOKU); the Institute for Animal Breeding and Nutrition, Austria; and the Oscar Kellner Research Institute for Animal Nutrition, Rostock, Germany. In 1992, Dr. Babinszky obtained a Ph.D. in Animal Nutrition from the University of Wageningen. His main research areas are swine and poultry nutrition. He has authored more than 300 publications (papers, book chapters) and edited four books and fourteen international conference proceedings.",institutionString:"University of Debrecen",institution:{name:"University of Debrecen",country:{name:"Hungary"}}},{id:"201830",title:"Dr.",name:"Fernando",middleName:"Sanchez",surname:"Davila",slug:"fernando-davila",fullName:"Fernando Davila",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/201830/images/5017_n.jpg",biography:"I am a professor at UANL since 1988. My research lines are the development of reproductive techniques in small ruminants. We also conducted research on sexual and social behavior in males.\nI am Mexican and study my professional career as an engineer in agriculture and animal science at UANL. Then take a masters degree in science in Germany (Animal breeding). Take a doctorate in animal science at the UANL.",institutionString:null,institution:{name:"Universidad Autónoma de Nuevo León",country:{name:"Mexico"}}},{id:"309250",title:"Dr.",name:"Miguel",middleName:null,surname:"Quaresma",slug:"miguel-quaresma",fullName:"Miguel Quaresma",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/309250/images/9059_n.jpg",biography:"Miguel Nuno Pinheiro Quaresma was born on May 26, 1974 in Dili, Timor Island. He is married with two children: a boy and a girl, and he is a resident in Vila Real, Portugal. He graduated in Veterinary Medicine in August 1998 and obtained his Ph.D. degree in Veterinary Sciences -Clinical Area in February 2015, both from the University of Trás-os-Montes e Alto Douro. He is currently enrolled in the Alternative Residency of the European College of Animal Reproduction. He works as a Senior Clinician at the Veterinary Teaching Hospital of UTAD (HVUTAD) with a role in clinical activity in the area of livestock and equine species as well as to support teaching and research in related areas. He teaches as an Invited Professor in Reproduction Medicine I and II of the Master\\'s in Veterinary Medicine degree at UTAD. Currently, he holds the position of Chairman of the Portuguese Buiatrics Association. He is a member of the Consultive Group on Production Animals of the OMV. He has 19 publications in indexed international journals (ISIS), as well as over 60 publications and oral presentations in both Portuguese and international journals and congresses.",institutionString:"University of Trás-os-Montes and Alto Douro",institution:{name:"University of Trás-os-Montes and Alto Douro",country:{name:"Portugal"}}},{id:"38652",title:"Prof.",name:"Rita",middleName:null,surname:"Payan-Carreira",slug:"rita-payan-carreira",fullName:"Rita Payan-Carreira",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRiFPQA0/Profile_Picture_1614601496313",biography:"Rita Payan Carreira earned her Veterinary Degree from the Faculty of Veterinary Medicine in Lisbon, Portugal, in 1985. She obtained her Ph.D. in Veterinary Sciences from the University of Trás-os-Montes e Alto Douro, Portugal. After almost 32 years of teaching at the University of Trás-os-Montes and Alto Douro, she recently moved to the University of Évora, Department of Veterinary Medicine, where she teaches in the field of Animal Reproduction and Clinics. Her primary research areas include the molecular markers of the endometrial cycle and the embryo–maternal interaction, including oxidative stress and the reproductive physiology and disorders of sexual development, besides the molecular determinants of male and female fertility. She often supervises students preparing their master's or doctoral theses. She is also a frequent referee for various journals.",institutionString:null,institution:{name:"University of Évora",country:{name:"Portugal"}}},{id:"283019",title:"Dr.",name:"Oudessa",middleName:null,surname:"Kerro Dego",slug:"oudessa-kerro-dego",fullName:"Oudessa Kerro Dego",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/283019/images/system/283019.png",biography:"Dr. Kerro Dego is a veterinary microbiologist with training in veterinary medicine, microbiology, and anatomic pathology. Dr. Kerro Dego is an assistant professor of dairy health in the department of animal science, the University of Tennessee, Institute of Agriculture, Knoxville, Tennessee. He received his D.V.M. (1997), M.S. (2002), and Ph.D. (2008) degrees in Veterinary Medicine, Animal Pathology and Veterinary Microbiology from College of Veterinary Medicine, Addis Ababa University, Ethiopia; College of Veterinary Medicine, Utrecht University, the Netherlands and Western College of Veterinary Medicine, University of Saskatchewan, Canada respectively. He did his Postdoctoral training in microbial pathogenesis (2009 - 2015) in the Department of Animal Science, the University of Tennessee, Institute of Agriculture, Knoxville, Tennessee. Dr. Kerro Dego’s research focuses on the prevention and control of infectious diseases of farm animals, particularly mastitis, improving dairy food safety, and mitigation of antimicrobial resistance. Dr. Kerro Dego has extensive experience in studying the pathogenesis of bacterial infections, identification of virulence factors, and vaccine development and efficacy testing against major bacterial mastitis pathogens. Dr. Kerro Dego conducted numerous controlled experimental and field vaccine efficacy studies, vaccination, and evaluation of immunological responses in several species of animals, including rodents (mice) and large animals (bovine and ovine).",institutionString:"University of Tennessee at Knoxville",institution:{name:"University of Tennessee at Knoxville",country:{name:"United States of America"}}},{id:"251314",title:"Dr.",name:"Juan Carlos",middleName:null,surname:"Gardón Poggi",slug:"juan-carlos-gardon-poggi",fullName:"Juan Carlos Gardón Poggi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/251314/images/system/251314.jpeg",biography:"Juan Carlos Gardón Poggi received University degree from the Faculty of Agrarian Science in Argentina, in 1983. Also he received Masters Degree and PhD from Córdoba University, Spain. He is currently a Professor at the Catholic University of Valencia San Vicente Mártir, at the Department of Medicine and Animal Surgery. He teaches diverse courses in the field of Animal Reproduction and he is the Director of the Veterinary Farm. He also participates in academic postgraduate activities at the Veterinary Faculty of Murcia University, Spain. His research areas include animal physiology, physiology and biotechnology of reproduction either in males or females, the study of gametes under in vitro conditions and the use of ultrasound as a complement to physiological studies and development of applied biotechnologies. Routinely, he supervises students preparing their doctoral, master thesis or final degree projects.",institutionString:null,institution:{name:"Valencia Catholic University Saint Vincent Martyr",country:{name:"Spain"}}},{id:"309529",title:"Dr.",name:"Albert",middleName:null,surname:"Rizvanov",slug:"albert-rizvanov",fullName:"Albert Rizvanov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/309529/images/9189_n.jpg",biography:'Albert A. Rizvanov is a Professor and Director of the Center for Precision and Regenerative Medicine at the Institute of Fundamental Medicine and Biology, Kazan Federal University (KFU), Russia. He is the Head of the Center of Excellence “Regenerative Medicine” and Vice-Director of Strategic Academic Unit \\"Translational 7P Medicine\\". Albert completed his Ph.D. at the University of Nevada, Reno, USA and Dr.Sci. at KFU. He is a corresponding member of the Tatarstan Academy of Sciences, Russian Federation. Albert is an author of more than 300 peer-reviewed journal articles and 22 patents. He has supervised 11 Ph.D. and 2 Dr.Sci. dissertations. Albert is the Head of the Dissertation Committee on Biochemistry, Microbiology, and Genetics at KFU.\nORCID https://orcid.org/0000-0002-9427-5739\nWebsite https://kpfu.ru/Albert.Rizvanov?p_lang=2',institutionString:"Kazan Federal University",institution:{name:"Kazan Federal University",country:{name:"Russia"}}},{id:"210551",title:"Dr.",name:"Arbab",middleName:null,surname:"Sikandar",slug:"arbab-sikandar",fullName:"Arbab Sikandar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/210551/images/system/210551.jpg",biography:"Dr. Arbab Sikandar, PhD, M. Phil, DVM was born on April 05, 1981. He is currently working at the College of Veterinary & Animal Sciences as an Assistant Professor. He previously worked as a lecturer at the same University. \nHe is a Member/Secretory of Ethics committee (No. CVAS-9377 dated 18-04-18), Member of the QEC committee CVAS, Jhang (Regr/Gen/69/873, dated 26-10-2017), Member, Board of studies of Department of Basic Sciences (No. CVAS. 2851 Dated. 12-04-13, and No. CVAS, 9024 dated 20/11/17), Member of Academic Committee, CVAS, Jhang (No. CVAS/2004, Dated, 25-08-12), Member of the technical committee (No. CVAS/ 4085, dated 20,03, 2010 till 2016).\n\nDr. Arbab Sikandar contributed in five days hands-on-training on Histopathology at the Department of Pathology, UVAS from 12-16 June 2017. He received a Certificate of appreciation for contributions for Popularization of Science and Technology in the Society on 17-11-15. He was the resource person in the lecture series- ‘scientific writing’ at the Department of Anatomy and Histology, UVAS, Lahore on 29th October 2015. He won a full fellowship as a principal candidate for the year 2015 in the field of Agriculture, EICA, Egypt with ref. to the Notification No. 12(11) ACS/Egypt/2014 from 10 July 2015 to 25th September 2015.; he received a grant of Rs. 55000/- as research incentives from Director, Advanced Studies and Research, UVAS, Lahore upon publications of research papers in IF Journals (DR/215, dated 19-5-2014.. He obtained his PhD by winning a HEC Pakistan indigenous Scholarship, ‘Ph.D. fellowship for 5000 scholars – Phase II’ (2av1-147), 17-6/HEC/HRD/IS-II/12, November 15, 2012. \n\nDr. Sikandar is a member of numerous societies: Registered Veterinary Medical Practitioner (life member) and Registered Veterinary Medical Faculty of Pakistan Veterinary Medical Council. The Registration code of PVMC is RVMP/4298 and RVMF/ 0102.; Life member of the University of Veterinary and Animal Sciences, Lahore, Alumni Association with S# 664, dated: 6-4-12. ; Member 'Vets Care Organization Pakistan” with Reference No. VCO-605-149, dated 05-04-06. :Member 'Vet Crescent” (Society of Animal Health and Production), UVAS, Lahore.",institutionString:"University of Veterinary & Animal Science",institution:{name:"University of Veterinary and Animal Sciences",country:{name:"Pakistan"}}},{id:"311663",title:"Dr.",name:"Prasanna",middleName:null,surname:"Pal",slug:"prasanna-pal",fullName:"Prasanna Pal",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/311663/images/13261_n.jpg",biography:null,institutionString:null,institution:{name:"National Dairy Research Institute",country:{name:"India"}}},{id:"202192",title:"Dr.",name:"Catrin",middleName:null,surname:"Rutland",slug:"catrin-rutland",fullName:"Catrin Rutland",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/202192/images/system/202192.png",biography:"Catrin Rutland is an Associate Professor of Anatomy and Developmental Genetics at the University of Nottingham, UK. She obtained a BSc from the University of Derby, England, a master’s degree from Technische Universität München, Germany, and a Ph.D. from the University of Nottingham. She undertook a post-doctoral research fellowship in the School of Medicine before accepting tenure in Veterinary Medicine and Science. Dr. Rutland also obtained an MMedSci (Medical Education) and a Postgraduate Certificate in Higher Education (PGCHE). She is the author of more than sixty peer-reviewed journal articles, twelve books/book chapters, and more than 100 research abstracts in cardiovascular biology and oncology. She is a board member of the European Association of Veterinary Anatomists, Fellow of the Anatomical Society, and Senior Fellow of the Higher Education Academy. Dr. Rutland has also written popular science books for the public. https://orcid.org/0000-0002-2009-4898. www.nottingham.ac.uk/vet/people/catrin.rutland",institutionString:null,institution:{name:"University of Nottingham",country:{name:"United Kingdom"}}},{id:"283315",title:"Prof.",name:"Samir",middleName:null,surname:"El-Gendy",slug:"samir-el-gendy",fullName:"Samir El-Gendy",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRduYQAS/Profile_Picture_1606215849748",biography:"Samir El-Gendy is a Professor of anatomy and embryology at the faculty of veterinary medicine, Alexandria University, Egypt. Samir obtained his PhD in veterinary science in 2007 from the faculty of veterinary medicine, Alexandria University and has been a professor since 2017. Samir is an author on 24 articles at Scopus and 12 articles within local journals and 2 books/book chapters. His research focuses on applied anatomy, imaging techniques and computed tomography. Samir worked as a member of different local projects on E-learning and he is a board member of the African Association of Veterinary Anatomists and of anatomy societies and as an associated author at local and international journals. Orcid: https://orcid.org/0000-0002-6180-389X",institutionString:null,institution:{name:"Alexandria University",country:{name:"Egypt"}}},{id:"246149",title:"Dr.",name:"Valentina",middleName:null,surname:"Kubale",slug:"valentina-kubale",fullName:"Valentina Kubale",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/246149/images/system/246149.jpg",biography:"Valentina Kubale is Associate Professor of Veterinary Medicine at the Veterinary Faculty, University of Ljubljana, Slovenia. Since graduating from the Veterinary faculty she obtained her PhD in 2007, performed collaboration with the Department of Pharmacology, University of Copenhagen, Denmark. She continued as a post-doctoral fellow at the University of Copenhagen with a Lundbeck foundation fellowship. She is the editor of three books and author/coauthor of 23 articles in peer-reviewed scientific journals, 16 book chapters, and 68 communications at scientific congresses. Since 2008 she has been the Editor Assistant for the Slovenian Veterinary Research journal. She is a member of Slovenian Biochemical Society, The Endocrine Society, European Association of Veterinary Anatomists and Society for Laboratory Animals, where she is board member.",institutionString:"University of Ljubljana",institution:{name:"University of Ljubljana",country:{name:"Slovenia"}}},{id:"258334",title:"Dr.",name:"Carlos Eduardo",middleName:null,surname:"Fonseca-Alves",slug:"carlos-eduardo-fonseca-alves",fullName:"Carlos Eduardo Fonseca-Alves",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/258334/images/system/258334.jpg",biography:"Dr. Fonseca-Alves earned his DVM from Federal University of Goias – UFG in 2008. He completed an internship in small animal internal medicine at UPIS university in 2011, earned his MSc in 2013 and PhD in 2015 both in Veterinary Medicine at Sao Paulo State University – UNESP. Dr. Fonseca-Alves currently serves as an Assistant Professor at Paulista University – UNIP teaching small animal internal medicine.",institutionString:null,institution:{name:"Universidade Paulista",country:{name:"Brazil"}}},{id:"245306",title:"Dr.",name:"María Luz",middleName:null,surname:"Garcia Pardo",slug:"maria-luz-garcia-pardo",fullName:"María Luz Garcia Pardo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/245306/images/system/245306.png",biography:"María de la Luz García Pardo is an agricultural engineer from Universitat Politècnica de València, Spain. She has a Ph.D. in Animal Genetics. Currently, she is a lecturer at the Agrofood Technology Department of Miguel Hernández University, Spain. Her research is focused on genetics and reproduction in rabbits. The major goal of her research is the genetics of litter size through novel methods such as selection by the environmental sensibility of litter size, with forays into the field of animal welfare by analysing the impact on the susceptibility to diseases and stress of the does. Details of her publications can be found at https://orcid.org/0000-0001-9504-8290.",institutionString:null,institution:{name:"Miguel Hernandez University",country:{name:"Spain"}}},{id:"350704",title:"M.Sc.",name:"Camila",middleName:"Silva Costa",surname:"Ferreira",slug:"camila-ferreira",fullName:"Camila Ferreira",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/350704/images/17280_n.jpg",biography:"Graduated in Veterinary Medicine at the Fluminense Federal University, specialist in Equine Reproduction at the Brazilian Veterinary Institute (IBVET) and Master in Clinical Veterinary Medicine and Animal Reproduction at the Fluminense Federal University. She has experience in analyzing zootechnical indices in dairy cattle and organizing events related to Veterinary Medicine through extension grants. I have experience in the field of diagnostic imaging and animal reproduction in veterinary medicine through monitoring and scientific initiation scholarships. I worked at the Equus Central Reproduction Equine located in Santo Antônio de Jesus – BA in the 2016/2017 breeding season. I am currently a doctoral student with a scholarship from CAPES of the Postgraduate Program in Veterinary Medicine (Pathology and Clinical Sciences) at the Federal Rural University of Rio de Janeiro (UFRRJ) with a research project with an emphasis on equine endometritis.",institutionString:null,institution:null},{id:"41319",title:"Prof.",name:"Lung-Kwang",middleName:null,surname:"Pan",slug:"lung-kwang-pan",fullName:"Lung-Kwang Pan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/41319/images/84_n.jpg",biography:null,institutionString:null,institution:null},{id:"125292",title:"Dr.",name:"Katy",middleName:null,surname:"Satué Ambrojo",slug:"katy-satue-ambrojo",fullName:"Katy Satué Ambrojo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/125292/images/system/125292.jpeg",biography:"Katy Satué Ambrojo received her Veterinary Medicine degree, Master degree in Equine Technology and doctorate in Veterinary Medicine from the Faculty of Veterinary, CEU-Cardenal Herrera University in Valencia, Spain.Dr. Satué is accredited as a Private University Doctor Professor, Doctor Assistant, and Contracted Doctor by AVAP (Agència Valenciana d'Avaluació i Prospectiva) and currently, as a full professor by ANECA (since January 2022). To date, Katy has taught 22 years in the Department of Animal Medicine and Surgery at the CEU-Cardenal Herrera University in undergraduate courses in Veterinary Medicine (General Pathology, integrated into the Applied Basis of Veterinary Medicine module of the 2nd year, Clinical Equine I of 3rd year, and Equine Clinic II of 4th year). Dr. Satué research activity is in the field of Endocrinology, Hematology, Biochemistry, and Immunology in the Spanish Purebred mare. She has directed 5 Doctoral Theses and 5 Diplomas of Advanced Studies, and participated in 11 research projects as a collaborating researcher. She has written 2 books and 14 book chapters in international publishers related to the area, and 68 scientific publications in international journals. Dr. Satué has attended 63 congresses, participating with 132 communications in international congresses and 19 in national congresses related to the area. Dr. Satué is a scientific reviewer for various prestigious international journals such as Animals, American Journal of Obstetrics and Gynecology, Veterinary Clinical Pathology, Journal of Equine Veterinary Science, Reproduction in Domestic Animals, Research Veterinary Science, Brazilian Journal of Medical and Biological Research, Livestock Production Science and Theriogenology, among others. Since 2014 she has been responsible for the Clinical Analysis Laboratory of the CEU-Cardenal Herrera University Veterinary Clinical Hospital.",institutionString:null,institution:null},{id:"201721",title:"Dr.",name:"Beatrice",middleName:null,surname:"Funiciello",slug:"beatrice-funiciello",fullName:"Beatrice Funiciello",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/201721/images/11089_n.jpg",biography:"Graduated from the University of Milan in 2011, my post-graduate education included CertAVP modules mainly on equines (dermatology and internal medicine) and a few on small animal (dermatology and anaesthesia) at the University of Liverpool. After a general CertAVP (2015) I gained the designated Certificate in Veterinary Dermatology (2017) after taking the synoptic examination and then applied for the RCVS ADvanced Practitioner status. After that, I completed the Postgraduate Diploma in Veterinary Professional Studies at the University of Liverpool (2018). My main area of work is cross-species veterinary dermatology.",institutionString:null,institution:null},{id:"291226",title:"Dr.",name:"Monica",middleName:null,surname:"Cassel",slug:"monica-cassel",fullName:"Monica Cassel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/291226/images/8232_n.jpg",biography:'Degree in Biological Sciences at the Federal University of Mato Grosso with scholarship for Scientific Initiation by FAPEMAT (2008/1) and CNPq (2008/2-2009/2): Project \\"Histological evidence of reproductive activity in lizards of the Manso region, Chapada dos Guimarães, Mato Grosso, Brazil\\". Master\\\'s degree in Ecology and Biodiversity Conservation at Federal University of Mato Grosso with a scholarship by CAPES/REUNI program: Project \\"Reproductive biology of Melanorivulus punctatus\\". PhD\\\'s degree in Science (Cell and Tissue Biology Area) \n at University of Sao Paulo with scholarship granted by FAPESP; Project \\"Development of morphofunctional changes in ovary of Astyanax altiparanae Garutti & Britski, 2000 (Teleostei, Characidae)\\". She has experience in Reproduction of vertebrates and Morphology, with emphasis in Cellular Biology and Histology. She is currently a teacher in the medium / technical level courses at IFMT-Alta Floresta, as well as in the Bachelor\\\'s degree in Animal Science and in the Bachelor\\\'s degree in Business.',institutionString:null,institution:null},{id:"442807",title:"Dr.",name:"Busani",middleName:null,surname:"Moyo",slug:"busani-moyo",fullName:"Busani Moyo",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Gwanda State University",country:{name:"Zimbabwe"}}},{id:"439435",title:"Dr.",name:"Feda S.",middleName:null,surname:"Aljaser",slug:"feda-s.-aljaser",fullName:"Feda S. Aljaser",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"King Saud University",country:{name:"Saudi Arabia"}}},{id:"423023",title:"Dr.",name:"Yosra",middleName:null,surname:"Soltan",slug:"yosra-soltan",fullName:"Yosra Soltan",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Alexandria University",country:{name:"Egypt"}}},{id:"349788",title:"Dr.",name:"Florencia Nery",middleName:null,surname:"Sompie",slug:"florencia-nery-sompie",fullName:"Florencia Nery Sompie",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Sam Ratulangi University",country:{name:"Indonesia"}}},{id:"428600",title:"MSc.",name:"Adriana",middleName:null,surname:"García-Alarcón",slug:"adriana-garcia-alarcon",fullName:"Adriana García-Alarcón",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"National Autonomous University of Mexico",country:{name:"Mexico"}}},{id:"428599",title:"MSc.",name:"Gabino",middleName:null,surname:"De La Rosa-Cruz",slug:"gabino-de-la-rosa-cruz",fullName:"Gabino De La Rosa-Cruz",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"National Autonomous University of Mexico",country:{name:"Mexico"}}},{id:"428601",title:"MSc.",name:"Juan Carlos",middleName:null,surname:"Campuzano-Caballero",slug:"juan-carlos-campuzano-caballero",fullName:"Juan Carlos Campuzano-Caballero",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"National Autonomous University of Mexico",country:{name:"Mexico"}}}]}},subseries:{item:{id:"28",type:"subseries",title:"Animal Reproductive Biology and Technology",keywords:"Animal Reproduction, Artificial Insemination, Embryos, Cryopreservation, Conservation, Breeding, Epigenetics",scope:"The advances of knowledge on animal reproductive biology and technologies revolutionized livestock production. Artificial insemination, for example, was the first technology applied on a large scale, initially in dairy cattle and afterward applied to other species. Nowadays, embryo production and transfer are used commercially along with other technologies to modulate epigenetic regulation. Gene editing is also emerging as an innovative tool. 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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. 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