\r\n\tThis book intends to provide the reader with a comprehensive overview of the current state-of-the-art novel imaging techniques by focusing on the most important evidence-based developments in this area.
",isbn:null,printIsbn:null,pdfIsbn:null,doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,isSalesforceBook:!1,isNomenclature:!1,hash:"d9159ce31733bf78cc2a79b18c225994",bookSignature:"Dr. Gabriel Cismaru",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11867.jpg",keywords:"Hypertrophic Cardiomyopathy, Dilated Cardiomyopathy, Restrictive Cardiomyopathy, Transesophageal Echocardiography, Intracardiac Echocardiography, 3-Dimensional Echocardiography, Adult Congenital Heart Disease, Tetralogy of Fallot, Transposition of the Great Vessels, Coronary Artery Disease, Risk Stratification, Revascularization",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"April 21st 2022",dateEndSecondStepPublish:"May 19th 2022",dateEndThirdStepPublish:"July 18th 2022",dateEndFourthStepPublish:"October 6th 2022",dateEndFifthStepPublish:"December 5th 2022",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"3 months",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"Dr. Cismaru Gabriel is an Assistant Professor at the University of Medicine and Pharmacy Cluj-Napoca, certified in Cardiology. After completing his certification in cardiology, Dr. Cismaru began his electrophysiology fellowship at the Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu. He has authored or co-authored peer-reviewed articles and book chapters in the field of cardiac pacing, defibrillation, electrophysiological study, and catheter ablation.",coeditorOneBiosketch:"Raluca Tomoaia is an MD, Ph.D. in novel techniques in Echocardiography at the University of Medicine and Pharmacy in Cluj-Napoca, Romania., assistant professor, and a researcher in echocardiography and cardiovascular imaging.",coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"191888",title:"Dr.",name:"Gabriel",middleName:null,surname:"Cismaru",slug:"gabriel-cismaru",fullName:"Gabriel Cismaru",profilePictureURL:"https://mts.intechopen.com/storage/users/191888/images/system/191888.png",biography:"Dr. Cismaru Gabriel is an assistant professor at the Cluj-Napoca University of Medicine and Pharmacy, Romania, where he has been qualified in cardiology since 2011. He obtained his Ph.D. in medicine with a research thesis on electrophysiology and pro-arrhythmic drugs in 2016. Dr. Cismaru began his electrophysiology fellowship at the Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu, France, after finishing his cardiology certification with stages in Clermont-Ferrand and Dinan, France. He began working at the Rehabilitation Hospital\\'s Electrophysiology Laboratory in Cluj-Napoca in 2011. He is an experienced operator who can implant pacemakers, CRTs, and ICDs, as well as perform catheter ablation of supraventricular and ventricular arrhythmias such as ventricular tachycardia and ventricular fibrillation. He has been qualified in pediatric cardiology since 2022, and he regularly performs device implantation and catheter ablation in children. Dr. Cismaru has authored or co-authored peer-reviewed publications and book chapters on cardiac pacing, defibrillation, electrophysiological studies, and catheter ablation.",institutionString:"Iuliu Hațieganu University of Medicine and Pharmacy",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"7",totalChapterViews:"0",totalEditedBooks:"2",institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"16",title:"Medicine",slug:"medicine"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:null},relatedBooks:[{type:"book",id:"5970",title:"Bedside Procedures",subtitle:null,isOpenForSubmission:!1,hash:"ba56d3036ac823a7155f40e4a02c030d",slug:"bedside-procedures",bookSignature:"Gabriel Cismaru",coverURL:"https://cdn.intechopen.com/books/images_new/5970.jpg",editedByType:"Edited by",editors:[{id:"191888",title:"Dr.",name:"Gabriel",surname:"Cismaru",slug:"gabriel-cismaru",fullName:"Gabriel Cismaru"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9064",title:"Epidemiology and Treatment of Atrial Fibrillation",subtitle:null,isOpenForSubmission:!1,hash:"1cd6bf2b3181eb82446347fbe478a2bc",slug:"epidemiology-and-treatment-of-atrial-fibrillation",bookSignature:"Gabriel Cismaru and Keith Andrew Chan",coverURL:"https://cdn.intechopen.com/books/images_new/9064.jpg",editedByType:"Edited by",editors:[{id:"191888",title:"Dr.",name:"Gabriel",surname:"Cismaru",slug:"gabriel-cismaru",fullName:"Gabriel Cismaru"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"6550",title:"Cohort Studies in Health Sciences",subtitle:null,isOpenForSubmission:!1,hash:"01df5aba4fff1a84b37a2fdafa809660",slug:"cohort-studies-in-health-sciences",bookSignature:"R. 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It is estimated that two thirds of people who have unprotected sexual intercourse with a HPV carrier are infected [1].
Since HPV has tropism for epithelial tissue [2-4], it can affect both skin and mucosa [3, 4]. It causes several types of injuries, ranging from asymptomatic infection and benign warts to invasive injuries [5]. HPV infection has been found in a wide range of anatomical sites: genital and anal tract, urethra, upper airway, tracheobronchial mucosa, nasal paranasal cavities, and oral cavity. HPV on oral mucosa presently afflicts 1% to 43% of the general population, depending on the diagnosis method used [5], and may be even associated with oral malignancies [6].
The aim of this review article is to offer the academic community an updated review of HPV, emphasizing its importance as a public health matter. This review encloses HPV epidemiology, virology description of different oral lesions, clinical picture, oncogenesis and, diagnostic tools. We have also reviewed current treatment choices and prophylaxis, as well as vaccines against HPV.
HPV is a small DNA virus belonging to
HPV genome presents a notable organization. It weighs 5.2x106D and contains 7.200 – 8.000 pairs of nitrogenous bases (pnb) [9]. All putative open reading frames (ORFs) are limited to only one strand of DNA [8]. Non-coding strand probably forms a second, which bears pieces of preserved ORFs, irrespective of localization and composition [8], Chlaudhary et al (2009) have suggested that the basis of the HPV molecule DNA can be divided in three parts. The first part, with 4.000 pnb, accounts for viral replication and cell transformation while the second part, with 3.000 pnb, represents an important codification zone, since it encodes the viral particle structural proteins. The last one, with only 1.000 pnb, contains a non-coding zone; it is, however, fundamental, since the viral origin of replication belongs to this part [9].
The difference of HPV types is due to the variation of E6 and E7 sequence of nitrogenous bases. This variation can produce either an easier to inhibit gene or a harder to inhibit one, thus stratifying the virus oncogenic phenotype into high, intermediate and low risk types [7].Besides its oncogenic potential, the HPV types vary according to tissue tropism and their association with these tissues [10]. Over a 100 HPV types [7] have been identified, but only 25 (HPV - 1, 2, 3, 4, 6, 7, 10, 11, 13, 16, 18, 31, 32, 33, 35, 40, 45, 52, 55, 57, 58, 59, 69, 72, 73) were associated with benign or malignant lesions [3, 10]. Low-risk HPV (6, 11, 38, 40, 42, 54, 55, 61, 62, 64, 67, 69, 70, 71, 72, 81, 83, 84, 89) [11] causes injuries which produce abnormal cell growth [8]; however, they are unlikely to undergo malignant neoplastic transformation. High-risk HPV (16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 73, 82) [11] are likely to induce malignant neoplastic transformation [3, 11]. Recently HPV- 26, 53, 66 have been found to be among the potentially high-risk types [12].
HPV - 6, 11 are related to condyloma
The American Cancer Society has estimated that more than 6 million people are infected by HPV each year, with 3 million affecting the 15- 25 age group [14].
Asymptomatic oral and oropharynx HPV prevalence at oral cavity has not yet been established [15], probably because different methods were used in different studies [3]. Methods have varied in terms of size of samples, collecting procedures, test sensibility and use of PCR or PCR inhibitors. This may explain the huge variation in HPV detection rate: 22 to 60% or 0 to 81.1%, depending on the methods and on the studied population [15].
Recent meta-analysis has demonstrated that HPV is an isolated risk factor for the development of oral carcinoma [2]. Oral squamous cell carcinoma is known to be linked with both heavy drinking and smoking and it has been related to HPV [6, 7].
When oral mucosa is considered normal, the epithelium may serve as a container of HPV which would be activated at some point in time and induce injury [16]. A huge number of different oral diseases may be associated with oral HPV, but they rarely cause lesions [17]. Lesions may range from benign warts, which are far more common, to malignant injuries [6].
Many studies have discussed HPV transmission, but the mechanisms involved remain unknown. Unprotected sexual intercourse is its leading cause, particularly oral-genital sex, when the genital mucosa is infected by the virus, which will be present both clinically and subclinically [1, 16] in adolescent and adults. Early sexual relationships, high number of sexual partners, parity, smoking and another sexually transmitted infection may elevate the rate of virus infection [6, 18, 19].
Oral HPV can be transmitted by direct skin-skin contact [3] and self-inoculation [1, 4]. Upper airway transmission has not yet been established [8].
Infant HPV is mainly transmitted at birth by infection of the maternal cervix. Thus, the recurrent laryngeal papillomatosis seems to be acquired by such manner [19, 20]. However, another transmission route is mother-fetus, before, during or after the child-birth [1, 4, 8] that may be made possible by infected amniotic fluid and umbilical cord blood [21].
The transmission of HPV through fomites may also occur [22].
In the social sphere, people who have yet to initiate sex life have a low probability of HPV infection. On the other hand, people who started their sex life earlier or have a promiscuous sexual life are more likely to have sexually transmitted infections, including HPV. In the economical sphere, it has been found that low levels of HPV infection were strongly related with higher income levels [4].
Early age initial sexual activity, oral sex, more than one sexual partner, not wearing condoms, infrequent use of condoms all pose important risks to any sexually transmitted infection, such as HPV. Homosexuals tend to have greater number of sexual partners than heterosexuals, and as such, they should be more commonly infected than heterosexuals, but studies have yet to confirm this trend [4, 8].
Smoking may pose a lower risk for infection with high risk oral and oropharyngeal HPV than it was previously believed probably because the oral mucosa keratinization makes it stronger against minor traumas and consequently HPV infection. On the other hand, high levels of alcohol consumption have been linked to a higher risk of HPV positivity, but this association needs further research in order to be more fully established [68].
Normally, people acquire HPV during their adolescent years, or when they approach their twenties, when they start their sexual life. An immune competent person can suppress HPV or even eliminate it, and suppressed HPV may be kept subclinical for years [8].
Among the leading protective factors, saliva stands out. It is composed of lysozymes, lactoferrin, IgA and cytokines which seems to be the reason behind low HPV transmission through self-inoculation, oral sex, and the virtually inexistence of transmission through kissing. It has been suggested that regular consumption of carotenoids would contribute to make HPV persistence less likely, and a high consumption of folic acid would reduce the risk of HPV infection [4].
HPV infection range from asymptomatic to visible lesions, which can be benign or malignant [6]. The most common oral manifestations are described below:
The lesion is caused by the abnormal proliferation of a squamous stratified epithelium [23]. Formerly it was believed that the only transmission route was by sexual contact, but now it is known that there are other routes, such as self-inoculation and mother-fetus transmission [15]. However, sexual contact remains the main route of transmission (20%) [23], and people who carry these lesions and practice oral sex have a 50% chance to acquiring oral condyloma. The incubation period range from 3 weeks to an undetermined period of time; after that, clinic progression will depend on cell permissiveness, virus type and host immune situation [24].
Condyloma acuminatum has tropism to tongue, lips, palate and mouth floor. Clinically, it is described as little pinkish or whitish nodules which proliferate in papillary projections that might be either pedicle or sessile. Outline surfaces present even more evident cauliflower shapes than papilloma, mainly when they converge (Figure 1 – A, B).
Condyloma acuminatum. Rose-colored nodule with a cauliflower-like surface in the floor of the mouth (
Histologically, oral condylomata are typically papillary proliferations of squamous epithelium with prominent acanthosis and parakeratin that line deep crypts, similar to their counterparts in the lower genital tract. Koilocytosis is the classic diagnostic feature, consisting of cells with perinuclear halos of various sizes and accompanied by variability in nuclear size and chromaticity, as well as nuclear membrane irregularity. These features are most prominent toward the surface of the lesion (Figure 1 – C, D) [25].
HPV presence was first determined by immunohistochemistry and later by hybridization with 75 to 85% of positivity [15]. The most involved types are 6 and 11 [5, 15, 18].
Differential diagnoses include oral squamous papilloma, verruca vulgaris, molluscum contagiosum, seborrheic keratosis, lichen planus and oral squamous cell carcinoma (OSCC) [15].
Condyloma acuminatum treatment is not always necessary. For 20-30% of HPV patients, lesions are self-limited and resolve spontaneously within six months, while for 60% of them, lesions may regress in a year. Relapses affect 20-30% of patients undergoing treatment, and they may reappear on the same sites or on different locations [24]. The choice of therapy is based on a range of factors, such as lesions size, aspect, number and sites. Other factors of equal significance include patient preference, costs, and adverse effects [23]. Commonly, lesions have been treated by excisional surgery, but in the last years a wider choice of treatments have become available, e.g., cryotherapy, electro cauterization and CO2 laser. Other options include caustic agents, such as trichloroacetic acid, podophyllin and 5-flourouacil which may cause tissue destruction [23].
Verruca vulgaris, also known as common wart is one of the most common lesions affecting mainly children [15], but seldom on oral mucosa [6].
It is usually found on lips, hard palate, gingival, and tongue dorsal surface [15], but especially on lips and tongue [18] (Figure 2 - A, B). Differential diagnoses is made with oral squamous papilloma and condyloma acuminatum [15, 18].
Verruca vulgaris. Exophytic lesion with hyperkeratotic surface, forming finger projections in the left commissure of the lip (
Histologically, verruca vulgaris show an almost symmetrical structure, with elongated rete ridges that are shorter at the periphery than in central area. Thin elongated connective tissue papillae form papillomatosis. The cryptoform surface shows a conspicuous hyperkeratinization, predominantly composed of orthokeratin. The stratum granulosum is often pronounced, particularly in the grooves between the elongated connective tissue papillae. Koilocytes may be seen. In the connective tissue, some dilated capillaries and a slight infiltration with lymphocytes are usually seen (Figure 2 C, D) [26]
Immunohistochemical methods and hybridization tests showed HPV presence in 43 to 100% of the studied lesions [15].
Most oral warts are self-limited, and resolve within 2 years. Aesthetic discomfort or bite injuries induce patients to look for treatment. Some treatment techniques are cauterization, surgical removal, liquid nitrogen cryotherapy, local hyperthermia, topic 5-fluoracil, CO2 laser, salicylic acid, squaric acid, interferon and wart material implantation [18].
Oral squamous papilloma (OSP) is a benign tumor that may occur in all ages, but it more commonly affects adults between 30 and 50 years old [15]. It is mainly related to HPV 6 and 11 [15, 18]. In adults, the lesion is usually located in the oral mucosa, mostly on palate and tongue, while in children the laryngotracheobronchial complex is a more common site [27].
OSP affects the soft palate, the lingual frenulum as well as the lower lip [15] and the uvula [27], most often presenting as a single, small lesion smaller than 1 cm, with exophytic growth and a wide basis or pedicle. On histopathology the pattern of epithelial proliferation repeats features described in the previous lesions, with squamous cell acanthosis, hyperkeratosis and a centrally disposed fibrovascular core.(Figure 3 – A, E). Koilocytosis may be present or not.
Oral squamous papilloma. Exophytic lesion with hyperkeratotic whitish surface, forming finger projections on the dorsum of the tongue (
Oral squamous papilloma may be isolated or multiple-recurring, which is more likely to affect immunosuppressed patients, such as HIV-positive patients. Multiple-recurring papilloma is also more likely to be malignant [27] and tends to relapse more often [28]. Differential diagnoses include exophytic carcinoma, verrucous carcinoma and condyloma acuminatum [27]. Surgical removal is the first choice of treatment, but electrocauterization, cryosurgery and interferon injections are other effective treatment courses [8].
Focal epithelial hyperplasia (FEH) or Heck disease was first described in 1965 [15] and can affect all age groups [29], but it is more common in children and adolescents (3 to 18 years) [30]. Malnutrition, poor hygiene and low social condition as well as genetic background also play an important role [31] in lesion development.
FEH shows a benign epithelial growth and commonly affects oral mucosa, lips, tongue [18], particularly the lower lip and more rarely the palate, floor of the mouth and oropharynx [30]. Clinically it presents as multiple papules (3 – 10 mm) [30] that tend to converge. They are characteristically nodular, sessile, circumscribed, painless and soft masses on oral mucosa. Color may range from pale pink to normal mucosa [15, 29- 31]. (Figure 4 – A, B). The diagnosis is both clinical and histological [30, 32].
Focal Epithelial Hyperplasia. Multiple flat and coalescent papules on the lower lip mucosa (
Microscopically it shows epithelial hyperplasia, acanthosis, mild parakeratosis and anastomosing rete ridges. Superficial layers of the epithelial tissue contain cytophatic changes (koilocytosis) and apoptotic or dyskeratotic cells with an apparent mitotic appearance (mitosoid cells) (Figure 4 – C, D) [30].
FEH has a steady association with HPV infection, and the most common types are 13 and 32 [15, 29]; they account for approximately 90% of infections [30, 32]. HPV-32 might be found in other type of lesions, but never out of the oral region [15]. Both HPV-1 and 11 are rare and show potential for malignancy. So far, the only malignant transformation reported has been found with HPV-24 [32].
Differential diagnoses include condyloma, viral warts, neuroma, white sponge nevus, oral papillomatosis, [30] and inflammatory fibrous hyperplasia.
FEH normally regresses spontaneously in a few months or years, but it can take longer [30]. Thus, treatment is often chosen to mitigate aesthetic problems or repeated bite injuries [31]. The most effective methods are surgical excision, electrocoagulation, cryotherapy [31], CO2 laser and interferon [30].
Oral lichen planus (OLP) is a common chronic immunomediated disease [18, 33, 34] of unknown etiology seemingly related to HPV in some lesions [18], affecting the skin and the mucosa [33-, 35]. OLP prevalence ranges from 0, 5% to 4% [35] and mainly affects the female population [33-35]. The most prevalent age is between 30 to 60 years old, although occurrence in children and adolescents seems to be on the rise [35]. In around 15% of the cases the skin is affected and this number increases to around 85% of cases affecting the mucosa, particularly the oral and genital mucosa. The oral mucosa is affected in 20% to 30% of the cases. Besides being more common, OLP is more resistant to treatment than skin OLP [34]. A possible relationship between OLP to Hepatitis C has been hypothesized, but it has not been clearly established.
Diagnoses depend on clinic manifestation as well as histopathology results [35]. OLP lesions are usually bilateral and symmetric affecting areas the oral mucosa, gingiva as well as the dorsum of the tongue and the lip mucosa (Figure 5 – A, F ).
The lesions may be single or multiple and may present in a wide range of forms- cauliflower- like, striated or annular. Long-time evolution of a lesion is usually atrophic, and when the lesion is located on the tongue it may cause papillae loss and modify gustation (Figure 5 – G, F ). Extensive lesions are also more painful [35].
Oral lichen planus. Most prominent features are bilateral white striae in buccal mucosa, with certain symmetry (
According to Silverman’s classification OLP may be presented as reticular, erosive and atrophic forms [33]. Each form has its different clinic evolution and determines different intensity and duration, with the possibility of evolving from one form into another [35].
On histopathology, we may find acanthosis in keratotic lesions, and atrophy in older lesions. Two important findings are hydropic degeneration of the basal layer, as well as a strong subepithelial lymphocytic infiltrate (Figure 5 – G, H). Those lesions that present dysplasia should not be classified as OLP [36, 37]. Biopsy should be preferably performed on keratotic areas, however this might be a complicated intervention when the patient has extensive oral candidiasis [34, 35]. Some other pathologic entities may present similar histopathologic features, such as lichenoid reaction, which is similar to lichen planus, but usually is related to amalgam fillings or certain medicines [33, 34].
The most prevalent and commonly found HPV types are 11 and 16 [18].
The conditions that may be considered as differential diagnosis of OLP include the reticular form which should be distinguished from systemic lupus erythematosus, candidiasis, traumatic lesions, secondary syphilis, hairy leukoplakia and incipient OSCC. The erosive form should be distinguished from aphthae, mucous membrane pemphigoid, pemphigus vulgaris, drug reaction, polymorphic erythema and systemic lupus erythematosus acute lesions [35].
Malignant transformation is reported for OLP, however, a current tendency is to consider those lesions that do not fulfill established clinical and pathologic criteria for OLP as oral lichenoid lesions. These lesions mimic OLP and would be the ones truly at risk of becoming a OSCC [36, 37].
Treatment does not assure cure, for unknown reasons, but it does reduce symptoms, particular when they are severe, atrophic and widespread. Unlike the asymptomatic reticular form, erosive lesions need prompt symptomatic treatment. Oral hygiene reduces inflammatory lesions and topic corticosteroids may be used in the form of mouth wash. Calcineurin inhibitor, a topic immunosuppressive agent, and topic retinoid, such as imiquimod, are other treatment options, with the latter being used together with topic corticosteroids [33-35].
Leukoplakia is considered a premalignant lesion or potentially malignant disorder on oral cavity, and reported rates of development into malignancy vary widely depending on the method of diagnosis and definition criteria used for oral leukoplakia [38]. The most common malignant transformation is into oral squamous cell carcinoma (OSCC) [38, 39], with percentages ranging from 3 to 37% [38].
Oral leukoplakia prevalence ranges from 0, 4 to 0, 7%, and there is no variability related to gender. However, some researchers believe that prevalence among women is higher [38].
Etiology is uncertain; however smoking along with alcohol consumption is pointed as the main risk factors. There are possible cofactors, such as candidiasis, HPV and more recently Epstain-Barr virus (EBV) has been associated with these lesions in imunossupressed patients [38]. EBV rarely affects immunocompetent people and it does not need a specific treatment [40]. Treatment should address the underlying cause of immunosuppression.
Oral leukoplakia may be located on lip vermillion, gingival, tongue and floor of mouth, and it is on these latter regions that there is a higher risk of malignancy (around 43%) [38, 40]. Oral leukoplakia distribution may be local or disseminated [41] (Figure 6 – A, F).
OL: Oral leukoplakia. OL located at lateral (
Histological examination reveals a range of epithelium changes varying from innocuous hyperplasia to dysplasia of varying degrees [18]. However, more commonly, OL presents hyperkeratosis and epithelial hyperplasia without dysplasia [38] (Figure 6 – G, H). Depending on the dysplasia degree, it may be classified as low, intermediate and high risk of malignancy [38], so that severity of the dysplasia is the key standard in malignancy prediction [39]. However, diagnosis of dysplasia is rather subjective and as such it is highly dependent on the pathologist/researcher [38, 39]. Another controversial issue is that it is virtually impossible to accurately predict which lesion, even among those with dysplasia, will develop into a malignant one [39]. Rather, we might get to know which lesion is more likely to become malignant, if clinic and histological characteristics are analyzed in association [38.37]
Viral etiology is unclear. Although HPV 6, 11 and 16 have been predominantly found, and also HPV 18, 31, 33, 35 [18, 38] in lesions, the viral etiology remains controversial. It seems that lesions which contain HPV are less malignant than oral leukoplakia in smokers, similar to what happens in OSCC. HPV-16 is present in 80% of the lesions, regardless of malignancy [5], and it has already been established that type 16 is related to OSCC in nonsmoker or nondrinkers. EBV seems to be an etiologic factor of oral leukoplakia because it appears in a great number of malignant lesions in imunossupressed patients [38]
Differential diagnoses are leukoedema, white sponge nevus (
There has not been any agreement as to the best treatment course, and prevention (smoking and drinking avoidance and a diet rich in fruits and vegetables) remains the best approach. A topical treatment based on topical bleomicyn and systemic retinoid is used as an effective short term treatment, however there are doubts as to its long term efficacy. Invasive treatments include cryosurgery, CO2 laser, and surgical resection. They are effective in the short run, but lesions may relapse in the long run [38, 42]
Oral verrucous carcinoma (OVC) is a squamous cell carcinoma (SCC) subtype [15, 43, 44], but it shows a much more benign behavior, with well distinguished morphology and clinical presentation. It is located on the head, neck and genitals, and more notably on the oral mucosa, and it has low probability of metastasis [43, 44].
OVC is a rare tumor and had been described by Ackerman [15, 43, 44] in 1948 as a cancer that involves the lips, oropharynx and laryngeal mucosa. It is also known as Ackerman’s tumor. However, the condition has also been referred as florid oral papilomatosis, epithelioma cuniculatum, carcinoma cuniculatum and also as Buschke-Loewestein tumor [43]. Nowadays carcinoma cuniculatum is considered as a separated pathologic entity [45].
The etiopathogenesis of OVC is unknown, but some studies have found associations mostly with smoking, some alcohol ingestion and infection by HPV [15, 44]. OVC related co-factors are poor oral hygiene, OLP or the presence of leukoplakia lesions. HPV may have an important role in tumor development and progression, but further research is necessary [44].
HPV has been widely described as one of the causes of OVC, and the most commonly found types are 6, 11, 16 and 18, which were identified by polymerase chain reaction (PCR), restriction fragments analyses and DNA slot hybridization [44].
Oral verrucous carcinoma is a male disease and affects predominantly the 50-80 age group [44]. OVC is characteristically situated on the oral mucosa, gingiva, mandible alveolus crest, tongue and lips [44].
It appears with slow exophytic growth, resulting in verrucous cauliflower lesions, with white plaques, normally extensive and with well demarcated hyperkeratotic lesions [15, 43, 44]. It is well circumscribed, invasive only on surface, with low probability of metastasis [43] (Figure7 – A, C). People usually look for doctors because of the extensive rapid growth, which scares them.
OVC histology is characterized by the presence of acanthosis and keratinization with keratin plugging and clefting [43, 44]. They are irregular and may extend into cleft. Atypia is minimal and usually there is inflammatory infiltrate on the subepthelial layer around epithelial invaginations which seem to compress the underlying tissue (“elephant feet”) [44] (Figure 7 – D, E).
Oral verrucous carcinoma of the lip mucosa. Typical clinical presentation showing an indolor sessile nodule with a white verrucous surface (
Main OVC differential diagnosis is verrucous hyperplasia, which is very similar, clinically and histologicallly. Verrucous hyperplasia has in fact been regarded as an OVC precursor [43]. Other differential diagnoses are OLP, benign keratosis, chronic candidiasis, verruca vulgaris, oral leukoplakia, reactive keratosis epithelial hyperplasia, pseudoepitheliomatous hyperplasia. It is difficult to distinguish OSCC from OVC, because they may share a similar clinical picture and incisional biopsy excerpts may not contain atypias [44].
Besides that, tumors mainly composed of OVC may contain small areas of OSCC and behave as one. Ideally, for definitive diagnosis the entire tumor mass with its surrounding tissue should be excised and sent for histopathologic analysis [43].
The treatment main option is surgical resection [15, 46] that may be associated with radiotherapy particularly on larger lesions. Relapse rate is high when surgical resection or radiotherapy is performed in isolation. Prognosis of OVC is better than for other types of tumor. Cytostatic drugs, such as α- interferon (IFN), should be considered for patients who cannot undergo surgery, but results are not superior from those obtained with surgery [46].
OSCC is a worldwide problem [47], representing approximately 3% of all malignant neoplasms; which means more than five thousand diagnosed cases a day [48], and more than 90% of all oral cancers [49].
It is a condition primarily related to environmental factors [8] and lifestyle as heavy smoking (more than a pack a day) and drinking (more than 100g a day) [47]. These two are the main risk factors for malignant epithelial transformation. Other risk factors include compromised immune system, poor buccal hygiene and inadequate eating habits [47, 49]. However, OSCC may affect 15 to 20% of patients with no known risk for the condition [8].
Friedrich et al. reported a 20% to 30% HPV association with OSCC [50]. A meta-analysis indicates that oral infection with HPV is an independent risk factor for OSCC. [51] Typically, elderly people [47, 49] are more affected than young people. However, the incidence in young adults is increasing. Some studies have shown that OSCC in young adults follow a different clinical course, being more aggressive and affecting more males [47]. On the other side, other authors have shown no difference in survival among elderly and young adults with OSCC [52].
The most commonly affected site for OSCC is the tongue, especially on inferior and lateral surfaces (40%) [53](Figure 8 – A, F), but it can also affect buccal mucosa, lips, posterior mandibular ridge, gingiva, hard palate and retromolar trigone [47, 49, 53, 54].
The clinical picture may vary among OSCC types. Typically they are nodular or ulcerative lesions [15, 18], with exophytic or ulceroproliferative features [47]. At more advanced stages lesions present an ulcerated center, not well defined with hard borders. At this point, symptoms such as loss of teeth, bleeding, dysarthria, dysphagia, odynophagia and otalgy may develop [54].Some of them, for unknown reasons, do not progress into metastasis, while others infiltrate quickly, invading the lymph nodes [55]. Tongue and floor of the mouth tumors invade cervical lymph nodes in up to 25% of initial stage cases [56, 57] and are often submitted to elective neck dissection. Cervical metastasis at diagnosis is the main indicator of a bad prognosis [45].
Clinical aspect of OSCC. It may present as an exophityc nodule, ulcerated (
Histologically a range of features may be present, but it is important to detect epithelial invasion in the stroma, that may occur as islands, cords, sheets and isolated epithelial malignant cells. Keratin may be present, mostly in well and moderately differentiated tumors. There are varying degrees of atypia, nuclear and cellular pleomorphism with aberrant and regular mitosis (Figure 9 – A, D). Usually poorly differentiated tumors are related to recurrence [58]. Clinic and histological features are important to determine treatment, prognostic factors and survival rates [58, 59]. There is a TNM staging scheme, for OSCC and salivary gland tumors [60]. At the initial stages survival rates reach 80%, while at more advanced stages they decrease to 21% [54].
OSCC histopathology. It is possible to observe superficial non affected oral epithelia and tumoral islands in the stroma (
A correlation between HPV and cervical SCC of the utherus has been identified, but despite the strong evidence of HPV presence, there is no clear-cut proof that would point to HPV as an isolate SCC cause on oral cavity. Some studies argue that HPV is a mere supporting causer [1, 61] while another study indicates that tumors positive for oncogenic types of HPV may show better survival [62], mainly in oropharynx, where HPV positive tumors are associated with a specific morphology (basaloid squamous cell carcinoma, a subtype of conventional carcinoma) and positivity for p16 using immunohistochemistry [63].
HPV-16 has been found in 90% of head and neck cancers and in 50% of oropharynx [1, 18, 53, 64]. However, some authors have not found such association [64].
Potentially malignant disorders such as leukoplakia, erytroplakia, proliferative verrucous leukoplakia and lichen planus may progress to OSCC [1] and upon biopsy, there may be already areas of an actual OSCC [65].
Surgical resection is the treatment of choice when the lesion is placed on oral cavity while chemoradiotherapy is used when the oropharynx is the afflicted site [22] or if it is a tumor in a very advanced stage [66].
Surgery may impair some functions as speech, swallowing, and chewing and abruptly change quality of life. To maintain swallowing and speech, an alternative course is ablative surgery (microvascular free tissue), but this is not regarded to be as effective as surgical resection. In advanced stage when metastasis is located on upper aerodigestive tract, treatment should be multimodal, combining surgery and chemoradiotherapy [46].
Recurrent OSCC is challenging as the risk of complication is increased due to fibrosis and tissue hipovascularization [51].
Radiotherapy may be primary, adjuvant or neoadjuvant. It is regarded as primary for unresectable tumor or for patients who cannot undergo surgery, adjuvant as a post-surgery complementary method, and neoadjuvant when performed before surgery to facilitate tumor resection [54].
HPV infection may lead to cell immortalization by means of infection of the mucosa and skin basal epithelial cells, which are the only ones that keep in the cell cycle [8, 61]. It may be by itself a causative agent of malignant transformation or when associated with other unclear cofactors [61]. However, some researchers have argued that HPV is not able to cause malignant transformation, despite the studies which point to the contrary [12].
Some factors should come into play to immortalize cells: virus type, synergetic action among physics, biological and chemical agents and genetic constitution, which are able to modify the natural course of the disease. But if the exposed person has a favorable condition and acquires high risk HPV it becomes easier to integrate viral DNA into human genome [61].
Oral HPV has been diagnosed in OSCC and it is believed that it has been involved in oral carcinogenesis by transforming the keratinocytes through a mechanism involving E6 and E7 proteins. However, the mechanisms behind immune response against high risk HPV remain unclear [67-69].
The identification of various types of HPV is a recent technological advance due to the growth impossibility in tissue cultures and research animals.
Diagnoses methods vary from simple to sophisticated ones, ranging from light microscopy to DNA expression, with low to high sensitivity. Light microscopy and in situ hybridization are considered low sensitivity methods because it only tests positive when there are more than 10 viral DNA copies per cell. Among the intermediate sensitivity methods we find southern blot, do blot and reverse hybridization with a positive detection result when there is from 1 to 10 DNA copies per cell. High sensitivity methods, such as PCR, needs less than 1 viral DNA copy per cell for microorganism detection [70].
This method provides some data, even though it has low sensibility and it does not inform the HPV type. The most common HPV induced changes are epithelial thickening, prominent keratohyalin granules, hyperkeratosis, nuclear dysplasia, hyperchromasia, double nucleation of superficial and intermediated cell, perinuclear cytoplasmic halos, and atypical immature metaplasia [9].
HPV particles may be identified by electron microscopy (EM), but not the HPV type. EM can detect the presence of virion on koilocytic and dyskeratotic cell nuclei, but it is a limited method to investigate infection, because high risk HPV do not reproduce and as such cannot be identified through EM [5].
Molecular methods can be divided into two types: non-hybridization, such as in situ amplification, southern and dot blot hybridization and the amplified, such as target amplification, signal amplification and probe amplification. Target amplification is best exemplified by PCR. Signal amplification may be represented by hybrid technique sample. Probe amplification which is a compound-probe is added to a probe generating signal (Ligase Chain Reaction) according to literature [5].
Southern Blot classifies and identifies new viral types. It is a labor-intensive process that requires well trained skills and depends on a new generation of equipments. This technique requires the total length of a DNA molecule, and offers additional information about viral integration and subtype [70].
Dot blot is a simplified southern blot, requiring less sophisticated facilities, but it is rarely performed because of its low sensitivity. It is often used as detection kits available on the market [70].
The classic example of target amplification is PCR. This is the best subtype detection method due to the high sensitivity [9]. It is commonly used as diagnostic tool for HPV DNA epidemiological investigation, but because of the high cost this method cannot be used in a routine clinical practice. PCR has a high sensitivity and it is very effective for both malignant and pre malignant lesions identification, and material can be collected with oral swab or wash [7, 9].
Using signal amplification with microplate chemiluminescent detection, this method identifies nucleic acid due to its high sensitivity [9]. HC is a very important tool to detect high risk HPV, and the method has identified HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68 types [9]. This technique is able to identify 5000 viral copies per sample [73].
Probe amplification methods differ from target amplification in that the amplification products contain a sequence only present in the initial probes. It is used currently as an important diagnostic application, the detection of high-risk genotypes of human papilloma viruses (HPV) [74].
One simple and effective prophylactic measure is patient education. It must be clear to patients that even after treatment the virus remains on the oral mucosa, so it is imperative to maintain good oral hygiene, condom use in all sexual relations and refrain from promiscuous sexual behavior. Clinical examinations have to be done periodically and smoking and chronic alcoholism must be abolished.
It is crucial that the population in general be informed about HPV prevention as a control strategy and early diagnosis promotion. Raising awareness of HPV through education is essential to develop population perception about risk factors, mainly those related to sexual activity[18]. It is also important to discourage early sexual initiation [69].
In view of the increasing figures of cervix cancer, the US Food and Drugs Administration (FDA) approved in 2006 a vaccine against HPV [75]. There is a bivalent vaccine that contains L1 HPV-16/18 protein which generates a huge number of genotype specific antibody [75]. For HPV 16/18 vaccine efficiency is round 96% on cervix cancer [69]. There is also a tetravalent vaccine that works in the same way as the bivalent, but provides further immunity enclosing HPV types 6, 11, 16, 18 [75]. Both of them use virus- like particles in their composition [9].
The vaccine(s) stimulates humoral response, but it also stimulates B cell immune memory response, which persists for five years [69]. After a 5 years follow up, it has demonstrated 100% of efficacy on persistent infection prevention [8].
As HPV’s physiopathology is very similar on the affected sites, whether they are the skin, cervix, penile, anus or oral mucosa, there is no reason to doubt that the vaccine which works well on the cervix would also prove effective for the prevention of oral mucosa lesions [75].
As HPV-16 seems to be an important risk factor for the progress of malignant lesions (because it is found in most OSCCs), it might be possible that the vaccine would prevent or even treat them [8].
HPV vaccine seems to be less effective on women who have already been exposed to the virus, hence the public health focus on vaccinating girls before their first sexual relation to prevent warts and more disaster lesions in the future [8, 9]. Some countries have promoted vaccination for any females from 9 to 26 years who have never had sexual experience before [76]. Other countries promote vaccination for females up to 45 years old [77]. Vaccines for men aged 11 up to 26 years old in order to prevent genital warts and anal cancer was approved in 2011 by the US Advisory Committee on Immunization Practices [78].
HPV is as frequent in men as in women; however, it is often asymptomatic in males, what makes them a HPV reservoir to cervix and non- cervical lesions in females, transmitted mainly by sexual activity [69]. Current studies have been done in order to further assess the natural history of the HPV infection in men [79, 80].
A therapeutic vaccine is under study, one which could be used as adjuvant on surgery or radiotherapy, to clean up microscopic waste of the lesion, thus generating immune response.
In view of the potential risks of HPV and the potential benefits of the vaccine (some not yet fully established) some researchers favor the extended use of the vaccine to all age groups of both sexes, regardless of previous sexual practice, as a form to interrupt the transmission cycle and as a preventive strategy in controlling and avoiding the risks posed by HPV, including various types of cancer in different locations in the human body.
We would like to thank Professor Simone Lourenço and Márcia Sother who were active in building clinical images archives for the Stomatology Specialization Course at Odontoclinica Central do Exército (OCEx – Rio de Janeiro, Brasil).
Since the year 2000 through to the end of 2018, a total of 5338 water-related disasters (WRD) are reported and led to over 326,000 fatalities and economic losses of more than USD 1.7 trillion globally. Floods accounted for about 54% of all WRD. Asia appears to be the hardest-hit continent, with 41% of all flood disaster events, followed by Africa (23%), the Americas (21%), Europe (13%), and Oceania (3%). Of the deaths caused by all WRD from 2001 to 2018, some 93,470 were due to floods. During the same period, floods alone were responsible for economic losses of nearly USD 500 billion globally—about one-third of the total financial damages caused by all WRD [1, 2]. To mitigate these disastrous flood impacts, flood early warning systems (FEWSs), among other flood risk mitigation measures, are operational in many parts of the world. The UN Office for Disaster Risk Reduction (UNDRR) recognizes the importance of FEWSs to mitigate flood disaster impacts and thus has set forth Target 7 in the Sendai Framework to explicitly focus on “substantially increasing the availability of and access to multi-hazard early warning systems and disaster risk information and assessments to people [3].” Among the early warning systems, FEWSs are the most common systems since floods are widespread around the globe. Comprehensive early warning systems comprise of four closely interrelated components including (i) disaster risk knowledge; (ii) detection, monitoring, analysis, and forecasting of hazards; (iii) warning dissemination and communication; and (iv) preparedness to respond [3]. Risk assessment forms the foundation of a FEWSs, and disaster risk knowledge refers to the awareness about both the hazards and vulnerabilities present in a particular area. It can be acquired through a risk assessment that may include hazard and vulnerability mapping based on the spatial repartition of the population, infrastructure, and economic activities in the area of interest. Detection and monitoring involve a continuous collection of hydroclimatic data so that watershed states that are precursors of indicators of an unfolding disaster are identified in time to trigger the response. Analysis refers to the processing of the collected data to generate products that not only can support monitoring and detection but can also provide hints about the possible evolution of the disaster. Forecasting refers to an estimation of the state of the watershed and impacted people and assets. It involves the acquisition or generation of a weather forecast, which is post-processed and used to force hydrologic models to obtain future river discharges. The river discharge may be used as an input to predict river stage and floodplain extent using either empirical relationships or hydraulic/hydrodynamic models. For locations of interest in the area monitored by the FEWS, pre-set flood warning thresholds are identified based on the river system configuration and land occupancy. If the pre-set threshold is likely to be exceeded shortly, a flood warning is issued. The warning is then disseminated through an operational telecommunication system from Flood Forecast Centers (FFCs) to local/national governmental authorities and communities at flood risk for prompt actions such as evacuating to safe grounds prespecified by the authorities.
\nFEWSs range from simple, i.e., technologically basic involving manual data collection and transfer and qualitative forecasts performed based on observations, to complex, i.e., technologically advanced involving telemetric data collection and transfer and modeling-based flood forecasting systems. The level of technological complexity in an operational FEWS varies significantly among different nations as well as different river basins, depending on several factors. These factors include access to comprehensive, timely, relevant, and reliable hydroclimatic information about the area covered by the FEWS, the availability of technically skilled personnel and computational capabilities to process the information, and finally, the ability to communicate the information to relevant stakeholders efficiently. The objective of this chapter is to highlight how advances in data sciences, remote sensing, and smart sensors have the potential of revolutionizing the components of FEWS. The authors recognize that FEWSs are evolving rapidly. Some FEWSs, especially in the developed world, are using either all or part of the emerging technologies. There is, however, inertia in technology adoption, and a majority of systems are in the developing world still using “traditional technologies” such as networks of hydrometric and climatic gauges, sometimes combined with lumped or semi-distributed hydrologic models. These systems are referred to as “Traditional FEWSs” in this chapter. The next section discusses the challenges that are typically encountered by “traditional FEWS,” and the following section highlights new technologies and how they can help overcome these challenges.
\nFlood risk knowledge can be acquired either by looking at historical flood records that occurred in the area, the survey of people and assets exposed to floods, the use of predictive modeling, expert knowledge, or any combination of the above. It also requires the knowledge of the likelihood of flood events and their impacts. The use of historical flood records is often limited by the availability of a long series of hydrologic data. Understanding vulnerabilities involves expensive mapping and surveys that need to be kept up to date with dynamic urban growth. Predictive modeling consists of the collection of spatial data sets such as topography, land use, soil, and exposure. It also requires the availability of skilled staff to run simulations and analyze the results. As a result of these challenges, risk knowledge is incomplete in most areas covered by FEWSs.
\nTo accurately predict the evolution of floodwater levels, FEWS operators need to have a good knowledge of the current and past values of key hydroclimatic parameters in the watershed upstream of the location of interest, as well as their plausible evolution in the near future. Commonly monitored variables include water levels, discharges, snowpack, precipitations, and temperatures. The current and past values of these parameters are available through a monitoring system, traditionally composed of a network of ground stations that may be complemented by occasional field surveys. The ground stations usually measure the variables of interest at a particular point, giving the FEWS operators only partial information about the state of the watershed, especially if the monitoring network has inadequate spatial coverage. About 75% of the flood forecasters surveyed in Perera et al. [1] indicated that their river basins are equipped with insufficient gauging stations for rainfall, water level, and streamflow observations. A total of 50% of the FCCs that responded revealed that their measuring equipment, gauges, and data transferring instruments have deficient technology. Data transmissions from the stations to the forecasting centers are another issue, as a significant number of stations in the developing world rely on human observers, impeding the accuracy and timely transmission of the data. As a result, most of the developing countries encounter challenges in capturing the amount, distribution, and variation of critical variables such as precipitation and streamflow during extremes. Meteorological radars and remote-sensed rainfall have the potential of improving watershed monitoring by providing spatial, real-time, or near real-time information. Still, the data they provide are of lower quality than gauging data, and these technologies are too recent to have long time series that can be used for robust hydrological model simulation.
\nIdeally, the collected hydroclimatic data are stored in a database and processed in real time by hydrologic/hydraulic models. Not all countries have a centralized database that is fed continually up to date. The data are sometimes temporarily in spreadsheets to undergo quality control before being fed in the central database days or months later. One of the significant challenges faced by operational systems is the lack of technical expertise and human resources. Trained personnel with flood forecasting expertise and adequate forecast group staffing are required by the FFCs to issue timely warnings effectively. However, 74% of the flood forecasting personnel confirm that their centers do not have the experts and staff capable of integrating data, performing forecasts, and disseminating information [1]. This can be partially attributed to the low number of specialized experts in the employment sectors and higher workload for rescue and post-disaster activities during major flood events [4]. In developing countries, the lack of investments in personnel and the absence of dedicated permanent staff is a significant limitation to the proper operation of FEWSs. Overall, Perera et al.’s [1] survey responses suggest that forecasters primarily possess technical know-how but lack knowledge of flood vulnerability assessment, warning communication, and downstream response capabilities, including evacuation preparedness.
\nThe knowledge evolution of climatic variables in the near future, especially precipitation, is an essential input for flood forecasting. Besides ground and satellite actual measurements of the land and atmosphere, meteorologists use sophisticated computer models to forecast the weather in the near future. Numerical weather predictions (NWP) focuses on taking current observations of weather and processing these data with computer models to forecast the future state of the weather. Knowing the current state of the land, ocean, and atmosphere, which influences modeling initialization at local, regional, and global scales, poses a great challenge for quantitative precipitation forecasting [5]. Also, in developed countries, forecasters have access to fine resolution modeling with ensemble predictions to capture the variability and uncertainty in the forecasts [6, 7]. National weather operational centers in developed countries provide global forecasts from their global NWP systems such as the global forecasting system [8] that could be used by developing countries. Still, those outputs are at a very low spatial resolution. These forecasts need to be downscaled by national services to a higher spatial resolution.
\nNevertheless, several countries struggle to generate their high-resolution forecasts as the required expertise and resources are not present. Even when forecasts are downscaled, they may suffer from residual bias or from the inherent lack of skills of the weather forecasts, which may lead to the non-detection of upcoming extreme floods or false alarms. Even the weather forecasts are skilled; their forecasts will be affected by the quality of the data assimilation scheme used to determine the initial conditions of the hydrological/hydraulic models. It is also affected by the configuration of hydrologic/hydraulic models such as model structure, simplifications of physical processes, and quality of calibration that can affect the performance of the models used for flood forecasting. Nearly half of the flood forecasters surveyed by Perera et al. [1] mentioned that the models they use for producing early warnings are not accurate or advanced enough for the purpose. Consequently, forecast hit rates varied for different modeling systems and river basins in different climatic regions.
\nPerera et al. [1] found that warnings, even when issued and disseminated with enough lead time, do not necessarily reach all the people-at-risk. Flood warning dissemination is an essential step in FEWSs, usually a “top-down approach,” which an FCC issues warning and communicates them to the national authorities to disseminate it to the relevant destinations. For a flood warning to be effective, it needs to reach the right stakeholders in the correct format at the right time. Unfortunately, it is doubtful whether the warning reaches all the highly vulnerable communities [9], particularly those in remote and/or coastal areas and illiterate and/or impoverished people, such as women, children, and elderly in developing and least developed countries. The reason is that warning messages are generally broadcasted on national or local media (television, radio, or website), and such vulnerable groups lack access to basic amenities required to receive these warnings [10]. These include power outages, lack of access to TV and radio, limitations in the broadcasting coverage of TV and radio, limited mobile network coverage, limited robustness of mobile and media broadcasts during hazardous flood events, and limited knowledge of using the emergency website for flood warnings and updates. The alternative modes of communication, such as sirens and loudspeakers, are used to reach low-income vulnerable people to alleviate the limited media coverage. However, this may result in a delayed response by that time, which consequently increases the risk of victimized to the oncoming flood.
\nAdditionally, even when the warning reaches a particular community, many fail to heed the warning due to a lack of knowledge in understating the warning [11, 12]. Also, when a flood warning is delivered, it is often incomplete due to the lack of standardized terminology, protocols, and standards for issuing the warnings. This leads to inadequate, irrelevant, or missing information in the warnings [9, 13]. A flood warning needs to be tailored to the local communities’ interests, needs, and values to trigger a responsive action. This involves the use of local language and content that targets the understanding of the recipient and contains an appropriately tailored course of action. An interactive and practical warning communication chain is essential to a successful FEWS since multiple stakeholders are involved at all levels and across sectors.
\nAs for the preparedness component of FEWSs, the identified challenges include lack of public interest, lack of risk awareness in early warnings, limited and irregular drills and training seminars, general contingency planning instead of specific and tailored to the community, lack of political commitment and will, financial and technical resource constraints, lack of participation of communities in the decision-making process, and lack of inter-agency planning and coordination particularly among transboundary river basins, among others.
\nFlood is a fast on-set disaster; hence, timely response from the vulnerable communities is vital to minimize life and property losses. Despite that, impediments are affecting the target communities to respond such as risk perceptions, inefficient communication chain, lack of resources to respond, limited knowledge of evacuation routes, inadequate infrastructure and other facilitation for evacuees, risk of losing livelihood, properties, and livestock, the culture of neglect, lack of trust in early warning systems, and suchlike. Affected residents often lack sufficient resources such as reliable modes of transportation, logistic support including life jackets, ropes, boat, helmet, and stretcher, knowledge of feasible escape route options, and safe shelters to respond to the warnings [14, 15].
\nNationally developed contingency plans are common in many countries [16]. However, they are not customized to better adapt to the localized target communities and integrate into emergency response plans due to a lack of participatory approaches in the planning and development of warning response measures [9]. The problem is complemented by fewer than necessary updates of contingency plans owing to the technical and financial resource constraints. A timely response is essential for protecting lives, household properties, and livestock to safer locations once the warning is issued. However, strong ties to the inherited lands, risk of losing cultivated areas, livelihood, and properties impede the ability of a community to respond to early warnings.
\nA FEWS is essentially a system that collects environmental data and NWP, processes it to generate risk-related information, and transfers these products to end-users through various channels. Its core functions include data acquisition, processing, visualization, and transmission. Progresses in data collection systems such as remote sensing, hydrological/hydraulic modeling, numerical weather forecasting (NWF) as well as information and computing technologies (ICT), are likely to affect the way FEWSs function.
\nArtificial intelligence (AI) is a rapidly growing field that aims at building systems that can mimic human intelligence and then function intelligently and independently. AI can use various deep learning and machine learning-based algorithms to understand data in any of the spatiotemporal forms [17]. This ability to interpret data, learn from data, and utilize data to accomplish objectives is being used extensively in the next generation of FEWSs [18]. AI can be an alternative to classical hydrologic and hydraulic models and/or can be used for prediction and forecast. As an example, Google, in its
The information required for risk assessment is often spatial, and its collection requires considerable resources. The availability of remotely sensed products is steadily increasing with the availability of products such as satellite-derived topography, vegetation, snow cover, precipitation, and soil moisture. While not as precise as information from ground stations, satellite-derived information is in use to overcome limited data availability and has the advantage of being spatially distributed with global coverage. As the rainfall data are the primary input for FEWSs, microwave and thermal remote sensing provide an indirect assessment of rainfall by assessing scattering and emission characteristics, cloud cover, type, cloud top temperature, etc. The rainfall estimated by satellite is freely available at several institutions which can be used by the developing countries to overcome the scarcity in their ground measurements. Examples include products from the Global Precipitation Measurement mission (GPM) [26]. Retrieval techniques make near-real-time availability of satellite-derived rainfall products, for example, NASA’s Integrated Multi-satellitE Retrievals for GPM (IMERG) [27], JAXA’s Global Satellite Mapping of Precipitation (GSMaP) [28], Precipitation Estimation from Remotely Sensed Information using Artificial Neural Networks (PERSIANN) [29], and NOAA’s the Climate Prediction Center (CPC) MORPHing method (CMORPH) [30]. Particularly, JAXA is providing GSMaP real-time products with 0-hour latency that is very useful for flood monitoring forecasting applications. GSMaP Realtime (GSMaP_NOW) has been provided within Asia-Pacific region (GEO-Himawari) since November 2015, and it has been extended to whole globe since June 2019. The JAXA Realtime Rainfall Watch website [28] equipped with graphical user interface (GUI) allows easy access to monitor and obtain current and past precipitation amount and distribution in real time, and the website is updated every 30 minutes. Similarly, NASA also provides the IMERG data product for every half an hour but with a 6-hour latency from the time of data acquisition [27]. Rainfall amounts estimated by satellite are usually bias corrected and merged with available ground records to improve their accuracy. The resulting rainfall products can be used for enhancing forecasting, early warning, preparedness, and mitigation activities [31, 32]. Recent advances in remote sensing techniques by using microwave satellite observations have also enabled the estimation of surface soil moisture (∼10 cm depth) [33], thus generating global soil moisture data usable in flood forecasting [34].
\nFor rapid flood and damage mapping at global scale, space charters such as the International Charter Space and Major Disasters [35], Global Monitoring for Environment and Security [36], and Sentinel Asia [37] provide emergency response services to access their satellite data in the event of natural disasters (e.g., flood) for registered users who can collect satellite imagery for free of charge. The maps are derived mainly from data acquired from synthetic aperture radar (SAR). SAR is independent of day-and-night visibility and weather conditions (e.g., persistent rain or cloud cover) during extreme events. To asses floods and their damages from SAR, data acquired before and during/after an extreme event are compared to detect flooded area and their extents.
\nHydrological models have become essential tools for generating information on water-related disasters (e.g., flood peak, inundation depths, and inundation extents) to support decision-making strategies. Advances in hydrological modeling are driven by the availability of spatially distributed ground and satellite data, improved understanding of hydrological processes, and advancements in computer resources. These have boosted the development of several distributed hydrological models (DHMs) [38, 39, 40, 41, 42, 43, 44]. DHMs, which integrated the capabilities of simulating catchment-scale rainfall runoff inundation processes, are capable of providing additional information (e.g., inundation extents, flooding depths, and the direction of flow paths). They are considered to be very informative and practical tools for developing a proactive FEWS and mapping flood hazards to provide crucial flood-related information for flood risk management and damage assessment. Recent developments in 2D and 3D models have made them in the standard of practice due to their versatility in producing flood-related information. However, the increased complexity of 2D and 3D models requires high-quality data and expertise in processing and visualization to produce accurate results. Examples of DHMs include MIKE SHE [45], LISFLOOD [46], and Rainfall-Runoff-Inundation (RRI) [47], and Water and Energy Budget-based Rainfall-Runoff-Inundation Model (WEB-RRI) [48]. Accurate topographic data are in demand for 2D and 3D flood modeling and to simulate correct flood depths and inundations. An airborne survey using LIDAR or synthetic aperture radar (SAR) is finding increasing applications in flood forecasting since it yields high vertical accuracy [49]. Apart from the DHMs, data-driven models also have high potential to be operational in FCCs. Bayesian models and hybrid adaptive neural-based fuzzy inference systems (ANFIS) combined by ANN, and fuzzy theories are recent developments in data-driven models includes [49]. Visualization and geographic information system (GIS) software benefits the modern-day FEWSs by producing user-friendly and descriptive flood maps and flood propagation areas likely to be submerged [46]. More training and capacity building workshops need to be conducted to provide opportunities for the flood forecaster to understand and apply appropriate models for their particular catchments.
\nOver the past 50 years, the advancements in science and technology, the proliferation of environmental observations, and improved scientific understanding of the land, atmosphere, and oceanic processes and their modeling radically transformed weather forecasting into an effective, global, and regional environmental prediction capability. Besides the remarkable developments, capturing and communicating the uncertainty in forecasting had always been a greater challenge for forecasters, who have to live with the possibility of uncertainties (i.e., misses and false alert). There are two main challenges faced by forecasters: (a) reduce uncertainty and (b) quantify the uncertainty. The increasing availability of ground and satellite observations and advancement of operational data assimilation (DA) methods and systems such as four-dimensional variational DA (4DVar), hybrid 4DVar with a local ensemble transform Kalman filter (LETKF), and hybrid data assimilation to improve the knowledge of the initial state of the atmosphere are keeping on narrowing down the range of uncertainties in the quantitative precipitation forecasting [50]. The ensemble forecasting has become a standard tool for quantifying the uncertainty in the forecast, recently. In this approach, instead of making a single forecast of precipitation, a set (or ensemble) of forecasts is produced with aims to indicate the most anticipated events, the range of possible future precipitation rates, and uncertainty information [51, 52]. As the multiple ensemble rainfall predictions can provide a better skill score than deterministic forecasts, the ensemble forecasting has become a standard in weather forecasting applications in the developed world. It is slowly being adopted in hydrological forecasting. Global ensemble prediction systems are now run by all major NWP centers [53] and available in their data portal. These data can be downloaded and downscaled at a national or local scale using mesoscale weather prediction models to produce ensemble quantitative rainfall forecast to generate ensemble flood forecasts.
\nEvidence generated by data is crucial for early warning and planning of flood disaster mitigation strategies. We live in an era of big data where the massive amount of data is collected from various sources. Big data refers to data sets with particular sizes and types that traditional relational databases are unable to capture, manage, and process the data [54]. The increasing prevalence of digital and mobile devices has increased the interconnectedness of society [55], as well as the rise of AI and IoT, which has contributed to newer and more complex forms of data available for FEWSs. For instance, big data can come from satellite-based sensors, UAVs, video/audio streams, networks, log files, transactional applications, web, and social media monitoring the water bodies and flows at various spatiotemporal resolutions [54]. The big data for FEWSs can be acknowledged through properties called the 5 Vs; volume, velocity, variety, veracity, and value. The volume of data might range from tens of terabytes of data to hundreds of petabytes and may be of unknown value. The velocity refers to the rate at which data are received in real time, and variety is attributed to the new semi- and unstructured data types such as text, audio, and video that need further processing to derive information. However, two more Vs have risen in case of FEWSs, which are value and veracity, respectively, which refer to the potential capital that may be exploited and the insight and knowledge that will be gained from it to manage the floods [56]. Through big data acquisition of Twitter logs, Deltares and Floodtags were able to map floods in the real time during February 2015 floods in Jakarta, Indonesia, and subsequently provide early warnings. The organizations were able to develop a method of utilizing data from social media posts into information where approximately 900 tweets were posted during the flooding peak.
\nThrough Twitter, census data, and hydrodynamic corrected digital elevation maps (DEM), real-time flood maps of Jakarta were created and provided adequate comparison when compared to photographs after Earth Engine Data Catalog [57]. SERVIR-Mekong, through its virtual rain gauge service, provides near real-time rainfall and stream height data from publicly available satellite measurements by the creation of a virtual network of rain gauges and stream gauges at points widely distributed over the entire Lower Mekong Region. This service is also used by the Mekong River Commission as part of their regional flood forecasting service [58]. The Google Earth Engine (GEE) cloud-based platform provides open access to 40 years of historical imagery and scientific analysis ready dataset (ARD), which has a size of 10 PB [57]. The access to ARD has transformed how remote sensing is processed for FEWSs. Chen and Han [59] developed a Flood Prevention and Emergency Response System (FPERS) based on GEE. In the preflood stage of the FPERS, a huge amount of geospatial data is integrated into the system and categorized as typhoon forecast and archive, disaster prevention and warning, disaster events, and analysis, or basic data and layers. This enabled the right data to be referred to at the right time during the flood prevention and emergency response [60].
\nIn addition to GEE, various national-level big data repositories are being used as a data source for FEWSs. Australia has set up its own big data infrastructure called Australian Geoscience Data Cube (AGDC), which aims to realize the full potential of Earth observation data holding for Australia [61]. The Swiss Data Cube (SDC) has been set up in collaboration with various national and international agencies to support the Swiss government in environmental monitoring and reporting, as well as enable Swiss scientific institutions to fully benefit from EO data for research and innovation [62]. Other worth mentioning big data repositories include Africa Regional Data Cube (ARDC), launched in May 2018, and Mexican Geospatial Data Cube, which is under development. The Japanese Ministry of Education, Culture, Sports, Science, and Technology (MEXT) supported the development of the Data Integration and Analysis System (DIAS) as part of the Earth Observation and Ocean Exploration System. DIAS is a demonstrative data system that effectively and efficiently integrates global and local observation data and information. It has led to research breakthroughs in understanding, forecasting, and adapting to global environmental changes, particularly concerning changes in the water cycle and the effects on water management systems and societies across the globe [63].
\nVolunteered geographic information (VGI), a component of citizen science, is user-generated information that is crowdsourced, and it relies on collaborative and specific web platforms and/or mobile phone applications [64]. In terms of FEWSs, VGI is citizen-generated data from various information sources: (i) social media, (ii) crowdsensing, and (iii) collaborative mapping [65]. Social media, as the name suggests, involves information sharing through platforms such as Twitter, Facebook, and Flickr. Crowdsensing is referred to as citizen observatories, where citizens on the web use different applications to register and share observations. Collaborative mapping is the mapping of geographic features to generate Internet-based interactive maps.
\nOne such effort of incorporating VGI to complement official sources of information (such as static and mobile environmental sensors) and support FEWSs is A Geospatial Open collaboRative Architecture—AGORA [66]. It is a conceptual architecture that uses information from VGI and traditional information sources into three layers: acquisition, integration, and application. Currently, it aims to improve flood disaster resilience in Brazil and works in close collaboration with the National Center for Monitoring and Early Warning of Natural Disasters (CEMADEN), Brazil [67].
\nSocial network analysis (SNA) is a broad general term that is used for representing connections among people and using graph analytic techniques to explore characteristics of that network [68]. Recently, there has been a surge in the application of SNA in flood disaster risk management [69].
\nRestrepo-Estrada et al. [70] developed a methodology to use geosocial media messages such as Twitter data as a proxy variable for rainfall estimates using transformation function to force hydrologic models and predict streamflow. This is particularly important for ungauged or poorly gauged sites to cover the spatial and temporal variability of ever-changing river basins. They have developed a historical and real-time global flood detecting database using 88 million tweets with 90% accuracy in reporting flood events. While the data from existing flood re-insurance sectors are not always freely accessible, Bruijn et al. [71] have made real-time data publicly available at www.globalfloodmonitor.org.
\nTkachenko et al. [72] used Yahoo! Flickr tags to learn its forecasting potential for floods without the use of complementary environmental sensors using a buffer period of 5 days before flood peak and different neutral and risk signaling semantic elements. They found that alternative social sensors such as Yahoo! Flickr can be used as a potential flood disaster predictor, especially in the areas where environmental sensors are absent. The study results are impressive. However, much research is needed in the area to be used as a sole potential indicator of flood disasters in ungauged sites.
\nIt is expected that in the future, there will be a shift toward a much broader concept of “extreme citizen science” rather than volunteered participatory monitoring merely as “citizen sensors” [73]. This will lead to involving citizens in all stages of the project life cycle, such as flood data analysis and its interpretation rather than only data collection.
\nThere are some upcoming technologies such as 5G networks and Blockchain technology that are likely to affect all systems that have a telecommunication component, hence FEWSs. 5G, also known as fifth-generation mobile network, is an emerging technology; it improved on many features from the previous 4G network, such as the increase in the speed of transfer rate, connections, and efficiency of frequency and the decrease in latency time [74]. The low latency time is essential for activities that require real-time updates for FEWSs. 5G will also allow FEWS experts to increase coverage and network capacity of smart data collection devices by enabling the assimilation of heterogeneous networks that possess various wireless access technologies, coverage area sizes, and topologies. Blockchain is an emerging data structure that is a collection of records or an open, public infrastructure environment of transactions or digital events that has been conducted between agencies and/or individuals [75]. Blockchain allows for increased trust in the system as the mechanisms are transparent and resistant to alterations, which is critical for the data to be used in FEWSs. In the future, it is expected that more and more data from smart sensors to be used in FEWSs will be stored on the blockchains; this will ensure the ownership of the data producers and accuracy of FEWSs.
\nFEWSs are recognized as a crucial tool to estimate the flood disaster risks and to mitigate the impacts of floods. As their core functions include data acquisition, processing, visualization, and transmission, they are expected to collect necessary data from various platforms such as ground, satellite, and NWP models and integrate them to produce superior products with lesser biases, use hydrological/hydrodynamic models to covert those data into useful risk-related products such as water levels and inundation distributions, and transfer these products to end-users through various communication channels.
\nThis chapter discusses various identified challenges in operational FEWSs worldwide. It highlights the recent progress in data collection and integration, numerical weather forecasting, hydrological/hydraulic modeling, as well as computing and information technologies that have great potential to enhance the performance of FEWSs. These scientific, technical, and technological advancements allow the integration, generation, and exploitation of large repositories of environmental and hydroclimatic information to produce valuable information for reducing flood-related risks and damages to reach the policymakers and public to collect information about flood occurrence, exposure, and vulnerabilities. These advancements are becoming available worldwide, and they can be utilized effectively to diminish the gaps between developing and developed countries in terms of FEWSs capabilities. Especially in forecast dissemination and access to nonconventional data sources such as satellite imagery, volunteered geographic information and social network analysis are possible venues where such technologies can address immediately. More and more, those technologies are becoming open-source platforms and tools which can be used by economically less privileged countries freely. However, more capacity development and training programs have to become frequent to grab the skills needed to utilize these technologies in such countries.
\nThis research is supported by the funds received by UNU-INWEH through the long-term agreement with Global Affairs Canada. The authors are thankful to the International Centre for Water Hazard and Risk Management (ICHARM) and the Public Works Research Institute (PWRI) of Japan for the financial assistance that enables this chapter to be published in this open-access book.
\nNo potential conflict of interest was reported by the authors.
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\n\nThe Corresponding Author agrees to indemnify and hold IntechOpen harmless against all liabilities, costs, expenses, damages and losses and all reasonable legal costs and expenses suffered or incurred by IntechOpen arising out of or in connection with any breach of the aforementioned representations and warranties. This indemnity shall not cover IntechOpen to the extent that a claim under it results from IntechOpen's negligence or willful misconduct.
\n\n4.2 Nothing in this Publication Agreement shall have the effect of excluding or limiting any liability for death or personal injury caused by negligence or any other liability that cannot be excluded or limited by applicable law.
\n\n5. TERMINATION
\n\n5.1 IntechOpen has a right to terminate this Publication Agreement for quality, program, technical or other reasons with immediate effect, including without limitation (i) if the Corresponding Author or any Co-Author commits a material breach of this Publication Agreement; (ii) if the Corresponding Author or any Co-Author (being an individual) is the subject of a bankruptcy petition, application or order; or (iii) if the Corresponding Author or any Co-Author (being a company) commences negotiations with all or any class of its creditors with a view to rescheduling any of its debts, or makes a proposal for or enters into any compromise or arrangement with any of its creditors.
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\n\n6.1 Unless prevented from doing so by events outside its reasonable control, IntechOpen, in its discretion, agrees to publish the Chapter attributing it to the Corresponding Author and any Co-Author.
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\n\n6.3 IntechOpen is granted the authority to enforce the rights from this Publication Agreement, on behalf of the Corresponding Author and any Co-Author, against third parties (for example in cases of plagiarism or copyright infringements). In respect of any such infringement or suspected infringement of the copyright in the Chapter, IntechOpen shall have absolute discretion in addressing any such infringement which is likely to affect IntechOpen's rights under this Publication Agreement, including issuing and conducting proceedings against the suspected infringer.
\n\n7. MISCELLANEOUS
\n\n7.1 Further Assurance: The Corresponding Author shall and will ensure that any relevant third party (including any Co-Author) shall, execute and deliver whatever further documents or deeds and perform such acts as IntechOpen reasonably requires from time to time for the purpose of giving IntechOpen the full benefit of the provisions of this Publication Agreement.
\n\n7.2 Third Party Rights: A person who is not a party to this Publication Agreement may not enforce any of its provisions under the Contracts (Rights of Third Parties) Act 1999.
\n\n7.3 Entire Agreement: This Publication Agreement constitutes the entire agreement between the parties in relation to its subject matter. It replaces and extinguishes all prior agreements, draft agreements, arrangements, collateral warranties, collateral contracts, statements, assurances, representations and undertakings of any nature made by or on behalf of the parties, whether oral or written, in relation to that subject matter. Each party acknowledges that in entering into this Publication Agreement it has not relied upon any oral or written statements, collateral or other warranties, assurances, representations or undertakings which were made by or on behalf of the other party in relation to the subject matter of this Publication Agreement at any time before its signature (together "Pre-Contractual Statements"), other than those which are set out in this Publication Agreement. Each party hereby waives all rights and remedies which might otherwise be available to it in relation to such Pre-Contractual Statements. Nothing in this clause shall exclude or restrict the liability of either party arising out of its pre-contract fraudulent misrepresentation or fraudulent concealment.
\n\n7.4 Waiver: No failure or delay by a party to exercise any right or remedy provided under this Publication Agreement or by law shall constitute a waiver of that or any other right or remedy, nor shall it preclude or restrict the further exercise of that or any other right or remedy. No single or partial exercise of such right or remedy shall preclude or restrict the further exercise of that or any other right or remedy.
\n\n7.5 Variation: No variation of this Publication Agreement shall be effective unless it is in writing and signed by the parties (or their duly authorized representatives).
\n\n7.6 Severance: If any provision or part-provision of this Publication Agreement is or becomes invalid, illegal or unenforceable, it shall be deemed modified to the minimum extent necessary to make it valid, legal and enforceable. If such modification is not possible, the relevant provision or part-provision shall be deemed deleted.
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\n\n7.7 No partnership: Nothing in this Publication Agreement is intended to, or shall be deemed to, establish or create any partnership or joint venture or the relationship of principal and agent or employer and employee between IntechOpen and the Corresponding Author or any Co-Author, nor authorize any party to make or enter into any commitments for or on behalf of any other party.
\n\n7.8 Governing law: This Publication Agreement and any dispute or claim (including non-contractual disputes or claims) arising out of or in connection with it or its subject matter or formation shall be governed by and construed in accordance with the law of England and Wales. The parties submit to the exclusive jurisdiction of the English courts to settle any dispute or claim arising out of or in connection with this Publication Agreement (including any non-contractual disputes or claims).
\n\nLast updated: 2020-11-27
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The relations are in terms of friction factor, bed load discharge, bed load diameter, and water discharge. The bed load formulae are those of Engelund and Hansen (1966) [1], Einstein (1950) [2], Shields (1936) [3], and Meyer-Peter and Muller (1948) [4].",book:{id:"4687",slug:"effects-of-sediment-transport-on-hydraulic-structures",title:"Effects of Sediment Transport on Hydraulic Structures",fullTitle:"Effects of Sediment Transport on Hydraulic Structures"},signatures:"Levent Yilmaz",authors:[{id:"19701",title:"Prof.",name:"Levent",middleName:null,surname:"Yilmaz",slug:"levent-yilmaz",fullName:"Levent Yilmaz"}]},{id:"49325",doi:"10.5772/61478",title:"Bedload and Suspended Sediment of a Watershed Impacted by Dams",slug:"bedload-and-suspended-sediment-of-a-watershed-impacted-by-dams",totalDownloads:1791,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"Sediment transport relates to suspended sediment and bedload. The suspended sediment plays the most important role on the land-ocen sediment flux. On the other hand, the bedload should be considered in order to assess the impacts of dams on sediment transport and sediment yield. Recent effects of dam construction have been widely reported. The sediment load has been reduced by more than 75% for major rives, such as Nilo, Orange, Volta, Indus, Ebro, Kizil Irmark, Colorado, and Rio Grande and more than 40% of its lux is trapped within large dams. In addition, the multiple trapping through sequential dams has impacted the sediment transfer from terrestrial to coastal zone, triggering the coastal erosion. In terms of sediment retention and transport, China stands out the most impacted country by dams, followed by United States, and continents such as Europe, Africa, and South America. Based on the foregoing, the impact of dams on sediment transport and yield of an important Brazilian watershed with multiple dams will be the focus of this chapter. Thus, a three years field sampling (2009-2011) was carried out to measure the sediment yield of Capibaribe Watershed, and also its contribution to coastal erosion. The ratio between QB and SSQ ranged from 0.12% to 27.3% with 76% of all values lower than 5%. Usually, the bedload transport rate of a river is about 5–25% of the suspended sediment transport. This ranging sheds light on the lack of bedload reaching the coastal zone and it is likely one of the reasons to yield coastal erosion. The low rates can be attributed to the presence of dams which have been admitted to have a strong effect on sediment transport. The sediment yield was equal to 3.69, 4.36, and 6.7 t km-2 ano-1 in 2009, 2010, and 2011, respectively. In comparison with bedload yield, the suspended sediment yield was higher than 95% for all studied years. Therefore, the limited bedload supply – mainly responsible for construction of coastal landform – is likely contributing to the coastal erosion along part of the northeast region, Brazil. The multiple dams along the Capibaribe River watershed produce a deficit in sediment flux to coastal zone of Pernambuco State, Brazil, which relies on the low ratios between bedload and suspended sediment. As a result, it generates energy to coastal erosion of the Brazilian northeast.",book:{id:"4687",slug:"effects-of-sediment-transport-on-hydraulic-structures",title:"Effects of Sediment Transport on Hydraulic Structures",fullTitle:"Effects of Sediment Transport on Hydraulic Structures"},signatures:"Jose Ramon B. Cantalice, Wagner Luis da Silva Souza, Yuri Jacques\nAgra Bezerra Silva, Sergio M.S. Guerra, Alex Mauricio Araújo,\nDouglas Monteiro Cavalcante and Cinthia Maria Cordeiro Atanazio\nCruz Silva",authors:[{id:"174133",title:"Prof.",name:"Jose Ramon",middleName:"Barros",surname:"Cantalice",slug:"jose-ramon-cantalice",fullName:"Jose Ramon Cantalice"},{id:"174468",title:"Dr.",name:"Wagner Luis",middleName:null,surname:"Sousa",slug:"wagner-luis-sousa",fullName:"Wagner Luis Sousa"},{id:"174469",title:"Dr.",name:"Yuri",middleName:null,surname:"Silva",slug:"yuri-silva",fullName:"Yuri Silva"},{id:"174470",title:"Prof.",name:"Alex",middleName:null,surname:"Araujo",slug:"alex-araujo",fullName:"Alex Araujo"},{id:"174471",title:"MSc.",name:"Douglas",middleName:null,surname:"Cavalcante",slug:"douglas-cavalcante",fullName:"Douglas Cavalcante"},{id:"174472",title:"Prof.",name:"Sergio Monthezuma",middleName:null,surname:"Guerra",slug:"sergio-monthezuma-guerra",fullName:"Sergio Monthezuma Guerra"}]},{id:"49484",doi:"10.5772/61459",title:"Assessment of Reservoir Sedimentation Effect on Coastal Erosion and Evaluation of Sediment Removal Techniques for Its Reduction — The Case of Nestos River, Greece",slug:"assessment-of-reservoir-sedimentation-effect-on-coastal-erosion-and-evaluation-of-sediment-removal-t",totalDownloads:1811,totalCrossrefCites:0,totalDimensionsCites:1,abstract:"Nestos is one of the most important transboundary rivers flowing through Bulgaria and Greece. In the Greek part of the river, two reservoirs, the Thisavros Reservoir and the Platanovrysi Reservoir, have already been constructed and started operating in 1997 and 1999, respectively. In the first part of the chapter, the reservoir sedimentation effect on the coastal erosion is investigated, for the case of the Nestos River delta and the adjacent shorelines, through a combination of mathematical modeling, modern remote sensing techniques, and field surveying, while in the second part, the mechanical removal as well as the flushing of sediment from the reservoir of Platanovrysi and its disposal in the subbasin downstream of the Platanovrysi Dam up to the Nestos River delta are investigated as potential treatment methods of reducing coastal erosion, using a modification of the same mathematical model that is utilized in the first part of the chapter. The overall findings and conclusions arising from the work presented and discussed in the present chapter contribute to the overall need to thoroughly understand the direct effect of dam construction on coastal erosion, as well as to examine the effectiveness of potential sediment management treatments.",book:{id:"4687",slug:"effects-of-sediment-transport-on-hydraulic-structures",title:"Effects of Sediment Transport on Hydraulic Structures",fullTitle:"Effects of Sediment Transport on Hydraulic Structures"},signatures:"Manolia Andredaki, Anastasios Georgoulas, Vlassios Hrissanthou\nand Nikolaos Kotsovinos",authors:[{id:"37707",title:"Prof.",name:"Vlassios",middleName:null,surname:"Hrissanthou",slug:"vlassios-hrissanthou",fullName:"Vlassios Hrissanthou"},{id:"113298",title:"Prof.",name:"Nikolaos",middleName:null,surname:"Kotsovinos",slug:"nikolaos-kotsovinos",fullName:"Nikolaos Kotsovinos"},{id:"174591",title:"Dr.",name:"Anastasios",middleName:null,surname:"Georgoulas",slug:"anastasios-georgoulas",fullName:"Anastasios Georgoulas"},{id:"174790",title:"Dr.",name:"Manolia",middleName:null,surname:"Andredaki",slug:"manolia-andredaki",fullName:"Manolia Andredaki"}]},{id:"49521",doi:"10.5772/61468",title:"The Impact of Ice Cover and Sediment Nonuniformity on Erosion Around Hydraulic Structures",slug:"the-impact-of-ice-cover-and-sediment-nonuniformity-on-erosion-around-hydraulic-structures",totalDownloads:1717,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Based on two case studies, the impact of ice cover on local scour around bridge piers is presented in this chapter. Bed material with different grain sizes is used and ice covers with different roughness is used to study the scour characteristics. The impact of nonuniformity of sediment is also investigated. Results show that with the increase in densimetric Froude number, there is a corresponding increase in the dimensionless scour depth. For nonuniform sediment, due to the formation of an armor layer, less maximum scour depth was noted around bridge foundation structures compared to uniformly distributed sediment. The increase in ice cover roughness results in a larger scour depth and geometry. The results indicate that it is imperative to pay attention to the impact of ice cover on the scour around hydraulic structures.",book:{id:"4687",slug:"effects-of-sediment-transport-on-hydraulic-structures",title:"Effects of Sediment Transport on Hydraulic Structures",fullTitle:"Effects of Sediment Transport on Hydraulic Structures"},signatures:"Peng Wu, Jueyi Sui and Ram Balachandar",authors:[{id:"36919",title:"Dr.",name:"Ram",middleName:null,surname:"Balachandar",slug:"ram-balachandar",fullName:"Ram Balachandar"},{id:"174497",title:"Prof.",name:"Jueyi",middleName:null,surname:"Sui",slug:"jueyi-sui",fullName:"Jueyi Sui"},{id:"174521",title:"Dr.",name:"Peng",middleName:null,surname:"Wu",slug:"peng-wu",fullName:"Peng Wu"}]}],mostDownloadedChaptersLast30Days:[{id:"49521",title:"The Impact of Ice Cover and Sediment Nonuniformity on Erosion Around Hydraulic Structures",slug:"the-impact-of-ice-cover-and-sediment-nonuniformity-on-erosion-around-hydraulic-structures",totalDownloads:1720,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Based on two case studies, the impact of ice cover on local scour around bridge piers is presented in this chapter. Bed material with different grain sizes is used and ice covers with different roughness is used to study the scour characteristics. The impact of nonuniformity of sediment is also investigated. Results show that with the increase in densimetric Froude number, there is a corresponding increase in the dimensionless scour depth. For nonuniform sediment, due to the formation of an armor layer, less maximum scour depth was noted around bridge foundation structures compared to uniformly distributed sediment. The increase in ice cover roughness results in a larger scour depth and geometry. The results indicate that it is imperative to pay attention to the impact of ice cover on the scour around hydraulic structures.",book:{id:"4687",slug:"effects-of-sediment-transport-on-hydraulic-structures",title:"Effects of Sediment Transport on Hydraulic Structures",fullTitle:"Effects of Sediment Transport on Hydraulic Structures"},signatures:"Peng Wu, Jueyi Sui and Ram Balachandar",authors:[{id:"36919",title:"Dr.",name:"Ram",middleName:null,surname:"Balachandar",slug:"ram-balachandar",fullName:"Ram Balachandar"},{id:"174497",title:"Prof.",name:"Jueyi",middleName:null,surname:"Sui",slug:"jueyi-sui",fullName:"Jueyi Sui"},{id:"174521",title:"Dr.",name:"Peng",middleName:null,surname:"Wu",slug:"peng-wu",fullName:"Peng Wu"}]},{id:"49484",title:"Assessment of Reservoir Sedimentation Effect on Coastal Erosion and Evaluation of Sediment Removal Techniques for Its Reduction — The Case of Nestos River, Greece",slug:"assessment-of-reservoir-sedimentation-effect-on-coastal-erosion-and-evaluation-of-sediment-removal-t",totalDownloads:1814,totalCrossrefCites:0,totalDimensionsCites:1,abstract:"Nestos is one of the most important transboundary rivers flowing through Bulgaria and Greece. In the Greek part of the river, two reservoirs, the Thisavros Reservoir and the Platanovrysi Reservoir, have already been constructed and started operating in 1997 and 1999, respectively. In the first part of the chapter, the reservoir sedimentation effect on the coastal erosion is investigated, for the case of the Nestos River delta and the adjacent shorelines, through a combination of mathematical modeling, modern remote sensing techniques, and field surveying, while in the second part, the mechanical removal as well as the flushing of sediment from the reservoir of Platanovrysi and its disposal in the subbasin downstream of the Platanovrysi Dam up to the Nestos River delta are investigated as potential treatment methods of reducing coastal erosion, using a modification of the same mathematical model that is utilized in the first part of the chapter. The overall findings and conclusions arising from the work presented and discussed in the present chapter contribute to the overall need to thoroughly understand the direct effect of dam construction on coastal erosion, as well as to examine the effectiveness of potential sediment management treatments.",book:{id:"4687",slug:"effects-of-sediment-transport-on-hydraulic-structures",title:"Effects of Sediment Transport on Hydraulic Structures",fullTitle:"Effects of Sediment Transport on Hydraulic Structures"},signatures:"Manolia Andredaki, Anastasios Georgoulas, Vlassios Hrissanthou\nand Nikolaos Kotsovinos",authors:[{id:"37707",title:"Prof.",name:"Vlassios",middleName:null,surname:"Hrissanthou",slug:"vlassios-hrissanthou",fullName:"Vlassios Hrissanthou"},{id:"113298",title:"Prof.",name:"Nikolaos",middleName:null,surname:"Kotsovinos",slug:"nikolaos-kotsovinos",fullName:"Nikolaos Kotsovinos"},{id:"174591",title:"Dr.",name:"Anastasios",middleName:null,surname:"Georgoulas",slug:"anastasios-georgoulas",fullName:"Anastasios Georgoulas"},{id:"174790",title:"Dr.",name:"Manolia",middleName:null,surname:"Andredaki",slug:"manolia-andredaki",fullName:"Manolia Andredaki"}]},{id:"49294",title:"Simulation of Reservoir Siltation with a Process-based Soil Loss and Deposition Model",slug:"simulation-of-reservoir-siltation-with-a-process-based-soil-loss-and-deposition-model",totalDownloads:2223,totalCrossrefCites:1,totalDimensionsCites:2,abstract:"Soil erosion on arable land is the key driver of reservoir siltation in the German loess belt. In this regard, the Baderitz Reservoir suffers from deleterious sediment inputs and resulting siltation processes. In order to estimate the reservoir lifespan, the event-based soil erosion and deposition model EROSION 3D was applied. Simulations of sediment input and sediment deposition processes within the reservoir were realized using a typical crop rotation and a normal heavy rainfall year of the region. Model parameterization was enabled by existing data based on a large number of artificial rainfall simulations. Yearly soil losses of approximately 12 t/ha correspond to sediment inputs of nearly 8800 t. The mean annual increase of the reservoir bottom of 9 cm causes a 13% loss of reservoir storage in only 10 years. The model results are plausible and could be used for planning and dimensioning of mitigation measures.",book:{id:"4687",slug:"effects-of-sediment-transport-on-hydraulic-structures",title:"Effects of Sediment Transport on Hydraulic Structures",fullTitle:"Effects of Sediment Transport on Hydraulic Structures"},signatures:"Marcus Schindewolf, Constanze Bornkampf, Michael von Werner\nand Jürgen Schmidt",authors:[{id:"174672",title:"Dr.",name:"Marcus",middleName:null,surname:"Schindewolf",slug:"marcus-schindewolf",fullName:"Marcus Schindewolf"},{id:"174673",title:"Dr.",name:"Constance",middleName:null,surname:"Bornkampf",slug:"constance-bornkampf",fullName:"Constance Bornkampf"},{id:"174674",title:"Dr.",name:"Michael",middleName:null,surname:"Von Werner",slug:"michael-von-werner",fullName:"Michael Von Werner"},{id:"174675",title:"Prof.",name:"Jürgen",middleName:null,surname:"Schmidt",slug:"jurgen-schmidt",fullName:"Jürgen Schmidt"}]},{id:"49325",title:"Bedload and Suspended Sediment of a Watershed Impacted by Dams",slug:"bedload-and-suspended-sediment-of-a-watershed-impacted-by-dams",totalDownloads:1791,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"Sediment transport relates to suspended sediment and bedload. The suspended sediment plays the most important role on the land-ocen sediment flux. On the other hand, the bedload should be considered in order to assess the impacts of dams on sediment transport and sediment yield. Recent effects of dam construction have been widely reported. The sediment load has been reduced by more than 75% for major rives, such as Nilo, Orange, Volta, Indus, Ebro, Kizil Irmark, Colorado, and Rio Grande and more than 40% of its lux is trapped within large dams. In addition, the multiple trapping through sequential dams has impacted the sediment transfer from terrestrial to coastal zone, triggering the coastal erosion. In terms of sediment retention and transport, China stands out the most impacted country by dams, followed by United States, and continents such as Europe, Africa, and South America. Based on the foregoing, the impact of dams on sediment transport and yield of an important Brazilian watershed with multiple dams will be the focus of this chapter. Thus, a three years field sampling (2009-2011) was carried out to measure the sediment yield of Capibaribe Watershed, and also its contribution to coastal erosion. The ratio between QB and SSQ ranged from 0.12% to 27.3% with 76% of all values lower than 5%. Usually, the bedload transport rate of a river is about 5–25% of the suspended sediment transport. This ranging sheds light on the lack of bedload reaching the coastal zone and it is likely one of the reasons to yield coastal erosion. The low rates can be attributed to the presence of dams which have been admitted to have a strong effect on sediment transport. The sediment yield was equal to 3.69, 4.36, and 6.7 t km-2 ano-1 in 2009, 2010, and 2011, respectively. In comparison with bedload yield, the suspended sediment yield was higher than 95% for all studied years. Therefore, the limited bedload supply – mainly responsible for construction of coastal landform – is likely contributing to the coastal erosion along part of the northeast region, Brazil. The multiple dams along the Capibaribe River watershed produce a deficit in sediment flux to coastal zone of Pernambuco State, Brazil, which relies on the low ratios between bedload and suspended sediment. As a result, it generates energy to coastal erosion of the Brazilian northeast.",book:{id:"4687",slug:"effects-of-sediment-transport-on-hydraulic-structures",title:"Effects of Sediment Transport on Hydraulic Structures",fullTitle:"Effects of Sediment Transport on Hydraulic Structures"},signatures:"Jose Ramon B. Cantalice, Wagner Luis da Silva Souza, Yuri Jacques\nAgra Bezerra Silva, Sergio M.S. Guerra, Alex Mauricio Araújo,\nDouglas Monteiro Cavalcante and Cinthia Maria Cordeiro Atanazio\nCruz Silva",authors:[{id:"174133",title:"Prof.",name:"Jose Ramon",middleName:"Barros",surname:"Cantalice",slug:"jose-ramon-cantalice",fullName:"Jose Ramon Cantalice"},{id:"174468",title:"Dr.",name:"Wagner Luis",middleName:null,surname:"Sousa",slug:"wagner-luis-sousa",fullName:"Wagner Luis Sousa"},{id:"174469",title:"Dr.",name:"Yuri",middleName:null,surname:"Silva",slug:"yuri-silva",fullName:"Yuri Silva"},{id:"174470",title:"Prof.",name:"Alex",middleName:null,surname:"Araujo",slug:"alex-araujo",fullName:"Alex Araujo"},{id:"174471",title:"MSc.",name:"Douglas",middleName:null,surname:"Cavalcante",slug:"douglas-cavalcante",fullName:"Douglas Cavalcante"},{id:"174472",title:"Prof.",name:"Sergio Monthezuma",middleName:null,surname:"Guerra",slug:"sergio-monthezuma-guerra",fullName:"Sergio Monthezuma Guerra"}]},{id:"49551",title:"General Hydraulic Geometry",slug:"general-hydraulic-geometry",totalDownloads:1571,totalCrossrefCites:1,totalDimensionsCites:1,abstract:"Employing bed load formulae hydraulic geometry relations were derived for stream width, meander wave length, and bed slope. The relations are in terms of friction factor, bed load discharge, bed load diameter, and water discharge. The bed load formulae are those of Engelund and Hansen (1966) [1], Einstein (1950) [2], Shields (1936) [3], and Meyer-Peter and Muller (1948) [4].",book:{id:"4687",slug:"effects-of-sediment-transport-on-hydraulic-structures",title:"Effects of Sediment Transport on Hydraulic Structures",fullTitle:"Effects of Sediment Transport on Hydraulic Structures"},signatures:"Levent Yilmaz",authors:[{id:"19701",title:"Prof.",name:"Levent",middleName:null,surname:"Yilmaz",slug:"levent-yilmaz",fullName:"Levent Yilmaz"}]}],onlineFirstChaptersFilter:{topicId:"650",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:11,numberOfPublishedChapters:91,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:108,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:333,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:11,numberOfPublishedChapters:144,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:125,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:113,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:23,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:12,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}},{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}}]},series:{item:{id:"14",title:"Artificial Intelligence",doi:"10.5772/intechopen.79920",issn:"2633-1403",scope:"Artificial Intelligence (AI) is a rapidly developing multidisciplinary research area that aims to solve increasingly complex problems. In today's highly integrated world, AI promises to become a robust and powerful means for obtaining solutions to previously unsolvable problems. This Series is intended for researchers and students alike interested in this fascinating field and its many applications.",coverUrl:"https://cdn.intechopen.com/series/covers/14.jpg",latestPublicationDate:"August 17th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:11,editor:{id:"218714",title:"Prof.",name:"Andries",middleName:null,surname:"Engelbrecht",slug:"andries-engelbrecht",fullName:"Andries Engelbrecht",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRNR8QAO/Profile_Picture_1622640468300",biography:"Andries Engelbrecht received the Masters and PhD degrees in Computer Science from the University of Stellenbosch, South Africa, in 1994 and 1999 respectively. He is currently appointed as the Voigt Chair in Data Science in the Department of Industrial Engineering, with a joint appointment as Professor in the Computer Science Division, Stellenbosch University. Prior to his appointment at Stellenbosch University, he has been at the University of Pretoria, Department of Computer Science (1998-2018), where he was appointed as South Africa Research Chair in Artifical Intelligence (2007-2018), the head of the Department of Computer Science (2008-2017), and Director of the Institute for Big Data and Data Science (2017-2018). In addition to a number of research articles, he has written two books, Computational Intelligence: An Introduction and Fundamentals of Computational Swarm Intelligence.",institutionString:null,institution:{name:"Stellenbosch University",institutionURL:null,country:{name:"South Africa"}}},editorTwo:null,editorThree:null},subseries:{paginationCount:4,paginationItems:[{id:"3",title:"Bacterial Infectious Diseases",coverUrl:"https://cdn.intechopen.com/series_topics/covers/3.jpg",isOpenForSubmission:!0,editor:{id:"205604",title:"Dr.",name:"Tomas",middleName:null,surname:"Jarzembowski",slug:"tomas-jarzembowski",fullName:"Tomas Jarzembowski",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRKriQAG/Profile_Picture_2022-06-16T11:01:31.jpg",biography:"Tomasz Jarzembowski was born in 1968 in Gdansk, Poland. He obtained his Ph.D. degree in 2000 from the Medical University of Gdańsk (UG). After specialization in clinical microbiology in 2003, he started studying biofilm formation and antibiotic resistance at the single-cell level. In 2015, he obtained his D.Sc. degree. His later study in cooperation with experts in nephrology and immunology resulted in the designation of the new diagnostic method of UTI, patented in 2017. He is currently working at the Department of Microbiology, Medical University of Gdańsk (GUMed), Poland. Since many years, he is a member of steering committee of Gdańsk branch of Polish Society of Microbiologists, a member of ESCMID. He is also a reviewer and a member of editorial boards of a number of international journals.",institutionString:"Medical University of Gdańsk, Poland",institution:null},editorTwo:{id:"484980",title:"Dr.",name:"Katarzyna",middleName:null,surname:"Garbacz",slug:"katarzyna-garbacz",fullName:"Katarzyna Garbacz",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0033Y00003St8TAQAZ/Profile_Picture_2022-07-07T09:45:16.jpg",biography:"Katarzyna Maria Garbacz, MD, is an Associate Professor at the Medical University of Gdańsk, Poland and she is head of the Department of Oral Microbiology of the Medical University of Gdańsk. She has published more than 50 scientific publications in peer-reviewed journals. She has been a project leader funded by the National Science Centre of Poland. Prof. Garbacz is a microbiologist working on applied and fundamental questions in microbial epidemiology and pathogenesis. Her research interest is in antibiotic resistance, host-pathogen interaction, and therapeutics development for staphylococcal pathogens, mainly Staphylococcus aureus, which causes hospital-acquired infections. Currently, her research is mostly focused on the study of oral pathogens, particularly Staphylococcus spp.",institutionString:"Medical University of Gdańsk, Poland",institution:null},editorThree:null},{id:"4",title:"Fungal Infectious Diseases",coverUrl:"https://cdn.intechopen.com/series_topics/covers/4.jpg",isOpenForSubmission:!0,editor:{id:"174134",title:"Dr.",name:"Yuping",middleName:null,surname:"Ran",slug:"yuping-ran",fullName:"Yuping Ran",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bS9d6QAC/Profile_Picture_1630330675373",biography:"Dr. Yuping Ran, Professor, Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China. Completed the Course Medical Mycology, the Centraalbureau voor Schimmelcultures (CBS), Fungal Biodiversity Centre, Netherlands (2006). International Union of Microbiological Societies (IUMS) Fellow, and International Emerging Infectious Diseases (IEID) Fellow, Centers for Diseases Control and Prevention (CDC), Atlanta, USA. Diploma of Dermatological Scientist, Japanese Society for Investigative Dermatology. Ph.D. of Juntendo University, Japan. Bachelor’s and Master’s degree, Medicine, West China University of Medical Sciences. Chair of Sichuan Medical Association Dermatology Committee. General Secretary of The 19th Annual Meeting of Chinese Society of Dermatology and the Asia Pacific Society for Medical Mycology (2013). In charge of the Annual Medical Mycology Course over 20-years authorized by National Continue Medical Education Committee of China. Member of the board of directors of the Asia-Pacific Society for Medical Mycology (APSMM). Associate editor of Mycopathologia. 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Radiotherapy and Nuclear Medicine Technology has always been my aspiration and my life. As years passed I accumulated a tremendous amount of skills and knowledge in Radiotherapy and Nuclear Medicine, Conventional Radiology, Radiation Protection, Bioinformatics Technology, PACS, Image processing, clinically and lecturing that will enable me to provide a valuable service to the community as a Researcher and Consultant in this field. 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He is the author or co-author of more than seventy papers in peer-reviewed journals and conferences as well as the co-author of several books. He serves as a reviewer for many scientific journals, international conferences, and research foundations. Since 2010, Dr. Placzek has been a reviewer of grants and projects (including EU projects) in the field of information technologies.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"35000",title:"Prof.",name:"Ulrich H.P",middleName:"H.P.",surname:"Fischer",slug:"ulrich-h.p-fischer",fullName:"Ulrich H.P Fischer",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/35000/images/3052_n.jpg",biography:"Academic and Professional Background\nUlrich H. P. has Diploma and PhD degrees in Physics from the Free University Berlin, Germany. He has been working on research positions in the Heinrich-Hertz-Institute in Germany. Several international research projects has been performed with European partners from France, Netherlands, Norway and the UK. He is currently Professor of Communications Systems at the Harz University of Applied Sciences, Germany.\n\nPublications and Publishing\nHe has edited one book, a special interest book about ‘Optoelectronic Packaging’ (VDE, Berlin, Germany), and has published over 100 papers and is owner of several international patents for WDM over POF key elements.\n\nKey Research and Consulting Interests\nUlrich’s research activity has always been related to Spectroscopy and Optical Communications Technology. Specific current interests include the validation of complex instruments, and the application of VR technology to the development and testing of measurement systems. He has been reviewer for several publications of the Optical Society of America\\'s including Photonics Technology Letters and Applied Optics.\n\nPersonal Interests\nThese include motor cycling in a very relaxed manner and performing martial arts.",institutionString:null,institution:{name:"Charité",country:{name:"Germany"}}},{id:"341622",title:"Ph.D.",name:"Eduardo",middleName:null,surname:"Rojas Alvarez",slug:"eduardo-rojas-alvarez",fullName:"Eduardo Rojas Alvarez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/341622/images/15892_n.jpg",biography:null,institutionString:null,institution:{name:"University of Cuenca",country:{name:"Ecuador"}}},{id:"215610",title:"Prof.",name:"Muhammad",middleName:null,surname:"Sarfraz",slug:"muhammad-sarfraz",fullName:"Muhammad Sarfraz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/215610/images/system/215610.jpeg",biography:"Muhammad Sarfraz is a professor in the Department of Information Science, Kuwait University. 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Prof. Sarfraz is also an editor-in-chief and editor of various international journals.",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"32650",title:"Prof.",name:"Lukas",middleName:"Willem",surname:"Snyman",slug:"lukas-snyman",fullName:"Lukas Snyman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/32650/images/4136_n.jpg",biography:"Lukas Willem Snyman received his basic education at primary and high schools in South Africa, Eastern Cape. He enrolled at today's Nelson Metropolitan University and graduated from this university with a BSc in Physics and Mathematics, B.Sc Honors in Physics, MSc in Semiconductor Physics, and a Ph.D. in Semiconductor Physics in 1987. After his studies, he chose an academic career and devoted his energy to the teaching of physics to first, second, and third-year students. After positions as a lecturer at the University of Port Elizabeth, he accepted a position as Associate Professor at the University of Pretoria, South Africa.\r\n\r\nIn 1992, he motivates the concept of 'television and computer-based education” as means to reach large student numbers with only the best of teaching expertise and publishes an article on the concept in the SA Journal of Higher Education of 1993 (and later in 2003). The University of Pretoria subsequently approved a series of test projects on the concept with outreach to Mamelodi and Eerste Rust in 1993. In 1994, the University established a 'Unit for Telematic Education ' as a support section for multiple faculties at the University of Pretoria. In subsequent years, the concept of 'telematic education” subsequently becomes well established in academic circles in South Africa, grew in popularity, and is adopted by many universities and colleges throughout South Africa as a medium of enhancing education and training, as a method to reaching out to far out communities, and as a means to enhance study from the home environment.\r\n\r\nProfessor Snyman in subsequent years pursued research in semiconductor physics, semiconductor devices, microelectronics, and optoelectronics.\r\n\r\nIn 2000 he joined the TUT as a full professor. Here served for a period as head of the Department of Electronic Engineering. Here he makes contributions to solar energy development, microwave and optoelectronic device development, silicon photonics, as well as contributions to new mobile telecommunication systems and network planning in SA.\r\n\r\nCurrently, he teaches electronics and telecommunications at the TUT to audiences ranging from first-year students to Ph.D. level.\r\n\r\nFor his research in the field of 'Silicon Photonics” since 1990, he has published (as author and co-author) about thirty internationally reviewed articles in scientific journals, contributed to more than forty international conferences, about 25 South African provisional patents (as inventor and co-inventor), 8 PCT international patent applications until now. Of these, two USA patents applications, two European Patents, two Korean patents, and ten SA patents have been granted. A further 4 USA patents, 5 European patents, 3 Korean patents, 3 Chinese patents, and 3 Japanese patents are currently under consideration.\r\n\r\nRecently he has also published an extensive scholarly chapter in an internet open access book on 'Integrating Microphotonic Systems and MOEMS into standard Silicon CMOS Integrated circuitry”.\r\n\r\nFurthermore, Professor Snyman recently steered a new initiative at the TUT by introducing a 'Laboratory for Innovative Electronic Systems ' at the Department of Electrical Engineering. The model of this laboratory or center is to primarily combine outputs as achieved by high-level research with lower-level system development and entrepreneurship in a technical university environment. Students are allocated to projects at different levels with PhDs and Master students allocated to the generation of new knowledge and new technologies, while students at the diploma and Baccalaureus level are allocated to electronic systems development with a direct and a near application for application in industry or the commercial and public sectors in South Africa.\r\n\r\nProfessor Snyman received the WIRSAM Award of 1983 and the WIRSAM Award in 1985 in South Africa for best research papers by a young scientist at two international conferences on electron microscopy in South Africa. He subsequently received the SA Microelectronics Award for the best dissertation emanating from studies executed at a South African university in the field of Physics and Microelectronics in South Africa in 1987. In October of 2011, Professor Snyman received the prestigious Institutional Award for 'Innovator of the Year” for 2010 at the Tshwane University of Technology, South Africa. This award was based on the number of patents recognized and granted by local and international institutions as well as for his contributions concerning innovation at the TUT.",institutionString:null,institution:{name:"University of South Africa",country:{name:"South Africa"}}},{id:"317279",title:"Mr.",name:"Ali",middleName:"Usama",surname:"Syed",slug:"ali-syed",fullName:"Ali Syed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/317279/images/16024_n.png",biography:"A creative, talented, and innovative young professional who is dedicated, well organized, and capable research fellow with two years of experience in graduate-level research, published in engineering journals and book, with related expertise in Bio-robotics, equally passionate about the aesthetics of the mechanical and electronic system, obtained expertise in the use of MS Office, MATLAB, SolidWorks, LabVIEW, Proteus, Fusion 360, having a grasp on python, C++ and assembly language, possess proven ability in acquiring research grants, previous appointments with social and educational societies with experience in administration, current affiliations with IEEE and Web of Science, a confident presenter at conferences and teacher in classrooms, able to explain complex information to audiences of all levels.",institutionString:null,institution:{name:"Air University",country:{name:"Pakistan"}}},{id:"75526",title:"Ph.D.",name:"Zihni Onur",middleName:null,surname:"Uygun",slug:"zihni-onur-uygun",fullName:"Zihni Onur Uygun",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/75526/images/12_n.jpg",biography:"My undergraduate education and my Master of Science educations at Ege University and at Çanakkale Onsekiz Mart University have given me a firm foundation in Biochemistry, Analytical Chemistry, Biosensors, Bioelectronics, Physical Chemistry and Medicine. After obtaining my degree as a MSc in analytical chemistry, I started working as a research assistant in Ege University Medical Faculty in 2014. In parallel, I enrolled to the MSc program at the Department of Medical Biochemistry at Ege University to gain deeper knowledge on medical and biochemical sciences as well as clinical chemistry in 2014. In my PhD I deeply researched on biosensors and bioelectronics and finished in 2020. Now I have eleven SCI-Expanded Index published papers, 6 international book chapters, referee assignments for different SCIE journals, one international patent pending, several international awards, projects and bursaries. In parallel to my research assistant position at Ege University Medical Faculty, Department of Medical Biochemistry, in April 2016, I also founded a Start-Up Company (Denosens Biotechnology LTD) by the support of The Scientific and Technological Research Council of Turkey. Currently, I am also working as a CEO in Denosens Biotechnology. The main purposes of the company, which carries out R&D as a research center, are to develop new generation biosensors and sensors for both point-of-care diagnostics; such as glucose, lactate, cholesterol and cancer biomarker detections. My specific experimental and instrumental skills are Biochemistry, Biosensor, Analytical Chemistry, Electrochemistry, Mobile phone based point-of-care diagnostic device, POCTs and Patient interface designs, HPLC, Tandem Mass Spectrometry, Spectrophotometry, ELISA.",institutionString:null,institution:{name:"Ege University",country:{name:"Turkey"}}},{id:"267434",title:"Dr.",name:"Rohit",middleName:null,surname:"Raja",slug:"rohit-raja",fullName:"Rohit Raja",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/267434/images/system/267434.jpg",biography:"Dr. Rohit Raja received Ph.D. in Computer Science and Engineering from Dr. CVRAMAN University in 2016. His main research interest includes Face recognition and Identification, Digital Image Processing, Signal Processing, and Networking. Presently he is working as Associate Professor in IT Department, Guru Ghasidas Vishwavidyalaya (A Central University), Bilaspur (CG), India. He has authored several Journal and Conference Papers. He has good Academics & Research experience in various areas of CSE and IT. He has filed and successfully published 27 Patents. He has received many time invitations to be a Guest at IEEE Conferences. He has published 100 research papers in various International/National Journals (including IEEE, Springer, etc.) and Proceedings of the reputed International/ National Conferences (including Springer and IEEE). He has been nominated to the board of editors/reviewers of many peer-reviewed and refereed Journals (including IEEE, Springer).",institutionString:"Guru Ghasidas Vishwavidyalaya",institution:{name:"Guru Ghasidas Vishwavidyalaya",country:{name:"India"}}},{id:"246502",title:"Dr.",name:"Jaya T.",middleName:"T",surname:"Varkey",slug:"jaya-t.-varkey",fullName:"Jaya T. Varkey",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/246502/images/11160_n.jpg",biography:"Jaya T. Varkey, PhD, graduated with a degree in Chemistry from Cochin University of Science and Technology, Kerala, India. She obtained a PhD in Chemistry from the School of Chemical Sciences, Mahatma Gandhi University, Kerala, India, and completed a post-doctoral fellowship at the University of Minnesota, USA. She is a research guide at Mahatma Gandhi University and Associate Professor in Chemistry, St. Teresa’s College, Kochi, Kerala, India.\nDr. Varkey received a National Young Scientist award from the Indian Science Congress (1995), a UGC Research award (2016–2018), an Indian National Science Academy (INSA) Visiting Scientist award (2018–2019), and a Best Innovative Faculty award from the All India Association for Christian Higher Education (AIACHE) (2019). She Hashas received the Sr. Mary Cecil prize for best research paper three times. She was also awarded a start-up to develop a tea bag water filter. \nDr. Varkey has published two international books and twenty-seven international journal publications. She is an editorial board member for five international journals.",institutionString:"St. Teresa’s College",institution:null},{id:"250668",title:"Dr.",name:"Ali",middleName:null,surname:"Nabipour Chakoli",slug:"ali-nabipour-chakoli",fullName:"Ali Nabipour Chakoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/250668/images/system/250668.jpg",biography:"Academic Qualification:\r\n•\tPhD in Materials Physics and Chemistry, From: Sep. 2006, to: Sep. 2010, School of Materials Science and Engineering, Harbin Institute of Technology, Thesis: Structure and Shape Memory Effect of Functionalized MWCNTs/poly (L-lactide-co-ε-caprolactone) Nanocomposites. Supervisor: Prof. Wei Cai,\r\n•\tM.Sc in Applied Physics, From: 1996, to: 1998, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Determination of Boron in Micro alloy Steels with solid state nuclear track detectors by neutron induced auto radiography, Supervisors: Dr. M. Hosseini Ashrafi and Dr. A. Hosseini.\r\n•\tB.Sc. in Applied Physics, From: 1991, to: 1996, Faculty of Physics & Nuclear Science, Amirkabir Uni. of Technology, Tehran, Iran, Thesis: Design of shielding for Am-Be neutron sources for In Vivo neutron activation analysis, Supervisor: Dr. M. Hosseini Ashrafi.\r\n\r\nResearch Experiences:\r\n1.\tNanomaterials, Carbon Nanotubes, Graphene: Synthesis, Functionalization and Characterization,\r\n2.\tMWCNTs/Polymer Composites: Fabrication and Characterization, \r\n3.\tShape Memory Polymers, Biodegradable Polymers, ORC, Collagen,\r\n4.\tMaterials Analysis and Characterizations: TEM, SEM, XPS, FT-IR, Raman, DSC, DMA, TGA, XRD, GPC, Fluoroscopy, \r\n5.\tInteraction of Radiation with Mater, Nuclear Safety and Security, NDT(RT),\r\n6.\tRadiation Detectors, Calibration (SSDL),\r\n7.\tCompleted IAEA e-learning Courses:\r\nNuclear Security (15 Modules),\r\nNuclear Safety:\r\nTSA 2: Regulatory Protection in Occupational Exposure,\r\nTips & Tricks: Radiation Protection in Radiography,\r\nSafety and Quality in Radiotherapy,\r\nCourse on Sealed Radioactive Sources,\r\nCourse on Fundamentals of Environmental Remediation,\r\nCourse on Planning for Environmental Remediation,\r\nKnowledge Management Orientation Course,\r\nFood Irradiation - Technology, Applications and Good Practices,\r\nEmployment:\r\nFrom 2010 to now: Academic staff, Nuclear Science and Technology Research Institute, Kargar Shomali, Tehran, Iran, P.O. Box: 14395-836.\r\nFrom 1997 to 2006: Expert of Materials Analysis and Characterization. Research Center of Agriculture and Medicine. Rajaeeshahr, Karaj, Iran, P. O. Box: 31585-498.",institutionString:"Atomic Energy Organization of Iran",institution:{name:"Atomic Energy Organization of Iran",country:{name:"Iran"}}},{id:"248279",title:"Dr.",name:"Monika",middleName:"Elzbieta",surname:"Machoy",slug:"monika-machoy",fullName:"Monika Machoy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248279/images/system/248279.jpeg",biography:"Monika Elżbieta Machoy, MD, graduated with distinction from the Faculty of Medicine and Dentistry at the Pomeranian Medical University in 2009, defended her PhD thesis with summa cum laude in 2016 and is currently employed as a researcher at the Department of Orthodontics of the Pomeranian Medical University. She expanded her professional knowledge during a one-year scholarship program at the Ernst Moritz Arndt University in Greifswald, Germany and during a three-year internship at the Technical University in Dresden, Germany. She has been a speaker at numerous orthodontic conferences, among others, American Association of Orthodontics, European Orthodontic Symposium and numerous conferences of the Polish Orthodontic Society. She conducts research focusing on the effect of orthodontic treatment on dental and periodontal tissues and the causes of pain in orthodontic patients.",institutionString:"Pomeranian Medical University",institution:{name:"Pomeranian Medical University",country:{name:"Poland"}}},{id:"252743",title:"Prof.",name:"Aswini",middleName:"Kumar",surname:"Kar",slug:"aswini-kar",fullName:"Aswini Kar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252743/images/10381_n.jpg",biography:"uploaded in cv",institutionString:null,institution:{name:"KIIT University",country:{name:"India"}}},{id:"204256",title:"Dr.",name:"Anil",middleName:"Kumar",surname:"Kumar Sahu",slug:"anil-kumar-sahu",fullName:"Anil Kumar Sahu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/204256/images/14201_n.jpg",biography:"I have nearly 11 years of research and teaching experience. I have done my master degree from University Institute of Pharmacy, Pt. Ravi Shankar Shukla University, Raipur, Chhattisgarh India. I have published 16 review and research articles in international and national journals and published 4 chapters in IntechOpen, the world’s leading publisher of Open access books. I have presented many papers at national and international conferences. I have received research award from Indian Drug Manufacturers Association in year 2015. My research interest extends from novel lymphatic drug delivery systems, oral delivery system for herbal bioactive to formulation optimization.",institutionString:null,institution:{name:"Chhattisgarh Swami Vivekanand Technical University",country:{name:"India"}}},{id:"253468",title:"Dr.",name:"Mariusz",middleName:null,surname:"Marzec",slug:"mariusz-marzec",fullName:"Mariusz Marzec",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/253468/images/system/253468.png",biography:"An assistant professor at Department of Biomedical Computer Systems, at Institute of Computer Science, Silesian University in Katowice. Scientific interests: computer analysis and processing of images, biomedical images, databases and programming languages. He is an author and co-author of scientific publications covering analysis and processing of biomedical images and development of database systems.",institutionString:"University of Silesia",institution:{name:"University of Silesia",country:{name:"Poland"}}},{id:"212432",title:"Prof.",name:"Hadi",middleName:null,surname:"Mohammadi",slug:"hadi-mohammadi",fullName:"Hadi Mohammadi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/212432/images/system/212432.jpeg",biography:"Dr. Hadi Mohammadi is a biomedical engineer with hands-on experience in the design and development of many engineering structures and medical devices through various projects that he has been involved in over the past twenty years. Dr. Mohammadi received his BSc. and MSc. degrees in Mechanical Engineering from Sharif University of Technology, Tehran, Iran, and his PhD. degree in Biomedical Engineering (biomaterials) from the University of Western Ontario. He was a postdoctoral trainee for almost four years at University of Calgary and Harvard Medical School. He is an industry innovator having created the technology to produce lifelike synthetic platforms that can be used for the simulation of almost all cardiovascular reconstructive surgeries. He’s been heavily involved in the design and development of cardiovascular devices and technology for the past 10 years. He is currently an Assistant Professor with the University of British Colombia, Canada.",institutionString:"University of British Columbia",institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"254463",title:"Prof.",name:"Haisheng",middleName:null,surname:"Yang",slug:"haisheng-yang",fullName:"Haisheng Yang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/254463/images/system/254463.jpeg",biography:"Haisheng Yang, Ph.D., Professor and Director of the Department of Biomedical Engineering, College of Life Science and Bioengineering, Beijing University of Technology. He received his Ph.D. degree in Mechanics/Biomechanics from Harbin Institute of Technology (jointly with University of California, Berkeley). Afterwards, he worked as a Postdoctoral Research Associate in the Purdue Musculoskeletal Biology and Mechanics Lab at the Department of Basic Medical Sciences, Purdue University, USA. He also conducted research in the Research Centre of Shriners Hospitals for Children-Canada at McGill University, Canada. Dr. Yang has over 10 years research experience in orthopaedic biomechanics and mechanobiology of bone adaptation and regeneration. He earned an award from Beijing Overseas Talents Aggregation program in 2017 and serves as Beijing Distinguished Professor.",institutionString:null,institution:{name:"Beijing University of Technology",country:{name:"China"}}},{id:"89721",title:"Dr.",name:"Mehmet",middleName:"Cuneyt",surname:"Ozmen",slug:"mehmet-ozmen",fullName:"Mehmet Ozmen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/89721/images/7289_n.jpg",biography:null,institutionString:null,institution:{name:"Gazi University",country:{name:"Turkey"}}},{id:"265335",title:"Mr.",name:"Stefan",middleName:"Radnev",surname:"Stefanov",slug:"stefan-stefanov",fullName:"Stefan Stefanov",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/265335/images/7562_n.jpg",biography:null,institutionString:null,institution:{name:"Medical University Plovdiv",country:{name:"Bulgaria"}}},{id:"242893",title:"Ph.D. Student",name:"Joaquim",middleName:null,surname:"De Moura",slug:"joaquim-de-moura",fullName:"Joaquim De Moura",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/242893/images/7133_n.jpg",biography:"Joaquim de Moura received his degree in Computer Engineering in 2014 from the University of A Coruña (Spain). In 2016, he received his M.Sc degree in Computer Engineering from the same university. He is currently pursuing his Ph.D degree in Computer Science in a collaborative project between ophthalmology centers in Galicia and the University of A Coruña. His research interests include computer vision, machine learning algorithms and analysis and medical imaging processing of various kinds.",institutionString:null,institution:{name:"University of A Coruña",country:{name:"Spain"}}},{id:"294334",title:"B.Sc.",name:"Marc",middleName:null,surname:"Bruggeman",slug:"marc-bruggeman",fullName:"Marc Bruggeman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/294334/images/8242_n.jpg",biography:"Chemical engineer graduate, with a passion for material science and specific interest in polymers - their near infinite applications intrigue me. \n\nI plan to continue my scientific career in the field of polymeric biomaterials as I am fascinated by intelligent, bioactive and biomimetic materials for use in both consumer and medical applications.",institutionString:null,institution:null},{id:"255757",title:"Dr.",name:"Igor",middleName:"Victorovich",surname:"Lakhno",slug:"igor-lakhno",fullName:"Igor Lakhno",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/255757/images/system/255757.jpg",biography:"Igor Victorovich Lakhno was born in 1971 in Kharkiv (Ukraine). \nMD – 1994, Kharkiv National Medical Univesity.\nOb&Gyn; – 1997, master courses in Kharkiv Medical Academy of Postgraduate Education.\nPh.D. – 1999, Kharkiv National Medical Univesity.\nDSC – 2019, PL Shupik National Academy of Postgraduate Education \nProfessor – 2021, Department of Obstetrics and Gynecology of VN Karazin Kharkiv National University\nHead of Department – 2021, Department of Perinatology, Obstetrics and gynecology of Kharkiv Medical Academy of Postgraduate Education\nIgor Lakhno has been graduated from international training courses on reproductive medicine and family planning held at Debrecen University (Hungary) in 1997. Since 1998 Lakhno Igor has worked as an associate professor in the department of obstetrics and gynecology of VN Karazin National University and an associate professor of the perinatology, obstetrics, and gynecology department of Kharkiv Medical Academy of Postgraduate Education. Since June 2019 he’s been a professor in the department of obstetrics and gynecology of VN Karazin National University and a professor of the perinatology, obstetrics, and gynecology department. He’s affiliated with Kharkiv Medical Academy of Postgraduate Education as a Head of Department from November 2021. Igor Lakhno has participated in several international projects on fetal non-invasive electrocardiography (with Dr. J. A. Behar (Technion), Prof. D. Hoyer (Jena University), and José Alejandro Díaz Méndez (National Institute of Astrophysics, Optics, and Electronics, Mexico). He’s an author of about 200 printed works and there are 31 of them in Scopus or Web of Science databases. Igor Lakhno is a member of the Editorial Board of Reproductive Health of Woman, Emergency Medicine, and Technology Transfer Innovative Solutions in Medicine (Estonia). He is a medical Editor of “Z turbotoyu pro zhinku”. Igor Lakhno is a reviewer of the Journal of Obstetrics and Gynaecology (Taylor and Francis), British Journal of Obstetrics and Gynecology (Wiley), Informatics in Medicine Unlocked (Elsevier), The Journal of Obstetrics and Gynecology Research (Wiley), Endocrine, Metabolic & Immune Disorders-Drug Targets (Bentham Open), The Open Biomedical Engineering Journal (Bentham Open), etc. He’s defended a dissertation for a DSc degree “Pre-eclampsia: prediction, prevention, and treatment”. Three years ago Igor Lakhno has participated in a training course on innovative technologies in medical education at Lublin Medical University (Poland). Lakhno Igor has participated as a speaker in several international conferences and congresses (International Conference on Biological Oscillations April 10th-14th 2016, Lancaster, UK, The 9th conference of the European Study Group on Cardiovascular Oscillations). His main scientific interests: are obstetrics, women’s health, fetal medicine, and cardiovascular medicine. \nIgor Lakhno is a consultant at Kharkiv municipal perinatal center. He’s graduated from training courses on endoscopy in gynecology. He has 28 years of practical experience in the field.",institutionString:null,institution:null},{id:"244950",title:"Dr.",name:"Salvatore",middleName:null,surname:"Di Lauro",slug:"salvatore-di-lauro",fullName:"Salvatore Di Lauro",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0030O00002bSF1HQAW/ProfilePicture%202021-12-20%2014%3A54%3A14.482",biography:"Name:\n\tSALVATORE DI LAURO\nAddress:\n\tHospital Clínico Universitario Valladolid\nAvda Ramón y Cajal 3\n47005, Valladolid\nSpain\nPhone number: \nFax\nE-mail:\n\t+34 983420000 ext 292\n+34 983420084\nsadilauro@live.it\nDate and place of Birth:\nID Number\nMedical Licence \nLanguages\t09-05-1985. Villaricca (Italy)\n\nY1281863H\n474707061\nItalian (native language)\nSpanish (read, written, spoken)\nEnglish (read, written, spoken)\nPortuguese (read, spoken)\nFrench (read)\n\t\t\nCurrent position (title and company)\tDate (Year)\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. Private practise.\t2017-today\n\n2019-today\n\t\n\t\nEducation (High school, university and postgraduate training > 3 months)\tDate (Year)\nDegree in Medicine and Surgery. University of Neaples 'Federico II”\nResident in Opthalmology. Hospital Clinico Universitario Valladolid\nMaster in Vitreo-Retina. IOBA. University of Valladolid\nFellow of the European Board of Ophthalmology. Paris\nMaster in Research in Ophthalmology. University of Valladolid\t2003-2009\n2012-2016\n2016-2017\n2016\n2012-2013\n\t\nEmployments (company and positions)\tDate (Year)\nResident in Ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl.\nFellow in Vitreo-Retina. IOBA. University of Valladolid\nVitreo-Retinal consultant in ophthalmology. Hospital Clinico Universitario Valladolid. Sacyl. National Health System.\nVitreo-Retinal consultant in ophthalmology. Instituto Oftalmologico Recoletas. Red Hospitalaria Recoletas. \n\t2012-2016\n2016-2017\n2017-today\n\n2019-Today\n\n\n\t\nClinical Research Experience (tasks and role)\tDate (Year)\nAssociated investigator\n\n' FIS PI20/00740: DESARROLLO DE UNA CALCULADORA DE RIESGO DE\nAPARICION DE RETINOPATIA DIABETICA BASADA EN TECNICAS DE IMAGEN MULTIMODAL EN PACIENTES DIABETICOS TIPO 1. Grant by: Ministerio de Ciencia e Innovacion \n\n' (BIO/VA23/14) Estudio clínico multicéntrico y prospectivo para validar dos\nbiomarcadores ubicados en los genes p53 y MDM2 en la predicción de los resultados funcionales de la cirugía del desprendimiento de retina regmatógeno. Grant by: Gerencia Regional de Salud de la Junta de Castilla y León.\n' Estudio multicéntrico, aleatorizado, con enmascaramiento doble, en 2 grupos\nparalelos y de 52 semanas de duración para comparar la eficacia, seguridad e inmunogenicidad de SOK583A1 respecto a Eylea® en pacientes con degeneración macular neovascular asociada a la edad' (CSOK583A12301; N.EUDRA: 2019-004838-41; FASE III). Grant by Hexal AG\n\n' Estudio de fase III, aleatorizado, doble ciego, con grupos paralelos, multicéntrico para comparar la eficacia y la seguridad de QL1205 frente a Lucentis® en pacientes con degeneración macular neovascular asociada a la edad. (EUDRACT: 2018-004486-13). Grant by Qilu Pharmaceutical Co\n\n' Estudio NEUTON: Ensayo clinico en fase IV para evaluar la eficacia de aflibercept en pacientes Naive con Edema MacUlar secundario a Oclusion de Vena CenTral de la Retina (OVCR) en regimen de tratamientO iNdividualizado Treat and Extend (TAE)”, (2014-000975-21). Grant by Fundacion Retinaplus\n\n' Evaluación de la seguridad y bioactividad de anillos de tensión capsular en conejo. Proyecto Procusens. Grant by AJL, S.A.\n\n'Estudio epidemiológico, prospectivo, multicéntrico y abierto\\npara valorar la frecuencia de la conjuntivitis adenovírica diagnosticada mediante el test AdenoPlus®\\nTest en pacientes enfermos de conjuntivitis aguda”\\n. National, multicenter study. Grant by: NICOX.\n\nEuropean multicentric trial: 'Evaluation of clinical outcomes following the use of Systane Hydration in patients with dry eye”. Study Phase 4. Grant by: Alcon Labs'\n\nVLPs Injection and Activation in a Rabbit Model of Uveal Melanoma. Grant by Aura Bioscience\n\nUpdating and characterization of a rabbit model of uveal melanoma. Grant by Aura Bioscience\n\nEnsayo clínico en fase IV para evaluar las variantes genéticas de la vía del VEGF como biomarcadores de eficacia del tratamiento con aflibercept en pacientes con degeneración macular asociada a la edad (DMAE) neovascular. Estudio BIOIMAGE. IMO-AFLI-2013-01\n\nEstudio In-Eye:Ensayo clínico en fase IV, abierto, aleatorizado, de 2 brazos,\nmulticçentrico y de 12 meses de duración, para evaluar la eficacia y seguridad de un régimen de PRN flexible individualizado de 'esperar y extender' versus un régimen PRN según criterios de estabilización mediante evaluaciones mensuales de inyecciones intravítreas de ranibizumab 0,5 mg en pacientes naive con neovascularización coriodea secunaria a la degeneración macular relacionada con la edad. CP: CRFB002AES03T\n\nTREND: Estudio Fase IIIb multicéntrico, randomizado, de 12 meses de\nseguimiento con evaluador de la agudeza visual enmascarado, para evaluar la eficacia y la seguridad de ranibizumab 0.5mg en un régimen de tratar y extender comparado con un régimen mensual, en pacientes con degeneración macular neovascular asociada a la edad. CP: CRFB002A2411 Código Eudra CT:\n2013-002626-23\n\n\n\nPublications\t\n\n2021\n\n\n\n\n2015\n\n\n\n\n2021\n\n\n\n\n\n2021\n\n\n\n\n2015\n\n\n\n\n2015\n\n\n2014\n\n\n\n\n2015-16\n\n\n\n2015\n\n\n2014\n\n\n2014\n\n\n\n\n2014\n\n\n\n\n\n\n\n2014\n\nJose Carlos Pastor; Jimena Rojas; Salvador Pastor-Idoate; Salvatore Di Lauro; Lucia Gonzalez-Buendia; Santiago Delgado-Tirado. Proliferative vitreoretinopathy: A new concept of disease pathogenesis and practical\nconsequences. Progress in Retinal and Eye Research. 51, pp. 125 - 155. 03/2016. DOI: 10.1016/j.preteyeres.2015.07.005\n\n\nLabrador-Velandia S; Alonso-Alonso ML; Di Lauro S; García-Gutierrez MT; Srivastava GK; Pastor JC; Fernandez-Bueno I. Mesenchymal stem cells provide paracrine neuroprotective resources that delay degeneration of co-cultured organotypic neuroretinal cultures.Experimental Eye Research. 185, 17/05/2019. DOI: 10.1016/j.exer.2019.05.011\n\nSalvatore Di Lauro; Maria Teresa Garcia Gutierrez; Ivan Fernandez Bueno. Quantification of pigment epithelium-derived factor (PEDF) in an ex vivo coculture of retinal pigment epithelium cells and neuroretina.\nJournal of Allbiosolution. 2019. ISSN 2605-3535\n\nSonia Labrador Velandia; Salvatore Di Lauro; Alonso-Alonso ML; Tabera Bartolomé S; Srivastava GK; Pastor JC; Fernandez-Bueno I. Biocompatibility of intravitreal injection of human mesenchymal stem cells in immunocompetent rabbits. Graefe's archive for clinical and experimental ophthalmology. 256 - 1, pp. 125 - 134. 01/2018. DOI: 10.1007/s00417-017-3842-3\n\n\nSalvatore Di Lauro, David Rodriguez-Crespo, Manuel J Gayoso, Maria T Garcia-Gutierrez, J Carlos Pastor, Girish K Srivastava, Ivan Fernandez-Bueno. A novel coculture model of porcine central neuroretina explants and retinal pigment epithelium cells. Molecular Vision. 2016 - 22, pp. 243 - 253. 01/2016.\n\nSalvatore Di Lauro. Classifications for Proliferative Vitreoretinopathy ({PVR}): An Analysis of Their Use in Publications over the Last 15 Years. Journal of Ophthalmology. 2016, pp. 1 - 6. 01/2016. DOI: 10.1155/2016/7807596\n\nSalvatore Di Lauro; Rosa Maria Coco; Rosa Maria Sanabria; Enrique Rodriguez de la Rua; Jose Carlos Pastor. Loss of Visual Acuity after Successful Surgery for Macula-On Rhegmatogenous Retinal Detachment in a Prospective Multicentre Study. Journal of Ophthalmology. 2015:821864, 2015. DOI: 10.1155/2015/821864\n\nIvan Fernandez-Bueno; Salvatore Di Lauro; Ivan Alvarez; Jose Carlos Lopez; Maria Teresa Garcia-Gutierrez; Itziar Fernandez; Eva Larra; Jose Carlos Pastor. Safety and Biocompatibility of a New High-Density Polyethylene-Based\nSpherical Integrated Porous Orbital Implant: An Experimental Study in Rabbits. Journal of Ophthalmology. 2015:904096, 2015. DOI: 10.1155/2015/904096\n\nPastor JC; Pastor-Idoate S; Rodríguez-Hernandez I; Rojas J; Fernandez I; Gonzalez-Buendia L; Di Lauro S; Gonzalez-Sarmiento R. Genetics of PVR and RD. Ophthalmologica. 232 - Suppl 1, pp. 28 - 29. 2014\n\nRodriguez-Crespo D; Di Lauro S; Singh AK; Garcia-Gutierrez MT; Garrosa M; Pastor JC; Fernandez-Bueno I; Srivastava GK. Triple-layered mixed co-culture model of RPE cells with neuroretina for evaluating the neuroprotective effects of adipose-MSCs. Cell Tissue Res. 358 - 3, pp. 705 - 716. 2014.\nDOI: 10.1007/s00441-014-1987-5\n\nCarlo De Werra; Salvatore Condurro; Salvatore Tramontano; Mario Perone; Ivana Donzelli; Salvatore Di Lauro; Massimo Di Giuseppe; Rosa Di Micco; Annalisa Pascariello; Antonio Pastore; Giorgio Diamantis; Giuseppe Galloro. Hydatid disease of the liver: thirty years of surgical experience.Chirurgia italiana. 59 - 5, pp. 611 - 636.\n(Italia): 2007. ISSN 0009-4773\n\nChapters in books\n\t\n' Salvador Pastor Idoate; Salvatore Di Lauro; Jose Carlos Pastor Jimeno. PVR: Pathogenesis, Histopathology and Classification. Proliferative Vitreoretinopathy with Small Gauge Vitrectomy. Springer, 2018. ISBN 978-3-319-78445-8\nDOI: 10.1007/978-3-319-78446-5_2. \n\n' Salvatore Di Lauro; Maria Isabel Lopez Galvez. Quistes vítreos en una mujer joven. Problemas diagnósticos en patología retinocoroidea. Sociedad Española de Retina-Vitreo. 2018.\n\n' Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor Jimeno. iOCT in PVR management. OCT Applications in Opthalmology. pp. 1 - 8. INTECH, 2018. DOI: 10.5772/intechopen.78774.\n\n' Rosa Coco Martin; Salvatore Di Lauro; Salvador Pastor Idoate; Jose Carlos Pastor. amponadores, manipuladores y tinciones en la cirugía del traumatismo ocular.Trauma Ocular. Ponencia de la SEO 2018..\n\n' LOPEZ GALVEZ; DI LAURO; CRESPO. OCT angiografia y complicaciones retinianas de la diabetes. PONENCIA SEO 2021, CAPITULO 20. (España): 2021.\n\n' Múltiples desprendimientos neurosensoriales bilaterales en paciente joven. Enfermedades Degenerativas De Retina Y Coroides. SERV 04/2016. \n' González-Buendía L; Di Lauro S; Pastor-Idoate S; Pastor Jimeno JC. Vitreorretinopatía proliferante (VRP) e inflamación: LA INFLAMACIÓN in «INMUNOMODULADORES Y ANTIINFLAMATORIOS: MÁS ALLÁ DE LOS CORTICOIDES. RELACION DE PONENCIAS DE LA SOCIEDAD ESPAÑOLA DE OFTALMOLOGIA. 10/2014.",institutionString:null,institution:null},{id:"243698",title:"Dr.",name:"Xiaogang",middleName:null,surname:"Wang",slug:"xiaogang-wang",fullName:"Xiaogang Wang",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243698/images/system/243698.png",biography:"Dr. Xiaogang Wang, a faculty member of Shanxi Eye Hospital specializing in the treatment of cataract and retinal disease and a tutor for postgraduate students of Shanxi Medical University, worked in the COOL Lab as an international visiting scholar under the supervision of Dr. David Huang and Yali Jia from October 2012 through November 2013. Dr. Wang earned an MD from Shanxi Medical University and a Ph.D. from Shanghai Jiao Tong University. 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